On December 29 we were dillucidating here if the drops meant "surprise, relatively neutral expression" or "a negative expression, horror" (Remember: https://t.co/J2gjQjAENw ). Well, December 22 drops seem to clarify it. First, the December 29 drop that generated the confusion 1/*

didn't appear in today drops, while several old ones have been posted again. I would say that all December 22 drops regarding facial expression mean and clarify "surprise". 2/*

More 3/*

And more. So, they didn't point to a negative event, just to one that generates surprise. 4/*

All these drops were completed with a Christmas gift one, confirming the surprise neutral meaning and adding a related positive one connected to the surprise. 5/*

A week ago I voluntarily admitted myself to the hospital to get help bc I am losing weight as a result of increased food intolerances, secondary to my very severe #MECFS. A psychiatrist here decided that im mentally ill, 1/

purely on the basis that the medical workup was unable to explain my food intolerance. My psych eval only found mild anxiety and depression. 2/

They have put me on a 72hr psych hold while they work to get the county courts to commit me to a psych ward. This is a nightmare. They have taken away most of my belongings, put me in a new uniform, and are keeping me under 24/7 video surveillance. 3/

In the middle of the night last night when I sat up to use the urinal loud alarms sounded, as though I was trying to escape. I can’t even walk and hadn’t even left my bed. 4/

If they succeed in having me fully committed I will lose ability to communicate with the outside world except for an occasional phone call. I will lose all agency, and will very likely have treatments forced upon me. 5/

Ankle joint is undertrained in a single joint means in both the frontal plane & in dorsiflexion 2 prevent lateral ankle sprains and shin splints. Single joint exercises allows you to evaluate the joint actions ROM & strength to understand injury risk & where development is needed

AJ Abduction (Cutting)

1. I pull the foot in2 dorsiflexion 2 stabilize the joint

2. I pull against the increasing tension of the band in2 abduction w/o losing dorsiflexion & also w/o externally rotating the thigh.

3. On the negative resist the bands pull eccentrically.

AJ Adduction (Cutting)

1. I pull the foot into dorsiflexion and I pull the foot into adduction against the tension of the band w/o medial rotation of the thigh.

2. I resist the negative movement of the band pulling the ankle into abduction eccentrically.

I’m deeply saddened to learn that Dr Joseph Sonnabend, one of the most important figures in the history of AIDS, died yesterday. I spent time with him in 2018 for one of the last interviews he ever gave. Let me tell you about this man and what he did:

Sonnabend was one of the first doctors to raise the alarm. In 1979, while running a sexual health clinic in Greenwich Village, he wrote to the NY Health Dept to warn them of the symptoms he was seeing: low white blood cell counts, enlarged lymph nodes. He didn’t get a reply. 2/

So he kept speaking out. When a patient of his developed a very rare cancer – Kaposi’s Sarcoma – he linked up with a dermatologist at NYU who said that over a dozen gay men had it. Sonnabend knew there was something very wrong. He started working at the lab at NYU — for free. 3/

It was soon after this in 1981 that the New York Times famously reported “Rare Cancer Found In 41 Homosexuals”. The next decade would kill most of Sonnabend’s patients and friends — and all of his lovers. What Sonnabend did was to fight for every single of them. 4/

Want to know who was the first to publish advice to wear a condom? That was Sonnabend. In 1983 he co-authored the first safe sex leaflet to fight AIDS: “How To Have Sex In An Epidemic”. 5/

12 things you should look out for before buying health insurance

A thread 🧵

It’s a good idea to make sure your health is protected under an insurance policy so that you don’t shell out large sums of money for hospitalization and treatment. But buying an individual health insurance policy can be daunting in itself.

Websites and policy documents can be overwhelming. There’s a lot of loaded terms, there’s a whole bunch of things that your policy may or may not cover. It’s important to know and understand the details though, so you’re not surprised later.

In this thread, we'll talk about the things you absolutely need to watch out for when buying an individual health insurance policy for yourself or your family members :)

If you take an individual health insurance policy and the insurance company offers to pay up to ₹15 lakhs during the year whenever you’re diagnosed with a disease or meet an accident, that amount is the 'sum insured'.

🧵 on Importance of correct indication of colonoscopic surveillance studies (English 🇺🇸🇬🇧)
@KM_Pawlak @KMonkemuller @drkeithsiau @JacquelineChuMD @PerelmansPearls @stevenbollipo @SWexner @DrBloodandGuts @ebtapper @DCharabaty @RashidLui @AdvaniRashmiMD @AtoosaRabiee @DrMohdZein

@GI_Guy @RodriguezParra_ @DrHarryThomas @TennysonMD @AustinChiangMD @KralJan @thomaskroner @alinkmd #GITwitter

1/ The implementation of screening and surveillance programs can reduce the incidence and mortality of

2 / But for these to be effective and to guarantee protection against CCR, they must meet a series of conditions. One of them is the correct indication for endoscopic studies for both screening and surveillance.

3 / According to a recent meta-analysis, the minority of patients who undergo colonoscopies have a correct indication, with less than 50% adherence to the surveillance intervals proposed by scientific

DR CHRIS MACKIE (@Healthmac) is London’s Medical Officer of Health and a government advisor.

Yesterday, he said schools being open, “SLOWS the spread of COVID.”

For context, let’s look at 23 other times he misused data or gave a bad unsupported take.

🧵A THREAD🧵

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...5/24

In medicine, reckoning with racism includes reappraising the very syntax we use every day. Proud to add my voice w/ @J_Ikeme and @RWGrantMD in this @JAMAInternMed pub addressing:

Does race/ethnicity belong in the first line of the patient

Some background: I’ve struggled with this question since early in medical school

Medical syntax is designed to communicate information in a predictable sequence with key elements prioritized to facilitate efficient communication and formation of an assessment and plan

2/

From preclinical lectures to Qbank questions to clerkship rotations, race/ethnicity was often prioritized in the same sentence as age + gender.

I grew accustomed to reading/hearing: a 70-year-old Black man w/ history of x, a 50-year-old Hispanic woman presented w/ y.

3/

However, when it came time for me to use race/ethnicity, there was always tension. Race/ethnicity are self/socially-ascribed identities that in clinical practice are almost always assumed by providers based on appearance. I was also concerned about the potential for bias

4/

I wondered how my own care would be impacted or not impacted by my ethnicity (Hispanic) – I have light skin so I’m not sure if my doctors would even identify me as such – but how would my care be different if I was presented as a 30-year-old Hispanic male?

5/

it seems to me that not many know that navalny is an avowed nationalist & racist and not just a blonde guy who likes to gently kiss his blonde wife before going to jail and watches “rick & morty”. so here’s a little thread and some of it is pretty personal.

here is navalny’s 2007 video. “a tooth without a root is called “dead”. a nationalist is someone who doesn’t want the russian root to be removed from the word “russia”. we have the right to be russian in russia, and we will defend it.”

i downloaded it to make sure it won’t disappear but it is still shared by navalny’s official youtube channel. btw, in this video, navalny is introduced in the caption as a “certified nationalist”.

here is another video navalny is not keen to share anymore, in which he compares muslims to cockroaches and flies and recommends shooting them with guns if swatters and shoes

here is a 2011 interview with navalny where he explains why he goes to the so-called “russian march”, a yearly nationalist gathering, and why he thinks it’s ok to collaborate with

After therapy sessions, it is occurring to me how my parents and maybe most desi parents don't really grow as parents. For example, a person would be a very different to a baby and to a teenager because the needs and vulnerabilities are so different.

But here, I feel that growth for parents stagnants sometime around when a child is 12-13. None of our parents really talk to us about puberty and growing up. None of us are taught or can talk about relationships because of moral reasons. So what do you have?

You have parents who are still parenting their adult children like kids, not apologising to us but asking us to eat, reminding us to wear jackets, locking up cars. They care. But they are coming from a care where the parent is always concerned about keeping the kid safe and alive

which imo really reduces the kind of parental advice and care one needs as an adult. Because adults know enough about the world to no longer be infantilized but we still have parents who expect us to be the same children because they're still the same kind of parents.

This is why so many of our parental relationships are strained or just based on civilities. We're forced to hide a lot from them because parents refuse to grow as parents and acknowledge us as adults. How many of us are still lectured, have curfews, other restrictions?

Masks. A short thread. In June last year my GP advised me that wearing a mask even for a short space of time would be harmful for me on two fronts. One - I have painful rosacea on my face. It’s a horrible condition and it’s lifelong. I can at times look scary!

Putting on a mask simply makes it worse. Two - I have hypertension. Manageable and controlled. GP also advises that mask wearing even for short periods can raise cortisol levels and make them dangerous to me.

On that basis and given the dreadful treatment us non-maskers have to suffer and to appease the abusers I have three times asked my GP to issue me with a letter relating to my conditions.

On each occasion she has said that there is no need. Whilst she won’t admit it straight up, all conversations suggest she’s been told not to. I happen to agree that no-one should need to reveal their medical history to anyone other than medical professionals responsible for me.

I’ve researched mask wearing in relation to what they are supposed to be used for ref *Covid* - I’m no thicko - I prepare risk assessments (and I’m qualified to do so) every day (or did) - and the evidence *for* is weak. Very weak.

APL Apollo conducted their earnings con-call today at 2:00 pm

"Vision of capacity of 4 Million Tone till 2025"

@hiddengemsindia @gvkreddi

Here are the key highlights 😀👇

Business Updates:

• Net Working Capital Remains under 10 days which is best in the building material
• Continue expanding rural region.
• Added 15 new distributors.
• Value added products contributed 50-60% of the topline.

Revenue breakup

• EBIDTA Margin Improvement: This was mainly because of cost structarize and better operational

• Working Capital Cycle as per mgmt should remain sustainable

• Blue Ocean: Company owns 100% subsidiary which contributes nothing but own property where corporate office is there

Improvement in Net Selling Realization:
• With expanding capacities at 2.6Million Tones and utlization of 75%, scalability has been affected.
• While the prices of steel has gone by by around 35%, due to shortage of steel.

• Apl Apollo being the dominant player past connection with steel companies worked well.
• Steel tubes supply from China is shrinking.
• Hence the discounting factor while selling the products has went away.

Controversial 3D. Probably none of you knows about Leber congenital amaurosis type 10, congenital blindness that affects 3 out of 100,000 children, condemning them to blindness for life. The only possible treatment is through gene therapy. 1/n

Thanks to Crispr-CAS9 technology we MODIFY the defective gene inside the patient eye ( they directly inject the treatment into the eye). Before CRISPR the treatment was based on Adenovirus carrying the correct form of the gene

In both cases, we MODIFY the patient DNA and that's the only way (today) to treat this disease. LCA10 is not the only genetic disease affecting kids unfortunately the list is long and the variety of diseases is terrifying.

Now think about a parent with a kid with a genetic disease, he/she would try and do anything to save him/her. ANYTHING and they would take some RISKS, gene therapy was a risk at the beginning, and any new experimental treatment shares a percentage of risk. 4/n

Now we come to #COVID19 and #vaccines. The new RNA vaccines are a HUGE scientific breakthrough, that may open new amazing therapeutic paths. And like ANY other human activity share a risk.

Want to include the menstrual cycle in your scientific work, but aren't sure how to do it? My lab (@katjaschmalen) have just published an article on best practices for observational studies of the cycle! Thread below! 🧵

Despite decades of research on the menstrual cycle, empirical studies have not adopted consistent methods for operationalizing the menstrual cycle, resulting in confusion in the literature and limited possibilities to conduct systematic reviews and meta-analyses.

Below, I summarize this "how to" article, and relay some of the key points!

PARTICIPANTS: All participants should be naturally-cycling people with ovaries (remember that they are not necessarily "women"! 🏳️‍⚧️ ⚧).

We provide a Reproductive Status Questionnaire with rules for identifying naturally-cycling people (current function of the sexual organs and hormonal/other medications that stop the cycle).

"Public health" isn't just about vaccinations, clinics and urgent care: it's a holistic discipline that encompasses all the contributors to health outcomes, which include things like housing, employment, transportation, pollution and more.

1/

A new working paper from @nberpubs estimates the number of US covid deaths that could have been prevented with a coherent, effective eviction moratorium and a ban on utility cutoffs:

The paper, written by a multidisciplinary group of Duke researchers from medicine and economics, found that housing precarity (a risk of losing your home) drove risky behavior that increased the spread of the disease and the resulting deaths.

3/

For example, it forced people to double-up on lodgings, making social distancing impossible, to say nothing of self-isolating after an exposure. It also drove people to tolerate high-risk workplace conditions, including illegal conditions.

4/

The authors used regression techniques to control for confounding variables, and used like-for-like counties with different utility and eviction policies to estimate the effect that these had on infection rates.

5/