Please no apologies, I meant nothing by it...I was just thinking out loud.... I'm sorry if it made you uncomfortable!

@KathyGrants @slomoshun1966 @kk131066 @foe_us @nature_org @jane__eden @impakterdotcom @sillymickel @vegix @how_sustainable @JamesrossrJames @climatemessages @sustainableuni1 @LolaGayleC @ResisterForever @mmpadellan @AdamParkhomenko @glennkirschner2 @morethanmySLE All the clinical Neuropsychological and forensic testing manuals that match the clinical measures we use...
Then made cheat sheets. (ok geek comment alert) the reason to do this is because if you don't understand the base rates and how they were derived, the populations 1/

@slomoshun1966 @kk131066 @foe_us @nature_org @jane__eden @impakterdotcom @sillymickel @vegix @how_sustainable @JamesrossrJames @climatemessages @sustainableuni1 @LolaGayleC @ResisterForever @mmpadellan @AdamParkhomenko @glennkirschner2 @morethanmySLE sampled to gain those "norms" and the year in which this was done, your interpretation of testing data will be significantly "off". If you can't assess the accurate diagnosis (meaning you misdiagnose) you end up causing pain and suffering not to mention treatment especially 2/

@slomoshun1966 @kk131066 @foe_us @nature_org @jane__eden @impakterdotcom @sillymickel @vegix @how_sustainable @JamesrossrJames @climatemessages @sustainableuni1 @LolaGayleC @ResisterForever @mmpadellan @AdamParkhomenko @glennkirschner2 @morethanmySLE if it involves psychopharm (meds)doesn't treat what actually ails the patient. When this happens, at best no one's treated for the actual illness they have which causes undue pain & suffering, at worst symptoms are exacerbated and or meds cause adverse reactions that can 3/

@slomoshun1966 @kk131066 @foe_us @nature_org @jane__eden @impakterdotcom @sillymickel @vegix @how_sustainable @JamesrossrJames @climatemessages @sustainableuni1 @LolaGayleC @ResisterForever @mmpadellan @AdamParkhomenko @glennkirschner2 @morethanmySLE have lasting effects (more pain and suffering) not to mention totally messing with the outcomes of legal cases
In short an inaccurate Diagnosis totally messed with people's lives.
. ..... So, if I use a measure you can bet Ive read the manual and understand the cautions, and 4/

@slomoshun1966 @kk131066 @foe_us @nature_org @jane__eden @impakterdotcom @sillymickel @vegix @how_sustainable @JamesrossrJames @climatemessages @sustainableuni1 @LolaGayleC @ResisterForever @mmpadellan @AdamParkhomenko @glennkirschner2 @morethanmySLE when to augment via clinical judgement. That often puts me at odds with folks in terms of opinions but I can back it all up via research and what's written in the manuals which often have caveats re use and application that people miss. More, as I went along it became obvious 5/

@jwdickerson @yourauntemma I think we've had this exchange before. Ive said from the beginning (and despite all those who vociferously insisted over and over he was a malignant narcissitic) that TRUMP IS A CRIMINAL PSYCHOPATH (who is dementing but that's another thread) and have written extensive 1/

@yourauntemma threads (see @threadreaderapp) explaining what criminal psychopathy is and why Trump is a criminal psychopath, AKA more formally as Anti-Social Personality Disorder w/Psychopathy (ASPDp).

1) Trump is NOT a Narcissist. He does NOT have NPD and IS NOT a nalignant narcissist 2/

@yourauntemma @threadreaderapp (which BTW isn't even a valid DX, is not in any iteration of the DSM and more importantly IS NOT backed by research)

Lastly (but very importantly) narcissists ARE NOT DRIVEN BY SADISM

2) Trump is NOT a sociopath (someone who due to poverty & social oppression with few if
3/

@yourauntemma @threadreaderapp any other options, is driven to crime to survive; who does not particularly enjoy it but as the only way to survive, become a way of life...eventually you become numb as that's just a fact of life)

4/

@yourauntemma @threadreaderapp 3) Trump IS/HAS Anti-Social Personality disorder w/PSYCHOPATHY
which is driven by sadism

i.e. Trump is a PSYCHOPATHIC criminal

Trump IS NOT a sociopath. He does not now nor did he ever need to commit crimes to survuve. TRUMP IS DRIVEN TO CRIME BECAUSE HE ENJOYS 5/

UAMS has taken the extraordinary step of asking leadership across our health system to refrain from traveling over the coming holidays and report to work or be available if needed. Other hospitals in our state are considering similar measures.

(1)

Although the health care system in the state of Arkansas is stressed right now, it is holding up, and additional surge capacity exists. But that capacity is not infinite.  Every day, we become more and more concerned about our ability to manage what lies ahead.

(2)

As health professionals, we are doing all we can. However, one thing is certain. We can’t meet this challenge unless you are with us. As Secretary Jose Romero of the AR Dept. of Health has said, we are in the midst of a “surge within a surge” in this COVID-19 pandemic.

(3)

Right now, the @UAMS_COPH COVID-19 forecasts, which have been strikingly accurate so far, indicate that the density of COVID-19 infections exceeds each of our abilities—yours & mine -- to avoid contact with actively infected individuals in our state...

(4)

...whenever we venture outside our homes. They predict an exponential increase in coronavirus deaths in the next two weeks, more than we saw in the first four months of the pandemic. We may soon exceed the number of beds, ventilators, & most importantly...

(5)

The #RELAx trial has been published today in @JAMA. It was coordinated by Anna Algera. This thread is to explain the rationale, what we did, the findings and the meaning.
The rationale of #RELAx is based on the following

First, there is NO adequate evidence on the level of PEEP in non-ARDS patients. Most of the studies are old, conducted in post-surgical patients (short-term ventilation), and were not powered to detect differences in patient-centered

Second, despite the absence of evidence, the levels of PEEP used in non-ARDS patients increased over years, from 5 to 7/8 cmH2O, probably as a reflection of studies and practice in ARDS

Third, one IPDM showed that higher levels of PEEP could benefit more severe ARDS patients. However, opposite trends (higher mortality and longer ventilation) were found in mild ARDS with higher PEEP (despite not powered to be statistically

Fourth, most of the weaning protocols include PEEP ≤ 5 cmH2O as a criterion for readiness to wean. Theoretically, a standardized liberal strategy of higher PEEP could delay weaning in some

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