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.

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

[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.

The health-wealth tradeoff of lockdowns is still hotly debated. Here are some thoughts that may help untangle the issues. 1/17 #EconTwitter #EpiTwitter
Figure courtesy of @luismbcabral

Let's start with concept of tradeoffs. With aggregate societal wealth and health on the axes, we can show all combinations that we can achieve though different policies. All points in purple region are feasible, those outside it are not. Which point should we choose? 2/17

Since society values both health and wealth, from any starting point, we want to move in North-East direction. When making a move, we say that there is a tradeoff if gaining more health necessarily means giving up some wealth. 3/17

It can never be optimal to stay at an interior point like E, because we can get both more wealth AND more health by moving to points like G or F on the frontier. So at an interior point like E, there may be no tradeoffs at all. We can find policies to improve BOTH. 4/17

At extremes with 100% or 0% lockdown (like points A and C or nearby points), we're on frontier but again may be able to get both richer and healthier. But in intermediate cases, like G and F, there is necessarily a tradeoff. 5/17

You what now

Are they disrupting my menstrual cycle because my body does that just fine I do not DO NOT need a startup for that

“You’ve been doing your period all wrong: an LA company smashes menstrual taboos.”

Okay first off I have kids. One does not survive toddlers if they’re squicked out by bodily fluids.

Second off what are they selling, I’ve only read the headline but they’re selling something

Wait they want me to do more chores

With two kids and unwashed dishes and a laundry mountain I’m supposed to buy new underwear that’s hand wash

This is...a product for a very specific kind of person who bleeds and that person is not me

God imagine being that ad exec “okay so we need to make women think they need this. It’ll make everything a bit harder and they’ll be doing more chores and also we need to tell them that they’re not attuned enough to their bodies. We’ll need that by the end of product Dev.”

I... WHO DOES NOT KNOW THAT THEY ARE FLOWING

Like what am I to learn from that excepting that I shouldn’t wear white pants SPECIFICALLY SO I DON’T HAVE TO SPEND AN HOUR SCRUBBING BLOOD OUT OF MY CLOTHES

NOW I HAVE TO ADD RITUALS TO AN ALREADY ANNOYING WEEK OF MY LIFE

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

Cross-sectional imaging often reveals unexpected pancreatic cystic lesions, it is a frequent clinical problem, Should we observe or remove it? What's the diagnosis? Is our patient in danger of malignancy?
Don’t miss this @aegastro @my_ueg #EducAEG #UEGambassador twitter thread

Importance of Pancreatic Cystic Neoplasms (PCN):
Most are asymptomatic at diagnosis, frequency increases with age
Symptoms: acute pancreatitis (Wirsung obstructed by the cyst or mucus), pain, obstructive chronic pancreatitis, jaundice
> symptoms, >malignancy risk!

Classification of PCN:
Mucinous: intraductal papillary mucinous neop. and mucinous cystic neop.
Nonmucinous: serous cystic neoplasm, solid pseudopapillary neoplasm and cystic neuroendocrine tumours
Endoderm- derived columnar epithelium is characteristic for mucinous lesions
👇

Intraductal papillary mucinous neoplasms (IPMN)
Characterized by papillary proliferation+mucus production. It may involve Wirsung (becomes dilated) and/or branch ducts (cysts connected to the ductal system). It may evolve to pancreatic cancer particularly if Wirsung is involved

IPMN subtypes :
Intestinal: main duct, head, 40%->coloid/tubular adenoca
Pancreatobiliary: main duct,head, 68%->tubular adenoca
Oncocytic: rare, nodules,50%-> coloid/tubular adenoca
Gastric: most frequent, branch-type, uncinate, 10%->tubular

A day in the life of a junior doctor on covid ward. By Jane Smith (not her real name) in the UK. /thread
"I begin my shift at 8am. Before I can even head to my allocated bay, a nurse is already asking for a doctor to help her. One of the patients won’t put on his mask

and his oxygen levels are dropping. It takes me a few moments to get on my PPE before I can get to him. I try to talk to the man, but it’s difficult for him to hear me through my mask and the noise of all of the CPAP oxygen machines. He tells me that he’s tired of fighting,

and that he wants to be left alone. I have to be sure that he understands the risks, so I ask him to explain to me what he expects will happen if he takes off his mask and doesn’t put it back on. He says he doesn’t know. I tell him that he has to understand that he will die

and that he needs to say those words to me if that is what he really wants. Eventually we compromise; he will put his mask on for another hour, then phone his wife and tell me his decision. This man is 61.

I am allocated B Bay, in which there are five patients. My patients are mostly men, ranging from their early 30s to their 60s. This is younger than normal on HDU because — as I explained to the man — we only have beds for people with a fighting chance.

I am not full sure people appreciate the impact of B117 strain on the course of the pandemic. TL;DR B117 is "a pandemic inside a pandemic" and demands both monitoring and preparation for when it arrives in a location. Vaccination is even more of a priority due to B117.

Context: I am an expert on human genetics and computational biology. I know experts in viral evolution, testing, infectious epidemiology, clinical trials. I have COIs in that I am long established consultant to @nanopore and I am on the Ox/AZ vaccine trial.

B117 clearly transmits faster. This has been clear in a UK context now for over a month, with particularly insightful backtracking of growth of B117 from low levels through October/November; it is true in Denmark; it is true in Ireland.

(Shout out the fast responding science of @CovidGenomicsUK, of the analysis of @jcbarret and @arambaut, of clever genomics-epi models of @MoritzGerstung and @harald_voeh and on it testing / spidey sense of @The_Soup_Dragon)

(In Denmark their excellent genomic surveillance, similar to UK's allows Denmark to know about the growth of B117 from low level in the context of other strains - props to @MadsAlbertsen85 and colleagues; In Ireland it is becoming one of the dominant variants)

📦 FREE SCHOOL MEAL PARCELS EXPLAINED

🍏 I’ve had a number of questions today about the parcels that have been going out for those who receive free school meals and aren’t able to take up this entitlement in school at the moment.

🌽You may have seen photographs circulating on the internet showing a box of food that had been distributed by a contractor. It was claimed this had food in it that was meant to last ten days.

🧀 The food in the picture was actually only intended for 5 days, not 10, and cost £10.50 not £30 as has been suggested by some. The company responsible have however acknowledged that it could have been better.

🥕 The food is supposed to be a substitute for the lunch children would be missing in school - it’s not intended to be food for the whole day and it is not intended to feed the rest of the family either.

There are however other schemes available for struggling families who need this as part of the Covid Winter Plan.

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

tw weight , dieting , eating disorders
/
/

can we all have a touch grass moment for a second. can we please remember that idols are real people. real people with problems they might not have the access to solutions for. many of them young, early 20’s, brains still unfinished.

yes, there is a level of responsibility when it comes to what you share with your audience, especially if they are young and impressionable, however, idols are not going to be hyperonline like most of us, and are not going to know the ins and outs of what might be acceptable +

+ especially in regards to something as nuanced and varied from place to place as diet culture. no, i don’t think talking about going on a diet as an idol is inherently bad. they are sharing their life with us.

as it stands, their jobs revolve around being open with us, and if it provides some comfort to them to be able to share things like this, then i don’t think it should necessarily be shamed as hard as it was this morning.

i saw a tweet saying to pick up a book on fat politics to see why this whole debacle is just unbridled fatphobia from the artist.

no idol that i know of has ever purported to be apart of any kind of body posi/fat liberation movement.

💥 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/

ALL ABOUT PAAN

Paan, also called as betel leaf.

When we hear word paan , a constant image comes on mind as everyone who eat pan, will spit on walls with typical red color, paan will have all typical tobaccos ingredients and only some are exception which just have non tobacco

Here we all go wrong :

These 2 myths about paan is totally wrong.

First : Paan is mentioned in our culture from centuries , Paan should never have these tobaccos options, tobaccos paan was alteration after India was attacked by various foreigner

Portuguese[Introduced tobacco] , British[introduced cigarette filled with tobacco], before that Paan was only eaten as mouth freshener and digestive option.

History and significance -

Puranic Reference

There is a reference in Srimad Bhagavatam, that Lord Krishna chewed paan.

According to Skanda Purana, the betel leaves are said to have emerged during the Samudra Manthana or The Churning of the Ocean.

There is also a mention of betel leaves in Ramayana and Mahabharata.

In Lalita Sahasranama, there is a verse- “tambula purita mukhi” meaning, one whose mouth is full of chewing betel.

The use of betel leaves is mentioned in Charaka and Sushruta Samhitas,