I do want to talk a bit about connections, conflicts and information during a pandemic. Since @fordnation insinuated I have COI which I don't, let's take a look at a single instance where @fordnation and Hospital for Sick Children are both making interesting decisions.

Both share a powerful supporter in Peter Gilgan, who has been a great supporter of Sickkids

But his company, Mattamy Homes, has also substantially bankrolled Ontario Proud, which I have reason to believe pushed the Postmedia hit on my reputation.

Sickkids and Mattamy have very close ties. Here is Mary Federau, a longtime Sickkids exec who has moved to Mattamy but remains involved with the Sickkids foundation:

Mary's bio is too modest. It looks as though it has been scrubbed a bit over the last 72 hours. Here's the google cache from Jan 25:

Me: Made a thread about how people don't understand hyperacusis and give advice that obviously I've already tried.

This person only a few tweets into the thread:

I only tweeted this because, like it or not, this is the general population's reaction to me talking about hyperacusis.

Similar replies happened when there was the whole "not clapping" article regarding Cambridge.

They're so quick to label disabilities as not real disabilities.

It's important to remember this when people may ask why we've never talked about this before, or why it's not talked about a lot.

Most people don't talk about their hyperacusis because if they do, people respond like this. So most of the time, honestly it's easier to say nothing

Yes I am petty enough to add screenshots of this toxicity to this thread:

Asking for accessibility is "pathetic." /s : )

ICYMI, public health officials fear community transmission of B.1.1.7 (the "UK variant") is underway in Ontario.

I'll dissect each piece of worrying news from this story.

1. Simcoe Muskoka has so far reported 3 positive tests in individuals *with no known links* to the massive B.1.1.7 outbreak at Roberta Place LTC.

Two of those are linked to separate outbreaks of their own (a different LTC and a mental health hospital). Testing underway.

2. Of the 225 cases at Roberta Place, 100+ are confirmed or preliminary + for B.1.1.7.

42 household contacts of ppl linked to the outbreak are also COVID+. Public health unit is worried about keeping cases (which are all likely B.1.1.7) from rippling further into the community.

3. A case in Kingston area who tested positive for COVID "several weeks ago" was just discovered to be B.1.1.7. That person travelled to Simcoe Muskoka, but had not travelled internationally, according to the local health unit.

4. Overall, Public Health Ontario counts 47 B.1.1.7 cases as of yesterday -- these are only the ones confirmed thru full genome sequencing. Preliminary screening tests not included (yesterday's 99 in Simcoe Muskoka, for example).

Here's a breakdown by health unit courtesy PHO:

Folks, we need to talk about this Vitamin D trial. I have no stake in this game - take Vitamin D if you want but this pre-print is super sus.

The paper is presented as a randomized trial of vitamin D supplementation in hospitalized patients with COVID. Interesting and important question! And the results appear dramatic:

If true, this would be one of (if not THE most) effective treatments for COVID. But there are problems...

The first clue something is up is that the randomized groups aren't the same size:

It took me a while to figure out why this was, then I saw in the text that INDIVIDUALS were not randomized, WARDS in the hospital were.

Our conscious experience exists. In fact, it's the only thing you can directly observe, as everything about reality and how we perceive it is filtered through how our brains process stimuli and information. You are the only one who can define who and what you are.

Don't get me wrong, I am a materialist who believes the universe exists in the absence of beings who can observe it from an intelligence standpoint, but we are all collections of atoms, our function governed by chemical processes, not perfectly replicated by the process of birth.

Our means of DNA replication is imprecise because of billions of years of random evolution. We are on one branch of many, and there is countless variation in how all living beings are formed, and how we classify traits of those creatures, including sex and reproduction methods.

It would be an error to say that people who are intersex and/or transgender are the results of mistakes or errors in reproduction, because it implies DNA is "trying" to create a binary model of people and sometimes gets it wrong. It doesn't "try" to do anything; DNA != conscious.

Rather, our biological blueprints are not precise, and this is true for all living things. We can crossbreed plants and animals because of that imprecise nature, it's responsible for what we perceive as the "races" of people, etc. We can observe variation everywhere.

@MSF was allowed to enter #Mekelle on 16 Dec & here is their account 👇

"no basic supplies. The local hospital was running at 30 to 40 %, with very little medication"

This is why one of the reason why we demand unfetters #HumanitarianCorridor
#TigrayGenocide

#Adigrat "The situation was very tense & its hospital was in a terrible condition. Most of the health staff had left, there were hardly any medicines &there was no food, no water and no money"
#StopWarOnTigray
#TigrayGenocide
#HumanitarianCorridor
#EritreaOutOfTigray

After 1 month since @AbiyAhmedAli declared victory

"#Adwa & #Axum. There we found a similar situation: no electricity & no water. All the medicines had been stolen from #Adwa general hospital & the hospital furniture & equipment were broken"

#StopWarOnTigray
#TigrayGenocide

"Beyond the hospitals, around 80 or 90 per cent of the health centres that we visited between Mekele and Axum were not functional, either due to a lack of staff or because they had suffered robberies"

#StopWarOnTigray
#TigrayGenocide
#EritreaOutOfTigray
@UN @POTUS @StateDept

"1 woman had been in labour for 7 days without being able to give birth. Her life was saved because we were able to transport her to #Mekele"

It is really heartbreaking to imagine how many of our mothers & sister have lost their lives.

#StopWarOnTigray
#TigrayGenocide
@UN

On #Cis [Sic]

The neologisms 'cissexual' and 'cisgender' were coined by Volkmar Sigusch in the late 90's https://t.co/KkhxJrldmS
Prevalent usage of the term Cis/Cisgender has since grown to imply the existence of a metaphysical precondition: something called 'gender identity' 1/

and some kind of weighing up of the 'fit' between that thing ('gender identity') and one's sex. As the theory goes, everyone has a 'Gender Identity' which 'fits' or 'matches' the sex which - again *according to the theory* - one is 'assigned' [sic] at birth.

Problems so far:
2/

1. 'Assigned at birth' is a term appropriated by Gender Identity Ideologues / lobbyists from intersex / VSD Communities for whom it has a painful historical resonance. Pleas for it not to be appropriated fall on deaf ears. The term has zero rational basis for application in 3/

most human births.
2. The 'Gender Identity' thing requires acceptance of the notion that humans have a pre-cultural capacity for orienting ourselves to modes of 'gender expression' i.e. dress, mannerisms, habitus, demeanour & so on. This capacity / spirit ('Gender Identity') 4/

is the 'thing' which somehow interprets its correctness or otherwise against one's sex. To expand on this process: a human male or female cross-checks the mysterious contents & characteristics of his or her 'gender identity' against their bodies and concludes a 'match' ('Cis) 5/

Spoke with my neighbour. A type 2 diabetic on medications and realized even now there is so much ignorance on this subject. I have done extensive research on this subject (was forced 2 after being diagnosed)

Here sharing it with you all. retweet it, it may save someone's life.

My Neighbour said his hba1c is 7. Everything is fine, he just needs to bring it below 6.9 and he would be fine.
That is just baloney! anything more than 5.6 will result in all kind of complications (Kidney failure,retina failure (blindness) amputations& heart attack etc etc

When i told him the benifits of intermittent fasting and fasting, My neighbour Nitin said, I cannot fast as doctor said i need to eat 5 -6 times a day.

FACT: If you are NOT on any insulin enhancing drugs. you can fast as much as you want. (metformin is OK)

to which he said These drugs r permanent & progressive, you can never stop using them.
FACT: if you can change your diet, you can change your sugar and insulin levels and no longer need these drugs. (advise not aplicable to type 1 diabetics, they wud always need insulin injection

Diet, I am on diet precribed by WHO.
FACT: Fuck WHO, and don't eat carbohydrates. infact another name of diabetes is carb intolerance. You can never acheive 5.6 or lower while eating your rice and roti.

OHA Public Health Director Rachael Banks during today’s press conference: "I want to give you an overview of the pandemic in Oregon and an update on the progress of our vaccination efforts."

"As @OregonGovBrown said, we just don’t have enough vaccines to immunize everyone. As long as supplies are scarce, we’ll face really tough calls on who to immunize next. There are good reasons to prioritize educators & good reasons to prioritize seniors."

"The plan is to vaccinate most educators before we start vaccinating seniors on February 8. If we want to give schools a shot at re-opening this school year with a vaccinated staff, this is the time to do it."

"Overall, new cases, hospitalizations and our test positivity rate have all declined. Thank you Oregonians.”

“As of today, we’re adding 877 new cases of COVID-19 in Oregon. There have been 136,839 reported cases of COVID-19 in Oregon to date. During the week of Jan. 11-17, we reported 7,860 new daily cases, a 4% decrease from the prev. week."

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

Many many clinicians, have difficulty distinguishing re: diagnosus between the three because it requires not only a great deal of indepth knowledge re: forensics and behavior, but experience as well. More, most of what people know about (ASPDp) criminal psychopaths comes 1/

from prison populations not the successful psychopaths that are functional enough to routinely get away with crime WITHOUT GETTING CAUGHT (these are you long running career Docs, politicians lawyers CEO'S who are typically caught late in life, if at all, and who shock everyone 2/

who thought they were pillars of society or admired for great skills and wealth--sound familiar?). Even folks who study prison populations have a difficult time identifying "successful criminals" out here in the world.
That's just the clinical axis.
We on the whole, 3/

we tend to automatically project our empathy, onto the behaviors of others in order to better understand them. When this occurs, it very often results in misdiagnosis. Then there's the pressure to constantly stay relevant, find new diagnoses and treatments re staying afloat 4/

Here's an interesting ncbi article on rage:

One of the claims argued, is that frustration triggers rage.

Either frustration from behaviour not producing expected outcomes, or frustration from someone not doing what one asks.

And, you can experimentally trigger rage by frustrating people sufficiently.

Get someone to do something in order to get a reward. Suddenly stop rewarding them for that. Bam, frustration and then rage.

Alternatively, pair your test subjects, ask them to cooperate to accomplish a task, and have your inside guy not listen.

Bam, frustration and then rage.

The thwarting of expectations is the common theme. Thwart someone's expectations, violate their model of how things work, and you frustrate them.

Keep at it, and you enrage them.

Okay, let's start this hypersomnia thread!

[note - I am not looking for unsolicited advice.]

Idiopathic hypersomnia or narcolepsy (not the same, but similar) is very hard to describe to people.

When I say "I slept 10 hours last night and I'm still tired" I'm not bragging. 1/16

For me, the accommodations I need are about time. My body doesn't care what I want to do - when I want to wake up or be asleep. My body wants to wake up at 10-11am, and go to sleep at 3am, always.

Just a one hour shift in my sleep schedule can screw me up for days. 2/16

When I tell people that I'd really "prefer it" if we could meet at 10am or later, it's because getting up before that has consequences for me. Big consequences. Most people won't see them. Sometimes I still give in and say it's fine. It ruins 2-3 of my days, sometimes more. 3/16

Let me explain. When I am required to wake up at 9am, esp. in covid times working from home, my body pays me back for it later.

I'm going to show you ways this happens. I can usually withstand 1 day of waking up early, with some consequences, but 2 days in a row kills me. 4/16

Let's say this graph represents Day 1, the first time I am required to get up early. The y-axis is my level of Sleepiness. Any symptom listed higher up includes that symptom + every other symptom below it. Getting up that early means I can't listen or concentrate all day. 5/16

Thrd: Menstruation/Dysphoria

1/ Difficult periods are sometimes the first catalyst for young women becoming alienated from their bodies.

Some have given congratulatory speeches about the vague accomplishment of "becoming a woman."

2/ Others learned about periods through a mundane sex-ed lesson at school. Yet others knew very little about their periods except they are sometimes painful, can be embarrassing, and make activities they’d taken for granted,

3/ like swimming and outdoor play, all-of-a-sudden much more difficult.

When young women hate their periods, they might be told, in a matter-of-fact grumbling way, “well, nobody likes having a period, honey. It’s just a part of life.”

4/ On a personal note, till my early/mid 30s, I knew very little about the menstrual cycle. For me it had always been completely out of sight, out of mind. Once a month, I’d be reminded it exists and I’d have a kind of “oh crap!” moment.

5/ I’d complete the necessary hygiene and try to move on with my life. I was often plowing through various stages of this monthly cycle with little acknowledgement or understanding of how my entire mind, body, and mood was ebbing and flowing. Every month, for years on end.

Here is a tweetorial from our latest publication in @Annals_Oncology about longitudinal tracking of esophageal adenocarcinoma. #OesophagealCancer #EsophagealCancer https://t.co/QWvrzBXmK7 1/8

We sequenced 245 plasma samples from 97 patients with oesophageal adenocarcinoma using a 77 gene pan-cancer ctDNA panel. 2/8

Variants derived from previously characterised driver oesophageal adenocarcinoma genes had a significantly higher VAF than variants from other genes, indicating selection. 3/8

Peripheral blood cell samples were also sequenced for 78/97 patients. CHIP mutations were identified in 23% of cases, longitudinal tracking of CHIP variants suggested these variants were dynamic over time. 4/8

We found patients that were ctDNA positive post-surgery had a significantly poorer survival than ctDNA negative patients, and the elimination of CHIP variants improved the positive predictive value. 5/8