BC HEALTH
Saved by @CodyyyGardner

This is a limited point about availability of efficacy data for vaccines under development in the context of the approval for CovidShield and Covaxin in India.

There have been many so-called experts on the idiotbox opining about apparent availability of P III data which 1/n

 2/n apparently the SEC had access to based on which it "supposedly" approved Covaxin. Another argument that is prevalent is other regulators (US FDA and MHRA) also approved vaccines based on P II data alone. Let me give you a few facts so that you can make your own decision.
3/n The protocols for both mRNA vaccines are publicly available. You can check. Both protocols *define* when the interim analysis will be done. This is not subjective. They clearly define how many infections need to be documented before the Data Safety Monitoring Board meets.
4/n Find the protocols for the bridging study for CovidShield and Covaxin and look for a similar milestone.

Here is one set of efficacy data post the interim analysis of a mRNA vaccine.

Source: https://t.co/BAPnP3PxEb
5/n This data was analyzed post the interim analysis where the blind was broken by the DSMB. Now ask yourself this question:
How does the SEC, or the sponsor of these studies, or the experts who are offering their opinion liberally on the idiotbox know what the efficacy is
6/n without the blind being broken? Do they have some divine insight into how the vaccine candidates are working? On what basis are they offering their considered opinion? Is that a valid question? Or is it that asking it makes one anti-national?
7/n To those who interview these experts, please ask the following simple questions:

A. Do they know if the blind was broken for the bridging study and the Phase III study?
B. If so, can they produce data like the one above showing how many subjects who were infected were
8/n on placebo Vs the vaccine candidate?

And if they cannot answer this question, then ask the following question:

C. In the absence of efficacy data, how does one claim that the vaccine candidate is effective?
D. Do they agree that therapeutic candidates ought to be approved
9/n just based on Phase II data? This is a yes or no question. Dont let them confuse the issue saying this is an emergency situation. Science doesnt work differently in emergencies.

If the decision is based on considerations other than Scientific, say that. Dont hide behind

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Tony Breu
Tony Breu
@tony_breu
1/16
Why do B12 and folate deficiencies lead to HUGE red blood cells?

And, if the issue is DNA synthesis, why are red blood cells (which don't have DNA) the key cell line affected?

For answers, we'll have to go back a few billion years.


2/
RNA came first. Then, ~3-4 billion years ago, DNA emerged.

Among their differences:
🔹RNA contains uracil
🔹DNA contains thymine

But why does DNA contains thymine (T) instead of uracil (U)?

https://t.co/XlxT6cLLXg


3/
🔑Cytosine (C) can undergo spontaneous deamination to uracil (U).

In the RNA world, this meant that U could appear intensionally or unintentionally. This is clearly problematic. How can you repair RNA when you can't tell if something is an error?

https://t.co/bIZGviHBUc


4/
DNA's use of T instead of U means that spontaneous C → U deamination can be corrected without worry that an intentional U is being removed.

DNA requires greater stability than RNA so the transition to a thymine-based structure was beneficial.

https://t.co/bIZGviHBUc


5/
Let's return to megaloblastic anemia secondary to B12 or folate deficiency.

When either is severely deficient deoxythymidine monophosphate (dTMP*) production is hindered. With less dTMP, DNA synthesis is abnormal.

[*Note: thymine is the base in dTMP]

https://t.co/AnDUtKkbZh
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Aureliano Stingi
Aureliano Stingi
@AurelianoStingi
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.
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Leandro Steinberg
Leandro Steinberg
@lean_stein
🧵 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

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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
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Hugh Alderwick
Hugh Alderwick
@hughalderwick
New NHS reforms announced today. Seems to be a story of two parts, plus a missing character. Quick thoughts (1/):

Part 1 of the story is a set of technical fixes wanted by NHS leaders to encourage collaboration in the health system. The direction here makes sense—and fits with what the NHS has been doing for ages. Competition is (mostly) out; collaboration is in: good (2/)

And the need for legal changes to tidy the mess left by Lansley’s 2012 Act has long been recognized. But... (3/)

The benefits of integration are often way overstated, and the risk of reorganizations underplayed. In its first 30 years, the NHS’s structure was relatively stable. But over the past 30, the NHS in England has been on an almost constant treadmill of reform and reorganization (4/)

Overall, evidence suggests that previous reorganizations have delivered little measurable benefit. They can also distract and disrupt, depending on how they’re done. The list of other things for the NHS to be doing during and after the pandemic is very long. So be cautious (5/)
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