What do peanuts have to do with lockdowns?

Unintended consequences.

A thread:

Peanut allergies were rare among American children up until the mid-1990s, when only four out of a thousand children under the age of eight had such an allergy. But by 2008, the rate had more than tripled, to fourteen out of a thousand.

No one knew why kids were becoming more allergic to peanuts. But the response was natural and seemingly rational: kids are vulnerable so keep them away from peanuts, peanut products, and anything that has been in contact with nuts of any kind.

But there was a severe and negative unintended consequence of this action, which was guided by the best intentions.

Researchers behind the authoritative LEAP study published in 2015 told half of participating parents to follow the standard advice for high-risk kids, which was to avoid all exposure to peanuts and peanut products.

@scottorandojin What if the false diagnosis rate was 90%?
Don’t misunderstand me. I’m a thorough believer in the existence of this virus.

To exemplify: the NHS is under severe winter pressure. Many staff are unavailable, largely due to forced isolation from testing. Also, I’m told the adaptations to the conditions make normal work almost impossible. Trying to keep apart patients in different categories must be...

...incredibly stressful. I doubt I could ever have coped. Add to this the real stream of sick people & it’s a complete nightmare. My sympathies won’t be accepted but I offer them anyway. As to “the deaths”, do you mean the reported count of “covid19 deaths”? Everyone is doing...

...their very best. But as to that count: it’s nothing to do with clinical judgement. A covid19 death is a death from any cause within 28d of a positive test. So once a person is labelled by a positive test, if they then die, they’re a covid19 death. Back to my substantive...

...question: how reliable is that labelling? It’s not a clinical diagnosis. We’re not used to this idea. Never before in medical history has someone had a disease (let alone cause of death) been defined by the result of a single year alone. Yet that’s where we are. I think that..

1. Last NYE was a quiet one for @AmyMcLellan2 & I, after a busy year writing and helping @DavidHHeadley and @LizzieCurle organise @CapitalCrime1

Someone I follow on Twitter shared this story, and we jokingly said we hoped it wouldn’t be another SARS.

2. A few days later, after watching social media footage coming out of Wuhan, I went for a meeting to plan Capital Crime 2021, and said it was likely we’d have to cancel the festival because of the emerging pandemic. My partners in crime looked at me as though I was unhinged.

3. As the situation worsened, I reconnected with people I knew from my previous life working as a consultant to the medical industry, and it became clear we were witnessing the start of a pandemic.

4. Knowing something about the history of pandemics, I was aware that early intervention, and quick and decisive action were essential. I was asked to write a report for Matt Hancock on the risks of reinfection and long-term ill health caused by coronaviruses.

5. Knowing the public health and economic costs of a pandemic, I joined people like @DrEricDing trying to raise the alarm in February, calling for decisive government action. In the report sent to Hancock, I recommended a 4-week precautionary border closure and lockdown...

Over the past few days I’ve been speaking to several frontline NHS staff working in hospitals in London and surrounding areas and it seems that the situation is incredibly dire

-- THREAD --

One doctor in a London hospital tells me that following a huge spike in cases their hospital is struggling to cope and they now have no choice but to ration Oxygen: “No beds, no space, minimal Oxygen supplies. We’re having to ration Oxygen.”

A senior doctor at one of the biggest London hospitals tells me that all elective surgery has now been cancelled and that roughly 80-85% of beds are currently being used for COVID patients.

At one hospital in London a specific team has been set purely to aid with the patient discharge process. Why? Simply to free up as much bed space as possible because demand is higher than it has ever been.

One medic tells me that the number ITU beds has increased at their hospital as they try and deal with extra demand but they only have staff to cover half of them: “Yes we have extra beds but what is the point if we don’t have any staff to actually work on them?”

THREAD 4

#ALEPH2020:

#ALEPH2020: humans are physiologically adapted to animal source

#ALEPH2020: Nutrients are not always easily obtained from plants

#ALEPH2020: special needs of vulnerable populations are met with animal source

#ALEPH2020: restricting animal source foods may put the young at

18 Interesting Things About Vitamin E you should know

1. Vitamin E is also known as “Tocopherol”.
2. Taking vitamin E by mouth will help reduce anxiety, depression and cravings in some women with PMS (Premenstrual syndrome).

A THREAD
RT

3. It increases the level of testosterone as such increases sex drive.
4. The required daily intake (RDA) of vitamin E is 15mg(22 IU) for both man and woman.

5. In men, vitamin E increases sperm count and sperm motility. Also, taking it by mouth improves pregnancy rates for men with fertility problems.
6. DO NOT CRUSH OR CHEW VITAMIN E CAPSULES.

7. Taking vitamin E together with vit C can help improve vision.
8. It has antioxidant properties and helps the nerves work well.
9. You can be allergic to it and toxity due to overdosage of vitamin E is possible.

10. The side effects of vitamin E are rare but they include
-Nausea
-Diarrhea
11. It is a fat soluble vitamin.
12. In older people, it can help strengthen the muscles and boost physical strength.

I previously did a wellness check on @SaRaAshcraft that resulted in her becoming very angry at me. She isn’t posting on Twitter. I am hoping that she is under Federal protection right now.

It wasn’t the wellness check that she was angry about - she thanked me for it - it was the fact that I characterized her as needing medical help.

This was based on her Tweets.

A true friend cares about others but also knows when to back off.

There is not a day that goes by that I do not reflect on Sarah, who is an amazing human being I was privileged to meet over Twitter.

The police officer who did the wellness check on Sarah told me his impression that she is highly intelligent, reported being a trauma victim, and only needed help to be OK.

I understand why the help he offered, eg to go to hospital, might not have been what she wanted.

The cor*na hoax thread. How and why, best as I can tell. First, how does the new virus work? The vast majority of cases are asymptomatic or indistinguishable from the common cold. A small minority of cases affect the lungs. But how it does should be clarified...

The virus doesn't cause pneumonia. Was often mistaken for pneu. at first, but doesn't cause the lungs to fill with fluid. Nor does it cause the failure of the lungs to pump; rather, it impairs the lungs' ability to absorb oxygen on a cellular level...

It also seems like it never fully destroys the lungs' ability to do this. From personal friends who've developed severe illness, like "having someone sitting on your chest". But I've never heard of a single cor*na death attributed to brain death due to no oxygen...

Rather, the stress caused by low oxygen makes some other organ "pop" first. The media is very vague on how it kills you, because you might start to put two and two together. That organ is almost always the heart. Lowered oxygen causes elevated heart rates. Sound familiar?

Yeah. The effects of the new virus on the body are indistinguishable from... moderate aerobic exercise. The only people who've died from the virus are -those who a light jog would kill-. What category is that? Does the data bear me out?

Mega thread on seismic few days of the pandemic in Ireland.

📍The govt implemented level five.

📍More info about the UK variant.

📍And NPHET held one of the most important briefings in months on New Years Eve.

What's happened and where does it leave us now?

If you've understandably avoided news for the last week or more this should bring you up to date:

First:📍Stay home unless you have to leave, no visitors bar support bubbles, exercise within 5km. Essential shops only to open.

Full info:

How did we get here? The current restrictions were introduced on Dec 30 by An Taoiseach.

Prior to that it was to be 'level 5 with adjustments'. Non-essential retail, gyms, tennis and golf clubs were to remain open, schools were to return on Jan

The 'level five with adjustments' plan was only introduced on Dec 23. It was supposed to be reviewed on January 12. Yet it was quickly overtaken, and superseded with stronger measures on December 30.

What happened that it was needed, and needed strengthening?

Background first: Cases flatlined into Dec around 300.

The hope was they'd fall further in the early weeks due to a lag effect from the previous level five of Oct-to-end-Nov, but they didn't. The baseline was about 300. In Oct, NPHET's aim was <100.

tw weight , dieting , eating disorders
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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.

[THREAD] I saw a few of us saying that their 2021 resolution was to improve their mental health. So I decided to write this guide in terms of what steps we can take to improve our mental health for 2021 and beyond. The most important step is to start some form of treatment.

While finances can be a huge barrier to getting treatment, there are a few things around that. Medications (especially those that have been around for a while) are generally much cheaper because they exist in generic form. They are safe, have decades of research behind them.

Antidepressants are not addictive at all and while there are a few side effects at the beginning, they tend to go away after the first few weeks. While it is hard to get rid of superstition and myths around meds, taking that first step of just taking it will help so much.

For therapy, there are always some free or low cost options. Sometimes, there are students about to graduate from their post grad who offer free or low cost therapy as experience (under the supervision of a fully licensed psychologist and legally).

They are the equivalent of a resident doctor, meaning they have the knowledge and expertise but lack the experience and both of you can benefit from working with each other. I remember when I was in that position and worked, I had my supervisor guide through every client.

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,

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

Essential reading for intensivists: things you didn't even dream were going on in your ventilated patients' lungs. With credit to @robertpdickson who does some very clever translational work on lungs

Firstly, we are aware of the inherent badness of oxygen. Here is protein content in alevoli after 48 hours of FiO2 95% (i.e. oedema), delightful.

Secondly, all those VAP's we get cross with (can someone silver impregnante the ET tube or something) that we think is just orally communicating flora/immunosuppression? Mais non. High FiO2 all but destroys weakling bacteria, leaving the redox-armoured king, staph aureus, to rule

Unmitigated staph surges and produces a truckload of PAMPs (pathogen associated molecular patterns). Being redoxically armoured, it is fairly happy to thwart oxidative burst from neutrophils attempting to kill them too.

Indeed the lung flora changes prior to the alveolar protein content - like both a canary in the coalmine moment, and then contributing to pathology.

#SouthSudan #Sudan #SSOT

*Exposé of the Healthcare Sector in South Sudan*

Monday 4 January, 2021
(Washington DC; London)

*HIV/AIDS in South Sudan: The Diagnosis That Leads to the Murder of Doctors*

*Thon Wal* is an officer within the South Sudan National Police Service (SSNPS).

He was partly trained in Khartoum, Sudan, by the north Sudanese National Intelligence Security Service of the former Omar Hassan Al-Bashir and National Congress Party regime.

Aside from being a...

...policeman in the SSNPS, Thon Wal has also been operating in South Sudan for several years as a “private contractor” within the South Sudanese security apparatuses. Mercenaries who make themselves available for hire; and are sometimes more commonly called, the “Unknown Gunmen”.

So what is the relationship between Thon Wal and the former southern Sudan Inspector General of Police (IGP), *Makuei Deng Majuch*?

What is Thon Wal’s relationship with the key eye-witness, another policeman called *Mathew Aluong Makor*, in the murder of the British medical doctor, neuroscientist and academic, *Dr. Ding Col Dau Ding*? (1)

Medical/Science Twitter - Do not trust IT hotshots with actual science data unless they have been trained in the real processes, know scientific method and their account/project/product managers approach with an established and medically respectable kind of taxonomy, plan, etc.

👋I will literally volunteer to sit in on these vendor pitches and translate snake oil sales pitches to make sure the stakeholder/end user requirements and needs and priorities are clearly defined so shit like this stops being a viable business model that does nothing but harm.👋

Very few people in IT at any actual level that is being given respect right now out of dire necessity have the kind of training or experience to handle this shit. Few if any of the data models that have been accepted and are being used follow the HIPAA-grade science methodology.

I only know this stuff because I built and managed informational and compliance portals for a pharmacy chain's operations team and designed/built/launched a ton of stuff for uses with ACA. And my best friend from home is doctor who keeps me in medical research journals if I ask.

But the need to approach this virus as a true unknown with constant expected variable shifts and false positives and correlating behaviors that may or may not even be related to each other as the real research work is being done is imperative. Don't buy IT's easy answers to this.