BC HEALTH
Saved by @Mollyycolllinss

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
In summary, we demonstrate in a large, national, prospectively-collected dataset that ctDNA in plasma following surgery for EAC is prognostic for relapse. Inclusion of peripheral blood cell samples can reduce or eliminate false positives from CHIP. 6/8
In the future, post-operative ctDNA could be used to risk stratify patients into high- and low-risk groups for intensification or de-escalation of adjuvant chemotherapy. 7/8
Many thanks to our founders and all patients who participated within the OCCAMS consortium framework. The study was carried out by our brilliant PhD student Emma Ococks, medical oncologist @LizzySmyth1, postdoc @AFrankell, and postdoc @neus_snows among others @MRC_CU. 8/8
@threadreaderapp unroll please

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Ary Serpa Neto
Ary Serpa Neto
@a_serpaneto
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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Starks\u262a\ufe0f\U0001f1f9\U0001f1e9
Starks☪️🇹🇩...
@MegaIntelIect
Thread on how atheism leads to mental retardation (backed with medical citations🧵💉)

To start with, atheism is an unnatural self-contradicting doctrine.

Medical terminology proves that human beings are naturally pre-disposed to believe in God. Oxford scientists assert that people are "born believers".

https://t.co/kE0Fi588yn
https://t.co/OqyXcGIMJn


It should be known that atheism could never produce an intelligently-functioning society and neither ever will.

Contrastingly, Islam produced several intellectuals & polymaths, was on the forefront of scientific development, boasting 100% literacy


It is also scientifically proven that atheism led to lesser scientific curiosity and scientific frauds, which is also why atheists incline to pseudo-science.

Whereas, religion in general and Islam in particular boosted education.

https://t.co/19Onc84u3g


Atheists are also likely to affected by pervasive mental and developmental disorders like high-functioning autism.

Cognitive Scientists and renowned Neurologists found that more atheism is leads to greater autism.

https://t.co/zRjEyFoX3P
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katya
katya
@kazbek
it seems to me that not many know that navalny is an avowed nationalist & racist and not just a blonde guy who likes to gently kiss his blonde wife before going to jail and watches “rick & morty”. so here’s a little thread and some of it is pretty personal.

here is navalny’s 2007 video. “a tooth without a root is called “dead”. a nationalist is someone who doesn’t want the russian root to be removed from the word “russia”. we have the right to be russian in russia, and we will defend it.”


i downloaded it to make sure it won’t disappear but it is still shared by navalny’s official youtube channel. btw, in this video, navalny is introduced in the caption as a “certified nationalist”.

here is another video navalny is not keen to share anymore, in which he compares muslims to cockroaches and flies and recommends shooting them with guns if swatters and shoes

here is a 2011 interview with navalny where he explains why he goes to the so-called “russian march”, a yearly nationalist gathering, and why he thinks it’s ok to collaborate with
HEALTH
Deputy Dawgly
Deputy Dawgly
@DDawgly
1) Anyone injecting people with EXPERIMENTAL mRNA 'gene-therapy', FRAUDULENTLY labelled ‘vaccines’, WITHOUT informing them they're taking part in an EXPERIMENT with potentially very serious health risks, including death, IS BREAKING THE LAW. Nuremberg Code https://t.co/OY1Q3L3DwA
HEALTH
Sumanta Pal
Sumanta Pal
@montypal
It's Monday AM post-@ASCO #GU21 & clinic starts in a couple of hours! Lots to process - I'll try to tackle optimal 1L tx for #kidneycancer. I'll make a case for cabo/nivo, leaning on the beautiful (& timely) tables below from @lalaniMD, @SoaresAndrey & @brian_rini (1/15)


What about IO/IO? We have long f/u w #CM214 data w nivo/ipi, no doubt (@AlbigesL et al in @myESMO Open). And treatment-free interval discussed by McDermott @BIDMChealth is no doubt impt. But we've known data not as impressive for favorable risk (2/15)


And furthermore, as @ERPlimackMD points out in another tweet, impt to look at primary PD rates (seen in @lalaniMD's table) - nivo/ipi at 19%!!! CR rate used to be something we highlighted w nivo/ipi, but now comparable across studies (3/15)


Okay now to the really tough stuff - comparing TKI/IO regimens. Something interesting I will add to @brian_rini @uromigos table above is the HR for PFS by INVESTIGATOR review. If the diff in HR for PFS by IND review caught your eye, this is even more striking (4/15)


I think INV-assessed PFS is impt, but if you're a skeptic, forget that argument. Turn instead to #QOL with axi/pembro. Kudos to @brian_rini @tompowles1 @ERPlimackMD et al for advocating for QOL in KN-426. @crisbergerot et al have taughts us the importance of these metrics. (5/15)
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Shaun Russell
Shaun Russell
@_ShaunRussell
"I really want to break into Product Management"

make products.

"If only someone would tell me how I can get a startup to notice me."

Make Products.

"I guess it's impossible and I'll never break into the industry."

MAKE PRODUCTS.

Courtesy of @edbrisson's wonderful thread on breaking into comics – https://t.co/TgNblNSCBj – here is why the same applies to Product Management, too.


There is no better way of learning the craft of product, or proving your potential to employers, than just doing it.

You do not need anybody's permission. We don't have diplomas, nor doctorates. We can barely agree on a single standard of what a Product Manager is supposed to do.

But – there is at least one blindingly obvious industry consensus – a Product Manager makes Products.

And they don't need to be kept at the exact right temperature, given endless resource, or carefully protected in order to do this.

They find their own way.
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Anu Satheesh \U0001f1ee\U0001f1f3
Anu Satheesh 🇮🇳...
@AnuSatheesh5
#Guruvayur_Krishna_Bhakthi  🕉
#Guruvayur
#Storytime
Beautiful Story of Guruvayurappan

Poonathanam Namboothiri was a great devotee of Guruvayurappan. One day Poonthanam was going to Guruvayur Kshetram. It was night time and eventhough Namboothiri was tired he continued to walk


Suddenly some thieves came and blocked his way. Poonthanam cried for Shri Krishna to help. Thieves snatched all valuables from him, but Namboothiri holding his Bhaghavatam book called Shri Krishna to help. That time a man came in a horse back and fought with thieves and protected


Namboothiri. Poonthanam thanked Krishna for helping him from danger and said to the man that "Shri Krishna has send you here and I don't know how to thank you".  The man smiled and told that he is Mangattachan, minister of  samoodhiris. Poonthanam once again thanked him and


gave his ring to Mangattachan as a token of thanks and continued his journey. He reached Guruvayur early morning for Nirmalya Darshan. Temple poojari came near him and told that Guruvayurappan came in his dreams and asked to hand over the ring to poonthanam.


When he opened Kshetra Nada poonthanam was surprised to see his ring on Guruvayurappan, which he gifted to Mangattachan. He understood that it was Guruvayurappan who came as Mangattachan to protect him. This is how Bhagwan treat his devotees.

Hare Krishna
🙏🕉🙏
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Sara Benincasa
Sara Benincasa
@SaraJBenincasa
Spent a quaint half hour in a cafe listening to a guy yell at his dad after his dad said that the women Trump molested wanted it: "Dad, that's like saying the Jews who died in the Holocaust were asking for it!" ENJOY YOUR TERRIBLE FAMILIES THIS WEEK!

"Mom, has a man ever touched you without your consent?"
"Of course."
"Did you report it?"
"No."
"Dad, your WIFE has been through this!"

Dad was unmoved and told the guy to stop arguing with him.

At this point we learned the boy child has allergies.

I forgot to remark upon the presence of the very cute grandson, who was very small and gave not one shit about the yelling. I believe a sister or aunt was present and feeling very stressed. I wanted to hand her a Xanax or seven.

It was really hard to not jump in and say, "Sounds like you guys are going to have a fun meal tomorrow!" so they could unite in hatred against me, the outsider, and stop squabbling. Instead I exchanged glances with a nearby fellow lady patron, who also emotionally ate a cookie.

Anyway, I want to thank the random family for yelling about rape and the Holocaust in an Israeli cafe in the US of A today because it reminded me that while this country isn't the greatest, it is inevitably my stupid favorite and I am never, ever bored.
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Suhas S. Hardutt
Suhas S. Hardutt
@HarduttSuhas
THE BATTLE OF TALIKOTA and the destruction of Vijaynagar (Hampi)
26 January 1565

A tale of valor, deception and decimation.

A grim reminder that if we fail to protect our heritage, it will eventually crumble under the onslaught of "forces of anarchy".
(Elaborate thread)


This decisive battle was fought between the Vijayanagara empire and the Deccan sultanates resulting in a rout of Vijayanagara and ending the last major medieval era Hindu kingdom in south India.(1)

The seeds of 1565 encounter were sown more than 250 years earlier when the forces of the Delhi Sultanate, during the time of Alauddin Khilji and later Md Bin Tughlaq swept through southern India in an expansion spree.(2)

By middle of the 14th century, facing rebellions, Tughlaq withdrew to Delhi, leaving behind 2 empires, Bahmani, which ruled the Deccan from Kalaburagi, and Vijayanagara, which ruled most south India with its capital at Vijayanagar.(3)

The Raichur Doab, between the Krishna and Tungabhadra rivers, existed as a natural boundary between these two kingdoms, with wars often breaking out over control of this territory.(4)
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ArmaniTalks \U0001f399\U0001f525
ArmaniTalks 🎙🔥...
@ArmaniTalks
Shy people are either overthinking or highly observant of the social setting.

And in many cases it can be both.

'So what do I do?'

You learn the 75/25 law.

'What is that?'

The law of charisma...👇

Let's address the over thinkers first.

Do you have any idea why you overthink?

'Yea. Because others are judging how shy I am.'

Incorrect.

Others are thinking about themselves, not you.

But the fact that you think they are thinking about you, you fuck up the interaction.

Now you stay in your head too much & avoid the present moment.

A major no no in the social world.

Your tendency to think that others are judging you for being shy, coincidentally makes you more shy.

And that's when you start giving off a strange vibration to the social setting.

This is when you begin attracting comments like 'why are you so quiet?'
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