@janethooton_ @ErinInTheMorn @fifi_EY 1/ The 🏴󠁧󠁢󠁥󠁮󠁧󠁿 government decided pediatric gender care in England would be a monopoly contract (a Labour minister, in 2008), despite all other NHS patients officially being entitled to a choice of providers, & second opinions on diagnoses & treatment, & gave it to GIDS, which has…

So now we have a certified Serologic testing of Red Cross US blood donations to identify SARS-CoV-2-reactive antibodies, and that battery of testing shows widespread presence of SARS-CoV-2-reactive antibodies in donations made between December 2019-January 2020

Fun fact: the standard advice for if a dog, cat, or human bites your hand, is to feed the bite. Push your hand further into their mouth, forcing the jaw open.

Nurses, EMTs, veterinarians, etc are taught to respond this

The advice for a human biting you is to jam your hand or arm deeper into their mouth, and rub the spot under their nose back and forth.

If you attempt to remove your hand, or forearm, the teeth do what they're supposed to and gouge out a chunk.

This vicious wolf attack illustrates proper technique.

So: every EMT and nurse who gets bitten by a human, is trained to jam their hand or forearm deeper into the mouth, feeding the bite so the jaw widens enough to remove the limb

Also, every redneck learns this along with the advice of "never run from an angry dog"

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.

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)