BC HEALTH
Saved by @CodyyyGardner

Minister @DrZweliMkhize committs to uploading MAC Vaccine ADVISORIES by end of briefing. Commits to urgency and expediting availability.

#Vaccines
#nocovidmonopolies

#1Country1Plan

 Aim for 67% of population. First HCWs, then elderly and those with co-morbidities.
Mainly COVAX. Balance of funds being secured from govt. when 'COVAX delivers'.
Aiming for earlier date than COVAX. Depends on bilat negotiations with phrma. No DRUG Company has CONFIRMED.
Medical schemes being included and through PMBs (amending reg.ns), public-private initiatives being set up. Task Team/s set up for medical schemes and govt and priv sector (BUSA).
3 funding sourcees: Govt., Medical Schemes, Priv. Sector.
NDAs signed by Govt. with drug companies for several bi-lateral negotiations (I BET NO PATENT LIFTING...).
Working with @SAHPRA1 for early fast track approval of vaccines for 'urgent attention'.
Distrbution structures being set up at district level. With CSOs and traditional structures. !
@tianjohnson
Deal with misconceptions around vaccine hesitancy.
Dealing*
President @PresidencyZA @CyrilRamaphosa also has Africa Vaccine Acquisition Task Team (AVATT) which Min appears to now also sit on...
Minister has been personally involved in some discussions with phrma.
President has reached out to stakeholders in Africa to look at how 'manufacturers' play their part to assist (closest ref to phrma power).
That we and continent 'not get left behind', 'we are working behind the scenes'.
PPP TASK TEAM - with private sector - to secure $ funding for 67% vaccination aim.
I am in despair, even in THIS PANDEMIC, our government is unable to ensure no patent restrictions-does not seem like it is going that way at all so far in this briefing. Grateful for a few temp. deals, but global south is a time bomb, world needs rapid scale up of manufacturing😪
And then this: Spot the outlier...
And of course, the current speaker, wrote this today:

https://t.co/AcG6APtmsZ
Shem, civil society - we only NB to 'make communities understand' - for door to door...
DDG (why is DG not presenting?) says 3 ways to give out a vaccine (that we still waiting for abd will pay who knows what): https://t.co/kWnBgb6Gsr based,
2.outreach / mobile, PHCs
3.vaccination centres for remote areas too.
And then, here we go: it ALL 'DEPENDS ON SUPPLIES - IF AVAILABLE'.
May use s21 special use, and looking at expedited approval with @SAHPRA1 - not all drug co sent data
May use emergency procurement (read: we may pay what phrma wants us to pay...
-where is @CompComSA to review prices BEFORE? OTHERWISE PANDEMIC gouging will happen).
Phrma negotiations/ many meetings: China, India, Pfizer, AstraZ, Cipla?, Moderna, JandJ.

(NDAs with public money is shameful!)
I ain't tweeting all of this...so here is a photo: 😷
Ah CIPLAnow makes sense- SERUM/ @AstraZeneca @UniofOxford - but *tiered
pricing* (WATCH)
@JNJNews @aspenpharma (seems DDG pushing this one)
I think he just said @moderna_tx is acting silly ... (was it someone else?) 🔊🔊🔊
COVAX - THE BLACK BOX -
So, we wait (not critique).
And expect 2nd Q 2021.

(Hence, deadline as I said before, was a big fat red herring...)
???

Who pays the COVAX balance of payment?

Where are the many women business leaders?

So we not pursuing price control or patent restrictions - phrma triumphs?
Hayibo!!!!
Wait- did we just convince @GovernmentZA on #1Country1Plan -so with a single, equitable allocation systemwhere med schemes cannot ALLOCATE in parallel?!!

Oh my.
So much info shared this evening, though alot being kept under wrap and by drug co. NDAs.

Why coudn't @GovernmentZA simply reply *in writing* to a letter asking these very questions from mid-Nov 2020 by @HealthJusticeIn ...major state capacity issues...
Our recourse against phrma will now it seema be at the @CompComSA for price examination, given public funding of several of these potential vaccine candidates. #nocovidmonopolies
#nopandemicgouging
Good thing @HealthJusticeIn & @ezintsha in JULY 2020 asked that @CompComSA work out pre-emptive price regulation of COVID19 products (so that we don't wait *after* deals signed).
Over to drug companies to PROVE PRICE IS CORRECT. Share data & either way, remember Dischem/Babelegi.
Did not fully understand answer on Russia / Sputnik.
Good for @DrZweliMkhize to mention and appreciate public's anxiety and uncertainty - not getting angry or defensive.

Hope @HealthZA gives a briefing every 3 to 5 days until roll out is complete.

We need info, not whispers...

@GCISMedia
We have NO price control over COVAX, as a MIC, we are at the mercy of the COVAX BOARD, a private foundation, no transparency at all.
Big black box.
Cost: approx ZAR 2 BILL.
Minister:
NO JUSTIFICATION for rich countries to hoard vaccines, 'release it'. And 'we fight behind the scenes'.
Come on, say to drug companies to *not profit* in a pandemic. It is OUR public money.
@PresidencyZA may still phone some companies and say 'come on'!

I hope @pfizer @JNJNews @aspenpharma @CiplaRSA @AstraZeneca @UniofOxford @BioNTech_Group and others are listening.

South Africans are tired of waiting, of paying too much, of being blocked.

Salute HCWs.
NOT A SINGLE MENTION THAT @GovernmentZA is also leading a TRIPS WAIVER REQUEST IN GENEVA asking for global IP RULES to be waived in this pandemic...

@HealthZA
@the_dti

Why?
These drug companies have out negotiatiated so many countries, even ours, NDAs aside, so shameful, even COVAX allows this...

We did warn. Months ago.
I am as confused as everyone else about the role of GEMS and Parmed and Polmed in vaccine procurement, distribution and allocation...
Ends with nothing material on TRIPS WAIVER status quo...

Over and out. 😷⏳🧩🧩🧩
Oh wait 😷😷😷
... seems like we did get #1country1plan through agreed upon national allocation *approach* that follows a triage system...

(Not a plan, cos I don't see it in writing, nor tabled in @ParliamentofRSA ! )

At present, slides and national presser.

☕
So @CompComSA most def needs an urgent COVID-19 Vaccine (internal) premptive pricing task team.
Help out at @HealthZA and
@SAHPRA1

Laws needed to PRICE ASSESS BEFORE WE SPEND THE MONEY.

Justify the price, or price variations. Prove it is low or no profit. And, not time bound.
The MAC Vaccine + ADVISORIES are now uploaded by @HealthZA :

https://t.co/QmcB3OboWU
And we still don't know the opposition parties views on IP AND PATENT monopolies. Do they support the status quo?

More from Health

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
HEALTH , PATHOPHYSIO
Buku Renal
Buku Renal
@BukuRenal
“Should I give them more fluid?”

Extremely common question during AKI referrals from junior docs.

⛔️ Fluid management is tricky, often misunderstood, & can cause huge iatrogenic harm ⛔️

We try to convey important principles in THREAD 👇

#tipsfornewdocs #medtwitter #tweetorial

Currently too often patients with high creatinine are given too much IV fluid, driven by an AKI ➡️ fluid reflex

We’ve seen 7 litres be given in one shift.

Medics & surgeons, juniors & seniors, it seems everyone loves to reach for extra IV fluid (especially if urine output poor)

Why does huge volume IV fluid ‘resuscitation’ consistently occur?

Lots of reasons, including FALSE beliefs:
🛑 IV fluid always “treats AKI”
🛑 Hypotension = hypovolaemia
🛑 Lactate >2 means fluid deficiency
🛑 Septic patients are very hypovolaemic

The rule with IV fluids and AKI is to remember this 5 word phrase:

💥 💥 Aim for euvolaemia, then stop💥 💥

Fluid status is like Goldilocks - hypovolaemia is bad for the kidneys BUT excess volume is also harmful for renal function and will cause other complications too.

It is easy to say “target euvolaemia” - but we agree it is more difficult to do!

Fluid status assessment is certainly made harder by a belief that we must only rely on a snapshot assessment of examination features which are NOT specific / sensitive / reliable to elicit like.…
HEALTH
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@DrOlufunmilayo
HELLO: If you pee and every time you finish, your urine looks like this picture, you may have a serious medical illness.

Foamy urine especially if it is persistent and noticeable over time may mean you have a serious kidney problem.

Let’s talk about this today...
RT for others.


What are the features of a normal urine?

A normal urine should have a light yellow colour, painless, odourless (or faint smell), steady stream and should ideally not foam when you pee.

When there’s something wrong, then you see changes in all the above normal features of urine.

For instance if urine becomes very deep yellow, it may mean you are dehydrated;

If urine becomes painful or smells really really bad, it may mean you have an infection;

If urine has a poor stream, especially in a man, it may mean a prostate problem like cancer.

Do you get me?

So today let’s talk about Foamy Urine.

What are the things that can cause urine to suddenly be foamy. As I said in the first tweet, it MAY mean a serious medical illness like a serious kidney problem.

First things first- it does NOT always mean a problem but it may as well.

Now what are the causes of Foamy Urine:

1. SPEED-
If you pee really fast or with a lot of force, it may make your urine more foamy than usual. The speed and force makes the urine generate a lot of bubbles which tend to almost quickly disappear as it is formed in the toilet bowl.
HEALTH
https://tinyurl.com/1ftbk46h
https://tinyurl.com/1f...
@Aelkus
half of this website believes that all of your problems can be solved by going to therapy

another half thinks that the entire psychological profession is fake and after some vaguely construed revolution mental health will be solved

what's funny about this is that nothing about it new

I wish this wasn't paywalled because the books Lasch reviewed (in 1976!) sound very familiar. The same kind of dumb debates on this subject that occur constantly here are inherited from boomers

the point Lasch makes towards the end is that all of these books are grasping towards something that neither therapy or politics fully covers, even if both are obviously relevant.

but first, he does a tour through the books. he encounters people who believe all character traits are a product of "propaganda" and "conditioning" that can be fixed with therapy or therapy-like processes, and people who think therapy is a distraction from politics
HEALTH
AutisticSciencePerson
AutisticSciencePerson
@AutSciPerson
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 : )
HEALTH

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An interesting set of games that I've been vaguely interested in since I was a kid, after seeing one at a friend's house and never being able to find it again, was the BATTLES IN A DISTANT DESERT/BATTLES ON DISTANT PLANETS series.


These are turn-based wargames for windows 3.x, sharing the same engine.
Battles in a Distant Desert is from 1992, and is based on the first Iraq war (Desert Storm)


and Battles on Distant Planets is from 1991, and takes place in SPACE!
I'm pretty sure this is the one I played as a kid.


They've got 3 options to play with:
* Player vs. Player
* Player vs. Computer
* Computer vs. Computer

So it's a 0-2 player game!


They also did a DOS strategy game called "STARDATE 2140.2: GALACTIC CONQUEST" in 1990, but it seems to be lost.
All the games share an experimental AI system based on neural networks.
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Yantrodharaka Anjaneya Temple, Hampi, Karnataka.

This temple dedicated to pawanputra Hanuman, near the banks of Tungabhadra river was built by dwaita philosopher and rajguru of the Vijayanagar empire, Sri Vyasaraja around +500 years ago.


:It is only in this temple that Hanuman appears in a prayer position. In this image, Bhagwan Hanuman’s crown has been formed by his tail.12 monkeys have been carved around this amulet.


:They represent the 12 days Sri Vyasaraja prayed to Hanuman ji. Each monkey holds the tail of the monkey in front of him but is facing backward. Seed syllables have also been carved around the amulet.


:It is believed that Sri Vyasaraja used to draw a picture of lord Hanuman here on the rocks before offering prayers using charcoal and the sketch disappeared after prayers.This incidence happened for 12 days in a row until he pleaded to bhagwan to appear in front of him.


On the 12th day, Hanuman ji appeared in front of Sri Vyasaraja and blessed him. Hanuman asked Sri Vyasaraja to constrain him in a hexagonal amulet & install him in that place.
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श्रीमाली हितेश अवस्थी...
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Sri Maha Bhairavar Rudhra alayam, Chengalpet, Tamilnadu

This temple is being constructed merely on the instructions from Bhairava by his devotee Shri Bhairava Siddhantham Swamy. The Temple is fully enshrinedin a transparent glass enclosure..1/n


with Rudrakshas on both the sides of the entrance This temple has a circular Sanctum Sanctorum which has twelve stepseach representing a sign of zodiac and after that twelve steps we find the supreme deity of this temple Sri Kshetra Paata Bhairava. 2/n


Beneath the Bhairava, in the lower level are installed the Ashta Bhairavas, SapthaRishis in the form of stones, and Saptha Kannis in the form of brass lamps. Thereare a number of little blue and white lights in the ceiling that is shaped like a dome.. 3/n


which give an ethereal atmosphere when switched on. The steps representthe twelve signs of the zodiac and when one steps over them to reach thesanctum sanctorum all the doshas pertaining to the horoscope are cleared onceand for all..4/n


The Sthala Vriksham ”Peepal Tree” which is grown on a pedestal, a trident which is considered as Bhairavi, Pancha Mukha Anjaneya, Prathyankara Devi, Subramanya, Rudra Vinayaga, Vaishnavi Devi, Naga Rudra, Eswara, Vana Durga etc. 5/5

#IncredibleBharat
#DekhoApnaDesh
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3/ What’s happening isn’t exclusively American: Similar trends are being observed in other countries, including Japan, Australia, the U.K., Finland, and the Netherlands.


4/ One cause is obvious: Adults under 35 are less likely to be living with a partner than in recent decades, and more likely to be living with their parents—which, it’s safe to say, isn’t great for one’s sex life.

5/ But I also found other explanations, each with profound implications. The first, unsurprisingly, has to do with internet enticements. Netflix and other online entertainment may be substituting for sex.
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"I had all of the advantages. I was already inside the network. No one suspected me. But they found my hack, kicked me off the network...

...and physically hunted me down."


Many pentests start from the outside, wanting to see how the perimeter might be breached.

This pentest started from the inside. My client wanted to assume they had already been breached, and, if breached, how far could an attacker go.

Could they stop me once I was inside?

So they snuck me in. Disguised me as a new employee. Gave me a work computer, an ID badge, an account in their system... hell, I even had a cubicle w/my assumed name on it.

The only person who knew who I really was was their CISO. Everyone else thought I was Jeremy in Marketing.

During most of the first morning, I completed onboarding, made introductions, and completed menial tasks.

But I had to act quick. I only had a week onsite. I had to hack their network while not raising suspicion.

So I set about it.

You have to understand... most "Internal Pentests" are straight forward. The hard part is breaching the network, but once you're inside, it's a target rich environment. End of Life computers, default passwords, everyone a Local Administrator...
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