➡️ BICAR-ICU: bicarbonate in severe ICU metabolic acidosis — no overall benefit, signal in AKI ➡️ BICAR-ICU 2 targeted AKI, but no clear answer ➡️ Are we changing numbers, physiology, or outcome? ➡️ SODa BIC picks up the uncertainty Register now: criticalcarereviews.com/meetings/ccr...

Noooooooooooooo. Gastrocnemius re-injured. My god. The third time. I cannot express how devastated I am 😢

Now do the NHS!! 🤞🏻

After France, Denmark is moving too: its Digitalisation Ministry plans to phase out Microsoft, switching to Linux and LibreOffice in the coming months. The goal is clear—reduce dependence on a handful of global tech giants and strengthen digital sovereignty.

I’m at the point where I think most sepsis (trial level) research is so fundamentally flawed that it is unlikely to show anything other that random noise. I don’t agree with everything Lawrence says, but he makes some extremely good points on this topic.

Prof Harrell really hits the nail on the head (again): "Target trial emulation runs the risk of serving as window dressing for inadequately designed observational studies". 100%; I'm seeing this everywhere now. www.fharrell.com/post/causal/

I really hope they don’t try and make more Star Trek for a decade or so. Current Star Trek is a weird blend of action and inter-personal conflict and just truly awful writing by people who don’t understand sci-fi or what made Star Trek special. Please let it rest 😢

Why must children today have water with them at all times and be given water breaks every 15 minutes? Seriously, is this some kind of conspiracy to maximally suppress ADH in all children? What could the possible benefit be to ensuring the maximum number of trips to the toilet??

Why do the Japanese like their buns askew (2026)

Not once in the 80s, 90s or 00s do I recall a politician urging the public to embrace email, mobile phones, texting, two factor authentication, online banking, air fryers, or to replace all their cassette collection with a CD collection. So forgive me if I smell a rat.

Just got around to watching the new scrubs. Wow. They nailed it. Totally on the nose.

In heterogeneous syndromes like ARDS and sepsis, I believe we generally are more likely to be able to find what causes iatrogenic harm than actual therapies. #emimcc #critcaresky

They’re here!

Brutal.

Happy First Contact Day 🖖🏽

He is risen

Even though I’ve muted quite a few trump and trump adjacent words, my feed is still absolutely full of him. I’m tapping out for a bit. It’s just relentless.

A truth that is widely applicable. Many of the people who think medical training can be shortened never take this into account.

“The last night I was a pediatric resident, a child came in with Hib and promptly died by the next day. I didn’t work for 50 years to have everything destroyed by one man.” -Dr. Kathryn Edwards, Vanderbilt University This is what RFK Jr. and the anti-vaxxers have wrought.

Just got the new Windows 11 April 2026 Update installed, wth is this Microslop?! 🤮

artemistracker.com 🚀🧑‍🚀T minus 10 hours!!

What’s the deal with all the age verification OS stuff? Can someone point to a good quality article to explain what’s happening.

Woo project Hail Mary was great! The book was miles better (may have to read it a third time 😬) but the movie was great! Phew!

Resident Doctors are back on strike. Full support from me. 💪🏻

For a moment I thought this was a gamblegram and the post was going to be about strong ions. Iykyk.

Happy "large enough n" day

It’s hard to correctly state the contribution Richard has made to statistical education. He’s made the subject come alive for so many students (myself included) and continues to iterate and improve on what is already wonderful pedagogy: all for free. An inspiration to educators everywhere. 🤩🙏🎓

Signposting this. Would love to see more intensivists at this course. Really educational day with a dedicated faculty.

www.weightmans.com/media-centre... This ruling is just a lot to unpack. 😨

#rstats is so back 💪🤩

These captchas just keep getting harder #rstats

Does anyone ever think about how supervision and mentorship are somewhat missing from healthcare. It's basically all self directed, with some form filling along the way. I can't help but feel that we could be doing it so much better.

Underrated comment.

Gell-Mann amnesia strikes again!

I deeply miss the time when I didn't hear trumps name every day.

Analyse as you Randomise.

This recent RCT of an "AI stethoscope" claims the technology "shows promise" for diagnosing cardiovascular conditions. It does not. It is a textbook example of the risks of conducting unprincipled 'per protocol analyses'. Once again, peer review at a major medical journal has failed. 🧵 1/

Wow. A friend just looped me in on what's happening over on the other site. I have absolutely no regrets about deleting that account. 🤯

😭😭

”Most of the applications of clustering are not well thought out, not even considering whether observation clustering aligns with clinical goals.” YES. Clustering has become a huge fad in psychology as well, I see it everywhere.

This highlights important differences. If the LaTeX code is wrong, it'll (nearly always) be obvious. Garbled table -> try again. And ultimately, it doesn't matter in the same way. Nice docs are nice, but people don't die from misformated bullet point If analysis code is wrong, it's not obvious.

Vibe research and vibe science have always been bad. AI now makes them easier than ever to do, in new ways. It's so tempting. I'm not even talking about pure slop. I've overheard conversations between grad students that should make us all uneasy... 😟

Victoria Embankment this morning. Why should hard working cyclists taxes go on these wide car lanes when motorists don't bother using them?

I find it baffling that people want AI to summarise papers for them. The point is to read the papers in order to become a domain expert. Better tools for education are great. But you need a little friction to learn. Also why tests and assessment are important.

This degree of rain is now too much for me. I haven't seen the sun in weeks. When dear god will this rain end. 🌂

Hamnet is utterly beautiful. Would recommend. 🥲

This was amazing. Ive always enjoyed this channel for his deep dives on a variety of facinating technology. This is probably his best work. Watch till the end.

In an editorial, @HSJnews suggests the NHS is “too reliant” on resident doctors. We disagree. Resident doctors provide essential care now & form the backbone of the NHS workforce of the future. The problem isn’t too many doctors - it’s system constraints. Our response: https://ow.ly/exmU50Y3W1K