NEW: Richard Tice failed to pay almost £100,000 in corporation tax, benefiting his investment company which made large donations to Reform UK. First time Reform's deputy leader's tax affairs can be directly linked to finances of Nigel Farage's party.

Couldn't have said it better 🔥

“Air Go Down, Plane Go Up” will now be my first-order explanation. It’s a MUCH better starting point than trying to explain pressure.

Breaking: HHS’s ban on gender-affirming care is struck down. Rarely have I read a ruling this sharply worded. “This case is one of a long list of examples of how a leader’s wanton disregard for the rule of law causes very real harm to very real people.” www.advocate.com/politics/nat...

Hardly “well”, Peter Kyle. Get a bloody grip @labouruk.bsky.social You have a massive majority. Keep pandering to the Tories and ReFuk. And, guess what? They don’t like you any better for it. Meanwhile you are squandering the votes of those who would customarily support you. IDIOTIC.

“Minister said 100k marching calling to shoot their leader is sign of healthy country.” This reeks either big brain overthink or panic meltdown mode.

I’d counter by having pensioners sent to classes on climate change, trade economics and the histories of slavery and colonialism. Two can play at this game.

Breast cancer diagnoses rose by over 300% between 1973 and 1992. Was there a breast cancer epidemic?! NO. Mammograms were implemented for screening in 1976. PREVALENCE is a function of being able to correctly diagnose something. This is also about autism.

Everyone needs to internalize that when they say they want to "eliminate autism" what they mean is "eliminate autistic people and their families".

The medicalisation of distress, and possible overdiagnosis of MH conditions needs discussion focused on how best to help people, rather than as route to cut the benefits bill. Elspeth Davies and me in @bmj.com www.bmj.com/content/389/...

Life on social media as a skeptic and science communicator. @dennisrenmd.bsky.social @kaymd.bsky.social @aineyoremd.bsky.social @mdaware.org

As UK doctors face yet another disaster in job applications & ⬆️ competition ratios, let me tell you how Saudi Arabia pays Univ Hosp Birmingham to allow their drs to side step into UK speciality training. No competition. Guaranteed places. All with @gmcuk.bsky.social & @england.nhs.uk approval. 1/8

If people cant access appropriate mental health treatment and support in a timely way in stands to reason their mental health will further deteriorate and the severity of their mental illness will increase. www.rcpsych.ac.uk/news-and-fea...

11/11 The paper is available here www.bmj.com/content/388/... and an accompanying editorial by Kieran Walshe is here www.bmj.com/content/388/... As he notes, “The prospects for extending their role … now seem remote”

5/11 ⚠️ Notably, we found no evidence that physician associates add value in primary care or that anaesthetic associates contribute positively in anaesthetics. If you add cost of supervision, which the studies don’t, it’s very unlikely they are cost-effective

4/11 🏥 Our findings suggested that the evidence was limited and preliminary. There were important concerns about the competence of PAs in managing complex patients and prescribing (which happens, even if illegal)

🧵 1/11 📚 Our new rapid systematic review, led by @trishgreenhalgh.bsky.social in @bmj.com examines the role of physician associates (PAs) and anaesthetic associates (AAs) in the UK. This is a crucially important question in light of the Leng Review

He’s moved on from ivermectin but I still cannot overstate how lazy and stupid this guy’s scams are. People have died from experimenting with DMSO, an industrial grade solvent. There is a wealth of scientific literature on it, and the only people pushing decades-old junk science like this are frauds

Per @janemayer.bsky.social: “POC” was targeted because they thought it meant “people of color.” It stood for “point of care” in medical emergencies: This Is the research Ted Cruz Calls “Woke.”

Interesting to watch the diplomacy dance. Zelensky not only gets his visit to see the King before Trump, and so quickly after Trump’s shameful attack, but it isn’t a standard one at Buck House either, but a private visit in Sandringham.

Taking inspiration from @robjimfleming.bsky.social I'm sharing some of my own #photography. I've never been a very arty or creative person, but the process of shooting and developing black and white film helps cover up the lack of skills. Shot with Nikon F80 on Ilford HP5+ film.

ICU Mechanical Ventilation (MV): There are many books & articles on the topic but this 8 years' old review has nice graphs/tables & a good discussion of the specific ventilatory approaches in ARDS and COPD:

"In just two weeks, an outbreak in northwest Texas jumped from two cases among unvaccinated children in Gaines County to 48 people across four counties" Geez...it's almost like measles is highly contagious or something🤔 Also, anti-vaxxers suck🤬 www.usatoday.com/story/news/n...

When evil men do their evil things and you're silent makes you an evil person.

"Citizenship by birth is an unequivocal Constitutional right. It is one of the precious principles that make the United States the great nation that it is. The President cannot change, limit, or qualify this Constitutional right via an executive order." storage.courtlistener.com/recap/gov.us...

Only in the foothills of 2 college elections (RCP + RCR) and already seeing: WhY aRE Pas aN iSSue? MoRe imPortAnt FinGs haPpeniG. Here's my response. 🧵 1/

My good friend @drasifqasim.bsky.social is standing to be President of Royal College of Physicians…I’ve only got to know Asif over the last 2 years in all the mess over #RCPEGM He is an outstanding physician, I cannot commend him enough. Tell your FRCP chums #VoteAsif asifqasim.co.uk/prcp

A thoroughly excellent systematic review from @trishgreenhalgh.bsky.social on the evidence base around physician associates & anaesthesia associates. Currently shared as a pre-print a/w publication, I'll summarise her findings. A 🧵 1/18

Look: The thing you need to understand about genAI is that every Next Big SV Thing of the last 15 years—NFTs, Web3, Metaverse, VR—has been utterly rejected by the market and the tech grifters know this is their last chance, no more. That’s why there is an apocalyptic level of capital invested in it.

It’s almost looking like a requirement of the Republican Party at this point.

⚖️| "With this ruling, as well as the independent Leng Review, we feel even more strongly the roll out of PAs and AAs needs to be paused." Our chair Ms Helen Fernandes welcomes a High Court ruling on the regulation #physicianassociate roles dauk.org/pas-legal-ru...

The myth that diversifying businesses led to discrimination against more qualified people has *always* been belied by the empirical evidence from hiring audit studies (which consistently show anti-Black discrimination) and basic demographic facts. Yet, the myth persists, comforting fragile egos.

Wonder which government allowed that metric to deteroriate so badly. Presumably a paper with that front page wouldn't have endorsed them for another term.

GMC also tells Royal College of Anaesthetists that their proposed safety standards for Anaesthesia Associates are too restrictive and might harm the viability of AAs and their training courses. Making it clear where their priorities lie, then. www.rcoa.ac.uk/sites/defaul...

SNAP3: Are multimorbidity and frailty the same? No. Most older surgical patients with multimorbidity aren’t frail. Most people with frailty are multimorbid. Not news to geriatricians and primary care; may not have hit consciousness of anaesthetists and surgeons so much? 11/ #AnSky #GeriSky #SurgSky

Thank you @iainmoppett.bsky.social for this really helpful summary thread of the first major publication from SNAP-3. We are really grateful to all the local investigators and patients who contributed the study, thank you! @rcoa-cri.bsky.social @bjajournals.bsky.social @anaesresidents.bsky.social

Steroids for everyone 😂

"Lowest ever" profit at "only" 100k It's no wonder the homeless are freezing to death whilst the elite play monopoly We need proper housing market controls. www.theguardian.com/business/202...

"every fraction of a degree matters" is true as hell. In the same way that releasing CO2 hurts people and planet, avoiding its release saves us from potential harm This isn't some saccharine 'hopeful' message: it's the hard, inarguable physical reality. www.ipcc.ch/report/ar6/w...

You’re not wrong. POCUS without an associated intervention is pointless IMHO And I say this as someone who does ward rounds with the ultrasound machine.

While focussed ECHO and POCUS clearly have utility, I’m increasingly seeing them prioritised in emergency situations while the basics get forgotten about. And I don’t see it change management all that often 🤷

What if it’s reverse vax depopulation theory? The fog virus will eliminate medical freedom-loving vaccine refuseniks before they can resist. Can’t help but notice that the vaccinated sheeple were rewarded for their compliance with protective immunity & proof that…vaccines work.

Elon Musk is a good example of how terrible people become increasingly radicalized into the far right simply because the far right is a community that accepts cruel, terrible people. It's tempting to say Elon is going "mask off", but I'd wager Elon didn't know who Tommy Robinson was 5 years ago. 1/

The situation is dire at the moment. Lots of ppl have flu. Today every single resident doctor in our team called in sick. Another consultant & I cancelled our leave to help our on-call colleague (in case there are people who still think consultants spend our time playing golf or doing private work)

They used to say there was no such thing as gay kids. That it was a choice that could be beaten or tortured out of them through conversion therapy

This remains, and I say this advisedly, one of the best exchanges I have ever seen on social media

At last, a figure has emerged who could wrench power from Viktor Orbán in Hungary | Viktória Serdült

Labour keep trotting out the excuse that a lack of money forces them to do it when announcing controversial policies. By far the single biggest factor hurting GDP is Brexit, yet Labour are taking a teaspoons-of-water-on-a-forest-fire approach to it. No Brexit honesty = absolutely zero credibility.

Let's not turn UK medicine into this rat race please.