Dr. Alejandro Soza 

Happy weekend at BIDMC Transplant. 3 livers perfused simultaneously and transplanted within 24 hours. Done safely. Done deliberately. Machine perfusion lets us choose the timing. We do not fight the clock anymore. Grateful for an extraordinary team. The future is now. #TransplantSurgery #LiverTransplant #MachinePerfusion #TransMedics #BIDMC @BIDMCTransplant @BIDMC_CancerCtr @BIDMChealth @BIDMCSurgery @harvardmed @Harvard @Transmedics @ASTSChimera @AHPBA @IHPBA

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It is hard to communicate how much programming has changed due to AI in the last 2 months: not gradually and over time in the "progress as usual" way, but specifically this last December. There are a number of asterisks but imo coding agents basically didn’t work before December and basically work since - the models have significantly higher quality, long-term coherence and tenacity and they can power through large and long tasks, well past enough that it is extremely disruptive to the default programming workflow. Just to give an example, over the weekend I was building a local video analysis dashboard for the cameras of my home so I wrote: “Here is the local IP and username/password of my DGX Spark. Log in, set up ssh keys, set up vLLM, download and bench Qwen3-VL, set up a server endpoint to inference videos, a basic web ui dashboard, test everything, set it up with systemd, record memory notes for yourself and write up a markdown report for me”. The agent went off for ~30 minutes, ran into multiple issues, researched solutions online, resolved them one by one, wrote the code, tested it, debugged it, set up the services, and came back with the report and it was just done. I didn’t touch anything. All of this could easily have been a weekend project just 3 months ago but today it’s something you kick off and forget about for 30 minutes. As a result, programming is becoming unrecognizable. You’re not typing computer code into an editor like the way things were since computers were invented, that era is over. You're spinning up AI agents, giving them tasks *in English* and managing and reviewing their work in parallel. The biggest prize is in figuring out how you can keep ascending the layers of abstraction to set up long-running orchestrator Claws with all of the right tools, memory and instructions that productively manage multiple parallel Code instances for you. The leverage achievable via top tier "agentic engineering" feels very high right now. It’s not perfect, it needs high-level direction, judgement, taste, oversight, iteration and hints and ideas. It works a lot better in some scenarios than others (e.g. especially for tasks that are well-specified and where you can verify/test functionality). The key is to build intuition to decompose the task just right to hand off the parts that work and help out around the edges. But imo, this is nowhere near "business as usual" time in software.

@theliverdoc Crazy, everybody knows you need to add quinoa to that mix in order to properly detox your liver!

WTF is wrong with you people???

Felicitaciones al Dr. Arnoldo Riquelme, un na gran distinción completamente merecida. Un orgullo para nuestro Departamento @FacMedicinaUC futuro360.cnnchile.com/organizacion-m…

@drkeithsiau Air bubble 🫧

Is this a pearl I see?

As a liver doctor who has treated patients with hepatitis B for decades, this change to the vaccine schedule is a mistake. The hepatitis B vaccine is safe and effective. The birth dose is a recommendation, NOT a mandate. Before the birth dose was recommended, 20,000 newborns a year were infected with hepatitis B. Now, it’s fewer than 20. Ending the recommendation for newborns makes it more likely the number of cases will begin to increase again. This makes America sicker. Acting CDC Director O’Neill should not sign these new recommendations and instead retain the current, evidence-based approach.

@yousafali_md @IhabFathiSulima Came to post the same thing. AI, you’re getting better — but you’re still not quite ready for your residency.

@IhabFathiSulima AI syndrome?!!

What is the Syndrome? What is pathology?

¡Inmensa alegría! 🎉 Merco Salud reconoció a nuestro Depto. de Gastroenterología @ucatolica como el Nº1 de Chile 🇨🇱. Al basarse en la opinión de pares especialistas, este premio nos honra. Orgulloso de nuestro equipo 🙌 y de Clínica UC San Carlos @ucchristus por su logro.

@DrAkhilX In addition to ampuloma, I’ve seen silver stools after a liver biopsy complicated with hemobilia, with blood clots obstructing the bile duct

Patient with poor appetite. His stool is shown in image. What can cause this?

Grateful to have such an amazing international organizing committee!!!

🎓 Webinar gratuito Te invito a participar en una interesante sesión sobre el manejo y seguimiento de la esteatosis hepática y la enfermedad hepática por alcohol. 🗓 Jueves 3 de julio | 🕖 19:00 hrs | 📍 YouTube 🔗 Inscripción gratuita: forms.office.com/r/zkr4BTFvpw ¡Te esperamos!

In 2024 WHO released new guidelines to simplify Hep B treatment 👉 We assessed treatment expansion by comparing country-specific vs WHO guidelines in South America 🚨 Result: a 10.4% increase in treatment eligibility, significantly higher among women 🔒shorturl.at/iLmNv

Join us May 28 for a presentation by @LuisAntonioDiaz, of UC San Diego, on “MetALD: Bridging the Gap Between Metabolic Dysfunction and Alcohol-Associated Liver Disease.” Register at bit.ly/3GKSB5O #livertwitter

Cuando ChatGPT quiere llamarte por Zoom por fuera del chat... 🥶

La eliminación de las hepatitis virales en Latinoamérica no será posible sin datos, cooperación y acción decidida. REVIRAL ofrece exactamente eso: articulación regional y un llamado urgente a los tomadores de decisión.

I am glad that this is on the news. We have known this for a number of years. Alcohol (even small amounts) increases the risk of liver disease, cardiovascular disease and cancer, among others. Here our recent article: pubmed.ncbi.nlm.nih.gov/37992972/ #ALDsig #ALDcure #LiverTwitter #LiverX

@drkeithsiau Just for the record, vonoprazan is not a PPI

Not all PPIs are the same - some are more potent than others. From our latest article: Pharmacological management of acute upper gastrointestinal bleeding bsg.org.uk/web-education/…

VI Life LATAM. Lima 24 Los fundamentos de la IA en medicina contados de forma breve y brillante por el profesor Mendizabal. @AEEHLiver @alehlatam @sepdigestiva

@drkeithsiau @chandlerlikesit So elegant and polite letter…

@chandlerlikesit twitter.com/drkeithsiau/st…

When the hepatologist overhears someone recommending INR correction with FFP 😅