@Curtisl131 @JimMcMurtry01 Is there demand for housing… in downtown Vancouver? Are you insane?!
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James Dundas
9.1K posts
James Dundas
@angularboxoid
Imaging Cardiologist. TTE, TOE, CMR, Cardiac CT. Astronomy, cinema, wine, beer, coffee, board games, politics, doomscrolling, Leicester Tigers, SAFC.
Newcastle UK via Vancouver BC Entrou em Ağustos 2010
713 Seguindo690 Seguidores
@JimMcMurtry01 I'm getting a Chinese ghost-city kind of vibe here. Did they bother seeing if there was a demand for all this?
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The wealthy 1500-member Musqueam tribe, which claims all of Vancouver, is building 11 towers (some 56 stories) on an 11.7-acre waterfront site.
This density breaks all the rules, but when you’re a court-supported racial oligarchy, you can do anything.
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@TJiMTS It doesn’t make any sense, it’s nonsense. If you’re an accountant and you don’t know that using cash costs businesses similarly to digital/card payment… glad you aren’t my accountant.
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This is the first time I've ever heard an argument for cash that makes sense
Rob Moore@robprogressive
If you give a £50 note to a butcher, who then buys from the baker, who then buys from the candlestick maker, it’s worth £50 to each of them, and after 50 transactions it’s still worth £50 If you pay by card, the bank takes 1.5%, 3% or even 5%. The butcher, baker and candlestick maker all have to pay the bank for the privilege of transacting, and by 50 transactions… The bank has the whole £50 in fees. This is the real reason they want a cashless society. Cash is freedom, but it’s also trillions the banks can NOT take from you
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@ncurzen True but 1) which trial tested LAAO for them (none that I’m aware - all vs OAC); 2) many patients with this label have a transient AC CI (eg subdural haematoma) that can actually have OAC later; and 3) you end up giving g OAC to LAAO patients with device thrombus…
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It’s an important result for patients who can have either strategy…. Then there are AF patients at risk of stroke who can’t take anticoagulants…
Benoy Shah MD@dr_benoy_n_shah
In this trial, LAAO was not non-inferior and was, in fact, inferior But not non-inferior does not always/automatically = Inferior This paper is a good read on NI trials Non-inferiority trials in cardiology: what clinicians need to know | Heart share.google/tvF7ELSUgI60xs…
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@jfdwolff @acutemedicine V tiny trials only for IP. But if we’re changing widespread practice based on the NICE (and we should), we should start with the patients it best applies to (stable, OP, euvolaemic), and work from there.
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@angularboxoid @acutemedicine Are you aware of any inpatient data at all?
Do diuretics work better if ADH is fully suppressed?
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Based on best evidence we can stop fluid restriction during heart failure admissions. @acutemedicine
Heart_BMJ@Heart_BMJ
Fluid restriction in patients with heart failure: a systematic review heart.bmj.com/content/early/…
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@DrSdeG I don’t think Martha’s Rule is (currently) applicable to Emergency Departments, just inpatients. (Not saying it shouldn’t be)
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Oh this is just so...horribly not surprising . I am guessing Victoria is American as the language isn't all what we would use here but it is all feels so familiar.
It feels like this is where Martha's law should be implemented when nothing is being done and a child is worsening
Victoria Teasdale@Imperfecting_It
I’m live tweeting my son’s experience at Doncaster Royal infirmary because this is an all too common public health story that happens more than people admit. It’s hard hearing nurses from three different departments get mad because they’ve spent 5 hours bleeping one consultant
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@iceman_ex Wasn’t this always obvious? CDT never made any sense - replacing a vein from the arm to the PA with… a plastic tube from the arm to the PA.
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Wait what
𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 💊@PulmCrit
Fresh blog: STRATIFY trial for PE Peripheral tPA infusion is EQUALLY EFFECTIVE as compared to ultrasound-assisted thrombolysis Catheter-directed thrombolysis for PE is dead We can get the same benefits with peripheral tPA infusions (w/o procedural costs & complications)...#1/2
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@montie Any other suspected criminals we shouldn’t prosecute until their mum dies, to avoid upsetting them?
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I'm just glad Thw Queen didn't see this day.
It would have broken her heart.
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@ElliotServaisMD Mr Cartland is no longer a doctor after he was struck off the register by the GMC for his conduct and has a long history of antivax / COVID denial nonsense. Unfortunately (like similar US quacks who still say MD) you can’t undo their degree so he can still mislead people on here.
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Not a typical post for me, but at a certain point physicians have an ethical obligation to speak up.
I find it extremely disconcerting that somewhat providing medical advice and according to profile a “Promotor of safe, EBM…” is calling vitamin K injection a “vaccine“.
Dr Dave Cartland BMedSc MBChB Ex-MRCGP@CartlandDavid
For anyone questioning Vit K vaccine for newborns - here is the package insert from the FDA. Extremely worrying. accessdata.fda.gov/drugsatfda_doc…
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@Don_pacific_ @JJ_McCullough Normal people do not want that.
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@JJ_McCullough Big difference between those two with AI integrated in the17 vs 15.
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I recently upgraded from an iPhone 15 to 17 and I see like, zero meaningful difference. It’s actually kind of hard for me to imagine what a smartphone could even DO better at this point. They can’t get any faster, the screen is crystal clear… Have we reached a phone plateau?
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@GregoryBesharov @cmwilliams99 True - but consultant / attending salary is much less than half of the US in the UK - probably 1/3 or so, (although varies more by specialty in US)
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@cmwilliams99 This is a huge amount of debt, but it's still not much more than half of what US doctors owe at graduation.
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The fundamental tension in UK medicine is that we now expect students to take on american level debt for UK salaries.
When it comes to pay: it's all about how much the public can afford (not a lot apparently).
When it comes to debt: "You knew the terms, it's on you"
Dr Luke Craddock@DrLukeCraddock
Student loans are becoming a headline area of interest recently. As a doctor who trained and is now working in the UK, I thought I would share my situation. Despite working for almost three years, my loan has continued to grow, and now sits at this amount. [1/7].
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@pash22 @ShaunLintern @GreatOrmondSt @NHSE_WTE Too simplistic. This works well in specialties with lots of the same procedure in high volume (eg joint replacement) and not well in niche / subspecialised / complex areas where numbers are low and may not be “national averages”. Some specialties already collect this nationally
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Why not Shaun? @GreatOrmondSt, like other surgical training centres have loads of surgical trainees who are all reqd to do clin' audits for their ARCP? Instead of doing worthless audits, why can't they be mandated by @NHSE_WTE to routinely audit the following
1. Procedure Volume: Ask how many times they have performed this specific procedure in the last year.
2. Complication Rates: Inquire about their personal rate of complications for the procedure and how it compares to national averages.
3. Revision Rates: Ask how often they have to redo this procedure.
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Are there more rogue surgeons in specialised areas? GOSH CEO Matt Shaw tells me the metrics did not flag Yaser Jabbar and its an area of weakness for other hospitals, he says.
Shaun Lintern@ShaunLintern
🚨 Exclusive: A dangerous surgeon at @GreatOrmondSt harmed more than a quarter of the children he operated on, a new report is expected to say this week. Now the trust chief tells @thetimes he is "deeply sorry" but there is no evidence of cover-up... thetimes.com/article/352ea8…
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@pjsrobertson That literally already exists- they’re called big cats.
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Imagine having a cat the same size as you. I’m so jealous
Explorer Of Moments@ExplorerMoment
The world's smallest adult man, Henry Behrens, dances with his cat. October 26, 1956
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@Adam_Skeen @cmwilliams99 Hmm. Final year GEM student finds fault with highly experienced senior colleague who is widely recognised as one of the good guys. If you knew who you were criticising, you’d not have chosen to do so.
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Consultant stating they’re not competent at using systems critical to delivering patient care is extremely poor form. Reinforcing that idea that resident doctors are just your admin support.
You signed up for a career of life long learning. Learn.
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James Dundas retweetou
@MarcusFrancis42 @obelith_social @its_The_Dr Americans think good service is where the staff constantly bother you asking if you’re ok, instead of bringing you the food and mostly leaving you in peace it eat it. The other thing they think is tip worthy is huge dilute filter coffees being constantly topped up (why?)
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@obelith_social @its_The_Dr “Tip” is built into the cost of the thing you pay for. My experience; Service was horrible…couldn’t wait to get back to America and tip someone! 🤦🏻♂️😂
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@ShonYewy @buffsoldier_96 What on earth are you talking about? The US has conquered and claimed territory across the entire pacific, just as far as UK to the Falklands.
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@buffsoldier_96 Theyre not in the right. Claiming sovereignty over landmasses halfway across the planet is a priviledge only a few old colonial nations get to have. No other country is allowed to do this including the US, which owns bases but doesnt claim ownership.
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It "feels wrong" because its a 'colonial' question where the white, Anglo settlers are in the right.
They didn't extirpate any indigenous tribes to colonise the land. So they're not morally 'tainted'. By any standard its 'their land' & they wish to remain British. End of.
Thorne 🌸@ExistentialEnso
They're discoursing about the Falkland Islands on The Other Site. British people are the indigenous populace of the Falkland Islands by any reasonable metric, even if that *feels* wrong
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@TexasForever79 @fleshsimulator @theoceanblooms Fair enough. I guess everyone who doesn’t bother voting doesn’t get a say in what the town is officially called, but people who live there can say what they like.
It’s interesting how some people are quick to virtue signal their dislike of native names though - wonder why.
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@angularboxoid @fleshsimulator @theoceanblooms Actually it was a small minority of people who showed up for the referendum. The fact is, if you go there, most of the natives still refer to it as Barrow.
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the city is not called barrow any more, they held a referendum and it reverted to the iñupiaq name utqiaġvik almost a full decade ago
All day Astronomy@forallcurious
🚨: The Sun has officially set in Barrow, Alaska, and it won't rise again until January 22, 2026.
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