Victor Tseng

@jmugele @TStettner Such a candid and touching post, thank you. I am beginning to think that Politics are an extension of Morality.

@luomoalto @__ice9 @farid__jalali @jopo899 2 - These are brilliant biochemists, 1000%. But it is frustrating that the signal is mixed; antioxidants often associated with poor outcomes. Now, we appreciate the critical need to understand the compartment, context, and time-dependent regulation of redox signaling.

@luomoalto @__ice9 @farid__jalali @jopo899 1 - Certainly, Linus Pauling and Joe McCord pioneered the concepts of chronic antioxidant dosing. But now it is clear that the field is moving into more complex and nuanced directions - reductive stress, positive oxidative stress, redox-sensitive reparative signaling etc.

@dr_supradip @Fluid_Academy @ThinkingCC @khaycock2 @iceman_ex @fluidloading @load_dependent @Manu_Malbrain @aroradrn @glennguru1 Thank you for the clarification. You English is wonderful; it's my mistake. Your point is well understood now 🙏 Apologies for my flawed interpretation, which was influenced by my (imperfect) practice of Buddhism. Here. "middle path" has a very different meaning.

@__ice9 @pathdoc3 Thanks🙂 I really enjoyed this discussion when it came out. Initially I was maybe over-enthusiastic about this. Presently, I view DAD/organizing DAD/AFOP on a spectrum reflecting a common final pathway of lung injury and disrepair.

@VectorSting Old post, but happened to see it and found this discussion article-- emcrit.org/pulmcrit/covid… Also @pathdoc3 may be interested.

Let's keep a finger on the pulse of this story. Confirmed with authors that AFOP was seen in 11 consecutive postmortem lung specimens from patients succumbing to persistent respiratory failure (> 2 weeks) stemming from COVID19 pneumonia. Significant implications for treatment.

@jopo899 @farid__jalali Holy smokes. I always learn new things after tuning into your posts. Today I learned about the intimate connection between ABO, vWF, and plasma proteases involved in hemoastsis/thrombosis.

@VectorSting @farid__jalali I did not know this!! How interesting. Tbh in a very bleedy society it would be an advantage (totally picturing sabre tooth tigers here!) wonder if holds true for VTE in general.

Intriguing hypothesis. How is this worked out though? What if outbreaks are happening in areas where people have more group A? It’s not uncommon

@jopo899 @farid__jalali So two possibilities: 1 - Activity-altering variants or SNPs of ADAMTS13 are segregated in disequilibrium with ABO 2 - ABO status of vWF renders it more or less resistant to proteolysis by ADAMTS Likely the second possibility.

@jopo899 @farid__jalali 🤯Here I am thinking we stumbled on spiffy novel idea, but it looks like this overlap didn't escape the authors of this GWAS. But I wanted to share what I'm learning in this paper. Shows that ABO group dictates ease with which vWF is proteolyzed pubmed.ncbi.nlm.nih.gov/12871537/

@__ice9 @farid__jalali

Apparently there has already been a small RCT for dipyridamole in mostly severe COVID-19 in China, N=31. Dipyridamole: all 8/8 severe and 1/2 critical patients cured. 1 critical died. No progression by any. Control: 2/12 severe died, 2/2 critical died, 1 severe to critical.

@jopo899 @ThinkingCC @farid__jalali @damarlalab @Karl03852883 @robertpdickson @cameronks @iceman_ex @NickJohnsonMD @gattinon @leticiakawano @ajaysheshadri @ColinRCooke @srrezaie @Miami_Brit @LCalabreseDO @nickmmark @AnnalsATS @Acute_Pulmo_Med @DrSamuelBrown @MiscSusan @rhsavel @toddrice_ICU @iwashyna @WalkeyAllan @anicalaw @phlegmfighter @PulmCrit @NidaQadirMD @jwmdebacker @seymoc @PeterAttiaMD Patients "becoming septic" (minutes to hours) often have big tachypnea/hyperpnea despite clear lungs. Colloquially called the non-edematous respiratory distress syndrome (NERDS) - my moniker. Clear lungs, acute V/Q mismatch, massive ventilator response.

@jopo899 @ThinkingCC @farid__jalali @damarlalab @Karl03852883 @robertpdickson @cameronks @iceman_ex @NickJohnsonMD @gattinon @leticiakawano @ajaysheshadri @ColinRCooke @srrezaie @Miami_Brit @LCalabreseDO @nickmmark @AnnalsATS @Acute_Pulmo_Med @DrSamuelBrown @MiscSusan @rhsavel @toddrice_ICU @iwashyna @WalkeyAllan @anicalaw @phlegmfighter @PulmCrit @NidaQadirMD @jwmdebacker @seymoc @PeterAttiaMD And now @jopo899 refocuses the spotlight on the chemoreceptive reflex arcs exerting control of RR involving acute phase reactants, 5-HT, TNFa, IL-6, etc. I bet these dictate the respiratory response even *before* rise in venous CO2.

@farid__jalali @ThinkingCC @Karl03852883 @robertpdickson @cameronks @jopo899 @iceman_ex @NickJohnsonMD @gattinon @leticiakawano @ajaysheshadri @ColinRCooke @srrezaie @Miami_Brit @LCalabreseDO @nickmmark @AnnalsATS @Acute_Pulmo_Med @DrSamuelBrown @MiscSusan @rhsavel @toddrice_ICU @iwashyna @WalkeyAllan @anicalaw @phlegmfighter @PulmCrit @NidaQadirMD @jwmdebacker @seymoc @PeterAttiaMD I also have to read more, thanks for the prompt. I do these PA contractility studies all the time, and maybe this explains why the hypoxia never gives the robust contraction as KCl or agonist phenylephrine. Maybe have been discounting the perivascular milieu too much!

@farid__jalali @ThinkingCC @Karl03852883 @robertpdickson @cameronks @jopo899 @iceman_ex @NickJohnsonMD @gattinon @leticiakawano @ajaysheshadri @ColinRCooke @srrezaie @Miami_Brit @LCalabreseDO @nickmmark @AnnalsATS @Acute_Pulmo_Med @DrSamuelBrown @MiscSusan @rhsavel @toddrice_ICU @iwashyna @WalkeyAllan @anicalaw @phlegmfighter @PulmCrit @NidaQadirMD @jwmdebacker @seymoc @PeterAttiaMD 2 - Need to think and read about that one. Do you think @jwmdebacker has any data on vessel caliber in supine and prone COVID patients from the FLUIDA datasets?

@farid__jalali @ThinkingCC @Karl03852883 @robertpdickson @cameronks @jopo899 @iceman_ex @NickJohnsonMD @gattinon @leticiakawano @ajaysheshadri @ColinRCooke @srrezaie @Miami_Brit @LCalabreseDO @nickmmark @AnnalsATS @Acute_Pulmo_Med @DrSamuelBrown @MiscSusan @rhsavel @toddrice_ICU @iwashyna @WalkeyAllan @anicalaw @phlegmfighter @PulmCrit @NidaQadirMD @jwmdebacker @seymoc @PeterAttiaMD 1 - I believe HPV is intrinsic to the vascular wall cells: HPV still happens in a denervated lung (e.g. post-transplant) and in isolated PA rings mounted in a tissue bath. Need to read more about potential NEB role, but my current understanding is that vessel alone is sufficient

@ThinkingCC @farid__jalali @Karl03852883 @robertpdickson @cameronks @jopo899 @iceman_ex @NickJohnsonMD @gattinon @leticiakawano @ajaysheshadri @ColinRCooke @srrezaie @Miami_Brit @LCalabreseDO @nickmmark @AnnalsATS @Acute_Pulmo_Med @DrSamuelBrown @MiscSusan @rhsavel @toddrice_ICU @iwashyna @WalkeyAllan @anicalaw @phlegmfighter @PulmCrit @NidaQadirMD @jwmdebacker @seymoc @PeterAttiaMD Patients with ARDS either had an improvement in cardiac output or no change (see key figure below). The patients with greater drop in PVR had the most improvement.

@ThinkingCC @farid__jalali @Karl03852883 @robertpdickson @cameronks @jopo899 @iceman_ex @NickJohnsonMD @gattinon @leticiakawano @ajaysheshadri @ColinRCooke @srrezaie @Miami_Brit @LCalabreseDO @nickmmark @AnnalsATS @Acute_Pulmo_Med @DrSamuelBrown @MiscSusan @rhsavel @toddrice_ICU @iwashyna @WalkeyAllan @anicalaw @phlegmfighter @PulmCrit @NidaQadirMD @jwmdebacker @seymoc @PeterAttiaMD The predicted hemodynamic response to proning is summarized in this flow diagram below. I adapted this from Jozwiak et al (PMID 24102072)

@siwatson @MicrobiomDigest @statsepi @nature @harvardmed Even though it can be a pain and requires stripping/re-probing, it's probably a good habit to always image the uncut membranes. If cutting or cropping can't be avoided, leave at least 5 band-widths to either side of the target band. And when possible, always save the blots.

@siwatson @MicrobiomDigest @statsepi @nature @harvardmed Because the raw data (i.e. the image) is been shown directly and can be further analyzed with forensic graphics software. No way to routinely audit other data types (PCR, etc). Majority of basic science article retractions are first detected through histology or IB images.

From a paper published in @nature yesterday by @HarvardMed scientists. I just reported it to the EiC, with shaking hands and pounding heart because scary to see that this passed #peerreview and editorial screening in such a high impact journal.