James Dundas

WE'RE ALL GOING ON A EUROPEAN TOUR 🌍

The moment Sunderland players discovered they’d qualified for European football for the first time in over 50 years. Those fans will be able to create special memories next season, I’m so happy for them! 👏👏

@SimonFraser00 People say this every year, and they’re just wrong. The playoffs are great, and it stops there being a huge dead rubber fest at the end of the season where most of mid table have nothing to play for.

@cardiojaydoc02 Spot on. 👏

I wanted to take a minute to respond to this one. “In the old days”, even in the 80’s, physician suicide has ALWAYS been higher than the general population. We likely suffered from PTSD, it was suppressed, not discussed, and manifested in other ways like divorce.

@AcademicTruther @cardiojaydoc02 @DavidLBrownMD Come on, what? Nobody would reasonably expect a mechanic to be back at work the day after being extubated. My grandad was a car mechanic and lost two finger tips in a work accident with a hydraulic jack. He obviously didn’t go back to work the next day…

@cardiojaydoc02 What do you think would happen if @DavidLBrownMD was a car mechanic? He would be expected to be back at work as soon as possible. Why do physicians or other white collar professions get more allowances than the middle class / working class?

If our initial response when recovering from a serious illness is relief that we aren’t imposing on our colleagues, we may want to question the level of brainwashing that is occurring in the healthcare system. Time for a change.

@DavidLBrownMD Not saying things might not have swung too far; but it seems very glib and heartless to say “nobody in my residency committed suicide” when physician suicide is quite a well documented phenomenon. You’d be unimpressed if (when) colleagues decided to stent based on n=3 data…

was to make sure all services were covered when trainees decided they needed a mental health day, had a doctors appointment, or a URI. Nobody in my residency committed suicide or developed PTSD as far as I know. But they were fully trained and competent internists after training

When I was an intern I developed massive acute bronchospasm from exposure to cat dander. I ended up intubated in the ICU at one of my program’s teaching hospitals. Thanks to high dose steroids, I was extubated the next day. The nurse then handed me the phone to answer a call.

@abhinuv23 @drjohnm Indeed, you can’t fight culture. I wonder if it’s a relic from US historically having low radial access rates? I can’t recall stopping OAC for angiography since the last days of femoral only operators (>10y ago).

@angularboxoid @drjohnm Because cath labs mostly mandate holding eliquis for over 24 hours. This has been the standard when I was in Wisconsin and is the standard here in San Diego in my cath lab. Cant always fight the system. And I was not arguing to send patients with type 2 NSTEMI from Af to cath

Why do people use heparin or enoxaparin for acute AF? It drives me bananas. There’s zero data!

@abhinuv23 @drjohnm Wasn't the question 'new' AF? Plenty of patients with established AF have NSTEMI. Quite often patients present with AF/rate-related symptoms and trop rise - not type 1 NSTEMI. less often, might have symptoms felt more likely to be ischaemic, but also new AF - may have both.

@angularboxoid @drjohnm I can recount just in last week I saw two patients with Afib who have NSTEMI? Are you saying these are mutually exclusive. Sorry I don’t get what you are saying - maybe I am missing the context if your comments

@abhinuv23 @drjohnm Of course can happen, but wouldnt have said very frequent that both events are brand new and independent. Usually can clinically adjudicate and do no coronary test (or CT). But when it does occur - why woudn't one just start a DOAC and send to cath?

@angularboxoid @drjohnm You have never seen with newly diagnosed Afib who has a plaque rupture from unrelated NSTEMi? The two have nothing to do with each other but they frequently coexist. I mean what’s so shocking about this

@VerwerftJan @drbennisahmed @bwoody58 Impressive that you can resource this - I am not saying there are no centres in UK that offer iCPET but I don’t know of any, and my own surgical centre and AFAIK the nearest transplant/PH unit don’t. Seems a lot of testing for modest treatment options? Is it cost effective?

@angularboxoid @drbennisahmed Exercise testing is intended for only patients remain undiagnosed or symptomatic despite first-line management ... and not everyone needs every test: • CPET as the foundation • ExEcho when feasible, simultaneously or stepwise • iCPET reserved for selected cases @bwoody58

Unexplained dyspnea? Here’s the new ESC framework for diagnosing HFpEF — and it goes way beyond a basic echo 🧵 From Landsteiner et al., Eur Heart J 2026, a stepwise domain-based approach

@abhinuv23 @drjohnm Why would patients with new AF be for Cath? And if there was an indication, why would oral anticoag be stopped for Cath? Neither makes a lot of sense.

@drjohnm And most of the times these patients have been also planned for cath inpatient so oral anticoagulants are a barrier in that setting

@alzsoalb @jakonian Because of the intrinsic nature of every single member, candidate, councillor, and MP they have.

@jakonian why would reform collapse?

My prediction for the next General Election: 🌹LAB: 30% | 340 seats 🌳CON: 25% | 179 🔶LDM: 13% | 65 ➡️RFM: 15% | 8 🌍GRN: 12% | 7 🎗️SNP: 30% (in Scotland) | 16 🏴󠁧󠁢󠁷󠁬󠁳󠁿PC: 26% (in Wales) | 10 ⚪️NI Parties: 18 ⚪️OTH: 7

@pjsrobertson Pedantry but in football, using your torso surely counts as a kick as it’s not handball or a header.

@AiForgeConsult @TheMG3D Hi, normal people do not want a fridge that automatically spends their money. Like that is the worst possible concept.

@TheMG3D But what if it can finally order it's own food and then I can just come and take from the neverending box of plenty? :))

Stop adding features nobody is asking for!

@maxdubler Wait, San Francisco is only just getting Nepali food? Like my parents’ sleepy English market town (v white) has had Nepali restaurants for years…

Anyway I’m here from San Francisco to let you know that Burmese and Nepali food are likely going to be the next big things.

The millennial craft movement vastly improved American gastronomy and I refuse to let zoomers with no cultural memory of the bland garbage we ate and drank 20 years ago meme me into thinking it is cringe.

@RussellScotland @ArturNadol7566 @BBC "I don't remember hearing any significant news reports from China". Are you serious? The other superpower? Taiwan? The pandemic? Any of this ringing a bell?

@ArturNadol7566 @BBC What were the other two international editors getting paid? There are hierarchies of foreign journalist postings, as with the diplomatic service. And the US is generally accepted as the top job, for the top person. I don’t remember hearing any significant news reports from China.

BBC BROKE EQUALITY LAW AND GOT CAUGHT Carrie Gracie spent 30 years at the @BBC. She spoke fluent Mandarin. She ran the Beijing bureau. She was one of four international editors, two men and two women. Then in 2017 the BBC was forced to publish salary data. Gracie looked at what her male equivalent, the North America editor, was earning. He was on nearly double her salary. She had explicitly said equal pay was a condition of taking the China role. The BBC agreed. Then quietly paid her far less anyway. She asked for equal pay. The BBC offered her a raise that still left her below the men. She turned it down. She resigned from the China post in January 2018 and published an open letter telling the licence fee public exactly what their broadcaster was doing. The BBC then put her through nearly a year of an internal grievance process that went nowhere. It took three meetings with the Director-General and the threat of an employment tribunal before she got a public apology and the backdated pay owed to her. The total came to £361,000. She donated every penny to the Fawcett Society (@fawcettsociety), the gender equality charity. She said the fight was about principle, not the payout. A publicly funded institution, legally obligated to follow equality law, paid women less than men in identical roles, got caught, dragged it out for a year, and only coughed up under threat of a tribunal. That is not a pay oversight. That is a policy. Gracie did not ask for a favour. She asked for what she was owed. The BBC made her fight for it like it was a privilege. Sources: @BBCNews, @guardian, @thetimes, @Independent.

@minarchist9 @MattZeitlin Right but is that not just a function of your age & kids being v cliquey about music (especially then) - like if you were into rock or indie or hip hop, no shit your mates weren’t into Jackson in the 90s. But he was comfortably the most famous person in the world at that time.

@MattZeitlin as someone in my 20s in the 90s, michael jackson had no penetration into my world and i never met a white person who liked michael jackson unless it was specifically thriller when they were a kid. he was considered weird and gay and also almost nonexistent (to us)

old people: what was michael jackson's public image in the 90s before the child abuse allegations. was he considered werid but in a kind of harmless eccentric way?

@Emma_A_Webb Don’t be daft. Of course it should be within the power of a sovereign government in a democracy. Whether they should choose to do so is a reasonable debate over policy, but saying “it should be impossible for the government to make laws over dangerous substances” is… bizarre.

I don’t smoke. Never have. I have no skin in the game. But this really is draconian. It should not be within the power of the government to interfere with the personal choices of citizens like this.

@castonian @SMalik86 If they’re tied on GD and goals for, I don’t think they’re gonna be separated on goals against…

@SMalik86 Yes, but thats after they have looked at >Goal For and < Goal against

Am I right that even if Arsenal and City end the season with the same points and goal difference that the title goes to city cos of the head-to-head points?