Semir Bulle, MD

Child of Ethiopian Refugees | Harar ➡️ Toronto | Psychiatry at the University of Toronto | 👇🏾

[Semir Bulle, MD @SemirBulle]

Yesterday I officially graduated from @uoftmedicine and I would like to formally thank all of my family & friends that got me to this point in my life which I never truly thought I would see.

I am truly fortunate that I will be starting my Psychiatry residency in my home city!!

[Underdog NBA @UnderdogNBA]

Karl-Anthony Towns:

"I just felt a calm and a peace that had to come from the woman above ... I felt like I was a kid getting ready to go play my Saturday AAU games and Sunday AAU games. In a way, I felt like I was seeing [my mom] in the stands."

[Ryan Grim @ryangrim]

Hamawy served as a combat surgeon in Iraq, which we invaded based on lies told by Ari Fleischer. Hamawy told me yesterday that on heavy days of battle he’d operate on as many as 30-40 American servicemembers, triaging where he had to.

Ari bears significant responsibility for every single one of those maimed men and women that Hamawy worked to save.

Now to have the balls to link him to Al Qaeda is not remotely the most shameful thing he’s done in his life, but it has to be in the top ten.

[Mayor Zohran Kwame Mamdani @NYCMayor]

I'm pleased to invite @Wemby to our second Commission on Government Efficiency hearing on Wednesday June 10th 5-8pm, where we'll be asking the public for their thoughts on how government can run better. Would love to have you there for the whole time!

[𝘽𝙡𝙖𝙠𝙚 @Arealmfngl]

If true this would be a huge win for feminism. Women are grossly underrepresented in the dictatorship and authoritarianism fields

[More Perfect Union @MorePerfectUS]

In the US, spending on data center construction now exceeds spending on public transportation infrastructure — including airports, marine terminals, and all mass transit.

[Alex Shams @alexshams_]

The US has refused to host Iran's national team for the World Cup even though they have to play all their games there

Which means they're based in Tijuana and will have to fly on the day of their games

I've never heard of this kind of discrimination in World Cup history

[Raghu Venugopal MD @raghu_venugopal]

Sobering reporting how the Ontario Conservative government put public hospitals into deficit, resulting in cuts while directing millions to for-profit private facilities. Thank you @TinaYazdani

[Jamarrius @YungxJayy]

“In hating Africa and in hating the Africans, we ended up hating ourselves, without even realizing it. Because you can't hate the roots of a tree, and not hate the tree. You can't hate your origin and not end up hating yourself.”
-Malcolm X

[Tina Yazdani @TinaYazdani]

Thousands of protesters accused the Ford government of privatizing public hospitals at a rally at Queen’s Park on Thursday.

Given the government’s significant investments in private clinics, I ask the health minister if Ontario is now operating a two-tier health-care system:

[Kyrie🤞🏾 @KyrieIrving]

Just because the generations before us did things a certain way doesn’t mean we have to continue.

#messageformy 30-40 year olds.

Hélà 🤞🏾♾🪶

[Mayor Zohran Kwame Mamdani @NYCMayor]

Young people are always told what not to do. But what should you do?

Did you know that most public libraries have a Nintendo Switch to use? That parks show free movies at night? That there's a map of pickup basketball games?

https://t.co/Nb8rOAGO4T is a map of free and affordable things to do this summer that we made just for you.

Because public programs mean nothing if you don't know how to access them. 


[Charging… @RedPillSayian]

Tucker Carlson and Professor Nick Maynard discuss Israelis torturing medical staff and raping prisoners 😳

“This surgeon’s mode of torture was being raped to death”

[99% Johnny Graz @jvgraz]

Canada has six major taxpayer-funded Holocaust museums and dozens of smaller memorials.

But a one single museum opens one single exhibit on the Nakba and Zionist Jews all lose their shit.

It's the Canadian Museum for Human Rights. Do Palestinians not have human rights?

[Avi Lewis @avilewis]

1/ Right now, a bill called C-22 is moving through Parliament. It would let police pull information on who you talk to, when, and where, all without a warrant. It's at committee this week. 🧵

[Tina Yazdani @TinaYazdani]

New: the Ford government has voted against an NDP bill to remove HST on food products & non-alcoholic beverages.

[Stevie @RaptorsShaq]

Hey so why did you lie?

[David Parker @david_parker]

This is why your healthcare sucks. Most of the money is being used to create fake jobs for parasites.

[Dr Sanil Rege FRANZCP | MRCPsych @sanilrege]

Clozapine isn’t really an “antipsychotic.”🚨
Or at least, it is not just an antipsychotic in the way we usually use the term.

Its mechanism offers clues about the heterogeneous pathophysiologies underlying schizophrenia.

Here’s why:

1. Low D2 affinity
Clozapine can be effective at relatively modest striatal D2 occupancy , often around 50–66%.

2. Minimal D2 supersensitivity signal

helps explain its role in tardive dyskinesia.

3. Higher D1 affinity

D1 modulation may be more relevant to prefrontal network regulation than simple striatal D2 antagonism.

Recent data also suggest D1 receptor modulation is associated with the antipsychotic response especially in hyperdopaminergic states.

In other words, clozapine may be dopamine-state dependent not merely “anti-dopamine.”

4. Serotonergic modulation

Clozapine has potent 5-HT2A and 5-HT2C effects, including 5-HT2A inverse agonism.

That last bit is why clozapine has a role in Parkinson’s disease psychosis.

5. 5-HT1A partial agonism

Clozapine’s 5-HT1A partial agonism may potentiate dopamine in the prefrontal cortex.

That is clinically relevant when thinking about negative symptoms.

6. Muscarinic effects

Clozapine itself is an M1 antagonist

But N-desmethylclozapine is an allosteric M1 agonist.

This may increase acetylcholine and dopamine signalling in cortex, while also enhancing NMDA currents in the hippocampus.

7. Non-receptor mechanisms

-Immune modulation.
-Neuroprotective signals.
-Retinoic acid signalling.
-Increased allopregnanolone - a GABA positive allosteric modulator.

Clozapine has acted as a clue.

For decades, “next-generation” antipsychotic development has been a search for the clozapine effect while trying to minimise the side effects.

In many ways, clozapine remains the blueprint.

It is a pharmacological map of schizophrenia’s heterogeneity.

[Ezzy @ezzyskii]

This is what people mean when they say that poverty is systemic and a class issue, and not because of personal choices.

[jaiden @jaidenerica]

Racist replies mad that I put myself through nursing school… I don’t gaf. Y’all can stay mad.