Amith

Gastroenterologist @OfficialJipmer | Pancreas & IBD | Gut-brain interactions | Fascinated by AI/LLMs | Movie Buff | AFMCite

[Amith @avstmd]

🧵New paper out in Pancreatology!
We treat acute pancreatitis as a homogeneous disease. Yet some drugs work in some patients and not others. Trial after trial has failed. In sepsis, immune subtypes exist. Some patients are overactivated, some are suppressed. 1/5

[Amith @avstmd]

New models. Not for us.

[OpenAI @OpenAI]

Introducing a limited preview of GPT-5.6 Sol, our next generation frontier model, as well as GPT-5.6 Terra, a balanced model for efficient, everyday work, and GPT-5.6 Luna, a fast and affordable model for high-volume work.

https://t.co/OoM83SyISN

[Amith @avstmd]

Apple could do the funny thing now and retract the price hike. No?

[Frank Harrell @f2harrell]

"Real world data" is an almost meaningless phrase. Our new @bmj_latest paper pushes the more helpful phrase "routinely collected data" and explains the many limitations of such for research purposes. https://t.co/VvsxLQvhfk #Statistics

[Amith @avstmd]

Delaying the next @Apple device purchase by at least two years so that I don't feel the guilt.

[Amith @avstmd]

Oh no!!!

[Abhishek Yadav @yabhishekhd]

APPLE'S INDIA PRICE HIKE IS BRUTAL 🇮🇳

Apple has increased prices across Macs and accessories in India, with some products now costing up to ₹1.7 lakh more than before.

Mac mini M4: ₹79,900 → ₹94,900 (+₹15,000)

Mac mini M4 Pro: ₹1,49,900 → ₹1,99,900 (+₹50,000)

MacBook Air M5 (13"): ₹1,19,900 → ₹1,49,900 (+₹30,000)

MacBook Air M5 (15"): ₹1,49,900 → ₹1,79,900 (+₹30,000)

MacBook Pro 14" M5: ₹1,89,900 → ₹2,39,900 (+₹50,000)

MacBook Pro 14" M5 Pro: ₹2,49,900 → ₹2,99,900 (+₹50,000)

MacBook Pro 14" M5 Max: ₹3,99,900 → ₹4,99,900 (+₹1,00,000)

MacBook Pro 16" M5 Max: ₹4,29,900 → ₹5,39,900 (+₹1,10,000)

Mac Studio M4 Max: ₹2,14,900 → ₹2,79,900 (+₹65,000)

Mac Studio M3 Ultra: ₹4,29,900 → ₹5,99,900 (+₹1,70,000)

HomePod mini: ₹10,900 → ₹15,900 (+₹5,000)

HomePod: ₹32,900 → ₹44,900 (+₹12,000)

Apple TV 4K (64GB): ₹14,900 → ₹25,900 (+₹11,000)

Apple TV 4K (128GB): ₹16,900 → ₹31,900 (+₹15,000)

The biggest shocker is the Mac Studio M3 Ultra, which is now ₹1.7 lakh more expensive than before. 💀🍎

Looks like Apple's AI era is coming with a premium price tag in India. 🇮🇳📈

[Amith @avstmd]

Must read as a primer on Genomics. Looking forward to more such books, maybe something advanced with updates on Indian research/Genome India project etc.

[Vinod Scaria @vinodscaria]

How many patients in your clinic have a diagnosis hidden in their DNA?

The answer may surprise you.

Genomics is transforming diagnosis, risk prediction, drug prescribing, and prevention across every specialty.

#MedTwitter

[Amith @avstmd]

I like it. It's difficult to manually reanalyse and check for new population data and reported variants every month. This makes it easy and automated. What do you think? @vinodscaria

[Peter Lee @peteratmsr]

Medical diagnoses can be improved by reanalyzing genomic data in rare disease cases. This is normally very burdensome, but today in @NatureMedicine we present Talos, a tool that in iterative monthly reanalysis reduces the burden to 1 variant per 200 cases https://t.co/quuF5wNgq1

[Frontline Gastro @FrontGastro_BMJ]

🚀 BSG EndoBridge Series (1/15): Diathermy Demystified

Most endoscopists can select a generator setting, but how many truly understand why it works?

📢 The first article in our 15-part BSG EndoBridge Special Issue explores the principles of diathermy that underpin everyday and advanced endoscopy.

🔗 https://t.co/ZGORnAKUfa

⚡ Why identical settings can produce different tissue effects
⚡ Cut vs coagulation: what's really happening?
⚡ The importance of voltage, impedance & current density
⚡ How saline immersion changes electrosurgical behaviour
⚡ Practical lessons for EMR, ESD, ERCP & third-space endoscopy

Whether you're performing a polypectomy or an ESD, understanding the physics behind electrosurgery can improve precision and reduce complications.

📖 All EndoBridge articles are fully Open Access.

#BSGEndoBridge #FrontlineGastroenterology #Endoscopy #EMR #ESD #ERCP #MedEd

@PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @BASLedu @BSGtrainees @WorldGastroOrg @ulstergastro @SEEDendoscopia @EASLedu @AmCollegeGastro @Aegastro @SAGES_updates @WAGE_media @my_UEG @amergastroassn @NASPGHAN @UHSEndoscopy @ESGE_news @amergastroassn @BritSocGastro @ASGEendoscopy @EndoCollabcom @JAG_Endoscopy @SimonMEverett @gastro3570 @drkeithsiau @DrOmerAhmad @Dunnepdj @shraddha_gulati @CardiffGastro @DrBuHayee @poodocnisha @Sharm_Sub

[Amith @avstmd]

@podimuwa Hi, Is there a resource/atlas for x100 zoom findings?

[Amith @avstmd]

32 shots and 0-1!

[Amith @avstmd]

@podimuwa Excellent! 👌

[Amith @avstmd]

Do it more often!

[ClaudeDevs @ClaudeDevs]

Update: we've gone ahead and reset 5-hour and weekly usage limits for everyone, across all plans. Enjoy your weekend!

[Amith @avstmd]

@DCharabaty @CrohnsColitisFn @EugeneYenMD @GI_PharmD @fudmanMD @KofiClarkeMD @JHashashMD @SivaShivi @DrMohamadShehab @VoiceForIBD @oridamas @ign76 Congratulations!

[Amith @avstmd]

P=G+E 👌

[INtegrative GENomics of HOst-PathogEn Lab @RajeshPandeyLab]

3rd and last day of the @humancellatlas meeting ventures into insights from Genotype to phenotype with focus on Global Exposomics, exploring new dimension from the Single Cell Multi-omics with evolving computational tools, crazy questions & above all fearless science @IGIBSocial

[Amith @avstmd]

As dirty as it can get.

[Troll Football @TrollFootball]

🚨 Close up of Madibo’s horror tackle on Koné

[Amith @avstmd]

@rebelliousgut @DCharabaty @ownyourcrohns @oaksandscopes @MondayNightIBD @SanofiUS @saia_gi But then after discussion, I realised it's not a great long term option. The better option was to empower them to make the choice by providing the options through Govt insurance which doesn't currently recognise IBD at all.

[Amith @avstmd]

@rebelliousgut @DCharabaty @ownyourcrohns @oaksandscopes @MondayNightIBD @SanofiUS @saia_gi When I joined the new Govt institute, I noticed how very few patients were on advanced therapies because of financial toxicity. I felt trials will be a great way to get them on these therapies. 1/2

[Laura Heacock, MD @heacockmd]

Apparently, yesterday @midjourney pivoted from AI image generation to...whole body ultrasound , presumably AI-augmented. I spent some time trying to find hard data and did not come up with much beyond the video. Some thoughts based on the X reactions today.

1) "Nobody's ever done this before." This seems to be a variant on ultrasound tomography, with Butterfly sensors arranged in rings. Ultrasound tomography is not new, with commercial systems available for breast imaging. The system proposed here seems very similar to Garrett et al 2024 (https://t.co/9ULMzSLfT8) which provided fuzzy images of the abdomen and extremity. By collating sound wave return from the ring array the system can attempt to minimize artifact from bone and gas. So, we have known this is possible since 2024.

2) "So easy for the patient." The system requires the patient to submerge themselves in water. For commercial breast UT, this simply requires laying on top of a shaped tank, but not going fully in water. As some people have difficulty lying on a DEXA or CT scanner (the latter of which can image in seconds) I will be interested to see how this is received by patients.

3) "This will revolutionize medical imaging." Ultrasound is limited by bone, air (lung, stomach, bowel) and depth of penetration. In the abdomen, this system can "see" around bowel and spine by adding together the full set of images. There is no workaround for the head or lungs and you'll notice that's why they didn't offer any pictures of those areas. It also means it won't be great at screening inside the stomach, intestine, or colon. I also note the volunteers appear fairly skinny. Ultrasound is always more limited in heavier patients.

4) "But AI can fix it!"...not really. Current DL-based reconstruction techniques require at least some undersampling of a region in order to reconstruct the image. You'll get a lovely picture of the outside of the skull. I can AI-upsample a fuzzy photograph but that doesn't mean what comes out of it actually existed. We have a variant of this issue already with MRI DL reconstruction.

5) "But this is better than MRI in the 1970s!" Yes, true. But the competition is not 1970s MRI, it's modern CT/MRI/US and most especially low-field MRI. For brain, for example, low-field MRI is already diagnostic quality and doesn't need shielding. A low-field scanner costs 50k and can be used in an ICU or put in a van. Why would I send a patient to get an experimental full body US when there's whole body MRI available that's already diagnostic quality? https://t.co/C93QMR3zJ6

6) "The FDA has no idea how to regulate this." This one made me laugh. There's an entire set pathway for this. Commercial ultrasound tomography already exists as an easy reference of a similar technology in the application. If they haven't submitted to the FDA, it's because they plan to try at a later date, or because they're not planning on submitting it at all.

Do I think this is new and exciting? Yes. It looks like it's going to be great for body composition, and I do think there will be improvement in the future.

Is it currently medical-grade diagnostic quality? No, not based on what they showed us. Apparently in-person there was a great hand demo. I don't see why that would be an improvement over routine US or MRI in visualizing hand soft tissues.

To quote @khakrish: "It feels like all the same problems as full body MRI with the added problem of an unproven imaging modality and no FDA clearance."

[Amith @avstmd]

@DCharabaty @rebelliousgut @ownyourcrohns @oaksandscopes @MondayNightIBD @SanofiUS Great points! I understand how trials are run and the safeguards in place. My pov was trials should not be seen as financial access. Like I will get a free colonoscopy, detailed evaluation, newer drugs if I'm part of a trial.