Devan Sinha

Neuroradiologist | Molecular Medicine | into science and data | via Oxford Med |

[Devan Sinha @DevanSinha]

This CT scan is definitely the most traumatic during lockdown I've been shown. Archery accident.

Arrow through the heart.

Miraculously and thankfully the patient survived.

Let's look at all the ways they were lucky:

[𒊓𒅂𒁓𒐗𒐕𒐗 Steve the skeptic @sib313]

This claim is ludicrous for two reasons:
1. The links in the article don't reference the original DH claim (so the Indie may have misreported it)
2. 20k fewer visits is trivial when there are ~20m visits per year.

[Devan Sinha @DevanSinha]

@JohnRentoul 6 UK bank failures requiring either direct nationalisation & state recapitalisation= £137 B or BoE back-stopped emergency sales/mergers. Whilst HMT had to underwrite £1.17 T of UK balance sheets

You've very rose tinted memories about how awesome the Blairite UK financial sys was

[Devan Sinha @DevanSinha]

@ConsUltaNT_ACP @Burnt2020 @MarionP63133117 @anaesthetic_spr US uses "mid level" recognising PAs, Nurse practitioner etc hv not completed the medical training & proven altitude of 1st yr qualified doctor. Mid= between base/nursing profession and qualified doctor. Pure NHS fallacious propaganda equating UK "middle grade" ie senior residents

[Devan Sinha @DevanSinha]

@ConsUltaNT_ACP @Burnt2020 @MarionP63133117 @anaesthetic_spr Work docs in UK were doing 20 yrs ago. Or are doing now in developed countries ex-UK or US

Only NHSE/DHSC wld look across pond to least cost effective, most dysfunctional & worst outcomed developed health sys & decide to copy. Even they daren't put "mid levels" on resident rotas

[Devan Sinha @DevanSinha]

@yarwoodwilliam Pay peaked in 2006. If intent on sleight of hand they shld use that yr. Maybe every1 economywide shld work for 1990 pay?

2009-now govt intent on pay cuts

Also doc housing allowances eliminated 2002-08 as part of pay-comp package deals (since NHS forces repeat moves) now reneged

[Devan Sinha @DevanSinha]

@andrew_lilico though abolishing and subsuming stamp duty land tax, council tax, "mansion" tax, second home tax penalties & business rates would all be good?

[Devan Sinha @DevanSinha]

Before the war:
A) Iran was sanctioned
B) Hormuz was open
C) Iran didn't have nukes

After the war:
A) Iran UNsanctioned
B) Hormuz open at IRGC discretion
C) No nukes but want them more...

First Iranian-Persian victory since 1823 Treaty of Erzurum after defeating Ottoman Empire?

[The White House @WhiteHouse]

🚨 "An Agreement has been largely negotiated, subject to finalization between the United States of America, the Islamic Republic of Iran, and the various other Countries, as listed..." - President Donald J. Trump

[Devan Sinha @DevanSinha]

@Papa_Heme We love you too, but we'd still rather you got sued than us buddy.

[Hedgie @HedgieMarkets]

🦔Microsoft canceled its internal Claude Code licenses this week after token-based billing made the cost untenable, even for a company with effectively infinite cloud resources. Uber's CTO sent an internal memo warning the company burned through its entire 2026 AI budget in just four months. American AI software prices have jumped 20% to 37%, and GitHub (owned by Microsoft) is dropping flat-rate plans for usage-based billing across its products.

My Take
The AI subsidy era is ending in real time. The same company that put $13 billion into OpenAI and built the Azure infrastructure powering most of Anthropic's compute just looked at the bill from a competitor's coding tool and decided it was not worth paying. That is not a productivity failure on Anthropic's end. Token-based pricing is forcing every enterprise customer to confront the actual cost of running these models at scale, and the number turns out to be far higher than the flat-rate experiments suggested.

This ties directly to my Gemini Flash post yesterday. Anthropic, OpenAI, and Google all raised effective prices in the last six months. Enterprises that built workflows assuming AI costs would keep falling are now watching annual budgets evaporate in months. Two outcomes look likely from here. Either enterprises scale back AI usage to fit budgets, which slows the revenue ramp the labs need to justify their valuations ahead of IPOs, or the labs cut prices and absorb the losses, which makes the unit economics worse at exactly the wrong moment. Both paths land in the same place, the numbers stop working, and somebody has to take the writedown.

Hedgie🤗

[Devan Sinha @DevanSinha]

@stefan_mccauley @medicalmodelbri Ours is IM + subspec and also we average 40-48 hrs per week (full-time) whilst the US
is 72-80hrs avg for residents and with less annual leave entitlement (2 weeks vs our 7 including the bank hols).

Total hours in post grad residency are probably within 10-20%.

[Devan Sinha @DevanSinha]

@ryanopines Risk:benefit for health not worth it & definite issues w/ BMI. Altho plenty of online pharmacies wld oblige!

Pos option in future if gain wt. My indian heritage= less muscle mass & more visceral fat at any given wt 🥲. Adjusted for diabetes & cardio risk BMI 26 is obese for us!

[Devan Sinha @DevanSinha]

Tremendous result for Phase III Retatrutide (GLP1 + GIP + Glucagon)

30% weight loss by week 104 in extension/crossover

morbidly curious what wld happen if I gave myself a stab as healthy male w/ BMI 20.5, probably hospital admission for malnutrition & parenteral feed by week 10

[Devan Sinha @DevanSinha]

@sib313 @Janeajnet @jo3hill contentions:
1) each doc has less capital to work w/ (beds/test/clinic/theatre capacity) they do not control
2) demand side 2/3 of episodes & cost is pop aged >70 (a demo grown 3x faster than whole pop). Meanwhile most cost effective part of sys in primary care - docs declined

[Devan Sinha @DevanSinha]

China saving the global economy from Trump's Hormuz energy crisis by foregoing 4Mbd of oil demand.

= 1/3 of total lost supply after partial SoH bypasses by Saudi & UAE pipelines

[Javier Blas @JavierBlas]

China continues to cushion the global oil market, with imports May-to-date plunging significantly below even the depressed levels seen in April.

At the current pace, Chinese crude oil imports are set to hit a 10-year low in May. On a four-week average, Chinese crude/condesate imports are running >4 million b/d BELOW pre-war levels.

[Devan Sinha @DevanSinha]

@medicalmodelbri No - Australia do not recognise. NZ in middle of setting up MCNZ's international registration pathway in 2026, but work opportunities will be niche & limited for a while yet.

Perfect for NHS - captive workforce at their mercy for work regardless of pay & conditions longer term.

[Devan Sinha @DevanSinha]

Even the new Japanese MAGLEV line is cheaper.

60% faster for 35% lower cost. Oh and 88% tunnel through bloody mountains 2x taller than Ben Nevis too.

🇯🇵 Chūō Shinkansen: $405 mn/km

[Benedict @carto_graph]

Ben isn’t exaggerating about the order of magnitude difference.

In constant $:
🇬🇧 HS2: $626 mn/km

🇫🇷 LGV to Bordeaux: $43 mn/km
🇮🇹 Brescia–Verona: $63 mn/km
🇰🇷 Suseo line: $89 mn/km. Pricey. But that’s because it’s 87% in tunnel.

[Ben Southwood @bswud]

HS2 was a brilliant idea for £10bn, and is a terrible one for £100bn. That’s why getting costs down is the most important thing for Britain to do if it wants infrastructure abundance.

[Devan Sinha @DevanSinha]

So Ed Miliband would rather help Putin's war machine than give up his 'green' shibboleth

[Ed Conway @EdConwaySky]

Remember how last Oct the UK said it was going to ban oil products (eg diesel/kerosene) made from oil that originally came from Russia (eg refined in India etc)?
Well now, in the face of the current shortage, that sanction has now been canned👇

[Devan Sinha @DevanSinha]

@simongerman600 Do you not expect to retire in the US?

Prime age participation looks fine.

Surely as the demographic ageing/longevity transition happens and boomers retire out the 16+ participation with automatically decline.

[Devan Sinha @DevanSinha]

@medicalmodelbri @RCRadiologists @rcpsych @RCPhysicians @RCollEM bc over 2-3 decades running of 'professional' organisations was outsourced to a non-medical managerial boards & unqualified class.

Incentives are maximising revenue w/exam fees (domestic & foreign) + membership subs irregardless of docs. Medical/subspec quality std matters not.