gromescu

La lluita només pot portar grabada al rostre, la rialla d'un infant ;D Metge i ex-estudiant d’arquitectura amb l'ecologia al cap 🐢🐝🌳 follow or rtw≠endorse

[Ignasi Moreta @IgnasiMoreta]

El Vasari en català, íntegre! És una grandíssima notícia!

@Ed_proa

[Toni García Arias @tonigarias]

Esto es absolutamente vergonzoso e injustificable.

[Arnaud Bertrand @RnaudBertrand]

I've been wanting to write this for a while: an article on the key characteristics of the Chinese health system, as a patient.

It's something that I - perhaps unfortunately - have come to have a lot of experience with in my eight years in China.

I've been to the doctor as a patient dozens of times. My wife delivered our first daughter in a Chinese hospital, and had cancer surgery in Shanghai. My younger daughter - who once completely severed her thumb in an unfortunate accident in rural Gansu - had emergency surgery in a small clinic there (her thumb is fine now!). We spent the entire covid episode in China. And, to this day, I still go back to China every year to do my routine health tests or the occasional procedure (like a thyroid biopsy in Harbin last year).

In other words, when it comes to the Chinese health system, I've seen a lot.

What's fascinating about the Chinese health system, and that's true in general about many things in China, is that it never inherited Western dogma about how things were supposed to work, it's completely unconstrained by what everyone else has decided is "normal".

And, as a result, you end up with things that would simply sound impossible to any Western patient: a consultation with the head cardiologist of one of Shanghai's best hospitals for less than $10, blood test results in under 30 minutes, and a system where you can walk in, see three specialists and walk out with a diagnosis and your medicine - all before noon.

As I argue in the article that's all enabled by 3 characteristics that sound super unorthodox:
1) extremely short consultation times, less than 5 minutes
2) no GP gatekeepers (you go straight to see specialists)
3) systematic testing for every patient, even if you just have a cold

Each one sounds wrong. And in fact when I describe them to doctor friends in the West they immediately explain to me why that can't possibly work, and how their own system is far superior.

Except that it does work, I checked the numbers (on top of my personal experience): the Chinese system handles close to 10 billion total outpatient visits a year (https://t.co/b1xd45O73F), or about 7 visits per person per year on average, and the average wait time is only about 18 minutes (https://t.co/S3At5DtbJP).

Contrast this with France, my country, where people already go to the doctor A LOT, but still less than in China: only 5.5 visits per person per year (https://t.co/sk1kQt59tK). And the French system can't even handle this lower volume: when you can see a specialist straight away in China - you don't even need to make an appointment in advance - you need to wait months to see one in France (50 days on average for a cardiologist, for instance: https://t.co/ZKZmhzoFFO).

I've personally managed to see 3 specialists AND do all related tests AND get the test results AND get diagnoses AND buy the medicine to cure me - all in the space of a morning at a hospital in Shanghai. That would have undoubtedly taken me a whole year in the French system.

My purpose here is not to argue that the West should replicate the Chinese health system wholesale, but to ask an honest question: what if some of the things we take for granted about healthcare aren't nearly as inevitable as we think? Is it completely unthinkable that we've developed some dogmas that are costing us - in money, in time, and occasionally in lives?

That's the whole point of my article: describing a health system built from first principles by people who never assumed we in the West knew better - up to you to decide if they have a point.

Enjoy the read here: https://t.co/cNXNmo195l

[Paul Wischmeyer MD @Paul_Wischmeyer]

A 2 year old in the US was diagnosed with a disease from the 1700s

He was brought to the ER because he stopped walking.

No trauma. No fall. He just slowly stopped bearing weight on his legs over 6 weeks until he was crawling instead of walking.

His gums were swollen and bleeding. He had a rash. Pinpoint bleeding under his skin. Pain in both legs. Decreased muscle tone.

He kept his legs in a frog leg position and screamed when anyone touched them.

The doctors suspected everything.

First visit: possible fracture. Orthopedics recommended repeat imaging. Four weeks later he was worse.

Second visit: concern for leukemia. Then concern for nonaccidental trauma. Child protective services was called.

Then the workup began

> CT scan of both legs. No fracture.
> MRI of head and spine. Normal.
> lumbar puncture to rule out Guillain Barre. Normal.
> inflammatory markers. Normal.
> muscle enzymes. Normal.
> heavy metal screening. Negative.
> vitamin D and B12. Normal.
> bone marrow biopsy to rule out cancer. Normal.
> electromyography. Normal.
> muscle biopsy. Normal.

Weeks of testing. Multiple hospital transfers. Invasive procedures on a toddler. His parents watched their child get poked and scanned and biopsied while nobody could tell them what was wrong.

Then someone asked the right question.

What does he eat?

Chocolate milk and graham crackers. That was his entire diet. His mother had mentioned he was a picky eater at the very first visit. Nobody followed up on it.

His vitamin C level came back at less than 0.1 mg per deciliter.

He had scurvy.

The same disease that wiped out entire ship crews during the Age of Exploration. The same disease the British Navy solved in 1795 by issuing lemon juice to sailors.

Scurvy impairs collagen production and compromises blood vessel integrity. That explains the bleeding gums. The rash. The periosteal elevation on MRI. The bone pain. The inability to walk.

Every single symptom pointed to one thing and it took months to get there.

He was started on vitamin C supplements. Within a week he was moving his legs again. At 4 months he was walking and his hemoglobin was normal.

The entire workup could have been avoided with one detailed dietary history at the first visit.

We have MRIs and bone marrow biopsies and genetic panels. But the most powerful diagnostic tool in medicine is still asking a parent what their child eats for dinner.

All that extensive workup could’ve been replaced by a 5 minute conversation about food.
🙏 Thanks to @docxusofficial for sharing this great case from @NEJM

[Pablo Malo @pitiklinov]

El autor de este post, que es neurocientífico, explica la razón real por la que la ciencia está rota: por culpa de unos incentivos institucionales perversos que priorizan la producción medible por encima del progreso real. Los investigadores deben autofinanciarse con becas (o sea, son los investigadores los que tienen que buscarse la financiación) y tienen unas tasas de éxito de alrededor del 10%, lo que genera una presión brutal y constante para producir artículos y aplicar a becas sin parar. Las instituciones evalúan sus carreras por métricas fáciles de medir: número de publicaciones, dólares captados en becas y citas, no por avances científicos genuinos.

Esto obliga a una aversión extrema al riesgo: los científicos evitan ideas inciertas o proyectos largos que puedan fallar, y optan por trabajo seguro, incremental y predecible que garantice artículos aunque no avance el conocimiento de verdad. En una encuesta de Pew a científicos de la Asociación Americana para el Avance de la Ciencia
(AAAS), el 69% dijo que el enfoque en proyectos con resultados rápidos tiene una influencia muy negativa en la dirección de la investigación. El resultado es un sistema optimizado para producción masiva, no para descubrimientos arriesgados y transformadores.

Pero esta situación, que es muy mala, va a ir a peor, en opinión del autor, por culpa de la IA. La IA no arregla el problema porque acelera y optimiza exactamente los mismos incentivos rotos: ya que aumenta la producción individual sin tocar las estructuras de recompensa subyacentes. Estudios recientes (como uno en Nature con 41 millones de papers) muestran que los científicos que usan IA publican tres veces más, reciben casi cinco veces más citas y aceleran sus carreras, pero el rango de temas investigados se reduce un 5%, y las interacciones con el trabajo de otros cae un 22%. Es decir, que se produce una contracción del espacio temático que se explora colectivamente y una homogeneización. Vamos, que los investigadores trabajan cada vez más todos en el mismo sitio y pocos se arriesgan a explorar lejos.

Otro estudio en Science con millones de preprints indica que el uso de LLMs aumenta los manuscritos un 36-60%, pero la prosa tan pulida por la IA se asocia con menor tasa de aceptación en revistas top, sugiriendo menor profundidad real. La IA empuja a "monocultivos científicos”, es decir, todos persiguen las mismas preguntas ignorando problemas importantes pero con pocos datos (el clásico "buscar bajo la farola"). La cuestión es que si no se reforma primero el tema de los incentivos perversos y la financiación, la IA solo va a agravar la crisis de calidad, diversidad y originalidad en la ciencia.

https://t.co/PKdTBfyx2D

[JAMA Cardiology @JAMACardio]

Editorial: The SCOT-HEART 2 substudy shows that CCTA screening for subclinical atherosclerosis better motivates lifestyle and therapy adherence than traditional risk scores, though long-term impacts on outcomes are unclear. https://t.co/u7Y9USNQeL

[gromescu @gromescu]

Super valuable insight to what many of us feel we perceive but doubt if it is just us who are getting old and biased towards others, specially younger generations.

[John Burn-Murdoch @jburnmurdoch]

NEW: Is the internet changing our personalities for the worse?

Conscientiousness and extroversion are down, neuroticism up, with young adults leading the charge.

This is a really consequential shift, and there’s a lot going on here, so let’s get into the weeds 🧵

[John Burn-Murdoch @jburnmurdoch]

NEW:

There’s been a lot of discussion lately about rising graduate unemployment.

I dug a little closer and a striking story emerged:

Unemployment is climbing among young graduate *men*, but college-educated young women are generally doing okay.

[Tom Calver @TomHCalver]

Terrific piece. Reminds me of this piece of YouGov polling: we all think the past was better, we just can't agree on when

[Albert Cuesta Zaragosí @albertcuesta]

Aquí us explico en primícia #Galàxia, el catàleg endreçat de gairebé 250 eines web en català que @accentobert_ i @softcatala obriran al públic dijous vinent.

El que més m'agrada: són tot eines web, fora de l'abast de Google i Apple.

(enllaç en obert)

https://t.co/yYOS37Rvqk

[Saloni @salonium]

LAUNCH DAY 🚀 Today I’m launching a new podcast, Hard Drugs, with Jacob Trefethen (@JacobTref)

Our first episode is about lenacapavir — a new HIV drug that blocks infections with an efficacy rate of nearly 100%, and which could completely change the fight against HIV worldwide.

It’s also about the scientific journey leading up to this point, and how HIV was transformed from a lethal to a manageable condition.

3:52 How was HIV discovered? Where did it come from, and how does it attack the body and cause AIDS?
38:10 Antiretrovirals: How did scientists develop breakthrough HIV drugs — from azidothymidine to protease inhibitors to PrEP?
1:51:35 How does prevention and treatment work today?
2:19:03 HIV’s capsid and the breakthrough of lenacapavir, the first-approved HIV capsid inhibitor
2:50:36 How to develop long-lasting treatments
3:14:45 Lenacapavir’s near 100% efficacy in clinical trials
3:48:40 The impact of global programs against HIV, and can we now end HIV?

[Albert Cuesta Zaragosí @albertcuesta]

16.000 milions de credencials filtrades.

Canvieu la contrasenya de Google.

I la d'Apple.

Ara.

Feu-me cas.

[Catalunya Ràdio @CatalunyaRadio]

El ruc català, una espècie en perill d'extinció: a tot Catalunya en queden entre 350 i 400 de registrats #SenseFronteresCatRàdio
https://t.co/de97H9jmcs

[Anna Saballs @AnnaSaballs]

"Estem protegint les balenes, els dofins, tot lo que tu vulguis, però del que tenim aquí al país, sembla que passem de tot."

Meravelloses declaracions. Extrapolable a tot.

[internet hall of fame @InternetH0F]

The cost to be a decent person is $0

[Xavier Abad MdG🎗 @XavierAbadMdG]

Interessant aquest enfilall que resumeix una entrevista d'un molt reconegut viròleg sobre la #virologia, els virolegs, les dades disponibles sobre l'#origen del #SARSCoV2, la polèmica #GoF, i la comunicació científica; #scicomm. Un resum, molt resum?
"Scientist can also lie".

[Carme Fenoll @CarmeFenoll]

👏 Entre les 💯 dones catalanes més influents a la llista Forbes, hi ha moltes figures destacades de la UPC:
- la física @prats_clara, -l'enginyera informàtica @KarinagibertK 👇(1/3) https://t.co/TIl3BlC9Z2

[Riojaberón/❤️ @riojaberon]

En este #apagón salen los expertos iluminados en #cortedeluz, red eléctrica y cables sueltos.

Pero hagamos caso a los expertos de verdad como Jorge Morales experto en energía; porque tenemos a los mejores profesionales y tenemos una Red Eléctrica muy preparada.
Explicación:

[JAMA Internal Medicine @JAMAInternalMed]

From @JAMA_current: The SPIRIT 2025 statement updates the guidelines for randomized trial protocols to enhance their completeness, transparency, and consistency, benefiting stakeholders involved in clinical research.

https://t.co/qjMlO6xABi

[Albert Mateos Poch @MateosPoch]

Final de temporada compromès
I jo almenys, faré costat a l'equip, en aquest darrers 5 partits d'infart, a pesar de que no ha rendit lo esperat i desitjat
Cal recolçar, per sobre de tot, al club que sentim des de sempre, i ara, a aquest GironaFC que volem que segueixi sent de 1era