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MyTEMP is one of the most important pragmatic trials ever done in nephrology, and though it was negative, it definitively answered the question asked and lights the way to how we find better ways to dialyze patients.

Check out the podcast, it's good.

nephjc.com/freelyfiltered/56/m

Black service members who served in wars, were often denied access to the GI Bill when they returned.

So white veterans could get loans for college, or to buy a house. Black veterans could not. This lack of access to affordable education and affordable housing had devastating impacts on Black veteran homelessness.

npr.org/2022/10/18/1129735948/

Black veterans were also denied access to medical care and benefits. This lack of access to healthcare also drove homelessness.

m.youtube.com/watch?v=9XEj1AL9

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@calimari Hello and welcome to Mastodon! I'm Sage, and I love to take photos of tide pool creatures. Here's a picture of a Horned Nudibranch I took recently.

I see the impact of microplastics on every beach I visit. Water bottles, plastic rope, foam containers, even frisbees and sun visors are everywhere. And worse, when you look closely at the sand, it's thousands of tiny specs of plastic.

Sea creatures (and everyone on earth!) are harmed by microplastics. We all have to do our part to eliminate plastic use.
#microplastics #plastics

Still looking for a job. The market's been rougher to me than it's ever been since I came out publicly as trans.
My record?
6 years 0 breaches.
I was part of the security leadership team that helped get 1Password to a 6.8 billion USD valuation.
DFIR, infrasec, infraops, I got you.
Please reach out.

The only "agenda" transgender people have is the right to exist.

"A large RCT in the community in Bangladesh found face masks reduced the risk of infection by 11% overall and 35% in people over 60 years. In contrast, in hospitals, N95 reduce risk by 67% against bacterial infections and 54% against viral infections."

Well-argued plain-language summary of randomised trials of masks

t.co/3DGTuCRKV4

After several years
of living with
a dangerous respiratory pathogen
one would think
that we would be prepared
for the threat of another
after all, we have had time
to perfect mitigation techniques
one would think
we would be prepared
yes, one would think that.

Once again a patient with upper respiratory symptoms just told me they do not have Covid because they had a negative home Covid test. A positive test is pretty reliable in saying Covid is present but a negative test (especially if not doing serial tests) does not rule out Covid. Still limit contact with others and wear a high quality mask. Even if not Covid, there is no point in spreading other viruses to others.

Tracking media coverage of today's action.

CTV/City TV VIDEO:
cp24.com/mobile/news/protest-o

✨️ Summary:
The Shelter and Housing Justice Network is holding a protest today in front of Toronto City Hall, calling for more supports for social housing and shelter in the city.

The housing and homelessness advocacy network has planned the sit-in protest and vigil for 11:30 a-m, adding there will be speakers at the event.

It comes after last week's extreme cold that brought wind chill values between minus 30 and minus 40 Celsius across much of southern and eastern Ontario.

The City of Toronto said on Friday it had increased capacity at its shelters and warming centres, and had directed workers in the system to not turn anyone away during the extreme cold.

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Dept of research that fits my bias

jamanetwork.com/journals/jamai in JAMAIM

Intensity of pre-transplant CAD work up (varying from 24 to 56% at centre level) and post #transplant outcomes to 30 days.

Doesn’t matter!

@cmclase @hswapnil pts 1,25 dihydroxyvit D was 40s so I figure can try to suppress that with either fluconazole or hydroxychloroquine off-label for more “targeted” treatment than bispnosphonates. Side note: she has excellent bone density…again would have been great to have a dx of FHH. Checked a ACE level (high of course w/no evidence of disease anywhere…why did I check it??) She agreed to give hydroxychloroquine a shot as a next step... will see if any response. Still needs a cscope done.

@cmclase @hswapnil thanks Catherine
For the input and tips on using mastodon!

I didn’t mention that this patient was heterozygous for a SLC34A3 variant Ser192Leu on the genetic testing. This causes increased risk of hypercalciuria (which are pt doesn’t have) due to low serum phos stimulating calcitriol synthesis. Bialleic cases have been described w/hypercalcemia but not monoalleic cases. I don’t feel this pts case is explained by that mutation but may be contributing medrxiv.org/content/10.1101/20

Risk of Nephrolithiasis in adults heterozygous for SLC34A3 Ser192Leu in an unselected health system cohort

Homozygous or compound heterozygous mutations in solute carrier family 34, member 3 ( SLC34A3 ) cause hereditary hypophosphatemic rickets with hypercalciuria (HHRH). Patients heterozygous for SLC34A3 pathogenic variants may be at increased risk for renal calcification but reports have been mostly limited to family members of patients with autosomal recessive HHRH. To determine the phenotypic spectrum of SLC34A3 Ser192Leu, we examined the most pathogenic SLC34A3 variant Ser192Leu (238 out of 174,417 participants) in an unselected, health system-based research cohort in central and northeast Pennsylvania. SLC34A3 Ser192Leu heterozygotes had higher risks of nephrolithiasis ICD diagnosis (13% vs. 6%), hypophosphatemia <2.5 mg/dL (31/96 [32%] vs. 6226/39636 [16%]), lower eGFR (−4.43, 95% CI: −7.03, −1.83; p=0.001) and tended to have higher prevalence of kidney/liver cyst ICD codes (5% vs. 3%; p=0.09), compared to controls. Further studies are needed to determine whether personalized approaches (i.e. phosphate supplementation) to patients heterozygous for SLC34A3 pathogenic variants can reduce kidney stone burden and risk of kidney function decline. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The patient enrollment and exome sequencing were funded by the Regeneron Genetics Center. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The ethics committee/IRB of Geisinger Medical Center gave ethical approval for this work, and participants completed informed consent in the Geisinger MyCode/DiscovEHR study I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present work are available upon reasonable request to the authors and subject to a data use agreement.

www.medrxiv.org

@cmclase thanks! Trying to see if I’m missing any zebras. With low calcium excretion I thought I’d pick up FHH. Genetic testing neg for FHH. Thought of the pheo zebra (some secrete calcitonin)…plasma metanephrines wnl. Parathyroid scan neg (I know it’s not 100%), i empirically gave cinacalcet and no improvement in calcium. Vit A wnl. Cystatin c eGFR is lower at 38 but don’t think would have hypercalcemia w/secondary hyperpara…

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