Teddy Tun Win HLA
@teddyhla.bsky.social
- intensive care medicine specialist registrar in London with an interest in cardio respiratory failure #ECMO
- data scientist in health sector
[own views / not related to employer]
- data scientist in health sector
[own views / not related to employer]
Reposted by Teddy Tun Win HLA
Firstly, do no (net) harm.
~ (adapted from) Hippocrates
Reading Hunink et al (2014) this morning…
~ (adapted from) Hippocrates
Reading Hunink et al (2014) this morning…
November 10, 2025 at 1:52 PM
Firstly, do no (net) harm.
~ (adapted from) Hippocrates
Reading Hunink et al (2014) this morning…
~ (adapted from) Hippocrates
Reading Hunink et al (2014) this morning…
🧐
Fascinating paper suggesting the assumption that there is a sigmoid dose response relationship and threshold effect ( "all-or-nothing") for loop diuretics rests on repeated misinterpretation of original studies from the 70s and 80s. #nephsky #cardiosky #emimcc academic.oup.com/ehjcvp/artic...
What are the pharmacodynamics of loop diuretics?
A recent editorial was entitled ‘Loop diuretics in heart failure: few facts and lots of prejudice’.1 I would argue that we have forgotten or distorted some
academic.oup.com
November 9, 2025 at 8:10 PM
🧐
Reposted by Teddy Tun Win HLA
So a recent Veritasium video on natural selection explains kin selection and does the unavoidable thing of saying that a parent shares "half of its genes with the child". This is wrong, because for any 2 humans, we share almost all of our genes. We share more than 95% with chimpanzees ffs. >>
November 4, 2025 at 3:44 PM
So a recent Veritasium video on natural selection explains kin selection and does the unavoidable thing of saying that a parent shares "half of its genes with the child". This is wrong, because for any 2 humans, we share almost all of our genes. We share more than 95% with chimpanzees ffs. >>
Reposted by Teddy Tun Win HLA
This honestly should be required reading for anyone undertaking (or evaluating) exploratory studies... ⬇️👍 (It's proper funny too 😅)
Which reminds me of this old classic on the Noise Miners.
“'Noise mining is a funny thing,' he said. 'When you first see a bit of noise, it doesn’t look so impressive. But as you work it out of the rock, it gets more and more refined.' This process, he explained, is called 'shucking.'"
“'Noise mining is a funny thing,' he said. 'When you first see a bit of noise, it doesn’t look so impressive. But as you work it out of the rock, it gets more and more refined.' This process, he explained, is called 'shucking.'"
October 30, 2025 at 10:05 AM
This honestly should be required reading for anyone undertaking (or evaluating) exploratory studies... ⬇️👍 (It's proper funny too 😅)
Reposted by Teddy Tun Win HLA
NEW paper "Clinical prediction models using machine learning in oncology: challenges and recommendations"
--> tinyurl.com/2h2mcy5h
#machinelearning #prediction #statssky #MLsky #methodsmatter
--> tinyurl.com/2h2mcy5h
#machinelearning #prediction #statssky #MLsky #methodsmatter
October 30, 2025 at 8:38 AM
NEW paper "Clinical prediction models using machine learning in oncology: challenges and recommendations"
--> tinyurl.com/2h2mcy5h
#machinelearning #prediction #statssky #MLsky #methodsmatter
--> tinyurl.com/2h2mcy5h
#machinelearning #prediction #statssky #MLsky #methodsmatter
Cool cake
Are you hungry for some Shigella news? Why not come to the 1st International Shigella meeting www.shigella2026.conferences-pasteur.org/home 20-24 April 2026 Paris
October 30, 2025 at 4:30 PM
Cool cake
Reposted by Teddy Tun Win HLA
Which reminds me of this old classic on the Noise Miners.
“'Noise mining is a funny thing,' he said. 'When you first see a bit of noise, it doesn’t look so impressive. But as you work it out of the rock, it gets more and more refined.' This process, he explained, is called 'shucking.'"
“'Noise mining is a funny thing,' he said. 'When you first see a bit of noise, it doesn’t look so impressive. But as you work it out of the rock, it gets more and more refined.' This process, he explained, is called 'shucking.'"
October 30, 2025 at 9:24 AM
Which reminds me of this old classic on the Noise Miners.
“'Noise mining is a funny thing,' he said. 'When you first see a bit of noise, it doesn’t look so impressive. But as you work it out of the rock, it gets more and more refined.' This process, he explained, is called 'shucking.'"
“'Noise mining is a funny thing,' he said. 'When you first see a bit of noise, it doesn’t look so impressive. But as you work it out of the rock, it gets more and more refined.' This process, he explained, is called 'shucking.'"
Reposted by Teddy Tun Win HLA
Remembering the most likely mediator of reduced mortality in the original EGDT therapy was the presence of the CI in the intervention arm, the regular attendance of an interested and informed clinician (and skilled ICU nurse) likely has a bigger impact than any single drug or intervention.
"One intangible advantage of capillary refill time is that performing it brings the clinician back to the bedside to reassess the patient. This act may be itself the holy grail of early sepsis management."
great piece on #sepsis
great piece on #sepsis
💬 Editorial: While capillary refill time shows promise for early #SepticShock management, integrating it into broader, multimodal resuscitation strategies remains key to improving outcomes.
#LIVES2025 @esicm.bsky.social
ja.ma/4hAs5u7
#LIVES2025 @esicm.bsky.social
ja.ma/4hAs5u7
October 29, 2025 at 4:08 PM
Remembering the most likely mediator of reduced mortality in the original EGDT therapy was the presence of the CI in the intervention arm, the regular attendance of an interested and informed clinician (and skilled ICU nurse) likely has a bigger impact than any single drug or intervention.
Reposted by Teddy Tun Win HLA
💬 Editorial: The BICARICU-2 trial finds IV sodium bicarbonate may delay or reduce kidney replacement therapy in #criticallyill patients with severe #acidemia and #AKI, but its effect on mortality remains uncertain.
#LIVES2025 @esicm.bsky.social
ja.ma/47NwK8E
#LIVES2025 @esicm.bsky.social
ja.ma/47NwK8E
October 29, 2025 at 1:25 PM
💬 Editorial: The BICARICU-2 trial finds IV sodium bicarbonate may delay or reduce kidney replacement therapy in #criticallyill patients with severe #acidemia and #AKI, but its effect on mortality remains uncertain.
#LIVES2025 @esicm.bsky.social
ja.ma/47NwK8E
#LIVES2025 @esicm.bsky.social
ja.ma/47NwK8E
Reposted by Teddy Tun Win HLA
ANDROMEDA-SHOCK-2 is up next…. this looks at personalised phenotype-based, capillary refill time (CRT) targeted resuscitation in early septic shock, comparing to standard resuscitation. It is large (86 centres, 19 countries).
Read it free from JAMA: tinyurl.com/mjcj8s5w
#Lives2025 #criticalcare
Read it free from JAMA: tinyurl.com/mjcj8s5w
#Lives2025 #criticalcare
Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock
This randomized clinical trial examines whether a personalized hemodynamic resuscitation protocol targeting capillary refill time was more effective than usual care in patients with early septic shock...
tinyurl.com
October 29, 2025 at 2:02 PM
ANDROMEDA-SHOCK-2 is up next…. this looks at personalised phenotype-based, capillary refill time (CRT) targeted resuscitation in early septic shock, comparing to standard resuscitation. It is large (86 centres, 19 countries).
Read it free from JAMA: tinyurl.com/mjcj8s5w
#Lives2025 #criticalcare
Read it free from JAMA: tinyurl.com/mjcj8s5w
#Lives2025 #criticalcare
Reposted by Teddy Tun Win HLA
EVERDAC is hot off press @esicm.bsky.social #Lives2025 in @nejm.org open access currently:
www.nejm.org/doi/full/10....
Reports that in (non-blinded trial) patients with shock, management *without* early a-line insertion was noninferior to early catheter insertion…. #Lives2025 #criticalcare
www.nejm.org/doi/full/10....
Reports that in (non-blinded trial) patients with shock, management *without* early a-line insertion was noninferior to early catheter insertion…. #Lives2025 #criticalcare
Deferring Arterial Catheterization in Critically Ill Patients with Shock | NEJM
In patients with shock, whether noninvasive blood-pressure monitoring is an effective
alternative to the recommended use of an arterial catheter is uncertain. In this multicenter,
open-label, nonin...
www.nejm.org
October 29, 2025 at 1:40 PM
EVERDAC is hot off press @esicm.bsky.social #Lives2025 in @nejm.org open access currently:
www.nejm.org/doi/full/10....
Reports that in (non-blinded trial) patients with shock, management *without* early a-line insertion was noninferior to early catheter insertion…. #Lives2025 #criticalcare
www.nejm.org/doi/full/10....
Reports that in (non-blinded trial) patients with shock, management *without* early a-line insertion was noninferior to early catheter insertion…. #Lives2025 #criticalcare
In light of the art line trial. Interesting result. Need to read in depth. We really have gone full circle. A lot reflects on my practice and how I have grown up doing icu 2016 on wards and the UK practice. Back in those days, icu is a place where things are done “properly” @drfreeze.bsky.social 1/n
well, gonna have to read this
New RCT: Avoiding A-line in shock didn't affect mortality (trend towards *reduction*) & decreased line complications
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
They avoided A-lines despite patients requiring pretty substantial doses of vasopressors
Very #zentensivist
Don't need to rush to an A-line
www.nejm.org/doi/full/10.... #EMIMCC
October 29, 2025 at 3:33 PM
In light of the art line trial. Interesting result. Need to read in depth. We really have gone full circle. A lot reflects on my practice and how I have grown up doing icu 2016 on wards and the UK practice. Back in those days, icu is a place where things are done “properly” @drfreeze.bsky.social 1/n
Reposted by Teddy Tun Win HLA
📚 Development and Validation of the Sequential Organ Failure Assessment (SOFA)-2 Score:
Presented today in the #LIVES2025 Hot Topics session.
🔗 Free to read online: ja.ma/4qzouAz
Presented today in the #LIVES2025 Hot Topics session.
🔗 Free to read online: ja.ma/4qzouAz
October 29, 2025 at 1:15 PM
📚 Development and Validation of the Sequential Organ Failure Assessment (SOFA)-2 Score:
Presented today in the #LIVES2025 Hot Topics session.
🔗 Free to read online: ja.ma/4qzouAz
Presented today in the #LIVES2025 Hot Topics session.
🔗 Free to read online: ja.ma/4qzouAz
Reposted by Teddy Tun Win HLA
From @jamanetworkopen.com: The SOFA-2 score updates the 1996 Sequential Organ Failure Assessment, reflecting current definitions, variables, and thresholds to grade organ dysfunction in critically ill adults receiving intensive care.
#LIVES2025 @esicm.bsky.social
ja.ma/3JuguA7
#LIVES2025 @esicm.bsky.social
ja.ma/3JuguA7
October 29, 2025 at 1:15 PM
From @jamanetworkopen.com: The SOFA-2 score updates the 1996 Sequential Organ Failure Assessment, reflecting current definitions, variables, and thresholds to grade organ dysfunction in critically ill adults receiving intensive care.
#LIVES2025 @esicm.bsky.social
ja.ma/3JuguA7
#LIVES2025 @esicm.bsky.social
ja.ma/3JuguA7
Who’s watching
Trials coming up at #esicm #lives2025
I am by far most interested in #andromedashock2.
The usual yearly sweepstakes apply ping @avkwong.bsky.social @redneeraj.bsky.social
I think all of those trials will be “positive”.
Your thoughts?
I am by far most interested in #andromedashock2.
The usual yearly sweepstakes apply ping @avkwong.bsky.social @redneeraj.bsky.social
I think all of those trials will be “positive”.
Your thoughts?
October 28, 2025 at 3:33 PM
Who’s watching
Reposted by Teddy Tun Win HLA
We now have a stream of garbage in US newspapers, like this one in @washingtonpost.com denigrating London, all coded attacks on @zohrankmamdani.bsky.social
Well, I live in London, love it, and am delighted to have Sadiq Khan @london.gov.uk as my mayor.
www.washingtonpost.com/opinions/202...
Well, I live in London, love it, and am delighted to have Sadiq Khan @london.gov.uk as my mayor.
www.washingtonpost.com/opinions/202...
Opinion | London’s sad decline is a warning to New Yorkers
In three terms as mayor, Sadiq Khan has crushed the economic life out of Britain’s capital.
www.washingtonpost.com
October 27, 2025 at 4:55 PM
We now have a stream of garbage in US newspapers, like this one in @washingtonpost.com denigrating London, all coded attacks on @zohrankmamdani.bsky.social
Well, I live in London, love it, and am delighted to have Sadiq Khan @london.gov.uk as my mayor.
www.washingtonpost.com/opinions/202...
Well, I live in London, love it, and am delighted to have Sadiq Khan @london.gov.uk as my mayor.
www.washingtonpost.com/opinions/202...
Reposted by Teddy Tun Win HLA
Because 40 minutes and no slides is my ideal session length and format…. I’m back for another clinical debate! This time on considerations around timing of intubation for invasive ventilation for patients already on non-invasive treatment 🫁 @esicm.bsky.social #Lives2025
October 27, 2025 at 9:29 AM
Because 40 minutes and no slides is my ideal session length and format…. I’m back for another clinical debate! This time on considerations around timing of intubation for invasive ventilation for patients already on non-invasive treatment 🫁 @esicm.bsky.social #Lives2025
Reposted by Teddy Tun Win HLA
🌟 Congratulations to Professor Maurizio Cecconi, recipient of the 𝟮𝟬𝟮𝟱 𝗘𝗦𝗜𝗖𝗠 𝗦𝗼𝗰𝗶𝗲𝘁𝘆 𝗠𝗲𝗱𝗮𝗹 for his outstanding contributions in #IntensiveCare!
As ESICM President (2020–2022), he led with vision through COVID-19 & drove initiatives like C19_SPACE, ICF, Airspace & the first Datathons.
#LIVES2025
As ESICM President (2020–2022), he led with vision through COVID-19 & drove initiatives like C19_SPACE, ICF, Airspace & the first Datathons.
#LIVES2025
October 27, 2025 at 6:35 PM
🌟 Congratulations to Professor Maurizio Cecconi, recipient of the 𝟮𝟬𝟮𝟱 𝗘𝗦𝗜𝗖𝗠 𝗦𝗼𝗰𝗶𝗲𝘁𝘆 𝗠𝗲𝗱𝗮𝗹 for his outstanding contributions in #IntensiveCare!
As ESICM President (2020–2022), he led with vision through COVID-19 & drove initiatives like C19_SPACE, ICF, Airspace & the first Datathons.
#LIVES2025
As ESICM President (2020–2022), he led with vision through COVID-19 & drove initiatives like C19_SPACE, ICF, Airspace & the first Datathons.
#LIVES2025
I would be really impressed w/ clusters from a set of variables, where the clusters are interesting (not just high/low/mix), w/ demonstrated stability, that can predict some other completely separate variable (other measurement scheme, domain) in a way that makes sense.
But I've never seen this...
But I've never seen this...
October 28, 2025 at 1:19 AM
Spot on
October 23, 2025 at 10:00 AM
Spot on
Great advice as always
I would normally not have batted an eye at this paper
But it’s by Robert Hahn, and is a nice overview of everything we know about fluid redistribution in the critically unwell- including gel phase, some glycocalyx stuff, 3 compartment models, and albumin escape rates
#foamed
But it’s by Robert Hahn, and is a nice overview of everything we know about fluid redistribution in the critically unwell- including gel phase, some glycocalyx stuff, 3 compartment models, and albumin escape rates
#foamed
Where does the fluid go?
💦 morphological changes/damage by fluid overload
🛌 fluid distribution in anesthesia
3️⃣ extracellular fluid compartments
💧 physiology, manipulation & max filling of slow-exchange fluid space
🔥 inflammation, capillary leakage & lymphatic flow 💦
🥚 albumin
🔓 rdcu.be/eLnfi
💦 morphological changes/damage by fluid overload
🛌 fluid distribution in anesthesia
3️⃣ extracellular fluid compartments
💧 physiology, manipulation & max filling of slow-exchange fluid space
🔥 inflammation, capillary leakage & lymphatic flow 💦
🥚 albumin
🔓 rdcu.be/eLnfi
October 18, 2025 at 6:16 PM
Great advice as always
Through the looking glass! This blog talk about having to pay for “AI humaniser” because your original written text comes across as “AI generated” : ai.gopubby.com/when-ai-dete...
When AI Detectors Do More Harm Than Good
Why tools meant to protect human creativity may actually be undermining it
ai.gopubby.com
October 18, 2025 at 10:37 AM
Through the looking glass! This blog talk about having to pay for “AI humaniser” because your original written text comes across as “AI generated” : ai.gopubby.com/when-ai-dete...
Reposted by Teddy Tun Win HLA
😱
Finally, a science reform we can all endorse!
Next time an institution tells you how seriously it takes research misconduct, ask them if it's *this* seriously. www.bmj.com/content/297/...
October 14, 2025 at 6:36 AM
😱
Reposted by Teddy Tun Win HLA
Well done Shafaq Aftab. When a reviewer stole her work and published it under his own name, she fought for a YEAR to get the journal to retract the paper. Just wondering why it took Wiley a YEAR to do this. 🧪 #academicsky
retractionwatch.com/2025/10/03/w...
retractionwatch.com/2025/10/03/w...
Wiley retracts study stolen by reviewer, following Retraction Watch coverage
A Wiley journal has retracted a paper more than a year after a researcher reported the work was hers and had been stolen by a reviewer for another journal. As we reported in July, Shafaq Aftab, now…
retractionwatch.com
October 12, 2025 at 4:57 AM
Well done Shafaq Aftab. When a reviewer stole her work and published it under his own name, she fought for a YEAR to get the journal to retract the paper. Just wondering why it took Wiley a YEAR to do this. 🧪 #academicsky
retractionwatch.com/2025/10/03/w...
retractionwatch.com/2025/10/03/w...