Patrick Howlett

‘Exodus’ of clinical researchers sparks concern over future of UK healthcare Lack of incentives is driving down the number of clinical researchers in Britain

Is an ‘exodus’ of clinical researchers threatening the future of UK healthcare?

“For young NHS clinicians coming through they are often not rewarded for what they’ve done in science whereas they used to be." – Prof Graham Cooke spoke to @financialtimes.com

www.ft.com/content/c4fa...

❤️ 🤝 collaboration with colleagues in UCT 🇿🇦, OK International 🇺🇸 and Kibong'oto (Tanzania) 🇹🇿

5) We can + must do more; starting with primary prevention.

Silica dust is main driver of disease

Pilot studies show levels can be ⬇️ 80-99% at low cost ($1000-5000 per mine)

What are we waiting for?

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@imperialnhli.bsky.social @imperialcollegeldn.bsky.social @thelancetph.bsky.social

3) Its under-researched; 6 basic science TB/silica papers in last 25 years... research being done largely unfunded + by in-country teams...

4) Disease has socioeconomic and political roots; mining has moved to lower income countries due to cost; demand will ⬆️ with electrification

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We argue:

1) There is a larger disease burden than we think; possibly 1 in 25 TB cases globally

2) Very high disease estimates - between 1 in 8 (!) and 1 in 50 miners having microbiological TB - are plausible given ⬆️⬆️ high silica exposures of 4 to 2400x the US max permissible exposure limits

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Confronting the growing epidemic of silicosis and tuberculosis among small-scale miners An estimated 49·5 million small-scale miners worldwide are exposed to high concentrations of silica during their work. The substantial morbidity and mortality of silicosis and tuberculosis among worke...

A day late for #worldtbday and published a couple of weeks ago...

www.thelancet.com/journals/lan...

We argue that we are failing to engage with a growing problem of lung disease - TB and silicosis mainly - in small-scale and informal miners

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@abdullahbashir.bsky.social grateful to be your first follower 🙏😌

👋

Report for: Altered IL-6 signalling and risk of tuberculosis: a multi-ancestry mendelian randomisation study In the top 5% of all research outputs scored by Altmetric

I've only just noticed that BlueSky is being reported by Altmetric: www.altmetric.com/details/1709...

Feels like a significant development.

#BTSWinter2024 two of the best talks I’ve heard in a long time from Esther Robinson and Gerry Davies at the TB Symposium… looking forward to the next by Celso Khosa

#BTSWinter2024

Fascinating stuff from Prof Ducharme at BPRS joint session - ongoing airway subclinical disease in those with asthma remission in childhood. Could this be the small airways disease subgroup…?

I constantly hear people say we need a prevention first approach. But I see no action or investment. Will this change? I could implement evidence based lifestyle medicine interventions tomorrow that would make a massive difference to my patients. But I'm told there's no time or money. #BTSWinter2024

One thing I would say missed in the possible future - @thekingsfund.bsky.social - no mention of preventing people’s respiratory illness affected by work. Often overlooked despite attributable fraction often 10-20% of all Resp diseases

#BTSWinter2024

On now #BTSWinter2024

Sarah Woolnough from @thekingsfund.bsky.social showing us a possible future for the respiratory world

Telling us health inequalities have the greatest effect on respiratory diseases among all health outcomes - this is our problem to own

Closely followed by more silicosis…

Silicosis is under diagnosed on CXR - sensitivity 0.76 compared to HRCT and 0.50 compared to autopsy on meta-analysis

Silicosis and TB screening among small scale miners is achievable at a cost of £17-21 per person

Welcome to the #BTSWinter2024!

So far this morning from occupational lung disease world

Journal club
- artificial stone silicosis in the uk
- high prevalences with dose response of autoimmune markers in Silica exposures
- organic exposures lead to HP and ILDs in the enviable Danish work cohort

That’s it! I hope to see you at #BTSWinter2024 Come and say hi!
21/21 /end brit-thoracic.org.uk/education-an...

Also, Demon Copperhead by Barbara Kingsolver - modern America!

Strong recommend on this!

Altered IL-6 signalling and risk of tuberculosis: a multi-ancestry mendelian randomisation study Our findings propose a causal relationship between reduced IL-6 signalling and lower risk of tuberculosis, akin to the effect seen in other IL-6 mediated diseases. This study suggests that IL-6 antago...

NEW PAPER! Work led by @gushamilton.bsky.social and @gpollara.bsky.social finds reduced IL-6 signalling may REDUCE risk of TB disease

Challenges idea that IL-6 plays essential role in immunity to Mtb, and suggests that IL-6 drives immunopathology

Great use of data from ITHGC

#IDSky #EpiSky

Very important finding from Joowhan Sung and Emily Kendall, presented at the Asymptomatic TB session at the #TBUnion conference last week!

We host monthly online international journal clubs on the latest #tuberculosis literature. We welcome researchers, clinicians, and anyone else interested in #TB - eepurl.com/hO4D79 to join the mailing list & hear about future meetings.

My first proper Bluesky post…

Has anyone (ever?) submitted an article and not had it returned for some small change to be made before processing?

#MedSky
#Academiclyf

#NGFeed ?

I am here!