The Scots took over Boston bars and sang "Take Me Home, Country Roads"

Gustavo Alfaro, the Paraguay coach, puts defeat down to the "complexity" of the US approach. "They dominated tactically, technically and physically... they create a pentagon in midfield... they have a solution to every problem".

Opening Statement. 🇺🇸

I know Paraguay, homefield, etc. but that was literally the best half of World Cup soccer for the USMNT in 96 years.

Maybe the foreigners have it right. Maybe the eagle and the flyover and the canyon and the kindness of a stranger with car keys really are worth crossing an ocean to see. Maybe, watching them fall in love with the place we take for granted, we could fall in love with it again ourselves and decide to be a little more charitable to the neighbor God told us to love, even when we cannot stand how he votes. ewerickson.substack.com/p/th…

ARISE-FLUIDS has arrived and it's awesome 🥳 For over a decade, the Surviving Sepsis Guidelines recommended that septic patients get at least 30 cc/kg fluid. In the United States, these guidelines were weaponized into performance metrics, pressuring clinicians to prescribe arbitrary volumes to every patient. Evidence-based clinicians have LONG known that this guideline lacked evidentiary support. For example, I've attached a picture of a blog I wrote about this back in 2017. Despite the lack of evidentiary support and some evidence of harm, the Surviving Sepsis Guidelines INSISTED on perpetually recommending 30 cc/kg fluid resuscitation. We finally have a prospective RCT demonstrating that mandating early administration of 30 cc/kg fluid (as compared to early vasopressors) doesn't help and may actually cause harm. It's important to note that all of the hard endpoints in this trial were neutral (e.g., mortality, days free of organ support). I still think that 30 cc/kg fluid is a pretty reasonable volume of fluid for *most* patients. But the study does suggest that giving too much fluid may promote edema - so we should be *thoughtful* about this intervention rather than mandating it for every septic patient. Based on the subgroup analysis, the fluid-conservative strategy may have helped the subgroup of pneumonia patients the most. This is statistically nonsignificant but aligns with my expectation. ARDSy patients often don't respond well to fluid. (In contrast, I really doubt that a liter of fluids in either direction matters for most urosepsis patients.) This is a great example of the over-reach of guidelines and protocoled medicine. People get all upset about practice variation, so sometimes they try to stomp it out using guidelines and protocols. But these guidelines are highly fallible, so what may occur is that you standardize care in a way that harms everyone equally. 🤦‍♂️

High-Dose Vitamin C in Burns Time to Stop? 🆕🔥🟢VICTORY RCT High-dose intravenous vitamin C did not reduce mortality and organ dysfunction and may be associated with harm in patients with severe burn injury The primary composite outcome of 28-day mortality and persistent organ dysfunction occurred in 40.8% of patients in the intravenous vitamin C group compared with 29.7% in the placebo group jamanetwork.com/journals/jam…

The Patrouille de France flying over the Statue of Liberty today. What a symbol. 250 years of shared history.

Inspiring development to the Brendan Sorsby story. Remember, kids: Always bet on yourself.

A major reason that it didn’t make sense to use AI to write an essay about a substantive topic is that until you write the essay you don’t actually know what you want to say or what you think. You think you do, but it is the writing itself that actually gets the thinking done.

Here is a gift link, if you want to hear my argument for why "the cultural and economic dynamics of marriage have changed because the “reservation wage” for women looking for men has gone up" -- and how we could help make young men more marriageable! thedispatch.com/article/marr…

This shit was 100x a bigger issue to address than expanding the tournament. We are losing college sports.

Stop sending urine culture for nosocomial fever workup 🔴 🌟Cystitis doesn't cause fever 🌟Urine from cath is NOT sterile 🌟( ) Urine culture # Infection #IDXposts #mustpost

A significant number of patients on azole therapy have undetectable levels, highlighting important role for TDM and pharmacist expertise. #MADIDxSIDP2026

RT @ABsteward: 🔥Our article in EJHP is now published🔥🌟s @drgabx @BradSpellberg “Universal high-dose meropenem for antimicrobial-resistant…

The National Guard arriving at Oxford during halftime

📣 New publication: Andes hantavirus outbreak on a cruise ship - an ESCMID Emerging Infections Subcommittee (EIS) rapid assessment clinicalmicrobiologyandinfec…

I finally lost it on the departmental AI survey.

At @JAMA_current today, 2 radiologists publish what should be the consent form for a total body MRI in healthy people Note: "no major medical society recommends whole-body MRI screening in the general population because it is unproven, and the harms likely outweigh the benefits." jamanetwork.com/journals/jam…