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@mackins

Retired doctor

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24.11.2023
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Latest posts by @mackins

A photo realistic close-up of a mixed selection of biscuits, including chocolate fingers, chocolate digestives, and a lemon puff

A photo realistic close-up of a mixed selection of biscuits, including chocolate fingers, chocolate digestives, and a lemon puff

The mastery of artist Harry Wingfield.
‘Biscuits ’
(Yes, it is a painting - from First Picture Book, 1970)

04.03.2026 20:26 👍 451 🔁 69 💬 11 📌 6
A map shows the locations of BTO satellite tagged Cuckoos in Africa. The headshots of four Cuckoos appear in circular frames around the map, alongside the wording: First Cuckoo Update for 2026.

A map shows the locations of BTO satellite tagged Cuckoos in Africa. The headshots of four Cuckoos appear in circular frames around the map, alongside the wording: First Cuckoo Update for 2026.

1/ And they’re off! 📢 Our BTO satellite-tagged Cuckoos are on the move! 🌍

Follow their migrations via our interactive map ➡️ www.bto.org/cuckoos #Ornithology 🪶

03.03.2026 18:07 👍 146 🔁 46 💬 2 📌 6

The first mention of the internet appears in Shakespeare. King Lear, Act Two, scene one:

Lear: why, fie sir!

28.02.2026 09:22 👍 94 🔁 21 💬 4 📌 1
A map of England, Scotland and Wales, showing the alignment of “the three norths”, which has moved through England over the last couple of years and is about to go into the North Sea. The movement is shown by a blue line.

A map of England, Scotland and Wales, showing the alignment of “the three norths”, which has moved through England over the last couple of years and is about to go into the North Sea. The movement is shown by a blue line.

This is cool. The three norths (True, Grid, Magnetic) met in Dorset in November 2022, worked their way northwards in tandem, and are now about to leave England and go hand in hand into the North Sea.

www.ordnancesurvey.co.uk/news/three-n...

12.12.2025 17:13 👍 128 🔁 52 💬 10 📌 4
We shed as we pick up, like travellers who must carry everything in their arms, and what we let fall will be picked up by those behind. The procession is very long and life is very short. We die on the march. But there is nothing outside the march so nothing can be lost to it. The missing plays of Sophocles will turn up piece by piece, or be written again in another language … You do not suppose, my lady, that if all of Archimedes had been hiding in the great library of Alexandria, we would be at a loss for a corkscrew?

We shed as we pick up, like travellers who must carry everything in their arms, and what we let fall will be picked up by those behind. The procession is very long and life is very short. We die on the march. But there is nothing outside the march so nothing can be lost to it. The missing plays of Sophocles will turn up piece by piece, or be written again in another language … You do not suppose, my lady, that if all of Archimedes had been hiding in the great library of Alexandria, we would be at a loss for a corkscrew?

From Stoppard’s Arcadia:

29.11.2025 20:29 👍 190 🔁 58 💬 0 📌 7
Preview
The deck of cards that is frailty Looking at frailty is a question of perspective, obviously, doh

A commentary on frailty from me. open.substack.com/pub/shibley/...
@emmavardy2.bsky.social

03.09.2025 08:34 👍 2 🔁 2 💬 0 📌 1
Preview
A blood-based epigenetic clock for intrinsic capacity predicts mortality and is associated with clinical, immunological and lifestyle factors - Nature Aging Fuentealba and colleagues build and validate a DNA methylation clock of intrinsic capacity (IC) to bridge resource-intensive clinical assessments of IC with molecular readouts of aging, highlighting s...

A blood-based #epigenetic clock for intrinsic capacity predicts mortality and is associated with clinical, immunological and #lifestyle factors

"...a validated tool bridging molecular readouts of #aging and clinical assessments of #IC..."

#IntrinsicCapacity #Frailty

www.nature.com/articles/s43...

10.06.2025 05:29 👍 3 🔁 2 💬 0 📌 0

A short 🧵

In a remote corner of Arctic Alaska, archaeologists have unearthed blue glass beads at sites like Punyik Point.
1/5

21.05.2025 17:43 👍 125 🔁 47 💬 3 📌 9

Sir Edward Grey, 1916:

"If the world cannot organise against war, if war must go on, then nations can protect themselves henceforth only by using whatever destructive agencies they can invent, till the resources and inventions of science end by destroying the humanity that they were meant to serve"

17.05.2025 14:24 👍 120 🔁 41 💬 0 📌 2
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NEW 🧵 Is human intelligence starting to decline?

Recent results from major international tests show that the average person’s capacity to process information, use reasoning and solve novel problems has been falling since around the mid 2010s

What should we make of this?

www.ft.com/content/a801...

14.03.2025 13:18 👍 2038 🔁 815 💬 294 📌 366
The H5N1 virus detected in US cattle & a human case in Wyoming now carry the D701N & E672K mutations both known to help the virus adapt better to humans.

These genetic changes raise serious concerns about increased transmission, making it easier for the virus to spread among mammals, including humans.

With H5N1 continuing to evolve, the risk of a wider outbreak is growing.

Bird flu is becoming a serious public health threat.

The H5N1 virus detected in US cattle & a human case in Wyoming now carry the D701N & E672K mutations both known to help the virus adapt better to humans. These genetic changes raise serious concerns about increased transmission, making it easier for the virus to spread among mammals, including humans. With H5N1 continuing to evolve, the risk of a wider outbreak is growing. Bird flu is becoming a serious public health threat.

Okay, so.

I don’t know how much of a heads up this is when it’s just a notice about these 2 mutations. Do they really raise serious concerns about “increased transmission?”

Sort of. It’s more complex than D701N & E626K, omg pandemic bird flu.

What do these mutations do in H5N1?

27.02.2025 12:36 👍 199 🔁 91 💬 11 📌 19
One glance at a book and you hear the voice of another person, perhaps someone dead for 1,000 years. To read is to voyage through time.

One glance at a book and you hear the voice of another person, perhaps someone dead for 1,000 years. To read is to voyage through time.

One glance at a book and you hear the voice of another person, perhaps someone dead for 1,000 years. To read is to voyage through time.

24.02.2025 13:19 👍 107 🔁 22 💬 4 📌 1
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#USDA posted an analysis of the D1.1 #H5N1 #birdflu viruses that infected Nevada cows — the new spillover event. They spotted a mutation in the PB2 gene that is associated with mammalian adaptation. What's this mean? Dunno. But 2 spillovers means more could come. www.aphis.usda.gov/sites/defaul...

07.02.2025 23:09 👍 181 🔁 81 💬 2 📌 6
First page of article.

Fairytale type pic of Princess leaning over dead or sleeping Prince.

Facing death and grief: revolution needed
Despite growing public interest in death, support for end-of-life care and bereavement remains inadequate. We urgently need a revolution: a community centred, public health approach to the social processes of dying and mourning, backed by properly funded palliative care, writes Lucy Selman.

First page of article. Fairytale type pic of Princess leaning over dead or sleeping Prince. Facing death and grief: revolution needed Despite growing public interest in death, support for end-of-life care and bereavement remains inadequate. We urgently need a revolution: a community centred, public health approach to the social processes of dying and mourning, backed by properly funded palliative care, writes Lucy Selman.

Pic of man in bed in hospital.

Sample of text:

In the UK around 90% of dying people would benefit from palliative care, but 25% don't get it. Demand is set to rise 25% over the next 25 years as lifespans increase and health conditions grow more complex, yet the sector is already critically underfunded. Just a third of UK hospice funding comes from the state, with the remaining £1bn raised annually through charity shops, fundraising events, and donation.
This funding gap sends a clear message: care for dying people is less valued than aggressive treatments and high tech medical advances. (It's surely no coincidence that 9 in 10 of the clinical and care workforce in UK hospices are women, reflecting a long history of "women's work" being undervalued.)

Pic of man in bed in hospital. Sample of text: In the UK around 90% of dying people would benefit from palliative care, but 25% don't get it. Demand is set to rise 25% over the next 25 years as lifespans increase and health conditions grow more complex, yet the sector is already critically underfunded. Just a third of UK hospice funding comes from the state, with the remaining £1bn raised annually through charity shops, fundraising events, and donation. This funding gap sends a clear message: care for dying people is less valued than aggressive treatments and high tech medical advances. (It's surely no coincidence that 9 in 10 of the clinical and care workforce in UK hospices are women, reflecting a long history of "women's work" being undervalued.)

Pic of someone being cared for and having their hair brushed.

Sample of text:

Clinicians too have a critical role in reshaping attitudes and so must build their own death and grief literacy. By discussing end-of-life care openly and challenging common misconceptions, they can model acceptance of dying, build trust, and show the public that it is safe to ask questions and voice doubts and fears.
Care must be emotionally aware, culturally sensitive, compassionate, and person centred-and this must be reflected in clinical education.
Clinical leaders must acknowledge the emotional weight of dealing with death and grief and offer support, encouraging sharing, peer support, and remembrance. By making space for grief and vulnerability in professional life we nurture the human side of being a clinician.

Pic of someone being cared for and having their hair brushed. Sample of text: Clinicians too have a critical role in reshaping attitudes and so must build their own death and grief literacy. By discussing end-of-life care openly and challenging common misconceptions, they can model acceptance of dying, build trust, and show the public that it is safe to ask questions and voice doubts and fears. Care must be emotionally aware, culturally sensitive, compassionate, and person centred-and this must be reflected in clinical education. Clinical leaders must acknowledge the emotional weight of dealing with death and grief and offer support, encouraging sharing, peer support, and remembrance. By making space for grief and vulnerability in professional life we nurture the human side of being a clinician.

“Facing death differently: revolutionising our approach to death and grief”.

A really important piece here from @lucyselman.bsky.social in the @bmj.com.

I’ll try to pick out some highlights in a🧵, but actually I’d recommend reading the whole article.

Link here:
www.bmj.com/content/387/...

04.01.2025 10:01 👍 101 🔁 55 💬 7 📌 7
An oil painting of Elizabeth Garrett Anderson in the 1860s

An oil painting of Elizabeth Garrett Anderson in the 1860s

Elizabeth Garrett Anderson (1836-1917), 1st female dean of a British med school, and 1st female mayor in Britain, pretended to be rich during med school (in Paris, 1870) so admin would think she'd be able to sue if they suddenly said women couldn't be doctors 1/10

17.12.2024 23:10 👍 172 🔁 45 💬 3 📌 10
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Why hasn’t the bird flu pandemic started? Some scientists examining mutations found in H5N1 viruses fear major outbreak is imminent but others says pathogen remains unpredictable

If an #H5N1 pandemic starts tomorrow or in three months, there will be little mystery as to how it happened. The conditions are all there. They have been for a while.
So in some ways the more interesting question to me at the moment is: Why aren’t we in a pandemic yet?
Story here, 🧵 to come:
🧪#IDSky

06.12.2024 12:54 👍 1424 🔁 675 💬 64 📌 85
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So much work done by GP practices is unseen

The media focus purely on appointments - 30 million a month & up 5 million since 2019

Imagine if appts are up 20% what is going on behind the scenes

All this with 20% £/patient since 2016 in real terms cuts

#MedSky #RCGP #GeneralPractice #NHS #TeamGP

23.11.2024 11:29 👍 117 🔁 50 💬 7 📌 3
A photo showing the operating theatre with wooden handrails encircling each riser. In the middle is a wooden table where the dissections would take place.

A photo showing the operating theatre with wooden handrails encircling each riser. In the middle is a wooden table where the dissections would take place.

Oldest-surviving anatomical theatre, located in Padua and built in 1594. Over the entrance is the Latin inscription: “hic est locus ubi mors gaudet succurrere vitam.” Roughly: “this is the place where death delights to help life (or the living).”

Photo: Rolando Paolo Guerzoni. #histmed #skystorians

23.11.2024 11:13 👍 756 🔁 119 💬 12 📌 7
Image shows the road gritters in Scotland with their names which includes Taylor Drift, Skate Bush, Air Salter Scott, Me Snow it all, Spready Mercury

Image shows the road gritters in Scotland with their names which includes Taylor Drift, Skate Bush, Air Salter Scott, Me Snow it all, Spready Mercury

It's the time of year to appreciate the names of Scottish gritters! #Scotland

19.11.2024 13:23 👍 657 🔁 171 💬 33 📌 21
View of fields and dry stone walls Yorkshire Dales

View of fields and dry stone walls Yorkshire Dales

17.11.2024 15:14 👍 2 🔁 0 💬 0 📌 0
A map of flight paths emanating from breeding colony of gulls, with this caption: Early on, LifeWatch noticed something odd. Most gulls were making daily trips to Mouscron, a city on the French border 65 km away. They went to investigate and found the birds bingeing on discarded snacks at the Roger & Roger potato factory.

A map of flight paths emanating from breeding colony of gulls, with this caption: Early on, LifeWatch noticed something odd. Most gulls were making daily trips to Mouscron, a city on the French border 65 km away. They went to investigate and found the birds bingeing on discarded snacks at the Roger & Roger potato factory.

Today in relatable science: Gulls making a mysterious daily trip that turned out to be to a potato chip factory

15.11.2024 20:15 👍 15973 🔁 4313 💬 248 📌 444

I’m not going to leave X just yet - I hate that sense of being driven away from a place I used to love. But after one day on here, I already know how much prefer it.

So if you see this and would be kind enough to share it to let people find me, that would be hugely appreciated. Thank you.

15.11.2024 19:21 👍 1242 🔁 769 💬 81 📌 10

Word of the Day, should you need it, is ‘latibulate’, a 17th-century verb meaning to find a corner somewhere and hide in it.

15.11.2024 08:16 👍 16396 🔁 2533 💬 466 📌 316
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07.11.2024 06:47 👍 28 🔁 4 💬 1 📌 2
A map spanning from the UK to central Africa. There is a red line tracking Torc’s journey – it starts in Southern Ireland, zips across France all the way down to the south of Greece, then back up to northern Germany (TORC TORC WHAT THE HELL ARE YOU DOING?) then almost due south again (phew!) to the bottom of France and thence across the Mediterranean and over the Sahara.

A map spanning from the UK to central Africa. There is a red line tracking Torc’s journey – it starts in Southern Ireland, zips across France all the way down to the south of Greece, then back up to northern Germany (TORC TORC WHAT THE HELL ARE YOU DOING?) then almost due south again (phew!) to the bottom of France and thence across the Mediterranean and over the Sahara.

TORC HAS CROSSED THE SAHARA

(Torc is a cuckoo)

08.11.2024 16:41 👍 309 🔁 59 💬 13 📌 8
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Britain raises risk level of bird flu to medium Britain has increased on Thursday the risk level of bird flu to medium from low after the virus was detected in a number of wild birds in the country over the autumn, the government said in an update posted on its website.

'Britain has increased the risk level of bird flu to medium after the virus was detected in a number of wild birds in the country this autumn. Bird flu [avian influenza] has increasingly spread to mammals, raising concern of human transmission.' @Reuters
www.reuters.com/world/uk/bri...

19.10.2024 09:38 👍 13 🔁 13 💬 0 📌 0
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This is extraordinarily good news: 43 of the people who were infected with #Marburg in Rwanda's outbreak have recovered; only 4 people remain in isolation & treatment. No new cases (62 in total), no new deaths (15 in total).
Things are looking very hopeful.

17.10.2024 19:20 👍 103 🔁 23 💬 1 📌 2
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Hungary and Italy report outbreaks of H5N1 bird flu, WOAH says Hungary and Italy have both reported an outbreak of the severe H5N1 avian influenza virus in the first such cases in the countries for several months, the World Organisation for Animal Health (WOAH) said, as the disease spreads again in Europe.

Hungary and Italy report outbreaks of H5N1 bird flu on farms, WOAH says - via Reuters

www.reuters.com/business/hea...

02.10.2024 19:50 👍 2 🔁 2 💬 1 📌 1
Video thumbnail

Just to make things clear, this might be the best-timed shot in science TV history. In the BBC series "Connections", James Burke points to a rocket just as it launches. It was filmed on August 20, 1977, during the launch of Voyager 2 spacecraft. 🧪🚀

11.09.2024 19:35 👍 2500 🔁 565 💬 101 📌 88