Robert Homer
@rjhomer57
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Pulmonary pathologist, medical educator and recovering Morris dancer @rjhomer.bsky.social. Opinions are my own (whose else would they be?)
New Haven, CT
Joined July 2014
“Education is the most powerful weapon which you can use to change the world.” Nelson Mandela
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Shocked, shocked, I say. Who would have predicted? https://t.co/mej6B5q1KB
statnews.com
Exclusive: Vinay Prasad has rattled FDA staff by expanding his power and pushing out senior leaders.
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PS. Gershon died in 1983 or so, so would not have been eligible for the Nobel in any event.
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For several years, the entire topic of immunoregulation was off the table. Sakaguchi revised it with more modern technology, but many of the underlying concepts were well known in the literature. end/
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The Gershonian universe also recognized a gene product of the murine major histocompatibility complex that played an important role. When the MHC was fully sequenced, no such gene existing. 4/
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In particular, the Gershonian universe described T cell generated antigen binding factors. When the actual T cell antigen receptor was finally identified, it was clear that that was not possible. 3/
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Sakaguchi was swimming against the tide only because the cellular and molecular details of that generation of work was overthrown by the concurrent molecular technology advances. 2/
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Richard Gershon described the same phenomenon at Yale in the early 1970's. The literature was full of similar findings by the 1980's. 1/
This year’s medicine laureate Shimon Sakaguchi discovered a new class of T cells. Sakaguchi was swimming against the tide in 1995, when he made a key discovery. At the time, many researchers were convinced that immune tolerance only developed due to potentially harmful immune
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4. Which leads me to final point in that unlike prior editions, it is unclear how to combine the various patterns of radiology and pathology. Perhaps we just keep the old tables?
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when you only have an airway or two and some parenchyma to evaluate. You can say an airway is involved but you can't say it is preferentially involved.
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3. The article persists in focusing on wedge biopsy diagnosis, a vanishing procedure. If a biopsy is obtained, it is usually a cryobx these days. In that case, It is not usually possible to indicate a process is bronchocentric
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2. Reproducibility in identifying patterns not mentioned .In particular, bronchocentric IP in my view is only readily identified in absence of advanced fibrosis. I don't see the point of attempting to add a new category when the real dx is end stage fibrosis.
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I suppose I should comment on the "new" ATS/ERS guidelines for ILD. Most of it is old wine in new bottles e.g. DIP = AMP. A few points. 1. Most disappointing was failure to highlight differences in fibrotic and non-fibrotic patterns
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Overpromises and under delivers.. Promised to redo a slide deck but resultant file was too large to download and no solution it offered worked.
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Send us your paper! Would love to read it.
@AJPathology is pleased to announce the addition of Dr. Robert Homer to our Associate Editor line-up!
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Finally out as reprint!!! "Alveolar epithelial cell plasticity & injury memory in human pulmonary fibrosis". Glad to share the results of our single cell nuc-seq & ATAC-seq analyses of human IPF & PCLS before peer review - see the key findings in 🧵👇🏽 https://t.co/ggvtGE3NMA
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An antibody targeting c-met just FDA approved for NSCLC. With an FDA approved companion diagnostic IHC kit. But no controls come with the kit or specified benchmarks to use...A very old story.
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The article completely ignored the many arguments made by multiple pathologists and others that the FDA approach would have harmed patients by making testing unavailable due to increased costs without corresponding benefits.
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They state "congressional agreement on LDTs has been out of reach for at least a decade". How does that justify bending the meaning of a different law to your desired end?
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the same way they did with tobacco regulation after SCOTUS struck down Kessler's use of FDA to regulate tobacco.
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