iiinova — where your digital self keeps evolving

Reposted by Alison Bays, MD (she/her)

Rheum Cat @rheumcat.bsky.social · 12/08/2026

Public comments open for how NIH should restructure funding mechanisms for mentored scientists who want to focus on clinical trials

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 11/08/2026

New Executive Order tells parents to "space out" the MMR vaccine. There's no new science behind it — the AAP and AAFP said so within hours. What it actually does is leave kids unprotected against measles for longer, in the middle of the worst measles year in decades. Call your reps: 5calls.org

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 08/08/2026

Congress held Anthony Fauci in contempt this week — decades of public-health service, now criminalized. Whatever you thought of any single call, this is how you make sure no scientist takes the job again. Sign: www.standupforscience.net/sufs-fauc…

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 30/07/2026

Continuing in my app era - new free app! rheumlens.org — image-based rheumatology flashcards. 134 cards live and building a question bank. Images from the ACR Rheumatology Image Library, used with permission for education.

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 29/07/2026

Medicaid work requirements don't filter out people who won't work. They filter out people who can't file paperwork on time — which in rheumatology is most of my sickest patients. Public comment is open: www.federalregister.gov/d/2026-11094

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 24/07/2026

LabLens — a free Mac app to organize your lab results from every portal in one place, with plain-English explanations. Everything stays on your own computer. www.glaze.app/app/lablens-GkByoP

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Reposted by Alison Bays, MD (she/her)

Lisa Fazio @lkfazio.bsky.social · 14/07/2026

Almost 350,000 comments on the proposed OMB rule aimed at politicizing and undermining American science (among other things). Well done everyone!! 👏👏👏 The fight isn't over but this was an excellent first round 🥊

Screenshot of the regulations.gov page

Document ID
OMB-2026-0034-0001

Comments Received
341,699

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Reposted by Alison Bays, MD (she/her)

Rheum Cat @rheumcat.bsky.social · 14/07/2026

It's online! I gathered a group of people within the rheumatology community with diverse experiences & perspectives to write about improving conference accessibility www.jrheum.org/content/jrhe...

jrheum.org

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 13/07/2026

Today is the last day to comment on the OMB rule that would hand federal research-grant decisions to political appointees instead of scientific peer review. Nearly every drug I prescribe for vasculitis and lupus exists thanks to NIH-funded science. regulations.gov/commenton/OMB-2026-0034-0001

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 08/07/2026

New national data on giant cell arteritis: even after years of "steroid-sparing" messaging, patients still averaged 7.6 g of prednisone over two years — and every gram tracked with higher mortality. There is no free steroid dose. doi.org/10.1136/rmdopen-2026-006866

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Reposted by Alison Bays, MD (she/her)

Kate Clancy @kateclancy.bsky.social · 03/07/2026

What a great article not only on faculty workloads, but how little our salaries actually factor in to most university budgets. A few highlights. First, our salaries are falling:

Third, faculty salaries are falling even if we statistically control for faculty rank and institution. By our analysis of National Center for Education Statistics data, tenured and tenure-track salaries are down 10 percent in real terms since 2016 and are lower today than they were in 2002; nontenured faculty salaries are down 4 percent since 2016 and are at 2002 levels today.

To put this plainly: Suppose sharply increased teaching loads enabled institutions to cut one out of every seven full-time faculty. (That’s roughly what we saw last year in severe cuts announced at West Virginia, Western Illinois, and St. Cloud State Universities.) The associated savings in salary and benefits even through such drastic action would amount to less than 2.5 percent of total institutional expenditures for the typical university.

The upshot? If you think higher education has a cost problem, squeezing more teaching out of faculty is not the first place you should look.

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Reposted by Alison Bays, MD (she/her)

ACR Journals @acr-journals.bsky.social · 25/06/2026

New insights in lupus nephritis show abnormal IgG glycosylation triggers podocyte injury via CLEC7A-SYK signaling. Blocking this pathway preserved podocyte function, uncovering a potential novel therapeutic strategy for LN Arthritis & Rheumatology doi.org/10.1002/art....

IgG Glycosylation-Dependent CLEC7A Signaling Drives Podocyte Dysfunction in Lupus Nephritis. Graphical abstract created using BioRender

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 25/06/2026

NIH wants to cap how many grants one scientist can hold. Sounds tidy — in practice it kneecaps the most productive labs and the trainees they fund. Public comment's open till Aug 3, and anyone can write one: grants.nih.gov/grants/guide/notice-…

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 24/06/2026

New Health Affairs piece names what most of us already feel: AI is no longer just "decision support" — it's quietly making prior-auth calls. doi.org/10.1093/haschl/qxag141

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 24/06/2026

A House committee is now pressing NIH over the OMB rule that would rewrite how research gets funded. You don't need a lab to weigh in — public comment is open to anyone through July 13. Two minutes: www.regulations.gov/commenton/OMB-2…

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 22/06/2026

New EGPA data (30-patient retrospective study): mepolizumab started within 30 days of steroids roughly halved a year's cumulative prednisolone — 25 vs 69 mg/kg. Hypothesis-generating, not practice-changing, but the right direction. pubmed.ncbi.nlm.nih.gov/42324522

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Reposted by Alison Bays, MD (she/her)

Rheumify @rheumify.bsky.social · 21/06/2026

New on the Rheumify Substack — Osteoporosis Module 1: bone remodeling and why the osteoclast/osteoblast tug-of-war decides who fractures. open.substack.com/pub/rheumify/p/os…

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 19/06/2026

The free Notion template I built to run the academic publishing cycle — manuscripts, submissions, paper ideas, abstracts — just added AI agents that draft cover letters and suggest target journals. Still free for rheum: notion.com/templates/scriptcycle

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Reposted by Alison Bays, MD (she/her)

Rheumify @rheumify.bsky.social · 17/06/2026

Vision loss in GCA is usually arteritic anterior ischemic optic neuropathy — from occlusion of the posterior ciliary arteries that supply the optic nerve head, not the central retinal artery. Once it's lost, it rarely comes back. pubmed.ncbi.nlm.nih.gov/9559737

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 16/06/2026

Most prior-auth denials are never appealed. In Medicare Advantage, only 11.7% of denied requests were appealed in 2023 — and when patients did appeal, 81.7% were overturned. The friction is the point: deny, and bank on people not fighting back. kff.org

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Reposted by Alison Bays, MD (she/her)

Rheum Cat @rheumcat.bsky.social · 16/06/2026

Post a comment to the Federal Register: USPS to impose regulations that impact mail in ballots - based on an Executive Order www.federalregister.gov/documents/20...

federalregister.gov

Ballot Mail for Federal Elections

The Postal Service is proposing to amend the Mailing Standards of the United States Postal Service, Domestic Mail Manual (DMM), regarding the transmission of mail-in or absentee ballots for federal el...

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 15/06/2026

GCA is filed under "headache and vision loss," but a 12,955-patient cohort tells a quieter story: higher all-cause mortality and markedly more MI, stroke, and heart failure. It's a cardiovascular disease wearing a temporal-artery disguise. pubmed.ncbi.nlm.nih.gov/42249005

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 14/06/2026

Three federal comment deadlines are quietly stacking up, but this one closes first: the OMB rule that would let political appointees cancel research grants at will. Comment by July 13. regulations.gov/commenton/OMB-2026-0034-0001

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 14/06/2026

Headed there today, Sunday afternoon, eek!

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 14/06/2026

Heads up: the AI agents (journal matcher, a mock “Reviewer 1·2·3” peer review, cover-letter writer, submission chaser + more) run on Notion AI, a paid Notion add-on. The tracker itself is 100% free and works fine without them.

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 14/06/2026

New PMR/GCA trial (RESCUE): even on ≤5mg prednisolone, patients can develop adrenal insufficiency that quietly tanks quality of life. It's testing "sick-day" hydrocortisone for the fatigue we too often wave off as "just the disease." pubmed.ncbi.nlm.nih.gov/42276802

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 13/06/2026

The new NIH plan to cap how many grants one scientist can hold won't spread money to the little guy — it'll gut the labs running the trials that gave my lupus and vasculitis patients their drugs. Comments open till Aug 3. NOT-OD-26-086: regulations.gov

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 13/06/2026

ANCA vasculitis: the FDA is moving to withdraw avacopan (Tavneos), alleging ADVOCATE remission endpoints were re-adjudicated after database lock — flipping a nonsignificant result to significant — and citing 76 serious liver-injury cases. Comment by June 29. fda.gov/media/192160/download

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 13/06/2026

Omg I have someone at work I need to send this to

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 12/06/2026

Medicaid "work requirements" don't create jobs — they create paperwork that drops eligible, working people from coverage. For my lupus and vasculitis patients, a month off meds can mean a kidney or an eye. Public comments open through the Federal Register: regulations.gov

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 12/06/2026

As of this month in Washington, an AI can approve your prior authorization — but it can't deny it. Only a human can. It sounds like a small rule. It's one of the more sensible sentences in health policy this year, and it should be the national floor. healthcaredive.com

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 11/06/2026

It's self-defeating: untreated autoimmune disease is one of the top reasons my patients can't work at all. Continuous coverage is what keeps them working. Comment by July 31 — regulations.gov (rule 2026-11094). You don't have to be a doctor to weigh in.

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 11/06/2026

And the stakes are irreversible. Lupus nephritis off treatment → kidney failure. Vasculitis or giant cell arteritis off treatment → permanent vision loss, within weeks. Coverage gaps don't inconvenience these patients — they disable them.

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 11/06/2026

The burden falls hardest on the sickest. Rheumatic disease flares in episodes — there are weeks my patients can't work, drive, or log into a reporting portal. That's exactly when they'd lose coverage, and when medical exemptions quietly fail them.

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 11/06/2026

Work requirements don't test work — they test paperwork. When Arkansas tried this in 2018, 18,000+ people lost coverage in months with NO rise in employment (Sommers et al., NEJM 2019). Most were already working or should've been exempt. They lost coverage to red tape.

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 11/06/2026

I'm a rheumatologist. About 1 in 4 of my patients is on Medicaid, and many are seriously ill. The proposed Medicaid work requirement (CMS rule, public comments open through July 31) will hurt them. Here's why I'm commenting against it. 🧵

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 11/06/2026

If your coverage is a self-funded employer (ERISA) plan, state "bad faith" law is preempted. Half of insured Americans are in these plans. blog.ifebp.org/erisa-preemption-101/

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 11/06/2026

New French cohort (~13,000 patients): giant cell arteritis carries higher long-term risk of MI, stroke, heart failure, and death vs matched controls. We treat GCA to save vision — but it's a cardiovascular disease too, and we should manage it like one. pubmed.ncbi.nlm.nih.gov/42249005/

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 10/06/2026

There's a federal rule that would let political appointees shape which science gets funded. Comments close July 13. The drugs that keep my GCA patients from going blind exist because review used to reward merit, not loyalty. regulations.gov/commenton/OMB-2026-0034-0001

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 10/06/2026

A federal panel just told Congress what every rheumatologist already knew: an algorithm shouldn't get to deny your medication. MACPAC wants every prior-auth denial reviewed by an actual human with relevant expertise. The bar is on the floor — and we still had to ask. macpac.gov

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 09/06/2026

Massachusetts just killed prior auth for primary care, ER/urgent, maternity, PT/OT, cancer imaging, and certain meds. The paperwork wall between patients and basic care — gone. I hope every other state copies this.

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 09/06/2026

The OMB wants the power to weigh research grants by political fit and cancel awards at will. Comment period closes July 13. Every biologic I prescribe came from merit-reviewed federal science. You don't have to be a scientist to say this is a bad idea. regulations.gov (OMB-2026-0034-0001)

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 09/06/2026

New French cohort, ~13,000 giant cell arteritis patients: higher risk of heart attack (1.6×), stroke, heart failure and death vs controls. GCA isn't just a threat to vision — it's vascular disease end to end. Screen the heart, not only the temporal artery. pubmed.ncbi.nlm.nih.gov/42249005/

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Alison Bays, MD (she/her) @alisonbays.bsky.social · 08/06/2026

The drugs I reach for in vasculitis clinic — tocilizumab, rituximab — exist because federally funded research was judged on whether the science was sound. A proposed OMB rule would change that. Public comment's open through July 13: regulations.gov/commenton/OMB-2026-0034-0001

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Reposted by Alison Bays, MD (she/her)

Rheumify @rheumify.bsky.social · 08/06/2026

Mnemonic Monday "GrandPA Cs the PR3tty cytoplasm." GPA = c-ANCA = anti-PR3, cytoplasmic staining. Flip side: Perinuclear (p-ANCA) = anti-MPO = MPA & EGPA. This week: ANCA-associated vasculitis.

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Reposted by Alison Bays, MD (she/her)

Rheumify @rheumify.bsky.social · 04/06/2026

Why Rheumify is moving to its own site!

open.substack.com

Rheumify has a new home!

Why make a move?

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