Dice.camp

0 posts0 participants0 posts today

David TullerBMJ Has Corrected the REGAIN Trial Paper–But Not the Editorial or Systematic Review Touting REGAIN’s FindingsBy David Tuller, DrPHLast February, The BMJ <a href="https://www.bmj.com/content/384/bmj-2023-076506" rel="nofollow noopener noreferrer" target="_blank">published a paper</a> called “Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial,” from McGregor et al. The study purported to have proven that this multi-disciplinary intervention was “clinically effective” in reducing symptoms associated with Long Covid. Unfortunately, the claim was fraught with problems that rendered it bogus. (I have written about the trial several times, including <a href="https://virology.ws/2024/02/20/trial-by-error-new-long-covid-exercise-and-therapy-study-claims-success-despite-clinically-insignificant-findings/" rel="nofollow noopener noreferrer" target="_blank">here</a> and <a href="https://virology.ws/2024/03/11/trial-by-error-letter-to-bmj-seeking-correction-in-study-of-long-covid-physical-and-mental-rehabilitation-program/" rel="nofollow noopener noreferrer" target="_blank">here</a>.)First and foremost, the study was unblinded and relied solely on subjective, self-reported outcomes—a combination of traits that inevitably leads to unknown amounts of bias. In such instances, modestly positive results would be expected as an artifact of the study design and are essentially meaningless.Beyond that, the study included some untenable flaws. Specifically:*In prominent sections of the paper, including the conclusion of the abstract and a highlights box called “What this study adds,” the investigators presented their findings as if they could be extrapolated to all Long Covid patients. This was completely unwarranted because it omitted a highly salient point. The study participants had all been hospitalized for acute Covid-19, while the great majority of Long Covid patients have not been hospitalized. Given the major differences between these two populations, it is scientifically unjustified to automatically assume that findings in one group apply to those in the other.*The reported benefit on the primary outcome fell below the recommended threshold for what is called the “minimal clinically important difference” (MCID) for that measure, as determined by those who developed it. If a trial’s results do not meet the MCID recommended by the creators of an outcome measure, it is hard to take seriously the investigators’ claim that the intervention is “clinically effective.” Given these and other issues, multiple complaints ensued. Some people filed rapid responses. I <a href="https://virology.ws/2024/03/11/trial-by-error-letter-to-bmj-seeking-correction-in-study-of-long-covid-physical-and-mental-rehabilitation-program/" rel="nofollow noopener noreferrer" target="_blank">organized a letter</a> to the journal’s editor-in-chief, Kamran Abbasi, signed by a dozen other colleagues. For their part, the investigators rejected all the criticisms in <a href="https://www.bmj.com/content/384/bmj-2023-076506/rr-0" rel="nofollow noopener noreferrer" target="_blank">their own rapid response</a>, posted last April. However, apparently someone at the BMJ disagreed with the investigators’ decision-making, because by May the paper bore <a href="https://www.bmj.com/content/385/bmj.q988" rel="nofollow noopener noreferrer" target="_blank">a correction</a>, although it addressed only the issue of the expansive extrapolation of the findings to all Long Covid patients. As the correction noted, the phrase “at least three months after hospital discharge for covid-19” was added to the key sections from which it had been omitted.The correction did not include an explanation for why or how the journal overruled the investigators’ position that no such correction was needed. It was nonetheless an acknowledgement that the investigators, whether intentionally or not, had conveyed inaccurate or untrue information to the public. Unfortunately, media outlets had already disseminated this widely right after the study’s initial publication. No media outlets seemed to cover the correction.Unfortunately for The BMJ, that is not the end of its responsibilities here. The claims from the trial have figured prominently in at least two other BMJ publications. An <a href="https://www.bmj.com/content/384/bmj.q20" rel="nofollow noopener noreferrer" target="_blank">invited editorial</a> accompanied the initial trial report last February. Like the trial itself, the editorial misrepresented the findings by not mentioning the limitations imposed by the study population until the very end.  No one who reads it would necessarily be aware that a correction to the trial has severely restricted the relevance of the findings to the larger Long Covid population.Even more troubling, The BMJ in November <a href="https://www.bmj.com/content/387/bmj-2024-081318" rel="nofollow noopener noreferrer" target="_blank">published an article</a> called “Interventions for the management of long covid (post-covid condition): living systematic review,” from Zeraatkar et al. The review relies solely on McGregor et al to claim “moderate certainty evidence” in favor of a program of physical and mental health rehabilitation for Long Covid patients. The investigators rejected the notion that the recommendation should be limited to patients who were hospitalized, even though the review was accepted for publication months after REGAIN was corrected to reinforce that specific point.Did anyone notice or care about this discrepancy? Hard to tell. The policy at The BMJ is to post peer reviews. In this case, no peer reviews of this systematic review have yet appeared, with no explanation offered for the delay. It goes without staying that if a study is corrected and its findings dramatically limited to a much smaller population, other articles that relied on the initial error should also be fixed—whatever the authors of those other articles think. Even the biopsychosocial fanatics apparently in charge at BMJ should be able to understand this basic principle.I organized letters to The BMJ editor on both counts. (They can be read <a href="https://virology.ws/2024/11/20/trial-by-error-my-letter-to-bmj-seeking-correction-to-editorial-on-regain-trial-of-mental-and-physical-health-rehab-for-long-covid/" rel="nofollow noopener noreferrer" target="_blank">here</a> and <a href="https://virology.ws/2024/12/09/trial-by-error-letter-to-bmj-editor-seeking-correction-in-new-review-of-interventions-for-long-covid/" rel="nofollow noopener noreferrer" target="_blank">here</a>.) In both cases, I received responses from BMJ’s “research integrity” department assuring me that the questions I had raised were being reviewed. I have not yet received any information about resolutions.********Meanwhile, there are now <a href="https://www.bmj.com/content/387/bmj-2024-081318/rapid-responses" rel="nofollow noopener noreferrer" target="_blank">eight rapid responses</a> appended to Zeraatker et al. (Embarrassingly, one is from the REGAIN investigators themselves, questioning the review’s statistical analysis.) Several raise concerns about the review’s over-broad claims regarding the REGAIN findings, among other problematic issues. Of particular note are smart, well-argued responses from two patient advocates, <a href="https://www.bmj.com/content/387/bmj-2024-081318/rr-5" rel="nofollow noopener noreferrer" target="_blank">Michiel Tack</a> and <a href="https://www.bmj.com/content/387/bmj-2024-081318/rr-1" rel="nofollow noopener noreferrer" target="_blank">Dominic Salisbury</a>. Perhaps at some point The BMJ and the team that produced this problematic “living systematic review” will decide to provide some answers.(<a href="https://virology.ws/2025/01/16/trial-by-error-bmj-has-corrected-the-regain-trial-paper-but-not-the-editorial-or-systematic-review-touting-regains-findings/" rel="nofollow noopener noreferrer" target="_blank">View the original post at virology.ws</a>)<a rel="nofollow noopener noreferrer" class="hashtag u-tag u-category" href="https://trialbyerror.org/tag/bmj/" target="_blank">#BMJ</a> <a rel="nofollow noopener noreferrer" class="hashtag u-tag u-category" href="https://trialbyerror.org/tag/regain/" target="_blank">#REGAIN</a>

David TullerLetter to BMJ Editor Seeking Correction in New Review of Interventions for Long CovidBy David Tuller, DrPHThe BMJ recently published <a href="https://www.bmj.com/content/387/bmj-2024-081318" rel="nofollow noopener noreferrer" target="_blank">a review of interventions for Long Covid</a> that–surprise!–recommended CBT and a rehabilitation program as treatments. The review is full of holes. I have focused on one in particular. The review relies for its rehabilitation recommendation on <a href="https://www.bmj.com/content/384/bmj-2023-076506" rel="nofollow noopener noreferrer" target="_blank">an earlier BMJ study</a>–even though that study <a href="https://www.bmj.com/content/385/bmj.q988" rel="nofollow noopener noreferrer" target="_blank">has itself already been corrected</a> for having misrepresented its findings in key sections. This morning, I sent the following letter to Dr Kamran Abbasi, editor-in-chief of The BMJ:Dear Dr Abbasi—A recent paper in The BMJ, Interventions for the management of long covid (post-covid condition): living systematic review, from Zeraatkar et al,drew a crucial conclusion from a trial whose findings were seriously misrepresented. That trial report, also published by The BMJ, has already been corrected. The review needs a similar correction.Zeraatkar et al recommended a mental and physical health rehabilitation program and cognitive behavior therapy as reasonable interventions for people suffering from the prolonged symptoms that characterize Long Covid. Each recommendation was based on a single clinical trial.The basis for the first recommendation was Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial, from McGregor et al. The paper was published by The BMJ in February of this year and then corrected in May.  The initial version failed to note in major sections—such as the conclusion of the abstract—that the sample included only patients who had been hospitalized for acute Covid-19. Given the significant differences between Long Covid patients who have and have not been hospitalized, the trial findings cannot automatically be extrapolated to everyone with prolonged symptoms. The corrected version now makes that clear.Unfortunately, the review from Zeraatkar et al committed the same error as the pre-corrected version of McGregor et al. The review did not mention in key passages—such as the abstract and conclusion–that its expansive recommendation for mental and physical rehabilitation came from a trial including only patients who had been hospitalized.  While the review noted this salient detail deep in the text, it nonetheless suggested that the intervention be offered far more broadly than warranted by the trial itself.In short, if the trial paper required a correction for not highlighting prominently enough an indisputable limitation of its findings, then the review requires the same.David Tuller (corresponding author) Center for Global Public Health University of California, Berkeley Berkeley, California, USA davetuller@berkeley.eduNicola Baker School of Health Sciences University of Liverpool Liverpool, England, UKSvetlana Blitshteyn Department of Neurology Jacobs School of Medicine and Biological Sciences University of Buffalo Buffalo, New York, USATodd Davenport Department of Physical Therapy University of the Pacific Stockton, California, USADavid Davies-Payne Department of Radiology Starship Children’s Hospital Auckland, New ZealandAndrew Ewing Department of Chemistry and Molecular Biology University of Gothenburg Gothenburg, SwedenMark Faghy Human Sciences Research Centre University of Derby Derby, England, UKKeith Geraghty Centre for Primary Care and Health Services Research Faculty of Biology, Medicine and Health University of Manchester Manchester, England, UKMady Hornig CORe Community (COVID Recovery through Community) New York, New York, USABrian Hughes School of Psychology University of Galway Galway, IrelandLeonard Jason Center for Community Research DePaul University Chicago, Illinois, USABinita Kane Respiratory Medicine Manchester University NHS Foundation Trust Manchester, England, UKDouglas Kell Institute of Systems, Molecular and Integrative Biology University of Liverpool Liverpool, England, UKAsad Khan North West Lung Centre Manchester University Hospitals Manchester, England, UKResia Pretorius Department of Physiological Sciences Stellenbosch University Stellenbosch, South AfricaDavid Putrino Department of Rehabilitation and Human Performance Icahn School of Medicine at Mt Sinai New York, New York, USACharles Shepherd ME Association Gawcutt, England, UKJohn Swartzberg Division of Infectious Diseases and Vaccinology School of Public Health University of California, Berkeley Berkeley, California, USASusan Taylor-Brown Department of Pediatrics, Developmental & Behavioral Pediatrics University of Rochester Medical Center Rochester, New York, USA(<a href="https://virology.ws/2024/12/09/trial-by-error-letter-to-bmj-editor-seeking-correction-in-new-review-of-interventions-for-long-covid/" rel="nofollow noopener noreferrer" target="_blank">View the original post at virology.ws</a>)<a rel="nofollow noopener noreferrer" class="hashtag u-tag u-category" href="https://trialbyerror.org/tag/bmj/" target="_blank">#BMJ</a> <a rel="nofollow noopener noreferrer" class="hashtag u-tag u-category" href="https://trialbyerror.org/tag/long-covid/" target="_blank">#LongCovid</a> <a rel="nofollow noopener noreferrer" class="hashtag u-tag u-category" href="https://trialbyerror.org/tag/regain/" target="_blank">#REGAIN</a>

David TullerThe BMJ Corrects REGAIN Study’s Expansive Claims; Results Only Applicable to Post-Hospitalized Long Covid PatientsBy David Tuller, DrPHIn February, The BMJ published <a href="https://www.bmj.com/content/bmj/384/bmj-2023-076506.full.pdf" rel="nofollow noopener noreferrer" target="_blank">a study</a> called Clinical effectiveness of an online supervised group physical and mental health rehabilitation programme for adults with post-covid-19 condition (REGAIN study): multicentre randomised controlled trial.” (Post-Covid-19 Condition, or PCC, is one of many current definitions for Long Covid.)The study, led by a team from the University of Warwick, suffered from some serious flaws. Its claims cannot be taken at face value—as <a href="https://www.s4me.info/threads/clinical-effectiveness-of-an-online-group-physical-mental-health-rehab-programme-for-post-covid-19-condition-regain-study-2024-mcgregor.37174/" rel="nofollow noopener noreferrer" target="_blank">many observers noted</a> and as I outlined <a href="https://virology.ws/2024/02/20/trial-by-error-new-long-covid-exercise-and-therapy-study-claims-success-despite-clinically-insignificant-findings/" rel="nofollow noopener noreferrer" target="_blank">here</a>. I also organized <a href="https://virology.ws/2024/03/11/trial-by-error-letter-to-bmj-seeking-correction-in-study-of-long-covid-physical-and-mental-rehabilitation-program/" rel="nofollow noopener noreferrer" target="_blank">a letter of concern</a> to the journal’s editor, co-signed by a dozen other experts.  A key issue was that the trial was unblinded and relied solely for its claims of success on subjective outcomes—a combination of elements that is guaranteed to generate an unknown amount of bias. Beyond that, the authors misrepresented the findings by declaring that the intervention was “clinically effective.”  In fact, the results for the primary outcome fell below the currently recommended level for the “minimal clinically important difference” (MCID) for their primary outcome, so the intervention should not be framed as having demonstrated “clinical effectiveness.” The investigators essentially lied about the MCID issue in the Methods section of the paper, and then contradicted themselves deeper in the text.Another major issue involved a different kind of misrepresentation of the findings—in this case, how broadly the results could be applied.  This was a trial of patients who had been hospitalized for Covid-19. However, the vast majority of PCC, or Long Covid, patients have not been hospitalized—rendering the study of questionable relevance for them. And yet, the investigators omitted this key detail in prominent sections of the paper that readers are most likely to see. The detail was not mentioned in the paper’s title. And in the conclusion of the abstract as well as in the “What This Study Adds” box, which accompanied the text and highlighted key messages, the findings were extrapolated to all PCC patients. (To reiterate, any claim of clinical effectiveness or benefit is itself an over-statement, given that the primary outcome results did not meet the currently recommended MCID threshold for that measure.)Hospitalized patients often have a different set of subsequent medical issues from those who have not been hospitalized, perhaps because their cases were more severe in the first place, or because of the impacts of the hospitalization itself, or other reasons. In this case, therefore, findings from hospitalized patients cannot be easily or automatically extrapolated to those who were not hospitalized. Whether the findings apply to non-hospitalized populations with PCC is a question that might be explored in future research. But it is certainly not appropriate to assume that the answer is positive—nor is it appropriate to disseminate this assertion as if it were an accurate interpretation of the research.The mismatch between the study sample and the larger PCC population is self-evident, so it is hard to understand how the investigators could have misrepresented their findings so dramatically. This oversight could have been either a deliberate effort to hype and bolster the apparent relevance of the findings or a sign of incompetence and cluelessness about the proper reporting of science. The letter I organized and sent to the journal editor noted, among our other concerns, that “it is inappropriate for the authors to extrapolate findings from patients who were hospitalized with covid-19 to the much larger number of patients with prolonged symptoms who were not hospitalized.” Similar criticism also appeared in online comments about the article.In a <a href="https://www.bmj.com/content/384/bmj-2023-076506/rapid-responses" rel="nofollow noopener noreferrer" target="_blank">rapid response</a> posted on The BMJ’s website on April 11th, the investigators rebutted the criticism that they had inappropriately extrapolated their findings by noting that they had provided the correct information in various sections, including the paper’s conclusion–which is not the same as the conclusion of the abstract. Their defense, while technically correct, missed the point. As far as I know, no one argued that the text of the study did not include the necessary information. The substance of the criticism was that, by omitting the detail in very prominent locations–such as the conclusion of the abstract–the paper had misled readers about the significance of the findings.Apparently, someone somewhere at The BMJ agreed with this negative assessment. On May 1st–less than three weeks after the investigators’ rapid response–the journal actually published <a href="https://www.bmj.com/content/385/bmj.q988" rel="nofollow noopener noreferrer" target="_blank">a correction</a> regarding this misrepresentation. The correction did not include an explanation for why the investigators had already rejected the need for such action. Here’s the text of the correction:“Several sections of this paper by McGregor and colleagues…have been updated for clarity of the study population. The conclusion in the abstract and the first and second points of the ‘What this study adds’ subsection of the box should have made it clear that in adults with post-covid-19 condition ‘at least three months after hospital discharge for covid-19’ the online, home based, supervised, group physical and mental health rehabilitation programme (REGAIN) showed clinical benefits and lack of harm.”It’s always laudable when journals and investigators agree to correct errors. But they do not deserve much credit for correcting false or obviously bogus statements that never should have been made in the first place. The study largely framed its findings as widely applicable to all PCC patients, so this major correction knocks the stuffing out of any such expansive declarations. But it does not fix the problems created by the initial publication. As far as I know, the media outlets and online influencers who touted the findings in the first place have not corrected the public record. So the false impression created by the study remains—and unfortunately will have an impact on the advice doctors provide and on the care patients receive.In fact, it seems the journal does not really seem to have taken the correction seriously. What leads me to that conclusion? Because <a href="https://www.bmj.com/content/384/bmj.q20" rel="nofollow noopener noreferrer" target="_blank">an editorial</a> published alongside the trial, which was commissioned by The BMJ and , features the same omissions that have now been corrected in the paper itself.  The editorial touts the reported findings but only mentions in the last paragraph that the study participants had been hospitalized, with this sentence: “Trial inclusion criteria required a history of hospital admission for covid-19, and it is unknown if findings can be generalised to patients with milder infection who do not require admission.” As with the paper itself, this salient limitation should have been mentioned in the most prominent parts of the editorial–and especially in the first reference to the study sample. As it is, the detail is presented as something of an afterthought. In other words, the journal is leaving intact in the editorial the same sort of expansive language that has now been corrected in the paper. Shouldn’t the editorial also be corrected, or at least updated, to align with the current version of paper? Perhaps someone should alert the editor to this discrepancy.<a rel="nofollow noopener noreferrer" class="hashtag u-tag u-category" href="https://trialbyerror.org/tag/long-covid/" target="_blank">#LongCovid</a> <a rel="nofollow noopener noreferrer" class="hashtag u-tag u-category" href="https://trialbyerror.org/tag/regain/" target="_blank">#REGAIN</a>

Susan Larson ♀️🏳️‍🌈🏳️‍⚧️🌈<a href="https://mastodon.online/tags/Labour" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Labour</a> leader <a href="https://mastodon.online/tags/KeirStarmer" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#KeirStarmer</a> has to <a href="https://mastodon.online/tags/regain" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#regain</a> <a href="https://mastodon.online/tags/trust" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#trust</a> of <a href="https://mastodon.online/tags/transgender" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#transgender</a> <a href="https://mastodon.online/tags/community" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#community</a>, <a href="https://mastodon.online/tags/TransPride" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#TransPride</a> <a href="https://mastodon.online/tags/boss" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#boss</a> says. <a href="https://mastodon.online/tags/TransPrideBrighton" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#TransPrideBrighton</a> <a href="https://mastodon.online/tags/cofounder" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#cofounder</a> <a href="https://mastodon.online/tags/SarahSavage" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#SarahSavage</a> said there is <a href="https://mastodon.online/tags/work" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#work</a> to be done by the new <a href="https://mastodon.online/tags/government" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#government</a> to make <a href="https://mastodon.online/tags/trans" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#trans</a> <a href="https://mastodon.online/tags/people" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#people</a> feel <a href="https://mastodon.online/tags/supported" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#supported</a>. <a href="https://mastodon.online/tags/Women" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Women</a> <a href="https://mastodon.online/tags/Transgender" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Transgender</a> <a href="https://mastodon.online/tags/LGBTQ" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#LGBTQ</a> <a href="https://mastodon.online/tags/LGBTQIA" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#LGBTQIA</a> <a href="https://mastodon.online/tags/UK" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#UK</a> <a href="https://mastodon.online/tags/Labour" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Labour</a> <a href="https://mastodon.online/tags/TERFS" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#TERFS</a> <a href="https://mastodon.online/tags/Hate" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Hate</a> <a href="https://mastodon.online/tags/Bigotry" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Bigotry</a> <a href="https://mastodon.online/tags/Violence" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Violence</a> <a href="https://mastodon.online/tags/Genocide" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Genocide</a> <a href="https://mastodon.online/tags/Discrimination" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Discrimination</a> <a href="https://mastodon.online/tags/Transphobia" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Transphobia</a> <a href="https://mastodon.online/tags/TERFIsland" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#TERFIsland</a> <a href="https://www.standard.co.uk/news/politics/keir-starmer-wes-streeting-people-rishi-sunak-labour-b1171432.html" rel="nofollow noopener noreferrer" translate="no" target="_blank">https://www.standard.co.uk/news/politics/keir-starmer-wes-streeting-people-rishi-sunak-labour-b1171432.html</a>

getmischCongress passes a law against machine guns, which Americans want. SCOTUS writes a 19 page technical ruling allowing gun owners to circumvent federal law. <a href="https://masto.nyc/tags/SCOTUS" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#SCOTUS</a> is bought; corrupted, illegitimate. It must be expanded to be considered legitimate again. <a href="https://masto.nyc/tags/bump" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#bump</a> <a href="https://masto.nyc/tags/stocks" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#stocks</a> <a href="https://masto.nyc/tags/legal" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#legal</a> <a href="https://masto.nyc/tags/again" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#again</a> <a href="https://masto.nyc/tags/thanks" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#thanks</a> <a href="https://masto.nyc/tags/corrupt" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#corrupt</a> <a href="https://masto.nyc/tags/court" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#court</a> <a href="https://masto.nyc/tags/UncleClarence" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#UncleClarence</a> <a href="https://masto.nyc/tags/Thomas" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Thomas</a> <a href="https://masto.nyc/tags/Alito" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Alito</a> <a href="https://masto.nyc/tags/Roberts" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Roberts</a> <a href="https://masto.nyc/tags/impeach" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#impeach</a> & <a href="https://masto.nyc/tags/remove" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#remove</a> <a href="https://masto.nyc/tags/UncleThomas" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#UncleThomas</a> <a href="https://masto.nyc/tags/ExpandTheCourt" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#ExpandTheCourt</a> <a href="https://masto.nyc/tags/expand" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#expand</a> <a href="https://masto.nyc/tags/illegitimate" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#illegitimate</a> <a href="https://masto.nyc/tags/regain" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#regain</a> <a href="https://masto.nyc/tags/USA" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#USA</a> <a href="https://masto.nyc/tags/respect" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#respect</a> <a href="https://masto.nyc/tags/gun" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#gun</a> <a href="https://masto.nyc/tags/rights" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#rights</a> <a href="https://masto.nyc/tags/over" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#over</a> <a href="https://masto.nyc/tags/public" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#public</a> <a href="https://masto.nyc/tags/safety" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#safety</a> <a href="https://www.scotusblog.com/2024/06/supreme-court-strikes-down-bump-stock-ban/" rel="nofollow noopener noreferrer" translate="no" target="_blank">https://www.scotusblog.com/2024/06/supreme-court-strikes-down-bump-stock-ban/</a>

Susan Larson ♀️🏳️‍🌈🏳️‍⚧️🌈The <a href="https://mastodon.online/tags/GOP" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#GOP</a> Has a 900 page <a href="https://mastodon.online/tags/MasterPlan" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#MasterPlan</a> to <a href="https://mastodon.online/tags/Criminalize" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Criminalize</a> <a href="https://mastodon.online/tags/Being" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Being</a> <a href="https://mastodon.online/tags/Trans" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Trans</a> in the <a href="https://mastodon.online/tags/UnitedStates" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#UnitedStates</a> by 2025, if <a href="https://mastodon.online/tags/Republicans" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Republicans</a> <a href="https://mastodon.online/tags/win" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#win</a> the <a href="https://mastodon.online/tags/presidency" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#presidency</a>. We can't let them <a href="https://mastodon.online/tags/keep" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#keep</a> or <a href="https://mastodon.online/tags/regain" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#regain</a> <a href="https://mastodon.online/tags/politicalpower" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#politicalpower</a> ever again!<a href="https://mastodon.online/tags/Women" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Women</a> <a href="https://mastodon.online/tags/Transgender" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Transgender</a> <a href="https://mastodon.online/tags/LGBTQ" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#LGBTQ</a> <a href="https://mastodon.online/tags/LGBTQIA" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#LGBTQIA</a> <a href="https://mastodon.online/tags/RepublicanParty" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#RepublicanParty</a> <a href="https://mastodon.online/tags/Hate" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Hate</a> <a href="https://mastodon.online/tags/Bigotry" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Bigotry</a> <a href="https://mastodon.online/tags/Violence" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Violence</a> <a href="https://mastodon.online/tags/Genocide" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Genocide</a> <a href="https://mastodon.online/tags/Discrimination" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Discrimination</a> <a href="https://mastodon.online/tags/Homophobia" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Homophobia</a> <a href="https://mastodon.online/tags/Transphobia" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#Transphobia</a> <a href="https://mastodon.online/tags/ThePartyOfHate" class="mention hashtag" rel="nofollow noopener noreferrer" target="_blank">#ThePartyOfHate</a> <a href="https://www.damemagazine.com/2023/08/14/the-gop-has-a-master-plan-to-criminalize-being-trans/" rel="nofollow noopener noreferrer" translate="no" target="_blank">https://www.damemagazine.com/2023/08/14/the-gop-has-a-master-plan-to-criminalize-being-trans/</a>

Recent searches

Search options

Administered by:

Server stats:

#regain