Welcome to the Pager Podcast. Tune in to hear about the topics changing the future of biology and medicine.
In this episode, author, speaker, campaigner and former palliative care doctor, Kathryn Mannix, joins us to discuss a range of topics related to dying. We talk about the importance of a wider public conversation about dying, misconception, the importance of good communication and more.
Dr Alain Vuylsteke, consultant in intensive care and cardiothoracic anaesthesia, Clinical Director of the Division of Surgery, Transplantation and Anaesthesia and the Director of the ECMO service at Royal Papworth Hospital joins us for an episode on extracorporeal membrane oxygenation. We discuss the ECMO service at Papworth, the evidence base, decision-making with regards to initiation and discontinuation, ECMO in the COVID-19 pandemic, cost and more. Resources:CESAR Trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61069-2/fulltextEOLIA Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1800385https://litfl.com/ecmo-extra-corporeal-membrane-oxygenation/
In this episode we speak with Dr Peter Hodkinson, the UK's first ever consultant in Aviation and Space Medicine and the head of the division of Aerospace Medicine at King's College. Topics include astronaut selection, adaptation to space flight and travel, managing medical conditions in space and more! An overview of space medicine: https://academic.oup.com/bja/article/119/suppl_1/i143/4638468
In this episode, Dr Ritu Raman joins us to discuss how engineered skeletal muscle is being applied to both robotics and medicine. We discuss everything from the influences early in Ritu's life and education which drove an interest in engineering, to optogenetics and gene modification. Some themes throughout the conversation are the interesting challenges posed by: inducing repair in muscle, and the complexity of fine motor control.Ritu is the d'Arbeloff Career Development Assistant Professor of Mechanical Engineering at MIT. She received her BS from Cornell University and her PhD as an NSF Graduate Research Fellow at the University of Illinois at Urbana-Champaign. She completed her postdoctoral research with Prof. Bob Langer at MIT, funded by a L'Oréal USA For Women in Science Fellowship and a Ford Foundation Fellowship from the National Academies of Sciences, Engineering, and Medicine.
Professor Paul Glasziou discusses a range of topics relating to evidence-based medicine, from reducing research waste to publication bias; translation of scientific findings; weighing up a body of evidence; incentivising high quality research and more. Follow us on twitter @PagerPodcast
Sharon Peacock, professor of public health and microbiology at the University of Cambridge, and director of the COVID-19 Genomics UK consortium (COG-UK), discusses all things relating to the UK's sequencing efforts, from the logistics of establishing sequencing networks, to the benefits of sequencing and applications of data collected,.
In this conversation, Dr Paola Bonfanti joins us to discuss recent work done by her group to reconstitute the human thymus outside of the human body, using cultured cells and a scaffold.We also discuss how the thymus develops, educates T cells, and how single-cell sequencing and spatial information are changing our understanding of the organ.Paola trained as a doctor in Milan, before training as a stem cell scientist at institutes in California and Switzerland. She now leads a research group at the Crick Institute in London that investigates tissues such as the thymus, and the pancreas in the context of their stem cell and epithelial cell biology.
In this episode, Emily Jackson , professor of law at the London School of Economics, joins us to discuss a range of issues relating to medical law. We talk about regulation of the pharmaceutical industry, clinical negligence, assisted reproduction and more.
Sam Gershman joins us for a discussion on both AI, and questions in Philosophy of Science. In the podcast we talk about:1) Whether observation and interpretation can be 'theory neutral'.2) How auxiliary hypotheses can 'buffer' our beliefs.3) A Bayesian framework for evaluating our auxiliary hypotheses.3) The aspects of human cognition that AI currently lacks.4) Advancing AI, and the AI alignment problem.Sam is a Professor within the Psychology department at Harvard, where his lab works on questions in learning, memory, and decision making from a computational cognitive neuroscience perspective.
Brain organoids are a new experimental model which will have broad implications for understanding and treating diseases of the brain. But as their sophistication continues to increase, could this ultimately lead to the develop of consciousness in vitro?Dr Insoo Hyun joins us in this episode to discuss bioethics and brain organoids. In the episode we cover:1) What brain organoids are, and the history of their development.2) How new scientific paradigms force are forcing philosophers to reassess age-old philosophical questions.3) How getting close to the actual research is important for ethics in the biomedical sciences.4) What it would mean for an organoid to develop 'consciousness', and how we might consider the ethical and philosophical implications.Dr Hyun is a bioethicist and the Director of Research Ethics at Harvard Medical School, as well as a professor of bioethics at Case Western Reserve Medical School. He's a prinicipal investigator a BRAIN initiative project to study bioethical questions surrounding human brain organoids, and he has also worked on various committees at the ISSCR.
In this episode, Drs Aideen Daly and Julia Fuchs join us to discuss the clinical trials for a new 'artificial pancreas' system. This system is designed to manage a type 1 diabetics blood sugar, by integrating a continuous glucose monitor, an app, as well as an insulin pump.We discuss:1) Some of the history of type 1 diabetics, and why diabetics need to inject insulin to regulate their blood glucose.2) Insights gained on from the trials about the system's efficacy3) The difference between a single hormone vs two hormone systemAideen and Julia are clinical researchers in the Hovorka group at the Wellcome-MRC Institute of Metabolic Science in Cambridge, which is focused on developing the artificial pancreas technology.
In this episode, Dr Neel Aluru joins us to discuss how toxicants in the ocean affect human health. Dr Aluru is an associate scientist at the Woods Hole Oceanographic Institute, where his research group investigates epigenetic and RNA mechanisms linking chemicals to human health.Topics include:The concept of a 'Developmental Origins of Health and Disease'How scientists investigate chemicals in the OceanPolychlorinated biphenyls, and their effects on genes in the brainModel systemsGene editing tools, and the future directions of the lab's work
Dr Zoë Fritz joins us for a discussion of the importance of advance care planning, patient-centred conversations surrounding resuscitation and future wishes and her work in developing the ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) process which seeks to improve approaches and outcomes in this setting. We also take a deep dive into medical ethics, touching upon best interest decisions, when discussions surrounding future care may not be appropriate and the role of family members in these conversations. Dr Fritz is a consultant in acute medicine at Addenbrooke's hospital in Cambridge, UK, and a Wellcome fellow in Society and Ethics. You can find out more about the ReSPECT process here: https://www.resus.org.uk/respect
In this episode Dr Arabella Simpkin, a paediatrician and Assistant Professor of Medicine at Harvard Medical School, joins us to discuss medicine’s relationship with uncertainty and how it can be embraced to improve the lives of patients and clinicians alike. We touch upon the sources of uncertainty in medicine, how we communicate and acknowledge it, its relationship with expertise and medical education, the future of research into uncertainty and more!
Dr Alasdair Munro joins us for a deep dive into all things relating to COVID-19 and children, from the role of children in transmission to ethical dilemmas over school closures, science communication in the pandemic and more.
Type 1 diabetes is an autoimmune characterised by the destruction of the insulin producing cells in the pancreas, the beta cells. The disease affects millions of people around the world, but what exactly is driving the disease's progression? Is it an overactive immune system, or are the beta cells initiating their own destruction?In this episode, Dr Stephan Kissler joins us to discuss how genetic tools, such as CRISPR, are deepening our understanding of type 1 diabetes pathophysiology. We also discuss diagnostic and therapeutic approaches which might slow or prevent disease progression, as well as stem cell-derived beta cells as a potential cure.Stephan completed his Ph.D. in Immunology at the University of Bristol, before moving to Boston for post-doctoral work at both the Dana-Farber Cancer Institute, and MIT. He was made a group leader at the Virchow Center in Germany, in 2007, before returning to Boston in 2012 to start the group he leads at the Joslin Centre for Diabetes.
Professor Neena Modi discusses the vital importance of promoting and protecting child and maternal health; its role in a post-COVID recovery and challenges associated with utilising and measuring the value of preventative health interventions. We also touch upon some common misconceptions in health economics and how to manage a long-term research agenda surrounding child and maternal health. Further reading: https://adc.bmj.com/content/early/2021/01/26/archdischild-2020-320898?rss=1 https://blogs.bmj.com/bmj/2018/03/20/neena-modi-a-bigger-vision-for-child-health/ https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30200-0/fulltext https://www.karger.com/Article/FullText/506865
In this episode, Dr Emma Rawlins joins us to discuss how our understanding of lung development has changed, and how this might allow us to regenerate lung damage therapeutically.How do our lungs develop from progenitor cells? How can stem cell populations respond to damage and disease in adults? How can these insights be leveraged to regenerate the lung following damage or disease?Some of the topics we cover include:Rare lung cell types important in regenerationHuman lung organoids and modeling SARS-CoV-2 infection The strengths and limitations of single-cell RNA sequencing in the fieldCell therapies and endogenous strategies for repairing the lungEmma is a Senior Group Leader at Cambridge University's Gurdon Institute. Her lab investigates stem and progenitor cells in the lung.
Dr Margaret McCartney, a practising GP in Glasgow, discusses communication of science, particularly during the pandemic, the nature of 'expertise', investigating the efficacy and potential harms of non-drug interventions, the nuances of screening and more.
Professor Paul Fletcher joins us for an episode which dives into the intricacies of psychosis. We discuss common misconceptions, the diversity of psychosis, our understanding of what causes it and more. Paul is both a psychiatrist and a professor of neuroscience at the University of Cambridge. His research focuses on the nature of perception and learning in psychiatric diseases, in particular those which can involve psychosis.
Professor Linda Bauld joins us for deep dive into the challenges and opportunities of public health. We discuss her longstanding work relating to tobacco control; assessing complex public health interventions; vested and political interests in public health as well as the challenge of balancing long- and short-term goals. Finally, Linda makes comparisons between the COVID-19 pandemic and other public health challenges.
In this week's episode, Ceren Ozek joins us to discuss how Growth Differentiation Factor 11, GDF11, affects the ageing process in the brain. As the brain ages, it's cognitive functions also decline, which can have huge effects on quality of life. Identified as a potential longevity factor found in the blood in 2014, GDF11 might have the potential to slow the ageing process in brain areas such as the hippocampus.This episode discusses the initial parabiosis experiments in young/old mice, the controversy surrounding GDF11's effects on skeletal muscle, the role that the vasculature plays in mediating the effects on the brain, and experimental designs.Ceren Ozek is a Postdoctoral Fellow in the Rubin lab, within Harvard’s Stem Cell and Regenerative Biology Department. Ceren completed her Ph.D. in Neuroscience at the University of Pennsylvania before coming to Harvard.
Dr Fiona Godlee, Editor-in-Chief of The British Medical Journal, joins for a fascinating discussion of the world of medical publishing and what can be done to improve future medical research. We cover conflict of interests, open data, investigative journalism, the future of the BMJ, health campaigning and medical journals’ own priorities to balance whilst at the forefront of scientific advancement.
In this episode, we discuss the effects of coffee on human health with Dr Rob van Dam. As one of the world’s most popular drinks, how might coffee be affecting all of us? The conversation starts with whether coffee changes our risk for diseases such as cancer and diabetes. This leads to everything from how it effects our state of mind, to the effects on the microbiome and sleep patterns. Dr van Dam is a professor at the National University of Singapore’s School of Public Health, as well as at Harvard’s Chan School of Public Health. His research is primarily focused on how dietary components influence the risks of type 2 diabetes, obesity, and cardiovascular disease. We hope you enjoy the episode, and you can find more wherever you get your podcasts!
Dr David Erritzøe, the clinical director of the Psychedelic Research Centre at Imperial College, London, joins us for a far-reaching discussion of research into the use of psychedelic drugs to treat mental health disorders, in particular depression. We touch upon our current understanding of how such drugs may work; challenges in designing clinical trials to test their efficacy such as challenges designing an appropriate placebo arm and using drugs illegal in the UK; the political background to such trials; microdosing; safety and more!
Dr Saurabh Johri, Chief Scientist at Babylon Health, joins us to discuss the use of artificial intelligence in medicine. We touch on what makes AI special, examples of how it can be harnessed in healthcare and the work done by Babylon in developing AI-based triage systems. We also explore how such systems should be tested to ensure safety and concerns raised surrounding bias and interpretability in AI systems.
Professor Alex London, director of the Centre for Ethics and Policy at Carnegie Mellon University, joins us to discuss a number of ethical questions faced in conducting human research in and out of the pandemic. How do we define "acceptable risks" to trial participants? How can collaboration be improved? Why is politicisation of science dangerous and is there really a trade off to be made between speed and quality of research? We also dive into the benefits yet also pitfalls of diversity in scientific opinion.
In this episode, Dr Roger Barker joins us to discuss our current understanding of Parkinson's disease.The first half of the conversation focuses on the disease process. Is Parkinson's a single disease or a group of connected diseases? How might this difference affect our thinking surrounding Parkinson's?The discussion then switches to the development of cell and gene therapies for Parkinson's. The unique challenges of a cell therapy for the brain, as well as the efficacy of a neurotrophic factor 'GDNF', are both discussed.Dr Barker is the professor of clinical neuroscience at the University of Cambridge, and a consultant neurologist at Addenbrooke’s hospital in Cambridge. His lab at the John van Geest Centre for Brain Repair is focused on better understanding both Parkinson's and Huntington's disease, as well as on developing therapies to treat these diseases.More information can be found at the lab's website: http://www.thebarkerwilliamsgraylab.co.uk/
David Nott, a consultant vascular and general surgeon at the Chelsea and Westminster Hospital in London, joins us to discuss practicing surgery in disaster and conflict zones.David has joined dozens of humanitarian missions to countries such as Bosnia, Haiti, and Syria in the last 25 years with organisations such as MSF, and the ICRC. He is also the author of the best-seller 'War Doctor', which documents his life work and experiences.What are the ethics surrounding treating combatants?How do teamwork and decision making change in 'austere' environments?What are the skills needed for humanitarian work?Can the humanitarian doctor advocate for non-combatants in geopolitics?These topics and more are discussed in the episode.
Dr Adam Cifu, a practising general internist in Chicago, joins us to discuss how medical practices previously adopted are later found out to be ineffective or harmful. Why does this reversal occur? How can we make better decisions for patients given what evidence is available and how should doctors approach uncertainty? We talk about some of the disconnect between the medical literature and a patient sitting in front of a clinician, as well as what can be done to both improve the evidence that doctors and patients use to make decisions and this decision-making process.
The heart is notoriously bad at regenerating following damage to the myocardium. On the horizon are cell therapies that could restore cardiac function following damage.In this episode, Dr Sanjay Sinha, a British Heart Foundation Senior Research Fellow, and a consultant cardiologist at Addenbrooke’s hospital, joins us discuss a stem cell derived cardiac ‘patch’, which could be transplanted into patients for heart repair after myocardial infarction. The potential of cardiac cells derived from iPSCs for personalised approached to treatment, and for modeling disease, are also discussed.
Dr Vinay Prasad, a haematologist oncologist and Associate Professor of Medicine at the University of California, joins us to talk about some of the issues with the current clinical trial landscape and the harms caused by these. From distorted incentive structures to lacklustre regulation, we talk about the roots of these problems before turning towards the changes that could be made around the world to counter them.
Dr Magdalena Skipper, Editor-in-Chief of Nature, joins to talk about the role of the journal in driving good science and communicating it around the world. We touch upon what can be done to improve reproducibility in research, how scientific publishing is changing, the different ways in which science can be valuable and how we can measure the value of science.
Dr Eric Rubin, Editor-in-Chief of the New England Journal of Medicine, joins us to talk about the roles of the journal in shaping how research is communicated, carried out and interpreted. What are the particular responsibilities of the world's top journals? How are papers assessed and has this changed during the COVID-19 pandemic?
Dr Richard Horton, Editor-in-Chief of The Lancet, joins us to talk about where the roles, responsibilities and future of one of the world's top medical journals lie. How has COVID-19 affected the journal? How political should a journal be and what makes a good editor? How are editorial decisions made? Have a listen to find out.
Dr Caroline Elton, an occupational psychologist and author of the book "Also Human: the Inner Lives of Doctors", joins us to talk about the important issue of mental health in the medical profession. Why are mental health issues so prevalent amongst doctors? How should medical schools select applicants and what is the case for institutional change to protect doctors' mental health? From dealing with the challenges faced when doctors become patients to pushing against short rotations for junior doctors with minimal social support and recognising mental health as a crucial focus for a healthcare system, what changes could, and indeed should, come in the future?
Introduce randomness, shorten the feedback loop, and optimise for happiness and meaning. In this episode, Dr. Ali Abdaal joins us to question where the value in education lies, and how we might rethink career and retirement to live more fulfilled lives.Ali is a junior doctor in Cambridge, as well as a content creator through YouTube and his weekly newsletter.We also touch on the value of management skills, how stressful work can be enjoyable in its own way, and where experience complements guidelines in medical practice.If you enjoy the episode, have a listen to the second-half in part II, all of Ali's content can be found at: https://aliabdaal.com/
Introduce randomness, shorten the feedback loop, and optimise for happiness and meaning. In this episode, Dr. Ali Abdaal joins us to question where the value in education lies, and how we might rethink career and retirement to live more fulfilled lives.Ali is a junior doctor in Cambridge, as well as a content creator through YouTube and his weekly newsletter.We also touch on the value of management skills, how stressful work can be enjoyable in its own way, and where experience complements guidelines in medical practice.If you enjoy the episode, have a listen to the second-half in part II, all of Ali's content can be found at: https://aliabdaal.com/
Trek from sea level to Everest Base Camp and the pressure of oxygen in the air will halve. Make it to the summit and it sits at just a third of sea level values. Why is it that some people are capable of summiting Everest without supplemental oxygen and some are not? What factors affect performance at altitude and why do traditional explanations of acclimatisation not paint the full picture? Dr Andrew Murray, a mitochondrial biologist at Cambridge University, joins us to talk about his work with the Xtreme Everest group and how work done at altitude can translate to improved care for patients at sea level. Got any feedback? We'd love to hear it. Leave us a review on Apple Podcasts or email us at pagerpodcast@gmail.com
All aspects of medicine have been dramatically affected by the COVID-19 outbreak and general practice is no exception. In this episode we look at how the largest medical specialty in the country is adapting to the pandemic. Professor Helen Stokes-Lampard, former chair of the RCGP, chair of the National Academy for Social Prescribing and a practising GP near Birmingham joins us to explore everything from the challenges of remote consultations and conversations around end-of-life care to morale amongst healthcare staff. We also touch upon social prescribing in a lockdown, what care is being prioritised amidst the pandemic and the consequences of lack of testing. Enjoyed this episode? Have a listen to our second one in which we look at what long-term effects COVID-19 could have on general practice.
In this episode we're joined by Professor Helen Stoke-Lampard, former chair of the RCGP, chair of the National Academy for Social Prescribing and a practising GP near Birmingham. We ask, what long-term effects will the COVID-19 outbreak have on general practice? This brings us to remote consultation, overprescribing, administration and more.
In this episode, Dr Rohin Francis joins us for a conversation on the COVID-19 outbreak in the UK, and it's effects on the NHS.Rohin is a practicing Cardiologist and a PhD student at UCL. Through his YouTube channel 'Medlifecrisis', he is actively involved in science communication on the virus.The discussion begins with how hospitals are preparing for the crisis and what the state of doctor morale is at the moment.We also discuss reports that the virus can cause cardiovascular pathology, as well as the government's decision to put the country on lockdown.Rohin's channel: https://www.youtube.com/channel/UCgRBRE1DUP2w7HTH9j_L4OQTwitter: https://twitter.com/MedCrisis?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor
Sir David Spiegelhalter joins us to discuss all things risk-related and his work as the Winton Professor of Public Understanding of Risk at Cambridge University. What is the best way to communicate risk in medicine and the broader public sphere? How can our perceptions of risk be dramatically altered by its presentation? How can we inform or persuade people using statistics and, moreover, should we? Finally, we also discuss how individuals and governments see risk through different eyes and how the risks presented in the media shouldn't always be taken at face value.
In this episode, Professor Dino Giussani joins us to discuss how hypoxia in utero plays a causative role in adult cardiovascular disease. The conversation covers what is meant by developmental programming, and Dino's research into antioxidant therapy as a future therapy to mitigate the effects of hypoxia. Dino discusses his optimism for the future effects of this work, and also the work that still needs to be done in order to bring antioxidants into clinical practice.
Professor Andrew Lever from the Department of Infectious Disease in Cambridge, joins us to discuss prevention of HIV, from pre-exposure prophylaxis, education and the limitations of vaccination, along with new and well-established methods of treating HIV infection.
Professor of infectious disease at Cambridge University, Andrew Lever, joins us to discuss the prospects of a cure for HIV. Why has curing HIV proved to be so difficult so far? What sort of approaches have been tested so far and what could a cure mean for HIV patients around the world?
How do athletes apply science to their training in order to improve? How can we apply this to our own training? Professor Dan Gordon joins us to discuss everything exercise and performance related. Dan is an exercise physiologist at Anglia Ruskin University and a former Paralympian.Topics include:VO2 maxStrength and enduranceUltramarathonsDehydration in combat sportsThe nervous system and performance
Surgical robots are used in over 5000 hospitals worldwide and this number is ever rising. CMR Surgical co-founder and consultant surgeon Dr Mark Slack joins us to discuss the field of robotic surgery today and where it might find itself in the future. We explore the merits of robotic surgery for patients and surgeons alike, potential risks associated with it and the challenges in developing robotic surgery systems following the official launch of CMR Surgical’s robotic system Versius in Europe.
Unclean water currently kills more people in the developing world than HIV and malaria combined, and the technology used to test for bacteria in water is 30 years out of date. Alex Patto joins us to discuss how a portable microscope system developed by his company WaterScope is on the cusp of changing how water is tested for bacterial contamination in the developing world. The topics we discussed included everything from WaterScope's field testing in a Tanzanian refugee camp, to Alex's experience transitioning from academia into a CEO position, and how he is learning new skills on the job.WaterScope is a not-for-profit company, founded in 2015, working to bring safe drinking water to rural and urban groups in developing countries. More information on the company can be found at: https://www.waterscope.org/
Cohosts of the Pager Podcast, George Milner and Stan Dale, sit down to explore some love-related questions sent in by listeners for Valentine's Day.Whether you're interested in the neurobiology of attraction, or want some (very amateur) tips for finding that special someone, this episode has something for you.Questions included:'What is the science behind a crush?''Why is it that the heart has been historically associated with love?''Do animals feel love like humans do?'And many more!
Professor Edward Bullmore, head of the Department of Psychiatry at the University of Cambridge, joins us in the first of two episodes on the relationship between inflammation and depression. We discuss the evidence that inflammation can be a driver of depression, how this relationship might work mechanistically and what this new understanding means for our overall perspective of depression.