Podcasts about Adverse

Patrick McKenzie (patio11) is joined again by Ricki Heicklen to discuss the evolution of her trading education business, Arbor, one year after their first conversation. They dive deep into the pedagogy of trading, exploring how simulated markets teach concepts like adverse selection, team dynamics, and risk management through hands-on experience. Ricki shares war stories from the bootcamp trenches—infinite loop bugs that mirror Knight Capital's disaster, WiFi outages that create unexpected trading opportunities, and that the most successful trading teams often focus on internal team communication even more than trade execution or technical acumen.See the full transcript: https://www.complexsystemspodcast.com/think-like-a-trader-ricki-heicklen/–[Patrick notes: Complex Systems now produces occasional video episodes.You can access them directly on YouTube: https://www.youtube.com/@patio11podcast. My kids inform me that I'm supposed to tell you to like and subscribe.]–Links:Trading Camp : https://trading.camp/Metagame: https://www.metagame.games/#tickets Story of Knight Capital: https://www.sec.gov/files/litigation/admin/2013/34-70694.pdf–Timestamps:(00:00) Intro(00:46) Ricki's journey from trading to teaching(01:25) The birth of Arbor and first bootcamps(03:32) Developing a trader's mindset(05:53) Understanding heuristics in trading(08:21) Adverse selection in everyday life(15:40) Insights from teaching trading bootcamps(21:07) Pedagogical approach: learning by doing(32:00) Handling mistakes and learning opportunities(36:17) Unplanned bugs and real-world lessons(39:47) Learning from Knight Capital's bug(40:24) Understanding exchange-side bugs(43:10) Risk limits and strategy separation(44:41) Importance of UI in trading bots(46:53) The Madagascar button(48:20) The big red button in manufacturing(49:45) Simulated trading and information aggregation(50:29) Sibling trading game explained(53:24) Modeling and hidden information(01:01:15) Trading behavior and market updates(01:04:38) Real-world applications and lessons(01:13:58) Surprises and market opportunities(01:16:24) Pedagogical approaches in trading education(01:17:08) Market dynamics and counterparty behavior(01:17:53) Retail vs. institutional order flow(01:19:23) Simplifying trading concepts for beginners(01:21:27) Introducing market characters and their roles(01:31:31) Team dynamics and communication in trading(01:39:13) The importance of redundancy in trading systems(01:47:52) Future of trading education and online classes(01:53:47) Wrap

This conversation provides a comprehensive overview of foundational legal principles in property and criminal law, emphasizing the importance of understanding key concepts for law school exams and the bar exam. It covers essential topics such as property rights, intellectual property, co-ownership, conveyancing, landlord-tenant relationships, and the intricacies of criminal law, including defenses and self-defense. The discussion highlights the interconnectedness of these legal fields and the analytical skills necessary for success in legal studies and practice.TakeawaysUnderstanding property law is crucial for law students.The concept of property as a 'bundle of sticks' is fundamental.Intellectual property rights encourage innovation.Co-ownership forms have distinct legal implications.Adverse possession allows non-owners to claim property.Conveyancing involves multiple legal steps in property sales.Self-defense laws vary significantly by jurisdiction.Criminal procedure safeguards individual rights during trials.The prosecution must prove guilt beyond a reasonable doubt.Legal principles are interconnected and require analytical skills.property law, criminal law, legal education, bar exam, property rights, intellectual property, co-ownership, conveyancing, landlord-tenant law, eminent domain, criminal procedure, self-defense, legal principles

김영철의 파워FM - 진짜 영국식 영어 443회 - 부작용이야~ = It's an adverse reaction.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Coronary Plaque, Inflammation, Subclinical Myocardial Injury, and Major Adverse Cardiovascular Events in the REPRIEVE Substudy.

THE LANCET 2003;362:772-776Background: Angiotensin converting enzyme inhibitors (ACEi) reduce mortality and morbidity in patients with systolic heart failure (see CONSENSUS and SOLVD trials). However, registry data showed that up to 20% of patients with systolic heart failure were not taking ACEi. One of the frequent causes for intolerance to ACEi is cough. Angiotensin converting enzyme inhibitors work by blocking the conversion of angiotensin I to angiotensin II, a key step in the renin–angiotensin–aldosterone system (RAAS). Angiotensin II receptor blockers were tolerated in patients with systolic heart failure who were intolerant to ACEi. However, data on long term effectives as an alternative to ACEi were lacking.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM)-Alternative trial sough to assess if the angiotensin-receptor blocker (ARB) candesartan, could improve outcomes in patients with systolic heart failure who are intolerant to ACEi.Patients: Eligible patients had left ventricular ejection fraction of 40% or less and NYHA class II, III or IV symptoms of at least 4 weeks duration. Patients had also to be intolerant to ACEi.Exclusion criteria were not provided in the main manuscript.Baseline characteristics: Patients were recruited from 618 centers in 26 countries. The trial randomized 2,028 patients – 1,013 randomized to receive candesartan and 1,015 to receive placebo.The average age of patients was 67 years and 68% were men. The average left ventricular ejection fraction was 30%. Cardiomyopathy was ischemic in 68% of the patients. The NYHA class was II in 48% of the patients, III in 49% and IV in 4%.Approximately 50% had hypertension, 27% had diabetes, 61% had prior myocardial infarction, 9% had stroke, 25% had atrial fibrillation and 14% were current smokers.At the time of enrollment, 85% were taking a diuretic, 46% were taking digoxin, 55% were taking beta-blockers and 24% were taking spironolactone.The most common reasons for ACEi intolerance were cough in 72% of the patients, hypotension in 13%, renal dysfunction in 12% and angioedema or anaphylaxis in 4%.Procedures: The trial was double-blinded. Patients were assigned in a 1:1 ratio to receive candesartan starting at 4 or 8mg once daily or placebo. The treatment was doubled every two weeks to a target dose of 32mg once daily.After randomization, follow up occurred at 2, 4, and 6 weeks, 6 months and every 4 months thereafter.Endpoints: The primary outcome was a composite of cardiovascular death or heart failure hospitalizations. All deaths were classified as cardiovascular unless there was a clear non-cardiac cause.Analysis was performed based on the intention-to-treat principle. The estimated sample size to have 80% power at 5% alpha was 2,000 patients. The sample size calculation assumed 18% relative risk reduction in the primary outcome with candesartan assuming a 15% annual event rate in the placebo arm.Results: The median follow up time was 34 months. The mean candesartan daily dose was 23mg at 6 months.Candesartan reduced the primary endpoint of cardiovascular death or heart failure hospitalizations (33.0% vs 40.0%, adjusted HR: 0.70, 95% CI: 0.60 – 0.81; p< 0.001). Candesartan reduced the individual components of the primary outcome - (21.6% vs 24.8%; p= 0.02) for cardiovascular death and (20.4% vs 28.2%; p< 0.001) for heart failure hospitalizations. All-cause death was also lower with candesartan (26.2% vs 29.2%, adjusted HR: 0.83, 95% CI: 0.70–0.99; p= 0.033). The number of patients who had any hospitalization as well as the total number of hospitalizations were numerically but not statistically significantly lower with candesartan (60.2% with candesartan vs 63.3%; p= 0.16) and (1,718 vs 1,835; p= 0.06).Candesartan was associated with more hypotension (3.7% vs 0.9%), more increase in creatinine (6.1% vs 2.7%) and more hyperkalemia (1.9% vs 0.3%). Angioedema occurred in three patients in the candesartan group and none in the placebo group. Cough occurred in two patients taking candesartan and four taking placebo.Authors reported no significant subgroup interactions, however, a corresponding graph was not provided.Conclusion: In patients with systolic heart failure who are intolerant to ACEi, candesartan reduced the primary composite outcome of cardiovascular death or heart failure hospitalizations with a number needed to treat of approximately of 14 patients over 34 months of follow up. Candesartan also reduced all-cause death with a number needed to treat of approximately 33 patients. Adverse events including hypotension, increase in creatinine and hyperkalemia were more common with candesartan.The reduction in the primary endpoint with candesartan was significant and offers an alternative for patients who are unable to tolerate ACEi. Of note, 72% of the patients enrolled in the trial were intolerant to ACEi due to cough. This trial did not include a head-to-head comparison between ARBs and ACEi, and therefore does not address which agent should be preferred as first-line therapy. Only 24% of participants were receiving spironolactone. The combination of ARBs with spironolactone, may increase the risk of adverse events, particularly hyperkalemia and kidney injury.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

Dr. Allison Zibelli and Dr. Rebecca Shatsky discuss advances in breast cancer research that were presented at the 2025 ASCO Annual Meeting, including a potential new standard of care for HER2+ breast cancer, the future of ER+ breast cancer management, and innovations in triple negative breast cancer therapy. Transcript Dr. Allison Zibelli: Hello and welcome to the ASCO Daily News Podcast. I'm Dr. Allison Zibelli, your guest host of the podcast today. I'm an associate professor of medicine and a breast medical oncologist at the Sidney Kimmel Comprehensive Cancer Center at Jefferson Health. There was a substantial amount of exciting breast cancer data presented at the 2025 ASCO Annual Meeting, and I'm delighted to be joined by Dr. Rebecca Shatsky today to discuss some of these key advancements. Dr. Shatsky is an associate professor of medicine at UC San Diego and the head of breast medical oncology at the UC San Diego Health Moores Cancer Center, where she also serves as the director of the Breast Cancer Clinical Trials Program and the Inflammatory and Triple-Negative Breast Cancer Program.  Our full disclosures are available in the transcript of this episode. Dr. Shatsky, it's great to have you on the podcast today. Dr. Rebecca Shatsky: Thanks, Dr. Zibelli. It's wonderful to be here. Dr. Allison Zibelli: So, we're starting with DESTINY-Breast09, which was trastuzumab deruxtecan and pertuzumab versus our more standard regimen of taxane, trastuzumab pertuzumab for first-line treatment of metastatic HER2-positive breast cancer. Could you tell us a little bit about the study? Dr. Rebecca Shatsky: Yeah, absolutely. So, this was a long-awaited study. When T-DXd, or trastuzumab deruxtecan, really hit the market, a lot of these DESTINY-Breast trials were started around the same time. Now, this was a global, randomized, phase 3 study presented by Dr. Sara Tolaney from the Dana-Farber Cancer Institute of Harvard in Boston. It was assessing essentially T-DXd in the first-line setting for metastatic HER2-positive breast cancer in addition to pertuzumab. And that was randomized against our standard-of-care regimen, which was established over a decade ago by the CLEOPATRA trial, and we've all been using that internationally for at least the past 10 years. So, this was a large trial, and it was one-to-one-to-one of patients getting T-DXd plus pertuzumab, T-DXd alone, or THP, which mostly is used as docetaxel and trastuzumab and pertuzumab every three weeks for six cycles. And this was in over 1,000 patients; it was 1,159 patients with metastatic HER2-positive breast cancer. This was a very interesting trial. It was looking at the use of trastuzumab deruxtecan, but patients were started on this treatment for their first-line metastatic HER2-positive breast cancer with no end date to their T-DXd. So, it was, you know, you were started on T-DXd every 3 weeks until progression. Now, CLEOPATRA is a little bit different than that, though, as we know. So, CLEOPATRA has a taxane plus trastuzumab and pertuzumab. But generally, patients drop the taxane after about six to seven cycles because, as we know, you can't be really on a taxane indefinitely. You get pretty substantial neuropathy as well as cytopenias, other things that end up happening. And so, in general, that regimen has sort of a limited time course for its chemotherapy portion, and the patients maintained after the taxane is dropped on their trastuzumab and their pertuzumab, plus or minus endocrine therapy if the investigator so desires. And the primary endpoint of the trial was progression-free survival by blinded, independent central review (BICR) in the intent-to-treat population. And then it had its other endpoints as overall survival, investigator-assessed progression-free survival, objective response rates, and duration of response, and of course, safety. As far as the results of this trial, so, I think that most of us key opinion leaders in breast oncology were expecting that this was going to be a positive trial. And it surely was. I mean, this is a really, really active drug, especially in HER2-positive disease, of course. So, the DESTINY-Breast03 data really established that, that this is a very effective treatment in HER2-positive metastatic breast cancer. And this trial really, again, showed that. So, there were 383 patients that ended up on the trastuzumab plus deruxtecan plus pertuzumab arm, and 387 got THP, the CLEOPATRA regimen. What was really interesting also to note of this before I go on to the results was that 52% of patients on this trial had de novo metastatic disease. And that's pretty unusual for any kind of metastatic breast cancer trial. It kind of shows you, though, just how aggressive this disease is, that a lot of patients, they present with de novo metastatic disease. It's also reflecting the global nature of this trial where maybe the screening efforts are a little bit less than maybe in the United States, and more patients are presenting as later stage because to have a metastatic breast cancer trial in the United States with 52% de novo metastatic disease doesn't usually happen. But regardless, the disease characteristics were pretty well matched between the two groups. 54% of the patients were triple positive, or you could say hormone-positive because whether they were PR positive or ER positive and PR negative doesn't really matter in this disease. And so, the interim data cutoff was February of this year, of 2025. So, the follow-up so far has been about 29 months, so the data is still really immature, only 38% mature for progression-free survival interim analysis. But what we saw is that T-DXd plus pertuzumab, it really improved progression-free survival. It had a hazard ratio that was pretty phenomenal at 0.56 with a confidence interval that was pretty narrow of 0.44 to 0.71. So, very highly statistically significant data here. The progression-free survival was consistent across all subgroups. Overall survival, very much immature at this time, but of course, the trend is towards an overall survival benefit for the T-DXd group. The median durable response with T-DXd plus pertuzumab exceeded 3 years. Now, importantly, though, I want to stress this, is grade 3 or above treatment-emergent adverse events occurred in both subgroups pretty equally. But there were 2 deaths in the T-DXd group due to interstitial lung disease. And there was a 12.1% adjudicated drug-induced interstitial lung disease/pneumonitis event rate in the T-DXd group and only 1%, and it was grade 1-2, in the THP group. So, that's really the caveat of this therapy, is we know that a percentage of patients are going to get interstitial lung disease, and that some may have very serious adverse events from it. So, that's always something I keep in the back of my mind when I treat patients with T-DXd. And so, overall, the conclusions of the trial were pretty much a slam dunk. T-DXd plus pertuzumab, it had a highly statistically significant and clinically meaningful improvement in progression-free survival versus the CLEOPATRA regimen. And that was across all subgroups for first-line metastatic HER2-positive breast cancer here. And so, yeah, the data was pretty impressive. Just to go into the overall response rate, because that's always super important as well, you had 85.1% of patients having a confirmed overall RECIST response rate in the T-DXd plus pertuzumab group and a 78.6 in the CLEOPATRA group. The complete CR rate, complete response was 15.1% in the T-DXd group and 8.5 in the CLEOPATRA regimen. And it was really an effective regimen in this group, of course. Dr. Allison Zibelli: So, the investigators say at the end of their abstract that this is the new standard of care. Would you agree with that statement? Dr. Rebecca Shatsky: Yeah, that was a bold statement to make because I would say in the United States, not necessarily at the moment because the quality of life here, you have to think really hard about. Because one thing that's really important about the DESTINY-Breast09 data is that this was very much an international trial, and in many of the countries where patients enrolled on this, they were not able to access T-DXd off trial. And so, for them, this means T-DXd now or potentially never. And so, that is a really big difference whereas internationally, that may mean standard of care. However, in the US, patients have no issues accessing T-DXd in the second- or third-line settings. And right now, it's the standard of care in the second line in the United States, with all patients basically getting this second-line therapy except for some unique patients where they may be doing a PATINA trial regimen, which we saw at San Antonio Breast Cancer in 2024 of the triple-positive patients getting hormonal therapy plus palbociclib, which had a really great durable response. That was super impressive as well. Or there is the patient that the investigator can pick KADCYLA because the patient really wants to preserve their hair or maybe it's more indolent disease. But the quality of life on T-DXd indefinitely in the first-line setting is a big deal because, again, that CLEOPATRA regimen allows patients to drop their chemotherapy component about five to six months in. And with this, you're on a drug that feels very chemo-heavy indefinitely. And so, I think there's a lot more to investigate as far as what we're going to do with this data in the United States because it's a lot to commit a patient in the first-line metastatic setting. These de novo metastatic patients, some of them may be cured, honestly, on the HER2-targeting regimen. That's something we see these days. Dr. Allison Zibelli: So, very interesting trial. I'm sure we'll be talking about this for a long time.  So, let's move on to SERENA-6, which was, I thought, a very interesting trial. This trial took patients with ER positive, advanced breast cancer after six months on an AI (aromatase inhibitor) and a CDK4/6 inhibitor. They did ctDNA every two to three months, and when they saw an ESR1 mutation emerge, they changed half of the patients to camizestrant plus CDK4/6 and kept the other half on the AI plus CDK4/6. Can you talk about that trial a little bit, please? Dr. Rebecca Shatsky: Yeah, so this was a big trial at ASCO25. This was presented as a Plenary Session. So, this was camizestrant plus a CDK4/6 inhibitor, and it could have been any of the three, so palbo, ribo, or abemaciclib in the first-line metastatic hormone-positive population, and patients were on an AI with that. They were, interestingly, tested by ctDNA at baseline to see if they had an ESR1 mutation. So, that was an interesting feature of this trial. But patients had to have already been on their CDK4/6 inhibitor plus AI for at least 6 months to enroll. And then, as you mentioned, they got ctDNA testing every 2 to 3 months. This was also a phase 3, double-blind, international trial. And I do want to highlight again, international here, because that's important when we're considering some of this data in the U.S. because it influences some of the results. So, this was presented by Dr. Nick Turner of the Royal Marsden in the UK. So, just a little bit of background for our listeners on ESR1 mutations and why they're important. This is the most common, basically, acquired resistance mutation to patients being treated with aromatase inhibitors. We know that treatment with aromatase inhibitors can induce this. It makes a conformational change in the estrogen receptor that makes the estrogen receptor constitutively active, which allows the cell to signal despite the influence of the aromatase inhibitor to decrease the estrogen production so that the ligand binding doesn't matter as much as far as the cell signaling and transcription is concerned. And camizestrant, you know, as an oral SERD, just to explain that a little bit too; these are estrogen receptor degraders. The first-in-class of a selective estrogen receptor degrader to make it to market was fulvestrant. And that's really been our standard-of-care estrogen degrader for the past 25 years, almost 25 years. And so, a lot of us are just looking for some of these oral SERDs to replace that. But regardless, they do tend to work in the ESR1-mutated population. And we know that patients on aromatase inhibitors, the estimates of patients developing an ESR1 mutation, depending on which study you look at, somewhere between 30% to 50% overall, patients will develop this mutation with hormone-positive metastatic breast cancer. There is a small percentage of patients that have these at baseline without even treatment of an aromatase inhibitor. The estimates of that are somewhere between 0.5 and up to 5%, depending on the trial you look at and the population. But regardless, there is a chance someone on their CDK4/6 inhibitor plus AI at 6 months' time course could have had an ESR1 mutation at that time. But anyway, so they got this ctDNA every 2 to 3 months, and once they were found to develop an ESR1 mutation, the patients were then switched to the oral SERD. AstraZeneca's version of the oral SERD is camizestrant, 75 mg daily. And then their type of CDK4/6 inhibitor was maintained, so they didn't switch the brand of their CDK4/6 inhibitor, importantly. And that was looked at then for progression-free survival, but these were patients with measurable disease by RECIST version 1.1. And the data cut off here was November of 2024. This was a big trial, you know, and I think that that's influential here because this was 3,256 patients, and that's a lot of patients. So, they were all eligible. And then 315 patients ended up being randomized to switch to camizestrant upon presence of that ESR1 mutation. So, that was 157 patients. And then the other half, so they were randomized 1:1, they continued on their AI without switching to an oral SERD. That was 158 patients. They were matched pretty well. And so, their baseline characteristics, you know, the two subgroups was good. But this was highly statistically significant data. I'm not going to diminish that in any way. Your hazard ratio was 0.44. Highly statistically significant confidence intervals. And you had a median progression-free survival in those that switched to camizestrant of 16 months, and then the non-switchers was 9.2 months. So, the progression-free survival benefit there was also consistent across the subgroups. And so, you had at 12 months, the PFS rate was 60.7% for the non-treatment group and 33.4% in the treatment group. What's interesting, though, is we don't have overall survival data. This is really immature, only 12% mature as far as overall survival. And again, because this was an international trial and patients in other countries right now do not have the access to oral SERDs that the United States does, the crossover rate, they were not allowed to crossover, and so, a very few patients, when we look at progression-free survival 2 and ultimately overall survival, were able to access an oral SERD in the off-trial here and in the non-treatment group. And so, that's really important as far as we look at these results. Adverse events were pretty minimal. These are very safe drugs, camizestrant and all the other oral SERDs. They have some mild toxicities. Camizestrant is known for something weird, which is called photopsia, which is some flashing lights in the periphery of the eye, but it doesn't seem to have any serious clinical significance that we know of. It has a little bit of bradycardia, but it's otherwise really well tolerated. You know, I hate to say that because that's very subjective, right? I'm not the one taking the drug. But it doesn't have any serious adverse events that would cause discontinuation. And that's really what we saw in the trial. The discontinuation rates were really low. But overall, I mean, this was a positive trial. SERENA-6 showed that switching to camizestrant at the first sign of an ESR1 mutation on CDK4/6 inhibitor plus AI improved progression-free survival. That's all we can really say from it right now. Dr. Allison Zibelli: So, let's move on to ASCENT-04, which was a bit more straightforward. Sacituzumab govitecan plus pembrolizumab versus chemotherapy plus pembrolizumab in PD-L1-positive, triple-negative breast cancer. Could you talk about that study? Dr. Rebecca Shatsky: Yeah, so this was also presented by the lovely Sara Tolaney from Dana-Farber. And this study made me really excited. And maybe that's because I'm a triple-negative breast cancer person. I mean, not to say that I don't treat hundreds of patients with hormone- positive, but our unmet needs in triple negative are huge because this is a disease where you have got to throw your best available therapy at it as soon as you can to improve survival because survival is so poor in this disease. The average survival with metastatic triple-negative breast cancer in the United States is still 13-18 months, and that's terrible. And so, for full disclosure, I did have this trial open at my site. I was one of the site PIs. I'm not the global PI of the study, obviously. So, what this study was was for patients who had had at least a progression-free survival of 6 months after their curative intent therapy or de novo metastatic disease. They were PD-L1 positive as assessed by the Dako 22C3 assay of greater than or equal to a CPS score of 10. So, that's what the KEYNOTE-355 trial was based on as well. So, standard definition of PD-L1 positive in breast cancer here. And basically, these patients were randomized 1:1 to either their sacituzumab govitecan plus pembrolizumab, day 1 they got both therapies, and then day 8 just the saci, as is standard for sacituzumab. And then the other group got the KEYNOTE-355 regimen. So, that is pembrolizumab with – your options are carbogem there, paclitaxel or nab-paclitaxel. And it's up to investigator's decision which upon those they decided. They followed these patients for disease progression or unacceptable toxicity. It was really an impressive trial in my opinion because we know already that this didn't just improve progression-free survival, because survival is so poor in this disease, of course, we know that it improved overall survival. It's trending towards that very much, and I think that's going to be shown immediately. And then the objective response rates were better, which is key in this disease because in the first-line setting, you've got a lot of people who, especially your relapsed TNBC that don't respond to anything. And you lose a ton of patients even in the first-line setting in this disease. And so, this was 222 patients to chemotherapy and pembro and 221 to sacituzumab plus pembro. Median follow-up has only been 14 months, so it's still super early here. Hazard ratio so far of progression-free survival is 0.65, highly statistically significant, narrow confidence intervals. And so, the median duration of response here for the saci group was 16.5 months versus 9.2 months. So, you're getting a 7-month progression-free survival benefit here, which in triple negative is pretty fantastic. I mean, this reminds me of when we saw the ASCENT data originally come out for sacituzumab, and we were all just so happy that we had this tool now that doubled progression-free and overall survival and made such a difference in this really horrible disease where patients do poorly. So, OS is technically immature here, but it's really trending very heavily towards improvement in overall survival. Importantly, the treatment-related adverse events in this, I mean, we know sacituzumab causes neutropenia, people who are experienced with this drug know how to manage it at this point. There wasn't any really unexpected treatment-related adverse events. You get some people with sacituzumab who have diarrhea. It's usually pretty manageable with some Imodium. So, it was cytopenias predominantly in this disease in this population that were highlighted as far as adverse events. But I'm going to be honest, like I was surprised that this wasn't the plenary over the SERENA-6 data because this, in my mind, there we have a practice-changing trial. I will immediately be trying to use this in my PD-L1 population because, to be honest, as a triple-negative breast cancer clinical specialist, when I get a patient with metastatic triple-negative breast cancer who's PD-L1 positive, I think, "Oh, thank God," because we know that part of the disease just does better in general. But now I have something that really could give them a durable response for much longer than I ever thought possible when I started really heavily treating this disease. And so, this was immediately practice-changing for me. Dr. Allison Zibelli: I think that it's pretty clear that this is at least an option, if not the option, for this group of patients. Dr. Rebecca Shatsky: Yeah, the duration of responses here was – it's just really important because, I mean, I do think this will make people live longer. Dr. Allison Zibelli: So, moving on to the final study that we're going to discuss today, neoCARHP (LBA500), which was neoadjuvant taxane plus trastuzumab, pertuzumab, plus or minus carbo(platin) in HER2-positive early breast cancer. I think this is a study a lot of us have been waiting for. What was the design and the results of this trial? Dr. Rebecca Shatsky: I was really excited about this as well because I'm one of those people that was waiting for this. This is a Chinese trial, so that is something to take note of. It wasn't an international trial, but it was a de-escalation trial which had become really popular in HER2-positive therapy because we know that we're overtreating HER2-positive breast cancer in a lot of patients. A lot of patients we're throwing the kitchen sink at it when maybe that is not necessary, and we can really de-escalate and try to personalize therapy a little bit better because these patients tend to do well. So, the standard of care, of course, in HER2-positive curative intent breast cancer with tumors that are greater than 2 cm is to give them the TCHP regimen, which is docetaxel, carboplatin, trastuzumab, and pertuzumab. And that was sort of established by several trials in the NeoSphere trial, and now it's been repeated in a lot of different studies as well. And so, that's really the standard of care that most people in the United States use for HER2-positive curative intent breast cancer. This was a trial to de-escalate the carboplatin, which I was super excited about because many of us who treat this disease a lot think carbo is the least important part of the therapy you're giving there. We don't really know that it's necessary. We've just been doing it for a long time, and we know that it adds a significant amount of toxicity. It causes thrombocytopenia, it causes severe nausea, really bad cytopenias that can be difficult in the last few cycles of this to manage. So, this trial was created. It randomized patients one to one with stage 2 and 3 HER2-positive breast cancer to either get THP, a taxane, pertuzumab, trastuzumab, similar to the what we do in first-line metastatic HER2-positive versus the whole TCHP with a carboplatin AUC of 6, which is what's pretty standard. And it was a non-inferiority trial, so important there. It wasn't to establish superiority of this regimen, which none of us, I think, were looking for it to. And it was a modified intent-to-treat population. And so, all patients got at least one cycle of this to be assessed as a standard for an intent-to-treat trial. And so, they assumed a pCR rate of about 62.8% for both groups. And, of course, it included both HER2-positive triple positives and ER negatives, which are, you know, a bit different diseases, to be honest, but we all kind of categorize them and treat them the same. And so, this trial was powered appropriately to detect a non-inferiority difference. And so, we had about 380 patients treated on both arms, and there was an absolute difference of only 1.8% of those treated with carbo versus those without. Which was fantastic because you really realized that de-escalation here may be something we can really do. And so, the patients who got, of course, the taxane regimen had fewer adverse events. They had way fewer grade 3 and 4 adverse events than the THP group. No treatment-associated deaths occur, which is pretty standard for- this is a pretty safe regimen, but it causes a lot of hospitalizations due to diarrhea, due to cytopenias, and neutropenic fever, of course. And so, I thought that this was something that I could potentially enact, you know, and be practice-changing. It's hard to say that when it's a trial that was only done in China, so it's not necessarily the United States population always. But I think for patients moving forward, especially those with, say, a 2.5 cm tumor, you know, node negative, those, I'd feel pretty comfortable not giving them the carboplatin here. Notes that I want to make about this population is that the majority were stage 2 and not stage 3. They weren't necessarily your inflammatory HER2-positive breast cancer patients. And that the taxane that was utilized in the trial is a little different than what we use in the United States. The patients were allowed to get nab-paclitaxel, which we don't have FDA approval for in the first-line curative intent setting for HER2-positive breast cancer in the United States. So, a lot of them got abraxane, and then they also got paclitaxel. We tend to use docetaxel every 3 weeks in the United States. So, just to point out that difference. We don't really know if that's important or not, but it's just a little bit different to the population we standardly treat. Dr. Allison Zibelli: So, are there patients that you would still give TCHP to? Dr. Rebecca Shatsky: Yeah, great question. I've been asked that a lot in the past like week since ASCO. I'd say in my inflammatory breast cancer patients, that's a group I do tend to sometimes throw the kitchen sink at. Now, I don't actually use AC in those because I know that that was the concern, but I think the TRAIN-2 trial really showed us you don't need to use Adriamycin in HER2-positive disease unless it's like refractory. So, I don't know that I would throw this on my stage 3C or inflammatory breast cancer patients yet because the majority of this were not stage 3. So, in your really highly lymph node positive patients, I'm a little bit hesitant to de-escalate them from the start. This is more of a like, if there's serious toxicity concerns, dropping carbo is absolutely fine here. Dr. Allison Zibelli: All right, great.  Thank you, Dr. Shatsky, for sharing your valuable insights with us on the ASCO Daily News Podcast today. Dr. Rebecca Shatsky: Thanks so much, Dr. Zibelli and ASCO Daily News. I really want to thank you for inviting me to talk about this today. It was really fun, and I hope you find my opinions on some of this valuable. And so, I just want to thank everybody and my listeners as well. Dr. Allison Zibelli: And thank you to our listeners for joining us today. You'll find the links to all the abstracts discussed today in the transcript of this episode. Finally, if you like this podcast and you learn things from it, please take a moment to rate, review, and describe because it helps other people find us wherever you get your podcasts. Thank you again. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. More on today's speakers Dr. Allison Zibelli Dr. Rebecca Shatsky @Dr_RShatsky Follow ASCO on social media:  @ASCO on Twitter  @ASCO on Bluesky  ASCO on Facebook  ASCO on LinkedIn   Disclosures: Dr. Allison Zibelli: No relationships to disclose Dr. Rebecca Shatsky: Consulting or Advisory Role: Stemline, Astra Zeneca, Endeavor BioMedicines, Lilly, Novartis, TEMPUS, Guardant Health, Daiichi Sankyo/Astra Zeneca, Pfizer Research Funding (Inst.): OBI Pharma, Astra Zeneca, Greenwich LifeSciences, Briacell, Gilead, OnKure, QuantumLeap Health, Stemline Therapeutics, Regor Therapeutics, Greenwich LifeSciences, Alterome Therapeutics  

In his weekly clinical update, Dr. Griffin and Vincent Racaniello discuss in shock how RFK is breaking his promise of not altering vaccine policies by appointing new members of the ACIP, next ACIP meeting on guidelines for the COVID and RSV vaccines, circulation of “human insect viruses” including West Nile virus, and an outbreak of mpox on a cruise ship, and the ongoing measles outbreak before Dr. Griffin reviews recent statistics on RSV, influenza and SARS-CoV-2 infections the Wasterwater Scan dashboard, how to reduce the use of antibiotics for RSV and influenza infections in children, approval of the moderna RSV mRNA vaccine, whether or not the NB.1.8.1 should be included in the fall 2025 vaccines, immunization recommendations for COVID-19 vaccines, where to find PEMGARDA, provides information for Columbia University Irving Medical Center's long COVID treatment center, where to go for answers to your long COVID questions, contacting your federal government representative to stop the assault on science and biomedical research, and a shout out for the special episode of TWiV with David Tuller on long COVID and ME/CFS. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode RFK Jr. is sabotaging the vaccine program. Here's how to stop him (Washington Post) Innovaciones Alumbra (Alumbra Innovaciones) John T Walton (Wikiepedia) Walmart (Wikipedia) Sam Walton (Wikipedia) Condé Nast (Wikipedia) Christy Walton (Wikipedia) Vaccine Integrity Project ( CIDRAP) CIDRAP launches Vaccine Integrity Project (Twin Cities: University of Minnesota) Next ACIP meeting (CDC: ACIP) June meeting: MEETING OF THE ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP)(CDC: ACIP agenda) West Nile Virus and Other Nationally Notifiable Arboviral Diseases — United States, 2023 (CDC: MMWR) Clade II Mpox Infections Among Cruise Ship Passengers and Crew Members — United States, 2024 (CDC: MMWR) H5 bird flu: current situation (CDC: Avian Influenza) Wastewater for measles (WasterWater Scan) Measles cases and outbreaks (CDC Rubeola) Weekly measles and rubella monitoring (Government of Canada) Measles (WHO) Get the FACTS about measles (NY State Department of Health) Measles (CDC Measles (Rubeola)) Measles vaccine (CDC Measles (Rubeola)) Presumptive evidence of measles immunity (CDC) Contraindications and precautions to measles vaccination (CDC) Measles (CDC Measles (Rubeola) Measles vaccine recommendations from NYP (jpg) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM) Measles Vaccination: Know the Facts (ISDA: Infectious Diseases Society of America) Deaths following vaccination: what does the evidence show (Vaccine) Influenza: Waste water scan for 11 pathogens (WastewaterSCan) US respiratory virus activity (CDC Respiratory Illnesses) Weekly surveillance report: clift notes (CDC FluView) Respiratory virus activity levels (CDC Respiratory Illnesses) Weekly surveillance report: clift notes (CDC FluView) Pediatric antibiotic use associated with respiratory syncytial virus and influenza in the United States, 2008-2018 (JID) FDA-CDC-DOD: 2025-2046 influenza vaccine composition (FDA) RSV: Waste water scan for 11 pathogens (WastewaterSCan) US respiratory virus activity (CDC Respiratory Illnesses) RSV-Network (CDC Respiratory Syncytial virus Infection) Novel Drug Approvals for 2025 (FDA) Effectiveness and impact of nirsevimab in Chile during the first season of a national immunisation strategy against RSV (NIRSE-CL) (LANCET: Infectious Diseases) Safety, Tolerability, and Immunogenicity ofmRNA-1345 in Adults at Increased Risk for RSV Disease Aged 18 to 59 Years (CID) Moderna Receives U.S. FDA Approval for RSV Vaccine, mRESVIA, in Adults Aged 18–59 at Increased Risk for RSV Disease (moderna) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 deaths (CDC) COVID-19 national and regional trends (CDC) Spatiotemporal Association of Coronavirus Disease 2019 Cases and Deaths With Exposure to Wildfire Particulate Matter in 2020 (OFID) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) Next ACIP meeting (CDC: ACIP) Antigenic and Virological Characteristics of SARS-CoV-2 Variant BA.3.2, XFG, and NB.1.8.1 (biRxiV) Where to get pemgarda (Pemgarda) EUA for the pre-exposure prophylaxis of COVID-19 (INVIYD) Infusion center (Prime Fusions) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Implementation of an online drug-drug interaction screener for the STRIVE ensitrelvir trial for COVID-19 (OFID) Drug interaction checker (University of Liverpool) Infectious Disease Society guidelines for treatment and management (ID Society) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) Managing healthcare staffing shortages (CDC) Steroids,dexamethasone at the right time (OFID) Anticoagulation guidelines (hematology.org) Daniel Griffin's evidence based medical practices for long COVID (OFID) Long COVID hotline (Columbia : Columbia University Irving Medical Center) The answers: Long COVID Long COVID and ME/CFS with David Tuller (microbeTV) Reaching out to US house representative Letters read on TWiV 1228 Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.

In this podcast, Dr. Danny Nguyen from the City of Hope, Huntington Beach, CA, USA, and Dr. Edgardo S. Santos from the Oncology Institute of Hope and Innovation, Broward County, FL, USA, aim to educate on strategies to mitigate and manage dermatologic adverse events associated with amivantamab + lazertinib. This podcast is published open access in Targeted Oncology and is fully citeable. You can access the original published video podcast/vodcast article through the Targeted Oncology website and by using this link: https://link.springer.com/article/10.1007/s11523-025-01163-3. All conflicts of interest can be found online. Open Access This podcast is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The material in this podcast is included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

Dr. David Clarke shares his 40-year journey as a medical consultant specializing in neuroplastic conditions—real physical symptoms generated by the brain in response to stress, trauma, or emotional challenges. He explains how these conditions affect 20% of adults and 40% of doctor visits, yet remain frequently misdiagnosed despite being highly treatable.• Neuroplastic symptoms are physical manifestations created by the brain in response to stress or trauma• These conditions affect strong individuals carrying burdens they've normalized, not "weak" or "neurotic" people• Adverse childhood experiences (ACEs) can create lasting impacts through stressful personality traits, triggers, and unrecognized emotions• Brain circuits physically change with chronic stress and can change back with appropriate treatment• The brain creates all sensations—even with physical injuries, pain signals originate in the brain• Long Covid and similar conditions may involve neuroplastic mechanisms that maintain symptoms after initial triggers• Recovery includes reframing self-perception from weakness to strength, setting boundaries, and processing emotions• Transformation extends beyond symptom relief to improved relationships and becoming "who you were meant to be"Visit Symptomatic Me to take a 12-item questionnaire assessing for neuroplastic symptoms, and check out "The Story Behind the Symptoms" podcast where Dr. Clarke interviews patients about their recovery journeys.Symptomatic.MeMessage the podcast! - questions will be answered on my youtube channel :) For more information about Long Covid Breathing courses & workshops, please check out LongCovidBreathing.com (music credit - Brock Hewitt, Rule of Life) Support the show~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~The Long Covid Podcast is self-produced & self funded. If you enjoy what you hear and are able to, please Buy me a coffee or purchase a mug to help cover costsTranscripts available on individual episodes herePodcast, website & blog: www.LongCovidPodcast.comFacebook @LongCovidPodcastInstagram Twitter @LongCovidPodFacebook Creativity GroupSubscribe to mailing listPlease get in touch with feedback, suggestions or how you're doing - I love to hear from you, via socials or LongCovidPodcast@gmail.com**Disclaimer - you should not rely on any medical information contained in this Podcast and related materials in making medical, health-related or other decisions. Please consult a doctor or other health professional**

American Farm Bureau Federation President Zippy Duvall says a flawed AEWR puts an ample workforce out of reach for many farmers.

The Georgia Fruit and Vegetable Growers Association and others are seeking detailed information about how the USDA calculates the Adverse Effect Wage Rate, and the EU says it's open to lowering tariffs on U.S. fertilizer imports.

Dr Erin Louise Bellamy founded Integrative Ketogenic Research and Therapies which uses principles of Metabolic Psychiatry to provide remote, highly personalized 1:1 Metabolic Therapy for both psychiatric conditions and overall metabolic health. Dr. Erin Bellamy has a PhD in Psychology, specializing in Ketogenic Diets & Depression from the University of East London. She also has an MSc in Psychiatric Research from the Institute of Psychiatry at King's College London. She is a Chartered Psychologist, an Associate Fellow of the British Psychological Society and an accredited member of the Society of Metabolic Health Practitioners. In this episode, Drs. Brian and Erin talk about… (00:00) Intro (01:36) How Dr. Erin became interested in Metabolic Psychiatry (05:38) Ketogenic diets and psychiatric conditions (15:39) Fasting and mental clarity (18:12) The areas in which clinical psychology is deficient in helping patients (23:46) Adverse childhood events, PTSD, and metabolic health (28:24) Binge eating, stress, and support groups (40:00) Food addiction and ketosis (43:59) Schizophrenia, autism, and ketosis (01:00:46) Outro/plugs For more information, please see the links below. Thank you for listening! Links: Please consider supporting us on Patreon: https://www.lowcarbmd.com/ Resources Mentioned in this Episode: Dr. Erin Bellamy on the Life's Best Medicine Podcast: https://lifesbestmedicine.com/podcast/episode-248-dr-erin-bellamy/ Dr. Erin Bellamy: Instagram: https://www.instagram.com/erinlouisebellamy/ X: https://x.com/erinlbellamy Integrative Ketogenic Research & Therapies: https://www.ikrt.org Dr. Brian Lenzkes:  Website: https://arizonametabolichealth.com/ Twitter: https://twitter.com/BrianLenzkes?ref_src=twsrc^google|twcamp^serp|twgr^author Dr. Tro Kalayjian:  Website: https://www.doctortro.com/ Twitter: https://twitter.com/DoctorTro Instagram: https://www.instagram.com/doctortro/ Toward Health App Join a growing community of individuals who are improving their metabolic health; together.  Get started at your own pace with a self-guided curriculum developed by Dr. Tro and his care team, community chat, weekly meetings, courses, challenges, message boards and more.  Apple: https://apps.apple.com/us/app/doctor-tro/id1588693888  Google: https://play.google.com/store/apps/details?id=uk.co.disciplemedia.doctortro&hl=en_US&gl=US Learn more: https://doctortro.com/community/ 

What if parents could truly change the future just by having more open conversations about alcohol? In this episode host Anna Donaghey is joined by Jessica Lahey, educator and author of The Addiction Inoculation. Together, they explore the factors that influence substance use in young people, the power of prevention, and how honest dialogue can break cycles of dependence. This episode guides listeners through what they can do, no matter their own history with alcohol, to build resilience in the next generation.Here are the highlights:00:00 Introduction05:15 Talking about substance use prevention is challenging 09:47 Lack of learned strategies to manage stress and anxiety15:12 Adverse childhood experiences can lead to substance use disorders16:28 Teenagers understand consequences but weigh positive outcomes more 20:43 Empowering kids with self-efficacy can prevent substance use34:34 Kids need at least one trusted adult to confide in37:29 Kids may try substances due to feeling inadequate or out of place50:39 Reliable information for teenagers is key for understanding and trust. If you're a mum wanting to explore your relationship with alcohol, join ‘Mummy Doesn't Need Wine' here: https://www.facebook.com/groups/mummydoesntneedwineAnna's group coaching community ‘Unstuck!' helps identify your alcohol ‘stories' and beliefs, breaking the cycle of alcohol and all the shame that goes with it. For more information and to find out how to join, please follow this link: Unstuck! community informationTo further explore your relationship with alcohol, check out Anna's self-guided programme, The Big Drink Rethink Experiment: https://www.thebeliefscoach.com/the-big-drink-rethink-experimentAnd apply the code POD99 to purchase for just £99 as a podcast listenerFor the free resources accompanying this series, please head to https://www.thebeliefscoach.com/registrationIf you're loving the podcast and would like to give Anna a warm, fuzzy feeling of appreciation, then you can buy her a coffee:https://buymeacoffee.com/bigdrinkrethinkAbout the host Anna:Anna is a certified Alcohol Mindset Coach, trained by Annie Grace of This Naked Mind. Drawing on her own journey out of alcohol addiction, she now helps others explore and control their drinking. With a career spanning 25 years as a Strategist in the Advertising industry, she combines her own lived experiences, with great insight into what makes us tick and what influences us to behave the way we do. Connect with Anna:Website: thebeliefscoach.comLinkedIn: linkedin.com/in/annadonagheyInstagram:

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-436 Overview: Many patients with chronic obstructive pulmonary disease (COPD) are improperly treated with inhaled corticosteroids (ICS), increasing their risk of harm. This episode explores the latest evidence on long-term ICS risks and provides practical guidance to help you align COPD care with current guidelines—improving outcomes while minimizing adverse effects like pneumonia, cataracts, type 2 diabetes mellitus, and osteoporosis. Episode resource links: Pace WD, Callen E, Gaona-Villarreal G, Shaikh A, Yawn BP. Adverse outcomes associated with inhaled corticosteroid use in individuals with chronic obstructive pulmonary disease. Ann Fam Med. 2025;23(2):127-135. doi:10.1370/afm.240030 Pocket Guide to COPD Diagnosis, Management, and Prevention: A Guide for Healthcare Professionals. 2025 Edition. Global Initiative for Chronic Obstructive Lung Disease. https://goldcopd.org/2025-gold-report/ Guest: Jillian Joseph, PA-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-436 Overview: Many patients with chronic obstructive pulmonary disease (COPD) are improperly treated with inhaled corticosteroids (ICS), increasing their risk of harm. This episode explores the latest evidence on long-term ICS risks and provides practical guidance to help you align COPD care with current guidelines—improving outcomes while minimizing adverse effects like pneumonia, cataracts, type 2 diabetes mellitus, and osteoporosis. Episode resource links: Pace WD, Callen E, Gaona-Villarreal G, Shaikh A, Yawn BP. Adverse outcomes associated with inhaled corticosteroid use in individuals with chronic obstructive pulmonary disease. Ann Fam Med. 2025;23(2):127-135. doi:10.1370/afm.240030 Pocket Guide to COPD Diagnosis, Management, and Prevention: A Guide for Healthcare Professionals. 2025 Edition. Global Initiative for Chronic Obstructive Lung Disease. https://goldcopd.org/2025-gold-report/ Guest: Jillian Joseph, PA-C   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

In this episode of the Global Medical Device Podcast, Etienne Nichols and regulatory expert Mike Drues take a critical look at the FDA's Manufacturer and User Facility Device Experience (MAUDE) database. While intended to serve as a vital tool for post-market surveillance, the MAUDE database is fraught with issues—from late reporting and missing data to unclear mission alignment. Mike challenges MedTech professionals to rethink how we engage with the system, exposing how widespread underreporting and data hygiene problems not only weaken safety efforts but also increase legal risk. This eye-opening discussion reveals where the breakdowns are occurring, who's responsible, and what industry and regulators can do to fix it.Key Timestamps[02:30] What is the MAUDE database, and why does it matter?[06:10] The critical difference between reportable and non-reportable adverse events[11:20] Limitations of MAUDE: Why FDA warns against using it for rate comparisons[17:45] Underreporting, late submissions, and missing data: The disturbing stats[25:00] High-profile companies dominating late reporting violations[32:10] Legal consequences: What expert witnesses look for in MAUDE data[38:50] Is it poor systems or lack of regulatory understanding causing failures?[46:00] Recommendations for manufacturers: What responsible reporting looks like[53:20] How FDA could modernize the MAUDE database to better serve patients[1:01:30] Carrots or sticks: Creating incentives vs. penalties for compliance[1:09:00] Final thoughts: The true mission of MAUDE and how to fulfill itStandout Quotes"A report in the MAUDE database is just a historical record. It doesn't say why it happened or who's at fault—just that it happened."— Mike DruesThis quote underscores the limited utility of MAUDE reports and why interpretation requires caution."If you're not a medical device professional without your tools, then you're not really a medical device professional."— Etienne NicholsA poignant reminder that compliance and quality are human-led, not software-enabled by default.Top TakeawaysLate Reporting is Widespread and RiskyNearly 30% of MAUDE reports are filed late, with 10% submitted more than six months past due. This creates legal exposure and potential patient harm.MAUDE Is Misused—Despite FDA WarningsManufacturers commonly use MAUDE for competitive analysis or trend detection, even though the FDA explicitly warns against it.Three Companies Account for Over Half of Late ReportsLarge, well-resourced companies like Medtronic and Becton Dickinson are responsible for a disproportionate share of noncompliance.Electronic Tools Help, but Culture Matters MoreSoftware can support MDR timelines, but organizations still need internal processes and urgency to act responsibly.FDA and Industry Both Need to EvolveSuggestions include AI-driven cross-referencing, tiered reporting urgency, and incentive-based compliance recognition.ReferencesFDA MAUDE Database21 CFR 803.16 – MDR Reporting RequirementsEtienne Nichols on LinkedInMedTech 101: What Is MAUDE and Why Should You Care?Think of the MAUDE database as a public logbook of adverse events involving medical

Since Mircea has just gotten to Aspen for the summer, we thought it would be a great time to talk about adjusting to adverse playing conditions in pickleball. Today we talk altitude, wind, indoor, sun, cold, and hot, and how to adjust to them! Learn more about your ad choices. Visit megaphone.fm/adchoices

Dustin, Tony, and Kyle are on to talk about 10/22's, 777 grain 45-70 rounds, Akdas Alcor conversion kits, AR10's, bush plinking, and How to Stay Motivated as Gun Owners in the Current Adverse Climate. The post Episode 608 – How to Stay Motivated as Gun Owners in the Current Adverse Climate appeared first on Slam Fire Radio.

Aradul Matinal este o emisiune de informații matinale pentru minți matinale servite în eter și-n online de Basil Mureșan, Mihai Todoca și Mihai Molnar. Cel mai provincial morning show!Ne auzim în fiecare dimineață, de Luni până Vineri, de la 07:00 la 11:00 pe 99,1FM sau online pe ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://live.radioarad.ro⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Aradul Matinal⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠este cel mai provincial morning show! 99,1 FM

The Legal Team discusses some of the nuances around disclosing material adverse facts.

Chaque jour, écoutez le Best-of de l'Afterfoot, sur RMC la radio du Sport !

In this JCO Article Insights episode, host Michael Hughes summarizes "Co-Occurrence of Cytogenetic Abnormalities and High-Risk Disease in Newly Diagnosed and Relapsed/Refractory Multiple Myeloma" by Kaiser et al, published February 18, 2025, followed by an interview with JCO Associate Editor Suzanne Lentzsch. Transcript Michael Hughes: Welcome to this episode of JCO Article Insights. This is Michael Hughes, JCO's editorial fellow. Today I have the privilege and pleasure of interviewing Dr. Suzanne Lentzsch on the “Co-Occurrence of Cytogenetic Abnormalities and High-Risk Disease in Newly Diagnosed and Relapsed/Refractory Multiple Myeloma” by Dr. Kaiser and colleagues. At the time of this recording, our guest has disclosures that will be linked in the transcript. The urge to identify patients with aggressive disease, which is the first step in any effort to provide personalized medical care, is intuitive to physicians today. Multiple myeloma patients have experienced heterogeneous outcomes since we first started characterizing the disease. Some patients live for decades after treatment. Some, irrespective of treatment administered, exhibit rapidly relapsing disease. We term this ‘high-risk myeloma'. The Durie-Salmon Risk Stratification System, introduced in 1975, was the first formal effort to identify those patients with aggressive, high-risk myeloma. However, the introduction of novel approaches in therapeutic agents—autologous stem cell transplantation with melphalan conditioning, proteasome inhibitors like bortezomib, or immunomodulatory drugs like lenalidomide—rendered the Durie-Salmon system a less precise predictor of outcomes. The International Staging System in 2005, predicated upon the burden of disease as measured by beta-2 microglobulin and serum albumin, was the second attempt at identifying high-risk myeloma. It was eventually supplanted by the Revised International Staging System (RISS) in 2015, which incorporated novel clinical and cytogenetic markers and remains the primary way physicians think about the risk of progression or relapse in multiple myeloma. Much attention has been focused on the canonically high-risk cytogenetic abnormalities in myeloma, typically identified by fluorescence in situ hybridization: translocation t(4;14), translocation t(14;16), translocation t(14;20), and deletion of 17p. Much attention also has been focused on the fact that intermediate-risk disease, as defined by the RISS, has been shown to be a heterogeneous subgroup in terms of survival outcomes. The RISS underwent revision in 2022 to account for such heterogeneity and has become the R2-ISS, published here in the Journal of Clinical Oncology first in 2022. Translocations t(14;16) and t(14;20) were removed, and gain or amplification of 1q was added. Such revisions to core parts of a modern risk-stratification system reflect the fact that myeloma right now is in flux, both in treatment paradigms and risk-stratification systems. The field in recent years has undergone numerous remarkable changes, from the advent of anti-CD38 agents to the introduction of cellular and bispecific therapies, to the very technology we use to investigate genetic lesions. The major issue is that we're seeing numerous trials using different criteria for the definition of high-risk multiple myeloma. This is a burgeoning problem and speaks very much now to a critical need for an effort to consolidate all these criteria on at least cytogenetic lesions as we move into an era of response-adapted treatment strategies. The excellent article by Kaiser and colleagues, published in the February 2024 edition of the JCO, does just that in a far-ranging meta-analysis of data from 24 prospective therapeutic trials. All 24 trials were phase II or III randomized controlled trials for newly diagnosed and relapsed/refractory multiple myeloma. The paper takes a federated analysis approach: participants provided summaries and performed prespecified uniform analyses. The high-risk cytogenetic abnormalities examined were translocation t(4;14), gain or amplification of 1q, deletion of 17p, and translocation t(14;16), if included in the original trials. All of these were collected into zero, single, or double-hit categories, not unlike the system currently present in diffuse large B-cell lymphomas. The outcomes studied were progression-free survival and overall survival, with these analyses adhering to modified ITT principles. The authors also performed prespecified subgroup analyses in the following: transplant-eligible newly diagnosed myeloma, transplant non-ineligible newly diagnosed myeloma, and relapsed/refractory myeloma. They, in addition, described heterogeneity by the I2 statistic, which, if above 50%, denotes substantial heterogeneity by the Cochrane Review Handbook, and otherwise performed sensitivity analyses and assessed bias to confirm the robustness of their results. In terms of those results, looking at the data collected, there was an appropriate spread of anti-CD38-containing and non-containing trials. 7,724 patients were evaluable of a total 13,926 enrolled in those 24 trials: 4,106 from nine trials in transplant-eligible myeloma, 1,816 from seven trials in transplant non-ineligible myeloma, and 1,802 from eight trials in relapsed/refractory disease. ISS stage for all patients was relatively evenly spread: stage I, 34.5%; stage II, 37%; stage III, 24%. In terms of high-risk cytogenetic lesions, double-hit disease was present in 13.8% of patients, and single-hit disease was present in 37.4%. In terms of outcomes, Kaiser and colleagues found a consistent separation in survival outcomes when the cohort was stratified by the number of high-risk cytogenetic lesions present. For PFS, the hazard ratio was for double-hit 2.28, for single-hit 1.51, without significant heterogeneity. For overall survival, the hazard ratio was for double-hit disease 2.94, single-hit disease 1.69, without significant heterogeneity except in patients with double-hit disease at 56.5%. By clinical subgroups, hazard ratios remained pretty consistent with the overall cohort analysis. In transplant-eligible newly diagnosed myeloma, the hazard ratio for progression is 2.53, overall survival 4.17. For transplant non-ineligible, 1.97 progression, 2.31 mortality. Relapsed/refractory disease progression 2.05, overall mortality 2.21, without significant heterogeneity. Of trials which started recruitment since 2015, that is to say, since daratumumab was FDA approved and thus since an anti-CD38 agent was incorporated into these regimens, analysis revealed the same results, with double-hit myeloma still experiencing worse survival by far of the three categories analyzed. Risk of bias overall was low by advanced statistical analysis. In terms of subgroup analysis, double-hit results for transplant-eligible newly diagnosed myeloma may have been skewed by smaller study effects, where the upper bound of the estimated hazard ratio for mortality reached into the 15 to 20 range. In conclusion, from a massive amount of data comes a very elegant way to think about the role certain cytogenetic abnormalities play in multiple myeloma. A simple number of lesions - zero, one, or at least two - can risk-stratify. This is a powerful new prognostic biomarker candidate and, somewhat soberingly, also may confirm, or at least suggests, that anti-CD38 agents are unable to overcome the deleterious impact of certain biologic characteristics of myeloma. Where do we go from here? This certainly needs further a priori prospective validation. This did not include cellular therapies. The very scale at which this risk-stratification system operates, agnostic to specific genetic lesion, let alone point mutations, lends itself also to further exploration. And to discuss this piece further, we welcome the one and only Dr. Suzanne Lentzsch to the episode. Dr. Lentzsch serves as an associate editor for JCO and is a world-renowned leader at the bleeding edge of plasma cell dyscrasia research. Dr. Lentzsch, there are several new investigations which suggest that translocation t(4;14), for example, is itself a heterogeneous collection of patients. There are other studies which suggest that point mutations in oncogenes like TP53, which were not assessed in Kaiser et al., carry substantial detrimental impact. Is this classification system - no-hit, single-hit, double-hit - too broad a look at tumor genetics? And how do you think we will end up incorporating ever more detailed investigations into the genetics of multiple myeloma moving forward? Dr. Suzanne Lentzsch: Michael, first of all, excellent presentation of that very important trial. Great summary. And of course, it's a pleasure to be here with JCO and with you to discuss that manuscript. Let me go back a little bit to high-risk multiple myeloma. I think over the last years, we had a lot of information on what is high-risk multiple myeloma, and I just want to mention a couple of things, that we separate not only cytogenetically high-risk multiple myeloma, we also have functional high-risk multiple myeloma, with an early relapse after transplant, within 12 months, or two years after start of treatment for the non transplant patients, which is difficult to assess because you cannot decide whether this is a high-risk patient before you start treatment. You only know that in retrospective. Other forms of high-risk: extramedullary disease, circulating tumor cells/plasma cell dyscrasia, patients who never achieve MRD positivity, extramedullary multiple myeloma, or even age and frailty is a high risk for our patients. Then we have gene expression and gene sequencing. So there is so much information currently to really assess what is high-risk multiple myeloma, that is very difficult to find common ground and establish something for future clinical trials. So what Dr. Kaiser did was really to develop a very elegant system with information we should all have. He used four factors: translocation t(14;16), t(4;14), gain or amplification of 1q, and deletion of 17p. Of course, this is not the entire, I would say, information we have on high risk, but I think it's a good standard. It's a very elegant system to really classify a standard single-hit, double-hit, high-risk multiple myeloma, which can be used for all physicians who treat multiple myeloma, and especially, it might also work in resource-scarce settings. So, ultimately, I think that system is an easy-to-use baseline for our patients and provides the best information we can get, especially with a baseline, in order to compare clinical trials or to compare any data in the future. Michael Hughes: Thank you, Dr. Lentzsch. To the point that you made about this isn't the full story. There does, as you said, exist this persistent group of functional high-risk multiple myeloma where we see standard-risk cytogenetics, but these patients ultimately either exhibit primary refractory disease or very early relapse despite aggressive, standard aggressive treatment. How do you see risk-stratification systems incorporating other novel biomarkers for such patients? Is it truly all genetic? Or is next-generation sequencing, gene expression profiling, is that the answer? Or is there still a role for characterizing tumor burden? Dr. Suzanne Lentzsch: Excellent question, Michael, and I wish I would have the glass ball to answer that question. I see some problems with the current approach we have. First of all, to do the cytogenetics, you need good material. You only detect and identify what you have. If the bone marrow is of low quality, you have mainly peripheral blood in your bone marrow biopsy, you might not really fully have a representation of all cytogenetic changes in your bone marrow. So I think with a low-quality sample, that you might miss one or the other really cytogenetic high risk. So, having said this, I think circulating tumor cells, that might be something we will look into in the future, because circulating tumor cells are readily available, can be assessed without doing a bone marrow biopsy. And what is even more exciting, in addition to the circulating tumor cells or plasma cells, using them is next-generation sequencing. I think at the moment, we are more in a collection phase where we really try to correlate sequencing with our cytogenetics and especially to establish next-generation sequencing in all of our patients. But I think after that collection phase, maybe in the future, collecting peripheral blood and doing sequencing on peripheral blood samples might be the way to go. In addition, I don't want to forget the imaging. We started with a skeletal survey, and we know that you probably need to lose 30% of the bone before you see a lesion at all. So having imaging, such as diffusion-weighted imaging, whole-body MRI, is also, together with sequencing of the tumor cells, a step into the right direction. Michael Hughes: Thank you, Dr. Lentzsch. Bringing this back to the article at hand, how has Kaiser et al. changed the way we discuss myeloma with patients in the exam room? Dr. Suzanne Lentzsch: I think we have more data on hand. So far, we talked about standard risk and high risk, but I think right now, with a very simple system, we can go into the room and we can tell the patient, "Listen, you don't have any of those cytogenetic abnormalities. I think you have a standard risk. We might give you a simple maintenance treatment with Revlimid." But we might also go into the room and say, "I'm really concerned. You have so-called double-hit multiple myeloma. You have high-risk and at least two of those abnormal cytogenetics which we discussed, and I think you need a more intense maintenance treatment, for instance, double maintenance." I think we know that a high-risk multiple myeloma can be brought into a remission, but the problem that we have is to keep those patients into a remission. So, I think a more intense treatment, for instance, with a double maintenance, or with consolidation after transplant, and a longer and more intense treatment is justified in patients who have that truly high-risk multiple myeloma described here. Michael Hughes: Dr. Lentzsch, thank you so much for your time and your wisdom. Dr. Suzanne Lentzsch: My pleasure. Thank you for having me. Michael Hughes: Listeners, thank you for listening to JCO Article Insights. Please come back for more interviews and article summaries, and be sure to leave us a rating and review so others can find our show. For more podcasts and episodes from ASCO, please visit ASCO.org/podcasts.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

reference: Sri Aurobindo and the Mother, Looking from Within, Chapter 4, Ordeals and Difficulties, pp.90-91This episode is also available as a blog post at https://sriaurobindostudies.wordpress.com/2025/05/26/overcoming-the-obstruction-of-universal-adverse-forces/Video presentations, interviews and podcast episodes are allavailable on the YouTube Channel https://www.youtube.com/@santoshkrinsky871More information about Sri Aurobindo can be found at www.aurobindo.net  The US editions and links to e-book editions of SriAurobindo's writings can be found at Lotus Press www.lotuspress.com

This discussion provides an overview of fundamental concepts in real property law. They explain different types of ownership interests, including fee simple estates, outlining the rights associated with owning land and attached structures. The texts also discuss how property interests are transferred, covering topics like deeds, mortgages as security interests, and recording statutes. Furthermore, they explore nonpossessory interests in property, such as easements, covenants, and servitudes, which affect how land can be used, alongside the government's power of eminent domain and the restrictions imposed by zoning laws. The sources highlight the legal doctrines and procedures surrounding these concepts.TakeawaysNon-possessory rights include easements, profits, and covenants.Easements allow use of another's land; profits allow resource extraction.Covenants can be real or equitable, affecting enforcement options.The Restatement Third of Property aims to unify property interests under servitudes.Moral obligation to keep promises is a key reason for enforcing covenants.Dead hand control concerns arise with perpetual restrictions.Traditionally, courts favored enforcing easements over real covenants and equitable servitudes. The American Law Institute's Restatement (Third) of the Law of Property unified these concepts under the term "servitudes" to simplify and rationalize the law.A prospective owner could purchase the property at its lower, encumbered market price and simultaneously negotiate and pay the holder of the servitude an amount to release it. This allows the purchaser to acquire the property free of the restriction.The two essential conditions are that the property must be used for a "public purpose only," and the property owner must be "compensated at fair market value."Inverse condemnation is an action initiated by a property owner when government regulation is so substantial that it effectively amounts to a taking, even without formal condemnation proceedings. Direct eminent domain is the government explicitly using its power to take private property.The "bundle of rights" concept views property ownership not as a single right, but as multiple distinct rights that can be held separately. Key rights include the right to possess, use, exclude others, enjoy benefits, and transfer interests. (Any two of these are acceptable).Fee simple is an estate of indefinite duration in real property that can be freely transferred. It is considered the most common and absolute type of estate, granting the owner the greatest discretion over the property's disposal.An estate for years is a leasehold that endures for a fixed, predetermined period and ends automatically without notice. A periodic tenancy endures for successive intervals (e.g., month to month) until properly terminated by notice equal to the length of the period (or as prescribed by statute).In most jurisdictions, a landlord has a duty to make reasonable efforts to re-let vacated premises if a tenant wrongfully abandons the lease. This duty is to reduce the landlord's losses and prevent them from allowing the property to remain empty while still suing for the full rent owed.Adverse possession is a legal doctrine allowing a trespasser to acquire valid title to land by occupying it in a continuous, exclusive, open, notorious, and hostile manner for a statutory period. The public policy motivation is to reward productive land use, quiet title disputes, and resolve boundary issues, discouraging neglected property.A grant deed is written proof that the property title is owned free and clear of claims or liens and promises that the property hasn't been sold to anyone else. A quitclaim deed transfers whatever interest the grantor has in the property, without making any warranties or guarantees about the title.property law, non-possessory interests, easements, covenants, eminent domain, legal concepts, law students, property rights, zoning, land use

This legal lecture explores the fundamental concepts of real property transfer, focusing on how land interests move from one party to another, how financing is secured through mortgages, and how buyers and lenders ensure they have good title to the property. It covers the essential steps in a land sale, including the requirement for a written contract under the statute of frauds and exceptions like part performance, along with the implications of equitable conversion during the contract period. The lecture also details the requirements for deeds that convey legal ownership, explains the different types of deeds and the warranties they provide, and discusses the crucial concepts of delivery and acceptance. Furthermore, it examines how recording systems determine priority among competing interests, explains the different types of recording statutes (race, notice, race-notice), and defines various forms of notice. Finally, it introduces mortgages as security devices, discusses different foreclosure methods, and covers title assurance methods like abstract and opinion and, more commonly, title insurance, while also briefly touching upon adverse possession as another way to acquire ownership.TakeawaysUnderstanding the contract for the sale of land is fundamental.The statute of frauds requires written agreements to prevent disputes.Equity can intervene in handshake deals through part performance.The deed is crucial for transferring legal title.Different types of deeds offer varying levels of protection.Delivery and acceptance are key to a valid deed transfer.Recording deeds provides public notice and establishes priority.Mortgages serve as security interests for lenders.Title insurance protects against hidden defects in property titles.Adverse possession allows for acquiring title through long-term possession.real property, land transfer, mortgages, title assurance, property law, contract, deed, title insurance, foreclosure, adverse possession

This legal lecture explores the fundamental concepts of real property transfer, focusing on how land interests move from one party to another, how financing is secured through mortgages, and how buyers and lenders ensure they have good title to the property. It covers the essential steps in a land sale, including the requirement for a written contract under the statute of frauds and exceptions like part performance, along with the implications of equitable conversion during the contract period. The lecture also details the requirements for deeds that convey legal ownership, explains the different types of deeds and the warranties they provide, and discusses the crucial concepts of delivery and acceptance. Furthermore, it examines how recording systems determine priority among competing interests, explains the different types of recording statutes (race, notice, race-notice), and defines various forms of notice. Finally, it introduces mortgages as security devices, discusses different foreclosure methods, and covers title assurance methods like abstract and opinion and, more commonly, title insurance, while also briefly touching upon adverse possession as another way to acquire ownership.TakeawaysUnderstanding the statute of frauds is crucial for real estate contracts.Part performance can create enforceable obligations despite unwritten agreements.Equitable conversion shifts risk of loss to the purchaser upon contract execution.Different types of deeds offer varying levels of protection to grantees.Delivery and acceptance are essential for a deed to convey legal title.Recording systems determine priority among competing claims to property.Mortgages can be classified under lien theory, title theory, or intermediate theory.The equity of redemption allows mortgagers to reclaim property before foreclosure.Foreclosure processes can be judicial or non-judicial, impacting strategy.Adverse possession allows for title acquisition through continuous possession.Real Property Law, land transfer, mortgages, title assurance, conveyance, contracts, deeds, foreclosure, title insurance, adverse possession

Irbesartan is an angiotensin II receptor blocker (ARB) used primarily for the management of hypertension and diabetic nephropathy in type 2 diabetes. It selectively inhibits the binding of angiotensin II to the AT1 receptor found in vascular smooth muscle and the adrenal gland. This blockade results in vasodilation, reduced aldosterone secretion, decreased sodium and water retention, and ultimately lower blood pressure. Irbesartan is administered orally, with a typical starting dose of 150 mg once daily, which may be increased to 300 mg depending on the patient's clinical response and tolerability. Adverse effects of irbesartan are generally mild but can include hyperkalemia and dizziness. Hypotension may occur, especially in volume-depleted individuals or those on diuretics. Routine monitoring of renal function and serum potassium is recommended, especially in patients with underlying kidney disease or those taking potassium-sparing agents or supplements. Irbesartan is contraindicated in pregnancy due to the risk of fetal toxicity and should be discontinued as soon as pregnancy is detected.

Entre février 2023 et janvier 2024, Christophe donne des cours de DJ pour une association. Au total, il doit être payé 2.645 €. Problème, l'association n'a réglé qu'une facture de 839 €. Une association déjà connu par la rédaction de l'émission ! Thomas Renard revient sur quelques détails croustillants du dossier... Au micro de Chloé Lacrampe, un membre de l'équipe de "Ça peut vous arriver" revient sur les négociations difficiles et les moments off de ces 2h d'antenne !Distribué par Audiomeans. Visitez audiomeans.fr/politique-de-confidentialite pour plus d'informations.

What are Adverse Religious Experiences (AREs) and spiritual abuse? Aren't they the same thing as religious trauma? Join Andrew and Laura on this week's episode to discuss AREs, spiritual abuse, dynamics of power and control, how this relates to fundamentalism and how all of this…isn't religious trauma? You heard us correctly!  Andrew and Laura discuss all of this AND how these things can result in religious trauma on this episode of Sunday School Dropouts!This podcast is brought to you by the Center for Trauma Resolution and Recovery: an online trauma coaching company whose practitioners are trauma informed and trauma trained to work with individuals, couples and families who have experienced high control religion, cults, and religious trauma. For more information on the support that CTRR provides, for resources–including courses, workshops, and more–head to traumaresolutionandrecovery.com or follow us on Instagram: @traumaresolutionandrecovery The views and opinions expressed by Sunday School Dropouts are those of the hosts and not necessarily reflect the official policy or position of the Center for Trauma Resolution and Recovery. Any of the content provided by our guests, sponsors, authors, or bloggers are their own ideas and opinions.The Sunday School Dropouts podcast is not anti-religion but it is anti -harm, -power and control, -oppression and, -abuse and will speak to the harmful practices and messaging of fundamentalist groups. Follow Andrew on Instagram and TikTok @deconstruct_everything Follow Laura on Instagram and TikTok @drlauraeanderson or on her website: www.drlauraeanderson.com Hosts: Laura Anderson and Andrew KerbsMusic by Benjamin Faye Music @heytherebenji Editing and Production by Kevin Crowe

​Mike Matthews investigates the fascinating news from the week and Mike answers what is happening with people trying to buy a brand new car. Join Mike as he podcasts live from Café Anyway in podCastro Valley with Chely Shoehart, Floyd the Floorman, and John Deer the Engineer. Next show it's Benita, the Disgruntled Fiddle Player, and the Brewmaster.

Hamed Kayello, Product Manager at Georgia-Pacific, joined us to talk about his webinar, “Advanced Design Against Adverse Conditions in a Commercial Roofing System.” Listen in as he chats about some common risk factors when it comes to roof damage, and the benefits of fiber glass gypsum-faced panels. Register for this free webinar

Sports Daily Full Show 7 May 2025

Today's guest is Marie Flanagan, Director of Product Management in Digital Projects and Solutions at IQVIA, who joins us to explore the overlooked intersection of AI and safety workflows in life sciences. As the industry experiences an explosion in the volume and diversity of data—from social media and call centers to audio and video files—Marie outlines the mounting challenges for pharmacovigilance and the opportunities AI is unlocking for healthcare and life sciences leaders. Marie discusses how advancements in voice-to-text transcription and automation are helping safety teams manage massive datasets, pinpoint potential risks, and reallocate human resources toward high-value activities like signaling and benefit-risk management. She also shares insights into where human expertise remains essential, particularly in interpreting complex clinical contexts that AI alone cannot fully capture. Want to share your AI adoption story with executive peers? Click emerj.com/expert2 for more information and to be a potential future guest on Emerj's flagship ‘AI in Business' podcast!

Marco Sammon joins Ben and Dan to unpack his latest paper, ‘Index Rebalancing and Stock Market Composition', beginning with how Marco's work (co-written by John Shim) compares to the Nobel Prize-winner Bill Sharpe's paper, ‘Arithmetic of Active Management.' We investigate the missing links in Sharpe's logic before defining “the market” and ascertaining the main objectives of index funds. Then, we dive deeper into the mechanics of Marco's paper, index and market tracking errors, why delayed rebalancing is more beneficial than instant rebalancing, and the role of technology in the modern tracking error obsession. We also assess the passive-active spectrum of index funds in portfolio management and learn how investors should choose their optimal excess return. To end, Marco shares practical applications for improving performance benchmarked against traditional indexes, and The Aftershow is all about bridging the gap between PWL Capital and you, our listeners. Key Points From This Episode:   (0:00:00) Key takeaways from Marco Sammon's latest paper and how it compares to Bill Sharpe's ‘Arithmetic of Active Management.' (0:08:10) Marco describes what's missing from the ‘Arithmetic of Active Management' logic. (0:09:11) Defining ‘the market', the main objective of an index fund, and how index funds track the market. (0:15:57) The mechanics of Marco's paper, ‘Index Rebalancing and Stock Market Composition.' (0:18:38) Factor exposure, index and market tracking errors, and how often index funds trade. (0:26:28) Rebalancing less frequently; why delayed does better than instant rebalancing. (0:31:59) The tech run-up and lazy rebalancing, and the modern tracking error obsession.  (0:36:51) Assessing the passive-active spectrum of index funds in portfolio management. (0:41:02) Exploring how investors should decide on their optimal excess return.  (0:45:14) How the rising index fund ownership of stocks impacts the implicit cost of indexing (0:46:58) Practical ways to improve performance benchmarked against traditional indexes. (0:52:30) The Aftershow: Canadian finances, more airtime for Cameron, and PWL – OneDigital.    Links From Today's Episode: Meet with PWL Capital — https://calendly.com/d/3vm-t2j-h3p Rational Reminder on iTunes — https://itunes.apple.com/ca/podcast/the-rational-reminder-podcast/id1426530582. Rational Reminder Website — https://rationalreminder.ca/  Rational Reminder on Instagram — https://www.instagram.com/rationalreminder/ Rational Reminder on X — https://x.com/RationalRemindRational Reminder on TikTok — www.tiktok.com/@rationalreminder Rational Reminder on YouTube — https://www.youtube.com/channel/ Rational Reminder Email — info@rationalreminder.caBenjamin Felix — https://pwlcapital.com/our-team/ Benjamin on X — https://x.com/benjaminwfelix Benjamin on LinkedIn — https://www.linkedin.com/in/benjaminwfelix/ Dan Bortolotti on LinkedIn — https://www.linkedin.com/in/dan-bortolotti-8a482310/ Episode 322: Prof. Marco Sammon: How are Passive Investors Affecting the Stock Market? — https://rationalreminder.ca/podcast/322 Episode 200: Prof. Eugene Fama — https://rationalreminder.ca/podcast/200  Episode 268: Itzhak Ben-David: ETFs, Investor Behavior, and Hedge Fund Fees — https://rationalreminder.ca/podcast/268  Episode 112: Michael Kitces: Retirement Research and the Business of Financial Advice — https://rationalreminder.ca/podcast/112  Marco Sammon — https://marcosammon.com/  Marco Sammon on LinkedIn — https://www.linkedin.com/in/marco-sammon-b3b81456/  Marco Sammon on X — https://x.com/mcsammon19  Marco Sammon | Harvard Business School — https://www.hbs.edu/faculty/Pages/profile.aspx?facId=1326895  Marco Sammon Email — mcsammon@gmail.com  John Shim on LinkedIn — https://www.linkedin.com/in/john-shim-2931271b/  Vanguard — https://global.vanguard.com/  Sheridan Titman on LinkedIn — https://www.linkedin.com/in/sheridan-titman-226b0811/  Alex Chinko — https://alexchinco.com/  Erik Stafford | Harvard Business School — https://www.hbs.edu/faculty/Pages/profile.aspx?facId=6625  Itzhak (Zahi) Ben-David on LinkedIn — https://www.linkedin.com/in/ibendavi/  Bill Ackman on X — https://x.com/billackman   ‘Millennium Loses $900 Million on Strategy Roiled by Market Chaos' — https://www.bloomberg.com/news/articles/2025-03-08/millennium-loses-900-million-on-strategy-roiled-by-market-chaos   Bogleheads — https://www.bogleheads.org/   The Money Scope Podcast Episode 8: Canadian Investment Accounts — https://moneyscope.ca/2024/03/01/episode-8-canadian-investment-accounts/  The Wealthy Barber Podcast — https://thewealthybarber.com/podcast/   Financial Advisor Success Podcast — https://www.kitces.com/blog/category/21-financial-advisor-success-podcast/  Financial Advisor Success Podcast Episode 433: When You 10X Your Advisory Firm To Over $20M Of Revenue…And Want To 10X Again, With Cameron Passmore — https://www.kitces.com/blog/cameron-passmore-pwl-capital-10x-revenue-growth-advisory-firm/   OneDigital — https://www.onedigital.com/  The Longview Podcast: Ben Felix   Papers From Today's Episode:    ‘The Arithmetic of Active Management' — https://www.jstor.org/stable/4479386    ‘Index Rebalancing and Stock Market Composition: Do Index Funds Incur Adverse Selection Costs?' — https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5080459     ‘Luck versus Skill in the Cross-Section of Mutual Fund Returns' — https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1356021    ‘The Passive-Ownership Share Is Double What You Think It Is' — https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4188052    ‘Long-Term Returns on the Original S&P 500 Companies' — https://www.researchgate.net/publication/247884354_Long-Term_Returns_on_the_Original_SP_500_Companies     ‘The Price of Immediacy' — https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1001762   ‘Competition for Attention in the ETF Space' — https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3765063    ‘Passive in Name Only: Delegated Management and “Index” Investing' — https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3244991      Jeremy Stein — “Unanchored” Strategy

Watch every episode ad-free & uncensored on Patreon: https://patreon.com/dannyjones Rick Strassman is best known for pioneering DMT research in humans and proposing that DMT could be a biological gateway to mystical or alternate realities. Currently, Dr. Strassman serves as a Clinical Associate Professor of Psychiatry at the University of New Mexico School of Medicine. His new book, "My Altered States: A Doctor's Extraordinary Account of Trauma, Psychedelics, and Spiritual Growth," is available now. SPONSORS http://morning.ver.so/danny - Use code DANNY for 15% off your first order. https://hims.com/danny - Start your FREE online visit today. https://whiterabbitenergy.com/?ref=DJP - Use code DJP for 20% off EPISODE LINKS https://x.com/rick_strassman https://www.rickstrassman.com FOLLOW DANNY JONES https://www.instagram.com/dannyjones https://twitter.com/jonesdanny OUTLINE 00:00 - Adverse effects of DMT 06:54 - Is DMT the source of human consciousness? 10:25 - Extended state DMT experiments 20:19 - DMT reveals a universal religion 29:08 - Psychedelic religion of mystical consciousness 35:10 - What Danny saw during DMT experiment 37:54 - Terrifying experience on 5-MeO DMT 41:39 - Melatonin & the pineal gland 52:43 - When DMT stops working 57:38 - DMT & NDE's 01:02:45 - Telepathic experiences on psychedelics 01:12:53 - Prophets of the bible 01:18:34 - The first anti-christ 01:31:42 - Drugs in antiquity 01:37:24 - CIA-funded LSD clinics w/ Charles Manson 01:40:13 - Rick's friendship with Joe Rogan 01:45:42 - Did ergot & psychedelics create religion? 01:53:12 - Government research on psychedelic soldiers 02:03:01 - Amphetamines & adderall 02:14:00 - Next species of humans will have telepathy 02:19:39 - John Mack's alien research vs. psychedelics 02:26:53 - Remembering previous lives 02:29:20 - Translating the book of Genesis 02:34:06 - DARPA research on buddhism Learn more about your ad choices. Visit podcastchoices.com/adchoices

Nearly forty medical drugs have been recalled by the Food and Drug Administrationover fears of faulty manufacturing. All of the medical drugs in question were produced byGlenmark Pharmaceuticals Inc at its factory in India and were initially recalled on March13. The FDA gave the recall a Class II risk level on April 8 th . If you take any medical drugs,over the counter or prescription standby for FDA warnings information.Special Guest – Larry Logsdon ‘How to Safely & Effectively Relieve AcidRefux/Heartburn'

In this podcast, Dr. Valentin Fuster discusses a study on pre-pregnancy obesity and its long-term effects on pregnancy outcomes and cardiovascular health later in life. The research highlights how pre-pregnancy obesity and overweight increase the risk of gestational diabetes, hypertension, and future cardiovascular disease, underscoring the need for early weight management and more research on treatments like GLP-1 receptor agonists.

This episode challenges the dental industry's casual approach to gingivitis and reframes bleeding gums as a severe systemic health warning that demands attention! Melissa and Tabitha reveal why making gingivitis identification compelling to patients is crucial for oral and overall health outcomes. Link to Meissa's Post mentioned in the episode:  https://www.instagram.com/reel/DG0LnVGsrnT/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA== Key Topics Covered

Show Notes: Cara Natterson moved to New York City where she worked for a drug rehabilitation center, and later moved to Baltimore, where she studied at Johns Hopkins Medical School. She eventually returned to L.A. and practiced pediatrics there. Her writing career began at the age of 31 when a co-worker asked her to read his manuscript, which inspired her to write her own book about raising kids. The Body Book Series and Less Awkward Company In 2008, Cara decided to leave clinical medicine and become a full-time writer. In 2011, after speaking at Mattel, she was signed on to write for the Body Book series from American Girl, which has since sold millions of copies. Cara then started touring the country, focusing on puberty education. During this time, she discovered that there was nothing else available for kids whose bodies, brains, feelings, and friends were changing. She launched her own business, Less Awkward, a company that created direct-to-consumer products designed for comfort and health like bras and socks. Cara has since expanded the company to focus on content across social media, podcasting, newsletter, and school curriculum. Health and Sex Education Curriculum In the past year, she has rolled out two platforms: a health and sex education curriculum for schools, which is already implemented in three states, and a membership for parents and trusted adults. Cara talks about the importance of understanding and discussing puberty in young people. She highlights the slower pace of puberty, with girls entering puberty at an average age of 8-9, and boys at an average age of 9-10. She emphasizes the importance of discussing the first signs of puberty, such as breast budding or testicular growth. She also highlights the importance of discussing the issue of first porn exposure, which is a significant concern for parents, family members, coaches, mentors, healthcare providers, and educators. She emphasizes the need to educate children about free porn, which is generally violent and aggressive, and calls for a less awkward approach to discussing this topic. By engaging in conversations about this topic, adults can help their children navigate the challenges of puberty and promote healthier lifestyles. Launching a Direct-to-Consumer Product Cara talks about the shift from a pediatrician to writer to entrepreneur. She initially went to medical school but, although she found it interesting, she also realized that she was more of a creative type. However, her background combined with her creative mind led to the drive to develop comfortable and healthy products. After a chat with a friend about bras, she was convinced that there was a need for comfortable bras for young girls. The two women partnered with a sewer who made a comfortable and healthy bra for their daughters, and later pulled together a team that developed the product over many years. They patented the product and launched the company during the COVID-19 pandemic. It was initially launched as a mask company, focusing on distribution and production channels instead of bras to supply the then current demand. Six months later they launched their bra products. She talks about the journey from design and development to launching the product and what she learned along the way. Cara's business ethos has always been to do well and to do good at the same time, and she has found this to be a recipe for success. The This Is So Awkward Podcast The conversation turns to Cara's podcast which she started with her partner, Vanessa Kroll Bennett. The podcast addresses the confusion about the length of puberty. It features background episodes and guest appearances with experts from various fields. In October 2023, they published a book called This Is So Awkward: Modern Puberty Explained, which explores the changes in puberty and how to talk about them, and it includes essays by kids about their experiences with acne, first periods, and heartbreaks. The podcast has expanded along with content on Instagram and TikTok. All of this content is also available on the website LessAwkward.com. They also have a school-based health and sex education curriculum called That Health Class. Navigating Today's Cultural Complexities Cara emphasizes the importance of pediatricians in understanding and managing the changes in puberty. She explains that kids and their adults are overwhelmed by the complexity of the world and the increased access to a wide and diverse range of information. Pediatricians often lack the time or bandwidth to provide anticipatory guidance for children, an especially big issue given the mental health crisis among children. Cara mentions that pediatricians often turn to the LessAwkward website where they have trained an AI bot on their content. Pediatricians are starting to use it as a healthcare solution when they don't have the time to answer questions but their patients want to be able to anticipate what's coming. The bot is reliable, gated, and trained on good data, making it engaging and entertaining. The levity and warmth of the content make it a valuable tool for pediatricians to recommend. Factors that Contribute to Early Puberty The American Girl Body Book series launched just after a 1997 study showed that girls were entering puberty earlier. It stated that the average age has shifted from 11 to 10, and a follow-up study in 2010 found it to be between eight and nine. The reason for this change is under investigation, but it is believed to be due to a number of factors, including stress, adverse childhood experiences, and antibiotics. Stress causes cortisol surges, which can either trigger the release of hormones like LH and FSH, or cause sex hormones to surge. Adverse childhood experiences, such as witnessing trauma or drug abuse, can increase the risk of entering puberty early. Evolutionary theory suggests that the human body is meant to reproduce before life ends, and so it makes sense that the general stress response might drive earlier development. She mentions Louise Greenspan, a woman who has been researching puberty for decades, has written a book called The New Puberty which further explores this topic. The Male Side of the Story Cara's parenting podcast has a diverse audience, with nearly 20% male listenership. She shares her experiences with male listeners and the challenges they face in connecting with their children. She wrote Decoding Boys, and states, with a degree of jocularity, that there is no data on the connection between testosterone and silence, but it is common among males, especially in their tween years. She shares personal strategies to help connect with tween or teen boys, as they do want to talk and share their thoughts with trusted adults. In the book, Cara shares strategies she has used, and in this conversation, she shares a personal experience on how she encouraged her son to talk to her.  Influential Harvard Courses and Professors Cara's career highlights her interest in sociology and biological anthropology, which she combined at Harvard. She wrote a junior paper about female genital mutilation in Africa and a thesis about HIV prevention in teenagers in Boston suburbs. She had a vivid memory of her thesis advisor, Irven DeVore, who was an interesting thinker and helped her fit her thesis idea into the curriculum. Timestamps: 02:12: Transition to Entrepreneurship  05:46: Insights on Puberty and Parenting 09:20: Launching Less Awkward  15:42: Content Creation and Engagement  29:05: Raising Boys and Communication Strategies  35:15: Daily Routine and Collaboration  37:19: Impact of Social Media and Content Creation  39:14: Influence of Harvard Education  Links: Website: https://lessawkward.com/ Podcast: https://lessawkward.com/podcast-this-is-so-awkward-2/ Instagram: less.awkward TikTok: less.awkward Cara's Instagram: caranatterson Featured Non-profit: The featured non-profit of this episode of The 92 Report is recommended by Chris Hull who reports: “Hi. I'm Chris Hull from Harvard's fabulous class of 1992. The featured nonprofit of this episode of The 92 report is The Funds for American Studies. TFAs is an educational nonprofit that develops courageous leaders by providing students who otherwise wouldn't get a chance to come to DC to learn about how to make a difference. I've been honored to have worked with TFAs for more than three decades, since they've allowed me to study at Georgetown. At the same time, I did an internship in Washington, which helped transform my life as it has for so many others over the last half century that it's existed, who otherwise couldn't possibly afford to do such a thing. You can learn more about their work@tfas.org.” To learn more about their work, visit: work@tfas.org

Welcome to episode 118 of Growers Daily! We cover:   the fascinating world of shade cloth colors, maximizing vermicompost and what to do about those overwintered carrots. We are a Non-Profit! 

Adverse possession allows a person to claim ownership of land that they have occupied for more than ten years without the owner's permission. In this decision, the Supreme Court clarifies the law surrounding how and when these claims should be made. https://uklawweekly.substack.com/subscribe Music from bensound.com

Drug interactions can cause more complex side effects than the side effects of a single drug, and can even contribute to dementia. Join me as I interview Hal Cranmer, owner of several assisted living homes, and Dr. Roshani Sanghani, board-certified endocrinologist, to discuss the side effects of multiple medications. Assisted Living Home: https://aparadiseforparents.com/Epocrates:https://www.epocrates.com/Taking the following drugs for an extended period of time may potentially increase your risk for dementia. 1. Drugs that block acetylcholineThis includes Benadryl, certain drugs for depression, and drugs that treat overactive bladder. 2. BenzodiazepineDrugs such as Valium and Xanax treat anxiety, insomnia, and seizures, affecting the central nervous system and brain.3. PPIsProton pump inhibitors, such as Prilosec and Nexium, that treat indigestion and heartburn may increase the risk of cognitive decline.4. Opioids Morphine, oxycodone, and other opioids that sedate the brain significantly affect cognitive function and may lead to dementia. Hal Cranmer owns several assisted living homes and sees first-hand the consequences of giving someone several drugs at once. Many residents in assisted living homes are on 20 to 30 medications. In Hal's facilities, he focuses on providing his residents with a healthy diet and eliminating sugar and ultra-processed foods. Many of Hal's residents have been able to get off their medication. Multiple medications often involve multiple doctors with multiple viewpoints. Each doctor focuses only on specific parts and functions of the body rather than the body as a whole. Adverse drug reactions are unexpected side effects directly caused by drugs. Around 90% are underreported. Adverse drug reactions are responsible for 10% of all hospital visits and are the 4th leading cause of death. Dr. Roshani Sanghani, a board-certified endocrinologist, uses epocrates.com to help keep track of drug interactions. She points out the problem of specialists focusing on and prescribing treatment for one body part and not considering the patients' other medications. The biggest contributor to chronic disease is diet. Medications are often prescribed to treat the symptoms caused by consuming ultra-processed foods. A healthy diet can turn this cycle around.

In this engaging episode of Shark Theory, host Baylor Barbee turns an impromptu challenge into a profound life lesson using a seemingly simple birthday cake as a metaphor. Challenged to find inspiration from a cake, Baylor explores the parallels between cake-making and personal growth, emphasizing the importance of the "oven" moments in life where ingredients—often appearing unpalatable on their own—combine under pressure to create something beautiful. He eloquently connects this analogy to the importance of recognizing and valuing one's unique life ingredients, or skills, highlighting the necessity of adversity as a refining force that ultimately leads to success. Baylor delves into the transformative power of adversity, encouraging listeners to embrace challenges as essential steps to unlocking their full potential. He stresses that facing setbacks isn't about giving up but recognizing these moments as a crucial part of the refining process that life demands. With a vivid tie to his own experiences, including how the COVID-19 pandemic tested the principles outlined in his book "Opportunity Engineer," Baylor reiterates the opportunity inherent in every obstacle. This episode is a call to action for listeners to inventory their skills, embrace adversity, and actively shape their lives into a celebrated masterpiece. Key Takeaways: The metaphor of cake-making illustrates personal growth, with each ingredient representing the skills and experiences that shape our lives. Adverse situations, much like the oven for a cake, serve as a necessary component for refining and realizing our true potential. Identifying personal skills and taking inventory of one's life is crucial to understanding what one can offer to the world. Viewing adversity through a positive lens can turn setbacks into opportunities, reinforcing resilience and capability. The importance of proactive engagement in life's "cooking process," aligning one's passions and skills to bring something meaningful into the world. Notable Quotes: "Everybody wants the finished product, but nobody realizes the ingredients that lead up to it and what the cake has to go through." "The fire in life is the adversities we face. It's the setbacks, it's the obstacles." "When somebody puts you to the fire, are they finding out that you're real? Or are they finding out that you're a fraud?" "If I can put my head down and work through this adversity, then I can see what I'm truly made of." "What are you cooking? What are you putting into the world?"

0:00 Intro2:25 Adverse Selection Deep Dive 40:35 Betting News1:14:35 How to Tell your Friends & Family You are a Pro Degen1:27:11 Live EV Betting v. Live Arbing1:34:25 Dealing with Downswings1:52:37 Why GP NO MORE PICKS?!?Welcome to The Risk Takers Podcast, hosted by professional sports bettor John Shilling (GoldenPants13) and SportsProjections. This podcast is the best betting education available - PERIOD. And it's free - please share and subscribe if you like it.My website: https://www.goldenpants.com/ Follow SportsProjections on Twitter: https://x.com/Sports__ProjWant to work with my betting group?: john@goldenpants.comWant 100s of +EV picks a day?: https://www.goldenpants.com/gp-picks

When Good Morning America's executive producer saw her doctor for joint pain, she never expected to be diagnosed with psoriatic arthritis—or that the medication prescribed to help her would trigger a life-threatening drug reaction. In Part 1 of this two-part episode, she shares her harrowing medical journey, from missed warning signs and delayed diagnosis to a year-long battle with the powerful steroid prednisone. We break down DRESS Syndrome, why medications are often overlooked as the cause of new symptoms, and the serious risks of steroids. Stay tuned for Part 2, where we explore how Cat's personal health crisis now shapes the national health news she brings to audiences on GMA3. Key Takeaways Don't ignore persistent symptoms. If you have fever, vomiting, or other concerning signs for more than 2 days, get medical care. Medications should always be on the suspect list. Adverse drug reactions don't always show up as a rash. They are great imitators of disease and may involve any organ system and without a rash. Oral steroids are powerful, but risky. They should never be the automatic go-to. If your doctor prescribes steroids, ask about alternatives and make sure there's a clear plan to taper off. Links GMA3: https://www.goodmorningamerica.com/author/gma3 Connect with Archelle ArcHealth Newsletter: https://www.archellemd.com/newsletter Email: SpeakUpForYourHealth@gmail.com Instagram:  https://instagram.com/speakupforyourhealth Facebook: https://www.facebook.com/speakupforyourhealth #arthritis #jointpain #sulfadrugs #drugallergy #GoodMorningAmerica #patientcare #patientadvocacy #prednisone

This episode is brought to you by Pique Life and Birch Living.  We used to think that the circadian rhythm only affected sleep. However, emerging science shows it's deeply connected to metabolism, cognition, chronic disease risk, and many other critical aspects of health. Our biology is designed to function in harmony with the natural light-dark cycle, but modern society has significantly disrupted this balance. Today on The Dhru Purohit Show, we bring you a special compilation episode featuring Dhru's conversations with leading experts on the critical role circadian rhythms play in our health and well-being. Dr. Satchin Panda delves into his groundbreaking research on circadian biology, revealing how leveraging your circadian rhythm can significantly improve sleep, reduce the risk of chronic diseases, and enhance cognitive function. He also shares how time-restricted eating, exercise, and light exposure can help program your circadian rhythm, with a special focus on the importance of these tools for shift workers. Dr. Moore-Ede discusses the dangers of chronic blue light exposure and its profound impact on health, highlighting research that reveals how it disrupts circadian rhythms. He also examines the connection between light exposure and obesity and explains why these risks remain underrepresented in mainstream media. Dr. Satchin Panda, a professor at the Salk Institute and founder of the UC San Diego Center for Circadian Biology, is a leading researcher in circadian biology. Dr. Martin Moore-Ede, a former Harvard Medical School professor and expert in circadian rhythms, has conducted groundbreaking research on light's role in regulating sleep-wake cycles and overall health. In this episode, Dhru and his guests dive into: Why when we eat is more important than what we eat (01:38) Effects of chronic late-night eating (08:18) Adverse effect of disrupting our circadian rhythm (16:25) What is sleep debt (19:21) Paying attention to when you eat (30:16) Research on time-restricted eating (34:08) Why sleeping with the lights on is damaging to your health (39:01) Why sun exposure is critical for good health (41:55) Dr. Martin's recommended time for sun exposure (49:28) The link between blue light and obesity (51:42) Master clock of the circadian rhythm, cortisol, melatonin, and others (54:06) Why doctors aren't talking about the harmful effects of blue lights (59:03) Blue lights in hospitals and how they prevent healing (01:04:47) Also mentioned: Full episode with Dr. Satchin Panda Full episode with Dr. Martin Ede-Moore This episode is brought to you by Pique Life and Birch Living.  Right now, Pique Life is offering 15% off the Radiant Skin Duo plus a free beaker and frother when you go to piquelife.com/dhru. To get 25% off your Birch Living mattress plus two free eco-rest pillows, head over to birchliving.com/dhru today. Learn more about your ad choices. Visit megaphone.fm/adchoices