Podcasts about Annals

Still struggling with IBS symptoms, even after trying everything?   It might not be “just IBS.”   In the first episode of The Gut Show, Season 8, Dr. Mark Pimentel breaks down the connection between SIBO, IMO, ISO, and IBS, and what patients need to know about testing, treatment, and what's actually causing your symptoms.   We talked about breath tests, stool tests, probiotics, antibiotics (like Rifaximin + Neomycin), the meds that cause SIBO, and more.   Covered in this episode: Introducing Dr. Pimentel, MD [2:18] What is SIBO, ISO and IMO? [3:18] Should everyone with IBS do breath testing? [7:14] New guidelines that have come out [9:50] How should a patient navigate testing? [11:11] What about stool testing? [13:16] Negative test + symptoms or positive test without symptoms [16:50] What does normal mean? [18:44] Who does all 3 [20:39] Glucose vs Lactulose for the test [21:05] What causes these overgrowths? [21:52] The medication that WILL make you have SIBO [23:53] MAST cells, IBD, endometriosis [24:34] Treatment [32:07] Rifaximin [34:19] Any Statin or seaweed based treatment updates? [37:51] Neomycin [39:25] Elemental diet [41:23] What Dr. Pimentel wants for his patients [45:17] Probiotics [46:40] The role of metabolic disorders [48:22] Rapid fire questions [50:59]   Mentioned in this episode:  MASTER Method Membership Take the quiz: What's your poop personality?      Sponsors of The Gut Show:  FODZYME is the world's first enzyme supplement specialized to target FODMAPs. When sprinkled on or mixed with high-FODMAP meals, FODZYME's novel patent-pending enzyme blend breaks down fructan, GOS and lactose before they can trigger bloating, gas and other digestive issues. With FODZYME, enjoy garlic, onion, wheat, Brussels sprouts, beans, dairy and more — worry free! Discover the power of FODZYME's digestive enzyme blend and eat the foods you love and miss. Visit fodzyme.com and save 20% off your first order with code THEGUTSHOW. One use per customer. Gemelli Biotech offers trusted, science-backed at-home tests for conditions like SIBO, IMO, ISO, and post-infectious IBS.  Their Trio-Smart breath test measures all three key gases: hydrogen, methane, and hydrogen sulfide to detect different forms of microbial overgrowth. And for those with IBS symptoms, IBS-Smart is a simple blood test that can confirm post-infectious IBS with clinical accuracy. You simply order the test, complete it at home, send it back, and get clinically backed results in about a week that you can take to your provider!  Find out which tests are right for you at getgutanswers.com and use code ERINJUDGE25 to save $25 on your order!   About our speaker: Mark Pimentel, MD, FRCP(C), is a Professor of Medicine at Cedars-Sinai and Professor of Medicine and of Gastroenterology through Geffen School of Medicine. Dr. Pimentel is also the Executive Director of the Medically Associated Science and Technology (MAST) program at Cedars-Sinai, an enterprise of physicians and researchers dedicated to the study of the gut microbiome in order to develop effective diagnostic tools and therapies to improve patient care. As a physician and researcher, Dr. Pimentel has served as a principal investigator or co-investigator for numerous basic science, translational and clinical investigations of irritable bowel syndrome (IBS) and the relationship between gut flora composition and human disease. This research led to the first ever blood tests for IBS, ibs-smart™, the only licensed and patented serologic diagnostic for irritable bowel syndrome. The test measures the levels of two validated IBS biomarkers, anti-CdtB and anti-vinculin. A pioneering expert in IBS, Dr. Pimentel's work has been published in the New England Journal of Medicine, Annals of Internal Medicine, American Journal of Physiology, American Journal of Medicine, American Journal of Gastroenterology and Digestive Diseases and Sciences, among others. Dr. Pimentel has presented at national and international medical conferences and advisory boards. He is a diplomate of the American Board of Internal Medicine (Gastroenterology,) a fellow of the Royal College of Physicians and Surgeons of Canada and a member of the American Gastroenterological Association, the American College of Gastroenterology, and the American Neurogastroenterology and Motility Society. Dr. Pimentel completed 3 years of an undergraduate degree in honors microbiology and biochemistry at the University of Manitoba, Canada. This was followed by his medical degree, and his BSc (Med) from the University of Manitoba Health Sciences Center in Winnipeg, Manitoba, Canada, where he also completed a residency in internal medicine. His medical training includes a fellowship in gastroenterology at the UCLA Affiliated Training Program.   Connect with Erin Judge, RD:  IG: https://www.instagram.com/erinjudge.rd TikTok: https://www.tiktok.com/@erinjudge.rd   Work with Gutivate:  https://gutivate.com/services   

Men don't have enough important dates to forget about? Gen Z wants WHAT at the office? Wait... Bob Vila is CUBAN?!?! Come learn other stupid things with us!PLUS: Celebrity birthdays!The Treehouse is a daily DFW based comedy podcast and radio show. Leave your worries outside and join Dan O'Malley, Trey Trenholm, Raj Sharma, and their guests for laughs about current events, stupid news, and the comedy that is their lives. If it's stupid, it's in here.The Treehouse WebsiteGet 60% off the Magic Mind offer with our link and code:  https://magicmind.com/ttsmf & TREEHOUSE60 #magicmind #mentalwealth #mentalperformanceGet a FREE roof inspection from the best company in DFW:Cook DFW Roofing & Restoration Defender OutdoorsUse code TREEHOUSE to unlock special discounts at Defender Outdoors!CLICK HERE TO DONATE:The RMS Treehouse Listeners FoundationLINKS:Airline Passenger's Violent Meltdown, Fight in Aisle Caught on VideoHow Remote Work Is Changing Gen Z's Sex Lives - EduBirdie.comWhy couples are celebrating wild 'arbitrary-versaries'Tequila-marinated turkey causes oven mishap on Madison's west side | News | channel3000.com

Episode 194: Acute low back pain.  Future Dr. Ibrahim presents a clinical case to explain the essential points in the evaluation of back pain.  Future Dr. Redden adds information about differentiating between a back strain and more serious diseases such as cancer, and Dr. Arreaza shares information about returning to work after back strain.Written by Michael Ibrahim, MSIV. Editing and comments by Jordan Redden, MSIV, and Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Dr. Arreaza:Welcome back, everyone. Today's topic is one that every primary care provider, emergency doctor, and even specialist sees routinely: low back pain. It's so common that studies estimate up to 80% of adults will experience it at some point in their lives. But despite how frequent it is, the challenge is to identify which cases are benign and which demand urgent attention.Jordan:Exactly. Low back pain is usually self-limiting and mechanical in nature, but we always need to keep an eye out for the rare but serious causes: things like infection, malignancy, or neurological compromise. That's why a good history and physical exam are our best tools right out of the gate.Michael:And to ground this in a real example, let me introduce a patient we saw recently. John is a 45-year-old warehouse worker who came in with two weeks of lower back pain that started after lifting a 50-lb box. He describes it as a dull, aching pain that radiates from his lower back down the posterior left thigh into the calf. He says it gets worse with bending or coughing, but he feels better when lying flat. He also mentioned some numbness in his left foot, but he denies any bowel or bladder issues. His vitals are completely normal. On exam, he had lumbar paraspinal tenderness, a positive straight leg-raise at 40 degrees on the left and decreased sensation in the L5 dermatome, though reflexes were still intact.Dr. Arreaza:That's a great case. Let's take a minute and talk about the straight leg raise test. This is a bedside tool we use to assess for lumbar nerve root irritation often caused by a herniated disc. ***Here's how it works: the patient lies supine, and you slowly raise their straight leg. If pain radiates below the knee between 30° and 70°, that suggests radiculopathy, especially involving the L5 or S1 nerve roots. Pain at higher angles is more likely due to hamstring tightness or mechanical strain.Michael:Right. So, stepping back: what do we mean by "low back pain"? Broadly, it's any pain localized to the lumbar spine, but it's often classified by type or cause:Mechanical (like muscle strain or degenerative disc disease), Radicular (nerve root involvement), Referred pain (like from pelvic or abdominal organs), Inflammatory (AS), and Systemic or serious causes like infection or malignancy. Jordan:In John's case, we're thinking radicular pain, most likely from a herniated disc compressing the L5 nerve root. That's supported by the dermatomal numbness, the leg pain, and that positive straight leg test.Dr. Arreaza:Good reasoning. Now, anytime we see back pain, our brains should run a checklist for red flags. These help us pick up more serious causes that require urgent attention. Let's run through the red flags.Michael:Sure. For fracture, we think about major trauma or even minor trauma in the elderly, especially those with osteoporosis or on chronic steroids. Also, anyone over 70 years old.Jordan:Then we have infections, which could include things like discitis, vertebral osteomyelitis, or epidural abscess. Red flags include fever, IV drug use, recent surgery, or immunosuppression.Michael:Malignancy is another critical one, especially if there's a history of breast, prostate, lung, kidney, or thyroid cancer. Clues include unexplained weight loss, night pain, or constant pain not relieved by rest.Jordan:And don't forget about inflammatory back pain, like ankylosing spondylitis, which is often seen in younger patients with morning stiffness that lasts more than 30 minutes and improves with activity.Dr. Arreaza:And of course, we always rule out cauda equina syndrome: a surgical emergency. That's urinary retention or incontinence, saddle anesthesia, bilateral leg weakness, or fecal incontinence. Missing this diagnosis can be catastrophic.Michael:Thankfully, in John's case, we don't see any red flags. His presentation is classic for uncomplicated lumbar radiculopathy. But we must stay vigilant, because sometimes patients don't offer up key symptoms unless we ask directly.Jordan:And that's where associated symptoms help guide us. For example:Radicular symptoms like numbness or weakness follow dermatomal patterns. Constitutional symptoms like fever or weight loss raise red flags. Bladder/bowel changes or saddle anesthesia raise alarms for cauda equina. Pain that wakes patients up at night might point to malignancy. Dr. Arreaza:So when do we order labs or imaging?Michael:Not right away. For most patients with acute low back pain, imaging is not needed unless they have red flags. If infection is suspected, we'd get CBC, ESR, and CRP. For cancer, maybe PSA or serum protein electrophoresis. And if inflammatory back disease is suspected, HLA-B27 can be helpful.Jordan:Yes, imaging should be delayed for at least six weeks unless red flags or significant neurologic deficits are present. When we do image, MRI is our go-to especially for suspected radiculopathy or cauda equina. X-rays can help if we're thinking about fractures, but they won't show soft tissue or nerve root issues.Michael:In the example from our case, since the patient doesn't have red flags, we'd go with conservative management: start NSAIDs and recommend activity modification. As this is the acute setting, physical therapy would not be recommended.Jordan:For the acute phase, research shows no serious difference between those with PT and those without in the long term. However, physical therapy is really the cornerstone of management for chronic back pain. It's not just movement: it's education, body mechanics, and teaching patients how to move safely. And PT can actually reduce opioid use, imaging, and injections down the line for patient struggling with long term back pain.Dr. Arreaza:Yes, and PT is not one-size-fits-all. PT might include McKenzie exercises, manual therapy, postural retraining, or even neuromuscular re-education. The goal is always to build core stability, promote healthy movement patterns, and reduce fear of motion.Jordan:Let's take a minute to talk about the McKenzie Method, a physical therapy approach used to treat lumbar disc herniation by identifying a specific movement, (often spinal extension) that reduces or centralizes pain. A common exercise is the prone press-up, (cobra pose for yoga fans) where the patient lies face down and pushes the upper body upward while keeping the hips on the floor to relieve pressure on the disc. These exercises should be done carefully, ideally under professional guidance, and discontinued if symptoms worsen.Michael:For our case patient, our working diagnosis is mechanical low back pain with L5 radiculopathy. No imaging needed now, no red flags. We'll treat conservatively and educate him about proper lifting, staying active, and recovery expectations.Jordan:We also emphasized to him that bed rest isn't helpful. In fact, bed rest can make things worse. Keeping active while avoiding heavy lifting for now is key.Dr. Arreaza:Return-to-work recommendations should be individualized. For example, an office worker, positioning while working, or work hours may be able to return to work promptly. However, those with physically demanding jobs may need light duty or be off work.Ice: no evidence of benefit. Heat: may reduce pain and disability in pain of less than 3 months, although the benefit was small and short.And we should always teach safe lifting techniques: bend at the knees, keep the load close, avoid twisting. It's basic knowledge, but it is very effective in preventing recurrence.Jordan:Now, if a patient fails to improve after 6 weeks of conservative therapy, or if they develop new neurologic deficits, that's when we think about referral to spine specialists or surgical consultation.Michael:And as previously mentioned: in cases where back pain becomes chronic (lasting more than 12 weeks) a multidisciplinary approach works best. That can include:Physical therapy, Cognitive behavioral therapy (CBT) And sometimes pain management interventions. Jordan:We can't forget the psychological toll either. Chronic back pain is associated with depression, anxiety, and opioid dependence. Increased risk factors include obesity, smoking, sedentary lifestyle, and previous back injuries.Dr. Arreaza:Well said. So, let's summarize. Michael?Michael:Sure! Low back pain is common, and most cases are benign. But we have to know the red flags that point to serious pathology. A focused history and physical exam are more powerful than many people realize. And the first step in treatment is almost always conservative, with a strong emphasis on maintaining physical activity.Jordan:And don't underestimate the value of patient education. Helping patients understand their pain, set realistic expectations, and stay active is often just as important as the medications or therapies we offer.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T., Shekelle, P., & Owens, D. K. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147(7), 478–491. https://doi.org/10.7326/0003-4819-147-7-200710020-00006Deyo, R. A., Mirza, S. K., Turner, J. A., & Martin, B. I. (2009). Overtreating chronic back pain: Time to back off? Journal of the American Board of Family Medicine, 22(1), 62–68. https://doi.org/10.3122/jabfm.2009.01.080102National Institute for Health and Care Excellence. (2020). Low back pain and sciatica in over 16s: Assessment and management (NICE Guideline No. NG59). https://www.nice.org.uk/guidance/ng59Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 166(7), 514–530. https://doi.org/10.7326/M16-2367UpToDate. (n.d.). Evaluation and treatment of low back pain in adults. Wolters Kluwer. https://www.uptodate.com (Access requires subscription)Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

In the June 2025 Annals podcast, Ryan and Rory discuss attrition rates for ED clinicians, web-based POCUS training, the risk of delayed respiratory failure in opioid overdoses and much more.

In this episode of The Breast Cancer Recovery Coach, we'll dismantle three of the most common—and misleading—nutrition myths that many women encounter after a breast cancer diagnosis. Whether you're in active treatment or navigating life post-cancer, this conversation offers clarity, compassion, and practical advice rooted in science, not fear.   You'll learn: Why not all carbohydrates are harmful and how whole-food carbs can actually support healing The truth about plant vs. animal foods and how to identify clean, high-quality animal proteins How “organic” and “plant-based” labels can mislead your food choices—and what to look for instead If you've ever felt confused or overwhelmed by nutrition advice, this episode will help you reconnect with your body, make informed choices, and feel confident in the way you nourish yourself. Topics Covered: The real difference between simple and complex carbohydrates How to eat carbs while maintaining stable blood sugar Nutrient density and bioavailability of animal vs. plant foods What qualifies as a clean animal food and why it matters The “health halo effect” of organic and plant-based labels Tips for tuning out food fear and tuning into what works for your body   Resources & References: Work with Laura Study: Glycemic load and cancer risk – Nutrition Journal Study: Dietary fiber intake and breast cancer – Annals of Oncology Study: Macronutrient combinations and glycemic response – Diabetes Care Study: Organic labeling and perception – Food Quality and Preference Study: Health halo of plant-based labels – Appetite (2018) Study: Plant-based health halo and risk perception – Appetite (2019)   Loved this episode? Share it with a friend or leave a review on Apple Podcasts to help more survivors find compassionate, clear guidance on living well after breast cancer.   Connect with Laura Lummer:

This new series will be a collaboration between BTK and Annals of Surgery, where we will be discussing hot topics in surgery research. No, we won't be getting into the nitty gritty of methods of individual papers but rather will focus on high-level discussions of contemporary topics that are moving our field forward. Hosts: Cody Mullens, MD is a general surgery resident at the University of Michigan, current Behind the Knife Surgery Education Fellow. (@Cody_Mullens) Justin B. Dimick, MD MPH is the Fredrick A Coller Distinguished Professor and Chair of Surgery at the University of Michigan. He also serves as the Editor in Chief at Annals of Surgery. (@jdimick1) Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Have a red, painful eye that's sensitive to light? Could be uveitis. Hear ophthalmologist Dr. Timothy Janetos discuss uveitis and how it relates to psoriasis and psoriatic arthritis. Join host Takieyah Mathis for an eye opening discussion about uveitis, cataracts, and eye health with ophthalmologist Dr. Timonthy Janetos from Northwestern Medicine, Department of Ophthalmology. Listen as they discuss what is uveitis and cataracts from key symptoms, the significance of the HLA-B27 marker, diagnosis, to treatment options that help reduce inflammation and preserve long term vision. This episode offers information to help you advocate for your eye health by recognizing when you need help from an ophthalmologist and what actions you can take to reduce your risks associated with uveitis. Timestamps: ·       (0:00)          Intro to Psound Bytes & guest welcome ophthalmologist                      Dr. Timothy Milton Janetos. ·       (1:21)          Definition of uveitis and the relationship to psoriatic                            disease. ·       (5:35)          Symptoms of uveitis. ·       (7:45)          How uveitis is diagnosed. ·       (9:24)          Treatment options for uveitis. ·       (13:11)       What happens if eye injections are needed as treatment. ·       (14:47)        Association between inflammation, psoriatic disease,                           and cataracts. ·       (15:48)        Symptoms of a cataract. ·       (16:33)        Treatment for cataracts. ·       (21:11)        New advancements in treating uveitis and cataracts. ·       (25:50)        General eye health actions to help reduce risks                                       associated with inflammation. Early detection is key. 4 Key Takeaways: ·       Uveitis is a huge spectrum of different diseases with about half of the associations due to chronic, immune related diseases like psoriasis or psoriatic arthritis.   ·       If you wake up with a red, painful eye that's sensitive to light, seek help from an ophthalmologist right away to minimize risk of scar tissue formation. ·       Work with a health care team to treat all aspects of psoriatic disease to reduce inflammation whether it's in the skin, joints, and/or the eye. ·       Lifestyle changes such as stop smoking and yearly eye exams are actions that can help reduce inflammatory factors and maintain overall eye health. Guest Bio: Dr. Timothy Milton Janetos is a board-certified and nationally recognized ophthalmologist with Northwestern Medicine, Department of Ophthalmology who specializes in uveitis and cataract surgery.  He is also an Assistant Professor at the Feinberg School of Medicine, Department of Ophthalmology. Dr. Janetos offers comprehensive care using a personalized treatment plan for both children and adults with intraocular inflammation and infections. He is a professional member of the American Uveitis Society (AUS) and the Association for Research in Vision and Ophthalmology (ARVO), as well as the Editor for Frontiers in Ophthalmology and an Editorial Board Member for Annals of Eye Science. Resources: Ø  Psoriatic Arthritis and Uveitis: What's it All About? Podcast with rheumatologist and ophthalmologist Dr. James Rosenbaum. (Released in 2019.)   https://www.psoriasis.org/watch-and-listen/psoriatic-arthritis-and-uveitis-whats-it-all-about-psa/   Ø  Eye Inflammation and Psoriatic Arthritis         https://www.psoriasis.org/advance/eye-inflammation-and- psoriatic-arthritis/  

This is the last episode of season FOUR! Whenever we wrap up a season, we like to look back and chat about each episode, provide some important takeaways, and share information about actionable steps you can take this summer to keep growing your knowledge base. Resources mentioned in this episode: All episodes of the Together in Literacy podcast Towards a dynamic, comprehensive conceptualization of dyslexia. Annals of dyslexia Super Dville 2.14 Using Evaluations to Better Understand Our Learners with Katy Vassar 2.4 How to Effectively Work with Older Students with Dyslexia 2.5 Word Attack Strategies for Older Students with Dyslexia Building Readers for Life Summer Conference Empowered Beyond the Program Membership Teaching Beyond the Diagnosis: Empowering Students with Dyslexia by Casey Harrison We officially have merch! Show your love for the Together in Literacy podcast! If you like this episode, please take a few minutes to rate, review, and subscribe. Your support and encouragement are so appreciated! Have a question you'd like us to cover in a future episode of Together in Literacy? Email us at support@togetherinliteracy.com! If you'd like more from Together in Literacy, you can check out our website, Together in Literacy, or follow us on Facebook and Instagram. For more from Emily, check out The Literacy Nest. For more from Casey, check out The Dyslexia Classroom. We're looking for topic and guest suggestions for season 4 of the Together in Literacy Podcast! Let us know what you want to hear this season! Thank you for listening and joining us in this exciting and educational journey into dyslexia as we come together in literacy!

In this episode of The Teamcast, Dr. Angus Fletcher joins Preston Cline to discuss the crucial role of "productive discomfort" and honesty in personal and professional growth. They explore how embracing emotional challenges, rather than shielding individuals from them, is vital for true learning and resilience. Angus describes his concept of "story thinking," emphasizing the brain's natural inclination to process experiences through narrative and emotion. The conversation touches on the shortcomings of modern education in fostering emotional robustness and concludes with practical advice for leaders on cultivating independent thinking by recognizing and congratulating actions that differ from their own.Dr. Angus Fletcher is a professor and practitioner of Story Science at Project Narrative at The Ohio State University. He holds degrees in neuroscience and literature. His research, which employs a mix of laboratory experiments, literary history, and rhetorical theory, explores how literature, art, and stories can cultivate emotional resilience, creativity, and common sense. He is the author of Wonderworks (2021), Storythinking (2023), and Primal Intelligence (2025), among other books. His work explores why children are more creative than computer AI and aims to understand how narrative can be leveraged to enhance innovation, resilience, and joy. His academic publications can be found in journals like Narrative, Annals of the New York Academy of Sciences, and Harvard Business Review.Check out Angus's work here: https://www.angusfletcher.co/

Jody responds to the American College of Physicians' Annals On Call Podcast episode released on May 19th, 2025.Links:Advanced Practice Clinicians Cannot Replace Primary Care Physicians. Annals On Call Podcast, 5-29-25Physician Assistant and Former PA-Turned-Physician Discuss the State of the Profession. Patients At Risk Podcast, 7-25-21 (Spotify)New Workforce Model Suggests Continued Physician Shortages In Nonprimary Care Specialties (AAMC Article)Christin Giordano McAuliffe. There Is No Substitute for Primary Care Physicians: A Response to the Association of American Medical Colleges' Workforce Model. Ann Intern Med.2025;178:590-591. [Epub 4 March 2025]. doi:10.7326/ANNALS-24-03806University of South Alabama Dual Role NP CurriculumRazavi, Moaven PhD*; O'Reilly-Jacob, Monica RN, PhD, FNP-BC†; Perloff, Jennifer PhD*; Buerhaus, Peter RN, PhD, FAAN, FAANP(h)‡. Drivers of Cost Differences Between Nurse Practitioner and Physician Attributed Medicare Beneficiaries. Medical Care 59(2):p 177-184, February 2021. | DOI: 10.1097/MLR.0000000000001477 McMenamin A, Turi E, Schlak A, Poghosyan L. A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions. Medical Care Research and Review. 2023;80(6):563-581. doi:10.1177/10775587231186720Kippenbrock T, Emory J, Lee P, Odell E, Buron B, Morrison B. A national survey of nurse practitioners' patient satisfaction outcomes. Nurs Outlook. 2019 Nov-Dec;67(6):707-712. doi: 10.1016/j.outlook.2019.04.010. Epub 2019 May 4. PMID: 31607371.Haas, D., Pozehl, B., Alonso, W. W., & Diederich, T. (2023). Patient Satisfaction With a Nurse Practitioner–Led Heart Failure Clinic. Journal for Nurse Practitioners, 19(4), Article 104496. https://doi.org/10.1016/j.nurpra.2022.11.006https://www.techtarget.com/patientengagement/news/366584669/Nurse-Practitioners-Boost-Patient-Satisfaction-Quality-Outcomeshttps://www.aanp.org/advocacy/advocacy-resource/position-statements/quality-of-nurse-practitioner-practicehttps://www.aacnnursing.org/news-data/all-news/rounds-with-leadership-focusing-on-the-outcomes-of-np-practiceStanik-Hutt, J., Newhouse, R. P., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., Wilson, R., Fountain, L., Steinwachs, D. M., Heindel, L., & Weiner, J. P. (2013). The quality and effectiveness of care provided by nurse practitioners. Journal for Nurse Practitioners, 9(8), 492-500.e13. https://doi.org/10.1016/j.nurpra.2013.07.004Savard I, Al Hakim G, Kilpatrick K. The added value of the nurse practitioner: An evolutionary concept analysis. Nurs Open. 2023 Apr;10(4):2540-2551. doi: 10.1002/nop2.1512. Epub 2022 Dec 17. PMID: 36527435; PMCID: PMC10006655.

Langeweile kennen Leon und Atze aus dem Alltag kaum noch. Und wenn sie doch mal anklopft, liegt das Smartphone griffbereit in der Hosentasche. Ist ja nicht schlimm, dass wir uns nur noch selten langweilen, oder? Ist schließlich ein furchtbares Gefühl. Und doch ist Stille, nichts tun, genau das, wonach sich Pico Iyer, ein englischer Reiseschriftsteller, sehnt. So sehr, dass er einen ungewöhnlichen Schritt wagt, der sein Leben für immer verändert. Auch, wenn wir nicht wie Iyer seit unserer Kindheit um die Welt jetten, können wir von ihm doch so einiges über Ruhe und Reizarmut lernen. Denn Langeweile will uns etwas sagen. Fühlt euch gut betreut Leon & Atze Instagram: https://www.instagram.com/leonwindscheid/ https://www.instagram.com/atzeschroeder_offiziell/ Mehr zu unseren Werbepartnern findet ihr hier: https://linktr.ee/betreutesfuehlen Tickets: Atze: https://www.atzeschroeder.de/#termine Leon: https://leonwindscheid.de/tour/ VVK Münster 2025: https://betreutes-fuehlen.ticket.io/ Start ins heutige Thema: 09:24 min. Quellen: Gross, M., Raynes, S., Schooler, J. W., Guo, E., & Dobkins, K. (2024). When is a wandering mind unhappy? The role of thought valence. Emotion. https://doi.org/10.1037/emo0001434 Killingsworth, M. A., & Gilbert, D. T. (2010). A Wandering Mind is an Unhappy Mind. Science, 330(6006), 932-932. https://doi.org/10.1126/science.1192439 Tam, K. Y., & Inzlicht, M. (2024). Fast-forward to boredom: How switching behavior on digital media makes people more bored. Journal of Experimental Psychology: General, 153(10), 2409. https://doi.org/10.1037/xge0001639 Hatano, A., Ogulmus, C., Shigemasu, H., & Murayama, K. (2022). Thinking about thinking: People underestimate how enjoyable and engaging just waiting is. Journal of Experimental Psychology: General, 151(12), 3213–3229. https://doi.org/10.1037/xge0001255 The Art of Stillness | Pico Iyer | TED https://www.youtube.com/watch?v=aUBawr1hUwo Nathan Scolaro (2016). Pico Iyer chooses stillness. Dumbo Feathers. https://www.dumbofeather.com/conversations/pico-iyer-chooses-stillness/? Tippett, K. (Host). (2018, November 29). Pico Iyer — The urgency of slowing down [Audio-Podcast-Episode]. In On Being. The On Being Project. https://onbeing.org/programs/pico-iyer-the-urgency-of-slowing-down-nov2018/ Buckner, R. L., Andrews‐Hanna, J. R., & Schacter, D. L. (2008). The brain's default network: anatomy, function, and relevance to disease. Annals of the new York Academy of Sciences, 1124(1), 1-38. https://doi.org/10.1196/annals.1440.011 HuffPost. (2015, April 14). Pico Iyer on the difference between a great living and a great life. https://www.huffpost.com/entry/pico-iyer-great-living-versus-life_n_7065356 Handley, D. (2020). Adventures in Going Nowhere with Pico Iyer [Audio podcast]. Wiser Conversations. https://www.wiserconversations.org/podcasts/pico-iyer Gross, T. (Host). (2025, Januar 15). 'Aflame' is Pico Iyer's memoir of losing everything in a wildfire [Audio podcast episode]. In Fresh Air. NPR. https://www.npr.org/2025/01/15/nx-s1-5259687/pico-iyer-aflame-silent-retreat Bharath, D. (2025, Februar 1). Author's story of coping after a wildfire resonates with community affected by latest LA-area fires. Associated Press. https://apnews.com/article/c560d7c2dc226d5b41f7162733bdee1f Elpidorou, A. (2014). The bright side of boredom. Frontiers in psychology, 5, 118190. https://doi.org/10.3389/fpsyg.2014.01245 Redaktion: Dr. Jan Rudloff Produktion: Murmel Productions

Sometime in the 800s, an anonymous monk in the abbey of Fulda–now in modern Germany–copied out a Latin history in one of the great inventions of the age, the handwriting known as Carolingian miniscule, which is more or less they system that we use today to print the English alphabet. Thanks to that monk, today we have the first part of the Annals of P. Cornelius Tacitus, arguably the greatest surviving history of imperial Rome. But who was Tacitus? Why is he important? How could such an opinionated historian proclaim that he was writing without “anger and partiality”? Was he a champion of Roman liberty, or simply a grumpy aristocrat? With me to discuss Tacitus is Dr. Eric Adler, Professor and Chair of Classics at the University of Maryland. His scholarly interests include Roman historiography, Latin prose, the history of classical scholarship, and the history of the humanities. This is his second time on the podcast. His last appearance was in Episode 195, which dropped on January 20, 2021, in which we discussed his then third book, The Battle for the Classics: How a Nineteenth-Century Debate Can Save the Humanities Today.   For Further Investigation Eric Adler recommends "some scholarship" on Tacitus's Agricola: Clarke, Katherine. 2001. “An Island Nation: Re-Reading Tacitus' Agricola.” Journal of Roman Studies 91: 94-112. Liebeschuetz, W. 1966. “The Theme of Liberty in the Agricola of Tacitus.” Classical Quarterly n.s. 16.1: 126-139. Momigliano, Arnaldo. 2012 (1990). “Tacitus and the Tacitean Tradition.”In Tacitus, edited by Rhiannon Ash. 411-433. Oxford: Oxford University Press. Sailor, Dylan. 2004. “Becoming Tacitus: Significance and Inconsequentiality in the Prologue of Agricola.” Classical Antiquity 23.1: 139-177. Syme, Ronald. 1958. Tacitus, vols. 1-2. Oxford: Clarendon Press.

SHOW NOTESWhat impact does surgery have on the body?Intentional trauma Physiological response Psychosocial impact StressWhen we think about surgery, it's essential to understand that it triggers a significant reaction in the body known as the 'stress response.' This response is a complex interplay of hormonal and metabolic changes directly linked to the degree of tissue damage during surgery. It can intensify if there are any complications after the operation. Let's break it down: The whole process starts when the hypothalamic-pituitary-adrenal axis, or HPA axis, kicks into gear. This leads to a surge in hormones like cortisol, growth hormone, glucagon and catecholamines. These hormones are important because they help the body cope with stress by boosting energy availability and adjusting other bodily functions.Ebb phase (0-48hrs)Increased catabolism of stored glycogen (glycogenolysis)Suppression of insulin secretion → transient hyperglycemiaIncreased catecholamines, cortisol, and inflammatory cytokines (IL-6, TNF-α)Flow phase (3-10 days)Hypermetabolism (increased BMR)Increased protein catabolism → muscle breakdown (to provide amino acids for tissue repair and immune function)Increased lipolysis (fat breakdown) for energySustained insulin resistance → continued hyperglycemiaEnhanced GNG Pro-inflammatory response → increased cytokines and acute-phase protein productionIn the initial stages after surgery, the body releases a wave of pro-inflammatory cytokines. These cytokines jumpstart the healing process by promoting inflammation, which is important for healing surgical wounds. However, to keep this inflammation from going overboard, the body soon follows up with anti-inflammatory cytokines.These inflammatory processes have widespread effects across the body. For example, they can influence how the hypothalamus regulates body temperature or how the liver produces certain proteins that help fight infection and aid in wound healing.But here's where it gets even more interesting: other hormones like glucagon, cortisol, and adrenaline also play a role in modulating these responses. They can affect everything from your blood sugar levels to how your cardiovascular system handles the stress.So, why is all this important? Well, by understanding and managing these responses effectively, we can significantly improve how patients recover from surgery. It's all about helping the body maintain balance during a time when it's incredibly vulnerableDisruption of Metabolic Homeostasis: Surgery often disrupts the body's normal metabolic balance, notably through insulin resistance, where cells fail to respond effectively to insulin, leading to 'diabetes of the injury.' Insulin Resistance and Hyperglycemia: Insulin resistance can cause high blood sugar levels, significantly increasing the risk of surgical complications and mortality. Post-surgery, the body may enter a catabolic state, breaking down muscle instead of fat, which impairs wound healing, weakens the immune system, and reduces muscle strength. Increased Risks for Vulnerable Groups: Elderly, diabetics, and cancer patients are particularly at risk due to their compromised metabolic and inflammatory states. These groups have less physiological reserve, leading to pronounced catabolic states and increased risk of severe post-operative complications. Impact on Recovery and Outcomes: The metabolic chaos from insulin resistance to protein loss not only delays recovery but also exacerbates risks of infection and other complications. Effective management of these changes is crucial for improving surgical outcomes and ensuring that patients thrive post-surgery.ERAS helps to mitigate these by Surgery isn't just about the physical repair or removal of tissue; it triggers a cascade of stress responses in the body that can complicate recovery. These include everything from the psychological impacts of anxiety and the physiological effects of fasting to direct tissue damage and the systemic reactions to it, such as fluid shifts and hormonal imbalances.Key Components of ERAS:Comprehensive Care: ERAS isn't just a single technique but a suite of practices designed to address every aspect of the patient's journey — before, during, and after surgery. This approach aims to minimise the stress responses by controlling pain, reducing fasting times, optimising fluid management, and promoting early mobility.Minimising Fasting: One traditional practice that ERAS revises significantly is the preoperative fasting rule. Old guidelines that required fasting from midnight before surgery are now replaced with more lenient, evidence-based practices that allow intake of clear fluids up to two hours and solids up to six hours before surgery. This change helps maintain normal blood glucose levels, reduces stress, and decreases the body's shift into a catabolic (muscle-degrading) state.Nutritional Optimisation: ERAS protocols emphasise the importance of not entering surgery in a depleted state. By allowing a carbohydrate-rich drink shortly before surgery, patients are better hydrated and less anxious, which in turn reduces insulin resistance and preserves muscle mass — critical factors in speeding up recovery post-surgery. Post-operatively, oral nutrition may be delayed by the medical team until bowel function returns, typically taking close to a week. This delay is stated to reduce postoperative complications such as abdominal distension and nausea/vomiting.For the first several days post surgery fluids of limited nutritional value such as water are provided to patient until tolerance is established leading to insufficient nutrition intake during this time increasing the risk of malnutrition. The ERAS protocol promotes early oral intake within 24 hours post surgery departing from traditional fasting practices. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Therefore addressing malnutrition is a key component of the ERAS protocol.Immune-Enhancing Diets: Post-surgery nutrition is just as crucial. ERAS encourages diets rich in nutrients that bolster the immune system and enhance wound healing. This includes omega-3 fatty acids, which help modulate the inflammatory response; arginine, which supports protein synthesis and tissue growth; glutamine, which is vital for cellular health and recovery; and nucleotides, which are essential for rapid cell division and immune function .Immuno-nutrition is a specialised medical nutrition therapy that has been shown to adjust the body's inflammatory response: It incorporates specific nutrients like omega-3 fatty acids, arginine, polyunsaturated fatty acids, and nucleotides. It's typically recommended starting 5-7 days before surgery and continuing post-operatively for over 7 days or until oral intake meets at least 60% of the patient's nutritional requirements.How can we use this info to optimize surgical outcomes?Patient education Early nutrition pre and post surgery - Minimise fasting time What is ERAS? How does it differ from traditional care/practice?Introduced by Henrik Kehlet in 1997, the Enhanced Recovery After Surgery (ERAS) protocol has revolutionised surgical practices by optimising perioperative care. A key aspect of ERAS is its interdisciplinary approach, involving healthcare professionals from various specialties to minimise surgical stress and facilitate recovery. What is malnutrition?Malnutrition, is defined as an involuntary reduction in body weight, muscle mass and physical capabilities, affects up to 65% of surgical patients and can worsen during hospital stays. Enhancing nutritional status and promoting functional nutrition therapy is essential, even forpatients without evident malnutrition, particularly when prolonged perioperative oral intake challenges arise. Addressing malnutrition is essential for preventing surgical complications, prolongedhospital stays and higher healthcare costs. What are the benefits of ERAS for the patient?It has been shown that the key physiological benefits include:-enhances the body's anabolic processes-promotes wound healing, which is critical for patient recovery.-Reduces the risk of nutritional depletion-Minimises insulin resistance, a common issue post-surgery, allowing for better blood sugar control and improved metabolic function.-Reduce protein catabolism-And lowers the risk of pressure injuries, which can develop due to extended immobility after surgery.What are the benefits of ERAS from a healthcare perspective? From a healthcare perspective, ERAS has been shown to-shorter length of hospital stay for patients,-Lower risk of ICU transfer rates-reduce readmission rates-And all of these improvements lead to lower healthcare costs, not just for the hospital but for the overall healthcare system, as fewer complications and shorter stays reduce the financial strain.Step 1: Screen & StrengthenIf you've lost any weight unintentionally in the lead up to surgery, or been eating poorly because of a reduced appetite, you may be at risk of malnutrition and it's really important to address this prior to surgery. Research suggests that between 40-50% of surgical patients have some degree of malnutrition. Pre-operative malnutrition is an independent predictor of poor post-operative outcomes. Addressing malnutrition is a key component of the ERAS protocol and why it's effective in improving surgical outcomes for patients.Book an appointment with a dietitian who can guide you on appropriate dietary changes to minimise muscle loss, build you up and optimise nutritional status and stores pre-op. A well-nourished body tolerates surgery better, heals faster, has a stronger immune system to fight infection, and experiences fewer complications.Step 2: Consider Immunonutrition If you're planned for major surgery, especially certain cancer and abdominal surgeries, consider the use of an immunonutrition supplement in the 5-7 days pre op. These are the supplements loaded with arginine, n3s, glutamine and nucleotides to support the immune system and reduce inflammatory responses, potentially leading to fewer infections and better recovery.Step 3: Build Your Strength & Energy Stores prior to surgery Carb load with food in the days leading up to surgery - think that big bowl of pasta a footy player would have the night before the grand final. ERAS protocols have significantly reduced or eliminated long periods of "nil by mouth" (NBM) before surgery.Ask your surgical team exactly when you need to stop eating solid food – it might be much later than you think, often around 6 hours before surgery for a light meal. For clear fluids, it could be as little as 2 hours before!We'll make the most of every second to prevent unnecessary dehydration, hunger, anxiety, and preserve your body's energyStep 4: The Pre-Surgery Carb Load using clear fluidsMany ERAS protocols include a special carbohydrate-rich drink taken a few hours before surgery. Your hospital may provide this, but if they don't, we can organise orders for you or point you in the right direction.  It's usually a clear, sweet drink. Think of it as topping off your fuel tank right before the 'race'."These have been shown to reduce post-operative insulin resistance (which can slow healing), help maintain muscle strength, can reduce nausea, and improve overall wellbeing. It basically tells your body it's in a 'fed' state, not a 'starvation' state, heading into surgery.This is best done with tailor made medical nutrition drinks as they come prepped with the correct doses of maltodextrin-polymer carbs and a lower osmolality than other solutions, which essentially means they gentler on your gut and better for gastric emptying so they don't linger in your gut during surgery. Always follow surgical instructions, but ideally we're aiming for 100 grams of carbohydrate the night before surgery and about 50 grams of carbohydrate in clear fluids approximately 2 hours before anesthesia. This might look like 4 x 200ml drinks the night before, and 2 the morning of surgery If you can't access these drinks, apple or cranberry juice are reasonable replacements.  Drop us an email or message or give us a call if you'd like advice on where to get pre-op and immunonutrition supplement drinks. Then we move on to post op and Step 5 which is aiming to eat early.  ERAS encourages starting to eat and drink as soon as it's safe after surgery – often within hours, not days!As soon as your team says it's okay, try sipping water, then progress to other clear fluids, and then light foods as tolerated. Even small, frequent amounts help. This helps to stimulates your gut to start working again, reducing the risk of ileus – a slow, sleepy bowel, provides energy for healing, and can help you feel more normal, faster.If you haven't been told you can eat or drink, keep asking the question! You are your best advocate! Another tip that can help here is step 6:  Chew GumIf your team allows it, start chewing sugar-free gum several times a day once you're able. It sounds simple, but it can be surprisingly helpful in mimicking eating even when you're not allowed to, and can stimulate your digestive system to return to usual function sooner and reduce the risk of ileus.Step 7 is to Nourish to Heal This is where we bring in our good friend protein to optimise tissue repair and recovery Include protein rich food at each meal, and chat to us if you're finding this difficult because there are plenty of hacks if you're not feeling up to chicken breast and steak! And finally step 8 is to Listen to Your BodyWhile ERAS encourages early eating, we always want you to be tuned in to your body's cues and speaking up to your medical team and us if something doesn't feel right. There are plenty of interventions that can be used to keep you comfortable while still optimising your nutrition to get the best outcomes from surgery. Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Hübner, M., Klek, S., et al. (2021). ESPEN practical guideline: Clinical nutrition in surgery. Clinical Nutrition, 40(7), 4745-4761.Weimann, A., Braga, M., Carli, F., Higashiguchi, T., Laviano, A., Ljungqvist, O., et al. (2017). ESPEN guideline: Clinical nutrition in surgery. Clinical Nutrition, 36(3), 623-650.Gustafsson, U. O., Scott, M. J., Schwenk, W., Demartines, N., Roulin, D., Francis, N., et al. (2019). Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. Clinical Nutrition, 38(2), 576-586. (Note: The ERAS® Society website, erassociety.org, is the primary source for the most current and comprehensive suite of procedure-specific guidelines.)Ljungqvist, O., Scott, M., & Fearon, K. C. (2017). Enhanced Recovery After Surgery: A review. JAMA Surgery, 152(3), 292-298.Thiele, R. H., Raghunathan, K., Brudney, C. S., Campos, S., Candiotti, K., Chaves, S., et al. (2016). American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management in adults. Perioperative Medicine, 5, 26. (Note: This is an example of ASER/POQI consensus; look for other relevant POQI statements on specific surgical procedures and their nutritional components.)Soon, K., Levy, G. M., Cusack, L. A., Varma, S., & Nicholson, G. A. (2020). The effect of preoperative carbohydrate loading on patient outcomes in elective surgery: A systematic review and meta-analysis. Systematic Reviews, 9(1), 254.Lewis, S. J., Egger, M., Sylvester, P. A., & Thomas, S. (2001). Early enteral feeding versus "nil by mouth" after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ, 323(7316), 773-776.Osland, E. J., Hossain, M. A., Khan, S., & Memon, M. A. (2014). Effect of timing of oral feeding on patient outcomes after elective colorectal surgery: A systematic review and meta-analysis. Journal of Gastrointestinal Surgery, 18(5), 1039-1051.Braga, M., Gianotti, L., Nespoli, L., Radaelli, G., & Di Carlo, V. (2002). Nutritional approach in malnourished surgical patients: a prospective randomized study. Archives of Surgery, 137(2), 174-180.Marimuthu, K., Varadhan, K. K., Ljungqvist, O., & Lobo, D. N. (2012). A meta-analysis of the effect of combinations of enhanced recovery after surgery (ERAS) interventions on postoperative outcomes. Annals of Surgery, 255(4), 640-649.

In this Leveling Up episode of the PRS Global Open Deep Cuts Podcast, Dr. James Chang discusses his path into hand surgery, his approach to various common hand conditions, his version of awake hand surgery, how he helps his residents develop confidence and competence, the importance of building rapport with patients, the change in his career path over time, his involvement in global health, and the influences of his mentors. Read a classic PRS Global Open article by Dr. Chang and his colleagues, “Modeling the Lifetime Impact of Reconstructive Plastic Surgery Training: Implications for Building Capacity in Global Surgery”: https://bit.ly/BldgGlobalCapacity_GOX  Dr. James Chang is the Chief of the Division of Plastic and Reconstructive Surgery at Stanford University. He graduated from Yale medical school, and then completed a residency in plastic surgery at Stanford, followed by a hand fellowship at UCLA in Los Angeles. He is the past editor in chief of the yearbook of hand surgery, and an associate editor at multiple journals, including Hand, Microsurgery, the Journal of Hand Surgery, and the Annals of Plastic Surgery. He was the Royal College of Surgeons Foundation traveling fellow, and the 2006 Sterling Bunnell traveling fellow. He has been deeply involved at the American Society for Surgery of the hand, taking on the roles of research director, treasurer, and president. He has also been the vice chair of the Plastic surgery residency review committee, and the secretary and treasurer of the American Board of Plastic Surgery. He is also the CMO for Resurge International. Your host, Dr. Puru Nagarkar, is a board-certified plastic and hand surgeon, and Associate Professor of Plastic Surgery at the University of Texas Southwestern Medical Center in Dallas. The views expressed by hosts and guests are their own and do not necessarily reflect the official policies or positions of ASPS. #PRSGlobalOpen #DeepCutsPodcast #PlasticSurgery #LevelingUp

În cadrul ediției de pe 20 mai a emisiunii Știința360 de pe Radio România Cultural, Dr. Marius Geantă, Președintele Centrului pentru Inovație în Medicină, a comentat ultimele noutăți din domeniul sănătății. Utilizarea dispozitivelor medicale pe bază de inteligență artificială ar putea avea un rol semnificativ în screening-ul cardiovascular al femeilor care urmează să devină mame sau care își doresc să facă acest pas în viitor. Oamenii de știință de la Mayo Clinic, SUA, au analizat performanțele unui instrument EKG-AI și a unui stetoscop inteligent în detectarea cardiomiopatiei în rândul femeilor aflate la vârstă fertilă. Publicat în Annals of Family Medicine, studiul arată cum cele două dispozitive digitale semnalează cu acuratețe prezența fracției de ejecție a ventriculului stâng (LVEF) sub 50%, indicator cunoscut în cazul unui mușchi cardiac slăbit.În fiecare an, aproximativ 300.000 de femei își pierd viața ca urmare a complicațiilor apărute în timpul sarcinii sau al nașterii. O parte din aceste complicații pot fi prevenite, evitate sau gestionate cu mai multă siguranță, cu cât viitoarea mamă și medicii care o îngrijesc cunosc mai multe detalii despre starea sa de sănătate. Ziua Mondială a Sănătății din acest an a adus în prim-plan sănătatea mamelor și a nou-născuților, subliniind importanța măsurilor preventive luate din timp. Screening-ul cardiovascular înainte și în timpul sarcinii, realizat prin mijloace digitale precum dispozitivele bazate pe AI, nu numai că este rapid și cost-eficient, dar poate depista timpuriu femeile aflate la risc și poate informa viitorul planul de îngrijire al acesteia.Mai multe detalii despre subiectele discutate - ▶ Dispozitivele digitale de tipul AI-EKG, utile în screeningul cardiovascular al femeilor care doresc să devină mame▶ CORDELIA, cel mai amplu studiu asupra sănătății cardiovasculare în Europa de Sud. Datele genomice, sociale și de mediu vor contribui la strategii de prevenție personalizată▶ Un program de screening pentru cancerul colorectal desfășurat timp de 20 ani a demonstrat reducerea cu 50% a mortalității▶ Prima terapie CRISPR personalizată salvează viața unui bebeluș cu o boală genetică rară.Ascultă emisiunea pe Radio România Cultural.

Jonathan Chibuike Ukah reads his poem "The Valley of the Living," and Maryella Desak Sirmon reads her poem "Uncertain Opposites."Jonathan Chibuike Ukah is a Pushcart-nominated poet living in the United Kingdom. His poems have been featured in TAB: The Journal of Poetry and Poetics, Unleash Lit, The Pierian, Propel Magazine, Atticus Review, The Journal of Undiscovered Poets, and elsewhere. He won the Alexander Pope Poetry Award in 2023. He was the Editor's Choice Prize Winner of Unleash Lit in 2024. He was shortlisted for the Minds Shine Bright Poetry Prize 2024 and the Second Poetry Prize Winner of The Streetlights Poetry Prize in 2024.Maryella Desak Sirmon believes life is a pilgrimage. Physician and lay eucharistic minister, she wrote her first poem in third grade. Her poetry has been published in Annals of Internal Medicine, Oracle Fine Arts Review, October Hill Magazine, Amethyst Review, Deep South Magazine, Delta Poetry Review, Ekstasis, Anomaly Poetry, and elsewhere.

The Environment We Live In and Health: A Complex RelationshipDeploy: Code: WOLVEFDescription:Join us on "The Environment We Live In and Health: A Complex Relationship," where we delve into the intricate dynamics between our environment and human health. This episode explores how environmental factors shape our well-being, examining the complex interplay between health outcomes and the world around us. We'll unpack the latest research, highlight innovative solutions, and tackle pressing challenges at the intersection of environmental science and public health. Whether you're a healthcare provider, an environmental advocate, or simply curious about the world we live in, this podcast will equip you with insights to foster a healthier future for both people and the planet. Tune in and discover how together we can create a sustainable, thriving environment for generations to come!Objectives: Discuss the intricate dynamics between environmental factors and human health and wellness. Explain the impact of the environment on health and well-being and the complex interplay between health outcomes and the surrounding world. Identify and appraise the latest information, innovative solutions, and pressing challenges at the intersection of environmental science and public health. Guests: Gina Alexander, PhD, MPH, MSN, RN, Texas Christian UniversityGina Hill: https://cse.tcu.edu/faculty-staff/view/gina-hill Brendan Lavy: https://cse.tcu.edu/faculty-staff/view/lavy-brendanBios: Gina Alexander, PhD, MPH, MSN, RNDr. Gina Alexander, Professor in the Harris College of Nursing and Health Sciences at Texas Christian University, champions interprofessional collaboration through education, research, and practice. She teaches public health nursing and coordinates interprofessional education initiatives with colleagues on campus and throughout the community.Dr. Alexander leads interprofessional, participatory action research focused on promoting equitable access to nature and food, improving social determinants of health in the local community and beyond. As the project lead of RxPLORE™: Prescribing Life Outdoors and Real Exploration, she develops community-academic-practice partnerships to advance nature-based health promotion and environmental stewardship.With a public health nursing practice grounded in collective action and advocacy, Dr. Alexander co-leads the Fort Worth Climate Safe Neighborhood Coalition and serves on the Immunization Collaboration of Tarrant County. Within the Association of Community Health Nursing Educators, she serves as Policy Committee Chair.Gina Jarman Hill, PhD, RD, LDDr. Gina Jarman Hill is a Professor in and the Chair of the Department of Nutritional Sciences at Texas Christian University (TCU). She joined the faculty of the Department of Nutritional Sciences in 2003. Dr. Hill earned her PhD in Nutrition from Texas Tech University in Lubbock, TX. Hill is a Registered and Licensed Dietitian and a member of the Hunger and Environmental Nutrition (HEN) dietetic practice group and the Dietitians in Integrative and Functional Medicine dietetic practice group. Her current research interests include hunger and food security, sustainability, urban agriculture, and community nutrition education and health. Hill is a Texas Master Gardener, is trained in Permaculture Design, and is an active community volunteer. In her spare time she enjoys gardening, spending time with her family, cooking, traveling and reading.Brendan Lavy, PhDDr. Brendan Lavy is an Assistant Professor at Texas Christian University. As a Professor in the Environmental and Sustainability Sciences, his teaching and research interests include sustainability metrics, business sustainability, urban environmental management, disaster recovery and resilience, watershed resilience, and geographic information systems. Dr. Lavy's research projects include how businesses' sustainability practices align with principles of the circular economy and the UN Sustainable Development Goals, how municipal environmental ordinances and their outcomes support urban sustainability initiatives, and how the recovery of parks and protected places influences the recovery of communities impacted by disasters. References:American Nurses Association. (2023, September 14). Nurses' role in addressing global climate change, Climate Justice, and health. ANA. https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/climate-change/ Haq, C., Iroku-Malize, T., Edgoose, J., Prunuske, J., Perkins, A., Altman, W., & Elwood, S. (2023). Climate change as a threat to health: Family medicine call to action and response. The Annals of Family Medicine, 21(2), 195–197. https://doi.org/10.1370/afm.29...

A recent study published in the eminent medical journal Annals of Medicine says that the damage that smoking, heavy drinking and lack of exercise does begins in your mid 30s. It's not surprising that a lifetime of these things is damaging. Professor Luke O Neill , Professor of Biochemistry at the school of Immunology, Trinity College tell us more.

Dr. Feroze Sidhwa discusses Gaza with Clint Borgen. Dr. Sidhaw is a Trauma Surgeon, based in California, with experience in Gaza, Ukraine, the West Bank, Zimbabwe, Haiti, Dominican Republic, and Burkina Faso. He received his Masters in Public Health from Harvard and his Medical Degree from the University of Texas Medical School.Take Action: Urge Congress to meet with American doctors who served in Gaza.Mentioned: Read the letter U.S. doctors sent to Congress.Official podcast of The Borgen Project, an international organization that works at the political level to improve living conditions for people impacted by war, famine and poverty.borgenproject.orgGuest BioDr. Feroze Sidhwa is a general, trauma, and critical care surgeon in California. He is triple-board certified in general surgery, trauma/surgical critical care, and neurocritical care, and is a Fellow of the American College of Surgeons and of the International College of Surgeons.Feroze is also a humanitarian surgeon. He has worked most extensively in Palestine, but has also worked in Ukraine three times with the International Medical Corps and Harvard Humanitarian Initiative, and in Zimbabwe, Haiti, Dominican Republic, and Burkina Faso. He has helped edit books on the Israeli-Palestinian conflict published by University of California Press (Berkeley, CA), O/R Books (London, UK), and the Institute for Palestine Studies (Washington, DC). He is widely published in the medical literature, including in The Journal of the American College of Surgeons, Annals of Surgery, World Journal of Surgery, Journal of Bone and Joint Surgery, Cochrane Database of Systematic Reviews, Surgical Infections, Plastic and Reconstructive Surgery, JAMA Pediatrics, Journal of Pediatric Surgery, and Journal of Laproendoscopic and Advanced Surgical Techniques, among others. Feroze has spoken on humanitarian relief work and its political implications at the Harvard FXB Center for Health and Human Rights, the University of California San Francisco School of Medicine, as the keynote speaker of the Stanford 31st Annual Trauma Critical Care Symposium, at UChicago Medicine Trauma Grand Rounds, at the University of Chicago Pritzker School of Medicine, University of Chicago Law School, Johns Hopkins University and School of Public Health, Johns Hopkins School of Advanced International Studies, MIT, Kings County Hospital in Brooklyn, SUNY Downstate College of Medicine, NYU, the Hawaii Medical Association, and the University of Hawaii A. John Burns School of Medicine. He has also spoken widely in the community, mostly in the San Francisco Bay Area but also with Jewish Voice for Peace Phoenix and Tucson, Massachusetts Peace Action, the 2024 Democratic National Convention, and elsewhere.Lay publications about Feroze's humanitarian surgical work and its political implications include:New York Times, October 9, 2024. “65 Doctors, Nurses and Paramedics: What We Saw in Gaza”Haaretz (Israel), October 17, 2024. “65 אנשי רפואה לניו יורק טיימס: אלה המחזות שראינו בעזה”Politico, July 19, 2024. “We Volunteered at a Gaza Hospital. What We Saw Was Unspeakable.”CommonDreams.org, May 23, 2024. “The Atlantic's Sloppy Reporting on UN Gaza Statistics Jeopardizes Its Credibility”CommonDreams.org, April 11, 2024. “As Surgeons, We Have Never Seen Cruelty Like Israel's Genocide in Gaza”Columbia Daily Spectator, January 29, 2025. “In Gaza, a ‘political' ethical problem is still an ethical problem.”Feroze is the primary author of two open letters to the Biden-Harris administration regarding the United States' role in the Israeli assault on Gaza that followed the October 7, 2023 attacks on Israel, as well as the appendices accompanying those letters. These letters were updated and sent to the Trump transition team on November 15, 2024.Feroze has appeared on CNN's Amanpour, PBS, MSNBC's Ayman Mohyeldin Reports, Democracy Now!, CNN international, the Australia Broadcasting Corporation, DropSite News, NPR, and the BBC World News, as well as a variety of radio programs and podcasts. He has been quoted widely in mainstream and alternative media, including on CBS Sunday Morning News, ABC News, Reuters, the Washington Post, Mother Jones, the New Republic, Mainchi Newspaper (Japan), Local Call (Israel), the Huffington Post, the New Statesman, NRK (Norway), the Guardian, the Independent, Pass Blue, and Democracy Now! Dr. Sidhwa serves as a peer reviewer for the Journal of the American College of Surgeons on global surgical topics and as an external expert reviewer for Human Rights Watch.Feroze was born in Houston, TX to Parsi parents who left Pakistan to find a better life. They moved to the UK and then in the United States. Feroze grew up in Flint, MI. After graduating from Johns Hopkins University in 2004 with a bachelor's degree in public health he lived in Haifa, Israel for one year, working with a Palestinian-Jewish cooperative in the city. He then taught middle school in east Baltimore for one year before starting medical school at the University of Texas School of Medicine at San Antonio. During his time in medical school he also obtained a Master of Public Health from the Harvard School of Public Health.After finishing medical school, Feroze joined the general surgery residency program at Boston Medical Center. During his residency he completed a surgical research fellowship at Boston Children's Hospital. During that time Feroze treated victims of the Boston Marathon Bombing. After finishing residency in 2018 he began his one-year trauma/surgical critical care fellowship at Cooper University Healthcare in Camden, NJ. After completing his fellowship, he moved to California where he now practices as a trauma surgeon at a county hospital and as a general surgeon in the Veterans Affairs Northern California Health Care System.Dr. Sidhwa critiques the United States' role in the Israeli-Palestinian conflict through a unique lens. He is a secular American with no ethnic or religious ties to the Middle East. He has a broad knowledge of Israeli and American academic work on the conflict, and closely follows the technical humanitarian, human rights, medical, political, economic, and environmental research done on the topic by Israeli, Palestinian, and international agencies. His public health degrees afford him a broad understanding of how these different areas affect the people of the region. He has no interest in any particular political solution to the conflict. And, most importantly to him, he has seen the conflict in person, seen what it is doing to Palestinians and to Israelis, and has treated its victims with his own hands.

This week we're traveling to the 1972 Olympics with September 5! Join us as we learn about journalists like Peter Jennings and Geoffrey Mason, satellite TV, and more! NOTE: Due to a technical issue, there are some sound quality problems on Jamie's audio. We promise these issues will be fixed on our next episode. Sources: Travis Vogan, ABC News Sports: The Rise and Fall of Network Sports Television. University of California Press, 2018 Peter Jennings Interview With Larry King, 2002. Transcript available at https://transcripts.cnn.com/show/lkl/date/2002-04-10/segment/00 Charles Glass, Peter Jennings Obituary, 2005. The Independent. https://www.independent.co.uk/news/obituaries/peter-jennings-304600.html Bob Granath, "Telstar Opened Era of Global Satellite Television," https://www.nasa.gov/history/telstar-opened-era-of-global-satellite-television/  Garry Whannel, "Television and the Transformation of Sport," The Annals of the American Academy of Political and Social Sciences 625 (2009): 205-18. https://www.jstor.org/stable/40375916  Eva Maria Gajek, "More than Munich 1972. Media, Emotions, and the Body in TV Broadcast of the 20th Summer Olympics," Historical Social Research, 43, no.2 (2018): 181-202. https://www.jstor.org/stable/26454286  David Wharton, "Eye on the Storm: Events in Munich forever changed Games, and how TV presents them," Los Angeles Times 26 August 2002: D1, D10.  Les Carpenter, "Telling it like it was in 'September 5' meant sidelining Howard Cosell," The Washington Post 14 January 2025.  CBS Sunday Morning, "Reporting the tragedy of the 1972 Munich Olympics," https://youtu.be/emhJrz4eYlc?si=r051-xBlOhbzVASh  "Why the media played a fatal role in the 1972 Munich Olympics | DW History and Culture" https://youtu.be/GwFG0d_wzds?si=W5G5-DKTKWKYEarR  https://books.google.com/books?id=5VYEAAAAMBAJ&printsec=frontcover&dq=LIFE+magazine+olympics+1972&hl=en&sa=X&ved=2ahUKEwidm9q5lPOMAxUuhIkEHQX6NmkQ6AF6BAgHEAM Sports Video Group, "Geoffrey Mason, Sean McManus on ABC Sports Remaining in Control of the Munich Massacre Coverage," https://youtu.be/cnElwryDcA0?si=mPczShOAirk_QKFn  Wikipedia: https://en.wikipedia.org/wiki/September_5_(film) Carolyn Giardina, "How the September 5 Filmmakers Created an Authentic Experience," Variety: https://variety.com/2024/artisans/artists/september-5-authentic-experience-cinematography-production-design-1236204356/ Jake Kanter, "‘September 5' Director Tim Fehlbaum Says Film About 1972 Olympics Massacre Is Not A “Political Statement” On Israel-Gaza — Venice Film Festival," Deadline, available at https://deadline.com/2024/08/september-5-tim-fehlbaum-not-political-statement-israel-gaza-venice-film-festival-1236072543/

BONUS: From Waterfall to Flow—Rethinking Mental Models in Software Delivery With Henrik Mårtensson In this BONUS episode, we explore the origins and persistence of waterfall methodology in software development with management consultant Henrik Mårtensson. Based on an article where he details the history of Waterfall, Henrik explains the historical context of waterfall, challenges the mental models that keep it alive in modern organizations, and offers insights into how systems thinking can transform our approach to software delivery. This conversation is essential for anyone looking to understand why outdated methodologies persist and how to move toward more effective approaches to software development. The True Origins of Waterfall "Waterfall came from the SAGE project, the first large software project in history, where they came up with a methodology based on an economic analysis." Henrik takes us on a fascinating historical journey to uncover the true origins of waterfall methodology. Contrary to popular belief, the waterfall approach wasn't invented by Winston Royce but emerged from the SAGE project in the 1950s. Bennington published the original paper outlining this approach, while it was Bell and Tayer who later named it "waterfall" when referencing Royce's work. Henrik explains how gated process models eventually led to the formalized waterfall methodology and points out that an entire generation of methods existed between waterfall and modern Agile approaches that are often overlooked in the conversation. In this segment we refer to:  The paper titled “Production of Large Computer Programs” by Herbert D. Benington (direct PDF link) Updated and re-published in 1983 in Annals of the History of Computing ( Volume: 5, Issue: 4, Oct.-Dec. 1983) Winston Royce's paper from 1970 that erroneously is given the source of the waterfall term. Direct PDF Link. Bell and Thayer's paper “Software Requirements: Are They Really A Problem?”, that finally “baptized” the waterfall process. Direct PDF link.   Mental Models That Keep Us Stuck "Fredrik Taylor's model of work missed the concept of a system, leading us to equate busyness with productivity." The persistence of waterfall thinking stems from outdated mental models about work and productivity. Henrik highlights how Frederick Taylor's scientific management principles continue to influence software development despite missing the crucial concept of systems thinking. This leads organizations to equate busyness with productivity, as illustrated by Henrik's anecdote about 50 projects assigned to just 70 people. We explore how project management practices often enforce waterfall thinking, and why organizations tend to follow what others do rather than questioning established practices. Henrik emphasizes several critical concepts that are often overlooked: Systems thinking Deming's principles Understanding variation and statistics Psychology of work Epistemology (how we know what we know) In this segment, we refer to:  Frederik Taylor's book “The Principles of Scientific Management” The video explaining why Project Management leads to Coordination Chaos James C. Scott's book, “Seeing Like a State” Queueing theory Little's Law The Estimation Trap "The system architecture was overcomplicated, and the organizational structure followed it, creating a three-minute door unlock that required major architectural changes." Henrik shares a compelling story about a seemingly simple feature—unlocking a door—that was estimated to take three minutes but actually required significant architectural changes due to Conway's Law. This illustrates how organizational structures often mirror system architecture, creating unnecessary complexity that impacts delivery timelines. The anecdote serves as a powerful reminder of how estimation in software development is frequently disconnected from reality when we don't account for systemic constraints and architectural dependencies. In this segment, we refer to Conway's Law, the observation that explicitly called out how system architecture is so often linked to organizational structures. Moving Beyond Waterfall "Understanding queueing theory and Little's Law gives us the tools to rethink flow in software delivery." To move beyond waterfall thinking, Henrik recommends several resources and concepts that can help transform our approach to software development. By understanding queueing theory and Little's Law, teams can better manage workflow and improve delivery predictability. Henrik's article on coordination chaos highlights the importance of addressing organizational complexity, while James C. Scott's book "Seeing Like a State" provides insights into how central planning often fails in complex environments. About Henrik Mårtensson Henrik Mårtensson is a management consultant specializing in strategy, organizational development, and process improvement. He blends Theory of Constraints, Lean, Agile, and Six Sigma to solve complex challenges. A published author and licensed ScrumMaster, Henrik brings sharp systems thinking—and a love of storytelling—to help teams grow and thrive. You can link with Henrik Mårtensson on LinkedIn and connect with Henrik Mårtensson on Twitter.

In our recent episode on global burn surgery with Dr. Barclay Stewart and Dr. Manish Yadav, we discussed several cases at Kirtipur Hospital in Nepal to illustrate the global burden of burns and similarities and differences in treating burns at Harborview Medical Center, a level 1 trauma and ABA verified burn center in Seattle, WA and Kirtipur Hospital (Nepal Cleft and Burn Center) in Kathmandu, Nepal. In this episode Dr. Stewart and Dr. Yadav return for an interview by UW Surgery Resident, Paul Herman, sharing insights on how to get involved in global surgery with an emphasis on sustainable participation. Hosts:  Manish Yadav, Kirtipur Hospital, Nepal Barclay Stewart, UW/Harborview Medical Center Paul Herman, UW/Harborview General Surgery Resident, @paul_herm  Tam Pham, UW/Harborview Medical Center (Editor) Learning Objectives 1.     Approaches to global surgery  a.     Describe historical perspectives on global health and global surgery reviewing biases global surgery inherits from global health due to the history of colonialism, neo-colonialism and systemic inequalities b.     Review a recently published framework and evaluation metrics for sustainable global surgery partnerships (GSPs) as described by Binda et al., in Annals of Surgery in March 2024. c.      Provide examples of this framework from a successful global surgery partnership d.     Define vertical, horizontal and diagonal global surgery approaches e.     Share tips for initial engagement for individuals interested in getting involved in global surgery References 1.     Gosselin, R., Charles, A., Joshipura, M., Mkandawire, N., Mock, C. N. , et. al. 2015. “Surgery and Trauma Care”. In: Disease Control Priorities (third edition): Volume 1, Essential Surgery, edited by H. Debas, P. Donkor, A. Gawande, D. T. Jamison, M. Kruk, C. N. Mock. Washington, DC: World Bank. 2.     Qin R, Alayande B, Okolo I, Khanyola J, Jumbam DT, Koea J, Boatin AA, Lugobe HM, Bump J. Colonisation and its aftermath: reimagining global surgery. BMJ Glob Health. 2024 Jan 4;9(1):e014173. doi: 10.1136/bmjgh-2023-014173. PMID: 38176746; PMCID: PMC10773343. https://pubmed.ncbi.nlm.nih.gov/38176746/ 3.     Binda CJ, Adams J, Livergant R, Lam S, Panchendrabose K, Joharifard S, Haji F, Joos E. Defining a Framework and Evaluation Metrics for Sustainable Global Surgical Partnerships: A Modified Delphi Study. Ann Surg. 2024 Mar 1;279(3):549-553. doi: 10.1097/SLA.0000000000006058. Epub 2023 Aug 4. PMID: 37539584; PMCID: PMC10829902.  https://pubmed.ncbi.nlm.nih.gov/37539584/ 4.     Jedrzejko N, Margolick J, Nguyen JH, Ding M, Kisa P, Ball-Banting E, Hameed M, Joos E. A systematic review of global surgery partnerships and a proposed framework for sustainability. Can J Surg. 2021 Apr 28;64(3):E280-E288. doi: 10.1503/cjs.010719. PMID: 33908733; PMCID: PMC8327986. https://pubmed.ncbi.nlm.nih.gov/33908733/ 5.     Frenk J, Gómez-Dantés O, Knaul FM: The health systems agenda: prospects for the diagonal approach. The handbook of global health policy. 2014 Apr 24; pp. 425–439 6.     Davé DR, Nagarjan N, Canner JK, Kushner AL, Stewart BT; SOSAS4 Research Group. Rethinking burns for low & middle-income countries: Differing patterns of burn epidemiology, care seeking behavior, and outcomes across four countries. Burns. 2018 Aug;44(5):1228-1234. doi: 10.1016/j.burns.2018.01.015. Epub 2018 Feb 21. PMID: 29475744. https://pubmed.ncbi.nlm.nih.gov/29475744/ 7.     Strain, S., Adjei, E., Edelman, D. et al. The current landscape of global international surgical rotations for general surgery residents in the United States: a survey by the Association for Program Directors in Surgery's (APDS) global surgery taskforce. Global Surg Educ 3, 77 (2024). https://doi.org/10.1007/s44186-024-00273-2 8.     Francalancia S, Mehta K, Shrestha R, Phuyal D, Bikash D, Yadav M, Nakarmi K, Rai S, Sharar S, Stewart BT, Fudem G. Consumer focus group testing with stakeholders to generate an enteral resuscitation training flipbook for primary health center and first-level hospital providers in Nepal. Burns. 2024 Jun;50(5):1160-1173. doi: 10.1016/j.burns.2024.02.008. Epub 2024 Feb 15. PMID: 38472005; PMCID: PMC11116054. https://pubmed.ncbi.nlm.nih.gov/38472005/ 9.     Shrestha R, Mehta K, Mesic A, Dahanayake D, Yadav M, Rai S, Nakarmi K, Bista P, Pham T, Stewart BT. Barriers and facilitators to implementing enteral resuscitation for major burn injuries: Reflections from Nepalese care providers. Burns. 2024 Oct 28;51(1):107302. doi: 10.1016/j.burns.2024.107302. Epub ahead of print. PMID: 39577105. https://pubmed.ncbi.nlm.nih.gov/39577105/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

In this episode Gudrun speaks with Nadja Klein and Moussa Kassem Sbeyti who work at the Scientific Computing Center (SCC) at KIT in Karlsruhe. Since August 2024, Nadja has been professor at KIT leading the research group Methods for Big Data (MBD) there. She is an Emmy Noether Research Group Leader, and a member of AcademiaNet, and Die Junge Akademie, among others. In 2025, Nadja was awarded the Committee of Presidents of Statistical Societies (COPSS) Emerging Leader Award (ELA). The COPSS ELA recognizes early career statistical scientists who show evidence of and potential for leadership and who will help shape and strengthen the field. She finished her doctoral studies in Mathematics at the Universität Göttingen before conducting a postdoc at the University of Melbourne as a Feodor-Lynen fellow by the Alexander von Humboldt Foundation. Afterwards she was a Professor for Statistics and Data Science at the Humboldt-Universität zu Berlin before joining KIT. Moussa joined Nadja's lab as an associated member in 2023 and later as a postdoctoral researcher in 2024. He pursued a PhD at the TU Berlin while working as an AI Research Scientist at the Continental AI Lab in Berlin. His research primarily focuses on deep learning, developing uncertainty-based automated labeling methods for 2D object detection in autonomous driving. Prior to this, Moussa earned his M.Sc. in Mechatronics Engineering from the TU Darmstadt in 2021. The research of Nadja and Moussa is at the intersection of statistics and machine learning. In Nadja's MBD Lab the research spans theoretical analysis, method development and real-world applications. One of their key focuses is Bayesian methods, which allow to incorporate prior knowledge, quantify uncertainties, and bring insights to the “black boxes” of machine learning. By fusing the precision and reliability of Bayesian statistics with the adaptability of machine and deep learning, these methods aim to leverage the best of both worlds. The KIT offers a strong research environment, making it an ideal place to continue their work. They bring new expertise that can be leveraged in various applications and on the other hand Helmholtz offers a great platform in that respect to explore new application areas. For example Moussa decided to join the group at KIT as part of the Helmholtz Pilot Program Core-Informatics at KIT (KiKIT), which is an initiative focused on advancing fundamental research in informatics within the Helmholtz Association. Vision models typically depend on large volumes of labeled data, but collecting and labeling this data is both expensive and prone to errors. During his PhD, his research centered on data-efficient learning using uncertainty-based automated labeling techniques. That means estimating and using the uncertainty of models to select the helpful data samples to train the models to label the rest themselves. Now, within KiKIT, his work has evolved to include knowledge-based approaches in multi-task models, eg. detection and depth estimation — with the broader goal of enabling the development and deployment of reliable, accurate vision systems in real-world applications. Statistics and data science are fascinating fields, offering a wide variety of methods and applications that constantly lead to new insights. Within this domain, Bayesian methods are especially compelling, as they enable the quantification of uncertainty and the incorporation of prior knowledge. These capabilities contribute to making machine learning models more data-efficient, interpretable, and robust, which are essential qualities in safety-critical domains such as autonomous driving and personalized medicine. Nadja is also enthusiastic about the interdisciplinarity of the subject — repeatedly changing the focus from mathematics to economics to statistics to computer science. The combination of theoretical fundamentals and practical applications makes statistics an agile and important field of research in data science. From a deep learning perspective, the focus is on making models both more efficient and more reliable when dealing with large-scale data and complex dependencies. One way to do this is by reducing the need for extensive labeled data. They also work on developing self-aware models that can recognize when they're unsure and even reject their own predictions when necessary. Additionally, they explore model pruning techniques to improve computational efficiency, and specialize in Bayesian deep learning, allowing machine learning models to better handle uncertainty and complex dependencies. Beyond the methods themselves, they also contribute by publishing datasets that help push the development of next-generation, state-of-the-art models. The learning methods are applied across different domains such as object detection, depth estimation, semantic segmentation, and trajectory prediction — especially in the context of autonomous driving and agricultural applications. As deep learning technologies continue to evolve, they're also expanding into new application areas such as medical imaging. Unlike traditional deep learning, Bayesian deep learning provides uncertainty estimates alongside predictions, allowing for more principled decision-making and reducing catastrophic failures in safety-critical application. It has had a growing impact in several real-world domains where uncertainty really matters. Bayesian learning incorporates prior knowledge and updates beliefs as new data comes in, rather than relying purely on data-driven optimization. In healthcare, for example, Bayesian models help quantify uncertainty in medical diagnoses, which supports more risk-aware treatment decisions and can ultimately lead to better patient outcomes. In autonomous vehicles, Bayesian models play a key role in improving safety. By recognizing when the system is uncertain, they help capture edge cases more effectively, reduce false positives and negatives in object detection, and navigate complex, dynamic environments — like bad weather or unexpected road conditions — more reliably. In finance, Bayesian deep learning enhances both risk assessment and fraud detection by allowing the system to assess how confident it is in its predictions. That added layer of information supports more informed decision-making and helps reduce costly errors. Across all these areas, the key advantage is the ability to move beyond just accuracy and incorporate trust and reliability into AI systems. Bayesian methods are traditionally more expensive, but modern approximations (e.g., variational inference or last layer inference) make them feasible. Computational costs depend on the problem — sometimes Bayesian models require fewer data points to achieve better performance. The trade-off is between interpretability and computational efficiency, but hardware improvements are helping bridge this gap. Their research on uncertainty-based automated labeling is designed to make models not just safer and more reliable, but also more efficient. By reducing the need for extensive manual labeling, one improves the overall quality of the dataset while cutting down on human effort and potential labeling errors. Importantly, by selecting informative samples, the model learns from better data — which means it can reach higher performance with fewer training examples. This leads to faster training and better generalization without sacrificing accuracy. They also focus on developing lightweight uncertainty estimation techniques that are computationally efficient, so these benefits don't come with heavy resource demands. In short, this approach helps build models that are more robust, more adaptive to new data, and significantly more efficient to train and deploy — which is critical for real-world systems where both accuracy and speed matter. Statisticians and deep learning researchers often use distinct methodologies, vocabulary and frameworks, making communication and collaboration challenging. Unfortunately, there is a lack of Interdisciplinary education: Traditional academic programs rarely integrate both fields. It is necessary to foster joint programs, workshops, and cross-disciplinary training can help bridge this gap. From Moussa's experience coming through an industrial PhD, he has seen how many industry settings tend to prioritize short-term gains — favoring quick wins in deep learning over deeper, more fundamental improvements. To overcome this, we need to build long-term research partnerships between academia and industry — ones that allow for foundational work to evolve alongside practical applications. That kind of collaboration can drive more sustainable, impactful innovation in the long run, something we do at methods for big data. Looking ahead, one of the major directions for deep learning in the next five to ten years is the shift toward trustworthy AI. We're already seeing growing attention on making models more explainable, fair, and robust — especially as AI systems are being deployed in critical areas like healthcare, mobility, and finance. The group also expect to see more hybrid models — combining deep learning with Bayesian methods, physics-based models, or symbolic reasoning. These approaches can help bridge the gap between raw performance and interpretability, and often lead to more data-efficient solutions. Another big trend is the rise of uncertainty-aware AI. As AI moves into more high-risk, real-world applications, it becomes essential that systems understand and communicate their own confidence. This is where uncertainty modeling will play a key role — helping to make AI not just more powerful, but also more safe and reliable. The lecture "Advanced Bayesian Data Analysis" covers fundamental concepts in Bayesian statistics, including parametric and non-parametric regression, computational techniques such as MCMC and variational inference, and Bayesian priors for handling high-dimensional data. Additionally, the lecturers offer a Research Seminar on Selected Topics in Statistical Learning and Data Science. The workgroup offers a variety of Master's thesis topics at the intersection of statistics and deep learning, focusing on Bayesian modeling, uncertainty quantification, and high-dimensional methods. Current topics include predictive information criteria for Bayesian models and uncertainty quantification in deep learning. Topics span theoretical, methodological, computational and applied projects. Students interested in rigorous theoretical and applied research are encouraged to explore our available projects and contact us for further details. The general advice of Nadja and Moussa for everybody interested to enter the field is: "Develop a strong foundation in statistical and mathematical principles, rather than focusing solely on the latest trends. Gain expertise in both theory and practical applications, as real-world impact requires a balance of both. Be open to interdisciplinary collaboration. Some of the most exciting and meaningful innovations happen at the intersection of fields — whether that's statistics and deep learning, or AI and domain-specific areas like medicine or mobility. So don't be afraid to step outside your comfort zone, ask questions across disciplines, and look for ways to connect different perspectives. That's often where real breakthroughs happen. With every new challenge comes an opportunity to innovate, and that's what keeps this work exciting. We're always pushing for more robust, efficient, and trustworthy AI. And we're also growing — so if you're a motivated researcher interested in this space, we'd love to hear from you." Literature and further information Webpage of the group G. Nuti, Lluis A.J. Rugama, A.-I. Cross: Efficient Bayesian Decision Tree Algorithm, arxiv Jan 2019 Wikipedia: Expected value of sample information C. Howson & P. Urbach: Scientific Reasoning: The Bayesian Approach (3rd ed.). Open Court Publishing Company. ISBN 978-0-8126-9578-6, 2005. A.Gelman e.a.: Bayesian Data Analysis Third Edition. Chapman and Hall/CRC. ISBN 978-1-4398-4095-5, 2013. Yu, Angela: Introduction to Bayesian Decision Theory cogsci.ucsd.edu, 2013. Devin Soni: Introduction to Bayesian Networks, 2015. G. Nuti, L. Rugama, A.-I. Cross: Efficient Bayesian Decision Tree Algorithm, arXiv:1901.03214 stat.ML, 2019. M. Carlan, T. Kneib and N. Klein: Bayesian conditional transformation models, Journal of the American Statistical Association, 119(546):1360-1373, 2024. N. Klein: Distributional regression for data analysis , Annual Review of Statistics and Its Application, 11:321-346, 2024 C.Hoffmann and N.Klein: Marginally calibrated response distributions for end-to-end learning in autonomous driving, Annals of Applied Statistics, 17(2):1740-1763, 2023 Kassem Sbeyti, M., Karg, M., Wirth, C., Klein, N., & Albayrak, S. (2024, September). Cost-Sensitive Uncertainty-Based Failure Recognition for Object Detection. In Uncertainty in Artificial Intelligence (pp. 1890-1900). PMLR. M. K. Sbeyti, N. Klein, A. Nowzad, F. Sivrikaya and S. Albayrak: Building Blocks for Robust and Effective Semi-Supervised Real-World Object Detection pdf. To appear in Transactions on Machine Learning Research, 2025 Podcasts Learning, Teaching, and Building in the Age of AI Ep 42 of Vanishing Gradient, Jan 2025. O. Beige, G. Thäter: Risikoentscheidungsprozesse, Gespräch im Modellansatz Podcast, Folge 193, Fakultät für Mathematik, Karlsruher Institut für Technologie (KIT), 2019.

In the April edition of the Annals of Emergency Medicine podcast, Rory and Ryan discuss ketamine for prehospital seizures, firearm injuries in the ED, and the best therapies for headaches.

Use code YDSAMPLE for a free snack pack from Skratch Labs!Support us on Patreon!Is organic food actually healthier—or just more expensive? This week on Your Diet Sucks, Zoë and Kylee break down the real science behind organic food, including what “organic” really means for produce, meat, and packaged snacks. We cover nutrition claims, pesticide exposure, antioxidant levels, and whether organic food impacts inflammation, gut health, or performance. We also dive into the environmental trade-offs of organic farming, the high cost of certification, and why that $19 strawberry feels morally superior. Plus: the truth behind the Dirty Dozen list, who really benefits from organic labels, and how to make food choices that work for your body and your budget.Big thanks to Microcosm Coaching for supporting the pod! We coach humans, not just athletes. Reach out for a free consultation and meet someone who's genuinely on your team.ReferencesBaranski, M., Średnicka-Tober, D., Volakakis, N., Seal, C., Sanderson, R., Stewart, G. B., ... & Leifert, C. (2014). Higher antioxidant and lower cadmium concentrations and lower incidence of pesticide residues in organically grown crops: A systematic literature review and meta-analyses. British Journal of Nutrition, 112(5), 794–811. https://doi.org/10.1017/S0007114514001366Średnicka-Tober, D., Baranski, M., Seal, C., Sanderson, R., Benbrook, C., Steinshamn, H., ... & Leifert, C. (2016). Composition differences between organic and conventional meat: a systematic literature review and meta-analysis. British Journal of Nutrition, 115(6), 994–1011. https://doi.org/10.1017/S0007114515005073Seufert, V., Ramankutty, N., & Foley, J. A. (2012). Comparing the yields of organic and conventional agriculture. Nature, 485(7397), 229–232. https://doi.org/10.1038/nature11069Smith-Spangler, C., Brandeau, M. L., Hunter, G. E., Bavinger, J. C., Pearson, M., Eschbach, P. J., ... & Bravata, D. M. (2012). Are organic foods safer or healthier than conventional alternatives? A systematic review. Annals of Internal Medicine, 157(5), 348–366. https://doi.org/10.7326/0003-4819-157-5-201209040-00007Tuomisto, H. L., Hodge, I. D., Riordan, P., & Macdonald, D. W. (2012). Does organic farming reduce environmental impacts? – A meta-analysis of European research. Journal of Environmental Management, 112, 309–320. https://doi.org/10.1016/j.jenvman.2012.08.018Clark, M., & Tilman, D. (2017). Comparative analysis of environmental impacts of agricultural production systems, agricultural input efficiency, and food choice. Environmental Research Letters, 12(6), 064016. https://doi.org/10.1088/1748-9326/aa6cd5Kniss, A. R., Savage, S. D., & Jabbour, R. (2016). Commercial crop yields reveal strengths and weaknesses for organic agriculture in the United States. PLoS ONE, 11(8), e0161673. https://doi.org/10.1371/journal.pone.0161673

Music can affect emotions, spark memories, and influence mood. In cases of musicogenic epilepsy, music can trigger seizures. In other cases, music may reduce seizure frequency. Dr. Cecilie Nome talks with Dr. Phillip Pearl and Prof. Nigel Osborne about the power of music and its effects on the brain.Links:Nigel Osborne - WikipediaPersonalised music as a treatment for epilepsy - Epilepsy & BehaviorNeuroscience and “real world” practice: music as a therapeutic resource for children in zones of conflict - Osborne - 2012 - Annals of the New York Academy of Sciences - Wiley Online LibraryX-System Overview  Sharp Waves episodes are meant for informational purposes only, and not as clinical or medical advice.Let us know how we're doing: podcast@ilae.org.The International League Against Epilepsy is the world's preeminent association of health professionals and scientists, working toward a world where no person's life is limited by epilepsy. Visit us on Facebook, Instagram, and LinkedIn.

The Filtered Fragments (OG Filtrate)Joel TopfJennie LinSwapnil HiremathSpecial Guest Brad Rovin GN God and second author from The Ohio StateKoyal Jain GN Specialist from UNCAlfred Kim Rheumatologist from Washington UniversityEditing bySimon Topf and Nayan AroraThe Kidney Connection written and performed by by Tim YauShow NotesJoel's monologue One of the most surprising facts of nephrology is that despite conventional wisdom that lupus nephritis is an antibody mediated disease, that over a decade ago, the LUNAR investigtors were unable to find a significant benefit when rituximab was added to conventional therapy. And this was after the equally negative phase 2 trial of rituximab, EXPLORER.In fact, despite this finding rituximab has been able to burough its way into treatment of many nephrologists and rheumatologists as well as the KDIGO guidelines where it is suggested for patients with persistent disease activity or inadequate response to initial standard-of-care therapy.This long conflict is now coming to an end. Obinutuzumab, a newer, better monoclonal antibody targeting the same CD20 that we grew to love with rituximab, but it has a number of advantages.One. It is humanized antibody rather than a chimeric mouse-human antibodyTwo. It's cytotoxicity is not complement dependent an particular advantage if you want to deploy it ina disease where hypocomplementemia is a disease characteristicThree, and most importantly, it causes stronger and deeper b-cell depletion than rituximab. Better B-cell depletion in the blood and tissue.And this brings us to tonight's topic, we had already seen the phase two results of obinutuzumab which, unlike EXPLORER, were positive, we will look at the phase three regency trial. This makes the third novel lupus nephritis drug in the last 4 years. We continue to remake glomerular nephritis.LUNAR: Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: the Lupus Nephritis Assessment with Rituximab study PubmedEXPLORER: Efficacy and safety of rituximab in moderately-to-severely active systemic lupus erythematosus: the randomized, double-blind, phase II/III systemic lupus erythematosus evaluation of rituximab trial PubmedREGENCY: Efficacy and Safety of Obinutuzumab in Active Lupus Nephritis NEJM | NephJCNOBILITY: B-cell depletion with obinutuzumab for the treatment of proliferative lupus nephritis: a randomised, double-blind, placebo-controlled trial Annals of Rheumatic DiseaseComparison of intravenous and subcutaneous exposure supporting dose selection of subcutaneous belimumab systemic lupus erythematosus Phase 3 program PubMed CentralClass 5 lupus nephritis is slow to respond Long-term Use of Voclosporin in Patients with Class V Lupus Nephritis: Results from the AURORA 2 Continuation Study ACR Meeting abstractTubular SecretionsSwap: Young Adult novel I Must Betray You by Ruta Sepetys (Amazon)Koyal: Taekwondo (Wikipedia)Jennie: these unprecedented times Trump NYT: Administration Freezes $1 Billion for Cornell and $790 Million for Northwestern, Officials SayAl: Acquired PodcastBrad: The Feather Thief by Kirk Wallace Johnson (Amazon)Joel: Paradise on Hulu (Wikipedia)

The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Adverse Outcomes Associated With Inhaled Corticosteroid Use in Individuals With Chronic Obstructive Pulmonary Disease. Annals of Family Medicine 2025. Discussion by:Guest:Barbara Yawn, MD, MSc, MPHAdjunct Professor, Department of Family and Community HealthUniversity of Minnesota Former Chief Scientific Officer at the COPD Foundation2. Optimal dietary patterns for healthy aging. Nature Medicine. Discussion by:Guest:Jessica Stieritz, MD Resident– Family Medicine Residency Program Jefferson Health – Abington3. Amount and intensity of daily total physical activity, step count and risk of incident cancer. British Journal of Sports Medicine. Discussion by:Guest:William Callahan, D.O. Associate Director – Family Medicine Residency ProgramJefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.

In this episode, my guest is Dr. Vaibhav Diwadkar, professor of Psychiatry and Behavioral Neurosciences at Wayne State University School of Medicine. We discuss the powers and limits of the human brain, the tentative yet evolving role of neuroscience, and the science of thermoregulation in both animals and humans.Our conversation explores the concept of hormesis-enhanced interoceptive refocusing—how combining stressors like cold exposure and breathwork with parasympathetic practices such as meditation or introspection can influence brain function, mood, and perception.We also discuss mental health disorders, drugs, pharmaceuticals, animal research, technology, exercise, the abundance of information and food, and the dynamic relationship between the mind, body, and environment. Connect and Learn MoreProfessor Profile: psychiatry.med.wayne.edu/profile/ax3112LinkedIn:  linkedin.com/in/vaibhav-diwadkar-7ba3107 RESOURCESPAPERS“Brain over body”–A study on the willful regulation of autonomic function during cold exposure , NeuroImage (March 2018)Human regulatory systems in the age of abundance: A predictive processing perspective, Annals of the New York Academy of Sciences (February 2025)The impact of a focused behavioral intervention on brain cannabinoid signaling and interoceptive function: Implications for mood and anxiety, Brain Behavior and Immunity Integrative (January 2024)PEOPLEAndrew HubermanEmerson PughFranz GallMartin Heidegger Otto MusikWim Hof

Episode 189: Intermittent Fasting (Religious and Sports)Future Doctors Carlisle and Kim give recommendations about patients who are fasting for religious reasons, such as Ramadan. They also explain the benefits and risks of fasting for athletes and also debunked some myths about fasting. Dr. Arreaza add input about the side effects of fasting and ways to address them.    Written by Cameron Carlisle, MSIV (RUSM) and Kyung Kim, MSIV (AUC). Editing by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction: In the last episode on fasting (#179), we explored how intermittent fasting (IF) can help manage type 2 diabetes by improving insulin sensitivity, promoting weight loss, and lowering inflammation. We discussed the benefits of methods like 16:8 time-restricted eating and the 5:2 meal plan, and even compared IF to medications like metformin. Today, we're bringing that science into real life. We'll talk about how people fast for religious reasons, like during Ramadan, how athletes use IF to stay in shape, and how we can use IF as a tool in family medicine to support community health and A1c control.Intermittent Fasting in Religious PracticeRamadan just ended on 3/30/25, but this is a great time to talk about the broader role of fasting in religion and health. Many faiths incorporate fasting into spiritual practice and understanding this can help us better support our patients.Islam (Ramadan): Ramadan is a month where Muslims fast from dawn to sunset, focusing on spiritual reflection and self-control. No food or drink is consumed during daylight hours. Despite this, studies have shown that with good planning, fasting during Ramadan does not significantly impair physical performance or metabolic health.Key health tips for patients observing Ramadan:Hydrate well between iftar (sunset) and suhoor (pre-dawn).Break the fast with dates and water to gently replenish energy and electrolytes.Eat balanced meals with complex carbs, protein, and healthy fatsAvoid greasy, heavy foods right after fastingLight exercise (such as a walk) after iftar is beneficialReview medications with a healthcare provider, especially for those on insulin or sulfonylureas.For example: Metformin should be taken when you break your fast and then again before dawn. If its an extended-release metformin, take it at night. Metformin does not cause significant hypoglycemia and can be continued during Ramadan. Basal insulin is advised to be given at Iftar, and the dose should be reduced by 25-35% if the patient is not well managed. And regarding the fast-acting insulin, it requires a little more reading, so you can look it up and learn about it. Judaism: In Judaism, fasting is practiced on days like Yom Kippur and Tisha B'Av, typically lasting 25 hours without food or water. These fasts are spiritual and reflective, and patients with medical conditions may seek guidance on how to participate safely.Christianity: Many Christians fast during Lent, either by abstaining from certain foods or limiting meal frequency. Some practice partial-day fasts or water-only fasts for spiritual renewal.A branch of Christianity known as The Church of Jesus Christ of Latter-day Saintsoften observe a 24-hour fast on the first Sunday of each month, known as Fast Sunday, where they abstain from food and drink and donate the cost of meals to charity. This practice is both spiritual and communal.Cameron: Fasting for religious reasons, when done safely, can align with IF protocols and be culturally sensitive for diverse patients in family medicine.IF in Athletes and PerformanceIntermittent fasting is gaining popularity in the sports world. Athletes are using IF to improve body composition, increase fat oxidation, and enhance metabolic flexibility. A recent study, known as the DRIFT trial and published in Annals of Internal Medicine, found that fasting three non-consecutive days a week led to more weight loss than daily calorie restriction. Participants lost an average of 6.37 pounds more over 12 months.Why? Better adherence. People found the 3-day fasting schedule easier to stick to than counting calories every day.Benefits of IF for athletes:Encourages fat burning (via AMPK activation and GLUT4 upregulation, listen to ep. 179).Helps maintain lean muscle while reducing fat.No major drop in performance when meals and workouts are timed properly.What are some practical tips?Schedule workouts during or just before eating windows.Eat protein-rich meals post-workout.Avoid intense training during long fasts unless adapted.Stay hydrated, especially in hot environments or endurance sports.Broader Applications and Myths Around IFHormonal Effects of IF: In addition to improving insulin sensitivity, IF also affects hormones such as ghrelin (which stimulates hunger, remember it as growling) and leptin (which signals fullness). Over time, IF may help the body regulate appetite better and reduce cravings. IF can also decrease morning cortisol levels, the stress hormone. That's why it's important to monitor sleep, hydration, and stress levels when recommending IF.Circadian Rhythm Alignment: Emerging research shows that aligning eating times with natural light/dark cycles—eating during the day and fasting at night—can improve metabolic outcomes. This practice, known as early time-restricted eating (eTRE), has been shown to lower blood glucose, reduce insulin levels, and improve energy use. Patients who eat earlier in the day tend to have better results than those who eat late at night.Myths and Clarifications on IF:-“Fasting slows metabolism” In fact, short-term fasting may boost metabolism slightly due to increased norepinephrine. -“You can't exercise while fasting.” Many people can safely train during fasted states, especially for moderate cardio or strength training. -“Skipping breakfast is bad.” For some, skipping breakfast is a useful IF strategy—as long as total nutrition is maintained. You can break your fast at 2:00 pm, it does have to be at 7:00 AM.What to Eat When Breaking a FastBreaking a fast properly is just as important as fasting itself. Whether it's after a Ramadan fast or a 16-hour fast, the goal is to replenish energy gently and restore nutrients.Ideal foods to break a fast:Dates and water: provide quick energy, potassium, and fiberSoups: lentil or broth-based soups are gentle on digestionComplex carbs: whole grains like brown rice or oatsLean proteins: chicken, fish, eggs, legumesFruits and vegetables: hydrate and provide fiberHealthy fats: nuts, avocado, olive oilProbiotics: yogurt or kefir for gut supportBalanced meals with carbs, protein, and healthy fats help the body transition smoothly back to a fed state.Using IF in Family Medicine and Community HealthIntermittent fasting can be a practical, cost-effective strategy in family medicine. In areas with high rates of obesity and diabetes, like Kern County, IF offers a lifestyle-based tool to improve metabolic health, especially in underserved populations. IF is free!How IF can help in family medicine:Lower A1c levels: improves insulin sensitivity and glucose controlPromote weight loss: decreases insulin resistance and inflammationReduce medication dependence: fewer meds needed over time for some patientsEncourage patient engagement: flexible and easier to follow than strict calorie countingFit diverse lifestyles: aligns with religious and cultural practicesAddress food insecurity: structured eating windows can help patients stretch limited food resourcesHow to apply IF in clinic:Start the conversation by asking if the patient has heard of IFRecommend simple starting points: 12:12 or 14:10Emphasize hydration and nutrient-dense mealsMonitor labs and symptoms, especially in diabetic patientsAdjust medications to avoid hypoglycemiaProvide follow-up and patient education handouts if possibleWhat if a patient isn't ready to try fasting?For those not ready to commit to intermittent fasting, one effective alternative is walking after meals. A simple 10–20 minute walk post-meal can help stimulate GLUT4 receptors in skeletal muscle, promoting glucose uptake independent of insulin. This reduces the demand on pancreatic beta cells and may help improve blood sugar control over time. This strategy is particularly useful for patients with insulin resistance or early-stage type 2 diabetes.Conclusion: Intermittent fasting is not one-size-fits-all, but it can be a powerful tool for both individual and community health. From Ramadan to race day, IF has a place in family medicine when used thoughtfully. Encourage patients to work with their healthcare providers to find an approach that fits their lifestyle, medical needs, and personal values. IF is a cost-effective toolEven without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:American Academy of Family Physicians. (2022). "Intermittent Fasting: A Promising Treatment for Diabetes." AAFP Community Blog. https://www.aafp.org/pubs/afp/afp-community-blog/entry/intermittent-fasting-a-promising-treatment-for-diabetes.htmlHealthline. (2023). "What Breaks a Fast? Foods, Drinks, and Supplements." https://www.healthline.com/nutrition/what-breaks-a-fast.Sarri KO, Tzanakis NE, Linardakis MK, Mamalakis GD, Kafatos AG. Effects of Greek Orthodox Christian Church fasting on serum lipids and obesity. BMC Public Health. 2003 May 16;3:16. doi: 10.1186/1471-2458-3-16. PMID: 12753698; PMCID: PMC156653. https://pmc.ncbi.nlm.nih.gov/articles/PMC156653/.Shang, Y., et al. (2024). "Effects of Intermittent Fasting on Obesity-Related Health Outcomes: An Umbrella Review." eClinicalMedicine.https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00098-1.Abaïdia AE, Daab W, Bouzid MA. Effects of Ramadan Fasting on Physical Performance: A Systematic Review with Meta-analysis. Sports Med. 2020 May;50(5):1009-1026. doi: 10.1007/s40279-020-01257-0. PMID: 31960369. https://pubmed.ncbi.nlm.nih.gov/31960369/.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

Measles: It's Back, It's Contagious, and You Probably Haven't Seen It Before In this episode, Kevin and Dr. Lisa Wolf dig into the return of a disease we thought had been eradicated in 2000. In case you missed it—we're in the middle of a national measles outbreak, and chances are high you've never actually seen a real case. Measles is back, and we need to be on high alert, as it remains one of the most contagious diseases in the world. What happens when a patient with a suspicious rash sits in your waiting room for hours? How long does measles hang in the air? (Spoiler: it's longer than you think.) From triage missteps to public health policies, this episode walks through how to identify, isolate, and respond to highly contagious diseases—especially when you've never seen them in real life. We also bust the autism myth (again), talk about vaccine hesitancy, and explore what your ED should be doing to prepare right now. Measles Resources Centers for Disease Control and Prevention. (2023, September 6). Measles signs and symptoms. U.S. Department of Health & Human Services. https://www.cdc.gov/measles/signs-symptoms/index.html Centers for Disease Control and Prevention. (2023, September 6). Photos of measles. U.S. Department of Health & Human Services. https://www.cdc.gov/measles/signs-symptoms/photos.html Child Vaccination Schedule https://www.cdc.gov/vaccines/hcp/imz-schedules/child-adolescent-age.html Vaccinations and Autism Eggertson, L. (2010). Lancet retracts 12-year-old article linking autism to MMR vaccines. CMAJ: Canadian Medical Association Journal, 182(4), E199–E200. https://doi.org/10.1503/cmaj.109-3179 Hviid, A., Hansen, J. V., Frisch, M., & Melbye, M. (2019). Measles, mumps, rubella vaccination and autism: A nationwide cohort study. Annals of Internal Medicine, 170(8), 513–520. https://doi.org/10.7326/M18-2101 Tanne, J. H. (2002). MMR vaccine is not linked with autism, says Danish study. BMJ: British Medical Journal, 325(7373), 1134. Immune Memory Loss & Measles Cohen, J. (2019, May 1). How measles causes the body to ‘forget' past infections by other microbes. Science. https://www.science.org/content/article/how-measles-causes-body-forget-past-infections-other-microbes

In this evidence-packed episode, Dr. Scott Watier and Tommy Welling analyze a brand-new clinical trial comparing 4:3 intermittent fasting versus daily caloric restriction over 12 months. The hosts break down the surprising finding that intermittent fasting participants lost significantly more weight (17 pounds vs 11 pounds) while experiencing a dramatic improvement in their relationship with food, shown by a remarkable two-point reduction in binge eating scores compared to almost no change in the calorie restriction group. They explain why fasting showed better long-term adherence (only 19% dropout rate versus 30% in the calorie counting group) despite both approaches creating the same weekly calorie deficit. The episode highlights how the fasting group was nearly 2.5 times more likely to achieve clinically significant 10% weight loss, and offers practical guidance for adapting this research-backed approach to your own fasting schedule. The hosts also discuss how results might be even better with increased protein intake and resistance training—two factors absent from the original study. Take the NEW FASTING PERSONA QUIZ! - The Key to Unlocking Sustainable Weight Loss With Fasting! Resources and Downloads: SIGN UP FOR THE DROP OF THE ULTIMATE GUIDE TO BLOOD SUGAR CONTROL GRAB THE OPTIMAL RANGES FOR LAB WORK HERE! - NEW RESOURCE! - December 2024 FREE RESOURCE - DOWNLOAD THE NEW BLUEPRINT TO FASTING FOR FAT LOSS! SLEEP GUIDE DIRECT DOWNLOAD DOWNLOAD THE FASTING TRANSFORMATION JOURNAL HERE! Partner Links: Get your FREE BOX OF LMNT hydration support for the perfect electrolyte balance for your fasting lifestyle with your first purchase here! Get 30% off a Keto-Mojo blood glucose and ketone monitor (discount shown at checkout)! Click here! Our Community: Let's continue the conversation. Click the link below to JOIN the Fasting For Life Community, a group of like-minded, new, and experienced fasters! The first two rules of fasting need not apply! If you enjoy the podcast, please tap the stars below and consider leaving a short review on Apple Podcasts/iTunes. It takes less than 60 seconds, and it helps bring you the best original content each week. We also enjoy reading them! Article Links: https://www.acpjournals.org/doi/10.7326/ANNALS-24-01631

Agrologist Cory Davis joins me to unpack the environmental toll of animal agriculture—and the enormous potential of plant-based food systems to reduce emissions, reclaim land, and restore ecosystems. Cory brings a systems-level perspective that blends science, ethics, and practical solutions. He also does some serious myth-busting about “sustainable” local meat and “regenerative grazing”. Whether you're a climate advocate or curious about food's environmental impact, this episode will challenge what you thought you knew about sustainable eating. Cory is a licensed professional agrologist with over 10 years of experience in natural resource and environmental management. He is a co-author of “Plant-Powered Protein: Nutrition Essentials and Dietary Guidelines for All Ages” along with Vesanto Melina and Brenda Davis, where he breaks down the environmental impacts of different protein choices. He also recently coauthored a paper in the Annals of Medicine titled "Health Disparities and Climate Change in the Marshall Islands".

Wie viel Muskulatur kannst Du wirklich aufbauen – ohne Deine Gesundheit zu verzocken? Und woran erkennst Du, wie weit Du Dein genetisches Fitness-Potenzial schon ausgereizt hast?Lass uns gemeinsam ein paar gängige Mythen rund ums genetische Muskelaufbaupotenzial entzaubern. Du erfährst, wie stark Du realistischerweise (und ohne Doping) werden kannst, was BMI und FFMI in dem Kontext wirklich aussagen und wie Du Deine Trainingserfolge besser einordnen kannst – basierend auf Wissenschaft, Erfahrung und einer Grafik, die es auf den Punkt bringt.In dieser Folge erfährst Du:Was das genetische Limit im Muskelaufbau tatsächlich bedeutetWie Du den FFMI nutzt, um Deinen Fortschritt greifbar zu machenWarum Social Media oft ein verzerrtes Bild liefertUnd wie eine simple Grafik Dir dabei hilft, smarter zu trainieren – statt härterViel Spaß beim Hören!____________*WERBUNG: Infos zum Werbepartner dieser Folge und allen weiteren Werbepartnern findest Du hier.____________Ressourcen zur Folge:Vollständiger Artikel mit der erwähnten Grafik zur FolgeAlles über Muskelfasertypen (Folge 265)kostenloser FFMI RechnerFitnessstudio: ScoopWeitere Quellen:Kouri, E. M., Pope, H. G., Katz, D. L., & Oliva, P. (1995). Fat-free mass index in users and nonusers of anabolic-androgenic steroids. Clinical Journal of Sport Medicine, 5(4), 223–228. https://doi.org/10.1097/00042752-199510000-00005Sagoe, D., Molde, H., Andreassen, C. S., Torsheim, T., & Pallesen, S. (2014). The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis. Annals of Epidemiology, 24(5), 383–398. https://doi.org/10.1016/j.annepidem.2014.01.009Hubal, M. J., Gordish-Dressman, H., Thompson, P. D., et al. (2005). Variability in muscle size and strength gain after unilateral resistance training. Medicine & Science in Sports & Exercise, 37(6), 964–972. https://doi.org/10.1249/01.mss.0000170469.90461.5fSchoenfeld, B. J., Grgic, J., Ogborn, D., & Krieger, J. W. (2017). Strength and hypertrophy adaptations between low- vs. high-load resistance training: a meta-analysis. Journal of Strength and Conditioning Research, 31(12), 3508–3523. https://doi.org/10.1519/JSC.0000000000002200Grgic, J., Schoenfeld, B. J., Orazem, J., & Sabol, F. (2018). Effects of resistance training frequency on measures of muscle hypertrophy: a systematic review and meta-analysis. Sports Medicine, 48(5), 1207–1220. https://doi.org/10.1007/s40279-018-0872-x Hosted on Acast. See acast.com/privacy for more information.

America Out Loud PULSE with Dr. Vaughn & Dr. Tankersley – Dr. Peter Marks, longtime FDA vaccine chief, is out—sparking scrutiny over his role in pushing COVID shots despite safety concerns. Billionaire doctor Patrick Soon-Shiong joins critics, calling for a return to honest medicine. From vaccine mandates to ignored cancer breakthroughs, this exposé reveals the deep flaws and corruption driving today's medical-industrial complex. Truth must come first.

America Out Loud PULSE with Dr. Vaughn & Dr. Tankersley – Dr. Peter Marks, longtime FDA vaccine chief, is out—sparking scrutiny over his role in pushing COVID shots despite safety concerns. Billionaire doctor Patrick Soon-Shiong joins critics, calling for a return to honest medicine. From vaccine mandates to ignored cancer breakthroughs, this exposé reveals the deep flaws and corruption driving today's medical-industrial complex. Truth must come first.

Ingrid Froeher apresenta um caso de dor lombar e púrpura para Joanne Alves e Caio Bastos.Referências: Knezevic, Nebojsa Nick et al. “Low back pain.” Lancet (London, England) vol. 398,10294 (2021): 78-92. doi:10.1016/S0140-6736(21)00733-9Antonov, Dimitar et al. “The rash that becomes purpuric, petechial, hemorrhagic, or ecchymotic.” Clinics in dermatology vol. 38,1 (2020): 3-18. doi:10.1016/j.clindermatol.2019.07.036Jarvik, Jeffrey G, and Richard A Deyo. “Diagnostic evaluation of low back pain with emphasis on imaging.” Annals of internal medicine vol. 137,7 (2002): 586-97. doi:10.7326/0003-4819-137-7-200210010-00010Downie, Aron, et al. "Red flags to screen for malignancy and fracture in patients with low back pain: systematic review." Bmj 347 (2013).https://doh.wa.gov/sites/default/files/legacy/Documents/2700/Coag.pdf?uid=62fc9e6dde835Bannow, Bethany Samuelson, and Barbara A Konkle. “How I approach bleeding in hospitalized patients.” Blood vol. 142,9 (2023): 761-768. doi:10.1182/blood.2021014766Novotny, Richard W et al. “Palpable Purpura.” American family physician vol. 109,3 (2024): 265-267.https://www.tadeclinicagem.com.br/guia/321/amiloidose-manifestacoes-clinicas-e-diagnostico/

In today's episode, Dr. Mitchell Posner, Dr. Sarah Shubeck, and Dr. Jelani Williams on the University of Chicago Medicine's new Comprehensive Cancer Center. Scheduled to open in 2027, the new center is a seven-floor, 575,000-square-foot building planned to have 80 private beds and 90 consultation and outpatient rooms. At the moment, the center is anticipated to see 200,000 outpatient visits and 5000 inpatient admissions annually. This would be the city of Chicago's first freestanding cancer pavilion.How will we ensure that this new center prioritizes the community's needs? In Chicago's South Side, cancer death rates are twice the national average, and cancer is also the second-leading cause of death on the South Side behind heart disease. In this conversation, you'll hear about the center's development, what patients can expect, and most importantly, the Department of Surgery's commitment to ensure the cancer center supports those who are most vulnerable. Dr. Mitchell Posner is the Thomas D. Jones Distinguished Service Professor of Surgery, Chief of the Section of General Surgery, and the Chief Clinical Officer of the University of Chicago Medicine Comprehensive Cancer Center. From clinical trials for cancer treatment to his more than 250 articles, abstracts, and book chapters, Dr. Posner is a leading authority in the management of upper gastrointestinal cancers. He is frequently voted among the country's best doctors. He is the past president of the Society of Surgical Oncology. He is deputy editor of the Annals of Surgical Oncology and section editor for the gastrointestinal cancer section of the journal Cancer. He served as chairman of the Gastrointestinal Committee of the American College of Surgeons Oncology Group (ACOSOG).Dr. Sarah Shubeck is an Assistant Professor in the Department of General Surgery. She is a Breast Surgical oncologist specializing in breast surgery, cancer, and benign disease treatment. In addition to her clinical practice, Dr. Shubeck's research has been published in many journals including Cancer, JAMA Surgery, and Annals of Surgical Oncology.Dr. Jelani Williams is a 5th-year general surgery resident at the University of Chicago. He is an aspiring surgical oncologist and attended the Eastern Virginia Medical School. He has published research on predictive models and surgery for metastatic pancreatic neuroendocrine tumors as well as the use of machine learning to distinguish benign and malignant thyroid nodules amongst other topics. Deep Cuts: Exploring Equity in Surgery comes to you from the Department of Surgery at the University of Chicago, which is located on Ojibwe, Odawa and Potawatomi land.Our executive producer is Tony Liu. Our senior producers are Alia Abiad, Caroline Montag, and Chuka Onuh. Our production team includes Megan Teramoto, Ria Sood, Ishaan Kumar, and Daniel Correa Bucio. Our senior editor and production coordinator is Nihar Rama. Our editorial team also includes Beryl Zhou and Julianna Kenny-Serrano. The intro song you hear at the beginning of our show is “Love, Money Part 2” from Chicago's own Sen Morimoto off of Sooper Records. Our cover art is from Leia Chen.A special thanks this week to Dr. Jeffrey Matthews — for his leadership, vision, and commitment to caring for the most vulnerable in our communities. Let us know — what have you most enjoyed about our podcast. Where do you see room for improvement? You can reach out to us on Instagram @deepcutssurgery. Find out more about our work at deepcuts.surgery.uchicago.edu.

In the March issue of the Annals of Emergency Medicine podcast, Rory and Ryan discuss cephalosporins for outpatient pyelonephritis, ED-initiated buprenorphine programs, cervical cancer screening in the ED and much more.

For this special episode of the Astonishing Healthcare podcast, Andrew Barnell, CEO of Geneoscopy, joins Justin Venneri in the studio for an insightful discussion about colorectal cancer (CRC) screening in observance of National CRC Awareness Month! Andrew explains how he and his "very talented" sister, Erica Barnell, MD, PhD, co-founded Geneoscopy to develop diagnostic tests using RNA biomarkers extracted from stool samples. Their newly FDA-approved test, ColoSense™, provides a non-invasive alternative to traditional colonoscopies.Barnell highlights the rising incidence of CRC in younger adults, which prompted guideline changes to lower the recommended screening age to 45. He stresses the urgent need for increased screening awareness and greater access to screening tools, noting that employers can help overcome barriers to screening through education and by encouraging engagement in wellness programs. Other topics covered include:Over 135,000 people are diagnosed with CRC every year, and despite CRC being one of the most preventable cancers with good long-term survival rates following treatment, 50,000 people die from it annually. Preventive screenings are increasingly covered with no patient out-of-pocket costs, but insurers' expenses are rising.Increasing early screening is crucial: 30-40% of eligible individuals remain unscreened, particularly in the 45-49 age group.Geneoscopy's decentralized clinical trial and overall use of technology to conduct its pivotal FDA approval study virtually, which increased patient diversity and efficiency.Regulatory challenges remain: FDA approval is just one step; Medicare coverage and guideline inclusion are key hurdles.Bringing targeted therapy approaches to autoimmune diseases like IBD to improve patient outcomes and reduce costs is Geneoscopy's next goal.Related ContentMultitarget Stool RNA Test for Colorectal Cancer Screening. Barnell EK, Wurtzler EM, La Rocca J, et al. JAMA. 2023;330(18):1760–1768. doi:10.1001/jama.2023.22231Pharmacogenomics (PGx) 101: What You Need to Know for Rx ProgramsReference Materials/Other Links (courtesy of Geneoscopy)Projected Impact and Cost-Effectiveness of Novel Molecular Blood-Based or Stool-Based Screening Tests for Colorectal Cancer. Ladabaum U, Mannalithara A, Schoen RE, Dominitz JA, Lieberman D. Ann Intern Med. 2024 Dec;177(12):1610-1620. doi: 10.7326/ANNALS-24-00910. Epub 2024 Oct 29. PMID: 39467291.Colorectal Cancer—Patient Version. National Cancer Institute (NCI)Productivity savings from colorectal cancer prevention and control strategies. Bradley CJ, Lansdorp-Vogelaar I, Yabroff KR, Dahman B, Mariotto A, Feuer EJ, Brown ML. Am J Prev Med. 2011 Aug;41(2):e5-e14. doi: 10.1016/j.amepre.2011.04.008. PMID: 21767717; PMCID: PMC3139918.Follow Geneoscopy on LinkedInFor more information about Capital Rx and this episode, please visit Capital Rx Insights.

In this episode of The Disrupting Dentistry Podcast, Melissa (USA) and Tabitha (Australia) dive into communication's critical role in improving patient outcomes. From explaining the oral-systemic connection to collaborating with medical professionals, they share actionable strategies to enhance patient engagement and drive whole-body health. You'll learn how patient-centered communication, visual aids, and interdisciplinary collaboration can transform your practice and reduce systemic inflammation. Tune in for practical tips backed by science! What You'll Learn in This Episode: Why effective communication is essential for improving patient compliance and health outcomes Patient-centered communication techniques that enhance understanding and engagement The power of visual aids, including biofilm disclosing and voice-activated periodontal charting How to clearly explain the oral-systemic link to patients The importance of collaborating with other healthcare providers for integrated patient care Link to the episode referneced: The One Where We Talk About Communication Key Takeaways: Use patient-friendly language and open-ended questions to foster better communication. Leverage visual aids and real-time technology to help patients "see" their oral health status. Clearly articulate the connection between oral health and systemic conditions like heart disease and diabetes. Build interdisciplinary relationships to deliver holistic patient care. References Mentioned: Bale, B., & Doneen, A. (2022). Beat the Heart Attack Gene: The Revolutionary Plan to Prevent Heart Disease, Stroke, and Diabetes. Epstein, R. M., et al. (2005). Patient-centered communication and diagnostic testing. Annals of Family Medicine, 3(5), 415-421. Gurenlian, J. R. (2022). Patient-centered care in dental hygiene. Journal of Dental Hygiene, 96(2), 121-127. Ha, J. F., & Longnecker, N. (2010). Doctor-patient communication: A review. Ochsner Journal, 10(1), 38-43. Ide, M., et al. (2016). Periodontitis and pregnancy outcomes. Journal of Clinical Periodontology, 43(6), 524-530. Liccardo, D., et al. (2019). Periodontal disease and systemic inflammation. International Journal of Molecular Sciences, 20(6), 1414. Patel, N., et al. (2015). Real-time patient data and adherence. Journal of the American Medical Informatics Association, 22(1), 74-80. Slack-Smith, L., et al. (2017). Interdisciplinary dental and medical collaboration. Australian Dental Journal, 62(1), 115-121. Slade, G. D., et al. (2020). Oral health and systemic disease links. Australian Dental Journal, 65(1), 58-64. van der Sluijs, E., et al. (2018). Biofilm disclosure and patient compliance. International Journal of Dental Hygiene, 16(3), 297-304. Connect With Us: Listen wherever you get your podcasts If you enjoyed this content, please leave us a review Follow us on Instagram: @DisruptingDentistryPodcast Subscribe and leave a review on your favorite podcast platform. Share this episode with your dental colleagues! Next Episode Teaser: Stay tuned for our next episode, where we explore how to prevent gingivitis by making it "sexy."

Send us a text✨ FREE LEARNING RESOURCES FOR A YEAR! - https://irishpagan.school/freeIn this deep dive into the ancient figure of Crom Cruach, Jon O'Sullivan from the Irish Pagan School explores the lore, legends, and mystery surrounding this lesser-known Irish deity. Crom Cruach, an enigmatic figure from Ireland's pre-Christian past, is mentioned in texts like the Annals of the Four Masters and the Metrical Dindshenchas, but much of what we know is fragmentary and colored by Christian reinterpretation. Was Crom Cruach a fearsome idol demanding human sacrifice, or a misunderstood deity associated with fertility, prosperity, and abundance?✨ Irish Pagan Resources Checklist available NOW - https://irishpagan.school/checklist/

America Out Loud PULSE with Dr. Vaughn & Dr. Tankersley – In July 2024, the Annals of Internal Medicine had an article that stated the obvious that our profession is in a moral crisis. Thus, it called for a return to humility. Given the generational headwinds that have developed, we can only hope and pray that science returns to the fundamentals, beginning with a penitent approach led by honest people...

America Out Loud PULSE with Dr. Vaughn & Dr. Tankersley – In July 2024, the Annals of Internal Medicine had an article that stated the obvious that our profession is in a moral crisis. Thus, it called for a return to humility. Given the generational headwinds that have developed, we can only hope and pray that science returns to the fundamentals, beginning with a penitent approach led by honest people...

Much like deprescribing, we plan to revisit certain high impact and dynamic topics frequently.  Substance use disorder is one of those complex issues in which clinical practice is changing rapidly.  You can listen to our prior podcasts on substance use disorder here, here, here, and here. Today we talk with experts Janet Ho, Sach Kale, and Julie Childers about opioid use disorder and serious illness.  We address: Why is caring for patients with this overlap so hard?  Inspired by Dani Chammas's paper in Annals of Internal Medicine titled, “Wishing for a no show” we talk about countertransference: start by asking yourself, “Why am I having difficulty? What is making this hard for me?”  Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. Why? How? What do they do? Do you need to be an addiction medicine trained physician to start such a clinic (no: Sach is not).  See Sach's write up about setting up this clinic in JPSM. What is harm reduction and how can we implement it in practice?  One key tenet of harm reduction we return to multiple times on this podcast: Accountability without termination (or, in more familiar language, without abandonment). When to consider bupenorphine vs methadone?  Why the field is moving away from prescribing methadone to bupenorphine; how to manage patients prescribed methadone for opioid use disorder who then develop serious and painful illness - should we/can we split up the once daily dosing to achieve better pain control? Who follows the patient once the cancer goes into remission? Who will prescribe the buprenorphine then?  Or when it progresses - will hospice pay? And so much more: maybe not the oxycodone for breakthrough; when the IV dilaudid is the only thing that works; pill counts and urine drug tests; the 3 Ps approach (pain, pattern, prognosis); stimulant use disorder; a forthcoming VitalTalk section… Thanks to the many questions that came in on social media from listeners in advance of this podcast.  We all have questions.  We addressed as many of your listener questions as we could. We could have talked for 4 hours and will definitely revisit this issue! Sometimes the drugs don't work. -Alex: @alexsmithmd.bsky.social

Trauma is a universal experience, and our approach as health care providers to trauma should be universal as well. That's my main take-home point after learning from our three guests today when talking about trauma-informed care, an approach that highlights key principles including safety, trustworthiness, peer support, collaboration, empowerment, and cultural sensitivity. With that said, there is so much more that I learned from our guests for this trauma-informed care podcast. Our guests include Mariah Robertson, Kate Duchowny, and Ashwin Kotwal. Mariah discussed her JAGS paper on applying a trauma-informed approach to home visits. Kate and Ashwin talked about their research on the prevalence of lifetime trauma and its association with physical and psychosocial health among adults at the end of life. We also explored several questions with them, including how to define trauma, its prevalence in older adults, the impact of past traumatic experiences, the potential triggers of trauma screening, and the application of trauma-informed principles in clinical practice. If you want a deeper dive, check out the following resources: Our “Nature of Suffering” podcast with BJ Miller and Naomi Saks Dani Chammas' Annals paper on countertransference and why we shouldn't say “that the patient was difficult rather than that I felt frustrated.”  A great Curbsiders podcast episode on Trauma-informed care with Megan Gerber CAPC's Trauma-informed care toolkit Mariah's article on Home-Based Care for LGBTQ or another diverse gender identity Older Adults

The practice of growing plants in water rather than soil isn't new, though early examples are difficult to substantiate. In the 1930s, hydroponic plant culture made headlines, but the field also had conflict among researchers. Research: Bacon, Francis. “Sylva sylvarum; or, A natural history, in ten centuries. Whereunto is newly added the History natural and experimental of life and death, or of the prolongation of life.” London. 1670. https://archive.org/details/sylvasylvarumorn00baco/page/116/mode/2up Britannica, The Editors of Encyclopaedia. "Hanging Gardens of Babylon". Encyclopedia Britannica, 13 Jan. 2025, https://www.britannica.com/place/Hanging-Gardens-of-Babylon Britannica, The Editors of Encyclopaedia. "chinampa". Encyclopedia Britannica, 26 May. 2017, https://www.britannica.com/topic/chinampa Britannica, The Editors of Encyclopaedia. "Julius von Sachs". Encyclopedia Britannica, 28 Sep. 2024, https://www.britannica.com/biography/Julius-von-Sachs. Ebel, Roland. "Chinampas: An Urban Farming Model of the Aztecs and a Potential Solution for Modern Megalopolis". HortTechnology hortte 30.1 (2020): 13-19. < https://doi.org/10.21273/HORTTECH04310-19 Gericke, W. F. “The Complete Guide To Soilless Gardening.” Prentice Hall. 1940. https://archive.org/details/in.ernet.dli.2015.271694/page/n1/mode/2up Gericke, W. F. “The Meaning of Hydroponics.” Science101,142-143. 1945. https://www.science.org/doi/10.1126/science.101.2615.142 "General Mills' Big Gamble on Indoor Farming." Dun's Review. 1979. https://www.nal.usda.gov/sites/default/files/card-image/DunsReviewGeneralMillsImage.jpg “Growing Crops Without Soil.” United States Department of Agriculture. Agricultural research service. June 1965. https://www.nal.usda.gov/sites/default/files/card-image/RaisingCropsWithoutSoil1965_0.jpg Hall, Loura. “NASA Research Launches a New Generation of Indoor Farming.” NASA. Nov. 23, 2021. https://www.nasa.gov/technology/tech-transfer-spinoffs/nasa-research-launches-a-new-generation-of-indoor-farming/ Hoagland, D.R. and D.I. Arnon. “The Water-culture Method for Growing Plants Without Soil.” Berkeley. 1950. https://archive.org/details/watercultureme3450hoag/page/n5/mode/2up “A Hydroponic Farm on Wake Island.” Science87,12-3. (1938). DOI:1126/science.87.2263.12.u Janick, Jules et al. “The cucurbits of mediterranean antiquity: identification of taxa from ancient images and descriptions.” Annals of botany vol. 100,7 (2007): 1441-57. doi:10.1093/aob/mcm242 Silvio, Caputo. “History, Techniques and Technologies of Soil-Less Cultivation.” Springer, Cham. https://doi.org/10.1007/978-3-030-99962-9_4 Singer, Jesse. “A Hydroponics Timeline. Garden Culture Magazine. Feb. 8, 2021. https://gardenculturemagazine.com/a-brief-overview-of-the-history-of-hydroponics/#:~:text=1627:%20Sylva%20Sylvarum,Chemist%20Jean%20Baptist%20van%20Helmont Stanhill, G. "JOHN WOODWARD—A NEGLECTED 17TH CENTURY PIONEER OF EXPERIMENTAL BOTANY". Israel Journal of Plant Sciences 35.3-4 (1986): 225-231. https://doi.org/10.1080/0021213X.1986.10677056 Stuart, Neil W. “About Hydroponics.” Yearbook of Agriculture, U.S. Department of Agriculture. 1947. Accessed online: https://archive.org/details/yoa1947/page/289/mode/2up Taylor, Judith. “National Nutrition Month: Hydroponics feed ailing WWII Army Air Forces personnel.” Air Force Medical Service. March 26, 2014. https://www.airforcemedicine.af.mil/News/Article/582803/national-nutrition-month-hydroponics-feed-ailing-wwii-army-air-forces-personnel/ “Plants Without Soil.” Brooklyn Eagle. Feb. 28, 1937.https://www.newspapers.com/image/52623587/?match=1&terms=hydroponics “Hydroponics.” Courier-Journal. March 2, 1937. https://www.newspapers.com/image/107727971/?match=1&terms=hydroponics See omnystudio.com/listener for privacy information.

Dr. Daniel Hale Williams is often described as the first person to successfully perform an open-heart surgery. That's not entirely accurate, but he was still a surgical innovator, and he was also a huge part of the Black Hospital Movement. Research: "Daniel Hale Williams." Contemporary Black Biography, vol. 2, Gale, 1992. Gale In Context: U.S. History, link.gale.com/apps/doc/K1606000260/GPS?u=mlin_n_melpub&sid=bookmark-GPS&xid=c4ae7664. Accessed 28 Jan. 2025. "Daniel Hale Williams." Notable Black American Men, Book II, edited by Jessie Carney Smith, Gale, 1998. Gale In Context: U.S. History, link.gale.com/apps/doc/K1622000479/GPS?u=mlin_n_melpub&sid=bookmark-GPS&xid=80e75e7e. Accessed 28 Jan. 2025. Buckler, Helen. “Doctor Dan: Pioneer in American Surgery.” Little, Brown and Company. 1954. Cobb, W M. “Daniel Hale Williams-Pioneer and Innovator.” Journal of the National Medical Association vol. 36,5 (1944): 158-9. COBB, W M. “Dr. Daniel Hale Williams.” Journal of the National Medical Association vol. 45,5 (1953): 379-85. Cook County Health. “Celebrating 30 Years: Provident Hospital of Cook County.” https://cookcountyhealth.org/provident-hospital-30th-anniversary/ Gamble, Vanessa Northington. “Making a place for ourselves : the Black hospital movement, 1920-1945.” New York : Oxford University Press. 1995. Gamble, Vanessa Northington. “The Provident Hospital Project: An Experiment in Race Relations and Medical Education.” Bulletin of the History of Medicine, WINTER 1991. Via JSTOR. https://www.jstor.org/stable/44442639 Gordon, Ralph C. “Daniel Hale Williams: Pioneer Black Surgeon and Educator.” Journal of Investigative Surgery, 18:105–106, 2005. DOI: 10.1080/08941930590956084 Hughes, Langston. “Famous American Negroes.” Dodd Mead. 1954. Jackson State University. “Who Was Dr. Daniel Hale Williams?” https://www.jsums.edu/gtec/dr-daniel-hale-williams/ Jefferson, Alisha J. and Tamra S. McKenzie. “Daniel Hale Williams, MD: ‘A Moses in the profession.’” American College of Surgeons CC2017 Poster Competition. 2017. Office of the Illinois Secretary of State. “51. Dr. Daniel Hale Williams Letter to Governor Joseph Fifer (1889).” 100 Most Valuable Documents at the Illinois State Archives. https://www.ilsos.gov/departments/archives/online_exhibits/100_documents/1889-williams-letter-gov.html Olivier, Albert F. “In Proper Perspective: Daniel Hale Williams, M.D.” Annals of Thoracic Surgery. Volume 37, Issue 1p96-97 January 1984. https://www.annalsthoracicsurgery.org/article/S0003-4975(10)60721-7/fulltext Raman, Jai. “Access to the Heart – Evolution of surgical techniques.” Global Surgery. Vol. 1, No. 2. doi: 10.15761/GOS.1000112 Rock County, Wisconsin. “Dr. Daniel Hale Williams.” https://legacy.co.rock.wi.us/daniel-hale-williams Summerville, James. “Educating Black doctors : a history of Meharry Medical College.” University of Alabama Press. https://archive.org/details/educatingblackdo0000summ/ The Provident Foundation. “History- Dr. Daniel Hale Williams.” https://provfound.org/index.php/history/history-dr-daniel-hale-williams “Early Chicago: Hospital of Hope.” DuSable to Obama: Chicago’s Black Metropolis. https://www.wttw.com/dusable-to-obama/provident-hospital See omnystudio.com/listener for privacy information.

Welcome to Dev Game Club, where this week we continue our series on 1999's Outcast. Tim can't get enough of the voxels, and we dive a little bit into combat, mounts, and structure. Dev Game Club looks at classic video games and plays through them over several episodes, providing commentary. Sections played: Mostly through Shamazaar Issues covered: revisiting Defeating Games for Charity, the work behind the event, launch of VGHF library, accepting the voxels, possible benefits of voxels, how to represent transfer, back to metaballs, generating noise in the voxels, collision and voxels, looking unlike other games of the time, leaving out polygons for the voxels to show through, avoiding the enemies vs blasting, apparent resource scarcity, weak stealth, projectile-based shooting, combat and missing all the time, enjoying dodging but hating missing, abstraction in games, enemies dropping guns that disappear, voice work, stand-out characters, having fun with the NPCs, not being too self-serious, investigating the twon-ha, the different aesthetics of European games, a flexible mount, stumbling on the quest log, skipping ahead in the knowledge tree, seeing games in the same family, a milieu or scene, what were the game inputs that got you to this game, coming at ideas from different directions, German dubbing, the voice of Pey'j, adding legitimization, the music.  Games, people, and influences mentioned or discussed: BioStats, Mark Garcia, Artimage, Final Fantasy VI, Video Game History Foundation, Phil Salvador, Minecraft, Starfighter, Steve Ash, Spore, System Shock 2, DOOM (1993), CliffyB, Chess, Annals of the Grand Historian, Arnold Schwarzeneggar, Bruce Willis, Halo, Dark Crystal, Beyond Good and Evil, Rayman, Ultima (series), Populous, Peter Molyneux, Sid Meier, Civilization (series), Vitor, Assassin's Creed (series), David Gasman, Star Wars, John Williams, Dark Souls 2, Kirk Hamilton, Aaron Evers. Next time: More Outcast Twitch: timlongojr Discord DevGameClub@gmail.com

Sugar-sweetened beverages, the epidemiology of driving after an ICD, BP measurements, and massive EBM lesson in EVT for acute stroke are the topics John Mandrola, MD, discusses in today's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Sugar-Sweetened Beverages Sugary Drinks Fuel Millions of Diabetes and CVD Cases https://www.medscape.com/viewarticle/sugary-drinks-fuel-millions-diabetes-and-cvd-cases-2025a10002wr Nature Medicin;e Epidemiologic Study https://www.nature.com/articles/s41591-024-03345-4 JAMA-Network Open;  Beverage Tax Observational Study https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829505 Lancet Regional Health; Beverage Tax Philadelphia EHR 10.1016/j.lana.2024.100906 II. Driving With an ICD JACC Electrophysiology paper https://doi.org/10.1016/j.jacep.2024.12.002 Earlier HEART paper https://heart.bmj.com/content/110/24/1401 III. Blood Pressure Measurements and Simple RCTs BP Readings in Noisy Market as Good as Quiet Office? https://www.medscape.com/viewarticle/bp-readings-noisy-market-good-quiet-office-2025a10002z0 Annals of Internal Medicine Study https://www.acpjournals.org/doi/10.7326/ANNALS-24-00873 IV. A Big Shake-up in Interventional Stroke Care Endovascular Therapy Fails to Show Benefit in Distal Occlusion Stroke  https://www.medscape.com/viewarticle/endovascular-therapy-fails-show-benefit-distal-occlusion-2025a100035u ESCAPE-MeVO https://www.nejm.org/doi/full/10.1056/NEJMoa2411668 DISTAL trial https://www.nejm.org/doi/full/10.1056/NEJMoa2408954 J. Mocco Editorial https://www.nejm.org/doi/full/10.1056/NEJMe2500492 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net