Podcasts about Annals

The same glucosamine pill millions take for joint pain may protect a healthy brain — and accelerate Alzheimer's in a brain already in decline. Here's the science.In this episode of Health Longevity Secrets, Robert Lufkin MD breaks down the 2026 plot twist on glucosamine and dementia: why a supplement once hailed as a longevity hack now carries an Alzheimer's warning, and why the answer comes down to one thing — the state of your metabolism. The same molecule helped the metabolically healthy and may have harmed the metabolically broken. The supplement didn't change; the soil it landed on did.Chapters:00:00 — Introduction00:39 — The Supplement Everyone Trusted01:06 — UK Biobank: Glucosamine and 15% Lower Death Risk01:38 — Why Glucosamine Looked Like a Longevity Hack02:48 — The 2026 Plot Twist: Nature Metabolism Study03:53 — Alzheimer's Mice and the Glucosamine Pathway04:13 — How Sugar Tagging (Glycosylation) Explains Both04:57 — Hyperglycosylation in the Alzheimer's Brain05:34 — The Honest Caveat: Association vs Causation06:55 — The Takeaway: Metabolic Health Decides EverythingKey takeaways:In healthy, cognitively normal adults, regular glucosamine use has been tied to lower all-cause mortality and lower risk of dementia — especially vascular dementia.A June 2026 University of Florida study in Nature Metabolism found the opposite signal in sick brains: in people with mild cognitive impairment, glucosamine use was associated with a 25% higher likelihood of progressing to Alzheimer's, and a 25% higher death risk in those already diagnosed.In Alzheimer's mice, glucosamine made memory worse; blocking the same sugar-tagging pathway made it better.The mechanism is metabolic: glucosamine feeds glycosylation (sugar-tagging of proteins). A healthy brain handles it fine; an Alzheimer's brain is already hyperglycosylated, so adding more is "pouring gasoline on the fire."This is association, not proof of cause — and the literature is genuinely mixed. If you're healthy, it's not a fire alarm. If you or a loved one has MCI or dementia, talk to your physician before the next refill.Studies & sources:Hawkinson et al., "Hyperglycosylation is a metabolic driver of Alzheimer's disease," Nature Metabolism 2026 (University of Florida)University of Florida news release on the glucosamine–dementia findingZheng et al., "Association of regular glucosamine use with incident dementia," BMC Medicine 2023 (UK Biobank)Habitual glucosamine use, APOE genotypes, and cause-specific dementia in older adults (UK Biobank)Li et al., "Associations of regular glucosamine use with all-cause and cause-specific mortality," Annals of the Rheumatic Diseases 2020 (UK Biobank)Read Dr. Lufkin's book "Lies I Taught in Medical School".⭐ Enjoying the show? Please leave a 5-star review on Apple Podcasts — it takes 30 seconds and helps more people discover the science of health and longevity. Thank you!New episodes every Tuesday & Thursday. Subscribe so you don't miss one.Continue this conversation on Substack: https://robertlufkinmd.substack.comLies I Taught In Medical School — Free sample chapter: https://www.robertlufkinmd.com/lies/Web: https://www.robertlufkinmd.comYouTube: https://www.youtube.com/robertlufkinmdX: https://x.com/robertlufkinmdInstagram: https://www.instagram.com/robertlufkinmd/TikTok: https://www.tiktok.com/@robertlufkinLinkedIn: https://www.linkedin.com/in/robertlufkinmd/

Links For The Occult Rejectshttps://linktr.ee/theoccultrejectsOccult Research Institutehttps://www.occultresearchinstitute.org/Substackhttps://substack.com/@theoccultrejects?r=7auau0&utm_campaign=profile&utm_medium=profile-pageCash Apphttps://cash.app/$theoccultrejectsVenmo@TheOccultRejectsBuy Me A Coffeebuymeacoffee.com/TheOccultRejectsPatreonhttps://www.patreon.com/TheOccultRejectsPart 1 focuses on the drum as an ancient technology of altered consciousness. The argument is not that every beat causes trance, or that neuroscience has proven spirits. The stronger argument is that rhythm enters the human organism through hearing, motor prediction, breath, movement, attention, emotion, expectation, culture, and social synchrony. The drum becomes powerful when sound, body, group, ritual frame, and meaning converge. These sources support the archaeology, neuroscience, EEG research, shamanic studies, possession studies, Indigenous and culturally specific drum traditions, ritual theory, placebo and meaning-response research, ceremonial magic, and modern witchcraft material used in the episode.Core Academic and Scientific SourcesHuels, Emma R., Hyoungkyu Kim, UnCheol Lee, Tirsa Bel-Bahar, Ana V. Colmenero, Alexandra Nelson, Stefanie Blain-Moraes, George A. Mashour, and Richard E. Harris. “Neural Correlates of the Shamanic State of Consciousness.” Frontiers in Human Neuroscience 15 (2021): 610466.Gordon, Yoel, Golan Karvat, Noa Dagan, and Ayelet N. Landau. “Neural Tracking at Theta Predicts Drumming-Induced Altered States of Consciousness.” Scientific Reports 16, no. 1 (2026): Article 10204.Aparicio-Terrés, R., et al. “The Neurobiology of Altered States of Consciousness Induced by Drumming and Other Rhythmic Sound Patterns.” Annals of the New York Academy of Sciences, 2025.Neher, Andrew. “Auditory Driving Observed with Scalp Electrodes in Normal Subjects.” Electroencephalography and Clinical Neurophysiology 13 (1961): 449–451.Neher, Andrew. “A Physiological Explanation of Unusual Behavior in Ceremonies Involving Drums.” Human Biology 34, no. 2 (1962): 151–160.Maurer, R., V. K. Kumar, L. Woodside, and R. J. Pekala. “Phenomenological Experience in Response to Monotonous Drumming and Hypnotizability.” American Journal of Clinical Hypnosis 40, no. 2 (1997): 130–145. Use for monotonous drumming, subjective altered experience, imagery, absorption, and hypnotizability.Maxfield, Melinda C. “Effects of Rhythmic Drumming on EEG and Subjective Experience.” PhD diss., Institute of Transpersonal Psychology, 1990. Use as older supporting context on drumming, EEG, imagery, body-image changes, and subjective altered experience. Do not make this the main scientific proof; use it as background.Nozaradan, Sylvie, Isabelle Peretz, and André Mouraux. “Tagging the Neuronal Entrainment to Beat and Meter.” The Journal of Neuroscience 31, no. 28 (2011): 10234–10240. Use for EEG evidence that the brain can track beat and meter. This supports the claim that the brain does not merely hear rhythm as background sound; it can represent rhythmic structure in measurable ways.Nozaradan, Sylvie. “Exploring How Musical Rhythm Entrains Brain Activity with Electroencephalogram Frequency-Tagging.” Philosophical Transactions of the Royal Society B 369, no. 1658 (2014). Use as broader rhythm/EEG entrainment support. This helps explain frequency-tagging, beat tracking, meter, neural entrainment, and the measurable relationship between rhythmic structure and brain activity.Thaut, Michael H., Gerald C. McIntosh, and Volker Hoemberg. “Neurobiological Foundations of Neurologic Music Therapy: Rhythmic Entrainment and the Motor System.” Frontiers in Psychology 5 (2015). Use for rhythm as motor-system timing information. This supports the claim that a beat can become bodily instruction, not just sound for the ear. Especially useful when discussing rhythmic auditory stimulation, motor planning, gait, entrainment, and the auditory-motor bridge.Ross, Jessica M., John R. Iversen, and Ramesh Balasubramaniam. “Time Perception for Musical Rhythms: Sensorimotor Perspectives on Entrainment, Simulation, and Prediction.” 2022. Use for rhythm, timing, prediction, sensorimotor entrainment, and the way musical rhythm interacts with time perception.Hove, Michael J., and Jane L. Risen. “It's All in the Timing: Interpersonal Synchrony Increases Affiliation.” Social Cognition 27, no. 6 (2009): 949–960. Use for synchrony and social bonding. This helps support the group-body argument: moving or acting in time with others can increase affiliation.Wiltermuth, Scott S., and Chip Heath. “Synchrony and Cooperation.” Psychological Science 20, no. 1 (2009): 1–5. Use for the claim that synchronized movement can increase cooperation and attachment among participants.Tarr, Bronwyn, Jacques Launay, and Robin I. M. Dunbar. “Music and Social Bonding: ‘Self-Other' Merging and Neurohormonal Mechanisms.” Frontiers in Psychology 5 (2014): 1096. Use for music, synchrony, bonding, endorphin/social mechanisms, and why group rhythm can feel like more than private listening.Fancourt, Daisy, Rosie Perkins, Sara Ascenso, Louise Atkins, Fatima Kilfeather, and Aaron Williamon. “Effects of Group Drumming Interventions on Anxiety, Depression, Social Resilience and Inflammatory Immune Response among Mental Health Service Users.” PLOS ONE 11, no. 3 (2016): e0151136. Use for modern group-drumming research showing psychological and physiological effects, including anxiety, depression, social resilience, wellbeing, and inflammatory immune response. Use carefully: this does not make group drumming a cure-all. It supports the more grounded claim that embodied rhythm and group participation can affect mood, social connection, and body chemistry.Bittman, Barry B., et al. “Composite Effects of Group Drumming Music Therapy on Modulation of Neuroendocrine-Immune Parameters in Normal Subjects.” Alternative Therapies in Health and Medicine 7, no. 1 (2001): 38–47. Use as older supporting material on group drumming and neuroendocrine-immune measures. Keep secondary. Fancourt is cleaner for the main script body.Archaeology and Deep History of DrumsLawergren, Bo. “Neolithic Drums in China.” In Music Archaeology in China. 2006. Use for clay drums in Neolithic China and the deep-history claim that drums are not just poetic symbols of antiquity. They appear in the archaeological record as instruments tied to early sound-making, ceremony, and social order.Both, Arnd Adje. “Music Archaeology: Some Methodological and Theoretical Considerations.” Use as general support for why ancient instruments should be treated as ritual and social evidence, not merely decorative objects.Anthropology, Ethnomusicology, Ritual, and TranceRouget, Gilbert. Music and Trance: A Theory of the Relations Between Music and Possession. Translated by Brunhilde Biebuyck. Chicago: University of Chicago Press, 1985. Essential source. Use for the caution that music does not mechanically or universally cause trance. Rouget helps keep the argument academically serious by emphasizing culture, ritual frame, meaning, and expectation.Becker, Judith. Deep Listeners: Music, Emotion, and Trancing. Bloomington: Indiana University Press, 2004. Use for music-linked trancing, emotional absorption, religious experience, and culturally trained ways of listening. This supports the “hearing versus entering” distinction.McNeill, William H. Keeping Together in Time: Dance and Drill in Human History. Cambridge, MA: Harvard University Press, 1995. Use for marching, dance, drill, muscular bonding, synchronized movement, and rhythm as social glue. This is useful both for Part 1's group-body material and Part 2's war-drum material.Eliade, Mircea. Shamanism: Archaic Techniques of Ecstasy. Princeton: Princeton University Press, 1964. Use carefully. Eliade's phrase “archaic techniques of ecstasy” is powerful, but the episode should also note that later scholarship criticizes his tendency to universalize shamanism.Winkelman, Michael. Shamanism: A Biopsychosocial Paradigm of Consciousness and Healing. 2nd ed. Santa Barbara, CA: Praeger, 2010. Use for shamanism as a ritual technology involving altered consciousness, healing, social integration, symbolism, and body-brain processes.Winkelman, Michael. “Shamanism and Psychedelics: A Biogenetic Structuralist Paradigm of Ecopsychology.” European Journal of Ecopsychology 4 (2013): 90–115. Use as supplemental background on shamanism, altered consciousness, and comparative models of trance and visionary states.Kontouli, Athanasia, Michael J. Hove, Alexandre Lehmann, Peter Vuust, and Peter E. Keller. “The Rhythms of Trance: Cultural Phenomenology and Neural Mechanisms of Music-Induced Lewis-Williams, David. The Mind in the Cave: Consciousness and the Origins of Art. London: Thames & Hudson, 2002. Use cautiously for altered states, entoptic imagery, ritual vision, and the relationship between neuropsychology and symbolic culture.Non-Ordinary States of Consciousness.” Neuroscience & Biobehavioral Reviews, 2026. Use for the bridge between cultural phenomenology and neuroscience. This supports the point that music-induced trance is not only acoustics; it involves body, training, expectation, culture, environment, and interpretation.Tart, Charles T., ed. Altered States of Consciousness. New York: Wiley, 1969. Use as classic altered-state background.Hultkrantz, Åke. “The Drum in Shamanism.” Use for classic comparative material on the shamanic drum, especially Arctic, SiberiAlso want to remind people about the website, if you're into reading we have tons of information by multiple contributors, and we got t-shirts up on the site if you're interested. Fun fact, the art is all based on the eyeball. A

What if one of the most important health crises affecting men today wasn't being caused by aging, but by the environment we live in? In this eye-opening solo episode, Darin Olien investigates the alarming decline in testosterone levels, fertility, and reproductive health among men worldwide. Drawing on decades of research, epidemiological studies, environmental science, endocrinology, and public health data, Darin examines the growing evidence connecting endocrine-disrupting chemicals, microplastics, sleep deprivation, chronic stress, poor lifestyle habits, and environmental toxins to declining testosterone levels across generations. From BPA, phthalates, atrazine, PFAS, and microplastics to sleep quality, circadian rhythms, cholesterol metabolism, cortisol regulation, and natural testosterone-supporting strategies, this episode explores what may be one of the most underreported public health issues of our time—and what men can do to take control of their health today.     What You'll Learn Why testosterone levels have been declining for decades The startling research on global sperm count decline How endocrine-disrupting chemicals interfere with hormone production Why BPA and phthalates may disrupt testosterone synthesis The role of atrazine, PFAS, and environmental toxins How chronic stress diverts resources away from testosterone production Why sleep may be the most important testosterone intervention The connection between cholesterol and hormone production How microplastics are being found throughout the human body The surprising relationship between statins and testosterone levels Natural lifestyle strategies that support healthy hormone production Practical steps to reduce environmental exposure and improve health     Chapters 00:00:00 – Welcome to SuperLife 00:00:33 – Sponsor: Fatty15 and cellular health 00:04:17 – The testosterone collapse explained 00:04:51 – Testosterone levels have been declining for decades 00:06:03 – Global sperm count decline and accelerating trends 00:07:02 – Why treating symptoms misses the root cause 00:07:27 – The hidden public health crisis 00:08:03 – Why low testosterone isn't just about aging 00:09:12 – Why hormone health affects longevity 00:09:53 – Low testosterone and increased mortality risk 00:10:35 – Testosterone's role in metabolism and cardiovascular health 00:11:27 – Endocrine-disrupting chemicals and hormone disruption 00:12:44 – BPA and its effects on testosterone production 00:13:59 – Phthalates and their impact on hormone pathways 00:16:00 – Glyphosate, atrazine, and pesticide exposure 00:17:07 – PFAS and reproductive health concerns 00:17:55 – Environmental toxins and population-wide effects 00:18:11 – Sponsor: Shakeology 00:20:02 – Cholesterol and hormone production 00:20:53 – Chronic stress and cortisol dominance 00:21:45 – Actionable solutions begin 00:21:56 – Why sleep is essential for testosterone production 00:23:07 – How sleep deprivation rapidly lowers testosterone 00:23:21 – Light pollution and circadian disruption 00:23:41 – Foods and nutrients needed for hormone health 00:24:23 – Microplastics and testicular tissue 00:24:53 – Statins and unintended hormonal consequences 00:25:39 – A practical testosterone sovereignty protocol 00:25:48 – Water filtration and reducing toxic exposure 00:26:13 – Eliminating plastics and fragrance chemicals 00:26:35 – Why organic food matters 00:26:45 – Sunlight and vitamin D 00:27:05 – Magnesium, omega-3s, and iodine 00:27:26 – Pine pollen and natural androgen support 00:28:01 – Tongkat Ali and ashwagandha 00:28:48 – Strength training and lifestyle interventions 00:29:10 – Habits that naturally support testosterone 00:29:27 – Darin's approach to healthy aging 00:29:37 – Plants, herbs, and common sense 00:29:51 – Reclaiming your health and sovereignty 00:30:00 – Final thoughts and closing message     Thank You to Our Sponsors Fatty15: Get an additional 15% off their 90-day subscription Starter Kit by going to fatty15.com/DARIN and using code DARIN at checkout. Shakeology: Get 15% off with code DARINO1BODI at Shakeology.com.     Join the SuperLife Patreon: This is where Darin now shares the deeper work: - weekly voice notes - ingredient trackers - wellness challenges - extended conversations - community accountability - sovereignty practices Join now for only $7.49/month at https://patreon.com/darinolien     Find More from Darin Olien: Website: darinolien.com Instagram: @darinolien Book: Fatal Conveniences Platform & Products: superlife.com New Show: Roadmap to Happiness     Key Takeaway "The testosterone crisis may be about far more than aging. It may be a reflection of the modern environment itself—one increasingly saturated with endocrine-disrupting chemicals, chronic stress, poor sleep, circadian disruption, and toxic exposures. While many of these forces feel outside our control, the encouraging reality is that many of the most powerful interventions remain accessible: improving sleep, reducing toxic load, eating whole foods, getting sunlight, managing stress, exercising regularly, and reclaiming responsibility for our health. The goal isn't fear. The goal is awareness—and action."     Bibliography/Sources: The Decline — Primary Research Levine, H., Jørgensen, N., Martino-Andrade, A., et al. (2022). Temporal trends in sperm count: A systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries. Human Reproduction Update, 29(2), 157–176. https://doi.org/10.1093/humupd/dmac035 Lokeshwar, S. D., Patel, P., Fantus, R. J., et al. (2021). Decline in testosterone levels in men aged 15–40: Results from the National Health and Nutrition Examination Survey (NHANES), 1999–2016. World Journal of Urology, 39(2), 447–452. https://doi.org/10.1007/s00345-020-03227-1 Spital Clinic. (2026, March). Declining testosterone levels by generation. https://www.spitalclinic.com Travison, T. G., Araujo, A. B., O'Donnell, A. B., Kupelian, V., & McKinlay, J. B. (2007). A population-level decline in serum testosterone levels in American men. The Journal of Clinical Endocrinology & Metabolism, 92(1), 196–202. https://doi.org/10.1210/jc.2006-1375 Low Testosterone — Mortality & Disease Risk Muraleedharan, V., Marsh, H., Kapoor, D., Channer, K. S., & Jones, T. H. (2013). Testosterone deficiency is associated with increased risk of mortality and testosterone replacement improves survival in men with type 2 diabetes. European Journal of Endocrinology, 169(6), 725–733. https://doi.org/10.1530/EJE-13-0321 Shores, M. M., et al. (2006). Low testosterone associated with increased all-cause and cardiovascular mortality. Archives of Internal Medicine, 166(15), 1660–1665. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/410754 Yeap, B. B., Marriott, R. J., Dwivedi, G., et al. (2024). Associations of testosterone and related hormones with all-cause and cardiovascular mortality and incident cardiovascular disease in men. Annals of Internal Medicine. https://doi.org/10.7326/M23-2781 Endocrine Disrupting Chemicals Associations between endocrine-disrupting chemical exposure and fertility outcomes: A decade of human epidemiological evidence. (2024). PubMed Central (PMC12299029). https://pmc.ncbi.nlm.nih.gov/articles/PMC12299029/ Hayes, T. B., Haston, K., Tsui, M., et al. (2002). Herbicides: Feminization of male frogs in the wild. Nature, 419, 895–896. https://doi.org/10.1038/419895a Mechanisms of testicular disruption from exposure to BPA and phthalates. (2020). Journal of Clinical Medicine, 9(2), 471. https://pmc.ncbi.nlm.nih.gov/articles/PMC7074154/ Meeker, J. D., Calafat, A. M., & Hauser, R. (2014). Urinary phthalate metabolites and their biotransformation products: Predictors and temporal variability among men and women. Journal of Exposure Science & Environmental Epidemiology. https://www.sciencedaily.com/releases/2014/08/140814124330.htm Zhao, Q., et al. (2023). Male reproductive toxicity of microplastics: Head and tail of the sperm. Science of the Total Environment, 872, 162181. https://doi.org/10.1016/j.scitotenv.2023.162181 Zhong, B., et al. (2024). Mixed EDC exposure associated with reductions in testosterone and free androgen index. Scientific Reports. https://doi.org/10.1038/s41598-024-76972-z Cortisol, Stress & the HPG Axis Bielohuby, M., et al. (2012). Swiss military cadets prolonged stress study. Psychoneuroendocrinology. Preprints.org. (2025). Sleep deprivation: A modifiable cause. https://doi.org/10.20944/preprints202505.0580.v1 SiPhox Health. (n.d.). Summary of Journal of Clinical Endocrinology & Metabolism data. https://www.siphoxhealth.com Viau, V. (2002). Functional cross-talk between the hypothalamic-pituitary-gonadal and -adrenal axes. Journal of Neuroendocrinology, 14(6), 506–513. https://doi.org/10.1046/j.1365-2826.2002.00798.x Sleep & Testosterone Leproult, R., & Van Cauter, E. (2011). Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA, 305(21), 2173–2174. https://jamanetwork.com/journals/jama/fullarticle/1029127 Reiter, R. J., et al. (2021). Melatonin and male reproductive health: Relationship to oxidative stress, mitochondrial function, and Leydig cell protection. Endocrine. Tan, D. X., Hardeland, R., Manchester, L. C., et al. (2023). Melatonin as a pleiotropic antioxidant hormone. Journal of Pineal Research. Nutrition — Zinc, Vitamin D, Cholesterol Corona, G., et al. (2010). Statin therapy and testosterone levels in men: A systematic review. The Journal of Sexual Medicine. Daniell, H. W. (2002). Hypogonadism in men consuming sustained-action oral opioids. The Journal of Pain, 3(5), 377–384. https://doi.org/10.1054/jpai.2002.126790 Pilz, S., Frisch, S., Koertke, H., et al. (2011). Effect of vitamin D supplementation on testosterone levels in men. Hormone and Metabolic Research, 43(3), 223–225. https://doi.org/10.1055/s-0030-1269854 Prasad, A. S., Mantzoros, C. S., Beck, F. W., Hess, J. W., & Brewer, G. J. (1996). Zinc status and serum testosterone levels of healthy adults. Nutrition, 12(5), 344–348. https://doi.org/10.1016/S0899-9007(96)80058-X Natural Testosterone Support — Botanical Evidence Pine pollen impacts testosterone-related symptoms in men. (2024). ACMCR Case Reports, 14(5), 1–9. Chinnappan, S. M., George, A., et al. (2021). Effect of Eurycoma longifolia standardised extract Physta on testosterone levels in ageing males: A randomised, double-blind, placebo-controlled multicentre study. Food & Nutrition Research, 65. https://doi.org/10.29219/fnr.v65.5647 Lazarev, A., & Bezuglov, E. (2021). Testosterone boosters intake in athletes: Current evidence and further directions. Endocrines, 2(2), 109–120. https://doi.org/10.3390/endocrines2020011 Leisegang, K., et al. (2022). Eurycoma longifolia (Tongkat Ali) improves serum total testosterone in men. Food & Nutrition Research. https://pubmed.ncbi.nlm.nih.gov/36013514/ Leitão, A. E., et al. (2021). 6-month double-blind RCT: Eurycoma longifolia 200mg + concurrent training. Maturitas. https://doi.org/10.1016/j.maturitas.2020.10.005 Lopresti, A. L., Smith, S. J., et al. (2019). An investigation into the stress-relieving and pharmacological actions of an ashwagandha extract. Medicine, 98(37), e17186. https://doi.org/10.1097/MD.0000000000017186 Pandit, S., Biswas, S., Jana, U., De, R. K., Mukhopadhyay, S. C., & Biswas, T. K. (2016). Clinical evaluation of purified shilajit on testosterone levels in healthy volunteers. Andrologia, 48(5), 570–575. https://doi.org/10.1111/and.12482 Saden-Krehula, M., Tajic, M., & Kolbah, D. (1971). Testosterone, epitestosterone and androstenedione in the pollen of Scotch pine Pinus sylvestris L. Experientia, 27(1), 108–109. https://doi.org/10.1007/BF02137731 Wankhede, S., Langade, D., Joshi, K., et al. (2015). Examining the effect of Withania somnifera supplementation on muscle strength and recovery: A randomized controlled trial. Journal of the International Society of Sports Nutrition, 12, 43. https://doi.org/10.1186/s12970-015-0104-9

This is The Briefing, a daily analysis of news and events from a Christian worldview.On today's edition of The Briefing, Dr. Mohler discusses the G7 and ceasefire with Iran, the thwarted drone attack at the White House, the collision of the Giants Pride night with religious liberty, and the two documents signed by Abraham Lincoln that will be on display at the Lincoln Memorial for America's 250th birthday.Part I (00:14 – 06:36)The G7 and the Ceasefire with Iran: President Trump Claims Victory Before World Leaders, But the Next 60 Days are CrucialPart II (06:36 – 13:20)A Thwarted Drone Attack at the White House: The Big Problem of Disaffected Young Men in the Digital AgePart III (13:20 – 21:50)Pride Night Collides with Religious Liberty and the San Francisco Giants: Three Pitchers Exercise Religious Freedom on Pride Night, and LGBTQ Revolutionaries are Up in ArmsMLB issues warning to Giants pitchers who wrote Bible verses on Pride Night caps by The Athletic (Steve Berman)Hawley Demands Answers from MLB for Penalizing Christian Players by U.S. Senator for Missouri (Senator Josh Hawley)Part IV (21:50 – 27:56)The Importance of Words in the Annals of History: Two Documents Signed by Abraham Lincoln Will Be on Display at the Lincoln Memorial for America's 250th BirthdayA look at the rare historic documents heading to the Lincoln Memorial by The Washington Post (Michael E. Ruane)Sign up to receive The Briefing in your inbox every weekday morning.Follow Dr. Mohler:X | Instagram | Facebook | YouTubeFor more information on The Southern Baptist Theological Seminary, go to sbts.edu.For more information on Boyce College, just go to BoyceCollege.com.To write Dr. Mohler or submit a question for The Mailbox, go here.

Doctor Mau Informa ®️ #drmauinforma Durante medio siglo, la endocrinología consideró al glucagón como el "villano" del metabolismo: la hormona responsable de subir el azúcar en la sangre. Sin embargo, ¿qué pasaría si pudiéramos domesticar a este villano para activar la quema extrema de grasa de forma segura. En este episodio de Doctor Mau Informa, analizamos la fascinante evolución científica que nos llevó desde tumores pancreáticos hasta el desarrollo del Retatrutide, un revolucionario fármaco "triple agonista". Descubre cómo la ciencia logró combinar tres señales hormonales (Glucagón, GLP-1 y GIP) en una sola inyección semanal para alcanzar resultados de pérdida de peso metabólica que antes solo le pertenecían al bisturí de la cirugía bariátrica. En este episodio aprenderás: → La balanza de la pérdida de peso: Por qué los medicamentos anteriores solo te quitaban el hambre, y cómo la nueva generación también acelera tu gasto energético. → El secreto del Glucagón: Cómo esta hormona del ayuno saca la grasa del hígado y eleva el metabolismo. → La evolución del GLP-1: El papel protector de la insulina natural para contrarrestar el azúcar y permitir una pérdida de peso segura. → Cirugía vs. Fármacos: Por qué los resultados de los nuevos tratamientos crónicos están cambiando el paradigma médico para siempre. → La realidad clínica: Efectos secundarios, la importancia de la titulación médica y por qué esto no es una "dieta milagro".

If you enjoy this episode, we're sure you will enjoy more content like this on The Occult Rejects.  In fact, we have curated playlists on occult topics like grimoires, esoteric concepts and phenomena, occult history, analyzing true crime and cults with an occult lens, Para politics, and occultism in music. Whether you enjoy consuming your content visually or via audio, we've got you covered - and it will always be provided free of charge.  So, if you enjoy what we do and want to support our work of providing accessible, free content on various platforms, please consider making a donation to the links provided below.  Thank you and enjoy the episode!Links For The Occult Rejectshttps://linktr.ee/theoccultrejectsOccult Research Institutehttps://www.occultresearchinstitute.org/Substackhttps://substack.com/@theoccultrejects?r=7auau0&utm_campaign=profile&utm_medium=profile-pageCash Apphttps://cash.app/$theoccultrejectsVenmo@TheOccultRejectsBuy Me A Coffeebuymeacoffee.com/TheOccultRejectsPatreonhttps://www.patreon.com/TheOccultRejectsBiblioBernardi, Luciano, Peter Sleight, Gabriele Bandinelli, Simone Cencetti, Luciano Fattorini, Johanna Wdowczyc-Szulc, and Alfonso Lagi. “Effect of Rosary Prayer and Yoga Mantras on Autonomic Cardiovascular Rhythms: Comparative Study.” BMJ 323, no. 7327 (2001): 1446–1449.Benson, Herbert, John W. Lehmann, Mark S. Malhotra, Ralph F. Goldman, Jeffrey Hopkins, and Mark D. Epstein. “Body Temperature Changes During the Practice of g Tum-mo Yoga.” Nature 295 (1982): 234–236.Benson, Herbert, Mark S. Malhotra, Ralph F. Goldman, Gregory D. Jacobs, and Jeffrey Hopkins. “Three Case Reports of the Metabolic and Electroencephalographic Changes During Advanced Buddhist Meditation Techniques.” Behavioral Medicine 16, no. 2 (1990): 90–95.Bremer, Brandon, Lorenzo Wu, Zoran Josipovic, and colleagues. “Mindfulness Meditation Increases Default Mode, Salience, and Central Executive Network Connectivity.” Scientific Reports 12 (2022).Brewer, Judson A., Patrick D. Worhunsky, Jeremy R. Gray, Yi-Yuan Tang, Jochen Weber, and Hedy Kober. “Meditation Experience Is Associated with Differences in Default Mode Network Activity and Connectivity.” Proceedings of the National Academy of Sciences 108, no. 50 (2011): 20254–20259.Britton, Willoughby B. and colleagues. Research associated with the “Varieties of Contemplative Experience” project on meditation-related challenges, adverse effects, and safety considerations in contemplative practice.Crowley, Aleister. Liber E vel Exercitiorum sub figura IX. In the A∴A∴ training corpus. Relevant sections include asana, pranayama, and dharana as foundational magical exercises.Dennison, Paul. “Insights From an EEG Study of Buddhist Jhāna Meditation.” Frontiers in Human Neuroscience 13 (2019).Fialoke, Shantala, Helen Weng, and colleagues. “Functional Connectivity Changes in Meditators and Novices During Yoga Nidra Practice.” Scientific Reports 14 (2024).Fox, Kieran C. R., Savannah Nijeboer, Matthew L. Dixon, James L. Floman, Melissa Ellamil, Samuel P. Rumak, Peter Sedlmeier, and Kalina Christoff. “Is Meditation Associated with Altered Brain Structure? A Systematic Review and Meta-analysis of Morphometric Neuroimaging in Meditation Practitioners.” Neuroscience & Biobehavioral Reviews 43 (2014): 48–73.Hölzel, Britta K., James Carmody, Mark Vangel, Christina Congleton, Sita M. Yerramsetti, Tim Gard, and Sara W. Lazar. “Mindfulness Practice Leads to Increases in Regional Brain Gray Matter Density.” Psychiatry Research: Neuroimaging 191, no. 1 (2011): 36–43.Kozhevnikov, Maria, Olesya Louchakova, Zoran Josipovic, and Michael A. Motes. “The Enhancement of Visuospatial Processing Efficiency Through Buddhist Deity Meditation.” Psychological Science 20, no. 5 (2009): 645–653.Kozhevnikov, Maria, John A. Elliott, Jennifer Shephard, and Klaus Gramann. “Neurocognitive and Somatic Components of Temperature Increases During g-Tummo Meditation: Legend and Reality.” PLOS ONE 8, no. 3 (2013): e58244.Laukkonen, Ruben E., and Heleen A. Slagter. “From Many to (N)one: Meditation and the Plasticity of the Predictive Mind.” Neuroscience & Biobehavioral Reviews 128 (2021): 199–217.Lomas, Tim, Juan Carlos Ivtzan, and Itai K. Fu. “A Systematic Review of the Neurophysiology of Mindfulness on EEG Oscillations.” Neuroscience & Biobehavioral Reviews 57 (2015): 401–410.Lott, James P., Richard J. Davidson, John D. Dunne, Thupten Jinpa, Antoine Lutz, and colleagues. “No Detectable Electroencephalographic Activity After Clinical Declaration of Death Among Tibetan Buddhist Meditators in Apparent Tukdam.” Frontiers in Psychology 11 (2021): 599190.Lutz, Antoine, Lawrence L. Greischar, Nancy B. Rawlings, Matthieu Ricard, and Richard J. Davidson. “Long-term Meditators Self-induce High-amplitude Gamma Synchrony During Mental Practice.” Proceedings of the National Academy of Sciences 101, no. 46 (2004): 16369–16373.Lutz, Antoine, Julie Brefczynski-Lewis, Tom Johnstone, and Richard J. Davidson. “Regulation of the Neural Circuitry of Emotion by Compassion Meditation: Effects of Meditative Expertise.” PLoS ONE 3, no. 3 (2008): e1897.Matko, Karin, Peter Sedlmeier, and colleagues. “Adverse Effects of Meditation and Mindfulness in Clinical Practice.” 2025.Patanjali. Yoga Sutras. Especially Book III, traditionally describing dharana, dhyana, and samadhi.Riegner, Gretchen, Fadel Zeidan, and colleagues. “Disentangling Self from Pain: Mindfulness Meditation-Induced Pain Relief Is Driven by Thalamic-Default Mode Network Decoupling.” Pain 164, no. 2 (2023): 280–291.Tang, Yi-Yuan, Britta K. Hölzel, and Michael I. Posner. “The Neuroscience of Mindfulness Meditation.” Nature Reviews Neuroscience 16 (2015): 213–225.Vago, David R., and David A. Silbersweig. “Self-awareness, Self-regulation, and Self-transcendence: A Framework for Understanding the Neurobiological Mechanisms of Mindfulness.” Frontiers in Human Neuroscience 6 (2012): 296.Zeidan, Fadel, and colleagues. Research on mindfulness meditation, pain modulation, attention, and the neural mechanisms of pain relief.Slagter, Heleen A., Antoine Lutz, Lawrence L. Greischar, Andrew D. Francis, Sander Nieuwenhuis, James M. Davis, and Richard J. Davidson. “Mental Training Affects Distribution of Limited Brain Resources.” PLOS Biology 5, no. 6 (2007): e138. Use for: Attentional blink, limited attention, and meditation changing how the brain allocates resources.Hölzel, Britta K., James Carmody, Mark Vangel, Christina Congleton, Sita M. Yerramsetti, Tim Gard, and Sara W. Lazar. “Mindfulness Practice Leads to Increases in Regional Brain Gray Matter Density.” Psychiatry Research: Neuroimaging 191, no. 1 (2011): 36–43. Use for: Neuroplasticity, repeated practice leaving measurable marks on the brain, and the “practice writes itself into the practitioner” idea.Laukkonen, Ruben E., and Heleen A. Slagter. “From Many to (N)one: Meditation and the Plasticity of the Predictive Mind.” Neuroscience & Biobehavioral Reviews 128 (2021): 199–217. Use for: Predictive processing, the brain as a prediction machine, meditation loosening automatic models, and the “veil” argument.Lutz, Antoine, Julie Brefczynski-Lewis, Tom Johnstone, and Richard J. Davidson. “Regulation of the Neural Circuitry of Emotion by Compassion Meditation: Effects of Meditative Expertise.” PLOS ONE 3, no. 3 (2008): e1897. Use for: Compassion meditation, loving-kindness, emotional circuitry, and training compassion as a repeatable state rather than just a moral idea.Kok, Bethany E., Kimberly A. Coffey, Michael A. Cohn, Lahnna I. Catalino, Tanya Vacharkulksemsuk, Sara B. Algoe, Marc A. Brantley, and Barbara L. Fredrickson. “How Positive Emotions Build Physical Health: Perceived Positive Social Connections Account for the Upward Spiral Between Positive Emotions and Vagal Tone.” Psychological Science 24, no. 7 (2013): 1123–1132. Use for: Loving-kindness, social connection, vagal tone, and the cautious “social nervous system” bridge.Black, David S., and George M. Slavich. “Mindfulness Meditation and the Immune System: A Systematic Review of Randomized Controlled Trials.” Annals of the New York Academy of Sciences 1373, no. 1 (2016): 13–24. Use for: Immune-system caution, inflammation markers, cell-mediated immunity, biological aging, and why this material should be framed as tentative rather than miracle healing.Burić, Ivana, Miguel Farias, Jonathan Jong, Christopher Mee, and Inti A. Brazil. “What Is the Molecular Signature of Mind–Body Interventions? A Systematic Review of Gene Expression Changes Induced by Meditation and Related Practices.” Frontiers in Immunology 8 (2017): 670. Use for: Stress biology, inflammatory gene expression, NF-kB-related language, and the cautious claim that mind-body practices may affect biology below ordinary mood.Also want to remind people about the website, if you're into reading we have tons of information by multiple contributors, and we got t-shirts up on the site if you're interested. Fun fact, the art is all based on the eyeball. A

La dernière fois que je me suis fait une bonne bouffe, une question a popé dans ma tête : les aliments, ils viennent d'où ? D'où arrivent les tomates, patates, échalotes, haricots, prunes et pêches qu'on mange, est-ce que tout ça poussait miraculeusement en Europe dès la Préhistoire ? Eh bien sans surprise, c'est non ! En fait, beaucoup de fruits et de légumes ont leur propre histoire et leur propre géographie ! Alors on se lance au cœur de la marmite pour enquêter sur leurs origines, toutes passionnantes !Bonne écoute !

You’re listening to American Ground Radio with Louis R. Avallone and Stephen Parr. This is the full show for June 11, 2026. We open with one of the most disturbing stories we've covered — federal officials have located 146,000 unaccompanied migrant children who entered the country during the Biden administration and disappeared into a broken government tracking system. Nearly half a million unaccompanied children were transferred into federal custody between 2019 and 2023, and the government lost track of three out of every four of them. Over 32,000 failed to appear for immigration court hearings — children who legally don't even have the capacity to be responsible for that. We point out that some sponsors used the same addresses and names over and over to claim multiple children — a hallmark of trafficking networks — and that acting Attorney General Todd Blanch confirmed this program was exploited for sexual assault and trafficking. We make the case that this level of failure isn't incompetence. It's a feature, not a bug, of an administration that prioritized volume over accountability — and we ask where these children go to get their childhoods back. In our Top 3 Things You Need to Know, President Trump paused another round of attacks on Iran after announcing a breakthrough in negotiations, with a final deal expected to be signed in Europe as early as this weekend — including guarantees Iran will never possess a nuclear weapon and that the Strait of Hormuz will reopen to shipping without Iranian tolls. Then the CEO of ActBlue refused to answer questions during a congressional hearing, repeatedly citing attorney-client privilege and Fifth Amendment protections amid allegations of fraudulent campaign donations including foreign contributions. And a Michigan court overturned the conviction of one of the men accused of plotting to kidnap Governor Gretchen Whitmer in 2020, ruling that kidnapping isn't a violent felony under Michigan's terrorism statute — we revisit the role the FBI itself played in organizing that plot. We also cover New York City Mayor Zoran Mamdani attending the NBA Finals at Madison Square Garden with a roughly $1,000 standing-room ticket — despite running a campaign built on taxing the wealthy and claiming he'd have to move back in with his parents due to financial strain. We make the broader point about socialism and its leaders — the people at the top always seem to find their way to the good seats while telling everyone else to live within their needs. Our American Mamas Teri Netterville and Kimberly Burleson tackle the question of whether MAGA is dead, as several prominent former Trump-aligned commentators have recently suggested. They point to Trump-endorsed candidates sweeping primaries in South Carolina, Louisiana, and Texas as evidence the movement is alive and well, and discuss the pattern of high-profile pundits — Megyn Kelly, Tucker Carlson, Candace Owens — making abrupt reversals after years of consistency, while Trump's messaging has remained the same. They draw a comparison to Ann Coulter's earlier break with Trump over the border wall timeline, suggesting some of these breaks come from single-issue voters whose patience ran out on one specific promise. We dig into the controversy over whether ICE enforcement should pause during the World Cup — with activists arguing that immigration enforcement makes undocumented immigrants feel unsafe attending games. We point out the absurdity by comparison — nobody argues pickpocketing laws should be suspended during the Super Bowl. In our Digging Deep segment, we cover the case of a Somali World Cup referee who was denied entry into the United States after Customs and Border Protection flagged his connections to Al-Shabaab, an Al-Qaeda affiliate — and his own social media posts containing antisemitic statements. We walk through why this isn't about ethnicity, despite Al-Shabaab itself issuing a statement calling it racial discrimination, and why a country has every right to keep people connected to designated terrorist organizations out, regardless of their profession. We also cover the first arrest from a new federal fraud task force's top-10 most-wanted list — a $100 million bank fraud case in Orange County involving falsified title insurance documents and altered digital metadata. For our Bright Spot, a new study out of the University of Maryland School of Medicine and published in the Annals of Family Medicine found that patients who received five minutes of intercessory prayer — including the laying on of hands — experienced significantly greater pain and anxiety reduction than those who listened to faith music or meditation, with benefits lasting up to six weeks. Remarkably, the results held regardless of whether the patient receiving prayer was a believer — what mattered was the faith of the person doing the praying. We connect it to the biblical example of the centurion asking Jesus to heal his servant, and note that researchers are now suggesting intercessory prayer become standard medical practice. And we close with Jimmy Kimmel mocking Spencer Pratt over losing his home in the LA wildfires by renting him a U-Haul — which we call exactly what it is, shameful — and the congressional baseball game, where Republicans beat Democrats 11-2, with Florida Rep. Greg Steube striking out five batters and Missouri Senator Eric Schmitt named MVP for a diving catch that left him bloodied. May your pursuit of happiness bring you joy. Listen now wherever you get your podcasts, visit AmericanGroundRadio.com, and join the conversation at 866-AGR-1776!See omnystudio.com/listener for privacy information.

CardioNerds (Drs. Rawan Amir, Tripti Gupta, and Alysha Joseph) discuss the fundamentals of adult congenital heart disease (ACHD) surgery with Dr. Elizabeth Stephens.  Audio editing by CardioNerds academy intern, Grace Qiu.  Using a case of a young adult undergoing a Ross procedure, the episode walks through what happens in the operating room—from induction and intraoperative transesophageal echocardiography (TEE) to cardiopulmonary bypass (CPB), myocardial protection, and surgical repair. The discussion highlights key concepts including cardioplegia, cross-clamp and bypass times, hypothermic circulatory arrest, and the complexity of redo sternotomy. This episode provides learners with a practical framework to interpret operative reports, anticipate postoperative physiology, and better collaborate with surgical teams. This episode was produced by the CardioNerds ACHD Council and planned by Dr. Rawan Amir.  CardioNerds Adult Congenital Heart Disease PageCardioNerds Episode Page Pearls “LV distension kills patients.”Preventing left ventricular distension with appropriate venting and awareness of aortic insufficiency is critical to intraoperative safety.  TEE can change the surgical plan in real time.Findings such as underestimated aortic regurgitation, mitral pathology, or a PFO may directly alter cannulation and cardioplegia strategy.  Cross-clamp time = myocardial ischemic time; bypass time = systemic stress.Both are key predictors of postoperative complications including renal injury, bleeding, and ventricular dysfunction.  Redo sternotomy risk is driven by anatomy, not just number.Aorta adherent to the sternum, conduit position, and chamber pressurization define risk more than the number of prior surgeries.  Think longitudinally—ACHD surgery is lifetime planning.Surgical materials and strategies must account for future interventions, especially in younger patients. Notes: Notes drafted by Dr. Alysha Joseph, aided by generative artificial intelligence. What are the key steps in congenital cardiac surgery from incision to closure? Preoperative planning is multidisciplinary, involving surgeon, anesthesia, cardiology, and ICU teams; high-risk inductions (e.g., critical AS, Williams syndrome) are identified early TEE is performed immediately after induction to reassess anatomy and may reveal new findings (e.g., underestimated AI, mitral disease, PFO) Median sternotomy is performed, followed by creation of a pericardial well to optimize exposure Heparin is administered prior to cannulation; arterial and venous cannulas are placed for initiation of CPB Cross-clamp is applied and cardioplegia delivered to arrest the heart, allowing a still and protected operative field Surgical repair (e.g., Ross procedure) is performed, followed by de-airing, cross-clamp removal, and reperfusion Patient is weaned from bypass with TEE reassessment, hemostasis achieved, and chest closed What is cardioplegia and how is it delivered? Cardioplegia is a potassium-rich solution that arrests myocardial activity and reduces metabolic demand Most commonly used solution in the U.S. is Del Nido cardioplegia, originally developed for pediatric myocardium Delivery strategies include: Antegrade (via aortic root) – standard approach  Ostial (direct coronary delivery) – used when aortic root cannot be relied upon  Retrograde (via coronary sinus) – useful in severe AI or coronary disease NOTE: Severe aortic regurgitation can impair antegrade delivery and requires alternative strategies and LV venting  What do cross-clamp time and bypass time represent clinically? Cross-clamp time = duration of myocardial ischemia while the heart is arrested Bypass time = total duration on CPB, reflecting systemic exposure to non-physiologic circulation Prolonged cross-clamp time (>2–3 hours) increases risk of myocardial dysfunction, especially with poor baseline function Longer bypass time is associated with increased risk of renal injury, coagulopathy, and bleeding These metrics often reflect both case complexity and intraoperative challenges What is hypothermic circulatory arrest (HCA) and when is it used? HCA involves complete cessation of blood flow to allow a bloodless surgical field Typically used in complex aortic arch repairs Patients are cooled to ~18°C to reduce metabolic demand and protect organs Duration is ideally limited to

In this powerful episode of Master Your Marriage, Sharla and Robert Snow explore one of the most misunderstood topics in relationships: forgiveness. They revisit the subject with fresh insights, addressing common misconceptions, the crucial difference between forgiveness and reconciliation, and when it might actually be wise to move slowly on reconciliation — while still choosing internal peace.Through personal stories (including Sharla's transformational experience with ho'oponopono), real client examples, and science-backed research, you'll discover how forgiveness is something you do for yourself — not for the offender. Learn how to let go of resentment without losing your boundaries or compromising your safety.Whether you're working through a small rupture or a deep wound, this episode offers clarity, hope, and practical tools to help you find freedom.Key Takeaways:Forgiveness is an internal process — it does not mean forgetting, excusing, or reconciling.You can forgive someone and still maintain strong boundaries (or even choose not to reconcile).Your peace does not have to wait for the other person to change — that's living at cause.Unforgiveness carries real physical and mental health costs, but forgiveness offers powerful benefits.Resources Mentioned:Companion Episode: Ho'oponopono Forgiveness Meditation (available on Spotify & Apple Podcasts) and available here!Research & Further Reading:Toussaint, L. L., et al. (2016). “Forgiveness, Stress, and Health: A 5-Week Dynamic Parallel Process Study.” Annals of Behavioral Medicine. PubMed Abstract | Full Text (PMC)Toussaint, L. L., et al. (2016). “Effects of Lifetime Stress Exposure on Mental and Physical Health in Young Adulthood: How Stress Degrades and Forgiveness Protects Health.” Journal of Health Psychology. PubMed Abstract | PDFEnright's Process Model of Forgiveness: International Forgiveness InstituteConnect With Us:Website: masteryourmarriage.usSubscribe on your favorite podcast app and leave a 5-star review — it helps us reach more couples!Follow us on social media @MasterYourMarriage

On August 12, 1984, 13-year-old Eugene Wade Martin vanished while delivering newspapers in Des Moines, Iowa. Just two years earlier, another paperboy, Johnny Gosch, disappeared under eerily similar circumstances only miles away. Despite extensive investigations, countless theories, and decades of speculation, neither boy has ever been found. In Part One of The Paper Boy Abductions, I walk you through the mysterious disappearance of Eugene Martin, the haunting parallels to Johnny Gosch's case, and the questions that continue to surround two of Iowa's most infamous unsolved child disappearances.Anyone with information about Eugene Martin is asked to call Det. Jeff Shannon at the Des Moines Police Department at (515) 283-4864. You may also call Det. Larry Penland at (515) 237-1550.Connect with us on Social Media!You can find us at:Instagram: @bookofthedeadpodX: @bkofthedeadpodFacebook: The Book of the Dead PodcastTikTok: BookofthedeadpodOr visit our website at www.botdpod.comAlex, T. (1984, August 16). Branstad gives moral support to Martin family. The Des Moines Register, 15A.Alex, T. (2001, September 3). Officer who investigated missing carrier retires. The Des Moines Register, 2B.Beedle, D. (2020, September 15). Eugene Wade Martin. Find a Grave. https://www.findagrave.com/memorial/215645180/martinCOLD CASE SPOTLIGHT: Johnny Gosch. (2015, June 11). NBC News. https://www.nbcnews.com/feature/cold-case-spotlight/cold-case-spotlight-johnny-gosch-n234291D.M. police don't know where to search. (1984, August 19). The Des Moines Register, 1B-3B.EUGENE WADE MARTIN | Missing Person Information Clearinghouse. (n.d.). https://missingpersons.iowa.gov/divisions/criminal-investigation/missing-persons/eugene-wade-martinGene didn't run away. . .his birthday was coming. (1984, September 2). The Des Moines Register, 1A-7A.Iowa Cold Cases, Inc. (2026, March 28). Eugene Martin | Iowa Cold cases. Iowa Cold Cases. https://iowacoldcases.org/case-summaries/eugene-martin/Krenz, A. (2015, November 6). Eugene Martin case remains open after 31 years. weareiowa.com. https://www.weareiowa.com/article/news/local/eugene-martin-case-remains-open-after-31-years/524-02cb76a5-43bd-4297-af0d-5275df5aee9eMokrzycki, P. (2015). Lost in the Heartland: Childhood, Region, and Iowa's Missing Paperboys. Annals of Iowa, 74(1), 29–69. https://doi.org/10.17077/0003-4827.12170Santiago, F. (1997, August 27). Gosch lives, mom is told. The Des Moines Register, 2A.Santiago, F., & Alex, T. (1994, August 22). Private eye believes Martin disappearance was planned. The Des Moines Register, 2A.Sederstrom, J. (2024, August 22). Why don't missing kids appear on milk cartons anymore? Oxygen. https://www.oxygen.com/the-girl-on-the-milk-carton/crime-news/why-dont-missing-kids-appear-on-milk-cartons-anymoreShort, M. (2025, June 7). Eugene Martin: 1984 Disappearance of Iowa Paperboy Still Unsolved. Medium. https://medium.com/bizarre-unsolved-cases/eugene-martin-1984-disappearance-of-iowa-paperboy-still-unsolved-27d88991a6c1Smith, G. (1985, August 10). Eugene Martin case no closer to solution. The Cedar Rapids Gazette, 5A.Suk, T. (1990, March 27). D.M. officers follow Martin case to Mexico. The Des Moines Register, 9.Tauscheck, M. (2017, October 9). Eugene Martin's brother talks about hope case will be solved. KCCI. https://www.kcci.com/article/eugene-martin-s-brother-talks-about-hope-case-will-be-solved/6923136The Associated Press. (1985, February 10). Parents heat up search. Quad City Times, 8A.The disappearance of Eugene Martin. (2025, April 14). Crime and Coffee Couple. https://crimeandcoffeecouple.wordpress.com/2024/07/11/the-disappearance-of-eugene-martin/The National Missing and Unidentified Persons System (NAMUS). (n.d.). NamUs.gov. https://www.namus.gov/MissingPersons/Case#/6348?navVanBaale, K. W. (2025, September 22). The Legacy of the Paperboy Abductions | A&E. AETV. https://www.aetv.com/articles/paperboy-abductions-milk-cartonIf you enjoyed the episode, consider leaving a review or rating! It helps more than you know! If you have a case suggestion, or want attention brought to a loved one's case, email me at bookofthedeadpod@gmail.com with Case Suggestion in the subject line.Stay safe, stay curious, and stay vigilant.

DAVID BEKÄNNER FÄRG. "Alla" älskar djup färg på whisky, men vad är det egentligen som ger whiskyn kulör? Era poddare sätter tänderna i Davids senaste text i ämnet, pratar torktider på ek, portvin, och till Mathias ohöljda förtjusning (not): En ny skala signerad Edinburgh Whisky Academy. Men det är lugnt: skalan har bara 21 steg. Eller 22. Lite kaffekask-cask-whisky på det? Vad var det i glaset? Mathias smakade något som han inte tror var whisky, tack till Ulf Thorman och kom gärna med facit; David drack en fegis, det vill säga en folköl; Jeroen hade även han en blind från Ulf Thorman. Färg i whisky! Davids långa bloggtext om färger i whisky: http://tjederswhisky.se/farger-i-whisky/ Citatet från det gamla avsnittet Hennes färger var E150a som ni kan lyssna på här: https://www.entreawhisky.se/3 Edinburgh whisky academy: https://www.edinburghwhiskyacademy.com/ Deras bild på färgskalan är faktiskt mest högupplöst på Davids blogg: http://tjederswhisky.se/wp-content/uploads/2026/06/EWA_Colour-Guide_page-0001-2048x914.jpg Rejält eknördig artikel för den skogstokige: Prida, Andrei, Alexis Ducousso A, Rémy J. Petit, Gérard Nepveu & Jean-Louis Puech, ”Variation in wood volatile compounds in a mixed oak stand: strong species and spatial differentiation in whisky-lactone content”, Annals of Forest Science 64 (2007), s. 313–320. De mycket likartade färgerna på de tre portvinslagringarna kan man studera här – är inte till och med Amruts fyraåring något mörkare än de andra…?: http://tjederswhisky.se/wp-content/uploads/2026/06/Port-10-11-4-scaled.jpg Det där med gobelängerna och Erasmus av Rotterdam kan man läsa om i historikern Norbert Elias mycket inflyteslerika tvåbandsverk Sedernas historia. Julmust cask finish : http://tjederswhisky.se/santa-18/; de gjorde sedan om konceptet i en senare utgåva, se http://tjederswhisky.se/santa-20-21-22-23/ Kaffekask cask finish: http://tjederswhisky.se/bergslagens-kaffekask-cask-finish/ Nya etiketter visar storytelling? Snygga etiketter på nya Glenfiddich men jösses jävlar vilken mundiarré i pressreleasen: https://www.mynewsdesk.com/se/nigab/news/vaerldens-mest-prisbeloenta-whisky-faar-ny-identitet-509915 Här når du oss: En trea whisky på Facebook Maila till oss på hej@entreawhisky.se Davids blogg tjederswhisky.se Följ oss på Instagram: https://www.instagram.com/entreawhisky Bli medlem! https://entreawhisky.memberful.com/checkout?plan=74960

A headline like “weight loss drugs may reduce breast cancer risk” grabs attention fast, but the real story lives in the fine print. We take you through a new Penn Medicine study that observed lower breast cancer rates among women with overweight or obesity who used GLP-1 medications, then we translate what that finding actually means in plain language. Observational data can reveal a signal worth studying, but it cannot prove the medication caused the outcome, and that distinction matters for your decisions and your expectations. We also zoom out to the bigger why: obesity is not just about body size. Fat tissue is biologically active, shaping chronic inflammation, estrogen exposure after menopause, insulin resistance, and even how well the immune system spots abnormal cells. Those pathways help explain why obesity is linked to many cancers, including postmenopausal breast cancer, and why researchers are curious whether effective obesity treatment could shift risk over time. Then we get practical. We review what stronger evidence from randomized controlled trials says so far: GLP-1 drugs like Ozempic, Wegovy, Mounjaro, and Zepbound do not appear to increase breast cancer risk in the available trial data, even though most trials were not designed to study cancer outcomes for many years. We also discuss why newer studies seem most suggestive for hormone receptor positive breast cancer, along with the leading theories: weight loss itself, improved metabolic health and insulin signaling, reduced inflammation, and the still-unclear possibility of direct GLP-1 effects in cancer biology. If you like evidence-based medicine with real-world context (and a little Philly-life banter), subscribe, share this episode with a friend, and leave a review so more people can find the show. What question do you want answered next about GLP-1s, obesity treatment, or cancer risk?ReferencesRisk for Cancer With Glucagon-Like Peptide-1 Receptor Agonists and Dual Agonists : A Systematic Review and Meta-Analysis. Ko A, Chang YC, Bahar F, et al. Annals of Internal Medicine. 2025;. doi:10.7326/ANNALS-25-02237.Do GLP-1 Receptor Agonists Increase the Risk of Breast Cancer? A Systematic Review and Meta-Analysis. Piccoli GF, Mesquita LA, Stein C, et al. The Journal of Clinical Endocrinology and Metabolism. 2021;106(3):912-921. doi:10.1210/clinem/dgaa891.Glucagon-Like Peptide 1 Receptor Agonists and Cancer Risk: The Good, the Bad and the Unknown. Mannucci E, Dicembrini I. Nature Reviews. Clinical Oncology. 2026;23(6):459-470. doi:10.1038/s41571-026-01135-0.GLP-1 Agonists Are Associated With a Significant Reduction in Breast Cancer Incidence in Women. McDonald ES, Gillis LB, Gabriel P, et al. JCO Oncology Practice. 2026;:101200OP2600485. doi:10.1200/OP-26-00485.GLP-1 therapy and hormone receptor–positive breast cancer risk and survival: A real-world analysis.. Shah Z, Hundal J, Afridi S, et al. Journal of Clinical Oncology. 2026;44(Suppl 16):10548. doi:10.1200/JCO.2026.44.16_suppl.10548.Survival and Recurrence With GLP-1 Receptor Agonists in Breast Cancer. Tatum KL, Dahman B, Stevenson A, et al. JAMA Network Open. 2026;9(5):e2612133. doi:10.1001/jamanetworkopen.2026.12133.Association of Glucagon-Like Peptide-1 Receptor Agonists With Risk of Cancers-Evidence From a Drug Target Mendelian Randomization and Clinical Trials. Sun Y, Liu Y, Dian Y, et al. International Journal of Surgery (London, England). 2024;110(8):4688-4694. doi:10.1097/JS9.0000000000001514.GLP-1 receptor agonists and breast cancer risk in type 2 diabetes.. Guo Cheng and Amanda Ward. Journal of Clinical Oncology. 2025;43(Suppl 16):10557. doi:10.1200/JCO.2025.43.16_suppl.10557.Glucagon-Like Peptide-1 Analogues and Risk of Breast Cancer in Women With Type 2 Diabetes: Population Based Cohort Study Using the UK Clinical Practice Research Datalink. Hicks BM, Yin H, Yu OH, et al. BMJ (Clinical Research Ed.). 2016;355:i5340. doi:10.1136/bmj.i5340.GLP-1 Receptor Agonists and Cancer: Current Clinical Evidence and Translational Opportunities for Preclinical Research. Valencia-Rincón E, Rai R, Chandra V, Wellberg EA. The Journal of Clinical Investigation. 2025;135(21):e194743. doi:10.1172/JCI194743.Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply.Support the showProduction and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RNArtwork Rebrand and Avatars:Vantage Design Works (Vanessa Jones) Website: https://www.vantagedesignworks.com/Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qrOriginal Artwork Concept: Olivia Pawlowski

Listener discretion is advised!!! References: Gabayan, G. Z., Gould, M. K., Weiss, R. E., Patel, N., Donkor, K. A., Chiu, V. Y., Yiu, S. C., Jones, J. P., Hoffman, J. R., & Sarkisian, C. A. (2016). Poor Outcomes After Emergency Department Discharge of the Elderly: A Case-Control Study. Annals of Emergency Medicine, 68(1), 43–51.e2. Ganetsky M, Lopez G, Coreanu T, Novack V, Horng S, Shapiro NI, Bauer KA. Risk of Intracranial Hemorrhage in Ground-level Fall With Antiplatelet or Anticoagulant Agents. Acad Emerg Med. 2017 Oct;24(10):1258-1266. Gokhroo, R. K., Ranwa, B. L., Kishor, K., et al. (2015). Sweating: A Specific Predictor of ST‐Segment Elevation Myocardial Infarction Among the Symptoms of Acute Coronary Syndrome: Sweating In Myocardial Infarction (SWIMI) Study Group. Clinical Cardiology, 39, 90–95. Knack SKS, Scott N, Driver BE, Prekker ME, Black LP, Hopson C, Maruggi E, Kaus O, Tordsen W, Puskarich MA. Early Physician Gestalt Versus Usual Screening Tools for the Prediction of Sepsis in Critically Ill Emergency Patients. Ann Emerg Med. 2024 Sep;84(3) Koo, A. (Oct 29, 2024). Putting Clinical Gestalt to Work in the Emergency Department. Available: https://www.acepnow.com/article/putting-clinical-gestalt-to-work-in-the-emergency-department/5/?singlepage=1 Long, B., Keim, S. M., Gottlieb, M., Carlson, J., Bedolla, J., & Reisdorff, E. J. (2024). Can I Discharge This Adult Patient with Abnormal Vital Signs From the Emergency Department? The Journal of Emergency Medicine, 67(4), e487–e493. Milner, K. A., Funk, M., Arnold, A., & Vaccarino, V. (2002). Typical symptoms are predictive of acute coronary syndromes in women. American Heart Journal, 143, 283–288.

Welcome to this week's Midlife Minute. Today, I'm focusing on all the questions I received about gallbladder health, including HRT-provoking symptoms, supplements that improve gallbladder health, and evidence-based food interventions. IN THIS EPISODE, YOU WILL LEARN: Why the risk of gallstones and gallbladder inflammation increases during the menopause transition How estrogen and progesterone HRT have different effects on gallbladder functioning The differences in risk between transdermal and oral HRT How the progesterone in HRT can cause gallbladder issues in some women What TUDCA is, and how it supports gallbladder health The value of TUDCA for women who have had their gallbladders removed How various nutrients and supplements support bile flow and gallbladder health What can contribute to gallstone formation Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com  Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.  Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Gallbladder Research: Cabrera D, Arab JP, Arrese M. UDCA, NorUDCA, and TUDCA in liver diseases: a review of their mechanisms of action and clinical applications. Seminars in Liver Disease. 2019;39(4):397–404. doi:10.1055/s-0039-1696799  Vang S, Longley K, Steer CJ, Low WC. The unexpected uses of urso- and tauroursodeoxycholic acid in the treatment of non-liver diseases. Global Advances in Health and Medicine. 2014;3(3):58–69. doi:10.7453/gahmj.2014.017  Bai M, Yang L, Liao H, et al. Tauroursodeoxycholic acid improves nonalcoholic fatty liver disease by regulating gut microbiota and bile acid metabolism. Journal of Agricultural and Food Chemistry. 2024;72(41):22655–22668. doi:10.1021/acs.jafc.4c04630  Simon JA, Hudes ES. Relation of serum ascorbic acid to serum vitamin B12, serum ferritin, and kidney stones in US adults. *Archives of Internal Medicine.*1999;159(6):619–624. doi:10.1001/archinte.159.6.619  Walcher T, Haenle MM, Kron M, et al. Vitamin C supplement use may protect against gallstones: an observational study on a randomly selected population. BMC Gastroenterology. 2009;9:74. doi:10.1186/1471-230X-9-74  Tsai CJ, Leitzmann MF, Willett WC, Giovannucci EL. Long-term intake of dietary fiber and decreased risk of cholecystectomy in women. American Journal of Gastroenterology. 2004;99(7):1364–1370. doi:10.1111/j.1572-0241.2004.30281.x  Leitzmann MF, Stampfer MJ, Willett WC, Spiegelman D, Colditz GA, Giovannucci EL. Coffee intake is associated with lower risk of symptomatic gallstone disease in women. Gastroenterology. 2002;123(6):1823–1830. doi:10.1053/gast.2002.37085  Moerman CJ, Smeets FW, Kromhout D. Dietary risk factors for clinically diagnosed gallstones in middle-aged men — a 25-year follow-up study. Annals of Epidemiology. 1994;4(3):248–254. doi:10.1016/1047-2797(94)90099-x Association between dietary magnesium intake and gallstones: the mediating role of atherogenic index of plasma. Lipids in Health and Disease. 2024;23(1):82. doi:10.1186/s12944-024-02074-4  Pitt HA, Doty JE, Murphy MM, Schwarz MB. Progesterone alters biliary flow dynamics. Annals of Surgery. 1999;229(2):205–209. doi:10.1097/00000658-199902000-00008

The Enhanced Games, hosted in Las Vegas last Saturday, made a bold claim. With the use of performance-enhancing drugs, enhanced athletes would break not just personal records but world records.  And the end goal? To sell those same drugs to the masses.  It's arguably the biggest marketing stunt of the year so far, and today on Nudge I reveal the psychology behind it.  Did the Enhanced Games succeed? Listen to find out.  --- Unlock the Nudge Vaults: https://www.nudgepodcast.com/vaults Subscribe to my newsletter: https://www.nudgepodcast.com/mailing-list  Connect on LinkedIn: https://www.linkedin.com/in/phill-agnew/  --- Today's sources  Landy, D., & Sigall, H. (1974). Beauty is talent: Task evaluation as a function of the performer's physical attractiveness. Journal of Personality and Social Psychology, 29(3), 299–304. Miller, A. G. (1970). Role of physical attractiveness in impression formation. Psychonomic Science, 19(4), 241–242. Mujika, I., & Burke, L. M. (2019). Swimming fast when it counts: A 7-year analysis of Olympic and World Championships performance. International Journal of Sports Physiology and Performance. Nicolau, J. L., Mellinas, J. P., & Martín-Fuentes, E. (2020). The halo effect: A longitudinal approach. Annals of Tourism Research, 83, 102938. Nisbett, R. E., & Wilson, T. D. (1977). The halo effect: Evidence for unconscious alteration of judgments. Journal of Personality and Social Psychology, 35(4), 250–256.

Links For The Occult Rejectshttps://linktr.ee/theoccultrejectsOccult Research Institutehttps://www.occultresearchinstitute.org/Substackhttps://substack.com/@theoccultrejects?r=7auau0&utm_campaign=profile&utm_medium=profile-pageCash Apphttps://cash.app/$theoccultrejectsVenmo@TheOccultRejectsBuy Me A Coffeebuymeacoffee.com/TheOccultRejectsPatreonhttps://www.patreon.com/TheOccultRejectsPart 1: The Road of RhythmPart 1 focuses on the drum as an ancient technology of altered consciousness. The argument is not that every beat causes trance, or that neuroscience has proven spirits. The stronger argument is that rhythm enters the human organism through hearing, motor prediction, breath, movement, attention, emotion, expectation, culture, and social synchrony. The drum becomes powerful when sound, body, group, ritual frame, and meaning converge. These sources support the archaeology, neuroscience, EEG research, shamanic studies, possession studies, Indigenous and culturally specific drum traditions, ritual theory, placebo and meaning-response research, ceremonial magic, and modern witchcraft material used in the episode.Core Academic and Scientific SourcesHuels, Emma R., Hyoungkyu Kim, UnCheol Lee, Tirsa Bel-Bahar, Ana V. Colmenero, Alexandra Nelson, Stefanie Blain-Moraes, George A. Mashour, and Richard E. Harris. “Neural Correlates of the Shamanic State of Consciousness.” Frontiers in Human Neuroscience 15 (2021): 610466. Use for the strongest modern EEG anchor. This study used high-density EEG with shamanic practitioners and controls during rest, shamanic drumming, and classical music listening. It assessed altered-state reports alongside brain measures such as power, connectivity, signal diversity, and criticality. Use carefully: the study does not prove spirits or show that drumming mechanically causes trance in everyone. It supports the more careful claim that trained practitioners entering shamanic states with drumming show measurable brain-state differences.Gordon, Yoel, Golan Karvat, Noa Dagan, and Ayelet N. Landau. “Neural Tracking at Theta Predicts Drumming-Induced Altered States of Consciousness.” Scientific Reports 16, no. 1 (2026): Article 10204. Use for the strongest updated drumming/theta/neural-tracking source. This study tested drumming at theta, delta, and alpha-rate rhythms while recording EEG, and found that stronger rhythmic neural tracking at theta was linked to stronger altered-experience reports. Use carefully: this does not mean theta equals the spirit world or that one frequency opens a portal. The serious point is that altered experience may depend partly on how strongly the nervous system tracks rhythmic stimulation.Aparicio-Terrés, R., et al. “The Neurobiology of Altered States of Consciousness Induced by Drumming and Other Rhythmic Sound Patterns.” Annals of the New York Academy of Sciences, 2025. Use for the newer review literature showing that rhythmic sound is now a serious altered-consciousness research topic. This supports the opening claim that modern academia is examining drumming, rhythmic sound, absorption, relaxation, cognition, and neural activity without reducing the subject to one simple “trance frequency.” The review is especially useful for framing the field as promising but still complex.Neher, Andrew. “Auditory Driving Observed with Scalp Electrodes in Normal Subjects.” Electroencephalography and Clinical Neurophysiology 13 (1961): 449–451. Use for the historical bridge between repetitive sound, EEG, auditory driving, and early scientific interest in rhythmic stimulation.Neher, Andrew. “A Physiological Explanation of Unusual Behavior in Ceremonies Involving Drums.” Human Biology 34, no. 2 (1962): 151–160. Use carefully. This is useful as an early attempt to connect ceremonial drumming and physiology, but it should be balanced with Rouget because the “drum simply causes trance” argument is too mechanical.Maurer, R., V. K. Kumar, L. Woodside, and R. J. Pekala. “Phenomenological Experience in Response to Monotonous Drumming and Hypnotizability.” American Journal of Clinical Hypnosis 40, no. 2 (1997): 130–145. Use for monotonous drumming, subjective altered experience, imagery, absorption, and hypnotizability.Maxfield, Melinda C. “Effects of Rhythmic Drumming on EEG and Subjective Experience.” PhD diss., Institute of Transpersonal Psychology, 1990. Use as older supporting context on drumming, EEG, imagery, body-image changes, and subjective altered experience. Do not make this the main scientific proof; use it as background.Nozaradan, Sylvie, Isabelle Peretz, and André Mouraux. “Tagging the Neuronal Entrainment to Beat and Meter.” The Journal of Neuroscience 31, no. 28 (2011): 10234–10240. Use for EEG evidence that the brain can track beat and meter. This supports the claim that the brain does not merely hear rhythm as background sound; it can represent rhythmic structure in measurable ways.Nozaradan, Sylvie. “Exploring How Musical Rhythm Entrains Brain Activity with Electroencephalogram Frequency-Tagging.” Philosophical Transactions of the Royal Society B 369, no. 1658 (2014). Use as broader rhythm/EEG entrainment support. This helps explain frequency-tagging, beat tracking, meter, neural entrainment, and the measurable relationship between rhythmic structure and brain activity.Thaut, Michael H., Gerald C. McIntosh, and Volker Hoemberg. “Neurobiological Foundations of Neurologic Music Therapy: Rhythmic Entrainment and the Motor System.” Frontiers in Psychology 5 (2015). Use for rhythm as motor-system timing information. This supports the claim that a beat can become bodily instruction, not just sound for the ear. Especially useful when discussing rhythmic auditory stimulation, motor planning, gait, entrainment, and the auditory-motor bridge.Ross, Jessica M., John R. Iversen, and Ramesh Balasubramaniam. “Time Perception for Musical Rhythms: Sensorimotor Perspectives on Entrainment, Simulation, and Prediction.” 2022. Use for rhythm, timing, prediction, sensorimotor entrainment, and the way musical rhythm interacts with time perception.Hove, Michael J., and Jane L. Risen. “It's All in the Timing: Interpersonal Synchrony Increases Affiliation.” Social Cognition 27, no. 6 (2009): 949–960. Use for synchrony and social bonding. This helps support the group-body argument: moving or acting in time with others can increase affiliation.Wiltermuth, Scott S., and Chip Heath. “Synchrony and Cooperation.” Psychological Science 20, no. 1 (2009): 1–5. Use for the claim that synchronized movement can increase cooperation and attachment among participants.Tarr, Bronwyn, Jacques Launay, and Robin I. M. Dunbar. “Music and Social Bonding: ‘Self-Other' Merging and Neurohormonal Mechanisms.” Frontiers in Psychology 5 (2014): 1096. Use for music, synchrony, bonding, endorphin/social mechanisms, and why group rhythm can feel like more than private listening.Fancourt, Daisy, Rosie Perkins, Sara Ascenso, Louise Atkins, Fatima Kilfeather, and Aaron Williamon. “Effects of Group Drumming Interventions on Anxiety, Depression, Social Resilience and Inflammatory Immune Response among Mental Health Service Users.” PLOS ONE 11, no. 3 (2016): e0151136. Use for modern group-drumming research showing psychological and physiological effects, including anxiety, depression, social resilience, wellbeing, and inflammatory immune response. Use carefully: this does not make group drumming a cure-all. It supports the more grounded claim that embodied rhythm and group participation can affect mood, social connection, and body chemistry.Bittman, Barry B., et al. “Composite Effects of Group Drumming Music Therapy on Modulation of Neuroendocrine-Immune Parameters in Normal Subjects.” Alternative Therapies in Health and Medicine 7, no. 1 (2001): 38–47. Use as older supporting material on group drumming and neuroendocrine-immune measures. Keep secondary. Fancourt is cleaner for the main script body.Archaeology and Deep History of DrumsLawergren, Bo. “Neolithic Drums in China.” In Music Archaeology in China. 2006. Use for clay drums in Neolithic China and the deep-history claim that drums are not just poetic symbols of antiquity. They appear in the archaeological record as instruments tied to early sound-making, ceremony, and social order.Both, Arnd Adje. “Music Archaeology: Some Methodological and Theoretical Considerations.” Use as general support for why ancient instruments should be treated as ritual and social evidence, not merely decorative objects.Anthropology, Ethnomusicology, Ritual, and TranceRouget, Gilbert. Music and Trance: A Theory of the Relations Between Music and Possession. Translated by Brunhilde Biebuyck. Chicago: University of Chicago Press, 1985. Essential source. Use for the caution that music does not mechanically or universally cause trance. Rouget helps keep the argument academically serious by emphasizing culture, ritual frame, meaning, and expectation.Becker, Judith. Deep Listeners: MAlso want to remind people about the website, if you're into reading we have tons of information by multiple contributors, and we got t-shirts up on the site if you're interested. Fun fact, the art is all based on the eyeball. A

Listener discretion is advised! References: Buttner & Arlanger. (May 3, 2022). ST depression does not localise. Available: https://litfl.com/st-depression-does-not-localise/ Cannon, J. W., Khan, M. A., Raja, A. S., et al. (2017). Damage control resuscitation in patients with severe traumatic hemorrhage. Journal of Trauma and Acute Care Surgery, 82, 605-617. Kabra, R., Acharya, S., Kamat, S., & Kumar, S. (2022). ST-Segment Elevation in Lead aVR With Global ST-Segment Depression: Never Neglect Left Main Coronary Artery (LMCA) Occlusion. Cureus. Lee, G.-K., Hsieh, Y.-P., Hsu, S.-W., Lan, S.-J., & Soni, K. (2019). Value of ST‐segment change in lead aVR in diagnosing left main disease in Non‐ST‐elevation acute coronary syndrome—A meta‐analysis. Annals of Noninvasive Electrocardiology, 24. Morrison, C. A., Carrick, M. M., Norman, M. A., et al. (2011). Hypotensive Resuscitation Strategy Reduces Transfusion Requirements and Severe Postoperative Coagulopathy in Trauma Patients With Hemorrhagic Shock: Preliminary Results of a Randomized Controlled Trial. Journal of Trauma: Injury, Infection & Critical Care, 70, 652-663. Rossaint, R., Afshari, A., Bouillon, B., et al. (2023). The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Critical Care, 27. Tamura, A. (2014). Significance of lead aVR in acute coronary syndrome. World Journal of Cardiology, 6(7), 630. Uthamalingam, S., Zheng, H., Leavitt, M., Pomerantsev, E., Ahmado, I., Gurm, G. S., & Gewirtz, H. (2011). Exercise-Induced ST-Segment Elevation in ECG Lead aVR Is a Useful Indicator of Significant Left Main or Ostial LAD Coronary Artery Stenosis. JACC: Cardiovascular Imaging, 4, 176–186. Weymouth, W., Long, B., Koyfman, A., & Winckler, C. (2019). Whole Blood in Trauma: A Review for Emergency Clinicians. The Journal of Emergency Medicine, 56, 491-498. Wang, A., Singh, V., Duan, Y., Su, X., Su, H., Zhang, M., & Cao, Y. (2020). Prognostic implications of ST‐segment elevation in lead aVR in patients with acute coronary syndrome: A meta‐analysis. Annals of Noninvasive Electrocardiology, 26.

A life-long treatment for high LDL, a VESALIUS subanalysis, tirzepatide beats semaglutide again, arrhythmia burden in cardiac amyloidosis, and a lipid guideline rebuttal are the topics John Mandrola, MD, discusses in this week'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 Permanent Lipid Lowering therapy Verve 102 Therapy for FH https://www.nejm.org/doi/full/10.1056/NEJMoa2601283 II Vesalius Substudy on PCSK9i Use in Patients With Previous PCI VESALIUS Subgroup Analysis https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.126.080616 VESALIUS Study - NEJM https://www.nejm.org/doi/full/10.1056/NEJMoa2514428 III Tirzepatide looking to be best again SURPASS-EARLY Trial https://www.acpjournals.org/doi/10.7326/ANNALS-25-05602 SURMOUNT-5 Trial https://www.nejm.org/doi/abs/10.1056/NEJMoa2416394 IV Arrhythmias in Cardiac Amyloidosis Loop Recorders Reveal Arrhythmias in Cardiac Amyloidosis https://www.medscape.com/viewarticle/loop-recorders-reveal-arrhythmias-cardiac-amyloidosis-2026a1000gq9 EXCALIBUR Study https://www.jacc.org/doi/10.1016/j.jacc.2026.04.030 V Lipid Guidelines ·       In Defense of the 2026 Dyslipidemia Guideline https://www.medscape.com/viewarticle/defense-2026-dyslipidemia-guideline-2026a1000hd0 Lipid Guidelines: Four Major Concerns https://www.medscape.com/viewarticle/lipid-guidelines-four-major-concerns-2026a1000fim 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

Every standout book has one thing in common: a strong editorial process behind it.  In this episode of “Inside Independent Publishing (with IBPA),” the Editorial Freelancers Association's Director of Professional Development Asher Rose Fox demystifies what it really takes for independent publishers, author-publishers, and authors to transform a manuscript into a market-ready book—covering every stage of editing, what you can expect to invest, and how to collaborate effectively with editors. If you're serious about publishing a book that readers—and reviewers—take seriously; this is an episode you can't afford to miss. PARTICIPANTS Asher Rose Fox (they/them) has been an editor and activist for over 30 years. A longtime member of the Editorial Freelancers Association, Asher is proud to serve the freelance editing community as the EFA's Director of Professional Development. They've held staff editorial roles at Publishers Weekly, About.com, PCMag, and The Annals of Improbable Research; freelanced for innumerable clients, including Strange Horizons, Popular Mechanics, nonsense nyc, Anesthesiology News, and many individual authors; and volunteered with 10%+, Common Cause, the League of Women Voters, Arisia, Readercon, and Kolot Chayeinu/Voices of Our Lives. Asher has also co-edited the groundbreaking and award-shortlisted anthology Long Hidden, delighted Twitter as GRAMMARHULK, and played a human aerodrome for paper airplanes at the Ig Nobel Awards. They make things better. Independent Book Publishers Association is the largest trade association for independent publishers in the United States. As the IBPA Director of Membership & Member Services, Christopher Locke assists the 4,000 members as they travel along their publishing journeys. Major projects include managing the member benefits to curate the most advantageous services for independent publishers and author publishers; managing the Innovative Voices Program that supports publishers from marginalized communities; and hosting the IBPA podcast, “Inside Independent Publishing (with IBPA).” He's also passionate about indie publishing, because he's an author publisher himself, having published two novels so far in his YA trilogy, The Enlightenment Adventures. LINKS Learn more about the Editorial Freelancers Association at https://www.the-efa.org/ Follow the EFA on: Facebook - https://www.facebook.com/EFAFreelancers Instagram - https://www.instagram.com/efafreelancers/ Bluesky - https://bsky.app/profile/efafreelancers.bsky.social YouTube - https://www.youtube.com/@efa1970/featured?themeRefresh=1 LinkedIn - https://www.linkedin.com/company/efafreelancers/ Follow IBPA on: Facebook – https://www.facebook.com/IBPAonline Instagram - https://www.instagram.com/ibpalovesindies/ LinkedIn: https://www.linkedin.com/company/independent-book-publishers-association This episode is presented by Friesens Corporation. Learn more at https://www.friesens.com/

In this episode, Lillian Erdahl, MD, FACS, is joined by Pringl Miller, MD, FACS, from Physican Just Equity, and Christine Heisler, MD, FACS, from the Mayo Clinic Health System. They discuss Drs Miller and Heisler's recent article, “Whether and How Surgeons Took Action Against Workplace Microaggression: Survey of American College of Surgeons Members,” in which the authors found that the most frequent perpetrator roles were surgeon colleagues and supervisors. A total of 57.4% of surgeons took action, with informal reporting to a colleague and/or directly confronting the perpetrator being most common actions taken. Surgeons who took action were less likely to choose a career in surgery again.   Disclosure Information: Drs Erdahl, Miller, and Heisler have nothing to disclose.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Heisler, Christine A MD, MS, FACS; Godecker, Amy L PhD, MS; Verran, Deborah MbChB, MHSM; Sinha, Michael S MD, JD, MPH; Byam, Jerome MD; Miller, Pringl MD, FACS. Whether and How Surgeons Took Action Against Workplace Microaggression: Survey of the American College of Surgeons Members. Journal of the American College of Surgeons 242(2):p 390-400, February 2026. | DOI: 10.1097/XCS.0000000000001648   Related work: Primary Study: Heisler CA, Godecker AL, Verran D, Sinha MS, Byam J, Miller P. Workplace microaggressions: results of a survey of the American College of Surgeons members. Am J Obstet Gynecol. 2024 Aug;231(2):265.e1-265.e8.   Secondary Study: Heisler CA, Godecker AL, Verran D, Sinha MS, Byam J, Miller P. Impact of Workplace Microaggressions on Surgeon Career Status and Trajectory: A Cross-Sectional Survey Study.  Accepted to the Annals of Surgery Open on April 30, 2026.     The secondary study was also presented at ACS Clinical Congress 2024: Heisler CA, Godecker A, Verran D, Sinha MS, Byam J, Miller P. Workplace Microaggressions and the Impact on a Surgeon's Career Trajectory: Results of a Survey of the American College of Surgeons Members. J Am Coll Surg. October 2024;239(5):S138-139.   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord

Why is it so hard to stop eating ultra-processed foods — even when you know they're hurting you? In Episode 13 of this 16-part series, Dr. Brendan McCarthy explains why the real problem is not just the food itself. The real problem is the loop: Cue or emotional state → Wanting → Bargaining → Consumption → Temporary relief → Crash/regret → Repeat. This episode explores how ultra-processed and hyper-palatable foods become attached to stress, boredom, loneliness, exhaustion, anxiety, and emotional discomfort — training the brain to seek relief through food. Key ideas from this episode: • Hunger is the body asking for nourishment • Wanting is the conditioned brain asking for the expected hit • The food is the bait. The loop is the trap. • The food breaks the feeling. It does not heal the source. • You cannot remove a counterfeit regulator without restoring real regulation. Dr. McCarthy breaks down why willpower alone often fails and why lasting change requires a physiologic off-ramp: stable meals, protein, fiber, hydration, sleep, movement, emotional regulation, cue reduction, social planning, and relapse repair. This is not about “perfect eating.” It is about building a life where food is no longer your primary regulator of stress, comfort, or identity. If you've ever felt trapped in cravings, emotional eating, binge-restrict cycles, or constant food noise, this episode is designed to help you understand the mechanism behind the loop — and how to begin leaving it.

Hosted by Michael Tetreault | Editor-in-Chief, Concierge Medicine Today Episode Overview In one of the most comprehensive episodes in DocPreneur Leadership Podcast history, host Michael Tetreault takes an honest, evidence-based, and encouraging look at the cash-pay and subscription-based primary care landscape — who it serves, how it works, where it's heading, and what every physician and advanced practice clinician needs to understand before making a career-defining decision. This episode doesn't take sides. It takes a clear-eyed look at the full picture — including the parts that don't always make it into the conference keynote. What's Covered in This Episode The Foundation Not all subscription-based primary care models are the same. Two models operating in this space share surface-level similarities but are structurally distinct businesses with different economic logic, different patient populations, and different long-term trajectories. Understanding which one you're considering — and why — changes everything about how you plan. A Lesson From Healthcare History Before committing to any practice model, it helps to understand what happened to the movements that came before it. This episode traces three instructive parallels: the micropractice and ideal medical practice movement of the early 2000s; the decades-long fight for healthcare price transparency and what happened when physicians finally got it; and the rise and reality check of retail health — what scaled, what didn't, and why. The common thread in every model that has achieved durable scale in American healthcare is the same: structural fit with the economic environment, not ideological purity. Two Pathways, One Brand Name The episode walks through both economic models in the cash-pay primary care space — the purist, cash-only, no-insurance model and the employer-integrated model — explaining how each works, who each serves, and what the financial picture actually looks like for physicians considering either path. The revenue math is done out loud. The sustainability data from peer-reviewed research is cited. The patient demographic fit for each model is examined honestly and specifically. Who Each Model Serves — and Where Other Models Fit Better A detailed breakdown of the patient populations each model genuinely serves well — and an honest, evidence-based look at the patient populations where other models may be a better structural fit. Including Medicare-eligible patients, patients with complex chronic disease, lower-income households, and employees of small and mid-sized businesses. The Overlooked Opportunity — NPs, PAs, and Advanced Practice Clinicians One of the most significant and underexplored opportunities in subscription-based healthcare delivery today is the direct-care model as a pathway for nurse practitioners, physician assistants, and other advanced practice clinicians. The evidence on NP and PA-led primary care outcomes is strong and peer-reviewed. The physician shortage projections make the need urgent. And the organizational infrastructure for advanced practice clinician-led direct-care practices is largely unbuilt — which means the opportunity belongs to whoever moves first. The Organizational Landscape An honest look at what the multiplicity of organizations, coalitions, and alliances in the cash-pay primary care space tells us — and what research on professional association dynamics says about the long-term implications of organizational fragmentation for legislative effectiveness and individual practice planning. One Brand, Two Directions Drawing on four documented historical parallels from the history of American medicine — the AMA and managed care, osteopathic medicine's identity divide, family medicine's emergence as a separate specialty, and the micropractice movement — the episode makes the case that two communities with genuinely different economic interests and regulatory priorities currently sharing a brand name may, consistent with historical precedent, find their own distinct professional homes over time. This is presented as pattern recognition grounded in verified historical evidence — and as practical planning context for physicians building practices today. The Tax and Structuring Update A clear, practical summary of the 2025 "One Big Beautiful Bill" Act changes — effective January 2026 — and what they mean for HSA eligibility of cash-pay membership fees. What qualifies, what doesn't, and why legal counsel is essential before making any representations to patients about tax-advantaged payment options. Eight Questions Before You Commit A practical pre-decision checklist — eight specific questions every physician or advanced practice clinician should be able to answer clearly before committing to any cash-pay practice pathway. Key Takeaways Cash-pay primary care and concierge medicine are not the same model, do not serve the same patient populations, and should not be evaluated as interchangeable alternatives. The purist cash-pay model has grown from approximately 100 practices in 2009 to over 2,100 by 2023 — real and meaningful growth. The financial sustainability data, however, reflects consistent challenges that peer-reviewed research has documented specifically in lower-income markets and solo practice settings. The employer-integrated pathway has stronger structural sustainability — multiple revenue streams, embedded benefit relationships, and documented employer cost reductions of 12 to 20 percent over three to five years. A December 2025 Johns Hopkins study found concierge and cash-pay primary care practices combined grew 83.1 percent between 2018 and 2023. The employer-integrated model is the primary driver of that growth trajectory. Concierge medicine — particularly the PCM model — is not retreating. The global concierge medicine market is projected to surpass $34 billion by 2032 and is growing at a compound annual rate that outpaces most healthcare market segments. The National Academy of Medicine's 2021 Future of Nursing report, AAMC physician shortage projections, and peer-reviewed NP/PA outcomes research collectively point to advanced practice clinician-led direct-care models as one of the most significant underexplored opportunities in subscription-based healthcare delivery. Pattern recognition from healthcare history — price transparency, retail health, the micropractice movement — consistently shows that the distance between a compelling healthcare idea and durable scaled impact is longer and more complicated than early advocacy suggests. Models that have achieved durable scale in American primary care share one characteristic: structural fit with the economic environment, not independence from it. Sources and Citations All claims in this episode are supported by published, verifiable sources. Full citations below. Micropractice and Practice Model History Moore, G. (2002). "Accountability and Improvement in Physician Practice." Family Medicine. Moore, G. & Showstack, J. (2003). "Primary Care Medicine in Crisis." Health Affairs. healthaffairs.org AAFP TransforMED Initiative. (2006). aafp.org Nutting, P.A. et al. (2010). "Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home." Annals of Family Medicine. Rittenhouse, D.R. et al. (2009). "Primary Care and Accountable Care." New England Journal of Medicine. Rittenhouse, D.R. & Shortell, S.M. (2009). "The Patient-Centered Medical Home." JAMA. Price Transparency Research Pathak, Y. & Muhlestein, D. (2024). "Public Awareness and Use of Price Transparency: Report From a National Survey." West Health Institute / Gallup. pmc.ncbi.nlm.nih.gov Parente, S.T. (2023). "Estimating the Impact of New Health Price Transparency Policies." Inquiry.pmc.ncbi.nlm.nih.gov ScienceDirect. (2025). "Outcomes of Price Transparency Policies for Healthcare Services in the United States: A Systematic Review." sciencedirect.com Retail Health Fein, A.J. (2017). "Retail Clinic Check Up: CVS Retrenches, Walgreens Outsources, Kroger Expands." Drug Channels. drugchannels.net CNBC. (2024). "Why Walmart, Walgreens, CVS Retail Health Clinic Experiment Is Struggling." cnbc.com Healthcare Finance News. (2023). "Retail Clinics Seeing Utilization Soar, Popularity Grow." healthcarefinancenews.com MedCity News. (2023). "Retail Clinics Are Gaining Momentum." medcitynews.com Cash-Pay and Subscription Primary Care Market Data MedCity News. (March 2026). "DPC Is Scaling — The Financing Architecture Isn't Ready." medcitynews.com Johns Hopkins. (December 2025). Study on concierge and cash-pay practice growth 2018–2023. As cited in MedCity News, March 2026. Liaw, W. et al. (2024). "Direct Primary Care: Financial Analysis and Potential to Reshape the U.S. Healthcare Landscape." Journal of General Internal Medicine. springer.com Lujan, D.Y. (2025). "Why Direct Primary Care Models Fail." KevinMD. kevinmd.com Doan, L. et al. (2019). "Physician Perspectives on Direct Primary Care." Family Medicine. Eskew, P.M. & Klink, K. (2015). "Direct Primary Care: Practice Distribution and Cost Across the Nation." Health Affairs. healthaffairs.org Tseng, P. et al. (2018). "Administrative Costs Associated With Physician Billing and Insurance-Related Activities." JAMA Internal Medicine. Medscape Physician Compensation Report. (2023). medscape.com Employer-Integrated Model Spann, S.J. et al. (2020). "Employer-Sponsored Direct Primary Care." Journal of Occupational and Environmental Medicine. National Alliance of Healthcare Purchaser Coalitions. (2021). purchaseralliance.org Kaiser Family Foundation. (2023). Employer Health Benefits Annual Survey. kff.org National Business Group on Health. (2022). businessgrouphealth.org Employers Health Coalition. (2022). employershealthcoalition.org Patient Demographics and Population Health Anderson, G.F. (2010). "Chronic Conditions: Making the Case for Ongoing Care." Johns Hopkins Bloomberg School of Public Health. Tikkanen, R. & Abrams, M.K. (2020). "U.S. Health Care from a Global Perspective." Commonwealth Fund.commonwealthfund.org Collins, S.R. et al. (2022). "Paying for It: How Health Insurance and Healthcare Costs Are Shaping the Lives of American Adults." Commonwealth Fund. commonwealthfund.org Bureau of Labor Statistics. (2023). "Contingent and Alternative Employment Arrangements." bls.gov Petterson, S. et al. (2012). "Unequal Distribution of the U.S. Primary Care Workforce." Annals of Family Medicine. Advanced Practice Clinicians and Nursing Laurant, M. et al. (2019). "Revision of Professional Roles and Quality Improvement in Primary Care." New England Journal of Medicine. Naylor, M.D. & Kurtzman, E.T. (2010). "The Role of Nurse Practitioners in Reinventing Primary Care." Health Affairs. healthaffairs.org National Academy of Medicine. (2021). "The Future of Nursing 2020–2030." nationalacademies.org AAMC. (2021). "The Complexities of Physician Supply and Demand: Projections from 2019–2034." aamc.org Legal, Tax, and Compliance Eischen, J. (2025). Legal Commentary on Cash Practice Structuring. eischenlawoffice.com DLA Piper. (2025). "Paying for Direct Primary Care Arrangements With HSAs." dlapiper.com IRS Notice 26-05. irs.gov CMS. "Opt-Out Affidavits and Private Contracts." cms.gov Organizational and Professional Identity Research Hoff, T.J. (2010). Practice Under Pressure: Primary Care Physicians and Their Medicine in the Twenty-First Century. Rutgers University Press. Scott, W.R. (2008). Institutions and Organizations: Ideas and Interests. SAGE Publications. Freidson, E. (2001). Professionalism: The Third Logic. University of Chicago Press. Wolinsky, H. & Brune, T. (1994). The Serpent on the Staff: The Unhealthy Politics of the American Medical Association. Putnam. Gevitz, N. (2004). The DOs: Osteopathic Medicine in America. Johns Hopkins University Press. Stephens, G.G. (1989). "Family Medicine as Counterculture." Journal of Family Practice. Colwill, J.M. (1992). "Where Have All the Primary Care Applicants Gone?" New England Journal of Medicine. Meltzer, D.O. & Chung, J.W. (2014). "The Population-Based Physician Workforce." Health Affairs.healthaffairs.org Bodenheimer, T. & Pham, H.H. (2010). "Primary Care: Current Problems and Proposed Solutions." Health Affairs. healthaffairs.org Grumbach, K. & Grundy, P. (2010). "Outcomes of Implementing Patient Centered Medical Home Interventions." JAMA. Concierge Medicine Market Data Grand View Research. (2022). Concierge Medicine Market Size & Growth Report. grandviewresearch.com Precedence Research. (2023). U.S. Concierge Medicine Market Size and Forecast. globenewswire.com MDVIP. (2020). Personalized Primary Care Reduces ER Visits, Hospitalizations, and Outpatient Expenditures.mdvip.com AAPP / Software Advice. (2023). "Concierge Medicine Salary and Definition." softwareadvice.com Disclaimer The DocPreneur Leadership Podcast is produced by Concierge Medicine Today, LLC, an independent healthcare leadership publication. This episode and its accompanying summary are intended for educational and informational purposes only. Nothing in this episode or summary constitutes medical, legal, financial, or accounting advice. The information presented reflects publicly available research, published data, and editorial observation, and is not intended to replace the guidance of qualified medical, legal, financial, or business professionals. All factual claims are supported by named, verifiable third-party sources, which are cited in full above. Concierge Medicine Today makes no guarantee regarding the completeness or currency of external sources cited and encourages listeners to verify information independently. References to specific organizations, publications, legal decisions, or market data are provided for educational context only. Mention of any organization, publication, or individual does not constitute endorsement, and no commercial relationship exists between Concierge Medicine Today and any source cited in this episode unless otherwise disclosed. Physicians, nurse practitioners, physician assistants, and other clinicians considering any practice model change are strongly encouraged to seek qualified legal counsel with specific experience in healthcare compliance, tax structuring, and the applicable regulatory environment in their state before making any practice or business decisions. © 2007–2026 Concierge Medicine Today, LLC. All rights reserved. Reproduction or distribution of this content without written permission is prohibited.

In this new episode of Speaking of SurgOnc, Dr. Rick Greene & Dr. Giorgos Karakousis discuss the article: "Assessing the Evidence for and Utility of Gene Expression Profiling of Primary Cutaneous Melanoma" from the March 2025 issue of the Annals of Surgical Oncology.

In this episode, I'm breaking down the four pillars of recomposition to help you shrink your body fat, build lean muscle, and reclaim the energy you had in your 20s. For 30 years, the fitness world has preached the same rule: you have to "bulk" to gain muscle, or "cut" to lose fat. But modern science shows us a different path. It is entirely possible to do both at the same time through a process called Body Recomposition. Sponsors: Sunlighten Sauna: https://get.sunlighten.com/axepodcast Manukora Manuka Honey: https://manukora.com/axe Caraway Home: carawayhome.com/drjoshaxe (Use code DRJOSHAXE) for an exclusive discount Watch The Dr. Josh Axe Show every Monday & Thursday on YouTube: ⁠⁠⁠https://www.youtube.com/@drjoshaxe?sub_confirmation=1⁠⁠⁠ 

This week we pull out The Secret Language of Birthdays from the 90s and read off personality breakdowns and find out which celebrities were born on the same date, plus some love for Broadway's Bob Fosse and how he changed theater and dance. Erin discusses the 5th Circuit Court of Appeals reinstated restrictions on Mifepristone, and how the Supreme Court temporarily restored access to the drug via mail until May 11, 2026. Bryan discusses a study published in Annals of Tourism Research showing how queer men of color from London feel sexier and more noticed on dating apps while on vacation, plus how St. George, Utah has to pay the legal fees for a group of drag queens who sued for being denied a permit for an all-ages drag show in a public park. For all our bonus content and video episodes visit patreon.com/attitudes

What if loneliness isn't just an emotion… but one of the most dangerous biological threats to your health? In this deeply personal and scientifically explosive solo episode, Darin opens up about something he recently realized in his own life: despite being surrounded by people, he was lonely. But what began as an emotional realization quickly became a deep dive into some of the most shocking research he's ever uncovered, showing that chronic loneliness may increase the risk of heart disease, dementia, cancer, autoimmune dysfunction, accelerated aging, and early death. From inflammatory gene expression and cortisol dysregulation to oxytocin, vulnerability, and the collapse of real human connection in the digital age, this episode reveals why loneliness may be the most overlooked "fatal convenience" of modern life, and how vulnerability may be the medicine. What You'll Learn Why loneliness is a biological crisis, not just an emotional feeling The shocking link between loneliness and heart disease, dementia, and early death Why the quality of your relationships is the #1 predictor of long-term health How loneliness activates inflammatory genes inside your body The role of cortisol, sleep disruption, and chronic stress in social isolation Why social media and "surface-level connection" are replacing real intimacy The connection between loneliness and Alzheimer's disease How oxytocin and genuine connection reduce inflammation Why vulnerability is the gateway to meaningful relationships Practical ways to create deeper connection starting today Chapters 00:00:33 – Sponsor: the truth about the exploding NAD supplement market 00:01:04 – Why supplement verification and transparency matter 00:02:17 – Opening: Darin admits something deeply personal 00:02:30 – "I realized recently… I'm lonely" 00:02:37 – The difference between being surrounded by people vs being truly known 00:03:06 – Loneliness as a biological experience, not just an emotional one 00:03:27 – The hidden risks: heart disease, dementia, cancer, early death 00:03:45 – Why this is not fringe science 00:04:13 – The most important predictor of long-term health 00:04:34 – Why relationship QUALITY matters more than quantity 00:05:06 – The global loneliness epidemic 00:05:11 – U.S. Surgeon General advisory on loneliness 00:05:39 – Loneliness declared a public health crisis 00:06:02 – 50% of Americans report measurable loneliness 00:06:22 – "A generational collapse of connection" 00:06:30 – 29% of adults have no close friends 00:06:40 – Face-to-face interactions dramatically declining 00:07:01 – The UK, Japan, and Australia loneliness crisis initiatives 00:07:32 – The paradox: hyperconnected but deeply isolated 00:08:04 – Loneliness as a biological alarm signal 00:08:31 – What loneliness actually looks like in modern life 00:08:42 – The lonely CEO, the unseen mother, the isolated social media addict 00:09:31 – "Perceived social isolation" and why the brain can't tell the difference 00:10:21 – Meta-analysis of 3.4 million people 00:10:55 – Loneliness vs obesity and smoking risk comparisons 00:11:18 – The biology of loneliness begins 00:11:50 – NF-kB: inflammatory gene activation explained 00:12:33 – How loneliness changes gene expression 00:13:02 – Chronic inflammation and disease pathways 00:13:21 – Cortisol, sleep disruption, and immune dysfunction 00:14:00 – How loneliness affects brain repair and amyloid plaque clearing 00:14:21 – Sponsor: Fatty15 and cellular health 00:18:02 – The Alzheimer's and dementia connection 00:18:25 – Loneliness as a major modifiable dementia risk factor 00:18:57 – Cortisol, neuroinflammation, and brain degeneration 00:19:16 – The hippocampus physically shrinking in lonely people 00:19:27 – Social media as a "fatal convenience" 00:19:57 – The oxytocin economy: connection as medicine 00:20:15 – Oxytocin as one of the body's strongest anti-inflammatory molecules 00:20:30 – HeartMath research: emotional synchronization between people 00:20:48 – "You regulate each other's biology" 00:21:07 – The real barrier: vulnerability 00:21:32 – Darin's recent experiences with radical vulnerability 00:21:54 – Conversations with family, ex-partners, and loved ones 00:22:35 – Brené Brown's research on connection and worthiness 00:23:14 – The "depth audit" exercise 00:23:42 – Reaching out, expressing appreciation, and owning your emotions 00:24:01 – Sacred hours: spending time without phones 00:24:13 – Questions that create real intimacy 00:24:30 – Darin's emotional conversation with his brother 00:25:03 – Protecting yourself from social media disconnection 00:25:20 – Becoming a source of joy and connection in everyday life 00:25:25 – Darin reflects on seven years of subtle loneliness 00:25:48 – The shift from surface conversations to meaningful connection 00:26:01 – "If you want love, give love" 00:26:19 – Final message: generate the connection you want to receive 00:26:22 – Closing thoughts and outro Thank You to Our Sponsors Truniagen: Go to www.truniagen.com and use code DARIN20 at checkout for 20% off Fatty15: Get an additional 15% off their 90-day subscription Starter Kit by going to fatty15.com/DARIN and using code DARIN at checkout. Join the SuperLife Community Get Darin's deeper wellness breakdowns — beyond social media restrictions: Weekly voice notes Ingredient deep dives Wellness challenges Energy + consciousness tools Community accountability Extended episodes Join for $7.49/month → https://patreon.com/darinolien Connect with Darin Olien: Website: darinolien.com Instagram: @darinolien Book: Fatal Conveniences Platform & Products: superlife.com New Show: Roadmap to Happiness Key Takeaway "Loneliness isn't weakness. It isn't failure. It's a biological signal telling you that something essential is missing. And in a world addicted to surface-level connection, the real medicine may simply be this: vulnerability, presence, eye contact, honesty, and the courage to let yourself truly be seen." Bibliography/Sources The Loneliness Epidemic & Public Health Data Bureau of Labor Statistics. (2023). American time use survey. U.S. Department of Labor. https://www.bls.gov/tus/ Cigna. (2023). Cigna U.S. loneliness index. Evernorth Health Services. https://newsroom.cigna.com/loneliness-epidemic-continues-to-rise-cigna-study Murthy, V. H. (2023). Our epidemic of loneliness and isolation: The U.S. Surgeon General's advisory on the healing effects of social connection and community. U.S. Department of Health and Human Services. https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf Survey Center on American Life. (2021). The state of American friendship: Change, challenges, and loss. American Enterprise Institute. https://www.americansurveycenter.org/research/the-state-of-american-friendship-change-challenges-and-loss/ Mortality & Systemic Health Risk Cohen, S., Doyle, W. J., Skoner, D. P., Rabin, B. S., & Gwaltney, J. M. (1997). Social ties and susceptibility to the common cold. JAMA, 277(24), 1940–1944. https://pubmed.ncbi.nlm.nih.gov/9200634/ Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40(2), 218–227. https://pubmed.ncbi.nlm.nih.gov/20396846/ Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352 Valtorta, N. K., Kanaan, M., Gilbody, S., Ronzi, S., & Hanratty, B. (2016). Loneliness and social isolation as risk factors for coronary heart disease and stroke. Heart, 102(13), 1009–1016. https://heart.bmj.com/content/102/13/1009 Genetics, Inflammation & The Immune System Cole, S. W. (2013). Social regulation of human gene expression: Mechanisms and implications for public health. American Journal of Public Health, 103(S1), S84–S92. https://pmc.ncbi.nlm.nih.gov/articles/PMC3786756/ Cole, S. W., Hawkley, L. C., Arevalo, J. M. G., Sung, C. Y., Rose, R. M., & Cacioppo, J. T. (2007). Social regulation of gene expression in human leukocytes. Genome Biology, 8(9), Article R189. https://pmc.ncbi.nlm.nih.gov/articles/PMC2375027/ Sleep & Cognitive Decline Cacioppo, J. T., Hawkley, L. C., Berntson, G. G., Ernst, J. M., Gibbs, A. C., Stickgold, R., & Hobson, J. A. (2002). Do lonely days invade the nights? Potential social modulation of sleep efficiency. Psychological Science, 13(4), 384–387. https://pubmed.ncbi.nlm.nih.gov/12137144/ Holwerda, T. J., Deeg, D. J. H., Beekman, A. T. F., et al. (2014). Feelings of loneliness, but not social isolation, predict dementia onset. Journal of Neurology, Neurosurgery & Psychiatry, 85(2), 135–142. https://jnnp.bmj.com/content/85/2/135 Oxytocin & The Biology of Connection Szeto, A., Sun-Suslow, N., Mendez, A. J., Hernandez, R. I., Wagner, K. V., & McCabe, P. M. (2017). Regulation of the macrophage oxytocin receptor in response to inflammation. American Journal of Physiology—Endocrinology and Metabolism, 312(2), E183–E189. https://journals.physiology.org/doi/full/10.1152/ajpendo.00424.2016 Uvnas-Moberg, K. (2003). The oxytocin factor: Tapping the hormone of calm, love, and healing. Da Capo Press. https://books.google.com/books?id=b-aKjQoB_nQC Psychology, Vulnerability & Relationship Science Aron, A., Melinat, E., Aron, E. N., Vallone, R. D., & Bator, R. J. (1997). The experimental generation of interpersonal closeness. Personality and Social Psychology Bulletin, 23(4), 363–377. https://doi.org/10.1177/0146167297234003 Brown, B. (2010). The gifts of imperfection: Let go of who you think you're supposed to be and embrace who you are. Hazelden Publishing. https://brenebrown.com/book/the-gifts-of-imperfection/ Cacioppo, J. T., & Patrick, W. (2008). Loneliness: Human nature and the need for social connection. W. W. Norton & Company. https://wwnorton.com/books/9780393335286 Dunbar, R. I. M. (2012). Bridging evolutionary approaches to the social brain and social bonding. In F. B. M. de Waal & P. F. Ferrari (Eds.), The primate mind. Harvard University Press. https://www.hup.harvard.edu/books/9780674063104 Dunbar, R. I. M. (2021). Friends: Understanding the power of our most important relationships. Little, Brown and Company. https://www.hachettebookgroup.com/titles/robin-dunbar/friends/9781408711736/ Waldinger, R., & Schulz, M. (2023). The good life: Lessons from the world's longest scientific study on happiness. Simon & Schuster. https://www.simonandschuster.com/books/The-Good-Life/Robert-Waldinger/9781982166694

THIS IS A PREVIEW. FOR THE FULL EPISODE, GO TO Patreon.com/worstofall   TICKETS TO OUR MAY 24 LIVE SHOW IN BROOKLYN ARE ON GENERAL SALE NOW! To get your tickets, go to Littlefieldnyc.com   The lads grab their fedoras and make for Cairo as they cover Steven Spielberg's 1981 megahit: Raiders of the Lost Ark. Topics include the undeniable charm of Harrison Ford, Indiana Jones' skeevy origins, and what it means to be an active part of living history.   Media Referenced In this Episode: Raiders of the Lost Ark. Dir. Steven Spielberg. 1981. The Treasure of the Sierra Madre. Dir. John Huston. 1948. King Solomon's Mines. Dir. Compton Bennett and Andrew Marton. 1950. Secret of the Incas. Dir. Jerry Hopper. 1954. Kiss Me Deadly. Dir. Robert Aldrich. 1955. Tim Tyler's Luck. Dir. Ford Beebe and Wyndham Gittens. 1937. The S From Hell by Rodney Ascher. 2010. Jungle Jim. Dir. Ford Beebe and Clifford Smith. 1937. Alfred Molina remembers Raiders CBS - Great Movie Stunts: Raiders of the Lost Ark “How Spielberg, Lucas, and Kasdan Created Raiders of the Lost Ark (Story Conference Transcript)” by Indie Film Hustle. Indie Film Hustle. May 31st, 2023. “Indiana Jones was an abusive creep (but he was almost much worse)” by Ben Kuchera. Polygon. August 3rd, 2015. “Raiders Floorplan Animatic” by Vashy Nedomansky and Jonathan Ochmann “Reel Bad Arabs: How Hollywood Vilifies a People” by Jack G. Shaheen. The Annals of the American Academy of Political and Social Science, vol. 588, 2003, pp. 171–93. “The Making of Raiders of the Lost Ark” by Empire. Empire. June 11th, 2021. The Making of Raiders of the Lost Ark Special Feature Documentary “The Spielberg Oner” by Every Frame a Painting     TWOAPW theme by Brendan Dalton: Patreon // brendan-dalton.com // brendandalton.bandcamp.com   Interstitial: “Florizo Forrestal and the Booby Trap of Doom” // Written by A.J. Ditty // feat. David Armstrong as “Florizo Forrestal/Indy” and A.J. Ditty as “Marcus” // Music by: Indiana Jones - Bad Recorder Cover 

Fasting is one of the most powerful healing practices in human history—it's free, requires zero equipment, and your body is literally designed for it. But while it sounds simple, there is a wrong way to do it, especially when it comes to the hormonal "engine switch" that happens in the first 24 hours. In this episode, I walk you through exactly what happens in your body during a 3-day fast, from clearing out "zombie cells" to the 60% drop in aging markers. Sponsors: Sunlighten Sauna: https://get.sunlighten.com/axepodcast Manukora Manuka Honey: https://manukora.com/axe Caraway Home: carawayhome.com/drjoshaxe (Use code DRJOSHAXE) for an exclusive discount Watch The Dr. Josh Axe Show every Monday & Thursday on YouTube: ⁠⁠https://www.youtube.com/@drjoshaxe?sub_confirmation=1⁠⁠ 

Chas & Melina discuss Lots of Scalps!, The Annals of Leavittism, and Why You Shouldn't Elect A Juvenile Psychopathic Bully WARNING: This episode of PEP may contain explicit language. Timestamps: 0:00 - Introducing: Melina Wicks 2:58 - Grateful (NBA, Late 80s Escape Pod) 9:57 - Updates (Shutdown, Congressional Sackings) 23:58 - Eric Swalwell 1:11:45 - Dave's Grateful 1:15:42 - Prediction Markets 2:00:58 - Virginia Redistricting 2:35:38 - Chavez-DeRemer Sacking 2:49:54 - Pope v Trump Round 2 3:00:54 - Unleashed (Pope Misleading Stories) 3:15:33 - Policy Time (401K Investments, Medical Marijuana, Mail-In Ballots) Homework: * 'Hold On' by The Models - https://bitly.cx/lc542 * Polymarket homework - https://bitly.cx/AI0QA SHOW LINKS: *Chat with the PEPpers on the Discord Server: https://discord.com/invite/WxDD2PPvaW THE (UPDATED) DR DAVE BOOK CLUB MASTERLIST: Connie Willis - Doomsday Book & To Say Nothing of the Dog (Mentioned 4:26, Ep 244) Richard Yates - Revolutionary Road  (Mentioned 1:48:45, Ep 240) Michael Lewis - Who Is Government? (Mentioned 2:19:59, Ep 235) Orlando Whitfield - All That Glitters (Mentioned 2:34:37, Ep 232) John Lyons - Balcony Over Jerusalem (Mentioned 2:45:26, Ep 231) Yukio Mishima - Spring Snow (Mentioned 2:35:12, Ep 227) John Steinbeck - Cannery Row (Mentioned 02:39, Ep 226) David Simon & Ed Burns - The Corner: A Year in the Life of an Inner-City Neighborhood (Mentioned 2:21:40, Ep 225) William Appleman Williams - The Tragedy of American Diplomacy (Mentioned 2:11:23, Ep 222) Mahmood Mamdani - Good Muslim, Bad Muslim (Mentioned 2:07:14, Ep 220) Carlo Rovelli - The Order Of Time (Mentioned 06:36, Ep 220) Carlo Rovelli - Reality Is Not What It Seems (Mentioned 06:36, Ep 220) Ryszard Kapuściński - Shah of Shahs (Mentioned 2:21:27, Ep 217) Ervand Abrahamian - Khomeinism (Mentioned 2:23:19, Ep 217) Anthony Seldon - Truss at 10 (Mentioned 1:36:09, Ep 215) Steven Teles - The Conservative Legal Movement (Mentioned 2:12:12, Ep 215) Amin Maalouf - The Crusades Through Arab Eyes (Mentioned 4:32, Ep 214) Geoffrey Blainey - The Causes Of War (Mentioned 43:49, Ep 198) Margaret Levi - Of Rule And Revenue (Mentioned 1:11:16, Ep 195) Margaret Levi - Consent, Dissent, and Patriotism (Mentioned 1:11:16, Ep 195) Sayaka Murata - Convenience Store Woman (Mentioned 2:14, Ep 194) Sid Meier - Sid Meier's Memoir! (Mentioned 16:30, Ep 178) David Simon & Ed Burns - The Corner (Mentioned 8:40, Ep 178) Maurice O. Wallace - King's Vibrato (Mentioned 14:26, Ep 164) Edward S. Herman and Noam Chomsky - Manufacturing Consent - (Mentioned 32:12, Ep 164) Robert Plunket - My Search For Warren Harding (Mentioned 1:49:12, Ep 158) Ian Lambot & Greg Girard - City of Darkness Revisited (Mentioned 39:25, Ep 157) Max Chafkin - The Contrarian (Mentioned 32:18, Ep 155) Claire Conner - Wrapped In The Flag (Mentioned 31:42, Ep 155) Rita Abrahamsen, Mike Williams et al - Global Right (Mentioned 31:12, Ep 155) Philip Gorski and Samuel Perry - The Flag And The Cross (Mentioned 30:49, Ep 155) Cynthia Miller-Idriss - Hate In The Homeland (Mentioned 30:10, Ep 155) Cory Doctorow & Rebecca Giblin - Chokepoint Capitalism (Mentioned 34:55, Ep 150) Elizabeth Ingleson - Made In China (Mentioned 31:50, Ep 150) John Corrigan - Religious Intolerance, America, and the World (Mentioned 1:16:18, Ep 141) Gérard Prunier - From Genocide to Continental War (Mentioned 48:18, Ep 141) Liu Cixin, - The Three Body Trilogy (Mentioned 1:11:04, Ep 136) Tilman Allert - The Hitler Salute (Mentioned 22:03, Ep 134) Philip Roth - Nemesis (Mentioned 1:56, Ep 133) Joshua Cohen - The Netanyahus Zeke Faux - Number Go Up Michael Paul Rogin - The Intellectuals and McCarthy Cathy Kramer - The Politics of Resentment Naomi Klein - Doppelganger Maria Bamford - Sure, I'll Join Your Cult Wendy Brown - States Of Injury Corey Robin. - The Reactionary Mind Patricia Lockwood - No One Is Talking About This David Cay Johnston - The Making of Donald Trump Jane Mayer - Dark Money Harry Frankfurt - On Bullshit Stephen King - The Dead Zone Elle Hardy - Beyond Belief Federico Finchelstein - From Fascism to Populism in History Robert Jervis - Why Intelligence Fails Alex Haley and Malcolm X - The Autobiography of Malcolm X Jonathan Haidt - The Righteous Mind David Graeber - Debt: The First 5000 Years Jerry L. Mashaw - Creating The American Administrative Constitution Brian Balogh - A Government Out of Sight Paul Connerton - How Societies Remember Paul Connerton - How Modernity Forgets Catherine Green and Sarah Catherine Gilbert - Vaxxers John Zaller - The Nature and Origins of Mass Opinion Matthew Karp - This Vast Southern Empire Robert Fatton - The Guise of Exceptionalism Anatol Lievin - Climate Change and the Nation State: The Realist Case James Alfred Aho - The Politics of Righteousness The substack that Dr Dave apparently plagiarises liberally from! https://luke.substack.com/ James Beverley - God's Man in the White House Jane Chi Hyun Park - Yellow Future Matthias Gardell - In The Name of Elijah Muhammad Gosta Esping-Andersen - The Three Worlds of Welfare Capitalism Suzanne Mettler - The Submerged State Brendon O'Connor - Anti-Americanism and American Exceptionalism James Morone - Hellfire Nation Nathan Kalmoe - With Ballots and Bullets Winnifred Fallers Sullivan - The Impossibility of Religious Freedom Mary L. Trump - Too Much And Never Enough Richard Cooke - Tired of Winning Jon Ronson - So You've Been Publicly Shamed Rodney Tiffen, Ross Gittins, Anika Gauja, David Smith, Brendon O'Connor - How America Compares Tony Horwitz - Confederates In the Attic Ghassan Hage - White Nation George Lakoff - Women, Fire and Dangerous Things George Lakoff - Metaphors We Live By Michelle Alexander - The New Jim Crow Alex S. Vitale - The End of Policing Dave Cullen - Parkland: Birth of a Movement Thomas Sugrue - The Origins of the Urban Crisis Rick Pearlstein - The Invisible Bridge Rick Pearlstein - Before the Storm Rick Pearlstein - Nixonland Brian Doherty - Radicals for Capitalism Leon Festinger, Henry W. Riecken, Stanley Schachter - When Prophecy Fails Nancy L. Rosenblum & Russell Muirhead - A Lot Of People Are Saying Benjamin Moffitt - The Global Rise of Populism Jon Krakauer - Missoula THANK YOU FOR YOUR ATTENTION TO THIS MATTER!

When Penn Holderness described APOE4 as a “ticking time bomb,” it struck a nerve for a lot of people, especially women in midlife who already feel vulnerable about their brain health.Could a GLP-1 medication protect your brain if you carry the APOE4 gene? Amy unpacks the science in plain English and explains why genes are not destiny, why menopause changes the conversation for women, and what research-backed actions you can start taking right now.What to Listen For[00:00] Why Penn Holderness's APOE4 reveal sparked such a big reaction [02:30] What it actually means to carry one or two copies of the APOE4 gene [05:30] Why APOE4 is a genetic predisposition, not a verdict [08:30] The critical difference between APOE4 and the rare genes that directly cause early-onset Alzheimer's [10:30] Why midlife and postmenopausal women may face a different level of APOE4-related risk [14:00] How fear drives people toward quick-fix solutions and why that matters in Alzheimer's prevention [18:00] What the observational GLP-1 research shows and the big caveat most people miss [22:00] What the EVOKE and EVOKE Plus semaglutide trials found in people with early Alzheimer's symptoms [25:30] What hormone therapy can do for sleep and symptom relief — and what it has not been proven to do for dementia prevention [28:30] Why the FINGER study, U.S. POINTER, and modifiable risk-factor research offer the most hopeful path forward [32:30] The free RESTORED guide, the 8 evidence-based lifestyle factors, and Amy's call to take action without panicIf you've been feeling afraid of your genetic risk, this episode is your reminder that APOE4 is not destiny. Amy explains why the most powerful path forward is still grounded in the basics: sleep, movement, metabolic health, stress management, and consistent daily choices. Listen now, subscribe to the show, and grab Amy's free guide so you can start protecting your brain one step at a time.From The EpisodeDownload the free RESTORED ProtocolBook your Breakthrough Roadmap sessionResearch cited in this episode:1. NIA Alzheimer's Disease Genetics Fact Sheet — APOE4 prevalence and risk breakdown https://www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/alzheimers-disease-genetics-fact-sheet2. Altmann A et al. (2014). Sex modifies the APOE-related risk of developing Alzheimer disease. Annals of Neurology. https://pmc.ncbi.nlm.nih.gov/articles/PMC4117990/3. Stanford Medicine (April 2026). Women get Alzheimer's more often than men: Five things the science tells us. https://med.stanford.edu/news/insights/2026/04/women-alzheimers.html4. Alzheimer's Association (2025). Statement on oral semaglutide phase 3 topline data (EVOKE/EVOKE+ trials). https://www.alz.org/news/2025/alzheimers-assRESOURCES:Book a FREE Discovery Call with AmyOrder Amy's book Thoughts Are Habits Too:  Master Your Triggers, Free Yourself From Diet Culture, and Rediscover Joyful Eating.Schedule your Breakthrough Roadmap session with AmyFollow Amy on Instagram @amylangcoaching Follow Amy on Facebook @amylangcoachingSubscribe to Amy's YouTube channel @happyandhealthywithamy

In this new episode of Speaking of SurgOnc, Dr. Rick Greene & Dr. Mohammed Farooq discuss the article "Recurrence Patterns and Survival Outcomes in Clinical Stage IIB/IIC Melanoma: Can We Stratify Patients for Consideration of Neoadjuvant Immunotherapy", from the January 2026 issue of the Annals of Surgical Oncology.    

Exploring the paradoxes of the Japanese diet, LDL cholesterol, and longevity, challenging conventional wisdom on fats and health.Chapters00:00 The Inconvenient Truth of Japanese Nutrition02:46 The Paradox of LDL and Longevity06:51 Challenging Dietary MythsReferencesKawamoto R, et al. (2021). Low density lipoprotein cholesterol and all-cause mortality rate in community-dwelling persons. BMC Geriatrics. https://pmc.ncbi.nlm.nih.gov/articles/PMC8436563/Ravnskov U, et al. (2020). The LDL Paradox: Higher LDL-Cholesterol is Associated with Greater Longevity. Annals of Epidemiology and Public Health, 3(1): 1040. https://meddocsonline.org/annals-of-epidemiology-and-public-health/the-LDL-paradox-higher-LDL-cholesterol-is-associated-with-greater-longevity.pdfObservatoire de la Prévention (2021). Why do the Japanese have the highest life expectancy in the world? https://observatoireprevention.org/en/2021/03/09/why-do-the-japanese-have-the-highest-life-expectancy-in-the-world/Japan Today (2023). People in Japan are eating a lot less fish now than they used to, but why? https://japantoday.com/category/features/food/people-in-japan-are-eating-a-lot-less-fish-now-than-they-used-to-but-whySustainability Hypotheses (2023). Meat consumption and sustainability: the case of Japan. https://sustainability.hypotheses.org/1037American Case Medical Reports (2023). Height is a Measure of Consumption that Incorporates Nutritional Quality. https://acmcasereport.org/wp-content/uploads/2023/06/ACMCR-v9-1835.pdfMeat Science / ScienceDirect (2022). Meat consumption and consumer attitudes in Japan: An overview. https://www.sciencedirect.com/science/article/abs/pii/S0309174022001474PMC / Nutrients (2024). Dietary pattern transition and its nutrient intakes and diet quality in Japan. https://pmc.ncbi.nlm.nih.gov/articles/PMC11645119/Sheng-Shu W, et al. (2023). Cholesterol paradox in community-living older adults. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC10755211/Journal of the American Geriatrics Society (2020). The Highs and Lows of Cholesterol: A Paradox of Healthy Aging? https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.16302

Braid is known for his work in hypnotism. But he was also a surgeon with a reputation for pioneering new treatments before he became fascinated with the scientific underpinnings of mesmerism. Research: Braid, James, and Arthur Edward Waite, ed. “Braid on hypnotism. Neurypnology; or, The rationale of nervous sleep considered in relation to animal magnetism or mesmerism and illustrated by numerous cases of its successful application in the relief and cure of disease.” London. George Redway. 1899. https://archive.org/details/braidonhypnotism00brai/page/n7/mode/2up “Clubfoot.” Cleveland Clinic. July 6, 2023. https://my.clevelandclinic.org/health/diseases/16889-clubfoot Crabtree A. “1784: The Marquis de Puységur and the psychological turn in the west.” J Hist Behav Sci.2019;55:199–215. https://doi.org/10.1002/jhbs.21974 Fletcher, George. “James Braid Of Manchester.” The British Medical Journal, vol. 2, no. 3590, 1929, pp. 776–77. JSTOR, http://www.jstor.org/stable/25334090 Hull, Clark L. “Hypnotism in Scientific Perspective.” The Scientific Monthly, vol. 29, no. 2, 1929, pp. 154–62. JSTOR, http://www.jstor.org/stable/14677 “Hypnotism.” Yorkville Enquirer. Feb. 23, 1860. https://www.newspapers.com/image/339341468/?match=1&terms=James%20Braid Lafontaine’s Third Conversazione on Mesmerism.” The Manchester Times and Manchester and Salford Advertiser and Chronicle. Nov. 20, 1841. https://www.newspapers.com/image/406088965/?match=1&terms=lafontaine Loudon, I. “Why are (male) surgeons still addressed as Mr?.” BMJ (Clinical research ed.) 321,7276 (2000): 1589-91. doi:10.1136/bmj.321.7276.1589 Macklis, R M. “Magnetic healing, quackery, and the debate about the health effects of electromagnetic fields.” Annals of internal medicine 118,5 (1993): 376-83. doi:10.7326/0003-4819-118-5-199303010-00009 Martin, Christy. “Mesmerized.” Science History Institute. Dec. 6, 2011. https://www.sciencehistory.org/stories/magazine/mesmerized/ Bramwell, J. Milne. “Hypnotism and treatment by suggestion.” New York. Da Capo Press. 1982. Accessed online: https://archive.org/details/hypnotismandtre00bramgoog/page/n6/mode/1up Rouse, Tyler. “The brief and strange history of mesmerism and surgery.” Hektoen International. Winter 2019. https://hekint.org/2018/12/24/the-brief-and-strange-history-of-mesmerism-and-surgery/ Sandby, George. “Mesmerism and its opponents.” London. Longman, Brown, Green and Longmans. 1848. https://archive.org/details/mesmerismandits01sandgoog “Sudden Death of Mr. James Braid, Surgeon.” The Guardian. March 26, 1860. https://www.newspapers.com/image/257847287/?match=1&terms=James%20Braid Weidow, Brandy, M.S. “James Braid.” Ebsco. 2024. https://www.ebsco.com/research-starters/health-and-medicine/james-braid Yeates, Lindsay Bertram. “James Braid: Surgeon, Gentleman Scientist, and Hypnotist.” University of New South Wales, Sydney. 2013. https://unsworks.unsw.edu.au/entities/publication/7573cb34-ceb9-41bb-a8b1-0951e93fdd10 See omnystudio.com/listener for privacy information.

Marcus Aurelius Anderson sits down for a return visit with J. Jason Hicks — author, technologist, and storyteller — to dig into his new nonfiction book The War of Leadership: Hard Lessons and Practical Truths for Surviving In and Beyond Leadership. Drawing from 30 years in the corporate world, Jason unpacks the uncomfortable truths that no one tells new leaders: the manipulation, the blind spots, the politics, and the quiet treachery of organizational life. Marcus and Jason explore why awareness of dark leadership tactics doesn't make you a bad leader — it makes you a prepared one. They also cover the craft of writing, the role of AI in creative work, and why the human element in art, music, and literature will never be replaceable. EPISODE HIGHLIGHTS The Dark Side of Leadership — 2:16 Jason reads the defining passage from the book: "You'll be misled. You will be asked to mislead..." — a raw, unflinching look at how leadership corrupts incrementally, and how good people get drawn into cycles they never intended to be part of. The Blame Game & Double-Edged Sword — 6:23 Marcus and Jason break down how leaders attack their predecessors while their own teams are quietly building a case against them. Leadership blind spots, self-preservation, and the vicious cycle of blame are all on the table. The Message in a Bottle — 12:05 Jason reveals who he really wrote this book for: the bright-eyed, naive young professional walking into the arena with no idea what's coming. This is the intel he wishes someone had given him early in his career. Agreeable and Wrong vs. Disagreeable and Right — 17:57 One of the most quotable moments of the episode: Jason drops the line "It's better to be agreeable and wrong than disagreeable and right — you'll be remembered for being disagreeable, not for being right." Marcus and Jason unpack the tactical wisdom of knowing when to push back and when to let the dust settle. Jason Hicks was born in Deerfield, Illinois, raised in New Berlin, Wisconsin, and graduated from the University of Wisconsin Oshkosh where he studied English literature, religions, and early Christianity. While attending a television screenwriting course, he won the department's screenwriting award for a Star Trek: The Next Generation script — then spent the next 30 years successfully avoiding writing while building a career in technology. Upon leaving that career, he returned to his first love and penned Ruin Waters: Bane Book One of the Annals of the Last Emissary, followed by the second book in the series, The Earth, My War. His debut nonfiction, The War of Leadership: Hard Lessons and Practical Truths for Surviving In and Beyond Leadership, draws directly from his three decades in the corporate world. He currently lives in Tucson, Arizona, where he writes, speaks, and coaches on leadership. Find him at linktr.ee/jjasonhicks and on social media @jjasonhicks. Learn more about the gift of Adversity and my mission to help my fellow humans create a better world by heading to www.marcusaureliusanderson.com. There you can take action by joining my ANV inner circle to get exclusive content and information.See omnystudio.com/listener for privacy information.

Celebrating our 10th year, Ka-Pow the Pop Cultured Podcast has nominated three moments from our past to serve as the inaugural class in our Annals of Fame. Joined by longest-serving Jesse, Jesse Starcher of The Source Material Comics Podcast, we take a trip down memory lane and bestow some of our all-time favorite bits KPP's highest honor that we just made up. Honoree #1 - original episode #66. Honoree #2 - original episode #41. Honoree #3 - original episode #20. Length - 00:45:02 Language - PG-13. (Contains mild adult language.)

If you've ever felt hungry and wondered “What is wrong with me?”—this episode will change how you see it.Hunger isn't a lack of discipline. It's a biological signal driven by your brain, hormones, and environment.In this episode, we break down what hunger actually is and why it can feel so hard to control. You'll learn how key hormones like ghrelin, leptin, insulin, and GLP-1 regulate appetite—and why your brain is the real decision-maker.More importantly, we cover the three types of hunger:Homeostatic (true energy need) Hedonic (pleasure-driven) Conditioned (habit-based) Understanding the difference is what gives you power.We also explore how ultra-processed foods, sleep, and stress disrupt hunger signals—and what you can do to better regulate your appetite without restriction.In this episode: What hunger actually is  The hormones behind appetite  The 3 types of hunger  How processed foods impact hunger  Why sleep and stress matter This isn't about fighting your hunger—it's about understanding it so you can make more informed choices.References: Batterham RL et al. (2002). Gut hormone PYY(3-36) physiologically inhibits food intake. Nature. Cummings DE et al. (2001). A preprandial rise in plasma ghrelin levels suggests a role in meal initiation. Diabetes. Friedman JM & Halaas JL (1998). Leptin and the regulation of body weight. Nature. Hall KD et al. (2019). Ultra-processed diets cause excess calorie intake and weight gain. Cell Metabolism. Leidy HJ et al. (2015). The role of protein in weight loss and maintenance. AJCN. Martinez Steele E et al. (2016). Ultra-processed foods in the US diet. BMJ Open. Monteiro CA et al. (2019). Ultra-processed foods: What they are and how to identify them. Public Health Nutrition. Morton GJ et al. (2006). Central nervous system control of food intake. Nature. Schwartz MW et al. (2000). Central nervous system control of food intake. Nature. Spiegel K et al. (2004). Sleep curtailment… decreased leptin and increased hunger. Annals of Internal Medicine. Volkow ND et al. (2013). Obesity and addiction: Neurobiological overlaps. Nature Reviews Neuroscience. Wang L et al. (2021). Trends in ultra-processed food consumption. JAMA. Woods SC (1991). The eating paradox. Psychological Review. Support the showGet Weekly Health Tips:  thrivehealthcoachllc.comJoin the Thrive Collective Facebook groupLet's Connect:@‌ashleythrivehealthcoach or via email: ashley@thrivehealthcoachingllc.comPodcast Produced by Virtually You!

Join the Johns Hopkins Thoracic Surgery Subspecialty team on this rapid research review revealing how investigative efforts have changed the way we view and use Veno-venous (VV) ECMO therapy in the pre-lung transplant patient population working to avoid ventilator dependence and the associated morbidity while facilitating continued ambulation and preoperative optimization. Hosts:- Dr. Alfred J. Casillan, MD, PhDAttending Thoracic Surgeon Johns Hopkins Hospital - Kyla Rakoczy, MD Johns Hopkins General Surgery ResidentReferences:Awake ECMO as Bridge to Lung Transplantation Fuehner T, Kuehn C, Hadem J, Wiesner O, Gottlieb J, Tudorache I, et al. Extracorporeal membrane oxygenation in awake patients as bridge to lung transplantation. American Journal of Respiratory and Critical Care Medicine. 2012;185(7):763–768. PMID: 22268135 Link: https://pubmed.ncbi.nlm.nih.gov/22268135/Predictors of Successful ECMO Bridging Tipograf Y, Salna M, Minko E, Grogan EL, Sonett JR, Bacchetta MD. Outcomes of extracorporeal membrane oxygenation as a bridge to lung transplantation. Annals of Thoracic Surgery. 2019;107(5):1456–1463. PMID: 30790550 Link: https://pubmed.ncbi.nlm.nih.gov/30790550/Intubation Status and ECMO Bridging Outcomes Zhou AL, Jennings MR, Akbar AF, et al. Utilization and outcomes of nonintubated extracorporeal membrane oxygenation as a bridge to lung transplant. Journal of Heart and Lung Transplantation. 2025;44(4):661–669. PMID: 39486773 Link: https://pubmed.ncbi.nlm.nih.gov/39486773/ECMO Duration and Waitlist Mortality Shou BL, Kalra A, Zhou AL, et al. Impact of extracorporeal membrane oxygenation bridging duration on lung transplant outcomes. Annals of Thoracic Surgery. 2024;118(2):496–503. PMID: 38740080 Link: https://pubmed.ncbi.nlm.nih.gov/38740080/Mechanical Ventilation as a Risk Marker Mason DP, Thuita L, Alster JM, Murthy SC, Budev MM, Mehta AC, et al. Lung transplantation in recipients requiring mechanical ventilation: outcomes and risk factors. Journal of Thoracic and Cardiovascular Surgery. 2010;139(1):114–119. PMID: 19931096 Link: https://pubmed.ncbi.nlm.nih.gov/19931096/***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6Please 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://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewOral Board Simulator: https://app.behindtheknife.org/oral-board-simulatorTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

On December 22nd, 1991, a 22-year-old medical student from Brisbane crawled under a rock overhang in the Nepalese Himalayas and waited for help. He had a sleeping bag, two chocolate bars, four books, and no way to make fire. No one knew where he was. The record for survival at that elevation in Himalayan winter — without food, without shelter beyond a sleeping bag, without fire — was ten days. Every expert, every search coordinator, every official who looked at the timeline said the same thing. It had been too long. The mountain didn't give people back after this many days. James Scott lasted forty-three. In this episode, Kaycee McIntosh and Julie Henningsen trace every decision that put him under that rock, what his body went through in the weeks that followed, and the two parallel stories running at the same time — a young man alone in the dark doing whatever it took to stay alive, and a sister in Kathmandu who refused, day after day, to accept what everyone around her was saying. This one will stay with you. 00:00 Podcast Intro 00:39 Storm on the Pass 02:35 Alone in the Whiteout 04:19 Shelter Under the Rock 05:16 43 Days Survival Setup 07:04 Backstory and Trek Plan 09:12 Winter Hazards and Bad Gear 12:15 Split Decision at the Pass 14:33 Creek Descent Goes Wrong 16:44 Rationing and Staying Alive 18:26 UV Damage and Darkness 19:26 Search Begins and Family Arrives 20:08 Joanne Refuses Defeat 21:15 Search Limits at Altitude 22:23 Life Under the Overhang 24:16 Why He Stayed Put 25:49 Helicopter Missed Signal 26:28 Giving Up Then Reversing 27:55 Collapse After 100 Meters 29:10 Day 42 Final Flyover 29:48 Blue Sleeping Bag Spotted 31:39 Hospital Recovery and Aftermath 33:30 Other Cases and Key Variables 35:18 Book, Media, and Missing Answers 37:05 Why He Survived 38:31 Hosts Reflect and Wrap   Listen AD FREE: Support our podcast at patreaon: http://patreon.com/TheCruxTrueSurvivalPodcast Email us! thecruxsurvival@gmail.com Instagram https://www.instagram.com/thecruxpodcast/ Get schooled by Julie in outdoor wilderness medicine! https://www.headwatersfieldmedicine.com/   SOURCES Primary Scott, J. and Robertson, J. (1993). Lost in the Himalayas. Melbourne: Lothian. Edinburgh edition 1994. Scott, J. (1992). 'James Scott: How I Survived.' Sun Herald, March 8, 1992. Republished at medicaltranslation.com.au Scott, J. and Bailey, E. (1993). 'Miracle in the Himalayas.' Reader's Digest, February 1993, pp. 31–38. UPI Archives (February 5, 1992). 'Man survives 43 days in mountains on snow and ice.' Includes direct quotes from Carl Harrison and Dr. F. Garlick. upi.com/Archives/1992/02/05/ Secondary Farafoot Survival Stories (2014). 'Lost in the Himalayas — A Fight for Survival.' farafootsurvivalstories.wordpress.com. Contains extended first-person account from James's 1992 Sun Herald article. Academic thesis: 'Traumatic Event Without Loss of Life.' Chapter 6, pp. 202–223. University of Queensland. reporting4work.com.au. Contains interview with Joanne Robertson. Wellcome Collection (1993). Archival illustration and reference materials. wellcomecollection.org/works/z65xekgt Zimmerman, M.D. et al. (1997). 'On being a patient: survival.' Annals of Internal Medicine, 127: 405–409. Hilless, B. (December 1998). 'A vision of human survival.' AMAQ News, Journal of the Queensland Branch of the Australian Medical Association. Real Risk Podcast, S2 E7 (October 15, 2020). 'Lost in the Himalayas — The Impossible Tale of James Scott.' realriskpodcast.com Trail Context Going the Whole Hogg (2025). 'Gosainkunda Trek: The Essential Guide.' goingthewholehogg.com/gosainkunda-trek-guide/ Note on Mark Fulton: Mark Fulton's account of events after he separated from James is not part of the public record. His absence from the book and from press coverage is documented in reader reviews of Lost in the Himalayas (Goodreads, 2020). This script reflects only what is verifiably documented. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Today we're delighted to talk with Anne Walling, Neil Wenger, and Rebecca Sudore about a pragmatic implementation trial aimed at increasing advance care planning for primary care patients with serious illness in University of California clinics, published in Annals of Internal Medicine. Seriously ill primary care patients were identified using structured data fields (meaning routinely captured without needing to read the chart or use natural language processing). This study focused on patients without a completed advance directive or POLST form. This was a 3 arm trial that tested a nudge in the patient portal and a mailed advanced directive vs. the nudge plus a link to PrepareForYourCare vs. the nudge plus PrepareForYourCare plus a navigator reminding patients to talk with their doctor and bring any completed advance directives or POLST forms to the PCP visit. In brief, the study found that at 2 years there were higher rates of advance directive or POLST in the electronic health record (about 20%) in the arm with the nudge plus PrepareForYourCare plus the navigator compared to the other 2 arms (around 13%). Rates of advance care planning discussions with primary care providers were similarly higher in the 3rd arm. Health care utilization, however, did not differ between arms.  Please see links to articles describing the intervention in detail and incorporation of stakeholder perspectives. I'm going to cut to the pushback to this article right up front:  The study's primary outcomes were advanced directives or completion of POLST forms - haven't we moved beyond thinking completion of forms should be the primary outcome of advance care planning research? There was no control condition. Observed increases in advance directive or POLST in the electronic health record may have occurred without any intervention.  People with serious illness get sicker with time and the sicker they are the more likely they are to engage in advance care planning, without any intervention. This is particularly true as the study occurred during the hight of the Covid pandemic, when there was a global effort to increase advance care planning. How much did these interventions contribute on top of that rise that might have occurred without intervention?  Observed documentation - 13-20% - was low.  Is it worth the effort of getting buy-in to automate these EHR nudges and spend FTE to hire a navigator? Particularly as health systems, who pushed for focusing on seriously ill patients because they are the most expensive/highest utilizers, did not get what they wanted, i.e. no difference in utilization of acute healthcare services between arms? Our guests provide a strong defense and additional context, which you can and should listen to on the podcast. And I have to point out, setting aside the advance care planning aspect, the method of identifying upstream primary care patients with serious illness is a major contribution to the field in and of itself.  Pioneers in the field, led by Amy Kelley, have been working to identify the seriously ill population for over a decade. And a fun fact about All You Need is Love - the verses are in 7/4 time! -Alex Smith  

This podcast is FULL of the background on the physician fee payment structure and how HR1 is immediately impacting this year. Dr. Fox is a long time advocate with great insight into how to bring about meaningful change moving forward.Revaluing Physician Services: CMS Has Some (but Not All) Answers | Annals of Internal MedicineWilliam Fox. Revaluing Physician Services: CMS Has Some (but Not All) Answers. Ann Intern Med.2026;179:127-128. [Epub 4 November 2025]. doi:10.7326/ANNALS-25-03638Schafer J, Vogel M, Grell T, Paez M, Parker A. 2023 Status of the Nebraska Healthcare Workforce. University of Nebraska Medical Center; 2023:70. https://www.unmc.edu/rural-health/_documents/healthcare-workforce-2024.pdf#2023%20ReportKey Findings on Primary Care Deserts (2023-2024 Data):County-Level Shortages: In 2023, 21 of Nebraska's 93 counties lacked a primary care physician.Maternity Care Deserts: Over 50% of Nebraska counties are considered maternity care deserts, lacking access to OB/GYN care or birth centers, which is significantly higher than the national average of 32.6%.Geographic Concentration: Approximately 83% of all diagnosing and treating practitioners in Nebraska are concentrated in metropolitan areas (Omaha/Lincoln), leaving rural areas underserved.Aging Workforce: A significant portion of the workforce is nearing retirement, with 19.4% of physicians in Nebraska being 61 or older, increasing the risk of further shortages in the next 5-10 years.Shortage Trends: While the number of counties with at least one primary care physician slightly increased, the overall number of primary care physicians per 100,000 population has continued to decline.Acronym key:Relative Value Scale Update Committee (RUC)Relative Value Units (RVU)Medicare Payment Advisory Commission (MedPAC)Medicare Access and CHIP Reauthorization Act 2015 (MACRA)Merit-Based Incentive Payment System (MIPS)Medicare Economic Index (MEI)William E. Fox, MD MACP is the Immediate Past Chair of the American College of Physicians, the country's largest medical specialty organization, representing internal medicine physicians, related subspecialists, and medical students.Previously, Dr. Fox served as Chair of ACP's Board of Governors and prior to that, he served as Governor of ACP's Virginia Chapter. Dr. Fox has received numerous honors and recognitions including the American College of Physicians Virginia Young Internist of the Year award in 2010, the Paul Florentino Volunteerism Award in 2013 and the Richard Neubauer Advocate for Internal Medicine Award in 2014.We rely on your donations to keep producing this podcast content and to support physician advocacy in Nebraska. If you would like to support Nebraska Alliance for Physician Advocacy, a 501(c)(3) organization in Nebraska please click to DONATE NOW. If you have questions or answers, please email us at contact@nebraskaallianceforphysicianadvocacy.orgPlease check out our website at: Nebraska Alliance for Physician AdvocacyFollow on social media:@NEAllianceforPhysicianAdvocacy on Instagramhttps://www.facebook.com/neallianceforphysicianadvocacy on Facebook

Contributor: Aaron Lessen, MD Educational Pearls: Burns range in complexity from minor first-degree burns to more severe full-thickness burns. Initial basic burn management: Run the burn under cool running water for 20 minutes. Do not scrub the skin. Do not use ice water. Ideally initiated as soon as possible, but no later than 3 hours after injury. Applicable to all burns ranging from superficial to full thickness. Then apply a non-adherent dressing or sterile gauze. Can be done at home or upon presentation to the emergency department. These steps decrease pain and minimize tissue damage. A study published in Annals of Emergency Medicine found that, out of 371 EMS and emergency medicine providers, 90% had not heard of the recommendation to run burns under cool water for 20 minutes. The majority of providers interviewed expressed motivation to implement this burn cooling practice but cited barriers such as: Difficulty immersing certain body parts (e.g., chest). Critically ill patients requiring other urgent interventions. References: Holbert MD, Singer Y, Palmieri T, et al. Cool Running Water as a First Aid Treatment for Burn Injuries. Annals of Emergency Medicine. 2025;S0196-0644(25)01138-2. doi:10.1016/j.annemergmed.2025.08.003. Olawoye OA, Isamah CP, Ademola SA, et al. Effect of Prehospital Topical Application of Water and Other Agents on Outcome in Burn Injured Patients: A Prospective Study. Burns. 2025;51(2):107357. doi:10.1016/j.burns.2024.107357. Summarized by Ashley Lyons, OMS3 | Edited by Ashley Lyons & Jorge Chalit, OMS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

The blueprint for your life starts much earlier than you realise - long before you took your first breath, before your heart beat its first beat, before your mum and dad even met.  This is the story of the first 1,000 days of life. From conception to age 2, a window so powerful that scientists now believe it influences our future risk of heart disease, obesity, diabetes, and even how our immune system reacts to the world. In this episode, the world's leading expert on how childhood nutrition and metabolism shape our long-term health, Professor Lucilla Poston, explains how early nutrition may influence appetite, metabolism, and future disease risk.  Lucilla and ZOE's Head Nutritionist, Dr Federica Amati, break down what science says about pregnancy, early feeding and the food children eat, and questions how lifelong health is shaped before a child even chooses their first meal. Lucilla offers practical guidance on what matters most and explains key nutrients to consider. They discuss why regular movement may help support healthy blood sugar levels. They also explain what a balanced diet can look like for parents and young children, why babies should try a wide range of whole foods, and why many packaged baby foods may contain far more sugar than parents expect. What small choices can you make today to help shape a healthier future for you, your children, and your children's children?

Contributor: Aaron Lessen, MD Educational Pearls: How long do we need to watch patients with a presumed overdose who were treated with naloxone in the field? A 2025 study in the Annals of Emergency Medicine took a look at this question Methods Prospective, multi-institutional cohort study Included ED patients with suspected acute opioid overdose with biologic testing to confirm substances. This paper performed a secondary analysis evaluating the risk of "delayed intubation," defined as intubation occurring >4 hours after ED arrival. Results 1,591 patients with presumed opioid overdose were included. Delayed intubation occurred in only 9 patients (0.6%). 8 of the 9 cases had non-respiratory causes contributing to intubation. Only 1 patient had respiratory-related deterioration, presenting with respiratory acidosis after receiving 6.4 mg naloxone prior to intubation. Key Takeaway Delayed respiratory deterioration requiring intubation after 4 hours of ED monitoring is extremely rare, suggesting prolonged monitoring may not be necessary for most stabilized overdose patients. How else can we mitigate risk? Give patients take-home naloxone at discharge and educate them on how to use it (See Episode 673: Leaving the ED with Naloxone). When are naloxone drips necessary? If a patient requires repeated naloxone boluses, consider a drip To get the dose, take the total naloxone dose that restored adequate breathing and give two-thirds of that dose per hour Typically these patients are admitted to the ICU References McCabe DJ, Gibbs H, Pratt AA, Culbreth R, Sutphin AM, Abston S, Li S, Wax P, Brent J, Campleman S, Aldy K, Falise A, Manini AF; ToxIC Fentalog Study Group. Risk of Delayed Intubation After Presumed Opioid Overdose in the Emergency Department. Ann Emerg Med. 2025 Jun;85(6):498-504. doi: 10.1016/j.annemergmed.2025.01.022. Epub 2025 Mar 4. PMID: 40047773; PMCID: PMC12955731. Summarized and edited by Jeffrey Olson MS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

Beta-blocker in non-obstructive hypertrophic cardiomyopathy, a head-to-head apixaban vs rivaroxaban RCT, diltiazem vs metoprolol combined with DOAC, and the accuracy of smart watches for AF are the topics John Mandrola, MD, discusses in this week'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 Listener Feedback EMPATICC trial https://academic.oup.com/eurheartj/article/47/9/1034/8242490 II Beta-blocker in Non-obstructive HCM BB vs Calcium Channel Blocker in Non-obstructive HCM https://doi.org/10.1016/j.jacc.2025.11.028 RCT of Metoprolol in Patients With Obstructive HCM https://doi.org/10.1016/j.jacc.2021.07.065 III Apixaban vs Rivaroxaban for Bleeding Risk COBRRA Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2510703 AMPLIFY Trial (Apixaban) https://www.nejm.org/doi/10.1056/NEJMoa1302507 EINSTEIN Trial (Rivaroxaban) https://www.nejm.org/doi/full/10.1056/NEJMoa1007903 IV Diltiazem vs Metoprolol When Combined with DOAC Risk for Bleeding in AF Patients Using Apixaban or Rivaroxaban With Diltiazem https://www.acpjournals.org/doi/10.7326/ANNALS-25-01408 V Actual Clinical Use of Smart Watches CIRCA-DOSE Original Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.042622 Wearable Smartwatches for AF Detection After Ablation https://doi.org/10.1093/europace/euaf280 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

What health habits actually protect your brain and long-term health?  In this episode, Professor Tim Spector shares the seven health ideas he has changed his mind about after reviewing new research. From oral health and inflammation to vitamin D, sleep, and exercise, Tim explains the daily habits he now prioritises and helps us understand what we should do differently if the science changes. Tim revisits 7 common health beliefs and explains how new evidence has shifted his thinking. He explores the link between oral health, inflammation and brain ageing, and discusses vitamin D, sunlight and omega-3s. The conversation also looks at sleep timing, exercise and how everyday habits interact with our biology. Tim also shares the small changes he now makes in his own routine and provides practical ideas for incorporating them into your daily life. We all know that science evolves as new evidence emerges, so if the research changes, should our daily health habits change too?

This episode was originally published on August 19th, 2021. This week's podcast guest is especially exciting to me as he is one of my literary heroes. John McPhee [24:10] is a Pulitzer Prize-winning author (Annals of the Former World), and in his numerous other books he has written about such diverse topics as nuclear energy, the merchant marine, basketball, Alaska, bark canoes, oranges, continental drift, flood control, tennis, farmer's markets, and many other eclectic topics. Whether or not you are interested in a subject, you can be sure you will be when you finish reading one of his books you will be fascinated. John has also been a staff writer for The New Yorker since the 1960s. In our interview, he talks about his two favorite fish to catch on the fly rod--the American shad (which he wrote an entire book about, The Founding Fish), and the chain pickerel, which he did not write a book about but did pen a short essay on in his collection of stories The Patch. (I doubt is anyone in the world who would count those two fish in combination as their favorites--but he is never conventional.) I hope you enjoy the interview as much as I enjoyed talking to him. In the Fly Box this week, we have some great questions and tips: A reminder from a listener that I wrote an encyclopedia of fly fishing. Some great tips from a listener on using tippet rings. A question about what constitutes a watershed when concerned about transporting aquatic invasives. A suggestion from a listener on ways to offset your carbon footprint when taking fishing trips.  Which is a better rod for fishing the surf and jetties--a traditional 9-foot 9-weight rod or a two-handed rod? Do you always recommend using a net? A listener calls me on the carpet for my flippant remark about manhandling carp. A great thought from a listener that sometimes taking photos of fish hinders the moment.

Robotic surgery has moved from novelty to norm, and in this episode of Behind the Knife, Drs. James Jung and Joey Lew sit down with urologic pioneer and Medtronic CMO Dr. Jim Porter to dissect how we got here, what the data really say about “the death of laparoscopy,” and where competing robotic platforms like Hugo may take the field next. From ergonomics and education to economics and global access, they tackle both the hype and the hard questions around robotics as the future of minimally invasive surgery.Hosts: ·      James Jung, MD, PhD, Assistant Professor of Surgery, Duke University·      Joey Lew, MD, MFA, Surgical resident PGY-3, Duke University, @lew__actuallyLearning Goals: By the end of this episode, listeners will be able to:·      Describe key clinical, ergonomic, and educational drivers behind the rapid adoption of robotic surgery in the United States and globally.·      Summarize current evidence comparing robotic and laparoscopic approaches for common procedures, including where outcomes are equivalent, inferior, or clearly superior.·      Explain how surgeon ergonomics, trainee experience, and video-based learning influence practice patterns and learning curves in minimally invasive surgery.·      Discuss the role of cost, reimbursement structures, and market competition (e.g., Medtronic Hugo vs da Vinci) in shaping robotic adoption across different health systems.·      Anticipate how next-generation, task- or organ-specific robotic platforms may further change standards of care in minimally invasive surgery.References:·      Violante T, Ferrari D, Novelli M, Larson DW. The Death of Laparoscopy - Volume 2: A Revised Prognosis. A retrospective study. Ann Surg. 2025 Jun 16. doi: 10.1097/SLA.0000000000006792. Epub ahead of print. PMID: 40518997. https://pubmed.ncbi.nlm.nih.gov/40518997/·      Yu Yoshida, Yoshiro Itatani, Takehito Yamamoto, Ryosuke Okamura, Koya Hida, Kazutaka Obama, Single-incision plus one robot-assisted surgery (SIPORS) using the Hugo robotic-assisted surgery (RAS) system for rectal cancer, Annals of Coloproctology, 10.3393/ac.2025.00787.0112, 41, 6, (586-591), (2025). https://pubmed.ncbi.nlm.nih.gov/41486916/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://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US