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The Roundtable Panel: a daily open discussion of issues in the news and beyond. Today's panelists are WAMC's Alan Chartock, investigative journalist and UAlbany adjunct professor Rosemary Armao, Peabody and Emmy Award winning journalist Linda Ellerbee, and former Associate Editor of the Times Union Mike Spain.
In this episode of the Award-winning PRS Journal Club Podcast, 2021 Resident Ambassadors to the PRS Editorial Board – Saïd Azoury, Emily Long, and Ronnie Shammas- and special guest Amy Colwell, MD, discuss the following articles from the January 2022 issue: “Risk of Developing Breast Reconstruction Complications: A Machine-Learning Nomogram for Individualized Risk Estimation with and without Postmastectomy Radiation Therapy” by Naoum, Ho, Shui, Salama, et al. Special Guest Amy Colwell, MD, is full time Faculty in the Division of Plastic Surgery at Massachusetts General Hospital and Professor of Surgery at the Harvard Medical School. Dr. Colwell has served as an Associate Editor in the Editorial Board of PRS since 2016 and is the new Co-editor of Plastic and Reconstructive Surgery Journal. READ the articles discussed in this podcast as well as free related content from the archives: https://bit.ly/JCJan22Collection #PRSJournalClub
The Roundtable Panel: a daily open discussion of issues in the news and beyond. Today's panelists are WAMC's Alan Chartock, investigative journalist and UAlbany adjunct professor Rosemary Armao, The Empire Report's J.P. Miller, and former Associate Editor of The Times Union Mike Spain.
In this episode, Social Justice and Sports Medicine Research Specialist, Sheree Bekker, talks about social justice in sports, medicine, and research. Today, Sheree talks about the conversations around physiology and injuries, and the different environments that affect the ACL injury cycle. How do clinicians implement the findings in the research? Hear about Sheree's qualitative research methods, the importance of recognising the social determinants of injuries, tackling systemic experiences, and get Sheree's advice to her younger self, all on today's episode of The Healthy, Wealthy & Smart Podcast. Key Takeaways “We have to recognise the human at the centre of those experiences.” “Gendered language that seems like everyday language in sport can be really harmful to both men and women.” “[Be] cognisant of, and [be] able to have those conversations with athletes, patients, people that you work with all the time about their social conditions of their lives.” “The social conditions of our lives play into our injuries and our rehabilitation.” “It is about not simply seeing rehab as a biomedical issue alone to solve, but thinking about it as socially, politically, and materially oriented is a practice that you might incorporate in your way of thinking.” “Injury prevention, and a contemporary vision for injury prevention, needs to be athlete-centred and human-focused.” “We need to have those uncomfortable conversations about our complex, messy realities.” “Context is everything.” “Sport isn't neutral. It isn't apolitical.” “We can start to ask these questions, start to have these conversations. The answers aren't going to come tomorrow.” “These ripples will take some time.” “Connection is greater than competition.” “Hold on to the power of connecting with people who are at the same career stage and doing work with people who are at the same career stage as you.” More about Sheree Bekker Dr Sheree Bekker (she/her) was born in South Africa, grew up in Botswana, completed her PhD in Australia, and now calls Bath (UK) home. She is an expert in ‘complexity' and research that links social justice and (sports) injury prevention. She has a special interest in sex/gender and uses qualitative methods. This underpins her work as an Assistant Professor in Injury Prevention and Safety Promotion in the Department for Health at the University of Bath. At Bath, she is Co-Director of the Centre for Qualitative Research, and a member of the Centre for Health and Injury and Illness Prevention in Sport (CHI2PS), and the Gender and Sexuality Research Group. Internationally, Sheree is an Early Career Representative for the International Society for Qualitative Research in Sport and Exercise, and a founding member of the Qualitative Research in Sports Medicine (QRSMed) special interest group. In 2020 she was appointed as an Associate Editor of the British Journal of Sports Medicine, and in 2021 she was appointed Qualitative Research Editor of BMJ Open Sport and Exercise Medicine. She completed a Prize Research Fellowship in Injury Prevention at the University of Bath from 2018-2020, and received the 2019 British Journal of Sports Medicine Editor's Choice Academy Award for her PhD research. Suggested Keywords Healthy, Wealthy, Smart, Physiotherapy, Social Justice, Injury, Prevention, Gender, Sexuality, Physiology, Sociology, Environment, Research, Change, Resources: Anterior cruciate ligament injury: towards a gendered environmental approach To learn more, follow Sheree at: Website: https://sites.google.com/view/shereebekker/home Twitter: @shereebekker Instagram: @sheree_bekker Subscribe to Healthy, Wealthy & Smart: Website: https://podcast.healthywealthysmart.com Apple Podcasts: https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264 Spotify: https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73 SoundCloud: https://soundcloud.com/healthywealthysmart Stitcher: https://www.stitcher.com/show/healthy-wealthy-smart iHeart Radio: https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927 Read the Full Transcript Here: 00:02 Hi, Sheree, welcome to the podcast. I'm so excited to have you on. I've been looking forward to this for a long time. So thank you so much for joining. 00:12 Thank you for having me. Karen. I am delighted to be talking to you today. 00:16 And today we're going to talk about some of now you had a couple of different presentations at the International Olympic Committee meeting in Monaco a few weeks ago, and we're going to talk about a couple of them. But first, I would love for you to tell the audience a little bit more about you, and about the direction of your research and kind of the why behind it. Because I think that's important. 00:43 Mm hmm. Yeah, I've actually I have been thinking about this a lot recently, over the course of the pandemic, and thinking about where my research and my work is going and why I'm so interested in in kind of social justice issues in sports injury research in Sport and Exercise medicine. And I guess for me, there are two reasons for that both of them related to my background. First of all, I was born in South Africa. And I grew up in Botswana. And I think, you know, growing up into countries that have interesting pasts, you know, South Africa having post of apartheid and Botswana having been a colonized country, I think I grew up in places where we were used to having difficult conversations about social justice issues on a national level. And I think, you know, that is something that has influenced me definitely in the way that I see the world. The second part for me is I studied human movement science at university. And my program was in a Faculty of Humanities and Social Sciences. And I didn't realize at the time that most people get their sport and exercise medicine, sports science, human movement, science training, in medical faculties, or in health faculties, whereas mine was very much social sciences and humanities. And I only realized this later that my training in this regard was quite different in terms of the way that I see the work that we do. And so now, I've landed here at the University of Bath, and I'm in a department for health. But once again, I'm back in a Faculty of Humanities and Social Sciences. So it's been a really, really nice connection for me to come back to these bigger social justice questions, I guess, that I'm interested, you know, in our field. So for me, that's really the why I think of why I do this work. 02:42 And, and kind of carrying along those themes of social justice and really taking a quat. Know, a quantitative, qualitative, sorry, qualitative eye, on athletes and on injury, let's talk about your first talk that you gave it at IOC, which is about the athletes voice. So take us through it. And then we'll ask some questions. So I'll, I'll shoot it over to you. 03:17 Yeah, so um, my first talk, the first symposium that I was involved in at IOC this year, we had titled The athlete's voice, and those of us who were involved with it, we're really proud to be able to get this topic, this kind of conversation onto the agenda in Monaco. I had so many people comment to me afterwards, that this was the first time that we've been able to have this kind of discussion at this specific conference. And, you know, previous editions, I think, have been very much focused on that biomedical that I was just talking about, given that it's Sport and Exercise medicine. And it was the first time that we've been able to bring athlete voice into this space. And so this symposium in my talk in particular, was really focused on qualitative research. Even though when we pitched the symposium, we kind of decided that we couldn't call it qualitative research, because it wouldn't have been accepted at the time. And, and now, it's amazing to me how far we've come that we can actually talk about qualitative research in these spaces. So what I spoke about, and what I was interested in is, you know, what are the kinds of different knowledges and who are the people that we might listen to in Sport and Exercise medicine and sports injury more broadly, that traditionally we maybe haven't scented and haven't listened to? And I was interested in those kinds of social meanings of injury and of injury prevention and how we might do things differently. So you know, for me, it was that Recognizing the value of alternative perspectives, and working across disciplines and advancing our research and practice in this way. And so that's really what I spoke about was, you know how we might do these things differently by actually listening to the people at the center of our work and listening to athletes themselves. And that was really the focus of that symposium. 05:26 And in looking through some of the slides from the symposium, some of the quotes that I'm assuming we're taking from the qualitative work are, gosh, they're kind of heartbreaking. So what do you do with that information once you have it, right? So you're conditioned not to quit, you turn off your emotions, you become a robot as soon as you step onto the field or the pitch or the court. So how do you take that qualitative research? And what do you do with that once you have it? 06:01 Yeah, so you know, my talk, the way I kind of structured my talk was to talk about how we generally do injury prevention. And what we generally do is we, you know, figure out what the issue is what the injury problem is, we develop an intervention, and then we implement that in intervention and hope that it works. And, and some, you know, that's the kind of general cycle that we use. And what I decided to do in my talk, which was only a 10 minute talk was to dedicate two of those minutes to a video that I showed, that was just set to music that flashed up all of these quotes from athletes. And there were quotes that I'd collected from a number of different sports, a number of different athletes and spaces over the years, that really speak about their experience in sports and these toxic environments, which is something that I think we tend to kind of put to the side, maybe sometimes and ignore, sometimes in sport, when we put sport up on a pedestal and only think about the good things that happen in sports. And those quotes are also, I guess, a throwback or connection to one of the other talks that I had at IOC, which is not something that I think we'll speak about today, but about safeguarding and recognizing safeguarding as an injury prevention issue. And so we had these, like two minutes of these quotes from athletes. And I think that video really signaled a palpable shift in the room in recognizing what athletes are actually saying, and what their experiences are in sport about needing to, I guess, you know, put their their kind of robot hat on and be this strong person within sport where they can't break down where they can't have injuries or anything like that. Otherwise, they're going to be the team. And just for us to come back and to recognize that humanity in that experience, within sport, I think is really, really important, especially when we're at a conference where we're talking about injury prevention and interventions, we have to recognize the human at the center of those experiences. And so for me, coming back to your question about what do we do with that information? I think that's really powerful information, in terms of how we think about what injury prevention is, and does. And I guess we always focus on bodies, and you know, body parts, the ankle, the knee, the hip, the growing. You know, that's, that's kind of been a big focus of injury prevention. And I think we often forget that injury prevention is and can be so much more than that. And that there are these social factors, or social determinants, that to play into injury and its prevention. So the social aspects of our lives in terms of, you know, abuse that might happen in these spaces, or just being exposed to toxic spaces, you know, how that does actually render us more susceptible to injury, and how that can thwart our injury prevention efforts in these spaces. So for me, it's about integrating both of those two things I think together, and that's what I'm kind of getting at with qualitative research. 09:19 And, and that leads me into something else I wanted to talk about, and that is a review from the British Journal of Sports Medicine that you co authored with Joanne Parsons and Stephanie Cohen, anterior cruciate ligament injury towards a gendered environmental approach. And what you just said, triggered in me something in in reading through that article was that there's intrinsic factors and extrinsic factors that can lead to injury and injury prevention programs, if done well, should incorporate both of those. Right but they often concentrate on the biomedical part of the The, whether it be strength training, or landing, or, you know, whatever it may be when we look at a lot of these injury prevention programs, but there are so many contextual issues and extrinsic issues that can impact any of those programs. So I'll kind of let you sort of talk through that a little bit and talk through some of the main points that you found in that paper. But gosh, it really gets you thinking like, Well, wait a second, it could be, like you said, if you are, depending on the environment in which you live, can have a huge impact. And it's, it's more than just, especially when it comes to girls and women, it's more than just oh, it's because you have your period. And that's why this happened. Or if your hips are wider, that's why you got injured, right? So go ahead, I'll throw it over to you. And you can kind of talk through that paper a little bit, and then we'll see what comes up. 11:04 Mm hmm. You know, I'm so happy to hear you say that, because I'm so I'm not a clinician, but it has been amazing to me to hear how this paper has resonated with clinicians and people working in this space in terms of your own experiences and what you see and what you hear from the people that you're working with. So yeah, you're absolutely right. I mean, this paper was born out of conversations that Steph and Joanne and I had in terms of how we were frustrated by I guess, the discourse around sports injury, particularly for girls and women, often being blamed on our physiology on our bodies, right. And to us, that seems like a bit of a cop out. And just to say, oh, you know, girls are more susceptible to ACL injury, because they have wider hips, so there's nothing that we can do about it, you know, so that's really pitched us that intrinsic risk factor that girls and women are just inherently weaker, or supposedly more fragile than boys and men, and there's nothing that we can do about it. So we're just going to have to kind of live with those injury breeds. Right. And, and we found that this kind of thinking had really underpins so much of the injury prevention work that we'd seen over the last 10 or 20 years. And we wanted to problematize this a little bit and to think through what those kind of other social and I would say structural determinants of sports injuries are. So I'm starting to talk about this idea of the social determinants of injury. So not just what are those intrinsic things, but actually, what are the what are the other other social modes, I guess, that we might carry that might lead to injury. So in this paper, we speak about how we, as human beings, literally incorporate I think, biologically, the world in which we live. So our societal or ecological circumstances, we incorporate that into our bodies. And so we can start to see how injury might be a biological manifestation of exposure to that kind of social load. So for girls and women, how our gendered experience of the world might render us more susceptible to injury, rather than just positioning ourselves as being more weak, or more fragile. So we were interested in how society makes us and skills in women more weaker, and more fragile. And so in this way, we speak about how you know, from the time that we're babies, girls are not expected to do as much physically we are brought up differently to young boy babies might be when we go through school and play sport in school, we play different kinds of sports, and again, you know, on average, or in general, and girls, goes out, you know, not encouraged to be as active and to do as much with our bodies as boys. And we then go in right to have this kind of that cumulative effect of less exposure to activities and doing things with our bodies. Actually, that is what leads to us being more susceptible to things like ACL injury over time. And this is carried on in the kind of elite sports space as well. So we see how girls and women's sports are devalued in so many ways and how we're not expected to do as much or to perform as well. Or to train as hard I guess, as boys and men So an example of this that actually happened a couple of weeks after we published the paper was the NCAA March Madness. I don't know if you remember, there were those pictures that were tweeted all over social media, about the women's division, only being supplied with one set of teeny, tiny Dunda. Whereas the men's division was given, you know, massive weight room with everything that they needed to be able to train to be able to warm up and do everything that they needed to do in that state. And the first that was just an excellent example of what we're talking about in terms of girls and women being expected to and actually being made, I guess, weaker than boys and men are in exactly the same sports spaces. And so that's kind of a rundown, I guess, of what we wrote about in the paper. 15:53 Yeah, and I look back on my career as I was a high school athlete, college athlete, and not once was it, hey, we should go into the gym and train with specific training programs, because it will help to make you stronger, maybe faster, better, less prone to injury, but the boys were always had a training program. You know, they always had a workout program. So I can concur. That is like a lived experience for me as to what training was like, comparing the boys versus girls college straight through or high school straight through to college. And yes, that March Madness thing was maddening. Pun intended. I couldn't you could not believe couldn't believe what we were seeing there. That was that was completely out of bounds. But what I'd like to dive in a little bit deeper to the article, not not having you go through everything line by line. But let's talk about the different environments that you bring up within the article, because I think they're important. And a little more explanation would be great. So throughout this kind of ACL injury paradigm, you come up with four different environments, the pre sport environment, the training environment, the competition environment, and the treatment environment. So would you like to touch on each of those a little bit? Just to explain to the listeners, how that fits into your, into this paper and into the structure of injury prevention? 17:31 Yeah, sure. So um, yeah, what we did with this paper was we take we take the the traditional ACL injury cycle, and that a lot of us working in sports injury prevention are aware of, and we overlay what we called gendered environmental factors on top of that, so we wanted to take this this site, call and think through how our gendered experiences and girls and women, again render us more susceptible, and over the course of a lifetime, or a Korean. And so starting with the pre sport environment, you know, that goes back to what I was just saying about girls and boys being girls being socialized differently to boys, when we're growing up. So that kind of life course effect, gender affects over the life course, in terms of what we're expected to do with our bodies. That really starts in that pre sport environment when we're babies and young boys and young girls. And then we track how that works throughout the ACL injury cycle. So moving into the next step, coming back to this NCAA example, you know, what the training environment looks like, and how it might be gendered in ways that we might not even pick up on. So another example here, and this is a practical example that we've given to some sports organizations, since then, is, you know, the kind of gendered language that seems like everyday language and sport that can actually be really harmful to both men and women. So for example, you know, talking about girl push ups, you know, that really does set a precedent for what we think about girls and women in sports spaces. When you say, Oh, you go over there and do some girl push ups, it really does render girls and women as being more weak, you know, weaker and more fragile than boys and men. So those kinds of gendered experience in sports spaces, and you're an example there is really key. But then we also talk about kind of during injury and post injury as well. And this comes more into the kind of rehabilitation space and so on how, again, expectations of girls and women's bodies might play into what we expect when we go through rehabilitation as well and, and how that plays into that ACL injury cycle of recovery, as well. So that's really for So it was overlaying gender, across all of those spaces. And I think that gives us a really powerful way of looking at ACL injury differently and to, to conceptualize what we might do both in injury prevention, but also once injury has happened to help girls and women differently. 20:20 And in reading through this paper, and and also going through the slides that you graciously provided on Twitter, of of all of your talks at IOC, as a clinician, it for me, gives me so much more to think about, and really sparked some thoughts in my head as to conversations to have with the patient. So what advice would you give to clinicians, when it comes to synthesizing a lot of this work? And taking it into the clinic, talking with their patient in front of them and then implementing it? Because some people may say, oh, my gosh, I have so much to do. Now, I have to read all of this. Now I have to incorporate this, do you know what I mean? So it can some be somewhat overwhelming. So what advice do you have for clinicians? Yes, 21:13 so I really do think and as I said earlier, I think a lot of what we're seeing here is what clinicians are doing all the time anyway, I think, especially people who are already connected to this kind of idea of this social determinants of health. And so I guess, for me, it is really just being cognizant of, and being able to have those conversations with athletes, with patients with people that you work with all the time, about their social conditions of their lives. So not again, not just reducing people down to bodies, but recognizing that people have you know, that the social conditions of our lives play into our injuries and our rehabilitation, and holding space for that, you know, when I'm teaching, that's what I say to my students all the time, but I know that that you know, this, and clinicians know this better than I do. You, you know, it's not just about saying to someone, go away and do these exercises, and come back to me when you know, that person might have a full time job with three kids to look after. And, you know, a lot of other things on their plate as well that that one exercise or exercise program isn't necessarily going to be the silver bullet or the answer to, you know, the way that they need to be dealing with that injury. So I think for me, it's again, that re humanizing and being able to have those those conversations and recognizing those social determinants of injury or recovery, and so on. And so I think for clinicians, it is about not simply seeing rehab as a biomedical issue alone to solve, but thinking about it as socially and politically and materially oriented as a practice that you might incorporate in your way of thinking. That's really it. It doesn't need to be any more than that. We don't need to complicate it. Any more than that. 23:10 Yeah. Perfect. Thank you for that. And as we start to wrap things up, is there a, are there any kind of key points that you want to leave the listeners with? Or is there anything that we didn't touch on that you were like, oh, I need I need people to know this. This is really important. Hmm. 23:36 Yeah, I think, you know, if we kind of connect the conversations that we've kind of had today with the different points that we've connected to, I think, you know, what I saw in IRC at the IOC conference in Monaco is I really felt especially on day one at that athlete centered symposium that we had, I really felt like a palpable shift in that room. And in the conversations that I've had afterwards, with people I've had so many people come up to me to say that, you know, that it was really inspiring, and it's helped them to be able to go away and have different kinds of conversations, incredibly have different kinds of conversations about the work that we're doing in injury prevention and in Sport and Exercise medicine more broadly. And so I really think that we need to focus on that idea that injury prevention and a contemporary vision for injury prevention needs to be athlete centered and human focused. And I think if we truly committed to this, I think the ways in which we develop our interventions, and the ways in which we might go about our work, more generally in Sport and Exercise medicine, in physiotherapy and so on, it needs to reflect the socio cultural, so meaning those social determinants of injury in cluding the ways in which things like sexism, and misogyny, and racism, and classism, and ableism, and homophobia and transphobia, how that all can and does actually lead to injury. I think those are larger conversations that we need to be having enough field that we've started to have very slowly, but they are difficult conversations to have. And we often cut them out when we only think about injury as a biomedical thing, again, only thinking about bodies. And so for me, I think those are the those are the thing that we now need to get uncomfortable, you know, about, we need to have those uncomfortable conversations about our complex, messy realities, and that we're dealing with that athletes are human beings, that these are our experiences of the world, that sport and exercise medicine needs to reflect that as well. In terms of our composition, we need to reflect the communities that we serve as well. And Tracy Blake talks about that often. And you know, those are the conversations that I'd like to see our field having going forward. And I do think there was a shift in being able to say those things at Monaco this year. 26:16 Yeah. And so what I'm hearing is, was the big takeaway for me from Monaco is context is everything. And we can't, we can no longer take that out. And focus, like you said, just on the biomedical aspect of this person in front of us as if they don't have past experiences and emotions and thoughts and fears and concerns. And context is everything. And for clinicians, it sounds like a challenge to start having these conversations at more conferences. I know it's this little kind of bubble of clinicians, but if it can start there, perhaps it can make a ripple out into the wider public and into having these conversations with your athletes and patients and not be afraid to have these difficult conversations, or to ask the probing questions to the person in front of you. Because they're more than just their ACL injury, they're more than just their back pain. So I think challenging clinicians to have these conversations, whether it be one on one like this, or within large groups at conferences, and then take that back to your, to your practice and really start living it and understanding that this can is as important, maybe, in some cases more important than the biomedical injury in front of you. 27:41 Oh, I could not agree more with that statement. I mean, something that I've spoken about a lot before is that, you know, sport isn't neutral. It's not a political. And it's the same for the work that we do. It's, you know, for far too long, it's been positioned as a neutral science thing that we do. And I think we're now starting to recognize the context around that, that our values and our principles and people's lives and experiences, you know, as you say, play as much as if not more of a role in their experience of sport, and injury, and rehab, and all of that. So I would agree with you completely, we need to be having more of these conversations, we need to recognize this within our research, we need to recognize this within our practice. And we can't keep going on as if you know, none of so if we can remove all of that from the practice of working with human beings and being human beings as well. You know, all of this is connected for me. And as you know, as we're seeing now, it's for all of us who work in this space, once we start to have these conversations, we can start to ask different questions, we can start to think about things differently. And I think that that's really powerful for the future of our work in this space. 28:55 Yeah. And I think it's also important to remember that we can start to ask these questions start to have these conversations that the answers aren't going to come tomorrow. So that instant gratification that has become the world that we are now living in that if it doesn't happen within the next couple of days, that means it's not going to happen, but that these ripples will take some time. Yeah, absolutely. 29:19 And, you know, so a lot of my work is in complexity theory. And what I say about that is, you know, there probably are not going to be hard and fast answers here. But it will bring up new considerations and it will bring up I think, I'd like us to move away from this idea that we can solve things, but actually move closer towards the idea that this is an ongoing practice. And that that's always going to be I think, more powerful for me when we see things like injury prevention as a process or a practice. That's not necessarily going to solve things. But that is you know, really To the context in which we live in our lives is an ongoing thing. And I think that's what we brought into the ACL injury cycle. Papers. Well, 30:09 yeah, I think it takes away from the clinician as being the MS or Mr. Fix it to, okay, we are layering ourselves into people's lives. And we need to be able to do that in a way that fits the person in front of us as best we can. 30:26 Yeah, exactly. Beautifully said exactly. We can't necessarily solve those things for them. But these provide considerations, things that we can do. And yeah, we can move with that. 30:39 Yeah, absolutely. Well, Cherie, thank you so much. I mean, we can go on and talk for days on end about this stuff. And perhaps when one of these days we will we'll have a bigger, wider, broader conversation and and make it go on for a couple of hours, because I'm sure it will bring up a lot of questions, maybe some answers, and perhaps some changing of minds when it comes to injury prevention and what our role is as clinicians. So thank you so much, where can people find you? 31:13 Thank you, Karen. And I love that I think broader conversations are so helpful in this space. So people can find me on Twitter at Shree Becker, that's probably the best place to find me. I'm always over there and happy to have broader conversations with everybody. So please come and find me on Twitter. 31:32 Perfect. And we'll have links to everything, including the paper that we're talking about. From BDSM. We'll have links to everything at the show notes at podcast dot healthy, wealthy, smart, calm. So one question left that I asked everyone and that is knowing where you are now in your life and in your career? What advice would you give to your younger self? 31:51 Oh, so that's a really good question. And it's I think it's my Elan series, again, connected to what we saw in Monaco. And something that I've said for many years now is connection is greater than competition. And something that I live in that I feel like I wish I had done earlier is to hold on to the power of connecting with people who are at the same career stage and doing work with people who are at the same career stages as you especially someone who has and is an emerging researcher, or researcher clinician in this space, because I think the exciting new conversations that we're seeing in this space are coming from people who are you know, recently merging, I guess, in these researchers faces and so it's okay to collaborate rather than being in competition with people who are doing great work in your area. So that would be my advice. 32:54 I love it. I love it and couldn't agree more. So Sheree, thank you so much for coming on. Thank you again. I appreciate it. 33:02 Thank you so much, Karen. And everyone. Thanks 33:04 so much for tuning in and listening and have a great couple of days and stay healthy, wealthy and smart.
My SLP professor, Dr. Stefka Marinova-Todd, is back on the SLP Corner podcast for a part two! She is a developmental psycholinguist with her main research interests being bilingual language development and second language acquisition. Dr. Marinova-Todd is an Associate Professor at the School of Audiology and Speech Sciences at UBC and is currently an Associate Editor at Applied Psycholinguistics, and is on the editorial board at Language, Speech and Hearing Services in Schools which is an ASHA journal. Previous podcast recordings with Dr. Marinova-Todd:25. SLP CORNER: Bilingualism and Language Development with Dr. Marinova-Todd26. SLP CORNER - SNACK: Bilingualism and Autism with Dr. Marinova-Todd86. The reference to Paradis' work on how monolingual SLPs could still do assessment on bilingual children:Paradis, J., Schneider, P. & Sorenson Duncan, T. (2013). Discriminating children with language impairment among English language learners from diverse first language backgrounds. Journal of Speech, Language and Hearing Research, 56, 971-981.Free resources fo the assessments used in the article that Johanne and her colleagues have provided on their websites:The ENNI instrumentThe Parental Questionnaire on first language development (ALDEQ)Two recent articles from the US on working with Spanish-English bilingual children:1. Lazewnik, R., Creaghead, N. A., Smith, A. B., Prendeville, J. A., Raisor-Becker, L., & Silbert, N. (2019). Identifiers of Language Impairment for Spanish-English Dual Language Learners. Language, speech, and hearing services in schools, 50(1), 126–137. 2. Elizabeth D. Peña, Lisa M Bedore, Mirza J. Lugo-Neris & Nahar Albudoor (2020) Identifying Developmental Language Disorder in School Age Bilinguals: Semantics, Grammar, and Narratives, Language Assessment Quarterly, 17:5, 541-558,CHILDES website: https://childes.talkbank.org4) The International Guide to Speech Acquisition (2007), Sharynne McLeod (Ed.), Delmar Publishers Inc.The Oxford Handbook of Speech Development in Languages of the World, which will be an updated and expanded version of the Guide, is coming up in the near future.Please rate and review the podcast and thank you for listening! Also, make sure to follow me on: Facebook - SLP Corner Instagram - slpcornerCheck out my blog: www.slpcorner.comSupport the show (https://www.buymeacoffee.com/slpcorner)
In this episode of the Award-winning PRS Journal Club Podcast, 2021 Resident Ambassadors to the PRS Editorial Board – Saïd Azoury, Emily Long, and Ronnie Shammas- and special guest Amy Colwell, MD, discuss the following articles from the January 2022 issue: “Exercise after Breast Augmentation: A Randomized Controlled Trial” by Basile and Oliveira. Special Guest Amy Colwell, MD, is full time Faculty in the Division of Plastic Surgery at Massachusetts General Hospital and Professor of Surgery at the Harvard Medical School. Dr. Colwell has served as an Associate Editor in the Editorial Board of PRS since 2016 and is the new Co-editor of Plastic and Reconstructive Surgery Journal. READ the articles discussed in this podcast as well as free related content from the archives: https://bit.ly/JCJan22Collection #PRSJournalClub
Associate Editor at Reason and reason.com Liz Wolfe, joined Rich to discuss colleges using Omicron as an excuse to switch back to virtual learning despite a high vaccination rate and mild symptoms of those who are infected with the Omicron variant.
Zeoli Show Hour 3: In the third hour of the Zeoli Show, Rich discussed the very controversial animal testing that Dr. Fauci is connected to, including the use of transgender hormones on primates to study HIV as well as beagle testing. Then, a Canadian politician gets slammed on Twitter for praising his wife for shoveling the driveway instead of him. Associate Editor at Reason Liz Wolfe joined Rich discussing colleges going back to a virtual learning model.
The Roundtable Panel: a daily open discussion of issues in the news and beyond. Today's panelists are WAMC's Alan Chartock, investigative journalist and UAlbany adjunct professor Rosemary Armao, Vice President for Editorial Development at the New York Press Association Judy Patrick, and former Associate Editor of The Times Union Mike Spain.
The Omicron variant of COVID-19 has been surging and Americans looking for a test have been faced with long wait times and a scarcity of at-home testing kits. Louisiana Republican Senator Bill Cassidy joins to explain why he's disappointed in the Biden administration's pandemic response and how the science surrounding cloth masks has evolved. Later, Senator Cassidy weighs in on Democrats' push to change the filibuster to pass voting rights legislation and his hopes President Biden and the Democrats attempt to work in a bipartisan manner on issues important to Americans. Though fewer jobs are now being created in the U.S. than economists initially predicted, we're seeing stable labor force participation rates, the lowest unemployment rate recorded since before COVID-19, and American workers making more money now than ever before. With increasing inflation levels, continuous supply chain disruptions, and a prominent rise in people quitting their jobs to seek better opportunities, it seems the current state of our economy is riddled with contradictions. Associate Editor of The Wall Street Journal John Bussey is here to explain how our economy manages to look this way amidst COVID-19 and offers potential predictions about what we can expect in light of the Omicron variant's recent surge in the U.S. Plus, commentary by Guy Benson, host of the Guy Benson Show.
In this special episode of Clean Beauty School, mbg associate beauty editor Jamie Schneider joins me as special guest host to talk about our new personal care line, product recs, and our 2022 new years goals. A must listen! Show notes: -Check out Jamie's work on mindbodygreen. -Learn more about our postbiotic body lotion & hand cream. -Read about the ingredients in our body care collection: pre and postbiotics, shea butter, aloe vera, moringa seed oil, coconut oil, squalene, coenzyme Q10. -Read more about topics covered in the episode: skin microbiome, skin barrier function, how the barrier relates to your overall health, cream blush resurgence, guide to brightening skin, maskne, how to layer products, -Products recommended in this episode: Youth To The People Superberry Dream Cleansing Balm, Tatcha's cleansers, Peach & Lily Glass Skin Serum, Grown Alchemist Instant Smoothing Serum, Savor Beauty Caviar Eye Cream, Glow Recipe Plump Plump Hyaluronic Acid Moisturizer, Tatcha Indigo Cream, Alpyn Beauty Wild Huckleberry 8-Acid Polishing Peel Mask, Indie Lee Brightening Cleanser, Mara Algae Enzyme Cleansing Oil, Hyper Skin Hyper Even Brightening Dark Spot Corrector, Beautycounter Counter+ All Bright C Serum, Indie Lee Brightening Cream, Pipette Mineral Sunscreen SPF 50, Kosas Revealer Concealer, MD Solar Sciences, Ilia Limitless Lash Mascara, Tata Harper Cream Blush, Tower 28 Beach Please Lip + Cheek Cream Blush, Freck Beauty Cheekslime Lip + Cheek Tint, Tatcha Water Cream, Burt's Bees Truly Glowing Gel Cream, Savor Beauty Truffle Face Cream, Vintner's Daughter Active Botanical Serum Oil, JVN Nurture Deep Moisture Hair Mask Comments: email@example.com Sponsorship inquiries: firstname.lastname@example.org
My SLP professor, Dr. Stefka Marinova-Todd, is back on the SLP Corner podcast! She is a developmental psycholinguist with her main research interests being bilingual language development and second language acquisition. Dr. Marinova-Todd is an Associate Professor at the School of Audiology and Speech Sciences at UBC and is currently an Associate Editor at Applied Psycholinguistics, and is on the editorial board at Language, Speech and Hearing Services in Schools which is an ASHA journal. Previous podcast recordings with Dr. Marinova-Todd:25. SLP CORNER: Bilingualism and Language Development with Dr. Marinova-Todd26. SLP CORNER - SNACK: Bilingualism and Autism with Dr. Marinova-ToddTwo recent articles from the US on working with Spanish-English bilingual children:Lazewnik, R., Creaghead, N. A., Smith, A. B., Prendeville, J. A., Raisor-Becker, L., & Silbert, N. (2019). Identifiers of Language Impairment for Spanish-English Dual Language Learners. Language, speech, and hearing services in schools, 50(1), 126–137. Elizabeth D. Peña, Lisa M Bedore, Mirza J. Lugo-Neris & Nahar Albudoor (2020) Identifying Developmental Language Disorder in School Age Bilinguals: Semantics, Grammar, and Narratives, Language Assessment Quarterly, 17:5, 541-558,Please rate and review the podcast and thank you for listening! Also, make sure to follow me on: Facebook - SLP Corner Instagram - slpcornerCheck out my blog: www.slpcorner.comSupport the show (https://www.buymeacoffee.com/slpcorner)
In this episode of the Award-winning PRS Journal Club Podcast, 2021 Resident Ambassadors to the PRS Editorial Board – Saïd Azoury, Emily Long, and Ronnie Shammas- and special guest Amy Colwell, MD, discuss the following articles from the January 2022 issue: “An Analysis of the Modified Five-Item Frailty Index for Predicting Complications following Free Flap Breast Reconstruction” by Magno-Pardon, Luo, Carter, et al. Special Guest Amy Colwell, MD, is full time Faculty in the Division of Plastic Surgery at Massachusetts General Hospital and Professor of Surgery at the Harvard Medical School. Dr. Colwell has served as an Associate Editor in the Editorial Board of PRS since 2016 and is the new Co-editor of Plastic and Reconstructive Surgery Journal. READ the articles discussed in this podcast as well as free related content from the archives: https://bit.ly/JCJan22Collection #PRSJournalClub
The Roundtable Panel: a daily open discussion of issues in the news and beyond. Today's panelists are WAMC's Alan Chartock, investigative journalist and UAlbany adjunct professor Rosemary Armao, The Empire Report's J.P. Miller, and former Associate Editor of The Times Union Mike Spain.
Please join author George Dangas and Associate Editor Brendan Everett as they discuss the article “Colchicine in Cardiovascular Disease.” Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: Welcome, everyone, to 2022. I'm Dr. Greg Hundley, Associate Editor, Director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Carolyn, oh, we're starting off the year with a twist on the feature article. It's a review article on colchicine and cardiovascular disease. But before we get to that, how about we grab a cup of coffee and jump into some of the other articles in the issue? Dr. Carolyn Lam: Absolutely. The new year is starting off with a bonanza issue. This first topic is so important. We know that various non-invasive, intermittent rhythm monitoring strategies have been used to assess arrhythmia recurrences in atrial fibrillation ablation trials. But the question is, what is the frequency and duration of non-invasive rhythm monitoring that accurately detects arrhythmia recurrences and approximates the atrial fibrillation burden derived from continuous monitoring using the gold standard, implantable cardiac monitor? Now to answer this question, investigators Jason Andrade and colleagues from the Montreal Heart Institute, who looked at the rhythm history in 346 patients enrolled in the CIRCA-DOSE trial. They reconstructed the rhythm history using computer simulations and evaluated event-free survivals, sensitivity, negative predictive value, and AF burden in a range of non-invasive monitoring strategies including those used in contemporary AF ablation trials. Dr. Greg Hundley: Ah, very interesting, Carolyn. So what did they find? Dr. Carolyn Lam: Detection of arrhythmia recurrence following ablation was highly sensitive to the monitoring strategy employed between trial discrepancies and outcomes, in fact, may reflect these different monitoring protocols. Binary efficacy outcomes, such as time to AF recurrence, appeared to underestimate the true impact of catheter ablation on the burden of atrial arrhythmia. The most commonly performed intermittent rhythm monitoring techniques, like short duration 24- or 48-hour ambulatory Holter, they do miss a substantial proportion of arrhythmia recurrences and significantly overestimate the true AF burden in patients with recurrences. So based on measures of agreement, serial long-term, that is four seven-day or two 14-day intermittent monitors accumulating at least 28 days of annual monitoring provide estimates of AF burden that are comparable with the implantable cardiac monitor. However, implantable cardiac monitors outperform intermittent monitoring for arrhythmias and should be considered the gold standard for clinical trials. Dr. Greg Hundley: Very nice, Carolyn. It sounds like a lot of clarification on monitoring of AF burden. Well, my first paper comes to us from Dr. Prabhakara Nagareddy from The Ohio State University, The Wexner Medical Center. Carolyn, acute myocardial infarction results in an overzealous production and infiltration of neutrophils in the ischemic heart, and this is mediated in part by granulopoiesis induced by the S100A8/A9 NLRP3, IL-1 beta signaling axis in injury-exposed neutrophils. In this study, Carolyn, the investigators evaluated a hypothesis as to whether IL-1 beta is released locally within the bone marrow by inflammasome prime and reverse migrating neutrophils. Dr. Carolyn Lam: Ah, okay. So what did they find, Greg? Dr. Greg Hundley: Okay, Carolyn. In response to myocardial infarction, the NLRP3 inflammasome prime neutrophils upregulated CXCR4 and reverse migrated to the bone marrow, where they adhered to adhesion molecules like P-selectin on the bone marrow endothelial cells. Second, Carolyn, in the bone marrow, the inflammasome prime neutrophils released IL-1 beta through gasdermin-dependent conduit pores without undergoing the mandatory pyroptosis. Third, genetic and/or pharmacological strategies aimed at limiting reverse migration of inflammasome prime neutrophils to the bone marrow or release of IL-1 beta, both suppressed granulopoiesis and improved cardiac function in mouse models of myocardial infarction. So Carolyn, therefore, strategies aimed at targeting specific signaling pathways within the neutrophils or reducing retention of the inflammasome prime neutrophils in the bone marrow may provide novel avenues to regulate inflammation and improve cardiac outcomes. Dr. Carolyn Lam: Wow, neat, Greg. Thanks for explaining that so nicely. Well, the next paper deals with my favorite topic, heart failure with preserved ejection fraction of HFpEF, and this time looks at mechanisms of sinoatrial node dysfunction. The investigators, led by Dr. Cingolani from Smidt Heart Institute at Cedars-Sinai Medical Center, sought to investigate the role of the intrinsic pacemaker on chronotropic incompetence in HFpEF. They performed extensive sinoatrial node phenotyping, both at baseline and after stress in the well-characterized Dahl salt-sensitive rat model of HFpEF. These rats exhibited limited chronotropic response associated with intrinsic sinoatrial node dysfunction, including impaired beta-adrenergic responsiveness and an alternating leading pacemaker within the sinoatrial node. Prolonged sinoatrial node recovery time and reduced sinoatrial node sensitivity to isoproterenol were confirmed in the two hit mouse model. Adenosine challenge unmasked conduction blocks within the sinoatrial node, which were associated with structural remodeling. Finally, single-cell studies and transcriptomic profiling revealed HFpEF-related alterations in both the membrane clock or iron channels and the calcium clock of the spontaneous calcium release events. Dr. Greg Hundley: Wow, Carolyn, lot of really interesting data here. So what were the clinical implications? Dr. Carolyn Lam: Yeah, it's a really great study. Two models of HFpEF-consistent result in an important topic. Basically, here at the take-home messages. Provocative testing can be valuable to elicit functional abnormalities to facilitate HFpEF diagnosis and considering the exceptionally high clinical and epidemiologic convergence between AFib and HFpEF, sinoatrial node dysfunction may underlie the development of abnormal atrial rhythms in HFpEF. Dr. Greg Hundley: Very nice, Carolyn. More information on HFpEF, again, one of your favorite subjects. Next, we're going to turn to a paper from Dr. Jian Li from the Peking Union Medical College Hospital. Carolyn, doxycycline has previously been demonstrated in a retrospective study to be associated with greater survival in patients with light chain AL amyloidosis. Therefore, Carolyn, this group prospectively compared the efficacy of bortezomib, cyclophosphamide, dexamethasone, or cyclophosphamide B or D, and cyclophosphamide B or D combined with doxycycline for cardiac amyloidosis. Dr. Carolyn Lam: Cool. So what did they find, Greg? Dr. Greg Hundley: Carolyn, this was a multi-center, open-label, randomized controlled trial, and 140 patients underwent randomization. The primary outcome was two-year progression-free survival. Progression-free survival was defined as the time from randomization to death, hematologic progression or organ progression, and that's the heart, the kidney, or the liver. And so Carolyn, these investigators in this trial demonstrated that doxycycline combined with cyclophosphamide B or D failed to prolong progression-free survival or cardiac progression-free survival compared with cyclophosphamide B or D alone in patients with cardiac AL amyloidosis. So Carolyn, a negative study that's quite informative and a very nice editorial that accompanies this article pertaining to future directions for management of AL cardiac amyloid. Dr. Carolyn Lam: Indeed important. Thank you. And there are other important papers in today's issue. There's a Research Letter by Dr. Pfeffer on the impact of sacubitril/valsartan versus ramipril on total heart failure events in the PARADISE-MI trial. Dr. Greg Hundley: Great, Carolyn. In the nail bag, boy, I've got a big list today. First, Dr. Churchwell has an AHA update on the need for policy change to improve maternal cardiovascular health. Next, Dr. Piazza has a Perspective piece on expanding the role of coronary CT angiography in interventional cardiology. There's an ECG challenge from Dr. Yarmohammadi entitled “Dancing Bundles with Stable Sinus Rhythm.” And next, we have our own Darren McGuire who, in this issue for all of 2021, is really recognizing our outstanding reviewers. And we want to thank all the listeners and everyone that reviews for us in this journal. Such an important feature and aspect to the publication of the wonderful articles that we receive. And then finally, there are some highlights from the circulation family of journals. Well, Carolyn, how about we get on to that feature discussion and learn more about colchicine and its use in cardiovascular disease. Dr. Carolyn Lam: Let's go and a Happy New Year, again, everyone. Dr. Greg Hundley: Welcome listeners to this January 4th feature discussion. This week, we're deviating a little bit because we are going to have an author discuss one of our in-depth reviews. As you know, we select those occasionally where they're is a topic that's very relevant in cardiovascular medicine and an investigator or team of investigators or authors will put together a very nice review of a topic. This week, we're going to talk about colchicine, and we have with us Dr. George Dangas from the Icahn School of Medicine at Mount Sinai and our associate editor, Dr. Brendan Everett, who manages this paper and he is from Brigham and Women's Hospital. Welcome, gentlemen. George, we'll start with you. George, why colchicine? Can you tell us a little bit about mechanism of action? Tolerability? Why would we want to use this particular agent in patients with cardiovascular disease? Dr. George Dangas: Thank you very much for the opportunity to join this interesting podcast. Colchicine is indeed an interesting drug. It's been around for centuries, in all honesty. In general, I would say it's a mild anti-inflammatory and in general, it's rather well tolerated. We'll go into those perhaps a little bit later. The precise mechanism is actually interestingly not quite defined. It may have a few ways to act by blocking perhaps the chemotaxis of the leukocytes or the adhesion of the leukocytes or the ability to release their granules, et cetera, but there isn't a specific major one that is targeting. Perhaps, it's targeting more than one mechanism in a mild way, and I think that goes into each utility, as well as the absence of the major side effect that might limit it. Dr. Greg Hundley: Very nice. So you started to mention the word utility, so maybe let's go through some clinical indications, or clinical uses perhaps rather than indications, can you tell us a little bit about its use in individuals with pericarditis? Dr. George Dangas: I think this is where it started to enter the cardiovascular field because we all recognize that pericarditis is an inflammatory disease and inflammation of the pericardium of different reasons perhaps. And anti-inflammatory drug is rather fitted to treat an inflammatory disease and besides, it's not like we had any other drug, in all honesty. Clearly, recurrent pericarditis might be treated with steroids for example, but steroids is not something any cardiologist would jump as a first line and give high doses and all that. Colchicine made its way to pericarditis like acute or recurrent pericarditis, post-cardiac cardiology syndrome, restless syndrome or the specific post-cardiac surgery, major inflammation. And indeed has a daily dosage perhaps with some loading dose or double the daily dosage or something initially and then we give it for a prolonged period of time in order to suppress. I would say this is a reasonable choice rather than jumping to the steroid. And of course, you reserve the steroid for the, I would say, more severe or more recurrent cases. I think everybody understands this type of activity. There've been quite a few clinical studies in this aspect. Again, in the absence of a competitor, I think it's a winner in this area. Dr. Greg Hundley: Very nice. And then, how about atrial fibrillation? Are there uses of this colchicine in patients with atrial fibrillation? Dr. George Dangas: Well, again, it's very interesting that a lot of atrial fibrillation, it may be in some ways inflammatory in origin. And quite frankly, we had an interesting [inaudible 00:14:50] clinical trial in American Heart Association in 2021. I'd like to point out here, the study that postoperative atrial fibrillation was mitigated when, during cardiac surgery, there was a slicing of the posterior pericardial. This allowing the inflammation in some ways that's related there. To me, that was a very interesting observation, though I related to colchicine because it validates the fact that there is something inflammatory in pericardial that related with the postoperative atrial fibrillation. So along these lines, let's go back to colchicine, Afib, and postop Afib, and post-ablation I would say patients. Again, there are risks of some inflammation and that's where the theory of a mild, rather well-tolerated, anti-inflammatory might come in. And there's been few studies, not a large definitive study, but several studies that are the, I would say, component with interesting results with colchicine in these patients. Dr. Greg Hundley: Very good. Another area of cardiovascular disease that's emerging literally with some demonstrable results using colchicine is the realm of ischemic heart disease. Can you walk us through some of the utility myocardial infarction or maybe even post-percutaneous coronary artery intervention? Dr. George Dangas: Again, the hallmark in this type of diseases, cardiovascular disease or coronary heart disease, is the hallmark of role of inflammation in this disease. And we know very well from the studies of the C-reactive protein, importance is a marker of inflammation. Very, very important in the CAD as well as in even the treatment with the antibody canakinumab a little bit earlier in the CANTOS trial a few years earlier at the very high level inhibited inflammation had a benefit and colchicine comes in maybe a milder anti-inflammatory about this agent, but at the same time with significantly less cause and significantly better recognition among the clinicians and a lot less, I would say, tolerability problems or issues are less unknowns. And I think that's where it comes in. The difficulty has been that whenever you go to cardiovascular, the cardiovascular, I would say coronary artery disease specifically, ACS and all that, the level evidence required for the doctors to believe in a therapy is very different than the areas we discussed before where there's little bit of a pericardial disease, for example, not that many drugs, all of a sudden, coronary artery disease, the bar is so high, and that's where the difficulty has been. There've been several studies. They've been interesting results with some benefits, particularly due to the decrease in inflammation and the secondary prevention, one can say. That is really the hallmark of where it aims to benefit in the secondary prevention, but there hasn't been one massive study with clearly superb results. I would say adequately powered single study that is missing in some ways. But several studies have been, again, very, very encouraging, but we learned that there's no much point if loading a lot of doses of high doses of colchicine, and it's a little bit better, again, when you aim with a daily dose towards reduced recurrences, particularly if you started early after an acute event. Dr. Greg Hundley: Very nice. Well, listeners, we're going to now turn to our associate editor, Dr. Brendan Everett, from Brigham and Women's Hospital. Brendan, you have a lot of papers come across your desk. First and foremost, what attracted you to this particular article? Dr. Brendan Everett: Well, thanks, Greg. And kudos to George and his team for putting together a really nice paper. It's great to have this kind of paper come into my inbox. That's specifically because colchicine, I think, has exploded as a really important novel therapy even though the therapy itself is perhaps hundreds of years old, as you heard George say a moment ago, but its role in treating cardiovascular diseases has really begun to emerge rapidly. I think there's a tremendous amount of enthusiasm for other ways to treat our patients who have really a recalcitrant cardiovascular disease, whether that's pericarditis, atrial fibrillation or I think, importantly, ischemic heart disease, because that's such a common disease and something where we're always looking for new ways to help patients live longer with fewer recurrent events. And so this paper I thought did a really good job of capturing the existing evidence for these conditions and some others and giving us a sense of where the strengths of that evidence lay and where the weaknesses were. I thought particular strength was in the tables where the authors laid out each of the trials and the results of the trial, their endpoints, where the benefit was potentially. And also importantly, where risks were seen because I think that's one of the really important questions that remains open with respect to colchicine therapy when we begin to talk about using it in a vast population of people with stable ischemic heart disease or post-myocardial infarction ischemic heart disease. Dr. Greg Hundley: Brendan, tell us a little bit about those risks. Dr. Brendan Everett: I'd be happy to do that. I want to emphasize before I dive in that I think the benefits that George has laid out are important, and I don't want to overshadow what the major trials have seen. But I think the thing that it is at least a little bit of the fly in the ointment, if you will, for colchicine in ischemic heart disease is that a couple of the large trials have shown an increased risk of non cardiovascular mortality or bad non-cardiovascular outcomes. And that's of concern, I think, as we saw in the CANTOS trial, which was the monoclonal antibody trial for canakinumab that George mentioned earlier, there was an increase in infection-related mortality. And so whenever you use an anti-inflammatory drug, you're worried about whether or not you're blunting other compensatory mechanisms that the body has to protect against infection and other diseases. I think it's likely that these findings are the play of chance, but we don't know for sure. For example, in the COLCOT trial, which I think is probably the largest and most interesting trial, which was designed and run in Canada, there was a slightly higher level of pneumonia in patients who got active therapy as compared to placebo. And then, two of the trials that were published more recently including LoDoCo2, which was a trial of about 5,000 patients run in the Netherlands and Australia. There was actually a marginally increased risk of non-cardiovascular mortality. That didn't reach statistical significance, but it was awfully close, and I think it gave people some concern. And then, there was also the COPS trial. Again, all these are really outlined in wonderful detail in the manuscript where there was a slight increase of total death and non-cardiovascular death. These events are few, but they're in a direction in two trials, and so they make people a little bit worried. I think the other thing that I noticed was the high prevalence of myalgia as a side effect. I think, Greg, you're always interested in the clinical implications and yesterday I was in clinic and saw a young patient who had had pericarditis. He had been prescribed colchicine by his primary care physician, and he literally couldn't stand and walk up straight because of the amount of abdominal pain he had, which was unusual. To be honest, I've given colchicine to a hundred patients at least, and none of them have had that profound of a side effect, but it's at least worth considering that some patients will not tolerate the therapy because of adverse effects. Dr. Greg Hundley: Very good. Well, in just 30 seconds or so, for each of you, first George and then Brendan. George, balancing some of the efficacy and then some of the concerns, what do you see is the next studies to be performed really in this sphere of research? Dr. George Dangas: This is a great question. And indeed, the concerns one can say or the issues, I would say, regarding this drug, are indeed real because any drug that suppresses inflammation has this risk. There are two ways one can address those. One is with term administration. You don't prescribe it as an annuity forever, but you prescribe it in a three- to six-month or one-month or try to control the time. I think this is done in clinical practice, in all honesty. I don't think that people are prescribing colchicine for life. Same way when we prescribe statins, for example. On the other hand or from investigational point of view, I think the two sets of information we need and, in all honesty, when you investigate issues regarding mortality or these are rare events, there's only one. You need a very large trial or a very large register. A very large trial preferably and colchicine being an often genetic drug, funding sources are rather limited, but we have NIH chipping in with some funding periodically and that might really be needed. So I want to outline that in the last table of our very large, I would say large table of our manuscript but were very happily outlined many ongoing trials. There are, in atrial fibrillation, three coronary artery disease. One in PCI and two in stroke. Something we didn't touch up again. But again, there's the question of inflammation in stroke. I think there's a lot of work ongoing. Perhaps you can see some meta-analysis, again, in order to get a handle of those risks, but at a rather low rate. It's just a difficult thing to come around. Dr. Greg Hundley: Very good. Brendan, anything to add? Dr. Brendan Everett: I would just add I agree a hundred percent with George just said. I think the only missing piece there is heart failure, which I think is and many have shown that there's an inflammatory component to heart failure, whether it's heart failure with reduced ejection fraction or preserved ejection fraction. And the timing of when that intervention might be, whether it might be before the development of symptoms or because there's a lot of trials out there that have struggled with this question and have unfortunately failed to show any benefit, I would just encourage the listeners of the podcast to look at this paper because it's a really marvelous compilation of the evidence for what is a really hot topic in cardiovascular medicine, a really important topic for a lot of the reasons that George mentioned. It's just very well done and comprehensive. Again, kudos to the authors for making such a great effort at putting something together that has a lot of clinical relevance, I think, and also points the way forward for research as you ask, Greg. Dr. Greg Hundley: Very nice. Well, listeners, we want to thank Dr. George Dangas from Icahn School of Medicine in Mount Sinai and our own associate editor, Dr. Brendan Everett from Brigham and Women's Hospital for bringing us this data pertaining to colchicine benefits, as we know in acute and recurrent pericarditis, but also emerging indications related to post-procedural atrial fibrillation or coronary artery disease. And really, colchicine's targeting of cardiovascular inflammation is being helpful in those alleviating those processes. Well, on behalf of Carolyn and myself, we want to wish you a great week, and we will catch you next week on the run. Dr. Greg Hundley: This program, this copyright of the American Heart Association 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.
Josh Daspit, an associate professor of religious studies in the Department of Philosophy at Texas State University, and Daniel Roy join the Big Ideas TXST podcast to discuss the Sustainable Cultivation and Advancement of Local Enterprises for Underserved Populations (SCALEUP) program. SCALEUP is a new initiative at Texas State designed to research the factors restraining minority-owned business growth and develop remedies. Daspit's research interest is in entrepreneurship and he focuses on issues related to family businesses, innovation and social dynamics. He has more than 40 articles published in outlets such as California Management Review, Corporate Governance, Entrepreneurship Theory & Practice, Family Business Review, Human Resource Management Review, Journal of Business Research and Journal of Knowledge Management. Daspit currently serves as an Associate Editor for Family Business Review and for Journal of Family Business Strategy. He also serves as the Social Media Editor of Family Business Review and is on the editorial review boards of Entrepreneurship Theory & Practice, Journal of Family Business Management and other journals. Roy is a graduate of St. Mary's University in San Antonio where he received a BBA in Corporate Financial Management. After a brief stint in corporate banking, he returned to Texas and embarked on 25-year entrepreneurial journey starting three successful companies each deeply committed to the core values of integrity, caring and excellence. Roy was part of a national effort to develop a certification credentialing program that provides foundational employability skills to help people land jobs and get promoted in retail stores and beyond. To date, more than 50,000 jobseekers have been trained nationally. He has also served on the State Board of Directors for the Texas Association of Business, as chairman of the board for the Greater San Marcos Chamber of Commerce and numerous community and non-profit boards. Further reading: Center for Innovation and Entrepreneurship project descriptions
The Roundtable Panel: a daily open discussion of issues in the news and beyond. Today's panelists are WAMC's Alan Chartock, Lecturer and Adjunct Professor in Communications for SUNY New Paltz and RPI Terry Gipson, political consultant and lobbyist Libby Post, and former Associate Editor of the Times Union Mike Spain.
This episode is brought to you by ButcherBox.Most of us hear the term “metabolic health” and think it only applies to our ability to burn calories and manage our weight. And while those are certainly big pieces of metabolic health, it also impacts everything from our cardiovascular health to cognition, mood, infertility, and so much more. That's because our metabolism is actually our body's ability to create energy and this happens all over the body. If our energy production in the brain is hindered, we could have memory loss; if it's not functioning properly in muscle cells, we may see chronic pain—and the list goes on. In today's mini-episode, Dhru speaks with Dr. Casey Means and Dr. Sara Gottfried about how our metabolic health impacts our overall health, indicators of poor metabolic health, and how to improve metabolic flexibility. Dr. Casey Means is a Stanford-trained physician, Chief Medical Officer and Co-founder of metabolic health company Levels, an Associate Editor of the International Journal of Disease Reversal and Prevention, and a Lecturer at Stanford University. Dr. Means has been featured in the New York Times, Wall Street Journal, Men's Health, Forbes, and more. Dr. Sara Gottfried is a board-certified physician who graduated from Harvard and MIT. She practices evidence-based integrative, precision, and Functional Medicine. She is a Clinical Assistant Professor in the Department of Integrative Medicine and Nutritional Sciences at Thomas Jefferson University, and Director of Precision Medicine at the Marcus Institute of Integrative Health. Her three New York Times bestselling books include The Hormone Cure, The Hormone Reset Diet, and Younger. Her latest book is Women, Food, and Hormones. Find Dhru's full-length conversation with Dr. Casey Means here: https://lnk.to/dhru-170/Find Dhru's full-length conversation with Dr. Sara Gottfried here: https://lnk.to/dhru-238/For more on Dhru Purohit, follow him on Instagram @dhrupurohit, and on YouTube @dhrupurohit. You can also text Dhru at (302) 200-5643.This episode is brought to you by ButcherBox.Wild-caught salmon is one of my favorite go-to's to get brain-supporting, anti-inflammatory fats and clean protein in my diet. ButcherBox only uses wild-caught, sustainably harvested, Alaskan salmon and will deliver it right to your door for an amazing price. Right now, ButcherBox is offering new members a great deal for the New Year! Sign up at ButcherBox.com/dhru, and you'll receive two pounds of FREE salmon in your first box. And for a limited time, ButcherBox is offering our listeners an additional $10 off. See acast.com/privacy for privacy and opt-out information.
The Neurosequential Model is a developmentally sensitive, neurobiology-informed approach to clinical problem solving. The model, developed by Bruce D. Perry, MD, PhD, is not a specific therapeutic technique or intervention. It is an approach that integrates core principles of neurodevelopment and traumatology to inform work with children, families and the communities in which they live.Dr. Erin Hambrick is the Director of Research for the ChildTrauma Academy, an Assistant Professor at the University of Missouri - Kansas City, and an Associate Editor for the Journal of Child and Family Studies. She works with children and families who have faced adversities and studies treatment options that best fit their strengths and needs.
Andrei Patkul is a Candidate of Sciences in Philosophy, Associate Professor of the Department of Philosophy of Science and Technologies of the Saint Petersburg State University, Associate Editor of Horizon. Studies in Phenomenology. He graduated from the philosophical faculty of the Saint Petersburg University (1999). The candidate theses The Conceptualizations of Being in the Absolute Idealism of Hegel and Fundamental Ontology of Heidegger defended in 2004. Author of over 180 scientific publications, including the monograph under the title The Idea of Philosophy as a Science of Being in the Fundamental Ontology of Martin Heidegger (2020). Two research internships: University of Passau, Germany (2002 – 2003) and Edmund Husserl Archive at the University Freiburg, Germany (2009). Translator from German of works of S. Maimon, F.W.J. Schelling, N. Hartmann, and C. F. Gethmann.His today's research interest includes: Philosophia prima, ontology, metaphysics, philosophy as a system, philosophy as a science, philosophy as philosophizing, philosophy and freedom. Basic concepts of the first philosophy: being, that-which-is, substance, essence, entities, existence, transcendence, world, subject, object, relation, ground, causality, function, event, necessity, actuality, contingency, etc. Philosophy of science, especially the problem of the correlation of non-philosophical (positive) sciences and philosophy, grounding of non-philosophical sciences by philosophy, regional ontologies, objectivation, philosophy of mathematics, philosophy of mind Phenomenology of digital reality, digital objects, res digitalisHistorically: Plato, Aristotle, Kant and early reception of his philosophy, Hegel, Schelling, Husserl, Heidegger, Nicolai Hartmann, Oskar BeckerFIND ANDREI ON SOCIAL MEDIALinkedIn | Facebook | VKontakte | Instagram================================PODCAST INFO:Podcast website: https://www.uhnwidata.com/podcastApple podcast: https://apple.co/3kqOA7QSpotify: https://spoti.fi/2UOtE1AGoogle podcast: https://bit.ly/3jmA7ulSUPPORT & CONNECT:Support on Patreon: https://www.patreon.com/denofrichTwitter: https://twitter.com/denofrichFacebook: https://www.facebook.com/denofrichYouTube: https://www.youtube.com/c/DenofRich
Joe and I dive into growing up California, moving to Idaho and his journey into the outdoors industry. It has been great connecting with Joe as we are both from California, different backgrounds with the same drive for spending time in the wilderness. www.Theflipflopguy.co use code “Podcast” for 10% off of your entire next order. … Continue reading Ep 104: @JoeFerronato Associate Editor For Petersens Hunting Magazine →
Editor's Summary by Preeti Malani, MD, Associate Editor of JAMA, the Journal of the American Medical Association, for the December 28, 2021 issue.
The Roundtable Panel: a daily open discussion of issues in the news and beyond. Today's panelists are WAMC's Alan Chartock, investigative journalist and UAlbany Adjunct Professor Rosemary Armao, Immigration attorney and partner with the Albany law firm of Whiteman Osterman & Hanna Cianna Freeman-Tolbert, and former Associate Editor of The Times Union Mike Spain.
In this episode of Shelf Care: The Podcast, Booklist's editors look back on the year in reading and talk about some of their fave titles from the Editors' Choice list, which is the main feature of our January issue. Here's what everyone talked about: Donna Seaman, Editor, Adult Books Chasing Me to My Grave: An Artist's Memoir of the Jim Crow South, by Winfred Rembert and Erin I. Kelly The Sentence, by Louise Erdrich The Book of Form and Emptiness, by Ruth Ozeki Martita, I Remember You, by Sandra Cisneros, translated by Liliana Valenzuela Below the Edge of Darkness: A Memoir of Exploring Light and Life in the Deep Sea, by Edith Widder Finding the Mother Tree: Discovering the Wisdom of the Forest, by Suzanne Simard Sarah Hunter, Editor, Books for Youth and Graphic Novels Himawari House, written by Harmony Becker, art by the author Bubbles…Up, by Jacqueline Davies, illustrated by Sonia Sánchez This Poison Heart, by Kalynn Bayron When We Were Infinite, by Kelly Loy Gilbert Heather Booth, Audio Editor Finnegan's Wake, by James Joyce, read by Barry McGovern and Marcella Riordan Island Queen, by Vanessa Riley, read by Adjoa Andoh My Heart is a Chainsaw, by Stephen Graham Jones, read by Cara Gee Miracle and Wonder: Conversations with Paul Simon, by Malcolm Gladwell and Bruce Headlam, read by Malcolm Gladwell and others A Master of Djinn, by P. Djèlí Clark, read by Suehyla El-Attar The Ex-Talk, by Rachel Lynn Solomon, read by Emily Ellet The Outlaws Scarlett and Browne, by Johnathan Stroud, read by Sophie Aldred Aristotle and Dante Dive into the Waters of the World, by Benjamin Alire Sáenz, read by Lin-Manuel Miranda Kaleidoscope, by Brian Selznick, read by Gwendoline Christie Maggie Reagan, Senior Editor, Books for Youth Cool for the Summer, by Dahlia Adler Instructions for Dancing, by Nicola Yoon Little Thieves, by Margaret Owen Susan Maguire, Senior Editor, Collection Management and Library Outreach A Thorn in the Saddle, by Rebekah Weatherspoon Blind Tiger, by Sandra Brown Light from Uncommon Stars, by Ryka Aoki Julia Smith, Senior Editor, Books for Youth The List of Unspeakable Fears, by J. Kasper Kramer Salt Magic, written by Hope Larson, illustrated by Rebecca Mock The Secret of the Magic Pearl, by Elisa Sabatinelli, illustrated by Iacopo Bruno, translated by Christopher Turner Annie Bostrom, Associate Editor, Adult Books And Now I Spill the Family Secrets, written by Margaret Kimball, art by the author Matrix, by Lauren Groff
In this week's edition of Circulation on the Run, Dr. Amit Khera introduces the new Social Media Editors to our Circulation listeners. Please welcome Dr. Vanessa Blumer, Dr. Pishoy Gouda, Dr. Xiaoming (Ming) Jia, Dr. Peder Langeland Myhre, and Dr. Sonia Shah to Circulation. Dr. Amit Khera: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Amit Khera, Associate Editor from UT Southwestern Medical Center in Dallas, and Digital Strategies' Editor for Circulation. And today I have the privilege of sitting in for your usual host, Dr. Carolyn Lam, and Dr. Greg Hundley. Well, two times a year, we really have a special issue, there's no print issue for Circulation in the summer and here in that holiday time. So, fortunately, we get to use this for really whatever we want to do. Dr. Amit Khera: And today we have a very special issue. A few months ago, we transitioned over from a prior social media editor team that was Jainy Savla Dan Ambinder, and Jeffrey Hsu. We were able to recruit a fantastic group of new social media editors. You probably have seen their work behind the scenes, but you've not gotten to meet them personally. So, today I have the privilege of introducing you to our new social media editors. This group of five, that's been working for several months and we get to know them a little bit. Get to hear a little bit about their perspective on social media from fellows in training, and also what they've learned so far in their few months in working with Circulation. So, I'm going to go one by one and introduce you. And first I want to introduce you to Dr. Vanessa Blumer. Vanessa, tell us a little bit about yourself. Dr. Vanessa Blumer: Thank you so much, Dr. Khera, it is such an honor to be here. And I've had so much fun the months that I've been working for Circulation, it's truly just a privilege to work alongside this talented group. So I'm Vanessa Blumer. I am originally from Caracas, Venezuela, born and raised there, did all of my medical training back home. That included medical school, a year of rural service, or rural medicine. Then I actually did residency training in Venezuela as well. It wasn't really in my plans straight away to come to the US, but a little bit due to the political situation that we all know that Venezuela's going or suffering, I decided to come to the US. Dr. Vanessa Blumer: I did residency in the University of Miami, Jackson Memorial hospital, which I loved. Stayed there for a chief year. And then after that came to Duke University to do cardiology fellowship. I'm currently a third year cardiology fellow at Duke, doing a year of research at the DCRI, which I am enjoying a lot, and will be doing heart failure next year. I will be going to Cleveland Clinic for a year of advanced heart failure. Dr. Amit Khera: Well, you've had quite a journey, Vanessa, and congratulations, I think your match was relatively recently. So, we're excited to see where your career takes you from here and appreciate your contribution so far. Now I'm going to introduce you to Pishoy Gouda. Pishoy Tell us a little bit about yourself. Dr. Pishoy Gouda: Morning, Dr. Khera. My name is Pishoy. I have had the privilege of doing my medical trading all over the world. I was born here in Toronto and moved to Edmonton where I mostly grew up. Since then, I traveled to Galway Ireland where I spent six years to do my undergraduate medical training. Hopped over a short flight and did my Masters in Clinical Trials in the London School of Hygiene and Tropical Medicine before returning to Canada to start my residency training. Got to work with some amazing people in Calgary while I completed my internal medicine training, and then finally returned home to Edmonton where I am in the last few months of my adult cardiology training. Dr. Pishoy Gouda: Next year, I'm really excited to start my interventional cardiology training, which is going to be really exciting. Some of my interests, working with social media, wearable technology so working with this great group has been really awesome. Dr. Amit Khera: Thank you Pishoy. Obviously lots of travels from you as well, and we definitely appreciate your expertise and interest in social media and in technology. It's been very valuable. Next someone who's closer to my backyard. Ming Jia. Ming, welcome. Dr. Xiaoming (Ming) Jia: Hello from Houston, and thank you Dr. Khera. So, it's been a great opportunity to be involved as a social media editor for Circulation. So I'm a current cardiology fellow at Baylor College of medicine in Houston, Texas. Was originally born in China, and grew up in sunny Florida. I did my medical training in Florida as well, and then moved over to Houston, Texas for residency, and now wrapping up my last year in general fellowship. Next year, I'll be staying in Houston at Baylor for interventional fellowship. Then, hopefully after that career in interventional cardiology, but as well as preventional cardiology as well, I tended to actually interest in both interventional and preventional cardiology. Dr. Amit Khera: Very cool. I know you and I were talking about this right beforehand, how that nexus of the two fields and just some of your interest in a lot of the research you've done so far. So again, offering a unique and different perspective, which we appreciate so, welcome, Ming. Next, Peder Myhre. Peder, welcome. Dr. Peder Langeland Myhre: Thank you so much, Dr. Khera. This is Peder Myhre from Norway, all the way across the pond. And it's such a great honor to be part of this podcast, which I've been a big fan since it started a couple years ago and where Carolyn Lam has been doing with it, it's been really amazing. And I've actually been promoting it to everyone I know with any kind of interest in cardiology. My position in training right now is that I'm in the last year of cardiology training and I'm also doing a 50% post-doc at the University of Oslo with Professor Torbjørn Omland as a mentor. And as a part of my training, I was one year at Harvard University at Brigham Women's Hospital to do research with Professor Scott Solomon's group a couple of years ago. Dr. Amit Khera: Well, we appreciate your affinity and now you get to be on the podcast. That's pretty exciting as well. I should say, each of you is linked to an outstanding Associate Editor at your home institution. And so we're glad you have that mentorship as well there too. And speaking of someone at home institution, someone who I've known for a very long time, Dr. Sonia Shah. Sonya, introduce yourself, please. Dr. Sonia Shah: Thank you, Dr. Khera. No, just to echo what everyone has said already, it truly has been an honor and a privilege to work with this awesome team. And it's been a lot of fun along the way. So I'm Sonia Shah. I'm a third year cardiology fellow at UT Southwestern in Dallas, Texas. Originally from Central Florida, actually. And then did my undergrad medical school training in Chicago and then went out to the West Coast for my residency training was out at Stanford and now I'm loving being in Dallas. So it's been a lot of fun. So I particularly have an interest in women's cardiovascular health and advanced imaging. And so currently looking for jobs now. Dr. Amit Khera: Well, I can say you've been a star fellow and have a really incredible and unique skillset. And, so we look forward to seeing what your career brings and certainly you've brought a lot to our podcast. And we'll talk more about that in just a bit, since you are longest standing social media editor currently. Well, I want to now dig in a little bit and you all again, I want to thank you for what you've done for the last several months. I certainly have learned a lot from you. We've had some discussions as a group about, thoughts about social media and how social media works. Dr. Amit Khera: And so maybe we'll start with the sort of existential question about, why social media? What is the value for journals, if you think about Circulation, but really any journal. What does social media bring? And again, you all have a unique perspective as largely fellows in training and Vanessa, maybe I'll go back to you a little bit about, why social media? What's the point of relevance about all this work that you're doing? Dr. Vanessa Blumer: Yeah. Thank you so much, Dr. Khera. I think that's a great question. And I do think that that's a question that we ask ourselves every day as we're doing this. I think the way that the medical literature has been evolving, it's been evolving in a way of social media and people are consuming more and more social media daily. I think in my own daily life, I discover articles that I'm interested in through social media a lot more than I used to before. And I also discover that I'm interested in particular articles, the way that they are transmitted in social media or the way that they're presented in social media. Dr. Vanessa Blumer: So I think we're reinventing ourselves and reinventing the way that we present to the public, the articles that we have in Circulation, so that people want to read our articles or want to read the articles that authors are doing such a great job at putting together. So I think, we are coming up with creative ideas every day and it's part of what we discuss as a group of how do we present this so that people want to read the articles and discover all the hard work that authors are putting together through different social media platforms. Because we know that people consume not just one social media platform, but several. So I think there's huge potential in social media if we use it in the right way. Dr. Amit Khera: Yeah. I think your points well taken. I know we're going to talk a lot about Twitter today, but as you pointed out, there are other media as well. That's just in the sort of main, I guess, currency and in the medical and cardiovascular literature. And you mentioned value to authors and one thing you mentioned, which I'll transition a little is about the way things are presented, help you get interested in them. And so that gets to the art of the tweet. Something we've talked about a little bit and, there's a little bit of on the job training, if you will. And we've talked about is there a gold standard in terms of what makes a good frankly, a medical journal tweet. Well, Ming, what do you think? You've been toiling over this for a few months now and tell us what you think is helpful in a medical journal tweet in terms of achieving the goals that Vanessa mentioned. Getting an audience interested in reading these articles is really doing justice for the authors to transmit their research. Dr. Xiaoming (Ming) Jia: Great question, Dr. Khera, and this is something that, as a social media editor, I'm still learning. So for me, writing a concise tweet is very important. Trying to get that essence of a entire study into a very limited number of characters. Obviously having a great figure that highlights the key findings of a study is also very important as well. Now at the same time, I think the most effective posts though, are those that serve as a hook for the paper. So, while we want are tweet to stand on their own. I think the most effective tweets helped to entice the audience to want to read a little bit more and go and read the entire manuscript. So certainly there is a art and skillset in terms of writing these effective posts. Dr. Amit Khera: Yeah. You certainly bring up some key points, right? So being concise, one by definition and but two is, there are tweets that sometimes can go on and on and that comes into using some interesting hashtags and some shortcuts. But I think your point about innuendo, enticing, not giving away the whole story, but just enough to get people to want to read more. And I think that that is an art. Dr. Amit Khera: And I've certainly seen as you all have done this more and more about how your own writing and tweets have evolved. Pishoy, we've talked a little bit about, all of you are researchers, you've all done some great research, about thinking about social media, sort of a research area. Again, since there's no gold standard about what's a great tweet, just thinking about it more of a discipline as we do any other area that we want to explore scientifically. What are your thoughts about, how do we figure out more, learn more about what makes a great tweet? Dr. Pishoy Gouda: Yeah. Evidence based tweeting is something that I've been interested in. Everything that we do, we want to make sure that we do it well and that we do it effectively and the same goes with social media posts. So what works, what raises interactions with our content. And that's something that other disciplines and advertising have been doing all the time and we should be doing the same as well. If our goal is to increase interactions with our content, then we want to make sure that we are doing it in the most evidence based way. And we've learned a few things. We know that cardiologists and individuals in medicine in general have been using Twitter much more frequently as a way to consume in both your medical and research content. Dr. Pishoy Gouda: So what makes a post great and what increases its interaction and the bottom line is we don't really know. We have a few studies and a few small randomized controlled trials that have been done that give us some insight. We know that vigor, that tweets that include images might pull readers to them a little bit more. But you know what exactly works. We have a lot of observational data, but we don't have a lot of high quality data that gives us the answer to this question. So what we've learned so far is use images, use links. If you can use graphical abstracts, that seems to help as well. But, it's something that we're continuously looking at and we're really excited to put together some new evidence coming up soon in the future. Dr. Amit Khera: Evidence based tweeting. I like it. As you and I have discussed, my predecessor Carolyn Fox had a randomized trail called Intention-to-Tweet using Circulation and then a follow-up study to that. So we hope to do also some good high quality research about social media and what works. Well, that gets to who's your audience, right? I always like to think about when you start something, who's your audience. And there could be lots of people. I think probably our strike zone is researchers, scientists, clinicians, of course, there's lots of lay individuals too, that are paying attention on social media. One thing that's different about Circulation than some other journals is this melding of basic science and clinical science. Some journals are all basic science and all clinical science and Circulation's both. Dr. Amit Khera: And I mean, frankly, that's posed an interesting challenge for this group. None of you are, including myself, are card carrying basic scientists, if you will. So we've had to translate those articles. And I would consider that both a challenge, but also an opportunity because, if we're speaking to a basic science audience, of course we may have one tone we use, but we want this basic science. I think that's the purpose of Circulation is basic science applicable to the clinician and clinical researchers. So, translating that's been a real opportunity. And Peta, maybe I can ask you about that opportunity of translating basic science for clinical researchers and clinicians. Dr. Peder Langeland Myhre: Yes. I completely agree. And I've learned so much from this job as a social media editor to really try to get the essence out of a basic science paper and the translational outlook for clinicians. Because all of the papers that are basic science that at least I came across in Circulation also have a clinical implication and a translational side of it. And I think when we read these papers and try to sum it up in one tweet, we want to keep the most important essentials of the basic science, but also extend it to clinicians so that they understand in what setting and what this can potentially mean in the future. So for me, that's the biggest challenge when we review basic science papers, but it's also perhaps the part of this job that I learn the most. Dr. Amit Khera: Yeah. I agree. I think we're all learning a lot. I've certainly learned a lot by delving in deeper into the basic science papers and figuring out how to translate them appropriately. And I think this really highlights, as you mentioned, what Dr. Hill our Editor in Chief, his feeling is basic science papers in Circulation all have to have important clinical implications. That's the benchmark, if you will. So I think we've seen that shew in terms of what papers have come across for you all. Dr. Amit Khera: Well, I'm looking now at our longest standing social media editor, Sonya Shaw, she started a few months before as sort of a transition because we certainly wanted someone in place that could help bridge between the old and the new. And Sonya, you've had a decent amount of experience now with two editorial teams. Tell us what you've learned so far by working as a social media editor at Circulation. What are some of the observations you've had and some of the things you've learned in this space? Dr. Sonia Shah: Yeah, certainly. So I think a couple things. I think my ability to accurately and concisely convey the important key points from each journal has definitely improved. But I think the other unique thing, unique perspective that we gain as social media editors is getting to actually see the behind the scenes workings of how the journal works and how papers are put together and accepted. And so I think it's been interesting to see how papers are being analyzed and the teamwork that's required by the Associate Editors and the Editors and making sure to do each paper justice and properly evaluate it. So I think that's been a really cool experience. It certainly has improved my ability to write when I try to think of, what are the key points I want to include. And how to convey information in a way that will be appealing to journals. Dr. Amit Khera: Well, thank you for that. We take this job very seriously, as you all have in that point about doing each paper justice, because you've seen, one, from the author's perspective about how much work they put in and you've been an author before and want to make sure that we appropriately appreciate that. And then also the Associate Editors, there are hours and hours of work for each paper. So even though it comes out, maybe in a few characters in a tweet, we appreciate all that's going behind it. And I'm glad you've gotten to see that process through. Ming, maybe I can come back to you. What have you learned so far by working in Circulation for the last few months? Dr. Xiaoming (Ming) Jia: I do want to echo what Sonya just said in terms of really getting a glimpse of the behind the scenes work is quite amazing. The amount of work and coordination it takes to get a paper from publication to promotion. And, we don't really get that exposure as a author for a manuscript or even as a peer reviewer. So, that part has definitely been a great learning experience. On the other side, I do find it interesting that ever since taking on this role as a social media editor, my way of writing has changed as well. So, trying to be more efficient, getting key points across and really being concise and focused in my manuscript writing. So that's been very helpful from a personal level as well. Dr. Amit Khera: We're very thankful for that. I think we always want this to be bidirectional where you all are contributing in meaningful ways. But that the goal here with fellows in training in this role, social media editors. But for you all to be learning something as well. So I'm glad that that has occurred. And we'll talk more about that in just a few minutes. Dr. Amit Khera: Well, we have a couple of international social media editors and this is my intention. We want to make sure we have a diverse group of social media editors. By background, by thought, by location. And, one way that the beauty of that is again, we get different perspectives. I guess the downside is time zones. We were just joking before, as we were starting this podcast about some of us are very early in the morning and one of our social media editors unfortunately is always late at night when we have our meetings. Peta, tell us a bit about unique observations from an international perspective. You said you've been following Circ for a while, but tell us, from your perspective in Europe, the social media process and how you see it. Dr. Peder Langeland Myhre: Thank you so much. And it's actually been a really transformation for me from before I spent my year in Boston to after. Because I really learned the potential of using social media and especially Twitter to stay updated and get the latest papers and thoughts from experts in the field. And I remember before I went there, I was often very frustrated that it was so inconvenient to get across important papers that was within my field of interest. Because all the journals were not longer sent in paper to our hospital and the websites were confusing. Dr. Peder Langeland Myhre: So when Dr. Vaduganathan at the Brigham & Women's Hospital introduced me to Twitter, that really was an eye opener for me. And, ever since that, 90% of the papers that I read I first see on Twitter. Because that's the first place, the people that are within my field, publish it or tweet it. And also I'm able to, you follow a certain amount of scientists and physicians and they have the same interest as you. So it's also, most of it is relevant for what I want to read. So it's really been a revolution for me to start to use Twitter and social media for medical and scientific purposes. And not only for friends and family. Dr. Amit Khera: Yeah. I think it's some great points. One, is even simplistically just be able to access articles, which we don't always appreciate, from people from around the world. And then obviously what many can, is follow people that have similar interests and amazing to see sort of how different people consume the literature. And for you Twitter being your entry point, I guess, for how you do that, which is I'm sure many, many people do the same. And we have another international editor you met earlier. Pishoy, tell us your perspective. And obviously you're in Canada now and have moved many places. What's your perspective from an international perspective, looking at social media? Dr. Pishoy Gouda: Coming to work at Circulation, I expected a very niche editorial board, but what I'm really finding out is boy, does it take a village. And it is people from all over the world. And it really hits home that collaboration and research has become a global phenomenon. And to be able to do art well and to appropriately represent researchers from across the world. We have an editorial board and team that is global and it really does take a village to take a paper from submission all the way through the publication team, starting from the authors to the peer reviewers, editors. But then the entire post-production team, which is behind the scenes and don't get a lot of glory, but they do a lot of the heavy lifting to make sure that, the research that's submitted gets in front of readers. And that's something that I hadn't really thought of before. And it's been really interesting to see how that process unfolds. So that's definitely been eye opening for me. Dr. Amit Khera: Well, I appreciate what you said about, when it takes a village and I would be remiss if I don't always call out Augie Rivera, who is the engine and mastermind behind Circulation, who's helping us do this podcast today and every week. But the other part is the international workings I think many may not appreciate. We have editorial board meetings every other week at very different time zones on purpose because we have people in Europe and in Asia and in Africa. And as you know, Dr. Lam who's the main podcast editor is in Singapore. Dr. Amit Khera: So, this is by intention. It really gives us a wonderful international perspective. And so we're so glad to have you two as part of our international team. Well, I think that's a great transition, a little bit to just talking about fellows in training and involvement in journals for Circulation perspective, and from the AHA, I should say, getting fellows in training involved in cardiovascular research, the editorial process, this is something that's really important to us and something we continually strive to find new ways to do. So, Vanessa, I'm going to come back to you. I know, not just at Circulation, but I know at other journals you've had some responsibilities. Tell us a little bit of what you tell other fellows in training about getting involved in journal activities. How to, and what's the benefit. Dr. Vanessa Blumer: Thank you so much Dr. Khera. I think this is such an important question. First my recommendation is, get involved in one way or another. I think there's different ways of getting involved as simple as just start reviewing articles. And the reason I say this is as I aspire to become an academic, a well-rounded academic cardiologist, I think my involvement with journals has just made me a much better researcher, a much better academic cardiologist. It's made me, I think, Sonya said this so well, it's made her a better author. It's made me a better writer. So I think it compliments what you do just so much better. I think you're better at what you do when you see the behind the scenes and you understand what happens in scholarly publishing. So I think there's different ways of getting involved. I know that Circulation has many and then probably a good way is to reach out. Dr. Vanessa Blumer: I know that people can reach out to us and we can probably guide them along the way, but different journals have different ways of getting involved. But I think if you want to start, one way is start reviewing. You learn a lot through the review process in itself on how an article is structured. And there's some journal that have a little bit more of a mentorship approach towards reviewing. And, that's also a good way starting out. When we start off as residents, we get some papers get in our inbox to review and we really don't necessarily know how to approach it. So maybe a mentorship approach to it is a good way to start. But overall, I would just say, start getting involved. I think it's a great experience. Personally, I have learned so much from it and I think I'm just a better academic cardiologist because of it. Dr. Amit Khera: Thank you for that. And I think your point about just find ways to get involved. And I think our challenge is to continue to facilitate ways for trainees, fellows in training and others to get involved. But I think that that first step in finding maybe a mentor of your institution that could help guide you would be important. And I'm going to finish with Sonya. I'm going to come back to you. You've not only had the social media editor window for quite some time. Being at Circulation, you get to see behind the curtain perhaps more than others because, Circulation is such a big part of what we do at UT Southwestern. And, we've had this Fellow Reviewer Program where you've been able to participate in reviews and things like that. From your perspective, maybe telling the fellows in training, listening out there about getting involved in journal activities, the value that you've seen and how to do so. Dr. Sonia Shah: Yeah, I think that's a really important question. At the end of the day, the ability to read and interpret and take away the major conclusions and properly interpret a study is a skill. And so I think the more you do it, certainly the better you get at it. And being part of a journal being on the reviewer end, being on the end where you're creating social media posts is really an opportunity to develop and refine that skill. And so to all the fellows out there who are interested, regardless of whether you want to do academic cardiology or not, it is an important skill, even in the future, to be able to read and properly interpret studies. So I highly recommend it. I find for me, I've definitely learned a lot through the process and have certainly improved. Dr. Amit Khera: Well, there you have it, our five social media editors. First, I want to thank you all for your contributions to Circulation. You're an incredibly bright group as everyone learned about. I have future leaders in cardiology. And we're very fortunate to have you contributing to Circulation and to our authors and readers. So thankful to have you as part of Circulation and look forward to working with you and innovating and coming up with some creative, new ways to think about social media and ways to transmit research for journal. Dr. Amit Khera: Well, I think there you have it. Again, I'm Amit Khera. I'm associate editor and standing in this week for Carolyn Lam and Greg Huntley, who will join you again next week. So thank you for joining us for Circulation on the Run. Dr. Greg Hundley: This program is copyright of the American Heart Association 2021. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more visit ahajournals.org.
https://youtu.be/BX-SICfFvB8 Host: Fraser Cain ( @fcain )Special Guest: This week we are excited to welcome Dr. Jake Abbott, director of the Telerobotics Laboratory at the University of Utah to the WSH. The proliferation of Space Debris has become an increasingly alarming reality. In fact, as recently as December 3, 2021, "The International Space Station (ISS) had to swerve away from a fragment of a U.S. launch vehicle" (source: https://www.reuters.com/lifestyle/sci...). In a paper published in November 2021 in the science journal Nature , Jake and his research team have proposed a new method of dealing with the debris: using a series of spinning magnets to move these objects. You can read more about their proposed solution here https://attheu.utah.edu/facultystaff/.... Jake Abbott is a Professor in the Department of Mechanical Engineering and an Adjunct Professor in the School of Computing at the University of Utah, and he is the director of the Telerobotics Laboratory. He joined the University of Utah in 2008. Before coming to Utah, he spent three years in Switzerland as a postdoctoral researcher working with Brad Nelson at the Institute of Robotics and Intelligent Systems at ETH Zurich. Dr. Abbott received his Ph.D. from the Johns Hopkins University in 2005 working with Allison Okamura, his M.S. from the University of Utah in 2001, and his B.S. from Utah State University in 1999, all in Mechanical Engineering. Jake Abbott's research has been funded by the NSF (including the CAREER Award), the NIH, NASA, the Air Force, and industry. He and his co-authors have won a number of Best Paper and Best Poster Awards at international conferences. He is currently an Associate Editor for the International Journal of Robotics Research, and was previously an Associate Editor for IEEE Transactions on Robotics. In Jake's spare time, he's a movie buff, a foodie, and an all-around supporter of the arts and the community in Salt Lake City. Jake's wife is a flamenco dancer and instructor in Salt Lake City, and he plays guitar and sings as part of her group. You can learn more about Jake and his research by visiting https://www.telerobotics.utah.edu/ind... and https://www.mech.utah.edu/directory/f.... Regular Guests: Dr. Nick Castle ( @PlanetaryGeoDoc ) C.C. Petersen ( http://thespacewriter.com/wp/ & @AstroUniverse & @SpaceWriter ) Pam Hoffman ( http://spacer.pamhoffman.com/ & http://everydayspacer.com/ & @EverydaySpacer ) This week's stories: - JWST & what it's going to be looking at. - A comet, 2 meteor showers, 2 contests & a citizen science project! - Crazy Pluto geology. - New information on the clouds of Venus. - Hyabusa samples. We've added a new way to donate to 365 Days of Astronomy to support editing, hosting, and production costs. Just visit: https://www.patreon.com/365DaysOfAstronomy and donate as much as you can! Share the podcast with your friends and send the Patreon link to them too! Every bit helps! Thank you! ------------------------------------ Do go visit http://www.redbubble.com/people/CosmoQuestX/shop for cool Astronomy Cast and CosmoQuest t-shirts, coffee mugs and other awesomeness! http://cosmoquest.org/Donate This show is made possible through your donations. Thank you! (Haven't donated? It's not too late! Just click!) ------------------------------------ The 365 Days of Astronomy Podcast is produced by the Planetary Science Institute. http://www.psi.edu Visit us on the web at 365DaysOfAstronomy.org or email us at info@365DaysOfAstronomy.org.
This week we are excited to welcome Dr. Jake Abbott, director of the Telerobotics Laboratory at the University of Utah to the WSH. The proliferation of Space Debris has become an increasingly alarming reality. In fact, as recently as December 3, 2021, "The International Space Station (ISS) had to swerve away from a fragment of a U.S. launch vehicle" (source: https://www.reuters.com/lifestyle/science/international-space-station-swerves-dodge-space-junk-2021-12-03/). In a paper published in November 2021 in the science journal Nature , Jake and his research team have proposed a new method of dealing with the debris: using a series of spinning magnets to move these objects. You can read more about their proposed solution here https://attheu.utah.edu/facultystaff/waste-of-space/. Jake Abbott is a Professor in the Department of Mechanical Engineering and an Adjunct Professor in the School of Computing at the University of Utah, and he is the director of the Telerobotics Laboratory. He joined the University of Utah in 2008. Before coming to Utah, he spent three years in Switzerland as a postdoctoral researcher working with Brad Nelson at the Institute of Robotics and Intelligent Systems at ETH Zurich. Dr. Abbott received his Ph.D. from the Johns Hopkins University in 2005 working with Allison Okamura, his M.S. from the University of Utah in 2001, and his B.S. from Utah State University in 1999, all in Mechanical Engineering. Jake Abbott's research has been funded by the NSF (including the CAREER Award), the NIH, NASA, the Air Force, and industry. He and his co-authors have won a number of Best Paper and Best Poster Awards at international conferences. He is currently an Associate Editor for the International Journal of Robotics Research, and was previously an Associate Editor for IEEE Transactions on Robotics. In Jake's spare time, he's a movie buff, a foodie, and an all-around supporter of the arts and the community in Salt Lake City. Jake's wife is a flamenco dancer and instructor in Salt Lake City, and he plays guitar and sings as part of her group. You can learn more about Jake and his research by visiting https://www.telerobotics.utah.edu/index.php/People/JakeAbbott and https://www.mech.utah.edu/directory/faculty/jake-abbott/. **************************************** The Weekly Space Hangout is a production of CosmoQuest. Want to support CosmoQuest? Here are some specific ways you can help: ► Subscribe FREE to our YouTube channel at https://www.youtube.com/c/cosmoquest ► Subscribe to our podcasts Astronomy Cast and Daily Space where ever you get your podcasts! ► Watch our streams over on Twitch at https://www.twitch.tv/cosmoquestx – follow and subscribe! ► Become a Patreon of CosmoQuest https://www.patreon.com/cosmoquestx ► Become a Patreon of Astronomy Cast https://www.patreon.com/astronomycast ► Buy stuff from our Redbubble https://www.redbubble.com/people/cosmoquestx ► Join our Discord server for CosmoQuest - https://discord.gg/X8rw4vv ► Join the Weekly Space Hangout Crew! - http://www.wshcrew.space/ Don't forget to like and subscribe! Plus we love being shared out to new people, so tweet, comment, review us... all the free things you can do to help bring science into people's lives.
Jonathan Balcombe was born in England, raised in New Zealand and Canada, and has lived in the United States since 1987. He is a biologist with a PhD in ethology, the study of animal behavior. He is the author of four popular science books on the inner lives of animals, including Pleasurable Kingdom, Second Nature, and What a Fish Knows, a New York Times best-seller. He has published over 60 scientific papers and book chapters on animal behavior and animal protection. Formerly Department Chair for Animal Studies with the Humane Society University, and Director of Animal Sentience with The Humane Society Institute for Science and Policy, Jonathan works as an independent author, and performs editing services for aspiring and established authors. He also serves as an Associate Editor for the journal Animal Sentience, and he teaches a course in animal sentience for the Viridis Graduate Institute. A popular speaker, Jonathan has lectured on six continents (the penguins eagerly anticipate his arrival in Antarctica). Jonathan currently lives in southern Ontario, where in his spare time he enjoys biking, baking, birding, Bach, and trying to understand the squirrels in his neighborhood. LINKS MENTIONED IN THIS PROGRAM: The world's first octopus farm – should it go ahead? Material Innovation Initiative HEART, Humane Education Advocates Reaching Teachers Ruby Roth author of several children's books: That's Why We Don't Eat Animals Vegan is Love V is For Vegan
In this episode of the Award-winning PRS Journal Club Podcast, 2021 Resident Ambassadors to the PRS Editorial Board – Saïd Azoury, Emily Long, and Ronnie Shammas- and special guest Amy Colwell, MD, discuss the following articles from the January 2022 issue: “Exercise after Breast Augmentation: A Randomized Controlled Trial” by Basile and Oliveira. “Risk of Developing Breast Reconstruction Complications: A Machine-Learning Nomogram for Individualized Risk Estimation with and without Postmastectomy Radiation Therapy” by Naoum, Ho, Shui, Salama, et al. “An Analysis of the Modified Five-Item Frailty Index for Predicting Complications following Free Flap Breast Reconstruction” by Magno-Pardon, Luo, Carter, et al. Special Guest Amy Colwell, MD, is full time Faculty in the Division of Plastic Surgery at Massachusetts General Hospital and Professor of Surgery at the Harvard Medical School. Dr. Colwell has served as an Associate Editor in the Editorial Board of PRS since 2016 and is the new Co-editor of Plastic and Reconstructive Surgery Journal. READ the articles discussed in this podcast as well as free related content from the archives: https://bit.ly/JCJan22Collection #PRSJournalClub
The Roundtable Panel: a daily open discussion of issues in the news and beyond. Today's panelists are WAMC's Alan Chartock, the Empire Report's J.P. Miller, political consultant and lobbyist Libby Post, and former Associate Editor of the Times Union Mike Spain.
Painful sex is not something women should have to suffer though. Yet women struggle to find answers and/or grin and bear it for a variety of reasons.Dr. Jill Krapf, a board-certified Obstetrician Gynecologist, specializes in female sexual pain disorders at The Center for Vulvovaginal Disorders. Her deep knowledge on the topic and passion for helping women certainly comes through in this episode.Dr. Krapf shares:Foundations of female anatomySymptoms related to pain with sexFour main causes for pain with sex and typical treatments for eachHow you can find supportIf you liked this episode and you're feeling generous, don't forget to leave a review on iTunes!Check out the following previous episodes referenced:Spotify Playlist Sexual HealthSpotify Playlist Pelvic FloorCorey Hazama | Pelvic Floor PT and PainDr. Allyson Shrikhande | How Pelvic Floor Rehab Can Help you in Surprising WaysAnd be sure to:Follow Fempower Health on Instagram for updates and tips.Subscribe to the podcast and tell your friends!Shop the Fempower Health store, which has many products discussed on the podcast.Sponsors:Let's Get Checked - 30% off with FEMPOWER30Dadikit - use FEMPOWER25 for $25 offMore About Dr Jill Krapf, MD MEd FACOG IFDr. Jill Krapf is a board-certified Obstetrician Gynecologist specializing in female sexual pain disorders at The Center for Vulvovaginal Disorders in Washington, D.C. She is a Clinical Assistant Professor in the Department of Obstetrics and Gynecology at The George Washington University. Dr. Krapf is active in research and has published chapters and peer-reviewed articles on vulvodynia and vulvar lichen sclerosus. She is Associate Editor for the medical journal Sexual Medicine, as well as for the textbook Female Sexual Pain Disorders, 2nd Edition. She is a Fellow of the International Society for the Study of Women's Sexual Health (ISSWSH), serving on the Education Committee and the Social Media Committee. She shares educational content on her Instagram page @jillkrapfmd.
PND took a Break From Toronto and the guys are taking a quick break from the studio with Omicron variant running wild. Very music heavy CHAT this week - Roddy Ricch's The ETCs interview and sophomore album ‘LiveLifeFast,' 6LACK's two-pack, Ne-Yo x Yung Bleu “Stay Down,” Capella Grey's “Talk Nice.” EMPLOYEE OF THE MONTH - Kemet High, Associate Editor at XXL getting love from the producers they're highlighting to end the year. SLIDE DECK - “With You” by Devin Morrison ft. Joyce Wrice (Nic), “Day Before” by Young Thug ft. Mac Miller. BOARD MEETING - The Importance of Going Away aka Taking A Break In Music. When should an artist do it? Why should an artist do it? How should they use the time? When and how should they return? Can certain artists not take breaks? We tackle it all. Please get tested, get boosted, and be smart about outside. Stay Safe, Stay Humble, Stay Busy.
Please join Guest Host and Associate Editor Mercedes Carnethon and author Christine Albert as they discuss the article "Effect of Long-Term Marine ω-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to The Journal and its editors. We are your co-hosts, I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, Associate Editor, Director of the Pauley Heart Center, VCU Health in Richmond, Virginia. Dr. Carolyn Lam: Greg, today's feature paper is such an important question clinically. It's something I've asked myself and so I cannot wait to discuss it in greater detail. It refers to the effect of long-term marine omega-3 fatty acid supplementation, and the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes. So it talks about a systematic review and meta-analysis published in this week's issue. Dr. Carolyn Lam: All right. Okay. You got to wait in suspense, as do I, and let's discuss other papers, very important papers in today's issue too. I'd like to start with a bit of a quiz. So Greg, for converting atrial fibrillation, is the anterior-lateral or anterior posterior electrode position better? What's your guess? Dr. Greg Hundley: Oh, wow, Carolyn. That's interesting. We put these pads on and we kind of just follow the directions on whatever the particular device says. Interesting question. It's a guess, Carolyn, it's a guess. Antro-lateral? Dr. Carolyn Lam: Smarty pants. Well, let's see. Frankly I didn't know the answer. It's just such an elegant question, isn't it? To answer in a study. And this is exactly what Professor Løfgren from Randers University Hospital and Denmark and colleagues did. They performed a multi-center investigator initiated open label trial, where they randomly assigned 468 patients with atrial fibrillation scheduled for elective cardioversion to anterior-lateral versus anterior-posterior electrode position. Dr. Carolyn Lam: The primary outcome was the proportion of patients in sinus rhythm after the first shock. And so drum roll. The primary outcome occurred in 54% assigned to an anterior-lateral electrode position. And in 33% assigned to an anterior-posterior electrode position, a significant risk difference of 22% in favor of the anterior-lateral electrode position. Dr. Carolyn Lam: Cheers, Greg. There were no significant differences between groups in any safety outcomes and the superiority of the anterior-lateral electrode position was statistically significant both after the initial low energy shock and after a final high energy shock. So this study really suggests a practice change in the standard approach to electrode positioning for cardioversion in favor of anterior-lateral electrode position. Dr. Greg Hundley: Very nice, Carolyn. Very nice. Well, I'm going to come at you using your heart failure expertise and ask you a quiz here in just a second. But first I want to introduce this paper from Dr. Javier Barallobre-Barreiro from King's College London. Okay, Carolyn, here's your quiz. Do you think that the extracellular matrix fibrosis contributes to LV dysfunction in heart failure patients? Dr. Carolyn Lam: Absolutely. Dr. Greg Hundley: Very nice. I think, of course, you are correct. So Carolyn, remodeling of the extracellular matrix is a hallmark of heart failure and this team's previous analysis of the secretome of mirroring cardiac fibroblast returned ADAMTS5, a disintegrin and metalloproteinase with thrombospondin motifs 5 as one of the most abundant proteases. So ADAMTS5 cleaves chondroitin sulfate proteoglycans such as Versican. The contribution of ADAMTS5 and its substrate Versican to heart failure is unknown. Dr. Carolyn Lam: Ah, so what did the authors find, Greg? Dr. Greg Hundley: Well, first Carolyn, there was a methodologic advance here. Left ventricular tissues from 86 heart failure patients and non-failing controls were analyzed by quantitative mass spectrometry, constituting the largest proteomics analysis on human heart failure today. And so what did they find? Accumulation of proteoglycan Versican was regulated by ADAMTS5, that disintegrin and metalloproteinase with thrombospondin motifs 5, and was associated with the reduction in proteins involved in intercellular communication. And Carolyn, interestingly, proteoglycan accumulation in ischemic heart failure was attenuated by beta blocker administration. Dr. Carolyn Lam: Oh, that's very interesting. Could you put that all together for us? What's the clinical implications, Greg? Dr. Greg Hundley: You bet, Carolyn. So proteoglycan secretion by cardiac fibroblast constitutes an important component of cardiac fibrosis after ischemic heart failure, just like you stated at the beginning with your quiz answer. This contributes to impaired cardiac function and besides their negative chronotropic and inotropic effects, beta blockers may modulate extracellular matrix remodeling. Dr. Carolyn Lam: Wow, nice, Greg, thank you for that. I've got another original paper and it deals with the very important topic of endothelial to mesenchymal transition. Now it has been reported that cardiac endothelial cells contribute to a substantial proportion of myofibroblast through this process called endothelial to mesenchymal transition. Lineage tracing studies have demonstrated that myofibroblasts are derived from expansion of resident fibroblasts rather than from transdifferentiation from endothelial cells. Dr. Carolyn Lam: However, it remains unknown whether endothelial cells can transdifferentiate into myofibroblast reversibly or would these endothelial to mesenchymal transition genes just transiently activated in endothelial cells during cardiac fibrosis? So these authors, corresponding authors, Dr. Sun from Shanghai Jiao Tong University School of Medicine, Dr. Lui from Price of Wales Hospital and Chinese University of Hong Kong, as well as Dr. Zhou from the University of Chinese Academy of Sciences in Shanghai and their colleagues. Dr. Carolyn Lam: What they did is they used the dual recombination technology to generate a genetic lineage tracing system for tracking endothelial to mesenchymal transition in cardiac endothelial cells and their genetic fate mapping results basically showed that although mesenchymal gene expression was activated in cardiac endothelial cells throughout the endothelial to mesenchymal transition in the developing heart, the endothelial cells do not transdifferentiate into myofibroblasts, nor do they transiently express some known mesenchymal genes during homeostasis or fibrosis in the adult heart. Resident fibroblasts that are converted to myofibroblast by activating mesenchymal gene expressions are in fact the major contributors to cardiac fibrosis. Dr. Greg Hundley: Ah, Carolyn, very interesting. So can you put this together? What are the clinical implications? Dr. Carolyn Lam: So what it really says is that it's the resident fibroblasts that are converted to myofibroblast by activating mesenchymal genes. These are the ones that represent a major therapeutic target and really unraveling these mechanisms, driving endothelial to mesenchymal transition in such a detailed way, provided new insights into therapeutic development to target cardiac fibrosis. Dr. Greg Hundley: Wow, Carolyn. You know, two really good preclinical science articles speaking to us about myocardial fibrosis. Dr. Carolyn Lam: Well, there are other papers in today's issue too. There's a Perspective piece by Dr. Christopher Lamb on “Liver Cirrhosis and Hepatocellular Carcinoma After the Fontan Operation: Reaching Clarity in the Face of Uncertainty. And this is paired with a Research Letter by Dr. Toshio Nakanishi on incidents and expected probability of liver cirrhosis and hepatocellular carcinoma after the Fontan operation. Dr. Greg Hundley: Very nice, Carolyn, and I've got an “In the News” piece from Bridget Kuehn entitled “Centering Equity in Cardiovascular Care as Michelle Albert Lays Out a Roadmap for our Profession.” Well, Carolyn, how about we learn a little more about those long term marine omega-3 fatty acid supplementations and the risk of atrial fibrillation? Dr. Christine Albert: Oh, I can't wait. Let's go, Greg. Dr. Mercedes Carnethon: Thank you so much for joining us for today's episode of Circulation on the Run. My Lame is Mercedes Carnethon, Professor and Vice Chair of Preventive Medicine at the Northwestern University Feinberg School of Medicine and Associate Editor at Circulation. And I have the great pleasure today of having a conversation with a long time friend, Dr. Christine Albert from the Department of Cardiology at the Smidt Heart Institute at Cedars-Sinai Medical Center in Los Angeles. Dr. Mercedes Carnethon: And today I've got the great pleasure of hearing directly from Christine about a wonderful original research piece that is being featured in Circulation about the effect of long term marine omega-3 fatty acid supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes. And the exciting innovation of this piece that we'll dig into is what we're learning from the systematic review and meta-analysis that Dr. Albert and her team carried out. So, thank you so much for joining us today, Christine. Dr. Christine Albert: Well, thank you, Mercedes. It's really great to be here. Dr. Mercedes Carnethon: Great. Well, I'd just like to launch with you telling us a little bit about the study, what you found, why you decided to conduct this meta-analysis and review. Dr. Christine Albert: Yeah. Great. So my first author, Dr. Baris Gencer and I decided to do this because we actually had participated in a randomized trial called the Vital Rhythm Trial, where we actually randomized people to omega-3 fatty acids and atrial fibrillation, and found a slightly elevated risk, but it wasn't significant. And at that time, a number of other articles came out saying that there really was an increased risk of atrial fibrillation. Dr. Christine Albert: So we wanted to put together the data to see what the combined data, our data, that's been published before, on this sort of long term treatment with omega-3 fatty acids and atrial fibrillation. As you may know, there have been studies that have looked at short term treatment, and specifically for atrial fibrillation, and did not find benefit. So this is why we went ahead and did this study. And what we did is we were able to find seven randomized trials that collected data on atrial fibrillation that had randomized people to omega-3 fatty acids over an average of about five years of follow up between all the different trials. And we found that when you combine all these trials together, you actually see that there is a slightly elevated risk of atrial fibrillation in the participants that were randomized to the omega-3 fatty acids. Dr. Mercedes Carnethon: Thank you so much for that summary, Christine. I think the findings themselves surprised me. This is not my primary area of work, but we hear so much about supplements and their benefits that I thought it was really telling to actually have these data coming from a large number of studies, and particularly large studies that suggest that there is a risk to benefit ratio that we need to consider. How would you recommend that clinicians weigh this evidence that you've generated today? Dr. Christine Albert: So I think that it's got to be individualized. There are benefit, as you said, of these omega-3 fatty acids. And I think it's just awareness, awareness that this potentially is a risk. If you have a patient on omega-3 fatty acids and they start to have atrial fibrillation, there could be a link. Also when you talk about it with patients, I think it's reasonable, especially with the higher doses, we can just discuss that this is a potential side effect. Does it prevent you from using it? I don't think so. I think you have to look at what is, again, as you said, the risk benefit ratio for the individual patient. And as I alluded to, we did do a dose analysis and we found that the risk was primarily seen, and it was higher, in those that were given more than a gram of omega-3 fatty acid a day. Dr. Christine Albert: However, I will say that the trials are very different when you take a meta-analysis, it's really hard to say, "What is the cause of the differences between trials?" You know, these trials that had the higher dose, the reduce it trial that used just a purified EPA was very different than the dose of the medication that was used in vital, different than the type of medication that was used in strength. And as you know, there's the whole debate about the placebo and reduce it versus strength. And so there are other differences, but one thing that is pretty consistent is that most of the point estimates are on the side of harm. So there is the thought that I think this is potentially very real and we should be considering it when we use these supplements. Dr. Mercedes Carnethon: You know, that's a really nice summary which really launches me into two subsequent questions. The first would give you the opportunity to speculate beyond the findings in your particular study, and this is one of the benefits to me of this Circ on the Run podcast, because you, of course, produced excellent science and weighed all of your findings based on what you found. But can you tell me, based on your experience, could you speculate about what you think the mechanism of elevated risk of atrial fibrillation is, particularly with those higher doses? Dr. Christine Albert: Yeah, no, it's interesting. You know, if you look at the epidemiology for this, Mercedes, it was totally inconsistent. When I postulated doing the vital rhythm trial, I actually have to be honest with you, I thought that there might be an increased risk, because when you look at some of the data of what these omega-3 fatty acids do, they increase vegal tone, they lower heart rate. They can actually slow conduction. So potentially those electrophysiologic actions might, might allow atrial fibrillation to emerge in people who are susceptible. Dr. Christine Albert: On the flip side, all of those things might be good for ventricular arrhythmias. So you see, if you look at the literature, there's benefits for…sudden death and epidemiologic studies and in some of the randomized trials, but then when you look at atrial fibrillation, at least the short terms, really didn't show a benefit. And again, that point estimate was more towards harm. Dr. Christine Albert: And then when you look at epidemiologic studies, looking at fish consumption, there's actually a lot of studies that suggest that people who eat more fish get more AFib. So it is really paradoxical. And we know as electrophysiologist that atrial arrhythmias and ventricular arrhythmias are not the same, we give drugs to prevent atrial arrhythmias that then cause ventricular arrhythmias. So it is interesting. And I think it's something that hopefully some of our translational scientists will help us to figure out. Dr. Mercedes Carnethon: All those contradictions are so challenging, but you were certainly speaking my language in describing the hypothesized mechanisms. It calls to mind, back in the day, in your early research on sudden cardiac death that I was citing as part of my dissertation work in epidemiology. So thank you for that. Dr. Christine Albert: Yeah. Dr. Mercedes Carnethon: You know, the second question that builds off of that is I thought that the figure where you display the heterogeneity by the dosage of omega-3's really underscores the argument that you were just presenting. What I was wondering is, did you happen to study heterogeneity by any other characteristics, particularly sex or age? Dr. Christine Albert: That would be fantastic to be able to do, unfortunately, because it's a summary level meta-analysis, we really can't do that. And that's one of the things that we'd love to do in collaboration with some of these authors if they would like to do that, is to really get that sort of paid participant level data, so we could do those kinds of analysis. Dr. Christine Albert: But what we did do is sort of separate out studies that had like confirmed AF, studies that had incident AF versus recurrent AF, so things where the studies were completely different, we were able to look for heterogeneity and we didn't find anything that suggested that there was heterogeneity on that basis. But there's a number of things that I would love to look at and age is definitely one of them, and also sex. And actually looking at, which would be really interesting, is to look at the omega-3 or EPA and DHA levels in these individuals. And again, I think each study has sort of tried to do it on their own and you can't because there's just not enough data. So putting all this data together would be great to have a better understanding of what's going on. Dr. Mercedes Carnethon: Oh, it sounds speaks to a number really thoughtful future directions for this work. One of the benefits of me being able to speak with you today in my role as a guest podcast host, but I was also the Associate Editor for the piece and was really excited when it came in. The discussions that we had amongst the editors about this were really very stimulating and raised a number of questions that led to you responding and making some modifications and explaining certain things. Could you tell our audience, why did you select trials over a certain size? You know, quite often we do meta-analyses in order to pull together smaller studies, but why did you choose larger studies? Dr. Christine Albert: I think it was so that, there were two criterias, one was larger and one was long term, because we felt that the smaller studies had been merged together previously and we wanted to have at least some data on atrial fibrillation. One of the problems I think that I think I want to emphasize a little bit here about research in general in cardiovascular disease is that until now, most studies hadn't really measured atrial fibrillation, and I think it's really important. And I think you can see, you can find off target effects of some of the agents that we use for cardiovascular disease on atrial fibrillation. So for instance, the Statin Trials, everybody said, "Oh, well statins might lower atrial fibrillation," but then nobody measured atrial fibrillation, so we never knew. And then people went back and tried to measure it as a side effect or something that has all kinds of biases to it. Dr. Christine Albert: So I think that what is exciting about this work is that both reduce it and strength and vital, pre-specified that they were going to look at atrial fibrillation. And so if we do that, we may actually find other agents that are beneficial, not just harm, but beneficial, like the SGLT2 inhibitors, there's lots of hypotheses. So the reason that we did pick the bigger trials was that we wanted to find trials that really kind of looked at atrial fibrillation, had enough power to look at atrial fibrillation and then over a long term, a follow up to gather enough events. Dr. Mercedes Carnethon: Again, it has been such a pleasure to hear directly from you. I really hope that our listeners today and our readers of The Journal will dig into this in the same way that we have as editors and really appreciate the thoughtfulness with which you've presented this outstanding work. So I want to thank you so much, Dr. Albert for joining us today. Dr. Christine Albert: Thank you for having me. Dr. Mercedes Carnethon: I guess I will sign off now. This is Mercedes Carnethon from the Northwestern University Feinberg School of Medicine and Associate Editor for Circulation. Disclaimer: This program is copyright of the American Heart association, 2021. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American heart Association. For more, visit ahajournals.org.
It was a year of lockdowns and border closures, and for many of us technology was a key part of how we worked, played, and connected with loved ones. On this episode, the last for 2021, we look at the year that was in technology, culture and media, gleaning what we can learn from the year and forecasting what we can expect next year. Guests: Amanda Yeo, co-host of the Queens of the Drone Age podcast Cam Wilson, Associate Editor at Crikey
Casey Means, MD is a Stanford-trained physician, Chief Medical Officer and Co-founder of metabolic health company Levels, and Associate Editor of the International Journal of Disease Reversal and Prevention. Her mission is to maximize human potential and reverse the epidemic of preventable chronic disease by empowering individuals with tech-enabled tools that can inform smart, personalized, and sustainable dietary and lifestyle choices.
Dr. Harvey Risch: Hydroxychloroquine, Ivermectin, Highly Effective in Early COVID Treatment Dr. Harvey Risch is Professor of Epidemiology in the Department of Epidemiology and Public Health at the Yale School of Public Health and Yale School of Medicine. Dr. Risch received his MD degree from the University of California San Diego and PhD, in mathematical modeling of infectious epidemics, from the University of Chicago. After serving as a postdoctoral fellow in epidemiology at the University of Washington, Dr. Risch was a faculty member in epidemiology and biostatistics at the University of Toronto before coming to Yale. Dr. Risch's research interests are in the areas of cancer etiology, prevention and early diagnosis, and in epidemiologic methods. He is especially interested in the effects of reproductive factors, diet, genetic predisposition, histopathologic factors, occupational/environmental/medication exposures, infection and immune functioning in cancer etiology. His major research projects have included studies of ovarian cancer, pancreas cancer, lung cancer, bladder cancer, esophageal and stomach cancer, and of cancers related to usage of oral contraceptives and noncontraceptive estrogens. Dr. Risch is Associate Editor of the Journal of the National Cancer Institute, Editor of the International Journal of Cancer, and was for six years a Member of the Board of Editors, the American Journal of Epidemiology. Dr. Risch is an author of more than 350 original peer-reviewed research publications in the medical literature and those research papers have been cited by other scientific publications more than 43,000 times. Dr. Risch has an h-index of 96 and is a Member of the Connecticut Academy of Sciences and Engineering.
The Roundtable Panel: a daily open discussion of issues in the news and beyond. Today's panelists are WAMC's Alan Chartock, Peabody and Emmy Award winning journalist Linda Ellerbee, the Empire Report's J.P. Miller, and former Associate Editor of the Times Union Mike Spain.
Please join Guest Host Mercedes Carnethon, author Jason Roberts, and Associate Editor Vlad Zaha as they discuss the article "Epigenetic Age and the Risk of Incident Atrial Fibrillation." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. We're your co-host, I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center in Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley Associate Editor, Director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Well, Carolyn, this week's feature we're going to learn more about the risk of incident atrial fibrillation, but as that pertains to epigenetics. But before we get to that feature, how about we grab a cup of coffee and get started on some of the other articles in the issue. Would you like to go first? Dr. Carolyn Lam: I would love to. And the first paper I want to highlight asks the question, are social economic variables associated with 30 day survival after out of hospital cardiac arrest. And this comes from Dr. Jonsson from Karolinska Institute in Stockholm, Sweden, and colleagues. They linked data from the Swedish Registry of Cardiopulmonary Resuscitation with individual level data on social economic factors. In other words, educational level and disposable income, all from statistics, Sweden. And what they found was that both higher disposable income and higher educational level independently associated with better 30 day survival following out of hospital cardiac arrest. The relationship between disposable income and 30 day survival was more robust for mediating factors compared to educational level. Dr. Greg Hundley: Oh, wow Carolyn. Really interesting in a very, what I would call hot topic these days. So what are the clinical implications of this particular study? Dr. Carolyn Lam: Well, the results really highlight the importance of preventive efforts aimed at patients with lower social economic status. And these preventive actions could include both early recognition and warning signs and for example, CPR and AED training. So very lovely paper there. Dr. Greg Hundley: Absolutely. Very nice Carolyn. Well, my first paper comes to us from Dr. Nan Wang from Columbia University Medical Center. And Carolyn this paper focuses on a common genetic variant called link RS 3184504, and it is associated with increased platelet and neutrophil counts, coronary artery disease, thrombotic stroke, and autoimmune diseases. And so this research group previously has shown that hematopoietic link deficiency synergizes with hyperlipidemia to promote platelet production and activation, neutrophilia, platelet neutrophil aggregates, atherosclerosis and arterial thrombosis, all of those things. So platelet activation and platelet neutrophil interactions have been shown to promote neutrophil extracellular traps or net formations. So nets are formed when neutrophils release their contents leading to the formation web-like structures made of DNA, myeloperoxidase, citrullinated histone and proteases that entrap and kill bacteria. Now, while nets may help to suppress infection, the formation of nets called NETosis in blood vessels can promote atherosclerosis and thrombosis. And so this study was undertaken to investigate the hypothesis that linked deficiency might promote NETosis leading to formation of unstable atherosclerotic plaques, and arterial thrombosis. Dr. Carolyn Lam: Wow. What a really neat hypothesis and NETosis. I learn new things all the time. So what do they find? Dr. Greg Hundley: Right Carolyn. First of all, hypercholesterolemic mice with hematopoietic link deficiency displayed accelerated arterial thrombosis with nets in thrombi and these changes were reversed by PAD4 deficiency or OxPL antibodies. Second, linked deficient platelet from hyperlipidemic mice expose and release increased OxPL when activated promoting NETosis, when incubated with link deficient neutrophils. Third, an AntiOxPL antibody reduced OxPL levels, NETosis and arterial thrombosis specifically in link deficient mice, and finally Carolyn targeting atherothrombotic risk using OxPL antibodies might be particularly effective in genetically defined populations with reduced link function or increased JAK-STAT signaling. Dr. Carolyn Lam: Wow. Okay. So they proved their hypothesis. Could you sum it up for us, Greg? Dr. Greg Hundley: You bet Carolyn. So this foundational work suggests that perhaps future studies targeting NETosis and OxPL in patients carrying the common link loss of function variant, could reduce atherothrombotic risk. Dr. Carolyn Lam: Wow. Thanks, Greg. My next paper is super interesting in its approach. Listen up. Now the assessment of the relationship between myocardial ATP production and cardiac workload. We know is important for better understand disease development and choice of nutritional or pharmacological treatment strategies. So what Dr. Berndt from Charity University and colleagues did, was they developed a comprehensive physiology based mathematical model of cardiac energy metabolism. And this model is called cardiokine one. And what it does is it recapitulates numerous experimental findings on cardiac metabolism obtained with isolated cardiomyocytes, perfused animal hearts and in vivo studies with humans. The model encompassed all pathways along, which the possible energy delivering substrates like glucose, long chain fatty acids, keto bodies, acetate, branch chain, amino acids are utilized. Dr. Carolyn Lam: They use the proteomic space, the abundance of metabolic enzymes and cardiac tissue to generate individualized metabolic models of cardiac energy metabolism. And so to prove their case, they further applied this approach to the left ventricles of controls in patients with mitral insufficiency and aortic stenosis, and showed that despite overall preserved systolic function, the ATP producing capacity of these left ventricles of patients with valvular dysfunction was generally diminished and correlated positively with mechanical energy demand and cardiac output. Dr. Greg Hundley: So Carolyn really interesting findings. Sort of linking metabolism them with ventricular dysfunction in those with valvular heart disease. So what were the clinical implications here? What's the take home? Dr. Carolyn Lam: Well, this methodology is just awesome, but what they also found I think is a very important physiological principle. And that is, while metabolic capacity have a significant correlation with biomechanical properties like myocardial power and cardiac output, they can also vary considerably between individual patients and therefore help us to understand in future perhaps why some patients develop heart failure over time while others with similar hemodynamic conditions do not. So just interesting. I think it just opens the space to a lot more. Dr. Greg Hundley: Absolutely beautiful summary there Carolyn. Well, in the rest of the mailbag for this issue, we have an exchange of letters between Professors Hu and Trifon on the previously published paper, entitled “Short Term Treatment with Aspirin plus Clopidogrel Compared to Monotherapy of Aspirin May Not Significantly Decrease the Risk of Stroke Recurrence.” Also, there's a Research Letter from Professor Catalucci entitled, “Nano miR-133A Replacement Therapy, Blunts Pressure Overloaded Induced Heart Failure.” And then finally Carolyn, there's an In-Depth article from Professor Aengevaeren entitled, “Exercise-Induced Cardiac Troponin Elevations From Underlying Mechanisms to Clinical Science.” Well Carolyn, how about we get onto that feature discussion and learn more about incident atrial fibrillation and the age of epigenetics. Dr. Carolyn Lam: Let's go. Dr. Mercedes Carnethon: Welcome to this episode of Circulation on the Run, where we're going to have a very exciting discussion about a paper on epigenetic age and the risk of incident atrial fibrillation. We're extremely excited to have the lead author here with us, Dr. Jason Roberts from the Population Health Research Institute, McMaster University and Hamilton Health Sciences in Ontario Canada. And I am really excited to host this episode alongside the handling editor. My name is Mercedes Carnethon and I'm the professor and vice chair of Preventive Medicine at the Northwestern University School of Medicine. And I'm pleased to be hosting this with Dr. Vlad Zaha from UT Southwestern Medical School, who was the associate editor who handled the piece. So I'm really excited to jump right into this because I think there's a lot that we can all learn from this. So welcome Jason, and thank you so much, Vlad. Dr. Jason Roberts: Thank you so much for having me, it's a delight to be here. Dr. Mercedes Carnethon: So Jason, tell us a little bit about the rationale for this study, what you found and what it means. Dr. Jason Roberts: Absolutely. So as a cardiac arrhythmia specialist, I see a lot of patients with atrial fibrillation. And in 2021, our understanding of its underlying pathophysiology still remains modest. Our treatment strategies for the condition are also somewhat modest, although catheter ablation and antiarrhythmic drugs can potentially be very effective. In the context of these limitations, they're also exacerbated to some extent by the prevalence of atrial fibrillation, increasing dramatically in developed countries. Part of this is related to the obesity epidemic. Things like hypertension increasing becoming more common, but because atrial fibrillation is age dependent and because of our aging populations in developed countries, this is felt to have a major contribution to the growing prevalence of atrial fibrillation. Unlike obesity and hypertension and other risk factors, which are potentially modifiable, chronological aging is viewed as non-modifiable. It's not something that we can tackle. That said, we know within the population and just from personal experience that people age at different rates. There are some people that are 65 who behave more like they're 50, other people that are 50 who behave more like they're 65. Dr. Jason Roberts: And in that context, biological aging, we wondered whether or not, does biological aging independent of chronological aging potentially impacts the risk of atrial fibrillation. If that was the case, because there are gradually accumulating to suggest that biological aging is potentially modifiable, that could potentially open up the possibility of tackling aging as a respective for atrial fibrillation. So that drove us to ask this question. In terms of what we found in the approach that we used. So we used our biological marker of aging, was something called an epigenetic clock. So it's been found that modifications to DNA, specifically methylation at CpG at dinucleotides, they correlate with aging. This has been appreciated for a few decades. It was initially felt that with aging, methylation levels gradually reduced over time. But with more careful interrogation, it's shown that there's patterns. Some methylation areas increase, other methylation areas there's decreases. Dr. Jason Roberts: And Steve Horvath, who is a scientist at UCLA has found that using mathematical algorithms, you're able to very accurately ascertain chronological age based on the patterns of DNA methylation, he's called these things epigenetic o'clock. That said, even though they very accurately ascertain chronological age, they aren't perfect in each individual in terms of matching up to their chronological age, but that's actually turned out to be a good thing. So when people, their epigenetic age is older than their chronological age, they're said to have positive epigenetic age acceleration. They may be biologically older than their actual chronological age. And then the reverse also holds. So using this concept of epigenetic age acceleration, we ask whether or not do people that are older biologically on the basis of their epigenetic age, do they have an increased risk of atrial fibrillation? And then we tackle that using a few different core works that I'm certainly happy to elaborate on in terms of what we found. Dr. Jason Roberts: So we used three population based cohorts from the United States, the well known Framingham Heart Study, the Cardiovascular Health Study and Eric as well. There were approximately just under 6,000 people from those studies that had undergone genome wide methylation analysis that in the enabled us to calculate their epigenetic ages. The follow period for these people was just under 13 years. And then we look to see whether or not these epigenetic clocks associated with instant atrial fibrillation. In these cohorts, we look at five different clocks. So there's the Horvath Clock and the Hannum clock that were designed to predict chronological aging. The more recent clocks, things like DNAm PhenoAge and DNAm GrimAge are more designed to predict aspects of clinical phenotype and also mortality. We found that in unadjusted analyses, all of these clocks were associated with atrial fibrillation. When we then adjusted for multiple different clinical variables, we found that the DNAm PhenoAge clock and the DNAm GrimAge clock continued to exhibit statistically significant associations with atrial fibrillation. Dr. Jason Roberts: Interestingly, the multi-variable adjustment, one concern is, do these clinical factors, are they confounders where we should be adjusting, or are they potentially mediators. If we adjust for mediators that potentially masks the effect of the clock. But regardless of how we treat them both DNAm PhenoAge and DNAm GrimAge, we're associated with increased risks of incident atrial fibrillation. Alluding to the possibility that biological aging independent of chronological aging is important in terms of determining risk for atrial fibrillation. And it may be that if we're able to modify biological aging, we could potentially reduce the risk of atrial fibrillation. So that's the study in a nutshell. Dr. Mercedes Carnethon: No, that is really exciting. You said something early on about chronological age being immutable. And I would have to say, both Vlad and I are not aging. And in fact, we are going in the opposite direction. If only this were not just an audio podcast, you would see that I steadily gotten younger and younger and I'm suddenly about 25 now. But no, these are really important findings. I really like the innovation of using multiple different strategies to characterize epigenetic age and genetic aging. So tell me Vlad, I want to turn to you. When this came across your desk, what excited you about this particular piece and why did you think that it would be of great interest to our readership? Dr. Vlad Zaha: Good morning Merci and Jason. This is a great question. And as in associate editor at Circulation for the bridging discipline section, it was fascinating to see this topic coming on my desk, thinking about all the genome wide association studies in nature of fibrillation and predisposition to atrial fibrillation, that in that case would not be changed by interventions because of different loci that would be determined. This was coming as a completely new perspective that was opening some new potentials. And it was very interesting to see some of the findings. Dr. Mercedes Carnethon: Certainly. So Jason, I have a question. So what surprised you about the findings of this particular study? Jason Roberts: Yeah, that's a great question. So we had hoped that biological aging would be associated with atrial fibrillation. I think the concept of being able to tackle biological aging is exciting. In terms of what surprised us, I guess we were hoping for these results, I guess. Dr. Mercedes Carnethon: Yeah. Dr. Jason Roberts: But we were…Yeah. So I guess we were pleasantly surprised that our hypothesis was born out. It's important to note that the epigenetic clocks don't tell the full story with chronological aging. So after we insert the clock into the model, chronological age continues to remain associated with instant atrial fibrillation. So this measure biological aging is just part of the story. So I think that's very important. I had wondered whether or not inserting the epigenetic clocks would that potentially eliminate the subsequent association of chronological aging. So that finding suggests it's part of the story. Dr. Jason Roberts: I think that in terms of the overall concept, the idea of this being reversible really excites me. In terms of the approach of how to reverse biological aging. Right now healthy lifestyle seems to be very important. I think it provides more evidence to suggest to patients with atrial fibrillation, living healthy from a diet perspective, from exercise, keeping your weight under control, all of these things that seem to impact epigenetic aging and biological aging can be helpful for preventing atrial fibrillation. So I think that can help reinforce this message to our patients. Dr. Jason Roberts: I think ultimately in terms of where we'll be at in 15 to 20 years, it's possible that new therapies in the future are developed that are able to more powerfully address biological aging. As you alluded to, will it be possible to reverse biological aging as you and Vlad are experiencing that? Dr. Mercedes Carnethon: Most definitely. Yes. Dr. Jason Roberts: I think it may be possible. This is an intense area of investigation that's being pursued and it's still in its relative infancy. But I think that could it be small molecules? Could it be potentially gene editing that can help adjust biological aging and not only increase lifespan, but also health span? I think those concepts are really exciting. Dr. Mercedes Carnethon: I completely agree. There's a lot of richness in this paper and I think our readership is going to really enjoy digging in. Part of the richness is the use of three different cohorts and the use of multiple measures of epigenetic age. And I think you provided a really nice description of the unique information that each of these markers of epigenetic age provide. One thing I note are differences in the strength of association across the different measures of epigenetic age, which I think makes sense, because you said they characterize different aspects of the phenomenon, but I also see what looks like some variability across the cohorts with Framingham in particular seeming to stand out. And that being the only cohort that is 100% one race. It's white. Versus both the cardiovascular health study and the Eric study, which have more diverse study populations. I'm wondering what your hypothesis is about the differential strength of association that it seems Framingham is demonstrating and what you think is possibly the source of those differences. Dr. Jason Roberts: Yeah. I think those are great questions for all of genetics. The question is, does it apply to all races? For example, polygenic risk scores. It seems like when a polygenic risk scores develop for one race, it may not perfectly translate over to other races. So how relevant is that for epigenetic age acceleration. In this study, I think it's difficult to make definitive conclusions about it. We needed the three cohorts to have adequate statistical power in terms of being able to determine a differential effect of race. I think it would really be primarily hypothesis generating. We weren't really powered to look at the different races. So it's difficult for me to comment. Dr. Jason Roberts: I think ultimately and I want to believe anyways, that epigenetic age acceleration is relevant to all races, but in terms of, was it race that drove the differential impacts that we saw to some extent in terms of the magnitude of the hazard ratios, it's difficult to know in terms of tests for interaction and were these actually truly statistically different. We weren't adequately powered to address that hypothesis. So it's difficult for me to comment in a definitive matter I'd say. And sorry to cop out on… Dr. Mercedes Carnethon: No, not at all. I mean, I think there are a lot of things where there is no firm answer and that was just one of my hypotheses when I saw what was going on differently across the cohorts. I think that's a perfectly reasonable answer that sets us on a course for thinking about how we set up future studies. So I wanted to turn to you Vlad for the closing frame around this. As the editor, how do you hope that our readership will use these findings? Dr. Vlad Zaha: That is an excellent question. I was going to follow on this excellent unpacking of the core messages of the manuscript by Jason here to get his perspective as an electrophysiologist into what these type of work may represent for the everyday life of an electrophysiologist in the connecting with the patients and how would this type of approach influence, and maybe now, maybe later when our treatment for atrial fibrillation. Dr. Jason Roberts: Yeah. So that's a great question. I think, as I alluded to some extent before, as far as reinforcing healthy lifestyle, I think this provides more evidence in that respect. So we know that things like excessive alcohol consumption, being excessively obese, poor diets, not engaging in enough exercise, all of those things seem to accelerate your epigenetic age. And those are all things that we think or feel that are important with atrial fibrillation in terms of driving the path of physiology and people progressing. So I think this gives more data to us to reinforce the patients that in addition to the treatments that we're offering in terms of catheter ablation and antiarrhythmic drugs, the concern is that the substrate can continue you to progress. And that's likely driven by to some extent these modifiable risk factors. So keeping all of these under best control as possible, and hence trying to slow your biological aging as much as possible. Dr. Jason Roberts: I think that this will provide us more motivation to push these messages to our patients. A lot of patients can sometimes be like, "Let's just get on with a catheter ablation and I want to get on with my life…" but it really I think, provides more data to suggest that modifying these very important risk factors that can lead to accelerated biological agents, is very important. And in terms of the future as mentioned, so chronological aging, as people get older, people view it as, "Well, there's nothing I can do, and I'm just going to get gradually more and more unhealthy." I think, and this is somewhat futuristic, but to what extent can we slow biological aging? Can we potentially reverse it in the future? There's certainly lots of very compelling and interesting animal work and people are starting to delve into this in a big way. Dr. Jason Roberts: And not only to increase lifespan, will we some day live until we're 200. Who knows? But the concept of prolonging your health span as well. So the number of healthy years that you have before your body starts to gradually give way, I guess to some extent. Hopefully in the future will have therapies that will help keep us healthy. And if we do that increased health span, I think this data suggests that atrial fibrillation will be one thing that benefits from this. So hopefully in the future, maybe in terms of curbing the AFib pandemic, being able to address biological aging will help push things in the right direction. Dr. Mercedes Carnethon: Well, thank you so much Jason. And thank you so much Vlad for your thoughtful questions. I really like that the final bottom line leans towards my area as an epidemiologist, which is maintaining and promoting healthy lifestyles as a way to hopefully help prevent some of the difficulties of atrial fibrillation and its long-term outcomes. Really pleased to have you on this episode of Circulation on the Run, Jason, and thank you again Vlad, and I hope everyone enjoys this episode of the journal and has an opportunity to really dig into this piece. This is Mercedes Carnethon from Northwestern University Feinberg School of Medicine, saying thanks for listening today. Dr. Greg Hundley: This program is copyright of the American Heart Association 2021. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American heart association for more visit ahajournals.org.
So much of our health depends on metabolism. And specifically, one of the most important players in this space is how well controlled is our blood sugar. In looking at blood sugar, how it changes following a meal turns out to be a central mechanism that has widespread implications both in the short term (how we feel today) and the long term (risk for serious health issues). I'm going to present a technical term here, postprandial glycemia, which you will hear mentioned quite a bit in this podcast. Postprandial means after a meal, and glycemic means blood sugar level. As such, we are exploring what happens to blood sugar after a meal, something we should all care about. Our guests today include Dr. Momo Vuyisich, Chief Science Officer at Viome. We will be discussing his fascinating new research that was able to accurately correlate the postprandial glycemic response with a unique measurement of the metabolic products produced by gut bacteria. Dr. Vuyisich was actually able to predict how people would respond to specific types of foods, in terms of their blood sugar response, by looking at these bacterial metabolic markers. In that measurement of glycemic response is so central to understanding this research, I've also invited Dr. Casey Means of Levels to join us on the program again. Levels is a company that focuses on using a new technology, continuous glucose monitoring, which allows us to fully understand how our glycemic response plays out in the face of our food and other lifestyle choices. This is an exciting program. Please enjoy! ==== Momo Vuyisich, PhD Co-founder and Chief Science Officer at Viome Momo is an entrepreneur-scientist who is obsessed with building a healthier future in which chronic diseases and cancers are covered in history books, not TV commercials. He has used his extensive scientific expertise and business acumen to lead the development of the core Viome technologies, and their application towards healthier humanity. These technologies are enabling the transformation of the current healthcare, which focuses on symptoms management, into a completely novel preventative and curative model, where individuals can take control of their own health. Momo obtained his PhD in Chemistry from the University of Utah, and BS in Microbiology from the University of Texas at El Paso. He is also an adjunct professor at the New Mexico Tech University. Casey Means, MD Casey Means, MD is a Stanford-trained physician, Chief Medical Officer and Co-founder of metabolic health company Levels, and Associate Editor of the International Journal of Disease Reversal and Prevention. Her mission is to maximize human potential and reverse the epidemic of preventable chronic disease by empowering individuals with tech-enabled tools that can inform smart, personalized, and sustainable dietary and lifestyle choices. Dr. Means's perspective has been recently featured in the Wall Street Journal, New York Times, Men's Health, Forbes, Business Insider, Techcrunch, Entrepreneur Magazine, The Hill, Metabolism, Endocrine Today, and more. Levelshealth.com
Skip the 160K person Levels waitlist with my personal link: levels.link/KAYLA My friend and today's podcast guest, Casey Means, MD, is a Stanford-trained physician, Chief Medical Officer and Co-founder of metabolic health company Levels, and Associate Editor of the International Journal of Disease Reversal and Prevention. Her mission is to maximize human potential and reverse the epidemic of preventable chronic disease by empowering individuals with tech-enabled tools that can inform smart, personalized, and sustainable dietary and lifestyle choices. Dr. Means's perspective has been recently featured in the Wall Street Journal, New York Times, Men's Health, Forbes, Business Insider, Techcrunch, Entrepreneur Magazine, The Hill, Metabolism, Endocrine Today, and more. She has held past research positions at the NIH, Stanford School of Medicine, and NYU. What is metabolic disease How glucose works, and why we want to manage it How glucose affects the brain Ways to hack your blood sugar Ketones vs. sugar, what is best for the brain + more Follow Casey on Instagram: https://www.instagram.com/drcaseyskitchen/ Follow Levels on Instagram: https://www.instagram.com/levels/
In the midst of war, the loss of his mother, and the heartbreak of unrequited love, poet W.H. Auden was rediscovering his faith. And the fitting response to the darkness and despair and apathy around him, he thought, was the Christmas event. So he set to work on a Christmas Oratorio called For the Time Being. Originally meant to be performed and sung, what emerged is a much more sobering and stark retelling of the Christmas narrative than you're used to. Auden's modernist poetry becomes a way for a modern humanity—whose resources are spent, whose plans have gone awry, whose hopes have been misplaced, whose sense of time has been unwound—to find redemption amidst the quotidian, the mundane, and the everyday. But also always in an eternally full "moment of decision"—a response to the bare fact of the Incarnation of God in infant Jesus. Evan Rosa is joined by writer Jeff Reimer (Associate Editor, Comment Magazine), who suggests that this modernist retelling of Christmas helps us to diagnose and treat the quintessentially modern vice of acedia, the noonday demon. They discuss the anachronistic cast of characters Auden uses to comment on the human condition. They read and marvel at several passages of the text. And they consider what Auden takes to be the matter of ultimate importance in our experience of Christmas: responding to the audacious claim that God has become human.About Jeff ReimerJeff Reimer is a writer with bylines at Commonweal, Comment, Plough, and Fare Forward. He is Associate Editor for Comment Magazine. Follow Jeff on Twitter @jreimr or check out his website for links to his writing.Show NotesW.H. Auden's For the Time Being (edited with introduction by Alan Jacobs)Read Jeff Reimer's What Comes After: W. H. Auden's cure for the post-Christmas bluesDealing with the Post-Christmas BluesFlipping the feast for the fast in contemporary Christmas cultureW.H. Auden's For the Time BeingDarkness, despair as the context for the Advent apocalyptic setting"Very little Christmas cheer"Auden's context for writing For the Time Being: World War II, the death of his mother, and his re-discovered faithPossibilities for hope and redemptionReason and optimism have run outCentral question of For the Time Being: "What do we do with this singular Christmas event?"Cast of charactersExistentialist influence on AudenThe silence of Christ in the poemStrange characters: Intuition, Sensation, Feeling, and Thought as an expression of the human selfMary and Joseph: Divergent responses to the Angel GabrielMary's humility and magnanimity togetherWhat it's like to be JosephThe temptation of St. JosephRedeeming the mundane and the quotidianAcedia: the quintessentially modern viceCharles Taylor: "Our present condition is one in which many people are happy living for goals which are purely imminent; they live in a way that takes no account of the transcendent.""The Time Being"—ennui, acedia, and depression following ChristmasThe noonday demonSimeon: Auden's intellectual, theological response to the incarnationHerod: Auden's stoic intellectual, politically indifferent, tragic-comic figureStoic virtue: apathea, or "cultivated indifference"The incarnation does not allow for cultivated indifferenceHerod's cultivated indifference ends up becoming outright violent resistance and the massacre of the innocentsThe difficulty of inhabiting a moment the way we're meant toThe way, the truth, the life"Seek him in the Kingdom of Anxiety."Production NotesThis podcast featured writer Jeff ReimerEdited and Produced by Evan RosaHosted by Evan RosaProduction Assistance by Martin Chan, Nathan Jowers, Natalie Lam, and Logan LedmanA Production of the Yale Center for Faith & Culture at Yale Divinity School https://faith.yale.edu/aboutSupport For the Life of the World podcast by giving to the Yale Center for Faith & Culture: https://faith.yale.edu/give
What is “capacity”? In science research and health interventions, it typically refers to the relative availability of equipment, infrastructure, personnel, and skills needed to get a job done. Noémi Tousignant's book, Edges of Exposure: Toxicology and the Problem of Capacity in Postcolonial Senegal (Duke UP, 2018), feels its way into the experience of capacity to observe a crucial characteristic. Capacity has “temporal qualities.” Waiting, interrupting, prolonging, repairing: these processes show that the elements of lab science and public health called “capacity” operate with different rhythms that often fail to synchronize or to be formally acknowledged. Yet the material world of capacity also implies a direction, which orients scientists to (im)possibilities for better futures, “to moral imaginations of responsibility and commitment.” The book won the 2020 Ludwik Fleck prize for outstanding book from the Society for the Social Studies of Science. The award signals the book's broad relevance for anyone interested in critical studies of science, technology, and health; intrigued by the phenomenology of time; keen to combine training in history with ethnographic methods; or interested in postcolonial studies, especially Africa. The book is based on Tousignant's field work in Senegal from in 2010 and 2011 studying professional toxicologists across three institutions as they “improvised and imagined a more capacious and protective toxicology.” In terms of empirical content, this work is important for anyone interested in environmental contamination and the politics of poisoning lands, waters, and bodies. The interview also refers to the work of Gabrielle Hecht on exposure and imaginaries of Africa, Julie Livingstone on improvisation and slow risks, Joanna Crane on commodification of global health, and Monika Krause on how NGOs perform worthy projects. This interview was a collaborative effort among Professor Laura Stark and students at Vanderbilt University in the course “American Medicine & the World.” Please email Laura with any feedback on the interview or questions about the collaborative interview process. Laura Stark is Associate Professor at Vanderbilt University's Center for Medicine, Health, and Society, and Associate Editor of the journal History & Theory. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network
The Roundtable Panel: a daily open discussion of issues in the news and beyond. Today's panelists are WAMC's Alan Chartock, research professor and Stuart Rice Honorary Chair at the University of Massachusetts Amherst's College of Information and Computer Sciences (CICS) and Faculty Associate at the Berkman Klein Center for Internet and Society at Harvard University Fran Berman, UAlbany adjunct professor and investigative journalist Rosemary Armao, and former Associate Editor of The Times Union, Mike Spain.
The Roundtable Panel: a daily open discussion of issues in the news and beyond. Today's panelists are WAMC's Alan Chartock, Chief of Staff and Vice President for Strategy and Policy at Bard College Malia Du Mont, political consultant and lobbyist Libby Post, and former Associate Editor of The Times Union MUSIC Mike Spain.
This episode is brought to you by InsideTracker and ButcherBox.Most of us hear the term “metabolic health” and think it only applies to our ability to burn food and manage our weight. And while those are certainly big pieces of metabolic health, it also impacts everything from our cardiovascular health to cognition, mood, infertility, and so much more. That's because our metabolism is actually our body's ability to create energy and this happens all over the body. If our energy production in the brain is hindered, we could have memory loss; if it's not functioning properly in muscle cells, we may see chronic pain—and the list goes on. In today's mini-episode, Dhru speaks with Dr. Benjamin Bikman and Dr. Casey Means about why insulin resistance has become so prevalent, and what makes us insulin resistant in the first place. They discuss how our diet and lifestyle have fundamentally changed in a way that greatly impacts how we regulate blood sugar, and how it's wreaking havoc on our metabolic health. They also talk about how to reverse and prevent insulin resistance through specific diet and lifestyle modifications, and how we can use continuous blood glucose monitoring to dramatically improve our health.Dr. Benjamin Bikman is a renowned metabolic research scientist, and a popular speaker on human metabolism and nutrition. He is the author of Why We Get Sick, which offers a thought-provoking yet real solution to insulin resistance and how to reverse pre-diabetes, improve brain function, shed fat, and prevent diabetes. Dr. Casey Means is a Stanford-trained physician, Chief Medical Officer and Co-founder of metabolic health company Levels, and Associate Editor of the International Journal of Disease Reversal and Prevention. Find Dhru's full-length conversation with Dr. Benjamin Bikman here: https://lnk.to/dhru-154/ and Dr. Casey Means here: https://lnk.to/dhru-170/.This episode is brought to you by InsideTracker and ButcherBox. InsideTracker looks at everything from metabolic and inflammatory markers to nutrients and hormones. Traditional lab tests can be hard to read on your own, but InsideTracker makes their results easy to understand and provides tips on how to use food first for optimal nutrition. Right now, they're offering my podcast community 25% off. Just go to insidetracker.com/DHRU. When I made the leap from being a vegetarian back to eating meat, my biggest focus was quality. With ButcherBox, I know I'm serving the people I love the highest quality clean protein, which means no inflammatory fats, antibiotics, or weird toxins. ButcherBox has a variety of different boxes, and you can choose your box and frequency. For a limited time, you can sign up today and get 2lbs of ground beef free in your first box plus $10 off by going to butcherbox.com/dhru. See acast.com/privacy for privacy and opt-out information.
Stand Up is a daily podcast. I book,host,edit, post and promote new episodes with brilliant guests every day. Please subscribe now for as little as 5$ and gain access to a community of over 800 awesome, curious, kind, funny, brilliant, generous souls Check out StandUpwithPete.com to learn more also please donate to GiveWell.org/StandUp and start a store or shop at Shopify.com/Standup Today's show opens with an almost 45 minute new recap then we get to my conversation with Christine Romans who is CNN's Chief Business Correspondent and anchor of Early Start with Laura Jarrett weekdays from 4 am to 6 am ET. She won an Emmy award for her work on the series "Exporting America" about globalization and outsourcing American jobs overseas, and is author of three books: Smart is the New Rich: If You Can't Afford it—Put it Down (Wiley 2010) How to Speak Money (Wiley 2012) and Smart is the New Rich Money Guide for Millennials (Wiley March 2015). Romans is known as CNN's explainer-in-chief of all things money. She covers business and finance from the perspective of American workers and small business owners, translating what budgets and bailouts and economic data mean for families. Romans brings an award-winning career in business reporting. In 2014, she crossed the country reporting for her series, "Is College Worth it." In 2010, Romans co-hosted "Madoff: Secrets of a Scandal," a special hour-long investigative report examining disgraced financier Bernard Madoff and how he perpetrated one of the largest investor frauds ever committed by an individual. In 2009, her special "In God We Trust: Faith & Money in America" explored the intersection of how our religious values govern the way we think about and spend our money. Her series of reports "Living Dangerously" illustrated the risks and precautions for the nearly 30 percent of America's population living in the path of an Atlantic-coast hurricane. In "Deadly Hospitals," she examined how hospitals spread dangerous infections and what patients can do to protect themselves. Romans joined CNN Business News in 1999, spending several years reporting from the floor of the New York Stock Exchange. Romans was the anchor of CNNfn's Street Sweep tracking the market's boom through the late 1990s to tragedy of Sept. 11 attacks. She anchored the first democratic elections in Iraq's history from CNN Center in Atlanta. She has covered four hurricanes and four presidential elections, and was part of the coverage teams that earned CNN a George Foster Peabody award for its Hurricane Katrina coverage and an Alfred I. duPont Award for its coverage of the tsunami disaster in Southeast Asia. The National Foundation for Women Legislators has honored her with its media excellence award for business reporting and the Greenlee School of Journalism named her the 2009 James W. Schwartz award recipient. ------------------------- My second guest today starts at 1:02 Lee McIntyre is a Research Fellow at the Center for Philosophy and History of Science at Boston University and an Instructor in Ethics at Harvard Extension School. He holds a B.A. from Wesleyan University and a Ph.D. in Philosophy from the University of Michigan (Ann Arbor). He has taught philosophy at Colgate University (where he won the Fraternity and Sorority Faculty Award for Excellence in Teaching Philosophy), Boston University, Tufts Experimental College, Simmons College, and Harvard Extension School (where he received the Dean's Letter of Commendation for Distinguished Teaching). Formerly Executive Director of the Institute for Quantitative Social Science at Harvard University, he has also served as a policy advisor to the Executive Dean of the Faculty of Arts and Sciences at Harvard and as Associate Editor in the Research Department of the Federal Reserve Bank of Boston.McIntyre is the author of How to Talk to a Science Denier (MIT Press, 2021), Philosophy of Science (Routledge, 2019), The Sin Eater (Braveship, 2019), The Scientific Attitude (MIT Press, 2019), Post-Truth (MIT Press, 2018), Respecting Truth (Routledge, 2015), Dark Ages (MIT Press, 2006), and Laws and Explanation in the Social Sciences (Westview Press, 1996). He is the co-editor of four anthologies: Readings in the Philosophy of Social Science (MIT Press, 1994), two volumes in the Boston Studies in the Philosophy and History of Science series: Philosophy of Chemistry: Synthesis of a New Discipline (Springer, 2006) and Philosophy of Chemistry: Growth of a New Discipline (Springer 2014), and The Routledge Companion to Philosophy of Social Science (Routledge, 2017). McIntyre is also the author of Explaining Explanation: Essays in the Philosophy of the Special Sciences (Rowman and Littlefield/UPA, 2012), which is a collection of twenty years' worth of his philosophical essays that have appeared in Synthese, Philosophy of the Social Sciences, Teaching Philosophy, Perspectives on Science, Biology and Philosophy, Critica, Theory and Decision, and elsewhere. Other work has appeared in such popular venues as the New York Times, Newsweek, Scientific American, the Boston Globe, the Chronicle of Higher Education, the New Statesman, the Times Higher Education Supplement, and the Humanist. Check out all things Jon Carroll Follow and Support Pete Coe Pete on YouTube Pete on Twitter Pete On Instagram Pete Personal FB page Stand Up with Pete FB page
Brené Brown has always called herself a mapmaker and in her sixth and newest book, the Atlas of the Heart, out this week, she takes us on a journey through 87 of the emotions and experiences that define what it means to be human. Her TEDx talk “the power of vulnerability” is one of the top five most viewed TED talks in the world with more than 50 million views. She joins Anita. This Sunday marks 100 years since women's football was banned by the English Football Association. Because of Covid the Women's FA Cup final, traditionally played in May, will take place with Arsenal taking on Chelsea and shown live on the BBC. Kelly Simmons, director of the Women's Professional Game at the Football Association; and Jen O' Neill, editor of football magazine She Kicks discuss the game. The number of tribunal cases in which employees are alleging menopause related discrimination is on the rise. Analysis of the Courts and Tribunals Service has shown that menopause was cited ten times in the first six months of 2021, and could rise to 20 by the end of the year, if the rate continues as it is. Research by Menopause Matters earlier this year found five cases in 2018, and 16 in 2020. Although these figures appear very small, nearly one million women are said to have left work due to menopausal symptoms and there is currently a Women and Equalities Committee inquiry looking into workplace practices around the menopause. So what can be done to prevent a situation getting as far as a tribunal? I'm joined by Lauren Chiren, who runs Women of a Certain Stage, providing coaching, mentoring and training on the menopause at work and Sinead Casey, a partner with the law firm Linklaters, who advise employers on workplace issues including menopausal women, and has been looking at the recent uptake in cases. Over the next few Fridays we'll be looking at alternative Christmas food ideas and who better to start off with than Ravinder Bhogal, journalist, chef and owner of Jikoni, her restaurant in London. Always challenging traditional notions of food preparation she joins Anita to share her thoughts on creating some rich adaptations of everything from brussel sprouts and ham to samosas and mathi. And tells us why Christmas is a particularly special time for her and her family. The British socialite Ghislaine Maxwell has been in court all week in New York City on sex trafficking and other charges. She's challenging claims that she groomed underage girls for convicted paedophile Jeffrey Epstein for sexual abuse. He died in prison in 2019. She's been in a US jail since her arrest last year. We hear from Stephen Wright, Associate Editor at the Daily Mail currently in New York City covering the Ghislaine Maxwell trial. Presenter: Anita Rani Producer: Kirsty Starkey Interviewed Guest: Brené Brown Interviewed Guest: Kelly Simmons Interviewed Guest: Jen O'Neill Interviewed Guest: Lauren Chiren Interviewed Guest: Sinead Casey Interviewed Guest: Ravinder Bhogal Interviewed Guest: Stephen Wright
Ryan Adams joins us to give an inside look on what it's like to write for PGA Magazine. After graduating from UCCS in 2014 he moved down to PGA Headquarters in Florida for an internship. He was then recommended by his boss to take his job as the associate editor for the magazine. Since 2016, Ryan has written many stories from Phil Mickelson becoming the oldest winner of a major to the United States beatdown of Europe in the 2021 Ryder Cup at Whistling Straights.
Dennis talks to Douglas Murray, Associate Editor of The Spectator. His new book is The Strange Death of Europe: Immigration, Identity, Islam. A Best of Prager Hour. Originally broadcast on June 22, 2017 See omnystudio.com/listener for privacy information.