Podcasts about associated editor

Did you know that JAMA Dermatology has its own podcast? In this Episode, we talk with Dr. Adewole Adamson, the host of the JAMA Dermatology Author Interviews podcast, and current Web Editor and Associated Editor of JAMA Dermatology. He currently serves as an assistant professor at Dell Medical School at the University of Texas at Austin, where he is also the Director of the Pigmented Lesion Clinic. Dr. Adamson talks about JAMA Dermatology's podcast and shares his numerous experiences and pearls--tune in and be inspired! Host: Grace Hobayan Learn More: https://twitter.com/AdeAdamson https://adeadamson.com/ Music: District Four by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3662-district-four License: https://filmmusic.io/standard-license --- Send in a voice message: https://podcasters.spotify.com/pod/show/derminterest/message

Rod Arquette Show Daily Rundown – Monday, January 23, 2023 4:20 pm: Utah Attorney General Sean Reyes joins the show to discuss a potential lawsuit the state may file against social media companies to address the harm they are doing to the mental health of Utah's youth 4:38 pm: Congressman Chris Stewart joins the program for a conversation about his plan to introduce legislation that would make it illegal for social media platforms to offer their services to people under 16-years of age as a way to improve the mental health of America's young people 6:05 pm: Robby Soave, Associated Editor of Reason.com, joins the show for a conversation about his recent piece about how emails released by Elon Musk and obtained from Facebook reveal that federal agencies, like the FBI and CDC, worked with moderators from those platforms to restrict anti-Covid speech 6:20 pm: Nathan Worcester of the Epoch Times joins the show for a conversation about his piece on how background reviews of officials at the National Archives supports allegations of bias at the organization 6:38 pm: Melisa Stark, Commissioner of Apprenticeships at the Utah Department of Workforce Services, joins Rod to discuss the apprenticeship opportunities available to high school graduates and others in the state

*The information in this podcast is intended for Healthcare Practitioners. Endometriosis is a common and debilitating condition that has proven difficult to treat. In this episode, Sun-Wei Guo, a geneticist turned Professor of Gynaecology, reveals his eye-opening research into the pathophysiology of endometriosis. Sun Wei explains how the theory of retrograde flow in endometriosis is necessary but not sufficient to explain the progression of the disease. Prof Guo explains that endometriotic lesions are wounds undergoing repeated tissue injury and repair (ReTIAR). Sun Wei further describes how surprising mediators in the endometriotic microenvironment are responsible for the incomplete repair process that leads to the cellular hallmarks of endometriosis. Hear about Prof Guo's preliminary work on herbal constituents and electrical stimulation that are generating encouraging results in endometriosis. Listen in to discover new non-hormonal targets that can be considered to combat this terrible affliction. Professor Guo received his Ph.D. from the University of Washington and had subsequent stints at University of Michigan and the Medical College of Wisconsin. Since 2010 Sun Wei has been a Professor at Shanghai OB/GYN Hospital, Fudan University and an adjunct professor at Department of Obstetrics, Gynecology and Reproductive Biology at Michigan State University College of Human Medicine. Prof Guo has been an Associated Editor of several reproduction journals and a board member of several endometriosis societies, including member of the Board of Trustees of the World Endometriosis Society (WES). Links: Guo SW. Fibrogenesis resulting from cyclic bleeding: the Holy Grail of the natural history of ectopic endometrium. Hum Reprod. 2018 Mar 1;33(3):353-356. https://pubmed.ncbi.nlm.nih.gov/29420711/ Xiao F, Liu X, Guo SW. Platelets and Regulatory T Cells May Induce a Type 2 Immunity That Is Conducive to the Progression and Fibrogenesis of Endometriosis. Front Immunol. 2020 Dec 14;11:610963. https://pubmed.ncbi.nlm.nih.gov/33381124/ Yan D, Liu X, Guo SW. Neuropeptides Substance P and Calcitonin Gene Related Peptide Accelerate the Development and Fibrogenesis of Endometriosis. Sci Rep. 2019 Feb 25;9(1):2698. https://pubmed.ncbi.nlm.nih.gov/30804432/ Huang S, Xiao F, Guo SW, Zhang T. Tetramethylpyrazine Retards the Progression and Fibrogenesis of Endometriosis. Reprod Sci. 2022 Apr;29(4):1170-1187. https://pubmed.ncbi.nlm.nih.gov/35099777/ Hao M, Liu X, Rong P, Li S, Guo SW. Reduced vagal tone in women with endometriosis and auricular vagus nerve stimulation as a potential therapeutic approach. Sci Rep. 2021 Jan 14;11(1):1345. https://pubmed.ncbi.nlm.nih.gov/33446725/ Hao M, Liu X, Guo SW. Activation of α7 nicotinic acetylcholine receptor retards the development of endometriosis. Reprod Biol Endocrinol. 2022 Jun 4;20(1):85. https://pubmed.ncbi.nlm.nih.gov/35658970/

Niall Stanage talks to Eamon about Cassidy Hutchinson's testimony at the sixth of the January 6th Committee Hearings. Niall Stanage is Associated Editor of The Hill and White House columnist for that paper.Recorded on 29th June 2022. See acast.com/privacy for privacy and opt-out information. Become a member at https://plus.acast.com/s/the-stand-with-eamon-dunphy.

Renita Coleman - She is Associated Editor of Journalism & Mass Communication Quarterly with over 15 years of experience as a newspaper journalist. Her research focuses on agenda-setting, race, visual communication and ethics. Her newest book is "Designing Experiments for the Social Sciences: How to Plan, Create and Execute Research Using Experiments” is a practical, applied text for courses in experimental design. She will join Tavis to discuss framing and word choice in today's top news stories and the role of overall journalism ethics

For many instructors making decisions about what content must be emphasized, what needs to be assessed, and how to design activities that maximize learning is a challenging task, regardless of the mode of teaching. In this episode, Drs. Ruth Streveler and Karl Smith who collaborated on writing an opinion piece on their CAP framework share with us a way of thinking about redesigning off and online learning environments using the CAP framework as a guiding model of instructional approach. Bios:Dr. Ruth A. Streveler is a Professor in the School of Engineering Education at Purdue University. Dr. Streveler has been the Principle Investigator or co-Principle Investigator of ten grants funded by the US National Science Foundation. She is an Associated Editor for the Journal of Engineering Education (JEE), has published articles in the JEE and the International Journal of Engineering Education, and contributed two chapters to the Cambridge Handbook of Engineering Education Research. She has presented workshops to over 500 engineering faculty on four continents. Dr. Streveler's primary research interests are investigating students' understanding of difficult concepts in engineering science and helping engineering faculty conduct rigorous research in engineering education.Dr. Karl A. Smith is Cooperative Learning Professor of Engineering Education, School of Engineering Education, at Purdue University. He is also Morse-Alumni Distinguished University Teaching Professor and Emeritus Professor of Civil, Environmental, and Geo- Engineering at the University of Minnesota. His research and development interests include building research and innovation capabilities in engineering education; faculty and graduate student professional development; the role of cooperation in learning and design; problem formulation and modeling; and project and knowledge management. Karl adapted the cooperative learning model to engineering education. His work on cooperative learning has helped thousands of faculty build knowledge, skills and confidence for involving their students in interactive and cooperative learning both during class time and outside of class.  The effects of the work are significant in terms of creating a sense of belonging and membership in a community, as well as much more engaged and deep learning. 

This week, ATG the Podcast interviews Mitchell Davis, CEO and Founder of BiblioLabs, and Robert Miller, CEO of Lyrasis, about the recent purchase of BiblioLabs by Lyrasis. The interview is conducted by Leah Hinds, Executive Director of the Charleston Hub, and Tom Gilson, Associated Editor of Against the Grain. Topics range from the acquisition, to potential changes in corporate culture, the future of existing projects, how they both see the future of ebooks, and more. Special Announcement The Charleston Conference is planning a very special “In Between” half-day virtual mini-conference event to explore important late-breaking developments that can't wait til November for discussion! Our first panel will cover the Clarivate acquisition of ProQuest, and will be moderated by Roger Schonfeld of Ithaka S+R. The second panel is called “Exiting the Tunnel” and will feature reflections from savvy executives on what the bright lights of a post-Covid world offers to them. We hope you'll join us on July 28 at 10:30 AM EST.  Registration is open now on our website.  Registration Link for "Charleston In Between:"  https://charlestonconference.regfox.com/charleston-in-between Visit Charleston-Hub.com for more info.

Interview with Lawrence Murray ESPN Associated Editor and Journalist. Background music which is owned by FesliyanStudios.

The CAP Framework is widely known in the engineering education community. It is focused on alignment of content, assessment, and pedagogy to progress towards learning objectives and is frequently used as an approach to curriculum development in engineering courses. Dr. Streveler talks to us about her personal experience with online teaching, ways the CAP framework can be used to rethink course design in an online environment, and the importance of social-emotional support in online instruction.References mentioned in this episode:Streveler, R. A., Smith, K. A., & Pilotte, M. (2012). Aligning course content, assessment, and delivery: Creating a context for outcome-based education. In Outcome-based science, technology, engineering, and mathematics education: Innovative practices (pp. 1-26). IGI Global.Bio:Dr. Ruth A. Streveler is a Professor in the School of Engineering Education at Purdue University. Dr. Streveler has been the Principle Investigator or co-Principle Investigator of ten grants funded by the US National Science Foundation. She is an Associated Editor for the Journal of Engineering Education (JEE), has published articles in the JEE and the International Journal of Engineering Education, and contributed two chapters to the Cambridge Handbook of Engineering Education Research. She has presented workshops to over 500 engineering faculty on four continents. Dr. Streveler's primary research interests are investigating students' understanding of difficult concepts in engineering science and helping engineering faculty conduct rigorous research in engineering education.

Dr. Paolo Cassano is assistant professor of psychiatry at Harvard Medical School and Director of Photobiomodulation at the Massachusetts General Hospital (MGH) Depression and Clinical Research Program and Principal Investigator at the MGH Center for Anxiety and Traumatic Stress Disorders.Since 2009, Dr. Cassano has led multiple studies on transcranial photobiomodulation with near-infrared light for anxiety and mood disorders, including translational studies aimed at discovering the mechanisms of action of photobiomodulation. His translational studies have focused on the effects of near-infrared light on mitochondria, cerebral blood flow (DCS), on brain electrical activity (EEG) and on autonomic reactivity (HRV). For his studies on photobiomodulation, he was awarded competitive, national grants such as the Brain and Behavior Research Foundation NARSAD.These groundbreaking projects have demonstrated preliminary efficacy of near-infrared light for the treatment of psychiatric disorders. Considerable press attention stemmed from these studies, with CNN, Washington Post and Boston Globe coverage at the national level. He has coauthored more than 50 publications and he is the Associated Editor of Photobiomodulation, Photomedicine, and Laser Surgery.https://www.massgeneral.org/doctors/19402/Paolo-Cassanohttps://giving.massgeneral.org/infrared-light-depression-research/https://niraxx.com/https://medium.com/@pcassanohttps://www.linkedin.com/in/paolo-cassano-md-phd/https://twitter.com/paolo_cassanohttps://www.instagram.com/paolocassanomd/Parties involved have authorized disclosure

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Ira Pastor, ideaXme exponential health ambassador, interviews Professor Dr. Frank Rühli, Director of the Institute of Evolutionary Medicine and on the Medical Faculty of University of Zurich, and Founding Director, Chair, Full Professor of Evolutionary Medicine. Ira Pastor Comments: Famous prominent Russian-American geneticist and evolutionary biologist, Theodosius Dobzhansky, stated in a 1973 essay that “Nothing in biology makes sense except in the light of evolution." When one applies this principle to medical research, it suggests that if you study only the proximal causes of health and disease (pathophysiology), you get a limited picture, and such dynamics could be better understood within an evolutionary framework. While traditional biomedical research is often concerned with pathophysiology, it is the relatively new science of evolutionary medicine that seeks to link human pathology with our past, present, and future evolutionary trajectories. Combining the study of proximal and distal reasons underpinning medical disorders yields a deeper understanding that may help to improve the ways diseases are screened for, treated, or prevented. Professor Dr. Frank Rühli: Professor Dr. Frank Rühli, is Director of the Institute of Evolutionary Medicine and on the Medical Faculty of University of Zurich, and Founding Director, Chair, Full Professor of Evolutionary Medicine. In addition to being the director of the institute he is also Head of the Paleopathology and Mummy Studies Group, as well as Head of the Museum‚ Medical Collection and Human Remains Group. Prof. Dr. Rühli studied Medicine at the University of Zurich and did Postgraduate Research to undertake a PhD at the Biological Anthropology and Comparative Anatomy Research Unit, Anatomical Sciences, University of Adelaide (Australia). He has a broad research domain including - Evolutionary Medicine, Paleopathology / Disease Evolution, Microevolution of Anatomical Norm Variations and Pathologies / Clinical Anatomy, Diagnostic Imaging of Ancient Mummies, as well as the biological standard of living and state of health of Swiss Armed Forces. He is Associated Editor, Editor and Editor–in-Chief of seven peer-reviewed journals: Evolution, Medicine and Public Health, Journal of Evolutionary Medicine, Homo - Journal of Comparative Human Biology, Journal of Biological and Clinical Anthropology, Yearbook of Mummy Studies, and Swiss Review of Military and Disaster Medicine. On this fascinating show we will hear from Dr. Ruhli: About his background and how he developed an interest in science, medicine, and the unique intersection with the study of evolutionary biology. The principle of "Micro-Evolution" and the fact that humans (Homo-Sapiens) "evolve" every day. His unique study of human mummies and application towards understanding our health "past." Evolutionary medicine insights for human diseases such metabolic disorders (including hypercholesterinemia and diabetes) and drug addiction. Thoughts on future human evolutionary trajectories. Thoughts on evolutionary medicine connection to ageing processes. Credits: Ira Pastor interview video, text, and audio. Follow Ira Pastor on Twitter:@IraSamuelPastor If you liked this interview, be sure to check out ourinterview exploring the human-animal connection for health and wellness! Follow ideaXme on Twitter:@ideaxm On Instagram:@ideaxme Find ideaXme across the internet including on iTunes,SoundCloud,Radio Public,TuneIn Radio,I Heart Radio, YouTube, Google Podcasts, Spotify and more. ideaXme is a global podcast, creator series and mentor programme. Our mission: Move the human story forward!™ ideaXme Ltd.

Dr Carolyn Lam:                Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center and Duke National University of Singapore.                                                 Today's feature paper is about statins, and it's the first population-based study to show a dose-dependent benefit on amputation and survival in peripheral artery disease. Very important data and a very important discussion coming right up after these summaries.                                                 The first original paper this week indicates for the first time that the natural history of coronary stenosis is better predicted by physiologic information by FFR, or fractional flow reserve, than by anatomic information from angiography. First author, Dr. Ciccarelli, corresponding author, Dr. DeBruyne, from OLV Hospital in Belgium compared the values of angiographic diameter stenosis and of fractional flow reserve in predicting the natural history among 607 patients from the FAME 2 trial who had documented stable coronary disease and in whom no revascularization was performed. The primary end point was defined as vessel oriented clinical end point at two years, and this was a composite of prospectively adjudicated cardiac death, vessel-related myocardial infarction, vessel-related urgent and non-urgent revascularization.                                                 The overall results showed that FFR predicted the natural history better than diameter stenosis. In addition, among the stenosis with mismatch between diameter stenosis and FFR, more than half had a low FFR in the presence of an angiographically mild stenosis and the rate of primary outcome was higher in those with reduced FFR regardless of whether diameter stenosis was significant or not. The take-home message is, therefore, that measurements of FFR should be considered not only an angiographically intermediate stenosis but also perhaps a mild or severe stenosis by visual evaluation.                                                 The next study provides population-based data on cardiovascular outcomes and risks after initiation of a sodium glucose cotransporter-2 inhibitor, or SGLT2 inhibitor. First and corresponding author, Dr. Udell, from University of Toronto, and his colleagues, performed population-based cohort study among type 2 diabetes patient with established cardiovascular disease and newly initiated on antihyperglycemic agents within the US Department of Defense Military Health System between 2013 and 2016. After propensity matching, more than 25,250 patients were followed for a median of 1.6 years. Initiation of SGLT2 inhibitors was associated with a lower all-cause mortality, lower hospitalization for heart failure events, lower major adverse cardiovascular events, but higher below-knee amputation risk. Findings underscore the potential benefits and risks to be aware of when initiating SGLT2 inhibitors. Importantly, it remains unclear whether the risk of below-knee amputation extends across a class of medications as the study was not powered to make comparisons among individual treatments.                                                 The next paper reports results of the redefined trial, which is the first trial to study the effects of renin-angiotensin-aldosterone system inhibitors in adults with tetrology of Fallot and mild right ventricular dysfunction in the absence of severe valvular lesions. First author, Dr. Bokma, and corresponding author, Dr. Bouma from Academic Medical Center Amsterdam, and their colleagues, studied 95 patients in the redefined trial and found that 150 mg of losartan daily did not significantly improve the primary outcome of right ventricular ejection fraction change compared to placebo. There were no significant treatment effects on secondary outcomes of left ventricular ejection fraction, peak aerobic exercise capacity or NT-proBNP. However, in a post hoc analysis, losartan was associated with improved right ventricular ejection fraction in a subgroup of 30 patients with nonrestrictive right ventricles and incomplete remodeling. The conclusion is, therefore, that losartan had no significant effect on right ventricular dysfunction or secondary outcome parameters in repaired tetralogy of Fallot. Future larger studies may determine whether there might be a role for losartan in specific vulnerable subgroups.                                                 The final study reinforces that vesicle trafficking plays an essential role in the signal regulation of pathologic hypertrophy and identifies a novel potential target in this process. This novel target is the transmembrane BAX inhibitor motif containing 1, or TMBIM1. First author, Dr. Deng, corresponding author, Dr. Li, from Wuhan University in China, and their colleagues, found that TMBIM1 expression levels were substantially decreased in both clinical and experimental hypertrophic hearts. Mechanistically, TMBIM1 interacted directly with tumor susceptibility gene 101 and accelerated the formation of multivesicular bodies to degrade activated toll-like receptor 4. Toll-like receptor 4 degradation in turn was essentially for the progression of cardiac hypertrophy. Importantly, expressing TMBIM1 in monkeys via lentivirus protected their hearts from aortic banding induced cardiac hypertrophy. In summary, these findings shed light on the role of vesicle trafficking in signal regulation during cardiac hypertrophy and provide a novel therapeutic target for treating hypertrophy.                                                 That wraps it up for our summaries. Now for our feature discussion.                                                 Peripheral artery disease, a disease that affects more than 200 million individuals worldwide and associated with a high risk of cardiovascular events and death and, of course, the much feared amputations. Yes, statin guidelines for peripheral artery disease are largely based on coronary artery disease or stroke data. Well, today's feature paper really addresses an important knowledge gap between statins, doses, amputation survival in peripheral artery disease. I'm delighted to have the first and corresponding author, Dr. Shipra Arya from Stanford University School of Medicine and, of course, our favorite, Dr. Josh Beckman, Associated Editor from Vanderbilt University.                                                 Now, Josh. I understand there's a bit of a back story of how this paper came to circulation. Want to share? Dr Josh Beckman:            Oh, absolutely. First of all, I have to say that one of the jobs of an associated editor is someone who kind of goes antiquing in every single store. Every place I am where people are presenting really good science, I'm kind of scoping it out. I'm interested. I want to see what's going on. I like to talk to the people who are doing the work to see how they're thinking about it, and I was lucky enough to see Dr. Arya's presentation. I think it was at an ATVB meeting, wasn't it? Dr Shipra Arya:                  That's right. Dr Josh Beckman:            I thought that this is an incredibly cool piece of work, and I basically hoped, I prayed, I asked. I said, "You know, maybe you should send this to us because we would really like to see the full manuscript," because inside I hoped that it would be just as impressive when it was written out as a full manuscript as it was when she was discussing it at the meeting. And, lo and behold, we were lucky enough that she submitted it to us and you can see the results online right now. Dr Carolyn Lam:                Indeed! Well put. Shipra, with that kind of lineup, please, tell us about your study and what you found. Dr Shipra Arya:                  Thank you for that invitation to submit to Circulation because initially I wasn't sure if Circulation would be interested in my work, so it was really great to hear when Josh said that this is something that it would certainly consider. The basic premise was to try and find out whether high-intensity statins as defined by the 2013 lipid guidelines, they would also have limb protective effects for PAD along with reduction mortality. As you said in the introduction, most of the data comes from either coronary data or comes from small groups of PAD patients, but never from such a large population.                                                 We identified about 150,000 veterans in the National VA database from 2003 to 2014 and excluded people who didn't have a diagnosis of PAD before 2003, and why this was such a labor of love was also to figure out how to identify the certainty that people had PAD and then getting into their pharmacy files and trying to parse out whether they were on high-intensity, low, moderate, or no statin. Initially, I had done the analysis of no statin, but then after review and discussion, it became clear that we needed a control group, which was people who were also on some guideline-directed therapy and not just no statin because they could be patients who were the noncompliant patients and who don't show up to the doctor's visits, and that's why they do poorly.                                                 That's why we chose a control group which were on antiplatelet therapy, at least aspirin or Plavix, any other antiplatelet agent. Even in that comparison, we find that after risk adjustment, patients who are on high-intensity statin had a more than 30% risk reduction of amputation as well as about a 24, 25% risk reduction of mortality compared to people who did not take a statin but at least took an aspirin. Low to moderate intensity statins were also effective, about 20%. Risk reduction in both amputation and mortality, but high-intensity statins when directly compared to the low to moderate intensity statins outperformed them.                                                 Just to be sure of our findings, we did it so many different ways. We did the Cox modeling. Then we did propensity matching that which person is more likely to receive the statin versus the other. Then we did subgroup analyses where we put people in different subgroups that people who had coronary artery disease as an indication, maybe that's why they were on these statins. But, people without coronary artery disease also same association [stack 00:11:12]. We were pretty confident in our findings, and that's why we sent it to Circulation. Dr Carolyn Lam:                Wow. You know, Josh, you are the best at putting papers like this into context and really expounding on the significant. Tell us, why did this catch your attention so much? Dr Josh Beckman:            Every time I think that statins have become just a standard part of therapy for patients with atherosclerosis, the first thing I noticed in this paper was that there were so many people who were still not on any statins or people who were on homeopathic doses of statins, and I can't understand how that happens. I think the mortality data was nice and consistent, but the amputation data is what really made a big difference. I'll ask Dr. Arya, but in my impression, the literature has been sort of back and forth as to whether or not statins really reduced limb outcomes. Your paper, I think, was clearly the largest sample that had taken a look at that question. Can you sort of separate out your papers from some of the previous work in that area? Dr Shipra Arya:                  Sure. I would add that a lot of work about amputations has been coming out from vascular surgery data, and a lot of that work just focuses on short term outcome for limb loss. They look at 30 days. Maybe they'll go look up to six months to a year, but actually patency of bypasses, patency of vessels is a long-term phenomenon. Much like mortality that can happen years later, your amputation risk can happen years later, too. I think what separates us is the lifetime followup for these patients, and we are looking in a cohort of patients who are in this veterans' healthcare system so the data is automatically getting captured even if they get their care outside. Records do make it back and diagnoses do make it back. It's the VA [inaudible 00:13:03], and we did some sensitivity analysis to show that, yes, most of the veterans we have in [inaudible 00:13:09] actually get their care and have data being added continuously into the corporate data warehouse.                                                 That was something I think that lent to the power of making the [sure 00:13:20] conclusion and that's where previous studies have not been able to show a significant association with amputation. The studies, if they are single center or they are focused from electronic medical records or perspective followup, either the patients get lost to followup or go see other doctors or other healthcare systems, and that information doesn't get back to the researchers, while mortality data you can get from Social Security Death Index or other sources. I think that's what makes the study different than other studies in this similar field in terms of followup. Dr Josh Beckman:            I don't think you're giving yourself enough credit. There's a whole bunch of things that make the study unique. One of the things that I was most taken with right upfront was the way that you defined peripheral artery disease for this population. There has been, as far as I know, at least seven or eight different definitions that people have used with administrative data to try and ferret out who has PAD, and in contrast to coronary disease and stroke, it's a much more complicated endeavor to do that. So, when I saw the way that you did it ... I'm going to say this in a way that I know is going to sound funny, but you made the complicated look really simple. Your definition is not something that required 3,000 lines of ICD-9 codes within inclusion and exclusion criteria and speaks, in my opinion, to the power of the large sample because, basically, they needed one ICD-9 code and either two ABIs, a visit to a vascular surgeon or procedural code. Now, I know that this definition comes from some of your work, so can you tell us how you derive this and then let's talk about what that means. Dr Shipra Arya:                  Absolutely. We looked at practice patterns for patients with vascular disease across the VA, and most patients who undergo procedures for PAD, we can confidently say that they do have PAD. When we look at the specificity of just that occurrence, it's pretty high, like [90% 00:15:23]. Then what we did was we did some random sampling in the VA data, about 300 patients, and used different codes to see if patients came back to the vascular surgeon within ... We used 14 months because it's usually one year followup that most people prescribe, so whether they went two months before or after because the appointment hours. We found that that was again a high specificity of about 80%. Then, when you look at patients who come back with ABI followup. So, we looked at CPT codes for ABI. We found out it's like a 99% specificity. If you have ABI followup within a year, and we relaxed it to 14 months, you could be 99% confident that this patient does have PAD.                                                 We just combined all those three together, and this is ... If Circulation is interested, I can send you this, too. We are working on this manuscript where we are giving researchers different algorithms that they could use to identify PAD because I wanted a more specific sample because I was looking at PAD outcomes. I wanted the PAD definition to be tight. Our specificity is greater than 80% combining all these three together, about 84%. We are fairly confident in this that, yes, these patients truly have PAD, so when we follow them up for outcomes, we can be confident in our results. If researchers wanted a more relaxed definition of PAD, they could use other algorithms that we are putting in that paper where they could say, "We will only use one ABI measurement, or we would use a combination of these." Dr Josh Beckman:            That brings up two points. You talk about this brings up the power of large data and the ability to tone down on people who really, truly, absolutely have PAD without any question. So, number one, are you worried that you're missing people that probably do have PAD and would benefit from therapy, and number two, do you worry that you're basically concentrating on the sickest right end of the curve of the group of PAD patients? Dr Shipra Arya:                  Right. That's a great point, and I discussed that with my coauthors and mentors and we wanted to be sure about our outcomes and not want to include people who did not have PAD, and then we are kind of including the effect size of what we may find, but yes, these are truly what we are calling a symptomatic PAD, and I think I mentioned that in the manuscript somewhere, that we probably would be missing people who are asymptomatic and not really being followed up. If we extended this analysis to people who are not regularly being followed or being under surveillance for their PAD, the results could be different. So, yes, it does not generalize the whole of that population. If we had gone that route and relaxed our inclusion, my worry was that we would get ... Because of large data setting up, as you say, if we include a bunch of people who are truly not PAD, we would be a [threading 00:18:17] risk in non-PAD patients. Dr Carolyn Lam:                Josh and Shipra, I loved the paper, but after this discussion I'm even more in love with the paper and impressed, so I think I just have a question for both of you. Is there any excuse not to give statins now? Do we actually think a trial is going to come on this topic? Is this the best data that we have? Is it going to enter guidelines? What do you think? Dr Josh Beckman:            I can give you my opinion first, if you want, because you're the person who actually has control of all the data. I would say this. I think it's been well known that statins should be used in all the patients with PAD for their cardiac outcome. My guess is that there are two things that are going to happen that are going to make people consider statins for limb outcomes.                                                 One, data like this and there's never going to be a trial, a prospective randomized trial at this point, I mean unless you disagree, but there's no way people will randomize to not statin. I think the second reason is the recent data on the PCSK9 inhibitor, evolocumab, which showed that on top of statins in PAD patients, there was a further reduction in limb events. I think we're heading towards getting the LDL to zero. It may take a couple more steps, but that's basically what's going to happen. Dr Shipra Arya:                  I agree. I think there has been time and time again data that shows, especially those already data supporting the mortality benefit for larger cohorts of patients with cardiovascular disease including PAD. I think this study really nails down the limb protector effects of statins, and doing a trial of this magnitude would be very difficult to do because to get that would be effect size that you have. You would need a huge cohort of patients, and you probably won't find statin-naïve patients because you have already half the patients with PAD have coronary artery disease, as well. So, not every study needs a trial. Not every question needs a trial, in my opinion. I think that's the power of large data sets. I think the evidence is overwhelming, and I would agree with Josh. Dr Josh Beckman:            I have always had a hard time explaining to people who came to see me for legs problems that they have to take a drug for their heart. It's sort of a weird two-step that people have a hard time accommodating. Do you think by telling them that this drug will also save their leg that they're going to be more likely to take the medicine by the end of the year? Dr Shipra Arya:                  Yes, absolutely. That's what I tell my patients who come and see me, that this medication works on arterial plaques, and it stabilizes them. It's not just the same plaque that you have in your heart is the one you have in your leg. Maybe a little different, but to oversimplify, yes. This is not just a heart medication, and this is not just a cholesterol medication. This is a medication for your plaques, for your blockages. That's how I explain it to them, and I think the uptake would be more if we explain to them that, yes, this will help you keep your leg, stay ambulatory and stay at home and not end up in assisted living or nursing home. Dr Josh Beckman:            Carolyn, this is so much fun, especially when we get to talk to the people that do so much hard work to put stuff in circulation, so I just want to say thanks again to Shipra and her coauthors. Dr Shipra Arya:                  Thank you so much, and thank you for giving us the opportunity. I think the comments from Circulation really made our paper better, so thank you for doing that. Dr Carolyn Lam:                I wish that we could just keep going on and on because I just know that Josh has even more great questions up his sleeve. See, Shipra, I told you, he's amazing. But, there you go. You're amazing, too. Your paper is amazing. Thank you so much for joining us today.

When did the arguments for free trade and the benefits of immigration go out of fashion? Why is the case for scaling back the power of the financial industry under attack by the Trump administration? Richard and Jim spoke to three experts for this episode of “Fix It Shorts.” Rana Foroohar, explains why the power of Wall Street distorts the economy. “The key lessons of the crisis of 2008 still remain unlearned,” she says. “Our financial system is just as vulnerable as ever.” Rana is the author of "Makers and Takers: The Rise of Finance and the Fall of American Business," She is also the Associated Editor and the Global Business Columnist for the Financial Times. "One of the prizes, one of the treasures of democracy is freedom of thought, freedom of action, freedom of movement," says Peter Coy, Economics Editor of Bloomberg Businessweek. He argues that immigration, especially legal immigration of skilled workers, is a plus for the economy. Economist Ruchir Sharma, author of the book “The Rise and... See acast.com/privacy for privacy and opt-out information.

Lewis M Greenberg is Professor of Ancient and Oriental Art history at the Moore College of Art & Design in Philadelphia. He was Associated Editor of the journal Pensee, and Editor-in-Chief of Kronos for 12 years; he contributed material to both publications as well as to Science, Astronomy, Biblical Archaeology Review, SIS Review and Kronos. Professor Greenberg on Dr. Immanuel Velikovsky