Podcast appearances and mentions of Bob Harrington

Dr. Bob Harrington discusses the importance of heart-healthy living through the life stages. He highlights the recent alarming statistics around cardiovascular diseases and its prevalence between men and women. He reviews the latest advancements in treating heart health and how Weill Cornell Medicine is leveraging unique technology and innovations to improve patient outcomes. He provides practical advice for lifestyle changes that patients can make to help better reverse health trends.

Listen to this insightful conversation with Don Worthington, Division President of Lowtility, and entrepreneur Bob Harrington! This is part one of an exciting two-part series where we dive into cost-effective ways to reduce your monthly expenses by combining existing debt with renewable energy home improvements. Learn from the experts about financing solutions that help you save money, hedge against rising energy costs, and keep more of your hard-earned cash in your pocket! Plus, we'll cover how Lowtility makes it easier to tackle essential upgrades like roof replacements, especially for Florida homeowners. Be sure to mark your calendars for next week's episode—there's even more valuable information on the way!Support the show

A review paper prompted a discussion among cardiologists Bob Harrington, Manesh Patel, and Michael Gibson on whether the ST-segment elevation myocardial infarction paradigm needs an update. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington From ST-Segment Elevation MI to Occlusion MI: The New Paradigm Shift in Acute Myocardial Infarction https://doi.org/10.1016/j.jacadv.2024.101314 Angiographic and Clinical Outcomes Among Patients With Acute Coronary Syndromes Presenting With Isolated Anterior ST-Segment Depression: A TRITON-TIMI 38 Substudy https://doi.org/10.1016/j.jcin.2010.05.012 Treatment Time and In-Hospital Mortality Among Patients With ST-Segment Elevation Myocardial Infarction, 2018-2021 https://jamanetwork.com/journals/jama/fullarticle/2798440 Evolution of Single-Lead ECG for STEMI Detection Using a Deep Learning Approach https://doi.org/10.1016/j.ijcard.2021.11.039 Implantable Cardiac Alert System for Early Recognition of ST-Segment Elevation Myocardial Infarction https://doi.org/10.1016/j.jacc.2019.01.014 TIME Trial: Effect of Timing of Stem Cell Delivery Following ST-Elevation Myocardial Infarction on the Recovery of Global and Regional Left Ventricular Function: Final 2-Year Analysis https://doi.org/10.1161/CIRCRESAHA.117.311466 Early Versus Delayed Invasive Intervention in Acute Coronary Syndromes https://www.nejm.org/doi/full/10.1056/NEJMoa0807986 Translating AI for the Clinician https://doi.org/10.1001/jama.2024.21772 A Novel Breakthrough in Wrist-Worn Transdermal Troponin-I-Sensor Assessment for Acute Myocardial Infarction https://doi.org/10.1093/ehjdh/ztad015 A Phase 3 Study of Zalunfiban in Subjects With ST-elevation MI (CELEBRATE) https://clinicaltrials.gov/study/NCT04825743 Selatogrel Outcome Study in Suspected Acute Myocardial Infarction (SOS-AMI) https://clinicaltrials.gov/study/NCT04957719 You may also like: Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Dr Bob Harrington interviews journalist Shelley Wood about her new book, "The Leap Year Gene of Kit McKinley," her creative process, and the difference between medical journalism and writing fiction. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington The Leap Year Gene of Kit McKinley https://shelleywood.ca/the-leap-year-gene/ Tragedy and Hope Wrapped in a Medical Mystery: Abraham Verghese and The Covenant of Water https://www.medscape.com/viewarticle/991751 You may also like: Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Medical practices are increasingly being acquired by private equity. Bob Harrington discusses why and what the ramifications are with the authors and editorialist of a research paper on the private equity landscape in cardiology vs other specialties. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington Private Equity Acquisitions of Outpatient Cardiology Practices in the United States, 2013-2023 https://doi.org/10.1016/j.jacc.2024.06.011 Private Equity in Cardiovascular Practice: Solution or Symptom? https://doi.org/10.1016/j.jacc.2024.06.012 Evaluating Trends in Private Equity Ownership and Impacts on Health Outcomes, Costs, and Quality: Systematic Review https://doi.org/10.1136/bmj-2023-075244 2020 American Heart Association and American College of Cardiology Consensus Conference on Professionalism and Ethics: A Consensus Conference Report https://doi.org/10.1161/CIR.0000000000000963 You may also like: Hear John Mandrola's, MD, summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Bob Harrington and Mitch Elkind discuss "food is medicine" initiatives and the challenges associated with conducting clinical trials. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington Health Care by Food Initiative https://healthcarexfood.org/ 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association https://doi.org/10.1161/CIR.0000000000001031 Rockefeller Foundation Food is Medicine https://www.rockefellerfoundation.org/initiative/food-is-medicine/ Targeted Scientific Research Projects to Demonstrate Effectiveness of 'Food Is Medicine' in Health Care https://newsroom.heart.org/news/targeted-scientific-research-projects-to-demonstrate-effectiveness-of-food-is-medicine-in-health-care Food Is Medicine: A Presidential Advisory From the American Heart Association https://doi.org/10.1161/CIR.0000000000001182 Medically Tailored Meal Delivery for Diabetes Patients With Food Insecurity: a Randomized Cross-over Trial https://doi.org/10.1007/s11606-018-4716-z 'Food Is Medicine' Strategies for Nutrition Security and Cardiometabolic Health Equity: JACC State-of-the-Art Review https://doi.org/10.1016/j.jacc.2023.12.023 Current Landscape of Produce Prescription Programs in the US https://doi.org/10.1016/j.jneb.2022.02.011 Behavioral Nudges Are Used Widely to Steer Clinicians and Patients Alike https://doi.org/10.1056/CAT.23.0125 A Primary Care Agenda for Brain Health: A Scientific Statement From the American Heart Association https://www.ahajournals.org/doi/10.1161/STR.0000000000000367# You may also like: Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

He got fired. He sold fruit out of a postal truck. He slept near the citrus. Then he and his family became the backbone of the restaurant culture in San Diego. The wild, never-give-up story of Bob Harrington, his brothers, and Specialty Produce.

Bob Harrington interviews fellow cardiologist Mike McConnell about his new book Fight Heart Disease Like Cancer and the need to model heart disease prevention and treatment after cancer. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington Fight Heart Disease Like Cancer https://www.press.jhu.edu/books/title/12793/fight-heart-disease-cancer PREVENT: AHA's New Risk Calculator Incorporates CKM Health https://www.medscape.com/viewarticle/998679 Artificial intelligence-enabled retinal vasculometry for prediction of circulatory mortality, myocardial infarction and stroke https://doi.org/10.1136/bjo-2022-321842 You may also like: Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Bob Harrington is the president of Specialty Produce, a family-owned wholesale produce company in San Diego since 1989. Specialty Produce is a culinary destination for chefs, foodies and retail consumers, and under Harrington's leadership, the company has a grassroots heartbeat mixed with a global vision. Throughout his career, Harrington says he has understood the importance of planning for tomorrow, and along with his wholesale company, he has created a digital platform to connect industry professionals, forecast trends in produce and share the story of fruits and vegetables. The Specialty Produce app has been shaped through decades of international travel, discussions with experts and harnessing the power of evolving technology. Harrington continues to care for the San Diego community through sourcing fresh ingredients, and his presence is recognized worldwide as an advocate for produce professionals

Cardiology researchers Bob Harrington and Bobby Yeh discuss how to do better observational research and the controversial notion of making causal inferences from such data. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington Academic Cardiology and Social Media https://doi.org/10.1161/CIRCOUTCOMES.118.004736 Bringing the Credibility Revolution to Observational Research and Cardiology https://doi.org/10.1161/CIRCULATIONAHA.123.064645 Cardio Twitter: An Essential Tool for Staying Current https://www.medscape.com/viewarticle/897512 Identification of Causal Effects Using Instrumental Variables https://doi.org/10.2307/2291629 Explaining Charter School Effectiveness https://www.aeaweb.org/articles?id=10.1257/app.5.4.1 Methods of Public Health Research - Strengthening Causal Inference from Observational Data https://doi.org/10.1056/NEJMp2113319 Publish or Perish and the Incentive for Quantity over Quality Research Papers https://www.medscape.com/viewarticle/998417 You may also like: Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Bob Harrington, Erin Michos, and Brahmajee Nallamothu discuss how the publish or perish culture can lead to sloppy research and the need for alternative models to measure success in academic medicine. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington With Great Power Comes Great Responsibility Big Data Research From the National Inpatient Sample https://doi.org/10.1161/CIRCOUTCOMES.117.003846 Adherence to Methodological Standards in Research Using the National Inpatient Sample https://doi.org/10.1001/jama.2017.17653 Publish or Perish: Where are we heading? https://pubmed.ncbi.nlm.nih.gov/24778659 The Kardashian Index of Cardiologists: Celebrities or Experts? https://doi.org/10.1016/j.jaccas.2019.11.068 You may also like: Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Bob Harrington and Mike Gibson discuss two of the hottest topics in cardiology and medicine for 2023: a proposed alternative to the maintenance of certification process, and artificial intelligence. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington Cardiovascular Organizations Pursue New, Independent Medical Board https://www.acc.org/About-ACC/Press-Releases/2023/09/21/15/02/Cardiovascular-Organizations-Pursue-New-Independent-Medical-Board The National Board of Physicians and Surgeons https://nbpas.org/ Level of Scientific Evidence Underlying the Current American College of Cardiology/American Heart Association Clinical Practice Guidelines https://doi.org/10.1161/CIRCOUTCOMES.118.005293 Validation of a Speech Analysis Application to Detect Worsening Heart Failure Events in Ambulatory Heart Failure Patients https://www.abstractsonline.com/pp8/?_ga=2.17782015.7532578.1693882428-1949139275.1663003561#!/10871/presentation/16568 A systematic review shows no performance benefit of machine learning over logistic regression for clinical prediction models https://doi.org/10.1016/j.jclinepi.2019.02.004 Recognizing a ruler instead of a cancer https://menloml.com/2020/01/11/recognizing-a-ruler-instead-of-a-cancer/ The Geographic Bias in Medical AI Tools https://hai.stanford.edu/news/geographic-bias-medical-ai-tools You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

For this year's review, Bob Harrington and Mike Gibson revisit the major cardiology conferences -- from ACC in New Orleans to AHA in Philly. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit: https://www.medscape.com/author/bob-harrington ACC 2023 Top Trials - Bempedoic Acid Cuts CV Events in Statin-Intolerant Patients: CLEAR Outcomes https://www.medscape.com/viewarticle/989100 - Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients - Phase 2b Randomized Trial of the Oral PCSK9 Inhibitor MK-0616 https://www.jacc.org/doi/10.1016/j.jacc.2023.02.018 ACC/WCC 2023 Collection Page https://www.medscape.com/viewcollection/36966 ESC 2023 Top Trials - Wegovy Scores HFpEF Benefits in People With Obesity https://www.medscape.com/viewarticle/995844 - Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2306963 - Acoramidis Shows Encouraging Results in ATTR Cardiomyopathy https://www.medscape.com/viewarticle/995883 ESC 2023 Collection Page https://www.medscape.com/viewcollection/36988 AHA 2023 Top Trials - Semaglutide 'A New Pathway' to CVD Risk Reduction: SELECT https://www.medscape.com/viewarticle/998373 - Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes https://www.nejm.org/doi/full/10.1056/NEJMoa2307563 - Bariatric Surgery is Associated With Improved Coronary Microvascular Function and Cardiorespiratory Fitness in Patients With Ischemia and Non-Obstructive Coronary Arteries https://www.ahajournals.org/doi/10.1161/circ.148.suppl_1.18949 - Angioplasty Finally Proven Beneficial in Stable Angina: ORBITA-2 https://www.medscape.com/s/viewarticle/998375 - A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina https://www.nejm.org/doi/full/10.1056/NEJMoa2310610 - Impressive Bleeding Profile With Factor XI Inhibitor in AF: AZALEA https://www.medscape.com/viewarticle/998418 - Promising First Results With DNA Editing to Lower LDL https://www.medscape.com/s/viewarticle/998719 - Single Injection Reduces Blood Pressure for 6 Months: KARDIA-1 https://www.medscape.com/viewarticle/998666 AHA 2023 Collection Page https://www.medscape.com/viewcollection/37277 Other Mentions - N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects https://www.nejm.org/doi/full/10.1056/NEJMc2031173 - Rimonabant: From RIO to Ban https://doi.org/10.1155%2F2011%2F432607 - Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial https://doi.org/10.1016/S0140-6736(17)32714-9 - Asundexian Phase 3 AF Study Halted for Lack of Efficacy https://www.medscape.com/viewarticle/998665 - Challenges in the Design and Interpretation of Noninferiority Trials https://www.nejm.org/doi/full/10.1056/nejmra1510063 - Milvexian for the Prevention of Venous Thromboembolism https://www.nejm.org/doi/full/10.1056/NEJMoa2113194 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Dr. Peter Hotez is a veritable force. He has been the tip of the spear among physicians and scientists for taking on anti-science and has put himself and his family at serious risk.Along with Dr. Maria Bottazzi, he developed the Corbevax Covid vaccine —without a patent— that has already been given to over 10 million people, and was nominated for the Nobel Peace Prize. Here an uninhibited, casual and extended conversation about his career, tangling with the likes of RFK Jr, Joe Rogan, Tucker Carlson, Steve Bannon, and an organized, funded, anti-science mob, along with related topics.Today is publication day for his new book, The Deadly Rise of Anti-Science.Transcript (AI generated)Eric Topol (00:00):Hello, this is Eric Topol with Ground Truths, and I'm with my friend and colleague who's an extraordinary fellow, Dr. Peter Hotez. He's the founding dean of the National School of Tropical Medicine and University professor at Baylor, also at Texas Children's founding editor of the Public Library Science and Neglected Tropical Disease Journal. and I think this is Peter, your fifth book.Peter Hotez (00:28):That's my fifth single author book. That's right, that's right.Eric Topol (00:32):Fifth book. So that's pretty amazing. Peter's welcome and it's great to have a chance to have this conversation with you.Peter Hotez (00:39):Oh, it's great to be here and great to be with you, Eric, and you know, I've learned so much from you during this pandemic, and my only regret is not getting to know you before the pandemic. My life would've been far richer. AndPeter Hotez (00:53):I think, I think I first got to really know about you. You were are my medical school, Baylor College of Medicine, awarded you an honorary doctorate, and that's when I began reading about it. Oh. I said, holy cow. Why didn't, why haven't I been with this guy before? SoEric Topol (01:08):It's, oh my gosh. So you must have been there that year. And I came to the graduation.Peter Hotez (01:12):No, I actually was speaking at another graduation. That's why I couldn't be there, . Ah,Eric Topol (01:18):Right. As you typically do. Right. Well, you know, it's kind of amazing to track your career besides, you know, your baccalaureate at Yale and PhD at Rockefeller and MD at Cornell. But you started off, I, I think deep into hookworm. Is that where you kind of got your start?Peter Hotez (01:36):Yeah, and I'm still, and I'm still there actually, the hookworm vaccine that I started working on as an MD-PhD student at Rockefeller and Cornell is now in phase 2 clinical trials. Wow. So, which is, I tell people, is about the average timeframe --about 40 years-- is about a, not an unusual timeframe. These parasites are obviously very tough targets. oh man. And then we have AOIs vaccine and clinical trials and a Chagas disease vaccine. That's always been my lifelong passion is making vaccines for these neglected parasitic infections. And the story with Covid was I had a collaboration with Dr. Sarah Lustig at the New York Blood Center, who, when we were working on a river blindness vaccine, and she said, Hey, I want you to meet these two scientists, New York Blood Center. They're working on something called coronaviruses vaccines.(02:27):They were making vaccines for severe acute respiratory syndrome and SARS and ultimately MERS. And so we, we plugged their, their, some of their discoveries into our vaccine development machine. And they had found that if you were using the receptor binding domain of the, of the spike protein of SARS and ultimately MERS it produced an equivalent protective immune response neutralizing antibodies without the immune enhancement. And that's what we wrote to the NIT to do. And they supported us with a $6 million grant back in 2012 to make SARS and MERS vaccines. And, and then when Covid 19 hit, when the sequence came online and BioXriv in like early 2020, we just pivoted our program to Covid and, and we were able to hit the ground running and it worked. Everything just clicked and worked really well. And stars aligned and we were then transferred that technology.(03:26):We did it with no patent minimizing strings attached to India, Indonesia, Bangladesh. any place that we felt had the ability to scale up and produce it, India went the furthest. They developed it into Corbevax, which has reached 75 million kids in India. And another 10 million as their, for their primary immunization. Another 10 million is adult booster. And then Indonesia developed their own version of our, of our technology called IndoVac. And, and that's also reaching millions of, of people. And now they're using it as a, also as a booster for Pfizer, because I think it may be a superior booster. So it was really exciting to s you know, after working in parasitic disease vaccines, which are tough targets and decades to get it through the clinical trials because the pressure was on to move quickly goes to show you when people prioritize it. And also the fact that I think viruses are more straightforward targets than complex parasites. And well, so that in all about a hundred million doses have been administered andEric Topol (04:33):Yeah, no, it's just a spectacular story, Corbevax and these other named of the vaccine that, that you and Maria Bottazzi put together and without a patent at incredibly low cost and not in the us, which is so remarkable because as we exchanged recently, the us the companies, and that's three Moderna, Pfizer, and Novavax are going to charge well over $110 per booster of the, the new booster updated XBB.1.5. And you've got one that could be $2 or $4 that's,Peter Hotez (05:11):And it's getting, so we're making, we're making the XBB recombinant protein booster of ours. And part of it's the technology, you can, you know, it's done through microbial fermentation in yeast, and it's been in a big bioreactor. And it's an older technology that's been around a couple of decades, and there's no limit to the amount you could scale. The yields are really high. So we can do this for two to $3 a dose, and it'd even be less, it wasn't for the cost of the adjuvant. The C P G, the nucleotide is probably the most expensive component, but the antigen is, you know, probably pennies to, to, you know, when you're doing it at that scale. And, and so that, that's really meaningful. I'd like to get our XBB booster into the us It's,Eric Topol (05:55):Yeah, it's just no respect from,Peter Hotez (05:58):We're not a pharma company, so we don't, we didn't get support from Operation Warp Speed, and so we didn't get any US subsidies for that. And it's just very hard to get on the radar screen of BARDA and those agencies and, 'cause that's, they're all set up to work with pharma companies.Eric Topol (06:16):Yeah, I know. It's, it's just not right. And who pays for this is the people, the public, because they, you know, the affordability is going to have a big influence on who gets boosters and is drivingPeter Hotez (06:27):. Yeah. So, so what I say is we, we provide, you know, the anti-vaccine guys, like the call me a Shill for pharma, not knowing what they're talking about. We've done the opposite, right? We've provided a path that shows you don't need to go to big pharma all the time. And, and so they should be embracing what we're doing. So we, we've, you know, have this new model for how you can get low cost vaccines out there. Not, not to demonize the pharma companies either. They, they do what they do and they do a lot of important innovation. But, but there are other pathways, especially for resource coordination. So we'd love to get this vaccine in, in the us I think it's looking a little work just, just as well, it's, you know, butEric Topol (07:12):You, yeah, I mean, it's not, I don't want ot demonize the vaccine companies either, but to raise the price fivefold just because it's not getting governed subsidy and the billions that have been provided by the government through taxpayer monies. Yeah.Peter Hotez (07:28):Well, the Kaiser Family Foundation reported that they did an analysis that, that pharma, I think it was Pfizer and Moderna got 25 to 30 billion Yeah. Dollars in US subsidies, either for development costs for Moderna. I think Pfizer didn't accept development costs, but they both took advanced purchase money, so $30 billion. And you know, that's not how you show gratitude to the American people byEric Topol (07:55):JackingPeter Hotez (07:56):Up the price times for, I think I said, guys, you know, have some situational awareness. I mean, do you want people to hate you? Yeah.Eric Topol (08:04):That's what it looks like. Well, speaking of before I get to kind of the anti-science, the, THE DEADLY RISE OF ANTI-SCIENCE, your new book, I do want to set it up that, you know, you spent a lot of your career besides working on these tropical diseases, challenging diseases, you know, Leischmania, and you know, Chagas, and the ones you've mentioned. You've also stood up quite a bit for the low middle income countries with books that you've written previously about forgotten people, Blue Marble Health. And so, I, I, before I, I don't want to dismiss that 'cause it's really important and it ties in with what the work you've done with the, the Covax or Covid vaccine. Now, what I really want to get into is the book that you wrote that kind of ushered in your very deep personal in anti-science and anti-vax, which I'm going in a minute ask you to differentiate. But your daughter, Rachel, you wrote a book about her and about vaccines not causing autism. So can you tell us about that?Peter Hotez (09:11):Yeah. So as you point out, my first two books were about these, what I would call forgotten diseases of Forgotten people. In fact, that's what the first book was called, forgotten People, forgotten Diseases, which my kids used to call Dad's Forgotten book on Forgotten people, Forgotten Diseases, all the, all the, now it's in his third edition. So, but it talks about, you know, the, how important these conditions are. It's just that they're widely prevalent. It's just that they're occurring among people who live in extreme poverty, including people in poverty in the United States. That's why we set up our School of Tropical Medicine on the US Gulf Coast. I didn't do it for the summer weather which is these days in this heat dome. It's like, well, living on planet Mercury right now, in here, here in Texas.(09:58):But then, so that, that's what, that's how I started learning how to advocate, you know, for people and for diseases through neglected diseases. But, you know, when we came to Texas, we saw this very aggressive anti-vaccine movement, and they were making false claims that vaccines cause autism. And, and I said, look, I'm, you know, I'm a vaccine scientist here in Texas. I have a daughter with autism, Rachel, with an, an intellectual disabilities. And so if I don't say something who does, and, and then wrote the book, vaccines did not cause Rachel's Autism, which unfortunately made me public enemy number one or two with anti-vaccine groups. but you know, it, it, it does a deep dive explaining the science, showing there's absolutely no link between vaccines and autism, but also an absence of plausibility because what we know about autism, how it begins in early fetal brain development through the action of autism genes.(10:54):And we actually did whole exome genomic sequencing on, on Rachel and my wife Ann and I, and we found Rachel's autism gene, which is like many of them in, involved in early neuronal communication and connections. It was actually a neuronal cytoskeleton gene, as are many, in this case, a neuronal spectrum. And that one hadn't been reported before, but other neuronal cytoskeleton genes had been reported by the Broad Institute at Harvard, m i t and others. And, and that was important to have that alternative narrative because the refrain from always was, okay, doc, if vaccines don't do it, what does cause autism? And, and being able to have that other side of the story, I think is very compelling.Eric Topol (11:37):What was it, the, the fabricated paper by Andrew Wakefield and the Lancet that, that got all this started? Or did it really annotate the ? There wasPeter Hotez (11:47):Something before in the eighties about the DPT, the diptheria, pertussis tetanus vaccine claiming it caused, you know, seizures and then could lead to neurodevelopmental difficulties. But it really took off with the Wakefield paper in 1998, published in The Lancet. And that claimed that the MMR vaccine, a live virus vaccine, had the ability to replicate in the colon of kids. And somehow that led to pervasive developmental disorder. That was the term used back then. And I was Rachel's diagnosis. And it never made sense to me how something, 'cause the reason it's pervasive is it's, it's global in, in the central nervous system in, in the brain. And how, how could something postnatally do something like that? I mean, there is, there are epigenetic underpinnings of autism as well, and that's fun. Eric, you ever talk to, ever try to talk to lay audience about epigenetics? That's a tough one. That's, that's a tough one. You start talking about microRNAs and DNA methylation, histone modification. The, the lights go out pretty quickly, butEric Topol (12:46):Chromatin and histone modification. Right? Bye-bye. Yeah, you got that one.Peter Hotez (12:51):That, so that's,Eric Topol (12:52):But that, that was your really, you knowPeter Hotez (12:55):But that's when, you know, I started going up against Robert F. Kennedy Jr. And, and, and all that was, that was pre-pandemic.Eric Topol (13:03):That was in 2018, right?Peter Hotez (13:05):2017 Trump came out and said, you know, it was about to be inaugurated and, and RFK Jr said he was going be appointed to run a vaccine commission by the Trump administration. And, and I actually was sitting, you know, in my office and my assistant said Dr. Francis Collins and Dr. Anthony Fauci are on the phone. Do you have time to talk with us ? And I said, yeah, I think so. And they arranged, they had arranged for me to, because I have a daughter with autism could articulate why vaccines don't cause out arranged for me to speak with RFK Jr threw it through a mediator and, and, and it didn't go well. He was just really dug in and, and soEric Topol (13:49):He, he was just as bad then as now.Peter Hotez (13:52):Yeah. I mean, it was just, you know, kept on, you know, as I say, moving the goalposts, you couldn't pin him down. Was he talking about MMR? Was he talking about the am Marisol, was he talking about spacing vaccines too close together? He just, that always kept on moving around and, and then it was not even autism at times. You were talking about it was something called chronic illness, you know, you know, what do you do with that? Mm-hmm. . So I, and that's one when I was challenged by, you know, Joe Rogan and Elon to debate RFK Jr, one of the reasons I didn't want to do it, because I, I knew, you know, doing it in public would be no different from doing this in, in, in private, that it would not be a productive conversation.Eric Topol (14:39):Yeah, no, that I can, I do want to get into that, because that was the latest chapter of kind of vicious anti-science, which was taking on covid and vaccines and the whole ball of wax whereby you were challenged by Joe Rogan on his very big podcast, which apparently is, you know, bigger than CNN  various cable news networks,Peter Hotez (15:07):Which I had done, I had been on his show a couple of times. Yeah. And that was, and that was okay. I mean, I actually liked the experience quite a bit. AndEric Topol (15:15):And he challenged you to go on with RFK Jr. And then Elon Musk, you know, joined and, you know, basically Peter Hotez (15:21):Actually, he started before then, about the week before, or a few days before, Steve Bannon publicly declared me a criminal. And you know, which I said, wow, that's, that's something. And then Roger Stone weighed in. So it was this whole sort of frontal attack from, well, people with extremist viewpoints. And there'sEric Topol (15:41):Been a long history, and a Tucker Carlson in the book, you quote, he referring to Hotezis a misinformation machine constantly spewing insanity. Speaking of projecting things, my goodness. Yeah.Peter Hotez (15:54):Yeah. Well, he did that. You know, he, that was the, that was in 2022. It was, he went on his broadcast the evening after the evening of the, in the, during that day I, with Maria, I was, we were nominated for the Nobel Peace Prize. And I guess, and I don't know if the two are related or not, I think it may have driven him off the edge, and then he just went on this rant against me. And, you know, claimed I have no experience anything about Covid. I mean, we had made two covid vaccines, right. And transferred the technology nominated for the Nobel Peace Prize and just, you know, omitted all of that. But this is how these guys work. It's, it's all about asserting control. And, and it seems to come from an extremist element of the, of the far right.(16:39): and, and, and it's not that I'm a very political person at all. I mean, you know, I've been here in Texas now for 12 years, and I've gotten, you know, I've gotten to know people like Jim Bakker and his wife Susan Baker and, and you know, a lot of prominent Republicans here in Texas, that that wasn't an issue. This is something sort of weird and, and twisted. And, and the point that I make in the book is, and it's not just a theoretical concern or a construct, it's the fact that so many Americans lost their lives during the delta and BA.1 omicron waves in 2021 and 2022, after vaccines were widely and freely available because they refused a vaccine. so vaccines were rolled out in 2021. we started strong and then vaccination rates stalled. And then we didn't get very far by this after the spring because there was this launch of an, of, of a wave of what I call anti-vaccine or anti-science aggression, convinced that deliberately sought to convince Americans not to take a covid vaccine.Eric Topol (17:56):Chapter, yeah. Your chapter in the book Red Covid. Yeah, gets into it quantifies it, hundreds of thousands of lives lost. And I know you've seen some of the papers whereby studies in red states or states like Ohio and Florida showing the, the, the connection between this.Peter Hotez (18:15):Yeah, I, I relied heavily on this guy Charles Gaba, who has a, a website called ACA signups. And he did some really in, you know, strong analysis showing that the, that the people who were refusing covid vaccines and losing their lives were overwhelmingly in red states and could even show the redder the county as measured by voters, the lower the immunization rate and higher the death rates. And the term Red Covid came from David Leonhart of the New York Times wrote an article about Charles Gaba's work, and he called it Red Covid and did a lot of updates. And the data is so strong. I mean, so much so that one person at the Kaiser Family Foundation wrote, if you wanted to ask me whether or not a person was vaccinated, and I can only know one thing about them, you know, she said, the one thing I'd want to know is what political party they're affiliated with.(19:09):It was, it's, it's that strong. And it's, and it's not that I care about your politics, even your extreme views, but somehow we have to uncouple this one from it, right. Because somehow not getting vaccinated been added to the canon of stuff that you're supposed to believe in. If you are, if you're down that rabbit hole watching Fox News every night, or, or listening to Rogan Podcasts and that sort of stuff. And somehow we have to uncouple those two, and it's the hardest thing I've ever had to do. First of all, it's unpleasant to talk about, because all of, you know, your training, Eric mine as well is, you know, said you don't talk about politics and you're, you know, we're supposed to be above all that. But what do you do when the death and dying is so strong on, on one side?(19:58):And, and I, I was in east Texas not too long ago, giving grand rounds at a new medical school in East Texas and Tyler, Texas, and very conservative part of the state. And, you know, basically everyone you talked to has lost a loved one mm-hmm. because they refused a Covid vaccine and died. I mean, that's, that's where you really start to see that. And then, and these people are wonderful people. I gave you know Bob Harrington at oh yes, at at Stanford Medicine, now he's going be the Dean of Cornell. He, he invited me with Michelle Berry to, to give grand rounds, medical grand rounds at Stanford. And I said, look, if, if my car had broken down and the flat had a flat tire, and you, and I can't fix, I'm, I'm a disaster at fixing anything.(20:49):So if you said, okay, where you had the choice, where, where do you want your car broken down in Palo Alto, California, or Stanford is, or very wealthy enclave or East Texas, I'd say I'd pick East Texas in a second. 'cause in East Texas, they'd be fighting over who you know, is going to rush to help you change your tire. Right? And these are, you know, just incredible people. And they were victims. They were victims of this far right. Attacks from, from Fox News. And one of the things I do in the book is, you know, the documentation is really strong media matters. The Watchdog group has looked at the evening broadcast of Tucker Carlson, Laura Ingram, and, and Hannity, and, you know, can I, you know, actually identify the anti-vaccine content with each broadcast during the summer and fall. And then our a social science research group out of ETH Zurich, the Federal University of Technology of Zurich, where Einstein studied, actually, you know, one of the great universities did another analysis and showed that watching Fox News is one of the great predictors of refusing a vaccine.(21:52):And, and so that, those were the amplifiers, but those generating a lot of the messages were elected leaders coming out of the House Freedom Caucus, or Senator, you know, Johnson's conservative senate that, I don't even like to use the word conservative, because it's not really that they're conservative, they're extremists. And yeah, a Senator Johnson of Wisconsin, or Rand Paul, you know, of, of Kentucky, you know, all the physician know what Yeah. And know physician and the CPAC conference of conservatives in Dallas, in 2021, they said, first you're gonna, they're going to vaccinate you, and then they're going to take away your guns and your Bibles. And as ridiculous as that sounds to us, people in my state of Texas and elsewhere in the South accepted it and didn't take a covid vaccine and pay for it with their lives. And, and how do we, you know, begin walking that back?(22:45):And, and the point of writing the book said, well, the first step is to at least describe it so people can know what we're talking about. Because I think right now, when you look at the way people talk about anti-vaccine or anti-science stuff, they, they call it misinformation or the infodemic, like it's just some random junk that appears out of nowhere on the internet. And it's not any of those things. It's, it's organized, it's well financed. It's politically motivated, and it's killing Americans on, on a massive scale. So I said, look, you know, I, I went, I'm did my MD and PhD in New York at Rockefeller and Cornell. I devoted my life to becoming a vaccine scientist. You know, the motto of Rockefeller universities to be the Rockefeller Institute of Medical Research translates to science for the benefit of humanity. And, and I believe making vaccines is one of the high expressions. And I think most physician scientists believe, I think you believe that too. And that's why you're, you're in this as well, you know, not vaccines, but you know, other lifesaving interventions. And, and so I said, well, now making vaccines is not enough. 'cause now we have to counter all of this anti-vaccine stuff, and there's, there's nobody better, you know, in terms of my training and my background going up against anti-vaccine movements because of Rachel to do this. So I, I've done it and yeah.Eric Topol (24:11):Well, you've done it. All right. you,Peter Hotez (24:14):That's my wife. Ann says you've done it. Alright, .Eric Topol (24:17):Well, as I wrote in your, with your book of blurb about you are a new species, the physician scientist warrior, and you are Peter, because you're the only one of all the physicians. We're talking about a million docs almost in this country who has stood up and you've put your life at risk, your family at risk, you've had death threats, you've had the people you know, come right to your house. and so what you've described this kind of coalescence of political will of extremists, media, of course, amplification because it benefits them. They, they're selling more you know, they get more viewers, more the spots for commercials and more they can charge. And then you're even, as you described in the book, so well, is you even have outside interested parties like Russia as part of this organization, of this coalescence of forces that are taking on the truth, that are promoting anti-science, that are winding up, people are dying, or, yeah. Or having a, you know, serious morbidity,Peter Hotez (25:26):Right? Yeah. In the case of, in the case of Russia, , it's a slightly different motivation. What they're doing is they're filling the internet and social media with both anti-vaccine messages and pro-vaccine messages. Because they have a different agenda. Their agenda is destabilized democracies. So what they're doing is they're cherry picking certain issues that they can use as a wedge to sow discord. And so when they saw the stuff about vaccines, yeah, they'll flood it with both pro and anti-vaccine message. And you see the stuff on Twitter, so much of it is computer generated, and it's just repeats the same stuff over and over again. And, and a lot of that are, you know, some of that not only, only Russia, I think China's doing it, North Korea, Iran's doing it, but particularly Russia. And that was documented by a colleague of mine, David Broniatowski who's a computer scientist at George Washington University, has really done a deep dive in that. So so'sEric Topol (26:22):I think a lot of people are not aware that's what your book, book brings to light of how organized, how financed, you know, how this thing is a machine from coming from many different domains, you know, and for different interests as you, as you just summarized, it's, it's actually scary. And besides you standing up and facing, you know, the really ultimate bravery with the, all of the, these factions attacking you, literally ad hominem, you know, personally attacking you, then you have you know, this continues to get legs throughout the pandemic, and there's no counter as you've, as you've touched on what is going to be done. You can't stand up alone on this.Peter Hotez (27:09):Well, there's, there's a couple of things. First of all, it's not only attacking the science, it's attacking the scientists. Right, right,Eric Topol (27:15):Right.Peter Hotez (27:16):Exactly. It's, it's portraying and you get get it too, as well. I mean, it's basically portraying scientists as enemies of the state. which I think is so dangerous. I mean, as I like to say, you know, this is a nation that's built on science and technology, right? The, you know, the strengths of our research universities and institutions like Scripps, like Baylor, like Rockefeller, like MIT and Stanford, and University of Michigan and University of Chicago. This is what, you know, helped us defeat fascism in World War II as evidenced by the Oppenheimer movie, right. Or, and or allowed us to achieve so many things, why people so admire our nation. When I served as US Science Envoy and the Obama administration, the State Department, and the White House. I mean, that's where people loved our country, is they all wanna study at our research universities, or they want their kids to study at our research universities.(28:10):And, and by attacking not only science, but the scientists, I think it's weakening our stature globally. And, and, and, and I think that's, that, that's another aspect. I think the other problem is we, we don't get the backing that I think we should from the scientific societies in the Times, even the National Academies. I think they, they could be out there more. exactly why, you know, I think part of it is they see, they see how I get beat up and they say, well, what's that? Right? Yeah. And I, and I understand that, but I think also, you know, they, they depend on, oftentimes on government funding. And I think they're worried that, you know, if they're, again, it's this idea that you have to be politically neutral, even if it favors the torment or the aggressor to paraphrase Desmond Tutu, that's part of it as well.(29:09):I mean, it, I mean, I do find it meaningful. It's scary at times, and I, but I do find it meaningful to ha to have this role. But getting, getting more help and backing, I mean, we're our, our university, I mean, Baylor College of Medicine, Texas Children's Hospital has been pretty good. You know, Stan, you know, having my back, it's not that way at every, and I know Scripps has been really strong with what Kristian Anderson's had to deal with around you know, all the phony bologna around covid origins. But, but not all academic health centers are that way. And, and I think we need our university presidents to be more vocal on this issue. And, and too often they're not as well as our academies and our, our scientific societies, because this is, I believe, going to do irreparable harm to, to science. Well, yeah.Eric Topol (30:04):You know, in my experience too, we, we've actually seen, you know, academic physicians who have basically, you know, supported conspiracy theories who have detracted from evidence and science, you knowin a major way. Some of the leading universities here as you, as you mentioned. And when I've contacted and others, their leadership, they say, well, freedom of speech, freedom of speech. 'cause they're afraid to confront them because, you know, all the different things. We've, we, you've mentioned social media, but no, the universities don't want to get attacked on social media. They're afraid of that. They're afraid of, of calling out, you know, one of the people, faculty members who are deliberately, you know garnering a lot of, yeah. And,Peter Hotez (30:56):And the point is, is it's not just, you know, freedom of speech in the sense of espousing you know, crazy views. It's the fact that they're going on the attack against mm-hmm. . I mean, I don't attack these guys, but they attacked me with, with impunity and Yes. Say terrible thing, untrue things about me. I mean, where's there's, isn't there something called professionalism or, or ethics, yeah. Right. That don't, don't, don't, don't we, aren't we supposed to be in instilling that in our, in our faculty and, and that that doesn't seem to happen.Eric Topol (31:28):So that'sPeter Hotez (31:28):Troubling asEric Topol (31:29):Well. They're, they're making credible scientists who are doing the best they can into pinatas Right. And attacking them. And with, and it can't, it can't be reciprocated because that's, that's beneath professionalism. I mean, just as you say. So, you know, you just keep, they just keep going at it. So what you have is now we've added all these different entities and all add more. One more is ai, which is going to further blur the truth.Peter Hotez (31:59):Yeah, Renee DiResta at the Stanford Internet Observatory, I don't if you know Renee, she does fabulous work. And she's written about, you know, what happens when, you know, all of the anti-science, anti-vaccine stuff is now imbued with ai, and, you know, it's going become even more sophisticated and more difficultEric Topol (32:17):To No, there's, there's gonna be a video of you saying that, you know, these vaccines are killing people but don't get a booster and it'll be just like you with your voice. Yeah.Peter Hotez (32:28):Well, they already, they already have. Now these, there's these few things on YouTube that, that claim, I'm secretly Jack Black, the actor . And that the CIA has arranged it so that Jack Black plays this fictional character named Dr. Peter Hotez. And they do all these things like, you know, focus in on my eyes and do like eye identification. It's just, it's just nuts. I mean, what, what's out there?Eric Topol (32:54):Well, has there been a time in these months where you were very scared you, you're for yourself or your family because of all the incredible density and, and what appears to be very serious threats and duringPeter Hotez (33:08):, during, during the day, during the day, I'm okay. I mean, in, you know, when the, when the, when the Steve Bannon in stuff and Joe Rogan stuff, then I had the stalking at the house, and, you know, I had to have a Houston Police Department officer parked in front of my house or a Harris County Sheriff that, that was troublesome. But it, it's more of during the day, I am fine. I'm working, I'm talking, you know, to people like you and in lab meetings, doing what scientists do, writing grants and throwing pencils at the wall when you get a paper with a major review or, or a major revision or rejection. But, but it's, I think at night, you know, wake up in the middle of the night and the, it's, the stuff does start to mess with your head at times. And it'sEric Topol (33:54):Well, and you travel a lot and you, you've, I think expressed that, hey, you could be given a talk in an innocent place and somebody could come, you know, attack youPeter Hotez (34:04):There. Yeah. So I have to, I have, I have security now at, in major venues when I speak. and, you know, I had an, there was an incident at the World Vaccine Congress in Washington. There were protesters out in front of the, out in front of the convention center waiting for me that that wasn't fun. And so, even, you know, we've got, we'll see what happens with the, when the, you know, I'm doing a number of events around the book in Washington DC and New York and elsewhere. We'll, we'll see how that goes. soEric Topol (34:38):Well take it. You, you're, I know you well enough to know that you're an optimistic person. I mean, you've been smiling and we've been laughing during this and discussing some very heavy, serious stuff. What gives you still optimism that this can someday get on track?Peter Hotez (34:57):Well, I think it could get worse before it gets better, first of all. And, and two fronts. One, you know, I had the opportunity to meet with Dr. Tedros, the World Health Organization Director, general of World Health Organization towards the end of last year. And to say this could be the warmup act in the sense that now it's globalizing. I'm anticipating spillover all childhood immunization rates. And, you know, you're starting to see the same US style of anti-vaccine rhetoric now, you know, even in low and middle income countries on the African continent in South Asia. So I worry about, you know, measles and polio, both in the US and, and globally. I think that's, that's, I'm worried about that. The other is, you know, a lot of this is heating up, I think because of the 2024 presidential election. I think one was that with, with our, our mutual friend and colleague Anthony Fauci, now that he's out of government he's not as visible as he was.(35:58):I think they're, the, the extremists are looking around for another, they need a monster right. To, to galvanize the base. And I think I've become that monster. You know, that's, that's one thing I'm worried about. But also you with, I talk to probably someone you've seen on Twitter. and I've gotten to know her somewhat, I'm very impressed with her. Molly Chong Fast, who's a commentator on c n at M S N B C, and she, you know, put out there, and she told me privately and put it out in public that, you know, one of the reasons why things are so vicious around RFK Jr, as they see him as a third party candidate that could take Biden votes away and help create a path for Trump being elected. So by, you know, by having me debate him, it, it kind of elevated in, in its own way, elevated his stature and made him seem like a more serious person. Right, right. And my refusal, you know, popped their bubble. And that, that's one of the reasons why, why they're so angry. So this is very much tied, I think, to the 2024 presidential look. And that's what you're having seen with the House subcommittee hearings too, portraying scientists as enemies of the state. It's all for, I mean, I don't know if you've seen this, the, that House Subcommittee Twitter site, it actually says something like, we're selling popcorn, you know, we'reEric Topol (37:18):Yeah, I know. I mean,Peter Hotez (37:20):They're, they're not, they're not even pretending it's anything, theEric Topol (37:23):PoliticalPeter Hotez (37:23):Theater for Fox News soundbites. So I think we're gonna see they're the word.Eric Topol (37:27):Alright. Yeah.Peter Hotez (37:28):Yeah. And, and, but, you know, but the attacks on biomedical science, I think are gonna be, you know, have a long-term effect. If for no other reason, I think people are gonna think twice about wanting to do a PhD in biomedical scientist or become an MD PhD scientist when they see that, you know, we'reEric Topol (37:47):. Well, that's what you, you also covered that really well in the Yeah. In the book. But when you think about where we are now with climate crisis, or we're facing future pandemics, not just the one we're still working through here where is the hope that we can counter this? I mean, we need armies of people like you. We need, as you say, the scientific establishment and community all stand up. That, that gets me to one of the things that makes you differentiates you from most physicians and scientists. You write books, you are active on social media. You, you appear on the media. Most scientists grew up to have their head do the work, do good science, get their stuff published, and get grants and, you know, try to advance the field and physicians doing that, are taking care of patients, same kind of thing. What prompted you in your career to say, Hey, you know, that's not enough. I got another dimension. And why, how can we get millions of clinicians and scientists to rally to do what you'rePeter Hotez (39:01):Doing? Well, in my, in my case, I, it's not that I was deliberately seeking to be a public figure or what some call a public intellectual. It was more the case, the issues that I was most interested in, nobody was talking about. Mm. And nobody was going to talk about it. So if I didn't talk about it, it wasn't gonna be talked about. So neglected tropical diseases, you know? Yeah. For guard people was, and, and I had two colleagues in the uk, Alan Fannick and David Mullen, who felt the same way. And so we began be, we became the three Musketeers of the neglected tropical disease space. And I found that extremely meaningful and interesting. And it was the same with vaccines. So although I, I'm often in the, you know, doing a lot of public engagement, if you notice, I don't try to be like some people who do it very well, like as Sanjay Gupta or, or some others that will, or Megan Rainey that will talk about, you know, just about any health issue.(39:56):I, I don't try to do that. I sort of stay, it's a wide lane, but I try to stay in my lane around infectious, neglected diseases and, and, and vaccines. And I think that's very important. Now, in terms of, you know, the statement, most scientists or physician scientists wanna keep their head done, write their grants and paper. I think that's perfectly fine. I don't think you people should be forced to do it, but I think there's enough of us out there that wanna do it, but don't know how to get started and don't feel safe doing it. I, and so I think we need to change that culture. Mm-hmm. I think we need to offer science communication to our graduate students in their PhD programs or in MD PhD programs for those who wanna do it, or in residency training or fellowship training. And so that, because there, there are things you can learn.(40:46):I mean, we had to do it by trial and error, and in my case, more error than trial. But, but, but there is a, there is, there are things you can learn from people who do this professionally. So I think that's important. I think the other is we need to change the culture of the institutions. You know, I, I get evaluated just like you do like everybody, like any, you know, senior scientist or professor at university, and, you know, what do they ask me about? They ask me about my grants and, and my papers preferably in high impact journals, and they ask me, and I don't see patients anymore, so they don't ask me about my clinical revenue, but they ask me about my grants and papers and my grants and papers, and my grants and papers. There's not even any place on my form, my annual evaluation from, to put in the single author books. I've written much less, you know? Yeah. The, the opinion pieces I've written, or certainly not social media or even, or even the cable news channel. So, so it basically, the academic health center is sending the message. And I don't think that's unique. I think that's probably the rule in most places. I think the, the culture of academic health centers is they're basically, they're sending a message just saying, well, we don't consider that stuff important, and somehow we have to make it important. I think for those who wanna do itEric Topol (42:08):AbsolutelyPeter Hotez (42:09):To send that message,Eric Topol (42:10):You're, you're, you're pointing out a critical step that has to be undertaken in the future. it'll take time to get that to gel, hopefully, but if it's promoted actively, I certainly promote that. I know you do. Yeah. I think,Peter Hotez (42:23):I think most, most offices of communications at academic health centers, as I said, Baylor and Texas Children's is pretty good, better than most, but most, you know, don't even like their docs and scientists speaking out. Yeah. Right. They wanna control the message. It's all about, you know, they're very risk averse. They're protecting the reputation of the institution. They only see the risk side. They don't, you know, you know, you wanna speak about social justice or, or combating anti-science. Well, you know, we guess we can't stop you, but they sort of cringe at, at the idea. And then, you know, they say, well, you know, ultimately you're a professor or a scientist here, you have academic freedom.com, but don't screw this up. Right. And don institution at risk. Right.Eric Topol (43:07):Ab you're describing exactly how university communications worked.Peter Hotez (43:12):Yeah. ButEric Topol (43:13):ThePeter Hotez (43:13):Point is, and so you do it with the sort of Damocles over your head, and, and you know, as you know, and as anyone knows, if you do enough, you will screw it up eventually, right? Everybody does. And, and you know, you're gonna make mistakes. That's how you learn. You make mistakes and you, you auto correct. But, but you have to have that freedom to be able to make mistakes and Yeah. And right now that's not there either.Eric Topol (43:35):What, what you're driving at though altogether is that we're defenseless. That is, if you have an organized finance coordinated attack on science, and also of course on vaccines, and you have no defense, you have, I mean, it's hard for the government to stand up because they're part of what's the conspiracy theory is, is, is against, and you, and, and the scientific community, the clinician community is, you know, kind of handcuffed as you are getting at. And also, you know, that's not the culture that's unwilling, but something's gotta give. And this is one thing I think you're really reinforcing that, that should a pathway to countering. I mean, we can't clone you. You know, we can't, we need lots of warriors. We need, you know, thousands and hundreds of thousands of points of light who support data and evidence, you know, as best that they can. And we don't have that today.Peter Hotez (44:36):Yeah. And we, we need to cultivate that. So I'm in discussions not only with people like yourself, but other colleagues about should we try to create, whether it's a nonprofit of 5 0 1 C three or C four the climate scientists are ahead of the game on this. Yeah. Yeah. I, I talk to Michael Mann every now and then, and, you know, they've got a climate science defense fund. They, they seem to be, 'cause it, they've, they've experienced this for longer than we have. You know, the, this all started a decade before with tax against climate scientists, you know, should, in the book I talk about, should we create something like a Southern Poverty Law Center equivalent to, to protect science and scientists? And, and I think we need that because the existing institutions don't seem willing to, to create something like that. It's somehow seen as too edgy or too out there and Right.(45:30):And it shouldn't be. But, but again, this is a I think a, a great opportunity for college presidents to, to step up and, and they're not doing that. They're, they're also pretty risk averse. So I think, you know, getting, getting the heads of the academic health centers, getting the college president, university presidents to say, Hey, this is important because otherwise science is at risk. And, and you're already starting to see some crazy stuff come out of the N I h now about doing international research. They're trying to put in rules to say they want, you know, if you have international collaborators, you're supposed to collect their notebooks and translate the how are you gonna do that? That's, that's completely, IM it's important. I mean, it's, and who's gonna review it and who's gonna sign off in general legal counsel at the university on, that's basically gonna halt international research. And we have to recognize that we need this because the threats are coming. Right? I mean,Eric Topol (46:33):CliPeter Hotez (46:34):Climate change is real, and pandemic threats are real. We're gonna see another major coronavirus pandemic possibly before 2030 or a flu or an arbovirus. And, and we're, we're, we need, this is a time we need to be reinforcing our, our virology research and our infectious disease research, not a time to, you know, start dismantling it, which is what totally the house hearings are, are meant to do, and what some of these new n i h rulings are meant to do. So it's gonna take a lot of strong players and, and, and government and at universities to stand up to this.Eric Topol (47:14):Well, if we ever need to be vaccinated or immunized, it's against this. And I hope that something will give to start to provide an antidote to what is a relentless progression of united science that you so elegantly eloquently in, in your book, Peter. So thanks for writing that. thanks for joining today. I know we'll have, as we do every week conversations yeah. You,Peter Hotez (47:41):You've been a, you've been an amazing friend and colleague, Eric, and I've learned so much from you. And, andEric Topol (47:46):No, no. I, I feel I can't tell you thank you. I, I, I think it's completely reciprocal from what you bring to this table of trying to make this a better place for advancing science search for, for the truth of what's really going on out there, rather than having to deal with wacky, you know, extremists that are advancing things for various purposes that are, that are nefarious in many cases. So, appreciate it. we'll be talking some more and this has been a really for me, an enriching conversation.Peter Hotez (48:21):Same, same Eric. And thank you so much for giving this attention and the dialect to be continued.Thanks for listening, reading and subscribing to Ground Truths!Please share if you found this podcast worthwhileFull video link Get full access to Ground Truths at erictopol.substack.com/subscribe

Bob Harrington and Manesh Patel discuss sudden cardiac death in athletes and the importance of the chain of survival. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington COVID and the Athlete's Heart https://www.medscape.com/viewarticle/945282 Outcomes Registry for Cardiac Conditions in Athletes https://doi.org/10.1161/JAHA.122.029052 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy https://doi.org/10.1161/CIR.0000000000000937 Point-of-care screening for HFrEF using artificial intelligence during ECG-enabled stethoscope examination https://doi.org/10.1016/s2589-7500(21)00256-9 International recommendations for electrocardiographic interpretation in athletes https://doi.org/10.1093/eurheartj/ehw631 Elevation of Cardiac Troponins After Endurance Running Competitions https://doi.org/10.1161/CIRCULATIONAHA.118.034655 Vigorous Exercise in Patients With Hypertrophic Cardiomyopathy https://doi.org/10.1001/jamacardio.2023.1042 Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Preamble, Principles, and General Considerations https://doi.org/10.1161/CIR.0000000000000236 RACE-CARS Trial https://racecarstrial.org/ AHA CPR Resources https://cpr.heart.org/en/cpr-courses-and-kits/hands-only-cpr You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine   https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology   https://www.medscape.com/twic Questions or feedback, please contact   news@medscape.net

Bob Harrington interviews Jag Singh about the COVID journey that led to his book, Future Care: Sensors, Artificial Intelligence, and the Reinvention of Medicine. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit: https://www.medscape.com/author/bob-harrington Future Care: Sensors, Artificial Intelligence, and the Reinvention of Medicine. https://www.jagsinghmd.com/book COVID-19 Hits Physician Couple: Dramatically Different Responses https://www.medscape.com/viewarticle/928530 Smartwatch Electrocardiogram and Artificial Intelligence for Assessing Cardiac-Rhythm Safety of Drug Therapy in the COVID-19 Pandemic. The QT-logs study https://doi.org/10.1016/j.ijcard.2021.01.002 The Care of the Patient https://doi.org/10.1001/jama.1927.02680380001001 Advancements and future directions in the teamwork, targets, technology, and tight control-the 4T study: improving clinical outcomes in newly diagnosed pediatric type 1 diabetes https://doi.org/10.1097/mop.0000000000001140 Social determinants of telemedicine utilization in ambulatory cardiovascular patients during the COVID-19 pandemic https://doi.org/10.1093/ehjdh/ztab039 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact: news@medscape.net

Jamie deRoy discsses her father backing "The Pajama Game" and "Damn Yankees"; her dad being a big fan of Broadway; getting advice from Harold Prince her senior year of high school to stay in Pittsburgh; her leaving for NY fter one year in college; working with Larry Keith and Margot Moser; Sidney Simon; Margot Moser wants her to stay in NY and take voice lessons with her teacher; getting cast in The Drunkard; becoming friends with its musical coordinator, Barry Manilow; getting hired in the mountains and having Barry write the charts; not writing patter; opening for Irving C. Watson; being a popular opening act with comedic songs; opening for Joan Rivers; performing in the Monkey Bar with Crandall & Charles and Mel Martin; Norman Steinberg; Jeffrey Richards has Jamie watch The Complete Works of William Shakespeare Abridged; she becomes co-producer; revival of show is paused by 9/11; producing Mr. Saturday Night; it was supposed to follow The Lehman Trilogy but COVID hit; Jamie performs a duet with Tyne Daly at a benefit for Primary Stages; COVID closed Broadway; many people quit acting; a British cast gets stranded in NY; Jamie gets COVID in October 2022; producing Beetlejuice, Tina, Fiddler on the Roof, Angels in America and The Inheritance; two most emotional theatre events - the end of The Inheritance and the first "Jamie deRoy and Friends" which paid tribute to cabaret critic Bob Harrington in 1992; producing The Lion, The Two of Us (with Jay Johnson) and Say Goodnight Gracie (with Frank Gorshin); seeing understudies; co-starring with Rene Auberjonois in Threepenny Opera; how sitting next to Martin Scorcese got her cast in Goodfellas and how leaving to go to Cannes got her a bigger part that wasn't cut; appearing in See No Evil, Here No Evil; recording nine albums; her TV show of over thirty years, Jamie deRoy and Friends; what shows she has currently out and about to come out; working with Judy Gold; and making sure to tape everything.

Bob Harrington talks to two former colleagues who made a mid- and senior-career switch to pharma and digital tech, respectively. How did they make this decision and what advice do they have for others? This podcast is intended for healthcare professionals only. To read a transcript or to comment https://www.medscape.com/author/bob-harrington Jeff Bezos - Regret Minimization https://www.youtube.com/watch?v=-qPii5ACVYw You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

In this week's episode of Fresh From The Field Fridays we continue our conversation with Bob Harrington of Specialty Produce in San Diego. Bob's recent produce trip to Southeast Asia brings interesting items as well as stories. What happens when you leave a Durian in your hotel room? Hanging buckets of money at the farmers market and the Produce Museum at Specialty Produce. It's all right here on this Friday the 13th lucky episode! Tune In and Turn On! FANCY SPONSORS: Ag Tools, Inc.: https://www.agtechtools.com, Flavor Wave, LLC.: https://flavorwavefresh.com, Noble Citrus: https://noblecitrus.com, Buck Naked Onions/Owyhee Produce, Inc.: http://www.owyheeproduce.com and John Greene Logistics Company: https://www.jglc.com CHOICE SPONSORS: Indianapolis Fruit Company: https://indyfruit.com, Equifruit: https://equifruit.com Arctic® Apples: https://arcticapples.com Sev-Rend Corporation: https://www.sev-rend.com, Jac Vandenberg Inc.: https://www.jacvandenberg.com Dole Fresh Vegetables: https://www.dole.com/en/produce/vegetables WholesaleWare: https://www.grubmarket.com/hello/software/index.html Continental Fresh, LLC: https://www.continentalfresh.com Golden Star Citrus, Inc.: http://www.goldenstarcitrus.com STANDARD SPONSORS: London Fruit Inc. https://londonfruit.com, Freshway Produce: https://www.freshwayusa.com and Citrus America: https://citrusamerica.com --- Support this podcast: https://anchor.fm/theproduceindustrypodcast/support

In this week's Fresh From The Field Fridays with Dan the Produce Man we kick off 2023 with world traveler Bob Harrington of Specialty Produce in San Diego! Have you seen the massive database of fresh produce information from all over the world? An enormous amount of research, studying, and traveling, at times into remote villages to put this ever growing information center together. Tune in and Turn On to Part One of Dan's conversation with Bob! FANCY SPONSORS: Ag Tools, Inc.: https://www.agtechtools.com, Flavor Wave, LLC.: https://flavorwavefresh.com, Noble Citrus: https://noblecitrus.com, Buck Naked Onions/Owyhee Produce, Inc.: http://www.owyheeproduce.com and John Greene Logistics Company: https://www.jglc.com CHOICE SPONSORS: Indianapolis Fruit Company: https://indyfruit.com, Equifruit: https://equifruit.com Arctic® Apples: https://arcticapples.com Sev-Rend Corporation: https://www.sev-rend.com, Jac Vandenberg Inc.: https://www.jacvandenberg.com Dole Fresh Vegetables: https://www.dole.com/en/produce/vegetables WholesaleWare: https://www.grubmarket.com/hello/software/index.html Continental Fresh, LLC: https://www.continentalfresh.com Golden Star Citrus, Inc.: http://www.goldenstarcitrus.com STANDARD SPONSORS: London Fruit Inc. https://londonfruit.com, Freshway Produce: https://www.freshwayusa.com and Citrus America: https://citrusamerica.com --- Support this podcast: https://anchor.fm/theproduceindustrypodcast/support

Trials on heart failure, hypertension and lipid-lowering drugs, and the evolution of antithrombin and antiplatelet therapy are discussed in part 2 of cardiologists Bob Harrington and Mike Gibson's annual review. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington Lipid Lowering Safety, Tolerability and Efficacy of Up-Titration of Guideline-Directed Medical Therapies for Acute Heart Failure (STRONG-HF): A Multinational, Open-Label, Randomised, Trial https://doi.org/10.1016/S0140-6736(22)02076-1 Why Combination Lipid-Lowering Therapy Should Be Considered Early in the Treatment of Elevated LDL-C for CV Risk Reduction https://www.acc.org/latest-in-cardiology/articles/2022/06/01/12/11/why-combination-lipid-lowering-therapy-should-be-considered Incidental Coronary Artery Calcium: Opportunistic Screening of Prior Non-gated Chest CTs to Improve Statin Rates (NOTIFY-1 Project) https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.062746 Equivalent Impact of Elevated Lipoprotein(a) and Familial Hypercholesterolemia in Patients With Atherosclerotic Cardiovascular Disease https://doi.org/10.1016/j.jacc.2022.09.021 Comparative Effects of Low-Dose Rosuvastatin, Placebo and Dietary Supplements on Lipids and Inflammatory Biomarkers https://doi.org/10.1016/j.jacc.2022.10.013 Antihypertensive Drugs No Survival Advantage for Either Torsemide or Furosemide in HF: TRANSFORM-HF https://www.medscape.com/viewarticle/983611 Chlorthalidone vs. Hydrochlorothiazide for Hypertension–Cardiovascular Events www.nejm.org/doi/full/10.1056/NEJMoa2212270 Antiplatelets Duration of Antiplatelet Therapy After Complex Percutaneous Coronary Intervention in Patients at High Bleeding Risk: A MASTER DAPT Trial Sub-analysis https://doi.org/10.1093/eurheartj/ehac284 PANTHER: Should Clopidogrel Become the 'New Aspirin' in CAD? https://www.medscape.com/viewarticle/980117 P2Y12 Inhibitor Versus Aspirin Monotherapy for Secondary Prevention of Cardiovascular Events: Meta-analysis of Randomized Trials https://doi.org/10.1093/ehjopen/oeac019 Ticagrelor Versus Clopidogrel in Patients With Acute Coronary Syndromes https://doi.org/10.1056/nejmoa0904327 TCT-320 Pharmacokinetic and Pharmacodynamic Profile of PL-ASA, a Novel Phospholipid-Aspirin Complex Liquid Formulation, Compared to Enteric-Coated Aspirin at an 81-mg Dose – Results From a Prospective, Randomized, Crossover Study https://www.jacc.org/doi/10.1016/j.jacc.2021.09.1173 Pharmacokinetic and Pharmacodynamic Profile of a Novel Phospholipid Aspirin Formulation https://europepmc.org/article/pmc/pmc8773391 Antithrombins/Factor XI Rivaroxaban in Patients With a Recent Acute Coronary Syndrome https://www.nejm.org/doi/full/10.1056/nejmoa1112277 Genetically Determined FXI (Factor XI) Levels and Risk of Stroke https://doi.org/10.1161/strokeaha.118.022792 Factor XIa Inhibition With Asundexian After Acute Non-cardioembolic Ischaemic Stroke (PACIFIC-Stroke): an International, Randomised, Double-Blind, Placebo-Controlled, Phase 2b Trial https://doi.org/10.1016/s0140-6736(22)01588-4 Safety of the Oral Factor Xia Inhibitor Asundexian Compared With Apixaban in Patients With Atrial Fibrillation (PACIFIC-AF): a Multicentre, Randomised, Double-Blind, Double-Dummy, Dose-Finding Phase 2 Study https://doi.org/10.1016/S0140-6736(22)00456-1 A Multicenter, Phase 2, Randomized, Placebo-Controlled, Double-Blind, Parallel-Group, Dose-Finding Trial of the Oral Factor XIa Inhibitor Asundexian to Prevent Adverse Cardiovascular Outcomes After Acute Myocardial Infarction https://doi.org/10.1161/circulationaha.122.061612 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback? Please contact news@medscape.net

In part 1 of their annual review, cardiologists Bob Harrington and Mike Gibson discuss in-person meetings, wearables and AI, COVID lessons for medical research, and the growth of RCTs from China. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington COVID Therapies Therapeutic Anticoagulation With Heparin in Noncritically Ill Patients With Covid-19 https://www.nejm.org/doi/full/10.1056/NEJMoa2105911 Effect of Intermediate/High Versus Low Dose Heparin on the Thromboembolic and Hemorrhagic Risk of Unvaccinated COVID-19 Patients in the Emergency Department https://doi.org/10.1186/s12873-022-00668-8 Two Old Meds and a DOAC a Bust Across Range of COVID Severity: The ACT Trials https://www.medscape.com/viewarticle/980049 Effect of Ivermectin vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19: A Randomized Clinical Trial http://jamanetwork.com/article.aspx?doi=10.1001/jama.2022.18590 FDA Halts Use of Some COVID Monoclonal Antibodies Due to Omicron https://www.medscape.com/viewarticle/967210 CT Surgeons Rise to Challenge, Lead Way in COVID Clinical Trials https://www.sts.org/publications/sts-news/ct-surgeons-rise-challenge-lead-way-covid-clinical-trials What Do We Know About Long COVID: A Cardiovascular Focus https://www.medscape.com/viewarticle/981435 COVID-19 and the Heart: Is Cardiology Ready? https://www.medscape.com/viewarticle/969206 The Stanford RECOVER Trial https://recovercovid.org/ The Heroes Study https://heroesresearch.org/ Artificial Intelligence Age and Sex Estimation Using Artificial Intelligence From Standard 12-Lead ECGs https://doi.org/10.1161/CIRCEP.119.007284 The Heartline Study https://www.heartline.com/about Evolution of Single-Lead ECG for STEMI Detection Using a Deep Learning Approach https://doi.org/10.1016/j.ijcard.2021.11.039 Recognizing a Ruler Instead of a Cancer https://menloml.com/2020/01/11/recognizing-a-ruler-instead-of-a-cancer/ Machine Learning Did Not Beat Logistic Regression in Time Series Prediction for Severe Asthma Exacerbations https://doi.org/10.1038/s41598-022-24909-9 A Systematic Review Shows No Performance Benefit of Machine Learning Over Logistic Regression for Clinical Prediction Models https://doi.org/10.1016/j.jclinepi.2019.02.004. Multinational Federated Learning Approach to Train ECG and Echocardiogram Models for Hypertrophic Cardiomyopathy Detection https://doi.org/10.1161/circulationaha.121.058696 Detection of Hypertrophic Cardiomyopathy Using a Convolutional Neural Network-Enabled Electrocardiogram https://doi.org/10.1016/j.jacc.2019.12.030 Here's Why We're Not Prepared for the Next Wave of Biotech Innovation (by Matthew Herper) https://www.statnews.com/2022/11/03/why-were-not-prepared-for-next-wave-of-biotech-innovation/ RCTs from China Bivalirudin Plus a High-Dose Infusion Versus Heparin Monotherapy in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Randomised Trial https://doi.org/10.1016/S0140-6736(22)01999-7 Chinese Herbal Medicine May Offer Benefits in STEMI: CTS-AMI https://www.medscape.com/viewarticle/983619 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week on This Week in Cardiology https://www.medscape.com/twic Questions or feedback? Please contact news@medscape.net

This week we have an extraordinary guest on the show with a fascinating mission in the world of fresh fruits and veggies. This man has to be one of the foremost experts, if not THE foremost expert, on the amazing diversity of edible plants that mother nature has to offer. Bob Harrington is the president of Specialty Produce, a wholesaler of fresh fruits and vegetables primarily to restaurants in San Diego, CA. They sell every type of fruit and vegetable, but as the name implies, they have become an invaluable source for chefs of more exotic, rare, and hard-to-find varieties. Bob has been traveling the world for almost three decades looking for and cataloging thousands of fruits and vegetables and their seemingly endless varieties. And he is going to tell us all about that adventure and what he has achieved. Tune in to hear about his quest and how you can access information on the thousands of fruits and veggies he has documented. --- Support this podcast: https://anchor.fm/produce-buzz/support

Do cardiologists from the AFFIRM generation treat AF less aggressively than the EAST-AFNET generation? Bob Harrington and Jonathan Piccini discuss this and upcoming trials on atrial fibrillation. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit: https://www.medscape.com/author/bob-harrington A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation (AFFIRM) https://www.nejm.org/doi/full/10.1056/NEJMoa021328 Early Rhythm-Control Therapy in Patients with Atrial Fibrillation (EAST-AFNET 4) https://www.nejm.org/doi/10.1056/NEJMoa2019422 Early AF Rhythm-Control Advantage Climbs With Comorbidity Burden: EAST-AFNET4 https://www.medscape.com/viewarticle/979627 Early Dronedarone Versus Usual Care to Improve Outcomes in Persons With Newly Diagnosed Atrial Fibrillation (CHANGE-AFIB) https://clinicaltrials.gov/ct2/show/NCT05130268 Generalizability of the EAST‐AFNET 4 Trial: Assessing Outcomes of Early Rhythm‐Control Therapy in Patients With Atrial Fibrillation https://doi.org/10.1161/JAHA.121.024214 Early Rhythm Control Therapy for Atrial Fibrillation in Low-Risk Patients A Nationwide Propensity Score–Weighted Study https://doi.org/10.7326/M21-4798 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Bob Harrington Opens Season Two of Stanford Healthcare Leadership PodcastThe first episode of the second season of the Stanford Healthcare Leadership Podcast features Dr. Bob Harrington, Chair, of the Department of Medicine. Dr. Harrington traces his early life, his journey through medical school, and his work at Duke University, Stanford University, and the American Heart Association.  His personal anecdotes paint a vivid (and sometimes poignant) picture of his life and his secret sauce to carving out a fulfilling career in medicine. 

This week, please join authors Paul Ridker and Eric Van Belle, editorialist Robert Harrington, and Guest Editor Allan Jaffe as they discuss the original research articles "Effects of Randomized Treatment With Icosapent Ethyl and a Mineral Oil Comparator on Interleukin-1β, Interleukin-6, C-Reactive Protein, Oxidized Low-Density Lipoprotein Cholesterol, Homocysteine, Lipoprotein(a), and Lipoprotein Associated Phospholipase A2: A REDUCE-IT Biomarker Substudy" and “Cerebral Microbleeds During Transcatheter Aortic Valve Replacement: A Prospective Magnetic Resonance Imaging Cohort” and the editorial "Trials and Tribulations of Randomized Clinical Trials." 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:           And I'm Dr. Greg Hundley, Associate Editor, Director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Dr. Carolyn Lam:             It's double feature time Greg. We've got two totally unique and interesting papers that we'll be discussing. The first, a biomarker substudy from the REDUCE-IT trial, that is looking at the effects of randomized treatment with icosapent ethyl, versus a mineral oil comparator, on inflammatory biomarkers. Now, don't use roll your eyes at me, because I'm telling you, this has results that you may not expect, and very, very important clinical implications, and implications for clinical trials. The second paper, very much up your alley, Greg, is a prospective MRI study of cerebral microbleeds during TAVR. But okay, enough now to whet your appetite, let's now just first grab coffees, and discuss the other papers and the issue, shall we? Dr. Greg Hundley:           You bet, Carolyn. And how about if I go first? Dr. Carolyn Lam:             Please. Dr. Greg Hundley:           So, Carolyn, my first paper comes from a group of investigators led by Dr. Araz Rawshani from the Institute of Medicine, and it included 715,143 patients with diabetes, registered in the Swedish National Diabetes Register, and compared them with over two million match controls, randomly selected from the general population, to determine the role of diabetes in the development of valvular heart disease, and particularly, the relation with risk factor control. Dr. Carolyn Lam:             Huh? Interesting, diabetes and valve disease. All right. What did they find, Greg? Dr. Greg Hundley:           Right, Carolyn. So they found, that individuals with type one and two diabetes, have greater risk for stenotic lesions. Whereas, risk for valvular regurgitation was lower in type two diabetes. Patients with well controlled cardiovascular risk factors, continued to display higher risk for valvular stenosis, without a clear stepwise decrease in risk between various degrees of risk factor control. So Carolyn, diabetes and a link with valvular heart disease. Dr. Carolyn Lam:             Wow. Really interesting, Greg. Thanks. Well, the next paper is a preclinical study with really interesting clinical implications. Now, we know the human heart has limited capacity to regenerate new cardiomyocytes, and that this capacity declines with age. Now, because loss of cardiomyocytes may contribute to heart failure, it is important to explore how stimulating endogenous cardiac regeneration, to favorably shift the balance between loss of cardiomyocytes and birth of new cardiomyocytes, occurs in the aged heart. Now, these authors, Doctors Rosenzweig, from Massachusetts General Hospital, and Dr. Lee from Harvard University and colleagues, previously showed that cardiomyogenesis can be activated by, guess what? Exercise in the young adult mouse heart. However, whether exercise also induces cardiomyogenesis in aged hearts, however, is not yet known. So in today's paper, the authors aim to investigate the effect of exercise on generation of new cardiomyocytes in the aged heart. And here, we're talking about 20 month old mice, who were subjected to an eight week voluntary running protocol, and age matched sedentary animals who served as controls. Dr. Greg Hundley:           Wow, Carolyn. Really interesting evaluation of exercise on cardiomyogenesis. So what did they find? Dr. Carolyn Lam:             Endogenous cardiomyogenesis can be stimulated by exercise in aged hearts. Comparative global transcriptional analysis further revealed, that exercise and age specific changes occurred in gene programs. The regulator of calcineurin RCAN1.4 was specifically found to be induced with exercise in aged hearts, and was accompanied by reduced calcineurin activity. So what's a take-home message? Exercise induced cardiomyogenesis may counter the increased cardiomyocyte loss and reduced cardio myogenic capacity in elderly patients. Dr. Greg Hundley:           Great, Carolyn. Well from the mail bag, there's an exchange of letters to the editor from Professor Zhou and Veith regarding a prior letter to the editor from Professor Jin and associates, pertaining to the previously published article “SPARC, A Novel Regulator of Vascular Cell Function in Pulmonary Hypertension.” And also, there's a Perspective piece, from Professor Mentz entitled, “Catastrophic Disruptions in Clinical Trials.” Dr. Carolyn Lam:             There's also a Research Letter by Dr. Kumar on [entitled] “von Willebrand Factor Is Produced Exclusively by Endothelium, Not Neointima, in Occlusive Vascular Lesions in Both Pulmonary Hypertension and Atherosclerosis.” There's also this beautiful tour of Cardiology News from the literature, from Tracy Hampton, which ranges from a study linking COVID-19 to higher long term cardiovascular risks, which was published in Nature Med, to uncovering alternative metabolic pathways involving cell fate transitions, published in Nature, to designing an autonomous biohybrid fish, from human stem cell derived cardiac muscle cells, that was published in Science. Wow. Isn't that amazing, Greg? Well, let's get on now though, to our two feature papers. Shall we? Dr. Greg Hundley:           You bet. Welcome listeners, to these two feature discussions on this particular day. And our first feature today, we have with us Dr. Paul Ridker, from Brigham and Women's Hospital in Boston, Massachusetts. Dr. Bob Harrington, from Stanford University in California. And also, Dr. Allan Jaffe, from Rochester, Minnesota. Welcome to you all. And Paul, we're going to start for you. Can you describe for us, the background information that really went into the construct of your study, and what was the hypothesis that you wanted to address? Dr. Paul Ridker: Sure, Greg. So first of all, my thanks to the AHA and the Circulation for publishing this paper, we always want to support the AHA, and we're delighted to be here today for these podcasts. The field of omega-3 fatty acids has been a complicated one for a long time. Epidemiology suggested that, fish consumption would lower cardiovascular risk, and there was a number of trials done. And my friend and colleague here at the Brigham, Deepak Bhatt, was the lead of a very big trial, called REDUCE-IT. Some 8,000 plus patients who received EPA alone, and they got a terrific result. A 25% reduction in their primary endpoint. And this was a New England Journal paper, back in 2019 or so. But another friend of mine, Steve Nicholls, ran another large trial of a combination of eicosapentaenoic acid, or EPA, plus docosahexaenoic acid that's DHA called STRENGTH. And that one showed, really, no benefit. And so, there's been some controversy out there. In any event, when Deepak and his colleagues published their original paper, they said it's interesting, because they got this big risk reduction, but it wasn't apparently due to the triglyceride lowering of the drug. And so, my interest, as many people know, has largely been in inflammation biology. And so we said, well maybe we should just do a test. Well, we said, we'll measure a number of biomarkers that we know were associated with atherosclerosis, some inflammatory, some with coagulation. And so, that was the core hypothesis, was simply to look at some other markers, and see what we might learn. And sometimes, you learn things that you didn't expect. And I think, that goes to the heart of what complicated clinical trials are all about. And I'd also say perhaps, what the roles of surrogate endpoints are, as compared to hard clinical endpoints, and things that make this whole field kind of interesting. Dr. Greg Hundley:           Right. Very nice, Paul. So you mentioned REDUCE-IT, so describe a little bit more for your study. What was the study population, and what was your study design? Dr. Paul Ridker: We were fortunate enough to work with REDUCE-IT investigators, to use their biobank. They had put together, again, it's 8,000 plus patients. I think, it was two thirds secondary prevention, one third primary prevention. And when they received the combination of EPA and DHA, as I said earlier, they had about a 25% reduction in the risk of their primary endpoint, which was cardiovascular death, nonfatal AMI, nonfatal stroke, coronary revascularization, and the like. What we did is, we basically said, "Okay, since the mechanism was uncertain, why don't we go ahead and measure a series of biomarkers?" Things that a lot of us are interested in, homocysteine, LPLa, oxidized LDL, my own interest in inflammation. We measured, IL-1β, we measured, IL-6, we measured CRP. We measured another molecule, Lp-PLA2, that people have been interested in. And the hypothesis, of course, was to see what the drug did, as compared to the comparator did. And the findings were interesting to us, in that, to simplify them, the actual icosapent ethyl arm didn't do much to most of those biomarkers, very little change. But the mineral oil comparator arm had some small to modest effects on all those biomarkers, all of which went up again. Now, some of these effects are pretty small, two to 3% for things homocystine, LPLa. Others were moderate, 10 to 20% increases in oxidized LDL, Lp-PLA2. And the inflammatory markers went up about 25%, sometimes, even a little more. So it's complicated. It's important to point out, that these changes on an absolute scale are relatively small. On a percent scale, they're different. The REDUCE-IT investigators themselves, to their credit, had earlier published that, they saw some increase in LDL cholesterol as well, about 10, 11% in those who had received the mineral oil comparator. So it's not exactly what we thought we were going to find, I guess, is the simplest way to express it. Dr. Greg Hundley:           Very nice. And so, describe for us just a little bit more, any differences in men and women, and what about age? Or for example, premenopausal, postmenopausal women. Dr. Paul Ridker: No, the effects were quite consistent across all various subgroups. It's a very large study. There were, again, 8,000 patients, lots of blood samples been drawn. And I should again, commend the REDUCE-IT investigators, for allowing us to do this work with them. And again, as I point out, sometimes you find things out that weren't what you expected. And the hard part, I was glad this got tossed over with Dr. Harrington, is sort to figure out well, what's it really mean? Because again, as a clinical trial list, I will say, my instincts are to trust the primary endpoint of the trial. That's what they did. They're going to go out and lower heart attacks and strokes. And then, here we are a couple years later, trying to figure out what the mechanism might be, and just came across some puzzling results. Dr. Greg Hundley:           Very nice. Well, next listeners, we're going to turn to the editor that actually processed this manuscript, Dr. Allan Jaffe. Allan, what drew you to this particular article? Dr. Allan Jaffe:   Well, I was asked to be a guest editor this week, by the Journal, because of some conflicts that were intrinsic to the editorial board. And since I have an interest in biomarkers, and had for a long time, it made perfect sense for me to become involved. I was particularly interested in this particular area, because I was aware that there were these two trials that had found different endpoints, and that there were some controversy as to what the mechanisms might be by which these effects could occur. And so I was pleased to get involved. And I think it's a compliment to the REDUCE-IT investigators, and to Dr. Ridker, that they were willing to put the data out there so that everybody could see it. And we could then begin to look. So it was of interest to me. I thought it was important to the field, to get really good reviewers who would be, make sure that the data that would eventually be published was clear, so that readers would understand it. And so that, at the end, we'd be able to at least, come to some conclusions that we could end up having an expert in clinical trials. And I thought about Bob Harrington, right from the beginning, might be able to comment on. Dr. Greg Hundley:           Very nice. Well, Bob he's setting you up here nicely, both Paul and Allan, to really help us put these results in perspective with other studies that have been performed in this space. What are your thoughts? Dr. Robert Harrington:   So first off, Greg, thanks for having me. And Allan, thanks for inviting me to review and comment on the paper. As both Allan and Paul have indicated, that I've spent the last 30 plus years doing clinical trials of all sizes. Very small, where we try to understand mechanisms, and very large, where what we're trying to understand is clinical outcomes. And I've been intrigued in this field, because of the inconsistency of the data across the field. Where in some trials, Paul had indicated this STRENGTH, there seemed to be no effect of omega-3 fatty acids, and in REDUCE-IT, there was quite a pronounced effect of the test agent. And so, when one sees discordance in a field, one tries to understand, well, why might that be? And so in the editorial, I took the position that, well, what are we trying to do in clinical trials? And in outcomes trials, we're trying to figure out what matters to patients. Do they live longer? Do they feel better? Do they avoid bad stuff happening to them? Like having to undergo revascularization procedure. So you're trying to do things that are really clinically meaningful, but that doesn't say that you're also not trying to understand mechanism. And as Allan said, there have been some questions raised. And so, trying to understand mechanism in the edit in trials can be quite useful, not just to understand that trial results, but to really form hypothesis for a field going forward. And so, I took the approach of, we learn things from different trials, and sometimes we learn things in the same trial. Meaning that, there's mechanistic work embedded in the large trial. One of the most famous examples of this, in the GUSTO trial 30 years ago, we learned through the mechanistic substudy, that it was rapid reprofusion TIMI-3 establishment of TIMI-3 flow, that really explained the difference between TPA and streptokinase. So I was very intrigued by how we might use these data to explore the results. And I find the findings fascinating, as Paul said. It is complicated, but it raises a really fundamental issue in clinical trials. There's an assumption in a placebo control trial, that because randomization is allowing you to balance everything, except for the randomized treatment groups, and therefore, that comparison has causal information in it. There's an underlying assumption that's really important. And that is, that the placebo is inert. That it has no biological effect of its own. Well, that assumption was violated here. The placebo is not inert in this clinical trial. Now, the investigators, I think to their credit, have said, "Well, this is small, probably doesn't matter." And that might be right, but it also may be wrong. And you can't just say, well, it doesn't matter, these are small effects. As Paul said, some of the effects are small, some are medium, some are large. So what explains it? And I made a point in the editorial, you could model all of this. If you get 5% of this, and 10% of this, and 20% of this, you could make some assumptions and say, well, the magnitude of the benefit was so great that it couldn't have been overcome by this. But that's just modeling, and there's uncertainty. So for me, as a trialist, and somebody who really believes in using evidence to guide practice and to guide public policy, I think there's uncertainty here. It's likely that the treatment effect is not as large as was observed, but how large is it? And how large is important? And how large might we want to consider to put into our practice guidelines? I think all of those open questions, particularly in a field where there is inconsistency across trials, in terms of the observation of the outcome. So my conclusion is, we need more work. We need another trial, if we really want to understand this. And we need to use an inert placebo, to really understand what the contribution was. I'd like nothing better to see that it didn't matter. But I can't say that it doesn't matter because I don't know. Dr. Greg Hundley:           Well, listeners, boy, we've got kind of some interest here in that an unexpected result. So Paul, it's nice doing an interview like this listeners, because each speaker sets up the next one. Paul, Bob is saying, well, what should we do next to clarify the results here? So maybe we'll go through each of you, and start with Paul. Just describe for us, what do you think is the next study that we need to perform? Dr. Paul Ridker: Well, Greg, it's a really interesting issue. We saw it, as authors, to write as neutral a paper as we could possibly write, and sort of do our academic job and say, here are the data. And I think we did it that way because, we don't really know what the interpretation should be. On the one hand, you have a very big beneficial result, which is great for patients. And there's a prior clinical trial called JELIS, which was open label, the same drug, and also got a large benefit. And we were trying to figure out mechanism. That being said, as Bob pointed out, I think what we stumbled into is some level of uncertainty. And the question is, how uncertain would it be, and does it matter in the big picture? Allan was interesting, because the Journal asked us to use the word comparator, rather than placebo. Now this was designed as a placebo controlled trial, but our paper uses the word comparator, because of the possibility, that as Bob Harrington points out, it may not be totally inert. So the writing of this was quite carefully done. I think, at the end of the day, my REDUCE-IT colleagues, who I have great respect for, and really worked terribly hard to do the main trial, understandably feel, that the trial would've showed, and I have a lot of sympathy for that, because it's the hard endpoints we should go with. On the other hand, I have sympathy with the idea that it never hurts to have more data. And if there could be a way to have a second trial, and I might change the population a little bit, maybe I'd do it in true primary prevention. This was one third primary prevention. My colleague, Joanne Manson had done her, she had a trial where they showed some potential benefit in the black populations. Maybe you might over sample some minority groups. But just the pragmatic issues here, make it tough to have a second trial. And so, uncertainty is just part of what we, as physicians, have to learn to live with. Dr. Greg Hundley:           Allan, turning to you. What do you think is a next study to perform in this space? Dr. Allan Jaffe:   Well, I think what Paul has said is correct. That it would be very hard to generate enthusiasm funding for a large trial. But it might not be nearly as difficult to begin to explore the effects of the mineral oil comparator, versus the active agent, versus perhaps, another potential placebo, and see over time what happens in primary prevention patients, as a way of beginning to put some context around what these results might mean. So for example, it could turn out that, the active agent actually kept the values from rising as they normally would've, and mineral oil had no effect at all. Alternatively, mineral oil may well have been a negative. It had a negative effect. And I think, those are the sorts of questions that could be explored reasonably in the short term, without doing another multimillion dollar randomized trial. Dr. Greg Hundley:           And Bob, your thoughts. Dr. Robert Harrington:   Well, and I mentioned this in the editorial, Greg. I didn't make my recommendation lightly. I know that these trials are expensive. I know these trials take a great deal of time, a great deal of energy. And I know that the REDUCE-IT investigators worked enormously hard over the years to get this done. So I don't say tritely, "Oh, just do another trial." But if you think about the magnitude of the public health issue here, there are millions of people to who this kind of therapy might apply globally. And so, shouldn't we be more certain than less certain, if we want to include it, for example, in ACC/AHA guidelines? I would say, the answer to that is yes. And so, I think of it as, okay, let's make some assumptions. Let's assume, that the effect that was observed in JELIS and REDUCE-IT, is the true effect. That's ground truth. Well, there are different study designs one might think about, from an analytic perspective, using Bayesian statistics, as opposed to frequency statistics. One might think about an intense interim analysis plan, to understand where the data are going, and be able to pull in the prior data for evaluation. I would advise getting a smart group of people together, who spend their lives thinking about trials in the atherosclerotic space, and the REDUCE-IT team is pretty darn good, and say, "How could we do this efficiently?" I do think, there's enough uncertainty that it would be ethical, from an equipoise perspective, to include high risk patients in a second evaluation, because we do have uncertainty. And if we really want to nail this down, I think we could look at high risk patients with hypertriglyceridemia, and try to use some interesting design issues, and some interesting analytical issues, to try to reduce the sample size, lot of attention in interim analyses, to try to answer the question. I'd like, as I said, nothing better to say, "Oh look, REDUCE-IT was the truth." This next trial is consistent. That'd be, to me, a terrific outcome of this. On the other hand, if you said to me, "Well, the effect's not 25%, it's more in the 15% range." Well, maybe then we think about how we apply it to our patients a little differently, maybe a little more cautiously. So I don't make the recommendation lightly, as I said, but I do think that there are some conversations that could be had, being respectful of the effort and the expense that goes into these kind of things. To try to answer the question efficiently. Dr. Greg Hundley:           Very nice. Well listeners, we want thank Dr. Paul Ridker, from Brigham and Women's Hospital, Dr. Bob Harrington from Stanford University, Dr. Allan Jaffe, from the Mayo Clinic, for bringing us the results of a substudy of the REDUCE-IT trial, that assessed a variety of serum biomarkers, pertaining to systemic inflammation, and highlighting uncertainty around the mechanism regarding the efficacy of icosapent ethyl, that's been used previously for primary or secondary prevention of cardiovascular events. And next listeners, we are going to move to our second feature discussion and review some data pertaining to microbleeds in the central nervous system, during and after TAVR procedures. Welcome listeners, to our second feature discussion on this August 2nd. And we are going to explore some of the world of TAVR and its potential complications. And we have with us today, Dr. Eric Van Belle, from Lille, France. And also, Dr. Manos Brilakis, from Minneapolis, Minnesota. Welcome gentlemen. And Eric, we'll start with you. Can you describe for us a little, the background information that you use to assemble and construct your study, and describe, or list for us, the hypothesis that you wanted to address? Dr. Eric Van Belle:           Yes. Thanks a lot for the question. So we knew for many years, that some of the complication of the TAVR procedure relate to the brain. And it has been described by many others, that there were some complication in the brain of patient undergoing TAVR. And there was no previous investigation on potential bleeding or microbleeding in this population. And on the other side, there are previous publication on, of course, initially chronic microbleeding, in patient with some of, let's say, disease in the brain, but also, a possibility of acute microbleeding. And especially, in some interesting population relating to the TAVR feed, that is patient with valve disease, patient with endocarditis, or patient with assist device. In this population, microbleedings, acute microbleeding, have been described. And what is interesting, if you look at all these populations, these are population in which the Von Willebrand factor has been impacted and modified, and could be one of the reason of the microbleeding. And one of the similar feature of the patient with aortic stenosis that undergo TAVI, or TAVR, that are patient with indeed also, this kind of Von Willebrand disease. So if we put everything together that is previously, we only looked at antibody complication in those population, and that Von Willebrand disease, which is present in patient with aortic valve stenosis, could promote a bleeding, in particular, bleeding in the brain. We decided to look at the potential appearance of microbleeding, in patient undergoing TAVR procedure. Dr. Greg Hundley:           Very nice. And Eric, can you describe for us, your study design, and who was your study population? Dr. Eric Van Belle:           Yes. So basically, the study population is a basic population of patient undergoing TAVI. Just to make sure that one of the difficulty of this study, was to conduct and perform an MRI, a brain MRI, before the procedure, and as short as possible after the procedure, within three days, which is logistically challenging. And also, to make sure that we keep most of the population to undergo the MRI, we had to exclude patient with a high risk of pacemaker, or patient with pacemaker that could not undergo the MRI. But basically, without this, it's just a regular population. And if we indeed, compare to some of the previous work I was mentioning, about describing the acute MRI, it was important for us to make sure, or to be as sure as we could get, that indeed, this microbleeding, if we observe them, could be related to the procedure. And it means that, the MRI, after the procedure, should be done as short as possible. And also, that an MRI, a baseline MRI, should be performed. Because we know, that in this population, you could have some microbleedings also observed before starting the procedure. Dr. Greg Hundley:           So a cohort study design where MRIs are performed before, and then very soon after, TAVR procedures. So Eric, what did you find? Dr. Eric Van Belle:           So what we observed, the first thing that we confirmed was indeed, that in this population of that age, that is patient around 80 years old, when we do the baseline MRI, you find in about one out of four patients already, some microbleedings. And this was expected, and it is very similar to what is expected in this kind of population. But what was indeed more striking, that when we repeated the MRI after three days, we observed another 23% of patient with a new microbleedings that were observed. This is indeed the most important observation. What was also important that, the patient with microbleedings, and the location of the microbleedings, were not related to the cerebellum brain, because indeed we could observe some cerebellum arise in this population, as it is expected. And there was no relation between the two. So it's also, an important observation, suggesting that this microbleeding are not hemorrhagic transformation of cerebellum brain, for instance. And we also observed that, the risk of microbleeding, or the chance to observe the microbleeding, was increased when the procedure was longer. And also, when the total duration of anticoagulation was longer, we also observed that, when the procedure was, when we used protamine at the end of the procedure, the risk of microbleeding was less. And also, importantly, the status of the Von Willebrand factor, and indeed, an alteration of the multimer of Von Willebrand factor, was also associated with the risk of microbleeding in this population. Dr. Greg Hundley:           Very nice. So in this cohort of 84 individuals, average age around 80, undergoing TAVR procedure, and about 50/50 men and women, you had several factors. Prior history of bleeding, amount of heparin, absence of protamine, all indicating a higher risk of these microbleeds. So very practical information. Well, Manos, you have many papers come across your desk. What attracted you to this particular paper? And then secondly, how do we put these results really, in the context of maybe other complications that can occur during or after TAVR procedures? Dr. Emmanouil Brilakis: Yes, thanks so much, Greg. And also, congratulations Eric, for a wonderful paper, and thanks for sending it to circulation. I think, with increasing the number of targets, as you know, TAVR now is becoming the dominant mode for treating severe aortic stenosis. Safety is of paramount importance. And even though there's been a lot of progress, we still have issues with the safety of the procedure. So understanding how can make it safer is very important. And I think, what was unique in this paper, again, congratulations for creating this study, is that it opens a new frontier. We worry about stroke. We're all very worried about the stroke, and having the patient have a permanent neurologic damage during the procedure. But there may be more to it than the classic embolic stroke. And I think, this study opens actually, a new frontier with the micro cerebral bleeds. Now we don't completely understand, despite the study, we don't understand the functional significance from this. And I think, that's one of the areas that will need further research. But I think, trying to understand what causes them, and preventing those microbleeds, would have a very important role in the future, for making TAVR even safer than it is. Dr. Greg Hundley:           Very nice. Well, Manos, you really lead us into the kind of the next question. So Eric, what do you see as the next study to be performed in this sphere of research? Dr. Eric Van Belle:           Again, to me, and to follow with the comment of Manos, we need to include, I would say, to solve two questions. We have to solve the question of, what could really impact these microbleedings. And what would be the impact of this microbleeding on the long term outcome of this patient? So it's means that we have to set, as part of the studies that we will design, potentially studies on aortic immolation. Or let's say for instance, we could investigate the role of protamine. It has been suggested that protamine could be something interesting, so it could be tested as part of a randomized study. But this means that, as part of such randomized study on the use of protamine, for instance, you would include a last cohort of patients with MRI after the procedure. And also, a long term follow of the neurological complication, which indeed, is the missing part of our current study. We would need to have a much larger cohort of patients, to be able to reconnect the neurological outcome to the MRI outcome, and also to include this. So let's say, for me, one of the studies we would be interested to perform, is to conduct a study on the use of protamine, which is very simple, randomized, yes or no, and includes brain MRI in this population, as a systematic investigation, which is difficult to conduct. You have to know that it's difficult to do, but it will be very important. And then, to look at the long term neurological outcome. Dr. Greg Hundley:           And I see, Eric, you mentioned the long term, because really in the short term, so within six months, you really didn't see any changes in neurological functional outcome or quality of life. So Manos, just coming back to you. What do you see is the next study that should be performed in this space? Dr. Emmanouil Brilakis: Yeah, I agree actually, with Eric. The next step is, this was an 80 patient study. Right? It's a very small preliminary data, all that opens a new system for evaluation, we're still a very small number of patients. So having a larger number of patients, I think for me, the key thing is to understand the connection. Does this actually cause neurologic symptoms? What does it mean having a microbleed? I think right now, we're still confused on the study. There was not really much impact on the neurologic status of the patient. So for me, the number one thing is, to understand how it impacts the patient's quality of life, the neurologic status. Perhaps more sensitive studies, neurocognitive studies, to understand exactly how it impacts. And then after doing that, I agree with Eric, if this is a bad, something really bad, then we can find different ways to prevent them from happening. Protamine is one of them during the procedure time, and not be a very feasible one. Or it could be interesting to see if different valves, for example, have different propensity for causing those microbleeds. Dr. Greg Hundley: Very nice. Well listeners, we want to thank Dr. Eric Van Belle, from Lille, France, and also, our own associate editor, Dr. Manos Brilakis, from Minneapolis, Minnesota for bringing this very important study, highlighting that one out of four patients undergoing TAVR has cerebral microbleeds before the procedure. And then, after the procedure, one in four patients develop new cerebral microbleeds. And then, procedural and antithrombotic management, and persistence of acquired Von Willebrand factor defects, were associated with the occurrence of these new cerebral microbleeds. 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 is 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.

Dr Bob Harrington talks with Drs Michelle Albert and Eldrin Lewis about the Association of Black Cardiologists' diversity scorecard for cardiovascular training programs. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit: https://www.medscape.com/author/bob-harrington The ABC Updates its CV DIBS Rankings | Association of Black Cardiologists https://abcardio.org/recent-news/the-abc-updates-its-cv-dibs-rankings/ FDA Takes Important Steps to Increase Racial and Ethnic Diversity in Clinical Trials https://www.fda.gov/news-events/press-announcements/fda-takes-important-steps-increase-racial-and-ethnic-diversity-clinical-trials Gender Diversity in Cardiovascular Clinical Trial Research Begins at the Top https://www.jacc.org/doi/abs/10.1016/j.jacc.2022.01.001 A Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops https://www.nejm.org/doi/full/10.1056/NEJMoa1717250 At Black Barbershops, BP Reductions Still in Style at 1 Year https://www.medscape.com/viewarticle/906724 Physician-Patient Racial Concordance and Disparities in Birthing Mortality for Newborns https://doi.org/10.1073/pnas.1913405117 Racial and Ethnic Diversity at Medical Schools -- Why Aren't We There Yet? https://www.nejm.org/doi/full/10.1056/NEJMp2105578 Medical School Enrollment More Diverse in 2021 https://www.aamc.org/news-insights/press-releases/medical-school-enrollment-more-diverse-2021#r You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact: news@medscape.net

Bob Harrington interviews fellow cardiologist Jacqueline Tamis-Holland, vice chair of the recent ACC/AHA revascularization guidelines, who takes us inside the process. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization https://doi.org/10.1016/j.jacc.2021.09.006 Evidence Based Medicine: What It Is and What It Isn't https://doi.org/10.1136/bmj.312.7023.71 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: https://doi.org/10.1161/CIR.0000000000000404 Ticagrelor With or Without Aspirin in High-Risk Patients After PCI https://doi.org/10.1056/NEJMoa1908419 Surgical Groups Push Back Against New Revascularization Guidelines https://www.medscape.com/viewarticle/966153 Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and Ischemia Severity https://doi.org/10.1161/CIRCULATIONAHA.120.049755 The Invisible Hand — Medical Care During the Pandemic https://www.nejm.org/doi/full/10.1056/NEJMp2006607 You may also like: Medscape Editor-in-Chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

To support this ministry and help us continue to reach people all around the world click here: http://newlifecity.org/donate Presence, prayer, transformation, evangelism: These are the core values and vision of New Life City, led by Pastor Paul Martini and based in Albuquerque, NM. — Stay Connected!

CardioNerds (Amit Goyal and Daniel Ambinder) join CardioNerds Ambassadors Dr. Pablo Sanchez (FIT, Stanford University) and Dr. Christine Shen (FIT, Scripps Clinic) for a discussion with Dr. Bob Harrington (Interventional Cardiologist, Professor of Medicine, and Chair of the Department of Medicine at Stanford University) about diversity and inclusion in the field of cardiology. This episode discusses Dr. Harrington's broader approach to mentorship, sponsorship, and allyship; and particularly how (and why) he used his position as the president of the American Heart Association to advocate against all-male panels, or “manels.” Listen to the episode to learn the background and motivations behind his evidence-based efforts to make Cardiology a more inclusive field. Special message by California ACC State Chapter President, Dr. Jamal Rana. The PA-ACC & CardioNerds Narratives in Cardiology is a multimedia educational series jointly developed by the Pennsylvania Chapter ACC, the ACC Fellows in Training Section, and the CardioNerds Platform with the goal to promote diversity, equity, and inclusion in cardiology. In this series, we host inspiring faculty and fellows from various ACC chapters to discuss their areas of expertise and their individual narratives. Join us for these captivating conversations as we celebrate our differences and share our joy for practicing cardiovascular medicine. We thank our project mentors Dr. Katie Berlacher and Dr. Nosheen Reza. Video Version • Notes • References • Production Team Claim free CME just for enjoying this episode! There are no relevant disclosures for this episode. The PA-ACC & CardioNerds Narratives in Cardiology PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Video version - Diversity and Inclusion https://youtu.be/SnUadVRhH70 Quotables - Diversity and Inclusion “If senior men don't change the field, it's not going to change. We have the senior positions. We have to change it.”“You're missing talent. You're missing talent of the women who have decided not to go into Cardiology. I say to a lot of my male colleagues...don't you care about the health of our specialty? Don't you want the very best people going into it?”“How great is that--to open up an artery in the middle of the night?... What could be better than that?...Why would you not want to be a cardiologist? Frankly, maybe the field is not so friendly to women...And that bothers me greatly because I love the specialty.”“To those who have been given much, much is expected. That's what people like me should do.”Dr. Bob Harrington Show notes - Diversity and Inclusion What are the gender disparities in the field of Cardiology? 45.8% of residents and fellows in ACGME-accredited programs are women. 14.9% of cardiologists are women. 8% of interventional cardiologists are women [1]. 30.6% of male faculty were full professors, while 15.9% of female faculty are full professors [2].Men are more likely to be influenced by positive attributes of a field, while women are more likely to be influenced by negative attributes [3].3% of percutaneous coronary interventions in the United States are performed by female operators [4]. What is mentorship, sponsorship, and allyship? A mentor provides advice and helps someone develop a skill.A sponsor is an advocate who helps someone secure career advancement opportunities.An ally partners with people, utilizing their power and influence to champion the rights of others [5].According to some studies, women report less sponsorship experiences than men. Additionally, in women it seems to translate less frequently into experiences that further their career (speaking engagements, serving on editorial boards, etc) [6].“I'm a mentor to a few people, I'm a sponsor to many, and I'm an ally to all.” - Dr.

A genomics giant with a family history of heart disease and an Olympic athlete accused of cheating are just two of the medical mysteries unraveled by DNA analysis. Bob Harrington interviews Euan Ashley, author of The Genome Odyssey: Medical Mysteries and the Incredible Quest to Solve Them (https://us.macmillan.com/books/9781250234995), who was inspired to write the book after watching an interview between "fellow nerds" Atul Gawande and Barack Obama. To read a transcript or to comment https://www.medscape.com/author/bob-harrington The Book The Genome Odyssey: Medical Mysteries and the Incredible Quest to Solve Them https://us.macmillan.com/books/9781250234995 The People Stephen Quake Clinical assessment incorporating a personal genome https://doi.org/10.1016/s0140-6736(10)60452-7 Leilani Graham https://www.leilanirgraham.com/ Eero Mäntyranta https://theolympians.co/2018/01/22/eero-mantyranta-the-ruddy-cheeks-and-the-genetic-advantange-of-a-cross-country-skiing-legend-from-finland/ You may also like: Medscape Editor-in-Chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear Dr John Mandrola's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

CardioNerd (Amit Goyal), Narratives in Cardiology FIT representative Dr. Zarina Sharalaya and Cleveland Clinic fellow Dr. Gregory Ogunnowo join Dr. Quinn Capers IV, UTSW as Professor of Medicine, Associate Dean of Faculty Diversity, and the inaugural Vice Chair of Diversity, Equity, and Inclusion in the Department of Internal Medicine, for an important and moving discussion about diversity, implicit bias, and #BlackMenInMedicine. Special thanks to Dr. Kimberly Manning for her introductory remarks for Dr. Capers. Audio editing by CardioNerds Academy Intern, Dr. Maryam Barkhordarian. Claim free CME just for enjoying this episode! Click here to see Dr. Caper's tweet regarding his daughter's original peice Cardionerds Narratives in Cardiology PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll Subscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! https://twitter.com/DrQuinnCapers4/status/1277715623246733317?s=20 CardioNerds Narratives in Cardiology The CardioNerds Narratives in Cardiology series features cardiovascular faculty representing diverse backgrounds, subspecialties, career stages, and career paths. Discussing why these faculty chose careers in cardiology and their passion for their work are essential components to inspiring interest in the field. Each talk will feature a cardiology faculty from an underrepresented group, within at least one of several domains: gender, race, ethnicity, religion, national origin, international graduate status, disadvantaged backgrounds, etc. Featured faculty will also represent a variety of practice settings, academic ranks, subspecialties (e.g. clinical cardiology, interventional cardiology, electrophysiology, etc), and career paths (e.g. division chief, journal editor, society leadership, industry consultant, etc). Faculty will be interviewed by fellows-in-training for a two-part discussion that will focus on: 1) Faculty's content area of expertise2) Faculty's personal and professional narrative As part of their narrative, faculty  will discuss their unique path to cardiology and their current professional role with particular attention to challenges, successes, and advice for junior trainees. Specific topics will be guided by values relevant to trainees, including issues related to mentorship, work-life integration, and family planning. To help guide this important initiative, the CardioNerds Narratives Council was founded to provide mentorship and guidance in producing the Narratives series with regards to guests and content. The CardioNerds Narratives Council members include: Dr. Pamela Douglas, Dr. Nosheen Reza, Dr. Martha Gulati, Dr. Quinn Capers, IV, Dr. Ann Marie Navar, Dr. Ki Park, Dr. Bob Harrington, Dr. Sharonne Hayes, and Dr. Michelle Albert. The Narratives Council includes three FIT advisors who will lead the CardioNerds’ diversity and inclusion efforts, including the current project: Dr. Zarina Sharalaya, Dr. Norrisa Haynes, and Dr. Pablo Sanchez. Guest Profiles - Physician Scientists Women Electrophysiology Dr. Quinn Capers, IV Dr. Quinn Capers, IV grew up in Dayton Ohio and left his hometown to do his undergraduate training at Howard University. He began his journey in medicine at The Ohio State University and went on to do residency, cardiology fellowship, and interventional cardiology training at Emory University. After graduation he worked for 8 years in private practice, and made the switch back to academics and came back to Ohio State to continue his career.  In 2009, he was named associate dean of admissions and in 10 years, the College of Medicine went from 13%  underrepresented minorities to 26% of the 2019 entering class, and in the last 6 years women have outnumbered men in the incoming classes. In 2019 he was promoted to Vice Dean for Faculty Affairs, received the award for professor of the year,

What is the incidence of post-COVID myocarditis and when is it safe to return to play? Bob Harrington and Manesh Patel discuss our evolving understanding of how SARS-CoV-2 effects the hearts of athletes and weekend warriors. To read a transcript or to comment https://www.medscape.com/author/bob-harrington Early Studies Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19) https://doi.org/10.1001/jamacardio.2020.3557 Cardiovascular Magnetic Resonance Findings in Competitive Athletes Recovering From COVID-19 Infection https://doi.org/10.1001/jamacardio.2020.4916 Pooled autopsy https://www.medscape.com/viewarticle/944496 Pathological Evidence for SARS-CoV-2 as a Cause of Myocarditis: JACC Review Topic of the Week https://doi.org/10.1016/j.jacc.2020.11.031 Lake Louise Criteria https://pubmed.ncbi.nlm.nih.gov/30545455/ Recognition and Initial Management of Fulminant Myocarditis A Scientific Statement From the American Heart Association https://doi.org/10.1161/CIR.0000000000000745 Long-Haul Post–COVID-19 Symptoms Presenting as a Variant of Postural Orthostatic Tachycardia Syndrome: The Swedish Experience https://doi.org/10.1016/j.jaccas.2021.01.009 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

Bob Harrington and Mike Gibson continue their review of 2020, discussing the 'riddle wrapped in an enigma' that was the COVID-19 pandemic.

Dr. Bob Harrington, the Chair of the Department of Medicine at Stanford and former American Heart Association President, discusses what it means to be the Chair of a large academic department and the President of a prominent medical nonprofit organization. --- Send in a voice message: https://anchor.fm/tdio/message

Mark-Alan moved to NYC from CT in the fall of 1980 to pursue a career in theatre. He attended two semesters at the American Academy of 'Traumatic' Arts. When he was not invited back for the third semester, he strolled down to the west village and found a Piano Bar to drown his sorrows. It was at 55 Grove St. and was then called the Duplex. A short 2 weeks later, he was working for Rob Hoskins and Erv Raible at Brandy’s, The Duplex and was the first waiter at Don’t Tell Mama when its cabaret room first opened. He quickly moved up the ranks and eventually became a booking manager for the Duplex for 2 1/2 years under the new owners, Rick and Larry. It was during that time that he befriended Bob Harrington - theatre/cabaret critic for NY Night Life, The New York Post and Backstage. M-A became a staple weekend performer at Rose’s Turn (55 Grove St) when it was bought by the Pham family. He is credited for naming the place along with his friend Cayte Thorpe. He is the recipient of 2 Bistro and 4 MAC awards and is (as of last August) a 25 year survivor of leukemia. He is still performing and currently lives in Sarasota, Florida with his husband, Fr. Jeffrey Hamblin, MD and their 2 dogs, Chloé and Grace. Other venues : The Oaks, Judy’s Chelsea, The Stonewall Inn, 88’s. Panache Encore Theatre: Whoop-de-Doo, Moby Dick- A Whale of a Tale w/ Terri White Surflight (7 shows) Theatre by the Sea (2) Hello Dolly Nunsense!

In this episode, Alison Bailey hosts Susan Smyth, Nancy Albert, and Bob Harrington, who are successful clinicians across the cardiovascular spectrum of basic science, clinical cardiology, and nursing science and education, in a discussion about developing a successful career that includes research.

Join us on the Solar-Fit Renewable Energy Show to hear Bill's interview with his long time friend, Mr. Bob Harrington, VP of Business Development Program Division for Enerbank!Bob does an excellent job of explaining how homeowners can invest in a Solar-Fit solar power system for zero money down... and let the utility company savings pay for their new solar system. Great information for folks who want to enjoy the benefits of solar without the upfront expense.Support the show (https://solar-fit.com/contact-us/)

Bob Harrington asks Michelle Albert why mortality rates are so high in minority communities, and whether COVID-19 will lead to meaningful changes in health and social inequities.

Bob Harrington and Mike Gibson continue their review of 2019 with the 'hottest trial of the year' and what to expect in healthcare in 2020.

Hello, everyone! Tune in to the Solar-Fit Renewable Energy Show to hear Bill's interview with Bob Harrington and Ken Ebbert!Listen in as Bob, Ken & Bill discuss topics various topics about solar, including its proliferation across America, and how solar is one of the most common-sense investments you can make for your home.If you're looking into going Solar, this is the episode for you!Support the show (https://solar-fit.com/contact-us/)

I have two guests for this episode:  Luis Vergara and Bob Harrington. Luis brings over 20 years in program and nonprofit management. He was a Strategic Director at the national research and strategy firm Cheskin. He also served as executive director of Youth Radio, a Senior Policy Associate with Safe Passages, and has worked extensively in youth development and gang prevention. He joined La Piana consulting in 2006 where he is now a partner. A native of San Francisco, Luis now lives in San Ramon, CA, with his wife and two teen-aged children. When not working you will find him watching or coaching soccer and lacrosse, supporting the Golden State Warriors, or finding the next trendy food spot in the Bay Area. My second guest is Bob Harrington. Before Bob became a consultant, he worked in the nonprofit social services field for close to 30 years, serving in organizations ranging from small community-based groups to statewide organizations with budgets over $20 million. He has experience as a staff member, administrator, and nonprofit board member. Also a partner with La Piana consulting, Bob has provided consulting services to the nonprofit sector for more than 15 years, drawing on his extensive nonprofit management experience. He has worked with organizations with budgets of $70,000 to those with budgets of over $110 Million. Bob received his Bachelor’s degree in Psychology from the University of California, Davis and his Masters of Social Work degree from the University of Wisconsin at Milwaukee. In his time off, Bob enjoys skiing, hiking, and cycling, and spends as much time as possible in the mountains. In this episode, Bob, Luis and I explore nonprofit strategic alliances, mergers both hands-on experiences with them and trends related to them. Please subscribe and, while you’re at it, rate and review. For more details about me or my work please go to: Hiland Consulting To get the free guide I created for you go to: 6 Steps You Must Do To Unleash The Potential of Your Nonprofit Board. You can learn more about Bob and Luis at La Piana Consulting.

Optimal medical therapy and recent advances show that heart failure is preventable and not obligatory, Clyde Yancy tells Bob Harrington.

GUEST: Bob Harrington of Milspec PlasticsSupport the show (https://www.patreon.com/Mittan)

Despite the vastness of available data, don't forget the basics, warns biostatistician Frank Harrell in this conversation with Bob Harrington.

Dr. Bob Harrington, an interventional cardiologist and Chairman of the Department of Medicine at Stanford University, speaks with Venrock’s Dr. Bob Kocher about his passion for coagulation and thrombosis (seriously, he loves it) and his involvement with Gusto, a clinical trial that changed the way doctors treat heart attack patients. Bob also talks about working with an executive coach to develop new skills, when he found himself managing teams at Duke Clinical Research Institute.

New Orleans evangelist Bob Harrington, known by many as “the Chaplain of Bourbon Street,” died recently. Learn about his long ministry career by listening now.

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

Some feel that the Christian life is boring! But that is because they have never truly experienced it. Living for God can be an awesome experience. Bob Harrington, the “Chaplain of Bourbon Street”, was famous for saying, “It’s fun being saved.” I believe that you can have a great life. I believe that your life can be blessed. However, I also believe that life is a growing process. I believe that there are obstacles to get over and by. There are some great examples in the scriptures of how individuals got over, when around, and defeated these obstacles. These obstacles keep us from living an exciting Christian life. To many of us just get used to being mediocre and live with believing, “I shall not be moved.” Be with us starting July the 6th and 7th and find out how you can say, “It’s fun being saved.”

This week, host Angelo Coppola provides several clips for listeners to enjoy. These include: Food Matters movie trailer, Weston A. Price Foundation, Marion Nestle, Dr. Loren Cordain Q&A, and Dr. Bob Harrington discusses Atkins and low carb with Dr. Eric Westman. Links for this episode:YouTube - ?Food Matters Official Trailer??YouTube - ?Dr Weston A Price??YouTube - ?Weston A Price Foundation - Educational Television??YouTube - ?Marketing Junk Food to Kids - Marion Nestle??YouTube - ?Loren Cordain - Origins and Evolution of the Western Diet: Health Implications for the 21st Century.??#31: Atkins, diet, obesity, and cardiovascular disease risk with Dr Eric Westman

Exponential 2010 Workshop with Bob Harrington. Coaching Planters - How it Works, Why It's Essential.

A series of independent, unsupported programs developed by theheart.org featuring discussions with world renowned cardiologists on the importance of the latest clinical trial findings and cardiology news.