Podcasts about Cardiogram

On this Episode 458 of Health Solutions, Shawn Needham R. Ph. discusses multifunction cardiogram, holistic health and preventing problems with Dr. Marianne Pinkston. 00:00 - Start 00:33 - Dr. Marianne Introduction 01:16 - Dr. Marianne's Background 03:48 - Unhealthy Health Care Professionals 05:53 - Rheumatoid Arthritis 06:51 - Multifunction CardioGram 12:45 - Preventing Problems 14:02 - Cardiovascular Disease 16:25 - Insulin Resistance 17:40 - MTHFR 20:18 - Lab Testing in Traditional Medicine 23:02 - How Insulin Works with Type 2 Diabetes 25:54 - Carbohydrates 27:37 - A Life-Long Struggle 31:08 - Dr. Marianne's Passion 33:00 - Dr. Marianne's Contact Information 33:52 - Closing Comments Episode Resources Facebook ~ https://www.facebook.com/pinkston4life Instagram ~ https://www.instagram.com/drmariannepinkston/ LinkedIn ~ https://www.linkedin.com/in/marianne-pinkston-md-857ba069/ Website ~ https://www.drpbetterlife.com/ EP 458: Doctor Talks About Multifunction Cardiogram with Dr. Marianne Pinkston and Shawn Needham RPh ~ #holistichealth #holistic #healthylifestyle #healthyliving #healthyhabits #multifunctioncardiogram #drpbetterlife #drpinkston #drpinkstonpodcast #drpinkstonyoutube #betterlife #betterlifepodcast #betterlifeyoutube #betterlifenetwork #betterlifetv #thebetterlifewithdrpinkston #podcastshow #podcast #podcastguest #optimalhealth #healthfreedom #MedicalFreedom #medicaleducation #medicalcare #HealthCare #PriceTransparency #freemarket #Liberty #FitAfter50 #FitOver50 #fitover40 #fitafter40 #Boise #IdahoFalls #Tricities #SiouxFalls #Wenatchee #EducateAndEmpower #NeedhamHealthSolutions #TeamNeedham #ShawnNeedham #HealthSolutions #MosesLakeProfessionalPharmacy #MLRX #SickenedTheBook #ShawnNeedhamRPh #ThinkOutsideTheSystem #OptimalHealthMatters #ItsTime ~ *** #BenShapiro & #DaveRamsey Fans. Learn how to be in the driver's seat for your healthcare choices {not the system or doctors!}

Karl Lambert, ARNP and CEO of Pacific Northwest Wellness Center, discusses a new cloud-based solution for analyzing the entire myocardium (heart) as a system: The Multifunction CardioGram (MCG). With heart health concerns and issues at an all-time high, Lambert brings clarity to this new technology that is pre-emptively saving lives. Karl also shares insights and his experience helping people with a myriad of reactions and health issues during the long years of the COVID pandemic, which continues to persist today.

SD214 - Comunidade de prática médica. Este podcast comemora o 1º ano da comunidade digital CardioGram da SD Conecta e, para falar de propósito, resultados, funcionalidades e futuro, Dr. Lorenzo Tomé convida os cardiologistas embaixadores, Dra. Pâmela Cavalcante e o Dr. Joaquim Barreto. A SD Conecta tem como propósito conectar e engajar profissionais para salvar vidas e promover o bem estar através da discussão de casos clínicos e a evolução da prática da saúde. Participe da nossa Comunidade de Cardiologia CardioGram! Acesse AQUI. Neste episódio, o que você vai encontrar: O background da Pâmela Natural de Brasília, fez sua formação na UnB, veio para SP fazer Clínica Médica na Unicamp e depois fez Cardiologia no Instituto Dante Pazzanese. Seu fellow foi no InCor em Valvopatias e Cardiopatias Estruturais, onde atua como médica pesquisadora, além de membro do corpo clínico do Hospital Albert Einstein. Ela conheceu a comunidade via posts de colegas no Instagram. O background do Joaquim Formado pela Unicamp, foi integrante do laboratório de Aterosclerose como aluno de iniciação científica. Fez um estágio na Inglaterra e retornou ao Brasil já para ingressar como aluno do doutorado na Unicamp. Também conheceu a CardioGram através de colegas médicos. Os resultados atuais A CardioGram contava, no dia em que completou 01 ano de atividades com: 9.952 médicos cadastrados; +1.990 posts no feed da comunidade; +7.700 comentários nos posts; +22.900 interações na plataforma. O propósito Discutir casos clínicos em cardiologia; Ajudar o médico que é um Key Opinion Leader a fazer a transição do analógico para o digital; Promover a integração entre os médicos experientes e os nativos digitais com menos experiência profissional; Disponibilizar atualizações científicas em ambiente seguro e de forma dinâmica.  Algumas funcionalidades Notificação para os embaixadores dos pedidos de ajuda, reduzindo o tempo de resposta; Membro pode pedir ajuda no feed de forma anônima; Casos clínicos disponíveis no feed para consulta posterior; Efeito de rede; Compartilhamento de experiências que auxiliam na tomada de decisão, além de outras muitos vantagens. O futuro "...a saúde digital é uma realidade. Acho que quem não existe em alguma plataforma, em alguma rede social, não existe. Você tem, o médico sente essa dor, sente essa necessidade de estar presente. Cada vez mais essas ferramentas. como a plataforma do CardioGram, vai ser o futuro. Você vai conseguir divulgar, fazer conferências, fazer webinares, divulgar trabalhos, gerar discussão de casos clínicos."   Comunidade Online Saúde Digital Podcast Você é médico? Quer interagir com o Lorenzo Tomé e com outros colegas inovadores da medicina digital?  Entre na Comunidade do Podcast Saúde Digital na SD Conecta! Assista este episódio também em vídeo no YouTube no nosso canal Saúde Digital Ecossistema! ACESSE AQUI! Episódios Anteriores - Acesse! SD213 - A Medicina fora dos grandes centros SD212 - Blackbook: App de suporte à decisão SD211 - Reflexões do Host sobre os EUA Músicas: Declan DP - Wanderlust | Declan DP - Joy | Declan DP - Island | Blessed Meditation - Tattooed Preacher "Music © Copyright Declan DP 2018 - Present. https://license.declandp.info | License ID: DDP1590665"

A One-Minute Refresher about doing regular spiritual heart checks. Listen to Refresh & Renew with Dan Longmore weekdays from 2-5 PM on WRGN.

SD184 - Como melhorar a Experiência do Paciente na Telemedicina. Neste podcast, uma conversa com o médico cardiologista, Dr. Cidio Halperin, para falar sobre Telemedicina, percepção do paciente, tecnologia e engajamento médico. Dr. Cidio é um early adopter autêntico, produtor de conteúdos nos mais variados meios de comunicação, ensina tecnologias digitais para médicos e um embaixador da CardioGram, comunidade digital da SD Conecta para médicos e com foco no tema cardiologia. Participe da nossa Comunidade de Cardiologia CardioGram! Acesse AQUI. Conheça os cursos de pós-graduação do Centro Universitário São Camilo. CLIQUE AQUI! Neste episódio, o que você vai encontrar: Um pouco sobre o Cidio Gaúcho. Cardiologista, arritmólogo, eletrofisiologista. Um interessado em tecnologia e com vocação para o empreendedorismo. Medicina e Tecnologia "...a gente acha fundamental que o ecossistema da saúde seja modificado. Que a gente possa centrar nas necessidades do nosso paciente, utilizando a tecnologia para resolver esses problemas." Evolução na Arritmologia Os equipamentos estão cada vez menores e são implantáveis. E a Telemedicina para o paciente? Redução no tempo de agendamento; Redução do tempo: de espera, deslocamento até o local da consulta, estacionamento, etc.; Segurança sanitária; Redução de custo: deslocamento, falta ao trabalho, substituição em tarefas como cuidas dos filhos; Acesso a profissionais que não são encontrados em algumas localidades; Uma certa falta de atenção do médico no momento da consulta. Telemedicina e Resolutividade A percepção do paciente de que ele foi bem atendido leva a uma maior adesão ao tratamento.  A conduta do profissional na Telemedicina Estar preparado para atender ao paciente. Estar focado no paciente durante a consulta. Dar importância real à comunicação verbal e corporal. Cuidar do tipo de linguagem utilizada. Comunidade Digital no apoio aos profissionais "A rede social dedicada, a rede social nichada, focada no profissional de saúde, nas suas necessidades, me parece ser o grande caminho, porque, cada vez mais, nós estamos conectados nas diferentes plataformas... e isso nos permite um acesso rápido e efetivo à informação." Comunidade Online Saúde Digital Podcast Você é médico? Quer interagir com o Lorenzo Tomé e com outros colegas inovadores da medicina digital?  Entre na Comunidade do Podcast Saúde Digital na SD Conecta! Assista este episódio também em vídeo no YouTube no nosso canal Saúde Digital Ecossistema! ACESSE AQUI! Episódios Anteriores - Acesse! SD183 - Tecnologia e a Medicina Baseada em Evidências SD182 - Como iniciar um Negócio Digital SD181 - Blockchain além das Criptomoedas Músicas | Declan DP - We are Here | Declan DP - Spaceship "Music © Copyright Declan DP 2018 - Present. https://license.declandp.info | License ID: DDP1590665" 

SD183 - Tecnologia e a Medicina Baseada em Evidências. Neste podcast, um papo com o médico cardiologista, Dr. José Nunes de Alencar, para falar sobre Medicina baseada em evidências, importância do rigor metodológico, excelência médica, inteligência artificial e futuro. Dr. José Alencar  é uma referência em sua especialidade e um embaixador da CardioGram, comunidade digital da SD Conecta para médicos e com foco no tema cardiologia. Quer encontrar o Dr. Alencar no Twitter e Instagram? Acesse AQUI. Participe da nossa Comunidade de Cardiologia CardioGram! Só acessar por AQUI. Conheça os cursos de pós-graduação do Centro Universitário São Camilo. CLIQUE AQUI! Neste episódio, o que você vai encontrar: Um pouco sobre o José Alencar Cardiologista e Arritmologista, autor do Tratado de ECG e do Manual de Medicina Baseada em Evidências. Ele tem mais de 49K seguidores no Twitter e mais de 100K no Instagram. Fez fellow em Eletrocardiografia em Barcelona com Dr. Antonio Bayes de Luna. Por que Medicina Baseada em Evidência "Acho que é a Medicina baseada em evidências é a maneira que nós temos pra entregar o melhor cuidado para o paciente e assim sermos melhores profissionais." Qual o valor da MBE "...ela vai dizer assim: Olha, esse estudo que você fez para poder definir que o medicamento "x", ele atua nesta doença e atua de maneira efetiva, é um estudo que tem bom rigor metodológico, tem estatística favorável, é significante, tem um apelo clínico importante, vai ter resultado depois e, mais pra o futuro, a gente pode estudar até sobre custo x efetividade dessa terapia..." Valor para o médico Encontrar um nível de excelência e ser reconhecido por isso Tornar-se uma autoridade médica por seu trabalho A crítica O rigor metodológico tira do médico o poder de considerar apenas a sua observação. Embora não seja muito considerada por muitos, essa observação é limitada e tem o menor grau de rigor que existe, dados os inúmeros fatores que podem interferir na cura ou piora de um paciente e que vão além do tratamento prescrito por um médico.  Como avançar? Ajustar a falha de muitas faculdades: a matéria é oferecida como opcional e nos ciclos iniciais quando o aluno ainda não está maduro. Conhecer os vieses que impactam a MBE. Conhecer os vieses nos estudos científicos. MBE e IA: essa associação ajuda? Alimentação adequada com conteúdo de valor, fidedigno, sem interferências e vieses e passível de feedback para melhoria contínua. Valor de Comunidade para a MBE A comunidade digital traz troca de informação entre pares, interação com especialistas autoridade no assunto e é uma ferramenta promissora de busca de conhecimento científico e de maneira consistente. Além de ser democrática e com curadoria garantida. Comunidade Online Saúde Digital Podcast Você é médico? Quer interagir com o Lorenzo Tomé e com outros colegas inovadores da medicina digital?  Entre na Comunidade do Podcast Saúde Digital na SD Conecta! Assista este episódio também em vídeo no YouTube no nosso canal Saúde Digital Ecossistema! ACESSE AQUI! Episódios Anteriores - Acesse! SD182 - Como iniciar um Negócio Digital SD181 - Blockchain além das Criptomoedas SD180 - Cannabis e Psilocibina na Saúde Mental Músicas | Declan DP - Joy | Declan DP - Fireworks "Music © Copyright Declan DP 2018 - Present. https://license.declandp.info | License ID: DDP15 

SD177 - A Tecnologia e a Entrega de Valor na Saúde. Nosso podcast traz mais um tema importante e atual: é melhor entregar valor ou entregar volume na saúde? Nosso convidado é o médico, palestrante, consultor e conselheiro, Dr. Sérgio Ricardo Santos, que nos fala sobre os modelos de remuneração e serviços com base em volume e o valor que esse modelo entrega ao paciente em oposição a uma estrutura de saúde mais preditiva, integrada e baseada em dados. Participe da Comunidade de Cardiologia: a CardioGram! Acesse AQUI! Dica de leitura: O Jogo Infinito - Simon Sinek Aos ouvintes do Saúde Digital Podcast, queremos agradecer pela audiência, desejar muitas bençãos e informar que daremos uma pausa na publicaçao de novos episódios, mas só por um breve período! Estaremos de volta no dia 11/01/2023 com um episódio novíssimo. Até lá, aproveite para ouvir ou revisitar nossos podcasts publicados nas principais plataformas e no You Tube! Neste episódio, o que você vai encontrar: O background do Sérgio Um médico pneumologista, que atuando dentro de uma grande operadora de saúde, a Amil, acabou migrando para a área administrativa, atuando como gestor até chegar a CEO. Antes atuou como professor na Escola Paulista de Medicina, Coordenador da Comissão Paulista de Tabagismo da SPPT e foi em membro  da comissão na SBPT. Hoje Dr. Sérgio atua como consultor e conselheiro de empresas na área de saúde. Value Basic Health Care Pertinência Eficiência Desfecho Experiência. O foco no paciente Compartilhamento de dados e transparência: divulgar os indicadores de resultados dos profissionais de saúde e dos hospitais e oferecer ao paciente um comparativo para que ele escolha os indicativos que sejam valor para ele. E o desfecho A tecnologia em plataformas digitais é cada vez mais necessária para a aquisição e a análise dos dados de desfecho. E a interoperabilidade é fundamental para que os dados sejam compartilhados, trabalhados e, assim, possibilitar a entrega de valor ao paciente. Indo além A análise de dados possibilita a inteligência preditiva ao detectar precocemente a possibilidade do desenvolvimento de uma doença em um paciente, por exemplo. O foco passa a ser o acompanhamento da vida do paciente e não mais um evento isolado. A experiência A experiência do paciente, do modo como é possível no ambiente em que ele estiver, vai determinar o seu engajamento com o tratamento. Comunidade Online Saúde Digital Podcast Você é médico? Quer interagir com o Lorenzo Tomé e com outros colegas inovadores da medicina digital?  Entre na Comunidade do Podcast Saúde Digital na SD Conecta! Assista este episódio também em vídeo no YouTube no nosso canal Saúde Digital Ecossistema! ACESSE AQUI! Episódios Anteriores - Acesse! SD175 - A Arte de Criar um Produto Digital SD174 - Automação digital na saúde SD173 - Oportunidades Digitais na Saúde Emocional Músicas | Declan DP - Spaceship | Declan DP - Island "Music © Copyright Declan DP 2018 - Present. https://license.declandp.info | License ID: DDP1590665"

SD176 - Empreendedorismo nos Distúrbios do Sono. Neste podcast, vamos discutir sobre como a tecnologia pode atuar para melhorar os distúrbios do sono que atingem 45% da população, são subnotificados e se traduzem em um mercado de $500bi. Para falar sobre o tema, a convidada é a Renata Bonaldi, CEO e Cofundadora da startup SleepUp, a 1ª plataforma de terapias digitais validada e aprovada com monitoramento contínuo do sono. Participe da Comunidade de Cardiologia: a CardioGram! Acesse AQUI! Neste episódio, o que você vai encontrar: O background da Renata Renata é formada em engenharia. Atuou na área de tecnologia em grandes multinacionais, coordenando projetos de inovação disruptiva. Morou fora do Brasil por 6 anos, período em que fez seu doutorado na área de tecnologias vestíveis para a saúde e um MBA na Universidade de Manchester, estudando tecnologias vestíveis para doenças crônicas. O distúrbio Uma avaliação equivocada fez com que, por muito tempo, a redução nas horas de sono fosse valorizada como indicativo de produtividade. Mas o resultado real é um impacto direto na concentração, memória, atenção, foco, produtividade e saúde como um todo. Impactos Uma avaliação equivocada fez com que, por muito tempo, a redução nas horas de sono fosse valorizada como indicativo de produtividade. Mas o resultado real é um impacto direto na concentração, memória, atenção, foco, produtividade e saúde como um todo. Alguns dados Durante a pandemia de Covid-19, insônia foi a palavra mais buscada no Google. 22% da população têm insônia crônica. Enquanto a insônia diz respeito ao comportamental, a apneia está associada a uma questão fisiológica e ela atinge 1 em cada 3 pessoas. 10% da população toma remédio para dormir diariamente. Higiene do sono Ter horários regulares; Exposição ao sol; Ir para a cama somente no horário de dormir; Não executar outras atividades em cima da cama. A oportunidade Um problema atingindo metade da população e sem tratamento disponível. Há menos de 500 médicos no Brasil com título em sono e menos de 30 psicólogos com essa especialização. A SleepUp Protocolos clínicos validados e digitalizados em uma plataforma em formato B2C e B2B. É um medicamento digital vendido em farmácia com a terapia cognitivo-comportamental e o pré-diagnóstico domiciliar. A jornada do paciente O cliente recebe do farmacêutico, dentro da farmácia, a indicação da SleepUp como tratamento coadjuvante do medicamento controlado ou é a indicação é feita na triagem nos casos de atendimento clínico feito na farmácia. O produto está disponível em forma de voucher com um código para o cliente comprar e baixar o aplicativo. Comunidade Online Saúde Digital Podcast Você é médico? Quer interagir com o Lorenzo Tomé e com outros colegas inovadores da medicina digital?  Entre na Comunidade do Podcast Saúde Digital na SD Conecta! Assista este episódio também em vídeo no YouTube no nosso canal Saúde Digital Ecossistema! ACESSE AQUI! Episódios Anteriores - Acesse! SD175 - A Arte de Criar um Produto Digital SD174 - Automação digital na saúde SD173 - Oportunidades Digitais na Saúde Emocional Músicas | Declan DP - Raindrop | Declan DP - Star | Declan DP - Wanderlust "Music © Copyright Declan DP 2018 - Present. https://license.declandp.info | License ID: DDP1590665"

SD175 - A Arte de Criar um Produto Digital. Neste podcast, falamos com o Eduardo Alvarez, CEO da ProRadis, sobre softwares de processos digitais, gestão e melhoria da jornada do paciente nos centros de diagnósticos, clínicas e hospitais. Digitalizando a saúde, a ProRadis disponibiliza ao mercado uma plataforma única que entrega desde a gestão contábil, fiscal e financeira até o gerenciamento de imagens, emissões de laudo, entrega de resultados e agendamento de consultas. Participe da Comunidade de Cardiologistas: a CardioGram! Acesse AQUI! Neste episódio, o que você vai encontrar: O background do Eduardo Formado em Informática Biomédica na USP de Ribeirão Preto, ele fez seu mestrado em Ciências Médicas no HC. Eduardo buscou formação em administração, marketing e vendas para aprender a administrar seu negócio. Como surgiu a ProRadis Em 2013, vendo a crescente demanda, Eduardo e dois sócios tiveram a ideia de conectar toda a cadeia de diagnóstico por imagem, como hospitais, serviços diagnósticos e clínicas, em uma única plataforma. Eles desenvolveram um sistema de gestão, depois um PAX, depois processos de faturamento até chegarem em uma switch que atende às demandas integralmente. Os processos Armazenamento de dados acima de 400TB; Capacidade de processamento de todos os dados; Foco no paciente. Valores para o paciente Análise de elegibilidade; Atendimento da recepção adequado; Direcionamento para o serviço correto; Execução adequada do exame , captação e acesso às informações necessárias e o preparo correto. Desenvolvendo um produto "Claro que tem um papel de quem estudou a tecnologia, o desenvolvimento, entende um pouco do mundo administrativo-empresarial de tirar um pouquinho do o que você quer e colocar muito daquilo de o que você precisa."  Agregando valor a um produto A importância do feedback: "Gerar um conflito de ideias é entender o que está se passando por ali e, de fato, entregar aquele produto." Comunidade Online Saúde Digital Podcast Você é médico? Quer interagir com o Lorenzo Tomé e com outros colegas inovadores da medicina digital?  Entre na Comunidade do Podcast Saúde Digital na SD Conecta! Assista este episódio também em vídeo no YouTube no nosso canal Saúde Digital Ecossistema! ACESSE AQUI! Episódios Anteriores - Acesse! SD174 - Automação digital na saúde SD173 - Oportunidades Digitais na Saúde Emocional SD172 - Cirurgia Robótica: novas tecnologias para o tratamento de hiperplasia benigna de próstata Músicas | Declan DP & KODOMOi - Raindrop | Declan DP - Story | Declan DP - We are Here "Music © Copyright Declan DP 2018 - Present. https://license.declandp.info | License ID: DDP1590665"

Rapha Rossi e Mateus Prata discutem derrame pericárdico em 4 tópicos para você aprender ou relembrar o manejo: causas, investigação, derrame com repercussão e derrame sem repercussão. Imagine uma plataforma gratuita onde você pode trocar experiências, pedir segundas opiniões e até mesmo agendar discussões com importantes nomes da cardiologia nacional. Pois é. Se inscrevam no Cardiogram e acompanhe nossas discussões!! Link: https://sdconecta.com/cardiogram/create?invite=A7UK. Introdução (00:00) Causas Derrame Pericárdico (02:20) Investigação Complementar (05:50) Manejo Derrame com Instabilidade (14:40) Manejo Derrame Sem instabilidade (18:30) Consideracoes Finais (22:30)

Wojciech Zaremba tells the story of an odd consort and an Ecuadoran centaurea.

A cry for help from a 70-year-old physician living in a wealthy country. Hi Bob, I wanted to tell you about my experiences with the bad effect of the Covid vaccine on me. 1. I was vaccinated twice with AstraZeneca as a result of pressure from family. I did not take a booster. 2. Despite having normal blood pressure, blood sugars (on Metformin), normal cholesterol (on statins) and on Eliquis (blood thinner), on February 9th, I woke up with severe chest pain around 7 AM. 3. Ambulance was in my bedroom within 10 minutes 4. Cardiogram showed ST-elevation heart attack (n.b. severe type that is frequently fatal)5. Rushed to the hospital and my cardiologist was already waiting for me6. Cardiac stents were used to open my coronary arteries within an hour 7. I saw the blood flow return immediately and the ST elevation and pain went away 8. Troponin (heart enzyme) was zero after 1 week9. Back to work after 1 week Also, my hearing had deteriorated dramatically since the vax. I now have trouble living without a hearing aid. My staff had to shout for me to hear them. RegardsSamDear Sam:Jeez, you knew the truth from my emails, and yet you bowed to idiots. You now know why I call it the clot shot. You got lucky.  The vax is a purpose-designed bioweapon that, like the virus, is being used for genocide. The criminality proven by the Pfizer data dump destroys any of the jab's credibility for treatment or prevention of disease. By the second month after its release, the company knew their injection was going to murder millions worldwide—by then, they had killed 1200 in the US alone—yet they proceeded anyway. Worse: the FDA approved it for babies. The evidence it is evil includes the VAERS database, military records, country comparisons, and insurance data that shows vastly increased population-wide fatalities. Deaths are up by a stunning 40 percent overall and far more in younger people. You damaged your immunity by getting jabbed. So now your chance of dying from COVID and other causes is higher. Vax damage involves multiple organ systems—heart, brain, circulatory system, and general inflammatory conditions that may continue years later. Lots of my friends have died and some had terrible strokes. Your experience is hardly unique. Well, I don't want to lose you. Ignore the advice of jackasses from now on. BestRobert See RobertYoho.substack.com for the complete essay. See RobertYohoAuthor.com to learn about my books, Butchered by “Healthcare” and Hormone Secrets. My essay with links to COVID treatment and more is HERE. “LEGAL” DISCLAIMER: Use this information at your own risk. It is general commentary and not medical advice. Robert Yoho is retired and no longer practices medicine. Make your healthcare decisions with the help of a physician or other licensed provider. Support the show

Today Howie called and said the FBI believes my life is in danger. Cardiogram tells me that spiked my heart rate from 70 to 95 but that's nothing compared to last Wednesday when it went to 143 for no apparent reason, so all in all, I think I'm taking the news pretty well.   Our attorney, Heather Hintz, in OKC said the FBI there intercepted something to make them think I'm in imminent danger, so they contacted the FBI here, who are supposed to call Howie and I later today.  They don't want us to tell anyone because they want to catch the person and use their testimony to put Joe Schreibvogel away for a while.   I think the police are totally inept, so the very fact that they know something is about to happen, means the person doing it is really sloppy and stupid, which means catching them should be pretty easy.   Meanwhile, Howie doesn't want me to tell anyone, and doesn't want me out on property, or coming and going from the property, so I'm feeling like I'm the prisoner here.   Hi, I'm Carole Baskin and I've been writing my story since I was able to write, but when the media goes to share it, they only choose the parts that fit their idea of what will generate views.  These are my views and opinions. If I'm going to share my story, it should be the whole story.  The titles are the dates things happened. If you have any interest in who I really am please start at the beginning of this playlist: http://savethecats.org/   I know there will be people who take things out of context and try to use them to validate their own misconception, but you have access to the whole story.  My hope is that others will recognize themselves in my words and have the strength to do what is right for themselves and our shared planet.     You can help feed the cats at no cost to you using Amazon Smile! Visit BigCatRescue.org/Amazon-smile   You can see photos, videos and more, updated daily at BigCatRescue.org   Check out our main channel at YouTube.com/BigCatRescue   Music (if any) from Epidemic Sound (http://www.epidemicsound.com) This video is for entertainment purposes only and is my opinion.  Closing graphic with permission from https://youtu.be/F_AtgWMfwrk

Today we bring you the second half of Harry's conversation with Dave deBronkart, better known as E-Patient Dave for all the work he's done to help empower patients to be more involved in their own healthcare. If you missed Part 1 of our interview with Dave, we recommend that you check that out before listening to this one. In that part, we talked about how Dave's own brush with cancer in 2007 turned him from a regular patient into a kind of super-patient, doing the kind of research to find the medication that ultimately saved his life. And we heard from Dave how the healthcare system in the late 2000s was completely unprepared to help consumers like him who want to access and understand their own data.Today in Part 2, we'll talk about how all of that is gradually changing, and why new technologies and standards have the potential to open up a new era of participatory medicine – if, that is, patients are willing to do a little more work to understand their health data, if innovators can get better access to that data, and if doctors are willing to create a partnership with the patients over the process of diagnosis and treatment.Please rate and review The Harry Glorikian Show on Apple Podcasts! Here's how to do that from an iPhone, iPad, or iPod touch:1. Open the Podcasts app on your iPhone, iPad, or Mac. 2. Navigate to The Harry Glorikian Show podcast. You can find it by searching for it or selecting it from your library. Just note that you'll have to go to the series page which shows all the episodes, not just the page for a single episode.3. Scroll down to find the subhead titled "Ratings & Reviews."4. Under one of the highlighted reviews, select "Write a Review."5. Next, select a star rating at the top — you have the option of choosing between one and five stars. 6. Using the text box at the top, write a title for your review. Then, in the lower text box, write your review. Your review can be up to 300 words long.7. Once you've finished, select "Send" or "Save" in the top-right corner. 8. If you've never left a podcast review before, enter a nickname. Your nickname will be displayed next to any reviews you leave from here on out. 9. After selecting a nickname, tap OK. Your review may not be immediately visible.That's it! Thanks so much.Full TranscriptHarry Glorikian: Hello. I'm Harry Glorikian.Welcome to The Harry Glorikian Show, the interview podcast that explores how technology is changing everything we know about healthcare.Artificial intelligence.Big data.Predictive analytics.In fields like these, breakthroughs are happening much faster than most people realize. If you want to be proactive about your own healthcare and the healthcare of your loved ones, you'll need to some of these new tips and techniques of how medicine is changing and how you can take advantage of all the new options.Explaining this approaching world is the mission of the new book I have coming out soon, The Future You. And it's also our theme here on the show, where we'll bring you conversations with the innovators, caregivers, and patient advocates who are transforming the healthcare system and working to push it in positive directions.In the previous episode we met Dave deBronkart, better known as E-Patient Dave for all the work he's done to help empower patients to be more involved in their own healthcare. If you missed it, I'm gonna recommend that you listen to the first discussion, and then come back here.We talked about how Dave's own brush with cancer in 2007 turned him from a regular patient into a kind of super-patient, doing the kind of research to find the medication that ultimately saved his life. And we heard from Dave how the healthcare system in the late 2000s was completely unprepared to help consumers like him who want to access and understand their own data.Today in Part 2, we'll talk about how all of that is gradually changing, and why new technologies and standards have the potential to open up a new era of participatory medicine – if, that is, patients are willing to do a little more work to understand their health data, if innovators can get better access to that data, and if doctors are willing to create a partnership with the patients over the process of diagnosis and treatment.We'll pick up the conversation at a spot where we were talking about that control and the different forms it's taken over the years.Harry Glorikian: You've observed like that there's some that there's this kind of inversion going on right now where for centuries doctors had sole control over patient data and sole claims to knowledge and authority about how patients should be treated. But now patients may have more detailed, more relevant and more up to date data than your doctors does. Right. You've talked about this as a Kuhnian paradigm shift, if I remember correctly, where patients are the anomalies, helping to tear down an old paradigm, you know. Walk us through the history here. What was the old paradigm and what's the new paradigm and what are you some of your favorite examples of this paradigm shift?Dave deBronkart: Well, so I want to be clear here. I have the deepest admiration for doctors, for physicians and for licensed practitioners at all levels for the training that they went through. I don't blame any of this on any of them. I did a fair amount of study about what paradigms are Thomas Kuhn's epic book The Structure of Scientific Revolutions, like discovering that the Earth isn't the center of the solar system and things like that. The paradigm is an agreement in a scientific field about how things work. And it is the platform, the theoretical model on which all research and further study is done. And these anomalies arise when scientists operating in the field keep finding outcomes that disagree with what the paradigm says. So in the case of the planets circling the earth and the how the solar system works. They discovered that Mars and other planets all of a sudden would stop orbiting and when they would do a little loop de loop. I mean, that's what they observed. And they came up with more and more tortured explanations until finally, finally, somebody said, hey, guess what? We're all orbiting the sun. Now, the paradigm inn health care has been that the physician has important knowledge. Lord knows that's true. The physician has important knowledge and the patient doesn't and can't. Therefore, patient should do as they're told, so called compliance, and should not interfere with the doctors doing their work. Well, now along comes things like all of those things that I mentioned that the patient community told me at the beginning of my cancer. None of that is in the scientific literature. Even here, 15 years later, none of it's in the literature. What's going on here? Here's that first clunk in the paradigm. Right. And we have numerous cases of patients who assisted with the diagnosis. Patients who invented their own treatment. And the shift, the improvement in the paradigm that we have to, where just any scientific thinker -- and if you want to be a doctor and you don't want to be a scientific thinker, then please go away -- any scientific thinker has to accept is that it's now real and legitimate that the patient can be an active person in healthcare.Dave deBronkart: Yeah, I mean, you've said you don't have to be a scientist or a doctor anymore to create a better way to manage a condition. So, I mean, it's interesting, right? Because I always think that my doctor and I are partners in this together.Dave deBronkart: Good participatory medicine. Perfect.Harry Glorikian: You know, he has knowledge in certain places I definitely don't. But there are things where him and I, you know, do talk about things that were like, you know, we need to look into that further. Now, I'm lucky I've got a curious doctor. I found somebody that I can partner with and that I can think about my own health care in a sort of different way. But I mean, sometimes he doesn't have all the answers and we have to go search out something. You know, I was asking him some questions about HRV the other day that, you know, he's like, huh, let me let me ask a few cardiologists, you know, to get some input on this. So do you see that, I mean, I see that as the most desired outcome, where a patient can have their record. They're not expected to go and become a physician at that level of depth, but that the physicians who also have the record can work in a participatory way with the patient and get to a better outcome.Dave deBronkart: Exactly. And the other thing that's happened is and I've only recently in the last year come to realize we are at the end of a century that is unique in the history of humanity until science got to a certain point in the late 1800s, most doctors, as caring as they were, had no knowledge of what was going wrong in the body with different diseases. And then and that began a period of many decades where doctors really did know important things that patients had no access to. But that era has ended. All right, we now have more information coming out every day than anyone can be expected to keep up with. And we now are at a point also where we've seen stories for decades of patients who were kept alive. But at what cost? Right. Well, and we now we are now entering the point where the definition of best care cannot be made without involving the patient and their priorities. So this is the new world we're evolving into, like and Dr. Sands wears a button in clinic that says what matters to you?Harry Glorikian: So I mean, one of the other, based on where you're going with this, I think is you know, there are some movements that have been arising over the years. I don't know, maybe you could talk about one of them, which is OpenAPS. It's an unregulated, open source project to build an artificial pancreas to help people with type 1 diabetes. And I think it was Erich von Hippel's work on patient driven innovation. I talk in my book about, and I ask whether we should be training people to be better patients in the era of, say, A.I. and other technologies. What do you think could be done better to equip the average patient with to demand access to patient data, ask their doctors more important questions, get answers in plain English. You know, be more collaborative. What do you think is going to move us in that direction faster or more efficiently, let's say?Dave deBronkart: Well, I want to be careful about the word better, because I'm very clear that my preferences are not everyone's preferences. Really, you know, autonomy means every person gets to define their own priorities. And another thing is one of the big pushbacks from the hospital industry over the last 10 years as medical records, computers were shoved down their throats along with the mandate that they have to let patients see their data in the patient portal was a complaint that most patients aren't interested. Well, indeed, you know, I've got sorry news for you. You know, when I worked in the graphic arts industry, I worked in marketing, people don't change behavior or start doing something new until they've got a problem. If it's fun or sexy, you know, then they'll change, they'll start doing something new. What we need to do is make it available to people. And then when needs arise, that gets somebody's attention and they're like, holy crap, what's happening to my kid? Right. If they know that they can be involved, then they can start to take action. They can learn how to take action. It's having the infrastructure available, having the app ecosystem start to grow, and then just having plain old awareness. Who knows? Maybe someday there will be a big Hollywood movie where people where people learn about stories like that and. You know, from that I mean that I think nature will take its course.Harry Glorikian: Well, it's interesting because I recently interviewed a gentleman by the name of Matthew Might. He's a computer scientist who became a surrogate patient advocate for his son, Bertrand, who had a rare and undiagnosed genetic disorder that left him without an enzyme that breaks down junk protein in the cells. But he, you know, jumped in there. He did his own research found in over-the-counter drug, Prevacid of all drugs., that could help with Bertrand's deficiency. But, I mean, Dave, you know, Matt is a, he was a high-powered computer scientist who wasn't afraid to jump in and bathe in that, you know. Is that the type of person we need? Is that a cautionary tale, or an inspiring tale? How do you think about that?Dave deBronkart: Desperate people will bring whatever they have to the situation. And this is no different from, you know, there have been very ordinary people who had saved lives at a car crash because they got training about how to on how to stop bleeding as a Boy Scout. You know, it is a mental trap to say, "But you're different." Ok. Some people said, "Well, Dave, you're an MIT graduate, my patients aren't like you." And people say, well, yeah, but Matt Might is a brilliant PhD type guy. What you mentioned few minutes before gives the lie to all of that, the OpenAPS community. All right, now, these are people you need to know appreciate the open apps world. You need to realize that a person with type 1 diabetes can die in their sleep any particular night. You know, they can even have an alarm, even if they have a digital device connected with an alarm, their blood sugar can crash so bad that they can't even hear the alarm. And so and they got tired of waiting the industry. Year after year after year, another five years will have an artificial pancreas, another five years, and a hashtag started: #WeAreNotWaiting. Now, I am I don't know any of the individuals involved, but I'll bet that every single diabetes related executive involved in this thought something along the lines of, "What are they going to do, invent their own artificial pancreas?" Well, ha, ha, ha, folks. Because as I as I imagine, you know, the first thing that happened was this great woman, Dana Lewis, had a digital insulin pump and a CGM, continuous glucose meter, and her boyfriend, who's now her husband, watched her doing the calculation she had to do before eating a hamburger or whatever and said, "I bet I could write a program that would do that."Dave deBronkart: And so they did. And one thing led to another. His program, and she had some great slides about this, over the course of a year, got really good at predicting what her blood sugar was going to be an hour later. Right. And then they said, "Hmm, well, that's interesting. So why don't I put that in a little pocket computer, a little $35 pocket computer?" The point is, they eventually got to where they said, let's try connecting these devices. All right. And to make a long story short, they now have a system, as you said, not a product, they talked to the FDA, but it's not regulated because it's not a product. Right. But they're not saying the hell with the FDA. They're keeping them informed. What are the scientific credentials of Dana Lewis and her boyfriend, Scott? Dana is a PR professional, zero medical computer or scientific skills? Zero. The whole thing was her idea. Various other people got involved and contributed to the code. It is a trap to think that because the pioneering people had special traits, it's all bogus. Those people are lacking the vision to see what the future you is going to be. See, and the beautiful thing from a disruptive standpoint is that when the person who has the problem gains access to power to create tools, they can take it in whatever direction they want. That's one of the things that happened when typesetting was killed by desktop publishing.Harry Glorikian: Right.Dave deBronkart: In typesetting, they said "You people don't know what you're doing!" And the people said, whatever, dude, they invented Comic Sans, and they went off and did whatever they wanted and the world became more customer centered for them.Harry Glorikian: So. You know, this show is generally about, you know, data, Machine learning and trying to see where that's going to move the needle. I mean, do you see the artificial intelligence umbrella and everything that's under that playing a role to help patients do their own research and design their own treatments?Dave deBronkart: Maybe someday, maybe someday. But I've read enough -- I'm no expert on AI, but I've read enough to know that it's a field that is full of perils of just bad training data sets and also full of immense amounts of risk of the data being misused or misinterpreted. If you haven't yet encountered Cathy O'Neil, she's the author of this phenomenal book, Weapons of Math Destruction. And she said it's not just sloppy brain work. There is sloppy brain work in the mishandling of data in A.I., but there is malicious or ignorant, dangerously ignorant business conduct. For instance, when companies look at somebody who has a bad credit rating and therefore don't give them a chance to do this or this or this or this, and so and they actually cause harm, which is the opposite of what you would think intelligence would be used for.Harry Glorikian: So but then, on the opposite side, because I talk about some of these different applications and tools in in the book where, you know, something like Cardiogram is able to utilize analytics to identify, like it alerted me and said "You know, you might have sleep apnea." Right. And it can also detect an arrhythmia, just like the Apple Watch does, or what's the other one? Oh, it can also sort of alert you to potentially being prediabetic. Right. And so you are seeing, I am seeing discrete use cases where you're seeing a movement forward in the field based on the analytics that can be done on that set of data. So I think I don't want to paint the whole industry as bad, but I think it's in an evolutionary state.Dave deBronkart: Absolutely. Yes. We are at the dawn of this era, there's no question. We don't yet have much. We're just going to have to discover what pans out. Really, I. Were you referring to the Cardia, the Acor, the iPhone EKG device a moment ago?Harry Glorikian: No, there's there's actually an, I've got one here, which is the you know...Dave deBronkart: That's it. That's the mobile version. Exactly. Yeah. Now, I have a friend, a physician friend at Beth Israel Deaconess, who was I just rigidly absolutely firmly trust this guy's brain intelligence and not being pigheaded, he was at first very skeptical that anything attached to an iPhone could be clinically useful. But he's an E.R. doc and he now himself will use that in the E.R. Put the patient's fingers on those electrodes and and send it upstairs because the information, when they're admitting somebody in a crisis, the information gets up there quicker than if he puts it in the EMR.Harry Glorikian: Well, you know, I always try to tell people like these devices, you know, they always say it's not good enough, it's not good enough. And I'm like, it's not good enough today. But it's getting better tomorrow and the next day. And then they're going to improve the sensor. And, yep, you know, the speed of these changes is happening. It's not a 10 year shift. It's it's happening in days, weeks, months, maybe years. But, you know, this is a medical device on my arm as far as I'm concerned.Harry Glorikian: It's a device that does medical-related things. It certainly doesn't meet the FDA's definition of a medical device that requires certification and so on. Now, for all I know, maybe two thirds of the FDA's criteria are bogus. And we know that companies and lobbyists have gamed the system. It's an important book that I read maybe five years ago when it was new, was An American Sickness about the horrifying impacts of the money aspect of health care. And she talked about, when she was talking specifically about device certification, she talked about how some company superbly, and I don't know if they laughed over their three martini lunch or what, some company superbly got something approved by the FDA as saying, we don't need to test this because it's the same as something else.Harry Glorikian: Ok, equivalence.Dave deBronkart: And also got a patent on the same thing for being completely new. Right. Which is not possible. And yet they managed to win the argument in both cases. So but the this is not a medical device, but it is, gives me useful information. Maybe we should call it a health device.Harry Glorikian: Right. Yeah, I mean, there are certain applications that are, you know, cleared by the FDA right now, but, you know, I believe what it's done is it's allowing these companies to gather data and understand where how good the systems are and then apply for specific clearances based on when the system gets good enough, if that makes sense.Dave deBronkart: Yes. Now, one thing I do want to say, there's an important thing going on in the business world, those platforms. You know, companies like Airbnb, Uber, whatever, where they are, a big part of their business, the way they create value is to understand you better by looking at your behavior and not throwing so much irrelevant crap at you. Now, we all know this as it shows up. As you know, you buy something on Amazon and you immediately get flooded by ads on Facebook for the thing that you already bought, for heaven's sake. I mean, how stupid is that? But anyway, I think it's toxic and should be prohibited by law for people to collect health data from your apps and then monetize it. I think that should be completely unacceptable. My current day job is for this company called Pocket Health, where they collect a patient's radiology images for the patient so the patient can have 24/7 access in the cloud. And when I joined there, a friend said, oh, I gather they must make their money by selling the data. Right? And I asked one of the two founding brothers, and he was appalled. That's just not what they do. They have another part of the company. And anybody who gets any medical device, any device to track their health should make certain that the company agrees not to sell it.[musical interlude]Harry Glorikian: Let's pause the conversation for a minute to talk about one small but important thing you can do, to help keep the podcast going. And that's to make it easier for other listeners discover the show by leaving a rating and a review on Apple Podcasts.All you have to do is open the Apple Podcasts app on your smartphone, search for The Harry Glorikian Show, and scroll down to the Ratings & Reviews section. Tap the stars to rate the show, and then tap the link that says Write a Review to leave your comments. It'll only take a minute, but you'll be doing us a huge favor.And one more thing. If you like the interviews we do here on the show I know you'll   like my new book, The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer.It's a friendly and accessible tour of all the ways today's information technologies are helping us diagnose diseases faster, treat them more precisely, and create personalized diet and exercise programs to prevent them in the first place.The book is now available for pre-order. Just go to Amazon and search for The Future You, Harry Glorikian.Thanks. And now back to our show.[musical interlude]Harry Glorikian: You mentioned FHIR or, you know, if I had to spell it out for people, it's Fast Healthcare Interoperability Resource standard from, I think, it's the Health Level 7 organization. What is FHIR? Where did it come from and what does it really enable?Dave deBronkart: So I'll give you my impression, which I think is pretty good, but it may not be the textbook definition. So FHIR is a software standard, very analogous to HTTP and HTML for moving data around the same way those things move data around on the Web. And this is immensely, profoundly different from the clunky, even if possible, old way of moving data between, say, an Epic system, a Cerner system, a Meditech system nd so on. And the it's a standard that was designed and started five or six years ago by an Australian guy named Graham Grieve. A wonderful man. And as he developed it, he offered it to HL7, which is a very big international standards organization, as long as they would make it free forever to everyone. And the important thing about it is that, as required now by the final rule that we were discussing, every medical record system installed at a hospital that wants to get government money for doing health care for Medicare or Medicaid, has to have what's called a FHIR endpoint. And a FHIR endpoint is basically just a plug on it where you can, or an Internet address, the same way you can go to Adobe.com and get whatever Adobe sends you, you can go to the FHIR endpoint with your login credentials and say, give me this patient's health data. That's it. It works. It already works. That's what I use in that My Patient Link app that I mentioned earlier.Harry Glorikian: So just to make it clear to someone that say that's listening, what does the average health care consumer need to know about it, if anything, other than it's accessible? And what's the part that makes you most excited about it?Harry Glorikian: Well, well, well. What people need to know about it is it's a new way. Just like when your hospital got a website, it's a new way for apps to get your data out of the hospital. So when you want it, you know that it has to be available that way. Ironically, my hospital doesn't have a FHIR endpoint yet. Beth Israel Deaconess. But they're required to by the end of the year. What makes me excited about it is that... So really, the universal principle for everything we've discussed is that knowledge is power. More precisely, knowledge enables power. You can give me a ton of knowledge and I might not know what to do with it, but without the knowledge, I'm disempowered. There's no dispute about that. So it will become possible now for software developers to create useful tools for you and your family that would not have been possible 15 years ago or five years ago without FHIR. In fact, it's ironic because one of the earliest speeches I gave in Washington, I said to innovators, data is fuel. Right. We talked about Quicken and Mint. Quicken would have no value to anybody if they couldn't get at your bank information. Right. And that's that would have prevented. So we're going to see new tools get developed that will be possible because of FHIR and the fact that the federal regulations require it.Harry Glorikian: Yeah, my first one of my first bosses actually, like the most brilliant boss, I remember him telling me one at one time, he goes, "Remember something: Knowledge is power." I must have been 19 when he told me that. And I was, you know, it took me a little while to get up to speed on what he meant by that. But so do you believe FHIR is a better foundation for accessing health records than previous attempts like Google Health or Microsoft Health Vault?Dave deBronkart: Well, those are apples and oranges. FHIR is a way of moving the data around. Several years into my "Give me my damn data" campaign, I did a blog post that was titled I Want a Health Data Spigot. I want to be able to connect the garden hose to one place and get all my data flowing. Well, that's what FHIR is now. What's at the other end of the hose? You know, different buckets, drinking glasses, whatever. That's more analogous to Google Health and Health Vault. Google Health and Health Vault might have grown into something useful if they could get all the important information out there, which it turns out was not feasible back then anyway. But that's what's going to happen.Harry Glorikian: What is the evolution you'd like to see in the relationship between the patient and the U.S. health care systems? You know, you once said the key to be would get the money managers out of the room. You know, if you had to sort of think about what you'd want it to evolve to, what would it be?Dave deBronkart: Well, so. There are at least two different issues involved in this. First of all, in terms of the practice of medicine, the paradigm of patient that I mentioned, collaboration, you know, collaboration, including training doctors and nurses on the feasibility and methods of collaboration. How do you do this differently? That won't happen fast because the you know, the I mean, the curriculum in medical schools doesn't change fast. But we do have mid career education and we have people learning practical things. So there's a whole separate issue of the financial structure of the U.S. health system, which is the only one I know in the world that is composed of thousands of individual financially separate organizations, each of which has managers who are required by law to protect their own finances. And the missing ingredient is that as all these organizations manage their own finances, nobody anywhere is accountable for whether care is achieved. Nobody can be fired or fined or put out of business for failing to get the patient taken care of as somebody should have. And so those are those are two separate problems. My ideal world is, remember a third of the US health care spending is excess and somebody a couple of years ago...Guess what? A third of the US health care spending is the insurance companies. Now, maybe the insurance companies are all of the waste. I don't know. I'm not that well-informed. But my point is there is plenty of money there already being spent that would support doctors and nurses spending more time with you and me beyond the 12 or 15 minutes that they get paid for.Harry Glorikian: So it's interesting, right? I mean, the thing that I've sort of my bully pulpit for, for a long time has been, once you digitize everything, it doesn't mean you have to do everything the same way. Which opens up, care may not have to be given in the same place. The business model may now be completely open to shift, as we've seen with the digitization of just about every other business. And so I you know, I worry that the EMRs are holding back innovation and we're seeing a lot of innovation happen outside of the existing rubric, right, the existing ivory towers, when you're seeing drug development using A.I. and machine learning, where we're seeing imaging or pathology scans. I mean, all of those are happening by companies that are accessing this digitized data and then providing it in a different format. But it's not necessarily happening inside those big buildings that are almost held captive by the EMR. Because if you can't access the data, it's really hard to take it to that next level of analytics that you'd like to take it to.Dave deBronkart: Yes, absolutely.Harry Glorikian: I mean, just throwing that out there, I know we've been talking about the system in particular, but I feel that there's the edges of the system aren't as rigid as they used to be. And I think we have a whole ecosystem that's being created outside of it.Harry Glorikian: Absolutely. And the when information can flow you get an increasing number of parties who can potentially do something useful with it, create value with it. And I'm not just talking about financial value, but achieve a cure or something like that. You know, interestingly, when the industry noticed what the open apps people were doing, all of a sudden you could no longer buy a CGM that had the ability to export the data.Harry Glorikian: Right.Dave deBronkart: Hmm. So somebody is not so happy about that. When an increasing number of people can get out data and combine it with their other ideas and skills and try things, then the net number of new innovations will come along. Dana Lewis has a really important slide that she uses in some presentations, and it ties in exactly with Erich von Hippel's user driven innovation, which of course, shows up in health care as patient driven innovation. The traditional industrial model that von Hippel talks about is if you're going to make a car, if you're going to be a company going into the car business, you start by designing the chassis and doing the wheels and designing the engine and so on and so on. And you do all that investment and you eventually get to where you've got a car. All right. Meanwhile, Dana shows a kid on a skateboard who can get somewhere on the skateboard and then somebody comes up with the idea of putting a handle on it. And now you've scooter. Right. And so on. The user driven innovations at every moment are producing value for the person who has the need.Harry Glorikian: Right. And that's why I believe that, you know, now that we've gotten to sort of that next level of of datafication of health care, that these centers have gotten cheaper, easier, more accessible. You know, like I said, I've got a CGM on my arm. Data becomes much more accessible. FHIR has made it easier to gain access to my health record. And I can share it with an app that might make that data more interpretable to me. This is what I believe is really sort of moving the needle in health care, are people like Matthew Might doing his own work where it's it's changing that. And that's truly what I try to cover in the book, is how these data [that] are now being made accessible to patients gives them the opportunity to manage their own health in a better way or more accurately and get ahead of the warning light going on before the car breaks down. But one of the things I will say is, you know, I love my doctor, but, you know, having my doctor as a partner in this is makes it even even better than rather than just me trying to do anything on my own. Dave deBronkart: Of course, of course. Dr. Sands is fond of saying "I have the medical training or diagnosis and treatment and everything, but Dave's the one who's the expert on what's happening in his life." Right. And and I'm the expert on my own priorities.Harry Glorikian: Right. Which I can't expect. I mean, my doctor has enough people to worry about, let alone like, me being his sole, the only thing he needs to think about. So, Dave, this was great. It was great having you on the show. I hope this is one of many conversations that we can have going forward, because I'm sure there's going to be different topics that we could cover. So I appreciate you taking the time and being on the show.Dave deBronkart: Well, and same to you. The this has been a very stimulating I mean, and the you've got the vision of the arriving future that is informed by where we're coming from, but not constrained by the old way of thinking. And that really matters. The reality, the emerging reality, whether anybody knows it or not, is that people with a big problem are able to act now in ways that they weren't before. I mean, another amazing example is a guy in England named Tal Golesworthy has Marfan syndrome. And one problem that people with Marfan syndrome face is aortic dissection. The walls of the aorta split open and it can be pretty quickly fatal. And he describes himself in his TED talk as a boiler engineer. And he says when we have a weak pipe, we wrap it. So he came up with the idea of exporting his CAT scan data or the MRI data of his beating heart and custom printing a fabric mesh to wrap around his aorta. And it's become and medically accepted treatment now. Harry Glorikian: That's awesome, right.Dave deBronkart: This is the data in the hands of somebody with no medical training, just. But see, that's the point. That's the point. He enabled by the data, is able to create real value, and it's now an accepted treatment that's called PEARS and it's been done hundreds of times. And, you know, here's a beautiful, it's sort of like the Dana Lewis skateboard scooter progression, years later, a subsequent scan discovered something unexpected. The mesh fabric has migrated into the wall of his aorta. So he hadn't he now has a know what doctor, what hospital, what medical device company would have ever dreamed of trying to create that? That's the beauty of liberation when data gets into the hands of the innovators.Harry Glorikian: Well, that's something that everybody can take away from today is at least thinking about their data, how it can help them manage their health better or their life better. Obviously, I always say, in cahoots with your doctor, because they have very specific knowledge, but having the data and managing yourself is better than not having the data and not understanding how to manage yourself. So on that note, Dave, thank you so much for the time today. It was great.Dave deBronkart: Thank you very much. See you next time.Harry Glorikian:That's it for this week's episode. You can find past episodes of The Harry Glorikian Show and MoneyBall Medicine at my website, glorikian.com, under the tab Podcasts.Don't forget to go to Apple Podcasts to leave a rating and review for the show.You can find me on Twitter at hglorikian. And we always love it when listeners post about the show there, or on other social media. Thanks for listening, stay healthy, and be sure to tune in two weeks from now for our next interview.

2:02 - Talking about my iPad Pro video and that "wrong keyboard" order 8:07 - How has the pandemic affected DAILYTEKK? 11:44 - Getting to the Apple news... 11:54 - Will iPhone 12 be released on time? 12:41 - Netflix and YouTube limiting streaming quality in Europe... 15:30 - With WWDC kinda in limbo... let's talk about upcoming software changes! 25:27 - Why (how) are cameras in Macs still this terrible?! 27:29 - How Apple's gonna do smart glasses without a camera... 32:32 - Conan is now shooting from home on an iPhone... 34:44 - Cardiogram on your Apple Watch and monitoring COVID-19 35:49 - Apple released new colors for iPhone & iPad cases, Apple Watch bands... 37:15 - You can now share iTunes movies with friends? 39:18 - Will the government use our phone location data to track COVID-19? 43:04 - Apple closed all it's retail stores "indefinitely" 45:01 - Movies are coming directly to our homes and skipping theatures now... 47:07 - 8 Apple products make the list of the top 100 greatest modern designs 48:57 - Somethig to do while you're stuck at home....

What’s the condition of your heart today? The one specific sign that our hearts are beating in a healthy rhythm with Jesus Christ is if we have a seeking heart.

A Cardiogram, uma App que analisa o ritmo cardíaco através de smartwatches como o Apple Watch, lançou um novo serviço de subscrição que permite monitorizar familiares e amigos com problemas cardíacos. Os dados que podem ser partilhados incluem o ritmo cardíaco, a qualidade do sono e atividade física, permitindo intervir, atempadamente, sempre que forem detetados valores fora do normal. Saiba mais sobre inovação e nova economia em supertoast.pt.

Este jueves hablamos con Martín Errante, de Motorola, por el teléfono One Vision y para tener un panorama del mercado local; de los 40 años del Walkman; también, de la inusualmente larga caída de Whatsapp, Instagram y Facebook; de la partida de Jony Ive de Apple; de la unión de Fitbit con Cardiogram para tener mejor información sobre tu corazón; de que EEUU levantó el bloqueo a Huawei (pero no tanto) y la compañía ahora se hace la ofendida.Acá, el audio para escuchar online o descargar como MP3

In today's episode we discuss Amazon Echo Show 5 , Cardiogram tracking WWDC19, Huawei and more. Check out our Tradfri Homekit video here. Today's sponsor is LastPass never remember complicated passwords again Want to sponsor us the contact us geekcorneruk@gmail.com

In today's episode we discuss Amazon Echo Show 5 , Cardiogram tracking WWDC19, Huawei and more. Check out our Tradfri Homekit video here. Today's sponsor is LastPass never remember complicated passwords again Want to sponsor us the contact us geekcorneruk@gmail.com

Последний выпуск BeardyBuilding в 2018 году — о часах Apple Watch Series 4. Это гаджет, который на протяжении последних четырех лет стал для Андрея и Романа постоянным спутником на тренировках; он стал быстрее, а приложения — лучше. О них и рассказываем. Ведущие подкаста: Андрей Барышников, Роман Юрьев. Темы 00:00:00 ⋅⋅⋅ Вступление. Что делать, если не тренируешься 00:06:28 ⋅⋅⋅ Впечатления от Apple Watch Series 4 00:11:45 ⋅⋅⋅ Ремешки 00:13:54 ⋅⋅⋅ Новые функции watchOS 5: автоопределение начала и конца тренировки, ходьбы; автоматическое воспроизведение музыки; плеер на экране тренировок 00:18:05 ⋅⋅⋅ Медитация и приложение «Дыхание» 00:26:27 ⋅⋅⋅ Сердцебиение: Cardiogram и HeartWatch 00:28:18 ⋅⋅⋅ Как работает ЭКГ в часах 00:30:55 ⋅⋅⋅ Тренировки: Workouts++ и SmartGym 00:36:30 ⋅⋅⋅ Здоровье: Gyroscope 00:38:15 ⋅⋅⋅ Сон: AutoSleep 00:42:18 ⋅⋅⋅ Новогодние поздравления :) Подписывайся Telegram: новости о технологиях и гаджетах BeardyCast: подкаст о гаджетах, играх, фильмах и сериалах The Big Beard Theory: подкаст о космосе BeardyCast.com: сайт со статьями о гаджетах, IT, космосе и медиакультуре

You can gauge the health of your physical heart by checking your pulse, but what about your spiritual heart? Is there a way to assess the strength of your testimony, your conversion, or your relationship with God? In this episode Alma plays the role of spiritual physician and asks some hard, heart-hitting questions the form, for us, a sort of spiritual cardiogram. How are you doing?   Show Notes: Alma's Spiritual Cardiogram - jpg: https://1drv.ms/u/s!AoPMl35TcIX9xxY68zdIqp05b63y pdf: https://1drv.ms/b/s!AoPMl35TcIX9xxWdSEoIl4dkyZlC

In this episode, Lauren & Aaron discuss a few of the ways smart technologies are improving health. From real-time monitoring and the deep learning analysis of heartbeats being used to diagnose disease, to AI-powered cancer-killing robots, the union of smart tech and healthcare is nothing short of wondrous! Lauren & Aaron also noticed how the same smart tech concepts can (and should) be applied to monitoring and improving the condition (or "health") and performance of buildings. Some of the stories they cover in this episode: Cardiogram and AI to diagnose diabetes: https://www.verdict.co.uk/smart-watches-using-artificial-intelligence-detect-diabetes/ DNA Nanobots killing cancer: https://techcrunch.com/2018/02/12/new-dna-nanorobots-successfully-targeted-and-killed-off-cancerous-tumors/ BONUS - VOC and Air pollution caused by household items: https://www.forbes.com/forbes/welcome/?toURL=https://www.forbes.com/sites/ericmack/2018/02/15/blame-los-angeles-air-pollution-smog-on-household-chemicals-emissions/&refURL=&referrer=#3abb677c6f0a Remember to like, follow and subscribe to Site 1001 on our other social media channels to stay up to date on the latest in building operations and smart technology news! LinkedIn: linkedin.com/company/site1001 Facebook: www.facebook.com/site1001 Twitter: twitter.com/site1001 Instagram: instagram.com/site1001

Последний фильм со звездой «Нефти» Дэниелом Дэй-Льюисом, слухи об проекте онлайн-трансляций игр Google Yeti, сериалы «Конец ***го мира» и «Человек будущего», приложения для отслеживания тренировок, сна и ритма сердцебиения — темы нового выпуска нашего подкаста.   Темы 00:00:00 — Рубрика о мобильной фотографии 00:10:35 — С апреля все новые приложения в App Store должны будут поддерживать экран iPhone X 00:21:49 — Приложения Cardiogram, Workouts++, AutoSleep++, Gyroscope Health 00:31:13 — Слухи о проекте Google Yeti 00:41:44 — Беспилотный автомобиль «Яндекса» 00:53:27 — Впечатления от Shadow of the Colossus (PS4) 00:59:38 — Реалия 01:08:09 — «Призрачная нить» Пола Томаса Андерсона 01:14:50 — «Конец ***го мира» 01:20:46 — «Человек будущего»   → Другие подкасты The Big Beard Theory | BeardyBuilding   → Подписаться в социальных сетях @BeardyShow | @BeardyTheory | Telegram   → Поддержать проект на Patreon Patreon

Can social media be “humane,” or is the push for addictive platforms just par for the course? Bryan Chaffin and Jeff Gamet discuss The Center for Humane Technology’s push for reform. They also talk about Cardiogram’s ability to detect diabetes from Apple Watch activity data, and they talk about Apple’s penchant for avoiding dark and edgy content.

Transcript for January 2018 Podcast Circulation: Genomic and Precision Medicine     Jane Ferguson:                 Hi, everyone. Happy New Year. You are listening to "Getting Personable: Omics of the Heart". I'm Jane Ferguson and this is episode twelve from January 2018.                                                  This month I have some exciting announcements to make. The journal formerly known as "Circulation: Cardiovascular Genetics" has a new name. As of this month, the podcast is brought to you by "Circulation: Genomic and Precision Medicine". We're still publishing papers focused on cardiovascular genetics but as genomics and other omics have expanded our scope has grown to so much more than just genetics.                                                 The new name, "Genomic and Precision Medicine" signifies the journals focus not only on genetics, but also genomics and all the other omic technologies and the feel of precision medicine. Along with the new name we have a new editing team. Dr. Kiran Musunuru, an associate professor of cardiovascular medicine and genetics at the Perelman School of Medicine at the University of Pennsylvania has officially taken over as editor-in-chief. He has already been implementing new initiatives to allow the journal to serve authors and readers even better.                                                 Along with create original research articles you can find accompanying editorials, videos and interviews with authors, including the interview we're featuring in this month's podcast.                                                 Finally, while "Circulation: Cardiovascular Genetics" was published every two months, "Circulation: Genomic and Precision Medicine" will now be published monthly. So, you can look forward to a new issue every month and even less time waiting for the newest research to be published. Check out the latest issue and all of the new material at circgenetics.ahajournals.org and follow us on Twitter at Circ_Gen.                                                 Now, along with the name change for the journal, we have another name change in the pipeline. Our AHA Council, Functional Genomics and Translational Biology, is also being renamed to "The Council on Genomic and Precision Medicine". As with the journal name change this better reflects the evolution in our scope and focus. This name change will be formalized in the coming months. So, if you are one of the many people who could never remember what the acronym FGTB stood for or what order all those letters came in, your struggles will soon be over.                                                 We have a number of interesting papers published this month, including an article by George Hindy and colleagues on how smoking modifies the relationship between a genetic risk score and coronary heart disease; a mendelian randomization study from Jie Zhao and  Mary Schooling on coagulation factors and ischemic heart disease; an exome wide association study of QT interfolds from Nathan Bihlmeyer and colleagues; a study on genetic testing of cardiac ion-channelopathies and still births from Patricia Munroe and colleagues; and a genetic study of cardiac disfunction in Duchenne Muscular Dystrophy from Tetsushi Yamamoto and colleagues.                                                 You can also catch up on the genetic cardi-oncology literature with a review by Marijke Linschoten and colleagues on chemotherapy related cardiac disfunction. And read a clinical case on left-ventricular non-compaction by Vi Tang and colleagues.                                                 Finally, we also have a scientific statement on the use of induced pluripotent stem cells for cardiovascular disease modeling in precision medicine by Kiran Musunuru and colleagues.                                                 Moving on to our feature article, Andrew Landstrom, an early career member of the Genomic and Precision Medicine Council, formerly FGTB, talk to Guillaume Paré and Sébastien Thériault about their article published this month entitled, "Polygenic Contribution in Individuals with Early Onset Coronary Artery Disease". In this paper, Dr. Thériault and colleagues report the use of the genetic risk score which improves on our ability to predict very early onset CAD. Listen on to the authors talk more about the background to this study and what they learned along the way. Andrew:              Welcome. My name is Andrew Landstrom, an assistant professor in the Department of Pediatrics, Section of Cardiology at Baylor College of Medicine. I am a member of the early career committee of the American Heart Association Council on Genomic and Precision Medicine, previously the Council Functional Genomics and Translational Biology. I'm joined today by Sebastien Theriault, assistant professor in the Department of Molecular Biology Medical Biochemistry and Pathology at Laval University, and Guillaume Pare, the Canada Research Chair in genetic and molecular epidemiology, assistant professor in integrative health bio-systems and associate professor of medicine at McMaster University. Guillaume:          Hi. Good morning. Andrew:              Well, I'm wondering if we could just start by introducing ourselves maybe a little bit more thoroughly than I just did and talking a bit about your research paper and what brought you to this as a research question. Guillaume:          Absolutely. So, this … [inaudible] and thank you for having us.                                 My name is Guillaume Pare, and as stated, I'm an associate professor at McMaster University, and I would say like my longstanding clinical interest is about individuals and families with very early coronary artery disease and heart disease. And this really was the basis for this project and to try to understand why do some people in family are afflicted by this disease when we cannot find any of the conventional risk factors. And as Sebastien came to join me and this endeavor, and spent two years with us here at McMaster and was instrumental in getting this project off the ground. Sebastien:           Yes, exactly. So, I was a physician trained in Quebec City and I went to McMaster University as a research and clinical fellowship. And that's where I did some cardiovascular clinics with Dr. Pare and that's when we noted that some patients with early coronary artery disease didn't have much explanation for their disease. So, that's how this project stem, that we wanted to understand what was going on and we thought that really genetic factors could be involved. Andrew:              And speaking of these genetic factors, in fact, you established a genetic risk score as sort of a way of aggregating a large number of genetic variants into a single prognostic risk indicator. How did you come up with the score, and where did these genetic variants that you aggregated come from? Sebastien:           So, the results of many of our studies looking at the association between common genetic variants and coronary artery disease have recently been released. For this study, we use the variants identified in the latest CARDIoGRAM for C4D consortium meter analysis, which includes more than 60000 individuals with coronary artery disease and 120000 individuals without coronary artery disease from a total of 48 studies. Most of the participants in these studies were European. And so we decided to use the independent variants that were associated with the disease in that very study and look if we could predict early coronary artery disease in some patients. Guillaume:          Andrew, maybe I'll backtrack a little bit. The initial idea about the gene score, first of all came from the observation that a lot of the patients who we're seeing do not have any traditional risk factor. The second observation is that we already knew that genetic risk scores are predictive of coronary artery disease. But the key question is, is it possible that there are people at the extreme of severity of a cardiovascular or genetic risk score that could be at much, much higher risk of having the disease. And this is what the hypotheses really that we wanted to test is whether these genes scores they could identify people that clearly have outlying risk, outlying genetic risk of having the disease.                                 And to explain, the patients that we were seeing a deflation in the clinic will clearly have an outlying risk of disease because they have a First Earth attack or multi vessel disease in their 30s or 40s, and we thought that this cannot be just like bad luck, there had to be some ... and this something is really most likely genetics. We cannot put a finger on it because all the known mutations that we know could cause this, well, we're just not finding them. Andrew:              Sure, sure. And there's certainly having a large number of genome association studies, which have implicated a number of common variants and not so common variants in coronary artery disease. So, is this where some of this idea behind the genetic risk or was initially thought of? Guillaume:          Absolutely. And I think you know ... and this is where Sebastian really came in and to really like look at this literature, to feel like the variants that went in into the score. Andrew:              And certainly to go to your earlier point, it seemed like you were saying early on that coronary artery disease would be a great phenotypic model to explore this question in, mainly because it would seem that at that age, with that severe disease, that it must be something innate to that person, and genetics would certainly play a role. Guillaume:          Absolutely. And to me, it's more than simply scientific because we see these patients at our clinic and we've got a lot of ref roles for these patients, and we really feel for them because they're really young people, and I think like when we think about genomic and like preventative medicine having an impact, I cannot see a greater impact than preventing a first heart attack in the 30s or early 40s. So, this is a ... it's a very vulnerable patient population. It's also a patient population that has a lot of questions about why this might be happening to them, and often what we see is that, I think everyone feels that clearly there's a genetic component, and one, a loved one has first attack in his or her 30s, this raises questions for the whole family really, and it clearly sends a shock wave in the family, and everyone, I think rightfully, is quite scared of having the disease and the fact that there is no answer for these people, to me is a huge unmet clinical need. And it's just for the sake of providing people with answers. Andrew:              Yeah. Absolutely, I think it's certainly a clinically relevant question that you attempted to answer. And to try to get to this a little bit, and you utilized a large UK-based biobank as your primary study population to establish this risk score. Can you tell me more about this biobank and what sort of data you were able to obtain from it? Sebastien:           Sure, I can speak a bit about it. So, the UK biobank is a large prospective cohort of about 500000 individuals between the age of 40 and 69, with an average of 58 years, and they were recruited from 2006 to 2010 in several centers in the United Kingdom, and the general objective is to study the effect on the environment and genetics on health. And what's interesting is that the data is made available to the research community worldwide following registration process. And the data in that includes a very vast amount of information, from questionnaires, specific evaluations, such as height, and weight, and aging data, and the diagnosis from the participants, medical charts, in addition to the genetic data of course.                                 And for this study we used the first release of the genetic data, which included information on about 40 million variants in about 150000 individuals, and selected the individuals who had a diagnosis of early coronary artery disease, so aged 40 or less for men, 45 or less for women, and then it underwent a reversed relation procedure in order to identify patients with obstruction in coronary artery disease, and we used all the other participants as controls. And that's basically leveraging this huge amount of data that we were able to confirm the fact that patients with early coronary artery disease, some of them very high and pathogenic components of their disease. Andrew:              That certainly sounds like a really amazing, both biobank and cohort of information that could be utilized. Such a huge sample population with so many clinical variables as well as genetic variables and collected prospectively. What a great resource. Sebastien:           Yes indeed. Guillaume:          It's a fantastic resource and to me, this type of initiative it's a game changer to accelerate research, because with these data being made available, then it's really up to testing new bold ideas to try to improve our understanding of this disease. So, I think you know we have to say kudos to United Kingdom for financing this this great cohort and making it available to researcher worldwide. Andrew:              And you didn't just stop there. You also utilized a local cohort as a foundation cohort for your study. Could you speak a little more about that? Guillaume:          So, that's interesting because this cohort really stems from the patients that we've seen at the clinic. And essentially, we felt this was this huge unmet clinical need. To better address causes of disease, and these roles that's barely a disease. And then we said, well, if we were to do this, let's do this formal, and let's do this properly and collect the information and samples and everything, and we had a very enthusiastic response from our cardiologist, and international cardiologist colleagues that really helped us identify these early cases and send them to us and in our study. And so these are local patients. These are people that we care deeply about, and that's really want to make a difference. And again, you know, when Sebastian was with us at McMaster, we were seeing these patients together, and maybe he can add some of the details there if you want. Sebastien:           Yeah. Just to specify again, these were patients at the very early coronary artery disease, for age 40 or less for men, and age 45 or less for women. And these were patients without the clear secondary cause of their disease. Most of them were clueless about what were the factors that caused the disease outside a few risk factors such as smoking or hypertension, there wasn't clear explanation as to why they had such early disease, and we could see that it was a struggle to try to understand and then see if there is a risk for their family also. So yeah, it was really interesting to find an explanation for some of them, and we did report the findings to a few of them who seemed to have polygenic contribution to their disease, and it did make a difference. They were quite happy to at least have some kind of an explanation to what was happening to them. Guillaume:          And I think that one thing that I think was striking to me when doing this is that when we started to formally collect family history in these individuals, we just realized that and in many, if not most of them, the family history is really striking. And these are folks that clearly has a very severe individual disease, but when we start asking about their brothers, and sisters, and parents, and uncles, you just realized that coronary artery disease was just all over the place and was very aggressive and early. And I think to us, this gave us purpose in this project to say that, 'Yes, we have to do something about this,' but also, I think it also reassures us that our primary hypothesis was right in thinking that there has to be a genetic component that goes beyond just having bad luck, and this genetic component was expressing itself by the family history that we saw.                                 And a further clue that I think we might be on the right track is that the pattern of inheritance didn't shift one of the single mutations that aggregates in a family and that can explain the disease. So, the disease was more diffuse and oftentimes it was both from the paternal and maternal branch of the family without a clear genetic pattern that would be more in line with the so-called mendelian disease, where a single gene mutation causes the disease. And I think really that puts to us in the mind that we might be looking at the different modes of inheritance, and this is partly how we came with this idea of looking at gene scores in these individuals and families. Andrew:              So certainly a close clinical connection to the patients and their families that you're trying to risk stratify and certainly, it sounds like clinical suggestion that you were dealing with something genetic and inheritable, but not necessarily mendelian, where one gene defect leads to say an autosomal balanoid express disease, more of a polygenic family history exactly. Guillaume:          Exactly. Andrew:              And so with these two scores and this genetic risk score, what exactly did you all find? Sebastien:           So first we found that participants from the UK biobank who had this early coronary artery disease had a very significantly higher number of common genetic risk variants. So the score was very significantly higher in these patients. And what was interesting too is that the increase in risk that was associated with the score was independent from traditional risk factors such as smoking and high blood pressure. And when we looked in the local cohort with early coronary artery disease, out of 30 participants that were involved, we found seven with a significant polygenic contribution, which we define as, a two-fold increase in risk, and one of the participants actually more than six-fold estimated increase in risk. So we really did identify an explanation for some of these participants with the early coronary artery disease. Guillaume:          And I think this was maybe a bit of a eureka moment to see that some of these individuals actually had a much, much increased risk of disease based on the polygenic risk score, and this really was the primary hypothesis that when looking at extreme of disease, which is what we're looking at, we might find extreme of genetic predisposition. But the one thing I thought that's quite striking is then we went back to think all that. And to try to put this in perspective with what we would usually do in these patients that we've done already, and to look for mutations that cause familial hypercholesterolemia.                                 Familial hypercholesterolemia is a disease of cholesterol metabolism that leads to a much increased concentration of cholesterol and early coronary artery disease, and a discovery that led to a Nobel Prize for Goldstein and Brown, back in the day, and really like, up to this point, when we see people with early disease clinically, this is what we will be looking for. And certainly, there's a lot of these individuals that have very high cholesterol and a lot of them is due to familial hypercholesterolemia. But it's a minority of patients really. It looks like we're having an association and this gene score concept is really panning out. But I wouldn't compare to familial hypercholesterolemia, and I guess that the results were kind of surprising to us and I think we had to take a step back and think about the implications. And I don't know, Sebastien do you want to describe these results or ... Sebastien:           Yeah, sure of course. So we've looked at how frequent this polygenic contribution to coronary artery disease could be. So we look at the prevalence of high genetic risk or that would cause a risk similar to familial hypercholesterolemia see the ratio about 3.7, and we realized that one in 53 individuals had an increasing risk that was similar. So that's almost 2% of the population, and that is way more frequent than the actual prevalence of familial hypercholesterolemia, which is one in 250. So in other words, the polygenic contribution could be almost five times more frequent than familial hypercholesterolemia. Andrew:              But yet not all of those individuals manifest as disease, which sort of hits as something that's a common thread in genetic association studies where we're trying to describe sort of multifactorial disease en points with finite genetic and a whole spectrum of acquired disease, required lifestyle modifications and things. So no model is 100% perfect, and so where do you think that additional variation lies, either in the reduced penetrance of some of these disease phenotypes, or are there other genetic loci, or are these all secondary to acquired changes that happen, or where does some of that variation lie? Guillaume:          Well, to me I think there's two parts to this question. The first one is that I see the cells study as in some sense, proof of concept, to look for the concept of very high burden of polygenic risk as a mendelian equivalent really. But the fact is that, especially with the new discoveries and the genetics of coronary artery disease, the gene scores that we've been using for this study could be much improved. And I think the concept is there, but the gene score could be improved, and I think they will be improved and I think in three, four, five, ten, years from now, they're going to be even better because we will have many more variants that we know are preceded with coronary artery disease and that might be upwards to 1000 variance, for example will have much better gene score I think we'll have much more predictive gene scores.                                 So I think the concept is there, but I think it's going to improve, with the years is only going to get better. And I think part of this missing risk, if I may, is due to the fact that we're missing a lot of genetic variants associated with coronary artery disease, and I'm very confident that the community will find them in the years to come.                                 I think the second part of the study is that, that being said, I think genetic risk is obviously important but we shouldn't neglect also classical risk factors. And a lot of [inaudible] … they did have the classic risk factors and that was a fairly high proportion of smokers, and a few cases of diabetes, and I think that individually, this risk factor wouldn't be enough to explain the aggressiveness of this disease. But I think the fact that we do find an enrichment for these factors also give us ... I think it feeds the idea that it's not only genetics and that even in these individuals classic risk factors do matter and trying our best to decrease the burden of these risk factors on a community and its role family level is probably also very important. Sebastien:           I'd also want to know that there's an environmental part that's involved even in these individuals with high genetic risk. And as he just mentioned, we did notice a high proportion of traditional risk factors in patients with early coronary artery disease even in some of them with high polygenic score, some of the environmental factors seem to be also involved in their disease. Guillaume:          And to some extent I think that's going to be an interesting research question, in these individuals with very high polygenic burden, do traditional risk factor, do they at the time, are they stronger or weaker, is there a synergistic effect between, for example, smoking and being at this extreme of the polygenic risk? And these are kind of open questions that we couldn't address in the current study but I think will be interesting to see in the years to come. Andrew:              Absolutely. I think there's definitely a road ahead of us but this is definitely a step in the right direction. What are some of the practical applications of this genetic risk scores, either from your study or from others in the identification of individuals? Is it something that could be used for primary production? I mean, in theory, this could be done at birth. You could be screened for these genetic variants and the risks will be calculated within the first days of life. What do you think are the practical applications of this and where is this fit into a rapidly expanding world of clinical genetics? Guillaume:          Well, I think you know what you've just described is exactly how I see the future, and I think that if we want to be consistent, and we consider folks with a familial [inaudible] mutation to be at higher risk, I think that someone with a predicted polygenic risk of twofold, threefold, or fourfold increase risk of coronary artery disease should definitely be put in a higher risk category when it comes to primary prevention irrespective of other risk factors, or maybe like in combination with these other risk factors, and I think should be treated accordingly. And as we see, these are people are very aggressively affected by the disease, and I think the sooner we could identify these individuals at high risk and try to intervene to lessen as much as possible this risk, I think we will do these individuals and families a great service.                                 So I think it's definitely a case for primary prevention and especially in a world where genomics is more clinically prevalent and used, also we see a role for this and the role that's already affected. And to me personally, I see great value in providing people with answer on why they've had an event and probably providing an answer not only to them, but also to their families. Andrew:              And so if something like this were to be able to be applied broadly in the clinical arena, what sort of steps do you think need to happen from this point forward to make this sort of testing ready for prime time? Guillaume:          This is a great question and I have to say that my passion I would say is to bring genomics to the clinic. I think there's a long road ahead to make this happen. But I think there's two main obstacles. The first one is that I think there's a knowledge gap between people that do this 24/7 like me, and I think you know the rest of the community and that there's been so much rapid progress in the field of genomics in the last few years that I think there's a lot of education to be done for people to catch up and just the concept of polygenic risk.                                 I think only a minority of clinicians will know about this and very rightfully, because right now it's in the realm of research papers. So I think to make this happen, there's a huge role in education and awareness. I also think that our hospitals ... or maybe it's a Canadian thing, are not prepared just for the flow of information and how to derive the routines commercially, and probably how to handle these highly multi-dimensional data and to be able to take the right information out of them and I think in this world, I would think that probably the best way to do it is to do it in a way that these gene scores can be updated, the science progress. But we're so far away.                                 Sometimes I feel that our hospital system is struggling to provide [inaudible] time to clinicians. And I'm just thinking without the prevention or how to handle something as complex as polygenic score, in this case we barely had like all the plugs in 200 variants, but you could clearly imagine like genetic risk scores being done with hundreds of thousands, if not millions of variants and will bring a whole new set of challenges. Andrew:              And Sebastian, do you have a perspective on this? Sebastien:           Yeah. I would just add that this knowledge is in the research community but to really put that into the clinic there's old setting, you have first to interpret the results and also to disclose the results to patients in a way that they can understand and that wouldn't create unnecessary anxiety, but more give them informed and an informed view of their health. So there's this also translation to the patient that needs to be evaluated and developed for it to be used to mainstream I would say. Guillaume:          And I think the classic tools like publications also presentations and meeting and even reaching out to the cardiology community to start discussing these concepts will be important. And clearly it's a big shift from just classic genetics and even familial hypercholesterolemia, I think there isn't a lot of awareness, I don't think there's enough awareness as far as I'm concerned. And then we're bringing new concepts that might be even further remote from what people have been taught about genetics and score, it's going to be a huge challenge, but we have to. And I think the great thing about the medical community as far as I'm concerned, is that every time that there's been something that was worthwhile to do clinically, the community has always come around and making sure that these things are implemented and made available and everything. So I'm also very confident, but I think there's a great challenge ahead as well. Andrew:              It sounds like the challenge has a potential for great benefit and if proper partnerships between the clinicians, and the geneticists, the scientists, and the patients and their families can all sort of come together to establish a path forward for this type of information to be applied clinically. Guillaume:          Yeah, absolutely. And I really like that to add there that you've put the clinicians, geneticists, and patients as well. I think it's very important, patient advocates are a very important part of the equation here. Andrew:              Going forward, are other disease processes besides early onset coronary artery disease that you all feel might benefit from a similar polygenic risk? Sebastien:           The recent studies show that a lot of complex traits seem to have polygenic origin. So traits like hypertension, diabetes, obesity, atrial fibrillation, for example, they show a similar genetic architecture where there seem to be combinations of a very large number of common variants that explain the genetic risk. So it's a big number of variants with smaller effects that seem to be responsible for the appearance of these complex traits. So this concept could potentially be applied to a lot of different diseases. Guillaume:          I think I would maybe just go even one step further, but I really have the feeling that most late onset disease actually has a polygenic architecture, which means that similar polygenic risk score could be done targeting the extreme of distribution to look into this. I mean obviously, I think metabolic traits, diabetes, hypertension as Sebastien mentioned, but probably why not some cancers, or [inaudible] or any of the large number of disease where a polygenic inheritance either has been proven or is highly suspected.                                 So I think that we will hear a lot of polygenic risk score in the future, and I might be biased here, but I think it might become a staple of clinical practice that people will be looking at polygenic risk for a number of disease. And I think the great thing is that now that we've got genome-wide genotyping that is really affordable and we can type with statistical imputation and tens of millions of variants, then I think one concept is that we only have to genotype once and then we can derive these polygenic risk scores for ... why not a dozen diseases that are important and are actionable and really like turbo charge primary prevention by using this information. I might be getting ahead of myself, but I really think that this is something that we might see and that for us, we should see. Andrew:              And certainly that seems to be the way that at least the literature is trending, definitely towards more, and more data and more, and more exploration into a number of diseases that may have mendelian inheritance pattern but may also have a significant component that's polygenic, particularly like you were saying in those individuals that present at the extremes of severity. So I think it's certainly where we're heading.                                 Is there anything else that either of you would like to share about the study that you feel be important? Guillaume:          I think we've covered a lot of ground here, but perhaps the one thing is just to reiterate that this is a proof of concept, but I really think that the act of polygenic risk score will continue to improve for quite a while, and as it improves, it will only get better. So we can only move forward with this in terms of the accuracy of the prediction, and I think that that's a great thing and hopefully with this we'll be able to better predict risk. And the other thing as well is that, I would say that at this point we can identify people at risk. And I think it's great because it provides answers, we can target known risk factors.                                 But I think a big part that's still open is, can we use this risk to derive like more individualized treatment, or to actually choose what should be the best way to prevent events in these individuals. And again, I don't think we're there yet but this is something that I think it's worthwhile investigating in the future and maybe trying to dissect this polygenic risk and to see maybe it falls in one or two categories or maybe it's a global risk, and these are all open questions that I think are important, but that are still very much of a mystery right now. Andrew:              Sebastian? Sebastien:           I think we've covered a lot of ground like you said and I don't have too much to add. Otherwise, I think we'll see a lot of these polygenic risk scores in the future and for risk improvement even to understand better the physiology of disease. These are very important concepts. Guillaume:          And I think you know the common approach of physiology is good because these gene scores they don't seem to be associated with classical risk factor. In our study, rather weak association with blood pressure and families history. Now, family history is kind of logical. Blood pressure suggests that perhaps there's an overlap between the two pathways, but clearly adjusting for blood pressure like that only slightly attenuated the predictiveness.                                 So basically what this is telling us is that this polygenic risk score seems to be acting through pathways that we don't know of, that we're not measuring clinically, and I think that’s a big part of the future would be to say, 'well, what are these pathways, and can we actually assess them? Are there other cholesterols out there?' Cholesterol is great because it's causal, we've got synthetic pharmachemicals, you've got tools to decrease it, and we've got fantastic evidence that decreasing cholesterol decrease risk. Is it possible that there's other pathways that are there and that we could do to sign, and I think all of this gives us great clues that this might be so.                                 I think as happens quite often in science, we start with an hypothesis and we try to address it the best we can, and at the end of the day, here I guess we've been lucky because it kind of panned out, but it also opens so many more questions about; So what are these other pathways that these genetic risk scores are capturing that we're not capturing clinically right now. And how could this lead to better treatment, and how to implement this and everything, and I think this is really what's so exciting about doing research, and as far as I'm concerned, doing research that has an impact on people's lives and trying to improve people and provide answers to people. Andrew:              Sounds like a great summary of the rationale for doing this. Thank you very much for joining me and for sharing your work. Guillaume:          My pleasure. Sebastien:           Thanks.   Jane Ferguson:                 Thanks for listening to "Getting Personal: Omics of the Heart." You can subscribe on iTunes to get each new episode delivered straight to you. And we'll be back with more next month.  

In episode 3 of Startups of the Week, we’ll tell you about Curbside, a company that wants to make that annoying trip to the pharmacy a little less annoying. Then, we’ll tell you about four more startups you likely haven’t heard of yet. Theme music is "Bot Fest" by Alex Vaan. Opening signature by Leah Garchik. Learn more about your ad choices. Visit megaphone.fm/adchoices

with Brandon Ballinger (@bballinger), Mintu Turakhia (@leftbundle), Vijay Pande (@vijaypande), and Hanne Tidnam (@omnivorousread) There's been a lot of talk about technology -- and AI, deep learning, and machine learning specifically -- finally reaching the healthcare sector. But AI in medicine isn't actually new; it's actually been there since the 1960s. And yet we didn't see it effect a true change, or even become a real part our doctor's offices -- let alone routine healthcare services. So: what's different now? And what does AI in medicine look like, practically speaking, whether it's ensuring the best data, versioning software for healthcare, or other aspects? In this episode of the a16z Podcast, Brandon Ballinger, CEO of Cardiogram; Mintu Turakhia, cardiologist at Stanford and Director of the Center for Digital Health; and general partner and head of a16z bio fund Vijay Pande in conversation with Hanne Tidnam discuss where will we start to see AI in healthcare first -- diagnosis, treatment, or system management -- to what it will take for it to succeed. Will we perhaps see a "levels" of AI framework for doctors as we have for autonomous cars?

Au programme : Apple Watch (iOS / 319€) (ou tracker avec rythme cardiaque) App Apple Activité (iOS / Gratuit) ou équivalent Withings Body (iOS & Android / 99,95€) Cardiogram (iOS / Gratuit) Results (iOS & Android / 9,99€ par mois) Zero - Fasting Tracker (iOS / Gratuit) WaterMinder (iOS & Android / Gratuit) Lifesum (iOS & Android / 50€ par an) Plus d'infos sur l'épisode : Les animateurs sont Jérôme Keinborg (@JeromeKeinborg), Cédric Bonnet (@CedricBonnet), Korben (@Korben) et Patrick Beja (@NotPatrick). Le générique est de Daniel Beja (@misterdanielb). Sa musique libre de droit est sur MusicInCloud.fr. La mise en ligne est assurée par Florent Berthelot (@Aeden_).

Je vous explique pourquoi je ne quitte plus mon Apple Watch.Retrouvez moi sur Twitter et Instagram : @FR_JessListe des applications citées:France Info https://appsto.re/it/zgiYu.iTwitter https://appsto.re/it/NwV5t.iN26 https://appsto.re/it/hUhc5.iWaterMinder https://appsto.re/it/RBh7M.iCardiogram https://appsto.re/it/kbXM7.iPillow https://appsto.re/it/8w8x0.iRuntastic https://appsto.re/it/kTbeu.i

Time-Stamped Notes  00:02 – Introduction to the new Leverage Podcast  00:13 – Sneek lets you see everybody on a webcam  01:57 – Spoil is an app for gift services  03:07 – Wind: an excellent company for shipping products  03:22 – Want to recommend a product? Email us at nick@getleverage.com  04:26 – Designrr enables you create stunning ebooks and lead magnets  05:31 – Cardiogram 2.0 takes your heart rate and sleep activity and translates it into useful information   06:54 – Xen.do is a cloud service that allows you to search all your cloud storage in one place  07:33 – Netatmo is a climate monitor that serves as a healthy home coach  10:03 – Gazelle and apple.com/recycling prices out your Apple items  10:38 – The leverage assistance has about a month waitlist  11:07 – End of today’s podcast   Less Doing Podcast Resources:    Trello Board -https://trello.com/b/jtqdNTp3/leverage-podcast-resourceshttps://trello.com/b/jtqdNTp3/leverage-podcast-resources 

Third and final installment of my 80's tribute series.

Second open-format mix of 2015. Named after one of my favorite cities in the world.

New workout mix features songs from Tiesto, Afrojack, Kanye West & more! Thanks for all the support!

By request! The second installment of my 80's series. Thanks for all of the support, I love you all.

The chemokine RANTES (regulated on activation, normal T-cell expressed and secreted)/CCL5 is involved in the pathogenesis of cardiovascular disease in mice, whereas less is known in humans. We hypothesised that its relevance for atherosclerosis should be reflected by associations between CCL5 gene variants, RANTES serum concentrations and protein levels in atherosclerotic plaques and risk for coronary events. We conducted a case-cohort study within the population-based MONICA/KORA Augsburg studies. Baseline RANTES serum levels were measured in 363 individuals with incident coronary events and 1,908 non-cases (mean follow-up: 10.2±4.8 years). Cox proportional hazard models adjusting for age, sex, body mass index, metabolic factors and lifestyle factors revealed no significant association between RANTES and incident coronary events (HR [95% CI] for increasing RANTES tertiles 1.0, 1.03 [0.75-1.42] and 1.11 [0.81-1.54]). None of six CCL5 single nucleotide polymorphisms and no common haplotype showed significant associations with coronary events. Also in the CARDIoGRAM study (>22,000 cases, >60,000 controls), none of these CCL5 SNPs was significantly associated with coronary artery disease. In the prospective Athero-Express biobank study, RANTES plaque levels were measured in 606 atherosclerotic lesions from patients who underwent carotid endarterectomy. RANTES content in atherosclerotic plaques was positively associated with macrophage infiltration and inversely associated with plaque calcification. However, there was no significant association between RANTES content in plaques and risk for coronary events (mean follow-up 2.8±0.8 years). High RANTES plaque levels were associated with an unstable plaque phenotype. However, the absence of associations between (i) RANTES serum levels, (ii) CCL5 genotypes and (iii) RANTES content in carotid plaques and either coronary artery disease or incident coronary events in our cohorts suggests that RANTES may not be a novel coronary risk biomarker. However, the potential relevance of RANTES levels in platelet-poor plasma needs to be investigated in further studies.