Podcasts about Cleveland Clinic

This week on The Bend Show from the “house burping” home trend to dumb outdoor criminal stories and how winter weather can trigger migraines. Join radio hosts Rebecca Wanner aka ‘BEC' and Jeff ‘Tigger' Erhardt (Tigger & BEC) with the latest in Outdoors & Western Lifestyle News! Home Trends, Outdoor Headlines & Health Impacts of Winter Weather House Burping: Why Some Homeowners Are Opening Windows in Winter Even as winter temperatures plunge, a growing number of homeowners are opening their windows on purpose — a trend known as “house burping.” The idea comes from a long-standing German practice called lüften, which simply means airing out your home to improve indoor air quality. Air quality experts say it can actually be healthy. Letting in fresh air helps reduce moisture, mold, carbon dioxide, and indoor pollutants — especially important since Americans spend about 90 percent of their time indoors. In Germany, lüften is so common that some rental agreements even require tenants to open windows regularly. The practice has gone viral in the U.S., with social media users sharing routines like airing out the house first thing in the morning, after cooking or showering, or after guests leave. There are downsides, though. Critics say opening windows in winter can hurt energy efficiency and drive up heating costs. Experts recommend keeping it short — about ten minutes is all it takes. So while it may feel counterintuitive, a quick blast of cold air could help keep your home healthier — just don't leave those windows open too long. Reference: https://www.today.com/life/what-is-house-burping-benefits-rcna255170 Outdoors Hunting & Fishing Dumb Crimes According to Outdoor Life, A former Alaskan guide with a long history of wildlife violations has once again been found guilty—this time for crimes tied to his commercial fishing business. Fifty-one-year-old Michael Patrick Duby of Juneau was convicted by a jury on January 15 of multiple charges, including falsifying commercial fishing records, selling fish taken for personal use, fishing out of season, and harvesting clams without a permit. Duby's record of fish and game violations stretches back more than 20 years. In 2012, he received one of Alaska's harshest sentences for wildlife crimes after a federal investigation found he illegally killed and sold protected birds. That case, along with other state offenses, cost him his hunting and sport fishing privileges, landed him in prison, and resulted in tens of thousands of dollars in fines. After losing those privileges, Duby shifted into commercial fishing, saying it was still his passion. But prosecutors say the pattern continued. His most recent convictions stem from actions in 2019 and 2020 while operating Genesis Seafoods, including felony charges for falsifying harvest records and reckless endangerment for selling untested clams. State prosecutors have described Duby as someone unable to stop breaking fish and game laws. His wife, who was charged as an accomplice and is a state fish and game operations manager, was acquitted. Patrick Duby represented himself at trial and is scheduled to be sentenced in May. Reference: https://www.outdoorlife.com/conservation/alaska-poacher-turned-commercial-fisherman-convicted/ Bronze Bighorn Stolen from Kuiu HQ—And the Getaway Didn't Go as Planned Two masked thieves targeted the Kuiu headquarters in Dixon, California, but their bold plan hit a snag—they couldn't fit what they stole into their car. In the early morning hours of December 31, surveillance video shows the suspects sawing a life-sized bronze bighorn sheep statue off its concrete base using a battery-powered saw. After tipping the heavy statue over, the pair struggled to load it into the backseat of what appears to be a Chrysler 300. When that didn't work, they left the scene, returned about 15 minutes later with a luggage cart, and wheeled the statue away. Police believe the bronze ram was later cut into smaller pieces so it could be transported and likely sold for scrap. The statue, nicknamed “Rocky,” had been installed outside Kuiu's headquarters just months earlier, in June of 2024. Bronze scrap currently sells for only a few dollars per pound, but thefts of bronze artwork are reportedly on the rise. Kuiu has released the surveillance footage and is offering a $5,000 reward for information leading to an arrest. The case is being handled by the Dixon Police Department, and the company says the response online has been immediate and overwhelming. Reference: https://www.outdoorlife.com/conservation/thieves-steal-kuiu-sheep-statute/ Missouri Offers $15,000 Reward in Bull Elk Poaching Case Missouri conservation officials are asking for the public's help after a bull elk was illegally shot and killed at Peck Ranch Conservation Area in southern Missouri. The Missouri Department of Conservation is offering a fifteen-thousand-dollar reward for information leading to an arrest and conviction. The adult bull elk was discovered the morning of November 26, 2025, lying dead in an open field with a gunshot wound to the left shoulder. Investigators say evidence at the scene shows the shooter drove a vehicle directly into the field toward the elk, then circled back onto a gravel trail and left the area at a high rate of speed. Tire tracks entering and exiting the field were clearly visible. Photos submitted by members of the public helped narrow down the timeline. One photo shows the elk alive and grazing around 5:15 the evening before. Another photo taken just after 8:00 the next morning shows the animal dead in the same field. The case is being handled through Missouri's Operation Game Thief program, which emphasizes that poaching hurts wildlife conservation efforts and the hunters who follow the law. Anyone with information is urged to call 800-392-1111. Tips can be made anonymously, and conservation officials say even small details could help bring the person responsible to justice. Reference: https://www.outdoornews.com/2026/01/20/missouri-offers-15k-reward-for-help-in-elk-poaching-case/ How Winter Weather Can Trigger Migraines — and What You Can Do  As winter weather settles in, doctors say colder temperatures and changing weather patterns may be triggering more migraines. According to a Cleveland Clinic headache specialist, sudden shifts in barometric pressure can create pressure changes in the sinuses, which may set off migraines in people who are already prone to them. Extreme cold can also be a factor. For those sensitive to winter temperatures, simply being out in frigid air can increase the chances of a migraine starting. There are steps you can take to help prevent winter-related migraines. On very cold days, staying indoors when possible can help. If you do head outside, bundle up — especially covering your head and neck to limit cold exposure. Doctors also recommend keeping migraine medications with you, so you can treat symptoms early. Beyond the weather, lifestyle habits matter. Getting enough sleep, staying active, managing stress, and addressing anxiety or depression can all play a role in reducing migraine frequency. And if migraines start interfering with daily life, Cleveland Clinic experts say it's time to talk with your doctor, who can help find the right treatment plan to better manage symptoms through the winter months. Reference: https://newsroom.clevelandclinic.org/2026/01/02/winter-weathers-impact-on-migraines OUTDOORS FIELD REPORTS & COMMENTS We want to hear from you! If you have any questions, comments, or stories to share about bighorn sheep, outdoor adventures, or wildlife conservation, don't hesitate to reach out. Call or text us at 305-900-BEND (305-900-2363), or send an email to BendRadioShow@gmail.com. Stay connected by following us on social media at Facebook/Instagram @thebendshow or by subscribing to The Bend Show on YouTube. Visit our website at TheBendShow.com for more exciting content and updates! https://thebendshow.com/ https://www.facebook.com/thebendshow WESTERN LIFESTYLE & THE OUTDOORS Jeff ‘Tigger' Erhardt & Rebecca ‘BEC' Wanner are passionate news broadcasters who represent the working ranch world, rodeo, and the Western way of life. They are also staunch advocates for the outdoors and wildlife conservation. As outdoorsmen themselves, Tigger and BEC provide valuable insight and education to hunters, adventurers, ranchers, and anyone interested in agriculture and conservation. With a shared love for the outdoors, Tigger & BEC are committed to bringing high-quality beef and wild game from the field to your table. They understand the importance of sharing meals with family, cooking the fruits of your labor, and making memories in the great outdoors. Through their work, they aim to educate and inspire those who appreciate God's Country and life on the land. United by a common mission, Tigger & BEC offer a glimpse into the life beyond the beaten path and down dirt roads. They're here to share knowledge, answer your questions, and join you in your own success story. Adventure awaits around the bend. With The Outdoors, the Western Heritage, Rural America, and Wildlife Conservation at the forefront, Tigger and BEC live this lifestyle every day. To learn more about Tigger & BEC's journey and their passion for the outdoors, visit TiggerandBEC.com. https://tiggerandbec.com/

The idea might seem like something out of a fantasy, but “Foreign Accent Syndrome” is a genuine, albeit very rare, neurological condition! It sees a person begin to speak with an accent different to the one they had prior to having a stroke; one which makes them sound like they come from an entirely different country! Since the first case was discovered in France in 1907, there have only been about 100 documented cases worldwide, according to the Cleveland Clinic. But certain cases have attracted the attention of the media and scientific researchers alike. One dates back to 1941 in Oslo, Norway, during a period of German occupation.  What is the foreign accent syndrom? What exactly happens in the brain in such cases? How serious can the syndrome be? In under 3 minutes, we answer your questions! To listen to the last episodes, you can click here: ⁠⁠⁠How to spot, prevent and treat heatstroke ?⁠⁠⁠ ⁠⁠⁠What are the strangest reactions caused by an orgasm?⁠⁠⁠ ⁠⁠⁠How can I learn 1000 words in a new language?⁠⁠⁠ A podcast written and realised by Amber Minogue. First Broadcast: 10/1/2025 Learn more about your ad choices. Visit megaphone.fm/adchoices

Managing heart failure isn't just about medications. It's about the everyday food choices that can either ease the strain on your heart or quietly make symptoms worse.In this episode, we break down why sodium has such a powerful impact on heart failure, how it drives fluid retention and shortness of breath, and why even small changes can lead to noticeable relief within days. You'll learn how to spot hidden sodium in common foods, what to eat instead, and how to build meals that support your heart without feeling restrictive or bland.We also explore simple, realistic nutrition strategies for real life, from eating well when energy is low or appetite is poor, to using flavor-forward ingredients that make low-sodium meals satisfying and sustainable. Whether you're living with heart failure, supporting a loved one, or trying to protect your heart long-term, this conversation offers practical, evidence-based guidance you can start using right away.Guest Bio:Julia Zumpano has been a registered dietitian with Preventive Cardiology and Rehabilitation at the Cleveland Clinic for 20 years. Her time in patient care is spent counseling on a cardio-protective diet, with focus on lipid, hypertension, diabetes, and weight management. She also serves as the Nutrition Media Liaison, where she manages the media requests to the outpatient Nutrition Therapy department, played an integral role in the development of the Cleveland Clinic diet app, and is the co-host of the Nutrition Essentials Podcast.“Simplify what you're consuming. Keep it very simple. Do what's with whatever is in your means, but if you are able to commit, let's say, three or four days to a low-sodium diet, you may find that you'll be able to get rid of some of that fluid you're retaining.” Question of the Day:What are some tips you use in your kitchen to make meals more flavorful without adding that extra sodium?On This Episode You Will Learn:Why sodium plays such a critical role in heart failure management, including what happens in the body when intake is too high and how it contributes to fluid buildup and worsening symptoms.How sodium affects blood pressure and heart function, why this added strain is especially dangerous for people with heart failure, and how even small reductions can lead to noticeable symptom relief.Common high-sodium foods that often go unnoticed, from packaged staples to restaurant meals, and practical tips for identifying hidden sodium on labels.What to eat for a stronger heart, highlighting staple ingredients and eating patterns that support fluid balance, reduce symptoms, and help meet nutrient needs even when appetite or energy is low.Making low-sodium eating realistic and enjoyable, with strategies to preserve flavor, honor food traditions, and build sustainable habits that support long-term heart health.Connect with Yumlish!Yumlish Website: YumlishYumlish on Instagram: @yumlish_Yumlish on Facebook: YumlishYumlish on Twitter: @yumlish_Yumlish on LinkedIn: YumlishConnect with Julia Zumpano!LinkedIn: https://www.linkedin.com/in/zumpano-julia-4757482a Nutrition Essentials Podcasts: https://www.youtube.com/playlist?list=PLMG0zKOgNqNmoVhXKP1zvIuFS5BcVXJyG

Dr. Margarita Fedorova outlines how genetic, environmental, and pathological factors interact in Parkinson's disease and what this means for patient counseling.  Show citation:  Blauwendraat C, Morris HR, Van Keuren-Jensen K, Noyce AJ, Singleton AB. The temporal order of genetic, environmental, and pathological risk factors in Parkinson's disease: paving the way to prevention. Lancet Neurol. 2025;24(11):969-975. doi:10.1016/S1474-4422(25)00271-6  Show transcript:  Dr. Margarita Federova: Welcome to Neurology Minute. My name is Margarita Fedorova, and I'm a neurology resident at the Cleveland Clinic. Today we're exploring a framework for understanding how genetic, environmental, and pathological factors interact in Parkinson's disease and what this means for how we counsel our patients. A personal view paper by Blauwendraat and colleagues, published in The Lancet Neurology in September 2025, addresses a critical question. We've identified over 100 genetic loci for Parkinson's, but how do they act? The common saying is genetics loads the gun and environment pulls the trigger, but this paper suggests the relationship may be more complex. The key tool here is alpha-synuclein seeding amplification assays or SAAs. These detect misfolded alpha-synuclein protein in cerebrospinal fluid. Over 90% of Parkinson's patients test positive for misfolded alpha-synuclein using this assay. But here's what's notable. 2% to 16% of neurologically healthy older adults also test positive with prevalence increasing with age. This means there are more asymptomatic people with detectable alpha-synuclein pathology than people with actual Parkinson's disease. Most of these asymptomatic individuals will never develop symptoms. This raises an important question. What determines who converts to a disease and who doesn't? By integrating SAA results with genetic data, researchers can examine whether genetic factors drive initial protein misfolding or whether they modulate the response to pathology triggered by environmental or random events. Preliminary data suggests polygenic risk scores don't strongly associate with SAA positivity in healthy older adults. In other words, people with high genetic risk for Parkinson's aren't necessarily more likely to have misfolded alpha-synuclein if they're healthy. This suggests most Parkinson's genetic risk factors may not be causing initial misfolding. Instead, they may be determining what happens afterward, such as whether the pathology progresses to clinical disease. LRRK2 mutations support this model. About 33% of LRRK2 related Parkinson's patients are SAA-negative compared to only 7% in sporadic disease. This means many people with LRRK2 mutations develop Parkinson's without the typical alpha-synuclein pathology. LRRK2 mutations also show varied pathology. Sometimes alpha-synuclein, sometimes tau, sometimes neither. This suggests LRRK2 may modulate responses to different initiating events rather than directly causing protein misfolding. What does this mean for us as clinicians? Asymptomatic SAA-positive individuals could represent a window for intervention. If we can understand what protects them from converting to disease or what triggers that conversion, we could enable earlier identification of at risk individuals and potentially intervene before symptoms develop. The authors call for large scale studies using SAAs in older populations, combined with genetic analysis and longitudinal follow-up. By integrating pathological biomarkers with genetic and environmental data, we can better understand the temporal sequence of events in development of Parkinson's. This approach could fundamentally change how we think about disease prevention and early intervention, potentially allowing us to identify at risk individuals before symptoms appear and develop targeted prevention strategies. That's your neurology minute for today. Keep exploring, and we'll see you next time. If you want to read more, please find the paper by Cornelis Blauwendraat et al titled The Temporal Order of Genetic, Environmental and Pathological Risk Factors in Parkinson's Disease: Paving the Way to Prevention, published online in September 2025 in Lancet Neurology.

What if playing it safe is actually keeping you from the life and relationships you truly want? Too often, fear convinces us to stay small, avoid discomfort, and stick to familiar routines, especially when it comes to our most important connections. The result? Missed opportunities for deep intimacy, vibrant trust, and authentic connection. It's a paradox: the very quest for comfort may be the greatest risk of all. In this episode, listeners are invited to challenge the idea that comfort equals happiness. Through inspiring stories and practical tools, the conversation explores how embracing courage, even in small, everyday ways, can lead to deeper, more meaningful relationships. Discover why facing fears (rather than running from them) is essential for personal growth and intimacy, and how a simple courage practice can transform both self-perception and connection with loved ones. Whether it's starting an uncomfortable conversation or supporting each other through life's uncertainties, this episode offers actionable steps to help anyone move from fear to flourishing in their relationships. Scott Simon is a thought leader, TEDx speaker, bestselling author, and founder of the Scare Your Soul movement, helping people transform their lives through small daily acts of courage. He's worked with the UN, Nestlé, Ritz Carlton, Logitech, and the Cleveland Clinic to build braver teams and more connected cultures. When he's not leading keynotes or designing transformative retreats, you'll find Scott chasing live music, journaling in strange airports, or hunting down the world's best hole-in-the-wall restaurants.   Episode Highlights 04:24 Overcoming the tendency to shrink back and building momentum through bravery and courage. 09:20 How embracing discomfort leads to growth and creativity. 16:16 How small actions outside your comfort zone can build courage and lead to transformative outcomes. 20:08 Challenging relationship norms for deeper bonds. 28:47 Unlocking authenticity through vulnerability in relationships. 32:10 Aligning courageous choices with core values in relationships. 35:30 Personal examples of standing in your truth. 39:56 Practicing self-awareness and micro acts of courage for relational growth.   Your Checklist of Actions to Take Start a daily courage practice: Each day, do one small thing that scares you or takes you out of your comfort zone, just as the guest recommends. Pause and check in with yourself: Before difficult conversations, take a moment to breathe deeply and center yourself, allowing self-awareness to guide your next steps. Reflect on your core values: Use your values as a filter when deciding which courageous actions to take in your relationships. Initiate honest conversations: If you're holding back something important, practice being the one to "go first" and share vulnerably, even if it feels risky. Name your feelings in real-time: During tough moments, state what you're experiencing physically or emotionally (e.g., "My heart is racing right now"), to foster connection and authenticity. Seek support for brave actions: Engage a partner or friend to do something courageous together, which can increase commitment and make the experience richer. Replace silence with authentic sharing: Consider what keeping quiet is truly serving, and choose to communicate openly instead of bottling things up. Practice small acts of kindness: Try courage-building social acts, like initiating a friendly conversation or buying someone a coffee, to strengthen your confidence and connectedness.   Mentioned Scare Your Soul (*Amazon Affiliate link) (book) David Schnarch (*Wikipedia link) Conscious Loving (*Amazon Affiliate link) (book) 12 Relationship Principles to Strengthen Your Love (free guide)   Connect with Scott Simon Websites: scottsimon.us | scareyoursoul.com Instagram: instagram.com/scareyoursoul Substack: scareyoursoul.substack.com

頻傳的施用包含依託咪酯等毒駕事件，導致交通部及內政部分別修正了「違反道路交通管理事件統一裁罰基準及處理細則」和「取締疑似施用毒品後駕車作業程序」，並於2025年11月20日正式上路執法。主持人 Zoe 分析，本次修法忽略精神物質代謝及其於體內實際作用的時間差。依照新修的兩細則規定，警察可對於行經臨檢站的汽機車及慢車駕駛，除酒測外也可進行唾液毒品快篩。一旦篩檢結果為陽性，即會被帶回警局驗尿。若駕駛在驗尿階段也呈陽性反應，就會違反刑法185-3 條「不安全駕駛罪」。Zoe 強調，唾液快篩是驗口水中的代謝殘留物，而不同的精神物質在體內作用的時間皆不相同。舉例來說，根據美國醫學權威單位 Cleveland Clinic 的研究，大麻可在唾液殘留24小時。這導致實際上路後，若台灣旅客於其他國家合法施用大麻製品後的24小時內在台灣駕駛汽機車，就有可能超過唾液快篩的門檻，導致即便沒有不能安全駕駛的情況，也會被認為違反不能安全駕駛罪。Zoe 也質疑唾液快篩執行的嚴謹性。雖新修「取締疑似施用毒品後駕車作業程序」有規範警察在判斷危害車輛時須符合「比例原則」，但 Zoe 認為警察在績效壓力下可能會以不同方式使駕駛同意自願搜索。駕駛若拒絕配合唾液快篩，「違反道路交通管理事件統一裁罰基準及處理細則」第19-4條規範，汽車駕駛人可處$18萬罰緩並吊銷駕照及吊扣牌照，慢車則可處 $4,800。Zoe 再次講解了「具體危險」和「抽象危險」的定義（聽眾朋友也可複習 EP123）。Zoe 也最後呼籲，她嚴格反對毒品濫用及毒駕，但她認為立法者及學者專家需要重視精神活性物質的實際作用和代謝時間這個支點，因現行規範是將「具體危險拉成抽象危險」。節目聲明：大麻

President Donald Trump has threatened to invoke the Insurrection Act to quell ongoing anti-ICE demonstrations in Minnesota in the wake of the shooting death of Renee Good by a U.S. Immigration and Customs Enforcement agent. Protests have erupted nationwide after Good's death, and there have been many in Northeast Ohio communities, including Cleveland, Akron and Kent. This week, social media has been filled locally with unverified reports of ICE activities in Cleveland. Noted immigration attorney Margaret Wong said there were reports of ICE agents in Cleveland and offered advice about people's rights should ICE agents come to their door. Cleveland Police took the extraordinary step on Wednesday to issue a statement saying it's not its job to enforce general federal immigration law. We will begin Friday's “Sound of Ideas Reporters Roundtable” with a discussion of CPD's statement and rising concerns over ICE. FirstEnergy is asking the Public Utilities Commission of Ohio to lower reliability standards for power outages, basically allowing for more outages that last longer before its determined that standards weren't met. A first hearing is scheduled for next month. The Cleveland Clinic announced yesterday that it intends to earn certification as a Level 1 trauma center at its Main Campus by 2028, its second Level 1 trauma center in the region, after Akron General. Cleveland Clinic main campus leader Dr. Scott Steele said he sees a need for this top tier of trauma care within the Clinic's own system. But Cleveland already has Level 1 trauma centers -- operated University Hospitals and also by MetroHealth, which called for the clinic to reconsider and claimed patient costs would rise as a result of the clinic's actions. An effort to repeal a new state law that makes changes to the recreational marijuana statute passed by voters and also bans intoxicating hemp suffered a setback this week. A group trying to prevent Senate Bill 56 from going into effect and allow voters to decide whether to repeal it in November had its petition summary language rejected by Attorney General Dave Yost. We've heard a lot about the Browns planned move to a new enclosed stadium in Brook Park from the Cleveland perspective. Now, we're getting a bit more insight into how the mega project could impact Brook Park. This week the Northeast Ohio Areawide Coordinating Agency or NOACA held a meeting about how the stadium could impact traffic. The Canton Hall of Fame Village has secured financing that could jump start the stalled construction on a massive indoor water park. "Game Day Bay" sits at the front of the Village property was started in 2022 but has been sitting unfinished since 2024. All this week on Ideastream Public Media you've been hearing reporting about the firefighting crisis facing Ohio. 70% of Ohio's fire departments are at least partially staffed by volunteers. Those volunteer positions are getting harder to fill as current volunteers near retirement. The reporting is a collaboration between Ideastream and The Ohio Newsroom and you'll find all the stories on our website as "Sound the Alarm". Guests: Glenn Forbes, Deputy Editor of News, Ideastream Public Media Abigail Bottar, Reporter, Ideastream Public News Karen Kasler, Statehouse News Bureau Chief, Ohio Public Radio/TV

The Cleveland Clinic will open a trauma 1 emergency center, to handle the most life-threatening emergencies Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us a textTingling toes. A strange electric buzz that won't let you sleep. We sat down with Dr. John Morren, Director of the Neuromuscular Center at Cleveland Clinic, to unpack what truly drives peripheral neuropathy, how to read the early signs, and which treatments actually help you function and rest again.We trace the most common causes—diabetes and the broader metabolic syndrome—while surfacing underrecognized risks like rapid weight loss, malabsorption after bariatric surgery, chemotherapy, infections, alcohol, and hidden vitamin pitfalls. B12 deficiency takes center stage as a treatable driver; we talk real thresholds, why neurologists aim above 400, and how methylmalonic acid exposes low B12 even when standard labs look “normal.”Looking ahead, we explore AI as augmented intelligence: tools that flag high-risk patients in primary care, prompt simple screening steps, and sharpen EMG and nerve conduction studies to detect nerve damage earlier. It's not man versus machine; it's smarter care through synergy, personalizing treatment and expanding access without losing the human touch.Support the show

He was a doctor, a father, and an experienced outdoorsman on a long-planned trip into Colorado's backcountry. It started off according to plan- until he continued on alone. What followed was a disappearance that sparked a massive search and left behind more questions than answers.Sources:Reddit, Edmonds and Evans Funeral and Cremation Services, Historic Fix, Cleveland Clinic, Post Independent, South Bend Tribune, Strange Outdoors, Eiseman HutSupport us on Patreon for as little as $1 a month, with benefits starting at the $3 tier!Follow us on Instagram at offthetrailspodcastFollow us on Facebook at Off the Trails PodcastIf you have your own outdoor misadventure (or adventure) story that you'd like us to include in a listener episode, send it to us at offthetrailspodcast@gmail.com  Please take a moment to rate and review our show, and a big thanks if you already have!**We do our own research and try our best to cross-reference reliable sources to present the most accurate information we can. Please reach out to us if you believe we have mispresented any information during this episode, and we will be happy to correct ourselves in a future episode.

Who should consider fertility preservation, when is the right time, and what are the risks? In this episode of BackTable OBGYN, Dr. Amy Park interviews Dr. Mindy Christianson, the section head of Reproductive Endocrinology and Infertility at the Cleveland Clinic, who shares how fertility preservation is evolving for patients planning families and those facing fertility-impacting treatments. --- SYNPOSIS Dr. Christianson discusses her journey into the field of fertility preservation, inspired by an early encounter with a breast cancer patient. The conversation covers various aspects of fertility preservation, including the preservation of eggs, embryos, ovarian and testicular tissue, and planned fertility preservation. Dr. Christianson elaborates on the protocols, patient demographics, and the evolving collaboration between oncology and reproductive endocrinology. The discussion also highlights technologies like ovarian tissue transplantation and in vitro maturation, as well as practical tips for healthcare providers on improving patient access to fertility preservation services. --- TIMESTAMPS 00:00 - Introduction03:34 - Understanding Fertility Preservation07:56 - Consultation Process for Fertility Preservation17:36 - Advancements in Egg Freezing Technology25:55 - Egg Freezing Recommendations26:34 - Collaboration Between Oncology and REI26:52 - Pediatric Oncology and Fertility Preservation28:58 - Ovarian Tissue Transplantation33:17 - Uterine Transposition Surgery40:05 - Gene Editing and Fertility Preservation43:01 - Financial and Emotional Aspects of Fertility Preservation48:02 - Practical Advice for OBGYNs51:12 - Resources and Final Thoughts --- RESOURCES Livestrong Fertilityhttps://livestrong.org/how-we-help/livestrong-fertility/ Resolve: The National Infertility Associationhttps://resolve.org/ Society for Assisted Reproductive Technologyhttps://www.sart.org/ American Society for Reproductive Medicinehttps://www.asrm.org/

In this episode of the Weinberg in the World podcast, Olyvia Chinchilla '18 shares how early experiences (from studying abroad in Poland to working with a Stanford-affiliated nonprofit) shaped her passion for economics, social justice, and empathy-driven research. Olyvia reflects on the challenges and rewards of creating change, emphasizing the importance of adaptability, framing conversations, and seeing people beyond statistics. Her career journey spans teaching, global research, and policy analysis. Transcript: Leonie: How did your career begin, and what were your career goals coming out of undergrad? Olyvia: Well, I believe I mentioned while I was at Northwestern, I had been in the reserve officer training course, I had been planning to go into the Navy, and that ended up not panning out because of a few athletic injuries. But earlier in my time at Northwestern, I believe it was the summer of my sophomore year, I studied abroad. And I was studying in Poland and it was my first time actually being out of the country, so it was super exciting. And I was just super excited also to explore Poland because my mom is originally from Poland. So it was just this really amazing moment. And I remember going into that program not being able to fully form sentences, to then leaving the program a few weeks later and literally just talking to my friends in the program in Polish as we tried to navigate the city. And I owed a lot of that to one of the instructors there at the program. So she spoke Polish the whole time, but she was so patient whenever we couldn't get it or we didn't understand or there's a translation error. And I think in that moment, my passion for learning was melded with my... I had this vision of perhaps using that to then also teach. So I had this idea, it stuck in the back of my mind, "Oh, maybe I could take a year off and teach or teach down the road." I did not take a year off, I went back to Northwestern, but I was at a career fair later. And one of the first people I ran into was a national teaching organization. And so that, again, kind of stoked that thought in my mind. And I had planned to actually teach for that program I got accepted, but then I took a year off actually to have a medical procedure following one of the athletic injuries. And when I took that year off, I'm like, "I'll just go to San Francisco for a few months and then Australia for the rest of that year." That was my plan to travel as I recovered. But when I got to San Francisco, I ended up getting in touch through the Northwestern network with a nonprofit based out of Stanford University, so they were sponsored by Stanford. And it was perfect because it melded my interest in teaching because they had a large educational component in the program for fifth through 12th grade students. And then there was also a significant amount of research being conducted by all of the people at the institution. So it was such, I think, a perfect blend for me because then I got to teach as well as do a lot of research for the program. And I actually ended up researching five continents, or I should say four. I didn't go to the last one, but I definitely traveled the whole world doing that research. So it was quite exciting. Leonie: Wow. What subjects were you teaching? Olyvia: So the program was structured so that people could focus on their specialties in teaching and research. So I was focused on economic and social policy, and I had colleagues that worked on immigration more specifically, more specifically on cybersecurity, technology issues. I did cover some of technology like AI issues where it met with economics. So I say I covered a lot of issues, but my specialty was always coming at it from an economic and social perspective. Leonie: And then I assume the research you were doing was related to economic policy? Olyvia: Yes, yes. Policy, but I would say also some of the societal and ethical questions that come up along with policymaking as well as just how communities work and operate. So for example, when we were studying immigration, we were also interviewing a lot of local businesses on the US-Mexico border. We talked with a lot of locals, nonprofits, immigration advocates. So it was kind of like a 360-degree look, but I was always the one who brought that economic knowledge and thought a lot about a lot of social issues too. So that's why several years later, I actually went to London to get a master's in political sociology. So that politics and society part, I think was definitely an element along with the economics. Leonie: Yeah. And you kind of touched on this earlier when you were speaking, but you can expand on it now. What was your motivation for going into this field? Olyvia: So I think I've always just been really fascinated with how people think and how people also are affected by different structures. And that's where the economics piece comes in because economics, of course, impacts different people differently, impacts different communities differently based on how the policies are structured. So I, for almost as long as I can remember, have been interested in economics. I remember as a 12-year-old, I read Adam Smith's The Wealth of Nations, and it was a really long book, but at that age, I was still really fascinated by it. So I've always just had that interest, how money interacts with people. But as I've went along, and definitely the role I was in really opened myself to thinking even more about a lot of the ways in which money and economics also creates wealth disparities, racial disparities, disparities for other minorities, like gender groups. So I feel like all of that, my thought and motivation has evolved quite a bit, I will say, but I think that as I've come along in my career, I've really, as I've just talked to so many people across the entire world, whether it's the communities in Colombia that are still recovering from drug trafficking or whether it's in Iceland talking to different police and then social groups or Portugal as they're working on drug decriminalization, and then seeing that in San Francisco as well in the criminal justice system, just having all of these conversations has really made me really just be motivated to see how we can create the best world for marginalized groups. Leonie: Yeah. And then along those lines, what has been the most rewarding and the most challenging aspect of your job? Olyvia: So for one, for teaching, it was incredibly rewarding to be able to work with students and to see them understand something. And I think it felt to me a little bit of a puzzle when they didn't as well, how's the best way you can communicate, what's the best way to present a topic? And what I found actually, which was interesting to me with teaching was that oftentimes the way I would structure a lesson to start would actually be the exact opposite of how I would end up teaching it. So I would perhaps structure it linearly, and then I compared it to pulling a plastic bag inside out. You would take something from the middle of that linear story and move it to the beginning and switch things around because I think the way that we actually think is often different than the way that we're tempted to explain things. So working with that jigsaw puzzle of how to best explain things was also very fascinating. And I think it's also inspired a lot of my thought process about even as I move forward with potentially moving more into policy implementation or other work and policy, definitely that experience will shape that moving forward because I find how we frame conversations around social policymaking really makes a big difference in terms of how it's understood, how it's received, even how people access the program, for example. There was a study I found very fascinating that was conducted, I believe it was by the University of Minnesota economists. And what they found was that even if they sent a letter in the mail to underprivileged students saying, "Hey, you qualify for this scholarship," but it was actually the same sort of funding they would get anyway just based on their need status, students were more likely to apply for that program. And so I think things like that are really fascinating where we're framing and conversation, thinking about how people think, not just students, but people broadly really does have a big impact on policy. So I think it was very just amazing and fulfilling to actually have that opportunity to grapple with that. But I think also even just the idea of stepping into a space where you're actively envisioning, researching, working towards creating a better world was very fulfilling. On the flip side, I think it is the same thing that's rewarding in that regards is also sometimes one of the challenges that I think definitely as someone who I really aspire to be a changemaker, and I think that that's sometimes you're constantly learning, constantly thinking. And I think sometimes it's easy to... It's challenging, I should say. It's easy to get burnt out or it's easy to perhaps work too hard maybe. But I would say, for example, even just some of the interviews that we conducted with people were challenging even to talk to unhoused people in the city or to talk to people in poverty in Aspen, Colorado when we were studying poverty there, or to interview people that had fled from Gaza and to hear their stories, all of those were definitely very emotionally challenging stories. And I think to meet people in that space, you have to give out a certain amount of empathy and understanding, even if it's for research purposes. And I think just navigating that balance was challenging in its own way. Leonie: Definitely. I think the point about balance is a really good one. I think being able to incorporate empathy into research is a very critical skill that I think sometimes is lacking. So I really do appreciate that point. And based on your vast experiences, how has your mindset towards your career evolved over time? Olyvia: It's interesting because I guess when I was younger, maybe a teenager, I was like, "Oh, A, B, C." And then when I was at Northwestern and it was like, "Well, you do this, and then that, and then this, and it's maybe not quite as linear as the alphabet, but it's point A, B, C." And so you kind of move forward. I think more recently I've come to realize that there's, and this has been a recurring lesson actually. It's not just now, but I would say when I left the military, for example, that was a lesson I was like, "There's many routes to the same destination. If service is one of my goals, there's many ways to serve, even if it's not in the military." Nowadays, I'm thinking about the fact that I stayed in San Francisco many years longer than I had expected. I was supposed to stay for three months, it became three years, six years, and counting at the moment. So I think one of the things I really realized is that sometimes life takes you in very different directions than you would've expected, and that's the same with your career. I think that definitely can be a challenge to be patient and understanding with the evolution that takes place, but definitely the experiences may be just as fulfilling on a very different route than what you had envisioned. Leonie: Yeah. Bringing us back to our Northwestern connection, are there any moments in your career that reminded you of CORE connected you to a lesson you learned at Northwestern? Olyvia: What I mentioned earlier about having the capacity to balance your own emotional needs as well as create change and serve, all of those lessons were lessons that I really learned at Northwestern. I remember when I was in ROTC, we watched this video that the Cleveland Clinic had put out, and it was a video that just shows different scenes in the hospital, but then it has thought bubbles next to the people. So for example, the girl petting the dog, it's like, "Well, her dad's dying of cancer. Or the woman sitting in the waiting room, she saw something on her mammogram." So all of these different thoughts and emotions people are experiencing, but you don't really know anything about it. And having such a diverse community at Northwestern as well as just thinking about that practice of empathy every day really helped me to see that even at Northwestern and since then, is that you might run into someone and think, "Oh, I don't know what to think about this person," or, "Oh, they're frustrating me at work," or, "Oh, this is happening." But a lot of times there's a lot more beneath the surface than we expect. So I think that lesson of empathy as well as humility is definitely... And I'd say empathy, humility, as well as endless possibilities for different lives of different people that all came together and sent me on a passion for learning and understanding people because I've come full circle, but I would say all of those lessons have really stuck with me throughout my work. And I'd say along those lines, in research, everyone that you're interviewing is more than a statistic. Leonie: Absolutely. Olyvia: A lot of times it's really hard to quantify things and we do our best as researchers, but sometimes what doesn't go into the research is actually sometimes the most impactful in many ways. Leonie: Yeah. Thank you for that answer. I'm a philosophy major and we've been talking a lot about character virtues, and so empathy comes up a lot in our classes. And yeah, seeing how you're able to use empathy in your research and looking at people's more than a statistic, I remember saying it before. Yeah, I think that's really touching and it gives me faith in the further research world and what people are able to do when they look at people beyond just their statistical measurements and whatnot. Yeah. Is there- Olyvia: Well, and I think to that point though, I think even if we think about ways that we've began to see different characteristics that have been left out of research, for example, even if we think about rates of death among African-American women during childbirth, or if we think about maybe other environmental effects of certain policies on particular communities that live by highways, for example, and low-income communities, all of that, if you don't look at the bigger picture, might go unnoticed, but definitely if you bring in those larger stories to individual people, you can understand a situation better. Leonie: Absolutely. Thank you for that.  

In this episode, Dr. Bruno Fernandes acts as host alongside special guest co-host Dr. Carlos Quezada-Ruiz to welcome Dr. Rishi Singh, the newly appointed Chair of Ophthalmology at Harvard Medical School and Mass Eye and Ear, and Chair of the Integrated Department of Ophthalmology at Mass General Brigham. Dr. Singh joins the podcast just 42 days into his new tenure to discuss the transition from the Cleveland Clinic to one of the world's most prestigious academic institutions. Key topics in this episode include: The "First 90 Days" Approach: Why listening is more important than prescribing solutions when taking on a new leadership role. The Circuitous Career Path: How taking on "unsexy" jobs like coding and documentation can build the essential skills needed for executive leadership. AI Realism: Dr. Singh shares his cautious optimism regarding Artificial Intelligence, discussing why it won't solve basic logistical issues instantly and the dangers of relying on the "black box" without human oversight. Retina & Drug Development: A look at the logistical burdens of Wet AMD treatment, the complexities of clinical trials, and the potential (and current limitations) of gene therapy as a "Holy Grail." Mentorship: Why being "uncomfortable" is the best way to grow as a young ophthalmologist. About the Guest: Dr. Rishi Singh is a vitreoretinal surgeon and physician-scientist with over 300 peer-reviewed publications. He formerly served as Vice President and Chief Medical Officer at Cleveland Clinic Martin Hospitals.

According to The Cleveland Clinic, around one in four people are affected by bad breath. It's also known as halitosis and bad breath can be a source of embarrassment. It's sometimes caused by consuming certain well-known foods, like garlic, onion, cheese, and coffee for example.  But it can also be a symptom of an underlying health condition, such as pneumonia, gum recession, kidney disease and gastrointestinal disorders. Do bacteria have anything to do with it? How can we avoid bad breath? In under 3 minutes, we answer your questions ! To listen to the latest episodes, click here: ⁠⁠Why do our stomachs rumble?⁠⁠ ⁠⁠Why does hair turn grey?⁠⁠ ⁠⁠What does it mean to be a seenager?⁠⁠ A Bababam Originals podcast written and realised by Joseph Chance. First Broadcast: 21/5/2023 Learn more about your ad choices. Visit megaphone.fm/adchoices

Using health data to rapidly identify clinical trial participants wherever they are broadens the reach of leading-edge oncology care and frees up nurses' time for patient care, says Dr. Aaron Gerds at the Cleveland Clinic's Cancer Institute.

Welcome to Ozempic Weightloss Unlocked, the podcast where we explore the latest news and breakthroughs surrounding one of today's most talked about medications.I'm your host, and today we're diving into what you need to know about Ozempic and its growing role in weight management and health.Let's start with the basics. Ozempic is a medication originally approved by the FDA for managing Type 2 diabetes. But here's where it gets interesting. The medication contains semaglutide, the same active ingredient found in Wegovy, which was specifically approved as an anti-obesity treatment. According to Cleveland Clinic, when Ozempic is prescribed for weight loss, it's considered off-label use, meaning doctors are prescribing it for a purpose beyond its original FDA approval.So how does it actually work? Ozempic belongs to a class of medications called GLP-1 receptor agonists. These drugs mimic a hormone your digestive tract naturally produces. When you take Ozempic, your body produces more of this hormone, which decreases your appetite and makes you feel fuller. But it does more than just suppress hunger. Cleveland Clinic explains that semaglutide changes how your body responds to food and weight loss by affecting the signaling between your gut and brain. This is significant because it treats obesity as a metabolic disease, not simply a behavioral problem.The weight loss results speak for themselves. In a landmark study cited by Cleveland Clinic, people using semaglutide combined with lifestyle changes lost about fifteen percent of their body weight in sixty-eight weeks, averaging thirty-four pounds. Those who didn't take the medication lost only about six pounds on average.But listeners, there's an important reality to understand. These medications aren't quick fixes. According to Cleveland Clinic, people often regain weight once they stop taking the medication. A follow-up study mentioned by Sword Health found that people who stopped semaglutide regained about two-thirds of the weight they lost within a year.Here's another critical point. Research shows that up to thirty-nine percent of weight lost on these medications can come from lean muscle, not just fat. This matters because muscle supports your metabolism. When you lose muscle, your body burns fewer calories, which can lead to weight loss plateaus. The solution isn't eating less. According to Sword Health, the most effective approach is preserving and rebuilding muscle through strength-focused movement.It's also important to know that Ozempic isn't suitable for everyone. Cleveland Clinic warns against obtaining these medications through unverified sources or compounded versions. The safety and effectiveness of compounded versions haven't been formally tested and may act differently in your body than FDA-approved versions.Cost remains a significant barrier. Cleveland Clinic notes that these medications can be expensive due to limited insurance coverage, which is why some listeners might be tempted to seek cheaper alternatives online. But that's where caution is essential.Looking ahead, research is exploring additional benefits beyond weight loss. These medications are now being studied for potential effects on aging and other health conditions.The bottom line for our listeners is this: Ozempic can be a powerful tool for managing obesity when combined with lifestyle changes and professional medical supervision. But it requires a long-term commitment and shouldn't be viewed as a quick solution.Thank you for tuning in to Ozempic Weightloss Unlocked. Please subscribe for more episodes exploring the latest developments in weight management medicine and health innovation.This has been a Quiet Please production, for more check out quiet please dot ai. Some great Deals https://amzn.to/49SJ3QsFor more check out http://www.quietplease.aiThis content was created in partnership and with the help of Artificial Intelligence AI

In this episode of The Medicine Grand Rounders, we're joined by Dr. Wilson Tang, research director and staff cardiologist in the section of heart failure and cardiac transplantation, who delves into the cardiorenal physiology, decongestion strategies and future therapies. Moderated by: Faysal Massad

On Today's episode of Transforming Healthcare with Dr. Wael Barsoum, we're honored to be filming today with Allen Passerallo. Allen Passerallo is Vice President of Category Management at Vizient, where he leads contracting and category management strategies for orthopedics and neuro-physician preference items, with a focus on cost management in ambulatory surgery centers (ASCs). He brings extensive experience in healthcare supply chain, sourcing and value analysis, with prior leadership roles at Johns Hopkins Health System and Cleveland Clinic. Allen holds an MBA from Indiana Wesleyan University and a Bachelor of Science in Sports Medicine from Mercyhurst University. Join us as we discuss supply chain, performance improvement, incentivization, alignment, and ASCs.

JCO PO author Dr. Shilpa Gupta at Cleveland Clinic Children's Hospital shares insights into her article, "Fibroblast Growth Factor Receptor 3 (FGFR3) Alteration Status and Outcomes on Immune Checkpoint Inhibitors (ICPI) in Patients with Metastatic Urothelial Carcinoma". Host Dr. Rafeh Naqash and Dr. Gupta discuss how FGFR3 combined with TMB emerged as a biomarker that may be predictive for response to ICPI in mUC. TRANSCRIPT Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, podcast editor for JCO Precision Oncology and Associate Professor at the OU Health Stephenson Cancer Center. Today I am excited to be joined by Dr. Shilpa Gupta, Director of Genitourinary Medical Oncology at the Cancer Institute and co-leader of the GU Oncology Program at the Cleveland Clinic, and also lead author of the JCO PO article titled "Fibroblast Growth Factor Receptor 3 Alteration Status and Outcomes on Immune Checkpoint Inhibitors in Patients With Metastatic Urothelial Carcinoma." At the time of this recording, our guest's disclosures will be linked in the transcript. Shilpa, welcome again to the podcast. Thank you for joining us today. Dr. Shilpa Gupta: Thank you, Rafeh. Honor to be here with you again. Dr. Rafeh Naqash: It is nice to connect with you again after two years, approximately. I think we were in our infancy of our JCO PO podcast when we had you first time, and it has been an interesting journey since then. Dr. Shilpa Gupta: Absolutely. Dr. Rafeh Naqash: Well, excited to talk to you about this article that you published. Wanted to first understand what is the genomic landscape of urothelial cancer in general, and why should we be interested in FGFR3 alterations specifically? Dr. Shilpa Gupta: Bladder cancer or urothelial cancer is a very heterogeneous cancer. And while we find there is a lot of mutations can be there, you know, like BRCA1, 2, in HER2, in FGFR, we never really understood what is driving the cancer. Like a lot of old studies with targeted therapies did not really work. For example, we think VEGF can be upregulated, but VEGF inhibitors have not really shown definite promise so far. Now, FGFR3 receptor is the only therapeutic target so far that has an FDA approved therapy for treating metastatic urothelial cancer patients, and erdafitinib was approved in 2019 for patients whose tumors overexpressed FGFR3 mutations, alterations, or fusions. And in the landscape of bladder cancer, it is important because in patients with non-muscle invasive bladder cancer, about 70 to 80% patients can have this FGFR3. But as patients become metastatic, the alterations are seen in, you know, only about 10% of patients. So the clinical trials that got the erdafitinib approved actually used archival tumor from local cancer. So when in the real world, we don't see a lot of patients if we are trying to do metastatic lesion biopsies. And why it is important to know this is because that is the only targeted therapy available for our patients right now. Dr. Rafeh Naqash: Thank you for giving us that overview. Now, on the clinical side, there is obviously some interesting data for FGFR3 on the mutation side and the fusion side. In your clinical practice, do you tend to approach these patients differently when you have a mutation versus when you have a fusion? Dr. Shilpa Gupta: We can use the treatment regardless of that. Dr. Rafeh Naqash: I recently remember I had a patient with lung cancer, squamous lung cancer, who also had a synchronous bladder mass. And the first thought from multiple colleagues was that this is metastatic lung. And interestingly, the liquid biopsy ended up showing an FGFR3-TACC fusion, which we generally don't see in squamous lung cancers. And then eventually, I was able to convince our GU colleagues, urologists, to get a biopsy. They did a transurethral resection of this tumor, ended up being primary urothelial and synchronous lung, which again, going back to the FGFR3 story, I saw in your paper there is a mention of FGFR3-TACC fusions. Anything interesting that you find with these fusions as far as biology or tumor behavior is concerned? Dr. Shilpa Gupta: We found in our paper of all the patients that were sequenced that 20% had the pathognomonic FGFR3 alteration, and the most common were the S249C, and the FGFR3-TACC3 fusion was in 45 patients. And basically I will say that we didn't want to generate too much as to fusion or the differences in that. The key aspect of this paper was that historically there were these anecdotal reports saying that patients who have FGFR alterations or mutations, they may not respond well to checkpoint inhibitors because they have the luminal subtype. And these were backed by some preclinical data and small anecdotal reports. But since then, we have seen that, and that's why a lot of people would say that if somebody's tumor has FGFR3, don't give them immunotherapy, give them erdafitinib first, right? So then we had this Phase 3 trial called the THOR trial, which actually showed that giving erdafitinib before pembrolizumab was not better. That debunked that myth, and we are actually reiterating that because in our work we found that patients who had FGFR3 alterations or fusions, and if they also have TMB-high, they actually respond very well to single agent immunotherapy. And that is, I think, very important because it tells us that we are not really seeing that so-called potential of resistance to immunotherapy in these patients. So to answer your question, yeah, we did see those differences, but I wouldn't say that any one marker is more prominent. Dr. Rafeh Naqash: The analogy is kind of similar to what we see in lung cancer with these mutations called STK11/KEAP1, which are also present in some other tumors. And one of the questions that I don't think has been answered is when you have in lung cancer, if you extrapolate this, where doublet or single agent immunotherapy doesn't do as well in tumors that are STK11 mutated. But then if you have a high TMB, question is does that TMB supersede or trump the actual mutation? Could that be one reason why you see the TMB-high but FGFR3 altered tumors in your dataset responding or having better outcomes to immunotherapy where potentially there is just more neoantigens and that results in a more durable or perhaps better response to checkpoint therapy? Dr. Shilpa Gupta: It could be. But you know, the patients who have FGFR alterations are not that many, right? So we have already seen that just patients with TMB-high respond very well to immunotherapy. Our last podcast was actually on that, regardless of PD-L1 that was a better predictor of response to immunotherapy. So I think it's not clear if this is adding more chances of response or not, because either way they would respond. But what we didn't see, which was good, that if they had FGFR3, it's not really downplaying the fact that they have TMB-high and that patients are not responding to immunotherapy. So we saw that regardless, and that was very reassuring. Dr. Rafeh Naqash: So if tomorrow in your clinic you had an individual with an FGFR3 alteration but TMB-high, I guess one could be comfortable just going ahead with immunotherapy, which is what the THOR trial as you mentioned. Dr. Shilpa Gupta: Yes, absolutely. And you know, when you look at the toxicity profiles of pembrolizumab and erdafitinib, really patients really struggle with using the FGFR3 inhibitors. And of course, if they have to use it, we have to, and we reserve it for patients. But it's not an easy drug to tolerate. Currently the landscape is such that, you know, frontline therapy has now evolved with an ADC and immunotherapy combinations. So really if patients progress and have FGFR3 alterations, we are using erdafitinib. But let's say if there were a situation where a patient has had chemotherapy, no immunotherapy, and they have FGFR3 upregulation and TMB-high, yes, I would be comfortable with using only pembrolizumab. And that really ties well together what we saw in the THOR trial as well. Dr. Rafeh Naqash: Going to the clinical applications, you mentioned a little bit of this in the manuscript, is combination therapies. You alluded to it a second back. Everything tends to get combined with checkpoint therapy these days, as you've seen with the frontline urothelial, pembrolizumab with an ADC. What is the landscape like as far as some of these FGFR alterations are concerned? Is it reasonable to combine some of those drugs with immune checkpoint therapy? And what are some of the toxicity patterns that you've potentially seen in your experience? Dr. Shilpa Gupta: So there was indeed a trial called the NORSE trial. It was a randomized trial but not a comparative cohort, where they looked at FGFR altered patients. And when they combined erdafitinib plus cetrelimab, that did numerically the response rates were much higher than those who got just erdafitinib. So yeah, the combination is definitely doable. There is no overlapping toxicities. But unfortunately that combination has not really moved forward to a Phase 3 trial because it's so challenging to enroll patients with such kind of rare mutations on large trials, especially to do registration trials. And since then the frontline therapy has evolved to enfortumab vedotin and pembrolizumab. I know there is an early phase trial looking at a next generation FGFR inhibitor. There is a triplet combination looking in Phase 1 setting with a next generation FGFR inhibitor with EV-pembro. However, it's not a randomized trial. So you know, I worry about such kinds of combinations where we don't have a path for registration. And in the four patients that have been treated, four or five patients in the early phase as a part of basket trial, the toxicities were a lot, you know, when you combine the EV-pembro and an FGFR3 inhibitor, we see more and more toxicity. So the big question is do we really need the "kitchen sink" approach when we have a very good doublet, or unless the bar is so high with the doublet, like what are we trying to add at the expense of patient toxicity and quality of life is the big question in my mind. Dr. Rafeh Naqash: Going back to your manuscript specifically, there could be a composite biomarker. You point out like FGFR in addition to FGFR TMB ends up being predictive prognostic there. So that could potentially be used as an approach to stratify patients as far as treatment, whether it's a single agent versus combination. Maybe the TMB-low/FGFR3 mutated require a combination, but the TMB-high/FGFR mutated don't require a combination, right? Dr. Shilpa Gupta: No, that's a great point, yeah. Dr. Rafeh Naqash: But again, very interesting, intriguing concepts that you've alluded to and described in this manuscript. Now, a quick take on how things have changed in the bladder cancer space in the last two years. We did a podcast with you regarding some biomarkers as you mentioned two years back. So I really would like to spend the next minute to two to understand how have things changed in the bladder cancer space? What are some of the exciting things that were not there two years back that are in practice now? And how do you anticipate the next two years to be like? Maybe we'll have another podcast with you in another two years when the space will have changed even more. Dr. Shilpa Gupta: Certainly a lot has happened in the two years, you know. EV-pembro became the universal frontline standard, right? We have really moved away from cisplatin eligibility in metastatic setting because anybody would benefit from EV-pembro regardless of whether they are candidates for cisplatin or not, which historically was relevant. And just two days ago, we saw that EV-pembro has now been approved for localized bladder cancer for patients who are cisplatin ineligible or refusing. So, you know, this very effective regimen moving into earlier setting, we now have to really think of good treatment options in the metastatic setting, right? So I think that's where a lot of these novel combinations may come up. And what else we've seen is in a tumor agnostic trial called the DESTINY-PanTumor trial, patients who had HER2 3+ on immunohistochemistry, we saw the drug approval for T-DXd, and I think that has kind of reinvigorated the interest in HER2 in bladder cancer, because in the past targeting HER2 really didn't work. And we still don't know if HER2 is a driver or not. And at ESMO this year, we saw an excellent study coming out of China with DV which is targeting HER2, and toripalimab, which is a Chinese checkpoint inhibitor, showing pretty much similar results to what we saw with EV-pembro. Now, you know, not to do cross-trial comparisons, but that was really an amazing, amazing study. It was in the presidential session. And I think the big question is: does that really tell us that HER2-low patients will not benefit? Because that included 1+, 2+, 3+. So that part we really don't know, and I think we want to study from the EV-302 how the HER2 positive patients did with EV and pembro. So that's an additional option, at least in China, and hopefully if it gets approved here, there is a trial going on with DV and pembro. And lastly, we've seen a very promising biomarker, like ctDNA, for the first time in bladder cancer in the adjuvant setting guiding treatment with adjuvant atezolizumab. So patients who were ctDNA positive derived overall survival and recurrence-free survival benefit. So that could help us select moving forward with more studies. We can spare unnecessary checkpoint inhibitors in patients who are not going to benefit. So I think there is a lot happening in our field, and this will help do more studies because we already have the next generation FGFR inhibitors which don't have the toxicities that erdafitinib comes with. And combining those with these novel ADCs and checkpoint inhibitors, you know, using maybe TMB as a biomarker, because we really need to move away from PD-L1 in bladder cancer. It's shown no utility whatsoever, but TMB has. Dr. Rafeh Naqash: Well, thank you so much, Shilpa, for that tour de force of how things have changed in bladder cancer. There used to be a time when lung and melanoma used to lead this space in terms of the number of approvals, the biomarker development. It looks like bladder cancer is shifting the trend at this stage. So definitely exciting to see all the new changes that are coming up. I'd like to spend another minute and a half on your career. You've obviously been a leader and example for many people in the GU space and beyond. Could you, for the sake of our early career especially, the trainees and other listeners, describe how you focused on things that you're currently leading as a leader, and how you shaped your career trajectory over the last 10 years? Dr. Shilpa Gupta: That's a really important question, Rafeh, and you and I have had these discussions before, you know, being an IMG on visas like you, and being in different places. I think I try to make the most of it, you know, instead of focusing on the setbacks or the negative things. Like tried to grab the opportunities that came along. When I was at Moffitt, got to get involved with the Phase 1 trial of pembrolizumab in different tumor types. And just keeping my options open, you know, getting into the bladder cancer at that time when I wanted to really do only prostate, but it was a good idea for me to keep my options open and got all these opportunities that I made use of. I think an important thing is to, like you said, you know, have a focus. So I am trying to focus more on biomarkers that, you know, we know that 70% patients will respond to EV-pembro, right? But what about the remaining 30%? Like, so I'm really trying to understand what determines hyperprogressors with such effective regimens who we really struggle with in the clinic. They really don't do well with anything we give them after that. So we are doing some work with that and also trying to focus on PROs and kind of patient-reported outcomes. And a special interest that I've now developed and working on it is young-onset bladder cancer. You know, the colorectal cancer world has made a lot of progress and we are really far behind. And bladder cancer has historically been a disease of the elderly, which is not the case anymore. We are seeing patients in their 30s and 40s. So we launched this young-onset bladder cancer initiative at a Bladder Cancer Advocacy Network meeting and now looking at more deep dive and creating a working group around that. But yeah, you know, I would say that my philosophy has been to just take the best out of the situation I'm in, no matter where I am. And it has just helped shape my career where I am, despite everything. Dr. Rafeh Naqash: Well, thank you again. It is always a pleasure to learn from your experiences and things that you have helped lead. Appreciate all your insights, and thank you for publishing with JCO PO. Hopefully we will see more of your biomarker work being published and perhaps bring you for another podcast in a couple of years. Dr. Shilpa Gupta: Yeah, thank you, Rafeh, for the opportunity. And thanks to JCO PO for making these podcasts for our readers. So thanks a lot. Dr. Rafeh Naqash: Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcast. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. DISCLOSURES Dr. Shilpa Gupta Stock and Other Ownership Interests: Company: BioNTech SE,  Nektar Consulting or Advisory Role: Company: Gilead Sciences, Pfizer, Merck, Foundation Medicine, Bristol-Myers Squibb/Medarex, Natera, Astellas Pharma, AstraZeneca, Novartis, Johnson & Johnson/Janssen Research Funding: Recipient: Your Institution Company: Bristol Myers Squibb Foundation, Merck, Roche/Genentech, EMD Serono, Exelixis, Novartis, Tyra Biosciences, Pfizer, Convergent Therapeutics, Acrivon Therapeutics, Flare Therapeutics, Amgen Travel, Accommodations, Expenses: Company: Pfizer, Astellas Pharma, Merck    

Instead of trying to get rid of dopamine, focus on stepping away from habits and behaviors that no longer serve you.Read the Harvard Article on Dopamine Fasting here. Read the Cleveland Clinic's: Dopamine Detoxes Don't Work: Here's What To Do InsteadRead Can the ‘Dopamine Detox' Trend Break a Digital Addiction?SUPPORT JULIE (and the show!)DONATE to the Palestinian Children's Relief Fund AND THE Sudan Relief FundGET AN OCCASIONAL PERSONAL EMAIL FROM ME: www.makeyourdamnbedpodcast.comTUNE IN ON INSTAGRAM AND YOUTUBESUBSCRIBE FOR BONUS CONTENT ON PATREON.The opinions expressed by Julie Merica and Make Your Damn Bed Podcast are intended for entertainment purposes only. Make Your Damn Bed podcast is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. ISupport this show http://supporter.acast.com/make-your-damn-bed. Hosted on Acast. See acast.com/privacy for more information.

Send us a textHot flashes don't keep a schedule, and neither do lab numbers. We sit down with Dr. Rachel Novik of Cleveland Clinic's Center for Specialized Women's Health to cut through the noise around perimenopause, menopause, and hormone testing—and focus on what actually helps you feel like yourself again.We talk about why the most reliable “diagnosis” of menopause is still 12 months without a period, and when lab work like estradiol and FSH can be helpful for patients with hormonal IUDs or after hysterectomy. She breaks down common myths about the Dutch test and other urine hormone panels, explains why major medical societies don't endorse them for menopause, and shows how chasing unvalidated numbers can drive unnecessary supplements and costs without improving outcomes.If you're overwhelmed by conflicting advice on “balancing hormones,” this episode offers a calmer path: collaborate with a clinician, align on goals, and judge success by how you feel, not a single number.Support the show

Listen to JCO's Art of Oncology article, "Smell," by Dr. Alice Cusick, who is a Hematology Section Chief at Veterans Affairs Ann Arbor Health System and Assistant Professor at the University of Michigan Division of Hematology and Oncology. The article is followed by an interview with Cusick and host Dr. Mikkael Sekeres. Dr Cusick shares a connection to a cancer patient manifested as a scent. TRANSCRIPT Narrator: Smell, by Alice Cusick, MD  Dr. Mikkael Sekeres: Welcome back to JCO's Cancer Stories: The Art of Oncology. This ASCO podcast features intimate narratives and perspectives from authors exploring their experiences in oncology. I'm your host, Mikkael Sekeres. I'm Professor of Medicine and Chief of the Division of Hematology at the Sylvester Comprehensive Cancer Center, University of Miami. Joining us today is Alice Cusick, Hematology Section Chief at the Veterans Affairs Ann Arbor Healthcare System and Assistant Professor at the University of Michigan, Division of Hematology and Oncology, to discuss her Journal of Clinical Oncology article, "Smell." Alice, thank you for contributing to Journal of Clinical Oncology and for joining us to discuss your article. Dr. Alice Cusick: Thank you so much for having me, Mikkael. I appreciate it. Dr. Mikkael Sekeres: It's really a pleasure, and as usual, Alice and I discussed this beforehand and agreed to call each other by first names. I always love to hear your story first. Can you tell us about yourself? Where are you from, and walk us through your career, if you could. Dr. Alice Cusick: I'm a Midwesterner. I grew up in Iowa and Illinois and went to a small college in Illinois, played basketball, Division lll, and was an English Literature major. I took one science class and was going to be an English professor. And then my father's a physician. My senior year, I realized I don't think I could spend all my time in a library. I didn't feel like I was helping anyone. And so I talked to my dad, and he said, "Yeah, I think you could be a doctor." So I thought I would help people by being a physician. So I moved to Iowa City and spent two years working in a lab and doing science classes and took the MCAT, which was the first year they had the essay on there, and I rocked that. That was my highest score. I got into the University of Iowa and then went on to residency and fellowship at the University of Wisconsin, just in hematology. I didn't do solid tumors. And then went on, spent a couple years there, worked in Pennsylvania in more of a group practice, and then came back to academics at the University of Michigan about 10 years ago. And then five years ago, I became the Hematology Section Chief at the VA in Ann Arbor. So I work there full time now. Dr. Mikkael Sekeres: I love that story. I served on the admissions committee at Cleveland Clinic and Case Western when I was also a Midwesterner for 18 years. And I always wondered if instead of searching for science majors, we should be searching for English majors because I think there's a core element of medicine that is actually storytelling. Dr. Alice Cusick: Oh, very much so. My father was a country doctor for many, many years in rural Iowa in the fifties and sixties. So he did house calls, and he talked about how you really got to know people by going to their house. And I'll never forget the first time that I did a full history and physical, I think I was maybe a second-year medical student, and I was telling him, "Oh, I'm so excited. I'm going to do my first history and physical." And he said, "Alice, don't talk to them about medicine right away or about their problems right away. Talk to them about something else. Get to know them because you know about sports, talk about sports." I said, "Dad, that's called establishing rapport." You know, that's what they had taught us. But it was intuitive to him. I'll never forget that he just said their story is important and how they live and where they live and who they live with is so important. It really helps you figure out their medical issues as well. And I've always tried to carry that through. Dr. Mikkael Sekeres: It's funny what we glean from our parents. My dad was a journalist for the Providence Journal-Bulletin. He was a reporter for a couple of decades, and I almost feel like some of what I'm doing is acting as a reporter. It's my job to get the story and get the story right and solicit enough details from a patient that I really have a sense that I'm with them on the journey of their illness, so I can understand it completely. Dr. Alice Cusick: Oh, very much so. And that's one of the things I really harp about with the fellows because sometimes I remember more of the social history than I do sometimes the medical history when I'm seeing a patient. I remind them, you need to know who they live with and how they live. It helps you take care of them. Dr. Mikkael Sekeres: Well, and that must be particularly germane with your patient population. When I was a medical student, my first rotation on internal medicine was at the Philadelphia VA, and it's actually what convinced me to specialize within internal medicine. What is it like caring for veterans? Dr. Alice Cusick: This is the best job I've ever had in my life. And I think because it speaks to my sense of duty that I got from my parents, particularly from my father, and I really feel I got back to my original focus, which is helping people. So that sense of duty and serving those who served, which is our core mission, this job is the most rewarding I've ever had because you really feel like you're helping people. Dr. Mikkael Sekeres: How much do you learn about your patients' military history when you first interact with them? Dr. Alice Cusick: It can come up in conversation. It sort of depends on what the context is and how much you ask and how much of that is incorporated into what's going on with their medical history. It comes up a lot in terms of, particularly cancer, because a lot of cancers that veterans develop can be related to their military exposures. So it can come up certainly in that context. Dr. Mikkael Sekeres: You write about how your patient and his wife brought in photographs of his younger self. Can you describe some of those photos? Dr. Alice Cusick: So a lot of it was about the sports he was doing at the time. He was kind of almost like a bodybuilder and doing like martial arts. So there were some pictures of him in his shirt and shorts, showing how healthy he was. He was much younger, but it was such a contrast to how he was at that time as he was nearing death. But it really rounded out my understanding of him because, as we all know, when we meet people, we see them when they're at that particular age, and we may not have that context of what they were 20, 30 years ago. But that still informs how they think about themselves. I mean, I still think of myself as an athlete even though I'm much older. So that's important to understand how the patient thinks about himself or herself. Dr. Mikkael Sekeres: You know, it's funny you mentioned those two photographs. I- immediately flashed into my mind, I had a patient who also was a martial arts expert, and I remember he was in his early seventies and hospitalized, but he made sure to put up that photo of him when he was in his prime, in his martial arts outfit in a pose. And I've had another patient who was a boxer, and all he wanted to talk about whenever he saw me was his first experience boxing in Madison Square Garden and what that moment felt like of climbing into the ring, squeezing in between the ropes, and facing off in front of what must have been some massive crowd. Dr. Alice Cusick: Yeah. Dr. Mikkael Sekeres: Why do you think it was important to them to bring in those photos to show you? Dr. Alice Cusick: I think it was to help me understand what he had been. I think it was important for him, and because we had a relationship, it wasn't just transactional in terms of his medical problems. It was really conversations every day about what he was doing and how his life was going. And I think he really wanted me to understand what he had been. And so I felt really honored because I think that was important. It told me that his relationship with me was very important to him. I found that very, very humbling. Dr. Mikkael Sekeres: Yeah, I find it fascinating the details that patients offer to us about themselves as opposed to the ones that we solicit. I think it speaks to also the closeness of the relationship we have with patients when they want to share that aspect of them. They want to show you who they were before they were ill. And it's not a point of bragging. It's not flexing for them. I think it's really to remind themselves and us of the vitality of the person who's sitting in front of us or lying in front of us in the hospital johnny or sitting on an exam table. Dr. Alice Cusick: Oh, very much so. And I've experienced that even with my own parents as they got older and were in the medical system. I remember vividly, my father had had a stroke, and the people taking care of him didn't understand what he had been. They didn't understand that his voice was very different. We kept asking, you know, "His voice is different." They had no concept of him beforehand. So that also really hit home to me how important it is to understand patients in the whole context of their lives. Dr. Mikkael Sekeres: And as a family member, do you think it's equally important to share that story of who somebody was before they were ill as a reminder to yourself and to the people taking care of a relative? Dr. Alice Cusick: Oh, very much so. I think it's very helpful because it also makes you feel like you're supporting the loved one as well by, if they can't speak for themselves, particularly when they're very ill, to help people understand, it may help the physicians or any provider understand their illness better, especially if there's a diagnostic dilemma, thinking about going home, what are they going to need at home, those sorts of things. I think it's always important to try to provide that context. Dr. Mikkael Sekeres: Patients will often talk about their deaths or transitions to hospice as an abstract future. Do you think they rely on us to make the decision about a concrete transition to hospice, or do you think they know it's time and are looking for us to verbalize it for their family and friends? Dr. Alice Cusick: I think it depends on how much groundwork you've done beforehand. So when you talk about end of life with people well before that transition it's almost mandatory, I think it's very important. It makes the transition much smoother because then they understand what hospice is, and they can prepare themselves. When they're not prepared, I think it's much more of a very clear transition. So it's almost like you're shutting one door, disease treatment, and moving on to, "I'm just going home to die," versus when you're laying the groundwork and you make sure that it's about how you live. I always try to emphasize, it's how you want to spend your time. It's how you want to live. Hospice is helping people live the best they can for as long as they can. And if you haven't prepared people, I think then they think much more you're closing the door and you're just sending me home to die. Dr. Mikkael Sekeres: It's tricky though, isn't it? Because as an oncologist or hematologist-oncologist, in our case, people look to us for that hope that there's still something to do and there's still life ahead of them. But at a certain point, we all realize that we need to transition our focus. But once we say that out loud, do you ever feel like it almost shuts a door for our patients? Dr. Alice Cusick: Again, it depends on the situation, and it depends on the support they have. It's different when you're dealing with somebody who's out in an outpatient world who has good family support and you've developed a relationship versus the patient who's taken a very sudden turn for the worse, and maybe is in the hospital, and things are more chaotic, and maybe they've been on very active treatment beforehand, but suddenly things have changed. So in my mind, it depends on the context that you're dealing with and what the relationship you have prior to. Maybe you're covering for your colleague, and you don't have a relationship with that particular family or that particular patient, but yet you have to talk to them. Somebody gets transferred from another hospital and you have a very brief relationship. And so I think the relationship kind of dictates sometimes how patients feel. But as long as you can help people understand the process of end of life as best as you can, I think that sometimes helps the transition. Some people are going to be angry no matter what. And that's totally understandable, angry about their family member dying, angry about what's happening to them if they're the patient. I think that's always part of the process, but it's hard to make things smooth all of the time. We do the best we can. Dr. Mikkael Sekeres: I was going to ask, has anyone ever been shocked when you start to talk about palliative care or hospice and never really did see it coming? Dr. Alice Cusick: Oh, of course. I think, especially if you've been doing this for a while, you sometimes see the future. You know what's, well, I mean, not exactly, but you have a good sense of what's going to happen. And there can be times when you start talking about end of life and palliative care or hospice and people are shocked, particularly family members, family members who may not be there all the time, who may not have seen their loved one frequently and haven't just understood what the disease course has been. And that certainly can be shocking. And again, totally understandable, but it's my responsibility to try to smooth that over and help people understand what's going on and make it a conversation. Dr. Mikkael Sekeres: It's a nice description of what we do. We make it a conversation. When talking about what you smelled that day when you saw your patient, you write, "Did I suddenly have a gift? Could I float through the hospital wards and smell the future? Or maybe I could only smell inevitability." It's a beautiful sentence. "Could I only smell inevitability?" What do you think it was that led you to know that his time had come? And I wonder, was it a distinct odor or what I refer to as a Malcolm Gladwell "blink" moment, you know, in which your 25 years of experience allowed you to synthesize a hundred different sensory and cognitive inputs in a split second to realize this was the time? Dr. Alice Cusick: I think I knew it was time because I had been seeing him so frequently and I knew him very well. The smell was very real to me. My husband and I disagree because I've talked to my husband about this. He thinks it was a real smell and that I did smell something. I think it was more that amalgamation of my experience and, as I said in the piece, a scent took the place of a thought. Dr. Mikkael Sekeres: Huh. Dr. Alice Cusick: But it bothered me so much, and that's when I talk about, "Did I have a gift?" You know, there are people who can smell diseases. There's a report of a woman who could smell Parkinson's disease. I thought, "Have I suddenly developed some sort of gift?" But in my mind, I thought, "You know, it was inevitability." I mean, it was inevitable that this gentleman was going to die of this disease. So that was my thought. I don't think I had a gift. I think it was smelling the inevitability that I understood through experience and knowing this patient so well. Dr. Mikkael Sekeres: Why do you think that smell haunted you so much afterwards? I mean, you really think about it and really dwell on it. I think in a way that any one of us would. Dr. Alice Cusick: I think because I thought there was something wrong with me. As I said in the piece, I thought it made my experience of that patient, my memory of that visit in particular and the whole relationship with him, I was thinking more about myself instead of thinking about him and his experience and his family's experience. And you know, you always grieve for patients, and it was interfering with my normal process. And so it really bothered me. In the end, it was more, "What was wrong with me?" This was weird, and it just sort of played with my usual understanding of how these things were supposed to go. And that's what really bothered me. Dr. Mikkael Sekeres: It is true. We really feel acutely our patients' loss, and it's so much more, I don't know if "acute" is the right word, or so much more meaningful when it's someone we've gotten to know over years, isn't it? Dr. Alice Cusick: Oh, very much so. You grieve for them, you miss them. At the same time, you also, you know, especially with this patient, his death was how he wanted it. So helping someone with the, quote unquote, "good death", the death surrounded by family, the death where there is no suffering or as minimal suffering as possible, you do find that helps with the grief, I think, instead of thinking, "Oh, what did I do wrong? What did I miss?" You can make it somewhat helpful in processing the grief. Dr. Mikkael Sekeres: It's perhaps one of the more exquisite aspects of the art of medicine is helping people with that transition in their final days and sharing in the emotions of that. It has been such a pleasure to have Alice Cusick, who is Hematology Section Chief at Veterans Affairs Ann Arbor Health System and Assistant Professor at the University of Michigan, Division of Hematology and Oncology to discuss "Smell." Alice, thank you so much for submitting your article and for joining us today. Dr. Alice Cusick: Oh, thank you so much. I really appreciate it. Dr. Mikkael Sekeres: If you've enjoyed this episode, consider sharing it with a friend or colleague or leave us a review. Your feedback and support helps us continue to have these important conversations. If you're looking for more episodes and context, follow our show on Apple, Spotify, or wherever you listen and explore more from ASCO at asco.org/podcasts. Until next time, this has been Mikkael Sekeres for Cancer Stories. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Show Notes: Like, share and subscribe so you never miss an episode and leave a rating or review. Guest Bio: Dr Alice Cusick is Hematology Section Chief at Veterans Affairs Ann Arbor Health System and Assistant Professor at the University of Michigan Division of Hematology and Oncology.

This special episode of the podcast is a recording of a panel discussion that took place at the 2025 Ohio VC Fest powered by @JumpStart Inc. entitled "AI-Driven Healthcare: The Heartland Advantage." Panelists include Michael Dalton (CEO & Founder at @Ovatient), Kaleigh Gallagher (VP of Tech Services & Network Management at @JumpStart), Matthew Zenker (Director of Tech Partnerships & Investments at @University Hospitals Ventures), Jennifer Owens (Senior AI Program Administrator at @Cleveland Clinic), and moderated by Duane Mancini. The conversation dives into the rapidly-growing AI-driven healthcare innovation in the Midwest, exploring the unique advantages the region faces. The discussion covers various topics including talent acquisition, clinical validation, partnerships with healthcare systems, and the role of data in accelerating growth.Michael Dalton LinkedInKaleigh Gallagher LinkedInMatthew Zenker LinkedInJennifer Owens LinkedInJumpStart Inc. WebsiteDuane Mancini LinkedInProject Medtech WebsiteProject Medtech LinkedIn

In this episode, Kelly talks with Dr. Remina Panjwani about health, personal growth, and purpose. Join us and explore the differences between conventional and functional medicine, why a reactive approach often falls short, and how personalized care can transform your life. Whether you're exploring functional medicine, personal growth, or breaking generational patterns, this episode offers insights to live more intentionally, authentically, and healthfully. [1:46] Paving the Way Forward "I'm the 1st generation to grow up in the United States to have a college education." [2:58] Choosing My Own Path "I come from a South Asian background as well. And so, if you're traditional, they're like, 'Oh, just get married, have kids, whatever,' right? I'm like, 'Mm, no. I needed to do something different.'" [5:17] The Military Path "I can say now with confidence, I was searching for my purpose." [10:30] Right Frequency "You find your people when you're in the right environment and the right frequency." [12:02] Building My Own Path in Medicine "We're in a sick reactive system. So I got certified in functional medicine from the Institute of Functional Medicine at Cleveland Clinic. And then I thought, well, the system's broken. 
I just need to make my own."   [17:27] Healing What's Underneath "You could be doing the right things. You could still be eating the right things, but there may be something deeper." [25:30] The Cortisol "So your body's still going to produce that cortisol and other neurochemicals that are released to keep you safe and flee and save your life. The thing is once that acute threat is gone, your body can relax." [36:27] Conventional Medicine and Functional Medicine "When you look at conventional medicine, it's a bandage approach, a reactive approach…when you look at functional medicine, advanced labs, it's actually really personalized, to the point where it's very advanced." [41:48]  The Odd Girl Out, Doctor Within: A Story of Purpose, Pillars, and Personal Power "So then if you don't have access to a functional medicine doctor, a holistic practice or spiritual guide or whatever, then I added each chapter to a supplemental workbook. So it can help guide yourself." [45:58] Generational Trauma "If the mom is in a stressful environment, be it physical, mental, they're consuming whatever the case is, toxins, right?  It's going to affect the baby, it gets into their telomeres, their DNA, etc." [53:27]  Growth Reveals True Connections "When you're awakened and you're becoming more of you. The right people will stick around you." Follow Dr. Remina Panjwani on Instagram @drremina - https://www.instagram.com/drremina?igsh=ZXBtc2s2OXNpcmp1 Visit Dr. Remina Panjwani's Website https://www.drremina.com Connect with Kelly here: Follow Me on Instagram at @chaselifewithkelly - https://www.instagram.com/chaselifewithkelly/ Follow Me on TikTok at @iamkellychase - https://www.tiktok.com/@iamkellychase _t=8WCIP546ma6&_r=1 Subscribe to My YouTube Channel - https://www.youtube.com/channel/UCNqhN0CXWVATKfUjwrm65-g Work with Me: Private 1:1 Business & Mindset Coaching- More Details- https://www.chaselifewithkelly.com/private-coaching  Rejection to Redemption - More Details: https://www.chaselifewithkelly.com/rejection-to-redemption  Online Business Accelerator- More Details: https://www.chaselifewithkelly.com/online-business-accelerator  Money Magnet - More Details: https://www.chaselifewithkelly.com/money-magnet  Goddess Magic Course Bundle - More Details - https://www.chaselifewithkelly.com/goddess-magic Kelly's Favorites  https://linktr.ee/chaselifewithkelly Visit Our Website!  https://www.chaselifewithkelly.com

Known as The Holistic Pain Doc, Scottsdale's Dr. Ashu Goyle believes in healing first, not insurance red tape.  From PRP to  groundbreaking new programs, he's helping people find freedom from pain without surgery or long-term medications.   After training at the world-renowned Cleveland Clinic, Dr. Goyle came to Scottsdale and built a practice that puts healing ahead of anything.  He's double board-certified in anesthesiology and interventional pain medicine and has spent years helping patients truly solve their pain rather than just masking it.    Through advanced regenerative treatments like PRP, bone marrow therapy, and a groundbreaking new program, Dr. Goyle is giving patients freedom from pain without surgery,  long-term medications, and without the limitations of insurance-driven medicine.  

Known as The Holistic Pain Doc, Scottsdale's Dr. Ashu Goyle believes in healing first, not insurance red tape.  From PRP to  groundbreaking new programs, he's helping people find freedom from pain without surgery or long-term medications.   After training at the world-renowned Cleveland Clinic, Dr. Goyle came to Scottsdale and built a practice that puts healing ahead of anything.  He's double board-certified in anesthesiology and interventional pain medicine and has spent years helping patients truly solve their pain rather than just masking it.    Through advanced regenerative treatments like PRP, bone marrow therapy, and a groundbreaking new program, Dr. Goyle is giving patients freedom from pain without surgery,  long-term medications, and without the limitations of insurance-driven medicine.  

Ever landed in a new time zone and felt like your head was playing catch-up while your body begged for rest?In this episode of Migraine Heroes Podcast, host Diane Ducarme unpacks how travel and jet lag can throw your body's rhythm off balance—and trigger migraines when you least expect it.Whether you're crossing oceans or just changing daylight hours, this episode gives you practical tools to keep your brain steady and your energy grounded.You'll discover: ✈️ How time-zone shifts confuse your body clock, cortisol rhythm, and melatonin cycle—creating the perfect storm for migraine vulnerability

In this episode, Dennis Laraway, CFO at Cleveland Clinic shares the major trends shaping the organization's strategy, including payment reform, cost transformation, and rapid advances in AI and technology, while highlighting how the system is driving efficiency and forging new partnerships to reimagine care.

Dr. Catherine Allan, Director of the Cardiac Care Unit and Inpatient Cardiology at the Cleveland Clinic joins us to talk about readiness for teams to perform pediatric ECMO, a high-risk, high-complexity therapy that staff might only see a third as often as they see patients on ventilators. ECMO can also be called for during CPR, which greatly increases the time pressure and complexity of the procedure. During ECPR, there is not only the ICU resuscitation microteam but also the surgical team and the perfusion team, leading to potentially having up to 20 people working in the room when running an ECPR case. We discuss how leaders can help connect seemingly imposed efforts like checklists and huddles to what it is that frontline workers are trying to achieve and are meaningful to them, and how simulation program designers must do the same in order to make sure that training is not a top-down checklist but rather a mutually owned process that gets teams where they believe they need to go. Host & Co-Producer: Chris Roussin, PhD, Senior Director, CMS-ALPS (https://harvardmedsim.org/chris-roussin/) Producer: James Lipshaw, MFA, EdM, Assistant Director, Media (https://harvardmedsim.org/james-lipshaw/) Consulting and readiness with CMS-ALPS: https://harvardmedsim.org/alps-applied-learning-for-performance-and-safety Dare to Be Ready on Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP Dare to Be Ready on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

In this episode, Dennis Laraway, CFO at Cleveland Clinic shares the major trends shaping the organization's strategy, including payment reform, cost transformation, and rapid advances in AI and technology, while highlighting how the system is driving efficiency and forging new partnerships to reimagine care.

For more than 30 years, Crain's Cleveland Business has been honoring young leaders across Northeast Ohio. Each year, the publication features 40 innovators to watch in diverse spaces, from mental and physical health, to sports and entertainment, the sciences, public service, policy development and beyond. The one thing they all have in common is that they're not even 40 years old. On Tuesday's "Sound of Ideas," we'll introduce you to seven of this year's 40 under 40 honorees ranging in age from 27 to 38, including a psychiatrist, an events booker, a real estate professional, and an astronomer to name a few. Guests:- Brooke Lowery, Senior Vice President of Booking and Events, Cleveland Cavaliers, Rock Entertainment Group and Rocket Arena- Poojajeet Khaira, M.D., Psychiatry Resident Physician and Academic Chief Resident, MetroHealth- Carmen Daniel, Ed.D., Business and Community Engagement Specialist, Heights Career Tech Consortium- Ty Stimpert, Community Outreach Program Manager, Cleveland Clinic's Taussig Cancer Institute- Maryam Kiefer, Senior Director of Public Policy, United Way of Greater Cleveland- Kevin Moss, Senior Vice President, CBRE- Monica Marshall, Astronomer, Cleveland Museum of Natural History

In this episode of ASTCT Talks, host Christina Ferraro, nurse practitioner from the Cleveland Clinic, sits down with Vanessa Kennedy, MD, from Stanford University, to address a critical aspect of survivorship: cognitive health, including issues like brain fog, memory lapses and reduced executive function.The discussion highlights:New ASTCT consensus guidelines on cognitive assessment.Practical strategies for operationalizing cognitive screening in busy clinical settings. How factors like anxiety, depression, sleep and polypharmacy influence cognition — and why addressing these is critical. Emerging interventions, from cognitive rehabilitation to surprisingly effective options like jigsaw puzzles.This episode offers actionable insights into supporting cognitive function and quality of life in survivorship care.

The HSPA Season of Giving is here! To help advance patient safety, the Healthcare Sterile Processing Association established the HSPA Foundation in 2016. Dedicated Sterile Processing (SP) professionals commit to continuing education and professional development to remain focused on doing what's right in the name of patient safety—for every instrument, surgical case and patient. The Foundation's mission is to support SP professionals and our industry through educational initiatives, research, scholarships, professional development grants and awards. In this December 2025 special episode, host Casey Czarnowski speaks with Richard Schule, Senior Director for Enterprise Sterile Processing with the Cleveland Clinic, and Damien Berg, VP of Strategic Initiatives at HSPA, about the HSPA Foundation. Our guests discuss the Foundation's background, successes and current initiatives, both in the U.S. and internationally. Listen to learn about the important work of the Foundation and how you can support your community and participate in the Season of Giving. Our Guests: Richard Schule, MBA, FAST, FCS, AAMIF, is the Senior Director for Enterprise Sterile Processing with the Cleveland Clinic. Damien Berg, BA, BS, CRCST, AAMIF, serves as HSPA's Vice President of Strategic Initiatives and is an HSPA Past-President (2018–2019). Additionally, he works closely with regulatory bodies and standards-making groups, including the Association for the Advancement of Medical Instrumentation (AAMI) and International Organization for Standardization (ISO), and he serves on the Executive Committee for the World Federation for Hospital Sterilisation Sciences (WFHSS). Please note: CE credit is not offered for this episode.

Historic preservationists sued President Donald Trump over his plans to paint an ornate office building housing his staff next to the White House, warning the structure could be “irreversibly damaged.” A valet is out of a job after being accused of taking a Cleveland Clinic patient’s Mercedes on a high-speed drive. According to a police report, officers clocked the 19-year-old valet going 128 mph on I-77 at about 1:30 Sunday morning. Please Like, Comment and Follow 'Philip Teresi on KMJ' on all platforms: --- Philip Teresi on KMJ is available on the KMJNOW app, Apple Podcasts, Spotify, YouTube or wherever else you listen to podcasts. -- Philip Teresi on KMJ Weekdays 2-6 PM Pacific on News/Talk 580 AM & 105.9 FM KMJ | Website | Facebook | Instagram | X | Podcast | Amazon | - Everything KMJ KMJNOW App | Podcasts | Facebook | X | Instagram See omnystudio.com/listener for privacy information.

In this episode of HALO Talks, host Pete Moore sits down with Reka Gobis from Kisaco Research. They discuss how their Connected Health & Fitness Conference is evolving to bring together industry leaders—from boutique gyms and major brands like Nike and Adidas, to healthcare giants like Mayo Clinic and Cleveland Clinic. They discuss the importance of creating actionable, science-backed insights and meaningful connections in an intimate setting, all designed to help operators deliver tech-enabled solutions and drive real change in the HALO sector. If you're looking for fresh ideas, strategic partnerships, and inspiration for 2026 and beyond, this episode is a great guide to why you should be at next year's Connected event in LA on Feb 18-20! Gobis states, "At Kisako, and especially at our Connected event, we focus on content all of which is based in hours and hours of research with the industry and most importantly the primary market. The gyms, boutiques, wellness clubs, hotels, spas, longevity clinics we spoke to . . . are based on the key challenges that they are experiencing in the industry, and what we're trying to do over the year is find potential solutions to these key challenges." Key themes discussed Evolution of the Connected Health & Fitness Conference. Integrating the health, wellness, fitness, and technology sectors. Senior-level industry attendance and networking opportunities. Science-backed, actionable conference content and research. Partnerships between operators, brands, and healthcare providers. Dedicated focus on women's health and longevity. Emphasis on community, member experience, and practical takeaways. A Few Key Takeaways:  1.Evolution and Focus of the Connected Event: Rika explained how the Connected Health & Fitness event has evolved over seven years, expanding beyond just connected fitness to now fully encompass health, wellness, fitness, and tech. The goal is to create an ecosystem that enables operators to deliver science-backed, holistic, and tech-enabled solutions for the industry. 2. High-Level Attendees and Diverse Ecosystem: One of the distinctive aspects of the event is its seniority of attendees—50-60% are C-level executives. The audience isn't limited to traditional fitness operators but also includes hotels, spas, healthcare providers (like Mayo Clinic and Cleveland Clinic), insurance, pharma, and big brands like Nike and Adidas. This diversity encourages powerful partnerships and networking across adjacent industries. 3. Research-Driven, Actionable Content: The programming is based on extensive industry research, focusing on real, current challenges faced by operators, boutiques, hotels, and clinics. The format emphasizes rapid-fire, specific sessions (typically 20-30 minutes) driven by data and science, not just generic panel discussions. Rika personally ensures all sessions deliver tangible ROI and actionable takeaways. 4. Special Emphasis on Emerging Topics: Women's Health & Longevity: A unique aspect of the 2026 event is a multi-hour Women's Health Symposium—a significant step up from the usual short panels—tackling issues like hormones, fertility, training around the menstrual cycle, and case studies from operators leading in this space. There's also a significant focus on longevity and how fitness operators can position themselves as preventive health "hubs" in partnership with healthcare. 5. Opportunities for Hands-On Learning, Networking & Fun: Attendees will have access to workshops, a workout room, media lounge for podcasts, workout/recovery pop-ups, and the chance to try the latest in equipment and wellness experiences. Rika guarantees not just actionable business insights, but meaningful connections and enjoyable experiences that can reshape attendees' strategic plans for 2026 and beyond. Resources:  Reka Gobis: https://www.linkedin.com/in/r%C3%A9ka-g%C3%B3bis-business-management-and-marketing   Connected Fitness: https://connectedhealthandfitness.com/events/connected-health-fitness-summit-2026  Integrity Square: https://www.integritysq.com Prospect Wizard: https://www.theprospectwizard.com Promotion Vault: https://www.promotionvault.com HigherDose: https://www.higherdose.com

On Today's episode of Transforming Healthcare with Dr. Wael Barsoum, we're excited to be filming for the first time and that too with an incredible leader in the payor industry, Tony Helton. Tony Helton is the President and Chief Executive Officer for Medical Mutual of Ohio. Prior to being appointed to his current role in November 2024, he was the organization's EVP and CFO. Earlier in his career, Helton spent nearly two decades at the Cleveland Clinic in several roles, including Interim CFO and Executive Director of Revenue Cycle Management and Continuous Improvement. Helton earned a bachelor's degree in accounting and an MBA from John Carroll University. Join us as we delve into what a mutual is, the differences between mutuals and insurances, and Tony's mission for his community and his incredible journey in this industry.    

Almost everyone with MS is aware of their sensitivity to heat. But cold weather presents a whole different set of challenges that we don't always think about. This week, I'm talking with Dr. James Stark about safely navigating cold-weather conditions when you're living with MS.  Dr. Stark is the Senior Attending Neurologist and Associate Medical Director at the International Multiple Sclerosis Management Practice. And he's sharing tips for staying safe and healthy when the temperature starts to drop. The FDA has just approved a new generic DMT, and the first biosimilar for MS is hitting the market. We'll tell you about these new disease-modifying therapy options, and we'll bring you up to speed on what biosimilars are all about. I ran into Dr. Robert Fox at ECTRIMS, the world's largest MS research conference. And, in a brief conversation, Dr. Fox provided a great overview of the MS research landscape. You won't want to miss this conversation!  If you missed the International Progressive MS Alliance's global webcast, Hidden Potential: How Existing Drugs Could Transform MS Treatment, you can still catch the video replay. We're sharing all the details.  We have a lot to talk about! Are you ready for RealTalk MS??! This Week: There's a lot to still be thankful for  :22 Your opportunity to support the organization that supports you  2:03 What you need to know about the new generic and biosimilar disease-modifying therapies  9:24 The Cleveland Clinic's Dr. Robert Fox shares an overview of the MS research landscape  10:29 Catch the International Progressive MS Alliance Global Webcast video replay  22:41 Dr. James Stark shares tips for navigating winter weather when you're living with MS  23:27 Share this episode  35:14 Next week's episode  35:35 SHARE THIS EPISODE OF REALTALK MS Just copy this link & paste it into your text or email: https://realtalkms.com/430 ADD YOUR VOICE TO THE CONVERSATION I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts! Email: jon@realtalkms.com Phone: (310) 526-2283 And don't forget to join us in the RealTalk MS Facebook group! LINKS If your podcast app doesn't allow you to click on these links, you'll find them in the show notes in the RealTalk MS app or at www.RealTalkMS.com DONATE to the National MS Society https://nationalmssociety.org/donate SIGN UP: Become an MS Activist https://nationalmssociety.org/advocacy WATCH: International Progressive MS Alliance Global Webcast Replay https://youtube.com/watch?v=hWK-iVMiQ_I LISTEN: RealTalk MS EP. 315: Understanding Generic and Biosimilar Drugs for MS with Dr. Jiwon Oh https://realtalkms.com/315 VISIT: Mark Cuban Cost Plus Drugs https://costplusdrugs.com JOIN: The RealTalk MS Facebook Group https://facebook.com/groups/realtalkms REVIEW: Give RealTalk MS a rating and review http://www.realtalkms.com/review Follow RealTalk MS on Twitter, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com. RealTalk MS Episode 430 Guests: Dr. Robert Fox, Dr. James Stark Privacy Policy

Dr. Vincenz Czerny performed the world's first breast augmentation in Vienna on 24th November, 1893. After removing a benign tumour via a mastectomy, Czerny addressed the asymmetry left behind by innovatively transplanting a non-cancerous lipoma from his patient's lower back to reconstruct her breast. Czerny's work was cutting-edge for its time (pun intended): it wasn't until the Second World War, in the era of curvier pin-up girls, that cosmetic surgery began to become widespread, alongside the rise of silicone. The breakthrough came in 1962, when American surgeons Frank Gerow and Thomas Cronin developed the first silicone breast implant, tested on a Texas woman named Timmie Jean Lindsay, who agreed to the surgery only after being promised an ear-pinning as a bonus. Arion, Rebecca and Olly uncover the story of breast surgery, both reparative and cosmetic; explain how early attempts at the art resulted in unfortunate outcomes like “paraffinomas”; and reveal why a dog named Esmeralda has an historic place in pantheon of historic boob jobs… Further Reading: • 'Breast implants: the first 50 years' (The Guardian, 2012): https://www.theguardian.com/lifeandstyle/2012/jan/11/breast-implants-50-years?CMP=twt_gu • ‘From supersized to a more natural look: The evolution of breast implants' (CNN, 2021): https://edition.cnn.com/style/article/evolution-of-breast-implants/index.html • 'Breast Implant Options for Augmentation & Reconstruction (Graphic)' (Cleveland Clinic, 2021): https://www.youtube.com/watch?v=twsPcwxNSQQ Learn more about your ad choices. Visit podcastchoices.com/adchoices

In this episode of our ASC 73rd Annual Scientific Meeting Attendee Series, we feature Ms. Taylor Kurcsak, a cytologist from the Cleveland Clinic, who attended the meeting for the very first time. Taylor shares her impressions of the event, highlights from the sessions, and how this experience is shaping her professional journey. If you've ever wondered what it's like to attend the ASC Annual Scientific Meeting as a First Timer, this conversation offers an authentic and inspiring perspective. Swikrity Upadhyay Baskota, MBBS Chair, The ASC Bulletin and CytoPathPod of the Editorial Board Taylor Kurcsak, CT(ASCP) Cleveland Clinic

Quantum computing may sound like something out of a sci-fi TV show. But the future is here, and it's right in our own backyard. In 2023, Cleveland Clinic and IBM deployed the first quantum computer dedicated to healthcare research. It was part of a 10-year partnership to accelerate research in healthcare and life sciences. Unlike supercomputers, quantum computing uses "qubits" that harnesses the laws of quantum mechanics, making it possible to explore certain complex problems and calculations - calculations impractical or impossible for supercomputers. For context, in what would take a supercomputer years to execute, a quantum computer can complete in hours, if not minutes.rnrnThis is a complete game-changer when it comes to research bottlenecks, identifying new scientific discoveries. And it's not just Cleveland Clinic tapping into this innovative technology. Have we entered a new race to the top in tech? And what does it mean to have one of the first quantum computers powering advanced biomedical research right here in Northeast Ohio?

In this episode of the Oncology Brothers podcast, we dived deep into the rapidly evolving landscape of non-muscle invasive bladder cancer (NMIBC) treatment. Joined by expert guests Dr. Joshua Meeks, a urologist from Northwestern University, and Dr. Shilpa Gupta, a medical oncologist from Cleveland Clinic, the discussion focused on the integration of immunotherapy into non-muscle invasive bladder cancer. Key topics included: The definition and characteristics of high-risk non-muscle invasive bladder cancer. Recent clinical trials, including the CREST and POTOMAC, exploring the combination of immunotherapy with BCG treatment. The evolving role of medical oncologists in managing NMIBC and the importance of a multidisciplinary approach. Patient-centered discussions on treatment options, event-free survival, and managing side effects of immunotherapy. Join us as we unpack the latest data and real-life scenarios in NMIBC, emphasizing the critical need for collaboration between urologists and medical oncologists to improve patient outcomes. Follow us on social media: ⁠X/Twitter: https://twitter.com/oncbrothers Instagram: https://www.instagram.com/oncbrothers Website: https://oncbrothers.com/ Don't forget to like, subscribe, and check out our other episodes for more insights into the world of oncology! #NMIBC #BladderCancer #Immunotherapy #BCG #Urology #OncologyBrothers #GUCancer

About Nikhil Buduma:Nikhil Buduma is a San Francisco–based entrepreneur, scientist, and engineer working at the cutting edge of AI and healthcare. He is the co-founder and CEO of Ambience Healthcare, an AI platform built to supercharge every healthcare worker with intelligent automation. Under his leadership, Ambience has grown into one of the most well-funded AI healthcare startups in the world, raising over $343 million from top investors, including a16z, OpenAI, Kleiner Perkins, Oak HC/FT, Optum Ventures, and industry pioneers such as Jeff Dean and Pieter Abbeel. Before becoming CEO, Nikhil served as Ambience's Chief Scientist, leading the development of its core AI systems that streamline documentation, coding, and clinical workflows for healthcare systems, including the Cleveland Clinic and St. Luke's.Prior to Ambience, Nikhil co-founded Remedy Health, where he applied machine learning to advance value-based care models, backed by Khosla Ventures and Greylock. He also co-founded Lean On Me, a nonprofit organization that supports mental health and wellness across U.S. college campuses through anonymous peer-to-peer text support networks at institutions such as MIT, Duke, and UC Berkeley.A graduate and valedictorian of Bellarmine College Preparatory, Nikhil earned both his bachelor's and master's degrees in computer science and engineering from MIT. His career reflects a rare blend of technical mastery, compassion, and vision—using AI not to replace clinicians, but to restore the human joy in the practice of medicine.Things You'll Learn:Health systems often see low real-world usage of ambient tools; when daily adoption crosses most clinicians and visits, the ROI conversation becomes meaningful. This requires solving fundamentals across specialties, not just shipping features.If AI generates notes that don't align with payer rules and codes, organizations incur rework and risk. Integrating HCC, ICD-10, and CPT selection, along with supporting language, at the point of care helps prevent denials.Revenue integrity upside: Bringing CDI intelligence forward can reclaim large sums from work already done but not credited. This strengthens both financial sustainability and compliance posture.Continuous third-party auditing and domain-specific modeling are essential because general reasoning models often struggle with the nuances of revenue cycles. Independent validation builds organizational trust.Patient Summary anticipates questions and data needs before the visit, while Chart Chat answers complex, EHR-aware queries in seconds, helping to democratize top-tier standards of care in rural settings.Resources:Connect with and follow Nikhil Buduma on LinkedIn.Follow Ambience Healthcare on LinkedIn and visit their website. 

The Senate passed a bill unanimously on Tuesday requiring the Department of Justice to release more files related to the deceased sex offender Jeffrey Epstein. The bill now goes to President Donald Trump for his signature, as the House passed the bill earlier in the day by 427-1. The president has said he would sign the bill if it came to his desk. The Epstein Files Transparency Act would order the Department of Justice to release “in a searchable and downloadable format all unclassified records, documents, communications, and investigative materials” related to Epstein no later than 30 days after the bill's enactment.Trump will deliver a speech at the U.S.–Saudi Investment Forum on Wednesday, according to a schedule released by the White House. Saudi Crown Prince Mohammed bin Salman will also be in attendance. The investment summit will include the heads of Salesforce, Qualcomm, Pfizer, the Cleveland Clinic, Chevron, and Aramco, Saudi Arabia's state-owned petroleum and natural gas company.

Exercise is key for managing symptoms for COPD patients. On World COPD Day, host Amy Attaway, MD, Cleveland Clinic, talks to Rachel Evans, MD, University of Leicester, and Russell Winwood, a patient advocate known as the "COPD Athlete", about how exercise can improve patient outcomes. They also discuss the annual Big Baton Pass, an international COPD awareness event, the importance for pulmonary rehabilitation, and the community built around COPD advocacy and support for patients. Learn more about the COPD Baton Pass: https://copdbatonpass.org/ 

   The Chiefs have gone from the team that almost lost to the team that almost won.  It's pretty obvious watching these guys that the game is almost always more important to their opponent than it is for KC.  If that doesn't change, this season is a train wreck.  But while Denver won its Super Bowl on Sunday at Mile High, there's just too many games left to count out the Chiefs.  If they find the fire, they will make it in easily and could be really hard to knock out.  If they keep up with the slop, this season could be over in 10 days.    KU hoops is suffering the modern drama of paying a great player that wants the money but doesn't want to be there.  It's now obvious to anyone watching that Darryn Peterson, his agent, his team and likely his family are taking Bill Self for a ride.  This is why older coaches are retiring.  The players are in control now.    It's a big week in DC as Putin says he wants to meet with Trump again.  Same for Maduro in Venzuela.  Trump has ordered the Epstein files released and we are about to get a huge change with the SNAP program.    The Cleveland Clinic jabbed up thousands of employees with a flu shot last year and found some incredible results.  Spoiler alert... don't get the shot unless your doctor tells you to.    A midwest city is going to charge you a fee to work your car accident and a rock star obliterates the Rock and Roll Hall of Fame calling it "shameful."

It's Friday, November 14th, A.D. 2025. This is The Worldview in 5 Minutes heard on 140 radio stations and at www.TheWorldview.com.  I'm Adam McManus. (Adam@TheWorldview.com) By Adam McManus Iranian Christian prisoner denied treatment after spinal fracture On October 31st, Iranian Muslim authorities denied proper medical treatment to a prisoner named Aida Najaflou, an Iranian Christian convert, after she fell and fractured her spine, reports International Christian Concern. Najaflou, who suffered from spinal disc issues before her arrest, sustained the injury when she fell from her top prison bunk. She was taken to a local hospital, where medical professionals diagnosed a fractured T12 vertebra. Shockingly, Muslim authorities refused to allow Najaflou to obtain treatment and, instead, used a stretcher to bring her back to the prison that same day.  Due to the inhumane treatment and pain that Najaflou endured, fellow prisoners reportedly protested the situation. Iranian officials responded by taking the woman to a second hospital, where doctors recommended emergency surgery to repair her vertebra.   According to the Cleveland Clinic, “spinal fracture surgery” is recommended if the spinal fracture is in danger of damaging your spinal cord or if your pain doesn't improve a few months after non-surgical treatments.” The prolonging of proper care for Najaflou's injury is likely to have caused additional, unnecessary pain. Romans 5:3-5 says, “We know that suffering produces perseverance;  perseverance, character; and character, hope.  And hope does not put us to shame, because God's love has been poured out into our hearts through the Holy Spirit, Who has been given to us.” Sadly, previous requests from Najaflou for a lower bunk, based on her pre-existing spinal problems and a rheumatoid arthritis diagnosis, were dismissed by prison authorities.  Najaflou, along with two other Christians, was arrested in February 2025 for their Christian activities, including “praying, performing baptisms, taking communion, and celebrating Christmas.” She also spoke out against the Islamic Republic of Iran. According to Open Doors, Iran is the ninth most difficult country worldwide for Christians. Trump chastises Democrats for 43-day gov't shutdown Late Wednesday night, President Donald Trump signed legislation to end the Schumer Shutdown of government that spanned 43 days, punting the next funding deadline into late January, reports Politico.com. He called out the extortion of the Democrats who tried to force the funding of health care for illegal aliens as well as the extension of Obamacare benefits which they themselves had sunset. TRUMP: “Today, we're sending a clear message that we will never give into extortion, because that's what it was. The Democrats tried to extort our country. “In just a moment, I'll sign a bill exactly like we asked Democrats to send us all along, many days ago.  Republicans never wanted a shutdown and voted 15 times for a clean continuation of funding. Yet the extremists in the other party insisted on creating the longest government shutdown in American history, and they did it purely for political reasons.” President Trump explained the harm the Democrats caused. TRUMP: “Over the past seven weeks, the Democrats shut down as inflicted massive harm. They caused 20,000 flights to be canceled or delayed. They look very bad, the Democrats do. “They deprived more than one million government workers from their paychecks and cut off food stamp benefits for millions and millions more Americans in need. They caused tens of thousands of federal contractors and small businesses to go unpaid. And the total effect of the damage their antics caused will take weeks, and probably months, to really calculate accurately. “So, I just want to tell the American people, you should not forget this. When we come up to midterms, don't forget what they've done to our country.” The House passed the funding measure earlier in the evening, after eight Senate Democrats broke with their party to advance the package Monday night. Paychecks to federal workers reportedly will begin going out Saturday, reports NewsMax. Trump faces biggest Republican rebellion yet over Epstein Republicans are preparing a mass rebellion against President Donald Trump in a vote to release all classified files related to the late sexual predator Jeffrey Epstein, reports The Telegraph. At least 100 or more Republicans are expected to support the release of the files after a selection of emails sent by the deceased pedophile financier, that frequently mention the U.S. president, were made public on Wednesday. President Trump was friends with Epstein before the pair fell out in the early 2000s, but has always denied any knowledge of or involvement with Epstein's sex-trafficking or abuse of underage girls. Senator John Fetterman hospitalized after fall John Fetterman, the senior U.S. senator from Pennsylvania, was hospitalized on November 13th after falling down and hitting his face due to a heart-related issue, reports The Epoch Times. Because he had “a ventricular fibrillation flare,” a condition where the heart stops pumping blood to parts of the body, Fetterman became “light-headed” and then fell to the ground in Braddock, Pennsylvania, “hitting his face with minor injuries.” Kamala to Jon Stewart: Biden was competent to be President As part of her 107 Days book tour, former Democratic presidential candidate Kamala Harris was oddly hesitant to question President Joe Biden's mental acuity on Jon Stewart's podcast Listen. HARRIS: “I believe he was fully competent to serve.” STEWART: “Do you really?” HARRIS: “Yeah, I do.” STEWART:  “That, that surprises me, actually.” HARRIS: “No, I do. There's a distinction to be made between running for president and being president.” STEWART: “What's the distinction?” HARRIS: “Well, being a candidate for president United States is about being in a marathon, at a sprinter's pace, having tomatoes thrown at you every step you take.” STEWART: (laughs) “That sounds lovely.” HARRIS: “Yeah, it's more than a notion. And to be the seated president, the sitting president, while doing that, it's a lot.” STEWART: “I think it's a hard case to make for people that he didn't have the stamina to run, but he had the stamina to govern, because I think most people view the presidency as a marathon, run at a sprint, with tomatoes being thrown at you, in terms of governance.” Not surprisingly, people on social media were incredulous. On X, AdaminHTownTX asked, “If Biden was competent to serve, why did his party force him out of the race and install Kamala as the nominee?” Harris has hinted at a second presidential bid in 2028. Obama accused of destroying national landmark to build monument to himself What kind of U.S. president demolishes a cherished piece of American history in order to build a shrine to himself? Locals are still trying to make sense of the $850 million Obama Presidential Center, dubbed “The Obamalisk,” which broke ground in Chicago's historic Jackson Park in 2021 and will be finished next spring, reports the New York Post. Renowned Chicago architect Grahm Balkany, a self-described liberal, is upset. He said, “Obama, of all people, should not be building a palace for himself, a fortress in the middle of a public park. It's just contrary to what I thought he believed in.” Greg Laurie to hold crusade where Charlie Kirk was killed And finally, Evangelist Greg Laurie will headline a Harvest Crusade event at Utah Valley University, where conservative Christian activist Charlie Kirk was assassinated on September 10th during a Turning Point USA event, reports The Christian Post. Approximately, 10,000 attendees are expected. Known as “Hope for America,” the event will be held this Sunday, November 16. LAURIE:  “This is the place where Charlie left this world for the next world. We're going to go into that campus where darkness took place, and we're going to turn on the radiant light of Jesus Christ and preach that same Gospel that Charlie preached and call people to Christ.” Romans 1:16 says, “For I am not ashamed of the Gospel, because it is the power of God that brings salvation to everyone who believes: first to the Jew, then to the Gentile.” Close And that's The Worldview on this Friday, November 14th, in the year of our Lord 2025. Follow us on X or subscribe for free by Spotify, Amazon Music, or by iTunes or email to our unique Christian newscast at www.TheWorldview.com.  I'm Adam McManus. Seize the day for Jesus Christ.

What's a normal amount of pain to feel after sex? Is everyone else sore after sex and not talking about it? How can you make sex less painful and more pleasurable? Today, learn from DB about what is and is not normal about pain during and after sex, when you should be worried, and when maybe you could just use some more lube. (Hint: Uberlube reigns supreme!) RESOURCES FROM THIS EPISODE Mayo Clinic's guide on when to seek care: https://www.mayoclinic.org/diseases-conditions/painful-intercourse/symptoms-causes/syc-20375967 The CDC's guide on condom and lube compatability: https://www.cdc.gov/condom-use/index.html The CDC's guide on Pelvic Inflammatory Disease (PID): https://www.cdc.gov/std/treatment-guidelines/pid.htm The Cleveland Clinic's guide on vaginal atrophy: https://my.clevelandclinic.org/health/diseases/15500-vaginal-atrophy Mayo Clinic's guide on STD symptoms: https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/in-depth/std-symptoms/art-20047081 Endometriosis and dyspareunia -- International Journal of Environmental Research and Public Health (2023). MDPI ABOUT SEASON 13 Season 13 of Sex Ed with DB is ALL ABOUT PLEASURE! Solo pleasure. Partnered pleasure. Orgasms. Porn. Queer joy. Kinks, sex toys, fantasies -- you name it. We're here to help you feel more informed, more empowered, and a whole lot more turned on to help YOU have the best sex. CONNECT WITH USInstagram: @sexedwithdbpodcast TikTok: @sexedwithdbThreads: @sexedwithdbpodcast X: @sexedwithdbYouTube: Sex Ed with DB SEX ED WITH DB SEASON 13 SPONSORS Uberlube, Magic Wand, and LELO. Get discounts on all of DB's favorite things here! GET IN TOUCH Email: sexedwithdb@gmail.comSubscribe to our BRAND NEW newsletter for hot goss, expert advice, and *the* most salacious stories. FOR SEXUAL HEALTH PROFESSIONALS Check out DB's workshop: "Building A Profitable Online Sexual Health Brand" ABOUT THE SHOW Sex Ed with DB is your go-to podcast for smart, science-backed sex education — delivering trusted insights from top experts on sex, sexuality, and pleasure. Empowering, inclusive, and grounded in real science, it's the sex ed you've always wanted. ASK AN ANONYMOUS SEX ED QUESTION Fill out our anonymous form to ask your sex ed question. SEASON 13 TEAM Creator, Host & Executive Producer: Danielle Bezalel (DB) (she/her) Producer and Growth Marketing Manager: Wil Williams (they/them) Social Media Content Creator: Iva Markicevic Daley (she/her) MUSIC Intro theme music: Hook Sounds Background music: Bright State by Ketsa Ad music: Soul Sync by Ketsa, Always Faithful by Ketsa, and Soul Epic by Ketsa. Thank you Ketsa!

McKay tackles a quiet but pervasive modern crisis: the decline of belief in ourselves, our institutions, and each other. Using powerful case studies and the core concept of the "Belief Window," he argues that this trust can be intentionally rebuilt, transforming our personal and collective realities.Starting off with Matthew McConaughey's observation that "belief is in short supply," McKay uses a 2025 Pew Research Center study to explore the root causes of this erosion of trust, from the internet's rise to political polarization. The episode then pivots from problem to solution, drawing on the real-world success of a struggling Scottish primary school and the cultural transformation of the Cleveland Clinic. These examples illustrate how specific, actionable strategies - such as listening, celebrating small wins, and fostering empathy - can reignite trust and achieve remarkable results.Main Themes:Belief is the invisible architecture of a functioning society, and its decline is a quiet crisis.Trust can be systematically rebuilt through intentional acts of listening, learning, and celebrating small wins.Our "Belief Window" is the powerful, personal filter that shapes our reality, and it can be changed.True leadership, whether in a family or a business, is about actively building belief in others.A belief in God or a higher purpose can provide a moral foundation and hope in the face of adversity.Deep learning fosters belief, while the age of easy information can lead to superficiality and mistrust.Top 10 Quotes:“In our world today, belief is in short supply.”“Trust is like the air we breathe. When it's present, nobody really notices. When it's absent, everybody notices.”“If you'll go home and be a light, not a judge, trust and belief will grow.”“The decline of belief is not an abstract philosophical idea. It very well could become a quiet crisis shaping our homes, our workplaces, and ourselves.”“You were not put here on this earth to be less than. You're not defined by where you've been, only by where you're going.”“Learning increases belief.”“Our belief window makes all the difference.”“The simple belief that there is a life after this, and the choices we make here in this life have a lasting impact, cause people to make better choices.”“If you bet on God and you open yourself to His love, you lose nothing, even if you're wrong.”Show Links:Open Your Eyes with McKay Christensen

Episode 499 / Claudia WieserClaudia Wieser is a German artist based in Berlin. Her work has been the subject of solo exhibitions at The Drawing Center, New York; the Contemporary Art Museum, St. Louis, MO; and Smart Museum, Chicago, IL. Her work has been included in recent group exhibitions at the Katonah Museum of Art, Katonah, NY; the Anderson Collection at Stanford University, CA; the Hamburger Bahnhof, Nationalgalerie der Gegenwart, Berlin Germany; Asia Culture Center, Gwangju, South Korea; Contemporary Arts Center New Orleans; Museum für Moderne Kunst, Frankfurt; and Marta Herford Museum for Art, Architecture, Design, Herford, Germany. Wieser's work included in a number or prominent public collections, such as the Contemporary Art Collection of the Federal Republic of Germany; Collection of the Berlin State Museums, Neue Nationalgalerie, Sammlung Goetz, Munich; Deutsche Bundesbank Kunstsammlung, Frankfurt; Mercedes-Benz Art Collection, Germany; K21-International Contemporary Art Collection of the Kunstsammlung North Rhine-Westfalia; the Anderson Collection, Stanford University, CA; the William Louis-Dreyfus Foundation Collection; and the Louiand Zabludowicz Collection, London. She has produced large-scale, site-specific commissions for Dior in Vienna, Paris, and Beverly Hills, the Cleveland Clinic in Ohio, and the City of Munich. In July 2021, Wieser unveiled her first outdoor public installation, commissioned by Public Art Fund, at Brooklyn Bridge Park in New York. In 2023, she presented work in collaboration with historic Yves Saint Laurent couture, designing a set and exhibiting her work at the Museé Yves Saint Laurent, Paris. In 2020 she collaborated with Hérmes to design a catwalk for Paris Fashion Week. She recently completed an outdoor installation at the Stavros Niarchos Foundation Cultural Center in Athens. Claudia earned an MA in Painting and Sculpture from the Academy of Fine Arts, Munich. She lives and works in Berlin. She just opened a solo show at Marianne Boesky gallery. 

America Out Loud PULSE with Dr. Vaughn & Dr. Tankersley – At the beginning of the year, the Cleveland Clinic published an important paper that showed last season's flu shots led to a significant increase in its recipients getting the flu more than those who didn't take the vaccines. We dive into the weeds on the science behind the weakening of the immune system by T-cell exhaustion...