Podcasts about Clinical

In this episode, Dr. Sylvester Youlo, Orthopedic Surgeon at Phelps Health, shares how shifting CMS rules and the move toward outpatient care are reshaping surgical practice in rural health systems. He discusses Phelps Health's clinical documentation initiative and why strong documentation is critical for patient care, reimbursement, and the future of healthcare delivery.

Photobiomodulation (PBM) is a light-based therapy that uses specific wavelengths to interact with body tissues, influencing cellular activity without heat and supporting recovery across both medical and general wellness settings Europe recently released its first formal clinical guide for PBM in oncology, marking a shift toward standardized use of light-based supportive care across cancer treatment centers Clinical research shows PBM is most strongly supported for managing oral mucositis and radiation-related skin damage, two common cancer complications that can interfere with eating, speaking, and treatment continuity Beyond cancer care, PBM has been studied for wound healing, nerve pain, musculoskeletal recovery, skin health, and hair loss, with consensus reviews supporting its safety when properly applied Effective PBM depends on correct wavelength selection, dosing, and device quality, with red and near-infrared light delivering biologically active energy when used within established therapeutic ranges

In his weekly clinical update, Dr. Griffin and Vincent Racaniello are shocked by recent events, including Dr. Oz's appeal for measles vaccination, Vinjay Prasad's unilateral rejection of Moderna's mRNA influenza vaccine application, and the increasing number of New World screw worm cases, then Dr. Griffin then deep dives into recent statistics on RSV, influenza and SARS-CoV-2 infections, the Wasterwater Scan dashboard, Johns Hopkins measles tracker, where to find PEMGARDA, how to access and pay for Paxlovid, the number of measles deaths in Mexico, long COVID treatment center, where to go for answers to your long COVID questions, choroid plexus alterations in long COVID association with neuropathologies and contacting your federal government representative to stop the assault on science and biomedical research. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode How Dr. Oz's appeal to get measles vaccine may differ from RFK Jr.'s messaging (ABC News) FDA reverses course, refuses to review Moderna's application for new mRNA flu vaccine (CIDRAP) Hepatitis B Vaccination at Birth: Safety, Effectiveness, and Public Health Benefit (American Academy of Pediatrics: Pediatrics) US Olympic Committee remains 'dialed in' to prevent spread of stomach illness at Winter Games (CNN) Oz promotes measles vaccination (NY Times; USA Today; Fortune) Screw worm in Mexico (Gobierno de Mexico) Mexico reports more human New World screwworm infections (CIDRAP) Wastewater for measles (WasterWater Scan) Measles cases and outbreaks (CDC Rubeola) Big outbreak, bright lights…Measles Dashboard (South Carolina Department of Public Health) Tracking Measles Cases in the U.S. (Johns Hopkins) Measles vaccine recommendations from NYP (jpg) Weekly measles and rubella monitoring (Government of Canada) Measles (WHO) Get the FACTS about measles (NY State Department of Health) Measles (CDC Measles (Rubeola)) Measles vaccine (CDC Measles (Rubeola)) Presumptive evidence of measles immunity (CDC) Contraindications and precautions to measles vaccination (CDC) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM) Measles Vaccination: Know the Facts (ISDA: Infectious Diseases Society of America) Deaths following vaccination: what does the evidence show (Vaccine) Measles outbreak poses risk of 'irreversible' brain damage, health officials warn (Fox News) In Mexico, at least 28 have died from measles outbreak that started 2025 (Reuters) Influenza: Waste water scan for 11 pathogens (WastewaterSCan) USrespiratory virus activity (CDC Respiratory Illnesses) Respiratory virus activity levels (CDC Respiratory Illnesses) Weekly surveillance report: cliff notes (CDC FluView) Influenza vaccination and the risk of myocardial infarction(BMC Publich Health) OPTION 2: XOFLUZA $50 Cash Pay Option(xofluza) RSV: Waste water scan for 11 pathogens (WastewaterSCan) Respiratory Diseases (Yale School of Public Health) USrespiratory virus activity (CDC Respiratory Illnesses) RSV-Network (CDC Respiratory Syncytial virus Infection) Long-term impact of nirsevimab on prevention of respiratory syncytial virus infection using a real-world global database (Infection) Vaccines for Adults (CDC: Respiratory Syncytial Virus Infection (RSV)) Economic Analysis of Protein Subunit and mRNA RSV Vaccination in Adults aged 50-59 Years (CDC: ACIP) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 deaths (CDC) Respiratory Illnesses Data Channel (CDC: Respiratory Illnesses) COVID-19 national and regional trends (CDC) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) Where to get pemgarda (Pemgarda) EUAfor the pre-exposure prophylaxis of COVID-19 (INVIYD) Infusion center (Prime Fusions) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Drug interaction checker (University of Liverpool) Help your eligible patients access PAXLOVID with the PAXCESS Patient Support Program (Pfizer Pro) Understanding Coverage Options (PAXCESS) Infectious Disease Society guidelines for treatment and management (ID Society) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) Managing healthcare staffing shortages (CDC) Anticoagulation guidelines (hematology.org) Daniel Griffin's evidence based medical practices for long COVID (OFID) Long COVID hotline (Columbia : Columbia University Irving Medical Center) The answers: Long COVID Choroid plexus alterations in long COVID and their associations with Alzheimer's disease risks (Alzheimer's & Dementia) Reaching out to US house representative Letters read on TWiV 1296 Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.

Send a textHow much oxygen is enough when resuscitating extremely preterm infants? This week on The Incubator Podcast, Ben and Daphna explore the TORPIDO 30/60 trial comparing 60% versus 30% FiO2 at birth. While primary outcomes were similar, babies in the 60% group needed fewer chest compressions and less epinephrine—a signal worth discussing.They examine an Indian non-inferiority study on surfactant thresholds (40% vs 30% FiO2), where waiting until 40% meant significantly fewer intubations and shorter respiratory support for the youngest babies. Ben presents compelling Melbourne data showing growth-restricted preterm infants face six-fold higher NEC risk—even with identical feeding protocols—and discusses how critical birth history gets "lost" as babies grow.Daphna tackles therapeutic hypothermia in late preterm infants, reviewing Toronto's retrospective analysis showing 34-35 weekers experience higher mortality and more brain injury compared to 36-37 weekers. As units rewrite cooling protocols, are we moving too fast on limited evidence?The episode concludes with Ben, Daphna, and Eli discussing the repeal of "sensitive locations" protections for immigration enforcement. Through the story of a mother detained while visiting her NICU baby in Chicago, they explore how these policies impact family-centered care and highlight advocacy opportunities through the Protecting Sensitive Locations Act.Current research meets real-world NICU challenges—all in one episode.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

In this episode of the Tick Boot Camp Podcast, Matt Sabatello sits down with Yuri Kim, the lead clinical research nurse for MIT's MAESTRO study, described as one of the largest studies in MIT history focused on Lyme disease and Infection-Associated Chronic Illnesses (IACI). Yuri explains how MAESTRO is collecting deep symptom histories and objective measurements—from eye tracking and EEG/P300 auditory testing to NASA Lean dysautonomia testing, capillaroscopy, and multi-sample biological collection—to identify patterns that validate patient experiences and accelerate real-world clinical understanding. Yuri's story is equally compelling: she began as an ER nurse in a Level 1 trauma center, transitioned into research nursing (including neurodegenerative and traumatic brain injury work), moved to South Korea during the pandemic, and ultimately joined MIT after a conversation with Dr. Mikki Tal changed the course of her career. Throughout the conversation, Yuri shares what she's learned from MAESTRO participants: a community often exhausted and dismissed, yet profoundly motivated to help others and drive scientific progress forward. Key Takeaways (Fast Scan) MAESTRO is nearing ~200 participants enrolled, with the chronic Lyme cohort full and enrollment closing soon. The study aims to objectively measure symptoms often dismissed as “anxiety” or “depression,” especially brain fog and dysautonomia. MAESTRO uses multiple cognitive and neurologic measures, including RightEye eye tracking, EEG + P300 auditory “oddball” testing, and remote cognitive battery tests. The team added capillaroscopy (nailfold and toe microvascular imaging) to explore vascular patterns and hemorrhages in chronic illness cohorts. Dysautonomia testing includes NASA Lean Test plus an earpiece device to estimate proxy cerebral blood flow, sometimes showing abnormalities even when vitals look “normal.” Extensive biological sampling (oral, blood, vaginal/rectal) supports proteomics/immune profiling and deeper molecular analysis. Yuri emphasizes: patients' willingness to participate—despite severe symptoms—is the engine of progress and future change. Detailed Chapter-by-Chapter Show Notes 1) Meet Yuri Kim: The Human Side of Cutting-Edge Lyme Research Matt introduces Yuri as the clinical research nurse leading day-to-day operations of MIT's MAESTRO study—positioning her as a rare bridge between lab science, clinicians, and patients. Yuri shares that the study is approaching enrollment completion and that the team is eager to analyze a large dataset to “speak up” for participants who have suffered without clear explanations. Highlights: MAESTRO is one of MIT's largest studies, with enrollment nearing completion. The mission is to transform patient suffering into measurable signals, data, and insight. 2) Yuri's Background: Pharma, ER Nursing, Research, and Why This Work Became Personal Yuri explains her path: early work as a medical information specialist in pharma (including literature searches and clinician guidance, often involving off-label questions), then an intense period as a Level 1 ER nurse where she witnessed both acute crises and chronic illness desperation. Key insight:Yuri notes that in pharma and ER settings, she repeatedly saw the same reality—patients searching for answers, clinicians constrained by time, and chronic illness voices falling through the cracks. 3) From the ER to Neuro Research: Brain Inflammation, TBI, and the Gap in Chronic Illness Care Yuri left ER work largely due to the physical toll of night shifts and moved into academic research at Boston University. She worked on complex studies involving Alzheimer's, amyloidosis, and traumatic brain injury. Matt asks whether Lyme came up in those neuro settings. Yuri says no—but now she views neurodegenerative symptoms differently and believes clinicians should consider underlying root causes, including infection. Listener connection:This segment reinforces how often Lyme-related cognitive decline can be misinterpreted or missed when viewed through siloed specialties. 4) Lyme Awareness Outside the U.S.: South Korea, Tick-Borne Illness, and Global Blind Spots During the pandemic, Yuri relocated to South Korea. She shares that Lyme isn't commonly discussed there, though other tick-borne illnesses exist. Yuri underscores a global concern: agricultural and rural communities face tick exposure without awareness of the chronic implications. 5) How Yuri Joined Dr. Mikki Tal and MAESTRO (And Why She Changed Her Mind) One of the most memorable segments: Yuri reveals she had already accepted another MIT nursing role—but after speaking with Dr. Tal, she pivoted immediately, calling it the best career decision she's ever made. Why it matters: It shows how MAESTRO is not just a study; it's a mission-driven effort that attracts top clinical talent. 6) Day One at MAESTRO: Meeting the Severely Ill and the Community's Unmatched Generosity Yuri recounts a powerful early experience: meeting a participant who was bedbound and profoundly symptomatic, yet eager to contribute anything possible to help the community. Matt connects this to Tick Boot Camp's origin story: people with minimal energy still showed up to help others. The theme becomes clear—Lyme patients are often depleted but relentlessly generous. What MAESTRO Measures (The Four-Hour Visit Breakdown) 7) Brain Fog: Why MAESTRO Treats It as a Complex Phenomenon Yuri explains MAESTRO's approach: brain fog isn't one symptom. It can involve memory, processing speed, visual stimulation sensitivity, pain-triggered cognition changes, and motor response delays. Core idea: MAESTRO attempts to measure brain fog from multiple angles—visual processing, auditory processing, reaction time, and executive function. 8) RightEye Eye Tracking: Visual Stimulus + Reaction Time as Objective Signal Participants complete a structured set of ocular motor tasks (pursuit, saccades) and reaction-time games (shape recognition mapped to numbered inputs). Yuri notes many chronic illness participants struggle even with basic saccades, often aligning with reported visual disturbances. What MAESTRO is measuring: Ocular motor control Visual processing Decision speed Reaction time consistency 9) EEG + P300 “Oddball” Test: Auditory Processing Meets Motor Output Participants wear an EEG cap (19 regions) and listen to tones: common low-pitch and rare high-pitch. They must press the spacebar only for the rare tone. Yuri notes that even a 4-minute test can be exhausting for people with cognitive dysfunction, and participants often describe a frustrating “delay” between knowing what to do and physically doing it. Why this matters: This may help validate cognitive dysfunction even when standard office screening looks normal. 10) Remote Cognitive Battery Testing: Scaling Measurement Beyond MIT Participants complete executive function tests at home (memory, Stroop-like color-word matching, trail-making tasks). Yuri emphasizes why this matters: many patients can't travel, and symptoms vary dramatically by day, cycle, and crash patterns. Big future direction: Remote testing could expand access to bedbound patients and capture “good day vs bad day” variability. 11) Dysautonomia & POTS: NASA Lean Test + Proxy Cerebral Blood Flow Yuri details NASA Lean testing: supine rest, then standing/leaning while monitoring vitals and symptoms. The standout: sometimes vitals appear stable while patients feel intensely symptomatic—yet the cerebral blood flow proxy measurement fluctuates significantly. Clinical implication discussed: This approach could become a tool for identifying dysautonomia-related issues when standard vitals “look fine.” 12) Capillaroscopy: Nailfold + Toe Microvascular Imaging MAESTRO added capillaroscopy to examine microvascular patterns, including abnormal shapes and possible hemorrhages seen more frequently in chronic cohorts (as her clinical observations suggest). They also measure capillaries pre- and post-NASA Lean to explore whether symptomatic shifts correlate with microvascular changes. Why patients find it meaningful: They can visually see something measurable that aligns with how they feel. 13) Standard Neuro Screening Doesn't Capture Lyme Brain Fog Yuri shares a crucial point: participants often perform fine on standard screens like the Mini-Mental State Exam, suggesting that infection-associated cognitive dysfunction can be subtle, dynamic, and not detected by traditional tools—reinforcing the need for MAESTRO-style measurement. Biological Samples: “Measure Everything” (Head to Toe) 14) Multi-Sample Collection: Oral, Blood, Vaginal, Rectal Yuri explains the breadth of biological sampling, including saliva/oral samples (cotton chew + gum swab), multiple blood tubes, and sex-specific sampling to explore immune, hormonal, microbiome, and gynecologic dimensions. Why it's being done: To connect symptom clusters to molecular patterns and explore sex differences in chronic illness response. 15) Storage, Batch Effects, and What Happens After Enrollment Closes Samples are aliquoted and stored at -80°C until they can be processed/shipped in ways that minimize batch effects. The next phase is analysis and collaboration—including proteomics and immune signaling exploration. 16) Giving Back to Participants: The Challenge and the Intention Yuri acknowledges the “fine line” between research-only testing and clinically actionable reporting, but stresses MIT's intention to return what can be responsibly shared through certified partners—while being careful not to over-interpret research findings. Collaboration, Scaling, and What Comes Next 17) Collaboration Across Institutions: The Missing Platform Matt compares Lyme research needs to cybersecurity threat-sharing between banks: competitors collaborate because the threat is bigger than any one organization. Yuri agrees and highlights the need for secure data-sharing platforms—similar to large national efforts in other fields. 18) What's Next: Focus on Female Brain Fog, Hormones, and Remote Studies Yuri previews upcoming directions: Brain fog and hormone cycle relationships Differentiating infection-associated cognitive dysfunction vs menopause-related brain fog Remote/at-home measurement studies to reach more symptomatic and bedbound patients Potential collaborations with pediatric and neuroimmune experts Closing Message: Hope Without Hype Yuri's message to patients and families is simple and emotional: “Please don't give up.” She believes answers are coming because serious teams are working together—and because patients are driving the research forward with their participation.

This episode will cover the background of cellular-based gene therapies from basic cell biology to genetic targets currently used in treatment. Experts will review the mechanisms for modifying cellular genetic material and the common viral vector platforms used in ex-vivo cellular therapy production. An overview of the steps and processes for cellular therapy preparation, manufacturing, handling and administration will be provided. Additionally, this presentation will discuss novel cellular therapy agents currently approved for use and the highly anticipated cellular therapies currently under investigation. CE for this episode expires 2 years after the date it was originally published. The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

Recent news highlights ongoing developments in weight loss treatments like Ozempic, with fresh insights from clinical reviews and patient experiences. On February 11, 2026, Cochrane reviews commissioned by the World Health Organization analyzed GLP-1 drugs including semaglutide, sold as Ozempic and Wegovy. These studies, drawing from dozens of trials with tens of thousands of participants, show semaglutide leads to an average weight loss of about 11 percent after six to 18 months when paired with diet and exercise. Tirzepatide, marketed as Mounjaro and Zepbound, achieved around 16 percent loss in similar periods. Researchers note these benefits persist during treatment but emphasize limited long-term safety data, common side effects like nausea, and heavy industry funding in most trials. Cochrane reports highlight the need for independent studies on heart health, quality of life, and global access, as high costs limit use in lower-income regions.A Rutgers Health study published this week in the Journal of Medical Internet Research examined why Ozempic users stick with it despite side effects. Analyzing online reviews, researchers found perceived effectiveness in curbing appetite and shedding pounds outweighs issues like stomach upset for most. Lead author Abanoub Armanious noted that everyday users prioritize real results over hype from celebrities or social media. Separately, Weill Cornell Medicine researchers reported on February 11 that GLP-1 drugs like tirzepatide may lower risks of diabetic retinopathy progression in diabetes patients, countering earlier concerns.Oprah Winfrey continues to speak openly about her GLP-1 use, as covered in recent AOL articles. The media icon, who lost about 50 pounds starting in 2023 but regained 20 after briefly stopping, now views these medications as a lifelong tool like blood pressure drugs. Promoting her book Enough, Winfrey shared on The View and her podcast that the drugs silenced constant food thoughts, freeing her from self-blame. She told listeners obesity is not a willpower failure but a brain-driven condition, urging others to seek medical options without shame. Winfrey, who covers costs for friends, also noted reduced alcohol cravings as a bonus.Meanwhile, excitement builds around Eli Lillys oral pill orforglipron, an injectable-free alternative to Ozempic. Phase 3 trials like ATTAIN-1 showed 12.4 percent average weight loss over 72 weeks, with many maintaining results after switching from shots. Walk In reports it could launch in Canada soon, offering daily convenience without fasting, though generics of semaglutide arrive mid-2026 for affordability.Thanks for tuning in, listeners. Come back next week for more. Thanks for listening, please subscribe, and remember this episode was brought to you by Quiet Please podcast networks. For more content like this, please go to 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

Send a textOn today's show we cover lots of questions including…Are there hydrogen peroxide free glosses for hair?Is retinaldehyde better than adapelene?What are our thoughts on cosmetics in terra cotta containers?Are oils or water better for locking in moisture to hair?How do you start your own skincare line?Beauty QuestionsAdapelene study - Clinical efficacy of adapalene (differin(®)) 0.3% gel in Chilean women with cutaneous photoagingStart a cosmetic line webinarApproximate timestamps0:00 - Intro1:00 - Chit chat9:00 - Listener feedback - Pantene16:30 - Hair gloss20:15 - Retinaldehyde and adapelene29:30 - Terra cotta cotainers34:50 - Oils lock in moisture44:35 - Starting your own line52:30 - EndingFive Ways to Ask a question -1. Send us a message through Patreon!2. You can record your question on your smart phone and email to thebeautybrains@gmail.com3. Send it to us via social media (see links below)4. Submit it through the following form - Ask a question5. Leave a voice mail message: 872-216-1856Social media accountson Instagram we're at thebeautybrains2018on Twitter, we're thebeautybrainsOn Bluesky we're at thebeautybrainsOn Youtube we are at thebeautybrains2018And we have a Facebook pageValerie's ingredient company - Simply IngredientsPerry's other website - Chemists CornerFollow the  Porch Kitty Krew instagram accountSupport the show

Send a textIn this episode of Neo News, the team examines the intersection of immigration policy and neonatal care. We review a recent op-ed discussing the "chilling effect" of immigration enforcement on families seeking care in "sensitive locations" like hospitals. The discussion highlights a harrowing report from The 19th about a family detained by ICE while en route to the NICU, sparking a conversation on how fear impacts parental presence and follow-up adherence. The hosts explore the Protecting Sensitive Locations Act and the critical role neonatologists play in advocating for safe access to healthcare for all families.----Vernon, L., Swenson, S., & Miller, E. (2025, October). Immigration policies are creating impossible choices for NICU families. Cleveland.com.  https://www.cleveland.com/opinion/2025/10/immigration-policies-are-creating-impossible-choices-for-nicu-families-lelis-vernon-sarah-swenson-and-emily-miller.htmlBarclay, M. L. (2025, December). Postpartum immigrant detention by ICE. The 19th. https://19thnews.org/2025/12/postpartum-immigrant-detention-ice/Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

February is heart month and Matt and Allie are back with this month's clinical corner article discussing aerobic exercise and the benefits for patients with chronic lumbar radicular pain. Follow along as Matt goes over the article, poses his question to PT students listening, and shares the outcomes and findings. You'll hear about five different cases of patients with this chronic issue who had clinically meaningful changes including aerobic exercise to their treatments.Read the article here: https://www.jospt.org/doi/10.2519/josptcases.2025.0171Did you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/

Is Cognitive Decline Reversible? Here's One Family's Game-Changing Discovery. In this episode of The Healthspan Podcast, Dr. Robert Todd Hurst, MD, FACC, FASE, sits down with Rob Liebrich, CEO of Goodwin Living and creator of the revolutionary brain health program, Stronger Memory. What began as a son trying to help his mom with mild cognitive impairment turned into a validated, science-backed intervention that has now helped over 60,000 people, and counting. Stronger Memory combines three simple daily habits like reading, reading aloud, writing by hand, and basic math, and has been shown in peer-reviewed studies to improve cognition, delay decline, and restore connection.   They discuss: 1. Why Rob created the program 2. How his mom reversed cognitive decline and still thrives 13 years later 3. The science behind the brain's prefrontal cortex and memory 4. How George Mason University validated the results 5 . How you can get started for free   Learn more about Stronger Memory at: https://strongermemory.org For personalized care, visit: https://join.healthspanmd.com   ⏱ Full Episode Time Stamps  Time  Topic 00:00 Why protecting the brain is the next frontier in longevity care 01:50 Women's health, heart disease, and vascular risk after menopause 03:30 Meet Rob Liebrich: CEO and son on a mission to save his mom's mind 06:50 The discovery: 3 habits that transformed his mom's cognition 09:10 From family breakthrough to national program: Stronger Memory 13:50 Clinical data, MoCA scores, and university-verified results 18:40 Social engagement and the power of connection 25:30 How to implement the program (and why it's free) 32:00 Minimal effective dose and habit formation strategies 37:00 Why more people don't know about this and how we change that 44:00 Dr. Hurst: “This may be one of the most impactful stories I've heard.” This information is for educational purposes only and is not medical advice. Don't make any decisions about your medical treatment without first talking to your doctor.   This information is for educational purposes only and is not medical advice. Don't make any decisions about your medical treatment without first talking to your doctor.   *Connect* *with* *HealthspanMD* :

In this episode, Dr. Sylvester Youlo, Orthopedic Surgeon at Phelps Health, shares how shifting CMS rules and the move toward outpatient care are reshaping surgical practice in rural health systems. He discusses Phelps Health's clinical documentation initiative and why strong documentation is critical for patient care, reimbursement, and the future of healthcare delivery.

In this episode, Dr. Sylvester Youlo, Orthopedic Surgeon at Phelps Health, shares how shifting CMS rules and the move toward outpatient care are reshaping surgical practice in rural health systems. He discusses Phelps Health's clinical documentation initiative and why strong documentation is critical for patient care, reimbursement, and the future of healthcare delivery.

Send a textIn this segment, Ben and Daphna review a retrospective study from the Hospital for Sick Children comparing outcomes of therapeutic hypothermia in late preterm (34-35 weeks) versus early term (36-37 weeks) infants. They discuss the significantly higher rates of mortality, hemodynamic instability, and hypoglycemia found in the younger cohort, known as "Group 1". The hosts explore the implications of using MRI scoring systems like the Weeke score for preterm brains and debate the ethical challenges of conducting future randomized trials as clinical practice shifts away from cooling younger babies based on emerging retrospective data.----Whole-body hypothermia in late preterm and early term infants: a retrospective analysis from a neurocritical care unit. Martinez A, Cikman G, Al Kalaf H, Wilson D, Banh B, Abdelmageed W, Beamonte Arango I, Christensen R, Branson HM, Cizmeci MN.Pediatr Res. 2026 Jan 7. doi: 10.1038/s41390-025-04701-x. Online ahead of print.PMID: 41501407Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

The Epstein Files Fallout: Navigating Client Trauma, Justice Fatigue, and Clinical Responsibility In this episode of the Modern Therapist's Survival Guide, Curt Widhalm and Katie Vernoy explore the emotional and clinical fallout following the release of the Epstein files. Rather than reacting to breaking news, they focus on what happens after the headlines fade—when trauma resurfaces, justice feels out of reach, and both clients and therapists are left carrying the weight. This conversation examines how trauma responses show up in the therapy room, how therapists can avoid minimization or burnout, and what clinical responsibility looks like when systems fail and outrage turns into numbness. Key takeaways for therapists: How public disclosures can retraumatize survivors and trigger moral injury Why clients may experience numbness, irritability, or hopelessness instead of anger How to ethically hold space without rushing clients toward resolution Ways therapists can manage their own exposure and remain grounded The importance of containment, validation, and agency during collective trauma Full show notes and resources available at:https://mtsgpodcast.com Join the Modern Therapist Community: Facebook Group: https://www.facebook.com/groups/therapyreimagined Patreon: https://www.patreon.com/c/mtsgpodcast Modern Therapist's Survival Guide Creative Credits Voice Over by DW McCannhttps://www.facebook.com/McCannDW/ Music by Crystal Grooms Manganohttps://groomsymusic.com/

In this episode of EMS One-Stop, Dr. Linda Dykes joins Rob Lawrence from the UK for a wide-ranging, transatlantic conversation that starts with workplace culture and ends with a practical look at how health systems can keep patients safely at home. In the first half, Linda breaks down her newly published (open-access) qualitative paper, provocatively titled “It's not bullying if I do it to everyone,” drawn from UK NHS “Med Twitter” responses: a raw, heartbreaking window into the red flags of toxic workplace culture, how bullying is experienced in the eye of the beholder, and why incivility and silence are not just HR problems — they're patient safety threats. In the second half, Linda brings listeners into the UK's evolving admission alternative world: frailty care at home, urgent community response models, and the increasingly important interface between EMS and community-based teams. She explains the UK's SPOA (single point of access) concept, why she dislikes the term “admission avoidance,” and how ED crowding and access change the risk-benefit equation for hospital vs. home. Rob connects the dots back to the U.S. reality — reimbursement, APOT/wall time, treatment-in-place policy — and why this work is becoming a shared challenge on both sides of the Atlantic. Timeline 00:51 – Rob opens, recaps NAEMSP in Tampa and recent content. 02:25 – Rob introduces Linda as the “triple threat” (emergency medicine, primary care/GP, geriatrics) and tees up two-part discussion. 05:39 – Rob introduces Linda's paper: “It's not bullying if I do it to everyone.” 06:13 – Linda explains why toxic culture is increasingly visible and how the tweet prompt became a dataset. 07:33 – “Flash mob research group” forms; Linda explains social-media-to-qualitative methodology and limitations. 10:03 – Rob asks about bias; Linda clarifies purpose: insight, not representativeness. 16:39 – Linda defines gaslighting and why it's so destabilizing. 18:21 – Reactions to publication; resonance, sharing and uncomfortable self-reflection on learned behaviors. 20:18 – The “16:55 Friday email” as a weapon — and as an accidental harm. 23:29 – Leadership as “the sponge” — absorbing pressure rather than passing it down. 25:27 – “One thing right now”: know the impact your words can have, especially on vulnerable staff. 26:41 – Rob on “pressure bubbles,” micro-movements and atmospherics: how leaders shift climate without realizing it. 30:53 – SPOA explained: single point of access and urgent community response behind it. 33:03 – EMS interface: calling before conveyance to find safe pathways to keep patients at home. 35:47 – Linda on mortality risk of access block/long waits and how that reframes risk decisions. 37:19 – Evolving models: primary care-led response vs. hospital at home approaches. 39:34 – Clinical myths challenged: oral antibiotics sometimes non-inferior to IV in conditions we assumed needed admission. 40:34 – Outcomes: hospital at home trial signals safety and fewer patients in institutional care by 6 months. 42:00 – Telemedicine/telehealth: underutilized but useful; when you still need a senior clinician in person. 44:50 – Closing takeaways: read the paper (with trigger warning); admission alternative work is deeply satisfying. Enjoying the show? Email editor@ems1.com to share feedback or suggest guests for a future episode. 

In this episode, host Jenna Hagan sits down with Keith M. Nord, MD—an orthopedic hand surgeon at Sports Orthopedics & Spine in Jackson, Tennessee—to explore how clinical AI is transforming his day-to-day practice. As the only orthopedic hand specialist in his region, Dr. Nord faces intense patient demand and a heavy documentation load. He shares how adopting ambient clinical AI has helped him reclaim time, reduce burnout, and focus more fully on patient care.

In this episode of AUANews Inside Tract, Dr. Ray Tan speaks with Dr. Emilie Johnson, pediatric urologist at Ann & Robert H. Lurie Children's Hospital of Chicago, about her work as an inaugural recipient of the Urology Care Foundation Bridge Award, supported by Dornier MedTech. Dr. Johnson discusses how the award is sustaining her implementation science research on equitable newborn circumcision care during a critical funding gap, and how user-centered design and global health frameworks are helping translate research into real-world clinical impact.

In Part 2 of our special three-part series marking 20 years since the 7/7 London bombings, paramedic Adam Desmond shares a deeply personal and unflinchingly honest account of responding to the attacks at King's Cross. This episode centres on the realities of working at the epicentre of a complex, evolving major incident and the lasting impact such events have on those who respond.In conversation, Adam reflects on the initial chaos, the scale of human suffering, and the difficult clinical and moral decisions faced in the confined, hazardous environment of the Underground. He speaks candidly about navigating severe trauma in darkness, confronting system pressures and operational breakdowns, and the personal toll of witnessing mass casualty devastation. Adam also explores the longer-term psychological consequences of the day, including grief, identity, and how the experience continued to shape his life and career long after the incident ended.This is a powerful and important discussion for anyone working in pre-hospital care, emergency medicine, healthcare leadership, or disaster and major incident response.Content Warning: This episode contains detailed and graphic descriptions of traumatic injuries, death, and first-person reflections on the 7/7 bombings. Listener discretion is strongly advised. The views and opinions expressed in this podcast are those of the individual speakers and do not necessarily reflect the views, policies, or positions of any affiliated organizations, employers, professional bodies, or regulatory authorities.The content discussed is intended for educational and informational purposes only. It does not constitute medical advice, clinical guidance, or a substitute for formal training, local protocols, or independent clinical judgment.Clinical decisions should always be made in accordance with current evidence, local guidelines, the scope of practice, and consultation with appropriately qualified healthcare professionals. Listeners are responsible for ensuring that any application of information discussed is appropriate to their own clinical context.⁠This episode is sponsored by PAX: The gold standard in emergency response bags.When you're working under pressure, your kit needs to be dependable, tough, and intuitive. That's exactly what you get with PAX. Every bag is handcrafted by expert tailors who understand the demands of pre-hospital care. From the high-tech, skin-friendly, and environmentally responsible materials to the cutting-edge welding process that reduces seams and makes cleaning easier, PAX puts performance first. They've partnered with 3M to perfect reflective surfaces for better visibility, and the bright grey interior makes finding gear fast and effortless, even in low light. With over 200 designs, PAX bags are made to suit your role, needs, and environment. And thanks to their modular system, many bags work seamlessly together, no matter the setup.PAX doesn't chase trends. Their designs stay consistent, so once you know one, you know them all. And if your bag ever takes a beating? Their in-house repair team will bring it back to life.PAX – built to perform, made to last.Learn more at ⁠https://www.pax-bags.com/en/⁠

Host: Yuval Zabar, MD Guest: Michelle Mielke, PhD Guest: Henrik Zetterberg, MD, PhD For the latest insights on tau and neurodegeneration biomarkers in Alzheimer's disease (AD), tune in to this recorded presentation featuring Doctor Michelle Mielke and Professor Henrik Zetterberg. Together, they delve into the role of tau in AD, exploring the ‘tau cascade', the current use of tau and neurodegeneration biomarkers in tracking disease progression, and how the AD biomarker landscape may evolve over time. Doctor Mielke is a Professor of Epidemiology and Neurology at the Wake Forest University School of Medicine, and Professor Zetterberg is a Professor of Neurochemistry at the University of Gothenburg. To learn more about tau in Alzheimer's disease, explore the Know Tau medical education platform. Know Tau is created and funded by Biogen and is intended for healthcare professionals only.

Die Themen in den Wissensnachrichten: +++ Unterhose misst Anzahl der Fürze von gesunden Erwachsenen +++ Jede zweite Mail ist Spam +++ Vögeln ist es oft zu laut +++**********Weiterführende Quellen zu dieser Folge:Smart underwear: A novel wearable for long-term monitoring of gut microbial gas production via flatus, Biosensors and Bioelectronics: X, 11.10.2025Kaspersky reports 15% growth in malicious email attacks in 2025, Kaspersky, 11.02.2026Zahl der Masernfälle in Europa und Zentralasien 2025 im Vergleich zum Vorjahr rückläufig, aber Gefahr von Ausbrüchen bleibt bestehen – UNICEF und WHO, WHO, 11.02.2026Increasing self- and desired psychiatric diagnoses among emerging adults: Mixed-methods insights from clinical psychologists, International Journal of Clinical and Health Psychology, 31.12.2025Trait-mediated effects of anthropogenic noise on bird behaviour and fitness, Proceedings B, 11.02.2026Alle Quellen findet ihr hier.**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok und Instagram .

Do you want your patients to feel confident and cared for and to become raving fans about your practice? Kiera takes listeners through specific steps to help practices refine what their patients go through upon entering to exiting your office. Episode resources: Subscribe to The Dental A-Team podcast Schedule a Practice Assessment Leave us a review Transcript: The Dental A Team (00:00) Dental A Team listeners. This is Kiera. And today I'm excited for a quick tactical practical tip for you guys that I just think is magical. And I'll start with like a story about it to kind of kick us off. ⁓ Jason and I, we just recently went to Ruth's Chris. We decided we were gonna do a day date and Jason and I, went to the spa. I convinced him to go to the spa. He's not like obsessed about it, but really loved in like the hot tub room that they actually turned on a football game for him. So.   I don't know how the spa gods were on my side that day, but they definitely were. And then we decided to go to Ruth's Chris. And if you guys are familiar with Ruth's Chris, ⁓ it's ⁓ an amazing steakhouse. And ⁓ I noticed when we went in there, there was just a different vibe. And I've been very obsessive about high-end restaurants, reading the book, Unreasonable Hospitality. I think I'm more aware of it. If you guys haven't read that book, I definitely recommend putting that on your book wish list. And what was interesting is,   When we came in, they said, hi, Mr. and Mrs. Dent, great to see you. And they took us back to our table and the waitress was so kind to us. And she said, here's this information. What information do you guys need? There were seat spot for us. The busser came through and was like, we really love working with people like you. You guys just make our life so much easier. They're like, here, let's just box this up for you. You made great choices for you. They had all of our stuff boxed for us. The presentation was beautiful.   They didn't come by and they weren't annoying to us, but they were so genuine to us. And then as we were leaving, they said, thank you, Mr. and Mrs. Dent. And they knew all about us. Okay. So that was one experience. Another experience has been Jason and I were in Bali and we went to the four seasons and I remember if you've been to Bali, you'll understand. Jason and I both got Bali belly. And if you haven't heard mine was, I got it on our flight home. I've never in all my years of flying, knock on wood, I've never once thrown up ever on a plane.   Mine is my flight home that was a nice nine hour flight from Taiwan to San Francisco. And I threw up and had diarrhea the entire freaking time of that flight. I had thrown up about 13 times in two hours and I figured out, if I can make a system for this, like it was hold the vomit bag, go to the bathroom and brush my teeth all at the same time. I realized you can create a system for anything. So that's a little bit beside the point. So I'm here to tell you about great experiences. But at the four seasons, they were top notch. They had an app. They would text us.   When I asked them like, hey, you guys have any medicine? They're like, ⁓ we don't have medicine. Here's the pharmacy. We can get it for you. We'll have it to your room. They had it to our room for us. They brought different things for us because they knew that we were sick. They had a turndown service for us. They paid attention to our likes. Our wants, made sure everything was done every single night for us. It was one of the most incredible experiences. And I think about it, like people are like, Kiera, you traveled all over the world. You've gone to Antarctica. You go to these places. And I'm like, Bali, even though I threw up for eight hours on my flight home.   Bollywood one of my most amazing experiences and I'm like, what was it? Like it was how I felt at Four Seasons. It was how I felt of everybody was so happy for us to be there. They were so grateful for us to be there. People would say hello to us. They knew our names as we walked through. And ⁓ I've just been paying attention to like Ruth's Chris was recent. The Four Seasons was another one. And then I think about other experiences that maybe weren't as great. I think about...   Hotels Jason and I we flew home. We missed a flight coming home from an international flight So we had to snag a hotel the only hotel available for us was a hotel I will not say But it was we'll just say a budget-friendly hotel and I remember we checked in and no one was there They weren't happy to see us. They were annoyed to see us the shuttle. I'm not joking you It was supposed to be there in 15 minutes We waited two hours to get our shuttle and they kept telling us one's on the way one's on the way. They were like you need to call this person By the time we got there our bed was dirty   The bathroom was broken. And I just thought, man, I remember that experience. I don't remember the Four Seasons experience, but which one do I want to go back to? Which one do I tell my friends about? Which one am I like, I threw up and I was so sick from Bali. You guys, would never recommend doing a cooking class internationally. I know exactly what caused our sickness. my gosh. And my stomach like to this day still hurts about it. But yeah, I loved that trip so much because of how I felt. And so that's what I want to go into today of   the patient experience in designing and creating a journey that the patient wants to be a part of and they want to rave about. And I know we've talked about this at several other times ⁓ because it's something where I remember I was at a conference once and they said, Kiera, what people remember is the beginning and the end. They don't really remember the middle. And so in dental practice, it's our beginning. It's our first phone calls and it's the end on how they leave. Yes, they might remember the middle of the procedure, but typically speaking, it's those, those two points in anything like think about a show you go to. You usually remember the beginning.   You remember the end. think about Taylor Swift and I'm like, definitely remember the countdown clock. Like I can remember that. remember everything coming out. Middle, like there was a lot going on and the ending, everybody can remember that. But, and yes, there are still things and that's not to say the middle can't be great, but we want to make sure that it is this experience that people are so obsessed with because we want to help them feel so good. And I think the dental office is such an intimate space. Dentistry is intimate. Everything that we do in dentistry is intimate. And so if we can help patients feel   a certain way and that doesn't mean we have to be perfect, but it does mean that we create a patient experience and a patient journey for them. So for me, even in Dental A Team, it should be that the patient experience, our customer experience is very intentional and not accidental. So we kind of think through it, like what do want our patients to feel? What do we want our patients to say about us? And it's also crazy because you can go look at your reviews right now and see what the patient experience is today.   what you've created maybe not intentionally or intentionally. Just go read it. What is it? For us at Dental A Team, I want people to feel like it's fun. I want it to feel like it's easy. I want people to feel like, my gosh, like they understood me, that they're thinking ahead of where I'm at, that they can guide us and that we are non-judgmental and that you and your team are gonna rise to the next level. Go read our reviews. That's what it is. But that's by intentionality and design. That's our core values. That's what we talk about constantly. It's how we onboard our consultants.   It's how we refine. how we take feedback from clients of if they're not getting it, how can we make this process easier? How can we make it easier for our consultants? How can we give better education? Like what can we do because that's the experience we want them to have. And so, ⁓ this is going to be an episode. If you really want patients to feel like super confident and cared for and to become raving fans for you to where they love the dentist, you have an opportunity to change how people feel about going to the dentist. And I think it's an amazing opportunity if you choose to do it. So   Number one is like, let's think about first impression. Remember, like it's the it's the end caps. And I think if we can even just design those two really, really intentionally, like four seasons and Roos Chris, did you notice in both of those? And this is not on purpose. I just sharing the story. I talked about my entrance and my exit at Bali. We were freaking sick on that last day. And I remember that the most more than anything. Yes, they did the turn down service and that was great. But I didn't talk about our New Year's Eve dinner that we had. I didn't talk about the waiters like none of that.   And as I think back, I'm like, yeah, that was really nice. I remember our first initial and our ending. Same thing with Ruth, Chris, how they entered us and how they exited. I talked about both of those. Go back and rewind. And that was not on purpose, but this even just proves my point that the experiences you remember are those end caps, the beginning and the end. So what is our presence? So number one is how do we answer the phone on the first new patient impression? That's going to be it. I talked about this just recently. If you haven't heard that, go back and listen, but like, how do we greet people? And are we like smiling when we answer? Are we excited or are we like,   Oh my gosh, another freaking phone call, like, hello. Right? I don't know if any of you had a mom who had a mom voice where she's like, Kiera Cherie. And I was like, hello. My mom was like, I didn't do that. I'm like, oh mom, you did. And you had the snap and you'd give me those mom eyes, right? Moms had those two voices. My sister's husband, he was like, my mom used to like snarl at me with her teeth. My mom didn't do the teeth, but we all know like, and I feel like that's how it should be like, we could be busy in the patients, but as soon as that phone rings, I want our front office to feel like.   my gosh, I am so excited to be answering this phone call. We are so excited you're here. Like almost like buddy the elf, like you're so excited. Maybe not that enthusiastic, but like that same sentiment. We are so excited. So we want it to be this like welcoming. We are happy you're here. We're not annoyed that you're here. And that's the very first impression. And then when they come into the practice, this is our next first impression. And if we botch our phone, we oftentimes can make it up on our second, but I will tell you that first phone impression is going to be paramount. So get our best person answering those.   best person and all of our front office team needs to realize when you answer the phone, you go on stage and you like sit up and you smile, even put mirrors up there so they can see themselves. You guys, not a joke. My mom said I was so vain. She gave me a like desk with a mirror and I used to sit there and talk on the phone in front of the mirror. And I was like, why do you do this? And I'm like, mom, like watch how I talk and I look at things and I look at, I practice my smile and it could have been a little vanity. Uh, but I know it's helped me present and be able to speak. And I guarantee you a lot of that mirror training.   is why I'm able to go present on stage today and be able to engage and invoke emotion because I practiced for a long time in the mirror. So having that mirror, having people see how they are, because if I'm sitting down, I'm like, hey guys, welcome to the podcast versus, hey guys, welcome to the podcast. You feel two very different things. And I feel too, I'm like super jazz on the second one. The first one I'm like, cool, I got a freaking podcast today. No, like I'm excited. I'm excited to hang out with you. I'm honored that you share your time with me. So we want it to be, and whatever your experiences, and some doctors you might not be like Kiera level 20.   Well, guess what? My team is Kiera level 20. We want to answer the phone in that level. If you are more like subdued and you're more like spa boutique, your phone needs to answer. Like I would be utterly shocked if I called the spa and they're like, hi, welcome to the spa. I'd be like, whoa, tone it down. Like this is the spa. And that's even Kiera who's excited. The dental office, it's like welcoming and engaging and like, hi, I'm like so excited you called. We're truly going to take great care of you. And I'm really excited to bring you into the practice. Notice I even have a patient voice that's different than my podcast voice, which is different than a spa.   My spa was like, hi, welcome to Serenity Spa. I'm so glad you're here. And I'm Kyra Dent and I'm changing right here, but it's because I feel that. And that's what I want people to experience in our phone and how people walk in is going to be our first step. So we need you to truly train and what is it? And if you haven't built this for your front office team, help them see this is what our, this is what our patient experience is. We want a confident, energetic, calm, whatever it is, first interaction. And we want our   online experience. our website, our scheduling, our messaging, our phone messaging to follow that same experience. So if that's our first impression, they're still filling it. Then they want to make the phone call. And we want to just like reduce any friction. How can I make this easier? I'm going to send you the paperwork. I'm going to schedule you now. I'm going to make sure I get this back in 48 hours. So I've got your appointment confirmed. This is how we're going to work. And I'm also setting clear expectations of we are so excited to have you here. And these are the rules of the game that we play by.   You notice like I even feel myself go into like a confident and welcoming human. That's our first experience. And if you will refine this, you will start to notice you train your patients from day one of we are so happy to have you. This is how we operate. We have you run on time. We have you send in our information. You always confirm your appointments 48 hours ahead of time. And we are so excited to welcome you to our family, whatever it is. listening to our new patient phone calls, experiencing that, putting the mirrors up there.   And then it's a, when the patient comes into the practice, let's make sure that that's an amazing experience too. Is our waiting room area clean? Do we have our front office person? You guys like, it drives me wild when I walk into a practice and it is cluttery with paper. You guys clear that clutter and make it clean. Dental practices need to be sterile. Yes, you can have cutesy stuff, but it still needs to feel clean and sterile. Front office team members, I'm gonna be a little bit hard right now. Do not freaking eat food in the front where patients can see you.   Go to the back. watch it so often. You're just sitting there like you break your crack or anything. No one can see you. They can. They see crumbs. It just feels. People can feel perfection. They can feel cleanliness. They can feel dirtiness. And this isn't me like ripping into you. I bend that person. I used to my snack drawer down there. That's not professional and that shouldn't be in the front office. Get it into the back office. Let's make sure it's clean. You can have all your cups. You can have all the things, but it needs to be clean. It needs to be sterile. It needs to be welcoming and inviting. Think about when you walk into a hotel. It's very inviting. Some   junkie janky and you're like, I don't want to stay here. Some are like, my gosh, this is amazing. Same thing with restaurants. How do we want our patients to feel? Let's make sure that the ambiance feels the same way. Even if your front office is on the phone, you can always welcome and say hi. Like while you're on the phone, I'll be right with you. That way they can feel super welcomed or like, hey, here's an iPad. I'll chat with you. And then as soon as like, Kiera, I'm so happy you're here. Welcome to the practice. Let me grab you a bottle of water. Do you prefer stilled or, or like do you prefer room temperature or chilled?   little small things that does not take a lot of effort, but that sets a very different impression rather than welcome to the practice. Okay. So let's make sure that first impression is very, very important. This is that first end block of the practice and patient experience. It's going to make it radically different for you and your practice. Then on the other side, is it's going to be during the visit? We need to make sure that we're still well oiled because if our front and end of those bookends are good, but the middle is ick.   They're going to actually remember that more than they remember these polished pieces. So the middle doesn't have to be like perfect perfection every time. what? Dentistry runs long. But as often as we can, let's be on time to our patients. Let's make sure that we have really clean handoffs. Let's make sure that when we are presenting our exams doctors that we use that NDTR. What's the next visit? What's the date? What's the time to return and make sure our re-care cleanings are scheduled. Make sure that the patient has that every time. Look me in the eyes. Involve me in that experience of patient, doctor, clinician. We're here.   All right, Kiera, we wanna see you back in two weeks for that crown on the upper right. We're gonna take great care of you. I need about an hour and a half for that. And we'll make sure that sister Susie over here gets you scheduled for your cleaning. What questions do you have for me? I'm really excited to work with you. Great, they know. And I will tell you if doctors will take the little bit of time to be super concise and clear on next steps, next visit, that's what people are remembering. So again, remember, yes, you've got the bookends of the appointment.   but also within the appointment in the chair, they're remembering how you seat them and how you end. Doctors, the essay heard the exam, but they're remembering your anchoring point of your end point. So nail that end point. Clinical team members, remember the end point. I used to try to like make jokes at the beginning and then have a good time at the end because I knew that that's what they were going to remember. Even if the procedure was hard, I still made sure that they had a great experience at the end. And if it was a hard procedure, I'm like, gosh, you did such a good job. I'm really, really proud of you. You did it.   you're gonna have the best results after this, whatever it is, but just make sure that they're clear, especially on exams. There is nothing worse than confusion. Confusion is the enemy of execution. So be crystal clear on where we're headed. And then after that, what we're gonna do is we're gonna let them know like, here's the next visit, here's what's gonna happen, we're gonna move them through it. This way your patients are so crystal clear on what's going on. And then at the end,   We have an amazing experience. So front office team, you're back on the, you're the shining stars. You welcome them in, you talk to them on the phone, and then you're the last impression. So making sure your people who are sitting in those seats recognize their role and their value in this whole experience. So on this, it's a perfect, let's get you scheduled. I make this really easy for them. Beautiful. What questions do you have for me? We say the same thing from what they said in the clinical team to the front office team. Front office has really good notes. So the clinical team just picks it right up.   And we have this in here of a very, very, very good experience at the end. Then if they had a great experience, I asked them for a review and say, Hey, I'd love you to share your experience with us. I can't wait to see you next time. Gosh, you're seriously one of my favorite patients. And I'm so grateful you're a part of our practice. That's not that hard, but what's that patient? You remember, gosh, they loved me when I came in, they loved me when I went out. And what it is, is it's not all these little pieces. It's the experience of how they felt just like me. I didn't tell you all the nuances of Ruth's Chris   I didn't tell you that my steak was amazing. I didn't tell you I had sweet potatoes. None of that. What I did tell you is how I felt at both. And guess what? I could have told you any experience, but I told you what's crazy is even at the spa, the football game was at the end. I didn't even tell you about my massage. I told you about the little thing that stood out to me. And remember, bad things actually could be what your patient's experiencing, even though you think you've got good pieces. If I've got an amazing welcoming, but I've got a jerk of a team member who's rude,   they're gonna remember that, cause that's gonna stand out way shinier than this one. And sometimes my doctor can be amazing, but your front office cannot be the same experience and it feels disjointed. And so you gotta make sure that you're, you have a team that's very similar and that we talk about what is our experience? How do I patients to feel? What are our core values? This is culture, but it's patient experience too. And if we get a whole team rallied around this, you're going to be able to have massive raving fans, but it's done with ease. So doing simple little things. So what I would say is when we have this of,   Let's go through number one, what is our patient experience? How do we want patients to feel? Look at our reviews and see what are they already saying and is that what we want? And if not, let's change it. Then let's make sure our phone calls, our website and our first impression when they come into the practice is dialed in and exactly what we want. Let's make sure are in the middle, pretty dang good. Doctors, you're ending with great exams. Clinical team members were ending with a great experience at the end of the exam. And then we take them up to front office and front office, we shine, we dazzle and we are so grateful to have these patients.   Now, if you're listening as a front office team member, you're like, I absolutely don't want to do that. It might be a wrong seat for you. I'm just going to say that front office team members are on stage. Just like I don't want to put a Disneyland, like someone who absolutely hates greeting guests and like putting them through the ticket counter. If they're like, I hate this job. They're, they're not the person. Cause that patient's going to feel that that guest is going to feel like, ⁓ checking into a hotel. I've got the person who's like, gosh, here you are. This is just a job and you're driving me nuts versus the person like, we are so happy you're here.   Make sure I've got right people in right seats for this experience. And that's critical. They could be the right team member, just the wrong seat. So let's make sure if you're listening to this, that you love this. I truly do. And I know Tiff does, and I know Kristy does, and I know Dana does, Britt actually, she's not the front desk. She doesn't like that guys. So she's not always on the podcast. And if Britt was listening, she'd be like, that's correct. I prefer back scenes. She likes to be there. Shelbi, you've never heard Shelbi on the podcast, cause she's like hard past no Kiera, that's not who I am.   but I've got all my consultants who would be like, yeah, Trish put her on. She'd love it. She'd say to the friend, she'd make everybody her best friend, Monica, Pam. They'd love it. So make sure you've got right people, right seat, and then make sure you really commit to having this incredible patient experience and you can check it. Let's do a monthly review, like do an audit of what are the top things the reviews are saying, have Chat GPT help you. There's easy ways to make sure that what we want of our patient experience is what patients are saying. And if not commit to change, it's how patients feel that they're going to remember more than it's what you say.   And if we can help you guys reach Hello@TheDentalATeam.com. These are the small annoying like cobwebs that make the big difference for patients that we are obsessed about helping you with. So reach out, running a successful practice does not have to be hard and it can be very easy for you. So reach Hello@TheDentalATeam.com. And as always, thanks for listening and I'll catch you next time on the Dental A Team Podcast.  

This episode describes what complex Post Traumatic Stress disorder (cPTSD) is, how it's diagnosed, and how it's different to similar disorders like PTSD and borderline personality disorder. This episode was inspired by the angry comments on Dr. Kibby's latest reel on spotting emotion dysregulation in borderline personality disorder. When someone has a history of childhood trauma and they struggle with intense emotions, self-esteem issues, and relationship problems- what disorder do they have? In this episode, Dr. Kibby delves into the criteria for complex PTSD, which is still not an official disorder in the DSM-V. Yet, so many people struggle with symptoms from long, painful histories of trauma that has shaped their entire lives and personalities.Dr. Kibby also discusses the nuanced differences between Complex PTSD and Borderline Personality Disorder, revealing how trauma shapes self-esteem, relationships, and emotional regulation in surprising ways. If you've ever wondered why these disorders often overlap—and how understanding their distinctions can transform healing—you'll want to hear this.Dr. Kibby shares her own experiences with online criticism around trauma representation, sparking a deeper conversation about stigma and bias in mental health. She dives into the hidden intricacies of CPTSD, explaining why it's often overlooked in the DSM-5 but recognized worldwide, and how prolonged trauma affects the brain's ability to process memories, dissociate, and regulate emotions.She also talks about how how trauma, whether overt or subtle, can lead to complex self-protection mechanisms that impact every aspect of life. Then she finishes with listing the best evidence-based treatments, from prolonged exposure to cognitive processing therapy and DBT, tailored for each disorder's unique challenges. She emphasizes the power of compassion and personalized treatment over stigma, advocating for a mental health field that treats all disorders with empathy and respect. Why diagnosis isn't about labels- it's a pathway to personalized healing and recovery.Resources:Sarr, R., Quinton, A., Spain, D., & Rumball, F. (2024). A Systematic Review of the Assessment of ICD‐11 Complex Post‐Traumatic Stress Disorder (CPTSD) in Young People and Adults. Clinical psychology & psychotherapy, 31(3), e3012.Simon, J. J., Spiegler, K., Coulibaly, K., Stopyra, M. A., Friederich, H. C., Gruber, O., & Nikendei, C. (2025). Beyond diagnosis: symptom patterns across complex PTSD and borderline personality disorder. Frontiers in Psychiatry, 16, 1668821.

Send a textIn this episode of Journal Club, Ben and Daphna review a prospective cohort study from the Journal of Perinatology that examines the care of neonates following in-utero growth restriction. The hosts unpack the critical distinction between Fetal Growth Restriction (FGR) and Small for Gestational Age (SGA), highlighting how the "decay of information" in the NICU can lead clinicians to overlook early risk factors as babies grow. They discuss the study's alarming findings regarding the six-fold increased risk of Necrotizing Enterocolitis (NEC) in SGA infants and the importance of maintaining a comprehensive medical history throughout a patient's stay.----Care of neonates following in-utero growth restriction: A prospective cohort study exploring neonatal morbidity. Alda MG, Wood AG, MacDonald T, Charlton JK.J Perinatol. 2025 Sep;45(9):1219-1225. doi: 10.1038/s41372-025-02397-9. Epub 2025 Aug 21.PMID: 40841433 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Frederico Amorim convida Ayrton Silveira e Flávio Barbieri para falar sobre diagnóstico de arboviroses em 4 partes:- Quando suspeitar?- Diferenças entre as arboviroses (dengue, chikungunya e zika)- Quais exames pedir?- Abordagem geralReferências:1. Pan American Health Organization. Recommendations for Laboratory Detection and Diagnosis of Arbovirus Infections in the Region of the Americas. Washington, D.C.: PAHO; 2023. Available from: https://doi.org/10.37774/9789275125878.2. WHO guidelines for clinical management of arboviral diseases: dengue, chikungunya, Zika and yellow fever. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO.3. Rosenberger, Kerstin D et al. “Early diagnostic indicators of dengue versus other febrile illnesses in Asia and Latin America (IDAMS study): a multicentre, prospective, observational study.” The Lancet. Global health vol. 11,3 (2023): e361-e372. doi:10.1016/S2214-109X(22)00514-94. https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/a/aedes-aegypti/monitoramento-das-arboviroses5. Dengue : diagnóstico e manejo clínico : adulto e criança [recurso eletrônico] / Ministério da Saúde, Secretaria de Vigilância em Saúde e Ambiente, Departamento de Doenças Transmissíveis. 6. ed. – Brasília : Ministério da Saúde, 2024.6. Shahsavand Davoudi, Amirhossein et al. “Ultrasound evaluation of gallbladder wall thickness for predicting severe dengue: a systematic review and meta-analysis.” The ultrasound journal vol. 17,1 12. 3 Feb. 2025, doi:10.1186/s13089-025-00417-57. Shabil, Muhammed et al. “Hypoalbuminemia as a predictor of severe dengue: a systematic review and meta-analysis.” Expert review of anti-infective therapy vol. 23,1 (2025): 105-118. doi:10.1080/14787210.2024.24487218. Tsheten, Tsheten et al. “Clinical predictors of severe dengue: a systematic review and meta-analysis.” Infectious diseases of poverty vol. 10,1 123. 9 Oct. 2021, doi:10.1186/s40249-021-00908-29. Boletim Epidemiológico – Monitoramento das arboviroses e balanço de encerramento do COE Dengue e outras Arboviroses 2024,Ministério da Saúde, Secretaria de Vigilância em Saúde e Ambiente, Volume 55, nº 11, 4 jul. 202410. Daumas, Regina P et al. “Clinical and laboratory features that discriminate dengue from other febrile illnesses: a diagnostic accuracy study in Rio de Janeiro, Brazil.” BMC infectious diseases vol. 13 77. 8 Feb. 2013, doi:10.1186/1471-2334-13-7711. Kamble N, Kumar VS, Rangaswamy DR, Kavatagi K. When it itches, dengue switches off: a retrospective case series. Bull Natl Res Cent. 2024;48:68. doi:10.1186/s42269-024-01225-y

Season 38 examines one of Victorian England's most infamous murderers: William Palmer, the Rugeley Poisoner. This four-part series traces his crimes from gambling addiction to serial murder—and the groundbreaking forensic investigation that brought him to justice.The Fatal WagerNovember 1855. A man lies dying in Room 10 of the Talbot Arms inn. His back arches off the mattress. His jaw locks. Every muscle seizes at once.John Parsons Cook had won big at the Shrewsbury races just days earlier. His horse Polestar crossed the finish line first, putting nearly a thousand pounds in his pocket. He should have been celebrating.Instead, he's being murdered—slowly, methodically—by his own friend and physician.Dr. William Palmer stands beside the bed, taking Cook's pulse. He doesn't call for help. He waits.The VictimJohn Parsons Cook was twenty-eight years old in 1855. Born into comfortable circumstances, he inherited enough money from his father to live without working. He trained for the law but never practiced—the racing circuit called to him instead.Cook followed the horse racing meets across England: Shrewsbury, Wolverhampton, Chester. He owned horses. He wagered heavily. He lived for the thundering hooves and the roaring crowds.But Cook suffered from chronic poor health. Stomach troubles plagued him. This made him dependent on physicians—a dependency that would prove fatal when his racing companion William Palmer decided he needed to die.The CrimeWilliam Palmer was a surgeon, a family man, and a serial killer.By November 1855, Palmer owed more than twenty thousand pounds to moneylenders. His gambling addiction had consumed him. He had already murdered for money—his wife Anne (insurance payout: thirteen thousand pounds), his brother Walter (insurance claim pending), possibly his mother-in-law, and at least four of his own infant children.When Cook won at Shrewsbury, Palmer saw an opportunity. The two men traveled together back to Palmer's hometown of Rugeley. Cook took his usual room at the Talbot Arms—directly across the street from Palmer's house.Palmer began visiting Cook immediately, administering "treatments" for his illness. Each time Cook improved, another dose sent him back to agony.Cook suspected. He told friends: "I believe that damn Palmer has been dosing me." But suspicion wasn't proof, and Palmer was a doctor. Doctors could be trusted.The InvestigationWhat followed Cook's death would transform British forensic science and create new legal precedent.Dr. Alfred Swaine Taylor, England's foremost toxicologist, examined Cook's remains. He found no strychnine in the body—the poison metabolized too quickly. But the symptoms were unmistakable: tetanic convulsions, locked jaw, arched back.Taylor's testimony established a critical principle: absence of poison does not equal absence of poisoning. Clinical symptoms and circumstantial evidence could establish murder even when the weapon couldn't be found.Palmer's trial became so notorious that Parliament passed special legislation—the Central Criminal Court Act 1856, forever known as "Palmer's Act"—to move the case from Staffordshire to London's Old Bailey.Thirty-two medical experts testified. The jury deliberated eighty-two minutes.Verdict: Guilty.Historical ContextThe Palmer case exposed the vulnerability of Victorian society to medical murderers. Physicians held almost unquestioned authority. Patients trusted them with their lives—literally.Palmer exploited this trust systematically. His medical knowledge allowed him to choose poisons that were difficult to detect, calculate doses that would kill without immediate suspicion, and explain away symptoms as natural illness.The case accelerated the development of forensic toxicology across Europe. Scientists raced to develop more sensitive tests for alkaloid poisons like strychnine.Sources consulted: Old Bailey Online trial transcripts (May 1856); The Times contemporary coverage; British Newspaper Archive; Oxford Dictionary of National Biography; forensic toxicology historical analysis.ResourcesPrimary Sources:Old Bailey Online: Trial of William Palmer (May 1856) — oldbaileyonline.orgBritish Newspaper Archive coverage of Rugeley poisoner caseFurther Reading:Katherine Watson, "Poisoned Lives: English Poisoners and Their Victims" (2004)Robert Graves, "They Hanged My Saintly Billy" (1957) — literary treatmentCrisis Resources:For concerns about elder financial abuse or medical exploitation: Adult Protective ServicesSupport the ShowIf Foul Play brings you into history's darkest corners, consider leaving a review on Apple Podcasts or Spotify. Reviews help new listeners discover the show—and every share helps us continue telling these stories.Our Sponsors:* Check out BetterHelp: https://www.betterhelp.comSupport this podcast at — https://redcircle.com/foul-play-crime-series/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Zach and Kevin welcome Alan back to the show by commiserating over those moments where you look at your schedule and wonder why you (or your past self) agreed to a specific procedure. Kevin's #16 Crown Prep: Kevin recounts the dread of seeing a crown prep on a third molar (#16) at 8:00 AM. Despite the technical difficulty and the "Is this a joke?" feeling, it ended up being successful with a rubber dam. Zach's "Self-Extracting" Molars: Zach shares a cautionary tale from his early career working with his father. He attempted to crown a second molar that was tilted so far distally it was practically trying to extract itself. The result? A lost contact, a lost crown, and eventually, a lost patient. The Bioclear Pivot: Alan discusses a recent case where he planned a crown on #15 but found decay so deep it was near the crest. He pivoted to a side-by-side Bioclear composite, which was harder and more time-consuming but ultimately the right clinical choice. Categorizing the "Resurrected" Patient The main theme of the episode focuses on patients who reappear after years—sometimes a decade—away from the chair. Alan and the hosts break these down into tiers: 1. The S-Tier (The Best Case) These are patients who didn't leave because of a conflict; they simply "had a gap in life." Examples: Moving away and moving back, going through a divorce, or the "COVID-12" (people who stopped coming in 2020 and are just now emerging). The Dynamic: They still feel like "your" patients. They often have a high follow-through rate because they are relieved to be back in a familiar, trusted environment. 2. The A-Tier (The "Grass Wasn't Greener") Patients who left for a specific reason—usually insurance—and realized that "a dentist is a dentist" isn't actually true. The Insurance Trap: Many leave because the office went out-of-network, only to find that the "in-network" experience lacked the technology or relationship they valued. The Result: When they return, they often have a newfound appreciation for the higher level of service and clinical care provided. 3. The Lower Tiers (The Friction Cases) The Billing "B-Tier": Patients who disappeared because they owed money. They usually only reappear when they have an emergency and are suddenly willing to pay their old balance to get out of pain. The Personality "C-Tier": Patients who left after a confrontation or a bad review. Professional Growth & "Hard Nos" Alan reflects on how his clinical confidence has changed over the years. When a patient returns after 10 years, they aren't seeing the same dentist; they are seeing a version of Alan that is more skilled, has better tools (like new Bioclear matrices), and more experience. When is a "Resurrection" a "Hard No"? Abuse of Staff: Rudeness, yelling, or cussing out the team. Chronic No-Shows: People who are "constitutionally incapable" of making it to an appointment. The Dismissed: If a formal dismissal letter was sent, the door remains closed regardless of the patient's willingness to pay. Join the Very Clinical Facebook group!  Join the Very Dental Facebook Group using one of these passwords: Timmerman, Paul, Bioclear, Hornbrook, Gary, McWethy, Papa Randy, or Lipscomb!  The Very Dental Podcast network is and will remain free to download. If you'd like to support the shows you love at Very Dental then show a little love to the people that support us! I'm a big fan of the Bioclear Method! I think you should give it a try and I've got a great offer to help you get on board! Use the exclusive Very Dental Podcast code VERYDENTAL8TON for 15% OFF your total Bioclear purchase, including Core Anterior and Posterior Four day courses, Black Triangle Certification, and all Bioclear products. Are you a practice owner who feels like the bottleneck in your own business? If you're tired of being the hardest-working person in your office, I've got something you need to hear. Dr. Paul Etchison, is hosting a virtual event that is a total game-changer. Paul is honestly one of the most brilliant minds in dental leadership today, and he's hosting the 3-Day Freedom Practice Workshop from February 19th through the 21st. He's going to show you exactly how to break through that two-million-dollar revenue ceiling while actually compressing your clinical week. It's about building a leadership team that takes ownership so you can finally step into the CEO role you deserve. Head over to DentalPracticeHeroes.com/freedom to grab your spot. And do me a favor—mention the Very Dental podcast when you sign up. It's 100% guaranteed, so you've got nothing to lose but the stress. Crazy Dental has everything you need from cotton rolls to equipment and everything in between and the best prices you'll find anywhere! If you head over to verydentalpodcast.com/crazy and use coupon code "VERYSHIP" you'll get free shipping on your order! Go save yourself some money and support the show all at the same time! The Wonderist Agency is basically a one stop shop for marketing your practice and your brand. From logo redesign to a full service marketing plan, the folks at Wonderist have you covered! Go check them out at verydentalpodcast.com/wonderist! Enova Illumination makes the very best in loupes and headlights, including their new ergonomic angled prism loupes! They also distribute loupe mounted cameras and even the amazing line of Zumax microscopes! If you want to help out the podcast while upping your magnification and headlight game, you need to head over to verydentalpodcast.com/enova to see their whole line of products! CAD-Ray offers the best service on a wide variety of digital scanners, printers, mills and even  their very own browser based design software, Clinux! CAD-Ray has been a huge supporter of the Very Dental Podcast Network and I can tell you that you'll get no better service on everything digital dentistry than the folks from CAD-Ray. Go check them out at verydentalpodcast.com/CADRay!  

Send a textIn this episode of Journal Club, Ben and Daphna review a non-inferiority trial from the European Journal of Pediatrics exploring surfactant administration thresholds in preterm neonates. The study, conducted in India, compares a 30% versus 40% FiO2 threshold for babies 26-32 weeks gestational age. The hosts break down the counterintuitive findings regarding respiratory support duration in younger subgroups and discuss the broader implications of using rigid FiO2 heuristics versus individualized patient assessment. They also debate how resource availability influences clinical protocols and the potential benefits of "LISA" (Less Invasive Surfactant Administration) for avoiding intubation.----Higher (40%) versus lower (30%) FiO2 threshold for surfactant administration in preterm neonates between 26 and 32 weeks of gestational age: a non-inferiority randomized controlled trial. Haq MI, Datta V, Bandyopadhyay T, Nangia S, Anand P, Murukesan VM.Eur J Pediatr. 2025 Nov 25;184(12):793. doi: 10.1007/s00431-025-06628-1.PMID: 41288797 Clinical Trial.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

In this episode, we continue our discussion of neonatal opioid withdrawal syndrome (NOWS), focusing on clinical features, treatment, and care after discharge. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the signs and symptoms clinicians use to recognize and assess withdrawal, along with current approaches to medication management and supportive care in the hospital setting. The conversation also addresses discharge planning, including criteria for safe transition home and coordination with caregivers. Finally, we explore the important role of the primary care pediatrician in follow-up—monitoring growth and development, supporting families, and coordinating ongoing services to promote the best possible outcomes for these infants. Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter, American Academy of Pediatrics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In this raw "trifecta" episode, Ashley, Brian, and Collin sit down for a candid update on Brian's battle with Stage 4 tongue cancer. Recorded just weeks before a life-altering surgery, the team discusses the physical toll of chemo, the overwhelming weight of "decision fatigue," and how the dental community has rallied to support them. This is an unfiltered look at resilience and the reality of navigating a healthcare system in crisis.1. Life in the "Messy Middle"Family Strength: Brian shares the emotional (and humorous) reality of home life, from their sons shaving their heads in solidarity to a breakthrough moment of faith and empathy with their middle son, Brady.The "Messy Years": Brian reflects on a quote by Chris Dixon: "The messy years make the obvious years possible." He views this grueling season as the "mess" that will eventually become a message of hope.2. Clinical & Dietary PivotsMetabolic Support: Brian details his 72-hour fast leading into his third round of chemo to improve treatment tolerance and "starve" the metabolic pathways of the tumor.The 180-Degree Shift: After seeing rapid growth on high protein, the couple pivoted to a 95% plant-based, whole-food diet inspired by Dr. Valter Longo. Ashley discusses the shift to juicing and "clean" plant proteins like lentils and tofu.Favorable Momentum: Recent imaging shows that while the journey is far from over, the tumor growth has slowed, and the lymph node architecture is improving.3. The Mental Burden: Decision FatigueThe Surgical Plan: Brian explains the upcoming Hemi-Glossectomy (removing half the tongue) and reconstruction using a thigh graft.The Weight of Choice: After researching alternative trials (like Chef Shirley's non-surgical path in Chicago), Brian speaks candidly about "decision fatigue." When every choice feels like life or death, he has reached a point of mental exhaustion. He finds a strange peace in surgery because it shifts his role from "decision-maker" to "rehab worker."4. Advocacy & A Broken SystemAccess Challenges: Despite being a physician, Brian reveals the "mind-boggling" difficulty of scheduling scans, with major institutions booked out for months.The Power of the Tribe: Ashley discusses her "bulldog" approach to advocacy—leveraging her network to get a patient liaison at MD Anderson in Houston within 30 minutes of a single text.This episode is made possible by: Studio 8E8 — Dentistry's story-driven growth agency for startups. Learn more at https://s8e8.com/vsl Net 32 — The online marketplace to compare brands and prices so you never overpay. Check them out at net32.com/themakingofSupport the showFind Out More Thank you for listening to The Making Of podcast. If you enjoyed it, please share with anyone you think will gain value from the show by clicking on one of the sharing tabs above. SUBSCRIBE to our NEWSLETTER HERE Also, please consider leaving an honest review on iTunes. It helps other listeners find the show, and I would be forever grateful.Questions or comments? Feel free to contact us at - themakingofadental@gmail.comFollow us on Instagram or Facebook and improve your dental practice every day!Have you subscribed? Don't miss a single episode!

Send a textIn this episode of Better Skills. Better Doctors., I talk about the outsized power the one-star review holds in Chinese medicine and why fear of being disliked is quietly undermining clinical authority, boundaries, and self-respect. I break down how people-pleasing masquerades as kindness, why running your practice like the hospitality industry erodes trust, and how making decisions from fear leads to burnout and resentment. I explain why specialists don't win on star ratings alone, how integrity matters more than universal approval, and why learning to let people be wrong about you is a core leadership skill. If you've ever bent your policies, overridden your instincts, or kept a patient you knew you shouldn't because you were afraid of a bad review, this episode will help you reclaim your authority and practice medicine like a doctor again.If this content and material resonates with you and you would like to pursue coaching with Rebecca, please visit:tcm-hub.com/fed and schedule a Breakthrough Call.

In this episode of the Atlas of Chiropractic podcast, Dr. John Stenberg delves into the complexities of somatosensory tinnitus, particularly its connection to cervical chiropractic care. He discusses the various types of tinnitus, the importance of identifying cervicogenic somatosensory tinnitus, and the role of central sensitization. The conversation emphasizes the need for thorough assessment, patient education, and collaborative care strategies, including referrals to other specialists when necessary. Dr. Stenberg provides actionable insights for upper cervical chiropractors to effectively manage tinnitus symptoms and improve patient outcomes.To received the PDF Clinical Companion:Share this episode on IGTag @zenith_chiro and @drbearderThat's it!

Si je vous dis qu'il existe un chiffre simple capable de réduire le risque de maladies cardiovasculaires, de diabète et même de certains cancers, vous penserez peut-être à une nouvelle tendance nutritionnelle ou à un super-aliment à la mode.Et pourtant non. Ce chiffre, c'est 30.30 grammes de fibres par jour.La recommandation officielle.Et pourtant, 8 Français sur 10 en sont encore très loin.Dans ce deuxième épisode de ma mini-série consacrée aux fibres alimentaires, je vous propose d'explorer leur véritable impact sur la santé, bien au-delà de la simple question du transit intestinal. Pourquoi consommons-nous aujourd'hui beaucoup moins de fibres que les générations précédentes ? Comment notre alimentation s'est-elle appauvrie sans que nous en ayons vraiment conscience ? Et surtout… quelles sont les conséquences concrètes dans votre organisme ?Dans cet épisode, je vous explique notamment :-comment les fibres participent à la régulation du cholestérol,-pourquoi elles jouent un rôle clé dans la stabilité de la glycémie,-et en quoi elles agissent comme une barrière protectrice au niveau du côlon.Mais peut-être vous dites-vous : « En théorie, c'est très bien… mais dès que j'augmente les fibres, mon ventre ne suit pas. »Ballonnements, inconfort digestif, sensation de ventre gonflé : ces réactions sont fréquentes, normales…

What if doctors and medical professionals, highly trained to identify child maltreatment through bruises and fractures, miss many injuries in children that leave no visible marks, yet are biologically and developmentally formative in ways that shape a child's entire quality of life and health?In this episode of Partnered with a Survivor, David and Ruth Mandel sit down with Dr. Norell Rosado, a child abuse pediatrician at the University of Wisconsin School of Medicine and Public Health, to examine how child maltreatment is currently identified in medical settings and where that approach falls dangerously short. We discuss how we can assist medical practitioners to better assess for child abuse injuries and danger that may not be seen, by using a pattern based rather than an incident based approach. Dr. Rosado explains that bruises and fractures remain the primary lens through which child physical abuse is identified, even though neglect is the most common form of maltreatment and many serious injuries leave no visible marks. Together, we explore how this narrow focus combined with time pressure, fear of court involvement, and lack of behavioral training creates gaps that allows for harm to go unseen by professionals. The conversation moves beyond bruise and bone based injuries to patterns which may help uncover silent injuries and invisible abuse. We unpack how domestic abuse and coercive control interfere with children's health in ways pediatric care often misses, including limbic harm, developmental delays, failure to thrive. We discuss perpetrator patterns like,  disrupting therapy and medication adherence, restricting access to food, heat, or transportation, and undermining a protective parent's ability to follow medical guidance or maintain safe housing. We ask the critical question rarely built into clinical practice: Is anyone interfering with this child's care or this parent's ability to parent safely?Dr. Rosado speaks candidly about mandated reporting, reasonable suspicion, and the anxieties clinicians face, especially when they have long-standing relationships with families. He also highlights the role of bias and why simple, consistent protocols can help clinicians ask better questions, reduce inequities, and document patterns rather than isolated incidents.We dig into the science behind what clinicians are seeing but often cannot name. From traumatic brain injuries without bruising to emerging research on epigenetics, the episode makes clear that exposure to violence can alter gene expression, increasing lifelong risk for chronic disease, disability, and early death. Child maltreatment, we argue, is not just a clinical concern. It is a multigenerational public health emergency.Throughout the conversation, we empSend a text Now available! Mapping the Perpetrator's Pattern: A Practitioner's Tool for Improving Assessment, Intervention, and Outcomes The web-based Perpetrator Pattern Mapping Tool is a virtual practice tool for improving assessment, intervention, and outcomes through a perpetrator pattern-based approach. The tool allows practitioners to apply the Model's critical concepts and principles to their current case load in realCheck out David Mandel's new book Stop Blaming Mothers and Ignoring Fathers: How to Transform the Way We Keep Children Safe from Domestic Violence.Visit the Safe & Together Institute website.Start taking Safe & Together Institute courses. Check out Safe & Together Institute upcoming events.

Abdominal organ procurement is a high-stakes operation that blends anatomy, speed, and coordinated teamwork. In this Behind the Knife episode, the UNMC transplant team walks through the practical “how-to” of deceased donor abdominal recovery—covering OR roles and logistics, key anatomic maneuvers, cannulation/flush troubleshooting, and the workflow differences that matter most between donation after brain death (DBD) and donation after circulatory death (DCD).HostsMadeline Cloonan, MD PhD – General Surgery Resident, University of Nebraska Medical Center (@maddie_cloonan) Evelyn Waugh, MD – Transplant Surgery Fellow, University of Nebraska Medical Center Jacqueline Dauch, MD – Abdominal Transplant Surgeon, University of Nebraska Medical Center Alex Maskin, MD – Kidney & Pancreas Transplant Surgeon, University of Nebraska Medical CenterLearning Objectives Compare DBD vs DCD donor workflow and define total vs functional warm ischemia.  Identify key OR roles and the ethical/legal separation of death declaration from procurement teams.  Outline the core steps of abdominal procurement, including exposure, cannulation, cross-clamp, and organ removal sequence.  Apply a practical troubleshooting approach when flush flow is inadequate References  Englesbe MJ, Mulholland MW. Operative Techniques in Transplantation Surgery. Philadelphia, PA: Wolters Kluwer; 2018. Tullius SG, Rabb H. Improving the supply and quality of deceased-donor organs for transplantation. N Engl J Med. 2018;378(20):1924–1933. doi:10.1056/NEJMra1708700. https://pubmed.ncbi.nlm.nih.gov/29768153/ Croome KP, Barbas AS, Whitson B, et al. American Society of Transplant Surgeons recommendations on best practices in donation after circulatory death organ procurement. Am J Transplant. 2023;23(2):171–179. doi:10.1016/j.ajt.2022.10.009. https://pubmed.ncbi.nlm.nih.gov/36695685/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

In this episode, we sit down with Sarah Kennedy, Founder and CEO of Calocurb, to explore a radically different approach to appetite control rooted in real science, not willpower. With decades of leadership in nutrition and food science, Sarah breaks down how GLP-1s work, the downsides of chronic calorie restriction, and the key differences between synthetic drugs like semaglutide and natural GLP-1 stimulation. We dive into the history of bitters, digestion, and how Calocurb's patented ingredient Amarasate® supports appetite regulation through the gut–brain axis. Sarah also shares compelling clinical trial results, insights on coming off GLP-1 drugs, and why under-eating—especially for women—can backfire hormonally. It's a nuanced, empowering conversation about working with your biology to feel satisfied, nourished, and in control.Founder and CEO of Calocurb, Sarah Kennedy shepherded years of scientific research and clinical trials to bring a revolutionary product to market. A veterinarian by training, with more than 20 years' experience in dietary and animal nutrition, Sarah has held a number of CEO and senior executive positions in food and agriculture industries, at companies including Fonterra and Healtheries/Vitaco NZ.  In 2010, at MIT, Sarah completed a Sloan Fellowship Program in Global Leadership and Innovation and has spent decades leading in health, nutrition and consumer products with executive roles at many, many companies.Calocurb is a 100% natural appetite control supplement. Amarasate®, the patented active ingredient in Calocurb, was developed in New Zealand over 14 years and with $30m invested by Plant and Food Research, the largest NZ government-owned research institute.SHOW NOTES:0:40 Welcome to the show!2:39 About Sarah Kennedy3:54 Welcome her to the podcast!5:04 What is a GLP-1?7:27 Downside of calorie restriction8:52 Natural vs synthetic GLP-113:41 Coming off of GLP-1s14:56 Why it isn't just willpower18:07 History of bitters in the diet20:12 Stimulating digestion & appetite suppression23:22 Calocurb Study26:02 Semaglutide vs Calocurb29:45 Clinical trial results32:54 Calocurb & PMS34:10 Dosing Calocurb40:08 Our personal experiences43:37 Importance of protein intake46:41 Females that are under-eating54:52 Where to find Sarah & Calocurb55:30 Her final piece of advice57:21 Thanks for tuning in!RESOURCES:Website: www.Calocurb.com - Discount code: BIOHACKERBABESIG: CalocurbFacebook: CalocurbGLOBALSupport this podcast at — https://redcircle.com/biohacker-babes-podcast/donationsAdvertising Inquiries: https://redcircle.com/brands

Episode 210: In this episode of Accelerate, host Nicola Graham is joined by Emma Meehan — Founder, CEO, and CTO of KinetikIQ. Emma is building technology that sits at the intersection of biomechanics, machine learning, and real-world performance. KinetikIQ turns any smartphone into a full-body 3D biomechanics system using LiDAR and AI — no wearables required — making advanced movement analysis far more accessible across sport and health. With a background in computer science and software engineering, alongside experience as a competitive weightlifter, Emma brings both technical depth and practitioner perspective to product development. Her work has already been recognised across sport, technology, and business — including wins at the KPMG Global Tech Innovator Ireland and the Barca Innovation Challenge, Best New Sports Business of the Year at the Irish Sport Awards, recognition from SportsTechX as a European startup to watch, and features in the Sunday Business Post and Irish Independent 30 Under 30 lists. Together, Nicola and Emma explore what it really takes to build a company as a technical founder, how the Irish startup ecosystem can support early-stage growth, and the realities of securing venture capital in sport and healthtech — alongside the lived experience of building as a female founder in a still-emerging industry. Topics discussed: Building a company as a technical founder The role of the Irish startup ecosystem in early growth Venture capital funding in sport and healthtech The realities of being a female founder in sports technology Where you can find Emma: LinkedIn Instagram KineticIQ - Sponsors Gameplan is a rehab Project Management & Data Analytics Platform that improves operational & communication efficiency during rehab. Gameplan provides a centralised tool for MDT's to work collaboratively inside a data rich environment VALD Performance, makers of the ForceDecks, ForceFrame, HumanTrak, Dynamo, SmartSpeed, NordBoard. VALD Performance systems are built with the high-performance practitioner in mind, translating traditionally lab-based technologies into engaging, quick, easy-to-use tools for daily testing, monitoring and training Hytro: The world's leading Blood Flow Restriction (BFR) wearable, designed to accelerate recovery and maximise athletic potential using Hytro BFR for Professional Sport.  -  Where to Find Us Keep up to date with everything that is going on with the podcast by following Inform Performance on: Instagram Twitter Our Website - Our Team Andy McDonald Ben Ashworth Steve Barrett  Pete McKnight

This SEO-optimized clinical briefing is designed for the optometric community. It synthesizes the AOA Evidence-Based Optometry (EBO) Committee June 2025 clinical report with the professional insights of Dr. Andrew Morgenstern, Director of the AOA Clinical Resources Group, regarding the management of patients on GLP-1 receptor agonists.

The second-ever pilot trial (published in the Journal of Affective Disorders) is making waves: a virtual medically supervised ketogenic diet showed impressive improvements in people with moderate to severe depression, including nearly 7 out of 8 study completers achieving clinical remission.In this interview, Dr. Bret Scher sits down with lead researcher Dr. Elisa Brietzke, Professor of Psychiatry at Queen's University, to explore the inspiration, execution, and implications of this study.What began as a bold idea, that metabolic dysfunction plays a role in depression, evolved into a fully remote clinical intervention. Despite skepticism and challenges, the results were clear: ketogenic therapy can be safely and effectively implemented in a remote outpatient setting. Participants who completed the study experienced improvements in depression, anxiety, and anhedonia (the loss of pleasure).In this conversation, Dr. Brietzke shares:Why she turned to metabolic therapy for mental healthHow the team pulled off a fully remote ketogenic trial during the pandemicThe science behind how inflammation, insulin resistance, and brain energy affect moodWhy traditional antidepressants often fail to address anhedoniaWhat's next for research, and how this could shape depression treatment guidelines

John Green knows how easy it can be to confuse anxiety and OCD—and how that confusion can keep people stuck. His own OCD symptoms were labeled and treated as generalized anxiety disorder for years, preventing him from getting the specialized care that he desperately needed. Now, he's passionate about helping others understand the difference so they can get the right help sooner.In this video, John joins Dr. Patrick McGrath, Chief Clinical Officer of NOCD, to break down the subtle ways OCD can disguise itself as anxiety—like arguing with your thoughts, trying to mentally prepare for every possible scenario, and “what if?” thought spirals. John opens up about the symptoms he missed, and Dr. McGrath shares how you can get effective treatment that truly helps.At NOCD, we specialize in exposure and response prevention therapy (ERP), the most effective treatment for OCD—a treatment that can help you live a fulfilling life. If you're ready to take your first step, book a free 15-minute call with us at https://learn.nocd.com/YT Hosted on Acast. See acast.com/privacy for more information.

Another LaLiga matchday means another LaLigaLowdown pod, this time with Ben Sully (@SullyBen) and Román de Arquer (@Aeroslavee) recapping this weekend's round of games.Part one covers Real Madrid's win at Mestalla, with Arbeloa's men not fully convincing but still putting pressure on the league leaders... Barça, who managed to win against Mallorca. Once again, the Blaugrana had a shaky start and left it all for the second half. While Betis managed to shock Atlético de Madrid at the Metropolitano, getting their revenge a few days after the 0-5 thrashing in Copa.Part two takes us to Anoeta, where Real Sociedad's fine form and Elche's decline continue. Athletic ended their dry spell against Levante after an early sending off tipped the balance in favour of the home team. The same goes for Getafe, with Bordalás breathing a bit easier after a long-awaited victory. The pod also covers Osasuna's win, Sevilla's late draw and the controversial postponement of Rayo Vallecano vs Real Oviedo.We thank you for listening to our pod, and remind you that you can access our bonus podcast and weekly articles over at lllonline.substack.com. Hosted on Acast. See acast.com/privacy for more information.

Vidur Mahajan joins host Catherine Glass to explore how imaging AI earns clinician trust. Learn how CARPL.ai bridges the gap between research and practice, ensures transparency, and empowers radiologists to evaluate and deploy AI safely.   Timestamps:  00:00 – Introduction  01:01 – Behind CARPL.ai  03:55 – Addressing scepticism  06:47 – Barriers in AI implementation  09:29 – Ensuring transparency  11:43 – Common challenges 

In this episode of The Untethered Podcast, Hallie Bulkin is joined by Melanie Peacock Shell to explore the deep shift from being a “therapist” to becoming a Certified Pediatric Feeding Therapist (CPFT). Melanie pulls back the curtain on the "hidden gem" of the Pediatric Feeding Hub, sharing how advanced mentorship and a community of experts can turn clinical overwhelm into streamlined, interdisciplinary success.They dive into the "gut-brain-plate" connection, discussing how gut health, sensory processing, and even sleep are the quiet drivers behind feeding challenges. If you've ever felt humbled by a complex case, this episode will show you how to lean into your community and use a holistic lens to finally see the results your families deserve.IN THIS EPISODE, YOU'LL LEARN:✔️ The CPFT Edge: How advanced certification shifts your clinical perspective and improves patient outcomes.✔️ The Gut-Brain Connection: Why understanding a child's gut health is non-negotiable for solving "sensory" feeding issues.✔️ Power in Numbers: The role of the Pediatric Feeding Hub in providing the mentorship and collaboration needed to survive private practice.✔️ The Holistic Evaluation: Integrating nutrition, sleep, and family dynamics into your therapy plan rather than just focusing on the "bite."✔️ Navigating Referrals: How to build an interdisciplinary "dream team" to support a child's developmental needs simultaneously.✔️ Overcoming the "Humble" Phase: Dealing with the realization that there is always more to learn—and why that makes you a better therapist.KEY TAKEAWAYS & SOUND BITES"This thing humbled me big time. Pursuing advanced certification isn't about knowing it all; it's about having the tools to figure out the 'why' behind the 'what'.""It all starts with nutrition. If the gut isn't happy and the child isn't sleeping, we are just spinning our wheels at the table."RELATED EPISODES YOU MIGHT LOVEEpisode 251: You're Worth The Time and Investment with Melanie Peacock Shell, MEd, CCC-SLPWhy Feeding Therapy Needs a Whole-Body LensOTHER WAYS TO CONNECT & LEARN

In this episode of "PICU Doc on Call," Drs. Pradip Kamat and Rahul Damania dive into a pediatric ICU case involving a 4-year-old girl who presents with severe anemia and bleeding, ultimately diagnosed with von Willebrand disease (VWD). They chat about the causes and different types of VWD, walk through the key clinical features, and break down how to diagnose and manage this condition. Drs. Kamat and Damania highlight the important roles of desmopressin and factor concentrates in treatment. Throughout the episode, they stress the need to recognize VWD in kids who have mucosal bleeding and offer practical tips for intensivists on lab evaluation and treatment strategies for this common inherited bleeding disorder.Show Nighlights: Clinical case discussion of a 4-year-old girl with severe anemia and bleeding symptomsDiagnosis of von Willebrand disease (VWD) and its significance in pediatric critical careEtiology and pathogenesis of von Willebrand diseaseClassification of von Willebrand disease into types (Type 1, Type 2 with subtypes, Type 3)Clinical manifestations and symptoms associated with VWDDiagnostic approach for identifying von Willebrand disease, including laboratory testsManagement strategies for VWD, including desmopressin and von Willebrand factor concentratesRole of adjunctive therapies such as antifibrinolytics and hormonal treatmentsImportance of multidisciplinary collaboration in managing complex bleeding disordersOverview of the pathophysiology of von Willebrand factor and its role in hemostasisReferences:Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter ***.Reference 1: Leebeek FW, Eikenboom JC. Von Willebrand's Disease. N Engl J Med. 2016 Nov 24;375(21):2067-2080.Reference 2: Ng C, Motto DG, Di Paola J. Diagnostic approach to von Willebrand disease. Blood. 2015 Mar 26;125(13):2029-37.Platton S, Baker P, Bowyer A, et al. Guideline for laboratory diagnosis and monitoring of von Willebrand disease: A joint guideline from the United Kingdom Haemophilia Centre Doctors' Organisation and the British Society for Hematology. Br J Haematol 2024 May;204(5):1714-1731.Mohinani A, Patel S, Tan V, Kartika T, Olson S, DeLoughery TG, Shatzel J. Desmopressin as a hemostatic and blood-sparing agent in bleeding disorders. Eur J Haematol. 2023 May;110(5):470-479. doi: 10.1111/ejh.13930. Epub 2023 Feb 12. PMID: 36656570; PMCID: PMC10073345.

Clinical psychologist Dr. Janissa Jackson has spent 20 years evaluating kids and watching childhood change. In this conversation, she explains why reading struggles can make everything feel harder (for kids and parents), what many interventions miss beneath dyslexia and attention issues, and why building cognitive skills like processing speed and working memory can change a child's entire trajectory (and quickly!) You'll also hear hopeful insight for adults dealing with ADHD, brain injury, or memory decline, plus the surprisingly grounding ranch life that keeps her anchored in the real world. Learn more about Dr. Jackson's centers at LearningRx: https://www.learningrx.com/ and explore locations here: https://www.learningrx.com/locations/ — and if you want to follow her work in Northwest Arkansas, start here: https://www.learningrx.com/fort-smith/ Learn more about evaluation services here Learn more about your ad choices. Visit megaphone.fm/adchoices

In his weekly clinical update during Ground hog week, Dr. Griffin and Vincent Racaniello are back to discuss the measles outbreak in South Carolina, American Academy of Pediatrics vaccine recommendations and shingles vaccine and the reduction of dementia, then deep dives into recent statistics RSV, influenza and SARS-CoV-2 infections, the Wastewater Scan dashboard, Johns Hopkins measles tracker, where to find PEMGARDA, how to access and pay for Paxlovid, estimated effectiveness of this year's COVID-19 vaccine, long COVID treatment center, where to go for answers to your long COVID questions, long COVID in children, the potential benefits of metformin to reduce disease severity following SARS-CoV-2 infection in obese and overweight patients and contacting your federal government representative to stop the assault on science and biomedical research. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Grading the groundhogs (National Oceanic and Atmospheric Administration) Sand Mountain Sam predicts an early spring (News19) All About the AAP Recommended Immunization Schedule (healthychildren.org) Recommended Childhood and Adolescent Immunization Schedule: United States, 2026: Policy Statement (American Academy of Pediatrics: Pediatrics) Herpes zoster vaccination and incident dementia in Canada: an analysis of natural experiments (LANCET: Neurology) Detection of avian flu antibodies in Dutch dairy cow: ECDC risk assessment remains unchanged (European Centre for Disease Prevention and Control) Wastewater for measles (WasterWater Scan) Measles cases and outbreaks (CDC Rubeola) Big outbreak, bright lights…Measles Dashboard(South Carolina Department of Public Health) Tracking Measles Cases in the U.S. (Johns Hopkins) Measles vaccine recommendations from NYP (jpg) Weekly measles and rubella monitoring (Government of Canada) Measles (WHO) Get the FACTS about measles (NY State Department of Health) Measles(CDC Measles (Rubeola)) Measles vaccine (CDC Measles (Rubeola)) Presumptive evidence of measles immunity (CDC) Contraindications and precautions to measles vaccination (CDC) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM) Measles Vaccination: Know the Facts (ISDA: Infectious Diseases Society of America) Deaths following vaccination: what does the evidence show (Vaccine) Influenza: Waste water scan for 11 pathogens (WastewaterSCan) US respiratory virus activity (CDC Respiratory Illnesses) Respiratory virus activity levels (CDC Respiratory Illnesses) Weekly surveillance report: clift notes (CDC FluView) OPTION 2: XOFLUZA $50 Cash Pay Option(xofluza) RSV: Waste water scan for 11 pathogens (WastewaterSCan) Respiratory Diseases (Yale School of Public Health) USrespiratory virus activity (CDC Respiratory Illnesses) RSV-Network (CDC Respiratory Syncytial virus Infection) Vaccines for Adults (CDC: Respiratory Syncytial Virus Infection (RSV)) Economic Analysis of Protein Subunit and mRNA RSV Vaccination in Adults aged 50-59 Years (CDC: ACIP) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 deaths (CDC) Respiratory Illnesses Data Channel (CDC: Respiratory Illnesses) COVID-19 national and regional trends (CDC) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) Estimated Effectiveness of 2024-2025 COVID-19 Vaccination Against Severe COVID-19 (JAMA) Where to get pemgarda (Pemgarda) EUA for the pre-exposure prophylaxis of COVID-19 (INVIYD) Infusion center (Prime Fusions) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Drug interaction checker (University of Liverpool) Help your eligible patients access PAXLOVID with the PAXCESS Patient Support Program (Pfizer Pro) Understanding Coverage Options (PAXCESS) Infectious Disease Society guidelines for treatment and management (ID Society) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) Managing healthcare staffing shortages (CDC) Anticoagulationguidelines (hematology.org) Daniel Griffin's evidence based medical practices for long COVID (OFID) Long COVID hotline (Columbia : Columbia University Irving Medical Center) The answers: Long COVID Long COVID associated with SARS-CoV-2 reinfection among children and adolescents in the omicron era (RECOVER-EHR): a retrospective cohort study (LANCET: Infectious Diseases) Long COVID is here to stay—even in children (LANCET: Infectious Diseases) Early administration of neutralising monoclonal antibodies and post-acute sequelae of COVID-19 (International Journal of Infectious Diseases) Preventing Long COVID With Metformin (CID) Metformin may reduce risk of long COVID by 64% in overweight or obese adults (CIDRAP) Effect of Metformin on the Risk of Post-coronavirus Disease 2019 Condition Among Individuals With Overweight or Obese (CID) Preventing Long COVID With Metformin (CID) New review highlights growing evidence that diabetes drug metformin can prevent long COVID (CIDRAP) Reaching out to US house representative Letters read on TWiV 1294 Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.

John Murray, Ian Dennis & Ali Bruce-Ball talk football, travel & language. They look ahead to what could be a landmark weekend for James Milner and get correspondence from a couple who listen to TCV in bed. Plus unintended pub and film names, Clash of the Commentators and the Great Glossary of Football Commentary. Suggestions and questions always welcome on WhatsApp voicenotes to 08000 289 369 & emails to TCV@bbc.co.uk01:10 Private Eye Colemanballs 02:30 John Murray caught in the wild 05:35 Commentaries this weekend 10:10 Owners and fans pulling in different directions? 12:20 James Milner in for landmark weekend? 17:25 TCV pillowtalk 21:15 John's surprise greeting 24:15 Unintended pub names 29:30 Clash of the Commentators 38:20 Great Glossary of Football Commentary 50:45 How to keep a dead game interesting5 Live / BBC Sounds commentaries: Sat 1500 Arsenal v Sunderland, Sat 1500 Bournemouth v Villa on Sports Extra, Sat 1730 Newcastle v Brentford, Sun 1400 Brighton v Palace, Sun 1630 Liverpool v Man City.Great Glossary of Football Commentary: DIVISION ONE 2-0 can be a dangerous score, Agricultural challenge, Back of the net, Back to square one, Bosman, Bullet header, Cruyff Turn, Cultured/educated left foot, Dead-ball specialist, Draught excluder, Elastico/flip-flap, False nine, Fox in the box, Giving the goalkeeper the eyes, Grub hunter, Head tennis, Hibs it, In a good moment, In behind, Magic of the FA Cup, Middle of the park, The Maradona, Off their line, Olimpico, Onion bag, Panenka, Park the bus, Perfect hat-trick, Rabona, Roy of the Rovers stuff, Schmeichel-style, Scorpion kick, Spursy, Stick it in the mixer, Target man, Tiki-taka, Towering header, Trivela, Where the kookaburra sleeps, Where the owl sleeps, Where the spiders sleep.DIVISION TWO Back on the grass, Ball stays hit, Beaten all ends up, Blaze over the bar, Business end, Came down with snow on it, Catching practice, Camped in the opposition half, Cauldron atmosphere Coat is on a shoogly peg, Come back to haunt them, Corridor of uncertainty, Couldn't sort their feet out, Easy tap-in, Daisy-cutter, First cab off the rank, Giant-killing, Good leave, Good touch for a big man, Half-turn, Has that in his locker, High wide and not very handsome, Hospital pass, Howler, In the dugout, In their pocket, Johnny on the spot, Leading the line, Leather a shot, Needed no second invitation, Nice headache to have, Nutmeg, On their bike, One for the cameras, One for the purists, Played us off the park, Points to the spot, Prawn sandwich brigade, Purple patch, Put their laces through it, Reaches for their pocket, Rolls Royce, Root and branch review, Row Z, Screamer, Seats on the plane, Show across the bows, Slide-rule pass, Steal a march, Straight in the bread basket, Stramash, Taking one for the team, Telegraphed that pass, Tired legs, That's great… (football), Thunderous strike, Turns on a sixpence, Walk it in, We've got a cup tie on our hands.UNSORTED After you Claude, All-Premier League affair, Aplomb, Bag/box of tricks, Brace, Brandished, Bread and butter, Breaking the deadlock, Bundled over the line, Champions elect / champions apparent, Clinical finish, Commentator's curse, Coupon buster, Denied by the woodwork, Draught excluder, Elimination line, Fellow countryman, Foot race, Formerly of this parish, Free hit, Goalkeepers' Union, Goalmouth scramble, Honeymoon Period, In and around, In the shop window, Keeping ball under their spell, Keystone Cops defending, Languishing, Loitering with intent, Marching orders, Nestle in the bottom corner, Numbered derbies, Opposite number, PK for penalty-kick, Postage stamp, Rasping shot, Red wine not white wine, Relegation six-pointer, Rooted at the bottom, Route One, Sending the goalkeeper the wrong way, Shooting boots, Sleeping giants, Slide rule pass, Small matter of, Spiders web, Stayed hit, Steepling, Stinging the palms, Stonewall penalty, Straight off the training ground, Taking one for the team, Team that likes to play football, Throw their cap on it, Thruppenny bit head / 50p head, Two good feet, Turning into a basketball match, Turning into a cricket score, Usher/Shepherd the ball out of play, Walking a disciplinary tightrope, Wand of a left foot, Wrap foot around it, Your De Bruynes, your Gundogans etc.

What happens when the world of GLP-1s collides with the operating room? Today, we're diving into the new era of obesity care. Hosts·       Matthew Martin, trauma and bariatric surgeon at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California) @docmartin2·       Adrian Dan, bariatric and MIS surgeon, program director for the advanced MIS bariatric and foregut fellowship at Summa Health System (Akron, Ohio) @DrAdrianDan·       Crystal Johnson Mann, bariatric and foregut surgeon at the University of Florida (Gainesville, Florida) @crys_noelle_·       Katherine Cironi, general surgery resident at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California) @cironimacaroniLearning objectives1.          Understand the evolving role of OMMs in bariatric surgical practice·       Recognize how widespread GLP-1 and dual-incretin therapies have reshaped patient presentations, expectations, and referral patterns.·       Appreciate current evidence comparing surgery to GLP-1 therapy, including the JAMA Surgery study out of Allegheny Health (2025), noting:o   Superior weight loss with bariatric surgery (~28% TBWL vs ~10% with GLP-1s)o   Higher health-care utilization and cost in GLP-1–treated patients.·       Frame OMMs not as alternatives but as complementary tools within a chronic disease model when treating obesity.2.           Review pharmacologic classes and their expected efficacy·       Surgeons should be able to articulate the mechanisms, efficacy, and limitations of:o   GLP-1 receptor agonists – incretin-based satiety; 5–12% TBWL.o   Dual GIP/GLP-1 agonists – most potent agents; 15–22% TBWL.o   Sympathomimetics – norepinephrine-driven appetite suppression; 3–7% TBWL.o   Combination agents (bupropion-naltrexone, phentermine-topiramate) – 5–12% TBWL depending on regimen.o   Emerging therapies – retatrutide, maritide, oral GLP-1s, with promising TBWL in phase 2 trials3.          Apply OMMs strategically in the preoperative phase·       Integrate OMMs without compromising surgical eligibility—OMM-related weight loss does not negate the indication for surgery.·       Counsel patients that medication response does not equal disease resolution; surgery remains the most durable intervention.·       Manage delayed gastric emptying and aspiration risk:o   Pause weekly GLP-1 or dual agonists for ≥1 week pre-op (longer if symptomatic).o   Collaborate closely with the anesthesia/OR teams·       Screen for nutritional depletion before surgery, especially protein deficits exacerbated by appetite suppression.·       Navigate insurance barriers that may paradoxically approve surgery but deny medication continuation.4.          Implement postoperative OMMs safely and effectively·       Establish criteria for OMM introduction:o   Typical initiation at 6–12 months, once the diet stabilizes and the physiologic curve flattens.o   Earlier initiation (4–6 weeks) may be appropriate in pediatric or select high-risk populations.·       Recognize altered pharmacokinetics after sleeve and bypass:o   Injectables may be preferred due to altered absorption of oral agents.·       Prevent postoperative nutritional compromise:o   Monitor protein intake, hydration, and micronutrient status (including iron, B12, and fat-soluble vitamins).o   Titrate doses slowly to minimize nausea/vomiting that can precipitate malnutrition.·       Frame OMM use as a tool for disease persistence (plateau/regain), not as a marker of failure.5.          Identify systems-level barriers and the implementation of coordinated care·       Understand insurance inconsistencies—coverage for surgery is often not paired with coverage for long-term medical therapy.·       Clearly document disease persistence and medical necessity when appealing denials.·       Avoid fragmented care: establish shared-care pathways between bariatric surgery, obesity medicine, and primary care.·       Use patient-centered language emphasizing complementary therapy, not hierarchy or competition between surgery and medications.6.          Counsel patients ethically and accurately within a chronic disease model·       Set expectations: sustained success requires surgery + medication + behavioral change.·       Educate patients that postoperative OMM use does not imply surgical failure.·       Normalize long-term multimodal management of obesity, analogous to diabetes or hypertension models.*Sponsor Disclaimer: Visit goremedical.com/btkpod to learn more about GORE® SYNECOR Biomaterial, including supporting references and disclaimers for the presented content.  Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. 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(00:00) — Curiosity in the halls of Mass General: Her mom's triple‑negative breast cancer and remission shape an early interest in medicine.(02:54) — Choosing a major without a premed major: From biochemistry to discovering neuroscience and why UMass ultimately fit.(06:04) — Double majoring without burning out: Overlap with prereqs, honest advising on dual degrees, and following interests.(09:13) — Make advising work for you: Meeting early, becoming a peer advisor, and hearing hard feedback you don't want to hear.(12:56) — Rethinking gap years: Fears about money give way to growth, responsibility, and better prep for med school.(17:23) — What went wrong on the first MCAT: Cramming, no plan, and taking it during senior year.(19:33) — The retake that worked: Six months, 3 hours a day, weekly full-lengths, and using AAMC practice tests.(22:52) — Lining up letters after graduation: Staying in touch with advisors and professors, and using undergrad resources.(25:34) — Clinical path: EMT to pediatric ER clinical assistant: Building skills during COVID, behavioral health work, and a role that cemented medicine.(32:05) — The application surprise: Not prewriting secondaries—and why she won't skip that again.(33:43) — First interview jitters and prep: Early invites, mock interviews, and centering fit.(35:52) — Eight interview invites: Why authenticity and geography beat obsessing over stats.(40:33) — Toughest interview prompt: Answering “Tell me about yourself” and a bartender curveball.(44:10) — The first acceptance: A full-circle moment at work and calling mom.(45:40) — Final advice to premeds: Keep an open mind—and be kind to yourself.Today's guest traces a clear, practical path from childhood curiosity in the halls of Mass General—while her mom underwent treatment and later entered remission—to a medical school seat built on consistency, flexibility, and honest self-reflection. She shares how starting at UMass in biochemistry, discovering neuroscience, and building an early relationship with her premed advisor shaped smarter decisions—like delaying the MCAT and embracing gap years she once feared.We dive into the first MCAT attempt that fell flat (no schedule, cramming during senior year, few practice tests) and the 15‑point turnaround that followed: six months post‑graduation, three hours a day, AAMC full‑lengths every Thursday, and a real study plan. She details lining up letters before leaving campus, keeping in touch after graduation, and why not prewriting secondaries became her biggest application headache.Clinically, she moved from EMT certification and campus EMS to behavioral health sitting and a clinical assistant role in a pediatric ER—experiences that cemented her desire to practice. Finally, we cover interviews (including a surprise bartender question), eight invites, the first acceptance at work, and her closing advice: keep an open mind—and be kind to yourself.What You'll Learn:- How to build a productive relationship with your premed advisor- A realistic MCAT retake plan: pacing, practice tests, and scheduling- Why gap years and nonclinical jobs can strengthen your application- Finding schools by fit and mission instead of fixating on stats- Timing letters and prewriting secondaries to avoid bottlenecks

A 2022 meta-analysis of 37 randomized trials found that berberine lowered glycated hemoglobin by 0.63% and fasting glucose by 0.82 mmol/L, with consistent results across diverse patient groups Earlier researchers also highlighted how berberine lowers blood sugar and harmful blood fats while also reducing liver fat and markers linked to kidney damage Berberine limits fat cell development and dampens inflammation as well, effects that may support weight control and improved insulin sensitivity In a 13‑week randomized study, researchers showed that berberine's blood sugar-lowering abilities are on par with the effects of the diabetes drug metformin Clinical studies support taking 500 mg of berberine with meals up to three times daily, starting with lower doses and increasing gradually; however, there are safety precautions to keep in mind