Podcasts about cme

Pediatrician Dr. Jill Schaffeld consults Dr. Ashley Walther from the Division of Pediatric Surgery on hernias. Episode recorded on August 7, 2025.  Resources discussed in this episode: Inguinal Hernia - Community Practice Support Tool   Financial Disclosure:  The following relevant financial relationships have been disclosed: None All relevant financial relationships listed have been mitigated. Remaining persons in control of content have no relevant financial relationships. To Claim Credit: Click "Launch Activity." Click "Launch Website" to access and listen to the podcast. After listening to the entire podcast, click "Post Test" and complete.   Accreditation In support of improving patient care, Cincinnati Children's Hospital Medical Center is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. Specific accreditation information will be provided for each activity. Physician:  Cincinnati Children's designates this Enduring Material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  Nursing:  This activity is approved for a maximum 0.25 continuing nursing education (CNE) contact hours. ABP MOCpt2: Completion of this CME activity, which includes learner assessment and feedback, enables the learner to earn up to 0.25 points in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program. Cincinnati Children's submits MOC/CC credit for board diplomates.   Credits AMA PRA Category 1 Credits™ (0.25 hours), ABP MOC Part 2 (0.25 hours), CME - Non-Physician (Attendance) (0.25 hours), Nursing CE (0.25 hours)    

In dieser Episode des Young Urban Anästhesiologist-Podcasts widmen wir uns dem Thema ROTEM, einem Point-of-Care Verfahren zur Beurteilung der Blutgerinnung. Sarah, die neu im Team ist, teilt ihre Erfahrungen aus einem klinischen Fall, in dem sie die Entscheidung treffen musste, ein ROTEM durchzuführen, und stellt die Frage, ob es hierzu bereits eine Podcast-Episode gibt, was zur heutigen Diskussion führte. Wir starten mit einem tiefen Einblick in die Blutgerinnung und klären die grundlegenden Konzepte der primären und sekundären Hämostase. Während wir die verschiedenen Phasen der Blutstillung analysieren, werfen wir einen Blick auf entscheidende Faktoren wie Thrombozyten, Fibrin und deren jeweilige Funktionen. Es wird ausführlich erklärt, wie die Verkettung der Gerinnungsfaktoren erfolgt und welche Rolle der extrinsische und intrinsische Weg dabei spielt. Im weiteren Verlauf besprechen wir die klassischen Labortests zur Blutgerinnungsdiagnostik und deren Limitationen. Hierbei wird klar, dass diese Tests oft nur Teilaspekte abbilden und nicht die tatsächliche Blutungsneigung eines Patienten widerspiegeln können. Im Gegensatz dazu zeigt ROTEM die gesamte Gerinnungsdynamik im Vollblut und ermöglicht uns, die Ursachen von Gerinnungsstörungen differenziert zu betrachten. Sarah und ich führen die Zuhörer durch die wichtigsten Parameter wie Clotting Time (CT), Clot Formation Time (CFT) und die maximale Clot Firmness (MCF). Zudem diskutieren wir spezifische Testansätze wie EXTEM, INTEM, FIBTEM und HEP-TEM, die einen detaillierten Blick auf die Blutgerinnung ermöglichen und helfen, gezielte therapeutische Entscheidungen zu treffen. Dabei betonen wir, wie entscheidend eine frühzeitige und gezielte Gerinnungsdiagnostik in Notfallsituationen ist, um den Patienten bestmöglich zu versorgen. Ein zentraler Punkt unserer Diskussion ist die Anwendung von ROTEM in der klinischen Praxis, insbesondere bei Patienten mit schweren Blutungen oder während komplexer chirurgischer Eingriffe. Wir erläutern, wie ROTEM die Behandlung von Patienten optimieren kann, indem es schnelle und maßgeschneiderte Entscheidungen ermöglicht, die für die Patientenversorgung von entscheidender Bedeutung sind. Dennoch halten wir die Limitationen von ROTEM für wichtig, da beispielsweise die Sensitivität gegenüber bestimmten Antikoagulanzien variieren kann und nicht alle Gerinnungsstörungen adäquat erfasst werden. Abschließend runden wir das Gespräch mit einem Ausblick auf die Zukunft solcher Verfahren in der klinischen Anwendung und deren Bedeutung in Leitlinien ab, während wir auf die Notwendigkeit von geschultem Personal hinweisen. Diese Episode ist für alle, die ein tieferes Verständnis für die Blutgerinnung und die modernen Diagnosetools in der Anästhesiologie und Notfallmedizin entwickeln möchten. hier gehts zum [Feedback und EFN-Formular](https://forms.gle/uFpbYdDPcut7CQQr6) Achtung: Fortbildungspunkte können nur innerhalb von 4 Wochen nach Veröffentlichung der Episode beantragt werden. Eine nachträgliche Meldung ist bei der Ärztekammer leider nicht möglich.

Join us as we review recent articles and news featured in The DIGEST #70, including PSA screening, acetaminophen and autism, COVID19 vaccines and cancer, and aspirin and anticoagulation in coronary artery disease. Fill your brain hole with a delicious stack of hotcakes! Featuring Drs. Paul Williams (@PaulNWilliamz), Nora Taranto (@norataranto), Rahul Ganatra (@rbganatra), Laura Glick (@lauraglick) and Matt Watto (@doctorwatto). Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! |Mailing List | Contact | CME! Credits Written and Hosted by: Nora Taranto MD; Rahul Ganatra MD MPH, Laura Glick MD, Paul Williams, MD, FACP, Adam Cifu MD, Matthew Watto MD, FACP Cover Art: Rahul Ganatra, MD MPH Reviewers: Rahul Ganatra MD MPH; Paul Williams, MD, FACP, Matthew Watto MD, FACP; Sai S Achi MD, MBA, FACP Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, disclaimer Prostate Cancer Screening Acetaminophen and Autism COVID19 vaccines and cancer risk Aspirin and anticoagulation in coronary artery disease Outro Sponsor: Aura Frames For a limited time, save on the perfect gift by visiting AuraFrames.com to get $35 off Aura's best-selling Carver Mat frames by using promo code CURB at checkout. Sponsor: DoxGPT by Doximity Visit doxgpt.com  and see how it can simplify your clinical workflow, from patient care to paperwork.  Sponsor: Continuing Education Company Use promo code Curb30 to get 30% off all online courses and webcasts—just for Curbsiders Listeners. Visit CMEmeeting.org/curbsiders to learn more. Sponsor: Freed Use code: CURB50 to get $50 off your first month when you subscribe!

In this episode, hosts Drs. Temara Hajjat and Jason Silverman talk to Dr. Paul Tran about attracting and educating a new generation of learners.Learning Objectives:Discuss an approach to attracting learners to pediatric gastroenterology while addressing perceived barriersReview approaches to capturing and maintaining interest in educational contentOutline approaches to incorporate digital content into medical educationLinks:Alimentary School on TikTok, Instagram and YouTubeNASPGHAN social media position paperMedical media paperSupport the showThis episode may be eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

Silver is exploding in value at a pace that is now outpacing many major cryptocurrencies — and the financial world is scrambling to understand why. In this urgent and revealing discussion, Michael Jaco and Dr. Kirk Elliott break down the unprecedented market behavior that has never been seen before in modern financial history. Prices are surging, trading halts are occurring, and major institutions are quietly preparing for something big. Dr. Elliott explains the real reasons silver is pulling away from crypto: industrial demand is skyrocketing, national stockpiles are being depleted, and global governments are shifting away from the failing fiat system toward asset-backed structures. With banks under pressure, inflation climbing, supply chains tightening, and global tensions rising, silver is entering a historic trajectory that may reshape the entire economic landscape. Michael and Dr. Elliott also discuss why crypto's volatility and speculative nature leave it vulnerable during global shocks, while silver's physical scarcity and industrial necessity make it the safer and more strategic option for the times we're entering. They address the CME's unexpected trading freeze, the suppression of spot prices, the widening gap between physical and paper silver, and why this disconnect signals a major financial stress point. This conversation provides a clear roadmap for anyone wanting to understand the mechanics behind silver's explosive upward movement and — more importantly — how to transition from crypto into silver without missing the window of opportunity. With the world rapidly moving toward a new financial paradigm, this episode lays out the steps required to preserve and grow wealth before the next major shock hits the system. If you want clarity, timing, strategy, and a deeper understanding of what's unfolding behind the scenes, this is the episode you need to hear.

Did you know that a single crumb of bread is enough to cause an autoimmune response in children with celiac disease? Dr. Pankaj Vohra, Professor of Pediatrics and Board-Certified Pediatric Gastroenterologist, joins medical student Andrea Smith to discuss the evaluation and management of celiac disease, as well as essential guidance for following a gluten-free diet. Specifically, they will: Review the epidemiology of celiac disease and identify common symptoms and presentations of celiac disease Describe the pathophysiology of celiac disease including histopathological changes to the duodenum Identify diagnostic tests and criteria for diagnosing celiac disease in the pediatric population Identify common sources of gluten and the basics of identifying gluten on food labels Discuss typical management of celiac disease including appropriate screening tests and managing accidental gluten ingestion Special thanks to Dr. Rebecca Yang and Dr. Neeharika Bade for peer reviewing this episode. CME available free with sign up: Link coming soon! References: Bolia, R., & Thapar, N. (2023). Celiac Disease in Children: A 2023 Update. In Indian Journal of Pediatrics. Springer. https://doi.org/10.1007/s12098-023-04659-w Gidrewicz, D., Potter, K., Trevenen, C. L., Lyon, M., & Butzner, J. D. (2015). Evaluation of the ESPGHAN celiac guidelines in a North American pediatric population. American Journal of Gastroenterology, 110(5), 760–767. https://doi.org/10.1038/ajg.2015.87 Hill, I. D., Fasano, A., Guandalini, S., Hoffenberg, E., Levy, J., Reilly, N., & Verma, R. (2016). NASPGHAN clinical report on the diagnosis and treatment of gluten-related disorders. Journal of Pediatric Gastroenterology and Nutrition, 63(1), 156–165. https://doi.org/10.1097/MPG.0000000000001216 Husby, S., Koletzko, S., Korponay-Szabó, I., Kurppa, K., Mearin, M. L., Ribes-Koninckx, C., Shamir, R., Troncone, R., Auricchio, R., Castillejo, G., Christensen, R., Dolinsek, J., Gillett, P., Hróbjartsson, A., Koltai, T., Maki, M., Nielsen, S. M., Popp, A., Størdal, K., … Wessels, M. (2020). European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. In Journal of Pediatric Gastroenterology and Nutrition (Vol. 70, Issue 1, pp. 141–156). Lippincott Williams and Wilkins. https://doi.org/10.1097/MPG.0000000000002497 Nenna, R., Tiberti, C., Petrarca, L., Lucantoni, F., Mennini, M., Luparia, R. P. L., Panimolle, F., Mastrogiorgio, G., Pietropaoli, N., Magliocca, F. M., & Bonamico, M. (2013). The celiac iceberg: Characterization of the disease in primary schoolchildren. Journal of Pediatric Gastroenterology and Nutrition, 56(4), 416–421. https://doi.org/10.1097/MPG.0b013e31827b7f64 Sahin, Y. (2021). Celiac disease in children: A review of the literature. In World Journal of Clinical Pediatrics (Vol. 10, Issue 4, pp. 53–71). Baishideng Publishing Group Co. https://doi.org/10.5409/wjcp.v10.i4.53 Salden, B. N., Monserrat, V., Troost, F. J., Bruins, M. J., Edens, L., Bartholomé, R., Haenen, G. R., Winkens, B., Koning, F., & Masclee, A. A. (2015). Randomised clinical study: Aspergillus niger-derived enzyme digests gluten in the stomach of healthy volunteers. Alimentary Pharmacology and Therapeutics, 42(3), 273–285. https://doi.org/10.1111/apt.13266 Schuppan, D., Mäki, M., Lundin, K. E. A., Isola, J., Friesing-Sosnik, T., Taavela, J., Popp, A., Koskenpato, J., Langhorst, J., Hovde, Ø., Lähdeaho, M.-L., Fusco, S., Schumann, M., Török, H. P., Kupcinskas, J., Zopf, Y., Lohse, A. W., Scheinin, M., Kull, K., … Greinwald, R. (2021). A Randomized Trial of a Transglutaminase 2 Inhibitor for Celiac Disease. New England Journal of Medicine, 385(1), 35–45. https://doi.org/10.1056/nejmoa2032441 Tack, G. J., van de Water, J. M. W., Bruins, M. J., Kooy-Winkelaar, E. M. C., van Bergen, J., Bonnet, P., Vreugdenhil, A. C. E., Korponay-Szabo, I., Edens, L., von Blomberg, B. M. E., Schreurs, M. W. J., Mulder, C. J., & Koning, F. (2013). Consumption of gluten with gluten-degrading enzyme by celiac patients: A pilot-study. World Journal of Gastroenterology, 19(35), 5837–5847. https://doi.org/10.3748/wjg.v19.i35.5837 Husby S, Koletzko S, Korponay-Szabó IR, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012; 54: 136–160

In episode 69 we discuss cystinicline for smoking cessation. Rigotti NA, et al. Cytisinicline for Smoking Cessation: The ORCA Phase 3 Replication Randomized Clinical Trial. JAMA Intern Med. 2025 Jun 1;185(6):648-655. We also discuss treating opioid use disorder in nursing homes and compulsive TikTok scrolling. Carolina Public Press: NC nursing home lawsuit settlement could expand access for people with drug issues MedicalXpress: Adults 65 years and older not immune to the opioid epidemic, study finds Washington Post: How TikTok keeps its users scrolling for hours a day --- This podcast offers category 1 and MATE-ACT CME credits through MI CARES and Michigan State University. To get credit for this episode and others, go to this link to make your account, take a brief quiz, and claim your credit. To learn more about opportunities in addiction medicine, visit MI CARES. CME: https://micaresed.org/courses/podcast-addiction-medicine-journal-club/ --- Original theme music: composed and performed by Benjamin Kennedy Audio editing: Michael Bonanno Executive producer: Dr. Patrick Beeman A podcast from Ars Longa Media --- This is Addiction Medicine Journal Club with Dr. Sonya Del Tredici and Dr. John Keenan. We practice addiction medicine and primary care, and we believe that addiction is a disease that can be treated. This podcast reviews current articles to help you stay up to date with research that you can use in your addiction medicine practice. The best part of any journal club is the conversation. Send us your comments on social media or join our Facebook group. --- Email: addictionmedicinejournalclub@gmail.com Facebook: @AddictionMedJC Facebook Group: Addiction Medicine Journal Club Instagram: @AddictionMedJC Threads: @AddictionMedJC YouTube: addictionmedicinejournalclub Twitter/X: @AddictionMedJC --- Addiction Medicine Journal Club is intended for educational purposes only and should not be considered medical advice. The views expressed here are our own and do not necessarily reflect those of our employers or the authors of the articles we review. All patient information has been modified to protect their identities. Learn more about your ad choices. Visit megaphone.fm/adchoices

Aktien hören ist gut. Aktien kaufen ist noch besser. Unser Partner Scalable Capital ist jetzt Bank und bietet euch dadurch jetzt noch bessere Konditionen. Mehr Infos findet ihr unter: scalable.capital/oaws. November war ok. Trotz Ausfällen bei Cloudflare, CME und Airbus. Bitcoin wird stabiler. Silber ist auf Rekordniveau. Chow Tai Fook macht Läden dicht. Delivery Hero soll sich verkaufen. Intel soll Chips an Apple verkaufen. SolGold lässt sich nicht kaufen. 60% Rendite in diesem Jahr. Gibt's bei vielen KI- und Rüstungsaktien und bei einer Mode-Aktie: Ralph Lauren (WKN: A1JD3A). Der Grund: Die K-shaped Economy. Von 60% Rendite kann Alimentation Couche-Tard (WKN: A3DSL8) nur träumen. Vor allem nach der gescheiterten 7-Eleven-Übernahme. Aber vielleicht ist genau das eine Chance. Diesen Podcast vom 01.12.2025, 3:00 Uhr stellt dir die Podstars GmbH (Noah Leidinger) zur Verfügung.

Listen in as our expert panel discusses critical aspects of managing patients on oral cancer therapies. Our experts review tips for optimizing patient care and share best practices for handling these specialized medications.Special guests:Jill Cassaday, BPharm, PharmD, BCPS, BCOPClinical Pharmacist Specialist – Multiple MyelomaBanner MD Anderson Cancer CenterSamuel Snowaert, PharmD, BCOP, MBAClinical Oncology Pharmacist Pharmacists Optimizing Oncology Care Excellence in Michigan (POEM)Covenant Cancer Care CenterLisa Thompson, PharmD, BCOP, CPPSClinical Pharmacy Specialist in Oncology Kaiser Permanente ColoradoYou'll also hear practical advice from TRC's Editorial Advisory Board member:Craig D. Williams, PharmD, FNLA, BCPSClinical Professor of Pharmacy PracticeOregon Health and Science UniversityNone of the speakers have anything to disclose. This podcast is an excerpt from one of TRC's monthly live CE webinars, the full webinar originally aired in October 2025.TRC Healthcare offers CE credit for this podcast. Log in to your Pharmacist's Letter, Pharmacy Technician's Letter, or Prescriber Insights account and look for the title of this podcast in the list of available CE courses.Claim CreditThe clinical resources related to this podcast are part of a subscription to Pharmacist's Letter, Pharmacy Technician's Letter, and Prescriber Insights: FAQ: Specialty MedsChart: Guide for Helping Patients Afford Their MedicationsChart: Drug Interactions: Cytochrome P450 (CYP), P-glycoprotein, and MoreToolbox: Medication Adherence StrategiesAlgorithm: Redosing Oral Medications After VomitingUse code mt1025 at checkout for 10% off a new or upgraded subscription.Send us a textEmail us: ContactUs@trchealthcare.com. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Find the show on YouTube by searching for ‘TRC Healthcare' or clicking here. Learn more about our product offerings at trchealthcare.com.

Although severe thyroid eye disease (TED) is easily recognizable, mild TED may go undiagnosed for months if not longer. In today's episode, Dr. Vivek Patel joins host Dr. Amanda Redfern to share how he uncovers subtle signs and symptoms of TED that can lead to a quicker diagnosis and the treatments that make a meaningful impact on quality of life. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Shawn & Janet Needham R.Ph. host Stefan Hartmann who a German-American raised in a holistic household steeped in Chinese Medicine, Tai Chi, and natural approaches to wellness. He studied at the University of Central Florida, graduating Magna Cum Laude in Sports & Exercise Science while working in the Emergency Department with the long-term goal of practicing medicine. After completing his Physician Assistant degree at Bay Path University, he gained broad clinical experience in urgent care, internal medicine, spine surgery, interventional pain management, family medicine, and psychiatry. His background in sports science, nutrition, anti-aging, and longevity-focused health shapes his root-cause, whole-person approach to care. He is known for emphasizing patient autonomy, personalized treatment, and a commitment to understanding each individual's unique health challenges rather than relying on symptom-based care. Stefan has been active in medical-freedom advocacy throughout the pandemic and continues to lead Iron DPC through rigorous research review, routine CME lectures, and evidence-based protocol development. He has treated patients of all ages and remains dedicated to helping individuals reverse chronic disease and optimize long-term vitality. Stefan Hartmann, MPAS, PA-C Facebook | https://www.facebook.com/IronDPC Instagram | https://www.instagram.com/irondirectprimarycare/ X | https://x.com/ironDPC YouTube | @irondirectprimarycare9440 Health Solutions Instagram | https://www.instagram.com/health_solutions_shawn_needham/ TikTok | https://www.tiktok.com/@healthsolutionspodcast Facebook | https://www.facebook.com/HealthSolutionsPodcast Moses Lake Professional Pharmacy Website | http://mlrx.com.com/ Facebook | https://www.facebook.com/MosesLakeProfessionalPharmacy/ Shawn Needham X | https://x.com/ShawnNeedham2 Shawn's Book | http://mybook.to/Sickened_The_Book Additional Links https://linktr.ee/mlrx

Brian talks about his experience being on the “other side” of the bedside with his wife's cancer treatmentHe really appreciated the extra time that the doctors spent with him and his wife to explain things – repetition is very helpful for your patients to really hear youBrian talks about balancing fatherhood and being a husband with our emergency medicine schedules and the challenges of being in a physician couple You have to figure out family priorities and what works well in your situationDate night is the most important investment you can makeWe talk about how to transition from ER mode to husband and father modeBrian talks about how finishing his notes helps to make his mind move on or answer some questions he may have to resolve a conflict he might be havingWe talk about church attendance as ChristiansBrian tells a powerful story where he was able to save and prolong a patient life so he could talk with his family“Sometimes it's more important to help someone die than to help them live”We need to be intentional about remembering the big and the small good things that happen throughout our dayYou never know when you might be the last person to interact with someone and may make the difference between them, deciding to give the ER another chanceBrian talks about advice to his younger self – don't work as hard, take more time offPrayer will get you to the right answer, if you call yourself Christian you should be displaying the Christian examples we are givenYou shouldn't have to leave your faith at home, it's your best ally at work Support the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

Eric Yeung specializes in geopolitical, economic effects on precious metals and commodities. He discusses the CME being offline due to a server issue, possibility of export controls on silver, revaluation of precious metals, stable coins, why bitcoin could hit 500k, and much more. PLEASE SUBSCRIBE LIKE AND SHARE THIS PODCAST!!!   Watch Show Rumble- https://rumble.com/v72egeo-cme-the-server-story-that-didnt-add-up-eric-yeung.html YouTube- https://youtu.be/sCc1gq7omog   Follow Me X- https://x.com/CoffeeandaMike IG- https://www.instagram.com/coffeeandamike/ Facebook- https://www.facebook.com/CoffeeandaMike/ YouTube- https://www.youtube.com/@Coffeeandamike Rumble- https://rumble.com/search/all?q=coffee%20and%20a%20mike Substack- https://coffeeandamike.substack.com/ Apple Podcasts- https://podcasts.apple.com/us/podcast/coffee-and-a-mike/id1436799008 Gab- https://gab.com/CoffeeandaMike Locals- https://coffeeandamike.locals.com/ Website- www.coffeeandamike.com Email- info@coffeeandamike.com   Support My Work Venmo- https://www.venmo.com/u/coffeeandamike Paypal- https://www.paypal.com/biz/profile/Coffeeandamike Substack- https://coffeeandamike.substack.com/ Patreon- http://patreon.com/coffeeandamike Locals- https://coffeeandamike.locals.com/ Cash App- https://cash.app/$coffeeandamike Buy Me a Coffee- https://buymeacoffee.com/coffeeandamike Bitcoin- coffeeandamike@strike.me   Mail Check or Money Order- Coffee and a Mike LLC P.O. Box 25383 Scottsdale, AZ 85255-9998   Follow Eric X- https://x.com/KingKong9888   Sponsors Vaulted/Precious Metals- https://vaulted.blbvux.net/coffeeandamike McAlvany Precious Metals- https://mcalvany.com/coffeeandamike/ Independence Ark Natural Farming- https://www.independenceark.com/    

Featuring perspectives from Dr Komal Jhaveri and Dr Virginia Kaklamani, including the following topics:  Introduction: Oral Selective Estrogen Receptor Degraders (SERDs) for the General Medical Oncologist (0:00) SERD Monotherapy (13:34) SERD and CDK Inhibitor Combination — The EMBER-3 Study (35:58) SERDs for "Molecular Progression" — The SERENA-6 Study (41:25) CME information and select publications

Dr Rinath M Jeselsohn and Dr Joyce O'Shaughnessy review current literature and datasets exploring the use of oral selective estrogen receptor degraders for the management of metastatic breast cancer. CME information and select publications here.

Think You Know Silver? Take the Quiz and Uncover What Most Investors Miss! https://www.rethinkingthedollar.com/silver-iq/Is the silver market finally breaking free, or is it being deliberately suppressed? This episode examines the suspicious COMEX trading halt that followed a $54 silver breakout and a significant contango event. As gold and silver futures surged, the CME halted trading, citing a data center cooling issue. However, many believe deeper issues are at play.The discussion explores whether this signals a global liquidity crisis in physical silver, the potential collapse risk facing the LBMA, and concerns over China's rapidly depleting leased silver supply. It also highlights why central banks, sovereign funds, and major bullion players are urgently shifting to physical metal instead of paper contracts.If you enjoy this analysis, hit the LIKE button, SUBSCRIBE for more breakdowns, and ring the bell so you don't miss our next deep dive.

Silver just hit a new all-time high (+$56 oz), and the fireworks started during a rare Thanksgiving-night CME outage. Beginning around 9:44 p.m. ET on November 27, CME futures trading was halted for nearly 10 hours, only resuming at 8:30 a.m. ET on November 28 — right as silver was breaking out. The timing has sparked big questions about what really happened and why the outage struck during one of the market's thinnest trading windows. Listen to see how the halt unfolded, what drove silver's surge, and why this could be a major turning point for the metal.

The 5 things you need to know before the stock market opens today: the CME temporarily halted trading for futures, foreign exchanges, and commodities due to a data center issue, the SEC is investigating Jefferies's relationship with a bankrupt auto parts maker, Alibaba has begun selling its AI smart glasses in China, Apple is challenging India's antitrust penalty law, and Disney's ‘Zootopia 2' clocked the biggest opening day in China for any Hollywood animated film.  Squawk Box is hosted by Joe Kernen, Becky Quick and Andrew Ross Sorkin.  Follow Squawk Pod for the best moments, interviews and analysis from our TV show in an audio-first format. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Carl Quintanilla, David Faber and Sara Eisen led off the show with the resumption of stock futures trading — after it had been halted at the CME due to a data-center cooling issue which knocked out futures and options across markets. The anchors also explored what to make of November volatility and the AI trade on the final trading day of the month. Covering the bases on Black Friday: Adobe out with data forecasting record sales, action at the malls, the retailers best positioned for success, Apple's holiday game plan. Squawk on the Street Disclaimer Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

For this years Holiday Gift Guide, listen as hosts Drew, Tanner, and Andy work you through their recommendations for anyone on your list. Don't forget, we are the official podcast of the American College of Osteopathic Emergency Physicians. Visit acoep.org today to learn more about an upcoming CME event!

Heidi Harris talks with Frank Miller about Black Friday sales trends, shifting consumer habits, and key market stories including the CME outage and updates on Nvidia, HP, Campbell's, and UPS. They touch on smartphone projections for Apple and Samsung, Amazon account fraud risks, and the Netflix outage during the Stranger Things season 5 premiere. The segment also covers rising fast food prices, app based deals, and how privacy trade offs are shaping consumer behavior in 2025.

APAC stocks were rangebound in the absence of a lead from Wall Street due to Thanksgiving Day and as participants digest a deluge of data at month-end.An outage at CME Group has halted trade in FX, commodities, Treasuries and equities futures; "Due to a cooling issue at CyrusOne data centres, our markets are currently halted," CME said. US President Trump said regarding Venezuela that they will begin to stop drug cartels on land soon.S&P said UK public finances remain constrained and it expects fiscal pressures in the UK to persist over the medium term despite revenue-raising measures announced in the Autumn Budget.European equity futures indicate a quiet open with Euro Stoxx 50 futures flat after the cash market finished little changed on Thursday.Looking ahead, highlights include German Import Prices (Oct), Retail Sales (Oct), French GDP Final (Q3), Prelim. HICP (Nov), Spanish Flash HICP (Nov), German Prelim. HICP (Nov), Italian Prelim. HICP (Nov), Swiss KOF (Nov), GDP (Q3), German Unemployment (Nov), Canadian GDP (Q3), Credit Review for France, Comments from ECB's Nagel.Desk Schedule: There is normal service on Friday, 28th November until 18:15GMT/13:15EST at which point the desk will close.Read the full report covering Equities, Forex, Fixed Income, Commodites and more on Newsquawk

European bourses are mostly flat, with the FTSE 100 (+0.1%) the only major index posting gains. Overall market action is muted amid light news flow, reflecting both Thanksgiving and the CME issues.An outage at CME Group has halted trade in FX, commodities, Treasuries and equities futures; "Due to a cooling issue at CyrusOne data centers, our markets are currently halted," CME said.DXY is firmer within a 99.50–99.75 range, having found support at the half-round figure and pushed above Thursday's 99.71 peak.EGBs are ultimately a little softer post-data; the EUR dipped during the releases but has since bounced off lows.WTI and Brent traded with a positive bias overnight, extending the prior session's gains. WTI trading was later halted due to the CME outage.Looking ahead, highlights Canadian GDP (Q3), German Nationwide HICP, Credit Review for France.Desk Schedule: There is normal service on Friday, 28th November until 18:15GMT/13:15EST at which point the desk will close.Read the full report covering Equities, Forex, Fixed Income, Commodites and more on Newsquawk

Die Nasdaq startet am Freitag leicht im Plus, rund +0,2 %, ebenso der S&P 500 mit +0,3 % und der Dow mit einem Anstieg von etwa 240 Punkten. Der Handel wird heute allerdings von einem ungewöhnlichen Ereignis überschattet: Ein Kühlungsproblem in einem Rechenzentrum hat in der Nacht den Futures-Handel an der CME zeitweise lahmgelegt. Der Zeitpunkt ist heikel – denn am Tag nach Thanksgiving sind die Handelsvolumina traditionell extrem niedrig. Das bedeutet: Schon kleine Orders können große Ausschläge verursachen. Gleichzeitig endet heute der schwierige Börsenmonat November. Besonders Tech-Aktien haben die großen Indizes belastet, weil Zweifel an der kurzfristigen Profitabilität vieler KI-Unternehmen aufgekommen sind. Die Nasdaq liegt im Monat fast 2 % im Minus und beendet damit ihren siebenmonatigen Aufwärtstrend. Der S&P 500 notiert leicht tiefer, während sich der Dow knapp behauptet. Trotzdem zeigt diese Woche ein deutlich freundlicheres Bild: Die großen Indizes liegen seit Montag zwischen 3 % und 4 % im Plus – angetrieben von einer Erholung im Technologiesektor. Ein weiterer Hingucker: Silber steigt heute auf ein neues Allzeithoch. Der Spot-Preis klettert um 3 % und liegt seit Jahresbeginn beeindruckende 90 % im Plus – deutlich stärker als Gold, das etwa 60 % gewonnen hat. Anleger schichten damit sichtbar in defensive Rohstoffe um, während die Erwartungen an die US-Geldpolitik weiter schwanken. Abonniere den Podcast, um keine Folge zu verpassen! ____ Folge uns, um auf dem Laufenden zu bleiben: • X: http://fal.cn/SQtwitter • LinkedIn: http://fal.cn/SQlinkedin • Instagram: http://fal.cn/SQInstagram

Pablo García, director de Divacons-AlphaValue; y Rafael Ojeda, agente y miembro del comité de inversiones de Ursus 3 Capital Agencia de valores. También hablamos del parón en CME con Pablo San Emeterio de Vapasec, empresa especializada en ciberseguridad.

link for CME credit coming soon! Host Holly Wayment speaks with Dr. Deena Sutter about rising H3N2 influenza activity, a partial vaccine mismatch, and what pediatricians and families should do as cases climb. They discuss vaccine effectiveness, when to test and treat, masking and infection control, and specific guidance to protect babies too young to be vaccinated. The episode also covers a local pertussis outbreak, the role of vaccination gaps, and practical communication tips for clinicians to counsel vaccine-hesitant parents.

Bitcoin is climbing back from Friday's drop, but the bounce looks weak and uncertain. Liquidity is shallow, flows are scattered, and the futures market just saw one of its sharpest resets of the cycle. Analysts say consolidation is more likely than a clean reversal, even as rate-cut odds rise and long-term holders accumulate. Institutional sentiment is mixed, CME derivatives are hitting records, and ETF flows remain soft, leaving a market that feels steadier than last week but far from confident the bottom is truly in. Enjoying this content? SUBSCRIBE to the Podcast: https://pod.link/1438693620 Watch on YouTube: https://www.youtube.com/@TheBreakdownBW Subscribe to the newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://blockworks.co/newsletter/thebreakdown⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Join the discussion: https://discord.gg/VrKRrfKCz8 Follow on Twitter: NLW: https://twitter.com/nlw Breakdown: https://twitter.com/BreakdownBW

Chuck is joined by Laura Goble, PA-C to discuss sports specialization by young athletes. In Part 2, they discuss nutrition and various risk factors, as well as the importance of truly understanding the athlete's priorities. Laura Goble was a speaker at our most recent annual conference. Earn Category 1 CME from this conference and others at PAOS.org!

Send us a textIn today's episode, Patrick with Grid Down Comms Up lists some of  his favorite prepper Christmas gifts. If you are looking for a present for your significant other, children, mag group member, or anyone else on your gift list, there is something here for you! We focus on practical gifts that have real value, whether the grid is up or the world has come crashing down. From books to power tools, precious metals, and beyond, the perfect gift idea of the prepper in your life awaits.  https://www.amazon.com/shop/preppernet Join PrepperNet.Net - https://www.preppernet.netPrepperNet is an organization of like-minded individuals who believe in personal responsibility, individual freedoms and preparing for disasters of all origins.PrepperNet Support the showPlease give us 5 Stars! www.preppingacademy.com Daily deals for preppers, survivalists, off-gridders, homesteaders https://prepperfinds.com Contact us: https://preppingacademy.com/contact/ www.preppernet.net Amazon Store: https://amzn.to/3lheTRTwww.forrestgarvin.com

Featuring an interview with Dr Priyanka Sharma, including the following topics: T-DXd versus trastuzumab emtansine for high-risk HER2-positive primary breast cancer with residual invasive disease after neoadjuvant therapy: Interim analysis of the DESTINY-Breast05 trial (0:00) Geyer C et al. Trastuzumab deruxtecan (T-DXd) vs trastuzumab emtansine (T-DM1) in patients (pts) with high-risk human epidermal growth factor receptor 2–positive (HER2+) primary breast cancer (BC) with residual invasive disease after neoadjuvant therapy (tx): Interim analysis of DESTINY-Breast05. ESMO 2025;Abstract LBA1.   DESTINY-Breast11 trial: Neoadjuvant T-DXd alone or followed by paclitaxel/trastuzumab/pertuzumab for high-risk HER2-positive localized breast cancer (5:42) Harbeck N et al. DESTINY-Breast11: Neoadjuvant trastuzumab deruxtecan alone (T-DXd) or followed by paclitaxel + trastuzumab + pertuzumab (T-DXd-THP) vs SOC for high-risk HER2+ early breast cancer (eBC). ESMO 2025;Abstract 291O.   Trastuzumab deruxtecan (T-DXd) and pertuzumab versus a taxane, trastuzumab and pertuzumab for HER2-positive advanced or metastatic breast cancer: Additional analyses of the DESTINY-Breast09 trial (10:00) Loibl S et al. Trastuzumab deruxtecan (T-DXd) + pertuzumab (P) vs taxane + trastuzumab + pertuzumab (THP) for patients (pts) with HER2+ advanced/metastatic breast cancer (a/mBC): Additional analyses of DESTINY-Breast09 in key subgroups of interest. ESMO 2025;Abstract LBA18.   CME information and select publications  

In this Thanksgiving Eve episode of the Futures Rundown, host Mark Longo navigates the complexities of the futures markets, breaking down the top futures trading activity for the week. The episode covers a diverse array of futures, including Ethereum, sugar, silver, S&P mid-caps, small caps, and more. The show also delves into the CME's new Solana futures contracts, exploring their specifics and implications for traders. To wrap up, a lively discussion on Thanksgiving side dishes ensues, with a poll questioning whether cranberry sauce is a side dish or merely a topping.

What if you ended the year not with burnout or urgency, but with a daily ritual of inspiration, generosity, and creative momentum for your CME writing?As CME writers, so much of our work happens behind the scenes — the interviews, the needs assessments, the outlines, the manuscripts. It's meaningful work, but it's often quiet and relentless, yet it carries real impact for learners and patients. This episode takes you behind the curtain into the reflection, intention, and creative spark that inspired the 12 Days of Giving. If you've ever wanted to reconnect with the why behind your own writing, this story will resonate.In this episode, you'll hear:My why behind the 12 Days of Giving How reflection helps us stay grounded in a profession that rarely slows down.Why generosity isn't just a nice idea, but a practical force that strengthens your craft and the CME community.Press play to step behind the scenes and discover the heart, intention, and creative spark powering this year's 12 Days of Giving.Ready to join the secret list? Do that here: https://www.alexhowson.com/12-days-interestMentioned in this episode:12 Days of GivingThis podcast uses the following third-party services for analysis: Podtrac - https://analytics.podtrac.com/privacy-policy-gdrp

Dystrophinopathies are heritable muscle disorders caused by pathogenic variants in the DMD gene, leading to progressive muscle breakdown, proximal weakness, cardiomyopathy, and respiratory failure. Diagnosis and management are evolving areas of neuromuscular neurology. In this episode, Kait Nevel, MD, speaks with Divya Jayaraman, MD, PhD, an author of the article "Dystrophinopathies" in the Continuum® October 2025 Muscle and Neuromuscular Junction Disorders issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Jayaraman is an assistant professor of neurology and pediatrics in the division of child neurology at the Columbia University Irving Medical Center in New York, New York. Additional Resources Read the article: Dystrophinopathies Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @IUneurodocmom Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Nevel: Hello, this is Dr Kate Nevel. Today I'm interviewing Dr Divya Jayaraman about her article on dystrophinopathies, which she wrote with Dr Partha Ghosh. This article appears in the October 2025 Continuum issue on muscle and neuromuscular junction disorders. Divya, welcome to the podcast, and please introduce yourself to the audience. Dr Jayaraman: Thank you so much, Dr Nevel. My name is Divya, and I am an assistant professor of Neurology and Pediatrics at Columbia University Irving Medical Center, and also an attending physician in the Pediatric Neuromuscular program there. In that capacity, I see patients with pediatric neuromuscular disorders and also some general pediatric neurology patients and also do research, primarily clinical research and clinical trials on pediatric neuromuscular disorders. Dr Nevel: Wonderful. Thank you for sharing that background with us. To set us on the same page for our discussion, before we get into some more details of the article, perhaps, could you start with some definitions? What comprises the dystrophinopathies? What are some of the core features? Dr Jayaraman: So, the dystrophinopathies, I like that term because it is a smaller subset from the muscular dystrophies. The dystrophinopathies are a spectrum of clinical phenotypes that are all associated with mutations in the DMD gene on chromosome X. So, that includes DMD---or, Duchenne muscular dystrophy---, Becker muscular dystrophy, intermediate muscular dystrophy (which falls in between the two), dilated cardiomyopathy, asymptomatic hyperCKemia, and manifesting female carriers. In terms of the core features of these conditions, so, there's some variability, weakness being prominent in Duchenne and also Becker. The asymptomatic hyperCKemia, on the other hand, may have minimal symptoms and might be found incidentally by just having a high CK on their labs. They all will have some degree of elevated CK. The dilated cardiomyopathy patients, and also the Becker patients to a lesser degree, will have cardiac involvement out of proportion to skeletal muscle involvement, and then the manifesting carriers likewise can have elevated CK and prominent cardiac involvement as well as some milder weakness. Dr Nevel: Now that we have some definitions, for the practicing neurologists out there, what do you think is the most important takeaway from your article about the dystrophinopathies? Dr Jayaraman: I like this question because it suggests that there's something that, really, any neurologist could do to help us pick up these patients sooner. And the big takeaway I want everyone to get from this is to check the CK, or creatine kinase, level. It's a simple, cheap, easy test that anyone can order, and it really helps us a lot in terms of setting the patient on the diagnostic odyssey. And in terms of whom you should be thinking about checking a CK in, obviously patients who present with some of the classic clinical features of Duchenne muscular dystrophy. This would include young boys who have toe walking, as they're presenting, sign; or motor delayed, delayed walking. They may have calf hypertrophy, which is what we say nowadays. You might have seen calf pseudohypertrophy in your neurology textbooks, but we just say calf hypertrophy now. Or patients can often have a Gowers sign or Gowers maneuver, which is named after a person called Gowers who described this phenomenon where the child will basically turn over and use their hands on the floor to stand up, usually with a wide-based gait, and then they'll sort of march their hands up their legs. That's the sort of classic Gowers maneuver. There are modified versions of that as well. So, if anyone presents with this classic presentation, for sure the best first step is to check a CK. But I would also think about checking a CK for some atypical cases. For example, any boy with any kind of motor or speech delay for whom you might not necessarily be thinking about a muscle disorder, it's always good practice to check a CK. Even a boy with autism for whom you may not get a good clinical exam. This patient might present to a general pediatric neurology clinic. I always check a CK in those patients, and you'll pick up a lot of cases that way. For the adult folks in particular, the adult neurologist, a female patient could show up in your clinic with asymptomatic hyperCKemia. And I think it's an important differential to think about for them because this could have implications not just for their own cardiac risks, but also for their family planning. Dr Nevel: So, tell us a little bit more about the timing of diagnosis. Biggest takeaway: check a CK if this is anywhere on your radar, even if somewhat of an atypical case. Why is it so important to get kiddos started on that diagnostic odyssey, as you called it, early? Dr Jayaraman: This is especially important for kids because if they especially get a Duchenne muscular dystrophy diagnosis, you might be making them eligible for treatments that we've had for some time, and also treatments that were not available earlier that hinge on making that diagnosis. So, for example, people may be skeptical about steroids, but there's population data to suggest that initiation and implementation of steroids could delay the onset of loss of ambulation as much as three years. So, you don't want to deprive patients of the chance to get that. And then all the newer emerging therapies---which we'll be talking about later, I'm sure---require a Duchenne muscular dystrophy diagnosis. So, that's why it's so important to check a CK, have this on your radar, and then get them to a good specialist. Dr Nevel: I know that you alluded already, or shared a few of the kind of exam paroles or findings among patients with dystrophinopathy. But could you share with us a little bit more how you approach these patients in the clinic who are presenting with muscle weakness, perhaps? And how do you approach this or think about this in terms of ways to potentially differentiate between a dystrophinopathy versus another cause of motor weakness or delay? Dr Jayaraman: It's helpful to think through the neuraxis and what kinds of disorders can present along that neuraxis. A major differential that I'm always thinking about when I'm seeing a child with proximal weakness is spinal muscular atrophy, which is a genetic anterior horn cell disorder that can also present in this age group. And some of the key differences there would be things like reflexes. So, you should have dropped reflexes in spinal muscular atrophy. In DMD, surprisingly, they might have preserved Achilles reflexes even if their patellar reflexes are lost. It may only be much later that they go on to lose their Achilles reflex. So, if you can get an Achilles reflex, that's quite reassuring, and if you cannot, then you need to be thinking about spinal muscular atrophy. They can both have low muscle tone and can present quite similarly, including with proximal weakness, and can even have neck flexion weakness. So, this is an important distinction to make. The reason for that is, obviously there are treatments for both conditions, but for spinal muscular atrophy, timing is very, very important. Time is motor neurons, so the sooner you make that diagnosis the better. Other considerations would be the congenital muscular dystrophies. So, for those that they tend to present a lot younger, like in infancy or very early on, and they can have much, much higher CKS in that age range than a comparable Duchenne or Becker muscular dystrophy patient. They can also have other involvement of the central nervous system that you wouldn't see in the dystrophinopathies, for example. My mnemonic for the congenital muscular dystrophies is muscle-eye-brain disease, which is one of the subtypes. So, you think about muscle involvement, eye involvement, and brain involvement. So, they need an ophthalmology valve. They can have brain malformations, which you typically don't see in the dystrophinopathies. I think those are some of the major considerations that I have. Obviously, it's always good to think about the rest of the neuraxis as well. Like, could this be a central nervous system process? Do they have upper motor neuron signs? But that's just using all of your exam tools as a neurologist. Dr Nevel: Yeah, absolutely. So, let's say you have a patient in clinic and you suspect they may have a dystrophinopathy. What is your next diagnostic step after your exam? Maybe you have an elevated CK and you've met with the patient. What comes next? Dr Jayaraman: Great question. So, after the CK, my next step is to go to genetics. And this is a bit of a change in practice over time. In the past we would go from the CK to the muscle biopsy before genetic testing was standard. And I think now, especially in kids, we want to try and spare them invasive procedures where possible. So, genetic testing would be the next step. There are a few no-charge, sponsored testing programs for the dystrophinopathies and also for some of the differential diagnosis that I mentioned. And I think we'll be including links to websites for all of these in the final version of the published article. So, those are a good starting point for a genetic workup. It's really important to know that, you know, deletions and duplications are a very common type of mutation in the DMD gene. And so, if you just do a very broad testing, like whole exome, you might miss some of those duplications and deletions. And it's important to include both checking for duplications and deletions, and also making sure that the DMD gene is sequenced. So always look at whatever genetic test you're ordering and making sure that it's actually going to do what you want it to do. After genetics, I think that the sort of natural question is, what if things are not clear after the genetics for some reason? We still use biopsy in this day and age, but we save it for those cases where it's not entirely clear or maybe the phenotype is a little bit discordant from the genotype. So, for mutations that disrupt the reading frame, those tend to cause Duchenne muscular dystrophy, whereas mutations that preserve the reading frame tend to cause Becker muscular dystrophy. There are some important exceptions to this, which is where muscle biopsy can be especially helpful in sorting it out. So, for example, there are some early mutations early in the DMD gene where, basically, they find an alternate start codon or an initiation codon to continue with transcription and translation. So, you end up forming a largely functional, somewhat truncated protein that gives you more of a milder Becker phenotype. On the other hand, you can have some non-frameshift or inframe mutations that preserve the reading frame, but because they disrupt a very key domain in the protein that's really crucial for its function, you can actually end up with a much more severe Duchennelike phenotype. So, for these sorts of cases, you might know a priori you're dealing with them, but might just be a child who is who you think has DMD has a mutation that's showed up on testing. There isn't enough in the literature to point you one way or another, but they look maybe a little milder than you would expect. That would be a good kid to do a biopsy in because there are treatment decisions that hinge on this. There are treatments that are only for Duchenne that someone with a milder phenotype would not be eligible for. Dr Nevel: So, that kind of stepwise approach, but maybe not all kids need a muscle biopsy is what I'm hearing from you. If it's a mutation that's been well-described in the literature to be fitting with Duchenne, for example. Dr Jayaraman: Absolutely. Dr Nevel: So, after you confirm the diagnosis through genetic testing---and let's say, you know, whether or not you do a muscle biopsy or not, after you know the diagnosis is a dystrophinopathy---how do you counsel the families and your patients? What are the most important points to relay to families, especially in that initial phase where the diagnosis is being made? Dr Jayaraman: This is a lot of what we do in pediatric neurology in general, right? So, I actually picked up this approach from the pediatric hematology oncology specialists at Boston Children's. They had this concept of a day-zero conversation, which is the day that you disclose the life-changing diagnosis or potentially, at some point, terminal diagnosis to a family. And some of the key components of that are a not beating around the bush, telling them what the diagnosis is, and then letting them have whatever emotional response they're going to have in the moment. And you may not get much further than that, but honestly, you want them to take away, this is what my child has. I did not do anything to cause this, nor could I have done anything to prevent this. Because often for these genetic conditions, there's a lot of guilt, a lot of parental guilt. So, you want to try and assuage that as much as possible. And then to know that they're not going to be alone on this journey; that, you know, they don't have to have it all figured out right then, but we can always come back and answer any questions they have. There's going to be a whole team of specialists. We're going to help the family and the kid manage this condition. Those are sort of my big takeaways that I want them to get. Dr Nevel: Right. And that segues into my next question, which is, who is part of that team? I know that these teams that help take care of people with dystrophinopathies and other muscle disorders can be very large teams that span multiple specialists. Can you talk a little bit more about that for this group of patients? Dr Jayaraman: Of course. So, the neuromuscular neurologist, really, our role is in coordinating the diagnosis, the initiation of any disease-specific treatments, and coordinating care with a whole group of specialists. So, we're sort of at the center of that, but everyone else is equally important. So, the other specialists include physical therapists; occupational therapists; rehab doctors or physiatrists; orthotists who help with all of the many braces and other devices that they might need, wheelchairs; pulmonology, of course, for managing the respiratory manifestations of this. It becomes increasingly important over time, and they are involved early on to help monitor for impending respiratory problems. Cardiac manifestations, this is huge and something that you should be thinking about even for your female carriers, the mother of the patient you're seeing in the clinic, or your patient who comes to adult clinic with asymptomatic hyperCKemia. if you end up making a diagnosis of DMD carrier for those patients, or if you make a Becker diagnosis, the cardiac surveillance is even more important because the cardiac involvement can be out of proportion to the skeletal muscle weakness. And of course, extremely important for the Duchenne patients as well. Endocrinologists are hugely important because in the course of treating patients with steroids, we end up giving them a lot of iatrogenic endocrinologic complications. Like they might have delayed puberty, they might have loss of growth, of height; and of course metabolic syndrome. So, endocrinology is hugely important. They're also important in managing things like fracture prevention, osteoporosis, prescribing bisphosphonates if necessary. Nutrition and GI are also important, not just later on when they might need assistance to take in nutrition, whether that's through tube feeds, but also earlier on when we're trying to manage the weight. Orthopedics, of course, for the various orthopedic complications that patients develop. And then finally, a word must be said for social work and behavioral and mental health specialists, because a lot of this patient population has a lot of mental health challenges as well. Dr Nevel: After you give the diagnosis, you've counseled the patient and families and you've had those kind of initial phase discussions, the day-zero discussion, when you start getting into discussions or thoughts about management, disease-specific medication. But what are the main categories of the treatment options, and maybe how do you kind of approach deciding between treatment options for your patients? Dr Jayaraman: So, there are two broad categories that I like to think about. So, one is the oral corticosteroids and oral histone deacetylase, or HDAC inhibitors, which share the common characteristic that they are non-mutation specific. And within corticosteroids, patients now have a choice between just Prednisone or Prednisolone, or Deflazacort or Vermilion. The oral HDAC inhibitors are newly FDA-approved as a nonsteroidal therapy in addition to corticosteroids in DMD patients above six years of age. I would say we're in the early phase of adoption of this in clinical practice. And then the other big category of treatment options would be the genetic therapies as a broad bucket, and this would include gene therapy or gene replacement therapy, of which the most famous is the microdystrophin gene therapy that was FDA-approved first on an accelerated approval basis for ages four to eight, and then a full approval in that age group as well as an accelerated approval for all comers, essentially, with DMD. This is obviously controversial. Different centers approach this a bit differently. I think our practice at our site has been to focus on the ambulatory population, just thinking about risk versus benefit, because the risks are not insignificant. So really this is something that should be done by experienced sites that have the bandwidth and the wherewithal to counsel patients through all of this and to manage complications as they arise with regular monitoring. And then another class that falls within this broader category would be the Exon-skipping therapies. So as the name suggests, they are oligonucleotides that cause an Exon to be skipped. The idea is, if there is a mutation in a particular Exon that causes a frame shift, and there's an adjacent Exon that you can force skipping of, then the resulting protein, when you splice the two ends together, will actually allow restoration of the reading frame. I think the picture I want to paint is that there's a wide range of options that we present to families, not all of which everyone will be eligible for. And they all have different risk profiles. And I really think the choice of a particular therapy has to be a risk-benefit decision and a shared decision-making process between the physician and the family. Dr Nevel: What is going on in research in this area? And what do you think will be the next big breakthrough? I know before we started the recording you had mentioned that there's a lot of things going on that are exciting. And so, I'm looking forward to hearing more. Dr Jayaraman: Of course. So, I'll be as quick as I can with this. But I mentioned that next-generation Exon skipping therapies, I think the hope is that they will be better at delivering the Exon skipping to the target tissue and cells and that they might be more efficacious. I'm also excited about next-generation gene therapies that might target muscle more specifically and hopefully reduce the off-target effects, or combination use of gene therapies with other immunosuppressive regimens to improve the safety profile and maybe someday allow redosing, which we cannot do currently. Or potentially targeting the satellite cells, which are the muscle stem cells, again, to improve the long term durability of these genetic therapies. Dr Nevel: That's great, thank you for sharing. Thank you so much for talking to me today about your article. I really enjoyed learning more about the dystrophinopathies. Today I've been interviewing Dr Divya Jayaraman about her article on the dystrophinopathies, which she wrote with Dr Partha Ghosh. This article appears in the October 2025 Continuum issue on muscle and neuromuscular junction disorders. Please be sure to check out the Continuum Audio episodes from this and other issues. Also, please read the Continuum articles for more details than what we were able to get to today during our discussion. Thank you, as always, so much to the listeners for joining us today, and thank you, Divya, for sharing all of your knowledge with us today. Dr Jayaraman: Thank you so much for having me on the podcast. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

In this CME episode, Dr. Andy Cutler and Dr. Christoph Correll discuss the complexities of managing bipolar disorder, with a focus on recognizing and treating mixed states. They address overlapping manic and depressive symptoms, comorbidities, and the importance of shared decision-making, family involvement, and patient education. The conversation also explores strategies to improve adherence, the impact of substance use, and the value of a collaborative, individualized approach to long-term stability and recovery. Create a free NEI guest account and obtain CME/CE by participating in this activity here: https://nei.global/e269-cme Never miss an episode!

Dr Priyanka Sharma from The University of Kansas Cancer Center in Westwood, Kansas, summarizes the treatment landscape for patients with breast cancer and discusses the implications of recently presented clinical findings from the ESMO Congress 2025. CME information and select publications here.

Ative seu cupom Flavio Conde pra a consultoria personalizada https://lvnt.app/61t6dr26/11 - Bolsa Recorde, RUMO +10% e HAPVIDA -5% Olá, sejam bem-vindo a mais um Fechamento de Mercado, comigo Flávio Conde e Ricardo Afonso, hoje é 4a. feira, dia 26 de novembro, e sugiro assistirem o Mata-Mata: “Qual Banco Comprar: BB, Itaú, Bradesco ou Santander?” que está muito bom. O Ibovespa fechou com forte alta de 1,7% a 158,6 mil pontos, com volume melhorando e indo a R$ 23 bi, R$ 2 bi abaixo da média das quartas de outubro e novembro. A combinação de inflação dentro do esperado e com sinais benignos no IPCA-15 em industriais e alimentos apesar de serviços a 6% a.a., possibilidade do Copom cortar os juros da Selic em janeiro ao invés de março mais a alta probabilidade do Fed reduzir juros em 10 de dezembro animou investidores estrangeiros e locais a comprar ações brasileiras.As bolsas subiram de novo nos EUA, Nasdaq +0,94% e Dow +0,78% - com apostas de cortes de juros subindo de 82,5% para 84,5% na CME.O dólar comercial em baixa de -0,13%, aos R$ 5,3680 de R$ 5,3761 ontem, seguindo o dólar norte-americano recuou -0,09% frente a moedas fortes.Os juros no Brasil recuaram de novo com o Tesouro Prefixado 2032 a 13,29% x 13,36%, ontem, e o IPCA+ 2029 quase estável em 7,74% a.a.

This episode is sponsored by Lightstone DIRECT. Lightstone DIRECT invites you to partner with a $12B AUM real estate institution as you grow your portfolio. Access the same single-asset multifamily and industrial deals Lightstone pursues with its own capital – Lightstone co-invests a minimum of 20% in each deal alongside individual investors like you. You're an institution. Time to invest like one.  How do you rise in academic medicine without losing your sense of purpose?Dr. Bradley Block joins Dr. Joseph Losee  for a powerful conversation about the real path to academic advancement. Drawing from over two decades as a department chair, program director, and mentor, Dr. Losee reveals how saying “yes” shaped his journey from young faculty member to national leader—and why the same word must be used intentionally at different seasons of life.The discussion explores the balance between sacrifice and wellbeing, the shifting culture of academic medicine, and how meaning and mentorship sustain long-term fulfillment. Dr. Losee also shares insights on conflict resolution, leadership development, and his latest venture, Clarity Med Solutions, where he pioneers early dispute mediation to restore trust and healing between physicians, patients, and health systems.This episode is a roadmap for physicians seeking impact, growth, and balance—without losing sight of what truly matters.Three Actionable Takeaways:Say Yes With Intention: Early in your career, saying yes opens doors, builds credibility, and creates opportunities. But as your life evolves, align your yeses with your passions—and protect your energy for what truly matters.Sacrifice is the Path to Leadership: Every leader pays a price for impact. True advancement in academic medicine requires time, service, and persistence—but when rooted in purpose, those sacrifices yield meaning and legacy.Relationships Are the Real Reward: From mentoring residents to mediating patient disputes, relationships—not titles—define success. Meaning in medicine comes from connection, compassion, and helping others thrive.About the Show:Succeed In Medicine  covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for real-world lessons we should have learned in med school!About the Guest:Dr. Joseph Losee is Vice Dean for Faculty Affairs at the University of Pittsburgh School of Medicine and the Dr. Ross H. Musgrave Endowed Chair of Pediatric Plastic Surgery. A nationally recognized surgeon, educator, and leader, he has authored over 250 publications, edited seven textbooks, and led multiple professional societies.He co-chairs the UPMC Physician Wellbeing Initiative, teaches leadership in the Katz Graduate School of Business, and is the founder of Clarity Med Solutions, a consulting firm specializing in leadership coaching and conflict resolution.

Send us a textIf you're running a medical practice in 2025, chances are—without even realizing it—you're leaving real money on the table. And I don't mean pennies—I mean tens or even hundreds of thousands or millions of dollars a year.Here's the thing: most practices aren't bleeding cash from one major hole. They're leaking it quietly, invisibly, in ways that seem small until they snowball. A missed code here. A denied claim that never got appealed. A payer contract that hasn't been touched in five years. And the result? Margins shrink. Stress rises. And groups that should be financially strong start treading water. There's no hemorrhage. Instead, it's death by a thousand paper cuts.The good news is that these problems are almost always fixable. But first, you have to see them. So today, we're going to walk through five of the most common ways medical groups lose money unnecessarily—and, just as importantly, what you can do about each one.If you recognize yourself in any of these, know this: you're not alone. These are common, especially in busy practices where the day-to-day crises take priority. But the practices that tighten these up are the ones that thrive—no matter what the market throws at them.Please Follow or Subscribe to get new episodes delivered to you as soon as they drop! Visit Jill's company, Health e Practices' website: https://healtheps.com/ Subscribe to our newsletter, Health e Connections: http://21978609.hs-sites.com/newletter-subscriber Want more formal learning? Check out Jill's newly released course: Physician's Edge: Mastering Business & Finance in Your Medical Practice. 32.5 hours of online, on-demand CME-accredited training tailored just for busy physicians. Find it here: https://healtheps.com/physicians-edge-mastering-business-finance-in-your-medical-practice/ Purchase your copy of Jill's book here: Physician Heal Thy Financial Self Join our Medical Money Matters Facebook Group here: https://www.facebook.com/groups/3834886643404507/ Original Musical Score by: Craig Addy at https://www.underthepiano.ca/ Visit Craig's website to book your Once in a Lifetime music experience Podcast coaching and development by: Jennifer Furlong, CEO, Communication Twenty-Four Seven https://www.communicationtwentyfourseven.com/

Join this concise CME program, designed to deliver practical guidance to improve cardiovascular safety and symptom management in narcolepsy and idiopathic hypersomnia (IH). Credit available for this activity expires: 11/24/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/cardiovascular-safety-and-symptom-management-narcolepsy-and-2025a1000w9x?ecd=bdc_podcast_libsyn_mscpedu

Explore key symptoms and updated management of narcolepsy and idiopathic hypersomnia in this expert CME. Credit available for this activity expires: 11/20/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/narcolepsy-and-idiopathic-hypersomnia-24-hour-conditions-2025a1000vzp?ecd=bdc_podcast_libsyn_mscpedu

Misguided ideas surface in healthcare settings all the time.  With warmth and loving amusement, we reflect on how these initiatives—often wrapped in corporate optimism—miss the mark.  yet don't have to steal our peace.  Brilliantly bad ideas aren't about you and tehy don't have to steal your peace. They're structural, impersonal, and often just disconnected from the day-to-day reality of clinical life. We invite you to laugh with us, reflect, and most importantly, not to take them personally. Pearls of Wisdom: • Bad ideas often come with good intentions—they're usually more about systemic gaps than personal disrespect. • You get to choose how much energy to bring to these initiatives—humor and grace are powerful tools. • "Wellness" programs often miss the mark because they don't reflect the lived reality of those they're meant to support. • Expecting and accepting mismatched ideas can bring lightness—and maybe even loving amusement. Reflection Questions: • What is your favorite "brilliantly bad idea?"  • How might you use humor to help you when the next one comes your way? Please send us the brilliantly bad ideas you have witnessed.  We would love to hear them! If you're navigating burnout, frustration, or the absurdities of healthcare, we offer coaching, retreats, and workshops to help you find clarity, compassion, and joy again. Jessie offers 1:1 coaching and mindful retreats designed to bring back peace, purpose, and presence in your work and life.  Learn more at www.jessiemahoneymd.com/coaching and www.jessiemahoneymd.com/retreats. CME is available for most Pause & Presence offerings. If you'd like to bring humor, mindfulness, and meaning to your institution or event, we both offer also offer keynotes and workshops. Learn more here: Jessie Mahoney, MD: www.jessiemahoneymd.com/speaking Ni-Cheng Liang, MD: www.awakenbreath.org Nothing shared in the Healing Medicine Podcast is medical advice.  

We talk about setting the right mindset, culture and tone as a leader of the department and especially in smaller facilitiesYou don't have to be perfect, but you can avoid the little negative comments and criticismsBeing a good example goes a long wayAs a Christian we are supposed to act like Christ wouldWe have a lot of metrics we have to worry about as clinicians but, as Christians, we need to worry about the metric of mercyUnderstanding that we are not as far removed from the homeless, drug addicted patient as we might thinkWe have to remember that, as we care for the homeless and drug addicted person that no one else will care for, we are doing it for JesusBrian tells his students to spend as much time with the patient as they need, you don't have to be the fastest provider right awayWe have to be careful about bias getting passed on from triage and from EMS reports as well, sometimes the problem is more subtle and requires more time with the patientHow we word things when talking with patients makes a big differenceWe talk about providing respect and dignity to those patients that dieBrian talks about some on-shift practices he uses to re-center himself on his purposeWe talk about the grey area in which we practice in the EDI try to practice assuming good intent on othersSupport the showEverything you hear today from myself and my guests is opinion only and doesn't represent any organizations or companies that any of us are affiliated with. The stories you hear have been modified to protect patient privacy and any resemblance to real individuals is coincidental. This is for educational and entertainment purposes only and should not be taken as medical advice nor used to diagnose any medical or healthcare conditions. This is not medical advice. If you have personal health concerns, please seek professional care. Full show notes can be found here: Episodes - Practical EMS - Content for EMTs, PAs, ParamedicsMost efficient online EKG course here: Practical EKG Interpretation - Practical EMS earn 4 CME and learn the fundamentals through advanced EKG interpretation in under 4 hours. If you want to work on your nutrition, increase your energy, improve your physical and mental health, I highly recommend 1st Phorm. Check them out here so they know I sent you. 1st Phorm | The Foundation of High Performance Nutrition

interview starts at 40:55 Ra Castaldo is back and joins us for a great chat about plasma physics, ancient wisdom, astral wars and much more. We talk about the Golden Lasso of the Gods, the luminous ether, theosophy, the Naga, Apollo, CME's, ancient battles with Dragons being our Sun v our Magnetosphere. Go to the Nightside to stay in this solar system after death.   We also get into ancient Egypt, the Hindu mythologies, dolmens in North America, John Lilly, Dolphins, divine intelligence, the dark forces, the Watchers, codes at birth and ET objects like 3I/Atlas and what they may bring.   Most cutting-edge thoughts on the fusion of science, religion and spirituality. Exploring our cosmic journey. Featuring world-renown research and experiences of Ralph-Anthony "RA" Castaldo and various Colleagues. Ra, born still inside the caul, is an all around Renaissance man. https://www.youtube.com/@ExploringtheKawithRa https://www.themysticalspiralstore.com/themysticalspiral   Bass Forge. Plasma Pixels: Understanding the Interface of Reality with Dana Kippel (@Dana.thealien) https://youtu.be/nXFid8D7q1Q?si=zG7F4-6mguqNDaa7   Become a Lord or Lady with 1k donations over time. And a Noble with any donation. Leave Serfdom behind and help Grimerica stick to 0 ads and sponsors and fully listener supported. Thanks for listening!! Help support the show, because we can't do it without ya. https://www.amazon.com/Unlearned-School-Failed-What-About/dp/1998704904/ref=sr_1_3?sr=8-3   Support the show directly: https://grimericacbd.com/ CBD / THC Gummies and Tinctures http://www.grimerica.ca/support https://www.patreon.com/grimerica http://www.grimericaoutlawed.ca/support www.Rokfin.com/Grimerica   The Eh- List site. Canadian Propaganda Deconstruction https://eh-list.ca/ The Eh-List YouTube Channel: https://youtube.com/@theeh-list?si=d_ThkEYAK6UG_hGX Adultbrain Audiobook YouTube Channel: https://www.youtube.com/@adultbrainaudiobookpublishing https://grimericaoutlawed.ca/The newer controversial Grimerica Outlawed Grimerica Show Check out our next trip/conference/meetup - Contact at the Cabin www.contactatthecabin.com Our audio book website: www.adultbrain.ca www.grimerica.ca/shrooms and Micro Dosing Darren's book www.acanadianshame.ca Grimerica on Rumble: https://rumble.com/c/c-2312992 Join the chat / hangout with a bunch of fellow Grimericans Https://t.me.grimerica https://www.guilded.gg/i/EvxJ44rk   Leave a review on iTunes and/or Stitcher: https://itunes.apple.com/ca/podcast/grimerica-outlawed http://www.stitcher.com/podcast/grimerica-outlawed Sign up for our newsletter https://grimerica.substack.com/ SPAM Graham = and send him your synchronicities, feedback, strange experiences and psychedelic trip reports!! graham@grimerica.com InstaGRAM https://www.instagram.com/the_grimerica_show_podcast/ Tweet Darren https://twitter.com/Grimerica Can't. Darren is still deleted. Purchase swag, with partial proceeds donated to the show: www.grimerica.ca/swag Send us a postcard or letter http://www.grimerica.ca/contact/ Episode ART - Napolean Duheme's site http://www.lostbreadcomic.com/ MUSIC https://brokeforfree.bandcamp.com/ - Something Galactic Felix's Site sirfelix.bandcamp.com - Should I

Will the Fed cut rates again before the end of 2025? The probability of the Federal Reserve cutting interest rates has decreased significantly, now standing at 30% according to CME's FedWatch tool. The slide comes amid concerns over a prolonged data blackout, as the Labor Department confirmed that it wouldn't release the jobs data for October. How will bitcoin and other risk assets react to the macro gloom? CoinDesk's Jennifer Sanasie hosts "CoinDesk Daily." - Break the cycle of exploitation. Break down the barriers to truth. Break into the next generation of privacy. Break Free. Free to scroll without being monetized. Free from censorship. Freedom without fear. We deserve more when it comes to privacy. Experience the next generation of blockchain that is private and inclusive by design. Break free with Midnight, visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠midnight.network/break-free⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ - Need liquidity without selling your crypto? Take out a ⁠⁠Figure Crypto-Backed Loan⁠⁠, allowing you to borrow against your BTC, ETH, or SOL with 12-month terms and no prepayment penalties. They have the lowest rates in the industry at 8.91%, allowing you to access instant cash or buy more Bitcoin without triggering a tax event. Unlock your crypto's potential today at Figure! ⁠⁠https://figuremarkets.co/coindesk⁠⁠ - Genius Group has partnered with CoinDesk for Bitcoin Treasury Month, launching the Genius x CoinDesk Quest. Participants can join the Bitcoin Academy, complete free microcourses from experts like Natalie Brunell and Saifedean Ammous, and enter to win 1,000,000 GEMs (worth 1 BTC) promoting bitcoin education and adoption.Learn more at:  ⁠⁠⁠⁠⁠⁠⁠⁠geniusgroup.ai/coindesk-bitcoin-treasury-month/⁠⁠⁠⁠⁠⁠⁠⁠ - This episode was hosted by Jennifer Sanasie. “CoinDesk Daily” is produced by Jennifer Sanasie and edited by Victor Chen.

Help Support CME Group's Charitable Efforts By Donating To St. Jude Children's Research Hospital Guy Adami and Dan Nathan are joined by Terry Duffy, CEO and Chairman of CME Group, at the CME Group Tour Championship in Naples, Florida. They discuss a range of topics including Bitcoin, gold, equities, and market correlations, offering insights into the current financial landscape. The conversation highlights the role of CME's initiatives in retail trading, emphasizing the company's efforts in prediction markets and partnerships with platforms like Robinhood and FanDuel. Other key points include the evolution of market structure, the significance of the ten-year bond, and the increasing relevance of gold and crypto assets. Additionally, Duffy reflects on his leadership style, institutional trust, and future challenges and opportunities in finance. —FOLLOW USYouTube: @RiskReversalMediaInstagram: @riskreversalmediaTwitter: @RiskReversalLinkedIn: RiskReversal Media

In this week's episode, we delve into the powerful documentary The Chaplain and The Doctor with two extraordinary guests: Betty Clark, the chaplain at the heart of the film, and Dr. Jessica Zitter, the physician and filmmaker who brought this story to the screen.  The film provides a deeply moving look into the ways personal stories and biases shape our interactions in healthcare. Through our conversation with Betty and Jessica, I gained a valuable insight: the narratives we carry within ourselves—whether conscious or unconscious—act as invisible forces that influence how we engage with patients and colleagues. I also learned that recognizing these stories and the biases they may produce, rather than avoiding them, can foster more genuine and empathetic care. They also may lead to deep friendships, as is clearly shown between Betty and Jessica. I love both this podcast episode and the film itself, as they shine a light on the deeply human—and oftentimes flawed—experience of working in healthcare. They remind us of the vital role of storytelling in shaping how we care for patients, and the often-overlooked yet essential contributions of chaplains in healthcare settings. Betty and Jessica's reflections underscore how chaplains bring compassion and humanity to the medical team, offering emotional and spiritual support to patients and providers alike.  If you're interested in watching The Chaplain and The Doctor during its festival tour, or would like to host a screening at your own institution, I encourage you to visit the film's website at TheChaplainandTheDoctor.com.    This episode of the GeriPal Podcast is sponsored by UCSF's Division of Palliative Medicine, an amazing group doing world class palliative care.  They are looking for physician faculty to join them in the inpatient and outpatient setting.  To learn more about job opportunities, please click here: https://aprecruit.ucsf.edu/apply/JPF05811   ** NOTE: To claim CME credit for this episode, click here **

Jeff Park is the Partner and Chief Investment Officer at ProCap BTC. In this conversation, we break down why bitcoin's price has been slipping and whether the market is actually signaling the start of a bear trend. Jeff explains the key forces driving sentiment — from liquidity pressures to global macro shifts — and why a slightly negative year for bitcoin might not be as bearish as it sounds.We also dig into what it would take for bitcoin to rip back toward the $125K–$150K range, plus how geopolitical dynamics in Japan, China, and elsewhere are shaping the broader investment landscape.======================BitcoinIRA: Buy, sell, and swap 80+ cryptocurrencies in your retirement account. Take 3 minutes to open your account & get connected to a team of IRA specialists that will guide you through every step of the process. Go to https://bitcoinira.com/pomp/ to earn up to $1,000 in rewards.======================In this episode, Pomp spotlights easyBitcoin.app—the app that pays you 1% extra on recurring buys, 2% annual bitcoin rewards, and 4.5% APY on USD. Download it now for iOS or Android at https://easybitcoin.onelink.me/F1zP/klc4v1p8 and start earning today. Your capital is at risk. Crypto markets are highly volatile. This content is informational and not financial advice.======================Core is the leading Bitcoin scaling solution, enabling you to lock in yield by locking up your Bitcoin. Simply lock it on the Bitcoin blockchain to secure the Core network, and get rewards. No bridging. No lending. Just holding. Still your keys. Still your coins. Now your yield. Start at https://stake.coredao.org/pomp======================Timestamps: 0:00 – Intro1:50 – Why is bitcoin dropping? Should investors be worried?4:36 – Do technical levels like CME gaps actually matter?8:13 – Harvard's bitcoin position and how endowments invest12:15 – Has optionality changed bitcoin's market dynamics?15:14 – What Jeff is watching for real signs of optimism17:30 – Is the 4-year cycle officially dead?23:18 – Macro risks: liquidity, global conflict, & Trump premium25:56 – What would a true upside black swan look like?28:05 – How do you underwrite quantum risk today?

Watch The X22 Report On Video No videos found (function(w,d,s,i){w.ldAdInit=w.ldAdInit||[];w.ldAdInit.push({slot:17532056201798502,size:[0, 0],id:"ld-9437-3289"});if(!d.getElementById(i)){var j=d.createElement(s),p=d.getElementsByTagName(s)[0];j.async=true;j.src="https://cdn2.decide.dev/_js/ajs.js";j.id=i;p.parentNode.insertBefore(j,p);}})(window,document,"script","ld-ajs");pt> Click On Picture To See Larger Picture Trump has withdrawn his nominee for the top IRS lawyer, he is an Obama donor. If you look at the US, the blue states are experiencing a recession, the policies are backfiring. Ford is now going to sell cars on Amazon. Trump wants to make life cheaper for Americans.  Investors are liquidating their Bitcoin positions pushing the price down.  The [CB] is the root of all evil. The fake news continues with their fake stories in regard to the illegals. The D's fell right into the trap that Trump set, they are exposing the Epstein files and clearing Trumps name and implicating themselves. They are now panicking. Trump is now beginning to separate the RINOS from MAGA, this is all in preparation for the midterms, Trump is also beginning to set the narrative for the Presidential race. Trump mission is to take the country back, the [DS] mission is to try to stop him, nothing can stop this.   Economy Trump Withdraws Nominee for Top IRS Lawyer Donald Korb served in the Bush administration from 2004 to 2008. President Donald Trump on Nov. 14 withdrew the nomination of Donald L. Korb, a veteran tax attorney, to serve as the top lawyer for the IRS. Source: theepochtimes.com Deputy Assistant Secretary of the Treasury for Tax Policy At The IRS Is A  Obama Donor   https://twitter.com/KobeissiLetter/status/1990137278304305391?s=20 (function(w,d,s,i){w.ldAdInit=w.ldAdInit||[];w.ldAdInit.push({slot:18510697282300316,size:[0, 0],id:"ld-8599-9832"});if(!d.getElementById(i)){var j=d.createElement(s),p=d.getElementsByTagName(s)[0];j.async=true;j.src="https://cdn2.decide.dev/_js/ajs.js";j.id=i;p.parentNode.insertBefore(j,p);}})(window,document,"script","ld-ajs"); https://twitter.com/KobeissiLetter/status/1990425179621621957?s=20 https://twitter.com/EricLDaugh/status/1990421230193643844?s=20  "More deals with pharma companies to make prescription drugs cheaper" This is HUGE!  BITCOIN Over $900 million in leveraged positions were liquidated since November 15, with longs taking the brunt (~$650 million). High leverage in derivatives markets (funding rates flipped negative) created a cascade: one sell triggered stops, pulling prices lower and wiping out more positions. Weekend and low-volume trading exacerbated the drop—daily spot volume fell to $2 billion (vs. $50 billion peaks in 2021), making BTC vulnerable to amplified moves. A CME futures gap at $92K was filled, adding technical fuel. Sentiment gauges like the Fear & Greed Index hit "extreme fear" (score: 18), spurring retail panic. Notably, on-chain data reveals no major spot selling—exchanges hold fewer BTC now than at the peak—suggesting this is a "synthetic" flush via derivatives, not fundamental dumping. Spot Bitcoin ETFs saw net outflows of $1.1 billion over the past 48 hours—the largest weekly redemptions since March 2025—driven by institutions like BlackRock's IBIT and Fidelity's FBTC. This reversed months of inflows that had propped up prices earlier in the year. https://twitter.com/ColonelTowner/status/1989700368951906382?s=20   Political/Rights https://twitter.com/CMDROpAtLargeCA/status/1990435847611552052?s=20 https://twitter.com/DHSgov/status/1990414982060581351?s=20   removal by an immigration judge from November 4, 2014. His criminal history includes assault with a deadly weapon, multiple counts of burglary, multiple counts of carjacking, carjacking with a firearm, trespassing onto private property, multiple counts of taking a vehicle without owner consent,