Podcasts about cme

Dan Pontefract is a renowned leadership strategist, author, and keynote speaker with over two decades of experience in senior executive roles at companies such as SAP, TELUS, and Business Objects. Since then, he has worked with organizations worldwide, including Salesforce, Amgen, Nestlé, Virgin Media O2, Autodesk, BMO, the Government of Canada, Manulife, Nutrien, and BDO, among others.As an award-winning and best-selling author, Dan has written six books: THE FUTURE OF WORK IS GREY, WORK-LIFE BLOOM, LEAD. CARE. WIN., OPEN TO THINK, THE PURPOSE EFFECT, and FLAT ARMY. His 2024, Work-Life Bloom, is the 2024 Thinkers50 Best New Management Book and the Gold Medal Winner of the Axiom Business Book Awards. He also writes for Forbes and Harvard Business Review.Dan is a renowned keynote speaker who has presented at four TED events and has delivered over 600 keynotes. He is an adjunct professor at the University of Victoria's Gustavson School of Business and has received over 25 industry, individual, and book awards.Dan's career is interwoven with corporate and academic experience, coupled with an MBA, B.Ed, and multiple industry certifications and awards. Notably, Dan is listed on the Thinkers50 Radar, HR Weekly's 100 Most Influential People in HR, PeopleHum's Top 200 Thought Leaders to Follow, and Inc. Magazine's Top 100 Leadership Speakers.Link to claim CME credit: https://www.surveymonkey.com/r/3DXCFW3CME credit is available for up to 3 years after the stated release dateContact CEOD@bmhcc.org if you have any questions about claiming credit.

For millions of young women and girls, often the first place they turn with questions about their bodies isn't a doctor's office, it's social media which can lead to encountering many misconceptions and outright misinformation. Or, if the right voices show up, it can mean something else entirely. Our guest today, Dr. Charis Chambers, is one of those voices. She's a board-certified OB/GYN with specialty certification in Pediatric & Adolescent Gynecology, and Chief Medical Officer at Clue, a leading period and cycle-tracking app. She's also the founder of The Period Doctor, a platform she launched in 2019 to provide medically accurate reproductive health information and to place more minority physicians in the spaces where patients are already looking for answers. As she tells Raise the Line from Elsevier host Lindsey Smith, Dr. Chambers embraces the role of being a bridge between generations: "I can serve as a medical mediator where I advocate for the child and then educate the parent so that the child's concerns are met." Stay tuned to this important conversation to also learn about: Her new book, The Period and Puberty Parenting Revolution, which tackles many of the same myths she encounters every day in her clinic; Why stubborn myths around periods rarely hold up once you ask where they come from; How she thinks about the responsibility, and limits, of being a trusted medical voice on social media. Mentioned in this episode: Clue The Period Doctor The Period and Puberty Parenting Revolution If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Featuring perspectives from Dr William G Wierda, including the following topics: Introduction: Overview of the Grand Rounds Chronic Lymphocytic Leukemia Initiative (0:00) Sequencing Road Map (12:39) Key Datasets — Pirtobrutinib (21:08) Investigator Survey (34:09) Chimeric Antigen Receptor T-Cell Therapy (45:08) Other Novel Therapy Approaches (49:58) EHA 2026 (54:45) CME information and select publications

Insomnia affects neurologic health, quality of life, and daily functioning, but effective treatments are available. In this episode, Dr. Brandon Peters-Mathews discusses a practical approach to evaluating chronic insomnia, highlights the importance of identifying contributing conditions such as sleep apnea and mood disorders, and reviews cognitive behavioral therapy for insomnia (CBT-I), the recommended first-line treatment. Learn how addressing sleep can improve outcomes across a wide range of neurologic disorders. In this episode, Katie Grouse, MD, FAAN, speaks with Brandon R. Peters-Mathews, MD, FAAN, FAASM, author of the article "Insomnia" in the Continuum® August 2026 Sleep Neurology issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California, San Francisco in San Francisco, California. Dr. Peters-Mathews is the Section Head of Sleep Medicine at Virginia Mason Franciscan Health in Seattle, Washington. Additional Resources Read the article: Insomnia 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: @BrandonPetersMD Full episode transcript available here Dr Grouse: Insomnia may be one of the most common medical issues experienced by patients, yet our knowledge about how to manage it remains limited. Today, I have the opportunity to speak with one of the world's leading experts on sleep disorders, Dr. Brandon Peters-Mathews, about the latest issue of Continuum on Neurology of Sleep.  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 Grouse: This is Dr. Katie Grouse. Today, I'm interviewing Dr. Brandon Peters-Mathews about his article on insomnia. This article appears in the August 2026 Continuum issue on Neurology of Sleep. Welcome to the podcast, and please introduce yourself to our audience.  Dr Peters-Mathews: It's my pleasure to join you, and I'm happy to talk about this article. I think it's an interesting one for most folks. I am a board-certified sleep neurologist. I practice at Virginia Mason Franciscan Health in Seattle. I did my neurology training back at the University of Minnesota and my sleep training at Stanford University. I've been in practice for more than thirteen years at this point. It's hard to believe, but it's exciting to be able to speak with you today.  Dr Grouse: This is definitely an important topic for everybody. Certainly, sleep and the lack of it affects all of our patients, and I can't imagine there's a single clinical neurologist who doesn't have to answer questions and help evaluate patients with this problem, so very high-yield topic for everyone. Now, having read your article, I'm curious if you had to choose one key point that you want the readers of your article to take away after reading it, what would it be?  Dr Peters-Mathews: Emphasize for my patients that insomnia is a condition that we can work through and resolve, that if we really can understand the underlying contributing causes and resolve those issues, we can typically improve sleep. It's a process. It takes time. It takes some attention and, and sometimes even testing to figure out what's going on. But if we can dial into these root causes, we can typically help somebody to sleep much better. As part of that, we often employ a therapy called CBT-I, which we'll talk about here a little bit later. But that also helps us to identify some of these contributing factors that are leading to the poor sleep.  Dr Grouse: And I definitely want to talk more about CBT, it's such an important topic. But even before we get into that, I'd love it if you could just walk us through a hypothetical case of a patient with insomnia. I think the type of patient that I think we've all seen in our clinical practice and somebody who says, "You know, I've had poor sleep. I've had insomnia for many years. I've tried all of the things you're supposed to try. You know, I've tried sleep hygiene. I've tried this. I've tried that. I've tried medications. Nothing seems to work." Could you walk us through how you would evaluate a patient like this and start to consider what to recommend? Dr Peters-Mathews: So, some simple information that we can gather, would be information about when they're trying to go to bed, how long it's taking them to fall asleep initially. If they wake in the night and have trouble getting back to sleep, how often they wake in the night. If they're experiencing early morning awakenings, their final wake time, and when they actually get out of bed in the morning. That gives me a sense of the structure of their sleep pattern and whether or not they might be spending an excessive amount of time in bed for their own sleep need at their current age. The other factors that we might consider are sleep disorders, and typically, I would assess for other symptoms that would point me towards sleep apnea or restless legs and occasionally other disorders of sleep. We wanna make sure we're not missing comorbid conditions that might be affecting that person. These often include mood disorders. Sleep and mood walk hand in hand, and so anxiety and depression are important to identify and treat if present. We also want to make sure someone's not suffering from chronic pain or other conditions that might be impacting their sleep. So, I take a broad approach. I ask the same questions to each patient that comes to see me. I wanna make sure I'm not missing some of these details. And then some of these folks will require testing to further understand their sleep. Others may move on to a different therapy, and long-term may require even other interventions, including medications, to fully resolve their condition.  Dr Grouse: You mentioned in your article circadian rhythm sleep disorders. How often are these really a factor in patients with chronic insomnia? And do you think that's something that we as kind of first-line clinicians should be screening for as well?  Dr Peters-Mathews: So delayed sleep phase syndrome is the most common circadian disorder, and these are folks who are night owls by nature. They often develop their sleep patterns, as teenagers, if not before, and they may fade away in the working years but come back in retirement age. I would say that's a very common condition. It may affect as many as one in ten people. The other circadian disorders are pretty uncommon, so advanced sleep phase syndrome, where somebody is sleepy early and waking too early, that may only affect one in three hundred people. There are other conditions that affect specific populations, like non-twenty-four circadian pattern affects blind people. Typically, half of blind people have that condition. There are conditions that affect the regularity of sleep, so an irregular sleep-wake pattern that might occur more in folks with maybe an advanced dementia. So, there are populations where these conditions can be fairly common, but among the general population, that night owl tendency is by far the most common.  Dr Grouse: That's really helpful. And just taking a step back, why is insomnia bad for us? So, we worry about this in our patients. We know it can make neurologic issues worse. But in general, like, what are the reasons that having poor sleep can affect our health? Dr Peters-Mathews: Yeah, and it's not enough hours, certainly quantity, but also quality of sleep that matters. And I tell people that sleep is a pillar of health, just like nutrition and exercise. It's the other main contributor to our health and well-being. And so, it has its fingers in almost every aspect of our health. Insomnia on its own is a risk factor for other psychiatric conditions, including depression, anxiety, even disorders like bipolar and schizophrenia. Folks with insomnia are more likely to have alcohol or drug abuse issues and are at higher risk for things like chronic pain, suicide and, and social and occupational dysfunction. So, it's a disorder that has a really profound effect on how someone functions during the day, and again, may take a toll on their health over time.  Dr Grouse: That makes sense, and I would assume that there are certain populations within our neurology practices where we should really be attuned to the risk of insomnia. Are there specific populations you'd recommend really make it a habit of screening for insomnia?  Dr Peters-Mathews: I was joking with someone recently that anyone with a neurological nervous system can have issues, impacted by poor sleep. There are certain groups, so chronic headache patients are perhaps one that might warrant a further evaluation and management. Folks with multiple sclerosis or Parkinson's may have physical conditions that lead to more discomfort in sleep, fewer movements of their body in sleep, issues around nocturia that would disturb their sleep. Certainly, those with dementia, Alzheimer's disease and other dementias. Parkinson's and Lewy body dementia overlap a lot, as does multiple system atrophy. That can point us towards other conditions like REM sleep behavior disorder, but also insomnia can be an important feature of those disorders as well. And then folks with stroke often have disturbance to their sleep and may develop insomnia after experiencing a stroke. So those are specific populations where I think the yield is high to be looking for insomnia and other sleep disorders.  Dr Grouse: Yeah, that makes sense. I think a lot of us think of insomnia as almost like, make sure we're not missing this as sort of a mimic of the problem, when in fact it's probably just more part and parcel of the problem and something we need to be thinking about treating as part of their disorder. So helpful to think about it in that light, at least in my own mind. Now, I want to get a little bit back to some of the therapies you've recommended, and I think first just stopping again at sleep hygiene. Your article has a really great list, I think, of sort of like a checklist of actions that people should be taking to make sure that they are managing their sleep hygiene well. And I definitely recommend our listeners look to that. How often do you think that focusing on sleep hygiene helps when you get a patient who says, "Hey, I have got terrible sleep. You know, what do I do?"  Dr Peters-Mathews: It's pretty common for people to have access to this information through their own reading online, and most folks have worked through this by the time they've come to see me, and often a primary care provider or specialist may have given some of this guidance as well. It's pretty rare for them to not recognize something as obvious as having caffeine too late in the day by the time they're coming to my attention. The sleep hygiene generally is used as a control when we do research to look at how something like medication is working or CBT-I might be working. It's the comparative control. It's almost like the null intervention. So, it's not highly effective, and if folks are not finding it helpful, they've made those adjustments to their sleep environment or their habits, and they're continuing to have issues, there's typically more that needs to be done, and that's where CBT-I really comes in as a strong intervention for those people.  Dr Grouse: And then getting on the topic of CBT-I, so helpful. I'm really glad that your article spent a lot of time talking about it as really a truly high-yield, great intervention for insomnia. And I really felt that the question shouldn't be: When is cognitive behavior therapy for insomnia helpful? But like, when isn't it helpful? What are your thoughts about that?  Dr Peters-Mathews: Yeah. I always point out that the American College of Physicians has recommended CBT-I for adult patients as the initial treatment for chronic insomnia even before the use of a medication for nearly ten years. That recommendation came out in July of 2016. So, there are folks who may not be good candidates for it, who may be screened out because of other conditions that they have, and there certainly are folks who don't do as well with CBT-I. And adherence is important. Somebody needs to be able to follow the instructions and apply that to their lives. And certainly, there are a number of things that could interfere with that compliance. I would say untreated anxiety and pain are two things that often trip people up. It's like running a race with a broken leg. Despite their best efforts, if those are not addressed, they will continue to have issues around insomnia. And then one thing that often is unrecognized and may be missed is untreated sleep apnea. That is a common contributor to a chronic insomnia, especially in older folks, women beyond the age of menopause and men even starting in middle age, thirties and forties. We don't want to miss sleep apnea. Even insomnia that's, "I can't fall asleep at the beginning of night," that could still be sleep apnea, so that's something I really emphasize with my patients.  Dr Grouse: Really great reminder about sleep apnea for sure. Something that always is beneficial to make sure we are not missing. Oftentimes I'll bring up a CBT for insomnia, and what is that? Like, what would we actually do, and what is a high-level overview of what happens with CBT-I?  Dr Peters-Mathews: Yeah. So, I generally tell my patients that this is a six-week program. It's a structured program, almost like a boot camp for sleep, in which we are addressing underlying causes, recognizing what those are and, and working through those underlying causes. There is often tracking using a sleep log or sometimes wearable data.To guide decisions that are made in the program. It's very goal-directed, science-based therapy. We often introduce concepts around sleep drive, circadian rhythm dealing with a busy mind at night. There's concepts of mindfulness and relaxation training that are introduced. People often are able to taper or stop using sleeping pills as part of this therapy. And the nice thing is they walk away with a set of skills that they can apply the rest of their lives to sleep more normally. And so, there's good research that suggests even years after someone's completed a CBT-I course, they continue to sleep more normally. They have the tools that they need to sleep better even years beyond that education.  Dr Grouse: You know, this just sounds so great. It almost sounds like why wouldn't someone benefit from this? But of course, like I would imagine many institutions experience, I've definitely run into difficulties with access for my patients for CBT-I, and we have long wait lists. And I imagine there's many places where there just aren't even any specialists that patients can get to, to help with this. What are the resources that our listeners can take advantage of for their patients to get access to these types of therapies?  Dr Peters-Mathews: So, one thing I tried to really emphasize in the article is that there are resources that can be drawn in. I'll give you some examples. So, at our institution, we have three sleep specialists, full-time sleep specialists, who trained at Stanford to become CBT-I specialists, and so we have more resources than probably most institutions would have. We do shared medical appointment workshops so that we can manage the number of patients that we have to see. And, and unfortunately, not everybody has that opportunity. You might plug into resources in your community, and one of the resources I point to in the article is the International Directory that's managed by the University of Pennsylvania that has eight hundred and seventy-five CBT-I specialists listed with contact information, et cetera. And I think that's an amazing opportunity to access this therapy. Unfortunately, there are countries and certainly states that do not have a specialist, that there's no one in the state that provides this therapy. And then we need to extend other resources, and that could be online treatment programs that can be done independently, bibliotherapy, so accessing books that could guide people through the therapy, even accessing other apps and maybe even wearables that pair with an app that could provide some of this guidance. The Veterans Administration worked with Stanford and worked with the National Center for PTSD and developed an app called CBT-I Coach that is free and can be downloaded and, and gives, I think, good education, good guidance. So, there are resources that exist. It's somewhat finding what might work for your individual patient, how they're preferring to access this or their learning preferences. Do they want to read a book or not? And getting them into the right pathway.  Dr Grouse: And I think that gets me into a whole other Pandora's box of the fact that they're already out there in the world are tons of different apps, wearable devices, all sorts of things that promise that they can help us with sleep, some that may have more, I think, data and evidence behind them than others. Do any of these apps or wearables in your mind show promise in our patients helping our patients track and diagnose and manage their insomnia?  Dr Peters-Mathews: Yeah, there's a lot out there, and unfortunately, some of these devices actually can make sleep worse. People can develop a condition called orthosomnia or straight sleep, where they're trying to perfect their sleep and their sleep numbers, their metrics, and the wearables feeding them data that they continue to try to improve upon. And that fixation on those metrics can actually make their sleep quite a bit worse. A lot of these wearables and apps and other resources have not been well-studied. There's not research trials showing outcomes comparing to other standards of care. I would say the basic guidance of CBT-I, which many of these programs are based on, I think will be helpful to the majority of folks who are able to engage and complete that education. A lot of these are not dependent on that sort of framework or structure so that we may not actually be using the standards of CBT-I to try to improve sleep. They may be connecting you with other resources, like listen to this sleep story or this relaxation file or do some meditation, et cetera, which again, may be of some benefit, but it is not the same as a structured CBT-I experience. So, I think there are a few good resources that we highlight within the article, and I think there are probably others coming that may give individuals a more individualized, directed approach to managing their sleep issues. But it's almost like going to the App Store and there's thousands of apps. It's hard to know which one might be most based on science or the most beneficial to that individual.  Dr Grouse: Well, I really appreciate in your article that you did have a great list of apps and things along those lines to try, so I do encourage our listeners to check that out as well. Some really, really great resources there in the article in many different areas. Now, I wanted to turn the conversation to a slightly different thing, which is medications for insomnia. Now, when are medications appropriate for treating insomnia? When should we be thinking about turning to these for our patients?  Dr Peters-Mathews: So again, we would suggest that CBT-I would be first, and that failing improvement with CBT-I, that medications would be extended to a person affected by insomnia. And over-the-counter options as well as prescription medications might be used. Unfortunately, that's not how things unfold in the real world. Many people are jumping to medications first, whether that be an over-the-counter supplement or other medication, or they're seeing primary care and other specialists who's providing them a prescription for sleep aid. So there's data from the CDC going back to twenty twenty that suggests that about six point three percent of adults were taking a sleeping medication every day in the months prior to the survey. And women who were older than sixty five, white women, were more likely to be using a sleeping medication every day. That number was 13.5 percent of those surveyed. So, lots of folks are on medications, and certainly melatonin is widely used. Unfortunately, it's not regulated by the FDA in a sense that we don't have exact concentrations controlled. So, people can take melatonin that has no melatonin in it. They might take melatonin that's forty or more times the dose. There's variance within lots from the same manufacturer. There's a lot of trouble knowing exactly what you're getting when you try to take something like melatonin over the counter. Other sleep aids that we might reach to over the counter, like variants of diphenhydramine or doxylamine, and these are often the PM drugs that we think about. They have risks associated with population-based studies which suggest risk of dementia, risk of falling, risk of mortality with these drugs, especially in older populations. So again, that would give us potentially pause. The prescription medications that we go to, there are some that the American Academy of Sleep Medicine would recommend as more beneficial than harmful, and some are good for both initiating and maintaining sleep. Some have such a short half-life that they're really best as initiation drugs. And then others are better for maintenance of sleep, so reducing awakenings and wakefulness in the night. My own individual take, often people are coming to me on medications, typically over the counter, but often prescriptions, and have even tried and failed many of those medications before they finally come to see a specialist. And so, I don't often reach to medications until I've exhausted CBT-I, until we've completed a sleep test to make sure we're not missing something like sleep apnea, until we've ruled out some other potential contributing causes. But there are patients I have who really will not sleep without medication support and sometimes even multiple medications that work in complementary ways to try to normalize their sleep. And so, in some cases it is necessary, but it is not meant to be a first line for anyone.  Dr Grouse: Yeah, and I think all of our listeners can relate to the fact that we often see patients who've been on sleep medicines for many, many years and take them every night. It's good to know that there is sort of a procedure here to consider and perhaps again, back to the plug to CBT-I as being the right starting point to see if there's some that we can help get off of these meds, although, as you mentioned, maybe not always going to be successful. Well, I really appreciate our conversation about this. It's been really great to read this article about insomnia. Again, I encourage our listeners to check it out. Some really great resources for many different therapies, thinking about other alternative diagnoses and different medical conditions where insomnia really needs to be considered. And I really appreciate you writing this article. It's been a pleasure to talk with you today.  Dr Peters-Mathews: It's my pleasure to share this information with folks, and I hope that you find it useful in your clinical practice or even your personal life as the need arises.  Dr Grouse: Again today, I've been interviewing Dr. Brandon Peters-Mathews about his article on insomnia. This article appears in the August 2026 Continuum issue on Neurology of Sleep. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today.  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. 

Update Series (2026): Evaluating Abnormal Urine Cytology Without Clinically Demonstrable Urinary Tract Disease Host: Mark L. Gonzalgo, MD, PhD, MBA Guest: Sherri M. Donat, MD Now in its 45th installment, the AUA Update Series is renowned for delivering high-quality lessons to practicing urologists, fellows and residents. All content is developed by internationally recognized experts in urology, making the AUA Update Series the most professional and sought-after self-study program available. Improve your practice and patient care by staying abreast of the latest treatments and surgical techniques in urology. For more information or to subscribe to the AUA Update Series, please visit CME.auanet.org

0:30 - Jeanne Ives & Jim Iuorio filling in for Dan 14:16 - Flock Camera Rebellion 32:59 - State Rep for district 101 Chris Miller on the estate tax, the Farmers Bureau, and the embarrassing ineptness in Springfield. For more on Chris’ work for district 101 repcmiller.com 49:14 - Jeff Carter, former CME board member and co-founder of West Loop Ventures, on leaving Illinois for Nevada and how Idiocy Reigns in Chicago. Check out Jeff’s substack Points And Figures 01:09:48 - Elk Grove Village Mayor Craig Johnson separates fact from fiction amid the hysteria surrounding data centers. For more on Mayor Johnson and EGV elkgrove.org 01:27:12 - Wirepoints founder Mark Glennon warns Chicago's lack of growth is dragging the city down and it may already be too late to turn things around. 01:43:01 - FAIR Director of Strategic Communications Brian Lonergan exposes what he calls a calculated betrayal of America's working families and asks, "Who is this system really serving?" Brian is also co-host of the “No Border, No Country” podcast 01:58:55 - Former United States Deputy Undersecretary of Defense & contributor to the Washington Times, Jed Babbin: Trump Must Choose Between Victory and Defeat. Follow Jed on X @jedbabbinSee omnystudio.com/listener for privacy information.

North Michigan Avenue's recovery is gaining momentum with a drop in vacancy and infusions of capital. Crain's commercial real estate reporter Rachel Herzog joins host Amy Guth to discuss. Plus: State Farm sued by L.A. County for delays and denials to fire victims, UChicago and U of I land $75 million in federal funding for quantum research, Kalshi goes after the big traders on CME and Cboe's home turf and Deere launches AI assistant named JD to guide farmers' choices. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Featuring an interview with Prof Ticiana Leal, including the following topics: Pathophysiology and clinical signs and symptoms (0:00) Screening and/or diagnostic approaches (5:45) Potential impact of available therapies for small cell lung cancer (SCLC) on paraneoplastic syndromes (7:36) Key clinical trial data for amifampridine and practicalities of its administration (14:05) Building awareness among patients, caregivers and the oncology community (22:37) Role of pyridostigmine in managing Lambert-Eaton myasthenic syndrome (LEMS); potential integration of EMG (electromyography) into monitoring (25:35) Case: A man in his early 70s who receives a diagnosis of limited-stage SCLC (LS-SCLC) with LEMS and undergoes treatment (27:41) Case: A woman in her late 70s already diagnosed with LS-SCLC who is subsequently evaluated and treated for LEMS (37:55) Current research and potential developments in the treatment of SCLC (48:32) CME information and select publications

Description: Featuring a slide presentation and related discussion from Prof Ticiana Leal, including the following topics: ·      Incidence, pathophysiology and clinical presentation (0:00) ·      Diagnostic challenges and evaluation process (3:37) ·      Treatment modalities and therapeutic options (10:01) ·      Mechanistic effects and key clinical trial data for amifampridine (12:20) ·      Key takeaways and conclusions (17:32) CME information and select publications

Send us Fan MailTechnology is transforming healthcare at an incredible pace—but for independent physician practices, it can also become one of the biggest financial risks. Every week brings another vendor promising to solve your problems with the latest AI platform, workflow tool, or revenue cycle solution. How do you know what's worth your investment—and what's simply the next bright, shiny object?In this episode of Medical Money Matters, I sit down with Corey Pearson, Founder of Pearsonable Health Network, to discuss why physicians need more than technology—they need a trusted network of advisors.Corey shares why the most successful practices don't make important technology decisions alone. Instead, they build a "board of trusted advisors" who provide objective guidance, help evaluate opportunities, and ensure technology investments align with the practice's long-term goals—not just the latest sales pitch. With more than 15 years of experience helping healthcare organizations navigate technology, partnerships, and operational challenges, Corey offers practical advice for making smarter business decisions while protecting your bottom line. Corey is the Founder of Pearsonable Health Network, a healthcare advisory firm that connects independent medical practices with carefully vetted healthcare experts and technology partners. His mission is to help practices navigate complex business and technology decisions through trusted relationships, objective guidance, and proven results—not sales pressure. YOu can connect with Corey here:

Featuring perspectives from Mr Michael Lai, Dr Scott T Tagawa, Ms Stacy E Walker and Dr Evan Y Yu, moderated by Dr Tagawa, including the following topics: Introduction (0:00) Overview of Prostate Cancer (3:00) Hormonal Therapy for Nonmetastatic and Metastatic Hormone-Sensitive Prostate Cancer (HSPC) (6:12) Potential Role of Capivasertib in Metastatic HSPC (27:22) Current and Potential Future Role of PARP Inhibitors in Metastatic PC (46:39) Current and Future Role of Lutetium Lu 177 Vipivotide Tetraxetan for Patients with Metastatic PC (1:09:14) CME information and select publications

Franklyn Wang, founder and CEO of Liquid, joins us on profit-maxxing with perps and why on-chain derivatives keep taking share. We get into why CME is losing its mind over Hyperliquid, how a legacy monopoly reacts when permissionless venues start listing markets faster than it can, and where Coinbase fits as centralized exchanges try to compete with DEX perps. Plus a live demo trading the CLARITY Act ahead of the September 15 Senate vote.~This episode is sponsored by Tangem~Tangem ➜ https://bit.ly/TangemPBNUse Code: "PBN" for Additional Discounts!Guest: Franklyn Wang, CEO Liquid TradingStart Trading & Connect You're A.I. To Liquid ➜ https://bit.ly/LiquidTradingAI00:00 Intro00:10 Sponsor: Tangem00:50 Liquid growth since launch01:30 What is Liquid?05:15 Coinbase A.I. to trade?06:30 Co-Invest not trading meme coins07:50 Is A.I. calling a crypto bottom?08:20 How will A.I. trade CLARITY act passing vs failing?09:45 CLARITY Token to trade = unknown11:00 CFTC on spicy CFTC brawl12:30 Terry Duffy also wants to ban over 5X leverage13:10 Trump bringing Hyperliquid to U.S.14:00 A.I. IPO season16:00 How long until TradFi uses Liquid?16:45 Should $HYPE be worried about marketshare?18:00  A.I. Chips hype vs Crypto18:45 Should investors diversify right now?20:45 Local compute vs centralized giants21:20 We called $ARROW: will Liquid be using robinhood chain?#Crypto #Ethereum #ai ~How To Maximize Gains With A.I. Trading Perps

Nonfat rallied nearly 30 cents in about 15 days. Can that rally can hold? WPC80 is showing its first real signs of softness in a while. Is it a seasonal slowdown or a sign? And milk proteins are still finding support. Will demand stay strong as new products come online, or will the economy finally put a lid on protein? In episode 105 of The Milk Check, host Ted Jacoby III and the T.C. Jacoby & Co. team focus on two of the busiest corners of the dairy market right now: nonfat and protein. In this episode, we cover: Why low inventories could keep powder markets volatile How exports, Mexico and production interruptions contributed to the move How the price gap between whey and milk proteins is encouraging reformulation What consumer spending, GLP-1 use and alternative proteins, and the economy could mean for dairy protein demand But this is still a market with plenty of unanswered questions. Listen as the team at T.C. Jacoby & Co. shares their view and outlook on what's coming and why. Listen to The Milk Check episode 105: Powder pops. WPC 80 slips. Dairy proteins defy gravity. Also available on: Amazon Music, Apple Podcasts, Spotify, and YouTube. Got questions? We'd love to hear them. Submit below, and we might answer it on the show. Ask The Milk Check Transcript: Ted Jacoby III: [00:00:00] Coming up on the Milk Check. Diego Carvallo: We’ve had a 28 or 30 cent nonfat rally in a matter of about 15 days that caught a lot of people by surprise. Ted Jacoby III: Welcome to the Milk Check from T.C. Jacoby & Co., your complete guide to dairy markets, from the milking parlor to the supermarket shelf. I’m Ted Jacoby. Let’s dive in. Ted Jacoby III: We are going to have a very focused market discussion. We’re recording this on August 24th, and the reality is, so far in the milk side of the business, things have been relatively underwhelming. We’re expecting milk to tighten up. It has, but only in a very normal way, so nothing huge to talk about. Cheese has been a non-event. The cheese market is very quiet right now. We’re expecting it to stay quiet. But there’s been a lot going on in nonfat and a lot going on in protein. So we’re gonna focus on nonfat and protein today. Diego, let’s go ahead and get started on nonfat. What’s been going on in the nonfat market, and what do you think is gonna happen next? Diego Carvallo: It’s been a very interesting market, Ted. We’ve had a 28 or 30 cent nonfat rally in a matter of about 15 days that caught a lot of people by surprise. We went from about $1.45 per pound to $1.75. And now we’re slightly below that. We’re close to the 1.70, but the CME spot market has remained at a premium. I think what led to this rally were a couple of things. One is when we got to 1.45, we became very competitive for skim milk powder. And we know for a fact that a few of the large producers in the U.S. made very interesting sales for exports after having exported very little for this year so far. That helped manufacturers and the whole market, find some sort of psychological support to prices. And then, at the same time, we noticed how several of the manufacturers were in a relatively good spot when it comes to sales for August and September. They were not having burdensom inventories, and they were pretty proud with their offers. So I think the whole market realized that Mexico still had a few shorts that they needed to cover. We made some international exports after not exporting for a while, so I think the whole market found some support and it rallied quite a bit. I was also surprised to see that rally. I think we got to the $1.75 and we started seeing pushback from Mexico. We started not being competitive in international markets again. And I wouldn’t be surprised if we see a correction in the coming days. At the same time, there are some rumors and also facts of production interruptions by some manufacturers. That also got people nervous, and I think that also contributed to the market rally. Ted Jacoby III: What do you mean by production interruptions? Diego Carvallo: There’s news that have gone around about some plants having recalls and some also production issues that have delayed [00:03:00] their releases. That added to a market that was nervous already. Ted Jacoby III: So, basically, a supply chain that has been relatively low on inventory to begin with, any kind of potential supply disruption such as another FDA recall or something that at least holds that product for a little while, the market’s just pretty sensitive to that, and that’s causing this extra volatility. Diego Carvallo: Exactly. Yep. Ted Jacoby III: Jake, what has this volatility been doing to the hedgability of our nonfat market? Jacob Menge: We’ve seen pretty poor CME NDPSR correlation compared to history. I don’t know if poor correlation is the word, but if you’re in short-term hedges you have a coin flip here of how well that hedge is gonna work for you. But in general the market’s actually been pricing in lower volatility than what we have actually realized. That’s over a multi-month period. So there might be a week where you are along for the ride of a really sharp move one way or the other. But in general I would say it’s been fairly functional, the market has. Weird low volume in some of this volatility. I think that’s probably the one note is you’ll have really volatile markets like this. I would have expected better volume like we saw with our crazy run-up in February, March, whenever that was. Ted Jacoby III: What do you read into the low volume? Jacob Menge: Yeah, I don’t know. They’re numb to it now, after what everybody experienced in March, a quick little, 15, 20 cent pop doesn’t scratch the itch anymore. The market probably was a little bit better covered than they were back in February, March. So, even though the pop happened, more participants could sit on the sideline without panicking yet. Now, if we continue at these prices for another month or something like that, there’s gonna have to be more buyers, and I would imagine that leads to some more participation. Ted Jacoby III: Diego, how do you see this market playing out over the next three to six months? Do you think the volatility comes out of the market, or do you think we’re on this rollercoaster and we still gotta stay buckled up? Diego Carvallo: I think we’re gonna still have volatility, Ted. And the main reason is Europe, which is a significant player for the SMP market has gone through very bad weather. It’s gotten very hot. Solids in the milk are going down, and for that reason the cheese plants are having to use more milk. So, there’s fewer volumes of liquid milk hitting the dryer at a period where we have little inventories in Europe, so I think that’s gonna contribute to high volatility. And the same scenario can be said of the U.S. We don’t have much inventory. The manufacturers are sitting in a good spot in terms of availability. They do not have too much pressure to sell. So, any type of disruption to supply chains, production, or any pickup in demand, it’s gonna result in big swings, both ways, not only up. Josh White: I think that our seasonality has shifted. We’re already hearing rumblings that there’s some Ramadan buying beginning [00:06:00] to happen. That’s business not too many years ago didn’t happen until the first quarter. That helped create a outlet to clean your inventories before the heavy seasonal production for Europe and the U.S. Now, that business is trying to get in front of Christmas business and Chinese New Year business, and it’s coming at the worst time, when the U.S. is in a short squeeze, Europe is going through a heat wave, New Zealand’s not yet completely online, and it’s keeping things tight. My personal opinion is that we’re drowning in nonfat within the first quarter. We don’t have anywhere to go with it. This whole phenomenon’s been set up that we’ve been selling nonfat domestically somewhere that used to take skim solids. Somewhere in the margins, people are buying powder that usually interchange between powder or cheap skim, that it may have been buying skim more recently. Right now is the tightest time ever to be selling UF products, yet everyone’s responding with incremental UF production at the same time that everyone’s launching more UF competitive products. That’s gonna be saturated at the exact same time we don’t have anywhere to go with powder. Q1 looks ugly to me from a skim solid standpoint. Ramadan is like the second week of February or slightly before, which means that Chinese New Year, they’re within a few weeks of each other. Last year they were already bumping into each other, but there was plenty of inventory. Don Street: You get through October, typically we would say U.S. Christmas demand, certainly for nonfat, is filled at that point because you’re manufacturing things, cookies, crackers, whatever, and that would also be your lead time to ship. So, you could even see, if you’re right, this convergence to the downside in November, December, even before Q1. Josh White: I think markets have been really smart, too. Whenever we find the points at which we think it happens, it seems like the market’s anticipating, and we’ve been trading anticipatory markets, and it’s moving a little bit in advance of that. This sounds really smart until you realize you’re already in it. I think we are already in it, and that’s created a little bit of the bump that we’ve seen right now as everyone’s trying to get in front of short covering. Every sell-off I think is gonna be met With buying for the next month or so. Ted Jacoby III: Everybody, we will be right back after these messages. Diego Carvallo: I’m Diego Carballo with T.C. Jacoby & Co. T.C. Jacoby & Co. specializes in international dairy markets. For new customers that haven’t done business with Jacoby, I would tell them that we can provide them with many of the powders, dairy products that they consume, not only with the physical product, but we can also help them mitigate their risk. We know dairy. We know the main players. We know the main providers for the whole value chain. We are one of the strongest players in the U.S. market because we have contact all the way from the farmer moving the liquid milk all the way to the end users that buy the end products. I am [00:09:00] Diego Carballo with T.C. Jacoby & Co., and we bring dairy to the world. Ted Jacoby III: We’re gonna come back to nonfat in a second, but I’m gonna switch over to protein and ask Josh what he’s seeing in the protein market, and then we’re gonna talk about if there’s any relationship between the two. Josh, what’s going on in protein, whey proteins, milk proteins? Has this market changed at all, or are we still on the bullish ride? Josh White: I’m not really ready to call a change in the long-term trend, but the market has softened, particularly for WPC80 over the past few weeks. What’s difficult to read, is this the product of the summer holiday season and just a little bit of a Q3 slowdown in B2B buyer activity and are things fine on the consumer end? Ted, it’s a tough-to-read market at the moment, but I would say over the last several weeks to a month, we’ve definitely seen more availability for products like WPC80 in the market, and the market’s really trying to digest that. After many quarters of higher pricing than the prior quarter, we’re now in a spot where if you’re out there looking for an extra load or two, you might be able to achieve it at a price better than you did in the prior quarter or where your quarterly contracts are. It’s the first time we’ve experienced that in a while. I don’t know that I’m ready to call that the end of the long-term uptrend in dairy protein, in particular whey protein, but it certainly feels like we could retrace a bit. Let’s take a peek at one or two variables that could be contributing to this. One is just the seasonality of it. We’re coming out of the summer holiday season. A lot of buyers, particularly in the B2B transactions, have been away from their desks on their summer holidays and are now starting to return to the desk and take an assessment of how their supply chain and inventory situation looks. I don’t think that’s limited just to protein. We’re seeing that across all of our dairy commodities. And over the last seven to 10 days, some of the activity with customers has picked up a bit. Secondly, we’ve priced ourselves out of the international market, or at least the European pricing and the U.S. pricing has achieved levels that have slowed down the international appetite. And as a result, we’ve seen that reflected in our export numbers. Does that create enough incremental and additional volume for the U.S. consumer that puts us in a spot where there’s extra product available? And maybe we will see a little bit more of an aggressive offer to try to clear some incremental volume that was leaving for an international buyer previously. Or have we actually tested a point where the consumer products have to increase their prices and the consumers are going to push back or are starting to push back? Anecdotally, talking to the people that are more more retail end-user-facing, it feels like their demand’s fine. It feels like they are expecting promotion activity for the fourth quarter. They’re not indicating any type of slowdown. We’ll see after a month or two where this thing settles out, but it feels like a few more incremental offers than it does customers pushing back. But I don’t know that every manufacturer out there would [00:12:00] describe that the same. The market’s a bit confused right now. Ted Jacoby III: Do you think that there’s been any changes on the supply side? Josh White: No, not substantial changes on the supply side. I don’t. Ted Jacoby III: So we might just be in that point where everybody’s looking at their inventories, right-sizing their inventories. If they have a few extra loads, they slow down their buying a little bit, but they’re gonna wait for the fall orders, which tend to be heavier than the rest of the year, to come through to see whether they need to do any more adjustments or if they’re good to go forward. Josh White: There’s like a poker hand of possibilities right now. You know, on the one hand, we’ve seen more product launches and new product introductions outside of the traditional health and wellness or sports nutrition space than we’ve ever seen before. Has that created a vacuum effect, and has that overstated demand a bit? Some of those products might win, some of those products might lose, but ultimately, to launch them, you have to produce them, and that creates a pipeline fill and a vacuum effect. Has that overstated demand? Am I right that we were just in a summer slowdown and people may have depleted their working inventories a bit, and we’ll see reorders happen over the next month or two? Did we kill enough international demand to saturate the U.S. consumer and the U.S. market? Did we see enough incremental production that outperformed against forecasts? We just had the July milk production report released. In June, numbers were revised higher. We’ve got plenty of milk. I think most of us would’ve argued that July should’ve been a bit slow given all the heat we experienced in Middle America, yet we reported year-over-year milk production growth against very, very strong comparables. Did we outperform our production expectations? Or has the consumer finally started to push back? And I really don’t know the answer to that, and I imagine it’s a combination of all of them. We’ll just see as we go into the fourth quarter what that means. The price responsiveness to some of these signals is going to change. A larger percentage of this dairy protein, and whey protein in particular, is being used in applications that are relatively new to our demand profile. We’re seeing it added as an ingredient in snack foods and as an ingredient in food manufacturing-type products. That’s something that trades much differently than the quarterly priced sports nutrition market. To digest exactly how shifts on the CPG level might reflect in what the current S&D situation feels like, that’s uncharted territory for us in a lot of ways. Ted Jacoby III: You mentioned WPC 80. Has whey protein isolate been weakening in the same way? Josh White: No, WPI has been well-reported to be pretty stable. I don’t believe that’s going to change in the short run. I really think the higher you go in terms of the value of the product at the moment, the more specialized and ingredient-based it is. And it feels like the majority of the WPI is graduating into an area that has much less price elasticity than the traditional WPC80 products. So, at the moment, it’s held fairly strong. We haven’t experienced any major production shifts in WPI for over a quarter. And as [00:15:00] long as we don’t test the consumer’s price tolerance anytime soon, it sure feels like they’re gonna hang in there and continue to buy the product and prices will remain firm. Ted Jacoby III: What about milk proteins? Have we seen any slowdown on the milk protein side or has that demand stayed strong as well? Diego Carvallo: It stayed strong, Ted. We’re actually seeing growing demand of companies and projects switching from WPC80 to MPC80, 85, and 90. There’s a greater amount of new projects asking us for samples on MPCs than WPCs. What we have seen is that whenever nonfat moved from let’s say $2 to $1.45, the price of MPC also moved lower by a smaller degree, but it still moved a little bit lower because the manufacturers had the wiggle room to make their offers a little bit more competitive. Ted Jacoby III: So, in the whey protein markets, one of the things we’re anticipating and we’re already starting to see is that for those annual contracts, the multipliers are probably gonna go up relative to the whey market, probably quite significantly. Are we seeing the same thing in the MPC market as well? Diego Carvallo: Yes. The multiple has strengthened. MPC 85, as a reference, it usually traded for many years at, let’s say, two and a half plus a premium of 70 cents, 60 cents, and I think it’s now closer to three times nonfat plus maybe another 75, maybe 80 cents. It’s definitely strengthening. Ted Jacoby III: Further production of whey protein is restricted by additional cheese capacity. So, unless we’re gonna build another big cheese plant, we may not be able to create much more whey protein production, at least here in the U.S. Whereas with milk proteins, it’s easier and cheaper to switch over, let’s say, a nonfat plant and make it a milk protein plant. So, increasing that capacity is gonna be a lot easier. How’s that gonna play out? Do you think that MPC multiples will stay strong even as we see added MPC production? Diego Carvallo: I agree that there’s gonna be more supply, but I think demand is gonna be higher than the additional supply that we’re seeing, at least for the coming two to three years. I think multiples are gonna be long-term stronger than they are right now. Josh White: I take the other side in this particular instance. The UF side has a different demand profile than the dry product side with the RTD movement and so many launches and so much interest in ultra-filtrated liquid products. That creates opportunity for the market to find some imbalances, and for the milk protein side to feel more commoditized seasonally. You’ve got a tremendous buyer in the cheese side that can step in and take solids and well support the multiple when it makes economical sense. But the profile for making UF or MPCs, relative to traditional nonfat and skim, could result [00:18:00] in more drying seasonally of MPCs that could make that basis a bit more volatile than what we’ve experienced in the past. Ted Jacoby III: I’m anticipating that protein demand stays strong and maybe even continues to grow internationally. The demand for milk proteins will continue to go up because it’ll be slower to see whey protein production go up than these demand increases. So, I’m splitting the difference between the two of you guys. I do think that we will switch over nonfat production to MPC production in various plants throughout the country, but I also agree with Diego. The demand is gonna be there. There’s going to be a lot of new products that wanna be able to say, “Hey, we have 30 grams of protein in our product, too.” But they can’t really make it cost-effective on the whey side, so they’re gonna do it on the milk protein side. That’ll keep things strong. But the pressure’s gonna be there. Jake, do you have any thoughts? Jacob Menge: None. Outside my Area of expertise. Ted Jacoby III: Thanks. You’re a big help. Jacob Menge: I’m just being honest. Ted Jacoby III: Tristan, do you have any thoughts? Tristan Suellentrop: Yes. At what point does MPC get expensive enough that you lose the substitution advantage over WP80? Ted Jacoby III: Josh, I think you’re the one who needs to answer it. Tristan Suellentrop: It’s a hard question. Josh White: The simple math is the per unit protein value. We would start there. They’re relatively similar from a total protein value. WPC80 market is trading between $12 and $13 a pound, and you’re about half that for your MPC 85. They are not the same product. They have different functionality characteristics and different nutritional profiles. Similar in many applications, but different in many ways, which means when you rank the highest valued application for your whey proteins to the most competitive value for the whey proteins, the MPCs would need to compete in the final tranche of your traditional WPC consumer tier. It means that MPCs do not need to achieve WPC pricing to start to get pushback. The pushback begins long before it achieves parity. The MPC market has the opportunity to balance itself much differently. The MPC can toggle between a dry product and a liquid product, depending on where that demand pull is. And right now the real growth in the dairy category and the superstar as of late has been the ultrafiltrated products. I think that most households have some version of this in their refrigerator now. It’s a growing category, but it’s also becoming a highly competitive market. You’re gonna see some volatility. I think to Diego’s point, we are seeing some CPG applications and some sports nutrition applications reformulating where they can, but not on a one-for-one basis. They’re adding it as an additional ingredient or increasing the inclusion rate of the milk proteins relative to the whey proteins, but they’re not one-for-one interchangeable.  We can afford to see MPCs go up several dollars a pound or WPCs come down several dollars a pound without eliminating the advantage to explore reformulation in MPCs for those that can use it. Ted Jacoby III: Mike, do you have any thoughts? Mike Brown: I just came back from Interstate [00:21:00] Milk Processors meeting. Lots of talk between the whey guys and the MPC guys on demands and expectation for further substitution of WPCs with MPCs where it can happen. There’s places that really works. There’s places it doesn’t work quite so well, particularly in some beverages. As long as there’s a cost advantage, we’ll see it. It’s already happening in some of the protein ice creams, for example. Ted Jacoby III: So, what’s the prognosis when it comes to proteins? Demand stays strong, but we continue to produce more concentrated proteins, at least on the milk side? How is it all gonna play out from a price perspective, let’s say in the next six months? Josh, it sounds like your thoughts are: we’re steady as she goes. We’ve maybe reached a point where we’re range-bound rather than just ratcheting higher? Josh White: I think you just walked me into a trap that is absolutely gonna blow up in about six or nine months when this podcast is still being played. But right now, the story is over the next six months, I believe we will see lower whey protein pricing. Over the next six months, I’m not 100% convinced, but I would still call the milk proteins as bullish. What we need to decide then, was that a retracement? Was that a pullback in price? And with enough time, the consumer’s going to respond? Or are we in an unhealthier macroeconomic environment than any of us expected, and will that influence the dairy proteins or not? We seem to have come out of the summer holiday, and people were spending. Now, I get anecdotal reports that the spending is slowing. People are running out of money, the disposable income is not readily there, and at the same time, we’ve achieved unbelievable price increases in dairy proteins overall, and particular whey proteins. Does that at some moment come to a head? Ted Jacoby III: I’ll go ahead and stick my neck out a little bit on this one. So, one of the reasons that I think proteins, and whey proteins in particular, have stayed strong even as our macroeconomy has weakened but not fallen apart, is the way I’d call it, is because the way that most of the population seems to be dealing with this inflationary environment that is causing their spending to be restricted is to cut back on their restaurant visits. They’re just spending less when they go out. And the majority of increasing whey protein demand that I’ve seen seems to be happening more on the retail side. Meaning, it’s happening in their stay-at-home consumption rather than their restaurant-going consumption, and that has helped keep that market strong. If we start to see retail demand weaken because the economy gets even weaker, then I think we’ll start to see whey protein demand weaken with it. Jacob Menge: The implication is actually equally as interesting that if the economy gets better, you would argue that also impacts whey protein demand. You don’t go to a restaurant and order a protein shake. Ted Jacoby III: So, the possibility exists that if the economy strengthens, we’ll also see a weakening in dairy protein demand because the meat protein demand would go up, but dairy protein demand could drop. Assuming [00:24:00] that the increase is a per capita increase rather than a total increase. Mike Brown: I think the elasticity for the proteins is very low. Consumer demand’s gonna remain relatively consistent. It’s purchased for a different reason. Again, back from the conference I just came from, there was a marketing person who said in GLP households, calorie count of purchases are down 30%, cost is down only 1%. So, people are definitely moving up the quality of food that they’re buying, and proteins play a role. I think rather than say the prices are going up or going down, I think where I see is that the spread between MPC and WPC is just gonna lessen, to some degree, as uses develop to replace when possible. We’re at such high levels, what’s down? We go down to $9 on WPC 80. two years ago that was unheard of ever. So, part of this, I think, is a function of a changing consumer shift. Will that stay? It’s hard to say. If people are feeling better about how they feel and how they live, I would say that demand’s gonna remain strong. What I found interesting is that lactose still sells. It seems like the whole dry complex is relatively healthy. As we talk in our industry, we’ve always talked for years about three, four spreads, and I think the thing we’re seeing is the demand for the protein side on Class IV milk, dry powder milk, is gonna keep those prices tight and often inverse compared to what history has shown us, just because that demand for protein is so strong. Ted Jacoby III: One of the things that history has shown us is that people tend to take major market trends, like in this case protein consumption, and underestimate the significant macro shifts in those patterns. It’s been strong, it’s gonna stay strong. How could we be wrong? Is there anything out there that nobody’s paying attention to that we think could cause a fundamental shift in protein demand relative to what we’re seeing right now? Josh White: If we find out GLP-1s are dangerous, things will change fast. And I’m not crediting GLP-1s to this entire movement. I think that too many people actually give all of the credit to the protein movement, to the American adoption of the GLP-1 drugs. I actually think this is a broad movement that was overwhelming dairy’s ability to provide enough of the high-quality protein that the market demanded, particularly when it was on the cheaper end of its historical price curve several years ago. Now, we’re in a spot where the market is moving in this direction, the health and wellness trend is a global trend, the science is behind dairy as a highly functional and digestible protein And then you have this catalyst of many Americans watching their diet better than ever before and wanting to enhance their total digestible protein intake and create an efficient use of the calories that they’re bringing in. It’s the perfect storm. That being said, it’s the perfect storm that may have driven prices slightly above where we would’ve seen them without the intervention or addition of the GLP-1 user community. If that were to shift, it could take the entire final tier out of this price, and I don’t even wanna try to [00:27:00] define what that tier looks like at the moment. Mike Brown: I think the bigger threat is through food science, no matter what it might be, is alternative proteins to milk. I think we can’t underestimate what may happen with plant proteins, for example, with time, with genetics. It gets down to a cost, and we all know the functionality can be very different, and to Josh’s point, nutrition can be very different. Does the price spread get wide enough? For example, if you go into the protein bars in your local Costco, the ones that are the lowest cost are the pea protein. They’re plant protein-based bars. The whey and milk protein are higher. I don’t think we wanna assume that it’s dairy’s business forever, ’cause there’ll be people looking at ways to get the taste, flavor, and to some degree the digestibility with alternative sources. Just because if there’s a savings in the long run, they’ll try to do it. So far, I think the success has been kinda limited, but I wouldn’t wanna count it out not happening. There’s enough dollars at stake to make it worthwhile to look into that. Ted Jacoby III: You know what, Mike? I’ll piggyback on what you’re saying, and I would say this. If we step back five years and remember the time when all we were talking about was cellular agriculture and how you could create all this protein in a vat, and then that kinda just died off, and I think it died off because people found that it was more expensive than they thought to run that process. However, innovative technology such as cellular protein tends to have, come in waves, where the first wave often will fail, but then people in the background will continue to work on ways to improve the process, make the process more efficient. And if another innovation comes along that makes it less expensive, all of a sudden you can see a big rise in, let’s say, whey protein-like proteins being created in a vat, a la cellular agriculture. Mike Brown: It hasn’t popped like we all thought it was going to, or at least a lot of the industry did. I’m a former insulin user. I know what it costs to make insulin. It’s the same process. It’s kinda hard to make a digestible protein with that process and make it competitive cost-wise. For example, take lactoferrin. That’s a different story. And- Mm-hmm … … as they get more efficient, will we move down the chain to more common ingredients or even supplements, too. I’ve learned, with food science, just never say never, ’cause you’ll be surprised. Someone’ll come up with something that can make a difference. Meanwhile I think the demand for high-quality protein isn’t going away. I think we need to make sure that dairy remains the key source of that, ’cause right now it certainly is. The high-protein products that are the most popular are milk protein based or whey protein based. Ted Jacoby III: Cool. Thanks, Mike. All right, guys, before we wrap up, what conferences are we going to in the next couple of months? Let’s tell our listeners where they might be able to find us. Diego, how about you? Diego Carvallo: So, we’ll have a stand at the next show in Mexico City at the end of September. It’s called Banamex Mexico City Show. Would love to see you guys there. Ted Jacoby III: Is that the one everybody refers to as FOOD TECH®? Diego Carvallo: Yes, exactly. Ted Jacoby III: Perfect. Yeah. Awesome. How about you, Josh? Josh White: The International Whey Conference in Chicago is in September, and we’ll have some people at that along with the ADPI board of directors meeting. And then shortly after as we get into October, SupplySide Global [00:30:00] is in Las Vegas, and we will be exhibiting in the ADPI section. Ted Jacoby III: Excellent. Awesome. And I will probably be joining Diego at FOOD TECH®, and then Joe and I will be heading over to Food Ingredients Europe in November. So look forward to seeing everybody there. Hey, thanks everybody for tuning in. I hope this was a educational market discussion for everybody, and look forward to seeing you guys soon. End commercial. Mike Brown: For one part of the supply chain to be successful, everyone has to be. My superpower is practical application of data and analysis. I believe firmly that Jacoby’s success is because we help our suppliers and our buyers be successful. I’m Mike Brown, and I love working for T.C. Jacoby & Co. because I get to help people make their businesses more successful.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/NPY865. CME credit will be available until August 24, 2027.Taking Initiative to Optimize Lipid-Lowering Therapy in High-Risk Patients With ASCVD: A Call to Action for CardiologistsThe University of Cincinnati is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.The University of Cincinnati and PVI, PeerView Institute for Medical Education, are both accredited by the ACCME to provide continuing medical education for physicians and have collaborated to design and execute this activity. For accreditation purposes, the University of Cincinnati is responsible for certification and documentation of attendance for this activity.SupportThis activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/NPY865. CME credit will be available until August 24, 2027.Taking Initiative to Optimize Lipid-Lowering Therapy in High-Risk Patients With ASCVD: A Call to Action for CardiologistsThe University of Cincinnati is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.The University of Cincinnati and PVI, PeerView Institute for Medical Education, are both accredited by the ACCME to provide continuing medical education for physicians and have collaborated to design and execute this activity. For accreditation purposes, the University of Cincinnati is responsible for certification and documentation of attendance for this activity.SupportThis activity is supported by an educational grant from Novartis Pharmaceuticals Corporation.Disclosure information is available at the beginning of the video presentation.

Featuring perspectives from Prof Peter Schmid and Dr Melinda Telli, including the following topics: Introduction: TROP2-Targeting Antibody-Drug Conjugates (ADCs) for Metastatic Triple-Negative Breast Cancer (0:00) First-Line Therapy (PD-L1 Negative) (6:53) First-Line Therapy (PD-L1 Positive) (23:40) Second-Line Therapy (Sequencing) (34:08) Adverse Events with TROP2-Targeting ADCs (43:43) CME information and select publications

BEEF Let's start with a little good news. On Monday, the border in Arizona was opened for beef cattle. Monday had 716 head presented for inspection. 692 were approved with 24 rejected. Similar numbers on Tuesday with 634 inspected, 588 approved and 46 rejected. Estimated weekly crossing is expected to be about 3,000 head per week. Not enough to make a big change but it is progress. A second crossing will open in New Mexico in 30 days as long as Arizona goes well. The current beef market, however, is high and still moving higher. Weekly beef harvest continues restrained, 523K head last week, up from 517K the week prior.  With one more week running up to Labor Day and the end of the summer season, back to school, vacations over, I do think we will see declines in beef pricing. But we've got to get there. Middle meats continue to lead the way higher with ribeyes, tenderloins, and strips all strongly moving higher. Chucks and rounds moving up, too. Grinds are moving higher and we'll wait to see if additional tariff-free imported lean beef will have any effect on pricing. I'd keep the same advice I've been saying for a while now. Stay ahead of your needs simply because inventories are tight, but I would not get too far ahead as I do expect a market correction after Labor Day. POULTRY The recent pattern is done, at least for now. Wings are moving a bit lower, while boneless skinless random breasts and tenders are holding steady for the week. Production continues strong staying ahead of last year which I think should protect us from any surge in chicken moving into fall. On the avian flu beat, four new cases affecting 32K birds. GRAINS It seems war and international unrest is good for grain prices. Corn closed today at $5.31, the highest close in three years. We flirted with $5 a few months ago; now it's here and we'll see where this will end. Still plenty of corn and new crop coming in so will demand keep these prices up. Soy and wheat both up similarly to corn. I do expect we will see firming prices in oil and flour. PORK Pork bellies continue to decline, today's close $148, down from last week's $154. I do expect this to continue to decline heading into fall. Loins, butts, ribs, minimal movement. DAIRY Another mixed week on the CME. Through Thursday's close, barrel is up 1, block declines again, down 5, and butter up 1. Not much to push these markets higher, plenty of raw material available. Savalfoods.com | Find us on Social Media: Instagram, Facebook, YouTube, Twitter, LinkedIn

Koreen Pagano is a globally recognized expert in skills strategy, AI transformation, analytics, learning technology, and immersive experiences. She founded Tandem Learning, where she pioneered immersive learning through virtual worlds, games, and simulations. She has held product leadership roles at Lynda.com, LinkedIn, D2L, Degreed, and Wiley. Today, Pagano advises organizations on AI and skills transformation in her role as co-founder of Rising Tide Cooperative and CEO of Talent Rewire. She is a seasoned international speaker and author of Immersive Learning and Building the Skills-Based Organization. She lives in Carpinteria, CA.Link to claim CME credit: https://www.surveymonkey.com/r/3DXCFW3CME credit is available for up to 3 years after the stated release dateContact CEOD@bmhcc.org if you have any questions about claiming credit.

"I'd already finished my cardiovascular unit. I'd finished my pulmonary unit. I had never heard about this in any of my classes." That was Dr. Joel Bervell's reaction to discovering that a device used every day in hospitals -- the pulse oximeter -- reads less accurately on darker skin tones. He posted a 30-second video about this consequential discrepancy that, to his utter surprise, gained over 500,000 views by the next morning. That video launched Dr. Bervell into orbit as a social media presence and created his identity as The Medical Mythbuster. In just a few years, he's built a following of two million people, earned a Peabody Award and was named to the inaugural Time 100 Creators list, all while finishing his residency.  On this episode of Raise the Line, host Lindsey Smith welcomes Dr. Bervell to explore the roots of this kind of bias and the real world impact of drawing attention to it. “The most impactful biases in medicine exist because no one stops to ask who was included in the original data and who was left out,” Dr. Bervell explains. Stay tuned to also learn about: His YouTube animated series The Doctor is In which helps kids understand how their bodies work, as well as providing medical role models; How to build trust with marginalized communities; His forthcoming book, The Default Body which examines who medicine was actually designed for. Mentioned in this episode:Dr. Bervell on InstagramTikTok ChannelFacebook"The Doctor Is In" Show If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Featuring perspectives from Dr Terence Friedlander, Dr Matthew Galsky, Dr Shilpa Gupta and Prof Andrea Necchi, moderated by Dr Friedlander, including the following topics: Case: A patient with T4 disease, pelvic wall involvement and a positive pelvic node treated as metastatic disease with enfortumab vedotin and pembrolizumab attains a complete response on imaging after 6 cycles (0:00) Case: A man with muscle-invasive bladder cancer who receives neoadjuvant chemotherapy with durvalumab receives positive circulating tumor DNA results before cystectomy and negative results after surgery (7:41) CME information and select publications

Shane is joined by BKFi tax manager Tiffini Parker for a jam-packed half episode covering AI compute markets, Stripe's singularity announcement, wealth management's cash hoarding problem, South Korean dating culture, and a Reddit question that every financial advisor will have opinions about. They kick off with AI computing power becoming a tradable futures contract at the CME, what that actually means for transparency in the compute market, and why Stripe buried a four-page memo about the singularity inside an acquisition announcement. Then it's on to the Wall Street Journal's $3 trillion problem — why investors are keeping too much cash in money market funds and why advisors can't seem to convince them otherwise. They also cover the dating scene in South Korea, being completely overtaken by Samsung chip engineers and what massive AI-era bonuses are doing to the marriage market, Spirit Airlines' flight attendant data privacy fight against Google's bankruptcy bid, and close with a Reddit question from a $17 million net worth individual who sold his company and wants to know if he should hire a financial advisor. Shane and Tiffini have thoughts. Topics covered: AI computing power becomes a tradable futures contract at the CME Stripe says the singularity has started and acquired OpenRouter for billions Wealth management's $3 trillion cash hoarding problem and why advisors are losing the battle Investment-grade bonds, munis, and what advisors are actually recommending South Korea's dating scene is now dominated by Samsung chip engineers Spirit Airlines flight attendants fight to keep their data out of Google's bankruptcy bid Reddit: $17 million net worth, recent company sale, should I hire a financial advisor? Timestamps: 00:00 Intro, welcome back, Tiffini Parker 02:30 AI computing power is now a tradable futures contract at the CME 05:30 Stripe says the singularity has started and acquired OpenRouter for billions 09:00 Stripe's valuation, the potential PayPal acquisition, and why it built for AI by accident 12:00 Wealth management's $3 trillion cash hoarding problem 15:00 Why investors don't trust advisors and what it would take to change that 17:30 South Korea's dating scene is now dominated by Samsung chip engineers 21:30 Spirit Airlines flight attendants fight to keep their data out of Google's bankruptcy bid 26:00 Reddit: $17 million net worth, should I hire a financial advisor? 30:00 Why 50 bps is probably worth it and what this person actually needs

In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Erika Rangel, MD, FACS, from Brigham and Women's Hospital. They discuss Dr Rangel's recent article, “Flexibility Stigma and the Double Bind of Family Formation in Medical and Surgical Residency,” which found that flexibility stigma in residency discourages pregnant and parenting trainees from using needed work-life accommodations, creating harmful double binds between training expectations and personal well-being. Structural and cultural reforms are essential to support equity, retention, and trainee health.   Disclosure Information: All relevant conflicts have been mitigated and Drs Varghese and Rangel, moderators, have no relevant financial conflicts to disclose.   To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. This activity has been designated as Credit to Address Regulatory Mandates in the following categories: Cultural Competency and Behavioral Health. Individuals MUST check with their state or local medical board, hospital, or organization to verify that the content does meet the specific requirements. Listeners can earn CME credit for this podcast for up to 2 years after the original air date.   Rangel EL, Zeineddine J, Lovejoy MC, et al. Flexibility Stigma and the Double Bind of Family Formation in Medical and Surgical Residency Journal of the American College of Surgeons. Published online May 21, 2026. doi:10.1097/XCS.0000000000002046   Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more.   #JACSOperativeWord

Featuring perspectives from Dr Terence Friedlander, Dr Matthew Galsky, Dr Shilpa Gupta and Prof Andrea Necchi, moderated by Dr Friedlander, including the following topics: Case: A man in his early 80s with non-muscle-invasive bladder cancer (NMIBC) monitored by repeat TURBTs develops localized muscle-invasive bladder cancer and enrolls in a clinical trial of neoadjuvant enfortumab vedotin with pembrolizumab (0:00) Case: A man in his late 70s with newly diagnosed NMIBC with carcinoma in situ (CIS) receives BCG induction and experiences relapse of CIS during BCG maintenance (9:24) CME information and select publications

Featuring perspectives from Dr Matthew Matasar and Dr Sonali M Smith, including the following topics: Introduction: Lymphoma Survivorship (0:00) Novel Treatment Approaches for Diffuse Large B-Cell Lymphoma — Dr Matasar (6:49) Novel Treatment Approaches for Follicular Lymphoma and Mantle Cell Lymphoma — Dr Smith (32:14) CME information and select publications

Central sleep apnea is a complex and often underrecognized sleep-related breathing disorder that differs from obstructive sleep apnea by involving reduced respiratory drive rather than upper airway obstruction. In this episode, Dr. Ran Liu reviews the underlying mechanisms of central sleep apnea, including the role of ventilatory control instability, discusses its association with neurologic conditions such as stroke, multiple sclerosis, ALS, and myasthenic disorders, and highlights key considerations for diagnosis and management. Learn how emerging technologies, personalized treatment strategies, and advances in sleep medicine are improving outcomes for patients with this heterogeneous group of disorders. In this episode, Teshamae Monteith, MD, FAAN, speaks with Ran R. Liu, MD, FRCPC, MSc, author of the article "Central Sleep Apnea" in the Continuum® August 2026 Sleep Neurology issue. Dr. Monteith is the associate editor of Continuum® Audio and an associate professor of clinical neurology at the University of Miami Miller School of Medicine in Miami, Florida. Dr. Liu is an Adjunct Clinical Assistant Professor at McMaster University in Hamilton, Canada, and an Adjunct Lecturer at the University of Toronto in Toronto, Canada. Additional Resources Read the article: Central Sleep Apnea 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: @headacheMD Guest: @SleepyNeuroDoc  Full episode transcript available here Dr Monteith: You may be familiar with obstructive sleep apnea, but central sleep apnea is often less understood and frequently underdiagnosed. In this podcast, we break down the key clinical pearls to sharpen your diagnostic reasoning, discuss why central sleep apnea matters, and to explore some of the fascinating advances transforming the field. 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 Monteith: This is Dr. Teshamae Monteith. Today, I'm interviewing Dr. Richard Liu about his article on central sleep apnea. This article appears in the August 2026 Continuum issue on Neurology of Sleep. Welcome to our podcast. How are you?  Dr Liu: Good. Thank you, Dr. Monteith, for having me today.  Dr Monteith: Please introduce yourself to our audience.  Dr Liu: Hello, everybody. My name is Richard Liu. I am a sleep neurologist. I am working out of Toronto at both Sunnybrook Health Science Center and MedSleep. I did my residency at Queen's for neurology and my sleep medicine fellowship at Harvard University.  Dr Monteith: Great. And what got you interested in sleep?  Dr Liu: Thank you very much for asking. For me, sleep medicine is a field where essentially everything is connected. Certainly, impaired sleep can affect many other conditions, including many neurological conditions. And even within sleep medicine, when somebody has a sleep disorder, often the entire system is connected. So as an example, if you have insomnia and fragmented sleep and periodic limb movements of sleep, certainly these conditions can impact sleep apnea. And certainly, for today's topic of central sleep apnea, this is an extremely complicated disorder where it's a very in-depth integration between neurological and respiratory physiology, among other systems as well.  Dr Monteith: So, I guess you're kind of like the cornerstone, sleep being the cornerstone of neurology. Everyone has to sleep. That's for sure. Great. So why don't we talk about what central sleep apnea is, and how prevalent is it as a collective group of disorders compared to obstructive sleep apnea?  Dr Liu: So, one way to think about central sleep apnea is that this is a heterogeneous group of etiology. But the primary concept here for central sleep apnea is that there's a reduction in respiratory drive. This is in contrast to obstructive sleep apnea, where essentially this is some form of airway obstruction in the presence of relatively intact respiratory drive. And of course, there's mixed apneas where they may contain features of both. But of course, now we know that even obstructive sleep apnea, there's a certain degree of drive dependence somewhat blurring these distinctions. The overall prevalence of central sleep apnea is about five to ten percent of all patients with sleep- disorder breathing. And certainly, it could be higher in some neurological conditions, such as things like stroke, multiple sclerosis, and multisystem atrophy.  Dr Monteith: Great. So certainly, it's out there. Why don't you tell us about the objectives of your article?  Dr Liu: Absolutely. Thank you for asking. I think the main objective of this article is really to highlight that central sleep apnea is a complex syndrome resulting from a large group of heterogeneous etiologies. And of course, again, it could be associated with many neurological conditions. And really here, I want to highlight advancements, both medicine and technology, on both the side of diagnosis of central sleep apnea, as well as the multimodal targeted treatment.  Dr Monteith: And what do you want our listeners to take away from this talk and certainly your article? What are the key essential points?  Dr Liu: Thank you very much for asking. I think that one way of looking at central sleep apnea to etiologically divide this into both hypocapnic and hypercapnic central sleep apnea. And of course, loop gain being a major driver for a hypocapnic central sleep apnea, and that one can actually think about hypocapnic central sleep apnea beyond a phenotypic spectrum with obstructive sleep apnea, with many patients having overlapping features of both obstruction and central component. On the other hand, hypercapnic central sleep apnea, often also known as hyperventilation syndrome, can span etiology from chemoreflex dysfunction to a broad range of neuroanatomical localization, such as central nervous system, peripheral nervous system, neuromuscular junction, and muscle disorders.  Dr Monteith: And what are some of the symptoms of central sleep apnea? Do any of them differ from obstructive sleep apnea?  Dr Liu: Thank you for asking, that's an excellent question. So certainly, central sleep apnea symptoms can overlap with obstructive sleep apnea symptoms. And of course, given the large range of underlying etiology, often the CSA symptoms depend on the underlying etiology. There may be less snoring compared to obstructive sleep apnea patients, especially the hypocapnic CSA patients. Of course, these patients, like OSA, may have frequent awakenings, gasping and choking their sleep, and nocturia, and so on.These patients may have daytime sleepiness, insomnia-like symptoms, or they could be asymptomatic. Interestingly, the hypocarbnic central sleep apnea patients, they're a bit more prone to have the insomnia-like symptoms, whereas the hypercarbnic central sleep apnea patients, they tend to have a bit more of the daytime sleepiness and morning headaches.  Dr Monteith: You spoke about some of the neurological disorders that might be associated with central sleep apnea, like stroke and multiple sclerosis. What about some of the more traditional risk factors associated with obstructive sleep apnea or conditions associated with it, like obesity and hypertension? Or does that just mix the picture?  Dr Liu: There is many overlap between risk factors between obstructive sleep apnea and central sleep apnea, and certainly one of the things that I highlight in this article is really that often it's not just black and white, that this could be a spectrum with overlapping disease between both conditions. So certainly, in our neurological world, stroke is the most common thing that may be associated with central sleep apnea. But overall, cardiovascular issues such as heart failure, atrial fibrillation, these things can also be associated with central sleep apnea. And again, from the neurological perspective, if we were to divide from hypocarbnic versus hypercarbnic central sleep apnea, by thinking about the hypercarbic central sleep apnea, again, this is where we're thinking about hypoventilation syndromes. You know, anything that can cause neuromuscular weakness, this is something that we should have a high alarm for, that potentially there may be a hypoventilation component. So, things like any myasthenic syndromes and ALS.  Dr Monteith: Great. Why don't we also talk about the classification? When was the last time central sleep apnea's classification was updated, and what should we know about the classification?  Dr Liu: The most recent classification for central sleep apnea is written in the International Classification of Sleep Disorders, third edition. In this edition, it's classified with six central sleep apnea syndromes. So, these are the CSA with Cheyne-Stoke breathing, CSA due to high altitude periodic breathing, primary CSA, CSA due to medication or substance, CSA due to medical disorder without Cheyne-Stoke breathing, and treatment-emergent central sleep apnea. These classifications more so describe the circumstance of when CSA occurs. A more etiological classification that we can consider would be classifying them by the underlying pathophysiology, which is dividing this from hypercarbnic central sleep apnea versus a hypocarbnic central sleep apnea. Certainly, both set of classification are discussed in this article.  Dr Monteith: Yeah. You discussed at length, the major physiological factors that our audience is just going to have to read. I don't want them to hear this too much while they're driving or on the treadmill, cause its super high level. But why don't we just start with some very basic factors that we need to know about this circuitry?  Dr Liu: Perhaps I can start with this concept of loop gain, which is the most important concept under hypocarbnic central sleep apnea. For any one of my colleagues who's listening to this, they're probably laughing right now cause they think that loop gain is my favorite word. So, loop gain is an engineering term referring to the sensitivity of a feedback loop. So, in the context of sleep medicine, this is an overly sensitive respiratory control to carbon dioxide and oxygen fluctuation. There are three components. The main one is controller gain. This is a chemosensitivity predominant to CO2. The second is plant gain, which is the lung's effectiveness for carbon dioxide excretion. And the last is what's called the mixing gain. This is circuitry delay from the time the signal travels from the pulmonary artery to the peripheral and central chemoreceptors. So conceptually, one may think, let's say something decreases your ventilation, so for example, apnea or hypopnea. With this, as you can imagine, when you stop breathing, your CO2 builds up, and this builds up according to the curve of the plant gain. And of course, this build of CO2 signal takes time to go from your lung to your chemoreceptor. That's your mixing gain. And of course, here it meets the overly sensitive chemoreceptors. This is your controller gain. As a result, this results in amplification of your ventilation to the initial respiratory disturbance. So, you have a overshoot of ventilation. All of a sudden, you're blowing out too much carbon dioxide, then you become hypocarbnic. At one point, if you blow out way too much carbon dioxide, your CO2 goes below what's called a PCO2 apneic threshold. After this, if your CO2's below, you essentially stop breathing. And of course, after that, you can imagine your CO2s are building up again. So, when this loop goes over and over, you generate what's called a chemoreflex-driven respiratory oscillation, where you create a crescendo, decrescendo-like flow pattern, which is underneath what we see in periodic breathing in central sleep apnea.  Dr Monteith: So, without going into too much detail, what is the key way to target restoration of equilibrium? Are there anatomical targets, physiologic targets that we're trying to manipulate here? Dr Liu: Again, thank you very much for that wonderful question. There's certainly many approaches that we could do to improve the stability of the system. Certainly, there are treatments for ventilation, either CPAP or in the case of hypocarbon central sleep apnea, things like adaptive servo ventilation. There is also medications that we can certainly discuss later that can double down the entire system for loop gain. Positional therapy can help for many of these patients. For the appropriate patient, improving their arousal threshold can actually reduce arousal-induced amplification of loop gain. Many of these patients, again, if appropriate, certainly weight loss may be helpful, and these are among many things that we can potentially do to improve the ventilatory stability of these patients.  Dr Monteith: Okay, great. But let's also talk about the general overall approach to diagnosing, and much of it is by history, as you mentioned. There's also sometimes a need, as you say, to differentiate out how much is obstructive. So, what is the thinking process there when you're approaching a patient?  Dr Liu: So perhaps I can start with in terms of the diagnostic modalities that we could use for this. So, the gold standard for diagnosis of central sleep apnea is still our polysonogram. The home sleep apnea test sometimes may be harder to distinguish between obstructive and central events. In addition, on a PSG, you have EEG. This allows you to assess for sleep quality and arousals, as well as the EMGs, which can help you pick up periodic limb movements of sleep. And of course, all of these things themselves can affect the central sleep apnea and can be a potential treatment factor.  Dr Monteith: Before we get into treatment, can you just give us, like, the top five or six drugs or drug classes we need to look for so that, you know, we can discontinue or try something else for our patients that might be complicating their presentation?  Dr Liu: Certainly medications, in some cases, can help central sleep apnea, but other cases can certainly be a precipitant of central sleep apnea. So, one thing to consider would be opioid medication. They can certainly cause very complicated central sleep apnea, something called ataxic breathing, where you have irregularity to the tidal volume and the rate of breathing. Other medications such as Oxybate, baclofen, valproic acid, gabapentin, all of which can certainly contribute to central sleep apnea. And of course, in the stroke world, something that we should always think about is that Tetagelor can also contribute to central sleep apnea. And outside of this, things like muscle relaxants, anesthetic agents can also be a contributor.  Dr Monteith: Great. Now let's get into some of the treatment.  Dr Liu: I like to divide treatment into targeting a hypercarbnic central sleep apnea and a hypocarbonic central sleep apnea. For hypocarbonic central sleep apnea, the first line is CPAP treatment. But for many patients, CPAP therapy is insufficient. There's also adaptive servo ventilation, which is an advanced device designed for hypocarbonic central sleep apnea. For hypercarbic central sleep apnea, again, first line is CPAP treatment, with more advanced devices being a bilevel therapy as well as volume-assured pressure support ventilation. There are also medications that can reduce loop gain, with the most researched one being acetazolamide. We can also reduce arousal thresholds, which could be appropriate for certain patients. And for certain patients, improving arousal threshold can be helpful as, especially in hypocarbic central sleep apnea, that arousals can amplify loop gain. Weight loss can be helpful for both hyper- and hypocarbonic central sleep apnea, and we have great new medication on the market for this. Other therapy can include supplemental oxygen that can be added to PAP devices, as well as phrenic nerve stimulation, positional therapy, as well as carbon dioxide modulation.  Dr Monteith: Excellent. So, it sounds like there's a lot of opportunity to help patients. Now, what are you most excited about in terms of latest development for detection as well as for intervention?  Dr Liu: Thank you very much. I'm actually excited about many things in sleep medicine. Perhaps the thing that I'm most excited about in detection in sleep medicine would be the wearable technologies. So, these technologies may use photoplethysmography to detect peripheral artertonometry. This is where we're measuring the pulsatile arterial volume signals as a surrogate of cardiac and respiratory function. And when paired, that was often desaturation. With these technologies, we can actually detect the staging, autonomic arousals, and HI. So of course, these technologies do not have flow, and they do not have EEG. But they're very powerful technology that allows us to do multi-night testing from home. And of course, understanding both the potential limitation of these technology in the context of patients can be very useful. In terms of treatment-wise, we're learning so much about the underlying contributing drivers of different forms of central sleep apnea. So again, this is highlighted in my article that many of these patients needs multimodal targeted treatment, both between either a PAP device in addition to other things such as medication, oxygen, positional therapy, and so on.  Dr Monteith: Great. So, I mean, I think there's so much to this field. Your article is very extensive. Thank you very much for writing this. I know it may have taken a bit of time, and I appreciate you being on our podcast.  Dr Liu: Thank you very much.  Dr Monteith: Again today, I've been interviewing Dr. Richard Liu about his article on central sleep apnea. This article appears in the August 2026 Continuum issue on Neurology of Sleep. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining today.  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. 

Today we are doing something we have never done before.Once a month, members of The Metabolic Initiative get an hour to put their own questions directly to the scientists and clinicians at the forefront of metabolic health. Those sessions stay inside the platform. This one does not.After Dr. Ben Bikman joined us for episode 100, the questions kept coming. So we invited him back to sit with Dr. Dominic D'Agostino and MHI co-founder Victoria Field for a live member Q&A, and for the first time we are releasing the full session publicly.What came out of it: GLP-1 medications and the muscle loss debate, and how Ben's own position on these drugs has shifted. Insulin resistance and ceramides. Exogenous ketones, and when they may actually be useful. Metabolic approaches to cancer and the glucose ketone index. Exercise timing. Type 1 diabetes. Cortisol and fat distribution. Supplements.Questions Answered in This Episode:The muscle loss debate around GLP-1s has become polarized. Should clinicians be worried about muscle loss, muscle function, or neither?If you were diagnosed with cancer, are there any metabolic therapies you would start immediately?How long can it take for ceramides in adipose tissue to resolve — and insulin resistance to improve?Bioidentical D-BHB exogenous ketones are substantially more expensive. What is the value proposition over other forms?GLP-1 receptor agonists consistently raise resting heart rate. Is that something to be concerned about?Are there any emerging approaches to improving the management of type 1 diabetes?What happens metabolically, and to fat cells, glucose and ketones, when taking corticosteroids?This is the kind of conversation we host every month inside The Metabolic Initiative, alongside expert presentations from our conferences and a library built entirely around metabolic health and therapy, with CME credit available on eligible content for healthcare providers.If you want to be in the room for the next one, the first seven days are free. membership.metabolicinitiative.comSpecial thanks to the sponsors of this episode:Genova Connect: Get 15% off any Genova Connect test kit with code METABOLICLINK here.Cowboy Colostrum: Get up to 25% off with code METABOLIC here.More LinksDr. Ben Bikman's website: benbikman.comInsulin IQ: insuliniq.comYouTube: youtube.com/@benbikmanInstagram: @benbikmanphdIn every episode of The Metabolic Link, we'll uncover the very latest research on metabolic health and therapy. If you like this episode, please share it, subscribe, follow, and leave us a comment or review on whichever platform you use to tune in!You can find us on all your major podcast players here and full episodes are also up on our Metabolic Health Summit YouTube channel!Find us on social: InstagramFacebookYouTubeLinkedInPlease keep in mind: The Metabolic Link does not provide medical or health advice, but rather general information that does not serve as a substitute for a licensed healthcare professional. Never delay in seeking medical advice from an appropriately licensed medical provider for any health condition that you may have.

Send us Fan MailIf you've listened to this podcast for any length of time, you've probably heard me say that running a successful medical practice is a lot like practicing good medicine. You don't make decisions based on a single symptom. You gather data, look for patterns, identify root causes, and then prescribe the appropriate treatment. The same is true when managing the financial health of a medical practice.Today, we're going to talk about two of the most important—and often misunderstood—key performance indicators in revenue cycle management: Gross Collections Percentage and Net Collections Percentage.If you don't know these numbers for your practice, or if you receive them every month but aren't quite sure what they mean, this episode is for you. More importantly, I want to shift your thinking. These aren't just accounting metrics. They're diagnostic tools. They're your practice's financial vital signs. When you understand what they're trying to tell you, they can help you identify problems long before they become financial crises.As we've discussed in previous episodes on key performance indicators and revenue cycle management, no single metric tells the whole story. Days in Accounts Receivable, denial rates, clean claim rates, aging reports, provider productivity, coding accuracy, charge lag, and patient collections all work together. Gross and Net Collections Percentages are two pieces of that larger puzzle, but they're incredibly valuable because they summarize how effectively your entire revenue cycle is functioning.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: https://share.hsforms.com/1FMup6xLPSpeA8hB77caYQwd32sx?hsCtaAttrib=171926995377 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. Promo pricing available now: https://education.healtheps.com/offers/Ry3zfLYp/checkout?coupon_code=PHYSEDGE3000 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/    

Zach Pandl, Head of Research at Grayscale, joins us after Bessent's $4 billion Treasury buyback lit a debasement trade that sent Bitcoin up 22% and gold to fresh highs. We get into what happens when yields stay high but the dollar falls, whether weaponizing the dollar against Iran accelerates dedollarization, which altcoins are underrated right now, and how Grayscale is positioning its portfolios.GUEST: Zach Pandl, Head of Research, Grayscale InvestmentsFollow Zach on X ➜ https://x.com/LowBeta00:00 intro00:10 Sponsor: Uphold Staking00:45 AI rotation and liquidity intervention sparked rally02:00 Fear and greed skyrocket03:00 Treasury Dynamics vs Crypto Market04:30 Bessent will lose Bond battle?06:40 Altcoin ETFs dying?08:20 ZEC fund launched10:40 Is the bottom in?12:00 Why not launch a competitor to this but on Hood chain instead?13:50 $UNI exposure16:00 Our Top 2 “Fee Switch” Tokens17:50 Sui another fallen token?19:30 Perps: Will $JUP vs $HYPE reign supreme again soon?20:40 ETH and SOL too late to change tokenomics?22:20 Premium on SOL incoming?23:00 Mainstream media vs AI hype23:25 Tokenized gold vs Bitcoin wallets23:55 SOL $100 new floor?24:10 AAVE still worth it?25:00 ZEC squeezed float?25:45 $HYPE apocalypse soon?26:00 CME scarred of HYPE26:50 CFTC vs CLARITY27:30 After DTCC launch, crypto needs new narrative?28:00 USDT vs USDC28:50 Graystack coins#Crypto #Bitcoin #Ethereum~Dollar Debasement Mega Trend!

In this episode, Sam Ashoo, MD and Dr. Syeda Maria Muzammil, MD discuss the August 2026 Emergency Medicine Practice article, Emergency Department Management of Postthrombolysis Intracranial Hemorrhage.0:25 – Intro & sponsor message1:18 – Guest introduction: Dr. Maria Muzammil2:24 – Timeframe for post-thrombolysis hemorrhage & ED/ICU boarding considerations4:46 – Thrombolysis eligibility criteria & contraindications5:46 – Incidence rates & symptomatic vs. asymptomatic hemorrhage7:09 – Pathophysiology & risk factors for post-thrombolytic ICH10:18 – Combining IV thrombolysis with endovascular thrombectomy12:33 – Post-treatment monitoring protocols & neurological exam frequency15:02 – Differentiating hemorrhage from other causes of neurological decline18:34 – Initial ED steps20:35 – Heidelberg classification of hemorrhage types21:60 – Follow-up imaging25:27 – Treatment of confirmed hemorrhage30:10 – Platelet transfusion guidance32:39 – Delayed hemorrhage & treatment timing considerations34:21 – Blood pressure management goals post-hemorrhage37:20 – Special populations38:48 – Summary of ED management algorithm40:48 – Closing remarksSubscribers, take the CME test here.Emergency Medicine Residents, get your free subscription by writing resident@ebmedicine.net

In our fourth Summer School episode this season, hosts Dr. Amber Hildreth and Dr. Jordan Whatley have taken highlights from past episodes on liver disease and put them into a special episode full of clinical pearls.Former expert guests Dr. Bill Balistreri, Dr. Jorge Bezerra, Dr. Saul Karpen, Dr. Dennis Black, Dr. Amy Taylor and Dr. Rohit Kohli cover neonatal cholestasis, biliary atresia, PSC, AIH, and MASLD.Our Bowel Sounds Summer School series will include four episodes each summer on big topics in our field, artisanally crafted for the ears of learners of all stages from the young student to the seasoned attending.Learning Objectives:Understand the evaluation of neonatal cholestasisReview the natural history of PSCReview the diagnosis and management of AIHUnderstand the diagnostic evaluation and management of MASLD.Featured episodes:1. Bill Balistreri- Neonatal Cholestasis2. Jorge Bezerra- Advances in Biliary Atresia3. Saul Karpen- Updates in Biliary Atresia4. Dennis Black- Primary Sclerosing Cholangitis5. Amy Taylor- Autoimmune Hepatitis Management6. Rohit Kohli- Fatty Liver DiseaseAdditional Links:1. Guideline for the Evaluation of Cholestatic Infants2. AASLD PSC Guidelines3. AASLD AIH GuidelinesSend us Fan MailSupport 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.

Featuring perspectives from Dr Virginia Kaklamani and Dr Hope S Rugo, including the following topics: Introduction: San Antonio Memories (0:00) PI3K/AKT/PTEN Alterations and Therapies (7:18) Capivasertib (20:22) Gedatolisib (34:08) Inavolisib (47:07) New Agents and Ongoing Trials (52:34) CME information and select publications

Featuring perspectives from Ms Caroline Kuhlman, Dr Eileen M O'Reilly, Dr Philip A Philip and Ms Amanda K Wagner, moderated by Dr O'Reilly, including the following topics: ·      Introduction (0:00) ·      Clinical Presentation and Prognosis of Pancreatic Adenocarcinoma (PAD) (3:29) ·      Recent Advances in Up-Front Treatment for Metastatic PAD (15:47) ·      Selection and Sequencing of Therapy for Relapsed/Refractory Metastatic PAD (39:58) ·      Novel Strategies Targeting RAS Mutations in Advanced PAD (48:20) ·      Utility of Tumor Treating Fields in PAD Management (1:13:58) CME information and select publications

Highlights from the PER® CME activity "MET Alterations in NSCLC: Applying Diagnostic Advances and Targeted Therapies in a New Era of Treatment" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.In this podcast, experts Jonathan Goldman, MD; Sanja Dacic, MD, PhD; Deborah Doroshow, MD, PhD; and Anne S. Tsao, MD, MBA, discuss diagnostic and treatment strategies for patients with MET-altered non–small cell lung cancer.Earn CME credit by completing the full accredited activity (available through September 19, 2026): https://www.gotoper.com/courses/met-alterations-in-nsclc-applying-diagnostic-advances-and-targeted-therapies-in-a-new-era-of-treatment-vdpvThis podcast, including the narration, was developed by PER® (Physicians' Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by an educational grant from AbbVie, Inc.This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

What if the conversation in front of you is not asking you to fix anything? As physicians, caregivers, parents, and partners, we are trained to notice suffering and move quickly toward a solution. But even when our intention is to help, fixing can sometimes land as judgment. It can leave the other person feeling unseen, rushed, or as though they need to change. In this episode, Dr. Ni-Cheng Liang and Dr. Jessie Mahoney explore mindful communication as a practice of presence, curiosity, and generosity. They share why listening without immediately advising, correcting, rescuing, or preparing your response can be deeply healing—for the person speaking and for you. Together, they discuss practical ways to arrive more fully before an important conversation: a breath, a hand to heart, a quiet walk, a moment of noticing, or simply an intention to connect. This is not about performing perfect communication. It is an invitation to pause, listen, and remember that sometimes the most healing thing we can offer is our willingness to stay. In This Episode, We Explore Why the instinct to fix can unintentionally communicate judgment The difference between "How can I help?" and deciding what someone needs Listening as a gift of presence, not a tool for solving Why presence and monotasking can conserve emotional energy The question beneath our urge to fix: whose discomfort are we trying to relieve? Simple ways to prepare your body and mind for a difficult conversation How to practice mindful communication with patients, colleagues, children, partners, and parents Reflection Questions When someone comes to you with a problem, is your first instinct to fix or to simply listen? Where might your desire to help sometimes carry an unintended judgment? What does it feel like in your body when you are truly listening? What helps you arrive with presence before an important conversation? Who in your life might benefit from being listened to rather than being fixed? Connect in Nature Retreat Drs. Liang and Mahoney will be offering another Connect in Nature retreat in December, with CME available. Learn more and join them here: www.jessiemahoneymd.com/retreat-connect-in-nature If this conversation resonates, Jessie's coaching offers a place to pause, hear yourself more clearly, and make changes with more presence, self-trust, and ease. 1:1 Coaching: www.jessiemahoneymd.comCME Wellness Retreats: www.jessiemahoneymd.com/retreats Free Live-Stream Mindful Yoga: www.jessiemahoneymd.com/yoga Jessie's Blog: www.jessiemahoneymd.com/jessies-blog Podcast Page: www.jessiemahoneymd.com/mindful-healers-podcast Nothing shared in the Healing Medicine Podcast is medical advice. The Healing Medicine Podcast was formerly known as the Mindful Healers Podcast.  

Featuring perspectives from Dr Karim Fizazi, Dr Daniel George and Dr Elisabeth I Heath, moderated by Dr Heath, including the following topics: Treatment approach for AKT-mutated prostate cancer — Question from Neeraj Agarwal, MD, FASCO (0:00) Case: A man in his late 60s with de novo metastatic hormone-sensitive prostate cancer with widespread skeletal metastases and PTEN loss on next-generation sequencing receives relugolix/darolutamide with chemotherapy and experiences PSA decline that plateaus at approximately 1 ng/mL — Rana R McKay, MD, FASCO (10:29) CME information and select publications

The Centers for Medicare and Medicaid Services (CMS) has announced more concerning proposals that will affect access to care and reimbursement. Host Dr. Andrew Pouw reconvenes last year's guests from the Academy's DC office—Dr. John McAllister, Brandy Keys, and Rebecca Hyder—to unpack the proposed 2027 Physician Fee Schedule and explain how the changes will disproportionately burden surgical specialties. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Featuring perspectives from Dr Karim Fizazi, Dr Daniel George and Dr Elisabeth I Heath, moderated by Dr Heath, including the following topics: Role of PTEN deficiency in tumorigenesis of prostate cancer and optimal approach to PTEN assessment — Question from Neeraj Agarwal, MD, FASCO (0:00) Case: A man in his late 60s with a history of nonmetastatic hormone-sensitive prostate cancer (HSPC) that progressed to metastatic HSPC with PTEN loss by next-generation sequencing of primary archival tissue from 2017 receives abiraterone for 2 years — Rana R McKay, MD, FASCO (8:26) CME information and select publications

The lumber market has cooled off — but has it found a bottom? This week on The Lumber Word, Ashley, Gregg, Matt and Charles break down a market where you can seemingly “sell as much lumber as you want and not make any money.” Eastern SPF has taken a serious haircut, studs are showing signs of life, Southern Pine has firmed from its lows, and low inventories throughout the supply chain could make the next move happen fast. The crew digs into SPF, Southern Pine, Doug Fir, studs, 2x4 and 2x6, where real business is trading, and whether the recent bounce is the beginning of something — or just another short-lived rally in a seasonally softer second half. They also tackle the bigger picture: ugly housing data, mortgage rates, Treasury debt buybacks, CME futures versus cash, forward Q4 business, and what potentially opening more federal land to logging could mean for western sawmills and timber owners. But the real conversation is about risk. Why are people selling forward business below acceptable risk? When should you walk away from an order? Is the market already too short? And after a strong first half of 2026, should traders be shrinking inventory and waiting for the next real opportunity? Matt sums it up: don't buy or sell in a panic. Charles warns against the market's “false sense of security.” And the crew debates whether every rally between now and year-end may be an opportunity to sell. Less inventory. Less risk. Better decisions. And don't sell the bottom. Another unfiltered hour of lumber markets, trading strategy, housing, futures and plenty of Lumber Word banter. Advertiser Fastmarkets RISI Tiranth Amarasinghe Product Marketing Manager Tiranth.Amarasinghe@fastmarkets.com www.fastmarkets.com Show Contacts: Gregg Riley: Gregg@sitkainc.com Charles DeLaTorre: cdelatorre@ifpwood.com Matt Beymer: mattbeymer@hamptonlumber.com Ashley Boeckholt: ashley@sitkainc.com er market has cooled off — but has it found a bottom? This week on The Lumber Word, Ashley, Gregg, Matt and Charles break down a market where you can seemingly “sell as much lumber as you want and not make any money.” Eastern SPF has taken a serious haircut, studs are showing signs of life, Southern Pine has firmed from its lows, and low inventories throughout the supply chain could make the next move happen fast. The crew digs into SPF, Southern Pine, Doug Fir, studs, 2x4 and 2x6, where real business is trading, and whether the recent bounce is the beginning of something — or just another short-lived rally in a seasonally softer second half. They also tackle the bigger picture: ugly housing data, mortgage rates, Treasury debt buybacks, CME futures versus cash, forward Q4 business, and what potentially opening more federal land to logging could mean for western sawmills and timber owners. But the real conversation is about risk. Why are people selling forward business below acceptable risk? When should you walk away from an order? Is the market already too short? And after a strong first half of 2026, should traders be shrinking inventory and waiting for the next real opportunity? Matt sums it up: don't buy or sell in a panic. Charles warns against the market's “false sense of security.” And the crew debates whether every rally between now and year-end may be an opportunity to sell. Less inventory. Less risk. Better decisions. And don't sell the bottom. Another unfiltered hour of lumber markets, trading strategy, housing, futures and plenty of Lumber Word banter. Advertiser Fastmarkets RISI Tiranth Amarasinghe Product Marketing Manager Tiranth.Amarasinghe@fastmarkets.com www.fastmarkets.com Show Contacts: Gregg Riley: Gregg@sitkainc.com Charles DeLaTorre: cdelatorre@ifpwood.com Matt Beymer: mattbeymer@hamptonlumber.com Ashley Boeckholt: ashley@sitkainc.com

The CFTC's first Innovation Advisory Committee meeting put Coinbase, Ripple, Kraken and Solana Labs in the same room as CME, Nasdaq and ICE. Chaos ensues.~This episode is sponsored by Tangem~Tangem ➜ https://bit.ly/TangemPBNUse Code: "PBN" for Additional Discounts!00:00 intro00:10 Sponsor: Tangem00:45 CFTC Crypto Meeting02:40 Terry Duffy (CME) terrorizes hearing04:15 Kalshi eviscerates Terry Duffy05:50 Terry Duffy terrified of Hyperliquid & Trade.XYZ06:40 Kraken CEO says DTCC & Canton are old08:10 CBOE admits being old "gangsters”08:45 Frank Lasalla of DTCC threatens CFTC?10:00 Vlad: What's currently not available to U.S. customers11:10 IPO Perps might be approved next12:20 Mike Selig:  no new rules before CLARITY13:20 Ethereum Security & ZCash Privacy14:20 Zcash explodes14:30 Privacy trend will only go up14:50 San Diego privacy hearing proves this narrative won't die16:30 CLARITY countdown16:45 Odds climbing#Crypto #Ethereum #Solana~CFTC Crypto Meeting Turns Into A Brawl!

Brad Stulberg researches, writes, and coaches on performance, well-being, and sustainable excellence. He is the bestselling author of The Practice of Groundedness, Master of Change, and co-author of Peak Performance. Stulberg regularly contributes to the New York Times, and his work has been featured in The Wall Street Journal and The Atlantic among many other outlets. He serves as the co-host of the podcast "excellence, actually" and is on faculty at the University of Michigan. He lives in Asheville, North Carolina.Follow him on Instagram @BradstulbergLink to claim CME credit: https://www.surveymonkey.com/r/3DXCFW3CME credit is available for up to 3 years after the stated release dateContact CEOD@bmhcc.org if you have any questions about claiming credit.

Despite gains in recent years, Black, Hispanic, and Asian communities are still under-represented in the U.S. nursing workforce. We're going to explore that gap and how to close it on this episode of Raise the Line from Elsevier with Dr. Ernest Grant, Vice Dean for Diversity, Equity, Inclusion and Belonging at the Duke University School of Nursing. "You get a patient who is more compliant when they see someone who looks like them, who is from their culture and who can advocate on their behalf," he tells host Lindsey Smith.  Dr. Grant bases that and other insights on a rich professional background that includes 50 years in nursing, being a leading advocate for his profession and breaking down barriers himself as a male nurse of color and the first man elected president of the American Nurses Association.  In this thoughtful conversation, Dr. Grant reflects on what it took to earn credibility in leadership roles, how he's navigating the political climate on DEI initiatives, and the causes and solutions to the persistent shortage in nursing faculty, among other pressing issues. Tune in for a uniquely-informed look at what it will take to build a stronger, more representative nursing profession. Mentioned in this episode: Duke University School of Nursing American Nurses Association If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast

Featuring perspectives from Dr David H Ilson and Dr Kohei Shitara, including the following topics: Introduction (0:00) Biomarker Evaluation in Localized and Metastatic Disease (1:49) Role of Immune Checkpoint Inhibitors in the Management of Gastroesophageal Cancers — Dr Ilson (7:37) Other Available Therapeutic Approaches — Dr Shitara (33:22) CME information and select publications

Trump hosted Coinbase, Ripple, Gemini, Robinhood, a16z, Chainlink, Nasdaq, NYSE and CME at the White House one day after the SEC dropped its crypto rule, and the market ripped. Bitcoin cleared $69K, HYPE ran 20% after Trump said the CFTC chair is bringing Hyperliquid to the US, and Trump floated buying "sizable" amounts of Bitcoin for the reserve. He also pushed Congress to move on CLARITY before the September 15 Senate vote.~This episode is sponsored by Uphold~Uphold Staking ➜ https://bit.ly/UpholdStakingPB00:00 intro00:10 Sponsor: Uphold00:45 Crypto Summit Recap03:10 BTC Strategic reserve04:00 Trump pumps Hyperliquid04:30 HYPE 20%05:00 CFTC Meeting05:50 Historic Liquidations06:30 Rotation begins?07:30 MSNOW: Corruption watch09:20 Fakeout? Schiff cope?09:40 Robinhood: BTC DCA 5 years10:20 Standard Chartered $100K BTC10:45 Brian Armstrong: Sept. 1511:50 Uptober12:20 Altcoins12:50 ETH ETFs13:10 Don't forget LINK13:30 The Bessent Put14:50 Mohamed El-Erian: A bet on growth16:20 Big banks will 'extinguish crypto companies'#Crypto #Bitcoin #Ethereum~Trump's Crypto Summit Pump!

Steve Quirk began his career in 1987 on the fast-paced trading floors of Chicago, surviving the historic market crash that wiped out $1.7 trillion worldwide.From navigating open-outcry pits where a trader's word was their bond, Steve transitioned into market technology, helping build landmark tools at thinkorswim and leading trading strategy initiatives at TD Ameritrade. Today, as Chief Brokerage Officer at Robinhood, he sits at the intersection of retail investing, market structure, and financial innovation, shaping products for millions of retail investors.In this conversation, Steve shares key lessons from decades in the markets, the evolution of retail trading technology, and how removing friction like the Pattern Day Trader rule is unlocking the next era of retail investing. In this episode, we explore:• Steve's early days in the Chicago trading pits in 1987• Why decisive decision-making and accepting being wrong 50% of the time is crucial• The transition from floor trading to building technology at thinkorswim• How Robinhood levels the playing field for retail investors and opens up global access• Managing risks: framing the absolute worst-case scenario before taking a trade• The impact of removing the Pattern Day Trader (PDT) rule for retail traders About Steve Quirk:Steve Quirk is Chief Brokerage Officer at Robinhood Markets. With over 35 years of financial markets experience, he previously led trading strategy at TD Ameritrade, developed innovative trading tools for thinkorswim®, and created the TD Ameritrade U program. Steve started his career in 1987 in the Chicago open-outcry pits across the CME and CBOE, and is a frequent market commentator featured on CNBC, Fox Business, and The Wall Street Journal. Links + Resources:LinkedIn: https://www.linkedin.com/in/steve-quirk-56148a22/X (Twitter): https://x.com/SteveQuirk_ Sponsor of Chat With Traders Podcast:Trade The Pool: http://www.tradethepool.com Time Stamps:Please note: Exact times will vary depending on current ads. 00:00 From Chicago Pit Trader to Robinhood Exec 02:57 What Pulled You to the Market? 07:17 Trading Pits Are More Organized Than They Appear 11:51 Transitioning to Creating Technology for Retail Trading 19:01 Leveling the Playing Field for Retail Traders 21:10 Giving People What They Want 24:45 Did You Fall in Love with Scaling Robinhood Like You Did with Trading? 29:48 What Robinhood Is Doing to Teach 32:12 Early Mistakes in Trading
 34:31 Advice to People from Robinhood CBO
 36:44 What's Your Next Product Going to Be?
 40:24 What Is the PDT Rule?
 43:23 What Is a Memory That Came to Mind in Your Trading Career?
 45:16 Is There Anything in Your Life That Changed Your Line of Thinking?
 46:22 Your Piece of Advice to Your Younger Self 46:57 Where Can Traders Find You? Trading Disclaimer: Trading in the financial markets involves a risk of loss. Podcast episodes and other content produced by Chat With Traders are for informational or educational purposes only and do not constitute trading or investment recommendations or advice. Learn more about your ad choices. Visit megaphone.fm/adchoices

Featuring perspectives from Dr Rahul Aggarwal, Dr Matthew D Galsky and Dr Tian Zhang, including the following topics: Introduction: Welcome GU Oncology Fellows! (0:00) Prostate Cancer — Dr Aggarwal (12:48) Urothelial Bladder Cancer — Dr Galsky (45:01) Renal Cell Carcinoma — Dr Zhang (1:10:52) CME information and select publications

Advances in sleep technology are transforming how neurologists identify and manage obstructive sleep apnea, a condition that affects up to 70% of patients with certain neurologic disorders and can negatively impact cognitive and neurologic outcomes if left untreated. In this episode, Dr. Joyce Lee-Iannotti discusses the growing role of wearable and nearable sleep-monitoring devices, when home sleep studies are appropriate, and how emerging technologies are expanding access to diagnosis and treatment. Learn practical strategies for screening patients, interpreting sleep data, and partnering with sleep specialists to improve long-term neurologic health through better sleep. In this episode, Casey S. Albin, MD, FAAN, speaks with Joyce K. Lee-Iannotti, MD, FAAN, FAASM, author of the article "Sleep Diagnostics and Monitoring Technology in Obstructive Sleep Apnea" in the Continuum® August 2026 Sleep Neurology issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Lee-Iannotti is a Professor of Neurology at the Barrow Neurological Institute, University of Arizona College of Medicine, and Creighton School of Medicine in Phoenix, Arizona. Additional Resources Read the article: Sleep Diagnostics and Monitoring Technology in Obstructive Sleep Apnea 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: @caseyalbin Guest: @jleeiannotti Full episode transcript available here Dr Albin: Through the neurology of sleep issue, I think we have all been convinced that we all need better sleep, both for ourselves and for our patients. And fortunately, there is an abundance of new technology that can enable us to diagnose sleep problems, and then also make sure that our patients are getting the rest that's going to give them the best chance at a good cognitive recovery, and improve their cognitive function even if they are not currently suffering from a neurologic condition. Today, I am so excited to dive deeper into this topic.  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 Albin: Hello, this is Dr. Casey Albin. Today I'm interviewing Dr. Joyce Lee-Iannotti about her article on sleep diagnostics and monitoring technology in obstructive sleep apnea. This article appears in the August 2026 Continuum issue on neurology of sleep. Welcome to the podcast, I'd love to just start by having you introduce yourself to our audience.  Dr Lee-Iannotti: Sure. Thank you so much for having me, Dr. Albin. I'm Joyce Lee-Iannotti. I'm a professor of neurology at Barrow Neurological Institute. I am boarded in general neurology, stroke, and sleep, but I spend most of my time in the sleep world, so I jokingly say that I get more sleep doing sleep than I certainly did in stroke.  Dr Albin: Absolutely. I mean, wow, what a fascinating career, and I suspect that we're actually gonna get to some of how all of those pathophysiologies might overlap in the world of sleep. But you had the really exciting task of trying to distill this exciting, rapidly evolving field of sleep diagnostics, and I suspect it's relevant to many of the patients who end up in the neurology clinic, and I suspect that it's actually pretty relevant to many of our listeners who themselves might actually be wearing sleep tracking devices. And all of us probably wonder, well, how can we use that data to improve our own cognitive function and certainly make our patient's life even better? Before we even get into some of the meat and potatoes of this, I thought it would be really helpful for us to define some terms that come up in your article, one of which is wearables. We might figure that out, but the other is nearable. Walk us through what's a wearable, what's a nearable, how are they different?  Dr Lee-Iannotti: I'm happy to do that. First of all, the article is entitled Sleep Diagnostics and Monitoring Technology, and this was a super fun article for me to write because it's very practical, and it's generalizable to everybody. So, I'm going to start with a wearable, and a wearable is really a device that is simply worn on the body. And we're all familiar with wearables like smart watches, they're rings, they're patches, they're headbands, and the most validated form of a wearable that you've probably heard about is actigraphy, which we use in the sleep clinic.  Dr Albin: Tell us a little bit more. So, what is actigraphy? I've heard the word before, but don't actually know what it means.  Dr Lee-Iannotti: Actigraphy has been a tool that we've used in the sleep clinic for a really long time. Traditionally, we used it to monitor circadian rhythm patterns in people who are night owls or morning larks. And then more currently, we actually use it to track sleep patterns in people with suspected narcolepsy. So, before they come in for a sleep study, we actually have them wear an actigraphy for about a week just to get a sense of their sleep duration and their circadian pattern.  Dr Albin: Got it. And what is it monitoring? Our movement or the patterns that we may or may not make?  Dr Lee-Iannotti: It's really based on movement. You're exactly right.  Dr Albin: Cool. Okay, so most of this is based on gold standard monitoring with actigraphy. What other things can be incorporated into these wearable devices?  Dr Lee-Iannotti: Yeah, the technology is really advanced, and every day it changes, which is super exciting. So, on top of movement, these wearables can look at temperature. They can look at even EEG, like limited EEG, heart rate variability, and a really big word that we like to use in sleep technology, which is PPG, or photoplethysmography data, and that's really looking at heart rate variability and oxygenation, saturations, and following those levels as well.  Dr Albin: Wow, so you basically can get most of the data that you might have historically needed to go to a sleep lab to get.  Dr Lee-Iannotti: Most of them. They're still a surrogate. You'll hear me emphasize in the article as well that the gold standard remains the in-lab polysomnogram, but these are good surrogate markers that patients can wear long term to look at trends and patterns.  Dr Albin: Absolutely. And we're gonna unpack a little bit about who specifically those are best for and, really what it gives you in the clinic. But before we jump into that, what's a nearable, and how is that different?  Dr Lee-Iannotti: Yeah. Nearables are really exciting too. So, these are devices that monitor sleep but don't require direct contact on the body. So, these are devices that our patients will use, but it'll be at the bedside table. They're devices that actually go underneath the mattress, or they can be in, like, the ambient environment to detect sleep patterns.  Dr Albin: Oh my gosh. How is it doing that if it's not actually something you're wearing? Dr Lee-Iannotti: I know. It seems a little Big Brother-ish, doesn't it?  Dr Albin: Yes.  Dr Lee-Iannotti: So, they use a technology called radio frequency signals, sometimes radar, sometimes sonar, pressure sensors, even microphones, and they're picking up things like respiration, movement, snoring, and that's how they can decipher sleep patterns.  Dr Albin: Crazy. I mean, I guess the benefit of that is that it's less disruptive to the user 'cause it's not actually on them and having contact with them, and I suspect there's probably some downsides in terms of just it's a more limited data set you're getting.  Dr Lee-Iannotti: Absolutely. Yeah, you're exactly right. It's more convenient because it's not touching them, so, in theory, they're gonna sleep more comfortably. But I would like to think that the most validated forms of devices that we use to track sleep have to have some form of contact with the body, and this technology is new and probably needs a few layers of more sophistication to be as accurate as the wearables.  Dr Albin: Absolutely. I feel like we're going to have this conversation in five, maybe even less than that, years, and this data will have become like, oh, we all have something in our room that's monitoring everything. The world is crazy. All right. One of the places where your article really stood out to me is that sleep diagnostics have really taken off, particularly when we're thinking about obstructive sleep apnea. And I think we all might sort of scratch our heads and be like, "This is a neurology podcast. Why should I, as a neurologist, care about obstructive sleep apnea?" But I think you laid out a very convincing argument in the article. Walk us through why we should care about this.  Dr Lee-Iannotti: Absolutely. So, for neurologists, sleep matters, and I hope that my article translates that. Obstructive sleep apnea, which I'm gonna call OSA, is incredibly common in all of our neurologic patients, whether you see epilepsy, Parkinson's, stroke, Alzheimer's, neuromuscular, or even chronic headache patients. The prevalence of sleep apnea is as high as 70% in these patients.  Dr Albin: Wow. That's incredible. That is an incredibly high number.  Dr Lee-Iannotti: And if I can add, Dr. Albin, there's growing literature in multiple studies across the literature that show that untreated sleep apnea negatively impacts neurologic outcomes in our patients. So, it is really important to ask the question about sleep, and if the red flags pop up, to then screen for sleep apnea in particular.  Dr Albin: I think that that's a great point for us to drill down on, and obviously you're a sleep neurologist. You're very used to screening people in the clinic. But say someone comes in, and I'm gonna have you put your former stroke hat on, and say someone comes into the stroke clinic, and you're just making sure that they're optimized on their aspirin or dual antiplatelet therapy, and you're doing secondary risk modification. How would screening for OSA fit into that?  Dr Lee-Iannotti: It would be a part of that screening process to look at preventative ways to prevent strokes, whether it be primary or secondary prevention. So, we did a survey a while back, and it actually showed that 17% of stroke neurologists are screening for sleep apnea. It has quadrupled, fortunately, in the last few years due to public awareness and a lot of education that the AAN has done, in fact. So, at this point, I would say not asking about sleep apnea to a stroke patient is similar to not asking about diabetes.  Dr Albin: So, we really have to be cognizant and conscious about saying, you know, "Do you snore at night? Do you have episodes of apnea, or does someone witness you stop?" Are there things that you ask that maybe I wouldn't be aware and thinking of?  Dr Lee-Iannotti: Those are the right questions, and then very practically, very easy questionnaires to implement that literally take a minute that your nurses or medical assistants can administer to the patient, and the most commonly one that is used in stroke patients is called the STOP BANG, S-T-O-P B-A-N-G, which is a validated questionnaire to screen for symptoms.  Dr Albin: Absolutely. So okay, so this is easy to do. We should all be doing this. If you're not, now's the time. And I suspect if they screen positive, next steps, it can be hard to get into a sleep lab, and we're gonna talk about some workarounds, but I think some of our listeners may never have spent time in the actual sleep lab. So, let's say you refer a patient and you actually can get them in for a gold standard in-lab sleep study. What's gonna happen in that sleep study?  Dr Lee-Iannotti: Yeah. And I just want to preface this by saying that my article hopefully highlights that we've come a long way where we understand that there are many neurologic populations then that can undergo home ambulatory sleep studies with just as much accuracy as an in-lab polysomnogram. But with that, I wanna say an in-lab polysomnogram is actually a highly sophisticated physiologic recording overnight, typically, unless somebody is a day sleeper. So, if I could take a minute to kinda describe the data that we're monitoring throughout the night. There is a limited EEG. We concentrate on frontal, central, occipital leads to look at sleep staging. We have eye leads. We have EMG leads on the chin and the leg. We look at EKG, flow monitors, belt, and then we also do pulse oximetry, snoring mics, and even body position sensors. So, a lot is going on.  Dr Albin: This is incredible. Yeah, it truly is. I mean, this is like... I'm a neurointensivist, and so I think that you have just really outdone what I consider multimodal monitoring in your sleep study patients. I'm not even sure our neuro ICU patients accumulate that much data. All right, so tell me, they go through, and they can get this. But like you said, there's actually a lot of data that you've presented that, you know, not everyone needs to go to the in-lab sleep study. So how do you decide who actually needs to be in a sleep lab versus who can do this at home? And then how do you set them up with getting this done at home?  Dr Lee-Iannotti: Yeah. The home sleep studies are really more accessible ways for us to assess for sleep apnea in our neurologic patients, especially patients who live in very rural areas and don't have access or have very long wait times for an in-lab polysomnogram. With that being said, though, Dr. Albin, I will say that there are a subset of patients who have to go into the lab, and those are patients where you suspect a sleep disorder other than obstructive sleep apnea, so like parasomnias or central sleep apnea, patients with severe cognitive or physical debilitation, like our stroke patients who are hemiplegic and won't be able to apply the home sleep study. But for the most part, I do feel like a home sleep study is a good beginner study to screen the patient. And if there are red flags, then you can always get the in-lab afterwards.  Dr Albin: That's super helpful. And just from a pragmatic standpoint, will insurance cover the home sleep study?  Dr Lee-Iannotti: They will, yes, and it's all about documenting. So, if I could get really practical, for neurologists, it really just requires documenting snoring, for one, whether it's noted by the patient or by their bed partner, and then any form of hypersomnia, which is daytime sleepiness or even a sense of fatigue, having low energy or napping during the day.  Dr Albin: I suspect so many of our patients meet those criterias. That seems, like, wildly simple to do.  Dr Lee-Iannotti: Yes. And if you wanna be the favorite referral person to your sleep neurologist or your sleep specialist, then take another step and do that STOP-Bang. And if you record a score greater than three, that automatically gets them at least a home sleep study.  Dr Albin: It's amazing. And then when you get this data, again, this is really practical, pragmatic stuff, how do you get the report? Does it integrate in your electronic medical record? Does the patient bring it in? How do you get that data back?  Dr Lee-Iannotti: Yeah, so this is where technology is amazing, Dr. Albin. Now we have disposable devices. Sometimes they sync to the WatchPat, or the greater Wi-Fi. So we can get them all through password-protected internet forums that transmits the data, so sometimes the patients don't even have to come back to give us the data. And then we have different forms where we can actually relay the results as well, either through the electronic medical record or through systems themselves to relay those results directly to the patient.  Dr Albin: Yeah, and your article really laid out in beautiful tables, like, all the different devices that are available to patients, and it's honestly mind-blowing how many of these companies and devices exist. So, seems like the world is your oyster in terms of picking from them.  Dr Lee-Iannotti: Absolutely. I think there's... The last time I counted, there was over 20 different home sleep study devices for obstructive sleep apnea. And it's a great thing to have, but sometimes too many choices can be a little bit confusing. So that's where I do say partner with your sleep specialist close by, and they will find the right type of home sleep study device for your particular patient.  Dr Albin: Drilling down a little further, let's say your patient does get diagnosed with OSA. One of the things that really stuck out to me is that there's a whole range of now devices that are new that make this treatment easy so that we can actually prevent and treat neurological conditions by just improving patient sleep. So, walk us through a little bit about how that landscape has changed.  Dr Lee-Iannotti: Sure. And I'll start with the gold standard of treatment, which is still CPAP, which is continuous positive airway pressure. Not only can we monitor the pressure, look at adherence, change the humidification for the patient all remotely through, again, password-protected internet forums, but we can even change the pressure with patients 300-plus miles away.  Dr Albin: Wow.  Dr Lee-Iannotti: It's really cool, right? It prevents patients, especially with significant neurologic debilitation, from having to come into the office for adjustments. The other thing I wanted to mention, Dr. Albin, is for patients, a lot of patients like positive feedback on a daily basis. And a lot of these companies, if you are on CPAP, have come up with a smartphone app that you can look at how many hours you used your CPAP device. They give you a score, and they even tell you how many times you had stoppage of breathing that night.  Dr Albin: I think that this is what's really exciting about where we are in neurology and, like, neurologic care, is we have gotten so much better at getting patients their own data and allowing people to really see that data, integrate lifestyle changes, and see how it impacts them. And that positive feedback loop, I think, is a really powerful tool for our patients to say, "Look, this makes me better," or, "Oh, this makes me worse." I'm just really excited by how much data we can give directly to our patients.  Dr Lee-Iannotti: I agree. It's so empowering. You know, as a CPAP user myself, you want that positive affirmation that all of your efforts at night and cleaning your mask and your machine paid off, and everybody likes to see an A+ on their report card.  Dr Albin: I love that. Now I'm going to ask you on the flip side, I imagine, and I myself am a sleep tracker, like I have my little device and I look at, you know, the score in the morning and I kind of perseverate on like what makes it better, what makes it worse, and I can imagine that sometimes in sleep clinic, people are coming in to you and they have just pages and pages and, you know, they're flipping through all their data from the last year. And I imagine that's pretty overwhelming when you have just the insane amount of data that these devices can generate. So, from another pragmatic, practical standpoint, how are you integrating all that data when someone comes in for a sleep visit?  Dr Lee-Iannotti: I love that question. So first of all, I will say myself, and I think a lot of my sleep colleagues, we love objective data, right? Because it's something that we can see. We can see whether it matches their subject's symptoms. Sometimes it can be a lot of reassurance that, "Look, you actually got more sleep than you thought you did." But sometimes patients will bring in like a month's worth, and that's really hard to analyze, you know, in a 30 or 60-minute visit. So oftentimes what I do is I look at like the last week or last two weeks, and I look at trends. And I think a lot of the apps for whatever device you decide to use have done a really good job in terms of visual graphics to show how much sleep on average you're getting, how much deep sleep or REM sleep or wake-up times that you have. So, I, again, I feel like the technology has really helped us consolidate a lot of data, but also be efficient with the messaging that we relay to our patients.  Dr Albin: Absolutely. And I know personally, at least for the sleep tracker I wear, it also allows you to diary. So, you can say like, "Oh, last night I had a glass of wine," or, "Yesterday I had a really hard workout," or, "I stayed out late with friends," or, "I was on call." Turns out call is really, really bad for my sleep. But it does allow you to sort of track what behaviors, and I wonder how much of that informs what you're counseling patients to do in terms of trying to notice the things that either improve their sleep performance or their subjective feeling of restlessness or restfulness, and how all of that plays into what you're doing in the clinic.  Dr Lee-Iannotti: I love all of those comments. It is validation for the patient. Again, it's empowering for them to look at, what did I do last night to get more REM sleep than the night prior? I want to mention that the best people who do this so well are professional athletes, and they look at, how am I going to cater my day to make sure that I'm sleeping well, that I reduce my risk of injury and concussion and increase my reaction time? And I feel like all of us should do that. That's such a great philosophy, to analyze how we can do things better.  Dr Albin: I love that. This whole issue, but this article in particular, really emphasized to me that sleep, again, it's not a passive time that we're taking a nap. It's a really active form of sort of neurologic healing. There's important removal of toxins through the lymphatics. And like there's a lot happening in sleep, and there are so many more tools that allow us to unpack that sort of peak performance of sleep, which again, sort of is that athletic mentality of like, how can I make this better? Not just to treat a neurologic condition, but also really importantly, to prevent one.  Dr Lee-Iannotti: I often refer to sleep as icing on the cake. With our patients, when you're doing everything right, for example, a multiple sclerosis patient, they're on the right medications, they are exercising, they're participating in rehab, their mood is good, but they're just not getting to the quality-of-life metric that they want to be, it usually is sleep. And if you can add that as a neurologist to your piece of the algorithm to help your patient, it really does improve their quality of life and ultimately their neurologic outcome. I'm a true believer of that.  Dr Albin: I was a true believer. I've been made even more of a true believer through your article and getting to talk to you. I always like to close by asking the person I'm interviewing, what's one really exciting thing in this field? What are you kind of most looking forward to as you think about sleep medicine and its impact in neurology in the next five or 10 years?  Dr Lee-Iannotti: Oh, I love that question, too. So, the thing I'm most excited about in the field of sleep, and specifically sleep neurology, is the power of preventative care. When I did a lot of stroke, I would see young people, older people, healthy people, people with a lot of genetic risk factors come in, and one minute they were totally normal. The second minute, they're paralyzed and can't speak. And for a lot of these patients, I would ask, "Why am I seeing you now? Why couldn't I have seen you 10 years earlier, worked on risk factors, and prevented this outcome?" And I truly believe that is exactly where sleep lies. If you work on sleep, whether you're an adolescent, 20 year old, 30, et cetera, you are ultimately going to prevent horrible cardiovascular, cerebrovascular, neurologic diseases in the long run.  Dr Albin: So important. I really want to direct our listeners back to your article because all of the articles are really practical, but this one in particular looks at how do you do this? What are your options? How do you get this to patients? It really is sort of a step-by-step guidebook on like, A, why this is important, how you should screen, what you should do if someone screens positive for needing to have a sleep study.There's so much more technology that allows really anyone anywhere to have access to the testing that they need to get the right diagnosis, to improve their sleep, to improve their cognitive outcomes, to improve their neurologic health. It's pretty amazing.  Dr Lee-Iannotti: It is amazing. And in the article, I do allude to certain devices and then websites that are very helpful. If I can announce, Dr. Albin, I'm super excited about this. Through work with the American Academy of Sleep Medicine, endorsement with the AAN, we are coming out with a new clinical guideline specifically on home sleep study devices and looking at the validation studies. So, I think that's going to be very helpful. But I hope that everybody after listening to this picks up the phone, call your friendly sleep specialist, and align with them and partner with them. And this will ultimately help your patients, I guarantee it.  Dr Albin: Again, today I've been interviewing Dr. Joyce Lee-Iannotti about her article on sleep diagnostics and monitoring technology in obstructive sleep apnea. This article appears in the August 2026 Continuum issue on Neurology of Sleep. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners, and thank you, Dr. Lee-Iannotti, for joining us today. Dr Lee-Iannotti: Thank you.  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. 

Featuring perspectives from Prof Yohann Loriot, including the following topics: Case: A man in his early 80s with metastatic urothelial bladder cancer (mUBC) receives enfortumab vedotin (EV)/pembrolizumab but experiences immune-related adverse events requiring steroids and then develops neuropathy due to EV — Nazli Dizman, MD (0:00) Case: A man in his early 70s with diabetes who received adjuvant nivolumab for FGFR3-mutant metastatic urothelial cancer receives first-line EV monotherapy and experiences hyperglycemia and cancer progression, then receives erdafitinib and experiences elevated phosphase, Grade 2 diarrhea and stomatitis and eventual disease progression — Jacqueline T Brown, MD (7:00) Case: A man in his late 80s with mUBC receives first-line EV/pembrolizumab and develops pneumonitis — Fern Anari, MD (17:40) CME information and select publications

Featuring perspectives from Ms Blanca Ledezma, Dr Marissa Marti-Smith, Dr Heather McArthur and Dr Ruth M O'Regan, moderated by Dr McArthur, including the following topics: ·      Introduction (0:00) ·      Current Clinical Role of Oral Selective Estrogen Receptor Degraders (SERDs) in HR-Positive Metastatic Breast Cancer (3:37) ·      Practical Considerations with Oral SERDs (15:43) ·      Potential Role of Combination Approaches with Oral SERDs (26:33) ·      Gastrointestinal Adverse Events Documented with Oral SERDs (38:19) ·      Potential Role of Early Therapeutic Switching After Detection of an Emergent ESR1 Mutation (46:54) ·      Other Class-Effect Toxicities Associated with Oral SERDs (1:00:56) ·      Emerging Utility of Adjuvant Oral SERDs (1:10:20) ·      Unique Toxicities Associated with 1 or More Oral SERDs (1:19:22) CME information and select publications

Send us Fan MailWhat happens to your medical practice when the unexpected happens?Whether it's a cyberattack, natural disaster, prolonged power outage, staffing crisis, or another major disruption, every medical group needs a plan to continue caring for patients while protecting its people, operations, and financial stability.In this episode of Medical Money Matters, I welcome Christopher Riccardi, CHSP, CHEP, CHCM-SEC, Manager of Emergency Management and Business Continuity at Rady Children's Hospital Orange County, for an insightful discussion on why business continuity planning is no longer optional for healthcare organizations.Chris has more than two decades of experience helping healthcare organizations prepare for emergencies, build resilient operations, and maintain continuity of care during crises. His work focuses on enterprise business continuity, emergency management, disaster preparedness, and operational resilience across complex healthcare systems.Together, we discuss practical strategies that physician practices and medical groups can implement today to reduce risk, protect patients, and strengthen their organizations before disaster strikes. We discuss what business continuity planning really means for physician practices, some of the most common disruptions affecting medical groups today, and where practices should begin if they don't have a continuity plan.You can reach Chris at: https://www.linkedin.com/in/christopher-riccardi-chsp-chep-chcm-sec-7aba9a59/ and you can download the resources he discusses at: https://asprtracie.hhs.gov/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: https://share.hsforms.com/1FMup6xLPSpeA8hB77caYQwd32sx?hsCtaAttrib=171926995377 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. Promo pricing available now: https://education.healtheps.com/offers/Ry3zfLYp/checkout?coupon_code=PHYSEDGE3000 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/    

This episode explores complex questions around addiction treatment from our audience, including the off-label use of GLPs for SUDs, the nuances of naloxone, and managing high-dose methadone in hospital settings. Experts Drs. Shawn Cohen and Zina Huxley-Reicher, in addition to the co-hosts Drs. Carolyn Chan and Era Kryzhanovskaya share insights, resources, and practical tips for clinicians navigating these challenging scenarios.Claim CME for this episode at curbsiders.vcuhealth.org!By listening to this episode and completing CME, this can be used to count towards the new DEA 8-hr requirement on substance use disorders education.Episodes | Subscribe | Spotify | iTunes | CurbsidersAddictionMed@gmail.com | CME!Show Segments Intro, disclaimer Picks of the Week Off-Label GLP use Naloxone review Acute pain in patients with opioid use disorder (OUD) Care Coordination with opioid treatment programs (OTPs) New medications for pain; suzetrigine Perioperative pain management for patients with OUD Outro Credits Producer, Show Notes, Infographic: Era Kryzhanovskaya, MD Hosts: Carolyn Chan, MD. MHS and Era Kryzhanovskaya, MD Reviewer: Kenny Morford, MD Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest: Shawn Cohen, MD; Zina Huxley-Reicher, MD Sponsor: The Permanente Medical GroupJoin us in New York City as we host Information Sessions on Thursday, August 20th, Friday the 21st, and Saturday the 22nd, , as well as a Social Mixer at the Castell Rooftop Lounge on Friday, August 21st. Visit northerncalifornia.permanente.org and RSVP todaySponsor: UpToDateFor a limited time, listeners can get 10% off UpToDate packages with code CURB1. Visit store.uptodate.com.Sponsor: FIGSGet 15% OFF your first order at wearfigs.com with code FIGSRX.Sponsor: Quince Download the Quince app for app-exclusive offers, or go to Quince.com/curb. Get free shipping on your order and 365-day returns