Podcasts about cme

A regulated exchange suing its own regulator almost never happens. The hosts trace why CME did it, and why the CFTC may have better odds than crypto Twitter thinks. Thanks to our sponsor!

The crew debates whether Saylor's STRC preferred shares are "Luna for suits," unpacks the ETH Labs spin-out and Ethereum Foundation layoffs, breaks down the CME's lawsuit against the CFTC to kill domestic perps, and weighs whether Meta's leaked prediction market Arena is a real threat to Polymarket. Welcome to The Chopping Block – where crypto insiders Haseeb Qureshi, Tom Schmidt, Tarun Chitra, and Robert Leshner chop it up about the latest in crypto. This week, Saylor's STRC preferred shares, which have broken below their $100 target. Laura argues it's a confidence crisis, Tarun calls it "Luna for suits," and Haseeb pushes back — there's no death spiral, Saylor can just defer dividends and "burn the boat." Then the Ethereum Foundation shakeup: ETH Labs spinning out with seven senior EF members while the EF lays off 20% of its headcount. The back half covers the CME suing the CFTC to block domestic perps — which Haseeb frames as "suing for the right to not compete" — and Meta's leaked prediction market Arena, where Tom reveals this is Meta's third or fourth attempt at prediction markets. Let's get into it. Listen to the episode on Apple Podcasts, Spotify, Pods, Fountain, Podcast Addict, Pocket Casts, Amazon Music, or on your favorite podcast platform. Show highlights

Rebecca Hinds is the bestselling author of Your Best Meeting Ever and a leading expert on work transformation and the future of work. Rebecca earned a B.S., M.S., and Ph.D. from Stanford University. In 2022, she founded the Work Innovation Lab at Asana, a first-of-its-kind think tank that conducts actionable research to help leaders and organizations navigate the growing challenges and changes of work. In 2025, she founded the Work AI Institute at Glean, where she leads cutting-edge research on how AI is reshaping work. Rebecca's award-winning research and insights are consistently featured in places like Harvard Business Review, The New York Times, The Wall Street Journal, Forbes, Inc., and Time. Rebecca is a co-instructor for the CNBC Make It course, How to Use AI to Be More Successful at Work, and a columnist at Inc. and Reworked.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.

While Elsevier's most recent Clinician of the Future Report shows increasing adoption of artificial intelligence tools among physicians and nurses, and optimism that they will improve quality of care in the future, a majority raised concerns about trust and reliability. To increase the level of trust, 60% said transparent citations of evidence-based and peer-reviewed research will be key. How to provide that transparency is our focus today as Raise the Line host Lindsey Smith welcomes Elsevier colleagues Rhett Alden and Raman Kaur to guide us through the complexities involved, including the concept of traceability and what role it plays in how AI tools such as Elsevier's ClinicalKey AI are built and deployed.  “Traceability changes the confidence that a clinician has in an AI tool so that they aren't trusting the AI, they're trusting the underlying evidence they're consuming from the AI-assisted platform,” says Raman, who brings years of experience as a primary care practitioner to her work.  It's also important, Rhett adds, to provide additional information, pulled from both the clinician's query and the patient's medical record, to inform clinical thinking. “ClinicalKey AI can be more than a response engine by establishing a larger context to provide a more precise answer for that individual patient.” In this thought-provoking discussion, these experts also provide insights on: Mitigating bias in AI results; Using AI responsibly with sustainability in mind; What type of clinician will benefit most from AI Mentioned in this episode: ClinicalKey AI Clinician of the Future Report 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

Three years ago, Chris Perkins sat across from Terry Duffy in Congress and made the case for perpetuals. Duffy pushed back — hard. Now Duffy's CME is suing the very regulator that finally allowed them. The CME argues Bitcoin perpetual futures are really swaps and should carry far more collateral. Chris traces the Dodd-Frank history that created the swap-versus-future divide, and Austin Campbell lays out why picking this fight in a post-Chevron court could backfire on the incumbent. Is a perpetual a swap or a future, and who gets to decide? Hosts: Austin Campbell - Host of Bits + Bips, Founder of Zero Knowledge Group, and Adjunct Professor at NYU Stern Ram Ahluwalia - Co-host of Bits + Bips and CEO of Lumida Chris Perkins - Co-host of Bits + Bips and Head of Franklin Crypto This clip is from a longer conversation on tokenization, the AI trade, and the CME's lawsuit against the CFTC. Full episode here: https://youtube.com/live/oSiOeWq_pKE  We go live every Monday at 4:30pm ET - subscribe to catch it live.  Sponsor Cape: Your biggest crypto vulnerability isn't your wallet, it's your phone number. Cape is America's privacy-first mobile carrier that rotates your SIM identity daily and blocks SIM swaps before they happen. Get 33% off your first six months at https://cape.co/unchained (use code: UNCHAINED). Chapters ⚖️ 00:00 The incumbent sues its own regulator: what the CME is actually claiming

Send us Fan MailWhat if the biggest threat to your medical practice isn't declining reimbursement, staffing shortages, rising expenses, or even physician burnout?What if it's the culture you've unintentionally created?That may sound dramatic, but after working with hundreds of physician practices across the country, I've seen something over and over again. Practices spend enormous amounts of time worrying about external threats while overlooking the internal dynamics that are quietly draining productivity, increasing turnover, damaging morale, and ultimately affecting patient care.Every day, medical practices lose talented employees, valuable revenue, and patient trust because teams spend more time assigning blame than solving problems.And here's the difficult truth. Most toxic workplace cultures don't begin with bad people. They begin with good people operating inside broken systems.Today we're going to talk about why blame culture develops in healthcare organizations, the hidden costs that most leaders never calculate, how the infamous front-office-versus-back-office battle hurts everyone involved, and most importantly, how you can transform your practice into a culture built on accountability, transparency, and continuous improvement.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/    

Joe's Premium Subscription: www.standardgrain.comGrain Markets and Other Stuff Links —Apple PodcastsSpotifyTikTokYouTubeFutures and options trading involves risk of loss and is not suitable for everyone.

Featuring perspectives from Dr Kristen K Ciombor and Dr John Strickler, including the following topics: Introduction (0:00) Current and Future Role of Immune Checkpoint Inhibitors in the Management of Colorectal Cancer (CRC) — Dr Ciombor (3:58) Other Recent Advances in CRC Management — Dr Strickler (32:57) CME information and select publications

Featuring perspectives from Dr Adam M Brufsky and Dr Kevin Kalinsky, including the following topics: Introduction (0:00) Current and Future Role of TROP2-Directed Antibody-Drug Conjugates in Therapy for Triple-Negative Breast Cancer (TNBC) — Dr Brufsky (5:08) Established Treatment Paradigm for Localized and Metastatic TNBC — Dr Kalinsky (35:20) CME information and select publications

Featuring an interview with Prof Bernd Kasper, including the following topics: Case: A woman in her early 30s develops a progressing desmoid tumor in her abdomen during pregnancy(0:00) Case: A woman in her late 30s with a painful small desmoid tumor in her rectus abdominus undergoes cryoablation (8:04) Case: A woman in her late teens with recurrent desmoid tumors in her right thigh undergoes multiple resections (13:58) Case: A woman in her mid 70s has a desmoid tumor causing erosion in her scapular region (17:19) CME information and select publications

Kalshi just brought crypto perps to the US, targeting a $90 trillion offshore market. Its Head of Crypto, John Wang, explains the bet, the risks, and who Kalshi is actually competing with. ======================================================== Thank you to our sponsor! ⁠⁠⁠Fidelity⁠⁠⁠: Fidelity has been building in crypto and DeFi since 2014 — now they're hiring. Explore career opportunities at one of the most forward-thinking names in finance here: ⁠⁠⁠crypto.fidelitycareers.com⁠⁠⁠. ⁠⁠⁠Cape⁠⁠⁠: Your biggest crypto vulnerability isn't your wallet, it's your phone number. Cape is America's privacy-first mobile carrier that rotates your SIM identity daily and blocks SIM swaps before they happen. Get 33% off your first six months at cape.co/unchained (use code: UNCHAINED). ======================================================== The $90 trillion offshore market for crypto perpetual futures just got its first US-regulated entrant. Kalshi — the prediction market exchange that raised $1 billion at a $22 billion valuation — launched the first CFTC-approved crypto perps, becoming the only domestic exchange approved on launch day. John Wang, Kalshi's Head of Crypto, joins Laura Shin to map how perpetual futures work, why Kalshi's guarantee fund and segregated accounts differ from what offshore venues provide, and how the exchange plans to compete with Hyperliquid, Coinbase, and Kraken. Wang pushes back on CME Group CEO Terry Duffy's claim that crypto perps are "a disaster waiting to happen," noting CME's own futures carry higher leverage than Kalshi's platform. He covers the ARCA and Galaxy block trades on Kalshi's prediction markets, insider trading protections built around athlete and congressional staff lists, and the regulatory filings separating Kalshi from perps on equities. Wang estimates only 0.2% of the US has adopted perpetual futures — the real growth has barely started. Host: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Laura Shin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, Host / Unchained Guests: ⁠⁠⁠⁠⁠⁠⁠⁠⁠John Wang - Head of Crypto at Kalshi Timestamps

CoinDesk hosts Rebecca Rettig and Renato Mariotti open on the record-breaking SpaceX IPO, then turn to Terry Duffy's exit from CME and the exchange's threatened lawsuit against the CFTC over whether perpetuals are swaps or futures. Their guest is Dan Berkovitz, former Commissioner of the CFTC and former General Counsel of the SEC, now at Millennium Management, who brings a rare both-agencies vantage point to the push for SEC–CFTC harmonization, the swaps-versus-futures fight over perps, and the "economic purpose" test he argues sports-betting prediction markets cannot meet. - Check out CoinDesk's latest episode of Public Keys from the NYSE: https://www.youtube.com/watch?v=75LrBmSScvY&list=PLZWrc_gWChqnim-9ZbIKZTOrPA7IgFKVR&pp=sAgC - Register now for CoinDesk's Policy and Regulation event on September 22, 2026: https://policy-regulation.coindesk.com/. - Timecodes: 00:00 The Role of CFTC 00:25 Welcome to The Policy Protocol 00:44 The Record SpaceX IPO and Retail Demand 01:41 Synthetic SpaceX Perps on Hyperliquid 03:40 Terry Duffy Exits CME and Sues the CFTC 06:07 Dan Berkovitz Joins the Show 06:44 Can the SEC and CFTC Harmonize? 08:29 Are Perpetuals Swaps or Futures? 09:11 Prediction Markets and the 'Economic Purpose' Test 11:07 The ErisX Sports Betting Precedent 13:07 The Hurricane Hedging Counterargument 15:02 Why Crypto Couldn't 'Come In and Register' Before 17:28 Gary Gensler Is Back 20:27 Person of the Week: Jamie McDonald

Efforts to preserve Pope Leo XIV's Dolton roots are slowly inching forward. Crain's reporter Rachel Herzog discusses with host Amy Guth. Plus: Controversial Fulton Market high-rise gets City Council sign-off, CME sues CFTC as battle over perpetual futures heats up, Blackstone unit reaches $7 million settlement in RealPage price-fixing lawsuit and Fulton Market retail hub aims to give online brands IRL exposure. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Featuring perspectives from Dr Yelena Y Janjigian and Dr Samuel J Klempner, including the following topics: Introduction (0:00) Role of Anti-PD-1/PD-L1- and CLDN18.2-Directed Antibodies in the Management of Gastroesophageal Cancers — Dr Klempner (5:52) Management of HER2-Positive Gastroesophageal Cancers — Dr Janjigian (28:20) CME information and select publications

Featuring perspectives from Dr Deborah K Armstrong and Dr David M O'Malley, including the following topics: Introduction (0:00) PARP Inhibitors and Strategies Targeting Folate Receptor Alpha in Advanced Ovarian Cancer — Dr Armstrong (4:37) Other Novel Agents and Strategies for the Treatment of Advanced Ovarian Cancer — Dr O'Malley (35:18) CME information and select publications

Craig Earley serves as the COO at Baptist Memorial Hospital - Memphis. In this role, Craig provided strategic leadership across numerous ancillary and clinical service lines, driving improvements in coordination, efficiency, patient experience, and employee engagement. His leadership contributed to meaningful reductions in test turnaround times and length of stay, as well as record-high outpatient satisfaction scores.In May, Craig will become the CEO and Administrator of NEA Baptist Hospital in Jonesboro, AR.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.

It's been one year since the U.S. Centers for Disease Control and Prevention, in an unprecedented move, dismissed all the members of its Advisory Committee on Immunization Practices (ACIP), kicking off what would turn out to be a very concerning and busy year for infectious disease specialists.  We're going to recap this turbulent period – which includes a resurgence of measles, an unusually rough flu season, the emergence of a new COVID strain and outbreaks of hantavirus and Ebola – with Dr. William Schaffner, one of the country's most frequently quoted medical experts on infectious disease, vaccination, and public health. As a member of ACIP for decades, Dr. Schaffner brings unique insight into the dismantling of the committee and the distrust of vaccines that lies at the root of the changes. As he explains to Raise the Line host Lindsey Smith, while many vaccine critics are beyond reach, there are those he describes as vaccine hesitant that may be persuadable if the right approach is taken. “Beyond providing facts, we have to listen to them and respond to their concerns and make them feel comfortable. Information is fundamental, but behavior change only comes with a change in attitude.” Tune in for a wealth of wisdom and context that includes observations on: What's complicating containment of the Ebola outbreak; Challenges in public health communication in the current social media environment; What grade health authorities should get on their response to the hantavirus outbreak. Mentioned in this episode:Vanderbilt University School of Medicine 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 a slide presentation and related discussion from Prof Martin Reck, including the following topics: Overview of small cell lung cancer (SCLC) (0:00) First-line chemoimmunotherapy for extensive-stage SCLC (ES-SCLC) (3:50) Lurbinectedin as first-line maintenance therapy for ES-SCLC (12:36) Case: A man in his early 60s with ES-SCLC receives first-line atezolizumab/carboplatin/etoposide followed by maintenance lurbinectedin/atezolizumab (18:46) Case: A woman in her mid 70s with ES-SCLC experiences a strong response to first-line chemoimmunotherapy and maintenance lurbinectedin/atezolizumab (21:21) CME information and select publications

Featuring perspectives from Dr Hans Lee and Dr Noopur Raje, including the following topics: Introduction (0:00) Integrating Chimeric Antigen Receptor T-Cell Therapy and Bispecific Antibodies into the Management of Relapsed/Refractory Multiple Myeloma (R/R MM) — Dr Raje (4:30) Antibody-Drug Conjugates and Other Emerging Therapies for R/R MM — Dr Lee (28:33) CME information and select publications

Featuring perspectives from Dr Terence Friedlander and Dr Daniel P Petrylak, including the following topics: Introduction (0:00) Role of Immunotherapeutic Strategies in the Management of Nonmetastatic Urothelial Bladder Cancer (UBC); Emerging Utility of Circulating Tumor DNA Evaluation — Dr Friedlander (3:53) Other Novel Agents and Strategies for Nonmetastatic and Metastatic UBC — Dr Petrylak (26:41) CME information and select publications

Featuring an interview with Prof Martin Reck, including the following topics: Case: A woman in her mid 70s with extensive-stage small cell lung cancer (ES-SCLC) experiences a strong response to first-line chemoimmunotherapy and maintenance lurbinectedin/atezolizumab (0:00) Biology of small cell lung cancer and pharmacodynamics of systemic treatment (3:25) Considerations with maintenance therapy for ES-SCLC (9:31) Considerations with immunotherapy for ES-SCLC (13:12) Curability of SCLC with systemic therapy (15:17) Data with chemoimmunotherapy for patients with poor performance status (25:55) Future developments in therapy for SCLC (30:11) Rapid fire: Small Cell 101 (35:45) CME information and select publications  

CME Group filed a federal lawsuit in Washington, D.C. against the U.S. Commodity Futures Trading Commission (CFTC) and Chairman Michael Selig. The suit challenges the regulator's recent decision to approve perpetual futures for Kalshi and Coinbase, arguing that these 24/7 contracts are legally swaps rather than futures. GUEST: Chris Perkins, CEO of 250 Digital Asset Follow Chris on X ➜ https://x.com/perkinscr97 ~This episode is sponsored by iTrust Capital~ iTrustCapital | Get $100 Funding Reward + No Monthly Fees when you sign up using our custom link! ➜ https://bit.ly/iTrustPaul 00:00 intro 00:10 Sponsor: iTrust Capital 00:31 Chris Perkins on Perps 03:25 Terry Duffy Sues CFTC 04:35 CME Trying To Kill Crypto Perps 07:24 Terry Duffy Calls Michael Selig a Liar on CNBC 07:56 Banning Hyperliquid? 09:55 CME Monopoly Power 11:20 Chicago Crypto "Privilege Tax" 12:17 Federal Reserve Stablecoin ID Checks!? 16:19 $STRC Collapsing! 18:35 BlackRock Causing $STRC Mass Exit? 19:54 Coincidence? 20:15 CNBC Fudding Michael Saylor 21:08 Nothing To Worry About? 22:24 Michael Saylor: A.I. is Not a Problem 23:00 Quantum & A.I. will help crypto? 24:00 Lightning Round 24:26 July 4th Crash 24:40 Peter Schiff 24:52 CME vs Hyperliquid 25:11 Strategy to BlackRock? 25:34 Brian vs Dimon 26:10 Morpho & Vaults 27:12 SpaceX vs Solana & Hyperliquid 27:40 Binance vs Coinbase 28:55 Federal Reserve vs Uncertainty 30:36 outro #Bitcoin #XRP #Ethereum ~TradFi Sues CFTC!

Alex Thorn talks with CZ, founder of Binance, about where we sit in the four-year cycle and whether $60K is the new floor, why there are no dead bodies floating up this time, the great convergence of TradFi and crypto and why he thinks it should just be one industry, perps coming onshore to CME and CBOE, his take on Hyperliquid's no-KYC model, prediction markets and the state-versus-federal fight, why he'd freeze Satoshi's coins a year after a quantum fork, what YZI Labs is funding beyond crypto including an artificial womb company, and why agentic AI payments will run on crypto in months not years. Participants, along with Galaxy Digital, hold a financial interest in Bitcoin (BTC). Galaxy regularly engages in buying and selling BTC, including hedging transactions, for its own proprietary accounts and on behalf of its counterparties. Galaxy also provides services to vehicles that invest in BTC.  If the value of such assets increases, those vehicles may benefit, and Galaxy's service fees may increase accordingly. The valuation in this communication is based on technical, fundamental, and market analysis and not on any formal valuation method. For more information, please refer to Galaxy's public filings and statements. Cryptocurrencies, including BTC, are inherently volatile and risky and ultimate market movements may not align with this statement.   For additional risks related to digital assets, please refer to the risk factors contained in filings Galaxy Digital Inc. makes with the Securities and Exchange Commission (the “SEC”) from time to time, including its Quarterly Report on Form 10-Q, available at www.sec.gov. This episode was recorded on Wednesday, June 10, 2026. ++ Follow us on Twitter, @glxyresearch, and read our research at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.galaxy.com/research/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ to learn more! This podcast, and the information contained herein, has been provided to you by Galaxy Digital Holdings LP and its affiliates (“Galaxy Digital”) solely for informational purposes. View the full disclaimer at ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.galaxy.com/disclaimer-galaxy-brains-podcast/⁠⁠⁠⁠⁠⁠⁠⁠

Listen to the SF Daily podcast for today, June 18, 2026, with host Lorrie Boyer. These quick and informative episodes cover the commodity markets, weather, and the big things happening in agriculture each morning. Key points that are impacting the commodity markets today include the Iran peace deal in relation to global energy markets. Many are pushing for vessels to resume moving through the Straits of Hormuz, and the global weather. Ethanol output fell slightly, with the Midwest experiencing the lowest level in three weeks. Feeder cattle futures saw a slight increase, and the CME feeder cattle index was up 2 cents. Wholesale box beef prices were mixed, with Choice boxes down and Select boxes up. Flood warnings were issued for northern Illinois due to excessive rainfall, and more rain was expected in western and central Illinois and southern Wisconsin. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Featuring perspectives from Dr Joyce F Liu, Dr David M O'Malley and Dr Brian M Slomovitz, moderated by Dr O'Malley, including the following topics: Introduction (0:00) Strategies to Identify Patients with HER2-Positive Gynecologic Cancers — Dr Liu (2:52) Available Data with and Practical Application of HER2-Targeted Therapy in Advanced Gynecologic Cancers — Dr Slomovitz (25:16) Identification and Management of Adverse Events with Trastuzumab Deruxtecan — Dr O'Malley (1:00:31) CME information and select publications

Primary stroke prevention is a critical opportunity for neurologists, with most stroke risk driven by modifiable factors such as hypertension and lifestyle behaviors. This episode highlights practical tools and strategies, including Life's Essential 8 and contemporary risk calculators, while also exploring evolving approaches to shared decision making and secondary prevention. In this episode, Katie Grouse, MD, FAAN, speaks with Mitchell S. Elkind, MD, MS, FAAN, author of the article "Stroke Prevention" in the Continuum® June 2026 Cerebrovascular Disease 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. Elkind is the Chief Science Officer for Brain Health and Stroke at the American Heart Association in Dallas, Texas, and a professor of neurology and epidemiology at Columbia University in New York, New York. Additional Resources Read the article: Stroke Prevention 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 Guest: @MitchElkind Full episode transcript available here Dr Grouse: Neurologists have generally been more involved in secondary stroke prevention, but primary stroke prevention is increasingly recognized as an important topic of discussion for neurologists. Today, I have the opportunity to interview Dr. Mitchell Elkind, who wrote the article on stroke prevention in the newest Continuum issue on cerebrovascular disease.  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. Mitchell Elkind about his article on stroke prevention. This article appears in the June 2026 Continuum issue on cerebrovascular disease. Welcome to the podcast, and please introduce yourself to the audience.  Dr Elkind: Thank you so much, Katie. So, my name is Mitch Elkind, and I'm the Chief Science Officer for Brain Health and Stroke at the American Heart Association and a stroke neurologist by background.  Dr Grouse: Well, I just want to start by saying that I really enjoyed reading this article. I think this is just a really wonderful article I recommend strongly. Such a high yield, an important topic for a lot of us who see patients who are interested in learning about their stroke risks or need help with, uh, stroke prevention after having a stroke. So, I wanted to start. What's changed in the last couple of years? You know, what are some big highlights that you really want to stress that are different from maybe the last time we reviewed this topic?  Dr Elkind: Sure. Well, there's been a lot of development in the field of secondary stroke prevention, for one thing. But even beyond that, I think we increasingly appreciate how important it is to control what we call the social drivers of health on the earlier side, primordial or primary prevention. And that has been a big advance, I'd say. And I would also say, I think it's really important for neurologists to understand some of those questions about primordial and primary prevention. You know, we tend to get involved with patients after they've had a stroke or maybe a TIA, some kind of event. But sometimes we find people who are following for, you know, non-stroke related conditions who have risk factors also. And we can really play an important role in identifying those risk factors and helping to prevent a first stroke or vascular event as well. So, I think it's real important for us to be doctors even before we're neurologists. So, you know, Katie, about ninety percent of stroke risk is modifiable, so we can do a great job as neurologists in preventing stroke. And one of the most important things that we can do is to identify and treat high blood pressure. And recently, actually, the American Heart Association, American College of Cardiology guidelines on the management of hypertension have said that treatment of high blood pressure not only prevents stroke, but it can also help to prevent cognitive decline and dementia. And this is the first time that we've had a class of recommendation one and level of evidence A, the highest level of recommendation we give for the use of blood pressure treatment to prevent dementia. And that's largely based on the results of some large trials that have come out recently showing that you can prevent dementia with blood pressure control. So that's a really exciting link, I think, between cardiovascular risk factor control and subsequent brain health. It just illustrates the role that neurologists can play in, so many conditions outside of stroke as well.  Dr Grouse: That's a really great point, and I want to get a little more into the idea of primordial stroke prevention. Can you tell us a little bit more about what that might be?  Dr Elkind: So primordial prevention refers to addressing how we can prevent risk factors from occurring in the first place, and how can we improve the environments in which people live. You know, we know that only about twenty percent of health outcomes is dependent on what happens between the patient and their doctor in the office. About eighty percent of it is due to what happens in the environments in which we live, work, pray, and play. And so that's what we mean when we refer to the social drivers of health. What is the neighborhood like where somebody lives? Do they have access to healthy food? Do they have places where they can go to exercise? Is there air pollution in the area that may affect their health? You know, one really interesting fact that's become apparent in the last few years is that air pollution is a major risk factor for stroke. Something like a sixth of all strokes can be attributed to the quality of air. And so, what are the things we can do at the broader public policy, community level to reduce the risk of risk factors like high blood pressure and diabetes even before somebody has an event that brings them to the attention of the doctor? So that's what we're thinking about with regard to primordial prevention. It's the earliest stage in prevention.  Dr Grouse: And that's really fascinating. You know, I think an area that we haven't, as neurologists, really put a lot of our time thinking about, but clearly a very important thing. I really appreciated reading your article about how you incorporated the fact that, you know, a lot of these risk factors overlap very, very closely with all the risk factors for various types of cardiovascular events. And I would imagine that the work you've done as the Chief Clinical Science Officer for the American Heart Association has informed a lot of the way you've thought about-Trying to bring all these risks together and think a little bit more holistically about the whole thing. Could you tell us a little bit more about that and the work that you've done on the American Heart Association's Life's Essential 8 score?  Dr Elkind: Sure. I can't take credit for it. It's really work that was done by others at the Heart Association, particularly a cardiologist and epidemiologist named Don Lloyd-Jones. But many other volunteers participated. Life's Essential 8 is our approach to primary stroke prevention and cardiovascular prevention more broadly. We say Life's Essential 8 because it includes four health behaviors and four health factors that people can observe to reduce their risk of cardiovascular disease. The four factors are kind of things like know your numbers, your blood pressure, your blood sugar, your body mass index, right, which is a combination of weight and height, and your cholesterol level. So, know those numbers and keep them within the recommended ranges, and talk to your doctor if they're not. And then four lifestyle behaviors. So, one of them is to eat a healthy diet, and typically that means the Mediterranean diet. It means getting regular exercise, and we recommend 150 minutes a week of moderate to vigorous physical activity. Of course, it means abstinence from smoking or other tobacco products. And the last one, the eighth one, which I was so excited about when we added this, is sleep, recommending at least seven hours of sleep a night. So, I was really excited about this because we used to talk about Life's Simple 7, and then the last iteration of our recommendations included this recommendation for adequate sleep because of the mounting evidence of the importance of sleep to cardiovascular health. But sleep is really a brain function, right? And so, it was really the first, in a way, specific brain function that was added to our recommendations. So that's Life's Essential 8. People can read about it online at heart.org and recommend it to your patients as a simple way for people to understand the best approach to reducing their risk of cardiovascular disease, including stroke.  Dr Grouse: I checked it out myself after reading the article. It's very accessible to patients. It's a great education tool. And they can, you know, see their own score and use that in their own way to, to think about what their risks are and how they can help mitigate and then rescore themselves down the line. There's also, though, on the kind of more the clinician side, the PREVENT calculator as well. Could you tell us a little bit more about how we could use that in approaching this patient population?  Dr Elkind: Yeah. So, I think of Life's Essential 8 as being a patient-focused tool that people can use. PREVENT is really more for clinicians. Anybody can look it up online and enter your data into it. There's a risk calculator online. But the basic idea behind PREVENT and other similar risk calculators is that it's a way to estimate somebody's risk of having a cardiovascular event like stroke or a heart attack or even heart failure by entering information about your health. And we used to think, we used to use something called the ASCVD, atherosclerotic cardiovascular disease risk calculator, or the Framingham score. Framingham Heart Score, for example, was another one. PREVENT is the latest version, and it has several advantages over those earlier types of risk predictors. For one thing, it predicts risk at younger ages as well. It goes down to age 30. It predicts risk over a longer duration of time, so over 30, 10 or 30 years. It eliminates the use of race as an item to put into the calculator and substitutes for that socioeconomic status, so it's not a race base, but a measure of social disadvantage. And it also includes kidney elements, kidney measures. It includes renal function, for example, that weren't included in prior measures, and it can also be used to predict heart failure, which was not part of the original calculators. Another major advantage of the PREVENT study is that it was based on real-world data from about three million patients, many, many more than the 50,000 or so that the earlier risk calculators were based on. So, it has a much more robust data set and therefore allows a bit more precision in the ability to predict future risk of events. And typically, primary care doctors would enter their patient's data, calculate a risk, and then based on the results of the risk calculator, they can make recommendations about what type of medications a person should take or what other strategies they could use to reduce their risk. And so that's the role that PREVENT plays, is really being focused more for the clinician than the patient.  Dr Grouse: Really great tool for us to be aware of. You earlier alluded to the fact that neurologists are in the situation where we sometimes are helping patients with this primary prevention. But you also make a case for why it's in the patient's best interest for us to be involved in, in these conversations when we can, when we have the opportunity. Can you tell us more about that?  Dr Elkind: Shared decision-making is really important because we know that people aren't going to lead the healthiest possible lives if they're not invested in their care. And so, a doctor telling somebody what to do if the patient doesn't want to do it is gonna have limited benefit.So we emphasize the importance of shared decision-making as much as possible. And I think that where this comes up a lot is actually in the situation of, for example, atrial fibrillation, where patients will often be put on a blood thinner. And many people are fearful of blood thinners. They worry about the risk of bleeding. Maybe they know a relative who's had a bleeding complication from a blood thinner, and so they may be disinclined to try it. And so, it's really important to have these discussions about the risks and the benefits of medication and engage the patient in thinking about this. And there are even tools and visual aids that people can look to to help explain some of these complicated concepts to patients. So, these are the kinds of things that reflect implementation science as a way to improve adherence. We know what works in a clinical trial setting often, but the challenge is translating that into the real world and getting our patients to use the medications that we believe scientifically have been shown to be of benefit. I've actually been surprised sometimes at conversations I've had with people, in some cases, healthcare professionals who resist going on blood thinners because of their fear of the complications. And I feel like the evidence is there. Why don't they believe me? And that's why it's really important to have the conversation. Even our peers and colleagues can sometimes question the evidence, and it's important for us to be aware of that.  Dr Grouse: Absolutely. I think that sounds very reasonable to me, and hopefully these tools will help us with making some of these decisions with our patients. Now, turning our attention a little bit to secondary prevention. So, you know, someone's already had a stroke or a TIA, sort of thinking about what we can do to optimize their risk factors for further strokes. You know, I think there has been some changes that have happened, I think, in the last few years that might be affecting some of the decisions we're making and some of the advice we're giving our patients. I wanted to talk a little bit about GLP-1 receptor agonist medications. Is the data there to support use of this either in secondary prevention or even in primary prevention in the case of stroke?  Dr Elkind: There is evidence that supports the use of GLP-1s for stroke prevention. We need more data, though. We need trials that focus only on patients with stroke, for example, there have been studies in patients with cardiovascular disease broadly that include stroke patients. But if you look at the subcategory just of stroke patients alone, the data in that subgroup alone don't always show a benefit. And so, we need more data that's focused on stroke patients alone. So, I think the data are continuing to emerge, but we need more still.  Dr Grouse: Is there any development in the thought about whether we should be putting patients on antiplatelet therapies for incidental, incidentally identified strokes? For instance, if you got an MRI for migraine or for other reasons and you found one, no history of any stroke-like symptoms. Should we be putting these patients on aspirin or any other types of therapies?  Dr Elkind: That's a really great question. And again, it's an area where there's some controversy and really, there's really no definitive data that would support using antiplatelet therapy in people with incidentally discovered infarcts or what we call, you know, whispering strokes or silent strokes. Many stroke neurologists will use antiplatelet agents. This is one of those areas where it's so important to identify the risk factors. As we were saying before, patients who have other neurological disorders like migraine or epilepsy may turn out to have cardiovascular risk factors like diabetes and high blood pressure. That's why it's so important for neurologists to be able to treat those patients or refer them to specialists who can. Patients who have incidentally discovered lesions similarly are a group where we should be looking for risk factors. So, I don't think of it only in terms of do we put them on an antiplatelet or not, but really more holistically, can we identify their other risk factors and address those? Should the patient's information be entered into a risk calculator like PREVENT, for example, so that we can come up with a more global or holistic measure of their cardiovascular risk and address that as appropriate? Because if they are at risk for stroke, they're also at risk for cardiac events, including heart attack, heart failure, sudden cardiac arrest, and so forth. So, I think of it as a, as a great kind of teachable moment or an opportunity to catch somebody and bring them into the healthcare system more broadly and address those other potential risk factors.  Dr Grouse: Speaking of, of risk factors that we often like to think about and work up when possible, in cases where it seems certainly possible the patient had an embolic stroke, but perhaps we've done a few weeks or four weeks of cardiac monitoring, have not found any evidence of atrial fibrillation. What's new and what's the current recommendations for doing further monitoring when there's high suspicion for cardioembolic stroke?  Dr Elkind: This is a really active area of investigation, and guidelines suggest that we should do some cardiac monitoring for atrial fibrillation after an unexplained stroke, but it's not clear how much we should do. Studies generally show that the longer you follow somebody on a cardiac monitor after stroke, the more likely you are to detect atrial fibrillation. It could be as high as thirty percent after a few years. And that's great. And if you detect atrial fibrillation, people usually end up being recommended for a blood thinner. But how extensively we should monitor remains unknown. And I think a lot of the investigation recently has been around the question of, are there other ways to get that information rather than waiting six months or a year for the person to develop atrial fibrillation?It's a little bit funny logically to think a person has a stroke today, a year later you discover atrial fibrillation on the monitor, and you say, "Oh, now I know what caused your stroke a year ago." Right? The temporality, the causality perhaps is off in that case. And so, wouldn't it be better if we could tell what somebody's risk of having another cardioembolic stroke is, or the likelihood that they have atrial fibrillation is at the time that you first see them for the stroke, you know, in the hospital, for example. And so, there's some really new technologies that have evolved like AI or artificial intelligence interpretation of EKGs that can give a really good indication of which people are gonna go on to develop atrial fibrillation. And so, I think we need some more trials in that area to demonstrate that we can detect the risk of AFib and treat that even before it appears on one of those delayed monitors. That's an area that I think is very exciting right now. There's also a further question with regard to how to treat these patients, which is that sometimes atrial fibrillation is a consequence of the stroke itself. So, we can think about what people call known AF, meaning atrial fibrillation that's known about before the stroke even occurs, versus AF that's detected after a stroke, or AF-DAS, people will say. Those may have very different implications for the risk of recurrence and what the person's cardiovascular status is. So, I think what we've learned over the last few years is that atrial fibrillation, it used to be like the slam dunk for a stroke neurologist. It was the easy thing. You know, you had a stroke, you have AFib, you should be on a blood thinner. Now we know that there's lots of different kinds of AFib. There's AFib before stroke, there's AFib after stroke, there's burden of atrial fibrillation. So, some people may have 30 seconds of AFib, some people may have several hours, some people may be in it continuously. It comes and goes, and that can make it challenging to manage. So, we have a lot more work to do to understand this problem better.  Dr Grouse: That also gets me into some other interesting areas that I think there's still some question, you know, how aggressive should you be? How often is it a case of is this correlated or is this causative? For instance, when a patent foramen ovale is, is discovered in patients with cryptogenic stroke. Are there any tools or new developments to help us understand whether these PFOs should be closed in these cases?  Dr Elkind: PFO and stroke is a great story that's been going on for decades. And again, we've made tremendous progress in the last several years. So, it's true that about 20% or so of people have a PFO, and because of that, it can be really hard to say with any certainty whether an individual patient sitting in front of you, that the PFO was the cause of their stroke. Rarely we can have a really high degree of certainty. You know, if somebody has, uh, a DVT, for example, and shortly after that maybe they have pulmonary embolism and then a stroke, and we can say, "Oh, clearly this was a paradoxical embolism," went to the lungs and then some crossed over and went to the brain. That happens really infrequently. Most of the time you're faced with a patient who has a PFO and a stroke, and they may have some other risk factors. There are some tools that we can use to help figure out the likelihood that a PFO is related to a stroke. One of those is called the ROPE score or the risk of paradoxical embolism score that was developed by David Thaler and, uh, David Kent from Tufts and a group of other investigators as well. That score allows one to say what the likelihood is that the PFO was causative of the stroke, and it's based on a person's risk factors such that the younger you are, the more likely it is the PFO caused the stroke. And the absence of risk factors make it more likely that the PFO caused the stroke. So, the higher your ROPE score indicating the fewer other reasons you have a stroke, the more likely the PFO is to be causative. So that can be helpful in identifying patients who may have had a stroke due to their PFO. There are other features that are identified in something called the PASCAL score, which is a way of assessing the degree of shunting and whether or not there's an atrial septal aneurysm that can be used as additional factors that lead to the likelihood that a PFO was causative rather than just incidental. So, by putting this kind of information together, we can kind of do precision neurology or precision prevention by identifying which patients with a PFO are really the ones we need to worry about and do procedures like closure.  Dr Grouse: I look forward to hearing more and learning more as more advances are made in these areas. Dr Elkind: Thank you.   Dr Grouse: And thank you so much for joining us today to talk about your article.   Dr Elkind: Oh, I appreciate it. Thank you for giving me the opportunity. I really enjoyed it.  Dr Grouse: Again, today I've been interviewing Dr. Mitchell Elkind about his article on stroke prevention. This article appears in the June 2026 Continuum issue on cerebrovascular disease. 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.

AUA2026: Focus on: Metastatic Urothelial Carcinoma CME Available: https://cme.auanet.org/URL/FOCUS264ONL LEARNING OBJECTIVES: After participating in this CME activity, participants will be able to: 1. Select appropriate first-line therapies for patients with locally advanced or metastatic urothelial carcinoma during initial treatment planning, in accordance with updated NCCN guidelines. 2. Evaluate holistic management approaches, including treatment sequencing, therapy transitions, and long-term follow-up for patients with locally advanced or metastatic urothelial carcinoma throughout the course of disease. 3. Implement strategies to recognize, monitor, and mitigate treatment-related adverse events in patients receiving systemic therapy for locally advanced or metastatic urothelial carcinoma. 4. Integrate shared decision-making tools and communication strategies into clinical practice to ensure alignment of treatment choices with patient values and caregiver input. 5. Distinguish between treatment pathways for different stages of advanced bladder cancer, including variant histologies to ensure accurate staging and appropriate therapy selection based on the latest NCCN guidelines. ACKNOWLEDGEMENTS Support provided by independent educational grants from: Merck & Co., Inc. Pfizer, Inc.

In this episode, Tracey Davidoff, MD, Joe Toscano, MD, and Christopher Chao, MD, discuss the June 2026 Evidence-Based Urgent Care article, Management of Acute Asthma Exacerbations in Urgent Care: An Update.0:27 Podcast introduction1:26 Housekeeping & promotions2:06 Topic introduction2:54 GINA guidelines & ICS rescue9:43 Epinephrine — IM & inhaled12:15 Managing severe exacerbations17:14 Pregnant patients30:01 Pediatric considerations30:40 Exercise-induced bronchospasm vs. exercise-triggered asthma33:07 Dangers of oral corticosteroids35:37 Outro & next month's topicSubscribers, take the CME here.Not a subscriber? Join here!

In this special episode, Rip shares a preview of Vital Signs: Real Food. Real Medicine. Real Change., Plant Strong's upcoming CME-focused conference for healthcare providers who want to bring the power of whole-food, plant-based nutrition into real-world clinical care.This is not just another conference. Vital Signs is about helping doctors, nurses, dietitians, health coaches, and medical professionals build confidence in the evidence so they can walk into the exam room and talk about food with clarity, conviction, and hope.And here's why that matters: most providers see roughly 1,000 patients a year. Each of those patients eats three meals a day. That means every provider we reach with this message has the potential to influence nearly one million meals.One million meals.That is the power of changing the confidence of one healthcare provider. That is the power of putting real food, real evidence, and real tools into the hands of the people patients already trust.In this preview, Rip begins with the gap in medical education: providers receive thousands of hours of training in diagnosing, prescribing, and managing disease, yet most are taught very little about food as a clinical tool. And yet so much of what walks through the door every day — heart disease, type 2 diabetes, hypertension, obesity, metabolic dysfunction, inflammation, fatigue, and loss of vitality — is deeply connected to diet and lifestyle.This conversation asks a better clinical question:What would change if food was treated as part of the prescription?You'll hear from physicians who are using lifestyle medicine in real clinical settings, beginning with cardiologist Dr. Brian Asbill, who shares a powerful patient case that changed the way he practiced medicine. His story shows that food as medicine is not simply about “eating better.” It can be a therapeutic intervention that moves risk factors, restores hope, and helps patients understand that their bodies can respond.From there, Dr. Laurie Marbas, a board-certified family and lifestyle medicine physician, brings the conversation into the realities of primary care. She shares how providers can begin a food-as-medicine conversation inside a 15-minute visit, how to avoid overwhelming patients, and how one practical, specific recommendation can plant a seed for meaningful change.Next, Dr. Sunny Sharma shares what changed when he went from physician to patient after being diagnosed with a rare brain tumor. His experience deepened his empathy, strengthened his belief in prevention, and reminded him that patients are not just lab values. They are people carrying fear, stress, family responsibilities, habits, barriers, and hope.The conversation then turns to the provider side of the exam room with Dr. Kristin Kelber, a physician in Cleveland who now practices lifestyle medicine full time. Dr. Kelber speaks to provider burnout, moral distress, and the joy that can return to medicine when clinicians are equipped to help patients truly reclaim their health.Finally, Rip closes the faculty portion with a special message from his father, Dr. Caldwell B. Esselstyn Jr., whose decades of work have helped reshape what is possible in the prevention and treatment of cardiovascular disease. Dr. Esselstyn speaks directly to providers about nutrition, cardiovascular disease, patient empowerment, and the importance of helping patients become the locus of control in their own health.What you'll hear in this episode is a compressed version of what Plant Strong is building atVital Signs 2026, taking place October 18–20 at Case Western Reserve University in Cleveland, Ohio.At the full event, providers will go deeper into cardiovascular disease, metabolic health, behavior change, patient resistance, provider burnout, implementation, whole plant-centered meals, peer exchange, and the practical tools needed to bring lifestyle medicine into real patient care.This episode is also a call to action for the Plant Strong community.So many listeners ask, “Where can I find a provider who supports my decision to use a plant-based lifestyle in pursuit of better health?”One powerful answer is this: help us reach the providers who already care for you.Share this episode with your doctor, cardiologist, nurse practitioner, dietitian, health coach, or healthcare team. Invite them into this conversation. Encourage them to attend Vital Signs.Because if we want to move the needle in healthcare, we have to help the people inside healthcare feel empowered to prescribe one of the most powerful medicines on the planet: plants.Learn more about Vital Signs:https://plantstrongevents.com/VitalSignsWatch the Conference Preview on YouTube:https://youtu.be/U42ySRuG4gw

Featuring perspectives from Dr Neeraj Agarwal, Dr Elisabeth I Heath, Dr Daniel P Petrylak, Dr Fred Saad and Dr Neal D Shore, moderated by Dr Heath, including the following topics: Introduction (0:00) Evolving Management of Nonmetastatic Hormone-Sensitive Prostate Cancer (HSPC) — Dr Shore (2:12) Current Hormonal Treatment for Metastatic HSPC (mHSPC) — Dr Petrylak (27:54) Current and Future Role of PARP Inhibitors for Metastatic Prostate Cancer (mPC) — Dr Agarwal (50:49) Emerging Role of AKT Inhibition for Patients with mHSPC — Dr Heath (1:13:12) Current and Future Use of Radiopharmaceuticals for mPC — Dr Saad (1:37:26) CME information and select publications

Featuring perspectives from Dr John N Allan and Dr Adam Kittai, including the following topics: Introduction (0:00) Current Management of Newly Diagnosed Chronic Lymphocytic Leukemia — Dr Allan (8:47) Noncovalent Bruton Tyrosine Kinase Inhibitors and Other Novel Strategies — Dr Kittai (38:14) CME information and select publications

Send us Fan MailIf I walked into your organization today and asked you one simple question — “What is your revenue cycle trying to tell you?” — would you know the answer?Not your collections rate. Not your days in A/R. Not your monthly deposits. I mean the deeper answer. What operational stories are hiding inside your numbers right now?Because most healthcare organizations still think about revenue cycle as a billing department function. Claims go out. Payments come in. Denials get worked. Aging gets reviewed. End of story.But high-performing organizations understand something very different: your revenue cycle is not just billing. It is operational intelligence. It is one of the clearest mirrors of how your organization is actually functioning.Every metric tells a story. Your denial patterns tell stories. Your charge lag tells stories. Your payer behavior tells stories. Your provider coding and undercoding variation tells stories. Your scheduling data tells stories. Even your unapplied credits and unpostables tell stories. And the organizations that thrive financially are usually the organizations that have learned how to listen carefully.So today I want to challenge you to think differently about your revenue cycle. Not as a back-office function. Not as an administrative burden. But as one of the most important diagnostic tools in your entire organization.Because here's the truth: your revenue cycle is talking to you every single day. The question is whether anyone is listening.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/    

In this episode, Farm4Profit sits down with Tommy Grisafi, founder of Ag Bull Trading and Ag Bull Media, a veteran commodity trader with more than three decades of experience navigating agricultural markets. Tommy shares the story of how a high school field trip to the Chicago Board of Trade sparked a lifelong passion for commodity trading and eventually led him to become a member of both the Chicago Board of Trade and CME. The conversation explores the realities of grain marketing and why it often proves more difficult than growing the crop itself. Tommy dives into the emotions that drive decision-making—greed, hope, ego, and fear—and explains how these factors can quietly cost farmers more than any market downturn. Topics include: Tommy's journey from the CBOT trading floor to Ag Bull Trading How commodity markets have evolved over the past 30 years Whether today's flood of information helps or hurts decision-making How producers can identify trustworthy market advisors Why risk management matters more than ever The traits shared by successful grain marketers Common habits that hold producers back Why profitable opportunities are often missed Market outlooks for corn, soybeans, wheat, fertilizer, fuel, and interest rates What younger farmers should focus on as they build their operations The importance of discipline and consistency in marketing plans Tommy also shares stories from some of the most volatile periods in agricultural markets and discusses the lessons he's learned from both winning and losing trades. Whether you're marketing old crop grain, planning for next year, or simply trying to make better decisions in an uncertain environment, this episode offers valuable insights from someone who has spent a lifetime studying market behavior. Want Farm4Profit Merch? Custom order your favorite items today!https://farmfocused.com/farm-4profit/ Don't forget to like the podcast on all platforms and leave a review where ever you listen! Website: www.Farm4Profit.comShareable episode link: https://intro-to-farm4profit.simplecast.comEmail address: Farm4profitllc@gmail.comCall/Text: 515.207.9640Subscribe to YouTube: https://www.youtube.com/channel/UCSR8c1BrCjNDDI_Acku5XqwFollow us on TikTok: https://www.tiktok.com/@farm4profitllc Connect with us on Facebook: https://www.facebook.com/Farm4ProfitLLC/Farm4Profit Media is not a financial, legal, or tax advisor. Content is provided for informational purposes only, and we serve solely as a platform for third-party opinions. Any actions taken based on this content are at your own risk. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this special Bowel Sounds and Nutrition Pearls collaboration episode, hosts Dr. Jennifer Lee and clinical dietitian Nicole Misner talk to Lisa Richardson about the ins and outs of infant formula. This is a must listen episode for all pediatricians, pediatric gastroenterologists, dietitians and anyone who is using or recommending infant formulas. Learning ObjectivesExplain infant formula nutrition, components, and comparison to breast milkDifferentiate formula types, ingredients, and clinical useApply guidance for fomula selection, safety, and caregiver educationLinks:Infant Formula Preparation and Storage | Infant and Toddler Nutrition | CDCInfant Formula Homepage | FDAOperation Stork Speed | FDAInfant Formula ReferencesLarson-Nath C, Bashir A, Herdes RE, et al. Term infant formula macronutrient composition: An update for clinicians. J Pediatr Gastroenterol Nutr. 2025;80(5):751-759. doi:10.1002/jpn3.70002Rodrigo ML, Tymann HA, Lochen HA, Shores DR. Infant formula ingredients: Updates for clinicians. J Pediatr Gastroenterol Nutr. 2024;78(5):1005-1008. doi:10.1002/jpn3.12192Lewis JI, Dror DK, Hampel D, et al. Reference Values for Macronutrients in Human Milk: the Mothers, Infants and Lactation Quality (MILQ) Study. Adv Nutr. 2025;16 Suppl 1(Suppl 1):10050. doi:10.1016/j.advnut.2025.100501Taylor SN, Buck CO. Post-discharge nutrition to optimize preterm infant short- and long-term outcomes. Semin Fetal Neonatal Med. 2025;30(2):101637. doi:10.1016/j.siny.2025.101637Send 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.

Crain's healthcare reporter Jon Asplund joins host Amy Guth to discuss West Suburban Medical Center's second forced closure this year and federal prosecutors dropping charges in the $300 million Loretto Hospital fraud case. Plus: Huntington Bank expands office footprint, bucking Loop downsizing trend; distressed Gold Coast hotel goes up for sale; CFTC considers blocking CME's 24/7 oil contract bid; and how the FAA's O'Hare flight cuts could affect your summer travel. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Featuring perspectives from Dr Manali Kamdar, Dr Krish Patel and Dr Gilles Salles, including the following topics: Introduction (0:00) Antibody-Drug Conjugates and Other Novel Strategies for the Management of Diffuse Large B-Cell Lymphoma (DLBCL) — Prof Salles (7:05) Current and Future Role of Monoclonal and Bispecific Antibodies in the Management of DLBCL — Dr Patel (26:21) Chimeric Antigen Receptor (CAR) T-Cell Therapy for DLBCL — Dr Kamdar (43:12) CAR T-Cell Therapy for Follicular Lymphoma (FL) — Prof Salles (1:08:33) Other Approved and Emerging Novel Therapies for FL — Dr Patel (1:24:44) Integrating Bispecific Antibodies into the Management of FL — Dr Kamdar (1:41:34) CME information and select publications

Featuring perspectives from Dr Eileen M O'Reilly and Dr Philip A Philip, including the following topics: Introduction (0:00) Optimal Incorporation of Chemotherapy into the Management of Advanced Pancreatic Cancer — Dr Philip (7:27) Other Available and Emerging Novel Approaches for Pancreatic Cancer — Dr O'Reilly (28:05) CME information and select publications

In this episode Amanda and I discuss Michael Saylor's Strategy Bitcoin lie, Jim Cramer SpaceX IPO vs Bitcoin, MasterCard AI Agent stablecoin payments, CME crypto index futures, new legislation to establish the Federal Cryptocurrency Theft Task Force, and much more.Brought to you by

Featuring perspectives from Dr Thomas E Hutson, Dr Erik A Singer and Dr Ulka Vaishampayan, moderated by Dr Hutson, including the following topics: Introduction (0:00) Current Indications for Adjuvant Immune Checkpoint Inhibitor Therapy in the Management of Renal Cell Carcinoma (RCC) — Dr Singer (2:32) Potential Role of Hypoxia-Inducible Factor-2 Alpha Inhibitors as a Component of Adjuvant Treatment — Dr Hutson (30:53) Tolerability of Current and Emerging Adjuvant Approaches for RCC — Dr Vaishampayan (1:06:37) CME information and select publications

The Obama Presidential Center was meant to lift up local contractors. Some say they're paying a high price for the project's delays and cost overruns. Crain's commercial real estate reporter Danny Ecker talks with host Amy Guth about how some contractors say they're fighting to collect millions of dollars in unpaid bills. Plus: Illinois joins states' challenge to Trump's anti-DEI contract rules, CME plans to offer 24/7 oil and gold contracts, Prada's Oak Street flagship building up for sale and Chicago gets one more shot at fixing the parking-meter mess. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

BEEF We'll start again with the New World screwworm. We now have 6 confirmed cases in Texas and 1 in New Mexico. Affected animals are a dog, a goat and 5 cattle. While our border with Mexico has been closed for months now to live animals, Texas cattle is now barred from export to Canada and I'd expect that list to continue to grow. This is a growing issue that will affect our beef industry for the foreseeable future. Beef production was 533K head last week, up from the holiday shortened prior week of 448K. This keeps inventories tight and product prices pushing higher. Middle meats, those ribeyes, tenderloins, and strips are finding support to continue moving higher. Chucks and rounds are holding steady for now though they are not big demand items in the summer. Ground beef is the big demand item and it's moving higher every day. Briskets and sirloin flap are moving lower, but I don't think we'll see this for long. It's a market where I'd make sure I stay ahead of my needs and keep inventory on hand. This market is moving higher.  POULTRY The declining chicken market is done. Pricing will be moving higher next week on boneless skinless random breasts, tenders and party wings. Compared to other proteins, still a great value but the declines of the last month are done. Chicken production continues strong up about 2% over last year. There is plenty of chicken in production. On the avian flu report, only three new cases affecting 20K birds. The summer is looking good for avian flu. GRAINS Corn continues to be a great value closing at $4.25/bushel today, that's down from $4.39 last week. Soy has pulled back a bit from the highs we saw last week, but I would not be surprised if they go on another run. High fuel prices put soy in play with biofuels, that is not over. Wheat is moving lower; I do think we'll see lower flour costs soon. PORK Pork bellies holding steady for the week, closing today at $120, about the same as last week. This will be moving higher soon, but it is a great price right now. Butts were on a tear higher, but they seem to have leveled off, we may see some better pricing shortly. Ribs are about as high as expected to see them this year. Loins continue to be the value in pork.  DAIRY CME Limited moves on the CME this week, thru Thursday's close, butter is down 2, block is up 1, and barrel is up 2. Let's look for a quiet market at least the next couple weeks. Savalfoods.com | Find us on Social Media: Instagram, Facebook, YouTube, Twitter, LinkedIn

Fabrice Bernhard is the co‑founder and Chief Technology Officer of Theodo Group, a global technology consulting firm he co‑founded in Paris in 2009. Under his technical leadership, Theodo has grown rapidly by combining Lean principles with modern software engineering to help organizations build scalable, resilient digital capabilities. Fabrice is a recognized thought leader in Lean Tech, advocating for the application of Toyota Production System principles to software development and technology organizations. He is a frequent speaker and writer on continuous improvement, learning cultures, and human‑centered technology, and is a co‑author of The Lean Tech Manifesto. His work focuses on enabling teams to deliver value faster while empowering people through better systems and smarter use of technology.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.

"Do nothing for us without us." According to today's guest Robyn Bussey, that operating principle is the basis for effective community health work. "You don't go into a community and dictate. You go and listen and trust and be a partner," she adds. As you'll learn in this enlightening conversation, Bussey is following that approach in her current work as Just Health Director at the Partnership for Southern Equity, an Atlanta-based nonprofit advancing racial equity and shared prosperity across the South.  On this episode of Raise the Line from Elsevier, Bussey provides illuminating  examples of community-rooted work in South Fulton County and rural Georgia, and explains why community health workers may be the most underutilized asset in addressing health disparities. This wide-ranging interview with host Michael Carrese also explores: Bussey's candid perspective on what happened to the surge of interest in health equity that occurred during COVID; Why life expectancy gains in many Southern states have lagged behind the rest of the country; Her advice to students and early-career clinicians about where they're needed most.   Mentioned in this episode:  Partnership for Southern Equity 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

Do the benefits really outweigh the risks when it comes to the use of thrombolytic drugs for central retinal artery occlusion (CRAO)? Drs. Amanda Henderson and Michael Carper weigh in on the recently published Tenecteplase in Central Retinal Artery Occlusion Study (TenCRAOS) and how ophthalmologists should proceed in their management of CRAO with tenecteplase (TNK) or another tissue plasminogen activator (tPA). For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Featuring perspectives from Dr Sara A Hurvitz and Dr Virginia Kaklamani, including the following topics: Introduction: Which Biomarkers and When (0:00) Optimizing First-Line Therapy for Patients with Hormone Receptor (HR)-Positive Metastatic Breast Cancer (mBC) (5:31) SERENA-6 Trial (19:44) Inavolisib (23:08) Management of HR-Positive mBC Progressing on a CDK4/6 Inhibitor and Endocrine Therapy (31:46) Selective Estrogen Receptor Degraders (41:15) AKT (46:13) CME information and select publications

Listen to the SF Daily podcast for today, June 11, 2026, with host Lorrie Boyer. These quick and informative episodes cover the commodity markets, weather, and the big things happening in agriculture each morning. The USDA's June WASDA report release today is expected minor demand adjustments, and Brazil's Conab updated crop estimates. Weekly export sales data showed steady ethanol production at 1.108 million barrels per day, with Midwest output rising. Live cattle futures gained 42 cents to $207, while feeder cattle futures were mixed. Mexico suspended U.S. cattle imports due to screw worms. Severe weather in the Midwest included tornado warnings and flash flood risks. The CME feeder cattle index dropped to $360.806, and wholesale box beef prices varied. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Social determinants of health, including housing, food access, insurance status, and structural inequities, significantly influence stroke prevention, recovery, and long term outcomes. These factors affect biological risk, treatment adherence, and disparities in care, even when traditional clinical measures are addressed. This episode highlights practical strategies for integrating screening, leveraging multidisciplinary teams, and identifying opportunities for advocacy to improve patient outcomes. In this episode, Teshamae Monteith, MD, FAAN, speaks with Nneka L. Ifejika, MD, MPH, author of the article "Social Determinants of Health and Their Impacts on Stroke Prevention and Outcomes" in the Continuum® June 2026 Cerebrovascular Disease 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. Ifejika is an adjunct professor of physical medicine and rehabilitation at UT Southwestern Medical Center in Dallas, Texas, and the chief scientific officer of the Division of Academics at Ochsner Health System in New Orleans, Louisiana. Additional Resources Read the article: Social Determinants of Health and Their Impacts on Stroke Prevention and Outcomes 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 Full episode transcript available here Dr Monteith: Two patients have the same stroke, but when they return, they have very different outcomes. We can look into some of their comorbidities, but something we don't spend enough time talking about is the social determinants of health. Stay tuned to this discussion. I promise you, you'll become a better neurologist. 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. Nneka Ifejika about her article on social determinants of health and their impacts on stroke prevention and outcomes. This article appears in the June 2026 Continuum issue on cerebrovascular disease. How are you? Welcome to our podcast. Dr Ifejika: Thanks for having me. I'm doing great. Dr Monteith: Great. So, can you introduce yourself to our audience? Dr Ifejika: Sure. I'm Dr. Nneka Ifejika. I am the Chief Scientific Officer of Ochsner Health System in New Orleans, Louisiana. But I'm also a cerebrovascular rehabilitation doctor. I've been practicing for about nineteen years, and am happy and honored to be a contributor to this Continuum Neurology article. It's a really important topic. Dr Monteith: Great. So, what got you into this field, first of all? Dr Ifejika: Well, I was deciding between PM&R and neurology, and I was putting in both match lists. And I thought about it and I leaned toward PM&R, but stroke still had a grasp on my heart and my mind. And so, after I finished my residency, I joined the UT Houston stroke team, and I did a, thankfully did a two-year fellowship and became cross-trained in stroke as well as physical medicine rehab. So, I am a jack of both trades. Dr Monteith: So, you got your way in a way. Dr Ifejika: I did. Dr Monteith: You know, we have a lot of learners that are listening, so it's always, uh, nice for them to be inspired, I think, by people's career paths. So why don't we talk about the objectives of your article? Dr Ifejika: Sure. So, one of the most important things that we wanted to do was make sure that medical students, residents, faculty, and fellows understood the impact of social determinants of health on stroke recovery and stroke rehabilitation. It's not as simple as you have hypertension, hyperlipidemia, we're going to manage your stroke risk factors. Oh, you had an ischemic stroke. You presented in time for the window. We're going to give you endovascular therapy and then modified Rankin scale at hospital discharge in ninety days. No, no, no. The stroke survivor and their caregivers and their family have a lot more to deal with outside of what we look at during the acute stroke hospitalization and post-acute rehabilitation. Things like, can they afford the medication that we're prescribing? Antiplatelet agents or anticoagulation can be extremely expensive. Do they have housing insecurity? Is there food insecurity? What's going on behind the scenes that we are not addressing that can directly impact the admission rate and the readmission rate after we take care of a stroke survivor? Dr Monteith: I love the article because you took a real deep dive into social determinants of health, what they are, why they matter, and what we can do about them. And so why don't we talk a little bit about the NINDS framework for social determinants of health? I think many of us might not be familiar with the framework per se. Dr Ifejika: So, the framework consists of multiple domains specifically that relate to social determinants of health that were published in Neurology a couple of years ago. So, I do hope that people who are hearing this recording actually read them. There are interpersonal domains, there are classic medical domains, there are indeterminate domains, and there are six total domains. And health domains are the last domain. So, things like when it comes to housing insecurity, food insecurity, that's a domain of social determinants of health. When it comes to chronic racism, when it comes to biases that patients experience, those actually impact outcomes. So, there are six separate indices that we're going to get into in detail and how we address them as clinicians, whether it be at the medical student level, resident level, faculty level, to integrate the social determinants of health in our care plans, because we could be doing a much better job. And I think it'll be really important from the interpersonal perspective when we really relate to our patients and their families that we ask these questions. For example, if we're prescribing someone to have treatment for their diabetes mellitus and ha- and, and be taking insulin, if they have housing insecurity and they're in a homeless shelter, they have to leave the homeless shelter during the day. So, what happens to the insulin that we prescribe? These are variables that we are not considering on a regular basis, but they directly relate to compliance. Dr Monteith: Great. So that was one thing I wanted to bring up. We're very good at measuring blood pressure and trying to determine, uh, the association between stroke outcomes and things that we can measure, glucose, lipids, blood pressure. What is the evidence for social determinants of health and stroke outcome? Dr Ifejika: The evidence is growing, and there have been many publications that have come out that are, are going to be highlighted in this article related to structural determinants of health inequities, like structural racism, as well as disparities related to ethnicity and race. There's geographical disparities. For example, a lot of patients are, are primarily concerned about rural versus urban, whether you have access to different post-acute rehabilitation, whether you have access to secondary stroke prevention because you simply don't have the transportation from a, a rural area to get to a drugstore to get things available to you. Social status. There are actually publication related to socioeconomic status and the concerns when it comes to air pollution. So particulate matter 2.5, we know that that has a direct impact on stroke outcomes and health overall, but we don't really think about it as a structural determinant of health inequity. There's several multiple layers of research that have gone on specifically that have been cited in the literature that relate directly to social determinants of health and how we can address them moving forward. Dr Monteith: And what I found interesting in your article in that you gave at least a few examples where social factors like income, education were controlled for, and maybe in large part it is, but even when you control for some of these very obvious social risk factors, you still have inequities. Dr Ifejika: Absolutely. And I think it was really important to show that we had strong peer review evidence behind this, as it wasn't just something that we were creating or hypothesizing about. There have been studies that have been done over this over decades of time, showing the impacts of social determinants of health on outcomes. But the question and concern that we have is we know this growing body of literature continues to expand. What are we doing about it when it comes to education of the future generations of providers who will be caring for this population? Dr Monteith: Before we get into how, you know, what we're going to do about that, let's just kind of put that link, cause the evidence is there. How does it drive biology? Dr Ifejika: It's a great question. So, for example, particulate matter 2.5 in air pollution has been shown to have an existing impact on hypertension, raising your blood pressure. So that's a direct effect of a social determinant of health related to socioeconomic status because people who live in areas with higher air pollution are... They're not green spaces. They live near highways. Those are areas that unfortunately are also impacted by food deserts. Food deserts, if you're not able to get fresh fruits, vegetables, whole foods, increases your risk of developing diabetes, hyperlipidemia, also increases your sodium intake, again, increasing hypertension. These things are all connected to biological determinants. It's just that we're not asking about them necessarily within the social history when we're taking people into the hospital, but they have direct effects. Dr Monteith: Great. Neurologists tend to be busy and, you know, we're... have all of these things that we're being asked to do and chart and click and all of that stuff. And so how can we more readily integrate screening for social determinants of health and that conversation into the work we do? We recognize it's important. We recognize it's an important risk factor. There's a lot of these determinants. So, what is a good way to do so? And I, I know that in the paper you've, you've given different roles to different team players, so I want you to talk about that too, but just kind of even a regular routine office visit. Walk us through a way we can more easily integrate that kind of conversation. Dr Ifejika: It's an excellent question, and what I've recommended that we do in a standard office visit is utilize the time before the visit to send out screeners. So, for example, usually with an electronic medical record, you can send documents before the visit even starts, where people can check off whether they have any concerns regarding housing, food insecurity. They can check out their location of where they live, whether they live near a highway or not near a highway. It's specifically related to socioeconomic status. We can ask about insurance status, whether they have insurance, insured versus uninsured, but then also types of insurance, whether they have Medicaid insurance versus Medicare insurance. Then even drilling even further, type of Medicare insurance, Medicare Advantage versus traditional Medicare, cause all of those things actually play a role in this. Dr Ifejika: And evaluate these things and don't take time during your office visit. Send these screeners out beforehand. Have them be assimilated by your medical staff. Make sure you're utilizing every resource that you have at your disposal to help streamline things, so by the time the person comes in for the visit, you've primed the pump. You have this information already in your hands at your fingertips cause it was sent out in advance, and you have your medical staff already have an understanding of. If they didn't fill it out electronically, give it to them in the lobby. Make sure they have a handwritten copy in the lobby so that when they come into the office visit, you have the information at your fingertips. Dr Monteith: Are there any particular resources that you recommend for those types of screeners? Dr Ifejika: What I've used in the past, if you have patient-reported outcomes, so the PROMIS instruments, that's a good start. It doesn't get into the details of housing insecurity, food insecurity, but it's a good start to help prime questions and to start the conversation during your office visit. In my clinics, I do a PROMIS 27 on every patient, as well as a PHQ-9 for depression on everyone. And then I collect data longitudinally, and I can always drill down on factors that I noticed that could become a problem moving forward. Dr Monteith: Yeah. And then also in your article, you spoke a bit about this impact from the acute presentation in the hospital to rehab. Dr Ifejika: Yeah. Dr Monteith: So why don't you talk about these different entry points where we can really engage our patients and try and help reduce their burden? Dr Ifejika: Sure. So, healthcare can be quite fragmented, and the stroke patient, stroke survivor, and their family member have no grasp of that. They've had a stroke, and they may be going from the ER to the ICU to the stroke unit to the floor to the rehab unit, and we see it as multiple levels of care, multiple types of providers. They see it as one hospital. And the concern that we have is, at those branch points, things get dropped, and we have the opportunity to pick things up at those branch points. So, during the acute care hospitalization-Primarily, that's the establishment of what has happened, how we're gonna treat it, what are the variables that we can control for right now to address those determinants of health moving forward, and to specifically looking at whether they were taking medications before, whether they could afford medications before, what that looks like at hospital discharge. Is there any duplication of medications? If a person is taking Coreg and you prescribe metoprolol, but they still have the Coreg at home, should we have really prescribed the metoprolol? We're just spending money that they may have concerns when it comes to access to care and the cost of these prescriptions. So, it's the responsibility of the acute care physician to kind of look at that. Those are subtle things that we think are subtle, but they add up quickly for the family when it comes to having one group of medications that's the same class and having to buy another type. When it comes to post-acute rehabilitation, it's really an important time to screen for whether the caregiver can handle what's occurring. So specifically, if the caregiver is already burning out and the average length of stay for a stroke patient is five days and they've come to rehab for two weeks, what's gonna happen in the next two years or the next four years? So, during the post-acute rehabilitation phase, it's time to kind of look at that and drill down on those kind of questions. Also, the levels of care, Dr Ifejika: it's really important to look at other levels of rehabilitation, so skilled nursing facilities, making sure people have access to that if they need to, if the caregiver is burned out and they don't have the ability to go straight home. Because acute inpatient rehab, the goal of it afterwards, is to go straight home. It's not to go to another facility. So, you need to have that screener in place when it comes to whether the family can take care of this person, and whether the family can do it in an effective way to prevent them being readmitted. Dr Monteith: Great. I also like that you spoke about kind of the team approach and different roles, both for screening and for intervention, both being very important, especially the intervention. And so why don't you give us a few examples how the team could break up the responsibility and how also for the intervention component that can be done. Dr Ifejika: Sure. So, I broke up the team into several levels. So, the team medically is the medical student, resident, and faculty physician. However, the team also includes the support staff, so your case manager, your social worker, the therapist, physical therapy, occupational therapy, speech therapy, the pastoral services, all these members of the team. You know, sometimes as physicians, we don't read those notes. There's a lot of information in the notes from social work, care coordination, and the therapist. They get down to subtleties cause they're asking questions, for example, "What kind of equipment do you have at home? How many stairs do you have at home? What level of house do you have, one story, two story? If you live in an apartment, do you have an elevator access?" That's important for someone with hemiparesis. When it comes to medications, when it comes to insurance status, when it comes to your ability to have the mechanisms to pay for care as an outpatient, social workers are required to ask these questions cause they have to figure out resources for the patient and their family to help facilitate improved outcomes. So, they have to ask questions regarding these tasks. The concerns are, do we read what they're saying? So, it's really important to interact with them, and if it's not something that you're looking at in the chart, cause we're all so tied to our computers, find where they are in the hospital. Walk by their office and have a chat. Run your list with them, especially for people who you're concerned have vulnerabilities, and make sure that you're setting an example for your medical students with your faculty doing so. If you're looking at it from the medical student, resident, faculty perspective, medical students, listen. This is your opportunity to really contribute to the team as well as learn about social determinants of health and research in their fields. You are the boots on the ground for the medical team. You are the ones who should be priming the pump and asking these questions of the family members. We're sending you into the rooms to do a history and physical. Social determinants of health should be a part of your history and physical, and you should be taking what we're saying in this article and asking these questions and tying it into your resident. Now, the resident is the work person of the hospital. We all know this. Things run through the resident. Things run through the fellow. It's really important that they have this information in a manner that is negotiable. The list keeps getting longer, and a resident doesn't need to be overburdened. It needs to be synthesized in a manner that can help facilitate the resident being able to act as well as communicate any concerns to the faculty. And at the faculty level, we are the voices that can affect change. So, if there's any concerns when it comes to advocacy, research, making sure that people are accessing care in a way that makes sense, particularly when it comes to the ability for us to galvanize change on a national level, that's kind of our job. Dr Monteith: Great, and so let's talk about intervention. What are things that, let's say, the neurologist can do to deal with some of these social factors? Dr Ifejika: From the neurology perspective, I think it's really important to identify missed opportunities and making sure that we address them. For example, the conversations around the ability to have access to care related to insurance versus no insurance. There are many, many ways that neurologists are able to advocate for a person being able to get to Medicare insurance, particularly in the outpatient setting. When we see patients in clinic, it takes two years, them, to qualify for Medicare, two years at a minimum. But there's a gap there that can be filled by us making sure that we document what's happened, contact their providers, facilitate communication with their employers, if they're employees, they can get some short-term disability benefits to help bridge that gap prior to receiving Medicare insurance. It behooves us to do this because if we do not, they fall into the gap and they get readmitted and they're back on service anyway. So, what's important is the outpatient that we really kind of focus on things that we can impact and things like insurance and getting people transitioned from having employer-based insurance versus getting to Medicare is a really important way that we can effect change in a, in a way that's viable and, and replicable. So, in the outpatient setting, neurologists have a wonderful opportunity to effect change in social determinants of health. When it comes to employed persons, who had a stroke transitioning to Medicare, it takes two years to do so. So, in the outpatient clinic, if you have an employed person, make sure that you fill out their short-term disability benefits forms, their long-term disability benefits form. Bridge the gap. Get that information to their employer so they can maintain constant coverage. Because if they do not, if they have to choose between refilling medications and putting food on the table, they're going to choose putting food on the table, and that's going to directly impact their outcomes if they're not taking the medication that we recommend. Dr Monteith: I think that's a great point. I mean, there's a lot that we can do, and in some ways, it may not take that much to document and to be able to ask the questions and to include some of that information into the assessment and plan is really a, a great idea. Dr Ifejika: And you know, if we don't bring these things up and have these conversations, it doesn't get addressed. And that's why I'm very, very thankful that I had the opportunity to do so, cause this is a part of what I do all day. I think that if I wasn't integrating these kind of conversations into my practice, I wouldn't have the ability to share these tips and these abilities to move things forward in a manner that will be constructive for our field overall and for our patients. Dr Monteith: And towards the end of the article, you brought up something I think we don't see in many articles, and that's the role of advocacy and getting involved in health policy. So, can you talk a little bit about that? Dr Ifejika: You know, it's really important to facilitate change when you see that there are things that need to be changed. And the best way to do that is through advocacy at the local or state or federal level. A lot of these variables that we're dealing with can be addressed through legal changes. I'll give you an example. End-stage renal disease, if you have immediate hemodialysis and you have that requirement upon hospital discharge, you qualify for Medicare immediately. Immediately. Before you even leave the hospital. Why wouldn't something be similar for a stroke? Well, the reason why is because there was a level of advocacy that came around end-stage renal disease and a member of Congress's wife had hemodialysis requirements. And so, a law was passed to make sure Medicare covered it immediately after hospital discharge. So, it requires advocacy in some significant ways to get things done, but we have the bandwidth to do this. We take care of a population that has some of the highest rates of preventable disability. That's not going away. We need to make sure that we're effecting change for this group to make sure that they have the best possible outcomes they can experience. Dr Monteith: So, any final messages for our listeners? Dr Ifejika: I look forward to hearing everyone's feedback about our issue. I am thankful for the opportunity to talk about, address, and write about this important topic, and look forward to everyone's feedback. Dr Monteith: Well, thank you so much for being on our podcast. It was a really wonderful summary and we had a very thorough conversation, but you didn't give away too much, so I think they're going to have to read the article. Dr Ifejika: You're going to have to read the article. And we want medical students, residents, fellows, faculty, all of our ancillary staff within the hospitals, please read this article. We really appreciate it. Dr Monteith: Again today, I've been interviewing Dr. Nneka Ifejika about her article on social determinants of health and their impacts on stroke prevention and outcomes. This article appears in the June 2026 Continuum issue on cerebrovascular disease. 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.

Featuring perspectives from Dr Christine L Hann and Dr Jacob Sands, including the following topics: Introduction: Biopharmacology of Small Cell Lung Cancer — "Wildfire sparked in dry grass" (0:00) Limited-Stage Disease (9:22) Extensive-Stage Disease (16:23) Paraneoplastic Syndromes — Lambert-Eaton Myasthenic Syndrome (23:54) Bispecific T-Cell Engagers — Tarlatamab (30:00) Antibody-Drug Conjugates — Ifinatamab Deruxtecan (39:19) Other Novel Agents — Alisertib, Chimeric Antigen Receptor T-Cell Therapy (52:54) CME information and select publications

Become the Medetomi-Dean of AdmissionsStep up your hospital addiction medicine game by learning to troubleshoot methadone dose confirmations/missed doses and understanding how medetomidine's emergency in the drug supply is impacting patients and withdrawal management. We're joined by Dr Maggie Lowenstein (University of Pennsylvania)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!Credits Writer, Producer, and Show Notes: Shawn Cohen MD Infographic and Cover Art: Zoya Surani  Hosts: Carolyn Chan, MD. MHS and Shawn Cohen MD Reviewer: Payel Jhoom Roy MD, MSc Showrunner: Carolyn Chan, MD, MHS Technical Production: PodPaste Guest:  Maggie Lowenstein MD MPhil MSHP Sponsor: BabbelGo to Babbel.com/CURB for up to 60% off.Sponsor: FIGSCurbsiders listeners can get 15% off. Just go to WearFIGS.com and use code FIGSRX.Sponsor: FreedSetup takes 30 minutes and pricing starts at $149 a month. Try it free for 7 days at getfreed.ai/front-desk.

Malignant Bowel Obstruction, VTE and Goals of CareMaster malignant bowel obstruction, cancer-associated thrombosis, and goals-of-care conversations in hospitalized patients with advanced cancer. Learn practical approaches to symptom management, anticoagulation decisions, and navigating high-stakes discussions around prognosis and hospice care. We're joined by  Dr. Jensa Morris, @JensaMorrisMD (Yale School of Medicine).Claim free CME for this episode at curbsiders.vcuhealth.org!Show Segments Intro Picks of the Week Case 1: Malignant small bowel obstruction: definitions, initial management, medications, NG tubes, nutrition, and procedural options Case 2: Cancer-associated VTE: choice of anticoagulant, treatment duration, unusual thromboses, and anticoagulation with brain metastases  Case 3: Goals of care: prognosis, performance status, palliative care, hospice and end-of-life planningTake Home Points Outro  Credits Writer, producer, and show notes: Reaford Blackburn, Jr., MD Infographic, Cover Art: Caroline Coleman, MD Hosts: Monee Amin, MD and Meredith Trubitt, MD    Reviewer: Rahul Ganatra, MD Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Technical Production: PodPaste Guest: Jensa Morris, MD Sponsor: Continuing Education CompanyVisit CMEmeeting.org/curbsiders and use promo code Curb30 for 30% off all online courses and webcasts.  Sponsor: LocumstoryLocumstory.com is literally just a free, unbiased resource dedicated to educating physicians about locums.Sponsor: Mint MobileTo get your new wireless plan for just 15 bucks a month, go to mintmobile.com/CURB.