Podcasts about Combination

Listen to consonant sounds in words and you may notice something: the consonants are often weaker to the point of being hard to hear. In fact, they are still having a noticeable impact on the word, but not in the way you may expect. Let's look at held sounds/stop sounds with the letter T + N, and see how these affect consonants in English, how they happen, when they happen, and how to practiceMore held T practice: https://youtu.be/X__-ORzyLbcGet a free podcast/mp3/audio version: https://open.spotify.com/show/7f77KK0bWJ8ohC3QWDDwVYMore weaking consonants practice: https://youtu.be/yrGUOvM5VuEWelcome to For Word, the platform dedicated to guiding you towards better spoken performance. We're constantly looking at techniques to add more vocal variety to how we talk by incorporating more softness and firmness to our, furrowing eyebrows, smiling, raising and lowering pitches, adding pauses in order to convey frustration, sadness, joy and nervousness, and considering how to add more breath to everything we say. Let's see how these elements of contrast, body language, and other elements of communication can lead to richer expression.#performance #poetry #speaking

(71) Magic Island - 10 Seconds For The CombinationBecome a supporter of this podcast: https://www.spreaker.com/podcast/harold-s-old-time-radio--4206392/support.

In this episode of Why Distance Learning, your hosts continue their conversation with Jered Borup — professor at George Mason University and one of the most-cited researchers in K-12 online learning — about what AI in education is actually doing to relationships, what social presence requires when "build a video lecture" can be done by a chatbot, and why teacher burnout is the real bottleneck the field doesn't want to talk about. Borup connects his earliest 2012 work on asynchronous video to his 2025 Open Praxis research on combining AI-generated text with human-created video, and argues that AI used to offload feedback erodes the very thing online learners need: the felt sense that the teacher is real and knows them.Together, the hosts and Jered explore the conflation of social media, video games, and ed tech in the parental imagination after the pandemic; how to use AI without replacing the relational core of teaching; why one-on-one asynchronous video may build social presence more reliably than synchronous Zoom classes; the DLAC Phase 2 research agenda Borup co-authored with Michael Barbour and Kristen DeBruler; the mental-health gap between teachers and other professionals with comparable education; and Borup's one-line answer to the show's title question — that personalization and Universal Design for Learning are easier to do online than off.This is Part 2 of a two-part conversation. Listen to Part 1 for the foundational ACE framework, the on-site mentor model, and the parent question.Key Topics"Emergency remote learning" vs. real online learning — what parents are still confusingSocial presence — old research, new tools (asynchronous video, AI-plus-human-video)The risk of offloading teacher feedback to AIAsynchronous one-on-one video as a relationship lever (vs. one-to-many Zoom)DLAC Research Agenda Phase 2 — what's keeping researchers up at nightTeacher mental health and the AI strain on top of pandemic strainAuthentic assessment and "we're too in love with the five-paragraph essay"Empathy as the core design move"Why distance learning?" — empowerment, personalization, UDLLinks & ResourcesJered Borup's site: https://sites.google.com/site/jeredborup/ACE Framework on EdTech Books: https://edtechbooks.org/encyclopedia/academic_communities_of_engagement_ace_frameworkA Framework for Establishing Social Presence Through the Combination of AI-generated Text with Human-created Video (Open Praxis, 2025): https://openpraxis.org/articles/10.55982/openpraxis.17.1.769Harnessing the Power of Generative AI to Support ALL Learners (Borup, Evmenova & Shin, 2024): https://www.researchgate.net/publication/380570253_Harnessing_the_Power_of_Generative_AI_to_Support_ALL_LearnersDLAC Research Agenda Phase Two (Borup, Barbour & DeBruler, Sept 2025): https://www.deelac.com/wp-content/uploads/2025/10/DLAC-Research-Agenda-Phase-2-Final-1052025.pdfBreaking Through the Screen: Practical Tips for Engaging Learners in the Online and Blended Classroom (Borup & Joan Kang Shin, National Geographic Learning): https://www.amazon.com/Breaking-Through-Screen-Practical-classroom/dp/0357541855K-12 Blended Teaching open-source book series: https://edtechbooks.org/k12blended_seriesJered's Google Scholar: https://scholar.google.com/citations?user=PGs7TacAAAAJ&hl=enPart 1 of this conversation: [LINK — add when published]Guest Bio: Jered BorupJered Borup is a professor in the Division of Learning Technologies at George Mason University and co-coordinator of the Learning Technologies in Schools graduate program. His research, grounded in six years of junior-high history teaching, focuses on K-12 online and blended learning: the support communities that surround a learner, the parental role in online education, and how generative AI can extend personalized support to historically underserved students. He earned his Ph.D. in Instructional Psychology and Technology from Brigham Young University and has been recognized as one of the top 2% most-cited researchers in his field.About the HostsSeth Fleischauer is the founder of Banyan Global Learning and host of Why Distance Learning. Through Banyan, he designs live virtual programs that connect K-12 classrooms to global peers and expert facilitators — building the kind of structured, human-centered distance learning the podcast explores. See https://banyangloballearning.com/Allyson Mitchell works with CILC, the Center for Interactive Learning and Collaboration, to help educators implement high-quality live virtual learning experiences across grade levels. Discover more at CILC.org.

Audio of "The Poverty of Philosophy" by Karl Marx, published in 1847. Read online at: https://www.marxists.org/archive/marx/works/1847/poverty-philosophy/ (including pdf and docx). Recording based on https://en.wikisource.org/wiki/The_Poverty_of_Philosophy See the article on it here https://workersliberty.org/story/2026-05-05/our-reference-points-1-debunking-religion-class-struggle And study notes: https://www.workersliberty.org/story/2019-04-11/poverty-philosophy-notes-study-sessions Contents and (approximate) timestamps: 00:00 Translator's foreword; Preface by Engels from 1884; Author's Preface Chapter 1 — A Scientific Discovery: 43:05 Ch. 1 Section 1 — Opposition of Utility Value to Exchange Value 1:09:04 Ch. 1 Section 2 — Constituted or Synthetic Value 2:03:10 Ch. 1 Section 3 — Application of the Law of the Proportion of Value: (a) Money, (b) Surplus Labour Chapter 2 — The Metaphysics of Political Economy: 2:54:39 Ch. 2 Section 1 — The Method 3:42:35 Ch. 2 Section 2 — The Division of Labor and Machinery 4:19:37 Ch. 2 Section 3 — Competition and Monopoly 4:37:58 Ch. 2 Section 4 — Property and Rent 5:02:48 Ch. 2 Section 5 — Strikes and the Combination of Workmen Appendices: 5:20:17 Appendix 1 — Proudhon Judged by Marx 5:39:14 Appendix 2 — John Gray and his Theory of Labor Notes 5:47:50 Appendix 3 — Free Trade #2 from Marxist points of reference: a reading list https://workersliberty.org/marxist-points-reference-reading-list Playlist of recordings from that list here https://soundcloud.com/workers-liberty/sets/marxist-points-of-reference-a Audiobook public domain from librivox; music public domain. Subscribe to the podcast "Solidarity & more" by "Workers' Liberty" wherever you listen to podcasts. More info: https://workersliberty.org/audio

After meeting in college, Shane & Shane began writing songs and touring the country leading worship. Many years later, they’re writing more music than ever, with no intention of slowing down. Their desire has always been to glorify the Lord instead of themselves and they do so by writing music that is biblically based, lyrically rich, and sonically engaging. Check out their discography! Over the past few years, Shane & Shane have dedicated their lives to encourage and equip worship leaders and their teams through an online resource called The Worship Initiative. The Worship Initiative is an equipping ministry and a collective of worship leaders that, over the past few years, has grown into a thriving community in and of itself. This is a flashback interview from many years ago and my co-host was Karen Hunt, listen in!Support the show: http://historymakersradio.com/See omnystudio.com/listener for privacy information.

Think energy, digestion, and weight. In this episode, Nurse Doza breaks down berberine — the metabolism-supporting supplement that helps regulate blood sugar, support a healthy insulin response, and improve cholesterol (LDL, HDL, total). Discover why MSW Nutrition's Berberine Plus is 5x more absorbable in the gut, how to dose it morning and night, and why it works at the level of your gut microbiome. The berberine supplement your metabolism has been waiting for. Featured Partner: MSW Nutrition — Berberine Plus MSW Nutrition's Berberine Plus delivers dihydroberberine (DHB) — the bioactive, highly absorbable form of berberine sourced from Berberis aristata — so you get berberine's full metabolic benefits at a fraction of the dose, without the gut upset that comes from mega-dosing standard berberine. That enhanced absorption is exactly why it's the berberine supplement Nurse Doza reaches for to support blood sugar, digestion, and weight — as discussed in this episode.

This week! A bit of Memorial Day catchup then Natalie Moon joins the show to discuss local comedy in Baltimore among other things like Seth MacFarlane Stuff, Bob’s Burgers, Big Bang Theory (for some reason), Widow’s Bay and more!!

Creativity through the lens of a lawyer, online entrepreneur, tech founder"Finding ways to combine things in original ways" Bobby is a Harvard Law Grad turned online entrepreneur—but he's NOT your typical lawyer. He doesn't do suits, he hates legalese more than you do, and he tends to make bad pop-culture references and dad jokes. With his extensive expertise from a 20+ year legal career, Bobby is now focusing on making the legal stuff simple for online business owners. He and his team developed the Plainly Legal™ software to automate legal protection for coaches, course creators, consultants, service providers, and other online business owners. Website: www.plainlylegal.comLinkedIn: www.linkedin.com/in/robertklinck/FB: www.facebook.com/robert.klinck.1Send us Fan Mail

In this episode Dr. Thad McDonald, (retired OBGYN and Chair of the WakeMed Board of Directors) explains what the strategic combination with Atrium Health means for patients and the community. He discusses how the partnership will speed development of local cancer services, preserve safety net care, and improve access to specialty services. Learn more and stay informed at https://www.wakemed.org/wakemed-atrium-combination.

– EVs and innovation – (Yet another) reason not to try to time the market – The compound power of combination – Why ‘adoption’ wins See omnystudio.com/listener for privacy information.

Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice.In this Mind Moments episode, Todd Arnedt, PhD, professor of psychiatry and neurology at Michigan Medicine-University of Michigan, joins the podcast to discuss the recently published American Academy of Sleep Medicine clinical practice guideline on combination treatment for chronic insomnia disorder in adults. Arnedt explains the rationale behind formal recommendations for concurrent use of cognitive behavioral therapy for insomnia (CBT-I) and pharmacotherapy, particularly as combination treatment becomes increasingly common in clinical practice. The conversation reviews the evidence supporting CBT-I as the preferred foundational treatment approach, where combination therapy may offer advantages over pharmacotherapy alone, and how clinicians should think about factors such as symptom burden, treatment goals, access to CBT-I, and patient preference when selecting treatment strategies. Arnedt also outlines ongoing research gaps involving sequential treatment approaches, medication classes, long-term outcomes, and personalized insomnia care. Looking for more Sleep Disorders discussion? Check out the NeurologyLive® Sleep Disorders clinical focus page.Episode Breakdown: 1:15 – Why formal insomnia combination treatment guidance was needed 2:45 – Defining concurrent CBT-I and pharmacotherapy approaches 4:35 – Evidence supporting CBT-I as foundational insomnia treatment   7:15 – Situations where combination therapy may improve patient outcomes 7:50 – Neurology News Network  10:20 – Patient-specific factors influencing insomnia treatment selection 12:30 – Barriers involving CBT-I access, cost, and real-world implementation 16:55 – Research gaps surrounding sequencing, long-term outcomes, and personalization The stories featured in this week's Neurology News Minute, which will give you quick updates on the following developments in neurology, are further detailed here: Topline Phase 2 CELIA Results Show Diranersen Misses Primary End Point in Early Alzheimer Disease FDA Grants Priority Review to Bayer's Asundexian for Secondary Stroke Prevention Dyne Submits BLA for Z-Rostudirsen in Exon 51 Skipping Duchenne Muscular Dystrophy Thanks for listening to the NeurologyLive® Mind Moments® podcast. To support the show, be sure to rate, review, and subscribe wherever you listen to podcasts. For more neurology news and expert-driven content, visit neurologylive.com.

Minera Alamos has announced a positive pre-feasibility study for the Copperstone Gold Project. Magna Mining has reported Q1 2026 operating and financial results from the McCreedy West mine. Paramount Gold Nevada has released an updated feasibility study for the Grassy Mountain Gold Project. Exploration updates from Scorpio Gold, Andina Copper, Tocvan Ventures and American Pacific Mining. This episode of Mining Stock Daily is brought to you by... ⁠⁠⁠⁠⁠⁠Revival Gold ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Vizsla Silver⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Equinox Gold⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Integra Resources ⁠⁠⁠

Li-FT Power CEO Francis MacDonald joins Mining Stock Daily to discuss the company's completed combination with Winsome Resources and the strategic addition of the Adina lithium project in Quebec's rapidly emerging James Bay district. Francis explains why the consolidation of the Adina and Galina properties creates a significantly larger development opportunity, how existing infrastructure at the nearby Renard mine could accelerate production timelines, and why he believes James Bay could become the largest hard rock lithium district in the world. The conversation also provides updates from Yellowknife, where Li-FT continues expanding the Big East pegmatite system through ongoing drilling while balancing capital allocation between two major lithium development projects. With lithium prices rebounding sharply, multiple resource and engineering catalysts ahead, and continued consolidation opportunities on the table, Li-FT believes it is positioning itself as one of the leading lithium development companies in Canada.

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Daniel Buysse and Dr. Todd Arnedt, both members of the AASM clinical practice guideline committee, to discuss the newly released guidelines on combination treatment for chronic insomnia disorder in adults. Unlike previous guidelines, this new guidance specifically addresses what happens in real-world clinical practice: patients often request both cognitive behavioral therapy for insomnia (CBT-I) and pharmacotherapy, or arrive seeking medications while clinicians advocate for behavioral interventions. The guidelines provide evidence-based recommendations for navigating these combination treatment scenarios, incorporating patient preferences in ways previous guidelines did not. The conversation explores the guideline development process, including how committee members were selected and how diverse professional backgrounds enriched the discussion. Dr. Buysse and Dr. Arnedt explain why patient preference wasn't adequately reflected in original practice guidelines and how this updated version addresses that gap. The first recommendation receives detailed examination: In adults with chronic insomnia, the AASM suggests combination treatment with CBT-I plus medication over medication alone (conditional recommendation, low certainty of evidence). The experts clarify which medications were examined, including whether dual orexin receptor antagonists (DORAs) were included, and explain why evidence certainty is low despite numerous studies. Pharmaceutical sponsorship creates methodological differences—PSG outcomes, fixed time in bed requirements—that complicate interpretation. The high placebo response in insomnia trials adds another layer of complexity. Critical implementation questions arise: What does "combination therapy" actually mean? Should both treatments start simultaneously, or should one precede the other? Can patients start medications while awaiting CBT-I appointments given typical access delays? The second recommendation appears paradoxical: The AASM suggests against combination treatment over CBT-I alone, yet recommends combination over medication alone. Dr. Buysse and Dr. Arnedt explain this nuanced position—CBT-I alone remains superior, but for patients who prioritize rapid total sleep time improvement over daytime symptom reduction, combination therapy may be reasonable. The conversation addresses whether treatment order matters and whether clinical (not just insurance-driven) logic suggests a medication hierarchy—zolpidem before eszopiclone, the role of trazodone, when to consider ramelteon. A crucial question emerges: What about patients who refuse or cannot access CBT-I? How do these guidelines apply when the preferred behavioral treatment is unavailable or unwanted? Throughout, the experts emphasize that guidelines inform but don't dictate clinical decisions. Patient preferences, values, and individual circumstances must shape treatment plans. The guidelines provide evidence-based frameworks while acknowledging the complexity of real-world insomnia management. Whether you're treating chronic insomnia, navigating patient requests for medications, addressing CBT-I access barriers, or seeking evidence-based approaches to combination therapy, this episode provides essential guidance. Join us for this important conversation about balancing behavioral and pharmacological approaches to chronic insomnia in clinical practice.

AUA2026 Spotlight: PARP-Inhibitor Combination Treatments for the Urologic Care Team CME Available: https://cme.auanet.org/URL/PARP26ONL LEARNING OBJECTIVES: At the conclusion of this CME activity, participants will be able to: 1. Integrate biomarker and genetic testing principles into clinical workflows for patients with metastatic prostate cancer, including when to order testing, how to interpret HRR mutation results (inclusive of BRCA and non-BRCA), and how to address barriers to testing through multidisciplinary coordination. 2. Explain the mechanism of action of PARP inhibitors and the biological and clinical rationale for their use—both as monotherapy and in combination approaches—in the treatment of mPC. 3. Evaluate emerging efficacy and safety data on PARPi combinations, including patient subgroup analyses, sequencing strategies, and the role of combination therapy in different stages of mPC. 4. Apply best practices for side effect monitoring and mitigation in patients receiving PARP inhibitors alone or in combination, leveraging the multidisciplinary team for optimal therapy management and patient quality of life. 5. Implement guideline-concordant care strategies in practice, including genetic testing workflow implementation, coordination among care team members, and patient engagement in shared decision-making and clinical trial enrollment. 5. Utilize current evidence-based guidelines to select and sequence PARP inhibitor therapy for patients with mPC, optimizing oncologic outcomes while individualizing care based on molecular profile and patient-specific factors. ACKNOWLEDGEMENTS: Support provided by independent educational grants from: Astrazeneca Merck & Co., Inc Pfizer, Inc.

Sponsored By: → Santa Barbara Chocolate | CocoaDynamics available at https://SantaBarbaraChocolate.com. Use code DRG20 for 20% off. → Timeline | Timeline's clinically proven formula is now available at a new, lower price. Mitopure now starts at $79, when you go to https://timeline.com/DRG → AquaTru | Go to https://AquaTru.com now for 20% off (your purifier) using promo code DRG. AquaTru even comes with a 30-day best-tasting water guarantee. Episode Description You can eat 30 grams of fiber a day and still be making the wrong choice for your microbiome. Because it was never just about how much you eat. It's about where that fiber is actually fermenting in your colon. Dr. Karan Rajan is a surgeon, gut health expert, and one of the most followed doctors on the internet. He spent years operating on colon cancers and bowel disease before realizing the most powerful thing he could do was hand people the information they were never given. In this conversation he breaks down the gut in a way that will make you want to reorganize your entire kitchen by the time it's over. In this episode, you'll discover:  • Why the old soluble vs insoluble fiber model is outdated and what fermentation geography actually means — and how eating only one type of fiber can cause gas and bloating even when you're hitting your daily target  • Why the protein obsession sweeping wellness culture may be quietly turning your gut bacteria into gremlins, and what happens when your microbes run out of fiber to eat  • How your microbiome can begin to change within 48 hours of increasing fiber intake, and the exact ramp up strategy Dr. Karan uses to avoid the gas and bloating that makes most people quit If you have a gut, this episode is for you. Find Dr. Karan:  Instagram: https://www.instagram.com/drkaranrajan  TikTok: https://www.tiktok.com/@dr.karanr  YouTube: https://www.youtube.com/c/DrKaran Book: This Is Vital Information — https://www.amazon.com/This-Vital-Information-Everything-Embarrassed-ebook/dp/B0FHC36WLD Timestamps: 0:00 - Intro 1:58 - Meet Dr. Karan Rajan: Gut Surgeon Turned One of the Most Followed Doctors Online 3:02 - Rapid Fire: Ground vs. Whole Chia Seeds, the Gut-Skin Axis & How Often You Should Poop  9:03 - Why He Left Surgery to Educate Millions for Free  12:42 - The Microbiome: Medicine's "Dark Matter" (And Who's Really in Control)  15:22 - Could Your Microbiome Be Influencing Who You're Attracted To?  17:47 - The Gut-Brain Axis: Is Mental Health Treatment Missing a Huge Piece?  24:43 - What's Actually Exciting Right Now in Microbiome Science  29:47 - The Breakfast Swap That Changed His Life in Two Weeks  33:08 - Should You Be Eating More Like Your Ancestors?  35:54 - Fast, Medium & Slow Fermenting Fibers: Why It Matters Where Fiber Ferments in Your Colon  40:47 - Psyllium Husk, Chia Seeds & What Most Fiber Supplements Get Wrong  41:57 - The Best Foods for Your Microbiome (According to the Doc Who Studies It)  43:14 - Cooked and Cooled Starch & Why Freezing Bread Actually Works  44:07 - The Truth About Colonics: Helpful or Harmful? 46:41 - Your Microbiome Can Change Within 48 Hours — Here's How to Start  48:01 - The Fiber Fart Curve: Why Gas Is a Good Sign You're Doing It Right  50:33 - Why the Rise in Colon Cancer Is Directly Tied to Fiber Deficiency  51:42 - Too Much Protein, Not Enough Fiber: How You Turn Gut Bacteria Into Gremlins  56:27 - The Book & Why He Never Wants Anyone to Die of Embarrassment Again Learn more about your ad choices. Visit megaphone.fm/adchoices

China is preparing to launch the Shenzhou-23 crewed spaceship. The combination of the spaceship and its carrier rocket has been transferred to the launch area.

Yes good and bad

Proceedings from a live event on April 11, 2026, held during the 2026 SGO Annual Meeting on Women's Cancer and moderated by Dr Ritu Salani, including the following topics: Biology of Advanced Endometrial Cancer (EC); Optimal Approach to Biomarker Assessment in Patients with Newly Diagnosed Disease — Dr Backes (0:00) Current Up-Front Chemoimmunotherapeutic Approaches for Advanced EC — Dr Powell (25:18) Current and Future Role of Anti-PD-1/PD-L1 Antibodies in Combination with Systemic Therapies Beyond Chemotherapy in Advanced EC — Dr Salani (59:02) CME information and select publications

In this episode, Donald Gintzig, President & CEO of WakeMed Health & Hospitals, outlines specifics about the strategic combination with Atrium Health and why it matters for access, equity, and long-term community health in Wake County. Hear about the benefits of expanded services, new facilities, investments in southeast Raleigh and more that aim to improve care for all. Visit WakeMed.org/wakemed-atrium-combination to learn more.

As long as you tolerate it, it stays the same.But the moment you say, “No Lord, things have to change,” heaven begins to move. You are not separate from Him — He is the Head, you are the body; He is the Vine, you are the branch.In the beginning, the Spirit hovered… and when God spoke, light appearedThat same light now lives in you.When Word and Spirit come together, growth begins.Develop your prayer life. Stay filled with Spirit-inspired Word.As long as you tolerate it, it stays the same.But the moment you say, “No Lord, things have to change,” heaven begins to move. ✨You are not separate from Him — He is the Head, you are the body; He is the Vine, you are the branch.In the beginning, the Spirit hovered… and when God spoke, light appearedThat same light now lives in you.When Word and Spirit come together, growth begins.Develop your prayer life. Stay filled with Spirit-inspired Word.The Most Powerful Combination: Spirit + Word | सबसे शक्तिशाली संयोजन: आत्मा + वचन | Prophet Ezekiah Francis– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – Watch in Englishhttps://youtube.com/live/TtrURfXCvY4Watch in Tamil (தமிழ்) https://youtube.com/live/uyBino3oFjgWatch in Hindi (हिंदी) https://youtube.com/live/FS-a4t4CsxoWatch in Telugu (తెలుగు) https://youtube.com/live/qA_vjWh_36kWatch in Malayalam (മലയാളം) https://youtube.com/live/TiKSFxgzEngWatch in Kannada (ಕನ್ನಡ)https://youtube.com/live/ZqXQegWLgeg

PERWIRA (The Indonesian Society in Victoria), which actively organizes cultural events, will host Mahasuara at Prahran Market, Melbourne, on the 2nd of May 2026. This festival will feature Dangdut Koplo and Bollywood music. It will also feature stalls of Indonesian food, especially traditional Indonesian cuisine. - PERWIRA (Perhimpunan Warga Indonesia di Victoria) yang aktif menyelenggarakan acara-acara budaya itu, pada tanggal 2 Mei 2026 akan menyelenggarakan Mahasuara di Prahran Square, Melbourne. Yaitu festival musik Dangdut Koplo dan musik Bollywood. Yang diramaikan pula dengan stal-stal makanan khas Indonesia terutamanya.

In this episode of the WCNFluencer podcast, host Christopher MacLellan interviews Dr. Mark Goldstein, a founding member of GEM Research. Throughout the episode, Christopher and Dr. Goldstein discuss Dr. Goldstein's transition from private practice to a focus on clinical trials, particularly in Alzheimer's. The conversation covers the importance of clinical trials, the distinction between Alzheimer's and dementia, recognizing symptoms, current treatments, hereditary factors, and the broader research focus at JEM Research Institute. Dr. Goldstein emphasizes the need for early intervention and the potential for future breakthroughs in Alzheimer's treatment. Takeaways - Dr. Goldstein transitioned from private practice to clinical trials. - Clinical trials are essential for developing new medications. - Dementia is a broader term, with Alzheimer's being a major type. - Recognizing early symptoms is crucial for caregivers. - Biomarkers can help diagnose Alzheimer's earlier than before. - Current treatments slow progression but are not cures. - Hereditary factors can increase the risk of Alzheimer's. - GEM Research conducts trials for various neurological conditions. - Combination therapies may be the future of Alzheimer's treatment. - Participation in clinical trials is free and private. To learn more about Dr. Goldstein and JEM Research Institute, click HERE!

Victor Radley joins Josh Reynolds and Charlie White to chat about the Roosters’ solid start to 2026, Luke Keary’s media masterclass thus far, his thoughts on the new Origin eligibility and what it would mean to represent NSW, the temptation of joining the new PNG side, Tedesco’s epic form, and the DCE–Walker combination and how it is building. He also previews the Roosters–Broncos match on Saturday. Plus, we look at what is going on with the Bulldogs, the depleted Tigers taking on the Sharks, Melbourne’s must-win match against the Dolphins, and preview all of the Round Nine clashes in the NRL! Check out Triple M NRL's Instagram, Facebook, TikTok and YouTube!See omnystudio.com/listener for privacy information.

Victor Radley joins Josh Reynolds and Charlie White to chat about the Roosters’ solid start to 2026, Luke Keary’s media masterclass thus far, his thoughts on the new Origin eligibility and what it would mean to represent NSW, the temptation of joining the new PNG side, Tedesco’s epic form, and the DCE–Walker combination and how it is building. He also previews the Roosters–Broncos match on Saturday. Plus, we look at what is going on with the Bulldogs, the depleted Tigers taking on the Sharks, Melbourne’s must-win match against the Dolphins, and preview all of the Round Nine clashes in the NRL! Check out Triple M NRL's Instagram, Facebook, TikTok and YouTube!See omnystudio.com/listener for privacy information.

It's opening day of French Quarter Fest, and Dave talks about what makes Southeast Louisiana so special! Also, Dave Cohen talks about how the New Orleans City Council, on Thursday, in a 4-3 vote, approved the New Orleans Police Department's purchase of the $250,000 drone and docking station, despite opposition from residents and three city council members. Then, Dave has a discussion about the Louisiana Senate approving a bill (SB4) with a 26-7 vote, allowing local communities to vote on removing fluoride from their public water systems. Finally, Mike Strain, Commissioner of the Louisiana Department of Agriculture & Forestry, joins the show to discuss farmers saying they can't survive without migrant labor, then on the flip side, others said that farmers are being too greedy and won't pay an American wage.

* Exploring Vrontok* This is our second go at this topic* Located in the shadow of Sky Point* Desperate, lawless, crowded town built on the slave trade* Not a vacation spot!* Like Bartertown... but darker* Combination of town, slave market, and military base.* Stealing slaves is the most serious crime.* Only punishments for crime are enslavement or death.* Fortified by a high wall and dry moat with sharpened stakes.* Three gates: Empire Gate (SE), Vivane Gate (NE), Outlaw Gate (NW)* Theran citizens are not subject to laws in Vrontok* Mayor T'rask, former slaver with large force of thugs.* Taxes: House Tax, Guest Tax, Exit Tax* T'rask focused on keeping the Therans from getting upset.* Lots of business that serve the slave merchants: taverns, gambling halls, brothels.* Result of imperialism; empires thrive on exploited labor.* Reflections on Thera and Vrontok in light of present-day economic and political systems.* "Keep politics out of rpgs!" is a crock.* Contrast of Sky Point's wealth and power to Vrontok's "wretched hive"* Fourth Edition changes and updatesFind and Follow:Email: edsgpodcast@gmail.comYouTube: https://www.youtube.com/@EDSGPodcastFind and follow Josh: https://linktr.ee/LoreMerchantGet product information, developer blogs, and more at www.fasagames.comFASA Games on Facebook: https://www.facebook.com/fasagamesincOfficial Earthdawn Facebook Group: https://www.facebook.com/groups/officialearthdawnFASA Games Discord Channel: https://discord.gg/uuVwS9uEarthdawn West Marches: https://discord.gg/hhHDtXW

In this podcast episode, we break down our list of the best producer, artist, and engineer combinations in music. From iconic collaborations to legendary studio chemistry, we talk about the teams that created timeless records and changed the sound of music. If you're into music production, audio engineering, recording, and the creative process behind great songs, this episode is for you.➡️ Get Our Rosetta Plugins: https://helpmedevvon.com/s/rosettaseries➡️ The Black Vortex Plugin: https://helpmedevvon.com/s/theblackvortex➡️ Our Site With Goodies: https://helpmedevvon.com/s/helpmedevvon➡️Buy From Sweetwater: https://cutt.ly/7hamejT _________________________________________________________ ▶ JOIN OUR COMMUNITY HERE: ➡️ Become A Member Of This Channel To Access Perks:https://thehmdcircle.com➡️Instagram: https://instagram.com/helpmedevvon➡️Twitter: https://twitter.com/helpmedevvonEmail Me: helpmedevvon@gmail.com #mixing #mastering #tutorial

The Yeah C'mon Show 04/07/2026 - Combination? Listen to today's Track 13 here: https://youtu.be/m0JMCaKwOUY?si=4qSx0KpK5Svf-C6G

In the first hour of the Chase & Big Joe Show, the guys shared their question of the day. What is the best sports brother combination? Later in the hour, Chase & Big Joe answered some calls and texts about their question of the day. Listen to hear more.

Today we're taking listeners beyond technical skill and into one of the most critical yet often overlooked competencies in the operating room: emotional intelligence. In a profession defined by precision, timing, and high-stakes decision-making, the ability to understand and manage emotions can be just as vital as mastering airway management or pharmacology. Joining the conversation is Brian Barry, who brings a powerful perspective on how emotional intelligence shapes not only individual performance but also team dynamics, leadership effectiveness, and ultimately patient outcomes.  Here's some of what you'll hear in this episode:

Wheat Status: Cold, Hot, Mites and Drought, Part 1 Wheat Status: Cold, Hot, Mites and Drought, Part 2 Pruning Trees   00:01:05 – Wheat Status: Cold, Hot, Mites and Drought, Part 1: K-State Extension agronomists Jeanne Falk Jones and Logan Simon are on today's show to explain the current status of wheat in Kansas. They mention how the cold snap impacted the crop and if they think it will recover.   00:12:05 – Wheat Status: Cold, Hot, Mites and Drought, Part 2: Jeanne and Logan continue the show and their conversation as they chat about how fields can differ in regions and their recommendations. Wheat Status: Injury Symptoms from Freeze Damage Mesonet.k-state.edu   00:23:05 – Pruning Trees: Ending the show is K-State Extension horticulture expert, Matt McKernan, discussing the basic guidelines for pruning and how to find an arborist when the project is too big to tackle yourself.      Send comments, questions or requests for copies of past programs to ksrenews@ksu.edu.   Agriculture Today is a daily program featuring Kansas State University agricultural specialists and other experts examining ag issues facing Kansas and the nation. It is hosted by Shelby Varner and distributed to radio stations throughout Kansas and as a daily podcast.   K‑State Extension is a short name for the Kansas State University Cooperative Extension Service, a program designed to generate and distribute useful knowledge for the well‑being of Kansans. Supported by county, state, federal and private funds, the program has county Extension offices statewide. Its headquarters is on the K‑State campus in Manhattan. For more information, visit Extension.ksu.edu. K-State Extension is an equal opportunity provider and employer.

In the final episode of the 2025-2026 wrestling season, The Gazette sports writer KJ Pilcher and Iowa wrestling legend Dick Briggs discuss the NCAA Men's Wrestling Championship.

Daniel Lam talks about how Chinese equities are at an important juncture and could benefit from a potential de-escalation in the Middle East and the return of positive reflation.Speaker: - Daniel Lam, Head, Cross-Asset Derivative Strategy, Standard Chartered BankFor more of our latest market insights, visit Market views on-the-go or subscribe to Standard Chartered Wealth Insights on YouTube.

In this episode, Lucas Aoun sits down with Mimi from The Medicin to unpack one of the most underrated immune compounds in human health: AHCC (Active Hexose Correlated Compound). AHCC has been quietly used in clinical settings for decades, yet most people still associate immune support with vitamin C, zinc, or mushrooms, missing what the human data on AHCC actually shows. This conversation cuts through the hype and focuses on human evidence, mechanisms, and practical application, making it essential listening for anyone serious about immune optimization, longevity, or performance-based health.Relevant Links:https://www.themedicin.com/ Check Out My Website For Coaching, Recommended Products and Much More:https://www.boostyourbiology.com/ Disclaimer:The information provided in this podcast episode is for entertainment purposes and is NOT MEDICAL ADVICE. If you have any questions about your health, contact a medical professional. This content is strictly the opinions of Lucas Aoun and is for informational and entertainment purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All viewers of this content are advised to consult with their doctors or qualified health professionals regarding specific health questions. Neither Lucas Aoun nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this content. All consumers of this content especially taking prescription or over-the-counter medications should consult their physician before beginning any nutritional, supplement or lifestyle program.Chapters00:00 Introduction to Immune Health and Supplements05:34 Mimi's Journey into Supplements and AHCC11:42 Understanding AHCC: The Science Behind It18:03 AHCC and Cancer Research28:29 Dosage and Usage of AHCC36:56 AHCC in Combination with Other Treatments46:31 The Unique Mechanisms of AHCC48:10 Conclusion and Resources for Further Learning Hosted on Acast. See acast.com/privacy for more information.

In this episode, we explore the Fifth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting, the latest international update designed to guide clinicians toward more effective prevention and treatment strategies. These updated recommendations reflect a growing body of research and introduce several important shifts in how anesthesia providers approach PONV. From expanded use of multimodal prophylaxis to greater emphasis on risk reduction strategies and post-discharge nausea and vomiting, the new guidelines encourage clinicians to think more proactively and systematically about managing this common complication. Here's some of what you'll hear in this episode:

The Gazette sports writer KJ Pilcher and Iowa wrestling legend Dick Briggs discuss the upcoming Division 1 NCAA Wrestling Championship and recap the Division 3 NCAA Wrestling Championship results.

Awareness and acceptance lay the groundwork, but nothing changes until you take action. In this final episode of the budgeting series, Brian Thompson brings the framework full circle by focusing on what to actually do with your numbers. Because understanding your finances and accepting where you are is only powerful if it leads somewhere. This episode is about making intentional, strategic decisions that move your mission-driven business forward.   Start With Vision, Not Spreadsheets Before diving into tactics, Brian starts with something that might surprise you in a budgeting conversation: vision. Your budget is more than a financial document. It's a reflection of the business and life you want to build. Do you want a lean lifestyle business with flexibility and freedom? A growing company with employees and systems? A business optimized for profit so you can invest, travel, or retire early? There's no wrong answer. But the budget you build should reflect your vision, directing your money toward what matters most to you.   The Three Financial Levers Once you know your numbers and your vision, the path forward becomes clearer. Brian outlines three levers every entrepreneur can pull. The Income Lever. Sometimes the most straightforward way to improve your financial picture is to focus on revenue growth. That might mean raising your prices, adding new services, improving your marketing, or increasing your capacity to serve more clients. The Expense Lever. Reducing expenses doesn't mean slashing everything or operating from a scarcity mindset. It means asking thoughtful questions: Are there subscriptions or tools you're no longer using? Services you could renegotiate? Expenses that don't actually move the business forward? As Brian noted in the first part of this series on awareness, sorting expenses from highest to lowest can reveal a lot. Sometimes one or two adjustments can significantly improve your financial flexibility. A Combination of Both. Most of the time, the right answer lives somewhere in the middle. A small price increase combined with trimming a few unnecessary expenses can create a surprisingly big impact on both sides of the equation.   The Profit First Framework For clients looking for a practical system to manage cash flow, Brian recommends the Profit First model. Rather than treating profit as whatever is left over after expenses, Profit First flips the equation so you are allocating income intentionally across four key categories from the start: profit, owner's pay, taxes, and operating expenses. Setting percentages for each category and revisiting them quarterly creates guardrails that keep your business financially healthy and enforces a powerful mindset shift: profit is no longer an afterthought. It becomes a priority.   Give Yourself Permission to Have a "Building Year" For anyone feeling pressure to make every year better than the last, Brian offers a grounding reminder: business growth is not a straight line. Some years are building years. Maybe you hired your first employee, invested in new systems, launched a new service, or restructured your client roster. In those years, expenses often increase before revenue catches up. And that's okay. Sometimes investing now is exactly what creates something better later.   Your Action Step Look at the numbers you gathered during the awareness exercise and ask yourself one question: which lever do I need to pull right now? Do you need to focus on increasing income, reducing expenses, or a combination of both? Then identify one intentional change you can make this month. Just one. Small, consistent decisions are what ultimately build strong businesses. Thank you for following along with this three-part budgeting series. If there's one takeaway from awareness, acceptance, and action, it's this: budgeting isn't about restriction. It's about clarity, compassion, and intentional decision making. When you know your numbers, accept where you are, and take thoughtful action, you give your mission-driven business the foundation it needs to thrive. If you found this series helpful, share it with a fellow entrepreneur — and as always, Brian welcomes your questions and insights on Instagram at @BTFinancial.   Resources + Links Episode 110: Budgeting Series #1: A Guide to Financial Awareness Episode 111: Budgeting Series #2: A Guide to Money Mindset Shifts Newsletter Sign Up Follow Brian Thompson Online: Instagram, Facebook, LinkedIn, X, Forbes Follow & review the podcast: on Spotify and Apple Podcasts   About Brian and the Mission Driven Business Podcast Brian Thompson, JD/CFP®, is a tax attorney and Certified Financial Planner® who specializes in providing comprehensive financial planning to LGBTQ+ entrepreneurs who run mission-driven businesses. The Mission Driven Business podcast was born out of his passion for helping social entrepreneurs create businesses with purpose and profit. On the podcast, Brian talks with diverse entrepreneurs and the people who support them. Listeners hear stories of experiences, strength, and hope and get practical advice to help them build businesses that might just change the world, too.

To what degree do you feel capable of saying what you want to say in your life and in your relationships? In this episode, I'm revisiting one of my favorite episodes about the powerful combination of choice and voice. A revolution happens when women say what they want to say. When you can express how you really feel, it becomes easier to stand up for yourself and set expectations. Your relationships shift, your choices become clearer, and you stop performing and start actually living. Here's what I cover:One of the key skills I teach my clients: how to articulate themselves during difficult conversationsHow reconnecting to your own wants and needs is a process that takes timeWhy we are capable of updating the relationships in our lives to match our current wants and needsWhy authenticity removes the pressure to perform in order to feel acceptedHow learning to handle the stress of advocating for yourself leads to deeper integrity and lasting comfortFind Sara here:sarafisk.coachpages.sarafisk.coach/difficultconversationswww.instagram.com/sarafiskcoach/www.facebook.com/SaraFiskCoaching/www.tiktok.com/@sarafiskcoachwww.youtube.com/@sarafiskcoaching1333What happens inside the free Stop People Pleasing Facebook Community? Our goal is to provide help and guidance on your journey to eliminate people pleasing and perfectionism from your life. We heal best in a safe community where we can grow and learn together and celebrate and encourage each other. This group is for posting questions about or experiences with material learned in The Ex-Good Girl podcast, Sara Fisk Coaching social media posts or the free webinars and trainings provided by Sara Fisk Coaching. See you inside!Book a Free Consult

In this episode of Let's Combinate, Subhi Saadeh speaks with Jen Riter about analytical method validation for drug device combination products. The discussion explores how traditional drug analytical validation under ICH Q2 differs from validating functional and mechanical performance methods used for combination products. These methods often require an engineering mindset that incorporates measurement system analysis (MSA), gage R&R studies, and the use of fabricated surrogate standards when devices cannot be reused for testing.They also discuss platform test methods and how standards such as ISO 11040 and other ISO references can serve as starting points for method development. The conversation touches on the evolving alignment between ISO based device methods and pharmacopeial expectations such as USP . The episode also covers make vs buy testing decisions, when to outsource specialized testing such as CCIT and extractables and leachables, and how sponsors manage oversight of contract testing laboratories.Timestamps00:00 Welcome and Guest Introduction00:53 ICH Q2 vs MSA Mindset Shift04:37 Surrogate Standards for Mechanical Testing11:12 Platform Methods and ISO 1104015:14 ISO vs USP Verification Debate20:06 Outsourcing Analytical Testing Strategy24:07 Choosing the Right Test Lab26:20 Sponsor Oversight of Contract Labs30:09 Wrap UpAbout Jen RiterJen Riter is an analytical testing and laboratory leader with nearly three decades of experience working in pharmaceutical packaging, drug delivery systems, and combination products. She has held leadership roles at West Pharmaceutical Services and Kindeva Drug Delivery, where her work has focused on analytical method development, validation, and testing strategies for drug delivery systems and injectable combination products. She is also a contributor to the Combination Products Handbook, where she authored a chapter on analytical testing and method validation for combination products.About Subhi SaadehSubhi Saadeh is the Founder and Principal of Let's Combinate BioWorks, where he helps companies close the gaps between drug and device development, quality systems, and regulatory expectations. He is a Certified Quality Auditor and ISO 13485 Lead Auditor with leadership experience at Baxter, Pfizer, and Gilead Sciences including responsibility for management and oversight of assemble label pack sites and working with device primary, secondary and tertiary packaging suppliers. Subhi previously chaired the Combination Product Working Group for Rx-360, served as International Committee Chair for the Combination Products Coalition, and served on AAMI's Combination Products Committee. He also hosts the Let's Combinate podcast and is a writer and speaker on quality at the intersection of drugs and devices.

The Gazette sports writer KJ Pilcher and Iowa wrestling legend Dick Briggs talk about the Big 10 and Big 12 wrestling tournaments, the inaugural NCAA Women's wrestling championships and the upcoming Div.3 NCAA Wrestling Championship in this weeks Pinning Combination edisode.

The Gazette sports writer KJ Pilcher and Iowa wrestling legend Dick Briggs talk about the upcoming post season in NCAA Wrestling across Iowa.

With data increasingly positioning thermal ablation as a viable alternative to surgery for select liver metastases, the demands on the interventional oncologist have never been higher. Mastering the nuances of patient selection and precise margin assessment is now essential for ensuring effective disease control locally. In this episode of the BackTable Podcast, interventional radiologist Dr. Jonas Redmond of UC San Diego Health joins host Dr. Sabeen Dhand to discuss the current state of microwave ablation (MWA) in the management of oligometastatic liver disease, focusing on tumor assessment, preprocedural planning, and the integration of local and systemic therapies. --- This podcast is supported by: Varian IntelliBlatehttps://www.varian.com/products/interventional-solutions/microwave-ablation-solutions --- SYNPOSIS The conversation delves into the complexities of timing systemic versus local ablative therapies and explores questions surrounding adequate treatment margins. Dr. Redmond goes on to emphasize the need for operators to approach procedures with a high level of adaptability, advocating for interdisciplinary preprocedural planning and thoughtful modality selection. Exploring the complications that could arise from injury to adjacent viscera, the physicians speak to the critical importance of rigorous intraprocedural reassessment and discuss how modern software and robotics are transforming procedural precision and safety. Framing these MWA pearls within the context of recent clinical trials like COLLISION and ACCLAIM, the episode underscores the transition of interventional oncology from providing palliative services to increasingly curative solutions that may offer better prospects for patients with metastatic disease. --- TIMESTAMPS 00:00 - Introduction04:30 - Role of Local Therapy in Systemic Disease09:49 - Patient Selection and Treatment Modalities13:15 - Challenging Lesion Characteristics and Locations19:56 - Y-90 Radioembolization versus Microwave Ablation23:04 - Intraoperative Ablation and Combining Locoregional Modalities29:36 - Complications of Microwave Ablation in the Liver36:43 - Future of Ablation and Liver Metastases Treatment39:25 - Final Thoughts and Closing Remarks --- RESOURCES UC San Diego Health. Cryoablation and Arterial Infusion of SD-101 in Combination with Durvalumab and Tremelimumab.https://clinicaltrials.ucsd.edu/trial/NCT06710223 COLLISION trialhttps://clinicaltrials.gov/study/NCT03088150 ACCLAIM trialhttps://clinicaltrials.gov/study/NCT05265169

Welcome to the Oncology Brothers podcast! In this episode, we dived into the evolving frontline treatment landscape for triple-negative breast cancer (TNBC). Listen us on: Spotify: https://open.spotify.com/show/31BXhY9FM4gPWG10WgE11o Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Join us as we welcomed Dr. Sherene Loi, a leading breast medical oncologist from Australia, to discuss the challenges of treating TNBC and the exciting new treatment options available. We explored the significance of PD-L1 scoring in metastatic TNBC, the implications of recent trials like ASCENT-04, and the potential of antibody-drug conjugates (ADCs) such as sacituzumab govitecan and datopotamab deruxtecan. Key topics included: • The role of PD-L1 positivity in treatment decisions • Insights from the ASCENT-04 trial and its findings • Common side effects associated with sacituzumab and strategies for management • The future of immunotherapy and ADCs in TNBC treatment Whether you're a healthcare professional or someone interested in the latest advancements in oncology, this episode is packed with valuable information and clinical pearls. Don't forget to subscribe for more insightful discussions on cancer treatment! #TNBC, #PDL1positive, #ASCENT04, #Immunotherapy, #OncBrothers

The Gazette sports writer K.J. Pilcher and Dick Briggs talk about Iowa college wrestling from the previous week including results between Iowa vs. Oklahoma State, Iowa State vs. Missouri and UNI vs. Wisconsin.

The Gazette sports writer K.J. Pilcher and Iowa wrestling legend Dick Briggs discuss Iowa college wrestling from the past week and upcoming matches including Iowa Hawkeyes traveling to Oklahoma State and the in-state match between Iowa State and UNI.

In this engaging conversation, Vincent A. Lanci and Ben Albert explore the multifaceted journey of entrepreneurship, emphasizing that success is not a single key but a unique combination of skills, experiences, and connections. The guest shares his unexpected path to entrepreneurship, the importance of niche marketing, and effective strategies for leveraging platforms like LinkedIn for social selling. The discussion also highlights the evolution of the guest's podcast, 'Real Business Connections,' and concludes with a thought-provoking reflection on the ultimate entrepreneur, Jesus Christ.As you listen:00:00 The Key to Success: A Unique Combination01:51 The Journey to Entrepreneurship04:50 From Zero to Hero: Building a Business Podcast08:44 Marketing Strategies for the Clueless11:53 Leveraging LinkedIn for Social Selling13:45 Finding Your Unique Key to Success15:32 The Evolution of a Podcast: Real Business Connections17:38 A Conversation with Jesus: The Ultimate Entrepreneur"There is no key to success.""I'd love to ask him about it.""This kicked butt."Takeaways:-Success is a unique combination, not a single key.-Entrepreneurship can emerge from unexpected circumstances.-Niche down to create a smaller, more manageable market.-Networking through podcasting can lead to mentorship and clients.-Promoting others can be an effective marketing strategy.-LinkedIn is a powerful tool for social selling.-Building trust is essential before pitching products or services.-Your podcast can serve as a diary of your learning journey.-Engaging with your audience can lead to valuable connections.-The journey of entrepreneurship is ongoing and ever-evolving.

The Gazette sports writer K.J. Pilcher and Iowa wrestling legend Dick Briggs discuss Iowa colleges wrestling from the past week including upcoming matchups.

What happens when the world of GLP-1s collides with the operating room? Today, we're diving into the new era of obesity care. Hosts·       Matthew Martin, trauma and bariatric surgeon at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California) @docmartin2·       Adrian Dan, bariatric and MIS surgeon, program director for the advanced MIS bariatric and foregut fellowship at Summa Health System (Akron, Ohio) @DrAdrianDan·       Crystal Johnson Mann, bariatric and foregut surgeon at the University of Florida (Gainesville, Florida) @crys_noelle_·       Katherine Cironi, general surgery resident at the University of Southern California/Los Angeles General Medical Center (Los Angeles, California) @cironimacaroniLearning objectives1.          Understand the evolving role of OMMs in bariatric surgical practice·       Recognize how widespread GLP-1 and dual-incretin therapies have reshaped patient presentations, expectations, and referral patterns.·       Appreciate current evidence comparing surgery to GLP-1 therapy, including the JAMA Surgery study out of Allegheny Health (2025), noting:o   Superior weight loss with bariatric surgery (~28% TBWL vs ~10% with GLP-1s)o   Higher health-care utilization and cost in GLP-1–treated patients.·       Frame OMMs not as alternatives but as complementary tools within a chronic disease model when treating obesity.2.           Review pharmacologic classes and their expected efficacy·       Surgeons should be able to articulate the mechanisms, efficacy, and limitations of:o   GLP-1 receptor agonists – incretin-based satiety; 5–12% TBWL.o   Dual GIP/GLP-1 agonists – most potent agents; 15–22% TBWL.o   Sympathomimetics – norepinephrine-driven appetite suppression; 3–7% TBWL.o   Combination agents (bupropion-naltrexone, phentermine-topiramate) – 5–12% TBWL depending on regimen.o   Emerging therapies – retatrutide, maritide, oral GLP-1s, with promising TBWL in phase 2 trials3.          Apply OMMs strategically in the preoperative phase·       Integrate OMMs without compromising surgical eligibility—OMM-related weight loss does not negate the indication for surgery.·       Counsel patients that medication response does not equal disease resolution; surgery remains the most durable intervention.·       Manage delayed gastric emptying and aspiration risk:o   Pause weekly GLP-1 or dual agonists for ≥1 week pre-op (longer if symptomatic).o   Collaborate closely with the anesthesia/OR teams·       Screen for nutritional depletion before surgery, especially protein deficits exacerbated by appetite suppression.·       Navigate insurance barriers that may paradoxically approve surgery but deny medication continuation.4.          Implement postoperative OMMs safely and effectively·       Establish criteria for OMM introduction:o   Typical initiation at 6–12 months, once the diet stabilizes and the physiologic curve flattens.o   Earlier initiation (4–6 weeks) may be appropriate in pediatric or select high-risk populations.·       Recognize altered pharmacokinetics after sleeve and bypass:o   Injectables may be preferred due to altered absorption of oral agents.·       Prevent postoperative nutritional compromise:o   Monitor protein intake, hydration, and micronutrient status (including iron, B12, and fat-soluble vitamins).o   Titrate doses slowly to minimize nausea/vomiting that can precipitate malnutrition.·       Frame OMM use as a tool for disease persistence (plateau/regain), not as a marker of failure.5.          Identify systems-level barriers and the implementation of coordinated care·       Understand insurance inconsistencies—coverage for surgery is often not paired with coverage for long-term medical therapy.·       Clearly document disease persistence and medical necessity when appealing denials.·       Avoid fragmented care: establish shared-care pathways between bariatric surgery, obesity medicine, and primary care.·       Use patient-centered language emphasizing complementary therapy, not hierarchy or competition between surgery and medications.6.          Counsel patients ethically and accurately within a chronic disease model·       Set expectations: sustained success requires surgery + medication + behavioral change.·       Educate patients that postoperative OMM use does not imply surgical failure.·       Normalize long-term multimodal management of obesity, analogous to diabetes or hypertension models.*Sponsor Disclaimer: Visit goremedical.com/btkpod to learn more about GORE® SYNECOR Biomaterial, including supporting references and disclaimers for the presented content.  Refer to Instructions for Use at eifu.goremedical.com for a complete description of all applicable indications, warnings, precautions and contraindications for the markets where this product is available. Rx only Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

The Super Bowl is coming up, and you know what that means: chips. Also dip. And commercials. If there's time, perhaps some football as well. Next Tuesday it'll also mean Bob and Costaki get to gloat about the Patriots losing thanks to Minnesota talent. That's right, we're calling it now.Topics:NFL franchise valuationUpcoming Super BowlRip the puppyNew Disney CEOCharlie's giant pizza sliceSJUSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.