Podcasts about cost effectiveness

Greg Morley (he/him), Author, Speaker, and HR Thought Leader, and I recap the latest 5 Things (good vibes in DEI) in just 15 minutes. This week, our conversation is about spreadsheets saving lives, vacation rentals finally getting accessible, and the only lesbian film fest in a quilting town.Here are this week's good vibes:Game, Set, EquityDisability Inclusion Gets a Desert DebutAccess Granted, Finally!Queer Reels, River VibesAid Cuts, She DeliversGood Vibes to Go: Bernadette's GVTG: In the spirit of Pride month, here's a book recommendation: Tomorrow Will Be Different by U.S. Senator Sarah McBride, the first transgender senator. This was written before she was elected to any office, but it is a great trans memoir. Greg's GVTGs: Read more! Greg buys and reads two books a month to challenge himself, get out of the wormhole that can be social media, and also learn things that the media would not gravitate to directly. Secondly, before bed, consider two things that you're grateful for from the day, big or small, and one thing you'd like to do better tomorrow. Read the Stories.Connect with Greg Morley on Linkedin, Instagram, and his website.Subscribe to the 5 Things newsletter.Watch the show on YouTube. Join thousands of readers by subscribing to the 5 Things newsletter. Enjoy some good vibes in DEI every Saturday morning. https://5thingsdei.com/

JCO PO author Dr. Dean A. Regier at the Academy of Translational Medicine, University of British Columbia (UBC), and the School of Population and Public Health, BC Cancer Research Institute shares insights into his JCO PO article, “Clinical Effectiveness and Cost-Effectiveness of Multigene Panel Sequencing in Advanced Melanoma: A Population-Level Real-World Target Trial Emulation.” Host Dr. Rafeh Naqash and Dr. Regier discuss the real-world clinical effectiveness and cost-effectiveness of multigene panels compared with single-gene BRAF testing to guide therapeutic decisions in advanced melanoma. Transcript Dr. Rafeh Naqash:Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, Podcast Editor for JCO Precision Oncology and Assistant Professor at the OU Health Stephenson Cancer Center in the University of Oklahoma. Today, we are excited to be joined by Dr. Dean A. Regier, Director at the Academy of Translational Medicine, Associate Professor at the School of Population and Public Health, UBC Senior Scientist at the British Columbia Cancer Research Institute, and also the senior author of the JCO Precision Oncology article entitled "Clinical Effectiveness and Cost-Effectiveness of Multigene Panel Sequencing in Advanced Melanoma: A Population-Level Real-World Target Trial Emulation." At the time of this recording, our guest's disclosures will be linked in the transcript. Dean, welcome to our podcast and thank you for joining us today. Dr. Dean Regier:Thank you. I'm delighted to be here. Dr. Rafeh Naqash:So, obviously, you are from Canada, and medicine, or approvals of drugs to some extent, and in fact approvals of gene testing to some extent is slightly different, which we'll come to learn about more today, compared to what we do in the US—and in fact, similarly, Europe versus North America to a large extent as well. Most of the time, we end up talking about gene testing in lung cancer. There is a lot of data, a lot of papers around single-gene panel testing in non-small cell lung cancer versus multigene testing. In fact, a couple of those papers have been published in JCO PO, and it has shown significant cost-effectiveness and benefit and outcomes benefit in terms of multigene testing. So this is slightly, you know, on a similar approach, but in a different tumor type. So, could you tell us first why you wanted to investigate this question? What was the background to investigating this question? And given your expertise in health economics and policy, what are some of the aspects that one tends or should tend to understand in terms of cost-effectiveness before we go into the results for this very interesting manuscript? Dr. Dean Regier:Yeah, of course, delighted to. So, one of the reasons why we're deeply interested in looking at comparative outcomes with respect to single- versus multigene testing— whether that's in a public payer system like Canada or an insurer system, a private system in the United States— is that the question around does multigene versus single-gene testing work, has not typically tested in randomized controlled trials. You don't have people randomized to multigene versus single-gene testing. And what that does, it makes the resulting evidence base, whether it's efficacy, safety, or comparative cost-effectiveness, highly uncertain. So, the consequence of that has been uneven uptake around the world of next-generation sequencing panels. And so if we believe that next-gen sequencing panels are indeed effective for our patients, we really need to generate that comparative evidence around effectiveness and cost-effectiveness. So we can go to payers, whether it be single payer or a private insurer, to say, "Here are the comparative outcomes." And when I say that uptake has been uneven, uptake there's been actually plenty, as you know, publications around that uneven uptake, whether it be in Europe, in the United States, in Canada. And so we're really interested in trying to produce that evidence to create the type of deliberations that are needed to have these types of technologies accessible to patients. And part of those deliberations, of course, is the clinical, but also in some contexts, cost-effectiveness. And so, we really start from the perspective of, can we use our healthcare system data, our learning healthcare system, to generate that evidence in a way that emulates a randomized controlled trial? We won't be able to do these randomized controlled trials for various, like really important and and reasons that make sense, quite frankly. So how can we mimic or emulate randomized controlled trials in a way that allows us to make inference around those outcomes? And for my research lab, we usually think through how do we do causal inference to address some of those biases that are inherent in observational data. So in terms of advanced melanoma, we were really interested in this question because first of all, there have been no randomized controlled trials around next-gen sequencing versus single-gene testing. And secondly, these products, these ICIs, immune checkpoint inhibitors, and BRAF and MEK inhibitors, they are quite expensive. And so the question really becomes: are they effective? And if so, to what extent are they cost-effective? Do they provide a good reason to have information around value for money? Dr. Rafeh Naqash:So now going to the biology of melanoma, so we know that BRAF is one of the tumor-agnostic therapies, it has approvals for melanoma as well as several other tumor types. And in fact, I do trials with different RAF-RAS kinase inhibitors. Now, one of the things that I do know is, and I'm sure some of the listeners know, is the DREAMseq trial, which was a melanoma study that was an NCI Cooperative Group trial that was led by Dr. Mike Atkins from Georgetown a couple of years back, that did show survival benefit of first-line immunotherapy sequencing. It was a sequencing study of whether to do first-line BRAF in BRAF-mutant melanoma followed by checkpoint inhibitors, or vice versa. And the immune checkpoint inhibitors followed by BRAF was actually the one that showed benefit, and the trial had to stop early, was stopped early because of the significant benefit seen. So in that context, before we approach the question of single-gene versus multigene testing in melanoma, one would imagine that it's already established that upfront nivolumab plus ipilimumab, for that matter, doublet checkpoint inhibitor therapy is better for BRAF-mutant melanoma. And then there's no significant other approvals for melanoma for NRAS or KIT, you know, mucosal melanomas tend to have KIT mutations, for example, or uveal melanomas, for that matter, have GNAQ, and there's no targeted therapies. So, what is the actual need of doing a broader testing versus just testing for BRAF? So just trying to understand when you started looking into this question, I'm sure you kind of thought about some of these concepts before you delved into that. Dr. Dean Regier:I think that is an excellent question, and it is a question that we asked ourselves: did we really expect any differences in outcomes between the testing strategies? And what did the real-world implementation, physician-guided, physician-led implementation look like? And so, that was kind of one of the other reasons that we really were interested is, why would we go to expanded multigene panel sequencing at all? We didn't really expect or I didn't expect an overall survival a priori. But what we saw in our healthcare system, what happened in our healthcare system was the implementation in 2016 of this multigene panel. And this panel covered advanced melanoma, and this panel cost quite a bit more than what they were doing in terms of the single-gene BRAF testing. And so when you're a healthcare system, you have to ask yourself those questions of what is the additional value associated with that? And indeed, I think in a healthcare system, we have to be really aware that we do not actually follow to the ideal extent randomized controlled trials or trial settings. And so that's the other thing that we have to keep in mind is when these, whether it's an ICI or a BRAF MEK inhibitor, when these are implemented, they do not look like randomized controlled trials. And so, we really wanted to emulate not just a randomized controlled trial, but a pragmatic randomized controlled trial to really answer those real-world questions around implementation that are so important to decision making. Dr. Rafeh Naqash:Sure. And just to understand this a little better: for us in the United States, when we talk about multigene testing, we generally refer to, these days, whole-exome sequencing with whole-transcriptome sequencing, which is like the nuclear option of of the testings, which is not necessarily cheap. So, when you talk about multigene testing in your healthcare system, what does that look like? Is it a 16-gene panel? Is it a 52-gene panel? What is the actual makeup of that platform? Dr. Dean Regier:Excellent question. Yeah, so at the time that this study is looking at, it was 2016, when we, as BC Cancer—so British Columbia is a population right now of 5.7 million people, and we have data on all those individuals. We are one healthcare system providing health care to 5.7 million people. In 2016, we had what I call our "home-brew" multigene panel, which was a 53-gene panel that was reimbursed as standard of care across advanced cancers, one of them being advanced melanoma. We have evolved since then. I believe in 2022, we are using one of the Illumina panels, the Focus panel. And so things have changed; it's an evolving landscape. But we're specifically focused on the 53-gene panel. It was called OncoPanel. And that was produced in British Columbia through the Genome Sciences Centre, and it was validated in a single-arm trial mostly around validity, etc. Dr. Rafeh Naqash:Thank you for explaining that. So now, onto the actual meat and the science of this project. So, what are some of the metrics from a health economy standpoint that you did look at? And then, methodology-wise, I understand, in the United States, we have a fragmented healthcare system. I have data only from my institution, for that matter. So we have to reach out to outside collaborators and email them to get the data. And that is different for you where you have access to all the data under one umbrella. So could you speak to that a little bit and how that's an advantage for this kind of research especially? Dr. Dean Regier:Yeah. In health economics, we look at the comparative incremental costs against the incremental effectiveness. And when we think about incremental costs, we think not just about systemic therapy or whether you see a physician, but also about hospitalizations, about all the healthcare interactions related to oncology or not that a patient might experience during their time or interactions with the healthcare system. You can imagine with oncology, there are multiple interactions over a prolonged time period depending on survival. And so what we try to do is we try to—and the benefit of the single-payer healthcare system is what we do is we link all those resource utilization patterns that each patient encounters, and we know the price of that encounter. And we compare those incremental costs of, in this case, it's the multigene panel versus the single-gene panel. So it's not just the cost of the panel, not just the cost of systemic therapy, but hospitalizations, physician encounters, etc. And then similarly, we look at, in this case, we looked at overall survival - we can also look at progression-free survival - and ask the simple question, you know, what is the incremental cost per life-year gained? And in that way, we get a metric or an understanding of value for money. And how we evaluate that within a deliberative priority setting context is we look at safety and efficacy first. So a regulatory package that you might get from, in our case, Health Canada or the FDA, so we look at that package, and we deliberate on, okay, is it safe and is it effective? How many patients are affected, etc. And then separately, what is the cost-effectiveness? And at what price, if it's not cost-effective, at what price would it be cost-effective? Okay, so for example, we have this metric called the incremental cost-effectiveness ratio, which is incremental cost in the numerator, and in this case, life-years gained in the denominator. And if it is around $50,000 or $100,000 per life-year gained—so if it's in that range, this ratio—then we might say it's cost-effective. If it's above this range, which is common in oncology, especially when we talk about ICIs, etc., then you might want to negotiate a price. And indeed, when we negotiate that price, we use the economic evaluation, that incremental cost-effectiveness ratio, as a way to understand at what price should we negotiate to in order to get value for money for the healthcare system. Dr. Rafeh Naqash:Thank you for explaining those very interesting terminologies. Now, one question I have in the context of what you just mentioned is, you know, like the drug development space, you talked about efficacy and safety, but then on the safety side, we talk about all-grade adverse events or treatment-related adverse events—two different terminologies. From a healthcare utilization perspective, how do you untangle if a patient on a BRAF therapy got admitted for a hypoxic respiratory failure due to COPD, resulting in a hospitalization from the cost, overall cost utilization, or does it not matter? Dr. Dean Regier:We try to do as much digging into those questions as possible. And so, this is real-world data, right? Real-world data is not exactly as clean as you'd get from a well-conducted clinical trial. And so what we do is we look at potential adverse event, whether it's hospitalization, and the types of therapies around that hospitalization to try- and then engage with clinicians to try to understand or tease out the different grades of the adverse event. Whether it's successful or not, I think that is a real question that we grapple with in terms of are we accurate in delineating different levels of adverse events? But we try to take the data around the event to try to understand the context in which it happens. Dr. Rafeh Naqash:Thank you for explaining that, Dean. So, again to the results of this manuscript, could you go into the methodology briefly? Believe you had 147 patients, 147 patients in one arm, 147 in the other. How did you split that cohort, and what were some of the characteristics of this cohort? Dr. Dean Regier:So, the idea, of course, is that we have selection criteria, study inclusion criteria, which included in our case 364 patients. And these were patients who had advanced melanoma within our study time period. So that was 2016 to 2018. And we had one additional year follow. So we had three total years. And what we did is that we linked our data, our healthcare system data. During this time, because the policy change was in 2016, we had patients both go on the multigene panel and on the single-gene BRAF testing. So, the idea was to emulate a pragmatic randomized controlled trial where we looked at contemporaneous patients who had multigene panel testing versus single-gene BRAF testing. And then we did a matching procedure—we call it genetic matching. And that is a type of matching that allows us to balance covariates across the patient groups, across the multigene versus BRAF testing cohorts. The idea again is, as you get in a randomized controlled trial, you have these baseline characteristics that look the same. And then the hope is that you address any source selection or confounding biases that prohibit you to have a clean answer to the question: Is it effective or cost-effective? So you address all those biases that may prohibit you to find a signal if indeed a signal is there. And so, what we did is we created—we did this genetic matching to balance covariates across the two cohorts, and we matched them one-to-one. And so what we were able to do is we were able to find, of those 364 patients in our pool, 147 in the multigene versus 147 in the single-gene BRAF testing that were very, very similar. In fact, we created what's called a directed acyclic graph or a DAG, together with clinicians to say, “Hey, what biases would you expect to have in these two cohorts that might limit our ability to find a signal of effectiveness?” And so we worked with clinicians, with health economists, with epidemiologists to really understand those different biases at play. And the genetic matching was able to match the cohorts on the covariates of interest. Dr. Rafeh Naqash:And then could you speak on some of the highlights from the results? I know you did survival analysis, cost-effectiveness, could you explain that in terms of what you found? Dr. Dean Regier:We did two analyses. The intention-to-treat analysis is meant to emulate the pragmatic randomized controlled trial. And what that does is it answers the question, for all those eligible for multigene or single-gene testing: What is the cost-effectiveness in terms of incremental life-years gained and incremental cost per life-years gained? And the second one was around a protocol analysis, which really answered the question of: For those patients who were actually treated, what was the incremental effectiveness and cost-effectiveness? Now, they're different in two very important ways. For the intention-to-treat, it's around population questions. If we gave single-gene or multigene to the entire population of advanced melanoma patients, what is the cost-effectiveness? The per-protocol is really around that clinical question of those who actually received treatment, what was the incremental cost and effectiveness? So very different questions in terms of population versus clinical cost and effectiveness. So, for the intention-to-treat, what we found is that in terms of life-years gained is around 0.22, which is around 2.5 months of additional life that is afforded to patients who went through the multigene panel testing versus the single-gene testing. That was non-statistically significant from zero at the 5% level. But on average, you would expect this additional 2.5 months of life. The incremental costs were again non-statistically significant, but they're around $20,000. And so when we look at incremental cost-effectiveness, we can also look at the uncertainty around that question, meaning what percentage of incremental cost-effectiveness estimates are likely to be cost-effective at different willingness-to-pay thresholds? Okay? So if you are willing to pay $100,000 to get one gain of life-years, around 52.8% of our estimates, in terms of when we looked at the entire uncertainty, would be cost-effective. So actually that meets the threshold of implementation in our healthcare system. So it's quite uncertain, just over 50%. But what we see is that decision-makers actually have a high tolerance for uncertainty around cost-effectiveness. And so, while it is uncertain, we would say that, well, the cost-effectiveness is finely balanced. Now, when we looked at the population, the per-protocol population, those folks who just got treatment, we actually have a different story. We have all of a sudden around 4.5 or just under 5 months of life gained that is statistically significantly different from zero, meaning that this is a strong signal of benefit in terms of life-years gained. In terms of the changes in costs or the incremental costs, they are larger again, but statistically insignificant. So the question now is, to what extent is it cost-effective? What is the probability of it being cost-effective? And at the $100,000 per life-year gained willingness-to-pay, there was a 73% chance that multigene panel testing versus single-gene testing is cost-effective. Dr. Rafeh Naqash:So one of the questions I have here, this is a clarification both for myself and maybe the listeners also. So protocol treatment is basically if you had gene testing and you have a BRAF in the multigene panel, then the patient went on a BRAF treatment. Is that correct? Dr. Dean Regier:It's still physician choice. And I think that's important to say that. So typically what we saw in both in our pre- and post-matching data is that we saw around 50% of patients, irrespective of BRAF status, get an ICI, which is appropriate, right? And so the idea here is that you get physician-guided care, but if the patient no longer performs on the ICI, then it gives them a little bit more information on what to do next. Even during that time when we thought it wasn't going to be common to do an ICI, but it was actually quite common. Dr. Rafeh Naqash:Now, did you have any patients in this study who had the multigene testing done and had an NRAS or a KIT mutation and then went on to those therapies, which were not captured obviously in the single-gene testing, which would have just tried to look at BRAF? Dr. Dean Regier:So I did look at the data this morning because I thought that might come up in terms of my own questions that I had. I couldn't find it, but what we did see is that some patients went on to clinical trials. So, meaning that this multigene panel testing allowed, as you would hope in a learning healthcare system, patients to move on to clinical trials to have a better chance at more appropriate care if a target therapy was available. Dr. Rafeh Naqash:And the other question in that context, which is not necessarily related to the gene platform, but more on the variant allele frequency, so if you had a multigene panel that captured something that was present at a high VAF, with suspicion that this could be germline, did you have any of those patients? I'm guessing if you did, probably very low number, but I'm just thinking from a cost-effective standpoint, if you identify somebody with germline, their, you know, first-degree relative gets tested, that ends up, you know, prevention, etc. rather than somebody actually developing cancer subsequently. That's a lot of financial gains to the system if you capture something early. So did you look at that or maybe you're planning to look at that? Dr. Dean Regier:We did not look at that, but that is a really important question that typically goes unanswered in economic evaluations. And so, the short answer is yes, that result, if there was a germline finding, would be returned to the patient, and then the family would be able to be eligible for screening in the appropriate context. What we have found in economic evaluations, and we've recently published this research, is that that scope of analysis is rarely incorporated into the economic evaluation. So those downstream costs and those downstream benefits are ignored. And when you- especially also when you think about things like secondary or incidental findings, right? So it could be a germline finding for cancer, but what about all those other findings that we might have if you go with an exome or if you go with a genome, which by the way, we do have in British Columbia—we do whole-genome and transcriptome sequencing through something called the Personalized OncoGenomics program. That scope of evaluation, because it's very hard to get the right types of data, because it requires a decision model over the lifetime of both the patients and potentially their family, it becomes very complicated or complex to model over patients' and families' lifetime. That doesn't mean that we should not do it, however. Dr. Rafeh Naqash:So, in summary Dean, could you summarize some of the known and unknowns of what you learned and what you're planning in subsequent steps to this project? Dr. Dean Regier:Our North Star, if you will, is to really understand the entire system effect of next-generation sequencing panels, exome sequencing, whole genomes, or whole genomes and transcriptome analysis, which we think should be the future of precision oncology. The next steps in our research is to provide a nice base around multigene panels in terms of multigene versus single-gene testing, whether that be colorectal cancer, lung cancer, melanoma, etc., and to map out the entire system implications of implementing next-generation sequencing panels. And then we want to answer the questions around, “Well, what if we do exomes for all patients? What if we do whole genomes and transcriptomes for all patients? What are the comparative outcomes for a true tumor-agnostic precision oncology approach, accounting for, as you say, things like return of results with respect to hereditary cancers?” I think the challenge that's going to be encountered is really around the persistent high costs of something like a whole-genome and transcriptome sequencing approach. Although we do see the technology prices going down—the "$1,000 genome" or “$6,000 genome" on whatever Illumina machine you might have—that bioinformatics is continuing to be expensive. And so, there are pipelines that are automated, of course, and you can create a targeted gene report really rapidly within a reasonable turnaround time. But of course, for secondary or what I call level two analysis, that bioinformatics is going to continue to be expensive. And so, we're just continually asking that question is: In our healthcare system and in other healthcare systems, if you want to take a precision oncology approach, how do you create the pipelines? And what types of technologies really lend themselves to benefits over and above next-generation sequencing or multigene panels, allowing for access to off-label therapies? What does that look like? Does that actually improve patients? I think some of the challenges, of course, is because of heterogeneity, small benefiting populations, finding a signal if a signal is indeed there is really challenging. And so, what we are thinking through is, with respect to real-world evidence methods and emulating randomized controlled trials, what types of evidence methods actually allow us to find those signals if indeed those signals are there in the context of small benefiting populations? Dr. Rafeh Naqash:Thank you so much, Dean. Sounds like a very exciting field, especially in the current day and age where cost-effectiveness, financial toxicity is an important aspect of how we improve upon what is existing in oncology. And then lots more to be explored, as you mentioned. The last minute and a half I want to ask about you as an individual, as a researcher. There's very few people who have expertise in oncology, biomarkers, and health economics. So could you tell us for the sake of our trainees and early career physicians who might be listening, what was your trajectory briefly? How did you end up doing what you're doing? And maybe some advice for people who are interested in the cost of care, the cost of oncology drugs - what would your advice be for them very briefly? Dr. Dean Regier:Sure. So I'm an economist by training, and indeed I knew very little about the healthcare system and how it works. But I was recruited at one point to BC Cancer, to British Columbia, to really try to understand some of those questions around costs, and then I learned also around cost-effectiveness. And so, I did training in Scotland to understand patient preferences and patient values around quality of care, not just quantity of life, but also their quality of life and how that care was provided to them. And then after that, I was at Oxford University at the Nuffield Department of Population Health to understand how that can be incorporated into randomized control trials in children. And so, I did a little bit of learning about RCTs. Of course, during the way I picked up some epidemiology with deep understanding of what I call econometrics, what others might call biostatistics or just statistics. And from there, it was about working with clinicians, working with epidemiologists, working with clinical trialists, working with economists to understand the different approaches or ways of thinking of how to estimate efficacy, effectiveness, safety, and cost-effectiveness. I think this is really important to think through is that we have clinical trialists, we have people with deep understanding of biostatistics, we have genome scientists, we have clinicians, and then you add economists into the mix. What I've really benefited from is that interdisciplinary experience, meaning that when I talk to some of the world's leading genome scientists, I understand where they're coming from, what their hope and vision is. And they start to understand where I'm coming from and some of the tools that I use to understand comparative effectiveness and cost-effectiveness. And then we work together to actually change our methods in order to answer those questions that we're passionate about and curious about better for the benefit of patients. So, the short answer is it's been actually quite a trajectory between Canada, the UK. I spent some time at the University of Washington looking at the Fred Hutch Cancer Research Center, looking at precision oncology. And along the way, it's been an experience about interdisciplinary research approaches to evaluating comparative outcomes. And also really thinking through not just at one point in time on-off decisions—is this effective? Is it safe? Is it cost-effective?—not those on-off decisions, but those decisions across the lifecycle of a health product. What do those look like at each point in time? Because we gain new evidence, new information at each point in time as patients have more and more experience around it. And so what really is kind of driving our research is really thinking about interdisciplinary approaches to lifecycle evaluation of promising new drugs with the goal of having these promising technologies to patients sooner in a way that is sustainable for the healthcare system. Dr. Rafeh Naqash:Awesome. Thank you so much for those insights and also giving us a sneak peek of your very successful career. Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review, and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcast. Thank you. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

Title: Journal Club Series Episode 14- Cost Benefit, Cost Effectiveness, and Outcomes Target Audience This activity is directed to physicians, medical students, nurse practitioners, nurses, and physician assistants. Objectives: Upon completion of this activity, participants should be able to: •      Evaluate cost-benefit analyses and their impact on patient outcomes. •      Analyze cost-effectiveness studies and their influence on patient outcomes.   Course Directors: Tony R. Tarchichi MD — Associate Professor, Department of Pediatrics, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center (UPMC.) Paul C. Gaffney Division of Pediatric Hospital Medicine. No relationships with industry relevant to the content of this educational activity have been disclosed. Lynsey Vaughan, MD — Assistant Professor, Department of Pediatrics, University of Texas at Austin, Dell Medical School No relationships with industry relevant to the content of this educational activity have been disclosed. Conflict of Interest Disclosure: No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose. Accreditation Statement: In support of improving patient care, the University of Pittsburgh is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. The University of Pittsburgh School of Medicine designates this enduring material activity for a maximum of 0.5 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.   Disclaimer Statement: The information presented at this activity represents the views and opinions of the individual presenters, and does not constitute the opinion or endorsement of, or promotion by, the UPMC Center for Continuing Education in the Health Sciences, UPMC / University of Pittsburgh Medical Center or Affiliates and University of Pittsburgh School of Medicine.  Reasonable efforts have been taken intending for educational subject matter to be presented in a balanced, unbiased fashion and in compliance with regulatory requirements. However, each program attendee must always use his/her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses. Released 4/15/2025,  Expires 4/15/2028 The direct link to the course is provided below: https://cme.hs.pitt.edu/ISER/app/learner/loadModule?moduleId=25797&dev=true

Summary In this article, I estimate the cost-effectiveness of five Anima International programs in Poland: improving cage-free and broiler welfare, blocking new factory farms, banning fur farming, and encouraging retailers to sell more plant-based protein. I estimate that together, these programs help roughly 136 animals—or 32 years of farmed animal life—per dollar spent. Animal years affected per dollar spent was within an order of magnitude for all five evaluated interventions. I also tried to estimate how much suffering each program alleviates. Using SADs (Suffering-Adjusted Days)—a metric developed by Ambitious Impact (AIM) that accounts for species differences and pain intensity—Anima's programs appear highly cost-effective, even compared to charities recommended by Animal Charity Evaluators. However, I also ran a small informal survey to understand how people intuitively weigh different categories of pain defined by the Welfare Footprint Institute. The results suggested that SADs may heavily underweight brief but intense suffering. Based [...] ---Outline:(02:16) Background(02:46) Results(05:57) Explanations of the programs(08:59) Why these estimates are very uncertain(13:48) Animal welfare metric(16:42) Comparison to SADs(19:42) Comparison to other charities(19:47) Comparisons of SADs estimates(20:54) Comparisons of cage-free estimates(24:26) For how many years do reforms have an impact?(25:21) Cage-free(29:45) Broilers(31:18) Stop the farms(32:57) Fur farmsThe original text contained 8 footnotes which were omitted from this narration. --- First published: April 10th, 2025 Source: https://forum.effectivealtruism.org/posts/sLYSa7MyuDKxreN5h/cost-effectiveness-of-anima-international-poland-1 --- Narrated by TYPE III AUDIO. ---Images from the article:Apple Podcasts and Spotify do not show images in the episode description. Try Pocket Casts, or another podcast app.

"If you're an employer, if someone comes up and knocks on your door, take a second, breathe, and listen to what they have to say." - Christopher CordonChristopher Cordon joined me this week to talk about something that may initially seem contradictory to what I typically preach: level-funding. Chris shares why worksite benefits sales for employers with under 50 employees led him to level-funding as a solution, and why he's so passionate about serving that under-served market.  Chris has a background as an actor, and we also discussed how that has helped him in sales and in the entrepreneurial world, as well as in his recent LinkedIn content. Chris is a passionate guy who genuinely wants to make insurance affordable and easy for small employers, and I hope you'll tune in to hear just how he does that. Chapters:00:00:00 Health Insurance Benefits With Less Than 50 Employees | with Christopher Cordon00:08:37 Chris's Career Path00:23:56 Learning How To Navigate Sales00:33:45 Why Large Employers Are Almost All Self-Funded00:44:33 The Efficiency and Cost-Effectiveness of Direct Primary Care00:48:21 Why Chris Has Embraced Level-Funding00:52:59 Simplifying Self-Insurance01:01:51 How Do We Make Healthcare Sustainable?01:10:27 AI's Impact on Healthcare CostsKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/Key Words: Direct Primary Care, DPC, Level Funded, Level Funding, Employer Solutions, Healthcare Consulting,  Insurance Business, AI in Healthcare, entrepreneurship, christopher cordon, spencer smith, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance#DirectPrimaryCare #DPC #LevelFunded #LevelFunding #EmployerSolutions  #HealthcareConsulting  #InsuranceBusiness #AIinHealthcare #entrepreneurship #christophercordon #spencersmith #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance

"If you're an employer, if someone comes up and knocks on your door, take a second, breathe, and listen to what they have to say." - Christopher CordonChristopher Cordon joined me this week to talk about something that may initially seem contradictory to what I typically preach: level-funding. Chris shares why worksite benefits sales for employers with under 50 employees led him to level-funding as a solution, and why he's so passionate about serving that under-served market.  Chris has a background as an actor, and we also discussed how that has helped him in sales and in the entrepreneurial world, as well as in his recent LinkedIn content. Chris is a passionate guy who genuinely wants to make insurance affordable and easy for small employers, and I hope you'll tune in to hear just how he does that. Chapters:00:00:00 Health Insurance Benefits With Less Than 50 Employees | with Christopher Cordon00:08:37 Chris's Career Path00:23:56 Learning How To Navigate Sales00:33:45 Why Large Employers Are Almost All Self-Funded00:44:33 The Efficiency and Cost-Effectiveness of Direct Primary Care00:48:21 Why Chris Has Embraced Level-Funding00:52:59 Simplifying Self-Insurance01:01:51 How Do We Make Healthcare Sustainable?01:10:27 AI's Impact on Healthcare CostsKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/Key Words: Direct Primary Care, DPC, Level Funded, Level Funding, Employer Solutions, Healthcare Consulting,  Insurance Business, AI in Healthcare, entrepreneurship, christopher cordon, spencer smith, podcast, healthcare, health insurance, self funded, self funding, self funded health insurance, self funded insurance#DirectPrimaryCare #DPC #LevelFunded #LevelFunding #EmployerSolutions  #HealthcareConsulting  #InsuranceBusiness #AIinHealthcare #entrepreneurship #christophercordon #spencersmith #podcast #healthcare #healthinsurance #selffunded #selffunding #selffundedhealthinsurance #selffundedinsurance

Keywords:  entrepreneurship, startups, technology, finance, machine learning, Y Combinator, Go Parrot, Penguin AI, business growth, digital transformation, website engagement, conversion rates, technology insights, personalized communication, business transition, automation, small business, challenges, future vision Summary:  In this episode, Mitch Beinhaker interviews John DiLoreto, who shares his journey from finance to entrepreneurship. John discusses his early career at JP Morgan, his transition to tech, and his experiences with startups, including Go Parrot and Penguin AI. He emphasizes the importance of learning through experience, the challenges of scaling a business, and the critical role of websites in B2B conversions. In this conversation, John DiLoreto discusses the importance of understanding website engagement and conversion rates, leveraging technology to gain insights into visitors, and the significance of personalized communication in converting leads. He shares his journey transitioning from Penguin AI to Knock2.ai, emphasizing the need for businesses to automate customer engagement processes. John also highlights the challenges of running a business, the importance of time management, and his vision for the future of Knock2.ai, which aims to provide businesses with tools to capture interest and convert it into real value. Takeaways John studied finance at Villanova but didn't know his career path. He transitioned from finance to tech due to interest in machine learning. John's first startup experience was with Go Parrot, which was acquired by Square. He learned valuable lessons about sales and customer engagement at Go Parrot. Scaling a business requires different management strategies than starting one. John's experience at Y Combinator provided a supportive entrepreneurial community. Penguin AI focuses on improving B2B website conversion rates. The average B2B website converts only about 1% of its traffic. Networking and personal connections are crucial for business success. John emphasizes the importance of learning from mistakes in entrepreneurship. Understanding visitor engagement is crucial for conversion rates. Technology can provide insights into website visitors. Personalized communication increases the likelihood of conversion. Transitioning businesses requires careful planning and execution. Automation can save time and improve customer engagement. Small businesses can benefit from cost-effective technology solutions. Time prioritization is essential for effective business management. Building a team allows for better delegation of tasks. Every business should know who is interested in their services. The future of business technology lies in automation and personalization. Titles From Finance to Tech: John's Entrepreneurial Journey Navigating the Startup World: Lessons from Go Parrot Scaling Businesses: Insights from a Growing Company The Importance of Community in Entrepreneurship Penguin AI: Revolutionizing B2B Conversions Sound Bites "I was technically still a student." "I handed out about 500 flyers." "I learned a ton about management." "The website is still critical." "You only get 1% of that." "1% is just too low." "Not having to start from scratch each time." "We can fully automate it." "Time prioritization is always it." "You can't do everything yourself." "You should know who's expressing interest." Chapters 00:00 Introduction to Entrepreneurship and Background 06:04 Transition from Finance to Tech 09:27 First Startup Experience: Go Parrot 17:32 Scaling and Learning in a Growing Company 25:36 Founding Penguin AI and Y Combinator Experience 29:30 Understanding Website Engagement and Conversion Rates 31:51 Leveraging Technology for Visitor Insights 36:21 The Importance of Personalized Communication 38:34 Transitioning from Penguin AI to Knock2.ai 40:10 Building a Business on Your Own Terms 43:15 The Role of Automation in Customer Engagement 47:50 Cost-Effectiveness for Small Businesses 51:11 Challenges of Running a Business 54:07 Future Vision for Knock2.ai

In this month's Digital Health Download, Steve, Halle, and Michael take a deliberately optimistic look at key headlines in healthcare technology. From the impressive impact of AI scribing tools on physician satisfaction to encouraging survival rates among digital health unicorns from the ZIRP-era, the hosts highlights bright spots in an often challenging industry.We cover:

For this special episode of the Astonishing Healthcare podcast, Andrew Barnell, CEO of Geneoscopy, joins Justin Venneri in the studio for an insightful discussion about colorectal cancer (CRC) screening in observance of National CRC Awareness Month! Andrew explains how he and his "very talented" sister, Erica Barnell, MD, PhD, co-founded Geneoscopy to develop diagnostic tests using RNA biomarkers extracted from stool samples. Their newly FDA-approved test, ColoSense™, provides a non-invasive alternative to traditional colonoscopies.Barnell highlights the rising incidence of CRC in younger adults, which prompted guideline changes to lower the recommended screening age to 45. He stresses the urgent need for increased screening awareness and greater access to screening tools, noting that employers can help overcome barriers to screening through education and by encouraging engagement in wellness programs. Other topics covered include:Over 135,000 people are diagnosed with CRC every year, and despite CRC being one of the most preventable cancers with good long-term survival rates following treatment, 50,000 people die from it annually. Preventive screenings are increasingly covered with no patient out-of-pocket costs, but insurers' expenses are rising.Increasing early screening is crucial: 30-40% of eligible individuals remain unscreened, particularly in the 45-49 age group.Geneoscopy's decentralized clinical trial and overall use of technology to conduct its pivotal FDA approval study virtually, which increased patient diversity and efficiency.Regulatory challenges remain: FDA approval is just one step; Medicare coverage and guideline inclusion are key hurdles.Bringing targeted therapy approaches to autoimmune diseases like IBD to improve patient outcomes and reduce costs is Geneoscopy's next goal.Related ContentMultitarget Stool RNA Test for Colorectal Cancer Screening. Barnell EK, Wurtzler EM, La Rocca J, et al. JAMA. 2023;330(18):1760–1768. doi:10.1001/jama.2023.22231Pharmacogenomics (PGx) 101: What You Need to Know for Rx ProgramsReference Materials/Other Links (courtesy of Geneoscopy)Projected Impact and Cost-Effectiveness of Novel Molecular Blood-Based or Stool-Based Screening Tests for Colorectal Cancer. Ladabaum U, Mannalithara A, Schoen RE, Dominitz JA, Lieberman D. Ann Intern Med. 2024 Dec;177(12):1610-1620. doi: 10.7326/ANNALS-24-00910. Epub 2024 Oct 29. PMID: 39467291.Colorectal Cancer—Patient Version. National Cancer Institute (NCI)Productivity savings from colorectal cancer prevention and control strategies. Bradley CJ, Lansdorp-Vogelaar I, Yabroff KR, Dahman B, Mariotto A, Feuer EJ, Brown ML. Am J Prev Med. 2011 Aug;41(2):e5-e14. doi: 10.1016/j.amepre.2011.04.008. PMID: 21767717; PMCID: PMC3139918.Follow Geneoscopy on LinkedInFor more information about Capital Rx and this episode, please visit Capital Rx Insights.

In today's digital age, where social media reigns supreme and content is king, the ability to create engaging and high-quality video content has become essential for individuals and businesses alike. The advent of smartphones has democratized content creation, allowing anyone with a device to capture and share their stories. However, the challenge often lies in streamlining the process and ensuring that the content produced is not only engaging but also aligns with branding and marketing strategies. This is where innovative platforms like YourStoryz come into play, making smartphone content creation easier and more efficient.The Rise of Smartphone ContentSmartphones have transformed the landscape of content creation. With advancements in camera technology, users can now shoot high-definition (HD) and even 4K videos right from their devices. This shift has empowered individuals, influencers, and businesses to produce content that was once only possible with expensive equipment and professional crews. However, the mere ability to shoot video does not equate to effective content creation. The challenge lies in the production, editing, and dissemination of that content.Streamlining the ProcessYourStoryz is a platform specifically designed to address the complexities of content creation. It allows users to easily upload and share their videos directly from their smartphones, thus eliminating the need for additional equipment or complex software. The platform is geared towards a broad audience, including influencers, consumers, and small business entrepreneurs, all of whom can benefit from its user-friendly features.One of the standout features of YourStoryz is its templated approach to video creation. This system allows users to create engaging videos by simply dragging and dropping their footage into pre-set templates. This not only saves time but also ensures that all content adheres to brand guidelines, maintaining consistency across various platforms. For entrepreneurs launching new products, this means they can produce professional-looking videos without the hefty price tag of hiring a production team.Authenticity and User-Generated ContentAnother key aspect of the platform is its ability to integrate user-generated content. John Wittmaekers from YourStoryz emphasizes the importance of authentic content. By enabling users to share their experiences and stories, businesses can create a more relatable and genuine connection with their audience. This approach not only enhances engagement but also fosters a community around the brand.The ability to gather first-hand user content is invaluable in today's marketing landscape. Consumers are increasingly drawn to brands that showcase real experiences rather than polished advertisements. YourStoryz facilitates this by allowing businesses to easily collect and incorporate user-generated content into their marketing strategies, further enriching their storytelling capabilities.Cost-Effectiveness and AccessibilityAt a subscription rate of $9.95 per month, YourStoryz offers a cost-effective solution for those looking to enhance their content creation efforts. This pricing is competitive, especially considering the potential costs associated with hiring professional videographers or editors. By providing a platform that combines ease of use with powerful features, YourStoryz makes professional-grade content creation accessible to a wider audience.Conclusion: Content Creation Made EasierIn conclusion, the evolution of smartphone technology has paved the way for a new era of content creation. Platforms like YourStoryz are at the forefront of this movement, simplifying the process and making it easier than ever for individuals and businesses to create, share, and engage with their audiences. By harnessing the power of smartphones, these platforms not only democratize content creation but also emphasize the importance of authenticity and community in today's digital landscape. As we continue to navigate this ever-changing environment, the ability to create compelling and relatable content will remain a critical asset for anyone looking to tell their story.Interview by Don Baine, The Gadget Professor.Sponsored by: Get $5 to protect your credit card information online with Privacy. Amazon Prime gives you more than just free shipping. Get free music, TV shows, movies, videogames and more. The most flexible tools for podcasting. Get a 30 day free trial of storage and statistics.

In today's digital age, where social media reigns supreme and content is king, the ability to create engaging and high-quality video content has become essential for individuals and businesses alike. The advent of smartphones has democratized content creation, allowing anyone with a device to capture and share their stories. However, the challenge often lies in streamlining the process and ensuring that the content produced is not only engaging but also aligns with branding and marketing strategies. This is where innovative platforms like YourStoryz come into play, making smartphone content creation easier and more efficient.The Rise of Smartphone ContentSmartphones have transformed the landscape of content creation. With advancements in camera technology, users can now shoot high-definition (HD) and even 4K videos right from their devices. This shift has empowered individuals, influencers, and businesses to produce content that was once only possible with expensive equipment and professional crews. However, the mere ability to shoot video does not equate to effective content creation. The challenge lies in the production, editing, and dissemination of that content.Streamlining the ProcessYourStoryz is a platform specifically designed to address the complexities of content creation. It allows users to easily upload and share their videos directly from their smartphones, thus eliminating the need for additional equipment or complex software. The platform is geared towards a broad audience, including influencers, consumers, and small business entrepreneurs, all of whom can benefit from its user-friendly features.One of the standout features of YourStoryz is its templated approach to video creation. This system allows users to create engaging videos by simply dragging and dropping their footage into pre-set templates. This not only saves time but also ensures that all content adheres to brand guidelines, maintaining consistency across various platforms. For entrepreneurs launching new products, this means they can produce professional-looking videos without the hefty price tag of hiring a production team.Authenticity and User-Generated ContentAnother key aspect of the platform is its ability to integrate user-generated content. John Wittmaekers from YourStoryz emphasizes the importance of authentic content. By enabling users to share their experiences and stories, businesses can create a more relatable and genuine connection with their audience. This approach not only enhances engagement but also fosters a community around the brand.The ability to gather first-hand user content is invaluable in today's marketing landscape. Consumers are increasingly drawn to brands that showcase real experiences rather than polished advertisements. YourStoryz facilitates this by allowing businesses to easily collect and incorporate user-generated content into their marketing strategies, further enriching their storytelling capabilities.Cost-Effectiveness and AccessibilityAt a subscription rate of $9.95 per month, YourStoryz offers a cost-effective solution for those looking to enhance their content creation efforts. This pricing is competitive, especially considering the potential costs associated with hiring professional videographers or editors. By providing a platform that combines ease of use with powerful features, YourStoryz makes professional-grade content creation accessible to a wider audience.Conclusion: Content Creation Made EasierIn conclusion, the evolution of smartphone technology has paved the way for a new era of content creation. Platforms like YourStoryz are at the forefront of this movement, simplifying the process and making it easier than ever for individuals and businesses to create, share, and engage with their audiences. By harnessing the power of smartphones, these platforms not only democratize content creation but also emphasize the importance of authenticity and community in today's digital landscape. As we continue to navigate this ever-changing environment, the ability to create compelling and relatable content will remain a critical asset for anyone looking to tell their story.Interview by Don Baine, The Gadget Professor.Sponsored by: Get $5 to protect your credit card information online with Privacy. Amazon Prime gives you more than just free shipping. Get free music, TV shows, movies, videogames and more. The most flexible tools for podcasting. Get a 30 day free trial of storage and statistics.

In today's rapidly evolving technological landscape, the integration of artificial intelligence (AI) with existing infrastructure has become increasingly vital for businesses and organizations. One of the most promising advancements in this realm is the transformation of traditional closed-circuit television (CCTV) systems into smart surveillance systems using ZARK. This transformation not only enhances security and operational efficiency but also maximizes the value of existing investments in technology.The Challenge of Legacy SystemsMany businesses, from retail stores to airports, have invested heavily in CCTV systems. These systems, while effective for basic surveillance, often lack the advanced capabilities required to meet modern security challenges. Upgrading to new hardware can be prohibitively expensive and logistically complex. Mohamed from Blue Dove says that the key to modernizing these systems lies in leveraging existing infrastructure while introducing intelligent software solutions.The Role of AI and Cloud TechnologyThe introduction of AI-driven software, such as ZARK, offers a solution that allows organizations to capitalize on their current CCTV hardware. By connecting a simple laptop or PC to the existing network of cameras, businesses can download and implement the ZARK software, which enhances the functionality of their surveillance systems. This software employs cloud technology to process data and provide real-time analytics, including facial recognition and emotional detection.For instance, ZARK can recognize individuals and assess their emotional states, such as happiness or distress. This capability not only aids in security but can also enhance customer service experiences. In a bustling environment, such as a trade show, the system can identify returning customers, allowing businesses to engage with them personally. This level of interaction could significantly improve customer relations and drive sales.Cost-Effectiveness and EfficiencyOne of the most compelling arguments for transforming existing CCTV systems into smart systems is the cost-effectiveness of such an approach. As Mohamed noted, replacing outdated hardware can be financially burdensome. By utilizing existing cameras and enhancing them with intelligent software, organizations can achieve significant improvements in surveillance capabilities without the need for a complete overhaul of their systems.Moreover, the integration of cloud services ensures that as technology advances, the system can be updated automatically without requiring additional hardware changes. This feature not only saves costs but also ensures that organizations remain at the forefront of technological advancements.Regulatory ConsiderationsWhile the potential benefits of transforming CCTV systems are substantial, it is essential to navigate the regulatory landscape carefully. Different countries have varying laws regarding surveillance, data privacy, and facial recognition technology. Organizations must consider these regulations when implementing AI-driven surveillance systems. Compliance with legal standards is crucial to avoid potential legal repercussions and to maintain the trust of customers and stakeholders.Conclusion: AI Can Turn CCTV Into A Powerful SystemThe transformation of existing CCTV systems using ZARK represents a significant opportunity for businesses across various sectors. By harnessing the power of AI and cloud technology, organizations can enhance security, improve customer interactions, and maximize their existing investments. As the technology continues to evolve, it is imperative for businesses to stay informed about regulatory requirements and advancements in AI to fully leverage the potential of smart surveillance systems. The future of security lies not in replacing outdated systems but in intelligently upgrading them to meet the demands of a rapidly changing world.Interview by Marlo Anderson of The Tech Ranch.Sponsored by: Get $5 to protect your credit card information online with Privacy. Amazon Prime gives you more than just free shipping. Get free music, TV shows, movies, videogames and more. The most flexible tools for podcasting. Get a 30 day free trial of storage and statistics.

In today's rapidly evolving technological landscape, the integration of artificial intelligence (AI) with existing infrastructure has become increasingly vital for businesses and organizations. One of the most promising advancements in this realm is the transformation of traditional closed-circuit television (CCTV) systems into smart surveillance systems using ZARK. This transformation not only enhances security and operational efficiency but also maximizes the value of existing investments in technology.The Challenge of Legacy SystemsMany businesses, from retail stores to airports, have invested heavily in CCTV systems. These systems, while effective for basic surveillance, often lack the advanced capabilities required to meet modern security challenges. Upgrading to new hardware can be prohibitively expensive and logistically complex. Mohamed from Blue Dove says that the key to modernizing these systems lies in leveraging existing infrastructure while introducing intelligent software solutions.The Role of AI and Cloud TechnologyThe introduction of AI-driven software, such as ZARK, offers a solution that allows organizations to capitalize on their current CCTV hardware. By connecting a simple laptop or PC to the existing network of cameras, businesses can download and implement the ZARK software, which enhances the functionality of their surveillance systems. This software employs cloud technology to process data and provide real-time analytics, including facial recognition and emotional detection.For instance, ZARK can recognize individuals and assess their emotional states, such as happiness or distress. This capability not only aids in security but can also enhance customer service experiences. In a bustling environment, such as a trade show, the system can identify returning customers, allowing businesses to engage with them personally. This level of interaction could significantly improve customer relations and drive sales.Cost-Effectiveness and EfficiencyOne of the most compelling arguments for transforming existing CCTV systems into smart systems is the cost-effectiveness of such an approach. As Mohamed noted, replacing outdated hardware can be financially burdensome. By utilizing existing cameras and enhancing them with intelligent software, organizations can achieve significant improvements in surveillance capabilities without the need for a complete overhaul of their systems.Moreover, the integration of cloud services ensures that as technology advances, the system can be updated automatically without requiring additional hardware changes. This feature not only saves costs but also ensures that organizations remain at the forefront of technological advancements.Regulatory ConsiderationsWhile the potential benefits of transforming CCTV systems are substantial, it is essential to navigate the regulatory landscape carefully. Different countries have varying laws regarding surveillance, data privacy, and facial recognition technology. Organizations must consider these regulations when implementing AI-driven surveillance systems. Compliance with legal standards is crucial to avoid potential legal repercussions and to maintain the trust of customers and stakeholders.Conclusion: AI Can Turn CCTV Into A Powerful SystemThe transformation of existing CCTV systems using ZARK represents a significant opportunity for businesses across various sectors. By harnessing the power of AI and cloud technology, organizations can enhance security, improve customer interactions, and maximize their existing investments. As the technology continues to evolve, it is imperative for businesses to stay informed about regulatory requirements and advancements in AI to fully leverage the potential of smart surveillance systems. The future of security lies not in replacing outdated systems but in intelligently upgrading them to meet the demands of a rapidly changing world.Interview by Marlo Anderson of The Tech Ranch.Sponsored by: Get $5 to protect your credit card information online with Privacy. Amazon Prime gives you more than just free shipping. Get free music, TV shows, movies, videogames and more. The most flexible tools for podcasting. Get a 30 day free trial of storage and statistics.

In this episode, we delve into the critical transition from demonstrating the efficacy of exercise to proving its cost-effectiveness, a pivotal shift necessary for securing insurance reimbursement for supervised exercise therapy. We explore how the effectiveness of exercise, well-supported by numerous studies showcasing its benefits for various health conditions, forms the foundation. However, the challenge lies in aligning this efficacy with the economic metrics that insurance companies prioritize. Discussions will cover methodologies for quantifying health outcomes in monetary terms, the impact of long-term health cost savings, and the importance of structured exercise programs in preventive health care.Moreover, the episode highlights the strategic approaches required to present a compelling case to insurance providers. This involves gathering robust data that not only underscores the direct health benefits and improved quality of life for patients but also demonstrates significant cost reductions in managing chronic diseases and potentially expensive medical treatments. By showcasing examples from programs that have successfully navigated this path, we aim to provide a roadmap for exercise professionals and healthcare providers. The goal is to expand access to supervised exercise therapy, ultimately making it a standard part of medical care covered by insurance policies.Show Notes Page: www.wellnessparadoxpod.com/episode139Follow us on social at the links below: https://www.facebook.com/wellnessparadox https://www.instagram.com/wellnessparadox/ https://www.linkedin.com/company/wellness-paradox-podcast https://twitter.com/WellnessParadox

In this episode, Lillian Erdahl, MD, FACS, is joined by Peter C Minneci, MD, FACS, MHSc, from the Department of Surgery, Nemours Children's Health, Delaware Valley. They discuss Dr Minneci's recent article, “Cost-Effectiveness of Nonoperative Management vs Upfront Laparoscopic Appendectomy for Pediatric Uncomplicated Appendicitis Over 1 Year,” in which the authors found that cost-effectiveness of management of pediatric appendicitis is sensitive to changes in utilities achieved by nonoperative management. Further studies should investigate reasons for treatment failure and the importance of shared decision-making in choosing treatment.   Disclosure Information: Drs Erdahl and Minneci have nothing to disclose. This research was funded by the Patient-Centered Outcomes Research Institute (PCORI ID CER-1507-31325) and the National Center for Advancing Translational Sciences (grant UL1TR001070). CME for this episode will be available on January 31, 2025. To earn 0.25 AMA PRA Category 1 Credits™ for this episode of the JACS Operative Word Podcast, click here to register for the course and complete the evaluation. Listeners can earn CME credit for this podcast for up to 2 years after the original air date. Learn more about the Journal of the American College of Surgeons, a monthly peer-reviewed journal publishing original contributions on all aspects of surgery, including scientific articles, collective reviews, experimental investigations, and more. #JACSOperativeWord

Commentary by Dr.  Hailei Liu

This episode with Chris Crawford, CEO of RxSaveCard, is not about the when, why, or how of GLP-1s for weight loss or best-practice prescribing. This episode very, very specifically is about the how and why of the pickle plan sponsors get themselves into often enough where if they impose formulary restrictions to limit the volume of meds that they are paying for, then unit prices go up, which is a thing for GLP-1s. And this is critical just given how the costs associated with GLP-1s for weight loss contribute to some pretty significant increases in pharmacy trend for plan sponsors who choose to cover the GLP-1s for weight loss. Chris Crawford and Stacey Richter discuss the challenges plan sponsors face with the rising costs of GLP-1 medications for weight loss. They explore how plan sponsors' efforts to manage pharmacy trends often result in a tradeoff: lowering unit costs by increasing volume or vice versa. Chris also introduces a potential solution leveraging the growing cash marketplace, where employers can bypass traditional PBM contracts to achieve cost savings. Tune in for actionable insights into the perverse incentives in the pharmacy supply chain and innovative ways to navigate them. (Continued below the links) === LINKS ===

Editor in Chief Cecelia E. Schmalbach, MD, MSc, is joined by senior author Priyesh N. Patel, MD, and Associate Editor Peter M. Vila, MD, MSPH, to discuss the role of the operating room and its necessity in treating skin cancer defects as outlined in the paper “Cost-Effectiveness Analysis of Operating Room and In-Office Reconstruction of Skin Cancer Defects” which published in the December 2024 issue of Otolaryngology–Head and Neck Surgery. They weigh the effects of operating room on efficiency, patient satisfaction, and procedure success. Click here to read the full article.

Welcome to another episode of Predictable B2B Success! Today, we're delving into the transformative world of AI-driven podcasting with the innovative Ian Harris of Pulse Podcasts. Have you ever wondered how AI can reshape content creation and facilitate seamless engagement? Ian is here to unravel the mysteries. Specializing in problem-solving through first principles, Ian has revolutionized how businesses approach content, pushing them beyond narrow confines to explore broader horizons. We'll uncover how Pulse Podcasts leverages large language models to curate engaging news and convert written content into captivating audio experiences. Discover the intricate balance between human touch and AI efficiency in creating natural-sounding, top-quality podcasts that don't just inform but enthrall. Vinay Koshy and Ian dive deep into the challenges and triumphs of this evolving industry, revealing strategies for harnessing podcasts as powerful branding tools. Whether you're intrigued by the future of AI in content creation or looking to enhance your marketing arsenal, this episode promises a wealth of insights. Join us as we explore how AI can make podcast production cost-effective, broaden audience reach, and build enduring customer relationships. Don't miss this chance to reimagine your content strategy with Pulse Podcast's visionary approach! Some areas we explore in this episode include: Problem-Solving Using First Principles: Utilizing first principles to innovate and solve business challenges.Pulse Podcast System: Using large language models, transitioning from a text-to-audio engine to a content curation system.Script Development Approach: The multi-step process of refining content into engaging podcast scripts.AI in Podcast Production: Use of AI for fully automated podcasts and hybrid interviews, reducing production costs while maintaining quality.Role of Podcasts in Content Strategy: Podcasts as a branding tool that builds long-term relationships rather than immediate lead generation.Client Acquisition Strategies: Effective methods like conference speaking, podcast advertising, and leveraging customer referrals.Cost-Effectiveness of AI-Powered Podcasts: Significant cost reductions with high-quality AI-produced podcasts.Natural-Sounding Text-to-Speech: Advances in text-to-speech technology for authentic and engaging audio content.Exploring New Business Opportunities: Strategic expansion into adjacent markets, like local governments, using podcasts.Future of Podcasting and AI: AI's supportive role in podcasting with humans steering branding and messaging.And much, much more ...

Researchers Assess Cost Effectiveness of Supportive Periodontal Care By Today's RDH Research Original article published on Today's RDH: https://www.todaysrdh.com/researchers-assess-cost-effectiveness-of-supportive-periodontal-care/ Need CE? Start earning CE credits today at ⁠⁠https://rdh.tv/ce⁠⁠  Get daily dental hygiene articles at ⁠⁠https://www.todaysrdh.com⁠⁠ Follow Today's RDH on Facebook: ⁠⁠https://www.facebook.com/TodaysRDH/⁠⁠ Follow Kara RDH on Facebook: ⁠⁠https://www.facebook.com/DentalHygieneKaraRDH/⁠⁠ Follow Kara RDH on Instagram: ⁠⁠https://www.instagram.com/kara_rdh/

Join us for this Microbruin about updated grizzly mortality information, a few tangents, and our thoughts on a recent story about a group of hunters who attempted to haze several grizzlies off an elk kill. Spoiler alert: the grizzlies paid the price for bad decisions by humans.Find us on all the things: http://linktr.ee/bearsandbrewspodcastLinks We Discussed:Federal database of grizzly deaths in the GYE:https://wyofile.com/wp-content/uploads/2024/10/GB_Mortality_2024.csvMontana Grizzly Bear Mortality Information: https://experience.arcgis.com/experience/cfdfbb4a5c9f4758816b296410d3fc94/page/Page/?views=OverviewSources Cited:Gantchoff, M. G., et al. “Mortality of a Large Wide-Ranging Mammal Largely Caused by Anthropogenic Activities.” Scientific Reports, vol. 10, no. 1, 22 May 2020, p. 8498, www.nature.com/articles/s41598-020-65290-9, https://doi.org/10.1038/s41598-020-65290-9.Gehring, Thomas M., et al. “Livestock Protection Dogs in the 21st Century: Is an Ancient Tool Relevant to Modern Conservation Challenges?” BioScience, vol. 60, no. 4, 1 Apr. 2010, pp. 299–308, academic.oup.com/bioscience/article/60/4/299/226197?login=true, https://doi.org/10.1525/bio.2010.60.4.8.Khorozyan, Igor, and Matthias Waltert. “Variation and Conservation Implications of the Effectiveness of Anti-Bear Interventions.” Scientific Reports, vol. 10, no. 1, 18 Sept. 2020, www.nature.com/articles/s41598-020-72343-6?fromPaywallRec=false, https://doi.org/10.1038/s41598-020-72343-6.Mosley, Jeffrey C., et al. “Mitigating Human Conflicts with Livestock Guardian Dogs in Extensive Sheep Grazing Systems.” Rangeland Ecology & Management, vol. 73, no. 5, Sept. 2020, pp. 724–732, https://doi.org/10.1016/j.rama.2020.04.009.Saitone, Tina L., and Ellen M. Bruno. “Cost Effectiveness of Livestock Guardian Dogs for Predator Control.” Wildlife Society Bulletin, vol. 44, no. 1, Mar. 2020, pp. 101–109, wildlife.onlinelibrary.wiley.com/doi/10.1002/wsb.1063, https://doi.org/10.1002/wsb.1063.Smith, Bethany R., et al. “The Ecological Effects of Livestock Guarding Dogs (LGDs) on Target and Non-Target Wildlife.” Journal of Vertebrate Biology, vol. 69, no. 3, 2 Dec. 2020, https://doi.org/10.25225/jvb.20103.Smith, Martin E., et al. “Review of Methods to Reduce Livestock Depradation: I. Guardian Animals.” Acta Agriculturae Scandinavica, Section a - Animal Science, vol. 50, no. 4, Dec. 2000, pp. 279–290, https://doi.org/10.1080/090647000750069476. Hosted on Acast. See acast.com/privacy for more information.

“The good thing about retargeting is that most of the sales don't actually come from people clicking on the ad. They come from people seeing the ad and then either Googling the company or typing in the URL in the browser.” – Zaid Ammari The finer details of this episode:Marketing strategies focused on paid advertising and retargeting.The significance of understanding data analytics in marketing.Explanation of retargeting and its psychological impact on consumers.Common mistakes businesses make in retargeting campaigns.The importance of lead quality over quantity in marketing efforts.The role of Google Analytics 4 (GA4) in optimizing marketing strategies.Differences between hiring freelancers and agencies for marketing services.Effective communication and client management in marketing.The onboarding process for new clients and setting realistic expectations.Practical applications of retargeting across various platforms. Episode resources:Summit Virtual CFO by Anders website: https://www.summitcpa.net/Love our content? Sign up for our newsletter: https://www.summitcpa.net/summit-newsletterDigital Dollars and Cents: A Virtual CFO's Playbook to help Digital Companies Create a Financial Roadmap to Success, is now an audio book! Download it here: https://vcfo.summitcpa.net/ddcConnect with Zaid here: linkedin.com/in/zaidammariCheck out PPC Masterminds here: ppcmasterminds.comFree audit:  https://ppcmasterminds.com/free-google-ads-audit/Studio report mentioned in the show:https://lookerstudio.google.com/reporting/cc7472bf-0d0e-40d4-b275-22f1996ca339/page/VAzeB. Timestamps:Introduction to the Episode (00:00:00)Overview of the Creative Agency Success Show and its purpose for agency owners. Discussion of Different Mindsets (00:00:14)Jamie and Jody reflect on their different perspectives during the episode with Zaid. Topics Covered in the Episode (00:00:42)Jody highlights the focus on retargeting and its common mistakes discussed with Zaid. Guest Introduction (00:01:38)Jamie introduces Zaid Ammari, a marketing expert from PPC Masterminds. Zaid's Background (00:02:07)Zaid shares his journey from banking to becoming a paid marketing specialist. Client Targeting in Marketing (00:04:42)Jody asks about Zaid's target clients and his focus on paid search. Industries of Focus (00:05:28)Zaid discusses his typical clients, primarily in e-commerce and service industries. Introduction to Retargeting (00:06:24)Zaid explains retargeting and its psychological impact on potential customers. Cookies and Ad Competition (00:08:13)Discussion on how cookies compete in ad placements and auction dynamics. Dynamic Retargeting (00:09:10)Zaid describes how dynamic retargeting can tailor ads based on user behavior. Common Retargeting Mistakes (00:09:37)Zaid identifies mistakes businesses make by using the same ads repeatedly. Cost-Effectiveness of Retargeting (00:10:20)Zaid explains how retargeting can be one of the cheapest marketing methods. Tracking Conversions (00:11:04)Discussion on how to track conversions from retargeting ads. Using Data Analytics (00:12:02)Zaid emphasizes the importance of segmenting traffic for better insights. Variability Among Companies (00:14:03)Zaid discusses the vast differences in performance metrics across companies. Click-Through Rate Misconceptions (00:15:58)Zaid clarifies how high click-through rates can mislead about lead quality. Ad Copy Strategies (00:16:59)Zaid advises on including pricing in ad copy to filter out unqualified leads. Google's Role in Advertising (00:18:51)Zaid discusses how Google Ads operates and their profit motives. Outsourcing vs. In-House Marketing (00:19:47)Zaid shares insights on when companies should consider outsourcing their marketing. Agency vs. Freelancers (00:21:16)Discussion on the differences between hiring agencies and freelancers for marketing services. Onboarding Process (00:22:25)Overview of the onboarding process and its impact on effective marketing strategies. Revenue Tracking Audit (00:22:49)Importance of auditing revenue tracking for e-commerce and service companies. Estimating Costs (00:23:59)Using PPC calculators to estimate costs and expected sales conversions. Budget Planning (00:26:26)Advice on budgeting for marketing campaigns and managing client expectations. Communication with Clients (00:27:00)The significance of proactive communication in maintaining client relationships. Retargeting Ads (00:27:59)Discussion on the underutilization of retargeting ads in marketing strategies. Voice Recognition Marketing (00:28:38)Exploration of how voice recognition may influence targeted ads. Prime Day Product Searches (00:30:00)Personal anecdotes about product searches during Prime Day promotions. Final Thoughts and Resources (00:34:16)Wrap-up of the conversation and sharing of additional resources for listeners.

Send us a text. We love to hear from our fans.SummaryIn this conversation, Janet Engel interviews Eve Hill, an aging in place specialist realtor, and founder of Customized Aging about the impact of ageism on older adults and the importance of home modifications for aging in place. Eve shares her personal journey that led her to focus on ageism awareness and discusses the four types of ageism: internalized, interpersonal, institutional, and ideological. They explore how media representation affects perceptions of aging and highlight the importance of technology in supporting older adults. Eve also introduces innovative age-tech products that can enhance the quality of life for seniors. The conversation explores innovative technologies and solutions for aging in place, particularly for individuals with dementia. It discusses the role of ambient AI, remote monitoring, and home technologies that enhance personal hygiene and safety. The importance of universal design in home modifications is emphasized, along with financial resources available for aging in place. The discussion also addresses the cost-effectiveness of home modifications compared to assisted living and the need to combat ageism to improve outcomes for older adults.TakeawaysAgeism is prevalent and often unconscious.Home environments often do not support aging in place.Universal design can benefit everyone, not just the elderly.Internalized ageism affects decision-making about home modifications.Interpersonal ageism can undermine older adults' confidence.Institutional ageism impacts healthcare policies and practices.Media representation of older adults is often negative or absent.Older adults are increasingly tech-savvy and adaptable.Positive views on aging can lead to longer, healthier lives.Innovative age-tech products can significantly improve quality of life. Innovative technologies can significantly improve dementia care.Ambient AI offers privacy-friendly monitoring solutions.AI companions can assist with medication and appointments.Home technologies like induction stoves enhance safety.Personal hygiene technologies can reduce health risks.Universal design benefits all age groups.Financial resources exist for home modifications.Proactive home modifications can delay assisted living.Reverse mortgages are underutilized for aging in place.Combating ageism can lead to better health outcomes.Sound Bites"I want to bust the ageism that's in ourselves.""Most homes in the U.S. were not built with the longevity revolution in mind.""Internalized ageism really can have a big impact.""Less agitation for caregivers and families.""Remote monitoring without cameras is possible.""AI companions can help with medication reminders."Chapters00:00 Introduction to Aging in Place and Ageism04:14 Understanding Ageism: The Four I's12:46 Ideological Ageism: Media's Role in Aging Perception20:06 Technology and Aging: Debunking Myths25:02 Innovative Age-Tech Products for Better Living27:31 The Role of Ambient AI in Healthcare29:41 Home Technologies for Aging in Place32:09 The Importance of Universal Design37:24 Cost-Effectiveness of Home ModificatiSupport the showwebsite: https://homedesignsforlife.com/Email: homedesignsforlife@gmail.com

Highlights from this week's conversation include:Christina's Accidental Career Path (0:51)Entry Into Hedge Funds (2:43)Storytelling in Venture Capital (3:22)Market Research Importance (5:54)Lessons from Bridgewater (7:55)Consulting at FBG (11:28)Education's Role in Consulting (13:03)Client Needs for Reliable Data (15:32)Understanding Venture Goals (17:39)DPI vs. IRR Narrative (18:43)Insider Segment: Custom AI Model Training (21:10)Data Security Risks (26:11)Cost-Effectiveness of Custom Solutions (28:14)Renaissance Venture Capital Overview (30:36)Overview of Startup Event Success (35:07)Investment Culture in Michigan (37:45)Criteria for Fund Selection (39:11)Importance of Risk Management (41:24)Final Thoughts and Takeaways (44:15)The Renaissance Venture Capital Fund was formed with the philosophy that venture capital is important for economic growth and that many major industrial and business regions such as the State of Michigan are underserved in the amount of venture capital available to fund exciting new ideas and technologies. Success is often built by a combination of innovation, capital and strong working relationships. Our belief is that by providing much needed capital to top tier venture capital firms that are active in Michigan and by building bridges between young innovation companies and Michigan's established business community, we can achieve regional success in the form of strong investment returns and economic growth.Bottega8 offers secure and cost-efficient AI Model Training and Fine-Tuning tailored for financial institutions. If you're concerned about the expense and complexity of building in-house AI teams, or worried about the privacy and security risks inherent in Big Tech AI APIs, we provide the ideal solution for your proprietary data.Bottega8's solution is specifically designed for institutional financial clients, including PE/VC funds, hedge funds, broker-dealers, traders, investment banks, and fintechs. By partnering with us, you eliminate the need for expensive AI engineers, hefty API fees, and complex technical roadmaps—reducing your AI development costs by up to 85%. If you're seeking AI Model Training and Fine-Tuning services that prioritize security and cost-efficiency without sacrificing Big Tech fidelity, we'd love to talk to you. Learn more at bottega8.com/swimming.Swimming with Allocators is a podcast that dives into the intriguing world of Venture Capital from an LP (Limited Partner) perspective. Hosts Alexa Binns and Earnest Sweat are seasoned professionals who have donned various hats in the VC ecosystem. Each episode, we explore where the future opportunities lie in the VC landscape with insights from top LPs on their investment strategies and industry experts shedding light on emerging trends and technologies. The information provided on this podcast does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this podcast are for general informational purposes only.

I'd like to thank Derek Shiller from Rethink priorities for extensive discussions and looking over this post. Introduction I've been following the "animal welfare" debate this week on the EA forum, and noticed that a key crux for a lot of people was that calculations showed that animal welfare campaigns (specifically the "caged chicken corporate campaign") was much more cost effective than a human global health development project like the against malaria foundation. But while most estimates agreed that AW was more effective than GHD, I noticed there was a wide discrepancy in how much more effective it was. Vasco Grilo claimed it was 1500 times better. This report by Laura Duffy of rethink priorities (when you convert from order of magnitude to real numbers in table 1) claimed it was about 60 times better. Whereas if you go the Cross cause comparison website, also by RP, and [...] The original text contained 7 footnotes which were omitted from this narration. --- First published: October 14th, 2024 Source: https://forum.effectivealtruism.org/posts/qARKFgYhCqmKB2YpF/explaining-the-discrepancies-in-cost-effectiveness-ratings-a --- Narrated by TYPE III AUDIO.

Joining us on Well Said is Dr. Pina Sanelli, Vice Chair of Radiology Research for Northwell Health and Director of the Imaging Clinical Effectiveness and Outcomes Research (iCEOR) division, to talk about the balance between the cost of diagnostic tests and their usefulness for patients.

Download The Peptide Cheat Sheet: https://peptidecheatsheet.carrd.co/

Join hosts Phil Seboa and Ed Fuentes as they welcome principal engineer Lachlan Wright from PWD. Solutions. This episode of Unplugged dives deep into the world of industrial IoT, touching on Lachlan's career in automation, IIOT vs. IOT, the power of open frameworks, and the future of industrial automation. Lachlan shares his experiences with Raspberry Pi, Arduino, and emerging PLC technologies, alongside discussing the importance of data accessibility and the role of agile development in today's evolving tech landscape. Tune in for an enlightening conversation filled with valuable industry insights. 00:00 Introduction to Unplugged IIoT Podcast 00:45 Meet Lachlan Wright, Principal Engineer of PWD. Solutions 02:43 Phil's Passion for 3D Object Creation and Gaming through Blender 04:22 Ed's Journey with Python and Databasing 07:08 Versatility of Skills in Industrial and Control Systems 11:35 Lachlan's Home Automation: PLC MQTT for Power Monitoring 14:58 Lachlan's Experience with Chat GPT and New Facebook Tools 17:24 Phil on Llama 3.5 Models and Their Vast Resources 21:46 Lachlan's Industrial Anecdote: PLC, TCP Driver, InfluxDB, and Ignition 27:15 Pitfalls of Agile Methodology in IoT Digital Transformation 32:03 Importance of Community Collaboration in Open Source 35:16 Evolving PLCs: The Role of Software and Programming Languages 38:45 Integration of Docker Containers in Development 41:18 User Experience and Visualization in Industrial Applications 43:09 Shift Towards Web Native Technology 44:38 From Traditional SCADA to the WebDev Mindset 48:49 Interest in Time Series Databases like InfluxDB and Timescale 50:20 Enthusiasm for Continuous Learning and Technology Exploration 52:35 Unique Solutions for Different Industries and Sites 55:10 Raspberry Pi and Beckhoff CX 7000 Series in IIoT Deployments 58:46 Cost-Effectiveness of New Systems like Octo 22 Groove and PLC Nexts 01:02:19 Adoption of Raspberry Pi for Initial Automation Testing Connect with Lachlan on LinkedIn: https://www.linkedin.com/in/plcexpert/ Connect with Phil on LinkedIn: https://www.linkedin.com/in/phil-seboa/ Connect with Ed on LinkedIn: https://www.linkedin.com/in/ed-fuentes-2046121a/ ------ About Industry Sage Media: Industry Sage Media is your backstage pass to industry experts and the conversations that are shaping the future of the manufacturing industry. Learn more at: http://www.industrysagemedia.com

Are you looking for innovative ways to boost your calves' weight gain without breaking the bank? In this eye-opening episode, I sit down with Mark Johnson, a professor at Oklahoma State University, to explore the potential of creep grazing as an alternative to traditional creep feeding. Drawing from his rich background in commercial cow-calf operations, Mark shares valuable insights into this cost-effective management practice that could revolutionize your approach to calf nutrition. We delve into the nuts and bolts of creep grazing, comparing its advantages to conventional creep feeding methods and discussing how it might fit into your operation's unique needs. Key Points Covered: • The fundamentals of creep grazing and its potential benefits • Cost-effectiveness compared to traditional creep feeding • Practical implementation strategies and infrastructure considerations • Ideal timing for introducing creep grazing in your management plan 00:02:30 Passion for Beef Production 00:05:11 Understanding Creep Grazing 00:06:31 Variety in Forage Options 00:08:09 Advantages of Creep Grazing 00:08:24 The Pros and Cons of Creep Feeding 00:13:17 Cost Effectiveness of Creep Grazing 00:14:32 Marketing Considerations for Creep Grazing 00:16:00 Setting Up Creep Grazing Structures 00:17:29 Challenges and Considerations of Creep Grazing 00:19:08 Benefits of Creep Grazing for Calves 00:20:28 Simplicity and Cost-effectiveness of Creep Grazing 00:22:29 Determining Creep Grazing Area Size 00:24:07 Timing and Benefits of Starting Creep Grazing 00:25:47 Excitement for Future of Beef Industry https://www.casualcattleconversations.com/

Health Affairs' Editor-in-Chief Alan Weil interviews Sanjay Basu of Waymark on his recent study that considers a potential risk of perpetuating health disparities with the continued utilization of cost-effectiveness analyses to inform health care and public health policy decisions.Order the August 2024 issue of Health Affairs.Currently, more than 70 percent of our content is freely available - and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone.

Cost-effectiveness of strength exercise or aerobic exercise compared with usual care for patients with knee osteoarthritis: secondary results from a multiarm randomised controlled trial in Norway Killingmo RM, Øiestad BE, Risberg MA, et al. BMJ Open. 2024;14(5):e079704. doi:10.1136/bmjopen-2023-079704 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by our sponsors at: CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight Koal Challenge – Sam Roux

In this episode, Ben Notterman from Snug Valley Farm and Brian discuss the integration of GPS collar technology for livestock management and the transition from direct-to-consumer to wholesale distribution. The conversation includes the learning curve associated with new technology, battery life concerns, and unexpected benefits such as maintaining control during natural disasters. Ben shares insights into the costs, savings, and practical applications of GPS collars, along with strategies for balancing consumer and wholesale sales. The discussion highlights the dynamic nature of farming, the importance of selecting reliable partners, and the need to continuously adapt and embrace innovative tools to optimize farm operations.   00:00 Morning Greetings and Weather Update 00:44 Drought Monitor and Climate Change Discussion 02:20 Introduction to No Fence Collars 03:27 Pilot Study and Initial Experiences 04:33 Technical Details of No Fence Collars 08:25 Battery Life Challenges and Solutions 13:24 Grazing Strategies and Collar Effectiveness 20:49 Animal Behavior and Collar Training 28:23 Insights from Grazing Heat Maps 33:02 Managing Virtual Paddocks 40:33 Challenges of Installing and Using Collars 44:53 Battery Life and Solar Panel Efficiency 48:42 Viability and Cost-Effectiveness of Collars 59:30 Training Animals to Use Collars 01:01:07 Software Improvements and Future Updates 01:10:43 Wholesale Distribution and Market Shifts 01:16:49 Final Thoughts and Embracing New Technology Snug Valley Farm --------------- Dale Strickler's Regenerative wisdom grazing school! No Till Bus tour! ⁠⁠⁠⁠⁠⁠⁠⁠⁠Discord!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Grassroots Carbon! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Landtrust Info!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Audubon Conservation Ranching!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Buy Wild Ass Soap and CBD!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Use the Coupon code "Reboot" for an extra discount!! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Buy BoBoLinks Here! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Use code "BOBOREBOOT" for $10 off ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Support the Podcast on Spotify!⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ --- Support this podcast: https://podcasters.spotify.com/pod/show/ranching-reboot/support

In this closing conversation, Healthy Livers, Healthy Lives Chair Jeff Lazarus and Surfers Jörn Schattenberg, Louise Campbell and Roger Green discuss the upcoming United Nations General Assembly side event and consider ways listeners can support the "Healthy LIvers, Healthy Lives" coalition.Jeff discussed this impact on global care when the World Health Organization develops and releases a global health sector strategy. One key goal in public health is to lobby for a MASLD strategy. To that end, Healthy Livers, Healthy Lives is holding a side event at the United Nations General Assembly meeting in mid-September.  00:40:41 - Presenting MASLD to politicians One challenge in educating policymakers about MASLD is that people do not die from MASLD. One recent example: policymakers did not respond to the spread of SARS-CoV-2 until COVID-19 produced massive numbers of deaths. When asked, Jeff draws the chain from MASLD to MASH to cirrhosis and end-stage liver cancer and notes that we are already seeing MASLD as a leading cause of liver transplant. Roger suggests that Jeff reframe the issue to be about how many people die with MASLD, not from MASLD. Jeff believes this simple change may change the dialogue.  00:43:06 - How listeners can support this initiative Roger asks Jeff how listeners can support the Healthy Livers, Healthy Lives initiative. Jeff suggests that we all be careful to name the disease and let people know how easily MASLD can be identified and treated. For those who work in related areas or help set policy for their organizations, make sure that MASLD is included and, whenever possible, linked to diabetes, obesity, and other relevant metabolic conditions.   00:44:58 - LiverAIM and exit. As his closing comment, Jeff discusses LiverAIM, the largest European Commission-funded liver project in 26 years. (Jörn and Maja Thiele, who is leading the 100,000-person randomized clinical trial, discuss this in Episode 15.) Roger commits to producing an episode on LiverAIM this fall.   After Jeff departs, Jörn restates the importance of working with colleagues like Jeff who can systematically develop public health approaches and drive policy change from the top down. Roger agrees that a top-down approach can be extremely valuable, but may have limits in primary care. He suggests that professional organizations also need to bring allied health providers into the dialogue. 

Healthy Livers, Healthy Lives Chair Jeff Lazarus joins Jörn Schattenberg, Louise Campbell and Roger Green to discuss the value of the updated EASL/EASD/EASO MASLD clinical practice guidelines and consider the role of Big Data in early MASLD screening. Roger asks Jeff whether he considers the updated MASLD CPG a step forward. Jeff praises the guidelines as "amazing" and suggests that one reason is that EASD and EASO are partners in drafting and promoting them.Roger's next question to Jeff addresses the idea that Big Data can provide a set of common variables that will outperform FIB-4 in predicting which patients are at high risk of MASLD or MASH, as Hannes Hagstrom discussed in Episode 17 this year. Jeff believes we can use more data than only the FIB-4 today but that, in the long run,we need better biomarkers to simplify the system. Jörn adds that having historical blood tests will allow for that kind of analysis, which should be superior to FIB-4. Jeff points out the challenge: not all variables are collected in each country. Bottom line: the solution must be simple and realistic to apply in practice in different countries.  

Healthy Livers, Healthy Lives Chair Jeff Lazarus joins Jörn Schattenberg, Louise Campbell and Roger Green to discuss some of the specific structural challenges that confront global MASLD public policy, along with some promising local activities. Louise observes that, in her experience, primary care practitioners appreciate the support that specialist nurses can bring in educating providers about the disease and patients about how to better support themselves. Jeff responds that these are good findings as individual cases, but to make major changes in the field, we need large-scale, top-down innovations. One thing that, oddly, works in MASLD's favor is that most patients with advanced MASLD will have concomitant diseases requiring involvement with other specialties. Today, teams are looking at system issues to find the largest, most intractable structural problems so that solutions can emerge. After that, "we'll start to see bigger and faster improvements in the field." Jeff talks about several positive things happening in New York. First, he mentions a New York Times article about junk food and how manufacturers target aggressive marketing to poor and marginalized populations, with the net result that these populations have processed and ultra-processed foods making up a large share of their diets. Also, a "visionary" health commissioner is creating a program, Healthy NYC, with the goal of increasing life expectancy by reducing specific diseases.MASLD is not part of the effort today but with clinician support. we can get there over time. Earlier, Jeff had commented about the ease of implementing the FIB-4 test. Now, Roger raises the issue again, this time mentioning that SurfingMASH guests from ex-US markets have mentioned that ALT is not a standard test in their countries and asks Jeff if MASLD is making progress here. Jeff discusses the debate around this issue.  

Editor in Chief Sue Yom hosts a discussion of An Economic Analysis of SC.24: A Randomized Study of SBRT Compared with Conventional Palliative RT for Spinal Metastases. Guests are first and second author Dr. Marc Kerba, clinical associate professor in the Department of Oncology at the University of Calgary and radiation oncologist at the Tom Baker Cancer Centre, and Dr. Richard De Abreu Lourenco, Professor with the Centre for Health Economics Research and Evaluation at the University of Technology Sydney.

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Cost-effectiveness of epidemic/pandemic preparedness, published by Vasco Grilo on June 30, 2024 on The Effective Altruism Forum. Summary I Fermi estimate the cost-effectiveness of epidemic/pandemic preparedness is 0.00236 DALY/$. Relative to the above, I calculate GiveWell's top charities are 4.12 times as cost-effective, and corporate campaigns for chicken welfare, such as the ones supported by The Humane League (THL), 6.35 k times. Calculations My calculations are in this Sheet. I Fermi estimate the cost-effectiveness of epidemic/pandemic preparedness of 0.00236 DALY/$ multiplying: The expected annual epidemic/pandemic disease burden of 68.2 MDALY. I obtained this from the product between: The expected annual epidemic/pandemic deaths of 1.61 M, which I determined multiplying: The epidemic/pandemic deaths per human-year from 1500 to 2023 of 1.98*10^-4, which is the ratio between 160 M epidemic/pandemic deaths, and 808 G human-years from Marani et. al 2021[1]. The population predicted for 2024 of 8.12 G. The disease burden per death in 2021 of 42.4 DALY. The relative reduction of the expected annual epidemic/pandemic disease burden per annual cost of 3.46 %/G$. I got this aggregating the following estimates with the geometric mean: 8 %/G$ (= 0.2/(250*10^9/100)), which is based on Millett & Snyder-Beattie 2017: "We extend the World Bank's assumptions to include bioterrorism and biowarfare - that is, we assume that the healthcare infrastructure would reduce bioterrorism and biowarfare fatalities by 20%". "We calculate that purchasing 1 century's worth of global protection in this form would cost on the order of $250 billion, assuming that subsequent maintenance costs are lower but that the entire system needs intermittent upgrading". 1.5 %/G$ (= 0.3/(20*10^9)), which is based on Bernstein et. al 2022: 30 % is the mean between 10 % and 50 %, which are the values studied in Table 2. "We find that the sum of our median cost estimates of primary prevention (~$20 billion) are ~1/20 of the low-end annualized value of lives lost to emerging viral zoonoses and

Welcome back to another enlightening episode of Operation Agency Freedom! I'm your host, Chris Martin, and today, we are diving into the evolving landscape of strategic marketing leadership with none other than John Jantsch, the founder of Duct Tape Marketing. With over 25 years of industry experience, John shares invaluable insights on why businesses are increasingly recognizing the need for a well-crafted strategy to navigate tough times. In this episode, we discuss the rising prominence of the "fractional CMO," a role that's reshaping how agencies and businesses approach marketing strategies. John elucidates the benefits of leading with strategy, especially in an era where AI-driven tools are commoditizing traditional marketing services like content creation and SEO. We'll explore how agencies can reposition themselves as trusted advisors by offering fractional CMO services and focus on building long-term client relationships. John explains the cost-effectiveness of this model compared to hiring full-time employees and delves into the strategic role of a fractional CMO in orchestrating marketing efforts. Whether you're a business owner, a freelancer, or running an agency, this episode is packed with strategies to help you improve your marketing efforts and generate quality leads. Stay tuned as we uncover the secrets to providing high-value services and making the right recommendations to build unshakeable trust with your clients. Don't forget to subscribe and connect with us on social media for more insights from industry leaders like John Jantsch. Let's dive in!  

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Extraordinary cost-effectiveness analyses call for theoretical buttressing, published by Seth Ariel Green on June 25, 2024 on The Effective Altruism Forum. What needs to be true for an estimate to be reasonable? Pure Earth is a GiveWell grantee that works to reduce lead and mercury exposure. In an August 2023 post, they provided a "preliminary analysis" suggesting that their lead reduction program in Bangladesh "can avert an equivalent DALY for just under $1." By contrast, they estimate that GiveDirectly "has a cost-effectiveness of approximately $836 per DALY-equivalent averted." About 86% of the money GiveDirectly spends goes directly to recipients, so an $836 donation to GiveDirectly results in about~$719 going directly to a very poor person. In effect, Pure Earth is claiming that either GiveDirectly can give a person in poverty $719, or Pure Earth can spend $1 helping people in Bangladesh, and these would be about equally good for human welfare. Pure Earth calls this an "extraordinary result" and forthrightly identifies places where their analysis might go wrong. But what I'm missing is a sense of why their analysis might be right -- a story about why this extraordinary opportunity exists. In other words, theory. I find this to be a pretty common lacuna in effective altruist CEAs.[1] Our explanations tend to be technical but not contextual. They tend to focus on our assumptions about the world at large but lack granularity about social and political conditions. But for my tastes, any claim that that boils down to 'we can help poor people more effectively than they can help themselves' requires theoretical buttressing in the form of a plausible story. What kinds of theories might suffice? In the case of lead reduction in spices, six come to mind. 1. Poor people are generally bad at managing their own affairs and need external guidance. (I do not find this very plausible.) 2. There is extraordinary political gridlock that an external organization is especially well-suited to solving. (Pure Earth says that the "project's impact lies not in identifying and enforcing food safety regulations, but rather in expediting its implementation by several years.") 3. There is a narrow opportunity for positive impact stemming from deep insight about a particular context. 4. There is a market failure, e.g. a collective action problem, where a push from an NGO can create a self-sustaining equilibrium. 5. There is a cognitive bias and/or cultural failure that leads people to undervalue something that is good, or overvalue something that is bad, and they need a push in the right direction. 6. Unconditional cash transfers engender negative spillovers, whereas public health interventions typically have positive spillovers. The story will vary from case to case. For New Incentives, I assume it's some version of theories 4, 5, and 6. For anti-malarial interventions, I am not sure (and am generally a skeptic). For Pure Earth, I am also not sure, because I am not an expert. As a potential donor, I am looking for explanation about aspects of the world that I don't understand. I can potentially back that story out of a spreadsheet. But I'd prefer to hear it directly. 1. ^ I use Pure Earth to illustrate because their CEA was on the far tail of the distribution, so it stuck in my memory, but this point could be made about many cost-effective analyses posted the forum. As far as I can tell, Pure Earth is doing great work on an important, neglected, and tractable issue. Thanks for listening. To help us out with The Nonlinear Library or to learn more, please visit nonlinear.org

00:00 - Introduction and Background of Dr. Mark Tyndall03:25 - The Importance of Harm Reduction in Treating Substance Use05:58 - The Impact of Drug Use on Brain Rewiring12:03 - Evaluating the Effectiveness of Supervised Injection Sites16:02 - Challenges in Engaging Substance Users in Harm Reduction24:07 - The Impact of Safe Injection Sites on Overdose Deaths and HIV Transmission28:31 - The Political Aspect and Misunderstandings of Safe Injection Sites34:09 - Shifting Societal Attitudes44:54 - Dispelling Misconceptions48:49 - The Cost-Effectiveness of Harm Reduction53:35 - Engaging with Individuals and Offering HopeCheck out Mark Tyndall's work: https://www.ted.com/speakers/mark_tyndallDr. Mark Tyndall, a professor at the UBC School of Population and Public Health, discusses harm reduction and its importance in addressing drug use. Harm reduction is about making potentially risky behaviors less risky, and it is a key principle in public health. However, there is a stigma associated with harm reduction when it comes to illegal drug use. Dr. Tyndall emphasizes that harm reduction is the first step towards treatment and recovery, and that compassion and empathy are crucial in engaging people in the process. He also highlights the impact of drugs on the brain and the potential for healing and recovery. In this conversation, Mark Tyndall discusses the importance of harm reduction strategies in addressing drug addiction and the opioid crisis. He emphasizes that harm reduction is not about encouraging drug use, but rather about providing support, compassion, and safe environments for individuals struggling with addiction. Tyndall highlights the need for a shift in societal attitudes towards addiction, recognizing it as a disease that requires treatment and support rather than punishment. He also addresses the misconception that harm reduction strategies increase drug use, stating that there is no evidence to support this claim. Tyndall emphasizes the cost-effectiveness of harm reduction approaches compared to the criminal justice system and the importance of engaging with individuals and offering them hope and opportunities for recovery.Support the Show.Visit my NEW Website! https://www.christopherbalkaran.comCheck out my Instagram/Tik Tok for daily posts: Instagram @openmindspodTiktok @openmindspodcast

Meg welcomes Liz Kwo, MD, MBA, and Masters in Public Health (all from Harvard). Dr. Kwo is the Chief Commercial Officer at Everly Health, a personalized diagnostic-driven care-at-home solution. She is an experienced healthcare executive specializing in P&L management, B2B/B2C marketing and sales, strategic partnerships, and post-merger integration. Dr. Kwo is an expert at building and scaling digital health products, leveraging predictive and prescriptive analytics to improve outcomes.In this episode, Liz shares her experience as a healthcare executive, investor, physician, and company builder, and how those can tie the market and community needs together to reach more patients. She discusses her personal inspiration, experience bringing companies to market, getting the right investors, and teaching resilience across generations.Dr. Kwo's new book, Digital MD: Revolutionizing the Future of Health Care is available for pre-order now! Link below… Further Reading:Digital MD: Revolutionizing the Future of Health CareCurrent state and future potential of AI in occupational respiratory medicineThe Promise of Liquid Biopsies for Cancer DiagnosisEvaluating the Clinical and Cost Effectiveness of Musculoskeletal Digital Health SolutionsEpisode Credits: The Game-Changing Women of Healthcare is a production of The Krinsky Company. Hosted by Meg Escobosa. Produced by Meg Escobosa, Calvin Marty, Chelsea Ho, Medina Sabic, Markala Comfort, and Wendy Nielsen.Edited, engineered, and mixed by Calvin Marty. All music composed and performed by Calvin Marty. ©2024 The Krinsky Company

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-385 Overview: Through the framework of a case-based scenario, this episode explores both pharmacological and surgical treatment options for obesity. We discuss the efficacy and cost challenges of injectable medications, insurance coverage, and alternative payment solutions. Gain valuable insights into the cost-effectiveness of treatments, including recent research on endoscopic sleeve gastroplasty, to better advise patients. Episode resource links: Haseeb M, Chhatwal J, Xiao J, Jirapinyo P, Thompson CC. Semaglutide vs Endoscopic Sleeve Gastroplasty for Weight Loss. JAMA Netw Open. 2024;7(4):e246221. doi:10.1001/jamanetworkopen.2024.6221 https://obesitymedicine.org/blog/does-insurance-cover-weight-loss-medication/ Guest: Jillian Joseph, PA-C   Music Credit: Richard Onorato

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-385 Overview: Through the framework of a case-based scenario, this episode explores both pharmacological and surgical treatment options for obesity. We discuss the efficacy and cost challenges of injectable medications, insurance coverage, and alternative payment solutions. Gain valuable insights into the cost-effectiveness of treatments, including recent research on endoscopic sleeve gastroplasty, to better advise patients. Episode resource links: Haseeb M, Chhatwal J, Xiao J, Jirapinyo P, Thompson CC. Semaglutide vs Endoscopic Sleeve Gastroplasty for Weight Loss. JAMA Netw Open. 2024;7(4):e246221. doi:10.1001/jamanetworkopen.2024.6221 https://obesitymedicine.org/blog/does-insurance-cover-weight-loss-medication/ Guest: Jillian Joseph, PA-C   Music Credit: Richard Onorato

In this episode, we discuss routine bacterial vaginosis screening in patients with preterm labor symptoms. Then, we discuss some dietary and other less-discussed findings from the Women's Health Initiative. We also discuss a new review article about first trimester anatomic ultrasounds. Finally, we answer a listener question about implementing postpartum sterilization routinely into unsupportive hospitals. 00:00:02 Testing for BV in Preterm Labor00:12:28 Clinical Diagnosis of Bacterial Vaginosis00:21:14 First Trimester Ultrasound in Women's Health00:34:12 First Trimester Ultrasound Anomalies and Costs00:38:29 The Cost-Effectiveness of Early Ultrasounds00:46:32 Improving Postpartum Sterilization Access00:55:32 Strategies for Postpartum Sterilization ProceduresFollow us on Instagram @thinkingaboutobgyn.

Throp-X 2023 panel discussion is ideal for anyone planning a building project in Jamaica. In this stimulating panel, we addressed an array of important matters, including green space creation, city planning, trends in Jamaican housing developments, water harvesting, building from overseas, and budget planning and adhering. This video is ideal for homeowners and investors, giving you insights into having a successful and environmentally sustainable construction journey in Jamaica. Video on YouTube - https://youtu.be/qjuVmPOCh5I Chapter Markers 0:00 Intro 2:02 An Architect's Role from Foundation to Finish 4:06 Quantity Surveyor on Budgeting & Cost Control for Jamaican Construction 8:11 Points from a Structural Engineer on Considerations when Building in Jamaica 10:38 Landscape Architecture | Budget Planning & Building from Abroad 14:05 What does a landscape architect do? 17:30 Material Choices & Cost-Effectiveness in Jamaican Construction 23:03 Building with Termites & Wildlife in Jamaica 29:45 Enhancing Eco-Sustainability in Jamaican Developments 36:53 Water Solutions | Rainwater & Graywater Harvesting in Jamaica 42:37 Considerations for Maximizing Natural Light in Your Homes 45:05 Integration Tips for Graywater Systems in Existing Buildings 46:41 Bamboo as a Sustainable Construction Material 49:56 Termite and Wildlife Management 50:37 Urban Greenery vs. Parking in Jamaica's City Planning 1:02:33 Cost-Saving Building Solutions Speakers Contact 1. Landscape Architect - Mark Martin www.gardenism.com design@gardenism.com 1-876-819-0822 2. Structural Engineer - Ryan Johnson 3. Quantity Surveyor - Phil Turnbull www.jiqs.com 4. Architect - Conrad Jackson ljrobinsonarchitechs@ljrm.com 1-876-977-1929 1-876-977-1965

Hair straighteners cause AKI - Cost-effectiveness: Important! - Daxibotulinum toxin: It's like DOUBLE BOTOX!!! - Emollient + phototherapy = better - Morgellons disease... is it sometimes Lyme disease? Want to donate to the cause? Donate to the podcast: uofuhealth.org/dermasphere Check out our video content on YouTube: https://www.youtube.com/@dermaspherepodcast and VuMedi!: https://www.vumedi.com/channel/dermasphere/ The University of Utah's Dermatology ECHO: ⁠https://physicians.utah.edu/echo/dermatology-primarycare - ⁠ Connect with us! - Web: ⁠https://dermaspherepodcast.com/⁠ - Twitter: @DermaspherePC - Instagram: dermaspherepodcast - Facebook: https://www.facebook.com/DermaspherePodcast/ - Check out Luke and Michelle's other podcast, SkinCast! ⁠https://healthcare.utah.edu/dermatology/skincast/⁠ Luke and Michelle report no significant conflicts of interest… BUT check out our friends at: - ⁠Kikoxp.com ⁠(a social platform for doctors to share knowledge) - ⁠https://www.levelex.com/games/top-derm⁠ (A free dermatology game to learn more dermatology!)

For a full transcript of this episode, click here. This conversation I am having with Dan Mendelson, my guest today, all started with a post that he had written on LinkedIn considering how pharmacy benefits can or should be optimized within the broader context of value-based care. Total cost of care, value-based medical care, and pharmacy benefits—these worlds have to collide. There is just so much intertwined into all of this, which is why I pretty much immediately invited him to come back on the pod to discuss in greater detail. A few years ago, I heard a doctor say that practicing medicine without considering pharmacy is like getting to the 90 yard line, putting down the ball, and walking off the field. And, yeah … when a patient gets to a certain point in a whole lot of disease progressions, optimal medical therapy includes pharmacy. It's a thing. Adherence is a thing. In fact, I saw a stat the other day that patients not taking their meds costs an estimated $3874 PEPY (per employee per year). Also, half of all hospital admits are caused by nonadherence. Those two stats, by the way, are from a post on LinkedIn by Brian Bellware, who was recapping a video from Eric Bricker, MD. But also, as Barbara Wachsman (EP430) said on the show, half, I think she said, of all ER visits are due to patients not taking their meds right. Olivia Webb (EP337) was on the pod, if you want to go back and listen to that one, talking about how she spends hours every month trying to figure out how to navigate access issues to manage to get her Crohn's disease drug. So, yeah … one underlying reason why a lot of this stuff happens is that pharmacy benefits are purchased and siloed a lot of times. In fact, I have yet to see, really, any mainstream contract wherein a PBM (pharmacy benefit manager) is held accountable in any way for downstream medical costs, which may be incurred because of suboptimal pharmacy benefit design, right? And there are so many examples of bad downstream medical impacts. I really like how Mark Fendrick, MD, put it in episode 308. He said benefits, including pharmacy benefits, are like peanut butter and jelly relative to enabling high-quality care. You gotta have both working in concert, like CMS or a plan sponsor just paid a ton of money to get a patient an organ transplant, and then the patient can't afford their transplant meds, which aren't on formulary and are really expensive, and therefore there's organ rejection. This happens. Or a patient with uncontrolled diabetes with a huge co-pay for insulin. Doctor says, “Hey, you gotta take your insulin.” Patient says, “Can't afford it.” Right? This makes no sense, and it's shockingly common. I'm thinking right now of that young man who died in the Midwest because he could not get his asthma inhaler. It wasn't on formulary. So, here's the game plan. I talk with Dan about the five kind of vital considerations he had brought up in that aforementioned LinkedIn post when considering how pharmacy benefits can or should be optimized within the broader context of value-based care. Dan's advice for the pharma industry is woven in here as much as his advice for EBCs (employee benefit consultants) and employers. I am sure that most of our listeners are going to be very familiar with Dan Mendelson, my guest today, and his work; but the quick background here is that he runs Morgan Health. The mission over there at Morgan Health is to drive innovation in employer-sponsored healthcare, and they do that by investing and working with their portfolio companies in the context of the 300,000 or so employees over at JPMorgan Chase. At the same time, Morgan Health also engages in policy discussions because, as Dan says, no one employer is going to control public policy. As a footnote here, I just will say that I actively seek out opportunities to listen to Dan Mendelson's thoughts. He has spoken a lot and really eloquently and with great insight about setting up the economic models for healthcare, not sick care. Recently, actually, he was on a panel at the Milken conference along with Natalie Davis; Yele Aluko, MD, MBA; and Henry Ting, MD. There are definitely insights to be gleaned. Also mentioned in this episode are Brian Bellware, CIC, CHVP; Eric Bricker, MD; Barbara Wachsman; Olivia Webb; Mark Fendrick, MD; Natalie Davis; Yele Aluko, MD, MBA, FACC, FSCAI; Henry Ting, MD; Ashok Subramanian; Rik Renard; Nina Lathia, RPh, MSc, PhD; Don Berwick, MD; Kenny Cole, MD; Steve Pearson, MD, MSc; Sarah Emond; Alex Sommers, MD, ABEM, DipABLM; and Jodilyn Owen. You can learn more at the Morgan Health Web site and follow Dan on LinkedIn.   Dan Mendelson is the chief executive officer of Morgan Health at JPMorgan Chase & Co. He oversees a business unit at JPMorgan Chase focused on accelerating the delivery of new care models that improve the quality, equity, and affordability of employer-sponsored healthcare. Mendelson was previously founder and CEO of Avalere Health, a healthcare advisory company based in Washington, DC. He also served as operating partner at Welsh Carson, a private equity firm. Before founding Avalere, Mendelson served as associate director for health at the Office of Management and Budget in the Clinton White House. Mendelson currently serves on the boards of Vera Whole Health and Champions Oncology (CSBR). He is also an adjunct professor at the Georgetown University McDonough School of Business. He previously served on the boards of Coventry Healthcare, HMS Holdings, Pharmerica, Partners in Primary Care, Centrexion, and Audacious Inquiry. Mendelson holds a Bachelor of Arts degree from Oberlin College and a Master of Public Policy (MPP) from the Kennedy School of Government at Harvard University.   04:50 How do we connect the dots between value-based care and pharmacy benefits? 07:43 Where do things need to go for employers in terms of drug spend integration? 08:42 How do we think about having a value-based component in the decision-making process? 09:44 How do we enable the necessary information to make proper decisions? 10:56 EP206 with Ashok Subramanian. 11:21 “Many payviders just haven't gotten to pharmacy yet; they need to.” 14:14 Why do pharmaceutical companies need to be prepared to contract on the basis of value? 16:46 EP426 with Nina Lathia, RPh, MSc, PhD. 17:36 EP431 with Kenny Cole, MD. 18:07 Why is it important to “let the market work”? 21:04 Why do we have cost sharing, and when does it not make sense to have that as a co-pay? 23:59 Why are evidence requirements good for everyone? 28:45 Why is pooling of risk important? 29:49 How do you pool risk without going to an insurance company? 32:03 What is Dan's advice to hospitals? 33:30 “In a value-based world, buy and bill does not make sense.” 33:36 What is Dan's advice to primary care doctors? 33:54 What is Dan's advice to entrepreneurs and innovators?   You can learn more at the Morgan Health Web site and follow Dan on LinkedIn.   @dnmendelson discusses #pharmacybenefits on our #healthcarepodcast. #healthcare #podcast #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Dr Benjamin Schwartz, Justin Leader, Dr Scott Conard (Encore! EP391), Jerry Durham (Encore! EP297), Kate Wolin, Dr Kenny Cole, Barbara Wachsman, Luke Slindee, Julie Selesnick, Rik Renard

Swapnil Agarwal, CEO and founder of NITU Capital, shares his journey from humble beginnings in India to becoming a successful real estate investor in the US. He discusses the challenges he faced and the lessons he learned along the way. Swapnil emphasizes the importance of tenacity, adaptability, and taking calculated risks. He also talks about the market cycle from 2019 to 2024 and the impact of COVID-19 on the real estate industry. Swapnil addresses the misleading articles and provides his side of the story, highlighting the strategic decisions he made to navigate the market. Swapnil Agarwal discusses the challenges he has faced in the real estate industry and how he is navigating through them. He talks about the negative media attention he has received and how it has affected his reputation and investor base. Despite the challenges, Swapnil remains resilient and focused on his goals. He shares his strategies for cost-effectiveness and vertical integration in his business operations. Swapnil also mentions the books that have added value to his life and the importance of having mentors. Overall, he emphasizes the importance of staying positive and focused during difficult times. Takeaways Tenacity and adaptability are crucial for success in the real estate industry. Taking calculated risks can lead to significant growth and opportunities. The market cycle from 2019 to 2024 was influenced by COVID-19 and government interventions. Misleading articles can cause unnecessary concern and confusion. Strategic decision-making and working with lenders and servicers can help navigate challenging situations. Negative media attention can have a significant impact on reputation and investor base. Staying positive and focused during challenging times is crucial for success. Implementing cost-effective strategies and vertical integration can help mitigate risks and control expenses. Having mentors and seeking wisdom from successful individuals can provide valuable insights and guidance. Long-term thinking and perseverance are key to achieving success in the real estate industry. Chapters 00:00 Introduction and Background 01:08 Swapnil Agarwal's Origin Story and Early Experiences 10:04 Transitioning to Entrepreneurship and Building NITU Capital 13:36 Overcoming Challenges and Learning from Mistakes 19:27 Addressing Misleading Articles and Setting the Record Straight 22:06 Strategic Decision-Making and Navigating Challenging Situations 23:38 Navigating Challenges in the Real Estate Industry 26:05 The Impact of Negative Media Attention on Reputation 28:36 Strategies for Cost-Effectiveness and Vertical Integration 37:42 The Value of Mentors and Wisdom 40:23 The Importance of Staying Positive and Focused