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Send us a textThis episode explores the mystery of a cellular organelle known as the vault and how unlocking the secrets of nano vaults could revolutionize Disease Cures. Though its structure is well know and its protein composition well established, its function remains a mystery. Joining us to explain this mystery is its discoverer, Dr. Leonard Rome.Dr. Leonard H. Rome is a cell biologist, biochemist and part-time dean involved in research, teaching and administration at the University of California, Los Angeles. He earned his undergraduate degree (B.S. in Chemistry) and graduate degrees (M.S. and Ph.D. in Biological Chemistry) at the University of Michigan, Ann Arbor. He was a postdoctoral fellow at the National Institutes of Health, where he worked on lysosome biogenesis.Dr. Rome has been on the faculty of the David Geffen School of Medicine at UCLA since he joined the Department of Biological Chemistry in 1979. He became a full Professor in 1988 and has been Senior Associate Dean for Research in the School of Medicine since 1997. Since 2005 he has been the Associate Director of the California NanoSystems Institute. Dr. Rome has served as the elected Chair of the School of Medicine Faculty Executive Committee and he is actively involved in Graduate and Medical Education. In 1991 he received a UCLA School of Medicine Award for Excellence in Education.If you would like to learn more about vaults check out Dr. Rome's youtube channel or go to our website:https:/natureandsciencepodcast.com
May 5, 1862. The French have landed in Mexico. Napoleon III wants to conquer the country and assert France's imperial dominance in the Americas. In his way? The Mexican army, held up in the city of Puebla. The Battle of Puebla will come to define this struggle: a European monarch against a fledgling democracy, led by Benito Juárez. Mexico's victory will be especially celebrated by Latinos in the United States, who are watching this struggle play out while their new country is embroiled in a Civil War. This first holiday, in 1862, would mark the beginning of a new tradition, unique to this new American community. How is Cinco de Mayo connected to a broad struggle for freedom across the continent in the 1860s? And what does this holiday really mean? Special thanks to David Hayes-Bautista, distinguished professor of medicine and director of the Center for the Study of Latino Health and Culture at the David Geffen School of Medicine at UCLA, and author of El Cinco de Mayo: An American Tradition. To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices
In this month's episode of the HAE Speaks Podcast, please join Raffi Tachdjian, MD, MPH, Associate Clinical Professor, David Geffen School of Medicine at UCLA, and Kenny Robinson, MD, Head of Medical Affairs, North America at Pharvaris, for a discussion about the full spectrum of a bradykinin-mediated angioedema attack. This podcast episode highlights the experience of the physician and those living with bradykinin-mediated angioedema, explores the nuances of attack progression and resolution, and shares strategies to inform clinical assessment and improve outcomes for individuals with HAE.We would like to thank Pharvaris for sponsoring this episode of the HAE Speaks Podcast.
Dr. Joseph Ladapo is a Nigerian-American physician and health policy researcher currently serving as the Surgeon General of Florida since 2021. Born in Nigeria, he immigrated to the United States at the age of 5 with his family when his father, a microbiologist, came to continue his studies. Dr. Ladapo completed his undergraduate studies at Wake Forest University, where he was a decathlete and captain of the varsity track and field team. He then went on to earn his MD from Harvard Medical School and a PhD in Health Policy from Harvard Graduate School of Arts and Sciences. He completed his clinical training in internal medicine. Throughout his career, Dr. Ladapo has held various academic positions. He served as a faculty member in the Department of Population Health at NYU School of Medicine and as a Staff Fellow at the U.S. Food and Drug Administration (FDA). Prior to his current role, he was an Associate Professor at the David Geffen School of Medicine at UCLA. Dr. Ladapo's research focuses on clinical trial interventions and reducing the population burden of cardiovascular disease. His work has been funded by the National Institutes of Health (NIH) and the Robert Wood Johnson Foundation, and his studies have been published in leading medical journals. In recent years, Dr. Ladapo has gained prominence for his bold stance on COVID-19 mitigation measures, in which he opposed mask and vaccine mandates, questioned the safety of COVID-19 vaccines, and approved alternative treatments. Currently, Dr. Ladapo serves as a Professor of Medicine at the University of Florida College of Medicine in addition to his role as Florida's Surgeon General. He is married and has three young children.
Thoughts on Record: Podcast of the Ottawa Institute of Cognitive Behavioural Therapy
Comments or feedback? Send us a text! In this episode, I'm joined by Dr. Joe Pierre, psychiatrist and author of False, to explore why people believe things that aren't true—and why challenging those beliefs is rarely as simple as presenting the facts. Drawing from research in psychiatry, cognitive science, and social psychology, Dr. Pierre unpacks the emotional, identity-based, and relational roots of misinformation and conspiratorial thinking. Whether you're a clinician, educator, or simply someone trying to make sense of our “post-truth” era, this conversation offers an evidence-based look at the psychology behind false beliefs. In this conversation we discuss: Why smart people believe irrational things The emotional and identity functions of conspiracy theories How misinformation spreads—and why it's so sticky The limits of fact-checking and logic-based persuasion The "prognosis" for someone who believes in conspiracy theories The role of mental illness in extreme beliefs (and where the line is) Online echo chambers, tribalism, and distrust in institutions The psychological appeal of certainty in uncertain times Strategies for promoting critical thinking and intellectual humility Bio: Joe Pierre, MD, is a clinical professor in the Department of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA. With a background in both molecular biology and psychology from MIT and medical training at UCLA, Dr. Pierre's career has focused on severe mental illness, particularly psychotic disorders. In addition to his clinical work, he's a prolific writer and commentator on the psychology of belief, delusion, and misinformation. His Psych Unseen column for Psychology Today explores the intersection of psychiatry, media, and culture. False is his definitive exploration of why we believe things that aren't true, and what that means for our mental health and collective future.drjoepierre.compsychologytoday.com/us/blog/psych-unseen@psychunseen@psychunseen.bsky.social
Save 20% on all Nuzest Products WORLDWIDE with the code MIKKIPEDIA at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.comThis week on the podcast, Mikki speaks to Dr. Matt Budoff – a world-renowned cardiologist and researcher who has spent decades at the forefront of cardiovascular imaging and prevention. Known for his pioneering work in coronary artery calcium (CAC) scoring and computed tomography angiography (CCTA), Dr. Budoff has helped transform how we detect and assess heart disease risk.In this conversation, we explore what first sparked his interest in cardiovascular imaging and how his views on lipids, plaque, and heart disease risk have evolved over time. We dig into his recent research on lifestyle interventions—particularly low-carbohydrate and ketogenic diets—and how they affect LDL cholesterol, atherosclerosis, and overall coronary health.We also discuss the implications of his KETO study, which found no direct correlation between elevated LDL-C and plaque burden in lean, metabolically healthy individuals following a ketogenic diet.Dr. Matthew J. Budoff is a distinguished cardiologist and professor of medicine at the David Geffen School of Medicine at UCLA. He holds the Endowed Chair of Preventive Cardiology at Harbor-UCLA Medical Center and serves as the Program Director and Director of Cardiac CT in the Division of Cardiology Renowned for his pioneering work in non-invasive cardiovascular imaging, Dr. Budoff has significantly advanced the use of coronary artery calcium (CAC) scoring and computed tomography angiography (CCTA) to detect and monitor coronary artery disease. His research focuses on early detection methods for cardiac disease, aiming to identify high-risk patients and implement preventive strategies Dr. Budoff has authored or co-authored over 50 books and book chapters and more than 2,000 articles and abstracts. His contributions have been recognised with numerous awards, including the Gold Medal Award from the Society of Cardiovascular Computed Tomography and designation as a Master of the Society Matt Budoff https://profiles.ucla.edu/matthew.budoffLMHR https://www.jacc.org/doi/10.1016/j.jacadv.2024.101109 Curranz Supplement: Use code MIKKIPEDIA to get 20% off your first order - go to www.curranz.co.nz or www.curranz.co.uk to order yours Contact Mikki:https://mikkiwilliden.com/https://www.facebook.com/mikkiwillidennutritionhttps://www.instagram.com/mikkiwilliden/https://linktr.ee/mikkiwilliden
A week before the High Holidays, three rabbis find themselves in a room fighting to save a family by building a bridge between orthodoxy and modernity. One of these rabbis is Chava, the child of a dynastic Hasidic rabbinical family and destined to become a leader of the next generation before the revelation of her trans identity clashed explosively with the strictly gendered world in which she was raised. As we jump through memory—and wrestle with theology—truths and secrets emerge that ensure no one will read the old stories the same way again. Sarah chats with playwright, Emil Weinstein about this exciting new play, Becoming Eve. EMIL WEINSTEIN (Playwright) is a writer and director whose work spans theater, television, and filmmaking. He graduated from the David Geffen School of Drama at Yale, where he directed the first workshop production of Slave Play by Jeremy O. Harris. His productions as a theater director include Twelfth Night and Romeo & Juliet at Two River Theater, Comedy of Errors and As You Like It (upcoming) at the Old Globe, and developmental work with EnGarde Arts, Rattlestick Theater, Shakespeare and Company, and New York Theatre Workshop. For television, Emil worked as a staff writer on Amazon's “A League of Their Own,” and directed four episodes for the final season of “The L Word Generation Q” for Showtime. His short films “Candace” and “In France Michelle is a Man's Name” played at festivals around the world, winning multiple awards including two Academy Award Qualifying Grand Jury Prizes. Becoming Eve is Emil's Off-Broadway playwriting debut. Emil is a transgender man and uses he/him pronouns. Connect with GOOD SHOW! Instagram: @goodshowpodcast Tik Tok: @goodshowpodcast Learn more about your ad choices. Visit megaphone.fm/adchoices
Ronald A. Alexander, PhD, MFT, SEP (Somatic Experiencing Practitioner) is a Creativity and Communication Consultant, and an Executive and Leadership Coach, with a private psychotherapy practice working with individuals, couples, families, and groups in Santa Monica, California. He is the Executive Director of the OpenMind® Training Institute, a leading-edge organization that offers personal and professional training programs in core creativity, mind-body therapies, transformational leadership, and mindfulness meditation. For more than forty-four years, Alexander has been a trainer of healthcare professionals in North America, as well as in Europe, Russia, Japan, China, and Australia. As a Mindfulness and Zen Buddhist practitioner, he specializes in utilizing mindfulness meditation in his professional and corporate work to help people transform their lives by accessing the mind states that open the portal to their core creativity.Alexander is a leading pioneer in the fields of Mindfulness Based Mind-Body Therapies, Gestalt Therapy, Somatic Experiencing, Ericksonian Mind-Body Therapies, Holistic Psychology, and Integrative and Behavioral Medicine. He is a long-time extension faculty member of the UCLA Departments of Humanities, Social Sciences, and Entertainment, a lecturer in the David Geffen School of Medicine, and an adjunct faculty member at Pacifica Graduate Institute and Pepperdine Universities. Alexander received his SEP Certificate from the Somatic Experiencing Trauma Institute in Boulder Colorado. He consulted with and received treatment from Milton H Erickson MD. He personally trained with Ernest Rossi and Steven Gilligan in Ericksonian Hypnotherapy as well as with Daniel P. Brown of the Harvard Medical Cambridge Hospital professional training's seminars in hypnosis and hypno-analysis. He trained with and was certified by the Los Angeles Gestalt Therapy Institute and with Erving and Miriam Polster PhD of the Gestalt Training Center of La Jolla. He also received training and supervision in Contemporary Gestalt and Family Therapies, Psychoanalytic Self-Psychology, Relational and Object Relations Therapies.Dr. Ronald Alexander, PhD is a leading Creativity and Communication Coach, International Clinical Trainer, Executive and Leadership Coach, with a private practice in Santa Monica, California. He is the originator of the OpenMind Training® Institute, a leading edge organization that offers personal and professional training programs in mindfulness based mind-body therapies, transformational leadership, and meditation. His unique method combines ancient wisdom teachings with Leadership Coaching and Core Creativity into a comprehensive integrated, behaviorally effective mind-body program. This system combines techniques that support strategies of personal, clinical, and corporate excellence and growth.Alexander's extensive training includes core creativity, conflict management, Gestalt therapy, leadership and organizational development, and vision and strategic planning. He pioneered the early values and vision-based models for current day leadership and professional coaching. He specializes in Mind-Body therapies and has been studying and teaching Mindfulness Meditation, Creative Visualization and Transpersonal Psychology since 1970. Alexander studied with and was influenced by noted leaders in these fields such as Ken Blanchard, Werner Erhard, Warren Bennis, Umberto Materana and Francesco Variela, and was one of the grandfathers of coaching along with Jim Rohn, Tony Robbins and Jack Canfield.To learn more about Dr. Ron and his work, visithttps://ronaldalexander.com
In today's episode, we invited experts from across oncology specialties to discuss the long-term effects of the COVID-19 pandemic—the onset of which occurred 5 years ago. Our guests shared how the pandemic's lingering effects continue to shape patient care. We heard from: Ramez N. Eskander, MD, a gynecologic oncologist and assistant professor of obstetrics, gynecology, and reproductive sciences at the University of California San Diego Health Rachel N. Grisham, MD, an associate attending physician at Memorial Sloan Kettering Cancer Center in New York, New York Benjamin Herzberg, MD, an assistant professor of medicine at Columbia University Medical Center and an oncologist at Herbert Irving Comprehensive Cancer Center in New York, New York Kelly McCann, MD, PhD, an assistant professor and breast medical oncologist at UCLA Health's David Geffen School of Medicine in Los Angeles, California Gregory Roloff, MD, a hematologist/oncologist at the University of Chicago Medicine in Illinois
The mature lung in both humans and mice is highly vascularized, with approximately 30% of all cells being endothelial cells (ECs). The blood vessels have a physiological role in gas exchange within the tissue, but the vascular cells have additional role(s) beyond supplying oxygen and nutrients to the tissue. For example, the adult lung endothelium responds to injury by activating pathways for alveolar re epithelialization and during embryonic development, disrupting vascularization ex vivo affects the stereotypical pattern of airway branching, consistent with a perfusion-independent crosstalk between the endothelium and epithelium. Today's guests explore the molecular contribution of ECs and pericytes to the differentiation of distal airway progenitor cells into mature alveolar epithelial cells and will discuss the broader role of the vascular system in the maturation and regeneration or the lung. GuestsPaolo Panza is with the Justus-Liebig University Giessen, Germany. He previously was a postdoctoral fellow in Didier Stainier's laboratory at the Max Planck Institute for Heart and Lung Research and received his PhD from University of Tübingen, Germany. Professor Panza is the first author of the recently published paper, The lung microvasculature promotes alveolar types 2 cell differentiation via secreted SPARCL1, which forms the basis of our discussion today. Mingxia Gu is an Associate Professor at the David Geffen School of Medicine at the University of California, Los Angeles. She received her PhD from a joint training program between Peking University, Beijing, China and Stanford University, USA, and was a postdoctoral fellow in Marlene Rabinovitch's laboratory at Stanford. The Gu laboratory studies the regeneration lung, and vasculature among other tissues. Professor Gu is an elected Fellow of the American Heart Association and a member of Early Career Editorial Board for Stem Cell Reports.HostJanet Rossant, Editor-in-Chief, Stem Cell Reports and The Gairdner FoundationSupporting ContentThe lung microvasculature promotes alveolar type 2 cell differentiation via secreted SPARCL1, Stem Cell Reports About Stem Cell ReportsStem Cell Reports is the open access, peer-reviewed journal of the International Society for Stem Cell Research (ISSCR) for communicating basic discoveries in stem cell research, in addition to translational and clinical studies. Stem Cell Reports focuses on original research with conceptual or practical advances that are of broad interest to stem cell biologists and clinicians.X: @StemCellReportsAbout ISSCRWith nearly 5,000 members from more than 80 countries, the International Society for Stem Cell Research (@ISSCR) is the preeminent global, cross-disciplinary, science-based organization dedicated to stem cell research and its translation to the clinic. The ISSCR mission is to promote excellence in stem cell science and applications to human health.ISSCR StaffKeith Alm, Chief Executive OfficerYvonne Fisher, Managing Editor, Stem Cell ReportsKym Kilbourne, Director of Media and Strategic CommunicationsMegan Koch, Marketing ManagerJack Mosher, Scientific AdvisorHunter Reed, Senior Marketing CoordinatorVoice WorkBen Snitkoff
We kicked off the program with four news stories and different guests on the stories we think you need to know about!Mass. Dems look for their Trump-era message - searching for a path forward following their 2024 election losses… Mike Deehan – Axios Boston Reporter checked in with Dan.NFL Free Agency Moves – What's next for the Patriots in free agency? Chris Price – Boston Globe Sportswriter stopped by to discuss it with Dan.50 New England sayings & slang, explained! Some of the unique, quirky slang words you'll most likely only hear in New England! Stacy Milbouer – writer/journalist for the Granite Post banged a wicked uey to join Dan. The U.S. is facing a critical hospital bed shortage by 2032, UCLA research suggests! Dr. Richard Leuchter – assistant professor of medicine at the David Geffen School of Medicine at UCLA and the study's lead investigator discussed it with Dan.Listen to WBZ NewsRadio on the NEW iHeart Radio app and be sure to set WBZ NewsRadio as your #1 preset!
Alice Soragni, PhD shares information about PREMOST: an organoid-based functional PREcision Medicine trial in OSTeosarcoma (NCT06064682), a clinical trial that is studying the feasibility of using organoids for predicting drug response and guiding therapy in osteosarcoma.Patient-derived tumor organoids (PDTOs) are lab-grown replicas of tumors that closely resemble the original cancer in both structure and behavior. These models can be rapidly created from small samples obtained during biopsies or surgeries, allowing us to test their responses to different drugs in the lab. This makes them highly valuable for developing personalized treatment strategies, particularly in light of a growing body of evidence showing how PDTOs can in many cases accurately mimic clinical responses. The Soragni Lab has developed a unique platform to grow these organoids efficiently from osteosarcoma surgical samples. They can create these three-dimensional avatars without needing complicated cell sorting or lengthy lab procedures. This means they can start testing drugs and get results within a week of the surgery, a turnaround that is rapid enough to potentially be used in the future to help guide treatment decisions In a pilot study, they found that testing drugs on these organoids provided insights that closely matched the patients' actual clinical outcomes. Osteosarcoma organoids with low viability after neoadjuvant chemotherapy matched patients who experienced higher tumor cell death (necrosis) after treatment and long-term disease status. The lab also investigated responses of PDTOs from advanced, recurrent, and metastatic sarcomas and found that the viability of these organoids in the lab correlated with the time to the next treatment in patients. The data suggests that osteosarcoma organoids could help predict how well some treatments may work. Encouraged by these promising results, the Soragni Lab has initiated a clinical trial to further explore the use of PDTOs to predict osteosarcoma therapy responses. Dr. Soragni will describe the study design for this first-of-its-kind, organoid-based clinical trial in sarcoma.Alice Soragni, PhD, is an Associate Professor in the David Geffen School of Medicine at UCLA, and a member of the Jonsson Comprehensive Cancer Center. She has a Bachelor and Master of Science cum Laude from the University of Bologna, Italy, and a PhD from the ETH of Zuerich, Switzerland. Her laboratory couples basic research into mechanisms of disease to the development of novel therapeutic strategies. Her expertise lies in the development of tumor organoid models to investigate the biology of rare tumors such as osteosarcoma and perform screenings for functional precision medicine applications.
Ronald A. Alexander, PhD, MFT, SEP (Somatic Experiencing Practitioner) is a Creativity and Communication Consultant, and an Executive and Leadership Coach, with a private psychotherapy practice working with individuals, couples, families, and groups in Santa Monica, California. He is the Executive Director of the OpenMind® Training Institute, a leading-edge organization that offers personal and professional training programs in core creativity, mind-body therapies, transformational leadership, and mindfulness meditation. For more than forty-four years, Alexander has been a trainer of healthcare professionals in North America, as well as in Europe, Russia, Japan, China, and Australia. As a Mindfulness and Zen Buddhist practitioner, he specializes in utilizing mindfulness meditation in his professional and corporate work to help people transform their lives by accessing the mind states that open the portal to their core creativity.Alexander is a leading pioneer in the fields of Mindfulness Based Mind-Body Therapies, Gestalt Therapy, Somatic Experiencing, Ericksonian Mind-Body Therapies, Holistic Psychology, and Integrative and Behavioral Medicine. He is a long-time extension faculty member of the UCLA Departments of Humanities, Social Sciences, and Entertainment, a lecturer in the David Geffen School of Medicine, and an adjunct faculty member at Pacifica Graduate Institute and Pepperdine Universities. Alexander received his SEP Certificate from the Somatic Experiencing Trauma Institute in Boulder Colorado. He consulted with and received treatment from Milton H Erickson MD. He personally trained with Ernest Rossi and Steven Gilligan in Ericksonian Hypnotherapy as well as with Daniel P. Brown of the Harvard Medical Cambridge Hospital professional training's seminars in hypnosis and hypno-analysis. He trained with and was certified by the Los Angeles Gestalt Therapy Institute and with Erving and Miriam Polster PhD of the Gestalt Training Center of La Jolla. He also received training and supervision in Contemporary Gestalt and Family Therapies, Psychoanalytic Self-Psychology, Relational and Object Relations Therapies.Dr. Ronald Alexander, PhD is a leading Creativity and Communication Coach, International Clinical Trainer, Executive and Leadership Coach, with a private practice in Santa Monica, California. He is the originator of the OpenMind Training® Institute, a leading edge organization that offers personal and professional training programs in mindfulness based mind-body therapies, transformational leadership, and meditation. His unique method combines ancient wisdom teachings with Leadership Coaching and Core Creativity into a comprehensive integrated, behaviorally effective mind-body program. This system combines techniques that support strategies of personal, clinical, and corporate excellence and growth.Alexander's extensive training includes core creativity, conflict management, Gestalt therapy, leadership and organizational development, and vision and strategic planning. He pioneered the early values and vision-based models for current day leadership and professional coaching. He specializes in Mind-Body therapies and has been studying and teaching Mindfulness Meditation, Creative Visualization and Transpersonal Psychology since 1970. Alexander studied with and was influenced by noted leaders in these fields such as Ken Blanchard, Werner Erhard, Warren Bennis, Umberto Materana and Francesco Variela, and was one of the grandfathers of coaching along with Jim Rohn, Tony Robbins and Jack Canfield.To learn more about Dr. Ron and his work, visithttps://ronaldalexander.com
Listen to Yao Ming, former NBA player and former President of the Chinese Basketball Association, and Logan Tom, Vice President of Player Personnel for the U.S. Pro Volleyball Federation and head coach of Maccabi Raanana, talk about U.S.-China sports exchange in a discussion moderated by Nancy Yao, Assistant Professor Adjunct & Assistant Dean for the David Geffen School of Drama at Yale University. This dialogue was part of the 2024 U.S.-China People's Dialogue, which took place in Beijing on November 21, 2024. See full bios and learn more about the event: https://www.ncuscr.org/2024-us-china-peoples-dialogue/
Guest: Dr. Christian de Virgilio is the Chair of the Department of Surgery at Harbor-UCLA Medical Center. He is also Co-Chair of the College of Applied Anatomy and a Professor of Surgery at UCLA's David Geffen School of Medicine. He completed his undergraduate degree in Biology at Loyola Marymount University and earned his medical degree from UCLA. He then completed his residency in General Surgery at UCLA-Harbor Medical Center followed by a fellowship in Vascular Surgery at the Mayo Clinic. Resources: Rutherford Chapters (10th ed.): 174, 175, 177, 178 Prior Holding Pressure episode on AV access creation: https://www.audiblebleeding.com/vsite-hd-access/ The Society for Vascular Surgery: Clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access: https://www.jvascsurg.org/article/S0741-5214%2808%2901399-2/fulltext KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/ Outline: Steal Syndrome Definition & Etiology Steal syndrome is an important complication of AV access creation, since access creation diverts arterial blood flow from the hand. Steal can be caused by multiple factors—arterial occlusive disease proximal or distal to the AV anastomosis, high flow through the fistula at the expense of distal arterial perfusion, and failure of the distal arterial networks to adapt to this decreased blood flow. Incidence and Risk Factors The frequency of steal syndrome is 1.6-9%1,2, depending on the vessels and conduit choice Steal syndrome is more common with brachial and axillary artery-based accesses and nonautogenous conduits. Other risk factors for steal syndrome are peripheral vascular disease, coronary artery disease, diabetes, advanced age, female sex, larger outflow conduit, multiple prior permanent access procedures, and prior episodes of steal.3,4 Long-standing insulin-dependent diabetes causes both medial calcinosis and peripheral neuropathy, which limits arteries' ability to vasodilate and adjust to decreased blood flow. Patient Presentation, Symptoms, Grading Steal syndrome is diagnosed clinically. Symptoms after AVG creation occurs within the first few days, since flow in prosthetic grafts tend to reach a maximum value very early after creation. Native AVFs take time to mature and flow will slowly increase overtime, leading to more insidious onset of symptoms that can take months or years. The patient should have a unilateral complaint in the extremity with the AV access. Symptoms of steal syndrome, in order of increasing severity, include nail changes, occasional tingling, extremity coolness, numbness in fingertips and hands, muscle weakness, rest pain, sensory and motor deficits, fingertip ulcerations, and tissue loss. There could be a weakened radial pulse or weak Doppler signal on the affected side, and these will become stronger after compression of the AV outflow. Symptoms are graded on a scale specified by Society of Vascular Surgery (SVS) reporting standards:5 Workup Duplex ultrasound can be used to analyze flow volumes. A high flow volume (in autogenous accesses greater than 800 mL/min, in nonautogenous accesses greater than 1200 mL/min) signifies an outflow issue. The vein or graft is acting as a pressure sink and stealing blood from the distal artery. A low flow volume signifies an inflow issue, meaning that there is a proximal arterial lesion preventing blood from reaching the distal artery. Upper extremity angiogram can identify proximal arterial lesions. Prevention Create the AV access as distal as possible, in order to preserve arterial inflow to the hand and reduce the anastomosis size and outflow diameter. SVS guidelines recommend a 4-6mm arteriotomy diameter to balance the need for sufficient access flow with the risk of steal. If a graft is necessary, tapered prosthetic grafts are sometimes used in patients with steal risk factors, using the smaller end of the graft placed at the arterial anastomosis, although this has not yet been proven to reduce the incidence of steal. Indications for Treatment Intervention is recommended in lifestyle-limiting cases of Grade II and all Grade III steal cases. If left untreated, the natural history of steal syndrome can result in chronic limb ischemia, causing gangrene with loss of digits or limbs. Treatment Options Conservative management relies on observation and monitoring, as mild cases of steal syndrome may resolve spontaneously. Inflow stenosis can be treated with endovascular intervention (angioplasty with or without stent) Ligation is the simplest surgical treatment, and it results in loss of the AV access. This is preferred in patients with repetitive failed salvage attempts, venous hypertension, and poor prognoses. Flow limiting procedures can address high volumes through the AV access. Banding can be performed with surgical cutdown and placement of polypropylene sutures or a Dacron patch around the vein or graft. The Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (MILLER) technique employs a percutaneous endoluminal balloon inflated at the AVF to ensure consistency in diameter while banding Plication is when a side-biting running stitch is used to narrow lumen of the vein near the anastomosis. A downside of flow-limiting procedures is that it is often difficult to determine how much to narrow the AV access, as these procedures carry a risk of outflow thrombosis. There are also surgical treatments focused on reroute arterial inflow. The distal revascularization and interval ligation (DRIL) procedure involves creation of a new bypass connecting arterial segments proximal and distal to the AV anastomosis, with ligation of the native artery between the AV anastomosis and the distal anastomosis of the bypass. Reversed saphenous vein with a diameter greater than 3mm is the preferred conduit. Arm vein or prosthetic grafts can be used if needed, but prosthetic material carries higher risk of thrombosis. The new arterial bypass creates a low resistance pathway that increases flow to distal arterial beds, and interval arterial ligation eliminates retrograde flow through the distal artery. The major risk of this procedure is bypass thrombosis, which results in loss of native arterial flow and hand ischemia. Other drawbacks of DRIL include procedural difficulty with smaller arterial anastomoses, sacrifice of saphenous or arm veins, and decreased fistula flow. Another possible revision surgery is revision using distal inflow (RUDI). This procedure involves ligation of the fistula at the anastomosis and use of a conduit to connect the outflow vein to a distal artery. The selected distal artery can be the proximal radial or ulnar artery, depending on the preoperative duplex. The more dominant vessel should be spared, allowing for distal arterial beds to have uninterrupted antegrade perfusion. The nondominant vessel is used as distal inflow for the AV access. RUDI increases access length and decreases access diameter, resulting in increased resistance and lower flow volume through the fistula. Unlike DRIL, RUDI preserves native arterial flow. Thrombosis of the conduit would put the fistula at risk, rather than the native artery. The last surgical revision procedure for steal is proximalization of arterial inflow (PAI). In this procedure, the vein is ligated distal to the original anastomosis site and flow is re-established through the fistula with a PTFE interposition graft anastomosed end-to-side with the more proximal axillary artery and end-to-end with the distal vein. Similar to RUDI, PAI increases the length and decreases the diameter of the outflow conduit. Since the axillary artery has a larger diameter than the brachial artery, there is a less significant pressure drop across the arterial anastomosis site and less steal. PAI allows for preservation of native artery's continuity and does not require vein harvest. Difficulties with PAI arise when deciding the length of the interposition graft to balance AV flow with distal arterial flow. 2. Ischemic Monomelic Neuropathy Definition Ischemic monomelic neuropathy (IMN) is a rare but serious form of steal that involves nerve ischemia. Severe sensorimotor dysfunction is experienced immediately after AV access creation. Etiology IMN affects blood flow to the nerves, but not the skin or muscles because peripheral nerve fibers are more vulnerable to ischemia. Incidence and Risk Factors IMN is very rare; it has an estimated incidence of 0.1-0.5% of AV access creations.6 IMN has only been reported in brachial artery-based accesses, since the brachial artery is the sole arterial inflow for distal arteries feeding all forearm nerves. IMN is associated with diabetes, peripheral vascular disease, and preexisting peripheral neuropathy that is associated with either of the conditions. Patient Presentation Symptoms usually present rapidly, within minutes to hours after AV access creation. The most common presenting symptom is severe, constant, and deep burning pain of the distal forearm and hand. Patients also report impairment of all sensation, weakness, and hand paralysis. Diagnosis of IMN can be delayed due to misattribution of symptoms to anesthetic blockade, postoperative pain, preexisting neuropathy, a heavily bandaged arm precluding neurologic examination. Treatment Treatment is immediate ligation of the AV access. Delay in treatment will quickly result in permanent sensorimotor loss. 3. Perigraft Seroma Definition A perigraft seroma is a sterile fluid collection surrounding a vascular prosthesis and is enclosed within a pseudomembrane. Etiology and Incidence Possible etiologies include: transudative movement of fluid through the graft material, serous fluid collection from traumatized connective tissues (especially the from higher adipose tissue content in the upper arm), inhibition of fibroblast growth with associated failure of the tissue to incorporate the graft, graft “wetting” or kinking during initial operation, increased flow rates, decreased hematocrit causing oncotic pressure difference, or allergy to graft material. Seromas most commonly form at anastomosis sites in the early postoperative period. Overall seroma incidence rates after AV graft placement range from 1.7–4% and are more common in grafts placed in the upper arm (compared to the forearm) and Dacron grafts (compared to PTFE grafts).7-9 Patient Presentation and Workup Physical exam can show a subcutaneous raised palpable fluid mass Seromas can be seen with ultrasound, but it is difficult to differentiate between the types of fluid around the graft (seroma vs. hematoma vs. abscess) Indications for Treatment Seromas can lead to wound dehiscence, pressure necrosis and erosion through skin, and loss of available puncture area for hemodialysis Persistent seromas can also serve as a nidus for infection. The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines10 recommend a tailored approach to seroma management, with more aggressive surgical interventions being necessary for persistent, infected-appearing, or late-developing seromas. Treatment The majority of early postoperative seromas are self-limited and tend to resolve on their own Persistent seromas have been treated using a variety of methods-- incision and evacuation of seroma, complete excision and replacement of the entire graft, and primary bypass of the involved graft segment only. Graft replacement with new material and rerouting through a different tissue plane has a higher reported cure rate and lower rate of infection than aspiration alone.9 4. Infection Incidence and Etiology The reported incidence of infection ranges 4-20% in AVG, which is significantly higher than the rate of infection of 0.56-5% in AVF.11 Infection can occur at the time of access creation (earliest presentation), after cannulation for dialysis (later infection), or secondary to another infectious source. Infection can also further complicate a pre-existing access site issue such as infection of a hematoma, thrombosed pseudoaneurysm, or seroma. Skin flora from frequent dialysis cannulations result in common pathogens being Staphylococcus, Pseudomonas, or polymicrobial species. Staphylococcus and Pseudomonas are highly virulent and likely to cause anastomotic disruption. Patient Presentation and Workup Physical exam will reveal warmth, pain, swelling, erythema, induration, drainage, or pus. Occasionally, patients have nonspecific manifestations of fever or leukocytosis. Ultrasound can be used to screen for and determine the extent of graft involvement by the infection. Treatments In AV fistulas: Localized infection can usually be managed with broad spectrum antibiotics. If there are bleeding concerns or infection is seen near the anastomosis site, the fistula should be ligated and re-created in a clean field. In AV grafts: If infection is localized, partial graft excision is acceptable. Total graft excision is recommended if the infection is present throughout the entire graft, involves the anastomoses, occludes the access, or contains particularly virulent organisms Total graft excision may also be indicated if a patient develops recurrent bacteremia with no other infectious source identified. For graft excision, the venous end of the graft is removed and the vein is oversewn or ligated. If the arterial anastomosis is intact, a small cuff of the graft can be left behind and oversewn. If the arterial anastomosis is involved, the arterial wall must be debrided and ligation, reconstruction with autogenous patch angioplasty, or arterial bypass can be pursued. References 1. Morsy AH, Kulbaski M, Chen C, Isiklar H, Lumsden AB. Incidence and Characteristics of Patients with Hand Ischemia after a Hemodialysis Access Procedure. J Surg Res. 1998;74(1):8-10. doi:10.1006/jsre.1997.5206 2. Ballard JL, Bunt TJ, Malone JM. Major complications of angioaccess surgery. Am J Surg. 1992;164(3):229-232. doi:10.1016/S0002-9610(05)81076-1 3. Valentine RJ, Bouch CW, Scott DJ, et al. Do preoperative finger pressures predict early arterial steal in hemodialysis access patients? A prospective analysis. J Vasc Surg. 2002;36(2):351-356. doi:10.1067/mva.2002.125848 4. Malik J, Tuka V, Kasalova Z, et al. Understanding the Dialysis access Steal Syndrome. A Review of the Etiologies, Diagnosis, Prevention and Treatment Strategies. J Vasc Access. 2008;9(3):155-166. doi:10.1177/112972980800900301 5. Sidawy AN, Gray R, Besarab A, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg. 2002;35(3):603-610. doi:10.1067/mva.2002.122025 6. Thermann F, Kornhuber M. Ischemic Monomelic Neuropathy: A Rare but Important Complication after Hemodialysis Access Placement - a Review. J Vasc Access. 2011;12(2):113-119. doi:10.5301/JVA.2011.6365 7. Dauria DM, Dyk P, Garvin P. Incidence and Management of Seroma after Arteriovenous Graft Placement. J Am Coll Surg. 2006;203(4):506-511. doi:10.1016/j.jamcollsurg.2006.06.002 8. Gargiulo NJ, Veith FJ, Scher LA, Lipsitz EC, Suggs WD, Benros RM. Experience with covered stents for the management of hemodialysis polytetrafluoroethylene graft seromas. J Vasc Surg. 2008;48(1):216-217. doi:10.1016/j.jvs.2008.01.046 9. Blumenberg RM, Gelfand ML, Dale WA. Perigraft seromas complicating arterial grafts. Surgery. 1985;97(2):194-204. 10. Lok CE, Huber TS, Lee T, et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis. 2020;75(4):S1-S164. doi:10.1053/j.ajkd.2019.12.001 11. Padberg FT, Calligaro KD, Sidawy AN. Complications of arteriovenous hemodialysis access: Recognition and management. J Vasc Surg. 2008;48(5):S55-S80. doi:10.1016/j.jvs.2008.08.067
Send your questions or provocations to Adam or Budi here!In the first episode of the year, Budi sits down with Micha Espinosa, the Artistic Director of the Fitzmaurice Voice Institute, and Christopher Bayes, Professor in the Practice of Acting and Head of Physical Acting at David Geffen School of Drama, to talk about their most recent Bali Retreat they hosted of the New Years. Support the showIf you enjoyed this week´s podcast, please leave a review on Apple Podcasts. To submit a question: Voice- http://www.speakpipe.com/theatreofothers Email- podcast@theatreofothers.com Show Credits Co-Hosts: Adam Marple & Budi MillerProducer: Jack BurmeisterMusic: https://www.purple-planet.comAdditional compositions by @jack_burmeister
David Eisenman, MD, MSHS, is a professor at the David Geffen School of Medicine at UCLA and has a joint appointment at the UCLA Fielding School of Public Health where he directs the Center for Public Health and Disasters and is the Deputy Director for Community Partnerships at the UCLA Center for Healthy Climate Solutions. Dr. Eisenman is also an Associate Natural Scientist at RAND. Dr. Eisenman lives and surfs in Marina del Rey, California. His research is focused on public health and disasters, including wildfires, heat-waves, and climate change.
Check out this podcast replay of our one on one conversation with 2023 Tony Award Winner Michael Arden hosted by SDCF and the Museum of Broadway. Interviewed by SDC Executive Director Laura Penn, this conversation focuses on Michael's expansive career to date including a deeper dive into his work as an artist and practice as a director. We held this conversation in March 2024. The video and audio was recorded by Michael Weir supported by the Maria Torres Emerging Artists Foundation. Transcript available upon request. Michael Arden (Director) was awarded the 2023 Tony Award for Best Direction of a Musical for his production of Parade starring Ben Platt and Micaela Diamond, which will have a national tour beginning early 2024. Michael was also Tony nominated for his revivals of Once On This Island and Spring Awakening. Michael wrote and directed Charles Dickens' A Christmas Carol which played the Nederlander Theatre last Holiday season and starred Jefferson Mays. Michael will helm the new Stephen Schwartz and Lindsey Ferrentino musical The Queen of Versailles starring Kristin Chenowith and a new musical adaptation of the cult film The Lost Boys. Other directing credits include: Maybe Happy Ending at the Atlanta Alliance, Joseph and the Amazing Technicolor Dreamcoat at Geffen Hall at Lincoln Center, and site specific works: American Dream Study and ALIEN/NATION with his company The Forest of Arden. Arden has been named on Variety's Impact List and is the winner of an NAACP Award for best direction of his revival of Merrily We Roll Along at the Wallis Annenberg in Los Angeles. In addition to directing theater in America and around the globe, he regularly directs “The Connors” on ABC, and has appeared in numerous features and TV shows, most notably: Grey's Anatomy, Bride Wars, Anger Management, Source Code, and The Marvelous Mrs. Maisel. On stage, Arden has appeared on Broadway in Big River; The Times, They Are A-Changin', and King Lear. Arden is a Presidential Scholar in the Arts and alumni of the Interlochen Arts Academy and The Juilliard School. Michael and longtime creative and design partner Dane Laffrey founded AT RISE CREATIVE, a production company that strives to create groundbreaking live experiences with an emphasis on design and innovating technologies. Photo credit: Laura Penn has been Executive Director of Stage Directors and Choreographers Society (SDC) since 2008. This year, she was appointed by President Biden to serve as a member of the President's Committee on the Arts and the Humanities. Most recently, she was elected to the Board of the Entertainment Community Fund. Under her leadership, SDC's Membership has grown more than 100%, a result of her work expanding jurisdictions; leading bold and successful negotiations; and furthering the Union's Equity, Diversity, and Inclusion (EDI) initiatives and political engagement. She serves on the General Board of the Department for Professional Employees, AFL-CIO (DPE) and is an active member of DPE's Arts, Entertainment, and Media Industry Coordinating Committee (AEMI). She is co-Chair of the Coalition of Broadway Unions and Guilds, the first woman to hold a leadership position with this coalition of 18 influential unions representing workers on Broadway. Laura serves on the Tony Awards Administration Committee and is a Tony Voter. She served as a panelist for the New York State Council for the Arts, for more than a decade was a site evaluator for the National Endowment for the Arts, was Vice President of the League of Resident Theatres, and was two-term Chair of the Seattle Arts Commission. Recognized with Seattle's Distinguished Citizen Medal, she is an advocate for civic dialogue and public participation and has been dedicated throughout her career to the idea that artistic excellence and community engagement are intrinsically connected. Laura previously served as an arts executive for Intiman Theatre and Seattle Repertory Theatre and began her career at D.C.'s Arena Stage, Living Stage Theatre Company. She currently teaches Labor Relations in the graduate program at the David Geffen School of Drama at Yale.
In this episode of Audible Bleeding, editor Dr. Imani McElroy (@IEMcElroy) is joined by General Surgery PGY-4 Sasank Kalipatnapu(@ksasank) along with Dr.David Rigberg, MD (@drigberg), and Dr. Guillermo Escobar, MD (@GAEscobarMD) to discuss the Society for Clinical Vascular Surgery (SCVS) Rising Seniors / Incoming Fellows Program. This episode brings out a conversation exploring the history behind the development of the program, the current state of the program, and the overwhelming importance of the program in the current day. The episode also provides a broad overview of the content presented in the program and the reasoning behind the talks. Guests: Dr. David Rigberg - Professor of Surgery, Division of Vascular and Endovascular Surgery, Gonda Vascular Center, Program Director for the Vascular fellowship and integrated vascular surgery residency at the David Geffen School of Medicine, UCLA, Los Angeles, California Dr. Guillermo Escobar- Associate Professor, Division of Vascular Surgery and Endovascular Therapy, Program Director for the Vascular Surgery Fellowship and Residency at Emory University School of Medicine Relevant links: Rising Seniors / Incoming Fellows Program - Program Details SCVS - Fellows & Chief Residents Program SCVS - Young Vascular Surgeons Program To apply for the Rising Seniors / Incoming Fellows Program, go to apply now! Audible Bleeding team: Dr. Imani McElroy is 1st year vascular surgery fellow at USC/LA and editor at Audible Bleeding Dr. Sasank Kalipatnapu, PGY-4 general surgery resident, Dept of Surgery, UMass Chan Medical School, Worcester, MA Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.
Emeran A. Mayer is a Gastroenterologist, Neuroscientist and Distinguished Research Professor in the Department of Medicine at the David Geffen School of Medicine at UCLA, the Executive Director of the G. Oppenheimer Center for Neurobiology of Stress & Resilience at UCLA and Founding Director of the Goodman Luskin Microbiome Center at UCLA. As one of the pioneers and leading researchers in the role of brain gut interactions in health and chronic disease, in particular in IBS, his scientific contributions to basic and translational enteric neurobiology with wide-ranging applications in clinical GI diseases and disorders is unparalleled. He has published close to 410 scientific papers, co-edited 3 books, published the best selling The Mind Gut Connection book in 2016 and The Gut Immune Connection book in June 2021. He is the recipient of the 2016 David McLean award from the American Psychosomatic Society and the 2017 Ismar Boas Medal from the German Society of Gastroenterology and Metabolic Disease. His most recent work has focused on alterations in the bidirectional communications within the brain gut microbiome system and their role in chronic inflammatory and functional diseases of the gut, obesity, and cognitive decline. Links:Dr. Mayer's Website: EmeranMayer.comDr. Mayer on Instagram and YouTubeDr. Mayer's books, The Mind-Gut Connection and The Gut-Immune Connection
In this episode, we're joined by Dr. Suthana, a leading neuroscientist from UCLA's David Geffen School of Medicine and the Jane & Terry Semel Institute for Neuroscience & Human Behavior. Dr. Suthana's career sits at the intersection of neuroscience, neural technology, and engineering, focusing on memory disorders and innovative brain technologies. We explore her groundbreaking research on memory enhancement through deep brain stimulation (DBS), focusing on a study where stimulation of the entorhinal cortex enhanced memory retention during learning. She also delves into the challenges of translating laboratory findings into real-world clinical improvements. In a truly unique part of her work, Dr. Suthana uses virtual reality (VR) and mobile tech to study memory in naturalistic settings. Her lab even developed a custom backpack system, allowing participants to move freely while recording real-time brain activity to better understand memory and spatial navigation. We also discuss her recent work on PTSD, where she uses responsive stimulation in the amygdala to help reduce trauma-triggered responses. Dr. Suthana expresses her excitement about the future of wearable tech and how it might revolutionize the field by combining real-time data collection with neurostimulation. Tune in for an inspiring look at the future of neuromodulation and memory enhancement as Dr. Suthana shares her vision and insights into this cutting-edge field.
Two-time Emmy and Three-time NAACP Image Award-winning television Executive Producer Rushion McDonald interviewed Douglass Fort. He founded The Blerd Academy (Black Nerds). It's a wealth building program that helps High-Achieving Black-American youth get scholarships to HBCU's. They have secured over $8 million dollars in scholarships! Please welcome to Money Making Conversations Master Class Douglass Fort. Why did you start the Academy? What are some outcomes of the Academy? Why should the Black-American community highlight our nerds? · Since 2016 Fort has secured $8 million in scholarships for 63 high-achieving Black American students. Full-ride and tuition-only scholarships to HBCUs through graduate school.· PJ's sister, Marissa, also went through the program. She graduated Cum Laude from Hampton University with a degree in Accounting, earned a Master's degree from Columbia University all debt-free, and now works for Deloitte in New York City.· Other success stories: A Tennessee State U graduate now works in the front office for the NFL's Chicago Bears.· Two are Obama-Cheskey Voyager scholars.· Fort says: “We don't talk enough about Black scientists, mathematicians, and doctors. Only 1% of athletes make it to the NFL. We're hustling backward having our kids focus on sports over education.”· Criteria for the students he assists: a 3.5 GPA, a 28 ACT score, or a 1300 SAT score for a full-ride scholarship, or a minimum 3.2 GPA, a 23 ACT score, or an 1130 SAT score for tuition-only scholarships. AP and/or Honors classes, community service, and school leadership is also beneficial.· Since the 2023 U.S. Supreme Court ruling of Students for Fair Admissions, Inc. v. President and Fellows of Harvard College and Students for Fair Admissions, Inc. v. University of North Carolina struck down Affirmative Action in college admissions Fort has been busy.· Several HBCUs saw a surge in applications, including Washington D.C.'s Howard University, Clark-Atlanta University, which outpaced the University of Georgia, and Florida Agricultural Mechanical University (FAMU).· Fort says: Parents just don't know there is money and resources at these institutions for their high-achieving students, but they should because their kids have excelled in the classroom, and they deserve it.” MONEY MAKING CONVERSATIONS TALKING POINTSGuest: Douglass J. Fort, Founder, The BLERD Academy· Grew up in East Palo Alto, California· Liked school but got caught up in the streets· Was shot as a teen.· A childhood friend suggested he apply to Jackson State University. When he was accepted, hesitated, but did go.· Graduated from JSU. A Criminal Justice Major/Urban Affairs/Development minor. After graduation, he returned to East Palo Alto where he started the violence prevention program, For Youth By Youth.· Worked with law enforcement to help clean up Black neighborhoods.· His son received a full-ride athletic scholarship to Morehouse College but turned it down to play Division 1 Football at a PWI, and never played.· Doug was heartbroken that his son turned down Morehouse. A close friend told him he had to get over it and focus on kids who wanted the HBCU experience.· Founded The BLERD Academy, a combination of the words Black and Nerd in 2016 in Oakland; a non-profit wealth-building program that assists high-achieving Black American students graduate, debt-free from more than 100 HBCUs.· Found the first BLERD while working at a Bay Area JSU Black College Expo booth. It was 6'5 honor roll student, Phillip Patrick Jr. who had a 3.6 GPA and 28 ACT score. Fort offered him a full-ride Presidential scholarship to Jackson State on the spot.· Phillip Patrick had played baseball all his life and thought he would have to continue playing in college on scholarship. When he received the full-ride, he told his mother he no longer wanted to play baseball, he wanted to be a brain surgeon.· Patrick Jr. majored in Biology Pre-Med and graduated from JSU in 2020. He is now in the 3rd year of a five-year medical program at UC Irvine Medical School where he will receive his Master's in Public Health and Medical Degree in Cardiac Anesthesiology. UC Irvine is fully financing his medicaldegree. He is engaged to a fellow Blerd who graduated from Howard University and is in Medical School at the David Geffen School of Medicine at UCLA. Also debt free.· Fort advises his kids to leverage their B.L.E.R.D and secure their bag of money through graduate school.· He is especially passionate about young Black men from tough neighborhoods like he came from.· He is a big proponent of kids buying property as early as possible.· Fort says: “This is a spiritual calling. My mission is to rebuild our community, and it starts with young men because they are the ones who will be the providers for their families. We exist as an organization to build a healthy community that is Black, Educated, Resourceful, and Determined, and we are doing it one B.L.E.R.D at a time.”· Website: www.theblerdacademy.com, Instagram: TheBlerdAcademy #STRAW #BEST #SHMSSupport the show: https://www.steveharveyfm.com/See omnystudio.com/listener for privacy information.
Two-time Emmy and Three-time NAACP Image Award-winning television Executive Producer Rushion McDonald interviewed Douglass Fort. He founded The Blerd Academy (Black Nerds). It's a wealth building program that helps High-Achieving Black-American youth get scholarships to HBCU's. They have secured over $8 million dollars in scholarships! Please welcome to Money Making Conversations Master Class Douglass Fort. Why did you start the Academy? What are some outcomes of the Academy? Why should the Black-American community highlight our nerds? · Since 2016 Fort has secured $8 million in scholarships for 63 high-achieving Black American students. Full-ride and tuition-only scholarships to HBCUs through graduate school.· PJ's sister, Marissa, also went through the program. She graduated Cum Laude from Hampton University with a degree in Accounting, earned a Master's degree from Columbia University all debt-free, and now works for Deloitte in New York City.· Other success stories: A Tennessee State U graduate now works in the front office for the NFL's Chicago Bears.· Two are Obama-Cheskey Voyager scholars.· Fort says: “We don't talk enough about Black scientists, mathematicians, and doctors. Only 1% of athletes make it to the NFL. We're hustling backward having our kids focus on sports over education.”· Criteria for the students he assists: a 3.5 GPA, a 28 ACT score, or a 1300 SAT score for a full-ride scholarship, or a minimum 3.2 GPA, a 23 ACT score, or an 1130 SAT score for tuition-only scholarships. AP and/or Honors classes, community service, and school leadership is also beneficial.· Since the 2023 U.S. Supreme Court ruling of Students for Fair Admissions, Inc. v. President and Fellows of Harvard College and Students for Fair Admissions, Inc. v. University of North Carolina struck down Affirmative Action in college admissions Fort has been busy.· Several HBCUs saw a surge in applications, including Washington D.C.'s Howard University, Clark-Atlanta University, which outpaced the University of Georgia, and Florida Agricultural Mechanical University (FAMU).· Fort says: Parents just don't know there is money and resources at these institutions for their high-achieving students, but they should because their kids have excelled in the classroom, and they deserve it.” MONEY MAKING CONVERSATIONS TALKING POINTSGuest: Douglass J. Fort, Founder, The BLERD Academy· Grew up in East Palo Alto, California· Liked school but got caught up in the streets· Was shot as a teen.· A childhood friend suggested he apply to Jackson State University. When he was accepted, hesitated, but did go.· Graduated from JSU. A Criminal Justice Major/Urban Affairs/Development minor. After graduation, he returned to East Palo Alto where he started the violence prevention program, For Youth By Youth.· Worked with law enforcement to help clean up Black neighborhoods.· His son received a full-ride athletic scholarship to Morehouse College but turned it down to play Division 1 Football at a PWI, and never played.· Doug was heartbroken that his son turned down Morehouse. A close friend told him he had to get over it and focus on kids who wanted the HBCU experience.· Founded The BLERD Academy, a combination of the words Black and Nerd in 2016 in Oakland; a non-profit wealth-building program that assists high-achieving Black American students graduate, debt-free from more than 100 HBCUs.· Found the first BLERD while working at a Bay Area JSU Black College Expo booth. It was 6'5 honor roll student, Phillip Patrick Jr. who had a 3.6 GPA and 28 ACT score. Fort offered him a full-ride Presidential scholarship to Jackson State on the spot.· Phillip Patrick had played baseball all his life and thought he would have to continue playing in college on scholarship. When he received the full-ride, he told his mother he no longer wanted to play baseball, he wanted to be a brain surgeon.· Patrick Jr. majored in Biology Pre-Med and graduated from JSU in 2020. He is now in the 3rd year of a five-year medical program at UC Irvine Medical School where he will receive his Master's in Public Health and Medical Degree in Cardiac Anesthesiology. UC Irvine is fully financing his medicaldegree. He is engaged to a fellow Blerd who graduated from Howard University and is in Medical School at the David Geffen School of Medicine at UCLA. Also debt free.· Fort advises his kids to leverage their B.L.E.R.D and secure their bag of money through graduate school.· He is especially passionate about young Black men from tough neighborhoods like he came from.· He is a big proponent of kids buying property as early as possible.· Fort says: “This is a spiritual calling. My mission is to rebuild our community, and it starts with young men because they are the ones who will be the providers for their families. We exist as an organization to build a healthy community that is Black, Educated, Resourceful, and Determined, and we are doing it one B.L.E.R.D at a time.”· Website: www.theblerdacademy.com, Instagram: TheBlerdAcademy #STRAW #BEST #SHMSSee omnystudio.com/listener for privacy information.
Two-time Emmy and Three-time NAACP Image Award-winning television Executive Producer Rushion McDonald interviewed Douglass Fort. He founded The Blerd Academy (Black Nerds). It's a wealth building program that helps High-Achieving Black-American youth get scholarships to HBCU's. They have secured over $8 million dollars in scholarships! Please welcome to Money Making Conversations Master Class Douglass Fort. Why did you start the Academy? What are some outcomes of the Academy? Why should the Black-American community highlight our nerds? · Since 2016 Fort has secured $8 million in scholarships for 63 high-achieving Black American students. Full-ride and tuition-only scholarships to HBCUs through graduate school.· PJ's sister, Marissa, also went through the program. She graduated Cum Laude from Hampton University with a degree in Accounting, earned a Master's degree from Columbia University all debt-free, and now works for Deloitte in New York City.· Other success stories: A Tennessee State U graduate now works in the front office for the NFL's Chicago Bears.· Two are Obama-Cheskey Voyager scholars.· Fort says: “We don't talk enough about Black scientists, mathematicians, and doctors. Only 1% of athletes make it to the NFL. We're hustling backward having our kids focus on sports over education.”· Criteria for the students he assists: a 3.5 GPA, a 28 ACT score, or a 1300 SAT score for a full-ride scholarship, or a minimum 3.2 GPA, a 23 ACT score, or an 1130 SAT score for tuition-only scholarships. AP and/or Honors classes, community service, and school leadership is also beneficial.· Since the 2023 U.S. Supreme Court ruling of Students for Fair Admissions, Inc. v. President and Fellows of Harvard College and Students for Fair Admissions, Inc. v. University of North Carolina struck down Affirmative Action in college admissions Fort has been busy.· Several HBCUs saw a surge in applications, including Washington D.C.'s Howard University, Clark-Atlanta University, which outpaced the University of Georgia, and Florida Agricultural Mechanical University (FAMU).· Fort says: Parents just don't know there is money and resources at these institutions for their high-achieving students, but they should because their kids have excelled in the classroom, and they deserve it.” MONEY MAKING CONVERSATIONS TALKING POINTSGuest: Douglass J. Fort, Founder, The BLERD Academy· Grew up in East Palo Alto, California· Liked school but got caught up in the streets· Was shot as a teen.· A childhood friend suggested he apply to Jackson State University. When he was accepted, hesitated, but did go.· Graduated from JSU. A Criminal Justice Major/Urban Affairs/Development minor. After graduation, he returned to East Palo Alto where he started the violence prevention program, For Youth By Youth.· Worked with law enforcement to help clean up Black neighborhoods.· His son received a full-ride athletic scholarship to Morehouse College but turned it down to play Division 1 Football at a PWI, and never played.· Doug was heartbroken that his son turned down Morehouse. A close friend told him he had to get over it and focus on kids who wanted the HBCU experience.· Founded The BLERD Academy, a combination of the words Black and Nerd in 2016 in Oakland; a non-profit wealth-building program that assists high-achieving Black American students graduate, debt-free from more than 100 HBCUs.· Found the first BLERD while working at a Bay Area JSU Black College Expo booth. It was 6'5 honor roll student, Phillip Patrick Jr. who had a 3.6 GPA and 28 ACT score. Fort offered him a full-ride Presidential scholarship to Jackson State on the spot.· Phillip Patrick had played baseball all his life and thought he would have to continue playing in college on scholarship. When he received the full-ride, he told his mother he no longer wanted to play baseball, he wanted to be a brain surgeon.· Patrick Jr. majored in Biology Pre-Med and graduated from JSU in 2020. He is now in the 3rd year of a five-year medical program at UC Irvine Medical School where he will receive his Master's in Public Health and Medical Degree in Cardiac Anesthesiology. UC Irvine is fully financing his medicaldegree. He is engaged to a fellow Blerd who graduated from Howard University and is in Medical School at the David Geffen School of Medicine at UCLA. Also debt free.· Fort advises his kids to leverage their B.L.E.R.D and secure their bag of money through graduate school.· He is especially passionate about young Black men from tough neighborhoods like he came from.· He is a big proponent of kids buying property as early as possible.· Fort says: “This is a spiritual calling. My mission is to rebuild our community, and it starts with young men because they are the ones who will be the providers for their families. We exist as an organization to build a healthy community that is Black, Educated, Resourceful, and Determined, and we are doing it one B.L.E.R.D at a time.”· Website: www.theblerdacademy.com, Instagram: TheBlerdAcademy #STRAW #BEST #SHMSSee omnystudio.com/listener for privacy information.
Send your questions or provocations to Adam or Budi here!For our final playwright interview in the 2024 Audio New Play Festival, Adam and Budi sit down with Sneha Sakhare to discuss her audio play 'Ragas of the Rooted Heart'.Sneha is an actor, singer, writer, voiceover artist, and teacher from Yavatmal, India, currently based in New York City. Her work is deeply rooted in ‘Prasada Budhi,' which means a mindset of thinking that everything is a divine offering with whatever is presented to us, shaped by her spiritual background in Yoga through her father and the teachings in Vedas. As an actor, Sneha is a classically trained clown with intensive four-year training with her teacher-mentor Christopher Bayes at the Pandamonium Studio. She has also been trained with Aitor Basauri (Clown, Bouffon), Jim Calder (Intensive Acting, Commedia), and Budi Miller (Balinese performing arts and mask work) in Bali, Indonesia. Sneha has completed her 1-year acting conservatory program at The Barrow Group theatre company, Manhattan, 2017-18. As a singer trained in Indian Classical Music for almost a decade, Sneha as a bhajan (devotional song) singer has been offering her performances at numerous spiritual centers, pilgrimages, and temples in India. She has received many prestigious accolades like ‘Singing Idol' and ‘Voice of the Region' through which she performed on National television and had experience performing in concerts in front of thousands of people in various cities of India.Sneha received her Bachelor's in Electronics and Telecommunication Engineering from India and worked for 4 years as an engineer where she created corporate theatre performances immersed in music and corporate theories.Sneha has been awarded multiple scholarships as a performer which includes a one-year full scholarship by Christopher Bayes at Pandamonium Studio in 2020, ‘The Eugene O'Neill Scholarship' in 2021 at Oneil Theatre, Waterford, CT, and “A distinct 2-year fellowship from Lin-Manuel Miranda and the Miranda Family for emerging artists of color who have exhibited exceptional passion, drive, and unique points of view in various artistic mediums – including but not limited to theatre, dance, film, visual arts, and music – and is actively working to expand her professional development,2021-2023”She has written and performed original works like ‘Pandemic Chapati' and devised a piece called ‘Glimpse' in collaboration with Global majority artists for Rattlestick Theatre Company, New York City in 2021. Currently, Sneha is on her one-year apprenticeship program as a teacher with Christopher Bayes at the David Geffen School of Drama at Yale University, New Haven, CT, and at the PandamonTiny Bar ChatsChats with influential, inspiring, prolific and community oriented folks.Listen on: Apple Podcasts SpotifySupport the showIf you enjoyed this week´s podcast, please leave a review on Apple Podcasts. To submit a question: Voice- http://www.speakpipe.com/theatreofothers Email- podcast@theatreofothers.com Show Credits Co-Hosts: Adam Marple & Budi MillerProducer: Jack BurmeisterMusic: https://www.purple-planet.comAdditional compositions by @jack_burmeister
The pursuit of your dream job is often considered Plan A, but life's responsibilities may cause you to consider a side job or what many consider Plan B. So, what if Plan B aligned with Plan A? Would the dream still be worth the pursuit? In this week's episode of Our 4th Annual Divine 9 Series, we are joined by Caleb Armstrong, Gamma Epsilon Chapter member of Omega Psi Phi Fraternity, Inc. During COVID, Caleb decided to participate in a theatrical Zoom production of ‘The Colored Museum' at the suggestion of his advisor. He did not know what to expect, but he thoroughly enjoyed the experience and is now in pursuit of a Theatre Arts degree at Hampton University in Hampton, Virginia. Find out how he maintains his desire for a career in Acting while he waits for his dream job to come along, and why he believes Generation Z will be the most important voice in this year's upcoming election. Caleb is currently completing his major in Theatre Performance and his minor in Leadership Studies at Hampton University. He has thrived by taking part in several productions that have included both musicals and dramatic plays. In Spring 2024, he also became the Phi Mu Chapter member of the Alpha Psi Omega National Theatre Honor Society. Caleb's long-term goal is to be a professional actor in television and film, and he plans to attend graduate school, preferably the David Geffen School of Drama at Yale. He then plans to continue his aspirations in his hometown of Los Angeles, California. To learn more about Caleb, connect with him on IG @caleb_cmoney or visit him on LinkedIn.
Ken Landau talks with Stephen Sideroff, Professor of Psychology and Clinical Psychologist at the David Geffen School of Medicine at UCLA, who guides lawyers on how to build resilience while reducing stress. He is the author of "The 9 Pillars of Resilience."
LBLT Welcomes Kemar Jewel, Director Of Ain't No Mo' at David Geffen School Of Drama At Yale by WNHH Community Radio
JCO PO author Dr. Amar U. Kishan, Professor, Executive Vice Chair, and Chief of Genitourinary Oncology Service in the Department of Radiation Oncology at the University of California, Los Angeles, shares insights into his JCO PO article, “Transcriptomic Profiling of Primary Prostate Cancers and Nonlocalized Disease on Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography: A Multicenter Retrospective Study.” Host Dr. Rafeh Naqash and Dr. Kishan discuss the relationship between Decipher genomic classifier scores and prostate-specific membrane antigen (PSMA) PET/CT-based metastatic spread. 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 articles. I'm your host, Dr. Rafeh Naqash, Assistant Professor at the OU Health Stephenson Cancer Center at the University of Oklahoma. Today we are joined by Dr. Amar Kishan, Executive Vice Chair of the Department of Radiation Oncology at the David Geffen School of Medicine at UCLA and UCLA Jonsson Comprehensive Cancer Center, and also the corresponding and senior author of the JCO Precision Oncology article entitled, “Transcriptomic Profiling of Primary Prostate Cancers and Non Localized Disease on Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography/Computed Tomography: A Multicenter Retrospective Study.” Dr. Kishan, welcome to our podcast and thank you for joining us today. Dr. Amar Kishan: Thank you so much for that kind introduction and the invitation to be here today. Dr. Rafeh Naqash: Well, it seems to me that there's a theme that people in the GU space, investigators in the GU space, are very interested in trying to understand risk predictors for prostate cancer. We had somebody, I believe from Huntsman Cancer Center a few months back on a previous podcast, where they were trying to do risk prediction modeling as well. Could you tell us why that's something that the GU community is very interested in? What's the background? Is it because there's no risk prediction approaches currently? And would this somehow influence management in the near future? Dr. Amar Kishan: Yeah, that's a great question. So, I think this goes back to the point that we're in the era of precision medicine now, and many cancers have these molecular stratification scores and all that. Prostate cancer has lagged a little bit behind in that regard, despite the fact that it's such a common cancer that affects so many people across the country and across the world. So, we do have risk stratification schemes for prostate cancer. These are based off clinical and pathologic variables, like the level of PSA, the size of the tumor on digital rectal examination, now, we're incorporating MRI imaging as well, and then what the cancer looks like under the microscope, the Gleason score. And now there have been revisions to the Gleason score, but it's really kind of the architecture, what the biopsy looks like. And this was kind of developed many, many years ago by Donald Gleason, a pathologist at the VA. What we're not necessarily taking into account routinely is kind of the biology of the cancer per se. You know, what are the molecular drivers? How could that influence ultimate outcome? And that's very important because we have these risk groups, low risk, very low risk, favorable intermediate risk, unfavorable intermediate risk, high risk, very high risk. But within each of those groups, based on the clinical kind of pathological characteristics, there's a huge heterogeneity in outpatients too, and our treatments are effective, but they can be morbid. Putting someone on hormone therapy for an extended period of time has a lot of side effects. Dose escalating radiotherapy or doing surgery and then radiation afterwards, these are big things that have a big impact on the patient, and I think we really need better risk stratification tools to understand who needs intensification and who we can de-escalate treatment for. Dr. Rafeh Naqash: I think those are absolutely valid points, perhaps not just for prostate cancer, more so for all cancers that we currently treat, especially in the current day and age, where we have a tendency to add more and more therapies, combination therapies for patients, and as you mentioned, risk stratification to help identify high risk versus low risk, where you can de intensify treatment, is of high value from a patient standpoint as well as from a financial toxicity standpoint. So then, going to this next part of the approach that you used, and from what I understand in this paper, you had the radiological aspect, which is the PSMA PET, which we'll talk about. Then you had the genomic aspect, where you did some genomic risk-based stratification. Then you had the transcriptomic score based on the Decipher score. So, could you go into some of the details, first, for the PSMA PET, when is it used? What is the utilization? What is it based on, the science behind the PSMA PET? And then we can talk about some of the other genomic transcriptomic predictors that you use in this study. Dr. Amar Kishan: Sure. Absolutely. So, a PSMA PET is an advanced molecular imaging tool. PSMA stands for prostate specific membrane antigen. It's a membrane protein that is expressed on the surface of prostate cancer cells. It is expressed elsewhere in the body as well. The utilization of this for imaging has been a revolution in the staging of prostate cancer, both upfront and in the recurrent setting. We basically had fairly recent approval for PSMA PET being used more routinely in upfront staging and recurrent staging in 2022. Essentially, what this is it gives us an ability to detect whether prostate cancer has spread at a time of diagnosis or try to localize the recurrence. Now, no imaging test is perfect, of course, and a PET has a resolution of about 3 mm. There are questions about the sensitivity of the PET. You get it on a patient with high-risk disease, the PET is negative; you do surgery, there are positive lymph nodes. That can happen, but it's far superior to the tools that we have had before. For instance, beforehand, all we would have is a contrast enhanced CT, bone scan, and MRI. And the sensitivity of those is far below that of a PSMA PET. And that has actually been shown in a randomized trial called the ProPSMA trial out of Australia, where they compared conventional upfront imaging versus PSMA upfront imaging with a crossover design, and there was better detection of disease with the PSMA PET. So that's been a revolution in how we stage prostate cancer. But I'm sure many of your listeners and others are aware of the concerns. When you get a new test and you're detecting disease that's extra prostatic, for instance, are you seeing truly significant new disease that we do need to change our management for, or are we just seeing stuff that wasn't there before that actually wouldn't impact anything? And what I mean by that is, let's say you're seeing things that would never have made a difference to the patient, but now you're saying they have metastatic disease. You're changing their entire treatment paradigm, all kinds of things like that. There's implications to this that hasn't been fully fleshed out. But very recently, like we're talking in July of 2024, essentially, there was a Lancet Oncology paper that looked at the long-term prognosis of patients who had extra prostatic disease on PSMA PET, judged by something called a PROMISE score, kind of gives a quantification on the volume of disease, the brightness of disease, and they correlated that with long term outcomes. And that was really the first time that we have long term follow up data that this extra prostatic disease on PSMA PET actually is prognostically important. So, we're getting there. I mean, now that it's approved and, in some sense, the cat is out of the bag, patients are coming in asking for a PSMA PET, etc. I'm sure everyone has experienced that, but I think we now do have good evidence that it actually is prognostically important as well. Dr. Rafeh Naqash: Thank you for that explanation. And again, to put this into context for things that I've seen and that might also help the listeners in other tumors, so, for example, melanoma surveillance tends to be or while on treatment, patients tend to have more PET scans than what you see, maybe in individuals with lung cancer, where you get a baseline PET and then you have follow up CT scan based imaging is that something that you guys have shifted from in the prostate cancer space with the approval for PSMA PET, where follow up imaging, whether patient is on treatment or surveillance imaging, is PSMA PET based? Dr. Amar Kishan: Yeah, that's a good question. I think there's actually less robust data to support it as a means of treatment response. But in terms of evaluating a recurrence, then, yes, that has become kind of a standard tool. It's very complicated because all of the metrics that we have for, say, a treatment failing are based on conventionally detected metastases or something that shows up on a CT or bone scan. So, again, that question arises if someone is on systemic therapy and then you see something on a PSMA PET, are you going to abandon the therapy that you're on? It technically would be earlier than you would otherwise have done that, or what are you going to do? So, that hasn't been fully fleshed out, but it is used in that circumstance. So, I'd say less for treatment monitoring and more for evaluation of suspected recurrence. Dr. Rafeh Naqash: Understood. And I'm guessing, as a futuristic approach, somebody out there may perhaps do a trial using PSMA PET based imaging to decide whether treatment change needs to be made or does not need to be made. Dr. Amar Kishan: Yeah. It is being incorporated into trials as we speak, I think. Dr. Rafeh Naqash: Now, going to the second part of this paper is the Decipher score. Could you explain what the score is, what its components are, how it's calculated? Is it DNA, is it RNA, is it both combined? Is it tissue based; is it blood based? Dr. Amar Kishan: Yeah. So, the Decipher is also an approved test now, was approved in 2018. What it is, essentially, and how it's derived is based on the idea originally that patients might have a recurrence after surgery for prostate cancer. And it's just a PSA recurrence. It's this way. It's literally what we call a biochemical recurrence. That patient might not have any problems, whereas other patients with a recurrence might go on to develop metastatic disease. And we didn't have a good way of determining which patient is which. Get back to that prognostic problem that we have. So, some investigators, they looked at men that had radical prostatectomy from 1987 to 2001 at the Mayo Clinic that had archived tissue. They looked at FFPE, or basically paraffin embedded tissue. They extracted the RNA and then did a microarray analysis and looked at transcriptomic signatures and wanted to see, could this discern the patients who had mets, who had clinically significant recurrences from those that didn't? And out of that exercise came the Decipher Genomic Classifier, which basically is based on 22 genes. These are involved with cell proliferation, etc., but it's an RNA-based, tissue-based assay. So, if you wanted to order a Decipher on somebody, you would need to use a biopsy or prostatectomy specimen to do so. Essentially, that the samples, they would take the highest grade, highest Gleason grade specimen, send it to their lab. Their main lab is in California. The company is called Veracyte. And then they will do this RNA express analysis with a microarray and then return a score. The score is 0 to 1. Basically, 0 is the lowest, one is the highest, and it is a way of prognosticating the risk of metastasis. Originally, when you get a Decipher report, it actually will tell you the 5 and 10-year risks of distant metastasis, and we'll quantify that. Dr. Rafeh Naqash: And you said this is approved or has been approved in 2018. So, is this insurance reimbursable at this point? Dr. Amar Kishan: Most insurances do, not all, and the criteria for getting it can vary, so we can talk about it, but it was initially developed in this post-op setting. On the basis of a significant amount of validation studies, it has been moved to being used in the upfront setting as well. So, if you look at some of the ongoing NRG trials, for instance, they are stratifying patients based off the upfront Decipher score. And this is based off of validation studies that have been conducted looking at past RTOG trials and other trials. That said, sometimes it is not approved by commercial insurances in the upfront setting, because that wasn't where it was initially validated and derived. But honestly, here in 2024, that's very uncommon. It's much more common that it's approved. Dr. Rafeh Naqash: Understood. And in your practice, or the medical oncologist practice at your institution or other institutions, is this something that is commonly used for some sort of treatment decision making that you've seen? Dr. Amar Kishan: Yeah. So, as a radiation oncologist, I do think it's a useful test, because my approach is, if we're talking about adding hormone therapy, for instance, which is oftentimes dominating the conversation, we know that it offers a relative benefit to a lot of patients. We've published on this; others have published on it. Let's say it reduces the chance of metastasis by about 40%. 10-year risk of metastasis has a ratio of 0.6. So, 40% reduction. But if your risk of metastasis is 2%, that benefit is not that much in absolute terms. And we don't historically have a great way of saying, what is your absolute risk of metastasis? And I think Decipher is one tool that does tell us that - it literally gives it on the report. Now, is that a holy grail? Is it 100% accurate? Nothing is 100% accurate. But it does give us some quantification. Then I can go back to the patient and say, yes, you will get a benefit from adding hormone therapy, but you're talking about going from 2% to 1%, and so they can decide if that's worth it to them. Conversely, it could be a situation where they really don't want hormone therapy, but it comes back that their risk of metastasis is 20%, and then there's actually a big absolute benefit. So that's how I use it as a radiation oncologist, and we would use it upfront. Now surgeons, and if I was consulting on a post operative patient, maybe it plays more of a role. And do we need to do post operative radiotherapy on this patient, or do we need to add hormone therapy in the postoperative situation? From the medical oncology perspective, there are emerging data that may be useful in the choice of systemic therapy for metastatic disease, but that is a little bit earlier in the investigational stage, I would say. So, when I'm working with medical oncologists, it's often still in this localized setting, and typically, do we add hormone therapy or not, and that type of thing. Dr. Rafeh Naqash: Understood. And from a reporting standpoint, so the Decipher score, I'm guessing it's some sort of a report that comes back to the ordering physician and you basically see the score, it gives you a potential recurrence free survival percentage or a metastasis percentage of what is your risk for having metastasis in the next five years - is that how they generally do it? Because I've personally never seen one, so I'm just curious. Dr. Amar Kishan: Yeah, essentially, it comes back with a score, a numerical score, again, from 0 to 1, and it will basically give you the five-year risk of distant metastasis. The ten-year risk of distant metastasis. You can request an extended report that provides additional, not as well supported signatures that are out there, like ADT response signature, etc. But those maybe may have been published, but are not clinically validated as much, but the actual Decipher report, which goes to patients too, just has this kind of 5,10-year risk of distant metastasis. They have some estimations on prostate cancer specific mortality as well. Dr. Rafeh Naqash: Sure. Now, the third part of this project, and correct me if I'm wrong, the grid database of the 265 genomic signature score. From what I understood, this is a different component than the Decipher score. Is that a fair statement? Dr. Amar Kishan: Yeah. No, that's exactly correct. And that was an exploratory part of this analysis, to be honest. Basically, I think our main focus in the paper was those advances that we've talked about PSMA and Decipher, those happened concurrently. People started developing PSMA PET, people started developing Decipher. And so, what we wanted to understand was, if you have a patient that has extra prosthetic disease on PSMA PET, are those biologically more aggressive cancers, is their Decipher score going to be higher? What can we learn about the biology of this? And we were the first, to my knowledge, where we actually had a large data set of patients that actually received PSMA PETs and Decipher. And that's kind of the gist of the paper. We have patients in the upfront setting, patients in the post radical prostatectomy setting, and we're essentially showing that there is this correlation. In the upfront setting, the odds of extra prosthetic disease are higher for higher Decipher scores, which is kind of maybe validating that this biology is capturing something that's akin to this ability to spread. And in the post-op setting, because we have time to failure, technically, we can calculate a hazard ratio rather than odds ratio. So, we have a hazard ratio that's significantly associated with an increased risk of spread for patients with higher Decipher. The grid portion, which is the genomic resource information database, was more of an exploratory part where I mentioned the Decipher score is based off this microarray, they're looking at 1.4 million transcripts. Only 22 are part of the Decipher, but you can request the rest of the signature data as well. And so, we wanted to look at other pathways, other signatures that have been published, like looking at DNA repair, neuroendocrine pathway, just to see if we could see any correlations there that's not necessarily as clinically actionable. These are more exploratory. But again, we were trying to just look at whether patients who had non localized disease on their PSMA PET, whether their primary had more aggressive biology. We did see that. So that's kind of loosely speaking things like PTEN loss, androgen receptor, DNA repair, metabolism, neuroendocrine signaling, which are thought to be portenders of aggressive disease. Those pathways were upregulated at the RNA level in patients who had non-localized disease. And that's kind of the take home from that. But I wouldn't say any of that is clinically actionable at this point. It's more kind of defining biology. Dr. Rafeh Naqash: Some of the interesting correlations that you make here, at least in the figures that we see, you're looking at different local occurrences, nodal metastases, M1A and M1B disease. And one thing that I'm a little curious about is the Decipher score seems to be lower in pelvic nodal metastasis, that is, PSMA PET positive versus local recurrence, which has a slightly higher Decipher score. Is that just because of a sample size difference, or is there a biologically different explanation for that? Dr. Amar Kishan: Yeah, that's a good point. I would assume that's probably because of a sample size in this case, and it's a little bit complicated. It wasn't statistically different. And it was 0.76 on average for patients with local recurrence and 0.7 for patients with a pelvic nodal metastasis. Well, what I think is interesting is we can maybe think that in this post-op setting the time to failure could have been long in some of these cases. So, it is conceivable that an isolated nodal recurrence 10 years after the surgery, for instance, is not as aggressive a cancer as a local recurrence in a short time after the surgery. And that's not taken into account when you're just looking at median scores like we are in this fox and whiskers plot. But overall, I think what it's suggesting is that there are patients who have more indolent disease. That's actually pretty widespread there. There are pretty indolent cases that have these nodal metastases. So just because you have a nodal metastasis doesn't mean it's an incredibly aggressive cancer, biologically. Dr. Rafeh Naqash: Now, the exploratory component, as you mentioned, is the grid part where you do look at TP53, which is a cell cycle gene, and higher TP53 associated with worse recurrences, from what I understand. Do you see that just from a cell cycle standpoint? Because from what I, again, see in the paper, there's a couple of other cell cycle related signatures that you're using. Is that just a surrogate for potential Gleason score? Have you guys done any correlations where higher Gleason score is associated with maybe higher cell cycle checkpoint, pathway related alterations and replication stress and DNA damage and perhaps more aggressive cancers? Dr. Amar Kishan: Yeah, that's a great question. We haven't done that in this paper, but it has been published before that there is this correlation loosely between grade and some of these parameters - so repair, metabolism, androgen receptor signaling. However, it's a very great point that you bring up, which is that it's pretty heterogeneous and that's why we need something like this as opposed to Gleason score. So, you can have Gleason 10 cancer. I mean, that would be pretty uncommon. But within the Gleason 9, at least, which we have published on and looked at, there's a heterogeneity. There are some that are biologically not that aggressive. And the converse Gleason 7, you can have some that are actually biologically aggressive. That's why it may be useful to move away from just the pathological architecture and get a little bit more into some of these pathways. Dr. Rafeh Naqash: What's the next step here? I know this perhaps isn't ready for primetime. How would you try to emphasize the message in a way that makes it interesting and clinically applicable for your colleagues in the GU community? Dr. Amar Kishan: Yeah. I think for me, what I would try to emphasize here and what I think is the main takeaway is this is kind of a validation that having extra prostatic disease on PSMA PET is likely suggestive of a more aggressive disease biology. And I think what this stresses to me is the importance of getting a PSMA PET, particularly in patients with high-risk prostate cancer. This isn't always happening. And I think if we see things on a PSMA PET, we really need to consider systemic therapy intensification. And what do I mean by that as a practical point? You have a high-risk prostate cancer patient. You get a PSMA PET, you see an isolated pelvic lymph node. If we believe the results of the study, that's a more aggressive biology likely. Whether we have the Decipher or whether we have genomic signatures, which we may or may not have, maybe that patient should get treated with something like an androgen receptor signaling inhibitor in addition to ADT, more akin to a clinically node positive case. So, intensify the systemic therapy, more aggressive disease. That's how I would incorporate it practically into my practice, that really what we're seeing on the PSMA PET is real. It's a reflection of biology that's aggressive. It's not just some Will Rogers effect where you're upstaging stuff needlessly. I think this is telling us some true biology. So that's kind of what my takeaway would be. I think future areas of investigation would be, honestly, to try to have a better idea of what's going on in these metastases. So, if you could design a study potentially, where your biopsy some of these and actually do sequencing and understand a little bit more of that. And so, we're looking into stuff like that. But my takeaway for like the everyday clinician would be to try to get a PSMA PET, if you can, and to intensify therapy on the basis of that, or at least consider it, discuss it in a multidisciplinary setting. Dr. Rafeh Naqash: And I'm guessing somebody out there, perhaps even you, are thinking or planning on doing a ctDNA MRD based correlation here, since that's up and coming in this space. Dr. Amar Kishan: That is up and coming, I think one of the challenges in prostate cancer is the amount of ctDNA can be low. But yes, you're right, that's certainly things that a lot of us are looking at, too. Dr. Rafeh Naqash: Excellent. Well, thank you for the science discussion, Dr. Kishan, could you tell us a little bit about yourself, your career trajectory, where you started, what you're doing, and perhaps some advice for early career junior investigators, trainees, things that might have worked for you, that could also work for them as they are progressing in their careers. Dr. Amar Kishan: Sure. So, yeah, I'm a radiation oncologist at UCLA. I run the prostate cancer radiation program. Clinically. I'm also heavily involved in our research enterprise, so I kind of oversee the clinical and translational research aspect. That's what I do currently. So, I did my residency in radiation oncology at UCLA. Just on a personal note, my wife is from LA, her parents live in LA. We really wanted to stay in LA, so I was fortunate to be able to join the faculty here. I always liked GU oncology, so that was kind of a natural thing for me to kind of go into this position here and try to build the GU program. I've been very fortunate to have great collaborators. My message to students and trainees is to try to reach outside your department for mentorship as well. It's important to have people inside your department who can mentor you. But as a radiation oncologist, I work so closely with urology, so closely with medical oncology that I'm very fortunate to have individuals in those departments who have a vested interest in me and my success as well. I like working with them. It's important to be a team player. If they need help, you help them. If you need help, you ask for help from them. So, I think that's the single biggest thing that I would say to any trainee is don't be intimidated. Please reach outside of your department. Lots of people are willing to help and provide mentorship, and it's helpful to have that perspective. We are in a very multidisciplinary environment and era of practicing medicine. Dr. Rafeh Naqash: Well, thank you again for those personal insights and especially for submitting your work to JCO PO. And we hope to see more of this work perhaps in the subsequent sessions for JCO PO, and maybe we'll bring you back again. And at that point, the Decipher and the PSMA PET scan will have more data, more implementation in the clinically relevant real-world setting. Dr. Amar Kishan: Thank you very much. And if I could just give one quick shout out. The first author of this work, which I presented, was Dr. John Nikitas, who is a trainee that works with me here at UCLA a PGY5 resident. So, I do want to give credit to him as well. Dr. Rafeh Naqash: And John, if you're listening to this hopefully, it's always great to get a shout out from your mentor. Thank you both again for putting in the work and effort to submit this manuscript. 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/podcasts. 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. Disclosures Dr. Kishan Honoraria Company: Varian Medical Systems, Boston Scientific, Janssen Oncology Consulting or Advisory Role Company: Janssen, Boston Scientific, Lantheus Research Funding Company: Janssen , Point Biopharma
On October 10, 2024 we met with Ranmal Samarsinghe to talk about the use of cortical assembloids, three-dimensional cultures containing both excitatory and inhibitory neurons. to explore the development and function of the cerebral cortex. Guest: Ranmal Samarasinghe, an Assistant Professor in the Department of Neurology at the David Geffen School of Medicine at UCLA. Participating: Sara Mirsadegi, Department of Neuroscience, Developmental and Regenerative Biology, UTSA Host: Charles Wilson, Department of Neuroscience, Developmental and Regenerative Biology, UTSA
Dr. Lisa Mathew interviews Dr. Raman Muthusamy, professor of clinical medicine at the David Geffen School of Medicine at UCLA, and medical director of endoscopy for UCLA Health, about a new clinical guideline for endoscopic eradication therapy to prevent the progression of Barrett's esophagus to esophageal cancer. Esophageal cancer is preventable if high-risk patients, such as those with Barrett's Esophagus, are treated with endoscopic eradication therapy to eliminate the Barrett's tissue. Endoscopic eradication therapy is highly effective, but the challenge is identifying the high-risk patients to treat and the low-risk patients for whom long-interval surveillance may be appropriate. Join Dr. Mathew and Dr. Muthusamy as they explore new technologies for identifying patients who are most at risk and the potential innovations that could stop a majority of Barrett's Esophagus patients from progressing to esophageal cancer. Produced by Andrew Sousa and Hayden Margolis for Steadfast Collaborative, LLC Mixed and mastered by Hayden Margolis Gastro Broadcast, Episode 65
Just as big pharma has recently discovered a simple mechanism to reverse weight gain and obesity, it is highly likely that soon, we will discover something equally simple that triggers the onset of aging, postulates Joel Geiderman, a distinguished physician and professor at Cedars-Sinai and the David Geffen School of Medicine at UCLA who is considered one of the pioneers of emergency medicine. It could be as simple as a protein we can block. And with AI speeding up research, Geiderman firmly believes the day we “cure” aging is not far off. This entirely plausible concept is the basis for his novel, The Plasma Cell Report. But then what? Geiderman cautions that so much could go wrong, and that society and our planet are simply not ready for nature's course to change. He'd be happy to chat with you about this. Among the concerns he points to are:An ever-expanding population that will skew increasingly toward older people and could ostensibly double in number every twenty years.Uncertainty around whether Earth really has the natural resources - from energy to water and food - to support this ongoing population growth.Doubt about how to meet the increased need for infrastructure -- everything from transportation and housing to education and healthcare facilities.Questions over social issues such as entitlements such as social security and how to finance them as the number of retired people grows as a share of the population.Matters of equity: who would have access to the new treatments? What about those left behind?Moral issues such as: would we be interfering with a divine plan? Doesn't nature know best? And in times like these, we must also consider:The risk of older generations maintaining a grip on top leadership positions to the detriment of change and renewal; andThe potential dangers of lifetime terms for people in public office (e.g., the Supreme Court). As the father of the atomic bomb Robert Oppenheimer said, “The deep things in science are not found because they are useful; they are found because it is possible to find them.” Become a supporter of this podcast: https://www.spreaker.com/podcast/late-night-health-radio--2804369/support.
Just as big pharma has recently discovered a simple mechanism to reverse weight gain and obesity, it is highly likely that soon, we will discover something equally simple that triggers the onset of aging, postulates Joel Geiderman, a distinguished physician and professor at Cedars-Sinai and the David Geffen School of Medicine at UCLA who is considered one of the pioneers of emergency medicine. It could be as simple as a protein we can block. And with AI speeding up research, Geiderman firmly believes the day we “cure” aging is not far off. This entirely plausible concept is the basis for his novel, The Plasma Cell Report. But then what? Geiderman cautions that so much could go wrong, and that society and our planet are simply not ready for nature's course to change. He'd be happy to chat with you about this. Among the concerns he points to are:An ever-expanding population that will skew increasingly toward older people and could ostensibly double in number every twenty years.Uncertainty around whether Earth really has the natural resources - from energy to water and food - to support this ongoing population growth.Doubt about how to meet the increased need for infrastructure -- everything from transportation and housing to education and healthcare facilities.Questions over social issues such as entitlements such as social security and how to finance them as the number of retired people grows as a share of the population.Matters of equity: who would have access to the new treatments? What about those left behind?Moral issues such as: would we be interfering with a divine plan? Doesn't nature know best? And in times like these, we must also consider:The risk of older generations maintaining a grip on top leadership positions to the detriment of change and renewal; andThe potential dangers of lifetime terms for people in public office (e.g., the Supreme Court). As the father of the atomic bomb Robert Oppenheimer said, “The deep things in science are not found because they are useful; they are found because it is possible to find them.” Become a supporter of this podcast: https://www.spreaker.com/podcast/late-night-health-radio--2804369/support.
In this first annual William G. Bradley Memorial RLI Taking the Lead episode, sponsored by the California Radiological Society Foundation, host Geoffrey Rubin, MD, MBA, FACR, talks with Denise R. Aberle, MD, Professor of Radiological Sciences at the David Geffen School of Medicine at the University of California Los Angeles (UCLA) and Professor of Bioengineering in the UCLA Samueli School of Engineering.
On this Living to 100 Club podcast, our guest is Joel Geiderman, MD. Our guest has served as the co-chair of Emergency Medicine at Cedars-Sainai Medical Center in Los Angeles for thirty years. The focus of this podcast, however, centers on Dr. Geiderman's concerns about the ethical, social, and economic consequences of stopping the natural aging process. What happens if people no longer get old? In his new medical thriller, The Plasma Cell Report, our guest has taken up the serious societal dilemmas that are posed if and when the aging process is cured – that is, stopped. If the aging clock starts at some point, what will happen when science learns how to stop it? Will there be competition for life-prolonging treatments? Can we run out of resources to provide for everyone on the planet? Will a policy like “death control” become necessary to pare down the elderly population? Alarming questions that are explored in our guest's new book of fiction, but questions that must be raised as science flirts with prolonging life indefinitely. Mini Bio Dr. Joel Geiderman has been practicing medicine for more than forty years. He has been the co-chair of Emergency Medicine at Cedars-Sinai Medical Center in Los Angeles for thirty years. He is a professor at both Cedars-Sinai and the David Geffen School of Medicine at UCLA. Dr. Geiderman was also formerly the vice chair of the United States Holocaust Memorial Museum in Washington, DC, appointed by President George W. Bush. He has authored more than one hundred peer-reviewed papers and book chapters. This is his first novel. Dr. Geiderman lives in Beverly Hills with two of his four children and his dog, affectionately named Reagan. Website for Dr. Geiderman's Book https://theplasmacellreport.com/See omnystudio.com/listener for privacy information.
On this Living to 100 Club podcast, our guest is Joel Geiderman, MD. Our guest has served as the co-chair of Emergency Medicine at Cedars-Sainai Medical Center in Los Angeles for thirty years. The focus of this podcast, however, centers on Dr. Geiderman's concerns about the ethical, social, and economic consequences of stopping the natural aging process. What happens if people no longer get old? In his new medical thriller, The Plasma Cell Report, our guest has taken up the serious societal dilemmas that are posed if and when the aging process is cured – that is, stopped. If the aging clock starts at some point, what will happen when science learns how to stop it? Will there be competition for life-prolonging treatments? Can we run out of resources to provide for everyone on the planet? Will a policy like “death control” become necessary to pare down the elderly population? Alarming questions that are explored in our guest's new book of fiction, but questions that must be raised as science flirts with prolonging life indefinitely. Mini Bio Dr. Joel Geiderman has been practicing medicine for more than forty years. He has been the co-chair of Emergency Medicine at Cedars-Sinai Medical Center in Los Angeles for thirty years. He is a professor at both Cedars-Sinai and the David Geffen School of Medicine at UCLA. Dr. Geiderman was also formerly the vice chair of the United States Holocaust Memorial Museum in Washington, DC, appointed by President George W. Bush. He has authored more than one hundred peer-reviewed papers and book chapters. This is his first novel. Dr. Geiderman lives in Beverly Hills with two of his four children and his dog, affectionately named Reagan. Website for Dr. Geiderman's Book: https://theplasmacellreport.com
Dr Dana M Chase from the David Geffen School of Medicine at UCLA in Los Angeles, California, discusses select 2023 data sets on the management of ovarian, endometrial and cervical cancers, moderated by Dr Neil Love. Produced by Research To Practice. CME information and select publications here (https://www.researchtopractice.com/YiR2023/Gyn).
Dr Dana M Chase from the David Geffen School of Medicine at UCLA in Los Angeles, California, discusses select 2023 data sets on the management of ovarian, endometrial and cervical cancers.
“Our anger is “I'm angry because something happened that I feel was unjust or unfair” And if it continues, then I want my justice and you know, our injustices from childhood turn out to be society's burdens because I want payback here, even though you had nothing to do with it. So, hate and love go together because they're both strongly bonding connection, right? But really bond us in order to hate you, I've got to feel a lot about you, right? You did something to betray me, to violate me, to say, no, I can't do this, whatever it is. And so both are really strongly bonded, you know, just like anger is bonding. When we're angry with each other, it's a way to stay bonded and connected, even though it's unpleasant.” So says Stan Tatkin, an author, therapist, and researcher who guides couples toward more durable relationships. He developed the Psychobiological Approach to Couples Therapy (PACT), a non-linear approach that explores attachment theory to help couples adopt secure-functioning principles: In short, Stan and his wife, Tracey, train therapists to work through a psychobiological lens. Often, our brains get away from us when we're in conflict in our relationships—we lose ourselves to our instincts. He has trained thousands of therapists to integrate PACT into their clinical practice, offers intensive counseling sessions, and co-leads couples retreats with his wife. Tatkin is also an assistant clinical professor at the David Geffen School of Medicine at UCLA. Stan wrote Wired for Love: How Understanding Your Partner's Brain and Attachment Style Can Help You Defuse Conflict and Build a Secure Relationship more than a decade ago and it became an instant classic. It was due for a refresh to encompass the wider range of relationships we're now experiencing and it's just been re-issued, better than ever. In today's conversation we talk about the table stakes of a good relationship: Nobody cares about your survival more than your partner, something we easily forget. As it were, we get into a fascinating sidebar on Pre-Nuptial Agreements, which in Stan's estimation cause many relationships to founder. I'll let him tell you why. MORE FROM STAN TATKIN: Wired for Love: How Understanding Your Partner's Brain and Attachment Style Can Help You Defuse Conflict and Build a Secure Relationship In Each Other's Care: A Guide to the Most Common Relationship Conflicts and How to Work Through Them We Do Wired for Dating Stan Tatkin's Website Follow Stan on Instagram To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices
The gut-brain connection is a two-way communication system between your gut and brain. It's an intricate network of nerve cells, chemicals, and microbes and explains why your stomach produces juices when you think about food, and why stress can cause stomach cramps or a churning feeling. This connection links your central nervous system (CNS), including the brain, with the enteric nervous system (ENS) in your gut. Often referred to as the "second brain," the ENS significantly impacts (and creates a link between) gut health and mental health. Phrases like "gut-wrenching" or "butterflies in the stomach" illustrate this connection further, as our digestive system responds to emotions such as anger, anxiety, sadness, nervousness and happiness. Consequently, gastrointestinal issues can both cause and result from stress, anxiety, or depression; demonstrating the close relationship between the brain and the digestive system. So if we improve our gut health, we better our mental health. And in return, better mental health can alleviate certain digestive issues and lead to stronger gut health. Dr Emeran Mayer is a leading expert on the mind-gut connection. A world renowned and award winning gastroenterologist, neuroscientist and Distinguished Research Professor in the Departments of Medicine, Physiology and Psychiatry at the David Geffen School of Medicine at UCLA, Dr Emeran has accumulated 35 years of research on the clinical and neurobiological relationship between the digestive system and the nervous system. Dr Emeran is also a best selling author of the books “The Mind-Gut Connection”, “The Mind-Gut Immune Connection” and the recipe book “Interconnected Plates”. His work primarily explores the complex interactions between the gut and the brain, particularly how these interactions impact conditions like irritable bowel syndrome (IBS), chronic pain, and emotional well-being. In this episode of The Happier Life Project, Dr Emeran simplifies how the brain and gut communicate. He discusses the influence food has on our emotions and expresses his frustrations with ultra-processed food suppliers, for producing harmful and addictive products. Dr Emeran also explains the science behind the Mediterranean diet as a model for optimal gut health and shares research on the benefits of following a restricted eating window. By not not having food in your stomach 24 hours a day, you allow your gut to cleanse itself of unwanted bacteria in the small intestine and activate its 'housekeeper' function. To download the My Possible Self App: https://mypossibleself.app.link/podcast To follow My Possible Self on Instagram: https://www.instagram.com/mypossibleself For more information on Dr Emeran Mayer and the mind-gut connection: https://emeranmayer.com/ To follow on Dr Emeran Mayer on Instagram: https://www.instagram.com/emeranmayer All links to Dr Emeran's books, courses, masterclass and podcast: https://linktr.ee/emayer
Discussing innovative quantum radiation research for pediatric cancerBio for Dr. Kei Imawoto: I attended the University of California, Berkeley to earn a double AB degree in Physics and in Biochemistry. I received a PhD degree from the UCLA School of Medicine in Biomedical Physics in the specialty of Radiation Biology and Experimental Therapeutic Oncology. I then worked at the Radiation Effects Research Foundation (RERF) in Hiroshima, Japan, as a fellow of the U.S. National Academy of Sciences, to study the molecular mechanisms of radiation carcinogenesis among the atomic bomb survivors. RERF is a binational research institute funded equally be the governments of Japan and the U.S. I moved back the U.S. to accept a faculty position and set up a laboratory in the Division of Molecular and Cellular Oncology of the Department of Radiation Oncology within the David Geffen School of Medicine at UCLA.You can also get involved with the National Pediatric Cancer Foundation through fundraising, volunteering, promoting awareness, or contributing to pediatric cancer research. Visit nationalpcf.org for more information about the foundationTo contact Tiffany, please email tmcconathy@nationalpcf.org To contact Kelly, please email kgoddard@nationalpcf.org
Stan Tatkin, PsyD, MFT, author of Wired for Love, joins us to talk about the neuroscience of love. Stan is a clinician, teacher, researcher, and developer of the psychobiological approach to couples therapy (PACT). He and his wife, Tracey Boldemann-Tatkin, cofounded the PACT Institute to train other mental health professionals worldwide to use this method in their clinical work. Tatkin is an assistant clinical professor at the David Geffen School of Medicine at UCLA. He maintains a private practice in Southern California, and directs PACT programs in the US and internationally. He is author of In Each Other's Care and six other books. Visit our website at www.newharbinger.com and use coupon code 'Podcast25' to receive 25% off your entire order. Buy the Book: New Harbinger - https://bit.ly/3U4BO0n Amazon - https://a.co/d/fJCvaBr Barnes & Noble - https://www.barnesandnoble.com/w/1128699983 Bookshop.org - https://bit.ly/3U9J8I2 If you have ideas for future episodes, thoughts, or questions, we'd love to hear from you! Send us an email at podcast@newharbinger.com
Dr. Joseph Shirk is the Chief of Urology at the Greater Los Angeles VA Health System and Assistant Professor of Urology at David Geffen School of Medicine at UCLA. Dr. Shirk explains what constitutes the stages of testicular cancer, the different cell types, and breaks down what some of the common vocabulary is regarding testis cancer. Sponsored by Dee's Nuts. Use code "nutcheck" at checkout on https://grabdeesnuts.com Want to be a guest? Apply here: https://www.testicularcancerawarenessfoundation.org/it-takes-balls-submissions Follow Testicular Cancer Awareness Foundation: https://www.testescancer.org https://www.twitter.com/testescancer https://www.instagram.com/testescancer https://www.facebook.com/tca.org/ Connect with Dr. Shirk: https://www.uclahealth.org/providers/joseph-shirk Follow Steven Crocker: https://www.twitter.com/stevencrocker https://www.instagram.com/stevencrocker https://www.facebook.com/steven.crocker2 Theme song: No Time Like Now - Tom Willner www.tomwillner.com
ICYMI: Hour Two of ‘Later, with Mo'Kelly' Presents – ‘Beyond the Box Score' with regular guest contributor Jackie Rae; Long Beach Post/WNBA Reporter and host of ‘The Jackie Rae Show,' weighing in on the N.C.A.A.'s landmark athlete-pay settlement AND the suicide death of two-time PGA Tour winner Grayson Murray…PLUS – A look at iHeartWellness with Dr. Nicholas Bernthal the Chair and executive medical director of the Department of Orthopaedic Surgery at UCLA Health & the Chair and Executive Medical director at the David Geffen School of Medicine at UCLA - on KFI AM 640…Live everywhere on the iHeartRadio app
ICYMI: ‘Later, with Mo'Kelly' Presents – A look at iHeartWellness with Dr. Nicholas Bernthal; the Chair and executive medical director of the Department of Orthopaedic Surgery at UCLA Health & the Chair and Executive Medical director at the David Geffen School of Medicine at UCLA - on KFI AM 640…Live everywhere on the iHeartRadio app
William Cheng has been working in the Silicon Valley area since 2000. He graduated from Harvard as a bio concentrator and later attended UCLA's David Geffen School of Medicine. He completed residency training in internal medicine at Santa Clara Valley Medical Center, a county hospital affiliated with Stanford Hospital System. He then joined the Palo Alto Medical Foundation as a hospitalist, focusing on acutely ill patients. Working as a Hospitalist William's understanding of the world has changed over the two decades as a hospitalist. He now understands the importance of non-hard science aspects, such as interactions, communication skills, and bedside manners. He also learned logistical skills, such as navigating the healthcare system and getting patients in and out of the hospital efficiently. William talks about the need for continuous learning in his field, including navigating insurance and bureaucracy. He shares how the recent pandemic had a significant impact on the Bay Area, and how the hospital environment has evolved over time, with new challenges and opportunities for growth. William shares tips for being a smart patient in the hospital, such as asking questions, double-checking medication, and understanding the importance of being a smart consumer of hospital care. He emphasizes the importance of clear communication and respecting the intelligence of patients and families. William explains what makes a good doctor, and the various demands that come with the job, including intellectual demands, emotional demands, physical demands, and long hours on the feet. Challenges Faced by Hospitalists Hospitalists interact with patients and families more frequently during the day, especially in difficult situations such as difficult medical diagnoses, potentially life-threatening diagnoses, and end of life care. These discussions can be gratifying and stressful, but they also involve complex social interactions and relationships. He talks about the challenges of discussing severe conditions with patients, determining the appropriate treatment options, and navigating complex social discussions. Another challenge is reviewing charts quickly, understanding the patient's condition, and formulating a plan of action. In the initial admission orders, physical therapy and occupational therapy are often put in, but if the patient is too weak, additional help may be needed. Social workers or nursing case managers can then discuss these recommendations with the patient or family early on. They can teach the patient or family about the process of getting them home and ensuring they understand the process. William talks about the admission process and mentions that there are different types of patients, such as good teaching patients and non-teaching patients. A Professional Point of Pride From a professional standpoint, William is most proud of his early involvement in scheduling for his group. Scheduling is one of the main pain points or stress factors for hospitalists, as they have to be on call for certain periods of time. The traditional seven-on-seven off schedule is not ideal for patients, as it can lead to stress and dread of work. William developed a good system that has led to very little turnover in his group and accommodates everyone's time off requests. His scheduling is essentially a giant logic puzzle, and he does it all by hand within a spreadsheet for over 20 years. He continues to do this to this day to ensure that everyone is happy with their work. Influential Professors and Courses at Harvard William mentions his love for the Glee Club Harvard Glee Club, where he sang in junior and senior year. William found that there was no experience after college that matched the quality of his time at Harvard. He has been involved in an alumni chorus, which he started in the late 2000s, which has been performing in Japan and the US. They have performed three times so far and are planning to perform at SEMA this year, focusing on peace and harmony among the world. Timestamps: 02:56 Medical education, hospital care, and COVID-19 experiences 08:25 Hospital care and communication between doctors and patients 13:35 Medical work-life balance and emotional stress 18:27 Challenges and skills of a hospitalist 25:01 Streamlining hospital discharge process for elderly patients 27:35 Medical education and patient care 31:50 End-of-life care and scheduling for hospitalists 37:13 Work-life balance, scheduling, and singing experiences 43:46 Singing, harmony, and endorphins with a Harvard Glee Club alumnus
Hello, beautiful listeners! This week, we have the honor of having a very informative and candid conversation with the absolutely phenomenal Adaira Landry.Dr. Landry was raised in Rialto, California. While she had the love and support of her parents, she lacked mentorship and training on how to navigate the educational system and the workplace. Through her best efforts, in 2002, she attended University of California, Berkeley to study Molecular Cell Biology and African American Studies. She completed her medical school training at David Geffen School of Medicine at University of California, Los Angeles in 2011, her Emergency Medicine Residency at New York University as Chief Resident in 2015, and a combined fellowship in Ultrasound at the Department of Emergency Medicine at Brigham and Women's Hospital and a master's degree in Education at the Harvard Graduate School of Education program in 2017.Her academic interests focus on mentorship of underrepresented students and trainees. She speaks nationally on strategies to optimize mentor-mentee relationships.Today she is also a wife and a mother to 3 children. She hopes to raise her 3 children to understand and value the importance of supporting others in need.See you on the inside…What You Learn:Dr. Adaira's journey through academia and weaving through the educational system with no mentorshipHer struggles as a woman of color in medicine and in the nonfiction spaceDr. Adaira's tips for being more productive in one's career and lifeMore information on Dr. Adaira's book MicroSkills: Small Actions, Big Impact!Featured on the Show:Learn more about Dr. Adaria and her work on her website!Check out Dr. Adaira's new book, MicroSkills: Small Actions, Big Impact Follow Dr. Adaira on Instagram, X, and LinkedInLearn more about how you can work directly with AnitaClick HERE to bring the Conversations in Color Workshop to your organization today!Follow this link to check out the coaching programs I offer and see what works best for youCheck out my newsletter titled “Did You Know” on LinkedIn which covers Leadership and Personal Development Topics for Women, teaching you how to lead confidently and consciously using practical and spiritual concepts.Begin your healing journey by joining the Relationship Architect Academy and find the support you need today!Love the show? Leave a review of the show on Apple Podcasts (click the link to find out...
Metabolism has a direct impact on aging and the way we look. On today's episode, we discuss the current research around metabolism with experts Dr. Heather Christofk and Dr. Navdeep Chandel and dive into hair follicle stem cell activation, a lesson on hyaluronic acid from naked mole rats, and the complexity of addressing oxidative stress and the skin's extracellular matrix.Heather Christofk, Ph.D., is a Professor of Biological Chemistry at UCLA's David Geffen School of Medicine and a director at the Jonsson Comprehensive Cancer Center. Her research focuses on the role of metabolism on cancer and virus infections. She is co-founder of Pelage Pharmaceuticals, a company developing new drugs to treat baldness that activate hair follicle stem cells by changing their metabolism. She earned a bachelor's degree at UCLA and a Ph.D. at Harvard University.Navdeep Chandel, Ph.D., is the David W. Cugell, MD, Distinguished Professor of Medicine, Biochemistry, and Molecular Genetics at Northwestern University. His research focuses on metabolism and mitochondrial signaling, particularly as it relates to cancer biology, the immune system, neuroscience, and aging. He's the author of Navigating Metabolism. He earned his bachelor's degree and Ph.D. in cell physiology at the University of Chicago. Dr. Chandel received the 2023 Lurie Prize in Biomedical Sciences by the Foundation for the National Institutes of Health.(01:45) – Introducing Dr. Heather Christoff and Dr. Nadi Chandel(05:51) – Crossing paths(09:15) – Drawn to metabolism and cell signaling(12:43) – Hair follicle stem cells(18:50) – Therapeutic potential(32:59) – Other tissue stem cells(34:43) – Hyaluronic acid(39:49) – Reactive oxygen species(47:44) – Cancer and ferroptosis(51:30) – Skin aging(57:06) – Mitochondrial functionIf there are topics that you are interested in learning more about, please visit MichaelJLeeMD.com.If you'd like to receive new episodes as they're published, please follow I'd Love to Know in Apple Podcasts, Spotify, or wherever you get your podcasts. If you enjoyed this episode, please consider leaving a review on Apple Podcasts or Spotify. It really helps others find the show.The information from this podcast does not constitute medical advice and is meant for basic informational purposes only. If you're interested in pursuing any of the therapies, supplements, or medications discussed here, please consult with your physician.Podcast episode production by Dante32.
Welcome to Superhumanize!In today's episode, we're exploring the intricate pathways where science meets the essence of human experience—our breath. Joining us is Dr. Jack Feldman, whose groundbreaking work in neurobiology illuminates how the simple act of breathing shapes our mental, emotional, and physical health.Dr. Jack Feldman holds the David Geffen School of Medicine Chair in Neuroscience and is a Distinguished Professor of Neurobiology at the University of California, Los Angeles (UCLA).He discovered and named the pre-Bötzinger complex, an area in the brain stem that is responsible for controlling breathing. He was the recipient of the Hodgkin–Huxley–Katz Prize from the Physiological Society in 2017.In our conversation we explore the profound implications of his discoveries, revealing insights that expand our understanding of what it means to live a fully oxygenated life and the science behind the breath's power to transform.In my conversation with Dr. Feldman, you'll discover:-How the connection between the breath and the brain materialized into a full-fledged field of study...01:50-How our breath affects our emotions and even cognitive functions...09:50-Breathing exercises to help maintain composure in the most difficult emotional settings...24:30-Dr. Feldman's thoughts on cyclic hyperventilation and its most well-known proponent, Wim Hof...28:52-How various breathing modalities affect our well being and physiology...41:35-Thoughts on kundalini yoga, nostril breathing, and more as it pertains to inner peace and well-being...46:30-Research and academic studies on the breath/brain/body connection...49:06-We all breathe; but we don't all know how the breath affects every aspect of our lives...56:38-And much more!Resources mentioned:https://bri.ucla.edu/people/jack-feldman/https://bioscience.ucla.edu/people/jack-feldman/https://en.wikipedia.org/wiki/Jack_L._FeldmanP.S. If you enjoy this episode and feel it helps to elevate your life, please give us a rating or review. And if you feel others may benefit from this podcast as well, spread the word, share and help grow our tribe of Superhumans. When we help heal One, we help heal All. Much gratitude and love.Yours,Ariane
Interviewer: Dr. Lisa Meeks Interviewees: Dr. Lee Miller, Dr. Mijiza Sanchez-Guzman, Dr. Kama Guluma, Dr. Erick Hung, and Dr. Sharad Jain Description: In this episode, we delve into the pivotal role of disability within medical education, particularly its significance in the realms of diversity, equity, inclusion, and justice. Joining us are leaders from California Medical Schools, including Dr. Lee Miller, Dr. Mijiza Sanchez-Guzman, Dr. Kama Guluma, Dr. Erick Hung, and Dr. Sharad Jain, who generously share their experiences and insights on the profound impact of disability within the medical field. Our discussion begins with an exploration of the catalysts driving the integration of specialized support systems for disability-related issues within medical schools. Our guests discuss the instrumental role of student advocacy groups in elevating the unique needs of students with disabilities and chronic illnesses and the imperative for specialized support. They also discuss the transformative effects of incorporating specialized Disability Resource Professionals (DRPs) within medical school frameworks. Our guests outline the myriad benefits associated with dedicated DRPs, ranging from heightened student satisfaction to an enriched curriculum that prioritizes disability-related matters with greater awareness and inclusivity. The guests further examine the strategic advantages inherent in investing in specialized support mechanisms, emphasizing the importance of fostering an inclusive community, eradicating stigmas surrounding disability in medicine, and cultivating a workforce that authentically reflects the diverse fabric of society. This conversation also confronts the challenges and valuable lessons learned from the implementation of specialized support programs. Our guests offer candid reflections on navigating transitions from external disability services to an in-house DRP, overcoming logistical obstacles, and garnering essential support from institutional leadership. Ultimately, this episode serves as a testament to the critical significance of specialized support for disability within medical education. It underscores the necessity of embracing inclusive practices, championing diversity and inclusion, and creating an environment where all students can thrive equitably. Bios Sharad Jain, MD is Professor of Medicine and Associate Dean for Students at the UC Davis School of Medicine. Dr. Jain completed medical school and residency in internal medicine at UCSF, where he was on faculty for several years. Prior to coming to UC Davis, Dr Jain served as the residency director of the UCSF/SFGH Primary Care Medicine Residency Program where he focused on training primary care leaders in the care of vulnerable populations. At UC Davis, he focuses on supporting students from diverse backgrounds to excel in medical school through academic advising, wellness initiatives, career decision-making, community building, and ensuring a respectful learning environment. He practices general internal medicine at the Sacramento County Health Center, an FQHC affiliated with UC Davis. Dr. Erick Hung is a Professor of Clinical Psychiatry in the UCSF Department of Psychiatry and Behavioral Sciences and is a member of the UCSF Academy of Medical Educators. He is the Associate Dean for Students in the UCSF School of Medicine. Prior to joining the Dean's team, he served as the Program Director of the Adult Psychiatry Residency Training Program from 2012-2022 and the Director of Curricular Affairs for GME for the UCSF School of Medicine from 2015-2022. He completed his medical school, psychiatry residency, and forensic psychiatry fellowship training at the University of California, San Francisco and joined the faculty at UCSF in 2009. He actively teaches in the areas of risk assessment, medical education, forensic psychiatry, leadership, and ethics. His interests include primary care and mental health integration, the interface between mental health and the legal system, inter-professional collaboration and training, HIV psychiatry, LGBTQ mental health, and medical education. His educational scholarship interests include competency-based assessment, faculty development, and near-peer learning in the workplace setting. Kama Z. Guluma, MD, is a Clinical Professor of Emergency Medicine and the Associate Dean for Admissions and Student Affairs at UC San Diego School of Medicine. As the Associate Dean for Admissions and Student Affairs, he oversees the offices of Admissions, Student Affairs, and Financial Aid. Dr. Guluma joined the Department of Emergency Medicine as a faculty member in 2001. He joined the Division of Medical Education as Associate Dean for Admissions and Student Affairs in October 2018. Prior to becoming Associate Dean, he served as the Director of Student Programs for the Department of Emergency Medicine, and as an Academic Community Director in the UC San Diego School of Medicine. He is a past recipient of the Medical Student Teaching Award in the UC San Diego Department of Emergency Medicine, has been a nominee for the Kaiser Excellence in Teaching Award in the UC San Diego School of Medicine, and a recipient of the Faculty Mentorship Award from the UC San Diego Graduate Student Association. Lee Todd Miller, MD is Professor of Pediatrics and the Associate Dean for Student Affairs at the David Geffen School of Medicine at UCLA. After completing medical school and post-graduate training at the University of Virginia, for the last 38 years, Dr. Miller has been heavily involved at UCLA in both undergraduate and graduate medical education in pediatrics. Prior to moving into the Dean's Office, he served for 10 years as the Vice Chair of Education within the Department of Pediatrics. He is the 12-time recipient of the UCLA School of Medicine's Golden Apple Award, the national Humanism in Medicine Award sponsored by the Association of American Medical Colleges, and the University of California Academic Senate Distinguished Teaching Award. In addition to his current roles in Student Affairs and pediatric education, Dr. Miller is also one of the founders of the medical school's Global Health Program, nurturing the global health interests of countless students and residents over the years. He has worked on education-related projects in the Democratic Republic of the Congo, Ethiopia, Mozambique, Rwanda, South Africa, Zambia, Afghanistan, Myanmar, Peru, and Ecuador. Mijiza M. Sanchez-Guzman is the Associate Dean, Office of Medical Student Affairs, at the Stanford School of Medicine. She has worked in higher education and the health sciences for more than 18 years with a commitment to diversity and inclusion, gender equity, and leadership development. Transcript Keywords: DRP, Disability Inclusion, Medical Education, Leadership, Students, Structures, Processes, Specialized Support. Produced by: Lisa Meeks Audio editor: Nicole Kim Digital Media: Katie Sullivan and Lisa Meeks
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