Podcasts about diagnostics

Highlights from the PER® CME activity "OncoBytes Adaptive Learning Pathways™: Decoding Precision Diagnostics and Targeted Therapies in Glioma" — this podcast is not certified for credit. To participate in the full accredited activity and earn CME credit, use the link below.In this podcast, experts Vinay K. Puduvalli, MD; Ruham Nasany, MD; and Angela Waanders, MD, MPH, MS; discuss advances in molecular diagnostics and strategies to treat adults with low- and high-grade gliomas.Earn CME credit by completing the full accredited activity (available through September 1, 2027): https://www.gotoper.com/courses/oncobytes-adaptive-learning-pathways-decoding-precision-diagnostics-and-targeted-therapies-in-gliomaThis podcast, including the narration, was developed by PER® (Physicians' Education Resource®, LLC) editorial staff from the full online CME activity developed with these faculty. The narration was voiced by a PER staff member or by an AI tool. The podcast contains no product advertising. The full activity is supported by an educational grant from Jazz Pharmaceuticals, Inc.This content is for educational purposes only and is not a substitute for the independent clinical judgment of a health care professional. Faculty may discuss investigational or off-label uses; consult prescribing information for any products discussed.

LIVE from ILADS: Tick Boot Camp reconnects with Nicole Bell, CEO of Galaxy Diagnostics, for a focused conversation about one of the biggest challenges in Lyme disease and tick-borne illness: getting an accurate diagnosis. Bell breaks down the differences between antibody testing, antigen testing, and PCR-based direct detection while explaining why stealth pathogens such as Borrelia, Bartonella, and Babesia can be so difficult to find. She also introduces Galaxy's BBB Direct Detect digital PCR testing, discusses emerging findings involving Babesia species, and explains why a negative antibody test doesn't always tell the entire story. For Bell, the mission is deeply personal. Her husband, Russ, initially tested negative for Lyme disease and was later diagnosed with Alzheimer's disease before his family ultimately discovered tick-borne infections were part of his complex illness. That experience helped redirect Bell's engineering and medical technology background toward improving diagnostics for other patients searching for answers. This interview was recorded live at the ILADS conference, so you may hear some of the energy and background activity of the event throughout the conversation. Why Can Lyme Disease Testing Be So Difficult? Bell begins by explaining one of the fundamental problems with diagnosing Lyme disease and other tick-borne infections: many of the pathogens clinicians are searching for can be difficult to detect. Some occur at low levels in the bloodstream. Others may migrate into tissues or circulate intermittently. Historically, much of tick-borne disease testing has therefore relied on indirect detection — looking for the patient's immune response rather than directly detecting the organism. Antibody testing can provide useful information, but Bell explains why interpretation can become complicated. A patient's antibody response can vary depending on factors including: Timing of infection Individual immune response Immune suppression or dysregulation Previous exposure Previous treatment Medications that suppress immune activity Cross-reactivity Whether an infection is current or historical This is why Bell views antibody testing as one tool rather than the entire diagnostic toolbox. Antibody Testing: Detecting the Immune Response Antibody testing is an indirect testing method. Instead of looking for Borrelia itself, for example, the test looks for evidence that the patient's immune system has responded to it. Bell discusses IgM and IgG antibodies and why timing matters. IgM antibodies are generally associated with an earlier immune response, while IgG responses can take longer to develop. In Lyme disease, that delay creates a particular challenge because early diagnosis and treatment can be especially important. Some infected patients may mount a strong measurable antibody response, while others may produce a weaker or delayed response. Bell points to research showing how dramatically immune responses can differ even under controlled experimental conditions. This creates an important distinction: A test of the immune response is not necessarily the same thing as a test for the pathogen itself. When Antibodies Don't Tell the Whole Story Bell uses her husband's experience to illustrate the stakes. Russ had likely been ill for years before his most significant symptoms emerged. By then, Bell says his immune system was dysregulated and his overall antibody levels were low. His Lyme testing was negative, and his worsening cognitive symptoms ultimately led to an Alzheimer's diagnosis. There is also another side to antibody testing. A person may have antibodies because of a previous infection even when the original infection is no longer active. That can make it difficult to determine whether persistent symptoms are associated with an ongoing infection, an undiagnosed coinfection, immune dysregulation, or another process. Bell's point is not that antibody testing has no value. It is that complex tick-borne illness may require more than one diagnostic tool. Antigen Testing: Looking for Evidence of the Pathogen The conversation then moves from indirect testing to direct detection. One method is antigen testing. Rather than measuring the immune system's response, an antigen test searches for a component associated with the pathogen itself. Bell discusses Galaxy's work with a urine-based Lyme disease antigen approach designed to capture and concentrate a protein shed by Borrelia. Why urine? Bell explains that Lyme-causing Borrelia may not remain abundantly present in the bloodstream. A pathogen-derived protein, however, may be filtered through the kidneys and become detectable in urine. Galaxy continues to work on direct-detection approaches to Lyme disease testing as it pursues broader clinical adoption and regulatory pathways. PCR Testing: Searching for Pathogen DNA Another form of direct detection is PCR testing. PCR looks for genetic material from the pathogen rather than relying on the patient's antibody response. Galaxy uses PCR-based approaches for pathogens including: Borrelia Bartonella Babesia But direct detection presents its own challenge. These organisms may occur at extremely low levels in a sample. A patient can be infected while very little pathogen DNA happens to be circulating in the particular blood sample collected that day. That is where digital PCR, or dPCR, becomes especially interesting. The Three B's: Borrelia, Bartonella & Babesia Bell introduces Galaxy's approach to what Tick Boot Camp often calls the Three B's: Borrelia. Bartonella. Babesia. As patient and clinician awareness of tick-borne illness has evolved, these three pathogens have become increasingly important to the conversation around complex cases. Galaxy's BBB Direct Detect digital PCR testing is designed to directly detect DNA from Borrelia, Bartonella, and Babesia. Unlike an antibody test asking whether the immune system has responded to a pathogen, direct PCR testing asks a different question: Can we find genetic evidence of the organism itself? How Digital PCR Searches for Low-Abundance Pathogens Bell gives a simple analogy for understanding digital PCR. Imagine searching for a needle in a haystack. Traditional PCR is trying to identify a tiny amount of pathogen DNA — the needle — among an enormous amount of human genetic material — the haystack. Digital PCR effectively divides that haystack into thousands of much smaller piles and examines them individually. That partitioning can make it easier to detect extremely small amounts of genetic material. Galaxy also uses a culture-enrichment step for Bartonella. The blood sample is placed in an environment designed to encourage Bartonella growth before PCR analysis, increasing the amount of target material available for detection. Learn more about Galaxy Diagnostics' direct-detection technology and its approaches to Borrelia, Bartonella, and Babesia testing. Why Are We Seeing So Many Coinfections? Tick Boot Camp and Bell also discuss an observation that has become increasingly common in patient interviews: many people with complex chronic tick-borne illness aren't reporting only Lyme disease. Instead, patients frequently describe combinations involving the Three B's and other infections. Why? Bell says several factors may contribute. Diagnostic technology has improved. Clinicians have become more aware of coinfections. Ecological research indicates ticks can carry multiple pathogens. But Bell raises another important possibility: patients carrying multiple pathogens may also be among those who become the sickest and therefore are disproportionately represented within chronic illness communities. That distinction matters. Observing many coinfections among severely ill patients doesn't necessarily mean every tick-borne disease patient has the same microbial picture. Bartonella, the Immune System & the Tipping Point Bell discusses Bartonella as an example of the complexity surrounding infection and illness. Exposure may be more common than many people realize, and Bartonella has multiple potential vectors and reservoirs. Bell describes a hypothesis in which some people may harbor an infection while their immune system keeps it under control. Then another infection, environmental exposure, significant stressor, or other immune-disrupting event may alter that balance. A person who had previously remained relatively healthy may cross what Bell describes as a tipping point and begin experiencing significant illness. This raises questions researchers are still working to answer. Were multiple infections transmitted simultaneously? Did they occur through separate exposures? Was one infection already present before another destabilized the immune system? Bell emphasizes that the answer may differ from patient to patient. Emerging Questions About Babesia Some of the most intriguing discussion in this interview involves Babesia. Bell explains that research associated with the North Carolina State University team has identified Babesia species in complex patients beyond the organisms traditionally emphasized in U.S. human babesiosis. She specifically discusses findings involving Babesia odocoilei and Babesia divergens-like organisms and contrasts those findings with expectations surrounding Babesia microti and Babesia duncani. Bell also discusses the possibility of low-level parasitemia — infections involving pathogen levels that may be much lower than the classic severe presentation clinicians associate with babesiosis. These emerging observations raise important research questions about Babesia species, their prevalence, their role in human disease, and whether existing diagnostic assumptions capture the full picture. Bell is careful in the interview to distinguish between what Galaxy's current assay detects and what researchers may suspect based on sequencing and related scientific work. Nicole Bell's Personal Mission Bell's work in tick-borne disease diagnostics grew out of an experience no family wants to have. Her husband, Russ, developed neurological and psychiatric symptoms, including cognitive problems, anxiety and hallucinations. Despite Bell specifically requesting Lyme disease testing early in his illness, his initial test was negative and his diagnostic journey eventually led to an Alzheimer's disease diagnosis. Bell later documented her family's experience in her memoir, What Lurks in the Woods. Today, she brings her engineering background and personal experience together in an effort to improve the diagnostic tools available to clinicians and patients. From MIT & Duke to Galaxy Diagnostics Nicole Bell is CEO of Galaxy Diagnostics and an engineer with extensive experience in medical devices and diagnostics. She earned bachelor's and master's degrees in Materials Science and Engineering from MIT and a master's degree in Biomedical Engineering from Duke University. Before joining Galaxy, she worked in technology and medical-device development, including leadership roles involving diagnostic platforms and FDA submissions. Bell became CEO of Galaxy Diagnostics in 2024, bringing together her professional background in engineering and diagnostics with the lessons learned through her husband's illness. The State of Lyme Disease Research Bell is also the primary author of The State of Lyme Disease Research in the United States for the Center for Lyme Action. The paper examines gaps in Lyme disease research and outlines recommendations involving fundamental science, diagnostics, prevention, treatment, and research infrastructure. In this interview, Bell references one particularly important issue explored in that work: delays in Lyme disease diagnosis and treatment are associated with a greater risk of patients experiencing persistent symptoms. Better testing isn't simply about producing a more sophisticated laboratory report. It's about helping clinicians get patients appropriate answers earlier. Key Topics in This Episode Lyme disease testing, Lyme diagnostics, Nicole Bell, Galaxy Diagnostics, Borrelia testing, Bartonella testing, Babesia testing, Three B's, BBB Direct Detect, digital PCR, dPCR, PCR testing, antibody testing, antigen testing, direct detection, indirect testing, stealth pathogens, Lyme disease antibodies, coinfections, polymicrobial tick-borne disease, low-abundance infections, Bartonella culture enrichment, Babesia microti, Babesia duncani, Babesia odocoilei, Babesia divergens, chronic Lyme disease, diagnostic delays, and tick-borne disease research. About This LIVE from ILADS Interview This short-form conversation was recorded in person at the 2025 International Lyme and Associated Diseases Society Annual Scientific Conference, From Terrain to Treatment: Advances in Vector-Borne Illness, held October 9–12, 2025, in San Antonio, Texas. Because these interviews were recorded live at the conference, they have a different feel from Tick Boot Camp's traditional long-form virtual and studio conversations — shorter, focused, and surrounded by the activity of one of the world's major gatherings of Lyme and tick-borne disease clinicians, researchers, advocates, and innovators. Explore all Tick Boot Camp LIVE from ILADS interviews. More from Tick Boot Camp Hear more conversations with Lyme disease doctors and healthcare professionals about testing, diagnosis, treatment, and complex tick-borne illness. Explore the Tick Boot Camp Podcast for interviews with patients, doctors, researchers, advocates, and innovators working to improve understanding of Lyme disease and help people move toward recovery.

Caroline Vissers, co-founder of Immunectra and a former UCSF faculty member, who walked away from a lab of her own to build a company. Working alongside scientific co-founders Joe DeRisi and Michael Wilson, Caroline is developing blood-based tests capable of detecting autoimmune disease long before a patient ever shows symptoms.In this episode, Caroline shares why she gave up a faculty position most scientists spend a career chasing, how she prepared for the jump with a venture capital course and consulting work before committing and why the entrepreneurial path was always the real destination. She also breaks down epitranscriptomics in plain terms and explains the unusual path that led from RNA methylation research into autoimmunity.The core of the conversation is early detection. Caroline explains the prodromal phase, why MS patients often wait years for a diagnosis while irreversible neurological damage is already happening and what it means to detect disease up to five years before onset. We get into the uncomfortable reality that healthcare reimbursement is built for reactive medicine rather than prediction, how employer-based insurance may open the door and why she is upfront that policy will have to catch up with the science.We also cover the access to biobanked military samples that made the discovery possible and now serves as a competitive moat, why so many life science investors avoid diagnostics entirely and Caroline's advice for anyone weighing up a leap into founding a company.Timestamps[00:02:00] Why She Gave Up a Faculty Position Most Scientists Chase[00:03:32] Learning to Be a Founder Before Making the Leap[00:05:38] Epitranscriptomics Explained in Plain Terms[00:09:07] The Prodromal Phase and Detecting MS Before Symptoms[00:11:31] Why Reimbursement Is Built for Reactive Medicine[00:13:45] What Most People Do Not Understand About Living With MS[00:15:20] Could This Replace the Spinal Tap and Repeat MRIs?[00:17:39] The Operational Chaos Nobody Warns First-Time Founders About[00:19:48] Why So Many Life Science Investors Will Not Touch Diagnostics[00:22:30] Why Nobody Has Done This Before: Sample Access as a MoatConnect with Sandy - https://www.linkedin.com/in/caroline-vissers-b7431285/Learn more about Immunecetra - ⁠https://qb3.org/invoke-bio-immunectra-win-100k-qb3-mentoring-awards-for-precision-cancer-vaccines-ms-diagnostic/https://qb3.org/im-all-in-immunectras-founder-left-her-faculty-position-to-form-groundbreaking-company/Get in touch with Karandeep Badwal - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/karandeepbadwal/ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Follow Karandeep on YouTube - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/@KarandeepBadwal⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medical device training courses delivered by Karandeep through Bywater - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.bywater.co.uk/

Lumos Diagnostics CEO Doug Ward joined Steve Darling from Proactive to discuss the continued commercial expansion of the company's FebriDx rapid diagnostic test across the United States, highlighting growing adoption among major urgent care operators and health-system-owned networks. Ward said Lumos has increased the number of live FebriDx deployment sites to 215 urgent care locations across 26 states, up from 170 previously, as the company continues to gain traction with large healthcare providers. The rollout reflects growing recognition of the test's ability to support clinical decision-making for patients presenting with acute respiratory illnesses. At the same time, the number of sites actively evaluating FebriDx has expanded to 405 locations from 350, further strengthening the company's commercial pipeline. Lumos noted that two additional top-100 U.S. urgent care groups have advanced beyond evaluation and entered network rollout phases across more than 40 combined sites. The company is also working with two other top-100 urgent care operators that are currently conducting clinical and economic validation studies across more than 45 locations. These evaluations are designed to assess FebriDx's clinical effectiveness, reimbursement performance, workflow integration and overall health-economic benefits before broader deployment decisions are made. Ward explained that Lumos is strategically focused on the top 100 urgent care organizations in the United States, which the company estimates represent approximately 40% of all urgent care sites nationwide. To support this effort, Lumos employs a structured four-stage commercialization strategy that progresses from qualified opportunities through clinical and economic evaluation, network rollout and ultimately standardized adoption across provider networks. The company's current live network of 215 sites is estimated to serve between 900,000 and 1.2 million acute respiratory illness patient visits annually, creating a substantial opportunity for test utilization. Importantly, reimbursement coverage for FebriDx remains strong, with payment support exceeding 90% at approximately US$41.38 per test. One notable success story has been the expansion within WellStreet, which initially evaluated the test before increasing deployment to 44 locations. The successful rollout has created a pathway toward broader implementation across WellStreet's network of more than 165 urgent care centers. Meanwhile, the 405 sites currently undergoing active evaluation represent an estimated 1.6 million to 2.2 million annual acute respiratory illness visits, providing Lumos with a significant opportunity to further expand market penetration as additional healthcare organizations complete their validation programs. #proactiveinvestors #lumosdiagnosticsholdings #asx #ldx #otc #ldxhf #FebriDx #HealthcareInnovation #Diagnostics #RapidTesting #UrgentCare #HealthcareTechnology #MedTech #DigitalHealth #HealthcareStocks #BiotechNews #MedicalDevices #HealthSystems #PatientCare

Robert Befidi, Jr., President of DEXIS & President, Diagnostics at Envista joins the show. Robert discusses: AI-powered imaging Connected clinical workflows Navigating industry challenges To learn more about DEXIS visit: https://dexis.com/en-us To explore all of Envista's innovative dental companies visit: https://envistaco.com/en You can also connect with Robert on LinkedIn here: https://www.linkedin.com/in/robertbefidijr/ Subscribe to our channel for more episodes and stay updated on the latest DSO news, insights, and events! If you like our podcast, please give us a ⭐⭐⭐⭐⭐ review on iTunes https://apple.co/2Nejsfa and a Thumbs Up on YouTube.  

Watch Full Video EpisodeOscilloscopes are becoming more powerful, accessible, and common in repair shops—but choosing the right scope is only part of the equation. You also need to understand how your particular scope captures, stores, and displays its data.Matt Fanslow answers listener questions about automotive oscilloscopes, including the new eight-channel PicoScope, how many channels a shop actually needs, and whether beginners should start with an inexpensive scope or jump directly into a more capable platform.He also explains the distinctly different way Snap-on scopes handle their sample buffer, and why misunderstanding that behavior can cause a technician to lose the exact event they were trying to capture.Topics discussed include:What we currently know about Pico's new eight-channel automotive scopeHow Pico BNC+ powers and automatically identifies compatible probes and transducersWhy current probes, pressure sensors, and microphones are all transducersWhere a single-channel AESwave uScope remains extremely usefulWhy two channels are helpful but a four-channel scope should now be considered a shop necessityWhen five, six, or eight channels become valuableUsing crankshaft, camshaft, ignition, and other signals togetherWhy the Snap-on Vantage Pro remains an excellent and affordable starting pointWhether a PicoScope is really too advanced for a first-time scope userHow modern scope hardware can compensate for less-than-perfect setup choicesWhy capable modern scopes resemble modern supercars: approachable in ordinary use, with substantial performance available when neededWhy oscilloscopes of this caliber should generally be considered shop equipmentHow Snap-on scope screens differ from the displays used by many other scopesUnderstanding the Snap-on screen as a window into a continuously moving bufferWhy Snap-on scopes allow technicians to zoom out after a capture—but not zoom inSetting the time base correctly when looking for details such as injector pintle movementHow a captured event can disappear from the buffer even though the display appears frozenWhen to save a screenshot instead of relying only on the scope-data fileThe difference between Snap-on's Graphing Meter and Lab Scope modesCommon setup mistakes made by Snap-on scope usersThe practical limitations of older Snap-on sample rates and memory configurationsHow descriptive filenames make saved waveforms far easier to find years laterWhat vehicle, engine, system, signal, and operating-condition information should accompany a saved waveform?A scope is only useful when its operator understands what it is doing. Regardless of the brand, spend time learning how your instrument acquires, stores, displays, and saves information before an intermittent failure puts that knowledge to the test.Thanks to our Partners, Pico Technology and AutelAre you chasing elusive automotive problems? Pico Technology empowers you to see what's really happening. Their PicoScope oscilloscopes transform your diagnostic capabilities. PicoAuto.comFrom drivability diagnostics and TPMS service to ADAS and advanced safety systems, Autel helps technicians follow OEM procedures and repair with confidence. Autel.comContact InformationEmail Matt: mattfanslowpodcast@gmail.comSubscribe on YouTube: @automotivefieldtheoryThe Automotive Repair Podcast Network: https://automotiverepairpodcastnetwork.com/Download and Listen on Our Mobile App: https://automotiverepairpodcastnetwork.com/app/Remarkable Results Radio Podcast with Carm Capriotto: https://remarkableresults.biz/Business by the Numbers with Hunt Demarest: https://huntdemarest.captivate.fm/The Auto Repair Marketing Podcast with Kim and Brian Walker: https://autorepairmarketing.captivate.fm/The Weekly Blitz with Chris Cotton: https://chriscotton.captivate.fm/Speak Up! Effective Communication with Craig O'Neill: https://craigoneill.captivate.fm/

Dr. Christine Johnston, Professor at the University of Washington and expert on herpes simplex virus (HSV), takes us through different clinical scenarios on the diagnosis and management of HSV with National STD Curriculum Podcast Editor Dr. Meena Ramchandani.This podcast is dedicated to an STD [sexually transmitted disease] review for health care professionals who are interested in remaining up-to-date on the diagnosis, management, and prevention of STDs and STIs. Editor and host Dr. Meena Ramchandani is an Assistant Professor of Medicine at the University of Washington (UW), Program Director of the UW Infectious Diseases Fellowship Program, and Associate Editor of the National STD Curriculum.

Advance early Alzheimer's diagnosis: Master the appropriate use and interpretation of blood-based biomarkers in part 3 of this live masterclass. Credit available for this activity expires: 9/21/27 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/alzheimers-disease-precision-diagnostics-3-part-live-2026a1000xvy?ecd=bdc_podcast_libsyn_mscpedu

Imagine unlocking 20 years of QC data to let AI forecast instrument downtime. John Welsh of Agilent reveals how the Allotrope simplified model and modern lab informatics turn compliance into a competitive edge. Discover why regulated pharma, biotech and med‑tech leaders can't afford to ignore this shift.-------------------------Episode Sponsor: Agilent is a global leader in life sciences, diagnostics and applied markets, recognized for uncompromising integrity in all we do. Our mission is to advance quality of life by focusing our expertise in six key markets: Food, Environmental and Forensics, Pharmaceutical, Diagnostics, Chemical and Advanced Materials and Research.-------------------------Want to stay current with the latest GxP trends? Join our free, enlightening certification webinars at ⁠⁠www.qualistery.com⁠⁠.-------------------------For guest or sponsorship inquiries, contact us at info@qualistery.com.-------------------------

Dr. Chris Thompson, MD, Professor of Medicine at Harvard Medical School, Chief of Interventional Gastroenterology at Mass General Brigham in Boston, and Co-Director of the Center for Weight Management and Wellness, is a world-renowned expert on gastroenterology, metabolism, nutrition, and obesity medicine. He explains how your GI tract regulates hunger, fullness, and blood sugar, as well as the gut microbiome, metabolic health, and weight loss. We also discuss common GI tract issues and which particular tests or interventions are actually useful. We discuss both GLP-1 medications and non-GLP-1 approaches to weight loss. Given that gut health is vital to all the organs of the body, overall health, and longevity, our discussion ought to be of interest and practical value to everyone, including, of course, those struggling with gut health or weight loss challenges. Thank you to our sponsors AG1: https://drinkag1.com/huberman Function: https://functionhealth.com/huberman Lingo: https://hellolingo.com/huberman LMNT: https://drinklmnt.com/huberman Our Place: https://fromourplace.com/huberman Timestamps (00:00:00) Dr. Chris Thompson (00:02:16) Digestive Tract, Gut Hormones & Nutrient Absorption (00:08:06) Colon Microbiome & Colon Cancer Screening (00:11:13) Sponsors: LMNT & Lingo (00:13:40) Swallowing Problems & Zenker's Diverticula (00:16:08) Bowel Movements & Constipation (00:18:28) Fiber, Resistant Starch & the Gut Barrier (00:21:50) Intermittent Fasting & the Gut Microbiome (00:23:38) Fermented Foods, Microbial Diversity & Butyrate (00:27:12) H. pylori, Stress & Stomach Ulcers (00:30:20) GLP-1 Medications: Benefits & Limitations (00:33:42) Lower GLP-1 Doses, Weight Regain & Muscle Loss (00:37:35) GLP-1 Side Effects, Food Noise & Apathy (00:39:49) Bariatric Surgery & Medical Innovation (00:46:07) Sponsor: AG1 (00:47:44) Hunger & Satiety: Ghrelin, CCK, GIP & GLP-1 (00:50:01) Retatrutide & Combining Hormonal Targets (00:52:55) Ultra-Processed Foods, Overeating & Leptin (00:55:32) Incretin Discovery, Exendin-4 & the Gila Monster (00:59:35) Endoscopic Ultrasound & Pancreatic Biopsy (01:07:40) Early Metabolic Markers, CGMs & Fasting Insulin (01:13:06) Insulin Resistance & Metabolic Flexibility (01:15:53) Sponsor: Function (01:17:35) Patient Data, Screening & Treatment Adoption (01:26:31) AI, Robotics & Improving Procedures (01:29:27) Choosing a Surgeon & Measuring Procedure Quality (01:35:29) Image Guidance & Hyperspectral Imaging (01:37:19) Sponsor: Our Place (01:38:56) Diagnostics & Targeted Metabolic Treatments (01:42:45) Gastric Bypass, Foregut Exclusion & Diabetes (01:47:59) Duodenal Liners & Mucosal Resurfacing Research (01:52:58) Gut Permeability, Inflammation & Fatty Liver (01:59:39) Artificial Sweeteners, Fructose, Fats & Omega-3s (02:05:00) Resistance Training, Zone 2 Cardio & Intervals (02:06:31) Weight Set Point & Metabolic Adaptation (02:08:13) Endoscopic Sleeve Gastroplasty & Fundus Ablation (02:10:30) Magnetic Intestinal Connections & Combined Treatments (02:16:52) GLP-1 Gene Therapy Research (02:22:13) Innovation, Problem Solving & Teamwork (02:25:58) Zero-Cost Support, Sponsors & Neural Network Newsletter Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices

Inside Episode 400: What A New Direction with Coach Jay Uncovered About My Life, Values, and Purpose Four hundred conversations in, A New Direction with Coach Jay finally turned the microphone around on its own host. For episode 400, Steve Riddle — founder of CoachStation and author of Falling Into Leadership, and a two-time guest on the show — sat across from me and asked the questions I usually ask everyone else. Not softball ones, either. Steve went after my life, the challenges that shaped it, and the choices that took a farm kid’s kind of grit and built it into the coach, speaker, and podcast host I am today. From there, the conversation on A New Direction with Coach Jay moved into the work itself — my coaching philosophy, and what actually holds it together. Steve pushed past the surface and asked what writing four books taught me, what my philosophy has meant in practice, and how that philosophy shows up when I’m working with a competitive youth athlete or a business leader trying to find their footing. Coaching isn’t a technique you apply the same way twice. It’s a set of principles you adapt to the person in front of you, and Steve made me articulate that out loud, maybe for the first time this clearly. The heart of the episode, though, was core values and purpose — the two things every guest on this show eventually circles back to, whether they mean to or not. Steve asked me directly: after 400 conversations, what do I actually believe drives people? I talked about the values that have anchored me through every version of this business, from A New Direction with Coach Jay to Real Estate Right Now to the coaching work with business execs and owners to young athletes, and why purpose has to survive contact with hard seasons or it isn’t real purpose at all. Then Steve turned to the pattern recognition — what 400 interviews across authors, entrepreneurs, and leaders have taught me about people and business that you wouldn’t expect. A New Direction with Coach Jay has never been a highlight reel, and this episode wasn’t either. It was a direct look at what changes in you when you’ve spent years listening for what makes people tick, and what that means for anyone building a business, a team, or a life on purpose. Please thank the sponsors of A New Direction Podcast – Jay Izso Linda Craft Team, REALTORS® when you are looking to sell your home or buy a new home for more than 40 years Linda Craft Team, REALTORS® is there to help you! Their thousands of clients call them “The Legends of Customer Service”.  They will also tell you that the relationship is their first priority. Whether you are in the Greater Raleigh Research Triangle Park area of North Carolina or anywhere in the world, they can help you with your home dreams.  Contact our friends at the Linda Craft Team at www.LindaCraft.com Your Business Isn’t Broken. It’s the Person Running It. The marketing is fine. The team is capable. The market is there. And the business still won’t move. You’ve read the books. Hired the consultants. Rebuilt the org chart twice. None of it touched the actual problem, because the actual problem was never in the business. It’s fear. It’s ego. It’s the story you keep telling yourself about what you can and can’t do. It’s the “personal stuff” you’ve been leaving at the door every morning — except it doesn’t stay there. It walks in with you and runs the company. I’m Jay Izso. I’m an Executive Performance Coach, and I work with CEOs and founders of $5M–$50M companies who’ve hit a wall they can’t explain. I don’t fix algorithms. I fix the behaviors and mindsets that are strangling your growth. No Motivational Platitudes I find the personal behavioral pattern that’s driving the business dysfunction. Then I help you disrupt it so the company can actually grow. That’s the whole method. No vision boards. No affirmations on the monitor. Diagnostics, intervention, results. If you want to feel better about your business, hire a hype man. If you want it to change, keep reading — because where I learned to do this isn’t a place most coaches have ever set foot. Raised on the Farm. Trained in Psychology. My approach comes from two places most coaches never set foot in. The farm. I grew up a farmhand in Ithaca, Nebraska — population 100. I started working at nine. By fourteen I was castrating boars, and nobody was coming to do it for me if I froze. By the time I left for college I’d spent a decade learning that you can’t cheat the harvest, that pain is part of the job, and that the work gets done whether you feel like it or not. That’s not a charming childhood story. It’s why I don’t flinch when a CEO’s real problem turns out to be uglier than the one they hired me to fix. I’ve done harder, dirtier work than a hard conversation. The forensic unit. In graduate school at Washington State University, I trained under Dr. Thomas Brigham — co-author of the Handbook of Applied Behavior Analysis — in a human behavior lab built around real-world problems, not theory. I followed that into a Clinical Psych II role at Eastern State Hospital in Medical Lake, Washington: a forensic setting, evaluating people charged with the most serious criminal offenses. Sixteen months reading human behavior at its most extreme teaches you one thing fast: how to get past what someone’s telling you and see what’s actually driving the decision. That’s not a metaphor I use with executives — it’s the literal skill I use on them. Most consultants react to what a CEO says the problem is. I was trained to find what’s underneath it. How the Work Actually Happens We find the pattern. Not “leadership style” — the specific behavior that shows up under pressure and quietly runs the company into a wall. The decision you keep re-making. The hire you keep avoiding. The conversation you keep having in your head instead of in the room. We name it, out loud, without the corporate padding. Then we disrupt it — deliberately, on purpose, on a schedule — until the new behavior is the automatic one. Not a seminar. Not a one-time breakthrough you feel good about for a month. A rebuilt habit, tested against your actual business, week over week. If you also want to hear how this plays out in other people’s companies before you talk to me, that’s what the show is for. Every week on A New Direction, I sit down with CEOs, founders, and the researchers behind the science of leadership performance — the decisions that built their companies, the mistakes that nearly ended them, and the breakthrough that changed everything. The podcast is where you can watch the diagnosis happen to someone else first. Who This Is For This works if you’re the CEO or founder of a $5M–$50M company, you already know — or strongly suspect — that you’re the bottleneck, and you’re willing to look at that directly instead of managing around it. This doesn’t work if you want a quick fix. I can’t help you if what you’re after is a pep talk before your next board meeting. I work with people who value authenticity and effort. If you’re ready to dig in, find the root cause, and grow — keep reading. Your Growth Journey Starts Here Big idea, bold goal, or a wall you can’t explain — start the conversation. Schedule your audio session and tell me the one thing about your business that doesn’t add up. I’ll tell you, straight, whether it’s a business problem or a personal one wearing a business costume. Thank you everyone for listening to A New Direction with Coach Jay. Please tell your friends. Give us a thumbs up on YouTube. Wherever you may be listening…please give A New Direction with Coach Jay a 5 star review.

In this episode of “Answers From the Lab,” host Bobbi Pritt, M.D., chair of the Division of Clinical Microbiology at Mayo Clinic, is joined by William Morice II, M.D., Ph.D., president and CEO of Mayo Clinic Laboratories, to discuss seasonal vaccination planning and survey findings on laboratory industry growth. Later, Leslie Donato, Ph.D., a clinical chemist at Mayo Clinic, shares how an innovative testing panel is improving the diagnosis of bile acid malabsorption.Survey highlights laboratory growth strategies (00:29): Discover where laboratory leaders are investing, the challenges shaping the industry, and the strategies organizations are adopting to achieve sustainable growth.Seasonal viruses and vaccination planning (05:29): Discover how to learn more about vaccination options for viruses that typically surge during the fall and winter.Diagnostics for chronic diarrhea (07:43): Hear how a novel test is improving diagnosis and advancing understanding of bile acid malabsorption.ResourcesSurvey reveals four strategies for laboratory growthVaccine and immunization guidance from Mayo ClinicTesting Options for Patients with Chronic Diarrhea: A Focus on Bile Acid Malabsorption WebinarBile acid malabsorption: A patient-centered approach to diagnose a common cause of chronic diarrheaThe right testing for an underrecognized cause of chronic diarrhea

In this episode, we sat down with Paul Coletta ( https://www.linkedin.com/in/paulcoletta ), the co-founder and CEO of Vero Bioscience ( https://www.verobioscience.com/ ). Vero's OrganAge™ assay measures the biological age of each organ from a single bl...

Learn about lyme/bartonella/coinfection testing & diagnosis with CEO of Galaxy Diagnostics, Nicole Bell.We dive into WHY standard Lyme disease testing can miss cases, what IgM and IgG antibodies can—and cannot—tell us, and how direct-detection methods such as PCR and urine antigen testing differ from ELISA, Western blot, and FISH testing.We also discuss:Why a negative Western blot does not necessarily rule out Lyme diseaseThe difference between antibody testing and direct pathogen detectionWhy testing for Borrelia, Bartonella, and Babesia mattersHow IgM cross-reactivity can complicate test interpretationPersistent infection versus post-treatment Lyme disease syndromeWhy multiple positive antibodies do not always mean multiple active infectionsThe emerging connection between infections, neuroinflammation, dementia, and cognitive declineWhy insurance coverage for advanced testing remains so difficultHow to advocate for yourself when a diagnosis does not explain your symptomsThis conversation is a powerful reminder that receiving a diagnosis does not necessarily mean you have found the root cause. Chronic fatigue syndrome, fibromyalgia, dementia, and even PCOS describe patterns of symptoms-but the bigger question is: WHY are those symptoms happening?My Website & Work with Me: Instagram: ⁠⁠⁠⁠⁠⁠www.instagram.com/faithandfit⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.upliftfitnutrition.com⁠⁠⁠⁠⁠⁠Email for coaching & phone consults: laceydunn@upliftfitnutrition.com & fitandfaith@gmail.comFind Galazy Diagnostics at: https://www.galaxydx.com

On this episode of Your Pet Matters, Dr. T talks and gives breeding advice for pet owners, the decline of preventive care and how personal finances may affect pet car. On Producers Pet Project, Kadie DiGiuseppe goes over affordable breeding options for young pet owners. This is an encore of a previous episode.

6 Pillars of Leadership Most Bosses Get Backwards You can’t cheat the harvest. Not in farming, not in funeral service, and not in leadership. That’s the line I kept coming back to after tonight’s conversation with Jay Jacobson, author of Lead by Legendary Example — a book forged inside a profession with zero room to fake competence: funeral service. Forty years of leading people through the worst day of their lives taught Jacobson something most executive coaches never pick up in a classroom. Leadership isn’t a title, a slide deck, or a TED Talk. It’s what you do when nobody’s applauding. Jacobson’s framework rests on six leadership pillars — Integrity, Presence, Vision, Servant Leadership, Adaptability, and Mentorship — and the mistake most bosses make is treating them like a checklist instead of a practice. They chase vision before they’ve earned presence. They demand loyalty before they’ve modeled integrity. Tonight, Jacobson walked us through a grandfather-and-grandson story that reframed what dignity in leadership actually looks like, and a piece of his own history — assisting families after the Sioux City air disaster and later testifying before the U.S. Senate — that shows exactly what these leadership pillars look like when the stakes are real and there’s no script to follow. Here’s the part that stuck with me most: trust isn’t built in the big speech. It’s built in the routine call you actually prepared for. I tell my coaching clients and hockey parents the same thing — character shows up in the boring repetitions, not the highlight reel. If you run a team, a business, or a household, this episode hands you a mirror. Which of these six pillars are you skipping because it’s inconvenient, and which one is quietly costing you the trust you’re trying to build? You don’t have to take my word for how it unfolds — watch it yourself. The full replay of tonight’s episode of A New Direction with Jay Jacobson is live now on YouTube and available everywhere you get your podcasts. If you lead people — at work, at home, or on a bench — block out 45 minutes and let Jacobson’s version of legendary leadership put yours to the test. Then tell me in the comments: which pillar are you getting backwards? Jay Jacobson‘s book, “Lead by Legendary Example” is a combination of real stories, and practical psychological and behavioral practices that anyone can employ right now.  You don’t have to wait to make things happen with these 6 pillars of leadership, you can start today, this very moment. This book is also special because not only is it a book that you will read, but at the end of each chapter he has simple practical exercises that you can do to change you.  And the second half of the book are 10 sessions that you can even train your team on. The real point of the book however is one that many of us struggle to comprehend.  Change does not come from performing better, real change occurs because we changed our internal selves.  We make a choice through our mind, will and emotions to change the way think so that we can become the leaders and practice the leadership that can be within all of us…if we make that choice. I loved this book.  It read so fast. The stories are real and the insights that Jay Jacobson pulls out of them are relevant and poignant. This book is for everyone.  Not simply “business leaders” it is for all of us who interact with others, because we are all leaders in one way or another.  This book is for you and me! Get your copy of Lead by Legendary Example by clicking here. A New Direction is so grateful to our sponsors, please reach out to them and tell them thank you, and please LIKE their social media pages. Linda Craft Team, Realtors for more than 40 years their customers call their customer service “legendary”. Linda and her team built their business on building relationships and understanding your home is full of memories that are important to you! It is about the relationship, not the transaction. So if you have a question, want a free market analysis of your home just click on over to www.LindaCraft.com and Check out their Facebook Page ABOUT YOUR HOST Meet Jay Izso Executive Performance Coach  |  Host of A New Direction Every week on A New Direction, I sit down with CEOs, founders, and the researchers behind the science of leadership performance. The conversations go deep. We talk about the decisions that built companies, the mistakes that nearly destroyed them, and the personal breakthroughs that changed everything. But here's what most people don't know about me: the show is an extension of the work I do every day with executives behind closed doors. Who I Am I'm an Executive Performance Coach. I work with CEOs and founders of $5M-$50M companies who have hit a wall they can't explain. The marketing looks fine. The team is capable. The market is there. But the business won't move. The problem, almost every time, is the person running it. I find the personal behavioral patterns that are driving the business dysfunction. Then I help the CEO disrupt those patterns so the company can grow. That's it. No motivational platitudes. No vision boards. Diagnostics, intervention, results. Where This Comes From My approach comes from two places most coaches never set foot in. The farm. I grew up as a farmhand in Ithaca, Nebraska—population 100. I started working at nine years old. By the time I left for college, I'd spent a decade learning that you can't cheat the harvest, pain is part of the job, and the work has to get done whether you feel like it or not. I was fourteen the first time I had to castrate boars. Nobody was going to do it for me. That lesson never left: sometimes you have to do things afraid. The forensic psychology unit. In graduate school at Washington State University, I trained under Dr. Thomas Brigham—co-author of the Handbook of Applied Behavior Analysis—in a human behavior lab focused on real-world problems. I then served in a Clinical Psych II role at Eastern State Hospital in Medical Lake, Washington, a forensic setting where I conducted psychological evaluations of individuals charged with the most serious criminal offenses. Sixteen months assessing human behavior at its most extreme taught me how to cut through defenses, identify what's really driving someone's decisions, and see what they can't see in themselves.

Send us Fan MailEmail Lennie at lennielawson2020@gmail.com

Interruptions are, in a way, the currency of emergency medicine. But many of them may be making patient care worse rather than safer. EKGs are a perfect example: physicians may be interrupted thousands of times each year so that every tracing receives immediate attention, even when the overwhelming majority do not represent an emergency. Protecting physician attention doesn't have to come at the expense of quickly identifying patients who need immediate intervention.In this episode, we explore how one emergency department dramatically reduced unnecessary EKG interruptions, why a 10-minute interpretation window may be safer than reflexively interrupting physicians, and how local data helped turn a counterintuitive idea into departmental practice. We also examine how asynchronous communication, protected workspaces, nursing partnerships, and a different way of thinking about attention can create a safer and more intentional emergency department.Guest Bio: Dr. Jake Zadra is a board-certified Emergency Physician and the current Chair of the Department of Emergency Medicine and Diagnostics at St. Mary's Hospital in Janesville, WI, where he also serves as Vice Chief of Staff. He completed medical school ('18) and EM residency ('21) at the University of Wisconsin, where he served as chief resident. Outside of medicine, he's a live music enthusiast, enjoys slipping Lord of the Rings references into everyday conversation, and spends as much time outdoors as possible. He remains one of the few Emergency Physicians with no interest in ultramarathons or BASE jumping.We Discuss:Why Every EKG Doesn't Need to Be an EmergencyThe Cost of 7,000 Interruptions to Find Two Unflagged STEMIsWhat Happens When the EKG Machine Misses a STEMIWhy Fewer Interruptions May Lead to Better EKG InterpretationHow the Workflow Handles Gray-Zone EKGsRethinking the 10-Minute EKG RuleUsing Local Data to Build a Safer WorkflowHow an EKG Drop Zone Keeps Deferred Reviews From Getting LostHow a Quieter Workspace Reduces Drive-By InterruptionsWhy Not Every Interruption Deserves the Same ResponseHow Secure Chat Can Become an Asynchronous InboxWhy Nurses Need Protection From Interruptions TooHow Making Interruptions Visible Creates Buy-InMentioned in this episode:Rob's Book: SupranormalSupranormal: A Field Guide for the Impossible Job, tackles the parts of being a doctor that medical training leaves out, with practical tools for navigating conflict, overwhelm, burnout, and the sustained complexity of medicine, so you can build a career that is both sustainable and fulfilling.Get SupranormalGet Out On TimeThe Out-On-Time Course gives you the tools to complete your charts on shift, manage overwhelm and interruptions, and create fast, focused, kickass notes, so you can stay out of chart debt and get home on time. Self-paced. 12 hours AMA PRA Category 1 CME.Learn More About The Out-On-Time CourseSix Sessions to Recalibrate Your CareerStill like the doctoring, but all the stuff around it is taking a toll? Career Longevity Coaching is six one-on-one sessions over five months to identify what's making your work harder than it needs to be and start making changes. If you're wondering, "How long can I keep doing it like this?" Don't wait until the answer is "I can't."Career Longevity and Burnout Coaching

Dr. Andrew Holman is a rheumatologist and the CEO of Seattle-based Inmedix, which recently received FDA clearance for the first cloud-based heart rate variability (HRV) diagnostic platform. Dr. Holman shares how a “detective” mindset led him from early interests in orthopedics and cardiology into rheumatology, fibromyalgia research, and ultimately entrepreneurship. He explains how chronic stress, the autonomic nervous system, and conditions like sleep apnea and restless leg syndrome can influence cardiovascular risk and autoimmune disease outcomes, and why measuring stress biology with medical-grade precision matters. Dr. Holman also offers hard-earned advice for physician-innovators, reflects on pivotal study results, and shares what he hopes to be remembered for: never dismissing patients in distress.  Guest links: https://www.inmedix.com | https://www.linkedin.com/company/inmedix-inc Charity supported: Save the Children Interested in being a guest on the show or have feedback to share? Email us at theleadingdifference@velentium.com.  PRODUCTION CREDITS Host & Editor: Lindsey Dinneen Producer: Velentium Medical   EPISODE TRANSCRIPT Episode 088 - Andrew Holman [00:00:00] Lindsey Dinneen: Hi, I'm Lindsey and I'm talking with MedTech industry leaders on how they change lives for a better world. [00:00:09] Diane Bouis: The inventions and technologies are fascinating and so are the people who work with them. [00:00:15] Frank Jaskulke: There was a period of time where I realized, fundamentally, my job was to go hang out with really smart people that are saving lives and then do work that would help them save more lives. [00:00:28] Diane Bouis: I got into the business to save lives and it is incredibly motivating to work with people who are in that same business, saving or improving lives. [00:00:38] Duane Mancini: What better industry than where I get to wake up every day and just save people's lives. [00:00:42] Lindsey Dinneen: These are extraordinary people doing extraordinary work, and this is The Leading Difference. Hello, and welcome back to another episode of The Leading Difference podcast. I'm your host, Lindsey, and today I'm delighted to be welcoming as my guest Dr. Andrew Holman. Dr. Holman is a rheumatologist and the CEO of Inmedix, a Seattle-based medical diagnostics company that recently received FDA clearance for the first cloud-based heart rate variability diagnostic platform. He has 25 years of clinical experience with 16 peer-reviewed papers and clinical trials demonstrating that measuring stress biology with medical grade precision can improve success rates in autoimmune diseases. All right. Andrew, welcome to the show. I'm so glad you're here today. [00:01:30] Andrew Holman: Yes, happy to be here. Thank you for inviting me. [00:01:33] Lindsey Dinneen: Course, of course. Well, I would love, if you wouldn't mind starting out telling us a little bit about who you are, what your background is, and what led you to medtech. [00:01:44] Andrew Holman: Sure. Well, I'm a, a guy from Seattle, Washington. Grew up here, but trained everywhere else, became a rheumatologist. We study autoimmune diseases, lupus, rheumatoid arthritis. I also was very interested in fibromyalgia and pain. We're the immunologists of medicine. So, I started my practice, golly, a while ago. 1992, I finished my prac- my training, and I was the main rheumatologist at a large suburban hospital at the southern end of Seattle. So hometown, circle back to the hometown. I went into rheumatology because you have many choices when you do internal medicine. You can go be a specialist in many things. But I like the puzzles. The immunology has grown and it's a, it's a particularly sort of detective-oriented specialty. So, I didn't set out to be an entrepreneur. That came 25 years later. I was an in-the-trenches doc trying to help the person in front of me with these devastating diseases that are crippling diseases, usually of young women mostly. [00:02:45] Lindsey Dinneen: Yeah. Okay, and I'm sure there's, there's much more we're gonna dive into, but one thing that really stood out really fast was you, you kind of called yourself a detective, which I really love that term. And so I'm curious, is that something that you always thought you wanted to specialize in, in medicine, or was this, you know, detectiving to come later? Was this something that, you know, you ended up learning more about while in med school and thought, "Oh, this sounds really cool. I could put really two interesting passions together"? [00:03:19] Andrew Holman: Yeah, it was-- you know, things just sort of come into play sometime. For those who are not in medicine, they may not realize it takes about ten years to go to college, med school, re- internship, residency, fellowship, you know, and then you, then you finally get to go be a doctor, and you have to go learn how to be a doctor s- a little more. The patients teach you a lot more than people realize. So I was gonna be an orthopedist. I liked orthopedics. I liked architecture, bones, joints. I thought it was a lot of fun. I just had very little aptitude for what they do. I, I don't-- I, I'm not very g- a good carpenter. I just, you know, I didn't-- just wasn't gonna be a great orthopedist. So then I thought, "I really love cardiology." Rhythm disturbances, all kinds of things. In the 1980s, when I was in medical school , all the new stents and procedures and non- less invasive things than bypass surgery were all coming up. Joint valve replacement. You know, it's really exciting. But I never... and I never took a, a f- a course in rheumatology until I was actually an intern in internal medicine program in Denver, all set to be a cardiologist. And there were 12 of us in the, in the program per year, and s- five of us became rheumatologists because of this one doctor who took us out, a guy named Daryl McCarter. Prob- maybe people who know him, he's retired recently. He would bring us in the office, and we'd see every other patient with him because in between the patients, he would give us an X-ray, say, "I want you to look at this. There's a clue here. See if you can find it." Or, "I want you to look at this pathology slide," or something. "There's a secret, you know, to figure this one out." And I go, "Wow, this is really fun stuff." And once you figured it out, we weren't as good at treating it yet, but we were getting better. We were getting better. So it was the cutting edge and very fertile ground for discovery. So, rheumatologists are called the consult of last resort for a reason. There aren't very many of us. You've usually seen everybody else first, and by the time they-- you see us, we're pretty good at figuring out the rare diseases that are not in other people's board exam. But we're also pretty good at figuring out the common disease that presents in a very strange way, you know? And, and that's what our strength is. So we may... Everybody who sees us who gets diagnosed may not have a rheumatology answer, but we try to get them an answer. And now we're really in the golden age of rheumatology in the last 20 years of really making a difference for so many people. The downside, we don't make a difference for enough people, you know? We, we... That's the problem. So we've got these very motivated doctors out there, eager, and we just need, you know, more. And that's why I became an entrepreneur, because I learned more neurology than I was supposed to know and more sleep physiology than I was supposed to know. You just follow the breadcrumbs, you know? [00:06:17] Lindsey Dinneen: Yeah. Okay, so I know you didn't start out wanting to, or maybe even being interested in being an entrepreneur, but that is the path that you chose, and I would love to hear about that, the company, and what you're all doing. And then also would love to hear about your journey into deciding that this is the next right step for me. [00:06:38] Andrew Holman: Yeah. Well, thanks for asking it. It is a little unusual. So I was actually studying and trying to help patients with fibromyalgia about 30 years ago. And fibromyalgia patients terribly dismissed till they're all making this up. There's not 10 million people that can make anything up and be consistent. I mean, they all say the same thing. So I thought that was nonsense, and I was really thrown into the crowd of, you know, "You're, you're crazy too." And I go, "Well, I'm board certified in crazy." So I w- I was interested in it, and I was irritated that these people were dismissed. And I was around other doctors in Seattle who were similarly that way, which was very, very unusual. It's unusual to find people in the '90s who had an avid interest in that disorder. And so I started doing what rheumatologists are good at, incrementally advancing ideas and therapeutics very carefully, very cautiously. We do a lot of things off-label. When I was-- finished my fellowship in 1992, half the diseases on our board exam had no FDA-approved treatment. We had to do something, right? You couldn't just say, "Well, come back when there's a couple of articles in the New England Journal of Medicine." You, you can't do that, right? People are depending on you. So rheumatologists are particularly good at that, and that's not something most doctors want to do. Most doctors find that very uncomfortable. They're very, very careful people. And, and rheumatologists are careful too, but we take this mission seriously that we need to do something for you. So basically, I was looking at off-label ideas and work on fibromyalgia, and I'll share this with your audience. I was actually pulled up-- pulled in by some senior doctors who said, "We wanna talk with you." And I'd been there about three years as a new doctor. Oh, you know, seem to be doing a good job. Maybe they wanna pat me on the back or something. No, not that. It was actually an intervention, which I had never... I mean, I had no familiarity with what an intervention was. And they said, "Look, we like you. You're a great doc, but you're gonna ruin your reputation if you believe all these people, mostly women And you really need to not take it so seriously or write prescriptions for this c-- this and that." I said, "Well, thank you very much." That's polite. That's not what I was thinking. And I, I... But it prompted me to pull all the charts and say, "You know, I think I'm making some progress here with some ideas here, and let me see if I'm getting fooled and just seeing the people who get better to come back. Let me really honestly look at my performance." And so I pulled about 200 charts. It was my first abstract at the national meeting. And you know what? We were making progress. That had morphed into more progress, following the breadcrumbs, looking at neurology, looking at the autonomic nervous system. So that was about a five-year process. Y-you know, I didn't lose my reputation, obviously. I lecture around the world now. But it led to being very careful about getting clinical evidence if I had a hypothesis. And so we were using the office, and we actually finally did a double-blind prospective study where I bought all the drug myself, had it reformulated, little capsules that, you know, and, and worked with the FDA to get permission to do the study. And that study in fibromyalgia to this day has the highest response rate of any fibromyalgia study for pain that's ever been done. Now, we don't use that treatment anymore. It's 20 years later, we have other things to do. But it did prompt Pharmacia, got bought by Pfizer, I believe, and Boehringer Ingelheim, which co-marketed the drug I was using and reporting on, to pay me $10 million for the patents that I had filed, utility patents. I didn't own the drug. I didn't use it for Parkinson's disease, but I thought there was use in fibromyalgia. So before I told the world, I filed utility patents, and they wanted to exploit that discovery. So did two other pharmaceutical companies, and they had to pay for the privilege of doing it. So at 46, I retired. So I didn't intend to do that, but I do come from a family of lawyers and judges, and so the idea of having a utility patent on a n- a new innovative idea was not a foreign concept to me. [00:10:40] Lindsey Dinneen: Yeah. [00:10:41] Andrew Holman: That is something I teach all young doctors. [00:10:46] Lindsey Dinneen: That is awesome, and I, I was thinking, okay, this is a great segue because first of all, that's an incredible story. Secondly, I, I would be very curious to know exactly that, what is your advice for some of these incredible physicians, great ideas, that are potentially going to end up becoming an entrepreneur just because that's the path that, that is sort of presented to them? What is some of your advice for that? 'Cause that can't just be... you, you had the privilege at least of, of, of knowing and having some background in that, the legal aspects of IP protection and whatnot, but what are some of the things that you tell people? [00:11:22] Andrew Holman: Well, a couple things I would say and I have these conversations often 'cause I really like the younger people coming along. I say, first of all, don't define yourself as an ent- as being an entrepreneur. Make sure you have other things in your life that are more important to you. Now, the investors are not gonna like to hear that. They, they want you to live and die on your, on your company, right? But I'm saying, you know, you don't have to tell the VCs, but have other things that matter more in your life. You still gotta work really hard because you may, you may find that it's really a slog, and it's very long, and it's very hard. But, you know, make sure that, that, that what you-- though is important, your family, you know, your integrity the scientific problem at hand, the patients, you know, they're number one. Make sure we don't lose sight of all that, and do a few things. Go for a walk. Do something for yourself. Something. I do this twenty-four seven for the last 10 years, you know, every day 'cause I love doing it. It does wear you out, though. Even if you make-- even if you're successful with milestones, it does wear you out. But that's what I tell them. I say, "You know, make sure that you take care of yourself a little bit, too." It's kinda like a analogy. What do you do for a pregnant woman who has a, who has a, a lupus? Lupus is terribly dangerous for the fetus and for the mom. Though the worst thing you do to-- for the baby is not take care of the mom. Take care of mom, [00:12:44] Lindsey Dinneen: Mm-hmm. [00:12:45] Andrew Holman: then get the baby delivered. So, you know, everybody's talking about the baby, but take care of mom. That's the most important thing you do for that baby. So that's kinda what I would say. [00:12:54] Lindsey Dinneen: Yeah. Yeah, that's great. I appreciate that. Yeah, that, that makes a lot of sense too. We've been talking, actually it's been a, a bit of a theme too lately in some of the conversations that I've been having with folks, especially leaders, to talk about that identity component and, and be aware that your job isn't the only thing that defines you or needs to. There's a lot more to your life. There's a lot more to who you are. And so also, you know, our identities change over time and how you refer to yourself and th- those are, those are good things. That's growth, that's movement. So, being comfortable with who you are outside of your career. Yeah. [00:13:33] Andrew Holman: The other thing too is, you know, people used to joke 20 years ago that participation mem- medals were like a farce and what. That's the l- that's the last thing I would say to anybody. Give yourself a pat on the back for going out there trying to attack the castle, you know. Give yourself some credit there because a lot of people just wouldn't do it. My middle daughter was a hundred-meter hurdler at Boise State. She's a Division I athlete. There's a lot of sprinters out there that don't wanna get anywhere near that hurdle 'cause it really hurts when you hit it, right? And so half of that was not-- was being brave. So be brave, be brave, you know. My other daughter was a Division I athlete at Rice. She was a h- she was a volleyball player. Yeah. So, yeah. So I, I, I, I watch other people, see how they persevere and, you know, okay, gotta pick yourself up. Gotta go. Gotta get up this morning. Gotta go. [00:14:23] Lindsey Dinneen: That's right. That-- Yeah. [00:14:25] Andrew Holman: Then remember, people are depending on you, not just your investors. I take that so seriously. But the s- the people who have decided that they're gonna hook their wagon to you. [00:14:34] Lindsey Dinneen: Yeah. [00:14:35] Andrew Holman: You know, that's a lot of responsibility. [00:14:37] Lindsey Dinneen: It is. Yeah. [00:14:38] Andrew Holman: Give yourself a little credit that you're stepping up. [00:14:41] Lindsey Dinneen: Yes. Great advice. Yeah. Okay, so all right. So let's talk about your company now. So now you're an entrepreneur, in addition to obviously the rest of who, what makes you, you. But and I know that you're also a clinical professor, and I would love to hear about both of those things if you don't mind sharing. [00:14:59] Andrew Holman: Yeah, sure. So, technically I'm an associate clinical professor at the University of Washington. A, a lot of private docs do, and they participate in helping teach the y-young residents and fellows and so forth. So it's a joy to me. I, I think my job is a job of teaching. I'm constantly talk... I'm not-- I don't see patients anymore, although I do maintain my license in malpractice 'cause I get, I get contacted for the fibromyalgia work I did. So it's, my email's on the papers, right? So I, I don't wanna let that go. People need help. But basically, we're constantly teaching patients, you know. Now, we're listening, hopefully do better and better at that, but then I have to make a case. You know, I'd, the-- I'd like you to try this or that. Why do I wanna do that and so forth. We're constantly, you know... We don't-- It, it sounds too trite to call it selling something. We're not doing that. We're in there with you. We're collaborating. But I have to be, I have to have a reason and be persuasive and all that, so that, that academic teaching part's kind of fun. Now, sometimes I go into the lion's den. I will tell you, it's a little nerve-wracking to give rheumatology grand rounds at Harvard. Yeah, yeah, okay. You know, and the University of Washington, they're a little friendlier. It's my hometown. But Guy's Hospital in London and the Hospital for Special Surgeries, I... My first rheumatology grand rounds came at the HSS in 2009. I get there, I completely bomb. All these famous people are in the front row. I'm... They're, they're just not buying any of this thing we call immunoautonomics and how stress affects the immune system. I'm quoting the NIH. I'm doing everything I... I know how to do it, right? Pathology slides, I'm there. Then I find out the way they pick the speakers is the fellows get to find something interesting, and they pick the speakers, not the not the high mucky-mucks. So the only reason I was there is because the fellows, the young folks, thought, "This is an interesting topic. We'd like to hear more." And it turns out they were 15 years ahead of the rest of the world, because this is the most fascinating topic of how the immune system affects the autonomic nervous system affects the immune system, so it inflames it. [00:17:03] Lindsey Dinneen: Yeah. Oh my gosh. Actually, that is one thing I wanted to talk about, 'cause I, I noticed on your LinkedIn profile there was, you know, a reference to how much stress affects cardiovascular health maybe particularly chronic stress. And I would just love to hear more about that and, and maybe some ways... I know there's like, y- of course you always get your standard, "Here are some things that you could do to lower your stress." But, but from your perspective as a physician who's studied this, I'd love to hear more from you about, okay, how does this affect health, especially cardiovascular health, and then really what are some practical things that we can do? [00:17:39] Andrew Holman: Yeah, let me see what I can do. Now I wish I could fast-forward because we will have some magnificent things in the next five to 10 years based on what's being discovered now. But the bottom line is, stress and pain are awful things, but they have a purpose in the near term. So pain is good because it'll keep you from putting your hand back in the fire, right? Just don't do that again. But chronic pain is terrible and not productive. Stress is the same thing. You wanna get away from the lion. You, you, you need to perform. If your child needs you, whatever, you, you need to perform on it instant. But chronic stress is not productive. The problem with the stress response is it's controlled in the brain by the autonomic nervous system, which is called the ANS, and it's divided into two components, the sympathetic fight or flight, which we all know what that feels like. You know, ooh, scary. And the other is the parasympathetic, which is getting more talk now, which is the opposite, which is related to rest, restorative, sleep, recovery, growth hormone, all these things. And both of these systems are on simultaneously all the time, but they jockey for predominance depending on what the demands are around you, right? So turns out the sympathetic part has a significant negative impact on cardiovascular health, as you might expect, right? If you're driving your car at five thousand RPMs-- now, nobody has a stick shift anymore-- but if you're driving at five thousand RPMs, you're gonna wear down your engine, even if you go at the same speed as someone who has a two thousand RPMs, right? It, it's, it's what's going on inside the hood there is really important. So stress responses chronically do have measurable, tangible, well-published effects on cardiovascular mortality in long prospective studies. So if we had a magic something, we would do something to lower that epinephrine adrenaline response. Unless, of course, you're in the military, where someone's-- you need every heightened, m-- you know, response that you can get to survive. But for the rest of us, it's better that that system does not ramp up and activate. And we all have a different propensity to how powerful it is and how much it turns on, and also how poorly it turns off. So the stress response, we think of it like epinephrine, adrenaline. That's the easiest way to do it. So what you'd wanna do is to make sure this magnificent part of your brain that is your-- does all your housekeeping functions, this autonomic nervous system, the command and control center that you just wanna work, you don't wanna think about it, is not on a turbocharged, right? And there are people I take care of that they were just born that way. A lot of them, by the way. So things like all the wellness opportunities you can think of are, are targeted just to simply calm the autonomic nervous system. Tai chi, meditation, diet, exercise, all these things have been around for thousands of years because of that. That's what they do. And the practitioners will share that with you. I mean, the there are monks that can lower their heart rate, you know, to like, you know, what would seem lethal to the rest of us, right? That's the parasympathetic drive that lowers heart rate, lowers blood pressure. So those wellness opportunities are real. It will be important that you can manage whether the-- what you're doing is working or not. [00:21:04] Lindsey Dinneen: Mm-hmm. [00:21:04] Andrew Holman: Right? And that's where my company comes in. But the other is things like obstructive sleep apnea. You might think heavy guys... See, someone's gonna send me for a sleep study for sure, but they're not gonna send you. Big mistake, because it turns out that fifty-three percent of Japanese women with rheumatoid arthritis have unexpected obstructive sleep apnea. Oops. And, and we were just taught that we wouldn't even check those people. Well, turns out sleep apnea untreated is a major cardiovascular risk factor equal to cigarette smoking, according to the Sleep Heart Health Study in 2004. That's a big deal. And also, we learned in rheumatoid arthritis, getting back to my work, world, that patients with rheumatoid arthritis don't die from joint disease, they die from premature heart disease. They can also get cancers. So why is that? Well, there's been a lot of effort to try to figure that out in the last twenty-five years, and their risk factors for cardiovascular disease are not explained by the Framingham risk factor of hypertension, cholesterol, smoking, and all the things we, we look, see. But nobody looked at sleep apnea. [00:22:15] Lindsey Dinneen: Mm-hmm. [00:22:17] Andrew Holman: The other reason it's so relevant, though, is sleep apnea is a potent sympathetic arousal. It, it-- You struggle to breathe, right? You kind of obstruct. And what part of your brain tells you to breathe? Your autonomic nervous system. Breathe, right? And it stimulates this adrenaline response over and over and over, and it pounds your heart over the years, and it can lead to sudden death and arrhythmias. So there's a, there's a link there. Never miss sleep apnea. The other one is we found in our office and published about restless leg syndrome. You know, people tap their toes in the airport or they kick the covers around at night. It's pretty benign for most people, but it looks like it very well might be a sympathetic arousal, and there may be relevance there. The therapies for that may have relevance to what we're talking about. Again, very off-label. We're not talking about FDA-approved here. But it-- You ask what can you do? The other one that's coming is vagus nerve stimulation. That is FDA-approved now for rheumatoid arthritis, and they're going to other opportunities to, again, to, to increase the parasympathetic and to lower the sympathetic, right? So that background activity doesn't harm you. The autonomic nervous system may be the primary reason that two patients respond differently to the same treatment. What you bring to the table. It's no different than if I have two people coming to me for a back problem. One is five foot three and one is seven foot three. The way their spine is designed makes it a whole lot harder to treat the seven-foot back, right? I'm not surprising anybody here. So there are things that the patients can bring to the table that matter. Here's the irony. Ninety-seven percent of patients with rheumatoid arthritis in a survey in England said that stress affected their disease activity. It's no surprise to them. And sixty-five percent said they thought it predated getting the disease, that it actually contributed to getting it in the first place. And now there's evidence to suggest that may be true. [00:24:17] Lindsey Dinneen: Oh, boy. [00:24:19] Andrew Holman: So we can't miss sleep apnea just out there. We can't miss restless leg. We can't miss Ehlers-Danlos type three hypermobility type where people can... you can't see me here, but my fingers can bend backwards. But it's, it basically it's very, very common, and those people tend to have increased sympathetic activity naturally. [00:24:39] Lindsey Dinneen: Fascinating. [00:24:39] Andrew Holman: So yeah, so we're, we're waking up a little bit to some very important features here of individuals that may help us do better with the diseases they also come in. [00:24:50] Lindsey Dinneen: Yeah. Wow. [00:24:52] Andrew Holman: Sorry, long answer. Sorry, but there's a lot. [00:24:54] Lindsey Dinneen: No, that's great. I appreciate it, and yeah, well, then there you go. Managing stress is critical to, to your health. It's not just a nice to have, like yeah, yeah, kind of thing. Okay. Whew. [00:25:07] Andrew Holman: Good learning. [00:25:08] Lindsey Dinneen: Okay, awesome. Yeah, so, I'm curious... Okay, so, so again, I like, I like looking at guests' LinkedIn profiles and, and learning more about, you know, what makes you tick outside of your career as well, and I noticed some very fun things that you have listed. So we've got creative writing, horsemanship, golf, and vintage passenger rail cars. I feel like this warrants... [00:25:33] Andrew Holman: Yeah, it's called... Yeah, the American Association of Private Railcar Owners. Yeah. I get ribbed a lot for that, but they're a great bunch. There are about --I don't know if I know all the numbers now, but about 75 to 80 vintage cars from the '20s, '30s, '40s, '50s, who tag on the back of Amtrak, and Amtrak drags them around, and you can actually go rent them, stay in them, whatever. And they have a a annual meeting where they just get on a private train, and they go on tracks that you wouldn't go on naturally, like private rails in the, you know, middle of nowhere. So that's what they like to do. And it's just a lot of fun, especially the dome cars. [00:26:12] Lindsey Dinneen: Okay. That's so cool. [00:26:14] Andrew Holman: I've been a handful of times. I've got a lot of friends there. I don't own a car, but boy, I'd sure like to have one. [00:26:19] Lindsey Dinneen: Yeah. Okay. That is so cool. And then how about horsemanship? How did you... Have you been riding horses your whole life, or how did that come about? [00:26:29] Andrew Holman: So I went to a high school called Thatcher School in Ojai, California, where there are 50 in a class, and there was a requirement, this is over 100 years old, this school, that you had to have a horse. And they would say s- that something about the "outside of a horse is good for the inside of a boy," right? I was the last all-male class in 1977. Now young women get to go there too. It's of note that I have 15 people from Thatcher investing as family and friends in, Inmedix. So, th-they that, that's pretty special. But it's a boarding school. I was there for four years. My dad had gone there, so I'd heard of it. But I got a tremendous education. Th-there aren't a lot of prep schools on the West Coast, but there are some. And, and that's where I learned how to ride a horse like riding a bicycle. My sister is a thoroughbred horse trainer for 40 years. She's retired. She had three or four or five horses, a har-- not the fancy kind of stuff at the Derby. But they, you know, get up at 4:00 a.m. and ride, you know, that kind of... Tough life, but she loved horses. So yeah, I, I'm as, I'm more comfortable on a horse than I am around anything, probably. [00:27:34] Lindsey Dinneen: That's so cool. Okay. Well, this has been really fun to, to get to hear your incredible life story so far, and I'm excited to see where the company continues to advance medical technology. So, you know, I really appreciate everything you're doing. But I do want to ask, is there a moment that stands out to you along your career path so far where you just thought, "Wow, I am in the right industry at the right time"? [00:28:02] Andrew Holman: Yeah, I'd, I'd say there probably was. When we unblinded the prospective double-blind study that we did looking at this five-minute next generation heart rate variability, this HRV we got through the FDA last year. When we unblinded the study, and although that's not part of the FDA clearance, it was a very important moment for me because it showed that it predicted a year in advance who would respond to treatment of rheumatoid arthritis with ninety percent sensitivity, ninety-five percent specificity. So I wanna emphasize that is not what it's cleared for. It's cleared as an HRV tool that doctors can use at their discretion. But that study is what you asked me to answer. And when you unlock a study and you see the results, two things happen. One is we were happy that I was on the right track. That was nice. You know, positive study. Your hypothesis is valid. But it completely changed the view of immunology, [00:28:58] Lindsey Dinneen: Hmm. [00:28:59] Andrew Holman: Because we would have a test now that could measure the autonomic nervous system with exquisite precision. Nobody cared except me. About 10 years ago, we were waiting for better biologics, the things on TV, right? They asked, "Ask your doctor if it's good for you." Nobody realizes that they work about twenty-five percent of the time in terms of disease control. That's a big gap, but it looks like it's the brain that monitors inflammation. The inflammation the immune system is not firewalled against everything. The brain c-controls it, and it's not the endocrine so much with cortisol, it's the autonomic that works in milliseconds that, that epinephrine response. So that's a... You know, you're pretty nervous when you un-- when you-- someone tells you, "Okay, here is the results." [00:29:48] Lindsey Dinneen: Yeah. Wow. [00:29:50] Andrew Holman: And, and, and that was it. And then it turned out in 2015, the other moment was when I was going through the airport at Seattle and I saw the cover of of Scientific American, Bioelectric Medicine, Setpoint Medical's vagus nerve stimulation, hacking the the vagus nerve to fix the autonomic nervous system to reduce the burden of rheumatoid arthritis. I go, "Okay, now it's time." We had the patent on it. Okay. Ten years forward, we're where we are now. We're launching in June, and we have a software juggernaut here and a literally a vital sign. So, th-the doctors decide what to do with this, but we've put it in their hands, and it's paid for by insurance. So yeah. [00:30:34] Lindsey Dinneen: Amazing. Well, that's, that's so cool. Congratulations on that. That's fantastic. Okay, so to pivot the conversation a little bit just for fun, [00:30:43] Andrew Holman: Hmm? [00:30:43] Lindsey Dinneen: imagine that you were to be offered a million dollars to teach a master class on anything you want. What would you choose to teach? [00:30:53] Andrew Holman: Well, I, I learned that you've all had professors that didn't probably know as much as they should about a subject, but they thought it was just fun. I would probably stick with what I know. So I would do a master class on fibromyalgia because you can actually treat it. And there's published data, but it's very-- it's not widely known. We will be using Inmedix and autonomic testing to do research to validate and get that problem finally solved and put to bed. And then the other is this thing called immunoautonomics. It, the term-- I made up the term 15 years ago. It's in the medical literature. So that's what I would teach. Teach what I know. [00:31:27] Lindsey Dinneen: I love that. Okay, excellent. And how do you wish to be remembered after you leave this world? [00:31:34] Andrew Holman: Well, I, you know, it all come... I define myself by what the patients, how they do and what they say. It's not about five stars and all that, you know, you know, there's plenty of those. But it's, it's... I made a, a commitment if somebody says anything about me, I made a commitment when I was a rheumatologist with all these mostly young women upset, that I would never leave the room with them crying. Didn't matter how far behind I was, didn't matter. We went through a lot of Kleenex. There's a l- it's devastating to get these diseases when you're a young woman. And they can put that on my tombstone, not to dismiss people. We had a saying in the office, "It's gotta be something." You know? It's, it's always something. Drives me crazy when doctors will say, "Oh, that's nothing." Well, well, first of all, we know it's not nothing. It, it is always something, and there's something that defines your success, and there has to be things that define your failure. So let's figure out what the something is, but let's not argue that there's nothing there. So let's not dismiss people who are frightened and worried, and maybe they don't tell the story as clearly as we'd hope. But you know what? It's not, it's not their fault. They're in distress. It's amazing what people are like after you help them with their chronic pain. [00:32:45] Lindsey Dinneen: Yeah. Yeah. That is really cool and makes so much sense. Yeah. Thank you. Okay, and then final question: what is one thing that makes you smile every time you see or think about it? [00:32:59] Andrew Holman: It's making me smile right now. When I talk to the young fellows that are in their training and they're finishing up, so they've done three years or four years of medicine, three years of internal medicine after that, and then they do three or two, three, four years of rheumatology, and then they're gonna go out, I tell them how jealous I am of what they're gonna see. The, the last, the last 40 years we had these young men mostly coming in with terrible weight loss and immune systems, falling apart, and these strange tumors, and they're dying of, of infections like yeast and candida that, you know, everybody did fine with, and it was HIV, right? It had to be figured out. Now HIV is a chronic disease. It's like diabetes. We had so many people die in the '80s. Hepatitis C was... You'd have liver enzymes up, and it wasn't hepatitis A 'cause we could test for that, and it wasn't hepatitis B 'cause we could test for that. So we just called it non-A, non-B. Literally, that's what we called it. And then that got to be called hepatitis C, right? 'Cause it was too embarrassing to call it n- what it wasn't. And now hepatitis C is curable with antiviral agents in, like, three weeks. I mean... And then the biologics showed up. They're not perfect, but they were a big step. And then this immunoautonomics and, and understanding how pain and sleep and the autonomic nervous system work. I'm just really jealous of what those young clinicians are gonna get to see. [00:34:27] Lindsey Dinneen: Yeah. Yeah, that's really... Yeah, I can see why. But it sounds like you are, you know, keeping, keeping your what, what would they say? Like, toe in the water or something so that you're able to, to watch some of this as well and be a part of that next [00:34:40] Andrew Holman: I feel like I'm a ne- I feel like I'm neck deep and I'm just hoping I don't go down any lower. [00:34:47] Lindsey Dinneen: Fair enough. [00:34:48] Andrew Holman: 'Cause I have to find a way to pay for it. [00:34:50] Lindsey Dinneen: Oh, yeah, yeah, yeah. The details, you know. Yeah, yeah. [00:34:53] Andrew Holman: You got those details, yeah. [00:34:54] Lindsey Dinneen: Yeah. Oh my gosh. Well, this has been an incredible conversation. I really appreciate your time today and sharing your insights and, and stories and, yeah, I'm so excited to see the future of medicine, and I appreciate perspectives of, like yours, where you just, you share a lot of hope and optimism, and you're actively working to change lives for a better world. So, thank you. [00:35:16] Andrew Holman: Yeah, I, I irritate a lot of people with that optimism, but I'm sorry, it's just there. I can't fix it. [00:35:22] Lindsey Dinneen: Brilliant. Well, I love it. It makes my heart happy, so thank you so much again, and I hope you have the best rest of your day. [00:35:31] Andrew Holman: Thank you so much. Thanks for having me. [00:35:32] Lindsey Dinneen: Of course. [00:35:34] Dan Purvis: The Leading Difference is brought to you by Velentium Medical. Velentium Medical is a full service CDMO, serving medtech clients worldwide to securely design, manufacture, and test class two and class three medical devices. Velentium Medical's four units include research and development-- pairing electronic and mechanical design, embedded firmware, mobile app development, and cloud systems with the human factor studies and systems engineering necessary to streamline medical device regulatory approval; contract manufacturing-- building medical products at the prototype, clinical, and commercial levels in the US, as well as in low cost regions in 1345 certified and FDA registered Class VII clean rooms; cybersecurity-- generating the 12 cybersecurity design artifacts required for FDA submission; and automated test systems, assuring that every device produced is exactly the same as the device that was approved. Visit VelentiumMedical.com to explore how we can work together to change lives for a better world.

Mastering the $250,000 Interview: 4 Lessons From Our Conversation With Craig A. Fleming What actually separates the candidate who walks away with a $250,000 offer from the one who walks away with “we'll be in touch”? That's the question we sat down with on this episode of A New Direction, talking with Craig A. Fleming, author of Mastering the $250,000 Interview. You can catch the full episode now on your favorite podcast platform. But whether you've already listened or you're catching up now, here's what the book — and the conversation — comes down to: the interview most people prepare for isn't the interview that's actually happening. Here are just four of the ideas and thoughts Craig shared. 1. The Interview Starts Long Before You Sit Down The biggest myth about high-stakes interviewing is that it's a performance you can improvise your way through if you're smart enough or charming enough.  At the six-figure level, nobody wins an interview by winging it. Preparation and rehearsal aren't about memorizing a script — canned answers get spotted from a mile away in an executive-level interview. They're about doing the unglamorous work beforehand so that, by the time you're in the room, you already sound like the answer to a question the company hasn't even asked out loud yet. The candidates who get the offer aren't the ones improvising the best answers. They're the ones who rehearsed until the room had nothing left to catch them off guard. 2. Every Question Has a Question Underneath It Here's where a lot of good candidates lose a great interview: they answer the question they were asked instead of the question that was actually meant. Craig give us insights that you must build skills around the idea that reading between the lines is the real skill — figuring out what a company is genuinely looking for, versus what the job posting says on paper. The book points out as well as Craig does on the show, it is rarely about whether you can technically do the job. It's about whether you can solve the specific problem that's keeping someone up at night. That means the strongest interview answers aren't the most polished ones — they're the ones that show you actually understood the problem behind the posting. 3. Your Résumé Isn't Your Life Story — It's a Sales Document One of the more useful reframes in the book: stop treating your résumé, and the interview itself, like a formality where you simply report your history. Start treating both like what they actually are — a sales pitch. The résumé's job is to get you into the room. The interview's job is to close. That shift changes everything about how you prepare. You're not there to be interesting. You're there to prove, point by point, that you're the fix for a specific, expensive problem. Every answer in a $250,000 interview should be doing sales work, whether you think of it that way or not. 4. It Doesn't End When You Leave the Room Maybe the most eye-opening piece of Mastering the $250,000 Interview: the evaluation doesn't stop at the door. Long before — and long after — you sit across from a hiring committee, there's a silent search running in the background. Your social media. Your online footprint. Everything a company can find about you without ever asking you a single question in an interview. The book's point isn't to make you paranoid. It's to make you aware. What shows up in that silent search can either back up everything you said in the interview or quietly undercut it. Either way, it's part of the interview now, whether it's on the official agenda or not. Listen to the Full Interview We covered all four of these in depth in this episode of A New Direction with Coach Jay Izso — why interview preparation matters more than raw talent, how to read what a company is really asking, why your résumé and your interview answers should both be doing sales work, and what the silent search means for how you show up online long before you ever get invited to interview. If you're heading into an interview where real stakes — and real money — are on the line, this is worth the listen. Find the episode on your favorite podcast platform — Apple Podcasts, Spotify, YouTube, or wherever you listen. And if this hit home, share it with someone who has a big interview coming up. They'll thank you for it. Craig Fleming’s book, “Mastering the $250,000 Interview: A Step-by-Step System” is simple the best book on interviewing I have ever read.  And I have read dozens of books on the subject and have taught interviewing at the college level.  While the book may be geared toward the executive interview, the lessons and structure can apply to any interview situation. Every chapter is filled with practical guidance from the psychology of how to read and interpret the job listing, to the psychology of how the interviewers think, to what your online brand and reputation may say about you that is holding you back from getting that next level job or promotion. Craig touches on topics like spending days preparing for the interview, how to express confidence without being over confident, demonstrating your value so you can demand the best salary and benefits, how to turn your resume from experience to a story that demonstrates results and so much more! This book was quite convicting for me, because I say in myself that I have developed habitual words and phrases that are not helping me in my communication.  That if I were in the interview situation would probably disqualify me pretty quickly.  If you want the edge in your next interview you must read this book. Get your copy of Mastering the $250,000 Interview by Clicking Here. Please reach out and like A New Direction sponsors: Linda Craft Team, REALTORS –www.LindaCraft.com Linda Craft Team Facebook Page – Click Here For 40 years helping people all over the world make a transition in life.  They take the stress out of the home selling and home buying process. When you are looking for consistent, top of their game, professional real estate service with a track record of successfully helping 1000's, check out Linda Craft Team, REALTORS. Hey…do me a favor and please tell your friends to subscribe to A New Direction on their favorite podcast platform and give us a 5 star rating we are so grateful when you do! ABOUT YOUR HOST Meet Jay Izso Executive Performance Coach  |  Host of A New Direction Every week on A New Direction, I sit down with CEOs, founders, and the researchers behind the science of leadership performance. The conversations go deep. We talk about the decisions that built companies, the mistakes that nearly destroyed them, and the personal breakthroughs that changed everything. But here's what most people don't know about me: the show is an extension of the work I do every day with executives behind closed doors. Who I Am I'm an Executive Performance Coach. I work with CEOs and founders of $5M-$50M companies who have hit a wall they can't explain. The marketing looks fine. The team is capable. The market is there. But the business won't move. The problem, almost every time, is the person running it. I find the personal behavioral patterns that are driving the business dysfunction. Then I help the CEO disrupt those patterns so the company can grow. That's it. No motivational platitudes. No vision boards. Diagnostics, intervention, results. Where This Comes From My approach comes from two places most coaches never set foot in. The farm. I grew up as a farmhand in Ithaca, Nebraska—population 100. I started working at nine years old. By the time I left for college, I'd spent a decade learning that you can't cheat the harvest, pain is part of the job, and the work has to get done whether you feel like it or not. I was fourteen the first time I had to castrate boars. Nobody was going to do it for me. That lesson never left: sometimes you have to do things afraid. The forensic psychology unit. In graduate school at Washington State University, I trained under Dr. Thomas Brigham—co-author of the Handbook of Applied Behavior Analysis—in a human behavior lab focused on real-world problems. I then served in a Clinical Psych II role at Eastern State Hospital in Medical Lake, Washington, a forensic setting where I conducted psychological evaluations of individuals charged with the most serious criminal offenses. Sixteen months assessing human behavior at its most extreme taught me how to cut through defenses, identify what's really driving someone's decisions, and see what they can't see in themselves.

Learn more about Refrigeration Mentor Customized Technical Training Programs at www.refrigerationmentor.com/courses Join the Refrigeration Mentor Hub here In this episode, we're reviewing a recent field story from inside the Refrigeration Mentor Community of handling a "compressor proof/safety failure" alarm. Upon arrival, the compressor was running. But instead of assuming a nuisance trip, this episode walks through how confirm the cause of issue by running diagnostics using free manufacturer software (Copeland CoreSense). Being able to accurately to validate findings builds technician confidence, speeds up troubleshooting time and helps prevent future costly failures. In this episode, we discuss: (00:48) Compressor Trip Alarms (02:23) Copeland CoreSense Basics (04:02) Laptop and Cable Setup (05:42) Connection Pain Points (07:09) Fixing the Wiring (08:42) How Validation Builds Confidence (10:19) Refrigeration Troubleshooting Skills Helpful Links & Resources: Website: Copeland CoreSense Episode 378. Field Stories: Compressor Failure, Case Freeze-Up Troubleshooting, and Electrical Safety Episode 295. A Compressor Story: The Key to Faster Troubleshooting

In this episode, William Morice II, MD, PhD, President and Chief Executive Officer, Mayo Clinic Laboratories, discusses the evolving role of diagnostics, AI and precision medicine in improving patient care. He also shares Mayo Clinic Laboratories' growth priorities, the changing expectations of patients and the challenges of advancing innovation amid reimbursement pressures.

Recorded at AIDS 2026 in Rio de Janeiro at the Roche Diagnostics booth, host Ben Plumley speaks with Professor Pedro Cahn (Fundación Huésped, Argentina) and Dr. Rupa Patel (Whitman-Walker Health, Washington, DC) about why diagnostics—often overlooked in the HIV continuum—are the essential entry point to prevention and care, especially amid reduced funding. They discuss late diagnosis and loss to follow-up, structural barriers like clinic access and hours, and the need for community-led, person-centered delivery models including outreach brigades, mobile and home-based services, and task shifting to peers and other health workers. The conversation covers integrating point-of-care and lab testing, the promise and risks of self-testing with real-time linkage to support, and linking HIV diagnostics with broader health needs such as TB, STIs, diabetes, and cancer screening to advance equity and progress toward 95-95-95. 00:00 Welcome and Setup 01:22 Live Booth Kickoff 02:20 Why Diagnostics Matter 07:11 Late Diagnosis and Equity 12:15 Reimagining Care Delivery 19:28 Outreach Testing in Practice 22:53 Point of Care vs Lab 27:28 Self Testing Debate 34:35 Building Integrated Platforms 38:30 Policy and Provider Barriers 43:43 Closing Calls to Action Guests: Professor Pedro Cahn Scientific Director Fundación Huésped, Argentina Dr. Rupa R. Patel Biomedical HIV Prevention Clinical and Research Lead Whitman Walker Institute and Health, Washington D.C. Roche Diagnostics https://diagnostics.roche.com AIDS 2026 https://www.iasociety.org/conferences/aids2026 Check Out Ben's Substack: https://substack.com/@benplumley1 Join the Conversation! How do you see the future of global health unfolding? Share your thoughts in the comments! Subscribe & Stay Updated: Listen on Spotify, Apple Podcasts, or your favorite podcast platform. Watch on YouTube & subscribe for more in-depth global health. #hivaids #HIV #AIDS #globalhealth #AIDS2026 #RocheDiagnostics

AI is changing so much in the world of healthcare, including diagnosing illnesses. The technology means this can be done much faster and more accurately than ever before. Between a lack of funding and a shortage of pathology expertise, nearly half of the global population is currently missing out on accessing proper diagnostics. It's a problem that AI can help with, and in this episode of the Swiss Connection science podcast, we will find out how.   Join host Jo Fahy and healthcare reporter Aylin Elçi to look at how the rapid advance of AI in the field is solving some problems, while also creating some new ones.  In this episode we gain expert insight from Dr Laura Rubbia-Brandt, head of the pathology division at Geneva hospital; Dr Francis Meier, one of the three cofounders of the “Centre Suisse de Médecine Préventive” (Swiss Center for Preventive Medicine) in Geneva, which works in collaboration with the “Hôpital de La Tour"; and Dr Suzanne O'Sullivan, a consultant neurologist at University College London. Send us Fan MailSWI swissinfo.ch is a public service media company based in Bern, Switzerland. 

Two people with the same cancer diagnosis might actually need completely different treatments. Here is where digital diagnostics can make a difference. Michelle Martin speaks with Arun Krishna, Area Vice President, Asia at AstraZeneca, about why diagnostic gaps remain a major challenge across the region and where AI can step in. On Live Well with Michelle, listen for a fascinating discussion on how digital diagnostics could reshape the future of healthcare in this part of the worldSee omnystudio.com/listener for privacy information.

Get the free Core Drives in the Wild guide, behavioral design applied to real products: professorgame.com/WildCD Episode Summary Rob breaks down the peak-end rule, the finding from Daniel Kahneman and Donald Redelmeier's 1996 study that people remember an experience by its most intense moment and its ending, not its average. He walks through how cruise lines engineer both moments with nightly raffle dinners, a captain's dinner placed near the end of the trip, and a deliberately overinvested farewell, mapping each to Core Drives 1, 5, and 7 from the Octalysis Framework. Listeners learn why the remembering self, not the experiencing self, drives repeat purchases, how to cap sessions while desire is still climbing, and where the ethical line sits between honest peak design and covering up a bad experience. About the Host Rob Alvarez is Head of Engagement Strategy, Europe at The Octalysis Group (TOG), a leading gamification and behavioral design consultancy. A globally recognized gamification strategist and TEDx speaker, he founded and hosts Professor Game, the #1 gamification podcast, and has interviewed hundreds of global experts. He designs evidence-based engagement systems that drive motivation, loyalty, and results, and teaches LEGO® SERIOUS PLAY® and gamification at top institutions including IE Business School, EFMD, and EBS University across Europe, the Americas, and Asia. Key Takeaways In Kahneman and Redelmeier's 1996 study, deliberately extending a painful colonoscopy so it ended on milder discomfort increased total pain, yet those patients remembered the procedure as less bad and returned for follow-ups at higher rates. The remembering self, not the experiencing self, makes the decision to come back, and it is a terrible statistician: it keeps two data points, the peak and the ending, and discards the average entirely. Cruise lines run the peak-end rule as a business model: nightly raffle dinners built on Core Drive 7 (Unpredictability and Curiosity) and Core Drive 5 (Social Influence and Relatedness) rewrite a mediocre day with a manufactured high. The captain's dinner adds Core Drive 1 (Epic Meaning and Calling) near the end of the trip, and disembarkation is deliberately overinvested because cruises live off travelers who rebook every year, not first-timers. A concrete design move: cap the session while desire is still climbing, so the last memory is "I wanted more" instead of "I was starting to get bored." The ethical line: peak-end design is honest when the peak and the ending tell the truth about the experience, and manipulative when those two moments are used to cover up an experience that was genuinely terrible. Topics Covered 0:00 — The peak-end rule and a painful paradox 1:34 — Inside Kahneman and Redelmeier's 1996 study 2:55 — Experiencing self versus remembering self 4:07 — Rob's reluctant cruise vacation 5:47 — How cruises manufacture nightly peaks 7:38 — Overinvesting in the ending on purpose 9:55 — Cap the session while it's climbing 11:26 — The ethical line of designed memories 12:11 — Diagnostics: did you design your ending? Mentioned in This Episode The peak-end rule Daniel Kahneman and Donald Redelmeier's 1996 study on patients' memories of painful medical procedures The Octalysis Framework and the 8 Core Drives Core Drives in the Wild: Professor Game Free Guide Free Resources and Get in Touch Core Drives in the Wild: Professor Game Free Guide Get Daily Value on Your Email Let's chat about your gamification project YouTube LinkedIn Instagram Facebook Start Your Community on Skool for Free Ask a question

Multiomics: The Next Frontier In Precision Medicine And Diagnostics Standard blood tests aren't giving you the most accurate picture of your health. Our expert examines the critical blind spots in standard medical testing and reveals emerging technology that catches disease at the cellular level. Guest: Dr. Adrijana Kekic, CEO & founder, Futurome Host and Producer: Kristen Farrah   Closing The Info Gap: A New App That's Empowering Patients And Caregivers Patients routinely forget up to 80 percent of the information shared during a doctor's appointment. Thankfully, a new app puts control directly back into the hands of patients by bridging this critical information gap and eliminating the stress of lost instructions. Our expert explores how empowering individuals with clear, accessible records of their care can transform the patient experience and relieve burnout for healthcare providers. Guests: Dr. Arpan Parikh, psychiatrist, CEO & co-founder, Kin Health Host: Greg Johnson Producer: Kristen Farrah Facebook: ingoodhealthpodX: @ ingoodhealthpodIG: @ingoodhealthpodYouTube: @ingoodhealthpodSpotify Apple Podcast In Good Health PodcastSubscribed to the newsletterFull ArchiveContact UsBecome an Affiliate Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Multiomics: The Next Frontier In Precision Medicine And Diagnostics Standard blood tests aren't giving you the most accurate picture of your health. Our expert examines the critical blind spots in standard medical testing and reveals emerging technology that catches disease at the cellular level. Guest: Dr. Adrijana Kekic, CEO & founder, Futurome Host and Producer: Kristen Farrah Facebook: ingoodhealthpodX: @ ingoodhealthpodIG: @ingoodhealthpodYouTube: @ingoodhealthpodSpotify Apple Podcast In Good Health PodcastSubscribed to the newsletterFull ArchiveContact UsBecome an Affiliate Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

This is the third week of our four-part series on the 7th-leading cause of death in the United States.  At Holistic Integration, thorough diagnostics are central to our approach so that we know exactly what is going on and how to treat it.  In this episode, you'll learn:—The standard tests used to diagnose Diabetes.   —How the Hemoglobin A1c test helps to diagnose and monitor Pre-Diabetes and Diabetes.—Why urine tests are helpful in diagnosing Diabetes. —What the C-Peptide test shows about how well the body produces Insulin. —The Body Composition Analysis that is given to every new patient at Holistic Integration and measures your fat percentage better than the BMI. —Why the "research gold standard" Autonomic Nervous System Test is important in evaluating Glucose regulation. —How Holistic Integration is able to diagnose Neuropathy early.  And the high success rate at Holistic Integration for reversing Neuropathy. —The theory of Enterovirus in the development of Diabetes.  And how Indianapolis has one of the highest concentrations of Coxsackievirus. —How a Hair Analysis is helpful for Diabetes in measuring Heavy Metal Toxicity and nutritional Mineral deficiencies.  And the tests for gut health and food allergies that can kick off Diabetes. —Why annual lab tests are necessary for everyone, including babies.  And why it's important for a child's health to test parents even before the baby is conceived. http://www.TheVoiceOfHealthRadio.com*Receive exclusive bonus content as a member of our Voice Of Health Patreon Community:https://www.patreon.com/cw/VoiceofHealthPodcast

Diagnostics for the Brain, ADHD and SPECT Scans with Dr Emily Cabrera A teenager with cognitive disorder, with testing who had a brain injury at three so problem was low blood flow. Looking at nutrition, your metabolic system, the whole person. Dr. Emily K. Cabrera of Dual Minds Integrative Psychiatry Dual Minds Integrative Psychiatry dualmindspsychiatry.com (508) 233-8354 https://dreamvisions7radio.com/paperclips-and-periods/ Daniel Gregory Amen is an American celebrity doctor who practices as a psychiatrist. He is the founder and chief executive officer of Amen Clinics. He is also the founder of Change Your Brain Foundation, BrainMD, and Amen University. He is a twelve-time New York Times best-selling author as of 2023 Please feel free to email Phil at philgeorge@charter.net with any health/nutrition/exercise questions. https://www.wellnesswave.net/ This Week's Video: Join biochemist Phil George as he breaks down what really happens when a dedicated medical professional is forced to navigate a broken healthcare system. From insurance denials to dangerous delays in care, Phil exposes the hidden failures patients never see — and the consequences doctors can't ignore. A Medical Professional vs. a Broken Healthcare System — don't miss this eye‑opening episode. https://youtu.be/Kua-fhRaEKI?si=QPzeDQtwchj2jzEs

Can a company really put people first and still build a thriving workplace culture? On A New Direction with Coach Jay Izso, my guest Josh Block says yes — and he’s got fifteen years of proof. Who Is Josh Block? Josh Block spent fifteen years leading Block Imaging, growing the team from fifty people to more than four hundred, and revenue from thirty million dollars to two hundred fifteen million. He didn’t get there by squeezing more out of people — he got there by building a workplace culture rooted in trust. He went on to found Cube Mobile Imaging, expanding access to medical imaging for patients across the country, and today serves as Executive Advisor at Block Imaging. He’s also the author of the new book People Matter @Work. Josh works with executives navigating growth, brand-new managers who got the title without the training, and teams stuck in fear and disengagement — helping them reshape their workplace culture around trust, ownership, and generosity instead of pressure. Why Workplace Culture Starts With “We,” Not “Me” At the center of People Matter @Work is a simple but demanding idea: the biggest thing standing between a team and real performance often isn’t strategy, budget, or talent — it’s a leader running everything through “me.” Josh’s framework is built to shift workplace culture from isolation to ownership, and from pressure to possibility. If leadership has ever felt heavier the more responsibility you took on, this is the conversation for you. 3 Shifts That Build a Stronger Workplace Culture Josh breaks it down into three practices any leader can start using right away to strengthen their workplace culture: Lead together, not alone. Shared ownership — not hoarded decisions — is the backbone of a healthy workplace culture. Make decisions with intention. Thoughtful choices beat leading on autopilot, and they signal the kind of workplace culture you’re building. Practice transparency. Managing perception wears leaders out; honesty is what makes a workplace culture people actually trust. Whether you’re an executive navigating change, a manager who wasn’t quite ready for the promotion, or leading a team stuck in disengagement, these three shifts are the blueprint for a workplace culture where people — and performance — actually thrive. Listen to the Full Conversation Josh’s book is a playbook for building the kind of workplace culture where trust, accountability, and generosity aren’t posters on a wall — they’re how the place actually runs. Catch the full conversation with Josh Block on A New Direction with Coach Jay Izso, live and on the podcast, and get a new direction on what it actually means to lead. Josh Block’s book, “People Matter at Work: Fostering a Culture Where Team Members Thrive and Everyone Wins” is an outstanding book.  If you are a fan of “The 5 Dysfunctions of a Team” by Lencioni then you are going to love this book!  It takes a deeper look at how we will can truly build a team that builds trust and makes you organization and business more profitable. We have all heard the saying, “culture eats strategy for breakfast” well Josh Block has the proof as he takes his company to a higher stratosphere financially through a powerful workplace culture shift.  And how does he do that?  By sharing the principles of People Matter @Work. Josh literally takes us through his step of becoming a 20 something President of an already successful company and makes it even better.  He recognizes during his own humbling experience there are 3 T’s, Working Together, making Thoughtful Decisions that affect his people, and being Transparent, helps his entire workforce become safe, seen, and successful.  And the result is people take ownership of the company to want to see it succeed and in turn makes it tremendously profitable. It may sound like a risk to the average CEO, but as Josh points out the real risk was by not doing the work to make his entire team a integral part of the business.  This book is for both the current leader and the aspiring leader.  And he not only has proved, he gives you the tools and the mindset to create it for your business as well.  Really enjoyed every page of the book.  I highly recommend it. Get your copy of People Matter @Work by clicking here!  Please Thank The Sponsors of A New Direction by LIKING and Following their pages: Linda Craft Team, REALTORS no matter where you live in the world, Linda Craft and her team can help you find the best professional in your area to help you sell or buy your next home. While most real estate professionals belong to a nationally affiliated company where they are obligated to use the people in their company's network. Linda Craft Team are privately owned and operated.  That means they can find the absolute best professional from ANY company to ensure you get the best service. Located in the Raleigh Research Triangle Park of North Carolina…they are indeed legendary when it comes to service.  Learn more  by going to Linda Craft & Team, REALTORS  www.LindaCraft.com Hey…do me a favor and please tell your friends to subscribe to A New Direction on their favorite podcast platform and give us a 5 star rating we are so grateful when you do! ABOUT YOUR HOST Meet Jay Izso Executive Performance Coach  |  Host of A New Direction Every week on A New Direction, I sit down with CEOs, founders, and the researchers behind the science of leadership performance. The conversations go deep. We talk about the decisions that built companies, the mistakes that nearly destroyed them, and the personal breakthroughs that changed everything. But here's what most people don't know about me: the show is an extension of the work I do every day with executives behind closed doors. Who I Am I'm an Executive Performance Coach. I work with CEOs and founders of $5M-$50M companies who have hit a wall they can't explain. The marketing looks fine. The team is capable. The market is there. But the business won't move. The problem, almost every time, is the person running it. I find the personal behavioral patterns that are driving the business dysfunction. Then I help the CEO disrupt those patterns so the company can grow. That's it. No motivational platitudes. No vision boards. Diagnostics, intervention, results. Where This Comes From My approach comes from two places most coaches never set foot in. The farm. I grew up as a farmhand in Ithaca, Nebraska—population 100. I started working at nine years old. By the time I left for college, I'd spent a decade learning that you can't cheat the harvest, pain is part of the job, and the work has to get done whether you feel like it or not. I was fourteen the first time I had to castrate boars. Nobody was going to do it for me. That lesson never left: sometimes you have to do things afraid. The forensic psychology unit. In graduate school at Washington State University, I trained under Dr. Thomas Brigham—co-author of the Handbook of Applied Behavior Analysis—in a human behavior lab focused on real-world problems. I then served in a Clinical Psych II role at Eastern State Hospital in Medical Lake, Washington, a forensic setting where I conducted psychological evaluations of individuals charged with the most serious criminal offenses. Sixteen months assessing human behavior at its most extreme taught me how to cut through defenses, identify what's really driving someone's decisions, and see what they can't see in themselves.

What if the difference between listing your house as-is and walking away with real money came down to knowing exactly where to put $10,000 — and exactly where not to? That’s the question I dug into on this episode of Real Estate Right Now with Steve Kruger, Senior Listing and Sales Expert with Linda Craft Team, REALTORS. Steve’s team built a Fix & Flip program that lets sellers renovate before they list and pay at closing — but here’s what most people miss: the real value isn’t the financing. It’s Steve walking through a home and telling you, room by room, which fixes actually move the sale price and which ones are just money out the window. We spent real time on this, because it’s the heart of the episode — how Steve decides whether spending $10,000, $25,000, or $50,000 leaves a seller ahead at the closing table, or just leaves them poorer with a shinier house. And we didn’t stop at theory. Steve walked us through an actual before-and-after: the condition the home was in, what he recommended, what it cost, and what it sold for. That one example alone is worth the listen. If you’ve got a home that needs some love before you sell — or you’ve been told “just list it as-is” and aren’t sure that’s the right call — catch the full conversation, “Fix It, List It, Profit: The Smart Way to Sell for More.” Link in the comments. Then tell me: what’s the one improvement you’d never skip before selling? Linda Craft Team, REALTORS no matter where you live in the world, Linda Craft and her team can help you find the best professional in your area to help you sell or buy your next home. While most real estate professionals belong to a nationally affiliated company where they are obligated to use the people in their company's network. Linda Craft Team are privately owned and operated.  That means they can find the absolute best professional from ANY company to ensure you get the best service. Located in the Raleigh Research Triangle Park of North Carolina…they are indeed legendary when it comes to service.  Learn more  by going to Linda Craft & Team, REALTORS  www.LindaCraft.com Hey…do me a favor and please tell your friends to subscribe to A New Direction on their favorite podcast platform and give us a 5 star rating we are so grateful when you do! ABOUT YOUR HOST Meet Jay Izso Executive Performance Coach  |  Host of A New Direction Every week on A New Direction, I sit down with CEOs, founders, and the researchers behind the science of leadership performance. The conversations go deep. We talk about the decisions that built companies, the mistakes that nearly destroyed them, and the personal breakthroughs that changed everything. But here's what most people don't know about me: the show is an extension of the work I do every day with executives behind closed doors. Who I Am I'm an Executive Performance Coach. I work with CEOs and founders of $5M-$50M companies who have hit a wall they can't explain. The marketing looks fine. The team is capable. The market is there. But the business won't move. The problem, almost every time, is the person running it. I find the personal behavioral patterns that are driving the business dysfunction. Then I help the CEO disrupt those patterns so the company can grow. That's it. No motivational platitudes. No vision boards. Diagnostics, intervention, results. Where This Comes From My approach comes from two places most coaches never set foot in. The farm. I grew up as a farmhand in Ithaca, Nebraska—population 100. I started working at nine years old. By the time I left for college, I'd spent a decade learning that you can't cheat the harvest, pain is part of the job, and the work has to get done whether you feel like it or not. I was fourteen the first time I had to castrate boars. Nobody was going to do it for me. That lesson never left: sometimes you have to do things afraid. The forensic psychology unit. In graduate school at Washington State University, I trained under Dr. Thomas Brigham—co-author of the Handbook of Applied Behavior Analysis—in a human behavior lab focused on real-world problems. I then served in a Clinical Psych II role at Eastern State Hospital in Medical Lake, Washington, a forensic setting where I conducted psychological evaluations of individuals charged with the most serious criminal offenses. Sixteen months assessing human behavior at its most extreme taught me how to cut through defenses, identify what's really driving someone's decisions, and see what they can't see in themselves.

Is an elevated prostate-specific antigen (PSA) the beginning or the end of the prostate cancer workup? On this episode of BackTable Urology, Dr. Ruchika Talwar interviews Dr. Tarik Benidir to explore the “PSA problem,” explaining why PSA is biologically useful but clinically imprecise, often leading to false positives, unnecessary biopsies, and detection of indolent disease. They discuss a rational, patient-centered approach to elevated PSA, including when to repeat the test, how to interpret results in the context of age, race, family history, and prostate size, and the use of PSA density and age-adjusted norms instead of rigid cutoffs. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported byCleveland Diagnosticshttps://www.isopsa.com/ --- Timestamps 00:00 - Introduction04:03 - Why PSA Can Be Misleading06:43 - Approach to Elevated PSA and Initial Workup09:51 - MRI, PSA Density, and Biomarker Testing14:31 - Guidelines, Diagnostics, and When to Biopsy20:16 - Comparing 4K, IsoPSA, and Other Biomarkers25:23 - Choosing Between Transperineal and Transrectal Biopsy28:42 - Management Considerations for Elderly and Comorbid Patients33:09 - Active Surveillance, Recurrence, and Long-Term Monitoring40:47 - Key Takeaways and Closing Remarks --- More about this episode The conversation highlights the role of reflex biomarkers, MRI scans, and selective biopsy strategies to reduce unnecessary procedures and focus on identifying clinically significant cancers. Dr. Benidir explains how to weigh MRI results, when to use biomarkers, and how to approach decisions in elderly or comorbid patients. They also discuss new biopsy modalities, active surveillance, and future directions for optimizing PSA-based screening and management. --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Servant Leadership: Are You Avoiding It? What if the biggest leadership breakthrough of your career isn’t a new strategy, a new title, or a new set of KPIs — but a philosophy you’ve been overlooking your whole career? That’s the question at the heart of today’s show. At 5pm Eastern on “A New Direction with Coach Jay,” I’m sitting down live with Mark Miller — co-author, alongside legendary leadership expert Ken Blanchard, of the newly revised and expanded 4th edition of “The Secret: What Great Leaders Know and Do.” Blanchard and Miller say 82 percent of managers struggle to lead effectively, and their answer to why is deceptively simple: servant leadership. If that number makes you uncomfortable, good — that’s exactly why this conversation matters. “The Secret” isn’t your typical leadership book stacked with theory and jargon. It’s a business fable — the story of Debbie Brewster, a newly promoted executive who’s drowning in low morale, high turnover, and a team that’s losing faith in her. Her mentor hands her one deceptively simple truth: great leaders serve. That’s servant leadership in action, and it plays out through the five practices of the SERVE model — seeing the future, engaging and developing others, reinventing continuously, valuing both results and relationships, and embodying the values you claim to hold. What makes this conversation especially powerful is who’s sitting across from me. Mark Miller didn’t study servant leadership from a distance — he lived it. He walked into Chick-fil-A as the company’s 16th employee, starting out in the warehouse and mailroom, and spent the next 45 years working his way up through Corporate Communications, Field Operations, and Training and Development before retiring as Vice President of High-Performance Leadership. That’s a quarter century spent directing research and initiatives worth tens of millions of dollars to figure out, test, and validate what actually works when you’re trying to lead people well.  This is a man who has been in the trenches — which means today’s conversation isn’t theory, it’s tested truth. So here’s what we’ll be digging into together: why so many capable, hardworking managers still fail to lead effectively — and what the small percentage who practice true servant leadership are doing differently. We’ll talk about what it really means to “see the future” as a leader, why reinventing yourself never stops being optional, and how you rebuild trust and credibility once it’s been damaged.  Whether you’re leading a team of two or two thousand, this episode is going to hand you a servant leadership framework you can start using before the day is over. If you would like engage Mark’s services you can call him on his cell phone directly: 678-612-8441 or email Mark, mark@leadeveryday.com Ken Blanchard & Mark Miller‘s book, “The Secret: What Great Leaders Know and Do, , 4th Edition, Revised and Expanded” is what I would refer to as a timeless guide for those seeking to be great leaders.  Why do I say timeless?  Because the principles in this book would work in the first century and will work any time in the future. I had never read the previous versions of the book, so I do not know what to compare it to, but I can tell you that was fundamental mind shifts in every single chapter.  The book is counter-intuitive for those leaders that believe they must be in control.  Yes, you need to be valuing results, but if you want your leadership to translate into great results you need to value those relationships both inside and outside of your organization or business. You have probably heard the term “servant leadership”.  But you may have not really thought how a leader actually serves others.  Well, this is where the book sets itself apart from other books.  It doesn’t just talk about it as a philosophical ideal, but puts into practical terms that translate into greater profits, and truly having a great team. I truly enjoyed reading every page of this book.  What I pulled from The Secret was more than a great story that surrounded the main principles of SERVE, but also the valuable practical nuggets that made me think, and that I could apply to my own leadership immediately.  Do yourself and your business a huge favor and get it. You can get your copy of The Secret by clicking here. Please reach out and thank the sponsors of  A New Direction and bringing you great guests like these: Linda Craft Team Realtors. So what can you say about a real estate company that has spent more than 40 years at the top of their game? Well the first thing is you have to admit that their customers and clients continue to drive their business…but why? That's because the Linda Craft Team continue to believe that every person and every relationship is important, not just now, but even in the future. It is why she is devoted to continually adding value to her clients and community by serving them in ways that matter…it is also why their clients say, “The Linda Craft Team have legendary customer service!” When it comes to real estate start with the legends start with Linda Craft & Team, Realtors – www.LindaCraft.com Hey…do me a favor and please tell your friends to subscribe to A New Direction on their favorite podcast platform and give us a 5 star rating we are so grateful when you do! ABOUT YOUR HOST Meet Jay Izso Executive Performance Coach  |  Host of A New Direction Every week on A New Direction, I sit down with CEOs, founders, and the researchers behind the science of leadership performance. The conversations go deep. We talk about the decisions that built companies, the mistakes that nearly destroyed them, and the personal breakthroughs that changed everything. But here's what most people don't know about me: the show is an extension of the work I do every day with executives behind closed doors. Who I Am I'm an Executive Performance Coach. I work with CEOs and founders of $5M-$50M companies who have hit a wall they can't explain. The marketing looks fine. The team is capable. The market is there. But the business won't move. The problem, almost every time, is the person running it. I find the personal behavioral patterns that are driving the business dysfunction. Then I help the CEO disrupt those patterns so the company can grow. That's it. No motivational platitudes. No vision boards. Diagnostics, intervention, results. Where This Comes From My approach comes from two places most coaches never set foot in. The farm. I grew up as a farmhand in Ithaca, Nebraska—population 100. I started working at nine years old. By the time I left for college, I'd spent a decade learning that you can't cheat the harvest, pain is part of the job, and the work has to get done whether you feel like it or not. I was fourteen the first time I had to castrate boars. Nobody was going to do it for me. That lesson never left: sometimes you have to do things afraid. The forensic psychology unit. In graduate school at Washington State University, I trained under Dr. Thomas Brigham—co-author of the Handbook of Applied Behavior Analysis—in a human behavior lab focused on real-world problems. I then served in a Clinical Psych II role at Eastern State Hospital in Medical Lake, Washington, a forensic setting where I conducted psychological evaluations of individuals charged with the most serious criminal offenses. Sixteen months assessing human behavior at its most extreme taught me how to cut through defenses, identify what's really driving someone's decisions, and see what they can't see in themselves.

Today on the Uplevel Dairy Podcast, Peggy Coffeen interviews Dr. Kyle Becker, a Heritage Vet Partners veterinarian and former Indiana dairy farm kid who learned to AI cows at 12 and began practicing immediately after graduation. Becker describes his atypical, influencer-style DiSC profile and how it supports team-building, client collaboration, and bridging ownership–employee gaps on modern dairies. He shares using Krishi's SHERPA Vision technology to rapidly analyze nasal swabs for antibiotic resistance, enabling treatment plans within hours and earlier intervention on the ascending side of a disease “bell curve,” with examples including a stressed calf raiser and a Salmonella Dublin outbreak with no deaths. Becker discusses adapting to changing disease, production, and technology, balancing farmer and veterinarian perspectives, raising five children involved in chores, and prioritizing community service, learning, and farm culture.Heritage Vet Partners is the nation's leading veterinary partnership, specializing in mixed and large animal practices.  Heritage Vet Partners provides a unique partnership model that preserves local practice legacies, serving dairy and other livestock producers and companion animal owners through shared services, data, and strategic growth. Learn more at HeritageVetPartners.com04:34 Growing Up Dairy05:41 AI School at 1210:47 Choosing Vet Medicine12:56 Thrown Into Practice14:20 Going Solo Consulting15:54 Connector Problem Solver18:28 Rapid Resistance Testing22:32 Managing the Bell Curve26:43 Salmonella Rapid Response28:06 Speed Beats Analysis28:54 Finding The PI Calf30:55 Four Days Saved32:05 Future Of Animal Health35:19 Vet And Farmer Perspective38:24 Family And Farm Chores40:46 Community First Values

When is cerebrospinal fluid (CSF) biomarker testing the best choice for diagnosing Alzheimer's disease (AD)? Credit available for this activity expires: 8/19/27 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/alzheimers-disease-precision-diagnostics-3-part-live-2026a1000rmh?ecd=bdc_podcast_libsyn_mscpedu

Our dear friends invited us to an event this weekend in LA… they are partnering with Gary Brecka to build Ultimate Longevity Centers which will bring treatments and testing that just hasn't been easily accessible before now. I believe the way we look at aging is outdated and I'm going to share the biggest take aways I got from his on stage message and chatting with him one on one. We are talking about very practical starting points and Gary Brecka's actual morning health routine. Stop waiting until something is wrong to start taking care of your body. We have been taught this idea that getting older automatically means getting weaker, having less energy, gaining weight, losing muscle, sleeping worse, becoming more anxious, needing more medications and eventually developing all of the diseases that "run in our family." Gary challenges a lot of that thinking. His message is essentially… What if we became obsessed with keeping our bodies functioning incredibly well for as long as possible? What if instead of asking, "How do I treat disease once I have it?" we asked, "How do I create a body that is incredibly difficult for disease to thrive in?" And then there's the longevity piece that completely fascinates me. Gary believes we're entering a period where medicine, AI, biological data and longevity research are going to advance so rapidly that lifespan could look radically different in the future. Maybe 120. Maybe beyond. We don't know. But what we do know is that we need to keep ourselves healthy enough NOW to benefit from whatever becomes possible later. So today's episode is about doing the things that give you the strongest, healthiest, most capable body possible. I've been listening to Gary Brecka talk about health, longevity, anxiety, genetics, sleep, sunlight, oxygen, muscle, bloodwork and what he believes is coming next in longevity science. THE BIG IDEA: YOUR HEALTH IS BUILT EVERY DAY One of my biggest takeaways from Gary is that health isn't something we deal with when there's a problem. It's something we're building every single day. Your sleep last night matters. What you do when you wake up matters. Whether you move your body matters. Whether you maintain muscle matters. Your metabolic health matters. Your stress matters. Your relationships matter. Your nutrition matters. Your environment matters. And individually, none of these things feels life-changing. But repeated for years and decades… they become your life. Gary describes his routine as simple, portable and repeatable. I LOVE that. Because the best health routine isn't the $100,000 biohacking setup. It's the one you'll actually do every day. HABIT #1: HYDRATE BEFORE YOU DO ANYTHING ELSE Gary starts his morning with water and minerals. One version of his routine is a large glass of room-temperature water with mineral salt and sometimes lemon. His current routine also frequently includes mineral salt, hydrogen water and essential amino acids. Wake up and hydrate. You've just spent roughly eight hours without drinking anything. Don't make coffee your first liquid of the day. Put water next to your bathroom sink. Put it next to your coffee machine. Make it automatic. Gary likes mineral salt because sodium and other minerals participate in fluid balance and normal nerve and muscle function. HABIT #2: GET OUTSIDE FIRST THING Gary says to get outside within the first part of your morning and get natural outdoor light into your eyes. His routine generally calls for about 10 minutes outside. Morning light helps tell your brain: It's daytime. Start the clock. Light is one of the strongest environmental signals for the circadian system. Properly timed morning light can shift circadian timing earlier and increase daytime alertness. And I love thinking of sleep this way: Your good night's sleep starts in the morning. We tend to think sleep health starts when we crawl into bed. But your body has been receiving signals all day telling it when to be awake and when to prepare for sleep. HABIT #3: BREATHE ON PURPOSE Gary talks about oxygen constantly. His personal morning practice has included three rounds of deep breathing followed by breath holds. And this connects to another thing we've been talking about: Anxiety. I love the idea that when you feel anxious, you shouldn't immediately decide: "I'm an anxious person." Anxiety is a state your nervous system is experiencing. Sometimes your thoughts are driving your physiology. And sometimes your physiology can amplify anxious thoughts. Either way, changing the physical state can sometimes help change the mental state. Research on structured breathwork has found modest improvements in stress and anxiety, although it isn't a cure-all and the quality of studies varies. HABIT #4: GIVE YOUR BRAIN SILENCE Gary often combines his morning breathing with quiet, gratitude and reflection. He has described sitting quietly for around 10 minutes, looking toward the horizon or closing his eyes and thinking about gratitude. (PodScripts (https://podscripts.co/podcasts/the-ultimate-human-with-gary-brecka/246-gary-brecka-answers-googles-most-searched-questions-on-his-diet-wellness-and-lifestyle?utm_source=chatgpt.com)) Think about how different this is from what most of us do. Eyes open. Phone. Email. Instagram. News. Text messages. Stress. Other people's priorities. And we wonder why we feel overstimulated. TRY THIS: Before consuming everybody else's thoughts… Have some of your own. What am I grateful for? What matters today? Who needs me today? How do I want to feel today? What is actually important? PRACTICAL VERSION: Five minutes. That's it. No phone. No podcast. No input. Just quiet. HABIT #5: USE CONTROLLED DISCOMFORT Cold exposure is another major Brecka habit. If he has access to a cold plunge, he uses it. When traveling, he has said a cold shower works too. But I think there is a bigger lesson here than whether everybody needs to buy a cold plunge. Stop designing your entire life around comfort. Human beings are unbelievably adaptable. Exercise is stress. Heat is stress. Cold is stress. Fasting is stress. Challenging your brain is stress. The key is appropriate amounts of stress followed by recovery. HABIT #6: MOVE EARLY Gary includes movement in his morning routine. But here's what I love: It doesn't need to be a full workout. Walk. Stretch. Squat. Lift. Do yoga. Go outside. Movement tells your body: We're alive. We're using this machine today. And then keep moving after the morning is over. One exceptionally practical habit is walking after meals. Instead of finishing dinner and immediately sitting on the couch… WALK FOR 10 MINUTES. Moving skeletal muscle after eating can help the body handle glucose. You don't need workout clothes. You don't need a gym. You don't even need to sweat. Walk around your neighborhood. Walk your dog. Walk while you're on a phone call. ONE OF THE EASIEST HEALTH RULES: Eat → walk. HABIT #7: BUILD MUSCLE LIKE YOUR FUTURE DEPENDS ON IT This is where I think longevity conversations get really practical. MUSCLE IS NOT JUST ABOUT LOOKING GOOD. Maintaining muscle becomes increasingly important as we age. Resistance training is one of the most powerful non-drug strategies available for preserving and building skeletal muscle. Losing muscle eventually affects: strength balance mobility independence your ability to recover from illness your ability to do normal life You're not building your 2026 body. You're building your 2056 body. HABIT #8: PRIORITIZE PROTEIN AND REAL FOOD- avoid processed foods Gary emphasizes protein and essential amino acids because preserving lean tissue is a major part of his longevity philosophy. The research strongly supports resistance training for preserving muscle, while evidence regarding how much additional benefit comes from protein supplementation specifically is more mixed. HABIT #9: PROTECT YOUR METABOLIC HEALTH I think this deserves WAY more attention. We obsess over weight. Gary talks much more about metabolic health. There is a difference. Weight is one number. Metabolic health includes things like: blood glucose insulin sensitivity blood pressure blood lipids waist circumference fitness body composition Instead of only asking: "How much do I weigh?" Ask: "How well is my body functioning?" Someone can lose weight while losing muscle. Someone can be thin and still have poor metabolic health. PRACTICAL HABITS: Strength train. Walk. Walk after meals. Eat mostly whole foods. Get enough sleep. Maintain healthy body composition. Reduce constant snacking if it isn't serving you. Know your basic health numbers. THE GOAL ISN'T SKINNY. The goal is metabolically capable. HABIT #10: TEST… DON'T JUST GUESS This might be one of my favorite parts of Brecka's philosophy. Stop guessing about everything. If you're exhausted all the time… investigate. If you're unusually anxious… investigate. If your sleep has suddenly changed… investigate. If your energy has disappeared… investigate. If your hormones feel completely different… investigate. If you feel awful despite doing "everything right"… investigate. Don't immediately decide: "I'm getting old." "This runs in my family." "I'm just an anxious person." "My metabolism sucks." "This is just how I am." ASK BETTER QUESTIONS. Could something modifiable be contributing? sleep nutrient deficiencies thyroid function iron status medications hormones metabolic health stress alcohol caffeine environment psychological health This does NOT mean ordering every exotic test on the internet. It means becoming curious about your own biology. HABIT #11: DON'T TURN ANXIETY INTO YOUR IDENTITY This is worth repeating because I think this is such an important mental shift. Instead of: "I AM anxious." Try: "I'm experiencing anxiety." Those are very different statements. One is an identity. One is a temporary condition worth investigating. Gary's message leans heavily toward investigating biology. He talks about things like methylation pathways and MTHFR. There are legitimate genetic influences on anxiety. But anxiety is complex. Research suggests anxiety disorders arise through a combination of genetic vulnerability and environmental influences, not one single "anxiety gene." (PubMed (https://pubmed.ncbi.nlm.nih.gov/15699295/?utm_source=chatgpt.com)) So I would approach it from ALL DIRECTIONS: Calm the body. Investigate the biology. Work on the thoughts. Breathwork. Sleep. Exercise. Less overstimulation. Healthy relationships. Therapy when needed. Medical evaluation when something feels physiologically off. Nutrition. Less caffeine when appropriate. Time outdoors. Don't choose between: "It's psychological." or "It's biological." It can be both. HABIT #12: GENETICS ARE INFORMATION… NOT ALWAYS DESTINY This is another Gary Brecka concept that I think is incredibly empowering when we phrase it accurately. People say: "Diabetes runs in my family." "Anxiety runs in my family." "Heart disease runs in my family." "Autoimmune disease runs in my family." And we can start thinking: Well… I guess that's coming for me too. But genetics often represent susceptibility rather than certainty. Your genes can increase risk. Your environment can increase or decrease risk. Your behaviors matter. Your metabolic health matters. Your exposures matter. Your entire biological environment matters. So instead of thinking: "My family gets this disease." Think: "I may have inherited a vulnerability. What parts of that vulnerability can I modify?" THAT is empowering. Important distinction: Some diseases absolutely are caused by inherited genetic mutations. So we should not say: "Genetic diseases aren't real." They absolutely are. The better message is: Genes can load the gun. They don't always pull the trigger. And with many complex chronic diseases, what ultimately happens involves an interaction between genetics and environment. HABIT #13: STOP THINKING OF SLEEP AS LOST PRODUCTIVITY Sleep is when your body gets to repair. And Brecka's evening routine reflects this. He emphasizes regular sleep, reducing stimulation late at night and setting up the next morning by protecting the night before. My favorite way to think about sleep: Tomorrow starts tonight. Stop trying to squeeze another hour out of your day if it destroys tomorrow. Decide when you're going to bed BEFORE you're tired. Dim things down. Get off your phone. Stop working. Let the nervous system receive a signal that the day is ending. Pick a bedtime and protect it the same way you'd protect an important meeting. NOW LET'S TALK ABOUT LIVING TO 120 The speed of advancement is changing. AI can analyze enormous amounts of biological data. Diagnostics are improving. Scientists are studying the actual biology of aging rather than treating aging purely as an unavoidable decline. Researchers are investigating cellular senescence, epigenetics, regenerative medicine and other mechanisms associated with biological aging. Gary believes these developments could eventually change human lifespan dramatically. And his argument is essentially: Stay alive and stay healthy long enough to benefit from what's coming. That hit me HARD. Because imagine being 75 in the future… But instead of arriving at 75: metabolically sick weak frail sedentary cognitively struggling carrying multiple preventable chronic illnesses You arrive: strong metabolically healthy active engaged cognitively sharp sleeping well maintaining muscle surrounded by people you love THAT is the bridge. Not: "How do I live forever today?" But: "How healthy can I be when tomorrow's medicine arrives?" DON'T JUST CHASE LIFESPAN. CHASE HEALTHSPAN. I don't want to simply exist until I'm 120. I want to LIVE. I want to: travel walk everywhere lift my suitcase play with grandchildren hike swim think clearly learn new things have great conversations have energy be independent laugh have purpose wake up excited THAT is longevity. Not adding years at the end where you can't live. Adding life to the years. WHAT SHOULD WE ACTUALLY DO RIGHT NOW? If you took this entire episode and boiled it down into a daily longevity checklist… MORNING Hydrate. Get outside. Get natural morning light. Breathe intentionally. Spend a few minutes in quiet. Think about gratitude. Move your body. Use cold exposure if you enjoy it and it's appropriate for you. Don't immediately flood your brain with stress. DURING THE DAY Eat nutrient-dense real food. Prioritize protein. Strength train consistently. Walk. Walk after meals. Stay metabolically healthy. Maintain muscle. Build meaningful relationships. Have purpose. Keep learning. Get outside. NIGHT Stop eating mindlessly late into the evening. Reduce stimulation. Get off the phone. Give yourself a predictable bedtime. Sleep. THROUGHOUT YOUR LIFE Know your numbers. Do appropriate preventive screening. Investigate symptoms rather than ignoring them. Don't automatically assume something is "just aging." Don't automatically assume family history means destiny. Continue learning as science changes. Protect your muscle. Protect your metabolism. Protect your brain. Protect your relationships. Protect your sleep. THE SIMPLEST VERSION OF EVERYTHING GARY BRECKA IS SAYING 1. Get sunlight. 2. Breathe. 3. Hydrate. 4. Move. 5. Build muscle. 6. Eat real nutrient-dense food. 7. Protect your metabolism. 8. Sleep like it matters. 9. Challenge your body sometimes. 10. Investigate problems instead of simply accepting them. 11. Don't confuse genetic risk with guaranteed destiny. 12. Don't turn anxiety into your identity. 13. Build relationships and a life that gives you purpose. 14. Stay unbelievably healthy while longevity science continues advancing. And maybe most importantly… DON'T WAIT UNTIL YOU'RE SICK TO BECOME INTERESTED IN YOUR HEALTH. I learned that every single thing that gives me the best chance of being healthy at 120 also gives me a better life at 45. Getting sunlight tomorrow morning makes tomorrow better. Sleeping tonight makes tomorrow better. Building muscle makes this decade better. Eating well makes today better. Getting outside makes today better. Putting my phone down makes today better. Managing anxiety makes today better. Having people I love around me makes today better. So this isn't really an episode about trying to cheat death. It's about refusing to sleepwalk through your health. Your body is the vehicle that carries you through every single experience you're hoping to have. Every trip. Every adventure. Every business idea. Every dinner. Every workout. Every moment with your kids. Every future grandkid. Everything. So take ridiculously good care of it. And instead of looking at aging and thinking… "Well, I guess everything starts going downhill from here…" What if we thought completely differently? What if our goal was: I want to be stronger next year. Healthier next year. More metabolically healthy next year. More informed next year. More capable next year. And then do it again. And again. And again. For decades. Let's make the goal to be fully alive for as much of it as humanly possible. That's the health lesson I'm taking from Gary Brecka. Don't wait for the future of longevity medicine. Build the kind of body today that's ready for it.

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

Thanks to our Partners, NAPA Auto Care and NAPA TRACS Watch Full Video EpisodeWhat if the best place to train your technicians isn't a classroom, but your own shop?In this episode of Remarkable Results Radio, Carm Capriotto sits down with Brandon Steckler, former Motor Age editor and industry educator, to discuss S.W.A.T. (Steckler Worldwide Automotive Technical Training and Diagnostics) and his mission to elevate automotive repair through hands-on education, diagnostic support, and a culture of continuous learning.Brandon explains why effective training should close knowledge gaps rather than simply provide quick answers, and why shop owners should view education as an investment in their people, their business, and the entire local repair community.What You'll LearnHow S.W.A.T. combines just-in-time diagnostic support with technician training.Why on-site training can create stronger technical foundations and better diagnostic habits.Why shop owners shouldn't fear inviting neighboring businesses to participate in training.How collaboration between local shops can strengthen the entire automotive repair community.Why technicians need to become "perpetual students" as vehicle technology continues to evolve.How investing in training can improve technician confidence, productivity, and profitability.Why bringing education directly into the shop can shorten the distance between learning and earning.Great technical training doesn't simply help a technician fix today's vehicle. It builds the knowledge, habits, confidence, and diagnostic thinking needed for tomorrow's challenges. Brandon's message is clear: shops that consistently invest in education create stronger professionals, stronger teams, and a stronger industry.Brandon Steckler, S.W.A.T Training and Diagnostics. Brandon's previous episodes HERE.Brandon's Cell Phone: 1 (484) 824-4621Learn more about NAPA Auto Care and the benefits of being part of the NAPA family by visiting https://remarkableresultsradiopodcast.captivate.fm/napaautocare NAPA TRACS will move your shop into the SMS fast lane with onsite training and six days a week of support and local representation. Find NAPA TRACS on the Web at http://napatracs.com/Connect with the Podcast:Download and Listen on Our Mobile App: https://automotiverepairpodcastnetwork.com/app/Visit the Website: https://remarkableresults.biz/Subscribe on YouTube: https://www.youtube.com/carmcapriottoFollow on Facebook: https://www.facebook.com/RemarkableResultsRadioPodcast/Follow on LinkedIn: https://www.linkedin.com/in/carmcapriotto/Follow on Instagram: https://www.instagram.com/remarkableresultsradiopodcast/Join Our Virtual Toastmasters Club: https://remarkableresults.biz/toastmastersJoin Our Private Facebook Community: https://www.facebook.com/groups/1734687266778976Join our Insider List: https://remarkableresults.biz/insiderAll books mentioned on our podcasts: https://remarkableresults.biz/booksOur Classroom page for personal or team learning: https://remarkableresults.biz/classroomSpecial episode collections: https://remarkableresults.biz/collectionsBuy Me a Coffee: https://www.buymeacoffee.com/carmThe Automotive Repair Podcast Network: https://automotiverepairpodcastnetwork.com/Remarkable Results Radio Podcast with Carm Capriotto: Facilitating Wisdom Through Storytelling and Open Discussion. https://remarkableresults.biz/Automotive Field Theory: From Diagnostics to Quantum Physics and Mental Health, Matt Fanslow is Lifting the Hood on Life. https://mattfanslow.captivate.fm/Business by the Numbers: Understand the Numbers of Your Business with CPA Hunt Demarest. https://huntdemarest.captivate.fm/The Auto Repair Marketing Podcast: Marketing Experts Brian & Kim Walker Work with Shop Owners to Take it to the Next Level. https://autorepairmarketing.captivate.fm/The Weekly Blitz: Weekly Inspiration with Business Coach Chris Cotton from AutoFix - Auto Shop Coaching. https://chriscotton.captivate.fm/Speak Up! Effective Communication: Develop Interpersonal and Professional Communication Skills with Craig O'Neill. https://craigoneill.captivate.fm

What should you do differently when a UTI becomes a recurring problem? In this episode of the Backtable Podcast, host Dr. Anjali Kapur is joined by physician-scientist Dr. Glenn Werneburg to discuss the latest approaches to recurrent urinary tract infections, including key updates from the 2025 AUA, CUA, and SUFU guidelines. They use real clinical cases to explore diagnosis, prevention, antibiotic selection, and the management of complex patients. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Medtronichttps://www.medtronic.com/en-us/e/patients-caregivers/urinary/overactive-bladder.html --- Timestamps 00:00 - Introduction04:05 - Case One: Recurrent UTIs05:19 - Workup Basics08:50 - Non-Antibiotic Prevention11:42 - Antibiotic Prophylaxis Options15:16 - Case Two: Asymptomatic Bacteriuria 19:14 - Case Three: Complex Patients19:58 - Male vs. Female UTIs21:22 - Neurogenic Bladder Workup22:52 - Elderly Patients and ID Consults25:01 - Case Four: Transplant ESBL25:23 - Machine Learning for Antibiotics 29:49 - Catheter Biofilms31:55 - Embedded Bladder Reservoirs35:23 - Recurrent UTI Vaccine36:23 - Future of Recurrent UTIs39:04 - Wrap Up --- More about this episode The doctors define recurrent UTI and outline the standard workup, including history, physical and pelvic exam, urinalysis, urine culture, and antibiotic sensitivities. They also review occasions where additional testing may be warranted. The discussion covers interpretation of urinalysis, non-antibiotic prevention options, and antibiotic prophylaxis strategies, with consideration of antibiotic resistance and microbiome disruption. They address asymptomatic bacteriuria and when treatment is indicated, along with management considerations for men, patients with neurogenic bladder or CIC, and elderly patients. Dr. Werneburg also discusses his work with machine learning tools to predict antibiotic susceptibility earlier, catheter biofilms, the concept of embedded bladder bacteria reservoirs, and his multidisciplinary complex UTI clinic. --- Resources Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025)https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

What should you do differently when a UTI becomes a recurring problem? In this episode of the Backtable Podcast, host Dr. Anjali Kapur is joined by physician-scientist Dr. Glenn Werneburg to discuss the latest approaches to recurrent urinary tract infections, including key updates from the 2025 AUA, CUA, and SUFU guidelines. They use real clinical cases to explore diagnosis, prevention, antibiotic selection, and the management of complex patients. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:05 - Case One: Recurrent UTIs05:19 - Workup Basics08:50 - Non-Antibiotic Prevention11:42 - Antibiotic Prophylaxis Options15:16 - Case Two: Asymptomatic Bacteriuria 19:14 - Case Three: Complex Patients19:58 - Male vs. Female UTIs21:22 - Neurogenic Bladder Workup22:52 - Elderly Patients and ID Consults25:01 - Case Four: Transplant ESBL25:23 - Machine Learning for Antibiotics 29:49 - Catheter Biofilms31:55 - Embedded Bladder Reservoirs35:23 - Recurrent UTI Vaccine36:23 - Future of Recurrent UTIs39:04 - Wrap Up --- More about this episode The doctors define recurrent UTI and outline the standard workup, including history, physical and pelvic exam, urinalysis, urine culture, and antibiotic sensitivities. They also review occasions where additional testing may be warranted. The discussion covers interpretation of urinalysis, non-antibiotic prevention options, and antibiotic prophylaxis strategies, with consideration of antibiotic resistance and microbiome disruption. They address asymptomatic bacteriuria and when treatment is indicated, along with management considerations for men, patients with neurogenic bladder or CIC, and elderly patients. Dr. Werneburg also discusses his work with machine learning tools to predict antibiotic susceptibility earlier, catheter biofilms, the concept of embedded bladder bacteria reservoirs, and his multidisciplinary complex UTI clinic. --- Resources Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025)https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti --- BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women's health. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

Send us an inquiry through a text message here!Welcome to a very special episode of The Veterinary Roundtable! This week, the ladies are joined by the multitalented Dr. Jordan Towns... and she's done a little bit of everything. The conversation dives into the rapidly evolving world of AI in veterinary medicine, including the risks of putting too much trust in AI-generated lab results, how AI and machine learning actually interpret cytology slides, and why these tools are best used as an assistant... not a replacement for veterinary professionals. Dr. Towns shares her incredible journey as a pentathlon athlete on the Olympic team and the story of how she found herself coaching college football games. AI, veterinary medicine, the Olympics, and college football... all in one episode! You definitely don't want to miss this one!Do you have a question, story, or inquiry for The Veterinary Roundtable? Send us a text or voicemail from the link above, ask us on any social media platform, or email theveterinaryroundtable@gmail.com!Episodes of The Veterinary Roundtable are on all podcast services along with video form on YouTube!YouTube: https://www.youtube.com/@TheVeterinaryRoundtableInstagram: https://www.instagram.com/theveterinaryroundtable/TikTok: https://www.tiktok.com/@theveterinaryroundtableTimestamps00:00 Intro02:20 Introducing Dr. Jordan Towns10:35 Dr. Towns' Veterinary Career Path12:04 The Journey into Modern Pentathlon & Team USA17:17 How Pentathlon Works: Horses, Fencing, Swimming, & Shooting20:28 Discovering a Passion for Clinical Pathology24:41 Clinical Pathology vs. Anatomic Pathology Explained27:38 How Vet History Improves Pathologist Accuracy34:29 Teaching Philosophy: Safe Spaces & Interactive Learning40:33 A Systematic Approach to Reading Lab Work42:42 How AI and Machine Learning Read Cytology Slides49:41 Concerns Over AI57:17 FDA Regulations on Animal Medical Equipment01:08:50 The Ideal Role of AI as an Assistant, Not a Replacement01:20:16 Questions Vet Clinics Should Ask Before Adopting AI01:24:59 Officiating College Football: How It Started01:40:50 Outro

You May Think You have Authentic Leadership… But Reality is You and I are Hiding Things We Don’t Want to Look At What are you hiding — and what is it actually costing you? Not just in your business, but in your marriage, your friendships, the relationship with your own kids. That’s the question at the center of my conversation tomorrow at 5pm Eastern, LIVE on A New Direction, with Tyler Dickerhoof, author of the brand-new book The Things We Hide. If you’ve ever wondered why so many high performers still feel alone at the top, this is a conversation about the hidden barriers to authentic leadership — and how to finally tear them down. Tyler isn’t theorizing about authentic leadership from the sidelines. He built businesses generating over $500 million in combined sales, and sat on John Maxwell’s Network Marketing Advisory Council. But he’ll tell you the whole time he was doing it, he was hiding — behind the results, behind the intensity, behind the belief that his worth was tied to how much he knew and how hard he could push. It took losing his younger brother Joel as a teenager, and decades of pushing people away while pushing through everything alone, before Tyler finally turned around and faced what he’d spent 25 years running from. That turn is exactly what separates performance from authentic leadership.Shorten with AI That’s the real subject of The Things We Hide: the hidden barriers that keep capable, driven people from ever leading — or living — authentically. Tyler breaks it down into what he calls the Four Walls of Insecurity: Intensity, Inactivity, Insensitivity, and Isolation. These are the defense mechanisms so many high achievers mistake for strengths. We’re going to talk about why “intensity is a bulldozer” that clears a path for success but leaves relationships in the wreckage. We’re going to talk about the lie that leadership has to be lonely. And we’re going to unpack his core message, one every leader chasing authentic leadership needs to hear: what you hide controls you, what you face transforms you. So clear your schedule, and join us for a real conversation about hidden barriers, vulnerability, and what authentic leadership actually looks like once the performance drops away. Bring your questions, bring your comments, and bring whatever wall you’ve been hiding behind — because Tyler and I are going to talk about how to tear it down without tearing yourself apart in the process. This isn’t just another leadership interview. Tyler Dickerhoof’s book, “The Things We Hide: A Guide to Identifying Hidden Barriers and Leading with Authenticity” is a deep, insightful view into ourselves that most of us do not want to look at.  And yet, is fundamentally required if we want to achieve both true significance and success. We all have walls.  We all have fears and insecurities.  For most of us we will never admit them throughout our lifetime.  Instead, when our insecurities are triggered, we become intense, maybe we become inactive hoping this will just go away, perhaps it we resort to becoming insensitive because the more calluses that we have we don’t have to feel others’ pain, or maybe we just isolate and disappear.  Maybe it is some combination of all of these. The point is…our insecurities will show up. So what do we do about it?  Well this is where this book separates itself from so many others.  Tyler includes exercises and free assessments in the book that if you choose to take on the mission can start moving you onto the path of true significance, success, and real authentic leadership. This book is not going to be easy.  It is going to challenge you. It is going to make you uncomfortable, but growth comes from being comfortable getting uncomfortable. This book will make you think and help you grow if you choose to follow his guidelines.  I loved every page! Get your copy of The Things We Hide by clicking here! Please reach out to our sponsors and LIKE their social media pages as their financial contributions help keep A New Direction on the air and bring us great guests. Linda Craft Team, REALTORs for more than 40 years their clients and friends have said when it comes to real estate they have “legendary customer service”. Locally owned, and independent of any national brand, they have literally helped people all over the world by finding the best real estate professional in your area.  And because they are independent they are unbiased who they choose because they have relationships with the best agents regardless of company. So, if you live somewhere else, or you live in the Raleigh, Durham, Chapel Hill, Research Triangle Park, before you sell or buy your home, start with the “legends” that know the local market, and stay on the bleeding edge of technology at Linda Craft Team, REALTORS…you can learn more by going to www.LindaCraft.com ABOUT YOUR HOST Meet Jay Izso Executive Performance Coach  |  Host of A New Direction Every week on A New Direction, I sit down with CEOs, founders, and the researchers behind the science of leadership performance. The conversations go deep. We talk about the decisions that built companies, the mistakes that nearly destroyed them, and the personal breakthroughs that changed everything. But here's what most people don't know about me: the show is an extension of the work I do every day with executives behind closed doors. Who I Am I'm an Executive Performance Coach. I work with CEOs and founders of $5M-$50M companies who have hit a wall they can't explain. The marketing looks fine. The team is capable. The market is there. But the business won't move. The problem, almost every time, is the person running it. I find the personal behavioral patterns that are driving the business dysfunction. Then I help the CEO disrupt those patterns so the company can grow. That's it. No motivational platitudes. No vision boards. Diagnostics, intervention, results. Where This Comes From My approach comes from two places most coaches never set foot in. The farm. I grew up as a farmhand in Ithaca, Nebraska—population 100. I started working at nine years old. By the time I left for college, I'd spent a decade learning that you can't cheat the harvest, pain is part of the job, and the work has to get done whether you feel like it or not. I was fourteen the first time I had to castrate boars. Nobody was going to do it for me. That lesson never left: sometimes you have to do things afraid. The forensic psychology unit. In graduate school at Washington State University, I trained under Dr. Thomas Brigham—co-author of the Handbook of Applied Behavior Analysis—in a human behavior lab focused on real-world problems. I then served in a Clinical Psych II role at Eastern State Hospital in Medical Lake, Washington, a forensic setting where I conducted psychological evaluations of individuals charged with the most serious criminal offenses. Sixteen months assessing human behavior at its most extreme taught me how to cut through defenses, identify what's really driving someone's decisions, and see what they can't see in themselves.

Point-of-care ultrasound (POCUS) is rapidly transforming emergency medical services, stepping up as the modern equivalent of the 12-lead ECG for today's paramedics, according to Dr. Ross Prager. While portable ultrasound technology was initially developed to miniaturize heavy hospital equipment for field use, widespread adoption faced friction due to complex training demands and accuracy drop-offs in fast-paced environments. AI integration directly tackles these scaling bottlenecks by guiding real-time image acquisition and providing high-level diagnostic interpretation.   By automatically identifying critical structures like the pleural line or organ interfaces, AI helps paramedics capture crisp, reliable views—even under chaotic field conditions with severe glare, heat, or noise. For trauma and undifferentiated dyspnea calls, prehospital ultrasound delivers vital objective data. Detecting free abdominal fluid or absent lung sliding allows EMS teams to notify receiving trauma centers immediately. This clinical head start mobilizes blood banks, surgical staff, and operating rooms before the ambulance even arrives, cutting down critical time to definitive care.

Hey there Voices of the Bench community, this is Trish Jones with Ivoclar. If you've been curious about fast-firing zirconia to improve efficiency but aren't convinced it can deliver predictable, high-quality results, I'd encourage you to connect with us. Our new IPS Emax Zirconia offers multiple fast-fire protocols designed to help save you valuable production time while maintaining consistent results. Time is money in every lab. Don't wait. Reach out to your local Ivoclar rep today and discover how IPS Emax Zirconia can help streamline your workflow. As full-arch dentistry continues to grow, so do the demands on today's dental laboratories. That's why Knight Dental recently launched SimplyARCH Studio, a dedicated production environment built exclusively for full-arch restorations. To support this specialized workflow, Knight invested in an XTCERA milling system and carefully evaluated multiple CAM software solutions before choosing hyperDENT. The decision came down to exceptional milling quality, minimal hand finishing, and impressive production efficiency. But what truly set hyperDENT apart was the implementation process. From the very beginning, the team provided more than software training—they shared the knowledge and experience needed to build an optimized workflow for complex full-arch cases. With proven expertise in advanced milling strategies and laboratory production, hyperDENT helped ensure SimplyARCH Studio was designed for long-term success from day one.Matt Everatt joins Elvis and Barb for a fascinating conversation that takes a deep dive into his journey through the dental laboratory industry and the story behind his book, The Invisible Profession. From discovering dental technology at 16 and specializing in maxillofacial prosthetics and orthodontics to working in hospitals, developing early sleep-apnea appliances, and nearly leaving the profession altogether, Matt's career has taken some seriously interesting turns. Eventually, he helped co-found S4S, building a successful business around sleep-apnea appliances, occlusal splints, orthodontics, and more before eventually stepping away from ownership. This week on Voices From the Bench, we finally sit down with someone we've been wanting to have on the show for a LONG time—Philip Gold! Philip grew up in the dental laboratory, quite literally pulling teeth out of formaldehyde bottles in his father Raymond Gold's lab in Atlanta. His father started the laboratory in 1946, and Philip eventually found himself following in those footsteps, although not without first taking a seven-year detour working for Williams Gold. That experience gave him the opportunity to visit laboratories all over the country, learn from some of the best in the industry, and see firsthand how different labs operated. Philip eventually returned to the family laboratory in 1980 and began the process of taking over from his father. What followed was a career built around learning, adapting, building teams, and—most importantly—relationships. Philip shares what it was like stepping into a leadership role at a young age, earning the respect of experienced technicians, and learning that being a leader isn't about knowing everything yourself, but understanding the work well enough to help the people around you succeed. He also talks about selling the laboratory to National Dentex with the goal of giving the business and its people an opportunity to continue growing, only to eventually find his way back into the laboratory world with By Design Dental Studio alongside his daughter Katie and Denise. And if you know Philip, you know he's never stopped learning. He currently holds six CDT certifications, including ceramics, crown and bridge, partials, implants, dentures, and digital. His story about preparing for the digital practical exam is a perfect example of his determination—his first practice run took seven and a half hours for an exam designed to be completed in just over five. So he reorganized, practiced again, changed his workflow, and eventually got it down to under five hours. And of course, Philip isn't pursuing certifications just for himself. He wants to set an example, motivate the next generation of technicians, and encourage more people in the laboratory to continue learning. We also get into the importance of customer service, why relationships are at the heart of this industry, and why sometimes the best thing a laboratory can do is simply pick up the phone and help. Philip shares his philosophy that when something goes wrong, you drop everything and make it right. We talk about giving back to the industry, the people who helped shape Philip's career, and how the dental laboratory community has always been willing to share knowledge when you're willing to ask. And yes… somewhere along the way we also hear the greatest “okey-doke” story in dental laboratory history. Special Guest: Phillip Gold.

Drs. Paul Crane, Fiifi Duodu, and Malya Sahu discuss neuroimmunology and multiple sclerosis diagnosis in Africa, including challenges and efforts to improve care.  Show citation:  Sahu M, Chomba M, Duodu F, Diaz MM, Sokhi D, Saylor D. The Current State of Diagnostics for Neuroimmunological Disorders in Africa. J Cent Nerv Syst Dis. 2025;17:11795735251385319. Published 2025 Nov 19. doi:10.1177/11795735251385319 

Dr. Paul Crane talks with Drs. Fiifi Duodu and Malya Sahu about neuroimmunology and multiple sclerosis diagnosis in Africa, including challenges and efforts to improve care.  Read the related article here.  Disclosures can be found at Neurology.org.   

Industrial service teams are facing two compounding pressures at once: decades of hands-on expertise walking out the door through retirement, and the equipment itself growing more complex to diagnose and maintain.   In this episode, Scot Burdette, Global Division CIO at ABB, unpacks how remote diagnostics and AI-driven insights are reshaping who does the work of keeping industrial equipment running, in conversation with host Yolandi de Weerdt. He outlines how leaders can prioritize the most critical processes first, build the data discipline needed to support predictive maintenance, and transfer expertise before it's lost rather than after.   This episode is sponsored by Aquant.   Emerj works with a select group of AI vendors to reach Fortune 500 decision makers through research, media, and direct access. If you want to be considered, download our media kit at emerj.com/AD1  

3 Hard Truths for a Leadership Mindset Shift Are you struggling to transition from a high-performing technical expert to an effective people manager? On the next live episode of A New Direction, best-selling author Steven Riddle joins us for Part 2 of our deep dive into his book, Falling into Leadership. Join us as we tackle the critical leadership mindset shift required when stepping into executive roles. Many new managers fall into the trap of leading through the exact technical skills that got them promoted, failing to realize that team management and executive growth require an entirely different playbook. One of the biggest hurdles in leadership development is mastering difficult conversations in leadership. Why do founders and executives endlessly rehearse tough performance reviews or confrontational talks in their head, only to avoid having them altogether? Steven exposes how surface-level communication erodes trust and why moving toward active listening and practical empathy is essential for creating psychological safety. By understanding the nuance between empathy, sympathy, and apathy, leaders can stop micromanaging and start asking powerful questions that build real engagement and clarity. As you climb the organizational ladder, executive loneliness becomes an unmistakable reality. The higher you advance, the more isolated decision-making feels, making emotional intelligence and self-awareness non-negotiable tools for survival. We discuss how resilient leadership helps senior executives navigate uncertainty, adapt to constant workplace change, and lead with steady character rather than relying on sheer force of personality. True adaptability isn’t about avoiding stress; it's about maintaining presence under pressure so you can guide your team through disruption without getting knocked off center. Ultimately, the leadership mindset shift is from task-based management to sustainable leadership requires mastering effective delegation and structuring high-impact 1-on-1 meetings that foster team accountability. Strong organizational culture isn’t built top-down through rigid policy; it is forged daily through authentic connection, shared values, and mutual respect. Tune in to New Direction, to learn how to focus on the human inputs that drive high performance and leave behind a lasting leadership legacy. Steve Riddle's book, “Falling Into Leadership: How Leaders Emerge, Grow and Lead With Purpose” is a play by play guide into coaching a new leader. In Steve Riddle's approach we are introduced to a new emerging leader in Sally who is open and willing to change as a leader, but is uncertain of the steps. In 8 sessions Steve Riddle walks us through his process of coaching that helps you have a Leadership Mindset Shift to help you go from promoted to great. Steve Riddle has a very organized approach that starts with focusing on the leader's own self-awareness. His big push is if that self-awareness is only the beginning, but without it, you will never get to the next steps of growth. His methodology of using questions to push the client are both refreshing and eye opening for all of us.  And that leadership mindset shift is fundamentally necessary for growth. Behind the curtain he takes through the importance of emotional intelligence, communication, adaptability, resilience, and what true accountability looks like. He emphasizes the importance of the leaders role of empowering, inspiring, and influencing those the leader leads, and helps us recognize that as a leader our responsibility is to leave a legacy of leaders in our employees. Packed with tons of insights and thought provoking questions, and leadership mindset shifts, the book, in my opinion is using the case of Sally to take a closer look at ourself. Some of our dysfunctional mindsets, becoming more self-aware and becoming the leader we had always hoped we would become. Please reach out and thank the awesome sponsors of A New Direction: Every real estate agent is asking the same question right now: is AI going to help me, or leave me behind? Here’s the honest answer — the agents who’ve learned to use it are already pulling ahead. They’re writing listings in minutes, answering every lead the second it comes in, and following up until customers become clients, all without adding hours to their week. And if you’re not using AI yet — because you’re not sure how, or it honestly feels a little intimidating — you’re not behind. You’re exactly who this was built for. You don’t need to be technical or “good with computers.” You just need a clear, plain‑English path to putting these tools to work in your business. That’s what AIREpro Certification is: a step‑by‑step course, built by real estate coaches for real estate agents, that teaches you to use AI to grow your business and make more money. Convert and close more of the leads you already have. Improve your marketing while saving marketing dollars. Get the work of a marketing assistant and a personal assistant for about the price of one lunch a month — not a salary. It’s twelve self‑paced modules, zero jargon, and a certificate that shows clients you’re AI‑ready. Best of all, you can try Module One completely free — no signup, no credit card — and decide for yourself. If it’s a fit, the full certification is just $99 Linda Craft Team, Realtors when you are looking to sell your home or buy a new home start with what their clients refer to as “the legends of customer service”. Whether you are in the Greater Raleigh Research Triangle Park area of North Carolina or any where in the world they can help you with your home dreams. Contact our friends Linda Craft Team at www.LindaCraft.com ABOUT YOUR HOST Meet Jay Izso Executive Performance Coach  |  Host of A New Direction Every week on A New Direction, I sit down with CEOs, founders, and the researchers behind the science of leadership performance. The conversations go deep. We talk about the decisions that built companies, the mistakes that nearly destroyed them, and the personal breakthroughs that changed everything. But here's what most people don't know about me: the show is an extension of the work I do every day with executives behind closed doors. Who I Am I'm an Executive Performance Coach. I work with CEOs and founders of $5M-$50M companies who have hit a wall they can't explain. The marketing looks fine. The team is capable. The market is there. But the business won't move. The problem, almost every time, is the person running it. I find the personal behavioral patterns that are driving the business dysfunction. Then I help the CEO disrupt those patterns so the company can grow. That's it. No motivational platitudes. No vision boards. Diagnostics, intervention, results. Where This Comes From My approach comes from two places most coaches never set foot in. The farm. I grew up as a farmhand in Ithaca, Nebraska—population 100. I started working at nine years old. By the time I left for college, I'd spent a decade learning that you can't cheat the harvest, pain is part of the job, and the work has to get done whether you feel like it or not. I was fourteen the first time I had to castrate boars. Nobody was going to do it for me. That lesson never left: sometimes you have to do things afraid. The forensic psychology unit. In graduate school at Washington State University, I trained under Dr. Thomas Brigham—co-author of the Handbook of Applied Behavior Analysis—in a human behavior lab focused on real-world problems. I then served in a Clinical Psych II role at Eastern State Hospital in Medical Lake, Washington, a forensic setting where I conducted psychological evaluations of individuals charged with the most serious criminal offenses. Sixteen months assessing human behavior at its most extreme taught me how to cut through defenses, identify what's really driving someone's decisions, and see what they can't see in themselves.