Podcasts about EPUB

Today, we are tackling a massive grey area in obstetrics/maternal-fetal medicine: What happens after early fetal growth restriction resolves? When a baby bounces back on the growth chart during the second or third trimester, are they completely out of the woods? Or is there a hidden, lingering risk we aren't talking about enough? To find out, we're doing a deep dive into two major publications that dropped just this month, in August 2026 in sister journals (AJOG and AJOG MFM). Both are retrospective, both ask the exact same burning question…and get this: they arrive at completely opposing conclusions. How is that possible? Listen in for details. 1. Melamed B, Mei-Dan E, Aviram A. Sonographic fetal weight estimation percentiles should be interpreted with caution in the second trimester. Int J Gynaecol Obstet. 2026 May;173(2):930-939. doi: 10.1002/ijgo.70693. Epub 2025 Nov 25. PMID: 41288086.2. Ramos SZ, Has P, Gimovsky AC, Danilack VA, Savitz DA, Lewkowitz AK. Outcomes among Neonates after a Diagnosis of Persistent or Transient Fetal Growth Restriction Delivered at Term. Am J Perinatol. 2024 May;41(S 01):e1470-e1477. doi: 10.1055/a-2051-3859. Epub 2023 Mar 9. Erratum in: Am J Perinatol. 2024 May;41(S 01):e1478. doi: 10.1055/s-0044-1786526. PMID: 36894159; PMCID: PMC10562520.3. Keller N, Jackson F, Abelman S .Neonatal morbidity following resolution of fetal growth restriction diagnosed at second-trimester anatomy ultrasound. American Journal of Obstetrics & Gynecology MFM, 2026; Aug 8. 4. Cenac LA, Wodoslawsky S, Patel V, McLaren Jr. R, Aghai ZH, Makhamreh MM, Al-Kouatly HB, Persistent, Resolved, and Absent Fetal Growth Restriction: A Comparison of Neonatal Outcomes, American Journal of Obstetrics and Gynecology (2026), doi: https:// doi.org/10.1016/j.ajog.2026. Aug 19

Episode No. 772 features art historians Zanna Gilbert and Andrew Perchuk; and curator Meg Linton, museum director Taras Matla, and associate museum director Steve Comba. Along with Emily Pugh, Gilbert and Perchuk are the project leads for "Ed Ruscha's Streets of Los Angeles," a Getty Research Institute project that has, among other things, digitized Ed Ruscha's five-decade-long photographic project to document the streets of Los Angeles. The GRI project also considers Ruscha's Streets of Los Angeles archive within a range of historical frameworks, spotlights what it tells us about modern and contemporary art, architecture, and the physical, social, and cultural geographies of Los Angeles. GRI-produced websites include: "Artist, Image, Archive, City," a free digital book featuring visualizations, essays, images and more (the book is also available in free PDF and EPUB formats); "12 Sunsets," which features Ruscha's famed photos of the Sunset Strip, including how the street has changed over the last 50 years; The Ed Ruscha's Streets of Los Angeles Archive at the GRI; Research Collections Viewer for Ruscha's photographs of Sunset Boulevard and Hollywood Boulevard; Research Collections Viewer for Ruscha's photographs of (other) Los Angeles streets; Digitized images from the collection. On the second segment, we discuss the dispersal of artist Steve Roden's estate with curator Meg Linton, who has advised the estate, University of Maryland Art Gallery director Taras Matla, and Benton Museum of Art at Pomona College associate director Steve Comba. Roden was a Los Angeles-area-based artist who worked in sound, sculpture, painting, and other media, who passed away in 2023 at the age of 59. The Roden estate has recently dispersed works to museums all over the United States, including those represented on this week's program, as well as to the Grunwald Center at the Hammer Museum, the Los Angeles County Museum of Art, the Museum of Contemporary Art, Los Angeles, the UC Irvine Langson Orange County Museum of Art, Ruby City, San Antonio, and more. Roden created sound for The MAN Podcast in 2011. Air date: August 20, 2026.

Today, we are taking a deep dive into a medical truth thatsounds completely counterintuitive, almost upside down, based on everything you think you know about women's health. But here's the kicker: it's actually nothing new at all. For over two decades, ever since the landmark Women'sHealth Initiative (WHI) study made global headlines back in 2002, the blanket narrative surrounding menopausal hormone therapy has been clear and persistent: hormones equal breast cancer risk. But there is a massive asterisk in thatscience that got completely lost in the media noise. While combination therapy with conjugated equine estrogens paired with medroxyprogesterone acetate (CEE +MPA) did show an increased risk, the story for estrogen-only therapy (mainly CEE) in women wh had a hysterectomy is entirely different. In fact, an overwhelming mountain of growing data shows that estrogen-only therapy is protectiveagainst both breast cancer incidence and breast cancer mortality. In this episode, we're unpacking the latest high-level evidence that cements this crucial distinction. We'll examine the broad statistical landscape, including a comprehensive meta-analysis by Qing et al. (officially set for the December 2026 issue of Annals of Medicine, following its ahead-of-print release in March 2026). Their work breaks down how randomized controlled trial data consistentlypoint to estrogen-only therapy having a protective effect, in stark contrast to combination therapy. We'll also dive into a brand-new Clinical Perspective published in mid-August 2026 in Obstetrics & Gynecology (the Green Journal) by Drs. Andrew Kaunitz and Jason Wright. They call urgent attention to this phenomenon, highlighting RCT meta-analyses that demonstrate a 23% reduction in breast cancer incidence with estrogen alone (RR = 0.77), alongside striking cohort data showing a dramatic risk reduction even in high-risk populations, like carriers of the BRCA mutation.  Listenin for details.1.     Wu Q, Shen L, Hu S, Yang R, Wang Y, Xue D, SunY, Ma H, Dai Z. Relationship between menopausal hormone therapy and incidencerisk of breast cancer: systematic review and meta-analysis. Ann Med. 2026Dec;58(1):2640244. doi: 10.1080/07853890.2026.2640244. Epub 2026 Mar.2.     Kaunitz, Wright. Menopausal Estrogen Therapy andRisk of Breast Cancer. Obstet Gynecol. Aug 20263.     Chlebowski RT, Aragaki AK, Pan K, et al.Randomized Trials of Estrogen-Alone and Breast Cancer Incidence: AMeta-Analysis. Breast Cancer Research and Treatment. 2024. 4.     Writing Group for the Women's Health InitiativeInvestigators. (2002). Risks and benefits of estrogen plus progestin in healthypostmenopausal women: Principal results from the Women's Health Initiativerandomized controlled trial. JAMA, 288(3), 321–333.

En este episodio nos adentramos en la atmósfera oscura e inquietante de Ese no es mi nombre, la electrizante novela de suspenso de la autora Megan Lally.La historia arranca con una pesadilla desgarradora: una joven despierta a un lado de la carretera, magullada, ensangrentada y sin ningún recuerdo de quién es o cómo llegó allí. Cuando un hombre desesperado llega a la comisaría asegurando ser su padre y llamándola "Mary", parece que la pesadilla ha terminado y que está a salvo. Ella pensaba que había recuperado su vida... pero estaba gravemente equivocada.A medida que "Mary" intenta encajar en una casa que no le resulta familiar y con un padre que actúa cada vez más extraño, la tensión se dispara. Paralelamente, conocemos la historia de Drew, un chico que busca desesperadamente a su novia desaparecida, Lola. ¿Cómo se cruzan estas dos vidas? Analizamos las pistas, las identidades robadas y los giros escalofriantes de este thriller que no te deja soltar el libro.Consigue el libro en Amazon: Ese no es mi nombre - Megan Lally¿Qué harías si despiertas sin recordar nada y sientes que la persona que cuida de ti te está mintiendo? Si ya leíste la novela, ¿lograste adivinar el giro principal antes de tiempo? Déjanos tus comentarios en nuestras redes sociales o en tu plataforma de podcasts favorita. ★ Support this podcast on Patreon ★

Chuck and Chris review 6 recent Journal of Hand Surgery articles with a variety of topics.  Tune in and see below.1) Arends GR, van Kooij YE, Stern BZ, Hovius SER, Wouters RM; Hand-Wrist Study Group; de Ridder WA. Understanding Why Certain Patients With Hand and Wrist Conditions Are Dissatisfied Despite Achieving Their Expressed Personal Improvement Goals Anchored at Satisfaction: A Qualitative Study. J Hand Surg Am. 2026 Jun;51(6):687-697. doi: 10.1016/j.jhsa.2025.12.009. Epub 2026 Jan 29. PMID: 41609542.2) Lee SH, Kim MB, Lee YH. Surgical Management of Delayed Mallet Finger Fractures Using Combined Two-Extension Block Kirschner Wire and Dorsal Counterforce Techniques. J Hand Surg Am. 2026 May;51(5):555-563. doi: 10.1016/j.jhsa.2025.12.019. Epub 2026 Jan 29. PMID: 41609545.3) Lunasin RM, Capell W, Kaufman KR, Shin AY. Rethinking Muscle Testing: Dynamic EMG Studies of Elbow Positioning as a Differentiator of Pronator Teres and Quadratus Functions. J Hand Surg Am. 2026 Apr;51(4):437.e1-437.e8. doi: 10.1016/j.jhsa.2025.09.013. Epub 2025 Oct 29. PMID: 41159989.4) Morisaki S, Yoshii K, Tsuchida S, Oda R, Takahashi K. Comparison of Manual Tie and Knotless Suture Anchor Techniques in Arthroscopic Transosseous Foveal Repair of the Triangular Fibrocartilage Complex. J Hand Surg Am. 2026 May;51(5):503-510. doi: 10.1016/j.jhsa.2026.01.021. Epub 2026 Mar 4. PMID: 41778936.5) Mwangi J, Henriquez AR, Varney CR, Yu R, Kim JK, Baker RL Jr, Pidgeon T, Hammert WC. Suture-Button Suspensionplasty Does Not Provide a Sustained Functional Advantage Over Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis. J Hand Surg Am. 2026 Jun;51(6):623-630. doi: 10.1016/j.jhsa.2026.02.019. Epub 2026 Apr 3. PMID: 41934451.6) Surke C, Del Rosario PA, Huntington LS, Ek ETH, Tham SK, Ackland D. Fracture Fixation in an Unstable Scaphoid Fracture Model: A Biomechanical Comparison of Double Screw Osteosynthesis With Two Common Bone Graft and Fixation Techniques. J Hand Surg Am. 2026 Apr;51(4):391.e1-391.e8. doi: 10.1016/j.jhsa.2025.09.007. Epub 2025 Oct 25. PMID: 41137815.See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities.The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/.As always, thanks to @iampetermartin for the amazing introduction and concluding music.For additional links, the catalog.  Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Send us Fan MailThe full week of Journal Club in one place. Monday, the PLaNT trial of prophylactic CPAP for late preterm infants born by cesarean, with senior author Dr. Edgardo Szyld. Tuesday, whether parental holding during therapeutic hypothermia changes feeding and length of stay. Wednesday, the Connection Study, the first live biotherapeutic product tested under an IND, and what it means for probiotics returning to the NICU. Thursday, a handheld light probe that reads bowel through the skin to catch NEC before the X-ray does. Friday, Dr. Dinushan Kaluarachchi on the respiratory severity score and what its trajectory tells us.----First-in-human pilot study of broadband optical spectroscopy (BOS) as noninvasive surveillance for necrotizing enterocolitis (NEC). Dodd AC, Lehane AJ, Lee A, Hurlock A, Su Y, Ilahi I, Lautz TB, Backman V, Goldstein SD.J Pediatr Surg. 2026 May;61(5):162978. doi: 10.1016/j.jpedsurg.2026.162978. Epub 2026 Feb 3.PMID: 41643767Association of parental holding during therapeutic hypothermia and NICU outcomes for infants with hypoxic-ischemic encephalopathy. Nguyen TT, Glass HC, Chan N, Taketa E, Pineda R, Cornet MC, Miller MJ.J Perinatol. 2026 Jun 22. doi: 10.1038/s41372-026-02753-3. Online ahead of print.PMID: 42332041Live biotherapeutic product IBP-9414 (L. reuteri) in very low birth weight infants: the Connection Study. Neu J, Del Moral T, Guthrie SO, Hudak ML, Indrio F, Kim JH, Kronström A, Martin CR, Modi N, Rastad J, Schnitzer TJ, Singh R, Strömberg S, Szajewska H, Thuresson M, Caplan M.Pediatr Res. 2026 Feb 20. doi: 10.1038/s41390-026-04826-7. Online ahead of print.PMID: 41721054Prophylactic CPAP at Cesarean Birth in Late-Preterm Newborns: A Multicenter RCT. Shah BA, DeShea L, Schmölzer GM, Josephsen JB, Fabres J, Wetzel EA, Rykovich H, Thomas A, Law B, Garrido C, Szyld E.Pediatrics. 2026 Aug 1;158(2):e2025070998. doi: 10.1542/peds.2025-070998.PMID: 42457181 Clinical Trial.Association Between Delivery Room Continuous Positive Airway Pressure and Neonatal Outcomes in Late Preterm and Term Infants: A Systematic Review and Meta-Analysis. Chin Y, Hill M, Sett A, Thomas N, Razak A.J Paediatr Child Health. 2026 Jul 28. doi: 10.1111/jpc.70516. Online ahead of print.PMID: 42517258 Review.Bronchopulmonary Dysplasia Definition Based on Respiratory Severity Score. Kaluarachchi DC, Peebles PJ, Lasarev MR, Guthrie SO, Laughon MM.Pediatr Pulmonol. 2026 Jul;61(7):e71750. doi: 10.1002/ppul.71750.PMID: 42478108 Free PMC article. No abstract available.Respiratory severity score patterns by birth gestational age among a cohort of extremely preterm infants. Peebles PJ, Lasarev MR, Guthrie SO, Laughon MM, Keller RL, Kaluarachchi DC.J Perinatol. 2026 Jun 29. doi: 10.1038/s41372-026-02778-8. Online ahead of print.PMID: 42374145 No abstract available.Respiratory severity score as a predictor for need for tracheostomy in infants with severe bronchopulmonary dysplasia. Kaluarachchi NM, Afah Annah S, Lasarev MR, Peebles PJ, Kaluarachchi DC.J Perinatol. 2026 Jun 25. doi: 10.1038/s41372-026-02720-y. Online ahead of print.PMID: 42350618 No abstract available.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Send us Fan MailNEC still tends to announce itself on an X-ray, usually later than we want. This week Daphna reviews the first-in-human study of broadband optical spectroscopy, a handheld transcutaneous probe out of Lurie Children's that reads reflected light from 350 to 2500 nanometers to look at bowel beneath the skin. Just under 100 preterm infants, more than 11,000 scans, and a machine learning model that separated NEC from non-NEC scans with 100% sensitivity and a 100% negative predictive value, though the positive predictive value sat at 24%. Ben and Daphna work through what the curves actually show and what would have to come next.----First-in-human pilot study of broadband optical spectroscopy (BOS) as noninvasive surveillance for necrotizing enterocolitis (NEC). Dodd AC, Lehane AJ, Lee A, Hurlock A, Su Y, Ilahi I, Lautz TB, Backman V, Goldstein SD.J Pediatr Surg. 2026 May;61(5):162978. doi: 10.1016/j.jpedsurg.2026.162978. Epub 2026 Feb 3.PMID: 41643767Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Today on the Yoga Medicine Podcast, Tiffany Cruikshank and co-host Katja Bartsch explore the latest research on strength training during pre- and post-menopause. Using a newly published systematic review and meta-analysis of 126 studies involving more than 4,000 women, they unpack what the evidence actually says about building strength and improving body composition in different stages of reproductive aging. Together, Tiffany and Katja separate common myths from current research, discussing progressive overload, lean muscle, body composition, estrogen, and why strength gains remain possible well into midlife and beyond. They also explore why consistency and enjoyment may be just as important as the specific type of resistance training you choose, offering practical takeaways for yoga practitioners, teachers, and anyone looking to age well.  "When we intervene, when we start to create a plan... the capacity to build strength is the same." — Tiffany Cruikshank. — What You'll Learn: Overview of the latest research on strength training across the female lifespan [01:25] Why strength gains remain possible after menopause [08:47] Body composition changes with strength training [16:25] Why enjoyment and consistency are key to long-term success [21:36] Current research gaps and unanswered questions [27:07] Shifting the focus from weight loss to feeling and functioning your best [31:08] How yoga complements strength training for lifelong health [32:34] — Links Mentioned: Watch this episode on YouTube Isenmann E, Geisler S, Havers T, Siegert F, Hemke F, Held S. It's never too late: The impact of resistance training on strength and body composition in females across the lifespan - A systematic review and meta-analysis. J Sci Med Sport. 2026 Mar 18:S1440-2440(26)00096-4. doi: 10.1016/j.jsams.2026.03.002. Epub ahead of print. PMID: 41963141. — Learn More: Find the full show notes at YogaMedicine.com/podcast-173. Learn more about insider tips, online classes or information on our teacher trainings at YogaMedicine.com. To support our work, please leave us a 5 star review with your feedback on iTunes/Apple Podcasts or wherever you listen to podcasts. 

What does it take to go from astrophysics to running operations at one of the fastest-growing AI companies in the world?In this Fan Favorite episode, Cameron Herold sits down with Victoria Weller, former Chief of Staff and now Lead of Operations at ElevenLabs, to revisit one of the show's most fascinating conversations. Victoria's path is rare: astrophysics, space medicine, quantum encryption, and Palantir, before landing at the AI voice company reshaping how the world listens.She breaks down what a Chief of Staff really does at an early-stage startup, how she cleared SOC 2 compliance in seven weeks, and why ElevenLabs grew so fast. They also get into voice cloning, deepfake safeguards, and surprising use cases across hospitals, transit, and accessibility.Whether you want a COO seat or you are building functions from nothing, Victoria's story is a masterclass in figuring it out fast. Listen now.Sponsored by:Redirect Health - Affordable healthcare benefits designed to make traditional insurance optional, with 24/7 access to primary care and Rx support that helps businesses reduce costs while keeping employees covered.Learn more: http://www.redirectcoo.com/Timestamped Highlights[00:00:44] – The ElevenLabs mission, and why an EPUB can become an instant audiobook[00:02:55] – Munich to Edinburgh to Berlin to New York: a career across four countries[00:04:06] – What actually happens to an astronaut's blood in zero gravity[00:07:54] – Lasers, quantum encryption, and the pivot toward tech[00:13:06] – Cameron asks the big ones: aliens, and are we living in a simulation?[00:19:12] – What ElevenLabs is really building, explained simply[00:20:50] – How context lets an AI voice sound genuinely sad or genuinely happy[00:28:12] – The accessibility use cases the team never saw coming[00:31:03] – Cloning a late loved one's voice, and the compliance behind it[00:33:16] – Stopping deepfake voice scams: watermarks and the AI Speech Classifier[00:38:31] – What a Chief of Staff actually does, and why it feels like a SWAT team[00:40:32] – Does a great Chief of Staff work themselves out of a job?[00:47:07] – The advice Victoria would give her 21-year-old selfAbout the GuestVictoria Weller is the former Chief of Staff and now the Lead of Operations at ElevenLabs, the AI voice company behind lifelike text-to-speech and voice cloning, where she owns internal operations, compliance, and hiring. She cleared the company's SOC 2 process in seven weeks. Before ElevenLabs she was a reliability engineer at Palantir Technologies in New York and London. Her background spans astrophysics at the University of Edinburgh, space-medicine research in Berlin, and a master's in applied physics from Columbia University.

Digital surgery has morphed from buzzword into ubiquitous high-impact technology. In this episode, the BTK MIS team steps into the rapidly evolving ecosystem of cameras, sensors, robotics, and software that are turning surgical operations into structured, analyzable datasets. From AI segmentation to real-time telepresence, don't miss this opportunity to catch up on what's new and what's next, what's exciting and what's terrifying, just on the horizon of your surgical career. Hosts: ·      James Jung, MD, PhD, Assistant Professor of Surgery, Duke University·      Jacob Greenberg, MD, EdM, MIS Division Chief and Vice Chair for Education, Duke University·      Zachary Weitzner, MD, Minimally Invasive and Bariatric Surgery Fellow, Duke University, @ZachWeitznerMD·      Joey Lew, MD, MFA, Surgical resident PGY-3, Duke University, @lew__actuallyLearning Goals: By the end of this episode, listeners will be able to:·      Define “digital surgery” and describe its core components, including video capture, instrumentation, robotics, data analytics, and system connectivity. ·      Discuss current and emerging applications of digital surgery in surgical education, including video-based self-assessment, procedural segmentation, and structured feedback models. ·      Describe how digital tools can be used to improve OR efficiency and resource utilization, including instrumentation usage, operative time analysis, and workflow optimization. ·      Summarize current telepresence and teleproctoring technologies and their clinical use cases, including augmented reality–based collaboration across institutions and geographic boundaries. ·      Identify key ethical, legal, and operational challenges in digital and tele-surgery, including credentialing, cross-state licensure, liability, and trust in remote expertise. ·      Discuss how digital surgery may reshape surgical training and competency-based assessment, including implications for autonomy, deliberate practice, and feedback frequency. ·      Recognize future directions of digital surgery integration, including predictive analytics, simulation using patient-specific imaging, and AI-assisted intraoperative decision support.References:  Balvardi S, Semsar-Kazerooni K, Kaneva P, et al. Validity of video-based general and procedure-specific self-assessment tools for surgical trainees in laparoscopic cholecystectomy. Surg Endosc. 2023;37(3):2281-2289. doi:10.1007/s00464-022-09466-6 [https://pubmed.ncbi.nlm.nih.gov/36307525/] Hospital Utilizes Intraoperative Idle Time Metrics to Improve Surgical Safety and Efficiency. Theator | The Surgical Intelligence Company. Accessed March 20, 2026. https://theator.io/customer-story/hospital-utilizes-intraoperative-idle-time-metrics-to-improve-surgical-safety-and-efficiency/ Campbell KK, Abreu AA, Zeh HJ, et al. Using OR Black Box Technology to Determine Quality Improvement Outcomes for In-situ Timeout and Debrief Simulation. Ann Surg. 2026;283(1):122. doi:10.1097/SLA.0000000000006438 [https://pubmed.ncbi.nlm.nih.gov/38317208/] Al Abbas AI, Meier J, Daniel W, et al. Impact of team performance on the surgical safety checklist on patient outcomes: an operating room black box analysis. Surg Endosc. 2024;38(10):5613-5622. doi:10.1007/s00464-024-11064-7 [https://pubmed.ncbi.nlm.nih.gov/39069926/] Proximie's telepresence platform helps surgeons across the globe grow and exchange experience in real-time. World Health Expo Insights. Accessed March 20, 2026. https://www.worldhealthexpo.com/insights/telemedicine/proximie-s-telepresence-platform-helps-surgeons-across-the-globe-grow-and-exchange-experience-in-real-time Hassan AE, Desai SK, Georgiadis AL, Tekle WG. Augmented reality enhanced tele-proctoring platform to intraoperatively support a neuro-endovascular surgery fellow. Interv Neuroradiol. 2022;28(3):277-282. doi:10.1177/15910199211035304 [https://pubmed.ncbi.nlm.nih.gov/34538166/] SAGES Digital Surgery Working Group; Ali JT, Yang G, Green CA, Reed BL, Madani A, Ponsky TA, Hazey J, Rothenberg SS, Schlachta CM, Oleynikov D, Szoka N. Defining digital surgery: a SAGES white paper. Surg Endosc. 2024 Feb;38(2):475-487. doi: 10.1007/s00464-023-10551-7. Epub 2024 Jan 5. PMID: 38180541. [https://pubmed.ncbi.nlm.nih.gov/38180541/] Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewOBGYN Oral Board Review Coures: https://behindtheknife.org/course/obgyn-oral-board-reviewEPA Playbook: https://behindtheknife.org/course/epa-playbookSurgical Instrument Flashcards: https://behindtheknife.org/course/surgical-instrument-flashcardsABSITE Review: https://behindtheknife.org/course/absite-2026-exam-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Dr. Kurt Olding shares with us the latest published recommendations for conservative treatment for spinal stenosis. Dr. Kurt Olding has been in practice for over 40 years, opening Minster Chiropractic Center in 1986 after graduating from National College of Chiropractic in Lombard, IL in 1984. Through the years Dr. Kurt has enjoyed treating all age groups, from infants to athletes and parents to grandparents. He took special interest in sports medicine during his early years in practice, completing 300 hours of continuing education through the Certified Chiropractic Sports Physician program. Dr. Kurt earned Cox® Technic certification in 2009. In 2012 he began co-instructing the technique, and since 2015 has been a full-time instructor alongside Dr. James Cox, Dr. Ralph Kruse, and Dr. George Joachim. Through his work with Cox® Technic, Dr. Kurt has had several exciting opportunities. In March of 2016, he taught Cox® Technic in Bern, Switzerland as part of the Swiss Chiropractic Academy's "technique series" program. Later that month, he presented research on Cox® Technic with his mentor Dr. James Cox at the annual Association of Chiropractic Colleges Research Agenda Conference. Dr. Kurt co-authored a paper published in the June 2016 edition of the Journal of Chiropractic Medicine titled Chiropractic Distraction Spinal Manipulation on Post-surgical Continued Low Back and Radicular Pain patients: A Retrospective Case Series. In 2015, Dr. Kurt became board certified as a Chiropractic Orthopedist, and a Fellow of the Academy of Chiropractic Orthopedists (FACO). He is also a board member of the Academy of Chiropractic Orthopedists, serving since early 2016. Dr. Kurt and his wife Jackie are Minster natives. They have three children: Sunni, Kregg, and Jack. Sunni and her husband Tyler joined the practice in 2014. Resources: Minster Chiropractic Center kurt.olding@gmail.com Find a Back Doctor thebackdoctorspodcast.com The Cox 8 Table by Haven Medical References: Young I, Dunning J, Butts R, Bliton P, Zacharko N, Garcia J, Mourad F, Charlebois C, Gorby P, Fernández-de-Las-Peñas C. Spinal manipulation and electrical dry needling as an adjunct to conventional physical therapy in patients with lumbar spinal stenosis: a multi-center randomized clinical trial. Spine J. 2024 Apr;24(4):590-600. doi: 10.1016/j.spinee.2023.12.002. Epub 2023 Dec 14. PMID: 38103739. Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ, Furlan AD, Stuber K, Ahmed A, Cancelliere C, Adeboyejo A, Ornelas J. Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review. BMJ Open. 2022 Jan 19;12(1):e057724. doi: 10.1136/bmjopen-2021-057724. PMID: 35046008; PMCID: PMC8772406.   Schneider MJ, Ammendolia C, Murphy DR, Glick RM, Hile E, Tudorascu DL, Morton SC, Smith C, Patterson CG, Piva SR. Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis: A Randomized Clinical Trial. JAMA Netw Open. 2019 Jan 4;2(1):e186828. doi: 10.1001/jamanetworkopen.2018.6828. PMID: 30646197; PMCID: PMC6324321.   Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE, Chernish G, Cox JM, Gliedt JA, Haskett D, Jensen RK, Marchand AA, Tomkins-Lane C, O'Shaughnessy J, Passmore S, Schneider MJ, Shipka P, Stewart G, Stuber K, Yee A, Ornelas J. Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical Practice Guideline. J Pain. 2021 Sep;22(9):1015-1039. doi: 10.1016/j.jpain.2021.03.147. Epub 2021 Apr 12. PMID: 33857615.   Comer C, Williamson E, McIlroy S, Srikesavan C, Dalton S, Melendez-Torres GJ, Lamb SE. Exercise treatments for lumbar spinal stenosis: A systematic review and intervention component analysis of randomised controlled trials. Clin Rehabil. 2024 Mar;38(3):361-374. doi: 10.1177/02692155231201048. Epub 2023 Sep 16. PMID: 37715644; PMCID: PMC10829420.   Bise CG, Schneider M, Freburger J, Fitzgerald GK, Switzer G, Smyda G, Peele P, Delitto A. First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization. Phys Ther. 2023 Sep 1;103(9):pzad067. doi: 10.1093/ptj/pzad067. PMID: 37379349.   Hernandez-Martínez J, Cid-Calfucura I, Vásquez-Carrasco E, Perez-Carcamo J, Herrera-Valenzuela T, Aravena-Sagardia P, Barramuño-Medina M, Valdés-Badilla P. Timed Up-and-Go as a predictor of fracture risk: a systematic review and meta-analysis in a population of over 1.6 million people. Front Public Health. 2026 May 11;14:1841017. doi: 10.3389/fpubh.2026.1841017. PMID: 42200137; PMCID: PMC13199231.   Henn MC, Rae A, Fecker AL, McIntyre M, Larsen A, Wright J. A Nationwide Survey of the Spine Education of Medical Students. Cureus. 2026 Apr 4;18(4):e106443. doi: 10.7759/cureus.106443. PMID: 42093772; PMCID: PMC13139429.   James G, Ahern B, Goodwin W, Goss B, Hodges P. ISSLS Prize in Basic Science 2025: Structural changes of muscle spindles in the multifidus muscle after intervertebral disk injury are resolved by targeted activation of the muscle. Eur Spine J. 2025 May;34(5):1600-1613. doi: 10.1007/s00586-025-08646-x. Epub 2025 Jan 15. Erratum in: Eur Spine J. 2025 May;34(5):2046. doi: 10.1007/s00586-025-08744-w. PMID: 39810036.   Gong G, Yan Z, Lai Q, You P, Yu P, Li X, Wang Z, Lin S, Dai Y, Jiang H, Liu J. Inflammation preservation strategy: reconciling pain control and disc resorption in lumbar disc herniation. Front Immunol. 2025 Sep 2;16:1653681. doi: 10.3389/fimmu.2025.1653681. PMID: 40963597; PMCID: PMC12436131.

Welcome to the latest episode (August 2026) of DOC Updates, where every month Neil Skolnik, MD and John Russell, MD review the most important articles on diabetes, obesity, and cardiometabolic disease. This month on DOC Updates: Hirsh Elhence, Jennifer L. Dodge, Stephen Fuest, et al. National Prevalence of Clinical Obesity by BMI Class: A National Cross-Sectional Study. Ann Intern Med. [Epub 2 June 2026]. doi:10.7326/ANNALS-25-05287 Eva Johnsen, et al. Achieving at Least 15% Weight Loss Within 2 Years of Type 2 Diabetes Diagnosis Is Associated With Lower Risks of Macrovascular and Microvascular Complications: A U.K. Cohort Study. Diabetes Care 20 July 2026; 49 (8): 1480–1489. doi.org/10.2337/dc26-0937 Carel W. le Roux, et al. Survodutide Once Weekly for the Treatment of Adults with Obesity. The New England Journal of Medicine June 2026 DOI: 10.1056/NEJMoa2600751 Yu Wang, Shichao Tang, Xilin Zhou, Ping Zhang. National Trends in Out-of-Pocket Cost for Glucose-Lowering Drugs Among U.S. Adults With Diabetes, 2000–2022. Diabetes Care 20 July 2026; 49 (8): 1414–1419. https://doi.org/10.2337/dc25-2040 Jelle M. Beernink, et al. Effect of Finerenone on Albuminuria in Type 1 Diabetes by Baseline HbA1c Level and Diabetes Duration: An Exploratory Analysis of the FINE-ONE Trial. Diabetes Care 20 July 2026; 49 (8): 1434–1441. https://doi.org/10.2337/dc26-0882 Welch M, Forst T, Jia W et al. Orforglipron compared with dapagliflozin in adults with type 2 diabetes and inadequate glycaemic control with metformin (ACHIEVE-2): a multicentre, randomised, non-inferiority, open-label, phase 3 trial. The Lancet, 2026; 408, 125-140 DOI: 10.1016/S0140-6736(26)00800-7 Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health DOC Updates is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's three science and medical journals—Diabetes, Diabetes Care, and Diabetes, Obesity, and CardioMetabolic CARE. Intended for practicing physicians and health care professionals, DOC Updates discusses how the latest research is relevant in clinical practice. For information about the American Diabetes Association's scholarly journals, visit diabetesjournals.org. For more about this podcast, click here.

En este episodio conversamos sobre Ovejas detectives (Glennkill), la ingeniosa y divertida novela de la autora alemana Leonie Swann.Todo empieza en un apacible prado de Irlanda, cuando el pastor George Glenn aparece muerto en la hierba, atravesado por una pala de granja. Sus ovejas, encabezadas por Miss Maple (la más inteligente del rebaño), deciden que no van a quedarse de brazos cruzados esperando a que la policía local haga un trabajo mediocre.A lo largo del episodio comentamos cómo estas peculiares detectives interpretan el comportamiento humano, arman su propia lógica para investigar a los sospechosos del pueblo y se enfrentan a un misterio mucho más complejo de lo que parece a simple vista.Mas información sobre este libro: Las Ovejas Detectives de Leonie SwannSíguenos en nuestras redes sociales

Episode 358! JC is in the host chair with Salvis running the boards, joined by Rita, Preston, Donald, Nora, Veronica, and a bus-riding drop-in from Phil. Stacey is away this week, and the crew opens their hearts for her: Phil asks everyone to keep Stacey James and her family in their prayers as wildfires burn near Spokane, Washington.The retro gold of the night: JC discovers that a developer has ported the legendary DECtalk synthesizer to iOS as a standalone app (GitHub download, Android port too) and plays a live demo. Perfect Paul lives again on a modern iPhone, along with Beautiful Betty, Huge Harry, Frail Frank, Dr. Dennis, Kit the Kid, Uppity Ursula, Rough Rita, and Whispering Wendy. Preston flashes back to Perfect Paul reading the weather radio on his first Sony Walkman. Pure nostalgia for every longtime screen-reader user.Donald unveils Extreme eBook Builder Professional 3.0, his new Windows program for building e-books in Kindle, EPUB, and even standalone EXE formats from any text, Word, RTF, or HTML source. Fully menu-driven and screen-reader friendly with NVDA and JAWS, no mouse required. Retail price $297.KSRN keeps expanding: Preston reports the Crazy Stacey Radio Network got approved on the Audacy app and website just 24 hours before taping, plus new listings on Simple Radio, the radio-browser.info public directory, and MyTunerRadio. He is also registering for the NFB of Pennsylvania state convention in Hershey.In the accessible app corner, JC covers Earshot, a new podcast player app making waves in the blind community, and shares his experience testing Lumen, a voice-driven email app for visually impaired users. Plus the roadmap tease: iOS 27 lands in September, and JC plans a full demo of iOS 27 and the new Siri AI on a future episode. And Suno AI keeps surprising: on this week's NFB Access On podcast, Jonathan Mosen used Suno to build a song about the NFB 2026 convention, and JC shouts out his friend Andrea, who is releasing her own Suno-made songs on Apple Music.Music moments: JC plays a stereo recording from the end of the praise party at his Delight monthly meeting, and Nora's karaoke rendition of "Put on a Happy Face" gets new life with an instrumental track added by a friend she fondly calls "the guru." JC teases a possible duet with Gabby and Jaden next week.Rita shares a belated birthday visit from her cousin, who shares her June 2 birthday and spent his working in Florence. He visited with his wife bearing roses, balloons, and Rita's beloved Nutty Bars. Donald talks tilapia on Dave's Killer Bread with hot sauce, plus a Chili's run for ribs and white cheddar mac and cheese.Echo Grace updates: JC's mom officially became a church member last weekend. New Spanish-team additions Angela Martel, Gabby E., and John Santiago, who now directs the Spanish team. The June Night of Worship recording is up on the Echo Grace YouTube page, honoring Pastor Andrew, who has moved to Florida. The "You Ask For It" sermon series continues, with all messages available as a podcast. Preston also tells the story of the fair: a new country artist named Greyland James, a canceled grandstand headliner, refunded tickets, and a free-stage rescue show of live local country.George is off this week, but Preston refuses to let the tradition die: "Doodles spilled the milk!" - and Donald makes sure George can't have any.Keep technology alive, let your talent shine.Recorded 2026-08-05. Hosted by JC with Salvis on the boards, on the VisionCast Network.

Alexander Aarvold from the University Hospital Southampton joins the show this month to discuss his eagerly anticipated publication on the outcomes of the incomplete acetabuloplasty (or “pelletoplasty”) as an adjunctive treatment during open reduction of developmental hip dislocations. The group also discusses recent publications on treatment of infant femur fractures, open forearm fractures, and the outcomes of periacetabular osteotomy in skeletally immature patients. Your hosts are Carter Clement from Children's Hospital Colorado, Julia Sanders from Children's Hospital Colorado, and Will Morris from Scottish Rite in Dallas. Music by A.A. Aalto.  Aarvold A, Uren N, Rhodes A, Elliott KG, Lindisfarne EA, Carsi B, Clarke NMP. Growth Stimulating Minimal Acetabuloplasty, Alongside Hip Open Reduction: A Simpler One-stop Operative Treatment for Developmental Dysplasia of the Hip. J Pediatr Orthop. 2026 Apr 16. doi: 10.1097/BPO.0000000000003259. Epub ahead of print. PMID: 41988894. https://pubmed.ncbi.nlm.nih.gov/41988894/  Murphy-Zane MS, Keeter C, Baumann A. Hip Abduction Brace Is an Effective Treatment Alternative for Femur Fractures in Infants 12 Months and Younger. J Pediatr Orthop. 2026 Jul 1;46(6):e535-e541. doi: 10.1097/BPO.0000000000003172. Epub 2025 Nov 25. PMID: 41490478; PMCID: PMC13232693.  https://pubmed.ncbi.nlm.nih.gov/41490478/ Kronk TA, Steiner RP, Ritzman TF, Floccari LV. Surgical Treatment of Pediatric Open Forearm Fractures: A Comparison of Outcomes With or Without Internal Fixation. J Pediatr Orthop. 2026 Jul 1;46(6):e524-e528. doi: 10.1097/BPO.0000000000003159. Epub 2025 Nov 5. PMID: 41191825. https://pubmed.ncbi.nlm.nih.gov/41191825/ Pun SY, Kha ST, Park MO, Richey AE, Pham NS, Millis MB. Is the Bernese Periacetabular Osteotomy Safe for the Treatment of Acetabular Dysplasia When the Triradiate Cartilage is Still Open? A Preliminary Study. J Pediatr Orthop. 2026 Jul 1;46(6):335-341. doi: 10.1097/BPO.0000000000003275. Epub 2026 May 5. PMID: 42084192. https://pubmed.ncbi.nlm.nih.gov/42084192/

Cannabinoid Hyperemesis Syndrome (CHS) continues to be a major clinical challenge in the emergency department. Patients present with severe abdominal pain, intractable vomiting, and significant fluid and electrolyte derangements. CHS often affects people who have been using cannabis routinely for months to years – it can be difficult for patients to understand that their symptoms are related to cannabis.  Today, emergency pharmacist Haley Burhans joins us to discuss first-line treatments, fluid management, discharge strategies, and how to navigate these tough bedside conversations. First-Line Therapies: Haldol vs. Droperidol Haloperidol (Haldol): Supported by the HAVOC trial (haloperidol vs. placebo), which showed a reduction in symptoms and ED length of stay. Droperidol: Highly effective alternative with similar dopaminergic mechanism of action. May carry a lower risk of extrapyramidal symptoms compared to haloperidol.  Capsaicin Cream: addresses the TRPV1 pathway thought to drive CHS. Patients often dislike it as it causes a burning sensation on the skin and can be inadvertently spread to eyes or face. Can be an option if symptoms persist after trying the above meds and hot showers aren't feasible.  Backup Options & Anti-Emetics Alternative Dopaminergic Agents: Metoclopramide or prochlorperazine can be used. Standard Anti-Emetics (e.g., Ondansetron): Serotonergic anti-emetics generally fail to address the underlying CHS pathway. However, a single dose of ondansetron given alongside a butyrophenone (haloperidol/droperidol) is reasonable if you suspect co-existing etiologies. QTc Prolongation Warning: Chronic vomiting leads to electrolyte depletion. Combining anti-emetics and haloperidol or droperidol increases the risk of QTc prolongation. Baseline EKG: Not strictly required for every low-risk patient, but strongly recommended for patients with multiple risk factors (e.g., co-ingestion/use of methadone, history of heart failure, or severe baseline bradycardia). Fluid Resuscitation & Electrolyte Management CHS patients can vomit to the point of severe dehydration and profound electrolyte/acid-base derangements. Fluid Selection: Normal Saline (NS): A solid choice for initial volume resuscitation when sodium and chloride are severely depleted. Lactated Ringer's (LR): Ideal as a follow-up or maintenance fluid because it contains a small amount potassium. Potassium Repletion: Oral repletion may not be tolerated in the acute setting. Consider IV potassium repletion in the ED, followed by oral home supplementation once nausea is controlled. Magnesium: While acute vomiting primarily drives potassium loss, consider IV magnesium if Mg is low or there is concern for QTc prolongation. Discharge Planning: What to Send Home Low-Dose Olanzapine ODT: Send the patient home with 2.5 mg Olanzapine ODT (orally disintegrating tablets). Why it works: It dissolves instantly on the tongue, bypassing the stomach, and provides extended dopaminergic coverage over the multi-day washout period.  Pharmacokinetics Pearl: Infrequent user THC half-life: ~1.3 hours (cleared in 5–6 hours). Chronic user THC half-life: THC accumulates in adipose tissue. In heavy users, therapeutic levels can persist for up to 2 weeks, driving prolonged receptor dysregulation even after cessation. Navigating the Bedside Conversation Explaining to a chronic user that their daily cannabis—the very thing they use to relieve nausea—is causing their illness requires empathy and validation. Explain the Neurological Link: Cannabis acts on receptors throughout the entire body, including the brain's nausea center and the nervous system of the gut. Chronic, heavy saturation can paradoxically overload these pathways. Validate Their Experience: Acknowledge how counterintuitive it feels: “I know it's hard to believe that something you've used for years to feel better is causing this, but long-term daily use can change how your body processes it.” Set Realistic Expectations: Reiterate that symptoms will not resolve overnight. Even after stopping, it takes time for the pathways to recalibrate. What do you find most helpful for treating CHS? How do you have these difficult conversaions with your patients? Share your experience with us on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis Resources: Borgundvaag B, Bellolio F, Miles I, et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. Acad Emerg Med. 2024 May;31(5):425-455. doi: 10.1111/acem.14911. PMID: 38747203. Rech MA, Shalaby M, Gage KA, Gottlieb M. Managing Cannabinoid Hyperemesis Syndrome. Ann Emerg Med. 2026 Jun;87(6):717-722. doi: 10.1016/j.annemergmed.2025.12.024. Epub 2026 Feb 3. PMID: 41632059. *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

Send us Fan MailDescription: An immersive reading of Morning Tea by Michael L. Wynn with reflection on atrial fibrillation, strokes, space and time.Website:https://anauscultation.wordpress.comWork: https://www.neurology.org/doi/10.1212/WNL.0000000000214487 References:Wynn ML. Morning Tea. Neurology. 2025 Dec 23;105(12):e214487. doi: 10.1212/WNL.0000000000214487. Epub 2025 Nov 20. PMID: 41264895.

En este episodio exploramos la siniestra y fascinante atmósfera de The House That Horror Built, la aclamada novela gótica moderna de la autora superventas Christina Henry (Good Girls Don't Die, Alice).Conocemos a Harry Adams, una madre soltera y gran aficionada al cine de terror que lucha por salir adelante en Chicago. Cuando consigue trabajo como limpiadora en Bright Horses —la imponente y sombría mansión del afamado (y recluido) director de cine de terror Javier Castillo— parece el empleo soñado. La mansión está repleta de utilería, disfraces escalofriantes y estatuillas de sus películas clásicas.Sin embargo, para mantener el empleo y sostener a su hijo adolescente Gabe, Harry debe seguir la regla principal: discreción absoluta y no hacer preguntas. Pero todo se complica cuando empieza a escuchar susurros y gritos de auxilio tras una puerta siempre cerrada con llave, en una casa donde supuestamente nadie más vive... ¿Son efectos especiales, manifestaciones paranormales o un secreto aterrador que su jefe oculta?

Send us Fan MailIn this small prospective pilot study, Adrianne and Nim explore a domain rarely discussed on rounds, how a mother's cardiovascular function in preeclampsia shapes her newborn's circulatory transition. Using maternal echo and neonatal electrical cardiometry across 13 mother-baby dyads, the authors found an inverse relationship: the worse the mother's cardiac function, the higher the neonate's cardiac output, though vascular tone barely budged. It's a compelling hypothesis about placental strain and fetal adaptation. But Nim pushes back hard on the methodology, pairing this paper with a companion study showing electrical cardiometry consistently overestimates cardiac output in neonates, and questioning why daily echoes were performed on these babies but the results never reported.----Linking maternal and neonatal circulation in preeclampsia. Piani F, Annesi L, Degli Esposti D, Vincenzi S, De Crescenzo S, Della Gatta AN, Simonazzi G, Corvaglia L, Martini S.Am J Physiol Heart Circ Physiol. 2026 Mar 1;330(3):H708-H716. doi: 10.1152/ajpheart.00945.2025. Epub 2026 Jan 12.PMID: 41525138 Free article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Send us Fan MailIn this systematic review and meta-analysis, Nim and Adrianne dig into just how common brain injury really is in neonates with critical congenital heart disease. Pooling 31 studies spanning two decades, the authors found that nearly 70% of these babies show some form of ischemic brain injury, split roughly between pre-operative and post-operative timing. Counter to what most clinicians would predict, kids who went to surgery earlier (days 4-6) had higher rates of white matter injury than those who waited longer. MRI remained the most sensitive tool for picking up these lesions, well ahead of ultrasound or CT. But the data stops well short of proving these findings predict long-term outcomes, and Nim pushes back on the idea that an abnormal scan alone should steer decisions about whether to operate.----Prevalence of Ischemic Brain Injury in Neonates With Congenital Heart Disease: A Systematic Review and Meta-Analysis.Kim C, Chetan D, Kazazian V, Alzamil J, Chau V, Seed M, Miller SP, Selvanathan T.Neurology. 2026 Feb 10;106(3):e214569. doi: 10.1212/WNL.0000000000214569. Epub 2026 Jan 9.PMID: 41512205Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Charles Berde, MD, PhD, is the Sara Page Mayo Chair in Pediatric Pain Medicine and a Professor of Anaesthesia at Harvard Medical School. As a co-founder of the Pain Treatment Center at Boston Children's Hospital, he has spent decades at the forefront of pediatric analgesic pharmacology and the development of novel local anesthetics. His extensive translational research focuses on local anesthetic mechanisms and prolonged-duration formulations, making him a preeminent authority on the physiological impacts and safety profiles of these agents in neonates and children. A recipient of the Myron Yaster Lifetime Achievement Award from the Society for Pediatric Anesthesia, Dr. Berde brings unparalleled expertise to the discussion of managing and preventing local anesthetic systemic toxicity (LAST) within the high-stakes environments of the PICU and pediatric operating rooms.Guest Conflicts of Interest (COI)Algavita Bio: Collaborator/Developer of novel, prolonged-duration local anesthetics.Quiver Bioscience: Unpaid Scientific Advisor and co-PI on an NINDS-HEAL grant focused on rare disease pain treatments.Latigo Biotherapeutics: Scientific Advisor and recipient of past research support for novel analgesics development.Algos: Scientific Advisor for non-opioid analgesics development.Learning Objective: By the end of this podcast, listeners should be able to discuss an evidence-based and expert-guided approach to the management of local anesthetic systemic toxicity (LAST) in children.References:Patient and Doctor Reconcile for Greater GoodBerde CB. Toxicity of local anesthetics in infants and children. J Pediatr. 1993 May;122(5 Pt 2):S14-20. doi: 10.1016/s0022-3476(11)80004-1.McMahon K, Paster J, Baker KA. Local anesthetic systemic toxicity in the pediatric patient. Am J Emerg Med. 2022 Apr;54:325.e3-325.e6. doi: 10.1016/j.ajem.2021.10.021. Epub 2021 Oct 25. Lavonas et al. 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2023 Oct 17;148(16):e149-e184. doi: 10.1161/CIR.0000000000001161. Epub 2023 Sep 18. Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com.  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

En este episodio nos adentramos en el intrigante mundo de "El matrimonio perfecto", la aclamada novela de suspenso psicológico escrita por la autora bestseller Jeneva Rose.Analizamos la historia de Sarah Morgan, una exitosa abogada penalista de Washington D. C. cuya vida parece impecable, hasta que su esposo Adam, un escritor frustrado, es arrestado por el brutal asesinato de su amante, Kelly Summers. Lo verdaderamente inquietante ocurre cuando Sarah toma la impactante decisión de ser la abogada defensora de su propio marido.¿Hasta dónde llega la lealtad? ¿Es Adam culpable o una víctima de una trampa? Desgranamos los giros de guion, el ritmo narrativo y ese final del que todo el mundo está hablando.

Join Jenn Dawson and Mitchell Hanson for some quick-hitting "research hot takes!"Topical Therapies Supporting Links and Articleshttps://nextstepsinderm.com/derm-topics/expanding-the-treatment-landscape-for-atopic-dermatitis-hidradenitis-suppurativa-and-chronic-hand-eczema/https://www.dermatologytimes.com/view/advancing-topical-stewardship-and-expanding-nonsteroidal-optionshttps://www.arcutis.com/arcutis-announces-publication-of-positive-long-term-safety-and-efficacy-data-with-zoryve-roflumilast-cream-0-05-for-treatment-of-mild-to-moderate-atopic-dermatitis-in-children-ages-2-5/Social Unrest Leads to Access Barriers Supporting Links and ArticlesC. L. Presley, J. Meisenheimer VII, C. W. Rundle, S. Maguiness, I. A. Maher, and A. J. M. Anderson, “Social Unrest and Its Implications on the Pediatric Dermatological Patient: Lessons From a Single Center Academic Dermatology Department,” Pediatric Dermatology (2026): 1–2, https://doi.org/10.1111/pde.70260.Mukerjee K, Shah S, Falusi O. State Policies and Access to Care for Immigrant Children—Implications for Pediatric Health Outcomes. JAMA Netw Open. 2025;8(12):e2545833. doi:10.1001/jamanetworkopen.2025.45833Skin of Color in Pediatric Dermatology Supporting Links and ArticlesDondi, A., Ranieri, A., Andreozzi, L., Leuzzi, M., D'Alanno, G., Pierantoni, L., Zama, D., Battelli, E., Calegari, R., Borghesi, A., Lanari, M., & Neri, I. (2026). Skin of Color in Pediatric Dermatology: A Cross-Sectional Retrospective Analysis Addressing Inclusive Diagnosis and Care. Life (Basel, Switzerland), 16(4), 578. https://doi.org/10.3390/life16040578Fagan E, Reagen C, Ituarte B, Shet P, Shaver-Dominguez N, Harter N, Wei EX, Oudenhoven M. Trends in Pediatric Representation Within Skin of Color Dermatology Literature: A Decade-Long Analysis. Pediatr Dermatol. 2026 Jan-Feb;43(1):95-97. doi: 10.1111/pde.16038. Epub 2025 Aug 13. PMID: 41611238.This episode is presented by Disc Medicine. Although Disc Medicine provided funding for this PeDRA Pearls Podcast, the contents of the podcast were developed independently by PeDRA. Learn more about Disc Medicine.

In this episode of *Pediatric Critical Care Insights*, Dr. Monica Gray and Dr. Pradip Kamat chat about how capnography, specifically end-tidal CO2 monitoring, is used in the pediatric ICU. They walk through a real-life case of a 9-year-old with respiratory failure from influenza A, showing how ETCO2 monitoring helps confirm endotracheal tube placement, guides ventilation, spots cardiac arrest, and even helps assess the quality of CPR. Along the way, they break down how to interpret capnography waveforms, discuss different types of devices, and explain the key physiological concepts. The episode is packed with practical, bedside tips for intensivists caring for critically ill kids.Show Highlights:Importance of capnography (end-tidal CO2 monitoring) in the pediatric intensive care unit (PICU)Clinical case study of a 9-year-old boy with respiratory failure due to influenza AUse of capnography for confirming endotracheal tube placement and assessing ventilation statusDetection of cardiac arrest and guidance for CPR quality through ETCO2 monitoringOverview of capnography physics and physiology, including terminology distinctionsTypes of capnography: mainstream vs. sidestream, and their applications in pediatric patientsAssumptions for accurate ETCO2 approximation of arterial CO2 and conditions affecting this relationshipAnalysis of capnography waveform phases and their clinical significancePrognostic value of ETCO2 during cardiac arrest and its correlation with patient outcomesPractical applications of ETCO2 monitoring in critical care, focusing on airway, breathing, and circulation managementReferences:Noninvasive respiratory monitoring and assessment of gas exchange. David F. Butler; Kenneth A. Schenkman. Fuhrman and Zimmerman's Pediatric Critical Care, 43, 483-491.e3Humphreys S, Schibler A, von Ungern-Sternberg BS. Carbon dioxide monitoring in children—A narrative review of physiology, value, and pitfalls in clinical practice. Pediatr Anaesth. 2021;31:839–845. https://doi.org/10.1111/pan.14208Lasa JJ, Dhillon GS, Duff JP, et al. Part 8: Pediatric Advanced Life Support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics. 2026;157(1):e2025074351O'Flaherty. Capnography: principles and practice. London: BMJ Publishing Group; 1994.Aminiahidashti H, Shafiee S, Zamani Kiasari A, Sazgar M. Applications of End-Tidal Carbon Dioxide (ETCO2) Monitoring in Emergency Department; a Narrative Review. Emerg (Tehran). 2018;6(1):e5. Epub 2018 Jan 15. PMID: 29503830; PMCID: PMC5827051.

What if one tiny molecule played the central role in your blood pressure, heart health, brain function, exercise performance, and even your risk of diabetes and Alzheimer's disease? Dr Nathan Bryan believes that molecule is nitric oxide. And he walks the walk, having used his N101 products for decades testing shows his endothelial health to be of someone half his biological age! This is an incredible, illuminating podcast that deserves worldwide attention.Dr. Nathan Bryan has been involved in nitric oxide research for the past 25 years and has made many seminal discoveries in the field. His many seminal discoveries have resulted dozens of issued US and International patents and the product technology resulting from his discoveries and inventions has improved patient care worldwide. His companies and product technology are responsible for more than one billion dollars in product sales worldwide. Bryan is an international leader in molecular medicine and nitric oxide biochemistry.Contact: Website - https://n1o1.comJoin us as we explore:The secret power of nitric oxide - the root causes of deficiency, the #1 symptom of insufficiency and why it's molecularly a hormone.Nitric oxide's causation to diabetes, cardiovascular disease and Alzheimer's disease.Eliminating deadly soft arterial plague with nitric oxide lozenges.Why most nitric oxide promoting supplements are false marketing.How your toothpaste and mouth wash are destroying your nitric oxide.How exercise creates nitric oxide.The key enzyme for nitric oxide and how to keep it in high supply.Mentions Podcast - Dr Robert Elliot, https://podcasts.apple.com/za/podcast/the-made-to-thrive-show/id1509452847?i=1000718543359 Podcast - Dr John Osborne, https://podcasts.apple.com/za/podcast/the-made-to-thrive-show/id1509452847?i=1000766332388Study - Elrod JW, Calvert JW, Gundewar S, Bryan NS, Lefer DJ. Nitric oxide promotes distant organ protection: evidence for an endocrine role of nitric oxide. Proc Natl Acad Sci U S A. 2008 Aug 12;105(32):11430-5. doi: 10.1073/pnas.0800700105. Epub 2008 Aug 6. PMID: 18685092; PMCID: PMC2516252Support the showFollow Steve's socials: Instagram | LinkedIn | YouTube | Facebook | Twitter | TikTokSupport the show on Patreon:As much as we love doing it, there are costs involved and any contribution will allow us to keep going and keep finding the best guests in the world to share their health expertise with you. I'd be grateful and feel so blessed by your support: https://www.patreon.com/MadeToThriveShowSend me a WhatsApp to +27 64 871 0308. Disclaimer: Please see the link for our disclaimer policy for all of our content: https://madetothrive.co.za/terms-and-conditions-and-privacy-policy/

If you've scrolled through your feeds recently, you've probably seen the video that's causing a stir: a prominent infertility doctor sharing her “Hot Take” personal observations on social media, claiming that IUDs are a hidden cause of intrauterine adhesions- or severe uterine scar tissue. Now, Listen. It is completely natural to see a specialist standing in a white coat making a passionate claim and think, "Wow, should I be worried about my birth control?" But here is the reality we need to establish right out of the gate: a handful of individual cases shared online is the very definition of anecdotal evidence. It does not fulfill the criteria of rigorous scientific observation. When we pull back from the algorithm and look at the actual clinical data involving millions of IUD users worldwide, the science shows us something completely different. In fact, large-scale studies demonstrate that IUDs do not cause this scarring—and historically, certain models have actually been used to prevent the uterine walls from sticking together during post-surgical healing. So today, we are separating the scrolling panic from the actual science. We have REA data from the recent FACT (Fertility After Contraceptive Termination) study from 2021 (AJOG). We're breaking down what the data really says, why the internet loves a medical scare, and the true, proven causes of intrauterine adhesions. 1. Abel MK, Wald K, Cedars MI, Noel M. Uterine Synechiae After Intrauterine Device Use: A Case Series. Journal of Assisted Reproduction and Genetics. 2021. 2. Chung E, Wang F, Zhang J, Strug M, Aghajanova L, Lathi R. The impact of prior hormonal intrauterine device (IUD) use on endometrial lining thickness in the fertility clinic setting: a retrospective cohort study. J Assist Reprod Genet. 2026 Jun 25. doi: 10.1007/s10815-026-03950-x. Epub ahead of print. PMID: 42347902.3. Peipert JF, Zhao Q, Schreiber CA, Teal S, Turok DK, Natavio M, Cordon S, Daggy J. Intrauterine device use, sexually transmitted infections, and fertility: a prospective cohort study. Am J Obstet Gynecol. 2021 Aug;225(2):157.e1-157.e9. doi: 10.1016/j.ajog.2021.03.011. Epub 2021 Mar 11. PMID: 33716075.

Is there really one correct way to move? For decades, clinicians and coaches have acted like there is. In this episode, we prosecute that idea. We start in a 1930s Soviet forge, where Nikolai Bernstein filmed blacksmiths and found their hammer strikes landed in the same spot every time, despite every joint angle differing swing to swing. That's "repetition without repetition." From there we bring in Mark Latash's motor abundance: why your nervous system treats extra degrees of freedom as a resource, not a problem, and what that means for scapular "dyskinesis," core stability cues, and fear-based rehab language. We close with a practical clinical translation for coaches and clinicians. Plus: a quick update on my next in-person workshop, The Complete Shoulder Workshop, Melbourne 17 October. Key resources Low M. A Time to Reflect on Motor Control in Musculoskeletal Physical Therapy. J Orthop Sports Phys Ther. 2018 Nov;48(11):833-836. doi: 10.2519/jospt.2018.0614. PMID: 30381024. Latash ML. The bliss (not the problem) of motor abundance (not redundancy). Exp Brain Res. 2012 Mar;217(1):1-5. doi: 10.1007/s00221-012-3000-4. Epub 2012 Jan 14. PMID: 22246105; PMCID: PMC3532046. Register for the complete shoulder online course Melbourne workshop details Connect with Jared: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 See our Disclaimer here: The Shoulder Physio - Disclaimer

¿Qué pasa cuando descubres que la persona con la que compartías tu vida era un asesino? ¿Y qué ocurre después, cuando el resto del mundo también lo sabe?En este episodio hablamos de The Secret Lives of Murderers' Wives, de Elizabeth Arnott, un thriller que deja de lado la investigación policial para enfocarse en algo mucho más incómodo: las personas que sobreviven al monstruo.La novela sigue a tres mujeres cuyas vidas quedan destrozadas cuando sus esposos son señalados como asesinos. Aunque cada una enfrenta el escándalo de forma distinta, todas comparten el mismo peso: la culpa por asociación, el juicio público y la eterna pregunta de si realmente conocían al hombre con el que vivían.Elizabeth Arnott construye una historia donde los secretos familiares, las apariencias y las relaciones humanas tienen más protagonismo que la sangre o la violencia. Es un thriller pausado, cargado de tensión psicológica, que poco a poco va revelando que nadie es exactamente quien dice ser.⚠️ Aviso: Este episodio contiene una sección sin spoilers y otra con spoilers, así que podrás decidir hasta dónde escuchar si aún no has leído el libro.Sí. Puedes encontrar la edición Kindle del libro en Amazon aquí:

Antenatal corticosteroids are a MAJOR win in the management of preterm labor. An initial course of antenatal corticosteroids has been shown to reduce morbidity and mortality in patients with preterm prelabor rupture of membranes. For patients who remain undelivered after the initial course of antenatal corticosteroids, it is uncertain whether a booster course of antenatal corticosteroids reduces neonatal morbidity or increases the infection risk. The ACOG, in its current guidance, has concluded that the current evidence is insufficient to make a recommendation. Corticosteroids, especially at the doses given, are also powerful immunosuppressants. When you administer that first course, you accept a minor, calculated risk for a massive, proven benefit. But when you introduce a second course of steroids into a uterine environment that has already been ruptured and exposed to vaginal flora for weeks, you are pouring fuel on the fire. PLUS, the environment for the fetus with prolonged preterm prelabor rupture of membranes is unique. PPPROM, the chronic exposure to ruptured membranes and the resultant oligohydramnios is theorized to trigger a kind of stress response in the fetus- so the baby may make their own endogenous corticosteroid flare. So, rescue steroids after an initial course of steroids in PPROM cases has remained controversial but we have updated data that has provided new insights. In this episode, we will highlight an RCT from 2023 and a more recent systematic review and meta-analysis from May 2026 on this very subject. Listen in for details. 1. Garite TJ, Kurtzman J, Maurel K, Clark R; Obstetrix Collaborative Research Network. Impact of a 'rescue course' of antenatal corticosteroids: a multicenter randomized placebo-controlled trial. Am J Obstet Gynecol. 2009 Mar;200(3):248.e1-9. doi: 10.1016/j.ajog.2009.01.021. Erratum in: Am J Obstet Gynecol. 2009 Oct;201(4):428. PMID: 19254583.2. Tenbrink E, Quain A, Rone V, Harris K, Hadley E, Haas D, Shanks A. Risk of Neonatal Sepsis With Rescue Steroids in Preterm Premature Rupture of Membranes. Cureus. 2023 Apr 6;15(4):e37207. doi: 10.7759/cureus.37207. PMID: 37159785; PMCID: PMC10163895.3. Melamed N, Murphy KE, Pylypjuk C, et al. Timingof Antenatal Corticosteroid Administration and Neonatal Outcomes. JAMA Netw Open. 2025;8(5):e2511315. 4. Porreco R, Garite TJ, Combs CA, Maurel K, Huls CK, Baker S, Fortner KB, Longo SA, Nageotte M, Lewis D, Tran L; Obstetrix Collaborative Research Network. Booster course of antenatal corticosteroids after preterm prelabor rupture of membranes: a double-blind randomized trial. Am J Obstet Gynecol MFM. 2023 May;5(5):100896. doi: 10.1016/j.ajogmf.2023.100896. Epub 2023 Feb 14. PMID: 36796641.5. Da Costa Y, Ramanathan V, Oliveira JA, Brito J, Yousif A. Repeat versus Single Course of Antenatal Corticosteroid in Management of Preterm Premature Rupture of Membranes: A Systematic Review and Meta-analysis. Am J Perinatol. 2026 May;43(7):925-932. doi: 10.1055/a-2708-5314. Epub 2025 Oct 9. PMID: 41067234

The Bakri Postpartum Balloon was described and first used clinically in 1999 by Dr. Younes N. Bakri (Georgia, USA). It is intended to treat postpartum hemorrhage (PPH). In the United States, it received its first major FDA clearance (via 510(k) for commercial marketing) on April 17, 2002. Manufacturer guidelines for the Bakri (Cook Medical) state that the balloon may be left indwelling for a maximum of 24 hours, but the determination of removal time is left to the clinician once “bleeding is controlled and the patient is stable.” However, the optimal duration of intrauterine balloon tamponade placement remains unclear. One retrospective cohort study from AJOG (Einerson et al) of 274 women found no significant difference in PPH outcomes when intrauterine balloon tamponade was left in place for 2–12 hours, compared with more than 12 hours. However, only 30 women had the intrauterine balloon tamponade placement for 10 hours or less. And remember, this was not a prospective trial looking at a minimum of 2 hours, 2 hours was just the lower margin of the “short duration” group. Now, a new RCT (with authors from Denver and Vermont) published in the July 2026 Green Journal provides new data. In this first of its kind pragmatic, randomized trial of noninferiority, a 6-hour duration of intrauterine balloon tamponade usage for postpartum hemorrhage (PPH) control was compared with an 18-hour duration. Listen in for details. 1. Durfee, J., Adkins, K., Heyborne, K., Larrea, N., & Schultz, C. (2026). Intrauterine Balloon Tamponade Duration for Postpartum Hemorrhage: A Randomized Controlled Trial. Obstetrics & Gynecology, 148(1), 113–120. https://doi.org/10.1097/AOG.00000000000062952. Garabedian C, Prats C, Seco A, Deneux-Tharaux C, Rozenberg P, Berveiller P. Duration of Intrauterine Balloon Tamponade in Post-Partum Haemorrhage Management After Vaginal Delivery: A Secondary Cohort Analysis From the French TUB Trial. BJOG. 2026 Jan;133(1):123-131. doi: 10.1111/1471-0528.18345. Epub 2025 Sep 1. PMID: 40888007; PMCID: PMC12676195.3. Einerson BD, Son M, Schneider P, Fields I, Miller ES. The association between intrauterine balloon tamponade duration and postpartum hemorrhage outcomes. Am J Obstet Gynecol 2017;216:300.e1–5.

Join us as we discuss research on mental health and wellbeing in the surgical workforce with Drs. Yang and Collins. The episode explores key findings from recent national surveys showing that nearly one in seven surgeons report suicidal ideation in the past year, with depression, anxiety, and PTSD affecting 15–20% of the surgical population. The conversation highlights protective factors—professional fulfillment, resilience, self-valuation, and connection—while distinguishing between healthy resilience and normalized suffering. Dr. Yang and Dr. Collins discuss systemic barriers including time constraints, out-of-pocket mental health costs, and persistent stigma, alongside actionable institutional interventions: protecting dedicated wellbeing time, establishing peer support and psychological first aid programs, ensuring free mental health access, and expanding research to understand what helps surgeons thrive. The episode emphasizes that self-care is essential to patient safety and invites listeners to become advocates, engage with the literature, and help drive culture change within their institutions. For more information about the AAS wellbeing survey, please email Dr. Yang at CJYANG@MGH.HARVARD.EDU.Host:   Steven Thornton, MD (General Surgery Resident at Duke University) Agnes Premkumar (General Surgery Resident at Creighton) Guests: Jeff Yang, MD (Massachusetts General Hospital) Reagan Collins, MD (University of Pennsylvania) Publications Discussed: Hughes TM, Collins RA, Cunningham CE. Depression and Suicide Among American Surgeons-A Grave Threat to the Surgeon Workforce. JAMA Surg. 2024 Jan 1;159(1):7-8. doi: 10.1001/jamasurg.2023.4658. PMID: 37792380. [https://pubmed.ncbi.nlm.nih.gov/37792380/] Collins RA, Herman T, Snyder RA, Haines KL, Stey A, Arora TK, Geevarghese SK, Phillips JD, Vicente D, Griggs CL, McElroy IE, Wall AE, Hughes TM, Sen S, Valinejad J, Alban A, Swan JS, Mercaldo N, Jalali MS, Chhatwal J, Gazelle GS, Rangel E, Yang CJ, Donelan K, Gold JA, West CP, Cunningham C. Unspoken Truths: Mental Health Among Academic Surgeons. Ann Surg. 2024 Mar 1;279(3):429-436. doi: 10.1097/SLA.0000000000006159. Epub 2023 Nov 23. PMID: 37991182. [https://pubmed.ncbi.nlm.nih.gov/37991182/]  Yaghmour NA, Bynum WE 4th, Hafferty FW, Könings KD, Richter T, Brigham TP, Nasca TJ. Causes of Death Among US Medical Residents. JAMA Netw Open. 2025 May 1;8(5):e259238. doi: 10.1001/jamanetworkopen.2025.9238. Erratum in: JAMA Netw Open. 2025 Jul 1;8(7):e2523489. doi: 10.1001/jamanetworkopen.2025.23489. PMID: 40366660; PMCID: PMC12079293. [https://pubmed.ncbi.nlm.nih.gov/40366660/] Nasca BJ, Hunt ML, Ramirez RT, Eng JS, Li RD, Agarwal G, Bilimoria KY, Hu YY. One is too many: suicidality among general surgery residents. Acad Med. 2025 Dec 24:wvaf105. doi: 10.1093/acamed/wvaf105. Epub ahead of print. PMID: 41819820. [https://pubmed.ncbi.nlm.nih.gov/41819820/] Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

En este episodio hablamos de Te encontraré, una de las novelas más adictivas de Harlan Coben. La historia sigue a David Burroughs, un hombre que cumple una condena por el asesinato de su pequeño hijo. Todo cambia cuando aparece una fotografía que pone en duda aquello que todos daban por cierto y abre la puerta a una pregunta inquietante: ¿y si su hijo sigue vivo?A partir de ese momento, Coben construye un thriller lleno de giros inesperados, secretos familiares y decisiones desesperadas. Si te gustan los thrillers con mucho suspenso, personajes que esconden más de lo que aparentan y tramas que no te dejan soltar el libro, este episodio es para ti.Te Encontraré - Harlan CobenSíguenos en nuestras redes sociales

In this week's episode, we share nine tips and tricks to help indie authors manage their files. Since I now have 174 novels, file management has become important! This coupon code will get you 25% off the ebooks in the Dragonskull series at my Payhip store: JULYSKULL The coupon code is valid through July 27, 2026. So if you need a new ebook this summer, we've got you covered! TRANSCRIPT 00:00:00 Introduction and Writing Updates Hello, everyone. Welcome to Episode 311 of The Pulp Writer Show. My name is Jonathan Moeller. Today is July 10th, 2026. Today we are discussing file management tips for indie authors. Before we get into that, we'll have Coupon of the Week and an update on my current writing, publishing, and audiobook projects. First up, let's do Coupon of the Week. This coupon code will get you 25% off the ebooks in the Dragonskull series at my Payhip store. That coupon code is JULYSKULL. As always, the coupon code and the links to the appropriate pages in my Payhip store will be available in the show notes for this episode. This coupon code is valid through July the 27th, 2026. So if you need a new ebook for this summer, we have got you covered. Now let's have an update on my current writing, publishing, and audiobook projects. As I mentioned last week, Blade of Thieves is now out. You can get it at Amazon, Barnes & Noble, Kobo, Google Play, Apple Books, Smashwords, Bookshop.org, and my own Payhip store. It is selling well and people seem to be enjoying it, so thank you all for that. Now that Blade of Thieves is out, my next main project is Cloak of Frost, which will be the 15th book in the Cloak Mage urban fantasy series. As of this recording, I am 52,000 words into it. I'm thinking the rough draft will be about 100,000 words. So if all goes well, I hope to have the book out in August. My secondary project is Blade of Visions, the sequel to Blade of Thieves, and I am 4,000 words into that. Once Cloak of Frost is finished, Blade of Visions will become my new main project. In audiobook news, recording is done for Dragon-Mage, the sixth book in the Rivah series, and that will be excellently narrated by Leanne Woodward. I just have to proof/listen to that and then we can submit it to QA and then it should be showing up on the audiobook stories in a few weeks. Recording has started on Cloak of Worlds, which will be [recorded by] Hollis McCarthy, and Blade of Thieves, which will be [recorded by] Brad Wills. So look for more news and updates about that in the coming weeks. So that is where I'm at with current writing, publishing, and audiobook projects. 00:02:16 Main Topic of the Week: File Organization for Writers So let's move on to our main topic this week, file organization tips for writers. One of the inspirations for this episode was an episode of the sitcom Community, which is quite funny. In the episode, the college is making a movie based on a legal loophole because they have some archival footage of a suddenly popular actor. One of the characters, Jeff, becomes concerned that people aren't treating the movie as seriously as they would deserve. So he steals the laptop with the movie and sets out to edit it himself. However, Jeff doesn't know anything about editing a movie, so he watches a YouTube tutorial about how to edit videos. The first lesson is "Step 1: How to properly organize your files." Jeff rages that no, he just wants to learn how to edit movies. While realizing that proper file organization is vital in the age of digital video editing, maintaining a good file structure isn't quite as rigid for authors and writers as it would be for video editors. However, even though many people consider file structure to be old-fashioned or pointless in the age of Google Docs and AI, in my years working in IT, I found that people wasted many hours trying to find files unnecessarily. For example, I always flinch a little bit when I see someone whose desktop is just a wall of misplaced icons and thousands of documents stacked upon each other. I used to do tech support for someone who had the most amazing gift for the most unhelpful and un-useful file names, often with misspelled words. He would get very frustrated and angry that he couldn't find anything because he hadn't labeled files properly with good file names. Better file structures and file naming conventions would have saved them all that stress and time. It's not wise to have all your files stacked up on your desktop and hope for the best. As you grow as a writer, files suddenly become much more complicated than one single draft in a word processing file. There needs to be organization for audiobook files, cover art, marketing materials, research, and much more. Blade of Thieves was my 174th book. So if you think about it, that means I have 174 separate book files on my computer. Many of them have audiobooks. They all have cover art. The audiobooks have cover art, to say nothing of the hundreds of short stories I've written and all of that needs to be organized properly so I can find it when I need it to. So today we're going to talk about setting up and organizing file structures for your writing work. First of all, what do I mean by file structures? In traditional computing, files like Word documents and Excel spreadsheets are organized in folders. How you navigate through the folder structure on your computer or server to find the files is called a path. Much like with a real path on a hiking trail, you want the path to find a file in a folder to be as clear from junk and confusion as possible. Good file and folder naming is like setting up signs on that hiking trail to help you find the way. Setting up your folders and files correctly makes them easier to use, find, and share with others. So let's go through some tips on how to properly organize your writing files and save yourself much stress and hassle of trying to find things. #1: Make a plan before you begin. Instead of borrowing someone else's file structure, take some time to think about how you use your writing files every day. Do you have a lot of project files for each book like book research, cover ideas, mood boards, and so on? Do you do most of your writing collaboratively? Think about your working style, the amount of files you have, and what kind of files you have that need organizing. It helps to plan for flexibility and growth in the future as the amount of files you have grows. For example, if someone currently runs only ads on Amazon but wants to add other companies like Facebook or BookBub, it'd be messier to add files from those projects if everything in their advertising folder was all Amazon documents with no sub-folder for Amazon. Making an Amazon sub-folder right away in your advertising folder prevents confusion as you start to add other companies into your advertising strategy. What you design should be realistic and as simple to use as possible. Are you someone who makes grand and complicated plans, but then sees them fall by the wayside after a couple of weeks? Many people are. Good organization is something where it's easy to let the perfect be the enemy of the possible. If you design overly complicated file and folder structures and naming conventions that you can't remember without a 20-page guide, you're not very likely to keep up with it. It's better to make something simple that it's easy to remember. Carve out the time to do this with your full attention instead of trying to do it in bits and pieces on the fly. It may take anywhere from an hour to days, depending on how many writing files you have. At the very least, set up the initial folders in one chunk of time so the organization is in place before you start moving files around. #2: Clean up before you start organizing. Get rid of duplicate and obsolete files before starting to organize other files. It will save time and make the process easier. #3: File structure is supported by good naming. Versions and drafts should be numbered to find the most recent one. Be specific. "Second draft" or "Volume one" without a book title isn't helpful if there are multiple books with that name across multiple folders. If you are using dates, be sure to include day, month, and year because in 10 years, "March ads" is not going to make much sense without the context of a year. Be consistent in how you order month, date, and year in a file because being inconsistent with it could make for mixed up dates. #4: Version control. "Rough draft THIS ONE" is not a good name to indicate that this is the latest draft and never use "final" as part of a draft or project name until it's well and truly done. On both Windows, Mac, and Linux, you get 256 characters for file names and it's a good idea to use them to be as descriptive as possible in your file names. #5: Be consistent. Don't make a folder called "Fix These File Names Later" because guess what? That date won't come. In the meantime, you'll probably get annoyed trying to find one of those files that don't have a correct name. If you're struggling with remembering to use your folder and file names, either make yourself a one-page reminder guide or take it as a sign that you might have made your structure and naming conventions too complicated. Remember that simpler is always better. #6: Document it. As with so many areas of life, proper documentation will help you remember something in the future. Write out how your folders are going to be structured, what style and formatting you will use to name the folders and files, and give yourselves some examples to jog your memory. If you're sharing the files and folders with others, make sure to share documentation with them and go over the system with them. That will save much time later since you won't have to spend so much time explaining to people where to find things in your file structure. #7: Decluttering isn't just for your college t-shirts. Schedule a regular time monthly or quarterly to declutter and fix anything in your file structure that isn't working or isn't consistent or correct. Much like organizing a drawer of shirts, things will only stay in order if you keep up with putting in and taking things out using your system. #8: It should fix, not create problems. Your first attempt at file organization may not work once you've added more files or tried it out for a while. Reflect on what is causing problems, what you would like your system to be able to do, and what you dislike about your current system. Train others who will use it. For example, differences in month/[day]/year naming conventions between countries can lead to incorrect dates if it isn't clear what date style is being used. Abbreviations should be standard to prevent confusion. For example, United States state abbreviations could follow the US Postal Service Conventions instead of writing your own abbreviations. MN would be Minnesota instead of M-I-N-N or M-I-N-N-E-S. (Though this can cause a confusion if you're not accustomed to them since, for example, in the postal codes, people often get Missouri and Minnesota mixed up.) Tip #9: Sharing isn't always caring. You can set up password protection on folders and files you don't want to share with others, especially if you're in a shared storage space. Read-only access is a way to share documents with others without worrying about them changing the files. For example, I have read-only access set for my book files so that someone working on my series bibles can download them without editing or changing the files themselves. So instead of having to make extra folders and files that are safe for someone to use without changing, I just set read-only access to those files [for that user]. Now let's take a look at some pros and cons of some typical structures. I'm going to provide examples of three possible folder structures you could use for writing and give you some of the pros and cons for each. #1: Organizing by date. In this system, the year is the first file and more specific files like quarters and months are sub-folders. This system might work best if you write based on challenges or projects such as National Novel Writing Month where each year is its own project. If you're taking writing courses, organizing by date and then by semester or course also would make sense for many people. For many writers, however, this could be a difficult way to organize because then you have to remember what year each book was written and many books are written across several years or months. If you're sharing the files with others, then you have to give them information on the history of each book project so they know which folder dates to look at, which creates extra work and most likely confusion. Like for example, off the top of my head, I could tell you that Ghost in the Forge is the sixth book in the Ghost series. However, I couldn't remember what year or month it was written in. I think it would be 2012, maybe February of 2012, but I would not be able to confirm that without looking it up, which would mean trying to find the file for Ghost in the Forge if I needed it would be a bit of a challenge. #2: Organizing by book. In this system, each book has its own folder and then other aspects like drafts, marketing materials, research, and covers are subfolders. If you don't have a large volume of books and don't have many writing adjacent activity files like research and advertising and don't share files with others, often this is a pretty straightforward way to organize your writing files. #3: Organizing by project type. In this system, the type of project is the main subfolder and sub-folders such as the books, marketing materials, covers, and series bibles would be in folders instead of being organized by individual books. For example, there would be a folder for marketing images. Instagram would be a sub-folder, and then there would be sub-folders in that folder for specific images and ads or individual books. If you have a lot of marketing images, that can be easier than trying to remember what image was for a certain book. This file organization system is more complex than just organizing by book and could be hard to keep up without some dedication. It might be unnecessarily complex for someone who only has a handful of books and only a small amount of files. As your writing adjacent activities like marketing and social media grow, it can be easier to organize this way than just by individual books. It's also much easier to share folders in a granular way using this method. For example, if you hire an assistant to help with social media posts, you can give them access to the social media marketing folders without having to give them access to the folders that have the book files and drafts in them. Now, what do I do for my own file organization system? Now, my system has partly been thought out and partly developed organically over the 15 years I've been doing this. And I found for me, since I've written so many books and series, that the best organizational principle is to run by series. My rough drafts are not super organized because once I am done with the book, I tend not to look back at the rough draft files. So usually my rough drafts are sitting in individual folders for the series like Frostborn, Dragontiarna, Blades of Ruin, and so forth. I am much more organized in the final drafts. Each individual series has its own folder and within the series, each individual book has its own folder as well. To help with keeping things in order, I usually number the folders. So for example, in Blades of Ruin, the first folder within it would be 01 Blade of Flames, then 02 Blade of Shadows, 03 Blade of Storms, and so forth. Within the individual book folders, I have the final files in ePub and PDF form for the books along with the cover images for both ebook, audiobook, and paperback. However, as I mentioned earlier in the podcast, I don't have just the book files. I also have audiobook files, advertising files, and a very large photo library from a combination of stock photos, 3D renders, and photographs I have specifically taken over the years for the purpose of using for ebook covers and advertising materials. For advertising images and materials, like I said, I found the best organizing principle for me is by series. So I generally tend to just organize them by series. So Frostborn, Sevenfold Sword, Dragontiarna, and the Andomhaim books generally have just one folder of advertising images since I can use the advertising image for both Frostborn: the Gray Knight and Sevenfold Sword: Champion. For my audiobooks, I keep those on a separate drive because they eat up a lot of space. But then I just have them organized out by book and series, which is pretty easy when I need to find something. For my stock photos, I do have those pretty well organized and again, in a separate drive, which I back up separately. I divide out the images by type. So I have a folder for castles, a folder for medieval or ancient cities, a folder for modern cities, a folder for fireballs and so forth. And so if I'm making a book cover image and I think, hmm, I want a sword, I can go into the swords folder and look at appropriate pictures of swords until I find one that would work for the project. How this [has] changed over time is I've had to become a bit more organized with the files because I started using Vellum, which generates a separate file of its own. So then I had to make sure that those were organized into proper files. I used to keep all my stock photos in just one big folder that quickly became unmanageable. So I once took two days to properly organize these stock photos. Just keeping all the rough drafts in one big folder for the series has worked pretty well for me because once I am done with the rough draft and have turned into the final draft, I just ignore the rough draft file and any changes that need to be made are obviously made to the final draft file. I also used to keep all the cover images in one folder for some reason and that was a bad idea. So then I started keeping the specific cover image in the folder with the specific book and that has worked out well. Would this be something I would recommend to someone just starting out? I think so. You can obviously get more complicated with this and my file structure is pretty simple overall, but it works for me. I can find anything I need to pretty quickly. In fact, my folder structure is deep enough I find sometimes that I get halfway down the folder structure and forget what I am looking for before I find it, which is a separate problem from folder organization. But I've stuck to this pretty consistently over the last 15 years and it's worked well for me. So I think I could recommend this to someone starting out. I'd have a folder for your rough drafts and then a folder with separate folders within it for your final drafts. Conclusion File organization is not glamorous, but as any records manager at a US government agency can tell you, it is extremely important for finding, organizing, and preserving what you create. Searching for files is not a writing adjacent activity that you want to take up your time and you definitely don't want the stress of losing something that you worked on for a long time by naming and storing it incorrectly. Finally, I want to close out with a reminder that however you set up your writing files and organizing them, they absolutely need to be backed up on a regular basis. I would recommend using a combination of cloud and local backups since they reinforce each other. If heaven forbid your house explodes and you lose your local backups, you still have your cloud backups. And if your cloud provider goes down or gets hacked or something, you still have your local backups. So no matter how you organize your files or how well organized they are, you definitely want to back them up on a very regular basis. So that is it for this week. Thank you for listening to The Pulp Writer Show. I hope you found the show useful. A reminder that you can listen to all of the back episodes at https://thepulpwritershow.com. If you enjoyed the podcast, please leave a review on your podcasting platform of choice. Stay safe and stay healthy and we'll see you all next week.  

Gonadal hormones have a complicated influence on appetite. Estradiol generally suppresses appetite, whereas progesterone opposes estradiol's action such that their combined presence represents a high-risk hormonal milieu for Binge Eating (BE). Testosterone is thought to be associated with increased BE in females but appears protective in males. In some reports, combination oral contraceptive (COC) use has been linked to greater BE-related appetitive processes (e.g., food intake). Now, we have 2 recent, back-to-back publications (June 2026 in JAMA Network Open, and July 2026 in Appetite) that have examined the relationship of hormonal contraception on binge eating behavior. These found seemingly opposing conclusions. Listen in for details. 1. Klump KL, Di Dio AM, Anaya C, et al. Combined Oral Contraceptive Use and Binge Eating. JAMA Netw Open. 2026;9(6):e2619047. doi:10.1001/jamanetworkopen.2026.190472. Katz JM, Yan R, Beltz AM, Gearhardt AN. Associations between reproductive hormonal milieus and binge eating: The roles of sex and hormonal contraceptive use. Appetite. 2026 Jul 1;222:108547. doi: 10.1016/j.appet.2026.108547. Epub 2026 Mar 20. PMID: 41866083.3. Bass L, Prostináková T, Silang KG, Griffiths-Gray A, McQuilliam S, Mahon E, Whitehead A, Johnson KO. Does it hold weight? The perceived effects of contraceptive use on weight status in females: A mixed-methods study. PLoS One. 2025 Dec 29;20(12):e0339323. doi: 10.1371/journal.pone.0339323. PMID: 41460817; PMCID: PMC12747328.

About our Guests: Fran Balamuth, MD, PhD, MSCE, is division chief of Pediatric Emergency Medicine at the Children's Hospital of Philadelphia. Dr. Balamuth's research interests focus on pediatric sepsis recognition using epidemiologic and translational approaches, for which she has received NIH and foundation funding. She is the co-PI of the PROMPT BOLUS trial, a multinational pragmatic trial comparing saline vs balanced fluids in pediatric sepsis, which will be the largest acute care pediatric trial in history. In addition, she co-leads the CHOP Pediatric Sepsis Program, which supports and promotes local clinical, research, educational, and quality-improvement initiatives related to sepsis. She is an internationally recognized sepsis leader, and has been invited to serve on the national steering committee for the Improving Pediatric Sepsis Outcomes quality collaborative through the US Children's Hospital Association, and 2 international task forces focused on defining pediatric sepsis through the US Centers for Disease Control and Prevention and the Society of Critical Care Medicine.Scott L. Weiss, MD, MSCE, FCCM, is a Professor of Pediatrics & Pathology and Genomic Medicine at Thomas Jefferson University and division chief of Critical Care Medicine at Nemours Children's Hospital, Delaware. Previously, Dr. Weiss was on the faculty at the Children's Hospital of Philadelphia, where he earned recognition as an international expert in pediatric sepsis. Dr. Weiss' NIH-funded research focuses on epidemiology, fluid resuscitation, and mitochondrial dysfunction in pediatric sepsis. Dr. Weiss is an international expert in pediatric sepsis and served as the co-PI of the PRoMPT BOLUS trial.Nathan Kuppermann, MD, MPH, is Executive Vice President and Chief Academic Officer of Children's National Hospital and Director of the Children's National Research Institute. He also serves as chair of the Department of Pediatrics and associate dean of Pediatric Academic Affairs at the George Washington University School of Medicine and Health Sciences. He is an internationally recognized clinical trialist in pediatric trauma, pediatric DKA, and acute pediatric infections. As the original chair of the Pediatric Emergency Medicine Applied Research Network (PECARN); his research is focused on clinical trials and clinical prediction rules using large cohorts of acutely ill and injured children. Dr. Kuppermann served as the senior investigator of the PRoMPT BOLUS trial.Selected References:Weiss SL, Balamuth F, Long E, Thompson GC, Hayes KL, Katcoff H, Cook M, Tsemberis E, Hickey CP, Williams A, Williamson-Urquhart S, Borland ML, Dalziel SR, Gelbart B, Freedman SB, Babl FE, Huang J, Kuppermann N; Pragmatic Pediatric Trial of Balanced Versus Normal Saline Fluid in Sepsis (PRoMPT BOLUS) Investigators of the PECARN, PERC, and PREDICT Networks. PRagMatic Pediatric Trial of Balanced vs nOrmaL Saline FlUid in Sepsis: study protocol for the PRoMPT BOLUS randomized interventional trial. Trials. 2021 Nov 6;22(1):776. doi: 10.1186/s13063-021-05717-4. Erratum in: Trials. 2025 Oct 7;26(1):390. doi: 10.1186/s13063-025-09164-3. PMID: 34742327; PMCID: PMC8572061.Weiss SL, Balamuth F, Thurm CW, Downes KJ, Fitzgerald JC, Laskin BL. Major Adverse Kidney Events in Pediatric Sepsis. Clin J Am Soc Nephrol. 2019 May 7;14(5):664-672. doi: 10.2215/CJN.12201018. Epub 2019 Apr 18. PMID: 31000518; PMCID: PMC6500940.Semler MW, Self WH, Wanderer JP, Ehrenfeld JM, Wang L, Byrne DW, Stollings JL, Kumar AB, Hughes CG, Hernandez A, Guillamondegui OD, May AK, Weavind L, Casey JD, Siew ED, Shaw AD, Bernard GR, Rice TW; SMART Investigators and the Pragmatic Critical Care Research Group. Balanced Crystalloids versus Saline in Critically Ill Adults. N Engl J Med. 2018 Mar 1;378(9):829-839. doi: 10.1056/NEJMoa1711584. Epub 2018 Feb 27. PMID: 29485925; PMCID: PMC5846085.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the showHow to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com.  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!

En este episodio nos metemos de lleno en una novela que mezcla thriller psicológico, terror gótico, asesinos seriales, psiquiatría y una atmósfera que se siente como si todo el tiempo estuvieras caminando por un pasillo oscuro sin saber qué hay al final.Hablamos de El aspecto del diablo, de Craig Russell, una historia ambientada en 1935, en un castillo convertido en manicomio en la zona rural de Checoslovaquia. Ahí conocemos al doctor Viktor Kosárek, un joven psiquiatra que llega con una misión bastante ambiciosa: estudiar a seis homicidas conocidos como “Los Seis Demonios”, criminales tan perturbadores que cada uno parece guardar algo más oscuro que una simple explicación médica.Pero claro, como suele pasar en este tipo de libros, nada es tan sencillo. Mientras Viktor intenta entender qué hay detrás de esos crímenes, afuera también se siente el peso de una Europa que se está preparando para algo terrible. Y esa tensión histórica le da al libro una capa extra de incomodidad, como si el verdadero monstruo no estuviera solamente encerrado en el castillo.Libro digital recomendado en este episodioSíguenos en nuestras redes sociales

Revival and The Men God Uses is avaiable in EPUB, PDF and pamphet for from Chapellibrary org.

Revival and The Men God Uses is avaiable in EPUB, PDF and pamphet for from Chapellibrary org.

Placenta previa has an incidence of about 0.4% to 0.5% (or 1 in 200 to 1 in 250 deliveries). Anterior placenta previa poses a unique obstacle in fetal extraction at CS: Is it best to transect (enter) the placenta or to cause a marginal abruption at the placental edge for fetal extraction? In this episode we will review an upcoming “Surgeon's Corner” in the AJOG (July 2026) which provides some tips and tricks for this very issue.1. Verspyck E, Douysset X, Roman H, Marret S, Marpeau L. Transecting versus avoiding incision of the anterior placenta previa during cesarean delivery. Int J Gynaecol Obstet. 2015 Jan;128(1):44-7. doi: 10.1016/j.ijgo.2014.07.020. Epub 2014 Aug 27. PMID: 25218131.2. Nieto-Calvache AJ, Palacios-Jaraquemada JM, Basanta N, Suarez-Revelo MA, Benavides-Calvache JP, Meade P, Lopez-Franco MJ, Burgos-Luna JM. How to avoid placental transection during low transverse cesarean delivery for anterior placenta previa. Am J Obstet Gynecol. 2026 Jul;235(1):225-228. doi: 10.1016/j.ajog.2026.02.032. Epub 2026 Feb 25. PMID: 41759607.

Send us Fan MailIn this double-blind randomized controlled trial, Adrianne and Nim examine whether norepinephrine outperforms dopamine as a first-line vasoactive agent in neonates with fluid-refractory septic shock. The primary outcome, shock reversal at 30 minutes, was not significantly different between groups, at 32 percent for norepinephrine and 46 percent for dopamine. Secondary outcomes including mortality, IVH, NEC, and need for additional vasoactive support were also similar. The episode critically examines the methodological limitations of the study, including unclear sepsis definitions, absence of echo phenotyping, and unusually high starting doses, and asks whether the field needs better tools before these questions can be properly answered.----Norepinephrine versus Dopamine for Septic Shock in Neonates: A Randomized Controlled Trial.Mazhari MYA, Priyadarshi M, Singh P, Chaurasia S, Basu S.J Pediatr. 2025 Jul;282:114599. doi: 10.1016/j.jpeds.2025.114599. Epub 2025 Apr 17.PMID: 40252959 Clinical Trial.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

In 2018, the ARIVE trial was published in the NEJM revealingthat induction of labor at 39 weeks reduced cesarean deliveries and gestational hypertension/preeclampsia in low-risk nulliparous women who had labor induced,compared to expectant management. Then, in 2025, and partly in response to L&D units across the country becoming saturated with low- risk, nulliparous patients awaiting their induction of labors at 39 weeks and 0 days, the ACOGreleased its clinical practice update in Jan 2025 stating, “The optimal timing of delivery for full-term pregnancies (39 0/7 to 40 6/7 weeks of gestation has not been determined”. Now there is new data, released as an article in press(June 26, 2026), out of the AJOG that raises some interesting questions about potential benefits of induction of labor LATER in the “full term” interval (40- 40 and 6 days) compared to earlier full term (39 weeks to 39 weeks 6 days). Thesefindings are “hypothesis- generating”.  Listen in for details. Strong Coffee Company - Protein Coffee PLUS MORE; Get 20%OFF | Promo Code: CHAPANOSPINOBG https://promocode.to/strong-coffee-company/chapanospinobg-hbv​     Grobman WA, Rice MM, Reddy UM, Tita ATN, et al;Eunice Kennedy Shriver National Institute of Child Health and Human DevelopmentMaternal–Fetal Medicine Units Network. Labor Induction versus ExpectantManagement in Low-Risk Nulliparous Women. N Engl J Med. 2018 Aug9;379(6):513-523. ​     Damri NT, Sheiner E, Wainstock T, GestationalAge at Full-Term Delivery and Long-Term Offspring Morbidity in Low-RiskPregnancies: A Population-Based Cohort Study, American Journal of Obstetricsand Gynecology (2026), ​     Management of Full-Term Nulliparous IndividualsWithout a Medical Indication for Delivery: ACOG Clinical Practice Update.Obstet Gynecol. 2025 Jan 1;145(1):e45-e50. doi: 10.1097/AOG.0000000000005783.Epub 2024 Nov 7. PMID: 39513607.

Send us Fan MailIn this double-blind randomized controlled trial from northern India, Nim and Adrianne review whether early hydrocortisone reduces 14-day all-cause mortality in preterm infants with fluid-refractory shock. The primary outcome showed no statistically significant difference between groups, though an 11 percent absolute reduction in mortality in the hydrocortisone group raised clinical interest. A major limitation was the high rate of open-label steroid crossover, with over 70 percent of both groups ultimately receiving hydrocortisone. The study highlights the difficulty of achieving equipoise when clinicians already believe strongly in a therapy, and raises important questions about study design in neonatal shock research.----Early hydrocortisone verses placebo in neonatal shock- a double blind Randomized controlled trial. Dudeja S, Saini SS, Sundaram V, Dutta S, Sachdeva N, Kumar P.J Perinatol. 2025 Mar;45(3):342-349. doi: 10.1038/s41372-025-02222-3. Epub 2025 Feb 13.PMID: 39948354 Clinical Trial.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Deep Dive in DDH is a three-part limited series where experts in the field of DDH have been invited to discuss the controversies in the management of hip dysplasia. Episode 1 was published in August and discussed management of DDH in infants under 6 months of age. Episode 2 was published in January and discussed the controversies in the management of developmental hip dislocations in the operating room. For the final episode we are joined by Drs. Rachel Goldstein from Children's Hospital of Los Angeles and Steve Frick from Atrium Health in Charlotte. This episode focuses on evaluation and management of residual dysplasia including nonoperative management with bracing, surveillance, and if/when to operate. Hosted by Will Morris (Scottish Rite for Children). Music by A. A. Aalto. Referenced Publications: Gans I, Flynn JM, Sankar WN. Abduction bracing for residual acetabular dysplasia in infantile DDH. J Pediatr Orthop. 2013 Oct-Nov;33(7):714-8. doi: 10.1097/BPO.0b013e31829d5704. PMID: 23812157. Swarup I, Talwar D, Sankar WN. Part-time Abduction Bracing in Infants With Residual Acetabular Dysplasia: Does Compliance Monitoring Support a Dose-dependent Relationship? J Pediatr Orthop. 2021 Feb 1;41(2):e125-e129. doi: 10.1097/BPO.0000000000001704. PMID: 33165268. Morris WZ, Kak A, Mayfield LM, Kang MS, Jo CH, Kim HKW. Does brace treatment following closed reduction of developmental dysplasia of the hip improve acetabular coverage? Bone Joint J. 2023 Dec 1;105-B(12):1327-1332. doi: 10.1302/0301-620X.105B12.BJJ-2023-0255.R1. PMID: 38035597. Albinana J, Dolan LA, Spratt KF, Morcuende J, Meyer MD, Weinstein SL. Acetabular dysplasia after treatment for developmental dysplasia of the hip. Implications for secondary procedures. J Bone Joint Surg Br. 2004 Aug;86(6):876-86. doi: 10.1302/0301-620x.86b6.14441. PMID: 15330030. Novais EN, Pan Z, Autruong PT, Meyers ML, Chang FM. Normal Percentile Reference Curves and Correlation of Acetabular Index and Acetabular Depth Ratio in Children. J Pediatr Orthop. 2018 Mar;38(3):163-169. doi: 10.1097/BPO.0000000000000791. PMID: 27261963. Haider S, Mayfield L, Kim HK, Gill CS, Sucato DJ, Podeszwa DA, Morris WZ. The Impact of Age on Outcomes Following Secondary Reconstructive Surgery for Residual Dysplasia in DDH. J Pediatr Orthop. 2026 Jan 1;46(1):e61-e66. doi: 10.1097/BPO.0000000000003067. Epub 2025 Jul 21. PMID: 40686010; PMCID: PMC12688450. Koura T, Tetsunaga T, Yamada K, Inoue T, Okuda R, Masada Y, Tetsunaga T, Okazaki Y, Ozaki T. MRI at 5 years predicts upsloping acetabular sourcil at skeletal maturity in developmental dysplasia of the hip. Hip Int. 2026 May 6:11207000261436397. doi: 10.1177/11207000261436397. Epub ahead of print. PMID: 42093127. Sucato DJ, Brabham CE, De La Rocha A, Podeszwa DA, Karol LA. Radiographic Outcome Following Treatment of Residual Hip Dysplasia with Pemberton Versus Salter Osteotomy: Comparison of Results in Patients Followed to Skeletal Maturity. J Bone Joint Surg Am. 2025 Jan 1;107(1):46-52. doi: 10.2106/JBJS.23.01346. Epub 2024 Nov 7. Erratum in: J Bone Joint Surg Am. 2025 Aug 20;107(16):e82. doi: 10.2106/JBJS.ER.23.01346. PMID: 39509475.  

"I write for myself, but I edit for the reader." — Liz Lazarus --- ABOUT THIS EPISODE Liz Lazarus is an engineer by education, a GE Healthcare executive by experience, and an author by calling. Her fourth novel, Dawn Before Darkness, is a psychological thriller about a vet tech named Dawn Smith who escapes a toxic relationship only to find herself stalked, harassed, and dragged into a guardianship battle for her aging mother. It's a story ripped from Liz's own life — she spent ten years and thousands of dollars fighting a stranger for legal guardianship of her mom in South Carolina. To build her supervillain, Liz interviewed ten women who survived stalkers and combined their experiences into one relentless antagonist. Mike and Liz talk about writing as therapy, journaling your way into a debut novel, the puzzle of twist endings, self-publishing as self-determination, and why you should sit down with your family and have the uncomfortable estate planning conversation before it's too late. --- KEY TAKEAWAYS 1. Writing began as therapy, not ambition. Liz's first novel, Free of Malice, started as a journal she kept after a man broke into her house in college at Georgia Tech. She didn't know she had PTSD — she just knew journaling was helping her process what happened. That journal eventually became a legal thriller about self-defense. 2. The four things she needs before writing. Liz won't start a novel until she knows the protagonist, the antagonist, the twist ending, and the opening hook. Once those are locked, she outlines, interviews experts, and writes when she has content — no rigid daily schedule. 3. Every book educates and entertains. All four novels carry social causes — self-defense law, stalking, guardianship abuse — but entertainment comes first. The education is baked into the story, never lectured. 4. A ten-year guardianship nightmare inspired the book. Liz fought a family member, then a professional guardian, for control of her mother's care. The judge recused himself; they moved counties; the costs were staggering. Dawn's story in the novel is actually a softened version of what Liz lived through. 5. Ten stalker survivors built one supervillain. Liz put the word out on Facebook asking women with stalker experiences to talk. Several came forward, and she combined their stories into a single antagonist so devastating that reviewers say they've never hated a character more. 6. Characters are real people — and sometimes they surprise you. Liz describes writing in a groove as watching characters on a screen and taking notes. Twice a character did something she didn't plan — including getting fired — and she kept it because human behavior trumps outlines. 7. Self-publishing is owning your destiny. Liz created her own publishing company, learned ISBNs, layout, Mobi, EPUB, and PR from scratch. She values the control — no risk of being dropped by a publisher, no lost say over covers or release dates. 8. A twist must be earned. Inspired by The Usual Suspects, Liz insists every twist must make the reader say "I should have caught that." No tropes, no lost phones — it has to follow from human behavior and planted clues. --- GET THE BOOK Dawn Before Darkness by Liz Lazarus Amazon: https://www.amazon.com/Dawn-Before-Darkness-Liz-Lazarus/dp/099093747X?tag=rettocasgra-20 Barnes & Noble: https://www.barnesandnoble.com/w/dawn-before-darkness-liz-lazarus/1146561497 Bookshop.org: https://bookshop.org/a/54587/9780990937470 Book Website: http://www.dawnbeforedarkness.com/ Also by Liz Lazarus: Free of Malice, Plea for Justice, Shades of Silence --- CONNECT WITH LIZ Website: https://lizlazarus.com Linktree: https://linktr.ee/lizlazarus --- CONNECT WITH YOUR HOST Mike Carlon | Uncorking a Story Website: https://uncorkingastory.com YouTube: @uncorkingastory — https://www.youtube.com/@uncorkingastory Instagram: @uncorkingastory — https://www.instagram.com/uncorkingastory/ Facebook: Uncorking a Story — https://www.facebook.com/uncorkingastory TikTok: @uncorkingastory — https://www.tiktok.com/@uncorkingastory Twitter/X: @uncorkingastory — https://twitter.com/uncorkingastory LinkedIn: Uncorking a Story — https://www.linkedin.com/company/uncorking-a-story/ SUBSCRIBE & LEAVE A REVIEW — It helps more readers and writers find the show! Apple Podcasts: https://podcasts.apple.com/us/podcast/uncorking-a-story/id563636205 Spotify: https://open.spotify.com/show/5HZiAEtFlhAzk60Z4eAkhY RSS Feed: https://feeds.megaphone.fm/uncorkingastory --- Uncorking a Story is produced by Mike Carlon. New episodes drop every Tuesday. --- HASHTAGS #UncorkingAStory #DawnBeforeDarkness #LizLazarus #PsychologicalThriller #ThrillerBooks #WritingCommunity #AuthorInterview #BookPodcast #Stalking #GuardianshipAbuse #ElderCare #SelfPublishing #WomenWriters #TwistEnding #WritersOfInstagram #BookRecommendations #AuthorsOfInstagram #Podcast #SuspenseNovel #TrueCrimeInspired Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us Fan MailIn this retrospective single-center study from Toronto, Adrianne and Nim explore the echo findings of preterm infants with septic shock and hypoxemic respiratory failure. Contrary to the common assumption that elevated pulmonary vascular resistance drives hypoxemia in sepsis, the data points to left ventricular dysfunction as a key contributor. Babies with hypoxemic respiratory failure showed lower LV systolic and diastolic performance, while pulmonary pressures were similar between groups. Mortality was significantly higher in the hypoxemic group. This challenges the reflex to reach for nitric oxide first and asks clinicians to look at the whole heart.----Cardiopulmonary Physiology of Hypoxemic Respiratory Failure Among Preterm Infants with Septic Shock. Kharrat A, Nissimov S, Zhu F, Deshpande P, Jain A.J Pediatr. 2025 Mar;278:114384. doi: 10.1016/j.jpeds.2024.114384. Epub 2024 Nov 6.PMID: 39510164Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Dr. Amy Vertrees reflects on the weekend screening of the documentary A Thousand and One Cuts and the coaching call that followed it, unpacking why women surgeons' careers are rarely derailed by one dramatic event but by an accumulation of small, repeated moments. She backs this up with hard data: female physicians and surgeons consistently produce lower mortality and complication rates than their male counterparts across multiple large studies, including a JAMA Internal Medicine analysis of 1.5 million Medicare hospitalizations and a 2025 meta-analysis spanning 13.4 million patients — yet women retire from medicine at 49 versus 62 for men. Amy then teaches the core coaching framework from that call: the difference between a fact (something everyone would agree happened) and a thought (your interpretation of it) — including why "microaggression" is a thought, not a fact, and why that distinction actually gives you more power, not less. She closes with tactical empathy, the "mythical white male" trap, and the idea that forcing yourself to be falsely polite is its own kind of self-inflicted harm.Tsugawa Y, Jena AB, Figueroa JF, Orav EJ, Blumenthal DM, Jha AK. Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians. JAMA Intern Med. 2017;177(2):206–213. doi:10.1001/jamainternmed.2016.7875Heybati K, Chang A, Mohamud H, Satkunasivam R, Coburn N, Salles A, Tsugawa Y, Ikesu R, Saka N, Detsky AS, Ko DT, Ross H, Mamas MA, Jerath A, Wallis CJD. The association between physician sex and patient outcomes: a systematic review and meta-analysis. BMC Health Serv Res. 2025 Jan 17;25(1):93. doi: 10.1186/s12913-025-12247-1. PMID: 39819673; PMCID: PMC11740500.Saka N, Yamamoto N, Watanabe J, Wallis C, Jerath A, Someko H, Hayashi M, Kamijo K, Ariie T, Kuno T, Kato H, Mohamud H, Chang A, Satkunasivam R, Tsugawa Y. Comparison of Postoperative Outcomes Among Patients Treated by Male Versus Female Surgeons: A Systematic Review and Meta-analysis. Ann Surg. 2024 Dec 1;280(6):945-953. doi: 10.1097/SLA.0000000000006339. Epub 2024 May 10. PMID: 38726676; PMCID: PMC11542977.Wallis CJD, Jerath A, Aminoltejari K, et al. Surgeon Sex and Long-Term Postoperative Outcomes Among Patients Undergoing Common Surgeries. JAMA Surg. 2023;158(11):1185–1194. doi:10.1001/jamasurg.2023.3744Shannon G, Jansen M, Williams K, Cáceres C, Motta A, Odhiambo A, Eleveld A, Mannell J. Gender equality in science, medicine, and global health: where are we at and why does it matter? Lancet. 2019 Feb 9;393(10171):560-569. doi: 10.1016/S0140-6736(18)33135-0. PMID: 30739691. Rittenberg E, Liebman JB, Rexrode KM. Primary Care Physician Gender and Electronic Health Record Workload. J Gen Intern Med. 2022 Oct;37(13):3295-3301. doi: 10.1007/s11606-021-07298-z. Epub 2022 Jan 6. PMID: 34993875; PMCID: PMC9550938. Branford GL, Bucala MD, Hepper A, Hadeed NM, Northway RM, Brenner MJ. The Gender Gap in EHR Workload: A Comparative Analysis of Primary Care Physician In Basket Usage. J Gen Intern Med. 2025 Jul;40(10):2255-2264. doi: 10.1007/s11606-025-09629-w. Epub 2025 May 29. PMID: 40439865; PMCID: PMC12344033. Rotenstein LS, He Z, Dziura J, Tsugawa Y, Venkatesh AK, Melnick ER, Gettel CJ. Sex Differences in Physician Attrition from Clinical Practice Across Specialties: A Nationwide, Longitudinal Analysis. J Gen Intern Med. 2026 Apr 2. doi: 10.1007/s11606-026-10362-1. Epub ahead of print. PMID: 41927984.

If you practice obstetrics, you already know that our entire world is ruled by a stopwatch. Think about it: we are obsessed with time. We wait exactly 60 or 120 minutes for a gestational diabetes challenge. We stare at a monitor for a strict 30 minutes timing a biophysical profile. The entire pregnancy is dictated by an Estimated Date of Delivery that has us counting down the literal days. But what happens when we step into the OR? Once that scalpel hits the skin for a cesarean section, does the clock matter just as much? There are two separate intervals which have generated data: the skin incision to delivery interval, and the uterine incision to delivery interval. In today's episode, we are CUTTING INTO the data. First, we are summarizing a hot-off-the-press study from AJOG-MFM (Pink) that takes a hard look at the macro clock—the skin incision-to-delivery interval. Then, we are going to contrast those findings with the recent Bart 2026 study published in the AJOG (Grey) Journal, which tracked over 5,800 routine deliveries to see exactly what happens to a baby's pH and clinical outcome when that uterine extraction takes longer than 120 seconds. These two are somewhat at odds. Listen in for details. Strong Coffee Company - Protein Coffee PLUS MORE; Get 20% OFF | Promo Code: CHAPANOSPINOBG https://promocode.to/strong-coffee-company/chapanospinobg-hbv​ Zayat N, Bertozzi-Villa C, Cavallino A, et al. Skin incision-to-delivery interval and neonatal outcomes: A retrospective cohort study. Am J Obstet Gynecol MFM2026;00:101980.​ Bart Y, Sibai BM, Fishel Bartal M, Mazaki-Tovi S, Yoeli R. Uterine incision-to-delivery interval and neonatal outcomes among nonurgent, term, cesarean deliveries. Am J Obstet Gynecol. 2026 May;234(5):1459-1469. doi: 10.1016/j.ajog.2025.12.059. Epub 2025 Dec 30. PMID: 41478544.

As colorectal cancer rates rise among younger adults, surgeons are increasingly caring for patients with rectal cancer who are pregnant or hoping to preserve future fertility. With more individuals delaying childbearing, balancing effective cancer treatment with fertility preservation and maternal–fetal safety has become an important clinical challenge. This timely topic was recently highlighted by Dr. Sharon Suwanabol during a presentation at the American Society of Colon and Rectal Surgeons annual meeting 2026. In this episode, we explore the intersection of rectal cancer, fertility, and pregnancy through a multidisciplinary, case-based discussion. We review how surgery, chemotherapy, and pelvic radiation can affect fertility and sexual function in both men and women, and why early counseling and referral to reproductive endocrinology specialists are essential. The discussion also emphasizes that evaluation and treatment during pregnancy can often be performed safely, with care individualized based on tumor stage, gestational age, and the patient's goals and values. Hosts and discussants ·      Dr. Betelhem Yohannes, General surgery resident at the University of Washington ·      Dr. Griffen Allen, General surgery resident at the University of Washington  ·      Dr. Raga Siddharthan, Assistant Professor of Surgery in the Section of Colorectal Surgery at the University of Washington  ·      Dr. Stacey Cohen, Professor in the Division of Hematology and Oncology at the University of Washington and a gastrointestinal medical oncologist at Fred Hutch Cancer Center, specializing in colorectal and other GI cancers. Learning objectives ·      Describe the impact of rectal cancer surgery on fertility, sexual function, and future childbearing potential. ·      Review the effects of chemotherapy and pelvic radiation on reproductive health and fertility preservation. ·      Discuss available fertility preservation strategies and the importance of early pre-treatment counseling and referral. ·      Recognize the diagnostic challenges of rectal cancer during pregnancy, including overlapping gastrointestinal symptoms. ·      Review appropriate staging and workup considerations for suspected rectal cancer in pregnant patients. ·      Discuss multidisciplinary management strategies for rectal cancer during pregnancy, including individualized treatment sequencing. ·      Examine ethical and patient-centered considerations when balancing maternal cancer treatment and fetal outcomes. References  Siegel RL, Wagle NS, Star J, Kratzer TB, Smith RA, Jemal A. Colorectal cancer statistics, 2026. CA Cancer J Clin. 2026;76(2):e70067. doi:10.3322/caac.70067 [https://pubmed.ncbi.nlm.nih.gov/38240409/] Pregnancy at Age 35 Years or Older: ACOG Obstetric Care Consensus No. 11. Obstet Gynecol. 2022;140(2):348-366. doi:10.1097/AOG.0000000000004873 [https://pubmed.ncbi.nlm.nih.gov/35640237/] Stal J, YI SY, Cohen-Cutler S, et al. Fertility Preservation Discussions Between Young Adult Rectal Cancer Survivors and Their Providers: Sex-Specific Prevalence and Correlates. Oncologist. 2022;27(7):579-586. doi:10.1093/oncolo/oyac052 [https://pubmed.ncbi.nlm.nih.gov/35708892/] Druvefors E, Myrelid P, Andersson RE, Landerholm K. Female and Male Fertility after Colectomy and Reconstructive Surgery in Inflammatory Bowel Disease: A National Cohort Study from Sweden. J Crohns Colitis. 2023;17(10):1631-1638. doi:10.1093/ecco-jcc/jjad079 [https://pubmed.ncbi.nlm.nih.gov/37341355/] Ito M, Tsukada Y, Watanabe J, et al. Long-term survival and functional outcomes of laparoscopic surgery for clinical stage I ultra-low rectal cancers located within 5 cm of the anal verge: A prospective phase II trial (Ultimate trial). Ann Surg. Published online April 1, 2024. doi:10.1097/SLA.0000000000006290 [https://pubmed.ncbi.nlm.nih.gov/38629555/] Teh WT, Stern C, Chander S, Hickey M. The impact of uterine radiation on subsequent fertility and pregnancy outcomes. Biomed Res Int. 2014;2014:482968.  Johnson GGRJ, Park J, Helewa RM, Goldenberg BA, Nashed M, Hyun E. Total neoadjuvant therapy for rectal cancer: a guide for surgeons. Can J Surg. 2023 Apr 21;66(2):E196-E201. doi: 10.1503/cjs.005822. PMID: 37085291; PMCID: PMC10125160. [https://pubmed.ncbi.nlm.nih.gov/37085291/] Naren G, Guo J, Bai Q, Fan N, Nashun B. Reproductive and developmental toxicities of 5-fluorouracil in model organisms and humans. Expert Rev Mol Med. 2022 Jan 31;24:e9. doi: 10.1017/erm.2022.3. PMID: 35098910; PMCID: PMC9884763. [https://pubmed.ncbi.nlm.nih.gov/35098910/] National Comprehensive Cancer Network. (2026). NCCN Clinical Practice Guidelines in Oncology: Rectal Cancer (Version 2.2026). Retrieved from NCCN Guidelines for Rectal Cancer [https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1449] Oktay, Kutluk M.D., Ph.D.. Expert Commentary on Fertility Preservation in Colorectal Cancers: Current State and Practical Tips for the Cancer Practitioner. Diseases of the Colon & Rectum 63(6):p 726-727, June 2020. | DOI: 10.1097/DCR.0000000000001688 [https://pubmed.ncbi.nlm.nih.gov/32479532/] Stal J, YI SY, Cohen-Cutler S, et al. Fertility Preservation Discussions Between Young Adult Rectal Cancer Survivors and Their Providers: Sex-Specific Prevalence and Correlates. Oncologist. 2022;27(7):579-586. doi:10.1093/oncolo/oyac052 [https://pubmed.ncbi.nlm.nih.gov/35708892/] Gentile G, Ciccarone M. Management of fertility preservation in young female patients with gastrointestinal cancer: A case series and systematic literature review. Curr Probl Cancer. 2025;57:101221. doi:10.1016/j.currproblcancer.2025.101221 [https://pubmed.ncbi.nlm.nih.gov/39598263/] Saif MW. Management of colorectal cancer in pregnancy: a multimodality approach. Clin Colorectal Cancer. 2005;5(4):247-256. doi:10.3816/ccc.2005.n.035 [https://pubmed.ncbi.nlm.nih.gov/16183863/] Rogers JE, Dasari A, Eng C. The Treatment of Colorectal Cancer During Pregnancy: Cytotoxic Chemotherapy and Targeted Therapy Challenges. Oncologist. 2016 May;21(5):563-70. doi: 10.1634/theoncologist.2015-0362. Epub 2016 Mar 21. PMID: 27000464; PMCID: PMC4861360. [https://pubmed.ncbi.nlm.nih.gov/27000464/] Jiang Q, Hua H. Fertility in young-onset colorectal patients with cancer: a review. Oncologist. 2024;29(10):e1237-e1245. doi:10.1093/oncolo/oyae141 [https://pubmed.ncbi.nlm.nih.gov/39292850/] Dolmans MM, Hollanders de Ouderaen S, Demylle D, Pirard C. Utilization rates and results of long-term embryo cryopreservation before gonadotoxic treatment. J Assist Reprod Genet. 2015;32(8):1233-1237. doi:10.1007/s10815-015-0533-z [https://pubmed.ncbi.nlm.nih.gov/26162569/ Moawad NS, Santamaria E, Rhoton-Vlasak A, Lightsey JL. Laparoscopic Ovarian Transposition Before Pelvic Cancer Treatment: Ovarian Function and Fertility Preservation. J Minim Invasive Gynecol. 2017;24(1):28-35. doi:10.1016/j.jmig.2016.08.831 [https://pubmed.ncbi.nlm.nih.gov/27599763/] Fish R. Ovarian transposition in rectal cancer: uncertain benefit at a high price. Colorectal Dis. 2022;24(6):706-707. doi:10.1111/codi.16086 [https://pubmed.ncbi.nlm.nih.gov/35191146/] Ribeiro R, Baiocchi G, Moretti-Marques R, Linhares JC, Costa CN, Pareja R. Uterine transposition for fertility and ovarian function preservation after radiotherapy. Int J Gynecol Cancer. 2023;33(12):1837-1842. Published 2023 Dec 4. doi:10.1136/ijgc-2023-004723 [https://pubmed.ncbi.nlm.nih.gov/38104863/] Haggar F, Pereira G, Preen D, et al. Maternal and neonatal outcomes in pregnancies following colorectal cancer. Surg Endosc. 2013;27(7):2327-2336. doi:10.1007/s00464-012-2774-6 [https://pubmed.ncbi.nlm.nih.gov/23645367/] Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Chuck and Chris catch up and discuss the new JBJS 'What's New in Hand Surgery', written by Eric Wagner and Nina Suh.  This takes us through 2025 and highlights new and impactful scientific articles on our field. Wagner ER, Suh N. What's New in Hand and Wrist Surgery. J Bone Joint Surg Am. 2026 Mar 18;108(6):401-409. doi: 10.2106/JBJS.25.01568. Epub 2026 Feb 3. PMID: 41632853.We are still need of a podcast intern!  We would appreciate any referrals!See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities.The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/.As always, thanks to @iampetermartin for the amazing introduction and concluding music.For additional links, the catalog.  Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Welcome back to the show, everybody! Today, we are diving deep into the intersection of maternal-fetal medicine and cardiology. We're tackling a condition that keeps every OB/GYN, MFM, and cardiologist up at night: Peripartum Cardiomyopathy, or PPCM. And to keep our clinical gears turning, we are framing this discussion squarely through the lens of Society for Maternal-Fetal Medicine (SMFM) Consult Series #73, which focuses on right and left heart failure in pregnancy, alongside the foundational data from ACOG Practice Bulletin #212. PPCM presents fundamentally as acute left heart failure with reduced ejection fraction. Think of the left ventricle as the primary engine pump of the systemic circulation. When it stalls, everything upstream gets backed up. While this was traditionally called IDIOPATHIC, newer data says otherwise. We are going to cover presentation, eval, care and prognosis. So, get your palpitations in check- here we go. 16% OFF TONA ACTIVE WEAR PROMO: https://tonaactive.com/discount/CHAPANOSPINOBG1. SMFM CS 73; 20252. ACOG PB 212; 20193. Arany Z. Peripartum Cardiomyopathy. The NEJM. 2024. 4. Sliwa K, Hilfiker-Kleiner D, Damasceno A, Al Farhan H, Goland S, Johnson MR, Bauersachs J. Peripartum cardiomyopathy. Lancet. 2025 Nov 22;406(10518):2483-2493. doi: 10.1016/S0140-6736(25)01451-5. Epub 2025 Oct 28. PMID: 41173010.