Podcasts about EPUB

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.

Servicio maquetar un libro para Amazon ➡️ https://www.letraminuscula.com/maquetacion-profesional-libros/ Instrucciones tapa blanda Amazon ➡️ https://kdp.amazon.com/es_ES/help/topic/G202145400 Descargar Kindle Create ➡️ https://www.amazon.com/Kindle-Create/b?ie=UTF8&node=18292298011 Plantillas tapa blanda y dura ➡️ https://kdp.amazon.com/es_ES/help/topic/G201834230 SI deseas PUBLICAR escríbenos : contacto@letraminuscula.com Llama☎ o WhatsApp: +34640667855 RESUMEN: En este vídeo aprenderás paso a paso cómo maquetar un libro para publicarlo en Amazon KDP. Se explican los formatos adecuados para libros impresos y ebooks, el uso de Kindle Create, las plantillas oficiales de Amazon y las diferencias entre una maquetación amateur y una profesional realizada con Adobe InDesign. ⏲MARCAS DE TIEMPO: ▶️00:00 Cómo maquetar un libro para Amazon KDP ▶️00:32 Qué es maquetar un libro ▶️01:00 Formatos correctos para ebook y papel ▶️01:43 Convertir archivos a formato EPUB ▶️02:10 Adobe InDesign: opción profesional ▶️03:30 Diferencias entre PDF y ebook EPUB ▶️04:24 Qué significa un ebook responsive ▶️04:48 Índice con enlaces en un ebook ▶️05:12 Nunca subas un ebook en PDF ▶️05:33 Recursos oficiales de Amazon KDP ▶️06:14 Kindle Create para crear ebooks ▶️07:05 Cómo usar Kindle Create paso a paso ▶️08:34 Exportar el libro para Kindle y EPUB ▶️09:34 Kindle Create: opción sencilla y gratuita ▶️10:24 Plantillas de Amazon para tapa blanda ▶️11:23 Cómo usar las plantillas de Word ▶️12:15 Combinar plantillas y Kindle Create ▶️13:12 Publicar libro impreso y ebook ▶️14:05 Servicio profesional de maquetación ▶️14:46 Despedida y contacto

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

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.  

La misma Amazon nos proporciona el editor y el lector para pasar nuestros textos a libro electrónico, en cualquiera de los formatos mencionados.kdp.amazon.com/es_ES/help/topic/GUGQ4WDZ92F733GCCreador KDP.kdp.amazon.com/es_ES/help/topic/G202131170Lector KDP

El formato KFP es él utilizado por Amazon para sus libros electrónicos, en tanto que Google Libros emplea ePUB.

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!

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!

Gut health trends are everywhere, but which ones deserve a closer look, and which ones need a reality check?In this episode, we break down the biggest gut health trends getting clicks, likes, and follows online. From our "hard no" to "I'm curious," we share where each trend lands on our hype scale and explain the science, physiology, and gut-brain connection behind our take.We explore what actually helps symptoms like constipation, bloating, and digestive discomfort without fueling anxiety, wasting money, or creating unnecessary health risks.From viral wellness trends to evidence-based advice, here's what we're discussing:Does the viral chia seed "internal shower" actually cleanse your colon or is that just clever marketing?Are colonics and coffee enemas detox heroes, or do they go against how your gut is designed to work?Can lemon water and apple cider vinegar really "wake up" your digestion first thing in the morning?Can a simple self-care routine improve your gut symptoms, even if it doesn't "heal" your digestive system?Are fermented foods always packed with probiotics or is there more to the story? (Tune in for a revisit of Episode 20!)Can you make colonoscopy prep more tolerable with "prep mocktails" without interfering with the procedure?Can you have too much of a good thing? What happens when "fibermaxxing" goes too far?Are gut-healing protocols and at-home microbiome tests helping you understand your gut or making you more confused and anxious?Do lactose intolerance patches actually work, or does the science tell a different story?Are castor oil packs a legitimate digestive therapy?Whether you're tempted to try the latest gut health hack or just wondering what's worth your attention, this episode will help you separate science from social media. Resources:Chia seeds (Salvia hispanica L.): A therapeutic weapon in metabolic disorders. Food Sci Nutr. 2022 Dec 15;11(1):3-16. doi: 10.1002/fsn3.3035.Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2024 Update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis. 2024. doi: 10.1093/cid/ciae104.Fermented Foods via ISAPPMisselwitz B, Butter M, Verbeke K, Fox MR. Update on lactose malabsorption and intolerance: pathogenesis, diagnosis and clinical management. Gut. 2019 Nov;68(11):2080-2091. doi: 10.1136/gutjnl-2019-318404. Epub 2019 Aug 19. PMID: 31427404; PMCID: PMC6839734.Learn more about Kate and Dr. Riehl:Website: www.katescarlata.com and www.drriehl.comInstagram: @katescarlata @drriehl and @theguthealthpodcastOrder Kate and Dr. Riehl's book, Mind Your Gut: The Science-Based, Whole-body Guide to Living Well with IBS.  The information included in this podcast is not a substitute for professional medical advice, examination, diagnosis or treatment.  Always seek the advice of your physician or other qualified health care provider before starting any new treatment or making changes to existing treatment.

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

In this episode, Dr. Chuang discusses some of her research, which has focused on racial disparities in health care delivery. She shares her journey to this topic starting with her childhood experiences as a witness to structural racism and implicit bias. She discusses how bias and structural inequities are reproduced in many ways, all affecting health and healthcare outcomes. Her work includes several focuses including interpersonal bias in healthcare communication with patients with serious illness and their families, bias in public health practices and bias in Artificial Intelligence. The discussion concludes with the ways that biomedical research has contributed to bias in healthcare over time. The discussion also includes some ways that researchers can move forward even in a challenging funding environment.Chuang E, Hope AA, Allyn K, Szalkiewicz E, Gary B, Gong MN. Gaps in Provision of Primary and Specialty Palliative Care in the Acute Care Setting by Race and Ethnicity. J Pain Symptom Manage. 2017 Nov;54(5):645-653.e1.Chuang E, Yu S, Georgia A, Nymeyer J, Williams J. A Decade of Studying Drivers of Disparities in End-of-Life Care for Black Americans: Using the NIMHD Framework for Health Disparities Research to Map the Path Ahead. J Pain Symptom Manage. 2022 Jul;64(1):e43-e52.Chuang E, Grand-Clement J, Chen JT, Chan CW, Goyal V, Gong MN. Quantifying Utilitarian Outcomes to Inform Triage Ethics: Simulated Performance of a Ventilator Triage Protocol under Sars-CoV-2 Pandemic Surge Conditions. AJOB Empir Bioeth. 2022 Jul-Sep;13(3):196-204.Binkley CE, Dellavalle NS, Chuang E. From Mitigation to Flourishing: We Must Harness Emerging Technologies to Improve Health of the Most Vulnerable. Am J Bioeth. 2026 Feb;26(2):127-129.Cited in this episode:Barnato AE, Berhane Z, Weissfeld LA, Chang CC, Linde-Zwirble WT, Angus DC; Robert Wood Johnson Foundation ICU End-of-Life Peer Group. Racial variation in end-of-life intensive care use: a race or hospital effect? Health Serv Res. 2006 Dec;41(6):2219-37.Johnson KS, Kuchibhatla M, Payne R, Tulsky JA. Race and residence: intercounty variation in black-white differences in hospice use. J Pain Symptom Manage. 2013 Nov;46(5):681-90. doi: 10.1016/j.jpainsymman.2012.12.006. Epub 2013 Mar 21.Ashana DC, Welsh W, Preiss D, Sperling J, You H, Tu K, Carson SS, Hough C, White DB, Kerlin M, Docherty S, Johnson KS, Cox CE. Racial Differences in Shared Decision-Making About Critical Illness. JAMA Intern Med. 2024 Apr 1;184(4):424-432.Dellavalle NS, Ellis JR, Moore AA, Akerson M, Andazola M, Campbell EG, DeCamp M. What patients want from healthcare chatbots: insights from a mixed-methods study. J Am Med Inform Assoc. 2025 Nov 1;32(11):1735-1745.

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.

Discover how blind and visually impaired users can harness AI tools like Claude to build accessible solutions, enhance independence, and master screen reader fundamentals—guided by Tony Gebhard's No Sight Required. Tony Gebhard joins Steven Scott and Shaun Preece to discuss his new book, No Sight Required: A Blind User's Guide to AI. Written from a first-hand perspective, the book tackles the lack of consolidated resources for blind users exploring artificial intelligence. Tony explains why screen reader fundamentals are essential before diving into AI projects and shares how tools like Claude and Codex can help create custom solutions, from NVDA training modules to accessible web tools. The conversation covers: Why learning core navigation and assistive technology basics is crucial. How AI can act as a personal assistant, editor, and creative partner. Balancing accessibility, practicality, and patience when experimenting with LLMs. Creating solutions that empower blind users to solve problems independently. Tony also opens up about the writing process, using AI for editing and production, managing community expectations, and the importance of feedback for future editions. Relevant Links NVDA: https://www.nvaccess.org Email Tony for ePub: info@tonygebhard.me Key Quotes “Claude is smart—but you are the programme director. The AI is your worker; you give it the assignment.” — Tony Gebhard “We finally have the tools to build our own solutions. Let's go fill the gaps ourselves.” — Tony Gebhard Hashtags #AccessibleTech #ScreenReaders #AIForGood ----Follow on:YouTube: https://www.doubletaponair.com/youtubeX (formerly Twitter): https://www.doubletaponair.com/xInstagram: https://www.doubletaponair.com/instagramTikTok: https://www.doubletaponair.com/tiktokThreads: https://www.doubletaponair.com/threadsFacebook: https://www.doubletaponair.com/facebookLinkedIn: https://www.doubletaponair.com/linkedinSubscribe to the Podcast:Apple: https://www.doubletaponair.com/appleSpotify: https://www.doubletaponair.com/spotifyRSS: https://www.doubletaponair.com/podcastiHeadRadio: https://www.doubletaponair.com/iheartAbout Double TapHosted by the insightful duo, Steven Scott and Shaun Preece, Double Tap is a treasure trove of information for anyone who's blind or partially sighted and has a passion for tech. Steven and Shaun not only demystify tech, but they also regularly feature interviews and welcome guests from the community, fostering an interactive and engaging environment. Tune in every day of the week, and you'll discover how technology can seamlessly integrate into your life, enhancing daily tasks and experiences, even if your sight is limited."Double Tap" is a registered trademark of Double Tap Productions Inc. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

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

In this episode of RetinaLIVE, Kourous Rezaei, MD is joined by Lejla Vajzovic, MD, FASRS and Aleksandra Rachitskaya, MD, FASRS to discuss their experiences with UNITY® VCS in vitreoretinal surgery. The conversation covers instrument design, workflow, training and the integration of new technology in clinical practice, offering perspectives on collaboration and adapting to evolving surgical tools.  For Important Product Information, visit unityvcs.com. Featured surgeons are paid Alcon consultants. The views expressed are their own. Disclaimers: 1:15, 19:31, 26:25: Compared to CONSTELLATION® Vision System. Based on bench data. 1:47, 2:15, 2:42, 3:19, 9:55: Compared to HYPERVIT 20K 2:15, 2:21, 7:24: Based on bench data. For both 25 Ga and 27 Ga vitrectomy probes. 7:24, 7:54, 18:46: Versus Alcon's Non-Dynamic Stiffener 27+ technology 9:55, 12:21: When the Dynamic Stiffener is fully retracted 16:20: MSLP(4) is 3 times faster than SSLP 23:58: Compared to CONSTELLATION® Vision System. Based on bench data. Mean fluctuation at flow vs. setpoint of 2.36 ± 2.13, 4.19 ± 1.97, 1.84 ± 2.82, and 2.13 ± 2.86 mmHg during phacoemulsification, irrigation/aspiration (IA), vitrectomy, and extrusion/fragmentation, respectively. †IOP setpoint as low as 16 mmHg (posterior) and 20 mmHg (anterior) without exceeding a mean fluctuation of 4.19 ± 1.97 mmHg.   References: Hypervit Directions for Use. TetraSpot Multi-spot Laser Probe Directions for Use. UNIFEYE Directions for Use. Alcon Data on File, 2024. [REF-24644] Alcon Data on file, 2024. [REF-24615] Alcon Data on File, 2024. [REF-24379] Alcon Data on File, 2024. [REF-24615] Alcon Data on File, 2024. [REF-24576] UNITY VCS and CS User Manual. Alcon Data on File, 2024. [REF-27800] Gerardo GS, Chow DR. Shovel and Cut Technique: Beveled Vitrectomy Probes to Address Diabetic Tractional Retinal Detachments. Retina. 2023. 1;43(7):1207-1208 Berrocal MH. All-probe vitrectomy dissection techniques for diabetic tractional retinal detachments: Lift and shave. Lift and Shave. Retina. 2018 Sep;38 Suppl 1:S2-S4. González-Saldivar G, Chow DR. The Shovel and cut technique: Beveled vitrectomy probes to address diabetic tractional retinal detachments. Retina. Published online ahead of print. doi:10.1097/IAE.0000000000002938. Po-Lin Chen, Yan-Ting Chen, San-Ni Chen, Comparison of 27-gauge and 25-gauge vitrectomy in the management of tractional retinal detachment secondary to proliferative diabetic retinopathy. Plos One. 2021:16(3) Kasi SK, Hsu J, Hariprasad SM. Making the Jump to 27-Gauge Vitrectomy: Perspectives. Ophthalmic Surgery, Lasers and Imaging Retina. 2017;48(6):450-456. doi:10.3928/23258160-20170601-02 James M. Lai, et all. Mechanical Property Comparison of 23-, 25- and 27-gauge Vitrectors Across Vitrectomy Systems. Ophthalmology Retina. 2022. Alcon Data on File, 2024. [REF-09694] Alcon Data on File, 2024. [REF-25374] Alcon Data on File, 2024. [REF-24899] Scarfone HA, Rodriguez EC, Rufiner MG, Riera JJ, Fanego SE, Charles M, Albano R. Vitreous-lens interface changes after cataract surgery using active fluidics and active sentry with high and low infusion pressure settings. J Cataract Refract Surg. 2024 Apr 1;50(4):333-338. doi: 10.1097/j.jcrs.0000000000001359. PMID: 37938025; PMCID: PMC10959530. Liu Y, Hong J, Chen X. Comparisons of the clinical outcomes of Centurion® active fluidics system with a low IOP setting and gravity fluidics system with a normal IOP setting for cataract patients with low corneal endothelial cell density. Front Med (Lausanne). 2023 Nov 23;10:1294808. doi: 10.3389/fmed.2023.1294808. PMID: 38076276; PMCID: PMC10704024. Taiki Kokubun, et al. Verification for the usefulness of normal tension cataract surgery. Hanga Beres, et al. Does low infusion pressure microinsision cataract surgery (LIPMiCS) reduce the frequency of post-occulsion breaks? 2022. 66(2) Rauen MP, Joiner H, Kohler RA, O'Connor S. Phacoemulsification using an Active Fluidics System at Physiologic versus High IOP: Impact on Anterior and Posterior Segment Physiology. J Cataract Refract Surg. 2024 Apr 8. doi: 10.1097/j.jcrs.0000000000001457. Epub ahead of print. PMID: 38595209.   © 2026 Alcon Inc.   04/26   US-UVC-2600054

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

In this episode of PICU Doc on Call, hosts Dr. Monica Gray and Dr. Pradip Kamat explore procedural sedation in the pediatric ICU. They cover sedation levels, pre-screening, risk stratification using ASA classifications, and medication selection tailored to each patient's hemodynamic and respiratory status. Through real-world case discussions involving respiratory failure, septic shock, and acute neurological decline, they highlight the importance of end-tidal CO2 monitoring and early adverse event recognition. Key takeaways include avoiding the term "conscious sedation," preparing rescue plans, and prioritizing patient safety through careful assessment and monitoring.Show Highlights:Definitions and levels of sedation (minimal, moderate, deep sedation, and general anesthesia)Importance of terminology in procedural sedationMonitoring sedation levels using scales like the Richmond Agitation-Sedation Scale (RASS)Pre-screening and risk stratification considerations for pediatric patientsASA physical status classification system for assessing patient riskUnique challenges of procedural sedation in critically ill childrenAdverse events associated with pediatric procedural sedation, particularly respiratory complicationsManagement strategies for specific cases requiring sedation (e.g., respiratory failure, septic shock)Importance of end-tidal CO2 monitoring during sedationKey takeaways for safe sedation practices in the pediatric ICU settingReferences: Nir Atlas; Rahul C. Damania; Pradip P. Kamat In Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 135, 1624-1628Statement on Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia by Committee on Quality Management and Departmental Administration. Last Amended: October 23, 2024.Coté CJ, Wilson S; AMERICAN ACADEMY OF PEDIATRICS; AMERICAN ACADEMY OF PEDIATRIC DENTISTRY. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures. Pediatrics. 2019 Jun;143(6):e20191000. doi: 10.1542/peds.2019-1000. PMID: 31138666.xKrauss B, Green SM. Procedural sedation and analgesia in children. Lancet. 2006 Mar 4;367(9512):766-80. doi: 10.1016/S0140-6736(06)68230-5. PMID: 16517277.Sharif S, Kang J, Sadeghirad B, Rizvi F, Forestell B, Greer A, Hewitt M, Fernando SM, Mehta S, Eltorki M, Siemieniuk R, Duffett M, Bhatt M, Burry L, Perry JJ, Petrosoniak A, Pandharipande P, Welsford M, Rochwerg B. Pharmacological agents for procedural sedation and analgesia in the emergency department and intensive care unit: a systematic review and network meta-analysis of randomised trials. Br J Anaesth. 2024 Mar;132(3):491-506. doi: 10.1016/j.bja.2023.11.050. Epub 2024 Jan 6. PMID: 38185564.Smith, Heidi A. B. MD, MSCI (Chair)1,2; Besunder, James B. DO, FCCM3,4; Betters, Kristina A. MD1; Johnson, Peter N. PharmD, BCPS, BCPPS, FCCM, FPPA, FASHP5,6; Srinivasan, Vijay MBBS, MD, FCCM7,8; Stormorken, Anne MD9,10; Farrington, Elizabeth PharmD, FCCM11; Golianu, Brenda MD12,13; Godshall, Aaron J. MD14; Acinelli, Larkin CPNP-AC, ACHPN15; Almgren, Christina CPNP16; Bailey, Christine H. MD17; Boyd, Jenny M. MD18,19; Cisco, Michael J. MD20; Damian, Mihaela MD, MPH21,22; deAlmeida, Mary L. MD23,24; Fehr, James MD13,25; Fenton, Kimberly E. MD, FCCM14; Gilliland, Frances DNP, CPNP-AC/PC26,27; Grant, Mary Jo C. CPNP-AC, PhD, FAAN28; Howell, Joy MD29; Ruggles, Cassandra A. PharmD, BCCCP, BCPPS30; Simone, Shari DNP31,32; Su, Felice MD21,22; Sullivan, Janice E. MD33,34; Tegtmeyer, Ken MD, FAAP, FCCM35,36; Traube, Chani MD, FCCM29; Williams, Stacey CPNP-AC37; Berkenbosch, John W. MD, FAAP, FCCM (Chair)33,34. 2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility. Pediatric Critical Care Medicine 23(2):p e74-e110, February 2022. | DOI: 10.1097/PCC.0000000000002873Benzoni T, Agarwal A, Cascella M. Procedural Sedation. [Updated 2025 Mar 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551685/Kerson AG, DeMaria R, Mauer E, Joyce C, Gerber LM, Greenwald BM, Silver G, Traube C. Validity of the Richmond Agitation-Sedation Scale (RASS) in critically ill children. J Intensive Care. 2016 Oct 26;4:65. doi: 10.1186/s40560-016-0189-5. PMID: 27800163; PMCID: PMC5080705.Tel-Dan SF, Shavit D, Nates R, Samuel N, Shavit I. Emergency Physician-Administered Sedation for Thoracostomy in Children With Pleuropneumonia. Pediatr Emerg Care. 2021 Dec 1;37(12):e1209-e1212. doi: 10.1097/PEC.0000000000001975. PMID: 31929389.Cosgrove P, Krauss BS, Cravero JP, Fleegler EW. Predictors of Laryngospasm During 276,832 Episodes of Pediatric Procedural Sedation. Ann Emerg Med. 2022 Dec;80(6):485-496. doi: 10.1016/j.annemergmed.2022.05.002. Epub 2022 Jun 23. PMID: 35752522.Cravero JP, Blike GT, Beach M, Gallagher SM, Hertzog JH, Havidich JE, Gelman B; Pediatric Sedation Research Consortium. Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium. Pediatrics. 2006 Sep;118(3):1087-96. doi: 10.1542/peds.2006-0313. PMID: 16951002.

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.

In this episode of the Epigenetics Podcast, we talked with Tae-Kyung Kim from POSTECH in South Korea about the discovery and characterisation of enhancer RNAs. Dr. Kim describes joining Danny Reinberg's lab as a graduate student, where he was trained in protein biochemistry and general transcription mechanisms. He recalls this period as a formative time, when research on transcription factors and RNA polymerase II was rapidly advancing and many findings were still novel. Kim then moved into neurobiology through Michael Greenberg's lab, where he first worked on a project related to L-type voltage-gated channels. He says his work shifted toward chromatin and gene regulation in neurons after learning that chromatin immunoprecipitation could be applied to neuronal systems and after the arrival of next-generation sequencing. He explains that eRNAs were discovered in his lab through RNA-seq and ChIP-seq data from neuronal activity experiments, especially around the FOS locus. He later showed that eRNAs are transcribed from enhancers, are typically unstable, often lack splicing and polyadenylation, and have defined initiation sites, suggesting regulated transcription. Kim says eRNAs can interact with transcription and epigenetic regulators, including factors involved in pause release and mediator complexes. He describes experiments showing that eRNA knockdown reduced ARC induction and that eRNA production depends on proper enhancer-promoter contact. He concludes by describing newer work in his lab using spatial transcriptomics and eRNA-based reporter systems to map active neural populations, including studies related to cocaine-responsive circuits. He says his future work will focus on spatial technologies to better understand brain organization and function at molecular resolution. References Kim TK, Hemberg M, Gray JM, Costa AM, Bear DM, Wu J, Harmin DA, Laptewicz M, Barbara-Haley K, Kuersten S, Markenscoff-Papadimitriou E, Kuhl D, Bito H, Worley PF, Kreiman G, Greenberg ME. Widespread transcription at neuronal activity-regulated enhancers. Nature. 2010 May 13;465(7295):182-7. doi: 10.1038/nature09033. Epub 2010 Apr 14. PMID: 20393465; PMCID: PMC3020079. Schaukowitch K, Joo JY, Liu X, Watts JK, Martinez C, Kim TK. Enhancer RNA facilitates NELF release from immediate early genes. Mol Cell. 2014 Oct 2;56(1):29-42. doi: 10.1016/j.molcel.2014.08.023. Epub 2014 Sep 25. PMID: 25263592; PMCID: PMC4186258. Kim SK, Liu X, Park J, Um D, Kilaru G, Chiang CM, Kang M, Huber KM, Kang K, Kim TK. Functional coordination of BET family proteins underlies altered transcription associated with memory impairment in fragile X syndrome. Sci Adv. 2021 May 19;7(21):eabf7346. doi: 10.1126/sciadv.abf7346. PMID: 34138732; PMCID: PMC8133748. Gorbovytska V, Kim SK, Kuybu F, Götze M, Um D, Kang K, Pittroff A, Brennecke T, Schneider LM, Leitner A, Kim TK, Kuhn CD. Enhancer RNAs stimulate Pol II pause release by harnessing multivalent interactions to NELF. Nat Commun. 2022 May 4;13(1):2429. doi: 10.1038/s41467-022-29934-w. PMID: 35508485; PMCID: PMC9068813. Related Episodes Enhancer Communities in Adipocyte Differentiation (Susanne Mandrup) Enhancer-Promoter Interactions During Development (Yad Ghavi-Helm) Enhancers and Chromatin Remodeling in Mammary Gland Development (Camila dos Santos) Contact Epigenetics Podcast on Mastodon Epigenetics Podcast on Bluesky Dr. Stefan Dillinger on LinkedIn Active Motif on LinkedIn Active Motif on Bluesky Email: podcast@activemotif.com

🧭 REBEL Rundown Click here for Direct Download of the Podcast. 💨 What Is Nitrous Oxide? Nitrous Oxide (N2O) is a colorless, odorless inhaled anesthetic that has been used for centuries, particularly in the surgical world. Mechanistically, it can induce euphoria, anxiolysis, and intoxication via NMDA receptor antagonism.During the late twentieth century, nitrous oxide was increasingly used recreationally due its accessibility and perceived benign nature.The modern day slang term for nitrous oxide is “whippets” – which tends to refer to the canisters that contain this agent and are frequently used as whipped cream foaming agents.Despite the legal nature and benign perception of nitrous, frequent use can lead to lasting and permanent neurologic effects. 🧠 How Nitrous Oxide Causes Toxicity Nitrous oxide toxicity results from its ability to oxidize the cobalt moiety in Vitamin-B12, thus leading to a functional B12 deficiency, despite adequate consumption and absorption.1Functioning B12 is needed as a cofactor for methionine synthase.2 This enzyme has two critical roles:The conversion of 5-methyl tetrahydrofolate to tetrahydrofolate; tetrahydrofolate is essential for the synthesis of our DNA.And the conversion of homocysteine to methionine; methionine is needed to maintain the integrity of the myelin sheath of our axons.As a result, nitrous toxicity leads to: a megaloblastic anemia and demyelination of both the dorsal columns and the lateral corticospinal tracts (also known as subacute combined degeneration). 🚶‍️ Clinical Manifestations of Nitrous Oxide Toxicity These patients will have a combination of both upper and lower motor neuron symptoms due to demyelination of the dorsal columns, lateral corticospinal tracts, and peripheral nerves. As a result, the following may manifest:Dorsal Columns: diminished sense of proprioception, vibration, and fine touch.Lateral Corticospinal Tracts: upgoing plantars, hyperreflexia, weakness of voluntary distal muscle controlPeripheral Nerves: numbness/tingling and weakness in a glove and stocking pattern (symptoms that start initially in the feet and hands that progressively spread proximally to the ankles and wrists)Taking all of this into account, patients may present with difficulty ambulating, positive Romberg sign, dysmetria (difficulty with finger to nose or heel to shin), upgoing Babinski reflex, and decreased strength and sensation in a glove and stocking pattern. 🔍 How to Diagnose Nitrous Oxide Neurotoxicity History is key! As with a lot of pathologies in toxicology, identifying the exposure will expedite management.A thorough neurologic exam will narrow the differential – with a particular focus to fine, peripheral motor and sensory deficits, dysmetria, proprioception, and ability to ambulate.Magnetic resonance imaging of the spine may identify enhancement and/or edema of the dorsal columns, specifically on T2 weight axial imaging – sometimes referred to as the “inverted V” or “inverted rabbit ears appearance.”3Serum B12 concentrations may be normal as the issue is with a functional deficiency as opposed to a vitamin absence. However, patients have elevated concentrations of both homocysteine and methylmalonic acid, both of which are metabolized in the presence of functional B12. 💉 Management of Nitrous Oxide Toxicity First and foremost, cessation of nitrous oxide abuse is crucial to limit/prevent toxicity.While there is no universally agreed upon treatment regimen, supplementation with intramuscular B12 is recommended.Approaches vary from daily or every other day injections until symptoms improve at which point injections can be spaced out to weekly and then monthly.Physical and occupational therapy may be needed depending on the degree of functional debility.It is important to note, that depending of the severity and chronicity of toxicity, some proportion of patients may not fully return to their baseline. 📌 Take-Home Points Though legal and seemingly benign, nitrous oxide abuse can lead to permanent neurologic dysfunction.Nitrous oxide toxicity can affect the dorsal columns, lateral corticospinal tracts, and peripheral nerves.Thus leading to a constellation of both upper and lower motor neuron deficits, particular in a glove and stocking pattern: deficits in proprioception and fine motor skills, positive Romberg, upgoing Babinski, peripheral numbness, tingling, and weakness.Magnetic resonance imaging may identify symmetric high signal intensity in the dorsal columns.Treatment includes B12 supplementation and physical/occupational therapy as needed. 📚 References Long H. Chapter 81. Inhalants. In: Nelson LS, et al. Goldfrank’s Toxicologic Emergencies. 11th ed. New York: McGraw-Hill; 2019Shah K, Murphy C. Nitrous Oxide Toxicity: Case Files of the Carolinas Medical Center Medical Toxicology Fellowship. J Med Toxicol. 2019 Oct;15(4):299-303. doi: 10.1007/s13181-019-00726-x. Epub 2019 Aug 6. PMID: 31388940; PMCID: PMC6825085.Schmitz ZP, Hoffman RS. Magnetic resonance imaging in a patient with nitrous oxide-induced subacute combined degeneration of the spinal cord. Clin Toxicol (Phila). 2023 Nov;61(11):1006-1008. doi: 10.1080/15563650.2023.2286205. Epub 2023 Dec 19. PMID: 38060330. Post Peer Reviewed By: Marco Propersi, DO (Twitter/X: @Marco_propersi), and Mark Ramzy, DO (X: @MRamzyDO) 👤 Associate Editor Anand Swaminathan MD, MPH All Things REBEL EM Meet The Team 🔎 Your Deep-Dive Starts Here REBEL Core Cast – Pediatric Respiratory Emergencies: Beyond Viral Season Welcome to the Rebel Core Content Blog, where we delve ... Pediatrics Read More REBEL Core Cast 143.0–Ventilators Part 3: Oxygenation & Ventilation — Mastering the Balance on the Ventilator When you take the airway, you take the wheel and ... Thoracic and Respiratory Read More REBEL Core Cast 142.0–Ventilators Part 2: Simplifying Mechanical Ventilation – Most Common Ventilator Modes Mechanical ventilation can feel overwhelming, especially when faced with a ... Thoracic and Respiratory Read More REBEL Core Cast 141.0–Ventilators Part 1: Simplifying Mechanical Ventilation — Types of Breathes For many medical residents, the ICU can feel like stepping ... Thoracic and Respiratory Read More REBEL Core Cast 140.0: The Power and Limitations of Intraosseous Lines in Emergency Medicine The sicker the patient, the more likely an IO line ... Procedures and Skills Read More REBEL Core Cast 139.0: Pneumothorax Decompression On this episode of the Rebel Core Cast, Swami takes ... Procedures and Skills Read More Showing Slide 1 of 7 The post REBEL Core Cast—Nitrous Oxide Toxicity: Whippets and Neurologic Injury appeared first on REBEL EM - Emergency Medicine Blog.

Send us Fan MailIs five days of antibiotics enough to treat a urinary tract infection in a NICU infant? In this Journal Club episode, Ben and Daphna review a single-center study from Nationwide Children's Hospital examining adherence and safety of a five-day antibiotic treatment guideline for culture and urinalysis-proven UTIs in the NICU. Among 77 infants with 93 bacterial UTIs, the five-day course was associated with a 1% failure rate, defined as reinitiation of antibiotics within seven days for the same organism. The episode also explores the potential role of enteral antibiotic therapy and what shorter treatment courses could mean for babies still weeks away from discharge.----Urinary tract infection in the neonatal intensive care unit. Magers J, Burton A, Prusakov P, White NO, Miller RR, Moraille R, Theile AR, Sánchez PJ; Nationwide Children's Hospital Neonatal Antimicrobial Stewardship Program (NEO-ASP).J Perinatol. 2026 May;46(5):754-760. doi: 10.1038/s41372-026-02690-1. Epub 2026 Apr 29.PMID: 42056240 Free PMC 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!

This is my personal favorite topic, but probably your least favorite: strength training.  Before you run away, hear me out! Because whether you’re bed-bound, housebound, or just convinced your body can’t handle it right now, this episode is for you. I’m breaking down exactly WHY resistance and strength training isn’t just helpful for vestibular disorders—it’s essential.  You Have to Move Your Body to Manage Your Dizziness From the dizzy-anxious-dizzy cycle to blood sugar regulation to better sleep to reduced inflammation, strength training touches virtually every struggle vestibular warriors face. I’m not letting anyone off the hook, but I am meeting you exactly where you are. Starting with 3 minutes? That counts.  Walking to the mailbox and back? That counts too.  Because the goal here is progress, not perfection. And you know I have the science to back every single word of it! In this episode, we'll dig into: Why strength training is non-negotiable for vestibular disorder management How exercise helps break the dizzy-anxious-dizzy cycle “In the moment” vs. “hangover” dizziness and how to adjust your approach Why EDS, HSD, or MCAS makes building muscle even more critical The truth about the fear of getting “bulky” How to start exercising when you’re bedbound or couch-bound What physical activity guidelines actually say, and where most people fall short How functional movements like the deadlift directly support vestibular patients How Vestibular Group Fit makes strength and resistance training accessible Whether you start with 3 minutes or 30, the most important thing is that you start. Because your vestibular system, your mood, your balance, and your future self are all counting on it. Links Mentioned: Vestibular Group Fit (code GROUNDED at checkout for 15% off!): https://thevertigodoctor.com/vestibular-group-fit Free Resources: ⁠The 4 Steps to Managing Vestibular Migraine: https://thevertigodoctor.myflodesk.com/cb5js0y78n ⁠The PPPD Management Masterclass⁠: https://thevertigodoctor.myflodesk.com/new-pppd ⁠What your Partner Should Know About Living with Dizziness⁠: https://thevertigodoctor.myflodesk.com/partnership ⁠The FREE Mini VGFit Workout⁠: https://thevertigodoctor.myflodesk.com/minifit ⁠The FREE POTS – safe Workouts⁠: https://thevertigodoctor.myflodesk.com/pots Connect with Dr. Madison (@TheVertigoDoctor): https://instagram.com/thevertigodoctor Work with Dr. Madison: For 1:1 Vestibular Rehabilitation Therapy, email madison@thevertigodoctor.com Otherwise, I'll see ya in Vestibular Group Fit! Connect with Dr. Jenna (@dizzy.rehab.therapist): https://www.instagram.com/dizzy.rehab.therapist/ Learn about the Oak Method: http://thevertigodoctor.com/why-vestibular-group-fit Citations: Adriano Oliveira, Andressa Fidalgo, Paulo Farinatti, Walace Monteiro,Effects of high-intensity interval and continuous moderate aerobic training on fitness and health markers of older adults: A systematic review and meta-analysis,Archives of Gerontology and Geriatrics,Volume 124,2024,105451,ISSN 0167-4943,https://doi.org/10.1016/j.archger.2024.105451.(https://www.sciencedirect.com/science/article/pii/S0167494324001274) Yu Y, Wang J, Xu J. Optimal dose and type of exercise to improve cognitive function in patients with mild cognitive impairment: a systematic review and network meta-analysis of RCTs. Front Psychiatry. 2024 Sep 12;15:1436499. doi: 10.3389/fpsyt.2024.1436499. PMID: 39328348; PMCID: PMC11424528. Zhang Y, Zhou M, Yin Z, Zhuang W, Wang Y. Relationship between physical activities and mental health in older people: a bibliometric analysis. Front Psychiatry. 2024 Oct 21;15:1424745. doi: 10.3389/fpsyt.2024.1424745. PMID: 39497901; PMCID: PMC11532734. Garcia Meneguci, C. A., Meneguci, J., Sasaki, J. E., Tribess, S., & Júnior, J. S. V. (2021). Physical activity, sedentary behavior and functionality in older adults: A cross-sectional path analysis. PloS one, 16(1), e0246275. https://doi.org/10.1371/journal.pone.0246275 Mennitti C, Farina G, Imperatore A, De Fonzo G, Gentile A, La Civita E, Carbone G, De Simone RR, Di Iorio MR, Tinto N, Frisso G, D’Argenio V, Lombardo B, Terracciano D, Crescioli C, Scudiero O. How Does Physical Activity Modulate Hormone Responses? Biomolecules. 2024 Nov 7;14(11):1418. doi: 10.3390/biom14111418. PMID: 39595594; PMCID: PMC11591795. Beavers KM, Brinkley TE, Nicklas BJ. Effect of exercise training on chronic inflammation. Clin Chim Acta. 2010 Jun 3;411(11-12):785-93. doi: 10.1016/j.cca.2010.02.069. Epub 2010 Feb 25. PMID: 20188719; PMCID: PMC3629815.  Chastin, S.F.M., Abaraogu, U., Bourgois, J.G. et al. Effects of Regular Physical Activity on the Immune System, Vaccination and Risk of Community-Acquired Infectious Disease in the General Population: Systematic Review and Meta-Analysis. Sports Med 51, 1673–1686 (2021). https://doi.org/10.1007/s40279-021-01466-1 Hoffman GJ, Malani PN, Solway E, Kirch M, Singer DC, Kullgren JT. Changes in activity levels, physical functioning, and fall risk during the COVID-19 pandemic. J Am Geriatr Soc. 2022 Jan;70(1):49-59. doi: 10.1111/jgs.17477. Epub 2021 Sep 24. PMID: 34536288. Rey-Lopez JP, Rimm EB, Tabung FK, Giovannucci EL. Long-Term Leisure-Time Physical Activity Intensity and All-Cause and Cause-Specific Mortality: A Prospective Cohort of US Adults. Circulation. 2022 Aug 16;146(7):523-534. doi: 10.1161/CIRCULATIONAHA.121.058162. Epub 2022 Jul 25. PMID: 35876019; PMCID: PMC9378548. Hupin D, Roche F, Gremeaux V, Chatard JC, Oriol M, Gaspoz JM, Barthélémy JC, Edouard P. Even a low-dose of moderate-to-vigorous physical activity reduces mortality by 22% in adults aged ≥60 years: a systematic review and meta-analysis. Br J Sports Med. 2015 Oct;49(19):1262-7. doi: 10.1136/bjsports-2014-094306. Epub 2015 Aug 3. PMID: 26238869. Chandrasekaran B, Ganesan TB. Sedentarism and chronic disease risk in COVID 19 lockdown – a scoping review. Scott Med J. 2021 Feb;66(1):3-10. doi: 10.1177/0036933020946336. Epub 2020 Jul 27. PMID: 32718266; PMCID: PMC8685753. Izquierdo M, Merchant RA, Morley JE, Anker SD, Aprahamian I, Arai H, Aubertin-Leheudre M, Bernabei R, Cadore EL, Cesari M, Chen LK, de Souto Barreto P, Duque G, Ferrucci L, Fielding RA, García-Hermoso A, Gutiérrez-Robledo LM, Harridge SDR, Kirk B, Kritchevsky S, Landi F, Lazarus N, Martin FC, Marzetti E, Pahor M, Ramírez-Vélez R, Rodriguez-Mañas L, Rolland Y, Ruiz JG, Theou O, Villareal DT, Waters DL, Won Won C, Woo J, Vellas B, Fiatarone Singh M. International Exercise Recommendations in Older Adults (ICFSR): Expert Consensus Guidelines. J Nutr Health Aging. 2021;25(7):824-853. doi: 10.1007/s12603-021-1665-8. PMID: 34409961; PMCID: PMC12369211. Bunnell E, Stratton MT. The Impact of Functional Training on Balance and Vestibular Function: A Narrative Review. J Funct Morphol Kinesiol. 2024 Dec 3;9(4):251. doi: 10.3390/jfmk9040251. PMID: 39728235; PMCID: PMC11679947. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985 Mar-Apr;100(2):126-31. PMID: 3920711; PMCID: PMC1424733. Warner A, Vanicek N, Benson A, Myers T, Abt G. Agreement and relationship between measures of absolute and relative intensity during walking: A systematic review with meta-regression. PLoS One. 2022 Nov 3;17(11):e0277031. doi: 10.1371/journal.pone.0277031. PMID: 36327341; PMCID: PMC9632890. “Metabolic Equivalent (MET): Pick the Best Exercise for Longevity.” Whyiexercise.com, www.whyiexercise.com/metabolic-equivalent.html. Love what you heard?Consider leaving a review on your favorite podcast platform to help us reach more vestibular warriors like you! This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. ————————————— strength and resistance training, exercises for vestibular disorders, living with vestibular migraine, guidelines of physical activity, anxiety and depression, chronic dizziness, couch bound, bed bound, dizzy-anxious-dizzy cycle, physical therapist

Join Dr. Clancy and his guests Dr. Endres and Lori Winborn as they delve into the world of ultra processed foods, exploring their origins, popularity, potential harms, and practical guidance for adopting a healthier diet. Episode Transcript CE Credit Available Host: Gerard Clancy, MD Senior Associate Dean for External Affairs Professor of Psychiatry and Emergency Medicine University of Iowa Carver College of Medicine Guests: Jill Endres, MD, MS, FAAFP Clinical Professor of Family and Community Medicine University of Iowa Carver College of Medicine Lori Winborn, MPH, RDN, LD Dietician University of Iowa Health Care Financial Disclosures:  Dr. Gerard Clancy, his guests, and Rounding@IOWA planning committee members have disclosed no relevant financial relationships. Nurse: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this activity for a maximum of 0.75 ANCC contact hour. Physician: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Providers: A certificate of completion will be available after successful completion of the course. (It is the responsibility of licensees to determine if this continuing education activity meets the requirements of their professional licensure board.) References/Resources:  Grinshpan LS, Eilat-Adar S, Ivancovsky-Wajcman D, Kariv R, Gillon-Keren M, Zelber-Sagi S. Ultra-processed food consumption and non-alcoholic fatty liver disease, metabolic syndrome and insulin resistance: A systematic review. JHEP Rep. 2023 Nov 17;6(1):100964. doi: 10.1016/j.jhepr.2023.100964. PMID: 38234408; PMCID: PMC10792654. Vitale M, Constabile G.. et al. Ultra-Processed Foods and Human Health: A Systemic Review and Meta-Analysis of Prospective Cohort Studies. Adv Nutr. 202444 Jan;15(1):100121. doi: 10.1016/i.advnut.2023.09.009. Epub 2023 Dec 18. PMID: 38245358; PMCID: PMC10831891  

En este episodio nos metemos de lleno en Cómo vender una casa embrujada, una novela que empieza con una situación bastante familiar: volver a la casa de la infancia, enfrentarse a los recuerdos, a los problemas familiares… y de paso descubrir que quizá la casa no está tan vacía como debería.La historia sigue a Louise, quien regresa a su hogar familiar después de la muerte de sus padres. La idea parece “sencilla”: encargarse de los arreglos, lidiar con su hermano Mark y vender la casa. Pero claro, cuando hay resentimientos viejos, secretos familiares y objetos demasiado cargados de historia, nada puede salir tan fácil.Lo interesante de este libro es que no se queda solamente en la típica casa embrujada. Aquí el terror viene de muchas partes: de la infancia, de las cosas que heredamos sin pedirlas, de los traumas familiares y, sí, también de esos objetos inquietantes que uno preferiría no tener cerca jamás. Hay momentos incómodos, raros, absurdos y hasta medio graciosos, pero debajo de todo eso hay una historia bastante emocional sobre la familia y las heridas que se quedan guardadas por años.Esto mencionamos en el episodio:Como vender una casa embrujada (libro recomendado)Síguenos en nuestras redes sociales

Historically we were taught as surgeons that 1-centimeter bites that between suture throws on a Pfannenstiel (low transverse) fascial closure was enough to prevent hernia formation and optimize facial healing. But is this still evidence based? We can extrapolate data from a May 2026 systematicreview/meta-anlysis as well as a separate study from the Dutch published in 2021. Both of these studies were in the journal Hernia. The evidence does favor one technique over the other! Listen in for details.1.     Golling M, Baumann P, Kuger F, Fortelny RH.Impact of the SUture BIte TEchnique on clinical outcomes after midlinelaparotomy closure: SUBITE-a systematic review and meta-analysis. Hernia. 2026May 19;30(1):221. doi: 10.1007/s10029-026-03700-z. PMID: 42154339; PMCID:PMC13186860.2.     Paulsen CB, Zetner D, Rosenberg J. Variation inabdominal wall closure techniques in lower transverse incisions: a nationwidesurvey across specialties. Hernia. 2021 Apr;25(2):345-352. doi:10.1007/s10029-020-02280-w. Epub 2020 Aug 8. PMID: 32770366.

En este episodio hablamos de Home Is Where the Bodies Are, un thriller familiar de Jeneva Rose, autora conocida por novelas de suspenso como The Perfect Marriage. Esta historia arranca con: tres hermanos distanciados regresan a la casa familiar después de la muerte de su madre, pero lo que parecía ser una reunión incómoda para arreglar asuntos de herencia termina convirtiéndose en una investigación oscura sobre el pasado de su propia familia.Beth, Nicole y Michael no solo cargan con sus propios resentimientos, heridas y versiones de lo ocurrido en casa; también descubren unas cintas VHS que revelan que su infancia quizá no fue como la recordaban. La desaparición de su padre, los secretos de su madre y una tragedia escondida por años empiezan a salir a la luz, obligándolos a preguntarse qué tanto conocen realmente a su familia.Menciones en el episodio:Widow's Bay(serie de television en Apple TV +)Maximum Pleasure Guaranteed (Apple TV +)Home is where the bodies are (libro recomendado)Síguenos en nuestras redes sociales

In this insightful interview, Chad Herst shares his transformative journey through yoga, personal grief, and coaching. He discusses the profound lessons from his book 'The Performance Trap,' exploring themes of vulnerability, surrender, and self-acceptance. Chad began practicing Ashtanga Yoga in 1993, with David Williams as his first teacher, and was authorized to teach by Sri K. Pattabhi Jois in 2003. He made the pilgrimage to Mysore for fourteen years, studied with Tim Miller, Chuck Miller, and Eddie Stern, and went on to found three Mysore-style programs. He still practices today. He's also a former licensed acupuncturist and has spent the last twenty years coaching high performers. His new book, The Performance Trap, is in part a reckoning with what the practice did to his body, and with the harder question underneath: why he kept going back long after he knew better, and what it means to still be on the mat at fifty-something. He lives in Northern California with his wife, Melissa.   Main Topics: ·       The impact of grief on personal growth ·       The role of discipline and surrender in yoga ·       The importance of honesty and vulnerability in coaching ·       How the desire for success can mask deeper ache Websites: herstwellness.comChad's Book:  The Performance Trap: The Ache No Success Will Ever Fix Listen to the first chapter in Chad's voice: herstwellness.com/chapter-one  Full audiobook, EPUB, and PDF for anyone who wants to read the whole thing herstwellness.com/book  SUPPORT KEEN ON YOGA Become a Patron: https://www.keenonyoga.com/patrons/ Buy us a coffee: https://www.buymeacoffee.com/infoRf FULL PODCAST LIST https://www.keenonyoga.com/keen-on-yoga-podcast-guests/   CONNECT WITH ADAM https://linktr.ee/Keenonyoga WATCH: https://www.youtube.com/@keenonyoga LISTEN Apple podcast:  https://podcasts.apple.com/us/podcast/keen-on-yoga-podcast/id1509303411 Spotify: https://open.spotify.com/show/5iM9lcw52JskHUZ2eFvVxN

How is AI transforming accessibility for indie authors — and why should you care even if you consider yourself able-bodied? What happens when the tools designed to help people with disabilities end up making everyone's creative business better? Jeff Adams, accessibility expert and romance author, explores how AI is opening doors that were previously closed. In the intro, Spotify Audiobook Innovations; The Economics of Convention Life [The Indy Author]; Friction in your Author Business [Self-Publishing with ALLi]. Today's show is sponsored by Draft2Digital, self-publishing with support, where you can get free formatting, free distribution to multiple stores, and a host of other benefits. Just go to www.draft2digital.com to get started. This show is also supported by my Patrons. Join my Community at Patreon.com/thecreativepenn Jeff Adams is the author of YA thrillers and gay romance, and the co-author of Content for Everyone, a practical guide for creative entrepreneurs to produce accessible and usable web content. You can listen above or on your favorite podcast app or read the notes and links below. Here are the highlights and the full transcript is below. Show Notes How ending a long-running podcast made space for more writing — and how to know when it's time to let go of a good thing What accessibility really means for indie authors and why your digital content might be excluding part of your audience How AI agents like Claude Cowork are removing physical and cognitive barriers for authors with disabilities, chronic pain, or limited energy The culture of shame around AI use in the writing community and why blanket anti-AI statements can be ableist Practical tools including NotebookLM, ElevenReader, and ChatGPT for marketing copy, metadata management, and multimodal research Exciting futures in personalised reading, real-time translation, and AI browser agents that could change how everyone interacts online You can find Jeff at JeffAdamsWrites.com. Jeff also now has a SubStack at contentforeveryone.substack.com Transcript of the interview with Jeff Adams Jo: Jeff Adams is the author of YA thrillers and gay romance, and the co-author of Content for Everyone, a practical guide for creative entrepreneurs to produce accessible and usable web content. Welcome back to the show, Jeff. Jeff: Thanks so much, Jo. It's good to be back. Jo: It is. You were last on the show in March 2023, so over three years ago now. Give us a bit of an update on your writing and publishing business and what it looks like at the moment. Jeff: Sure. I think the biggest thing that happened is that my husband Will, who is also a writer, we ended the Big Gay Fiction Podcast at the end of 2024, after 470-something episodes. It was basically time to do that. So we both focused on writing from that point. In 2025 we had some of our biggest successes in getting writing out into the world. I refound my groove—my difficulty in writing went away finally. We talked a little bit about that back in 2023 too. Will started a new pen name and started producing again, and it was really good to be able to move in that direction. Jo: Was this the hockey romance that really hit at the right time? Jeff: You know, I wish I could have capitalised more on Heated Rivalry when it came out, but I did get hockey books out, and I think I did get to ride that wave a little bit there too. Jo: Yes, and if people don't know about that, that was a super popular streaming series. Was that based on a book? Jeff: It was, yes. Rachel Reid was the author of that book and that series that then Jacob Tierney optioned and made into what fairly turned into a global phenomenon at the end of 2025. Jo: Yes, absolutely. Although I particularly liked Red, White and Royal Blue. That was the one I liked. Not so much into hockey. But anyway, I just wanted to ask you about the Big Gay Fiction Podcast. As you say, you did hundreds of episodes over many years. You and I met over podcasting. You've had lots of connections with people. You ended it, and I know you struggled with ending it, but it sounds like it went really well for you. So maybe you could talk a bit about— How do you know when it's time to end something—a good thing rather than something bad? Does that make more space for writing, essentially? Jeff: It absolutely did make more space for writing for both of us, in particular for me because I have a day job. I balance everything on the creative side with the day job. Will and I had been talking about it for over a year. It just was like, it's really time. After nine years, getting to that 470 mark, we thought about trying to get to 10 years and we thought about, if not 10, then getting to 500 and ending on a milestone. As we looked at everything in our creative business, it was like, this is fun, we enjoy it, but we're not getting as much out of it as we might be if we were actually also writing books, which we also really want to do. It became a time thing and what was the best use of the time. We absolutely miss it occasionally. The whole Heated Rivalry thing, I would've loved to have had episodes to talk about that on, but in the long run, it was worth it. Jo: I mean, one of the things with a podcast, particularly around fiction, was that it was a marketing angle for your fiction. This show is a marketing angle mainly for my nonfiction. So what did you replace the podcast with, in terms of book marketing? Jeff: It was really stepped-up email marketing. I'd always had a list. Will started a list, of course, as he started his new pen name. So it was really turning on that, focusing on that, getting some email marketing with a Bargain Booksy and a Fussy Librarian and a BookBub occasionally to do that work. To be honest, even though we covered things in our genre that if you like what we're talking about, you should like our books, there was never as much of a connection there as you'd want there to be. Even from that book marketing angle, these other things that we can do, it's also a better spend of the money to get those types of promos than it was to continue running the show. Jo: Yes, that is interesting. I mean, obviously I think about podcasting a lot since I have this one, and I put Books and Travel on a hiatus and that was meant to help my fiction and definitely didn't help my fiction sales. But I want to bring it back again because I love doing it. Do you have this hankering sometimes? Do you think you'd ever do the podcast again? Because you are also quite into all the technical stuff and all that. Jeff: It's possible. I've toyed with the idea of doing a short accessibility podcast geared towards creatives, tilting to the same audience that Content for Everyone does. Then I come back and look at the time—is my time better served writing new fiction or perhaps starting a Substack, which I also toy with the idea of, for accessibility stuff? So it bounces around in my head to do another show, but I haven't really decided to jump on that yet. Jo: Yes, and I think that waiting is really good. As you say, you quit a big thing and you don't have to rush to fill it again. I love that you guys are writing more books. So I wanted us to talk about that up front because I know people who listen to this show—I encourage people to start podcasts if you want to, but equally it can take a lot of time. So that's fantastic. Now, you mentioned accessibility, and I feel like the word can be quite difficult for people. So let's just start with a definition. What is accessibility? Why do you care and why should we care? Jeff: So accessibility is really about making sure that whatever the thing is, whether it's something out in the physical world or in the online world, that everybody has access to it. Access to the information, access to getting into a building or being able to cross the street appropriately, whatever that is—that the accessibility of the thing is high. So that regardless of who is approaching it, they can interact with whatever the thing is. If we put that into the digital world, it's about making sure that text on a screen can be perceived by anybody, whether they're trying to read it visually or if they're trying to read it through a screen reader or through a braille monitor. Whatever that is, they need to be able to interact with it, get the information they need, do all the functions of whatever it is on the screen. Check out on Amazon, check out at their favourite e-commerce place, be able to get the products in their cart, check out, et cetera. For creatives, it's about the things that we do: the websites that we build for ourselves, the e-commerce platforms that we use, our email marketing, our social media posts. Making all of that as accessible as we can so that we're not perhaps missing a part of our audience or our prospective audience from being able to engage with our work and in turn, hopefully, buy our books and enjoy our books and become a fan. This became important to me because of my day job. I hadn't really considered this—like, I think most people don't—until I started working at UsableNet. It's going to be 15 years I've been at that company come this autumn, and I really started to see the impacts because UsableNet is all about accessibility on the digital front. I really started to learn, being a project manager for them, what all of that meant and how it impacted people who couldn't buy something online, couldn't book a hotel room, couldn't book an airline ticket. It just really became something I got passionate about. I ended up writing the book because I realised that nobody talks to creatives about this. Nobody tells the independent author what they should do to help make their digital stuff accessible so that they don't miss people. I never expected my day job to interact with my creative side so much, but this certainly has over the last few years. Jo: I mean, has it got better? Like we said, you were on here three years ago. We did talk about some of the things around EPUB formats and taking off DRM and what we need to do on our websites—labelling images, for example, and that kind of thing. Do you think accessibility has gotten better? Jeff: I think the awareness of it has improved, both within the creative community and in the broader web ecosphere, that the awareness is better. There's so much knowledge that needs to go into creating something that is accessible. Sometimes there's so much that you have to think about with colours and alt tags on images and all the little bits and pieces, if it doesn't really come to muscle memory, it's easy for it to fall off. There's a survey that's done by WebAIM every year about the top one million homepages out in the universe, and they surveyed those for just the things that an automated scan can detect, which is a small portion of overall accessibility, and the number of errors across that top million actually ticked up this year. Even though there's all these laws around the world—people get sued all the time in the US—the number of errors ticked up for the first time in a few years. So I think the awareness is up, but I think being able to take action on it and make the time to take action on it isn't where it needs to be. Jo: So last time you gave us all those tips. I'll refer people back to that and also to your book Content for Everyone, which has got loads of great stuff in. I wanted to talk to you for this show because I was sitting watching Claude Cowork—now I use Claude Code a lot more—but updating 140 titles on IngramSpark, where me clicking things and there's like 15 clicks per record on IngramSpark updates for pricing, is an absolute nightmare. I was watching the AI do the work and I realised this isn't just saving me time, it's actually saving my wrist and my arm from repetitive strain injury. That's when I thought about this accessibility thing. As you mentioned, for example being physically accessible into a building, say someone's in a wheelchair, they can't necessarily get into a building if there's no ramp. I was thinking that for many years, being an indie author, being a writer online, there's also been these physical barriers because there's a lot of plumbing and clicking for us. So I wondered, starting with an attitude around a shift in who this is opening up to— How is AI starting to help people with these accessibility issues? Jeff: Yes, there's so much opportunity around this. We should note, just to timestamp this, that we're talking on 14th April 2026, because who knows what will change, even in an hour from now. I think Cowork was one of the first things that we saw, and that's only been out since the very top of this year. Being able to do actual agentic tasks. Other things have sort of gotten there, but Cowork really opened it up. You mentioned the repetitive stress that you would've had clicking all of those forms on IngramSpark across 140 books. But there's that type of stress, chronic pain, cognitive drain for somebody who may have some cognitive disability and trying to work through that form. The cognitive energy just might drain out and maybe knock them out for several days after trying to get through that, or the tasks take them multiple days to do. Someone who has lower vision, someone who's trying to work through that form with a screen reader—all of that draws energy, draws focus. Now we've got something where, with plain language, we could say something like: here's all my pricing information, I've logged into IngramSpark, go update these books. Obviously the prompt's going to be a little more than that, but in broad terms, that's what we're going to tell it. Jo: Hmm. Jeff: And being able to have it go through and do the thing. If it gets stuck, have it come back and say, “Hey, I've got trouble with this. Please help me.” That can just free up so much of the drains that people can have—the things that can take them out of doing the part of the work that they need to do for an author business. They can go write the book through whatever process you're going to use to do that, rather than getting caught up in something like having to update all those books on IngramSpark. Jo: You mentioned writing the book there. I have this real sense of being an able-bodied indie author in terms of my computer use and my ability to write a whole book, a 70,000-word thriller that I write regularly. We're all special in some way, but I do have a reasonably normal brain where I can do this work without too much strain. It's hard work, but I can do it. I meet people who are now using AI to help them write, to help them organise their work—maybe someone has dyslexia or ADHD or cognitive issues or pain—there's just so many things that I take for granted that don't affect me. I hear from people who, at this point in time in the community, are almost shamed for using AI to write. So I wanted to bring this up to discuss it under the terms of accessibility. Do you have any thoughts on that? Jeff: I have real difficulty with people who will say anything in the broad range of, “I don't need to use this thing, and therefore you should not either.” Which is adjacent to indie anti-AI speak that there is out there. Certainly we're living right now at probably the highest point that it's ever been, where more and more there's a sentiment towards not using AI for whatever the reason is. I totally respect that people can have concerns about the environment and about energy use and water use, et cetera. Not to mention all the other things that are on the more difficult side of AI. To shame someone who may not be able to put their story out there without the use of that AI, whichever one they're using, or to shame them because they're using AI to run part of their business—updating IngramSpark, doing other things like that—I think it can come down to there being some ableism there. Ther is some privilege behind that too, where they're just like, “I don't need this, and you shouldn't have it either.” I want to give people just a sliver of an idea of what this can mean for someone who is disabled and what AI can unlock for them. There is a person on LinkedIn that I follow whose name is Hannah Desmond. She's an ADHD coach and a former software developer, and very recently she posted this on LinkedIn. This is a paraphrase of what she said, but: having something that can meet you where you are and help you bridge that gap is what I think I have found so helpful about using AI. Here's what I keep coming back to. Without that support, I wasn't more motivated or more capable. I was just stuck. That's the bit that gets lost. We've been taught that struggling is how you know you're doing it properly. So when something reduces the struggle, it can feel wrong—even when it's the thing that actually makes the work possible. Because there's a difference between avoiding thinking and being able to think at all. I think that rounds it up. She's talking about her time as a software developer, but you can apply that to any realm of AI when we're thinking about trying to shame someone for why they may be using it. We may not know that they have a disability because we don't always share that part of ourselves. So I really feel strongly about that and how we are in this culture of shame. Jo: Yes. It drives me up the wall, actually. But I will also say: you don't have to have a disability or accessibility issues in order to use AI in whatever way you personally decide is okay—talking to the listeners now. I think Orna Ross from the Alliance of Independent Authors says it well, which is you should have your own AI policy. So you personally decide where your lines are, how it helps you, what you want to keep for you, and what you want help with. I was also thinking in terms of accessibility around money. Again, for many of us, professional cover design, professional editing, professional human-level translation, these are things that are pretty pricey for many people. So again, this makes it more accessible. One of the reasons we got into the indie way and being indie authors was to try and remove the barriers to entry to people who have been excluded from the environment of publishing. So, yes, it is really hard to talk about this, and yet that's why I wanted to talk about it, because— There's so many variables for each individual and there's no situation that's the same, really, is there? Jeff: No, not at all. The things that I may need to do my work in the most efficient way possible is different from the way that you're going to work, is different than the way my husband's going to work, is different than every other person and the way that they're going to work. Which is why any kind of blanket statement about “I don't need something and therefore you shouldn't need it either” can just be so problematic, because we have no idea what someone else is going through. Either it's a permanent part of their lives or maybe it's something that is happening temporarily with them where they might need to leverage other tools. Jo: Yes. Talking about that temporary, I think I really got the first sense of this when I had COVID the first time, which was really bad. I remember I was so sick, the only thing I could do was listen to an audiobook. I couldn't think, I couldn't read. It was really probably months of not having my brain back. Then the other thing that's happened as I age, as women age, is menopause kicks in and the brain fog is a real thing. I've heard from other people too who've said having Claude or whoever, an AI tool, to help with the brain fog is so important because otherwise I just wouldn't be able to gather my thoughts. Again, as you said— Even if we don't need these things now, it's quite likely we're going to need them at some point, given ageing, given the potential for injury and disease. I mean, we don't escape this alive, do we? Jeff: Yes, that's a great point because unless we're extremely lucky as individuals, we're all likely to have some sort of a disability in our lives at some point. I know for me, as I age and my eyes get more and more tired after being in front of a screen all day for work, and then whatever creative stuff I do in the afternoon on a book—when it comes near bedtime and I do want to read, I probably want to do that with an audiobook, much more audio, especially for any long reading project. That can also be like, if I have a long document or a long article to read, I am likely to give it to ElevenReader, let it load itself up, and then listen to it, because I take the information in better than trying to follow words across a screen. Jo: Yes. Jonathan, my husband, now also listens to a lot of academic papers on ElevenReader. Most of us will know it as where we publish some audiobooks from ElevenLabs, or you can also publish other things there. So it is super useful to think about what we can do with ElevenReader. Another thing that I found really useful recently is NotebookLM. On NotebookLM, there is a free tier. You can put various things in there and then create a custom audio. So this is something I've been doing as part of research. You can put in, say, 10 YouTube videos or some PDFs or your book or whatever, and then you can create a custom audio. Then I'll go for a walk and I'll listen to the custom audio, and then I'll go back and look at the detail of what it was. It gives me the framework of whatever I'm thinking about on a broader level, and then I can come back to the details. So again, it's this multimodal approach that can help us manage our energy, I guess. Jeff: And it's all about the managing of the energy, I think, too. That is a great way to think about the accessibility of it all. You mentioned a great use there for NotebookLM. That could also be putting your book in there and having it help you build a world bible or something like that. Or building marketing materials off of that. There's a lot of things now that NotebookLM can do in terms of helping you create FAQs maybe for a newsletter or for your website, and building video stuff off of the material that it has. So there's a lot of options there, and ever-growing options that can be useful for someone to manage any number of the things that they may need in their creative business. Jo: Yes. In fact, talking about Claude, there are a lot of Claude plugins now, skills and integrations. Shopify just released a Claude plugin and many of us now have Shopify stores. I have a lot of products with a lot of different variations and the metadata. There's so much metadata. And again, I'm just so pleased now that I can work with Cowork and get it to actually update directly into Shopify. In fact, coming back, you mentioned updating alt tags earlier. That's something again that AI could help you update—the back list of your alt tags on a website. I've now got my Cowork doing EPUBs so I could finally update all my EPUBs with back matter and all of this kind of thing. So I feel like perhaps we could go beyond accessibility to talk about amplification. All the things that we didn't do because it was too tiring and we just couldn't be bothered, or it would just be way too much work, that now it's opened up as a possibility because of these tools. Jeff: Absolutely. I mean, you look at a backlist as large as yours and the things that you're now able to do. I didn't know that Claude had a Shopify plugin. So the abilities that we have now to maybe do things in the business that we hadn't before. One of the things I've been working with Claude on is rewriting my website and creating a more proper website for Will. I'm really making sure that it is not only SEO prepared but also GEO prepared, with all the metadata and all the backend code schema that it needs so that LLMs can find me, can understand what I do, can understand the books, branch out to the other areas that it needs to. Doing that through WordPress would've been so much more difficult, even with Claude, that to be able to rewrite the site in a way that is going to let me manage it better so that I will do it on a more consistent basis. Whatever that thing is, we're now able to do these things. That could be updating keywords in Amazon or making sure we're aligned across all of the sales platforms that we might be on and things like that, that Claude can do and do well. Jo: Yes, I think marketing is just the killer app really for people, isn't it? I think most authors do not enjoy marketing. I find Claude better for creative work, for strategic work, for doing work through Cowork or Code, but— ChatGPT with marketing copy is very, very good. So I've actually been using that as we record this. I've got a Kickstarter launching next week, so I've been getting it to do ad copy and social media copy and all that kind of thing. This is stuff when you have to produce—give me 20 taglines, give me 20 hooks, give me another 20 and another 20. I mean, we just cannot do it as humans, right? Jeff: Yes, I have found GPT wildly helpful. I mentioned trying to get Bargain Booksy and Fussy Librarian promos. Jo: Mm. Jeff: And you have to give it the marketing hook, and it can't just be the blurb that's on Amazon—it's got to be something fresh, and they each have slightly different requirements. Having GPT—here's the blurb, give me a dozen different options—and then I may take pieces of all of them and create one of my own. But it reworks that much faster than my brain was ever going to try to find the right thing I want to give to Bargain Booksy. Jo: Yes, you are right. Or it says write this in 300 characters or less. Jeff: Yes. Jo: I do exactly the same. That kind of transformative work can be really good. In fact, there was somebody I know who has been rampantly anti-AI for years and then said, “Would this help me? I have to do a synopsis for an agent, so I've got this 100,000-word book and it needs to be a 10-page synopsis. How would I do that with AI?” So I was encouraging her to take each chapter and ask it to summarise the chapter, and of course read through it and everything. But I mean, doing a synopsis once you've actually written a book—that can be super useful. So I think what we're saying is— There are levels of need in terms of both the author and the audience. Then there are levels of your personal use from one end of the spectrum to the other in terms of how far you want to go in every area of the business. And in that way, it's just different for everyone. Jeff: Yes, and I think getting to that mindset shift that we were talking about a little bit—it can be so easy to dip your toes in. That one author came to you and said, “Do you think it could do this?” And I think that's the beginning exploratory area for perhaps anyone. People are going to hear us talk about this and it might inspire them to go try something that we've talked about. But these things, whether it's Claude or GPT or Gemini or whichever one it is, you can come to it and say, “I'm an author, I have X, Y, Z going on in my life”—whether that's a disability, whether that's a time constraint because you have a day job and maybe you have kids and a family that need your attention—”I have these time constraints, I want to do X, Y, and Z in my business. How can you help me with that?” It's going to tell you what it can do to help you with that. I would even say, if you have the ability to have multiples of these, you could ask the same question to GPT and Claude, and they're going to give you similar answers in some instances, but they may also have different ones because of the abilities that the different platforms have around these things as well. That can help you make that mindset shift of, “Well, now I see that it can do that. Could it also do this?” And then ask it if it could do that. Because I know for me, Jo, I've taken so much from you and your journey with Cowork that it's like, “Oh, she did that. I wonder if I could do this.” And all of that piles on top of itself. Then eventually I think your brain starts to think on its own, “Oh, I have to do this task. Can Claude maybe do this for me? Let's go find out.” Jo: Yes, and if it couldn't do it for you yesterday, you never know, it might be able to do it tomorrow. Jeff: Right? Because I haven't tested yet its new ability to actually use your computer. Jo: Mm. Jeff: And I'm curious what that might open up. Because one of the things that I've seen that I wish it would do is be able to take the EPUB that's on my drive and actually put it into a platform I'm trying to upload to. Cowork on its own hasn't been able to cross that barrier, but I wonder if with computer use added to that, if it could. Like, “here's the EPUB, upload that over there,” be able to pick it from the file picker, essentially. Jo: Yes. I think, well, a little tip for everyone: I wouldn't give access to your entire file system to the AI. Jeff: That's a good point too. Jo: Yes. I have a Claude folder in my drive and it only has access there. So if you put files in that drive, it might be able to do that. But I know what you mean. I have been using it to help me publish things in German on KDP. Now I can use the browser, so you can actually do that. In terms of uploading the actual file, I know what you mean. These things will change. As we record this, again middle of April, we are almost about to get the next models being Mythos, which might be Claude 4.7 Opus, or also ChatGPT has a new model coming, and these models are getting very powerful. With every shift they can do more things. So as you say, the very first thing to do is ask it, “I want to do this—what are my options?” And some of them, for example, doing an AI-narrated audiobook, ChatGPT and Claude don't do that. You want ElevenLabs or one of the other services for that, but they can tell you what your options are. So that's one thing, but I wondered if you have any thoughts on the gaps that you are seeing. You mentioned one there around file uploads, but— What do you hope might come and some of the things that might be exciting if they arrive? Because you never know, they might be here already. Jeff: There's certainly some movement in some areas. One of the things I'll share is, in March I was at the 2026 CSUN Assistive Technology Conference—CSUN is California State University, Northridge—and they've run this conference for some 40 years now. One of the sessions I went to was from Tara Maisel—I hope I'm pronouncing her last name right. She's a senior project manager in books accessibility at Amazon, and she was doing a session specifically on readability. She had all kinds of statistics and information about what goes into making something readable. One of the things she talked about with AI was the future of personalised reading. If you think about the Kindle app, for example, there's a lot of settings you can make there—font size, colours, brightness, text spacing. There's a lot of tools in there. She was pointing out that potentially readers don't even know what they actually need for the optimised visual reading experience. She sees a world where AI can perhaps do an analysis of your reading behaviour and then help you find the optimal settings. Maybe even multiple optimal settings for, say, if you were reading in a room that had daylight versus at bedtime, and the ways you might shift it. I was almost thinking of this like when you're at the optometrist and they're like, “Which lens is better—this one or that one?” Jo: Oh, sometimes that is very hard. Jeff: Yes. It's that AI could step you through that a little bit to help you find that optimal reading experience in that moment. And then it might even notice, potentially, if you're changing something in the way that you're moving through a page, that it might flag to say, “Hey, do we need to adjust something?” Some other areas that I think are really exciting, for everyone and perhaps particularly for people who are disabled and needing the support of some assistive technology, is what we're seeing in the browsers. OpenAI's Operator has been out for quite a while now, since sometime I think autumn of last year. Perplexity Comet has been around even longer. Then we've got browser extensions from Gemini and Claude that are available, that can let you just type natural language. You know, “Please go find for me jeans in this size that are on sale on this website. Find me the best price for blue jeans on this site and this size,” and it'll just go do it. Which can certainly speed things up for people in the disabled community to find things quickly, to spend time navigating less, and maybe ending up with the AI coming back and saying, “I found these five things. Which one would you like me to buy for you?” Or, “I found this one thing that you do need and it's waiting for you in your shopping cart.” The ability for that on the horizon is an amazing jump from an accessibility point of view. But really it's one of those things that accessibility will then help everyone because we can all just shop that way, if we choose to. These are early days for these browsers and these extensions. The other side of it comes back to basic web accessibility too, because I've seen these types of activities not work so well on a site that may not actually be accessible on its own. A great example is something I ran into with Claude Cowork about a month ago. I was testing to see if it could help me navigate and get things uploaded together for a site where I wanted to upload books, knowing again that it's not going to upload the actual file, but it could fill in the metadata from my master database of metadata stuff. There were areas on the site that it actually couldn't hit the button, because the site itself was also not functional to a screen reader. So there are gaps there. It's early days, but I really see that as an interesting future that'll really help people with disabilities—but again, help everybody too, just manage time better. Jo: I know exactly what you mean there. I've done some collaborative work with Claude Code when it's like, “I can't click the button,” and I'm like, well, I'll click the button—you fill in everything else. Jeff: Exactly. Jo: It's actually quite a funny situation. But goodness, coming back to IngramSpark again—these things need APIs. We need better functions. It's funny because I think a lot of traditional publishers have these APIs or backend upload things that you can do. I'm like, well, we need to get to that with these systems. But I think things will change. Another thing that I think has also shifted is the use of voice. Voice for dictation—it used to be with dictation that you would have to say “comma,” “open quote,” “new line,” and all of that. And you'd also have to make sense. Whereas now I feel like you can just dictate a whole load of things to these AIs and then say, “Tidy that up,” and they will do a lot more than the old situation. So I think voice will also help. Also automatic translation. I don't know if you know this about X, and if you're on X anymore, but just this week they've made it multi-language. So I can read tweets by people who've posted in another language in English. I can read something from Korean or read something that someone French has posted and it gets translated. It has made a huge difference to the content I'm seeing, which is fascinating because I don't think we've ever had this kind of automatic “everything is translated into your language” situation. It's really got me thinking about how [automatic translation] might work for eBooks or other things if the rights are there. I don't know. Have you seen stuff like that? Jeff: There's so much available now with voice and the ability to not have to speak all the other stuff that went with it—comma, full stop, next line. It was a little mind-bending sometimes, trying to think about quote marks and all that stuff. And now it's so good. Different platforms do it to different degrees of ability. Even being able to speak your prompts into the very platforms themselves without having to type all of it. Chronic pain comes to mind, any kind of mobility thing—all the typing would be a drain or maybe even impossible. So the voice ability is so powerful there and unlocks more things. At the same time, those translation abilities—I believe AirPods now have the ability, if you've got the right stuff on your phone, that you could be talking to somebody, they may speak back to you in a language you don't speak, but your AirPods will give it to you in your language. Jo: Hmm. Jeff: Google has, I believe, a live captioning app that you can use. I think there's even a split screen—I don't know if that's available now or something in their future—where you could put the phone on the table and tell it who's looking at what side of the screen, and it'll put the language that I need on my side and the language the other person needs on the other. So there continues to be such a shift in how we're being able to translate stuff that really opens up communication and can open up our books to so many more people. I'm very interested to see—I haven't pulled the trigger on this yet—but how Amazon's auto-translation rolls out and how that's received in terms of the accessibility around our books and being able to put it in someone's hands who doesn't speak—I think it's only English to other languages right now—but who doesn't speak the language it was written in but wants to read that book. We could never, as indies, or really even big five publishers, wouldn't have the money to create custom translations everywhere. But if the AI can help do that and spread those books around so that everybody could have the story they want to read, I think that's such a win for the reading audience. Jo: Yes, I think it's so exciting to think what might be coming, and that's what I want to stay on the side of on the AI discussion. There's enough negativity out there and you can get that information somewhere else, but for me I want us to stay on the positive side of how this helps both the author and the reader. And hopefully the community, to create more and read more and enjoy being human more. Right? Because I find that I do get out more and listen to stuff, or I'm out walking instead of at my desk, and I mean, that's what it's about. I'm pretty excited about the future. How about you? Jeff: I am. I think there are, quite honestly, some scary things that could be out there in the future. I mean, there's been a lot of talk about what Mythos is capable of. But on the other side of it, there are all these advances. I also look back at Google and AlphaFold and what DeepMind was able to do there for science. There's more of that stuff out there, and individually for each of us, spending a little bit of time—and I do have to say, I think you need to spend time on a paid plan because the free stuff doesn't give you the idea of what these platforms are actually capable of. So if you only drop in, even briefly, to experiment on one of the $20-a-month plans and give it your situation, ask it what it can do for you, I think you'll see where, on a personal level, AI will help you unlock some things. It can help you move some things to the next level in your business that for whatever reason you haven't been able to do. You don't have to use it for everything. You may decide that it's still not for you for whatever reason, and that's fine. But I think there's so much to explore here and to let your curiosity run for a little bit to see what's possible and what you might unlock with it. Jo: Brilliant. So where can people find you and your books and everything you do online? Jeff: So pretty much everything lives at JeffAdamsWrites.com. Jo: Well, thanks so much for your time, Jeff. That was great. Jeff: I loved it, Jo. Thanks for having me..The post Accessibility And AI: How New Tools Are Opening Doors For Indie Authors With Jeff Adams first appeared on The Creative Penn.

En este episodio hablamos sobre una novela de horror La chica de al lado del autor Jack Ketchum un libro perturbador que esta basado en hechos reales. Meg y su pequeña hermana se mudan a vivir con Ruth una mujer que esta al cuidado de sus tres hijos. Meg y su hermana son las únicas sobrevivientes de un terrible accidente donde sus padres lamentablemente pierden la vida. Ruth es un pariente lejano de la familia; por lo tanto, ella se tendrá que hacer cargo de las hermanas. Sin embargo, la vida de Meg está a punto de convertirse en un infierno por los abusos y tortura que va a sufrir a manos de Ruth y sus hijos. Por otro lado, David, un pequeño que vive al lado de la casa de Ruth, es quien nos cuenta esta historia y quien estuvo enamorado de Meg. El horror y sufrimiento que viven Meg y su hermana es algo que no se puede imaginar. Debes tener precaución al leer esta novela; nos llevó un poco de tiempo el poder terminarla. Any por momentos hacía pausas y se ponía a leer otras novelas para poder contener la ira, la impotencia hacia los personajes que maneja el autor. Existe una adaptación cinematográfica con el mismo nombre que puedes ver en plataformas; hay pequeños cambios, pero puedes hacer una combinación o leer primero el libro y después ver la película. Aquí te dejamos los enlaces al libro y la película por si estás interesado. La chica de al ladoPelicula La chica de al ladoSíguenos en nuestras redes sociales

Chuck and Chris continue the initiative working with The Journal of Hand Surgery on a quarterly journal club.  Nash and Macerena choose the articles from the previous quarter and Chris and Chuck review the articles and discuss practical implications.  See articles below.In addition, we discuss a case of possible pronator syndrome together with carpal tunnel syndrome including debate on the role of nerve studies, physical examination, and ultrasound.1) Rames JD, Emanuels AF, Tunaboylu MF, Moran SL. A 40-Year Retrospective Evaluation of Vascularized Bone Grafting for Kienböck Disease. J Hand Surg Am. 2026 Jan;51(1):13.e1-13.e9. doi: 10.1016/j.jhsa.2025.07.025. Epub 2025 Aug 29. PMID: 40879579.2) Suzuki T, Kiyota Y, Matsumura N, Sato K, Nakamura M, Iwamoto T. Anatomical Reconstruction of the Terminal Tendon and Lateral Band for Severe Chronic Tendon Mallet Injury. J Hand Surg Am. 2026 Jan;51(1):92.e1-92.e7. doi: 10.1016/j.jhsa.2025.04.025. Epub 2025 Jun 21. PMID: 40542795.3) Lee C, Shin S, Fraipont G, Hung V, McGarry MH, Lee TQ. Dermal Allograft Augmentation With Proximal Row Carpectomy: A Biomechanical Study. J Hand Surg Am. 2026 Feb;51(2):143-152. doi: 10.1016/j.jhsa.2025.05.006. Epub 2025 Jul 4. PMID: 40613810.4) Jaarsma EH, Ring D, Tonn MD, Brinkman N. Do Patients Older Than 40 Years with Work Claims for Unilateral Wrist Symptoms Have Symmetric, Bilateral MRI Signal Changes That Do Not Correspond with Symptoms? J Hand Surg Am. 2026 Mar;51(3):313-320. doi: 10.1016/j.jhsa.2025.11.012. Epub 2026 Jan 29. PMID: 41609546.5) Pohl NB, Brush PL, Parson JP, Fitzgerald P, Charlton A, Beredjiklian PK, Fletcher DJ. Incidence and Predictors of Subsequent Triggering Requiring Treatment After Trigger Finger Release. J Hand Surg Am. 2026 Feb;51(2):203.e1-203.e8. doi: 10.1016/j.jhsa.2025.02.009. Epub 2025 Apr 9. PMID: 40202483.We are in 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

In this episode, Yoga Medicine founder Tiffany Cruikshank and Katja Bartsch take a deep dive into the latest stretching research and what it means for yoga teachers, athletes, and movement professionals. Together, they unpack the latest recommendations around stretching for flexibility, stiffness, strength, hypertrophy, vascular health, recovery, and injury prevention while exploring the limitations of stretching as a standalone tool. Tiffany and Katja discuss why prolonged static stretching before explosive activity may impair athletic performance, how longer-held yin-style stretches may influence tissue stiffness, and why emerging vascular research around stretching is generating so much interest. They also explore why yoga recovery likely involves far more than just stretching mechanics, including nervous system regulation, breathwork, and relaxation. "We do not overestimate or underestimate what stretching can do." — Katja Bartsch. — What You'll Learn: What the new 2025 stretching consensus paper reveals about flexibility research [02:57] • Definitions of static, dynamic, and PNF stretching in both research and yoga practice [06:00] • Acute vs. chronic stretching effects on range of motion and mobility [13:54] • Recommendations for improving long-term flexibility and maintaining mobility with age [20:09] • The "Goldilocks" principle of tissue stiffness and athletic performance [27:24] • Why longer yin-style holds may influence connective tissue adaptation [32:12] • How stretching impacts strength, explosive performance, and warm-ups [34:32] • Research on stretching for strength gains and muscle hypertrophy [37:36] • Emerging evidence around stretching and vascular health [42:01] • Breathwork, nervous system regulation, and yoga's broader therapeutic effects [51:24] • Why stretching alone may not improve recovery or prevent soreness [54:07] • The limitations of flexibility-only approaches for injury prevention [1:00:13] • Why individualized mobility, stability, and strength work matter in yoga practice [1:01:40] • Final takeaways on stretching frequency, recovery, and long-term mobility [1:04:32] — Links Mentioned: Watch this episode on YouTube Warneke K, Thomas E, Blazevich AJ, Afonso J, Behm DG, Marchetti PH, Trajano GS, Nakamura M, Ayala F, Longo S, Babault N, Freitas SR, Costa PB, Konrad A, Nordez A, Nelson A, Zech A, Kay AD, Donti O, Wilke J. Practical recommendations on stretching exercise: A Delphi consensus statement of international research experts. J Sport Health Sci. 2025 Dec;14:101067. doi: 10.1016/j.jshs.2025.101067. Epub 2025 Jun 11. PMID: 40513717; PMCID: PMC12305623. — Learn More: Find the full show notes at YogaMedicine.com/podcast-167. 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. 

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-485 Overview: Teenagers are at higher susceptibility for hearing loss and often engage in behaviors that greatly increase their risk of permanent damage. In this episode, we look at current prevalence data and the pathophysiology of adolescent hearing loss, providing practical, office-ready prevention strategies to identify at-risk teens and intervene early. Episode resource links: Reijers SNH, Vroegop JL, Paping DE, Pronk M, Goedegebure A, Kremer B, van der Schroeff MP. Longitudinal Insights into Sensorineural and Noise-Induced Hearing Loss in Adolescents Aged 13-18 Years. Otolaryngol Head Neck Surg. 2025 Dec;173(6):1385-1392. doi: 10.1002/ohn.70042. Epub 2025 Oct 14 Byeon H. Associations between adolescents' earphone usage in noisy environments, hearing loss, and self-reported hearing problems in a nationally representative sample of South Korean middle and high school students. Medicine (Baltimore). 2021 Jan 22;100(3):e24056. doi: 10.1097/MD.0000000000024056. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

En este episodio conversamos sobre la novela y serie El Caso Holst de Søren Sveistrup . Vuelve los personajes de Thulin y Hess. Una inquietante rima infantil grabada en un bosque, mensajes de texto anónimos que dicen "Te encontré" y una desaparición que reactiva un caso cerrado hace 30 años.Compartimos nuestras impresiones (¡sin spoilers!) sobre la nueva producción/temporada de la serie, debatiendo si logra capturar la atmósfera opresiva y el horror psicológico que plantea el libro.Consigue el libro digitalSíguenos en nuestras redes sociales

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-485 Overview: Teenagers are at higher susceptibility for hearing loss and often engage in behaviors that greatly increase their risk of permanent damage. In this episode, we look at current prevalence data and the pathophysiology of adolescent hearing loss, providing practical, office-ready prevention strategies to identify at-risk teens and intervene early. Episode resource links: Reijers SNH, Vroegop JL, Paping DE, Pronk M, Goedegebure A, Kremer B, van der Schroeff MP. Longitudinal Insights into Sensorineural and Noise-Induced Hearing Loss in Adolescents Aged 13-18 Years. Otolaryngol Head Neck Surg. 2025 Dec;173(6):1385-1392. doi: 10.1002/ohn.70042. Epub 2025 Oct 14 Byeon H. Associations between adolescents' earphone usage in noisy environments, hearing loss, and self-reported hearing problems in a nationally representative sample of South Korean middle and high school students. Medicine (Baltimore). 2021 Jan 22;100(3):e24056. doi: 10.1097/MD.0000000000024056. Guest: Robert A. Baldor MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Send us Fan MailIn this episode of Journal Club, we wrap up a marathon recording session with a deep dive into the world of neonatal neuroprognostication. Daphna reviews a systematic review and meta-analysis from Pediatric Neurology that evaluates whether combining EEG and MRI provides better answers for families of preterm infants. While MRI remains a powerful tool for structural assessment, the data suggests that adding the functional insights of EEG significantly boosts specificity, particularly when predicting severe neurodevelopmental outcomes. We discuss the importance of timing these studies and the clinical value of sleep-wake cycling as a developmental milestone at the bedside.----Combined Use of Electroencephalography and Magnetic Resonance Imaging in the Prognostication of Neurodevelopmental Outcomes in Preterm Infants - A Systematic Review and Meta-Analysis. Forrest CD, Biagioni T, Liley HG, Lai MM, Colditz PB, Ware RS, Boyd RN, Roberts JA.Pediatr Neurol. 2026 Feb;175:116-129. doi: 10.1016/j.pediatrneurol.2025.11.005. Epub 2025 Nov 13.PMID: 41337899 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!

Spring is a season of rapid change inside the hive, and in this Bee Science segment, Dr. Dewey Caron walks through what drives colony expansion—and how beekeepers can respond effectively.   Dewey emphasizes that spring growth is fundamentally tied to pollen availability and favorable flying weather. Colonies in warmer climates may expand gradually, while northern colonies often experience a compressed and intense buildup. This variability makes local awareness and timing essential. Nutrition plays a central role. Research going back to Heather Mattila's 2006 work shows that colonies receiving pollen or protein supplements begin brood rearing earlier and build stronger populations. More recent work reinforces that locally sourced pollen may improve effectiveness, and emerging commercial feeds are showing measurable gains in overwinter survival and pollination strength. As colonies grow, so does the risk of swarming. Dewey underscores the importance of proactive management—providing adequate space, maintaining ventilation, and monitoring brood nest congestion. Once swarm preparation begins, options narrow quickly, making early intervention key. The episode also introduces the "Goldilocks effect" in evaluating colony strength. Colonies that are too weak struggle to build, while overly strong colonies risk swarming. The goal is finding that "just right" balance through regular inspection, brood assessment, and strategic frame movement. Health risks remain present during this expansion phase. Diseases like European foulbrood and chalkbrood, along with pesticide exposure and nutritional stress, can limit colony development. At the same time, brood expansion creates ideal conditions for varroa reproduction, reinforcing the need for integrated management. Dewey's central message is clear: spring requires active, informed management—but not overmanagement. Listen to the bees, respond to conditions, and aim for balance between growth and control. Links and references mentioned in this episode: Caron, Dewey M. Bee MD Bee MD [https://idtools.org/thebeemd/index.cfm?pageID=3094] Mattila, Hearther R. and Gard W Otis. 2006. Influence of pollen diet in spring on development of honey bee (Hymenoptera: Apidae) colonies. J. Econ Entomol. 99(3):604-13. doi: 10.1603/0022-0493-99.3.604 Kulhanek, Kelly, et. al.  2026. Enhanced Honey Bee Colony Strength and Economic Returns from Fall and Winter Feeding with a Complete Pollen-Replacing Feed. Insects 2026, 17(3), 243; https://doi.org/10.3390/insects17030243 Basu, Priya. 2024 Honey bee Nutrition HBHC https://honeybeehealthcoalition.org/nutritionguide/ Tew, James. 2025. Giving it Your Best Guess. March. Bee Culture DeGrandi-Hoffman G, Gage SL, Corby-Harris V, Carroll M, Chambers M, Graham H, Watkins DeJong E, Hidalgo G, Calle S, Azzouz-Olden F, Meador C, Snyder L, and  Ziolkowski N. 2018. Connecting the nutrient composition of seasonal pollens with changing nutritional needs of honey bee (Apis mellifera L.) colonies. J Insect Physiol.109:114-124. doi: 10.1016/j.jinsphys.2018.07.002. Epub 2018 Jul 7.PMID: 29990468 Hoover SE, Ovinge LP, and Kearns JD.  2022. Consumption of Supplemental Spring Protein Feeds by Western Honey Bee (Hymenoptera: Apidae) Colonies: Effects on Colony Growth and Pollination Potential. J. Econ Entomol.115(2):417-429. doi: 10.1093/jee/toac006.PMID: 35181788Free PMC article. ______________ Brought to you by Betterbee – your partners in better beekeeping.   Betterbee is the presenting sponsor of Beekeeping Today Podcast. Betterbee's mission is to support every beekeeper with excellent customer service, continued education and quality equipment. From their colorful and informative catalog to their support of beekeeper educational activities, including this podcast series, Betterbee truly is Beekeepers Serving Beekeepers. See for yourself at www.betterbee.com _______________ We hope you enjoy this podcast and welcome your questions and comments in the show notes of this episode or: questions@beekeepingtodaypodcast.com Thank you for listening!  Podcast music: Be Strong by Young Presidents; Epilogue by Musicalman; Faraday by BeGun; Walking in Paris by Studio Le Bus; A Fresh New Start by Pete Morse; Wedding Day by Boomer; Christmas Avenue by Immersive Music; Red Jack Blues by Daniel Hart; Bolero de la Fontero  by Rimsky Music; Perfect Sky by Graceful Movement; Original guitar background instrumental by Jeff Ott. Beekeeping Today Podcast is an audio production of Growing Planet Media, LLC ** As an Amazon Associate, we may earn a commission from qualifying purchases Copyright © 2026 by Growing Planet Media, LLC

Send us Fan MailIs your NICU considering the shift to 24 hour in house attending coverage? In this episode of Journal Club, we explore a provocative brief communication from the Journal of Perinatology. Ben and Daphna discuss the impact of moving from home call to on site presence at UC Davis. While the change was intended to improve patient care, the data reveals a surprising 15 percent decrease in work RVUs. We examine how proactive weaning and bedside presence might actually lower billing levels under current CPT codes. Are we being penalized for doing the right thing for our patients?----From on-call to on-site: the impact of 24-hour in-house neonatology on billing patterns and physician productivity. Donohue L, Lakshminrusimha S.J Perinatol. 2026 Feb;46(2):289-292. doi: 10.1038/s41372-025-02530-8. Epub 2026 Jan 5.PMID: 41490931 Free PMC article. 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!

In this episode, our expert panel dives into the critical, historically debated topic of early burn wound excision using a real-world case of a patient with massive surface area burns. We explore the dramatic shift from the pre-1970s "wait and watch" approach to the modern standard of early source control, backed by landmark literature showing reduced mortality and shorter hospital stays. The discussion also highlights the nuances of this timeline, covering specific scenarios where delaying surgery is actually safer due to physiologic instability, uncertain burn depths, or mass casualty events. Tune in to hear the evidence behind these clinical decisions and learn why modern burn surgeons believe that removing necrotic eschar early is the best way to dominate the day!Hosts: - Kathleen Romanowski – University of California Davis Hospital, Shriners Hospital Sacramento- Laura Johnson – Grady Memorial Hospital- Lauren Nosanov – Grady Memorial Hospital-  Victoria Miles – Louisiana State University Health Science Center, University Medical Center New OrleansLearning Objectives:- Review the historical development of early burn excision and understand how these studies shaped modern burn surgical practice.-  Evaluate contemporary evidence on the timing of burn excision.- Apply current evidence and clinical principles to operative decision-making, identifying key patient and injury factors that influence the timing of excision and grafting in patients with major thermal injury.References:- Thompson P, Herndon DN, Abston S, Rutan T. Effect of early excision on patients with major thermal injury. J Trauma. 1987 Feb;27(2):205-7. doi: 10.1097/00005373-198702000-00019. PMID: 3820353. https://pubmed.ncbi.nlm.nih.gov/3820353/-  Gray DT, Pine RW, Harnar TJ, Marvin JA, Engrav LH, Heimbach DM. Early surgical excision versus conventional therapy in patients with 20 to 40 percent burns. A comparative study. Am J Surg. 1982 Jul;144(1):76-80. doi: 10.1016/0002-9610(82)90605-5. PMID: 7046487. https://pubmed.ncbi.nlm.nih.gov/7046487/- De La Tejera G, Corona K, Efejuku T, Keys P, Joglar A, Villarreal E, Gotewal S, Wermine K, Huang L, Golovko G, El Ayadi A, Palackic A, Wolf SE, Song J. Early wound excision within three days decreases risks of wound infection and death in burned patients. Burns. 2023 Dec;49(8):1816-1822. doi: 10.1016/j.burns.2023.06.003. Epub 2023 Jun 15. PMID: 37369613; PMCID: PMC10721718. https://pubmed.ncbi.nlm.nih.gov/37369613/- Ramsey WA, O'Neil CF Jr, Corona AM, Cohen BL, Lyons NB, Meece MS, Saberi RA, Gilna GP, Satahoo SS, Kaufman JI, Schulman CI, Namias N, Proctor KG, Pizano LR. Burn excision within 48 hours portends better outcomes than standard management: A nationwide analysis. J Trauma Acute Care Surg. 2023 Jul 1;95(1):111-115. doi: 10.1097/TA.0000000000003951. Epub 2023 Apr 11. PMID: 37038260. https://pubmed.ncbi.nlm.nih.gov/37038260/- Hayashi K, Sasabuchi Y, Matsui H, Nakajima M, Otawara M, Ohbe H, Fushimi K, Ono K, Yasunaga H. Does early excision or skin grafting of severe burns improve prognosis? A retrospective cohort study. Burns. 2023 May;49(3):554-561. doi: 10.1016/j.burns.2023.01.013. Epub 2023 Feb 3. PMID: 36774244. https://pubmed.ncbi.nlm.nih.gov/36774244/- Janzekovic Z. Once upon a time ... how west discovered east. J Plast Reconstr Aesthet Surg. 2008;61(3):240-4. doi: 10.1016/j.bjps.2008.01.001. Epub 2008 Feb 1. PMID: 18243082. https://pubmed.ncbi.nlm.nih.gov/18243082/

In response to increasing surgeon burnout, unsustainable clinical demands, and ongoing loss of surgeon autonomy in the setting of employee-based models, the American College of Surgeons is speaking out. In this episode, hosts Dr. Steven Thornton and Dr. Emma Burke sit down with Dr. Douglas Wood, Chair of Surgery at the University of Washington and Dr. Thomas Varghese, Editor-in-Chief of the Journal of the American College of Surgeons, to discuss the new ACS Workplace Standards Framework. The conversation covers how this initiative grew out of discussions around unionization, what domains the framework addresses — from call intensity and OR block access to administrative burden and inpatient census limits — and how specialty-specific guidelines can be developed and implemented at the local level. Dr. Wood and Dr. Varghese also reflect on the culture of "unlimited endurance" that has long defined surgery, why meaningful systems-level change is both necessary and achievable, and how improving workplace sustainability could transform the pipeline of future surgeons for generations to come.Hosts: Emma Burke and Steven ThorntonGuests: Dr. Douglas Wood & Dr. Thomas Varghese Jr.Papers Discussed:1. Wood DE, Wolinsky PR, Dodgion CM, et al. Developing Specialty-Specific Workplace Standards for Surgeons: A Framework to Support Sustainable Surgical Careers. Journal of the American College of Surgeons, 2026. DOI: 10.1097/XCS.0000000000001880 https://pubmed.ncbi.nlm.nih.gov/41773743/2. Varghese TK Jr. Toward Sustainable Surgical Practice: Defining Workplace Standards for the Modern Era. J Am Coll Surg. 2026 Mar 3. doi: 10.1097/XCS.0000000000001888. Epub ahead of print. PMID: 41773737. https://pubmed.ncbi.nlm.nih.gov/41773737/***Fellowship Application Link: https://forms.gle/QSUrR2GWHDZ1MmWC6Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium:General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewOral Board Simulator: https://app.behindtheknife.org/oral-board-simulatorTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US