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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.

Head Injuries need a thorough and consistent workup in urgent care, which includes looking for signs of depressed skull fracture.     Check out the paper mentioned Bressan S, Tancredi D, Casper CT, Da Dalt L, Kuppermann N. Palpable signs of skull fractures on physical examination and depressed skull fractures or traumatic brain injuries on CT in children. Eur J Pediatr. 2024 Dec;183(12):5321-5330. doi: 10.1007/s00431-024-05807-w. Epub 2024 Oct 10.    Check out the MDCalc pages - PECARN - Canadian CT head   Check out the RCHM Page mentioned   Check out the video of Petr Čech's injury     www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice, always consult your usual doctor

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

The publication of CREST-2 has reignited one of the longest-standing debates in vascular medicine: should asymptomatic carotid stenosis still be treated invasively in the era of modern best medical therapy? In this episode, Laurence Bertrand and Rosalinda D'Amico discuss the trial with Barbara Rantner and Caitlin Hicks, exploring its methodology, controversial findings, and the implications for the management of asymptomatic carotid stenosis.Full name of guests:Dr. Barbara Rantner – TUM University Hospital, Munich, Chair of ESVS and DGG guideline writing committeeDr. Caitlin Hicks, Johns Hopkins University School of Medicine, Member of the writing committee ESVS and SVS guidelinesShownotes: Brott TG, Howard G, Lal BK, Voeks JH, Turan TN, Roubin GS, Lazar RM, Brown RD Jr, Huston J 3rd, Edwards LJ, Jones M, Clark WM, Chamorro Á, Llull L, Mena-Hurtado C, Heck D, Marshall RS, Howard VJ, Moore WS, Barrett KM, Demaerschalk BM, Sangha N, Aronow H, Foster M, Sternbergh WC 3rd, Shawl F, Lanzino G, Rapp J, Tran HS, Ecker R, Mackey A, Ali V, Given C 2nd, Teal P, Kashyap VS, Mukherjee D, Harrigan M, Silverman S, Koopmann M, Wadley VG, Zhang Y, Rhodes JD, Chaturvedi S, Meschia JF; CREST-2 Investigators. Medical Management and Revascularization for Asymptomatic Carotid Stenosis. N Engl J Med. 2026 Jan 15;394(3):219-231. doi: 10.1056/NEJMoa2508800. Epub 2025 Nov 21. PMID: 41269206; PMCID: PMC13148431.Halliday A, Bulbulia R, Bonati LH, Chester J, Cradduck-Bamford A, Peto R, Pan H; ACST-2 Collaborative Group. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy. Lancet. 2021 Sep 18;398(10305):1065-1073. doi: 10.1016/S0140-6736(21)01910-3. Epub 2021 Aug 29. PMID: 34469763; PMCID: PMC8473558.

🧭 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.

Mesh oder nicht bei der Typ-I-Hiatushernie? In dieser Folge sprechen wir über eine retrospektive Analyse aus dem Herniamedregister, in der das Outcome von Patientinnen und Patienten mit einer axialen Hiatushernie (mesh vs. non-mesh) anhand eines propensity-score matchings verglichen wurde. Viel Spaß beim Reinhören! Moderation: Felix Rühlmann Gast: Prof. Dr. Jessica Leers Besprochene Publikation: Hoffmann H, Glauser P, Adolf D, Kirchhoff P, Köckerling F. Mesh vs. non-mesh repair of type I hiatal hernias: a propensity-score matching analysis of 6533 patients from the Herniamed registry. Hernia. 2024 Oct;28(5):1667-1678. doi: 10.1007/s10029-024-03013-z. Epub 2024 Mar 29. PMID: 38551794; PMCID: PMC11450037.

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

Book Synopsis Heather Happenstance Rockaway Pointe's girl about town and roving reporter is at it again as she joins an adventure to find the hairy man beast terrorizing the beings at Whistling Gulch Retreat in the Forest of the Forbidden. She'll encounter multiple paramours, strange creatures, the Forest of the Forbidden Bears, and her own inner secrets and shadows as she works with the newly appointed Ranger Haniford to solve the mystery of the beast and the strangely severed hand that weirdly resembles that of her ex husband and rock star Blaze Mulholland. THANKS FOR Being here

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. 

Join me in sisterhood as we part the mists and have a gal hang in Avalon together. This month we're focusing on the apple as creative projects. Tapping into our latent sexual energy to create and disperse stuck sacral chakra vibes.Also this month we're committing to Sisters in Service as we send good energy, uplifting thoughts, and high vibes of support to all of our front line Bringers of the Light in the Inner Worlds. They're the invisible armies that could really use our support right now.And we'll finish with a little time for our Twin Flame Sisters in a show of solidarity and support for the very unique and often confounding thing that is the twin flame journey.THANKS FOR Being here

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.

Part 3 of the Women's Health SeriesBloating, gas, urgency, abdominal pain, and that relentless “what if something happens?” loop can turn sex from a close connection into stress fast. Digestive symptoms can quietly impact some of the most vulnerable parts of our lives...including intimacy, relationships, and self-esteem. And often, the shame surrounding those experiences feels heavier than the symptoms themselves. If you've ever pulled away from connection because your gut felt unpredictable, this conversation is for you. In this episode, we're opening up an honest and empowering discussion about gut health, confidence, and reclaiming intimacy without fear or embarrassment.We dive into this topic with our expert guest, Dr. Alyse Bedell, GI psychologist and Certified Sex Therapist, covering: • Why digestive functions feel taboo in sexual relationships • How IBS and IBD symptoms can impact desire, relaxation, and satisfaction • Myth-busting the idea that sex must be spontaneous to be pleasurable • Scripts and “reset” strategies for handling symptoms in the moment • Redefining intimacy so closeness does not always imply intercourse • Flexible planning around meals, energy, triggers, and symptom patterns • Partner support that reassures without becoming patronizing • The circular sexual response cycle and starting from sexual neutrality • Rebuilding sexual self-esteem with stigma work and acting with "as if” confidence This episode has been sponsored by Ardelyx. References: Ballou S, McMahon C, Lee HN, et al. Effects of Irritable Bowel Syndrome on Daily Activities Vary Among Subtypes Based on Results From the IBS in America Survey. Clin Gastroenterol Hepatol. 2019 Nov;17(12):2471-2478.e3. Fretz KM, Hunker KE, Tripp DA. The Impact of Inflammatory Bowel Disease on Intimacy: A Multimethod Examination of Patients' Sexual Lives and Associated Healthcare Experiences. Inflamm Bowel Dis. 2024 Mar 1;30(3):382-394. doi: 10.1093/ibd/izad106. PMID: 38206426; PMCID: PMC10906359.Wang J, Varma MG, Creasman JM, et al. Pelvic floor disorders and quality of life in women with self-reported irritable bowel syndrome. Aliment Pharmacol Ther. 2010;31(3):424-431. doi:10.1111/j.1365-2036.2009.04180.xDubinsky MC, Potts Bleakman A, Schreiber S, et al.. Impact of moderate-to-severe ulcerative colitis and Crohn's disease on sexual activity: United States and European patient perspectives from the communicating needs and features of IBD experiences (CONFIDE) survey. Curr Med Res Opin. 2025 Jun;41(6):1017-1030. doi: 10.1080/03007995.2025.2530736. Epub 2025 Jul 17. PMID: 40635574.Come As You Are: Revised and Updated: The Surprising New Science That Will Transform Your Sex Life by Emily Nagoski Ph.D.  Becoming Cliterate: Why Orgasm Equality Matters--And How to Get It by Laurie MintzThe American Association of Sexuality Educators, Counselors and Therapists (AASECT) (great resources as well as a place to find a certified sex therapist)Give us a follow us on social media @TheGutHealthPodcast, where we'd love for you to share your thoughts, questions, and experiences. 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.

Heather Happenstance Rockaway Pointe's girl about town and roving reporter is at it again as she joins an adventure to find the hairy man beast terrorizing the beings at Whistling Gulch Retreat in the Forest of the Forbidden. She'll encounter multiple paramours, strange creatures, the Forest of the Forbidden Bears, and her own inner secrets and shadows as she works with the newly appointed Ranger Haniford to solve the mystery of the beast and the strangely severed hand that weirdly resembles that of her ex husband and rock star Blaze Mulholland. THANKS FOR Being here

No weights for home pole dance conditioning? No problem! Dr. Rosy Boa addresses how pole dancers can build strength at home without gym access or heavy weights. She explains the basic strength principle of applying load and allowing recovery, noting weights are the most efficient for rapid, targeted gains, with free weights often preferable to machines for pole due to stabilization and range-of-motion demands. She then covers three accessible alternatives: isometrics (80–100% maximal effort holds for 1–5 seconds, scaling well but joint-angle specific), scalable bodyweight training (using variations such as changing points of contact, lever length, duration, reps, and power), and resistance bands (types, selecting by length/shape/resistance, variable tension through range, latex cautions, and use for assistance/spotting). She emphasizes consistency, enjoyable training, and doing the conditioning you will actually do.Are you a pole nerd interested in trying out online pole classes with Slink Through Strength? We'd love to have you! Use the code “podcast” for 10% off the Intro Pack and try out all of our unique online pole classes: https://app.acuityscheduling.com/catalog/25a67bd1/?productId=1828315&clearCart=true  Chapters:00:00 Welcome and Topic00:58 Membership Shoutouts02:59 Strength Basics05:56 Isometrics Explained09:11 Bodyweight Training12:04 Scaling Difficulty16:55 Resistance Bands24:52 Consistency Over Intensity28:47 Wrap Up and Invite Citations: Weights (machines or free weights) do have the largest effect size in building strength... but that's not necessarily our only goalWiedenmann T, Held S, Morat T, Rappelt L, Isenmann E, Berndsen E, Hopp NH, Donath L. The Effects of Different Resistance Training Modalities on Muscle Strength in Community-Dwelling Older Adults: A Network Meta-Analysis. Gerontology. 2025;71(7):576-588. doi: 10.1159/000546346. Epub 2025 May 27. PMID: 40452461. Isometrics scale with strength! (but you gotta PUSH: 80 - 100% effort and hold for a couple seconds)Lum D, Barbosa TM. Brief Review: Effects of Isometric Strength Training on Strength and Dynamic Performance. Int J Sports Med. 2019 May;40(6):363-375. doi: 10.1055/a-0863-4539. Epub 2019 Apr 3. PMID: 30943568. Bands do help with strength, might be more helpful with explosive/powerStanković D, Lazić A, Trajković N, Okičić M, Bubanj A, Vencúrik T, Gašić T, Bubanj S. Effects of Elastic Band Training on Physical Performance in Team Sports: A Systematic Review and Meta-Analysis. J Funct Morphol Kinesiol. 2025 Oct 17;10(4):402. doi: 10.3390/jfmk10040402. PMID: 41133592; PMCID: PMC12551113.

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!

GLOW stands for Guided Layout & Output Workflow — a guided, confidence-building accessibility experience built for real publishing workflows. The GLOW Accessibility Toolkit helps authors, publishers, and organizations produce documents that comply with the American Council of the Blind Large Print Guidelines and WCAG 2.2 Level AA. The toolkit audits, fixes, and templates Word, Excel, PowerPoint, Markdown, PDF, and ePub documents for accessibility. Presenter Contact Info Email: jeff@jeffbishop.com GLOW website: https://glow.bits-acb.org/about/

En este episodio con motivo del día de las madres en México, Any trae una recomendación que habla de La Madre una novela de Fiona Barton. También hablamos de algunos recuerdos y anécdotas de esos días festivos. La trama se dispara cuando se encuentran los restos de un bebé en una zona de construcción en Londres, un hallazgo que desentierra un misterio de hace décadas. La narrativa se estructura a través de varias perspectivas:Kate Waters: La periodista que busca la exclusiva, pero que se ve envuelta emocionalmente en el caso.Angela: Una madre cuyo bebé fue robado del hospital años atrás y que vive con la eterna esperanza de encontrar respuestas.Emma: Una joven que guarda secretos oscuros sobre su propio pasado y su familia.“A veces, los secretos son la única forma de mantener a una familia unida, hasta que el peso de la verdad se vuelve insoportable”.La Madre - Fiona BartonSíguenos en nuestras redes sociales

In this special Complex Care Journal Club podcast episode, co-hosts Drs. Emily Goodwin, Kristie Malik, and Kathleen Huth interview presenters of posters and oral abstracts relevant to the care of children with medical complexity at the Pediatric Academic Societies (PAS) 2026 annual meeting, as well as at a pre-PAS event focused on home- and community-based care and training in complex care. Speakers describe their key findings, messages for care teams including patients and families, and opportunities to translate their findings into practice.‌ SPEAKERS Flor Arellano, MPH Clinical Research Coordinator, University of California, Los Angeles Jennifer Arnold, MD, MSc Medical Director, Skeletal Health, Boston Children's Hospital Ryan Brewster, MD Neonatal- Perinatal Medicine Fellow, Stanford University School of Medicine Meg Comeau, MHA Senior Project Director, Center for Innovation in Social Work & Health, Boston University School of Social Work John Greenwood, PT Executive Director for Physical Therapy, Occupational Therapy and Rehabilitation Services, Boston Children's Hospital Elaine Lin, MD Complex Care Pediatrician, Boston Children's Hospital Michelle Macy, MD, MS Professor of Pediatrics, Northwestern University Feinberg School of Medicine Scientific Director, Community, Population Health, and Outcomes, Research and Evaluation Center, Ann & Robert H. Lurie Children's Hospital of Chicago Ashley Nmoh, BA Medical Student, Duke University School of Medicine Jennifer Peralta, MD, MSHPN Assistant Clinical Professor, University of California, Los Angeles Nora Renthal, MD, PhD Assistant Professor of Pediatric Endocrinology, Boston Children's Hospital Erin Ward, MEd Patient Engagement Consultant, Complex Care Service, Boston Children's Hospital HOSTS Emily J. Goodwin, MD Clinical Associate Professor of Pediatrics, University of Missouri Kansas City School of Medicine Pediatrician, General Academic Pediatrics Beacon Program, Children's Mercy Kansas City Kristina Malik, MD Assistant Professor of Pediatrics, University of Colorado School of Medicine Medical Director, KidStreet Pediatrician, Special Care Clinic, Children's Hospital Colorado Kathleen Huth, MD, MMSc Pediatrician, Complex Care Service, Division of General Pediatrics, Boston Children's Hospital Assistant Professor of Pediatrics, Harvard Medical School DATE Initial publication date: May 11, 2026. ARTICLES REFERENCED - Brewster RC, Kats DJ, Elborki M, Chilukuri N, Ray M, Shaar N, Hron J, Khan A. Clinical Outcomes of Postedited Artificial Intelligence Translation for Discharge Instructions. Hosp Pediatr. 2026 Apr 10:e2025008986. doi: 10.1542/hpeds.2025-008986. Epub ahead of print. PMID: 41956490. - FamilyCIRCLE. University of Wisconsin–Madison, Department of Pediatrics. Accessed May 4, 2026. https://familycircle.pediatrics.wisc.edu/ - Pediatric Academic Societies. Online program guide. Accessed May 4, 2026. https://2026.pas-meeting.org/ - Pediatric Academic Societies. Who we are. Accessed May 4, 2026. https://www.pas-meeting.org/about/ - Pediatric Academic Societies. Academic Pediatric Association (APA) awards. Accessed May 4, 2026. https://www.pas-meeting.org/2026-awards-apa/‌ TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/k7qqm93qqpqgb5k3jw4f3w2t/PAS_2026_conference_transcript_5-8-26‌ Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6. CITATION Goodwin EJ, Malik K, Arellano F, Arnold J, Brewster R, Comeau M, Greenwood J, Lin E, Macy M, Nmoh A, Peralta J, Renthal N, Ward E, Huth K. Practice-Changing Research in Complex Care at the Pediatric Academic Societies 2026 Annual Meeting. 05/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/practice-changing-research-in-complex-care-pediatric-academic-societies-2026.

In this episode of PICU Doc on Call, Dr. Monica Gray and Dr. Pradip Kamat chat about flexible fiberoptic bronchoscopy (FFB) in the pediatric ICU. They walk through a case involving an eight-year-old who's dealing with respiratory failure after a stem cell transplant. Along the way, they talk about when and why you might use bronchoscopy both for diagnosis and treatment—plus how to approach sedation and what effects the procedure can have on the heart and lungs. They also dive into important topics like managing hypoxia, handling increased airway and pulmonary vascular resistance, and what to keep in mind if your patient has a traumatic brain injury. The episode wraps up with tips for managing fever after the procedure and a quick look at how rigid bronchoscopy compares.Show Highlights:Use of flexible fiberoptic bronchoscopy (FFB) in the pediatric ICU (PICU)Indications for performing bronchoscopy (diagnostic and therapeutic)Management of sedation and analgesia during bronchoscopyCardiovascular effects associated with bronchoscopy proceduresRespiratory effects and complications during bronchoscopySpecial considerations for bronchoscopy in patients with traumatic brain injury (TBI)Post-procedure complications, including fever and its managementOverview of rigid bronchoscopy and its indicationsImportance of understanding physiological changes during bronchoscopyEducational focus on acute pediatric care for current and aspiring PICU internsReferences:Reference 1: Sachdev A, Chhawchharia R. Flexible Fiberoptic Bronchoscopy in Pediatric Practice. Indian Pediatr. 2019 Jul 15;56(7):587-593. PMID: 31333214.Reference 2: Li SX, Tao XF, Wu HJ, Jin F, Zhu GH, Wang YS, Tang LF, Chen ZM, Wu L. Advances in pediatric flexible bronchoscopy. World J Pediatr. 2025 Oct;21(10):945-956. doi: 10.1007/s12519-025-00967-7. Epub 2025 Oct 4. PMID: 41045338; PMCID: PMC12578761.Reference 3: Truitt BA, Kasi AS, Kamat PP, Fundora MP, Simon DM, Guglani L. Cryoextraction via flexible bronchoscopy in children with tracheobronchial obstruction. Pediatr Pulmonol. 2023 Sep;58(9):2527-2534. doi: 10.1002/ppul.26540. Epub 2023 Jun 23. PMID: 37350368.

In which we interview Rani Elwy about her work at the intersection of implementation science and policy as she served as a Robert Wood Johnson health policy fellow in the US Senate focusing on menopause care. We discuss menopause policy, stigma, implementation and deimplementation challenges for menopause care, and what it was like to work as a policy fellow for Senator Patty Murray. Discussed on today's show:  Bauer MS, Kirchner J. Implementation science: What is it and why should I care? Psychiatry Res. 2020 Jan;283:112376. doi: 10.1016/j.psychres.2019.04.025. Epub 2019 Apr 23. PMID: 31036287. Lane-Fall MB, Curran GM, Beidas RS. Scoping implementation science for the beginner: locating yourself on the "subway line" of translational research. BMC Med Res Methodol. 2019 Jun 28;19(1):133. doi: 10.1186/s12874-019-0783-z. PMID: 31253099; PMCID: PMC6599376.

I say this with my full chest — Undertone was not lying when it said that it is "the scariest movie you'll ever hear." And I cannot un-hear it!In this spoiler-free episode, I explore Undertone (2025) and the psychology of sound.I talk about:How sound can help us form secure attachments The psychology behind "therapist voice"How sound helps regulate our nervous systemsWhy we are naturally drawn to live music as a primal actHow silence can help grow your brainHow the 8 of wands tarot card helps us explore our relationship to silence and the unknown Mental Health is Horrifying is hosted by Candis Green, Registered Psychotherapist and owner of Many Moons Therapy...............................................................Show Notes:Tarot for Creative Therapists — Join the waitlist for this course designed for mental health professions who want to learn how to confidently and ethically incorporate tarot into clinical work. (https://candisgreen.podia.com/tarot-for-creative-therapists)Podcast artwork by Chloe Hurst at Contempo MintTheme music is by Sound Gallery by Dmitry Taras via pixabay Thunder by Music by John Britton from PixabayAll sound effects and music via pixabay Undertone (2025)See ‘Undertone' with Dolby Atmos, or You'll Miss Half the HorrorEnhancing the Raw Sound of ‘Undertone' – with David Gertsman and Jon LawlessIan Tuason haunted his own house when making his new horror filmBady SL. The voice as a curative factor in psychotherapy. Psychoanal Rev. 1985 Fall;72(3):479-90. PMID: 3931132. Soma CS, Knox D, Greer T, Gunnerson K, Young A, Narayanan S. It's not what you said, it's how you said it: An analysis of therapist vocal features during psychotherapy. Couns Psychother Res. 2023 Mar;23(1):258-269. doi: 10.1002/capr.12489. Epub 2021 Nov 18. PMID: 36873916; PMCID: PMC9979575. Sawamura, Yasuaki, Why We Overstimulate Ourselves: How Sensory Overload Blocks Memory and Weakens Learning (March 31, 2025). How Music Resonates in the BrainGentle Whispering ASMR Moonlight Cottage ASMR 

You know how, when teaching finishes for the summer, you feel all-powerful and end up vastly over-estimating how much you'll be able to get done before the new academic year? And, have you ever noticed that the opposite happens once term starts up again: you're overwhelmed, you panic because you don't think you're going to manage to do everything, but then you surprise yourself and it's all fine in the end? Yeah, well, there's a reason for that. Join your imperfectionist pal for a speculative little dive into the psychology of perception, and some ideas about how you can smooth out the bumps and make nice, sensible plans all year round.ReferencesBalcetis E, Dunning D. Cognitive dissonance and the perception of natural environments. Psychol Sci. 2007 Oct;18(10):917-21. doi: 10.1111/j.1467-9280.2007.02000.x. PMID: 17894610.Balcetis E, Dunning D. Wishful seeing: more desired objects are seen as closer. Psychol Sci. 2010 Jan;21(1):147-52. doi: 10.1177/0956797609356283. Epub 2009 Dec 17. PMID: 20424036.Proffitt DR, Bhalla M, Gossweiler R, Midgett J. Perceiving geographical slant. Psychon Bull Rev. 1995 Dec;2(4):409-28. doi: 10.3758/BF03210980. PMID: 24203782.Proffitt DR, Stefanucci J, Banton T, Epstein W. The role of effort in perceiving distance. Psychol Sci. 2003 Mar;14(2):106-12. doi: 10.1111/1467-9280.t01-1-01427. PMID: 12661670.Schnall S, Zadra JR, Proffitt DR. Direct evidence for the economy of action: glucose and the perception of geographical slant. Perception. 2010;39(4):464-82. doi: 10.1068/p6445. PMID: 20514996; PMCID: PMC3298360.

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/

En este episodio compartimos una lectura conjunta que disfrutamos muchísimo. Todo comenzó cuando Any empezó a leer El último invitado de la boda de Jason Rekulak, autor del que ya habíamos reseñado una obra anteriormente. Como Mixbuscaba algo distinto a sus lecturas habituales, le pidió una recomendación a Any, quien ya llevaba más del 50% del libro. Decidieron terminarlo juntos, compartiendo dudas y teorías hasta llegar al final.La historia nos presenta a Frank, un padre que siempre ha intentado darle lo mejor a su única hija, Maggie. Sin embargo, tras una serie de decisiones rebeldes por parte de ella, la comunicación entre ambos se rompió por completo. Después de un largo tiempo de silencio, Frank recibe una llamada inesperada: Maggie lo invita a su boda.Resulta que Maggie tiene una relación con un joven artista y hay planes de matrimonio. Ahora, Frank deberá viajar para conocer no solo a su futuro yerno, sino también a toda su nueva familia política. Y lo que todo parece felicidad se convertirá en un desenlace inesperado para Frank.Amamos los personajes de Frank, la hermana Tammy y la niña Abigail.Consigue la novela en el siguiente enlace y no te olvides de compartir este episodio, coméntanos que te pareció, si ya has leído esta novela o algo mas de este autor. El último invitado de la boda - Jason RekulakSíguenos en nuestras redes sociales

The belief that IV dextrose is necessary to clear ketones in hyperemesis gravidarum originated from a logical, and now known to be outdated, extrapolation of basic starvation ketosis physiology and the treatment paradigm for diabetic ketoacidosis (DKA). The original experiments that led to this conclusion go back to the 1960s (Foster data). Not only is this outdated, but it is also physiologically incorrect. We've learned a lot about IV fluid replacement about hyperemesis gravidarum in the last several years- in the last data review was in January 2026 in Lancet. Even the correction of hyponatremia has evolved. Should we be following urine ketones for patients being treated for HG? Is Dextrose needed? Listen in for details.1. Nana M, Painter R, Williamson C et al. Hyperemesis gravidarum. The Lancet, Jan 2026; 407, 78-892. Clark SM, Zhang X, Goncharov DA. Inpatient Management of Hyperemesis Gravidarum. Obstet Gynecol. 2024 Jun 1;143(6):745-758. doi: 10.1097/AOG.0000000000005518. Epub 2024 Feb 1. PMID: 38301258.3. Ayus JC, et al.Correction rates and clinical outcomes in hospitalized adults with severe hyponatremia: a systematic review and meta-analysis. JAMA Intern Med. 2025;185(1):38-51. 4. ACOG Clinical Epert Series: Inpatient Management of Hyperemesis Gravidarium. Obstet Gynecol; 2024

From Barbara Robertson and Nancy Mohrbacher: Using new research in clinical practice? How do we do this? When is it time to let go of our old ways of doing things and incorporate new information? These are some of the questions Nancy and Barbara discuss in this episode of All Things Breastfeeding. Sometimes, incorporating new research in clinical practice is easy. It can be an “ah-ha” moment. Nancy had this when she learned about Suzanne Colson’s research on releasing babies’ reflexes to stimulate breastfeeding. She knew Suzanne’s description was true and immediately began incorporating Suzanne’s ideas into her practice. Barbara had this type of moment when she read Nancy’s article, “The Magic Number.” On the other hand, we can also suffer from confirmation bias. We may want to believe that we can use human milk for longer than the current recommendations (see article below), so we are happy when a study suggests this might be true. On the other hand, it can take 17 years or longer for research to become clinical practice. When should we wait? When is it time to change? Some clear guidance both Nancy and Barbara use is: “Will it be harmful?” It does not harm anyone to start playing around with latch and positioning, or adding extra milk removals, for someone struggling with milk supply. Take a listen to learn more about Nancy’s and Barbara’s thoughts on this subject. Enjoy! Resources: Colson SD, Meek JH, Hawdon JM. Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Hum Dev. 2008 Jul;84(7):441-9. doi: 10.1016/j.earlhumdev.2007.12.003. Epub 2008 Feb 19. PMID: 18243594.: https://pubmed.ncbi.nlm.nih.gov/18243594/ Anders, L. A., Mesite Frem, J., & McCoy, T. P. (2025). Flange size matters: A comparative pilot study of the Flange FITSTM guide versus traditional sizing methods. Journal of Human Lactation, 41(1), 54-64. https://pubmed.ncbi.nlm.nih.gov/39614713/ Mohrbacher, N. (2011). The Magic Number and Long-Term Milk Production. Clinical Lactation 2(1), 15-18. https://lactalearning.com/wp-content/uploads/2025/07/MohrbacherMagicNumber2011.pdf All Things Breastfeeding Episode 108: Tongue Tie Update: https://lactalearning.com/tongue-tie-update/ Scharff, A. Z., Sedlacek, L., de Oliveira Mekonnen, A., Liolios, I., Ritter, S., Fuchs, F., & Happle, C. (2026). Leftover Infant Milk After Bottle Feeding: Parental Practices and Microbiological Findings. medRxiv, 2026-02. https://www.medrxiv.org/content/10.64898/2026.02.13.26346179v1 The post All Things Breastfeeding Episode 110: Using Research in Clinical Practice appeared first on The Breastfeeding Center of Ann Arbor.

CardioNerds Drs. Dinu Balanescu, Billy-Joe Mullinax, and Mariana Garcia discuss systemic thrombolysis in pulmonary embolism with expert Dr. Allison Burnett. Audio editing by CardioNerds Academy intern, student doctor, Pace Wetstein. Pulmonary embolism is the third leading cause of cardiovascular death in the US, and high-risk PE carries a 30-day mortality risk as high as 30-50%. In this episode, we discuss the indications for systemic thrombolysis, including high-risk PE and cardiac arrest. We addressed how to appropriately select candidates for systemic thrombolysis, balancing the high risk of bleeding. Additionally, we discussed anticoagulation management and timing concurrent with lytic therapy, as well as the importance of multidisciplinary PERT teams.  The 2026 American multi-society PE guidelines were published after this episode was recorded. Dr. Dinu Balanescu and Dr. Billy-Joe Mullinax are Co-chairs for the CardioNerds PE Series, developed in collaboration with the PERT Consortium.   Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Pulmonary Embolism PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Risk stratification is crucial in acute pulmonary embolism care. Based on the ESC 2019 guidelines, low-risk PE patients are those who are normotensive with no evidence of right ventricular dysfunction. Intermediate risk includes two categories: intermediate-low, with normotensive patients who have a high PE score with negative biomarkers, and intermediate-high risk, which has elevated biomarkers or signs of RV strain. High-risk PE includes hemodynamically unstable patients (SBP

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

“GOOD VIBRATIONS”: Its not just a Marky Mark song, but it is also part of GYNECOLOGIC SEXUAL HEALTH! In this episode, we will highlight an April 2026 new qualitative study on women's vibrator use, as well as a separate publication (on a similar topic) also released in April 2026 in the journal Menopause.1. Leong KA, Carlton CE, Deverdis EC, Grimes CL, Jacobs BE, Rogers RG, Roberts BL. Intimacy and empowerment in urogynecology: a qualitative exploration of vibrator use. Am J Obstet Gynecol. 2026 Apr;234(4):1103-1111. doi: 10.1016/j.ajog.2025.11.037. Epub 2025 Dec 2. PMID: 41344528.2. Lehmiller JJ, Graham CA, Ferrall L, Mendelson EA, Prine MS. The role of masturbation in relieving symptoms associated with menopause. Menopause. 2026 Apr 1;33(4):384-394. doi: 10.1097/GME.0000000000002675. PMID: 41217890; PMCID: PMC13011940.

Contributor: Aaron Lessen, MD Educational Pearls: What are the common causes of agitation in the elderly? Baseline dementia causing a behavioral disturbance Delirium precipitated by an acute medical problem such as a UTI, pneumonia, overdose/side effect of home medications, urinary retention, constipation, pain, hypoxia, electrolyte abnormality, etc. Exacerbation of a primary psychotic condition such as schizophrenia or bipolar disorder. What environmental changes can help reduce agitation? Maintain a quiet, calm, uncluttered environment Dim the lights Ensure the patient has their glasses, hearing aids, and dentures Avoid excessive lines such as foleys Minimize restraints and other forms of immobilization Reassure the patient frequently and have the family check in with the patient What are the best options if medications are required? If the patient is unsafe or non-pharmacologic measures fail, consider a second-generation ("atypical") antipsychotic using the lowest effective dose: Olanzapine Risperidone Quetiapine One special consideration is Dementia with Lewy Bodies, which can be very sensitive to antipsychotics. In this case, Quetiapine is the preferred agent. Avoid when possible: Diphenhydramine and other anticholinergics, which can worsen delirium (including urinary retention and sedation) Benzodiazepines, which may worsen confusion, falls, and respiratory depression Haloperidol, which has a higher risk of extrapyramidal symptoms and QT prolongation than many atypicals References Badwal K, Kiliaki SA, Dugani SB, Pagali SR. Psychosis Management in Lewy Body Dementia: A Comprehensive Clinical Approach. J Geriatr Psychiatry Neurol. 2022 May;35(3):255-261. doi: 10.1177/0891988720988916. Epub 2021 Jan 19. PMID: 33461372. Kurlan R, Cummings J, Raman R, Thal L; Alzheimer's Disease Cooperative Study Group. Quetiapine for agitation or psychosis in patients with dementia and parkinsonism. Neurology. 2007 Apr 24;68(17):1356-63. doi: 10.1212/01.wnl.0000260060.60870.89. PMID: 17452579. Shenvi C, Kennedy M, Austin CA, Wilson MP, Gerardi M, Schneider S. Managing Delirium and Agitation in the Older Emergency Department Patient: The ADEPT Tool. Ann Emerg Med. 2020 Feb;75(2):136-145. doi: 10.1016/j.annemergmed.2019.07.023. Epub 2019 Sep 26. PMID: 31563402; PMCID: PMC7945005. Summarized and edited by Jeffrey Olson, MS4 Donate: https://emergencymedicalminute.org/donate/ Join our mailing list: http://eepurl.com/c9ouHf

A career in surgery has a profound impact on those who practice the craft. High rates of poor mental health are well described but incompletely understood. One potential mechanism for advancing our understanding of surgeon well-being is studying surgeons' emotional experiences. Shame, a self-conscious emotion reflecting how an individual feels about themselves, could be a particularly powerful lens. In this series on shame in surgery, we explore what we know about shame in surgery and what shame can tell us about learning and working as surgeons.In this third episode, we talk with Drs. Sheina Theodore and Tejal Brahmbhatt about their study examining the relationship between internalized shame states and burnout among surgery residents. They make a compelling case that addressing the well-being crisis in surgery requires looking beyond external stressors to the internal experience of shame: the quiet, invisible voice that tells residents they aren't good enough, and ask what role the culture of surgery plays in that internal monologue. Host: Steven ThorntonGuests:1.    Sheina Theodore (Assistant Professor of Surgery, Boston University)2.    Tejal Brahmbhatt (Associate Professor of Surgery, Cedars Sinai Medical Center) Publications Discussed:1.    Smith SM, Kobzeva-Herzog A, McGillen P, Castagne-Charlotin M, Davies J, Sanchez SE, Dechert T, Brahmbhatt TS, Theodore S. Internalized Shame Experiences and Burnout in General Surgery Residents. J Surg Educ. 2025 Apr;82(4):103447. doi: 10.1016/j.jsurg.2025.103447. Epub 2025 Feb 6. PMID: 39919584. https://pubmed.ncbi.nlm.nih.gov/39919584/***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

A career in surgery has a profound impact on those who practice the craft. High rates of poor mental health are well described but incompletely understood. One potential mechanism for advancing our understanding of surgeon well-being is studying surgeons' emotional experiences. Shame, a self-conscious emotion reflecting how an individual feels about themselves, could be a particularly powerful lens. In this series on shame in surgery, we explore what we know about shame in surgery and what shame can tell us about learning and working as surgeons. In this second episode, we talk with Dr. ElAbd and Dr. Zammit about their study examining the relationship between shame-based learning, grit, and burnout across surgical specialties. Their findings highlight how grit may both protect against burnout and mediate whether residents go on to shame others. Host: Steven ThorntonGuests:1.    Rawan ElAbd (Plastic Surgery Resident, McGill University)2.    Dino Zammit (Assistant Professor of Plastic Surgery, McGill University)Publications Discussed:1.    ElAbd R, Pu L, Esmonde-White C, ElHawary H, Vorstenbosch J, Zammit D. Association of Grit and Shame Based Learning on Burnout in Surgical Training: A Single Institution Analysis. J Surg Educ. 2025 Sep;82(9):103583. doi: 10.1016/j.jsurg.2025.103583. Epub 2025 Jun 27. PMID: 40580606.https://pubmed.ncbi.nlm.nih.gov/40580606/***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

A career in surgery has a profound impact on those who practice the craft. High rates of poor mental health are well described but incompletely understood. One potential mechanism for advancing our understanding of surgeon well-being is studying surgeons' emotional experiences. Shame, a self-conscious emotion reflecting how an individual feels about themselves, could be a particularly powerful lens. In this series on shame in surgery, we explore what we know about shame in surgery and what shame can tell us about learning and working as surgeons.In this first episode, we talk with Dr. Will Bynum and Professor Luna Dolezal about how they understand shame in medicine, why it's so hard to see even when it's everywhere, and how developing what they call "shame competence" might be one of the most important steps we can take toward humanizing surgical training.Host: Steven ThorntonGuests: Will Bynum (Associate Professor of Family Medicine, Duke University) Luna Dolezal (Professor of Philosphy and Medical Humanities, Exeter University) Publications Discussed: Dolezal L, Bynum W. Shame competence: addressing the effects of shame in health care. Lancet. 2024 Oct 19;404(10462):1514-1515. doi: 10.1016/S0140-6736(24)02269-4. PMID: 39426826. https://pubmed.ncbi.nlm.nih.gov/39426826/ The Nocturnists. Shame in Medicine: The Lost Forest [podcast series]. The Nocturnists; 2022. https://thenocturnists.org/shameinmedicine Nguyen LN, Bynum WE 4th. When I Say…self-conscious emotions. Med Educ. 2021 Mar;55(3):291-292. doi: 10.1111/medu.14425. Epub 2020 Dec 23. PMID: 33289140. https://pubmed.ncbi.nlm.nih.gov/33289140/ Tracy, J. L., Robins, R. W., & Tangney, J. P. (Eds.). (2007). The self-conscious emotions: Theory and research. The Guilford Press. ***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