Podcast appearances and mentions of erasmus medical center

With Robert M.A. van der Boon, Erasmus Medical Center, Rotterdam - The Netherlands, and Anuradha Lala, Mount Sinai Fuster Heart Hospital, New York City - USA. In this episode of HFA Cardio talk, we dive into how factors like sex, socio-economics status and ethnicity shape the way heart failure presents and progresses in different populations. We'll discuss why recognizing these differences is critical for accurate diagnosis and effective treatment and highlight practical steps clinicians can take to close the gaps in prevention and care. Papers: https://onlinelibrary.wiley.com/doi/10.1002/ejhf.2534 https://academic.oup.com/eurheartj/article/40/47/3859/5652224?login=true https://www.sciencedirect.com/science/article/pii/S1071916421004322?via%3Dihub https://www.sciencedirect.com/science/article/pii/S0002914922010074?via%3Dihub https://www.sciencedirect.com/science/article/pii/S2468266719301082?via%3Dihub https://journals.lww.com/co-cardiology/fulltext/2021/05000/racial_and_ethnic_disparities_in_heart_failure_.12.aspx https://onlinelibrary.wiley.com/doi/10.1002/ehf2.14986   This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.

Learn about the fascinating story behind the intriguing Human metapneumovirus (hMPV) and how it was first discovered. Why were parents once asked about contact with birds? How can the recent outbreak in China make a difference? Join an insightful conversation with distinguished guests and leading experts Ab Osterhaus, Member of the ESWI board and Director of the Center of Infection Medicine and Zoonosis Research and Guest-Professor at the University of Veterinary Medicine Hannover, Germany, who first identified the virus together with Bernadette van den Hoogen, Associate Professor at Erasmus Medical Center in Rotterdam, and Ann Falsey, Professor of Medicine, Infectious Diseases, and co-director of the Vaccine Treatment and Evaluation Unit at the University of Rochester School of Medicine.They tease out the subtle differences between HMPV, flu, and RSV, discuss the burden of disease, the role of diagnostics and the importance of fundamental research. Plus, why does public awareness matter and could a name change be on the horizon?

Editor in Chief Dr. Sue Yom and Associate Editor Dr. Neil Taunk, Assistant Professor of Radiation Oncology and Chief of the Gynecologic Radiation Service at the University of Pennsylvania, co-host a podcast on "Biomarker expression and impact on clinical outcomes in an international study of chemoradiation and MRI-based image-guided brachytherapy for locally advanced cervical cancer: BIOEMBRACE," with guests Dr. Supriya Chopra, Professor at Tata Memorial Centre in Mumbai, India, and Dr. Remi Nout, Professor and Head of the Department of Radiotherapy of the Erasmus Medical Center, University Medical Center, in Rotterdam, Netherlands, who were the first and last authors and both principal investigators of the BIOEMBRACE study.

In this episode of Lung Cancer Considered, host Dr. Stephen Liu discusses the recently approved bispecific T-cell engager, tarlatamab, for small cell lung cancer. Guest: Dr. Anne-Marie Dingemans is a pulmonologist and Professor of Thoracic Oncology at Erasmus Medical Center in Rotterdam, the Netherlands. Guest: Dr.Ryan Gentzler is an Associate Professor and Director of the Thoracic Oncology Clinical Research Program at the University of Virginia

DMEA, Connecting Digital Health Messe und Kongress, in Berlin hat alle Erwartungen übertroffen: Über 800 nationale und internationale Aussteller, etwa 350 Referenten und 18.600 Teilnehmer:innen. Wir waren mit unserem MehrEinsatzWagen dabei.  In der Folge 35 unseres Podcasts berichten Tobias Gantner und Artur Olesch über die Highlights der DMEA. Wir werfen einen Blick auf die Kassandra-Apotheke – eine aus LEGO-Steinen gebaute Apotheke der Zukunft. Haben sich die Besucher:innen der DMEA von dem Konzept der digitalen Gesundheit überzeugen lassen, um eine drohende Katastrophe im Gesundheitswesen abzuwenden?  Wir fassen die Live-Aufzeichnung unseres Podcasts mit Marghrieta Greet Vink (Direktorin des Smart Health Tech Center am Erasmus Medical Center in Rotterdam) und Peter Gocke (Chief Digital Officer an der Charité) zusammen. Margrietha sagte, sie fühle sich ein wenig wie in einer archäologischen Ausstellung, denn viele der Themen, die wir gerade in Deutschland verhandeln – wie zum Beispiel die elektronische Patientenakte (ePA) – sind seit vielen Jahren in den Niederlanden bereits erledigt. Ansonsten erklären wir, was Peter Gocke meinte, als er sagte: "If Charité were a hotel, it would be a one-star hotel only."  Wir befassen uns mit dem Vortrag des Bundesgesundheitsministers Karl Lauterbach, in dem er betonte, dass die breitere Nutzung von Gesundheitsdaten die Forschung und Entwicklung, auch im Bereich der KI-Lösungen, unterstützen sollte. "Diese KI kann Leben retten – außer in Deutschland. Wir haben die Verpflichtung, diesen Schatz zu heben", sagte Sacha Lobo. War seine Keynote wirklich der Höhepunkt der diesjährigen DMEA?  Außerdem berichten wir von der Debatte "Neue Wege der Versorgung im ländlichen Raum" und dem Satelliten-Event "Nordische Nacht" in den Nordischen Botschaften in Berlin, wo das Thema des Europäischen Gesundheitsdatenraums, European Health Data Space EHDS, im Mittelpunkt stand.  Zum Schluss treffen wir Dr. Georg Münzenrieder, Referatsleiter im Referat 12 - Grundsatzangelegenheiten der Digitalisierung in Gesundheit und Pflege, Zukunfts- und Innovationsprojekte im Bayerischen Staatsministerium für Gesundheit, Pflege und Prävention.  Vielen Dank an den Bundesverband der Pharmazeutischen Industrie (BPI) für die Unterstützung.  Kassandra Apotheke: https://www.linkedin.com/posts/healthcare-futurists-gmbh_dmea-healthcaremakermobil-activity-7185217501599801344-Cm0L?utm_source=share&utm_medium=member_desktop  HealthCare Futurists: https://www.linkedin.com/company/healthcare-futurists-gmbh/posts/?feedView=all  Tobias Gantner: https://www.linkedin.com/in/dr-tobias-daniel-g-bb4a832/  Artur Olesch: https://www.linkedin.com/in/arturolesch/ Schreibt uns Eure Kommentare gerne an MehrEinsatzWagen@healthcarefuturists.com und vernetzt euch mit uns auf unseren Social Media Kanälen.

In der aktuellen Folge haben wir Prof. Dr. Irwin Reiss, Neonatologe und pädiatrischer Intensivmediziner, und seit 2011 Leiter der Neonatologie am Erasmus Medical Center in Rotterdam, zu Gast. Wir sprechen mit ihm darüber, was sich durch die Einbeziehung von Technik in der Versorgung von Neugeborenen für Möglichkeiten ergeben haben und wie es in den 90er Jahren ausgesehen hat. Wir fragen ihn, welche gamechanger unser Management in der klinischen Praxis verändert haben und welche Vorteile, aber auch Gefahren, diese Entwicklungen auch bergen. Außerdem gibt Prof. Dr. Reiss Literaturempfehlungen und gibt jungen Kollegen oder Kolleginnen Tipps für ihre weitere wissenschaftliche bzw. klinische Karriere.

On the version of Hot off the Wire posted Sept. 29 at 7:06 a.m. CT: WASHINGTON (AP) — The House is in a familiar position with little time left to prevent a government shutdown: It's effectively paralyzed as conservatives feud with Speaker Kevin McCarthy. The California congressman has pushed his Republican conference to embrace a short-term spending plan that would include a sweeping Republican proposal for the southern border. But a small group of hard-line conservatives has defied McCarthy's leadership in a quest to get rid of stopgap funding plans even if it means a government shutdown. The conflict has resulted in a House Republican conference struggling to pass spending legislation just as government funding expires. The deadline is Saturday. WASHINGTON (AP) — House Republicans have spent more than six hours making their case for pursuing an impeachment inquiry against President Joe Biden. They launched their first hearing Thursday promising to “provide accountability” as they probe the family's finances and the lucrative business dealings of Biden's son Hunter. Republicans so far have shown no hard evidence of wrongdoing by the president, and key witnesses said they do not yet see hard evidence of impeachable offenses. It all comes just before a potential government shutdown. The White House called the hearing a “baseless stunt.” Oversight Chairman James Comer later issued subpoenas for additional Biden family bank records. The National Weather Service is warning of heavy rains and the chance of flooding in the Northeast, including New York City and Connecticut. HONOLULU (AP) — Hawaii authorities are looking for a man who fled with a handgun after getting into a scuffle while trying to talk to soldiers at an Army base. No shots were fired but the Army treated it as an “active shooter situation” and two military bases on Oahu went into lockdown for several hours. The Army is working with the Honolulu Police Department to find the suspect, who is still at large. Wheeler Army Airfield also went into lockdown. Schofield Barracks is on Oahu and is about 20 miles north of Honolulu. It hosts the 25th Infantry Division and the 8th Theater Sustainment Command. QUETTA, Pakistan (AP) — Authorities in Pakistan say at least 52 people were killed and nearly 70 wounded after a powerful bomb exploded in a crowd of people celebrating the Prophet Muhammad's birthday in the southwest of the country. The bombing, one of the deadliest in recent years, occurred in Mastung, a district in Baluchistan province, an area that has witnessed scores of attacks by insurgents. Videos showed an area near a mosque strewn with the shoes of the dead and wounded. Some of the bodies had been covered with bedsheets. Two people were killed in a separate blast at a mosque in the northwest. A champion is crowned in the American League East, the Mariners win a crucial game with a late inning rally, the Blue Jays now have a firm hold on the American League's second wild card spot, the race for the final two wild card spots in the National League remains tight with weather adding a wrinkle to the already tension filled race, and the Lions move to 3-1. On the version of Hot off the Wire posted Sept. 28 at 4 p.m. CT: WASHINGTON (AP) — House Republicans are making the case for pursuing an impeachment inquiry against President Joe Biden. They launched their first hearing Thursday with testimony from outside experts in tax law, criminal investigations and constitutional legal theory. It's a high-stakes opening act for Republicans as as they try to link the business dealings of Biden's son, Hunter, to the president. But so far they have no hard evidence of wrongdoing by the president. it comes just before a potential government shutdown. Oversight Chairman James Comer says they want to “provide accountability” to Americans. But Democrats argued Donald Trump who is Biden's chief rival in 2024 is egging them on, with no evidence of Biden wrongdoing. THE HAGUE, Netherlands (AP) — Police in the Netherlands say a lone gunman wearing a bulletproof vest opened fire in an apartment and a hospital in the Dutch port city of Rotterdam, killing three people, including a 14-year-old girl. The shooting sent patients and medics fleeing the Erasmus Medical Center in downtown Rotterdam, including some who were wheeled out of the building in beds. Police Chief Fred Westerbeke says the shooter was a 32-year-old student from Rotterdam. He was arrested at the hospital carrying a firearm. The suspect's identity has not been released, and the motive for the shootings remains under investigation. WASHINGTON (AP) — The U.S. economy grew at a 2.1% annual pace from April through June, extending its sturdy performance in the face of higher interest rates, the government said Thursday, leaving its previous estimate unchanged. The second-quarter expansion of the nation's gross domestic product — its total output of goods and services — marked a modest deceleration from the economy's 2.2% annual growth from January through March. Consumer spending, business investment and state and local government outlays drove the second-quarter economic expansion. The economy and job market have shown surprising resilience even as the Federal Reserve has dramatically raised interest rates to combat inflation, which last year hit a four-decade high. SAN ANTONIO (AP) — The Pentagon says that the American soldier who sprinted into North Korea across the heavily fortified border between the Koreas more than two months ago was whisked to a Texas Army base for medical checks and interviews after his return to the U.S. North Korea abruptly announced a day earlier that it would expel Pvt. Travis King. The White House says his return was organized with the help of ally Sweden and rival China. While officials have said King is in good health and the immediate focus will be on caring for him and reintegrating him into U.S. society, his troubles are likely far from over. King ran into the North while on a civilian tour of a border village on July 18. Lawmakers probing the cause of last month's deadly Maui wildfire did not get many answers during Thursday's congressional hearing on the role the electrical grid played in the disaster. Hawaii's top public utility officials and the president of Hawaiian Electric testified in the hearing about the role the electrical grid played in last month's deadly Maui wildfire. Hawaiian Electric president Shelee Kimura promised to provide the committee with more details about the timeline that day. The Lahaina fire killed at least 97 people and destroyed more than 2,000 buildings. It erupted on Aug. 8, when strong winds appeared to cause a Hawaiian Electric power line to fall, igniting dry brush and grass near a large subdivision. WELLINGTON, New Zealand (AP) — From Sunday, workers at the main United States base in Antarctica will no longer be able to walk into a bar and order a beer, after the federal agency overseeing the research program decided to stop serving alcohol. The National Science Foundation says researchers and support staff can still buy a weekly ration of alcohol from the McMurdo Station store. But the changes could prove significant because the bars have been central to social life in the isolated environment. The changes come as concerns grow that sexual misconduct has been allowed to flourish at McMurdo. An investigation by The Associated Press last month uncovered a pattern of women who said their claims of sexual harassment and assault were minimized by their employers. BOSTON (AP) — A California man has pleaded guilty to arranging hundreds of sham marriages in an effort to circumvent immigration laws. That is according to federal prosecutors. Forty-nine-year-old Marcialito Biol Benitez, a Philippine national living in Los Angeles, pleaded guilty Wednesday to conspiracy to commit marriage fraud and immigration document fraud. U.S. District Court Judge Denise Casper scheduled sentencing for Jan. 10. The U.S. attorney's office in Boston said Benitez operated a large-scale marriage fraud agency in which he arranged marriages between foreign nationals and American citizens. Prosecutors alleged the agency charged up to $35,000 to submit false paperwork substantiating the sham marriages. NEW YORK (AP) — Hollywood actors will resume negotiations with studios and streaming services next week. The announcement Wednesday comes the same day that a nearly five-month writers strike formally ended. That strike's end quickly led to announcements that TV's late-night hosts would return to the air by Monday. That's the same day negotiators from the Screen Actors Guild-American Federation of Radio and Television Artists will resume talks on a new contract. They've been on strike more than two months, leading to a complete shutdown of movie and film productions. This week's end to the writers strike raised hopes that a deal with actors could be reached soon. LONDON (AP) — Michael Gambon, the Irish-born actor knighted for his long and storied career on the stage and screen and who gained admiration from a new generation of moviegoers with his portrayal of Hogwarts headmaster Albus Dumbledore in six of the eight “Harry Potter” films, has died. He was 82. A statement by his family, issued by his publicist on Thursday, said he died following “a bout of pneumonia.” While the Potter role raised Gambon's international profile and found him a huge audience, he had long been recognized as one of Britain's leading actors. His work spanned TV, theater, film and radio over five decades. He was cast as the much-loved Dumbledore after his predecessor, Richard Harris, died in 2002. DETROIT (AP) — Miguel Cabrera's career will end with the Detroit Tigers on Sunday against Cleveland at Comerica Park, where a sold-out crowd will include a few thousands fans paying for standing-room only tickets to cheer for him one more time. The 12-time All-Star leaves the game with quite a legacy. The popular player has also provided a desperately needed jolt of joy in his native Venezuela during a crisis that has pushed millions into poverty and compelled 7.3 million people to migrate. Cabrera has put himself in the conversation with all-time greats at the plate. NEW YORK (AP) — Elton John, Brandi Carlile, Dave Matthews, H.E.R., Chris Stapleton, St. Vincent and New Edition will perform at this fall's Rock & Roll Hall of Fame induction ceremony, which will be broadcast live for the first time. The ceremony will be live on Disney+ on Nov. 3 and streamable afterward. ABC will air a special featuring performance highlights and standout moments on Jan. 1. The inductees this year include Missy Elliott, Willie Nelson, Sheryl Crow, Chaka Khan, “Soul Train” creator Don Cornelius, Kate Bush and the late George Michael. Nominees were voted on by more than 1,000 artists, historians and music industry professionals. The curtain is finally coming down on Netflix's once-iconic DVD-by-mail service, a quarter century after the birth of a concept that obliterated Blockbuster video stores while providing a springboard into video streaming that has transformed entertainment. The DVD service that has been steadily shrinking in the shadow of Netflix's video streaming service will shut down after its five remaining distribution centers mail out their final discs Friday to the fewer than 1 million remaining subscribers. It marks the end of a service that began when a first-class stamp cost 32 cents, less than half today's price, and went on make its red-and-white envelopes a welcome sight in mailboxes. —The Associated Press About this program Host Terry Lipshetz is a senior producer for Lee Enterprises. Besides producing the daily Hot off the Wire news podcast, Terry conducts periodic interviews for this Behind the Headlines program, co-hosts the Streamed & Screened movies and television program and is the producer of Across the Sky, a podcast dedicated to weather and climate. Lee Enterprises produces many national, regional and sports podcasts. Learn more here.See omnystudio.com/listener for privacy information.

Dr. Michel van Genderen, physician, AI leader and founder of the Datahub at Erasmus Medical Center in the Netherlands, shares his passion for ethical AI in hospitals.  Could AI be a game-changer for the health care industry? Dr. van Genderen thinks so, and explains the two biggest global health care challenges are the shortage of personnel and an increasing health care demand. He believes trustworthy AI could alleviate these pressures and solve clinical challenges faster. For example, Erasmus Medical Center developed an AI model used in the intensive care unit that decreases the administrative workload for nurses.  Using AI in a responsible, ethical and sustainable manner is crucial to its adoption in clinical settings so that health care professionals trust AI when they use it at the bedside. To develop and deploy AI models in clinical settings, a group of multidisciplinary teams comes together, including data scientists, data engineers, physicians, nurses, patients and more, which is the remit of the Datahub at Erasmus Medical Center. Adhering to ethical guidelines is crucial when teams develop models, monitor their performance and adopt them in clinical or operational settings. Dr. van Genderen is optimistic that all industries will be able to benefit from AI, as long as decisions made with analytics and AI are ethical, trustworthy, explainable and fair.

On June 21, 2022, the Erasmus Medical Center in Rotterdam the Netherlands summarily dismissed their scientist Rogier Louwen. Shortly thereafter, we recorded this interview, agreeing to publish it only after the trial would be over. The story Louwen tells is that of a whistleblower who conducted an EU-funded investigation into pandemics. Both internally and externally, he pointed at the potential dangers and risks of the public health strategies chosen at the time, based on sound scientific research, after which he was fired.In his backyard, Louwen candidly tells his first-hand story about the investigation he led, the run-up to the dismissal and what that did to him and his team.On Potkaars: https://potkaars.nl/blog/2023/6/21/i-stood-up-for-the-public-interest-and-risked-everything-for-an-open-scientific-discussion

Duane Peters from the Lupus Foundation of America talks to Dr Sylvia Kamphuis and Dr Javad Wahadat from the Erasmus Medical Center in Rotterdam in the Netherlands about aiming for a Low Lupus Disease Activity State (LLDAS) in children with systemic lupus erythematosus (SLE). They outline the difference between LLDAS and clinical remission (CR), and discuss how LLDAS may be a more achievable target for patients than CR that nevertheless still brings significant clinical benefits in terms of decreasing damage accrual and improving health-related quality of life. Access the paper here: https://lupus.bmj.com/content/8/1/e000571

Dr. Kelly Tappenden interviews Dr. Esther Neelis, a pediatric resident at Erasmus Medical Center in the Netherlands, discussing the gut microbiota and its diet-related activity in children with intestinal failure (IF) receiving parenteral nutrition (PN) compared with those of healthy controls (HC) and in relation to disease characteristics. Business Corporate by Alex Menco | alexmenco.net Music promoted by www.free-stock-music.com Creative Commons Attribution 3.0 Unported License creativecommons.org/licenses/by/3.0/deed.en_US March 2022

T3 #10 Autistics traits and food fussiness - Holly Harris Today we talk to @holly_a_harris about autistic traits and food fussiness or food selectivity. This is work she has been carrying out at Erasmus Medical Centre, in the Netherlands, working on the INTERCEPT project on the Generation R cohort. Hoy hablamos con @holly_a_harris sobre los rasgos autistas y la selectividad alimentaria o el ser remilgoso para comer (food fussiness). Este es un trabajo que ha estado realizando Holly en Erasmus Medical Center, en Holanda, trabajando en el proyecto INTERCEPT en la cohorte Generation R. If you want to read more about this subject, here is a link to an article in The Conversation with Holly and Dr. Rebecca Byrne/ Si quieres leer más sobre este tema, aquí hay un enlace a un artículo en The Conversation con Holly y la Dra. Rebecca Byrne. https://theconversation.com/how-to-tell-if-your-kids-fussy-eating-phase-is-normal-92118 You can watch this video on YouTube/Puedes ver este video en YouTube: https://www.youtube.com/channel/UCDWwrRafBe4ig5AXuQYSBPQ?view_as=subscriber Or listen to it on your favourite podcast platform/ o escuchar en tu plataforma de podcast favorita.

Dr. Graham interviews Dr. Robbert Wouters of Erasmus Medical Center, regarding his article “A Standard Set for Outcome Measurement in Patients With Hand and Wrist Conditions: Consensus by the International Consortium for Health Outcomes Measurement Hand and Wrist Working Group” which appears in the October 2021 issue of the Journal of Hand Surgery.

Death rattle, defined as noisy breathing caused by the presence of mucus in the respiratory tract, is common among dying patients. Harriette van Esch, MD, from the Erasmus Medical Center, the Netherlands, and Jared R. Lowe, MD, from the University of North Carolina, join JAMA Associate Editor Ethan Basch, MD, to discuss evidence about use of prophylactic scopolamine butylbromide to reduce the death rattle. Related Content: Effect of Prophylactic Subcutaneous Scopolamine Butylbromide on Death Rattle Preventing Death Rattle With Prophylactic Subcutaneous Scopolamine Butylbromide

Welcome to FractureLine: the official weekly news feed from the Chest Wall Injury Society; where we will listen to all the bottom line CWIS updates, shout outs, fun facts and weekly banter! We (Tom, Sarah, Adam and I) are looking forward to connecting to all our CWIS members! If you have questions you need addressed, issues you want to bring forth, or just wanna say hi and chat- please let us know, we'd love to address them or even host you on a weekly episode... This week we welcome Dr Suzanne Van Wijck, International Research Fellow and PhD Candidate from Erasmus Medical Center- now at Denver Health!

Viv talks to the fantastic Dr Tom van Eijk & Dr Leonie Schelke, both of whom are based in Amsterdam, Netherlands.Tom works as an aesthetics specialist practitioner, trainer & researcher. He provides treatments for his own patients & also carries out training for practitioners at his own Tom van Eijk Academy in Amsterdam, as well as in venues worldwide.Leonie specialises in the use of ultrasound scanning in the course of non-surgical facial aesthetic treatment & complications assessment, diagnosis & treatment. She's involved in patient treatment, research at Erasmus Medical Center in Rotterdam & also practitioner training provision at Cutaneous in Amsterdam.They talk about a range of topics, including their different roles as non-surgical aesthetics specialists, what their work involves & also about their plans for the future.You can follow Tom on his Instagram page- @tom.van.eijkYou can follow Leonie on her Instagram page- @facial_ultrasoundYou can see the full video here.

This episode of Season 5 of the BSP Podcast features Sadaf Soloukey, Erasmus Medical Center, Rotterdam, The Netherlands. The presentation is taken from our 2020 annual conference: ‘Engaged Phenomenology’ Online.   ABSTRACT: Spinal Cord Injury (SCI) is a field of research currently experiencing unprecedented results in functional recovery of patients due to neurotechnological developments. As such, the number of patients with SCI receiving neural implants is expected to increase steadily. However, current literature seems to lack a parallel development focused on users’ experience in terms of implanted tool incorporation or embodiment of neurotechnological devices in general. As such, we ignore how interwoven neurotechnological efforts are with human experience, and how vital accurate considerations in this process are for treatment success. In a previous publication, I developed a theoretical framework forembodiment in neuro-engineering and defined three concepts that facilitate ‘transparency’: functionality, sensorimotor feedback and affective tolerance. Based on these concepts, I discuss practical guidelines for clinicians which can contribute to the actual success of embodiment: 1) The ‘Patient Preference Diagnosis’, which warms up the patient for the existential reorientation and 2) The ‘Patient Transparency Diagnosis‘ during and after implantation, which provides  the patient with possibilities to fine-tune the level of incorporation. However, this attempt to capture the complexity of tool incorporation into a single theoretical framework might be inherently limited and calls for a move back from the bench to the actual bedside. In this paper, we present the results of a series of in-depth interviews with five SCI patients receiving temporary neural implants as part of a clinical trial. Based on our previously published embodied phenomenological framework, we questioned our patients on domains including 1) body image, 2) expectations of the neural implant, 3) their judgement on the possibility of incorporation of the device and 4) their ‘ideal’ implant. Interviews were performed both pre- and post-implantation, subjected to thematic analysis and compared against the backdrop of the previously mentioned theoretical framework based on embodied phenomenology as developed by group.   BIO: Sadaf Soloukey is a MD/PhD-Candidate in the departments of Neuroscience and Neurosurgery at the Erasmus Medical Center in Rotterdam, The Netherlands. Sadaf holds two MSc-degrees (Neuroscience and Health Economics) and one MA-degree (Philosophy, cum Laude). Sadaf's research interests lie in neuro-technology and include neuromodulation for Spinal Cord Injury. Additionally, Sadaf works on identifying the phenomenological implications of neuro-technological interventions in the clinical domain.Sadaf’s applied philosophical work has so far received multiple awards, including the prestigious prof. Brouwer Prize awarded by the Dutch Royal Academy of Arts and Sciences (KNAW) to the best philosophical thesis of that academic year.   This recording is taken from the BSP Annual Conference 2020 Online: 'Engaged Phenomenology'. Organised with the University of Exeter and sponsored by Egenis and the Wellcome Centre for Cultures and Environments of Health. BSP2020AC was held online this year due to global concerns about the Coronavirus pandemic. For the conference our speakers recorded videos, our keynotes presented live over Zoom, and we also recorded some interviews online as well. Podcast episodes from BSP2020AC are soundtracks of those videos where we and the presenters feel the audio works as a standalone: https://www.britishphenomenology.org.uk/bsp-annual-conference-2020/   You can check out our forthcoming events here: https://www.britishphenomenology.org.uk/events/ The British Society for Phenomenology is a not-for-profit organisation set up with the intention of promoting research and awareness in the field of Phenomenology and other cognate arms of philosophical thought. Currently, the society accomplishes these aims through its journal, events, and podcast. Why not find out more, join the society, and subscribe to our journal the JBSP? https://www.britishphenomenology.org.uk/

Charlamos con: -Raquel Crespo, doctoranda de Biología Molecular en el Erasmus Medical Center de Rotterdam. -Alex Alonso, doctorando de Ingeniería Eléctrica en la Universidad Politécnica de Cataluña. Además os recomendamos encarecidamente: Un poco de Netflix cuando estamos agobiados y no damos para más: "Social Dilema" y "(Un)well". Y electrónica, pimpam: https://www.youtube.com/channel/UCPKT_csvP72boVX0XrMtagQ Disfruten. Para contactarnos, os contestaremos encantadas en: phdtalks.es@gmail.com También estamos estrenando Instagram: @PhDtalks_ ¡Mucho love y algo de follow por aquí!

De langste podcast tot nu toe is een gesprek met Jeroen de Vrij. De podcast bestaat uit drie delen. We starten met wat er allemaal gebeurd is met onze voormalige dorpskroeg en wat dat gaat worden, vervolgens gaat het gesprek over het onderzoekswerk dat Jeroen verricht naar het genezen van hersentumoren en we eindigen met een heldere uitleg wat virussen nu eigenlijk zijn en waarom het zo lang duurt om een vaccin daarvoor te maken. 

I know there are a lot of concerns regarding this current virus that have devastated many families, multiple states and not excluding countries. I am inviting you to listen to this and share with your friends and family. In the meantime, let's also share some good news. Someone shared the following and I thought it was perfect for this post. Let's talk some GOOD NEWS, shall we? It's reported that: China has closed down its last coronavirus hospital. Not enough new cases to support them. Doctors in India have been successful in treating Coronavirus. Combination of drugs used: Lopinavir, Retonovir, Oseltamivir along with Chlorphenamine. They are going to suggest same medicine, globally. Researchers of the Erasmus Medical Center claim to have found an antibody against coronavirus. A 103-year-old Chinese grandmother has made a full recovery from COVID-19 after being treated for 6 days in Wuhan, China. Apple reopens all 42 china stores. Cleveland Clinic developed a COVID-19 test that gives results in hours, not days. Good news from South Korea, where the number of new cases is declining. Italy is hit hard, experts say, only because they have the oldest population in Europe. Scientists in Israel likely to announce the development of a coronavirus vaccine. A network of Canadian scientists are making excellent progress in Covid-19 research. A San Diego biotech company is developing a Covid-19 vaccine in collaboration with Duke University and National University of Singapore. Plasma from newly recovered patients from Covid -19 can treat others infected by Covid-19. So it's not ALL bad news. Let's care for each other and stay focused on safety of those most vulnerable. Focus on the positive, there are more alive than otherwise. SistaQueen. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

 Dr Carolyn Lam:               Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to The Journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Center, and Duke National University of Singapore. Dr Greg Hundley:             And I'm Greg Hundley, also associate editor in Richmond, Virginia at VCU Health.  Dr Carolyn Lam:               So, PCI or no PCI for chronic total occlusion. That is a perennial question, and we have the results of the decision CTO trial reported in this week's Journal. In fact, we're going to discuss it right after our little chat here.                                                 So, Greg, why don't you kick us off? What paper did you choose?  Dr Greg Hundley:            Yeah, thanks so much Carolyn. My first paper is from Laura Benschop from the Department of Obstetrics and Gynecology at Erasmus Medical Center in Rotterdam, the Netherlands. It's going to focus on placental growth factor as an indicator of maternal cardiovascular risk after pregnancy.                                                 So, as we all know, pregnancy is accompanied by extensive maternal hemodynamic changes that allow for proper placental implantation, growth, profusion, and fetal development and this process requires a tight balance between pro-angiogenic factors like placental growth factor, and anti-angiogenic factors like soluble FMS like tyrosine kinase factors. So, in response to stress, the syncytiotrophoblast will decrease the production of placental growth factor and women with reduced placental growth factor and increased FLT-1, are more at risk of a complicated pregnancy. For example, like preeclampsia and spontaneous preterm birth.                                                 So, angiogenic placental growth factor concentrations can rise during pregnancy, peaking at the end of the mid-pregnancy. And low placental growth factor concentrations during pregnancy are associated with pregnancy complications with recognized later life cardiovascular risk. So here, the authors hypothesize that low placental growth factor concentrations, especially in mid pregnancy, identify not only a subset of women at risk for pregnancy complications, but also women with greater cardiovascular risk factor burden after pregnancy, regardless of their outcome.                                                 So, among 5,529 women, the authors computed gestational age adjusted and mid-pregnancy placental growth factor concentrations and pregnancy complications, like preeclampsia, small for gestational age, spontaneous preterm birth, was obtained from hospital registries.  Dr Carolyn Lam:               Cool, and what did they find?  Dr Greg Hundley:            So six years after pregnancy, the authors found that women with mid pregnancy low placental growth factors, in the lowest quartile, had larger aortic diameters, left atrial diameters, and LV mass, and a higher systolic blood pressure by an average of 2.3 millimeters of mercury. High mid-pregnancy placental growth factor concentrations were the opposite. They were associated with smaller aortic diameters, smaller left atrial diameters, lower LV mass by 3.9 grams, and lower systolic blood pressure. And these differences persisted after exclusion of women with complicated pregnancies.                                                 So, the results suggest that a woman's response to the cardiovascular changes of pregnancy, measured by pre-mid-pregnancy placental growth factor levels could provide insight into the path of physiological mechanisms leading to future cardiovascular disease in multiparous women.  Dr Carolyn Lam:               Wow. That is really interesting. Well, the paper I chose really answers the question, are there racial differences in sudden cardiac death, and why? And this is from corresponding author Dr Guallar from Welch Center for Prevention, Epidemiology, and Clinical Research in Johns Hopkins Bloomberg School of Public Health and Colleagues.                                                 What they did is they compared the lifetime cumulative risk of sudden cardiac death among blacks and whites in the atherosclerosis risk in community study, or ARIC. They evaluated the risk factors that may explain racial differences in sudden cardiac death risk in this general population.                                                 What they found was that blacks had a much higher risk of sudden cardiac death in comparison with whites, with a sex adjusted hazards ratio of 2.12. Known factors explained 65% of the axis risk of sudden cardiac death in blacks compared to whites. The single most important factor explaining this difference was income, followed by education, hypertension, and diabetes. These racial differences were evident in both genders, but stronger in women than men.  Dr Greg Hundley:            Hmm. So are there implications, and are there potential strategies that could help reduce this risk in African Americans?  Dr Carolyn Lam:               Yeah, this is a really interesting study, and it really implies that efforts to reduce the sudden cardiac risk in blacks should perhaps focus on improving CPR outreach, medical care engagement in response to cardiac arrest, the quality of treatment in medical institutions in predominantly black neighborhoods, and factors such as that. Because remember the single most important factor explaining the difference was actually income and education.  Dr Greg Hundley:            Oh, wow. Well, I'm going to switch gears a little bit here Carolyn, and we're going to talk about pulmonary hypertension. And this next paper is going to focus on pericytes. We'll learn a little bit about what pericytes are. So, the paper is from Vinicio de Jesus Perez, who's an assistant professor of medicine and pulmonary critical care at Stanford University Medical Center in California.                                                 What are pericytes? So, pericytes are specialized perivascular cells embedded in the basement membrane of blood vessels, where in conjunction with neighboring and endothelial cells, they support vessel maturation and stability. In the lung, pericytes are mostly found associated with small precapillary arteries, the capillaries, and then those post capillary venules. And it's thought that pericytes are responsible for regulation of vasomotor tone and structural support of these micro-vessels. When the vessels become muscularized, pulmonary vascular resistance increases, resulting in pulmonary artery hypertension.                                                 So recent studies have focused on pericytes in addition to pulmonary endothelial cells, smooth muscle cells, and fiberglass, but not much is known about the contribution of pulmonary pericytes to pulmonary arterial hypertension. Two genes are involved in Wnt planar cell polarity pathway that is responsible for coordinating complex cell movements during tissue morphogenesis. So, in this group, they have produced prior results that show that restoration of the Wnt planar cell polarity in pulmonary arterial hypertension, pericytes could partially restore recruitment to PNVECs and increase vessel stability.  Dr Carolyn Lam:               Interesting, and so that was their past research, and what did the current paper show?  Dr Greg Hundley:            Right. So Carolyn, what they found is that pulmonary microvascular endothelial cells isolated from pulmonary arterial hypertension patients, and endothelium from pulmonary arterial hypertension tissue have reduced expression of Wnt-5a. Healthy PMVECs produce and package Wnt-5a in the form of exosomes which regulate pericyte recruitment, motility, and polarity.                                                 And so, the overall implication is that promising therapeutic strategies that help can restore the Wnt/PCP, or planar cell polarity pathway, and endothelial pericyte communication could help prevent micro-vessel loss in patients with pulmonary artery hypertension.  Dr Carolyn Lam:               Thanks, Greg. So, I'm going to take us to the cath lab for this next paper. And it's the results of the CANTIC study, which aimed to answer the question, does intravenous P2Y12 inhibitor Cangrelor have a role in bridging the gap in platelet inhibition in patients with STEMI undergoing primary PCI. And this is from corresponding author Dr Angiolillo from the University of Florida College of Medicine Jacksonville and Colleagues.                                                 Now, CANTIC was a prospective randomized double-blind placebo control parallel design investigation of the pharmacal dynamic effects of Cangrelor versus placebo in patients undergoing primary PCI, who were also treated with crushed Ticagrelor. So, after diagnostic angiography, patients were randomized to a blinded two-hour infusion of either Cangrelor or placebo. At the same time, 180 milligrams of crushed Ticagrelor was administered to both groups. Platelet reactivity was measured with Verify Now P2Y12 point of care testing, and with vasodilator-stimulated phosphoprotein, or VASP.  Dr Greg Hundley:            So what did the trial show, Carolyn?  Dr Carolyn Lam:               They found that addition of Cangrelor led to more prompt and potent platelet inhibitory effects, compared with crushed Ticagrelor alone in patients undergoing primary PCI. The significant differences were observed as early as five minutes post bolus administration, and persisted until the end of its two-hour infusion.                                                 Furthermore, after discontinuation of Cangrelor or the placebo infusion, there were no differences in levels of platelet reactivity between groups. And this importantly rules out a drug/drug interaction when Cangrelor and Ticagrelor are concomitantly administered. This lack of drug-drug interaction is important, as it supports a more versatile use of Ticagrelor with respect to timing of its administration in patients treated concurrently with Cangrelor.                                                 Overall, the results are reassuring and demonstrate reduced platelet reactivity, and no high on treatment platelet reactivity with Cangrelor in combination with Ticagrelor in primary PCI patients. Of course, the implications of these pharmacal dynamic findings really warrant investigation in an adequately powered clinical trial.                                                 And that brings us to the end of our summaries. Let's go to our featured discussion.                                                 So PCI, or no PCI for chronic total occlusion, that is a perennial question isn't it? Especially nowadays when procedural results for PCI and CTO have improved in recent years, and PCI strategies have moved towards more complete revascularization. Yet the evidence is clearly lagging behind for us to make decisions on this. And that's why we're so happy that our featured paper today is the DECISION-CTO trial from Korea, and so happy to have the first author, Dr Seung-Whan Lee from ASA Medical Center to tell us about this, as well as our associate editor, Dr Manos Brilakis from UT Southwestern.                                                 So Dr Lee, could you tell us about the DECISION-CTO trial? Dr Seung-Whan Lee:       Yeah, in our trial our multicenter, randomized, noninferiority trial, PCI-eligible patients were assigned to receive either one of two strategies; PCI or no PCI or CTO. We did the option for PCI of the other. The primary endpoint as you know the composite outcome of deaths, myocardial infraction, stroke, or any revascularization. As related to quality of life was assessed up to three years. However, because of the slow recruitment, the trial was stopped before completion. We started 208 planned enrollments. For six years 834 patients there were randomly assigned to the CTO PCI versus no CTO PCI strategy.                                                 Among the patients assigned to the no CTO PCI strategy, nearly 20 percent of patient cross over to the CTO PCI. That is our big limitation, as you know. Anyways, the primary end point was assessed per year, and then, finally, we founded the per year risk of the major adverse cardiac events there’s no difference in contributor composite outcome, MI, revascularization, and stroke.                                                 However, in our trial, in some detail, in CTO PCI was success rate around 91 percent. However, complication is very low, .6 percent of patient is complication. Very surprisingly the coheir is up to the three, and no difference between CTO PCI versus no CTO PCI.                                                   I think our main message is our patient is a relatively low-risk population, including the syntax score 20 and the score 22%. The majority of patient preserved LV function and single-vessel disease 25%. The relative low risk population CTO PCI versus no CTO PCI clinical outcome is no difference of the per year from the two groups.                                                 I think that our trial is make the reposition with the medical law in the CTO patient. That’s my summary. Dr Carolyn Lam:                Thank you. Manos, could you maybe paint the background and let us know why this was so important for us to publish in Circulation? Why is it so difficult to do these trials?  Dr Manos Brilakis:           This is the largest study on CTO PCI so congratulations on getting this accomplished. I know it was many years and a lot of effort.                                                 I think a couple of things on the background. As Dr Lee said as well, CTO PCI success rates have been improved, and now at experienced centers you can get 85 to 90 percent success fairly consistently.                                                 The complication rates are low. .5 to 3 percent is the average rate. We do have a tool right now. The procedure is mature, and it's time test in the randomized trials.                                                 The question has always been for CTO PCI, "How does it help?" Does it improve symptoms? Does it improve the heart outcomes? Myocardial Infarction?  This is what DECISION CTO was trying to answer.                                                 Couple of I think limitations that we should take into account when interpreting the results. The first one is that these were notations with an isolated CTO, but a significant proportion had also multi-vessel disease. They were enrolled before treating the other vessels, which were subsequently treated.                                                 Sometimes it's hard to know how much the residual ischemia or symptoms would be present after the other lesions were treated. That's one thing.                                                 The second is that there was a significant crossover for about 1 in 5 patients that randomized to medical therapy immediately crossed over to the CTO PCI group. And that always uses the power and creates difficulty in interpreting the results.                                                 In my mind, the question still remains, in low risk populations it's possible that CTO PCI doesn't improve symptoms, but the ones that were expected to improve, the heart outcomes dec-MI, would be the high-risk patients with significant ischemia. Ideally, studies in the future should actually look specifically at patients who have high ischemia, significant symptoms when looking at heart outcomes.  Dr Carolyn Lam:               Dr Lee, I think you did mention as well in your manuscript that a viability test was not mandatory for patient enrollment. I mean, clearly it was such as work of labor enrolling such patients. If you put even more criteria it would have been impossible, I suppose. Do you have some thoughts there on maybe future studies? Dr Seung-Whan Lee:       Yeah, as you know, the currently ongoing CTO PCI process medical treatment is nobel CTO and ischemia CTO is assessed at the reduction of the ischemia burden in CTO PCI. I think there maybe two studies that give us some answer for the low level of the CTO PCI for the reduction of the ischemia.                                                 So, I think the larger ischemic burden the patient is maybe high risk to make the however we don’t know exactly the cut off… ischemic burden in CTO patient. Usually instable angina any kind…coronary disease…3 years circulation showed more than 10 percent of ischemic burden is really predictive of future cardiac event. However, we don't know exactly the can be applied to CTO patient. We don't know exactly.  Dr Manos Brilakis:           Can I ask Dr Lee a question regarding the study and his interpretation as well. Now the study was borrowed for hard end points dec MI. What his is perception, based on the DECISION CTO, and, of course, everything else in the literature and the CTO study with symptomatic benefit...Dr Lee, what is your conclusion about, or your kind of thoughts about, the effect of CTO PCI on improving symptoms, which is a more accepted indication for the procedure right now? Dr Seung-Whan Lee:       As you know, the university trials symptom assessment was done after the no CTO PCI. However, our trial is a pragmatic trial, initial approach to the CTO vessel and the vessels that is patient.                                                 At this moment, I think the other vessel, other no CTO vessel intervention and OMT may improve the patient symptom and then CTO vessel is the intervention including the CI patient completely…improve the symptom status. However, analysis showed up to the 3 year, maybe no difference between two groups in the CTO PCI versus medical treatment.                                                 Our trials of the CTO PCI symptom, we don't exactly the role of the after no CTO PCI. We don't know exactly the CTO based symptom assessment was not done, because of the symptom assessment was done before the intervention.                                                 I think that our trials are more practical, because of the initial…multivessel… CTO. Our trials, maybe, completely vascularization including CTO and no CTO vessel revascularization without the CTO intervention. Sometimes the patient to complain of symptom multivessel with the CTO I think we can wait if we continue the patient symptom…                                                 However, in this trial showed CTO specific intervention trial, because of the symptom assessment was done after no CTO vessel intervention. There is some improvement of the… receptor treatment satisfaction of the angina stability. I think that the CTO intervention is maybe reserved for the symptom control after the medical treatment failure of patient.                                                 I fully agree the symptom control is possible with the CTO PCI.  Dr Manos Brilakis:           Wonderful. Thank you. I think that's a critical differentiation that the DECISION CTO is not specific for CTO, but it's multi-vessel disease plus CTO. Thanks for clarifying. That's very important for the leaders and the entire community to understand that part.                                                 One more question, if it's okay. I know that in Asian countries bypass patients are relatively less. I think in the U.S. 50 percent. Any comment on that? I know people get less bypass in Asia than they do in the United States. How may that affect the interpretation of the DECISION CTO? Dr Seung-Whan Lee:       Initially, I introduced my studies to our patients syntax score under 20. As you know, the U.S. Registry shows the syntax score more than I think the 20, and the tester score around 46. Quite different in population, because the risk factor is quite different. U.S. patient is hypertension and diabetic are more prevalent than the Asian patient. Bypass surgery is 40 percent in Asian patients. Bypass surgery is around 102 percent in CTO registry. Quite big difference of the base rank, risk factor, and morbidity.                                                 I cannot apply to U.S. population exactly the same ... Not same situation. We cannot apply directly to the U.S. population. I fully agree with your suggestion, though. Lowest population is maybe ... Our trial is maybe lowest population. We agree.  Dr Carolyn Lam:               I'm just learning so much listening to both of your interventionists. What do you think are the take-home messages from this? Maybe, could I start with Dr Lee, and then give Manos the last word? Dr Seung-Whan Lee:       CTO PCI critical outcome, it should be tested as a large random trial. Maybe Manos already mentioned about the high-risk population, because our population is the lowest population. However, in some large random trial with a high-risk population we have consider some random trial because they are not easy.                                                 Maybe not easy to test in high-risk population. However, you must do that, because of the two established CTO PCI law in the current practice.  Dr Carolyn Lam:               Manos?  Dr Manos Brilakis:           Yeah, I would agree with that. I think the main conclusion regarding the field of CTO PCI is that still right now, the key indication remains symptom improvement. We do have the trials at this point showing that you do CTO PCI in terms of improving mortality. However, CTO PCI is a tool. It's a revascularization tool. Patients who have severe, complex, coronary disease, multi-vessel disease, may be best served with bypass in the first place. Those who have multi-vessel disease that's less complex and don't have significant symptoms after fixing the non-CTO lesions, then they may not benefit from CTO PCI as well. But those who have CTO lesions and have significant symptoms, this is the population for which I think there is general agreement, and I the decision that CTO is good with that, that those patients could benefit from CTO intervention.  Dr Carolyn Lam:               Thank you so much for sharing your insights.                                                 Thank you, listeners, for joining us today. You've been listening to Circulation on the Run. Don't forget to tune in again next week.                                                 This program is copyright American Heart Association 2019.  

Dr Carolyn Lam:                Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore.                                                 FDG-PET CT was recently introduced as a new tool for the diagnosis of prosthetic valve endocarditis. However, can we improve on its diagnostic performance? Well, to learn more you have to listen to the upcoming featured discussion, right after these summaries.                                                 Our first original paper this week describes a potential novel therapy for hypertension. In this study from first author Dr Hu, corresponding author Dr Soong, from Yong Loo Lin School of Medicine National University of Singapore, authors showed that galectin-1 is a key regulator for proteasomal degradation of CaV 1.2 channels. L-type CaV 1.2 channels are known to play crucial roles in the regulation of blood pressure. In a series of elegant in vitro and in vivo experiments, the authors showed that galectin-1 promotes CaV 1.2 degradation by replacing CaV-beta and thereby, exposing specific glycines for polyubiquitination. This mechanistic understanding provided the basis for targeting CaV 1.2 galectin-1 interaction and demonstrated the modulatory role that galectin plays in regulating blood pressure. The study, therefore, offers a potential novel approach for the therapeutic management of hypertension.                                                 Direct oral anticoagulants or DOACs, are surpassing warfarin as the anticoagulant of choice for stroke prevention in non-valvular atrial fibrillation. However, DOACs outcomes in elective peri-procedural settings have not been well elucidated and remain a source of concern for clinicians.                                                 The next paper in today's issue was a meta-analysis designed to evaluate the peri-procedural safety and ethicacy of DOACs versus warfarin. For author Dr Nazha, corresponding author Dr Spyropoulos, from the Feinstein Institute for Medical Research in Northwell Health at Lenox Hill Hospital in New York, reviewed the literature for data from phase three randomized controlled trials comparing DOACs with warfarin in the peri-procedural period among patients with non-valvular atrial fibrillation. Sub study from four trials were included namely RE-LY, ROCKET-AF, ARISTOTLE, and ENGAGE-AF. The short-term safety and ethicacy of DOACs and warfarin were not different in patients with non-valvular atrial fibrillation peri-procedurally. Under an uninterrupted anticoagulation strategy, DOACs were associated with a 38% lower risk of major bleeds compared to warfarin.                                                 The next paper presents results from the Sarcomeric Human Cardiomyopathy Registry or SHARE, which combined longitudinal data sets curated by eight international hypertrophic cardiomyopathy specialty centers to provide a better understanding of the factors that contribute to heterogeneous outcomes in lifetime disease burden in patients with hypertrophic cardiomyopathy. First and corresponding author Dr Ho from Brigham and Women's Hospital and colleagues analyzed longitudinal clinical information on 4,591 patients with hypertrophic cardiomyopathy. By examining the data set spanning more than 24,000 patient-years, the mortality of patients with hypertrophic cardiomyopathy was shown to be 3-fold higher than the general population at similar ages. The lifetime cumulative morbidity of hypertrophic cardiomyopathy was considerable, particularly for patients diagnosed before age 40 years and patients with sarcomere mutations. Atrial fibrillation and heart failure were the dominant components of disease burden. Thus, young age of diagnosis and the presence of sarcomere mutations are powerful predictors of adverse outcomes in hypertrophic cardiomyopathy. These findings highlight the need for close surveillance throughout life and the need to develop disease-modifying therapies.                                                 The final original paper this week provides molecular insights into atherosclerosis and it shows that defective base excision repair of oxidative DNA damage in vascular smooth muscle cells promotes atherosclerosis. Now, we know that atherosclerotic blocks demonstrate extensive accumulation of oxidative DNA damage, predominantly as 8-oxoguanine lesions. In today's paper, first author Dr Shah, corresponding author Dr Bennett from University of Cambridge and colleagues studied levels of 8-oxoguanine and its regulatory enzymes in human atherosclerosis. They found that human plaque vascular smooth muscle cells showed defective nuclear 8-oxoguanine repair, associated with reduced acetylation of the base excision repair enzyme 8-oxoguanine-DNA-glycosylase-1. Furthermore, correcting the base excision repair defect in vascular smooth muscle cells alone markedly reduced plaque formation, thus indicating that endogenous levels of oxidative DNA damage in vascular smooth muscle cells promoted plaque development.                                                 And that brings us to the end of this week's summaries. Now for our feature discussion.                                                 Prosthetic valve endocarditis is a life-threatening complication. However, making a timely diagnosis of prosthetic valve endocarditis before the occurrence of severe complications is really difficult. Now, FDG-PET CT has recently been introduced as a new tool for the diagnosis of prosthetic valve endocarditis. However, previous studies reported only modest diagnostic accuracy and may have been hampered by confounders. But today's study, our feature study in Circulation, addresses this issue. We have none other than the corresponding author, Dr Ricardo Budde from Erasmus Medical Center in Rotterdam, the Netherlands, and our dear associate editor, Dr Victoria Delgado, who is in Leiden University Medical Center, also in the Netherlands.                                                 So please tell us, how does your study help us address this issue of the accuracy of FDG-PET CT Dr Ricardo Budde:           What we actually did is that of course endocarditis is a relatively rare disease, so we had six hospitals in the Netherlands that collaborated on this study and in each of the hospitals we searched for PET CT scans that were performed in patients with a prosthetic heart valve, either because they were suspected of having endocarditis, or if they were meant for other purposes, for example oncological follow-up. Then we grouped all those CT scans together, interpreted the PET CTs anew by dedicated interpreters, and then compared the findings with the actual diagnosis in the patient, which of course is always difficult in endocarditis because to make the diagnosis is difficult. So, also, one year follow-up period was included in that to be absolutely certain whether the patient had endocarditis or not. By taking this whole cohort of patients, we were able to determine the diagnostic accuracy of PET CT, as well as by using a logistics model, identify confounders which influence the diagnostic accuracy of PET CT.                                                 I think the study that we did addresses several important aspects and the way it helps physicians in actually interpreting and implementing PET CT to diagnose endocarditis is two-fold. First of all, we identified confounders that have to be taken into account when interpreting and using the PET CT. For instance, low inflammatory activity at the time of imaging and the use of surgical adhesive during a prosthetic heart valve implantation are confounders which should be taken into account when interpreting the PET CT. Furthermore, the guidelines have always insisted on not to use or use it very cautiously PET CT within the first three months after prosthetic heart valve implantation. However, we showed that actually this period after implantation does not necessarily have to be taken into account as also a good diagnostic accuracy can be obtained within the first three months after implantation. Dr Carolyn Lam:                Ricardo, that's wonderfully put. I don't do a CT, PET CT, routinely. In fact, I am echocardiologist and it used to be that infective endocarditis was diagnosed with echo. So Victoria, tell us, how does echo stand now with this information? Dr Victoria Delgado:        That's a very good question but I think the guidelines set a very clear figure of how the diagnostic workup of patients with prosthetic valve endocarditis should be performed. An echocardiography is the first imaging technique. The point is that transthoracic echocardiography in patients with suspicion of prosthetic valve endocarditis is very challenging. In terms of ideal, echocardiography is probably the best imaging technique to do first to evaluate whether it is endocarditis or not. It's difficult, we have to take into account that for a specific prosthetic valve, particularly mechanical, the shadowing can make that we don't see the [inaudible 00:10:22] and sometimes it's difficult, particularly in the early phase immediately after implantation, all the inflammation can be confounder for presence of endocarditis. In those cases, I think that this study provides additional and important data highlighting which are the confounders when you use PET CT to evaluate depressions of endocarditis. I think that, when you take into account those confounders, the accuracy of this technique is very good in order to make or help in the diagnosis of these patients. So, echocardiography, I think that will remain as our first imaging technique to rule out [inaudible 00:11:10] we can see but in those cases where the diagnosis is not confirm or rule out with transthoracic and transesophageal echocardiography this study provides additional data and important data showing that PET CT is a valuable complementary imaging diagnostic test for these patients. Dr Carolyn Lam:                Ricardo, would you agree with that because I think your study also emphasized that perhaps FDG-PET CT should be implemented early in the diagnostic workup to prevent the negative confounding effect of the low inflammatory activity? So how do we put this all together? Dr Ricardo Budde:           Well actually, I agree with Dr Delgado that echocardiography is and should be the first-line test that you do if you have a patient that has a suspicion of endocarditis. I mean, the advantages of echocardiography are many and it's non-invasive, it's bedside-available if needed, it's patient-friendly, and it provides a huge amount of information so you should always start with echocardiography. However, sometimes it can be difficult by echocardiography, for the reasons just explained by Dr Delgado, and I think then PET CT should be considered. And when you want to do a PET CT, then you should do it early within the diagnostic workup.                                                 Actually, in the article, one of the figures is a flow chart which we provide, and it provides information on how we think PET CT can best be implemented in the workup of endocarditis. In this flow chart we also start with doing an echocardiography and also, importantly, consult the endocarditis time to make initial classification of whether it's a rejected, possible, or definite prosthetic heart valve endocarditis. After that, you can follow the flow chart and see when you can best implement PET CT, in our opinion. Dr Carolyn Lam:                Indeed Ricardo, I am so glad you brought up this figure and listeners, you have to take a look at it. I can imagine that everybody will be using this and discussing it and how to incorporate this in the workflow. And indeed you do start with either transthoracic or transesophageal echo and blood cultures, so thank you for clarifying that.                                                 Now, for our clinicians out there, are there any situations you may be telling us to be a little more careful? Could you put it simply for us when it comes to the FDG-PET? Dr Ricardo Budde:           You mean when not to perform a PET CT? Dr Carolyn Lam:                Yeah, or when we have to be really careful about inaccuracies. Dr Ricardo Budde:           I think, of course, the confounders that we indicate in the article, especially if bioglue has been used by the surgeon during the initial surgery. We know that bioglue can be seen on a PET CT as a false positive uptake of FDG and it's also important to note that this is a phenomenon that can persist for a very long time after a valve implantation. It could be for years, so especially that I think is a very important confounder to take into account and be careful when you interpret PET CT or use the PET CT and always read the original surgical report if it is available to obtain this information. Dr Carolyn Lam:                That's wonderful advice. Victoria, do you have anything to add? Dr Victoria Delgado:        No, I think that Dr Budde explained perfectly this figure that is key in the article and also how to evaluate patients with suspected endocarditis of prosthetic valve. One thing that sometimes we forget is starting from the first step that is a good clinical history which includes also a good evaluation of previous history and, if possible, what has been done in the patient. I think that this key information to understand the findings on the echocardiography, transthoracic or transesophageal, and the subsequent investigations that you are going to perform. Either CT which is considered, for example, when you have a definitive prosthetic valve endocarditis and you want to rule out potential complications such as abscess, for example, and if you perform a PET CT or other imaging modalities that then also indicate the presence of infection like, for example, [inaudible 00:15:26] leukocytes with PET, for example. Dr Carolyn Lam:                And I just want to end up with one little point. Ricardo, how about the fact that part of your results don't corroborate the ESC guideline recommendations that they say you have to avoid FDG-PET in the recently implanted prosthetic valve. How do you feel it's going to play out for clinicians? Dr Ricardo Budde:           Well, I think the 2015 ESC guidelines on endocarditis are a very important document. One must take into account that the inclusion of PET CT in the ESC guidelines was a major step, and some might say that it was a little premature to include the use of PET CT because the number of data that was out there were still relatively limited. I think it's something that we are learning along the way. Now that we are using PET CT more often we are more aware of what we do to findings that we get and also the findings that we have within specific timeframes after the implantation of a prosthetic heart valve. One of the things that I think is desperately needed also at the moment is to have a prospective study where we would do PET CT in patients after implantation of a prosthetic heart valve that do not show any signs of endocarditis where we do PET CT just to determine these normal uptake values. I think that would be a major contribution to the whole learning experience that we're currently having with implementing PET CT within prosthetic heart valve endocarditis. Dr Carolyn Lam:                Indeed, and Ricardo your paper has added significantly to our understanding. Readers, remember, it's Figure 6 of our feature paper this week. It is a beautiful figure. Pick it up, take a look. In the meantime just thank you so much Ricardo and Victoria for joining me today.                                                 Listeners, don't forget to tune in again next week.  

Jane Ferguson:                 Hello, welcome to Getting Personal: Omics of the Heart. This is podcast Episode 15 from April 2018. I'm Jane Ferguson, an Assistant Professor of Medicine at Vanderbilt University Medical Center, and this podcast is brought to you by Circulation Genomic and Precision Medicine and the AHA Council on Genomic and Precision Medicine.                                                 As usual, we have a great lineup of papers in Circ Genomic and Precision Medicine this month. The first is actually the subject of our interview this month. Sony Tuteja talked to Craig Lee from the University of North Carolina about his manuscript entitled, "Clinical Outcomes and Sustainability of Using CYP2C19 Genotype Guided Antiplatelet Therapy After Percutaneous Coronary Intervention." This manuscript investigated the use of pharmacogenomics to improve treatment after PCI, and you can hear a lot more about it directly from the first author later in the podcast.                                                 Our next manuscript also used pharmacogenomics approaches to look for snips associated with plasma renin activity and to assess the effect of top snips with blood pressure response to atenolol and hydrochlorothiazide. The first and last authors are Caitrin McDonough and Julie Johnson from the University of Florida. And their manuscript is entitled, "Genetic Variants Influencing Plasma Renin Activity in Hypertensive Patients from the Pharmacogenomic Evaluation of Antihypertensive Response," or PEAR study. They find that snips in the SNNTXNDC11 gene region associate with higher baseline plasma renin activity in their sample of over 700 subjects and with a smaller systolic blood pressure reduction to hydrochlorothiazide. Variation in the region may act through modulation of TXNDC11 gene expression. They also identified several other candidate genes of interest. These new candidates may allow for precision medicine approach to selection of hypertensive treatment and further study the mechanisms may reveal novel biology on blood pressure response to pharmacological treatment.                                                 Next up is a manuscript by Deirdre Tobias and colleagues entitled, "Circulating Branch Chain Amino Acids and Incident Cardiovascular Disease in a Prospective Cohort of U.S. Women." I actually had the chance to talk to Deirdre about her research last month. So check out the March podcast, Episode 14, to hear more from Dr. Tobias about this study.                                                 A study of hypertrophic cardiomyopathy from Hannah [inaudible 00:02:36] and Michelle Michels and colleagues from the Erasmus Medical Center in the Netherlands assessed the effects of genetic screening in family members of patients with a known hypertrophic cardiomyopathy mutation. In their manuscript entitled, "Outcomes of Contemporary Family Screening and Hypertrophic Cardiomyopathy," they described their study which assessed cascade screening in 777 relatives of 209 probans between 1985 and 2016. Genetic and clinical screening resulted in a diagnosis of HCM in 30% of family members at the time of testing. An additional 16% of family members developed HCM over seven years of follow up. Of the 43% of family members who were genotype positive, 37% were ultimately diagnosed with HCM. There was no difference in survival between genotype positive and genotype negative family members or with relatives who did not undergo genetic testing.                                                 There are genetic considerations that are unique to the ancestral composition of the Netherlands with a high proportion of individuals with a founder mutation, so the proportion of probans with identified mutations is higher than in other reported studies. This paper demonstrates the potential benefit of genetic screening in family members, which can identify individuals who should undergo intensive screening, and at the same time reduce concerns for family members who are genotype negative. However, the classification of the pathogenicity of variants and understanding variable penetrance remains a challenge.                                                 A manuscript entitled, "Exome Sequencing in Children with Pulmonary Arterial Hypertension Demonstrates Differences Compared to Adults." From Na Zhu, Claudia Gonzaga-Jauregui, Carrie Welch, Wendy Chung, and colleagues from Columbia University, ask the question whether there were differences in the genetic mutations responsible for early onset pulmonary arterial hypertension, or PAH, in a pediatric sample compared with adult onset disease. While some mutations, particularly in BMPR2 appear to be similar in the pediatric and adult samples there were significantly more mutations in TBX4 in the children compared with adults.                                                 Further, children were more likely to have de novo mutations identified through exam sequencing that were predicted missense variants. Given the additional complications associated with pediatric onset of PAH, understanding the genetic differences in this population is an important step towards identifying novel genes and mechanisms which could guide future therapeutic development.                                                 Our next manuscript authored by Iisan Kadhen, Carolyn Macdonald, Mark Lindsay, and colleagues from Harvard Medical School is entitled, "Prospective Cardiovascular Genetics Evaluation in Spontaneous Coronary Artery Dissection," or SCAD. They genotyped individuals with SCAD to find out the genetic contribution to the disease. Of the patients for whom genetic testing was performed, six of them were 8.2%. Identifiable mutations in genes known to be involved in vascular disease, including COL3A1, LMX1B, PKD1, and SMAD3. These individuals were significantly younger at the time of their first SCAD event compared to patients with no identifiable mutation. Given the relatively higher rate of mutations identified in this sample, there may be a rationale to conduct genetic testing in all individuals presenting with SCAD, particularly in younger individuals.                                                 Shiu Lun Au Yeung, Maria-Carolina Borges, and Debbie Lawlor, from the University of Hong Kong and the University of Bristol, set out to find out if reduced lung function is causal in coronary artery disease. As reported in their manuscript, entitled "The Association of Genetic Instrumental Variables for Lung Function on Coronary Artery Disease Risk, A 2-Sample Mendelian Randomization Study," they used a Mendelian Randomization approach to assess causal relationships between two measures of lung function. Forced expiratory volume in one second, and forced vital capacity on CAD. Genetic predictors of increased forced expiratory volume were associated with lower risk of CAD. While there was a similar association with forced vital capacity, this was attenuated in sensitivity analyses. Overall, the data suggests that higher forced expiratory volume may independently protect against CAD. However, the mechanisms remain unclear.                                                 Finally, the April issue also contains a white paper from Kiran Musunuru, Xiao-zhong Luo, and colleagues entitled, "Functional Assays to Screen and Dissect Genomic Hits, Doubling Down on the National Investment in Genomic Research." This paper lays out strategies to followup on findings from high-throughput genomic analyses, including the use of novel technologies, assays, and model systems that can help to effectively translate big data findings and capitalize on previous investment in genomic discovery.                                                 To see the latest issue of Circulation Genomic and Precision Medicine, and to access all the papers we talked about and to browse previous issues, go to "circgenetics.ahajournals.org." Sony Tuteja:                       Hello, my name is Sony Tuteja, I'm an assistant Professor of Medicine at the University of Pennsylvania in Philadelphia, I'm also an early career member of the American Heart Association Council on Genomic and Precision Medicine. Today I'm joined by Dr. Craig Lee, an associate Professor of Pharmacy at the University of North Carolina School of Pharmacy. Dr. Lee is a first author of an article published in April 2018 issue of Circulation Genomic and Precision Medicine entitled, "Clinical Outcomes and Sustainability of Using CYP2C19 Genotype Guided Anti-Platelet Therapy After Percutaneous Coronary Intervention." Welcome Dr. Lee, and thank you for joining me today. Craig Lee:                            Thanks for having me. Sony Tuteja:                       First let me just say congratulations on spearheading such impactful work on the implementation of CYP2C19 pharmacogenetic testing. Craig Lee:                            Thanks, this has been a very complicated project, but a lot of fun. Sony Tuteja:                       Great. So I think some of our listeners may have not had time to read your paper yet so I was wondering if you could provide a brief overview of the paper and what the study was about. Craig Lee:                            Sure. Although it's been widely described that loss of function polymorphisms in the drug metabolizing enzyme, CYP2C19, which is responsible for the bio-activation of the antiplatelet drug clopidogrel, impairs its effectiveness, there remains considerable debate and uncertainties surrounding whether CYP2C19 genetic testing should be used clinically for guiding antiplatelet therapy in percutaneous coronary intervention, or PCI patients. As the evidence base is expanded, an increasing number of institutions are seeking to implement CYP2C19 genetic testing despite limited data on the use and impact of using this genetic testing to guide antiplatelet therapy selection following PCI in real world clinical settings.                                                 UNC was an early adopter for CYP2C19 genotype-guided antiplatelet therapy in high-risk PCI patients. Our algorithm recommends that patients carrying one or two loss of function alleles in CYP2C19 be prescribed an alternative antiplatelet therapy such as prasugrel or ticagrelor. Our algorithm was implemented back in the summer of 2012, under our then-director of the Catheterization Laboratory, and now Chief of Cardiology, Dr. Rick Stouffer. We conducted the study to better understand the feasibility, sustainability, and clinical impact of using CYP2C19 genetic testing to optimize antiplatelet therapy selection in PCI patients in real-world clinical practice.                                                 Basically what we did was following the implementation of our algorithm in the summer of 2012, we've been retrospectively collecting data from all patients that come through our Cath lab that undergo a PCI. We collect information on their clinical characteristics, whether or not they underwent CYP2C19 genetic testing, what antiplatelet therapy they were prescribed when they were in the hospital at discharge and over the course of followup, and more recently we've been assessing clinical outcomes, both ischemic outcomes and bleeding outcomes. The data presented in our paper described the algorithm's use at our institution over the first two years following its implementation from 2012 to 2014 with one year of followup data. Since we do about 600 PCI procedures per year on our Cath lab, the study population is just under 1200 patients.                                                 Our main findings were that CYP2C19 genotypes were frequently ordered, efficiently returned, and routinely used to guide antiplatelet therapy selection after PCI over this two year period. However, we also observed that the frequency of genotype testing and frequency of using alternative therapy such as prasugrel or ticagrelor in the patients that carried CYP2C19 loss of function alleles fluctuated over time. We also observed that use of clopidogrel in patients that were tested, but carried either one or two copies of a CYP2C19 loss of function allele was associated with a significantly higher risk of experiencing a major ischemic cardiovascular event compared to use of alternative therapy. These risks were particularly evident in the highest risk patients, and largely driven by patients who carry only one copy of the loss of function allele, the so-called intermediate metabolizers.                                                 Our primary takeaway from this analysis is that implementing a genotype-guided antiplatelet therapy algorithm is feasible, sustainable, and associated with better clinical outcomes in a real-world clinical settling, but challenging to maintain at a consistently high level over time. Sony Tuteja:                       Great. I know it's always challenging to implement new work flow and new testing into the clinical setting. Can you describe how the algorithm was incorporated in the cardiologist workflow to minimize disruption? Craig Lee:                            Absolutely. This algorithm was spearheaded by our interventional cardiologists with the support of our clinical pharmacy specialists and pathology laboratory. They key element to our success is that we have the capacity to do the genotype testing in our molecular pathology lab on site. Dr. Karen Weck is the director of that laboratory and is a coauthor on our paper. Since the prescribing decision for antiplatelet occurs in a highly specialized clinical setting, we have all the pieces in place to do this in-house at UNC, which seems to make things very efficient.                                                 There really wasn't very much disruption in the workflow given that the testing is done on-site and the test seems to be treated like another laboratory test that's done, which is really the ultimate goal of pharmacogenomics. We don't currently actually have clinical decision support built into our electronic health record, so the reason we could actually get this off the ground was because of the substantial collaboration between our physicians, pharmacists, and pathology lab.                                                 But one of the things we learned through this experience, which is described in the paper, is that there are fluctuations in the use of the genetic testing to guide prescribing over time that we believe could be remedied by developing more automated clinical decision support, to help make things a little bit more efficient for the clinicians. But at the start of it, it was really just a will to do it, which was really exciting to observe. Sony Tuteja:                       Absolutely. That's exciting that everybody was on board with this project. What do you think were the most challenging aspects of the implementation? Craig Lee:                            That's a great question, and one that often comes up. I think that the education on the front end is really, really important. It needs to recur as the implementation spans over a period of time. For example, there's turnover in the interventional cardiology fellows every summer as well as occasional turnover of attending physicians and clinical pharmacy specialists. As individuals come and go into the clinical environment, it is important that they understand how the algorithm works, and how it can be applied in practice. And this is accomplished by recurring education and communication.                                                 The other thing that's been a challenge is turnaround time. Even though our molecular pathology lab typically turns tests around within one day of a PCI procedure, if the test result isn't available or the antiplatelet therapy isn't changed in response to the genetic test before the patient is discharged from the hospital, we found that it can be challenging to followup on the result before the next encounter. Typically, if a change in medication needs to occur after discharge and prior to the first followup clinic visit, the communication piece has proven to be very important. It's not an insurmountable barrier, but one we observe that created one additional challenge. Other institutions around the country that are doing this have expressed similar things. Sony Tuteja:                       You showed in your study that during the middle of the implementation there was a decline in testing. What do you think were the major reasons that led to decrease in testing? Craig Lee:                            Yeah, that's a great question. We're not sure. We didn't collect information prospectively, and more specifically, we did not survey the physicians in terms of why they ordered the test. But we believe, just based on anecdotal experience and talking about this with everyone, there was this big surge of momentum, with the initial implementation, and as the practice evolved there was just sort-of a settling of individuals in terms of, I think, the practice patterns.                                                 Overall, the test was ordered and over 70% of PCI patients, an alternative therapy was prescribed and approximately 70% a loss of function allele carriers. These numbers exceeded 80% early on which was higher than we expected. They dropped down to about 60%, which is still a pretty high utilization rate when you compare to other institutions that have implemented. After some educational efforts, the testing rates and use of alternative therapy and loss of function allele carriers began to increase again over the last six months. Sony Tuteja:                       Yeah I was just gonna ask, since the study is completed, have you taken any further steps to maintain the frequency of the testing at the high level that you initially started with? Craig Lee:                            Yeah, so again recurring education has been really important particularly with interventional cardiology fellows, since they're the ones that really execute this in terms of ordering the tests and working with the clinical pharmacy specialists. And as I mentioned, we're in the process of developing clinical decision support to help make this a little bit easier on the prescribers. When a test result is available, we believe this will make it a little easier for the result to be more readily available for the clinical decision. Sony Tuteja:                       Yeah I think the CDS tools will be key to have more compliance with the results in adherence to the test results. I'm just curious, who pays for the genotype tests at your center and are you billing for these tests? Craig Lee:                            Yes. We're billing for these tests as part of routine clinical care. Sony Tuteja:                       Great, and you've had good success with reimbursement? Craig Lee:                            As far as we can tell, yes. Sony Tuteja:                       That's great to hear. I think that will really incentivize other centers to pursue similar lines of testing. So what do you think are the broader implications for implementing genetically guided care for other drugs? Craig Lee:                            Yeah, I think that it's interdisciplinary collaboration. Communication is really important among physicians, clinical pathologists, and clinical pharmacists. We found that this has been essential to success of the program here at UNC with this one gene drug pair. And again, this is fueled by a spirit of collaboration and will for our clinicians to work together to optimize patient care. And really, I think clinical pharmacists are uniquely positioned to help make this happen. Clinical pharmacists are uniquely positioned to interpret pharmacogenomic test results, provide medication recommendations, as well as counsel patients on how to interpret the tests and why the prescribing decision is being made. Our clinical pharmacists at UNC are fantastic and have really embraced this. They've shown that pharmacogenomics can be an important part of medication therapy management.                                                 Although implementation of pharmacogenomics testing is clearly a challenge, it is now part of the routine in our Cath lab and in our cardiology services. And again, that's been really exciting to observe. I also think this experience provides a foundation in an example for other pharmacogenomic implementations to occur at our institution. Sony Tuteja:                       That's great, it's so nice to hear about the team working together to get this accomplished. What has been the patient response to the testing? How have they responded to receiving genetic test results? Craig Lee:                            We think it has been overall positive. And again, it's now part of the workup in terms of providing the best possible care for the patient given the evidence that we have. And so again, since it's part of the clinical work flow, there's not a separate research consent that's done. The testing is part of the consent to the procedure. Sony Tuteja:                       Well great, that's all the questions I have for you today. Do you have any final thoughts you wanna share with our listeners? Craig Lee:                            No, other than just a thank you again for having me in for talking about our paper. And I guess, I would just urge those that are out there that are either planning to do this or doing this, to collect data. It's really important to evaluate the practice, evaluate the frequency of testing, the frequency of prescribing decisions being altered by the testing, and trying to understand what the barriers are. And if possible, evaluate clinical outcomes.                                                 You know, we started this study under the umbrella of continuous quality improvement and it really has taught us a lot. I think it has helped optimize how the algorithm is used, and as other centers around the country have been doing this, it provided a basis to collaborate and really evaluate the impact on clinical outcomes, which is really the question that is on everybody's minds. And as the evidence base expands, I think there will be a lot more comfort with doing these things, but we should always strive to generate the evidence we need to assure that we're making the right decisions in practice. Sony Tuteja:                       Absolutely, I think that outcomes piece will be critical to getting this in the mainstream. Well I'd like to thank you for your time today, it was a pleasure speaking to you and once again, congratulations. Craig Lee:                            Thanks. Jane Ferguson:                 That's all for this month. As a reminder you can follow us on Twitter, @Circ_Gen or connect with us on Facebook. Thanks for listening, and I look forward to bringing you more on genomics and precision medicine of the heart next month.  

Interview with Ruud Delwel, Prof of Molecular Leukemogenesis at Erasmus Medical Center in Rotterdam, Netherlands. Prof. Delwel discusses the topic 'AML biology'.The interview is led by Shaun McCann, Chair of EHATol Unit, Member of EHA Education Committee.

Interview with Ruud Delwel, Prof of Molecular Leukemogenesis at Erasmus Medical Center in Rotterdam, Netherlands. Prof. Delwel discusses the topic 'AML biology'.The interview is led by Shaun McCann, Chair of EHATol Unit, Member of EHA Education Committee.

Host: Doug Weaver, MD Guest: Don Poldermans, MD, PhD For patients undergoing major non-cardiac surgery, perioperative management often focuses on recognition and treatment of cardiac risk factors and disease. Dr. Don Poldermans, professor of medicine and head of perioperative cardiac care at Erasmus Medical Center in Rotterdam, the Netherlands, joins host Dr. Doug Weaver to explain how medical treatment and testing should factor into pre-operative preparations. How should you proceed with patients who you suspect possesses some risk, but displays no risk factors? Does aspirin complicate our approach to certain surgeries for certain patients?

Host: Doug Weaver, MD Guest: Don Poldermans, MD, PhD For patients undergoing major non-cardiac surgery, perioperative management often focuses on recognition and treatment of cardiac risk factors and disease. Dr. Don Poldermans, professor of medicine and head of perioperative cardiac care at Erasmus Medical Center in Rotterdam, the Netherlands, joins host Dr. Doug Weaver to explain how medical treatment and testing should factor into pre-operative preparations. How should you proceed with patients who you suspect possesses some risk, but displays no risk factors? Does aspirin complicate our approach to certain surgeries for certain patients?