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In this evidence-packed episode of Parallax, Dr Ankur Kalra welcomes back Dr Purvi Parwani, Associate Professor of Medicine at Loma Linda University Health, for a comprehensive review of groundbreaking trials presented at the European Society of Cardiology Congress. Dr Parwani guides listeners through what she describes as a "tectonic shift" in post-MI care with the REBOOT and BETAMI-DANBLOCK trials. These studies challenge the routine use of beta blockers after heart attack, revealing that patients with preserved ejection fraction above 50% may not benefit, while those with EF between 40-49% show significant risk reduction from continued therapy. The discussion moves to heart failure management, exploring the POTCAST trial's approach to optimising potassium levels in high-risk patients and the DIGIT-HF trial's examination of digitoxin as a potential option for patients who cannot tolerate modern four-pillar therapy. Dr Kalra and Dr Parwani conclude with the evolving role of aspirin in cardiovascular care. They discuss findings from NEO-MINDSET, TARGET-FIRST, and the AQUATIC trial, which together are reshaping antiplatelet strategies from the immediate post-PCI period through long-term management of stable coronary disease in patients requiring anticoagulation. Questions and comments can be sent to "podcast@radcliffe-group.com" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.

Dr. Hope Rugo and Dr. Giuseppe Curigliano discuss recent developments in the field of bispecific antibodies for hematologic and solid tumors, including strategies to optimize the design and delivery of the immunotherapy. TRANSCRIPT Dr. Hope Rugo: Hello and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I am your host, Dr. Hope Rugo. I am the director of the Women's Cancers Program and division chief of breast medical oncology at the City of Hope Cancer Center. I am also the editor-in-chief of the Educational Book. Bispecific antibodies represent an innovative and advanced therapeutic platform in hematologic and solid tumors. And today, I am delighted to be joined by Dr. Giuseppe Curigliano to discuss the current landscape of bispecific antibodies and their potential to reshape the future of precision oncology. Dr. Curigliano was the last author of an ASCO Educational Book piece for 2025 titled, "Bispecific Antibodies in Hematologic and Solid Tumors: Current Landscape and Therapeutic Advances." Dr. Curigliano is a breast medical oncologist and the director of the Early Drug Development Division and chair of the Experimental Therapeutics Program at the European Institute of Oncology in Milan. He is also a full professor of medical oncology at the University of Milan. You can find our disclosures in the transcript of this episode. Dr. Curigliano, Giuseppe, welcome and thanks for being here. Dr. Giuseppe Curigliano: Thanks a lot for the invitation. Dr. Hope Rugo: Giuseppe, I would like to first ask you to provide some context for our listeners on how these novel therapeutics work. And then perhaps you could tell us about recent developments in the field of bispecific antibodies for oncology. We are at a time when antibody-drug conjugates (ADCs) are all the rage and, trying to improve on the targeting of specific antigens, proteins, receptors in the field of oncology is certainly a hot and emerging topic. Dr. Giuseppe Curigliano: So, thanks a lot. I believe really it was very challenging to try to summarize all the bispecific antibodies that are under development in multiple solid tumors. So, the first thing that I would like to highlight is the context and the mechanism of action of bispecific antibodies. Bispecific antibodies represent a groundbreaking advancement in cancer immunotherapy, because these engineered molecules have the unique ability to target and simultaneously bind to two distinct antigens. That is why we call them bispecific. So typically, one antigen is expressed on the tumor cell and the other one is expressed on the immune effectors, like T-cell or natural killer cells. So this dual targeting mechanism offers several key advantages over conventional monoclonal antibodies because you can target at the same time the tumor antigen, downregulating the pathway of proliferation, and you can activate the immune system. So the primary mechanism through which bispecific antibodies exert their therapeutic effects are: First, T-cell redirecting. I mean, many bispecific antibodies are designed to engage tumor-associated antigens like epidermal growth factor receptor, HER2, on the cancer cell and a costimulatory molecule on the surface of T-cell. A typical target antigen on T-cell is CD3. So what does it mean? That you activate the immune system, immune cells will reach the tumor bed, and you have a dual effect. One is downregulating cell proliferation, the other one is activation of the immune system. This is really important in hematological malignancies, where we have a lot of bispecifics already approved, like acute lymphoblastic leukemia or non-Hodgkin lymphoma.  The second, in fact, is the engagement of the tumor microenvironment. So, if you engage immune effector cells like NK cells or macrophages, usually the bispecific antibodies can exploit the immune system's ability to recognize and kill the immune cells, even if there is a lack of optimal antigen presentation.  And finally, the last mechanism of action, this may have a role in the future, maybe in the early cancer setting, is overcoming immune evasion. So bispecific antibodies can overcome some of the immune evasion mechanisms that we see in cancer. For example, bispecific antibodies can target immune checkpoint receptors, like PD-L1 and CTLA-4. Actually, there is a bispecific under development in breast cancer that has a dual targeting on vascular endothelial growth factor receptor and on PD-L1. So you have a dual effect at the same time. So, what is really important, as a comment, is we need to focus first on the optimal format of the bispecific, the optimal half-life, the stability, because of course even if they are very efficient in inducing a response, they may give also a lot of toxicities. So in clinical trials already, we have several bispecifics approved. In solid tumors, very few, specifically amivantamab for non-small cell lung cancer, but we have a pipeline of almost 40 to 50 bispecifics under development in multiple solid tumors, and some of them are in the context of prospective randomized trials. Dr. Hope Rugo: So this is really a fascinating area and it's really exciting to see the expansion of the different targets for bispecific antibodies. One area that has intrigued me also is that some of the bispecifics actually will target different parts of the same receptor or the same protein, but presumably those will be used as a different strategy. It's interesting because we have seen that, for example, in targeting HER2. Dr. Giuseppe Curigliano: Oh, yes, of course. You may consider some bispecifics like margetuximab, I suppose, in which you can target specifically two different epitopes of the same antigen. This is really an example of how a bispecific can potentially be more active and downregulating, let us say, a pathway, by targeting two different domains of a specific target antigen. This is an important point.  Of course, not all the bispecifics work this way, because some of the target antigen may dimerize, and so you have a family of target antigen; an example is epidermal growth factor receptor, in which you have HER1, HER2, HER3, and HER4. So some of them can inhibit the dimerization between one target antigen and the other one, in order to exert a more antiproliferative effect. But to be honest, the new generation of them are more targeting two different antigens, one on the tumor and one on the microenvironment, because according to the clinical data, this is a more efficient way to reduce proliferation and to activate the immune system. Dr. Hope Rugo: Really interesting, and I think it brings us to the next topic, which is really where bispecific antibodies have already shown success, and that is in hematologic malignancies where we have seen very interesting efficacy and these are being used in the clinic already. But the expansion of bispecific antibodies into solid tumors faces some key challenges. It's interesting because the challenges come in different shapes and forms. Tell us about some of those challenges and strategies to optimize bispecific antibody design, delivery, patient selection, and how we are going to use these agents in the right kind of clinical trials. Dr. Giuseppe Curigliano: This is really an excellent question because despite bispecific antibodies having shown a remarkable efficacy in hematological malignancies, their application in solid tumors may have some challenges. The first one is tumor heterogeneity. In hematological malignancy, you have a clear oncogene addiction. Let us say that 90% of the cells may express the same antigen. In solid tumors, it is not the same. Tumor heterogeneity is a typical characteristic of solid tumors, and you have high heterogeneity at the genetic, molecular, and phenotypic levels. So tumor cells can differ significantly from one another, even if within the same tumor. And this heterogeneity sometimes makes it difficult to identify a single target antigen that is universally expressed in an hematological malignancy. So furthermore, sometimes the antigen expressed on a tumor cell can be also present on the normal tissue. And so you may have a cross-targeting. So let's say, if you have a bispecific against epidermal growth factor receptor, this will target the tumor but will target also the skin with a lot of toxicity. The second challenge is the tumor microenvironment. The solid tumor microenvironment is really complex and often immunosuppressive. It is characterized by the presence of immunosuppressor cells like the T regulators, myeloid derived suppressor cells, and of course the extracellular matrix. All these factors hinder immune cell infiltration and also may reduce dramatically the effectiveness of bispecific antibodies. And as you know, there is also an hypoxic condition in the tumor. The other challenge is related to the poor tumor penetration. As you know also with antibody-drug conjugate, only 1 to 3% of the drug will arrive in the tumor bed. Unlike hematological malignancies where tumor cells are dispersed in the blood and easily accessible, the solid tumors have a lot of barriers, and so it means that tumor penetration can be very low. Finally, the vascularity also of the tumor can be different across solid tumors. That is why some bispecifics have a vascular endothelial growth factor receptor or vascular endothelial growth factor as a target. Of course, what do we have to do to overcome these challenges? First, we have to select the optimal antigen. So knowing very well the biology of cancer and the tumor-associated antigens can really select a subgroup of epitopes that are specifically overexpressed in cancer cells. And so we need to design bispecifics according to the tumor type. Second, optimize the antibody format. So there are numerous bispecific antibody formats. We can consider the dual variable domain immunoglobulin, we specified this in our paper. The single chain variable fragments, so FC variable fragments, and the diabodies that can enhance both binding affinity and stability. And finally, the last point, combination therapies. Because bispecific antibodies targeting immune checkpoint, we have many targeting PD-1 or PD-L1 or CTLA-4, combined eventually with other immune checkpoint inhibitors. And so you may have more immunostimulating effect. Dr. Hope Rugo: This is a fascinating field and it is certainly going to go far in the treatment of solid tumors. You know, I think there is some competition with what we have now for antibody-drug conjugates. Do you see that bispecifics will eventually become bispecific ADCs? Are we going to combine these bispecific antibodies with ADCs, with chemotherapy? What is the best combination strategy do you think looking forward? Dr. Giuseppe Curigliano: So, yes, we have a bispecific ADC. We have actually some bispecifics that are conjugated with a payload of chemotherapy. Some others are conjugated with immunoactivation agents like IL-2. One of the most effective strategies for enhancing bispecific activity is the combination therapy. So which type of combination can we do? First, bispecific antibodies plus checkpoint inhibitors. If you combine a bispecific with an immune checkpoint, like anti-PD-1, anti-PD-L1, or anti-CTLA-4, you have more activity because you have activation of T-cells, reduction of immunosuppressive effect, and of course, the capability of this bispecific to potentiate the activity of the immune checkpoint inhibitor. So, in my opinion, in a non-small cell lung cancer with an expression of PD-L1 more than 50%, if you give pembrolizumab plus a bispecific targeting PD-L1, you can really improve both response rate and median progression-free survival.  Another combination is chemotherapy plus bispecific antibodies. Combining chemotherapy with bispecific can enhance the cytotoxic effect because chemotherapy induces immunogenic cell death, and then you boost with a bispecific in order to activate the immune system. Bispecific and CAR T-cells, until now, we believe that these are in competition, but this is not correct. Because CAR T-cells are designed to deliver an activation of the immune system with the same lymphocytes engineered of the patients, with a long-term effect. So I really do not believe that bispecifics are in competition with CAR T-cells because when you have a complete remission induced by CAR T-cell, the effect of this complete remission can last for years. The activity of a bispecific is a little bit different. So there are some studies actually combining CAR T-cells with bispecifics. For example, bispecific antibodies can direct CAR T-cells in the tumor microenvironment, improving their specificity and enhancing their therapeutic effect.  And finally, monoclonal antibody plus bispecific is another next generation activity. Because if you use bispecific antibodies in combination with existing monoclonal antibodies like anti-HER2, you can potentially increase the immune response and enhance tumor cell targeting. In hematological malignancies, this has been already demonstrated and this approach has been particularly effective. Dr. Hope Rugo: That's just so fascinating, the whole idea that we have these monoclonal antibodies and now we are going to add them to bispecifics that we could maybe attach on different toxins to try and improve this, or even give them with different approaches. I suppose giving an ADC with a bispecific would sort of be similar to that idea of giving a monoclonal antibody with the bispecific. So it is certainly intriguing. We also will need to understand the toxicity and cost overall and how we are going to use these, the duration of treatment, the assessment of biomarkers. There are just so many different aspects that still need to be explored.  And then with that idea, can you look ahead five or ten years from now, and tell us how you think bispecific antibodies will shape our next generation cancer therapies, how they will be incorporated into precision oncology, and the new combinations and approaches as we move forward that will help us tailor treatment for patients both with solid tumors and hematologic malignancies? Are we going to be giving these in early-stage disease in solid tumors? So far, the studies are primarily focusing on the metastatic setting, but obviously one of the goals when we have successful treatments is to move them into the early stage setting as quickly as possible. Dr. Giuseppe Curigliano: Let us try to look ahead five years rather than ten years, to be more realistic. So, personally I believe some bispecifics can potentially replace current approaches in specifically T-cell selected population. As we gather more data from ongoing clinical trials and we adopt a deeper understanding of the tumor immuno microenvironment, of course we may have potentially new achievement. A few days ago, we heard that bispecifics in triple negative breast cancer targeting VEGF and PD-L1 demonstrated an improvement in median progression-free survival.  So, how to improve and to impact on clinical practice both in the metastatic and in the early breast cancer setting or solid tumor setting? First, personalized antigen selection. So we need to have the ability to tailor bispecific antibody therapy to the unique tumor profile of individual patients. So the more we understand the biology of cancers, the more we will be able to better target. Second, bispecific antibodies should be combined. I can see in the future a potential trial in which you combine a bispecific anti-PD-L1 and VEGF with immune checkpoint inhibitor selected also to the level of expression of PD-L1, because integration of antibody bispecific with a range of immunotherapies, and this cannot be only immune checkpoint inhibitors, but can be CAR T-cells, oncolytic viruses, also targeted therapy, will likely be a dominant theme in the coming years. This combination will be based on the specific molecular and immuno feature of the cancer of the patient.  Then we need an enhanced delivery system. This is really important because you know now we have a next generation antibody. An example are the bicyclic. So you use FC fragment that are very short, with a low molecular weight, and this short fragment can be bispecific, so can target at the same time a target antigen and improving the immune system. And so the development of this novel delivery system, including also nanoparticles or engineered viral vectors, can enhance the penetration in the tumor bed and the bioavailability of bispecific antibodies. Importantly, we need to reduce toxicity. Until now, bispecifics are very toxic. So the more we are efficient in delivering in the tumor bed, the more we will reduce the risk of toxicity. So it will be mandatory to reduce off-target effects and to minimize toxicity.  And finally, the expansion in new indication. So I really believe you raised an excellent point. We need to design studies in the neoadjuvant setting in order to better understand with multiple biopsies which is the effect on the tumor microenvironment and the tumor itself, and to generate hypotheses for potential trials or in the neoadjuvant setting or in those patients with residual disease.  So, in my opinion, as we refine design, optimize patient selection, and explore new combination, in the future we will have more opportunity to integrate bispecifics in the standard of care. Dr. Hope Rugo: I think it is particularly helpful to hear what we are going to be looking for as we move forward to try and improve efficacy and reduce toxicity. And the ability to engineer these new antibodies and to more specifically target the right proteins and immune effectors is going to be critical, of course, moving forward, as well as individualizing therapy based on a specific tumor biology.  Hearing your insights has been great, and it really has opened up a whole area of insight into the field of bispecifics, together with your excellent contribution to the ASCO Educational Book. Thank you so much for sharing your thoughts and background, as well as what we might see in the future on this podcast today. Dr. Giuseppe Curigliano: Thank you very much for the invitation and for this excellent interview. Dr. Hope Rugo: And thanks to our listeners for joining us today. You will find a link to the Ed Book article we discussed today in the transcript of this episode. It is also, of course, on the ASCO website, as well as on PubMed. Please join us again next month on By the Book for more insightful views on the key issues and innovations that are shaping modern oncology. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Follow today's speakers:       Dr. Hope Rugo  @hope.rugo  Dr. Giuseppe Curigliano @curijoey Follow ASCO on social media:       @ASCO on X (formerly Twitter)       ASCO on Bluesky      ASCO on Facebook       ASCO on LinkedIn       Disclosures:      Dr. Hope Rugo:   Honoraria: Mylan/Viatris, Chugai Pharma  Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer  Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx  Dr. Giuseppe Curigliano: Leadership: European Society for Medical Oncology, European Society of Breast Cancer Specialists, ESMO Open, European Society for Medical Oncology Honoraria: Ellipses Pharma Consulting or Advisory Role: Roche/Genentech, Pfizer, Novartis, Lilly, Foundation Medicine, Bristol-Myers Squibb, Samsung, AstraZeneca, Daiichi-Sankyo, Boerigher, GSK, Seattle Genetics, Guardant Health, Veracyte, Celcuity, Hengrui Therapeutics, Menarini, Merck, Exact Sciences, Blueprint Medicines, Gilead Sciences Speakers' Bureau: Roche/Genentech, Novartis, Pfizer, Lilly, Foundation Medicine, Samsung, Daiichi Sankyo, Seagen, Menarini, Gilead Sciences, Exact Sciences Research Funding: Merck Travel, Accommodations, Expenses: Roche/Genentech, Pfizer, Daiichi Sankyo, AstraZeneca      

Host: Susanna Price Guest: Rudolf de Boer Want to watch that extended interview on AI in echocardiography? Go to: https://esc365.escardio.org/event/2175?resource=interview Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.  This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder Mycardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Rudolf de Boer has declared to have potential conflicts of interest to report: the institution of Rudolf de Boer has received research grants and/or fees from Alnylam, AstraZeneca, Abbott, Bristol-Myers Squibb, NovoNordisk, and Roche; Rudolf de Boer has had speaker engagements with and/or received fees from and/or served on an advisory board for Abbott, AstraZeneca, Bristol Myers Squibb, NovoNordisk, Roche, and Zoll; Rudolf de Boer received travel support from Abbott and NovoNordisk. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

This episode covers: Cardiology This Week: A concise summary of recent studies Visceral adiposity: paradigm shift in HFpEF management Artificial Intelligence in echocardiography Milestones: ISIS-2 Host: Susanna Price Guests: Carlos Aguiar, Milton Packer, Rudolf de Boer Want to watch the episode? Go to: https://esc365.escardio.org/event/2175 Want to watch the extended interview on AI in echocardiography? Go to: https://esc365.escardio.org/event/2175?resource=interview Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder Mycardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Rudolf de Boer has declared to have potential conflicts of interest to report: the institution of Rudolf de Boer has received research grants and/or fees from Alnylam, AstraZeneca, Abbott, Bristol-Myers Squibb, NovoNordisk, and Roche; Rudolf de Boer has had speaker engagements with and/or received fees from and/or served on an advisory board for Abbott, AstraZeneca, Bristol Myers Squibb, NovoNordisk, Roche, and Zoll; Rudolf de Boer received travel support from Abbott and NovoNordisk. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Milton Packer has declared to have potential conflicts of interest to report: 89bio, Abbvie, Actavis, Altimmune, Alnylam, Amarin, Amgen, Ardelyx, ARMGO, AstraZeneca, Attralus, Biopeutics, Boehringer Ingelheim, Caladrius, Casana, CSL Behring, Cytokinetics, Daiichi Sankyo, Imara, Lilly, Medtronic, Moderna, Novartis, NovoNordisk, Pharmacocosmos, Regeneron, Roche, Salamandra. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

“It's 5pm and your Consultant (attending) has headed off home. A patient arrives in the resuscitation room blood spurting from a stab wound in the armpit. Join Roisin – a junior Major Trauma fellow, Prash – a surgical trainee, Max – a senior trauma surgery fellow, and Chris – a Consultant trauma surgeon, as we talk through decision making from point of injury to aftercare in this challenging trauma surgical case”. • Hosts: Bulleted list of host names, including title, institution, & social media handles if indicated 1.     Mr Prashanth Ramaraj. General Surgery trainee, Edinburgh rotation. @LonTraumaSchool 2.     Dr Roisin Kelly. Major Trauma Junior Clinical Fellow, Royal London Hospital.  3.     Mr Max Marsden. Resuscitative Major Trauma Fellow, Royal London Hospital. @maxmarsden83 4.     Mr Christopher Aylwin. Consultant Trauma & Vascular Surgeon and Co-Programme Director MSc Trauma Sciences at Queen Mary University of London. @cjaylwin • Learning objectives: Bulleted list of learning objectives. A)    To become familiar with prehospital methods of haemorrhage control in penetrating junctional injuries. B)     To recognise the benefits of prehospital blood product resuscitation in some trauma patients. C)     To follow the nuanced decision making in decision for CT scan in a patient with a penetrating junctional injury. D)    To describe the possible approaches to the axillary artery in the context of resuscitative trauma surgery. E)     To become familiar with decision making around intraoperative systemic anticoagulation in the trauma patient. F)     To become familiar with decision making on type of repair and graft material in vascular trauma. G)    To recognise the team approach in holistic trauma care through the continuum of trauma care. • References: Bulleted list of references with PubMed links. 1.    Perkins Z. et al., 2012. Epidemiology and Outcome of Vascular Trauma at a British Major Trauma Centre. EJVES. https://www.ejves.com/article/S1078-5884(12)00337-1/fulltext 2.    Ramaraj P., et al. 2025. The anatomical distribution of penetrating junctional injuries and their resource implications: A retrospective cohort study. Injury. https://www.injuryjournal.com/article/S0020-1383(24)00771-X/ 3.    Smith, S., et al. 2019. The effectiveness of junctional tourniquets: A systematic review and meta-analysis. J Trauma Acute Care Surg. https://journals.lww.com/jtrauma/abstract/2019/03000/the_effectiveness_of_junctional_tourniquets__a.20.aspx 4.    Rijnhout TWH, et al. 2019. Is prehospital blood transfusion effective and safe in haemorrhagic trauma patients? A systematic review and meta-analysis. Injury. https://www.injuryjournal.com/article/S0020-1383(19)30133-0/ 5.    Davenport R, et al. 2023. Prehospital blood transfusion: Can we agree on a standardised approach? Injury. https://www.injuryjournal.com/article/S0020-1383(22)00915-9. 6.    Borgman MA., et al. 2007. The Ratio of Blood Products Transfused Affects Mortality in Patients Receiving Massive Transfusions at a Combat Support Hospital. J Trauma Acute Care Surg. https://journals.lww.com/jtrauma/fulltext/2007/10000/the_ratio_of_blood_products_transfused_affects.13.aspx 7.    Holcomb JB., et al. 2013. The Prospective, Observational, Multicenter, Major Trauma Transfusion (PROMMTT) Study. Comparative Effectiveness of a Time-Varying Treatment With Competing Risks. JAMA Surgery. https://jamanetwork.com/journals/jamasurgery/fullarticle/1379768 8.    Holcomb JB, et al. 2015. Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 vs a 1:1:2 Ratio and Mortality in Patients With Severe Trauma. The PROPPR Randomized Clinical Trial. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2107789 9.    Davenport R., et al. 2023. Early and Empirical High-Dose Cryoprecipitate for Hemorrhage After Traumatic Injury. The CRYOSTAT-2 Randomized Clinical Trial. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2810756 10.   Baksaas-Aasen K., et al. 2020. Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): a randomized, controlled trial. ICM. https://link.springer.com/article/10.1007/s00134-020-06266-1 11. Wahlgren CM., et al. 2025. European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Vascular Trauma. EJVES. https://esvs.org/wp-content/uploads/2025/01/2025-Vascular-Trauma-Guidelines.pdf 12. Khan S., et al. 2020. A meta-analysis on anticoagulation after vascular trauma. Eur J Traum Emerg Surg. https://link.springer.com/article/10.1007/s00068-020-01321-4 13. Stonko DP., et al. 2022. Postoperative antiplatelet and/or anticoagulation use does not impact complication or reintervention rates after vein repair of arterial injury: A PROOVIT study. Vascular. https://journals.sagepub.com/doi/10.1177/17085381221082371?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Send us a textWelcome back Rounds Table Listeners! Today we have a solo episode with Dr. Mike Fralick. This week, he discusses a recently published trial looking at aspirin in patients with chronic coronary syndrome receiving oral anticoagulation. Here we go!Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation (0:00 – 9:43).Throwback to EPIC-CAD: The Rounds Table Episode 94: Top Papers from the 2024 European Society of Cardiology Congress The Good Stuff:Trial Files is a free monthly newsletter on practice-changing trials, delivered straight to your inbox (https://trialfiles.substack.com/).Guidelines summaries coming to Trial Files soon!Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

This episode covers: Cardiology This Week: A concise summary of recent studies Strategic decisions in valvular heart disease Optimising drug therapy in chronic coronary syndromes Mythbusters: Does wearing a white coat make you smarter? Host: Susanna Price Guests: John-Paul Carpenter, Fabien Praz, Robert Storey Want to watch that episode? Go to: https://esc365.escardio.org/event/2092 Want to watch that extended interview on Optimising drug therapy in chronic coronary syndromes ? Go to: https://esc365.escardio.org/event/2092?resource=interview Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel, Fabien Praz and Susanna Price have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder Mycardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Robert Storey has declared to have potential conflicts of interest to report: research grants and personal fees from AstraZeneca and Cytosorbents, and personal fees from Abbott, Afortiori Development/Thrombolytic Science, Boehringer Ingelheim/Lilly, Bristol Myers Squibb/Johnson & Johnson, Chiesi, Idorsia/Viatris, Novo Nordisk, PhaseBio and Tabuk. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Susanna Price Guest: Robert Storey Want to watch that extended interview? Go to: https://esc365.escardio.org/event/2092?resource=interview Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder Mycardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.  Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Robert Storey has declared to have potential conflicts of interest to report: research grants and personal fees from AstraZeneca and Cytosorbents, and personal fees from Abbott, Afortiori Development/Thrombolytic Science, Boehringer Ingelheim/Lilly, Bristol Myers Squibb/Johnson & Johnson, Chiesi, Idorsia/Viatris, Novo Nordisk, PhaseBio and Tabuk. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

In this episode of Onc Now, Luis Paz-Ares, Chair of the Medical Oncology Department at Hospital Universitario 12 de Octubre in Madrid, Spain, shares his expert insights on the evolving science of lung cancer. From the critical role of prevention and smoking cessation through to the latest therapeutic breakthroughs, Paz-Ares offers a candid discussion on the progress, challenges, and hopes for the future of lung cancer research and treatment.  Timestamps:  00:00 – Introduction  01:09 – Key insights on lung cancers  02:26 – Luis's journey into oncology  04:10 – Highlights and lowlights of his role  08:30 – Delivering bad news to patients  10:30 – Current diagnosis process and treatment landscape  13:20 – Trends in lung cancer prevalence  16:00 – IMforte trial  21:15 – Biggest obstacles researchers and clinicians face today  22:50 – Non-smokers  24:40 – European Society for Medical Oncology (ESMO) 2025 predictions  26:00 – Luis's three wishes for cancer research    Disclaimer: The opinions expressed in this episode belong to the speakers and do not necessarily represent the opinions of EMJ.  

Vincent travels to Thessaloniki, Greece to attend the 27th meeting of the European Society for Clinical Virology, where he speaks with Pamela Vallely, ESCV President, and Piotr Kramarz, Chief Scientist, European CDC, about the activities of ESCV and ECDC. Host: Vincent Racaniello Guests: Piotr Kramarz and Pamela Vallely Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Intro music is by Ronald Jenkees Send your virology questions and comments to twiv@microbe.tv Content in this podcast should not be construed as medical advice.

Fertility & Sterility on Air is at the European Society of Human Reproduction and Embryology 41st Annual Meeting in Paris, France (Part 2)! In this episode, our hosts Kate Devine, Eve Feinberg, and Micah Hill cover: Discussing the state of assisted reproductive technology in Brazil with Giuliano Bedoschi (01:01) Whole transcriptome and genome sequencing of standard embryo biopsies can potentially reduce failed euploid transfers with Kaylene Ready and Jeremy Grushcow (09:03)  The use of AI in ovarian stimulation with Eduardo Hariton (19:45)  Modeling embryonic adhesion at cellular resolution within a microfluidic endometrium-on-a-chip platform with Sofia Zaragozano (32:33)  Assessing the ploidy status of atypically fertilised embryos – recovery of embryos for potential clinical use with Sharyn Stock-Myer (40:41)  Role of micronutrients and probiotics supplementation on reproductive outcomes in an oocyte donation program with Sara Maggi and Silvia Bonta (42:47)  Male infertility, life expectancy, and long-term health risks: exploring what can sperm reveal about health with Omar Ammar (58:00) Mitochondrial DNA ‘reversal' is common in children born following meiotic spindle transfer, potentially reducing the efficacy of mitochondrial replacement therapies with Munuse Savash (01:05:57) View Fertility and Sterility at https://www.fertstert.org/  

If you've found yourself holding a book at arm's length or squinting at your phone in dim light, you're not alone. Almost everyone develops presbyopia as they get older. It's a natural part of aging where the eye's lens loses flexibility, making it harder to focus on nearby objects. Traditionally, the go-to solution has been reading glasses, or, for some, surgery. But now, a surprising contender is on the horizon: eye drops. At the recent Congress of the European Society of Cataract and Refractive Surgeons, researchers presented results that could change how presbyopia is treated. In a study of 766 patients, eye drops combining pilocarpine and diclofenac helped people read extra lines on a near-vision chart, and the improvements lasted for up to two years. The drops contain two active ingredients working in tandem: Pilocarpine: an older drug that contracts the eye's ciliary muscle and makes the pupil smaller. This helps sharpen focus for near objects. Diclofenac: a common anti-inflammatory drug that eases the discomfort pilocarpine can cause. Together, they act like a workout and cushion for the eye: one trains the focusing muscles, the other keeps irritation at bay. Patients in the study used the drops twice a day once in the morning and once later in the afternoon, with the option for a third dose if needed. The findings were striking: Within one hour of the first dose, patients could typically read three extra lines on the near-vision chart. 99% of those using the lowest concentration (1% pilocarpine) gained at least two lines of improvement. For many, the improvements lasted more than a year, with some maintaining better vision for nearly two years. Side effects were mild and included temporary dim vision (32%), irritation (3.7%), and headaches (3.8%). Importantly, no serious complications like retinal detachment were reported. Imagine a future where instead of fumbling for your reading glasses at dinner, you simply use an eye drop in the morning and carry on with clear sight throughout the day. LISTEN ABOVESee omnystudio.com/listener for privacy information.

Updates on GLP-1 drugs in heart failure, β-blockers after myocardial infarction, the shingles vaccine, and more: Felix Mahfoud, MD, chair of the Department of Cardiology at University Hospital Basel, shares clinical research highlights from the recent European Society of Cardiology Congress. Related Content: GLP-1 Drugs in Heart Failure, β-Blockers After MI, the Shingles Vaccine, and More From ESC 2025

In this inspiring episode of Hema Now, Catherine Glass speaks with Rob Pieters, Professor of Pediatric Oncology at Utrecht University; and co-founder of the Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands, the largest dedicated childhood cancer centre in Europe. Pieters shares his personal journey in paediatric oncology, the breakthroughs that have reshaped care, and the vision behind uniting all of the Netherlands' childhood cancer expertise under one roof.  Timestamps   00:00 – Introduction  01:06 – Pieters' start in paediatric oncology  01:29 – Biggest breakthroughs in childhood cancers  02:35 – Parts of Pieters work that bring him the most joy  03:12 - Lessons learnt from patients or their families   04:31 – The vision behind the Princess Máxima Center  08:35 – The impact of the Princess Máxima Center   10:53 – How is research funding divided?  12:55 – Evolution of treatments in paediatric oncology  15:10 – What will it take to achieve 100% cure rate in acute lymphoblastic leukaemia?  18:55 – President Elect of the European Society for Paediatric Oncology (SIOPE)  22:20 – One message of hope to families facing childhood cancer  25:10 – Pieter's three wishes for healthcare 

Send us a textWelcome back Rounds Table Listeners! We are back today with a special Rapid Fire Podcast. This week, Drs. Mike and John Fralick discuss some of the top papers from the 2025 European Society of Cardiology (ESC) Congress. Hot off the presses, here we go!Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias (0:00 - 5:23)Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction (5:24 - 10:23)RSV Prefusion F Vaccine for Prevention of Hospitalization in Older Adults (10:24 - 16:09)Apixaban for Extended Treatment of Provoked Venous Thromboembolism (16:10 - 20:55)The Good Stuff (20:56 - 22:53):Thrombo Trial Files (https://thrombotrialfiles.substack.com/)John Candy: I Like Me at the Toronto International Film Festival The I'm Pharmacy podcast is now live on www.medicinepods.com Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

On va essayer de ne pas compliquer le traitement des cystites non compliquées en parlant de fosfomycine. Dans ce 63ème épisode disponible exclusivement aux membres Premium du Pharmascope, Nicolas, Sébastien et Isabelle discuteront de la fosfomycine sous tous ses angles: traitement de la cystite non compliquée et compliquée, germes multirésistants et prophylaxie des infections récurrentes. Les objectifs pour cet épisode sont: Identifier les patients pour qui la fosfomycine est indiquée Comparer l'efficacité et l'innocuité de la fosfomycine à d'autres antibiotiques dans le traitement de la cystite Expliquer les avantages et les inconvénients de la fosfomycine dans le traitement des infections urinaires Ressources pertinentes en lien avec l'épisode Guide d'usage optimal de l'INESSS Institut national d'excellence en santé et en services sociaux. Infection urinaire chez l'adulte. Octobre 2017. Lignes directrices de l'IDSA Gupta K et coll. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52:e103-20. Revues systématiques comparant la fosfomycine à d'autres antibiotiques Falagas ME et coll. Fosfomycin versus other antibiotics for the treatment of cystitis: a meta-analysis of randomized controlled trials. J Antimicrob Chemother. 2010;65:1862-77. Cai T et coll. Fosfomycin Trometamol versus Comparator Antibiotics for the Treatment of Acute Uncomplicated Urinary Tract Infections in Women: A Systematic Review and Meta-Analysis. J Urol. 2020;203:570-8. Étude randomisée contrôlée comparant la fosfomycine à la nitrofurantoïne Huttner A et coll. Effect of 5-Day Nitrofurantoin vs Single-Dose Fosfomycin on Clinical Resolution of Uncomplicated Lower Urinary Tract Infection in Women: A Randomized Clinical Trial. JAMA. 2018;319:1781-9. Étude comparative en traitement de cystite à germe multirésistant Senol S et coll. Carbapenem versus fosfomycin tromethanol in the treatment of extended-spectrum beta-lactamase-producing Escherichia coli-related complicated lower urinary tract infection. J Chemother. 2010;22:355-7. Revue systématique portant sur la prophylaxie d'infections urinaires récurrentes Nalliah S et coll. The use of chemotherapeutic agents as prophylaxis for recurrent urinary tract infection in healthy nonpregnant women: A network meta-analysis. Indian J Urol. 2019;35:147-55. Revue systématique portant sur la prophylaxie antibiotique lors de biopsie de la prostate Pilatz A et coll. Antibiotic Prophylaxis for the Prevention of Infectious Complications following Prostate Biopsy: A Systematic Review and Meta-Analysis. J Urol. 2020;204:224-30.

Special edition of the JAMA Editor's Summary featuring the JAMA Network articles published at the 2025 European Society of Cardiology Congress. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, with JAMA Executive Editor Gregory Curfman, MD, JAMA Senior Editor Philip Greenland, MD, and JAMA Cardiology Editor Robert O. Bonow, MD, MS. Related Content: Remote Screening for Asymptomatic Atrial Fibrillation Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation Systolic Blood Pressure and Microaxial Flow Pump–Associated Survival in Infarct-Related Cardiogenic Shock Helicobacter pylori Screening After Acute Myocardial Infarction Physiology-Guided Complete Revascularization in Older Patients With Myocardial Infarction Fractional Flow Reserve–Guided Complete vs Culprit-Only Revascularization in Non–ST-Elevation Myocardial Infarction and Multivessel Disease Transcatheter or Surgical Treatment of Patients With Aortic Stenosis at Low to Intermediate Risk Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction Bivalent RSV Prefusion F Protein–Based Vaccine for Preventing Cardiovascular Hospitalizations in Older Adults High-Dose vs Standard-Dose Influenza Vaccine and Cardiovascular Outcomes in Older Adults Risk of Myocarditis or Pericarditis With High-Dose vs Standard-Dose Influenza Vaccine Clonal Hematopoiesis and Risk of New-Onset Myocarditis and Pericarditis Participation of Women in Cardiovascular Trials From 2017 to 2023 Prevalence, Determinants, and Time Trends of Cardiovascular Health in the WHO African Region

Special edition of the JAMA Editor's Summary featuring the JAMA Network articles published at the 2025 European Society of Cardiology Congress. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, with JAMA Executive Editor Gregory Curfman, MD, JAMA Senior Editor Philip Greenland, MD, and JAMA Cardiology Editor Robert O. Bonow, MD, MS. Related Content: Remote Screening for Asymptomatic Atrial Fibrillation Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation Systolic Blood Pressure and Microaxial Flow Pump–Associated Survival in Infarct-Related Cardiogenic Shock Helicobacter pylori Screening After Acute Myocardial Infarction Physiology-Guided Complete Revascularization in Older Patients With Myocardial Infarction Fractional Flow Reserve–Guided Complete vs Culprit-Only Revascularization in Non–ST-Elevation Myocardial Infarction and Multivessel Disease Transcatheter or Surgical Treatment of Patients With Aortic Stenosis at Low to Intermediate Risk Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction Bivalent RSV Prefusion F Protein–Based Vaccine for Preventing Cardiovascular Hospitalizations in Older Adults High-Dose vs Standard-Dose Influenza Vaccine and Cardiovascular Outcomes in Older Adults Risk of Myocarditis or Pericarditis With High-Dose vs Standard-Dose Influenza Vaccine Clonal Hematopoiesis and Risk of New-Onset Myocarditis and Pericarditis Participation of Women in Cardiovascular Trials From 2017 to 2023 Prevalence, Determinants, and Time Trends of Cardiovascular Health in the WHO African Region

Fertility & Sterility on Air is at the European Society of Human Reproduction and Embryology 41st Annual Meeting in Paris, France (Part 1)! In this episode, our hosts Kate Devine, Eve Feinberg, and Micah Hill cover:  outcomes from programmed ovulatory frozen embryo transfer cycles vs. modified natural frozen embryo transfer cycles with Philippos Edimiris (0:56), non-invasive preimplantation genetic testing using metabolomics with Sofia Nunes (9:23), optimizing timing of modified natural cycle frozen embryo transfer cycles with Amelie Johansen and Kristine Løssl (17:46), mechanisms and consequences of ovarian aging with Francesca Duncan (27:18), comparing pregnancy loss rates in natural cycle vs. artificial cycle endometrial preparation prior to euploid embryo transfer with Caroline Roelens (38:24), and endometrial health and reproductive outcomes with Shari Mackens(49:44). View Fertility and Sterility at https://www.fertstert.org/  

All of this week's episodes of It Could Happen Here put together in one large file. - It Was Never About Crime feat. Prop - Abundance, Or How To Sell Tech Fascism To Liberals - ICE Partners with Israeli Phone Hacking Spyware - Recognizing Palestine as a State: Meaningful Farce feat. Dana El Kurd - Executive Disorder: White House Weekly #33 You can now listen to all Cool Zone Media shows, 100% ad-free through the Cooler Zone Media subscription, available exclusively on Apple Podcasts. So, open your Apple Podcasts app, search for “Cooler Zone Media” and subscribe today! http://apple.co/coolerzone Sources/Links: It Was Never About Crime feat. Prop https://link.springer.com/article/10.1007/s10567-025-00534-6#Sec9 https://www.thebanner.com/community/criminal-justice/baltimore-homicides-drop-WTR3QQN7LRGFXOVCGAAMNYMUBE/ https://theconversation.com/data-driven-early-intervention-strategies-could-revolutionize-phillys-approach-to-crime-prevention-258756 https://genius.com/Freeway-what-we-do-lyrics https://www.baltimorepolice.org/about/baltimore-police-crime-plan https://www.theguardian.com/us-news/2025/aug/16/baltimore-violent-crime-trump Abundance, Or How To Sell Tech Fascism To Liberals https://thebaffler.com/latest/whats-the-matter-with-abundance-harris?ref=newintermag.com https://newintermag.com/abundance-big-techs-bid-for-the-democratic-party/#fn16 https://archive.vn/zgPJ8 https://therevolvingdoorproject.org/wp-content/uploads/2025/09/Abundance-Ecosystem-Report-Final.pdf https://www.semafor.com/article/08/17/2025/with-the-argument-the-left-gets-a-new-publication http://www.thinktankwatch.com/2022/01/washingtons-newest-think-tank-institute.html https://www.vcinfodocs.com/venture-capital-extremism https://therevolvingdoorproject.org/who-is-behind-the-growing-abundance-movement/ https://www.vcinfodocs.com/the-tech-fascist-axis https://www.abundancedc.org/speakers https://www.vcinfodocs.com/the-tech-fascist-axis https://archive.vn/GKRmw#selection-377.0-377.19 https://www.theargumentmag.com/about https://prospect.org/economy/2024-11-26-abundance-agenda-neoliberalisms-rebrand/ https://www.reuters.com/legal/litigation/dc-attorney-general-inks-first-settlement-realpage-price-fixing-lawsuit-2025-06-02/ https://www.economicliberties.us/press-release/economic-liberties-launches-2025-end-rental-price-fixing-campaign/ https://bidenwhitehouse.archives.gov/cea/written-materials/2024/12/17/the-cost-of-anticompetitive-pricing-algorithms-in-rental-housing/ https://www.justice.gov/archives/opa/pr/justice-department-sues-realpage-algorithmic-pricing-scheme-harms-millions-american-renters https://www.justice.gov/archives/opa/pr/justice-department-sues-realpage-algorithmic-pricing-scheme-harms-millions-american-renters https://techfascism.substack.com/p/the-network-state-and-infrastructure ICE Partners with Israeli Phone Hacking Spyware https://ssd.eff.org/ https://citizenlab.ca/2025/03/a-first-look-at-paragons-proliferating-spyware-operations/ https://citizenlab.ca/2025/06/first-forensic-confirmation-of-paragons-ios-mercenary-spyware-finds-journalists-targeted/ https://www.theguardian.com/us-news/2025/sep/02/trump-immigration-ice-israeli-spyware https://jackpoulson.substack.com/p/exclusive-ice-has-reactivated-its https://www.wired.com/story/ice-paragon-solutions-contract/ https://dfrlab.org/wp-content/uploads/sites/3/2024/09/Mythical-Beasts.pdf https://finder.startupnationcentral.org/company_page/paragon https://red-dot.capital/portfolio https://www.forbes.com/sites/thomasbrewster/2021/07/29/paragon-is-an-nso-competitor-and-an-american-funded-israeli-surveillance-startup-that-hacks-encrypted-apps-like-whatsapp-and-signal/ https://www.presidency.ucsb.edu/documents/executive-order-14093-prohibition-use-the-united-states-government-commercial-spyware-that https://www.eff.org/deeplinks/2025/09/eff-statement-ice-use-paragon-solutions-malware Recognizing Palestine as a State: Meaningful Farce feat. Dana El Kurd Noura Erekat and Shahd Hammouri in Jadaliyya - https://www.jadaliyya.com/Details/46838 Paul Poast in World Politics Review - https://www.worldpoliticsreview.com/palestine-state-recognition-france/ NPR report - https://www.npr.org/2025/08/01/nx-s1-5485359/france-uk-palestine-state-explainer European Society of International Law on occupation - https://esil-sedi.eu/prolonged-occupation-or-illegal-occupant/#:~:text=The%20occupying%20power%2C%20throughout%20the,consistent%20with%20its%20trustee%20responsibilities. Daniel Kurtzer on the Oslo Accords - https://www.nytimes.com/interactive/2023/11/20/magazine/israel-gaza-oslo-accords.html Hanan Ashrawi on the Oslo Accords - https://www.972mag.com/hanan-ashrawi-oslo-accords/ Polling of Palestinians May 2025 - https://www.pcpsr.org/sites/default/files/Poll%2095%20press%20release%206May2025%20ENGLISH.pdf Dana El Kurd and Pablo Abufom for The Guardian - https://www.theguardian.com/commentisfree/2025/may/08/palestinians-leader-mahmoud-abbas-president Tanja Aalberts on sovereignty - Constructing Sovereignty between Politics and Law - 1st Edition - Tanj Jared Kushner “Peace to Prosperity” plan - trumpwhitehouse.archives.gov/wp-content/uploads/2020/01/Peace-to-Prosperity-0120.pdf Executive Disorder: White House Weekly #33 https://supreme.justia.com/cases/federal/us/422/873/ https://www.aclu.org/press-releases/customs-and-border-protection-settles-federal-lawsuit-american-citizens-racially https://www.lawfaremedia.org/article/l.g.m.l.-v.-noem--a-hearing-diary ttps://qz.com/higher-investment-means-hyundai-could-get-2-1-billion-1850832920 https://www.theguardian.com/us-news/2025/sep/10/hyundai-factory-ice-raid-legal-visa https://www.wired.com/story/far-right-reactions-charlie-kirk-shooting-civil-war/ https://www.nytimes.com/live/2025/09/11/us/charlie-kirk-shooting-news https://x.com/mkraju/status/1965108206969241953 https://x.com/TheJusticeDept/status/1963635111112446449 https://www.reuters.com/world/us/trump-administration-considering-banning-trans-people-buying-guns-us-media-2025-09-04/ https://www.cnn.com/2025/09/04/politics/transgender-firearms-justice-department-second-amendment https://archive.ph/kI2Uo https://www.wsj.com/health/healthcare/rfk-jr-hhs-to-link-autism-to-tylenol-use-in-pregnancy-and-folate-deficiencies-e3acbb4c https://www.youtube.com/watch?v=yok1fhPICAYSee omnystudio.com/listener for privacy information.

MedPod Today: the podcast series where MedPage Today reporters share deeper insight into the week's biggest healthcare stories. This week, MedPage Today reporters discuss the latest RFK Jr. news, Florida's announcement it would end vaccine mandates, and the top research from the European Society of Cardiologyannual meeting. Episode produced and hosted by Rachael Robertson. Sound engineering by

Last week, John was at the European Society of Cardiology conference in Madrid, and Adam was at the Preventing Overdiagnosis 2025 International Conference in Oxford. A conversation about what we learned.Digitoxin in Patients with Heart Failure and Reduced Ejection FractionBeta-Blockers Post-MI: A Clear Clinical MessageAspirin in Patients with Chronic Coronary Syndrome Receiving Oral AnticoagulationHow does decontextualised risk information affect clinicians' understanding of risk and uncertainty in primary care diagnosis? A qualitative study of clinical vignettesHow do we talk about overdiagnosis of mental health conditions without dismissing people's suffering? This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

Discussion of landmark trials presented at the European Society of Cardiology (ESC) congress 2025 Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

Welcome to Ozempic Weightloss Unlocked. Today we dive into the latest headlines, research, controversies, and the practical realities of Ozempic, a medication originally crafted for type two diabetes that has rocketed into the spotlight for its weight-loss effects.Ozempic, with the active ingredient semaglutide, was approved in the United States in December 2017 to help manage blood sugar in people living with type two diabetes. However, it soon became widely prescribed off-label for weight loss, a trend that only accelerated after the higher-dose version, branded as Wegovy, received federal approval in 2021. According to the Lawsuit Information Center, Ozempic works by mimicking a hormone called glucagon-like peptide 1, helping regulate blood sugar and appetite. Many people using it experience reduced appetite and significant weight reduction.While its popularity continues to grow, so does scientific understanding. A 2025 study presented at the European Society of Cardiology conference revealed that Swiss patients with type two diabetes using oral semaglutide experienced clinically significant drops in both blood sugar and body weight. GlobalData reports that no new safety risks were identified in that trial, supporting ongoing confidence among healthcare professionals.But for those interested only in weight loss, it is not all smooth sailing. Ozempic carries a range of potential side effects. According to King Law, hundreds of lawsuits have been filed in the last year, with plaintiffs claiming they suffered severe complications such as gastroparesis, intestinal blockages, blood clots, and even hair loss. A study published this August found that women on Ozempic experienced twice the rate of hair loss as women who were not taking the drug, while men saw their risk climb by more than half.The United States Food and Drug Administration updated Ozempic's packaging earlier this year to warn about the risk of pancreatitis and severe kidney injuries, including potentially fatal outcomes linked to dehydration from vomiting and diarrhea. The label changes were driven by new clinical trial data and reinforce the importance of medical supervision when using these drugs.Shortages, once a common concern, have eased. The Food and Drug Administration officially took Ozempic off the drug shortage list in February after Novo Nordisk provided reassurance about inventory and supply. That move, however, sparked legal challenges from compounders competing in the market.Unfortunately, enthusiasm for rapid weight loss has also created a black market for Ozempic and similar drugs. The Food and Drug Administration cautions against using compounded or counterfeit versions, which have not undergone review for safety or effectiveness. Some of these unregulated products might be contaminated, mislabeled, or dangerously dosed. Always fill your prescriptions through a licensed pharmacy.For listeners interested in alternatives, exciting research is underway. Purdue University food scientists are investigating foods and supplements that naturally stimulate GLP-1, the hormone Ozempic is designed to mimic. While these approaches will not produce the dramatic weight loss seen with medication, they may help those seeking more natural solutions—especially if someone discontinues their prescription and needs help maintaining a healthy weight.So, where does Ozempic stand today? We have a medication achieving strong results for blood sugar control and weight loss, but one that comes with a profile of side effects still being researched, legal actions underscoring patient concerns, and increased focus on responsible, safe prescribing.Thank you for tuning in to Ozempic Weightloss Unlocked. For more news, insights, and emerging research on the evolving world of weight loss and metabolic health, be sure to subscribe. This has been a quiet please production, for more check out quiet please dot ai. Some great Deals https://amzn.to/49SJ3QsFor more check out http://www.quietplease.ai

On this week's episode, hosts Paul Matteis, Sam Fazeli, John Maraganore, and Graig Suvannaveijh kick off the discussion with a more positive look at the sector and some of the fundamental factors at play. The group then shares an overview of Sanofi's 10% stock fall on the back of positive Phase 3 eczema data with worries about the Dupixent patent expiry. The discussion then turns to Insmed, a company that has had a monster year with the stock up 100% and a market cap of over $30 billion market. On the data front, the group highlights ApoC3 data from Ionis and Arrowhead at the European Society of Cardiology Congress 2025, which leads into a discussion around ASO versus RNAi. With multiple obesity readouts in recent weeks, the group theorizes on whether obesity is a zero sum game. It's a big year ahead for AD readouts and the hosts summarizes some important catalysts on the horizon. Other discussion topics include the launch of Corsera Health for cardiovascular prevention, Trump's Truth Social post on vaccine data, RFK Jr in front of congress, and public concern around access to vaccines. This episode aired on September 5, 2025.

Jake Phillips is Associate Professor at the University of Cambridge where he is the director of the MSt in Applied Penology, a masters course for people working in managerial and leadership roles in the criminal justice system. Prior to moving to Cambridge he worked at Sheffield Hallam University for 12 years. Before doing his PhD – at Cambridge – he worked in various roles in the criminal justice system such as drug interventions worker and various roles supporting people on probation to find work and access drug treatment. His academic research focuses primarily on probation policy and practice although he has carried out research in prisons, the police, parole and youth justice. He has carried out research on the emotional labour of probation work, probation practitioner wellbeing, the impact of inspection on probation, people who die whilst under probation supervision, privatisation in probation and, more recently, the concept of hope in the probation context. He is editor of Probation Journal and co-chair of the European Society of Criminology's working group on Community Sanctions and Measures.References for all texts cited in this podcast are on our Linktree.Presenters: Dr. Sally Tilt and Dr. Kerensa HockenProducer: Andrew WilkieAssistant Producer: Richie MakepeaceYou can follow this podcast on LinkedIn by clicking here.The Forensic Psychology Podcast is a co-production between HM Prison and Probation Service and the Prison Radio Association charity. Hosted on Acast. See acast.com/privacy for more information.

We returned from the Labor Day holiday to a spate of intriguing deals, including two that could surpass $2 billion: Vertex's new pact with Enlaza for autoimmune disease—which the Casgevy maker hopes could ease conditioning for the sickle cell/beta thalassemia gene therapy—and Novartis' agreement with Arrowhead for neurodegenerative diseases such as Parkinson's.  But as we look ahead, Thursday's Senate Finance Committee will be the focus this week, as Health and Human Services Secretary Robert F. Kennedy Jr. will answer questions after the ousting of CDC Director Susan Monarez. Her departure is reportedly linked to changes to the regulation of COVID-19 vaccines, for which the FDA last week issued restricted approvals to Moderna, Pfizer/BioNTech and Novavax and rescinded the emergency use authorizations. The next ACIP meeting—where COVID-19 vaccines will be on the agenda—is set for Sept. 18 and 19.   In the weight loss arena, Novo Nordisk presented results from a real-world study this weekend at the European Society of Cardiology Congress in Madrid showing that Wegovy cut the risk of heart attack, stroke or death by 57% compared to Eli Lilly's tirzepatide in people with obesity and cardiovascular disease. The company also continues to throw money into the space, last week inking a $550 million deal with Replicate for RNA-based treatments for obesity and diabetes. Meanwhile, Lilly is dropping studies of one oral obesity candidate as another nears a regulatory filing. Finally, the FDA greenlit the first GLP-1 generic for obesity.   We also discuss reactions to the FDA's new guidance on radiopharma drug development, four recent approvals for rare diseases, and everything you ever wanted to know about SPACs. 

Send us a textDr. Michael Koren joins Kevin Geddings to report live from Madrid on new developments being presented at the European Society of Cardiology meeting. This medical gathering, now the world's largest, is a showcase of developments in heart health and medicine. Dr. Koren notes excitement about progress in treating a genetic condition, lipoprotein(a), which raises cholesterol independently from diet and exercise. He notes that progress in this field is showing promise and that those with a family history of heart disease should have their lipoprotein(a) checked!Be a part of advancing science by participating in clinical research.Have a question for Dr. Koren? Email him at askDrKoren@MedEvidence.comListen on SpotifyListen on Apple PodcastsWatch on YouTubeShare with a friend. Rate, Review, and Subscribe to the MedEvidence! podcast to be notified when new episodes are released.Follow us on Social Media:FacebookInstagramX (Formerly Twitter)LinkedInWant to learn more? Checkout our entire library of podcasts, videos, articles and presentations at www.MedEvidence.comMusic: Storyblocks - Corporate InspiredThank you for listening!

Special edition of the JAMA Editor's Summary featuring the JAMA Network articles published at the 2025 European Society of Cardiology Congress. Hosted by JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, with JAMA Executive Editor Gregory Curfman, MD, JAMA Senior Editor Philip Greenland, MD, and JAMA Cardiology Editor Robert O. Bonow, MD, MS. Related Content: Remote Screening for Asymptomatic Atrial Fibrillation Long-Term Anticoagulation Discontinuation After Catheter Ablation for Atrial Fibrillation Systolic Blood Pressure and Microaxial Flow Pump–Associated Survival in Infarct-Related Cardiogenic Shock Helicobacter pylori Screening After Acute Myocardial Infarction Physiology-Guided Complete Revascularization in Older Patients With Myocardial Infarction Fractional Flow Reserve–Guided Complete vs Culprit-Only Revascularization in Non–ST-Elevation Myocardial Infarction and Multivessel Disease Transcatheter or Surgical Treatment of Patients With Aortic Stenosis at Low to Intermediate Risk Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction Bivalent RSV Prefusion F Protein–Based Vaccine for Preventing Cardiovascular Hospitalizations in Older Adults High-Dose vs Standard-Dose Influenza Vaccine and Cardiovascular Outcomes in Older Adults Risk of Myocarditis or Pericarditis With High-Dose vs Standard-Dose Influenza Vaccine Clonal Hematopoiesis and Risk of New-Onset Myocarditis and Pericarditis Participation of Women in Cardiovascular Trials From 2017 to 2023 Prevalence, Determinants, and Time Trends of Cardiovascular Health in the WHO African Region

Happy August! This month for the August 2025 episode of the RCEM Learning Podcast Andy returns to discuss the investigation of acute coronary syndrome in the ED. Becky and Chris begin a two part deep dive through a guideline looking at the management of atrial fibrillation. We then talk to Matt Reed about the RCEM Flagship Conference and we then end with New Online! If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:28) New in EM - Ruling out ACS in the ED Acute coronary syndrome rule-out strategies in the emergency department: an observational evaluation of clinical effectiveness and current UK practice (Trainee Emergency Research Network, 2025) (19:43) Guidelines for EM - Atrial Fibrillation (European Society of Cardiology) European Society of Cardiology - 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): Developed by the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC), with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Endorsed by the European Stroke Organisation (ESO) (ESC, 2025) (47:26) Matt Reed and the Flagship Conference RCEM - Flagship Conference 2026 (58:28) New Online – new articles on RCEMLearning for your CPD Kishan Indrakumar, Thomas Moore, Mayank Nagar, Preetibah Ratenavelu, Dominique Tirian - Chemical Eye Injuries in the ED Katy Guy, Olivia Curtis-Hughes - Sports-Related Concussions in the Emergency Department Susan Elizabeth Dorrian, Sarah Jones - Disturbed or Psychiatric Patients in the ED Additional Links RCEM - SECEM Conference 2025

A silent danger lurks within the descending thoracic aorta. While most Type B aortic dissections are managed medically, up to half of these patients will either require life-saving surgery or die within just five years. So how do we separate those who will quietly recover from those on the edge of catastrophe? How do we protect the spinal cord, bowel, and limbs from the devastating consequences of malperfusion? Join the University of Michigan Department of Vascular Surgery as they tackle the high-stakes decisions behind managing this unpredictable disease—where timing is critical, interventions are evolving, and lives hang in the balance. Hosted by the University of Michigan Department of Vascular Surgery: ·       Robert Beaulieu, Program Director ·       Frank Davis, Assistant Professor of Surgery ·       Luciano Delbono, PGY-5 House Officer ·       Andrew Huang, PGY-4 House Officer ·       Carolyn Judge, PGY-2 House Officer Learning Objectives: 1.         Discuss general approach to diagnosis and management of TBAD. 2.         Identifying high-risk features in uncomplicated TBAD and understanding their role in determining the need for surgical management. 3.         Review endovascular techniques for managing malperfusion of the limbs, viscera, and spinal cord and discuss associated decision making. References:  Authors/Task Force Members, Czerny, M., Grabenwöger, M., Berger, T., Aboyans, V., Della Corte, A., Chen, E. P., Desai, N. D., Dumfarth, J., Elefteriades, J. A., Etz, C. D., Kim, K. M., Kreibich, M., Lescan, M., Di Marco, L., Martens, A., Mestres, C. A., Milojevic, M., Nienaber, C. A., … Hughes, G. C. (2024). EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ. The Annals of Thoracic Surgery, 118(1), 5–115. https://doi.org/10.1016/j.athoracsur.2024.01.021 de Kort, J. F., Hasami, N. A., Been, M., Grassi, V., Lomazzi, C., Heijmen, R. H., Hazenberg, C. E. V. B., van Herwaarden, J. A., & Trimarchi, S. (2025). Trends and Updates in the Management and Outcomes of Acute Uncomplicated Type B Aortic Dissection. Annals of Vascular Surgery, S0890-5096(25)00004-4. https://doi.org/10.1016/j.avsg.2024.12.060 Eidt, J. F., & Vasquez, J. (2023). Changing Management of Type B Aortic Dissections. Methodist DeBakey Cardiovascular Journal, 19(2), 59–69. https://doi.org/10.14797/mdcvj.1171 Lombardi, J. V., Hughes, G. C., Appoo, J. J., Bavaria, J. E., Beck, A. W., Cambria, R. P., Charlton-Ouw, K., Eslami, M. H., Kim, K. M., Leshnower, B. G., Maldonado, T., Reece, T. B., & Wang, G. J. (2020). Society for Vascular Surgery (SVS) and Society of Thoracic Surgeons (STS) reporting standards for type B aortic dissections. Journal of Vascular Surgery, 71(3), 723–747. https://doi.org/10.1016/j.jvs.2019.11.013 MacGillivray, T. E., Gleason, T. G., Patel, H. J., Aldea, G. S., Bavaria, J. E., Beaver, T. M., Chen, E. P., Czerny, M., Estrera, A. L., Firestone, S., Fischbein, M. P., Hughes, G. C., Hui, D. S., Kissoon, K., Lawton, J. S., Pacini, D., Reece, T. B., Roselli, E. E., & Stulak, J. (2022). The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection. The Annals of Thoracic Surgery, 113(4), 1073–1092. https://doi.org/10.1016/j.athoracsur.2021.11.002 Papatheodorou, N., Tsilimparis, N., Peterss, S., Khangholi, D., Konstantinou, N., Pichlmaier, M., & Stana, J. (2025). Pre-Emptive Endovascular Repair for Uncomplicated Type B Dissection—Is This an Option? Annals of Vascular Surgery, S0890-5096(25)00007-X. https://doi.org/10.1016/j.avsg.2025.01.003 Trimarchi, S., Gleason, T. G., Brinster, D. R., Bismuth, J., Bossone, E., Sundt, T. M., Montgomery, D. G., Pai, C.-W., Bissacco, D., de Beaufort, H. W. L., Bavaria, J. E., Mussa, F., Bekeredjian, R., Schermerhorn, M., Pacini, D., Myrmel, T., Ouzounian, M., Korach, A., Chen, E. P., … Patel, H. J. (2023). Editor's Choice - Trends in Management and Outcomes of Type B Aortic Dissection: A Report From the International Registry of Aortic Dissection. European Journal of Vascular and Endovascular Surgery: The Official Journal of the European Society for Vascular Surgery, 66(6), 775–782. https://doi.org/10.1016/j.ejvs.2023.05.015 Writing Committee Members, Isselbacher, E. M., Preventza, O., Hamilton Black Iii, J., Augoustides, J. G., Beck, A. W., Bolen, M. A., Braverman, A. C., Bray, B. E., Brown-Zimmerman, M. M., Chen, E. P., Collins, T. J., DeAnda, A., Fanola, C. L., Girardi, L. N., Hicks, C. W., Hui, D. S., Jones, W. S., Kalahasti, V., … Woo, Y. J. (2022). 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Journal of the American College of Cardiology, 80(24), e223–e393. https://doi.org/10.1016/j.jacc.2022.08.004 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

This episode covers: Cardiology This Week: A concise summary of recent studies Oral anticoagulation in atrial fibrillation: answers to frequent questions Smartwatch, heart rate and ECG Milestones: Lyon Diet Heart study Host: Emer Joyce Guests: Carlos Aguiar, Tim Chico, Paulus Kirchhof Want to watch that episode? Go to: https://esc365.escardio.org/event/1811 Want to watch that extended interview on smartwatch, heart rate and ECG? Go to: https://esc365.escardio.org/event/1811?resource=interview   Disclaimer ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.  This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails.   Declarations of interests Stephan Achenbach, Emer Joyce and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Tim Chico has declared to have potential conflicts of interest to report: research funding from Google. Paulus Kirchhof has declared to have potential conflicts of interest to report: partially supported by European Union MAESTRIA (grant agreement 965286), British Heart Foundation (AA/18/2/34218), German Center for Cardiovascular Research supported by the German Ministry of Education and Research (DZHK, grant numbers DZHK FKZ 81X2800182, 81Z0710116, and 81Z0710110), German Research Foundation (Ki 509167694), Dutch Heart Foundation (DHF), the Accelerating Clinical Trials funding stream in Canada, and the Else-Kröner-Fresenius Foundation. Research support for basic, translational, and clinical research projects from German Research Foundation (DFG), European Union, British Heart Foundation, Leducq Foundation, Else-Kröner-Fresenius Foundation, Dutch Heart Foundation (DHF), the Accelerating Clinical Trials funding stream in Canada, Medical Research Council (UK), and German Center for Cardiovascular Research, from several drug and device companies active in atrial fibrillation, and has received honoraria from several such companies in the past, but not in the last five years. Listed as inventor on two issued patents held by University of Hamburg (Atrial Fibrillation Therapy WO 2015140571, Markers for Atrial Fibrillation WO 2016012783). Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Emer Joyce Guest: Tim Chico Want to watch that extended interview on smartwatch, heart rate and ECG? Go to: https://esc365.escardio.org/event/1811?resource=interview Want to watch that episode? Go to: https://esc365.escardio.org/event/1811   Disclaimer  ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.  This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails.   Declarations of interests Stephan Achenbach, Emer Joyce and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Tim Chico has declared to have potential conflicts of interest to report: research funding from Google. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.  Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

In this episode, Dr. Linda Chu explores a major Radiology consensus statement on optimizing CT angiography for suspected pulmonary embolism. The discussion covers advanced imaging techniques, key considerations for special populations, and standardized reporting practices to improve diagnostic clarity and patient outcomes. Optimal Approach to Performing and Reporting ComputedTomography Angiography for Suspected Acute PulmonaryEmbolism: A Clinical Consensus Statement of the ESC Working Groupon Pulmonary Circulation & Right Ventricular Function, the FleischnerSociety, the Association for Acute Cardiovascular Care (ACVC) andthe European Association of Cardiovascular Imaging (EACVI) of theESC, Endorsed by European Respiratory Society (ERS), Asian Societyof Thoracic Radiology (ASTR), European Society of Thoracic Imaging(ESTI), and Society of Thoracic Radiology (STR). Radiology 2025; 315(3):e243833.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Joseph Zacharias, a consultant cardiothoracic surgeon at the Lancashire Cardiac Center in Blackpool, England, about lifetime management of heart valve disease. Chapters 00:00 Intro 02:13 Early Intervention, Disease Management 04:40 JANS 1, Sept on Placental Support 07:04 JANS 2, Surgeon Well-Being 09:41 JANS 3, Cardiac 10:58 JANS 4, PPM in SAVR 12:57 JANS 5, Cardiac Registry 14:22 Video 1, Close U Ministernotomy 15:19 Video 2, Endo AVR & MVR 16:03 Video 3, VATS 17:20 Dr. Zacharias Interview, HVD 38:04 Upcoming Events 38:51 Closing They delve into Dr. Zacharias's recent paper titled “Lifetime Management of Heart Valve Disease—Treat It Early and Treat It Right, First Time,” and discuss how the idea for the paper originated highlighting key takeaways. They also address perceived risks vs actual risks and why less than 25 percent of patients are referred for necessary interventions. Additionally, they examine the future of cardiac surgery, endoscopic cardiac surgery, and endoscopic vein harvesting.   Joel also highlights recent JANS articles on a novel and logistic approach for hypoplastic left heart syndrome with intact atrial septum, a European Society of Thoracic Surgery survey on member well-being, transcatheter management of left-sided valvular heart disease following heart transplantation, a multi-institutional study on the prevalence and clinical impact of patient-prosthesis mismatch in surgical aortic valve replacement, and a systematic review and meta-analysis of the German registry of acute aortic dissection type A score for 30-day mortality prediction in type A acute aortic dissection surgery.   In addition, Joel explores how to close an upper ministernotomy, endoscopic aortic valve replacement and mitral valve replacement, and uniportal VATS decortication for late-stage TB empyema. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Open Atrial Septectomy on Placental Support: A Novel and Logistic Approach for Hypoplastic Left Heart Syndrome With Intact Atrial Septum  2.) Fit2Perform: European Society of Thoracic Surgery Survey on Member Well-Being  3.) Transcatheter Management of Left-Sided Valvular Heart Disease Following Heart Transplantation  4.) A Multi-Institutional Study on the Prevalence and Clinical Impact of Patient-Prosthesis Mismatch in Surgical Aortic Valve Replacement  5.) The German Registry of Acute Aortic Dissection Type A Score for 30-Day Mortality Prediction in Type A Acute Aortic Dissection Surgery: A Systematic Review and Meta-Analysis  CTSNet Content Mentioned  1.) How to Close an Upper Ministernotomy   2.) Endoscopic Aortic Valve Replacement and Mitral Valve Replacement   3.) Uniportal VATS Decortication for Late-Stage TB Empyema   Other Items Mentioned  1.) Lifetime Management of Heart Valve Disease—Treat It Early and Treat It Right, First Time  2.) Guest Editor Series Webinar: Coronary Arterial Anomalies—Pediatric and Adult Congenital 3.) Cardiac Surgical Arrest—An International Conversation, Part 4 4.) Career Center   5.) CTSNet Events Calendar 

Host: Emer Joyce Guest: Christian Hassager Want to watch that extended interview? Go to: https://esc365.escardio.org/event/1812?resource=interview  Want to watch the full episode? Go to: https://esc365.escardio.org/event/1812   Disclaimer ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails.   Declarations of interests Stephan Achenbach, Emer Joyce, Christian Hassager, Nicolle Kraenkel and Theresa McDonagh have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

This episode covers:  Cardiology this Week: A concise summary of recent studies Atrial fibrillation in heart failure Temperature management following cardiac arrest Statistics Made Easy: Collider bias Host: Emer Joyce Guests: Carlos Aguiar, Christian Hassager, Theresa McDonagh Want to watch that episode? Go to: https://esc365.escardio.org/event/1812 Want to watch that extended interview on temperature management following cardiac arrest? Go to: https://esc365.escardio.org/event/1812?resource=interview   Disclaimer ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails.   Declarations of interests Stephan Achenbach, Emer Joyce, Christian Hassager, Nicolle Kraenkel and Theresa McDonagh have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Listener discretion is advised. Reference: Tsukube, T., Okita, Y. (2017). Cardiac tamponade due to aortic dissection: clinical picture and treatment with focus on pericardiocentesis. E-Journal of Cardiology Practice. European Society of Cardiology. Available: https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Cardiac-tamponade-due-to-aortic-dissection-clinical-picture-and-treatment-with-focus-on-pericardiocentesis

Marcela Belleza, Caio Bastos e Nathalie Santana para conversar sobre incidentaloma adrenal em 4 clinicagens:- Avaliação de malignidade- Há produção de hormônio?- Tem indicação de cirurgia?- Como fazer o acompanhamentoReferências:1. Vassiliadi DA, Delivanis DA, Papalou O, Tsagarakis S. Approach to the Patient With Bilateral Adrenal Masses. J Clin Endocrinol Metab. 2024 Jul 12;109(8):2136-2148. doi: 10.1210/clinem/dgae164. PMID: 38478374.2. Martin Fassnacht, Stylianos Tsagarakis, Massimo Terzolo, Antoine Tabarin, Anju Sahdev, John Newell-Price, Iris Pelsma, Ljiljana Marina, Kerstin Lorenz, Irina Bancos, Wiebke Arlt, Olaf M Dekkers, European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors, European Journal of Endocrinology, Volume 189, Issue 1, July 2023, Pages G1–G42, https://doi.org/10.1093/ejendo/lvad0663. Rowe NE, Kumar R, Schieda N, Siddiqi F, McGregor T, McAlpine K, Violette P, Bathini V, Eng M, Izard J. Diagnosis, Management, and Follow-Up of the Incidentally Discovered Adrenal Mass: CUA Guideline Endorsed by the AUA. J Urol. 2023 Oct;210(4):590-599. doi: 10.1097/JU.0000000000003644. Epub 2023 Aug 9. PMID: 37556768.4. Yip L, Duh QY, Wachtel H, Jimenez C, Sturgeon C, Lee C, Velázquez-Fernández D, Berber E, Hammer GD, Bancos I, Lee JA, Marko J, Morris-Wiseman LF, Hughes MS, Livhits MJ, Han MA, Smith PW, Wilhelm S, Asa SL, Fahey TJ 3rd, McKenzie TJ, Strong VE, Perrier ND. American Association of Endocrine Surgeons Guidelines for Adrenalectomy: Executive Summary. JAMA Surg. 2022 Oct 1;157(10):870-877. doi: 10.1001/jamasurg.2022.3544. PMID: 35976622; PMCID: PMC9386598.5. Di Dalmazi G, Vicennati V, Garelli S, Casadio E, Rinaldi E, Giampalma E, Mosconi C, Golfieri R, Paccapelo A, Pagotto U, Pasquali R. Cardiovascular events and mortality in patients with adrenal incidentalomas that are either non-secreting or associated with intermediate phenotype or subclinical Cushing's syndrome: a 15-year retrospective study. Lancet Diabetes Endocrinol. 2014 May;2(5):396-405. doi: 10.1016/S2213-8587(13)70211-0. Epub 2014 Jan 29. PMID: 24795253.6. Rafael B Giorgi, Marcelo V Correa, Flávia A Costa-Barbosa, Claudio E Kater, Cyclic Subclinical Hypercortisolism: A Previously Unidentified Hypersecretory Form of Adrenal Incidentalomas, Journal of the Endocrine Society, Volume 3, Issue 3, March 2019, Pages 678–686, https://doi.org/10.1210/js.2018-00385

This episode covers: Cardiology This Week: A concise summary of recent studies ICD Indications in primary prevention Drug treatment of cardiac amyloidosis Mythbusters Host: Rick Grobbee Guests: Carlos Aguiar, Gerhard Hindricks, Marianna Fontana Want to watch that episode? Go to: https://esc365.escardio.org/event/1810   Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.  This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Rick Grobbee, Gerhard Hindricks and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Marianna Fontana has declared to have potential conflicts of interest to report: consultancy for Alnylam, Alexion/Caelum Biosciences, Astrazeneca, Bridgbio/Eidos, Prothena, Attralus, Intellia Therapeutics, Ionis Pharmaceuticals, Cardior, Lexeo Therapeutics, Janssen Pharmaceuticals, Prothena, Pfizer, Novonordisk, Bayer, Mycardium. Research grants from: Alnylam, Bridgbio, Astrazeneca, Pfizer. Share options in LexeoTherapeutics and shares in Mycardium. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Rick Grobbee Guest: Gerhard Hindricks Want to watch that extended interview? Go to: https://esc365.escardio.org/event/1810?r Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Rick Grobbee, Gerhard Hindricks and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Cori speaks at the European Society for Child & Adolescent Psychiatry conference, then returns home to find degenerates everywhere. Meanwhile, Nina's beloved cat dies. Cori calls out a “Protect the Dolls” campaign; Nina's lungs improve. Cori has to clean up human feces in his yard; Nina wears a dress. Cori gets into pronatalism and blames Nina for western collapse; Nina sighs. Plus: pain au chocolat, lazy consonants, TSA shoes, cannabinoids, sanitariums, and yelling at clouds.Links:European Society for Child & Adolescent Psychiatry in Strasbourg https://www.escap.eu/events/escap-2025-congress-in-strasbourgPain au Chocolat: https://en.wikipedia.org/wiki/Pain_au_chocolatTSA shoes: https://www.fox13memphis.com/news/travelers-will-no-longer-have-to-remove-their-shoes-for-tsa/article_c53fe231-d918-40e5-aa53-b7f0084e51ce.htmlOutCare - Protect the Dolls: https://mailchi.mp/outcarehealth/september-outtalk-6420697Dustin Nowaskie: https://www.outcarehealth.org/staff/dustin-nowaskie/Art Bell: https://en.wikipedia.org/wiki/Art_BellFTC Hearing: The Dangers of “Gender-Affirming Care” for Minors: https://www.ftc.gov/media/dangers-gender-affirming-care-minors?s=08 Get full access to Heterodorx Podcast at heterodorx.substack.com/subscribe

Dr. Harish Kinni, a triple-board-certified emergency medicine and critical care physician and assistant professor at the Mayo Clinic, provides an overview of the fundamentals of ventilator care for emergency department professionals. We will review key modes that we should know, the variables to set, how to adjust them for your patient's needs, and provide troubleshooting tips and tricks for when things suddenly go awry. This is sure to be one of the most helpful chapters of Always on EM, but don't let it take your breath away! CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Swart P, Nijbroek SGLH, Paulus F, Neto AS, Schultz MJ. Sex Differences in Use of Low Tidal Volume Ventilation in COVID-19-Insights From the PRoVENT-COVID Study. Front Med (Lausanne). 2022 Jan 3;8:780005. doi: 10.3389/fmed.2021.780005. PMID: 35300177; PMCID: PMC8923734. McNicholas BA, Madotto F, Pham T, Rezoagli E, Masterson CH, Horie S, Bellani G, Brochard L, Laffey JG; LUNG SAFE Investigators and the ESICM Trials Group. Demographics, management and outcome of females and males with acute respiratory distress syndrome in the LUNG SAFE prospective cohort study. Eur Respir J. 2019 Oct 17;54(4):1900609. doi: 10.1183/13993003.00609-2019. PMID: 31346004. Swart P, Deliberato RO, Johnson AEW, Pollard TJ, Bulgarelli L, Pelosi P, de Abreu MG, Schultz MJ, Neto AS. Impact of sex on use of low tidal volume ventilation in invasively ventilated ICU patients-A mediation analysis using two observational cohorts. PLoS One. 2021 Jul 14;16(7):e0253933. doi: 10.1371/journal.pone.0253933. PMID: 34260619; PMCID: PMC8279424. Evans, Laura1; Rhodes, Andrew2; Alhazzani, Waleed3; Antonelli, Massimo4; Coopersmith, Craig M.5; French, Craig6; Machado, Flávia R.7; Mcintyre, Lauralyn8; Ostermann, Marlies9; Prescott, Hallie C.10; Schorr, Christa11; Simpson, Steven12; Wiersinga, W. Joost13; Alshamsi, Fayez14; Angus, Derek C.15; Arabi, Yaseen16; Azevedo, Luciano17; Beale, Richard18; Beilman, Gregory19; Belley-Cote, Emilie20; Burry, Lisa21; Cecconi, Maurizio22; Centofanti, John23; Coz Yataco, Angel24; De Waele, Jan25; Dellinger, R. Phillip26; Doi, Kent27; Du, Bin28; Estenssoro, Elisa29; Ferrer, Ricard30; Gomersall, Charles31; Hodgson, Carol32; Hylander Møller, Morten33; Iwashyna, Theodore34; Jacob, Shevin35; Kleinpell, Ruth36; Klompas, Michael37; Koh, Younsuck38; Kumar, Anand39; Kwizera, Arthur40; Lobo, Suzana41; Masur, Henry42; McGloughlin, Steven43; Mehta, Sangeeta44; Mehta, Yatin45; Mer, Mervyn46; Nunnally, Mark47; Oczkowski, Simon48; Osborn, Tiffany49; Papathanassoglou, Elizabeth50; Perner, Anders51; Puskarich, Michael52; Roberts, Jason53; Schweickert, William54; Seckel, Maureen55; Sevransky, Jonathan56; Sprung, Charles L.57; Welte, Tobias58; Zimmerman, Janice59; Levy, Mitchell60. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Critical Care Medicine 49(11):p e1063-e1143, November 2021. | DOI: 10.1097/CCM.0000000000005337  Fan E, Del Sorbo L, Goligher EC, Hodgson CL, Munshi L, Walkey AJ, Adhikari NKJ, Amato MBP, Branson R, Brower RG, Ferguson ND, Gajic O, Gattinoni L, Hess D, Mancebo J, Meade MO, McAuley DF, Pesenti A, Ranieri VM, Rubenfeld GD, Rubin E, Seckel M, Slutsky AS, Talmor D, Thompson BT, Wunsch H, Uleryk E, Brozek J, Brochard LJ; American Thoracic Society, European Society of Intensive Care Medicine, and Society of Critical Care Medicine. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med. 2017 May 1;195(9):1253-1263. doi: 10.1164/rccm.201703-0548ST. Erratum in: Am J Respir Crit Care Med. 2017 Jun 1;195(11):1540. doi: 10.1164/rccm.19511erratum. PMID: 28459336. Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, Oczkowski S, Levy MM, Derde L, Dzierba A, Du B, Aboodi M, Wunsch H, Cecconi M, Koh Y, Chertow DS, Maitland K, Alshamsi F, Belley-Cote E, Greco M, Laundy M, Morgan JS, Kesecioglu J, McGeer A, Mermel L, Mammen MJ, Alexander PE, Arrington A, Centofanti JE, Citerio G, Baw B, Memish ZA, Hammond N, Hayden FG, Evans L, Rhodes A. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Crit Care Med. 2020 Jun;48(6):e440-e469. doi: 10.1097/CCM.0000000000004363. PMID: 32224769; PMCID: PMC7176264. Wang W, Scharfstein D, Wang C, Daniels C, Needham D, Brower R, NHLBI ARDS Clinical Network. Estimating the Causal Effect of Low Tidal Volume Ventilation on Survival in Patients with Acute Lung Injury. J R Stat Soc Ser C Appl Stat. 2011. PMC: PMC3197806 Brower RG, Thompson BT, NIH/NHLBI/ARDSNetwork. Tidal volumes in acute respiratory distress syndrome--one size does not fit all. Crit Care Med. 2006. Hager DN, Krishman JA, Hayden D, Brower RG, ARDSNet NIH / NHLBI. Tidal Volume Reduction in Patients with acute Lung Injury When Plateau Pressures Are Not High. Am J Resp Crit Care Med. 2005. Rubenfeld GD, Cooper C, Carter G, Thompson BT, Hudson LD. Barriers to providing lung protective ventilation to patients with acute lung injury. Crit Care Med. 2004. Chatburn RL, El-Khatib M, Mireles-Cabodevila E. A taxonomy for mechanical ventilation: 10 fundamental maxims. Respir Care. 2014 Nov;59(11):1747-63. doi: 10.4187/respcare.03057. Epub 2014 Aug 12. PMID: 25118309. Guo L, Wang W, Zhao N, Guo L, Chi C, Hou W, Wu A, Tong H, Wang Y, Wang C, Li E. Mechanical ventilation strategies for intensive care unit patients without acute lung injury or acute respiratory distress syndrome: a systematic review and network meta-analysis. Crit Care. 2016 Jul 22;20(1):226. doi: 10.1186/s13054-016-1396-0. PMID: 27448995; PMCID: PMC4957383. Rice TW, Wheeler AP, Bernard GR, Hayden DL, Schoenfeld DA, Ware LB, NIH NHLBI ARDS Network. Comparison of the Sp02/FI02 Ratio and the PaO 2/FI02 in Patients with Acute Lung Injury or ARDS. Chest. 2007. Zhang G, Burla MJ, Caesar BB, Falank CR, Kyros P, Zucco VC, Strumilowska A, Cullinane DC, Sheppard FR. Emergency Department SpO2/FiO2 Ratios Correlate with Mechanical Ventilation and Intensive Care Unit Requirements in COVID-19 Patients. West J Emerg Med. 2024 May;25(3):325-331. doi: 10.5811/westjem.17975. PMID: 38801037; PMCID: PMC11112664.   WANT TO WORK AT MAYO? EM Physicians: https://jobs.mayoclinic.org/emergencymedicine EM NP PAs: https://jobs.mayoclinic.org/em-nppa-jobs   Nursing/Techs/PAC: https://jobs.mayoclinic.org/Nursing-Emergency-Medicine EMTs/Paramedics: https://jobs.mayoclinic.org/ambulanceservice All groups above combined into one link: https://jobs.mayoclinic.org/EM-Jobs

This episode covers: Cardiology This Week: A concise summary of recent studies Big data in cardiology Measuring lipids: what clinicians need to know Milestones Host: Perry Elliott Guests: Carlos Aguiar, Karim Lekadir, Kostas Koskinas Want to watch that episode? Go to: https://esc365.escardio.org/event/1808 Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.  This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Nicolle Kraenkel and Karim Lekadir have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Perry Elliott has declared to have potential conflicts of interest to report: consultancies for Pfizer, BMS, Cytokinetics, AstraZeneca, Forbion. Kostas Koskinas has declared to have potential conflicts of interest to report: speaker fees / honoraria from MSD, Daiichi-Sankyo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Perry Elliott Guest: Karim Lekadir Want to watch that episode? Go to: https://esc365.escardio.org/event/1808?r Disclaimer: ESC TV Today is supported by Bristol Myers Squibb and Novartis. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English-language always prevails. Declarations of interests: Stephan Achenbach, Nicolle Kraenkel and Karim Lekadir have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Perry Elliott has declared to have potential conflicts of interest to report: consultancies for Pfizer, BMS, Cytokinetics, AstraZeneca, Forbion. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson."

Flexibility is a cardinal virtue in physical fitness, and according to political psychologist and neuroscientist Leor Zmigrod, it can be a cardinal virtue in our mental health, too. How she came to that conclusion and how common rigid thinking can be are themes explored in her new book, The Ideological Brain. “I think that from all the research that I've done,” she tells interviewer David Edmonds in this Social Science Bites podcast, “I feel that what rigid thinking does is it numbs people to the complexity of their own experience, and it simplifies their thinking. It makes them less free, less authentic, less expansive in their imagination.” And while she acknowledges there are times being unbending may be seen as an asset, “rigid thinking is rarely good for you at an individual level.” In this podcast, she details some of the work – both with social science experimentation and with brain imaging – that determines if people are flexible in their thinking, what are the real-life benefits of being flexible, if they can change, and how an ideological brain, i.e. a less flexible brain, affects politics and other realms of decision-making. “When you teach or when you try to impart flexible thinking, you're focusing on how people are thinking, not what they're thinking,” Zmigrod explains. “So it's not like you can have a curriculum of ‘like here is what you need to think in order to think flexibly,' but it's about teaching how to think in that balanced way that is receptive to evidence, that is receptive to change, but also isn't so persuadable that any new authority can come and take hold of your thoughts.” Zmigrod was a Gates Scholar at Cambridge University and won a winning a Junior Research Fellowship at Churchill College there. She has since held visiting fellowships at Stanford and Harvard universities, and both the Berlin and Paris Institutes for Advanced Study. Amond many honors the young scholar received are the ESCAN 2020 Young Investigator Award by the European Society for Cognitive and Affective Neuroscience, the Glushko Dissertation Prize in Cognitive Science by the Cognitive Science Society, . the 2020 Women of the Future Science Award and the 2022 Women in Cognitive Science Emerging Leader Award, and the 2022 Distinguished Junior Scholar Award in Political Psychology by the American Political Science Association. 

It's Tuesday, June 24th, A.D. 2025. This is The Worldview in 5 Minutes heard on 140 radio stations and at www.TheWorldview.com.  I'm Adam McManus. (Adam@TheWorldview.com) By Kevin Swanson and Adam McManus Syrian suicide bomber A suicide bomber entered an Orthodox Church in Damascus, Syria on Sunday killing 22 people and wounding at least 63 others, reports ABC News. The ISIS terrorist group has claimed responsibility. No increased nuclear radiation levels after U.S. bombing in Iran The International Atomic Energy Agency reports no increase in off-site radiation levels at the three Iranian sites bombed by the United States and Israel. The neighboring Kuwait government has also confirmed that “no abnormal radiation levels have been detected in any of the member states.” The whereabouts of 400 kilograms of highly enriched Uranium in Iran is still a mystery. Israel bombed Iran's Evin Prison Israel continues its bombardment on Iran, including a bombing of the notorious Evin prison, where a number of Christians are held, and have been tortured over the last several decades. Trump: Israel & Iran agreed to cease-fire to end “12-Day War” On Monday, President Donald Trump announced that Israel and Iran had agreed to a cease-fire, declaring an end to what he referred to as “The 12 Day War,” reports The Epoch Times. In a Truth Social Post, Trump wrote,  “It has been fully agreed by and between Israel and Iran that there will be a Complete and Total CEASEFIRE … for 12 hours, at which point the War will be considered ENDED!” Both sides will wind down their final military operations within 12 hours, beginning what Trump expects to be “PEACEFUL and RESPECTFUL” on both sides. The conflict will be declared over within 24 hours. However, The New York Times indicated that there is no confirmation yet from Israel and Iran. Russia bombed Ukraine with 16 missiles and 352 drones The Russian army unleashed a heavy bombardment on Kiev, Ukraine yesterday involving 352 drones and 16 missiles, reports Reuters. At least 10 Ukrainians died in the attack. This follows another attack last week which killed 28 people.  Zelensky assassination plot foiled Ukrainian President Volodymyr Zelensky was the target of an assassination plot to be carried out by a Polish elderly man who had first been recruited by the Soviet Union decades ago, reports Newsweek. The man was activated to take out Zelensky at Poland's Rzeszów–Jasionka Airport using either a first-person view drone or a sniper rifle. The would-be assassin was a firm believer in Soviet ideology. The assassination plot was foiled by a joint effort of Ukraine's SBU, the main internal security agency, and the Polish internal security service known as ABW. Americans less isolationist Americans are moving away from isolationism according to a recent survey by the Ronald Reagan Institute. In the last three years, Americans who believe the United States should be more engaged in international events has seen a 24% increase. Specifically, 69% of Republicans, 64% of Democrats, and 73% of MAGA/Trump Republicans want to see more engagement internationally. A supermajority of Americans – 84% -- state their support for preventing the Islamic Republic from gaining access to nuclear weapons. Only 57% of Americans would agree with the statement that “the United States is better served by withdrawing from international events and focusing on problems here at home.” The major shift in American opinions on this has occurred since the November election.  Russia economy expanded by 4.3% last year Despite international pressures, the Russian economy expanded by 4.3% last year. This compares to a 1.1% bump for the United Kingdom, and a 2.8% bump for the U.S. economy last year. Supreme Court temporarily allows deportations to third countries In a 6-3 decision on Monday, the Supreme Court temporarily lifted a lower court order blocking the Trump administration from deporting illegal immigrants to so-called third countries to which they have no connection, reports The Epoch Times. The unsigned order came in the case known as Department of Homeland Security v. D.V.D. Michigan church shooting prevented   A heavily-armed man attempted a massacre at the Wayne, Michigan Crosspointe Community Church, reports CBS News. Thankfully, he didn't make it into the building. A parishioner rammed him with his truck, and the security team engaged him in the parking lot.  The suspect was pronounced dead when police arrived on the scene. One security guard took a shot in the leg. Based on national news sources, there are 1-2 church shootings per year in this country. That's 1 out of 380,000 churches.  Psalm 27:1-2 is always the right mindset. It says, “The Lord is my light and my salvation; whom shall I fear? The Lord is the strength of my life; Of whom shall I be afraid?  When the wicked came against me to eat up my flesh, my enemies and foes, they stumbled and fell.” Ohio pro-life legislators want to protect babies from conception Several Ohio legislators are floating a bill that outlaws the willful murder of a child from the point of conception. The "Ohio Prenatal Equal Protection Act,” introduced by state Representatives Levi Dean and Johnathan Newman, would overturn the 2023 referendum amendment that legalized abortion in Ohio.  In Psalm 22, the psalmist confesses, “You … took me out of the womb; You made me trust while on my mother's breasts. I was cast upon You from birth. from my mother's womb You have been my God.”  Older Americans more likely to have Biblical worldview George Barna's 2025 American Worldview Inventory report has been released and he concludes that only 1% of adults under 30 have a Biblical worldview. That compares with 5% for adults over 50, and 8% for adults over 65. Also, 69% of young Gen Z Americans believe abortion is morally acceptable. That's up from 60% for the Gen X and Boomer generations. Then, 73% of Gen Zers agree that sex outside of marriage is okay.  That's up from 59% with the Boomer Generation.  Fifth Circuit deems Louisiana Ten Commandments law unconstitutional The 5th U.S. Circuit Court of Appeals overturned Louisiana's law requiring the posting of The Ten Commandments in public schools, reports Courthouse News Service. The Louisiana law required schools which receive public funding to post a framed copy of The 10 Commandments in the classrooms. Observatory identified and photographed 10 million galaxies The Rubin Observatory, located in South America's Andes Mountain, has completed its first 10 hours of operation and identified 2,104 new asteroids never seen before, and photographed 10 million galaxies, reports the BBC. The observatory features a 28-foot telescope and an ultra-wide, ultra-high definition camera.  Sperm donor passed cancer gene to 67 children In other science news, a sperm donor in Europe has passed a cancer gene on to 67 children. Already, at least ten of the children have signs of cancer, all of them born between 2008 and 2015. The case was discussed at the annual conference of the European Society of Human Genetics. Dr. Edwige Kasper, a specialist in genetic predisposition to cancer at the Rouen University Hospital in Rouen, France, said, “The variant would have been practically undetectable in 2008 when the individual started to donate sperm.” U.S. housing prices spike Housing prices in the U.S. are still reaching record highs. The median price of homes sold last month was $423,000, up 1.3% from May of 2024. 7 Worldview listeners gave $2,828.30  to fund our annual budget And finally, toward our final $123,500 goal by Monday, June 30th to fully fund The Worldview annual budget for our 6-member team, 7 listeners stepped up to the plate. Our thanks to Nathan in Cleveland, Tennessee who gave $25, N.B. in Ripon, North Yorkshire, England who gave $30, and Logan and Bianca in Manzini, Eswatini, Africa who gave $70. And we're grateful to God for Gloria in  Westminster, Colorado who gave $103.30, Payton in Georgetown, Texas who pledged $50/month for 12 months for a gift of $600, Amy in Eldorado, Wisconsin who gave $1,000, and Pamela in Sierra Madre, California who also gave $1,000. Those 7 Worldview listeners gave a total of $2,828.30. Ready for our new grand total? Drum roll please.  (Drum roll sound effect) $65,401.55 (People clapping and cheering sound effect)  Still need to raise $58,098.45!  Looking for 9 Super Donors! That means by this coming Monday, June 30th, we need to raise a whopping $58,098.45 in just 7 days.  Oh my!  I've got butterflies in my stomach. Is there 1 businessperson who could donate $10,000?  3 businesspeople who could give $5,000?  5 businesspeople who could contribute $2,500? If so, those donations would total $37,500. Then we would need another 8 people to pledge $100/month for 12 months for a gift of $1,200.  And another 16 people to pledge $50/month for 12 months for a gift of $600? Please, go to TheWorldview.com and click on Give on the top right.  If you want to make it a monthly pledge, click on the recurring tab. If everybody does something – no matter how big or small – we will knock this relatively modest budget out of the park. Attention donors from this year: Send email urging others to donate! Lastly, I would love to feature a 2-3 sentence email from those who have already given this year, whose names I will not cite, with your encouragement for your fellow listeners to consider a last minute gift.  Just include your city and state send it to Adam@TheWorldview.com Speak from your heart about why you gave and why you would urge others to join you to fund The Worldview in 5 Minutes. Close And that's The Worldview on this Tuesday, June 24th, in the year of our Lord 2025.  Follow us on X or subscribe for free by Spotify, Amazon Music, or by iTunes or email to our unique Christian newscast at www.TheWorldview.com.  Plus, you can get the Generations app through Google Play or The App Store. I'm Adam McManus (Adam@TheWorldview.com). Seize the day for Jesus Christ.

The white-coat effect is a measure of blood pressure change from before to during the visit in office/clinic when the blood pressure is recorded by a physician or nurse; this was first described in 1983 by Mancia et al, and was initially thought to represent a benign process. But it was unclear what this actually meant for pregnancy. Ambulatory blood pressure monitoring (ABPM) has been used in pregnancy for about 20 years now. Use of this monitoring option has revealed a subgroup of patients who have persistently high blood pressure (BP) in the presence of health care providers, but a normal ambulatory or self-measured BP. This phenomenon has been termed “White Coat Hypertension” (WCH). In 2013, The International Society for the Study of Hypertension in Pregnancy (ISSHP) published the revised classification for hypertensive disorders in pregnancy, that included WCH, not previously included. The ISSHP guidelines also emphasize that a diagnosis of white coat hypertension in pregnancy should only be considered before 20 weeks of gestation. We now know that WCH, outside of pregnancy, is not an entirely benign process. The role of metabolic risk factors in patients with white-coat hypertension was first outlined in 2000 by Kario and Pickering. When metabolic risk factors are present in association with white-coat hypertension, the increased risk of target organ damage is determined not only by the blood pressure characteristics but also by the metabolic abnormalities. Recognizing the potential risks of white coat hypertension was also published in a commentary in 2016 out of the European Society of Cardiology. That article's title was, “White-coat hypertension: not so innocent”. But what is the latest data on WCH in pregnancy? Is WCH linked to poor obstetrical outcomes? Does WHC need medication therapy? We have data from 2024 to help us. Listen in for details.

In this episode, we discuss the diagnosis and treatment of resistant hypertension, including a newer endothelin receptor antagonist (ERA) called aprocitentan (Tryvio®). Key Concepts The diagnosis of true resistant hypertension is based on requiring more than 3 antihypertensives (ACE inhibitor or ARB + calcium channel blocker + diuretic) to achieve goal BP, ruling out inaccurate BP readings, and ensuring patient adherence to their antihypertensive therapy. Non-pharmacologic therapy (especially dietary sodium restriction), medication adherence, and lifestyle changes are critical to the treatment of resistant hypertension. The preferred 4th line option for most patients with resistant hypertension is spironolactone. After adding spironolactone, additional therapies are based on expert opinion and patient-specific factors. These additional therapies may include beta blockers, alpha-2 agonists, alpha-1 blockers, hydralazine, minoxidil, and aprocitentan. References Carey RM, Calhoun DA, Bakris GL, et al. Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association. Hypertension. 2018;72(5):e53-e90. doi:10.1161/HYP.0000000000000084 Mancia G, Kreutz R, Brunström M, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens. 2023;41(12):1874-2071. doi:10.1097/HJH.0000000000003480

In this episode, Ben breaks down the science-backed, day-by-day timeline of what happens to your body when you walk just 30 minutes a day. Learn how this simple habit can lower blood sugar, shrink belly fat, improve digestion, boost mood, enhance insulin sensitivity, and even reduce your risk of death by up to 50%.