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What if your website already supports post-quantum cryptography, but nobody inside your organization knows how, why, or which provider controls it? I speak with David Warburton, Director of F5 Labs Threat Research, about new F5 research examining post-quantum cryptography across the world's top one million websites. According to the research discussed in our conversation, 54% now support PQC. It is an encouraging sign that preparations for future quantum threats are entering mainstream infrastructure. That figure is also easy to misread. David explains that much of the adoption comes from cloud and CDN providers enabling hybrid post-quantum protection for their customers. A smaller business could therefore appear better prepared than a large enterprise simply because its provider activated the technology automatically. However, that customer may have little understanding of the chosen cipher, the protection applied elsewhere, or the dependencies created around a small number of technology companies. David says the adoption rate looks very different when major CDN providers are removed from the data. This raises an important question about whether businesses are developing their own post-quantum security capabilities or temporarily benefiting from decisions made on their behalf. We discuss why current deployments combine established cryptography with newer post-quantum algorithms. This hybrid approach protects compatibility while browsers, APIs, operational technology, IoT devices, and older enterprise systems catch up. It also carries performance costs through larger cryptographic material and increased network traffic. David argues that crypto agility matters because organizations need the ability to change algorithms, certificates, and encryption methods as threats develop. The conversation also moves beyond encrypted traffic. Harvest now, decrypt later attacks involve collecting sensitive information today so it can potentially be decrypted when capable quantum computers arrive. David believes authentication and digital identity could create an even greater concern. A quantum computer able to produce valid certificates could potentially impersonate trusted websites, signed software, devices, or firmware. Legacy infrastructure remains one of the largest barriers. F5 Labs found that roughly one in ten leading websites lacked TLS 1.3 support, preventing them from supporting current hybrid PQC connections. David also explains why Germany and France may trail countries including the US, UK, Australia, Ukraine, and Singapore, despite strong national policies. Factors include digital sovereignty concerns and the concentration of older manufacturing and operational systems. For leaders beginning this work, David recommends speaking with suppliers, establishing internal ownership, reviewing business continuity plans, and creating a cryptographic bill of materials covering certificates, algorithms, libraries, applications, and devices. I'd love to hear your thoughts, so does your organization know where its cryptography lives and who controls its post-quantum readiness?
Working in coalition is one of the nonprofit sector's greatest strengths and can be especially powerful during election season. With the midterm elections around the corner, now is a good time for organizations to revisit their plans for election-related advocacy, including voter engagement, candidate education, and issue advocacy. A 501(c)(3) can collaborate with a 501(c)(4) and other nonprofits to advance common goals, pool resources, and build momentum. The key is knowing where collaboration ends and organizational boundaries begin, so allocate resources fairly, document cost-sharing agreements, and make sure each organization operates within the rules that apply to it. In this episode, we'll explore best practices for 501(c)(3)s collaborating and sharing resources with organizations operating under different tax rules during election season, including how to keep coalition work effective, compliant, and nonpartisan. Attorneys for this Episode: Maggie Ellinger-Locke Sarah Efthymiou Monika Graham 501(c)(3)s Must Remain Nonpartisan Internal Revenue Code: 501(c)(3) organizations are prohibited from directly or indirectly participating in partisan political activity on behalf of, or in opposition to, any candidate for public office. The Facts & Circumstances Analysis The IRS uses a "facts and circumstances" analysis to determine whether a 501(c)(3)'s communication about an issue is genuinely nonpartisan or is a veiled attempt to influence the outcome of an election. Factors include whether the communication mentions or evaluates candidates, references a candidate or election, occurs close to an election, or addresses an issue that distinguishes the candidates. The IRS also considers the broader context, including the timing, targeted audience, relationship to candidates' or political parties' communications, and whether the organization has a history of discussing the issue outside election periods. No single factor is determinative for the IRS looks at the full picture. What are some best practices for engaging in coalition work during election season? Build out the coalition's structure in advance. Develop a memorandum of understanding (MOU) with coalition partners outlining shared goals, decision-making processes, communications, roles, and responsibilities. Establish written cost-sharing agreements in advance to specify how shared costs will be allocated. Clarify who is responsible for particular communications, activities, and resources. Have a clear plan for keeping the 501(c)(3)'s work completely independent from partisan coalition work. Questions to ask in advance: What are your shared goals as a coalition? Are you time-limited, meaning you plan to disband after the election, or do you plan to continue working together toward a shared policy goal? Who is a member of the coalition? How will you communicate? How will decisions get made? How formal or informal do you want the coalition to be? What are some best practices for sharing resources? What can organizations actually pool to increase their collective impact? Staff, volunteers, office space, equipment, communications, educational resources, and other shared assets can expand a coalition's reach and strengthen collaborative power. Organizations can share tools and capacity so long as they adhere to the rules that apply to each entity. Things to Consider: 501(c)(3) resources and funds cannot be used to subsidize partisan political activity. Manage the expectations and agreements before you get going. Questions to ask: How will the organization share those resources? What are you going to share? Who owns or controls the resource? Which organization is using it, and for what purpose? How will costs be allocated? What happens if the use of that resource changes during the campaign? Best Practices: Know the Rules & Maintain Clear Boundaries: Understand each organization's tax status; keep governance, finances, and branding separate; and ensure there is a method for preventing the (c)(3)'s work from becoming intertwined with partisan activity. Document & Allocate Resources Fairly: Use written agreements, allocate shared costs using a reasonable method, track staff time accordingly; and maintain records of expenses, reimbursements, and resource-sharing arrangements. Don't Blur Organizational Lines: Use separate websites, social media accounts, and email addresses; clarify roles and responsibilities for each activity and/or communication; and make sure (c)(3) staff, volunteers, and resources are used only for activities it can legally undertake. Avoid Free or Below-Market Resource Sharing: If a resource has value—such as email lists, mailing lists, or voter registration files —it generally should be reimbursed at fair market value or through a reasonable cost-allocation agreement. Best practice is to use a list broker. Renting or exchanging lists can raise other legal and/or tax questions. For example, while list rental income is generally considered royalty income (and exempt from UBIT), if rented to a campaign, this exception does not apply to rentals made to political campaigns or PACs (the IRS does consider this to be UBI and therefore subject to tax. Nonpartisan voter registration files may only be rented to a 501(c)(4) or 527 at fair market value or exchanged for data of equal value. Even then, the circumstances in which these agreements can be made are complex, so it's wise to get legal advice. What's the bottom line? Sharing resources can strengthen partnerships, reduce costs, and advance meaningful change. Coalition building is literally solidarity in action—organizations coming together to advance joint goals. And we know we are stronger together, so establish agreements upfront, allocate costs fairly, keep good records, and maintain clear organizational boundaries. When done thoughtfully, collaboration can amplify a unified voice and build momentum while protecting each organization's tax-exempt status. Resources The Connection 501(c)(3) & 501(c)(4) Collaboration Sample Allocation of Costs Agreement Rules of the Game: Can We Rent (Or Share) That? Comparison of 501(c)(3) & 501(c)(4) Permissible Activities Rules of the Game: A Guide to Election Related Activities for 501(c)(3)s
Gold is swinging hard again — rebounding sharply today after an early selloff pushed prices to a near one-month low. But i-80 Gold CEO Richard Young says investors focused on the day-to-day volatility may be missing a much bigger shift in gold and commodities. In this conversation with Trey Reik, Young explains why he believes gold and commodities could be in a 5, 10, even 20-year run, why mining companies may increasingly benefit from expanding margins as technology becomes more capital intensive, and why hard assets with long lives and strong “moats” could become increasingly valuable. Young also breaks down what investors should look for when evaluating gold miners, why Nevada remains such an attractive mining jurisdiction, and how i-80 Gold navigated a massive recapitalization when hundreds of millions of dollars were coming due. Is the recent volatility just another shakeout inside a much bigger gold bull market?
Photo: Bernadette Hartley and other volunteers assemble opioid-reversal kits at an August 29, 2025, event in Anchorage, Alaska. (Yereth Rosen / Alaska Beacon) A new health report has mixed news for Alaskans. The findings come from the Healthy Alaskans program, a partnership between the Alaska Department of Health and the Alaska Native Tribal Health Consortium. As Yereth Rosen reports from the Alaska Beacon, key takeaways from the research show that chronic health problems like obesity and high blood pressure persist and childhood vaccinations continue to lag. Over the last decade, infant mortality rates have shown no improvement with markedly higher rates among Alaska Natives. The state's life expectancy remains unchanged, but the report points to some encouraging trends, particularly for younger Alaskans. The statewide assessment found a significant increase in prenatal care. High school graduation rates are up, and the longstanding graduation gap among Alaska Native students has narrowed. The reports says this is important, because education is linked to better health. It also found that Alaska teens are less likely today to be exposed to secondhand tobacco smoke, a trend the report links to tobacco-free zones and other policies. Drug overdose rates appear to be leveling off. The research found that more food grown in Alaska has become easier to find, while better access to trails supports exercise and traditional subsistence practices. There are some troubling developments on the horizon. Climate change has affected fish runs and the availability of wild foods, important to the diet of rural Alaskans. Environmental changes have also increased the risk of new diseases, while wildfire smoke poses health hazards in some parts of the state. The Voices Not Forgotten page on the FBI website shows current cases. The FBI is increasing rewards for information in cases involving missing and murdered Indigenous people and relatives in North Dakota and nationwide, as Judith Ruiz-Branch reports. Brandon Baity is executive director of the Indigenous Association in Fargo, North Dakota and a White Earth descendant, “We’re left very vulnerable due to a lot of systemic and intergenerational reasons. So the bottom line is addressing some of that vulnerability in our community overall would help us go further up the river, so we’re not always pulling people out of the river, literally and figuratively.” Forty percent of North Dakota's missing population is Indigenous. As part of the Voices Not Forgotten initiative, FBI officials have set a minimum $25,000 reward for help with cracking dozens of nationwide cases. Baity believes the level of attention a case receives can come down to whether a victim is viewed as “worthy”. He raises questions about which lives are deemed deserving of public concern and institutional resources. Factors like addiction or housing instability can lead to victim-blaming, Baity adds, even though every missing person has family, friends and loved ones who want them found. “They’re still people and they’re still deserving of care and support in our community and from our organizations and our institutions that are here to keep us safe. And so I just think we really need to focus more on, why are there so many murdered and missing Indigenous people in our country?” FBI data shows nearly 10,000 American Indian and Alaska Native individuals were reported missing nationwide in 2025. Baity says informal networks in the Fargo-Moorhead area mobilize and organize searches for local families who are impacted, but those efforts can be limited by a lack of resources and formal support. He adds that increased rewards and investigative resources are important, but preventing these cases in the first place requires sustained investment in the safety and stability of Indigenous communities. Get National Native News delivered to your inbox daily. Sign up for our daily newsletter today. Download our NV1 Android or iOs App for breaking news alerts. Check out today’s Native America Calling episode Tuesday, September 1, 2026 — Growing understanding of head injuries changes sports at all levels
CME in Minutes: Education in Rheumatology, Immunology, & Infectious Diseases
Please visit answersincme.com/JKK860 to participate, download slides and supporting materials, complete the post test, and get a certificate. Presented by Alison J. Birtle, FRCP, FRCR, MD; and Niklas Klümper, MD. In this activity, experts in oncology discuss systemic therapies for locally advanced and metastatic urothelial carcinoma. Upon completion of this activity, participants should be better able to: Assess the evidence for recommended systemic treatment regimens for patients with LA/mUC in the context of treatment guidelines; Propose appropriate patient assessment strategies to guide systemic therapy decisions; and Formulate individualized treatment strategies to optimize outcomes for patients with LA/mUC using recommended first-line systemic treatments.
Health and spacing aside, what factors may affect halachic decisions about contraception? Is it permissible to delay fulfilling the mitzva of procreation? Sources and transcript here: https://www.deracheha.org/contraception-3/ To dedicate an episode of Kol Deracheha email us at Deracheha@gmail.com
MICHAELBASHAM.COMBetter is a poor man who walks in his integrity than a rich man who is perverse in his speech and is a [self-confident] fool...
⚖️ What Factors Determine Who Gets Custody of a Child? | Los Angeles Divorce
The imposition of a 50% tariff on a substantial array of Canadian goods, particularly affecting the furniture sector, represents a significant development that we must scrutinize in depth. This tariff encompasses approximately $20 billion worth of Canadian products, including essential materials such as plywood, lumber, and various furniture items, that are now subject to elevated costs, irrespective of their qualification under the United States-Mexico-Canada Agreement (USMCA). As we delve into the ramifications of this policy, we will explore how these duties could fundamentally alter the pricing structures within American manufacturing, compelling U.S. producers to reassess their procurement strategies and operational costs. Additionally, we shall examine the response from Canadian authorities, including the retaliatory tariffs announced by Prime Minister Mark Carney, which are set to take effect shortly. Through this discourse, we aim to uncover the broader implications for the furniture industry, both in terms of market dynamics and consumer behavior amidst escalating costs and shifting trade policies.Takeaways:The recent imposition of a 50% tariff on Canadian goods significantly affects the furniture industry, impacting production costs.Approximately 5% of Canadian exports to the United States are subject to these new tariffs, complicating trade relations.The lack of a detailed product list regarding the tariffs raises uncertainties for manufacturers and retailers alike.Factors such as production costs and the competitive labor market will shape the future dynamics of furniture sales.Consumer sentiment towards domestically produced furniture remains positive, suggesting potential resilience in the market.The ongoing shift in consumer purchasing behavior indicates a preference for smaller, more intentional projects rather than large-scale renovations.
I was particularly excited to sit down with one of my long term colleagues, psychiatrist Dr. James Greenblatt for an exploration of his new book "Finally Hopeful subtitle". Dr. Greenblatt is one of the pioneers of functional and integrative psychiatry, and it's his fourth interview with the MindHealth360 Show. His first three were about suicide, ADHD and Eating Disorders. This one was about the biological root causes of depression – and why identifying them could fundamentally change the way we diagnose and treat mental illness. Dr. Greenblatt argues that depression is not one uniform condition: ten people with the same diagnosis may have ten different underlying drivers. From vitamin D and B12 deficiencies, amino acids, thyroid and hormone imbalances, to low cholesterol, impaired digestion and chronic infections, he explains why common and measurable biological factors can contribute to depressive symptoms – and why testing for root causes should often come before treatment. But this is not a conversation about replacing antidepressants with supplements. Dr. Greenblatt is equally critical of functional medicine approaches that focus on tests and large supplement protocols without understanding the individual patient. We explore his mantra to "treat patients, not tests", and examine why trauma and chronic stress can impair digestion and nutrient absorption, and why nervous-system regulation, and an understanding of psycho-social factors and relationships must sit alongside biochemical treatment. In this episode, you'll learn: Why ten people with depression may have ten completely different underlying causes. Why clinicians should investigate factors including thyroid function, iron, B12, zinc and vitamin D before automatically reaching for an antidepressant. Why vitamin D deficiency is associated with depression, anxiety and suicide risk – and why testing matters more than simply giving everyone vitamin D. How trauma and chronic stress can suppress stomach acid and digestion, leaving people low in amino acids even when they eat adequate protein. Why commonly accepted B12 "normal" ranges may miss deficiencies relevant to brain and mental health. Why very low cholesterol levels may be an overlooked biological factor in depression, addiction and suicide risk. What new research tells us about lithium orotate and brain health, and why lithium is being reconsidered by mainstream psychiatry. Why "treat patients, not tests" has become one of Dr. Greenblatt's central principles – and why more supplements do not necessarily mean better treatment. Why he considers somatic therapies particularly important for patients whose stress and trauma are held in the body. Why ketogenic diets and psychedelics can be powerful tools, but may still become sophisticated "Band-Aids" if basic biological deficiencies are overlooked. Take the conversation further at IMMH 2026 At this year's Integrative Medicine for Mental Health (IMMH) Conference, Dr. James Greenblatt will take several of the ideas explored in this episode into greater clinical depth across two sessions: Amino Acids as Precursors for Neurotransmitters – exploring how amino acid deficiencies can affect neurotransmitter production, and how targeted testing and repletion may support more personalised approaches to depression. Functional Medicine for Obsessive Compulsive Disorder – examining evidence-based nutritional approaches to OCD, including inositol, NAC and 5-HTP, alongside nutrigenomic testing to inform individualised treatment. Join Dr. Greenblatt and more than 50 leading clinicians, researchers and thought leaders at IMMH 2026, October 8–11 in San Diego. Early Bird ticket prices – available until August 31 In-person ticket: $1,045 Virtual ticket: $495 Get tickets here: https://www.immh.org/immh-2026/
Charles Schwab's Jim Ferraioli talks all about Bitcoin futures on this week's Crypto Corner. He examines how hedge funds are appearing to build plans to go long as dynamics in the crypto space continue to shift. ======== Schwab Network ========Empowering every investor and trader, every market day. Subscribe to the Market Minute newsletter - https://schwabnetwork.com/subscribeDownload the iOS app - https://apps.apple.com/us/app/schwab-network/id1460719185Download the Amazon Fire Tv App - https://www.amazon.com/TD-Ameritrade-Network/dp/B07KRD76C7Watch on Sling - https://watch.sling.com/1/asset/191928615bd8d47686f94682aefaa007/watchWatch on Vizio - https://www.vizio.com/en/watchfreeplus-exploreWatch on DistroTV - https://www.distro.tv/live/schwab-network/Follow us on X – https://twitter.com/schwabnetworkFollow us on Facebook – https://www.facebook.com/schwabnetworkFollow us on LinkedIn - https://www.linkedin.com/company/schwab-network/ About Schwab Network - https://schwabnetwork.com/about
Have you ever wondered why the way everyone else works just doesn't seem to work for you? In this episode, I introduce my TAAM framework and share what I learned from my Neuro Strength Survey of more than 1,200 neurodistinct professionals. I talk about how time, attention, agency, and motivation shape the way you work and why understanding those patterns can help you build a career that feels more aligned. Plus, I share questions to help you identify your own TAAM profile and start designing work that fits you better. Tune in to discover how understanding the way your brain works can help you build a career that works for you. Check out our sponsors: Shopify - Sign up for a $1 per month trial, just go to shopify.com/anxiousachiever Monarch - Use code ACHIEVER at monarch.com to get 50% off your first year Whatnot - Get free shipping on your first order. Just search W-H-A-T-N-O-T in the app store and start scoring amazing deals Pebl - Take advantage of Pebl's limited-time offer before it's gone. Visit hipebl.ai today. IM8 - Go to IM8HEALTH.com/achiever RIGHT NOW or click on the link in the description and use code achiever for a Free Welcome Kit, five free travel sachets, plus ten percent off your order DripDrop - Right now, DripDrop is offering podcast listeners 20% off your first order. Go to dripdrop.com and use promo code ACHIEVER Brevo - Get started for free today—or use code ACHIEVER50 to save 50% on Starter and Standard Plans for the first three months of an annual subscription Upwork - Visit upwork.com right now and post your job for free. In this Episode, You Will Learn 00:00 Why traditional work advice doesn't fit every brain. 04:15 Why understanding your individuality matters more than labels. 06:45 What more than 1,200 neurodistinct professionals revealed about work. 10:00 Why your brain is both a strength and a challenge. 12:15 The strengths neurodistinct professionals bring to the workplace. 15:15 Why flexibility matters more than productivity hacks. 17:15 What is the TAAM framework? 20:15 Rethink your relationship with time at work. 24:15 What helps your attention thrive instead of drain. 26:30 How agency shapes your experience at work. 30:30 What drives your motivation at work? 33:30 How to create your own TAAM profile. 38:00 Example of the TAAM framework in action. 42:15 Answering common questions about TAAM, values, and accommodations. Resources + Links Take the Neurostrength Survey HERE Download the TAAM Profile Worksheet HERE Pre-order The Atypical Achiever HERE Get a copy of my book - The Anxious Achiever Watch the podcast on YouTube Find more resources on our website morraam.com Follow Follow me: on LinkedIn @morraaronsmele + Instagram @morraam
Aspirin or biologics? How do you choose the right treatment for AERD? On this episode of the BackTable ENT & Allergy Podcast, Dr. Basil Kahwash interviews Dr. Andrew White, Director of the AERD Clinic at Scripps Clinic, to discuss the diagnosis and management of this often underrecognized condition. They cover practical strategies for identifying AERD, the importance of a detailed NSAID history, and how treatment decisions are shaped by patient goals and disease severity. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:08 - What Is AERD and Prevalence 06:32 - History Taking and Mechanism 11:10 - Typical Symptom Progression and Alcohol Intolerance 16:41 - When to Do Aspirin Challenge 19:00 - Challenge Protocol And Upper Airway Reactions24:53 - Aspirin Desensitization vs Challenge27:58 - Aspirin therapy after desensitization and Risk of GI Bleeds31:17 - Biologics Change AERD33:42 - Choosing Aspirin Desensitization vs Biologics 35:52 - Patient Counseling and Motivational Interviewing 41:26 - Convenience and Cost of Therapy 44:10 - ENT Allergy Collaboration47:22 - Rapid Fire Pearls51:13 - Future Research & Management Direction54:05 - Final Takeaways --- More about this episode Dr. White explains that AERD affects about 8 to 10 percent of asthmatics, with even higher rates in those with severe asthma or nasal polyps. He reviews typical adult-onset progression, alcohol-related respiratory symptoms, and the underlying pathophysiology, including imbalances in arachidonic acid mediators and leukotriene surges after NSAID exposure.The conversation includes practical questions to ask when taking an NSAID history, such as reactions to common pain relievers or alcohol, and when to consider aspirin challenge. Dr. White also details long-term treatment strategies, including the role of biologics like dupilumab and aspirin therapy after desensitization, with considerations for dosing and gastrointestinal risk. He explains how factors like asthma severity, recurrent polyp disease, sense of smell, cost, and convenience all influence therapy choice. The episode concludes with a discussion of multidisciplinary collaboration, patient counseling, and Dr. White's insights on future research directions in AERD management. --- Resources Aspirin sensitivity and severity of asthma: evidence for irreversible airway obstruction in patients with severe or difficult-to-treat asthmahttps://pubmed.ncbi.nlm.nih.gov/16275362/ Polyphenolic Activation of Basophils Explains Alcohol Hypersensitivity in AERDhttps://pubmed.ncbi.nlm.nih.gov/41065188/ New insights into the mechanisms of aspirin-exacerbated respiratory diseasehttps://pubmed.ncbi.nlm.nih.gov/39641750/ The role of aspirin desensitization followed by oral aspirin therapy in managing patients with aspirin-exacerbated respiratory disease: A Work Group Report from the Rhinitis, Rhinosinusitis and Ocular Allergy Committee of the American Academy of Allergy, Asthma & Immunologyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC7980229/ Safety and outcomes of aspirin desensitization for aspirin-exacerbated respiratory disease: A single-center studyhttps://pubmed.ncbi.nlm.nih.gov/28550988/ Selection of aspirin dosages for aspirin desensitization treatment in patients with aspirin-exacerbated respiratory diseasehttps://pubmed.ncbi.nlm.nih.gov/17208597/ Factors influencing aspirin therapy after desensitization (ATAD) tolerance in aspirin-exacerbated respiratory disease (AERD) patientshttps://pubmed.ncbi.nlm.nih.gov/41022281/ Feed the Good Wolf: Motivational Interviewing, Cognitive Behavioral Therapy, and Mindsethttps://pubmed.ncbi.nlm.nih.gov/42103433/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
Today, on the Egg Whisperer Show podcast, I'm excited to be joined by Dr. Andrea Vidali. He is a world renowned endometriosis specialist, surgeon, miscarriage specialist and reproductive immunologist. Dr. Vidali is the founder and CEO of Pregmune, a healthcare information company that leverages his research in the fields of IVF and its relation to miscarriage and Immunology. I'm delighted to have him join us to talk about Pregmune and the role immunological factors play in fertility. In today's interview, we are going to be talking about what fertility patients need to know about immunological factors, how immunological factors may present themselves when diagnosed with "unexplained infertility," 6 important factors that may impact your ability to conceive, and how to get tested in order to see if any immunological factors may be involved when having difficulty conceiving. Read the full show notes on Dr, Aimee's website. Tune in to the Egg Whisperer Show here. You can find Dr. Vidali at his website, here. Do you have questions about IVF, and what to expect? Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, September 14 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom. Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org where you can schedule a consultation. Other places to find The Egg Whisperer: Click to find The Egg Whisperer Show podcast on your favorite podcasting app. Watch videos of Dr. Aimee answer Ask the Egg Whisperer Questions on YouTube.Sign up for The Egg Whisperer newsletter to get updates
Why does pain sometimes persist—even after an injury has healed?In this episode, Leigh speaks with physicist, educator and pain specialist Dr Zoa Conner about the complex nature of persistent pain. They explore why pain is more than a purely physical experience and how muscular imbalances, nutrition, stress, emotions and the nervous system may all influence how pain is experienced.Zoa explains her systems optimisation approach: instead of viewing pain as an isolated symptom, she looks at the interconnected factors that may be keeping the body in a protective state.In this conversation, you'll discover:• Why pain should be understood as a protective message• How persistent pain can have multiple contributing factors• The potential roles of posture, muscular imbalance and weakness• How stress and emotional tension may affect physical symptoms• Why nutrition matters for healing and nervous-system health• How mindful awareness can change your relationship with pain• Ways to reintroduce gentle movement without forcing through symptoms• Why exploring root causes may be more effective than focusing only on pain reliefIf you're living with persistent pain and feel confused, frustrated or let down by symptom-focused approaches, this conversation offers a broader and more hopeful way to understand what may be happening.CONNECT WITH ZOATake Zoa's quiz:https://intentional-vitality.com/quiz/Next retreat—Montreal, October 2026:https://intentional-vitality.com/montreal-oct-2026/Zen and Vitality online and in-person wellness studio:https://www.zenandvitality.com/CONNECT WITH LEIGHBeyond the Pain—paperback:https://amzn.to/4y2HVWgBeyond the Pain—ebook:https://amzn.to/4y0lH78Beyond the Pain 14-Day Programme:https://bodychek.co.uk/beyond-the-pain-programme/Download the free Pain-Free Plate guide:https://www.bodychek.co.uk/freepainguide/Book a consultation with Leigh:https://www.bodychek.co.uk/consultationPlease follow or subscribe to the show and share this episode with someone who needs a new perspective on persistent pain.Disclaimer: This episode is for educational purposes only and is not a substitute for personalised medical advice, diagnosis or treatment. Consult an appropriately qualified healthcare professional about symptoms or changes to your health.
As climate change causes large parts of the northern hemisphere to experience high heat and raging wildfires, forecasters are warning it is a preview of what is to come for Australia. A very strong El Nino system is in play for the first time in a decade - and it's combining with other weather patterns to present a steamy forecast for spring and summer in the Asia Pacific. - Из-за изменения климата обширные районы Северного полушария страдают от экстремальной жары и разрушительных лесных пожаров. По словам метеорологов, это лишь предвестник того, что в ближайшее время может ожидать Австралию. Впервые за последнее десятилетие сформировалось очень сильное явление Эль-Ниньо. В сочетании с другими климатическими процессами оно создаёт предпосылки для необычайно жаркой весны и лета в странах Азиатско-Тихоокеанского региона.Больше историй, интервью и новостей от SBS Russian доступно здесь.Слушайте программу на русском языке SBS по понедельникам, четвергам и субботам в 12 часов дня.SKIP ADVERTISEMENTAdvertisementЧитайте нас в Facebook и подпишитесь на наши подкасты по этой ссылке.
CardioNerds (Dr. Apoorva Gangavelli, Dr. Cory Sejo, and Dr. Joseph Kassab), discuss tricuspid regurgitation evaluation and management with Dr. Sunil Mankad. This episode was produced as part of the CardioNerds Academy curriculum by House Einthoven under the guidance of House Chief, Dr. Apoorva Gangavelli and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. This discussion was planned in collaboration with the Mayo Clinic Cardiovascular Board Review Course. Audio editing by CardioNerds intern Emma Winakur. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Key Points: Tricuspid regurgitation is common and associated with increased mortality at every stage, regardless of etiology. Outcomes are worse with worsening severity, so accurate grading is critical. Etiology is critical to guide treatment decisions. Etiology includes primary vs secondary (atrial or ventricular) vs CIED-related TR. 3D echocardiography can be very helpful in determining TR etiology, especially in CIED-related TR. Diuresis with the goal of euvolemia is step one. Additionally, underlying contributory conditions (eg. pulmonary HTN, HFrEF, atrial fibrillation) should be addressed, if appropriate, and then TR severity reassessed. The choice between T-TEER and TTVR hinges on anatomy, RV function, pulmonary hypertension, and the ability to tolerate anticoagulation. T-TEER is generally first line in atrial functional TR with appropriate anatomy, in patients with poor RV function who cannot tolerate a sudden increase in RV afterload, or in patients who cannot tolerate the necessary anticoagulation with TTVR. TTVR is preferred with wide coaptation gaps and CIED-related TR. This is a team sport. Multidisciplinary discussions utilizing imaging (TTE/TEE, CT), risk scores (TRI-SCORE or TRIO), patient preference, and prior institutional experience are essential for the effective treatment of severe TR. Notes: What is the clinical importance of tricuspid regurgitation? TR is very common with approximately 4% of people over 75 having moderate or greater severity. TR (even mild) is associated with increased mortality. Those outcomes worsen as the TR severity worsens, and this phenomenon is independent of the mechanism of regurgitation. What is unique about the tricuspid valve compared to the other cardiac valves? It is at an anterior location which allows it to be imaged well with transthoracic echocardiography It is the largest valve and composed generally of 3 leaflets (but very often can have 4+ leaflets). Importantly, the RV is compliant and changes size and shape readily based on loading conditions. The TV annulus similarly changes size and shape based on hemodynamic conditions such as preload. What is a good framework for approaching the causes of tricuspid regurgitation? Determine the presence and define the severity of TR. Using TTE, we want to measure the right atrial size, the RV size, and any other concomitant valvular lesions. Use TTE (2D and 3D) to characterize leaflet anatomy and characteristics. Subtypes of TR mechanisms (many times etiology is mixed). Primary: primary leaflet abnormality, occurs in ~10% of cases. Look for prolapse, flail, endocarditis, etc. Secondary/functional: leaflets normal but surrounding structures are abnormal. Atrial: RA and tricuspid annular dilation but normal RV size/shape, and can be related to arrhythmias like atrial fibrillation. Ventricular: RV dilated and/or dysfunctional with leaflet tethering. Can be related to pulmonary hypertension or primary RV disease. Cardiac implantable electronic device (CIED): Related to device (usually pacemakers or ICD) interaction with TV leaflets. Includes perforation, entanglement in subvalvular apparatus, impingement, etc. 3D TTE particularly helpful to evaluate How do we grade TR severity? It is very important to grade the severity of TR, and this is generally done with echocardiography. There are both quantitative and qualitative methods which use Doppler and various equations to estimate TR severity. Current recommendations have expanded TR severity beyond mild/moderate/severe to include “massive” and “torrential” categories. The most important parameters measured/calculated are vena contracta width, regurgitant volume, regurgitant fraction, and effective regurgitant orifice area. Helpful qualitative metrics include hepatic venous flow reversal. When should additional studies beyond transthoracic echocardiography, such as transesophageal echocardiography (TEE), cardiac computed tomography (CT), and cardiac magnetic resonance imaging (MRI) be pursued? TEE is particularly helpful if TTE views are poor. Since TEE is used during transcatheter intervention, a pre-procedure TEE to define anatomy, determine procedure candidacy, and plan for the procedure is critical. CT is also helpful for procedure planning and has particular strengths in defining annulus size and geometry. A CT is required prior to transcatheter tricuspid valve replacement (TTVR). MRI is helpful for measuring RV volumes and function, but is not generally used to assess TR severity. What is the approach to the treatment for severe tricuspid regurgitation? The first step is to try to determine the etiology. For secondary TR, treating the underlying condition is indicated. For example, pulmonary vasodilators for pulmonary HTN or guideline therapy for heart failure with reduced ejection fraction. Diuretics are the mainstay for treatment, with the goal to obtain euvolemia. This may require inpatient admission to optimize volume status and medication regimen. Once reversible etiologies are addressed, if the patient is still symptomatic from TR, additional therapies can be considered. What is the role of right heart catheterizations (RHC) in patients with severe TR? RHC is very helpful for many reasons. We use it in TR to help determine volume status, cardiac output, and RV function. Additionally, identifying and characterizing pulmonary hypertension (with pulmonary artery pressures and calculating pulmonary vascular resistance) is an important factor when choosing future therapies. With severe tricuspid regurgitation, when should we refer for intervention (either with surgery or transcatheter repair or replacement)? Once reversible etiologies are addressed and euvolemia has been achieved, if the patient is still symptomatic from TR despite aggressive medical optimization, additional therapies can be considered. Once euvolemic, a repeat TTE should be ordered to reassess the severity of the TR. Use calculators (for example, either the TRI-SCORE or TRIO score) to predict operative mortality for isolated TR surgery. What are our transcatheter treatment options in severe tricuspid regurgitation, and how do we choose between them? The primary approved transcatheter treatment options for severe TR include transcatheter tricuspid edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR), of which the Edwards EVOQUE valve is the only one currently approved by the FDA. There are other TTVR device under investigation. These decisions should be made with a multi-disciplinary team including representation from cardiac imaging, interventional cardiology, and cardiothoracic surgery. Factors that go into the decision between T-TEER and TTVR include anatomy (annulus width, coaptation gap, leaflet length), RV reserve, pulmonary hypertension presence, ability to tolerate anticoagulation, patient preference, and institutional experience. T-TEER is generally the first line with atrial functional and suitable anatomy. It is successful at reducing TR but does not generally eliminate it. TTVR with EVOQUE is preferred in certain anatomic considerations like a large coaptation gap or when there is CIED-related TR (as this was excluded in T-TEER trials). Patients must be suitable for anticoagulation to receive TTVR as there is risk of leaflet thrombosis without it. If moderate/severe pulmonary hypertension is present, or there is poor RV function, TTVR may be avoided as the sudden elimination of TR causes a sudden increase in RV afterload which may not be tolerated. What is the role in advanced metrics for evaluating RV function? Advanced metrics like RV/PA coupling are under investigation but have not made it into the guidelines. The clinical utility is not yet known. Assessing the RV function is important as stated above. Dr. Mankad prefers using 3D TTE to calculate an RVEF, or tracking RV longitudinal free wall strain. If you do encounter CIED-related TR, how do you treat it? Evaluate with TTE or TEE. 3D is very helpful to identify relative anatomy and leaflet-device interactions. There is no clear consensus about treatment if CIED-related TR is the primary mechanism of severe TR. If recently implanted, repositioning may be a valid option, but requires discussions with multiple teams including electrophysiology, advanced cardiac imaging, CT surgery, and interventional cardiology. References O’Gara PT, Lindenfeld J, Hahn RT, et al. 10 Issues for the Clinician in Tricuspid Regurgitation Evaluation and Management: 2025 ACC Expert Consensus Decision Pathway. J Am Coll Cardiol. 2025;S0735-1097(25)07047-0. O’Gara PT, Little SH, Badhwar V, et al. Operator and Institutional Recommendations and Requirements for Tricuspid Interventions: 2026 ACC/AHA/ASE/HRS/STS Expert Consensus Systems of Care Document. J Am Coll Cardiol. 2026;S0735-1097(26)05481-1. Hahn RT. Tricuspid Regurgitation. N Engl J Med. 2023;388(20):1876-1891. Davidson LJ, Tang GHL, Ho EC, et al. The Tricuspid Valve: A Review of Pathology, Imaging, and Current Treatment Options: A Scientific Statement From the American Heart Association. Circulation. 2024;149(22):e1223-e1238.
As climate change causes large parts of the northern hemisphere to experience high heat and raging wildfires, forecasters are warning it is a preview of what is to come for Australia. A very strong El Nino system is in play for the first time in a decade - and it's combining with other weather patterns to present a steamy forecast for spring and summer in the Asia Pacific. - ขณะที่การเปลี่ยนแปลงสภาพภูมิอากาศทำให้หลายพื้นที่ในซีกโลกเหนือเผชิญอากาศร้อนจัดและไฟป่ารุนแรง นักพยากรณ์อากาศเตือนว่า สถานการณ์ที่เกิดขึ้นอาจเป็นภาพล่วงหน้าของสิ่งที่ออสเตรเลียกำลังจะเผชิญปีนี้ ปรากฏการณ์เอลนีโญมีกำลังรุนแรงมากที่สุดครั้งหนึ่งในรอบทศวรรษ และเมื่อเกิดขึ้นพร้อมกับรูปแบบสภาพอากาศอื่น ๆ ก็ยิ่งเพิ่มแนวโน้มที่ภูมิภาคเอเชียแปซิฟิก รวมถึงออสเตรเลีย จะเผชิญอากาศร้อนจัดในช่วงฤดูใบไม้ผลิและฤดูร้อนที่กำลังจะมาถึง
In this episode of Coffee & Cap Rates, Shimon Shkury, President and Founder of Ariel Property Advisors, discussed Ariel Property Advisors' Q2 2026 Multifamily Quarter in Review with Victor Sozio, Founding Partner, and Matt Swerdlow, Senior Director in Capital Services.The trio discussed the performance of the multifamily real estate market during the second quarter of 2022, including:Market Growth: The multifamily market totaled nearly $2.5 billion.Asset Class Performance:Free Market: This segment saw continued rent growth and strong investor competition. Manhattan and Brooklyn remain attractive for these types of assets.Rent Stabilized: This market faces significant struggles, with low trading volumes in outer boroughs like the Bronx, Queens, and Northern Manhattan. Factors contributing to this include a 0% rent increase, elevated interest rates and concerns regarding regulatory risks.Affordable Housing: Project-based Section 8 housing remains a premier asset class due to federal subsidies and stability. It represents about 10% of the overall transaction volume.Financing and Debt:For rent-stabilized assets, borrowers facing maturity are advised to engage lenders early to discuss potential modifications or extensions, as property values have changed significantly.Refinancing and acquisition financing remain available through agencies like Fannie Mae, Freddie Mac, and CMBS, with some deals achieving 70–75% loan-to-value ratios.Future Outlook: The speakers anticipate an active second half of the year, with a strong contract pipeline pointing toward sustained or increased transaction volume in the third and fourth quarters. Despite the challenges in the rent-stabilized sector, there is notable seller motivation to transact if debt-related issues can be resolved.Access the full report here.
Better is a poor man who walks in his integrity than a rich man who is perverse in his speech and is a [self-confident] fool. 2 Desire without knowledge is not good, and to be overhasty is to sin and miss the mark. 3 The foolishness of man subverts his way [ruins his affairs]; then his heart is resentful and frets against the Lord. 4 Wealth makes many friends, but the poor man is avoided by his neighbor. 5 A false witness shall not be unpunished, and he who breathes out lies shall not escape. 6 Many will entreat the favor of a liberal man, and every man is a friend to him who gives gifts. 7 All the brothers of a poor man detest him—how much more do his friends go far from him! He pursues them with words, but they are gone. 8 He who gains Wisdom loves his own life; he who keeps understanding shall prosper and find good. 9 A false witness shall not be unpunished, and he who breathes forth lies shall perish. 10 Luxury is not fitting for a [self-confident] fool—much less for a slave to rule over princes. 11 Good sense makes a man restrain his anger, and it is his glory to overlook a transgression or an offense. 12 The king's wrath is as terrifying as the roaring of a lion, but his favor is as [refreshing as] dew upon the grass. 13 A self-confident and foolish son is the [multiplied] calamity of his father, and the contentions of a wife are like a continual dripping [of water through a chink in the roof]. 14 House and riches are the inheritance from fathers, but a wise, understanding, and prudent wife is from the Lord. 15 Slothfulness casts one into a deep sleep, and the idle person shall suffer hunger. 16 He who keeps the commandment [of the Lord] keeps his own life, but he who despises His ways shall die. 17 He who has pity on the poor lends to the Lord, and that which he has given He will repay to him. 18 Discipline your son while there is hope, but do not [indulge your angry resentments by undue chastisements and] set yourself to his ruin. 19 A man of great wrath shall suffer the penalty; for if you deliver him [from the consequences], he will [feel free to] cause you to do it again. 20 Hear counsel, receive instruction, and accept correction, that you may be wise in the time to come. 21 Many plans are in a man's mind, but it is the Lord's purpose for him that will stand. 22 That which is desired in a man is loyalty and kindness [and his glory and delight are his giving], but a poor man is better than a liar.
Drawing on decades of research and practical field experience, the panel begins by examining large laboratory datasets that reveal substantial variation in trace mineral concentrations across forages and total mixed rations. These observations highlight the importance of understanding real-world variability rather than relying solely on average values when making nutritional decisions. (00:00–03:16) The discussion quickly moves into one of dairy nutrition's most debated topics: the reliability of TMR testing. While many nutritionists use TMR analyses as a quality control measure, others remain skeptical due to the challenges associated with obtaining representative samples from inherently heterogeneous rations. The panel agrees that TMR testing can provide valuable information, but only when consistent sampling protocols and proper laboratory procedures are followed. (03:16–06:46) Building on this theme, the group discusses mixer studies as a powerful quality control tool. By evaluating nutrient variation within a load and across multiple batches, producers and nutritionists can better assess feeding consistency, identify operational issues, and improve ration delivery accuracy. These studies often provide a more complete picture of feeding performance than a single feed sample alone. (06:46–12:12) A significant portion of the conversation focuses on trace mineral supplementation practices. The panel notes that although average mineral concentrations may appear appropriate on paper, many diets still contain excessive levels of trace minerals. Overfeeding can increase costs, contribute to nutrient antagonisms, impair rumen function, and raise concerns about toxicity. The experts emphasize the importance of balancing supplementation programs based on actual dietary contributions rather than adding large safety margins. (12:13–16:46) The discussion then shifts to the impact of soil contamination on forage analysis and nutrient interpretation. Soil contamination can dramatically influence ash concentrations and artificially inflate measured trace mineral levels, creating challenges for nutritionists attempting to accurately evaluate feed value. The panel highlights emerging approaches, including the use of carbon measurements as a more precise indicator of contamination, which may improve how forage quality is assessed in the future. (16:47–25:47) Regional differences in feed composition also receive considerable attention. Factors such as irrigation practices, soil characteristics, and co-product feeding programs can contribute to elevated sulfur and trace mineral concentrations in certain areas, increasing the risk of mineral antagonisms and affecting nutrient availability. Understanding these local influences is essential for developing effective mineral nutrition programs that are tailored to specific production environments. Looking ahead, the panel explores innovations that could transform feed evaluation and ration formulation. Topics include amino acid profiling, the industry's gradual move beyond crude protein as a primary nutritional metric, and the potential for artificial intelligence to improve predictions of forage quality and nutrient composition. These advances may provide nutritionists with more accurate tools for optimizing dairy cow performance and feed efficiency. (35:16–41:10) The episode concludes with a practical takeaway for dairy producers, nutritionists, and consultants: laboratory analyses and advanced technologies are most valuable when paired with a thorough understanding of feed variability and strong on-farm quality control practices. Whether evaluating trace minerals, interpreting forage analyses, or implementing new technologies, success ultimately depends on consistently managing variation throughout the feeding system. Please subscribe and share with your industry friends. Invite more people to join us at the Real Science Exchange virtual pub table. Please be sure to register for our upcoming Real Science Lecture Series webinars. Finally, if you want one of our Real Science Exchange t-shirts, screenshot your rating, review, or subscription, and email a picture to anh.marketing@balchem.com. Include your size and mailing address, and we'll mail you a shirt.
Talk the Talk - a podcast about linguistics, the science of language.
How does it feel to be isolated from a language and a culture that could have been yours? There are many paths to language loss, but there are also many ways back. Language revitalisation is now happening for communities and individuals. We're talking about it with journalist and lingToker Sophia Smith Galer, author of How to Kill a Language: Power, Resistance, and the Race to Save Our Words. Timestamps 00:00 Start 00:34 Intros: How are you "going"? 05:54 News: A font that can poison data for GenAI 13:51 News: A lost Golden Age of language in the Holocene 27:33 News: New language support for Netflix, Disney+ 33:59 Related or Not: Theme from Gordon 34:37 Related or Not: ramshackle 41:39 Related or Not: nap 48:57 Related or Not: adder, deer, natter, otter, hydra 54:12 Chat with Sophia Smith Galer: Her language background 01:00:31 The pain of separation from one's own language 01:05:01 Attacks on multicuturalism 01:07:34 Is all language death language murder? 01:09:41 The role of parents in language transmission 01:16:52 Factors influencing language survival 01:26:50 Will GenAI help or harm minority languages? 01:35:33 Challenging monoglossic language ideology 01:40:36 Sophia encourages linguistic curiosity 01:43:11 Responding to a review: Is it okay if languages die? 01:53:21 Word of the Week: slop zombie 01:55:29 Word of the Week: eternity leave 01:56:24 Word of the Week: spherical bastard 01:58:10 Word of the Week: the butter's penthouse 02:01:47 Word of the Week: Jimothy 02:04:42 Comments: Ingressive speech 02:08:33 The Reads 02:15:40 Outtakes: Hedvig's plant
Episode 400 of the Football Fitness Federation Podcast is with ex Professional Player & current Head of Goalkeeping at Stockport County Ben Hinchliffe We discussed: ▫️Reflections on his career ▫️Factors that led to only 1 injury across 22 years ▫️Sport Science changes ▫️Goalkeeper demands & much more! Keep up to date with the amazing work our sponsors are doing here: Good Prep - thegoodprep.com Discover the power of nutrition at WWW.THEGOODPREP.COM and use code FFF15 for 15% off your first order Hytro - hytro.com Maximise your athletic potential with Hytro BFR. Easier, safer and more practical BFR for squads to prepare for and recover from exercise than ever before. Click the link [[ bit.ly/3ILVsbU ]] Join our online community & get access to the very best Football Fitness content as well as the ability to connect with Sport Scientists and Strength & Conditioning coaches from around the world. To get FULL access to all of these & even more like this, sign up to a FREE month on our online community at the link below. https://www.footballfitfed.com/forum/index.aspx Keep up to date with everything that is going on at Football Fitness Federation at the following links: X - @FootballFitFed Instagram - @FootballFitFed Website - www.footballfitfed.com
Andy and Randy talk about some of Kevin Stefanski's comments ahead of Monday's practice as we head towards Friday's preseason game.
As climate change causes large parts of the northern hemisphere to experience high heat and raging wildfires, forecasters are warning it is a preview of what is to come for Australia. A very strong El Nino system is in play for the first time in a decade - and it's combining with other weather patterns to present a steamy forecast for spring and summer in the Asia Pacific. - 北半球の広い地域が記録的な猛暑や激しい森林火災に見舞われるなか、気象予報士たちはこれはオーストラリアの今後の姿を映し出していると警告します。Listen to SBS Japanese Audio on Tue, Thu and Fri from 1pm on SBS 3.Replays from 10pm on Tue, Thu and Sat on SBS1. Listen to past stories from our podcast. Download the free SBS Audio App and don't forget to visit SBS Japanese Facebook and Instagram page! - SBSの日本語放送は火木金の午後1時からSBS3で生放送!火木土の夜10時からはおやすみ前にSBS1で再放送が聞けます。SBS日本語放送ポッドキャストから過去のストーリーを聞くこともできます。無料でダウンロードできるSBS Audio Appもどうぞ。SBS 日本語放送のFacebookとInstagramもお忘れなく。
In this bonus episode Andrea Samadi introduces the Predictable Performance System, a practical roadmap from her Brain's Operating System. She shows how measuring patterns—not chasing daily scores—plus consistent movement and targeted recovery behaviors create reliable adaptations and better performance over time. Andrea shares two real-world experiments (including a nine-day green recovery streak), five clear steps—measure, move, recover, adapt, perform—and a simple 7-day challenge to help you discover the single habit that unlocks more consistent results. On BONUS EPISODE 2, we will cover: Why high performance isn't about being “green” every day (using a wearable device) What nearly 2,000 recovery scores taught me about consistency and performance Why your daily inputs matter more than any single recovery score How I reached a personal best of 9 green recoveries in a row What happened when hard training caused my recovery to drop—and why that wasn't failure How another WHOOP user improved his recovery by identifying one key gap: hydration How to find your own gap in sleep, hydration, stress, movement, training load, or recovery The Predictable Performance System™: Measure → Move → Recover → Adapt → Perform → Repeat Why recovery is the bridge between today's effort and tomorrow's capacity How to create your own 7-Day Predictable Performance Experiment The key question to ask yourself: “What is the one missing input that could unlock my next level of performance?” The goal: Find your gap. Uncover your recipe. Build the system that works for you. BONUS EPISODE 2 The Predictable Performance System™ How Small Daily Inputs Create Better Recovery, Adaptation and More Consistent Results WELCOME BACK Welcome back to the Neuroscience Meets Social and Emotional Learning Podcast, where we explore how understanding the brain can help us create measurable improvements in our well-being, achievement, leadership, productivity, and results. I'm Andrea Samadi, and over the past several months, we've been building something much bigger than a collection of interviews. We've been building what I call The Brain's Operating System—a roadmap for understanding how our brain and body work together to create optimal human performance. Before we jump into today's second Bonus Episode, let's quickly remember where we've been. PHASE 1 — REGULATION & SAFETY Everything begins with regulation. Before the brain can learn, perform, or grow, it first needs the biological conditions that support safety and stability. In Phase 1, we explored sleep, stress regulation, trauma, resilience and the nervous system. The lesson was simple: Regulation creates the conditions for growth. PHASE 2 — NEUROCHEMISTRY & MOTIVATION Then we asked: What moves us into action? We explored dopamine, beliefs, motivation, habits, attention and sustained effort. We learned that motivation isn't simply about willpower. Our brain is continually learning: What's worth pursuing? What should I repeat? Where should I invest my energy with? Phase 2 gave us some direction. PHASE 3 — MOVEMENT, LEARNING & COGNITION And now we're deep inside Phase 3. This is where movement becomes much more than exercise. Movement activates the brain. It supports attention. Learning. Memory. Metabolism. And when movement is paired with adequate recovery, something important happens: Adaptation. That's where our system begins to change. So the basic sequence we've been studying is: Movement → Recovery → Adaptation → Performance. But while studying this process, another question kept coming back to me. Why do some people consistently improve...while others feel like they're starting over every Monday and they are searching for the right formula. That question led me to today's framework: THE PREDICTABLE PERFORMANCE SYSTEM™ And this Bonus Episode is where I want to put the science into action. Throughout The Brain's Operating System, these Bonus Episodes will give me an opportunity to step away from the interviews and show you what happens when I apply what we're learning to my own life. I'll share the experiments. The data. What worked. What didn't. And most importantly... what we can learn from it, so we can ALL apply this information to our own lives. Because neuroscience becomes much more useful when we can turn what we know into something we can actually do. THE QUESTION THAT STARTED THIS EXPERIMENT Over the past five years, I've tracked close to 2,000 recovery scores using WHOOP (wearable device). And recently something happened that surprised me. I recorded nine green recoveries in a row (which meant for 9 days in a row, I had mastered recovery (my body's ability to take on strain and perform). This recovery score is calculated overnight using my RHR, HRV, RR, SpO2 (blood O2) and skin temperature. Factors like strain, stress and lifestyle choices affect this Recovery Score. That was a personal record. For years, I could put together a few strong days. Sometimes even a strong week. My record for years was 7 days in a row. But eventually something would interrupt the pattern. I'd train too hard. Sleep poorly. Travel. Get busy. Or simply fail to give myself enough time to recover. So when I reached nine consecutive green recoveries, instead of just celebrating the streak, I became curious. I asked: What changed? Because I wasn't on vacation. My work hadn't disappeared. I was still recording the podcast. Still exercising. Still traveling. Waking up early. Eating the same diet. In those green days most of the days I avoided alcohol (something I have learned from measuring everything I ingest—this will automatically tank my recovery score) but I did have one drink a couple of these days and still managed to keep a green score. Something that was highly unusual. I kept wondering what was I doing differently. Life hadn't suddenly become easy. So what was different? I went back through my data. And I stopped looking at individual scores. Instead, I started looking for patterns. That distinction changed everything. DON'T CHASE THE SCORE. STUDY THE PATTERN. When I first started tracking recovery, I'd look at each morning individually. Green? Great. Yellow? What did I do wrong? Red? I must have done something terribly wrong! Looking at the patterns, I did learn that after a 4-hour hike, even one alcoholic drink will kick my recovery score into the red unrecovered zone. When you push your body hard, it's just not worth it to ingest a neuro-toxin. At least for me, it's not worth it. We are all different, and that's why measuring your own data is a valuable activity. What tanks my score, might not tank yours. Now I'm wondering what happens repeatedly? What tends to happen before my strongest recoveries? What happens before my worst ones? (the recipe was beyond clear here). What habits disappear when my recovery starts declining? And which habits consistently appear when it improves? That's where the story became much clearer. It wasn't one workout. It wasn't one supplement. It wasn't one perfect night's sleep. And it definitely wasn't motivation. It was the accumulation of small behaviors being repeated consistently. And that led me to one of the most important lessons from this entire experiment: The recovery score doesn't create the result. The behaviors that happened before the recovery score create the conditions for the result. I learned my recipe to create a RED recovery, and how to create a GREEN. The wearable device simply gives us feedback on how well we are doing with our recipe for success. THE DATA TELLS TWO STORIES When I looked at the data, I realized I actually had two experiments happening. The first was mine. I had the recipe for how to recover, and how to tank my score. The second belonged to another WHOOP user. And together, they revealed something much more interesting than either story alone. STORY ONE — MY DATA When I zoomed out across 6 months, my average recovery was around 58%. That's real life. There were excellent weeks. There were difficult weeks. Travel. When I was away internationally, sometimes without internet, the data didn't record correctly, but this is a good picture of what my scores look like. Work. Training. Stress. Vacations. Life happens. But recently that monthly average climbed to approximately 63%—an 11% improvement over the month before. For me, that mattered. Historically, when my monthly recovery averages climbed substantially, it was often because I had removed myself from normal life. Maybe I was on vacation. Maybe I was completely unplugged. But this time I wasn't. I was working. Training. Recording. Traveling. Living normal life. Life didn't become easier. My daily system became more consistent. And eventually that consistency produced something I'd never seen before: Nine green recoveries in a row. But here's what happened next. If you look at the graph…I just went about life as usual. I trained hard. My recovery dropped. And that became perhaps an even more important part of the experiment. Because this time I didn't panic. I didn't interpret one lower score as failure. I simply returned to the consistent behaviors that had been working in my GREEN streak. Sleep. Hydration. Movement. Stress management. Recovery time. And within a few days, the stronger recovery scores returned. That taught me something important: Predictable performance does NOT mean perfect performance. It means that you've got to find a system you know how to return to. My GREEN scores are now predictable. STORY TWO — FIND THE LEVER Around the same time, another WHOOP user turned to me and asked “why am I stuck in RED (unrecovered) everyday?” His pattern looked completely different. His monthly recovery average was around 41%. Lots of yellow. Lots of red. And very little improvement. Instead of randomly changing everything, we looked at the inputs. Sleep. Stress. Training load. Recovery time. Hydration. And one variable stood out to me. Hydration. So rather than redesigning his entire life, we focused on consistently improving that one behavior. When I say he improved hydration, we increased not just water, but we added an electrolyte drink (Liquid IV sugar free[i]) to his water to replenish minerals like sodium and potassium that he was losing from sweating in the 115 degree weather we are experiencing at the moment in AZ. Then we watched the data. His recovery pattern improved. More yellows appeared. His averages increased. And his recovery became more consistent. Today I asked him what he's noticed with this one change, and he let me know that his scores have been creeping up slowly. No green scores yet, but he's high yellow, which shows me that he's cracking his recovery recipe. Now, that doesn't mean hydration is the magic answer for everyone. That's not the lesson. The lesson is: Find YOUR lever. For one person, it might be hydration. For someone else, it might be sleep. Alcohol. Stress. Training volume. Late-night eating. Travel. Or simply not allowing enough recovery between difficult training sessions. Your job isn't to copy someone else's system perfectly. Your job is to use feedback to discover what matters most for you. Find your gap in your recovery system and you unlock more consistent, predictable performance. TAKEAWAY #1 STOP GUESSING. START MEASURING. You cannot recognize a pattern you aren't observing. And you don't need WHOOP to do this. Just find what tool works best for you. You could track five simple things each morning: Sleep How well did I sleep? Energy How energetic do I feel? Stress How stressed or regulated do I feel? Movement What did I do yesterday? Recovery behaviors Did I hydrate, recover and give my body what it needed? Give each category a simple score out of 10. Then look at the entire week. Not just one day. TIP TO IMPLEMENT: For the next seven days, spend 30 seconds each morning recording: Hours of sleep Energy from 1–10 Stress from 1–10 Yesterday's movement One recovery behavior Don't change anything yet. First, collect information. Look for patterns before looking for the solution. THE BIG REALIZATION As I studied both experiments, the framework became obvious. Recovery isn't something that simply happens to us. There are many things we can't control. But every day we can influence the probability of recovering well. Our choices create patterns. Patterns create trends. Trends influence adaptation. And over enough time... those adaptations influence performance. Which brings us to the system. THE PREDICTABLE PERFORMANCE SYSTEM™ There are five steps. STEP 1 — MEASURE Awareness comes first. Track enough information to recognize trends. But remember: The goal isn't to become obsessed with data. (I'm borderline obsessed with mine). The goal is to use data to make better decisions. ASK YOURSELF: What's improving? What did I do to get this improvement? Write it down. What's declining? What did I do to tank my score? Write it down. And what repeatedly happens before each pattern? Learn your recovery recipe. What works for you? What does not work? TIP: Look at your weekly average instead of judging yourself by one day. One bad night doesn't define your health. One hard workout doesn't destroy your fitness. One red recovery doesn't erase your progress. Look for the trend. Learn what your personal recipe for success is. STEP 2 — MOVE Movement is the input. This is where Phase 3 begins. Movement challenges the system. We don't want to aim for a month of all green or high recoveries, because then we aren't challenging our system. Movement activates the brain and body and provides the stimulus from which adaptation can occur. But movement doesn't always mean crushing yourself in the gym. It might mean: Walking. Strength training. Hiking. Mobility. Cycling. Running. Playing a sport. Or simply interrupting long periods of sitting. TIP TO IMPLEMENT: Ask yourself each morning: "How will I move today?" Don't leave movement to chance. Put something on the calendar. Even a 20-minute walk counts. Consistency matters. STEP 3 — RECOVER This is the step I underestimated for years. I understood effort. I understood discipline. I understood training. But I didn't fully appreciate that the work isn't complete when the workout ends. The brain and body still have to process the stimulus. So recovery becomes an active part of the performance system. Protect sleep. Hydrate. Manage stress. Build recovery into the schedule. And learn when not to push. TIP TO IMPLEMENT: Create what I call your Recovery Minimums. Choose three behaviors that you protect even during busy weeks. For example: My Recovery Minimums ✓ Consistent sleep (going to bed and waking up at the same time) ✓ Daily hydration (I use liquid IV in the day and LMNT hot chocolate at night) ✓ Daily movement (I walk every morning, hike on the weekends, fit in gym workouts and strength training) to keep movement going. ✓ Stress regulation (always a work in progress, but breath work is my current way to manage stress) ✓ Time for recovery (I stack meditation and infrared sauna use together to save time). Your list may look different. But decide what your minimums are before life gets busy and you aren't putting time into recovery. STEP 4 — ADAPT This is the part we usually can't see. And it's one of the reasons people quit too early. Adaptation happens behind the scenes. You train. You recover. And your system responds. Over time, movement becomes easier. Your capacity expands. Your cardiovascular system becomes more efficient. Skills become more automatic. Your tolerance for challenge increases. Then one day... something that once felt difficult feels normal. TIP TO IMPLEMENT: Don't only measure outcomes. Look for evidence of adaptation. Ask: Is this workout getting easier? Am I recovering faster? Is my resting heart rate trending differently? Am I sleeping better? Look for how many wakes you have each night. Can I handle more work without feeling depleted? Is my concentration improving? Am I stronger? Do I have more energy? Those are clues that the system is adapting. STEP 5 — PERFORM This is where most people want to start. Results. Achievement. The High Performance. But performance isn't Step One. It's Step Five. First we provide the stimulus. We move. Then we recover. Then we adapt. And eventually... performance becomes evidence that the earlier steps worked. You will notice you can sit longer, stay focused on one task, and see tasks through to completion. This changes the question from: "How can I perform better today?" to: "What can I do today that makes better performance more likely tomorrow?" That's a very different way of thinking. TAKEAWAY #2 DON'T TRY TO FIX EVERYTHING. One of the most useful things we learned from the second recovery experiment was that sometimes one behavior acts as a bottleneck. For the person with the low recovery score, hydration appeared to be an important lever. Stick to changing ONE thing at a time. When I first saw his HRV, I wanted to go there, but we started with hydration. So here's something you can try. Look at your own patterns and ask: "What is the ONE behavior that would make everything else work better?" Maybe it's getting to bed earlier. Maybe it's drinking more water. Maybe it's moving every day. Maybe it's reducing alcohol. Maybe it's taking a recovery day. Maybe it's managing evening stress. Start there. TIP: Run a seven-day experiment. Change one variable. Keep everything else reasonably consistent. Track what happens. Then evaluate. Don't guess. Test. This has been the most eye-opening part of finding my own personal recipe for high performance. Once you uncover yours, you can create your own predictable formula for high performance. TAKEAWAY #3 CREATE A BASELINE YOU CAN RETURN TO. One of the biggest changes in my thinking came after the nine-green streak ended. My recovery dropped after hard training. But I knew what to do. I returned to the system. That's resilience. Not maintaining perfect conditions forever. But knowing how to return to your baseline when life knocks you away from it. Ask yourself: "When everything gets busy, what behaviors bring me back?" Write them down. That becomes your reset protocol. That's how I was able to create high recoveries the past few days making my monthly recovery a 16% increase over last month. TAKEAWAY #4 RECOVERY IS THE BRIDGE While developing this framework, I kept seeing the same image in my mind. A bridge. On one side is today's effort. On the other side is tomorrow's capability. Recovery is the bridge connecting the two. Without sufficient recovery, today's effort may never fully become tomorrow's capacity. With recovery, we give the brain and body an opportunity to adapt. Today's habits create the conditions for today's recovery. Recovery supports tomorrow's adaptation. Adaptation creates future capacity. And expanded capacity improves performance. That's the system. YOUR 7-DAY PREDICTABLE PERFORMANCE EXPERIMENT Here's your action step from today's episode. For the next seven days: MEASURE Track sleep, energy, stress and how overall recovered you feel each day. If you don't have a device to do this, just rank yourself on a scale of 0-10. MOVE Do something intentional every day. RECOVER Protect the recovery behaviors you've identified as most important. Mine are daily meditation, journaling, hydration, breath work and sauna use. LOOK FOR ADAPTATION Notice what begins becoming easier or more consistent. Where do you feel stronger? REVIEW YOUR PERFORMANCE At the end of seven days, ask: What improved? What got worse? What behavior had the biggest effect? What should I repeat next week? That's it. You're not trying to create a perfect week. You're trying to learn how your own system works. I don't know what your recipe for high performance will look like, but once you've got this recipe, your life will never be the same. THE BIG TAKEAWAY After nearly 2,000 recovery scores, here's what I believe matters most. Don't chase the score. Chase the behaviors that create the score. (Notice what they are—write them down). Don't chase one perfect workout. Build consistency. Don't panic when the data drops. Investigate. Don't change ten things at once. Find the lever. And above all... don't confuse effort with adaptation. Sometimes the thing that moves us forward isn't doing more. It's allowing the work we've already done to become part of us. The goal isn't perfect recovery. The goal isn't nine green days (while I've got my eye on how I can make this 10)… The goal isn't controlling every variable in our lives. The goal is to create a system that makes better outcomes more likely. Better days become better weeks. Better weeks become better months. And over enough time... what once felt difficult can become your new normal. REVIEW AND CONCLUSION To review and conclude BONUS EPISODE 2: Find the Gap—How Recovery Unlocks Predictable Performance, here's where we are in The Brain's Operating System. Phase 1 taught us to regulate. Before we can learn, perform, or grow, we need the biological conditions that support safety and stability. Phase 2 taught us what drives us to act. We explored motivation, dopamine, beliefs, attention, and the internal chemistry that moves us toward a goal. And now... Phase 3 is teaching us how we change. We move. We create a stimulus. We recover. The brain and body adapt. Our capacity expands. And eventually, that adaptation shows up as better performance. That's why today's framework matters. Because when performance feels inconsistent, the answer isn't always to work harder. Sometimes we need to ask: Where is the gap in my system? Is it movement? Sleep? Hydration? Stress? Recovery time? Consistency? Because when we can identify the gap, we can begin to change the input. And when we change the input consistently... we create new conditions for adaptation. That's how performance begins to change. So remember the sequence: Measure. Move. Recover. Adapt. Perform. And then repeat. Because performance isn't a finish line. It's feedback from the system you're building. When we complete Phase 3, we'll soon move into Phase 4—Connection, Emotion & Social Intelligence, where another layer enters the system: Other people. Relationships. Emotion. Trust. Communication. Empathy. Leadership. And then in Phase 5—Integration & Human Performance, we'll bring everything together: Regulation. Motivation. Movement. Recovery. Emotion. Relationships. Learning. Purpose. And performance. Because ultimately, no system works in isolation. Human performance is the result of all of these systems working together. FINAL TAKEAWAY If there's one idea I hope you remember from today's episode, it's this: Don't just chase the outcome. Study the system producing it. If your results aren't where you want them to be... find the gap. Because the gap may not be in your effort. It may be in your recovery. And when you find the gap in your recovery system... you unlock your next level of adaptation, capacity, and performance. Thank you for joining me for this second Bonus Episode. If today's framework helped connect the dots for you, I'd love to hear what you discover. What's the one habit that has the greatest impact on your recovery and performance? Sleep? Movement? Hydration? Stress management? Recovery time? And if you try the 7-Day Predictable Performance Experiment, pay attention to what your own data teaches you. Not whether every day is perfect. But what patterns begin to emerge. Until next time... Keep measuring. Keep moving. Keep recovering. Give your brain and body time to adapt. And keep building the systems that make better performance more predictable. Have an incredible week and we'll see you on EP 405 where we revisit Dr. Kristen Holmes and dive deep into more ways to improve our recovery., RESOURCES: Phase 1: Regulation & Safety The Foundation Core Question: Is the nervous system safe enough to learn? Everything begins with regulation. Before we can focus, learn, lead, or perform, the brain first asks one fundamental question: Am I safe? Throughout Phase 1, our guests showed us that regulation isn't simply about reducing stress—it's about creating the biological conditions that allow the brain to learn, adapt, and thrive. Together we explored: Baland Jalal – how sleep, curiosity, imagination, and creativity prepare the brain for learning. https://andreasamadi.podbean.com/e/hypnagogic-genius-capture-your-best-ideas-at-the-edge-of-sleep/ Dr. Bruce Perry – why regulation, rhythm, and relationships form the foundation of every healthy nervous system. https://andreasamadi.podbean.com/e/safety-first-why-a-regulated-brain-is-the-key-to-learning/ Dr. Sui Wong – how lifestyle medicine and autonomic balance build lifelong brain resilience. https://andreasamadi.podbean.com/e/your-eyes-the-brain-s-early-warning-system/ Rohan Dixit – how heart rate variability gives us real-time feedback on our ability to regulate stress. https://andreasamadi.podbean.com/e/breathe-to-reset-how-hrv-tech-reveals-hidden-stress/ Dr. Kristen Holmes – how recovery metrics reveal our physiological readiness to perform. https://andreasamadi.podbean.com/e/kristen-holmes-from-whoopcom-on-unlocking-a-better-you-measuring-sleep-recovery-and-strain/ Dr. Antonio Zadra – how sleep and dreaming consolidate memories, regulate emotions, and generate insight. https://andreasamadi.podbean.com/e/when-brains-dream-how-sleep-integrates-emotion-insight-and-creativity/ Together these conversations taught us that sleep and stress regulation aren't optional—they're the operating system that allows every higher brain function to work. Phase 2: Motivation & Neurochemistry The Direction Core Question: What moves us into action? Once the brain feels safe, it becomes ready to pursue goals. In Phase 2, we explored the internal chemistry that transforms intention into action. Our experts helped us understand that sustainable motivation isn't about willpower—it's about aligning our beliefs, thoughts, attention, energy, and movement. Together we discovered: Bob Proctor — our beliefs determine the direction of our lives. https://andreasamadi.podbean.com/e/belief-first-the-neuroscience-of-motivation/ Dr. Carolyn Leaf — our thinking literally changes our brain chemistry. https://andreasamadi.podbean.com/e/thoughts-as-biology-how-your-mind-shapes-neurochemistry/ Dr. John Medina — attention determines what the brain encodes and remembers. https://andreasamadi.podbean.com/e/theory-of-mind-the-missing-link-between-attention-reward-and-motivation Dr. Anna Lembke- Dopamine, Motivation and Why the Brain Repeats Behavior https://andreasamadi.podbean.com/e/dopamine-nation-the-pleasure%e2%80%93pain-balance-that-drives-motivation/ Dr. Friederike Fabritius — managing our energy allows high performance to become sustainable. https://andreasamadi.podbean.com/e/fun-fear-focus-closing-the-motivation-loop/ Dr. Chuck Hillman & Paul Zientarski — movement activates the brain, preparing it to learn. https://andreasamadi.podbean.com/e/move-to-learn-how-movement-activates-the-brain-and-fuels-motivation/ By the end of Phase 2, we introduced what became The Motivation Loop, showing how beliefs influence thoughts, thoughts influence actions, actions create results, and results reinforce future beliefs. Phase 3: Movement, Learning & Human Performance The Transformation Core Question: How does movement change the brain—and how does recovery transform that change into performance? Now we're taking the next step. Phase 3 builds on everything we've learned so far. If Phase 1 created a regulated nervous system... If Phase 2 created motivation and direction... Phase 3 explains how the brain and body actually become stronger. Together we've explored this process through conversations with: Dr. Chuck Hillman & Paul Zientarski — why movement activates the brain before learning. https://andreasamadi.podbean.com/e/movement-first-how-a-20%e2%80%91minute-walk-lights-up-the-brain/ Dr. John Ratey — how exercise builds a healthier, younger brain. https://andreasamadi.podbean.com/e/movement-matters-how-every-move-rewires-the-brain/ Dr. Kristen Holmes — why recovery determines adaptation and readiness. Dr. John Medina — how attention transforms movement into lasting learning. Jason Whitrock — how metabolism and cellular energy fuel long-term performance. WHERE WE ARE GOING NEXT Phase 4 — Connection, Emotion & Social Intelligence The Human System Core Question: How do we thrive with other people? The brain didn't evolve in isolation—it evolved through relationships. In Phase 4, we'll explore emotional intelligence, empathy, communication, trust, leadership, and psychological safety to understand how our relationships shape learning, well-being, and performance. Phase 5 — Integration & Human Performance The Complete System Core Question: How do all the systems work together? In our final phase, we'll bring everything together—regulation, motivation, movement, emotion, relationships, learning, and recovery—into one integrated framework. We'll discover how these systems work together to create measurable improvements in our well-being, achievement, leadership, productivity, and results. REFERENCES: [i] Liquid IV https://www.liquid-iv.com/collections/hydration-multiplier-sugar-free
⚖️ What Factors Determine Who Gets Custody of a Child? | Los Angeles Divorce ⚖️ Child custody decisions are not based on which parent simply wants custody more. California courts focus on the child's best interests and consider several factors when creating custody arrangements. Important considerations may include each parent's relationship with the child, ability to provide care, stability, involvement in daily life, and willingness to support a healthy relationship with the other parent.
Calvary Live is an outreach ministry of GraceFM(https://gracefm.com) at Calvary Church in Aurora, Colorado –https://calvaryco.churchPastor Ed Taylor is the Senior Pastor of Calvary Church –you can find more about him at https://edtaylor.orgBooks by Pastor Ed along with other curated discipleshipresources from his home church bookstore are available at calvaryco.storehttps://calvaryco.storeIf you like what you hear on Calvary Live – don't forget tofollow us, and share it with your friends and family!
In this episode, Dr. Karen Litzy and Dr. Tom Walters explore the current state of the physical therapy profession, weighing the challenges with the bright opportunities ahead. If you're a PT student, new graduate, or seasoned professional, this discussion offers valuable insights on navigating growth, risk-taking, and innovation. Key Topics Covered: The contrasting narratives about PT career prospects—debunking myths and highlighting opportunities Factors influencing PT career decisions, including debt, job satisfaction, and entrepreneurial ventures Strategies for students and new grads to create diverse career pathways beyond traditional settings How social media has transformed PT education, branding, and income streams over the past decade The importance of trust, clarity, and confidence in communication for professional success and patient care The influence of industry challenges such as insurance constraints and healthcare system limitations Practical advice for building a cash-based practice while managing burnout The potential for social media and content creation to elevate the entire PT field The role of patient education, telehealth, and hybrid models in future PT delivery Timestamps: 00:00 - Introduction: Is the PT profession broken or full of opportunity? 02:21 - Dr. Walters' take on whether PT is a broken system or ripe for growth 04:35 - How social media has changed career possibilities for PTs 05:42 - Advice to students and new grads about seeking opportunities and taking risks 06:47 - Personal stories of career leaps and the importance of thinking beyond traditional roles 08:48 - Building trust and clarity through communication for confidence and success 10:45 - Overcoming fears related to further education and career shifts 11:29 - Reflecting on the time investment of education and professional growth 13:00 - How teaching and social media experience have contributed to Dr. Walters' success 15:23 - The importance of consistency and long-term effort in building a following 16:52 - The evolution of social media content from early days to now 18:38 - Opportunities outside insurance-based clinics and how to leverage clinical experience 20:28 - Guiding students in career planning and the value of entrepreneurial thinking 22:28 - Strategies for transitioning from employment to ownership through small steps 24:13 - Can PT influencers replicate a successful model? Is it achievable for most? 26:26 - Social media's impact on professional visibility and community growth 27:55 - How content creation can elevate the PT profession as a whole 29:35 - The balance between hands-on care and digital/remote PT services 31:09 - The importance of rapport and human connection in healing 32:18 - Possibility of hybrid models combining in-person and remote PT 34:01 - The potential of technology to supplement, but not replace, hands-on care 36:35 - Addressing platform technical issues during the episode 38:36 - Final thoughts on building the future of PT and embracing new opportunities 39:31 - Advice for prospective DPT students on exploring career paths early 41:35 - The importance of financial literacy and budgeting education in PT programs 43:28 - Personal stories about student debt and managing educational costs 44:11 - Trust, clarity, and confidence as pillars for PT success and patient relationships 47:09 - How authenticity and communication foster trust within and outside the PT profession 50:22 - Review of what should be emphasized in PT curricula to prepare future practitioners 52:39 - The impact of viral content and strategic content creation on career trajectory 54:59 - Is the healthcare system broken or an opportunity? Dr. Walters' nuanced view 56:41 - Navigating personality types and finding the right work environment 56:55 - Practical tips for maintaining health, wealth, and intelligence in a PT career Final Takeaways: The PT industry is both challenged and full of opportunity—proactive, strategic, and authentic efforts can help shape its future. Embracing digital tools, building trust, and diversifying skills are keys to long-term success. Continuous learning, honest communication, and openness to entrepreneurship are essential for growth in today's evolving landscape. Thank you to Dr. Tom Walters for sharing his experience and insights. For more resources, courses, and his book, visit Rehab Science. Remember, your career trajectory depends on intentional choices, resilience, and innovative thinking—so take that leap! More About Dr. Walters Dr. Tom Walters is a board-certified orthopedic physical therapist who specializes in the treatment of pain and movement disorders. He is the founder of Rehab Science and has spent almost two decades teaching people about human movement, pain science, and how to effectively recover from injury. In addition to running his own clinical practice, Tom served as a full-time undergraduate kinesiology professor for eight years, teaching human biomechanics, therapeutic exercise, and pain science. He received his Doctor of Physical Therapy degree from Chapman University and completed a residency in orthopedic manual physical therapy and a fellowship in lower quarter functional biomechanics. Through his books, social media platforms, and the Rehab Science membership, Tom has helped millions of people better understand their bodies and take control of their recovery. Find more of Tom's content on Instagram and YouTube @rehabscience Resources from this Episode: Tom's Website: Rehab Science Tom on Instagram Tom on YouTube The Rehab Science Book Series The Rehab Science Membership Jane Sponsorship Information: Book a one-on-one demo here Front Desk @ Jane Mention the code LITZY1MO for a free month Follow Dr. Karen Litzy on Social Media: Karen's Twitter Karen's Instagram Karen's LinkedIn Subscribe to Healthy, Wealthy & Smart: YouTube Website Apple Podcast Spotify Stitcher iHeart Radio
As climate change causes large parts of the northern hemisphere to experience high heat and raging wildfires, forecasters are warning it is a preview of what is to come for Australia. A very strong El Nino system is in play for the first time in a decade - and it's combining with other weather patterns to present a steamy forecast for spring and summer in the Asia Pacific.
I am delighted to connect with Michael Rubino today. Michael is the founder and CEO of Home Cleanse and the chair of Change the Air Foundation, a nonprofit dedicated to improving indoor environments and public health. He is widely recognized as the leading authority on mold remediation and indoor air quality. In our conversation, we explore the connection between indoor air quality, gut permeability, and systemic inflammation. Michael explains how modern building practices, energy efficiency measures, and newer building materials may be contributing to health challenges. We discuss the types of tests he uses in his business, the symptoms he often sees in middle-aged women, considerations for frequent travelers, and why a bio-individual, data-driven approach matters for remediation. We also examine the role of genetics; the link between poor indoor air quality, leaky gut, and inflammation; practical interventions; the influence of social media; and what to look out for when contemplating a home addition or renovation. Mold exposure is, in my view, one of the most commonly overlooked contributors to chronic health issues in functional medicine. Its effects on the gut impact the health of the microbiome, increasing susceptibility to leaky gut, which can fuel neuroinflammation, and impair detoxification pathways. Stay tuned for a truly insightful discussion on indoor air quality, mold exposure, and the hidden environmental factors that may be influencing your health. IN THIS EPISODE, YOU WILL LEARN: How energy-efficient building practices may be contributing to indoor air quality concerns Why traditional air sampling may not provide a complete picture of mold exposure Testing options for evaluating mold and mycotoxin exposure Symptoms associated with mold and indoor environmental exposures How to reduce the likelihood of mold exposure while traveling Factors to consider when developing a remediation plan How poor indoor air quality can contribute to gut dysbiosis, leaky gut, and inflammation How genetics can influence susceptibility to mold and environmental exposures Why recommendations such as dehumidification and opening windows can only be helpful when applied appropriately Practical ways to improve indoor air quality and reduce mold exposure Bio: Michael Rubino Michael Rubino is an air quality expert and environmental wellness advocate. He is the founder of HomeCleanse, a company specializing in science-based remediation of toxic indoor environments, and chair & co-founder of the Change the Air Foundation, a nonprofit dedicated to education and policy advancement around indoor air health. Michael hosts the podcast Never Been Sicker and is a published author and sought-after speaker on mold and environmental wellness. Connect with Cynthia Thurlow Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Michael Rubino HomeCleanse The Dust Test Change The Air Foundation
⚖️ What Factors Determine Who Gets Custody of a Child? | Los Angeles Divorce
Want to have a smooth and successful business collaboration? In this episode, I'm sharing ten tips to ensure your next business-to-business collaboration is a success. When done correctly, collaborations are a powerful thing for your business. But when they're not done right, it can lead to exhaustion, frustration, and disappointment. I'm here to take away any fears you may have and prepare you with everything you need to find and work with your next collaboration partner. In Today's Episode We Discuss: How to choose the right partner to collaborate with What communication should look like with your collab partner Factors to keep in mind when tracking success If you have any questions or need help with any of these steps, I invite you to book a call with me so we can fine-tune your plans! Show notes available at www.leadinglady-coaching.com/podcast Resources Mentioned: Book a Discovery Call Have you joined the Leading Ladies Facebook Group yet?! I would love to see you in there! Head to https://www.facebook.com/groups/LeadingLadiesAAL to join! Let's connect on Facebook: https://www.facebook.com/aalcoaching Let's connect on Instagram: https://www.instagram.com/leading.lady.coach/
Refined product prices have remained elevated this summer even as crude oil prices have fallen from their 2026 highs set just a few months ago. In today's RBN blog, we look at several factors that help explain the seeming disconnect between product prices and crude oil prices.
"Market breadth could be telling us that this correction phase could be completely completed," says Rachel Dashiell. She joins Sam Vadas to discuss current conditions leading to new record highs for the S&P 500 (SPX) and Dow Jones ($DJI). Rachel uses several technical indicators to provide her analysis of the markets, including a chart of the NYSE New Yearly Lows fading. For the Mag 7 group, she points to Microsoft's (MSFT) bounce as a big reason behind multiple indexes getting a lift. ======== Schwab Network ========Empowering every investor and trader, every market day.Subscribe to the Market Minute newsletter - https://schwabnetwork.com/subscribeDownload the iOS app - https://apps.apple.com/us/app/schwab-network/id1460719185Download the Amazon Fire Tv App - https://www.amazon.com/TD-Ameritrade-Network/dp/B07KRD76C7Watch on Sling - https://watch.sling.com/1/asset/191928615bd8d47686f94682aefaa007/watchWatch on Vizio - https://www.vizio.com/en/watchfreeplus-exploreWatch on DistroTV - https://www.distro.tv/live/schwab-network/Follow us on X – https://twitter.com/schwabnetworkFollow us on Facebook – https://www.facebook.com/schwabnetworkFollow us on LinkedIn - https://www.linkedin.com/company/schwab-network/About Schwab Network - https://schwabnetwork.com/about
My guest this episode is Stacie Mintz, Managing Director and Head of Quantitative Equity at PGIM Quantitative Solutions.Stacie has spent 33 years at PGIM, and she's been there for every defining moment of the firm's quant equity effort: a first strategy born from a client's challenge to move beyond indexing, a 1999 decision to abandon Barra and bring the risk model in-house, surviving the quant quake of August 2007, and the post-GFC realization that in a crowded-factor world, it's not enough to be a quant — you have to be a different quant.We dig into what PGIM's "fundamental quant" label actually means in practice, from a financing factor that asks how a company funds its growth, to a factor taxonomy that includes an unfamiliar Linkages group and — unusually for a quant shop — excludes momentum entirely.In the back half, we turn to the frontier: turning qualitative signals like board composition and innovation into systematic factors, building models that assess emergent shocks like COVID and AI in real time, and why Stacie calls LLMs "bazookas" — tools powerful enough to blow up what already works, which is exactly why you start with the insight and only then reach for the tool.Please enjoy my conversation with Stacie Mintz.
⚖️ What Factors Determine Who Gets Custody of a Child? | Los Angeles Divorce How do California courts decide who gets child custody after a divorce? In Los Angeles custody cases, judges focus on one guiding principle: the child's best interests. Custody is not automatically awarded to one parent. Instead, courts evaluate the unique circumstances of each family when determining legal and physical custody arrangements. This video explains the factors California courts commonly consider and why every custody case is evaluated individually.
Your nutrition can be dialed in. Your training can be on point. Your tracking can be accurate. And you can still fail to lose fat if the lifestyle variables operating outside of your diet are working against you.These lifestyle variables aren't peripheral to fat loss. They're foundational. Your sleep quality determines whether you can manage hunger and appetite during a deficit. Your stress management determines whether your thyroid function supports your metabolism or works against it. Your daily movement determines whether your deficit holds across the week or quietly disappears as your body adapts. And the way you think about progress determines whether you're actually pursuing fat loss or just chasing a number on the scale that means nothing about your physique.In this episode, we shift into the lifestyle factors and behavioral patterns that sabotage fat loss progress even when your nutrition and training are dialed in. We cover the five most consequential mistakes I see derailing dieters during a phase, plus three honorable mentions that compound the problem when left unaddressed.Because once you understand how these variables affect your fat loss outcomes, you can finally address what's actually been holding you back.HERE'S WHAT WE COVER:WHY YOU CAN BE DOING EVERYTHING RIGHT WITH NUTRITION AND TRAINING AND STILL NOT LOSE FATWHY CHASING THE SCALE INSTEAD OF FAT LOSS LEADS TO MUSCLE LOSS AND POST-DIET REBOUNDTHE PROTEIN STAT AND WHY HYPERPHAGIA DRIVES POST-DIET FAT REGAINCOLLATERAL FATTENING AND THE YO-YO CYCLE THAT TRAPS CHRONIC DIETERSHOW WE OVERESTIMATE CALORIE BURN FROM EXERCISE BY 3-4XWHY FITNESS TRACKERS LIKE APPLE WATCH AND FITBIT HAVE 27-93% CALORIE BURN ERRORSTHE BURN AND EARN TRAP AND WHY EATING BACK CALORIES SABOTAGES FAT LOSSWHY YOU SHOULD TURN OFF AUTOMATIC CALORIE ADJUSTMENT IN YOUR TRACKING APPWHY 85-90% OF METABOLIC ADAPTATION DURING A DIET COMES FROM REDUCTIONS IN NEATTHE REGULATED AND NON-REGULATED ZONES OF APPETITEWHY STEP TRACKING IS NON-NEGOTIABLE DURING A FAT LOSS PHASEHOW 2 NIGHTS OF SLEEP LOSS CAN MIMIC AN AGGRESSIVE CALORIE DEFICITWHY SLEEP DEPRIVATION CAN INCREASE DAILY CALORIE INTAKE BY 300-560 CALORIESTHE CORTISOL AND THYROID CONNECTION THAT SUPPRESSES YOUR METABOLISMTHE DIFFERENCE BETWEEN DIETING-INDUCED AND STRESS-INDUCED THYROID DYSFUNCTIONHOW EMOTIONAL EATING DURING HIGH-STRESS WEEKS COMPOUNDS THE CORTISOL EFFECTWHY ALCOHOL, HYDRATION AND MICRONUTRIENT INTAKE MATTER MORE THAN MOST DIETERS REALIZEIf you've felt like your nutrition is on point but you're still not progressing, if you've been frustrated by stalls that seem to come from nowhere, or if you've never really thought about how variables outside of your diet are influencing your fat loss outcomes, this episode is going to give you the diagnostic framework to figure out what's actually going wrong and how to fix it.WHERE TO CONNECT WITH ME:Follow Brandon on IG: https://www.instagram.com/brandondacruz_/For Info on Brandon's Coaching Services: https://form.jotform.com/bdacruzfitness/coachinginquiryEmail: Bdacruzfitness@gmail.comMy Reading Recommendations:THE MUSCLE & STRENGTH PYRAMIDShttps://getdpd.com/cart/hoplink/25469?referrer=1l54og96lf1ccw
How do you decide which antimicrobial to use? This is a follow on from episode 69, 'Choosing an antimicrobial'. We did an overview of spectrum and syndromes... But now let's dive into the details!We consider the details of how to choose an antibiotic in simple, complicated and complex situations. We also talk about the Cynefin Framework for decision making in various circumstances; Don't worry if you don't know what that is; neither did Jame before this episode was recorded! Notes for this episode here: https://idiots.notion.site/144-Choosing-an-Antimicrobial-Host-Microbe-Drug-Factors-2d76a1ea09d8814787ccfc26fe779b3a Support the showSupport us on: Patreon: https://www.patreon.com/cw/IDIOTS_podBuyMeACoffee: https://www.buymeacoffee.com/idiotspodPrep notes for completed episodes can be found here (Not all episodes have prep notes).If you are enjoying the podcast please leave a review on your preferred podcast app!
As the Department of Labor reshapes how fiduciaries evaluate 401(k) investments, committees and advisors can't afford to wing it. In this episode, Michael Welz breaks down the proposed DOL safe harbor, the six-factor framework, and what it really means to prudently add alternatives and private assets to defined contribution plans.In this episode, Eric and Michael Welz discuss:Background and intent of the proposed DOL guidanceSix-factor safe harbor framework for investment selectionApplying risk-adjusted returns and appropriate time framesIncorporating private assets into defined contribution plansInvestment policy statements, due diligence, and ERISA litigation riskKey Takeaways:The proposed DOL regulation focuses less on picking “perfect” investments and more on whether fiduciaries follow a prudent, well-documented process.Evaluating performance now explicitly addresses risk-adjusted returns over an appropriate time frame, rather than just raw performance versus benchmarks.The proposed DOL guidance can be considered “investment option neutral” for DC plans, provided liquidity, valuation, and complexity are properly understood and documented.Investment policy statements are the core roadmap for due diligence, and many committees need to revisit and realign them with the new six-factor framework.By aligning committee processes with the proposed safe harbor, fiduciaries can both expand investment menus and potentially reduce excessive ERISA litigation risk.“On presumption of prudence, the process is the important part, not a checklist.” - Michael WelzMichael Welz is President of USI Consulting Group and USI Advisors, Inc., leading the firm's overall direction, strategy, and institutional investment solutions. With over 25 years of investment management experience, he oversees portfolio strategies, market research, and asset allocation, notably incorporating behavioral finance into defined contribution plan consulting. He previously served as USI Advisors' Chief Investment Officer and National Practice Leader for USICG's defined contribution group following a decade with major financial firms. Michael holds a master's equivalent in economics from the University of Cologne, holds CFA, CAIA, and CIMA credentials, and maintains FINRA Series 7, 63, and 65 licenses.Connect with Michael Welz:Website: https://www.usicg.com/ LinkedIn: https://www.linkedin.com/in/michael-welz-cfa-12997821/ Connect with Eric Dyson: Website: https://90northllc.com/Phone: 940-248-4800Email: contact@90northllc.com LinkedIn: https://www.linkedin.com/in/401kguy/ The information and content of this podcast are general in nature and are provided solely for educational and informational purposes. It is believed to be accurate and reliable as of the posting date, but may be subject to change.It is not intended to provide a specific recommendation for any type of product or service discussed in this presentation or to provide any warranties, investment advice, financial advice, tax, plan design, or legal advice (unless otherwise specifically indicated). Please consult your own independent advisor as to any investment, tax, or legal statements made.The specific facts and circumstances of all qualified plans can vary, and the information contained in this podcast may or may not apply to your individual circumstances or to your plan or client plan-specific circumstances.The opinions expressed by guests on the Be More Than a Fiduciary podcast are not necessarily the same as the opinions held by 90 North Consulting, or of Executive Director Eric Dyson.
Charles Schwab's Mike Townsend talks about the "unusual situation" surrounding the Fed and whether it will hike or hold interest rates. He's in the camp that the FOMC will hold, though without forward guidance, he believes a hike is on the table and expects dissents from members. Nate Peterson elaborates more on rate volatility and how the U.S.-Iran war continues to serve as an overhang creating lasting uncertainty. ======== Schwab Network ========Empowering every investor and trader, every market day. Subscribe to the Market Minute newsletter - https://schwabnetwork.com/subscribeDownload the iOS app - https://apps.apple.com/us/app/schwab-network/id1460719185Download the Amazon Fire Tv App - https://www.amazon.com/TD-Ameritrade-Network/dp/B07KRD76C7Watch on Sling - https://watch.sling.com/1/asset/191928615bd8d47686f94682aefaa007/watchWatch on Vizio - https://www.vizio.com/en/watchfreeplus-exploreWatch on DistroTV - https://www.distro.tv/live/schwab-network/Follow us on X – https://twitter.com/schwabnetworkFollow us on Facebook – https://www.facebook.com/schwabnetworkFollow us on LinkedIn - https://www.linkedin.com/company/schwab-network/ About Schwab Network - https://schwabnetwork.com/about
Ms. Brunswig hails from Scottsdale, Arizona for the past three years. In 2020, Ms. Brunswig was presented with the Marquis Who's Who, the world's premier publisher of biographical profiles, with the Albert Nelson Marquis Lifetime Achievement Award. An accomplished listee, Ms. Brunswig celebrates many years' experience in her professional network, and has been noted for achievements, leadership qualities, and the credentials and successes she has accrued in her field. Factors such as position, noteworthy accomplishments, visibility, and prominence in a field are all taken into account during the selection process. Now retired, Ms. Brunswig worked for the Washington State Governor's Office in Olympia for five years as an executive assistant before retiring in 1998. Her extensive career in state government included similar roles with the Governor's Office of Health Policy, The Legislative Office of the Department of Labor & Industries, Washington State Department of Health and the State Board of Health. Additionally, Ms. Brunswig served as a Legal Assistant 3 for the Thurston County Prosecutor's Office in Olympia as the Family Support Office Manager and was liaison to the State Office of Support Enforcement. During later years, while living in Mexico, she worked as a manager for a law firm after helping set up the newly formed office with the attorney and his family. Ms. Brunswig notably learned to speak fluent Spanish while living and working in the country. She later served a brief stint as Operations Manager for SeaBreeze Vacation Rentals. To support her government, Ms. Brunswig has been involved in a plethora of positions with various organizations as well. Most notably, she served as a councilwoman, mayor pro-tem and Mayor of the City of Centralia, Washington. Ms. Brunswig was also active as a staff member of the Governor's Task Force on Higher Education, a member of the Cascadia Mayors Council and, among other roles, a committee member of the campaign to elect Representatives Gary Alexander for the 20th District and Rep. J. Vander Stoep, Washington State House of Representatives. For two years, Ms. Brunswig served as a Governor's Friendship Force Ambassador to South Korea. Other civic activities to Ms. Brunswig's credit have included serving as treasurer of the Lewis County Children with Special Needs and as a speaker on behalf of the Centralia College Citizenship Class. With her late husband, she was a Guarantor and Board Member of the Lewis County Pope's Kids' Club in Centralia, Washington, a respite center providing individualized care for children and young adults with exceptional medical needs. She was a commissioner for the Fountain Hills Planning and Zoning Commission in Fountain Hills, Arizona. Likewise, Ms. Brunswig is also a Diamond life master member of the American Contract Bridge League. After returning to the United States from Mexico, Ms. Brunswig edited three children's books written and published by Attorney Laura G. Bueno. She is currently providing editing services for Attorney Bueno as her book, "Selkirk" is now being made into a movie. Her payment for these services were donated to two of her informally adopted Mexican children for their college fund. She has also edited several books on the topic of bridge, which were authored by Professor Allan DeSerpa, PhD of Tempe, AZ and consulting author in The Samoans chapter of Liz Moulder's book, "Tropical Tales," and W.T. O'Brien's book ""The Arboretum After Midnight." In support of her professional endeavors, Ms. Brunswig was a member and former nominating committee member of the Association of Washington Cities. She was also former president's advisory board member of the National Chamber of Congress and served nationally on the Bylaws Committee of the National Legal Professionals Association. Ms. Brunswig was born in Leone, a village on the southwest coast of Tutuila Island, American Samoa. She came to the U.S. in 1949 and later graduated with a Bachelor of Arts in Social Sciences from Washington State University, studied paralegal studies at Centralia College and general studies at Lower Columbia College, all in Washington, also receiving a diploma from Centralia Police Department's Citizens' Academy in 1996. She has volunteered her services as a counselor to individuals, pro bono for over 20 years. Ms. Brunswig was selected as an Outstanding Young Women in America in 1973 and was named Pledge of the Year from Beta Sigma Pi sorority, and Girl of the Year by Beta Sigma Phi International in 1978. For her work, she was named as Officer of the Year for Washington Association of Legal Secretaries, and the Washington State Legal Secretary of the Year by the Washington State Legal Professionals' Association in 1990. She lists being a Life Member of the Washington State University's Alumni Association and a lifetime Honorary Member of the United States Army Air Forces Ground Observers Corps, a Civil Defense program formed to protect U.S. territory against air attack. She is a lifetime member of Washington State University Alumni Association and an Honorary member of the United States Airforce (USAF) Air Defense Team.
CardioNerds (Drs. Apoorva Gangavelli, Jenna Skowronski, and Hannah Every) discuss the continuum of prevention and heart failure with Drs. Anu Lala and Martha Gulati. Grounded in a clinical case of a 55-year-old woman with uncontrolled hypertension, type 2 diabetes, and obesity who is on the trajectory toward heart failure, this episode unpacks a paradigm-shifting framework from a joint HFSA/ASPC Scientific Statement. The discussion explores how prevention should not be siloed from heart failure management but rather integrated across a patient’s lifespan—from primary prevention in at-risk individuals, to secondary prevention in those with established heart failure, to tertiary prevention in patients with advanced therapies such as LVADs and heart transplantation. The experts highlight the importance of aggressive risk factor management, biomarker-guided screening, the AHA’s Life’s Essential 8, and the need for multidisciplinary collaboration and systems-level change to shift heart failure care from reactive to proactive. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here. CardioNerds Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls Systemic inflammatory diseases are associated with an elevated CVD risk that has significant implications for early detection, risk Heart failure prevention is a continuum, not a checkpoint. Prevention applies at every stage—from at-risk (Stage A) through advanced/post-transplant care—and every clinical encounter is an opportunity to intervene. The AHA’s Life’s Essential 8 (diet, physical activity, nicotine exposure, sleep, BMI, blood lipids, blood glucose, blood pressure) forms the foundation at every stage. Hypertension carries the highest population-attributable risk for heart failure of any modifiable risk factor. In the Framingham Heart Study, 91% of patients with newly diagnosed HF had pre-existing hypertension. The SPRINT trial demonstrated a 38% reduction in HF incidence with intensive blood pressure targets (30 ng/L or NT-proBNP >125 ng/L) identify individuals at heightened risk for progression to symptomatic HF. The ACC/AHA/HFSA guidelines give a Class IIa recommendation for natriuretic peptide screening in at-risk patients. Urine albumin-to-creatinine ratio (UACR) is an underutilized screening tool that provides additional insight into CKM risk. The heart failure label does not close the prevention window—it accentuates it. Secondary prevention through GDMT optimization (quadruple therapy in HFrEF) and continued risk factor management remains critical. Tertiary prevention extends to post-LVAD and post-transplant patients, where hypertension, diabetes, obesity, and CKD management remain essential to long-term outcomes. Show notes For a comprehensive review, please review the full HFSA/ASPC Joint Scientific Statement: Lala A, Beavers C, Blumer V, et al. The Continuum of Prevention and Heart Failure in Cardiovascular Medicine. J Card Fail. 2026;32:75-105. doi:10.1016/j.cardfail.2025.06.013 1. What is the “continuum of prevention” framework, and how does it differ from traditional approaches to heart failure prevention? Historically, prevention and heart failure management have been treated as separate disciplines—primary prevention handled by preventive cardiologists and treatment managed by heart failure specialists. This joint HFSA/ASPC Scientific Statement reframes prevention as a dynamic, continuous process that spans a patient’s entire lifespan, regardless of HF stage or ejection fraction. The framework maps onto the ACC/AHA HF staging system: Primary prevention targets Stage A (“at risk”) and Stage B (“pre-HF”) patients to reduce the burden of incident HF. Secondary prevention targets Stage C (symptomatic) and Stage D (advanced) patients to reduce the impact of established HF through GDMT optimization and ongoing risk factor management. Tertiary prevention encompasses risk factor management in patients with LVADs or heart transplants—populations where hypertension, diabetes, and obesity still drive outcomes. The Central Figure of the statement illustrates that Life’s Essential 8 (blood pressure and lipid control, diabetes management, exercise, sleep, smoking cessation, weight management, and diet/nutrition counseling) forms the foundation at every stage, with pharmacologic and device-based therapies layered on top as disease progresses (Figure) 2. How do traditional risk factors drive heart failure, and what should clinicians prioritize? Hypertension carries the greatest population-attributable risk for HF. In the Framingham Heart Study (N=5,143), HTN was associated with a 2- to 3-fold increased risk of HF, with a population-attributable risk of 39% in men and 59% in women. The SPRINT trial showed a 38% reduction in HF incidence and 25% reduction in the primary composite outcome with intensive BP targets (30 ng/L or NT-proBNP >125 ng/L) are associated with heightened risk for progression to symptomatic HF. In the ARIC study, incorporating NT-proBNP reclassified 20% of older adults without HF into Stage B. Factors that affect interpretation include age, sex, obesity (lower values), and CKD (higher values). High-sensitivity cardiac troponin (hs-cTn): Concentrations above the 99th percentile are now included in the definition of Stage B HF. Troponin testing may complement natriuretic peptides, particularly when BNP/NT-proBNP values are ambiguous. Risk scores: The PCP-HF equation predicts 10-year HF risk using traditional risk factors plus QRS duration. The AHA PREVENT score incorporates HF risk calculation and includes markers of kidney function (albuminuria, eGFR), though it may underestimate risk in men and Black adults. The CKM syndrome staging framework (Stages 0–4) provides a holistic approach to assessing systemic cardiovascular-kidney-metabolic risk. 4. What are the key nontraditional risk factors and cross-cutting themes in heart failure prevention? Genetics: Pathogenic cardiomyopathy variants exist in ~1 in 200 individuals in the general population. The HFSA and ACMG recommend cascade testing to identify at-risk family members. Polygenic risk scores for dilated cardiomyopathy show a 3.8-fold risk for DCM in the top 10th percentile compared with the median. Sex-specific considerations: Women have 2.8 times the odds of developing HFpEF, while men have similarly increased odds of HFrEF. A complete obstetric/gynecologic history is essential—preeclampsia is associated with a 4-fold increased risk of HF. Peripartum cardiomyopathy requires intentional screening in high-risk populations. Cardiotoxic exposures: Clinicians should be aware of medications that cause direct myocardial toxicity (e.g., anthracyclines, trastuzumab, tyrosine kinase inhibitors). A team-based approach with pharmacists can help optimize medication selection and risk factor modification. Social determinants of health: Environmental exposures (air pollution, arsenic, lead, cadmium), food insecurity, financial instability, and limited healthcare access contribute to HF risk and progression. Equity-focused, risk-based prevention strategies are needed. Psychological health: Depression is common in HF and independently associated with worse outcomes. Screening with brief questionnaires (e.g., PHQ-2) is recommended. Meditation, spirituality, and holistic wellness approaches remain underutilized. 5. What systems-level and policy changes are needed to move the needle on heart failure prevention? Multidisciplinary HF prevention clinics that bring together preventive cardiologists, HF specialists, endocrinologists, nephrologists, dietitians, pharmacists, exercise physiologists, and genetic counselors are advocated by the statement. EHR-embedded risk stratification could proactively flag patients on a trajectory toward HF—analogous to sepsis alerts or fall risk flags—enabling earlier intervention, particularly for patients who may not reach a cardiologist. Cardiac rehabilitation remains underutilized, particularly in HFrEF (Class 2b recommendation) and HFpEF (not yet covered by Medicare). The HF-ACTION trial showed quality-of-life benefits, and the REHAB-HF trial showed particular benefit in older patients with HFpEF. Policy priorities include expanding insurance coverage for preventive screening and novel therapies (SGLT2i, GLP-1 RAs, nsMRAs), reducing clinical inertia through team-based care models with closer follow-up intervals, and ensuring equitable access to evidence-based therapies across diverse populations. Digital health and AI hold promise for personalized risk prediction, remote monitoring (e.g., wearable devices, implantable PA pressure monitors), and virtual cardiac rehabilitation to overcome access barriers. Figure Lala A, Beavers C, Blumer V, et al. The continuum of prevention and heart failure in cardiovascular medicine: a joint scientific statement from the Heart Failure Society of America and the American Society for Preventive Cardiology. J Card Fail. 2026;32(1):75-105. doi:10.1016/j.cardfail.2025.06.013) References Key references are bolded. Lala A, Beavers C, Blumer V, et al. The continuum of prevention and heart failure in cardiovascular medicine: a joint scientific statement from the Heart Failure Society of America and the American Society for Preventive Cardiology. J Card Fail. 2026;32(1):75-105. doi:10.1016/j.cardfail.2025.06.013 Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895-e1032. doi:10.1161/CIR.0000000000001063 Lloyd-Jones DM, Allen NB, Anderson CAM, et al. Life’s Essential 8: updating and enhancing the American Heart Association’s construct of cardiovascular health: a presidential advisory from the American Heart Association. Circulation. 2022;146(5):e18-e43. doi:10.1161/CIR.0000000000001078 SPRINT Research Group, Wright JT Jr, Williamson JD, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373(22):2103-2116. doi:10.1056/NEJMoa1511939 Levy D, Larson MG, Vasan RS, Kannel WB, Ho KK. The progression from hypertension to congestive heart failure. JAMA. 1996;275(20):1557-1562. doi:10.1001/jama.1996.03530440037034 Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288(23):2981-2997. doi:10.1001/jama.288.23.2981 Yusuf S, Sleight P, Pogue J, et al. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000;342(3):145-153. doi:10.1056/NEJM200001203420301 Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373(22):2117-2128. doi:10.1056/NEJMoa1504720 Anker SD, Butler J, Filippatos G, et al. Empagliflozin in heart failure with a preserved ejection fraction. N Engl J Med. 2021;385(16):1451-1461. doi:10.1056/NEJMoa2107038 Solomon SD, McMurray JJV, Claggett B, et al. Dapagliflozin in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2022;387(12):1089-1098. doi:10.1056/NEJMoa2206286 Filippatos G, Anker SD, Agarwal R, et al. Finerenone reduces risk of incident heart failure in patients with chronic kidney disease and type 2 diabetes: analyses from the FIGARO-DKD trial. Circulation. 2022;145(6):437-447. doi:10.1161/CIRCULATIONAHA.121.057983 Solomon SD, McMurray JJV, Vaduganathan M, et al. Finerenone in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med. 2024;391(16):1475-1485. doi:10.1056/NEJMoa2407107 Lincoff AM, Brown-Frandsen K, Colhoun HM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221-2232. doi:10.1056/NEJMoa2307563 Deanfield J, Verma S, Scirica BM, et al. Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial. Lancet. 2024;404(10454):773-786. doi:10.1016/S0140-6736(24)01498-3 Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389(12):1069-1084. doi:10.1056/NEJMoa2306963 Ndumele CE, Neeland IJ, Tuttle KR, et al. A synopsis of the evidence for the science and clinical management of cardiovascular-kidney-metabolic (CKM) syndrome: a scientific statement from the American Heart Association. Circulation. 2023;148(20):1636-1664. doi:10.1161/CIR.0000000000001175 Khan SS, Matsushita K, Sang Y, et al. Development and validation of the American Heart Association’s PREVENT equations. Circulation. 2024;149(6):430-449. doi:10.1161/CIRCULATIONAHA.123.067626 Khan SS, Ning H, Shah SJ, et al. 10-year risk equations for incident heart failure in the general population. J Am Coll Cardiol. 2019;73(19):2388-2397. doi:10.1016/j.jacc.2019.02.057 Bozkurt B, Fonarow GC, Goldberg LR, et al. Cardiac rehabilitation for patients with heart failure: JACC expert panel. J Am Coll Cardiol. 2021;77(11):1454-1469. doi:10.1016/j.jacc.2021.01.030 Packer M. Leptin-aldosterone-neprilysin axis: identification of its distinctive role in the pathogenesis of the three phenotypes of heart failure in people with obesity. Circulation. 2018;137(15):1614-1631. doi:10.1161/CIRCULATIONAHA.117.032474 Lala A, Tayal U, Hamo CE, et al. Sex differences in heart failure. J Card Fail. 2022;28(3):477-498. doi:10.1016/j.cardfail.2021.10.006 Bozkurt B, Coats AJS, Tsutsui H, et al. Universal definition and classification of heart failure. Eur J Heart Fail. 2021;23(3):352-380. doi:10.1002/ejhf.2115 Hershberger RE, Givertz MM, Ho CY, et al. Genetic evaluation of cardiomyopathy—a Heart Failure Society of America practice guideline. J Card Fail. 2018;24(5):281-302. doi:10.1016/j.cardfail.2018.03.004 Levine GN, Cohen BE, Commodore-Mensah Y, et al. 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I'm delighted to reconnect with my dear friend Ben Azadi today, in honor of his newly revised book, Keto Flex. Ben is a leading authority on metabolic health, an international Keystone speaker, and the New York Times best-selling author of Metabolic Freedom. In today's conversation, we discuss why women fail on keto. We examine how women's menstrual cycles and various life stages influence both the ketogenic diet and intermittent fasting, and the importance of coming out of ketosis and incorporating feast days. We explain what the Randall cycle is, why we need to be finely tuned to it, how to support healthy cortisol regulation, particularly the HPA axis, and tools to determine whether we are balanced within the autonomic nervous system, including heart rate variability, sleep, and whether our glucose and ketones are within range. We also explore the effects of anti-nutrients and elimination diets, and Ben shares his approach for women who feel keto hasn't worked for them, explaining why keto should be viewed as a process rather than a diet. This is, as always, a truly invaluable conversation with my dear friend Ben Azadi. Stay tuned, as we will also be offering giveaways to listeners of Ben's new book, Keto Flex. IN THIS EPISODE, YOU WILL LEARN: Various factors that could influence how women respond to a ketogenic diet How women need to adjust keto and fasting according to their menstrual cycle, perimenopause, and postmenopausal years, rather than continuously following the same approach Why Ben encourages women to have intentional feast days instead of remaining in ketosis indefinitely What a feast day looks like, and how it differs from a cheat day Why fasting should be adapted to how well your body tolerates stress Factors that can help to determine whether fasting is working for you Why you should adjust your training intensity and focus more on recovery as you get older How a temporary carnivore elimination diet can help identify foods your body doesn't tolerate Why Ben views keto as a metabolic process rather than a diet, and why he prioritizes lifestyle before medication Bio: Ben Azadi Ben Azadi, FDN-P, is a leading authority on metabolic health, an international keynote speaker, and the New York Times bestselling author of Metabolic Freedom. After facing his own health challenges, Ben transformed his life in 2008—losing 80 pounds and stepping into metabolic freedom. That turning point sparked a global mission: to help 1 billion people break free from physical and mental obesity through education, not medication. With 18+ years in the health and wellness space, Ben is now leading a bold 10-year initiative to naturally reverse type 2 diabetes in 1 million people. Through his work, Ben has reached millions worldwide and personally coached thousands to reclaim their health. His audience includes nearly 3M+ on digital platforms, more than 1M YouTube subscribers with over 100M views, and his top-ranked podcast, The Ben Azadi Show, which has surpassed 100 million downloads. Connect with Cynthia Thurlow Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Ben Azadi On his website Pre-order a revised-version copy of Keto Flex and claim your bonuses
I am honored to connect with Dr. Sharon Stills today. She is a graduate of naturopathic medical school with extensive training in European biological medicine, bioidentical hormone replacement, and anti-aging therapies. In our conversation today, we explore terrain-based medicine and strategies to support women in perimenopause and beyond. We talk extensively about gut health, the estroblome, the microbiome, how European biological medicine views these as terrain, disruptive factors, and why they matter for women in midlife. We also examine the influence of the lymphatic system and how castor oil packs support it, bioidentical hormones as a lifelong tool rather than a temporary fix, and why menopause is a sacred second act in women's lives. Dr. Stills is thoughtful, insightful, and grounded, and I know you will enjoy this conversation with her as much as I did recording it. IN THIS EPISODE, YOU WILL LEARN: How European biological medicine emphasizes the extracellular matrix (terrain) rather than focusing only on individual cells or mitochondria How declining hormones during menopause often expose longstanding yet previously hidden aspects of women's health Dr. Stills shares what she did to prepare herself for menopause in the preceding years Dr. Stills encourages women to create meaningful challenges or experiences to mark their major life transitions How limiting beliefs about aging can influence how you experience midlife and beyond Factors that could influence the health of your terrain How supplements can play an important role, but work best alongside lifestyle habits, mindfulness, and supporting your body's natural healing processes Why Dr. Stills considers the lymphatic system an overlooked contributor to hormone balance, and some practical ways to support healthy lymphatic flow How simple daily habits often have a greater impact on your health than wellness gadgets The value of bioidentical hormones, and why hormone therapy should be individualized rather than one-size-fits-all Bio: Dr. Sharon Stills Dr. Sharon Stills, a licensed Naturopathic Medical Doctor and graduate of The Sonoran University (2001), has spent over two decades transforming women's health, with a special focus on guiding women through perimenopause and menopause. Creator of the pioneering RED Hot Sexy Meno(pause) Program and host of the annual Mastering Your Meno(pause) Transition summit, she combines her expertise in European Biological Medicine, pro-aging therapies, and Bio-identical Hormone Replacement to help women rediscover vitality with natural methods. A respected voice in her field, Dr. Stills has lectured internationally at the Paracelsus Academy in Switzerland, contributed to Women's Health Network, and served on the boards of the Bio-Regulatory Medicine Institute and UCLA's Archive of Healing. She recently opened the Lasting Wellness Center in Scottsdale, AZ—alongside her son, Dr. Ben Stills—offering advanced diagnostic and therapeutic care for chronic illness and women's health. Connect with Cynthia Thurlow Follow on X, Instagram & LinkedIn Check out Cynthia's website. Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia's book, The Menopause Gut. Cynthia's Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Sharon Stills On her website