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⚖️ 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
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
Ever wonder how much debt is outstanding in the world? We go through that to kick off today's podcast. Plus, Robbie interviews Lower's Paul Zinn on how successful retail mortgage teams are staying competitive by evolving their sales strategies, investing in recruiting and developing top loan officers, and positioning their organizations to capitalize regardless of where we are in the market cycle. And we close with a look ahead to the Federal Reserve's meeting this week.Sponsored by Experian Verify, which provides mortgage lenders with automated income, employment, identity, and asset verification solutions that help accelerate underwriting while reducing fraud risk and manual documentation.The Chrisman Commentary is your go-to daily mortgage news podcast, where industry insights meet expert analysis. Hosted by Robbie Chrisman, this podcast delivers the latest updates on mortgage rates, capital markets, and the forces shaping the housing finance landscape. Whether you're a seasoned professional or just looking to stay informed, you'll get clear, concise breakdowns of market trends and economic shifts that impact the mortgage world.
Rabbi Feiner shiurim
⚖️ What Factors Determine Who Gets Custody of a Child? | Los Angeles Divorce ⚖️ Child custody decisions are not based on one single factor. In California, courts generally focus on what is in the child's best interests when determining custody arrangements. Factors such as each parent's relationship with the child, caregiving history, stability, and ability to support a healthy relationship with the other parent may all be considered. Understanding what courts look at can help parents prepare, communicate effectively, and create custody arrangements that prioritize their child's well-being.
Wall Street pulled back modestly this week as investors continued rotating away from some of the market's biggest technology names. The Dow Jones declined 0.4%, the S&P 500 fell 0.6%, and the Nasdaq dropped 2.1%. Despite the weekly decline, all three major indexes remain positive for the year, with the Dow up 8.1%, the S&P 500 up 8.3%, and the Nasdaq up 7.5% year to date. The Money Wise guys discuss the recent broadening of market leadership beyond the hyperscalers, reviewed the impact of rising oil prices and Treasury yields, and explain why recent weakness in technology stocks appears to be more of an orderly market rotation than a change in the long-term investment outlook. The conversation also highlights Davidson's continued emphasis on diversification and active portfolio management during periods of elevated volatility. The second half of the program shifts to investor education, focusing on the importance of understanding financial strategies before acting on marketing claims. The hosts discuss Roth conversions, explaining why they can be valuable in certain situations but are not appropriate for every investor and always require careful tax planning. They also emphasize the importance of maintaining adequate portfolio liquidity, particularly for investors with significant holdings in illiquid assets such as real estate or private investments. Roth Conversions Strategies like Roth conversions can provide meaningful long-term tax benefits, but they aren't one-size-fits-all solutions. Factors such as your current tax bracket, available cash to pay taxes, retirement timeline, and overall financial goals all play an important role in determining whether a conversion makes sense. Likewise, maintaining appropriate portfolio liquidity can help investors meet unexpected cash needs without being forced to sell long-term investments at inopportune times. Taking the time to evaluate these decisions within the context of a comprehensive financial plan can help investors make choices that align with their broader objectives rather than reacting to marketing messages or short-term trends. In the second hour, the Money Wise guys explore RIA vs. Broker. You don't want to miss the details! Tune in for the full discussion on your favorite podcast provider or at davidsoncap.com, where you can also learn more about the Money Wise guys or take advantage of a portfolio review and analysis with Davidson Capital Management.
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.
In this episode of Dean's Chat, Dr. Jeffrey Jensen welcomes Dr. Lee Rogers for a wide-ranging conversation on the evolution of diabetic foot care, career opportunities in podiatric medicine, and practical advice for new graduates entering today's job market.Episode Highlights• The UT Health San Antonio Storyo The history and national impact of the podiatry service at UT Health San Antonio.o How the program became a leader in diabetic foot research and multidisciplinary limb preservation.o The role academic medicine has played in advancing both patient care and the profession of podiatric medicine.• Research That Changes Practiceo The importance of clinical research in improving outcomes for patients with diabetes.o Building collaborations across specialties to advance evidence-based care.o Opportunities for podiatrists interested in academic medicine and research careers.• Career Opportunities in Today's Marketplaceo Navigating the diverse employment options available to today's podiatric physicians, including: Private practice Academic medicine Private equity-backed practices Hospital-employed positions Multispecialty medical groups Orthopedic groupso Advantages and challenges of each practice model.o Factors new graduates should consider when evaluating employment opportunities.• Employment Contracts: What Every Resident Should Knowo Understanding employment agreements before signing.o The pros and cons of non-compete clauses.o Why tail malpractice coverage matters—and who should pay for it.o Additional contract provisions that deserve careful review.o Practical advice for residents transitioning into their first professional position.Whether you're a student, resident, practicing podiatrist, or healthcare leader, this episode provides valuable insight into the future of diabetic limb preservation, the expanding career landscape in podiatric medicine, and the business realities facing new graduates.
A new mishnah! Does the mitzvah of covering the blood apply to an animal that is discovered to be unfit for consumption? Whether because the animal is a treyfa or because the slaughtering was done in the name of idolatry, for example. With sources, and machloket (of course) in the Gemara on the mishnah, with a focus on the rabbis and Rabbi Shimon, and then, eventually, the view of Rabbi Meir as well. Plus, Rabbi Meir's opinion and Rabbi Yehudah HaNasi's opinion line up for some of the cases, in any case.
The latest news from the world of wall street from Pete Najarian on our Friday Football and Finance segment on WCCO with Tom Hauser filling in for Vineeta.
The latest news from the world of wall street from Pete Najarian on our Friday Football and Finance segment on WCCO with Tom Hauser filling in for Vineeta.
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
Sepsis management has traditionally focused on timely antibiotic treatment, hemodynamic support, and source control, but emerging evidence suggests that outcomes may be shaped long before patients reach the ICU. In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Diane C. McLaughlin, DNP, AGACNP-BC, CCRN, FCCM, speaks with Sayed Abdulmotaleb Almoosawy, MBChB (Hons), about his article “The Association Between Socioeconomic Position and Mortality in Patients With Sepsis and Septic Shock—A Systematic Review and Meta-Analysis,” published in the April 2026 issue of Critical Care Medicine. Drawing on 13 observational studies that encompassed nearly 4 million patients, the analysis evaluates how factors such as insurance status, income, education, and neighborhood deprivation relate to short-term mortality outcomes. The findings reveal a consistent association between lower socioeconomic position and increased mortality, with lack of private insurance demonstrating the strongest signal—likely reflecting barriers to timely access to care and delayed presentation. This episode challenges clinicians and researchers alike to recognize the link between socioeconomic disadvantages and worse sepsis outcomes, highlighting the need to collect equity-relevant data and reduce gaps in care to improve survival for critically ill patients. Resources referenced in this episode: Almoosawy SA, Fernando SM, Rochwerg B, et al. The association between socioeconomic position and mortality in patients with sepsis and septic shock—a systematic review and meta-analysis. Crit Care Med. 2026;54(4):692-700. Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Med. 2026;54(4):725-812.
Co-hosts Ryan Piansky, a patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Science Advisory Council, interview Dr. Claire Beveridge about EoE and dysphagia. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own. Key Takeaways: [:49] Co-host Ryan Piansky introduces this episode, brought to you thanks to the support of Education Partners AstraZeneca, GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz. [1:17] Holly introduces today's topic, research on eosinophilic esophagitis (EoE) and dysphagia. [1:24] Holly introduces and welcomes today's guest, Dr. Claire Beveridge, a gastroenterologist at the Cleveland Clinic. Dr. Beveridge heads the EoE Adult Clinic and the Transition from Pediatric to Adult EoE Clinic. [1:36] Holly, a speech pathologist, says she is very excited to dive into the research Dr. Beveridge did with EoE and dysphagia. Holly asks Dr. Beveridge to share some of her background. [1:48] Dr. Beveridge was recruited to the Cleveland Clinic about five years ago to head the EoE Center. She loves the work they have done there. [1:57] Dr. Beveridge says it's been nice to center everything on their EoE patients and have multidisciplinary care with speech-language pathologists, allergists, dietitians, pulmonologists, and more. It's been a great experience. [2:15] Dr. Beveridge says the other thing they are really proud of is having a Transition Clinic. It can be tough for patients to transition from pediatric to adult care. [2:23] Dr. Beveridge says this is something she was inspired to do when she was finishing her training at the University of Pennsylvania, where they had been doing some of that. It was really important to her when she joined Cleveland Clinic. [2:34] Dr. Beveridge, with her Co-director, Dr. Sophia Patel, helps patients transition from pediatric to adult care. [2:41] Holly speaks of the challenge of transitioning from pediatric care at a multidisciplinary clinic to adult care. [3:08] Dr. Beveridge says you can't do any training at Northwestern without loving the esophagus. She did her residency there, got exposed to esophagology, and got to know Dr. Gonsalves and Dr. Hirano really well. [3:33] Drs. Gonsalves and Hirano are really big names in EoE. Dr. Beveridge was fascinated by the disease. She loved the patients and wanted to help them and make them feel better. It's a burgeoning field. [3:48] Dr. Beveridge says that it's only in the last few years that we have had FDA-approved medications for it, and that we have been jerry-rigging asthma medications to treat our patients. [4:03] Dr. Beveridge says it's really exciting to see the treatment options we can offer. [4:10] Ryan says it's exciting to see how EoE management has changed. [4:16] Ryan says we see so many patients who are untreated or poorly treated for years, who have restructuring of their esophagus and present with dysphagia, or have strictures and rings leading to food impactions; the long-term effects of untreated EoE. [4:34] Ryan says it's exciting that now we do have better treatment options for people, right off the bat. [4:43] Dr. Beveridge conducted some research on EoE and dysphagia and presented a poster at the 2024 Digestive Diseases Week. [4:51] The poster was titled, "Esophageal Luminal Diameter is Associated with Dysphagia and Eosinophilic Esophagitis: Implications for Endoscopic Dilation Therapy." [5:11] Dr. Beveridge says dysphagia means issues with swallowing. It's a feeling of something getting stuck or something slowly moving down. There are also subtle symptoms that can happen. [5:31] Dr. Beveridge says patients who have had EoE for a long time become accustomed to how they swallow. Things a patient may think are normal, like needing water and taking a sip after each bite, are learned accommodating behaviors. [5:58] Dr. Beveridge says accommodating behaviors are that you're needing to imbibe extra water, you're modifying how you're eating, extra chewing, avoiding pills, avoiding other certain foods, and things like that that can be modifying factors. [6:19] So, difficulty with swallowing, things getting stuck, slowly moving down, but also keeping in mind some of those modifying behaviors that we may end up using. [7:23] Dr. Beveridge says her motivation was seeing patients in her clinic who were having persistent symptoms, and getting them into histological remission. The goal of treating your EoE is to get the eosinophils less than 15; close to zero is great. [7:45] Dr. Beveridge says we have patients who, despite doing their endoscopies and taking biopsies, things look fine; they're still having issues with swallowing. Why is that the case? [7:58] Dr. Beveridge says in a different research paper she had done, looking at some of the predictors for that, one of them was fibrostenosis. There are also other things that can contribute, like esophageal hypervigilance and a fear of swallowing. [8:21] If a patient has had a food impaction, it's going to be scary to try to swallow again. Some of it is behavioral, but some of it is structural. At what luminal diameter (the size of the esophagus) is that causing a clinical problem for patients? [8:45] A normal esophagus is 20 to 24 mm in diameter. Traditionally, around 14 to 16 mm in diameter has been when we say that patients get symptoms or they're feeling the issues with swallowing. [9:03] Dr. Beveridge says a lot of those studies have never been done specifically for EoE patients. [9:08] Dr. Beveridge wanted to know, if we exclude cancer, if we exclude acid reflux, and all of these other things, and just look at our EoE patients, what size of the esophagus are we looking at? [9:20] Dr. Beveridge explained they specifically looked at patients whose histology was under control and then compared those who continued to experience symptoms with those who did not. The goal was to determine the histologic threshold at which patients begin to experience dysphagia. [9:54] Dr. Beveridge says they saw this threshold at 16 mm (1.6 cm). That's still quite the difference from a normal esophagus of 20 to 24. [10:08] Dr. Beveridge says our esophagus can definitely handle being smaller, but then, once you get to that 16 mm, for a lot of patients, it really does cause that feeling of things getting stuck or slowly moving down. [10:20] Holly says what's cool about the retrospective data Dr. Beveridge looked at, and the parameters she placed in the research, is that when a patient goes in for an endoscopy, the doctor can measure and say maybe this is why dysphagia is going on. [10:48] Holly finds that adult patients with food impactions are scared to eat the same food again. She loves having this data to share with patients and say, let's look at what your esophagus measures at. Let's do a smaller bite. Let's add a dip and liquid. [11:12] Holly says data can push so much progress. Holly, having multiple chronic illnesses, loves when doctors can say, this is going to be safe. This is the mode that we're going to go with. [11:30] Dr. Beveridge says in the retrospective study, they were looking at stuff that had already been done. We decided from here to assess patients more prospectively. All of this was based on chart review from when the note said symptoms or no symptoms. [11:53] Dr. Beveridge says when she started this EoE clinic at the Cleveland Clinic, part of it was to standardize better how we were collecting data from patients to understand their symptoms. [12:07] Dr. Beveridge has a standardized questionnaire for patients to understand if they are having heartburn and difficulty with swallowing, so she can know that at each point of their endoscopy. [12:18] Dr. Beveridge says it will be nice, hopefully in the future, when she can give a little more detail and depth in terms of assessing this more prospectively and seeing if that same number holds up or if she needs to tweak it a little bit. [12:34] Holly thinks it's fascinating. Numbers give us so much information, to know if my mm is this versus this, the next time, or during allergy season or not. [12:53] Ryan says it's cool that you're able to look back at existing patient records and identify this information. Now we have that 16 mm number in mind to say maybe this is where we'll start to see increased risk of dysphagia in these patients. [13:28] Dr. Beveridge says, how we had to do it retrospectively was based on the endoscopist estimating what the size is. Gastroenterologists recognize they're not always the best at estimating the size of the esophagus. [13:50] Dr. Beveridge says, if your endoscope could not pass through, or it was snugly passing through, you know the diameter of the endoscope. If a dilation was done, at what size dilation do we start to see a disruption? [14:19] Dr. Beveridge says, the goal of a dilation is to get a disruption because there's scar tissue we want to break open. A patient might think disruption means a perforation or something more scary, but that is the goal. We want to break open that scar tissue. [14:42] Dr. Beveridge says, once we see that scar tissue break open a little bit, then we can estimate what the diameter is, based on the size dilator we used. [15:10] Dr. Beveridge says for adults, we use a standard adult upper endoscope, and that's about 13 mm. The ones we use for kids are about 6 mm. [15:35] Dr. Beveridge says the adult endoscope is around 13 mm, and it's around 14 to 16 mm when we start to see the symptoms. [16:07] Dr. Beveridge says there are two main types of dilation that we do. One is the Savary dilator or wire-guided dilator, a long dilator that stretches the entire esophagus, from the mouth down to the stomach. [17:20] Dr. Beveridge says another way of doing it is while you have the endoscope in, you thread a catheter. At the end of the endoscope, there's a balloon. You fill the balloon with saline up to different sizes. Typically, they go up by 3 mm, so 12 to 15 mm. [18:01] Dr. Beveridge says the catheter balloon dilator is good for discrete strictures because the balloon isn't going to do the entire esophagus; it's just going to do one area of the esophagus, and you're watching it the whole time. [18:19] For the wire dilator, you remove the scope. You're not able to see, so it's important to assess ahead of time how narrow things are, so you start at a safe dilation. You go in each time to see if there's starting to be disruption, and then you can do more. [18:44] Holly asks if a gastroenterologist doing an upper endoscopy with sedation sees that it's tight, would the gastroenterologist automatically do a dilation? Or, can a patient with dysphagia symptoms request to have a dilation? [19:28] Dr. Beveridge says, right before an endoscopy, she discusses it with the patient and gets consent. She asks, even if their symptoms are good, but in the endoscopy she sees a narrowing where she would recommend a dilation, if they're OK with that. [20:05] Dr. Beveridge says, if they're having issues with swallowing, often she will ask if they're OK with her doing a dilation. If she sees a narrowing, she can focus on that area and dilate it. [20:19] Dr. Beveridge says not everywhere in the esophagus can we see as well. The very beginning of the esophagus is challenging to see and challenging to evaluate on imaging. [20:32] Dr. Beveridge talks about empiric dilation. You don't see a narrowing, but you want to rule it out, so you do a dilation at a safe size, like 16 or 18 mm, to make sure you're not missing something up high. [20:58] Dr. Beveridge says she always talks about that with her patients. Most say, go ahead. Some patients definitely want dilation; other patients say no, they really don't. [21:12] Dr. Beveridge then asks the patient if there's real narrowing that may cause a food impaction, would they want dilation then, or hold off for another day? [21:30] Dr. Beveridge never wants to do something the patient is not comfortable with. She also doesn't want them to need another endoscopy unnecessarily, if she can avoid that for them in the moment. [21:46] Dr. Beveridge mentions the BougieCap used in Europe. It's a cap you put at the end of the endoscope. You use your endoscope as the dilator. You watch the whole time. It is hard plastic that causes a nice dilation. We may see it come to the U.S. [22:37] Dr. Beveridge speaks of the FLIP catheter, which is a catheter with a balloon that doesn't cause dilation but distends and helps measure the diameter. [23:33] Holly asks if Dr. Beveridge gives tips to patients on how to prepare for dilation and the recovery process. [23:49] Dr. Beveridge had an upper endoscopy. She says there's nothing like experience to understand it better. She didn't have a dilation, but the biopsies caused discomfort. [24:21] Dr. Beveridge says a lot of her patients have been through upper endoscopies, so they know how it feels. She warns them that the biopsies and dilation can cause discomfort. [24:33] What's challenging is that everyone is different. Some patients are going to be more hypersensitive to it, and other patients are going to say they felt nothing and they were fine. [24:46] Dr. Beveridge says some patients need to modify their diet for a few days to avoid significant chest pain. You never want someone to have to go to the ER for significant chest pain when it will just heal over time, and there's no perforation. [25:12] Dr. Beveridge says other patients will be like her, eating chips and pretzels and saying they're fine. Dr. Beveridge typically has them start with liquids, nothing too hot or too cold, and advance as tolerated. [25:28] Dr. Beveridge says patients can always use TylenolⓇ and over-the-counter numbing agents. You'll still have patients who will get significant discomfort. For the most part, starting with liquids has worked for Dr. Beveridge's patients. [25:44] Holly recommends over-the-counter when her patients call, after she talks to their GI. Holly says after she has an endoscopy, she starts on liquids and shakes. On day three, she's fine. Holly says individualized care is amazing. We all are different. [26:14] In the pediatric setting, the parents get the counseling, and they have not had sedation, but on the adult side, you're talking with the patient, who had sedation. Sometimes they don't remember. [26:40] Dr. Beveridge says when possible, she waits for family members to come back and tells them they're going to have to "be the memory" because the patient probably won't remember this conversation. [26:55] If a patient says no, they don't want them to come back and hear about it, always respect that. But Dr. Beveridge always tells them, you may not remember what we say. [27:30] Ryan asks about data on how many times someone may need dilations. Dr. Beveridge says it comes down to the patient, but the biggest issue can be uncontrolled inflammation. [27:44] Dr. Beveridge says if a patient's EoE is not controlled, inflammation leads to continued scarring down. That's why we talk about dilation as being an adjunctive measure, but not a treatment for EoE. It doesn't do anything for the inflammation. [28:03] Dr. Beveridge says she has patients who ask why she can't just do a dilation every now and then. Dr. Beveridge considers dilation to be safe when needed, but if you can avoid it, that would be nicer for everyone. [28:21] Dr. Beveridge says there's no great data on whether you only need one, or whether you're going to need 10, but one big theme is just: have we gotten your inflammation under control? That's also true for other conditions, such as acid reflux. [28:45] Holly wasn't diagnosed until she was in her mid-twenties, and she had several upper endoscopies as a teenager and college student to dilate her, to help the situation. [29:17] Holly says she had to get more endoscopies to figure out her weird food triggers that are not typical for everybody, so even if she's treated, she still has inflammation. That's why she had so many upper endoscopies. [29:30] Ryan talks about underlying issues causing inflammation. Dilation is not treating those underlying causes. It's just helping with one symptom of this dysphagia, by expanding the esophagus. [29:50] Ryan asks, What changes in symptoms should patients expect after the dilation? Dr. Beveridge says, ideally, if there's been a stricture, you're going to start to feel like your swallowing is better. You can get pills and food down better. [30:07] Dr. Beveridge says, immediately post-dilation, sometimes people feel a little bit worse. Everything you swallow may be uncomfortable for you. But if it's been a successful dilation, hopefully, you're going to feel that things are going down better. [30:40] Holly says she is so grateful that Dr. Beveridge looked into this, and hopefully, there will be a new protocol in the future. Holly asks what other key takeaways from this research may interest Dr. Beveridge in researching something further. [31:02] Dr. Beveridge says, making sure that we're not missing scar tissue is big and important. One thing that we're trying to look at with our Pediatric GI colleagues is what threshold we should be looking at for the pediatric patient population. [31:19] Dr. Beveridge says a pediatric patient's esophagus is a different size than an adult patient's. Understandably, we are more cautious when doing a dilation in the pediatric patient population than we are with adults. [31:34] Dr. Beveridge may recommend empiric dilation for an adult but will feel more cautious about that with pediatric patients than with adult patients. Understanding what that threshold should be for the pediatrics is going to be really interesting. [31:57] Dr. Beveridge says the diameter threshold we discussed is going to be important to know about, but everyone is different. You may have a diameter of 14 mm, you feel fine, and you don't want a dilation; you can accommodate OK. That's reasonable. [32:15] Dr. Beveridge says she has had patients who get up to 18 mm, and that helps them, but they need a little bit more. If someone needs more of a dilation, we do that. Yes, have a threshold to assess, but always assess for what's personal for your patient. [33:04] Dr. Beveridge says not just to assess the luminal diameter, but a thing that is helpful for gastroenterologists to know will be if there are other factors at play. As in her study of dysphagia predictors, anxiety, depression, and hypervigilance can play roles. [33:37] Dr. Beveridge has patients who have to have a critical narrowing for them to finally feel an issue. Other patients, if they have the slightest of narrowing, are feeling something. Some patients are just more vigilant of what's happening in their esophagus. [34:07] Dr. Beveridge says there's definitely a role for asking if your anxiety is under control. If there's feedback in the nerves, should we ask your GI Psychologist to be involved in terms of CBT for your esophagus? Take a look at everything. [34:27] Dr. Beveridge says another part of the study they looked at was: are there different thresholds of eosinophils that we should be looking at? Is it just less than 15, or do some patients need it to be lower? Less than six? Less than 10? [34:43] Dr. Beveridge says look at it as a whole for your patient. [34:53] Dr. Beveridge says next, she will be working on a very long-term project: Can we identify a non-invasive method of screening a patient, diagnosing a patient for EoE, or monitoring a response to therapy? [35:13] Dr. Beveridge has looked at transnasal endoscopy, which is put into this category of minimally invasive. It's still invasive; you're putting a scope through someone's nose, but it doesn't require sedation, which is a nice thing for some patients. [35:29] There's the EnteroTrack, which started in Colorado. A patient swallows a string, and it stays in their esophagus for an hour, and we look at the proteins to see if things are active or not active. [35:45] Dr. Beveridge is also looking at the breath metabolome. If we breathe into a bag and take a look at all the volatile organic compounds that are in our breath, can we find a signature related to EoE? [36:01] It's assessing about 100 different compounds, not looking at one in particular, but how the whole thing looks. What signature is there, based on looking at all the compounds? [36:15] Dr. Beveridge presented some of that data at DDW and has a grant from the ACG to look at this and assess patients with and without EoE. [36:33] Dr. Beveridge says further, doing longitudinal data of looking at patients once they've gotten into remission on treatment and seeing, do we then see a signature change? [36:47] Dr. Beveridge says no one is under any illusion that endoscopies are going away. They will always be part of what we do in gastroenterology, but there are limitations: sedation, a full day away from work, nothing by mouth, and a driver, etc. [37:04] If there are alternatives to help supplement that, it would be nice. One of the barriers for patients doing diet elimination is the number of endoscopies that are required. If there's a way to assess by breath if a food is a trigger, that would be good. [37:32] Dr. Beveridge says that's the big thing she's looking at, but it will take years. It's not going to be a quick, easy one, but it's very interesting to take a look at. [37:45] Holly speaks of how much treatment has changed since she was diagnosed. She has done all the scopes. She says this sounds amazing. She loves that people like Dr. Beveridge are thinking of how to make testing less invasive and more comfortable. [38:12] Dr. Beveridge says another thing she is excited about is the transition of care. She recently did a survey and is analyzing the data to assess what the barrier is from the physician perspective in terms of helping our patients transition. [38:40] Dr. Beveridge is also looking at doing a nice multi-center consensus to help this as well, led by Dr. Sophia Patel and Dr. Emily McGowan, who are fantastic in the EoE world, looking to see how we can make this better for our patients. [38:58] Ryan says, with so much interesting work coming up, we'll have to have you back to chat about some of these additional projects. Everyone is super interested in less invasive stuff and better treatment pathways. Transition of care is an important part of that. [39:11] Ryan appreciates Dr. Beveridge for joining the conversation and hopes to have her back on another episode so we can learn more about EoE and these different future research endeavors. [39:20] For our listeners who would like to learn more about EoE today, you can visit apfed.org/EoE and check out the links in the show notes below. [39:27] If you're looking to find specialists who treat eosinophilic disorders, we encourage you to use APFED's Specialist Finder, available at apfed.org/specialist. [39:36] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at apfed.org/connections. [39:46] If you have personally been impacted by eosinophilic disorders and are interested in sharing your experience, please check out apfed.org/shareyourstory. [39:55] Ryan thanks Dr. Beveridge for joining us. This was a fun conversation and really insightful. Holly thanks APFED's Education Partners AstraZeneca, GSK, Sanofi, Regeneron, and Takeda for supporting this episode. Mentioned in This Episode: APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.orgapfed.org/specialist apfed.org/connections Claire Beveridge, MD Cleveland Clinic Education Partners: This episode of APFED's podcast is brought to you thanks to the support of AstraZeneca, GSK, Sanofi, Regeneron, and Takeda. Tweetables (Edited): "I have loved the work that we've done [at the Cleveland Clinic]. It's been really nice to center everything on our EoE patients and have nice multidisciplinary care with speech-language pathologists, allergists, dietitians, pulmonologists, and everyone." — Claire Beveridge, MD "It's a little crazy to think that it's only in the last few years that we have had FDA-approved medications for [EoE], and that we have been jerry-rigging asthma medications to treat our patients." — Claire Beveridge, MD "On the whole, dysphagia means issues with swallowing. … It's a feeling of something getting stuck or something slowly moving down. There are also subtle symptoms that can happen." — Claire Beveridge, MD "The goal of a dilation is to get a disruption because there's scar tissue we want to break open." — Claire Beveridge, MD "I am looking at the breath metabolome. If we breathe into a bag and take a look at all the volatile organic compounds that are in our breath, can we find a signature related to EoE?" — Claire Beveridge, MD Guest Bio: Claire Beveridge, MD, is a Staff Member in the Department of Gastroenterology and Hepatology and heads the Eosinophilic Esophagitis (EoE) adult clinic as well as the transition pediatric to adult EoE clinic. Dr. Beveridge's specialty interests include: EoE, Achalasia, Barrett's esophagus, GERD, esophageal swallowing disorders, and esophageal motility disorders.
It's been an interesting time for the tech sector, with many big companies reporting their results. Tech stocks recently reversed some of the recent selloff last night - with the Nasdaq up 1.9 percent. Milford Asset Management's Andrew Curtayne explained further. LISTEN ABOVESee omnystudio.com/listener for privacy information.
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
In this episode, Jason begins a new series on what happens when critical components are missing from an Integrated Production Control System. He explains how paradigms, mindsets, goals, system structure, and rules shape the way a construction project operates. When owners, designers, stakeholders, contracts, and company leaders are not aligned, even strong project teams can be forced into rushing, pushing, bureaucracy, and anti-lean behaviors. What you'll learn in this episode: Why the owner's perspective can determine how the entire project is managed. How misaligned mindsets create delays, conflict, and unstable working conditions. Why the goal of the system must prioritize people, quality, and finishing on time. How contracts, agreements, team structures, and legal requirements affect performance. Why restrictive project rules can prevent teams from implementing lean construction practices. Are you evaluating the project team's performance without first examining the system they are being asked to work within? If you like the Elevate Construction podcast, please subscribe for free and you'll never miss an episode. And if you really like the Elevate Construction podcast, I'd appreciate you telling a friend (Maybe even two
Welcome to the Mind Muscle Connection Podcast!Many people want to increase their maintenance calories, but only a few factors actually make a meaningful difference.In this episode, I break down what determines your maintenance calories and what actually influences how high they can get. Body size, muscle mass, activity levels, dieting history, and genetics all play a role, along with why metabolic adaptation isn't permanent and what you can realistically do to increase your maintenance calories. If you've ever felt like your maintenance calories are lower than they should be or wondered what you can do to improve them, this episode will help you understand the biggest levers you can actually control. Let's talk about:Body Recomp Workshop ReplayWhat Determines Your Maintenance CaloriesUnderstanding Total Daily Energy Expenditure (TDEE)Why Body Size and Muscle Mass Matter MostHow Activity Levels Increase Maintenance CaloriesHow Dieting History Affects Your Maintenance Calories The Role of GeneticsOther Factors That Influence Energy ExpenditureWhy There's a Ceiling to Maintenance CaloriesWhy You Can't Force Higher Calories ForeverWhat Maintenance Calories Should Most People Reach?Key Takeaways and Final ThoughtsBody Recomp Replay: https://chipper-producer-6244.kit.com/791129889cFollow me on Instagram for more information and education:https://www.instagram.com/jeffhoehn_/?hl=enHow You Can Work With Me?:https://jhhealth.net/workwithme/Coaching application:https://docs.google.com/forms/d/e/1FAIpQLSfE-99wLDZRXlOOY1pWuAmkogdZOm-7ZvN_thbqNWLdNrj5bg/viewform
In this episode, Dave takes a close look at the rise and fall of Pharmapacks, one of the largest Amazon sellers in the world back in 2016. For e-commerce sellers, this is more than a sad business story; its a reminder of how the mix of scaling, investors and thin margins can turn into danger really quickly. Thinking about taking some risk off the table? Or are you looking at taking an extended break from e-commerce in general? Know what your e-commerce business is worth with Quiet Light Brokerage. More Staffing connects ecommerce founders to top Filipino talent across supply chain, operations, CX, marketing, finance, and creative. More Staffing helps you build a team with real depth, at a cost structure that makes it viable for a brand at any stage. Check out More Staffing today to get all of your open positions filled for Q4. Timestamps 00:00 - Introduction to Pharmapacks and its significance 00:29 - Pharmapacks' rise to the largest Amazon seller in 2021 00:59 - What happened to Pharmapacks and its bankruptcy in 2022 01:42 - The business model and early success of Pharmapacks 03:05 - Market environment in 2016 and the reselling boom 04:02 - Investments and growth fueled by private equity 06:26 - Impact of COVID on Pharmapacks' revenue and operations 07:19 - The attempt to go public and market collapse 11:12 - Factors leading to Pharmapacks' collapse and high overhead 14:38 - Post-bankruptcy and current status of Pharmapacks 15:32 - The liquidation of Pharmapacks' assets and lessons learned 20:22 - Key takeaways for e-commerce sellers and strategic insights Resources Mentioned Quiet Light Brokerage More Staffing Packable - 3PL Services As always, if you have any questions or anything that you need help with, leave a comment down below if you're interested. Don't forget to leave us a review on iTunes if you enjoy our content. Thanks for listening! Until next time, happy selling!
Thomas Arnett is Senior Research Fellow at the Clayton Christensen Institute, focused on disruptive innovation in education. He is author of research on "What actually determines AI's impact on humanity". Thomas discusses how disruptive innovation transforms established systems and describes the incentives, governance, and business models shaping AI development. He explores how AI is changing the 'game' of work and education and that we must shift from traditional models as AI exposes their limitations. Thomas explains the need for curiosity and adaptable skills-based learning as career pathways change. KEY TAKEAWAYS [01:04] Fascinated by how the world works, Thomas studies economics. [01:53] Teaching middle school convinces Thomas that much of today's education system is outdated. [02:55] Thomas pursues graduate school to explore how to reinvent education. [03:38] The Christensen Institute gives Thomas a framework for understanding disruptive innovation. [04:48] Established systems are usually optimized to solve yesterday's problems rather than tomorrow's. [06:23] Disruptive innovation positive side effects making scarce solutions more abundant and available. [06:55] School systems face the innovators' dilemma as entities struggling to adopt new innovations. [08:26] Disruptive innovation frequently starts with inferior solutions to mainstream alternatives. [08:54] Disruptive innovations initially often serve overlooked users before improving and reaching mainstream audiences. [10:27] AI represents a technology capable of fundamentally changing how education creates value. [10:56] AI has created a new game to play while education systems teach how to succeed at the old game. [11:33] School is an artificial game where AI can help students succeed at school assignments while undermining the assignments' purpose. [12:16] Assessments need rethinking because AI changes what knowledge and capabilities matter. [14:17] AI companies' missions and their business models often drive them in different directions. [15:30] Investors, governance, and customer markets increasingly influence how AI products evolve. [16:33] Understanding incentives provides better insights into AI's future than reviewing technical capabilities. [18:02] The business models behind AI shape which applications receive the greatest investment. [18:26] Factors tempering AI companies' 'arms race' as feedback and safety issues influence decisions. [21:24] Thomas is optimistic about young people considering their reservations about AI. [22:29] Learning should focus more on critical thinking, developing judgment, and problem-solving. [23:02] Thomas stresses learning how to uncover nuances to succeed in the era of AI. [25:49] AI's cost efficiencies and capability expansion is generating more entrepreneurship possibilities. [29:06] AI's language interface adapts to us, rather than humans having to learn a new tech interface. [29:53] Many human roles were previously needed to deal with messy tech-human interfaces. [31:22] New entrants can adapt faster with new interfaces, fitting the organisation, designed AI-first. [33:49] Shifting to tax capital not labour as one possible solution to improve labour market dynamics. [34:44] Thomas suggests new modes of financing ventures as community-based capital. [37:24] Existing examples of Universal Basic Income – upsides and downsides are inevitable. [38:34] Recognising how financial security affects people's career decisions and viable opportunities. [39:09] School experiences must evolve as they determine students' ability to succeed in the workplace. [27:35] AI lowers barriers for individuals wanting to create value independently. [31:05] Defined career ladders are evolving into more fluid and adaptable pathways. [34:00] The future belongs to people who identify worthwhile problems before searching for solutions. [40:30] Education must prepare people to navigate uncertainty not just master established knowledge. [44:10] Human curiosity becomes increasingly valuable as AI can handle more routine cognitive work. [48:25] Career success will increasingly depend on adaptability. [53:15] Solving meaningful problems creates more lasting value than completing prescribed tasks. [59:50] IMMEDIATE ACTION TIP: Focus on understanding the problems that need solving and cultivate the curiosity to keep learning and creating solutions throughout your career. RESOURCES Thomas's research publication "What actually determines AI's impact on humanity". Thomas's article QUOTES "School is an artificial game... we've constructed this game and now we've got this technology that helps you win at the game but actually lose at the purpose of the game." "Most of the AI getting used in schools today is... not rethinking the assumptions of how school works, it's just using it to try and enhance the way the school system has always worked." "Don't just look at what AI can do. Look at the incentives driving the companies building it." "If you want to see where these [AI] companies are going, look at their governance structures, look at who their investors are, look at what customer base they're trying to target." "As long as you maintain that curiosity for understanding those problems and a desire to try and solve them, I think that is a mindset that is going to serve people well." "Systems get designed to solve certain problems and they get really good at doing the things they were designed to do, but not very good at doing things that are radically different from what they're originally designed to do."
Send us Fan MailThe car wash acquisition market is undergoing significant changes. Join us as industry expert Jeff Pavone breaks down the current trends, what buyers are really looking for, and how sellers can navigate the increasingly complex M&A process. From rigorous due diligence to understanding valuation drivers and avoiding common pitfalls, this episode provides essential insights for anyone looking to buy or sell a car wash business. Discover why quality deals are closing and what it takes to achieve a successful exit in today's environment.What You'll Learn:Why the car wash M&A process is more tedious and disciplined than ever.The current state of the car wash buying market and why quality deals are closing.Key factors that influence car wash multiples and valuations beyond surface numbers.The importance of robust preparation and what buyers scrutinize during due diligence.Common red flags that can deter buyers or lower a deal's value.Strategic advice for sellers, including avoiding single-buyer negotiations and resolving liabilities.How external factors like interest rates and competition impact the selling window.Equip yourself with the knowledge needed to succeed in the dynamic car wash M&A landscape.#CarWashMA #BusinessSales #DueDiligence #SellerStrategy #JeffPavoneConnect With Us:https://www.facebook.com/AmplifyCapGroup/https://x.com/i/flow/login?redirect_after_login=%2FCarWashAdvisors%2Fhttps://www.linkedin.com/company/amplifycapgroup/https://www.youtube.com/channel/UCyy2-_zM-liZr95drgKDX3g
The wheat complex exploded to the upside on Wednesday as concerns grow over the closure of the Kerch Strait, linking the Sea of Azov with the Black Sea, as fighting intensifies between Russia and Ukraine in the region. Could this be the start of a bigger rally across commodities as we re-add war premium into the trade? We talk wheat, crude oil, corn, inflation and the struggles in the cattle complex with Mike Zuzolo from Global Commodity Analytics on today's show. Find more online at https://www.globalcommresearch.com. 0:00 Wheat surges on Black Sea tensions 0:53 The Kerch Strait: a new bottleneck for wheat and crude 3:04 Energy: Russian diesel, the funds, and the Hormuz double whammy 6:46 Geography lesson: Kerch, Crimea, and Odessa under fire 9:12 The WTI–soft red wheat correlation 10:49 Paris wheat leads: highest since 2024 12:08 Corn: not a U.S. weather market... yet 14:15 Cattle on the struggle bus: a futures-led correction 17:11 Feeders, feed needs, and where to hedge 18:44 CPI and PPI come in cool 19:28 How to reach Mike Zuzolo
Factors For Wichita Hosting March Madness bonus 973 Mon, 13 Jul 2026 12:55:43 +0000 g46SBJ4urLaFcpA0OpSKNURXQcC6veDo sports Sports Daily sports Factors For Wichita Hosting March Madness Wichita's popular morning local sports talk radio show is Sports Daily with Jacob Albracht and Tommy Castor. Listen live M-F 7a-11a on KFH! 2024 © 2021 Audacy, Inc. Sports https://player.amperwavepodcasting.com?feed-link=http
I am honored to have Dr. Carrie Jones back on the podcast today. She's a naturopathic physician and hormone expert with over 20 years of clinical experience in women's health and endocrinology. In today's conversation, we unpack common social media myths about midlife, the influence of lifestyle choices in perimenopause, the role of cortisol and hormones, and current research on the parasympathetic nervous system. Dr. Jones explains vagal freeze, how our stress response can exacerbate it, and why stress has become so normalized. We also explore the influence of synthetic hormones, thyroid propaganda, immune system function, autoimmunity, lab reference values and ranges, and the timing hypothesis of hormone replacement therapy, and Dr. Jones shares her favorite new supplements. Stay tuned for another insightful conversation with one of my favorite voices in the hormone space. IN THIS EPISODE, YOU WILL LEARN: The importance of being thoughtful about information shared on social media regarding perimenopause and menopause How chronic stress becomes harder to tolerate and can cause an increase in inflammation during perimenopause Some simple strategies to help you feel safe, connected, and supported, and improve your vagal tone How actual stress, anticipated stress, and perceived stress all activate the same stress response How chronic stress affects every system within the body How certain women can tolerate synthetic hormones very well, while others develop various symptoms Why basic blood tests and reference ranges are not always optimal for everyone Factors that could influence thyroid function, and the benefits of a broader thyroid assessment than TSH alone Dr. Jones explains why she prefers to start hormone therapy early in perimenopause if appropriate The new supplements Dr. Jones uses to support mood, stress, and sleep 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. Carrie Jones On her website Instagram YouTube Hello Hormones Podcast
Featuring an interview with Dr Jamie E Chaft, including the following topics: Case: A man in his early 70s with a 40 to 50 pack-year history of smoking and cT2bN1 squamous cell carcinoma of the lung with PD-L1 60% treated with induction therapy and surgery (00:00) Available clinical data with immunotherapy in the neoadjuvant, perioperative and adjuvant settings (07:45) Factors in the selection of adjuvant immunotherapy, including circulating tumor DNA (11:39) Evolving approaches to management, including systemic therapy, surgery and radiation therapy techniques (19:28) Case: A woman in her early 60s with nonmetastatic non-small cell lung cancer (NSCLC) and an EGFR exon 19 deletion who is enrolled in the NeoADAURA study (24:03) Importance of clinical trials in the adjuvant setting (33:02) Data surrounding treatment in the neoadjuvant setting; key implications of the NeoADAURA study (35:41) Case: A man in his late 60s with a history of smoking and Stage III T4N3 NSCLC not otherwise specified with low PD-L1 expression, high tumor mutation burden, microsatellite stability and an STK11 mutation (41:34) Selecting patients for the NeoADAURA study treatment approach; deciding between chemoimmunotherapy and chemoradiation therapy (51:01) CME information and select publications
Be blessed as you listen to Factors to Consider When Finding Your Spouse by G. W. Arthur Ministries .Links:YouTube: https://youtube.com/@DrGWArthurFacebook: https://www.facebook.com/DrGWArthurInstagram: https://www.instagram.com/drgwarthur
“Pay attention to your community. Always look at them asyour big boss. You've got to make sure that they understand what it is you're trying to communicate, and ultimately, they're the ones you are serving.” Adriane K. GriffenThe HPP Podcast continues its celebration of DisabilityPride Month! In this episode, Dr. Adriane K. Griffen shares updates on her Inclusion Wheel of Factors and Conditions to Include People With Disabilities in Public Health Efforts, and where she is in evaluating its utility. She shares the applicability of the Inclusion Wheel to professional practice and its potential to improve the lives of people living with visible and invisible disabilities. Read the article in its entirety at https://journals.sagepub.com/doi/full/10.1177/15248399211070809.
Since we've done about 100 episodes pointing out the general lack of preparedness of BCBAs leaving grad school and jumping right into public school work, it'd be pretty mean of us not to have some episodes where we tell you HOW to prepare. And this week we have special guests, Dr. Kristin Foley and Dr. Fina Robertson, doing just that. We cover some of the basics as to how to make friends with teachers and administrators rather than alienating them with your behavior analytic jargon before discussing specific reflection and action steps needed to ensure not just competence in your work, but also maintaining your ethical expectations while you get to work. Quick! You've still got two months of summer vacation to listen up, follow Dr. Foley and Dr. Robertson's guidance, and get your prep in gear! This episode is available for 1.0 LEARNING CEU. Articles discussed this episode: Squires, M., Cutrer-Pãrraga, E.A., Morris, J.R., Miller, E.E., & Hansen, B.D. Navigating collaboration: Factors influencing special education teachers' relationships with BCBAs in diverse school contexts. Behavior Analysis in Practice, 17, 1033-1049. doi: 10.1007/s40617-024-010009-w Copeland, S.R., Duffie, P., & Maez, R. (2025). Preparation of behavior analysts for school-based practice. Behavior Analysis in Practice. doi: 10.1007/s40617-024-01028-7 Light-Shriner, C., Pizzella, D., Schreiber, J.B., & Wahman, C.L. (2025). Collaborative practices of behavior analysts in school settings: Evidence from the field. Behavior Analysis in Practice, 18, 681-692. doi: 10.1007/s40617-023-00883-0 Robertson, F., Favre, C., Foley, K., Symons, R. & Weiss, M.J. (in review). Ethical competence for the school-based behavior analyst: Perceptions and preparedness If you're interested in ordering CEs for listening to this episode, click here to go to the store page. You'll need to enter your name, BCBA #, the two episode secret code words, and answers to the knowledge check questions to complete the purchase. Email us at abainsidetrack@gmail.com for further assistance.
In this original What the Dementia episode, we will discuss whether newer anti-amyloid drugs for Alzheimer's disease, including Leqembi and Kisunla, truly make a meaningful difference for people living with mild cognitive impairment or mild dementia due to Alzheimer's disease. We break down the findings from a large independent review, explore both the potential benefits and risks of these treatments, and discuss important questions individuals and families may want to consider when deciding whether these medications align with their goals, values, and quality of life.This episode will cover:— What an independent review found about newer Alzheimer's treatments— The difference between changes seen on scans and changes in everyday life— Potential risks and monitoring requirements associated with treatment— Factors that may influence who experiences certain side effects— Questions to help families think through treatment decisions— Why personal goals and quality of life matter when weighing optionsREFERENCES: Cochrane Review | https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD016297/fullCONNECT, GET RESOURCES, LEARN MORE, + SIMPLIFY YOUR CARE JOURNEY:LinkTree | https://www.letsbambu.com/b/linktreeMUSIC CREDIT: Listen To SpillageVillage - Tropical Landing Pop Songs At Looperman.comDISCLAIMER: The information contained in Bambu Care LLC's website, blog, emails, programs, services and/or products is for educational and informational purposes only. While we draw on our prior professional expertise and background in other areas, you acknowledge that we are supporting you in our role exclusively as a Dementia Care Consultant. By participating in Bambu Care, LLC's website, blog, emails, programs, services and/or products, you acknowledge that we are not a licensed psychologist, professional counselor, or medical doctor. We in no way, diagnose, treat, or cure any illnesses or diseases. Dementia Care Consulting is in no way to be construed or substituted as psychological counseling or any other type of therapy or medical advice. The information provided by Bambu Care, LLC also does not constitute legal or financial advice nor is intended to be. Dementia Care Consulting is not a substitute for the services of a CPA or attorney.
The Office of Personnel Management's proposal to institute a standardized NDA that federal workers could be required to sign as a condition of employment has made for much discussion in federal workforce circles. While many are concerned with the chilling effect it could have on workers, some are wondering about the possible violation of first amendment rights. One of them is the organization Protect Democracy, which filed comments of its own opposing the measure. To get a read on its view, I spoke with Jules Torti who is counsel for the organization.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
On this episode of HALO Talks, Pete Moore sits down with Cricket Wardein, founder of Mighty Pilates, and Cat Martin, the company's CEO and longtime fan, to explore the explosive growth and evolution of their premium Pilates studio brand. Starting with a single location in San Francisco in 2009, Mighty Pilates has grown to 11 studios, with a 12th on the way, successfully combining authentic, high-quality Pilates instruction with a strong sense of community and innovative business strategies. Listen in as Cricket Wardein and Cat Martin share the story of Mighty Pilates, discuss building a sustainable and inclusive fitness brand, and reveal how a commitment to instructor training and neighborhood-focused locations has helped them thrive in an ever-expanding wellness market. On creating an inclusive fitness experience, Cat states, "We don't want technology to be the first thing someone sees when they walk in the door. We want it to be a smiling, welcoming face, a tour that takes you through the studio, a connection with a teacher that really understands how to move with your body." Key themes discussed Mighty Pilates' growth and expansion strategy Importance of high-quality instructor training Community-building and member experience Intentional studio design and amenities Pricing, market differentiation, and competition Flexibility and local adaptation in scheduling Balancing scale with operational excellence A Few Key Takeaways 1. Purposeful, Gradual Growth: Mighty Pilates expanded slowly and intentionally, choosing quality over rapid expansion. The company started with two studios, focusing on perfecting the member experience before scaling up to eleven locations, with a twelfth in progress. This growth was largely funded by studio profits rather than external capital, underscoring a sustainable, disciplined approach 03:14. 2. Commitment to High-Quality Instruction: A core differentiator for Mighty Pilates is its rigorous teacher training program. Instructors must complete 400–600 hours before teaching classes, and the company runs six to seven training cohorts per year. This commitment ensures a consistently high-quality experience, especially compared to the much shorter certifications at some other studios 07:01. 3. Community and Inclusivity Drive Retention: The studios are designed to foster community, with intentional spaces for clients to connect before or after class. Efforts such as coffee and tea stations, happy hour events, and a welcoming, home-like atmosphere encourage members to spend more time at the studio, strengthening loyalty and satisfaction 21:02. 4. Flexible, Data-Informed Studio Operations: Each studio tailors its class schedule and offerings to its local community, rather than applying a cookie-cutter approach. This involves analyzing neighborhood-specific habits (e.g., peak hours relating to school drop-off or urban work schedules) and responding nimbly to market trends like demand for heavier weights or new class types 17:32. 5. Selective and Strategic Expansion: Site selection is highly curated: for every twelve locations considered, only one may be chosen. Factors go beyond typical financial models, with heavy emphasis on surrounding amenities, neighborhood fit, and long-term potential for building community and training pipelines. The company avoids mass franchising, preferring to fill key markets and cluster studios where they can truly embed themselves 25:17. Resources: Mighty Pilates: https://www.mightypilates.com Cat Martin: https://www.linkedin.com/in/catmartin Cricket Wardein: https://www.linkedin.com/in/cricket-wardein-90625b Integrity Square: https://www.integritysq.com Prospect Wizard: https://www.theprospectwizard.com Promotion Vault: https://www.promotionvault.com HigherDose: https://www.higherdose.com
Discover how cancer develops and spreads, the biggest factors that increase cancer risk, and natural strategies to help prevent cancer by supporting your immune system and overall health.0:00 Cancer cells2:54 How cancer develops 4:36 Traditional cancer research vs. epigenetics 5:59 More cancer facts6:57 Prolonged fasting and cancer prevention 7:17 Cancer and your immune system 8:24 Cancer and vitamin D 9:08 Inflammation and cancer 9:28 Cancer and your DNA 10:09 Factors that increase cancer risk11:39 Cancer prevention tips
Ajahn Brahm teaches about the factors of enlightenment. Support us on https://ko-fi.com/thebuddhistsocietyofwa BSWA teachings are available: BSWA Teachings BSWA Podcast Channel BSWA DeeperDhamma Podbean Channel BSWA YouTube
In this week's episode of Built For Life Not Just Wealth, Ryan Burklo delves into the intricacies of investing with a research-backed, academic approach. He emphasizes the importance of focusing on long-term factors, diversification, and thorough portfolio analysis. By exploring these key elements, Ryan provides insights into managing risks effectively and optimizing returns. His discussion offers valuable guidance for both novice and experienced investors looking to enhance their financial strategies. Check out our website: https://www.builtforlifenotjustwealth.com/ Find us on YouTube: https://www.youtube.com/@builtforlifenotjustwealth/ Subscribe to our newsletter: https://www.quantifiedfinancial.com/subscribe-now Check out our Instagram: https://www.instagram.com/ryanburklofinance?igsh=ZTJzN3Jnajd5M2Mw Ryan Burklo's LinkedIn profile: https://www.linkedin.com/in/ryanburklo/ Alex Collin's LinkedIn profile: https://www.linkedin.com/in/alexandercollins/ For a quick assessment of your current financial life go to: https://www.livingbalancesheet.com/lbsVision/lite/RyanBurklo #BuiltForLifeNotJustWealth #Investing #PortfolioManagement #Academi Research #Diversification #RiskManagement #NobelLaureates #MarketFactors #FinancialPlanning Key Topics Market efficiency and instant reflection of information Four main factors influencing returns: bonds, size, value, profitability Importance of diversification across global assets Risks of over-concentration in single asset classes Using academic research to guide investment decisions Chapters 00:00 Investing Philosophy: A New Approach 02:52 Understanding Market Dynamics and Factors 06:10 The Importance of Diversification 08:51 Analyzing Portfolio Risks and Asset Allocation
In this episode, we talk about the factors that may help lead to repair after a breakup and how focusing on what you can do instead of factors outside of your control can change your perspective of the breakup. Check us out on YouTube: Coach Craig KennethGet Craig's help personally: https://www.askcraig.net/take-action/Get Victoria's help: https://www.askcraig.net/victoriaCraig's workbook series: https://www.askcraig.net/workbooks-1/Get Started on the Creative Healing Course: https://courses.askcraig.net/
Influence isn't about talking louder, having better slides, or learning one more sales trick. If people aren't moving, they're missing one of three things: trust, understanding, or certainty. Build those, and everything changes. Every leader wants more influence. Whether you're leading a team, selling a service, coaching a client, or raising a family, your ability to influence others determines your impact. But influence isn't charisma. It's a formula. In this episode, April shares the three elements that create influence: trust, understanding, and certainty. Miss even one of these, and people hesitate, procrastinate, or resist taking action. If you want people to confidently move forward, you have to intentionally build all three. In This Episode You'll Learn Why trust alone isn't enough to influence someone. The difference between being trusted and being understood. Why uncertainty creates procrastination. How leaders accidentally create hesitation. The three-part formula that builds confidence and action. Pivot Point Influence isn't about convincing people. It's about creating enough trust, understanding, and certainty that moving forward feels like the obvious next step. "Influence isn't magic. It's trust, understanding, and certainty working together." ---------------- Want more tools to help you create momentum, clarity, and growth in your business and life? Ready to take this work beyond the podcast? Join us at Collaborate 2026, our once-a-year, in-person transformational experience in Grass Valley, California. Spend 2.5 powerful days gaining clarity, building momentum, and doing the deep work alongside growth-minded leaders. Early Bird pricing ends March 31st, and seats are limited. Reserve yours at www.theaprilgarcia.com/collaborate.
As July heat makes its way to New England, we're staying inside with the AC on and a bevy of exciting guests in the studio. That's right: It's GUEST MONTH! Nothing but episodes featuring amazing guests. First we kick things off by reviewing how to get ready for the new school season with Dr. Kristin Foley and Dr. Fina Robertson sharing their work on preparing behavior analysts to work effectively and ethically in schools. Next Dr. Jon Bailey shares his unique and masterful perspective on ethical behavior from the past to the future! Turning back to schools, we learn from Dr. Mawule Sevon how to look for and plan against inequitable discipline practices that are harming Black students, especialy Black girls. Then Dr. Denise Ross and Dr. Douglas Greer teach us how to teach others how to read no matter the age in a secret Book Club episode. And it's a good time too because we also find out what books we'll be reading in the 2026-2027 podcast year. Will Diana be happy with our listeners' choices? Either way, she'll be happy with all these awesome guests! Articles for July 2026 Preparing for Public School Practice w/ Dr. Kristin Foley + Dr. Fina Robertson Squires, M., Cutrer-Pãrraga, E.A., Morris, J.R., Miller, E.E., & Hansen, B.D. Navigating collaboration: Factors influencing special education teachers' relationships with BCBAs in diverse school contexts. Behavior Analysis in Practice, 17, 1033-1049. doi: 10.1007/s40617-024-010009-w Copeland, S.R., Duffie, P., & Maez, R. (2025). Preparation of behavior analysts for school-based practice. Behavior Analysis in Practice. doi: 10.1007/s40617-024-01028-7 Light-Shriner, C., Pizzella, D., Schreiber, J.B., & Wahman, C.L. (2025). Collaborative practices of behavior analysts in school settings: Evidence from the field. Behavior Analysis in Practice, 18, 681-692. doi: 10.1007/s40617-023-00883-0 Robertson, F., Favre, C., Foley, K., Symons, R. & Weiss, M.J. (in review). Ethical competence for the school-based behavior analyst: Perceptions and preparedness. Ethics for Today and Tomorrow w/ Dr. Jon Bailey Bailey, J.S. (1991). Marketing behavior analysis requires different talk. Journal of Applied Behavior Analysis, 24, 445-448. doi: 10.1901/jaba.1991.24-445 Sellers, T.P., Seniuk, H.A., Lichtenberger, S.N., & Carr, J.E. (2025). The history of the Behavior Analyst Certification Board's ethics codes. Behavior Analysis in Practice, 18, 650-660. doi: 10.1007/s40617-023-00803-2 Inequitable Discipline w/ Dr. Mawule Sevon Ladson-Billings, G. (1998). Just what is critical race theory and what's it doing in a nice field like education? International Journal of Qualitative Studies in Education, 11, 7-24. doi: 10.1080/095183998236863 Epstein, R., Blake, J.J., & Gonzàlez, T. (2017). Girlhood interrupted: The erasure of Black girls' childhood [White paper]. Center on Poverty and Inequality, Georgetown Law. https://genderjusticeandopportunity.georgetown.edu/wp-content/uploads/2020/06/girlhood-interrupted.pdf Sevon, M. (2022). Schooling while Black: Analyzing the racial school discipline crisis for behavior analyst. Behavior Analysis in Practice, 15, 1247-1253. doi: 10.1007/s40617-022-00695-8 So You Want to Teach Reading (When Text Speaks Book Club) w/ Dr. Denise Ross + Dr. Douglas Greer Ross, D.E., Greer, R.D. (Eds.) (2025). When text speaks: Learning to read and reading to learn. Sloan Publishing.
Dr. Sara Amalie Solheim is a former PCC Fellow, and she is currently a Researcher and Athlete Passport Management Unit (APMU) Manager at the Norwegian Doping Control Laboratory and Nordic APMU. In this episode, Sara discusses her career path, her work a the Norwegian Doping control Lab, and her PCC-funded Fellowship research projects. These projects examined the potential confounding effects of non-analytical factors like cold shipment of blood samples, low energy availability, acute resistance training, and the menstrual cycle on biomarkers in the steroid and endocrine modules of the Athlete Biological Passport.
Brian Windhorst is joined by ESPN's Tim MacMahon and Vince Goodwill to break down the Hornets' continuing reset with the trade of Miles Bridges to the Suns including the doors that could open moving forward in Charlotte. Next, the guys break down the latest on Jaylen Brown's future in Boston and how the Celtics' trade approach could indicate the future of the franchise. Plus, could Kawhi be on the move if the Clippers are allowed to make a deal and is returning to Toronto on the table? Finally, we discuss some updates on where LeBron stands with the Lakers. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Today, I am delighted to welcome Emily Sadri, a board-certified women's health nurse practitioner and certified nurse-midwife, also trained in functional medicine. Emily is the founder of Aurelia Health, a private women's health practice in the Van Aken district of Shaker Heights, Ohio, offering telehealth services specializing in hormone therapy and weight-loss support for women ages 35 to 55. As a leading hormone expert, she has built her practice around a hormones-first approach. In today's conversation, Emily explains the differences between being a nurse practitioner and a midwife, and we discuss nurse practitioner training, scope of practice, professional support, anticipatory guidance, and the limitations of conventional midlife care. Emily also shares why she prioritizes precision-oriented, personalized care, the value of Mira monitoring for precision hormone replacement therapy management in perimenopause, key hormonal changes she sees in early perimenopause, the impact of cyclic, static, and physiologic dosing of HRT, the influence of progestin IUDs, trends in healthcare, and less common reasons why women in midlife tend to become weight loss resistant. Stay tuned for an insightful conversation on hormones, precision care, and supporting women through perimenopause and midlife. IN THIS EPISODE, YOU WILL LEARN: How women's health nurse practitioner training differs from midwifery, and how midwifery shaped Emily's professional philosophy and ethics Why women need to take ownership of their health throughout every life stage The importance of moving beyond treating symptoms by using comprehensive lab work to identify broader hormonal and metabolic patterns The value of using Mira, an at-home hormone monitoring system, to follow hormone patterns throughout an entire menstrual cycle, rather than relying on isolated laboratory measurements Why Emily believes in looking at hormone patterns rather than progesterone decline or isolated estrogen levels when making hormone replacement therapy decisions How static, cyclic, and physiologic HRT differ, and why Emily believes physiologic dosing deserves greater consideration. Why treating hormones in isolation often fails to address the bigger picture, particularly during perimenopause The importance of women being fully informed when considering hormonal birth control and intrauterine devices Factors beyond sarcopenia, nutrition, sleep, and stress that could contribute to weight loss resistance Bio: Emily Sadri Emily Sadri is a Board Certified Women's Health Nurse Practitioner, Certified Nurse Midwife, and hormone expert who founded Aurelia Health, a modern concierge telehealth company that serves women navigating perimenopause and menopause. Emily's areas of expertise include metabolic health, precision hormone care, and longevity medicine. Her mission is to advance comprehensive care in midlife, create a model that fills in the gaps where primary care is failing women, and to recenter care around the relationship AS the medicine. She resides in the Midwest with her husband, four children, and two dogs. 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 Emily Sadri On her website Instagram Aurelia Health
This episode of Cattle Chat focuses on practical management strategies for improving profitability in cow-calf operations, driven largely by listener questions. A major topic centers on how to add value to cull cows, emphasizing that even though calf sales make up most revenue, cull cow income is still significant. Experts discuss options like breeding open cows before sale, combining them into a single group, or simply adding weight through grazing or feeding to improve market value. Timing decisions based on forage availability and market conditions are highlighted as key to maximizing returns. The conversation then shifts to grazing management, particularly the differences between cool-season and warm-season grasses. While rotational grazing has well-documented benefits in cool-season systems, research shows less consistent improvement in native warm-season pastures. Factors like lower rainfall, reduced fertilizer response, and greater plant diversity may explain why responses differ. Speakers note that successful grazing management of warm-season systems often requires more flexibility and observation, blending science with practical “art.” Strategies like deferred rotation—changing grazing timing across pastures—may support long-term grass health, even if immediate livestock gains are less obvious. Overall, the discussion emphasizes tailoring decisions to each operation, using observation, records, and adaptability to balance forage productivity, animal performance, and economic outcomes.
Why do mosquitoes seem to love some people and completely ignore others? It isn't your imagination. Researchers have identified several factors that make certain people especially attractive to mosquitoes—and some of them are things you have little control over. https://theweek.com/articles/462191/5-things-that-make-irresistible-mosquitoes Most of us believe we make rational decisions when we shop. But behavioral scientists have discovered that many purchasing decisions are influenced by factors we barely notice. The way a product is described, where it is placed, how many alternatives are offered, what price is shown first, and even seemingly irrelevant details can dramatically affect what we buy. Richard Shotton has spent years studying the hidden psychological forces that shape consumer behavior. In this conversation, he explains why our choices are often less objective than we think, how marketers use these insights to influence us, and what you can do to become a smarter consumer. Richard is a behavioral scientist and author of The Illusion of Choice: 16½ Psychological Biases That Influence What We Buy (https://amzn.to/3q2Vne9). Ice seems so ordinary that it's easy to forget what a miracle it once was. Today, ice is available instantly at the push of a button. But not that long ago, obtaining ice was a massive undertaking involving dangerous harvests, international shipping routes, fortunes made and lost, and an industry that helped reshape the modern world. In fact, long before electric refrigeration existed, people were cutting huge blocks of ice from frozen lakes and transporting them thousands of miles. How did this unlikely commodity transform the way we eat, drink, preserve food, and live? Amy Brady, executive director of Orion magazine and author of Ice: From Mixed Drinks to Skating Rinks—A Cool History of a Hot Commodity (https://amzn.to/3MKX7Rc), reveals the remarkable story behind something most of us never think twice about. Finding a green potato chip in the bag can be a little unsettling. Is it safe to eat? And what about those unusually dark brown chips that occasionally show up? The answers have everything to do with how potatoes grow, how they're stored, and what happens before they ever become chips. https://www.mentalfloss.com/article/30746/whats-those-green-potato-chips-you-sometimes-find PLEASE SUPPORT OUR SPONSORS POCKET HOSE: For a limited time, when you purchase a new Pocket Hose Ballistic, you'll get a FREE 360 degree rotating pocket pivot and a FREE thumb drive nozzle! Just text SYSK to 64000 AIR DOCTOR: Head to https://AirDoctorPro.com and use promo code SYSK to get $250 off select AirDoctor air purifiers, including the 3500, 4000, and 5500 models. Plus, you'll receive a free 3year warranty! RULA: Thousands of people are already using Rula to get affordable, high-quality therapy that's actually covered by insurance. Visit https://Rula.com/sysk to get started. QUINCE: Elevate your summer wardrobe. Go to https://Quince.com/sysk for free shipping on your order and 365-day returns. Now available in Canada, too! SHOPIFY: It's time to turn those "what ifs" into CHA CHING with Shopify Today! Sign up for your $1 per month trail and start selling today at https://Shopify.com/sysk Learn more about your ad choices. Visit megaphone.fm/adchoices
Kolie Moore of Empirical Cycling returns to That Triathlon Show! In today's episode Kolie brings lists of his top underrated and overrated factors for cycling performance to the table, and we discuss these. Kolie also tests Mikael on logical reasoning, and has him guess whether each factor is overrated or underrated on Kolie's list. HIGHLIGHTS AND KEY TOPICS: Kolie's top underrated and overrated factors for cycling performance Without specifying which categories each of these belong in, some of the things we discuss include creatine, Zone 2 training, training plans, race specificity, and many more! What factors did Kolie overrate or underrate earlier in his coaching career? Listener submitted overrated/underrated suggestions, including heat training, lactate guided training, genetics and more SHOWNOTES, LINKS, RESOURCES AND RELATED EPISODES: The shownotes for today's episode can be found here. The full podcast episode archives (including category filters) can be found here. Kolie's website, podcast (Empirical Cycling Podcast), Instagram The Wason Test (here you can try your own logic!) Coaching Thoughts: 15 Underrated Factors for Triathlon Performance | EP#440 - Mikael's own list of underrated performance factors (for triathlon) Coaching Thoughts: 11 Overrated Factors for Triathlon Performance | EP#439 - Mikael's own list of overrated performance factors (for triathlon) Training Talk with Kolie Moore | EP#271 - Kolie's first appearance on That Triathlon Show Training, coaching and podcasting with Mikael Eriksson and Kolie Moore | EP#359 - This episode with Kolie interviewing Mikael originally aired on Empirical Cycling and was later republished on That Triathlon Show Watts Doc #61: Quantifying Diminishing Returns Watts Doc #58: Creatine's Actual Effects On Cycling Performance Watts Doc #50: Hypoxia And Muscular Adaptation Watts Doc #40: Endurance Adaptation Is Not Substrate Oxidation Much Ado About Zone 2: A Narrative Review Assessing the Efficacy of Zone 2 Training for Improving Mitochondrial Capacity and Cardiorespiratory Fitness in the General Population - Storoschuk et al. 2025 Long-Term Time-Course of Strength Adaptation to Minimal Dose Resistance Training Through Retrospective Longitudinal Growth Modeling - Steele et al. 2022 Limited reproducibility of individual physiological adaptations to repeated endurance exercise training - Odden et al. 2026 SPONSORS: Precision Fuel & Hydration produce our favourite gels, sports drinks, and electrolyte and carbohydrate products here at That Triathlon Show and Scientific Triathlon. Use the free Fuel & Hydration Planner to get a personalised plan for your carbohydrate, sodium and fluid intake in your next event, and get 15% off your first 2026 order by using the code TTS2026 at checkout. Rouvy is hands down the most complete indoor cycling platform for triathletes. Among their thousands of beautiful bike courses from all around the world, all filmed in stunning quality, they have over 75 IRONMAN and IRONMAN 70.3 race courses plus 20+ Challenge Family courses, so you can pre-ride your race from home. Real gradients, real visuals, and real feel! Head to rouvy.com and use the code TTS to get your first month free on top of a 7-day free trial. Effortless Swimming produce the best swim goggles for triathletes and open water swimmers. Their NanoClear anti-fog lenses give you clear, fog-free vision that lasts and doesn't wear off. Don't let foggy or leaky goggles ruin another swim. Go to shop.effortlessswimming.com and use the code TTS15 to get 15% off your goggles, and get a free two-month Effortless Swimming course membership. ZenAI is the next frontier of podcasting. It lets you turn your ideas into a podcast without any knowledge of audio editing, video, or production. You do the talking, and the AI handles the production, editing, clipping, and the rest, and you can direct your AI producer in plain English. You can even record from your phone, so no expensive studio gear is needed to sound great. ZenAI is a new product from Zencastr, a platform I've been a paying customer of for over nine years here at That Triathlon Show. ZenAI is currently in invite-only beta. Join the waitlist today here.LEARN MORE ABOUT SCIENTIFIC TRIATHLON: The Scientific Triathlon website is the home of That Triathlon Show and everything else that we doContact us through our contact form or email me directly (note - email/contact form messages get responded to much more quickly than Instagram DMs)Subscribe to our NewsletterFollow us on InstagramLearn more about our coaching, training plans, and training camps. We have something to offer for everybody from beginners to professionals.HOW CAN I SUPPORT THAT TRIATHLON SHOW (FOR FREE)? I really appreciate you reading this and considering helping the show! If you love the show and want to support it to help ensure it sticks around, there are a few very simple things you can do, at no cost other than a minute of your time. Subscribe to the podcast in your podcast app to automatically get all new episodes as they are released.Tell your friends, internet and social media friends, acquaintances and triathlon frenemies about the podcast. Word of mouth is the best way to grow the podcast by far!Rate and review the podcast (ideally five stars of course!) in your podcast app of choice (Spotify and Apple Podcasts are the biggest and most important ones).Share episodes online and on social media. Share your favourite episodes in your Instagram stories, start a discussion about interesting episodes on forums, reference them in your blog or Substack. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
In this episode a group of students and patrons join me to reflect on the recent Venus-Jupiter conjunction in Cancer, and to share stories of how it manifested in our lives based on which of the twelve houses it was transiting in their birth charts. The episode opens with a brief introduction where I talk about the importance of taking into account both the entire range of the sign-based conjunction or copresence between Venus and Jupiter, which lasted from May 18 until June 13, as well as the more intense range of the degree-based conjunction which went exact on June 9. After that I interview several people about their experience of the conjunction, looking at how it functioned in various houses alongside examples of notable public figures who also experienced this transit. This is episode 539 of The Astrology Podcast. Timestamps 00:00:00 Introduction00:02:27 Celebrity Examples: Musk, Spielberg, Biden, etc00:15:43 Factors that Makes the Conjunction More or Less Important00:19:25 Squares from Aries00:22:48 Michelle: Venus-Jupiter Conjunction in 2nd House00:26:30 Arrie - 8th House00:30:32 Laszlo - 3rd House00:34:07 Karina - 8th House00:38:59 Miriam - 12th House00:45:58 Margaret - 1st House00:51:29 Jessica - 1st House00:57:40 Delilah - 11th House01:04:02 Miscellaneous Examples01:17:06 Gillian - 1st House Challenging Example01:28:57 Chiron and Eris01:38:45 Concluding Remarks Watch the Video Version of This Episode https://www.youtube.com/watch?v=wwwZmj_Daco - Listen to the Audio Version of This Episode Listen to the audio version of this episode or download it as an MP3:
Irritable bowel syndrome (IBS) is one of the most common—and often frustrating—conditions seen in primary care. Patients may come in with chronic abdominal pain, diarrhea, constipation, bloating, or a mix of symptoms, and many have already been told that their testing is “normal.” So how do you confidently evaluate IBS, rule out more serious conditions, and help patients move forward?In this episode, Liz talks with neurogastroenterologist Dr. Zach Spiritos about the real-world approach to IBS, including the underlying pathophysiology, common diagnostic pitfalls, practical workup strategies, and treatment options that go far beyond medication alone.Whether you're a new NP or an experienced clinician, this episode offers practical strategies to help you approach IBS with greater confidence and compassion.Timestamps:00:00 - Introduction to Dr. Zach Spiritos and episode overview02:16 - Pathway into neuro gastroenterology and training background05:06 - What is IBS? Symptoms, diagnosis, and underlying mechanisms07:36 - Factors contributing to IBS: trauma, antibiotics, triggers09:21 - Differential diagnosis: celiac, SIBO, bile acid malabsorption11:54 - When to consider endoscopy and testing strategies14:35 - History-taking tips for primary care clinicians17:54 - Managing expectations in chronic GI conditions20:12 - Overuse of endoscopy and its limited findings22:08 - Understanding what endoscopy can actually reveal24:23 - Communicating with patients who have “all tests normal”27:40 - The multitude of IBS treatment approaches: diet, psychological, medication32:12 - Role of diet and FODMAP in symptom management35:10 - Pharmacological options for IBSC and IBSD39:06 - Medications overview: Linzess, Amitiza, Viberzi, and others44:04 - The role and limitations of probiotics and fiber45:08 - Tips on managing patient expectations and chronicity46:54 - Setting goals and tracking progress with patients48:16 - Final advice: empower patients with knowledge, manage expectations, and tailor treatmentsFor a full transcript and conversation chapters, visit the blog www.realworldnp.com/blog/ibs______________________________© 2026 Real World NP. For educational and informational purposes only, see https://www.realworldnp.com/disclaimer for full details. Hosted on Acast. See acast.com/privacy for more information.
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