Podcasts about FAP

In this episode, hosts Robby and Sammi welcome Jenny Jones, an author and advocate for those living with chronic pain. Jenny shares her personal journey with familial adenomatous polyposis (FAP), a hereditary condition that significantly impacts her life and her experience writing a children's book aimed at educating young readers about FAP. The conversation also delves into Jenny's struggles with chronic pain, including abdominal migraines and the importance of physical therapy in her recovery. She discusses the impact of her condition on her mental health, and how she has worked towards healing. The conversation also touches on her reflections on life and death, emphasizing the peace she has found in accepting her journey. Buy "Life's a Polyp: with Zeke and Katie" on Amazon!Follow Jenny's journey on www.lifesapolyp.com and on social media @LifesaPolypFollow the show on Instagram @thepainfultruthpodcast, as well as Robby @robert1950studios and Sammi @thesam.a.lamCheck out their TikTok @1950StudiosYou can find Limitless Broadcasting on Instagram @limitlessbroadcasting.Rant Radio is LIVE! Call 844-857-7268 and leave your rant today. Check out LimitlessBroadcastingNetwork.com for all of our podcasts, subscriptions, and to pick up some awesome merch!

durée : 00:03:51 - L'éco d'ici en Franche-Comté - CMF – Clean My FAP – est un atelier de nettoyage de FAP (Filtre À Particules) Dispositif installé sur l'échappement des véhicules, pour filtrer les particules, il concerne aussi désormais les véhicules essence. L'idée est donc de le nettoyer plutôt que de le changer, en en minimisant ainsi le coût.

My guest today is Holly Yates, LCMHC. Holly has been in private practice in North Carolina since 2004. Her specialty areas are working with adults both individually and in groups as well as couples addressing depression, anxiety, mood disorders and life stressors through clinical intervention and skills training. Holly's practice centers on third wave therapies most specifically Functional Analytic Psychotherapy (FAP) and Acceptance and Commitment Therapy (ACT). She is a founding facilitator of the online ACT Peer Intervision Network sponsored through ACBS and a Certified FAP Trainer through University of Washington. Holly presents FAP and ACT workshops locally and around the world. Holly is Co-founder of North Wake Counseling Partners in Raleigh NC.Some of the topics we explore in this episode include:- Holly's background with ACT and how it led to learning about FAP- The importance of the therapeutic relationship- Clinically relevant behaviors for connection building in the therapy room- The importance of encouraging authentic relationships outside of therapy- The courage and vulnerability involved in intentional self-disclosure- How ACT and FAP naturally blend together—————————————————————————Thank you all for checking out the episode! Here are some ways to help support Mentally Flexible:Sign up for PsychFlex through the Mentally Flexible link! PsychFlex.com/MentallyFlexibleYou can help cover some of the costs of running the podcast by donating a cup of coffee! www.buymeacoffee.com/mentallyflexiblePlease subscribe and leave a review on Apple Podcasts. It only takes 30 seconds and plays an important role in being able to get new guests.https://podcasts.apple.com/us/podcast/mentally-flexible/id1539933988Follow the show on Instagram: https://www.instagram.com/mentallyflexible/Check out my song “Glimpse at Truth” that you hear in the intro/outro of every episode: https://tomparkes.bandcamp.com/track/glimpse-at-truthCheck out my new album, Holding Space! https://open.spotify.com/album/0iOcjZQhmAhYtjjq3CTpwQ?si=nemiLnELTsGGExjfy8B6iw

In 1924, a surgeon and a pathologist had a conversation about some patients with multiple bowel polyps. The pathologist, Dr Cuthbert Dukes, and the surgeon, Mr JP Lockhart-Mummery, noted that patients had a family history of bowel cancer and could have hundreds of colonic polyps. They, with the help of HRJ Bussey, set up the Polyposis Registry. The registry collected information about these patients and the families from 1918 to 1954. They found that patients developed polyps in childhood, the risk of affected children was 50%, and cancer took 15 years to develop from first diagnosis. This was clearly a familial disease. Today, we know this a Familial Adenomatous Polyposis or FAP. The genetic basis for this condition was identified in the 1980s and 1990s. Professor Sir Walter Bodmer led a team to map the location of the Adenomatous Polyposis Coli (APC) gene involved. This is the story of Familial Adenomatous Polyposis (FAP) Our special guests: Professor Sir Walter Bodmer is a professor of the Cancer and Genetics laboratory and Department of Oncology at Oxford University. Areas of research include: HLA, population genetics, Human Genome Project, and mapped the APC gene. He was knighted in 1986. Dr Tristan Rutland is an Anatomical Pathologists, recipient of the Konrad Muller RCPA Outstanding Teaching Award (2020), and recipient of the Resident Advocate Award from the College of American Pathologists. Dr Emelia Ip is a trained medical oncologist, staff specialist in cancer genetics, and co-chair of EviQ Adult Cancer Genetics Reference Committee. Help support us on our donation page.See omnystudio.com/listener for privacy information.

In episode 485 I chat with Jonny Say. Jonny is a UK based therapist and co-director at The Integrative Centre for OCD Therapy.  We discuss the importance of the therapeutic relationship, the benefits of it to outcomes, functional analytic psychotherapy (FAP), how compulsions can get in the way of the therapeutic relationship, how a good therapeutic relationship can help acceptance and commitment therapy (ACT) and exposure and response prevention therapy (ERP), the therapeutic relationship as a way of dealing with shame, rupture and repair, Jonny and I share our own experiences from therapeutic relationships, and much more. Hope it helps.  Show notes: https://theocdstories.com/episode/jonny-485 The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://learn.nocd.com/theocdstories  FAP training for therapists: https://www.integrativecentreforocd.co.uk/live-trainings-therapists/fap-for-ocd  Join many other listeners getting our weekly emails. Never miss a podcast episode or update: https://theocdstories.com/newsletter   Thanks to all our patrons for supporting our work. To sign up to our Patreon and to check out the benefits you'll receive as a Patron, visit: https://www.patreon.com/theocdstoriespodcast 

In this powerful episode of It Happened To Me, hosts Beth Glassman and Cathy Gildenhorn are joined by author, advocate, and healthcare leader Laura Kieger, who shares her family's deeply personal journey with FAP (Familial Adenomatous Polyposis), a rare genetic condition that significantly increases the risk of colorectal and other cancers. Laura's memoir, Summer's Complaint, chronicles the emotional and medical challenges her family has faced across generations, from diagnosis and genetic testing to coping with loss and finding resilience. As someone who tested negative for the familial mutation herself, Laura also opens up about "survivor's guilt", the burden of watching loved ones endure cancer, and how her work in healthcare and leadership has informed her approach to caregiving and advocacy. Whether you're living with a hereditary cancer condition, supporting someone who is, or simply seeking to understand the human side of genetic risk, this episode offers insight, education, and compassion. Topics Covered: What FAP is and how it differs from other hereditary cancer conditions Laura's family's diagnosis journey and how it shaped their approach to screening and prevention The emotional experience of receiving a negative genetic test result when others in your family test positive The value of genetic counseling and early detection Misconceptions about FAP and what patients and families should really know How storytelling can raise awareness and build advocacy for rare diseases Highlights from Laura's memoir, Summer's Complaint, and what she hopes readers take away Laura Kieger is a healthcare human resources consultant, leadership coach, and author of Summer's Complaint. With decades of experience improving patient and employee experiences in healthcare settings, Laura brings both professional and personal insight to the conversation around rare diseases and inherited cancer risk. She's also a passionate advocate and speaker for organizations like the Ronald McDonald House and Care Partners.   Be sure to purchase your own copy of Laura's memoir Summer's Complaint; all proceeds go to continuing education credits for healthcare providers about hereditary cancer syndromes. During the episode Laura also mentioned a study about green bananas here and a private Facebook support group here.    Stay tuned for the next new episode of “It Happened To Me”! In the meantime, you can listen to our previous episodes on Apple Podcasts, Spotify, streaming on the website, or any other podcast player by searching, “It Happened To Me”.    “It Happened To Me” is created and hosted by Cathy Gildenhorn and Beth Glassman. DNA Today's Kira Dineen is our executive producer and marketing lead. Amanda Andreoli is our associate producer. Ashlyn Enokian is our graphic designer.   See what else we are up to on Twitter, Instagram, Facebook, YouTube and our website, ItHappenedToMePod.com. Questions/inquiries can be sent to ItHappenedToMePod@gmail.com.   

Subscriber-only episodeWhat drives men to constant masturbation and what's the real cost of this habit? The Chastity Queen cuts through the shame and embarrassment to explore why so many men fall into this pattern and—more importantly—how breaking free from it can transform your life.Sexual desire is natural, but constant release through masturbation depletes more than just physical energy—it diminishes your drive for achievement, relationship-building, and self-improvement. This episode exposes how the compulsion to masturbate weakens men mentally and emotionally, creating a cycle of addiction that's increasingly difficult to escape. "If I tell you to edge for one hour before being rewarded with release, that has more merit, more depth and meaning," explains the Chastity Queen, highlighting how structure and restraint create purpose.The most revolutionary concept? Denial actually increases desire and satisfaction. The growing "no FAP" movement among younger adults recognizes what the BDSM community has known for years—controlling sexual release channels that energy into productivity, confidence, and ultimately better connections with partners. Women can sense when a man has been "saving it" specifically for them, and this restraint becomes incredibly attractive. Ready to transform weakness into strength? Take the 7-day chastity challenge outlined in this episode, and discover how redirecting sexual energy into productive pursuits can change everything. Your key to breaking the cycle and experiencing true sexual fulfillment might be the opposite of what you've been taught.Subscribe now and use promo code CHASTITYQUEEN at lockedinlust.com for 15% off your first chastity device—because sometimes restraint is the most empowering choice you can make.Try to connect with your local BDSM community. Fetlife is a great way to see others in similar FLR and chastity lifestyles. You can check out Mine in Fetlife at Chastity-Queen. It's a free to join. Hugs, Chastity Queen Locked In Lust 15% OFF:CHASTITYQUEEN Use Discount Code:CHASTITYQUEEN for 15% OFF ANYTHING at www.lockedinlust.com LOVE SHOP 15% OFF Sex Toys & MORE Get 15% OFF sex toys, lingerie and more, using PROMO CODE: CHASTITY QUEEN Buzzsprout - Let's get your podcast launched!Start for FREE15% OFF Shoe Freaks-PROMO%CHASTITYQUEEN GET your 15% OFF ANYTHING when you buy SEXY Shoes, heels & Stripper Boots at Shoe Freaks Canada!www.SMBSM.com - Chastity Cages 10% OFFGet reasonably priced chastity cages, chastity belts, chastity wear, + chastity accessories.Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.https://www.linktr.ee/ChastityQUEEN

Cada xoves falamos de igualdade, rural, empoderamento, emprendemento e cultura con Kim Llobet. No espazo de hoxe falamos con Elena Raviña Eirín, titular da "FARMACIA EIRÍN" da Estrada. Explícanos polo miudo os programas Sentinela, de Medicamentos non Demorables e de Sistemas Personalizados de Dosificación. Que se levan a cabo dende as farmacias galegas. 🔊“Farmacias sentinelas é un programa, no que as farmacias facemos un estudo do número de antigripales, test covid e de gripe que se dispensaron durante o ano 2023. Con esos datos elaborouse unha curva para predecir cando iba a chegar o pico de gripe para que o sistema estivera preparado. Agora estamos enviando esos datos semanalmente”. 🔊“Non Demorables son medicamentos que o paciente non pode deixar de tomar. Nós comprobamos que non hai recetas dispoñibles e da pauta correcta. Nos chamamos a un número da Consellería no que hai un médico e que valida a información que lle damos e se comprometen no prazo de dúas horas de chamar ao paciente e de xerar a receta”. 🔊“Persoas con dereito á asistencia sanitaria e farmacéutica con cargo ao Sistema Público de Saúde de Galicia, de 70 anos ou máis e 10 ou máis prescricións activas crónicas de medicamentos, que presentan problemas de incumprimento da terapia ou dificultades para o correcto uso dos medicamentos por déficits de autonomía física ou psíquica, e viven sós/as ou non teñen unha rede de apoio sociofamiliar adecuada para o mantemento dos tratamentos instaurados”. 📢FARMACIAS SENTINELA Foi un tema que tivo moito impacto a nivel da sociedade, porque foi recollido en varias ocasións en prensa, televisión e recibiu o premio Perfecto Feijoo da RAFG, premio que distingue as iniciativas que contribúen a destacar a imaxe e a consideración social da farmacia galega e recentemente recibiu o premio Acción Farmacéutica que concede Redacción Médica. Esta rede de farmacias sentinela, iniciouse cun piloto no mes de decembro, e está formada a día de hoxe por 70 oficinas de farmacia distribuídas entre as catro provincias da seguinte forma: 30 farmacias na provincia da Coruña, 10 farmacias na provincia de Lugo, 10 farmacias na provincia de Ourense e 20 farmacias na provincia de Pontevedra. Estas farmacias achegaron información relacionada coa dispensación de determinados medicamentos (antigripais) e produtos sanitarios (test COVID E GRIPE) semanalmente, co fin de monitorar a súa dispensación e obter datos que están a ser integrados nos sistemas de vixilancia epidemiolóxica, no proxecto PREDÍ-FAR para a predición epidemiolóxica da gripe. Este proxecto é o inicio dunha colaboración máis ampla que se vai a levar a cabo coa Dirección de Saúde Pública da Consellería de Sanidade, e o noso obxectivo debe ser que un maior número das farmacias da provincia pasen a formar parte da Rede de Farmacias Sentinela, poñendo en valor o noso compromiso e colaboración para a mellora da saúde da poboación 📢PROGRAMA NON DEMORABLES Trátase dunha medida excepcional para renovar a prescrición dun só envase dunha determinada medicación, “medicación non demorable”, nos casos nos que o paciente non dispoña de receita nin desa medicación para 72 horas. 💡A listaxe dos medicamentos non demorables actualmente componse de 5 terapias: ✅Antidiabética: insulinas ✅Antiepiléptica e anticonvulsivante só para tratamento epilepsia ✅Antipsicótica en enfermidade psiquiátrica e demencia ✅Inmunosupresora do paciente transplantado ✅Cardivascular: nitratos, betabloqueantes, calcioantagonistas, heparinas e anticoagulantes de acción directa e agonistas alfa adrenérgicos. Nos casos nos que un paciente solicita un destes medicamentos de maneira urxente, hai un procedemento cun número de teléfono ao que o farmacéutico poderá chamar de luns a venres de 9 a 9 para que un profesional técnico renove a prescrición. Comprobar que o paciente non ten receitas activas e que non dispón de medicación para máis aló de 72 horas. Comprobar que o medicamento solicitado está en listaxe de non demorables Realizar unha chamada ao número de teléfono habilitado, de luns a venres de 9 a 21. Profesional técnico-verificación. Agendará unha cita telefónica para a renovación da prescrición confirmando co farmacéutico o número de teléfono de contacto do paciente. Prazo estimado da chamada o menor posible, compromiso 2 horas. Esta renovación excepcional empeza cunha pilotaxe desas 5 terapias, pero poderá actualizarse nun futuro, polo que será importante que desde as farmacias colaboremos detectando as diferentes casuísticas que se presentan e os medicamentos que máis solicitan con urxencia, por iso cando se envíe a documentación incluirase un formulario para o seu rexistro, e presentar os resultados na comisión de seguimento. 📢PROGRAMA DE MELLORA DA ADHERENCIA TERAPÉUTICA A TRAVÉS DA PREPARACIÓN E ENTREGA DE SISTEMAS PERSONALIZADOS DE DOSIFICACIÓN Persoas con dereito á asistencia sanitaria e farmacéutica con cargo ao Sistema Público de Saúde de Galicia, de 70 anos ou máis e 10 ou máis prescricións activas crónicas de medicamentos (independentemente da forma farmacéutica), que presentan problemas de incumprimento da terapia ou dificultades para o correcto uso dos medicamentos por déficits de autonomía física ou psíquica, e viven sós/as ou non teñen unha rede de apoio sociofamiliar adecuada para o mantemento dos tratamentos instaurados. Calquera profesional sanitario do Servizo Galego de Saúde, farmacéuticos/as comunitarios/as (de oficina de farmacia) e traballadores/as sociais, poden propoñer a inclusión dos/das pacientes nesta nova prestación. Unha vez detectado o/a paciente susceptible de inclusión, será derivado á/ao súa/seu enfermeira/o ou á/ao súa/seu FAP do centro de saúde. No caso dos farmacéuticos/as comunitarios/as, a derivación acompañarase dun informe xustificativo dos criterios de inclusión, no que poden achegar información pertinente sobre a medicación do/da paciente. 📢Máis información FARMACIA EIRÍN: ✔️Páxina Web: http://www.farmaciaeirin.es/ 📢Máis información COLEXIO DE FARMACÉUTICOS DE PONTEVEDRA: ✔️Páxina Web: https://cofpo.org/ 👉 Máis Información de MULLERES QUE PODEN ✔️Facebook: https://www.facebook.com/profile.php?id=100057202191221 🎙️ "SUSCRÍBETE" ao podcast👍 📢 MÁIS ENTREVISTAS: https://www.ivoox.com/podcast-salta-da-cama_sq_f1323089_1.html 👉Máis Información e outros contidos: ✔️Facebook: https://www.facebook.com/PabloChichas ✔️Twitter: https://twitter.com/pablochichas ✔️Instagram: https://www.instagram.com/pablochichas/ ✔️Clubhouse: @pablochichas ✔️Twich: https://www.twitch.tv/pablochichas

Dr Charlie Andrews talks to Dr John Leeds. John Leeds is a Consultant Pancreaticobiliary Physician and Endoscopist based at the Freeman Hospital in Newcastle and an Honorary Clinical Senior Lecturer based in the Population Health Sciences Institute at Newcastle University. He is involved in research in pancreaticobiliary disorders including benign and malignant conditions as well as outcomes from therapeutic/advanced endoscopy.John is a member of the British Society of Gastroenterology and Pancreatic Society of Great Britain and Ireland. He serves on the endoscopy and Pancreas committees for BSG and is the website lead for PSGBI.He is also a founder member of the BSG Pancreas Clinical Research Group which is coordinating research for the society.Key Learnings from this episode:Challenges in Early Detection of Pancreatic Cancer • Pancreatic cancer is often diagnosed at an advanced stage due to the deep location of the pancreas and the lack of early symptoms. • Tumors in the body and tail of the pancreas can grow significantly before causing symptoms, often invading major arteries or veins, making them inoperable. • Tumors in the head of the pancreas may present earlier due to bile duct obstruction, leading to jaundice, but even these are often detected late. Early Symptoms and Red Flags • Early symptoms are vague or absent, making early diagnosis difficult. • Possible early indicators include: • Weight loss (often a sign of advanced disease). • New-onset diabetes, particularly in individuals with a normal BMI or without typical risk factors for type 2 diabetes. • Jaundice, which is a significant red flag and often indicates a serious underlying condition. • Classic signs like painless jaundice and Courvoisier's sign (palpable gallbladder) are important but not always present. Limitations of Current Screening Methods • There is no reliable biomarker or screening test for pancreatic cancer: • CA19-9 is not suitable as a screening tool due to its lack of specificity (elevated in other conditions). • Imaging techniques like CT scans or MRIs are used but have limitations, including incidental findings that may lead to unnecessary anxiety (“scanxiety”) and over-investigation. • Screening is currently limited to high-risk groups, such as those with familial pancreatic cancer syndromes or hereditary pancreatitis. High-Risk Groups for Screening • Familial pancreatic cancer accounts for less than 10% of cases. Criteria for screening include: • Multiple family members with pancreatic cancer, especially diagnosed under age 50–60. • Genetic syndromes like BRCA mutations, familial adenomatous polyposis (FAP), and Peutz-Jeghers syndrome. • Hereditary pancreatitis patients have an increased risk but are harder to screen due to pre-existing pancreatic abnormalities. Emerging Research and Future Directions • Studies are exploring potential biomarkers, such as microbiome signatures in the pancreas, which might help identify high-risk individuals in the future. • Trials like the EuroPAC study focus on surveillance protocols for high-risk individuals using imaging techniques like MRI or endoscopic ultrasound. • Research into new-onset diabetes as a potential marker for pancreatic cancer is ongoing but currently has a low yield due to the high prevalence of type 2 diabetes unrelated to malignancy. Considerations for Screening and Surveillance • Screening should be carefully targeted to avoid over-diagnosis and unnecessary investigations. • The psychological impact of screening (e.g., anxiety from incidental findings) must be considered. • Smoking cessation is emphasized as smoking is a significant risk factor for pancreatic cancer. Advances in Treatment Approaches • PET-CT scans are increasingly used to detect systemic disease that might not be evident on standard CT scans. • Neoadjuvant treatments (therapy before surgery) are being... Chapters (00:00:00) - Ingest(00:00:53) - Pancreatic Cancer(00:04:03) - New diabetes and pancreatic cancer(00:08:01) - Pancreatic Cancer: Screening(00:15:42) - Determining breast cancer early is hard(00:16:03) - Pulmonary neuroendocrine tumors of the pancreas(00:22:26) - Pancreatic cancer 20, Management(00:29:00) - Pancreatic cancer, management principles(00:33:48) - Primary Care Take Home: Pancreas, pain(00:40:29) - Primary Care: Pancreas Cancer Episode 2

In episode 475 I chat with Nate Gruner and Meaghan Cleary. Nate is a staff behavioural therapist at the obsessive-compulsive disorder institute at McLean hospital. Meaghan is a licensed mental health counselor and a registered dance and movement therapist. She is also a behavioural therapist and group facilitator at the obsessive-compulsive disorder institute at McLean hospital.  We discuss what is functional analytic psychotherapy (FAP), the rules of FAP, using the therapeutic relationship to create change in OCD, what FAP looks like in a session, case examples, the therapist training we are running through the centre I co-run, integrating FAP with exposure and response prevention therapy (ERP) and acceptance and commitment therapy (ACT), why I'm interested in FAP, and much more. Hope it helps.  Show notes: https://theocdstories.com/episode/nate-and-meaghan-475  FAP training for therapists: https://www.integrativecentreforocd.co.uk/live-trainings-therapists/fap-for-ocd The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories Join many other listeners getting our weekly emails. Never miss a podcast episode or update: https://theocdstories.com/newsletter   Thanks to all our patrons for supporting our work. To sign up to our Patreon and to check out the benefits you'll receive as a Patron, visit: https://www.patreon.com/theocdstoriespodcast 

Dr. Navidi specializes in Hypnosis for GI Disorders and is a wealth of information that he shares with us on the podcast.  We talk about: ·       Underlying disorders ·       ARFID ·       How hypnosis works to help people feel better ·       Why some sessions are recorded and some are not ·       Interactive vs receptive hypnosis ·       Advanced hypnosis techniques ·       Apps like Nerva and whether they're helpful   About Dr. Ali Navidi Dr. Ali Navidi is a licensed clinical psychologist, one of the founders of GI Psychology and one of the founders and past president of the Northern Virginia Society of Clinical Hypnosis (NVSCH). Dr. Navidi has been helping patients with GI disorders, chronic pain and complex medical issues for over ten years for Kids, adolescents and adults Patients with Gastrointestinal (GI) Problems Patients with complex medical issues and chronic pain Clinical Hypnosis & Brief Therapy Cognitive Behavioral Therapy (CBT)   Get help through Dr. Navidi's practice for children, adolescents, and adults in the US at https://www.gipsychology.com/   Dr. Liz also offers Gut Directed hypnosis for adults in the US and Internationally. Contact her through her website https://www.drlizhypnosis.com   -------------- Support the Podcast & Help yourself with Hypnosis Downloads by Dr. Liz! http://bit.ly/HypnosisMP3Downloads Do you have Chronic Insomnia? Find out more about Dr. Liz's Better Sleep Program at https://bit.ly/sleepbetterfeelbetter Search episodes at the Podcast Page http://bit.ly/HM-podcast --------- About Dr. Liz Interested in hypnosis with Dr. Liz? Schedule your free consultation at https://www.drlizhypnosis.com Winner of numerous awards including Top 100 Moms in Business, Dr. Liz provides psychotherapy, hypnotherapy, and hypnosis to people wanting a fast, easy way to transform all around the world. She has a PhD in Clinical Psychology, is a Licensed Mental Health Counselor (LMHC) and has special certification in Hypnosis and Hypnotherapy. Specialty areas include Anxiety, Insomnia, and Deeper Emotional Healing. A problem shared is a problem halved. In person and online hypnosis and CBT for healing and transformation.  Listened to in over 140 countries, Hypnotize Me is the podcast about hypnosis, transformation, and healing. Certified hypnotherapist and Licensed Mental Health Counselor, Dr. Liz Bonet, discusses hypnosis and interviews professionals doing transformational work.

Episode 183: Colorectal Cancer in Young AdultsFuture Dr. Avila and Dr. Arreaza present evidence-based information about the screening and diagnosis of colorectal cancer and explain the increasing incidence among young adult and the importance to screen early in high risk groups.  Written by Jessica Avila, MS4, American University of the Caribbean School of Medicine. Edits and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.IntroductionJessica: Although traditionally considered a disease only affecting older adults, colorectal cancer (CRC) has increasingly impacted younger adults (defined as those under 50) at an alarming rate. According to the American Cancer Society, CRC is now the leading cause of cancer-related death in men under 50 and the second leading cause in women under 50 (American Cancer Society, 2024). Arreaza: Why were you motivated to talk about CRC in younger patients?Jessica: Because despite advancements in early detection and treatment, younger patients are often diagnosed at later stages, resulting in poorer outcomes. We will discuss possible causes, risk factors, common symptoms, and why early screening and prevention are important. Arreaza: This will be a good reminder for everyone to screen for colorectal cancer because 1 out of every 5 cases of colorectal cancer occur in adults between the ages of 20 and 54. The Case of Chadwick BosemanJessica: Many people know Chadwick Boseman from his role as T'Challa in Black Panther. His story highlights the worrying trend of increasing CRC in young adults. He was diagnosed with stage III colorectal cancer at age 39. This diagnosis was not widely known until he passed away at 43. His case shows how silent and aggressive young-onset CRC can be. Like many young adults with CRC, his symptoms may have been missed or thought to be less serious issues. His death drew widespread attention to the rising burden of CRC among young adults and emphasized the critical need for increased awareness and early screening efforts.Arreaza: Black Panther became a hero not only in the movie, but also in real life, because he raised awareness of the problem in young AND in Black adults. EpidemiologyJessica: While rates of CRC in older populations have decreased since the 1990s, adults under 50 have seen an increase in CRC rates of nearly 50%. (Siegel et al., 2023). Currently, one in five new CRC diagnoses occurs in individuals younger than 55 (American Cancer Society, 2024).Arreaza: What did you learn about the incidence by ethnic groups? Are there any trends? Jessica: Yes, certain ethnic groups are shown to have higher rates of CRC. Black Americans, Native Americans, and Alaskan Natives have the highest incidence and mortality rates from CRC (American Cancer Society, 2024). Black Americans have a 20% higher incidence and a 40% higher mortality rate from CRC compared to White Americans, primarily due to disparities in access to screening, healthcare resources, and early diagnosis. Hispanic and Asian American populations are also experiencing increasing CRC rates, though to a lesser extent.Arreaza: It is important to highlight that Black Americans have the highest rate of both diagnoses and deaths of all groups in the United States. Who gets colorectal cancer?Risk FactorsJessica: Anyone can get colorectal cancer, but some are at higher risk. In most cases, environmental and lifestyle factors are to blame, but early-onset CRC are linked to hereditary conditions. Arreaza: There is so much to learn about colorectal cancer risk factors. Tell us more.Jessica: The following are key risk factors:Modifiable risk factors:Diet and processed foods: A diet high in processed meats, red meat, refined sugars, and low fiber is strongly associated with an increased risk of CRC. Fiber is essential for gut health, and its deficiency has been linked to increased colorectal cancer risk (Dekker et al., 2023).Obesity and sedentary lifestyle: Obesity and physical inactivity contribute to CRC risk by promoting chronic inflammation, insulin resistance, and metabolic disturbances that promote tumor growth (Stoffel & Murphy, 2023).Gut microbiome imbalance: Disruptions in gut microbiota, especially an overgrowth of Fusobacterium nucleatum, have been noted in CRC pathogenesis, potentially causing tumor development and progression (Brennan & Garrett, 2023).Arreaza: As a recap, processed foods, obesity, sedentarism, and gut microbiome. We also have to mention smoking and high alcohol consumption as major risks factors, but the strongest risk factor is a family history of the disease.Non-modifiable risk factors:Genetic predisposition: Although only 20% of early-onset CRC cases are linked to hereditary syndromes such as Lynch syndrome and familial adenomatous polyposis (FAP), individuals with a first-degree relative with CRC are at a significantly higher risk and should undergo earlier and more frequent screening (Stoffel & Murphy, 2023).Arreaza: Also, there is a difference in incidence per gender assigned at birth, which is also not modifiable. The rate in the US was 33% higher in men (41.5 per 100,000) than in women (31.2 per 100,000) during 2015-2019. So, if you are a man, your risk for CRC is slightly higher. Protective factors, according to the ACS, are physical activity (no specification about how much and how often) and dairy consumption (400g/day). Jessica, let's talk about how colon cancer presents in our younger patients.Clinical Presentation and Challenges in DiagnosisJessica: Young-onset CRC is often diagnosed at advanced stages due to delayed recognition of symptoms. Common symptoms include:Rectal bleeding (often mistaken for hemorrhoids)Young individuals may ignore it, believe they do not have time to address it, or lack insurance to cover a comprehensive evaluation.Unexplained weight lossFatigue or weaknessChanges in bowel habits (persistent diarrhea or constipation)This may also be rationalized by dietary habits.Abdominal pain or bloatingIron deficiency anemia.Arreaza: All those symptoms can also be explained by benign conditions, and colorectal cancer can often be present without clear symptoms in its early stages. Jessica: Yes, in young adults, symptoms may be dismissed by healthcare providers as benign conditions such as irritable bowel syndrome (IBS), hemorrhoids, or dietary intolerance, leading to significant diagnostic delays. Arreaza: We must keep a low threshold for ordering a colonoscopy, especially in patients with the risks we mentioned previously. Jessica: We may also be concerned about the risk/benefit of colonoscopy or diagnostic methods in younger adults, given the traditional low likelihood of CRC. Approximately 58% of young CRC patients are diagnosed at stage III or IV, compared to 43% of older adults (American Gastroenterological Association, 2024). Early recognition and prompt evaluation of persistent symptoms are crucial for improving outcomes. Empowering and informing young adults about concerning symptoms is the first step in better recognition and better outcomes for these individuals.Arreaza: This is when the word “follow up” becomes relevant. I recommend you leave the door open for patients to return if their common symptoms worsen or persist. Let's talk about screening. Screening and PreventionJessica: Due to the trend of CRC being identified in younger populations, the U.S. Preventive Services Task Force (USPSTF) lowered the recommended screening age for CRC from 50 to 45 in 2021 (USPSTF, 2021). Off the record, some Gastroenterologists also foresee the USPSTF lowering the age to 40. Arreaza: That is correct, it seems like everyone agrees now that the age to start screening for average-risk adults is 45. It took a while until everyone came to an agreement, but since 2017, the US Multi-Society Task Force had recommended screening at age 45, the American Cancer Society recommended the same age (45) in 2018, and the USPSTF recommended the same age in 2021. This podcast is a reminder that the age of onset has been decreased from 50 to 45, for average-risk patients, according to major medical associations.Jessica: For individuals with additional risk factors, including a family history of CRC or chronic gastrointestinal symptoms, screening starts at age 40 or 10 years before the diagnosis of colon cancer in a first-degree relative. Dr. Arreaza, who has the lowest and the highest rate of screening for CRC in the US? Arreaza: The best rate is in Massachusetts (70%) and the lowest is California (53%). Let's review how to screen:Jessica: Recommended Screening Methods:Colonoscopy: Considered the gold standard for CRC detection and prevention, colonoscopy allows for identifying and removing precancerous polyps.Fecal Immunochemical Test (FIT): A non-invasive stool test that detects hidden blood, recommended annually.Stool DNA Testing (e.g., Cologuard): This test detects genetic mutations associated with CRC and is recommended every three years.Arreaza: Computed tomographic colonography (CTC) is another option, it is less common because it is not covered by all insurance plans, it examines the whole colon, it is quick, with no complications. Conclusion:Colorectal cancer is rapidly emerging as a serious health threat for young adults. The increase in cases over the past three decades highlights the urgent need for increased awareness, early symptom detection, and proactive screening. While healthcare providers must weigh the risk/benefit of testing for CRC in younger adults, patients must also be equipped with knowledge of concerning signs so that they may also advocate for themselves. Early detection remains the most effective tool in preventing and treating CRC, emphasizing the importance of screening and risk factor modification.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:American Cancer Society. (2024). Colorectal Cancer Statistics, 2024. Retrieved fromhttps://www.cancer.orgAmerican Gastroenterological Association. (2024). Delays in Diagnosis of Young-Onset Colorectal Cancer: A Systemic Issue. Gastroenterology Today.Brennan, C. A., & Garrett, W. S. (2023). Gut Microbiota and Colorectal Cancer: Advances and Future Directions. Gastroenterology.Dekker, E., et al. (2023). Colorectal Cancer in Adolescents and Young Adults: A Growing Concern. The Lancet Gastroenterology & Hepatology.Siegel, R. L., et al. (2023). Colorectal Cancer Statistics, 2023. CA: A Cancer Journal for Clinicians.Stoffel, E. M., & Murphy, C. C. (2023). Genetic and Environmental Risk Factors in Young-Onset Colorectal Cancer. JAMA Oncology.U.S. Preventive Services Task Force. (2021). Colorectal Cancer Screening Guidelines.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

BELIEVING IN HOPE WITHOUT COMPROMISE. Dr Virgilio Sacchini is dedicated to caring for people with breast cancer at the Memorial Sloan Kettering Cancer Center in New York. He originally trained at Universita degli Studi di Milano (UNIMI, Milan, Italy) where he is Professor of Surgery, and cooperates with the European Institute of Oncology in Milan (IEO, Milan, Italy). Dr Sacchini is a 2023 and 2024 Castle Connolly America's Top Doctor, the peer nominated group of the top 7% of all US practicing physicians. His goal is to achieve the best possible cancer outcomes and cosmetic results for his patients. “The new concept is to target only cancer cells.” “To cure someone and give him or her a miserable life is terrible, so the target in this moment is both better survival and better quality of life, less side effects.” “Once we prove that the combination of the medication with the Avacta technique works, of course it is approved and you can be cured everywhere in the world.”

Dear men!Discover the transformative power of chastity as I challenge the norms of routine stress-relief mechanisms like porn addiction and masturbation. Join me, Chastity Queen, on this journey of self-reflection and empowerment, where we question whether these habits still add value to our lives or if they have become dull, repetitive chores. Learn how adopting chastity can lead to greater mindfulness, self-awareness, and a revival of excitement in your daily routine. Embark on a guided meditation that encourages you to reexamine your habits, explore their psychological and emotional roots, and consider new, healthier coping strategies. Together, we will navigate the boundary between routine and spontaneity, revealing surprising insights into your desires and stress-relief methods. This episode isn't just about restriction; it's about rediscovering freedom and joy in new ways. Join the conversation, redefine your boundaries, and embrace a lifestyle that serves your growth and happiness.Ultimately, I love seeing you happy!Chastity QueenTry to connect with your local BDSM community. Fetlife is a great way to see others in similar FLR and chastity lifestyles. You can check out Mine in Fetlife at Chastity-Queen. It's a free to join. Hugs, Chastity Queen Locked In Lust 15% OFF:CHASTITYQUEEN Use Discount Code:CHASTITYQUEEN for 15% OFF ANYTHING at www.lockedinlust.com LOVE SHOP 15% OFF Sex Toys & MORE Get 15% OFF sex toys, lingerie and more, using PROMO CODE: CHASTITY QUEEN Buzzsprout - Let's get your podcast launched!Start for FREE15% OFF Shoe Freaks-PROMO%CHASTITYQUEEN GET your 15% OFF ANYTHING when you buy SEXY Shoes, heels & Stripper Boots at Shoe Freaks Canada!www.SMBSM.com - Chastity Cages 10% OFFGet reasonably priced chastity cages, chastity belts, chastity wear, + chastity accessories.Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the showhttps://www.linktr.ee/ChastityQUEEN

So that's how FAP does it. They compromise someone with an under age girl, that doesn't look it and they turn him into a snitch. - Phil Get weekly bonus content on our Patreon: www.patreon.com/kingmepod Email us at kingmepod@gmail.com

Historias de armamentos: Los EEUU nos donaron helicópteros (y en esta donación no se paga nada). La PNP tiene vehículos –donados y comprados– inservibles. Y la FAP comprará sí o sí aviones caza. MIENTRAS TANTO: La extraña mu3rt3 del policía descuartizador. Un video grabado por la propia PNP demuestra que los colegas del as3sin0 contaminaron la escena del crimen. Estos son los detalles. ADEMÁS: Lozano sale libre... pero se revelan los chats con su "presidente" Acuña. Y... ¿Necesitas un equipo de grabación para tu evento? ¿O quieres ir a una obra de teatro, a la presentación de un libro? Aquí tienes unas alternativas. **** Mira aquí la película “Rosa Chumbe”, dirigida por Jonatan Relayze https://www.tokyvideo.com/es/video/rosa-chumbe-2015-pelicula-completa **** ¿Te gustó este episodio? ¿Buscas las fuentes de los datos mencionados hoy? SUSCRÍBETE en http://patreon.com/ocram para acceder a nuestros GRUPOS EXCLUSIVOS de Telegram y WhatsApp. También puedes hacerte MIEMBRO de nuestro canal de YouTube aquí https://www.youtube.com/channel/UCP0AJJeNkFBYzegTTVbKhPg/join **** Únete a nuestro CANAL de WhatsApp aquí https://whatsapp.com/channel/0029VaAgBeN6RGJLubpqyw29 **** También estamos en TokyVideo https://www.tokyvideo.com/user/marcosifuentes/videos **** Para más información legal: http://laencerrona.pe

JCO PO author Dr. Michael J. Hall, Professor of Medicine, Chairman of the Department of Clinical Genetics, and Co-Leader of the Cancer Prevention and Control Program at Fox Chase Cancer Center in Philadelphia, PA, shares insights into the JCO PO article, “Uptake of aspirin chemoprevention in patients with Lynch Syndrome.” Host Dr. Rafeh Naqash and Dr. Hall discuss the finding that only about 1 in 3 patients with Lynch Syndrome use aspirin for cancer chemoprevention. TRANSCRIPT  Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash podcast editor for JCO Precision Oncology and Assistant Professor at the OU Health Stephenson Cancer Center at the University of Oklahoma. Today, I'm excited to be joined by Dr. Michael J. Hall, Professor of Medicine, Chairman of the Department of Clinical Genetics and co-leader of the Cancer Prevention and Control Program at the Fox Chase Cancer Center in Philadelphia, and also the lead author of the JCO Precision Oncology article entitled, “Uptake of Aspirin Chemo Prevention in Patients with Lynch Syndrome.” At the time of this recording, our guest disclosures will be linked in the transcript. Dr. Hall, welcome to the podcast and thank you for joining us today to explain and help the listeners understand your interesting research that was just published in JCO Precision Oncology. Dr. Michael J. Hall: Thank you so much for having me and really thanks for the interest in our work. I think it's an important subject and I hope people will also find it as interesting as we do. Dr. Rafeh Naqash: Absolutely. I think your research touches upon a few things. One, obviously, touches upon Lynch syndrome germline assessments of individuals. It also touches upon chemo prevention, prevention in general, and it also touches upon the knowledge and understanding of chemo prevention aspects. So to start off, I would like to ask you, for the sake of our listeners, many of whom who may not necessarily fully understand the length and breadth of Lynch syndrome, maybe perhaps some residents or trainees out there, could you tell us what Lynch syndrome is, what some of the mutations are, what the implications are, and then we can try to go and delve more into the research topic. Dr. Michael J. Hall: Sure, I'd be happy to. Lynch syndrome is probably, in the hereditary cancer genetics world, one of the most common hereditary risk syndromes we encounter. Recent estimates are that probably roughly about 1 in every 280 individuals in the population is a carrier of a pathogenic variant, one of the Lynch syndrome genes, there are roughly four. There's sort of a fifth gene that is also involved with Lynch syndrome, but really, we largely think about four genes in Lynch syndrome, MLH1, MSH2, MSH6, and PMS2. Over time we've begun to learn, and I'll say that the guidelines that we develop have become more specialized for each of those genes. They are not sort of all the same in the cancers they cause and the way they behave. But roughly, what is Lynch syndrome? It's a syndrome of DNA mismatch repair. So, individuals who have Lynch syndrome have some degree of deficiency in their ability to repair DNA via the mismatch repair system. Depending on the pathogenic variant that is within a family, that may be related to a more severe deficiency of mismatch repair, repair, editing, or for instance, with the PMS2 gene, we've learned over time that actually the degree of DNA repair deficiency is actually a milder phenotype. These individuals over a lifetime are at risk of a variety of different kinds of cancers, the most common being colon cancer. And the risk of that is variable by gene. With MLH1 and MSH2, it's close to 50% over a lifetime. With MSH6 and PMS2, somewhat lower. There are also risks of endometrial cancer, gastric cancer, ovarian cancer, pancreas cancer, a number of other ones. But they're all related again to the same underlying molecular deficiency, and that's this deficiency of being able to repair mistakes made in the DNA accurately. And so, mutations accumulate in the genome of cells in various tissues of the body. Dr. Rafeh Naqash: Thank you for that very simplified version of a very complicated topic otherwise. So, as you mentioned, these different genes have different implications. Perhaps some have higher risks for colorectal cancer than others. What are some of the current standardized approaches for screening or following these individuals over the course of their journey until perhaps either get detected with cancer or while they're being monitored? Dr. Michael J. Hall: Sure. It's a great question, because this is very much a moving target in this disease. I'm going to give you a quick second of history that up until maybe about six or seven years ago, we had uniform guidelines, really, that any Lynch syndrome pathogenic variant carrier should start colorectal cancer screening. Usually, we were recommending between the age of 20 and 25, and this was usually annual colonoscopy. And for years that was the standard. In more recent years, we've stuck to that tight interval, particularly in the higher risk genes, MLH1 and MSH2, although the guideline now reads every one to two years, because we recognize people need some degree of flexibility to live their lives. And there are people in the population who are more risk averse, and there are those who want a colonoscopy every year because they want to stick to that schedule. For MSH6, we recommend a somewhat later start at age 30, and that can be every one to three years for colon screening and for PMS2, similar recommendations, although I think there is a chance in the coming years, we may actually expand the screening interval even more, again, because the risks are somewhat lower. We still have ways to go in terms of screening for the other cancers in Lynch syndrome. I'll say that, for instance, endometrial cancer, which is the second most common cancer in this disease, we still struggle with what is the best way to screen women for a risk of endometrial cancer. Our guidelines in the past were always somewhat draconian, that once women sort of finish childbearing, they should immediately have a total abdominal hysterectomy and oophorectomy. And I'll say that with greater input from the gynecologic and GYN ONC community, we have somewhat softened those recommendations, especially for the endometrial cancer and also the age at oophorectomy, because we recognize that there were compensatory risks of taking the ovaries out too early in some women, risks of bone loss and cardiovascular disease. So those are the most common. For other tumors in Lynch syndrome, for instance, gastric cancer and pancreas cancer, the guidelines are still really evolving, and different groups have put out guidance for clinicians. And I'll say NCCN, which I participate in and help write those guidelines, has very good recommendations for docs. But I'll say that it is again, back to the idea that it's a moving target. And as we learn more, hopefully, we'll have better recommendations. Dr. Rafeh Naqash: I completely agree as far as a moving target is concerned, and we often look at the disconnect between the recommendations and then what's implemented or followed in the real-world setting. So I have a question in that context, and my question is, when you identify these individuals with Lynch syndrome, perhaps let's talk about academic settings, and then we can try to delve into how this might work in the real world community oncology settings, where the real world population actually exists, 60, 70% of individuals get treated in the community. So, when you talk about an academic center, what is the flow of the individual? Does the individual stay within the geneticist when they're diagnosed? Does the individual go to the primary care and the geneticist makes the recommendation and the primary care follows the recommendation? How does it work for you and what are some of the models that you've seen work best perhaps at different academic centers? Dr. Michael J. Hall: I think you get at a really great question. And I'll say there is really no one model. And I think models have to be fluid these days because people with Lynch syndrome are really being identified in more and more diverse settings, and by diverse means. I'll say at my own center, we are more of a traditional practice. So, we do the pre-test and the post-test counseling. Once we have counseled individuals identified Lynch syndrome, we will usually make referrals. If folks don't have a gastroenterologist that they have interacted with before, we keep them in our own group and follow them. But their Lynch syndrome home really sits both in a continuity clinic that I run for patients to come back and circle around every one to two years just to review guidelines and review their screening results. However, I do really make an effort to, first of all, keep primary care docs involved, because I think some of the things we recommend, it is critical that the primary care doc is aware so that patients are keeping up with some of the recommendations. For instance, we often recommend skin screening to make sure that folks have had at least one good skin exam somewhere in the 40s. And I think the primary care doc can be very helpful in making sure that happens. It is somewhat different, I think, in the community where many more patients with Lynch syndrome are being identified these days. I suspect that much more of the burden of making sure Lynch syndrome patients are well hooked in with a gastroenterologist and with a dermatologist and maybe a urologist probably does fall on that primary care doctor. In my experience, some primary care physicians have really kind of jumped up in and taken hold of this and really know their Lynch syndrome well, and I think that's amazing. I do, however, as kind of an expert in this area, I do get a lot of referrals in from the community as well, from docs who just feel that they may not have quite that expertise that they can get at a comprehensive center. So, someone may come in to me just for a consult to review what my recommendations would be, hear about research, hear about what's going on in the field, and those folks will often touch base with me again every couple year or so. Often, another thing I've started to experience is that I may meet people once or twice early on in their diagnosis, and then they go back to their primary docs and I may not hear from them again until something more profound happens in the family or into the patient and they get their screening colonoscopy and a stage 1 cancer is found. Often then, that's the patient who, after four or five years, will contact me again and say, “We haven't talked in a while, but something has happened, and can we re-consult about what would be the best way to do things?” Dr. Rafeh Naqash: Again, like you said, lots of moving targets, moving aspects to this whole care of these individuals. Do you think, in your experience, nurse navigation, maybe some centers have already implemented that perhaps you might have that, do you think nurse navigation could play a certain level of role? You know how in the multidiscipline care we have nurse navigators that coordinate care between radiation oncologists, medical oncologists, thoracic surgeons. So that's something that is being implemented. My second part of that question is telehealth in this case, maybe it's a little more difficult for somebody to drive three hours to come to you for a visit just to check in versus maybe virtually talking to you or your team getting a sense of where things are at in terms of their screening and their follow ups. Dr. Michael J. Hall: I think both are great, great questions and absolutely, we use both of those pieces in our model. And I know from colleagues that they do as well. So, in terms of navigation, we do have an embedded nurse navigator within our department. She joins and kind of helps facilitate all of our high risk follow up clinics. Mine, for GI, we have a high-risk prostate clinic, we have several high-risk breast clinics and those are populated by providers. We have a couple of nurse practitioners in my genetics group and a PA they are sort of the main provider in those clinics, but they are very much supported by that nurse navigator who, as you well point out, really helps with the coordination of the care. Telehealth as well, I do 100% support because you're absolutely right, if you look at a map of the United States and you first of all look at where there are good counseling services available, of course, there's ample counseling in the major metropolitan areas all over the U.S., but the minute you get outside of those counseling and then other management expertise, then– So we do have a model where particularly for folks who are from central Pennsylvania and sometimes more towards western Pennsylvania, I do have some individuals who've been identified with Lynch syndrome who telehealth in, again, for that follow up. A sort of side notes on telehealth, I think we learned a lot from the pandemic about how to use telehealth more effectively. And thank goodness, we've all gotten up to speed in medicine of how to be better telehealth providers. Unfortunately, I feel like with the pandemic kind of waning, there's been a little bit of a regression of the telehealth laws. So now if I want to do telehealth with someone who is from New Jersey, even though New Jersey sits very close to where I practice, it's more complicated now. Again, I have to get a license and same thing with New York and same thing with Delaware. I sort of wish we had a little bit of a better and welcoming system in the states where you could have easier ability to practice, especially when states were quite close using telehealth. But nonetheless, that's for another podcast, I think. Dr. Rafeh Naqash: Well, thank you again for some of those interesting aspects to this whole topic. But let's dive into the thing that we are here to talk about, which is aspirin in these individuals. So can you give us some context of why aspirin, what's the biology there and what's the data there, and then talk about why you did what you did. Dr. Michael J. Hall: So, we've known for many years that aspirin has preventive properties in terms of preventing colorectal cancer. Many observational studies and some interventional studies have shown us that aspirin has benefits for reducing the risk of colon cancer in an average risk population. There was even an interventional trial a number of years ago that looked at individuals who made polyps, and this looked at particularly adenomas, which we know are the precancerous polyps and adenoma prevention using aspirin. And that study clearly showed that aspirin had benefits for lowering risk of recurrent polyps and adenomas. Particularly even a lower dose of aspirin, 81 milligrams, was effective in that setting. Aspirin's also been studied in other hereditary risk syndromes, the most visible one being FAP, where data have shown that aspirin does help reduce polyp count in FAP, although is certainly not a perfect chemo prevention for that disease. So, in that background of knowing that aspirin has many benefits for colorectal cancer prevention, a study was initiated in the UK a number of years ago called the CAPP2 study, with its lead investigator being John Burn. And in this study, it was a two-arm factorial study that was not just aspirin, but they were also looking at resistant starch, which there was a lot of excitement about resistant starch back then. But in this study, they looked at using aspirin as a way of lowering risk of colorectal cancer in patients with Lynch syndrome. And that study, which was initially reported in The New England Journal, the initial outcomes did not actually show benefits in its first analyses of adenoma risk and colon cancer risk. But what they found over time was that there was a delayed effect and, in a follow, up paper looking at 10 plus years of follow up, they showed a substantial reduction in risk of colon cancer, about 40% risk reduction, which was really striking and exciting in the field to see such a large benefit from aspirin. Now, one caveat was in the analyses they performed, it was those individuals who were able to stick to the aspirin dose in that study, which was 600 milligrams a day. I always say to folks that back in the day, that was not a lot of aspirin, although I think these days we're much more skeptical about taking larger doses of any drug. So, 600 milligrams is roughly about two adult aspirin in the U.S. So those folks who were able to stick to that dose for at least two years were the ones who gained benefit from being on aspirin. And what was interesting is that benefit endured for really 10 years after those two years of being able to take aspirin. So, this was striking and it really changed our thinking about whether there may be chemo prevention options for folks with Lynch syndrome. However, and I think what formed the background of our study here was that there was a somewhat equivocal endorsement of aspirin by the major guidelines committees, mainly because, as we all know in oncology, we love one first big study, but we always really love secondary studies that solidify the finding of the first study. And so, because this was such a niche group and no one else out there was doing big aspirin studies when this result came out in 2011, we've sort of been waiting for many years for some follow up data. And the NCCN guidelines have always been a little bit equivocal that people could consider using aspirin to lower risk in their patients with Lynch syndrome, but without that kind of strong, “Everyone should do this.” And so, this has kind of formed the background of why we performed the study that we did. Dr. Rafeh Naqash: Interesting. And then you had a bunch of observations. One of the most important ones being that use of aspirin was pretty low. Could you dive into that and help us understand what were some of the factors surrounding those low implementation aspects? Dr. Michael J. Hall: Of course. So, what we were interested in then again in that background was, here's a high-risk population, docs are getting somewhat maybe ambiguous information from the guidelines, but what actually is going on out there in practice? How many patients are actually using aspirin? What doses are they using, and what are some of the factors that drive it? So, we performed a survey that actually occurred in two parts. One started at Fox Chase in our population here, and then we expanded it online to a convenience sample. Overall, we had 296 respondents. And yeah, what we found actually was the uptake of aspirin was only about roughly 30%, 35% or so among patients who were eligible to take aspirin. When you actually drill down to those people actually taking aspirin because they wanted to prevent Lynch syndrome, it was even lower. It was in the range of 25% to 30%. This somewhat surprised us. And then when we looked at the doses that people were using, of course, thinking back to that 600-milligram dose that was tested in the study, we found actually that more than half of folks were taking low dose aspirin, like an 81 milligram, and only about 8% of our study participants were using that 600-milligram range. So, again, I would say this somewhat surprised us because we thought it might be higher than this. I'll say as a somewhat caveat to this though, is that back to my comment about we always like another study that confirms our findings, and at a meeting earlier this year, there was a study performed in a New Zealand population by a medical oncologist named Rebecca Tuckey. And she actually found almost the same identical results that we did in the New Zealand population - very, very similar uptake rates of aspirin in the New Zealand population with Lynch syndrome, so kind of confirming that something we've stumbled upon appears to be true. But how do we understand why some folks use aspirin and why others don't in this condition? Dr. Rafeh Naqash: You had a very robust question there from what I saw in the paper. And some of the questions that I had around that was, did you or were you able to account for demographics, education level of the individuals? Were you also able to assess whether these individuals felt that they had been counseled appropriately when they met with either a primary care physician or of any provider on the genetic side, physician or non-physician? So how did you get an assessment of whether it was an apples-to-apples comparison or were there a lot of confounders. Dr. Michael J. Hall: Very good question. And of course, in the setting, unfortunately, we weren't interviewing people, which we could have gotten much richer data in some ways. And there were other things we were looking at in this survey as well, so our aspirin questions, we had a number of them, but perhaps in retrospect, it would have been nice to even have more. We did have some common covariates, age, sex, ancestry, marital status, which gene was affected, whether they had a history of cancer. We did not have education, unfortunately. And I think your question is a great one, but we did not actually ask folks about whether they had been counseled by their provider or their genetic counselor or someone else about whether they should use aspirin or not. We simply wanted to see whether folks were using it. We did ask them again whether they were using it because they wanted to lower their risk of a Lynch syndrome cancer or whether they were using it for another reason or a combination of both. So, yes, in retrospect, we actually do have another study plan to kind of drill deeper into these questions of is it more of a hesitancy question? Is it more of a question of just not as much awareness? Are there other reasons? I think there's a lot to answer, and I think answering these questions is really important because we both want to make sure we're talking about interventions that we think can help people, but we need to understand also some of the barriers they may face. And if people do have barriers to some forms of chemo prevention or I think about some of the vaccine research that's going on right now, if the kinds of things that we're working on to develop are actually not going to be palatable to the patient, the population, then I think we kind of need to step back and say we need to maybe understand what people want so that we can have a good meeting of what's going to work and what's going to fit the needs and lifestyles of our patients. Because these are things they might have to do for many, many years and starting maybe even in their 20s or 30s. So, it makes a difference. Dr. Rafeh Naqash: From what you learned in the study, are you thinking of any subsequent interventional approaches, whether they involve a simple phone call to the patient regularly or perhaps, even though I'm not a big fan of EMR prompts, like an EMR prompt of some sort, where they talk, where they're instructing the provider, whoever is seeing the patient physician or the APP or the geneticist that, “Hey. Did you counsel the patient?” And its sort of a metric how in the oncology side they say, “Well, your metric is you should stage all patients and you should talk about toxicities from a reimbursement standpoint and also from a quality improvement metric standpoint. “Is that something you're thinking of? Dr. Michael J. Hall: 100%. So, when we looked at the barriers, many of the kind of the things that were the strongest predictors of who used aspirin versus who didn't were really patients' perceptions of whether aspirin would cause side effects or whether aspirin would be burdensome to take on a daily basis, also, just how much benefit they thought would come from taking aspirin. So, I think there's, number one, I think an intervention and our next delve into this as an interventional study would be both education about the delta prevention benefit that you get from aspirin, the safety profile of aspirin, which is really quite excellent. And also, I think the data that are so important that in this study by Burn et al, it was actually only two years of intervention that then paid off for 10 years down the line, right? So, I think that's important. The other thing that we actually learned as an aside in this study was actually the kind of intervention that patients wanted the most was actually not a drug and was not a vaccine and was not another kind of special scope to stick somewhere. What they actually were most interested in were interventions related to diet. People really see diet as being an important part of health, or I should say diet and nutrition. And so, I think a subsequent study would perhaps wed both a nutritional intervention of some kind with a chemo prevention in some sort of time limited fashion, so that folks felt like they were both focusing on something that was more important to them, but also, something that was related to the study that we wanted to look at. So that's kind of my idea of where we're going to go in the future with this. Dr. Rafeh Naqash: Excellent. Sounds like the next big RO1 for your group. Dr. Michael J. Hall: Let's hope so. Dr. Rafeh Naqash: Well, I hope the listeners enjoyed talking about the science and learning about aspirin Lynch syndrome. The last couple of minutes are about you as an individual, as an investigator. Can you tell us what your career journey has been like, how you ended up doing what you're doing, and perhaps some advice for early career junior investigators on what this whole space looks like and how you pace yourself and how they can learn from you? Dr. Michael J. Hall: I really got interested in oncology during my residency training. I really found that I really liked oncologists. I found them to be a bit more of a science focused group. They liked research, but you're in oncology because you understand the fears and the challenges of cancer. And so, it's both a combination of that love of science, but also that real human touch of taking care of people. The thing I always tell my fellows as well is the other thing I love about oncology is if you tell people they don't have cancer, they don't want to come back to you. Now, of course, that's modified in the prevention setting. But I really like that when people come to me in my GI oncology clinic, it's because they have a diagnosis and if I say you actually don't have cancer, they go off to their life, and so you're really spending your time on real subjects. The person who really got me most interested in Lynch syndrome and this kind of prevention research was a mentor from University of Chicago, Funmi Olopade, who really has been an enormous mentor for many, many people in the field. Actually, three people in my fellowship class all went on to careers related to genetics and genomics. So, she's been highly influential and continues to mentor me even in my mid-career. I think in terms of pearls or what keeps this interesting for me, I think as much as oncology treatment and new drugs and trials is super exciting, I love being able to step away from that into my genetics and prevention population and kind of focus on treating people in a different format. Patients who are healthy but are worried about cancer because of a family history or carrying a gene or otherwise, and I feel that that's where I can have also an important impact, but on a different level in educating people and helping them understand how genetics works in an understandable and simple way, but also giving them some tools. And one reason for this study, and the reason I study preferences related to prevention is, again, I don't want to just develop something and spend 10, 15 years of my life developing some intervention that everyone looks at and is like, “I don't really want to do that.” I want to really understand what it is that is important to the patients so that we can hopefully work together to develop things that can not only have impact but have impact on a wide scale. Dr. Rafeh Naqash: Awesome. You mentioned Dr. Olopade. I crossed paths with her actually at an international medical graduate community of practice session earlier this year at ASCO where she talked about her journey as an immigrant, talked about how she started, the kind of impact that she's had. It was obvious evident in the picture that she showed with all her mentees who have kind of gone all over the world. So that was very phenomenal. And it's surprising how small of a world we live in. Everybody knows everybody else. Dr. Michael J. Hall: It's crazy. More so than anyone I think I've met in my career; she is really a huge believer in mentorship and spending that extra time with your mentees. And she has been someone who has continued to promote me as an investigator and build me up and get me involved in things. And like I said, I've been in oncology now for quite a few years. But having that person who I think is always thinking about their trainees and people who have learned and grown under them, because what it does is it gives you that fire as well as an investigator to do the same thing for the people that you are a mentor for and train. So, I try to be just as good of a mentor to my genetic counselors and the fellows who come through me and my APPs to give them opportunities to get them excited about research and when they have these big moments to do that. So, yeah, I know Funmi just has had a huge impact on the field of genetics. I still remember some of our early conversations on the wards when she said to me, “Oh, this is such an interesting case. We don't really have anyone who's studying Lynch syndrome so much right now and you should really get into this area.” And I remember thinking, “Okay, I want to develop a niche and here's a niche that's waiting.” Dr. Rafeh Naqash: Clearly it paid off big time and you're paying it forward with your mentees. So, thank you again for joining us. This was an absolute pleasure. Hopefully, the listeners learned a lot about the science and also your journey and how you're trying to impact the field. Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcasts   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinion, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement.      

Bienvenidos a un nuevo episodio del podcast de Al Corte, hoy tenemos con nosotros a Nico de Skin Cars Custom, un referente en España de los trabajos de tapicería y interior de coches, hablaremos de los acabados en los coches, de qué coches están mejor hechos y las locuras que piden los clientes para sus coches, si te gustan el motor y disfrutas de nuestras charlas quédate a pasar un rato con nosotros y SUSCRÍBETE!! #coches #porsche #acabados #asientos #volantes #bentley #podcast #alcorte Mira también:

How long were we off since the last episode? When did we first start recording Fetch a Pail? Is it Bad Rap or Bad Rep, or either? MDITF? Is gazpacho the only other cold soup? Is coffee soup? Is hottub soup? All these questions and more were written down hastily as Jill edited the episode but none of them are answered in this week's FAP. Tune in to find out why she asked them, but not what the answers are! It's like Jeopardy except instead of the questions being answers and the answers being questions, everything is just questions. Is questions soup? Email questions to fetchapailpodcast@gmail.com  Follow us on Instagram: https://instagram.com/fetchapail

FAP-301 Aesthetica of a Rogue Hero - That PLOT is really something with #TokyoTreat In this episode, we dive into the chaotic world of "Aesthetica of a Rogue Hero." With its wild plot and unconventional power scaling, this anime takes the isekai genre in a fresh direction. Did it hit the mark or miss it completely? Tune in to find out! Next Up: "Love Tyrant" Got thoughts on this or past selections? Share them with us! We'd love to hear your opinions or get suggestions for future picks. Submit your feedback here! Deals for Our Listeners: CrunchyRoll: Get 15% off your first order! TokyoTreat: Use code "FEATUREDANIME" for $5 off your first box! Our Merch Store: Show your support with exclusive merch! Watch Anytime, Anywhere! Stream your favorite anime with Crunchyroll. Start Your Free Trial Support Us on Patreon Enjoy bonus content and ad-free episodes by joining our Patreon community. Become a Patron Connect with Us: Anime List: Check Out Our Rankings Twitch: Join our live discussions every Monday at 10pm EST Discord: Be part of our community! Twitter: @ThoseAnimeGuys Facebook: Featured Anime Podcast Contact Us: Email: info@featuredanimepodcast.com Website: www.featuredanimepodcast.com About "Aesthetica of a Rogue Hero" Producers: Genco, Lantis, Media Factory, AT-X, Showgate Studio: Arms Aired: July 2012 - September 2012 Genres: Action, Fantasy, Ecchi, Harem, Isekai Source: Light Novel Episodes: 12 Our Ratings: Jack: 5/10 Rick: 6/10 Don't forget to follow us for more anime reviews and discussions. See you next episode! --- Support this podcast: https://podcasters.spotify.com/pod/show/featuredanimepodcast/support

This week, we stick the butter fork up the anal ca-nay-nal, FAP our way through "You All Everybody," and Lacy is a Debby Downer Bomb Dropper - get ready! Email us here (it may make it onto a video pod!) --- https://www.spacebearmedia.com/contact All our other links! --- https://linktr.ee/spacebearmedia *PLEASE RATE & REVIEW!*

This week we wrapped up Trigun Stampede and just like we thought, we enjoyed the last 6 episodes more, me much more and Artsy a little more! The breakdown Knives and Vash's history was done well, and finally seeing Vash stand up for himself was very enjoyable to see. There was loss, some triumph, and some big cliffhangers/callbacks to characters from Trigun 98. Next week we have a recommendation from Jack from FAP! Join us for No Game No Life!Want to join us live? Head over to twitch.tv/crazyjam where we live record each episode Wednesday night at 8:30 pm EST! If you want to recommend an anime to us, please use the following linktree to see our “recommend us an anime!” page and also every other way to interact with us! https://linktr.ee/xAnimeAnonymousxRatings:Artsy:9/10Cj:7/10 Hosted on Acast. See acast.com/privacy for more information.

Guest: Brianna Cagle The Discovery Team at Perspective has developed a compound, called PSV-359, which is a cyclic peptide radiopharmaceutical. It targets a protein, called fibroblast activation protein (FAP), which is a pan-cancer target and is expressed in a wide variety of cancers. To learn more about her presentation from SNMMI 2024, hear from Brianna Cagle, Research Scientist at Perspective Therapeutics in Iowa.

Listen to Lois Houston and Nikita Abraham, along with Senior Principal Product Manager Wes Prichard, as they explore the five core components of OCI AI services: language, speech, vision, document understanding, and anomaly detection, to help you make better sense of all that unstructured data around you.   Oracle MyLearn: https://mylearn.oracle.com/ou/learning-path/become-an-oci-ai-foundations-associate-2023/127177   Oracle University Learning Community: https://education.oracle.com/ou-community   LinkedIn: https://www.linkedin.com/showcase/oracle-university/   X (formerly Twitter): https://twitter.com/Oracle_Edu   Special thanks to Arijit Ghosh, David Wright, Himanshu Raj, and the OU Studio Team for helping us create this episode.   --------------------------------------------------------   Episode Transcript:   00:00 The world of artificial intelligence is vast and everchanging. And with all the buzz around it lately, we figured it was the perfect time to revisit our AI Made Easy series. Join us over the next few weeks as we chat about all things AI, helping you to discover its endless possibilities. Ready to dive in? Let's go! 00:33 Welcome to the Oracle University Podcast, the first stop on your cloud journey. During this series of informative podcasts, we'll bring you foundational training on the most popular Oracle technologies. Let's get started! 00:46 Nikita: Welcome to the Oracle University Podcast! I'm Nikita Abraham, Principal Technical Editor with Oracle University, and with me is Lois Houston, Director of Innovation Programs. Lois: Hi there! In our last episode, we spoke about OCI AI Portfolio, including AI and ML services, and the OCI AI infrastructure. Nikita: Yeah, and in today's episode, we're going to continue down a similar path and take a closer look at OCI AI services. 01:16 Lois: With us today is Senior Principal Product Manager, Wes Prichard. Hi Wes! It's lovely to have you here with us. Hemant gave us a broad overview of the various OCI AI services last week, but we're really hoping to get into each of them with you. So, let's jump right in and start with the OCI Language service. What can you tell us about it? Wes: OCI Language analyzes unstructured text for you. It provides models trained on industry data to perform language analysis with no data science experience needed.  01:48 Nikita: What kind of big things can it do? Wes: It has five main capabilities. First, it detects the language of the text. It recognizes 75 languages, from Afrikaans to Welsh.  It identifies entities, things like names, places, dates, emails, currency, organizations, phone numbers--14 types in all. It identifies the sentiment of the text, and not just one sentiment for the entire block of text, but the different sentiments for different aspects.  02:17 Nikita: What do you mean by that, Wes? Wes: So let's say you read a restaurant review that said, the food was great, but the service sucked. You'll get food with a positive sentiment and service with a negative sentiment. And it also analyzes the sentiment for every sentence.  Lois: Ah, that's smart. Ok, so we covered three capabilities. What else? Wes: It identifies key phrases in the text that represent the important ideas or subjects. And it classifies the general topic of the text from a list of 600 categories and subcategories.  02:48 Lois: Ok, and then there's the OCI Speech service...  Wes: OCI Speech is very straightforward. It locks the data in audio tracks by converting speech to text. Developers can use Oracle's time-tested acoustic language models to provide highly accurate transcription for audio or video files across multiple languages.  OCI Speech automatically transcribes audio and video files into text using advanced deep learning techniques. There's no data science experience required. It processes data directly in object storage. And it generates timestamped, grammatically accurate transcriptions.  03:22 Nikita: What are some of the main features of OCI Speech? Wes: OCI Speech supports multiple languages, specifically English, Spanish, and Portuguese, with more coming in the future. It has batching support where multiple files can be submitted with a single call. It has blazing fast processing. It can transcribe hours of audio in less than 10 minutes. It does this by chunking up your audio into smaller segments, and transcribing each segment, and then joining them all back together into a single file. It provides a confidence score, both per word and per transcription. It punctuates transcriptions to make the text more readable and to allow downstream systems to process the text with less friction.  And it has SRT file support.  04:06 Lois: SRT? What's that? Wes: SRT is the most popular closed caption output file format. And with this SRT support, users can add closed captions to their video. OCI Speech makes transcribed text more readable to resemble how humans write. This is called normalization. And the service will normalize things like addresses, times, numbers, URLs, and more.  It also does profanity filtering, where it can either remove, mask, or tag profanity and output text, where removing replaces the word with asterisks, and masking does the same thing, but it retains the first letter, and tagging will leave the word in place, but it provides tagging in the output data.  04:49 Nikita: And what about OCI Vision? What are its capabilities? Wes: Vision is a computed vision service that works on images, and it provides two main capabilities-- image analysis and document AI. Image analysis analyzes photographic images. Object detection is the feature that detects objects inside an image using a bounding box and assigning a label to each object with an accuracy percentage. Object detection also locates and extracts text that appears in the scene, like on a sign.  Image classification will assign classification labels to the image by identifying the major features in the scene. One of the most powerful capabilities of image analysis is that, in addition to pretrained models, users can retrain the models with their own unique data to fit their specific needs.  05:40 Lois: So object detection and image classification are features of image analysis. I think I got it! So then what's document AI?  Wes: It's used for working with document images. You can use it to understand PDFs or document image types, like JPEG, PNG, and Tiff, or photographs containing textual information.  06:01 Lois: And what are its most important features? Wes: The features of document AI are text recognition, also known as OCR or optical character recognition.  And this extracts text from images, including non-trivial scenarios, like handwritten texts, plus tilted, shaded, or rotated documents. Document classification classifies documents into 10 different types based on visual appearance, high-level features, and extracted keywords. This is useful when you need to process a document, based on its classification, like an invoice, a receipt, or a resume.  Language detection analyzes the visual features of text to determine the language rather than relying on the text itself. Table extraction identifies tables in docs and extracts their content in tabular form. Key value extraction finds values for 13 common fields and line items in receipts, things like merchant name and transaction date.  07:02 Want to get the inside scoop on Oracle University? Head over to the Oracle University Learning Community. Attend exclusive events. Read up on the latest news. Get first-hand access to new products. Read the OU Learning Blog. Participate in Challenges. And stay up-to-date with upcoming certification opportunities. Visit mylearn.oracle.com to get started.  07:27 Nikita: Welcome back! Wes, I want to ask you about OCI Anomaly Detection. We discussed it a bit last week and it seems like such an intelligent and efficient service. Wes: Oracle Cloud Infrastructure Anomaly Detection identifies anomalies in time series data. Equipment sensors generate time series data, but all kinds of business metrics are also time-based. The unique feature of this service is that it finds anomalies, not just in a single signal, but across many signals at once. That's important because machines often generate multiple signals at once and the signals are often related.  08:03 Nikita: Ok you need to give us an example of this! Wes: Think of a pump that has an output pressure, a flow rate, an RPM, and an electrical current draw. When a pump's going to fail, anomalies may appear across several of those signals but at different times. OCI Anomaly Detection helps you to identify anomalies in a multivariate data set by taking advantage of the interrelationship among signals.  The service contains algorithms for both multi-signal, as in multivariate, single signal, as in univariate anomaly detection, and it automatically determines which algorithm to use based on the training data provided. The multivariate algorithm is called MSET-2, which stands for Multivariate State Estimation technique, and it's unique to Oracle.  08:49 Lois: And the 2? Wes: The 2 in the name refers to the patented enhancements by Oracle labs that automatically identify and fix data quality issues resulting in fewer false alarms and more accurate results.  Now unlike some of the other AI services, OCI Anomaly Detection is always trained on the customer's data. It's trained using actual historical data with no anomalies, and there can be as many different trained models as needed for different sets of signals.  09:18 Nikita: So where would one use a service like this? Wes: One of the most obvious applications of this service is for predictive maintenance. Early warning of a problem provides the opportunity to deploy maintenance resources and schedule downtime to minimize disruption to the business.  09:33 Lois: How would you train an OCI Anomaly Detection model? Wes: It's a simple four-step process to prepare a model that can be used for anomaly detection. The first step is to obtain training data from the system to be monitored. The data must contain no anomalies and should cover the normal range of values that would be experienced in a full business cycle.  Second, the training data file is uploaded to an object storage bucket.  Third, a data set is created for the training data. So a data set in this context is an object in the OCI Anomaly Detection service to manage data used for training and testing models.  And fourth, the model is trained. A wizard in the user interface steps the user through the required inputs, such as the training data set and some training parameters like the target false alarm probability.  10:23 Lois: How would this service know about the data and whether the trained model is univariate or multivariate? Wes: When training OCI Anomaly Detection models, the user does not need to specify whether the intended model is for multivariate or univariate data. It does this detection automatically.  For example, if a model is trained with 10 signals and 5 of those signals are determined to be correlated enough for multivariate anomaly detection, it will create an internal multivariate model for those signals. If the other five signals are not correlated with each other, it will create an internal univariate model for each one.  From the user's perspective, the result will be a single OCI anomaly detection model for the 10 signals. But internally, the signals are treated differently based on the training. A user can also train a model on a single signal and it will result in a univariate model.  11:16 Lois: What does this OCI Anomaly Detection model training entail? How does it ensure that it does not have any false alarms? Wes: Training a model requires a single data file with no anomalies that should cover a complete business cycle, which means it should represent all the normal variations in the signal. During training, OCI Anomaly Detection will use a portion of the data for training and another portion for automated testing. The fraction used for each is specified when the model is trained.  When model training is complete, it's best practice to do another test of the model with a data set containing anomalies to see if the anomalies are detected and if there are any false alarms. Based on the outcome, the user may want to retrain the model and specify a different false alarm probability, also called F-A-P or FAP. The FAP is the probability that the model would produce a false alarm. The false alarm probability can be thought of as the sensitivity of the model. The lower the false alarm probability, the less likelihood of it reporting a false alarm, but the less sensitive it will be to detecting anomalies. Selecting the right FAP is a business decision based on the need for sensitive detections balanced by the ability to tolerate false alarms.  Once a model has been trained and the user is satisfied with its detection performance, it can then be used for inferencing.  12:44 Nikita: Inferencing? Is that what I think it is?  Wes: New data is submitted to the model and OCI Anomaly Detection will respond with anomalies that are detected. The input data must contain the same signals that the model was trained on. So, for example, if the model was trained on signals A, B, C, and D, then for detection inferencing, the same four signals must be provided. No more, no less. 13:07 Lois: Where can I find the features of OCI Anomaly Detection that you mentioned?  Wes: The training and inferencing features of OCI Anomaly Detection can be accessed through the OCI console. However, a human-driven interface is not efficient for most business scenarios.  In most cases, automating the detection of anomalies through software is preferred to be able to process hundreds or thousands of signals using many trained models. The service provides multiple software interfaces for this purpose.  Each trained model is accessible through a REST API and an HTTP endpoint. Additionally, programming language-specific SDKs are available for multiple languages, including Python. Using the Python SDK, data scientists can work with OCI Anomaly Detection for both training and inferencing in an OCI Data Science notebook.  13:58 Nikita: How can a data scientist take advantage of these capabilities?  Wes: Well, you can write code against the REST API or use any of the various language SDKs. But for data scientists working in OCI Data Science, it makes sense to use Python.  14:12 Lois: That's exciting! What does it take to use the Python SDK in a notebook… to be able to use the AI services? Wes: You can use a Notebook session in OCI Data Science to invoke the SDK for any of the AI services.  This might be useful to generate new features for a custom model or simply as a way to consume the service using a familiar Python interface. But before you can invoke the SDK, you have to prepare the data science notebook session by supplying it with an API Signing Key.  Signing Key is unique to a particular user and tenancy and authenticates that user to OCI when invoking the SDK. So therefore, you want to make sure you safeguard your Signing Key and never share it with another user.  14:55 Nikita: And where would I get my API Signing Key? Wes: You can obtain an API Signing Key from your user profile in the OCI Console. Then you save that key as a file to your local machine.  The API Signing Key also provides commands to be added to a config file that the SDK expects to find in the environment, where the SDK code is executing. The config file then references the key file. Once these files are prepared on your local machine, you can upload them to the Notebook session, where you will execute SDK code for the AI service.  The API Signing Key and config file can be reused with any of your notebook sessions, and the same files also work for all of the AI services. So, the files only need to be created once for each user and tenancy combination.  15:48 Lois: Thank you so much, Wes, for this really insightful discussion. To learn more about the topics covered today, you can visit mylearn.oracle.com and search for the Oracle Cloud Infrastructure AI Foundations course. Nikita: And remember, that course prepares you for the Oracle Cloud Infrastructure AI Foundations Associate certification that you can take for free! So, don't wait too long to check it out. Join us next week for another episode of the Oracle University Podcast. Until then, this is Nikita Abraham… Lois Houston: And Lois Houston, signing off! 16:23 That's all for this episode of the Oracle University Podcast. If you enjoyed listening, please click Subscribe to get all the latest episodes. We'd also love it if you would take a moment to rate and review us on your podcast app. See you again on the next episode of the Oracle University Podcast.

This week's episode will be focusing on the second part of genetic syndromes with risk of malignancy. Last week we covered Li Fraumeni, Lynch, FAP, BRCA ½ and Cowdens. This week we are going to cover the syndromes associated with RCC as well as MEN 1 and 2 and a few others. 

This week's episode will be focusing on genetic syndromes with increased risk of malignancies. In Part 1 we discuss Li-Fraumeni, Lynch Syndrome, FAP, BRCA 1 and 2, and Cowden's syndrome.

On this week's episode we discuss the highly contentious and taboo topic of masturbation(?!) to explore if there are any physical, mental or spiritual benefits to either extreme abstinence or uninhibited indulgence. We talk about the popular no-fap movement, government psyops and folk superstitions before digging into the hard science behind some of the claims commonly made of either extreme. What happens in the brain during orgasm anyway? Ted Bundy and Marquis De Sade then make an appearance to discuss their thoughts about pornography. In the extended version of the show we discuss semen retention as a traditional occult practice, the physiology of orgasm (male and female) and what any of this could possibly do with the Qabalistic Tree of Life. Aleister Crowley then shows up to the party to explain to us how to achieve Eroto-Comatose Lucidity and what the Ancient Egyptians thought about the topic of sex and sanctity. As a warning, we talk quite a bit about sex in this episode so it's not safe for work or kids. This episode might also be offensive to people who feel strongly polarized on the issue because we're exploring the nuance behind a lot of big claims from all sides. We also decided it was probably best to proclaim that we are not kink shaming anyone and are advocates of sexual freedom and as long as all parties involved are capable of and do consent. Thank you everybody and enjoy the show! On this week's episode we discuss: The Power of The Orgasm The No Fap MovementBenefits of Semen Retention?Mainstream Media Chamber of Echoes Folk Superstition Psychological WarfareYour Brain On OrgasmsWhat The Science SaysIs Pornography… bad? In the extended show available at www.patreon.com/TheWholeRabbit we take the discussion way further and discuss:Semen Retention as an Occult PracticeYogaThe Physiology of Many Orgasms Occult Significance of Bodily FluidsEroto-Comatose LucidityThe Qabalah of OrgasmAncient Egyptian Beliefs Each host is responsible for writing and creating the content they present. In the notes: red sections are written by Luke Madrid, green sections by Malachor 5, purple written by Heka Astra and blue by Mari Sama…Where to find The Whole Rabbit:Spotify: https://open.spotify.com/show/0AnJZhmPzaby04afmEWOAVInstagram: https://www.instagram.com/the_whole_rabbitTwitter: https://twitter.com/1WholeRabbitMusic By Spirit Travel Plaza: https://open.spotify.com/artist/30dW3WB1sYofnow7y3V0YoSources:2001 Abstinence Studyhttps://pubmed.ncbi.nlm.nih.gov/11760788/1998 Male Neuroendocrine Studyhttps://pubmed.ncbi.nlm.nih.gov/9695139/More sources available on Patreon. Support the Show.

Embark on a profound exploration of love, relationships, and the digital landscape in this riveting episode of the Kaka Balli Punjabi Podcast. We're honored to host Bhai Daman Singh Ji Canada waale, a celebrated fitness trainer, social media influencer, and the visionary behind the Instagram pages SikhsPack, KanedaToPunjab, and HighIQmen, as well as the YouTube channels “Sikhspack” and “Apna Podcast”. This episode unfolds with a personal tale of resilience and revelation following a bike accident that transformed Bhai Daman Singh Ji's outlook on life. We delve into the murky waters of social media governance, discussing the unexplained disabling of his Instagram page and the broader implications for digital rights and transparency. As a relationship guru, Bhai Daman Singh Ji enlightens us on the art of partner selection, sharing his expertise on fostering healthy relationships in an age dominated by digital interactions. He offers a balanced perspective on the impact of pornography on society, challenging preconceived notions and encouraging open dialogue. We tackle the cultural nuances of dating in India, debating whether Indian society is prepared for the Western approach to dating and the role of dating apps in shaping modern love stories. The conversation takes a critical turn as we examine the decline in relationship integrity and the rise of superficial connections. The podcast also addresses the silent epidemic of social media-induced depression, dissecting its contribution to the growing trend of couple separations. We venture into the realm of sexual health, debunking myths about testosterone and FAP, and discussing the importance of sexual education and wellness. Revisiting the ancient wisdom of the Kamasutra, we challenge its stigmatized image, revealing its true purpose as a guide to deepening intimacy and strengthening partnerships. The discussion extends to the sensitive subject of intercaste and interreligion marriages in India, reflecting on the evolving attitudes and the courage it takes to transcend traditional boundaries. In a cautionary segment, we expose the dark side of online scams, scrutinizing the role of social media influencers in promoting dubious investment opportunities. This serves as a reminder to our listeners to remain vigilant and informed in the face of persuasive digital marketing.

Listen to Lois Houston and Nikita Abraham, along with Senior Principal Product Manager Wes Prichard, as they explore the five core components of OCI AI services: language, speech, vision, document understanding, and anomaly detection, to help you make better sense of all that unstructured data around you. Oracle MyLearn: https://mylearn.oracle.com/ou/learning-path/become-an-oci-ai-foundations-associate-2023/127177 Oracle University Learning Community: https://education.oracle.com/ou-community LinkedIn: https://www.linkedin.com/showcase/oracle-university/ X (formerly Twitter): https://twitter.com/Oracle_Edu Special thanks to Arijit Ghosh, David Wright, Himanshu Raj, and the OU Studio Team for helping us create this episode. -------------------------------------------------------- Episode Transcript: 00:00 Welcome to the Oracle University Podcast, the first stop on your cloud journey. During this series of informative podcasts, we'll bring you foundational training on the most popular Oracle technologies. Let's get started! 00:26 Nikita: Welcome to the Oracle University Podcast! I'm Nikita Abraham, Principal Technical Editor with Oracle University, and with me is Lois Houston, Director of Innovation Programs. Lois: Hi there! In our last episode, we spoke about OCI AI Portfolio, including AI and ML services, and the OCI AI infrastructure. Nikita: Yeah, and in today's episode, we're going to continue down a similar path and take a closer look at OCI AI services. 00:55 Lois: With us today is Senior Principal Product Manager, Wes Prichard. Hi Wes! It's lovely to have you here with us. Hemant gave us a broad overview of the various OCI AI services last week, but we're really hoping to get into each of them with you. So, let's jump right in and start with the OCI Language service. What can you tell us about it? Wes: OCI Language analyzes unstructured text for you. It provides models trained on industry data to perform language analysis with no data science experience needed.  01:27 Nikita: What kind of big things can it do? Wes: It has five main capabilities. First, it detects the language of the text. It recognizes 75 languages, from Afrikaans to Welsh.  It identifies entities, things like names, places, dates, emails, currency, organizations, phone numbers--14 types in all. It identifies the sentiment of the text, and not just one sentiment for the entire block of text, but the different sentiments for different aspects.  01:56 Nikita: What do you mean by that, Wes? Wes: So let's say you read a restaurant review that said, the food was great, but the service sucked. You'll get food with a positive sentiment and service with a negative sentiment. And it also analyzes the sentiment for every sentence.  Lois: Ah, that's smart. Ok, so we covered three capabilities. What else? Wes: It identifies key phrases in the text that represent the important ideas or subjects. And it classifies the general topic of the text from a list of 600 categories and subcategories.  02:27 Lois: Ok, and then there's the OCI Speech service...  Wes: OCI Speech is very straightforward. It locks the data in audio tracks by converting speech to text. Developers can use Oracle's time-tested acoustic language models to provide highly accurate transcription for audio or video files across multiple languages.  OCI Speech automatically transcribes audio and video files into text using advanced deep learning techniques. There's no data science experience required. It processes data directly in object storage. And it generates timestamped, grammatically accurate transcriptions.  03:01 Nikita: What are some of the main features of OCI Speech? Wes: OCI Speech supports multiple languages, specifically English, Spanish, and Portuguese, with more coming in the future. It has batching support where multiple files can be submitted with a single call. It has blazing fast processing. It can transcribe hours of audio in less than 10 minutes. It does this by chunking up your audio into smaller segments, and transcribing each segment, and then joining them all back together into a single file. It provides a confidence score, both per word and per transcription. It punctuates transcriptions to make the text more readable and to allow downstream systems to process the text with less friction.  And it has SRT file support.  03:45 Lois: SRT? What's that? Wes: SRT is the most popular closed caption output file format. And with this SRT support, users can add closed captions to their video. OCI Speech makes transcribed text more readable to resemble how humans write. This is called normalization. And the service will normalize things like addresses, times, numbers, URLs, and more.  It also does profanity filtering, where it can either remove, mask, or tag profanity and output text, where removing replaces the word with asterisks, and masking does the same thing, but it retains the first letter, and tagging will leave the word in place, but it provides tagging in the output data.  04:29 Nikita: And what about OCI Vision? What are its capabilities? Wes: Vision is a computed vision service that works on images, and it provides two main capabilities-- image analysis and document AI. Image analysis analyzes photographic images. Object detection is the feature that detects objects inside an image using a bounding box and assigning a label to each object with an accuracy percentage. Object detection also locates and extracts text that appears in the scene, like on a sign.  Image classification will assign classification labels to the image by identifying the major features in the scene. One of the most powerful capabilities of image analysis is that, in addition to pretrained models, users can retrain the models with their own unique data to fit their specific needs.  05:20 Lois: So object detection and image classification are features of image analysis. I think I got it! So then what's document AI?  Wes: It's used for working with document images. You can use it to understand PDFs or document image types, like JPEG, PNG, and Tiff, or photographs containing textual information.  05:40 Lois: And what are its most important features? Wes: The features of document AI are text recognition, also known as OCR or optical character recognition.  And this extracts text from images, including non-trivial scenarios, like handwritten texts, plus tilted, shaded, or rotated documents. Document classification classifies documents into 10 different types based on visual appearance, high-level features, and extracted keywords. This is useful when you need to process a document, based on its classification, like an invoice, a receipt, or a resume.  Language detection analyzes the visual features of text to determine the language rather than relying on the text itself. Table extraction identifies tables in docs and extracts their content in tabular form. Key value extraction finds values for 13 common fields and line items in receipts, things like merchant name and transaction date.  06:41 Want to get the inside scoop on Oracle University? Head over to the Oracle University Learning Community. Attend exclusive events. Read up on the latest news. Get first-hand access to new products. Read the OU Learning Blog. Participate in Challenges. And stay up-to-date with upcoming certification opportunities. Visit mylearn.oracle.com to get started.  07:06 Nikita: Welcome back! Wes, I want to ask you about OCI Anomaly Detection. We discussed it a bit last week and it seems like such an intelligent and efficient service. Wes: Oracle Cloud Infrastructure Anomaly Detection identifies anomalies in time series data. Equipment sensors generate time series data, but all kinds of business metrics are also time-based. The unique feature of this service is that it finds anomalies, not just in a single signal, but across many signals at once. That's important because machines often generate multiple signals at once and the signals are often related.  07:42 Nikita: Ok you need to give us an example of this! Wes: Think of a pump that has an output pressure, a flow rate, an RPM, and an electrical current draw. When a pump's going to fail, anomalies may appear across several of those signals but at different times. OCI Anomaly Detection helps you to identify anomalies in a multivariate data set by taking advantage of the interrelationship among signals.  The service contains algorithms for both multi-signal, as in multivariate, single signal, as in univariate anomaly detection, and it automatically determines which algorithm to use based on the training data provided. The multivariate algorithm is called MSET-2, which stands for Multivariate State Estimation technique, and it's unique to Oracle.  08:28 Lois: And the 2? Wes: The 2 in the name refers to the patented enhancements by Oracle labs that automatically identify and fix data quality issues resulting in fewer false alarms and more accurate results.  Now unlike some of the other AI services, OCI Anomaly Detection is always trained on the customer's data. It's trained using actual historical data with no anomalies, and there can be as many different trained models as needed for different sets of signals.  08:57 Nikita: So where would one use a service like this? Wes: One of the most obvious applications of this service is for predictive maintenance. Early warning of a problem provides the opportunity to deploy maintenance resources and schedule downtime to minimize disruption to the business.  09:12 Lois: How would you train an OCI Anomaly Detection model? Wes: It's a simple four-step process to prepare a model that can be used for anomaly detection. The first step is to obtain training data from the system to be monitored. The data must contain no anomalies and should cover the normal range of values that would be experienced in a full business cycle.  Second, the training data file is uploaded to an object storage bucket.  Third, a data set is created for the training data. So a data set in this context is an object in the OCI Anomaly Detection service to manage data used for training and testing models.  And fourth, the model is trained. A wizard in the user interface steps the user through the required inputs, such as the training data set and some training parameters like the target false alarm probability.  10:02 Lois: How would this service know about the data and whether the trained model is univariate or multivariate? Wes: When training OCI Anomaly Detection models, the user does not need to specify whether the intended model is for multivariate or univariate data. It does this detection automatically.  For example, if a model is trained with 10 signals and 5 of those signals are determined to be correlated enough for multivariate anomaly detection, it will create an internal multivariate model for those signals. If the other five signals are not correlated with each other, it will create an internal univariate model for each one.  From the user's perspective, the result will be a single OCI anomaly detection model for the 10 signals. But internally, the signals are treated differently based on the training. A user can also train a model on a single signal and it will result in a univariate model.  10:55 Lois: What does this OCI Anomaly Detection model training entail? How does it ensure that it does not have any false alarms? Wes: Training a model requires a single data file with no anomalies that should cover a complete business cycle, which means it should represent all the normal variations in the signal. During training, OCI Anomaly Detection will use a portion of the data for training and another portion for automated testing. The fraction used for each is specified when the model is trained.  When model training is complete, it's best practice to do another test of the model with a data set containing anomalies to see if the anomalies are detected and if there are any false alarms. Based on the outcome, the user may want to retrain the model and specify a different false alarm probability, also called F-A-P or FAP. The FAP is the probability that the model would produce a false alarm. The false alarm probability can be thought of as the sensitivity of the model. The lower the false alarm probability, the less likelihood of it reporting a false alarm, but the less sensitive it will be to detecting anomalies. Selecting the right FAP is a business decision based on the need for sensitive detections balanced by the ability to tolerate false alarms.  Once a model has been trained and the user is satisfied with its detection performance, it can then be used for inferencing.  12:23 Nikita: Inferencing? Is that what I think it is?  Wes: New data is submitted to the model and OCI Anomaly Detection will respond with anomalies that are detected. The input data must contain the same signals that the model was trained on. So, for example, if the model was trained on signals A, B, C, and D, then for detection inferencing, the same four signals must be provided. No more, no less. 12:46 Lois: Where can I find the features of OCI Anomaly Detection that you mentioned?  Wes: The training and inferencing features of OCI Anomaly Detection can be accessed through the OCI console. However, a human-driven interface is not efficient for most business scenarios.  In most cases, automating the detection of anomalies through software is preferred to be able to process hundreds or thousands of signals using many trained models. The service provides multiple software interfaces for this purpose.  Each trained model is accessible through a REST API and an HTTP endpoint. Additionally, programming language-specific SDKs are available for multiple languages, including Python. Using the Python SDK, data scientists can work with OCI Anomaly Detection for both training and inferencing in an OCI Data Science notebook.  13:37 Nikita: How can a data scientist take advantage of these capabilities?  Wes: Well, you can write code against the REST API or use any of the various language SDKs. But for data scientists working in OCI Data Science, it makes sense to use Python.  13:51 Lois: That's exciting! What does it take to use the Python SDK in a notebook… to be able to use the AI services? Wes: You can use a Notebook session in OCI Data Science to invoke the SDK for any of the AI services.  This might be useful to generate new features for a custom model or simply as a way to consume the service using a familiar Python interface. But before you can invoke the SDK, you have to prepare the data science notebook session by supplying it with an API Signing Key.  Signing Key is unique to a particular user and tenancy and authenticates that user to OCI when invoking the SDK. So therefore, you want to make sure you safeguard your Signing Key and never share it with another user.  14:34 Nikita: And where would I get my API Signing Key? Wes: You can obtain an API Signing Key from your user profile in the OCI Console. Then you save that key as a file to your local machine.  The API Signing Key also provides commands to be added to a config file that the SDK expects to find in the environment, where the SDK code is executing. The config file then references the key file. Once these files are prepared on your local machine, you can upload them to the Notebook session, where you will execute SDK code for the AI service.  The API Signing Key and config file can be reused with any of your notebook sessions, and the same files also work for all of the AI services. So, the files only need to be created once for each user and tenancy combination.  15:27 Lois: Thank you so much, Wes, for this really insightful discussion. To learn more about the topics covered today, you can visit mylearn.oracle.com and search for the Oracle Cloud Infrastructure AI Foundations course. Nikita: And remember, that course prepares you for the Oracle Cloud Infrastructure AI Foundations Associate certification that you can take for free! So, don't wait too long to check it out. Join us next week for another episode of the Oracle University Podcast. Until then, this is Nikita Abraham… Lois Houston: And Lois Houston, signing off! 16:03 That's all for this episode of the Oracle University Podcast. If you enjoyed listening, please click Subscribe to get all the latest episodes. We'd also love it if you would take a moment to rate and review us on your podcast app. See you again on the next episode of the Oracle University Podcast.

SEASON 5 is (almost) HERE!! This is your one week warning... as the KREWE is BACK on Friday, March 8th, 12 noon CST.  Here's a sneak peek & preview of gusts & episodes to come:- The History & Evolution of Godzilla ft. Dr. William Tsutsui- Witness Fukushima's Recovery through Educational Tourism ft. William McMichael- Japanese Self-Study Strategies ft. Walden Perry- Visit Miyagi Prefecture ft. Ryotaro Sakurai & William Woods- Japanese Homes, Architecture & Aesthetic ft. Azby Brown- A Glimpse into the World of Geisha ft. Peter Macintosh- Japanese Music Scene ft. Patrick St. Michel- Pioneering Louisiana's Only High School Japanese Program ft. Dr. Tara Sanchez- Scoping Out Shojo Anime & Manga ft. Taryn of Manga Lela- as well as some other returning guests like Matt Alt, Rob Dyer, & Kate KitagawaGet Hyped! Subscribe today on your favorite podcast app! See you on March 8th!------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts.  Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below & our promo code from the episode (timestamps [hh:mm:ss] where you can find the code)!Liquid IV Offer Link  to save 20% Off your Entire Order! (00:12:38)Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan!  (00:13:54)------ JSNO Upcoming Events ------JSNO Event Calendar2024 Matsue Exchange Program ApplicationJoin JSNO Today!

In the this episode,  hosts Drs. Temara Hajjat and Peter Lu talk to Dr. Neha Santucci, an Associate Professor of Pediatrics and the Director of the Disorders of Gut-Brain Interaction Program at Cincinnati Children's. They discuss how to identify and manage functional abdominal pain in children with pre-existing organic GI disorders.  Learning Objectives:Learning how to diagnose functional abdominal pain  in patients with existing GI conditions Learning how to manage functional abdominal pain in patients with existing GI conditionsLearning when to utilize IB-Stim in patients with FAP.  Editor: Temara HajjatSupport the showThis episode is eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

There is a group that suggests people should refrain from a little self-gratification, even though most medical experts say that it's not healthy to refrain from masturbation completely.

Life often takes us on unexpected journeys, some that test our mettle and foundational beliefs. But it's within these challenges that we unearth the depth of our resilience and the capacity to impact others profoundly.  Mary welcomes Mike Caprio, a young man whose early encounter with a rare health condition led him to genuine introspection and personal growth. Initially met with isolation and despair, Mike's diagnosis of familial adenomatous polyposis spurred a transformation that not only impacted his physical well-being but also redefined his purpose in life. His narrative is one of courage and transformation, offering listeners a deep dive into the realities of grappling with a life-altering diagnosis. The conversation navigates through Mike's medical journey, starting with the absence of symptoms and the shocking discovery of his genetic condition, and advancing to the critical surgeries that saved his life. Mike and Mary explore the emotional toll of facing mortality at a young age, shedding light on the power of family support and the internal battles that accompany health crises. About Mike: Mike Caprio is a remarkable individual who has demonstrated immense resilience and strength in the face of a rare genetic condition known as familial adenomatous polyposis (FAP). Despite being diagnosed with FAP at just 18 and undergoing a series of complex surgeries right after high school, Mike turned his struggle into a powerful message of hope and determination. He candidly shares his journey of recovery and the lessons learned along the way, emerging as an inspirational figure and author of the book "A Bump in the Road," where he documents his experiences and the positive outlook that guided him through adversity.   Get His Book: https://www.amazon.com/Bump-Road-Medical-Potholes-Gratitude/dp/1636763626     Get Mary's New Book Today! https://marycraftsinc.com/ iTunes: https://podcasts.apple.com/us/podcast/crafting-a-meaningful-life-with-mary-crafts/id1336191892 Follow Mary on Instagram: https://www.instagram.com/marycrafts Follow Mary On Facebook: https://www.facebook.com/mary.crafts4   #crafting a meaningful life, #gratitude practices          

Episode 7 - Thriving without a colon, Kristly Bartlett, diagnosed with FAP at an early age, faces a rare inherited condition due to a defect in the denomatous polyposis coli (APC gene). Disclaimer: Please note that all information and content on the UK Health Radio Network, all its radio broadcasts and podcasts are provided by the authors, producers, presenters and companies themselves and is only intended as additional information to your general knowledge. As a service to our listeners/readers our programs/content are for general information and entertainment only.  The UK Health Radio Network does not recommend, endorse, or object to the views, products or topics expressed or discussed by show hosts or their guests, authors and interviewees.  We suggest you always consult with your own professional – personal, medical, financial or legal advisor. So please do not delay or disregard any professional – personal, medical, financial or legal advice received due to something you have heard or read on the UK Health Radio Network.

To quote Kevin Costner from the Postman - "is stuff getting better" for you in your recovery? In today's episode Vern explores a number of ways that we can determine if we are growing and moving forward in our recovery - or stalled out and stuck.To connect with Vern you can email him at bandofbrothers.care@gmail.com or check out the website for further resources https://www.bandofbrothers.care

One of our favorite parts of bringing The Health Detective Podcast to our listeners and viewers is that we get to highlight guests who deal with conditions that many of us would otherwise never hear about. Today's guest on the show, Michael Caprio, deals with a genetic condition that you very likely haven't heard of. At just eighteen years old, author Michael Caprio was diagnosed with Familial Adenomatous Polyposis, a rare genetic form of colorectal cancer that accounts for only 0.5 percent of all colorectal cancer cases in the United States. After enduring two life-saving operations, Michael has since made a full recovery and has become an author, advocate, leader, change-maker, and podcast guest in the spaces of mental health and colorectal cancer. Although this story is bit different than the ones we would typically bring on the show, we think it is important to not only give a spotlight for those dealing with conditions such as FAP in silence, but for the listeners and viewers to find inspiration in the incredible resiliency and determination that people like Michael display. We hope you enjoy this episode, and if you have an questions, you can always reach out to us directly @fdntraining on Instagram.    Where to find Michael: Facebook: A Bump in the Road  Instagram: @mikecaprio_author  Website: https://www.mikecaprioauthor.com/   Where to find FDN! Youtube: https://www.youtube.com/@FDNtraining/featured Instagram: www.instagram.com/fdntraining Facebook: https://www.facebook.com/FunctionalDiagnosticNutrition LinkedIn: https://www.linkedin.com/company/san-diego-natural-health-&-fitness-ctr  

Gap Inc. recently released its earnings report where CEO Richard Dickson revealed promising signs of revitalization as seen in the third quarter performance. This is particularly the case for the brand Old Navy, which according to Dickson, has witnessed a positive shift thanks to the launch of a women's marketing campaign and enhancement in site execution. Per the earnings call, the company states that these changes demonstrate their ability to adapt to evolving trends in consumer preferences and a competitive retail environment. In its effort to stay attuned to customer demands, Gap has focused heavily on creating more relevant marketing campaigns and maintaining insightful brand touchpoints. Fortifying the importance of offering trendy products, the company also reinforced its drive to curate an engaging omnichannel customer experience, which directly aligns with their objective of revitalizing each brand and boosting overall revenue. While the company grappled with a drop in net and digital sales, they recognized Old Navy's resilience in gaining market share and showing continued growth. Other brands under Gap Inc., specifically Banana Republic and Gap, are in the midst of strategic brand repositioning, a clear sign of the company's determination to triumph over existing obstacles. As for financial performance, Gap purportedly has taken strides to instill operational and financial discipline, which lead to an improved working capital situation, stronger balance sheets, and expanding margins. Conversely, with the drop in revenue and comparable sales, the company has been encouraged to reevaluate and refine its marketing, merchandising, and pricing strategies aiming to generate improved outcomes. Gap Inc. disclosed its plans for launching further campaigns, like women's marketing, improving site execution, invigorating in-store presentations, and reinforcing partnerships. Company highlighted the impact of these plans on key brands such as Old Navy, which include compelling gifting options and a redirected focus on core categories. To sustain its growth, Gap Inc. is reportedly resolute in maintaining financial stringency, rejuvenating its brand portfolio, bolstering operational platforms, and revitalizing corporate culture. As the company leaders declared on the earnings call, this comprises maintaining streamlined operations, optimizing investment in technology, and enhancing marketing and media strategies. Gap is also dedicated to offering trendy product lineups, fostering interactive omnichannel experiences and leveraging creative marketing to drive revenue growth and achieve long-term success. GPS Company info: https://finance.yahoo.com/quote/GPS/profile For more PSFK research : www.psfk.com  This email has been published and shared for the purpose of business research and is not intended as investment advice.

Continuing our conversation with warrior, Jenny Jones from S1E27. Jenny lives with two rare, chronic conditions called Familial Adenomatous Polyposis (FAP) and Short Bowel Syndrome and more recently was diagnosed with Post-Concussion Syndrome, Fibromyalgia, and Esophageal Dysmotility. Due to FAP, she underwent a total colectomy at age nine. Complications resulted in six additional surgeries and an eighth surgery to remove her gall bladder. Her genetics and additional factors led Jenny to decide not to have biological children. As fate would have it, she ended up becoming a very involved auntie to her twin nieces and stepmom to her bonus son. Listen to Part Two as Jenny discusses when and how she shares a health crisis with her bonus kid, how she addresses the challenges from her health limitations and being a stepmom and auntie, and more. To learn more about Jenny Jones, her blog, YouTube vlog, children's book, Life's a Polyp with Zeke and Katie or to support The National Organization for Rare Disorders Familial Adenomatous Polyposis Research Fund, go to her website at https://www.lifesapolyp.com. 

Let's catch up with warrior, Jenny Jones from S1E27. Jenny lives with two rare, chronic conditions called Familial Adenomatous Polyposis (FAP) and Short Bowel Syndrome and more recently was diagnosed with Post-Concussion Syndrome, Fibromyalgia, and Esophageal Dysmotility. Due to FAP, she underwent a total colectomy at age nine. Complications resulted in six additional surgeries and an eighth surgery to remove her gall bladder. Her genetics and additional factors led Jenny to decide not to have biological children. As fate would have it, she ended up becoming a very involved auntie to her twin nieces and stepmom to her bonus son. Tune in to Part One as Jenny fills us in on her health journey, shares her decision on kids and how she manages her many conditions as a stepmom and auntie. To learn more about Jenny Jones, her blog, YouTube vlog, children's book, Life's a Polyp with Zeke and Katie or to support The National Organization for Rare Disorders Familial Adenomatous Polyposis Research Fund, go to her website at https://www.lifesapolyp.com.

Join us for a fresh look at Patient-Centered Healthcare from the perspective of Dakota Fisher-Vance, a Global Patient Advocate, who is living with a rare disease. Learn from Dakota's personal and professional experience informed by a remarkable journey from her diagnosis with familial adenomatous polyposis (FAP) to her current role as Global Patient Advocacy Associate Director at BioCryst Pharmaceuticals. Tune in to discover the stories, insights, and innovations that are driving healthcare toward a more patient-centered future. Connect with Dakota: LinkedIn Additional Resources to check out: Rare X: https://rare-x.org Chronically Capable: https://www.wearecapable.org Young Adult Cancer Connection: https://yacancerconnection.org/ ClinicalTrials.gov https://clinicaltrials.gov

No solo en España: el fútbol femenino peruano también tiene una denuncia de acoso que incluso ha llegado a la fiscalía. Juana Acevedo comenta el duro panorama para las jugadoras. MIENTRAS TANTO: Guillermo Bermejo se llevaba el 1,5% de obras de la reconstrucción, según un colaborador eficaz. ADEMÁS: El escándalo de los "packs" con IA en un colegio de Lima. Y... La verdad está allí afuera: accedimos a los reportes oficiales de la FAP sobre avistamientos OVNI en el Perú. **** ¿Te gustó este episodio? ¿Buscas las fuentes de los datos mencionados hoy? Entra a http://patreon.com/ocram para acceder a nuestros grupos exclusivos de Telegram y WhatsApp. También puedes UNIRTE a esta comunidad de YouTube aquí https://www.youtube.com/channel/UCP0AJJeNkFBYzegTTVbKhPg/join **** ¿Quieres que tu emprendimiento sea mencionado en La Encerrona? Regístrate aquí para postular: https://encerroners.club

Let's talk all about p***y pumps VR porn, no fapping?! and a whole lot more with Layla from the Curious Girl Diaries podcast. How do you use a use a p**** pump? Is VR porn everything it's cracked up to be? How many fingers is best when fingering? And, do guys really FAP??? Tune in to find out plus hear Kathy and Layla talk all about their experience with a p**** pump and how Layla felt about the one Kathy bought for her, the pros and cons about VR porn and their experiences with it, how and why finger size is important to Kathy when fingering, how Layla learned to squirt while fingering herself and how she figured it out, an update on Layla's girl on girl action as well as find out whether or not she's pegged her sub, how and why she's currently obsessed with a guy who has “the biggest d*** in the world,” how and why the amount of jizz a guy produces is important to Layla, how much they think guys masturbate and why Layla believes no fapping is in style and why Kathy disagrees plus a whole lot more. Make sure to listen in and then chime in on our debate. You can find Layla's private podcast here: https://www.thecuriousgirldiaries **To see anonymous pics LAYLA plus see anonymous pics of my female guests + gain access to my PRIVATE Discord channel where people get super naughty + get early access to all episodes + hear anonymous confessions, + gain access to my Discord channel, join my Patreon. It's only $5 a month and you can cancel at any time. You can sign up here: https://www.patreon.com/StrictlyAnonymousPodcast Want to be on the show? Email me at strictlyanonymouspodcast@gmail.com or go to http://www.strictlyanonymouspodcast.com and click on "Be on the Show" Have something quick you want to confesss? Call the hotline at 347-420-3579. Want a private convo with me that won't be aired on the show? All calls are private, confidential and anonymous. Click here: https://calendly.com/strictlyanonymouspodcast/45min Sponsors: Get a generous sign-up bonus at MyBookie Casino https://mybookie.website/StrictlyAnonymous Want to have better S-E-X?! Who doesn't?! Use Promescent! https://promescent.com/strictlyanon Hear the hottest stories on Dipsea! 30 day FREE TRIAL https://www.dipseastories.com/strictlyanon Follow me! Instagram https://www.instagram.com/strictanonymous/ Twitter https://twitter.com/strictanonymous?lang=en Youtube https://www.youtube.com/c/StrictlyAnonymouspodcast Everything else https://linktr.ee/Strictlyanonymouspodcast Learn more about your ad choices. Visit megaphone.fm/adchoices

In episode 379 I chat with Nate Gruner. Nate is a staff Behavioral Therapist at McLean OCD institute.  I chat with Nate about functional analytic psychotherapy (FAP), the history of FAP, what is FAP, the 5 rules of FAP, why FAP may be helpful for people with OCD, content vs process, the principles of awareness, courage and love. Nate shares some client examples where he has used FAP with OCD, and much more. Hope it helps.  Show notes: https://theocdstories.com/episode/nate-379  The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories Thanks to all our patrons for supporting our work. This podcast episode is available as a video recording on our Patreon. To sign up to our Patreon and to check out the other benefits you'll receive as a Patron, visit: https://www.patreon.com/theocdstoriespodcast

The Momentum Replay Series replays our top episodes so that you have the chance to catch episodes you missed, and refresh on others. The idea is to support you more regularly as you take charge of 2023 (through whatever challenges may arise). Here's to health, wealth and wisdom on this heartfelt path of yours. In this episode I interview Holly Yates, MS, LPC, Certified FAP Trainer about Third-wave therapies that utilise acceptance and mindfulness skills to connect with your emotions and move towards the life you want to lead. Holly is very skilful in FAP, ACT and DBT, and you will find she is able to integrate the wisdom from each of these frameworks to provide you actionable advice relating to your emotions in a way that is effective. I think you will particularly enjoy how you can think of your emotions as ‘data', and the fight-or-flight response as an ‘overprotective parent'. Holly also an example about how she utilises these skills in her own life – I think you will relate! What is covered: >> An introduction to Functional Analytic Psychotherapy (FAP) >> The challenge of normalisation process in FAP >> Emotions as data >> An introduction to Dialectical Behaviour Therapy (DBT) >> Ways to get through emotional disregulation and ‘negative' feelings >> Understanding how your behaviour is functioning within contextual element >> Positive Reinforcement and how to positively shape your behaviours to reinforce things you value >> How different relationships are useful and provide different purposes to your life Links Discussed North Wake Counseling Partners Website (located in Raleigh, North Carolina) Holly Yates on Psychology Today Email Holly Yates Wisdom for Wellbeing episode with Dr. Steven C. Hayes   Head to www.drkaitlin.com for show notes, free resources and courses that support you a heartfelt life alongside peak performance.  "So much gratitude for Wisdom for Wellbeing." If that sounded like you, I would appreciate it if you'd take a moment to offer a review for the show. It really helps me to support more folks to access education and inspiration on their journey to creating a life of meaning. Keen? Just click here and scroll to the bottom: you can highlight the five stars and then click "Write a review." I'm so excited to hear your thoughts on this episode! If you haven't subscribed yet, make sure you click to follow now, so that you get all the upcoming episodes on the art and science of living well.

This month on Episode 46 of Discover CircRes, host Cynthia St. Hilaire highlights four original research articles featured in the March 3 and March 17th issues of Circulation Research. This episode also features an interview with Dr Andrew Hughes and Dr Jessilyn Dunn about their review, Wearable Devices in Cardiovascular Medicine.   Article highlights:   Delgobo, et al. Deep Phenotyping Heart-Specific Tregs   Sun, et al. Inhibition of Fap Promotes Cardiac Repair After MI   Sun, et al. Endosomal PI3Kγ Regulates Hypoxia Sensing   Johnson, et al. Hypoxemia Induces Minimal Cardiomyocyte Division   Cindy St. Hilaire:        Hi, and welcome to Discover CircRes, the podcast of the American Heart Association's Journal, Circulation Research. I'm your host, Dr Cindy St. Hilaire from the Vascular Medicine Institute at the University of Pittsburgh, and today I'm going to share four articles selected from the March 3rd and March 17th issues of CircRes. I'm also going to have a discussion with Dr Andrew Hughes and Dr Jessilyn Dunn about their review, Wearable Devices in Cardiovascular Medicine. And the Review is also featured in our March 3rd issue.   Cindy St. Hilaire:        First, the highlights. The first article I'm going to present is Myocardial Milieu Favors Local Differentiation of Regulatory T-Cells. The first author is Murilo Delgobo and the corresponding author is Gustavo Campos Ramos. After myocardial infarction, the release of autoantigens from the damaged heart cells activates local and infiltrating immune cells such as the T-cell. Studies in mice have shown that fragments of the muscle protein myosin can act as autoantigens, and these myosin fragments are the dominant driver of the T-cell response.   But how do these myosin specific T-cells behave in the damaged heart to drive inflammation and repair is unknown. To find out, Delgobo and colleagues studied endogenous myosin specific T-cells, as well as those transferred into recipient mice. They found, whether exogenously supplied or endogenously created, the myosin specific T-cells that accumulated in the animals' infarcted hearts tended to adopt an immunosuppressive T-regulatory phenotype.   Strikingly, even if the exogenous cells were differentiated into inflammatory TH-17 cells prior to transfer, a significant proportion of them were still reprogrammed into T-regs within the heart. Although cells pre-differentiated into an inflammatory TH-17 phenotype were less inclined to change after the transfer, the results nevertheless indicate that, by and large, the infarcted heart promotes T-cell reprogramming to quell inflammation and drive repair. Yet exactly how the heart does this is a question for future studies.   Cindy St. Hilaire:        The next article I'm going to present is titled Inhibition of FAP Promotes Cardiac Repair by Stabilizing BNP. The first authors of the study are Yuxi Sun and Mengqiu Ma, and the corresponding author is Rui Yue, and they are from Tongji University. After myocardial infarction, there needs to be a balance of recovery processes to protect the tissue. Fibrosis, for example, acts like an immediate bandaid to hold the damaged heart muscle together, but fibrosis can limit contractile function.   Similarly, angiogenesis and sufficient revascularization is required to promote survival of cardiomyocytes within the ischemic tissue and protect heart function. To better understand the balance between fibrotic and angiogenic responses, Sun and colleagues examined the role of fibroblasts activated protein, or FAP, which is dramatically upregulated in damaged hearts, and brain natriuretic peptide, or BNP, which promotes angiogenesis in the heart.   In this study, they found that genetic deletion or pharmacological inhibition of FAP in mice reduces cardiac fibrosis and improves angiogenesis and heart function after MI. Such benefits are not seen if BNP or its receptor, NRP-1, are lacking. The in vitro experiments revealed that FAP's protease activity degrades BNP, thus inhibiting the latter's angiogenic activity. Interestingly, while FAP is upregulated in the heart, its levels drop in the blood, showing that BNP inhibition is localized. Together, these results suggest that blocking FAP's activity in the heart after MI could be a possible strategy for protecting the muscle's function.   Cindy St. Hilaire:        The next article I want to present is Hypoxia Sensing of Beta-Adrenergic Receptor is Regulated by Endosomal PI-3 Kinase Gamma. The first author of this study is Yu Sun, and the corresponding author is Sathyamangla Naga Prasad. Hypoxia is the most proximate acute stress encountered by the heart during an ischemic event. Hypoxia triggers dysfunction of the beta-adrenergic receptors, beta-1AR and beta-2AR, which are critical regulators of cardiac function.   Under normoxic conditions, activation of PI3K-gamma by beta-adrenergic receptors leads to feedback regulation of the receptor by hindering its dephosphorylation through inhibition of protein phosphatase 2A or PP2A. Although it is known that ischemia reduces beta-adrenergic receptor function, the impact of hypoxia on interfering with this PI3K feedback loop was unknown.   Using in vitro and in vivo techniques, this group found that activation of PI3K-gamma underlies hypoxia sensing mechanisms in the heart. Exposing PI3K-gamma knockout mice to acute hypoxia resulted in preserved cardiac function and reduced beta-adrenergic receptor phosphorylation. And this was due to a normalized beta-2AR associated PP2A activity, thus uncovering a unique role for PI3K-gamma in hypoxia sensing and cardiac function.   Similarly, challenging wild-type mice post hypoxia with dobutamine resulted in an impaired cardiac response that was normalized in the PI3K-gamma knockout mice. These data suggests that preserving beta-adrenergic resensitization by targeting the PI3K-gamma pathway would maintain beta-adrenergic signaling and cardiac function, thereby permitting the heart to meet the metabolic demands of the body following ischemia.   Cindy St. Hilaire:        The last article I want to highlight is Systemic Hypoxia Induces Cardiomyocyte Hypertrophy and Right Ventricle Specific Induction of Proliferation. First author of this study is Jaslyn Johnson, and the corresponding author is Steven Houser, and they're at Temple University.   The cardiac hypoxia created by myocardial infarction leads to the death of the heart tissue, including the cardiomyocytes. While some procedures such as reperfusion therapy prevent some cardiomyocyte death, true repair of the infarcted heart requires that dead cells be replaced. There have been many studies that have attempted new approaches to repopulate the heart with new myocytes. However, these approaches have had only marginal success.   A recent study suggested that systemic hypoxemia in adult male mice could induce cardiac monocytes to proliferate. Building on this observation, Johnson and colleagues wanted to identify the mechanisms that induced adult cardiomyocyte cell cycle reentry and wanted to determine whether this hypoxemia could also induce cardiomyocyte proliferation in female mice.   Mice were kept in hypoxic conditions for two weeks, and using methods to trace cell proliferation in-vivo, the group found that hypoxia induced cardiac hypertrophy in both the left ventricle and the right ventricle in the myocytes of the left ventricle and of the right ventricle. However, the left ventricle monocytes lengthened while the RV monocytes widened and lengthened.   Hypoxia induced an increase in the number of right ventricular cardiomyocytes, but did not affect left ventricular monocyte proliferation in male or in female mice. RNA sequencing showed upregulation of cell cycle genes which promote the G1 to S phase transition in hypoxic mice, as well as a downregulation of cullen genes, which are the scaffold proteins related to the ubiquitin ligase complexes. There was significant proliferation of non monocytes in mild cardiac fibrosis in the hypoxic mice that did not disrupt cardiac function.   Male and female mice exhibited similar gene expression patterns following hypoxia. Thus, systemic hypoxia induced a global hypertrophic stress response that was associated with increased RV proliferation, while LV monocytes did not show increased proliferation. These results confirm previous reports that hypoxia can induce cardiomyocyte cell cycle activity in-vivo, and also show that this hypoxia induced proliferation also occurs in the female mice.   Cindy St. Hilaire:        With me today for our interview, I have Dr Andrew Hughes and Dr Jessilyn Dunn, and they're from Vanderbilt University Medical Center. And they're here to discuss the review article that they helped co-author called Wearable Devices in Cardiovascular Medicine. And just as a side note, the corresponding author, Evan Brittain, unfortunately just wasn't able to join us due to clinical service, but they're going to help dissect and discuss this Review with us. Thank you both so much for joining me today. Andy, can you just tell us a little bit about yourself?   Andy Hughes:             Yeah, thank you, Cindy. I'm Andy Hughes. I'm a third year medicine resident at Vanderbilt University who is currently on an NIH supported research year this year. And then will be applying to cardiology fellowships coming up in the upcoming cycle.   Cindy St. Hilaire:        Great, thank you. And Jessilyn, I said you are from Vanderbilt. I know you're from Duke. It was Evan and Andy at Vanderbilt. Jessilyn, tell us about yourself.   Jessilyn Dunn:             Thanks. I am an Assistant Professor at Duke. I have a joint appointment between biomedical engineering and biostatistics and bioinformatics. The work that my lab does is mainly centered on digital health technologies in developing what we call digital biomarkers, using data from often consumer wearables to try to detect early signs of health abnormalities and ultimately try to develop interventions.   Cindy St. Hilaire:        Thank you. We're talking about wearable devices today, and obviously the first thing I think most of us think about are the watch-like ones, the ones you wear on your wrists. But there's really a whole lot more out there. It's not just Apple Watches and Fitbits and the like. Can you just give us a quick summary of all these different types of devices and how they're classified?   Jessilyn Dunn:             Yeah, absolutely. We have a wide variety of different sensors that can be useful. A lot of times, we like to think about them in terms of the types of properties that they measure. So mechanical properties like movement, electrical properties like electrical activity of the heart. We have optical sensors. And so, a lot of the common consumer wearables that we think about contain these different types of sensors.   A good example that we can think about is your consumer smartwatch, like an Apple Watch or a Fitbit or a Garmin device where it has something called an accelerometer that can measure movement. And oftentimes, that gets converted into step counts. And then it may also have an optical sensor that can be used to measure heart rate in a particular method called PPG, or photoplethysmography. And then some of the newer devices also have the ability to take an ECG, so you can actually measure electrical activity as well as the optical based PPG heart rate measurement. These are some of the simpler components that make up the more complex devices that we call wearables.   Cindy St. Hilaire:        And how accurate are the measurements? You did mention three of the companies, and I know there's probably even more, and there's also the clinical grade at-home ECG machines versus the one in the smartwatch. How accurate are the measurements between companies? And we also hear recent stories about somebody's Apple Watch calling 911 because they think they're dead, things like that. Obviously, there's proprietary information involved, but how accurate are these devices and how accurate are they between each other?   Jessilyn Dunn:             This is a really interesting question and we've done quite a bit of work in my lab on this very topic, all the way from what does it mean for something to be accurate? Because we might say, "Well, the more accurate, the better," but then we can start to think about, "Well, how accurate do we need something to be in order to make a clinical decision based off of that?" And if it costs significantly more to make a device super, super accurate, but we don't need it to be that accurate to make useful decisions, then it actually might not be serving people well to try to get it to that extreme level of accuracy.   So there are a lot of trade-offs, and I think that's a tough thing to think about in the circumstances, is these trade-offs between the accuracy and, I don't know, the generalizability or being able to apply this to a lot of people. That being said, it also depends on the circumstances of use. When we think about something like step counts, for example, if you're off by a hundred step counts and you're just trying to get a general view of your step counts, it's not that much of a problem.   But if we're talking about trying to detect an irregular heart rhythm, it can be very bad to either miss something that's abnormal or to call something abnormal that's not and have people worried. We've been working with the Digital Medicine Society to develop this framework that we call V3, which is verification, analytic validation and clinical validation. And these are the different levels of analysis or evaluation that you can do on these devices to determine how fit for purpose are they.   Given the population we're trying to measure in and given what the goal of the measurement is, does the device do the job? And what's also interesting about this topic is that the FDA has been evolving how they think about these types of devices because there's, in the past, been this very clear distinction between wellness devices and medical devices. But the problem is that a lot of these devices blur that line. And so, I think we're going to see more changes in the way that the FDA is overseeing and potentially regulating things like this as well.   Cindy St. Hilaire:        These consumer-based devices have started early on as the step counters. When did they start to bridge into the medical sphere? When did that start to peak the interest of clinicians and researchers?   Jessilyn Dunn:             Yeah, sure. What's interesting is if we think back to accelerometers, these have been used prior to the existence of mobile phones. These really are mechanical sensors that could be used to count steps. And when we think about the smartwatch in the form that we most commonly think of today, probably looking back to about 2014 is when ... maybe between 2012, 2014 is when we saw these devices really hitting the market more ... Timing for when the devices that we know as our typical consumer smartwatch today was around 2012 to 2014.   And those were things that were counting steps and then the next generation of that added in the PPG or photoplethysmography sensor. That's that green light when we look on the back of our watch that measures heart rate. And so, thinking back to the early days, probably Jawbone, there was a watch called Basis, the Intel Basis watch. Well, it was Basis and then got acquired by Intel. Fitbit was also an early joining the market, but that was really the timing.   Cindy St. Hilaire:        How good are these devices at actually changing behavior? We know we're really good at tracking our steps now and maybe monitoring our heartbeat or our oxygen levels. How good are they at changing behavior though? Do we know yet?   Andy Hughes:             Yeah, that's a great question and certainly a significant area of ongoing research right now with physical activity interventions. Things that we've seen right now is that simple interventions that use the wearable devices alone may not be as effective as multifaceted interventions. And what I mean by that is interventions that use the smartwatch but may be coupled with another component, whether that is health education or counseling or more complex interventions that use gamification or just in time adaptive interventions.   And gamification really takes things to another level because that integrates components, competition or support or collaboration and really helps to build upon features of behaviors that we know have an increased likelihood of sustaining activity. With that being said, that is one of the challenges of physical activity interventions, is the sustainability of their improvements over the course of months to years.   And something that we have seen is the effects do typically decrease over time, but there is work on how do we integrate all of these features to develop interventions that can help to sustain the results more effectively. So we have seen some improvement, but finding ways to sustain the effects of physical activity is certainly an area of ongoing research.   Cindy St. Hilaire:        I know it's funny that even as adults we love getting those gold stars or the circle completions. All of these devices, whether it's smartwatches like we're just talking about, or the other things for cardiac rehabilitation, they're generating a ton of data. What is happening with all this data? Who's actually analyzing it? How is it stored and what's that flow through from getting from the patient's body to the room where their physician is looking at it?   Andy Hughes:             And that is certainly a challenge right now that is limiting the widespread adoption of these devices into routine clinical care is, as Jessilyn mentioned. The wearables generate a vast amount of data, and right now, we need to identify and develop a way as clinicians to sort through all of the noise in order to be able to identify the information that is clinically meaningful and worthy of action without significantly increasing the workload.   And a few of the barriers that will be necessary in order to reach that point is, one, finding ways to integrate the wearables' data into the electronic health record and also developing some machine learning algorithms or ways with which we can use the computational power of those technologies to be able to identify when there is meaningful data within all of the vast data that comes from wearables. So it's somewhere that certainly we need to get to for these devices to reach their full clinical potential, but we are limited right now by a few of those challenges.   Jessilyn Dunn:             I was just going to say, I will add on to what Andy was saying about this idea behind digital biomarkers because this fits really nicely with this idea that giving people this huge data deluge is not helpful, but if we had a single metric where we can say, "Here's the digital biomarker of step count, and if you're above some threshold, you're good to go. And if you're below some threshold, some intervention is needed." That's a lot of the work that we've been doing, is trying to develop what are these digital biomarkers and how can they be ingested in a really digestible way?   Cindy St. Hilaire:        Yeah, that's great. Regarding the clinical and the research grade devices, I know a Fitbit or Apple Watch can sometimes be used for those, but I guess I'm talking also about the other kind of more clinically oriented devices, how good is compliance and how trustable is that data? Everybody's on probably their best behavior when they're in the office with the physician or if they're on the treadmill in the cardiac lab, but home is a different story. And what don't we know about compliance when people are out of the office and the reliability of that data that's generated in that space?   Andy Hughes:             I think you touched on a really important point right here, and one of the potential advantages of these wearable devices is that they provide continuous long-term monitoring over the course of weeks to months to years as opposed to those erratic measurements that we get from the traditional office visits or hospitalizations where, for example, the measurements we're taking are either in a supervised environment with a six-minute walk distance, for example, or self-reported or questionnaires.   So we build upon that information, but then additionally, we go beyond the observer effect where many individuals, the first week or two that you're wearing this new device, you may be more prone to increase your activity because you know that you're being monitored or you have this novel technology, but as you wear it for months to years, you outgrow those potential biases and you really can garner more comprehensive information.   In terms of compliance, we can speak to some of the research studies that have either really struggled with compliance and that limits the interpretability of their results and something we'll need to address in the future, but I think that's something that can be addressed with future studies keeping in mind all of the advantages that these devices offer compared to some of the traditional measures that we have used in the past.   Cindy St. Hilaire:        With all this data we're collecting, whether it be biological data or even just behavioral data, have we actually learned anything new? And I mean that in terms of All Of Us study this, I don't know, it was like 5,000 patients I think, and lo and behold, it found out that higher step count correlated with lower risk for a ton of diseases, which is not exactly groundbreaking. So are we, at this point in time, learning anything new from the use of these at-home devices, or are they really just able to help us enforce what we thought we knew regarding behavior?   Andy Hughes:             I think these devices have certainly provided some novel insights that build upon our understanding of physical activity. Many of us can hypothesize that decreased activity would have poor outcomes on health, which the studies have demonstrated in many facets. But in reference to All Of Us study that you mentioned, I think it's interesting to look as well at some of the diagnoses or conditions that were associated with decreased activity.   For example, reflux disease was also highlighted in that study, which may not have been identified if we didn't have the vast data and ability to really look for associations with diseases that have not been previously studied or thought to be related to physical activity. So I think that's one of the strong features of that database, is the wealth of knowledge that really will be hypothesis generating and help to inform future studies as we look even beyond cardiovascular conditions.   Cindy St. Hilaire:        One question, and you did bring it up in a bit of the discussion in your piece, is the bias that is in these devices. We know from COVID at-home pulse oximeters do not work as efficiently on darker skin. We actually know that going into bathrooms with the hand sensors that spit out the paper towels. So what kind of disparities or biases do these devices create or reinforce in the population?   Jessilyn Dunn:             This is such a critical topic because a lot of these issues had been discovered retrospectively because the people who were developing the technologies were not the representative of the people who were using the technologies. I think that's something that across the board we've been looking at from device development to AI implementation, which is having people who are going to be using the devices in the process of developing the technology and having voices heard from across the board.   We did a detailed look when we were evaluating devices for their accuracy at this exact question of where the heart rate sensors in smartwatches use optical based technology. And there was some evidence that was also an issue for people with varying skin tones, for people with wrist tattoos or more hair or freckles. And so, we did a deep dive and the generation of devices that we looked at which would meet this study was probably about three years ago.   We didn't see any discrepancies. And so, that's just one study and there are many more to be done, but I think prior to the technology development as well as once the technology comes out, keeping an eye on how that technology is doing, whether there are continued reports of failure of the technologies is really important. And there are a lot of ways that we can be vigilant about that.   Cindy St. Hilaire:        Yeah, that's great. And so, Andy, regarding patient populations, I can also see perhaps socioeconomic implications of this because smartwatches are not cheap. So how do we see that in terms of helping our patients? Are we going to be able to get a smartwatch through our insurance company?   Andy Hughes:             I think that's one of the really important next steps, is finding ways to make sure that as we advance the field of wearable devices in clinical care, that we recognize some of the existing inequities in terms of access to care, access to digital technologies that currently exist, and find ways by partnering with health insurance companies and the industry and providers and members of that community, finding ways to not only advance wearables, but use it in a way that we can decrease health disparities by really helping to increase access for these digital technologies to the underserved communities.   Jessilyn Dunn:             Yeah, the beauty of these technologies is that truthfully, at their core, they're very cheap. They're not difficult to develop, they're not difficult to build and disseminate. So a lot of what we think about is the infrastructure that goes around these devices. Does it require a smartphone to transfer data? Does it require internet access? What are the other pieces that need to be in place for these devices to work within an ecosystem? So this starts to get to questions beyond the devices themselves, but there's certainly a lot to think about and be done in the area of equity and ensuring that these devices can help everyone.   Cindy St. Hilaire:        And there's also the, I guess, ethical considerations of who owns this data. Obviously, if it's a consumable that you went and bought at Target, that's probably different than the one you're getting from your cardiologist. But who owns the data? Who has access to it? And are there any cases in the literature where an individual who's had certain measurements taken, have those measurements come back to bite them?   And I guess I'm thinking of something like cardiac rehab. If a patient doesn't get up and move enough or doesn't follow their physical therapy enough or lose weight quick enough, could their insurance coverage get cut? Could their premiums go up? What safeguards are in place for these very tricky situations? Are there safeguards in place?   Andy Hughes:             And on the clinical side, I think it will be important to treat this information just like any other protected health information that we have as part of the electronic health record. And so, there will be inherently safeguards around that in a similar manner for how we treat other protected health information.   But I think another important component of that will be a very clear consent policy when we reach the point that patients are consenting to include this information and their electronic health record, in terms of what the proposed benefits are and the potential risks associated with it, because it really is a vast amount of unique data that needs to be protected and safeguarded. And part of that comes by treating it as protected health information, but we will also need to make sure that there's a very clear consent policy that goes with it.   Cindy St. Hilaire:        Yeah. What do we see as the next steps in wearable devices? What do you guys see as the next big thing? I know one's coming from the actual AI and device side of things, and the other one is coming from the clinical side of things. What do each of you see as the next thing in this field?   Jessilyn Dunn:             I think on the device and AI side of things, I think we're thinking toward improving battery life, increasing the suite of sensors that are being added to these devices so we have a wider variety of measurements that are more representative of physiology, and then better algorithms to have better detection of sleep or activity or certain types of activity or certain types of arrhythmias. This combination of hardware and software and algorithms, I think coming together as all of these different pieces evolve will show us some really cool technology in the years to come.   Andy Hughes:             And I think from a clinical side, it's really twofold moving forward. I think as Jessilyn mentioned, there's a lot of novel sensor technologies that have a lot of exciting and evolving potential that we can hopefully integrate into the clinical space, but on the other hand, it's how can we use these wearable devices to enhance traditional therapies that we're already using?   For example, if we take the heart failure population, is there a way that we can use the wearable devices and the existing measurements with heart rate and physical activity and blood pressure to find a way to improve remote management and safely up-titrate guideline directed medical therapy, which are medications that we know have clinical benefit. But can we augment their clinical benefit and their utility by using some of the existing technologies that we already have?   And then lastly, building upon the initial studies with larger trials in more diverse generalizable populations to really enhance our understanding of the benefits that these devices may have for different cardiovascular conditions.   Cindy St. Hilaire:        Well, this was wonderful. Dr Andrew Hughes and Dr Jessilyn Dunn, thank you so much for joining me. The review, Wearable Devices in Cardiovascular Medicine, will be out in our March 3rd issue of Circulation Research. I forget which one, so I'll have to edit that out. Thank you so much for joining us, and I learned a ton. This was great.   Jessilyn Dunn:             Thank you.   Andy Hughes:             Thank you.   Cindy St. Hilaire:        That's it for our highlights from the March 3rd and March 17th issues of Circulation Research. Thank you for listening. Please check out the Circulation Research Facebook page and follow us on Twitter and Instagram with the handle @CircRes and #DiscoverCircRes. Thank you to our guests, Dr Andrew Hughes and Dr Jessilyn Dunn.   This podcast is produced by Ishara Ratnayaka, edited by Melissa Stoner, and supported by the editorial team of Circulation Research. Some of the copy texts for the highlighted articles is provided by Ruth Williams. I'm your host, Dr Cindy St. Hilaire, and this is Discover CircRes, you're on-the-go Source for the most exciting discoveries in basic cardiovascular research.   This program is copyright of the American Heart Association, 2023. The opinions expressed by speakers in this podcast are their own, and not necessarily those of the editors or of the American Heart Association. For more information, visit ahajournals.org.  

In this episode, Drs. Temara Hajjat and Jason Silverman talk to Dr. Miranda van Tilburg about the behavioral treatment of functional abdominal pain. We discuss issues of pain perception, pain coping and maladaptive responses to pain. We also discuss some research-informed behavioral interventions to help treat children with FAP.Dr. van Tilburg needs is a psychologist and researcher who has worked extensively on the behavioural explanations for and treatment of functional GI disorders, including work supported by the NIH and the Rome Foundation. She is currently a Professor in the Department of Medicine at Marshall Health in Huntington, WV and was recently named Chair of the Ethics Committee at NASPGHAN. This episode is eligible for CME credit!  Once you have listened to the episode, click this link to claim your credit.  Credit is available to NASPGHAN members (if you are not a member, you should probably sign up).  And thank you to the NASPGHAN Professional Education Committee for their review!Learning Objectives:Understand the relationship of pain perception and pain coping to symptoms experienced by children with functional abdominal pain. Understand the importance of an appropriate framework to explain functional abdominal pain to children and their parents in a way that validates their experiences.Name 3 possible behavioral treatment options that may be useful in children with FAP.Produced by: Jason SilvermanSupport the showAs always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes!

Stirling Cooper (IG:@cooperstirling) is a former Australian adult performer and male escort turned men's self help coach. He's also a coach for the War Room and The Real World.ai. ——————————————————— Michael's Men of Action program is a Master's course dedicated to helping people elevate their social lives by building elite social circles and becoming higher status. Click the link below to learn more: https://m.moamentoring.com/podcast ———————————————————— Become an affiliate for MOA Mentoring: https://www.moamentoring.com/earn Subscribe on Youtube: https://www.youtube.com/user/MichaelSartain Listen on Apple Podcast: https://podcasts.apple.com/us/podcast/the-michael-sartain-podcast/id1579791157 Listen on Spotify: https://open.spotify.com/show/2faAYwvDD9Bvkpwv6umlPO?si=8Q3ak9HnSlKjuChsTXr6YQ&dl_branch=1 Filmed at Sticky Paws Studios: https://m.youtube.com/channel/UComrBVcqGLDs3Ue-yWAft8w 0:00 Intro 1:24 ** Getting Addicted to Porn 4:16 * Going to AVN 4:51 *** Finding Dirty Magazines in a landfill 5:51 **** Having Patience to Fap 6:23 *** The Porn Star Talent Pool 8:33 ** The Psychology of Beauty (Beauty is Objective) 12:27 * Female Pornstars Trash Talking the Industry 13:57 * Quit Porn If you have problems in the Bedroom 14:30 **** The new category of porn 15:00 * Human Trafficking in the Adult Industry 16:35 *** Porn being lead generation for OF 18:00 The Economics of the Porn industry 18:54 Mia Khalifa and Lana Rhodes 30:47 Andrew Tate 41:30 Andrew Tates next 30 days 43:40 Torey Lanez shooting Megan the Stallion 44:30 *** Taking 10 second clips used out of context 45:05 Vice Filming Andrew Tate 47:00 *** Getting Compensated before Testifying 50:01 The Tates Accused of kidnapping an american 51:59 **** Tristan Tate is a Player and its not a Felony 53:00 More about the Tate Brothers 56:45 We dont want another Amber Heard 59:40 Jonny Sins being Blue Pill 1:05:00 Poly does not work for men 1:06:00 Cheating Vs. Polygeny 1:06:40 Mixed Matched Sex Drive 1:07:27 **** Girls who bring home Girls for their man are irreplaceable 1:08:20 **** Having a threesome is expontentially better 1:09:10 Sex doesnt mean shit for Men 1:10:10 *** Kissa Sins 1:12:05 Women get Redpilled too 1:14:30 Andrew Tate spoke to a certain class of Men 1:15:15 Cancelling does not work 1:17:42 Haters on Twitter 1:20:22 **** Stirling Cooper get Cancelled from the Porn Industry 1:26:52 **** Brittany Renner and Andrew Tate 1:28:12 *** Men get told No, Hot Women Never get told No 1:31:27 Why is Justin Waller the Coolest Cowboy on the Planet 1:32:32 Why is Stirling Cooper Traveling so Much? 1:34:15 When was Stirling Red Pilled? 1:35:25 How Stirling Started his youtube Channel 1:39:07 *** Swingers 1:43:12 *** Devils Threesome 1:44:30 **** How to get a Mans Wife in an orgy 1:45:35 *** Celina Powell sucking off the Phoenix Suns 1:47:25 *** One of Stirling Funniest Porn Scenes 1:49:45 Stirling isnt Monetized on youtube 1:50:13 Being a Research Chemist 1:45:50 *** Thoughts on Cholestrol and Testosterone 1:56:08 * We are bombarded Estrogenic Compounds 1:56:55 Steroids 1:58:00 * Fear and Anticipation for Women 2:02:30 * Status and Presselection 2:05:45 ** Women Denegrating OF Stars 2:06:40 *** Pornstars probably have a lower body count than a Sororiety Girl 2:07:17 Girls like me because other girls like me 2:09:00 **** Hitch and 50 shades of Grey 2:10:45 Women get over Guys Faster 2:13:30 *** For Men its Player vs Player 2:17:45 Porn is to men what Instagram is to Women 2:19:36 Testosterone and Prolactin 2:20:40 Why do Women do Porn? 2:22:00 Passport Bros 2:23:00 Women think Porn and OF is Easy Money 2:25:30 Stirling Coopers Bedroom Courses

Jen meets with veteran LGBTQ researcher Dr. Caitlin Ryan to talk about how family responses can directly impact the health and wellbeing of their LGBTQ family member. Dr. Ryan talks about her decades-long research on behaviors that occur within families when an LGBTQ person comes out and how those behaviors directly impact their self-worth, hopefulness, risk behaviors, health, and self-care. Dr. Ryan discusses the importance of connectedness and gives tips for families whose child has recently come out. Don't miss this important conversation about family acceptance and the potential to impact the health and wellbeing of their LGBTQ loved one.Guest: Caitlin RyanCaitlin Ryan is the director of the Family Acceptance Project® — a research, education, intervention and policy project – to help ethnically, racially and religiously diverse families to support their LGBTQ children. Dr. Ryan is a clinical social worker, researcher and educator who has worked on lesbian, gay, bisexual, and transgender (LGBTQ) health and mental health for more than 40 years and whose work on LGBTQ health has shaped policy and practice for LGBTQ and gender diverse children and youth. She received her clinical training with children and adolescents at Smith College School for Social Work. Dr. Ryan started the Family Acceptance Project with Dr. Rafael Diaz in 2002 to help diverse families to decrease rejection and prevent related health risks for their LGBT children — including suicide, drug use, homelessness and HIV - and to promote family acceptance and positive outcomes including permanency. Dr. Ryan works with organizations, faith communities, families and providers to integrate FAP's family-based support approach to build healthy futures for children, youth and young adults.Links From the Show:Learn more about The Family Acceptance Project: https://familyproject.sfsu.edu/Donate to The Family Acceptance Project: https://familyproject.sfsu.edu/donate LGBTQ Youth and Family Resources: https://lgbtqfamilyacceptance.org/?fbclid=IwAR0VOSv6VY0mBSz04mfSvN2vxQvoWIWLEfGBasRVGOiWwFid8aXqx_dQEe8 Find LGBTQ Resources Near You: https://trainings-theinstitutecf.umaryland.edu/lgbtqfamily/map.cfm LGBTQ Crisis Lines: https://lgbtqfamilyacceptance.org/crisis-lines/ Faith-Based LGBTQ Resources: https://lgbtqfamilyacceptance.org/faith-based-resources/ Culture-Based LGBTQ Resources: https://lgbtqfamilyacceptance.org/culture-based-resources/ In the Den is made possible by generous donors like you.Help us continue to deliver quality content by becoming a donor today at mamadragons.org. If you have a short story, feedback, or any comments we would love to hear from you at 562-344-5010.Connect with Mama Dragons:WebsiteInstagramFacebookDonate to this podcast

Episode 778 - Fancast the FaP, Tynion Kickstarts, Secret Wars Spec 2026, Final Orders-Know Your Station #1 & High Republic Adv. #1, Sneak Peek at Next Week with Kyle & Drew-Traveling to Mars #1 & Specs #1, Support Our Patreon Unlock More C4FaP Bonus Content  https://www.patreon.com/comicsfunprofit Kyle's RPG Podcasts: Encore of the Lost & Two Past Midnight @DorkDayPodcast https://www.dorkdayafternoon.com Shop Kowabunga's Exclusive Variants https://shopkowabunga.com/shop/ Donations Keep Our Show Going, Please Give https://bit.ly/36s7YeL Get on the Kowabunga (Deep  Discount Comics) FOC and Preorder list http://eepurl.com/dy2Z8D Thank You Shout Out to Our Patrons: Adam P., Eric H., Jon A., Andrew C., Bradley R., Aaron M., Darrin W., Dennis C., David D., Martin F.  Email us at: Comicsforfunandprofit@gmail.com - questions, comments, gripes, we can't wait to hear what you have to say. Follow us on twitter.com/ComicsFunProfit & instagram.com/comicsforfunandprofit Like us on Facebook.com/ComicsForFunAndProfit Subscribe, rate, review on itunes, Spotify, Stitcher, YouTube. Thank you so much for listening and spreading the word about our little comic book podcast. Listen To the Episode Here: https://comcsforfunandprofit.podomatic.com/ 

☎️ Text us! 310-356-3920 ☎️ One of our funniest and most enlightening episodes yet! After much heated debate, my mom and I bring on our resident urologist, Dr. Joel, to set the record straight as to what cum smells like. We dive into all the juicy details about sexy fluids from scent and color to texture and taste. We also ask him about blue balls, squeezing the tip during sex, retrograde ejaculation, and no FAP (masturbation). My mom also shares an inside joke about cum that she used to have with my dad. Happy Father's Day! A big thanks to Dr. Joel for coming on the show! Not only is he an expert urologist, but he's also a talented playwright. If you're in the Chicagoland area, check out his theatrical productions and donate at https://www.glassappletheatre.com/. Please support our show and get discounts on our favorite brands by using our sponsors' links here! LIKE A KITTEN – It's time to take your partner on an erotic adventure with a sexy gift box from Like A Kitten! Get 15% off the BYOB Box when you go to LikeAKitten.com/mom and use code MOM. FÜM – Quit naturally with Füm and use code MOM to save 10% at https://www.breathefum.com/mom UBERLUBE – UberLube is our favorite lube! Perfect for oral, anal, and vaginal sex. Use code MOM at www.UberLube.com for 10% off and free shipping. ❣️You can view this full episode in video form by going to our YouTube channel. A special huge thank you to our wonderful videographer/editor/producer, Dale!  Join our sparkling new Sneaky Freak chatroom on Discord! Just visit: https://discord.gg/jJZqkUw3dV. To gain exclusive access to all our Discord channels, join us at Patreon.com/sextalkwithmymom. If you've enjoyed the show, please consider leaving us a review at RateThisPodcast.com/Mom. Also, it would mean the world if you'd support us through Patreon.com/sextalkwithmymom – a platform where you can get exclusive STWMM bonus episodes and Zoom chats with us! Grab some Sex Talk w/ My Mom swag at sextalkwithmymom.com. Get close with us on socials at: Text us - 310-356-3920 Facebook/Instagram - @SexTalkWithMyMom Twitter - @SexTalkPodcast Website - www.SexTalkWithMyMom.com Our podcast's music was crafted by the wildly talented Freddy Avis! Check out his work at http://www.freddyavismusic.com/ Sex Talk With My Mom is a proud member of Pleasure Podcasts, a podcast collective revolutionizing the conversation around sex.