Podcasts about Frailty

CardioNerds (Dr. Jenna Skowronski [Heart Failure Council Chair], Dr. Shazli Khan, and Dr. Josh Longinow) are joined by renowned leaders in the field of AHFTC (Advanced Heart Failure and Transplant Cardiology) and mechanical circulatory support, Dr. Jeff Teuteberg and Dr. Mani Daneshmand to continue the discussion of advanced heart failure therapies by taking a deep dive into the world of durable LVADs (Left Ventricular Assist Devices). In this episode, we will review the history of ventricular assist devices, the basics of LVAD function, selection criteria for LVAD therapy, and surgical nuances of LVAD implantation. Audio Editing by CardioNerds intern, Joshua Khorsandi. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. 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Pearls There have been significant advances in the field of MCS/LVAD therapy since the first implanted LVAD in the 1960s, to the first FDA approved device in the early 2000's, to now the HM3 LVAD, with the most important change being a centrifugal flow/magnetically levitated design that led to minimized hemocompatibility-related adverse events (HRAE's) (MOMENTUM 3 trial comparing HM2 and HM3).  The REMATCH trial in 2001 was a pivotal trial for LVAD therapy, demonstrating that in a population of patients with advanced HF (70% IV inotrope dependent), LVAD therapy significantly improved survival at both 1 and 2 years as compared to medical therapy alone.    MOMENTUM 3 trial was a landmark trial for the HM3 device, showing that in a population of end stage HF patients (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.  There are both patient-specific factors and surgical considerations when it comes to candidacy for LVAD therapy.  RV function prior to LVAD is a key determinant for success post-LVAD  Many patients being considered for LVAD may not have robust RV function, however, predicting RV failure after LVAD is exceedingly difficult.   In general, it doesn’t matter how bad the RV may look on imaging; we care more about the pre-LVAD hemodynamics (look at the PAPi and RA/wedge ratio).   What happens in the OR may be the most important determinant of how the RV will do with the LVAD!  Notes Notes drafted by Dr. Josh Longinow.  1. Historical background of heart pumps and LVADs  LVAD Evolution   FDA approval year  2001  2008  2012  2017  Pump  HeartMate XVE   HeartMate II  Heartware HVAD  HeartMate III  Flow/Design Features  Pulsatile Technology   Continuous flow Axial design  Continuous flow  Centrifugal design  Continuous flow   Full MagLev + Centrifugal design  The 1960's ushered in the first ‘LVADs', when the first air-powered ‘LVAD' was implanted. It kept the patient alive for four days before the patient expired.   The first generation of LVADs were pulsatile pumps   The first nationally recognized, FDA approved LVAD was the HeartMate XVE (late 1990s to early 2000s, REMATCH trial). The XVE pump used compressed air (pneumatically driven) to power the pump.   Prior to the XVE, OHT was the standard of care for patients with advanced, end-stage heart failure.   The second and third generations of LVADs were non-pulsatile, continuous flow devices and included the HVAD, HM2, and HM3 devices.   MOMENTUM 3 was a landmark trial for the HM3 device, showing that in a population of sick patients with end stage HF (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.   The only pump that is currently FDA approved for implant is the HM3, although other pumps are in clinical trials (BrioVAD system, INNOVATE Trial).  2. What are LVADs, and how do they work?   In simplest terms, the LVAD is a heart pump comprised of several key mechanistic components:   Inflow cannula  Mechanical pump   Outflow cannula  Driveline  Controller/Power source  The HM3 differs from its predecessors (HM2 and HVAD) in several key ways;   HM3 is placed intrapericardial whereas the HM2 was placed pre-peritoneal.   Perhaps most importantly, the HM3 is a fully magnetically levitated, centrifugal flow pump, whereas the HM2 is an axial flow device.  Axial flow pumps are not magnetically levitated, leading to more friction produced between the ruby bearing's contact with the pump rotors, and higher rates of hemocompatibility related adverse events (HRAEs, i.e. pump thrombosis) and the HM2 was ultimately discontinued in favor of the HM3 (MOMENTUM 3 trial).  3. What do the terms ‘Destination Therapy' (DT) or ‘Bridge to Transplant' (BTT) mean when it comes to LVADs?   When LVADs first came on the stage, EVERYONE was a BTT; these early pumps weren't designed for long term use (I.e. REMATCH Trial, Heartmate XVE)  Destination therapy means the LVAD was placed in leu of transplant because there are contraindications to transplant   REMATCH trial brought about the concept of “Destination therapy”, comparing outcomes in patients (with contraindications for transplant) who received an LVAD vs optimal medical therapy  Bridge to transplant means we are placing the LVAD in a patient who may not be a transplant candidate at this moment in time (is too sick, or conversely, not sick enough), but may be down the line   Bridge to recovery is another term used when the LVAD is being placed for a patient we think may have a recoverable cardiomyopathy  4. What are some factors we should consider when assessing a patient’s candidacy for LVAD, in general, and from a surgical perspective?   Patient factors   Older age might push us towards thinking LVAD rather than transplant  In general, age > 70 is the cutoff for transplant, but this is not a hard cut off and varies institution to institution    In general, think about things that help predict recovery after a major surgery; Frailty and Nutritional status are important, we try to optimize these prior to LVAD implant   Right ventricular function remains the Achilles heel of LV support  We know that needing temporary RV support post LVAD puts you on a different survival curve than patients who don’t need RVAD support  Studies have not been able to successfully predict who will develop RV failure after LVAD implantation  What happens in the time between when the patient goes to the OR and when they get back to the ICU is an important determinant who might develop RV failure post LVAD   Surgical techniques such as implanting the HM3 in the intra-thoracic cavity, rather than intra-pericardial may help maintain LV/RV geometry to help optimize the RV post LVAD   Surgical considerations for LVAD candidacy  Small, hypertrophied LV: HM3 inflow cannula is small, but small hypertrophied ventricles tend towards chamber collapse during systole causing suction, needing to run slower with lower flow rates  Chest size/diameter: pumps have gotten so small now, that for adults, these have become less of a consideration  BMI: low BMI used to be more of a concern with the older pumps due to where they were placed, and the relative size of the pump itself, not so much now with the smaller HM 3 pumps  Calcified LV apex: would increase risk of stroke, bleeding   Driveline tunneling becomes a concern in the super obese population, higher risk for driveline infections (might tunnel these driveline's shorter, and to a less fatty region of the abdomen, could even tunnel out the thoracic cavity in the super obese to limit skin motion)    5. Is there a role for MCS (i.e. temporary LVAD such as Impella) in pre-habilitation of patients prior to LVAD surgery?   The theory of being able to improve systemic perfusion, decongest the organs, and make the patient feel better prior to surgery makes sense, but becomes problematic due to the lack of a hard end point/time for prehabilitation which might risk delays in surgery   More likely that it can lead to delay in the surgery, with less-than-optimal benefit; you don't want to prolong the wait for surgery and increase the risk for complications prior to surgery    An Impella 5.5 is currently FDA approved for 2 weeks of support, not 2 months so timing is important to keep in mind  It’s unlikely that you will take a patient and convert them from a malnourished, cachectic person in 2 weeks’ time   6. Is there a role for LVAD therapy in the younger patient population? Should we be thinking of LVAD up front for these patients, with the goal of transplanting down the line?   Recovery may be more likely in certain populations, particularly younger females with smaller LV's; in those populations, perhaps bridge to recovery should be the focus, optimizing them on GDMT etc.   The replacement of transplant, with MCS (LVAD) in young patients has become a topic of discussion, because these pumps have become better and better, with the thinking that an LVAD could bridge a patient for 10 years or so, and they could get a transplant later   It is still a big unknown, but several concerns exist  Patients who get LVADs might end up with complications that become contraindication to transplant down the line (stroke, sensitization etc)   Patients and providers are more hesitant because of the more recent iteration for the UNOS criteria for OHT listing which no longer gives patients with an uncomplicated LVAD higher priority, and therefore they could end up waiting a longer time for a heart after undergoing LVAD  References Rose EA, Gelijns AC, Moskowitz AJ, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345(20):1435-1443. doi:10.1056/NEJMoa012175  Mehra MR, Uriel N, Naka Y, et al. A Fully Magnetically Levitated Left Ventricular Assist Device – Final Report. N Engl J Med. 2019;380(17):1618-1627. doi:10.1056/NEJMoa1900486  Mancini D, Colombo PC. Left Ventricular Assist Devices: A Rapidly Evolving Alternative to Transplant. J Am Coll Cardiol. 2015;65(23):2542-2555. doi:10.1016/j.jacc.2015.04.039  Mehra MR, Goldstein DJ, Cleveland JC, et al. Five-Year Outcomes in Patients With Fully Magnetically Levitated vs Axial-Flow Left Ventricular Assist Devices in the MOMENTUM 3 Randomized Trial. JAMA. 2022;328(12):1233-1242. doi:10.1001/jama.2022.16197  Rose EA, Moskowitz AJ, Packer M, et al. The REMATCH trial: rationale, design, and end points. Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure. Ann Thorac Surg. 1999;67(3):723-730. doi:10.1016/s0003-4975(99)00042-9  Kittleson MM, Shah P, Lala A, et al. INTERMACS profiles and outcomes of ambulatory advanced heart failure patients: A report from the REVIVAL Registry. J Heart Lung Transplant. 2020;39(1):16-26. doi:10.1016/j.healun.2019.08.017  Mehra MR, Netuka I, Uriel N, et al. Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure: The ARIES-HM3 Randomized Clinical Trial. JAMA. 2023;330(22):2171-2181. doi:10.1001/jama.2023.23204  Mehra MR, Nayak A, Morris AA, et al. Prediction of Survival After Implantation of a Fully Magnetically Levitated Left Ventricular Assist Device. JACC Heart Fail. 2022;10(12):948-959. doi:10.1016/j.jchf.2022.08.002  Bhardwaj A, Salas de Armas IA, Bergeron A, et al. Prehabilitation Maximizing Functional Mobility in Patients With Cardiogenic Shock Supported on Axillary Impella. ASAIO J. 2024;70(8):661-666. doi:10.1097/MAT.0000000000002170 

You know what frailty is, and you definitely want to avoid it. But have you heard of emotional frailty? No, of course not - I've just made it up. But if you've ever felt like you're completely winning at life, and then some tiny little setback knocks you sideways, leaving you wondering what's wrong with you and why you suddenly can't cope, emotional frailty is to blame. Emotional frailty is invisible, it's dangerous - and often, the culture around us encourages us to do exactly the sorts of things that exacerbate it. It's time to fight back. Your Imperfectionist friend is here to show you how.Find the Wheel of Life exercise here.

By Mary Lindow  I am by far not an expert on the subject of plumblines and righteousness, so take what I say in the light of one who at time gropes like a child in the dark, ever reaching for the hand of the ONE to lead me into a safe place filled with His Hope, His Mercy, His Light and Life. WE LIVE IN A CORRUPT WORLD and therefore, have the “effects and affects” of that corruption ever influencing, ever tainting and ever wooing the flesh.  Plumbline: a tool that consists of a small, heavy object attached to a string or rope and that is used especially to see if something (such as a wall) is perfectly vertical or in alignment)   A plumbline is a simple but accurate tool used for determining whether or not something is perfectly vertical or upright. The Lord also used, and uses, a "plumbline," His Word, to determine how upright His people truly are in His sight. How upright they think they are, or how upright they proclaim themselves to be, means nothing to God. "Behold, I WILL set a plumbline in the midst of My people".  -Amos 7:7  A PLUMBLINE SET OUT BY THE HAND OF GOD IS ONE THAT WE CAN ANCHOR OUR HEARTS TO. It will always, always, ALWAYS, direct us to the truth in a matter; even if it requires pain, loss, persecution and perhaps death in areas we feel we may well have rights to.  It will also be a shield, a balm, a comfort and a teacher to those who will yield to the directive positioning of the Master.  “I will make justice the measuring line and righteousness the plumbline.” -Isaiah 28:17  LIFE – DISTRESS - AND PERSECUTION  I have found that in my life, distress and persecution do not feel like God's care being poured out on me. My heart is not immediately drawn to thanksgiving and gratefulness for the faithfulness of God on display as I cling to the battered pieces that look like potential “rafts” of hope, only to find out that many of them have gaping holes or slow leaks in them.  Rather, it feels like yet another hurt is being permanently woven into my tattered and war-torn soul. It seems as if another mound of questions are piling up and just waiting for an answer and a true solid REAL anchor of hope.  I CAN REALLY CONNECT TO THE WRITER OF PSALM 42  He said “Why are you cast down, O my soul, and why are you in turmoil within me?” It's at those very times that the words of the Savior are so important. When we are down and in turmoil.  But, how do we connect the dots between what we know is true about God's faithfulness and what our hearts feel? When flipped and flung around by the waves, weary from crying and when no answer seems at hand, what is the answer?  When my circumstances show many foes and tyrants rising up against me and my heart is prone to wander and fear, what hope is there of peace?  When my feelings start controlling my thoughts, how can I rest in God's promises?  AT THIS POINT… I HEAR THE “GASPS” …  …And perhaps shocked comments of a few who are amazed that someone who appears to walk so fervently and intimately with the Lord would have such difficulties!  Well! Guess what? I do struggle, I do hurt, and yes I do doubt when I have been side swiped or “rammed” by skilled cons and those who, although may have the appearance of godliness and offered friendship or fellowship, end up having private and evil agendas behind their well placed and planned schemes. And boy oh boy! Those skilled players know the wicked art of wounding the heart and causing people to reel in pain!  BUT, THERE IS ONE WHO FULLY SEES IT ALL  The main skill in the issue of dealing with life as a spiritual person, is to know how to handle yourself when things not only crush and grind your heart, but what to do with the anguish and toll of their aftermath.  We have to get ourselves into a place where we hear clearly again.  We need have to address ourselves, preach to ourselves, and ask questions about ourselves.  We must say to our soul: "Why are you cast down –Why are you so anxious and lacking in peace?"  We must urge ourselves, and say ‘Hope in God'–instead of remaining in this paralyzed, aching state!”  AND THEN WE MUST TAKE IT A STEP FURTHER We must go on to remind ourselves just “Who “God is, and what God is and what God has done, and what God has promised that he Himself said that He would do.  Having done that we can stand up and sing out strongly, defying the torment of the soul, and resist other people's wicked tongues and arrogance, and refuse to go along with the devil and the whole world, and say: ‘Hope in God; for I shall again praise him, my salvation and my God.”  The hope and promise of the fairness of God's justice when dealing with the hurtful things and presumptions of others gives me the confidence to know that God will never turn away from me in my need. No matter how they seem to prosper in the short term, wicked men and women will ultimately pay for their sins, in this life or the next. Jesus died to meet my greatest hardships and sorrows for me, and I need to preach this to myself every day. His power is greater than my weariness and suffering.  The comforting and instruction that comes from simply running to feed upon His word instead of the toxic poison of the replaying of trauma reminds me that what Jesus has done is strong enough for my soul to rejoice in and to be set into a place where it can rest and regroup, gaining a healthy perspective about what to give out to others and what is simply… …. To be enjoyed by the Lord Himself.  THE NATURAL IMPULSES OF MANKIND ARE SINFUL AND DECEITFUL!  Human willpower alone will never be able to change this.  We need God's help to truly change our hearts.  REMEMBER. You cannot change the heart of anyone else either.  If you try to, you will feel the bite of stinging venom or be laughed out of a room. Only the power of the conviction of the Holy Spirit can permeate and get around the jam-packed hardhearted egos of the self sufficient and bitter.  Jeremiah 17:9 says that the human heart is deceitful in all things and is even beyond cure! We must be cautious and wise in reproving and warning such types of people about their bad behaviors and wicked actions where there seems to be no appearance or hope of change and where there is danger of experiencing great and heart wrecking retaliation and slander.  These types trample the warnings and urging for repentance and humbling of the heart under their feet, and turn again and slash at you, despising the warnings that are “tearfully and fearfully” given, and often hurt the persons who give them, either by words or deeds.  "Don't waste what is holy on people who are unholy.  Don't throw your pearls to pigs!  They will trample the pearls,  then turn and attack you.”  -Matthew 7:6    "GIVE ME THE FACTS MA'AM JUST THE FACTS”  I remember that phrase from a TV show called “Dragnet”. The detective would not allow the details of the case to be skewed by any assumptions or pontificating from those he interviewed. He stoically and firmly demanded only the facts.  And so, here are the “facts” about the heart of a good man or woman. 1.) The good man or woman: Brings good things out of the good stored up in his/her heart. And the facts about an evil man or woman.  2.) The evil man/woman brings evil things out of the evil stored up in his/her heart. For out of the overflow of his or her heart his or her mouth speaks. Luke 6:45    THE FRAILTY, BRIEFNESS, AND INSECURITY OF LIFE  The frailty, briefness, and insecurity of life should hold down the vanity and presumptuous confidence of all of our projects and boasting about future greatness and bragging rights! We are always to depend on the will and leading of God.  OUR TIMES ARE NOT IN OUR OWN HANDS, BUT ARE INSTEAD IN THE TIMING OF GOD. Our heads may be filled with cares and plans for ourselves, or our families, or our friends; but Divine intervention often throws our plans into bewilderment. All we have in mind, and all we do, should be with a humble and deep dependence on God. It is foolish, and it is hurtful, to boast of trendy “latest happening” things and prospective projects, and it will bring great disappointment and will prove destructive to relationships and meaningful help to others in the end.  “For the world offers only a craving for physical pleasure, a craving for everything we see, and pride in our achievements and possessions. These are not from the Father, but are from this world.”  -1 John 2:16 LISTEN KINDLY - BEFORE SPEAKING YOUR THOUGHTS  People don't need a lecture on the meaning of suffering or to have a barrage of scriptures “machine-gunned” at them as a reprimand for sharing their moment of grief or struggle! (Especially when their hearts are breaking, weary of the battle and if they are fatigued.) Job could have done without some of the self-righteous answers that came from his “well-meaning” friends. All of the answers could have even been true, but Job didn't need to hear any of them.  He needed their love, not their value judgments.  In fact, it appears as if God judged THEM for trying to offer simple solutions to things that were beyond their comprehension. They had never walked in the loss he was in anguish over.  WHEN WE SUFFER UNJUSTLY WE HAVE A MAJOR CHOICE TO MAKE How will we respond? We can feel sorry for ourselves (and understandably so, for a while), become bitter and cynical, get drawn into a war of words, or even become mixed up in a major conflict. On the other hand, we can take our suffering to the cross and allow our pain to draw us into a deeper place of understanding of what Jesus went though in his sufferings. This does not remove the pain, but does help us to know what to do with our hurt.  This is the 'fellowship of his sufferings' (Philippians 3:10), one of the gateways to closeness with God and the release of his power in our lives. The weight of heartbreak shared with a loving friend cuts it in half. When the burden is shared with many friends, we can cope with almost anything. We never feel more revitalized than when a friend loves us enough to walk with us in our pain. Not lecture us.  The apostle Paul wrote these words to the church in Corinth:  "Praise be to the God and Father of our Lord Jesus Christ, the Father of compassion and the God of all comfort, who comforts us in all our troubles, so that we can comfort those in any trouble with the comfort we ourselves have received from God". -1 Corinthians 1.3-4  SOMETIMES GOD GETS INVOLVED WITH DIRECT MIRACLES, Giving supernatural strength to those in need. But for the most part, he depends on us, his people, to do his work in the world. We love each other, work for healing, and suffer with those who suffer.  The next time you see a friend who is suffering, Jesus may just invite you to be the warm embrace! We comfort each other with the comfort we have received in Christ. And when we do, we become the Body of Christ and he receives the glory!  THE BIBLE IS CLEAR!  We are to bear one another's burdens.  We are to comfort others as Christ has given comfort to us.  Your hard time becomes my hard time.  We join hands in the journey.  When you succeed, I succeed.  When you suffer, I suffer. But we do it together. We share it together.  And we do it, not so much in our wisdom or our words, but in our availability, our understanding, and through our presence.  THAT'S WHAT FELLOWSHIP IS ALL ABOUT!  But not “bland” fellowship. It is CHRISTIAN fellowship. It is the business of burden bearing. Authentic CHRISTIAN fellowship says that when you need me . . . I'll be there. Support in suffering is at the core of what it means to share life together in Christ. The word for "comfort” is the same root word as the name Jesus used to describe one of the functions of the Holy Spirit in our lives (Paraclete). “I will be a comforter, one who comes alongside to give help.” And so as God comes alongside you, now you are able to come alongside another. As the Comforter is at work within you, so you also can be of comfort to those around you.  WE ARE CALLED TO BEAR ONE ANOTHER'S BURDENS.  To mourn with those who mourn. To be a follower of Jesus means to come alongside people who are hurting and find ways to help them walk even through the valley of the shadow of death. We are called to do this, as the word of God and care of God is shared with the intention of stirring, plowing up hardened hearts, creating a place for repentance and challenging saints to hope again, I know and believe that as we learn again as believers, to care, to truly listen and to hope fully again, that the sweet and heavy weight of HIS Glory will be made known and will manifest in unfettered and uncontrolled waves of worship and spontaneous adoration of the King of Heaven.  HE REALLY DOES KNOW WHAT HE WANTS Let's focus on bowing low and seeking His heart and plans in what matters to Him. Indeed, HE is the Plumbline.  Prayer  God, I ask in Jesus' name, that you comfort, strengthen and encourage all who are hurting deeply right now and are going through so much pain and heartache.  Don't allow them to give up in the heat of the battle.  Let them feel your arms wrapping around them and your love overflowing and filling them up. Lord, I will pray often and I know that you will hear my voice, even when I speak to You in my silent thoughts.  To You, I am crying out and my prayers are now before You.  Father, I give to You my problems, I do not want them.  Father, please restore them to You. I know that you have compassion for your children. Father, show them your ways and teach them your paths. Lead them in your truth and teach them you are the God of our salvation and on you we will wait.  Protect them from the evils of this life and guide them through all of their days. Father, thank You for hearing my prayer Father and for considering and for having compassion on all who hear and read these words, and all who hurt, in this troubled world we live in.  Keep them in the center of Your love.  In Jesus' Name ~ Amen  Duplication and sharing of this message is welcomed provided that complete article, podcast link and website information for Mary Lindow is included.  Thank You Copyright © 2026 " THE MESSENGER " ~ Mary Lindow www.marylindow.com https://marylindow.podbean.com Your Gracious Support and Donations Are So Very Helpful And Assist Mary In Publishing Her Teaching Podcasts and Audio Messages. THANK YOU! Please go to PAYPAL to donate  or support this blog:  Donate to the tax-deductible ministry name of:  paypal.me/mlindow    (His Beloved Ministries Inc.)  Or  You Can Mail a Check or Cashiers Check to:  His Beloved Ministries INC  PO Box 1253  Eastlake CO 80614  United States    

Send us a textDr. John Neustadt, ND, is the Founder and President of Nutritional Biochemistry, Inc. (NBI). Dr. Neustadt earned his naturopathic medical degree from Bastyr University where he was awarded the Founder's Award for academic and clinical excellence.Dr. Neustadt is a highly sought-out speaker at medical conferences, and has been recognized as one of the Top Ten Cited Authors in the world for his work. His research on integrative and functional medicine has been featured in the Natural Medicine Journal, Integrative Medicine: A Clinician's Journal, Holistic Primary Care, Molecular Nutrition & Food Research, and Experimental and Molecular Pathology.Dr. Neustadt has published more than 100 medical articles, written four health and wellness books and is now a #1 Amazon Best Selling Author in the field of Osteoporosis. His most recent book is, Fracture-Proof Your Bones: A Comprehensive Guide to Osteoporosis.Dr. Neustadt was also an editor of the textbook Laboratory Evaluations for Integrative and Functional Medicine, which was used across the United States to train and educate physicians on using functional medicine with their patients.Find Dr. Neustadt at-https://www.nbihealth.com/Find Boundless Body at- myboundlessbody.com Book a session with us here!

In this episode of Liver Lineup: Updates and Unfiltered Insights, hosts Kimberly Brown, MD, and Nancy Reau, MD, break down new research on liver transplantation, hepatocellular carcinoma (HCC), and the ongoing evolution of surveillance strategies in chronic liver disease. Drawing on their extensive experience as transplant hepatologists, Brown and Reau place new data into practical context, highlighting where evidence may meaningfully inform practice and where unanswered questions remain.Key episode timestamps:0:00:00 – Introduction0:00:19 – Frailty & Transplant Evaluation0:02:54 – How Centers Use Frailty Measures0:04:37 – Practicalities of the Six‑Minute Walk0:06:10 – MELD 3.0 and Sex/Size Disparities0:08:42 – Exception Points & Size Constraints0:10:05 – Need for a Dynamic MELD System0:10:19 – Immunotherapy as Bridge/Downstaging for HCC0:13:34 – Real‑World Use of IO Around Transplant0:15:22 – Managing Rejection Risk0:19:03 – MASLD Population & Surveillance Gaps0:20:21 – Adherence to HCC Surveillance0:22:42 – Practical Barriers: AFP, Ultrasound, Radiology Reports0:24:02 – Shift Toward Blood-Based Surveillance0:26:01 – How AFP-L3 and DCP Are Used in Practice0:27:39 – Rising AFP, Imaging Strategy & Broader Trend to Blood Tests0:28:27 – Guidelines vs Real-World Practice0:29:37 – Closing Thoughts on Guidelines & Early Detection

Feeling frail? The greatest Source of strength is available to you.   ---    Have you ever felt powerless? I have, and it's a horrible feeling. I'm used to being able typically to figure out the challenges that come my way. Sometimes, though, nothing seems to work. As we walk together through 2 Corinthians, we're going to see what true power really looks like. We're going to see in various ways that God's power is made perfect in our weakness, and we're going to see why Paul would say “when I am weak, then I am strong.”   Sermon Notes: http://bible.com/events/49556238  Submit a Question: bit.ly/BeyondSundayQuestions

Welcome to another transformative episode of the “Master Instructor Roundtable.” In this discussion, hosts Wendy Batts, and Marty Miller, break down a vital topic every fitness professional and enthusiast needs to hear: Why **strength** should be treated as a key vital sign for longevity and overall health.

In this episode of the Living to 100 Club Podcast, host Dr. Joseph M. Casciani speaks with J.J. Caruncho, founder of Sanctavia, an innovative longevity training system designed to help people move, think, and age more powerfully. Drawing from a background that spans dance, martial arts, and healthcare, J.J. explains how a prevention-focused upbringing shaped his approach to aging well. This approach centered on anti-frailty, functional movement, joint protection, and the brain-body connection. Rather than chasing intensity or exhaustion, Sanctavia emphasizes intelligent mechanics, visual cue training, stress resilience, and lifelong adaptability. The conversation explores how older adults can build and maintain strength, balance, and confidence well into later life. Our guest explains why aging powerfully is as much a neurological and psychological process as a physical one. Interestingly, J.J. also discusses how Sanctavia's intuitive online platform makes advanced training accessible to older adults. This is done through customizable levels, brain-based instruction, and integrated meditation and breathwork programs. This episode will resonate with anyone interested in aging well. It addresses preventing falls, maintaining independence, and rethinking what's possible as we grow older. Mini Bio J.J. Caruncho is a polymath, protector, Longevity & Body Mechanics Pioneer, Anti-Falling™ Researcher, master of learning, and Systems Builder. He knows over 30 different Martial Arts and was a Chess Champion growing up. He has taught Body Mechanics, Three Dimensional Spatial Analysis in Combat, Psychological Techniques of de-escalation, & Stress Resilience to the most elite Tier 1 Special Forces Operators on Earth. His training has saved many lives in the highest stakes situations imaginable. He is the Founder of Sanctavía®, the original school of Body Mechanics & Longevity that he developed over 18 years of Research and Development. Sanctavía has changed countless lives, and saved many. He is known for his endless passion for protecting and empowering his students, always going above and beyond to pour everything into them, and for inspiring millions of people to Fight for their Future, to have Courage, and to Never Surrender. Special Offer for Living to 100 Club Listeners JJ Caruncho has extended a locked-in lifetime discount—full access to all of his Sanctavia fitness programs for a single annual fee of $197. Normally, $197 gets you just one program. This offer includes the entire curriculum. Use discount code: 100Club Click Here to Access the Special Offer: https://sanctavia.com/100club Listeners May Also be Interested in: Setting a Goal Today of Daily Physical Exercise How to Future-Proof Your Home and Create Safer Living Spaces

In this episode of the Living to 100 Club Podcast, host Dr. Joseph M. Casciani speaks with J.J. Caruncho, founder of Sanctavia, an innovative longevity training system designed to help people move, think, and age more powerfully. Drawing from a background that spans dance, martial arts, and healthcare, J.J. explains how a prevention-focused upbringing shaped his approach to aging well. This approach centered on anti-frailty, functional movement, joint protection, and the brain-body connection. Rather than chasing intensity or exhaustion, Sanctavia emphasizes intelligent mechanics, visual cue training, stress resilience, and lifelong adaptability. The conversation explores how older adults can build and maintain strength, balance, and confidence well into later life. Our guest explains why aging powerfully is as much a neurological and psychological process as a physical one. Interestingly, J.J. also discusses how Sanctavia's intuitive online platform makes advanced training accessible to older adults. This is done through customizable levels, brain-based instruction, and integrated meditation and breathwork programs. This episode will resonate with anyone interested in aging well. It addresses preventing falls, maintaining independence, and rethinking what's possible as we grow older. Mini Bio J.J. Caruncho is a polymath, protector, Longevity & Body Mechanics Pioneer, Anti-Falling™ Researcher, master of learning, and Systems Builder. He knows over 30 different Martial Arts and was a Chess Champion growing up. He has taught Body Mechanics, Three Dimensional Spatial Analysis in Combat, Psychological Techniques of de-escalation, & Stress Resilience to the most elite Tier 1 Special Forces Operators on Earth. His training has saved many lives in the highest stakes situations imaginable. He is the Founder of Sanctavía®, the original school of Body Mechanics & Longevity that he developed over 18 years of Research and Development. Sanctavía has changed countless lives, and saved many. He is known for his endless passion for protecting and empowering his students, always going above and beyond to pour everything into them, and for inspiring millions of people to Fight for their Future, to have Courage, and to Never Surrender. Special Offer for Living to 100 Club Listeners JJ Caruncho has extended a locked-in lifetime discount—full access to all of his Sanctavia fitness programs for a single annual fee of $197. Normally, $197 gets you just one program. This offer includes the entire curriculum. Use discount code: 100Club Click Here to Access the Special Offer: https://sanctavia.com/100club Listeners May Also be Interested in: Setting a Goal Today of Daily Physical Exercise How to Future-Proof Your Home and Create Safer Living Spaces

There are 80 million women over 40 in America. Only 4,100 menopause certified clinicians. The gap is real. And my guest is working on changing that. Dr. Kelly Casperson is a urologist, sexual medicine physician, and bestselling author of The Menopause Moment and You Are Not Broken. She's been leading the charge on women's health advocacy from serving on the FDA panel that removed the box warning on estrogen to pushing for testosterone deregulation. She has a large following, but as Kelly says: it's just a drop in the bucket. HThere are 80 million women over 40 in America. Only 4,100 menopause certified clinicians. The gap is real. And my guest is working on changing that.Dr. Kelly Casperson is a urologist, sexual medicine physician, and bestselling author of The Menopause Moment and You Are Not Broken. She's been leading the charge on women's health advocacy from serving on the FDA panel that removed the box warning on estrogen to pushing for testosterone deregulation. She has a large following, but as Kelly says: it's just a drop in the bucket.We talk about the women who aren't on social media, who aren't listening to podcasts, who don't know their options exist. How we need to reach people in the community churches, community centers, libraries. We discuss why grassroots education matters, why testosterone is locked behind 1980s doping laws. We discuss why grassroots education matters, why testosterone is locked behind 1980s doping laws, and Kelly shares the real reason for menopause.This is a conversation about what's changing in women's health and what still needs to change.Highlights:Why grassroots advocacy in the community matters as much as social media.Why 30% of women prescribed vaginal estrogen won't use it (the box warning effect).Frailty isn't inevitable it's what happens when you don't maintain your health.The biopsychosocial model: how culture shapes your menopause experience.Kelly's philosophy: you have to advocate for yourself, but you're not alone.Don't be afraid to start conversations with friends and loved ones about menopause, hormones, and the options available. You might be the only person in their life talking about this and that conversation could change be life changing.Get in Touch with Dr. Casperson:WebsiteInstagramPodcastGet in Touch with Me: WebsiteInstagramYoutubeSubstack

In the latest episode of the Transforming Primary Care podcast, Dr Sarah Zaidi, GP and NHS England regional lead for frailty in the East of England and a panel of North-East and Yorkshire based GPs, geriatricians and other health and care professionals discuss how to help the most vulnerable people in our communities. They explore how the identification and successful management of frailty is key to the aims of the 10 Year Plan and the medium-term planning framework, as well as its role within neighbourhood working. For more information on neighbourhood health visit: https://www.england.nhs.uk/long-read/neighbourhood-health-guidelines-2025-26/ A full transcript of this episode is available on our website - https://www.england.nhs.uk/long-read/transforming-primary-care-podcast-2/ Please get in touch if you have any questions regarding this episode - england.ney.pctransformation@nhs.net

What are your thoughts on Alpha-ketoglutarate for healthy aging?A treatment for warts?Am I destined to develop diabetes given my strong family history of diabetes and high blood pressure?

Consequences of weight loss with weight loss drugs...Enter myostatin inhibitor drugsMy latest HgbA1c is 5.9, and I'm doing everything right. What gives?I'm approaching 80. Could you discuss aging?

As we close out this Best of 2025, these episodes represent far more than download numbers or chart positions. They reflect the conversations that resonated most with you, the ones that challenged practice, reinforced fundamentals, and reminded us why this work matters.From Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest with Mike Christian, to The Evolving Nature of Major Incidents with Adam Desmond, Paediatric Assessment in Critical Care with Anna Dobbie, Frailty in Geriatric Patients with Iain Wilkinson and James Adams, and The Last Year of Life focusing on Palliative and End of Life Care; each episode speaks to a different phase of life, a different clinical challenge, and a different kind of responsibility. Together, they capture the full spectrum of pre-hospital and emergency care: from critical care decisions to thoughtful, values-based care at the end of life.They remind us that excellence in practice is not just about technical skill or clinical algorithms, but about clear communication, teamwork, and compassion, whether we are managing traumatic cardiac arrest, supporting families during major incidents, caring for critically unwell children, advocating for frail older adults, or walking alongside patients in their final year of life.Thank you for being part of our podcast community throughout 2025. Your engagement is what makes these conversations possible, and it is a privilege to continue them with you into the year ahead. Finally, thank you to PAX bags for their continued support of the podcast. You can find the best-in-class medical bags here: https://www.pax-bags.com/en/

Discover all of the podcasts in our network, search for specific episodes, get the Optimal Living Daily workbook, and learn more at: OLDPodcast.com. Episode 3233: Eric Bach makes a compelling case for strength training as the most powerful tool to extend not just lifespan but healthspan. By preserving muscle mass, boosting metabolism, and improving mobility, intelligent resistance training can help you look, feel, and move like someone decades younger, no miracle diets or gimmicks required. Read along with the original article(s) here: https://bachperformance.com/strength-training-the-ultimate-fountain-of-youth/ Quotes to ponder: "Lifting weights isn't about being jacked, ‘bro. It's about living longer and healthier, ‘bro." "Getting stronger in the gym is the compound interest of training. The more you put in earlier, the more wealth you'll accumulate over time." "Building a foundation of strength improves your ability to build muscle." Episode references: Frailty and adverse health outcomes study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2465752/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Discover all of the podcasts in our network, search for specific episodes, get the Optimal Living Daily workbook, and learn more at: OLDPodcast.com. Episode 3233: Eric Bach makes a compelling case for strength training as the most powerful tool to extend not just lifespan but healthspan. By preserving muscle mass, boosting metabolism, and improving mobility, intelligent resistance training can help you look, feel, and move like someone decades younger, no miracle diets or gimmicks required. Read along with the original article(s) here: https://bachperformance.com/strength-training-the-ultimate-fountain-of-youth/ Quotes to ponder: "Lifting weights isn't about being jacked, ‘bro. It's about living longer and healthier, ‘bro." "Getting stronger in the gym is the compound interest of training. The more you put in earlier, the more wealth you'll accumulate over time." "Building a foundation of strength improves your ability to build muscle." Episode references: Frailty and adverse health outcomes study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2465752/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Popular media leverage weak study to criticize RFK Jr.'s rethink of standard recommendations for saturated fat avoidance; Poor quality plant-based diets hike cardio risk; A listener complains his lp(a) is going up with age despite his healthy diet, lifestyle; Scientists pinpoint cocoa ingredient that slows aging; Berry proanthocyanidins preserve brain power; Tattooing may promote inflammation, undermine immunity.

In the 200th episode of Health & Veritas, Harlan offers end-of-the-year reflections on medicine drawn from his editor's notes in JACC (the Journal of the American College of Cardiology), and Howie provides updates on gun violence, flu, measles, and the health benefits of yoga. Show notes: Editor's notes by Harlan Krumholz "The Day I Became a Doctor" "When Your Patient Dies" "Rethinking Physician Certification: A Call for a Modern, Meaningful Standard" Gun violence, flu, and measles "Mass shootings outnumber annual days in U.S., children are missing school due to measles, Covid-19 is peeping around the corner, and some hope" "Measles outbreaks worsen in South Carolina, Arizona and Utah" "Connecticut reports first measles case in years" "New Flu Variant May Be Triggering Spike in Severe Disease" "High-Dose Influenza Vaccine Effectiveness against Hospitalization in Older Adults" "Pfizer Reaffirms Full-Year 2025 EPS Guidance and Provides Full-Year 2026 Guidance" The benefits of yoga "Yoga for chronic non‐specific low back pain" "Yoga-based interventions may reduce anxiety symptoms in anxiety disorders and depression symptoms in depressive disorders: a systematic review with meta-analysis and meta-regression" "Effect of Yoga on Frailty in Older Adults" "Yoga in autoimmune disorders: a systematic review of randomized controlled trials" "Long-term effects of yoga-based practices on neural, cognitive, psychological, and physiological outcomes in adults: a scoping review and evidence map" "Yoga isn't just for flexibility. It may also protect brain health." In the Yale School of Management's MBA for Executives program, you'll get a full MBA education in 22 months while applying new skills to your organization in real time. Yale's Executive Master of Public Health offers a rigorous public health education for working professionals, with the flexibility of evening online classes alongside three on-campus trainings. Email Howie and Harlan comments or questions.

In this episode of GEMCast, host Dr. Christina Shenvi is joined by Dr. James Van Oppen, emergency physician and frailty expert at the University of Sheffield, to discuss the rising importance of frailty in emergency medicine. Frailty, defined as the loss of physiological resilience, is both common and clinically significant for older adults presenting to the emergency department (ED). The two discuss what frailty means, how it can be identified, and how to approach ED assessment and management in a frail patient, emphasizing the value of person-centred care. Furthermore, they highlight recent studies regarding frailty, which can be found in the resources below, and discuss the need for system-wide changes to support frailty care. Alongside his work as an emergency physician and clinical lecturer, Dr. van Oppen is the chair of the geriatric emergency medicine section of the European Society of Emergency Medicine. Tune in to this episode to expand your understanding of frailty and hear some practical tips to improve your clinical practice.

First shots fired in war against ultra-processed foods; What the big reveal of Trump's MRI really shows; Is cruelty to horses really necessary to make estrogen? Early smartphone use linked to mental harms in kids; Nutritionist sues American Diabetes Association for forcing her to promote unhealthy artificial sweeteners; Halle Berry dings California Governor Newsom for vetoing menopause awareness bill.

Nutritionist Leyla Muedin details a study on the effects of vitamins C and E supplementation in older women with sarcopenia. The study, published in the journal Medicine, found that combining 1000 mg of vitamin C and 335 mg of vitamin E with a 12-week resistance training program significantly improved muscle mass, strength, and certain blood parameters compared to a placebo group. The benefits were attributed to the alleviation of oxidative stress and inflammation. Leyla underscores the importance of adequate animal protein intake to optimize resistance training outcomes.

In the past on this podcast, we have often asked the question of whether a monster is born or are they made? This might be the episode that finally answers that question. The story that follows suggests that monsters are NOT born; they're made – often by the very people who should protect them.Have a question or comment? Text us on the Haunt Line @ 217-791-7859New Facebook page - https://www.facebook.com/troytaylorodditiesCheck out our updated website and sign up for our newsletter at AmericanHauntingsPodcast.comWant an episode every week, plus other awesome perks and discounts? Check out our Patreon pageFind out merch at AmericanHauntingsClothing.comFollow us on Twitter @AmerHauntsPod, @TroyTaylor13, @CodyBeckSTLFollow us on Instagram @AmericanHauntingsPodcast, @TroyTaylorgram, @CodyBeckSTLThis episode was written by Troy TaylorProduced and edited by Cody BeckOur Sponsors:* Check out CBDfx and use my code HAUNTINGS for a great deal: https://cbdfx.com* Check out Shopify: https://shopify.com/hauntings* Check out Uncommon Goods: https://uncommongoods.com/HAUNTINGSSupport this podcast at — https://redcircle.com/american-hauntings-podcast/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

No Soul Is Safe. "Giving Thanks Month" continues! A whole month of Patron-picked movies! Next up is Bill Paxton's 2001 directorial debut FRAILTY from longtime patron "James B"! In an FBI office, a man recounts a disturbing childhood tied to his father's divine mission to destroy evil. As his story unfolds, the present and past collide. Also this week: Traffic woes, Meatballs franchise trivia, and tryting to remember who the heck is in Tombstone? All this--and a whole lot more--on this week's episode of NEON BRAINIACS!! "Only demons should fear me... You're not a demon, are you?" ----- Check out our Patreon for tons of bonus content, exclusive goodies, and access to our Discord server! ----- Frailty (2001) Directed by Bill Paxton Written by Brent Hanley Starring Bill Paxton, Matthew McConaughey, Powers Boothe, Matt O'Leary, Jeremy Sumpter, Derk Cheetwood, and Missy Crider ----- 00:00 - Intro & Opening Banter 37:11 - "The Shpiel" 01:00:11 - Film Breakdown 01:51:25 - Stump The Brainiac & Outro

Commentary by Dr. Jian'an Wang.

Commentary by Dr. Jian'an Wang.

We're tantalizing ALL of your senses with our newest theme – RAW and Un-SENSE-ored: Horror Movies about the Senses – brought to you by Lucas! His first pick… maybe stretches the boundaries of the horror realm but we have a good time anyway tickling our olfactories with a discussion on PERFUME: STORY OF A MURDERER!   Go to patreon.com/SHUDcast where you can sign up for all kinds of extra goodies! 00:00 - 9:40ish -  Intros: Lucas went on an odyssey, Tron: Ares, Good Morning America   9:40ish - 1:08:00ish - The other stuff we watched this time!   Lucas - Skinamarink, Christmas Bloody Christmas, One Battle After Another, Perfect Neighbor, LOTR: The Two Towers, Uncut Gems   Cody - One Battle After Another, Sleepy Hollow, Primate, Exhuma, Here for Blood, Night of the Reaper, Bone Lake, Dust Bunny, Deathstalker, Death of a Unicorn, Frankenweenie, This Night I'll Possess Your Corpse, The Devil's Rejects, The Strange World of Coffin Joe, A Nightmare Before Christmas, Freaked!, Scream, Blink, Cape Fear, Ouija: Origin of Evil   Austin - Primate, Dust Bunny, Deathstalker, 28 Years Later, The Boy Behind the Door, Black Phone 2, K-Pop Demon Hunters, Presence, VHS Halloween, The Monkey, Sinners   Curtis - One Battle After Another, Primate, Dust Bunny, Deathstalker, Black Phone 2, Presence, VHS Halloween, No Other Choice, Chungking Express, The Furious, A Bittersweet Life, Pumpkinhead, At the Drive-In, Gonjiam: Haunted Asylum, Ernest Scared Stupid, Cronos, The Devil's Backbone, Mimic, 10 Cloverfield Lane, Lake Mungo, The Descent, Frailty, The Texas Chain Saw Massacre   1:08:00ish - 1:42:00ish - PERFUME: THE STORY OF A MURDERER - SHUDdown and discussion!   1:42:00ish - End - Movie #2 of “Raw and Un-SENSE-ored: Horror Movies about the Senses” brought to you by Lucas!

Welcome to Day 2730 of Wisdom-Trek. Thank you for joining me. This is Guthrie Chamberlain, Your Guide to Wisdom Day 2760 – Wisdom Nuggets – Psalm 90:10-17 – Daily Wisdom Wisdom-Trek Podcast Script - Day 2730 Welcome to Wisdom-Trek with Gramps! I am Guthrie Chamberlain, and we are on Day 2730 of our Trek. The Purpose of Wisdom-Trek is to create a legacy of wisdom, to seek out discernment and insights, and to boldly grow where few have chosen to grow before. The title of today's Wisdom-Trek is: The Wisdom to Number Our Days – A Prayer for Satisfaction and Significance Today, we reach the conclusion of the oldest psalm in the Psalter, Psalm Ninety, also known as the timeless Prayer of Moses, covering its remaining verses, ten through seventeen, in the New Living Translation. In our last conversation, we explored the sobering first half of this psalm. Moses established the immense chasm between the eternal God—our “home” and refuge who predates the mountains—and the transient life of man, who vanishes like a “dream” or “grass” that is withered by evening. We acknowledged that our fleeting years are often spent under the cloud of God's righteous anger against sin, as He sets our “secret sins in the light of [His] presence” (Psalm Ninety, verse eight). Now, Moses moves from somber theological reflection to a fervent, practical prayer. Recognizing the brevity and the sorrow of a life lived under divine displeasure, he prays for wisdom, mercy, and ultimate significance. This concluding segment is the mature response to our mortality: since our days are numbered, how can we ensure they are counted for something eternal? So, let us open our hearts to this ancient and vital prayer, learning how to redeem the time God has given us. The first segment is: The Frailty of Life and the Plea for Wisdom Psalm Ninety: verses ten through twelve Seventy years are given to us! Some even live to eighty. But even the best years are filled with pain and trouble; soon they disappear, and we fly away. Who can comprehend the power of your anger? Your wrath is as awesome as the fear you deserve. Teach us to realize the brevity of life, so that we may grow in wisdom. Moses begins by stating the typical limit of human lifespan, a stark number based on his long experience with the dying generation in the wilderness: "Seventy years are given to us! Some even live to eighty." This lifespan, while a gift, is often limited, but Moses acknowledges that longer life isn't always better: "But even the best years are filled with pain and trouble; soon they disappear, and we fly away." This speaks to a universal truth: even the healthiest and most prosperous years have their share of hardship—a reality that the ancient Israelites knew...

Frailty, once thought to be irreversible, is now recognized as a condition that can be improved through consistent outdoor movement, restoring strength, balance, and independence in older adults Research from Canada's GO-OUT studies shows that even simple walking programs — whether guided park walks or weekly reminders — measurably reduce frailty and boost mobility in as little as 10 weeks Confidence, not just time spent walking, proved to be the strongest predictor of improvement, as older adults who practiced in supportive outdoor groups felt safer and more capable continuing on their own A Hong Kong trial found that pairing a smartphone app with outdoor fitness equipment helped older adults stay active, build exercise confidence, and improve mental well-being far beyond structured classes You don't need a gym to rebuild vitality — start with short, daily walks outdoors, add small balance or strength challenges, and work toward one hour a day to strengthen muscles, circulation, and confidence naturally

Dr Mian discussed why frailty should be understood as a dynamic, evolving clinical state rather than a fixed baseline characteristic

This episode covers: Cardiology this Week: A concise summary of recent studies Lp(a) - What to expect in the very near future Myocardial infarction in older and frail adults Mythbusters: is beetroot good for your heart? Host: Rick Grobbee Guests: JP Carpenter, Vijay Kunadian, Erik Stroes Want to watch that episode? Go to: https://esc365.escardio.org/event/2177 Want to watch that extended interview on Lp(a), go to: https://esc365.escardio.org/event/2177?resource=interview   Disclaimer  ESC TV Today is supported by Bristol Myers Squibb and Novartis through an independent funding. The programme has not been influenced in any way by its funding partners. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. The ESC is not liable for any translated content of this video. The English language always prevails.    Declarations of interests Stephan Achenbach, Yasmina Bououdina, Rick Grobbee, Nicolle Kraenkel, Vijay Kunadian and Erik Stroes have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder MyCardium AI. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

In the quiet corridors of a seaside care home, on an ordinary weekday afternoon, a 92-year-old man sat confused in his wheelchair, gripping a butter knife he'd been using to eat his lunch. Within minutes, two police officers would arrive at his door after being alerted that it was vital for them to attend the scene quickly, as someone's life had been threatened…*** LISTENER CAUTION IS ADVISED *** This episode was researched and written by Eileen Macfarlane.Edited by Joel Porter at Dot Dot Dot Productions.Script editing, additional writing, illustrations and production direction by Rosanna FittonNarration, additional audio editing and mixing, and script editing by Benjamin Fitton.To get early ad-free access, including Season 1, sign up for They Walk Among PLUS, available from Patreon or Apple Podcasts.More information and episode references can be found on our website https://theywalkamonguspodcast.comMUSIC: Falling Skies by Louis Lion Darker Days by Alternate Endings Pursuit Of Wonder by Caleb Etheridge Road To Nowhere by Caleb Etheridge To What End by Caleb Etheridge Rampant by CJ0 Bane by Cody Martin Far From Home by Cody Martin Final Moments by Cody Martin Outer Rim by Cody Martin Rising Sun by Colossus Distant Water by Chelsea McGough Siege by Hill Creeper by Hill The Plot Thickens by Joshua Spacht Ancient Ground by Moments The Way Back by Moments Onward by Chelsea McGough SOCIAL MEDIA: https://linktr.ee/TheyWalkAmongUsSupport this show http://supporter.acast.com/theywalkamongus. Hosted on Acast. See acast.com/privacy for more information.

Ab 60 Jahren in die Muckibude? Häufiger ein Frühstücksei im Alter? Zurückhaltung bei der Blutdruckregulation? Persönlich wie auch fachlich besprechen Markus M. Lerch und Cornel Sieber die Besonderheiten bei Prävention und Therapien im Alter. Und was es eigentlich bedeutet, gebrechlich – also frail – zu sein.

Commentary by Dr. Xin Zhou.

Commentary by Dr. Mert Kaskal.

Blastober barrels forth with 2001's creepy psychological horror FRAILTY! FRAILTYDIRECTED BY: Bill PaxtonRELEASED: April 12, 2002STARRING: Bill Paxton, Matthew McConaughey, Powers Boothe, Luke Askew, Jeremy Sumpter BUDGET: $11mBOX OFFICE: $17,4mESTIMATED LOSS: $2mNEXT EPISODE: We wrap up Blastober with the third and final feature from a Master of Horror. SHOW NOTESAuto shop angelhttps://imgur.com/a/6Q7J43sScenes of Meat, TXhttps://imgur.com/a/g1kxxFn0:00 Intro 3:45 Show & tell8:30 This week's movie

Jade Greenfield • Psalm 77:1–77:20 • Steadfast

Jade Greenfield • Psalm 77:1–77:20

Welcome to The B-Side! Here we talk about movie stars! Not the movies that made them famous or kept them famous, but the ones that they made in between. Today we talk about a performer that we lost far too soon: Bill Paxton. Our B-Sides today include Brain Dead, Indian Summer, Traveller, and Frailty. Our guest is Billy Ray Brewton, and we cover a lot of ground. We dive into Paxton's Roger Corman origins (Crazy Mama getting reamed out by legend Stella Adler in New York, his ultimate move to Los Angeles, James Cameron, etc.), his love of movie-making and being on set, his tragic death, and much, much more. We mention his first directing gig (“Fish Heads” by Barnes & Barnes on SNL), his last directed feature (The Greatest Game Ever Played), and his recent podcast appearances before his death. There is also this charming late night appearance.

Targeting the biology of aging offers a path to stronger resilience and longer health. John C. Newman, M.D., Ph.D., explains that aging arises from measurable cellular processes, often called hallmarks of aging, including changes involving mitochondria, stem cells, cellular senescence, inflammation, and protein quality control. Newman describes how basic science in model organisms reveals mechanisms that can be manipulated to extend healthy lifespan and guide therapies. Emerging approaches aim either to strengthen stress responses that make cells more resilient or to address downstream consequences. Many clinical studies across the country now test interventions that target aging, supported by national efforts to standardize methods and expand training. Newman also investigates ketone bodies as energy sources that influence inflammation, muscle preservation, and other processes relevant to frailty and recovery. Series: "Stein Institute for Research on Aging" [Health and Medicine] [Show ID: 40961]

Targeting the biology of aging offers a path to stronger resilience and longer health. John C. Newman, M.D., Ph.D., explains that aging arises from measurable cellular processes, often called hallmarks of aging, including changes involving mitochondria, stem cells, cellular senescence, inflammation, and protein quality control. Newman describes how basic science in model organisms reveals mechanisms that can be manipulated to extend healthy lifespan and guide therapies. Emerging approaches aim either to strengthen stress responses that make cells more resilient or to address downstream consequences. Many clinical studies across the country now test interventions that target aging, supported by national efforts to standardize methods and expand training. Newman also investigates ketone bodies as energy sources that influence inflammation, muscle preservation, and other processes relevant to frailty and recovery. Series: "Stein Institute for Research on Aging" [Health and Medicine] [Show ID: 40961]

I. Pastoral Humility. II. Pastoral Integrity. III. Pastoral Proximity.

Think strength training is just about building muscle? Think again. Your workouts activate myokines that positively influence nearly every organ in your body. In this episode, Amy Hudson and Dr. James Fisher break down the world of myokines--the powerful messengers released during exercise that can fight disease, sharpen your brain, and even slow aging. Expect to learn how strength training floods your body with health-boosting signals, why myokines are called “magic,” and ways strength protects both your lifespan and healthspan. Tune in to discover why muscle is the most underrated organ in your body—and how to tap into its hidden power. Dr. Fisher starts by describing why we need to think of muscle differently: It's not just tissue that moves your body, it's a chemical messenger system that sends positive signals all over the body.  Amy and Dr. Fisher cover why exercise is medicine. Each contraction releases myokines that calm inflammation, boost immunity, and even protect against cancer and neurological decline.  For decades, scientists knew muscles released “something,” but the name myokines wasn't coined until 2003. Now we know muscles are the largest endocrine organ in our bodies. Dr. Fisher explains the endocrine connection: Your muscles talk to organs the way your thyroid or pancreas does, constantly sending and receiving instructions.  According to Amy, you don't need six months of training before myokines start working. Just one resistance session floods your body with signals that improve energy, mood, and metabolism. How to fight belly fat naturally. According to Dr. Fisher, a myokine called interleukin-15 literally shrinks fat cells, making them store less. At the same time, it activates immune cells that protect you against tumors and infections. Amy compares myokines to magic. Science shows that training creates chemical changes that feel almost supernatural. The “magic” is your body healing itself from the inside out. Learn how exercise boosts your brain: Myokines like BDNF (Brain-Derived Neurotrophic Factor) act like fertilizer for your brain cells. They help you think sharper, learn faster, and protect against cognitive decline. Dr. Fisher explains why muscle growth isn't accidental. There's a molecule called myostatin that tries to limit your muscle growth. Resistance training shuts it down—so your muscles can grow instead of being held back. Amy explains the anti-aging effects of strength training.  Dr. Fisher highlights the consequences of aging without strength: Frailty, injuries, and dependence. Building strength is the single best insurance policy against that future. According to Amy, life is not about how long you live—it's about how long you can thrive. Myokines help you extend the years you can stay active, engaged, and vibrant. Amy and Dr. Fisher discuss how every squat, push, or pull unlocks healing compounds you can't get from a pill.  Amy's parting thoughts: Your body is wired to reward strength, that's why each workout delivers an immediate chemical payoff that makes you feel good.     Mentioned in This Episode: The Exercise Coach - Get 2 Free Sessions! Submit your questions at StrengthChangesEverything.com     This podcast and blog are provided to you for entertainment and informational purposes only. By accessing either, you agree that neither constitute medical advice nor should they be substituted for professional medical advice or care. Use of this podcast or blog to treat any medical condition is strictly prohibited. Consult your physician for any medical condition you may be having. In no event will any podcast or blog hosts, guests, or contributors, Exercise Coach USA, LLC, Gymbot LLC, any subsidiaries or affiliates of same, or any of their respective directors, officers, employees, or agents, be responsible for any injury, loss, or damage to you or others due to any podcast or blog content.

  WITH AN AXE!!!

"Gain muscle mass and you will live longer.” ~ Dr. Jeff Gross. Dr Gross opens this episode with a simple truth backed by decades of clinical insight. Strategic exercise adds muscle, builds bone density, and prevents frailty. No marathon workouts required. In this conversation we unpack his weekly routine... short intervals, and one set to failure strength work. And then we explore how natural killer cell exosomes may support immune surveillance against cancer and zombie cells while protecting healthy tissue.

Join host Alex Crespo, MD as he chats with author Michael Weaver, MD about the Journal of Orthopaedic Trauma article on the Frailty Index as a possible stratification tool in the CMS hip fracture bundle. To access the abstract, click here. For additional educational resources visit OTA.org

Send us a textThe better than Van Helsing boys have spent their lives under the strict rule of their producer. Unaware of his dark past, they struggle to understand his increasingly erratic behavior. But when they begin to uncover the violent truths behind his mixing board, their world unravels, forcing them to confront having to produce the show without him. On Episode 683 of Trick or Treat Radio we discuss the film Abraham's Boys: A Dracula Story based on the short story from Joe Hill and directed by Natasha Kermani! We also talk about the upcoming Deathstalker film, isolationism and gaslighting from those you trust, and plenty of Dracula lore. So grab your monster hunting handbook, subvert any and all expectations, and strap on for the world's most dangerous podcast!Stuff we talk about: Steven Kostanski, The Void, Psycho Goreman, Frankie Freako, Deathstalker, Astron-6, practical FX, violence, sword and sorcery films, Jerry “The King” Lawler, f*ck WWE, The Incubus, Needful Things, the 13th Warrior, Eaters of the Dead, House of 1000 Corpses, Hunt for the Blood Orchid, Suspect Zero, Lets Scare Jessica to Death, The Last Exorcism, The Candyman, Watchmen, this day in horror history, Alexa Vega, bloody birthdays, The Tomorrow People, Machete Kills, Mothers Day, Psycho III, Zodiac, John Kassir, Rock and Shock, The Three Stooges, Benny and Joon, Will and Grace, Caveman, Todd Browning's Freaks, Rocket Ship XM, Invaders from Mars, Slash, Tim Seeley, Red Sonja, Rose McGowan, Deathwatch, The Dreadites, boomsword, Lucio Fulci, Conquest, covering the lens in vaseline, Sabrina Siana, Planet of the Gapes, Joe Hill, Abraham's Boys, Natasha Kermani, Titus Welliver, Jocelin Donahue, Frailty, Bill Paxton, PCU, Dogtooth, Yorgos Lanthimos, “the severed heads looked really good”, no style nor substance, Vanhelsing, movie of the week, “It's Better than Vanhelsing”, Batman, Monster: The Ed Gein Story, Wisconsin represents, Menendez Brothers, Brute 1976, Joe Knetter, Marcel Walz, Frute Brute, Countess Caramella, Brute 1976, Brut By Faberge, Mammoth, Robert Rodriguez, Greg Nicotero, Michael Jackson, Wolfgang Van Halen, Peter's Polar Bear Paradox, The Serial Killer Lookbook, Conquest and Divide, and The Ballad of Oswalt Patton.Support us on Patreon: https://www.patreon.com/trickortreatradioJoin our Discord Community: discord.trickortreatradio.comSend Email/Voicemail: mailto:podcast@trickortreatradio.comVisit our website: http://trickortreatradio.comStart your own podcast: https://www.buzzsprout.com/?referrer_id=386Use our Amazon link: http://amzn.to/2CTdZzKFB Group: http://www.facebook.com/groups/trickortreatradioTwitter: http://twitter.com/TrickTreatRadioFacebook: http://facebook.com/TrickOrTreatRadioYouTube: http://youtube.com/TrickOrTreatRadioInstagram: http://instagram.com/TrickorTreatRadioSupport the show

Feel like your midlife body has betrayed you? Stiffer joints, mysterious aches, less energy—these aren't just inconveniences, they're warning signals about your future independence. Dr. Vonda Wright, orthopedic surgeon, and author of "Unbreakable," returns to the show with a science-backed blueprint to prevent the broken hips, osteoporosis, and frailty plaguing too many women. As the country's leading voice on menopause's musculoskeletal impacts, she reveals why 70% of women experience debilitating joint pain and muscle loss. Plus, what are the six "time bombs" of aging you can control? How does your "unbreakable score" predict independence at 90? Why is muscle your literal longevity factory? Get the tools to stay strong, mobile, and unbreakable for decades ahead, beauties! FOLLOW A CERTAIN AGE: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ GET INBOX INSPO: Sign up for our newsletter ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠AGE BOLDLY⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ We share new episodes, giveaways, links we love, and midlife resources Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Robert Silverman, author of "Immune Reboot: Maximizing Immunity, Restoring Gut Health, and Optimizing Vitality," provides a comprehensive primer on the immune system. He explains how lifestyle factors—diet, sleep, exercise, and stress—impact immune resilience. He offers specific protocols for optimizing resistance to Covid, what to do if you come down with it, and how to treat Long Covid, as well as how to prepare for vaccines. 

Dr. Hoffman continues his conversation with Dr. Robert Silverman, author of "Immune Reboot: Maximizing Immunity, Restoring Gut Health, and Optimizing Vitality."

On this episode, Aaron and Derek tackle 2001's psychological horror film "Frailty" directed by and starring Bill Paxton. They talk about Bill Paxton's creepy earnestness, how the writing cleverly handles multiple twists and reveals, and what makes this an effective horror movie without any jumpscares. They also get into McConaughey's proto-True Detective mannerisms, this flick's place between late 90s and aughts horror, and many other aspects of the movie. Aaron and Derek know that destroying demons is good. Support us on Patreon: https://www.patreon.com/WatchIfYouDare We are on PodBean, Apple Podcasts, Podchaser, Goodpods, Amazon Music, Spotify, iHeartRadio and CastBox. Please rate, review, subscribe, and share our show. Also, check out our Spotify Music playlist, links on our Twitter and Podbean page. Our socials are on Bluesky and Facebook and Twitter @WatchIfYouDare