Podcasts about future directions

Is the era of cisplatin over, or are we simply becoming more precise about who benefits from it? As perioperative strategies in bladder cancer continue to evolve, emerging tools like circulating tumor DNA (ctDNA) are playing a bigger role in how clinicians assess recurrence risk and tailor treatment. In this episode of BackTable Tumor Board, host Alan Tan, medical oncologist at Vanderbilt-Ingram Cancer Center, is joined by bladder cancer experts Dr. Amanda Nizam and Dr. Brad McGregor to discuss recent advances in the diagnosis and treatment of urothelial carcinoma. --- SYNPOSIS The doctors examine the evolving management of muscle-invasive bladder cancer (MIBC), including the role of neoadjuvant and adjuvant therapies, the integration of immunotherapy, and the recent approval of enfortumab vedotin plus pembrolizumab. The discussion explores the rapidly changing perioperative landscape, the prognostic utility of ctDNA, and how biomarkers such as HER2 and FGFR are influencing treatment selection across disease states. They also address bladder preservation strategies, management of treatment-related toxicities, and the importance of multidisciplinary coordination. The episode concludes with a forward-looking discussion on emerging therapies and the potential to improve cure rates in bladder cancer. --- TIMESTAMPS 00:00 - Introduction01:44 - Overview of Bladder Cancer Treatment04:54 - Patient Staging and Treatment Goals10:12 - Bladder Preservation vs. Radical Cystectomy16:39 - Emerging Trials and Future Directions22:40 - ctDNA and Precision Medicine33:50 - Metastatic Disease and Biomarker Strategies42:16 - Managing Neuropathy in Metastatic Treatment48:44 - HER2 and FGFR in Bladder Cancer54:15 - Future Directions in Bladder Cancer Treatment --- RESOURCES EV-302/303 Trialhttps://newsroom.astellas.com/2023-12-15-PADCEV-R-enfortumab-vedotin-ejfv-with-KEYTRUDA-R-pembrolizumab-Approved-by-FDA-as-the-First-and-Only-ADC-Plus-PD-1-to-Treat-Advanced-Bladder-Cancer NIAGARA Regimenhttps://www.nejm.org/doi/full/10.1056/NEJMoa2408154 KEYNOTE-905 Studyhttps://www.annalsofoncology.org/article/S0923-7534(25)04894-X/fulltext

In this episode Ben and Spence welcome back Charlie Batch to discuss the latest in NFL news, including the AFC and NFC Championship games, predictions for the Super Bowl, and the hiring of Mike McCarthy. They dive into the importance of weather conditions in games, analyze team strategies, and share insights on the upcoming NFL draft. The conversation also highlights the significance of community engagement through the Best of the Batch Foundation, showcasing the impact of charitable work in the Pittsburgh area.Learn more about The Best of the Batch Foundation:https://www.batchfoundation.org/Footbahlin Cookbook:https://footbahlin-with-ben-roethlisberger.clockwise.io/products/footbahlin-cookbook-volume-2?00:00 Intro02:42 AFC Championship Game Analysis05:40 Weather's Impact on Game Strategy08:28 NFC Championship Game Insights11:19 Coaching Changes and Team Dynamics14:24 Mike McCarthy's Hiring and Future Prospects17:04 Quarterback Development and Team Strategy20:10 Final Thoughts on Super Bowl Predictions33:15 Quarterback Decisions and Team Dynamics37:14 Draft Strategies and Team Building40:20 Offensive Line and Receiver Priorities47:39 Coaching Changes and Team Philosophy53:22 NFLPA Leadership and Future Directions

Fibroid care: how it was, how it's changing, and where it's headed next. In this episode of BackTable OBGYN, hosts Dr. Mark Hoffman and Dr. Amy Park welcome minimally invasive GYN surgeon Dr. Arleen Song to discuss the evolving landscape of fibroid care. --- SYNPOSIS Dr. Song, a veteran in the field with nearly 20 years of experience, shares her journey from Michigan to Duke, current treatments in fibroid management, and the importance of personalized care. The team explores new surgical techniques, the role of medical therapies such as Ella GnRH antagonists, and the importance of patient education. They also address challenges such as access to care, the significance of research funding, and the evolving understanding of fibroid genetics and long-term management. This episode provides a comprehensive overview of the state of fibroid care and the strides being made in this vital aspect of women's health. --- TIMESTAMPS 00:00 - Introduction02:21 - Evolution of Fibroid Treatment05:50 - Advancements in Minimally Invasive Surgery08:47 - Longitudinal Care and Personalized Treatment13:00 - Modern Approaches to Fibroid Treatment21:15 - New Technologies and Procedures27:01 - Preoperative Assessment and Imaging31:15 - Preoperative Counseling and Risk Assessment33:14 - Medications for Fibroid and Endometriosis37:59 - Challenges in Access to Care38:43 - Racial Disparities in Fibroid Research42:35 - The Importance of Specialized Care49:22 - Future Directions in Fibroid Treatment

From a childhood farm in the Philippines to dairy operations worldwide with Dr. Mike Catangui.In this episode of the Uplevel Dairy Podcast, Peggy interviews Dr. Mike Catangui, the first entomologist and parasitologist to feature on the show. Dr. Mike discusses the critical role of entomology and parasitology in the dairy industry, highlighting the impact of insects like stable flies on dairy cattle health and milk production. He shares his professional journey from growing up on a farm in the Philippines to achieving advanced degrees and conducting significant research in the U.S. The conversation delves into the economic impacts of pests, the benefits of natural insecticides, and ongoing efforts to discover sustainable, effective solutions for pest control in agriculture. Dr. Mike also touches on his personal experiences and enduring passion for agricultural research.This episode is sponsored by MWI Animal HealthAt MWI Animal Health, we are your partner in animal health. Our people drive us to think forward every day. We are committed to working with you to identify cutting-edge solutions to your common challenges. We unite with innovators and manufacturers to provide access to products and solutions designed to help you find success in each aspect of your animal health business.Visit www.MWIAH.com00:00 Introduction to Dr. Mike00:15 The Role of Entomology and Parasitology in Dairy02:03 Dr. Mike's Journey from the Philippines to the US03:33 Research on Stable Flies and Their Impact09:36 Transition to Dairy and Natural Solutions15:53 Global Perspective on Insect Control19:09 Future Directions in Entomology23:41 Balancing Work and Life in Agriculture25:01 Conclusion and Final Thoughts

You're going to enjoy this. Watch on YouTube https://youtu.be/Cx1YPXoq6aQ LEARN about Sean McCormick - seanmccormick.com Evolution of memes, the impact of social media, and the importance of authenticity in communication. They discuss the challenges of censorship, the role of AI in content creation, and the significance of self-examination and personal growth 02:55 The Power of Memes 06:14 Censorship and Cultural Trends 08:54 Navigating AI and Content Creation 11:47 The Role of Honesty in Content 14:55 Personal Experiences with Vaccines and Weed 17:50 The Nature of Addiction and Escapism 20:56 The Pursuit of Truth and Awareness 23:51 Cultural Reflections and Personal Growth 26:46 Conclusion and Future Directions 35:57 The Hero's Journey and Self-Examination 37:01 Awakening and Consciousness 38:28 Tools for Self-Discovery  40:43 The Power of Float Tanks 43:46 Do It for the Plot 48:55 The Importance of Novelty 52:15 Curiosity and Risk-Taking 56:34 Navigating Truth in a Polarized World 01:07:32 The Evolution of Podcasting and Influencers 01:11:36 The Impact of Joe Rogan on the Float Industry 01:15:32 The Need for Authenticity in Media 01:16:01 The Dangers of Pornography and Its Cultural Impact 01:24:52 Detoxification and the Importance of Inner Work 01:32:53 The Journey Within: Finding Your Inner Self LEARN about Sean McCormick - seanmccormick.com I've 

If you value what we do, now is the time to join at FreshEdPodcast.com. If you represent an organization interested in partnership, please reach out there as well. We're always looking for new partners. -- To kick off the year, Stefania Giannini joins me to talk about the past, present and future of international education. We discuss the challenges facing the rule-based international order and what that means for education. We unpack the global teacher shortage and the reality of some countries spending more on debt servicing than on education. Stefania Giannini is the Assistant Director-General for Education at UNESCO and served as the Italian Minister of Education, Universities and Research between 2014 and 2016. We spoke just before the International Day of Education on January 24 and focused our conversation on UNESCO's new report “The Right To Education: Past, Present, and Future Directions”. https://freshedpodcast.com/giannini/ -- Get in touch! LinkedIn: @FreshEdpodcast Facebook: FreshEd Email: info@freshedpodcast.com

In this episode of Iron Culture, Eric Helms and Eric Trexler discuss the recent changes to the Dietary Guidelines for Americans (DGAs) and the implications of these updates. They begin by addressing the shift in their podcast schedule, emphasizing the importance of mental health and balance in their work. The conversation then transitions into a detailed analysis of the new dietary guidelines, highlighting the complexities of the process behind their formulation. Helms critiques the influence of corporate interests and the political landscape on the DGAs, while also acknowledging the positive aspects of the new recommendations, particularly the increased emphasis on protein intake. The hosts explore the historical context of dietary guidelines, the evolution of public health messaging, and the challenges of effectively communicating nutritional advice to the public. In this episode, Eric Helms and MASS Research delve into the complexities of the latest Dietary Guidelines for Americans (DGAs), discussing the implications of the visual representation of food groups and the recommendations for protein, fats, and processed foods. They critique the new guidelines for their lack of clarity and potential confusion, particularly regarding the emphasis on whole foods versus processed foods. The conversation highlights the disconnect between the written guidelines and their visual representation, which may mislead the public about healthy eating patterns. They also explore the political influences on these guidelines and how they may affect vulnerable populations, particularly in school lunch programs and social assistance programs. If you're in the market for some lifting gear or apparel, be sure to check out EliteFTS.com (and use our code "MRR10" for a 10% discount) Chapters 00:00 Introduction and Schedule Changes 07:15 The Dietary Guidelines Controversy 20:56 Understanding the Formation of Dietary Guidelines 32:30 The Influence of Food Industries on Guidelines 33:38 The Role of the Second Committee 43:49 Changes in Protein Recommendations 44:19 The Inverted Pyramid and Dietary Miscommunication 59:55 Understanding Fats in the New Guidelines 01:09:17 The Role of Full-Fat Dairy in Heart Health 01:15:06 Alcohol Consumption: New Guidelines Explained 01:21:52 Processed Foods and Public Health Implications 01:25:03 The Impact of Dietary Guidelines on Vulnerable Populations 01:30:34 Conclusions and Future Directions in Nutrition Guidelines

In this episode of The Mind–Gut Conversation, Dr. Emeran Mayer sits down with Tim Spector, MD, to discuss the implications of a landmark gut microbiome study involving more than 34,000 participants — one of the largest and most comprehensive efforts to date to understand what a “healthy” gut microbiome actually looks like.Drawing from the study's novel design and findings, they explore why defining gut health is far more complex than identifying a short list of “good” or “bad” microbes. The conversation unpacks what large-scale microbiome data can, and cannot tell us about health, disease prevention, and the growing interest in microbiome testing as a tool for personalized nutrition and healthcare.Together, they examine the deep connections between diet and the microbiome, highlighting why dietary patterns, particularly fiber- and prebiotic-rich foods, may play a more meaningful role than many commonly marketed probiotic products. They also discuss the challenges of translating microbiome research into actionable guidance for consumers and clinicians, and why education and context are essential as microbiome testing becomes more widely available.This wide-ranging discussion blends cutting-edge microbiome science with practical insight, offering a grounded perspective on where the field is headed and how emerging research may eventually shape everyday health decisions.Topics discussed include:• What a large-scale microbiome study reveals about gut health• Why defining a “healthy” microbiome is more complex than expected• The limitations of labeling microbes as simply good or bad• The role of diet, fiber, and prebiotics in shaping the microbiome• The promises and pitfalls of microbiome testing• How microbiome research may influence future healthcare practicesThis is a practical, evidence-based discussion for anyone interested in gut health, whether navigating dietary choices personally, exploring microbiome testing, or working in a clinical or research setting.Please leave any comments or feedback on the episode — we'd love to hear your thoughts.-------------------------------Chapters:00:00 Introduction02:05 The Landmark Study Overview05:29 Defining Healthy Gut Microbiomes10:02 The Good vs. Bad Microbes13:59 Implications for Diet and Health18:37 The Role of Prebiotics and Probiotics23:27 Future Directions in Microbiome Research27:49 Challenges in Proving Causality31:51 The Future of Gut Health Testing36:36 Future Outlook in Traditional Medicine40:10 Microbiome Testing in Clinical Practice43:20 Regulation, Wellness, and Medical Use46:10 Personalizing Diet Through the Microbiome48:50 Final Reflections

Think beyond the esophagus. Up to 75% of eosinophilic esophagitis (EoE) patients have ENT-relevant atopic disease that is often best managed with a multidisciplinary approach. Get caught up on best practices in EoE diagnosis and treatment with this episode of the BackTable ENT Podcast, featuring dual board-certified gastroenterologist and allergist-immunologist Dr. John Leung and host Dr. Basil Kahwash. --- SYNPOSIS The discussion covers the definition, symptoms, and diagnosis of EoE, highlighting the role of food and environmental allergies. Dr. Leung and Dr. Kahwash cover diagnostic techniques like endoscopy and emerging non-invasive methods, as well as various treatment options including dietary modifications, pharmacology, and biologics. The doctors also emphasize the importance of multidisciplinary collaboration between gastroenterologists, allergists, and otolaryngologists to provide optimal care for patients with EoE. --- TIMESTAMPS 00:00 - Introduction 03:13 - Understanding Eosinophilic Esophagitis (EoE)05:45 - EoE Symptoms and Diagnosis08:41 - Role of ENT in EoE Diagnosis11:32 - Diagnostic Criteria for EoE16:34 - Treatment Options for EoE20:55 - Role of Allergists and Environmental Allergies23:24 - Pharmacological Management of EoE29:38 - Complications and Risks of EoE36:21 - Follow-Up Endoscopies and Surveillance40:34 - Future Directions in EoE Management45:21 - Conclusion and Final Thoughts --- RESOURCES Dr. John Leunghttps://www.bostonspecialists.org/dr-leung-full-profile

Building Secure Software with Tanya Janca: From Coding to Cybersecurity Advocacy In this episode of Cybersecurity Today, host Jim Love interviews Tanya Janca, also known as She Hacks Purple, a renowned Canadian application security expert and author. Tanya shares her journey from a software developer and musician to becoming a penetration tester and cybersecurity advocate. She discusses her work in training developers on secure coding practices and application security, emphasizing the need for integrated security training in academic programs and the software development lifecycle. Tanya also talks about the challenges women face in the cybersecurity field and her efforts to empower underrepresented groups through initiatives like WOsec and We Hack Purple. Sponsored by Meter, this episode dives deep into the importance of building security into software development and the potential role of AI in improving code security. 00:00 Introduction and Sponsor Message 00:18 Meet Tanya Janca: The Journey Begins 01:05 From Developer to Pen Tester 03:14 Empowering Women in Cybersecurity 13:11 Challenges in Academia and Training 19:18 The Need for Secure Coding 21:22 Challenges in Medical Device Security 22:18 The Economics of Open Source 24:43 Building Security into Development 26:14 Training and Cultural Shifts 32:33 AI and Secure Coding 39:03 Incident Response and Preparedness 39:54 Final Thoughts and Future Directions

Patient access to interventional radiology services remains highly variable worldwide, reflecting global differences in training opportunities and infrastructure. Drawing on responses from more than 1,260 interventional radiologists worldwide, Dr. Justin Guan and Dr. Constantinos Sofocleous unpack the findings of a large international survey, highlighting where IR is advancing, where it remains fragmented, and what the data suggest about the future direction of the specialty. --- SYNPOSIS Key points of the episode involve the collaborative efforts put into this survey, how data was collected, and major findings from the respondents. These findings involve challenges with IR training, the significance of public awareness, and the need for standardized training programs. The discussion also covers the efforts required to promote IR globally, especially at global summits, and the potential steps to address these findings. Finally, the episode highlights the importance of developing region-specific programs and the ongoing efforts to elevate IR practices worldwide. --- TIMESTAMPS 00:00 - Introduction01:57 - Global IR Network and Survey Introduction10:30 - Survey Insights and Results19:26 - Challenges in IR Training and Awareness23:33 - Future Directions and Initiatives36:06 - Conclusion and Final Thoughts --- RESOURCES Results of a Global Survey on the State of Interventional Radiology 2024: https://pubmed.ncbi.nlm.nih.gov/39793699/

In this episode, the hosts discuss the importance of community and respect in fitness, the balance between open gym culture and group classes, and the future of training trends. They explore the role of technology and AI in fitness, the significance of individualized programs, and the impact of attitude on gym culture. The conversation also touches on morning routines and the rise of jujitsu as a popular form of training.   Takeaways   The main goal of a gym is to help people get healthier. Balancing open gym culture with community is essential. Respect between different training styles fosters a positive environment. Individual design can coexist with group classes if managed well. Setting clear standards helps maintain gym culture. Competitors should respect the space of regular gym-goers. Attitude and respect are crucial in fitness communities. Technology is shaping the future of fitness training. AI can enhance personalized training but should not replace human connection. Morning routines can set the tone for the day. Topics Building a Stronger Community in Fitness Navigating the Balance of Open Gym and Culture Sound bites "Respect is key in a fitness community." "We can coexist together in the gym." "Jumping 50 times can wake up your system." Chapters 00:00 Introduction and Setting the Scene 03:06 Balancing Open Gym and CrossFit Culture 05:51 The Importance of Community and Respect in Fitness 08:37 Individual Design vs. Group Classes 11:28 Setting Standards and Expectations in the Gym 14:39 The Role of Competitors in the Gym Community 17:31 The Impact of Attitude and Respect in Fitness 20:19 Fitness Trends and the Future of Training 23:15 Exploring 2026 Fitness Trends 26:07 The Role of Technology in Fitness 28:53 The Balance of AI and Human Connection in Training 32:10 The Importance of Individualized Fitness Programs 34:59 Trends in Group Fitness and Community Events 37:43 The Rise of Jujitsu and Self-Defense Training 40:39 The Gimmicks of Fitness Trends 43:29 The Importance of Strength Training 46:29 Morning Routines and Jumping into the Day 49:19 Closing Thoughts and Future Directions  

In part 2 of our behind-the-scenes series on the Volunteer Management Progress Report, Tobi Johnson returns with Allison Russell, Assistant Professor of Public & Nonprofit Management at the University of Texas at Dallas, for a powerful conversation on practitioner research and what it can teach us about the volunteer engagement profession. Allison steps into the interviewer role again as they dig into what the VMPR revealed over a decade of surveying volunteer engagement leaders and how practitioner research can drive real-world improvements in training, leadership, and volunteer program strategy. You'll hear what challenges consistently show up year after year, why response rates matter, and how turning research into action is what makes it truly valuable! Full show notes: 197. Behind the Scenes of 10 Years of Industry Research with Allison Russell – Part 2 Practitioner Research - Episode Highlights [02:06] - Diving into Volunteer Management Research [03:51] - Key Themes in Volunteer Management [05:30] - Challenges in Volunteer Recruitment [06:49] - Respect and Influence in Volunteer Management [08:43] - Using Research to Improve Practices [22:50] - Survey Design and Response Rates [30:33] - Understanding Research Participation [33:50] - Advice for Conducting Survey Research [37:18] - The Importance of Research Follow-Through [38:49] - Challenges in Volunteer Management Research [45:12] - Future Directions in Volunteer Research [50:38] - What's Next for Volunteer Pro  Helpful Links Volunteer Management Progress Report  VolunteerPro Impact Lab  Engage Journal  Volunteer Nation Episode #196 - Behind the Scenes of 10 Years of Industry Research with Pam Kappelides & Allison Russell Find Allison on LinkedIn  Allison's UT Dallas Profile  Thanks for listening to this episode of the Volunteer Nation podcast. If you enjoyed it, please be sure to subscribe, rate, and review so we can reach more people like you who want to improve the impact of their good cause. For more tips and notes from the show, check us out at TobiJohnson.com. For any comments or questions, email us at WeCare@VolPro.net.

This episode of Quality Matters examines primary care's evolving role and features Karen Johnson of the American Academy of Family Physicians and Jeff Sitko of NCQA. Karen and Jeff outline primary care's distinguishing focus on patient relationships, the strain on the primary care workforce, and technology's promise to ease burdens. The discussion connects the dots between workforce sustainability, AI-driven efficiency, payment reform, and NCQA's vision for next-generation primary care.Karen highlights the underappreciated fact that only 5% of health care spending goes to primary care, despite public perception that the figure is—and should be—higher. Jeff describes a dawning era of proactive, data-driven care delivery. He also previews NCQA's plans to build upon the successful Patient-Centered Medical Home model of primary care.HighlightsThe Human Core of Primary Care: Continuity and trust are what make primary care special, even as practice settings change.Workforce Challenges and Opportunities: Clinicians report high stress and burnout, yet relationships with patients keep them engaged. Building systems that protect these relationships—and make primary care careers attractive—is critical to sustainability.Economics and Incentives: Guests discuss new payment models, state-level initiatives and federal efforts to rebalance incentives and support primary care in new ways.Looking Ahead: The foundational Patient-Centered Medical Home model gets an update in 2026. Plus, Karen calls for a seismic shift to resource primary care as a common good.This episode is essential listening for healthcare executives, policymakers, and clinicians committed to strengthening primary care as the cornerstone of quality improvement.Key Quote:If you want to boil it down to the simplest terms, it's taking primary care from a reactive model—Call me when you're sick; I'll put you on my schedule; Come in and see me—to a proactive model.I am paying attention to a population of patients. They're mine. They're on my panel. And now maybe they're also tied to some accountability arrangement in value-based care, where performance comes into play.And so I'm going to be proactive for a lot of reasons. One, it's the right thing to do for patients. But I also want to make sure my patients are getting preventive services they need, they are taking the medications I prescribe, they are going to the referral I recommended. And I'm getting the information back from that physician, and my team is acting on that. It's all of those things that should be ubiquitous in primary care.-Karen Johnson, PhDTime Stamps:(01:07) The Changing Landscape of Primary Care(06:42) Challenges in the Primary Care Workforce(08:49) How Technology is Impacting Primary Care(15:59) Future Directions and Innovations(18:11) NCQA's Plans for 2026Dive Deeper:State of the Primary Care Workforce 2024 (HRSA)The Pulse of Primary Care (JGIM)Connect with Karen JohnsonConnect with Jeff Sitko Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode of the Voxology podcast, hosts Mike Erre and Tim Stafford discuss various pressing issues, including the recent tragedy involving the shooting of Renee Good by ICE agents, the implications of Christian nationalism, and the importance of hope amidst grief. They explore the fall of influential Christian leaders, the role of worship in justice, and the significance of understanding holiness in the context of the church's mission. The conversation emphasizes the need for community engagement, political action, and a deeper understanding of the nature of God's name and holiness. Further, Mike and Tim engage in a profound discussion on faith, justice, and societal change. They explore the significance of names and holiness, reflecting on current events and personal experiences. The conversation delves into the challenges of maintaining hope and integrity in a world filled with tragedy and injustice, while emphasizing the importance of community and active resistance against dehumanization. Chapters 00:00 Introduction and Personal Updates 02:58 Lamenting Tragedy and Violence 06:00 The Impact of Christian Nationalism 08:58 The Confession of Philip Yancey 11:59 Hope Amidst Despair 15:01 The Role of the Church in Society 17:56 Questioning Political Allegiances 21:08 The Importance of Community and Humanity 24:00 Navigating Dehumanization and Response 27:01 The Sermon on the Mount and Its Implications 29:57 Conclusion and Future Directions 34:30 The Significance of Names in the Ancient World 39:08 Understanding Holiness and Its Implications 45:01 Profaning the Name: Lessons from Israel's History 51:09 The Restoration of God's Name and Its Importance 57:05 The Interconnection of Worship, Justice, and Holiness As always, we encourage and would love discussion as we pursue. Feel free to email in questions to hello@voxpodcast.com, and to engage the conversation on Facebook and Instagram. We're on YouTube (if you're into that kinda thing): VOXOLOGY TV. Our Merch Store! ETSY Learn more about the Voxology Podcast Subscribe on iTunes or Spotify Support the Voxology Podcast on Patreon The Voxology Spotify channel can be found here: Voxology Radio Follow us on Instagram: @voxologypodcast and "like" us on Facebook Follow Mike on Twitter: www.twitter.com/mikeerre Music in this episode by Timothy John Stafford Instagram & Twitter: @GoneTimothy

Happy New Year! You may have noticed that in 2025 we had moved toward YouTube as our primary podcasting platform. As we'll explain in the next State of Latent Space post, we'll be doubling down on Substack again and improving the experience for the over 100,000 of you who look out for our emails and website updates!We first mentioned Artificial Analysis in 2024, when it was still a side project in a Sydney basement. They then were one of the few Nat Friedman and Daniel Gross' AIGrant companies to raise a full seed round from them and have now become the independent gold standard for AI benchmarking—trusted by developers, enterprises, and every major lab to navigate the exploding landscape of models, providers, and capabilities.We have chatted with both Clementine Fourrier of HuggingFace's OpenLLM Leaderboard and (the freshly valued at $1.7B) Anastasios Angelopoulos of LMArena on their approaches to LLM evals and trendspotting, but Artificial Analysis have staked out an enduring and important place in the toolkit of the modern AI Engineer by doing the best job of independently running the most comprehensive set of evals across the widest range of open and closed models, and charting their progress for broad industry analyst use.George Cameron and Micah-Hill Smith have spent two years building Artificial Analysis into the platform that answers the questions no one else will: Which model is actually best for your use case? What are the real speed-cost trade-offs? And how open is “open” really?We discuss:* The origin story: built as a side project in 2023 while Micah was building a legal AI assistant, launched publicly in January 2024, and went viral after Swyx's retweet* Why they run evals themselves: labs prompt models differently, cherry-pick chain-of-thought examples (Google Gemini 1.0 Ultra used 32-shot prompts to beat GPT-4 on MMLU), and self-report inflated numbers* The mystery shopper policy: they register accounts not on their own domain and run intelligence + performance benchmarks incognito to prevent labs from serving different models on private endpoints* How they make money: enterprise benchmarking insights subscription (standardized reports on model deployment, serverless vs. managed vs. leasing chips) and private custom benchmarking for AI companies (no one pays to be on the public leaderboard)* The Intelligence Index (V3): synthesizes 10 eval datasets (MMLU, GPQA, agentic benchmarks, long-context reasoning) into a single score, with 95% confidence intervals via repeated runs* Omissions Index (hallucination rate): scores models from -100 to +100 (penalizing incorrect answers, rewarding ”I don't know”), and Claude models lead with the lowest hallucination rates despite not always being the smartest* GDP Val AA: their version of OpenAI's GDP-bench (44 white-collar tasks with spreadsheets, PDFs, PowerPoints), run through their Stirrup agent harness (up to 100 turns, code execution, web search, file system), graded by Gemini 3 Pro as an LLM judge (tested extensively, no self-preference bias)* The Openness Index: scores models 0-18 on transparency of pre-training data, post-training data, methodology, training code, and licensing (AI2 OLMo 2 leads, followed by Nous Hermes and NVIDIA Nemotron)* The smiling curve of AI costs: GPT-4-level intelligence is 100-1000x cheaper than at launch (thanks to smaller models like Amazon Nova), but frontier reasoning models in agentic workflows cost more than ever (sparsity, long context, multi-turn agents)* Why sparsity might go way lower than 5%: GPT-4.5 is ~5% active, Gemini models might be ~3%, and Omissions Index accuracy correlates with total parameters (not active), suggesting massive sparse models are the future* Token efficiency vs. turn efficiency: GPT-5 costs more per token but solves Tau-bench in fewer turns (cheaper overall), and models are getting better at using more tokens only when needed (5.1 Codex has tighter token distributions)* V4 of the Intelligence Index coming soon: adding GDP Val AA, Critical Point, hallucination rate, and dropping some saturated benchmarks (human-eval-style coding is now trivial for small models)Links to Artificial Analysis* Website: https://artificialanalysis.ai* George Cameron on X: https://x.com/georgecameron* Micah-Hill Smith on X: https://x.com/micahhsmithFull Episode on YouTubeTimestamps* 00:00 Introduction: Full Circle Moment and Artificial Analysis Origins* 01:19 Business Model: Independence and Revenue Streams* 04:33 Origin Story: From Legal AI to Benchmarking Need* 16:22 AI Grant and Moving to San Francisco* 19:21 Intelligence Index Evolution: From V1 to V3* 11:47 Benchmarking Challenges: Variance, Contamination, and Methodology* 13:52 Mystery Shopper Policy and Maintaining Independence* 28:01 New Benchmarks: Omissions Index for Hallucination Detection* 33:36 Critical Point: Hard Physics Problems and Research-Level Reasoning* 23:01 GDP Val AA: Agentic Benchmark for Real Work Tasks* 50:19 Stirrup Agent Harness: Open Source Agentic Framework* 52:43 Openness Index: Measuring Model Transparency Beyond Licenses* 58:25 The Smiling Curve: Cost Falling While Spend Rising* 1:02:32 Hardware Efficiency: Blackwell Gains and Sparsity Limits* 1:06:23 Reasoning Models and Token Efficiency: The Spectrum Emerges* 1:11:00 Multimodal Benchmarking: Image, Video, and Speech Arenas* 1:15:05 Looking Ahead: Intelligence Index V4 and Future Directions* 1:16:50 Closing: The Insatiable Demand for IntelligenceTranscriptMicah [00:00:06]: This is kind of a full circle moment for us in a way, because the first time artificial analysis got mentioned on a podcast was you and Alessio on Latent Space. Amazing.swyx [00:00:17]: Which was January 2024. I don't even remember doing that, but yeah, it was very influential to me. Yeah, I'm looking at AI News for Jan 17, or Jan 16, 2024. I said, this gem of a models and host comparison site was just launched. And then I put in a few screenshots, and I said, it's an independent third party. It clearly outlines the quality versus throughput trade-off, and it breaks out by model and hosting provider. I did give you s**t for missing fireworks, and how do you have a model benchmarking thing without fireworks? But you had together, you had perplexity, and I think we just started chatting there. Welcome, George and Micah, to Latent Space. I've been following your progress. Congrats on... It's been an amazing year. You guys have really come together to be the presumptive new gardener of AI, right? Which is something that...George [00:01:09]: Yeah, but you can't pay us for better results.swyx [00:01:12]: Yes, exactly.George [00:01:13]: Very important.Micah [00:01:14]: Start off with a spicy take.swyx [00:01:18]: Okay, how do I pay you?Micah [00:01:20]: Let's get right into that.swyx [00:01:21]: How do you make money?Micah [00:01:24]: Well, very happy to talk about that. So it's been a big journey the last couple of years. Artificial analysis is going to be two years old in January 2026. Which is pretty soon now. We first run the website for free, obviously, and give away a ton of data to help developers and companies navigate AI and make decisions about models, providers, technologies across the AI stack for building stuff. We're very committed to doing that and tend to keep doing that. We have, along the way, built a business that is working out pretty sustainably. We've got just over 20 people now and two main customer groups. So we want to be... We want to be who enterprise look to for data and insights on AI, so we want to help them with their decisions about models and technologies for building stuff. And then on the other side, we do private benchmarking for companies throughout the AI stack who build AI stuff. So no one pays to be on the website. We've been very clear about that from the very start because there's no use doing what we do unless it's independent AI benchmarking. Yeah. But turns out a bunch of our stuff can be pretty useful to companies building AI stuff.swyx [00:02:38]: And is it like, I am a Fortune 500, I need advisors on objective analysis, and I call you guys and you pull up a custom report for me, you come into my office and give me a workshop? What kind of engagement is that?George [00:02:53]: So we have a benchmarking and insight subscription, which looks like standardized reports that cover key topics or key challenges enterprises face when looking to understand AI and choose between all the technologies. And so, for instance, one of the report is a model deployment report, how to think about choosing between serverless inference, managed deployment solutions, or leasing chips. And running inference yourself is an example kind of decision that big enterprises face, and it's hard to reason through, like this AI stuff is really new to everybody. And so we try and help with our reports and insight subscription. Companies navigate that. We also do custom private benchmarking. And so that's very different from the public benchmarking that we publicize, and there's no commercial model around that. For private benchmarking, we'll at times create benchmarks, run benchmarks to specs that enterprises want. And we'll also do that sometimes for AI companies who have built things, and we help them understand what they've built with private benchmarking. Yeah. So that's a piece mainly that we've developed through trying to support everybody publicly with our public benchmarks. Yeah.swyx [00:04:09]: Let's talk about TechStack behind that. But okay, I'm going to rewind all the way to when you guys started this project. You were all the way in Sydney? Yeah. Well, Sydney, Australia for me.Micah [00:04:19]: George was an SF, but he's Australian, but he moved here already. Yeah.swyx [00:04:22]: And I remember I had the Zoom call with you. What was the impetus for starting artificial analysis in the first place? You know, you started with public benchmarks. And so let's start there. We'll go to the private benchmark. Yeah.George [00:04:33]: Why don't we even go back a little bit to like why we, you know, thought that it was needed? Yeah.Micah [00:04:40]: The story kind of begins like in 2022, 2023, like both George and I have been into AI stuff for quite a while. In 2023 specifically, I was trying to build a legal AI research assistant. So it actually worked pretty well for its era, I would say. Yeah. Yeah. So I was finding that the more you go into building something using LLMs, the more each bit of what you're doing ends up being a benchmarking problem. So had like this multistage algorithm thing, trying to figure out what the minimum viable model for each bit was, trying to optimize every bit of it as you build that out, right? Like you're trying to think about accuracy, a bunch of other metrics and performance and cost. And mostly just no one was doing anything to independently evaluate all the models. And certainly not to look at the trade-offs for speed and cost. So we basically set out just to build a thing that developers could look at to see the trade-offs between all of those things measured independently across all the models and providers. Honestly, it was probably meant to be a side project when we first started doing it.swyx [00:05:49]: Like we didn't like get together and say like, Hey, like we're going to stop working on all this stuff. I'm like, this is going to be our main thing. When I first called you, I think you hadn't decided on starting a company yet.Micah [00:05:58]: That's actually true. I don't even think we'd pause like, like George had an acquittance job. I didn't quit working on my legal AI thing. Like it was genuinely a side project.George [00:06:05]: We built it because we needed it as people building in the space and thought, Oh, other people might find it useful too. So we'll buy domain and link it to the Vercel deployment that we had and tweet about it. And, but very quickly it started getting attention. Thank you, Swyx for, I think doing an initial retweet and spotlighting it there. This project that we released. And then very quickly though, it was useful to others, but very quickly it became more useful as the number of models released accelerated. We had Mixtrel 8x7B and it was a key. That's a fun one. Yeah. Like a open source model that really changed the landscape and opened up people's eyes to other serverless inference providers and thinking about speed, thinking about cost. And so that was a key. And so it became more useful quite quickly. Yeah.swyx [00:07:02]: What I love talking to people like you who sit across the ecosystem is, well, I have theories about what people want, but you have data and that's obviously more relevant. But I want to stay on the origin story a little bit more. When you started out, I would say, I think the status quo at the time was every paper would come out and they would report their numbers versus competitor numbers. And that's basically it. And I remember I did the legwork. I think everyone has some knowledge. I think there's some version of Excel sheet or a Google sheet where you just like copy and paste the numbers from every paper and just post it up there. And then sometimes they don't line up because they're independently run. And so your numbers are going to look better than... Your reproductions of other people's numbers are going to look worse because you don't hold their models correctly or whatever the excuse is. I think then Stanford Helm, Percy Liang's project would also have some of these numbers. And I don't know if there's any other source that you can cite. The way that if I were to start artificial analysis at the same time you guys started, I would have used the Luther AI's eval framework harness. Yup.Micah [00:08:06]: Yup. That was some cool stuff. At the end of the day, running these evals, it's like if it's a simple Q&A eval, all you're doing is asking a list of questions and checking if the answers are right, which shouldn't be that crazy. But it turns out there are an enormous number of things that you've got control for. And I mean, back when we started the website. Yeah. Yeah. Like one of the reasons why we realized that we had to run the evals ourselves and couldn't just take rules from the labs was just that they would all prompt the models differently. And when you're competing over a few points, then you can pretty easily get- You can put the answer into the model. Yeah. That in the extreme. And like you get crazy cases like back when I'm Googled a Gemini 1.0 Ultra and needed a number that would say it was better than GPT-4 and like constructed, I think never published like chain of thought examples. 32 of them in every topic in MLU to run it, to get the score, like there are so many things that you- They never shipped Ultra, right? That's the one that never made it up. Not widely. Yeah. Yeah. Yeah. I mean, I'm sure it existed, but yeah. So we were pretty sure that we needed to run them ourselves and just run them in the same way across all the models. Yeah. And we were, we also did certain from the start that you couldn't look at those in isolation. You needed to look at them alongside the cost and performance stuff. Yeah.swyx [00:09:24]: Okay. A couple of technical questions. I mean, so obviously I also thought about this and I didn't do it because of cost. Yep. Did you not worry about costs? Were you funded already? Clearly not, but you know. No. Well, we definitely weren't at the start.Micah [00:09:36]: So like, I mean, we're paying for it personally at the start. There's a lot of money. Well, the numbers weren't nearly as bad a couple of years ago. So we certainly incurred some costs, but we were probably in the order of like hundreds of dollars of spend across all the benchmarking that we were doing. Yeah. So nothing. Yeah. It was like kind of fine. Yeah. Yeah. These days that's gone up an enormous amount for a bunch of reasons that we can talk about. But yeah, it wasn't that bad because you can also remember that like the number of models we were dealing with was hardly any and the complexity of the stuff that we wanted to do to evaluate them was a lot less. Like we were just asking some Q&A type questions and then one specific thing was for a lot of evals initially, we were just like sampling an answer. You know, like, what's the answer for this? Like, we didn't want to go into the answer directly without letting the models think. We weren't even doing chain of thought stuff initially. And that was the most useful way to get some results initially. Yeah.swyx [00:10:33]: And so for people who haven't done this work, literally parsing the responses is a whole thing, right? Like because sometimes the models, the models can answer any way they feel fit and sometimes they actually do have the right answer, but they just returned the wrong format and they will get a zero for that unless you work it into your parser. And that involves more work. And so, I mean, but there's an open question whether you should give it points for not following your instructions on the format.Micah [00:11:00]: It depends what you're looking at, right? Because you can, if you're trying to see whether or not it can solve a particular type of reasoning problem, and you don't want to test it on its ability to do answer formatting at the same time, then you might want to use an LLM as answer extractor approach to make sure that you get the answer out no matter how unanswered. But these days, it's mostly less of a problem. Like, if you instruct a model and give it examples of what the answers should look like, it can get the answers in your format, and then you can do, like, a simple regex.swyx [00:11:28]: Yeah, yeah. And then there's other questions around, I guess, sometimes if you have a multiple choice question, sometimes there's a bias towards the first answer, so you have to randomize the responses. All these nuances, like, once you dig into benchmarks, you're like, I don't know how anyone believes the numbers on all these things. It's so dark magic.Micah [00:11:47]: You've also got, like… You've got, like, the different degrees of variance in different benchmarks, right? Yeah. So, if you run four-question multi-choice on a modern reasoning model at the temperatures suggested by the labs for their own models, the variance that you can see on a four-question multi-choice eval is pretty enormous if you only do a single run of it and it has a small number of questions, especially. So, like, one of the things that we do is run an enormous number of all of our evals when we're developing new ones and doing upgrades to our intelligence index to bring in new things. Yeah. So, that we can dial in the right number of repeats so that we can get to the 95% confidence intervals that we're comfortable with so that when we pull that together, we can be confident in intelligence index to at least as tight as, like, a plus or minus one at a 95% confidence. Yeah.swyx [00:12:32]: And, again, that just adds a straight multiple to the cost. Oh, yeah. Yeah, yeah.George [00:12:37]: So, that's one of many reasons that cost has gone up a lot more than linearly over the last couple of years. We report a cost to run the artificial analysis. We report a cost to run the artificial analysis intelligence index on our website, and currently that's assuming one repeat in terms of how we report it because we want to reflect a bit about the weighting of the index. But our cost is actually a lot higher than what we report there because of the repeats.swyx [00:13:03]: Yeah, yeah, yeah. And probably this is true, but just checking, you don't have any special deals with the labs. They don't discount it. You just pay out of pocket or out of your sort of customer funds. Oh, there is a mix. So, the issue is that sometimes they may give you a special end point, which is… Ah, 100%.Micah [00:13:21]: Yeah, yeah, yeah. Exactly. So, we laser focus, like, on everything we do on having the best independent metrics and making sure that no one can manipulate them in any way. There are quite a lot of processes we've developed over the last couple of years to make that true for, like, the one you bring up, like, right here of the fact that if we're working with a lab, if they're giving us a private endpoint to evaluate a model, that it is totally possible. That what's sitting behind that black box is not the same as they serve on a public endpoint. We're very aware of that. We have what we call a mystery shopper policy. And so, and we're totally transparent with all the labs we work with about this, that we will register accounts not on our own domain and run both intelligence evals and performance benchmarks… Yeah, that's the job. …without them being able to identify it. And no one's ever had a problem with that. Because, like, a thing that turns out to actually be quite a good… …good factor in the industry is that they all want to believe that none of their competitors could manipulate what we're doing either.swyx [00:14:23]: That's true. I never thought about that. I've been in the database data industry prior, and there's a lot of shenanigans around benchmarking, right? So I'm just kind of going through the mental laundry list. Did I miss anything else in this category of shenanigans? Oh, potential shenanigans.Micah [00:14:36]: I mean, okay, the biggest one, like, that I'll bring up, like, is more of a conceptual one, actually, than, like, direct shenanigans. It's that the things that get measured become things that get targeted by labs that they're trying to build, right? Exactly. So that doesn't mean anything that we should really call shenanigans. Like, I'm not talking about training on test set. But if you know that you're going to be great at another particular thing, if you're a researcher, there are a whole bunch of things that you can do to try to get better at that thing that preferably are going to be helpful for a wide range of how actual users want to use the thing that you're building. But will not necessarily work. Will not necessarily do that. So, for instance, the models are exceptional now at answering competition maths problems. There is some relevance of that type of reasoning, that type of work, to, like, how we might use modern coding agents and stuff. But it's clearly not one for one. So the thing that we have to be aware of is that once an eval becomes the thing that everyone's looking at, scores can get better on it without there being a reflection of overall generalized intelligence of these models. Getting better. That has been true for the last couple of years. It'll be true for the next couple of years. There's no silver bullet to defeat that other than building new stuff to stay relevant and measure the capabilities that matter most to real users. Yeah.swyx [00:15:58]: And we'll cover some of the new stuff that you guys are building as well, which is cool. Like, you used to just run other people's evals, but now you're coming up with your own. And I think, obviously, that is a necessary path once you're at the frontier. You've exhausted all the existing evals. I think the next point in history that I have for you is AI Grant that you guys decided to join and move here. What was it like? I think you were in, like, batch two? Batch four. Batch four. Okay.Micah [00:16:26]: I mean, it was great. Nat and Daniel are obviously great. And it's a really cool group of companies that we were in AI Grant alongside. It was really great to get Nat and Daniel on board. Obviously, they've done a whole lot of great work in the space with a lot of leading companies and were extremely aligned. With the mission of what we were trying to do. Like, we're not quite typical of, like, a lot of the other AI startups that they've invested in.swyx [00:16:53]: And they were very much here for the mission of what we want to do. Did they say any advice that really affected you in some way or, like, were one of the events very impactful? That's an interesting question.Micah [00:17:03]: I mean, I remember fondly a bunch of the speakers who came and did fireside chats at AI Grant.swyx [00:17:09]: Which is also, like, a crazy list. Yeah.George [00:17:11]: Oh, totally. Yeah, yeah, yeah. There was something about, you know, speaking to Nat and Daniel about the challenges of working through a startup and just working through the questions that don't have, like, clear answers and how to work through those kind of methodically and just, like, work through the hard decisions. And they've been great mentors to us as we've built artificial analysis. Another benefit for us was that other companies in the batch and other companies in AI Grant are pushing the capabilities. Yeah. And I think that's a big part of what AI can do at this time. And so being in contact with them, making sure that artificial analysis is useful to them has been fantastic for supporting us in working out how should we build out artificial analysis to continue to being useful to those, like, you know, building on AI.swyx [00:17:59]: I think to some extent, I'm mixed opinion on that one because to some extent, your target audience is not people in AI Grants who are obviously at the frontier. Yeah. Do you disagree?Micah [00:18:09]: To some extent. To some extent. But then, so a lot of what the AI Grant companies are doing is taking capabilities coming out of the labs and trying to push the limits of what they can do across the entire stack for building great applications, which actually makes some of them pretty archetypical power users of artificial analysis. Some of the people with the strongest opinions about what we're doing well and what we're not doing well and what they want to see next from us. Yeah. Yeah. Because when you're building any kind of AI application now, chances are you're using a whole bunch of different models. You're maybe switching reasonably frequently for different models and different parts of your application to optimize what you're able to do with them at an accuracy level and to get better speed and cost characteristics. So for many of them, no, they're like not commercial customers of ours, like we don't charge for all our data on the website. Yeah. They are absolutely some of our power users.swyx [00:19:07]: So let's talk about just the evals as well. So you start out from the general like MMU and GPQA stuff. What's next? How do you sort of build up to the overall index? What was in V1 and how did you evolve it? Okay.Micah [00:19:22]: So first, just like background, like we're talking about the artificial analysis intelligence index, which is our synthesis metric that we pulled together currently from 10 different eval data sets to give what? We're pretty much the same as that. Pretty confident is the best single number to look at for how smart the models are. Obviously, it doesn't tell the whole story. That's why we published the whole website of all the charts to dive into every part of it and look at the trade-offs. But best single number. So right now, it's got a bunch of Q&A type data sets that have been very important to the industry, like a couple that you just mentioned. It's also got a couple of agentic data sets. It's got our own long context reasoning data set and some other use case focused stuff. As time goes on. The things that we're most interested in that are going to be important to the capabilities that are becoming more important for AI, what developers are caring about, are going to be first around agentic capabilities. So surprise, surprise. We're all loving our coding agents and how the model is going to perform like that and then do similar things for different types of work are really important to us. The linking to use cases to economically valuable use cases are extremely important to us. And then we've got some of the. Yeah. These things that the models still struggle with, like working really well over long contexts that are not going to go away as specific capabilities and use cases that we need to keep evaluating.swyx [00:20:46]: But I guess one thing I was driving was like the V1 versus the V2 and how bad it was over time.Micah [00:20:53]: Like how we've changed the index to where we are.swyx [00:20:55]: And I think that reflects on the change in the industry. Right. So that's a nice way to tell that story.Micah [00:21:00]: Well, V1 would be completely saturated right now. Almost every model coming out because doing things like writing the Python functions and human evil is now pretty trivial. It's easy to forget, actually, I think how much progress has been made in the last two years. Like we obviously play the game constantly of like the today's version versus last week's version and the week before and all of the small changes in the horse race between the current frontier and who has the best like smaller than 10B model like right now this week. Right. And that's very important to a lot of developers and people and especially in this particular city of San Francisco. But when you zoom out a couple of years ago, literally most of what we were doing to evaluate the models then would all be 100% solved by even pretty small models today. And that's been one of the key things, by the way, that's driven down the cost of intelligence at every tier of intelligence. We can talk about more in a bit. So V1, V2, V3, we made things harder. We covered a wider range of use cases. And we tried to get closer to things developers care about as opposed to like just the Q&A type stuff that MMLU and GPQA represented. Yeah.swyx [00:22:12]: I don't know if you have anything to add there. Or we could just go right into showing people the benchmark and like looking around and asking questions about it. Yeah.Micah [00:22:21]: Let's do it. Okay. This would be a pretty good way to chat about a few of the new things we've launched recently. Yeah.George [00:22:26]: And I think a little bit about the direction that we want to take it. And we want to push benchmarks. Currently, the intelligence index and evals focus a lot on kind of raw intelligence. But we kind of want to diversify how we think about intelligence. And we can talk about it. But kind of new evals that we've kind of built and partnered on focus on topics like hallucination. And we've got a lot of topics that I think are not covered by the current eval set that should be. And so we want to bring that forth. But before we get into that.swyx [00:23:01]: And so for listeners, just as a timestamp, right now, number one is Gemini 3 Pro High. Then followed by Cloud Opus at 70. Just 5.1 high. You don't have 5.2 yet. And Kimi K2 Thinking. Wow. Still hanging in there. So those are the top four. That will date this podcast quickly. Yeah. Yeah. I mean, I love it. I love it. No, no. 100%. Look back this time next year and go, how cute. Yep.George [00:23:25]: Totally. A quick view of that is, okay, there's a lot. I love it. I love this chart. Yeah.Micah [00:23:30]: This is such a favorite, right? Yeah. And almost every talk that George or I give at conferences and stuff, we always put this one up first to just talk about situating where we are in this moment in history. This, I think, is the visual version of what I was saying before about the zooming out and remembering how much progress there's been. If we go back to just over a year ago, before 01, before Cloud Sonnet 3.5, we didn't have reasoning models or coding agents as a thing. And the game was very, very different. If we go back even a little bit before then, we're in the era where, when you look at this chart, open AI was untouchable for well over a year. And, I mean, you would remember that time period well of there being very open questions about whether or not AI was going to be competitive, like full stop, whether or not open AI would just run away with it, whether we would have a few frontier labs and no one else would really be able to do anything other than consume their APIs. I am quite happy overall that the world that we have ended up in is one where... Multi-model. Absolutely. And strictly more competitive every quarter over the last few years. Yeah. This year has been insane. Yeah.George [00:24:42]: You can see it. This chart with everything added is hard to read currently. There's so many dots on it, but I think it reflects a little bit what we felt, like how crazy it's been.swyx [00:24:54]: Why 14 as the default? Is that a manual choice? Because you've got service now in there that are less traditional names. Yeah.George [00:25:01]: It's models that we're kind of highlighting by default in our charts, in our intelligence index. Okay.swyx [00:25:07]: You just have a manually curated list of stuff.George [00:25:10]: Yeah, that's right. But something that I actually don't think every artificial analysis user knows is that you can customize our charts and choose what models are highlighted. Yeah. And so if we take off a few names, it gets a little easier to read.swyx [00:25:25]: Yeah, yeah. A little easier to read. Totally. Yeah. But I love that you can see the all one jump. Look at that. September 2024. And the DeepSeek jump. Yeah.George [00:25:34]: Which got close to OpenAI's leadership. They were so close. I think, yeah, we remember that moment. Around this time last year, actually.Micah [00:25:44]: Yeah, yeah, yeah. I agree. Yeah, well, a couple of weeks. It was Boxing Day in New Zealand when DeepSeek v3 came out. And we'd been tracking DeepSeek and a bunch of the other global players that were less known over the second half of 2024 and had run evals on the earlier ones and stuff. I very distinctly remember Boxing Day in New Zealand, because I was with family for Christmas and stuff, running the evals and getting back result by result on DeepSeek v3. So this was the first of their v3 architecture, the 671b MOE.Micah [00:26:19]: And we were very, very impressed. That was the moment where we were sure that DeepSeek was no longer just one of many players, but had jumped up to be a thing. The world really noticed when they followed that up with the RL working on top of v3 and R1 succeeding a few weeks later. But the groundwork for that absolutely was laid with just extremely strong base model, completely open weights that we had as the best open weights model. So, yeah, that's the thing that you really see in the game. But I think that we got a lot of good feedback on Boxing Day. us on Boxing Day last year.George [00:26:48]: Boxing Day is the day after Christmas for those not familiar.George [00:26:54]: I'm from Singapore.swyx [00:26:55]: A lot of us remember Boxing Day for a different reason, for the tsunami that happened. Oh, of course. Yeah, but that was a long time ago. So yeah. So this is the rough pitch of AAQI. Is it A-A-Q-I or A-A-I-I? I-I. Okay. Good memory, though.Micah [00:27:11]: I don't know. I'm not used to it. Once upon a time, we did call it Quality Index, and we would talk about quality, performance, and price, but we changed it to intelligence.George [00:27:20]: There's been a few naming changes. We added hardware benchmarking to the site, and so benchmarks at a kind of system level. And so then we changed our throughput metric to, we now call it output speed, and thenswyx [00:27:32]: throughput makes sense at a system level, so we took that name. Take me through more charts. What should people know? Obviously, the way you look at the site is probably different than how a beginner might look at it.Micah [00:27:42]: Yeah, that's fair. There's a lot of fun stuff to dive into. Maybe so we can hit past all the, like, we have lots and lots of emails and stuff. The interesting ones to talk about today that would be great to bring up are a few of our recent things, I think, that probably not many people will be familiar with yet. So first one of those is our omniscience index. So this one is a little bit different to most of the intelligence evils that we've run. We built it specifically to look at the embedded knowledge in the models and to test hallucination by looking at when the model doesn't know the answer, so not able to get it correct, what's its probability of saying, I don't know, or giving an incorrect answer. So the metric that we use for omniscience goes from negative 100 to positive 100. Because we're simply taking off a point if you give an incorrect answer to the question. We're pretty convinced that this is an example of where it makes most sense to do that, because it's strictly more helpful to say, I don't know, instead of giving a wrong answer to factual knowledge question. And one of our goals is to shift the incentive that evils create for models and the labs creating them to get higher scores. And almost every evil across all of AI up until this point, it's been graded by simple percentage correct as the main metric, the main thing that gets hyped. And so you should take a shot at everything. There's no incentive to say, I don't know. So we did that for this one here.swyx [00:29:22]: I think there's a general field of calibration as well, like the confidence in your answer versus the rightness of the answer. Yeah, we completely agree. Yeah. Yeah.George [00:29:31]: On that. And one reason that we didn't do that is because. Or put that into this index is that we think that the, the way to do that is not to ask the models how confident they are.swyx [00:29:43]: I don't know. Maybe it might be though. You put it like a JSON field, say, say confidence and maybe it spits out something. Yeah. You know, we have done a few evils podcasts over the, over the years. And when we did one with Clementine of hugging face, who maintains the open source leaderboard, and this was one of her top requests, which is some kind of hallucination slash lack of confidence calibration thing. And so, Hey, this is one of them.Micah [00:30:05]: And I mean, like anything that we do, it's not a perfect metric or the whole story of everything that you think about as hallucination. But yeah, it's pretty useful and has some interesting results. Like one of the things that we saw in the hallucination rate is that anthropics Claude models at the, the, the very left-hand side here with the lowest hallucination rates out of the models that we've evaluated amnesty is on. That is an interesting fact. I think it probably correlates with a lot of the previously, not really measured vibes stuff that people like about some of the Claude models. Is the dataset public or what's is it, is there a held out set? There's a hell of a set for this one. So we, we have published a public test set, but we we've only published 10% of it. The reason is that for this one here specifically, it would be very, very easy to like have data contamination because it is just factual knowledge questions. We would. We'll update it at a time to also prevent that, but with yeah, kept most of it held out so that we can keep it reliable for a long time. It leads us to a bunch of really cool things, including breakdown quite granularly by topic. And so we've got some of that disclosed on the website publicly right now, and there's lots more coming in terms of our ability to break out very specific topics. Yeah.swyx [00:31:23]: I would be interested. Let's, let's dwell a little bit on this hallucination one. I noticed that Haiku hallucinates less than Sonnet hallucinates less than Opus. And yeah. Would that be the other way around in a normal capability environments? I don't know. What's, what do you make of that?George [00:31:37]: One interesting aspect is that we've found that there's not really a, not a strong correlation between intelligence and hallucination, right? That's to say that the smarter the models are in a general sense, isn't correlated with their ability to, when they don't know something, say that they don't know. It's interesting that Gemini three pro preview was a big leap over here. Gemini 2.5. Flash and, and, and 2.5 pro, but, and if I add pro quickly here.swyx [00:32:07]: I bet pro's really good. Uh, actually no, I meant, I meant, uh, the GPT pros.George [00:32:12]: Oh yeah.swyx [00:32:13]: Cause GPT pros are rumored. We don't know for a fact that it's like eight runs and then with the LM judge on top. Yeah.George [00:32:20]: So we saw a big jump in, this is accuracy. So this is just percent that they get, uh, correct and Gemini three pro knew a lot more than the other models. And so big jump in accuracy. But relatively no change between the Google Gemini models, between releases. And the hallucination rate. Exactly. And so it's likely due to just kind of different post-training recipe, between the, the Claude models. Yeah.Micah [00:32:45]: Um, there's, there's driven this. Yeah. You can, uh, you can partially blame us and how we define intelligence having until now not defined hallucination as a negative in the way that we think about intelligence.swyx [00:32:56]: And so that's what we're changing. Uh, I know many smart people who are confidently incorrect.George [00:33:02]: Uh, look, look at that. That, that, that is very humans. Very true. And there's times and a place for that. I think our view is that hallucination rate makes sense in this context where it's around knowledge, but in many cases, people want the models to hallucinate, to have a go. Often that's the case in coding or when you're trying to generate newer ideas. One eval that we added to artificial analysis is, is, is critical point and it's really hard, uh, physics problems. Okay.swyx [00:33:32]: And is it sort of like a human eval type or something different or like a frontier math type?George [00:33:37]: It's not dissimilar to frontier frontier math. So these are kind of research questions that kind of academics in the physics physics world would be able to answer, but models really struggled to answer. So the top score here is not 9%.swyx [00:33:51]: And when the people that, that created this like Minway and, and, and actually off via who was kind of behind sweep and what organization is this? Oh, is this, it's Princeton.George [00:34:01]: Kind of range of academics from, from, uh, different academic institutions, really smart people. They talked about how they turn the models up in terms of the temperature as high temperature as they can, where they're trying to explore kind of new ideas in physics as a, as a thought partner, just because they, they want the models to hallucinate. Um, yeah, sometimes it's something new. Yeah, exactly.swyx [00:34:21]: Um, so not right in every situation, but, um, I think it makes sense, you know, to test hallucination in scenarios where it makes sense. Also, the obvious question is, uh, this is one of. Many that there is there, every lab has a system card that shows some kind of hallucination number, and you've chosen to not, uh, endorse that and you've made your own. And I think that's a, that's a choice. Um, totally in some sense, the rest of artificial analysis is public benchmarks that other people can independently rerun. You provide it as a service here. You have to fight the, well, who are we to, to like do this? And your, your answer is that we have a lot of customers and, you know, but like, I guess, how do you converge the individual?Micah [00:35:08]: I mean, I think, I think for hallucinations specifically, there are a bunch of different things that you might care about reasonably, and that you'd measure quite differently, like we've called this a amnesty and solutionation rate, not trying to declare the, like, it's humanity's last hallucination. You could, uh, you could have some interesting naming conventions and all this stuff. Um, the biggest picture answer to that. It's something that I actually wanted to mention. Just as George was explaining, critical point as well is, so as we go forward, we are building evals internally. We're partnering with academia and partnering with AI companies to build great evals. We have pretty strong views on, in various ways for different parts of the AI stack, where there are things that are not being measured well, or things that developers care about that should be measured more and better. And we intend to be doing that. We're not obsessed necessarily with that. Everything we do, we have to do entirely within our own team. Critical point. As a cool example of where we were a launch partner for it, working with academia, we've got some partnerships coming up with a couple of leading companies. Those ones, obviously we have to be careful with on some of the independent stuff, but with the right disclosure, like we're completely comfortable with that. A lot of the labs have released great data sets in the past that we've used to great success independently. And so it's between all of those techniques, we're going to be releasing more stuff in the future. Cool.swyx [00:36:26]: Let's cover the last couple. And then we'll, I want to talk about your trends analysis stuff, you know? Totally.Micah [00:36:31]: So that actually, I have one like little factoid on omniscience. If you go back up to accuracy on omniscience, an interesting thing about this accuracy metric is that it tracks more closely than anything else that we measure. The total parameter count of models makes a lot of sense intuitively, right? Because this is a knowledge eval. This is the pure knowledge metric. We're not looking at the index and the hallucination rate stuff that we think is much more about how the models are trained. This is just what facts did they recall? And yeah, it tracks parameter count extremely closely. Okay.swyx [00:37:05]: What's the rumored size of GPT-3 Pro? And to be clear, not confirmed for any official source, just rumors. But rumors do fly around. Rumors. I get, I hear all sorts of numbers. I don't know what to trust.Micah [00:37:17]: So if you, if you draw the line on omniscience accuracy versus total parameters, we've got all the open ways models, you can squint and see that likely the leading frontier models right now are quite a lot bigger than the ones that we're seeing right now. And the one trillion parameters that the open weights models cap out at, and the ones that we're looking at here, there's an interesting extra data point that Elon Musk revealed recently about XAI that for three trillion parameters for GROK 3 and 4, 6 trillion for GROK 5, but that's not out yet. Take those together, have a look. You might reasonably form a view that there's a pretty good chance that Gemini 3 Pro is bigger than that, that it could be in the 5 to 10 trillion parameters. To be clear, I have absolutely no idea, but just based on this chart, like that's where you would, you would land if you have a look at it. Yeah.swyx [00:38:07]: And to some extent, I actually kind of discourage people from guessing too much because what does it really matter? Like as long as they can serve it as a sustainable cost, that's about it. Like, yeah, totally.George [00:38:17]: They've also got different incentives in play compared to like open weights models who are thinking to supporting others in self-deployment for the labs who are doing inference at scale. It's I think less about total parameters in many cases. When thinking about inference costs and more around number of active parameters. And so there's a bit of an incentive towards larger sparser models. Agreed.Micah [00:38:38]: Understood. Yeah. Great. I mean, obviously if you're a developer or company using these things, not exactly as you say, it doesn't matter. You should be looking at all the different ways that we measure intelligence. You should be looking at cost to run index number and the different ways of thinking about token efficiency and cost efficiency based on the list prices, because that's all it matters.swyx [00:38:56]: It's not as good for the content creator rumor mill where I can say. Oh, GPT-4 is this small circle. Look at GPT-5 is this big circle. And then there used to be a thing for a while. Yeah.Micah [00:39:07]: But that is like on its own, actually a very interesting one, right? That is it just purely that chances are the last couple of years haven't seen a dramatic scaling up in the total size of these models. And so there's a lot of room to go up properly in total size of the models, especially with the upcoming hardware generations. Yes.swyx [00:39:29]: So, you know. Taking off my shitposting face for a minute. Yes. Yes. At the same time, I do feel like, you know, especially coming back from Europe, people do feel like Ilya is probably right that the paradigm is doesn't have many more orders of magnitude to scale out more. And therefore we need to start exploring at least a different path. GDPVal, I think it's like only like a month or so old. I was also very positive when it first came out. I actually talked to Tejo, who was the lead researcher on that. Oh, cool. And you have your own version.George [00:39:59]: It's a fantastic. It's a fantastic data set. Yeah.swyx [00:40:01]: And maybe it will recap for people who are still out of it. It's like 44 tasks based on some kind of GDP cutoff that's like meant to represent broad white collar work that is not just coding. Yeah.Micah [00:40:12]: Each of the tasks have a whole bunch of detailed instructions, some input files for a lot of them. It's within the 44 is divided into like two hundred and twenty two to five, maybe subtasks that are the level of that we run through the agenda. And yeah, they're really interesting. I will say that it doesn't. It doesn't necessarily capture like all the stuff that people do at work. No avail is perfect is always going to be more things to look at, largely because in order to make the tasks well enough to find that you can run them, they need to only have a handful of input files and very specific instructions for that task. And so I think the easiest way to think about them are that they're like quite hard take home exam tasks that you might do in an interview process.swyx [00:40:56]: Yeah, for listeners, it is not no longer like a long prompt. It is like, well, here's a zip file with like a spreadsheet or a PowerPoint deck or a PDF and go nuts and answer this question.George [00:41:06]: OpenAI released a great data set and they released a good paper which looks at performance across the different web chat bots on the data set. It's a great paper, encourage people to read it. What we've done is taken that data set and turned it into an eval that can be run on any model. So we created a reference agentic harness that can run. Run the models on the data set, and then we developed evaluator approach to compare outputs. That's kind of AI enabled, so it uses Gemini 3 Pro Preview to compare results, which we tested pretty comprehensively to ensure that it's aligned to human preferences. One data point there is that even as an evaluator, Gemini 3 Pro, interestingly, doesn't do actually that well. So that's kind of a good example of what we've done in GDPVal AA.swyx [00:42:01]: Yeah, the thing that you have to watch out for with LLM judge is self-preference that models usually prefer their own output, and in this case, it was not. Totally.Micah [00:42:08]: I think the way that we're thinking about the places where it makes sense to use an LLM as judge approach now, like quite different to some of the early LLM as judge stuff a couple of years ago, because some of that and MTV was a great project that was a good example of some of this a while ago was about judging conversations and like a lot of style type stuff. Here, we've got the task that the grader and grading model is doing is quite different to the task of taking the test. When you're taking the test, you've got all of the agentic tools you're working with, the code interpreter and web search, the file system to go through many, many turns to try to create the documents. Then on the other side, when we're grading it, we're running it through a pipeline to extract visual and text versions of the files and be able to provide that to Gemini, and we're providing the criteria for the task and getting it to pick which one more effectively meets the criteria of the task. Yeah. So we've got the task out of two potential outcomes. It turns out that we proved that it's just very, very good at getting that right, matched with human preference a lot of the time, because I think it's got the raw intelligence, but it's combined with the correct representation of the outputs, the fact that the outputs were created with an agentic task that is quite different to the way the grading model works, and we're comparing it against criteria, not just kind of zero shot trying to ask the model to pick which one is better.swyx [00:43:26]: Got it. Why is this an ELO? And not a percentage, like GDP-VAL?George [00:43:31]: So the outputs look like documents, and there's video outputs or audio outputs from some of the tasks. It has to make a video? Yeah, for some of the tasks. Some of the tasks.swyx [00:43:43]: What task is that?George [00:43:45]: I mean, it's in the data set. Like be a YouTuber? It's a marketing video.Micah [00:43:49]: Oh, wow. What? Like model has to go find clips on the internet and try to put it together. The models are not that good at doing that one, for now, to be clear. It's pretty hard to do that with a code editor. I mean, the computer stuff doesn't work quite well enough and so on and so on, but yeah.George [00:44:02]: And so there's no kind of ground truth, necessarily, to compare against, to work out percentage correct. It's hard to come up with correct or incorrect there. And so it's on a relative basis. And so we use an ELO approach to compare outputs from each of the models between the task.swyx [00:44:23]: You know what you should do? You should pay a contractor, a human, to do the same task. And then give it an ELO and then so you have, you have human there. It's just, I think what's helpful about GDPVal, the OpenAI one, is that 50% is meant to be normal human and maybe Domain Expert is higher than that, but 50% was the bar for like, well, if you've crossed 50, you are superhuman. Yeah.Micah [00:44:47]: So we like, haven't grounded this score in that exactly. I agree that it can be helpful, but we wanted to generalize this to a very large number. It's one of the reasons that presenting it as ELO is quite helpful and allows us to add models and it'll stay relevant for quite a long time. I also think it, it can be tricky looking at these exact tasks compared to the human performance, because the way that you would go about it as a human is quite different to how the models would go about it. Yeah.swyx [00:45:15]: I also liked that you included Lama 4 Maverick in there. Is that like just one last, like...Micah [00:45:20]: Well, no, no, no, no, no, no, it is the, it is the best model released by Meta. And... So it makes it into the homepage default set, still for now.George [00:45:31]: Other inclusion that's quite interesting is we also ran it across the latest versions of the web chatbots. And so we have...swyx [00:45:39]: Oh, that's right.George [00:45:40]: Oh, sorry.swyx [00:45:41]: I, yeah, I completely missed that. Okay.George [00:45:43]: No, not at all. So that, which has a checkered pattern. So that is their harness, not yours, is what you're saying. Exactly. And what's really interesting is that if you compare, for instance, Claude 4.5 Opus using the Claude web chatbot, it performs worse than the model in our agentic harness. And so in every case, the model performs better in our agentic harness than its web chatbot counterpart, the harness that they created.swyx [00:46:13]: Oh, my backwards explanation for that would be that, well, it's meant for consumer use cases and here you're pushing it for something.Micah [00:46:19]: The constraints are different and the amount of freedom that you can give the model is different. Also, you like have a cost goal. We let the models work as long as they want, basically. Yeah. Do you copy paste manually into the chatbot? Yeah. Yeah. That's, that was how we got the chatbot reference. We're not going to be keeping those updated at like quite the same scale as hundreds of models.swyx [00:46:38]: Well, so I don't know, talk to a browser base. They'll, they'll automate it for you. You know, like I have thought about like, well, we should turn these chatbot versions into an API because they are legitimately different agents in themselves. Yes. Right. Yeah.Micah [00:46:53]: And that's grown a huge amount of the last year, right? Like the tools. The tools that are available have actually diverged in my opinion, a fair bit across the major chatbot apps and the amount of data sources that you can connect them to have gone up a lot, meaning that your experience and the way you're using the model is more different than ever.swyx [00:47:10]: What tools and what data connections come to mind when you say what's interesting, what's notable work that people have done?Micah [00:47:15]: Oh, okay. So my favorite example on this is that until very recently, I would argue that it was basically impossible to get an LLM to draft an email for me in any useful way. Because most times that you're sending an email, you're not just writing something for the sake of writing it. Chances are context required is a whole bunch of historical emails. Maybe it's notes that you've made, maybe it's meeting notes, maybe it's, um, pulling something from your, um, any of like wherever you at work store stuff. So for me, like Google drive, one drive, um, in our super base databases, if we need to do some analysis or some data or something, preferably model can be plugged into all of those things and can go do some useful work based on it. The things that like I find most impressive currently that I am somewhat surprised work really well in late 2025, uh, that I can have models use super base MCP to query read only, of course, run a whole bunch of SQL queries to do pretty significant data analysis. And. And make charts and stuff and can read my Gmail and my notion. And okay. You actually use that. That's good. That's, that's, that's good. Is that a cloud thing? To various degrees of order, but chat GPD and Claude right now, I would say that this stuff like barely works in fairness right now. Like.George [00:48:33]: Because people are actually going to try this after they hear it. If you get an email from Micah, odds are it wasn't written by a chatbot.Micah [00:48:38]: So, yeah, I think it is true that I have never actually sent anyone an email drafted by a chatbot. Yet.swyx [00:48:46]: Um, and so you can, you can feel it right. And yeah, this time, this time next year, we'll come back and see where it's going. Totally. Um, super base shout out another famous Kiwi. Uh, I don't know if you've, you've any conversations with him about anything in particular on AI building and AI infra.George [00:49:03]: We have had, uh, Twitter DMS, um, with, with him because we're quite big, uh, super base users and power users. And we probably do some things more manually than we should in. In, in super base support line because you're, you're a little bit being super friendly. One extra, um, point regarding, um, GDP Val AA is that on the basis of the overperformance of the models compared to the chatbots turns out, we realized that, oh, like our reference harness that we built actually white works quite well on like gen generalist agentic tasks. This proves it in a sense. And so the agent harness is very. Minimalist. I think it follows some of the ideas that are in Claude code and we, all that we give it is context management capabilities, a web search, web browsing, uh, tool, uh, code execution, uh, environment. Anything else?Micah [00:50:02]: I mean, we can equip it with more tools, but like by default, yeah, that's it. We, we, we give it for GDP, a tool to, uh, view an image specifically, um, because the models, you know, can just use a terminal to pull stuff in text form into context. But to pull visual stuff into context, we had to give them a custom tool, but yeah, exactly. Um, you, you can explain an expert. No.George [00:50:21]: So it's, it, we turned out that we created a good generalist agentic harness. And so we, um, released that on, on GitHub yesterday. It's called stirrup. So if people want to check it out and, and it's a great, um, you know, base for, you know, generalist, uh, building a generalist agent for more specific tasks.Micah [00:50:39]: I'd say the best way to use it is get clone and then have your favorite coding. Agent make changes to it, to do whatever you want, because it's not that many lines of code and the coding agents can work with it. Super well.swyx [00:50:51]: Well, that's nice for the community to explore and share and hack on it. I think maybe in, in, in other similar environments, the terminal bench guys have done, uh, sort of the Harbor. Uh, and so it's, it's a, it's a bundle of, well, we need our minimal harness, which for them is terminus and we also need the RL environments or Docker deployment thing to, to run independently. So I don't know if you've looked at it. I don't know if you've looked at the harbor at all, is that, is that like a, a standard that people want to adopt?George [00:51:19]: Yeah, we've looked at it from a evals perspective and we love terminal bench and, and host benchmarks of, of, of terminal mention on artificial analysis. Um, we've looked at it from a, from a coding agent perspective, but could see it being a great, um, basis for any kind of agents. I think where we're getting to is that these models have gotten smart enough. They've gotten better, better tools that they can perform better when just given a minimalist. Set of tools and, and let them run, let the model control the, the agentic workflow rather than using another framework that's a bit more built out that tries to dictate the, dictate the flow. Awesome.swyx [00:51:56]: Let's cover the openness index and then let's go into the report stuff. Uh, so that's the, that's the last of the proprietary art numbers, I guess. I don't know how you sort of classify all these. Yeah.Micah [00:52:07]: Or call it, call it, let's call it the last of like the, the three new things that we're talking about from like the last few weeks. Um, cause I mean, there's a, we do a mix of stuff that. Where we're using open source, where we open source and what we do and, um, proprietary stuff that we don't always open source, like long context reasoning data set last year, we did open source. Um, and then all of the work on performance benchmarks across the site, some of them, we looking to open source, but some of them, like we're constantly iterating on and so on and so on and so on. So there's a huge mix, I would say, just of like stuff that is open source and not across the side. So that's a LCR for people. Yeah, yeah, yeah, yeah.swyx [00:52:41]: Uh, but let's, let's, let's talk about open.Micah [00:52:42]: Let's talk about openness index. This. Here is call it like a new way to think about how open models are. We, for a long time, have tracked where the models are open weights and what the licenses on them are. And that's like pretty useful. That tells you what you're allowed to do with the weights of a model, but there is this whole other dimension to how open models are. That is pretty important that we haven't tracked until now. And that's how much is disclosed about how it was made. So transparency about data, pre-training data and post-training data. And whether you're allowed to use that data and transparency about methodology and training code. So basically, those are the components. We bring them together to score an openness index for models so that you can in one place get this full picture of how open models are.swyx [00:53:32]: I feel like I've seen a couple other people try to do this, but they're not maintained. I do think this does matter. I don't know what the numbers mean apart from is there a max number? Is this out of 20?George [00:53:44]: It's out of 18 currently, and so we've got an openness index page, but essentially these are points, you get points for being more open across these different categories and the maximum you can achieve is 18. So AI2 with their extremely open OMO3 32B think model is the leader in a sense.swyx [00:54:04]: It's hooking face.George [00:54:05]: Oh, with their smaller model. It's coming soon. I think we need to run, we need to get the intelligence benchmarks right to get it on the site.swyx [00:54:12]: You can't have it open in the next. We can not include hooking face. We love hooking face. We'll have that, we'll have that up very soon. I mean, you know, the refined web and all that stuff. It's, it's amazing. Or is it called fine web? Fine web. Fine web.Micah [00:54:23]: Yeah, yeah, no, totally. Yep. One of the reasons this is cool, right, is that if you're trying to understand the holistic picture of the models and what you can do with all the stuff the company's contributing, this gives you that picture. And so we are going to keep it up to date alongside all the models that we do intelligence index on, on the site. And it's just an extra view to understand.swyx [00:54:43]: Can you scroll down to this? The, the, the, the trade-offs chart. Yeah, yeah. That one. Yeah. This, this really matters, right? Obviously, because you can b

Signup for the FREE Masterclass: https://www.thecustomersuccesspro.com/masterclassIn this episode of the Customer Success Pro Podcast, host Anika Zubair and guest AsAshley Stamps-Lafont discuss the evolving role of customer success within go-to-market strategies. They explore the importance of building relationships, establishing trust, and the necessity of aligning customer success with revenue goals. Ashley shares her experiences as the first VP of Customer Success at Quotapath, emphasizing the need for customer success leaders to understand financial metrics and the shift towards revenue ownership. The conversation also touches on the future of customer success, the importance of communication, and actionable advice for aspiring leaders in the field.Chapters:00:00 The Role of Customer Success in Go-To-Market Strategy14:39 Building Relationships and Trust in Customer Success24:44 Metrics and Revenue Ownership in Customer Success39:29 Future Directions for Customer Success46:51 Advice for Aspiring Customer Success LeadersConnect with Anika Zubair: Website: https://thecustomersuccesspro.com/LinkedIn: https://www.linkedin.com/in/anikazubair/RevUP Academy: https://thecustomersuccesspro.com/revupConnect with Ashley Stamps-Lafont:Linkedin: https://www.linkedin.com/in/ashleystampslafont/Book Anika as a speaker at your next team event: https://www.thecustomersuccesspro.com/team-eventWant to be my next podcast guest apply here: https://www.thecustomersuccesspro.com/podcast-guestDownload my freebies:https://thecustomersuccesspro.com/resources

Article: https://www.contemporarypediatrics.com/view/redefining-type-1-diabetes-early-identification-staging-and-clinical-implications-for-pediatric-careTable: https://thepediatriclounge.com/screening-to-prevent-dkaPetiete Trial: https://link.springer.com/article/10.1007/s00125-025-06586-1#Sec5Prevent Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa2308743Screening Summit: https://medschool.cuanschutz.edu/barbara-davis-center-for-diabetes/news-profdev/conferences-events/8th-childhood-diabetes-prevention-symposium---november-10th-11th--2025In this episode, Herb Bravo is joined by Dr. Andrew Cagel, a pediatric endocrinologist, and Dr. Dan Feiten, a pediatrician , to discuss groundbreaking advancements in Type 1 Diabetes (T1D) care. The episode delves into their recent publication, 'Redefining Type 1 Diabetes: Early Identification, Staging, and Clinical Implications of Pediatric Care,' highlighting the critical importance of early detection and intervention. The guests emphasize the urgent need for universal screening.00:00 Introduction to the Pediatric Lounge00:45 Meet the Guests: Dr. Andrew Cagel and Dr. Dan Fen01:08 Redefining Type 1 Diabetes01:36 Personal Stories and Experiences01:52 The Importance of Early Detection04:40 Advancements in Type 1 Diabetes Treatment13:55 The Role of EHR and AI in Pediatric Care19:13 Future Directions and Guidelines29:06 Pivotal Study in Pediatric Diabetes30:45 The Protect Trial: Slowing Disease Progression33:19 Challenges in Screening and Implementation37:46 The Role of Pediatricians and Influencers43:03 Advocacy and Future Directions56:22 Conclusion and Final ThoughtsA Podcast taking you behind the door of the Physician's Lounge to get a deeper insight into what docs are talking about today, from the clinically profound to the wonderfully routine...and everything in between. The conversations are not intended as medical advice, and the opinions expressed are solely those of the host and guest.Support the show

In this episode of the PFC Podcast, Dennis and John discuss the ongoing updates and changes within the Tactical Combat Casualty Care (TCCC) guidelines. They delve into the role of the TTC Committee, the importance of literature reviews in developing algorithms for trauma care, and the proposed changes to the March algorithm, emphasizing the need for resuscitation before decompression. The conversation also covers the overhaul of the analgesic section, the recommendations for antibiotics, and the role of TXA in treating hemorrhagic shock. Additionally, they touch on the significance of triage in mass casualty situations and the future directions of the committee's work.TakeawaysTCCC is continuously updated to reflect new research.Resuscitation should be prioritized over decompression in trauma care.The March algorithm may undergo significant changes to improve outcomes.Analgesic options are being re-evaluated due to supply issues.Rocephin is being recommended as a primary antibiotic.TXA is crucial for managing hemorrhagic shock in trauma patients.Triage protocols are essential for effective mass casualty management.The committee is open to innovative ideas and solutions.Training and education are vital for implementing new guidelines.Future meetings will focus on finalizing and voting on proposed changes.Chapters00:00 Introduction to the PFC Podcast02:46 Understanding the TTC Committee and Its Role06:06 Literature Review and Algorithm Development09:00 Resuscitation vs. Decompression in Trauma Care12:07 Proposed Changes to the March Algorithm15:06 Analgesic Section Overhaul and Alternatives18:09 Antibiotic Recommendations and Changes20:54 TXA and Its Role in Hemorrhagic Shock23:51 Triage in Mass Casualty Situations26:45 Future Directions and Upcoming Votes30:06 Conclusion and Final Thoughts For more content go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care

This episode of 'In the Woods' podcast, hosted by Jake Barker of Oregon State University's Extension Service, explores post-wildfire restoration on private forest lands based on the LEAF (Landowner Experience After Fire) survey. Conducted by OSU in response to the 2020 Labor Day fires, the survey gathered insights from over 200 landowners across Oregon on their recovery experiences from 2017 to 2023. Key findings were shared, including the importance of local capacity, coordination, and organizational support in driving effective recovery. Guest Kara Baylog, a program coordinator with OSU's Forestry and Natural Resources extension, discussed the survey's methodology, the barriers landowners faced, and the types of assistance that proved most effective in aiding recovery efforts. For more information on this and other episodes, go to inthewoodspodcast.com.List of Chapters and Timestamps:00:00 Introduction to In the Woods Podcast00:35 Overview of Today's Episode: Post-Wildfire Restoration01:57 Introducing Kara Baylog and the LEAF Survey02:34 Details of the LEAF Survey06:35 Survey Findings: Emotional and Practical Responses08:22 Challenges and Barriers in Post-Wildfire Restoration13:15 Importance of Management Planning17:13 Role of Agencies and Organizations in Recovery24:34 Types of Assistance Provided to Landowners32:33 Future Directions and Final Thoughts37:11 Conclusion and Lightning Round40:14 Credits and Acknowledgements

In this episode of Iron Culture, hosts Eric Trexler and Eric Helms discuss various themes surrounding fitness, nutrition, and the importance of open discourse in the community. The conversation addresses criticism received from listeners, the role of cynicism versus skepticism in fitness discussions, and the necessity of engaging with differing perspectives for personal and professional growth. The episode concludes with a call for self-awareness and openness in navigating the complexities of fitness discourse. If you're looking for some high-quality lifting gear or apparel, be sure to visit elitefts.com and use our discount code "MRR10" for a 10% discount. Chapters 00:00 Introduction and Holiday Greetings 02:18 Tiny Utensils and Eating Behavior 05:40 The Controversy Surrounding Brian Wansink 08:23 Updates and Future Directions for Iron Culture 11:20 Addressing Criticism and Community Discourse 17:20 Navigating Evidence-Based Practice and Guest Selection 30:27 Evaluating Content and Moral Standards 32:35 The Role of Evidence in Interviews 34:11 Career Paths in Fitness and Coaching 36:54 Critiques and Misunderstandings in Fitness 40:34 Navigating Disagreements in Evidence-Based Fitness 46:16 Cynicism vs. Skepticism in Fitness Discourse 55:45 The Shift from Ideas to Personal Attacks 59:03 The Drama of Evidence-Based Fitness 01:01:47 The Importance of Empirical Science 01:06:14 Navigating Cynicism and Skepticism 01:12:21 Engaging with Different Perspectives 01:17:59 Self-Awareness in Fitness Discourse 01:24:08 The Role of Change and Growth in Fitness

In this episode, recorded live at the World Dairy Expo, Peggy sits down with Tim Baumgartner, the genetics manager at Jer-Z-Boyz Ranch in Pixley, California. Tim shares his journey from growing up on a dairy farm in Wisconsin to becoming a pivotal figure in the dairy genetics industry. He discusses his passion for cows and people, recounting how one pivotal conversation led to a rewarding career in genetics. The episode explores how the Jer-Z-Boyz Ranch significantly improved the breed's genetics, the impact of mentorship, and how innovative technology, like the Milc Group's feed program, transformed their operations. Highlights include the discovery and development of high-fat Jersey cows, the challenge and success of polled genetics, and the importance of family and community in the dairy world. Tim's story is a testament to resilience, passion, and the pursuit of excellence in the dairy industry.This Episode is Brought to you by Milc GroupMilc Group is a dairy software company that brings real-time, actionable data to dairy farms across the world. They are dedicated to revolutionizing the dairy industry with their user-friendly cloud-based software. ONE™ by Milc Group is our all-in-one app that brings together all the important aspects of your dairy together in one place. With products such as feed and animal management software, people training, dairy facility monitoring, and scale management, Milc Group is committed to providing producers with the tools they need to succeed.ONETM Feed: https://www.milcgroup.com/product/feedONETM Scale: https://www.milcgroup.com/product/scale00:00 Introduction: Shaping a Breed and Leaving a Legacy00:07 Meet Tim Baumgartner: A Passion for Genetics01:23 Growing Up on a Dairy Farm in Wisconsin07:42 The Journey to California09:31 A Career in Genetics and Mentorship15:37 The Jer-Z-Boyz Ranch Transformation27:39 Innovations and Future Directions

PESTO Trial Results: What Stroke Survivors Need to Know About Perispinal Etanercept If you've spent any time in stroke recovery communities, you've probably seen the same pattern: a treatment gets talked about with real intensity, people share personal stories that pull you in, and suddenly you're left trying to sort hope from hype from “maybe.” When the decision also involves significant cost, that uncertainty can feel even heavier. That's exactly why I recorded this episode: to help stroke survivors and their families understand the PESTO trial results in plain language without drama, without attacks, and without jumping to conclusions. In this interview, Professor Vincent Thijs explains what the PESTO trial set out to test, why it was designed the way it was, and what the results can (and can't) tell us about perispinal etanercept in stroke recovery. The real problem: not “hope vs skepticism”… it's confusion If you're a stroke survivor, you're already doing something heroic: you're living inside a recovery journey that demands patience, grit, and constant adjustment. The challenge isn't that you “don't want to believe” in something. The challenge is that it's genuinely hard to make an informed decision when: People report different outcomes Online conversations become polarised fast Scientific studies use unfamiliar language The same treatment can be described in completely different ways depending on who you're listening to My goal here isn't to tell you what to do. It's to help you think clearly, ask better questions, and understand what the best available evidence from this trial actually tested. What the PESTO trial was trying to investigate (in simple terms) Professor Thijs explains that the PESTO trial was designed in response to strong community interest. Stroke survivors wanted to know whether the way perispinal etanercept is currently administered in some settings could be demonstrated to work under the standards used for medicines to become widely accepted as part of routine care. So the researchers designed a randomized, placebo-controlled clinical trial. In this type of study: A computer assigns participants to either the treatment or a placebo Participants and clinicians are kept “blinded” (they don't know who got what) Outcomes are measured in a consistent way at set time points In the PESTO trial, the focus was on stroke survivors with moderate to severe disability and reduced quality of life. The primary question was straightforward: Does quality of life improve after one or two injections compared with placebo, over the measured timeframe? Why this study looked at quality of life (not one symptom) One key detail Professor Thijs highlights is the design choice: the trial didn't only target one issue, like pain or walking. It aimed to be more “pragmatic,” reflecting how treatment is used in real-world settings where people seek help for different post-stroke challenges (mobility, fatigue, speech, cognition, pain, and more). That means the main outcome wasn't “Did walking speed improve?” or “Did pain reduce?” It was broader: Quality of life at 28 days And again after the second injection timeframe (56 days total) This matters because your results can look different depending on what you measure. A trial targeting one symptom might see a signal that a broad quality-of-life measure doesn't detect (and vice versa). What the PESTO trial results found In Professor Thijs' words, the trial did not show a difference in quality of life between the treatment and placebo groups at the measured time points: No clear quality-of-life improvement at 28 days No clear improvement after two injections at 56 days That's the central outcome. But there's another finding that grabbed my attention—and it's one many listeners will find surprising. Quote block (mid-article): “We saw that 58% of the people also had that improvement [with placebo] and 53% had it with etanercept… our initial guess was very wrong.” — Professor Vincent Thijs The “placebo signal” and why it matters A strong placebo response doesn't mean “it was all in their heads.” It means that in a blinded clinical trial, people can improve for multiple reasons that aren't specific to the drug itself, such as: Expectation and hope Natural fluctuations in symptoms The impact of being monitored and supported Regression to the mean (symptoms often move toward average over time) The structure and attention that come with trial participation Professor Thijs describes how, during the blinded phase, participants reported improvements in a variety of areas (like sensation, vision, speech). The crucial point is: the team didn't know who had a placebo or an active treatment at the time, which is exactly why blinding exists. For you, the listener, this is a reminder of something empowering: Personal stories can be real and meaningful—and still not answer the question of efficacy on their own. “Am I a candidate?” The trial's honest answer: we don't know how to predict it (yet) One of the most important parts of this conversation is the desire to identify who might benefit most. Professor Thijs explains that the team looked at subgroups (for example: age, sex, severity, diabetes, time since stroke). In this trial, they didn't find a clear subgroup where the treatment stood out as reliably beneficial compared with placebo. He also adds an important caveat: subgroup analysis is difficult, especially in trials that aren't extremely large. So the absence of a clear “responder profile” here doesn't automatically prove none exists—it means this trial didn't reveal one. What this episode is (and isn't) saying Let's keep this grounded and fair. This interview is not about attacking any person, provider, or clinic. It's not about shaming stroke survivors who tried something. It's not even about telling you that you should or shouldn't pursue a treatment. It is about this: Understanding what the PESTO trial tested Understanding what the results showed within their timeframe Knowing the limits of what the trial can conclude Using evidence to reduce confusion before making big decisions A simple “clarity plan” before you decide anything big If you're considering any high-stakes treatment decision, here's a neutral, practical way to move forward: 1) Ask: “What outcome matters most for me?” Is it pain? walking? fatigue? speech? cognition? daily function? quality of life? A treatment might be studied for one outcome and discussed online for another. 2) Ask: “What does the best evidence say—specifically?” Not “Does it work?” in general, but: In what population? Using what method? At what dose? Over what timeframe? Compared with what? 3) Ask: “What are my options and trade-offs?” Talk with a qualified healthcare professional who understands your medical history, risk factors, and rehab plan. Ask about: Potential risks and side effects Opportunity cost (what else could you do with the same time, money, and energy?) Evidence-based rehab and supports that match your goals Listen to the full interview If you want the clearest explanation of the PESTO trial results—from the lead researcher himself—listen to the full episode with Professor Vincent Thijs. And if you'd like to support the podcast (and help keep these conversations going for stroke survivors who need hope and clarity): Bill's book: recoveryafterstroke.com/book Patreon: patreon.com/recoveryafterstroke Medical disclaimer This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. PESTO Trial Results (Etanercept After Stroke) | Interview with Professor Vincent Thijs Confused about perispinal etanercept after stroke? Prof Vincent Thijs explains the PESTO trial results clearly, calmly, and evidence-first. More About Perispinal Etanercept: Etanercept Stroke Recovery: Wesley Ray's Relentless Comeback Dwayne Semple's Remarkable Stroke Journey and Perispinal Etanercept Etanercept for Stroke Recovery – Andrew Stopps Support The Recovery After Stroke Podcast on Patreon Highlights: 00:00 Introduction and Overview of the PESTO Trial 04:19 Design and Objectives of the PESTO Trial 11:23 Recruitment and Methodology of the Trial 18:31  PESTO Trial Results and Findings 24:28 Implications and Future Directions for Research 32:15 Conclusions and Final Thoughts Transcript: Introduction: PESTO Trial Results Bill Gasiamis (00:00) Hello and welcome back to Recovery After Stroke. Before we get started, a quick thank you to my Patreon supporters. Your support helps cover the hosting costs after more than 10 years of me doing this show solo. And it helps me keep creating episodes for stroke survivors who need hope and practical guidance. And thank you as well to everyone who comments on YouTube, leaves reviews on Spotify and Apple podcasts. buys the book and even to those of you who don’t skip the ads. Every bit of that supports keep this podcast going. Now today’s episode is about the PESTO trial results and I’m interviewing Professor Vincent Theis. If you’ve ever felt confused by the conversation online about perisponal antenna sept, some people sharing positive experiences while others are feeling disappointed and plenty of strong opinions in between, this episode is designed to bring clarity. We talk about what the PESTO trial set out to test, how the study was designed, what it found within the measured timeframes and what the results can and can’t tell us. Just a quick note, this conversation is educational and not medical advice. Always speak with a qualified health professional about your situation. All right, let’s get into it. Professor Vincent Dase, welcome to the podcast. Vincent Thijs (01:24) Thank you for having me, Bill. Bill Gasiamis (01:26) I’m really looking forward to this conversation. Atenosept is one of the most hotly discussed topics in stroke recovery. And there’s a lot of misconceptions about whether or not it is or is not efficacious. And while there’s a lot of anecdotal evidence where some people have had positive outcomes from injections, there’s also a lot of people’s feedback, which is very negative about their experience with the Etanercept injections and the lack of results. So today, the reason I reached out is because I wanted to get to the bottom of the findings of the PESTO trial. And I’m hoping that you can shed some light on that. The first question basically is, can you start by explaining in simple terms what it was that the PESTO trial set out to investigate? Vincent Thijs (02:22) All right. The PESTO trial was in response to community members, stroke survivors, wanting to find out whether the current practice of administering Etanercept has done in the U.S. in private practice. In Denmark, I hear there are some sites that provide this treatment. Whether the treatment and genders can be actually proven according to the standards that we use in the pharmaceutical industry to get it to become accepted as a standard of care treatment. For that, you need to do what we call a randomized controlled clinical trial, preferably two that show evidence that treatment does what it’s set out to do. And that’s why with this background and the community pressuring the minister several years ago, Mr. Hunt at the time, to fund a trial that would help answer that question. Design and Objectives of the PESTO Trial There was a call was set out to do this trial and several groups in Australia applied and then an independent committee decided to award the trial to the PESTO study group. And then we tried to design this trial to give an answer. So it’s mostly about people that have moderate to severe disability after their stroke that have reduced quality of life. And We wanted to know, does their quality of life improve when Etanercept is administered? And we wanted to test whether one or two injections were needed. Because that’s what we heard from stroke survivors that from Australia and internationally that went over to the US. Well, this is how it’s done. You get one or two injections and there was a paper that had shown big effects with one injection. So that was the primary endpoint, but then we also looked at whether two injections could help. And when you design a trial, you have to make a decision, will we focus on people with. pain after stroke, or will we look at people who have mobility issues or speech issues or cognitive issues? And we saw that current clinical practice actually was people with various impairments after stroke were accepted and received the treatment. And what would have been the advantage of doing say only mobility or only pain? Well, you can then look at the outcome of pain or mobility, does it improve? Or is your cognition improved? But because we wanted to be pragmatic and we know that recruitment in clinical trials needs to reflect how is current practice. So we thought let’s put in all the people with moderate to severe disability, whatever their impairment after stroke and reduce quality of life. And then we looked at quality of life as an outcome rather than an individual impairment. And so what we did then was to use the randomized technique and where it’s left up to the computer to decide what treatment a person will receive, the active Etanercept or a similar looking placebo, and then look at 28 days and we had to make a decision what makes sense 28 days, what is practical. to see whether that injection then had improved quality of life. And then we did another injection again with a placebo or the active drug. And then after 28 days again, we looked again whether that had made a difference. So we have people that had received two times the placebo, one time the placebo, and one active injection. And then we have people that had received two active injections. And then we were able to compare those and see whether they had made bigger improvements if you receive two injections versus one or zero. Unfortunately, we couldn’t show a difference in quality of life at 28 days. And we also couldn’t show an improvement at 56 days after people had two injections. But that was in a nutshell how we designed and the background of the study. Bill Gasiamis (07:25) So the main difference then between the Griffith University study and your particular study was that they did go after a specific improvement in one area, I believe. it in? Okay. So although those guys went after pain, you guys went after just a general improvement in quality of life after the injection and your stroke survivors. Vincent Thijs (07:39) Mostly, think. Bill Gasiamis (07:54) would have been as far as 15 years post stroke. Is that right? Vincent Thijs (07:59) Yes, correct. We wanted to have people early after stroke between one and five years, and then also between people five to 15 years after stroke. That was also for practical reasons. Once you start trial, you see how good recruitment is, how many people want to participate in the study. And we saw that if we went to up to five years. Recruitment was relatively slow. So we added this additional group of people later on after their stroke. that because many people, I’m five years, I’m six years after stroke. Why can’t I get the treatment? And you know, so we also wanted to expand the pool. And that’s also what happens in clinical practice. Current clinical practice, I don’t think the sites and the US and they would refuse the patient six years or so. We just wanted to reflect the people that we see on the website going for this treatment. Bill Gasiamis (09:01) Yeah, yeah. And then the difference between the Griffith trial and your trial as well was the actual dosage of Etanercept the amount that was in the injection. I do believe that your trial was a 25 milligram injection. And I believe that the Griffith University trial was 25 milligram. injection to 50 milligram injection. Vincent Thijs (09:34) Yeah, we just based on what people told us they received when they went to the clinic, also the other sites and then also 35 milligram was chosen because that’s in the patent for the street. Bill Gasiamis (09:49) Okay, I see. So you’re trying to as much as possible mimic what was happening out there in in the private practice Vincent Thijs (10:00) We wanted to answer the question, is current clinical practice, is that beneficial? And that’s what sort of what the call was to do a clinical trial in current clinical practice. You can, you have to make decisions, right? And I think this was the most relevant for a stroke survivor. Bill Gasiamis (10:17) Now that’s really interesting that stroke survivors were able to twist the arm of a minister to get the funding to begin that process of the trial. How long ago did this actually start? Vincent Thijs (10:28) I think it was 2016, 2017 or so. So it takes a while to get the minister and then I think that the trial started in 2019. took a while to complete as well. Bill Gasiamis (10:43) Right understood. Okay So then you recruit people they come along and they go through the trial through the particular trial How does that work on the day do they turn up are they admitted? We’ll be back with more of professor face explanation in just a moment But I want to pause here because if you’ve ever felt stuck between hope and uncertainty, you’re not alone When you’re recovering from stroke, you’re constantly making decisions and some decisions feel high stakes, especially when confronting information that’s conflicting. Recruitment and Methodology of the Trial In the second half of this conversation, we get into the parts that really help you think clearly. What the trial results do and don’t mean, and why placebo responses matter in blinded research, and how to frame smarter questions before you commit time, money, or energy to any path. If you want to support the podcast and keep these episodes coming, You can grab my book at recoveryafterstroke.com/book or join the Patreon at patreon.com/recoveryafterstroke All right, back to the episode. Vincent Thijs (11:51) All right, so we recruited from a variety of sources. So we had kept a log of people that were interested in this. We had a Facebook post in New Zealand, for instance, where we recruited as well. We had people from the Stroke Clinical Registry that were approached. We had a website and people could register their interest if they were doing a search online to participate in clinical trial. So the variety of sources and then we have to determine eligibility that was mostly done either via an in-person visit or remotely via telehealth. We tried to get their medical information, what type of stroke they had. And then we also questioned whether they had this modified rank in scale, the disability they had, the impairments they had from their stroke. so then people came. they were considered eligible, then we scheduled a visit and they would typically come in no overnight stay needed. It was a day procedure that was done. People were then receiving another questionnaire on the day itself to measure their quality of life and other measures like their fatigue levels and how much help they required, etc. And then we proceeded with the injection, which was done. We had bought a special bed that was able to do the, the, the tilting that was required. So we set the people up, injected and then tilted the table. so, we received the drug. It was prepared independently by the pharmacist. So the pharmacist, they took the drug off the shelf or the made the placebo. and they made sure it looked exactly alike. So then somebody from the trial team picked it up from the pharmacist. The pharmacist didn’t tell, of course, what it was. And then the administration happened. So the doctor who administered and the participant did not know what they received. So after the procedure, they were left like this for four minutes. And then after four minutes, people could sit up again. And we waited about half an hour. then we asked them how they were doing, whether there were any adverse reactions, ⁓ and ⁓ then after that half an hour of observation people could go back to their habitual situation. ⁓ it’s a very simple ⁓ procedure to do. Bill Gasiamis (14:35) I believe there was a was there 126 participants Vincent Thijs (14:40) Yes, 126 people participated. had anticipated a little bit more people to participate. So we had hoped 168, but recruitment fell flat after a while and we were not able to find more people to recruit. So we made a decision and then, you know, these clinical trials, they have some funding ⁓ and they require the treatment team to be paid, et cetera, and that ran out. So we had to stop at a certain time. Bill Gasiamis (15:13) Was the study stopped early because of a decrease in the amount of funding or was there an issue with the funding at some point? Vincent Thijs (15:23) Funding ran out. You hire people for a certain amount of years and then you have fewer patients than you anticipate. So you have to stop. Bill Gasiamis (15:32) huh, okay. So would that affect the outcome of the trial? Would you say the lack of funding or the lack of the ability to take the trial further? Vincent Thijs (15:42) Yeah, well, what we had when you do the trial, when you plan the trial, you say, well, this is what we’re going to expect in terms of efficacy. You have to make a guess and say, well, that many people will have an improvement in quality of life if we give them the placebo and that many people will have an improvement in quality of life with the trial drug. And we had thought that about 11 % would improve with the placebo based on an earlier study. And then we had to make a guess because nobody had done this type of study on what Etanosap would provide. But reading the report that was published several years ago now, where 90 % of the people reported improvement in their impairments, we thought, well, Let’s not go for 90%, but a 30 % improvement. And so that was based on that we needed 168 people to participate in the trial. So that was what we call the pre-planned sample size estimation, which is a guess. When we stopped at 126 participants, actually we saw that the results were very different. There was not that 11 % actually in the placebo arm. saw that 58 % of the people also had that improvement and 53 % had it with ethanosab. So our initial guess was very wrong based on some statistical advanced statistical techniques we have. We have quite a lot of power to estimate whether there was a difference. So I think the trial can provide us an answer. It’s large enough to give us an answer about this particular question. Is current clinical practice in these people with this range after their stroke, does it improve? quality of life after a month or after two months. I’m not speaking about early improvement, I’m not speaking about six months down the line. We only can decide what we see in this study. Bill Gasiamis (18:05) So you have some limitations because you can’t have the funding to test one month, two months, six months, 12 months. You have the funding to basically meet the design of your study and then you can report on that. Now what’s really interesting is that the placebo had such a large result. PESTO Trial Results and Findings Vincent Thijs (18:34) What kind of things were people reporting that improved for the people who had the placebo injection?Look, this is, course, when we were in the blinded phase, when neither myself or my colleagues who did these scales, we were totally blinded. And that’s, remember vividly people saying, it didn’t do anything for me. But then there were also people said that they could see again. And so people that had improvement in sensation. Some people had improvement in their speech. there were, we, we observed these things, but we didn’t know whether they were active or placebo. And then surprisingly we had some people in whom we thought, they must have had active drug that turned out to have the placebo, but that’s years after, right? Because it takes a little bit of time to accumulate a sufficient number of patients. And we were only reporting and breaking the blind when the trial was finished. because otherwise you may be biased in all your analysis, et cetera. You don’t want to do that. So you wait until the end of the study to break the blind. And that’s very frustrating for the participants because there were many people that said, I must have had the placebo because it didn’t do anything for me. And there were other people that were, and some people like that, they said, I still want to go to the US. Bill Gasiamis (19:37) I see. Vincent Thijs (19:59) And please, can you tell me if I received a placebo? And I understand it was terribly frustrating for these participants. But we were very strict. No, we don’t want to break the blind. This is against the rules that you have to adhere to in a clinical trial. And so we didn’t do that. Of course, once the trial was finished, we were able to report the results back to the the participants. And then there were some people that were very surprised that they had received the active drug. I remember one person vividly who said, you have to tell me now because I’m going. And then I said, hold off, hold off. And then we told them you had twice the active drug. And so they decided not to go anymore. So you see how From a clinical trial perspective, it’s very important to remain very objective and not being able to see what people have received. From a humane level, of course, I understand it was very important to these people. Bill Gasiamis (21:02) Yeah, that’d be difficult. ⁓ And then I imagine that had the placebo not worked and then the tenisept did work, then there would have been people who would have said, well, I’ve received the placebo. It didn’t work for me. Other people received the tenisept. It did work for them. Why can’t I get the tenisept injection now? Vincent Thijs (21:26) Yeah, and we also had two people, people that had twice the placebo who noticed an improvement and have told me the improvement is still there. Bill Gasiamis (21:35) Wow. Vincent Thijs (21:36) So it. Bill Gasiamis (21:38) That’s amazing. Now was the. Vincent Thijs (21:40) And often that, and I must tell you, often those were relatively little things that seemed to improve both with the placebo and in the active group. And you see that there are changes in quality of life that people have reported, but it happens as well with the placebo. Bill Gasiamis (21:58) Wow. Was the intention of the study that was funded at the very beginning in 2016 by Minister Hunt, was it to determine whether or not this was going to be an effective treatment for people in stroke and therefore to roll it out somehow in the Australian medical system for stroke survivors? What was the thinking for Minister Hunt? Do you know? Vincent Thijs (22:24) Of course, I was not involved in that lobbying to the minister or anything, but it was to bring it on a pathway towards regulatory approval. We know that Etanercept is a relatively cheap drug that you can get ⁓ and is approved already for some indications, especially in people with rheumatoid arthritis, the condition of the joints, but it’s not approved for stroke. And to be officially approved and then potentially re- reimbursed on the PBS. You need to have some trials that have been done such as PESTO. We do different trial phases. One would be a phase two trial and a phase three trial. So phase one is typically in people just to assess the safety and some dosages usually in healthy people. And then a phase two is safety amongst stroke survivors. and preliminary efficacy. And that’s where PESTO was what we call a phase two B trial. And then a phase three trial would then be a trial in many more participants based usually on the results of a phase two B trial. And then usually when you have a phase three trial and it’s convincing and the authorities may approve such a trial. Bill Gasiamis (23:46) So in this case, the phase two B trial, this PESTO trial didn’t find that it’s efficacious. And as a result, there’s not going to be a further trial. Would that be accurate? Vincent Thijs (23:56) Well, based on the findings we have in this particular type of ⁓ way of administering in this particular group of people, I don’t think there’s enough evidence to argue for a phase three trial. It may be that you could say, well, we want to focus on pain because that was more promising. Well, you’ll need to do another trial in that condition. Implications and Future Directions for Research After stroke or maybe within a year after stroke. I mean, there are other possibilities, but at the moment, current clinical practice type trials, I don’t think there’s enough evidence to move forward with that. Bill Gasiamis (24:43) What would the numbers have had to look like for the trial to conclude that there was evidence of efficacy? Vincent Thijs (24:51) Well, I think based on what we have now, you would need to design a much, much bigger trial because there was only a 5 % difference between the placebo and the active group. And actually it was in favor of the placebo. So the placebo did a little bit better, not statistically significant. So it could just be by chance, but you would need probably thousands of people. Bill Gasiamis (25:15) I see. And I imagine there’s not a lot of excitement about funding something like that by the people who fund these trials. Vincent Thijs (25:25) Yes, typically the funders will look at how good is the evidence to pursue this. And if you were a pharmaceutical company on a pathway to development for a drug, you probably would say, well, it looks safe, but it didn’t do what it intended to do. So let’s stop the development of this drug for this indication. Bill Gasiamis (25:45) I say so. I think one of the challenges with the path of administering a TANACEP to stroke survivors is that there seems to be a missing step. And the step to me is determining whether or not somebody is a candidate for a TANACEP. perhaps if we knew more about the stroke survivor, what was actually happening in their particular brain, and we were able to determine some similarities between the people who have had a positive result and we developed a method, then that would make it a lot easier. to say, well, I’m a stroke survivor. I’d like to have a TANACYPT and then go through a process of determining whether or not I was a candidate rather than just guessing whether I’m a candidate or not and then having to pay money to find out whether in fact I was a candidate. Vincent Thijs (26:33) The trial provides a little bit of answers to that. ⁓ You want to identify a marker or a subgroup of people in whom the drug will work particularly well. And so you could look at, and we looked at different things like females versus males, if you’re younger versus older, if you have very severe disability or less severe disability, if you have diabetes, are you early after your stroke or later? That one to five versus six to 15 category. And we could not identify a group in whom the the drug worked particularly well. Now there’s a caveat when you do a clinical trial, it’s really hard to look at subgroups, especially if your trial is relatively small and the PESTO trial is relatively small. So you have to take this with a grain of salt, but it was nothing really promising. that we could identify. So probably you need other markers. If you believe in Etanercept as a drug, you would possibly need to look at what are the levels of TNF alpha, the drug, the molecule that actually is targeted. Unfortunately, there’s nothing like readily available to do that. Could it be that people with a… a stroke in a particular location that would work particularly more than in others, but we don’t have any real way at the moment to do that. Bill Gasiamis (28:08) Okay, so we’re assuming that the people who experience an improvement after they’ve had an attempt to shut that the markers of TNF alpha were lower or higher or Vincent Thijs (28:21) Well, the theory is that they have a lot higher TNF-alpha. Now, as you know, the premise is Etanercept works by reducing this molecule and we have good evidence that it reduces this molecule in the blood, but we don’t have good evidence that it reduces the levels in the brain. That’s where you want it to be. And one of the difficulties and many scientists that work on the Etanercept and ⁓ have said, look, it doesn’t cross the blood-brain barrier. It doesn’t. go against the natural defense that we have to protect the brain against substances that could potentially be harmful for the brain or that have a large size. And the Tandacep we know has a large size would not cross the blood-brain barrier. So it doesn’t reach the brain. And many people look at it with relative skepticism that it actually enters the brain. Bill Gasiamis (29:18) ⁓ And then with regards to rheumatoid arthritis, doesn’t need to cross the blood-brain barrier. It just somehow gets to this, position or the place where inflammation is occurring. TNF-alpha is active and it can easily mitigate the impact that TNF-alpha is causing. In the brain, the brain is protected by the blood-brain barrier and it cannot cross the blood-brain barrier under normal conditions and therefore it can’t get to where the TNF-alpha is. if there’s any TNF alpha, if inflammation is the issue and it cannot resolve it one way or another. So for some people perhaps it can’t resolve it. Now, I don’t understand about Etanercept a lot. I don’t understand exactly how the molecule works, et cetera. But if it was injected into a blood vessel, is that not something that can occur? And if it was, if it can occur, would that then cross the blood brain barrier? Vincent Thijs (30:15) That wouldn’t cause a blood brain barrier, no. You would have to do what we call a lumbar puncture or put a little ⁓ injection into the ventricles and then hope that it would enter the area that is stark where the TNF alpha is elevated. Those experiments have not been done. Bill Gasiamis (30:17) Either. Okay, so a lumbar puncture is probably riskier than… Vincent Thijs (30:44) Well, it’s uncomfortable. It’s uncomfortable and we do it to administer drugs if needed. Some people with brain cancer receive it. There are other trials ongoing in certain areas of stroke where it’s done. Bill Gasiamis (30:58) Then the difficulty is, and my job here is to report back to the community how they should proceed with Etanercept going forward. Now, I don’t expect you to answer that. However, your study probably gives enough information for people to be able to make an even more informed decision than they did before. Previously, what I think was happening is people, and it still happens every day. And I’ve interviewed a lot of stroke survivors who’ve had positive results with Etanercept. The challenge is getting interviews with stroke survivors who have had negative results with Etanercept. That is something I haven’t been able to do. So if somebody happens to be watching and listening to this and they have had the Etanercept shots and they didn’t get positive results, please reach out so that we can share a balanced story of what’s happening out there in the community. Would there be a reason for the community to perhaps begin again to lobby a government or a minister of a government to look at perisponinal tenosept and study it in a different way, like administration via a lumbar puncture. Conclusions and Final Thoughts Vincent Thijs (32:08) I think we need more, probably go back to the drawing table to see whether, because we’re just taking a step back. The idea is that there is inflammation after stroke and we know that there is inflammation after stroke. We don’t, we just don’t know how long it is. We don’t have a good marker. Is it present only for weeks or months after stroke or can it persist for years? The theory is that it persists for years, but if you look at the actual experiments that have been done, it’s really hard to study in humans because we don’t have good tests. But if you look in animals, it’s also hard to do long-term studies in animals, but nobody has really proven that conclusively that there is still after the stroke causes a scar, that process is still really active. Is TNF-alpha years after a stroke still present? Yes, it’s present because we use TNF as a transmitter in the brain or a chemical in the brain, but is it still worth reducing its activity? That’s probably, I think, a bigger question that science needs to answer is to understand that all inflammation piece and the time after stroke that it persists in my Bill Gasiamis (33:35) Yeah, because it could still be the fact that the person has had brain damage. The particular part of their brain that’s damaged has, for example, taken offline one of their limbs and there is no way to recover that once it’s gone. there is no, there may also be no inflammation ⁓ there. So somebody in that situation receiving Etanercept wouldn’t get a result even if it was able to cross the blood-brain barrier because the damage is done and that’s the challenge with the brain is once it’s damaged restoring the damaged part is not possible. Vincent Thijs (34:15) Yeah, look, after this experience with the PESTA trial, I think we need to work on other avenues and I’m not as hopeful with this based on the data that I have seen. Bill Gasiamis (34:28) Yeah Well, my final question then is, are you planning on exploring inflammation and recovery after stroke with any work that you’re doing in the future? Is there any more of this type of work being done? Vincent Thijs (34:46) we’ve just launched a new study, which is not a randomized trial, but it’s trying to get at this common symptom that people have after stroke, which is fatigue and cognitive changes. And one of my post-docs, Dr. Emily Ramech, she’s a physio by background. We just launched what we call the deep phenotyping study after stroke. And we are looking at young people that have had a stroke up to age 55 and we’re taking them into the scanner. We will do a PET scan that’s looking at inflammation. We’re taking their bloods and looking at markers of inflammation and see how that relates to fatigue after stroke. This is between the first month and the sixth month after stroke. That will give us a little bit of timeline of inflammation after stroke. It will give us some information about fatigue, which is very common, but I have no plans at the moment to look at ethanocephaly. Bill Gasiamis (35:53) Fair enough. I appreciate your time. Thank you so much. All right, well, that brings us back to the end of the episode with Professor Vincent Dease on the PESLO trial results. My hope is that this conversation gives you more clarity, especially if you’re felt caught between personal stories, strong opinions, and a lot of uncertainty. The goal here isn’t to tell you what to do. It’s to help you ask better questions and make decisions with your eyes open alongside a qualified healthcare professional who knows your situation. If this episode helped you, please do a couple of things. Subscribe on YouTube or follow the podcast on Spotify or Apple. Leave a review if you can. It really helps more stroke survivors find the show. And if you’ve had an experience you’re willing to share respectfully, positive, negative or mixed, add a comment. Those real-world perspectives help community feel less alone. And if you’d like to support the podcast and keep it going, my book is at recoveryafterstroke.com/book. And you can join the Patreon at patreon.com/recoveryafterstroke. Thanks for being here with me. And remember you’re not alone in this recovery journey. Importantly, we present many podcasts designed to give you an insight and understanding into the experiences of other individuals. Opinions and treatment protocols discussed during any podcast are the individual’s own experience, and we do not necessarily share the same opinion, nor do we recommend any treatment protocol discussed. All content on this website and any linked blog, podcast or video material controlled this website or content is created and produced for informational purposes only and is largely based on the personal experience of Bill Gassiamus. Content is intended to complement your medical treatment and support healing. It is not intended to be a substitute for professional medical advice and should not be relied on as health advice. The information is general and may not be suitable for your personal injuries, circumstances or health objectives. Do not use our content as a standalone resource to diagnose, treat, cure or prevent any disease for therapeutic purposes or as a substitute for the advice of a health professional. Never delay seeking advice or disregard the advice of a medical professional, your doctor or your rehabilitator. program based on our content. you have any questions or concerns about your health or medical condition, please seek guidance from a doctor or other medical professional. If you are experiencing a health emergency or think you might be, call 000 if in Australia or your local emergency number immediately for emergency assistance or go to the nearest hospital emergency department. Medical information changes constantly. While we aim to provide current quality information in our content, we do not provide any guarantees and assume no legal liability or responsibility for the accuracy, currency or completeness of the content. If you choose to rely on any information within our content, you do so solely at your own risk. We are careful with links we provide. However, third-party links from our website are followed at your own risk and we are not responsible for any information you find there. The post PESTO Trial Results (Etanercept After Stroke) | Interview with Professor Vincent Thijs appeared first on Recovery After Stroke.

Jack Carr's explosive new thriller Cry Havoc takes us deep into Vietnam's shadow wars—where a young Tom Reece faces ruthless spycraft, betrayal, and carnage that shapes the Terminal List universe. In this full spoiler breakdown, Tyler joins Chris and Mike to dissect every twist, character arc, and tactical masterstroke, revealing why this might be Carr's best espionage thriller entry yet.---

Podcast: Industrial Cybersecurity InsiderEpisode: Why OT Must Lead the Manufacturing Cybersecurity ConversationPub date: 2025-12-17Get Podcast Transcript →powered by Listen411 - fast audio-to-text and summarizationKatie O'Brien shares her unconventional journey from music teacher to industrial cybersecurity expert, bringing over 25 years of IT experience into the OT world. In this conversation with Dino, Katie discusses the critical gaps in OT cybersecurity—from the lack of university programs teaching industrial security to the disconnect between IT and OT teams. They explore why system integrators and OEMs fail to design cybersecurity into new manufacturing projects from the start, compare it to building cars without safety features, and discuss the emergence of managed services in the OT space. Katie explains how Garland Technology helps organizations get visibility into aging infrastructure with unmanaged switches, and both hosts emphasize the urgent need for the OT ecosystem to drive cybersecurity conversations proactively rather than waiting for IT teams who may never have walked the plant floor.Chapters:(00:00:00) - The Hard Truths About OT Security Nobody Wants to Hear(00:01:06) - Katie's Unconventional Journey: From Music Teacher to OT Cybersecurity Expert(00:04:00) - The Current State of OT Cybersecurity and Future Directions(00:06:00) - The Education Gap: Why Universities Aren't Teaching Industrial Cybersecurity(00:08:00) - The Disconnect Between IT/Security Teams and OT Operations(00:10:00) - Designing Cybersecurity Into New Manufacturing Projects From the Start(00:13:00) - IT Teams Who've Never Walked the Plant Floor(00:16:00) - The Emergence of Managed Services in the OT Space(00:18:00) - Garland Technology: Getting Visibility Into Aging Infrastructure(00:19:00) - Software Defined Automation and the Future of Industrial Control(00:22:00) - Why the OT Ecosystem Must Drive the Cybersecurity Conversation(00:24:00) - The Real Cost of Downtime and Cyber Incidents in ManufacturingLinks And Resources:Katie O'Brien on LinkedInWant to Sponsor an episode or be a Guest? Reach out here.Industrial Cybersecurity Insider on LinkedInCybersecurity & Digital Safety on LinkedInBW Design Group CybersecurityDino Busalachi on LinkedInCraig Duckworth on LinkedInThanks so much for joining us this week. Want to subscribe to Industrial Cybersecurity Insider? Have some feedback you'd like to share? Connect with us on Spotify, Apple Podcasts, and YouTube to leave us a review!The podcast and artwork embedded on this page are from Industrial Cybersecurity Insider, which is the property of its owner and not affiliated with or endorsed by Listen Notes, Inc.

Transforming T1D Care: Innovations, Early Detection, and Empowered Pediatric PracticeArticle: https://www.contemporarypediatrics.com/view/redefining-type-1-diabetes-early-identification-staging-and-clinical-implications-for-pediatric-careTherapy: https://www.contemporarypediatrics.com/view/novel-therapies-for-type-1-diabetesTable: https://thepediatriclounge.com/screening-to-prevent-dkaPetiete Trial: https://link.springer.com/article/10.1007/s00125-025-06586-1#Sec5Prevent Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa2308743Screening Summit : https://medschool.cuanschutz.edu/barbara-davis-center-for-diabetes/news-profdev/conferences-events/8th-childhood-diabetes-prevention-symposium---november-10th-11th--2025In this episode of The Pediatric Lounge, host Herb Bravo is joined by Dr. Andrew Cagel, a pediatric endocrinologist, and Dr. Dan Feiten, a pediatrician and Chief Medical Officer of Office Practicum, to discuss groundbreaking advancements in Type 1 Diabetes (T1D) care. The episode delves into their recent publication, 'Redefining Type 1 Diabetes: Early Identification, Staging, and Clinical Implications of Pediatric Care,' highlighting the critical importance of early detection and intervention. The guests emphasize the urgent need for universal screening.00:00 Introduction to the Pediatric Lounge00:45 Meet the Guests: Dr. Andrew Cagel and Dr. Dan Fen01:08 Redefining Type 1 Diabetes01:36 Personal Stories and Experiences01:52 The Importance of Early Detection04:40 Advancements in Type 1 Diabetes Treatment13:55 The Role of EHR and AI in Pediatric Care19:13 Future Directions and Guidelines29:06 Pivotal Study in Pediatric Diabetes30:45 The Protect Trial: Slowing Disease Progression33:19 Challenges in Screening and Implementation37:46 The Role of Pediatricians and Influencers43:03 Advocacy and Future Directions56:22 Conclusion and Final ThoughtsSupport the show

We've gathered the NaPS lab to answer all your fascinating questions on all things sleep! A perfect bitesize episode to get stuck into the marvellous world of sleep. 1. How does sleep deprivation affect mental health? - Answered by Martha WawrzutaBunney, B. G. , Bunney, W. E. (2013). Mechanisms of Rapid Antidepressant Effects of Sleep Deprivation Therapy: Clock Genes and Circadian Rhythms. Biological PsychiatryFang, H., Tu, S., Sheng, J., Shao, A. (2018). Depression in sleep disturbance: A review on a bidirectional relationship, mechanisms and treatment. Journal of Cellular and Molecular Medicine2. What is narcolepsy? - Answered by Kyrillos MeshrekyLeschziner G., Narcolepsy: a clinical review, Practical Neurology 2014;14:323-3313. Does the full moon affect sleep? - Answered by Al Saqib MajumderCasiraghi, L. et al. (2021). Moonstruck sleep: Synchronization of human sleep with the moon cycle under field conditions. Chaput, J. P. et al. (2016). Are Children Like Werewolves? Full Moon and Its Association with Sleep and Activity Behaviors in an International Sample of Children. Sleep Medicine4. How does a smart watch track sleep? - Answered by Yan Wang5. What is orthosomnia? - Answered by Sophie Smith Baron, K.G., et al. (2017) Orthosomnia: Are some patients taking the quantified self too far? J Clin Sleep Med6. What is sleep regression and how long does it last? - Answered by Mo AbdellahiWeinraub, M. et al. (2012). Patterns of developmental change in infants' nighttime sleep awakenings from 6 through 36 months of age. Developmental PsychologyBruni O. et al. (2014) Longitudinal study of sleep behavior in normal infants during the first year of life. J Clin Sleep Med7. Does Magnesium Citrate help you sleep? - Answered by Dulni PeramunugamageMagnesium for sleep, Sleep Foundation, 20258. Does dark chocolate help you sleep? - Answered by Martha Nguyen Abdoli, E. et al. (2024). A clinical trial of the effects of cocoa rich chocolate on depression and sleep quality in menopausal women. Scientific reports,Garbarino, S., Garbarino, E., & Lanteri, P. (2022). Circadian Rhythm, Mood, and Temporal Patterns of Eating Chocolate: A Scoping Review of Physiology, Findings, and Future Directions. NutrientsMusic by Sergio Prosvirini from PixabayCheck out our NaPS website to find out more about the podcast, our research and events. This recording is the property of the Sleep Science Podcast and not for resale.

What if a powerful climate solution in cities isn't a new building, but the roof that's already there? As heat waves intensify across Europe, architect and MIT-trained educator Olivier Faber explains how his firm, Roofscapes is transforming overlooked rooftops into cooling, accessible, green infrastructure. Starting with Paris's iconic zinc roofs, the conversation unpacks why existing buildings are misaligned with today's climate, how shading and vegetation can dramatically reduce indoor temperatures without air conditioning, and why renovation and adaptation may matter more than new construction in the decades ahead. Along the way, Olivier reveals the political, technical, and cultural battles behind testing climate solutions in historic cities, and why climate adaptation is about changing how we value the buildings we already have.Thumbnail Image courtesy of RoofscapesSubscribe to Most Podern on:Spotify - https://open.spotify.com/show/3zYvX2lRZOpHcZW41WGVrpApple Podcasts - https://podcasts.apple.com/us/podcast/most-podern-podcast/id1725756164Youtube - https://www.youtube.com/@MostPodernInstagram - https://www.instagram.com/most.podernLinkedIn - https://www.linkedin.com/company/most-podernKeywordsarchitecture, climate change, renovation, urban design, sustainability, Roofscapes, green roofs, preservation, adaptation, building practices, Paris, urban design, heat island effectChapters00:00 Background and Journey into Architecture00:51 Exploring Alternative Architecture Practices03:52 Introducing Roofscapes and Its Mission06:17 Physical Adaptation: Before and After07:16 The Challenges of Zinc Roofs in Urban Design10:29 Innovative Solutions for Urban Heat Management11:34Pitching Green Roof Solutions to Building Owners14:08 Navigating the Complexities of Building Regulations17:14 Measuring the Impact of Climate Adaptation Projects24:09 Future Directions for Climate Adaptation in ArchitectureLinksOlivier Faber - https://www.linkedin.com/in/olivier-faberRoofscapes - https://www.roofscapes.studio/MITx - https://mitxonline.mit.edu/

This week on Inspire Change in this final episode of season seven, Gunter Swoboda reflects on a recent tragedy and its impact on community dynamics. He discusses the importance of inner work (the micro) for personal growth and emotional development, contrasting it with the broader societal issues (the macro) that stem from a lack of emotional maturity. Gunter recaps the themes of the season, emphasizing the need for men to reject harmful societal norms and embrace vulnerability. He introduces upcoming projects for season eight, including a focus on practical skills and the launch of a Patreon to support ongoing work. The episode concludes with a call to action for listeners to take meaningful steps towards personal transformation. TakeawaysThe micro is where the real action begins.Most men are trying to survive and feel competent.Intimacy can feel like work due to societal pressures.Emotional development is crucial for societal health.Men often trade vulnerability for dominance.Season seven challenged simplistic narratives about masculinity.The upcoming season will focus on practical skills.Patreon will provide tools for ongoing personal work.Intimacy must be examined beyond patriarchal norms.Personal transformation requires actionable steps.Sound Bites"Most men are not trying to be cruel.""You can't out think this, you outgrow it.""Who you become when you stop living a script."Reflections on Tragedy and Community DivisivenessThe Micro: Inner Work and Personal GrowthThe Macro: Societal Issues and Emotional DevelopmenSeason Seven Recap and Future DirectionsIntroducing Season Eight and PatreonClosing Thoughts Call to ActionGet your copy of Gunter Swoboda and Lorin Josephson's new book: Making Good Men Great Surfing the New Wave Of Masculinity Special Edition: https://shop.ingramspark.com/b/084?params=Ow2HhlFDbFjPEmN7n81q2RuJl5czASIU1xJXmSGqXzpJoin our Patreon to continue the conversation—through deeper insight, growth, and exclusive content:  www.Patreon.com/InspireChangeTakeawaysThe micro is where the real action begins.Most men are trying to survive and feel competent.Intimacy can feel like work due to societal pressures.Emotional development is crucial for societal health.Men often trade vulnerability for dominance.Season seven challenged simplistic narratives about masculinity.The upcoming season will focus on practical skills.Patreon will provide tools for ongoing personal work.Intimacy must be examined beyond patriarchal norms.Personal transformation requires actionable steps.Sound Bites"Most men are not trying to be cruel.""You can't out think this, you outgrow it.""Who you become when you stop living a script."Chapters 00:00 Reflections on Tragedy and Community Divisiveness 03:05 The Micro: Inner Work and Personal Growth 06:00 The Macro: Societal Issues and Emotional Development 08:48 Season Seven Recap and Future Directions 11:54 Introducing Season Eight and Patreon 15:03 Closing Thoughts and Call to ActionMid-Episode Break is brought to you by Distil Union.“You know, on this show we talk a lot about living with purpose — slowing down, paying attention, and being intentional about the choices we make every day. Because when we simplify the noise around us, we can better hear what really matters: empathy, connection, and showing up as the best version of ourselves. That's why I'm genuinely pleased to welcome our newest sponsor, Distil Union. Their philosophy aligns beautifully with what we do here.”  “Distil Union creates sleek, thoughtfully designed essentials — wallets, key organizers, phone cases — all built with a ‘less is more' approach. Their Wally wallets, Ferris key organizers… these are everyday tools that make life easier, cleaner, and calmer. And in that simplicity, there's space for clarity. There's space for change.” “As a thank-you to our Inspire Change community, they're offering 20% off any product with the promo code INSPIRECHANGE. Have a look, try them out, and see how simplifying your day can open the door to something deeper.” Visit distilunion.com and enjoy 20% off any product with promo code INSPIRECHANGE. That's distilunion.com with promo code INSPIRECHANGE at check out.”GRATITUDE MENTIONS & CLOSING -Hello and welcome, We thank YOU for tuning in and promoting positive social change.  This makes you a part of Gunter's efforts in transforming not only men's lives but lives in general and we are grateful you have joined us. This week on the Global Listeners List we see a new placement for #1.  We would like to share our gratitude with our listeners in Australia you made it to #1 with the strongest downloads from New South Wales, but look out! The Northern Territory is catching up as our listeners in Alice Springs have brought the outback to a strong player of positive social change.CONGRATULATIONS!!!We also wanted to give a special shout out to our listeners in Philadelphia and York for bringing Pennsylvania to the #6 on the USA listeners list!  Thank you so much for your continued support. We appreciate your efforts to support positive social change!  I, DeVonna Prinzi the Co-Exec Producer and our Show-runner Miranda Spigener-Sapon and everyone here at Inspire Change with Gunter wish you the most complete and joyous holiday season and we sincerely thank you as your efforts have made this year the absolute best!  We look forward to great things for Inspire Change and appreciate that you take the time to like, follow, subscribe, and share.  Please remember If you want to share your story of social change, feel free to reach out  to the show directly. Please see the show-notes for our contact information.  As always thank you to each  and every one of our listeners, and most importantly please keep Inspiring positive social change.Become a supporter of this podcast: https://www.spreaker.com/podcast/inspire-change-with-gunter--3633478/support.Gunter Swoboda and Lorin Josephson's neo-noir/supernatural thriller novel Amulets of Power, Book I A Brian Poole Mystery is officially ON SALE EVERYWHERE you like to get book, but if you want a discount please consider ording direct. ANY LISTENER who order's direct will get a surprise gift. https://shop.ingramspark.com/b/084?params=3RoOA6kVQ7ZgmqSK9LdnvNyDAZZFsg9IMaLUaprPgXKMake sure you LIKE SUBSCRIBE & FOLLOW our new Official YouTube Channel of Video Shorts series: https://www.youtube.com/@InspireChangewithGunterSwoboda/videos where we will be adding new videos and content every week from Gunter and our guests.  https://www.youtube.com/@InspireChangewithGunterSwoboda/videos

Summary This conversation features a group of five men discussing their experiences with male sexual abuse and the project 'Inside the Boys Club'. They emphasize the importance of raising awareness, creating a supportive community, and the need for justice and accountability. Personal stories highlight the long-lasting impact of abuse and the challenges of speaking out. The group aims to empower male survivors and foster collaboration for change, while also addressing the inadequacies of the judicial system and the importance of therapy in the healing process. Keywords male sexual abuse, awareness, support, mental health, collaboration, healing, justice, Inside the Boys Club, personal stories, community Takeaways The project aims to raise awareness about male sexual abuse. Boys comprise a significant number of sexual abuse victims. It takes men a long time to disclose their experiences. The importance of creating a supportive community for survivors. Collaboration among survivors can lead to greater impact. The judicial system often fails to support victims adequately. Therapy and professional help are crucial for healing. Speaking up can be a vital part of the healing process. There is a need for more awareness and support for male survivors. The project aims to create a platform for male voices.   Sound bites "We need to break the silence." "This is a global epidemic." "We're not alone anymore." Chapters 00:00 Introduction to Inside the Boys Club 02:45 The Importance of Addressing Male Sexual Abuse 05:30 Personal Stories and Experiences of Abuse 10:58 The Need for Awareness and Support 13:40 The Role of Society and Institutions 16:34 The Impact of Power Dynamics on Abuse 22:15 The Broader Context of Abuse Across Demographics 27:49 The Challenges of Disclosure and Support 33:10 Advice for Survivors Seeking Help 37:23 The Ripple Effect of Speaking Up 39:27 Judicial System Challenges and Victim Support 43:37 Reclaiming Voice and Agency 45:43 The Struggle for a Voice in Inquiries 48:28 The Importance of Speaking Up 50:46 Post-Traumatic Growth and Resilience 56:23 Future Directions and Collective Action

Dan, Andy Woodward, Rafael Viola, Joe Sabien, Tobi Tarquin Summary This conversation features a group of five men discussing their experiences with male sexual abuse and the project 'Inside the Boys Club'. They emphasize the importance of raising awareness, creating a supportive community, and the need for justice and accountability. Personal stories highlight the long-lasting impact of abuse and the challenges of speaking out. The group aims to empower male survivors and foster collaboration for change, while also addressing the inadequacies of the judicial system and the importance of therapy in the healing process. Keywords male sexual abuse, awareness, support, mental health, collaboration, healing, justice, Inside the Boys Club, personal stories, community Takeaways The project aims to raise awareness about male sexual abuse. Boys comprise a significant number of sexual abuse victims. It takes men a long time to disclose their experiences. The importance of creating a supportive community for survivors. Collaboration among survivors can lead to greater impact. The judicial system often fails to support victims adequately. Therapy and professional help are crucial for healing. Speaking up can be a vital part of the healing process. There is a need for more awareness and support for male survivors. The project aims to create a platform for male voices.   Sound bites "We need to break the silence." "This is a global epidemic." "We're not alone anymore." Chapters 00:00 Introduction to Inside the Boys Club 02:45 The Importance of Addressing Male Sexual Abuse 05:30 Personal Stories and Experiences of Abuse 10:58 The Need for Awareness and Support 13:40 The Role of Society and Institutions 16:34 The Impact of Power Dynamics on Abuse 22:15 The Broader Context of Abuse Across Demographics 27:49 The Challenges of Disclosure and Support 33:10 Advice for Survivors Seeking Help 37:23 The Ripple Effect of Speaking Up 39:27 Judicial System Challenges and Victim Support 43:37 Reclaiming Voice and Agency 45:43 The Struggle for a Voice in Inquiries 48:28 The Importance of Speaking Up 50:46 Post-Traumatic Growth and Resilience 56:23 Future Directions and Collective Action

In this episode, the CardioNerds (Dr. Natalie Tapaskar, Dr. Jenna Skowronski, and Dr. Shazli Khan) discuss the process of heart transplantation from the initial donor selection to the time a patient is discharged with Dr. Dave Kaczorowski and Dr. Jason Katz. We dissect a case where we understand criteria for donor selection, the differences between DBD and DCD organ donors, the choice of vasoactive agents in the post-operative period, complications such as cardiac tamponade, and the choice of immunosuppression in the immediate post-operative period. Most importantly, we highlight the importance of multi-disciplinary teams in the care of transplant patients. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls When thinking about donor selection, you need to consider how much physiologic stress your recipient can tolerate, and this may guide your selection of “higher risk” or “lower risk” donors.   The use of DCD donors has increased the potential donor pool and shortened waitlist times with very similar perioperative outcomes to DBD transplantation.  Post-operative critical care management rests on a fundamental principle to apply as much inotropic/vasoactive therapy as needed to achieve some reasonable physiologic hemostasis, and then getting “the heck out of the way!” There are no standard regimens as practices vary across centers, but rest on providing adequate RV support, maintaining AV synchrony, and early resuscitation.   The RV is fickle and doesn't take a joke too well. RV dysfunction post-transplant is important to watch for, and it can be transient or require aggressive support. Don't miss assessing for cardiac tamponade which can require surgical evacuation- “where there's space, that space can be filled with fluid.”   Induction immunosuppression post-transplant varies across centers, but some considerations for use may include (1) high sensitization of the patient, (2) high risk immunologic donor-recipient matching, and (3) recipient renal dysfunction to provide a calcineurin inhibitor (CNI) sparing regimen long term.  Management of heart transplant patients is a multi-disciplinary effort that requires coordination amongst heart failure/transplant cardiologists, cardiac surgeons, anesthesiologists, pathology/immunologists and a slew of ancillary services. Without a dynamic and collaborative team, successful cardiac transplantation could not be possible.  Notes Notes: Notes drafted by Dr. Natalie Tapaskar  What are the basic components of donor heart selection? In practicality, it can be a very inexact science, but we use some basic selection criteria such as: (1) size matching (2) ischemic time (3) donor graft function (4) immunologic compatibility (5) age of the potential donor and recipient (6) severity of illness of the recipient (7) regional variation in donor availability When thinking about accepting older donors (>50 years old), we ideally would screen for donor coronary disease and try to keep ischemic times as short as possible. We may accept an older donor for a recipient who is highly sensitized, which leaves a smaller potential donor pool. There is no clear consensus on size matching, but the predicted heart mass is most used. We are generally more comfortable oversizing than under-sizing donor hearts. Serial echocardiography is important in potential donors as initially reduced ejection fractions can improve on repeat testing, and these organs should not be disregarded automatically. For recipients who are more surgically complex, (i.e. multiple prior sternotomies or complex anatomy), it's probably preferable to avoid older donors with some graft dysfunction and favor donors with shorter ischemic times. What is the difference between DBD and DCD? DBD is donation after brain death- these donors meet criteria for brain death. Uniform Determination of Death Act 1980: the death of an individual is The irreversible cessation of circulatory and respiratory functions or The irreversible cessation of all functions of the entire brain, including those of the brain stem DCD is donation after circulatory death- donation of the heart after confirming that circulatory function has irreversibly ceased. Only donors in category 3 of the Maastricht Classification of DCD donors are considered for DCD donations: anticipated circulatory arrest (planned withdrawal of life-support treatment). DCD hearts can be procured via direct procurement or normothermic regional perfusion (NRP). The basic difference is the way the hearts are assessed, either on an external circuit or in the donor body. For the most complex recipient, DCD may not be utilized at some centers due to concern for higher rates of delayed graft function, but this is center specific and data is still evolving. What are some features surgeons consider when procuring the donor heart? Visual assessment of the donor heart is key in DBD or NRP cases. LV function may be hard to assess, but visually the RV can be inspected. Palpation of the coronary arteries is important to assess any calcifications or abnormalities. Ventricular arrhythmias at the time of procurement may be concerning. Key considerations in the procurement process: (1) Ensuring the heart remains decompressed at all times and doesn't become distended (2) adequate cardioplegia delivery (3) aorta is cross-clamped properly all the way across the vessel (4) avoiding injury to adjacent structures during procurement What hemodynamic parameters should we monitor and what vasoactive agents are used peri-heart transplant? There is no consensus regarding vasoactive agent use post-transplant and practice varies across institutions. Some commonly seen regimens may include: (1) AAI pacing around 110 bpm to support RV function and preserve AV synchrony (2) inotropic agents such as epinephrine and dobutamine to support RV function (3) pulmonary vasodilators such as inhaled nitric oxide to optimize RV afterload Early post-transplant patients tend to have low cardiac filling pressures and require preload monitoring and resuscitation initially. Slow weaning of inotropes as the patient shows signs of stable graft function and hemodynamics. RV dysfunction may manifest as elevated central venous pressure with low cardiac index or hypotension with reducing urine output. Optimize inotropic support, volume status, metabolic status (acidosis and hypoxia), afterload (pulmonary hypertension), and assess for cardiac tamponade. Tamponade requires urgent take-back to the operating room to evacuate material. Refractory RV failure requires mechanical circulatory support, with early consideration of VA-ECMO. Isolated RV MCS may be used in the right clinical context. Why do pericardial effusions/cardiac tamponade happen after transplant? They are not uncommon after transplant and can be due to: Inherent size differences between the donor and recipient (i.e. if the donor heart is much smaller than the recipient's original heart) Bleeding from suture lines and anastomoses, pacing wires, and cannulation sites Depending on the hemodynamic stability of the patient and the location of the effusion, these effusions may require urgent return to the OR for drainage/clot evacuation via reopening the sternotomy, mini thoracotomy, and possible pericardial windows. What are the basics of immunosuppression post-transplant? Induction immunosuppression is variably used and is center-specific. Considerations for using induction therapy may include: (1) high sensitization of the patient (2) younger patients or multiparous women with theoretically more robust immune systems (3) crossing of recipient antibodies with donor antigens (3) renal function to provide a CNI sparing regimen long term Some considerations for avoiding induction may include: (1) older age of the recipient (2) underlying comorbid conditions such as infections or frailty of the recipient What are expected activity restrictions post-transplant? Sternal precautions are important to maintain sternal wire integrity. Generally avoiding lifting >10 pounds in the first 4-12 weeks, no driving usually in the first 4 weeks, monitoring for signs and symptoms of wound infections, and optimizing nutrition and physical activity. Cardiac rehabilitation is incredibly important as soon as feasible. References Kharawala A , Nagraj S , Seo J , et al. Donation after circulatory death heart transplant: current state and future directions. Circ: Heart Failure. 2024;17(7). doi: 10.1161/circheartfailure.124.011678  Copeland H, Knezevic I, Baran DA, et al. Donor heart selection: Evidence-based guidelines for providers. The Journal of Heart and Lung Transplantation. 2023;42(1):7-29. doi:10.1016/j.healun.2022.08.030  Moayedifar R, Shudo Y, Kawabori M, et al. Recipient Outcomes With Extended Criteria Donors Using Advanced Heart Preservation: An Analysis of the GUARDIAN-Heart Registry. J Heart Lung Transplant. 2024;43(4):673-680. doi:10.1016/j.healun.2023.12.013  Kharawala A, Nagraj S, Seo J, et al. Donation After Circulatory Death Heart Transplant: Current State and Future Directions. Circ Heart Fail. 2024;17(7):e011678. doi:10.1161/CIRCHEARTFAILURE.124.011678  Copeland H, Hayanga JWA, Neyrinck A, et al. Donor heart and lung procurement: A consensus statement. J Heart Lung Transplant. 2020;39(6):501-517.

How is genicular artery embolization reshaping our clinical approach to patients with chronic knee pain? Dr. Rachel Piechowiak and Dr. Faraz Khan, interventional radiologists at IR Centers join Dr. Don Garbett in a deep dive into the current state of Genicular Artery Embolization (GAE). --- This podcast is supported by an educational grant from Varian. --- SYNPOSIS Dr. Piechowiak and Dr. Khan provide a deep dive on the technical nuances of GAE, covering patient selection, access strategies, and key procedural techniques. The conversation also details complex case scenarios and how to tailor catheters and embolics to navigate challenging anatomy. The doctors then share their structured approach to post-procedure follow-up, underscoring the importance of setting realistic treatment expectations with patients. The episode closes with their perspective on the future of genicular artery embolization, emphasizing the need for robust long-term outcomes data to better define the role of GAE in chronic knee pain management. --- TIMESTAMPS 00:00 - Introduction05:54 - Patient Workup for GAE10:42 - Setting Patient Expectations for GAE16:24 - Procedure Approaches and Techniques30:41 - Understanding Artery Targeting Strategies34:56 - Approaches to Microcatheter Selection38:18 - Choosing the Right Embolic Agents47:43 - Managing Complications and Follow-Ups51:23 - Challenges with Post-TKA Patients54:16 - Future Directions

Learn more about Novo: https://novo.org/Learn more about the community of people hearing God: https://receiveacademy.com/Chapters:00:00 Introduction02:28 Discovering Spiritual Authority02:57 Launching Training Programs05:39 Biblical Foundations of Hearing God12:17 Daily Practices and Rhythms14:22 Incorporating Listening in Meetings17:57 Future Directions and Mentorship31:21 Final Reflections and Encouragement

In this episode of NeedleXChange I interview Chloe Savage.Chloe is a conservation embroiderer, couture specialist, and educator whose studio practice spans everything from National Trust restorations to hands-on needlepoint kits.In this second half of our conversation, we trace Chloe's creative upbringing through diamond mines, Paris couture, and the Royal School of Needlework.She unpacks how life detours—from teen motherhood to science teaching—ultimately fueled her practice and how art became a lifeline through grief. Please note this episode briefly touches on emotional abuse.Another artist who processed personal trauma through artistic practice is the wonderful machine embroiderer Julie Heaton. We had a NeedleXChange way back in episodes 25 & 26.Timestamps:00:00:00 - Introduction00:01:30 - Conservation Stories and Experiences00:06:52 - Art as a Reflection of Personal Struggles00:15:33 - The Journey of Healing and Empowerment00:18:50 - Future Directions in Textile Art00:22:59 - Embracing Creative Freedom00:24:03 - The Role of Education in Artistic Expression00:27:04 - The Influence of Family on Creativity00:28:17 - Exploring Personal Interests and Hobbies00:29:27 - The Impact of Art Installations00:30:27 - Chloe's Favourites00:40:57 - Overcoming Challenges and Unique FactsLinks:Website: chloesavageembroidery.comInstagram: chloesavageembroideryIntro music is Getting Good at Letting Go (Instrumental Version) by Vicki Vox via Epidemic Sound.About NeedleXChange:NeedleXChange is a conversation podcast with embroidery and textile artists, exploring their process and practice.Hosted by Jamie "Mr X Stitch" Chalmers, it is an in-depth showcase of the best needlework artists on the planet.Visit the NeedleXChange website: needl.exchangeSign up for the NeedleXChange Newsletter here: bit.ly/NeedleXChangeNewsIf you want embroidery inspiration and regular doses of textile art, visit the Mr X Stitch site here: mrxstitch.comAnd follow Mr X Stitch on all the usual social media channels!Facebook: mrxstitchInstagram: mrxstitchPinterest: mrxstitchYouTube: mrxstitchLinkedIn: mrjamiechalmers

Reshma Ramachandran is an assistant professor of medicine at the Yale School of Medicine. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. J.D. Wallach, J.S. Ross, and R. Ramachandran. Enhancing FDA Drug-Safety Surveillance — Beyond Releasing Daily Adverse-Event Data. N Engl J Med 2025;393:2284-2286.

In this episode of the Additive Snack Podcast, host Fabian Alefeld delves into the technically demanding world of gas turbines with Dr. Ilya Fedorov, an R&D project manager at Siemens Energy. The discussion covers the transformative impact of additive manufacturing on turbo machinery, touching on innovations in combustion systems, turbine blades, and repair processes. Dr. Fedorov explains how Siemens Energy harnesses additive manufacturing to improve performance, strengthen supply chains, and embrace green fuels like hydrogen. The episode also explores the rigorous qualification processes for additive components, the development of new materials, and the potential future advancements in the sector.Long-Term Lifetime Validation of Hot Turbine Guide Vanes Manufactured by Laser Powder Bed Fusion | J. Eng. Gas Turbines Power | ASME Digital Collection00:00 Introduction to Additive Manufacturing in Gas Turbines01:47 Ilya Fedorov's Journey into Additive Manufacturing05:00 The Light Bulb Moment: Realizing Additive's Potential09:49 Siemens Energy's Additive Manufacturing Strategy15:03 Challenges and Innovations in Gas Turbine Environments19:25 Additive Manufacturing Applications in Gas Turbines25:11 Repair and Longevity of Gas Turbine Components36:52 Qualification and Testing of Additive Components44:57 Materials and Process Development in Additive Manufacturing49:39 Future Directions and Challenges in Additive Manufacturing59:05 Conclusion and Final Thoughts

One of our guests on Episode 3 of Midrats was Bryan McGrath, CDR, USN (Ret.). Over the years he's returned often, and has even graced us with the pleasure of a few guest posts here.As he's let people know for years, he was going to retire for good at 60. True to his word, he hung it up a few weeks ago.Earlier this year before he got too focused on his figs and vines, I asked Bryan to come on for a broad-ranging conversation.What a great hour.A retired Naval Officer, Bryan spent 21 years on active duty including a tour in command of USS BULKELEY (DDG 84), a guided-missile destroyer homeported in Norfolk, Virginia. In command, he received the “Admiral Elmo Zumwalt Award for Inspirational Leadership” from the Surface Navy Association and his ship earned the USS ARIZONA Memorial Trophy signifying its selection as the Fleet's most combat-ready warship. His final duties ashore included serving as Team Lead and Primary Author of the US Navy's 2007 Maritime Strategy “A Cooperative Strategy for 21st Century Seapower”.Bryan was formerly the Deputy Director of the Hudson Institute Center for American Seapower. In this capacity, he helped develop the Surface Navy's “Distributed Lethality” concept and the Center for Strategic and Budgetary Assessments' 2017 Navy Alternate Fleet Architecture Study.Bryan earned a BA in History from the University of Virginia in 1987, and an MA in Political Science (Congressional Studies) from The Catholic University of America. He is a graduate of the Naval War College.He retired again in November 2025 after 13 years in defense consulting.Show LinksThe End of the Road, Bryan McGrathIn Praise of the Military-Industrial Complex, Bryan McGrathSummaryIn this episode of Midrats, hosts Sal and Mark welcome back Bryan McGrath to discuss his reflections on retirement, the changes in the naval environment over the years, and the importance of relationships in naval policy. They delve into the challenges facing shipbuilding and naval strategy, the need for diverse naval capabilities, and the influence of Congress on naval development. The conversation also touches on personnel and leadership in the Navy, learning from past naval conflicts, and the impact of historical events on naval leadership. Bryan shares insights on future directions for naval operations, praises recent naval performance, and emphasizes the role of technology in naval warfare. The episode concludes with a discussion on collaboration between industry and military and Bryan's final thoughts on future advocacy in the naval sphere.Chapters00:00: Introduction and Guest Background04:46: Reflections on Retirement and Career Path07:35: Changes in Naval Environment Over the Years11:17: The Importance of Relationships in Naval Policy14:47: Challenges in Shipbuilding and Naval Strategy18:03: The Need for Diverse Naval Capabilities21:25: Congressional Influence on Naval Development24:40: Personnel and Leadership in the Navy28:14: Learning from Past Naval Conflicts32:45: The Impact of Historical Events on Naval Leadership36:08: Future Directions for Naval Operations39:00: Praise for Naval Performance in Recent Operations43:23: The Role of Technology in Naval Warfare46:57: Collaboration Between Industry and Military50:48: Final Thoughts and Future Advocacy

 If you want to help, you can donate to help support Hospice Explained at the Buy me a Coffee link   https://www.buymeacoffee.com/Hospice 165 A Rhythm to Remember: Enhancing End-of-Life Care In this episode of Hospice Explained, host Marie Betcher RN interviews Daniel DeLoma, a hospice chaplain and founder of Meditative Heartbeat Therapy. They discuss how this integrative approach helps patients achieve calm and comfort during end-of-life care. Daniel provides insights into the methods used in heartbeat therapy, its origins, and how it complements traditional care practices. The episode delves into the emotional and spiritual aspects of dying, illustrating the unique benefits of this therapeutic approach. They also touch on the importance of incorporating various forms of support for the patient, including the role of family and healthcare providers. 00:00 Introduction and Disclaimer 00:29 Meet Your Host: Marie Betcher RN 00:47 Introducing Daniel DeLoma and Meditative Heartbeat Therapy 03:12 The Origins of Meditative Heartbeat Therapy 05:20 Implementing Meditative Heartbeat Therapy in Hospice Care 06:09 The Role of Spiritual Care and Chaplaincy 10:00 Practical Applications and Future Directions 23:23 Funny Anecdotes and Personal Stories 25:37 Challenges and Improvements in Hospice Care 28:22 Conclusion and Final Thoughts  https://www.heartbeattherapy.com/    Hospice Explained Affiliates & Contact Information Buying from these Affilite links will help support this Podcast.  Maire introduces a partnership with Suzanne Mayer RN inventor of the  cloud9caresystem.com,  When patients remain in the same position for extended periods, they are at high risk of developing pressure injuries, commonly known as bedsores. One of the biggest challenges caregivers face is the tendency for pillows and repositioning inserts to easily dislodge during care.(Suzanne is a former guest on Episode #119) When you order with Cloud 9 care system, please tell them you heard about them from Hospice Explained.(Thank You)  If you would, you can donate to help support Hospice Explained at the Buy me a Coffee link  https://www.buymeacoffee.com/Hospice Marie's Contact Marie@HospiceExplained.com www.HospiceExplained.com   Finding a Hospice Agency 1. You can use Medicare.gov to help find a hospice agency, 2. choose Find provider 3. Choose Hospice 4. then add your zip code This should be a list of Hospice Agencies local to you or your loved one.

The Darwin-Wallace framework stands tall, but there are places where the seams show, where life presses back with its own kind of intention. Scott Turner guides us through those overlooked corners, tracing the ideas that slipped between theory and experience. We find organisms not as passive machines, but as players in a deeper, older rhythm. And in that recognition, the story of evolution widens into something more awake, more alive.PATREON https://www.patreon.com/c/demystifysciPARADIGM DRIFThttps://demystifysci.com/paradigm-drift-showHOMEBREW MUSIC - Check out our new album!Hard Copies (Vinyl): FREE SHIPPING https://demystifysci-shop.fourthwall.com/products/vinyl-lp-secretary-of-nature-everything-is-so-good-hereStreaming:https://secretaryofnature.bandcamp.com/album/everything-is-so-good-here00:00 Go! 00:09:00 Evolution's Philosophical Foundations 00:12:00 Linnaeus and Early Taxonomy 00:18:00 Idealism vs. Darwinian Thought 00:23:27 Ideological Divide in Evolutionary Theory 00:25:03 Early Evolutionary Inquiry and Natural Theology 00:29:00 Darwin's Voyage and Observations 00:33:57 Intelligence, Purpose, and Evolution 00:37:30 Geological and Evolutionary Gradualism vs. Catastrophism 00:41:40 Darwin & Wallace: Collaboration and Legacy 00:46:34 Mutationism vs. Natural Selection 00:49:44 Reconciling Mutationism and Darwinism 00:53:00 The Eclipse of Darwinism and Rediscovery of Mendel 00:56:14 Evolution, Loss of Purpose and Agency 01:00:30 Darwin's Pangenesis Theory 01:09:06 Biology, Culture, and Evolution 01:11:07 Evolutionary Theories and Future Directions #history, #consciousness, #evolution, #criticalthinking,#physicspodcast, #philosophypodcast MERCH: Rock some DemystifySci gear : https://demystifysci-shop.fourthwall.com/AMAZON: Do your shopping through this link: https://amzn.to/3YyoT98DONATE: https://bit.ly/3wkPqaDSUBSTACK: https://substack.com/@UCqV4_7i9h1_V7hY48eZZSLw@demystifysci RSS: https://anchor.fm/s/2be66934/podcast/rssMAILING LIST: https://bit.ly/3v3kz2S SOCIAL: - Discord: https://discord.gg/MJzKT8CQub- Facebook: https://www.facebook.com/groups/DemystifySci- Instagram: https://www.instagram.com/DemystifySci/- Twitter: https://twitter.com/DemystifySciMUSIC: -Shilo Delay: https://g.co/kgs/oty671

In this episode of Longevity by Design, host Dr. Gil Blander sits down with Dr. Emeran Mayer, Executive Director at the UCLA Center for Neurobiology of Stress and Resilience and founder of Mayer Interconnected. They explore the science behind the gut-brain connection and its role in shaping health and longevity.Emeran explains how signals flow between the brain, gut, and microbiome, influencing everything from digestion to emotions. He breaks down how modern diets, especially ultra-processed foods, disrupt the natural balance between humans and gut microbes—a relationship refined over thousands of years. The conversation highlights why early life exposure to antibiotics can have lasting effects on microbiome resilience, and how lifestyle choices like diet and exercise remain powerful tools for supporting gut-brain health at any age.The discussion closes with a look toward the future of gut-brain science, including engineered probiotics and the promise of more targeted therapies. Emeran shares practical habits for better gut-brain health and cautions against quick-fix “biohacking,” encouraging a return to whole foods, movement, and mindful living.Guest-at-a-Glance

In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Dr William Parker from Sheffield in the UK. They discuss how PCI has changed over the last 40 years, covering balloons, stents, drugs and the future. If you enjoy the show, please leave us a positive review wherever you get your podcasts. It helps us to reach more people - thanks! Link to published paper: https://heart.bmj.com/content/111/16/753

In this uplifting episode, hosts Beth Glassman and Cathy Gildenhorn sit down with Leanna Scaglione, a powerhouse rare disease advocate and marathon runner living with NF2-Related Schwannomatosis (NF2-SWN), formerly known as neurofibromatosis type 2. Diagnosed at just 16 years old, Leanna's life changed dramatically when tumors were discovered in her nervous system, a hallmark of NF2-SWN. Many would have slowed down. Instead, Leanna sped up. Today, she has: Completed multiple marathons, including Berlin and New York City Participated in clinical trials Become an advocate and 2025 Ambassador for the Children's Tumor Foundation Set her sights on becoming the first person with NF2 to complete all 7 Abbott World Marathon Majors Her message is powerful: a diagnosis doesn't define the finish line. In This Episode, We Discuss: What NF2-SWN is and how it impacts the nervous system The emotional toll of receiving a life-altering diagnosis as a teenager Losing a dream — and finding a new one Running marathons through surgeries, treatments, and uncertainty How advocacy and visibility can change the rare disease landscape Building a life rooted in resilience, purpose, and possibility About Our Guest: Leanna Scaglione is 34 years old living with NF2-Related Schwannomatosis (NF2-SWN). Ever since being diagnosed at 16 years old, she has refused to live defined by her diagnosis. From relearning to walk, participating in immunotherapy drug trials, and going through numerous surgeries she has defied the odds against her. Most recently she has undergone surgery to remove her right acoustic neuroma. She continues to live her best life as an endurance runner, sharing her story and experiences living with NF2 in hopes to spread awareness, motivate her community and rally for a cure. Resources:  Children's Tumor Foundation NF2 Accelerator: A Strategic Portfolio Approach to End NF2 Articles Explaining NF2 MedlinePlus GeneReviews National Organization for Rare Disorders (NORD) Research from China that Leanna reference for a gene therapy for NF2 Yuan R, Wang B, Wang Y, Liu P. Gene Therapy for Neurofibromatosis Type 2-Related Schwannomatosis: Recent Progress, Challenges, and Future Directions. Oncol Ther. 2024 Jun;12(2):257-276. doi: 10.1007/s40487-024-00279-2. Epub 2024 May 17. PMID: 38760612; PMCID: PMC11187037. Additional Research Articles Alexandra K. O'Donohue, Samantha L. Ginn, Gaetan Burgio, Yemima Berman, Gabriel Dabscheck, Aaron Schindeler, The evolving landscape of NF gene therapy: Hurdles and opportunities, Molecular Therapy Nucleic Acids, Volume 36, Issue 1, 2025, 102475 ,ISSN 2162-2531, https://doi.org/10.1016/j.omtn.2025.102475. Connect With Us:   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. 

Proudly sponsored by PyMC Labs, the Bayesian Consultancy. Book a call, or get in touch!Intro to Bayes Course (first 2 lessons free)Advanced Regression Course (first 2 lessons free)Our theme music is « Good Bayesian », by Baba Brinkman (feat MC Lars and Mega Ran). Check out his awesome work!Visit our Patreon page to unlock exclusive Bayesian swag ;)Takeaways:Ethan's research involves using lasers to compress matter to extreme conditions to study astrophysical phenomena.Bayesian inference is a key tool in analyzing complex data from high energy density experiments.The future of high energy density physics lies in developing new diagnostic technologies and increasing experimental scale.High energy density physics can provide insights into planetary science and astrophysics.Emerging technologies in diagnostics are set to revolutionize the field.Ethan's dream project involves exploring picno nuclear fusion.Chapters:14:31 Understanding High Energy Density Physics and Plasma Spectroscopy21:24 Challenges in Data Analysis and Experimentation36:11 The Role of Bayesian Inference in High Energy Density Physics47:17 Transitioning to Advanced Sampling Techniques51:35 Best Practices in Model Development55:30 Evaluating Model Performance01:02:10 The Role of High Energy Density Physics01:11:15 Innovations in Diagnostic Technologies01:22:51 Future Directions in Experimental Physics01:26:08 Advice for Aspiring ScientistsThank you to my Patrons for making this episode possible!Yusuke Saito, Avi Bryant, Giuliano Cruz, James Wade, Tradd Salvo, William Benton, James Ahloy, Robin Taylor, Chad Scherrer, Zwelithini Tunyiswa, Bertrand Wilden, James Thompson, Stephen Oates, Gian Luca Di Tanna, Jack Wells, Matthew Maldonado, Ian Costley, Ally Salim, Larry Gill, Ian Moran, Paul Oreto, Colin Caprani, Colin Carroll, Nathaniel Burbank, Michael Osthege, Rémi Louf, Clive Edelsten, Henri Wallen, Hugo Botha, Vinh Nguyen, Marcin Elantkowski, Adam C. Smith, Will Kurt, Andrew Moskowitz, Hector Munoz, Marco Gorelli, Simon Kessell, Bradley Rode, Patrick Kelley, Rick Anderson, Casper de Bruin, Michael Hankin, Cameron Smith, Tomáš Frýda, Ryan Wesslen, Andreas Netti, Riley King, Yoshiyuki Hamajima, Sven De Maeyer, Michael DeCrescenzo, Fergal M, Mason Yahr, Naoya Kanai, Aubrey Clayton, Omri Har Shemesh, Scott Anthony Robson, Robert Yolken, Or Duek, Pavel Dusek, Paul Cox, Andreas Kröpelin, Raphaël R, Nicolas Rode, Gabriel Stechschulte, Arkady,

Rockstroh examines emerging challenges in HIV care, including COVID-19 and mpox, novel therapies, and lessons from Europe's care model. Explore the possibilities of shifting from disease management towards long-term remission and functional cure. Timestamps: 00:00 – Introduction 00:45 – COVID-19 lessons 05:02 – Mpox challenges 07:42 – Novel therapies 12:56 – Improving care 15:39 – Remission or cure?

In this episode, the CardioNerds (Dr. Rachel Goodman, Dr. Shazli Khan, and Dr. Jenna Skowronski) discuss a case of AMI-shock with a focus on listing for heart transplant with faculty expert Dr. Kelly Schlendorf. We dive into the world of pre-transplant management, discuss the current allocation system, and additional factors that impact transplant timing, such as sensitization. We conclude by discussing efforts to increase the donor pool.  Audio editing for this episode was performed by CardioNerds Intern, Julia Marques Fernandes. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls The current iteration of heart allocation listing is based on priority, with status 1 being the highest priority.  The are multiple donor and recipient characteristics to consider when listing a patient for heart transplantation and accepting a heart offer.  Desensitization is an option for patients who need heart transplantation but are highly sensitized.  Protocols vary by center.  Acceptance of DCD hearts is one of many efforts to expand the donor pool   Notes Notes: Notes drafted by Dr. Rachel Goodman  Once a patient is determined to be a candidate for heart transplantation, how is priority determined?  The current iteration of heart listing statuses was implemented in 2018.  Priority is determined by acuity, with higher statuses indicating higher acuity and given higher priority.  Status 1 is the highest priority status, and Status 7 is inactive patients. (1,2)  What criteria should be considered in organ selection when listing a patient for heart transplant?  Once it is determined that a patient will be listed for heart transplantation, there are certain criteria that should be assessed.  These factors may impact pre-transplant care and/or donor matching (3).  (1) PVR  (2) Height/weight   (3) Milage listing criteria  (4) Blood typing/cPRA/HLA typing  What is desensitization and why would it be considered?  Desensitization is an attempt to reduce or remove anti-HLA antibodies in the recipient.  It is done to increase the donor pool.  In general, desensitization is reserved for patients who are highly sensitized.  Desensitization protocols vary by transplant center, and some may opt against it.  When considering desensitization, it is important to note two key things: first, there is no promise that it will work, and second desensitization involves the use of immunosuppressive agents, thereby putting patients at increased risk of infection and cytopenia. (4)  Can you explain DCD and DBD transplant?  DBD: donor that have met the requirements for legal definition of brain death.   DCD: donors that have not met the legal definition of brain death but have been determined to have circulatory death.  Because the brain death criteria have not been met, organ recovery can only take place once death is confirmed based on cessation of circulatory and respiratory function. Life support is only withdrawn following declaration of circulatory death—once the heart has stopped beating and spontaneous respirations have stopped. (5,6)  References 1: Maitra NS, Dugger SJ, Balachandran IC, Civitello AB, Khazanie P, Rogers JG. Impact of the 2018 UNOS Heart Transplant Policy Changes on Patient Outcomes. JACC Heart Fail. 2023;11(5):491-503. doi:10.1016/j.jchf.2023.01.009  2:  Shore S, Golbus JR, Aaronson KD, Nallamothu BK. Changes in the United States Adult Heart Allocation Policy: Challenges and Opportunities. Circ Cardiovasc Qual Outcomes. 2020;13(10):e005795. doi:10.1161/CIRCOUTCOMES.119.005795  3:  Copeland H, Knezevic I, Baran DA, et al. Donor heart selection: Evidence-based guidelines for providers. J Heart Lung Transplant. 2023;42(1):7-29. doi:10.1016/j.healun.2022.08.030  4: Kittleson MM. Management of the sensitized heart transplant candidate. Curr Opin Organ Transplant. 2023;28(5):362-369. doi:10.1097/MOT.0000000000001096  5:  Kharawala A, Nagraj S, Seo J, et al. Donation After Circulatory Death Heart Transplant: Current State and Future Directions. Circ Heart Fail. 2024;17(7):e011678. doi:10.1161/CIRCHEARTFAILURE.124.011678  6: Siddiqi HK, Trahanas J, Xu M, et al. Outcomes of Heart Transplant Donation After Circulatory Death. J Am Coll Cardiol. 2023;82(15):1512-1520. doi:10.1016/j.jacc.2023.08.006 

Where is God present—and how do believers describe it? In this thoughtful and poetic episode, Polish theologian Dr. Elżbieta Łazarewicz-Wyrzykowska joins Dru Johnson to reflect on theology, trauma, and spiritual presence. From her childhood in Warsaw—where bullet holes and tanks marked the legacy of war—to her academic path through Hebrew Bible, literary theory, and empirical psychology, Elżbieta has never stopped asking difficult questions. They discuss her research into the Book of Amos using the philosophical insights of Mikhail Bakhtin, seeing God as the “author” of Israel and disobedience as a form of anti-creation. They also explore her current interdisciplinary work in the psychology of religion: “We tried to measure where people locate God's presence. Eucharist was the one thing people named first.” She reflects on the tension between empirical categories and theological meaning: “God is present in special objects” didn't resonate. But “God is present in the Eucharist”? That made sense. “I still wanted to be faithful to what the community told me.” This episode is a masterclass in humility, scholarship, and the quiet brilliance of a scholar working at the intersection of Scripture, philosophy, trauma, and pastoral care. We are listener supported. Give to the cause here: https://hebraicthought.org/give For more articles: https://thebiblicalmind.org/ Social Links: Facebook: https://www.facebook.com/HebraicThought Instagram: https://www.instagram.com/hebraicthought Threads: https://www.threads.net/hebraicthought X: https://www.twitter.com/HebraicThought Bluesky: https://bsky.app/profile/hebraicthought.org Chapters: 00:00 Introduction and Personal Background 02:49 Warsaw: A City of Resilience 06:06 The Impact of Historical Trauma 08:41 Academic Journey in Hebrew Bible Studies 11:49 Literary and Philosophical Approaches to the Hebrew Bible 14:35 Interdisciplinary Work and Its Challenges 17:38 Exploring Bakhtin's Influence 20:31 The Book of Amos: A Case Study 23:42 Theological Measures and Empirical Research 26:35 The Role of Practical Theology 29:45 Conclusion and Future Directions

Understanding Visual Perception in Medical Diagnoses: A Deep Dive with Claudia Mello-ThomsIn this episode, Christine continues the conversation with Claudia Mello-Thoms, an expert in visual perception as it relates to medical diagnosis. The discussion delves into the use of templates by experts to quickly recognize abnormalities in medical images, despite their large size and complexity. Claudia explains how perception operates at a subconscious level, often leading to perceptual errors in medical practices like radiology and pathology. The conversation underscores the need to understand the human element in diagnostics to reduce errors and improve accuracy. The episode also explores the difference between rapid (fast) and deliberative (slow) processing in the assessment of medical images, emphasizing the importance of fresh perspectives when diagnostic clarity is lacking.00:00 Introduction to Visual Perception in Medical Diagnoses00:40 Understanding Templates in Medical Imaging01:34 Expert vs. Novice Diagnoses02:13 The Role of Clinical History in Pathology06:48 Fast vs. Slow Processing in Diagnoses09:42 Perception and Cognition in Medical Imaging10:31 Teaching and Learning in Medical Imaging21:48 Challenges and Future Directions in Radiology23:09 Conclusion and Final Thoughts

What does it take to save both life and function in a rapidly progressing infection? In this episode of BackTable Urology, Dr. Judith Hagedorn (University of Washington) joins Dr. George Koch (Ohio State University) to unpack the complexities of Fournier's gangrene management. --- SYNPOSIS They discuss advances in surgical techniques like skin-sparing debridement and the value of high-volume centers for patient outcomes. They also explore the use of wound vacuums, the challenges related to testicular management, and the future of Fournier's gangrene treatment, including early detection and better patient scoring systems. --- TIMESTAMPS 0:00 - Introduction3:04 - Evolution of Fournier's Management7:50 - Management at High-Volume vs. Community Centers20:39 - Use of Wound Vacs27:03 - Testicular Management43:56 - Future Directions

As new genetic and AI-powered tools emerge for bladder cancer screening, are we getting closer to reducing the need for invasive cystoscopies? In part five of the 2025 BackTable NMIBC Creator Weekend™ series, host Dr. Vignesh Packiam engages in an insightful discussion with Dr. Sarah Psutka from the University of Washington and Dr. Katie Murray from NYU about the complexities and potential benefits of using biomarkers in non-muscle invasive bladder cancer (NMIBC). --- This podcast is supported by: Ferring Pharmaceuticals https://www.ferring.com/home-classic/people-and-families/uro-uro-oncology/bladder-cancer/ --- SYNPOSIS The conversation covers the current challenges of interpreting positive biomarkers without clinical correlates, the gold standard of biopsies, and the potential of various biomarkers such as urine cytology, FISH, and newer genomic tests like the Decipher Bladder Genomic Classifier. They also touch upon the role of AI in pathology, the cost implications of biomarkers, and how these tools might influence future clinical practices and patient decisions. The episode emphasizes the need for precision medicine, careful patient counseling, and the impact of false positives and negatives on both patients and healthcare providers. --- TIMESTAMPS 00:00 - Introduction05:25 - Challenges with Current Biomarkers08:10 - New Biomarkers and Genomic Classifiers21:10 - AI and Pathology in Bladder Cancer35:13 - Screening and Future Directions41:20 - Challenges and Future Directions in Bladder Cancer Surveillance57:51 - Conclusion --- RESOURCES DaBlaCa-15 Trialhttps://pubmed.ncbi.nlm.nih.gov/40280776/ Sam Chang CHAI Studyhttps://pubmed.ncbi.nlm.nih.gov/40514253/