Podcasts about guidelines

Israeli forces fired shots at a food distribution site in Gaza after people, many of whom face the threat of starvation, had overrun the place. The incident happened on the first day that a new U.S.-based system distributed humanitarian aid. The U.S. government has updated its COVID-19 vaccine guidelines. The shot is no longer recommended for healthy children or healthy pregnant women. But independent health experts are voicing concerns. And thousands of children of ISIS fighters are stuck in Syrian detention camps.Want more comprehensive analysis of the most important news of the day, plus a little fun? Subscribe to the Up First newsletter.Today's episode of Up First was edited by Carrie Kahn, Rebecca Davis, Barrie Hardymon, HJ Mai and Alice Woelfle. It was produced by Ziad Buchh, Nia Dumas and Christopher Thomas. We get engineering support from Neisha Heinis and our technical director is Carleigh Strange.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Dr. Barbara Moscicki discusses the critical role of HPV in women's health, particularly its association with various cancers, including cervical cancer. She explains the dual nature of HPV as both a commensal organism and a pathogen, emphasizing the importance of understanding its oncogenic potential. The conversation also covers the significance of screening methods, such as Pap smears, in detecting precancerous changes and the complexities surrounding the treatment of different cervical intraepithelial neoplasia (CIN) stages. This conversation delves into the complexities of cancer screening methods, particularly focusing on cervical and anal cancer. Dr. Barbara Moscicki discusses the importance of understanding various screening guidelines, the role of HPV vaccination in preventing cancers, and the need for clear communication between clinicians and patients regarding these topics. The discussion highlights the evolving nature of cancer screening practices and the importance of patient education in navigating these changes.About Our Guest:Dr. Moscicki is a Pediatrician, Board Certified in Adolescent Medicine. She is the current Division Chief of Adolescent and Young Adult Medicine with clinical expertise in reproductive health care for menstrual irregularities, sexual health, and sexually transmitted diseases. Dr. Moscicki has expertise in HPV -related disease including diagnosis of cervical dysplasia and treatment. She also offers medical care for women with eating disorders.Resources & Links:This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features the PCORI research study here: https://pubmed.ncbi.nlm.nih.gov/33632649/ ‘Effect of 2 Interventions on Cervical Cancer Screening Guideline Adherence'Chapter Codes00:00 Introduction to HPV and Women's Health03:00 Understanding HPV's Role in Cancer06:01 The Dual Nature of HPV: Commensal vs Pathogenic08:57 Oncogenes and Their Impact on Cellular Regulation12:09 The Intersection of HPV and Screening Methods14:58 Cervical Cancer Screening and Pap Smears20:30 Understanding Cancer Screening Methods23:17 Guidelines for Cervical and Anal Cancer Screening31:02 The Importance of HPV Vaccination39:35 Key Messages for Clinicians and PatientsTakeaways- Dr. Moscicki specializes in adolescent and young adult medicine.- HPV is linked to multiple cancers beyond cervical cancer.- The understanding of HPV's role in cancer has evolved significantly.- E6 and E7 proteins from HPV disrupt normal cell regulation.- CIN3 is considered a true pre-cancer that requires treatment.- Liquid cytology has improved the accuracy of Pap smears.- CIN1 is often self-resolving and does not require treatment.- CIN2 presents a diagnostic dilemma due to variability in interpretation.- Women have options regarding the management of CIN2 lesions.Connect with Us:Enjoyed this episode? Make sure to subscribe, rate, and review! Follow us on Instagram, Facebook, or Linkedin @mantacares and visit our website at mantacares.com for more episodes and updates.Listen Elsewhere: Website: https://mantacares.com/pages/podcast?srsltid=AfmBOopEP5GJ-Wd2nL-HYAInrw YouTube: https://www.youtube.com/@mantacares Spotify: https://open.spotify.com/episode/3TR1lFLtf6em5YyKtlWy2L?si=6ma-9g_w Apple: https://podcasts.apple.com/us/podcast/navigating-cervical-cancer-screening-surger Disclaimer:All content and information provided in connection with Manta Cares is solely intended for informational and educational purposes only. This content and information is not intended to be a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.This episode was supported by an award from the Patient-Centered Outcomes Research Institute.

Alabama's parole board has proposed changes to its guidelines. An "aviation" high school is about to celebrate its first graduating class. And North Dakota is raising its maximum speed limit ... for those who might happen to be passing through North Dakota anytime soon. Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Lauren Kim is joined by Dr. Ivan Pedrosa and Dr. Robert Watson to discuss the newly updated ACR MRI Safety Manual. They explore key changes, the rationale behind new guidelines, and the implications for both clinical practice and research. American College of Radiology Manual on MR Safety:2024 Update and Revisions. Pedrosa et al. Radiology 2025; 315(1):e241405. The Updated ACR Manual on MR Safety and How It WillAffect Your Practice. Kanal. Radiology 2025; 315(1):e242954. ACR Manual on MR Safety 2024  

The All Local

This is the noon All Local for Tuesday, May 27, 2025

A federal judge is ordering the Trump administration not to block or withhold funding for New York state as retaliation for the MTA's congestion pricing program. Plus, the panel that sets the rent for tenants in a million stabilized apartments held a rare "re-vote" on Tuesday. Also, electric bills for New Jersey residents are about to jump up around 20% next month. Meanwhile, bird lovers in Manhattan plan to turn Broadway malls into avian oases. And finally, the New York Botanical Garden's new exhibit pays tribute to Dutch painter Vincent Van Gogh with botanical displays and large scale art.

New York City's Rent Guidelines Board is holding a rare revote this morning to reconsider the proposed range of increases for two-year leases on rent stabilized apartments. Meanwhile, more lanes are reopening this week on a damaged stretch of Interstate 80 in western New Jersey, though full repairs are still a month away. Plus, the New York Knicks head into a must-win matchup against the Indiana Pacers as the Eastern Conference Finals continue.

Feeling encouraged by the tributes paid to his valour by his fellow monkeys, Price Angada undertakes to exterminate the entire ogre race including Ravana and bring back Sita from Lanka. Jambavan, however, who is more sagacious and practical-minded, discourages him by recourse to potent counter-arguments.Recitation: 00:00 - 03:39Translation: 03:43 - 09:12

In this episode, board-certified plastic surgeon Dr. Jeffrey Roth from Las Vegas Plastic Surgery joins co-host Darrell Craig Harris to explore the recommended lifespan of breast implants. They dive into why implants aren't permanent, what signs to watch for, and when replacement might be necessary—valuable insights for anyone considering or currently living with breast implants. We invite you to contact us with your questions including suggestions for topics to cover on future episodes!  email: inquiry@darrellcraigharris.com Meet Dr. Jeffrey J. Roth from Las Vegas Plastic Surgery Drawn to medicine by his innate desire to help others, he received his medical degree from the University of Nevada School of Medicine. He completed his general surgery residency at the Medical College of Pennsylvania/Hahnemann University in Philadelphia and his plastic surgery residency at the University of California, San Francisco, serving as chief resident in both programs. He then furthered his training with a fellowship in microsurgery and hand surgery at USC, where he also served on the faculty. Having gathered the kind of expertise and experience that makes him a leader in his field, Dr. Roth returned to Las Vegas in 2003 and opened his practice, Las Vegas Plastic Surgery, Inc. Website www.JJRothMD.com  Social media www.Instagram.com/lasvegasplasticsurgery www.Instagram.com/lookinggoodfeelinggreatpodcast www.Facebook.com/lasvegasplasticsurgery www.Twitter.com/DrJeffreyRoth             

Drs. Amy Crockett (@amyhcrockett), Ben Ereshefsky (@brainofbpharm), and Pamela Bailey (@pamipenem) join Dr. Julie Ann Justo (@julie_justo) to discuss new treatment strategies for management of intraamniotic infections, also known as chorioamnionitis. They discuss whether it is time to move away from the combination of ampicillin, gentamicin, and/or clindamycin, alternative antibiotic regimens to consider, and stewardship strategies to approach this practice change at a local level. References: Basic stats/epi on chorioamnionitis: Romero R, et al. Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques. J Perinat Med. 2015 Jan;43(1):19-36. doi: 10.1515/jpm-2014-0249. PMID: 25720095. ACOG 2017 Guideline for IAI: Committee Opinion No. 712: Intrapartum Management of Intraamniotic Infection. Obstet Gynecol. 2017 Aug;130(2):e95-e101. doi: 10.1097/AOG.0000000000002236. PMID: 28742677. ACOG 2024 Update on clinical criteria for IAI: ACOG Clinical Practice Update: Update on Criteria for Suspected Diagnosis of Intraamniotic Infection. Obstetrics & Gynecology 144(1):p e17-e19, July 2024. doi: 10.1097/AOG.0000000000005593 Helpful review with more recent microorganisms : Jung E, et al. Clinical chorioamnionitis at term: definition, pathogenesis, microbiology, diagnosis, and treatment. Am J Obstet Gynecol. 2024 Mar;230(3S):S807-S840. doi: 10.1016/j.ajog.2023.02.002. PMID: 38233317. Cochrane Review: Chapman E, et al. Antibiotic regimens for management of intra-amniotic infection. Cochrane Database Syst Rev. 2014 Dec 19;2014(12):CD010976. doi: 10.1002/14651858.CD010976.pub2. PMID: 25526426. Helpful recent review on intrapartum infections: Bailey, P, et al_._ Out with the Old, In with the New: A Review of the Treatment of Intrapartum Infections. Curr Infect Dis Rep. 2024;26:107–113 doi: 10.1007/s11908-024-00838-8. Role of genital mycoplasmas in IAI: Romero R, et al. Evidence that intra-amniotic infections are often the result of an ascending invasion - a molecular microbiological study. J Perinat Med. 2019 Nov 26;47(9):915-931. doi: 10.1515/jpm-2019-0297. PMID: 31693497. Regimens without enterococcal coverage with similar clinical outcomes: Blanco JD, et al. Randomized comparison of ceftazidime versus clindamycin-tobramycin in the treatment of obstetrical and gynecological infections. Antimicrob Agents Chemother. 1983 Oct;24(4):500-4. doi: 10.1128/AAC.24.4.500. PMID: 6360038. Bookstaver PB, et al. A review of antibiotic use in pregnancy. Pharmacotherapy. 2015 Nov;35(11):1052-62. doi: 10.1002/phar.1649. PMID: 26598097. Updated review in pregnancy, includes data on frequency of antibiotic use in pregnancy: Nguyen J, et al. A review of antibiotic safety in pregnancy-2025 update. Pharmacotherapy. 2025 Apr;45(4):227-237. doi: 10.1002/phar.70010. Epub 2025 Mar 19. PMID: 40105039. Locksmith GJ, et al. High compared with standard gentamicin dosing for chorioamnionitis: a comparison of maternal and fetal serum drug levels. Obstet Gynecol. 2005 Mar;105(3):473-9. doi: 10.1097/01.AOG.0000151106.87930.1a. PMID: 15738010. Clindamycin CDI Risk: Miller AC, et al. Comparison of Different Antibiotics and the Risk for Community-Associated Clostridioides difficile Infection: A Case-Control Study. Open Forum Infect Dis. 2023 Aug 5;10(8):ofad413. doi: 10.1093/ofid/ofad413. PMID: 37622034. Impact of penicillin allergy on clindamycin use & cites 47% clindamycin resistance per CDC among GBS: Snider JB, et al. Antibiotic choice for Group B Streptococcus prophylaxis in mothers with reported penicillin allergy and associated newborn outcomes. BMC Pregnancy Childbirth. 2023 May 30;23(1):400. doi: 10.1186/s12884-023-05697-0. PMID: 37254067. Clindamycin anaerobic coverage data: Hastey CJ, et al. Changes in the antibiotic susceptibility of anaerobic bacteria from 2007-2009 to 2010-2012 based on the CLSI methodology. Anaerobe. 2016 Dec;42:27-30. doi: 10.1016/j.anaerobe.2016.07.003. PMID: 27427465. Older PK study of ampicillin & gentamicin for chorioamnionitis: Gilstrap LC 3rd, Bawdon RE, Burris J. Antibiotic concentration in maternal blood, cord blood, and placental membranes in chorioamnionitis. Obstet Gynecol. 1988 Jul;72(1):124-5. PMID: 3380500. Paper putting out the call for modernization of OB/Gyn antibiotic regimens: Pek Z, Heil E, Wilson E. Getting With the Times: A Review of Peripartum Infections and Proposed Modernized Treatment Regimens. Open Forum Infect Dis. 2022 Sep 5;9(9):ofac460. doi: 10.1093/ofid/ofac460. PMID: 36168554. Vanderbilt University Medical Center experience with modernizing OB/Gyn infection regimens: Smiley C, et al. Implementing Updated Intraamniotic Infection Guidelines at a Large Academic Medical Center. Open Forum Infect Dis. 2024 Sep 5;11(9):ofae475. doi: 10.1093/ofid/ofae475. PMID: 39252868. Prisma Health/University of South Carolina experience with modernizing OB/Gyn infection regimens: Bailey P, et al. Cefoxitin for Intra-amniotic Infections and Endometritis: A Retrospective Comparison to Traditional Antimicrobial Therapy Regimens Within a Healthcare System. Clin Infect Dis. 2024 Jul 19;79(1):247-254. doi: 10.1093/cid/ciae042. PMID: 38297884.

New York City's Rent Guidelines Board will hold a re-vote next week after internal disagreements over proposed rent hikes for stabilized two-year leases. Meanwhile, The White House says Andy Byford AKA “Train Daddy”, who ran the city's subways and buses from 2018 until early 2020, has been tapped by President Trump to lead the redevelopment of Penn Station. Also, the city will deploy drones with life-saving equipment and speakers to assist lifeguards at public beaches this summer. Plus, mayoral candidate Adrienne Adams delivered an emotional speech marking the anniversary of her father's death and linked it to former Governor Andrew Cuomo's handling of the pandemic. Finally, residents at Rochdale Village, a co-op complex in Southeast Queens, are bracing for steep increases in monthly maintenance fees to cover repairs, mortgage debt, and an unpaid water bill.

UPMC Chief Medical Officer Don Yealy on the new covid vaccine guidelines full 420 Thu, 22 May 2025 18:26:16 +0000 2Ai6jGnb2X8gGfRvWp5oLweOe2poey4y covid 19,upmc marty,news,a-newscasts,top picks Marty Griffin covid 19,upmc marty,news,a-newscasts,top picks UPMC Chief Medical Officer Don Yealy on the new covid vaccine guidelines On-demand selections from Marty's show on Newsradio 1020 KDKA , airing weekdays from 10 a.m. to 2 p.m. 2024 © 2021 Audacy, Inc. News News News News news News News News News News False https://player.amper

Vitamin D recommendations in 1941 began this debate. Over the years, updated guidelines have continued to spark controversy and debate in the field of vitamin D research.In this episode of Daily Value, we look at the recent “Vitamin D-ilemma” reinvigorated by the Endocrine Society's updated 2024 guidelines. These new recommendations have dialed back routine testing and supplementation targets, igniting pushback from leading researchers who argue we might be overlooking significant health benefits (including reduced risks for 8 out of the top 10 leading causes of death). Join us as we Look at the evolving science behind vitamin D, why randomized trials and observational studies seem to tell different stories, and how you can practically navigate these conflicting recommendations to optimize your own health.00:00 Introduction: The Vitamin D Controversy01:00 Historical Guidelines and Shifts01:54 The 2011 Guidelines and Their Impact03:57 The 2024 Update: A New Debate06:13 Understanding Vitamin D's Role in the Body07:29 Clinical Trials vs. Observational Studies09:13 Health Benefits of Higher Vitamin D Levels11:58 Challenges in Vitamin D Research15:56 Practical Recommendations for Optimal Vitamin D19:32 Conclusion: Striving for Optimal HealthPMID: 39861407PMID: 38828961PMID: 37004709PMID: 30992519Support the show

Episode three of four on Paediatric ENT. Doctors Lisa and Sara are back with Paediatric Ear Nose and Throat Consultant Dr Simone Schaefer for this episode on Recurrent Epistaxis in Children. We discuss important differentials, including a rare condition that can present in predominantly teenage boys not to be missed, before moving on to discuss options for management and why the vast majority of these patients can often be safely managed in the community. We discuss cases that would be useful to be seen by the ENT team. Short and sweet, full of useful resources.   You can use these podcasts as part of your CPD - we don't do certificates but they still count :) Resources: Success Rates of Naseptin (Chlorhexidine dihydrochloride and neomycin sulfate) in reducing Epistaxis: Garry S, Wauchope J, Hintze J, Ryan E, O'Cathain E, Heffernan C. Factors affecting Naseptin treatment success – A prospective cohort study. International Journal of Pediatric Otorhinolaryngology. Volume 171. 2023: https://www.sciencedirect.com/science/article/abs/pii/S0165587623001878#:~:text=80.8%25%20(n%20%3D%20101),effects%20(skin%20irritation%20etc.) ENT UK: How to use a Nasal Spray: https://www.entuk.org/patients/conditions/79/how_to_use_nasal_sprays/ Asthma and Lung UK, How to use a Nasal Spray useful Video for patients: https://www.youtube.com/watch?v=S31maomo1xQ Alder Hey Children's Hospital Patient leaflet: Nosebleeds: https://www.alderhey.nhs.uk/conditions/symptoms-checker/nosebleeds/ ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it's release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

We had a ridiculous amount of fun recording this episode! The main science topic was on a new pre-print study on post-exercise ketones, showing higher carb storage and lower glycemia in athletes taking them. Is it possible that high carb has a special interaction with post-exercise ketones that might be at the heart of recent performances? It's uncertain. We just take them because we like the taste of robot butt.We also had a big breakdown of the cost of high-carb fueling. Megan did calculations on the price per gram of carbohydrates of different fueling sources, from gels to drink to at-home creations. It seems like some companies are giving you amazing deals, and some... are not. We name names.And this one was full of great topics! Other topics: heat training, a promo for the Core 2 sensor, David's post-race knee pain and the uncertainty of being an athlete, total energy expenditure during and after ultras, thoughts on the Cocodona 250, Stephanie Case's remarkable performance at Ultra Trail Snowdonia, plus a Q+A on depletion runs and a how-to on uphill treadmill.May your pantry be full of carbs and your secret drawer be full of SECRET hair.We love you all! Huzzah!-David and MeganClick "Claim Reward" for free credit at The Feed here: thefeed.com/swap Buy a Core 2 Sensor: https://thefeed.com/products/core-2-temperature-monitorCheck out Carbs Fuel: https://thefeed.com/products/carbs-fuel-original-energy-gelFollow Huzzah: https://www.instagram.com/thehuzzahhub/Buy Janji's amazing gear: https://janji.com/ (code "SWAP")For weekly bonus podcasts, articles, and videos: patreon.com/swap

Yes, your podcast can win a Golden Globe-ish, what you need to know about the FTC and AI podcast ad reads, covering Spotify announcing public plays and how they encountered the wrath of podcasters. iOS 19's new accessibility features, Libsyn's downloads per podcast category! And mean, media and user agents stats are back. Audience feedback drives the show. We'd love for you to contact us and keep the conversation going! Email thefeed@libsyn.com, call 412-573-1934 or leave us a message on Speakpipe! We'd love to hear from you!

Yes, your podcast can win a Golden Globe-ish, what you need to know about the FTC and AI podcast ad reads, covering Spotify announcing public plays and how they encountered the wrath of podcasters. iOS 19's new accessibility features, Libsyn's downloads per podcast category! And mean, media and user agents stats are back. Audience feedback drives the show. We'd love for you to contact us and keep the conversation going! Email thefeed@libsyn.com, call 412-573-1934 or leave us a message on Speakpipe! We'd love to hear from you!

  Last time we spoke about the February 26th incident. Within the turbulent “ government of assassination” period of 1936 Japan, a faction of discontented junior officers, known as the Kodoha, believed that their emperor, Hirohito, was being manipulated by corrupt politicians. In a desperate bid for what they termed a "Showa Restoration," they meticulously plotted a coup d'état. On February 26, they launched a rebellion in Tokyo, attempting to assassinate key figures they deemed responsible for undermining the emperor's authority. The young officers executed coordinated attacks on prominent leaders, resulting in several deaths, while hoping to seize control of the Imperial Palace. However, their plan unraveled when their actions met with unexpected resistance, and they failed to secure strategic locations. Dark snow blanketed the city as Hirohito, outraged by the violence, quickly moved to suppress the uprising, which ultimately led to the downfall of the Kodoha faction and solidified the military's grip on power, ushering in a new era marked by militarism and radicalism.   #151 The Suiyuan Operation Welcome to the Fall and Rise of China Podcast, I am your dutiful host Craig Watson. But, before we start I want to also remind you this podcast is only made possible through the efforts of Kings and Generals over at Youtube. Perhaps you want to learn more about the history of Asia? Kings and Generals have an assortment of episodes on history of asia and much more  so go give them a look over on Youtube. So please subscribe to Kings and Generals over at Youtube and to continue helping us produce this content please check out www.patreon.com/kingsandgenerals. If you are still hungry for some more history related content, over on my channel, the Pacific War Channel where I cover the history of China and Japan from the 19th century until the end of the Pacific War. So we last left off with the February 26th incident breaking out in Japan, but now I would like to return to China. Now we spoke a little bit about some influential Japanese politicians in the previous episode. Prime Minister Satio Makoto oversaw Japan from May 1932 to July 1934, succeeded by Prime Minister Keisuke Okada from July 1934 to March 1936. The foreign policy of Japan towards China during the Saitō and Okada administrations exhibited a notable paradox, characterized by two conflicting elements. On one hand, Foreign Minister Hirota championed a diplomatic approach that emphasized friendship, cooperation, and accommodation with China. On the other hand, the military actively undermined the authority of the Nationalist government in northern China, creating a significant rift between diplomatic rhetoric and military action.    The Okada cabinet then endorsed the Army Ministry's "Outline of Policy to Deal with North China" on January 13, 1936. This policy document explicitly proposed the eventual detachment of five provinces, Hubei, Chahar, Shanxi, Suiyuan, and Shandong from the Nationalist government in Nanking. The approval of this outline marked a pivotal moment, as it represented the first official government endorsement of the military's longstanding agenda and underscored the army's evolution from a mere rogue entity operating in the region to the de facto authority dictating the course of Japan's policy towards China. Despite this, on January 22, during the 68th Diet session, Hirota reaffirmed his dedication to fostering better ties with China, to which a representative from the Chinese Ministry of Foreign Affairs responded positively. The Nationalist government in Nanjing also expressed interest in engaging in formal negotiations. However, this diplomatic initiative quickly faltered, and the expected discussions in Nanjing never took place. Shortly thereafter, a mutiny by young army officers on February 26, 1936, led to the fall of the Okada cabinet. Following Prince Konoe Fumimaro's refusal of the imperial mandate to form a new government, Hirota stepped in to establish a cabinet on March 9. General Terauchi Hisaichi was appointed as the Minister of the Army, Admiral Nagano Osami took charge of the Navy Ministry, and Baba Eiichi became the finance minister. Hirota briefly served as foreign minister until Arita Hachirö, who had just submitted his credentials as ambassador to China on March 6, returned to Japan. The Hirota Koki cabinet, established immediately following the February 26 incident further entrenched military influence in politics while allowing interservice rivalries to impede national objectives. In May 1936, Hirota, influenced by army and navy ministers, reinstated the practice of appointing military ministers solely from the ranks of high-ranking active-duty officers. He believed this would prevent associations with the discredited Imperial Way faction from regaining power. By narrowing the candidate pool and enhancing the army's power relative to the prime minister, Hirota's decision set the stage for army leaders to leverage this advantage to overthrow Admiral Yonai's cabinet in July 1940. Arita began his new job by meeting with Foreign Minister Chang Chen while hearing views from the Kwantung Army chief of staff General, Itagaki Seishiro. Yes, our old friend received a lot of promotions. Itagaki had this to say about the Kwantung Army's policy in China "The primary aim of Japan's foreign policy, is the sound development of Manchukuo based upon the principle of the indivisibility of Japan and Manchukuo. If, as is probable, the existing situation continues, Japan is destined sooner or later to clash with the Soviet Union, and the attitude of China at that time will gravely influence operations [against the Soviet Union]." The Kwantung Army's was growing more and more nervous about the USSR following its 7th comintern congress held in July and August of 1935. There it publicly designated Japan, Germany and Poland as its main targets of comintern actions. Japanese intelligence in the Red Army also knew the Soviets were gradually planning to expand the military strength so they could face a simultaneous west and east front war. This was further emboldened by the latest USSR 5 year plan. Alongside the growing Red northern menace, the CCP issued on August 1st a declaration calling upon the Nationalist Government to end their civil war so they could oppose Japan. By this time the CCP was reaching the end of its Long March and organizing a new base of operations in Yenan in northern Shanxi. The developments by the USSR and CCP had a profound effect on Japan's foreign policy in China. The Kwantung Army believed a war with the USSR was imminent and began to concentrate its main force along the border of Manchukuo. The Kwantung Army's plan in the case of war was to seize Vladivostok while advancing motorized units towards Ulan Bator in Outer Mongolia, hoping to threaten the Trans-Siberian Railway near Lake Baikal. Their intelligence indicated the USSR could muster a maximum of 250,000 troops in eastern Siberia and that Japan could deal with them with a force two-thirds of that number. The IJA at that point had inferior air forces and armaments, thus urgent funding was needed. The Kwantung Army proposed that forces in the home islands should be reduced greatly so all could be concentrated in Manchuria. To increase funding so Kwantung leadership proposed doing away with special allowances for Japanese officials in Manchuria and reorganizing the Japanese economic structure. The Kwantung leaders also knew the submarine base at Vladivostok posed a threat to Japanese shipping so the IJN would have to participate, especially against ports and airfields. All said and done, the Kwantung Army planned for a war set in 1941 and advised immediate preparations. On July 23, 1936, Kanji Ishiwara presented the army's document titled “Request Concerning the Development of Industries in Preparation for War” to the Army Ministry. He asserted that in order to prepare for potential conflict with the Soviet Union, Japan, Manchukuo, and North China must have the industries critical for war fully developed by 1941. Ishiwara emphasized the urgent need for rapid industrial growth, particularly in Manchukuo. He followed this request on July 29 with a draft of a “Policy on Preparations for War” regarding the Soviet Union, advocating for immediate reforms to Japan's political and economic systems to facilitate economic expansion and lay the groundwork for future fundamental changes. However, he cautioned that if significant turmoil erupted in economic sectors, Japan must be ready to execute a comprehensive overhaul without delay. At the same time, the Hirota cabinet initiated a review of its policy towards China. In the spring of 1936, a secret committee focused on the Current Situation was formed, consisting of officials from the Army, Navy, and Foreign ministries. Their discussions led to the adoption of the "Measures to Implement Policy toward China" by the Four Ministers Conference on August 11, along with the "Second Outline of Policy to Address North China," which the cabinet approved as part of the "Fundamentals of National Policy" on the same day. The first of these documents outlined the following actionable steps: “1. Conclusion of an anti-Communist military pact. a) To prepare for the conclusion of such a pact, a special secret committee of military experts from both countries should be organized. b) Their discussions should cover the scope and substance of the pact and ways and means of realizing the objectives of the pact.  2. Conclusion of a Sino-Japanese military alliance. A special secret committee, composed of an equal number of delegates from each nation, should be organized to prepare for the conclusion of an offensive and defensive alliance against attack by a third country.  3. Acceleration of solutions of pending questions between China and Japan. a) Engagement of a senior political adviser: The Nationalist government should engage a senior Japanese political adviser to assist in the conduct of the domestic and foreign affairs of the Nationalist government. b) Engagement of military advisers: The Nationalist government should engage military advisers, along with military instructors. c) Opening of airline services between China and Japan: Airline services between China and Japan should be opened immediately. To realize such a service, various means should be used to induce the Nanking authorities to establish an airline corporation in North China, to begin flights between Formosa and Fukien province, and to start test flights between Shanghai and Fukuoka. d) Conclusion of a reciprocal tariff treaty: A reciprocal tariff treaty should be concluded promptly between China and Japan, on the basis of the policy approved by the ministries concerned, with regard to the abolition of the special trade in eastern Hopei province and the lowering of the prohibitively high tariffs. For this purpose Japan should, if necessary, propose the creation of a special committee composed of Japanese and Chinese representatives.  4. Promotion of economic cooperation between China and Japan. Japan should promote cooperation with the common people of China to establish realistic and inseparable economic relations between China and Japan that will promote coexistence and co-prosperity and will be unaffected by changes in the Chinese political situation. “ The document also included suggestions for Japan's economic expansion into South China. This included tapping into the natural resources of the provinces of Fujian, Guangdong, and Guangxi, building a railway between Guangzhou and Swatow, and establishing air routes between Fuchoz and Taipei, which would connect to services in Japan and Thailand. It also called for survey teams to be dispatched to explore the resources of Sichuan, Gansu, Xinjiang, and Qinghai provinces, and for support to be provided to the independence movement in Inner Mongolia. However, these initiatives presented significant challenges. The preface to the "Second Outline of Policy to Deal with North China" cautioned, "In implementing this policy, we must carefully consider the Nanking government's prestige and avoid actions that could prompt it to adopt an anti-Japanese stance in response to the desires of the Chinese people."  On September 19th, six fundamental points for a settlement in North China were dictated to China to “establish a common defense against communism, promoting economic cooperation, lowering tariffs, initiating an airline service between the two nations, employing Japanese advisers, and controlling subversive Koreans." September 22 was set as the deadline for a response from China. While agreeing to some Japanese requests, the Chinese included several counter-demands that the Japanese found completely unacceptable. These demands required Japan to “(a) refrain from using armed intervention or arbitrary actions in its dealings with China, (b) recognize China as an equal and sovereign state, (c) avoid leveraging antigovernment groups or communist elements, and (d) remove any derogatory references to China from Japanese textbooks. The Chinese also insisted that any agreement regarding North China “must precede the annulment of the Tanggu and Shanghai cease-fire agreements, the disbanding of the East Hopei regime, a prohibition on unauthorized Japanese flights over North China, a ban on smuggling activities by Japanese, the restoration of China's right to control smuggling, and the disbandment of the illegal East Hopei government along with the armies of Wang Ying and Prince De in Suiyuan”. Now that mention of a Prince De in Suiyuan brings us to a whole new incident. This podcast series should almost be called “the history of Japanese related incidents in China”. Now we've spoken at great lengths about Japan's obsession with Manchuria. She wanted it for resources, growing space and as a buffer state. Japan also had her eyes set on Inner Mongolia to be used as a buffer state between Manchukuo, the USSR and China proper. Not to mention after the invasion of North China, Inner Mongolia could be instrumental as a wedge to be used to control Northern China. Thus the Kwantung Army began fostering a Mongolian independence movement back in August of 1933. They did so through a special organ led by chief of the general staff Koiso Kuniaki. He began work with the Silingol League led by Prince Sonormurabdan or “Prince So” and another influential Mongol, Prince Demchukdongrob or “Prince De”. Prince De was the West Sunid Banner in Northern Chahar. Likewise the Kwantung Army was grooming Li Xuxin, a Mongol commoner born in southern Manchuria. He had been a bandit turned soldier absorbed into Zhang Xueliangs army. Li had distinguished himself in a campaign against a group of Mongols trying to restore the Qing dynasty to further establish an independent Mongolia. During Operation Nekka Li had served in a cavalry brigade under Zu Xingwu, reputed to be the best unit in Zhang Xueliangs Northeastern border defense army. He led the army's advance unit into western Shandong. Afterwards Li suddenly became friends with Major Tanaka Hisashi, the head of the Special Service Agency at Dungliao where he defected to the Kwantung Army. He soon was leading a force too strong to be incorporated into the Manchukuo Army, thus it was disbanded, but his Kwantung Army buddies encouraged him to move to Tolun in Rehe province. At one point during the Nekka campaign, Li's army was threatened by a strong Chinese counterattack, but they had Manchukuo air support allowing them to capture Tolun. This victory launched what became the East Chahar Special Autonomous District with Li becoming a garrison commander and chief administrator.  Back in time, upon the founding of the Chinese Republic, the affairs of Inner Mongolia fell upon the Bureau of Mongolian and Tibetan Affairs. This was reorganized in 1930 into the Commission on Mongolian and Tibetan Affairs when the provinces of Chahar, Suiyuan and Ningxia were organized. Prince De had been a member of a nationalist group known as the Young Mongols, although his aim was self-determination for Inner Mongolia within China, not independence. The Nationalist government's support for Chinese settlement in Mongol territories and its disregard for Mongol perspectives quickly triggered a rise in Mongol nationalism and anti-Chinese feelings. This was exacerbated by the government's introduction of a law on October 12, 1931, requiring local Mongolian administrative units to consult with hsien officials on matters concerning their administration. The nationalist sentiment was further fueled by the presence of the neighboring Mongolian People's Republic in Outer Mongolia and the establishment of Xingan province in western Manchuria by Manchukuo authorities in March 1932. This new province included the tribes of eastern Inner Mongolia and granted them greater autonomy than other Manchukuo provinces while banning Chinese immigration into it. When Nanjing did not react to these developments, Prince De and his supporters took steps toward gaining autonomy. On July 15th, 1933, Mongol leaders from western Inner Mongolia gathered at Pailingmiao for two weeks to deliberate on a declaration for regional independence. Although many princes were initially hesitant to take this step, they reconvened on August 14 and sent a cable to Nanjing announcing their decision to create an autonomous Mongolian government. The cable was signed by Prince So and Prince De. Over the following two months, additional conferences at Pailingmiao were held to organize the new government, which would operate under Nanking's guidance but without involvement from provincial chairmen. On October 22, Prince Yun, head of the Ulanchap League and a close ally of Prince De, was elected to lead the new regime, with Prince De assuming the role of chief of its political affairs bureau. After receiving a cable from the Mongolian leaders in August, Nanjing quickly sent Minister of the Interior Huang Shao-hung and Xu Qingyang, head of the Commission on Mongolian and Tibetan Affairs, to halt the movement. However, the Mongols declined to travel to Kalgan or Kueisui to meet Huang. In November, as the leader of a special commission appointed by Nanjing, Huang reached an agreement with Yun De and other Mongolian leaders concerning a proposal that abandoned the Mongols' demand for an autonomous government. This agreement was later altered by Nanjing, and its essential points were excluded from a measure approved by the Central Political Council of the Kuomintang on January 17, 1934. The dispute reignited, fueled by the Nationalist government's rising concerns over the anticipated enthronement of Pu Yi in Manchukuo. On February 28, the Central Political Council enacted a measure that outlined "eight principles of Inner Mongolian autonomy" and created the Mongolian Local Autonomous Political Council. Since these principles did not grant authority over foreign and military affairs, powers explicitly reserved for the central government in the January measure, they were seen as a concession to the Mongols and were accepted. On March 7, the central government issued regulations to establish a semi autonomous regime for Inner Mongolia, which was officially launched at Pailingmiao on April 23. Although the council was led by three moderate princes, Prince Yun, supported by Princes So and Sha, the real administrative authority was held by Prince De, who served as the secretary-general. Most of the twenty-five council members were of Mongolian royalty, through whom Prince De aimed to fulfill his objectives. Nevertheless, the Nationalist government seemed to consider the council merely a token gesture to placate De, as Nanking never provided the promised administrative funds outlined in the "eight principle declaration." Was not much of a shock Prince De sought support from the Kwantung Army, which had established contact with him as early as June 1934. Japanese pressures in North China were starting to alter the power dynamics, and after the first Western incident in Jehol in February 1935, it compelled the relocation of Sung Queyuan's army from Chahar to Hopei, providing encouragement to Prince De. In May, he met with Kwantung Army Vice Chief of Staff Itagaki Seishirö, Intelligence Section Chief Kawabe Torashirö, and staff officer Tanaka Ryükichi, where he was officially informed for the first time about the Kwantung Army's intention to assist him. On July 25, the Kwantung Army drafted its "Essentials of Policy toward Inner Mongolia," which regarded Japanese support for cooperation between De and Li Xuxin as part of their strategic preparations for a potential conflict with the Soviet Union. Shortly after this policy was adopted, a conflict arose over who had the authority to appoint the head of the Mongol Xukung banner, situated north of the Yellow River and Paot'ou. Following the death of the previous administrator, Prince Xu declared that he had taken control of the position. In response to a request from the local abbot, Prince Yun, acting in his capacity as chairman of the Mongolian Political Council, dismissed Xu. Xu then turned to Nanking through Suiyuan Provincial Chairman Fu Zuoyi, arguing that the central government held the authority to appoint heads of administrative units. In retaliation, Prince De dispatched troops to Xukung. On November 10, Fu presented a mediation proposal, which was rejected since it not only failed to acknowledge Shih's dismissal but also demanded the withdrawal of De's forces. De refused to pull back, further intensifying his hostility toward the Nanking government. In December, the Kwantung Army attempted to move Li's forces from eastern Chahar into the six Xun to the north of Kalgan, which serves as Chahar's granary. Following the Qin-Doihara agreement, Matsui Gennosuke from the Kalgan Special Service Agency secured a deal to separate these six districts from the southern region predominantly populated by Chinese; a Mongolian peace preservation corps was tasked with maintaining order in the northern area, while a Chinese corps was responsible for the south. During the discussions for an autonomous regime centered around Song Queyuan in North China in November 1935, Kwantung Army troops were concentrated around Gubeikou. To exert pressure on Song's rear, the Kwantung Army proposed replacing the Chinese peace preservation unit in the area north of Kalgan with Li Xuxin's army, which would establish this territory as its base.   The operation commenced on December 8. In a surprise attack just before dawn, Li captured Paochang. By December 12, despite facing strong Chinese resistance and the heaviest snowfall in sixty years, Li, aided by Kwantung Army planes disguised as those of the Manchukuo Airline Corporation, had taken control of Kuyuan. Further advances were halted by an order from Kwantung Army headquarters, and on December 13, it was reported that, had the operation not been stopped, Tokyo would have issued an imperial command. The operation had faced opposition from the Tientsin army, which feared it would weaken Song Queyuan's position just as they were informing Tokyo that the autonomy movement was going smoothly. Additionally, both Britain and the United States publicly expressed strong opposition to the Kwantung Army's involvement in the autonomy movement. However, the directive was ultimately prompted by the emperor's anger upon discovering that a unit of the Kwantung Army led by Colonel Matsui Takurö had advanced to Tolun to support Li's progress. Although Li's advance was halted, the operation undeniably contributed to the formation of the Hopei-Chahar Political Council.   Although the operation was halted, the Kwantung Army remained committed to its objectives. They contended that Li's army's advance into the six districts north of Kalgan was merely a peace preservation unit moving into territory within the truce line established by the Tanggu Agreement. Consequently, on December 29, they ordered Li to advance southward. Li peacefully occupied Changpei the following day and entered Shangtu on December 31. Manchukuo civil officials were appointed to oversee the six districts, and the currency of Manchukuo was introduced, although the existing tax system initially remained unchanged. The Kwantung Army allocated silver worth 6 million yuan to support administrative expenses. This outcome, known as the Eastern Chahar incident, marked a complete success for the Kwantung Army, which then redirected its focus toward Suiyuan Province. Each year, the Kwantung Army developed a secret plan for covert operations for the following year. The 1936 plan included strategies to secure air bases for routes connecting Europe and Asia, targeting Tsinghai and Sinkiang provinces, Outer Mongolia, Western Mongolia, and even remote areas of Ningxia province. In January 1936, staff officer Tanaka Ryūkichi formulated a document titled "Essentials of Policy Toward (Northwestern) Inner Mongolia." This document advocated for the establishment of a Mongolian military government to facilitate Japanese operations in northwestern Mongolia and suggested pushing Fu Tso-yi out of Suiyuan into Shansi province. Tanaka's proposals were incorporated into the final plan of the Kwantung Army, ultimately leading to the Suiyuan incident of November 1936. In February 1936, a meeting at Pailingmiao, where Prince De proposed the independence of Inner Mongolia, resulted in the departure of Prince So and several other Mongolian leaders from the coalition. They sought to establish a rival political council at Kueisui under the protection of Fu Zuoyi. By April, De and his supporters decided to form a military government at Tehua in Chahar, which was officially inaugurated in June as the Inner Mongolian government, headed by De with Li Shou-hsin as his deputy. This new government quickly signed a mutual assistance treaty with Manchukuo, and the emperor granted De the title of prince.   In July, at a conference in Tehua, Tanaka was appointed as the head of the Special Service Agency for Inner Mongolia with the mission of implementing the army's Intelligence Section plans. He traveled to Pingtiqüan alongside Chief of Staff Itagaki and Intelligence Chief Mutō Akira to propose a local anti-Communist agreement to Fu. After failing to convince Fu, he attempted to persuade Sun Tien-ying to form a puppet army but managed to recruit only a bandit from Suiyuan, Wang Ying. The February 26 mutiny in Tokyo heightened anti-Japanese sentiments in China, resulting in increased violence. By August, the construction of an airplane hangar in Paot'ou was halted due to riots by local Chinese residents. On August 13, a group of fifteen Japanese, led by Nakajima Manzo, was ambushed while delivering ammunition to a pro-Japanese leader who was shortly thereafter assassinated. Chinese soldiers from Wang Qingkuo's 70th Division carried out the attack, and tensions escalated as the arrival of ammunition and Japanese laborers in Kalgan prompted border villages to strengthen their defenses.   By late September, Tanaka's "Guidelines for the Execution of the Suiyuan Operation" received approval, with operations set to commence in early November. The plan evolved from a covert mission into a personal initiative by Tanaka, financed largely through funds from the Kwantung Army's secret services and profits from special trading in eastern Hopei. Tanaka claimed to have transported 600,000 yen to Tehua in October and later sent 200,000 yuan into Inner Mongolia, estimating total expenses at approximately 6 million yen. He acquired new weaponry from the disbanded Northeast Army and established three clandestine forces: Wang Ying led 500 men, including artillery; Qin Xiashan commanded 3,000 from Sun Tienying's army; and Chang Futang also led 3,000 specialized units. During strategic meetings, Tanaka dismissed proposals for unified command and refusing to integrate secret units into the Mongolian army. He advocated for the slogan "Overthrow Chiang Kai-shek," while Matsui managed to include "Independence for Inner Mongolia."   The Japanese had developed the entire battle strategy. The 1st Army, commanded by Li Xuxin, would serve as the left flank, while the 2nd Army, led by Demchugdongrub, would be positioned on the right. Wang Ying's forces were designated as the central force. Their initial targets would be Hongort, Xinghe, Tuchengzi, and Guisui city, followed by a division to seize Jinging, Baotou, and Hetao. On November 13, Prince Demchugdongrub's and Wang Ying's forces left Shandu in two columns to assault Xinghe and Hongort. By the 15th, 1,500 troops reached Hongort, where they engaged the 1st Cavalry Division led by Peng Yubin. The next day, Ryukichi Tanaka, Demchugdongrub's chief advisor, sent two cavalry brigades and one infantry brigade to capture the town, effectively overrunning its defenders. Meanwhile, Wang Ying dispatched a smaller group to secure Tuchengzi.   Fu Zuoyi established his headquarters in Jining that same day. After assessing the situation, he concluded that if the enemy secured Hongort, it would diminish his defenders' morale. Consequently, he launched a counterattack. Peng Yubin led a joint force of the 1st Cavalry Division and Dong Qiwu's 218th Brigade to confront around 400 of Wang Ying's men defending Hongort and Tuchengzi. By 7 AM on the 18th, Tuchengzi was reclaimed, and at 8:30 AM, the 1st Cavalry Division entered Hongort, charging through 500 of Wang Ying's soldiers. The struggle for Hongort persisted for over three days, resulting in nearly 1,000 casualties before Fu Zuoyi regained control.   As the tide shifted against the invaders, Fu Zuoyi initiated an offensive toward the Bailing Temple, the rear base of the enemy, well-stocked and defended by 3,000 men under Prince Demchugdongrub. Fu Zuoyi ordered the 2nd Cavalry Division, along with the 211th and 315th Brigades, the 21st Artillery Regiment, and a convoy of 20 trucks and 24 armored vehicles to assault the Bailing Temple as quickly as possible. Taking advantage of the Mongolian chaos, Fu Zuoyi's 35th Brigade executed a flanking maneuver west of the Bailing Temple amid a severe snowstorm.   At 1 AM on the 24th, the battle for the Bailing Temple commenced as the Chinese engaged the Mongolians for the fortified positions around the temple. From 2 to 4 AM, the Chinese advanced closer to the temple walls, facing artillery and machine-gun fire. They launched desperate frontal assaults against the city gates, suffering heavy losses. A fierce stalemate ensued, with Japanese aerial bombardments causing significant casualties to the Chinese forces. Fu Zuoyi subsequently ordered all armored vehicles to converge at the main city gate. Despite intense fire, the armored cars managed to breach the gate, allowing Chinese infantry to flood into the temple area. The resulting carnage within the temple walls led to 900 Mongol deaths, with 300 captured as the rest fled. The Chinese suffered 300 casualties but secured the strategically vital rear base, along with a substantial stockpile of provisions, including 500 barrels of petrol, 600 rifles, 10 machine guns, vehicles, and field guns. Following the devastating defeat at Bailing Temple, the invaders regrouped at Xilamuleng Temple. On the 28th, the Japanese sent 100 vehicles to transport 3,000 troops to prepare for a significant counteroffensive to recapture Bailing Temple. On the 29th, Wang Ying personally led 2,000 cavalry north of Shangdu to Taolin in an attempt to contain the enemy. However, after he left the bulk of his forces at Xilamuleng Temple, officers from the Grand Han Righteous Army secretly began negotiating to defect to the Chinese side, undermining the forces needed for the counterattack against Bailing Temple.   The counteroffensive commenced on December 2nd, with 10 armored vehicles and 1,000 Mongol troops leading the charge at 6 AM. They were pushed back by the heavily fortified 211th Brigade, which was well-supplied with machine guns and artillery. The following day, at 3 AM, the Mongols attempted a surprise attack but faced an ambush as they crept toward the temple. They incurred hundreds of casualties, with 230 men either captured or having defected. After this, the counterattack stalled, as the Mongol forces couldn't approach within 3 miles of the temple. Subsequently, the Chinese 2nd Cavalry Division launched a pincer maneuver, causing significant casualties among the invaders. By 9 AM, the enemy had suffered 500 casualties and was in retreat. At 7 PM, Fu Zuoyi ordered another counteroffensive. By the next morning, hundreds more had been lost, and several hundred soldiers were captured. With such heavy losses, the defense of Xilamuleng Temple weakened significantly, prompting more officers to defect to the Chinese. Late on the 4th, Fu Zuoyi assembled a force comprising two cavalry regiments, one infantry regiment, one artillery battalion, four armored vehicles, and a squadron of cars to launch a nighttime assault on Xilamuleng Temple.   Meanwhile, the 2nd Cavalry Division clashed with Wang Ying's cavalry 30 miles northeast of Wulanhua. Wang Ying's 2,000 cavalry had been raiding nearby villages to create diversions, drawing enemy forces away from the Bailing-Xilamuleng theater. By the 9th, Wang Ying's cavalry were encircled in Xiaobei, where they were nearly annihilated, with Wang escaping with around a hundred guards toward Changpei. On the 7th, some Grand Han Righteous Army officers set in motion plans to defect to the Chinese side. Early on the 9th, these officers led their men to invade the residence of Japanese advisors, killing all 27 Japanese officers under Colonel Obama. Simultaneously, Fu Zuoyi's forces executed a flanking maneuver against the Xilamuleng Temple amidst the chaos. With mass defections, the Chinese forces surged into the temple area, resulting in the invader army disintegrating in confusion and surrender. After seizing the temple, the invaders were routed, their lines of communication severed, and only isolated pockets continued to resist. Taking advantage of the confusion, Fu Zuoyi launched simultaneous attacks, attempting to capture Shangdu. However, Yan Xishan sent him a telegram, ordering him to halt, stating that Shangdu fell under the jurisdiction of Shanxi and not Suiyuan.   In response to the loss, Tanaka planned a counteroffensive with Qin's troops, but Chiang kai-shek commanded a strong defense of Pailingmiao, successfully outmaneuvering Tanaka's strategies. The resurgence of Chinese forces led to the disintegration of Qin's troops, who revolted and eventually joined the Nationalist army. The Kwantung Army aimed to redeploy its forces for recovery but faced opposition from Tokyo, which criticized the situation. After Chiang kai-shek was kidnapped by Zhang Xueliang on December 12, Tanaka and Prince De seized the opportunity to reassess their strategy. Ultimately, the Kwantung Army decided to abandon efforts to reclaim Pailingmiao, marking the official end of hostilities on December 21. The Suiyuan incident ultimately strengthened Chinese resolve against Japan and increased international distrust.   The defeat of Japan's proxy forces inspired many Chinese to advocate for a more vigorous resistance against the Japanese. The triumph in Suiyuan was celebrated throughout China and surprised the international media, marking the first occasion where the Chinese army successfully halted a Japanese unit. Delegations traveled from as distant as southern Chinese provinces to encourage the defenders to continue their fight. Captured Japanese weapons and equipment served as proof of Japan's involvement in the conflict, despite Japan's Foreign Minister Hachirō Arita claiming that "Japan was not involved in this conflict in Suiyuan at all." After his defeat, Prince Demchugdongrub and his Inner Mongolian troops retreated to northern Chahar, where he had to reconstruct his army due to significant losses. The Japanese implemented new regulations for the Mongolian Army to enhance its effectiveness, and efforts to recruit new soldiers commenced.   I would like to take this time to remind you all that this podcast is only made possible through the efforts of Kings and Generals over at Youtube. Please go subscribe to Kings and Generals over at Youtube and to continue helping us produce this content please check out www.patreon.com/kingsandgenerals. If you are still hungry after that, give my personal channel a look over at The Pacific War Channel at Youtube, it would mean a lot to me. More incidents and more battles to seize territory raged in North China. However things did not go according to plan for the Japanese and their puppets. The tides had turned, and now a more angry and invigorating China would begin lashing out against the encroachment. It was only a matter of time before a full blown war was declared. 

 JUST DROPPED! The 2025 Genitourinary Syndrome of Menopause (GSM) guidelines are here — and trust us, they're a game-changer for pelvic health pros. Pelvic pain, dryness, urgency, and more — GSM is so much more than just hot flashes.The 2025 Genitourinary Syndrome of Menopause guidelines just dropped — and they're packed with clinical pearls pelvic health OTs can't afford to miss. What's new? What's outdated? What's YOUR role as an OT?We're breaking it all down in this week's episode of the OTS in Pelvic Health Podcast — and let's just say…you'll never look at menopause the same way again. Listen now. Learn more. Lead better. Link in bio.#PelvicHealthOT #GSM2025 #MenopauseMatters #OccupationalTherapy #WomensHealthOT #PelvicFloorTherapy #GSMguidelines #TraumaInformedOT #OTpodcast_______________________________________________________________Podcast: OTs in Pelvic HealthOT Pelvic Health HeadQuarters____________________________________________________________________________________________Pelvic OTPs United - Lindsey's off-line interactive community for $39 a month! Inside Pelvic OTPs United you'll find:​ Weekly group mentoring calls with Lindsey. She's doing this exclusively inside this community. These aren't your boring old Zoom calls where she is a talking head. We interact, we coach, we learn from each other.​ Highly curated forums. The worst is when you post a question on FB just to have it drowned out with 10 other questions that follow it. So, she's got dedicated forums on different populations, different diagnosis, different topics (including business). Hop it, post your specific question, and get the expert advice you need. More info here. Lindsey would love support you in this quiet corner off social media!

Join Tony Bruin and Jack Wilkie in this engaging episode of Cogitations as they delve into the complex topic of cancel culture within the Church. They discuss Jack's controversial article "The Church of Christ Invented Cancel Culture," the difference between biblical discipline and online mob behavior, and their personal experiences with online backlash. Jack also shares insights about his book Church Reset and the challenges of modern Christian leadership. Tune in for a thought-provoking conversation that aims to foster understanding and healthy dialogue within the Christian community.Timestamps:00:00 Introduction and Guest Introduction01:22 Jack Wilkie's Background and Work01:55 Discussion on Church Reset Book04:08 The Church of Christ and Cancel Culture04:52 Personal Experiences with Cancel Culture07:34 The Concept of Cancel Culture in the Church10:07 Debating Doctrinal Differences12:41 Challenges of Church Discipline and Cancel Culture22:49 Social Media's Impact on Church Dynamics43:41 Misuse of Romans 16:17 and Final Thoughts44:27 The Balance of Disagreements45:39 Public Criticism and Qualifications48:20 Social Media and Clout Chasing50:02 Guidelines for Facebook Ministry54:34 Local Church Autonomy56:55 Building on Positive Foundations01:00:04 Determining Public vs. Private Responses01:06:17 Practicing Church Discipline Biblically01:08:12 Engaging in Constructive Dialogue01:09:05 Final Thoughts and Comments

In this episode of the Sky Women's Health Podcast, Dr. Carolyn Moyers, board-certified OB/GYN and Menopause Society Certified Provider, breaks down the newly released 2024 American Urological Association (AUA) Clinical Guideline on Genitourinary Syndrome of Menopause (GSM).

This week, John and Elliot discuss updates to the US Department of Justice corporate enforcement policy, the OCC's priority areas, Transparency International's report on corruption's role in fueling arms diversion, and other items impacting the financial crime prevention community.

1 section- clarification of guidelines for "lashon nekiya" and related stories illustrating this idea

1 section- clarification of guidelines for "lashon nekiya" and related stories illustrating this idea

In today's MadTech Daily, we cover the IAB and MRC's release of draft guidelines for attention measurement, Frasers Group's launch of retail media network ELEVATE, and new research valuing the global podcast industry at USD$7.3bn, more than double previous estimates.

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The FiltrateJoel TopfAC GomezSophia AmbrusoNayan AroraSpecial Guest Charles Edelstein, MD, PhD Professor, Medicine-Renal Med Diseases/HypertensionExtra-Special GuestMichelle Rheault, MD Professor of Pediatrics, University of MinnesotaEditing bySimon and Joel TopfThe Kidney Connection written and performed by by Tim YauShow NotesKDIGO ADPKD Guidelines:WebsiteGuideline PDFExecutive Summary PDFNephJC coverageConsortium for Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP)Hy's Law (Wikipedia) has three components:ALT or AST by 3-fold or greater above the upper limit of normalAnd total serum bilirubin of greater than 2× the upper limit of normal, without findings of cholestasis (defined as serum alkaline phosphatase activity less than 2× the upper limit of normal)And no other reason can be found to explain the combination of increased aminotransferase and serum total bilirubin, such as viral hepatitis, alcohol abuse, ischemia, preexisting liver disease, or another drug capable of causing the observed injuryMeeting this definition yields a very high risk of fulminant kidney failure (76% in one series)Clinical Pattern of Tolvaptan-Associated Liver Injury in Subjects with Autosomal Dominant Polycystic Kidney Disease: Analysis of Clinical Trials Database (PubMed) Two of 957 patients on tolvaptan met Hy's law criteria. None had fulminant kidney failure.Effects of Hydrochlorothiazide and Metformin on Aquaresis and Nephroprotection by a Vasopressin V2 Receptor Antagonist in ADPKD: A Randomized Crossover Trial (PubMed) Patients had a baseline urine volume on tolvaptan of 6.9 L/24 h. Urine volume decreased to 5.1 L/24 h with hydrochlorothiazide and to 5.4 L/24 h on metformin.TEMPO 3:4 Tolvaptan in Patients with Autosomal Dominant Polycystic Kidney Disease (NEJM)Reprise Trial Tolvaptan in Later-Stage Autosomal Dominant Polycystic Kidney Disease ( NEJM | NephJC )Unified ultrasonographic diagnostic criteria for polycystic kidney disease by Edelstein in JASN (PubMed)Tolvaptan and Kidney Function Decline in Older Individuals With Autosomal Dominant Polycystic Kidney Disease: A Pooled Analysis of Randomized Clinical Trials and Observational Studies (PubMed)Charles' draft choice Recommendation 4.1.1.1: We recommend initiating tolvaptan treatment in adults with ADPKD with an estimated glomerular filtration rate (eGFR) ‡25 ml/min per 1.73 m2 who are at risk for rapidly progressive disease (1B).Sophia's draft choice Recommendation 1.4.2.1: We recommend employing the Mayo Imaging Classi cation (MIC) to predict future decline in kidney function and the timing of kidney failure (1B).Progression to kidney failure in ADPKD: the PROPKD score underestimates the risk assessed by the Mayo imaging classification (Frontiers of Science)AC's draft choice Recommendation 9.2.1: We recommend targeting BP to ≤ 50th percentile for age, sex, and height or ≤ 110/70 mm Hg in adolescents in the setting of ADPKD and high BP (1D).HALT-PKD Blood Pressure in Early Autosomal Dominant Polycystic Kidney Disease (NEJM)Nayan's draft choice Recommendation 6.1.2: We recommend screening for ICA in people with ADPKD and a personal history of SAH or a positive family history of ICA, SAH, or unexplained sudden death in those eligible for treatment and who have a reasonable life expectancy (1D).Screening for Intracranial Aneurysms in Patients with Autosomal Dominant Polycystic Kidney Disease (CJASN)Surgical Clipping Versus Endovascular Coiling in the Management of Intracranial Aneurysms (PubMed) Clipping is associated with a higher rate of occlusion of the aneurysm and lower rates of residual and recurrent aneurysms, whereas coiling is associated with lower morbidity and mortality and a better postoperative course.Joel's editorial pick Recommendation 6.1.1: We recommend informing adults with ADPKD about the increased risk for intracranial aneurysms (ICAs) and subarachnoid hemorrhage (1C).Joel's first draft pick The bring out your dead pick:Recommendation 4.3.1: We recommend not using mammalian target of rapamycin (mTOR) inhibitors to slow kidney disease progression in people with ADPKD (1C).Recommendation 4.4.1: We suggest not using statins specfiically to slow kidney disease progression in people with ADPKD (2D).Recommendation 4.5.1: We recommend not using metformin specifically to slow the rate of disease progression in people with ADPKD who do not have diabetes (1B).Recommendation 4.6.1: We suggest that somatostatin analogues should not be prescribed for the sole purpose of decreasing eGFR decline in people with ADPKD (2B).Perfect match: mTOR inhibitors and tuberous sclerosis complex (Orphanet Journal of Rare Diseases)Navitor Pharmaceuticals Announces Janssen Has Acquired Anakuria Therapeutics, Inc. (BioSpace) This is press release about acquiring the mTor1 inhibitor.Joel's second draft pick Recommendation 4.2.1.1: We suggest adapting water intake, spread throughout the day, to achieve at least 2–3 liters of water intake per day in people with ADPKD and an eGFR ≥ 30 ml/min per 1.73 m2 without contraindications to excreting a solute load (2D).Nayan's bonus draft Practice Point 4.7.1: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) should not be used to slow eGFR decline in people with ADPKD.Open-Label, Randomized, Controlled, Crossover Trial on the Effect of Dapagliflozin in Patients With ADPKD Receiving Tolvaptan (KIReports)SMART Trial of GLP-1ra in non-diabetics: Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial (PubMed)Tubular SecretionsNayan: Landman on Paramount Plus (IMDB)Sophia: PassNayan: steps in with The Pitt on HBO (Wikipedia)Charles: The White Lotus, Yellowstone 1923, Poirot (IMDB)AC: The PittMichael Crichton's Estate Sends The Pitt to the Courtroom (Vulture)Joel: I Must Betray you by Ruta Sepetys (Amazon)

Thinking about plastic surgery after weight loss? Wondering if you're mentally ready for the change?In this powerful episode of Bari Connected, host Mel sits down with Dr. Ashley Steinberg, a renowned board-certified plastic surgeon from Houston, to dive into everything you NEED to know before going under the knife post-bariatric surgery.

Is minimally invasive ablation the future of metastatic cancer care? We now have the results of the COLLISION Trial, which investigates the non-inferiority of thermal ablation compared to surgical resection. How will these findings change treatment paradigms and practice patterns around metastatic colorectal cancer? In this week's episode of BackTable, interventional radiologist Dr. Chris Beck discusses the impact and implications of the COLLISION Trial with principal investigator Dr. Martijn Meijerink from Amsterdam UMC.---SYNPOSISThe doctors explore the COLLISION Trial's design, results, complication rates, and future directions. They also cover best practices for ablation techniques and the potential for interventional oncology to enter a “golden era.” Finally, Dr. Meijerink highlights the importance of standardizing intervention quality and being present in tumor boards to ensure optimal patient care.---TIMESTAMPS00:00 - Introduction 03:21 - Understanding Metastatic Colorectal Cancer and IR's Role05:18 - Introduction to the COLLISION Trial07:40 - Radiofrequency vs Microwave Ablation and Technological Advancements09:02 - Trial Design and Patient Eligibility16:20 - Ablation Techniques and Approaches22:05 - Trial Results and Analysis30:19 - Impact on Guidelines and Practice39:44 - Best Practices in Thermal Ablation43:27 - Future Directions in Interventional Oncology---RESOURCES“Surgery versus thermal ablation for small-size colorectal liver metastases (COLLISION): An international, multicenter, phase III randomized controlled trial.” (Meijerink, 2024)https://ascopubs.org/doi/10.1200/JCO.2024.42.17_suppl.LBA3501

Global Crossing Airlines Group confirms cyberattack Google settles privacy lawsuits UK launches software security guidelines  Huge thanks to our sponsor, Vanta Do you know the status of your compliance controls right now? Like...right now? We know that real-time visibility is critical for security, but when it comes to our GRC programs…we rely on point-in-time checks. But more than 9,000 companies have continuous visibility into their controls with Vanta. Vanta brings automation to evidence collection across over 35 frameworks, like SOC 2 and ISO 27001. They also centralize key workflows like policies, access reviews, and reporting, and helps you get security questionnaires done 5 times faster with AI. Now that's…a new way to GRC. Get started at Vanta.com/headlines.

Which imaging techniques should you prioritize for TMD patients? Does a panoramic radiograph hold any value?  When should you consider taking a CBCT of the joints instead? How about an MRI scan for the TMJ? Dr. Dania Tamimi joins Jaz for the first AES 2026 Takeover episode, diving deep into the complexities of TMD diagnosis and TMJ Imaging. They break down the key imaging techniques, how to use them effectively, and the importance of accurate reports in patient care. They also discuss key strategies for making sense of MRIs and CBCTs, highlighting how the quality of reports can significantly impact patient care and diagnosis. Understanding these concepts early can make all the difference in effectively managing TMD cases. https://youtu.be/NBCdqhs5oNY Watch PDP223 on Youtube Protrusive Dental Pearl: Don't lose touch with the magic of in-person learning — balance online education with attending live conferences to connect with peers, meet mentors, and experience the true essence of dentistry! Join us in Chicago AES 2026 where Jaz and Mahmoud will also be speaking among superstars such as Jeff Rouse and Lukasz Lassmann! Need to Read it? Check out the Full Episode Transcript below! Key Takeaways: Imaging should follow clinical diagnosis → not replace it. Every imaging modality answers different questions; choose wisely. TMJ disorders affect more than the jaw → they influence face, airway, growth, posture. Think beyond replacing teeth → treatment should serve function, not just fill space. Avoid “satisfaction of search error” → finding one problem shouldn't stop broader evaluation. Highlights of this episode: 02:52  Protrusive Dental Pearl 06:01 Meet Dr. Dania Tamimi 09:04 Understanding TMJ Imaging 16:00 TMJ Soft Tissue Anatomy  21:04 The Miracle Joint: TMJ Self-Repair 24:26 The Role of Imaging in TMJ Diagnosis 28:15 Acquiring Panoramic Images 39:35 Guidelines for Using Different Imaging Techniques 41:26 Case Study: Misdiagnosis and Its Consequences 45:46 Balancing Clinical Diagnosis and Imaging 50:17 Role of Imaging in Orthodontics 53:18 The Importance of Accurate MRI Reporting 58:27 Final Thoughts on Imaging and Diagnosis 01:00:54 Upcoming Events and Learning Opportunities

Dr. Stanley gives a biblical approach to meditation with helpful strategies and powerful motivators to get you started.

Maintaining a hygienically clean environment is paramount—inside and outside of the operating room. Proper infection control protocols extend beyond the OR—to the hallways, changing rooms, and even our communities. That's why AORN's updated guidelines for surgical attire are so crucial. These standards address the vital role attire plays in minimizing the risk of surgical site infections (SSIs) for patients, while also protecting healthcare workers and preventing the spread of microorganisms throughout the entire healthcare facility. These revisions address everything from lanyards and cell phones to head coverings and shoe covers, reflecting the latest evidence-based research and best practices. This isn't just about what you wear; it's about creating a consistently safe environment for every surgical procedure.Support the showWelcome to the Periop Talk—your go-to vlog and podcast series where we examine the world of perioperative nursing.Episode after episode, we're bringing you professional tips, clinical wisdom, and personal stories that'll make you feel like you're chatting with your work BFFs. Curious about the latest surgical techniques? We got you. Wondering how to navigate the challenges of the periop journey? We're here for that too.Our vlog and podcast series isn't just about sharing information; it's about building a community. Meet the people behind the masks, hear their journeys, and join the rotation of periop professionals making a difference. From students and new nurses to seasoned pros, we've got content for every stage of your perioperative practice.Periop Talk is your peek behind the red line to the world of perioperative nursing. It's not just about the OR – it's about the heart and soul of healthcare. Let's scrub in and share the periop love!Watch us at: (1) Periop Talk vlog - YouTube

Tell us what you think about this podcast!Offerings are an act of faith, obedience, and sacrifice. In Ezra 1, those who couldn't physically rebuild the temple were still expected to support the work through freewill offerings—the first biblical example of a building fund. God's people are called to give willingly and consistently, as shown in Exodus 36, where the people gave so much that they had to be stopped.Offerings should reflect how God has blessed us (Deut. 16:10)—not based on pressure, but from a grateful heart.For more lessons and sermons, follow our YouTube channel at https://www.youtube.com/@GBT

Send us a message with this link, we would love to hear from you. Standard message rates may apply.Safe infant sleep guidelines have reduced SIDS deaths by 50-80% over the last three decades, yet funding for this critical public health campaign is now at risk of being cut.• Explained difference between SIDS (sudden infant death syndrome) and SUID (sudden unexpected infant death)• Described the "triple risk model" that leads to SIDS: vulnerable infant + critical developmental period + external stressor• Detailed the history of the Back to Sleep campaign which began in 1994• Outlined key safe sleep recommendations: babies on backs, firm flat surface, no loose bedding or soft objects• Discussed why co-sleeping increases SIDS risk despite cultural preferences• Clarified that products like Dockatot are not designed for safe sleep• Highlighted that Black and Indigenous communities experience higher SIDS rates• Examined how funding cuts could impact access to life-saving health information• Connected these changes to a broader pattern of removing evidence-based health information from government resourcesCheck out our website, email us at yourcheckuppod@gmail.com with questions or feedback, and most importantly, stay healthy until next time.Support the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski

Join the ASGPodcast as we talk about the Medicare Part B Premium Giveback, how it's been overhyped and misrepresented, and how to stay compliant when talking about it.   Read the text version   Resources: 5 Things About the 2026 CMS MA and Part D Rate Announcement: https://lnk.to/asgf20250411 Do's and Don'ts of Medicare Compliance: https://ritterim.com/blog/dos-and-donts-of-medicare-compliance/ Guidelines for Sharing Personal Beneficiary Data with Other TPMOs: https://lnk.to/asg647 How to Stay Compliant During All Medicare Sales: https://lnk.to/41gE4C What Not to Say During Medicare Educational and Sales Events: https://ritterim.com/blog/what-not-to-say-during-medicare-educational-and-sales-events/   References: “Costs.” Medicare.Gov, Medicare, www.medicare.gov/basics/costs/medicare-costs. Accessed 15 Apr. 2025. “Misleading Medicare Marketing: What to Look Out For.” Ncoa.Org, National Council on Aging, www.ncoa.org/article/misleading-medicare-marketing-dont-be-fooled-during-medicare-open-enrollment/. Accessed 15 Apr. 2025.   Follow Us on Social! Ritter on Facebook, https://www.facebook.com/RitterIM Instagram, https://www.instagram.com/ritter.insurance.marketing/ LinkedIn, https://www.linkedin.com/company/ritter-insurance-marketing TikTok, https://www.tiktok.com/@ritterim X, https://x.com/RitterIM and YouTube, https://www.youtube.com/user/RitterInsurance     Sarah on LinkedIn, https://www.linkedin.com/in/sjrueppel/ Instagram, https://www.instagram.com/thesarahjrueppel/ and Threads, https://www.threads.net/@thesarahjrueppel  Tina on LinkedIn, https://www.linkedin.com/in/tina-lamoreux-6384b7199/   Not affiliated with or endorsed by Medicare or any government agency. Contact the Agent Survival Guide Podcast! Email us ASGPodcast@Ritterim.com or call 1-717-562-7211 and leave a voicemail.

Dr. Stanley gives a biblical approach to meditation with helpful strategies and powerful motivators to get you started.

Dr. Stanley gives a biblical approach to meditation with helpful strategies and powerful motivators to get you started.

Robert F Kennedy leads the "Make America Healthy Again" Commission, focusing on chronic childhood diseases and promoting transparency in federally funded health research.Policy Directives: The commission aims to ensure transparency in health research, prioritize research on the causes of illnesses, expand treatment options, and collaborate with farmers to ensure healthy, affordable food. In this episode, George discusses the new HHS policies and how the average person should be thinking of the bigger picture. https://www.georgebatista.com/what-we-know-about-vaccine-safety-studies/

Dr. Kimberly Perez and Dr. Jaydira Del Rivero discuss the new guideline from ASCO on symptom management for well-differentiated GEP-NETs. They share the latest recommendations on managing symptoms related to hormone excess, including carcinoid syndrome and carcinoid heart disease, managing symptoms of functioning pancreatic neuroendocrine tumors, and also palliative interventions. Dr. Perez and Del Rivero share how to use this guideline in concert with the systemic therapy for tumor control in metastatic well-differentiated GEP-NETs guideline, and hope for the future for the treatment of gastroenteropancreatic neuroendocrine tumors. Read the full guideline, “Symptom Management for Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors: ASCO Guideline.” Transcript This guideline, clinical tools, and resources are available on ASCO.org. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in JCO Oncology Practice.        Brittany Harvey: Hello and welcome to the ASCO Guidelines Podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Kim Perez from Dana-Farber Cancer Institute and Dr. Jaydira Del Rivero from the Center for Cancer Research at the National Cancer Institute, co-chairs on “Symptom Management for Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors: ASCO Guideline.” Thank you for being here today, Dr. Del Rivero and Dr. Perez. Dr. Kim Perez: Thank you. Dr. Jaydira Del Rivero: Thank you so much for the invitation. Brittany Harvey: And then before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Perez and Dr. Del Rivero, who have joined us here today, are available online with the publication of the guideline in JCO Oncology Practice, which is linked in the show notes. So then to jump into the content here, first Dr. Del Rivero, could you provide an overview of the scope and purpose of this guideline? Dr. Jaydira Del Rivero: Yeah. Thank you so much. Well, first, we really wanted to thank ASCO for allowing us to develop these guidelines for the management of gastroenteropancreatic neuroendocrine tumors. I do want to mention that there is also another set of guidelines that I was very fortunate also to co-chair with Dr. Perez on the systemic management of gastroenteropancreatic neuroendocrine tumors. But when discussing these guidelines as well as with the different panelists, experts in this type of disease, we also realized that the management of these tumors are quite complex, not only from the management of the disease progression, but at the same time, management of the symptoms related to the hormone excess. And because of that, we like to thank ASCO for allowing us to then not only have a discussion on the systemic management of these tumors, but at the same time develop recommendations for the symptoms related to the different hormones that these neuroendocrine tumors may produce. These guidelines are for the management of grade 1 to grade 3 metastatic gastroenteropancreatic neuroendocrine tumors. These guidelines include the management of the different aspects and the symptoms related to hormone excess, such as carcinoid syndrome, carcinoid heart disease, how to manage carcinoid crisis, as well as the different symptoms and how to manage the functional pancreatic neuroendocrine tumors and as well as provide recommendations in the different treatments for these tumor types, not only from the systemic management but also from the surgical management as well as for liver-directed therapy options and the different aspects in terms of the palliative care of these patients to improve not only the symptoms related to the hormone excess caused by these tumors, but as well as to improve the quality of life. Brittany Harvey: Absolutely. And I appreciate that overview. And yes, we'll link the guideline on the Systemic Therapy for Tumor Control for Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors in the show notes for our listeners so that they can refer to that companion guideline as well. So then you just described the several different categories of recommendations that this guideline covers on symptom management. So, Dr. Perez, I'd like to start reviewing some of those key recommendations of that guideline. So, starting with what are the key recommendations for carcinoid syndrome and carcinoid heart disease? Dr. Kim Perez: Thank you Brittany. Yeah, I also want to thank ASCO for inviting us to do this podcast today. Just to start, I think these guidelines will really add to what's available in the literature to provide a kind of a quick look for the community provider to manage carcinoid-related symptoms. I think the highlights that I would point out are we've all been using somatostatin analogs for the last few decades to manage symptoms, but with the newer treatments that are now available, we tried to highlight what does the literature support in regards to PRRT, what does the literature support in regards to using systemic therapy for disease management, but also the benefits that you will get from a symptom management perspective using other modalities. I think the highlight really is it's a multidisciplinary approach. We are now considering surgery and embolization or interventional radiology as a critical piece. And I think the third that I'd highlight is the fact that sometimes we get too focused on carcinoid syndrome and the symptoms will actually, may result from other things. And the highlight in the algorithms that we've provided is what other things cause carcinoid-related diarrhea. And let's not forget about that because we will find ourselves treating and patients getting very frustrated with persistence of symptoms when in actuality, we should be treating something else that is causing a very similar symptom. For carcinoid heart disease, I think there are more and more guidelines that are now available to provide guidance there, but I think the major advances are that we should be utilizing heart assessment with echocardiogram with lab values such as BMP. But also critical to this is consulting with our cardiology colleagues and making sure that we're identifying heart related issues that are resulting from hormone excess sooner than later because interventions on the earlier side can really make a significant impact on quality of life and associated comorbidities and mortality. Brittany Harvey: Thank you for reviewing those key points for both carcinoid syndrome and carcinoid heart disease symptom management. So then the next set of recommendations. Dr. Del Rivero, what are the key highlights for symptom management of functioning pancreatic neuroendocrine tumors? Dr. Jaydira Del Rivero: Yes, it's very important to recognize the symptoms related to hormone excess due to pancreas neuroendocrine tumors. Up to 10% of pancreas neuroendocrine tumors may produce different hormones. Among those hormones can be insulin, gastrin, glucagon, somatostatin. So it's important to know and understand that based on what a neuroendocrine tumor is, they may produce different types of hormones. The importance of these guidelines is to also recognize some of these symptoms and how to address that, because it's not necessarily in these tumor types besides the management of metastatic disease, and know the different options that we recommend for metastatic disease from the systemic therapy, such as chemotherapy or targeted therapies or PRRT. It's important to recognize the symptoms because based on the symptoms we may recommend a different approach. That's something that is important to acknowledge and recognize. Moreover, in certain functional pancreas neuroendocrine tumors, as Dr. Perez mentioned, is a multidisciplinary approach. And it's important to also discuss these different cases with your endocrinologist. You may need to have an experienced endocrinologist to manage, for example, the excess of insulin. And also discuss your cases with a surgeon and interventional radiologist because some of these approaches can certainly improve the symptoms related to hormone excess. I understand that sometimes medical oncologists in the communities may not have access to the multidisciplinary approach or have the different teams that can manage these tumors, and that's the reason why with these guidelines we wanted to establish the understanding of different symptoms associated with the hormone excess to these neuroendocrine tumors as well as how to manage this. For example, in the case of insulinoma, I think for the medical oncologist it is important to know that the everolimus is an option to be used for these tumors, not only to manage tumor progressions related to this tumor type at the same time, because everolimus as a side effect causes hyperglycemia, that can also improve some of the symptoms related to the excess of insulin besides the somatostatin agonist. I think these recommendations will allow the medical oncologist to recognize the symptoms and based on what the symptoms cause, then you can have a different approach that could be added to the systemic therapies options as well. Brittany Harvey: Yes, beyond systemic therapy, it's important to be recognizing symptoms to provide an individualized approach for every single patient. So then, following that overview of symptom management for functioning pancreatic neuroendocrine tumors, Dr. Perez, what is recommended regarding palliative interventions for patients with gastroenteropancreatic neuroendocrine tumors? Dr. Kim Perez: Yeah, great question. So I think what's unique to neuroendocrine tumors is that the palliative approach really mirrors what we would be doing for symptom management. Some of these patients are living a very long time with carcinoid related symptoms. And so the approach that we take for the carcinoid symptom control is going to mirror the palliative piece of it. I think for those who develop a burden of disease related symptoms, I think it mirrors what we do across the board for all cancer-related complications. And so I think what we attempted to highlight here and included one of our colleagues who focuses specifically on the field of palliative care and neuroendocrine tumors, was to never really lose sight of what we've been doing to care for symptom management throughout the patient's journey and to always rereview the etiology of the symptoms, ensure that we don't focus solely on carcinoid-related issues, but also the symptom management that we would apply to all patients with cancer-related burden symptoms. Brittany Harvey: Definitely. I think that's a helpful approach to consider when thinking about how to manage these palliative interventions as well. So then Dr. Del Rivero, what should clinicians know as they implement these symptom management recommendations? Dr. Jaydira Del Rivero: Yes, thank you so much for that question. As we have discussed in the last 10 or 15 minutes, we have discussed the different approaches on the management of gastroenteropancreatic neuroendocrine tumors. Clinicians, I think it's important to know that neuroendocrine tumors is a quite complex disease because we're not only addressing the management of tumor growth, but we're also addressing the management of the symptoms related to hormone excess and the complexity associated with that. When medical oncologists or clinicians implement these recommendations it's to understand what symptoms these tumors may cause related to the hormone excess but at the same time, how do we approach those symptoms? As Dr. Perez said that I think is very important is to recognize the different types of diarrhea. It doesn't mean that if the patient has worsening diarrhea, it doesn't mean that this is related to disease progression. So it's important to recognize so that way you can address that, because the type of diarrheas can be related because of the lanreotide or somatostatin agonist, it could be because of the prior surgery. I think it's important to recognize those in order to address the symptom. And the same with the gastroenteropancreatic neuroendocrine tumors. It's important to know what hormones they produce because there are different measurements that may be added to the systemic management of these tumors. I think that there are two aspects here, and that's the reason why these guidelines were implemented in the sense that not only we're going to manage disease progression of these tumors, or how do we manage the metastatic disease of these tumors, but at the same time, how do we manage the symptoms related to the hormone excess and the different complications. Moreover, I think, as we discussed earlier, we need to manage these tumors in a multidisciplinary approach. And something very important is not like one size fits all, because the treatment recommendations, it will depend on different characteristics in terms of the tumor presentations. And hormone excess is one of the important aspects to recognize so that way we can implement these recommendations that will definitely help the quality of life of these patients. Brittany Harvey: Absolutely. And using these guidelines in concert with the systemic therapy guidelines is key. And then beyond this impact for clinicians that Dr. Del Rivero has just outlined, Dr. Perez, what does this new guideline mean for patients with gastroenteropancreatic neuroendocrine tumors? Dr. Kim Perez: Yeah, I think that's an important highlight of this guideline. It really gives patients a voice. I think it recognizes the fact that these symptoms can go unmanaged or mismanaged or just missed, and patients commonly will come in feeling very frustrated and feeling very ill. And I think it will provide them a means to open up a conversation with their providers and say, “Hey, this is what I'm experiencing. Let's talk about what's available. How does this apply to me?” And I think that can be very empowering. I think it's really hard nowadays with so many sources and resources online and patients are really left wondering what are the bullet points that they should be bringing to their clinician appointments? And I think that these guidelines provide them a good framework for those discussions. Brittany Harvey: Yes, bringing these discussion points for patients is very important to be able to have those resources. And we have some patient resources and information available on the website for this guideline and we can link that in the show notes for listeners. So then you've both touched on the importance of this guideline for improving quality of life and we continue to see advancements in this field. So Dr. Del Rivera, what are the outstanding questions regarding symptom management and tumor control for gastroenteropancreatic neuroendocrine tumors? Dr. Jaydira Del Rivero: I have to say whenever somebody asks me that question, the word that I will say is I feel hopeful, because more than 10 years ago we didn't have that many options for gastroenteropancreatic neuroendocrine tumors. And it has been in the last decade or so that there has been more developments in the management of these tumors as well as the understanding of the symptoms related to these tumors. But that said, yes, we do need more therapies for gastroenteropancreatic neuroendocrine tumors. Of the treatment options that we have, we all know in the field that even though we have disease control by using the different options for the systemic management of gastroenteropancreatic neuroendocrine tumors, we need options where we can achieve an objective response, especially for these tumor types. But there is a significant volume of disease and we see a lot of these patients with gastroenteropancreatic neuroendocrine tumors. And now where the field is going is to make some of these therapies more effective, to develop more therapies as well. For example, immunotherapies, a different type of immunotherapy understand the tumor immune microenvironment of these tumors in order to develop therapies as well. From the antibody drug conjugates, I think that's a new way to also address or treat these tumor types, understanding about the different markers found on these tumors that way they can be addressed in different ways. Now with the development of new therapies, I think that's something that can help us as well not only have disease control and as well as having an objective response, but having a better objective response can certainly also help with the symptoms related to hormone excess too. In terms of other therapies, I think some of the issues that we encounter are like the refractory carcinoid diarrhea and how do we manage this. We do have therapies that can help us control the diarrhea in the refractory settings, such as telotristat. Telotristat is one of the newer medications that can help us control the refractory diarrhea. But that said, despite this, that we still encounter situations where it's sometimes difficult to control. I think in those situations it will be good to understand more about the biology of these tumors as well and how we manage. If there is a different time or how do we implement these options. I think there is so much to learn. But that said, I feel we're in hopeful times. We're understanding more about these tumors so that way we can help us develop better therapies not only to have control of the tumor growth as well having control of the symptoms. And it's the same with the pancreas neuroendocrine tumors in the metastatic setting. Sometimes it may be difficult to control this hormone excess. But understanding these and having therapies that can achieve more of an objective response, I think that will definitely help us more and manage these patients. But one aspect I want to mention, and Dr. Perez also mentioned as well, the fact that we have these guidelines that help us understand about the different symptoms related to hormone excess and how to address it, I think is very important because having symptoms related to hormone excess can be detrimental to the quality of life on patients with neuroendocrine tumors that may necessarily be related to disease progression and having this information is so important. And I'm hopeful for the different therapies. There's different clinical trials ongoing for neuroendocrine tumors and especially in the field of PRRT. And a lot of more information will come with the different alpha-PRRT and combination therapy. So more information to come in the next couple of years. So this is, in my opinion, hopeful times for this field. Brittany Harvey: It's great to hear that you're hopeful for all the developments in this field and we'll look forward to the development and discovery of new therapies and further research and then, hopefully incorporate those updates into guidelines in the future. So I want to thank you both so much for your work to develop these guidelines and thank you for your time today. Dr. Del Rivero and Dr. Perez. Dr. Jaydira Del Rivero: Thank you so much for having us. Dr. Kim Perez: Thank you. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/gastrointestinal-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

This episode of ACCESS, the official podcast of Stroke: Vascular & Interventional Neurology, provides an overview of the 1st and 2nd issue of 2025. Highlights of the journal with summaries of the latest advances in vascular and interventional neurology by Editor-in-Chief, Dr. Ashutosh Jadhav followed by a discussion with Dr. Lauren Sansing, Dr. Bijoy Menon, Dr. Robert Regenhardt  and Dr. Vivek Yedavalli on the ground breaking research discussed at ISC 2025 held in Los Angeles.  https://www.ahajournals.org/do/10.1161/podcast.20250423.30226/full/  

Today we speak with award-winning native garden designer Marie Chieppo about how to reduce your lawn in order to introduce more native plants as well as creating a soft landing for insects under trees. Order Marie's new book, Guidelines for Cape-Friendly Landscapes, at: ecoplantplans.com. Join Catherine Greenleaf, a certified wildlife rehabilitator with 20 years of experience rescuing and rehabilitating injured wildlife, for twice-monthly discussions about restoring native habitat and helping the birds in your backyard. Access the BIRD HUGGER Newsletter here: www.birdhuggerpodcast.com. Send your questions about birds and native gardening to birdhuggerpodcast@gmail.com. (PG-13) St. Dymphna Press, LLC.

On this episode of the Pain Pod, we discuss the details of the PhARM OUD Guidelines with our special guest Dr. Tyler Varisco. We're ready to dive into buprenorphine in community pharmacies, so buckle up and enjoy the ride! Come one, come all, to the Pain Pod!!! PhARM OUD Guidelines • https://forefdn.org/grantee-spotlight-engaging-community-pharmacists-in-improving-treatment-outcomes-for-patients-with-opioid-use-disorder/  Pain Guy • www.painguy.us • PhARM OUD Guideline Link on Pain Guy Website: https://painguy.us/resources  

Sean “Diddy” Combs' case is unfolding within the strict architecture of the federal criminal justice system, meaning every stage—from indictment through sentencing—is governed by the same procedural and constitutional rules described above. His arrest followed a lengthy investigation, likely involving sealed warrants, grand jury subpoenas, and cooperation from multiple agencies. Once federal authorities gathered enough evidence to establish probable cause, a grand jury returned an indictment, triggering his initial appearance in federal court. There, issues like bail, representation, and pretrial release were addressed under the Bail Reform Act. With a trial date now scheduled, the case has moved past the early procedural phases and is entering the critical stages of pretrial motions and evidentiary challenges, including potential Rule 12 motions by the defense to suppress evidence or challenge the sufficiency of the indictment.As Diddy's federal trial begins today, he now faces the full weight of the government's case under the high-stakes adversarial structure of federal criminal procedure. With plea negotiations reportedly rejected, the prosecution must now prove its allegations beyond a reasonable doubt before a jury. The courtroom will become a battleground for evidentiary rulings, cross-examinations, and strategic maneuvering, all governed by the Federal Rules of Evidence and Criminal Procedure. Defense counsel will work to undermine the government's witnesses, challenge the admissibility of key materials, and inject doubt into the narrative being presented. If convicted, Diddy would then move into the sentencing phase, where the U.S. Probation Office will prepare a Presentence Investigation Report factoring in conduct enhancements and criminal history to produce an advisory Guidelines range. His sentence would ultimately be shaped by both the Guidelines and the judge's application of the § 3553(a) factors—bringing the full machinery of federal prosecution to bear.to contact me:bobbycapucci@protonmail.com

Sean “Diddy” Combs' case is unfolding within the strict architecture of the federal criminal justice system, meaning every stage—from indictment through sentencing—is governed by the same procedural and constitutional rules described above. His arrest followed a lengthy investigation, likely involving sealed warrants, grand jury subpoenas, and cooperation from multiple agencies. Once federal authorities gathered enough evidence to establish probable cause, a grand jury returned an indictment, triggering his initial appearance in federal court. There, issues like bail, representation, and pretrial release were addressed under the Bail Reform Act. With a trial date now scheduled, the case has moved past the early procedural phases and is entering the critical stages of pretrial motions and evidentiary challenges, including potential Rule 12 motions by the defense to suppress evidence or challenge the sufficiency of the indictment.As Diddy's federal trial begins today, he now faces the full weight of the government's case under the high-stakes adversarial structure of federal criminal procedure. With plea negotiations reportedly rejected, the prosecution must now prove its allegations beyond a reasonable doubt before a jury. The courtroom will become a battleground for evidentiary rulings, cross-examinations, and strategic maneuvering, all governed by the Federal Rules of Evidence and Criminal Procedure. Defense counsel will work to undermine the government's witnesses, challenge the admissibility of key materials, and inject doubt into the narrative being presented. If convicted, Diddy would then move into the sentencing phase, where the U.S. Probation Office will prepare a Presentence Investigation Report factoring in conduct enhancements and criminal history to produce an advisory Guidelines range. His sentence would ultimately be shaped by both the Guidelines and the judge's application of the § 3553(a) factors—bringing the full machinery of federal prosecution to bear.to contact me:bobbycapucci@protonmail.com

Sean “Diddy” Combs' case is unfolding within the strict architecture of the federal criminal justice system, meaning every stage—from indictment through sentencing—is governed by the same procedural and constitutional rules described above. His arrest followed a lengthy investigation, likely involving sealed warrants, grand jury subpoenas, and cooperation from multiple agencies. Once federal authorities gathered enough evidence to establish probable cause, a grand jury returned an indictment, triggering his initial appearance in federal court. There, issues like bail, representation, and pretrial release were addressed under the Bail Reform Act. With a trial date now scheduled, the case has moved past the early procedural phases and is entering the critical stages of pretrial motions and evidentiary challenges, including potential Rule 12 motions by the defense to suppress evidence or challenge the sufficiency of the indictment.As Diddy's federal trial begins today, he now faces the full weight of the government's case under the high-stakes adversarial structure of federal criminal procedure. With plea negotiations reportedly rejected, the prosecution must now prove its allegations beyond a reasonable doubt before a jury. The courtroom will become a battleground for evidentiary rulings, cross-examinations, and strategic maneuvering, all governed by the Federal Rules of Evidence and Criminal Procedure. Defense counsel will work to undermine the government's witnesses, challenge the admissibility of key materials, and inject doubt into the narrative being presented. If convicted, Diddy would then move into the sentencing phase, where the U.S. Probation Office will prepare a Presentence Investigation Report factoring in conduct enhancements and criminal history to produce an advisory Guidelines range. His sentence would ultimately be shaped by both the Guidelines and the judge's application of the § 3553(a) factors—bringing the full machinery of federal prosecution to bear.to contact me:bobbycapucci@protonmail.com

We put on our space cowboy outfits for this great episode! The main topic centered on the almost-ubiquitous use of higher carb intakes in recent races, from the Canyons 100k to the Boston Marathon to the cycling classics. What once seemed optional is now mandatory. Where do the next breakthroughs come from? We outline some ideas to try to catch the waves before they become obvious.There was also some fascinating science on warm-weather and metabolic processes, showing reduced carb oxidation rates in heat. That could have big implications for how fueling and GI training changes with harder efforts.And this one was full of the best topics! Other topics: Megan's heat suit debut, our current thinking on heat suit guidelines, David's 50k race, what he is learning approaching Western States, fluid intake, a study on intense PM exercise and sleep, the wild Canyons 100k, Kilian's fascinating training approach for Western States, a follow-up on the shoes dominating the road scene, the Breaking 4 Project, and putting power in your stride, plus a Q+A on steep vert, Jess McClain's Boston Marathon training, and fueling from gas stations!You are all heat champions to us. May you be blessed with the stickiest treadmills.We love you all! Huzzah!-Megan and DavidClick "Claim Reward" for free credit at The Feed here: thefeed.com/swap Buy Janji's amazing gear: https://janji.com/ (code "SWAP")For weekly bonus podcasts, articles, and videos: patreon.com/swap