Podcasts about guidelines

This year we are doing my group coaching course together via this podcast! It's free and it only gets better as the year progresses.  In January we began with God at the center of our day and our home. We worked to build the habit of a morning prayer routine. I highly recommend the rosary. It's only about 20 minutes and you'll meditate on the whole life of Jesus. February is the month of decluttering. Saturday episodes have been added to focus on decluttering in the kitchen. Each month will have a different focus area and the Saturday episodes will help you focus on one small section of that room.  If you're new here, welcome and give this first episode of 2026 a listen to hear where to begin: 316. Your 2026 Life Overhaul Plan: Faith, Clutter, Debt, Diet and More!  If you've never prayed a rosary or you want to see how you can incorporate it into active decluttering, here is the first episode of my rosary declutter series from last summer. 288. Summer Declutter Series Week Just getting started on your decluttering journey? Give this episode a listen before you begin: 322. Guidelines to Decluttering ***Are you so overwhelmed with clutter that you find yourself unable to make any decisions? Do you plan on decluttering only to find yourself standing in a room confused about where to start? Are you hoping motivation will strike and you'll get it all done in one weekend? If this sounds like you, let's work together. Book a one hour virtual coaching session via Zoom. Together we craft a decluttering plan and I walk you through the process. You'll complete much of the decluttering on your own time at your own pace. I just give you the roadmap and the accountability. Cost $77 per hour. Virtual Coaching Schedule   Not sure what you need? No problem! Book a complimentary 15 minute clarity call. We'll meet via Zoom and see if working with me would benefit you.  Email me at: tightshipmama@gmail.com to schedule a time.   Looking for community of like-minded women? Join the private Facebook community here: Facebook Group   Prefer to receive a weekly email with the monthly freebie like a group rosary, group declutter, or budget Q&As?  Join my mailing list here: Monthly Newsletter   For any other inquiries or guest appearances, please email me at: tightshipmama@gmail.com

Send us a message!In this episode we will be covering Facebook Live Questions 2/10-2/24/26  from Dana's free Facebook Group Registered Dietitian Exam Study Group with Dana RD!Check out the Practice Questions Program here.  Grab the Acronym flashcards here.Get the free RD Exam Prep Masterclass here. test out the recorded classes with the Free Trial.  Looking for additional tutoring service? Visit my website! Shop all recorded courses at https://danajfryernutritiontutoring.teachable.comJoin the RD Exam Prep Mastery Program for access to the Situational Practice Questions,  Key Topics Review, Vocab Classes, Wed 8pest Group tutoring , study guides and a new trouble area video each week!Need a Crash Course before your exam? Check out the 4 part Pre-Exam Crash Course: Key Topics Review.

Welcome to the Wholesale Hotline Podcast Weekend Edition (Flipping Mastery Edition), where Jerry teaches how to master the art of house flipping, wholesaling, and new construction development.Show notes -- in this episode we'll cover:Straightforward, step-by-step training on making six and seven figures from real estate deals.Insider tactics for finding motivated sellers, analyzing deals, and raising private money.Learn how to flip houses virtually from anywhere—even with zero experience.Whether you're a beginner or scaling up, Jerry gives you the blueprint to build real wealth through real estate.  Please give us a rating and let us know how we are doing!➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖ ☎️ Welcome to Wholesale Hotline & Flipping Mastery Breakout! ☎️Jerry Norton went from digging holes for minimum wage in his mid 20's to becoming a millionaire by the age of 30. Today he's the nation's leading expert on flipping houses and has taught thousands of people how to live their dream lifestyle through real estate. **NOTE: To Download any of Jerry's FREE training, tools, or resources…Click on the link provided and enter your email. The download is automatically emailed to you. If you don't see it, check your junk/spam folder, in case your email provider put it there. If you still don't see it, contact our support at: support@flippingmastery.com or 888) 958-3028. ➖➖➖➖➖➖➖➖➖➖➖➖➖➖➖ 

Dr. Andy Southerland and Dr. Shyam Prabhakaran explain the significance of these guidelines and why they are important.  Show citation:  Prabhakaran S, Gonzalez NR, Zachrison KS, et al. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke. Published online January 26, 2026. doi:10.1161/STR.0000000000000513  Show transcript:  Dr. Andy Southerland: Hello everyone. This is Andy Southerland from the University of Virginia. And for this week's Neurology Minute, I've just been speaking with my colleague, Shyam Prabhakaran, from the University of Chicago, who was the Chair of the 2026 AHA/ASA guidelines for the early management of patients with Acute Ischemic stroke published in the January 2026 online version of the journal, Stroke. So Shyam, in our brief Neurology Minute today, why don't you just give a plea about why these guidelines are so important? Dr. Shyam Prabhakaran: Thanks, Andy. These guidelines are the first guidelines since 2019, so a lot has happened. So when you look at these guidelines, you'll see a lot of new recommendations. In fact, I think the majority have been revised in some way or another. And I'd point to the actual guideline document, which is in the journal Stroke online January '26, and the print version will be for the March edition of the journal Stroke. In addition to that, I'd say because you want to have interpretability and ease of practice, there are a bunch of derivatives on the AHA website that are very useful. They include case studies, they include figures and workflows that could be really useful for you to have these conversations. And there's even a slide deck that was prepared by our AHA ambassadors. There are these young whippersnappers that did a great job putting together a slide deck for anyone to use. They can use that to have conversations locally or anywhere they want. I encourage people, read the guidelines, but then also use the derivative products that people spent a lot of time on developing. Dr. Andy Southerland: Thank you, Shyam. I think that's a great message from the Chair of the writing group, that when you look at these guidelines, they can seem daunting. But the way you all have provided all these additional resources and analogs for people to interpret it and apply it in their own stroke centers and practice, I think folks definitely will be running out to do that, just to seek out the full guideline, and let's apply all this great new evidence to better care for our patients. So Shyam, thanks again for joining us for this week's Neurology Minute. 

New AHA/ACC guidelines overhaul pulmonary embolism management with a five-tier risk classification, endorsing ED discharge for low-risk patients and DOACs as first-line therapy. A JAMA trial confirms IV acetaminophen adds modest but real pain relief when combined with morphine. A large cohort study shows SGLT2 inhibitors dramatically reduce kidney, cardiovascular, and liver complications in diabetic cirrhosis patients.

Dr. Andy Southerland talks with Dr. Shyam Prabhakaran about the 2026 AHA/ASA guidelines for the early management of acute ischemic stroke, highlighting key recommendations, the role of advanced imaging, and the importance of thrombolysis and thrombectomy.  Read the related article in the journal Stroke.  Disclosures can be found at Neurology.org. 

In this episode, Dr. Cristina Castagnini sits down with Binge Eating Recovery Coach Stefanie Michele to discuss the alarming parallels between modern "wellness" food guidelines and eating disorder behaviors. They dismantle the fear-mongering around carbohydrates, the elitism of "clean eating," and the dangers of new inverted food pyramid trends that demonize essential macronutrients. Stefanie shares her personal 25-year battle with eating disorders and how she finally found recovery at age 40. Together, they explore the dangerous intersection of GLP-1 medications and restrictive diet culture, offering a compassionate perspective on why you might feel stressed about food and how to find your way back to balance. SHOW NOTES: Click here Follow me on Instagram: https://www.instagram.com/behind_the_bite Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode of Curiosity Killed the Plaque, Spring Hatfield, RDH, BSPH, looks at oral health and pregnancy.Like this show? Leave us a review on your favorite podcasting app!Need CE? Start earning CE credits today at ⁠⁠⁠https://rdh.tv/ce⁠⁠⁠ Get daily dental hygiene articles at ⁠⁠⁠https://www.todaysrdh.com⁠⁠⁠ Follow Today's RDH on Facebook: ⁠⁠⁠https://www.facebook.com/TodaysRDH/⁠⁠⁠Follow Kara RDH on Facebook: ⁠⁠⁠https://www.facebook.com/DentalHygieneKaraRDH/⁠⁠⁠Follow Kara RDH on Instagram: ⁠⁠⁠https://www.instagram.com/kara_rdh/⁠

Dr. Lakshmi Rajdev and Dr. Manish Shah join the podcast to discuss the updated guideline on immunotherapy and targeted therapy in unresectable locally advanced, advanced, or metastatic gastroesophageal cancer. They share first-line and subsequent-line recommendations for both gastroesophageal adenocarcinoma and esophageal squamous cell carcinoma based on actionable biomarkers including PD-L1 expression, MMR and/or MSI, CLDN18.2 expression, and HER2 status. They note the importance of the algorithms and tables in the guidelines that provide visual illustrations and quick reference guides of the evidence-based recommendations. They also comment on ongoing and recently presented trials that may impact future guidelines in this space. Read the full guideline, "Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline Update" at www.asco.org/gastrointestinal-cancer-guidelines" TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/gastrointestinal-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology,  https://ascopubs.org/doi/10.1200/JCO-25-02958      Timestamps ·       00:00 – 02:15 Introduction and Overview ·       02:16 - 08:20 First-line treatment for patients with pMMR/MSS, HER2-negative gastroesophageal adenocarcinoma ·       08:21 –10:29 First-line treatment for patients with pMMR/MSS, HER2-positive gastroesophageal adenocarcinoma ·       10:30 – 14:39 First-line treatment for patients with dMMR/MSI-H, gastroesophageal adenocarcinoma ·       14:40 – 18:03 First-line treatment for ESCC ·       18:04 – 22:04 Second- and third-line therapy for gastroesophageal adenocarcinoma and ESCC ·       22:05 – 24:38 Importance of guideline ·       24:39 – 27:45 Outstanding questions and future research   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 am interviewing Dr. Lakshmi Rajdev from the Icahn School of Medicine at Mount Sinai and Dr. Manish Shah from Weill Cornell Medicine, co-chairs on "Immunotherapy and Targeted Therapy for Advanced Gastroesophageal Cancer: ASCO Guideline Update." Thank you for being here today, Dr. Rajdev and Dr. Shah. Dr. Lakshmi Rajdev: Thank you. Dr. Manish Shah: Thank you for having us. It is wonderful. Brittany Harvey: And then just before we discuss this guideline, I would 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. Rajdev and Dr. Shah, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then to dive into what we are here today to talk about, Dr. Shah, I would like to start first with what prompted the update to this guideline, which was previously published in 2023, and what is the scope of this updated guideline? Dr. Manish Shah: Yes, terrific. So even in the last few years, the pace of drug development in gastroesophageal cancers has just been astounding. So, what prompted this guideline is actually the practice-changing results for a new biomarker, CLDN18.2 hat was based on the GLOW and SPOTLIGHT studies, as well as a practice-changing study in HER2-positive disease where we added pembrolizumab to trastuzumab and chemotherapy for tumors that are HER2-positive and PD-L1 CPS 1 or greater. And then there were also new studies and new approvals in esophageal squamous cell cancer that you will hear about as well. So there were several studies, overall more than 5,000 patients were reported on, and that led to several new therapies, new indications, and it really necessitated this guideline. Brittany Harvey: Excellent. It is great to hear about all of these exciting updates in this space. So then to next review the key recommendations of this guideline by clinical question that the expert panel addressed. So, Dr. Rajdev, what is the recommended first-line treatment for patients with proficient mismatch repair, microsatellite stable, HER2-negative gastroesophageal adenocarcinoma? Dr. Lakshmi Rajdev: Thank you for that question. So historically, we have sort of used fluoropyrimidine and platinum doublets, which yielded a survival of about one year. More recently, immunotherapy and targeted therapy options have improved outcomes in patients with advanced esophageal and gastric adenocarcinoma, as well as squamous cell carcinoma. Patients with gastric and GE junction adenocarcinoma have a high rate of actionable alterations, so it is imperative that physicians test the following biomarkers upfront so that it can help guide therapy. The markers recommended by the ASCO panel are HER2, MMR or MSI, CLDN18.2, and PD-L1. And also, it was recommended to use NGS if feasible in this patient population. HER2, as we know, is expressed in about 15% to 25% of patients; PD-L1 expression occurs in about 80% of patients; MSI-high, deficient MMR is present in about 5% to 8% of patients; and CLDN18.2 expression is present in about 40% of patients. There is, of course, biomarker overlap. About 13% to 22% of CLDN18.2 patients are also PD-L1 positive. For patients with pMMR or microsatellite stable HER2-negative disease with PD-L1 expression greater than 1 and absence of CLDN18.2, the panel recommended a first-line therapy with fluoropyrimidine and platinum-based therapy in combination with immunotherapy. These recommendations stem from large phase 3 trials, and the agents approved in the United States are pembrolizumab, nivolumab, and tislelizumab. It has been shown that immunotherapy benefit is greater in patients with higher PD-L1 expression, and it is not possible to comment on the individual PD-L1 cutoff scores and sort of identify the optimal PD-L1 cutoff score that sort of balances benefits and harms. But what is recommended is that immunotherapy-based treatments can be offered in patients with a CPS score of greater than 1. With regard to the choice of immunotherapy agents, that is pembrolizumab, nivolumab, or tislelizumab, these agents are considered to have similar efficacy, and the selection of an agent could be based on dosing schedule, cost considerations, toxicity, and the method of administration. Typically, clinicians should avoid withholding the start of chemotherapy while awaiting biomarker testing, depending on the clinical scenario. Now, for patients with pMMR microsatellite stable disease that is HER2-negative with PD-L1 expression less than 1 and positive CLDN18.2 expression, zolbetuximab-based treatments or in combination with chemotherapy is recommended, and this is based on two global phase III randomized controlled trials, the GLOW and the SPOTLIGHT. And across both studies, the hazard ratio for the overall survival was 0.78, and similarly, there was also an improvement in progression-free survival favoring the zolbetuximab group compared to the chemotherapy group alone. An important note is that nausea, vomiting is commonly associated with zolbetuximab-based treatments, and the panel recommended prophylactic antiemetics, adjusting zolbetuximab infusion rates, pausing infusion temporarily, using non-prophylactic antiemetics, and hydration intravenously prior to discontinuation of zolbetuximab-based chemotherapy. So effective handling of the GI-related symptoms with zolbetuximab is recommended prior to discontinuation of therapy. Now, for patients with pMMR microsatellite stable HER2-negative gastric, GE junction adenocarcinoma with PD-L1 expression greater than 1 and CLDN18.2 positivity, the ones with the dual expression with CLDN18.2 as well as PD-L1 chemotherapy, the choice of therapy can be based on the degree of PD-L1 expression, the toxicity profile, the burden of symptoms, and the anticipated improvement in symptoms associated with response to treatment, the patient comorbidities, the prior medical and treatment history. So this decision needs to be made on a case-by-case basis, and these are some of the factors that we suggested that could potentially influence the choice of therapy. For patients with pMMR microsatellite stable disease that is HER2-negative and a PD-L1 expression less than 1 and an absence of CLDN18.2 expression, first-line therapy with fluoropyrimidine and platinum-based chemotherapy is recommended. So you can see we have segmented out patients based on PD-L1 expression, pMMR and microsatellite stable disease expression, and also based on CLDN expression. Brittany Harvey: Absolutely. And that first point you noted, I think is really important, that biomarker testing is really critical for treatment decision-making in this space. So then the next subgroup of patients that the panel looked at, Dr. Shah, what first-line therapy is recommended for patients with proficient mismatch repair, microsatellite stable, HER2-positive gastroesophageal adenocarcinoma? Dr. Manish Shah: So this was an update from a few years ago. So we have known for 15 years now that if you are HER2-positive, you should get trastuzumab plus chemotherapy. That was based on the ToGA trial. And the update now is based on a trial called KEYNOTE-811, where it examined the addition of pembrolizumab to trastuzumab and chemotherapy versus trastuzumab and chemotherapy, and there was a progression-free and overall survival benefit. And again, here, the biomarkers are important. If your CPS PD-L1 is less than 1, we would not recommend Pembrolizumab in that setting, so you would still get trastuzumab and chemotherapy. But if it is 1 or greater, the PD-L1 CPS score, then we do recommend pembrolizumab unless there is a contraindication to immunotherapy. The take-home message really is from the onset of diagnosis, please check your biomarkers. And I will just, it is worth repeating, it is important to check your PD-L1 status, HER2 status, mismatch repair status, and CLDN18.2 status. And then the optimal therapy, and it is outlined in the publication, is really biomarker-driven. We know that if we are able to hit the target that is overexpressed, we are going to have a better outcome. And Dr. Rajdev did mention where there is overlap, there can be a lack of data, and that is where we are with both PD-L1 positive and CLDN positive. Here we do have data in HER2-positive cases where if you are both HER2-positive and PD-L1 positive, you would combine trastuzumab and pembrolizumab for the best outcomes. Brittany Harvey: Understood. I really appreciate you detailing what is most important for each individual biomarker combination that patients may have. So then following that, Dr. Rajdev, what does the expert panel recommend for first-line treatment for patients with esophageal squamous cell carcinoma that is not amenable to definitive chemoradiation? Dr. Lakshmi Rajdev: There are three phase III randomized clinical trials that have influenced practice in patients with esophageal squamous cell carcinoma examining the benefit of immunotherapy in this patient population. The RATIONALE-306 was a randomized trial of tislelizumab plus chemotherapy with platinum and fluoropyrimidine or paclitaxel versus placebo with chemotherapy. And then you have the KEYNOTE-590, which compared pembrolizumab plus chemotherapy versus chemotherapy alone. And then you have CheckMate-648, which included comparisons of nivolumab plus chemotherapy versus nivolumab plus ipilimumab or chemotherapy. And the primary endpoints for these studies were overall survival, and they did look at subgroups with PD-L1 expression. They used TPS score greater than 1% in CheckMate-648 and PD-L1 CPS greater than 10 in KEYNOTE-590. The bottom line is that the overall hazard ratio for overall survival across this patient population was 0.72. So clearly, there is benefit in patients that express PD-L1 CPS greater than 1 for benefit for the addition of immunotherapy. Now, the benefit again in patients with a PD-L1 expression less than 1 remains limited, and so the panel has made a recommendation for using immunotherapy in combination with platinum-based chemotherapy in patients with a PD-L1 greater than 1. Again, we know that it is hard to make recommendations on what PD-L1 cutoffs are recommended in this patient population, meaning that should it be limited to patients with a PD-L1 of 1 to 4 or greater than 10? I think that the general consensus that has been gleaned from the data is that the higher the PD-L1 expression, the greater the benefit. I do want to comment on another option that is available in patients with squamous cell carcinoma compared to adenocarcinoma, and that is the combination of nivolumab and ipilimumab. Now, in CheckMate-648, nivolumab with ipilimumab was also recommended as a treatment option in patients that have a PD-L1 score of greater than 1. There was a survival benefit demonstrated with this combination compared to chemotherapy alone. And an important observation in this study is that, although there was a slightly increased rate in early death, but there was really no significant difference in PFS and OS compared to chemotherapy alone. Importantly, the treatment appeared to be pretty well tolerated by the study population. There was a notable difference in the objective response rate, which was 35% in the nivolumab plus ipilimumab group compared to patients receiving nivolumab and chemotherapy, where it was 53%. So superiority is, so the importance of chemotherapy in patients with esophageal squamous cell carcinoma is to be noted. However, there is no difference in overall survival and progression-free survival when using the combination of nivolumab and ipilimumab, and thus it affords a chemotherapy-free option for this patient population with esophageal squamous cell carcinoma and a CPS with a score of greater than 1. Brittany Harvey: Understood. I appreciate you reviewing the evidence underpinning those recommendations as well. So then the next patient population that the guideline panel addressed, what first-line therapy is recommended for patients with deficient mismatch repair, microsatellite instability-high, gastroesophageal adenocarcinoma or esophageal squamous cell carcinoma? Dr. Lakshmi Rajdev: The rate of MSI-high expression is about 3% to 7% across different studies. Now, the KEYNOTE-158 was a tumor-agnostic study in patients with non-colorectal cancers, and again, the problem with the MSI-high population, given that it is so rare, the numbers in the individual studies are fairly small. But consistent outcomes do emerge, indicating high response to immunotherapy. So in KEYNOTE-158, a response rate of about 46% was noted. The number of patients was small, it was about 24. In CheckMate-649, which is a study of chemotherapy plus or minus nivolumab in patients with advanced gastric adenocarcinoma, there was again a very small number of patients, and patients that were MSI-high or deficient MMR did experience substantial benefits with the addition of immunotherapy, with hazard ratios in the order of about 0.38. In KEYNOTE-062, again, it was a very small number of patients, again about 6% or so, and similar to CheckMate-649, a substantial benefit was noted in combination with chemotherapy, but also there were benefits noted with pembrolizumab alone. The RATIONALE-305 again was a study of tislelizumab in combination with chemotherapy and similarly showed benefits to the combination of chemotherapy plus immunotherapy in this patient population. I think that we are all aware of the dramatic benefits of immunotherapy in this particular subset of patients, deficient MMR MSI-high, and also we have seen in CheckMate-649 they did have a subset of patients that received nivolumab and ipilimumab. And in this patient population, they noted unstratified hazard ratio of 0.28. So I think that the overall consensus is that immunotherapy is a very important treatment modality in patients with deficient MMR MSI-high disease, given that a lot of the trials in gastroesophageal adenocarcinoma have utilized chemotherapy-based options, that is certainly a recommendation of the panel to use chemotherapy in combination with immunotherapy. However, on a case-by-case basis, the panel recommended immunotherapy alone as well, and given the high response rates noted in trials across different diseases as well as noted in this disease as well. Brittany Harvey: Certainly. And I appreciate you both for reviewing these first-line recommendations. So moving to later lines of therapy, Dr. Rajdev, what recommendations did the expert panel make for second or third-line therapy for gastroesophageal adenocarcinoma and esophageal squamous cell carcinoma? Dr. Lakshmi Rajdev: So, I think that the RAINBOW trial that investigated the utility of the addition of ramucirumab as second-line therapy has been around since 2014, and those results have led to the addition of ramucirumab to taxane-based therapy in the second-line setting. Based on the utilization of oxaliplatin and platinum-based therapy in the front-line setting, there may be patients that have an underlying neuropathy, and so we wanted to really include treatment options for this patient population so that an agent that is less neurotoxic could also be recommended in combination with ramucirumab. The RAMIRIS trial is one such trial where ramucirumab was combined with FOLFIRI, and it demonstrated benefit in combination with ramucirumab. So we have listed that as a potential treatment option for patients in the second-line setting who may have an underlying neuropathy or even for whatever reason that based on the toxicity profile, that needs to be the preferred option by a physician, that recommendation is new from the older guidelines that we have. With regard to the utility of PD-1 inhibitors, there really has been no benefit noted in the second-line setting with regard to overall survival or progression-free survival, so no recommendation is made for that option. I think an important study that has been recently presented is the DESTINY-Gastric04 trial, which really has been practice-changing and has led to the recommendation for trastuzumab deruxtecan in patients that have HER2-positive metastatic gastric or GE junction adenocarcinoma. Now, this is a phase III trial in patients who retained HER2-positive disease after progressing on front-line trastuzumab-based treatments, and the comparator for this trial was trastuzumab deruxtecan versus ramucirumab plus paclitaxel. There was significant improvement and progression-free survival in patients that received trastuzumab deruxtecan. The patients that were excluded from the trial are patients that have pulmonary problems, interstitial lung disease; that is one of the toxicities of this particular agent, and close monitoring and prompt initiation of therapy such as glucocorticoid treatment in patients who develop this toxicity was also highlighted by the panel. So to summarize, the new guidelines highlight the possibility of FOLFIRI plus ramucirumab as a second-line option and then trastuzumab deruxtecan as a later-line option in patients that still retain HER2 expression. And that is very important because the trial did retest patients whether they expressed HER2. As we know, in a substantial number of patients, there is downregulation of HER2, and there is emerging data that the benefit for subsequent HER2-directed therapies is best noted in patients that still retain HER2 expression. Brittany Harvey: Great. So as our listeners have heard, there are many recommendations and new treatment options for advanced gastroesophageal cancer. Dr. Shah, earlier you highlighted the importance of biomarker testing, but I would like to hear in your view, what is the importance of this guideline and how will it impact both clinicians and patients with gastroesophageal carcinoma? Dr. Manish Shah: So as we have discussed throughout this podcast, the treatment for gastroesophageal cancer, both adenocarcinoma and squamous cell cancer, is increasingly complex, increasingly biomarker-driven. And I think the value of the guideline is to place all of that into context. So it provides the data for why certain biomarkers are important, what therapies should be indicated. Not only that, but if you are able to review the guideline, it provides the details of each of these studies and summarizes them in a meta-analysis fashion to sort of give you the context, because sometimes the individual studies can be maybe a little bit discordant or confusing and the guideline attempts to harmonize all that. And then also, I think the tables are very, very interesting because they give you actual numbers in terms of how many patients over a thousand would this benefit or how many patients over a thousand would this cause harm in terms of nausea, vomiting, or other things like that. So it gives you context for helping clinicians and patients weigh the potential benefits of the novel treatment strategies against the potential adverse events. And then finally, the guideline does also provide an algorithm that you are able to follow based on the biomarkers, and those are in figures 4 and 5. So I think overall, it is a very comprehensive guideline. It intends to make more manageable a very complex subject, and you know, I really encourage our listeners to review it after listening to the podcast. Dr. Lakshmi Rajdev: If I can add to that, I think that what is also really good about the guidelines is there are quick summaries. So if someone is busy in the clinic, of course, there is the opportunity to review the data supporting the guidelines in great depth in the manuscript, but what is also really good is that there are good summaries. In the event that you are very busy, you can easily identify what the recommendations should be for that particular patient based on these summaries. Brittany Harvey: Absolutely. Listeners are encouraged to review the full guideline, including those tables and figures that may be more helpful when they are looking for something quick to look at in the clinic as well. So, as you both mentioned, there have been a number of recent practice-changing trials in this area. So I imagine there is still a lot of ongoing research as well. So Dr. Shah, what are the outstanding questions regarding treatment options for patients with locally advanced unresectable, advanced, or metastatic gastroesophageal carcinoma? Dr. Manish Shah: I think we touched upon it a little bit. The guidelines are based on the data available, and they are primarily examining one novel therapy with chemotherapy in a specific biomarker population. But as you know, the biomarkers are not either/or; you are not either CLDN18.2 positive or PD-L1 positive. A portion of patients could have dual biomarkers, and you know, I think that we are generating data on how to manage those patients. At the recent GI Symposium in January this year, the ILUSTRO trial was presented by Dr. Shitara, which looked at combining zolbetuximab and chemotherapy with immunotherapy for dual-positive biomarkers, and that is leading to a phase III study that has begun to enroll. So unanswered questions are: how do we manage dual-positive biomarkers? The other thing that was mentioned is that the current data for mismatch repair deficiency involve chemotherapy plus immunotherapy. Only squamous cell cancer is there a study with a positive non-chemotherapy kind of backbone, that is CheckMate-648 that Dr. Rajdev mentioned. As we move forward, it will be good to get data on non-chemotherapy options in certain biomarker-positive populations. And then finally, another update, which is likely to be practice-changing, is the HERIZON-GEA-01 study that looked at zanidatamab, which is another biparatopic antibody that targets HER2, and that is likely to change practice. And as that data gets published, we may look to even do a rapid update for the current immunotherapy and targeted therapy guideline that is just being published. Dr. Lakshmi Rajdev: So, if I can add to that, there are numerous ADCs that look very interesting. There are bispecific antibodies; in fact, the zanidatamab is a bispecific antibody showing improved activity in patients with HER2-positive disease. So I think there are studies from Asia looking at CLDN CAR T-based therapies. So, I think that there are a lot of novel agents and a lot of excitement in the field. We know that the bemarituzumab study, unfortunately, the FGFR2 inhibitor failed to demonstrate any benefit, but I think that there are other agents that are being explored, so there are newer targets, newer agents, ADCs, bispecifics that could potentially change the field in the future. Brittany Harvey: Yes, we will look forward to the data to address these unanswered questions and new agents and inform future guideline updates. So, I would like to thank you both for all of your work to review the evidence here and update this important guideline, and for your time today, Dr. Rajdev and Dr. Shah. Dr. Lakshmi Rajdev: Thank you. Dr. Manish Shah: Thank you. Brittany Harvey: And finally, 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 have 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.

Leaders in PSM and co-creators of the Yale consensus guidelines meet to discuss key aspects of the recently updated consortium recommendations.

This episode is a deep dive into the new 2026 guidelines on type 2 diabetes, applying the guidelines to various case-based scenarios. Zero to GP podcast: https://www.buzzsprout.com/2590332Zero to GP YouTube channel: https://www.youtube.com/@ZeroToGPZero to AKT course: https://zerotofinals.com/courses/zerotoakt/Books: https://zerotofinalsshop.com/

Opening Bible Verse: 1 Corinthians 15:5 This year we are doing my group coaching course together via this podcast! It's free and it only gets better as the year progresses.  In January we began with God at the center of our day and our home. We worked to build the habit of a morning prayer routine. I highly recommend the rosary. It's only about 20 minutes and you'll meditate on the whole life of Jesus. February is the month of decluttering. Saturday episodes have been added to focus on decluttering in the kitchen. Each month will have a different focus area and the Saturday episodes will help you focus on one small section of that room.  If you're new here, welcome and give this first episode of 2026 a listen to hear where to begin: 316. Your 2026 Life Overhaul Plan: Faith, Clutter, Debt, Diet and More!  If you've never prayed a rosary or you want to see how you can incorporate it into active decluttering, here is the first episode of my rosary declutter series from last summer. 288. Summer Declutter Series Week Just getting started on your decluttering journey? Give this episode a listen before you begin: 322. Guidelines to Decluttering ***Are you so overwhelmed with clutter that you find yourself unable to make any decisions? Do you plan on decluttering only to find yourself standing in a room confused about where to start? Are you hoping motivation will strike and you'll get it all done in one weekend? If this sounds like you, let's work together. Book a one hour virtual coaching session via Zoom. Together we craft a decluttering plan and I walk you through the process. You'll complete much of the decluttering on your own time at your own pace. I just give you the roadmap and the accountability. Cost $77 per hour. Virtual Coaching Schedule   Not sure what you need? No problem! Book a complimentary 15 minute clarity call. We'll meet via Zoom and see if working with me would benefit you.  Email me at: tightshipmama@gmail.com to schedule a time.   Looking for community of like-minded women? Join the private Facebook community here: Facebook Group   Prefer to receive a weekly email with the monthly freebie like a group rosary, group declutter, or budget Q&As?  Join my mailing list here: Monthly Newsletter   For any other inquiries or guest appearances, please email me at: tightshipmama@gmail.com  

Dr. Bishal Gyawali and Dr. Tessa Cigler share the new, comprehensive, evidence-based update of the ASCO guideline on the use of hematopoietic colony-stimulating factors in patients with cancer. They discuss recommendations on primary prophylaxis, secondary prophylaxis, and treatment of febrile neutropenia along with stem cell mobilization, efficacy, safety, duration, dosing, and administration of CSFs – including biosimilars. They highlight where it is appropriate to use a CSF, and importantly, when not to use a CSF. They touch on the significance of individual patient considerations and cost implications, and future work to refine the risk factors for the development of complications of febrile neutropenia. Read the full guideline, "White Blood Cell Growth Factors: ASCO Guideline Update" at www.asco.org/supportive-care-guidelines TRANSCRIPT This guideline, clinical tools and resources are available at www.asco.org/supportive-care-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology,  https://ascopubs.org/doi/10.1200/JCO-25-02938     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. Bishal Gyawali from Queen's University in Kingston, Ontario, Canada, and Dr. Tessa Cigler from Weill Cornell Medicine in New York, New York, co-chairs on "White Blood Cell Growth Factors: ASCO Guideline Update." Thank you for being here today, Dr. Gyawali and Dr. Cigler. Dr. Bishal Gyawali: Thank you very much for having me. It's a pleasure. Dr. Tessa Cigler: Hi there. Nice to be here as well. Brittany Harvey: Great. 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. Cigler and Dr. Gyawali, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then I'd like to dive into the guideline that we're here today to talk about. So first, what prompted an update to this guideline on the use of hematopoietic colony-stimulating factors in patients with cancer, and what is the scope of this updated guideline? Dr. Bishal Gyawali: The last version of the guidelines from ASCO on this topic was back in 2015, so it has been more than a decade since ASCO had a guideline on the use of G-CSF in patients with cancer receiving treatment. So it was due for an update because there has been a lot more evidence based on not necessarily new drugs, but evidence for proper timing of these agents and the duration of these agents, as well as there have been a lot of new biosimilars, and there are questions about are these biosimilars equivalent or how do we choose among these different options. One is that content of the evidence that has evolved over time in the last decade, but also I think the last time we had these guidelines, the ASCO guidelines were not incorporated to have those evidence GRADE tables. So the quality of the ASCO guidelines itself has evolved over the years, so we wanted to have a new version of the guideline that includes not only the new evidence, but also contains those evidence GRADE tables that will help to quantify the benefits. And so I think it was high time, and even more than that, the newer ASCO guidelines for any guideline, they also include considerations of cost, access, equity, and all these factors that were not included in the previous version of the guideline. So I think it's only natural that with time the guideline should also evolve. Dr. Tessa Cigler: I agree completely, and just as a framework, as we all know, neutropenia and its complications, including febrile neutropenia and infections, are still an important toxicity of many myelosuppressive chemotherapies. And these neutropenic complications do require prompt evaluation and treatment and often hospitalization, and we know that hematopoietic colony-stimulating factors, which I'm going to refer to as growth factors, can reduce the duration and severity of neutropenia and the risk of febrile neutropenia, so it remains an important topic in the practice of clinical oncology. Brittany Harvey: Absolutely. It's an important topic for both clinicians and for patients who are receiving treatment for their cancer. And as you said, there was a substantial amount of literature to review here and updating everything to be in line with the GRADE evidence rating system, so there was a lot of work that you both put into this. So then next, I'd like to review the key recommendations of this guideline by clinical question. So first, what factors did the expert panel identify that should influence the decision to administer primary prophylaxis of febrile neutropenia with a CSF? Dr. Bishal Gyawali: Yeah, so I think that constitutes one of the most important recommendations in our guidelines about primary prophylaxis with G-CSF. And this is important because not only it's about when to use it, it's also about when not to use it, as in the ASCO "Choosing Wisely" campaign has also made some recommendations about this. So our guideline recommendations are also aligned with that. So first of all, we recommend that primary prophylaxis with G-CSF is recommended when the risk of febrile neutropenia because of the chemotherapy regimen is equal to or more than 20% unless an alternative chemotherapy regimen with comparable efficacy and safety that does not need G-CSF is available. And the quality of evidence to make this recommendation is high, so we give a strong strength of recommendation for this. Having said that, even for patients where the risk of febrile neutropenia is not necessarily 20%, it's a little lower, but because of other patient-related factors, the patient is at a higher risk of complications from febrile neutropenia, such as age, comorbidities, and other factors, in such case primary prophylaxis with G-CSF should be offered. And we also make a recommendation that if G-CSF is not affordable or available, then antibiotic prophylaxis can also be offered, but the evidence quality for this is low, and the strength of recommendation is very conditional. A couple of things to highlight here would be that, I think Dr. Cigler can attest to that, we ran into lots of problems about finding the data for the evidence base to say what are the patient-related factors that actually make them at a higher risk of febrile neutropenia, you know, like how did that 20% benchmark come about? Why 20%? Or when we say even if it's less than 20%, if based on other comorbidities, if the risk is higher, we tried to dig into that evidence. For example, we're talking about our "Box 1" in the guideline, what is the evidence for each item we have included under that "Box 1"? And we tried to do a lot of search to find the evidence for that, and some of them do have strong evidence, and that will tie into our future research ideas as well. And some of them actually don't have such solid evidence too, so that was one of the reasons why we ran into lots of problems about how do we quantify whether someone is at a high risk of febrile neutropenia and where that 20% benchmark comes from. Dr. Tessa Cigler: And definitely, because there's not very clear data, our guidelines definitely leave room for physician discretion in all these situations. Brittany Harvey: Absolutely. I find that in a lot of these guidelines the key point is that there's a lot of shared decision-making with patients after talking through what risk factors they may have and what is best for them in their individual clinical scenario. So then moving on to secondary prophylaxis, what factors did the expert panel identify that should influence the decision to administer secondary prophylaxis of febrile neutropenia with a CSF? Dr. Tessa Cigler: So for patients who've already experienced a neutropenic complication from a previous cycle of chemotherapy, the question is which patients should then receive prophylactic G-CSF for subsequent cycles of chemotherapy. And without a lot of evidence again to guide us, the panel really felt strongly that secondary prophylaxis should be used when a treatment delay or when a reduced dose of chemotherapy would be thought to compromise cure rates or survival outcomes. We do note that in many situations, certainly a dose reduction or a delay would be a very reasonable alternative or an additional strategy to G-CSF administration. Dr. Bishal Gyawali: Yeah, I think it's more like if there is going to be compromise in outcomes without using G-CSF, as in if we can't maintain the dose intensity and that's going to lead to inferior outcomes, then we should. But if we can reduce the dose intensity and treatment frequency and still have the same outcomes, then I guess in simple words, we're just trying to say use it when it's absolutely needed, or you can also look into other alternatives that might not need G-CSF but you could maintain the same outcomes. Brittany Harvey: Understood. It's helpful to review those options for clinicians and showing that there's not just one way to address potential neutropenic complications for later cycles of chemotherapy. So then following those recommendations for prophylaxis, what does the expert panel recommend regarding CSFs for the treatment of febrile neutropenia? Dr. Bishal Gyawali: This is an important question because this ties strongly with the "Choosing Wisely" campaign. In other words, primary and secondary prophylaxis we talked about when CSF should be used; here we make a sort of negative recommendation in that we say when CSF should not be used, because this is where we see most overuse or overtreatment with G-CSF. So first, we say that we should not be using a CSF routinely simply because a patient has neutropenia. If they are afebrile but they only have neutropenia, we recommend against using CSF just to boost neutrophil counts; that's not a meaningful metric. Then the second recommendation we make is CSF should not be routinely used as an adjunctive treatment with antibiotic therapy for patients with fever and neutropenia. So the first one was neutropenia, no fever, don't use it. The second one is okay, there is neutropenia and fever, but the treatment for that is use of antibiotic therapy, and so in such situations routinely we should not be using G-CSF just to boost the neutrophil count. And that is tied on to the third recommendation where if the patient has fever and neutropenia but is also at a very high risk for infection-related complications or who have other prognostic factors that we think will lead to poor outcomes for the patient, then in such situations, a CSF can be used as an adjunctive treatment. But we talk about the data in the manuscript, but the data show that the most that this will do is reduce the days of hospitalization by a couple of days. It actually does not have any data that it's going to improve the mortality rates. So as of now, we use the word "may be offered," it's not "should be offered," it's "may be offered" if there are other factors that we think will make the patient at the very poor risk of mortality outcomes, and the evidence quality here therefore is low and our strength of recommendation is conditional. And we also have a box that lists those items that we think might be associated with poor prognosis for the patients, but again the data for those, are they really hard evidence? No. And that is also tied with our future research recommendation that we should study more about these factors that might lead to these poor outcomes. Dr. Tessa Cigler: And again, allowing for discretion of the treating physician. Brittany Harvey: Absolutely. It's just as important to know when not to use CSFs routinely, and those risk factor boxes that you mentioned are available in the full manuscript along with the full list of recommendations, and our listeners can refer to that; a link will be in the show notes of the episode . Dr. Tessa Cigler: Just so you know, the panel, we really discussed those criteria a lot and agonized over them and gave you our best recommendations. Brittany Harvey: Definitely, and it sounds like there was varying degrees of evidence to support a lot of those risk factors, and so it's really important that the evidence supports those, but also there was expert consensus of the panel in reviewing each of those factors individually to come up with recommendations that can be applicable for all clinicians. Dr. Bishal Gyawali: If I may add, we're proud of our panel because I think our panel is quite inclusive of people representing different specialties within cancer care, as in we had radiation oncologist, we had infectious disease expert, pharmacists, and most importantly, we also had patient partners. Brittany Harvey: Absolutely. Having a multidisciplinary panel is really important for each and every guideline. So then, this is probably relevant now, but addressing a few more specific sections addressed in the guideline, what is the role of CSFs as adjuncts to progenitor cell transplantation? Dr. Tessa Sigler: Great question, and so, as solid tumor oncologists, Dr. Gyawali and I really leaned heavily on our hematology experts within the panel. The panel decided that a CSF should be used alone after chemotherapy or in combination with a CXCR4 inhibitor to mobilize peripheral blood progenitor cells. Clearly the choice of mobilization strategy depends on the type of cancer and the type of transplantation. The panel noted that a CSF should be routinely administered after autologous stem cell transplantation to reduce the risk of severe neutropenia, and that a CSF may be administered after allogeneic stem cell transplant to reduce the duration of severe neutropenia. Again, this last recommendation has not a lot of evidence to support it, and so we kind of tempered our language that it may be administered or can be considered based on clinical judgment of the physician and the clinical status of the patient. Brittany Harvey: And that really highlights the need for a multidisciplinary panel, because as you are solid tumor oncologists, you need the hematologists to make recommendations for all sorts of patients and make sure that these guidelines are comprehensive.   So then moving on to another smaller subset population, for patients receiving concomitant chemotherapy and radiation therapy, are CSFs recommended? Dr. Bishal Gyawali: I think there is very little evidence for patients who are receiving radiation therapy alone, so there is no evidence to suggest the use of CSF in patients with radiation therapy alone. The bigger question is in patients who are receiving both chemo and radiation together, chemoradiotherapy. In those patients, up until now, the classical recommendation has been to avoid G-CSF use. I think in our updated guidelines we discuss a couple newer trials that are trying to address this issue, but in the totality of evidence, we still stick with the same recommendation as before, which is CSFs are not recommended in patients receiving concomitant chemotherapy and radiation therapy, especially those involving the mediastinum because the biggest evidence of harm is for these patients. Dr. Tessa Cigler: I agree completely. Brittany Harvey: Definitely. It's important to recognize when that balance of benefits and harms leans more towards harms, and so that this should not be recommended for those patients. So there are several different CSFs that are recommended in the guideline, including biosimilars. So do the recommended CSFs differ in efficacy or safety? Dr. Tessa Cigler: So as supported by evidence, and the panel all agreed, that the various forms of CSFs, including the biosimilars, really have the same evidence for efficacy and for safety, and that the choice of agent really should depend on cost, availability, accessibility, patient convenience, and sometimes disease subtypes and treatment regimens. But, in essence, these can be used interchangeably without concern for efficacy or toxicity differences. Dr. Bishal Gyawali: I completely agree. I think in terms of efficacy outcomes, I don't think there is anything to choose between these agents. The choice between these agents would largely depend on different patient and treatment-related factors: cost, availability, affordability, feasibility. We even discuss things like where does the patient live, as in how frequently the patient can commit to the cancer center, and we also discussed things like even for the daily shots of filgrastim, patients can be taught and they can get it by themselves at home. So we discussed all these factors, but in a nutshell, the choice within these agents primarily depends not on efficacy factors, but simply based on all these other factors that are equally important but which can lead to informed decision-making about what is best for a given patient. But we mention it explicitly that the biosimilars, there is nothing to choose between them, especially the biosimilars; it's about price competition and what you can get at an affordable rate. Brittany Harvey: Understood. It's great to have many different options for patients so that there's something that can work for them based off access, cost, and all these factors that you listed. As you mentioned, it may be easier for some patients to get their treatment at home rather than in clinic, and so having different options and reviewing those with patients is very important. Dr. Bishal Gyawali: As we are having this conversation, I'm thinking that we might be a very unique guideline in that I don't think in many other settings you have this many options that you are asking about, you know, choices between equally good options and making decisions based on cost. I don't think there are any other areas in oncology where we have the privilege of making these decisions based on cost and convenience and all these factors, as well as we might be one of those guidelines where we have, as discussed before, so many recommendations about when not to do things and trying to promote judicial use of treatments. Dr. Tessa Cigler: As you might imagine, our panel discussions were very lively. Dr. Bishal Gyawali: Yes. But Dr. Cigler, do you recall any other guideline where there is so much discussion about when not to use things and how we have so many biosimilar options and we can choose the one that's most appropriate? I don't recall any other. Dr. Tessa Cigler: I agree with you. Brittany Harvey: It's certainly a unique guideline in that regard. So we'll move into the last clinical question that the expert panel addressed. But what does the expert panel recommend for the initiation, duration, dosing, and administration of CSFs? Dr. Bishal Gyawali: Yeah, I think there has been some new data in this regard that were not available in the previous guideline. For example, we have new trials testing a shorter duration of filgrastim injections compared to the standard of care. So we have some data, we call this 'de-escalation of treatment'. So we have more data supporting de-escalation of treatment. We have some data for lower dose of pegfilgrastim, we have data for lower duration of filgrastim, we have also some new data about timing of treatment, as in there has been some newer data presented about the relationship of timing of the drug and the frequency of adverse events from G-CSF such as bone pain. There is also the question about, for patients who don't live near the cancer center, can they get their pegfilgrastim shot on the day of chemo while they are in the cancer center? So all these questions that are very pragmatic and important questions, but were not answered before, we're glad that we had more evidence to talk about all these factors and give a more solid recommendation to our users of the guideline. Brittany Harvey: Definitely. And listeners can review the full list of dosing and administration recommendations in Table 2 in the guideline, and that will be linked in the show notes of the episode. So then I really want to thank you both for reviewing all of these recommendations. There's certainly a large amount of clinical questions and recommendations that you went through. I'd like to next ask, in your view, what is the importance of this updated guideline and how will it impact both clinicians and patients? Dr. Bishal Gyawali: I think the importance of this updated guideline is that, as mentioned before, we talk about newer data that have come up with regards to not just the most important two questions as in when to use it as primary prophylaxis and when to use it as secondary prophylaxis and when to use it as treatment, but also with regards to the duration and timing and dosing and multiple options and how these all factors as well as patient-related factors should be combined to make an informed decision, the most appropriate decision for the patient. And as mentioned before, we have the GRADE tables that were not in the previous version of this guideline. So I think even those users that are familiar with the 2015 guideline, I think they will find very novel content in this new updated guideline, and they will find it useful for their practice. I would encourage the readers to not only read the headlines of the box recommendations, but also read the full text of these guidelines because we have worked really hard to incorporate the latest evidence and also interpret them contextually. The discussion regarding de-escalation, patient considerations, cost implications; usually, people just skip these portions when they read a guideline. But I think these are also one of the most important paragraphs in our guideline, so they have been written with very careful thought, and I think reading the whole guideline is very much worth your time. Dr. Tessa Cigler: As you can imagine, I agree completely, having just spent several months thinking about these guidelines and all their nuances. Brittany Harvey: Certainly, this guideline is definitely a very comprehensive update, and that nuance in the manuscript is really important for clinicians to understand and read through and understand when it's appropriate to make certain decisions. So then to wrap us up, I'd like to ask, what are the outstanding questions and active research areas regarding the use of white blood cell growth factors in patients with cancer? Dr. Tessa Cigler: As you all know from clinical practice and that we've said several times already in this podcast is that the risk factors for the development of complications of febrile neutropenia are still not clearly worked out. And one of the things that is, I think, really needed in clinical practice is the development of predictive algorithms or biomarkers to really allow us to understand who might be more at risk and to allow for the clinician to be able to tailor the use of G-CSF as needed. Brittany Harvey: Yes, and so we'll look forward to future updates in this space to inform new recommendations and an updated guideline in the future. So I want to thank you both so much for your work to develop this comprehensive guideline. It was certainly a lot of effort, and thank you for your time today, Dr. Gyawali and Dr. Cigler. Dr. Tessa Cigler: Oh, my pleasure. It's nice to be here and to speak with you all. Dr. Bishal Gyawali: Yeah, it was great to speak with both of you but also through you to the audience, and we had a great time. Thank you. Brittany Harvey: And then finally, 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/supportive-care-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, 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.

“In this sense, human and AI means a synergy where teams of humans and AI together lead to superior outcomes than either the human or the AI operating in isolation.” – Davide Dell'Anna About Davide Dell'Anna Davide Dell'Anna is Assistant Professor of Responsible AI at Utrecht University, and a member of the Hybrid Intelligence Centre. His research focuses on how AI can cooperate synergistically and proactively with humans. Davide has published a wide range of leading research in the space. Webiste: davidedellanna.com LinkedIn Profile: Davide Dell'Anna University Profile: Davide Dell'Anna What you will learn The core concept of hybrid intelligence as collaborative human-AI teaming, not replacement Why effective hybrid teams require acknowledging and leveraging both human and AI strengths and weaknesses How lessons from human-human and human-animal teams inform better design of human-AI collaboration Key differences between humans and AI in teams, such as accountability, replaceability, and identity The importance of process-oriented evaluation, including satisfaction, trust, and adaptability, for measuring hybrid team effectiveness Why appropriately calibrated trust and shared ethics are central to performance and cohesion in hybrid teams The shift from explainability to justifiability in AI, emphasizing actions aligned with shared team norms and values New organizational roles and skills—like team facilitation and dynamic team design—needed to support successful human-AI collaboration Episode Resources Transcript Ross Dawson: Hi Davide. It’s wonderful to have you on the show. Davide Dell’Anna: Hi Ross, nice to meet you. Thank you so much for having me. Ross: So you do a lot of work around what you call hybrid intelligence, and I think that’s pretty well aligned with a lot of the topics we have on the podcast. But I’d love to hear your definition and framing—what is hybrid intelligence? Davide: Well, thank you so much for the question. Hybrid intelligence is a new paradigm, or a paradigm that tries to move the public narrative away from the common focus on replacement—AI or robots taking over our jobs. While that’s an understandable fear, more scientifically and societally, I think it’s more interesting and relevant to think of humans and AI as collaborators. In this sense, human and AI means a synergy where teams of humans and AI together lead to superior outcomes than either the human or the AI operating in isolation. In a human-AI team, members can compensate for each other’s weaknesses and amplify each other’s strengths. The goal is not to substitute human capabilities, but to augment them. This immediately moves the discussion from “what can the AI do to replace me?” to “how can we design the best possible team to work together?” I think that’s the foundation of the concept of hybrid intelligence. So hybrid intelligence, per se, is the ultimate goal. We aim at designing or engineering these human-AI teams so that we can effectively and responsibly collaborate together to achieve this superior type of intelligence, which we then call hybrid intelligence. Ross: That’s fantastic. And so extremely aligned with the humans plus AI thesis. That’s very similar to what I might have said myself, not using the word hybrid intelligence, but humans plus AI to say the same thing. We want to dive into the humans-AI teaming specifically in a moment. But in some of your writing, you’ve commented that, while others are thinking about augmentation in various ways, you point out that these are not necessarily as holistic as they could be. So what do you think is missing in some of the other ways people are approaching AI as a tool of augmentation? Davide: Yeah, so I think when you look at the literature—as a computer scientist myself, I notice how easily I fall into the trap of only discussing AI capabilities. When I talk about AI or even human-AI teams, I end up talking about how I can build the AI to do this, or how I can improve the process in this way. Most of the literature does that as well. There’s a technology-centric perspective to the discussion of even human-AI teams. We try to understand what we can build from the AI point of view to improve a team. But if you think of human-AI teams in this way, you realize that this significantly limits our vocabulary and our ability to look at the team from a broader, system-level perspective, where each member—including and especially human team members—is treated individually, and their skills and identity are considered and leveraged. So, if you look at the literature, you often end up talking about how to add one feature to the AI or how to extend its feature set in other ways. But what people often miss is looking at the weaknesses and strengths of the different individuals, so that we can engineer for their compensation and amplification. Machines and people are fundamentally different: humans are good at some things, AI is good at others, and we shouldn’t try to negate or hide or be ashamed of the things we’re worse at than AI, and vice versa. Instead, we should leverage those differences. For instance, just as an example, consider memory and context awareness. At the moment, at least, AI is much more powerful in having access to memory and retrieving it in a matter of seconds—AI can access basically the whole internet. But often, when you talk nowadays with these language model agents, they are completely decontextualized. They talk in the same way to millions across the world and often have very little clue about who the specific person is in front of them, what that person’s specific situation is—maybe they’re in an airport with noise, or just one minute from giving a lecture and in a rush. The type of things you might say also change based on the specific situation. While this is a limitation of AI, we shouldn’t forget that there is the human there. The human has that contextual knowledge. The human brings that crucial context. Sometimes we tend to say, “Okay, but then we can build an AI that can understand the context around it,” but we already have the human for that. Ross: Yes, yes. I don’t think that’s what I call the framing. Framing should come from the human, because that’s what we understand—including the ethical and other human aspects of the context, as well as that broader frame. It’s interesting because, in talking about hybrid intelligence, I think many who come to augmentation or hybrid intelligence think of it on an individual basis: how can an individual be augmented by AI, or, for example, in playing various games or simulations, humans plus AI teaming together, collaborating. But the team means you have multiple humans and quite probably multiple AI agents. So, in your research, what have you observed if you’re comparing a human-only team and a team which has both human and AI participants? What are some of the things that are the same, and what are some of the things that are different? Davide: Yes, this is a very interesting question. We’ve recently done work in collaboration with a number of researchers from the Hybrid Intelligence Center, which I am part of. If you’re not familiar with it, the Hybrid Intelligence Center is a collaboration that involves practically all the Dutch universities focused on hybrid intelligence, and it’s a long project—lasting around 10 years. One of the works we’ve done recently is to try to study to what extent established properties of effective human teams could be used to characterize human-AI teams. We looked at instruments that people use in practice to characterize human teams. One of them is called the Team Diagnostic Survey, which is an instrument people use to diagnose the strengths and weaknesses of human teams. It includes a number of dimensions that are generally considered important for effective human teams. These include aspects like members demonstrating their commitment to the team by putting in extra time and effort to help it succeed, the presence of coaches available in the team to help the team improve over time, and things related to the satisfaction of the members with the team, with the relationships with other members, and with the work they’re doing. What we’ve done was to study the extent to which we could use these dimensions to characterize human-AI teams. We looked at different types of configurations of teams—some had one AI agent and one human, others had multiple agents and multiple humans, for example in a warehouse context where you have multiple robots helping out in the warehouse that have to cooperate and collaborate with multiple humans. We tried to understand whether the properties of—by the way, we also looked at an interesting case, which is human-animal-animal teams, which is another example that’s interesting in the context of hybrid intelligence. You see very often in human-animal interaction—basically two species, two alien species—interacting and collaborating with each other. They often manage to collaborate pretty effectively, and there is an awareness of what both the humans and the animals are doing that is fascinating, at least for me. So, we tried to analyze whether properties of human teams could be understood when looking at human-AI teams or hybrid teams, and to what extent. One of the things we found is that some concepts are very well understood and easily applicable to different types of hybrid teams. For example, the idea of interdependence—the fact that members in the team, in order to be a team, need to be mutually dependent, at least to some extent. Otherwise, if they’re all doing separate jobs, there’s a lack of common goal. There are also things related to having a clear mission or a clear objective as a team, and aspects related to the possibility of exhibiting autonomy in the operation of the team and taking initiative. Also, the presence and awareness of team norms, like a shared ethical code or shared knowledge about what is appropriate or not. These were things that we found people could easily understand and apply to different configurations of teams. Ross: Just actually, one thing—I don’t know if you’re familiar with the work of Mohammad Hussain Johari, who did this wonderful paper called “What Human-Horse Interactions May Teach Us About Effective Human-AI Interactions.” Again, these are the cases where we can have these parallels—learning how to do human-AI interactions from human-human and human-animal interactions. But again, it comes back to that original question: what is the same? I think you described many of those facets of the nature of teams and collaboration, which means they are the same. But there are, of course, some differences. One of the many differences is accountability, essentially, where the AI agents are not accountable, whereas the humans are. That’s one thing. So, this allocation of decision rights across different participants—human and AI—needs to take into account that they’re not equal participants. Humans have accountability, and AI does not. That’s one possible example. Davide: Yeah, definitely. I totally agree, and I remember the paper you mentioned. I agree that human-animal collaboration is a very interesting source of inspiration. When looking at this paper, we looked at the case of shepherds and shepherd dogs. I didn’t know much about it before, but then I started digging a little bit. Shepherd dogs are trained at the beginning, but over time, they learn a type of communication with the shepherd. Through whistles, the shepherd can give very short commands, and then the shepherd dogs—even in pairs—can quickly understand what they need to do. They go through the mountains, collect all the sheep, and bring them exactly as intended by the shepherd, with very little need for words or other types of communication. They manage to achieve their goals very effectively. So, I think we have a lot to learn from these cases, even though it’s difficult to study. But just to mention differences, of course—one of the things that emerged from this paper is the inherent human-AI asymmetry. Like you mentioned, accountability is definitely one aspect. I think overall, we should always give the human a different type of role in the team, similar to the shepherd and the shepherd dogs. There is some hierarchy among the members, and this makes it possible for humans to preserve meaningful control in the interactions. This also implies that different rules or expectations apply to different team members. Beyond these, there is asymmetry in skills and capabilities, as we mentioned earlier, and also in aspects related to the identity of the members. For instance, some AI could be more easily replaceable than humans. Think, for example, of robots in a warehouse. In a human team, you wouldn’t say you “replace” a team member—it’s not the nicest way to say you let someone go and bring someone else in. But with robots, you could say, “I replace this machine because it’s not working anymore,” and that’s fine. We can replace machines with little consequence, though this doesn’t always hold, because there are studies showing that people get attached to machines and AI in general. There was a recent case of ChatGPT releasing a new version and stopping the previous one, and people complained because they got attached to the previous version. So, in some cases, replacing the AI member would work well, but in others, it needs to be done more carefully. Ross: So one of the other things looked at is the evaluation of human-AI teams. If we’re looking at human teams and possibly relative performance compared to human-AI teams, what are ways in which we can measure effectiveness? I suppose this includes not just output or speed or outcomes, but potentially risk, uncertainty, explainability, or other factors. Davide: Yes, this is an interesting question, and I think it’s still an open question to some extent. From the study I mentioned earlier, we looked at how people measure human team effectiveness. There are aspects concerning, of course, the success of the team in doing the task, but these are not the only measures of effectiveness that people consider in human teams. People often consider things related to the satisfaction of the members—with their teammates, with the process of working together, and with the overall goals of the team. This often leads to reflection from the team itself during operation, at least in human teams, where people reassess and evaluate their output throughout the process to make sure satisfaction with the process and relationships goes well over time. In general, there are aspects to measure concerning the effectiveness of teams related to the process itself, which are often forgotten. It’s a matter, at least from a research point of view, of resources, because to evaluate a full process over time, you need to run experiments for longer periods. Often people stop at one instant or a few interactions, but if you think of human teams, like the usual forming, storming, norming, and performing, that often goes over a long time. Teams often operate for a long time and improve over time. So, the process itself needs to be monitored and reassessed over time. This is a way to also measure the effectiveness of the team, but over time. Ross: Interesting point, because as you say, the dynamics of team performance with a human team improve as people get to know each other and find ways of working. They can become cohesive as a team. That’s classically what happens in defense forces and in creating high-performance teams, where you understand and build trust in each other. Trust is a key component of that. With AI agents, if they are well designed, they can learn themselves or respond to changing situations in order to evolve. But it becomes a different dynamic when you have humans building trust and mutual understanding, where that becomes a system in which the AI is potentially responding or evolving. At its best, there’s the potential for that to create a better performing team, but it does require both the attitudes of the humans and well the agents. Davide: Related to this—if I can interrupt you—I think this is very important that you mentioned trust. Indeed, this is one of the aspects that needs to be considered very carefully. You shouldn’t over-trust another team member, but also shouldn’t under-trust. Appropriate trust is key. One of the things that drives, at least in human teams, trust and overall performance is also team ethics. Related to the metrics you mentioned earlier, the ability of a team to gather around a shared ethical code and stick to that, and to continuously and regularly update each other’s norms and ensure that actions are aligned with the shared norms, is crucial. This ethical code significantly affects trust in operation. You can see it very easily in human teams: considering ethical aspects is essential, and we take them into account all the time. We respect each other’s goals and values. We expect our collaborators to keep their promises and commitments, and if they cannot, they can explain or justify what they are doing. These justifications are also a key element. The ability to provide justifications for behavior is very important for hybrid teams as well. Not only the AI, but also the human should be able to justify their actions when necessary. This is where the concept of hybrid teams and, in general, hybrid intelligence requires a bit of a philosophical shift from the traditional technology-centric perspective. For example, in AI, we often talk about explainability or explainable AI, which is about looking at model computations and understanding why a decision was made. But here, we’re talking about a different concept: justifiability, which looks at the same problem from a different angle. It considers team actions in the context of shared values, shared goals, and the norms we’ve agreed upon. This requires a shift in the way we implement AI agents—they need to be aware of these norms, able to learn and adapt to team norms, and reason about them in the same way we do in society. Ross: Let’s say you’ve got an organization and they have teams, as most organizations do, and now we’re moving from classic human teams to humans plus AI teams—collaborative human-AI teams. What are the skills and capabilities that the individual participants and the leaders in the teams need to transition from human-only teams to teams that include both humans and AI members? Davide: This is a complicated question, and I don’t have a full answer, but I can definitely reflect on different skills that a hybrid team should have. I’m thinking now of recent work—not published yet—where we started moving from the quality model work I mentioned earlier towards more detailed guidelines for human-AI teams. There, we developed a number of guidelines for organizations for putting in place and operating effective teams. We categorized these guidelines in terms of different phases of team processes. For instance, we developed guidelines related to structuring the teamwork—the envisioning of the operations of the team, which roles the team members would have, which responsibilities the different team members should have. Here, I’m talking about team members, but I’m still referring to hybrid teams, so this applies to both humans and AI. This also implies different types of skills that we often don’t have yet in AI systems. For example, flexible team composition is a type of skill required to make it possible at the early stage of the team to structure the team in the right way. There are also skills related to developing shared awareness and aspects related to breaking down the task collaboratively or ensuring a continuous evolution of the team over time, with regular reassessment of the output. If you think of these notions, it’s easy to think about them in terms of traditional organizations, but when you imagine a human-AI team or a small hybrid organization, then this continuous evolution, regular output assessment, and flexible team composition are not so natural anymore. What does it mean for an LLM agent to interact with someone else? Usually, LLM architectures rely on static roles and predefined workflows—you need to define beforehand the prompts they will exchange—whereas humans use much more flexible protocols. We can adjust our protocols over time, monitor what we’re doing, and reassess whether it works or not, and change the protocols. These are skills required for the assistants, but also for the organization itself to make hybrid teaming possible. One of the things that emerges in this recent work is a new figure that would probably come up in organizations: a team designer or a team facilitator. This is not a team member per se, but an expert in teams and AI teammates, who can perhaps configure the AI teammates based on the needs of the team, and provide human team members with information needed about the skills or capabilities of the specific AI team member. It’s an intermediary between humans and AI, with expertise that other human team members may not have, and could help these teams work together. Ross: That’s fantastic. It’s wonderful to learn about all this work. Is there anywhere people can go to find out more about your research? Davide: Yeah, sure. You can look me up at my website, davidedellanna.com. That’s my main website—I try to keep it up to date. Through there, you can see the different projects I’m involved in, the papers we’re working on, both with collaborators and with PhD and master students, who often bring great contributions to our research, even in their short studies. That’s the main hub, and you can also find many openly available resources linked to the projects that people may find useful. Ross: Fantastic. Well, it’s wonderful work—very highly aligned with the idea of hybrid intelligence, and it’s fantastic that you are focusing on that, because there’s not enough people yet focusing in the area. So you and your colleagues are ahead, and I’m sure many more will join you. Thank you so much for your time and your insights. Davide: Thank you so much, Ross. Pleasure to meet you. The post Davide Dell'Anna on hybrid intelligence, guidelines for human-AI teams, calibrating trust, and team ethics (AC Ep33) appeared first on Humans + AI.

George Brauchler, 23rd District Attorney joins Dan to outline the battle by law enforcement, prosecutors, and Republican legislators to increase minimum sentencing guidelines for sexual assault crimes.See omnystudio.com/listener for privacy information.

Host: Heather Norman-Burgdolf, PhD, Associate Extension Professor for Nutrition and Health, University of Kentucky, Department of Dietetics and Human Nutrition Guest: Courtney Luecking, PhD Assistant Extension Professor and Extension Specialist for Maternal and Child Health, Department of Dietetics and Human Nutrition Season 8, Episode 38 Join host Dr. Heather Norman Bergdorf and guest Dr. Courtney Luecking as they unpack the 2026 Dietary Guidelines for Americans, explaining what the Guidelines are, how they're developed, and what's changed. They cover key takeaways: the Guidelines' public-health (not clinical) purpose, the emphasis on overall dietary patterns and balance rather than single nutrients, continued support for whole grains and fiber, and real-world implementation issues like cost, access, and school nutrition. Learn how Cooperative Extension translates these evidence-based recommendations into practical, community-relevant guidance. For more information: Dietary Guidelines for Americans Connect with FCS Extension through any of the links below for more information about any of the topics discussed on Talking FACS. Kentucky Extension Offices UK FCS Extension           Website           Facebook           Instagram           FCS Learning Channel

This week is more about the news that slid under the radar for most, but I caught them and now it looks like everything we wondered about in 2022 when Google killed the URL parameter tool has come home to roost.I bring the receipts to demonstrate that the Canonical code is more like guidelines than rules.This episode - Last week's episode⁠Last week's episode: https://www.confessionsofanseo.com/podcast/bot-crawl-space-and-time-season-6-episode-7/Mentioned in the show: https://www.confessionsofanseo.com/podcast/season-2-episode-15-wow-its-all-the-blue-socks-google-url-parameter-tool/https://developers.google.com/search/blog/2022/03/url-parameters-tool-deprecatedhttps://ed.codes/blog/weird-shopify-seo-issue-millions-of-indexed-pagesGet early access to Vizzex. https://vizzex.ai/aitruth-replayWhere does your site drop off the siteRadius in the Helpful Content classification system?Join in a special group and be the first to know how to determine it.Tools that I use and recommend:Vizzex - ⁠⁠⁠⁠⁠⁠Helpful Content Analysis Tool⁠⁠⁠⁠⁠⁠Indexzilla -⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.indexzilla.io⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (indexing technology)⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SEO in ATX ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠- SEO as a serviceYoutube Channel -⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Confessions of An SEO®⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://g.co/kgs/xXDzBNf⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠-------- Crawl or No Crawl Knowledge panelInterested in supporting this work and any seo testing?Subscribe to Confessions of an SEO™ wherever you get your podcasts. Your subscribing and download sends the message that you appreciate what is being shared and helping others find Confessions of an SEO™An easy place to leave a review ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.podchaser.com/podcasts/confessions-of-an-seo-1973881⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠You can find me on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Carolyn Holzman⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ - Linkedin⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠American Way Media⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Google Directly⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠AmericanWayMedia.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Consulting AgencyNeed Help With an Indexation Issue? - reach out Text me here - 512-222-3132Music from Uppbeathttps://uppbeat.io/t/doug-organ/fugue-stateLicense code: HESHAZ4ZOAUMWTUA

Laura Tierney, CEO of The Social Institute, joins the pod to discuss shifting the narrative from technology bans to intentional usage. Explore fresh data on student AI perceptions, the rise of private backchannels, and why tech leaders must act as "quarterbacks" in fostering student-centered social etiquette in an evolving digital world.The Social Institute, organization equipping students, families, and educators with modern life skills to impact learning, well-being, and students' futuresStudent Insights Report (2026), from The Social Institute, documenting how students are navigating social media, technology, and everyday life, both online and offlineFamily Toolkit, from The Social Institute, includes expert tech tips, summaries of social media apps, and positive family huddle questions..Resources for educators, from The Social Institute“Clear is kind”, quote from Brene Brown and her book Dare to LeadBrick, physical device and app that temporarily removes distracting apps and their notifications from your phoneYondr, program creating phone-free spaces for artists, educators, organizations and individualsThe Philadelphia Eagles Playoff Loss

In this episode of JACC This Week, Dr. Carolyn Lam and Dr. Harlan Krumholz spotlight the 2025 Adult Congenital Heart Disease (ACHD) Guidelines and explore what they signal for the future of cardiovascular care. Framed by Dr. Krumholz's Editor's Page, "From Survival to Stewardship," this discussion highlights a broader transformation in cardiology: advances that once turned fatal conditions into survivable ones now demand lifelong, structured, and hyper-specialized care. The conversation examines how ACHD exemplifies the shift from episodic survival to coordinated stewardship—where surveillance, systems design, and scalable expertise are essential. The episode also reviews key updates from the guidelines, including risk-based classification, lifelong monitoring, ACHD center collaboration, and global and early-career perspectives. Additional highlights from the issue include cardiac screening in the young, cardio-renal trial insights from CONFIDENCE, wildfire-related cardiovascular risk, and emerging cardiometabolic intersections. This mini-spotlight issue challenges clinicians to rethink how specialized cardiovascular care can be delivered effectively at scale.

Happy New Year! This month for the February 2026 episode of the RCEM Learning Podcast Andy and Dave discuss blood pressure targets in spinal cord injury. Becky and Chris talk through a New Zealand Chest Injury Guideline and Rob then talks with Charlotte Underwood and the role of gender in the assessment of abdominal pain. If you'd like to email us, please feel free to do so here. After listening, complete a short quiz to have your time accredited for CPD at the RCEMLearning website! (02:14) New in EM - Blood pressure targets in spinal cord injury Early Blood Pressure Targets in Acute Spinal Cord Injury: A Randomized Clinical Trial (Sajdeya et al., 2025) (17:06) Guidelines for EM - New Zealand Chest Injury Guidance Health New Zealand - National Chest Injury Guidance (2025) [PDF] (59:44) Gender and assessment of abdominal pain - Charlotte Underwood Expression of interest to join this study Gender disparity in analgesic treatment of emergency department patients with acute abdominal pain (Chen et al., 2008) Race and Sex Are Associated With Variations in Pain Management in Patients Presenting to the Emergency Department With Undifferentiated Abdominal Pain (Drogell et al., 2022) Women's experiences of seeking healthcare for abdominal pain in Ireland: a qualitative study (Windrim et al., 2024) Ending the neglect of women's health in research (Galea et al., 2023)

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SHS865. CME/MOC/NCPD/AAPA/IPCE credit will be available until February 28, 2027.Preparing for the New Era of Blood-Based Biomarkers in Alzheimer's Disease: Navigating Guidelines, Understanding Policy, and Integrating Into Practice Workflows In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SHS865. CME/MOC/NCPD/AAPA/IPCE credit will be available until February 28, 2027.Preparing for the New Era of Blood-Based Biomarkers in Alzheimer's Disease: Navigating Guidelines, Understanding Policy, and Integrating Into Practice Workflows In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SHS865. CME/MOC/NCPD/AAPA/IPCE credit will be available until February 28, 2027.Preparing for the New Era of Blood-Based Biomarkers in Alzheimer's Disease: Navigating Guidelines, Understanding Policy, and Integrating Into Practice Workflows In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SHS865. CME/MOC/NCPD/AAPA/IPCE credit will be available until February 28, 2027.Preparing for the New Era of Blood-Based Biomarkers in Alzheimer's Disease: Navigating Guidelines, Understanding Policy, and Integrating Into Practice Workflows In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SHS865. CME/MOC/NCPD/AAPA/IPCE credit will be available until February 28, 2027.Preparing for the New Era of Blood-Based Biomarkers in Alzheimer's Disease: Navigating Guidelines, Understanding Policy, and Integrating Into Practice Workflows In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SHS865. CME/MOC/NCPD/AAPA/IPCE credit will be available until February 28, 2027.Preparing for the New Era of Blood-Based Biomarkers in Alzheimer's Disease: Navigating Guidelines, Understanding Policy, and Integrating Into Practice Workflows In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SHS865. CME/MOC/NCPD/AAPA/IPCE credit will be available until February 28, 2027.Preparing for the New Era of Blood-Based Biomarkers in Alzheimer's Disease: Navigating Guidelines, Understanding Policy, and Integrating Into Practice Workflows In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/NCPD/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/SHS865. CME/MOC/NCPD/AAPA/IPCE credit will be available until February 28, 2027.Preparing for the New Era of Blood-Based Biomarkers in Alzheimer's Disease: Navigating Guidelines, Understanding Policy, and Integrating Into Practice Workflows In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Lilly.Disclosure information is available at the beginning of the video presentation.

For some people, six hours of sleep is a huge win despite the 7-9 hour guideline. Krissy, Sabrina, and Ryann dig into why sleep duration guidelines exist in the first place, what chronic low sleep is linked to (from mood and performance to long-term cognitive health), and why "I've always slept bad" isn't the same as "this isn't affecting me." Then they get practical. How do you work with six hours instead of obsessing over eight? What if you're a shift worker, training hard, under-eating, stressed about work, or wired the second your head hits the pillow? What if you're doing "all the right things" and it's still not improving? They cover auditing your sleep environment, small bedtime shifts instead of dramatic overhauls, why quality often matters more than quantity, how nutrition and training quietly impact sleep, and when it's time to escalate beyond habit tweaks and involve a sleep study or medical support. No shame or sleep virtue signaling. Just a nuanced conversation about protecting your health when perfect sleep isn't on the table. Black Iron Nutrition Book a Free Discovery Call Free Macro Calculator Free Downloads Black Iron Blog  

Michelle Chew is a Professor of Anesthesiology and Intensive Care Medicine at Karolinska Institutet, Stockholm, Sweden, and editor for the British Journal of Anaesthesia. Hear her sharing her Perioperative Profile on TopMedTalk with Andy Cumpstey. After initial anaesthesia training in Denmark, she moved to Lund University, Sweden, combining clinical work and research, later establishing her own experimental haemodynamics group studying septic and haemorrhagic shock and myocardial changes. She balances academic and family life by prioritizing rather than seeking "life balance," noting challenges for women in academia despite Scandinavian support. She explains journal editing—from rapid assessment, literature checks, peer review coordination, to feedback synthesis—and entered the field via the European Journal of Anaesthesiology, later serving at BJA and other journals. She also describes developing clinical guidelines, emphasizing expert panels, systematic reviews, consensus, and local adaptation, with involvement in Scandinavian and European anesthesia societies. Throughout, she highlights lessons from mentors and family, especially her grandmother, stresses taking opportunities and putting in the work, and emphasizes that science and clinical medicine ultimately serve patients. -- Join us at Evidence Based Perioperative Medicine (EBPOM) World Congress 2026 in London. Be part of a global conversation as clinicians from around the world gather between 7-9th July at the British Library in London. Three days of evidence-based perioperative medicine, global insights, and expert debate—featuring speakers including Michael Marmot and Ken Rockwood. Register here - https://ebpom.org/product/ebpom-world-congress-2026/

Congress intended most first-time non-violent offenders receive a non-custodial sentence.  That's how federal law worked before the guidelines.  But, the guidelines did not fulfill that promise because the majority of those sentenced, end up having to serve time in the crumbling, overcrowded Bureau of Prisons.  All that may be about to change, with revolutionary new proposals the Commission is considering.   Take a listen, and then make your voice heard by lodging your comment on the USSG website: https://www.ussc.gov/policymaking/public-comment/public-comment-2026-proposed-amendments   IN THIS EPISODE: Trump Tarriff case and it's implications in the criminal world; The major questions doctrine; Proposed complete restructuring of sentencing guidelines table; Proposed post-offense rehabilitation reductions   LINKS: Visit the SET FOR SENTENCING SHOWNOTES FOR THE FOLLOWING LINKS: -prior recent podcast on other guideline amendment -3 R'S of Sentencing Narrative Article -New Law 360 Article by Doug Passon and Mark Allenbaugh on Guideline changes  

From the MTA as featured on OneLegUpAlex Adapts: Join the MTA Advisory Committee for Transit AccessibilityMTA is searching for new members to join the Advisory Committee for Transit Accessibility (ACTA) for the 2026-2027 term!We are looking for members of the community who want to advise the MTA on addressing riders' accessibility needs, identifying barriers across the transit system, recommending community-informed improvements, and supporting the MTA with its mission of Accessibility for All.If you or if someone you know is interested, please do apply! Being on the ACTA Committee is a voluntary position. Learn more about the Guidelines for the Advisory Committee for Transit Accessibility (ACTA).Applications are due on March 4, 2026. https://click.info.mta.org/?qs=eyJkZWtJZCI6ImQ2MDEzYjYxLWJkZmEtNGI3NS1hYmM2LWRmNjdmNWYzZjMyYyIsImRla1ZlcnNpb24iOjEsIml2IjoieVJTbXhWMkRzakZDblJXZ1dueHMrdz09IiwiY2lwaGVyVGV4dCI6Ikx3YUpvc1NLR2d5RlRlWEdvT0hFOXFkdjI0Ny8zZ1dpMkQvSzdodXAramhXWVZtWTRuVlQvNDdzU2ZqRUhtd1p2QUhTUTNzWU1FMlRwaWV0c0dXQUZvU01LYjR3eVJTbXhWMkRzakZDblJXZ1dueHMrdz09IiwiYXV0aFRhZyI6IkdEQk5rNllucmJCbGdCYUVqQ20rTUE9PSJ9

Guidelines for parents & students of hifz, Part 2 Guest: Qari Basheer Patel by Radio Islam

In this third collaboration between SIDP's Breakpoints and ESCMID's Communicable podcasts, hosts Erin McCreary and Angela Huttner invite two veteran authors of guidelines and guidances, Pranita Tamma (Philadelphia, USA) and Benedikt Huttner (WHO, Geneva, Switzerland) [1-3]. Together, they deconstruct the complex landscape of developing and implementing guidelines into digestible components: they discuss why different organizations develop guidelines and what need they hope to fulfil, the framework including the GRADE methodology under which guidelines are written, and major barriers in the uptake of guidelines. The conversation also details the distinction between guideline and guidance as well as the art and science behind formulating recommendations or suggestions, with a few anecdotal cases sprinkled in from the panel. References 1. WHO handbook for guideline development, 2nd Edition, https://www.who.int/publications/i/item/9789241548960 2. The WHO AWaRe (Access, Watch, Reserve) antibiotic book https://www.who.int/publications/i/item/9789240062382 3. IDSA 2024 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections, https://www.idsociety.org/practice-guideline/amr-guidance/ Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/

What if the guideline isn't wrong—but incomplete?And what if your patient isn't “non-compliant”—just complex?In this episode, I'm joined by Joost Van Wijchen to explore the tension between clinical guidelines and the messy reality of practice. We unpack the concept of mindlines—the experience-shaped frameworks that actually guide what we do—and why uncertainty isn't a flaw in care, but part of it.You'll learn:Why guidelines are population-informed—but patients are personalHow “mindlines” shape clinical reasoning more than we realizeWhy outcome measures like the Oswestry don't tell the whole storyHow the capability approach shifts focus from impairments to meaningful freedomPractical ways to navigate uncertainty without losing clinical integrityHow to co-construct care instead of imposing solutionsIf you've ever felt the tension between measurable outcomes and meaningful outcomes, this conversation will resonate.If this episode challenges or sharpens your thinking, subscribe and share it with a colleague.*********************************************************************

In this third collaboration between SIDP's Breakpoints and ESCMID's Communicable podcasts, hosts Erin McCreary and Angela Huttner invite two veteran authors of guidelines and guidances, Pranita Tamma (Philadelphia, USA) and Benedikt Huttner (WHO, Geneva, Switzerland) [1-3]. Together, they deconstruct the complex landscape of developing and implementing guidelines into digestible components: they discuss why different organizations develop guidelines and what need they hope to fulfil, the framework including the GRADE methodology under which guidelines are written, and major barriers in the uptake of guidelines. The conversation also details the distinction between guideline and guidance as well as the art and science behind formulating recommendations or suggestions, with a few anecdotal cases sprinkled in from the panel. This episode was edited by Kathryn Hostettler and Lacy Worden. It was peer reviewed for Breakpoints by Lacy Worden and for Communicable by Ljiljana Lukić of University Hospital for Infectious Diseases in Zagreb, Croatia.  References WHO handbook for guideline development, 2nd Edition The WHO AWaRe (Access, Watch, Reserve) antibiotic book IDSA 2024 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative InfectionsFurther readingESCMID AMR Guidelines, https://clinicalmicrobiologyandinfection.com/retrieve/pii/S1198743X21006790 GRADE working group, https://www.gradeworkinggroup.org/GRADE Book, https://book.gradepro.org/ IDSA's intraabdominal guidelines, https://www.idsociety.org/practice-guideline/intra-abdominal-infections/ ESCMID Manual for Clinical Practice Guidelines and Other Guidance Documents, https://www.escmid.org/guidelines-journals/guidelines/ International Consensus Guidelines for the Optimal Use of the Polymyxins https://accpjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/phar.2209 American Thoracic Society guidelines on community-acquired pneumonia, https://www.atsjournals.org/doi/abs/10.1164/rccm.202507-1692ST 

This year we are doing my group coaching course together via this podcast! It's free and it only gets better as the year progresses.  In January we began with God at the center of our day and our home. We worked to build the habit of a morning prayer routine. I highly recommend the rosary. It's only about 20 minutes and you'll meditate on the whole life of Jesus. February is the month of decluttering. Saturday episodes have been added to focus on decluttering in the kitchen. Each month will have a different focus area and the Saturday episodes will help you focus on one small section of that room.  If you're new here, welcome and give this first episode of 2026 a listen to hear where to begin: 316. Your 2026 Life Overhaul Plan: Faith, Clutter, Debt, Diet and More!  If you've never prayed a rosary or you want to see how you can incorporate it into active decluttering, here is the first episode of my rosary declutter series from last summer. 288. Summer Declutter Series Week Just getting started on your decluttering journey? Give this episode a listen before you begin: 322. Guidelines to Decluttering ***Are you so overwhelmed with clutter that you find yourself unable to make any decisions? Do you plan on decluttering only to find yourself standing in a room confused about where to start? Are you hoping motivation will strike and you'll get it all done in one weekend? If this sounds like you, let's work together. Book a one hour virtual coaching session via Zoom. Together we craft a decluttering plan and I walk you through the process. You'll complete much of the decluttering on your own time at your own pace. I just give you the roadmap and the accountability. Cost $77 per hour. Virtual Coaching Schedule   Not sure what you need? No problem! Book a complimentary 15 minute clarity call. We'll meet via Zoom and see if working with me would benefit you.  Email me at: tightshipmama@gmail.com to schedule a time.   Looking for community of like-minded women? Join the private Facebook community here: Facebook Group   Prefer to receive a weekly email with the monthly freebie like a group rosary, group declutter, or budget Q&As?  Join my mailing list here: Monthly Newsletter   For any other inquiries or guest appearances, please email me at: tightshipmama@gmail.com

Send a textWhat actually needs to be in place before digital pathology can replace the microscope?In this episode of DigiPath Digest, I walk through the 2026 Polish Society of Pathologists guidelines and translate them into practical steps for real pathology labs. This isn't theory. It's about hardware fidelity, data integrity, validation, and AI integration — and what each of these actually requires in daily workflow.We talk about scanner resolution standards (≤0.26 μm per pixel), 4K monitor calibration, visually lossless compression (20:1), scalable storage, pathologist-driven validation, and what “non-inferiority” truly means.Digital pathology is not just a change of medium. It's an operational shift.Episode Highlights[00:02] Community & growth 1,600+ new newsletter subscribers, 10,000+ Facebook members, and free Digital Pathology 101 book access.[07:20] The 4 pillars of adoption Hardware fidelity · Data integrity · Clinical validation · Future integration.[08:30] Hardware requirements 40x equivalent scanning (≤0.26 μm/px), 4K monitors, >300 cd/m² luminance, 10-bit color depth.[12:00] Workflow & throughput 200–300 slides/day per scanner, automated focus control, urgent case prioritization.[17:25] Storage & archiving ~1 GB per slide. Active archive (6–24 months). Long-term retention (10–20 years). GDPR compliance & TLS encryption.[23:09] Validation philosophy Pathologist-centered validation. Two phases: • Familiarization (~20 retrospective cases) • Dual review with discrepancy tracking Goal: digital must be non-inferior to glass.[29:03] AI in digital pathology AI supports quantification (Ki-67, HER2, ER/PR, PD-L1), tumor detection, and future multimodal predictions — but pathologists remain central.[33:26] Intraoperative telepathology

What if the version of you who already built the wealth, freedom, and life you desire could speak to you right now?This is an urgent transmission from your future millionaire self.MAGNETIC AFFIRMATIONS (1HR+): https://21-day-break-up-glow-up-challenge.teachable.com/p/making-mind-magnetic-affirmations-all-eyes-will-be-on-you-793498

Show notes at pharmacyjoe.com/episode1106 In this episode, I'll discuss the 2026 AHA Stroke Guideline changes to how contraindications to thrombolytics are presented.

Doctors Lisa and Sara talk to Consultant Endocrinologist Dr Rupinder Kochhar about patients with Type 2 Diabetes. Using hypothetical cases, we talk a little bit about diagnosis, but spend most of the time discussing the details of management in younger patients as well as how to de-escalate treatment and what the goals might be in a more frail elderly patient. Disclaimer: All educational content in this podcast was developed as part of the Circulation Health collaborative working project between Boehringer Ingelheim Limited, Greater Manchester Primary Care Provider Board and Health Innovation Manchester. Content has been created by Circulation Health Clinical Leads for educational purposes, reflecting NHS Clinical Lead and guideline-based recommendations. Boehringer Ingelheim had no input into content development. They have provided financial resources to support Podcast recordings related to this project. You can use these podcasts as part of your CPD - we don't do certificates but they still count :) Resources: NICE draft guideline - Type 2 diabetes in adults: management: https://www.nice.org.uk/guidance/gid-ng10336/documents/450 Managing Heart Failure, CKD and T2DM in Primary Care: https://pckb.org/e/managing-heart-faiure-ckd-and-t2dm-in-primary-care/ Essential steps in primary care management of older people with Type 2 diabetes: an executive summary on behalf of the European geriatric medicine society (EuGMS) and the European diabetes working party for older people (EDWPOP) collaboration: https://pmc.ncbi.nlm.nih.gov/articles/PMC10628003/ Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes: https://diabetesjournals.org/care/article/45/11/2753/147671/Management-of-Hyperglycemia-in-Type-Diabetes Diabetes UK: https://www.diabetes.org.uk/ ___ 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.

Have you seen the new 2025-2030 Dietary Guidelines for Americans and wondered if you should follow them? You may have seen talk about them on the news and social media, and don't know quite what to believe. The slogan of eating more ‘real foods' sounds good though, and the New Pyramid diagram seems to show that all foods - including butter, steak, whole milk and cheese – would be fine to eat and that we don't really need to worry about the amounts eaten. But DO we need to worry? And what about the recommendations about protein and nutritional adequacy issues in vegan and vegetarian diets?   Let's talk about this. In this episode, we'll take a deeper dive into the New Dietary Guidelines for Americans and look at 3 more KEY things you need to know about them, to inform your own health. We'll touch on protein, what the Guidelines say about vegan and vegetarian diets, and what has been found through research. Listen in!   For the list of references to this episode, please go to this episode's webpage at: www.plantnourished.com/blog/      Related Episode: 119 | What To Supplement? Here Are 3 Key Nutrients Vegans AND Meat-Eaters Need https://podcasts.apple.com/us/podcast/119-what-to-supplement-here-are-3-key-nutrients-vegans/id1697444279?i=1000725676993     Contact -> healthnow@plantnourished.com Learn -> www.plantnourished.com Join -> Plant-Powered Life Transformation Course: www.plantnourished.com/ppltcourse Get Free 15-Minute Strategy Call -> www.plantnourished.com/strategycall Free Resource -> 7 Ways to Test-Drive a Plant-Based Diet: www.plantnourished.com/testdrive     Have a question about plant-based diets that you would like answered on the Plant Based Eating Made Easy Podcast? Send it by email (healthnow@plantnourished.com) or submit it by a voice message here: www.speakpipe.com/plantnourished         [Health, Dietary Guidelines, Protein, Nutrition, Vegan, Plant Based Diets, Plant-Based Eating, Vegetarian, Heart Disease, DGA, New Guidelines, Nutrition, Hearth Health, Cholesterol, Diabetes, Blood Pressure, What to Eat, Saturated Fat, Healthy Eating]  

Today is Tuesday, February 17. Here are the latest headlines from the Fargo, North Dakota area. InForum Minute is produced by Forum Communications and brought to you by reporters from The Forum of Fargo-Moorhead and WDAY TV. For more news from throughout the day, visit InForum.com.

The development of up-to-date evidence and consensus based clinical care guidelines and algorithms for pTBI provide guidance to care providers in the prehospital and emergency medicine, surgical and intensive care settings. Brad Elder, MD Randy S. Bell, MD (CAPT (ret), MC, USN) Gregory W. J. Hawryluk, MD, PhD

Recent updates to U.S. guidelines for HIV post‑exposure prophylaxis (PEP) provide modernized recommendations for both non‑occupational and occupational exposures — reflecting advances in antiretroviral therapy and evolving evidence. This course summarizes key changes, including preferred regimens, testing/follow‑up modifications, and special‑population considerations, and explores how these updates influence clinical practice. You will gain the practical knowledge needed to inform prompt PEP decision‑making, patient counseling, and care coordination.HOSTRachel Maynard, PharmDGameChangers Podcast Host and Clinical Editor, CEimpactLead Editor, PyrlsGUESTKenric Ware, Pharm DClinical Associate Professor of Pharmacy PracticeMercer University Pharmacists, REDEEM YOUR CPE HERE!CPE is available to Health Mart franchise members onlyTo learn more about Health Mart, click here: https://join.healthmart.com/CPE INFORMATION Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Identify current guideline recommendations for initiating HIV PEP after occupational and non-occupational exposure.2. Describe key considerations for selecting and managing HIV PEP regimens.Rachel Maynard and Kenric Ware have no relevant financial relationships with ineligible companies to disclose.0.05 CEU/0.5 HrUAN: 0107-0000-26-052-H01-PInitial release date: 2/16/2026Expiration date: 2/16/2027Additional CPE details can be found here.

Recent updates to U.S. guidelines for HIV post‑exposure prophylaxis (PEP) provide modernized recommendations for both non‑occupational and occupational exposures — reflecting advances in antiretroviral therapy and evolving evidence. This course summarizes key changes, including preferred regimens, testing/follow‑up modifications, and special‑population considerations, and explores how these updates influence clinical practice. You will gain the practical knowledge needed to inform prompt PEP decision‑making, patient counseling, and care coordination.HOSTRachel Maynard, PharmDGameChangers Podcast Host and Clinical Editor, CEimpactLead Editor, PyrlsGUESTKenric Ware, Pharm D Clinical Associate Professor of Pharmacy PracticeMercer UniversityGET CE FOR THIS LISTENING!The GameChangers Clinical Update Series for Pharmacists delivers 52 expert-led podcast episodes and 30+ hours of clinically actionable continuing education, all for a one-time purchase of just $99—that's less than $3 per hour for high-impact learning you can apply immediately in practice. Click here to enroll. PRACTICE RESOURCEReceive the exclusive Practice Resource to use as a reference guide for this episode by purchasing the GameChangers Clinical Update Series. CPE REDEMPTIONThis course is accredited for continuing pharmacy education! Click the link below that applies to you to take the exam and evaluation to claim credit:If you are already enrolled in this course, click here to redeem your credit. To purchase the Clinical Update Series and claim your CPE credit, click here or to purchase this course individually, click here.  CPE INFORMATIONLearning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Identify current guideline recommendations for initiating HIV PEP after occupational and non-occupational exposure.2. Describe key considerations for selecting and managing HIV PEP regimens.Rachel Maynard and Kenric Ware have no relevant financial relationships with ineligible companies to disclose. 0.05 CEU/0.5 HrUAN: 0107-0000-26-052-H01-PInitial release date: 2/16/2026Expiration date: 2/16/2027Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagram

Revisiting EPA climate guidelines, debating Sharia on Capitol Hill, and Petra returns with a new album. Plus, Hunter Baker on sports gambling, a slip-and-fall lawyer as Olympic curling alternate, and the Thursday morning newsSupport The World and Everything in It today at wng.org/donateAdditional support comes from The Master's University, equipping students for lives of faithfulness to The Master, Jesus Christ. masters.eduFrom The Joshua Program at St. Dunstan's Academy in the Blue Ridge Mountains: work, prayer, and adventure for young men. stdunstansacademy.org

Meg, Hal and Symphony discuss episode 199 of Welcome to Night Vale: Guidelines for Retrieval. They chat about hope, trauma and frozen yogurt toppings. They are joined by Night Vale writer Brie Williams for a conversation about the funniest thing you can put in an eye patch, a go to diner order, recurring nightmares and how life experiences inspired this episode.  Find out more about calzones on our ⁠⁠⁠⁠⁠Patreon.⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠www.patreon.com/goodmorningnightvale⁠⁠⁠⁠⁠ Follow us on ⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠. Good Morning Night Vale is a production of ⁠⁠⁠⁠⁠Night Vale Presents⁠⁠⁠⁠⁠ Hosted by Symphony Sanders, Hal Lublin, and Meg Bashwiner Produced by Meg Bashwiner Edited by Felicia Dominguez Mixed by Vincent Cacchione Theme Music by ⁠⁠⁠⁠⁠Disparition Learn more about your ad choices. Visit megaphone.fm/adchoices