Podcasts about hospital boston

Send us a textDr. Sui Huang, MD, PhD is a Professor at the Institute for Systems Biology ( ISB - https://isbscience.org/people/sui-huang-md-phd/?tab=biography ) where his lab is focused on studying how gene regulatory networks control gene activity to create stable cellular states, such as different cell types, and how these states transition into different lineages in both healthy and diseased conditions.Dr. Huang is a molecular and cell biologist with a strong background in theoretical biology and has devoted much of his research to understanding the very phenomenon of cancer from a complex systems perspective. Before joining the ISB in fall 2011, Dr. Huang held faculty positions at the University of Calgary (Institute of Biocomplexity and Informatics), where he helped establish biocomplexity as a discipline in research and teaching, and at Harvard Medical School (Children's Hospital) where he obtained first experimental evidence for the existence of high-dimensional attractors in mammalian gene regulatory networks.Dr. Huang grew up in Geneva and Zurich. He received his MD degree from the University of Zurich and obtained thereafter, as the first recipient of the PhD-Program-for-Physicians Award of the Swiss National Science Foundation, his PhD in molecular biology and physical chemistry for work on interferons. As a postdoctoral fellow at Children's Hospital Boston he investigated tumor angiogenesis and cell growth control. In that period he also studied dynamical systems through his affiliation with the New England Complex Systems Institute.Important Episode Link - "The end of the genetic paradigm of cancer" - PLOS Biologyhttps://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3003052#SuiHuang #InstituteForSystemsBiology #Interferon #Angiogenesis #AttractorStates #Epigenetics #Cancer #Oncology #TumorMicroenvironment #DonaldIngber #ConradWaddington #Organogenesis #Morphogenesis #LeeHood #BeatriceMintz #ProgressPotentialAndPossibilities #IraPastor #Podcast #Podcaster #Podcasting #ViralPodcast #STEM #Innovation #Science #Technology #ResearchSupport the show

Welcome to Episode 245 of Autism Parenting Secrets. In this episode of Autism Parenting Secrets, we're joined by Dr. Richard Frye, a renowned child neurologist specializing in neurodevelopmental disorders, to explore the critical medical insights that can help children with autism thrive. Dr. Frye shares his expertise on mitochondrial dysfunction, immune system dysregulation, and other underlying medical issues affecting autism. We discuss the importance of evidence-based treatments, foundational aspects like sleep and gut health, and the significance of a tailored approach to each child's unique needs. Join us as we delve into the strategies and emerging interventions that offer the most promise for helping children with autism live their best lives.The secret this week is... EVIDENCE-BASED Treatments FIRSTYou'll Discover:Two Connected Challenges to Tackle Early in the Journey (4:15)Signs of Poor Gut Health (11:29)Three Key Issues You Can Measure and Treat (19:58)Why Mitochondria Matter So Much (22:49)The Importance of Folate Metabolism (25:35)Why Less Is MORE (34:43)About Our Guest:Dr Frye is a Child Neurologist with expertise in neurodevelopmental and neurometabolic disorders. He received an MD and PhD in Physiology and Biophysics from Georgetown University.  He completed a residency in Pediatrics at the University of Miami, Residency in Child Neurology and Fellowship in Behavioral Neurology and Learning Disabilities at Harvard University/Children's Hospital Boston, and Fellowship in Psychology at Boston University.  He also received a Master's in Biomedical Science and Biostatistics from Drexel University. He holds board certifications in Pediatrics and Neurology with Special Competence in Child Neurology.  He has authored over 300 publications and book chapters and serves on several editorial boards.Dr. Frye is a national leader in autism spectrum disorder (ASD) research. He is President and Chief Scientific Officer of the Autism Discovery and Treatment Foundation, Chief Medical Officer of the Neurological Health Foundation, Director of Research and Neurologist at the Rossignol Medical Center, and Principal Investigator at the Southwest Autism Research and Resource Center.He has led several clinical studies on children with ASD, including studies focusing on defining the clinical, behavioral, cognitive, genetic, and metabolic characteristics of children with ASD and mitochondrial disease and several clinical trials demonstrating the efficacy of safe and novel treatments that target underlying physiological abnormalities in children with ASD, including studies on leucovorin, cobalamin and tetrahydrobiopterin and has an ongoing multicenter controlled clinical trial on leucovorin, neuroimmune modulators and photobiomodulation.https://drfryemdphd.com/References in The Episode:Medical Academy of Pediatrics & Special Needs MAPSAdditional Resources:Unlock the power of personalized 1-on-1 support, visit allinparentcoaching.com/intensiveTake The Quiz: What's YOUR Top Autism Parenting Blindspot?To learn more about Cass & Len, visit us at www.autismparentingsecrets.comBe sure to follow Cass & Len on InstagramIf you enjoyed this episode, share it with your friends.

The imPROVE study aims to bridge the gap in patient-reported outcomes (PRO) data for Black women with breast cancer by enhancing engagement with tailored electronic PROs (ePROs) and partnering with community leaders to address barriers and ensure accessibility and relevance in community cancer care settings. In this episode, CANCER BUZZ speaks with Manraj Kaur, PhD, investigator and lead faculty for research and innovation at Patient-Reported Outcomes, Value, and Experience (PROVE) center at Mass General Brigham and Andrea Pusic, MD, chief of division of plastic and reconstructive surgery, director of PROVE center at Mass General Brigham, and professor of surgery at Harvard Medical School about the imPROVE study's efforts to enhance Black women's engagement in ePROs in breast cancer treatment.  Dr. Kaur sheds light on strategies to improve technology accessibility for Black women in their cancer care center by providing iPads and refined usability features on the imPROVE app. Dr. Pusic highlights imPROVE implementation results at five community cancer centers, including utilizing local champions and equitable access to resources.   “When we make sure Black women are included, we gain a more accurate picture of health, we can design better care, and then we take a real step towards closing the health equity gap.” – Manraj Kaur   “The imPROVE study is all about increasing accessibility of patient-reported outcome measurements to Black breast cancer patients receiving care in community cancer centers.” – Andrea Pusic   Manraj Kaur, PhD   Investigator, Lead Faculty for Research and Innovation Patient-Reported Outcomes Value Experience (PROVE) Center  Brigham and Women's Hospital  Boston, MA    Andrea Pusic, MD  Chief of Division of Plastic and Reconstructive Surgery  Director, PROVE Center  Brigham and Women's Hospital  Professor of Surgery  Harvard Medical School  Boston, MA    Resources: ACCC imPROVE Study Blog - https://www.accc-cancer.org/acccbuzz/blog-post-template/accc-buzz/2024/06/18/the-power-of-patient-reported-outcome-measures-to-community-cancer-centers? Harvard/BWH PROVE Center - https://prove.bwh.harvard.edu/current_project/improve-breast-cancer-care/

Send us a textImagine discovering that a simple misdiagnosis dramatically shaped your early years. That's exactly what happened to Dr. Mark Campbell-Foster, our guest and Director of Audiology Sales and Marketing at Redux. Mark takes us through his journey from a childhood misinterpreted as developmental delays to the revelation of his hearing loss at Children's Hospital Boston—a turning point that fueled both personal and professional growth. He navigates the intricacies of deaf culture, explores genetic underpinnings like Connexin 26 in his family, and stresses the life-changing importance of accurate diagnoses.As Mark recounts his high school years with hearing aids and the monumental transition to cochlear implants, we hear about the hurdles of living in a predominantly hearing world. The challenges are numerous, including the emotional and social aspects of needing to self-advocate. Mark shares the poignant moment when he realized hearing aids were no longer enough, prompting a life-altering decision for a cochlear implant. His story is a compelling mix of personal resilience and family adaptation, illustrating the emotional and practical aspects of embracing new hearing experiences.Mark's professional journey is equally inspiring, showing how he brings personal experience into his work with Redux. Mark celebrates the community and technological support that have been foundational to his success, highlighting the importance of connection and innovation in the field of audiology. Join us for this episode full of insights and inspiration as we explore the intersection of personal challenges and professional triumphs in hearing health. Connect with the Hearing Matters Podcast TeamEmail: hearingmatterspodcast@gmail.com Instagram: @hearing_matters_podcast Twitter: @hearing_mattasFacebook: Hearing Matters Podcast

In the latest episode of the 5 Second Rule podcast, guest Chris Smith delves into the collaboration between the Missouri Department of Health and Senior Services and APIC, resulting in the development of a school-based IPC Toolkit for Missouri Schools. This initiative equips the school community with valuable resources to enhance infection prevention practices in K-12 schools. Learn more about the toolkit's components, the TEAMS (Training, Education, Assistance, Mentorship, and Support) model approach, impact assessment through pre/post evaluations, and its potential to enhance population health beyond the healthcare sector. Hosted by: Kelly Holmes, MS, CIC and Lerenza Howard, MHA, CIC, LSSGB About our Guest: Chris Smith, MHA, Program Manager for APIC Chris A. Smith, MHA, is currently a Program Manager for the Association for Professionals in Infection Control and Epidemiology (APIC), acting as the project manager for the MO KIDS IPC Toolkit project. Ms. Smith has worked in the public health and medical fields for the last 30 years. Roles that she has held include Environmental Health Specialist and Bio-terrorism Response Planner for Columbia/Boone County Health Department, Communications and Emergency Preparedness Manager for University of Missouri Healthcare, Emergency Preparedness Director for Brigham and Women's Hospital (Boston), Senior Program Manager of the Boston Medical Intelligence Center, Boston Public Health Commission, and leading training development projects for workforce development for the Federal Emergency Management Agency, Field Operations Directorate. Ms. Smith is also an adjunct professor for the Massachusetts Maritime Academy, teaching Public Health Issues in Emergency Management. She earned her Master's in Health Administration (MHA) from the University of Missouri - Columbia.

For decades, academic clinical trials consortia have collaborated to optimize outcomes for childhood cancers through evaluating incremental improvements in conventional multi modality treatment regimes. There are now increasing opportunities to partner with industry to test new medicines in academic-sponsored trials, but these collaborative studies rarely contribute to marketing authorizations. Under the auspices of the multistakeholder platform ACCELERATE, a working group of representatives was convened from clinical academia, the pharmaceutical industry, the European Medicines Agency, US Food and Drug Administration, and patient advocacy to explore why this is the case and to seek solutions to enable academic-sponsored trials to directly contribute to the licensing of new medicines. This presentation summarizes the group's findings and provides an industry perspective on how to move forward.Dr. Barry is a board-certified pediatrician and pediatric hematologist/oncologist with over 15 years of experience in drug development. Prior to joining Day One in 2021, she was the Global Clinical Lead for Pediatric Oncology at Pfizer, as well as Head of Pfizer's Pediatric Oncology Leadership Team where she oversaw more than 10 pediatric oncology clinical programs. She has also held previous roles at Genzyme and Millenium/Takeda focused on the development of oncology therapeutics in adults. Dr. Barry serves on the Industry Advisory Council for CureSearch and is a member of the ACCELERATE Platform Steering Committee. She is also a co-chair of the Children's Oncology Group Industry Relations Council. Dr. Barry is a graduate of the pediatric hematology/oncology fellowship program at the Dana Farber Cancer Institute and Children's Hospital Boston, and the pediatric residency program at Tufts. She received her M.D. at Yale University School of Medicine and also obtained a Masters in Medical Science degree from Harvard Medical School.

First, what makes a good mentor? I recall Rev. Mary, a former Chaplain of Children's Hospital Boston saying, "Active listening is an important key". Another is empathy, being able to stand in the shoes of another. TWFYT notes: "The understanding, experience, and wisdom of mentors help us solve problems we would have a hard time handling independently." Take a listen to today's reading and maybe you will hear some pointers that might prove helpful when choosing a mentor. Blessings, Presiding Elder Barbara Hayes TWFYT

Dr. Robert S. Langer is the David H. Koch Institute Professor at the Massachusetts Institute of Technology (MIT). Being one of the eight Institute Professors is the highest honor that can be awarded to a faculty member at MIT. Much of Bob's research is at the interface between materials and medicine. His lab has created nanoparticles and drug delivery systems, engineered tissues and organs for things like artificial skin for burn victims, and made organ-on-a-chip technology to help develop and test new drugs that may someday help patients. When he's not working, Bob enjoys spending time with his family, taking his kids to sporting events, lifting weights, and going on walks with his wife. He received his bachelor's degree in chemical engineering from Cornell University and his Sc.D. in chemical engineering from Massachusetts Institute of Technology. Afterwards, Bob worked as a postdoctoral fellow at the Children's Hospital Boston and at Harvard Medical School. He joined the faculty at MIT in 1978. Since then, Bob has accepted more than 220 major awards and honors, including the U.S. National Medal of Science, the U.S. National Medal of Technology and Innovation (he is one of 3 living individuals to have received both these honors), the Charles Stark Draper Prize (often called the Engineering Nobel Prize), Queen Elizabeth Prize for Engineering, Albany Medical Center Prize, Breakthrough Prize in Life Sciences, Kyoto Prize, Wolf Prize for Chemistry, Millennium Technology Prize, Priestley Medal (highest award of the American Chemical Society), Gairdner Prize, Hoover Medal, Dreyfus Prize in Chemical Sciences, BBVA Frontiers of Knowledge Award in Biomedicine, Balzan Prize, and the Dr. Paul Janssen Award. In 1998, he received the Lemelson-MIT prize, the world's largest prize for invention for being “one of history's most prolific inventors in medicine,” and he was inducted into the National Inventors Hall of Fame in 2006. He is an elected Fellow of the Institute of Medicine of the National Academy of Sciences, the National Academy of Engineering, the National Academy of Sciences, and National Academy of Inventors, and the Royal Academy of Engineering. He has been awarded over 1,000 patents and has received 42 honorary doctorate degrees, including degrees from Harvard, Yale, Columbia, and Northwestern. In our conversation, he shares more about his life and science.

Currently only 1 out of 5 people with hearing loss seek treatment (and it is estimated that 48 Million people in the U.S. suffer from a disabling form of hearing loss!). Dr. Darrow's passion is helping patients, Audiologist, and future Audiologist, understand the positive benefits of treating hearing loss that include improved quality of life, increased cognitive function, restoring proper stimulation to the brain, and decreasing an individual's risk of developing mind-robbing Dementia.    By Host, The DocPreneur Leadership Podcast/Editor, Concierge Medicine Today   Our guest today is Dr. Keith Darrow (Co-Founder, Audiologist, Neuroscientist). Dr. Darrow is a distinguished expert, owner of the Hearing and Brain Centers of New England and founder of the Healthy Hearing Foundation of New England, as well as a board member of the Sound of Life Foundation (both non-profit organizations dedicated to providing education and hearing health care for those in need).   Topics Discussed Include: Unveiling the Connection Between Hearing Healthcare and Cognitive Wellness Navigating the Future of Audiological Advancements The Hidden Benefits of Hearing Healthcare How Hearing Affects Overall Well-being The Role of Hearing Healthcare in Cognitive Decline Prevention Strategies for Preserving Hearing Health Trends & Innovation for Private Practitioners Forecasting Trends in Hearing Healthcare   Dr. Darrow is a distinguished expert in Speech and Hearing Bioscience and Technology with a doctoral degree from the joint Massachusetts Institute of Technology (M.I.T) and Harvard Medical School program. He is a former Clinical Professor at Northeastern University (Boston, MA) and is currently a tenured professor at Worcester State University.   Dr. Darrow's clinical experience is vast and includes a clinical fellowship at the Department of Otolaryngology at Brigham and Women's Hospital (Boston, MA) and a trainingship at the Audiology Department in the East Orange (NJ) Veterans Association Hospital. He is the owner of the Hearing and Brain Centers of New England and founder of the Healthy Hearing Foundation of New England, as well as a board member of the Sound of Life Foundation (both non-profit organizations dedicated to providing education and hearing health care for those in need). He was recently named the Director of Audiology Research at Intermountain Audiology and has chosen to lead the Excellence In Audiology movement across the country.   Dr. Darrow is also a nationally recognized speaker, trainer, and researcher whose publications and research have been cited over 1000 times.   Dr. Darrow's career in hearing health care is singularly focused on helping people understand the benefits of improved hearing and communication, and the positive impact healthy hearing can have on a healthy cognition. Dr. Darrow believes wholeheartedly that Hearing Care is Health Care; and that hearing loss can have a significant impact on an individual's personal, social, economic and cognitive capacity.    Connect With Dr. Darrow and AUDExperts AudExperts.com ... Dr. Darrow's Podcast: Preventing Decline with Neuroscientist Dr. Keith N. Darrow Join the Community of Private Practices ... Learning Center and Online University ... Office Tel. (435) 272-0324 LinkedIn ...   Books Mentioned In Our Interview: 'Healthy Food Healthy Brain' - Dr. Keith Darrow - The Definitive Guide to Feeding Your Brain Healthy Foods Preventing Decline: Advances in the Medical Treatment of Hearing Loss and Tinnitus Silenced: The Medical Treatment of Hearing Loss   © Concierge Medicine Today, LLC. ("CMT") All rights reserved.   Disclaimers: All content presented here is for general information purposes only. It is NOT intended to provide medical, legal, professional, accounting or financial advice. No warranties or guarantees are assumed or implied and user(s) releases Concierge Medicine Today, LLC, its agents, representatives, affiliated brands/companies and/or guests from all damages, liability and/or claims. Be advised, some references, companies, individuals, products, services, resources and/or links may be out-of-date. Concierge Medicine Today, LLC does not update content past its release date. User(s) assume all risk and liability with any use of the content as well as third party links. Concierge Medicine Today, LLC., has no formal peer review and, therefore, cannot guarantee the validity of information and/or content contained on its web sites, podcasts, and/or all content it produces or releases. While some of our speakers may be licensed Physicians, they are not your Physician. Please consult your Physician related to anything you may have read or heard or have questions about or call 911. The views, thoughts, and opinions expressed are the speaker's own and do not necessarily represent the views, thoughts, and/or opinions of Concierge Medicine Today, LLC. The "Concierge Medicine Today, LLC" ("CMT") name and all forms and abbreviations are the property of its owner and its use does not imply endorsement of or opposition to any specific organization, product, or service. 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We discuss the importance of starting mental and emotional health conversations with children from a young age, highlighting the benefits for their emotional development and future stability and happiness.  In today's episode, Rebecca Rolland, a Harvard lecturer and author, emphasizes that these discussions should be ongoing and developmentally appropriate, focusing not only on negative emotions but also on the positive aspects of mental health to build resilience and empathy.  Rolland encourages openness and adaptability in these talks, reassuring children they have support and an open line of communication for any emotional challenges they may face. “Just as children are constantly developing over time in, say, their ability to read, their ability to tie their shoes and do physical things, we want to think about them as developing emotions and emotional vocabulary. We wouldn't tell a 6- or 7-year-old, well, let's talk about the nuances of depression in the same way we would do that with a teenager. That wouldn't make sense to them because they don't necessarily have a framework for that.” ~Rebecca Rolland, EdD To learn more -- or read the transcript -- please visit the official episode page. Our guest, Rebecca Rolland is the author of The Art of Talking with Children (HarperOne, 2022), a book designed to support educators, parents, and caregivers in enhancing their interactions with children. She is a nationally certified speech-language pathologist who has worked clinically with populations ranging from early childhood through high school and provided teacher professional development. She teaches at the Harvard Graduate School of Education and Harvard Medical School. She served as the Academic Learning Specialist at Kingsley Montessori School and as an Oral and Written Language Specialist in the Learning Disabilities Team at Children's Hospital Boston. She has an Ed.D. from the Harvard Graduate School of Education, an M.S. in Speech-Language Pathology from the MGH Institute of Health Professions, and a B.A. in English from Yale Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can't imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this study, researchers from Cedars-Sinai Los Angeles and Brigham and Women's Hospital Boston demonstrate that vaccination in long COVID patients causes a flare-up of the immune system. Flare-up is my (Dr. Been's) word. They used the word “aberrant” in some places. The comparison cohort were non-infected individuals as reference and infected and recovered as comparison cohort. Let's review. DrBeen: Medical Education Onlinehttps://www.drbeen.com/ FLCCC | Front Line COVID-19 Critical Care Alliancehttps://covid19criticalcare.com/ URL list from Oct. 26, 2023Serological response to vaccination in post-acute sequelae of COVID | BMC Infectious Diseases | Full Texthttps://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-023-08060-y A Possible Role for Anti-idiotype Antibodies in SARS-CoV-2 Infection and Vaccination | NEJMhttps://www.nejm.org/doi/full/10.1056/NEJMcibr2113694 Disclaimer:
This video is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. The content provided in this video is for informational and educational purposes only. Please consult with a physician or healthcare professional regarding any medical or mental health related diagnosis or treatment. No information in this video should ever be considered as a substitute for advice from a healthcare professional.

Your child's pediatrician is likely one of their most important; it's where all things begin. Author of the “411” series and revered pediatrician, Dr. Ari Brown, gives great insight on traits you should look for in your own pediatrician, vaccine schedules and resources to help you be the best advocate for your NICU baby.   In this episode, we chat about: After receiving your degree in child development, what made you pursue a career in pediatrics? What are things your pediatrician should be looking at and considering if your child is a NICU graduate? What traits should you consider in your pediatrician to best serve your child? When should a parent consult a pediatrician and when should they seek counsel from an additional specialist for their child? What should the relationship look like between a child's pediatrician and their other specialists? In an age of digital medicine, i.e. Dr. Google, how do you counsel your parents on when to seek medical care and when to treat things at home? Describe the ideal pediatrician-patient relationship. Let's talk about delayed vaccination schedules for medically fragile children. Tell us about your books: Baby, Expecting and Toddler 411. What can reader's expect? For a NICU parent who feels hyper-sensitive to every symptom their child presents, what's your best advice? Ari Brown, MD is a practicing pediatrician in Austin, Texas, for over 25 years after completing her pediatric residency and fellowship in developmental/behavioral pediatrics at Harvard Medical School/Children's Hospital Boston. Her passion to advocate for children and educate families extends beyond the office setting. She is the author of the bestselling "411" parent education book series including Baby 411: Clear Answers and Smart Advice for Your Baby's First Year with the new 20th anniversary/10th edition out this year, Toddler 411, and Expecting 411 available where books are sold and on Amazon. She also hosts online courses on newborn care and sleeping through the night. She has appeared on numerous national news and talk shows including NBC's Today Show, Dr. Phil, and CNN. She is a trusted voice for children's health, serving as a spokeswoman for the American Academy of Pediatrics (AAP). Dr. Brown has received the American Academy of Pediatrics Lifetime Achievement Award for child health advocacy.   Connect with Dr. Brown: Twitter: https://twitter.com/baby411   Facebook: https://www.facebook.com/expecting411  TikTok: https://www.tiktok.com/@aribrownmd  Website: https://baby411.com/    Buy Dr. Brown's books: https://amzn.to/3drAzH3   Learn about Dr. Brown's online newborn care and sleeping courses: https://store.draribrown.com/   The NICU is hard. We're here to help.   Hand to Hold is a national nonprofit dedicated to providing neonatal intensive care unit (NICU) parents with personalized emotional support, educational resources and community before, during and after their baby's NICU stay. NICU support is available at no cost to NICU parents in English and Spanish.   Connect with Hand to Hold: Learn more or get support at handtohold.org   Follow Hand to Hold on social media: Facebook: https://www.facebook.com/handtohold Instagram: https://www.instagram.com/handtohold/   Twitter: https://www.twitter.com/NICUHandtoHold YouTube: https://www.youtube.com/HandtoHold    The following music was used for this media project: Music: Thriving Together [Full version] by MusicLFiles Free download: https://filmmusic.io/song/10332-thriving-together-full-version License (CC BY 4.0): https://filmmusic.io/standard-license   Music: Bright Colors Of Life by MusicLFiles Free download: https://filmmusic.io/song/7855-bright-colors-of-life License (CC BY 4.0): https://filmmusic.io/standard-license  

Are you considering adopting or fostering? Or taking in a relative's child? Do you suspect or know that the birth mom used drugs or alcohol during pregnancy? Join us today to learn how these substances might impact the child and how you parent. Our guest is Dr. Lisa Prock, a Developmental and Behavioral Pediatrician, Director of the Developmental Medicine Center at Children's Hospital, Boston, and Clinical Director of the Translational Neuroscience Center at Harvard Medical School and Children's Hospital Boston. She is an Assistant Professor of Pediatrics at Harvard Medical School.In this episode, we cover:Foster, adoptive, and kinship parents and caregivers often need to consider whether they are the right family to parent a child with prenatal alcohol and drug exposure.The US government estimates that about 10% of children born in the US have been prenatally exposed to alcohol, drugs, or both. How common is prenatal substance exposure for foster and adoptive children, as well as those kids living with grandparents and other relatives?Are there signs or symptoms with a child that may have been exposed to alcohol and drugs in utero, absent confirmation from the mother?What is known about the amount or timing of alcohol or drug use and the impact on the baby or child?Short-term and long-term impacts of the following substances:Alcohol-does it matter the type of alcohol?Methamphetamines  Adderall, Concerta, Ritalin or other ADHD medicationOpiates/opioids-prescriptionOpioids-illegalHeroinFentanylMethadone, Suboxone, Subutex, BuprenorphineMarijuanaEcstasy, inhalantsTobacco-smoking cigarettes or vapingHow common is dual exposure/polysubstance exposure—alcohol and drugs?Do children who have been prenatally exposed to alcohol or drugs have a greater risk of abusing drugs in adolescence or adulthood?How do you get a child diagnosed with prenatal substance exposure?What should parents consider when trying to decide if they are the right family for a child with prenatal exposure?Creating a Family's Prenatal Substance Exposure Trainings for Parents, Daycare/Preschool Teachers, and Afterschool Staff. Support the showPlease leave us a rating or review RateThisPodcast.com/creatingafamily

I had a truly surprising lightbulb moment this week in my conversation with Dr. Joshua Sparrow about why saying "just try your best" could actually be harmful. Join me again in conversation with Dr. Joshua Sparrow, child, adolescent, and general psychiatrist; associate clinical professor of psychiatry at the Harvard Medical School; and supervisor for outpatient psychiatry services at Children's Hospital Boston. Sponsored by PM Pediatric Care: For more information about PM Pediatric Care and a list of locations, visitpmpediatriccare.com Skylight Frame: This has been SUCH a special gift for our family. Get $15 off your purchase of a Skylight Frame when you go SkylightFrame.com and enter code HUMANS KiwiCo: Give Awesome this holiday season with KiwiCo! Get your first month of ANY crate line FREE at kiwico.com/HUMANS. Produced by Dear Media This episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct, or indirect financial interest in products, or services referred to in this episode.

Many parents are in touch with their emotions and are comfortable being sensitive, but struggle to set clear boundaries and limits - which are two separate things - without feeling guilty. How can we communicate clear, effective boundaries while remaining emotionally sensitive? Join me in conversation with Dr. Joshua Sparrow, child, adolescent, and general psychiatrist; associate clinical professor of psychiatry at the Harvard Medical School; and supervisor for outpatient psychiatry services at Children's Hospital Boston. Caraway: Visit www.Carawayhome.com/humans or use code humans at checkout for 10% off your next purchase! Skylight Frame: This has been SUCH a special gift for our family. Get $15 off your purchase of a Skylight Frame when you go SkylightFrame.com and enter code HUMANS CDPH: Californians ages 12 and older can now get their updated booster- and children as young as five are eligible to receive the original booster. Head to myturn.ca.gov for more information about COVID-19 vaccines and boosters for the entire family. Produced by Dear Media

Rebecca Givens Rolland is an oral and written language specialist in the Neurology Department of Children's Hospital Boston and a lecturer at Harvard University. As a nationally certified speech-language pathologist, she has worked clinically with populations ranging from early childhood through high school and provided teacher professional development. As faculty and Module Director at Harvard Medical School, she lectures on topics of communication, mental focus, and creativity. She frequently consults with organizations working to design powerful learning experiences for kids and adults, including the World Bank. She has an Ed.D. from the Harvard Graduate School of Education, an M.S. in Speech-Language Pathology from the MGH Institute of Health Professions, an M.A. in English from Boston University, and a B.A. in English from Yale. She lives in Boston, Massachusetts with her husband and two children. RebeccaRolland.com Hosted on Acast. See acast.com/privacy for more information.

Six months ago, Josie was bedridden with a flare-up of the Multiple Sclerosis (MS) she's been battling for the past decade, alongside her husband, Joe, and some help from their much loved custom tandem bike. Over that same period, Josie and Joe have logged over 10,000 miles and raised $100,000 for research into MS, a disorder where the immune system attacks the nervous system.   But would her latest flare-up permanently sideline this avid cycling couple? “When this happened, I could not move a muscle,” recalls Josie.  “And when you were flat on your back and said you wanted to bike again,” recalls Joe, “I was skeptical… but hopeful.” Six months later, we cycled next to their tandem bike and heard about that uphill journey back from her flare-up, along with the ups and downs since our first interview at the National MS Society Bike Maine Getaway in 2019.  Expert commentary is provided from Dr. Mary A. O'Neal, Director of the Women's Neurology Program at Brigham & Women's Hospital (Boston), and Dr. Jacob Meyer of Iowa State, both suggesting we broaden our understanding of the benefits of physical activity to include improved mood and motivation.   Listen in for an informative, inspiring story of perseverance and teamwork against the steep challenge of MS.  My Body Odyssey is a Fluent Knowledge production. Original music by Ryan Adair Rooney. What's your body odyssey? Let us know: https://fluentknowledge.com/contact SHOW NOTES Expert Guests: Mary A. O'Neal, MD: Brigham and Women's Hospital Director of Women's Neurology Program  Notable Publications:  A Review of Women's Neurology Neurologic diseases in women: Five new things Jacob Meyer, PhD: Wellbeing and Exercise Lab, Twitter Principal Investigator of the WellEx lab at Iowa State University Expert on the neurobiological effects of exercise on depression Notable Publications: Changes in physical activity and sedentary behavior in response to COVID-19 and their associations with mental health in 3052 US adults Association of efficacy of resistance exercise training with depressive symptoms: meta-analysis and meta-regression analysis of randomized clinical trials Resources What is Multiple Sclerosis?  National MS Society Da Vinci Tandem Bikes Bike MS: Bike Maine Getaway 2022 The prevalence of MS in the United States What Causes MS? Find Support More at www.mybodyodyssey.com Subscribe to the show so you don't miss an episode! And follow us on: Twitter: @mybodyodyssey Facebook: @mybodyodysseypod Instagram: @mybodyodysseypodcast

VIDEOS: The fight for water | DW Documentary   New study shows Rhodiola rosea root might be beneficial for managing type 2 diabetes University of California at Irvine, August 15, 2022 A team of researchers led by the University of California, Irvine has discovered that treatment with an extract from the roots of the Rhodiola rosea plant might be effective for helping manage type 2 diabetes, showing promise as a safe and effective non-pharmaceutical alternative. The study, recently published online in Scientific Reports, found that in a mouse model of human type 2 diabetes, Rhodiola rosea lowered fasting blood sugar levels, improved response to insulin injections, modulated the composition of bacteria in the gastrointestinal tract and decreased several biomarkers of inflammation. The team utilized a genetically engineered mouse model that develops obesity, insulin resistance and high blood sugar, similar to advanced human type 2 diabetes, to test whether Rhodiola rosea could improve glucose homeostasis. In the study, cohorts of age-matched male and female mice were randomly assigned to one of two groups: control, which received water, or experimental, which received Rhodiola rosea extract. (NEXT) Meta-analysis concludes benefits for selenium supplementation in cognitively impaired individuals Instituto de Pesquisa Pelé Pequeno Príncipe (Brazil), August 15 2022.  A systematic review and meta-analysis published  in Nutrients found that supplementing with selenium was associated with improved levels of the mineral and the antioxidant enzyme glutathione peroxidase, as well as better cognitive function among patients with mild cognitive impairment (MCI) or Alzheimer disease (AD).  “For the first time, our study demonstrated, through a systematic review and meta-analysis, the possible benefits of selenium supplementation on selenium levels in patients with MCI or AD, as well as on markers of oxidative stress and on cognitive test performance,” Meire Ellen Pereira and colleagues wrote. Among studies that evaluated the effects of selenium without other nutrients, selenium measured in plasma, serum, red blood cells or cerebrospinal fluid increased among participants who received the mineral while remaining essentially the same or lower in the control groups. The meta-analysis determined that supplementing with selenium increased selenium levels by an average of 4 times in plasma, 1.88 times in serum, 3.73 times in red blood cells and 2.18 times in cerebrospinal fluid.  (NEXT) Skip the elevator: A 15-minute walk can help your brain fight off Alzheimer's German Center for Neurodegenerative Disease, August 15 2022 Older people can stave off Alzheimer's disease with a daily 15-minute walk or other physical activities, according to new research. Researchers in Germany say moderate physical activity boosts all areas of the brain, especially those involved in memory. Staying active also benefits people over 70 the most. They see the biggest increase in grey matter, compared to their “couch potato” peers. “Our study results indicate that even small behavioral changes, such as walking 15 minutes a day or taking the stairs instead of the elevator, may have a substantial positive effect on the brain and potentially counteract age-related loss of brain matter and the development of neurodegenerative diseases. In particular, older adults can already profit from modest increases of low intensity physical activity.” (NEXT) Antioxidants in fruit boosts immunity and protects thymus gland  Scripps Research Institute, August 8, 2022 Eating fruit and vegetables or taking antioxidant supplements may combat one of the most harmful aspects of aging by protecting a vital immune system organ, research suggests. Scientists demonstrated how ageing sabotaged the thymus gland, weakening the immune system and putting the elderly at greater risk of infection. But the irreversible damage could be reduced by the action of antioxidants such as vitamin C. Experiments showed that antioxidants – which are abundant in many fruits and vegetables – cut down the destruction wrought by a highly reactive by-product of normal metabolism. In studies on mice, animals given vitamin C and another antioxidant used in human medicine experienced significantly less age-related deterioration of the thymus. US lead scientist Dr Howard Petrie, from the Scripps Research Institute in San Diego, California, said: “The thymus ages more rapidly than any other tissue in the body, diminishing the ability of older individuals to respond to new immunologic challenges, including evolving pathogens and vaccines. Its function is to manufacture T-cells, essential immune system cells in the front-line of the body's defences against harmful foreign invaders and cancer. (NEXT) Modern Processed Diets Are Coding DNA and Gut Bacteria To Pass On Poor Immune Functions To Our Children Yale University and Erlangen-Nuremberg University, August 6, 2022 A team of scientists from Yale University in the U.S and the University of Erlangen-Nuremberg, in Germany, has said that junk food diets could be partly to blame for the sharp increase in autoimmune diseases such as multiple sclerosis, including alopecia, asthma and eczema. The new stark warnings come in a review published in Nutrition Journal, which analysed the impact that the modern Western diet has on immune function and risk of ill-health related to poor immunity and inflammation."While today's modern diet may provide beneficial protection from micro- and macronutrient deficiencies, our over abundance of calories and the macronutrients that compose our diet may all lead to increased inflammation, reduced control of infection, increased rates of cancer, and increased risk for allergic and auto-inflammatory disease," warned Myles in his review. Each person harbors a unique and varied collection of bacteria that's the result of life history as well as their interactions with the environment, diet and medication use. Western diet and lifestyles consisting of fast and processed foods are leading to a lower diversity of bacteria in the gut, say researchers. Of potentially greatest concern, our poor dietary behaviours are encoded into both our DNA scaffolding and gut microbiome, and thus these harmful immune modifications are passed to our offspring during their most critical developmental window. (NEXT) The aging heart accumulates mutations—while losing the ability to repair them Children's Hospital Boston, August 12, 2022 Why does the risk of heart disease go up as we age? Known risk factors such as hypertension or high cholesterol don't explain all cases. A first-of-its-kind study from Boston Children's Hospital now shows that the cells that make up our heart muscle accumulate new genetic mutations over time—while losing the ability to repair them. The findings were published in the journal Nature Aging. The research team, led by Sangita Choudhury, Ph.D., and August Yue Huang, Ph.D., in the Division of Genetics and Genomics at Boston Children's, sequenced the entire genomes of 56 individual heart muscle cells, known as cardiomyocytes, from 12 people across the age spectrum—from infancy to 82 years—who had died from causes unrelated to heart disease.  

Do we often pay attention to the conversations we're having with children? Or is it just automatic? Rebecca Rolland, a speech pathologist, affiliated with Children's Hospital Boston, has put together a guide to achieving what she calls "rich talk." It is a deeper conversation that can transform your relationships with children. The science of conversation has been around for centuries, but in the 21st century, it's more important than ever. A great chat can boost your students' learning and well-being years later. Courtesy RebeccaRolland.com Rolland's new book, "The Art of Talking with Children," is an evidence-based guide that will show you how to communicate with kids to feel understood while growing into happy adults who can connect better at home or school. In Episode 223 of Class Dismissed, Rolland shares some of her strategies for engaging in rich talk. She offers ideas to promote children's empathy, curiosity, and ability to embrace challenges. And she provides us with ideas to feel more effective and confident as a teacher. To hear our full interview with Rolland, listen to Episode 223 of Class Dismissed Podcast on iTunes or your favorite podcasting app. All Rights Reserved. Class Dismissed Podcast 2017-2022.

Learn about current treatment options. About the Speaker Dr. Anselm is a member of MitoAction's medical advisory committee and practices in Child Neurology at Children's Hospital Boston. Her research is focused on clinical presentation of children with mitochondrial disorders and their response to therapy with different medications and vitamins/ supplements. Dr. Anselm is currently participating in several clinical research studies. She is a co-investigator in a study using Dichloroacetate (DCA) to treat children with lactic academia. She sees children enrolled in the protocol when they are admitted to CH for DCA initiation and follows them in the Mitochondrial Program while they are being maintained on the DCA. Dr. Anselm also is Principal Investigator in a study entitled "Indirect calorimetry and nutritional assessment in patients with mitochondrial disorders." Children enrolled in this study undergo evaluation of their resting energy expenditure by indirect calorimetry and nutritional assessment. They also undergo metabolic evaluation by measurement of the levels of micronutrients/vitamins in their blood. Dr. Anselm also is involved in a multicenter study of patients with Angelman syndrome.

In this episode of the Balance Boldly Podcast sitting with Naketa Ren Thigpen let's welcome Diann Wingert Rebecca Rolland, she is an oral and written language specialist in the Neurology Department of Children's Hospital Boston and a lecturer at Harvard University. What you will learn:To realize that we face challenges across our entire life, and overcoming them guarantees us we are prepared and in charge of our lives and what it throws us up.More about Rebecca RollandShe has an Ed.D. from the Harvard Graduate School of Education, an M.S. in Speech-Language Pathology from the MGH Institute of Health Professions, an M.A. in English from Boston University, and a B.A. in English from Yale. Contact Rebecca RollandWebsite:  https://rebeccarolland.com/ Twitter:  @rolland_rg LinkedIn: @rebecca.g.rolland Join me for the upcoming Joy Map Method Masterclass- Undiluted! The Joy Map Method is for Married Women Entrepreneurs who want more out of life than living in the shadows of mediocrity. It's time to be unbound. Hosted by Naketa Ren Thigpen, a few limited times per year, you will want to set aside 90 minutes for this energetic, empowering, (and) equipping masterclass.  Register here> https://bit.ly/JoyMapMethodSubscribe, REVIEW, Share & Balance BoldlyOn the Balance Boldly Podcast, host Naketa Ren Thigpen talks with ambitious women in business (and a few brave men) from a wide array of industries about their pursuit of success, how they face business burnout, navigate relationship hurdles, and what overall work/life balance looks like for them. Not your conventional personal development podcast, Balance Boldly uncovers real solutions to real problems afflicting real people at home and in the workplace, daily.If you enjoyed this episode, head over to Apple Podcasts, Spotify, iHeart Radio, or your favorite podcast app to subscribe to the show and leave your honest review.If you want to dive deeper into personal development topics shared on the BBP (Balance Boldly Podcast) and get the “how-to” for implementing and infusing these tools, connect on LinkedIn so you get notifications for the Live Fully LinkedIn LIVESTREAMS held every Wednesday at 12 pm EST (as long as I'm not selfishly vacationing and intentionally refueling)

Dr. Brandon Fornwalt is the Senior Vice President of Cardiology at Tempus Labs. He earned his Bachelor's degree from the University of South Carolina, his MD from Emory, and his Ph.D. from Georgia Tech, followed by a one-year internship in pediatrics at Children's Hospital Boston. As you will hear, his passion for research took him next to the University of Kentucky as an Assistant Professor where he established his research program, before heading to Geisinger as a Diagnostic Radiology Resident before ultimately joining the faculty. He left Geisinger for Tempus Labs in 2021. Dr. Fornwalt's career pathway exemplifies the versatility of dual-degree training, and we pick his brain about life in and out of academics and clinical medicine, what it means to be a physician-scientist, and his advice for thriving in this career. Credits: Our thanks to Dr. Fornwalt for being on the podcast. Follow Dr. Fornwalt on Twitter: @BrandonFornwalt Dr. Fornwalt's faculty page: http://www.fornwaltlab.com/people.html Host: Bejan Saeedi Co-Host and Audio Engineer – Joe Behnke Executive Producer and Social Media Coordinator – Carey Jansen Executive Producer – Michael Sayegh Faculty Advisor – Dr. Brian Robinson Twitter: @behindthescope_ Instagram: @behindthemicroscopepod Facebook: @behindthemicroscope1 Website: behindthemicroscope.com

Join us for an informative discussion with Dr. Richard Frye, Director of Autism Research and Director of the Autism Multispecialty Clinic at Arkansas Children's Hospital Research Institute. There is increasing evidence that mitochondrial dysfunction is associated with autism spectrum disorder. Learn more about the latest research investigating the causes of this relationship, including the role of oxidative stress for these children. Topics include: The evidence for mitochondrial disease and dysfunction in autism spectrum disorder The importance of the oxidative stress in autism spectrum disorder and its impact on mitochondrial function The evidence for a subset of children with autism with acquired mitochondria dysfunction as a result of high levels of oxidative stress About The Speaker Dr. Richard Frye is the Director of Autism Research at Arkansas Children's Hospital Research Institute, Director of the Autism Multispecialty Clinic at Arkansas Children's Hospital and Associate Professor in Pediatrics at the University of Arkansas for Medical Sciences. He received his MD/PhD from Georgetown University in 1998. He completed a residency in Pediatrics at the University of Miami, Residency in Child Neurology and Fellowship in Behavioral Neurology and Learning Disabilities at Harvard University/Children’s Hospital Boston and Fellowship in Psychology at Boston University. He holds board certifications in Pediatrics, and in Neurology with Special Competence in Child Neurology. Dr. Frye is a national leader in autism research. He has authored over 100 peer-reviewed publications and book chapters, and serves on several editorial boards of prestigious scientific and medical journals. Over the past several years he has completed several clinical studies on children with autism spectrum disorder (ASD), including studies focusing on defining the clinical, behavioral, cognitive, genetic and metabolic characteristics of children with ASD and mitochondrial disease and several clinical trials demonstrating the efficacy of safe and novel treatments that address underlying physiological abnormalities in children with ASD, including open-labels on tetrahydrobiopterin, cobalamin and folinic acid and a recent double-blind placebo controlled trial on folinic acid. Future research efforts are focused on defining physiological endophenotypes of children with ASD and developing targeted treatments.

Join MitoAction and Dr. Richard Frye to discuss the distinction between primary and secondary mitochondrial diagnosis. Some talking points will include: Primary mitochondrial disease (PMD) is ideally diagnosed by a known or indisputably pathogenic mitochondrial or nuclear DNA mutation. Secondary mitochondrial dysfunction (SMD) can be caused by genes encoding either function nor production of the oxphos proteins and accompanies many heriditary non-mitochondrial diseases. Secondary mitochondrial dysfunction (SMD) can also be caused by enviornmental factors. In the absence of the ability to diagnose a primary mitochondrial disease (PMD), mitochondrial dysfunction can be effectively treated with standard treatments for PMD. When the etiology of mitochondrial dysfunction is unknown, re-evaluation for genetic and other causes should be revisited on a regular basis. About The Speaker: Dr. Richard Frye is a pediatric neurologist and Chief of the Division of Neurodevelopmental Disorders at Phoenix Children's Hospital. He received his MD/PhD from Georgetown University in 1998. He completed a residency in Pediatrics at the University of Miami, Residency in Child Neurology and Fellowship in Behavioral Neurology and Learning Disabilities at Harvard University/Children’s Hospital Boston and Fellowship in Psychology at Boston University. He holds board certifications in Pediatrics, and in Neurology with Special Competence in Child Neurology. Dr. Frye is a national leader in autism research. He has authored over 100 peer-reviewed publications and book chapters, and serves on several editorial boards of scientific and medical journals.

Dr. Pat O’Malley from Massachusetts General Hospital talks about long-term care and quality of life support for adults and children with mitochondrial disease. This month’s meeting is held in loving memory of Christopher A. Clark, whose family remained dedicated to helping him have the best quality of life possible every day. About the Speaker Dr. O’Malley has cared for several families with mitochondrial disease and helped them to find quality of life and balance despite the tragic progression of the disease. Join us as we learn more about palliative care and hospice, and work to uncover the benefits and break down the myths around what is often only associated with end-of-life. Dr. O’Malley has trained in pediatrics, pediatric critical care, emergency medicine and palliative care at Massachusetts General Hospital and Children’s Hospital Boston. She has served as the director of the Pediatric ED at MGH for 25 years and is also the director of the new Pediatric Palliative Care Team.

MitoAction welcomed Dr. Irina Anselm, pediatric neurologist and head of the mitochondrial disease clinic at Children’s Hospital Boston to discuss the topic of pain for patients with mitochondrial disease at our monthly international teleconference.

This week, join authors Steven Lubitz and Associate Editor Mark Link as they discuss the article "Screening for Atrial Fibrillation in Older Adults at Primary Care Visits: VITAL-AF Randomized Controlled Trial." Dr. Carolyn Lam:             Welcome to Circulation on the Run, your weekly podcast, summary and backstage pass of the journal and its editors. We're your co-hosts. I'm Dr.  Carolyn Nam, Associate Editor from the National Heart Center in Duke National University of Singapore. Dr. Greg Hundley:           And I'm Dr. Greg Huntley, Associate Editor, Director of the Pauley Heart Center from VCU Health in Richmond, Virginia. Dr. Carolyn Lam:             Well, guess what we have for the featured discussion today, Greg. It's about screening for atrial fibrillation in older adults at primary care visits. Very, very important topic. And what we'll be looking at is the vital AF randomized control trial. Ooh, we're going to keep everyone in suspense here as we carry on and discuss today's papers. Can I start? Dr. Greg Hundley:           Absolutely. Dr. Carolyn Lam:             Alright. This first paper is about infective endocarditis. Now, we know that cardiac surgery often represents the only treatment option in patients with infective endocarditis. However, infective endocarditis surgery may lead to a sudden release of inflammatory mediators, which is associated with the severity of postoperative organ dysfunction. So, authors Dr. Doesnst from Friedrich Schiller University of Jena in Germany, and colleagues, decided to investigate the impact of hemo absorption during infective endocarditis surgery on post-operative organ dysfunction. This multicenter, randomized, non-blinded controlled trial assigned 288 patients undergoing cardiac surgery for infective endocarditis to hemo absorption, which is integration of cytosorb to the cardiopulmonary bypass or control. The primary outcome was defined as the difference between the mean total postoperative sequential organ failure assessment score, calculated maximally to the ninth postoperative day, and the difference with the basal score. Secondary outcomes were 30 day mortality, durations of mechanical ventilation, basal presser and renal replacement therapy. Cytokines were also measured in the first 50 patients. Dr. Greg Hundley:           Interesting study, Carolyn. Wow. So, what are the results? Dr. Carolyn Lam:             Yes, this trial involved a lot of work and results showed, however, that there was a failure to demonstrate a reduction in postoperative organ dysfunction, 30 day mortality, or any of the clinically relevant secondary outcomes through intraoperative hemo absorption. Although hemo absorption reduced plasma cytokines at the end of cardiopulmonary bypass, there was no difference in any of the clinically relevant outcomes. Dr. Greg Hundley:           Great description, Carolyn. Well, my first paper comes to us from the world of preclinical science. And Carolyn, the ascending thoracic aorta, site of aneurysm formation, is populated by a mosaic of medial and adventitial cells that are embryonically derived from either the second heart field, or the cardiac neural crest. Second heart field derives cells, populate areas that coincide with the spatial specificity of thoracic aortopathies that are often associated with aneurysms. And so, this study, led by Dr. Alan Daugherty, from the University of Kentucky. Its purpose was to determine whether and how second heart field derived cells contribute to as sending aortopathies. Dr. Carolyn Lam:             Wow, an important topic, Greg. What did the authors find? Dr. Greg Hundley:           Okay. So, Carolyn, first, ascending aortic pathologies were examined in patients with sporadic thoracic aortopathies and angiotensin 2 infused mice. And so, the investigators found several things. First, second heart field derived smooth muscle cells and fibroblasts associate with angiotensin 2 induced aortic pathologies. Second, angiotensin 2 induced a distinct fibroblast sub-cluster that was less abundant for messenger RNAs related to major extracellular components and TGF beta-ligands and receptors, but more abundant for proliferative genes. Third, TGFBR2 deletion in second heart field derived cells were embryonically lethal, with significant dilatation of the outflow tract in the mice. And finally, second heart field specific deletion of LRP1 led to aortic pathologies in mice, supporting the importance of second heart field derived cells in maintaining ascending aortic wall integrity. Dr. Carolyn Lam:             Wow. Could you just sum up the clinical implications for us, Greg? Dr. Greg Hundley:           Well, Carolyn, I knew you were going to ask me that. So, these results indicate that heterogeneity of the embryonic origins of smooth muscle cells and fibroblasts contributes to complex mechanisms of vasculopathy formation, which should be considered when investigating the pathogenesis of thoracic aortopathies. Dr. Carolyn Lam:             Wow, thanks Greg. Well, my next study is also a translational study, and this one provides a deeper understanding of insulin regulation of cholesterol metabolism, and its disruption in type one diabetes. So, this is from Dr. Biddinger from Children's Hospital Boston and colleagues. In order to define the mechanisms by which insulin controls plasma cholesterol levels, the authors knocked down the insulin receptor, FOXO1, and the key bioacid synthesis enzyme, CYP8B1, in mice. They measured bioacid composition, cholesterol absorption, and plasma cholesterol. In parallel, they measured markers of cholesterol absorption and synthesis in humans with type one diabetes treated with ezetimibe and statins in a double blind crossover study. Dr. Greg Hundley:           Oh, wow, Carolyn. So, experiments in both animal models and in human subjects. So, what did they find? Dr. Carolyn Lam:             Insulin, by inhibiting FOXO1 in the liver, reduces 12 alpha hydroxylated bio acids, reduces cholesterol absorption and reduces plasma cholesterol levels. Thus, type one diabetes leads to a unique set of derangement in cholesterol metabolism with increased absorption rather than increased synthesis. These derangements are reversed by ezetemibe, which is a cholesterol absorption inhibitor, but not simvastatin, which is a cholesterol emphasis inhibitor. So, taken together, these data suggest that a personalized approach to lipid lowering in type one diabetes may be more effective, and highlight the need for further studies specifically in this group of patients. Dr. Greg Hundley:           Nice, Carolyn. Well, we've got some other really interesting or articles in the issue. And first, from the mail bag, there's a Research Letter from Professor Bers, entitled "Empagliflozin Reverses Late Sodium Current Enhancement and Cardiomyocyte Proarrhythmia in a Translational Murray Model of Heart Failure with Preserved Ejection Fraction." Carolyn, there's another research letter from Professor Shu entitled, "Activation Of INKY Cells at the Maternal Fetal Interface that Predisposes Offspring to Cardiac Injury." Also, there's a really nice, in depth article entitled, "Takasubo Syndrome Pathophysiology Emerging in Concepts and Clinical Implications." And it's from Dr. Trisha Singh. Dr. Carolyn Lam:             Nice. We also have an ECG challenge by Dr. Mugnai on “A Tachycardia in Disguise” and a Perspective piece by Dr. Alexander on “Equipoise in Clinical Trials: Enough Uncertainty [but] in Whose Opinion?” Isn't that interesting? Wow, thanks, Greg. Now, though, let's go on to this super exciting feature discussion on screening for atrial fibrillation in older adults' primary care. Dr. Greg Hundley:           You bet. Well, listeners, we are here for the feature discussion, now, on this March 29th issue. And we have with us Dr. Steve Lubitz, from Mass General and Boston, and our own associate editor, Dr. Mark Link, from University of Texas Southwestern Medical Center in Dallas, Texas. Welcome, gentlemen. So, Steve, we're going to start with you. Can you describe for us some of the background information that went into the construct of your study, and then what was the hypothesis that you wanted to address? Dr. Steven Lubitz:            Sure. Well, thanks for the opportunity to talk with you today about our work. So, as we know, AFib is a common and more bitter arrhythmia. And the first manifestation of AFib can be stroke in a substantial number of individuals. Strokes from atrial fibrillation or debilitating, but they can be prevented using oral anticoagulants if we know who has atrial fibrillation. But atrial fibrillation can be a symptomatic and it's possible, therefore, that screening pre-AFib could lead to new diagnoses and ultimately improve outcome by enabling stroke prevention. Point of care screening for AFib has been embraced by some guidelines for individuals age 65 or older, such as those in Europe, and mobile technology has now evolved and enables rapid mask screening using handheld ECGs, single lead ECGs, which obviates the need and expense of performing 12-lead ECGs to screen for AFib. Nevertheless, though, some guidelines have suggested that data are insufficient to recommend screening AFib using ECGs, such as those from the United States Preventative Services Task Force. We tested whether screening individuals age 65 or older at the time of a primary care clinic visit using a single lead ECG would lead to an increased rate of detection of AFib in contemporary United States practices. Dr. Greg Hundley:           Very nice. And so, maybe describe for us this task force, and also what was your study design and, again, your study population? Dr. Steven Lubitz:            Sure. So, specifically our study design, we performed a cluster randomized control trial in which primary care practice clinics were randomized to the screening intervention or to usual care, and patients aged 65 or older arriving for a primary care visit with their provider were eligible for participation. Patients were offered screening by practiced medical assistants at the time of their vital sign assessments, and screening was performed, if they consented, within a live core cardio mobile single ECG device, which was affixed to an iPad and stationed in the clinic. The results of the screening were made available to the providers at the time of the visit, and then the provider was able to make any and all decisions about subsequent management, confirmation or treatment. The primary outcome was a new diagnosis of Afib made in the medical record at one year following the start of the screening intervention, and the outcome was ascertained using the electronic health record and then manually adjudicated. We powered the study to detect a difference of nearly 0.5% in the rate of atrial fibrillation diagnoses at 12 months between the screening and usual care arms. Dr. Greg Hundley:           And how many patients did you enroll? And then what were your study results? Dr. Steven Lubitz:            Well, eight practices were randomized to the screening arm and eight practices to the usual care arm. And in total, that equated to about 15000 patients without a history of atrial fibrillation in the screening arm and 15000 patients in the control arm without a history of atrial fibrillation. The mean age was about 74, about 60% were female, 82% were white. And the mean chad-vad score was 3.4. We observed several main findings. The first is that, of the individuals in the screening arm, 91% were screened at least once. And this is the largest point of care screening study to date. The rate of screening in the intervention arm was substantially greater than any other contemporary trial, point of care, single ECG screening. We think that high rate of compliance with the intervention reflects patient enthusiasm for screening and a widespread feasibility of incorporating single ECGs into the routine vital sign practice workflow. Secondly, the primary endpoint, however, incidence of new AFib diagnoses at 12 months, was 1.72% in the screening arm, and 1.59% in the usual care arm, which equates to a risk difference of .13%. That was not statistically significant in the overall sample. We observed a substantial difference in new AFib diagnoses among those aged 85 or older in pre-specified subgroup analyses, 5.56% in the screening arm and 3.76% in usual care arm, which corresponds to a risk difference of 1.8%, where a number needed a screen of about 55, raising the possibility that point of care single ECG screening among the oldest and highest risk individuals might be effective. But this finding warrants future study. Third, we observed a shift in the location of diagnosis. So, they fit with a higher likelihood of diagnosis at a primary care practice encounter in the screening arm, as compared to the usual care arm, which is as expected. And the implications on downstream management pathways, cost of care, other downstream work flows is unknown at the moment. And lastly, we observed it in anticoagulation use was high, even among those with AFib diagnosed in the screening arm, which is a reassuring finding, suggesting that clinicians recognized that AF detected using this single lead point of care screening is likely to represent high burden, persistent AF that carries a substantial risk of stroke. Dr. Greg Hundley:           Very nice. Well, Mark, I know you review many papers for us here at Circulation. What attracted you to this particular paper? Dr. Mark Link:    This issue of point of care screening for AFib is a very hot topic. We all know that clinically diagnosed AFib carries with it a high risk of stroke, but what we don't know is incidentally found Afib, or nonclinically found Afib, what does that mean? This was one of the largest, if not actually the largest, study of point of care screening. And the i-cors are a very accurate device, or reasonably accurate device. So, we thought it's an important contribution to the literature. I think it surprised the authors, as well as us, there wasn't a difference in the diagnosis of AFib between the two arms. I think all of us would've expected to see that. But we're still learning a lot about point of care screening, and we're not to the point where we know what to do yet. Dr. Greg Hundley:           And Mark, what are some of your thought? Steve raised the point that, in that subgroup, greater than age 85, any additional insights there? Dr. Mark Link:    Yeah. I think that, if you can enrich your group with people that are more likely to have AFib, and the older you get, the more likely you are to have AFib, you are more likely to find Afib. But then treating people over age 85 also becomes a little bit riskier, with both anticoagulants and antirhythmic drugs and ablation. Dr. Greg Hundley:           Great points. Well, Steve, coming back to you, what do you see as the next study to be performed, really, in this sphere of research? Dr. Steven Lubitz:            Thanks. I think I proposed two additional lines of inquiry. At first, I think our hypothesis generating observation to the point of care screening with a single EDCG can lead to higher rates of AFib detection among the oldest individuals, age 85 or older, with a small number needed to screen warrants, replication, and the downstream implications of that on stroke and bleeding merit further evaluation. I think secondly, given the proliferation of wearable technology, future studies should examine the effectiveness of detecting perccismal atrial fibrillation for preventing downstream adverse events, including stroke. This point of care screening is likely to detect the highest burden persistent forms of atrial fibrillation in contrast to some of the wearable technology, like consumer wearable technology, that might detect paroxysmal atrial fibrillation, more commonly. Dr. Greg Hundley:           Ah, great point. And Mark, how about you? Anything to add? What future study do you see needs to be performed in this space? Dr. Mark Link:    It's clear from a number of studies that the longer that you monitor someone, the more likely you are to get a diagnosis of AFib. And that's pretty clear. This was a 30 second monitor. We have a number of studies that have shown two week and ILS monitoring is far more likely to get a diagnosis of AFib. But what we don't know is, if making that diagnosis of AFib makes any difference on ultimate outcomes. That's the studies that we need to see, is does treatment of incidentally found AFib improve clinical care. Dr. Greg Hundley:           Very good. Well, listeners, we want to thank Dr. Steve Lubitz from Mass General in Boston, and also Dr. Mark Link from UT Southwestern in Dallas, bringing us results from this study indicating that screening for atrial fibrillation using a single lead EKG at a primary care visit did not affect new atrial fibrillation diagnoses among those that were aged 65 years or older. There was, perhaps, a difference in those aged greater than 85 years, but more research is to come in that space. And, of course, looking for peroxisomal AFib with handheld devices is another area you yet to be investigated. Well, on behalf of Carolyn and myself, we want to wish you a great week and we will catch you next week, On the Run. Dr. Greg Hundley:           This program is copyright of the American Heart Association 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

Kevin Boston-Hill speaks with Oral and Written Language Specialist in the Neurology Department of Children's Hospital Boston and Lecturer at Harvard University, Dr. Rebecca Rolland as she shares insights into her new book, "The Art of Talking With Children - The Simple Ways to Nurturing Kindness, Creativity, and Confidence in Kids". Dr. Rolland shares strategies on how to communicate with the most difficult force on Earth - our children.

In this new episode, Dr. Dan speaks to Rebecca Givens Rolland (Neurology Department of Children's Hospital Boston) about her work as an oral/written language specialist and her new book https://rebeccarolland.com/books/the-art-of-talking-with-children/ Rebecca Rolland offers life-changing advice for every parent, caregiver, and educator to communicate more effectively with children in ways that let them foster relationships with less conflict and more joy and kindness. In addition, Dr. Dan and Rebecca, who is also a https://rebeccarolland.com/about/ talk about tips, tricks, and secrets of how to help kids of all ages—from infants through adolescents, from neurotypical to neurodivergent—open up. Rebecca Givens Rolland is an oral and written language specialist in the Neurology Department of Children's Hospital Boston and a lecturer at Harvard University. As a nationally certified speech-language pathologist, she has worked clinically with populations ranging from early childhood through high school and provided teacher professional development. She lives in Boston, Massachusetts with her husband and two children.  More information is on her website https://rebeccarolland.com/. Email your parenting questions to Dr. Dan podcast@drdanpeters.com (we might answer on a future episode) Follow us @parentfootprintpodcast (Instagram, Facebook) and @drdanpeters (Twitter) Listen, subscribe, rate, review on Apple Podcasts, Stitcher, or wherever you like to listen For more information  www.exactlyrightmedia.com  www.drdanpeters.com For podcast merch   www.exactlyrightmedia.com/parent-footprint-shop See omnystudio.com/listener for privacy information.

Rebecca Rolland is an oral and written language specialist in the Neurology Department of Children's Hospital Boston and a lecturer at Harvard University. Her new book, THE ART OF TALKING WITH CHILDREN: THE SIMPLE KEYS TO NURTURING KINDNESS, CREATIVITY, AND CONFIDENCE IN KIDS, is the topic of discussion in this episode.

Kathryn interviews Entrepreneur Rebecca Rolland EdD.Entrepreneur Bukola Somide introduces “Somi” the Computer Scientist. This beautiful interactive African American doll focuses on exposing kids to computer science concepts in a fun way. Her aim is to engage, educate, and inspire children everywhere. The Somi doll also touches on Cyberbullying, to bring awareness to what it is and to then encourage better online conduct. This interactive STEM doll also uses real life situations to explain coding terminology to children. Somide has worked for big tech giants like Intel. She's worked in the IT industry for 17 years and throughout her career recalls being the only Black person or Black woman on the Software Development team. After years of success in her field, Somide's vision is to help increase the number of minority girls thriving in the Computer Science industry.Kathryn also interviews Author Rebecca Rolland EdD. Science has shown that the best way to help our kids become independent, confident, kind, empathetic, and happy is by talking with them. Yet, so often, parents, educators, and caregivers are at a loss and have trouble communicating with kids. Conversations can feel trivial or strained—or worse, are marked by constant conflict. Rebecca Rolland, EdD, faculty member at Harvard Medical School and language specialist in the Neurology Department of Children's Hospital Boston shares an invaluable guide that provides readers with evidence-based tools and techniques to communicate more effectively with children, helping them foster relationships with less conflict and more joy and kindness. Rolland frequently consults with organizations working to design powerful learning experiences for kids and adults, including the World Bank.

Kathryn interviews Entrepreneur Rebecca Rolland EdD.Entrepreneur Bukola Somide introduces “Somi” the Computer Scientist. This beautiful interactive African American doll focuses on exposing kids to computer science concepts in a fun way. Her aim is to engage, educate, and inspire children everywhere. The Somi doll also touches on Cyberbullying, to bring awareness to what it is and to then encourage better online conduct. This interactive STEM doll also uses real life situations to explain coding terminology to children. Somide has worked for big tech giants like Intel. She's worked in the IT industry for 17 years and throughout her career recalls being the only Black person or Black woman on the Software Development team. After years of success in her field, Somide's vision is to help increase the number of minority girls thriving in the Computer Science industry.Kathryn also interviews Author Rebecca Rolland EdD. Science has shown that the best way to help our kids become independent, confident, kind, empathetic, and happy is by talking with them. Yet, so often, parents, educators, and caregivers are at a loss and have trouble communicating with kids. Conversations can feel trivial or strained—or worse, are marked by constant conflict. Rebecca Rolland, EdD, faculty member at Harvard Medical School and language specialist in the Neurology Department of Children's Hospital Boston shares an invaluable guide that provides readers with evidence-based tools and techniques to communicate more effectively with children, helping them foster relationships with less conflict and more joy and kindness. Rolland frequently consults with organizations working to design powerful learning experiences for kids and adults, including the World Bank.

Kathryn interviews Entrepreneur Rebecca Rolland EdD.Entrepreneur Bukola Somide introduces “Somi” the Computer Scientist. This beautiful interactive African American doll focuses on exposing kids to computer science concepts in a fun way. Her aim is to engage, educate, and inspire children everywhere. The Somi doll also touches on Cyberbullying, to bring awareness to what it is and to then encourage better online conduct. This interactive STEM doll also uses real life situations to explain coding terminology to children. Somide has worked for big tech giants like Intel. She's worked in the IT industry for 17 years and throughout her career recalls being the only Black person or Black woman on the Software Development team. After years of success in her field, Somide's vision is to help increase the number of minority girls thriving in the Computer Science industry.Kathryn also interviews Author Rebecca Rolland EdD. Science has shown that the best way to help our kids become independent, confident, kind, empathetic, and happy is by talking with them. Yet, so often, parents, educators, and caregivers are at a loss and have trouble communicating with kids. Conversations can feel trivial or strained—or worse, are marked by constant conflict. Rebecca Rolland, EdD, faculty member at Harvard Medical School and language specialist in the Neurology Department of Children's Hospital Boston shares an invaluable guide that provides readers with evidence-based tools and techniques to communicate more effectively with children, helping them foster relationships with less conflict and more joy and kindness. Rolland frequently consults with organizations working to design powerful learning experiences for kids and adults, including the World Bank.

Kathryn interviews Entrepreneur Rebecca Rolland EdD.Entrepreneur Bukola Somide introduces “Somi” the Computer Scientist. This beautiful interactive African American doll focuses on exposing kids to computer science concepts in a fun way. Her aim is to engage, educate, and inspire children everywhere. The Somi doll also touches on Cyberbullying, to bring awareness to what it is and to then encourage better online conduct. This interactive STEM doll also uses real life situations to explain coding terminology to children. Somide has worked for big tech giants like Intel. She's worked in the IT industry for 17 years and throughout her career recalls being the only Black person or Black woman on the Software Development team. After years of success in her field, Somide's vision is to help increase the number of minority girls thriving in the Computer Science industry.Kathryn also interviews Author Rebecca Rolland EdD. Science has shown that the best way to help our kids become independent, confident, kind, empathetic, and happy is by talking with them. Yet, so often, parents, educators, and caregivers are at a loss and have trouble communicating with kids. Conversations can feel trivial or strained—or worse, are marked by constant conflict. Rebecca Rolland, EdD, faculty member at Harvard Medical School and language specialist in the Neurology Department of Children's Hospital Boston shares an invaluable guide that provides readers with evidence-based tools and techniques to communicate more effectively with children, helping them foster relationships with less conflict and more joy and kindness. Rolland frequently consults with organizations working to design powerful learning experiences for kids and adults, including the World Bank.

KMOX's Megan Lynch talks with Rebecca Rolland, nationally certified speech pathologist with Children's Hospital Boston and Harvard University, and author of the new book "The Art of Talking with Children".  Rolland's new book gives parents a guide for engaging in meaningful conversations with their kids.   Rolland says as you talk to children about world events, try to regulate your own reactions so you don't bring stress to the conversation.  She says a good starting point is to try to get a sense of what they think is going on and pull out a map to give them a visual perspective on their world. 

Are halo foods really worth the hype? Skylar Griggs, a licensed registered dietitian and nutrition counselor specializing in a variety of nutrition-related conditions, is joining us today to talk about how one specific diet might not be the perfect answer to all of your problems, it all comes down to lifestyle changes. Skylar has experience working in pediatric and family nutrition as well as pre/post-natal nutrition, eating disorders, weight management, cardiac risk factors including hypertension, high cholesterol and obesity, diabetes, and overall wellness. She is presently the lead dietitian for the preventive cardiology division at Children's Hospital Boston and the owner of Newbury Street Nutrition, a private practice focused on weight management and heart health. Tune in now on SpotOn! --- Thank you for listening! Find us on Social: www.facebook.com/SpotOnDrJSB/ www.instagram.com/spot_on_podcast/ twitter.com/joansalgeblake

This Needs To Be Read hosts Author Rebecca Rolland THE ART OF TALKING WITH CHILDREN: The Simple Keys to Nurturing Kindness, Creativity, and Confidence in Kids (HarperOne; 3/1/22) by Rebecca Rolland, EdD - Harvard faculty member, speech pathologist, and mother - is an invaluable guide that provides readers with evidence-based tools and techniques to communicate more effectively with children in ways that let them foster relationships with less conflict and more joy and kindness. Science has shown that the best way to help our kids become independent, confident, kind, empathetic, and happy is by talking with them. Yet, so often, parents, educators, and caregivers are at a loss and have trouble communicating with kids. Conversations can feel trivial or strained—or worse, are marked by constant conflict. ABOUT THE AUTHOR: REBECCA GIVENS ROLLAND is an oral and written language specialist in the Neurology Department of Children's Hospital Boston and a lecturer at Harvard University. As a nationally certified speech-language pathologist, she has worked clinically with populations ranging from early childhood through high school and provided teacher professional development. As faculty and Module Director at Harvard Medical School, she lectures on topics of communication, mental focus, and creativity. She frequently consults with organizations working to design powerful learning experiences for kids and adults, including the World Bank. She has an Ed.D. from the Harvard Graduate School of Education, an M.S. in Speech-Language Pathology from the MGH Institute of Health Professions, an M.A. in English from Boston University, and a B.A. in English from Yale. She lives in Boston, Massachusetts with her husband and two children. https://rebeccarolland.com/ - @rolland_rg --- Send in a voice message: https://anchor.fm/tntbsmedia/message

As the country continues to grapple with the impact of racism in our communities, we wanted to understand how an institution like healthcare - which prides itself on scientific objectivity - was coming to terms with the impact racism has on doctors and patients alike. We reached out to Dr. Omolara Uwemedimo, a leading voice in advocating for black women physicians, to talk about her experiences as a doctor, as a patient and as a community builder seeking to heal with more than just medicine.    We sat with Dr. Uwemedimo on a canal separating her Long Island town of Baldwin, from neighboring Oceanside, New York. It was one of the first warm days of spring, and it seemed like everyone in the neighborhood was out with a leaf-blower or lawnmower, and every bird had a lot to say, especially the ducks and geese and laughing gulls that Omolara's kids consider their pets.    Luckily, Omolara is practiced at staying serene amidst chaos. She was a practicing pediatrician for many years in the United States as well as in several countries across Latin America, Asia and sub-Saharan Africa, while also teaching at Columbia University Medical Center, and founding the organizations Melanin and Medicine — to support black women doctors — and the Coalition To Advance Antiracism in Medicine.   She holds a bachelors degree in biomedical sciences from the City University of New York, she received her medical degree from New York University School of Medicine and completed her residency training in pediatrics at the Boston Medical Center / Children's Hospital Boston. She completed a research fellowship in health services research while completing a master's degree in population and family health at Columbia University Mailman School of Public Health.

by Mary Oliver in American Primitive

Happy International Women's Day from The Two Jess(es)! In celebration of all the incredible women in the WeSTAT community, our gift to you is the release of one episode every day this week. Jess and Jess have put together an inspiring line up of women who are making a difference in the world around them by practicing the values and virtues of THE INTERNATIONAL WOMAN (which include):JusticeDignityHopeEqualityCollaborationTenacityAppreciationRespectEmpathyForgivenessToday we celebrate community support through our conversation with Cherie Craft, CEO and Founder of Smart from the Start, a non-profit with programs running in inner city Boston and DC. Cherie shares their grassroots approach to setting up and living, breathing, working, in the communities that they are working to serve. The foundation of supporting the parents in order to increase a child's chances of life long success is simple yet profound in the way it works to change families perspectives of themselves, their capabilities and what it means to be a part of a community.This is a moving conversation that honors women in their strength, commitment and innovation. And is the perfect way to kick off this momentous week!https://smartfromthestart.org/Meet Cherie Craft:Cherie Craft is a native of inner city Boston, where she’s raised 5 children. She’s dedicated her life to educating children and empowering families living in challenging situations. Having studied Sociology and Counseling Psychology, she began her career in Pediatrics at Boston City Hospital and is now the Founder/CEO and Executive Director of Smart from the Start, a community engagement and family support organization that promotes the healthy development of young children and families. Additionally, for 22 years Ms. Craft has served as senior faculty with the National Institute for Family Centered Care, and after recently stepping down from the Community Board of Children’s Hospital Boston, Ms. Craft was appointed to the Maternal Mortality Review Committee and Maternal Child Health Council of DC. Ms. Craft engages in national and international speaking engagements and is a member of the NAACP, Urban League, and International Society for the Prevention of Child Abuse, among other organizations. Support the show (http://www.paypal.com)

Kevin Hrusovsky, Precision Health Visionary, Chairman & CEO, QuanterixKevin Hrusovsky is a biotech entrepreneur and healthcare visionary who has dedicated his career to transforming medicine into preventative and personalized healthcare. Hrusovsky currently serves as the President, Chairman and CEO of Quanterix, a company digitizing biomarker analysis to advance Precision Health, and is the founder of Powering Precision Health (PPH). He holds an M.B.A. from Ohio University and a B.S. in Mechanical Engineering from The Ohio State University. He received an Honorary Doctorate from Framingham State University and helped build the competitive strategy curriculum at the Institute for Strategy & Competitiveness at Harvard Business School. Hrusovsky lends his business expertise on the boards of several innovative technology companies, and was most recently named Chairman of the Board of Directors for Quanterix. He also serves on the Educational Board of the Massachusetts Biotech Council, the JALA Editorial Board, and the Strategy Committee of Children’s Hospital Boston.  John Marchica, CEO, Darwin Research GroupJohn Marchica is a veteran health care strategist and CEO of Darwin Research Group, a health care market intelligence firm specializing in health care delivery systems. He’s a two-time health care entrepreneur, and his first company, FaxWatch, was listed twice on the Inc. 500 list of fastest-growing American companies. John is the author of The Accountable Organization and has advised senior management on strategy and organizational change for more than a decade. John did his undergraduate work in economics at Knox College, has an MBA and M.A. in public policy from the University of Chicago, and completed his Ph.D. coursework at The Dartmouth Institute. He is a faculty associate in the W.P. Carey School of Business and the College of Health Solutions at Arizona State University, and is an active member of the American College of Healthcare Executives. About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

On this special episode, we've partnered with the podcast hosts of Healthy Homes, the Hippocratic Hosts and What is Black? Today, we're talking with Dr. Lauren A. Smith, Chief Health Equity and Strategy Officer for the CDC Foundation, and Dr. Letitia Dzirasa: Commissioner of Health for the Baltimore City Health Department. We're talking with these public health and pediatric health experts to help parents better understand the science behind the COVID-19 vaccines, address misinformation, strategies to communicate health information about the vaccine to families of color, and discuss the impact of the vaccine on children of color.Dr. Lauren Smith, MD, MPH, is the chief health equity and strategy officer for the CDCFoundation. As chief health equity and strategy officer, Smith partners with the CDC Foundation's other senior leaders to develop and drive strategic efforts to embed health equityacross the Foundation's COVID-19 response activities with an explicit focus onaddressing systemic racism and its impact on vulnerable populations' resiliencyamidst the pandemic. In addition, she leads activities to build organizational capacity to integrate health equity into the Foundation's practice, process, action, innovation, and organizational performance to elevate the importance of and deepen the Foundation's health equity impact. Smith holds a BA with honors in biology from Harvard College, an MD from the University of California, San Francisco School of Medicine, and an MPH from the University of California, Berkeley School of Public Health. She completed her pediatrics residency and chief residency at Children's Hospital Boston and her general pediatrics fellowship at BostonMedical Center, Department of Pediatrics.Dr. Letitia Dzirasa, MD, joined the Baltimore City government as the Commissioner of Health in March 2019. Dr. Dzirasa, a Hopkins trained pediatrician, believes that equitable care is the basic right for all and will tirelessly advocate for programs that support the overall health and wellbeing of all Baltimore City residents. Dr. Dzirasa's special interests include obesity management and prevention, trauma-informed care in children and adolescents, and expanded use of technology to improve health outcomes. In addition to holding a B.S. from the University of Maryland, Baltimore County in biological sciences, Dr. Dzirasa graduated from Meharry Medical College, Summa Cum Laude, in 2007. She lives in downtown Baltimore with her husband and son.

On this special episode, we’ve partnered with the hosts of Flesh ’N Bold, Healthy Homes with The Hippocratic Hosts and What is Black?. Today, we’re talking with Dr. Lauren A. Smith, Chief Health Equity and Strategy Officer for the CDC Foundation and Dr. Letitia Dzirasa, Commissioner of Health for the Baltimore City Health Department. We’re talking with these public health and pediatric health experts to help parents better understand the science behind the  COVID-19 vaccines, address misinformation, strategies to communicate health information about the vaccine to families of color and discuss the impact of the vaccine on children of color. Dr. Lauren Smith, MD, MPH, is the chief health equity and strategy officer for the CDC Foundation. As chief health equity and strategy officer, Smith partners with the CDC Foundation’s other senior leaders to develop and drive strategic efforts to embed health equity across the Foundation’s COVID-19 response activities with an explicit focus on addressing systemic racism and its impact on vulnerable populations’ resiliency amidst the pandemic. In addition, she leads activities to build organizational capacity to integrate health equity into the Foundation’s practice, process, action, innovation, and organizational performance to elevate the importance of and deepen the Foundation’s health equity impact. Smith holds a BA with honors in biology from Harvard College, an MD from University of California, San Francisco School of Medicine, and an MPH from University of California, Berkeley School of Public Health. She completed her pediatrics residency and chief residency at Children’s Hospital Boston and her general pediatrics fellowship at Boston Medical Center, Department of Pediatrics.Dr. Letitia Dzirasa, MD, joined Baltimore City government as the Commissioner of Health in March 2019. Dr. Dzirasa, a Hopkins trained pediatrician, believes that equitable care is the basic right for all and will tirelessly advocate for programs that support the overall health and wellbeing of all Baltimore city residents. Dr. Dzirasa’s special interests include obesity management and prevention, trauma informed care in children and adolescents, and expanded use of technology to improve health outcomes. Dr. Dzirasa also has close clinical ties to the Baltimore community, having trained at the Johns Hopkins Hospital in pediatrics and having worked as medical director for school based health and quality at Baltimore Medical System from 2013-2016.  In addition to holding a B.S. from University of Maryland, Baltimore County in biological sciences, Dr. Dzirasa graduated from Meharry Medical College, Summa Cum Laude, in 2007. References:http://info.primarycare.hms.harvard.edu/blog/racial-disparity-mortality-covid-children#:~:text=American%20Indian%2FAlaska%20Native%20https://www.covkidproject.org/disparitieshttps://www.npr.org/sections/health-shots/2017/12/12/569910574/native-americans-feel-invisible-in-u-s-health-care-systemhttps://khn.org/morning-breakout/efforts-to-address-hardest-hit-black-latino-communities-hamstrung-by-generations-of-distrust-in-health-system/Editing and music by Manni Simon

We're excited to share a joint episode in collaboration with the What is Black? and Flesh & Bold podcasts in which we're discussing everything you need to know about the COVID vaccines. Joining us are Dr. Lauren Smith, Chief Health Equity and Strategy Officer for the CDC Foundation, and Dr. Letitia Dzirasa, Commissioner of Health for the Baltimore City Health Department, who talk about the launch of the COVID vaccine, the COVID vaccine and children, health inequities, and the vaccine rollout in communities of color. Listen in now!Lauren A. Smith, MD, MPH is the Chief Health Equity and Strategy Officer for the CDC Foundation. In this role, she partners with the CDC Foundation’s other senior leaders to develop and drive strategic efforts to embed health equity across the Foundation’s COVID-19 response activities with an explicit focus on addressing systemic racism and its impact on vulnerable populations’ resiliency amidst the pandemic. Her previous leadership roles have included serving as co-CEO of FSG, one of the world’s leading social impact consulting firms; as medical director and then interim commissioner for the Massachusetts Department of Public Health; as senior strategic advisor for a national innovation and improvement network focused on reducing infant mortality; as national medical director of the Medical Legal Partnership for Children; and as the medical director of the pediatric inpatient service at Boston Medical Center, where she was on faculty in the Department of Pediatrics at Boston University School of Medicine. She currently serves on the boards of Blue Cross Blue Shield of Massachusetts, Health Law Advocates, Tobacco Free Mass and Zero to Three. She has published extensively in peer-reviewed literature on health equity and the implication of social policies on child and family wellbeing. Dr. Smith holds a BA with honors in biology from Harvard College, an MD from the University of California, San Francisco School of Medicine, and an MPH from the University of California, Berkeley School of Public Health. She completed her pediatrics residency and chief residency at Children’s Hospital Boston and her general pediatrics fellowship at Boston Medical Center, Department of Pediatrics.Letitia Dzirasa, MD joined the Baltimore City government as the Commissioner of Health in March 2019. Her special interests include obesity management and prevention, trauma-informed care in children and adolescents, and expanded use of technology to improve health outcomes. Prior to joining the Health Department, she worked at Fearless Solutions (Fearless), a Baltimore-based digital services firm that builds custom software solutions for local and federal government clients. In her role at Fearless as Health Innovation Officer, Dr. Dzirasa was responsible for managing the Healthcare IT portfolio for the company and provided clinical subject matter expertise to HIT projects. Dr. Dzirasa also has close clinical ties to the Baltimore community, having trained at the Johns Hopkins Hospital in pediatrics and having worked as medical director for school-based health and quality at the Baltimore Medical System from 2013-2016. In addition to holding a BS from the University of Maryland, Baltimore County in biological sciences, Dr. Dzirasa graduated from Meharry Medical College summa cum laude in 2007. She lives in downtown Baltimore with her husband and son.

I want to talk today about your legacy, what are you doing to make a difference. For you in your life, for the wing, with your family, in your community and in the world. First thing is Thank you all for your service, by serving in the military you are already making a difference, less than 1% of the US Population is serving in the military, you are part of an elite group of volunteers. My challenge to you is what can you do beyond your service to make a difference, what will your legacy be? How can you make a difference? Let’s throw out some ideas. Be a mentor, reach out to a fellow airman or a friend and make a difference in their life. Share your experiences both good and bad and you may just provide something that can be used to change someone’s life. Be a blood or platelet donor if you can. Just to let you know how important blood donation is, did you know that one pint of blood helps four children and it takes less than 30 minutes to donate. Along with becoming a blood donor I want to ask you to pull your license out now and look to see if you have a heart symbol on your license – I do. Have you thought about registering to become an organ donor? Please take time to look at Donate Life’s website for information on Organ Donation, right now there are over 110,000 people waiting for a lifesaving transplant and you could help save one of them. I am not sure if you know this but there are current and former wing members who saved a life by being a living organ donor, this is the most amazing thing to know that our wing members gave the gift of life. While I was deployed to Germany in 2016, my wife Sandra saved a life by donating one of her kidneys anonymously to a child at Children’s Hospital Boston. My family experienced the gift of life when my son Matty received a liver transplant when he was five years old, giving us two more years of making memories with him. Do you volunteer? Look for opportunities to volunteer at the 102nd and in your community. You can make a difference by volunteering and you will also make connections. Volunteerism is an important part of my family makeup allowing us to give back, meet new friends and make a difference in our community. You don’t need to leave your keyboard to volunteer, a great example of this is 102nd Intel Runners Facebook group. What a great idea to provide tips, motivation and connection to your fellow wing members. COVID has changed much of our everyday lives and many folks don’t venture out in order to stay safe. Are you reaching out to your friends and family? We can stay safe and connected at the same time – make a phone call, send a text message – reach out to someone that you have not seen in a while. The last thing that I want to talk about is you. Take care of yourself and make sure you do something for you. Do you want to finish your degree? Sign up for an online class. Did you always want to learn a musical instrument? Buy a used instrument and take lessons (or take a free online lesson.) Join the 102nd Intel Runners Facebook group and become a runner! Do something that makes you happy. Volunteer, reach out, stay connected and make a difference, this is about you!

PureTech Health is an advanced, clinical-stage biopharmaceutical company developing novel medicines targeting serious diseases that result from dysfunctions in the nervous, immune, and gastrointestinal systems (brain-immune-gut or the “BIG” axis), which together represent the adaptive human systems. PureTech Health is at the forefront of understanding and addressing the biological processes and crosstalk associated with the BIG axis. By harnessing this emerging field of human biology, the Company is pioneering new categories of medicine with the potential to have great impact on people with serious diseases. PureTech Health is advancing a rich pipeline that includes multiple post human proof-of-concept studies and pivotal stage programs. PureTech’s rich research and development pipeline has been advanced in collaboration with some of the world’s leading scientific experts, who along with PureTech’s team of biopharma pioneers, entrepreneurs and seasoned Board, identify, invent, and clinically de-risk new medicines. With this experienced team pursuing cutting edge science, PureTech Health is building the biopharma company of the future focused on improving and extending the lives of people with serious disease. Ms. Zohar created PureTech Health, assembling a leading team to help implement her vision for the Company. Ms. Zohar has been recognized as a top leader and innovator in biotechnology by a number of sources, including EY, BioWorld, MIT’s Technology Review, the Boston Globe, and Scientific American. She sits on the Technology Development Fund Advisory Board at Children’s Hospital Boston, is an Editorial Advisor to Xconomy, and is on the Board of Advisors of Life Science Care 

The Sleep Forum and World Sleep Society have come together to produce TEN podcasts about sleep as we countdown to World Sleep Day on March 13, 2010. In this podcast, Ruth Marion, Editor of The Sleep Forum and Allan O'Bryan, Executive Director of The Sleep Society speak with guest speaker, Dr. Judith Owens, Director of Sleep Medicine, Center for Pediatric Sleep Disorders, Department of Neurology, Children's Hospital Boston. O'Bryan explains to our listeners that “world sleep society is a non-profit, membership based organization representing sleep researchers and clinicians around the world focusing on awareness and education. Our leadership is volunteers looking to promote sleep worldwide. We use World Sleep Day as opportunity for our membership reach out to the public and highlight the importance of sleep.” When asked by O'Bryan to discuss the most prevalent sleep disorders in children, Owens replied that sleep disorders in children "encompass a variety of potential problems such as breathing, insomnia, parasomnias, and insufficient sleep." She commented that sometimes an individual or whole family unit needs to change certain behaviors so that it can positively impact sleep. The most important thing is to make sure that kids get the recommended amount of sleep. Owens mentioned that the groups like the World Sleep Society and events like World Sleep Day are fantastic because it raises awareness for sleep health and sleep disorders for caregivers and health care providers as well. When asked why she felt sleep disorders in children has risen, she replies "anxiety levels in children and adolescents have increased for lots of reasons. Anxiety is a driver for insomnia – difficulty falling asleep or falling back to sleep.  The use of electronic devices we know quite clearly not only is stimulating to the brain but there is a biological piece – the blue light coming from the screen that inhibits the production of melatonin.  Owens talked about treatment and protocols for insomnia in adolescents. When teenagers go into puberty they also have a shift in their natural falling asleep and wake time. Most adolescents it is hard for them to fall asleep before 11 pm at night but their natural wake time also shifts.  One of the issues that comes into play is early school start time. Environmental factors like social networking, increasing homework, extra curricular activities and being over-scheduled makes sleep fall to the bottom of their priority list. Adolescents today are more sleep deprived than any other group we have seen in history and their consequences could be long term. Some recommendations by Owens included rearranging priorities so adolescents can get the sleep they need, taking a short strategic nap and maintaining a consistent sleep schedule on school days and non school days. Owens continued by talking about research that has proved the short term and long term consequences of sleep deprivation in adolescents. "We know there is a decline in executive functions which include decision making, planning, motivation, regulating emotions and problem solving.  Not getting enough sleep negatively impacts these executive functions." This is one of the reasons why car accidents are the number one cause of death in adolescents. Lack of impulse control leads to risky behaviors such as driving after drinking or while tired. Sleep deprived adolescents suffer from mood changes and depression which is also why suicide is the third highest cause of death among adolescents. In addition, poor academic function and obesity can be short term effects of sleep deprivation. Long term consequences will be cardiac disease, cognitive impairment, high blood pressure and other life threatening conditions. Owens reminds us to stay empowered and to bring up concerns about sleep at all ages to your health care providers. Health care providers are becoming more informed and reminded to ask these ...

Dr. Jessica Barnes is the CEO & Co-founder of the 20Lighter Program, a ground breaking scientifically based obesity intervention. She has a passion for health, female entrepreneurship, and helping others be their best. She is an alumnus of Worcester Polytechnic Institute, and earned her PhD in Molecular Neuroscience from the University of Illinois at Urbana-Champaign. She was a fellow in the department of pediatric neuro-oncology at the Dana-Farber Cancer Institute and Children's Hospital Boston under the mentorship of Dr. Judah Folkman. Her previous roles have included Director of New Ventures at Access BridgeGap Ventures, Senior Science Officer at Summer Street Research Partners, and Vice President in MEDACorp at Leerink Swann. Additionally, she provides Business & Corporate Development consulting services to biotech & medical device companies. Fun Fact: Dr. Barnes is training for her first Triathlon.Dr. Dembrowski received his doctorate from Palmer College of Chiropractic West. With a deep 20+ year background in private practice and primary patient care he brings extensive integrative patient care experience along with holistic health expertise to the 20Lighter team.

Jake A. Kushner M.D., Medical Director, McNair Interests, provides a thorough overview of his research and study of diabetes. Currently, Dr. Kushner serves as the Medical Director for McNair Interests. He is a renowned diabetes researcher as well as a pediatric endocrinologist with a particular expertise in biotechnology, biomedical research, type 1 diabetes and other specific endocrine disorders. Dr. Kushner is the former Chief of Pediatric Diabetes and Endocrinology and McNair Medical Institute Scholar at the Baylor College of Medicine and Texas Children's Hospital. He has worked with the National Institutes of Health, served on the type 1 diabetes advisory council for Lexicon Corporation, and been a strategic advisor for Sanofi. Dr. Kushner discusses his background as a pediatric endocrinologist and how he came to be interested in the research and study of diabetes. Dr. Kushner is a respected, nationally recognized expert in type 1 diabetes research. His background in medicine is significant and includes endocrinology and diabetes, specifically caring for children with type 1 diabetes, as well as cystic fibrosis-related diabetes, and treating children who have hypoglycemia. He explains type 1 diabetes, and talks about how it affects many people worldwide.  Dr. Kushner delves into the complex issue of insulin and how the body reacts and responds to nutrients. He explains in detail, the storage of glucose, carbohydrates, and how the body processes everything that comes into it, as well as how stress affects everything. He talks at length about the kinds of meals that people eat, and explains how specific foods are processed by the body for use, including what the body needs, especially for those who have special dietary requirements due to health conditions or disease. Dr. Kushner is a UC Berkeley graduate and earned a medical degree from Albany Medical College in New York. Dr. Kushner completed his medical residency in pediatrics at Brown University. Additionally, Dr. Kushner engaged in a clinical fellowship at Children's Hospital Boston and a prestigious research fellowship at the Joslin Diabetes Center, the world's largest diabetes research center, at Harvard Medical School in Boston. 

This week we Flashback to one of our more popular shows with Christine Oliver, MD. Dr. Oliver joined us to discuss Odors and Chemical Sensitivities about 2 years ago. This was prior to our first YouTube videos so we are going to add some graphics and photos this week. Dr. Oliver is President of Occupational Health Initiatives, Inc. in Brookline, MA. She is an Associate Physician in the Department of Medicine (Pulmonary and Critical Care Division) at the Massachusetts General Hospital (MGH) and Associate Clinical Professor of Medicine at Harvard Medical School in Boston. Board certified in occupational medicine and in internal medicine. Dr. Oliver’s primary specialty is Occupational and Environmental Medicine, with an emphasis on occupational and environmental lung disease. At the MGH she evaluates and cares for patients with occupational and environmental illness and disease, including occupational asthma, interstitial lung disease, building-related health problems, and chemical sensitivities. Dr. Oliver has done research and published in the area of occupational lung disease and she has testified before the United States Congress with regard to work-related health issues and risks. For the past three decades an important focus of Dr. Oliver’s consulting work has been indoor air quality and related health effects. She has lectured and published on this subject and she has been actively involved in indoor air quality assessments in a variety of settings. These include health care facilities, courthouses and other government buildings, schools, and commercial office buildings. Together with industrial hygienists, engineers, and human systems specialists she has worked to identify, characterize, and resolve air quality problems and their related health effects. In 2009 she was a participant and presenter in the ASTM Johnson Conference on the standardization of mold response procedures. An important component of Dr. Oliver’s clinical work has been in the area of fragrances and their related health effects, including causation and/or exacerbation of chemical sensitivities. She has lectured on these topics, counseled patients and their families with regard to steps that can be taken to identify and remove fragranced products from their environment, and advocated for a fragrance-free policy in the clinic in which she works.

This week we Flashback to one of our more popular shows with Christine Oliver, MD. Dr. Oliver joined us to discuss Odors and Chemical Sensitivities about 2 years ago. This was prior to our first YouTube videos so we are going to add some graphics and photos this week. Dr. Oliver is President of Occupational Health Initiatives, Inc. in Brookline, MA. She is an Associate Physician in the Department of Medicine (Pulmonary and Critical Care Division) at the Massachusetts General Hospital (MGH) and Associate Clinical Professor of Medicine at Harvard Medical School in Boston. Board certified in occupational medicine and in internal medicine. Dr. Oliver's primary specialty is Occupational and Environmental Medicine, with an emphasis on occupational and environmental lung disease. At the MGH she evaluates and cares for patients with occupational and environmental illness and disease, including occupational asthma, interstitial lung disease, building-related health problems, and chemical sensitivities. Dr. Oliver has done research and published in the area of occupational lung disease and she has testified before the United States Congress with regard to work-related health issues and risks.    For the past three decades an important focus of Dr. Oliver's consulting work has been indoor air quality and related health effects. She has lectured and published on this subject and she has been actively involved in indoor air quality assessments in a variety of settings. These include health care facilities, courthouses and other government buildings, schools, and commercial office buildings. Together with industrial hygienists, engineers, and human systems specialists she has worked to identify, characterize, and resolve air quality problems and their related health effects. In 2009 she was a participant and presenter in the ASTM Johnson Conference on the standardization of mold response procedures. An important component of Dr. Oliver's clinical work has been in the area of fragrances and their related health effects, including causation and/or exacerbation of chemical sensitivities. She has lectured on these topics, counseled patients and their families with regard to steps that can be taken to identify and remove fragranced products from their environment, and advocated for a fragrance-free policy in the clinic in which she works.

Skylar Griggs is a licensed registered dietitian and nutrition counselor specializing in a variety of nutrition-related conditions. She has experience working in pediatric and family nutrition as well as pre/post-natal nutrition, eating disorders, weight management, cardiac risk factors including hypertension, high cholesterol and obesity, diabetes, and overall wellness. Skylar is the lead dietitian for the preventive cardiology division at Children’s Hospital Boston, the teaching hospital of Harvard Medical School. In this episode, Skylar talks with Anna about the special dietary concerns of members of the congenital heart defect community. She shares with Anna why she is passionate about nutrition and being a dietician and she explains how taking care of ourselves by eating healthy food doesn't have to be that hard.In addition to talking with Anna, Skylar spends the last segment of the show answering questions from a live, studio audience. The audience features members from around the world! You won't want to miss this very special episode!Support the show (https://www.patreon.com/HearttoHeart)

Guest: Dr. Carla Kim is a Professor in the Division of Hematology/Oncology and Pulmonary Respiratory Diseases at Children’s Hospital Boston, as well as in the Department of Genetics at Harvard Medical School and in the…

This week we speak with Dr. Douglas Mah, Assistant Professor of Pediatrics - Harvard Medical School and Director of the Pacemaker and ICD Service at Children's Hospital Boston about a recent paper he published with his colleagues on coronary artery compression from epicardial pacemaker leads. Who is at risk for this rare complication? How can patients be screened? Once identified, what is the treatment? We review all this and more with Dr. Mah. doi: 10.1016/j.hrthm.2018.06.038

Dr Carolyn Lam:                Welcome to Circulation On The Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center and Duke National University of Singapore. Our featured discussion today centers on the challenges of cardiovascular disease risk evaluation in people living with HIV infection, an important discussion coming right up after these summaries.                                                 The first original paper this week provides experimental evidence that nicotinamide riboside could be a useful metabolic therapy for heart failure. First author Dr. Diguet, corresponding author Dr. Mericskay, from University Paris-Sud investigated the nicotinamide adenine dinucleotide or NAD homeostasis pathways in the failing heart. They found that an expression shift occurs in both murine and human failing hearts in which the nicotinamide riboside kinase two enzyme, which uses the nucleoside nicotinamide riboside was strongly up-regulated for NAD synthesis.                                                 Nicotinamide riboside supplemented diet administered to murine models of dilated cardiomyopathy or pressure overloaded induced heart failure restored the myocardial NAD levels and preserved cardiac function. Nicotinamide riboside increased glycolysis as well as citrate and Acetyl-CoA's metabolism in these cardiomyocytes. Thus, nicotinamide riboside supplemented diet may be helpful in patients suffering from heart failure and may help them to cope with the limited myocardial ATP supply by restoring NAD coenzyme levels and its associated signaling.                                                 In the single ventricle reconstruction trial, one year transplant-free survival was better for the Norwood procedure with the right ventricle to pulmonary artery shunt compared with the modified Blalock‒Taussig shunt in patients with hypoplastic left heart and related syndromes. In the paper in this week's journal, authors compare transplant-free survival and other outcomes between these groups at six years. First and corresponding author Dr. Newburger from Children's Hospital Boston and her group showed that the right ventricular pulmonary artery shunt group had similar transplant-free survival at six years, but required more catheter interventions before the Fontan procedure.                                                 Right ventricular ejection fraction, New York Heart Association class and complications did not differ by shunt time. Cumulative incidences of morbidities by six years included 20% with a thrombotic event, 15% with a seizure, and 7.5% with a stroke. These data therefore emphasize the importance of continued follow-up of the cohort, and the need to find new strategies to improve the long-term outlook for those with single ventricle anomalies.                                                 The next paper presents results of the CREATIVE trial, which stands for Clopidogrel Response Evaluation and Anti-Platelet Intervention in High Thrombotic Risk PCI Patients). First and corresponding author Dr. Tang from Fuwai Hospital National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College conducted a head-to-head comparison of the safety and effectiveness of intensified anti-platelet therapies either a double dose clopidogrel or adjunctive cilostazol and conventional strategy in 1078 post-PCI patients at high thrombotic risk as identified thromboelastography, which is a platelet function test.                                                 The primary outcome was the incidence of major adverse cardiac and cerebral vascular events at 18 months post-PCI they find as a composite of all cause death, myocardial infarction, target vessel revascularization, or stroke. The authors found that the primary end point occurred in 14.4% of those in the conventional strategy. 10.6% in those given double dose clopidogrel alone. And 8.5% in those also given adjunctive cilostazol. Now, although both intensified anti-platelet strategies achieved increased platelet inhibition, only the triple strategy with adjunctive use of cilostazol significantly reduced adverse events in the long-term follow-up.                                                 No increased rates of major bleeding was found with the intensified anti-platelet therapy regimes. Thus, in patients with low responsiveness to clopidogrel as measured by thromboelastography, the intensified anti-platelet strategies with adjunctive use of cilostazol significantly improved the clinical outcomes without increasing the risk of major bleeding.                                                 The final original paper sheds light on the prevalence and predictors of cholesterol screening awareness and statin treatment among American adults with familial hypercholesterolemia or other forms of severe dyslipidemia. First and corresponding author Dr. Bucholz from Boston's Children's Hospital and their colleagues used data from the National Health and Nutritional Examination Survey, and showed a high prevalence of screening and awareness above 80%. However, there were relatively low rates of statin use among individuals with familial hypercholesterolemia at 52.3%.                                                 And even lower rates among those with severe dyslipidemia at 37.6%. The discrepancy between the prevalence of cholesterol screening and treatment was most pronounced in younger patients, uninsured patients, and patients without a usual source of healthcare. This study highlights an imperative to improve the frequency of cholesterol screening and statin prescription rates to better identify and treat this high risk population. Additional studies are needed to better understand how to close these gaps in screening and treatment.                                                 And that brings us to the end of our summaries. Now for our feature discussion. The natural history of infection with HIV has completely changed with the use of potent antiretroviral therapies. We now know that people living with HIV actually have morbidity and mortality patterns that really resemble the general population, especially with regards to cardiovascular disease, which is very prominent in this population. And I suppose it's this that has led to the assumption perhaps that risk prediction tools and intervention strategies that we apply in the general population may be used in patients living with HIV.                                                 Is this the case however? Well, this week's feature discussion is going to be so enlightening. And it's so important we are talking across the world here, from South Africa to the United States, and of course with me here in Singapore. I am so pleased to have the authors of this week's feature paper and they are none other than Dr. Virginia Triant from Massachusetts General Hospital, Dr. Ralph D'Agostino from Boston University. And our associate editor, Dr. Bongani Mayosi from University of Cape Town. Thank you so much for joining me for today's exciting discussion. Virginia, could I ask you to first describe your study? Dr Virginia Triant:             As you mentioned in the introduction, we have found that patients infected with HIV have an increased risk of cardiovascular disease. That includes both myocardial infarction and stroke compared to age-matched controls in the general population. And extensive data has suggested that the etiology of this increased risk is related both to traditional cardiovascular risk factors, as well as novel risk factors that are specific to HIV infection. And these include chronic inflammation in the immune activation. So consequently, it remains relatively unknown whether established cardiovascular risk prediction functions are accurate for patients with HIV because they include only risk factors that are traditional factors and they don't reflect the complete mechanism that we know is at play in cardiovascular disease associated with HIV.                                                 So in our study, we assess the performance of three established cardiovascular risk prediction functions, two Framingham functions, and then the ACC/AHA pooled cohort's equations and we applied this to a longitudinal HIV infected cohort that was comprised of men. And we investigated the performance of the risk scores in terms of comparing regression coefficients, discrimination and calibration, which are standard metrics in cardiovascular risk prediction. So I'll briefly summarize our overall results as a start. We found that overall, the risk prediction functions underestimated risk in our group of HIV-infected men.                                                 We found that discrimination was modest to poor, and this was indicated by low c-statistics for all of the equations. And we also found that the calibration or the agreement between observed or predicted risk was also poor across the board for all three risk prediction functions. So our results suggests that simply taking the risk prediction functions and transporting them to an HIV infected group may actually result in mis-classification in terms of patient risk. And in underestimation of cardiovascular risk. Dr Carolyn Lam:                Well, Virginia, beautifully summarized of a beautiful paper. But perhaps at this point, we should take a step back and ask ourselves how exactly were these risk prediction scores originally developed. And I can't imagine asking a better person than Ralph. Ralph, could you take us on a jaunt along history and tell us how were those Framingham risk scores developed in the first place? Who are they supposed to be applied to? And did these results surprise you? Dr Ralph D'Agostino:      After the second World War, what was becoming quite clear is things like cardiovascular disease were becoming very prominent. Things like infections and what have you, we were developing all sorts of ways of handling them with medicines and so forth. But with cardiovascular disease, it's a thing that progresses slowly over the years and it starts wiping out people. And back in those days, one out of three men between the ages of 30 and 60 had some kind of cardiovascular event. Women weren't that bad off, but they were pretty bad off also. And so what happened is the American government and the American Heart Institute set up this study in Framingham, where they took a third of the individuals between the ages of 30 and 60 and actually followed them. They took values of variables like blood pressure, cholesterol, things they thought might be useful.                                                 And took values on them. And they had to come back every two years and after as time went on, they took the data after six years, after 10 years they took the data, and started to look at how each individual's blood pressure related to cardiovascular disease. Does cholesterol, and the answer was yes. And then I started getting involved and we were developing these cardiovascular functions where you could actually take an individual, take their measurements now, and make a prediction that had a lot of validity, good discrimination, high predictability over what was going to happen in ten incidents and then the government, the US Government, started having guidelines and what we did is we ran a study where we took a number of different studies in the US, different cardiac studies, the ARIC studies, number of 'em, and we thought applying our functions how well would they do. And it turned out that for whites in the country, the Framingham functions did very well.                                                 But Japanese-Americans in the country, it over-predicted. Then we found out that you could make a calibration adjustment and what we've gone to, like in China, we have a big study where we had a function and Framingham function it over-predicted but calibration adjustment would make enough corrections and so now with Jeanne and the HIV, our hope was that you could take these functions and see how they work on the HIV population. When we did it we were quite well aware, because people have been looking at different things, there's something beyond the original cardiovascular risk. And what the paper shows, quite nicely, these cardiovascular risks do have some relationship but they don't explain enough. The HIV population have a much bigger burden and a simple calibration adjustment just isn't going to work. We need new variables, we need new insights on what to add to these functions. Dr Carolyn Lam:                Thank you so much for that. That's just such important part of history because I have to thank you for those equations. We apply those definitely in our Asian cohorts with that calibration factor. But I was just reflecting as you were telling that story of how we've come full circle now to actually talk about an infection again. It's the midst of an infection, like HIV infection, that we're now testing these equations once again. What better than to ask than Bongani, you're in the epicenter, if I may, of HIV infection. What do you think of the applicability of these findings to the patients you see? Dr Bongani Mayosi:         Yes. These findings are clearly of great interest to us here in the Sub-Saharan African region because it is really the epicenter HIV pandemic. We found population, in terms of risk factors for arteriosclerosis disease still remains low although there clearly derives, for example, in the incidence of myocardial infarction that's being detected in a number of the leading centers now. And with HIV we have observed cases of myocardial infarction while they tend to be younger men who almost always smoke and who get a lot more of a thrombotic episodes.                                                 When you catch them on a thrombotic load, you do not find arteriosclerosis disease. It's going to be important, I think, as we move forward to make sure that as we develop risk functions that will predict cardiovascular disease in patient HIV that the African epidemiological context is completed teaching that HIV affects younger people, affects large numbers of women, but that, quite clearly, is associated with decreased cardiovascular event and stroke and stroke is well demonstrated. But in terms of actually looking at the risk factor this population was still in the early day and certainly in future studies would have to have a major contribution of the African cohort. Dr Carolyn Lam:                That's true, Bongani, but may I ask how would you, perhaps, advise your African colleagues now to look at these data? Then I'd also like to turn that same question over to you, Virginia. What do we do? What's the clinical take home message of these findings? Dr Bongani Mayosi:         I think the message is true that HIV infection is associated with the increased risk of cardiovascular event, there's no doubt about that. That there are some risk factors that can carry through, such as the smoking population but it's important for all clinicians to be aware of that. The ordinary risk you find in using Framingham and other established risk functions is not going to give us all the information that we need. So that recommendation should come through we need to know that risk factors are unknown, that they're important and we need to learn more about these patients in order to give us a perfect prediction of what will happen in the future. Dr Virginia Triant:             I think the findings have a lot of clinical relevance. This suggests, I think, that there are a lot of clinical implications for any patient who has novel cardiovascular risk factors that may not be accounted for in heart functions. And what our findings suggest is that if functions don't reflect the actual composition of risk factors in the population, that can result in misclassification and thus we underestimate risk, we might miss high-risk individuals, high-risk patients who would benefit from aggressive risk reduction but are not currently receiving it. This is a real clinical challenge as sit in clinic and we pull up the scores and calculate them for our patients, whether that is a trustworthy number or whether we should, perhaps, thinking that it's higher, thinking that it's different than what we're seeing for predicted 10-year risk. I think what this suggests is that the functions may need to be further tailored to different populations and sub-populations to reflect the actual composition of risk factors in that population. Even within HIV patients and populations, the risk factors in South Africa might be different than those in Boston, with different relative contributions.                                                 One of the next stepped planned for our team is to actually look at developing, new risk functions which are tailored to HIV and incorporating both HIV itself as a risk factor, as well as HIV specific variables and to attempt to see if we can improve the performance of these functions for HIV populations. Perhaps HIV or HIV related factors might become sort of a new cardiovascular risk equivalent and we can serve patients in this population as higher cardiovascular risk baseline. I also just wanted to mention, briefly, that I think that there are important clinical implications beyond HIV that extend to other chronic inflammatory conditions. Inflammation is increasingly recognized as important in cardiovascular risk and this way HIV can serve as a prototype population. But these results are likely to extend to a lot of different populations who have chronic inflammation for different reasons. Dr Carolyn Lam:                That's a great point, Virginia. As I'm listening, I'm wondering is there no end to this because now we say HIV and then we put other inflammatory diseases, then we say, "Well, women may be different from men," and then different ethnicities may be different. I think gonna be going closer and closer to precision risk prediction, if I might say. Could I just pick your brain here? What do you think the future is? Where's the room for machine learning approaches for risk prediction, individual almost down to that level? What do you think? Dr Ralph D'Agostino:      I think you're right on target. In some sense, the functions we have there's a sort of massiveness about it, when you come to view this population, back in the 50s and 60s and so forth, cardiovascular disease was such a major ... it still is a major problem ... such a major problem you identify some of the real items like the blood pressure and cholesterol, and you attack and develop functions on that and you'd find that you're affecting positively a huge number of individuals, but now as, like Jeanne was saying, and others have been saying, you start focusing, you've got this massive group of individuals who should have their blood pressure controlled and what have you, but if you go into HIV, you go into a number of other populations and so forth, there are other things that are driving these disease and driving the manifestations of the disease. It isn't that blood pressure isn't important, it's that there's other things that are important. And so it's machine learning and so forth and deep learning that you're gonna have to be dealing with manifestations on very high levels and maybe even get into genetics.                                                 Look in the cancer field ... I do a lot of work with the FDA ... look at the cancer field now; how it's so genetically driven in terms of a lot of the drugs the so-called biomarkers, which are basically driven by uniqueness in populations. I think that's definitely going to be, or is the future of these cardiovascular functions. Dr Carolyn Lam:                Okay audience. You heard it, right here. These are exciting times. In the meantime, thank you so much for this precious, valuable piece of work. Virginia, Bongani, Ralph, it was great having you on the show.                                

Date: July 1, 2010 Featuring: Barry Silbaugh, MD, MS, FACPE, CEO, American College of Physician Executives Kevin Stewart, FRCP, Medical Director Winchester and Eastleigh NHS Trust; Health Foundation Fellow, IHI Charlotte Guglielmi, RN, CNOR, Perioperative Nurse Specialist, BIDMC; President, Association of periOperative Registered Nurses Gerald B. Healy, MD, Emeritus Healy Chair in Otolaryngology, Children’s Hospital (Boston); Senior Fellow, IHI Ron Wyatt, MD, MHA, General Internist, Huntsville Hospital (Alabama); Merck Fellow, IHI   Over the years, the positions held by doctors in health care organizations have unfortunately empowered some to behave unprofessionally towards other staff and practitioners, especially nurses. Giving a pass to belligerent or temperamental clinicians, even while many of those affected quietly seethe, has been tolerated in part because of the pecking order in medicine, and in part as a nod to the organization’s sources of revenue.   Well, the times are a changing…and not just because hospitals are worried about their reputation or retaining staff. Those in a position to confront a culture that’s permitted outbursts and intimidation now consider such behavior a contributor to medical errors, and a major disruption to the teamwork and robust communication that’s so critical to patient safety and quality improvement today. It’s a start. And nurses with a penchant for coming down hard on other, less senior RNs, or giving new interns and residents a hard time, are also being called out.   WIHI host Madge Kaplan gathers an expert panel to parse out these complicated and controversial issues, get a handle on what regulators have to say about unprofessional conduct, and learn about a new determination among professional societies and hospitals to face up to behavior that truly has no place in a safe, high performing organization. The guests have stories to share and, most importantly, are tracking the solutions and policies that show the most promise. There’s word that that newer generations of health professionals are more willing to stand up to inappropriate behavior of colleagues and superiors alike. That’s the right spirit… now we need the systems to back this up.

Listen NowThis past May 4, US House or Representative Republicans passed the American Health Care Act (AHCA).  The bill, defined by Republicans as a repeal of the Affordable Care Act (ACA), is now under debate among Senate Republicans. (Neither any House Democrat voted for the AHCA nor are there any Senate Democrats expected to vote for related Senate bill should it make the Senate floor.)  Per the Congressional Budget Office's (CBO) estimate of the AHCA's spending and revenue effects, published May 24, the AHCA would cause 14 million Americans to lose their health insurance in 2018 and 23 million by 2026, 14  million of this latter total would be Medicaid recipients.  This is because the AHCA would cut $834 billion from the Medicaid program over the ten year budget window, or by 2026.  The cuts in Medicaid spending, along with substantial reductions in tax credits, would allow for ACA taxes, approximately $600 billion, to be rescinded.  For example, the ACA's 3.8% tax applied to capital gains for family incomes over $250,000 and a 0.9% Medicare surtax on wage income in excess of $250,000 per year, i.e., tax cuts that would benefit the comparatively wealthy.           During this 25 minute conversation Dr. Silverstein provides, among other things, his assessment of the AHCA, i.e., legislation moreover as tax relief for the wealthy, the likely effect it would have one women's health and on disparities in care and alternatively how the ACA could be improved. Dr. Jason Silverstein is a Lecturer and Writer-in-Residence at Harvard Medical School in the Department of Global Health and Social Medicine. He is also currently an Instructor at the Harvard T. H. Chan School of Public Health.  He is also a faculty affiliate of the Science, Religion and Culture Program at the Harvard Divinity School.  He is a regular contributor to VICE's health channel, Tonic.   He has written for The New York Times, the Atlantic, The Guardian, Slate, The Nation and others and has provided commentary for, among others, MSNBC, NPR, HuffPost Live and BET.   His previous experience includes conducting research at Children's Hospital Boston, the Dana-Farber Cancer Institute, Harvard Law School's Program on Disability, and Stony Brook's HIV Treatment Development Center. Dr. Silverstein holds a Ph.D. and Master's in Anthropology from Harvard, a Master's in Religion, Ethics and Politics from Harvard Divinity and an undergraduate degree in philosophy from Penn. State. Dr. Silverstein's Tonic writings are at: https://tonic.vice.com/en_us/contributor/jason-silverstein.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

David W. Bates, M.D., M.Sc. Chief, Division of General Internal Medicine, Brigham and Women's Hospital Medical Director of Clinical and Quality Analysis, Partners HealthCare Dr. Bates is an internationally renowned expert in patient safety, using information technology to improve care, quality-of-care, cost-effectiveness, and outcomes assessment in medical practice. He is a Professor of Medicine at Harvard Medical School, and a Professor of Health Policy and Management at the Harvard School of Public Health, where he co-directs the Program in Clinical Effectiveness. He directs the Center for Patient Safety Research and Practice at Brigham and Women's Hospital. He served as external program lead for research in the World Health Organization's Global Alliance for Patient Safety and is the immediate past president of the International Society for Quality in Healthcare (ISQua) and the editor of the Journal of Patient Safety. He has been elected to the Institute of Medicine, the American Society for Clinical Investigation, the Association of American Physicians and the American College of Medical Informatics, and was chairman of the Board of the American Medical Informatics Association. He has published over 700 peer-reviewed papers and has an h-index of 115, which ranks him among the 400 most cited biomedical researchers of any type. Websites: www.patientsafetyresearch.org 00:00 The Prospect Study. 03:35 Facilitating Engagement and Minimizing Harm. 04:40 “Sometimes it's the right thing not to do some of the things on the checklist, but sometimes we're just too busy.” 05:00 Patients and Care Partners contributing to the overall Quality of Care. 06:00 Why Brigham and Women's Hospital chose to focus on Patient and Caregiver Engagement. 07:00 “Healthcare is so multifactorial there are many, many ways to make it better.” 08:20 The Nature of Innovation. 10:00 The stages in Brigham and Women's Hospital's pipelines. 14:20 Narrowing focus. 16:00 David discusses Clinical Imperative. 16:40 Defining Costs. 17:35 Working with ValueScope to address Patient Costing. 20:00 An example of Patient Cost. 25:00 Social Determinants. 26:00 High Cost Patient Management. 26:50 Using the LACE Risk Stratification tool. 29:20 Achieving gains with Caregivers. 29:40 “What are the Key Barriers to Care?” 31:00 SCAMPs - Standardized Clinical Assessment and Management Plans. 34:45 You can learn more by emailing David directly at dbates@partners.org.

This week we welcome Christine Oliver, MD to the show. Dr. Oliver is President of Occupational Health Initiatives, Inc. in Brookline, MA. She is an Associate Physician in the Department of Medicine (Pulmonary and Critical Care Division) at the Massachusetts General Hospital (MGH) and Associate Clinical Professor of Medicine at Harvard Medical School in Boston. Board certified in occupational medicine and in internal medicine, Dr. Oliver's primary specialty is Occupational and Environmental Medicine, with an emphasis on occupational and environmental lung disease. At the MGH she evaluates and cares for patients with occupational and environmental illness and disease, including occupational asthma, interstitial lung disease, building-related health problems, and chemical sensitivities. Dr. Oliver has done research and published in the area of occupational lung disease and she has testified before the United States Congress with regard to work-related health issues and risks. For the past three decades an important focus of Dr. Oliver's consulting work has been indoor air quality and related health effects. She has lectured and published on this subject and she has been actively involved in indoor air quality assessments in a variety of settings. These include health care facilities, courthouses and other government buildings, schools, and commercial office buildings. Together with industrial hygienists, engineers, and human systems specialists she has worked to identify, characterize, and resolve air quality problems and their related health effects. In 2009 she was a participant and presenter in the ASTM Johnson Conference on the standardization of mold response procedures. An important component of Dr. Oliver's clinical work has been in the area of fragrances and their related health effects, including causation and/or exacerbation of chemical sensitivities. She has lectured on these topics, counseled patients and their families with regard to steps that can be taken to identify and remove fragranced products from their environment, and advocated for a fragrance-free policy in the clinic in which she works

This week we welcome Christine Oliver, MD to the show. Dr. Oliver is President of Occupational Health Initiatives, Inc. in Brookline, MA. She is an Associate Physician in the Department of Medicine (Pulmonary and Critical Care Division) at the Massachusetts General Hospital (MGH) and Associate Clinical Professor of Medicine at Harvard Medical School in Boston. Board certified in occupational medicine and in internal medicine, Dr. Oliver's primary specialty is Occupational and Environmental Medicine, with an emphasis on occupational and environmental lung disease. At the MGH she evaluates and cares for patients with occupational and environmental illness and disease, including occupational asthma, interstitial lung disease, building-related health problems, and chemical sensitivities. Dr. Oliver has done research and published in the area of occupational lung disease and she has testified before the United States Congress with regard to work-related health issues and risks. For the past three decades an important focus of Dr. Oliver's consulting work has been indoor air quality and related health effects. She has lectured and published on this subject and she has been actively involved in indoor air quality assessments in a variety of settings. These include health care facilities, courthouses and other government buildings, schools, and commercial office buildings. Together with industrial hygienists, engineers, and human systems specialists she has worked to identify, characterize, and resolve air quality problems and their related health effects. In 2009 she was a participant and presenter in the ASTM Johnson Conference on the standardization of mold response procedures. An important component of Dr. Oliver's clinical work has been in the area of fragrances and their related health effects, including causation and/or exacerbation of chemical sensitivities. She has lectured on these topics, counseled patients and their families with regard to steps that can be taken to identify and remove fragranced products from their environment, and advocated for a fragrance-free policy in the clinic in which she works

Host Dawn Davenport, Executive Director of Creating a Family, the national infertility & adoption education and support nonprofit, interviews Dr. Joshua Sparrow, child/adolescent psychiatrist, associate clinical professor in psychiatry at Harvard Medical School and Director of Strategy, Planning and Program Development at the Brazelton Touchpoints Center at Children’s Hospital Boston, and syndicated columnist for the NYTimes. For a discussion of this show, go to our blog tomorrow http://creatingafamily.org/blog/.  Creating a Family has many free resources related to this topic on our website at www.CreatingaFamily.org.  Please leave us a review on iTunes. Thanks. Click to Tweet:http://ctt.ec/5vMj7 Share on Facebook: https://www.facebook.com/sharer/sharer.php?u=https%3A//creatingafamily.org/adoption-category/adopting-child-sexually-abused/ Show Highlights: https://creatingafamily.org/adoption-category/adopting-child-sexually-abused/ Support the show (https://creatingafamily.org/donation/)

This video discusses optimizing cardiac output in the post-operative management of the pediatric cardiac patient. Initial publication: January 29, 2014. Last reviewed: May 23, 2019. Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu Please note: OPENPediatrics does not support nor control any related videos in the sidebar, these are placed by Youtube. We apologize for any inconvenience this may cause. Optimizing Cardiac Output After Surgery, by Dorothy Beke. Hello. My name is Dorothy Beke. I'm a clinical nurse specialist in the Cardiac Intensive Care Unit at the Children's Hospital Boston. In this video on post-operative considerations after pediatric cardiac surgery, I will discuss issues related to optimizing cardiac output in the post-operative pediatric cardiac patient. Maintaining Cardiac Output. Preserve myocardial function and minimize oxygen consumption by decreasing stress to the heart. Too much inotropic support, such as with dopamine or epinephrine, causes the heart to work harder, produces cardiac arrhythmias, and increases both systemic and pulmonary vascular resistance. Low intracardiac or central venous pressures will cause tachycardia and decreased peripheral profusion. Fluid boluses of 5 to 10 milliliters per kilogram may be indicated to ensure adequate cardiac preload. Monitor for Increased Systemic and Pulmonary Vascular Resistance. Increased pulmonary vascular resistance may be due to excessive pulmonary blood flow, inflammatory and ischemic responses related to cardiopulmonary bypass, edema, or prolonged mechanical ventilation. Increased systemic vascular resistance may be related to left ventricular failure, cardiopulmonary bypass, hypoxia, acidosis, or low body temperature, or pain. Measures to decrease pulmonary and systemic vascular resistance include adequate mechanical ventilation and oxygenation, analgesia and sedation as well as afterload reducing agents such as nitroprusside. Milrinone has both inotropic and afterload reducing effects. Maintain cardiac output for improving cardiac contractility with inotropic medications such as dopamine, and by maintaining normal acid-base balance and adequate tissue oxygenation. Normal sinus rhythm will optimize cardiac output. Milrinone. The PRIMACORP trial was one of the few multi-centered, randomized, double blinded, placebo-controlled trials of a pediatric cardiovascular drug. Milrinone is a non-catecholamine inotropic agent with vasodilatory and lusitropic or cardiac relaxation effects. It has been shown to improve cardiac output while lowering filling pressures and systemic and pulmonary vascular resistance with minimal cardiac oxygen consumption. In the PRIMACORP trial, patients were randomized to high-dose Milrinone of 0.75 micrograms per kilogram per minute, 1/3 were randomized to low-dose Milrinone of 0.25 micrograms per kilogram per minute, and 1/3 were randomized to placebo. The prophylactic use of Milrinone in a 64% relative risk reduction in developing low cardiac output syndrome and the first 36 hours after cardiopulmonary bypass with high-dose Milrinone of 0.75 micrograms per kilogram per minute.

Guest For this episode, we bring on internationally recognized stem cell pioneer Dr. George Daley from Children’s Hospital Boston and the Harvard Stem Cell Institute to discuss all things stem cells. Resources and Links New…

Pediatric Grand Rounds Aaron Bernstein, MD, MPH Children's Hospital Boston

This month, Colleen Farrell, a second-year medical student at Harvard Medical School, interviewed Dr. Sad Sayeed, assistant professor of Global Health and Social Medicine at Harvard Medical School and attending neonatologist and assistant professor of pediatrics at Children’s Hospital Boston. In the interview Dr. Sayeed discusses the distinctive challenges of becoming a new mother. He also shares his insights on caring for terminally ill children and helping mothers and fathers come to terms with the unimaginable fact that their child is dying.

Dr Maurizio Scaltriti talks with ecancer at the 2013 AACR Annual Meeting in Washington DC about hyper activation of the PI3 kinase pathway and its prevalence in breast and head and neck cancer subtypes. Many inhibitors currently inhibit cell activity on many different levels, but recent findings in preclinical and phase I studies reveal that, while they do inhibit this pathway, their affect is limited. Complications predominantly include toxicity and tumours cells overcoming inhibition. The new types of inhibitors have a large therapeutic window, but those that are close to clinical use, such as alpha inhibitors, will be used in combination with other agents rather than as a single agent.

Dr Alice Shaw talks to ecancer at the 2012 ESMO meeting in Vienna about a randomised phase III study comparing targeted therapy crizotinib with standard chemotherapy in cases of ALK+ lung cancer. ALK+ lung cancer is defined by a genetic abnormality and is present in about 5% of the total lung cancer population. The trial looked to increase progression free survival; results confirmed with a 7.7 month average increase with crizotinib compared to 3 months with standard chemotherapy. The total response rate with crizotinib was 65.3 percent. Side effects that occurred were visual disturbance, nausea vomiting diarrhea, liver irritation, but all were at manageable levels.

 Dr. Richard Dittrich  has been a practicing physician for over 25 years. He created ProfessionalAesthetics and Wellness Center as an extension of his private OB/GYN practice. As his patients' needs changed, he was repeatedly asked “How can I feel better?” In response, Dr. Dittrich created a professional center that offers comprehensive medical services which include weight loss and anti-aging therapies. All programs and procedures are based on his philosophy that, “Today's medicine is all about overall wellness.” Dr. Sean Wright is a plastic surgeon in the Philadelphia area. He is a graduate from Harvard Medical School and completed his plastic surgery training at the Harvard affliliated hospitals including Massachusetts General Hospital, Brigham and Women's Hospital, and Children's Hospital Boston. He specializes in breast and body aesthetic surgery and is board certified by the American Board of Plastic Surgery.  Matthew Passen is a nationally recognized attorney who represents individuals and families in serious personal injury, medical malpractice and wrongful death lawsuits.  His law firm, Passen Law Group, is based in Chicago.    Evan Levow is the senior and managing partner of Levow & Associates and a nationally recognized DWI attorney. Mr. Levow's legal practice is 100% devoted to DWI defense

Robert Truog—an HMS professor and a senior associate in critical care medicine at Children’s Hospital Boston—reflects on the evolving patient-doctor relationship. He recently authored a perspective piece on the topic in the New England Journal of Medicine. In addition to being a practicing physician, Truog has a master’s degree in philosophy, and he holds a leadership role in the HMS Division of Medical Ethics.

Special guest: Julie Cevallos, VP of Marketing for the National Down Syndrome Society (NDSS).She is the new Vice President of Marketing, most recently from Brooks Brothers. Her background is in all aspects of marketing, including direct mail, social media, and online marketing. Julie is a parent of a 2-year old daughter, Nina, who has Down syndrome, and also has 6-year old son, Alec. Click here to read her story about Nina as featured in the NDSS My Great Story campaign. Special Guest: Dr. Brian Skotko, Medical Advisor to the NDSS. He is a clinical fellow in genetics at Children's Hospital Boston, Massachusetts General Hospital, Brigham & Women's Hospital, and Dana Farber Cancer Institute. He is a graduate of Duke University, Harvard Medical School, and Harvard Kennedy School, He has been featured in The Wall Street Journal, The New York Times, The Washington Post, The L.A. Times, NPR's "On Point," and ABC's "Good Morning America." , www.brianskotko.com The mission of the National Down Syndrome Society is to be the national advocate for the value, acceptance and inclusion of people with Down syndrome. http://www.NDSS.org

The suicide rate among children and adolescents has steadily risen and many of these children are first seen in hospital EDs. Children’s Hospital Boston has developed a treatment algorithm to facilitate screening, assessment and intervention in the ED. AJN editor in chief Shawn Kennedy and senior editor Sylvia Foley discuss the case that prompted this article with authors Alexis Schmid and Frances Damian, as well as key points about pediatric suicide and what ED nurses need to keep in mind with these troubled children.

Regenerative Medicine Today welcomes Leonard I. Zon, MD. Dr. Zon is the Grousbeck Professor of Pediatric Medicine at Harvard Medical School, Investigator at Howard Hughes Medical Institute, and Director of the Stem Cell Program, Children’s Hospital Boston. Dr. Zon discusses his research on the use of the zebrafish model for research into hematopoiesis and [...]

Editorial director and interim editor-in-chief Shawn Kennedy and clinical editor Christine Moffa present the highlights of the November issue of the American Journal of Nursing. Of note: a special report on “Transforming Care at the Bedside,” detailing nurses' work around the country; two CE articles; and two new series: “Evidence-Based Practice, Step-by-Step”, and the first of three articles from Children's Hospital Boston in AJN's new “Cultivating Quality” column.

Editorial director and interim editor-in-chief Shawn Kennedy and clinical editor Christine Moffa present the highlights of the November issue of the American Journal of Nursing. Of note: a special report on “Transforming Care at the Bedside,” detailing nurses’ work around the country; two CE articles; and two new series: “Evidence-Based Practice, Step-by-Step”, and the first of three articles from Children’s Hospital Boston in AJN’s new “Cultivating Quality” column.

Peter C. Laussen, MD, discusses an article published in the May 2007 issue of Pediatric Critical Care Medicine, titled "Pediatric Staff Perspectives on Organ Donation After Cardiac Death in Children." Dr. Laussen is director of the cardiac intensive care unit at Children's Hospital Boston. This is the first podcast in a two-part interview. Part two will feature an interview with lead author Martha A.Q. Curley, RN, PhD. (Ped. Crit. Care Med. 2007;8[3]:212).