Podcasts about icad

Dana Brown serves as President, CEO, and Chairman of the Board at iCAD Inc., which has developed a next-generation approach that leverages advancements in AI and imaging technology to improve the accuracy and efficiency of breast cancer screening.  This technology can help reduce unnecessary biopsies and additional tests while more accurately identifying cancers that need immediate attention. The concerning trend of rising breast cancer in younger women highlights the importance of early detection and personalized care plans. Dana explains, "Literally, iCAD's first FDA-cleared product in a first-generation AI was around 2002. So it's been well over 20 years. We're now on our fourth generation. So, yes, you're very accurate in describing this as a next-generation approach. So, not only has imaging technology improved over the past 20 years, but artificial intelligence has also improved. We continue to leverage the latest in artificial intelligence technology, how the artificial intelligence can be trained and learn, and a broad base of researchers that help us develop the solution. So you have new minds, new ways to think about solving the problem, and new technology that can be used to solve the problem. Then, there is a new underlying screening technology that gets better and better at clearer imaging." "The American Cancer Society reports that if we can catch a breast cancer very early in stage one, then the likelihood of, I'll say surviving breast cancer is 99%, so very, very high. So the earlier we can catch a breast cancer, the less invasive and costly and length of time the treatments can be. There are more options for those patients as well as the likelihood of a positive outcome, being able to again, have no further evidence of the disease is increased." #iCAD #BreastCancer #BreastCancerScreening #Radiology #CancerDetection #BreastBiopsies #Mammogram #WomensHealth #MedAI icadmed.com Download the transcript here

Dana Brown serves as President, CEO, and Chairman of the Board at iCAD Inc., which has developed a next-generation approach that leverages advancements in AI and imaging technology to improve the accuracy and efficiency of breast cancer screening.  This technology can help reduce unnecessary biopsies and additional tests while more accurately identifying cancers that need immediate attention. The concerning trend of rising breast cancer in younger women highlights the importance of early detection and personalized care plans. Dana explains, "Literally, iCAD's first FDA-cleared product in a first-generation AI was around 2002. So it's been well over 20 years. We're now on our fourth generation. So, yes, you're very accurate in describing this as a next-generation approach. So, not only has imaging technology improved over the past 20 years, but artificial intelligence has also improved. We continue to leverage the latest in artificial intelligence technology, how the artificial intelligence can be trained and learn, and a broad base of researchers that help us develop the solution. So you have new minds, new ways to think about solving the problem, and new technology that can be used to solve the problem. Then, there is a new underlying screening technology that gets better and better at clearer imaging." "The American Cancer Society reports that if we can catch a breast cancer very early in stage one, then the likelihood of, I'll say surviving breast cancer is 99%, so very, very high. So the earlier we can catch a breast cancer, the less invasive and costly and length of time the treatments can be. There are more options for those patients as well as the likelihood of a positive outcome, being able to again, have no further evidence of the disease is increased." #iCAD #BreastCancer #BreastCancerScreening #Radiology #CancerDetection #BreastBiopsies #Mammogram #WomensHealth #MedAI icadmed.com Listen to the podcast here

In this episode of Exploring Artificial Intelligence (AI) in Oncology, Dr. Waqas Haque sits down with Dana Brown, the President, CEO, and Chairman of the Board at iCAD, a company whose mission is to use innovative AI solutions that empower providers to accurately, reliably, and quickly detect cancer and improve outcomes. Ms. Brown shares more about iCAD's products and recommendations for how to integrate AI into the clinic, including: • Her own background in the technology industry and why she joined iCAD • The products and solutions that iCAD offers • How iCAD utilizes AI to improve mammography accuracy • The ProFound Breast Health Suite and how it enhances cancer detection and patient outcomes • Their recent partnership with Densitas and CancerIQ and their impact on breast health • What distinguishes iCAD's AI algorithms from other solutions in the market • The importance of company culture in driving success of AI startups and defining traits behind iCAD's success • Recommendations for clinicians in practice to learn about and integrate AI into their workflow • And more!

Dana Brown, iCAD's president, chairman and CEO, shares how the company is changing the way we think about breast cancer detection. Brown gives us an update on the partnership with Google. Plus, she talks about her time at Susan G. Komen and how cancer detection has changed throughout the years. She also gives some tips for aspiring medtech professionals in this new episode of Let's Talk Medtech.Omar : How are you?Dana: Great. Thanks for having me.Omar: I'm doing well, just a bit sleep-deprived with a newborn at home, but otherwise, all good.Dana: Congratulations.Dana: Thank you. So, Dana, it's been over a year since you took the reins at iCAD. How has the journey been so far?Dana: Better than I expected, honestly. I joined ICAD's board over two years ago, initially thinking it was my dream role. But I saw an opportunity to contribute more directly given my background in cloud technologies and breast health. Jumping in has been fantastic—the team is great, and seeing our solutions in action, not just on paper, has been incredibly rewarding.Omar: That's wonderful to hear. Before we dive into iCAD, let's talk about your time at Susan G. Komen. Can you share about your role there?Dana: Sure, at Susan G. Komen, I served as the chief strategic and operations officer for nearly five years. My focus was enhancing direct patient engagement, ensuring initiatives like helplines, financial aid, and support resources were impactful and accessible. It was about making sure Komen's efforts directly benefited patients throughout their breast cancer journey.Omar: How have your experiences at Komen influenced your approach at iCAD?Dana: Three main takeaways: continuous learning, particularly in management and collaboration; leveraging technology like EMRs and research registries to enhance patient care; and fostering a culture of innovation, crucial for developing effective solutions in breast health.Omar: It sounds like a wealth of knowledge to bring to iCAD. Speaking of which, let's touch on iCAD's use of AI in breast cancer detection. How is AI reshaping mammography?Dana: AI has revolutionized mammography by enhancing accuracy and efficiency. Unlike human eyes, AI processes data at a granular level, making it a reliable second opinion for radiologists. Beyond cancer detection, we're exploring applications like detecting breast arterial calcification, offering a more holistic view of a patient's health.Omar: That's impressive—AI as a precision tool in healthcare. Is it making mammogram results more understandable for patients?Dana: Currently, AI primarily aids clinicians by providing trusted decision support. However, patients are becoming aware of AI's role and its potential to offer them clearer, faster insights into their health—a promising development we're exploring further.Omar: Moving forward, iCAD has partnered with Google Health. What can you tell us about this collaboration?Dana: Our collaboration with Google Health spans two key initiatives: integrating our technology into Google's cloud infrastructure for seamless healthcare operations, and jointly developing advanced AI algorithms. This includes creating an AI-powered second reader for mammograms, aiming to streamline diagnosis and reduce turnaround times, addressing the shortage of radiologists globally.Omar: That's a significant step forward in leveraging technology for healthcare efficiency. While we await regulatory clearances, how do you see AI influencing patient care in the future?Dana: AI is empowering patients with knowledge and enabling more informed healthcare decisions. It's part of a broader trend towards patient empowerment, where individuals actively engage in their health management—a positive shift we're committed to advancing at ICAD.Omar: Your...

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/NAX865. CME/MOC/AAPA credit will be available until December 16, 2024.Shattering the Barriers to Glioblastoma Care: Revolutionary Advances With Innovative Technologies and Modern Systemic Approaches In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and American Brain Tumor Association. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Blue Earth Diagnostics and Novocure, Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerSteven Brem, MD, has no financial interests/relationships or affiliations in relation to this activity.Faculty/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Grant/Research Support from Seagen Inc.Stock Shareholder in CytoDyn Inc.; MedInnovate Advisors LLC; and MimiVax, LLC.Faculty/PlannerMichelle Kim, MD, has a financial interest/relationship or affiliation in the form of:Grant/Research Support from Blue Earth Diagnostics.Patient/PlannerJB Bird has no financial interests/relationships or affiliations in relation to this activity.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/AWE865. CME credit will be available until December 27, 2024.Brainstorming New Approaches to Improve Glioblastoma Care: Revolutionary Advances With Modern Gene Fusion–Targeted Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/AWE865. CME credit will be available until December 27, 2024.Brainstorming New Approaches to Improve Glioblastoma Care: Revolutionary Advances With Modern Gene Fusion–Targeted Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/NAX865. CME/MOC/AAPA credit will be available until December 16, 2024.Shattering the Barriers to Glioblastoma Care: Revolutionary Advances With Innovative Technologies and Modern Systemic Approaches In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and American Brain Tumor Association. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Blue Earth Diagnostics and Novocure, Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerSteven Brem, MD, has no financial interests/relationships or affiliations in relation to this activity.Faculty/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Grant/Research Support from Seagen Inc.Stock Shareholder in CytoDyn Inc.; MedInnovate Advisors LLC; and MimiVax, LLC.Faculty/PlannerMichelle Kim, MD, has a financial interest/relationship or affiliation in the form of:Grant/Research Support from Blue Earth Diagnostics.Patient/PlannerJB Bird has no financial interests/relationships or affiliations in relation to this activity.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/AWE865. CME credit will be available until December 27, 2024.Brainstorming New Approaches to Improve Glioblastoma Care: Revolutionary Advances With Modern Gene Fusion–Targeted Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/AWE865. CME credit will be available until December 27, 2024.Brainstorming New Approaches to Improve Glioblastoma Care: Revolutionary Advances With Modern Gene Fusion–Targeted Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/NAX865. CME/MOC/AAPA credit will be available until December 16, 2024.Shattering the Barriers to Glioblastoma Care: Revolutionary Advances With Innovative Technologies and Modern Systemic Approaches In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and American Brain Tumor Association. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Blue Earth Diagnostics and Novocure, Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerSteven Brem, MD, has no financial interests/relationships or affiliations in relation to this activity.Faculty/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Grant/Research Support from Seagen Inc.Stock Shareholder in CytoDyn Inc.; MedInnovate Advisors LLC; and MimiVax, LLC.Faculty/PlannerMichelle Kim, MD, has a financial interest/relationship or affiliation in the form of:Grant/Research Support from Blue Earth Diagnostics.Patient/PlannerJB Bird has no financial interests/relationships or affiliations in relation to this activity.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/NAX865. CME/MOC/AAPA credit will be available until December 16, 2024.Shattering the Barriers to Glioblastoma Care: Revolutionary Advances With Innovative Technologies and Modern Systemic Approaches In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and American Brain Tumor Association. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Blue Earth Diagnostics and Novocure, Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerSteven Brem, MD, has no financial interests/relationships or affiliations in relation to this activity.Faculty/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Grant/Research Support from Seagen Inc.Stock Shareholder in CytoDyn Inc.; MedInnovate Advisors LLC; and MimiVax, LLC.Faculty/PlannerMichelle Kim, MD, has a financial interest/relationship or affiliation in the form of:Grant/Research Support from Blue Earth Diagnostics.Patient/PlannerJB Bird has no financial interests/relationships or affiliations in relation to this activity.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/NAX865. CME/MOC/AAPA credit will be available until December 16, 2024.Shattering the Barriers to Glioblastoma Care: Revolutionary Advances With Innovative Technologies and Modern Systemic Approaches In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and American Brain Tumor Association. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Blue Earth Diagnostics and Novocure, Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerSteven Brem, MD, has no financial interests/relationships or affiliations in relation to this activity.Faculty/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Grant/Research Support from Seagen Inc.Stock Shareholder in CytoDyn Inc.; MedInnovate Advisors LLC; and MimiVax, LLC.Faculty/PlannerMichelle Kim, MD, has a financial interest/relationship or affiliation in the form of:Grant/Research Support from Blue Earth Diagnostics.Patient/PlannerJB Bird has no financial interests/relationships or affiliations in relation to this activity.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/AWE865. CME credit will be available until December 27, 2024.Brainstorming New Approaches to Improve Glioblastoma Care: Revolutionary Advances With Modern Gene Fusion–Targeted Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/NAX865. CME/MOC/AAPA credit will be available until December 16, 2024.Shattering the Barriers to Glioblastoma Care: Revolutionary Advances With Innovative Technologies and Modern Systemic Approaches In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and American Brain Tumor Association. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by educational grants from Blue Earth Diagnostics and Novocure, Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerSteven Brem, MD, has no financial interests/relationships or affiliations in relation to this activity.Faculty/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Grant/Research Support from Seagen Inc.Stock Shareholder in CytoDyn Inc.; MedInnovate Advisors LLC; and MimiVax, LLC.Faculty/PlannerMichelle Kim, MD, has a financial interest/relationship or affiliation in the form of:Grant/Research Support from Blue Earth Diagnostics.Patient/PlannerJB Bird has no financial interests/relationships or affiliations in relation to this activity.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/AWE865. CME credit will be available until December 27, 2024.Brainstorming New Approaches to Improve Glioblastoma Care: Revolutionary Advances With Modern Gene Fusion–Targeted Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Bayer HealthCare Pharmaceuticals Inc.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresChair/PlannerManmeet S. Ahluwalia, MD, MBA, FASCO, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AnHeart Therapeutics; Apollomics, Inc.; Autem Therapeutics; Bayer Corporation; Bugworks; Cairn Therapeutics; Caris Life Sciences; Celularity, Inc.; GSK; GT Medical Technologies; Insightec; Janssen Pharmaceuticals, Inc.; Kiyatec Inc.; Modifi Bio; NH TherAguix; Novocure, Inc.; Nuvation Bio, Inc.; Prelude Therapeutics; Pyramid Biosciences; Sumitomo Dainippon Pharma Oncology; The Menarini Group; Tocagen Inc.; Varian Medical Systems, Inc.; ViewRay Technologies, Inc.; Voyager Therapeutics, Inc.; and Xoft, a subsidiary of iCAD, Inc.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

A aprovação da lei no Ohio, o projeto piloto nos Países Baixos e a criação do ICAD em Portugal são alguns dos temas em destaque nesta edição do podcast. /sites/default/files/2020_07_podcast_quatro_e_vinte_3_thumbnail_podcasts_esq_net.png

A aprovação da lei no Ohio, o projeto piloto nos Países Baixos e a criação do ICAD em Portugal são alguns dos temas em destaque nesta edição do podcast.

Welcome to the MassDevice Fast Five medtech news podcast, the show that keeps you up-to-date on the latest breakthroughs in medical technology. Here's what you need to know for today, October 24, 2023. Check out the show notes for links to the stories we discussed today at MassDevice.com/podcast. We are back for a new episode of the Fast Five after a week-long hiatus to focus on our DeviceTalks West conference in Santa Clara, California. Before we jump into the news you should know for today, we would be remiss if we didn't talk about the biggest stories from last week – J&J MedTech is restructuring its orthopedics business, and there's finally some insight into what caused the EU antitrust probe into Edwards Lifesciences' business. We break down the news we missed last week and more to get the show started. Plus, you can find all coverage from DeviceTalks West on MassDevice and on our sister site Medical Design & Outsourcing. This week, GE HealthCare announced a cardiac imaging collaboration with Boston Scientific. Fast Five hosts Danielle Kirsh and Sean Whooley discuss the goal of the collaboration and some of the highlights GE HealthCare is expected to showcase at TCT this week in San Francisco. iCad has sold its Xoft brachytherapy business to Elekta. Find out the value of the deal and what technology Elekta is acquiring in this deal, plus executive reactions.  The FDA cleared Insulet's iPhone app for Omnipod 5. The clearance is a long time coming. Hear what makes this clearance significant, what analysts think and some of the challenges that had to be overcome to make the Omnipod 5, according to Chief Technology Officer Mark Field during a DeviceTalks West conversation. Philips posted Q3 earnings results this week that included an increased outlook for the year despite ongoing role reductions and the implications of the Respironics recall. Whooley details the financial highlights of the quarter, what the company attributed the growth to and the updates Philips provided regarding the Respironics recall. Medtronic won an FDA nod for its extravascular defibrillator. Find out what the system is and how it works, and what doctors think about the technology in today's episode.

Artificial intelligence is making its way through the medtech industry. iCad recently announced plans to integrate Google AI into its ProFound Breast Health Suite for 2D mammography. Fast Five hosts Sean Whooley and Danielle Kirsh go over how the company wants to use AI and the details of its existing partnership with Google. A new study from Edwards Lifesciences offers potential support for people with hypotension. Results from a study showed that using Acumen HPI may help reduce the duration and severity of intraoperative hypotension in patients having non-cardiac surgery. Hear how the software works and the full results of the study in today's episode. Siemens Healthineers and SSM Health want to increase health equity in the U.S. Learn how the two firms aim to expand access to high-quality care and aid in training the next generation of healthcare workers and what executives are saying about the collaboration. Surgical robotics are a hot topic in medtech, and more new systems are slated to hit the market in the next few years. Asensus Surgical, in particular, is hoping for an FDA clearance of its Luna surgical robot in 2025. Whooley shares the progress the company has made to achieve that goal. The FDA issued a notice labeling another recall of Getinge subsidiary Datascope's Cardiosave pump as Class I. Kirsh and Whooley discuss the recall, including the problem that led to the recall, how many devices are affected and if there have been any reports of injury so far. Check out the show notes for links to the stories we discussed today at MassDevice.com/podcast.

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Today's guest is Dr. Ameer Hassan, a triple board-certified neurologist who specializes in stroke, and is Head of the Neuroscience Department and a Professor of Neurology and Radiology at the University of TX Rio Grande Valley Dr. Hassan joined us for a Vascular Neurology Grand Rounds and stuck around to record this episode with one of our Vascular Neurology Fellows, Danish Kherani to answer some more questions so that we can share more of his insight and research.  ____________________________________ Twitter: @UTHealthStroke Instagram: @UTHealthStroke Facebook: facebook.com/uthealthstroke LinkedIn: linkedin.com/company/uthealth-stroke Ideas and opinions are our own and this podcast is not a substitute for expert medical advice. About StrokeBusters is a podcast series of recorded conversations on the topic of stroke and cerebrovascular disease. Based in the Texas Medical Center, the largest medical center in the world, we tap into our local network of astonishing leaders in healthcare and medicine to discuss the latest and most exciting news on stroke. Throughout this ten-episode series, we connect with UTHealth physicians and researchers, many of who are experts in their field, to discuss their practice, cutting-edge research, and medical care. Who We Are The Institute for Stroke and Cerebrovascular Disease, better known as the Stroke Institute, serves as a multi-disciplinary hub for research and best practices in stroke recovery, stroke prevention, services, population health, and vascular dementia. We are one of the most active research and clinical programs in the country, the first Comprehensive Stroke Center in the state, and launched the first Mobile Stroke Unit in the nation. Our stroke program, founded by Dr. James Grotta in 1979, specializes in stroke epidemiology, clinical trial design, and basic science. We train the next generation of revolutionary academics and leaders in cerebrovascular disease through our NINDS-funded fellowship programs. Contact For more information or if you have any questions, please contact us at ⁠info.uthiscd@gma⁠il.com

We hand over the reins to all-around great Medtech guy and sales guru Omar M. Khateeb, host of the State of Medtech show on LinkedIn. Chris Newmarker, executive editor of MassDevice, brought along his latest Newmarker's Newsmakers delivering news about iCad, Better Therapeutics, Philips, GE Healthcare, Masimo and Signifier Health. Chris, Omar and Tom Salemi, Editorial Director of DeviceTalks, share their views on the news before sharing the lessons they've learned over their career about how Medtech professionals can position themselves for professional success. The conversation ranges far and wide with discussion about storytelling, knowing your powers, and the threat of “silent non-competes.” We mention a code in there to get 25% off the registration for DeviceTalks Boston (It's OMAR25) on May 10-11. Don't be shy. Register now at DeviceTalks.com

Our Newest Sponsor, Windmill Lane has been around for 45 years, helping storytellers to express their stories through post, VFX, audio and creative partnerships. Earlier this month, WFT Board Member and Producer Fiona Kinsella spoke with Head of Production at Windmill Lane, Deborah Doherty about the industry, her impressive career to date, and all things post-production. Deborah Doherty Deborah has been with Windmill Lane for almost 18 years working as an Audio Studio manager, Producer and now Head of Production across its Film and TV, Commercial and VFX sectors. She ran the successful Number 4 audio studios from 2005-2019 growing the team and resulting in several IFTA, ICAD, Irish Animation awards and an Emmy nomination. Recent projects include dramas Kin and Smother, features My Little Pony: a new generation, Greta, Black 47, Murder at the Cottage and new VFX work for Netflix and Paramount. She is passionate about finding and developing new talent in the industry and helping Windmill's diverse client base take their projects and exceed all expectations. Prior to joining Windmill Lane, Deborah worked for audio studios in London, and for radio stations and marketing agencies in Leeds after completing her degree there at the University of Leeds. Originally from the Co. Derry north coast, Deborah has lived in Dublin since 2005 and is a busy mum to Noah age 6 and Sadie age 3, and loves living near the sea, walks on the beach, and great TV drama. This podcast has been made possible with the support of Coimisiún na Meán. https://wft.ie/

President Biden recently signed into law the FDA Modernization Act 2.0, new legislation that ends the FDA's mandate that all drugs be tested on animals prior to human clinical trials. The new law doesn't prohibit animal testing, but it does give companies the choice of whether to conduct animal experiments or not, and could lead to many fewer animals being used as test subjects.  If we don't use animals as test tubes prior to human clinical trials, what should we use? Emulate claims it has the answer. The organ-on-a-chip company's CEO Jim Corbett testified before Congress in favor of the new legislation and says his company's products deliver much more reliable data than does animal experimentation.  And why shouldn't it? We all know that rats (the most popular animal on whom to experiment) have pretty different biologies than humans. For example, people with pet rats are regularly warned not to give their rats onions since it can sicken them. We all know dogs are apparently not supposed to eat chocolate. Yet humans do just fine eating these foods that are toxic to rats and dogs.  So what if we could test on actual human cells that have been placed on chips which mimic the functions of a human body? In this episode, Jim discusses Emulate's technology, its promise to slash the number of animals used for testing while delivering safe drugs to market more quickly, who opposes their efforts, and where this is all leading us.  Emulate so far has raised a whopping quarter-billion dollars of venture capital investment, so someone believes that these folks are onto something big. Time will tell, and for now, their CEO will tell you the Emulate story. Discussed in this episode Emulate was birthed from Don Ingber's lab at Harvard with funding from DARPA Fast Company and WIRED on Emulate's work. Nature Communications Medicine Performance assessment and economic analysis of a human Liver-Chip for predictive toxicology (2022) Science Translational Medicine Reproducing human and cross-species drug toxicities using a Liver-Chip (2019) Jim recommends the book Endurance to would-be startup founders Jim credits the Center for a Humane Economy with leading the passage of the FDA Modernization Act 2.0. More about Jim Corbett Jim Corbett has served as a leader of successful international businesses across diverse sectors, including biotechnology, medical imaging, analytical instruments and in vitro diagnostics. His experience ranges from Fortune 100 companies to entrepreneurial start-ups.  Until becoming the CEO of Emulate, he served in leadership roles at PerkinElmer during an 11-year tenure, including Executive Vice President and President of Discovery & Analytical Solutions. His other roles at PerkinElmer included President of Diagnostics & Life Sciences, Senior Vice President of Life Sciences Solutions, and Vice President of North America Genetic Screening. Prior to PerkinElmer, Corbett was President of ViaCell, Inc. which was acquired by PerkinElmer in 2007. Previously, he co-founded CADx Systems, a company focused on the oncology market, where he held the position of Executive Vice President and Director with responsibility for worldwide sales and marketing, technical support and business development. Following the 2004 acquisition of CADx by iCAD, Inc., he was named Chief Commercial Officer.  In addition, Corbett worked for Abbott Laboratories for 14 years in a variety of sales and marketing positions including Worldwide Marketing Manager for Abbott Diagnostics Immunoassay Systems and Region Manager for Abbott Diagnostics. Corbett holds a Bachelor of Science from The University of Massachusetts, Amherst.

Podcast jest dostępny także w formie newslettera: https://ainewsletter.integratedaisolutions.com/ W świecie sztucznej inteligencji (AI) i uczenia maszynowego (ML) rok 2022 był prawdopodobnie rokiem modeli podstawowych lub modeli AI trenowanych na masową skalę. https://venturebeat.com/ai/stanford-debuts-first-ai-benchmark-to-help-understand-llms/ Harvey, start-up budujący coś, co określa jako „drugiego pilota dla prawników”, wyszedł dziś z ukrycia z 5 milionami dolarów finansowania kierowanego przez OpenAI Startup Fund, transzę, za pośrednictwem której OpenAI i jego partnerzy inwestują w firmy AI na wczesnym etapie, zajmujące się poważnymi problemy. https://techcrunch.com/2022/11/23/harvey-which-uses-ai-to-answer-legal-questions-lands-cash-from-openai/ Google pracuje nad narzędziem, które uczy kod samodzielnego pisania i przepisywania. https://www.businessinsider.com/google-ai-write-fix-code-developer-assistance-pitchfork-generative-2022-11 Firma med-tech iCAD ogłosiła, że dzięki strategicznej umowie dotyczącej rozwoju i komercjalizacji włączy technologię sztucznej inteligencji Google Health do mammografii do swoich rozwiązań do obrazowania piersi. https://www.mobihealthnews.com/news/google-health-licenses-breast-cancer-screening-ai-icad Naukowcy opracowali nowy model sztucznej inteligencji (AI), który jest w stanie przewidzieć 10-letnie ryzyko zgonu pacjenta z powodu zawału serca lub udaru – wszystko to na podstawie jednego zdjęcia rentgenowskiego klatki piersiowej. https://radiologybusiness.com/topics/medical-imaging/radiography/new-ai-model-calculates-risk-heart-attack-or-stroke-using-single Odwiedź www.integratedaisolutions.com

In der Welt der künstlichen Intelligenz (KI) und des maschinellen Lernens (ML) war 2022 wohl das Jahr der Grundlagenmodelle oder KI-Modelle, die in großem Umfang trainiert wurden. https://venturebeat.com/ai/stanford-debuts-first-ai-benchmark-to-help-understand-llms/ Harvey, ein Startup, das einen sogenannten „Copiloten für Anwälte“ aufbaut, ist heute mit 5 Millionen US-Dollar aus der Tarnung hervorgegangen, die vom OpenAI Startup Fund geleitet werden, der Tranche, durch die OpenAI und seine Partner in KI-Unternehmen in der Frühphase investieren, die große Probleme angehen Probleme. https://techcrunch.com/2022/11/23/harvey-which-uses-ai-to-answer-legal-questions-lands-cash-from-openai/ Google arbeitet an einem Tool, das Code beibringt, sich selbst zu schreiben und neu zu schreiben. https://www.businessinsider.com/google-ai-write-fix-code-developer-assistance-pitchfork-generative-2022-11 Das Medizintechnikunternehmen iCAD kündigte an, dass es die Mammographie-KI-Technologie von Google Health dank einer strategischen Entwicklungs- und Vermarktungsvereinbarung in seine Brustbildgebungslösungen integrieren werde. https://www.mobihealthnews.com/news/google-health-licenses-breast-cancer-screening-ai-icad Forscher haben ein neues Modell der künstlichen Intelligenz (KI) entwickelt, das in der Lage ist, das 10-Jahres-Risiko eines Patienten, an einem Herzinfarkt oder Schlaganfall zu sterben, vorherzusagen – alles mit einer einzigen Röntgenaufnahme des Brustkorbs. https://radiologybusiness.com/topics/medical-imaging/radiography/new-ai-model-calculates-risk-heart-attack-or-stroke-using-single Visit www.integratedaisolutions.com

In the world of artificial intelligence (AI) and machine learning (ML), 2022 was arguably the year of foundational models, or AI models, trained at scale. https://venturebeat.com/ai/stanford-debuts-first-ai-benchmark-to-help-understand-llms/ Harvey, a startup building a so-called "Copilot for Lawyers," emerged today with $5 million from the cloak being led by the OpenAI Startup Fund, the tranche through which OpenAI and its partners in AI companies in early-stage investing that tackle big problems. https://techcrunch.com/2022/11/23/harvey-which-uses-ai-to-answer-legal-questions-lands-cash-from-openai/ Google is working on a tool that will teach code to write and rewrite itself. https://www.businessinsider.com/google-ai-write-fix-code-developer-assistance-pitchfork-generative-2022-11 Medical technology company iCAD announced that it will integrate Google Health's mammography AI technology into its breast imaging solutions through a strategic development and commercialization agreement. https://www.mobihealthnews.com/news/google-health-licenses-breast-cancer-screening-ai-icad Researchers have developed a new artificial intelligence (AI) model capable of predicting a patient's 10-year risk of dying from a heart attack or stroke -- all with a single chest X-ray. https://radiologybusiness.com/topics/medical-imaging/radiography/new-ai-model-calculates-risk-heart-attack-or-stroke-using-single Visit www.integratedaisolutions.com

Negli ultimi due anni gli smartwatch hanno raggiunto una maturità tecnologica tale da poter soddisfare, a livello di mercato, le esigenze di ogni singola persona, partendo dai più attenti al monitoraggio della salute, arrivando fino agli amanti degli sport estremi. In questa puntata parliamo proprio di quest'ultimo settore, in particolare analizzando il ruolo degli smartwatch professionali nel monitoraggio delle attività sportive meno comuni come il diving o le maratone. Nella sezione delle notizie parliamo di come si potrà utilizzare la tecnologia 5G sugli aerei, dell'IA di Google per prevenire il cancro al seno e infine di Tesla che ha consegnato i suoi primi semirimorchi. --Indice-- • Il 5G arriva sugli aerei (00:56) - DDay.it - Matteo Gallo • L'IA di Google per prevenire il cancro al seno (02:19) - HDBlog.it - Luca Martinelli • Tesla consegna i suoi primi semirimorchi (03:28) - TheVerge.com - Davide Fasoli • Smartwatch per sport estremi, un settore in continua evoluzione (05:05) - Matteo Gallo --Contatti-- • www.dentrolatecnologia.it • Instagram (@dentrolatecnologia) • Telegram (@dentrolatecnologia) • YouTube (@dentrolatecnologia) • redazione@dentrolatecnologia.it --Brani-- • Ecstasy by Rabbit Theft • In My Head by Arcando (feat. Britt Lari)

El algoritmo de inteligencia artificial de Google para ayudar a detectar el cáncer de mama ahora formará parte de las mamografías comerciales. El 28 de noviembre, la compañía anunció que otorgó la licencia de su tecnología de inteligencia artificial a iCAD, una compañía de tecnología médica que brinda servicios de detección de cáncer de mama a centros de atención médica en todo el mundo.

El algoritmo de inteligencia artificial de Google para ayudar a detectar el cáncer de mama ahora formará parte de las mamografías comerciales. El 28 de noviembre, la compañía anunció que otorgó la licencia de su tecnología de inteligencia artificial a iCAD, una compañía de tecnología médica que brinda servicios de detección de cáncer de mama a centros de atención médica en todo el mundo.

China avanza en la carrera espacial, venden datos de Twitter en la Dark Web y Google usa tecnología para detectar cáncer. Puedes apoyar la realización de este programa con una suscripción. Más información por acáNoticias: -El año pasado hubo una filtración masiva de datos de Twitter en donde más de cinco millones de números telefónicos y correos se liberaron, pero aun hay más, ya que, de acuerdo con un reporte de 9to5Mac, la vulnerabilidad que permitió esto, fue explotada por varios actores maliciosos y esta información se ofrece en venta en la dark web por varias fuentes. -Este martes, el Banco Central de la India anunció que lanzará el primer piloto de una moneda digital de uso común para el 1º de diciembre, extendiendo la prueba para la creación y distribución de la rupia electrónica con un grupo de comerciantes y clientes. -En Japón, la cadena de tiendas de conveniencia Lawson abrió su primera tienda atendida casi en totalidad por avatares.-Mientras tanto, en China, tres astronautas viajan rumbo a la estación espacial Tiangong usando la nave Shenzhou 15, con lo que arranca una nueva era en la carrera espacial, ya que China está operando una estación espacial independiente y completamente funcional.-Google anunció que colaborará con la compañía de tecnología médica iCAD para integrar sus sistemas de inteligencia artificial en las herramientas de modelos de análisis de detección de cáncer. Análisis: La Inteligencia Artificial al servicio de la medicina¿Prefieres leer las noticias? ¡Suscríbete a mi newsletter y te llegarán todos los días!   Become a member at https://plus.acast.com/s/noticias-de-tecnologia-express. Hosted on Acast. See acast.com/privacy for more information.

There's a difference between communicating with someone and having an intentional conversation. As a Professor of Communication and Co-Director of ICAD at James Madison University, Lori Britt has spent her career teaching others how to identify their own personal schema and the walls that may be preventing them from effectively engaging with others. Whether you're speaking to an individual or working as a group, her insights will prove valuable in helping shape your next conversation. This is Brand Story, a podcast celebrating the stories of real people who are making an impact on brands, business, and the world around them. Episodes feature guests from a variety of backgrounds who bring their own unique perspectives to the conversation. Brand Story is created and produced by Gravity Group, a full-service brand and marketing agency, and is hosted by Gravity Group President, Steve Gilman. Continue the conversation on social: For more of Brand Story, check out our LinkedIn (https://www.linkedin.com/company/gravitygroupmarketing), where we'll post previews and highlights of shows, behind-the-scenes sneak peeks, plus other marketing news you can use. We're also on: Instagram — https://www.instagram.com/gravitygroup Facebook — https://www.facebook.com/gravitygroupmarketing

Dr. Zafer Keser reviews the article, "Stroke Prevention in Symptomatic Large Artery Intracranial Atherosclerosis Practice Advisory" published in the March 21, 2022, Neurology Journal. Show references: https://n.neurology.org/content/98/12/486

March 23, 2022: https://www.linkedin.com/in/lyudkovitch/ (Laurence Yudkovitch), Product Manager and https://www.linkedin.com/in/josh-dagenhart-91997438/ (Josh Dagenhart), AI Solutions Architect-Manager at https://www.icadmed.com/ (iCAD) join https://linkedin.com/in/IntegratorBrad (Brad Genereaux), Medical Imaging & Smart Hospitals Alliance Manager for https://www.nvidia.com/en-us/ (NVIDIA) to discuss the next evolution of radiology solutions with integrated AI. Specifically the NVIDIA AI Enterprise on VMware vSphere with https://tanzu.vmware.com/ (VMware Tanzu) solution. What do Customers Look for in an Imaging AI Solution? What are infrastructure considerations? What about high availability and disaster recovery? Where is the market going with modern apps? Key Points: 00:00:00 - Intro 00:03:30 - 40 million mammograms done annually 00:05:00 - Our key value proposition is reducing the amount of radiologist read time by over 50% 00:12:15- How do you make clinicians more productive? More effective? 00:24:00 - It used to be PACS interoperability. Now it's platform interoperability. https://www.icadmed.com/ (iCAD) https://www.nvidia.com/en-us/ (NVIDIA) https://tanzu.vmware.com/ (VMware Tanzu)

A special ViVE and HIMSS conference sneak peak episode. What can we expect to see from VMware and NVIDIA in collaboration with iCAD and Rhino Health this year? https://www.linkedin.com/in/IntegratorBrad/ (Brad Genereaux), Medical Imaging Alliance Manager for https://www.nvidia.com/en-us/ (NVIDIA) joins Bill to talk about democratizing access to artificial intelligence across healthcare. What are the exciting advances that we can do with AI in the enterprise? How is it helping to drive efficiencies across every single department in the hospital? How do we empower IT departments with the virtualization stack from VMware to really demonstrate what AI enterprise means for hospitals? There will be an increased number of AI models running in hospitals five years from now, what does that look like? https://www.nvidia.com/en-us/ (NVIDIA: The way it's meant to be played) https://www.vmware.com/ (VMware - Delivering a Digital Foundation For Businesses) https://www.rhinohealth.com/ (Rhino Health - Healthcare AI with Federated Learning) https://www.icadmed.com/ (iCAD - Global medical technology leader providing innovative cancer detection and therapy solutions)

A special ViVE and HIMSS conference sneak peak episode. What can we expect to see from VMware and NVIDIA in collaboration with iCAD and Rhino Health this year? https://www.linkedin.com/in/IntegratorBrad/ (Brad Genereaux), Medical Imaging Alliance Manager for https://www.nvidia.com/en-us/ (NVIDIA) joins Bill to talk about democratizing access to artificial intelligence across healthcare. What are the exciting advances that we can do with AI in the enterprise? How is it helping to drive efficiencies across every single department in the hospital? How do we empower IT departments with the virtualization stack from VMware to really demonstrate what AI enterprise means for hospitals? There will be an increased number of AI models running in hospitals five years from now, what does that look like? https://www.nvidia.com/en-us/ (NVIDIA: The way it's meant to be played) https://www.vmware.com/ (VMware - Delivering a Digital Foundation For Businesses) https://www.rhinohealth.com/ (Rhino Health - Healthcare AI with Federated Learning) https://www.icadmed.com/ (iCAD - Global medical technology leader providing innovative cancer detection and therapy solutions)

With breast cancer, early detection is critical in survival and remission rates. If you can reduce the amount of time it takes to find cancerous cells by using AI/ML workflows, you can literally save lives. Laurence Yudkovitch joins us to discuss just how iCad is cutting cancer detection times down, increasing accuracy and reducing the workload of radiologists.

On Episode 6 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the July 2021 issue of Stroke: “Prevalence and Clinical Correlates of Intracranial Dolichoectasia in Individuals With Ischemic Stroke” and “Dose Escalation and Safety of Capsaicin for Cerebral Perfusion Augmentation.” She also interviews Dr. Osama Zaidat about his article “Impact of Age and Alberta Stroke Program Early Computed Tomography Score 0 to 5 on Mechanical Thrombectomy Outcomes.” Dr. Negar Asdaghi: 1) Is intracranial dolichoectasia the new intracranial atherosclerotic disease? 2) What is the latest on collateral flow improvement through sphenopalatine ganglion stimulation in patients with acute ischemic stroke? 3) Is endovascular therapy futile in patients presenting with a low ASPECTS score? These are the topics that we will cover in today's podcast. You're listening to the Stroke Alert Podcast. Stay with us. Dr. Negar Asdaghi:         From the Editorial Board of Stroke, welcome to the Stroke Alert Podcast. My name is Negar Asdaghi. I'm an Associate Professor of Neurology at the University of Miami Miller School of Medicine and your host for the monthly Stroke Alert Podcast. Dr. Negar Asdaghi:         For the July 2021 issue of Stroke, we have a systematic review and meta-analysis of safety and efficacy of dual antiplatelet therapy with P2Y12 inhibitors and aspirin versus aspirin monotherapy in patients with mild ischemic stroke or high-risk transient ischemic attack, which I encourage you to review in addition to today's podcast. Dr. Negar Asdaghi:         Later in the podcast, I have the pleasure of interviewing Dr. Osama "Sam" Zaidat, Professor of Neurosurgery and Neurology at Bon Secours Mercy Health Neuroscience Institute. Dr. Zaidat will speak to us about his work on endovascular therapy in patients presenting with a large ischemic core as determined by a low ASPECTS score on presentation. But first with these two articles. Dr. Negar Asdaghi:         In the setting of acute ischemic stroke, intracranial large-vessel disease is often equated with processes which result in narrowing of the intracranial vessels, such as what is seen in the setting of intracranial atherosclerotic disease, or ICAD, where much research has focused on the degree of noumenal stenosis. Less is known about intracranial dolichoectasia, or IDE, which is characterized by ectasia, that is dilation, or dolichosis, which is increased length or tortuosity of the intracranial arteries. Dr. Negar Asdaghi:         IDE can occur due to inflammatory, infectious, or genetic abnormalities. But much like its stenotic counterpart, or ICAD, most cases of IDE are diagnosed in the setting of uncontrolled vascular risk factors. Keeping in mind that the pathophysiology of ICAD and IDE are entirely different. Dr. Negar Asdaghi:         Despite recent advances in recognition of IDE beyond an arteriopathy involving the basilar artery alone, the prevalence of IDE in patients with acute ischemic stroke is unknown, in part related to the lack of a unified diagnostic criteria for this condition. In this issue of the journal, Dr. Victor Del Brutto from the Division of Cerebrovascular Disease at the University of Miami and colleagues studied the prevalence and clinical correlates of IDE among 211 consecutive acute ischemic stroke patients admitted to a tertiary care hospital during a four-month period. IDE was defined as either ectasia or dolichosis of at least one proximal intracranial artery equal or greater than two standard deviations from the study population mean as measured by semi-automated segmentation method. Dr. Negar Asdaghi:         So, what they found was that IDE was identified in 24% of stroke cases: a small percentage, which was only 5%, with only isolated ectasia; 9.5% with isolated dolichosis; and the rest with both ectasia and dolichosis. Anterior and posterior circulation were equally involved, but not surprisingly, the basilar artery was the single most common affected artery by IDE. After a complete stroke work-up, stroke was classified as cardioembolic in 25.5% of their population, large-artery atherosclerosis in 30%, small-artery occlusion in 14.5%, and undetermined in 25.5% of cases. Using cardioembolic stroke as a reference, the prevalence of IDE was significantly higher across strokes of undetermined etiology with odds ratio of 2.8. And there was a trend towards higher IDE prevalence in those whose stroke was classified as small-vessel disease. Dr. Negar Asdaghi:         Furthermore, IDE was considered the most likely pathogenic mechanism in 6% of the entire cohort, which represented over 23% of strokes initially categorized as undetermined etiology and 21% of those with strokes categorized in small-vessel disease category, suggesting a likely causal correlation between parent vessel dolichoectasia and occlusion of the small vessel perforators in these patients. Dr. Negar Asdaghi:         The authors concluded that IDE is an arteriopathy frequently found in patients with acute ischemic stroke and likely responsible for a sizable fraction of strokes initially categorized as undetermined etiology and those with small-vessel ischemic disease. Dr. Negar Asdaghi:         The concept of freezing ischemic penumbra refers to either pharmacological or non-pharmacological interventions that aim to reduce tissue energy requirements for increased oxygen delivery and collateral perfusion to the tissue at risk for ischemia while awaiting revascularization therapies. Sphenopalatine ganglion, or SPG, electrical stimulation via an injectable implant had been previously shown to augment collateral flow and improve clinical outcomes in patients with acute ischemic stroke. Dr. Negar Asdaghi:         The benefit of SPG stimulation is likely conferred not only from its potent collateral augmentation properties, but also from other mechanisms, such as blood-brain stabilization, direct neuroprotection and enhancement of neuroplasticity, though the need to implant the device diminishes its applications in the hyperacute stroke setting. Dr. Negar Asdaghi:         Capsaicin, the pungent ingredient in hot chili peppers, is an SPG chemical stimulator, which affects the trigeminal vascular system, resolving in vasodilation and improved collateral flow. In the paper titled "Dose Escalation and Safety of Capsaicin for Cerebral Perfusion Augmentation: A Pilot Study," Dr. Juan Manuel Marquez-Romero from IMSS Institute in Mexico and colleagues completed a dose escalation study of capsaicin ranging from 33 to 165 micromole topically applied to the posterior surface of the subject's hemi-palate in 30 healthy volunteers. By applying capsaicin in the palate mucosa, the SPG can be stimulated directly through the greater and lesser palatine nerves while minimizing that pungent sensation. Dr. Negar Asdaghi:         During the 20-minute applications, the investigators used transcranial Doppler to study various flow parameters, including the mean velocity, positivity index, and the CBF index, or cerebral blood flow index, over the middle cerebral artery. The median age of participants in the study was 21. All reported having consumed capsaicin in their diets sometimes in the past. So, what they found was, at baseline, TCD measurements and the calculations were all within normal limits. All the tested doses of capsaicin reduced augmentation of the MCA mean velocity while reducing the positivity index. The effects peaked between the five and the 10 minutes measurements and then returned to basal levels for all doses of capsaicin, except for the 66 micromole dose group, in which the effect remained stable with the same pattern. There were no side effects reported, and the investigators found no correlation between the perceived pungency and the dose of capsaicin administered. Dr. Negar Asdaghi:         The authors noted that capsaicin appears to produce a hemodynamic response in the intracranial circulation, similar to the one achieved with SPG electrical stimulation. Understanding that this is data from a small pilot study, the results are hypothesis-generating at this point, and further research is required to measure the safety and efficacy of capsaicin in the elderly stroke population. Dr. Negar Asdaghi:         Endovascular thrombectomy is an effective evidence-based treatment to improve outcomes in patients with acute ischemic stroke. Studies to expand the applications of this therapy to late-presenting patients, those with large ischemic cores, or distal occlusions are leading to major changes in clinical practice worldwide. Whether the ischemic core is measured by volumetric methods or by ASPECTS score, the presenting infarct core beyond which endovascular therapy is futile, or even potentially harmful, has not been established. Dr. Negar Asdaghi:         So, the commonly encountered question in routine practice is whether thrombectomy should be offered to patients with presenting low ASPECTS. In other words, what are the characteristics of patients who continue to benefit from thrombectomy despite presenting with a large ischemic core? In the paper titled "Impact of Age and ASPECTS of 0 to 5 on Mechanical Thrombectomy Outcomes: Analysis From the STRATIS Registry," we learn about the outcomes of thrombectomy-treated patients stratified into low and high ASPECTS categories and the specific interaction between increasing age and low ASPECTS. Dr. Negar Asdaghi:         I'm joined now by the first author of the paper, Dr. Osama "Sam" Zaidat, who's one of the principal investigators of the STRATIS Registry. Dr. Zaidat, of course, needs no introduction to our listeners. He's the past president of the Society of Vascular and Interventional Neurology. He's a leader in the field of neurointerventional therapists and currently is the neurology residency director and the endovascular fellowship director at the Bon Secours Mercy Health Neuroscience Institute. Welcome Sam. Welcome to our podcast. Thank you for joining us. Dr. Osama Zaidat:           Thanks for having me. I really appreciate Dr. Negar and the Stroke journal team for featuring our research and our results and sharing it with your listeners today. Thank you for having me. Dr. Negar Asdaghi:         Thank you very much. So, let's start by learning about the STRATIS Registry. Can we please hear an overview of the registry? Dr. Osama Zaidat:           Yes, that's a good question because this is kind of the database where we really go and mine for questions that we still need answers for in the stroke field. For example, and specifically in the thrombectomy field, the STRATIS Registry was designed to evaluate post-marketing, real-life experience and results using Solitaire device stent retriever as the first mechanical thrombectomy choice. So, if you have enrolled a patient, that means the first attempt to take the clot out was using the Solitaire device for large vessel occlusion that presented with acute ischemic stroke. Dr. Osama Zaidat:           We planned about 1,000 patients, so we needed a bigger patient population than the randomized trial. So, we have 1,000 patients treated with Solitaire device within eight hours from symptoms onset with large vessel occlusion presenting with acute ischemic stroke. To do that, we needed 55 medical centers with various clinical experience, various volume, and various operator experience because that really reflects a little bit of not a selection bias, meaning that data can be reproducible and can be validated across different spectrum of centers and neurointerventionalists and stroke neurologists for that matter. Dr. Osama Zaidat:           This also, the aim of it — the spectrum — in addition to validate and reproduce randomized clinical trial data, to try to address questions that are hard to address with a clinical trial. For example, what's the outcome in nonogenarians? What's the outcome in tandem lesion? What's the outcome in different technique we use in the lab? What's the outcome of large infarct sites? Until we find the randomized trial, we can have some signals from those large registry to really inform future randomized trial. Dr. Osama Zaidat:           So that's kind of the scope of the STRATIS Registry. Dr. Negar Asdaghi:         Perfect. So truly a real-life, large cohort of endovascularly-treated patients, allowing us to look at the many aspects of this therapy in real life, rather than in a randomized setting. Dr. Negar Asdaghi:         So, now coming to the current paper, we often think of low ASPECTS as a phenomenon of late presenters. Yet the current paper included endovascularly treated patients in a relatively early time window, within eight hours of symptom onsets. Please walk us through what percentage of your study patients actually had low ASPECTS, and what were their baseline characteristics as compared to high ASPECTS of patients? Dr. Osama Zaidat:           That's an excellent question. STRATIS was basically a core lab adjudicated. So, independent, experienced core lab have read all the angiogram outcomes and have read all the CT scan, all the MRI, so he doesn't know about what's going on at 90 days functional outcome. And we wanted to restrict the analysis to the available baseline CT scan that was evaluated by the core lab, like you mentioned. So, from the 984 evaluable patients, only 763 patients, almost 75%, had the CT scan available for the core lab and the core lab blinded to the functional outcome and blinded to the angiographic outcome have read the ASPECTS. Dr. Osama Zaidat:           So, this is a centrally read ASPECTS score by experienced interpreter that read them. So, 75% has available CT, or 763 patients. From those 763 patients, as a clinical practice out there, 92.5% had an ASPECTS of six to 10, consistent with the guidelines that we all treat on everyday basis. If the CT scan looks good, we treat. STRATIS is consistent with that. 92.5% had an ASPECTS of six to 10, or 706 patients. 7.5%, close to 8%, of the site had enrolled patients with low ASPECTS, or 57 patients have low ASPECTS, zero to five. So, about one out of maybe eight, less than one out of 10 patients, had low ASPECTS at the time the STRATIS was conducted between 2014 and 2016. Dr. Osama Zaidat:           People were following the AHA/ASA guideline, with an ASPECTS of six to 10 the majority of the time, like in the STRATIS. It came up to 92% with ASPECTS and 8%, very low ASPECTS, for example. Dr. Osama Zaidat:           So, kind of really what we like about the STRATIS, the real-life practice tried to adhere to the guideline for most of the time. However, we managed to find good sample size, 57, that people kind of did not necessarily, for one reason or another follow the guidelines. Dr. Osama Zaidat:           And I feel like the first things, when you asked me the second question, the baseline characteristics, is there is a difference between the low ASPECTS group and the good ASPECTS. The first thing, really, that stand out-- the young age. So, the age was 62 years versus almost 69. So there's absolute difference of about seven years between low ASPECTS and good ASPECTS, six to 10 versus less than five. And the P value was significant. The listener can look at the paper, but it was a very statistically significant ASPECTS. Dr. Osama Zaidat:           My feeling and my interpretation to this difference is that the physician felt, even with the low ASPECTS, he wanted to give the younger population a chance and take the clot out and see if they do well. So, I think they were more aggressive to take a low ASPECTS in a young patient than not necessarily offering them a mechanical thrombectomy, which probably mirrors what you do and what I would do in real life. If you have 55 years old and ASPECTS of four, you want to say, "Let me take the clot out and see how the functional status pans out." So, that's one thing. Dr. Osama Zaidat:           The other difference, besides the difference in age, slightly more diabetic in the low ASPECTS, but it didn't reach statistical significance. Slightly less AFib than the ASPECTS of six to 10. What really also makes sense, besides the age, is the stroke scale, the stroke severity scale. The stroke severity scale was higher in the low ASPECTS, which makes sense. The infarct is completed, the patient had a worse stroke scale at baseline. So, their stroke scale was almost 20 versus 17, consistent with literature and the good ASPECTS. So, 17 in the good ASPECTS, the average score, and 20 in the low ASPECTS, slightly higher stroke severity scale. Dr. Osama Zaidat:           What also makes sense in the low ASPECTS is you have more ICAT occlusion. When you have an ICAT occlusion, will lead to loss of collateral, will lead to more tissue, and more core infarct volume with a completed stroke. Dr. Osama Zaidat:           So, I feel like also that's consistent. So, the difference between the baseline characteristic can be summarized with younger age, higher proximal occlusion, and more severe stroke than usual. And then the general anesthesia use was more often because now you have more severe stroke, now you have more core infarct volume, you are more likely to need anesthesia than not. So again, that's also consistent. Dr. Osama Zaidat:           The onset to puncture time, because you may need more anesthesia, the patient was sicker to stabilize, the onset to puncture time was also more prolonged in the lower ASPECTS group versus the good ASPECTS. Dr. Osama Zaidat:           So, those are the differences at baseline, Negar, as you can see. Not sure how you think about it, how you feel about them as well, but kind of the best way to explain them. But I'm curious also to hear your thought about them, if you have any comment or questions. Dr. Negar Asdaghi:         Yeah, I think I want to repeat just what you said and the point you raised because it's, as you mentioned, it is not surprising to see that low ASPECTS patients are presenting with more severe strokes with higher NIH Stroke Scale, have more tandem occlusions or more proximal occlusions. They're obviously sicker patients. So, those differences were not surprising at all to a reader of your paper. What was surprising is that age gap that you mentioned within your low ASPECTS and high ASPECTS category, and that from the registry-based study is actually, exactly what you mentioned, is a signal that clinicians are more comfortable to push the guidelines boundaries in the younger population. That's something that has to be taken with a grain of salt, because we're not talking about a population-based study where we're comparing age groups between low ASPECTS and high ASPECTS. We're talking about a highly selected group of individuals who've already received endovascular therapy, and now we're comparing the age groups depending on their lower ASPECTS. So that's an important distinction that you beautifully outlined for our listeners. Dr. Negar Asdaghi:         Now, coming to your primary outcomes, please tell us about the reperfusion rates in the study and comparing the low to high ASPECTS categories. Dr. Osama Zaidat:           That's an excellent question, to try to see — in spite of you're taking the chances — and treating patients with low ASPECTS. How did they do functionally and angiographically? The angiographic outcome and revascularization success can be a surrogate of functional outcomes. So, let's try to review with your listeners and readers the reperfusion outcome, like you mentioned. If you look at the reperfusion outcome in the paper, and I direct the readers and the listeners to Table 2. Specifically, what stands out is the rate of complete reperfusion because that's the one with the highest difference and significance between the two groups, which is TICI 3. The frequency of obtaining TICI 3 was 83 patients out of 662 that had an angiographic outcome with a good ASPECTS was zero out of the 55 patients; none of them had a TICI 3 complete occlusion. Dr. Osama Zaidat:           What's really astonishing in the result is the fact that there's a statistical difference between complete reperfusion, TICI 3, between the low ASPECTS group and cohort versus the good ASPECTS cohort of six to 10, and the theory and explanation, one of the explanations at least that may be plausible, is the fact that you probably had a good collateral in the good ASPECTS to have less core infarct, and the good collateral reduced the clot length, because the pial flow goes all the way backward into the clot in a retrograde fashion and makes it probably more likely to have a successful removal of the clot and hence achieving a TICI 3. Dr. Osama Zaidat:           So, but overall, if you just lump TICI 2b or higher, the standard definition of successful reperfusion as TICI 2b or higher, there was no statistical difference between the group. It was 85.5% in the low ASPECTS and 87.6% in the good ASPECTS group. So, that was not statistically different. Dr. Osama Zaidat:           When we looked at the first-pass effect, there was a trend toward more first-pass effect in the good ASPECTS group, but 61% and 57% in the low ASPECTS. That's defining first pass as TICI 2b from the first attempt, and not TICI 3, for example. Dr. Osama Zaidat:           So again, you can see that your success of reperfusion probably related to the ASPECTS in an indirect way, as a surrogate of collateral. Poor collateral tissue dies quickly, low ASPECTS and higher core infarct volume, and hence low success of reperfusion, but again, the only statistical significance here is in the complete reperfusion and TICI 3. Dr. Osama Zaidat:           So, if you kind of evaluate if the reperfusion outcome translated to a difference in the functional outcome, yes, indeed. In the low ASPECTS group, three out of 10 patients achieved independence at 90 days, or to be precise, 28.8% of that cohort and population had mRS of zero to two at 90 days in comparison to 59.7% in the good ASPECTS group. Dr. Osama Zaidat:           So, it's almost six out of 10 patients in the good ASPECTS versus three out of 10 patients in the low ASPECTS group. Still, they achieved a good outcome because we don't have a control group, but in comparison to the good ASPECTS, it's lower outcome, as you can see on Table 2, as well. Dr. Osama Zaidat:           The mortality is higher; it's almost 31% in the low ASPECTS versus 13.4% in the good ASPECTS group. The symptomatic hemorrhage rate was 7% versus almost 1% only in the good ASPECTS group. So, functional outcome across the board is lower than the good ASPECTS, but since this is not a randomized trial, we don't know if doing nothing to those low ASPECTS will necessarily yield similar results. Dr. Osama Zaidat:           So, it could be better than control, but clearly it's the likelihood of the patient doing better correlates with a better ASPECTS, which we all kind of already know, but we want to try to identify the group beyond which, like you started, Dr. Negar, beyond which the mechanical thrombectomy may be futile. Dr. Negar Asdaghi:         Right. So a very unfortunate vicious cycle almost, that those who needed the first-pass effect, TICI 3 perfusion the most actually ended up achieving it less than their high ASPECTS counterpart, as you mentioned. And again, it's important to understand that these observations are based on an observational large registry study. Dr. Negar Asdaghi:         Now, you found an important interplay between age and low ASPECTS in the clinical outcomes from thrombectomy in your study. Can you please elaborate on those findings? Dr. Osama Zaidat:           Absolutely. That's an excellent question because that's kind of the unique part of our research and our paper is we're trying to really combine the low ASPECTS with another variable that we all know as a clinician and people who treat stroke on a daily basis, that influence outcome. If you combine two poor predictors of good functional outcome. A good predictor that they could predict the outcome one way or another in either direction, good or bad outcome, you know ASPECTS was one of them, and age. So, we wanted to see if there's a threshold beyond which, if you combine the two, you can identify the patients that are almost less likely to benefit and the resources and the, if you may say, the resources and the message to the patient and their families should be with this consideration to try to provide guidance to the clinician nowadays. Dr. Osama Zaidat:           So, based on the previous data, we kind of wanted to really trichotomize the age into young, less than 65, 65 to 75, and 75. Dr. Osama Zaidat:           There is enough signal in the literature out there that 75 with low ASPECTS is a good cutoff to see. And indeed, we looked at that and we compared those three cohorts. We compared less than 65, 65 to 75, and more than 75 in the low ASPECTS group to see which one stands out. Now, the sample size is fairly small. So, I want to caution the reader and the listener to us today that this is a good signal, this is a good hypothesis-generating result; however, it needs to be reproduced in, again, large sample size and see if other researchers and investigators can have similar results. Dr. Osama Zaidat:           What we've found in this group of more than 75 and less than 65, I feel like the equipoise should remain between 65 and 75, but less than 65 is probably beneficial more than 75. Unfortunately, we could not find a strong signal of good functional outcome in those people more than 75. Dr. Osama Zaidat:           We had 12 patients; none of them achieved (mRS of) zero to two at 90 days, 0% at zero to two. And their mortality was close to 60%, and their symptomatic hemorrhage was close to 15%. So, when you treat a low ASPECTS (zero to five), and they are older than 75, the current data or the current signals suggest that the likelihood of good outcome is 0%, if you consider good outcome as (mRS) 0-2, and the likelihood of mortality close to 60%. More than half of them will die, and the likelihood of symptomatic hemorrhage is going to be higher, close to 16%. Dr. Osama Zaidat:           So, that's the cohort that we have to be very cautious about. I think the younger cohort had even better outcome than the overall zero to five. If you recall, from the previous question of Dr. Negar, discussion that the overall was 28.8%. If you restrict the analysis to the young, they have probably a good plasticity, good recovery, good rehab potential. If you look at those less than 65, their mRS zero to two went up to 44.8%, which is decent, acceptable, functional outcome in those young patients, and their mortality went down from 30% or 31% to 20%, and the symptomatic hemorrhage from 7% to 6%. So, it seems that there is a good signal in those less than 65 for being aggressive and try to provide them with a therapy, less aggressive with 75, and in between, where we really have no clear answer, and their mRS score was close to 20% versus 44 and 0%. So 44%, 18%, and 0%; less than 65, 65 to 75, and older than 75. Dr. Osama Zaidat:           Hopefully, this will shed the light and make the decision-making in the middle of the night probably more informed to the best of our knowledge nowadays. Dr. Negar Asdaghi:         Right. And how do these rates, the symptomatic intracerebral hemorrhage rates and mortality rates, compare in the low ASPECTS group as compared to those reported from the randomized trials? Dr. Osama Zaidat:           This is an excellent question because the randomized clinical trial had the advantage of having a control group, and the HERMES meta-analysis in all patient-level meta-analysis have looked at the CT ASPECTS. However, they combined it with the MRI ASPECTS, so kind of a heterogeneous population. It's not exactly the same, like the STRATIS low ASPECTS study that we're discussing today, and they have a very small sample size. What they found in that group from three to five, that 31%, so almost identical- if you think about -it to our outcome in the ASPECTS group. HERMES group didn't go to the 24 hour; they did up to six hours. Maybe the ESCAPE was 12 hours, the only one with the expanded time window, but interesting that their three to five ASPECTS had a good outcome of mRS zero to two at 31% versus 16% in the tPA group with an absolute difference about 15%. Dr. Osama Zaidat:           So, again, our result is consistent with the HERMES patient-level meta-analysis. However, in the (ASPECTS) zero to two group, they found the futility in the zero to two. They found 0%  (90 day mRS) in the mechanical thrombectomy. We didn't have that much of a sample size of zero to two (ASPECTS), and we didn't obtain a 0% (90 day mRS) similar to them, but we did obtain a 0% (mRS) if you are zero to five (ASPECTS) and older than 75. They have not really looked at the intersection and the interaction with the age like we looked at it, for example. So again, in their trial, the three to five (ASPECTS) is consistent with the ASPECTS with our low ASPECTS trial at 28.8% (90 day mRS) versus 31% in the HERMES meta-analysis, for example. Dr. Osama Zaidat:           MR-CLEAN group, however, even they have a better outcome, zero to four (ASPECTS), than us and HERMES, at about (90 day mRS) 36.7%. Their sample size was very small, less than 30 patients in the whole cohort, almost half the size of our sample size. So MR-CLEAN showed also, so if you think about it, the registry is close to 30% (mRS of 0-2 at 90 days), the randomized trial 31% to 35%. So, we are within the confidence interval of what's the likelihood of good outcome, which is almost one-third of the patients with low ASPECTS would have a good outcome. Dr. Osama Zaidat:           The good news that the standard care therapy with tPA gives you half of that outcome almost. So, there's a good signal that future randomized trial may be positive if they follow the STRATIS registry, HERMES, or MR-CLEAN data. Dr. Negar Asdaghi:         So, Sam, very important information and percentages to keep in mind as we counsel patients and family members, especially those elderly patients we see with large ischemic cores and low ASPECTS in the early timeframe from stroke onset. Dr. Negar Asdaghi:         I know you alluded to the future randomized trials, but I want to end with our takeaway message from your study, and how do you see these randomized trials in low ASPECTS population unfolding in the future? Dr. Osama Zaidat:           I mean, this is an excellent question that has two aspects about it. One is, can we use some of this data to guide us nowadays until we have future randomized trial? And I think each patient is individual, each family's individual family. I want the listener and the readers to take their time to explain the data to the patient. They have to keep in mind that there is a small sample size and also how definitive they feel about their reads with ASPECTS score, how definitive they feel about the large core infract, and is this plus minus one, is five the cutoff, in the elderly? Is it four or zero? Dr. Osama Zaidat:           So, I think if you are confident that your score may be zero to three, and the patient is more than 75, is more justifiable, kind of, at that extreme and to say this is less likely to benefit (from endovascular therapy) based on collective data. Dr. Osama Zaidat:           Again, without randomized trial, it's hard to strongly send a message, don't treat them (endovascularly) and futile. But based on HERMES, based on our analysis, extreme ASPECTS in older than 75, probably you have to be cautious taking them to the (cath) lab, for example. Now that's been said, the future trial will answer that. We are running the randomized trial ourself, myself and my co-PI, Dr. Albert Yoo, are doing an international TESLA trial. We are close to 125 patients randomized from two to five ASPECTS score and up to 85 years of age. So, we have almost 60-plus randomized in each arm, and we are hoping if we continue at this rate in the next two years to complete the enrollment and have some answer. Dr. Osama Zaidat:           Our sample size-it's an adaptive design trial called TESLA Trial--and our sample size is 300 patients. In Germany, there is an ongoing Tension trial. In U.S., there is another trial that mixed a CT scan with the perfusion for large core infarct called SELECT 2. That's ongoing, as well. And then a fourth trial, which is the IN EXTREMIS trial in France, that also going to answer it, and hopefully we can do a meta-analysis among those four large core infarct trials. Dr. Osama Zaidat:           Some of them allowed diffusion MRI, as well as CT scan; some of them allowed perfusion. And this way, if we combine all our data together, we can have probably a more reliable and precise answer to this important clinical question that has been identified by the National Institutes of Health [inaudible 00:36:43] as priority number one for thrombectomy following what we know so far. It's ranked as the next question that needs answer. Dr. Negar Asdaghi:         Dr. Sam Zaidat, congratulations on this work, and we look forward to the completion of TESLA results and the results of other randomized trials. Thank you for being with us today. Dr. Osama Zaidat:           Thank you for having me, and I appreciate the listener tuning in, and I appreciate the ASA and the journal team for having me. This is on behalf of my co-authors, the sponsor of the registry. Thank you very much. Dr. Negar Asdaghi:         Thank you. Now, before we end the July podcast, I want to draw your attention to a special invited report prepared by the Stroke Council Leadership on behalf of the American Heart and Stroke Associations on diagnosis and management of cerebral venous sinus thrombosis, or CVST, with vaccine-induced immune thrombotic thrombocytopenia. Dr. Negar Asdaghi:         This report is to heighten clinicians' awareness regarding the six cases of CVST, with thrombocytopenia in patients who received the Johnson & Johnson vaccine in the United States. Similar thromboembolic events were reported in Europe following the administration of AstraZeneca vaccination. These are adenoviral vector–containing vaccines, which are mechanistically different from the mRNA SARS-CoV-2 vaccines produced by Pfizer and Moderna. Dr. Negar Asdaghi:         The putative mechanism of vaccine-induced thrombotic thrombocytopenia is believed to be related to the leakage of DNA from the adenovirus-infected cells that subsequently binds to the platelet factor 4 and triggers the production of auto-antibodies against platelets. Dr. Negar Asdaghi:         The authors emphasize that while we wait for further research on the causal nature of the relationship of vaccines to CVST with thrombocytopenia, it is important to keep in mind that the reported risk of CVST associated with COVID-19 infection itself is far greater than that associated with vaccination. Dr. Negar Asdaghi:         And with that, we conclude our podcast for the July 2021 issue of Stroke. On behalf of the Editorial Board, I want to thank you all for listening and a special thanks to our healthcare providers and clinicians who continue to work on the front lines of this pandemic. We hope that you find this information useful, and until our next podcast, stay alert with Stroke Alert. This program is copyright of the American Heart Association, 2021. 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, visit AHAjournals.org.

Stroke Alert June 2021 On Episode 5 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the June 2021 issue of Stroke: "Preexisting Mild Cognitive Impairment, Dementia, and Receipt of Treatments for Acute Ischemic Stroke” and “Body Mass Index in 1.9 Million Adolescents and Stroke in Young Adulthood.” She also interviews Dr. Shyam Prabhakaran, from the University of Chicago, about his article "Predictors of Early Infarct Recurrence in Patients With Symptomatic Intracranial Atherosclerotic Disease." Dr. Negar Asdaghi: 1) Do people with mild cognitive impairment receive the same quality of stroke care as their cognitively normal counterparts? 2) Is there a causative relationship between the alarming rise in adolescent obesity and the rise in the incidence of stroke under the age of 50? 3) What are the independent predictors of radiographic recurrence in patients with symptomatic intracranial atherosclerotic disease? These are the topics that we will cover in today's podcast. You're listening to the Stroke Alert Podcast. Stay with us. Dr. Negar Asdaghi:                        From the Editorial Board of Stroke, welcome to the Stroke Alert Podcast. My name is Negar Asdaghi. I'm an Associate Professor of Neurology at the University of Miami Miller School of Medicine and your host for the monthly Stroke Alert Podcast. For the June 2021 issue of Stroke, we have a range of publications that cover a variety of topics from activation of neuroinflammatory pathways and intracerebral hemorrhage to predictors of outcome in patients with mild and rapidly improving ischemic stroke, which I encourage you to review, in addition to our podcast. Later in today's podcast, I have the privilege of interviewing Dr. Shyam Prabhakaran from University of Chicago on his work with various radiographic biomarkers as predictors of outcome in patients with symptomatic intercranial atherosclerotic disease. But first, with these two papers. Dr. Negar Asdaghi:                        In the United States, one in five adults over the age of 65 have mild cognitive impairment, and one in seven have a formal diagnosis of dementia. With our aging population, these numbers are estimated to triple by year 2050. Prior studies suggest that patients with dementia are less likely to receive evidence-based stroke care as compared to those with normal cognition. Less is known about the quality of stroke care amongst patients with mild cognitive impairment. In their paper titled "Preexisting Mild Cognitive Impairment, Dementia, and Receipt of Treatments for Acute Ischemic Stroke," Dr. Deborah Levine from Departments of Neurology and Internal Medicine at the University of Michigan and colleagues studied the quality of care in acute ischemic stroke patients with mild cognitive impairment, or MCI, and preexisting dementia as compared to patients with normal cognition. Dr. Negar Asdaghi:                        This was a cross-sectional analysis of prospectively obtained data on adults with acute ischemic stroke included in the Brain Attack Surveillance in the Corpus Christi project from 2008 to 2013. Primary outcome of the study is a composite quality measure of defect-free care calculated by dividing the number of treatments that a patient received by the number of treatments they were eligible to receive. Defect-free care was defined as receipt of seven stroke performance measures when eligible, and included administration of IV tPA, use of antithrombotic therapy by end of hospital day two, administration of DVT prophylaxis, assessment for rehabilitation, discharge on antithrombotic therapy, discharge on lipid-lowering therapy, and discharge on anticoagulation therapy for atrial fibrillation. Dr. Negar Asdaghi:                        Amongst 836 adults included in this study with a median age of 65, 58%, that's over half of the patients in this study, had some degree of cognitive impairment prior to their presenting stroke. 44% of patients with preexisting dementia received defect-free care as compared to 55% with either normal cognition or mild cognitive impairment. The difference, they did not reach statistical significance after adjusting for the sex, vascular comorbidities, and BMI in multivariate analysis. However, preexisting MCI remain an independent factor to be negatively associated with receipt of IV tPA echocardiogram and assessment for rehabilitation. Similarly, after adjusting for all confounders, preexisting dementia remained negatively associated with receipt of antithrombotic therapy by day two, lipid-lowering therapy at discharge, and receiving an echocardiogram. The authors highlighted their findings as a call to action to improve the overall delivery of stroke care and measures to all stroke patients, and caution that disparities noted in their study might contribute to differences in post-stroke outcomes, such as functional disability and recurrent stroke in the growing population of patients with mild cognitive impairment and dementia. Dr. Negar Asdaghi:                        Having a stroke at a young age has profound personal, societal, and economic implications. For the young stroke survivors, a long life expectancy after stroke, and the cost of long-term care pose huge challenges to healthcare systems, which are different than that encountered in the elderly stroke population. Over the past two decades, the incidence of ischemic stroke has substantially increased in the young, with adults under the age of 50 now comprising 10% of all ischemic stroke cases. This comes in parallel with the continuous rise in the prevalence of adolescent obesity in many Western countries, but the association between the two remains unclear. In the current issue of the journal, Dr. Aya Bardugo from the Department of Military Medicine, Hebrew University, in Jerusalem, and colleagues studied the association of adolescent body mass index, or BMI, with first stroke event in young adults as part of a nationwide population-based study of 1.9 million adolescents, followed for a cumulative 9.48 million person-years. BMI values were categorized in five groups of underweight, low-normal, high-normal, overweight, and obese. Dr. Negar Asdaghi:                        So, what they found was that the incident rate of any stroke and ischemic stroke increased gradually across the five BMI categories. Importantly, the hazard ratio for ischemic stroke became significant, even in the high-normal BMI group at 1.4, and increased to 2 for the overweight and 3.5 in the obese category. Though a similar increase in the rate of hemorrhagic stroke was noted, there was no significant association between BMI and hemorrhagic stroke in the study. Not surprisingly, many vascular risk factors, including high blood pressure and diabetes, were also elevated in the higher category BMI adolescents. However, alarmingly, these trends remain significant even after adjustment for age, sex, sociodemographic factors, and when the data was limited to otherwise healthy adolescents, those without diabetes and those without high blood pressure. Overall, the authors found that overweight and obese adolescents had approximately two- to threefold increased hazard for ischemic stroke that could present prior to the age of 30 irrespective of sex, race, ethnicity, and socioeconomic status. Dr. Negar Asdaghi:                        The authors detailed various mechanisms in which increased adolescent BMI may lead to stroke in the young, including progressive risk of large vessel intra and extracranial atherosclerotic disease, increased cardiovascular disease, and a shift to young onset heart failure and atrial fibrillation, as well as a strong association with being high BMI in children and adolescents, and that of obesity in adults. These findings are important observations as we face a growing epidemic of childhood and youth obesity worldwide with the potential to increase the future burden of stroke in young adults. Dr. Negar Asdaghi:                        Intracranial atherosclerotic disease, or ICAD, is an important cause of ischemic stroke worldwide. In addition to neurological deficits caused by index event, patients with ICAD remain at high risk for development of recurrent ischemic events. The risk of clinical recurrence is estimated to be between 12% to 20% at one year based on prior studies, despite best medical management. But recent studies have shown that up to 25% of patients with symptomatic ICAD have evidence of radiographic recurrence on follow-up MRI imaging. Dr. Negar Asdaghi:                        Who will remain stable and who will have more events with symptomatic ICAD is a common question that practicing clinicians struggle with in routine practice. The Mechanisms of Early Recurrence in Intracranial Atherosclerotic Disease, or the MYRIAD study, aimed to get us closer to that answer. Joining me now is Dr. Shyam Prabhakaran, Professor of Neurology and Chair of the Department of Neurology at the University of Chicago, who was one of the principal investigators of the MYRIAD study and the first author of the paper in the current issue of the journal titled "Predictors of Early Infarct Recurrence in Patients With Symptomatic Intracranial Atherosclerotic Disease." Good afternoon, Shyam. Thank you for joining us. Dr. Shyam Prabhakaran:              Thank you, and good afternoon to you. Dr. Negar Asdaghi:                        Thank you. Shyam, can you please start by telling us how MYRIAD's design was different from prior studies of symptomatic ICAD? And what were the main objectives of the study? Dr. Shyam Prabhakaran:              Sure, so MYRIAD was conceived as a study to really unravel and study the mechanisms of recurrent stroke after symptomatic ICAD presentation. Prior studies, I think, have really helped in many ways, obviously to understand the natural history of the disease, including through clinical trials, where we learned about the different interventions that could be applied, medical and endovascular, through WASID and then SAMMPRIS. However, both of those studies, which provided probably the bulk of information about the disease in multi-center study, did not really focus on mechanisms, per se, understanding it through biomarkers, understanding whether certain subsets of patients have higher or lower risk of recurrence. So, MYRIAD was conceived to try to tackle that particular aspect of research that we felt was understudied. Dr. Negar Asdaghi:                        Yes, thank you. Traditionally, as you mentioned, the location and the degree of stenosis have been considered as important radiographic factors to predict outcomes in symptomatic ICAD. MYRIAD looked at many more imaging biomarkers than just degree of stenosis and the location. Can you please elaborate on those radiographic biomarkers that were included in MYRIAD? Dr. Shyam Prabhakaran:              Yeah. So, again, MYRIAD wanted to explore these imaging biomarkers, and we split them into three categories. One was biomarker of antegrade flow. What would help us understand the amount or volume of flow through a particular diseased artery? And we used quantitative MRA for that, which is a technique that's been around a long time, a phase contrast MR approach, to get vessel-specific flow measurements. And aim two thought of the distal flow beyond the stenosis and aimed to look at two types of imaging biomarkers that might answer the question of flow in the distal territory, one through perfusion imaging. So looking at CT or MR perfusion, but MR was the one that we selected, where we would measure the tissue flow through Tmax measurements, and then the other using TCD, transcranial Doppler, and vasomotor reactivity testing of the distal arterials. So that was aim two. Can we look at those biomarkers potentially as predictors of recurrence? And then the third was emboli detection, so the plaque vulnerability or instability biomarker. So, could we look at distal emboli in the territory and assess its role in predicting recurrence? So, those were really the main biomarkers tied to the objectives of the grant. Dr. Negar Asdaghi:                        Perfect. So, obviously, great, and a comprehensive various biomarkers looking at different imaging predictors of early recurrence. We're excited to hear about your primary results. So, what did your study find? Dr. Shyam Prabhakaran:              So, in MYRIAD, we enrolled 105 subjects who had symptomatic intercranial stenosis at 10 centers across the US. And we were able to track them for both the primary outcome, which was stroke in the territory of the stenosis, clinical stroke at one year, and the secondary outcome, which was radiographic occurrence of new infarcts on six- to eight-week MRI. So that was a prespecified outcome. In the primary analysis of the clinical outcome, we did find a fairly high rate of recurrent events. Roughly 10% of patients in the cohort had a recurrent clinical event at one year, consistent with findings from, say, SAMMPRIS, which with maximum medical or aggressive medical management found a roughly 12% recurrence. So, we were able to confirm that there is a high rate of clinical recurrence. However, none of the biomarkers that we were looking at, quantitative MRA, profusion imaging, transcranial Doppler for BMR or emboli detection were predictors of the clinical outcome at one year. So, that was our main results. Dr. Shyam Prabhakaran:              Our secondary outcome was recurrent infarcts on study-specific research MRIs performed at the sites, and looked for recurrences compared to baseline MRIs that were performed at the time of their index stroke or TIA. So, in this paper, we were really interested in looking at whether there were any specific predictors of recurrent radiographic infarct, and that really was an interest of ours because we did find such a high rate of radiographic recurrence. Roughly 24% of our cohort had a recurrent infarct on brain imaging at six to eight weeks. So, we recognized right away that this is potentially an unrecognized phenomenon, that there's potentially an excess of radiographic events to clinical events. And there could be, obviously, a potential consequence of this radiographic accumulation of disease. Particularly, it might be important to prevent those radiographic occurrences in the future if they are affecting an individual's performance on cognition or even physical function as a result of accumulating lesions. So, we were really interested in seeing whether there were some early predictors of this six- to eight-week recurrence that we saw at a high rate. So, the paper looked at clinical factors, as well as imaging factors, that were available in the MYRIAD cohort, really trying to delve into a model that we could use to identify a subset that is at the highest risk of these early recurrent infarcts. Dr. Negar Asdaghi:                        Right, so very, very important findings. So, just to reiterate for our listeners, one in four patients in your study had evidence of radiographic recurrence despite clinically seemingly having no clinical events. So, this clinical radiographic dissociation would have absolutely gone unnoticed had it not been for these early MR images that were performed in the study. So, I want to clarify this from a pathophysiological standpoint. Is it hypoperfusion, plaque rupture, or both? Based on your results, what is the driving factor in development of new ischemia in symptomatic ICAD? Dr. Shyam Prabhakaran:              So, one of our main findings here, which is reported in this paper, is that those with multiple infarcts at their index stroke, so a pattern on diffusion-weighted imaging that was more than a singular infarct lesion, was a strong, independent predictor of having a recurrent event, recurrent infarct at six to eight weeks. And the part that isn't really highlighted in the paper, but is true, is the other factor that was co-mingled with multi-lesion, multi-infarct and index was borderzone pattern. They were co-linear, and they were essentially the same patients who were borderzone also had multiple lesions. So, one way we've interpreted this, and I can speak to a little bit about the different biomarkers that were studied in addition to the infarct pattern, but one way we've interpreted this is that multi-lesions can probably fall under two subsets. Dr. Shyam Prabhakaran:                           It could either be in this borderzone pattern, where you have multiple lesions due to hypoperfusion mechanisms, typically within either cortical or internal borderzones. And that may be then telling us about a mechanism of low flow. On the other hand, some of these patients could also have scattered lesions that are embolic in etiology and suggest a plaque that was unstable and potentially showered at their index event, resulting in that pattern that we saw. So, both of them probably are mixed in. We're favoring the borderzone because they were so co-linear that that probably was the more likely mechanism. And we're probably concerned that that could also be a factor that leads to early recurrence because flow failure typically is associated with critical hypoperfusion and imminent recurrence. Dr. Shyam Prabhakaran:              But, interestingly, in the paper, we talk about this, none of the specific prespecified biomarkers that were looking at flow, perfusion imaging, vasomotor reactivity were significant by themselves as predictors of recurrent infarct. So, it's a little hard for us to know why. It could be that the technology that we use, perfusion imaging, is still not quite picking up the kind of flow failure that we need to. Maybe it's more subtle than even we found because we looked at different cut points of Tmax and other parameters on perfusion imaging, and yet, we're not able to find a cutoff that was predictive, likewise with vasomotor reactivity. So, it could be that those are not quite good enough surrogates of hypoperfusion. And yet, borderzone or multi-infarct patterns may have been a surrogate of hypoperfusion. So, I think the short answer here is that it could be both mechanisms, plaque instability and hypoperfusion, although we're maybe favoring hypoperfusion because there was a strong co-linearity with borderzone pattern. Dr. Negar Asdaghi:                        Understood. Now Shyam, recurrent events on maximum medical therapy, this is not what we like to hear. Where do you see the future of symptomatic ICAD therapy? Now in your view, is there a role for interventional treatment or other therapies in a select group of ICAD patients? Dr. Shyam Prabhakaran:              I think that's really where we still face real challenges. I think the work done by many of the investigators before us on maximum medical therapy and interventional therapies have found, obviously, that there are some benefits to the medical approaches that we now consider standard of care. The dual antiplatelet therapy, the lipid-lowering therapy, the lifestyle management that SAMMPRIS also implemented and successfully showed some benefits of physical activity. So, those things clearly matter. And yet, the clinical event rate is still very high, and the radiographic event rate is even higher. So, you have this real challenge facing clinicians and patients of a disease that has a very high rate of recurrence, much higher than the other subtypes of ischemic stroke, and certainly higher than, say, AFib patients even, where we sometimes obviously are concerned and adopt strategies to lower risk. So, we are in a position, I think, today where we have to go back to the well and think about novel strategies. Dr. Shyam Prabhakaran:              Now, flow is a component of this, and I do think that SAMMPRIS, albeit now almost a decade ago, tested an interventional approach. It may be worth revisiting interventional strategies. Of course, we know from endovascular therapy for ischemic stroke, try once and fail, and try again, and you might find a different result because technologies get better, practitioners, proceduralists get better. So, that's one angle that I think people are very interested in, is whether or not an interventional approach for flow failure patients is a path forward. And that, I think, will get a lot of attention in the years to come with new studies that are being designed. Dr. Shyam Prabhakaran:              I think the other important point here is that aggressive medical management in the current day and age may still have room for improvement. Maybe the drugs that we're using, especially with DAPT and lipid-lowering therapies, they're not as quick or necessarily universally responsive for every patient. So, we know that about clopidogrel, that there's a certain rate of non-responders. We could probably do better than that with other choices, antiplatelet choices or even anticoagulant choices, which are being considered. And we know that lipid-lowering therapy with statins works well, but perhaps PCSK9 drugs could be considered in this population to lower cholesterol levels even more rapidly and more aggressively. So, all of these, I think, should be on the table as we move forward. Dr. Negar Asdaghi:                        Dr. Shyam Prabhakaran, thank you for joining us on the podcast today. We look forward to having you back here and covering more of your work in the future. Dr. Shyam Prabhakaran:              Thank you for having me. Dr. Negar Asdaghi:                        Thank you. And this concludes our podcast for the June 2021 issue of Stroke. Please be sure to check out the June table of contents for the full list of publications, including an important update from the American Stroke Association and the Stroke Council on how cerebrovascular disease is expected to temporarily fall from the fifth to the sixth leading cause of death in the United States in 2020. Sadly, this is not because of advances in stroke prevention and therapies, but rather because mortality from COVID-19 will displace stroke as a leading cause of death, a grim reminder of the year we put behind us and the many lives lost to this global pandemic. And yet we look ahead with hope, and with the promise that science has the power to resolve and the ability to push the human race forward. Every small step, every question will get us closer to learning more, answering more and knowing more. So, as we end this podcast today, we look forward to asking more at our next, and our promise to stay alert with Stroke Alert. This program is copyright of the American Heart Association, 2021. 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, visit AHAjournals.org.

Episode 445 of the Creativity Matters Podcast: tips for the Index-Card-a-Day Challenge (ICAD) and ideas for thinking about doing a series.

Greenspun grew up in Bethesda, Maryland, and received a B.S. in Mathematics from MIT in 1982. After working for Hewlett Packard Research Labs in Palo Alto and Symbolics, he became a founder of ICAD, Inc. Greenspun returned to MIT to study electrical engineering and computer science, eventually receiving a Ph.D. Working with Isaac Kohane of Boston Children's Hospital and Harvard Medical School, Greenspun was the developer of an early Web-based electronic medical record system. The system is described in "Building national electronic medical record systems via the World Wide Web" (1996).[1] Greenspun and Kohane continue to work together on a medical informatics at Harvard Medical School. In 1995, Greenspun was hired to lead development of Hearst Corporation's Internet services, which included early e-commerce sites. In 1997 he co-founded ArsDigita, a web services company which grew to $20 million in annual revenues by 2000. Photo.net and ArsDigita In 1993, Greenspun founded photo.net, an online community for people helping each other to improve their photographic skills. He seeded the community with "Travels with Samantha",[3] a photo-illustrated account of a trip from Boston to Alaska and back. Photo.net became a business in 2000 with the help of some of his cofounders Rajeev Surati and Waikit Lau. Having grown to 600,000 registered users, it was acquired by NameMedia in 2007 for $6 million, according to documents filed in connection with a planned public offering of NameMedia shares. Greenspun founded the open-source software company ArsDigita and, as CEO, grew it to about $20 million in revenue before taking a venture capital investment. Greenspun was an early developer of database-backed Web sites, which became the dominant approach to engineering sites with user contributions, e.g., Amazon.com. Greenspun was also a developer of one of the first Web-based electronic medical record systems. Greenspun's Oracle-based community site LUSENET was an important early host of free forums. Aviation Greenspun has written several textbooks on developing Internet applications, including Philip and Alex's Guide to Web Publishing,[21] SQL for Web Nerds,[22] and Software Engineering for Internet Applications,[23] the textbook for an MIT course. Greenspun is the editor of Medical School 2020, which provides a first-person account by a medical student.[24] Teaching Greenspun and his co-founders at ArsDigita started a non-profit foundation that ran the ArsDigita Prize, an award for young web developers, and the ArsDigita University, a tuition-free one-year program teaching the core computer science curriculum, one course at a time. Winners of the Prize include a 12 year old Aaron Swartz.[25] Greenspun has taught electrical engineering and computer science at MIT.[26] One of Greenspun's most famous students is Randal Pinkett, who built an online community for low-income housing residents in Greenspun's 6.171 Software Engineering for Internet Applications course. Pinkett went on to win NBC TV show The Apprentice. In 2003, And please join my mailing list to get resources and enter giveaways to win a FREE copy of my book (and more) http://briankeating.com/mailing_list.php

Selain kalori yang berlebihan. Akhir-akhir ini dunia nutrisi dipopulerkan istilah obesogen. Latar belakangnya adalah berdasar penelitian di mana bahkan dengan konsumsi kalori yang terkontrol, ternyata apabila obesogennya ada, orang bisa mengalami kenaikan kadar lemak tubuh dan obesitas lho. Obesogen ini berasal dari kata obese yaitu gemuk dan genik yaitu membuat. Kalau digabungkan obesogen artinya zat yang memicu kegemukan dan obesitas. Yuk kita simak penjelasan dari obesogen bersama @steadfastnick dan kiat-kiat untuk mengatasinya di FIT TALK EPISODE 46 di Spotify! 00:10 OBESOGEN dan OBESOGENIC penyebab orang gagal turun berat badan! Kok bisa? 02:29 obesogen Makanan atau zat yang membuat obesitas! 03:15 karbohidrat dan lemak termasuk obesogen 04:00 kualitas makanan buruk, sel lemak meningkat! 08:00 one unhealthy food doesn't make you unhealthy vice versa 10:55 terlalu banyak konsumsi gula atau manis manis metabolisme jadi rusak! 12:53 fungsi dari konsumsi gula atau simple sugar sebelum berolahraga 20:00 konsumsi gula maksimal per hari hanya 4 sendok makan = 50 gram berdasarkan pedoman gizi seimbang! 22:00 lemak yang sehat dan tidak sehat! Apa saja? 23:00 asam lemak omega 3 tidak boleh kena panas tinggi! 28:40 4 sehat 5 sempurna sudah kuno! Kenapa? 30:30 obat anti depressan, obat tidur, obat psikotik memicu obesitas 32:00 Turunin lemak salah satu caranya efektifnya adalah membentuk otot! 34:51 latihan beban adalah kunci untuk semua gender membangun otot dan mengurangi lemak! 36:30 inflammaging, semakin bertambah tua semakin mudah untuk menjadi gemuk 39:10 semakin tua harusnya semakin aktif! 42:10 rahasia awet muda! Thanks to @muscleboundepfc Check our socials Instagram : @igetfit.id Host : @weightlifty, @ynsamuel,@icad_rado

Perjalanan menuju berat badan ideal memang selalu menjadi kegiatan rutin yang dilakukan oleh orang. Namun perjalanan menuju hal tersebut banyak sekali informasi yang diperoleh. Orang biasanya hanya mengetahui hal umum seperti kalori defisit, rendah gula dan rendah lemak. Kita perlu mengetahui bahwa sel otot dan lemak itu kompleks dan banyak pengetahuan baru yang belum diketahui orang. Pada podcast kali ini kita bersama @steadfastnick mencoba mengupas sedikit dari kompleksitas sel lemak dan otot serta hubungannya dengan genetik 02:00 Clean bulking atau lean massing. Apasih? 03:10 konsep lean bulking atau lean massing 07:40 genetik mempengaruhi perkembangan sel lemak, benarkah? 10:00 salah kaprah soal bulking! Idealnya berapa kg per minggu naik berat badan? 20:20 semakin tinggi lemak dalam tubuh akan semakin sulit turun berat badan, kok bisa? 27:00 berapa surplus kalori yang aman untuk menambah massa otot tanpa ada efek negatif? 35:00 hormon mempengaruhi berkembangnya massa otot dan sel lemak 38:00 5 tahun ngga menstruasi!? Kok bisa? Yuk disimak di FIT TALK EPISODE 45 di Spotify! Thanks to @muscleboundepfc Check our socials Instagram : @igetfit.id Host : @weightlifty, @ynsamuel , @icad_rado

Doctissimo dans le collimateur de l’ONG britannique, Privacy International qui l’a assignée devant la CNIL, la start-up canadienne North rachetée par Google, le métro parisien entièrement couvert par la 4G même dans les espaces les plus contraints, le cloud public d’Oracle labélisé HDS (hébergeur de données santé), iCAD pourrait permettre de prédire un cancer du sein à deux ans et permettre donc un dépistage précoce.

In the latest episode of Tom Cilek’s New Best Friend, banker and master connector Tom Cilek calls up Kate Moreland, president of the Iowa City Area Development Group, to talk about the evolution of ICAD, the launch of ICR Iowa and her path to one of the top economic development jobs in the Corridor.

The Iowa Idea: Kate Moreland The value of owning one's voice. In this episode of The Iowa Idea Podcast, I sit down with Kate Moreland. Kate is the President of ICAD (Iowa City Area Development Group). She is also the co-founder of Her Experience, and certified Strategic Doing practitioner. ICAD's mission is to create, collaborate […]

Episode 393 of the Creativity Matters Podcast: It's okay. Thoughts on summer art, ICAD, prepping for a series, and a creative book.

S01 : E01 Callback merupakan segmen baru yang menghadirkan kawan kawan lama. Untuk kehidupan, kisah romansa, dan juga pandangan tentang kejadian yang ada disekitar. Kali ini berkesempatan berbincang bersama orang dibalik podcast #prattalk (@irsyadicadd) --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/baaames/message

With special guest Balveer Chandrawat Raising Stroke Awareness LIVE FROM INDIA! Balveer Chandrawa Bio: Works At and Specializes in Medtronic || Acute Ischemic Stroke || India and Subcontinents I am Pharmacy Graduate & passionate professional working in the field of Neurovascular since 2007. I have worked only for Hemorrhagic and Ischemic Stroke related Neuro Interventional devices in last 12 years there for I have sound understanding of therapy. I have been part of all kind of procedures with physicians like Brain Aneurysm ,AVM,ICAD ,Carotid Stenting and Acute Stroke. I have assisted more than 1000 Neurovascular cases to physicians inside OT in my 12 years of career. I work for Medtronic and since last one year I am purely focused on Acute Ischemic Stroke therapy, as in India we have 10% of global stroke burden while we treat less than 1% .In recent stroke prevalence has also increased and as per WSO it is no more 1 in 6 its 1 in 4 now has risk of stroke in their lifetime. We are currently working on projects to increase awareness of stroke among Public therefore I am keen to be part of this program in order to reach out to more people. What so ever I will be sharing with you all are my personal views hence they should not be correlated with my Medtronic or on behalf of Medtronic. DISCLAIMER Today's show and it's content are the opinion of the speaker and are not necessarily the opinion of Medtronics.

S01 : E01 Callback merupakan segmen baru yang menghadirkan kawan kawan lama. Untuk kehidupan, kisah romansa, dan juga pandangan tentang kejadian yang ada disekitar. Kali ini berkesempatan berbincang bersama orang dibalik podcast #prattalk (@irsyadicadd) --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/baaames/message

How did Cayetano end up running the SEA Games anyway? VP Robredo fired as ICAD co-chair. A taste of Usapang Endo on the Usapang Econ podcast. The "Safe Philippines" project. Young people lead actions against climate change. Hong Kong voters have a message. The inventor of the world wide web wants to save the internet. Should Facebook have the power to filter? And we recommend a new book: Women in Diplomacy. --- Send in a voice message: https://anchor.fm/pumapodcast/message

VP Robredo and PDEA Chief admit being confused with their responsibilities as ICAD co-chairpersonsPH Brokers Association: Fallout from brokerage firm theft could hit P2-BTwo suspects in killing of PH radio broadcaster arrested 

Dans l'actualité de l'intelligence artificielle:Le Global Forum on AI for Humanity s’est tenu la semaine dernière à Paris.Scientifiques et innovateurs publient 10 recommandations pour un partenariat européen public-privé sur l'intelligence artificielle.La France et l'Allemagne annoncent un projet d’infrastructure européenne et sécurisée des données.Belgique : Agoria annonce lancer le premier cours en ligne gratuit pour et par les entreprises en Europe.Les Émirats arabes unis annoncent l'ouverture de la première université du monde consacrée à l'intelligence artificielle.Le prix Territoires & Innovation du Grand Prix National de l'Ingénierie a été décerné aux équipes d'Altereo pour leur système d’intelligence artificielle HpO®.IA et Défense : Impact, Golem.ai, Masa et Magellium remportent le défi C2IA* organisé par l'Agence Innovation Défense (AID) et le Commandement pour les Opérations Interarmées (CPOIA).Challenge EIT Digital 2019 : découvrez les 25 finalistes européens et leurs innovations Deep Tech.Voici les 21 startups de la délégation Business France qui se rendront au Web Summit 2019.L’incubateur de la SATT Aquitaine accueille trois nouveaux projets : AERODIODE, KUNE et ZENITH.IA Flash, le projet IA développé pour fiabiliser la constatation des contraventions à partir de la reconnaissance d’images.SYSTRAN lance une Marketplace de modèles sectoriels de traduction neuronale.La Banque Européenne d'Investissement finance Prophesee.Dhatim signe un accord avec Sage autour de Conciliator Expert, sa solution à base d'IA.Focus sur TrauMatrix, le partenariat de recherche pour la gestion des traumatismes graves dans les premières 24h.iCAD installe sa solution ProFound AI 2D pour la mammographie et pour la tomosynthèse 3D au Centre d’Imagerie Paris Nord Sarcelles.Manutan accélère grâce à l'IA de compréhension du langage naturel de Golem.aiZoom sur les 5 conférences plénières organisées au Salon BE 4.0.L’intelligence artificielle nous veut-elle du bien ? sur France Culture avec Yann Le Cun et Gaspard Koenig.Support the show (https://www.actuia.com)

Fotoğrafın icadının haberlere yansıması

Bersosial media pake mental? Sounds weird but real, man. Kali ini aku ngobrol sama Ricard Dirwan yang biasa aku panggil Icad. Dia dulu selebgram yang gabisa hidup tanpa sosial media (Duh!). Tapi sekarang dia turn to be orang yang hanya menggunakan sosial media buat bisnisnya aja. Kata dia "Menurut Gue, main sosmed itu perlu pake mental. Mau lo cuman netizen ataupun lo Selebgram. Sepenting itu, Cil" Oiya, btw aku ganti nama podcast jadi Ruang 008. And, enjoy!

Listen to Codrin Arsene interview Michael Klein, the CEO @ iCAD, one of the few FDA-approved artificial intelligence solutions for radiologists. iCAD's AI analyzes hundreds of data-points to deliver powerful software solutions for breast tomosynthesis, breast density and 2D mammography. In simple terms, the iCAD software (Profound AI) analyzes mammogram images and correlates them to demographic data to produce cancer probability scores for radiologists. Whereas iCAD cannot officially 'diagnose' breast cancer, the software alerts radiologists of any abnormalities tied to mammogram images for further inspection. In the clinical trial which led to iCAD getting FDA approval, Profound AI was responsible for detecting 8% more cancers than the group of radiologists that analyzed the same data set. Listen to the podcast to learn about the history of iCAD, their current AI solution, new exciting features and functionalities iCAD plans to release later this year and the future of AI in healthcare.

In this episode we interview CEO Mike Klein who is Executive Chairman and CEO of iCAD a medical technology company, focused on artificial intelligence image interpretation technologies and intra-operative radiation therapy. Mike is a CEO board member who career has spanned Fortune 200 companies as well as startups. Mike lives in the Bay Area and has been a adjunct lecturer at the Leavey School of Business at Santa Clara University teaching the next generation of business leaders. Mike is an active member of the Silicon Valley entrepreneurial community.

Dr. Jeffrey Hoffmeister, MD, VP, Medical Director at iCAD, a global leader in medical technology providing innovative cancer detection and therapy solutions, discusses the role of 3D mammography on radiologist burnout and what steps practices can take to address it. Listen to more health-related stories and research updates at www.hpr.fm

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.                                                 In today's feature discussion, we will be doing a deep dive into the LEADER trial results, looking at new results of liraglutide and its effects in patients with type two diabetes, with or without a history of myocardial infarction or stroke. All of that coming right up after these summaries.                                                 In today's issue, five groups of investigators in two original basic research articles and three research letters tackled the same biological question, and all reached the same conclusion that cells in the heart expressing the SCA-1 cell surface antigen do not become cardiomyocytes to any meaningful degree, and instead become endothelial cells. Among the original basic papers, first author Dr Vagnozzi, corresponding author Dr Molkentin from Howard Hughes Medical Institute and Cincinnati Children's Hospital Medical Center, and their colleagues use the inducible recombinase method and generated a constitutive recombinase at the SCA-1 locus. They found that cardiac resident SCA-1 positive cells were not significant contributors to cardiomyocyte renewal in vivo. Instead, SCA-1 positive cells generated cardiac vasculature throughout development, during aging, and following injury with trivial contribution to the cardiomyocyte population.                                                 In the second paper from co-first authors, Drs Zhang and Sultana, with corresponding author Dr Cai from Indiana University School of Medicine and colleagues, these authors engineered a series of genetically altered mice to identify and track SCA-1 positive cells in the heart, and found that SCA-1 positive cells were purely of the endothelial lineage. Together with three research letters, these five papers add to the growing body of evidence that in adult mammals, our new cardiomyocytes arise from preexisting cardiomyocytes and rarely, if at all, from adult cardiac stem cells.                                                 Could metformin be cardioprotective in patients with type one diabetes? Co-first authors Drs Bjornstad and Schafer, corresponding author Dr Nadeau from University of Colorado School of Medicine, and their colleagues hypothesized that adolescents with type one diabetes have impaired vascular function, and that metformin may improve insulin resistance and vascular dysfunction.                                                 To test this hypothesis, they studied 48 adolescents with type one diabetes and 24 non-diabetic controls using MRI of the ascending and descending aorta, as well as assessment of carotid intima-medial thickness by ultrasound, brachial distance ability by DynaPulse, fat and lean mass by DXA, fasting labs following overnight glycemic control, and insulin sensitivity by hyperinsulinemic euglycemic clamp. The adolescents with type one diabetes were randomized one as to one to three months of 2000 milligrams metformin or placebo daily, after which the baseline measures were repeated.                                                 The authors detected early signs of cardiovascular disease with MRI in these adolescents with type one diabetes compared to controls. They further found that three months of metformin therapy improved insulin sensitivity as assessed by gold standard hyperinsulinemic euglycemic clamp, both in normal weight and obese adolescents with type one diabetes. Moreover, metformin improved carotid intima-medial thickness and aortic wall shear stress and stiffness. Thus, metformin may hold promise as a cardioprotective intervention in type one diabetes.                                                 What are the clinical genetic and environmental determinants of varicose vein formation? Co-first authors Drs Fukaya and Flores, corresponding author Dr Leeper from Stanford University, and colleagues applied machine learning to agnostically search for risk factors of varicose veins in nearly half a million individuals in the UK bio bank. They found that greater height appeared as a novel predictor of varicose vein disease in machine learning analyses, and was independently associated in multi-variable adjusted Cox regression. Using Mendelian randomization, they demonstrated that greater height had a causal role in varicose vein development. A genome-wide association study identified 30 new genome-wide significant loci, identifying pathways involved in vascular development, and skeletal/limb biology, and discovering a strong genetic correlation between varicose veins and deep vein thrombosis. The knowledge greatly expands our understanding of disease pathophysiology, and may help future improvements in the management of varicose veins and their associated complications.                                                 The final original paper describes the effect of glucagon-like peptide-1 receptor agonist liraglutide on cardiovascular events, and all-cause mortality in patients with type two diabetes and chronic kidney disease. First and corresponding author Dr Mann from Friedrich Alexander University of Erlangen in Germany and their colleagues performed a post hoc analysis of the LEADER trial comparing the liraglutide's treatment effects in patients with and without kidney disease.                                                 As a reminder, LEADER was designed to recruit a subgroup of at least 660 patients with an estimated glomerular filtration rate, or eGFR, less than 60, approximately 220 patients with severe renal impairment, eGFR less than 30, and at least 440 patients with moderate renal impairment with an eGFR of 30 to 60. The authors found that the liraglutide reduced the risk of major adverse cardiovascular events, and all-cause mortality compared with placebo in patients with chronic kidney disease defined as an eGFR less than 60, and also in patients with albuminuria defined as a urinary albumin to creatinine ratio above 30.                                                 The overall risk of adverse events did not differ between the liraglutide and placebo treated patients either with or without chronic kidney disease in the LEADER trial. In summary, these results show that liraglutide added to standard of care reduced the risk of major cardiovascular events and all-cause mortality in patients with type two diabetes and chronic kidney disease. Furthermore, these results appear to apply across the chronic kidney disease spectrum that was enrolled.                                                 And that brings us to the end of our summaries. Now for this week's feature discussion.                                                 Cardiovascular outcome trials have transformed the world of treating patients with diabetes. And for our feature discussion today, we're going to be talking about a new analysis from a very important trial, the LEADER trial of GLP-1 receptor agonists, and that's the liraglutide. I'm very proud to have the corresponding author of this paper with us, Dr Subodh Verma, and he's from St Michael's Hospital and University of Toronto, and our senior associate editor, Dr Gabriel Steg, from University of Paris. Actually, Gabriel, I'm actually going to start with you for once because I recall perhaps something you may have written about cardiovascular outcome trials. Dr Gabriel Steg:                Yeah, it's really funny. I'll try to take it graciously. You know, I wrote a frame of reference in Circulation a few years ago, wondering whether we were doing good by doing all these large outcome trials for safety with new anti-diabetic drugs, because there had been not one but two, three, four, five, six trials that were essentially neutral, enrolling more than 107 patients and participants at the expense of millions of dollars, and not much came out of it. And this was published in circulation. I was very happy until the next trial comes up, and this is EMPA-REG. And the next one is LEADER. And we have two trials that literally transform our vision of anti-diabetic agents as major agents for cardiovascular prevention. The trial we're going to discuss today, which you wrote about, is one of these trials. And I think I have to revisit my own writings and probably eat my hat. Dr Carolyn Lam:                So indeed, that's a great segue. Thank you, Gabriel. And Subodh, tell us then, what did you look at this time in LEADER? And maybe start by saying a little bit about LEADER, and the rationale for doing this particular sub analysis. Dr Subodh Verma:           Right. So, as Dr Steg mentioned, these were FDA-mandated studies to look at safety and potential efficacy of newer antihyperglycemic agents. The entire premise was that cardiologists and cardiovascular specialists were not really getting that excited about antihyperglycemic therapies in people with diabetes, because there was no data that they did much. And as Dr Steg mentioned, even the data leading up to some of these trials were disappointing, suggesting that they're safe, but they neither reduce nor increase events.                                                 So, I think EMPA-REG and LEADER really changed the calculus in many ways of how we look at cardiovascular risk reduction with antihyperglycemic agents. LEADER was a trial that was 9,340 patients. These are patients that were at high cardiovascular risk, but unlike EMPA-REG that only enrolled people with prior to ischemic cardiovascular events ICAD, PAD, and CVD, LEADER took a position of enriching the population with this spectrum of patients with cardiovascular disease and risk factors.                                                 So, some were in so-called high risk primary prevention who had not had established ASCVD, but had multiple risk factors such as uncontrolled hypertension or chronic kidney disease. Some had evidence of ASCVD, but had not had a prior myocardial infarction. And some, in fact, had had a prior MI stroke or PAD. So, it was a broad population of patients that was enrolled. And the primary result, again, for the primary outcome of MACE, demonstrated a significant reduction in favor of liraglutide versus placebo. And then for the individual components of that primary outcome, they were all statistically significant, or at least went in the right direction. Importantly, CV death was reduced by 22% with liraglutide versus placebo.                                                 I would like to emphasize that in this day and age, and Dr Steg has nicely set the stage, we have started thinking about how do we think about cardiovascular phenotypes of patients. You know, is a drug more likely to reduce heart failure? More likely to reduce ischemic events? And with LEADER, we found that in fact the trial actually reduced mostly ischemic events, and was really not that beneficial on heart failure related outcomes.                                                 So, that was the broad positive outcome from LEADER. They've led to guideline changes worldwide that patients with diabetes should be prioritized to receive an agent that has shown benefit, particularly if they have cardiovascular disease. And one of those agents was empagliflozin. The other was liraglutide. But, secondary prevention is a pretty crowded space, and not everybody can get everything, and not everybody should get everything, and not everybody can afford everything. So, I think leaders like the two of you here are often thinking about, how do you risk-stratify these populations, and how do we start thinking about people who are at greater risk, people who can actually derive benefit? And I think that's the smart and thoughtful way of doing this. And is there a certain threshold at which point the therapy loses its ability to reduce cardiovascular events, at least in the short term?                                                 So, in that theme, in that vein, what we looked at here was an analysis of people in LEADER who truly had a prior ischemic event. And the work that Dr Steg and others have done in REACH registries, etc. clearly establish that that's a population of patients, type two diabetes and a prior ischemic event. You don't really need many more calculators beyond that. That's the highest risk population. And then, the next level is really type two diabetes with a ASCVD. And we know that from REACH as well, that that's the next level of risk. And then, what about people who have type two diabetes just by itself? Which certainly are much higher risk than people who don't have diabetes, but we didn't have a non-diabetic group to compare to.                                                 And what we find is that the higher the baseline risk defined by this, the greater is the absolute risk reduction. The P value is consistent for ... You know, this is non-significant for heterogeneity. but specifically, people with a prior ischemic event derive benefit. People without a prior ischemic event who've had ASCVD derive significant benefit. But, in fact, we found that the curves were almost superimposable for people who did not have prior ASCVD. And that's not to say the GLP-1 receptor agonists should not be used in diabetes in the absence of cardiovascular disease, because they're great glucose lowering agents. They cause hypoglycemia, they cause weight loss. And potentially, within longer exposure times, cardiovascular benefit may actually emerge. And we've heard data from Dr Gerstein's study called Rewind that is positive, that will be presented next year. Harmony Outcomes was a study that was presented recently that also showed a benefit. So, whether in the primary prevention group we see a benefit in the future remains to be seen. Dr Carolyn Lam:                Oh, that's a great, great summary. But Subodh, you know, it's become a bit of what do we define as a primary and secondary prevention anymore, you know? And the patient that already got type two diabetes. Now, in this paper, it's very nice. As you said, has a history of myocardial infarction and stroke. And maybe I could just clarify to the audience, you couldn't just pick up the primary paper and see that because the way the inclusion exclusion criteria were designed in LEADER, you can't just pick up the sub-groups. So, this specific analysis, so carefully and wonderfully done, was absolutely needed. But then you know, what do you think? What's primary and what's secondary prevention anymore? Dr Gabriel Steg:                Well, I want to commend the authors for doing the careful stratification of diabetic patients they've done in the paper, and particularly for pointing out that it's one thing to have had an event where you actually ruptured a plaque and had a traumatic event. And it's very different from merely having plaque in one of your carotids or your arteries, and which is, of course, in turn very different from the majority of diabetic patients who have neither an event, nor diagnosed plaque or established plaque. And when we think about preventing cardiovascular and diabetes, we have to remember that the outer circle, the broader circle of diabetic patients who haven't had disease is the largest component. Dr Subodh Verma:           True. Dr Gabriel Steg:                And these are the patients whom we treat every day with the hope of eventually keeping them from harm, safe from harm, or with therapies that are new and potentially beneficial. And I think your research very clearly shows that there's a gradient of benefit. The sicker the patient, the greater the benefit in preventing MACE. And as long as you get to more healthier phenotypes of diabetes, then there is less of a benefit. Which doesn't mean that we shouldn't use these agents. As you point out, they're very convenient and effective agents for glucose control. But then, their cardiovascular benefits are more uncertain. And I think this is the key message from this analysis, and it's a great analysis. Dr Subodh Verma:           Thank you. I appreciate that. I totally agree that for the doctor in the trenches, particularly the cardiologist who's just trying to get their feet wet with antihyperglycemic therapy, you know? Cardiologists will embrace PCSK9 inhibitors and rivaroxaban at low dose, and maybe a new way of doing surgery or putting an LVAD. But it's very hard to get their attention when it comes to antihyperglycemic therapy. So, defining for them the population that matters the most, where the greatest risk and risk reduction can be achieved, I think is quite important from a clinical standpoint. And I think most cardiologists will agree that type two diabetes and a prior ischemic event is a high-risk population. Type two diabetes in a prior ASCVD is a high-risk population, and the magnitude of CV death reduction here is something meaningful for them to pay attention to. Dr Carolyn Lam:                Yeah, indeed. That's what I love best about this paper. It's actually asking the question the way a cardiologist would, exactly like you had both put. So, what do you think is the next step now? Do you think we need to look at this primary prevention type two diabetics with no established cardiovascular disease? Do we really need to? Is it that we need a method analysis, which you can talk about? Or, is it that we need longer follow up? Or, what next? Dr Subodh Verma:           I think that first of all, we have to get rid of the terminology, and maybe as a heart surgeon, I can be a little bit provocative and just say it. I wrote an editorial to the Declare Study that was just published yesterday in The Lancet called "Pumps, Pipes, and Filter: Do SGLT2 inhibitors cover it all?" Then I made a strong statement there that this nomenclature of primary and secondary really is artificial because it only captures ischemic risk, and does not capture risk of heart failure or renal disease. So, in a patient, as you've asked, Carolyn, who has type two diabetes, whose renal function is 54 or GFR is 55, who's not had a prior MI ... Is that patient primary prevention? Maybe from an ischemic standpoint, but he's clearly secondary prevention from a renal standpoint. Dr Subodh Verma:           So, I think we need to just think about all disease as a spectrum, and not as an artificial cutoff that, if you've had an ischemic event, suddenly the world changes for you there. Because, that gradient I think is probably what we need to somehow appreciate as to where that risk lies. The patient who's 40 who's had no risk factors, you know? The Rashami paper from the New England Journal that looks at risk factor control and diabetes make a very compelling story that if you control your five risk factors, you actually don't have an excess risk of cardiovascular events in diabetes, at least from MACE. The story is whether anybody can have those five risk factors controlled. But, early on in diabetes, with diabetes duration not being that significant, with risk factors not being that significant, I think maybe that's not the population to go after. But certainly, waiting for ASCVD to develop and then start therapy is also not the right way of doing it, so ... Dr Carolyn Lam:                Interesting. I really wonder what new guidelines are gonna show. Gabriel, any other perspective? Dr Gabriel Steg:                Well, first of all, I love the editorial. I thought the title was fantastic, and you summarize here what we need to think about when we think about diabetes; not solely the pipes. As an interventional cardiologist, I'm very interested in the pipes. Dr Subodh Verma:           Me, too. Dr Gabriel Steg:                Not solely the pump, but also the filter. And there's more than the heart and vessels in the complications of diabetes. So I thought it was a great, great title. My view is that we still need to remember that if we take the lifetime perspective, a healthy youngster with type one diabetes, a relatively healthy patient in his fifties with type two diabetes, their probability of dying from cardiovascular disease is enormous. Even though risk calculators will give them a relatively low probability over the 5 year or 10 year term, eventually that's what's gonna get them. And therefore, we still have progress to make. We are fortunate to have lived an incredible period in the past few years where we've had emergence of new risk preventive therapies in diabetes. That's incredible. It's an epiphany. But, it's not over. We need more information, more trials in other populations. We need to look at renal function and heart failure. So, it's a great time to be doing clinical trials in diabetes. Dr Subodh Verma:           Right. Dr Carolyn Lam:                And indeed, a great time to be publishing in circulation. We've been really doing a lot of publications in the cardiovascular outcome trials in diabetes here. Dr Subodh Verma:           And it's being noticed. There's no doubt about it. Dr Carolyn Lam:                I hope so. And, maybe a time for a new frame of reference, because what you just said was diametrically sort of in contrast. Dr Subodh Verma:           I would emphasize one more point, and that is, you know in atherosclerosis, the dominant mechanism has been LDL, right? And Dr Steg here is changing the landscape of that with Odyssey Outcomes and many other strategies. But again, in Circulation, Dr Bhatt, and I, along with the LEADER investigators, recently presented and published a paper showing that liraglutide's benefit is seen independent of LDL cholesterol, and all the way down to people with LDLs of below .5. So, the point is that this mechanism of benefit of GLP-1 seems to be complimentary to LDL lowering. And therefore, I think it offers great hope that you can actually reduce the ischemic burden in diabetes, not just by ultra-low LDL, but by potentially additional mechanisms as well. Dr Carolyn Lam:                Absolutely. And then now, because I have to have the last word here on this show, let's not forget heart failure outcomes in diabetes. I think it's underestimated. I think it's really important. Okay, and with that, thank you gentlemen for joining me today.                                                 You've been listening to Circulation on the Run. Don't forget to tune in again next week.                                                 This program is copyright American Heart Association, 2018.  

Episode 314 of the Creativity Matters Podcast: gearing up for a creative challenge like the Index-Card-a-Day (ICAD) challenge.

Episode 312 of the Creativity Matters Podcast: a review of a Gilmore Girls cookbook, ICAD is coming, and random creative talk.

Brian O’Malley and Face2Face host David Peck talk about ghosts, fear, love, freedom, choice and responsibility, Gothic overtones in life, art, sculpture and psychological horror. Biography Before moving into Directing, Brian studied Sculpture in the DIT School of Fine Art. Whilst there his fascination with the exploration of three-dimensional space inevitably led to him picking up a video camera and creating his first experimental short films. Through these experiments, he discovered visual directors like Sergio Leone and Martin Scorsese, and his desire to be a highly visual commercial film director was born. His video work in college got the attention of his fellow students and before long he was making no-budget music videos for college bands. He considered abandoning art school in favour of film school, however, he felt compelled to complete his studies. After leaving college Brian worked internationally as a snow, ice and sand sculptor, taking part in many international competitions and creating sculptures on a corporate level. By this stage, cinema had bitten Brian hard, and he returned to making music videos in order to develop his skills further as a director. After winning national awards for his work, he began to direct music videos with bigger budgets for EMI records. From here Brian turned his attention to world of TV commercials, where he has enjoyed a successful career since 2001, directing several Golden Lion, Shark and ICAD award-winning TV campaigns. Despite this commercial success, Brian’s love of music, design, art, sculpture, and storytelling - and how all of these art forms could be explored in parallel through cinema - meant that Brian’s focus remained on directing feature films. In 2004 Brian’s short film Screwback won a BAFTA certificate at the Aspen Film Festival, and in 2005 he was awarded the Hartley Merrill screenwriting Award at Cannes for his unproduced feature film screenplay Sisk. After a number of false starts, Brian’s persistence meant he got the opportunity to direct his debut feature film with Let Us Prey winning the Méliès d’Argent award for its world premiere at the Brussels International Fantastic Film Festival in 2014. Synopsis A gothic ghost story about orphaned twins Edward and Rachel who share a crumbling manor in 1920s rural Ireland - but they are not alone. They share the house with unseen entities who control them with three absolute rules. As separate fates draw them apart, the twins must face the terrible truth about their family’s ghostly tormentors. Trailer ---------- For more information about David Peck's podcasting, writing and public speaking please visit his site here or check out the site of his podcast on film, social change and much more. With thanks to producer Josh Snethlage and Mixed Media Sound.   Image Copyright: Brian O’Malley and Tailored Films. Used with permission. See acast.com/privacy for privacy and opt-out information.

In Episode 237: Bounce, the lowdown on recent equipment failure, renewed clarity about the importance of talking to the ether, and a bit of bullet journaling refresh. Plus, drawing happy people, and ICAD is coming!

Preparations for ICAD, to use color or not to use color, thinking through the stuffed animal theme, and two storybooks about artists.

In Episode 176: personal big data, an amazing personal data postcard project, charming books on engineering and girls to read aloud, a great cookbook full of muffins, a prompt from Tammy of Daisy Yellow, and more creative talk. Dear Data (fantastic book) Dear Data (project site) Graphing your to-do list: An art project reveals the personal side of big data (Washington Post Know More) Data drawing pen pals (Flowing Data) DEAR DATA PROJECT: ARTWORK BY GIORGIA LUPI & STEFANIE POSAVEC (Forth Magazine) A Data Viz Diary (Print) Dear Data: Two Designers Visualize the Mundane Details of Daily Life in Magical Illustrated Postcards Mailed Across the Atlantic (Brain Pickings) Nicholas Felton (check the personal annual reports) Huckleberry: Stories, Secrets, and Recipes From Our Kitchen The Most Magnificent Thing Rosie Revere, Engineer Daisy Yellow (blog) ICAD (info) ICAD Facebook Group  

In this podcast Elaine Mc Devitt from ICAD details some of the organisation's activties including the Upstarts programme as well as the challenges facing the creative departments in today's advertising and design industries. Also Don Farell from Irish e.mail marketing specialists Circulator gives me his insigts into best practice in email marketing.