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MDs react to JAMA op-ed claiming autonomous AI will outperform doctors on routine medical tasks by 2030, spurring widespread layoffs: When even intravenous iron isn't enough to stave off anemia; “Emergency “ home medical kits draw ire of medical experts: Meta dinged $567 for teen addiction—why spending it for therapy of adolescents who are hooked on social media may be a waste of money; Adequate vitamin D minimizes post-op pain; When is a second prostate biopsy called for?
You stayed late again, the service is still short-staffed, and when you finally say something, the answer is: you just need to be more efficient. More resilient. That's the go-to explanation for almost everything hard about residency — but what if the problem isn't your resilience at all? In the finale of Beyond the Match, Mckenzie Roebuck, Carl Engelke, Michael Brinton, and Omer Hassan of CoSEF look downstream at what happens after residents match: working conditions, culture and mental health, the practical barriers that make transferring so difficult, why residents may not trust existing reporting systems, and what real accountability and resident voice would require.Hosts: Dr. Mckenzie Roebuck, CoSEF BTK Lead, Inova Fairfax Medical Campus, mckenzie.rowe@inova.org Dr. Carl Engelke, The Ohio State University, Carl.Engelke@osumc.edu Dr. Michael Brinton, Medical College of Wisconsin, mbrinton@mcw.edu Dr. Omer Hassan, University of Calgary/Alberta Children's Hospital, omerh91@gmail.com CoSEF: X @surgedfellows, cosef.org Learning objectives: Summarize the real problems the congressional report identifies in working conditions, mistreatment reporting, and resident mental health Distinguish necessary difficulty in residency training from preventable system dysfunction, and describe its relationship to resident well-being and reporting Explain the practical barriers to resident mobility, including position availability, training requirements, funding, visa status, professional risk, and stigma Describe local and national accountability mechanisms — including program reporting, GMECs, ACGME pathways, and unions — and the limitations of each Identify strategies to strengthen resident voice, psychological safety, anti-retaliation protections, and institutional accountability rather than relying on individual resilience alone. References: House Committee on the Judiciary. Medical Mis-Match: How a Residency Hiring Monopoly Harms Patients, Doctors, and the American Public. Published online March 27, 2026. Gianakos AL, Freischlag JA, Mercurio AM, et al. Bullying, Discrimination, Harassment, Sexual Harassment, and the Fear of Retaliation During Surgical Residency Training: A Systematic Review. World J Surg. 2022;46(7):1587-1599. doi:10.1007/s00268-021-06432-6PubMed Link: https://pubmed.ncbi.nlm.nih.gov/35006329/ Mata DA, Ramos MA, Bansal N, et al. Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis. JAMA. 2015;314(22):2373-2383. doi:10.1001/jama.2015.15845PubMed Link: https://pubmed.ncbi.nlm.nih.gov/26647259/ Malone TL, Zhao Z, Liu TY, Song PXK, Sen S, Scott LJ. Prediction of Suicidal Ideation Risk in a Prospective Cohort Study of Medical Interns. PLoS One. 2021;16(12):e0260620. doi:10.1371/journal.pone.0260620PubMed Link: https://pubmed.ncbi.nlm.nih.gov/34855821/ Drolet BC, Schwede M, Bishop KD, Fischer SA. Compliance and Falsification of Duty Hours: Reports From Residents and Program Directors. J Grad Med Educ. 2013;5(3):368-373. doi:10.4300/JGME-D-12-00375.1PubMed Link: https://pubmed.ncbi.nlm.nih.gov/24404298/ National Resident Matching Program. The Match Agreement. Accessed August 2026. https://www.nrmp.org/intro-to-the-match/the-match-agreement/. Intealth (ECFMG). J-1 Physicians Training in the US (infographic). Accessed August 2026. https://www.intealth.org/pdfs/J-1_US_Infographic.pdf. (Note: Institutional PDF; no PubMed entry available). Foote DC, Rosenblatt AE, Amortegui D, et al. Experiences With Unionization Among General Surgery Resident Physicians, Faculty, and Staff. JAMA Netw Open. 2024;7(7):e2421676. doi:10.1001/jamanetworkopen.2024.21676PubMed Link: https://pubmed.ncbi.nlm.nih.gov/39018072/ Accreditation Council for Graduate Medical Education. Report an Issue. https://www.acgme.org/residents-and-fellows/report-an-issue/?utm_source. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewOBGYN Oral Board Review Course: https://behindtheknife.org/course/obgyn-oral-board-reviewSurgical Critical Care Review: https://behindtheknife.org/premium/surgical-critical-care-reviewEPA Playbook: https://behindtheknife.org/course/epa-playbookSurgical Instrument Flashcards: https://behindtheknife.org/course/surgical-instrument-flashcardsABSITE Review: https://behindtheknife.org/course/absite-2026-exam-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
Interview with Dana S. Guggenheim, BA, and Justin S. Golub, MD, MS, authors of Newborn Hearing Screening in the Otoferlin Gene Therapy Era. Hosted by Paul C. Bryson, MD, MBA. Related Content: Newborn Hearing Screening in the Otoferlin Gene Therapy Era
Conventional platelets last five to seven days. Cryopreserved platelets last two years. So why aren't we using them everywhere? In this episode of the eCritCare Podcast, Dr Swapnil Pawar sits down with Professor Michael Reade, intensivist, researcher and chief investigator of the CLIP-II trial, published in JAMA in 2026. CLIP-II randomised 388 high-risk cardiac surgical patients across 11 Australian hospitals and compared cryopreserved platelets with standard liquid-stored platelets in the 202 who needed a transfusion. The headline result: cryopreserved platelets did not meet the pre-specified 20% non-inferiority margin for chest drain bleeding in the first 24 hours. But as Professor Reade explains, that is only part of the story. In this conversation: Why cardiac surgery was the right population, and the platelet transfusion risk calculator that came out of it How the team achieved double blinding with blood products (and what may have unblinded clinicians anyway) Why 20% was chosen as the non-inferiority margin What "could not conclude non-inferiority" actually means, and why 13% of not very much is not very much The mortality signal and what it does and does not tell us Would he give frozen platelets to a bleeding patient in a regional hospital? Yes. The unpublished New Zealand and US military trials still to come Behind the scenes: training blood bank staff, minus 80 freezers, and running a trial through COVID Paper: Reade MC, Marks DC, Howe BD, et al. Cryopreserved vs Liquid-Stored Platelets for the Treatment of Surgical Bleeding: The CLIP-II Randomized Noninferiority Clinical Trial. JAMA. 2026;335(7):600-608. doi:10.1001/jama.2025.23355
Acute Appendicitis explained, including classic and atypical appendicitis symptoms, the pathophysiology of appendicitis, as well as causes, diagnosis (including scores like the Alvarado score) and treatment.PDFs available here: https://rhesusmedicine.com/products/general-surgeryConsider subscribing on YouTube (if you found any of the info useful!): https://www.youtube.com/channel/UCRks8wB6vgz0E7buP0L_5RQ?sub_confirmation=1Patreon: https://www.patreon.com/rhesusmedicineBuy Us A Coffee!: https://www.buymeacoffee.com/rhesusmedicineTimestamps:0:00 What is Appendicitis?0:32 Appendicitis Pathophysiology2:00 Causes of Appendicitis2:59 Appendicitis Symptoms & Signs 5:29 Appendicitis Diagnosis8:44 Appendicitis Treatment / Appendectomy LINK TO SOCIAL MEDIA: https://www.instagram.com/rhesusmedicine/Please remember this podcast and all content from Rhesus Medicine is meant for educational purposes only and should not be used as a guide to diagnose or to treat. Please consult a healthcare professional for medical advice. ReferencesBMJ Best Practice (2026) Acute appendicitis. Available at: https://bestpractice.bmj.com/topics/en-gb/3000094Di Saverio, S., Podda, M., De Simone, B., et al. (2020) 'Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines', World Journal of Emergency Surgery, 15(1), p.27. Available at: https://wjes.biomedcentral.com/articles/10.1186/s13017-020-00306-3Moris, D., Paulson, E.K. and Pappas, T.N. (2021) 'Diagnosis and management of acute appendicitis in adults: a review', JAMA, 326(22), pp.2299-2311. Available at: http://www.ncbi.nlm.nih.gov/pubmed/34905026MSD Manual (2024) Appendicitis. Available at: https://www.msdmanuals.com/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/appendicitisStatPearls Publishing (2024) Appendicitis. Available at: https://www.ncbi.nlm.nih.gov/books/NBK493193/Bhangu, A., Søreide, K., Di Saverio, S., Assarsson, J.H. and Drake, F.T. (2015) 'Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management', The Lancet, 386(10000), pp.1278-1287. Available at: https://pubmed.ncbi.nlm.nih.gov/26460662Flum, D.R., Davidson, G.H., Monsell, S.E., et al. (2020) 'A randomized trial comparing antibiotics with appendectomy for appendicitis', New England Journal of Medicine, 383(20), pp.1907-1919. Available at: https://pubmed.ncbi.nlm.nih.gov/33017106Addiss, D.G., Shaffer, N., Fowler, B.S. and Tauxe, R.V. (1990) 'The epidemiology of appendicitis and appendectomy in the United States', American Journal of Epidemiology, 132(5), pp.910-925. Available at: https://pubmed.ncbi.nlm.nih.gov/2239906
C'est l'un des livres phares de cette rentrée littéraire. JE, publié aux éditions Gallimard, quatrième roman de l'autrice Lilia Hassaine, figure sur la première sélection en vue du prix Goncourt. Dans cette fiction, la romancière reprend l'histoire du Jane Eyre de Charlotte Brontë, mais du point de vue de Bertha Antoinette Rochester, la première épouse de Mr Rochester, enfermée durant dix ans dans un grenier en raison de sa folie supposée. Sous la plume de Lilia Hassaine, Bertha Antoinette Rochester n'est plus le bourreau mais la victime d'un homme violent et manipulateur ; ce n'est plus une femme aliénée et dangereuse mais une victime sous emprise et abandonnée par ses pairs. Un roman d'époque tout ce qu'il y a de plus contemporain. RFI : Dans JE, vous reprenez l'histoire du Jane Eyre de Charlotte Brontë, mais à travers les yeux de Bertha Antoinette Rochester, la première épouse de Mr Rochester, enfermée pendant 10 ans dans un grenier en raison de sa folie supposée. D'où vous est venue l'envie de raconter l'histoire, du point de vue de ce personnage omniprésent dans Jane Eyre et qu'on ne rencontre pourtant jamais vraiment ? Lilia Hassaine : Le point de départ de cette histoire, c'est vraiment une histoire plutôt personnelle qui m'a conduite à m'interroger sur cette femme, ce personnage féminin dans lequel je me suis reconnue en relisant Jane Eyre à l'âge adulte. Et surtout, je me suis posé la question suivante : que fait-on d'une histoire personnelle ? Faut-il aller vers le témoignage, ou faut-il que je raconte cette histoire au présent ? Je trouvais plus intéressant de montrer ce qu'il y avait d'invariant, d'intemporel dans cette question des violences, et comment, aujourd'hui, je peux me reconnaître dans un personnage du XIXe siècle, dans cette femme enfermée. À partir de mon imagination, des trous laissés par le roman de Charlotte Brontë, il y a un autre récit possible qui est effectivement plus contemporain. En donnant une histoire et une parole à Antoinette, vous donnez aussi plus de profondeur au personnage de Rochester. Vous le décrivez avec tous les atours de ce qu'on appellerait aujourd'hui un « pervers narcissique » : froid, calculateur, manipulateur. D'où vous est venue cette intuition-là, vis-à-vis de ce personnage ? Finalement, tout est déjà dans le roman de Charlotte Brontë. Ce n'est pas un personnage sympathique, c'est un personnage qui est assez menteur. C'est un homme qui séquestre son épouse à domicile. Et je trouvais intéressant de voir ce qui, dans ce personnage, avait pu tant me plaire à l'adolescence, et à quel point ces comportements ont participé à la construction d'un imaginaire romantique chez les jeunes femmes que nous avons été. Ceci dit, sans le travail de Charlotte Brontë, je ne me serais jamais autorisée à détruire un personnage, ou à me dire que j'allais sauver Antoinette. Simplement, il y avait déjà tout en germe, et assez d'espace pour un imaginaire plus contemporain. Une autre thématique qui est très présente dans votre réinterprétation, c'est la dimension de l'esclavage, des rapports de domination coloniaux, du racisme en fait. Pourquoi est-ce que vous avez souhaité intégrer cet aspect-là à votre relecture ? Parce que c'est déjà présent dans le roman de Charlotte Brontë. Rochester a un regard de propriétaire ; et ce qui rend possible la violence de cet homme à l'égard de sa femme, ce qui l'amplifie, c'est le contexte raciste. Lorsqu'Antoinette arrive en Angleterre [de Jamaïque, NDLR], elle a beau être blanche, elle subit une forme de racisme car elle est créole. Elle est née sur une terre noire, on la soupçonne donc de l'être un peu ; elle vient d'une île où il fait chaud, or on imagine à l'époque que la chaleur peut rendre fou. Ces imaginaires se rencontrent, viennent légitimer les violences, et les rendent plus facilement acceptables. Existe-t-il, selon vous, d'autres personnages féminins de la littérature à qui il faudrait redonner une histoire ou une voix ? Parfois, c'est vraiment le contexte culturel qui a provoqué des lectures qui n'étaient pas forcément liées aux intentions de l'auteur. Je n'ai pas l'impression qu'il faille apporter un regard moderne. Mais notre société évolue, ce qui nous amène à revisiter des œuvres du passé et à nous rendre compte que l'intention première de l'auteur était parfois très en avance. En tant que lecteur, on comprend ce que l'on a envie de comprendre, ce que l'époque nous pousse à comprendre. Je trouve qu'il est plus intéressant d'aborder les œuvres littéraires sous cet angle-là ; de voir ce qu'elles ont déjà en elles, de réflexions, de troubles, de jeux avec les préjugés, etc., plutôt que d'essayer de déconstruire a posteriori. À lire aussiDans le laboratoire de la transparence, avec Lilia Hassaine
C'est l'un des livres phares de cette rentrée littéraire. JE, publié aux éditions Gallimard, quatrième roman de l'autrice Lilia Hassaine, figure sur la première sélection en vue du prix Goncourt. Dans cette fiction, la romancière reprend l'histoire du Jane Eyre de Charlotte Brontë, mais du point de vue de Bertha Antoinette Rochester, la première épouse de Mr Rochester, enfermée durant dix ans dans un grenier en raison de sa folie supposée. Sous la plume de Lilia Hassaine, Bertha Antoinette Rochester n'est plus le bourreau mais la victime d'un homme violent et manipulateur ; ce n'est plus une femme aliénée et dangereuse mais une victime sous emprise et abandonnée par ses pairs. Un roman d'époque tout ce qu'il y a de plus contemporain. RFI : Dans JE, vous reprenez l'histoire du Jane Eyre de Charlotte Brontë, mais à travers les yeux de Bertha Antoinette Rochester, la première épouse de Mr Rochester, enfermée pendant 10 ans dans un grenier en raison de sa folie supposée. D'où vous est venue l'envie de raconter l'histoire, du point de vue de ce personnage omniprésent dans Jane Eyre et qu'on ne rencontre pourtant jamais vraiment ? Lilia Hassaine : Le point de départ de cette histoire, c'est vraiment une histoire plutôt personnelle qui m'a conduite à m'interroger sur cette femme, ce personnage féminin dans lequel je me suis reconnue en relisant Jane Eyre à l'âge adulte. Et surtout, je me suis posé la question suivante : que fait-on d'une histoire personnelle ? Faut-il aller vers le témoignage, ou faut-il que je raconte cette histoire au présent ? Je trouvais plus intéressant de montrer ce qu'il y avait d'invariant, d'intemporel dans cette question des violences, et comment, aujourd'hui, je peux me reconnaître dans un personnage du XIXe siècle, dans cette femme enfermée. À partir de mon imagination, des trous laissés par le roman de Charlotte Brontë, il y a un autre récit possible qui est effectivement plus contemporain. En donnant une histoire et une parole à Antoinette, vous donnez aussi plus de profondeur au personnage de Rochester. Vous le décrivez avec tous les atours de ce qu'on appellerait aujourd'hui un « pervers narcissique » : froid, calculateur, manipulateur. D'où vous est venue cette intuition-là, vis-à-vis de ce personnage ? Finalement, tout est déjà dans le roman de Charlotte Brontë. Ce n'est pas un personnage sympathique, c'est un personnage qui est assez menteur. C'est un homme qui séquestre son épouse à domicile. Et je trouvais intéressant de voir ce qui, dans ce personnage, avait pu tant me plaire à l'adolescence, et à quel point ces comportements ont participé à la construction d'un imaginaire romantique chez les jeunes femmes que nous avons été. Ceci dit, sans le travail de Charlotte Brontë, je ne me serais jamais autorisée à détruire un personnage, ou à me dire que j'allais sauver Antoinette. Simplement, il y avait déjà tout en germe, et assez d'espace pour un imaginaire plus contemporain. Une autre thématique qui est très présente dans votre réinterprétation, c'est la dimension de l'esclavage, des rapports de domination coloniaux, du racisme en fait. Pourquoi est-ce que vous avez souhaité intégrer cet aspect-là à votre relecture ? Parce que c'est déjà présent dans le roman de Charlotte Brontë. Rochester a un regard de propriétaire ; et ce qui rend possible la violence de cet homme à l'égard de sa femme, ce qui l'amplifie, c'est le contexte raciste. Lorsqu'Antoinette arrive en Angleterre [de Jamaïque, NDLR], elle a beau être blanche, elle subit une forme de racisme car elle est créole. Elle est née sur une terre noire, on la soupçonne donc de l'être un peu ; elle vient d'une île où il fait chaud, or on imagine à l'époque que la chaleur peut rendre fou. Ces imaginaires se rencontrent, viennent légitimer les violences, et les rendent plus facilement acceptables. Existe-t-il, selon vous, d'autres personnages féminins de la littérature à qui il faudrait redonner une histoire ou une voix ? Parfois, c'est vraiment le contexte culturel qui a provoqué des lectures qui n'étaient pas forcément liées aux intentions de l'auteur. Je n'ai pas l'impression qu'il faille apporter un regard moderne. Mais notre société évolue, ce qui nous amène à revisiter des œuvres du passé et à nous rendre compte que l'intention première de l'auteur était parfois très en avance. En tant que lecteur, on comprend ce que l'on a envie de comprendre, ce que l'époque nous pousse à comprendre. Je trouve qu'il est plus intéressant d'aborder les œuvres littéraires sous cet angle-là ; de voir ce qu'elles ont déjà en elles, de réflexions, de troubles, de jeux avec les préjugés, etc., plutôt que d'essayer de déconstruire a posteriori. À lire aussiDans le laboratoire de la transparence, avec Lilia Hassaine
Save 20% on all Nuzest Products WORLDWIDE with the code MIKKIPEDIA at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.comCurranz Supplement: Use code MIKKIPEDIA to get 20% off your first order - go to www.curranz.co.nz or www.curranz.co.uk to order yours NZ listeners - save 10% off Calocurb by using the code Mikkipedia10 at www.calocurb.co.nzEpisode SummaryThis week Mikki talks with Dr Robert Kushner, an obesity medicine physician, educator and researcher with over four decades in the field. He is Professor Emeritus at Northwestern University Feinberg School of Medicine, a founder and the first chair of the American Board of Obesity Medicine, and a past president of The Obesity Society. He was also the corresponding author on the STEP 1 semaglutide trial published in the New England Journal of Medicine in 2021, and sat on the steering committee for SELECT — so he has watched this field from the inside, before and after GLP-1 receptor agonists arrived.The conversation traces what clinicians actually understood about obesity in the 1980s and 90s, Bob's own leptin trial and why it did not deliver, and how reframing obesity as a biological disease led researchers to the gut hormones. From there it moves into the practical territory: how the clinical conversation has shifted from counting calories to diet quality, which side effects are real and which are social media noise, what happens to muscle mass and physical function, how dose escalation should actually work, why hunger returning is not the same as weight regain, and what the evidence says about stopping. Bob is careful throughout to separate what the trials show from what is still unknown, which makes this a useful listen whether you work with clients on these medications or are weighing them up yourself.Key TopicsWhat clinicians believed about obesity three decades ago — excess body fat was known to cause system-wide harm, but the mechanisms, and appetite dysregulation in particular, were not understood, and weight regain after lifestyle intervention was already expectedBob's own leptin trial in the 1990s, published in JAMA, and why leptin turned out to be a useful biological signal rather than a treatment — it defends against weight loss but was never built to stop overeatingThe STEP 1 result and why it changed the field: 15% average weight loss at 68 weeks against a previous benchmark of 6–9%, with a third of participants losing 20%How the clinical conversation shifted from quantity to quality — when the medication does the heavy lifting, the questions become whether someone is eating enough, staying hydrated and getting sufficient protein, rather than how to control cravingsWhich side effects are real and which are overstated: GI effects are the genuine shared profile and can be substantially reduced through diet during dose escalation, while hair thinning and facial fat loss follow large weight loss by any routeMuscle mass, sarcopenia and the groups who need watching, alongside the consistent finding that physical function and quality of life improve in trials — possibly because fatty infiltration of muscle resolvesDose escalation in the real world versus the trial protocol, and why there are still no pretreatment predictors of who will respondWhy appetite drifting back is normal and not a failure — Bob's framing of restored appetite regulation at a lower body weight, with "the amplitude smaller than it was before"Benefits beyond weight loss, including SELECT's 20% reduction in cardiovascular events on top of standard care, plus sleep apnoea, knee osteoarthritis, MASH and psoriasis — driven both by weight loss and by independent mechanismsCost and access, microdosing, extending the interval between injections, and where bariatric surgery still fitsChapters00:00 Introduction05:13 Obesity medicine before GLP-1s13:34 Gut hormones and the STEP 1 result21:00 From calorie counting to diet quality25:00 Side effects and social media myths29:54 Muscle mass, function and exercise35:08 Dose escalation and who responds40:30 When hunger comes back46:37 Stopping the drug, cost and access52:24 Benefits beyond weight loss57:37 Long-term safety and microdosing1:01:10 Coming off, surgery and what's nextGuest / ResourcesDr Robert KushnerProfessor Emeritus, Northwestern University Feinberg School of MedicineFounder and first chair of the American Board of Obesity MedicinePast president of The Obesity SocietyAuthor or editor of 15 books, 56 book chapters and 230 original and review articlesWebsite: drrobertkushner.comBooksSix Factors to Fit: Weight Loss that Works for You! — written for the patientPatient-Centered Weight Management: The Six Factor Professional Program and Toolkit — written for the clinicianTrials and studies discussedSTEP 1 — once-weekly subcutaneous semaglutide, New England Journal of Medicine, 2021. 1,961 adults, 68 weeks, ~15% average weight loss. Bob was the corresponding authorSTEP 1 extension — the off-treatment follow-up showing weight regain after stoppingSELECT — semaglutide versus placebo in 17,000 people with obesity or overweight and pre-existing cardiovascular disease but no diabetes, over nearly four years. A 20% reduction in second heart attack, stroke or cardiovascular death, on top of standard care. Bob sat on the steering committeeSURMOUNT-1 extension — participants with pre-diabetes maintained on treatment for three years, with weight remaining stableLook AHEAD — an intensive behavioural therapy trial in diabetes; of those who lost 10% of body weight, around 40% maintained it for about four years without medicationKushner's leptin trial (1990s) — placebo versus leptin injections, published in JAMAA tirzepatide dose-reduction study — 15mg reduced to 5mg, with partial weight regainA randomised microdosing study in people with diabetes — standard monthly dose escalation versus gradual weekly escalation to the same final dose, showing better tolerability and fewer dropouts. Bob refers to this study but does not name it, so it is referred-to-but-not-identifiedResearchers mentionedAndres Acosta, Mayo Clinic — phenotype and biomarker work on predicting treatment responseOrganisationsNorthwestern University Feinberg School of MedicineAmerican Board of Obesity MedicineThe Obesity SocietyObesity Action CoalitionNovo Nordisk — the sponsor of STEP 1Mayo ClinicMedications and hormones discussed GLP-1 receptor agonists; semaglutide; liraglutide; tirzepatide; phentermine; topiramate; naltrexone; bupropion. Gut hormones: GLP-1, GIP, glucagon, amylin. Also leptin, insulin, statins, beta blockers, testosterone and oestrogen.Terms that come up Appetite dysregulation; food noise; leptin resistance; medu...
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from September 5-11, 2026.
Un nouvel épisode du Pharmascope est disponible! Dans ce premier d'une série de deux épisodes sur l'hyperplasie bénigne de la prostate, Nicolas, Olivier et Amélie discutent d'évaluation, de mesures non-pharmacologiques et commencent à jaser de traitements. Les objectifs pour cet épisode sont les suivants: Discuter de l'évaluation et du diagnostic de l'hyperplasie bénigne de la prostate. Discuter des traitements non-pharmacologiques de l'hyperplasie bénigne de la prostate. Discuter des produits naturels dans le traitement de l'hyperplasie bénigne de la prostate. Ressources pertinentes en lien avec l'épisode Wei JT, Dauw CA, Brodsky CN. Lower Urinary Tract Symptoms in Men: A Review. JAMA. 2025 Sep 2;334(9):809-821. Elterman D, et coll. UPDATE – Canadian Urological Association guideline: Male lower urinary tract symptoms/benign prostatic hyperplasia. Can Urol Assoc J. 2022 Aug;16(8):245-256. Goueli R, et coll. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline (2026) Part I: Presentation and Evaluation. J Urol. 2026 Aug;216(2):143-151. McConnell JD, et coll; Medical Therapy of Prostatic Symptoms (MTOPS) Research Group. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med. 2003 Dec 18;349(25):2387-98. Platz EA, et coll. Incidence and progression of lower urinary tract symptoms in a large prospective cohort of United States men. J Urol. 2012 Aug;188(2):496-501. Kumar A, et coll. Self-management interventions for men with lower urinary tract symptoms: A systematic review and meta-analysis of randomized controlled trials. Arch Gerontol Geriatr. 2025 Apr;131:105742. Brown CT, et coll. Self management for men with lower urinary tract symptoms: randomised controlled trial. BMJ. 2007 Jan 6;334(7583):25. Franco JV, et coll Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement. Cochrane Database Syst Rev. 2023 Jun 22;6(6):CD001423.
Difficulty managing money is often one of the earliest signs of Alzheimer's disease and related dementias, frequently appearing years before an official diagnosis. This loss of financial capacity leaves individuals vulnerable to costly mistakes and exploitation, threatening the financial security and quality of life of entire families. In this episode, we sit down with Dr. Lauren Hersch Nicholas, Dr. Duke Han, and Dr. Jason Karlawish to examine the intersection of cognitive decline, financial decision-making, and patient protection. We covered a lot of topics, including these key ones: The Financial Prodrome: Dr. Nicholas shares her health economics research showing that missed payments and credit score drops can appear up to six years before a dementia diagnosis—causing major wealth loss long before healthcare providers catch the issue, especially in lower-income communities. Brain Function & Social Buffers: Dr. Han discusses new neuroimaging research on how cognitive decline impairs financial judgment and explains how strong social connections can serve as a critical protective buffer. Clinical & Policy Solutions: Dr. Karlawish outlines the medical, policy, and financial-sector interventions needed to safeguard vulnerable patients. For a deeper dive on some of the articles we discussed, check out these references: My first JAMA paper on Finances in the Older Patient With Cognitive Impairment Lauren's plant money podcast on how your bank account might predict dementia Lauren's article on Management of Financial Assets by Older Adults With and Without Dementia or Other Cognitive Impairments Jason's editorial on the Importance of Asking Older Adults Whether They Are Having Difficulty Managing Finances. Jason's article on Desktop Medicine and the Practice of Wealth Care Duke's article on Financial exploitation vulnerability and social connectedness in middle-aged and older adults without dementia https://www.tandfonline.com/doi/full/10.1080/13607863.2025.2475331
What if the second most important organ system in your body isn't your heart, lungs, or liver — but your skeleton? That's the case my guest, Peter Simonson, makes in this episode. Peter trained as a mechanical engineer at Georgia Tech, then spent years designing spinal implants for Medtronic before discovering — almost by accident — a dormant bone technology company called Juvent after its founder passed away. He and his brother revived it, and what he's since learned about bone as a metabolic, hormone-producing organ (not just a structural frame) reshapes how you think about aging, mobility, and even things like blood pressure and balance. In this Get Yourself Optimized episode, Peter breaks down: ➡️ Why your skeleton functions more like an endocrine organ than scaffolding ➡️ How osteoporosis can show up in children, not just the elderly ➡️ Why more "powerful" vibration platforms can actually be dangerous ➡️ The JAMA-published, placebo-controlled study that found a 10% bone density increase from safe microimpact therapy ➡️ Peter's own daily biohacks — from seasonal fasting to reframing walking as "a luxury," not a chore If you've ever taken your mobility for granted, this conversation will change that.
Drs. Owens and de Feria review emerging data on epicardial adipose tissue and MRI-based markers to refine hypertrophic cardiomyopathy risk assessment. They highlight integrating imaging and biomarkers, including NT‑proBNP, to predict heart failure and arrhythmic outcomes.
John 19:1 “Pilate then took Jesus and scourged Him.” As we begin chapter 19 let's remember what's happened previously. Jesus gave Himself up to the Jews and Romans. He endured an unlawful arrest and trials by Annas, Caiaphas and the Jewish council, Pilate and Herod. After efforts to wiggle himself out of dealing with Jesus, Pilate succumbed to the pressure of the Jews to crucify Jesus. They were compelled by hate and jealous self-ambition to destroy Jesus and His movement. Pilate caved to the pressure and handed Jesus over to his soldiers to carry out the most excruciating execution imaginable. We read here that Pilate did the deed, but we know he never laid a hand on Jesus. He was guilty of authorizing the scourging and execution in the name of Rome. As we read about the crucifixion of Jesus, let's remember He is allowing everything that happened to Him. At any given moment in the chain of events that led to His death, He could have stopped it all with a word if the Father had so willed it. Pilate had Jesus scourged. The Jews by law could not give more than 40 lashes, but there was no limit to a Roman scourging. In an article On the Physical Death of Jesus Christ, in JAMA, March 21, 1986—Vol. 255, No. 11, a Roman scourging was described. “The severity of the scourging depended on the disposition of the soldiers and was intended to weaken the victim to a state just short of collapse or death. As the Roman soldiers repeatedly struck the victim's back with full force, the iron balls would cause deep contusions, and the leather thongs and sheep bones would cut into the skin and subcutaneous tissues. Then, as the flogging continued, the lacerations would tear into the underlying skeletal muscles and produce quivering ribbons of bleeding flesh. Pain and blood loss generally set the stage for circulatory shock. The extent of blood loss may well have determined how long the victim would survive on the cross. After the scourging, the soldiers often taunted their victim.” We know from Scripture that the goal was bring the Jesus to the edge of death through loss of blood and pain so that they could be finished before observing the Passover celebration. We also know from Scripture that this was God's doing because the Son's innocent blood had to be spilt in payment for our sins. This is love, that He, who knew no sin, laid down His life for us, who are hostile in mind and engaged in evil deeds (Col. 1:21). Through our oneness with Jesus, we are saved from our sins. He conquered our enemies and reigned as our King of love as He suffered. What Pilate and the Romans meant for evil, God meant it for good. Let's give thanks to our God. “Father, Son, and Holy Spirit, we praise You and thank You for enduring the pain and bloodshed that we might be justified, forgiven, and have fellowship with You. It is our privilege to live to love with You today.” Acknowledgment: Music from “Carried by the Father” by Eric Terlizzi. www.ericterlizzi.com
Ce lundi 7 septembre, c'est la rentrée scolaire pour les enfants haïtiens. Pourtant, de nombreux parents peinent à réunir l'argent nécessaire pour envoyer leurs enfants à l'école. Et bon nombre d'établissements ont dû être déplacés en raison de l'insécurité, sans avoir retrouvé de locaux adaptés pour accueillir les écoliers. Peterson Luxama, correspondant de RFI à Port-au-Prince, est allé à la rencontre de parents et d'un directeur d'établissement. Esclavage : la Jamaïque dépose une demande de réparations au Royaume-Uni Y aura-t-il un jour des réparations pour l'esclavage ? C'est ce que tente d'obtenir la Jamaïque, ancienne colonie britannique, mais toujours membre du Commonwealth. En visite au Royaume-Uni, la ministre jamaïcaine de la Culture a présenté une demande en ce sens au roi Charles III ce lundi. Le monarque britannique, toujours chef de l'État de la Jamaïque, doit décider ensuite s'il la transmet ou non à l'instance judiciaire compétente en la matière. Le pays caribéen pose trois questions : la traite des Africains en Jamaïque était-elle légale au regard du droit anglais ? La traite des esclaves était légale au regard du droit international ? La Grande-Bretagne doit-elle accorder des réparations en conséquence ? Honduras : non-lieu pour l'ancien président Hernandez L'ex-président Juan Orlando Hernandez, condamné à 45 ans de prison pour narcotrafic aux États-Unis, et gracié par Donald Trump en janvier, n'affrontera finalement pas la justice de son pays. Le 1er septembre, un tribunal hondurien a prononcé un non-lieu dans l'affaire Pandora 2. Dans cet immense dossier de corruption, une trentaine de personnes du Parti national, dont Juan Orlando Hernandez lui-même, étaient soupçonnées d'avoir détourné l'équivalent de 11 millions d'euros. Avec ce non-lieu définitif, plusieurs voix de la justice et des droits humains dénoncent un grave retour en arrière pour le Honduras, explique la correspondante de RFI à Tegucigalpa, Marie Griffon. À lire aussiHonduras : indignation après un non-lieu pour l'ex-président Juan Orlando Hernandez dans une affaire de corruption Dans le journal d'Outre-mer La 1ère Aux Antilles, les victimes du chlordécone sont de plus en plus nombreuses à demander réparation, explique Edwige Saint-Thomas. À écouter aussiLe journal d'Outre-mer La 1ère
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from August 29-September 4, 2026.
Credits: 0.75 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com Episode resource links: Zhou H et al. Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355. eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884 Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041 Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257 Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698. Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930. Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541. Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.: American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022. Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485. Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234. Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455 Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666 Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301. Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015 Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024 Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0 Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575 Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1 Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.
Credits: 0.75 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com Episode resource links: Zhou H et al. Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355. eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884 Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041 Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257 Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698. Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930. Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541. Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.: American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022. Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485. Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234. Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455 Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666 Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301. Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015 Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024 Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0 Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575 Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1 Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.
On this episode of Diabetes Connections In the news… The FDA approves a new indication and health benefit for Mounjaro, lots of CGM news including an update on Medicare coverage for people who don't use insulin and a new study about using CGM when you don't have diabetes, metformin and aging, statins and type 2, and did you know there was a Dolly Parton diabetes connections? That and much more... Check out all of our events like Moms' Night Out and Club 1921 here. Announcing Community Commericals! Learn how to get your message on the show here. Learn more about studies and research at Thrivable here Please visit our Sponsors & Partners - they help make the show possible! Omnipod - Simplify Life All about Dexcom All about VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com On this episode of Diabetes Connections In the news… The FDA approves a new indication and health benefit for Mounjaro, lots of CGM news including an update on Medicare coverage for people who don't use insulin and a new study about using CGM when you don't have diabetes, metformin and aging, statins and type 2, and did you know there was a Dolly Parton diabetes connections? That and much more.. that's coming up right after this. (AD BREAK) Welcome! I'm your host Stacey Simms and this is an In The News episode.. where we bring you the top diabetes stories and headlines happening now. A reminder that you can find the sources and links and a transcript and more info for every story mentioned here in the show notes. Welcome to September! Want to let you know about a webinar I'm doing with Abbott later this month. That's Sept 23 at 7pm ET. We'll be talking about ketones, DKA and learn more about their dual CGM/ketone monitor that was just approved – more on that coming up. But please register – the link is in the show notes. So much going on over here – tomorrow night we have our Club 1921 in Charlotte, later this month Moms' Night Out Detroit/Bloomfield and in October we're going to Seattle. Please join us. More at d-c dot com slash events. Okay.. our top story this week: XX Another indication for Mounjaro – the FDA approved it to lower the risk of major adverse cardiovascular (CV) events (MACE), including CV death, non-fatal heart attack, or non-fatal stroke in adults with type 2 diabetes who are at high risk for these events. Mounjaro – the brand name of tirzepatide - is already approved as an adjunct to diet and exercise to improve blood sugar in adults and children 10 years of age and older with type 2 diabetes. The approval was based on results from the largest and longest tirzepatide study to date, enrolling more than 13,000 participants across 30 countries over more than four and a half years. In the trial, Mounjaro demonstrated non-inferiority to Trulicity (dulaglutide), a GLP-1 treatment with established cardiovascular benefit, with an 8% lower rate of cardiovascular death, heart attack or stroke (MACE-3). The estimated hazard ratio for time to first MACE was 0.92 (95.3% CI: 0.83, 1.01) for Mounjaro compared to Trulicity (dulaglutide). https://www.prnewswire.com/news-releases/fda-approves-lillys-mounjaro-tirzepatide-to-reduce-cardiovascular-risk-in-adults-with-type-2-diabetes-302862415.html XX The FDA approves the Libre Duo – the first device designed to continuously monitor both blood sugar levels and ketone levels in people with diabetes. The Libre Duo 10-Day Continuous Dual Glucose Ketone Monitoring System is now approved for those ages 2 and older. Until now, the agency said, people had to monitor ketone levels with separate tests that only provided a single measurement at one point in time. The new system combines blood sugar and ketone tests and monitors them continuously. Readings -- and alerts in case of dangerous trends -- are sent wirelessly to a smartphone app. The FDA previously granted "breakthrough device" status to the system, which is meant to expedite the device's development and review. https://www.upi.com/Top_News/US/2026/08/25/fda-oks-blood-sugar-ketone-monitor/5521787688375/ XX Diabetes tech firms Dexcom and Abbott are watching closely for a Medicare coverage expansion that could significantly broaden access to their glucose sensors. The Centers for Medicare and Medicaid Services is expected to expand Medicare coverage of continuous glucose monitors to people with diabetes who do not take insulin. Currently, coverage is limited to people with Type 1 or Type 2 diabetes who take insulin or have a history of problematic low blood sugar. Dexcom CEO Jake Leach told investors in a late July earnings call that the company expects to hear back from the CMS before the end of the year, with coverage going into effect in mid-2027. Dexcom presented results of a randomized, controlled trial earlier this summer at the American Diabetes Association's Scientific Sessions that it expects will support the CMS' decision. The 26-week study found that people who used a CGM had a larger hemoglobin A1C reduction than the control group and spent five more hours per day in a normal glucose range than the control group. https://www.medtechdive.com/news/dexcom-abbott-await-medicare-coverage-expansion-for-cgms/828775/ XX A new study suggests continuous glucose monitors (CGMs) may offer benefits for people with type 1 diabetes that go beyond improving blood sugar and reducing hypoglycemia. Researchers analyzed health records from more than 8,400 adults with type 1 diabetes receiving care through the Veterans Health Administration. Over one to four years of follow-up, people who started using a CGM had a 10% to 16% lower risk of death from any cause compared with those who did not use one. The association appeared strongest among people over age 65 and those who were not using insulin pumps. Researchers did not find meaningful differences based on A1C, race or ethnicity, or frailty. Importantly, this was an observational study using medical records, not a randomized clinical trial, so it cannot prove that CGM use directly caused the lower death rate. But the findings suggest CGM may have important long-term health benefits beyond glucose management.https://visualize.jove.com/42319755-continuous-glucose-monitoring-initiation-is-associated-with-reduced-mortality-in-older-onset-type-1-diabetes-patients-a-target-trial-emulation-study-within-the-veterans-health-administration XX We've been talking about people without diabetes using CGMs for a long time.. now a new study weighs in. Research published in JAMA finds that this wellness trend isn't helpful for people without a diabetes diagnosis. They found that the strongest evidence for CGM use is for people who are already living with diabetes, but not for those without the condition who use them for wellness purposes. It's also worth noting, though, that this new study is a narrative review. This means that the researchers drew their conclusions from the findings reported in several other studies. More randomized controlled trials would be necessary to see whether there are any meaningful health benefits of using a CGM if you don't have diabetes. Dower also warned that constantly monitoring your blood sugar when you don't have diabetes could lead to unintended health anxiety. In some cases, you may even make accidental lifestyle changes that could be harmful. "[Blood sugar] spikes may occur after meals, but if this leads someone to replace healthy food such as fruit with unhealthy food such as something high in fat but low in carbohydrate, the glucose information has done more harm than good," Dower said. https://www.verywellhealth.com/blood-sugar-monitor-for-people-without-diabetes-12058575 XX Could metformin somehow influence the biological processes that drive aging? A new review found evidence that metformin may affect several key features of aging, including how cells use energy, inflammation, cellular damage and even some changes in gene activity. Animal studies have shown longer lifespans or improvements in markers of biological aging, while some human studies have also found promising results. But researchers say there's still no proof that metformin actually slows aging or helps healthy people live longer. Most human research has involved people with diabetes or other health conditions, and one large trial found that while metformin helped prevent type 2 diabetes, it did not reduce cancer, cardiovascular disease or deaths. Researchers say larger clinical trials in people without diabetes are needed to determine whether metformin can truly extend healthy lifespan—or whether its benefits are primarily related to preventing and treating specific diseases. https://www.technologynetworks.com/drug-discovery/news/metformin-may-influence-longevity-through-the-gut-microbiome-and-epigenetic-changes-416035 XX More to come including more research on a spice thought to help diabetes, predictions about the number of people who may be living with type 1 in the years to come around the world, and a connection I didn't know about between diabetes and Dolly Parton. XX A compound found in turmeric may help protect blood vessels from some of the damage caused by Type 1 diabetes. In rats, curcumin reduced inflammation, improved cellular signaling, and restored vascular health to levels resembling those of nondiabetic animals. The results hint at a possible new way to reduce the long-term cardiovascular risks of diabetes, but human trials are still needed. Curcumin, the natural compound responsible for turmeric's vivid yellow color, is widely studied for its anti-inflammatory and antioxidant properties. https://www.sciencedaily.com/releases/2026/08/260824065543.htm XX New research estimates the number of people living with type 1 diabetes (T1D) worldwide will increase by 29% from 9.4 million in 2025 to 12.1 million in 2049. This will be presented at EASD, the Annual Meeting of The European Association for the Study of Diabetes (EASD) in Milan, Italy (Sept 28 – Oct 2 The USA will see an increase of over half a million, going from 1,492,825 to 2,055,235. The authors suggest that the reasons for the predicted high incidence and prevalence in 2049 in countries such as Australia, US, UK are likely to be a combination of genetics, environmental triggers and also high case detection rates (due to the good health care infrastructure here and in other HIC). Unlike previous estimates, the DIAMOND-T1D model takes historical patterns of insulin availability into account and aims to provide global, regional and country-specific estimates of T1D incidence, prevalence and mortality from 1900 to 2050. Although the majority of people with T1D live in high-income countries (HIC) and middle-income countries (MIC), the largest relative increase in the T1D prevalence is expected to occur in LIC as access to insulin, glucose monitoring and survival all improve in those countries. https://www.news-medical.net/news/20260828/Type-1-diabetes-cases-projected-to-increase-worldwide-by-2049.aspx XX Early initiation of statins after a diagnosis of type 2 diabetes was associated with a lower risk of dementia, according to a study published in The Lancet Regional Health – Europe. According to the Lancet Commission, nearly half of dementia cases could theoretically be prevented by eliminating 14 risk factors. "Detecting and treating high levels of low-density lipoprotein cholesterol (LDL-C) from midlife is one such highlighted risk factor," From Danish registers, researchers identified 132,585 statin-naive individuals who developed type 2 diabetes from 2006 through 2019, with follow-up until the end of 2021. Medical records were searched for diagnoses of all-cause dementia. A clone-censor-weight design was used to analyze dementia incidence in patients with no statin initiation within five years after diagnosis, in those with early statin initiation within one year and in those with late statin initiation between one and five years after diagnosis. https://medicalxpress.com/news/2026-08-early-statins-diagnosis-diabetes-dementia.html XX We are heartbroken over the loss of our friend Dolly Parton. Dolly was a beloved icon whose extraordinary generosity, warmth, and compassion touched countless lives, including those of the Children's Diabetes Foundation and the Barbara Davis Center for Diabetes. Her support of The Carousel Ball and Carousel of Hope Ball reflected her deep commitment to helping children and families affected by type 1 diabetes. Beyond her remarkable talent, Dolly will be remembered for the kindness and joy she shared so generously with others. Our hearts are with her family, friends, and all who loved her as we celebrate her extraordinary life and lasting legacy. She will be deeply missed.
Credits: 0.75 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com Episode resource links: Zhou H et al. Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355. eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884 Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041 Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257 Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698. Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930. Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541. Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.: American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022. Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485. Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234. Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455 Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666 Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301. Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015 Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024 Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0 Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575 Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1 Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.
Links For The Occult Rejectshttps://linktr.ee/theoccultrejectsOccult Research Institutehttps://www.occultresearchinstitute.org/Substackhttps://substack.com/@theoccultrejects?r=7auau0&utm_campaign=profile&utm_medium=profile-pageCash Apphttps://cash.app/$theoccultrejectsVenmo@TheOccultRejectsBuy Me A Coffeebuymeacoffee.com/TheOccultRejectsPatreonhttps://www.patreon.com/TheOccultRejectsBibliographyCurses, Blessings, and Ritual HarmCannon, Walter B. “‘Voodoo' Death.” American Anthropologist 44, no. 2 (1942): 169–181.Faraone, Christopher A. Ancient Greek Love Magic. Cambridge, MA: Harvard University Press, 1999.Gager, John G., ed. Curse Tablets and Binding Spells from the Ancient World. New York: Oxford University Press, 1992.Graf, Fritz. Magic in the Ancient World. Translated by Franklin Philip. Cambridge, MA: Harvard University Press, 1997.Ogden, Daniel. Magic, Witchcraft, and Ghosts in the Greek and Roman Worlds: A Sourcebook. 2nd ed. New York: Oxford University Press, 2009.Stratton, Kimberly B., and Dayna S. Kalleres, eds. Daughters of Hecate: Women and Magic in the Ancient World. New York: Oxford University Press, 2014.Tambiah, Stanley Jeyaraja. “The Magical Power of Words.” Man 3, no. 2 (1968): 175–208.Placebo, Nocebo, and Medical CommunicationBarsky, Arthur J., Ralph Saintfort, Malcolm P. Rogers, and Jonathan F. Borus. “Nonspecific Medication Side Effects and the Nocebo Phenomenon.” JAMA 287, no. 5 (2002): 622–627.Benedetti, Fabrizio. Placebo Effects: Understanding the Mechanisms in Health and Disease. Oxford: Oxford University Press, 2009.Benedetti, Fabrizio, Marina Lanotte, Lorella Lopiano, and Luana Colloca. “When Words Are Painful: Unraveling the Mechanisms of the Nocebo Effect.” Neuroscience 147, no. 2 (2007): 260–271.Colloca, Luana, and Fabrizio Benedetti. “Nocebo Hyperalgesia: How Anxiety Is Turned into Pain.” Current Opinion in Anaesthesiology 20, no. 5 (2007): 435–439.Colloca, Luana, and Damien Finniss. “Nocebo Effects, Patient–Clinician Communication, and Therapeutic Outcomes.” JAMA 307, no. 6 (2012): 567–568.Colloca, Luana, and Franklin G. Miller. “The Nocebo Effect and Its Relevance for Clinical Practice.” Psychosomatic Medicine 73, no. 7 (2011): 598–603.Enck, Paul, Fabrizio Benedetti, and Manfred Schedlowski. “New Insights into the Placebo and Nocebo Responses.” Neuron 59, no. 2 (2008): 195–206.Häuser, Winfried, Ernil Hansen, and Paul Enck. “Nocebo Phenomena in Medicine: Their Relevance in Everyday Clinical Practice.” Deutsches Ärzteblatt International 109, no. 26 (2012): 459–465.Inner Speech and DevelopmentFernyhough, Charles. The Voices Within: The History and Science of How We Talk to Ourselves. New York: Basic Books, 2016.Vygotsky, Lev S. Thought and Language. Revised and expanded ed. Edited and translated by Alex Kozulin. Cambridge, MA: MIT Press, 1986.Winsler, Adam, Charles Fernyhough, and Ignacio Montero, eds. Private Speech, Executive Functioning, and the Development of Verbal Self-Regulation. Cambridge: Cambridge University Press, 2009.Rumination and Repetitive Negative ThinkingBrosschot, Jos F., Bart Verkuil, and Julian F. Thayer. “Conscious and Unconscious Perseverative Cognition: Is a Large Part of Prolonged Physiological Activity Due to Unconscious Stress?” Journal of Psychosomatic Research 69, no. 4 (2010): 407–416.Ehring, Thomas, and Edward R. Watkins. “Repetitive Negative Thinking as a Transdiagnostic Process.” International Journal of Cognitive Therapy 1, no. 3 (2008): 192–205.Nolen-Hoeksema, Susan. “Responses to Depression and Their Effects on the Duration of Depressive Episodes.” Journal of Abnormal Psychology 100, no. 4 (1991): 569–582.Nolen-Hoeksema, Susan, Blair E. Wisco, and Sonja Lyubomirsky. “Rethinking Rumination.” Perspectives on Psychological Science 3, no. 5 (2008): 400–424.Smith, Jeannette M., and Lauren B. Alloy. “A Roadmap to Rumination: A Review of the Definition, Assessment, and Conceptualization of This Multifaceted Construct.” Clinical Psychology Review 29, no. 2 (2009): 116–128.Treynor, Wendy, Richard Gonzalez, and Susan Nolen-Hoeksema. “Rumination Reconsidered: A Psychometric Analysis.” Cognitive Therapy and Research 27, no. 3 (2003): 247–259.Watkins, Edward R. “Constructive and Unconstructive Repetitive Thought.” Psychological Bulletin 134, no. 2 (2008): 163–206.Watkins, Edward R. Rumination-Focused Cognitive-Behavioral Therapy for Depression. New York: Guilford Press, 2016.Self-Talk and PerformanceHardy, James. “Speaking Clearly: A Critical Review of the Self-Talk Literature.” Psychology of Sport and Exercise 7, no. 1 (2006): 81–97.Hatzigeorgiadis, Antonis, Nikos Zourbanos, Evangelos Galanis, and Yiannis Theodorakis. “Self-Talk and Sports Performance: A Meta-Analysis.” Perspectives on Psychological Science 6, no. 4 (2011): 348–356.Theodorakis, Yiannis, Antonis Hatzigeorgiadis, and Nikos Zourbanos. “Cognition: Self-Talk and Performance.” In The Oxford Handbook of Sport and Performance Psychology, edited by Shane M. Murphy. New York: Oxford University Press, 2012.Affect Labeling, Emotion, and LanguageBarrett, Lisa Feldman. “Solving the Emotion Paradox: Categorization and the Experience of Emotion.” Personality and Social Psychology Review 10, no. 1 (2006): 20–46.Lieberman, Matthew D., Naomi I. Eisenberger, Molly J. Crockett, Sabrina M. Tom, Jennifer H. Pfeifer, and Baldwin M. Way. “Putting Feelings into Words: Affect Labeling Disrupts Amygdala Activity in Response to Affective Stimuli.” Psychological Science 18, no. 5 (2007): 421–428.Lindquist, Kristen A., Lisa Feldman Barrett, Eliza Bliss-Moreau, and James A. Russell. “Language and the Perception of Emotion.” Emotion 6, no. 1 (2006): 125–138.Torre, Jared B., and Matthew D. Lieberman. “Putting Feelings into Words: Affect Labeling as Implicit Emotion Regulation.” Emotion Review 10, no. 2 (2018): 116–124.Self-Distancing and Reflective ProcessingAyduk, Özlem, and Ethan Kross. “From a Distance: Implications of Spontaneous Self-Distancing for Adaptive Self-Reflection.” Journal of Personality and Social Psychology 98, no. 5 (2010): 809–829.Kross, Ethan, and Özlem Ayduk. “Making Meaning out of Negative Experiences by Self-Distancing.” Current Directions in Psychological Science 20, no. 3 (2011): 187–191.Kross, Ethan, Özlem Ayduk, and Walter Mischel. “When Asking ‘Why' Does Not Hurt: Distinguishing Rumination from Reflective Processing of Negative Emotions.” Psychological Science 16, no. 9 (2005): 709–715.Kross, Ethan, Emma Bruehlman-Senecal, Jiyoung Park, Aleah Burson, Adrienne Dougherty, Holly Shablack, Ryan Bremner, Jason Moser, and Özlem Ayduk. “Self-Talk as a Regulatory Mechanism: How You Do It Matters.” Journal of Personality and Social Psychology 106, no. 2 (2014): 304–324.Moser, Jason S., Adrienne Dougherty, Whitney I. Mattson, Benjamin Katz, Tim P. Moran, Darwin Guevarra, Hannah Shablack, et al. “Third-Person Self-Talk Facilitates Emotion Regulation Without Engaging Cognitive Control: Converging Evidence from ERP and fMRI.” Scientific Reports 7 (2017): 4519.Affirmation and Counter-IncantationCascio, Christopher N., Matthew B. O'Donnell, Francis J. Tinney Jr., Matthew D. Lieberman, Shelley E. Taylor, Victor J. Strecher, and Emily B. Falk. “Self-Affirmation Activates Brain Systems Associated with Self-Related Processing and Reward and Is Reinforced by Future Orientation.” Social Cognitive and Affective Neuroscience 11, no. 4 (2016): 621–629.Cohen, Geoffrey L., and David K. Sherman. “The Psychology of Change: Self-Affirmation and Social Psychological Intervention.” Annual Review of Psychology 65 (2014): 333–371.Wood, Joanne V., W. Q. Elaine Perunovic, and John W. Lee. “Positive Self-Statements: Power for Some, Peril for Others.” Psychological Science 20, no. 7 (2009): 860–866.Implementation Intentions and ActionGollwitzer, Peter M. “Implementation Intentions: Strong Effects of Simple Plans.” American Psychologist 54, no. 7 (1999): 493–503.Gollwitzer, Peter M., and Veronika Brandstätter. “Implementation Intentions and Effective Goal Pursuit.” Journal of Personality and Social Psychology 73, no. 1 (1997): 186–199.Gollwitzer, Peter M., and Paschal Sheeran. “Implementation Intentions and Goal Achievement: A Meta-Analysis of Effects and Processes.” Advances in Experimental Social Psychology 38 (2006): 69–119.Schweiger Gallo, Inge, Andreas Keil, Kathleen C. McCulloch, Brigitte Rockstroh, and Peter M. Gollwitzer. “Strategic Automation of Emotion Regulation.” Journal of Personality and Social Psychology 96, no. 1 (2009): 11–31.Ritual, Identity, and Psychological FormationBell, Catherine. Ritual Theory, Ritual Practice. New York: Oxford University Press, 1992.Hobson, Nicholas M., Juliana Schroeder, Jane L. Risen, Dimitris Xygalatas, and Michael Inzlicht. “The Psychology of Rituals: An Integrative Review and Process-Based Framework.” Personality and Social Psychology Review 22, no. 3 (2018): 260–284.Rappaport, Roy A. Ritual and Religion in the Making of Humanity. Cambridge: Cambridge University Press, 1999.Xygalatas, Dimitris. Ritual: How Seemingly Senseless Acts Make Life Worth Living. New York: Little, Brown Spark, 2022.Also want to remind people about the website, if you're into reading we have tons of information by multiple contributors, and we got t-shirts up on the site if you're interested. Fun fact, the art is all based on the eyeball.
Credits: 0.75 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-500 Overview: To celebrate our 500th episode, each member of our team revisits a popular topic from the podcast's earlier installments—GLP-1s, cervical and breast cancer screening, diet and exercise, contraception, hypertension, and lipid management—to trace how the evidence and guidelines have changed since it was first covered. Whether you're catching up or reinforcing what you know, this milestone episode helps you bring the latest evidence into everyday patient care. Guest: Robert Baldor, MD, Alan Ehrlich, MD, Susan Feeney, DNP, FNP-BC; FAANP, Jillian Joseph, PA, Mariyan L. Montaque, DNP, FNP-BC, Jill Terrien PhD, ANP-BC, FAAN Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com Episode resource links: Zhou H et al. Evaluation and Comparison of the PREVENT and Pooled Cohort Equations for 10‐Year Atherosclerotic Cardiovascular Risk Prediction. Journal of the American Heart Association Volume 14, Number 4 Goff DC et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129:S49–S73. Circulation. 2018 Jul 24;138(4):345-355. eClinicalMedicine 2025: 103741. Curry, J. (2018). Screening for cervical cancer: US Preventive Services Task Force Recommendation Statement. JAMA.320(7):674-686. doi:10.1001/jama.2018.10897 https://www.ncbi.nlm.nih.gov/pubmed/30140884 Perkins RB, Wolf AMD, Church TR, et al. Self-collected vaginal specimens for human papillomavirus testing and guidance on screening exit: An update to the American Cancer Society cervical cancer screening guideline. CA Cancer J Clin. 2026;e70041. doi:10.3322/caac.70041 Screening for Cervical Cancer (2026). Obstetrics & Gynecology, 148(1), e63-e67. https://doi.org/10.1097/AOG.0000000000006257 Jad Zeitouni, Nosayaba Osazuwa-Peters, Yusuf Dundar, Gregory Zimet, Mark A. Varvares. (2025). Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity, The Lancet Regional Health - Americas, (51), https://doi.org/10.1016/j.lana.2025.101243 Diabetes, Obesity and Metabolism 28, no. 6 (2026): 5043–5057, https://doi.org/10.1111/dom.70698. Relationship of early rapid weight loss to efficacy and safety of tirzepatide and semaglutide for obesity: SURMOUNT-5 post hoc analysis. Am J Med. 2026 Jul;139(7):913-921. doi: 10.1016/j.amjmed.2026.03.010 US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Screening for breast cancer: US Preventive Services Task Force recommendation statement. JAMA. 2024;331(22):1918–1930. Trentham-Dietz A, Chapman CH, Jayasekera J, et al. Collaborative modeling to compare different breast cancer screening strategies: a decision analysis for the US Preventive Services Task Force. JAMA. 2024;331(22):1931–1946. Giaquinto AN, Sung H, Miller KD, et al. Breast cancer statistics, 2022. CA Cancer J Clin. 2022;72(6):524–541. Qaseem A, Harrod CS, Balk EM, et al. Screening for breast cancer in asymptomatic, average-risk adult females: a guidance statement from the American College of Physicians (Version 2). Ann Intern Med. 2026.: American Cancer Society. Breast Cancer Facts & Figures 2022–2024. Atlanta, GA: American Cancer Society, 2022. Hu X, Chehal PK, Kaplan C, et al. Racial differences in patient-reported symptoms and adherence to adjuvant endocrine therapy among women with early-stage, hormone receptor-positive breast cancer. JAMA Netw Open. 2022;5(8):e2225485. Torres JM, Sodipo MO, Hopkins MF, Chandler PD, Warner ET. Racial differences in breast cancer survival between Black and White women according to tumor subtype: a systematic review and meta-analysis. J Clin Oncol. 2024;42(35):4225–4234. Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: evidence and interventions. Lancet. 2017;389(10077):1453–1463. Hypertension. 2026;83:00–00. DOI: 10.1161/HYPERTENSIONAHA.125.25787 Allen RH, Bartz D. Opill: The Over-the-Counter Contraceptive Pill. Obstet Gynecol. 2024;143(2):184-188. doi:10.1097/AOG.0000000000005455 Cahill EP, Kaur S. Advances in contraception research and development. Curr Opin Obstet Gynecol. 2020;32(6):393-398. doi:10.1097/GCO.0000000000000666 Charles DN, Nagarsheth M, Oshman L. Pain Management for IUD Insertion in Primary Care. Am Fam Physician. 2025;111(4):299-301. Chen, C., Strasser, J., Banawa, R., Luo, Q., Bodas, M., Castruccio-Prince, C., Das, K., & Pittman, P. (2022). Who is providing contraception care in the United States? An observational study of the contraception workforce. American journal of obstetrics and gynecology, 226(2), 232.e1–232.e11. https://doi.org/10.1016/j.ajog.2021.08.015 Diedrich,J., Klein, D. Peipert, J.(2017). Long-acting reversible contraception in adolescents: a systematic review and meta-analysis, Am J Ob Gyn, April 2017. http://dx.doi.org/10.1016/j.ajog.2016.12.024 Li RHW, Lo SST, Gemzell-Danielsson K, Fong CHY, Ho PC, Ng EHY. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402(10405):851-858. doi:10.1016/S0140-6736(23)01240-0 Mørch LS, Meaidi A, Corn G, Hargreave M, Wessel Skovlund C. Breast Cancer in Users of Levonorgestrel-Releasing Intrauterine Systems. JAMA. 2024;332(18):1578–1580. doi:10.1001/jama.2024.18575 Nguyen AT, Curtis KM, Tepper NK, et al. U.S. Medical Eligibility Criteria for Contraceptive Use, 2024. MMWR Recomm Rep. 2024;73(4):1-126. Published 2024 Aug 8. doi:10.15585/mmwr.rr7304a1 Paradise SL, Landis CA, Klein DA. Evidence Based Contraception: Common Questions and Answers. American Family Physician. 2022. https://www.aafp.org/afp/2022/0900/contraception The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.
The Context of White Supremacy hosts the Counter-Racist Weekly Review 08/29/26. This broadcast examines current events from across the globe to learn what's happening in all areas of people activity. We cultivate Counter-Racist Media Literacy by scrutinizing journalists' word choices and using logic to deconstruct what is reported as "news." We'll use these sessions to hone our use of terms as tools to reveal truth and neutralize Racists/White people. #ANTIBLACKNESS **Wisconsin Race Soliders Hoarding Skulls Again**: A White Man in Fond Du Lac, Wisconsin. FOX11 News reports that 47-year-old Benjamin Larson's was arrested after authorities "found many disturbing items, including books, documents and memorabilia related to murders and serial killers. Skeletal remains, including many apparent human skulls, were also found." Jeff Dahmer, Max Anderson, White Culture. **Sade C. Robinson**: Larson arrest and stash of human remains dramatically underscores Gus's ongoing efforts to obtain all public records related to the criminal case of Sade C. Robinson. At this juncture, Milwaukee courthouse Race Soldiers Judge Laura Crivella, court reporter Julie Persinger and their Racist courthouse lackeys continue to obstruct Justice. **Was Dr. Frances Cress Welsing correct about Recreational Cannabis?**: We'll review a WNYC segment where New York Times' Roni Caryn Rabin details a new JAMA study showing a growing number of US residents are self-reporting cannabis addiction and dependency. The great Neely Fuller Jr. warned non-white people about letting others (especially Racists) increase our needs. **Brain Damage & The NFL**: A sobering new report shows that at least 25% of NFL players in this study tested positive for CTE (brain damage). The most important aspect of this report is that more than half the players who did not test positive for CTE did not have their brain tested at all. Thus, the number of players with brain damage is logically much higher. Some NFL analysts speculate this sort of info could eventually end tackle football. #TheCOWS17Years #JusticeForSade #EmmettLouisTill #CounterRacism #GlobalWhiteSupremacy #BenjaminLarson #CTE FondDuLac #Wisconsin #Milwaukee #Cannabis #PennState Call-In Number: 720.716.7300 Code: 564943#
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from August 22-28, 2026.
In a recent paper published in JAMA, researchers find that over 50% of IVF cycles in the United States are now done at fertility clinics affiliated with private equity firms. Read the full article here.Episode TranscriptFor more on this story and for others like it, visit the Health Lab website where you can subscribe to our Health Lab newsletters to receive the latest in health research and information to your inbox each week. Health Lab is a part of the Michigan Medicine Podcast Network, and is produced by the Michigan Medicine Department of Communication. You can listen to Health Lab wherever you get your podcasts. All Health Lab content including health news, best practices and research insights are for informational purposes only and are not a substitute for professional medical guidance. Always seek the advice of a health care provider for questions about your health and treatment options. Hosted on Acast. See acast.com/privacy for more information.
A new analysis out of Japan says a dementia drug might ease Long COVID fatigue and depression. But it's basically a reanalysis of the same trial that already failed back in 2025, and even where it helped, results were mixed. The reanalysis splits people by whether they had a reactivated herpesvirus. Evan H. Hirsch, MD breaks down what that virus is actually doing to your brain, why the drug only helped part of the group and made others worse, and why chasing one virus and one brain chemical never gets to the real cause. He also shares how a client recovered by addressing all of the Toxic 5, the five root causes behind almost every case of Long COVID and chronic fatigue. In this episode, you'll learn: Why the new Japan analysis is actually a reanalysis of the same JAMA trial that already found no benefit in 110 people, and why results stayed mixed even where it helped How HHV6B, a herpesvirus that reactivates after COVID, produces a protein called SITH1 that drains acetylcholine and drives brain fog Why treating one reactivated virus or one brain chemical never resolves Long COVID on its own What the Toxic 5 are, and why nervous system dysfunction, what Dr. Patrick Porter calls neurological lock, is one of the five root causes How a client recovered by addressing all five root causes together, not just the reactivated virus driving her brain fog Discover your fatigue score and the root causes keeping you stuck: https://myfatiguescore.com Free Fatigue Masterclass: https://fixyourfatigue.com See real results: https://energymdmethod.com/results Chapters: 00:00 - Introduction 00:25 - What the New Japan Analysis Found 01:39 - Why the Results Were Still Mixed 02:17 - Why Donepezil Misses the Bigger Picture 02:54 - The Toxic 5 and Neurological Lock 04:08 - Case Study: A Client's Recovery 05:55 - Why Full Recovery Takes Time Subscribe to the EnergyMD Podcast for weekly conversations with leading experts on resolving ME/CFS and Long COVID by addressing the real root causes. . For more information about Evan and his program, Click Here. Prefer to watch on Youtube? Click Here. Please note that any information in this episode is for educational purposes only and does not constitute medical advice.
Weight maintenance is a challenging topic for both clinicians and patients. In this special episode, Neil Skolnik is joined by Jamie Almondoz, MD, who discusses the toxic narratives that have historically been part of the weight loss conversation, and the latest strategies for maintaining a healthy weight after the initial loss. This special episode is sponsored with support from Lilly. Please listen to the episodes by clicking on the podcast player below or by freely subscribing to DOC Updates via Apple Podcasts, Amazon Music, Spotify, or your preferred podcast platform. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Jamie Almondoz, MD, Professor of Internal Medicine and the Medical Director of the Weight Wellness Program at the University of Texas Southwestern Medical Center and Vice-Chair of the American Board of Obesity Medicine (ABOM) References: Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN): a multicentre, double-blind, randomised, placebo-controlled trial. Lancet. June 2026; 407:2305-2318 Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity The STEP 4 Randomized Clinical Trial. JAMA 2021;325;(14):1414-1425 Orforglipron for maintenance of body weight reduction: the double-blind, randomized phase 3b ATTAIN-MAINTAIN trial. Nat Med 32, 2679–2687 (2026) Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes Obes Metab. 2022; 24(8): 1553-1564
Photo by Troy T on Unsplash Cigarette smoking remains the leading cause of preventable death and disease in the United States. Over 2/3 of those adults who smoke want to quit and more than half try to do so in any given year; but only 1 in 10 will be successful. Nicotine e-cigarettes were designed to help people to stop smoking cigarettes but their use for withdrawing from regular cigarettes has been controversial, as some argue it perpetuated the nicotine addiction that cigarettes induce and with its own set of toxins. And an additional concern has been that youth, in particular, may be taking up e-cigarettes and quickly get addicted to nicotine. JAMA, the official publication of the AMA, just published evidence-based recommendations about the use of e-cigarettes from a working group within the Treatment Research Network of the International Society for Research on Nicotine and Tobacco on July 30th. In that same issue of JAMA, Dr. Jamie Hartmann-Boyce, DPhil, Associate Professor in Health Policy and Management at University of Massachusetts Amherst, wrote an editorial about the recommendations on the use of e-cigarettes for smoking cessation. HealthCetera Producer and Host, Diana Mason, PhD, RN, talked with Dr. Hartman-Boyce about e-cigarettes, their use for smoking cessation, and the evidence on whether people should be concerned about using e-cigarettes, including teens. This interview first aired on WIOX Radio on August 12, 2026. The post E-Cigarettes and Smoking Cessation appeared first on HealthCetera.
Citicoline and Stroke Recovery: What the Major Clinical Trials Actually Found If you’re recovering from a stroke or brain injury, there’s a familiar, exhausting question that shows up once the rehab schedule is set: is there anything else a supplement, a nutrient, something that could genuinely support the brain while it rebuilds itself? Citicoline comes up in that search constantly, across nootropic forums, supplement stores, and even some hospital protocols. It also happens to have one of the largest clinical trial records of any brain-recovery compound available. So rather than trusting a product label, it’s worth going straight to what those trials actually found, including the parts that didn’t work. What Citicoline Is Citicoline (cytidine diphosphate-choline, or CDP-choline) is a compound your body already produces. It’s a building block for phosphatidylcholine, a major structural component of neuronal cell membranes. The theory behind supplementing it is straightforward: give the brain more raw material to repair damaged membranes and support neurotransmitter production after an injury. It’s sold over the counter as a supplement (often branded as “Cognizin”), and in some countries it’s used clinically, including intravenously, in hospital stroke and TBI protocols. What the Major Trials Actually Show This is a case where the size of the evidence base is unusually large, and the results are humbling rather than triumphant. The ICTUS trial, published in The Lancet in 2012 with 2,298 patients, tested citicoline for acute ischemic stroke and found no significant benefit over placebo for global recovery at 90 days; the trial was stopped early for futility (PMID 22691567). The COBRIT trial, published in JAMA the same year with 1,213 traumatic brain injury patients, tested a higher dose of 2,000 mg per day for 90 days and again found no meaningful difference in functional or cognitive outcomes at 90 or 180 days (PMID 23168823). A 2020 Cochrane review pooling ten randomized trials and more than 4,000 stroke patients concluded there was little to no difference between citicoline and placebo in mortality, disability, or neurological recovery, and rated the overall evidence quality as low, noting six of the ten trials were industry-sponsored (PMID 32860632). Here’s where the picture becomes more interesting. A separate trial gave stroke survivors citicoline continuously for twelve months, rather than just during the acute phase, and found real improvements in attention, executive function, and temporal orientation compared to usual care, along with a non-significant trend toward better long-term functional outcome (PMID 23406981). A broader 2020 systematic review across neurological conditions similarly found citicoline useful for slowing dementia progression and enhancing cognition in healthy adults, while describing its effect on TBI specifically as “unclear” (PMID 33053828). A separate meta-analysis of twelve trials found citicoline significantly improved functional outcomes overall, even while showing no significant difference on several other individual outcome measures a genuinely mixed result rather than a clean positive or negative (PMID 28458415). The pattern that emerges: as a short-term rescue treatment for acute stroke or acute TBI, the largest, best-designed trials say no, it doesn’t move the needle. As a longer-term support for post-stroke cognitive function, taken consistently over months, there’s a more modest but real signal. What This Means for Stroke Survivors – The Honest Limits Citicoline is not an acute miracle treatment, and the largest trials in the field say so plainly. If you were hoping for a supplement that meaningfully changes outcomes in the days or weeks after a stroke, the evidence doesn’t support that expectation. The more genuine finding of better attention and executive function with twelve months of continuous use comes from a single open-label trial that wasn’t blinded, so it deserves a more cautious read than the large, definitive negative trials. There’s also a dosing gap worth knowing about before anyone assumes a supplement bottle reflects the research: clinical trials used 500 to 2,000 mg per day, often for months, while most over-the-counter citicoline products are dosed at 250 to 500 mg per day, meaningfully lower than the doses that produced the modest cognitive signal. Practical Takeaways – Questions to Bring to Your Treating Team Ask your neurologist or doctor whether citicoline makes sense for your specific recovery stage. Acute stroke support and long-term cognitive support are different questions with different evidence behind them. If you’re considering a supplement, check the label dose against what was actually studied. A product dosed well below 500 mg per day is not comparable to the trials that showed a cognitive benefit. Search “ICTUS citicoline,” “COBRIT trial,” or “citicoline cognitive stroke” on PubMed yourself, and form your own view. The honest picture here is nuanced enough that it’s worth reading past the marketing copy. The value of citicoline, if it exists for you, isn’t as a substitute for rehab, sleep, movement, and nutrition; it’s a small addition on top of everything else you’re already doing well, chosen because you understand the actual trial record rather than a supplement label. For the broader framework I used to separate genuine evidence from supplement hype throughout my own recovery, see my book: https://recoveryafterstroke.com/book. If breakdowns like this one are useful to you, the Recovery After Stroke Patreon (https://patreon.com/recoveryafterstroke) directly funds more of them. This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. The post Citicoline for Brain Recovery: What the Major Trials Actually Found appeared first on Recovery After Stroke.
The Point Was Never the Lineage: A Call to Deliver What Only You Can Bring We're sent to a place to change it and make it match our culture. Which means at certain points you have to put aside the culture that you were given for the one that heaven gives you.Heaven never sabotages a human being. The events of our lives, even those that appear devastating, are designed to empower the soul.Yet, most of us spend our lives trapped on the ground floor, letting our lineage act as a ceiling. We treat ancestry, conditioning, and our original environment as the permanent walls of who we are. From that low vantage point, every hardship feels like a personal injustice.But consciousness has many mansions. Shifting to a higher floor means realizing that life is a series of experiences designed for your expansion, not a trap set by your past.To see what living entirely free of a baseline looks like, we have to look past lineage altogether. This brings us to the archetype of Melchizedek. Walking onto the ancient page with no father, no mother, and no recorded genealogy, Melchizedek represents a consciousness untouched by an origin story. He is the ultimate expression of the penthouse view—proof that you can step completely outside the architectural blueprint you were handed and claim a wholly sovereign reality.He appears in Genesis 14:18-20, brings bread and wine, blesses Abraham, and disappears. In a text obsessed with family trees and pedigrees, that deliberate absence is the loudest detail. It tells you something crucial: your authority doesn't have to come from your lineage. It can come from who you are in this moment, standing in unbroken connection to the Source.He wasn't just a king who blessed people or a priest who led. He held both capacities at once, fully integrated. That's the architecture of self-mastery—and it's available to you the moment you step outside the temporary lines you were born into.What His Name Actually Tells YouMelchizedek comes from two Hebrew roots: Melech, meaning king, and Zedek, meaning righteous. King of Righteousness. That's not just a title. It's a description of the operating system.Kingly authority is the outer capacity: leadership, boundary-setting, stewarding resources, making decisions, protecting the mission.Priestly authority is the inner capacity: self-awareness, processing difficult emotional material, navigating your inner landscape, staying aligned with something greater than the urgent noise at the surface.Most of us are lopsided. We either execute well but internally burn out, or we stay spiritually centered but never produce anything tangible. The Melchizedek model is the integration of both—attending to the visible and invisible realms at the same time, without outsourcing your worth to either one.The priesthood of Melchizedek is described as eternal, distinct from temporary systems. Other orders are tied to tribes, structures, chains of inheritance. This one is tied to something else entirely: the character and continuous inner union of the person standing in it. No expiration date. No dependence on human appointment.The Practical Invitation: From Survival to OverflowStrip away the religious packaging, and here's the truth: you're invited to stop living as a product of your past and start living as the author of your future.This means something specific: you stop worrying about survival even when circumstances are challenging, and you start receiving the Royal family's overflow.Think about it. Most of us are in perpetual defense mode. We're protecting ourselves against scarcity, anxiety, and the fear that we won't have enough. But what if your identity shifted? What if you understood yourself not as someone trying to scrape by, but as a child of the Most High—someone with access to infinite resources?That means moving from a life of earthly limitations—constant exhaustion, desperate need for validation, survival-mode reactions—into what we might call multi-dimensional functioning. You become the kind of person whose inner alignment with the Divine is so complete that your outer actions flow naturally from it.You stop hustling to prove yourself and start producing from overflow.The goal isn't just doing better. It's becoming a complete expression of the Source you're connected to, so that your presence alone shifts the room. (That's the framework most people are missing.)Why God Grants You Access to Kingdom Wealth and AbundanceWe want God to show up. We want the kingdom to invade our earth. We want resources to appear. But we're not actually agreeing to anything. We're standing at the buffet saying “I want that” without getting in line.This isn't about luck or wishful thinking. There are three foundational reasons why you deserve—and are designed to receive—Kingdom wealth and abundance:1. To live a comfortable life.God is not against your prosperity. He wants you living comfortably while you serve Him. Rest, provision, peace—these are not luxuries reserved for someone else. They're your inheritance.2. To advance the Kingdom of God.If you're financially incapacitated, you're spiritually handicapped. You can't do much for the Kingdom when you're in survival mode. Wealth removes the barrier between your calling and your execution.3. To be a blessing to the world in a practical, definite way.(See Genesis 12:3.) Your abundance isn't for hoarding—it's for circulation. It flows through you to those around you. But here's the thing: your motivation for accessing wealth must be purified by these revelations. It's not about status or ego. It's about capacity to serve.What You're Actually Here to DeliverYou weren't created just to make a living and keep the bills away. That's survival, not purpose.That business, book, movement, healing practice, or unlikely project only you could've dreamed up? It's not a coincidence. It's something planted in you before you had words for it. An idea is a kind of pregnancy—it gestates in your mind and heart until it can't be hidden anymore.Your job is straightforward: conceive it, believe it, protect it, and when the time is right—push.This isn't just inspirational talk. Research published in JAMA followed thousands of adults over fifty and found that a sense of purpose was linked to a 15% lower risk of death over eight years. Purpose isn't a luxury. It's a survival instinct. People who stop carrying something die long before their bodies catch up.Thomas Edison understood this:“I have not failed 10,000 times. I have successfully found 10,000 ways that will not work.”Successful people have one secret: they refuse to quit. Postpone failure long enough, and it becomes success.Understanding What Increase Actually MeansHere's where most people get stuck: they confuse increase with just “having more.” It's not that simple.Increase is a multi-dimensional process of becoming progressively greater. It's not merely about accumulation. It's about growth in four key areas:Size: Expansion in your personal reach or physical domain. Your influence grows.Volume: Greater capacity to hold or handle resources. You're not just getting more—you're becoming larger to contain more.Number: Multiplication of your results or influence. Your impact compounds.Intensity: Increasing the power, passion, and effectiveness of your work. You're not just busier; you're more potent.Notice something? Increase isn't random. It's not a product of luck. It's a law-governed outcome. Just as physical laws govern the earth, Kingdom mysteries govern spiritual progress. To experience this, you must shift your mindset from mere desire to active engagement with these laws.The 5 Keys to Sustained IncreaseIf you want increase to actually stick—to become part of your permanent reality and not just a temporary spike—these five keys are non-negotiable:1. Connection with Holy SpiritThis is the foundation. Like a branch connected to a vine, your fruitfulness depends entirely on the health of your intimacy with the Holy Spirit. Everything flows from this relationship. Cut the connection, and nothing else matters.2. KnowledgeIgnorance is the primary barrier to progress. You must pursue distilled knowledge—not just the technical skills of your field, but the spiritual laws that govern success. Honor. Diligence. Stewardship. These aren't optional. They're the operating system beneath everything.3. DutifulnessThe quality of living out our duties or tasks with care and loyalty.4. FaithfulnessGod tests your ability to handle small assignments before trusting you with greater ones. If you are not faithful with what you currently have, you cannot expect an increase. Small is the training ground for large.5. ThanksgivingGratitude is a powerful act of faith. By refusing to complain and instead praising God for the present, you keep the atmosphere of your life open to supernatural intervention. You literally create the conditions for more.Mary: A Study in Real ExecutionThe best real-world case study is Mary. Let's keep it practical.First, the call interrupts your plans. She was engaged, and suddenly the biggest assignment in human history landed on her calendar. When purpose shows up, it won't always fit neatly into your five-year plan. That's not a problem. That's the signal.Second, you'll feel like a virgin. Meaning: you've never done this before. It will scare you. That's confirmation you're in over your head—which is exactly where you need to be.Third, you need backup. The first thing Mary did was go to Elizabeth, another woman carrying an impossible miracle. Find people who already believe crazy things can happen. Hang around dreamers, and your own vision starts leaping.Fourth, protect it. Mary and Joseph hid the child from Herod. There's a season to share the vision and a season to strengthen it. Not everyone who says “amen” is safe. Let them earn your trust.Fifth, say yes and move. Mary's response was simply: “Let it be done to me as you have said.” Then she got up and went. Indecision is still a decision—usually the wrong one.The Law of HarvestHere's what most people miss: everything you receive from God often arrives in seed form. The increase you desire is a harvest that requires you to sow.This includes sowing acts of love, seeds of kindness, and seeds of diligence. You must act as a farmer—consistently planting the qualities you wish to see manifest in your life. You can't harvest what you didn't plant. And you can't plant what you're not willing to become.Integrating the King-Priest WithinNow bring the two halves together.Operating as a fully integrated person means dissolving the artificial barrier between your outer work and your inner awareness. You're not a spiritual being on Sundays and a steely operator on weekdays. Those two selves merge into one.King mode is the outer work: setting boundaries, making hard calls, building systems, stewarding resources, protecting the mission.Priest mode is the inner work: stillness, self-awareness, processing the pain you keep avoiding, staying connected to the Source.When these two merge, your daily decisions stop being reactions. You stop needing an outside mediator, a temporary title, or a prestigious lineage to validate your worth. You move through life with continuous, self-authored authority.Melchizedek didn't need a pedigree because his identity was anchored in something eternal. That's the whole point: you stop letting where you came from dictate where you're capable of going.The Tipping PointTo step fully into your calling, you must embrace your true identity: you are offspring of the Most High, seated in heavenly places, operating within the order of Melchizedek. You function simultaneously as priest and king—knowing the heart of the Father and bringing His will to earth. When you speak, you're not just sharing opinions; you're collapsing possibilities into reality. That's the weight you carry.It doesn't take equal numbers to tip the balance. t takes enough awakened ones—each carrying their assignment—to provide the momentum for breakthrough.You were born for such a time as this. Not to survive it. Not to post about it. But to deliver what you were born to bring.Now GoStop waiting for perfect conditions. Make the call ruthlessly.* Cut the circle that's killing your vision.* Lay down the need to control the timeline.* Stay patient through the messy middle.* And when the moment arrives—push.The world has been waiting for what you carry. Not for who you were. For who you're becoming.Now go deliver it.Love, KassandraThe Light Between is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit thelightbetween.substack.com/subscribe
À Dakar et en région, il ne se passe pas un week-end sans « sound system », du nom de ces soirées reggae de la scène underground. Autrefois marginalisées, elles se font une place dans les nuits sénégalaises et gagnent en reconnaissance. De notre correspondante à Dakar, À Dakar, sur une piste à ciel ouvert, les corps se laissent porter par les vibrations reggae. Aux platines, le DJ enchaîne des titres venus d'Europe, des États-Unis et de Jamaïque, bien sûr. « Ici, on aime le dancehall, on aime le reggae et la culture rasta », confie Omar. Ce dernier appartient à la communauté des Baye Fall, une branche du mouridisme connue au Sénégal pour ses valeurs communes avec le mouvement rasta, comme le sens du service et l'amour de la nature. Chez lui, le reggae a toujours résonné comme une prière. Ces dernières années, il a vu peu à peu les « sound system » s'ouvrir au reste de la société. « Il y a des pères et des mères de famille, il y a des couples mariés. Il y a des responsables et cadres d'entreprise qui viennent ici juste pour profiter de la musique. Plus de personnes sont conscientes du message qu'il y a derrière », explique-t-il. Au Sénégal, les premiers « sound system » datent des années 1990, impulsés par le travail du célèbre animateur radio Cheikh Amala Doucouré. Dès 1985, ce dernier consacre chaque samedi une émission reggae sur les ondes de la radio-télévision nationale (RTS). Mais le mouvement ne prend pas vraiment, associé à une forme de déviance morale et religieuse. Aujourd'hui, les réseaux sociaux changent la donne : la rébellion pacifique de Bob Marley ou la résistance radicale de Peter Tosh trouvent un nouvel écho chez les jeunes. « Moi, ce qui m'intéresse, c'est que les gens puissent voir les messages au lieu de voir la marijuana, la fumette, etc. Tous les rastas revendiquent l'indépendance de l'Afrique en général. Il y a encore le système Babylone qui règne partout dans le monde. Moi, en tant que Sénégalais, je rejoins leur mode de pensée », souligne Omar. Dreadlocks, code vestimentaire vert-or-noir aux couleurs de la Jamaïque… Ici, chacun affiche les symboles du reggae et revendique toute l'histoire qui y est rattachée. Arame Ndiaye est responsable chez Sen Reggae, l'entité qui organise les « sound system ». « Les Jamaïcains se sentent Africains. Ce sont des descendants d'esclaves, ils sont vraiment très attachés à leur terre ici. Je vous donne un exemple : un artiste reggae qui vient au Sénégal. Il veut aller à Gorée et voir la Porte du Chemin sans retour. Pourquoi ? Parce que c'est le sang », explique-t-elle. Les « sound system » veulent désormais sortir de l'ombre du mbalax et de l'afrobeats, plus populaires au Sénégal. Bien plus que de simples fêtes, Arame Ndiaye y voit un espace de cohésion sociale. « C'est un message de paix et d'harmonie. Par exemple, avec la situation politique actuelle du pays, si plus de gens écoutaient du reggae, ils seraient beaucoup plus apaisés, comprendraient mieux les choses et agiraient différemment », estime-t-elle. À Dakar, le « sound system » a rassemblé plus d'un millier de personnes le 11 mai dernier, date anniversaire de la mort de la légende Bob Marley. À lire aussiHistoire de la nuit africaine: l'Afrika Shrine, la salle mythique de Fela Kuti [7/10]
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from August 15-21, 2026.
In this episode, host Leda McDaniel speaks with Dr. Thomas Ibounig, shoulder and elbow surgeon at Helsinki University Hospital and researcher with the Finnish Centre for Evidence-Based Orthopaedics.Dr. Ibounig discusses his 2026 JAMA study, “Incidental Rotator Cuff Abnormalities on Magnetic Resonance Imaging.” The conversation explores how common rotator cuff abnormalities are on MRI, including in asymptomatic individuals, and what that means for clinicians interpreting imaging findings in patients with shoulder pain.The study used a representative Finnish population sample, bilateral 3 Tesla MRI imaging, shoulder surgeon clinical examination, and extensive questionnaire data to examine the relationship between imaging findings, symptoms, clinical tests, and broader patient factors.Dr. Ibounig explains why MRI findings and isolated clinical tests may not identify the source of pain as reliably as clinicians often assume. He also discusses why terminology matters when explaining imaging to patients, how structural findings can become over-medicalized, and why future research needs to look beyond anatomy toward psychological, occupational, metabolic, and longitudinal contributors to shoulder pain.This episode is especially relevant for orthopedic manual physical therapists, surgeons, sports clinicians, educators, and anyone helping patients make sense of shoulder MRI findings.Link to referenced study: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2844659Key TakeawaysMRI abnormalities are extremely common after age 40.Dr. Ibounig reports that nearly every shoulder over 40 in the study showed some abnormality on MRI.Abnormal does not always mean pathological.Findings such as tendinopathy, partial-thickness tears, and even some full-thickness tears may be part of aging rather than the clear source of symptoms.Symptoms and imaging do not map cleanly.Full-thickness rotator cuff tears were more common in symptomatic shoulders, but many findings were also present in asymptomatic shoulders.Clinical tests may not add as much certainty as clinicians hope.Even a thorough clinical exam did not clearly improve the ability to distinguish symptomatic from asymptomatic rotator cuff findings.Language matters.Telling a patient their shoulder is “torn” or “broken” can create fear, even when the finding may be common for their age.Shoulder pain needs a broader explanatory model.Dr. Ibounig emphasizes that future research should explore pain mechanisms beyond structure, including psychological, metabolic, occupational, and longitudinal factors.Clinical humility is essential.One of the episode's strongest messages is that experience often brings less certainty, not more.
Como a inovação em vacinas adaptadas à epidemiologia brasileira, o modelo comunitário de saúde mental e o armazenamento de plaquetas impactam a medicina? Neste episódio do Afya News, analisamos o desenvolvimento de imunizantes nacionais contra o Plasmodium vivax (UniMav e Vivaxin), focados na ativação de células T CD8+ para combater a espécie responsável pela ampla maioria dos casos de malária no Brasil. Discutimos também a pesquisa publicada no The Lancet Psychiatry sobre o programa ACCESS Open Minds, mostrando como o acolhimento comunitário precoce reduz internações e custos em saúde mental juvenil. Por fim, apresentamos no Radar o estudo do JAMA demonstrando a segurança e eficácia do uso de plaquetas refrigeradas por até 21 dias. O Afya News apresenta notícias da medicina com informação confiável e atualizada no seu tempo. Criado pela Afya, o maior hub de educação e soluções para a prática médica do Brasil, nosso propósito é transformar a saúde junto com quem tem a medicina como vocação.Fontes do episódio aqui:https://portal.afya.com.br/podcasts/afya-news/21-08-2026Conteúdo 100% validado por equipe médica.Médico Responsável: Dr. Guilherme Rodrigues — CRM-RJ 1049461.
Today, we are taking a deep dive into a medical truth thatsounds completely counterintuitive, almost upside down, based on everything you think you know about women's health. But here's the kicker: it's actually nothing new at all. For over two decades, ever since the landmark Women'sHealth Initiative (WHI) study made global headlines back in 2002, the blanket narrative surrounding menopausal hormone therapy has been clear and persistent: hormones equal breast cancer risk. But there is a massive asterisk in thatscience that got completely lost in the media noise. While combination therapy with conjugated equine estrogens paired with medroxyprogesterone acetate (CEE +MPA) did show an increased risk, the story for estrogen-only therapy (mainly CEE) in women wh had a hysterectomy is entirely different. In fact, an overwhelming mountain of growing data shows that estrogen-only therapy is protectiveagainst both breast cancer incidence and breast cancer mortality. In this episode, we're unpacking the latest high-level evidence that cements this crucial distinction. We'll examine the broad statistical landscape, including a comprehensive meta-analysis by Qing et al. (officially set for the December 2026 issue of Annals of Medicine, following its ahead-of-print release in March 2026). Their work breaks down how randomized controlled trial data consistentlypoint to estrogen-only therapy having a protective effect, in stark contrast to combination therapy. We'll also dive into a brand-new Clinical Perspective published in mid-August 2026 in Obstetrics & Gynecology (the Green Journal) by Drs. Andrew Kaunitz and Jason Wright. They call urgent attention to this phenomenon, highlighting RCT meta-analyses that demonstrate a 23% reduction in breast cancer incidence with estrogen alone (RR = 0.77), alongside striking cohort data showing a dramatic risk reduction even in high-risk populations, like carriers of the BRCA mutation. Listenin for details.1. Wu Q, Shen L, Hu S, Yang R, Wang Y, Xue D, SunY, Ma H, Dai Z. Relationship between menopausal hormone therapy and incidencerisk of breast cancer: systematic review and meta-analysis. Ann Med. 2026Dec;58(1):2640244. doi: 10.1080/07853890.2026.2640244. Epub 2026 Mar.2. Kaunitz, Wright. Menopausal Estrogen Therapy andRisk of Breast Cancer. Obstet Gynecol. Aug 20263. Chlebowski RT, Aragaki AK, Pan K, et al.Randomized Trials of Estrogen-Alone and Breast Cancer Incidence: AMeta-Analysis. Breast Cancer Research and Treatment. 2024. 4. Writing Group for the Women's Health InitiativeInvestigators. (2002). Risks and benefits of estrogen plus progestin in healthypostmenopausal women: Principal results from the Women's Health Initiativerandomized controlled trial. JAMA, 288(3), 321–333.
JJ Cox joins us as we talk through what actually changes when we perform cesarean delivery in patients with morbid obesity, from incision planning to anesthesia risk to the wound that has to heal at home. We share practical tips, review key trials on negative pressure dressings and antibiotics, and focus on decisions that protect both safe delivery and lower wound complications. • panniculus anatomy driving incision choice more than BMI • using ultrasound to find the uterus when landmarks mislead • paniculus retraction treated as an anesthesia maneuver • distance and geometry limiting exposure and delivery technique • planning the wound's postoperative “home” before making the cut • negative pressure wound therapy evidence including the 2020 JAMA trial and skin blistering risk • skin glue vs standard dressings as competing narratives with limited data • closing deep subcutaneous space in layers to reduce dead space • avoiding staples and favoring subcuticular suture based on available evidence • antibiotic prophylaxis realities including azithromycin dose questions and shortage workarounds • extended postoperative antibiotics data shift when azithromycin is already used • OR contamination habits including Yankauer discipline and glove-changing debate • calling for help early and building a short pre-op plan to prevent downstream problems Be sure to check out thinking about obgyn.com for more information. And be sure to follow us on Instagram. 0:00 Welcome And Guest Introduction2:55 Why These C-Sections Are Higher Risk7:00 Picking The Incision With Ultrasound14:25 Panniculus Retraction Is Anesthesia Critical17:35 Delivery Tips When Distance Is The Enemy19:55 Think About The Wound Before Cutting24:20 Negative Pressure Dressings What Trials Show34:45 Subcutaneous Closure Sutures Beat Shortcuts38:55 Antibiotics Dosing Azithromycin Reality Check45:55 Contamination Control Yankauer And Gloves52:10 Assistance Planning And Hemorrhage Limits55:30 Meta-Analysis Takeaways And ClosingFollow us on Instagram @thinkingaboutobgyn.
Welcome to the Veterinary Breakroom! Join Alyssa Watson, DVM, and Beth Molleson, DVM, as they discuss pressing issues impacting the veterinary profession. Would you want an AI agent renewing your personal prescription? How about your patient's? In this episode, Dr. Alyssa and Dr. Beth react to a recent JAMA article on Utah's first-of-its-kind pilot program allowing an autonomous AI agent to renew prescriptions for people—and the medical licensing board pushback that followed. Don't miss this candid conversation about what this could mean for patients, providers, and a veterinary profession that may not be far behind. Brought to you by Zoetis Resources: https://www.healthcareitnews.com/news/utahs-ai-prescription-refill-pilot-could-affect-patient-safety-critics-say https://jamanetwork.com/journals/jama-health-forum/fullarticle/2846947 https://www.apoquel.com Contact: podcast@instinct.vet Where To Find Us: Website: CliniciansBrief.com/Podcasts YouTube: Youtube.com/@clinicians_brief Facebook: Facebook.com/CliniciansBrief LinkedIn: LinkedIn.com/showcase/CliniciansBrief/ Instagram: @Clinicians.Brief X: @CliniciansBrief The Team: Alyssa Watson, DVM - Host Beth Molleson, DVM - Host Alexis Ussery - Producer & Multimedia Specialist Disclaimer: This podcast recording represents the opinions of Dr. Alyssa Watson and Dr. Beth Molleson. Content is presented for discussion purposes and should not be taken as medical advice. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.
This Is The G Podcast | @thisisthegpodcast Episode 324: Phi Slama Jamma Legend Basketball royalty Larry Micheaux (PhiSlama Jamma, NBA) joins the crew to discuss player development, navigating NIL, modern WNBA growth, and athletic longevity. Key Highlights Phi Slama Jamma & the Pros: Larry reflects on his Houston Cougars legacy and NBA career. Modern College Game & NIL: The impact of one-and-done rosters and how Larry's new podcast with daughter Latoya educates families on recruiting and financial literacy. WNBA & League Leadership: The rise of Caitlin Clark and Angel Reese, media narratives, and the need for strong league guidance. Basketball Evolution: LeBron's longevity, lost fundamentals, and strategic shifts in the three-point era. News & Culture: Syracuse Mike covers top headlines; Tonya B breaks down radio legacies, the Tupac trial, Verzuz, and classic R&B. Timestamps 00:00 – Intro & Larry Micheaux welcome 02:23 – Navigating NIL & youth sports education 03:31 – One-and-done culture vs. player development 04:49 – WNBA explosion: Caitlin Clark & Angel Reese 07:21 – Modern league leadership & standards 12:37 – LeBron James, longevity & the GOAT debate 16:29 – Fundamentals, physicality & financial literacy 27:56 – Tanya B's Tea: Fugees, radio legends & Verzuz 36:53 – News Roundup: Tupac trial, Lakers valuation & headlines Memorable Quotes "We try to educate parents and athletes about the UIL, the NIL, the changes that they've been making with sports." — Larry Micheaux "You have to have different parts... when you play your part, then you have to compete to a championship." — Larry Micheaux
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from August 8-14, 2026.
A man is struck by a car on the streets of Los Angeles. In the emergency department, a CT scan ordered to look for traumatic injuries reveals something nobody expected: a mass in his colon. Days later, sitting across from Dr. Belinda Waltman, he calls the accident “a blessing in disguise.” Then he changes the subject. He is less worried about cancer than about whether he can afford to miss another day of work. In this season finale of Standard Deviation, host Dr. Oliver Bogler explores what happens when biomedical science collides with the realities of the healthcare safety net. Dr. Waltman, a primary care physician in Los Angeles County, specializes in expedited cancer workups for uninsured and underinsured patients. Every diagnosis arrives carrying another set of questions about housing, transportation, food insecurity, wages, and survival that rarely appear in medical records or scientific literature. For years, Waltman carried those stories without knowing how to bring them into the academic record. As a full-time clinician without a research lab, grant funding, or publication pipeline, she faced barriers familiar to many working scientists and physicians whose most important observations happen outside traditional research settings. With support from the Life Science Editors Foundation's JEDI program, those experiences became The Margins Matter, a narrative medicine essay published in JAMA that argues the social realities surrounding cancer care are not background details. They are part of the disease itself. Bogler traces how editorial mentorship transformed lived clinical experience into published scholarship while asking a larger question about who gets to shape the scientific record. The conversation examines cancer care, Medicaid, health-related social needs, medical publishing, and the structural incentives that determine which stories become evidence and which disappear from view.The result is a conversation about documentation, visibility, and why the margins of medicine often determine who survives long enough to benefit from its advances.RELATED LINKSDr. Belinda WaltmanThe Margins Matter | JAMAThe Margins Matter | PubMedLife Science Editors FoundationFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Article at Kennedys and King Read Here Aguilar’s letter to the Federal Bar News and Journal criticizing Posner.View Here Aguilar’s book review of Bugliosi’s Reclaiming History, as published in The Federal Lawyer.View Here Transcript of Bugliosi’s reply to Aguilar (originally handwritten). View Here Background to the many lies of the corrupt J. Edgar Hoover The Warren Commison was depending on the FBI for investigation The Warren Commission had no criminal investigators. It was completely dependent on the FBI The notoriously corrupt chief, J. Edgar Hoover, announced Oswald guilt before starting the investigation. Hoover “file checked” the Commission and the staff for “derogatory information” Hoover had Gerald Ford secretly spy on the Commissioners The conclusion was set at the outset Anthony Lewis said all the evidence had been released by the Commission In 1964 The New York Times’s Anthony Lewis reported that the Warren Commission released all the evidence it had collected. 30 years later the ARRB discovered that more than 3000 Commission documents were still being withheld.†Gary wrote to the journal “The Federal Lawyer” the official, peer-reviewed journal of the U.S. Justice Dept Media reviewers are almost always ignorant of the facts of the case Lance DeHaven-Smith The CIA had to make up the term Conspiracy Theorists Carl Bernstein reported Church Committee had evidence that the CIA had over 400 assets in major American Media Neutron activation analysis is a scientific technique that was used to try to link JFK’s bullet fragments to Oswald’s rifle. It doesn’t work. Gary and Cyril Wecht explained in the journal, “The Federal Lawyer,” and elsewhere, that NAA couldn’t provably match the bullet fragments taken from JFK’s autopsy with Oswald’s rifle, and that Vincent Bugliosi misrepresented the NAA science. Charles Crenshaw, MD, a Parkland Hospital witness, an AMA member and Warren critic, sued the Journal of the American Medical Association (JAMA) for libel for falsely reporting Crenshaw’s claims in his book, “JFK – Conspiracy of Silence,” was bogus because he never saw JFK. Crenshaw was there; JAMA lost the suit, and it paid Crenshaw $215,000.00, plus court costs. George Lundberg was called and asked to slander the film “JFK” Warren Commisson defenders have no crediblity Louis Alvarez another example… Time after time we have been decieved and lied to by government Peter Dale Scott “You don’t rise to a powerful position in government unless they have the “goods” on you; that is, unless they have compromising information on you.” HSCA Medical panel was fixed from the start Only Cyril Wecht held his ground in the search for the truth
Urge urinary incontinence (UUI) places a significant emotional and physical burden on women affected. Sacral neuromodulation has been and remains a well-established implant-based therapy for UUI. The concept originated in the early 1970s from sacral anterior root stimulation research for neurogenic bladder, with human clinical trials beginning in 1982. Medtronic's InterStim device received FDA approval in 1997 for UUI, and in 1999 for urgency-frequency and nonobstructive urinary retention. This was a game changer for affected women. Now, as of August 5, 2026, the FDA has granted 510(k) clearance for a new, less invasive neuromodulation implant- placed in the ANKLE. This is the Revi Extend Implant system (BlueWind Medical). What was the phase 3 data on this? What does the “wearable controller device” look like? Listen in for details. 1. Lukacz ES, Santiago-Lastra Y, Albo ME, Brubaker L. Urinary Incontinence in Women: A Review. JAMA. 2017;318(16):1592–1604. doi:10.1001/jama.2017.121372. Amundsen CL, Sutherland SE, Heesakkers JPFA, et al. Three-year efficacy and safety of Revi implantable tibial neuromodulation from the pivotal OASIS study. J Urol. 2026;216(2):219-229. doi:10.1097/JU.00000000000050623. BlueWind Medical receives FDA 510(k) clearance for Revi Extend implant. News release. BlueWind Medical Ltd. August 5, 2026. Accessed August 5, 2026. https://www.businesswire.com/news/home/20260805290667/en/BlueWind-Medical-Receives-FDA-510k-Clearance-for-Revi-Extend-Implant
Today's guest, Dr. Meena Seshamani, ran Medicare at CMS and is now Secretary of Health in Maryland. She is leading one of the country's most ambitious health reform efforts: evolving Maryland's all-payer model, expanding investment in primary care, and using data infrastructure to strengthen coverage and population health—all while navigating the implementation of HR1. In this conversation, recorded at Aspen Ideas Health, Meena makes the case that policy design matters, but implementation is where its promise is realized or lost.Meena and Claudia discuss:How Maryland saved $1.6 billion for MedicareNew primary care investment strategiesHow the state is leveraging CRISP, the state's HIE, to implement HR1 and streamline enrollment in public programsMeena shares how Maryland is strengthening food systems using rural health transformation funding:“We are also taking rural health transformation dollars and investing in cold storage, food aggregators, and distribution hubs for our local Maryland farms, so that when we are doing outreach on healthy eating and providing nutritious food to people, that's actually coming from our local Maryland farms. So it's boosting the local economy in our rural areas as well.“Relevant LinksMaryland's Total Cost of Care Model: Evaluation of the First Four YearsArticle on the impact of Maryland's modelHow CRISP supports Medicaid redeterminationThe state's Rural Health Transformation planAbout Our GuestMeena Seshamani, MD, PhD serves as the Secretary of Health for Maryland in the Moore-Miller Administration, where she stewards a $20 billion health system that encompasses public health, Medicaid, disability, behavioral health, and 11 state-run hospitals. She leads the state's mission to improve the health and well-being of all Marylanders through a focus on accessibility, affordability, and equity.Under her leadership, Maryland has emerged as a national laboratory for healthcare innovation. Dr. Seshamani successfully negotiated a first-of-its-kind, multi-billion dollar healthcare payment model with federal partners and secured $168 million in inaugural funding to transform rural health delivery. Her tenure is also marked by a proactive approach to public health, exemplified by ensuring broad vaccine access in the state through the creation of a landmark program providing free vaccines to uninsured and underinsured residents—codifying health security as a statewide priority.Prior to her cabinet appointment, Dr. Seshamani served as Deputy Administrator and Director of the Center for Medicare at CMS. There, she executed the most significant pharmaceutical reform in decades: the Medicare Drug Price Negotiation program, achieving $6 billion in first-year savings. Her work at CMS fundamentally shifted the Medicare model to value-based care by introducing payments for community health services, caregiver training, and navigating patient care, while simultaneously tightening accountability and oversight.A board-certified head and neck surgeon and an Oxford-trained health economist, Dr. Seshamani's perspective is grounded in how health care policy and operations impact the real lives of patients. She previously served as Vice President of Clinical Care Transformation at MedStar Health, maintaining a surgical practice while leading large-scale system changes.A widely published author in the New England Journal of Medicine and JAMA, her insights are frequently sought by The New York Times, The Wall Street Journal, and major news networks. Dr. Seshamani holds her MD from Johns Hopkins University and her PhD from the University of Oxford, where she was a Marshall Scholar.SourceConnect With UsFor more information on The Other 80 please visit our website - www.theother80.com. To connect with our team, please email claudia@theother80.com and follow us on twitter @claudiawilliams and LinkedInSubscribe to The Other 80 on YouTube so you never miss our video extras or special video episodes!
Is it really a good idea to get medical care from online pharmacies posing as clinics?This week on Fat Science, Dr. Emily Cooper, Mark Wright, and Andrea Taylor dig into a Yale secret shopper study that tested 49 websites selling GLP-1 medications online. The websites look and market like medical clinics, but the study found that most patients never spoke to a clinician at all before getting a prescription. Dr. Cooper, Mark, and Andrea unpack what real medical care requires, why these platforms skip it, and what that means for anyone considering this route.KEY TAKEAWAYTwo-thirds of the sites in the study issued a prescription with no clinician contact of any kind — despite marketing themselves as medical clinics.Fewer than 40% asked for any clinical measurement (blood pressure, labs, etc.), and only 18% asked whether the patient even had a primary care doctor.Many of these sites are financially connected to compounding pharmacies and use leading questions to push add-ons that create untested drug combinations.Real medical care means a full history, objective labs, and ongoing monitoring — not a five-minute questionnaire and an automatic credit card charge.NOTABLE QUOTE"The marketing appears to be a medical clinic or a medical company, when in fact it's really just a sale of a drug." Dr. Emily CooperLINKS & RESOURCESStudy published in JAMA on the secret shopper findingsLinks & ResourcesPodcast Home: fatsciencepodcast.comCooper Center for Metabolism: coopermetabolic.comResources from Dr. Cooper: coopermetabolic.com/resourcesJoin Our Community: patreon.com/cw/FatSciencePodcastSubmit Your Question: questions@fatsciencepodcast.com or dr.c@fatsciencepodcast.comFat Science is supported by the Diabesity Institute, a nonprofit dedicated to increasing access to effective, science-based metabolic care.This podcast is for informational purposes only and is not intended as medical advice. Please consult with a qualified healthcare provider for personalized recommendations.
Editor's Summary by Linda Brubaker, MD, and Preeti Malani, MD, MSJ, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from August 1-7, 2026.
Improving patient access requires more than new processes. It also requires clinicians, administrators, and healthcare leaders to work toward a shared goal. In Part 2 of our conversation, Victor Hassid, MD, Associate Vice President of Access Strategic Operations at MD Anderson Cancer Center, discusses how organizations can align teams, overcome operational challenges and begin putting a patient safety approach to access into practice. You can listen to the first half of the conversation here. You can find Dr. Hassid's article in JAMA here. (paywall) Hosted on Acast. See acast.com/privacy for more information.
We got intellectually swole on creatine and astrology before this great episode! The main science topic was a study connecting carb oxidation to hydration status. We explain how hydration is the gateway to fueling.We also provided details of the first week of David's creatine experiment. There is some very strange heart rate data that we're tracking. Correlation or causation? We'll find out!And this one was full of fun topics! Other topics: bailing on workouts on bicarb days, how runners should think about improving bike power, tons of thoughts from the Tour de France including the massive power numbers and a follow-up on overnight drug testing, AI in mathematics, a fantastic article in JAMA on tendon healing, and questions on dealing with an identity crisis in athletics, stairmill v. biking, a listener passionate about oysters, a grooming tip, Malcolm Gladwell, stoppage time in runs, and low iron levels.You'll never look at Cheez-Its the same. We're sorry and/or thank you. We love you all! HUZZAH!-David and MeganClick "Get 40% Off" button for 40% off at The Feed here: thefeed.com/swapBuy Janji's amazing gear: https://janji.com (code "SWAP")Get a deal on the best treadmill on the market from Wahoo: https://www.wahoofitness.com/devices/running/treadmills/kickr-run-buy (code “SWAP”)For training plans, weekly bonus podcasts, heart rate zones, articles, and videos: patreon.com/swap
In this informative episode Dr. Tom Frieden former CDC director for eight years for President Obama shares his journey in public health. Tom discusses his 'See, Believe, Create' formula for better health, and insights on how individuals can contribute to global health improvements. Kimberly and Tom disscus practical tips for longevity, the importance of trust in public health, and stories from his global experiences, including Ebola and COVID-19 responses. Tom speaks about his new book; The Formula for Better Health: How to Save Millions of Lives and Your Own. Chapters00:00 Introduction to Dr. Tom Frieden's Journey02:56 The Philosophy of Service and Health05:47 Understanding the Formula: See, Believe, Create09:04 Navigating Misinformation in Public Health11:55 Experiences in Global Health: Ebola and Beyond14:51 Reflections on COVID-19 and Lessons Learned17:10 The Importance of Belief in Public Health19:59 The Legacy of Smallpox Eradication21:17 Preventable Health Issues Today23:19 Key Factors for a Healthy Life26:36 The Power of Physical Activity27:54 Nutrition and Its Impact on Health29:21 Environmental Toxins and Health Risks30:57 Fertility Challenges in Modern Society33:21 Creating a Healthier Future37:37 The Call to Action for Global HealthEpisode Sponsor: ANIMA MUNDI OFFER: Anima Mundi is giving Feel Good Podcast listeners their largest discount of the year. It's a great opportunity to treat yourself or a friend to some soothing self-care by going to AnimaMundiHerbals.com and use the code: SOLLUNA20 for 20% off your purchase. USE LINK: AnimaMundiHerbals.com Code: SOLLUNA20 for 20% off your purchase.Dr. Tom Frieden Resources: Book: The Formula for Better Health: How to Save Millions of Lives—Including Your OwnWebsite: resolvetosavelives.orgSocial: X @drtomfriedenBio: Dr. Tom Frieden is a physician specializing in internal medicine, infectious diseases, public health, and epidemiology. He led New York City's control of multidrug-resistant tuberculosis and other health threats, directed the CDC during the Ebola epidemic, and helped start Mayor Michael Bloomberg's global health philanthropy, particularly the Bloomberg Initiative to Reduce Tobacco Use, which has helped countries implement measures that will prevent more than 35 million deaths. His work has appeared in medical journals including The New EnglandJournal of Medicine, JAMA, and The Lancet as well as media outlets including the New York Times, Washington Post, and The Wall Street Journal. Dr. Frieden is the founder and CEO of Resolve to Save Lives, a global health organization that accelerates action against the world's deadliest health threats. The organization has partnered with countries around the world to support implementation of programs that will prevent more than 9 million deaths.Dr. Frieden's forthcoming book, The Formula for Better Health: How to Save Millions of Lives—Including Your Own (MIT Press, September 2025), distills four decades of public health leadership into a clear, actionable framework to extend healthy lives. Drawing from real-world successes and failures, the book bridges the lethal gap between scientific knowledge and life-saving action.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Neurologist Dr. David Perlmutter Explains Brain Inflammation and Alzheimer's Risk Your brain has its own immune system, and when it turns against you, it becomes the hidden driver behind Alzheimer's, Parkinson's, depression, and even long COVID. This episode hands you the science to recognize it early and reverse it. Get Dr. Perlmutter's new book Brain Defenders: https://drperlmutter.com/books/brain-defenders/ Host Dave Asprey sits down with Dr. David Perlmutter, a board-certified neurologist and six-time New York Times bestselling author whose work sits at the intersection of neurology, nutrition, and brain health. He is a Fellow of the American College of Nutrition, serves on its Board of Directors, and sits on the Editorial Board of the Journal of Alzheimer's Disease. His books, including the number one bestseller Grain Brain, span 32 languages and have sold over a million copies, and his upcoming release, Brain Defenders, explores the pivotal role of microglia, the brain's immune cells, in protecting, repairing, and reprogramming the brain for lifelong resilience. Dave and Dr. Perlmutter break down how microglia, the brain's resident immune cells, shift from a supportive state into a destructive one called M1, and why this shift, not amyloid plaque, may be the real driver of Alzheimer's, Parkinson's, and other neurodegenerative conditions. They dig into why the leading amyloid-clearing drugs fail to improve cognition, what a landmark JAMA study revealed about reversing cognitive decline through lifestyle intervention alone, and why a single daily serving of ultra-processed food raised Alzheimer's risk by 13 percent in a 12.7 year study. They also cover new research on GLP-1 drugs and brain inflammation, the surprising role of gum disease and oral bacteria in dementia risk, and why 40 hertz light therapy is emerging as a low-cost tool for clearing brain plaque and calming neuroinflammation. You'll Learn: Why the shift from supportive to destructive brain immune cells may be the true root cause of Alzheimer's and Parkinson's Why leading Alzheimer's drugs fail to improve cognition, and what the original research behind the amyloid hypothesis actually showed How one daily serving of ultra-processed food raises Alzheimer's risk, and what a landmark lifestyle intervention study found instead Whether GLP-1 drugs help or harm brain inflammation, based on new Parkinson's and Alzheimer's trial data How gum disease and oral bacteria are linked to dementia, and simple daily habits that reduce that risk Why 40 hertz light therapy is emerging as a tool to clear brain plaque and calm neuroinflammation How ketones, DHA, and metabolic health protect the brain after head injury Thank you to our sponsors! - Beyond Wonderland Conference | Oct 13 - 14, 2026. Get your ticket now at wonderlandconference.com. - ZenBud | Dave's Nervous System Biohack. Visit zenbud.health and use code DAVE15 at checkout for a discount. - Pique | Head over to Piquelife.com/Dave to get 20% off your order. That's P-I-Q-U-E life dot com slash DAVE - PredictiveMind™ | Get your Brain Pattern Mapping report at predictivemind.io/dave and use code DAVE for 10% off. Dave Asprey is a four-time New York Times bestselling author, founder of Bulletproof Coffee, and the father of biohacking. With over 1,000 interviews and 1 million monthly listeners, The Human Upgrade brings you the knowledge to take control of your biology, extend your longevity, and optimize every system in your body and mind. Each episode delivers cutting-edge insights inhealth, performance, neuroscience, supplements, nutrition, biohacking, emotional intelligence, and conscious living. New episodes are released every Tuesday, Thursday, Friday, and Sunday (BONUS). Dave asks the questions no one else will and gives you real tools to become stronger, smarter, and more resilient. Keywords: microglia, brain inflammation, Alzheimer's prevention, Parkinson's disease, amyloid hypothesis, neurodegeneration, GLP-1 drugs, semaglutide, ultra-processed food, gum disease and dementia, oral microbiome, 40 hertz light therapy, ketones, DHA, mitochondria, brain fog, long COVID, David Perlmutter, Brain Defenders, Grain Brain, functional medicine, biohacking, longevity, neuroplasticity Resources: • Get Dr. Perlmutter's New Book Brain Defenders: https://drperlmutter.com/books/brain-defenders/ • Learn More About Dr. Perlmutter's Work At: https://drperlmutter.com/ • Get My 2026 Clean Nicotine Roadmap | Enroll for free at https://daveasprey.com/2026-clean-nicotine-roadmap/ • Dave Asprey's Latest News | Go to https://daveasprey.com/ to join Inside Track today. • Danger Coffee: https://dangercoffee.com/discount/dave15? • My Daily Supplements: SuppGrade Labs (15% Off) • Favorite Blue Light Blocking Glasses: TrueDark (15% Off) • Dave Asprey's BEYOND Conference: https://beyondconference.com • Dave Asprey's New Book – Heavily Meditated: https://daveasprey.com/heavily-meditated • Join My Substack (Live Access To Podcast Recordings): https://substack.daveasprey.com/ • Upgrade Labs: https://upgradelabs.com Timestamps: 00:00 – Trailer 00:40 – Intro 02:38 – Ultra-Processed Foods 06:34 – Are Carbs Bad? 08:48 – Alcohol & Brain Health 12:28 – Microglia & Inflammation 24:37 – Head Injury & Recovery 29:27 – Oral Bacteria & Dementia 34:08 – GLP-1s & Brain Inflammation 40:20 – 40 Hertz Light Therapy 48:35 – Air Pollution vs. Lead 50:27 – David's Closing Truth See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
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