Podcasts about Johns Hopkins

How to Reverse Cognitive Decline, Grow Your Hippocampus, and Protect Your Brain from Alzheimer's Disease with Nutrition, Exercise, Sleep, and Stress Reduction Your brain is physically shrinking right now, and most people have no idea it's happening. In this episode, you will discover the exact mechanisms behind cognitive decline, why brain fog is always treatable, and the proven strategies to grow your brain back, protect your memory, and slash your Alzheimer's risk regardless of your genetics. -Watch this episode on YouTube for the full video experience: https://www.youtube.com/@DaveAspreyBPR Host Dave Asprey sits down with Dr. Majid Fotuhi, a neuroscientist and neurologist who earned his PhD from Johns Hopkins University and his medical degree from Harvard Medical School. He currently serves as an adjunct professor at the Mind/Brain Institute at Johns Hopkins while also teaching at George Washington University and Harvard Medical School. With 37 years of experience in clinical practice, teaching, and neuroscience research, Dr. Fotuhi pioneered the Brain Fitness Program, a multidisciplinary approach to cognitive performance and brain vitality at any age that has produced measurable results documented in peer-reviewed journals. He is the author of three books including the bestselling The Invincible Brain and one of the world's leading experts on neuroplasticity, hippocampus growth, and successful aging. If anyone has earned the right to tell you your brain can get better, it is him. Dr. Fotuhi and Dave break down why Alzheimer's is not a single disease but a soup of modifiable problems, why your lab results can show "normal" while your brain is starving, and how the five pillars of brain health connect directly to longevity, mitochondria function, and human performance. They also get into the brain effects of GLP-1s, the therapeutic promise of psychedelics like psilocybin and ketamine, the role of nootropics and supplements like B12, lithium orotate, and CoQ10, and why your VO2 max may be the single most important number for brain aging. . You'll Learn: Why 97% of Alzheimer's cases involve multiple modifiable causes and what to do about each one How to physically grow your hippocampus through exercise, meditation, and nutrition Why "normal" lab ranges are actively harming millions of people and what optimal actually looks like The 7 everyday things that are shrinking your brain right now How stress, loneliness, and isolation cause measurable brain atrophy Which supplements including B12, lithium orotate, CoQ10, and nootropics support long-term brain health Why VO2 max predicts brain aging better than almost any other marker What psychedelics like psilocybin and ketamine actually do to your brain according to a Johns Hopkins neurologist How the APOE4 gene affects Alzheimer's risk and why exercise can erase that risk entirely Why mitochondria health is the foundation of both brain function and longevity Thank you to our sponsors! - Viome | Check it out at viome.com and use code 10DAVE for 10% off. It's time to stop guessing and start knowing your body. - BrainTap | Go to http://braintap.com/dave to get $100 off the BrainTap Power Bundle. - Pique | Go to Piquelife.com/dave for 20% off. - BodyHealth | Visit BodyHeath.com and use code DAVE20 for 20% off your first purchase 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: Majid Fotuhi, Dr. Majid Fotuhi, The Invincible Brain, brain health, cognitive decline, Alzheimer's prevention, hippocampus, neuroplasticity, brain fog, memory loss, APOE4, brain shrinkage, B12 deficiency, lithium orotate, CoQ10, nootropics, VO2 max, mitochondria, longevity, anti-aging, biohacking, brain optimization, sleep optimization, stress reduction, functional medicine, human performance, psilocybin, ketamine, GLP-1, semaglutide, telomeres, BDNF, brain training, cognitive performance Resources: • Learn More About Dr. Fotuhi's Work At: https://drfotuhi.com/ • Purchase Dr. Fotuhi's New Book The Invincible Brain: https://a.co/d/0iHCgPpL • 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 00:59 – Intro 03:00 – Cannabis & Nicotine 04:15 – Understanding Alzheimer's 05:38 – Five Pillars Explained 07:55 – Best Cognitive Training 09:08 – Brain Size & Growth 12:36 – B12 & Lab Ranges 17:48 – Head-to-Toe Evaluation 24:17 – Sex & Brain Health 25:43 – Loneliness & Isolation 33:59 – ApoE4 Genetics 35:28 – Alzheimer's Declining 48:44 – Lithium & Brain 59:38 – VO2 Max & Fitness 1:06:42 – Psychedelics 1:09:38 – GLP-1s & Brain 1:12:38 – Closing & Action Steps See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

A new, comprehensive study takes a look at lifestyle factors and colorectal cancer in younger people and fails to find a relationship. Kimmel Cancer Center director William Nelson at Johns Hopkins says he thinks it may be more subtle and … Is there a relationship between diet, obesity and colorectal cancer? Elizabeth Tracey reports Read More »

Daraxonrasib is the name of a drug for pancreas cancer that almost doubled survival for people with the disease in a clinical trial. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says while the drug is going … A new drug for pancreas cancer may be a game changer, Elizabeth Tracey reports Read More »

In trying to discern factors that may account for colorectal cancer incidence in younger people many diet and lifestyle factors fell short, a new study finds. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, points toward insulin … Will GLP1 drugs tease out the relationship between insulin and cancer? Elizabeth Tracey reports Read More »

Johns Hopkins foreign policy analyst Jeffrey Pryce is sceptical of US President Donald Trump's claim that an agreement in the Middle East is approved and ready to be signed. Speaking to Francesca Rudkin, Pryce pointed to the extensive demands in a proposed Memorandum of Understanding from several weeks ago, which did not progress. That MoU had included a permanent ceasefire, likely including Lebanon; the opening of the Strait of Hormuz and removal of the US naval blockade; and the beginning of nuclear negotiations, possibly including progress on unfreezing Iranian assets or lifting sanctions on Iran. There was also a push for the Gulf states to sign the Abraham Accords – all of which was “a lot to put into an agreement”. Pryce did agree with Trump that the Iranian decision-making progress could be very extended. “Things have to be brought up to the Supreme Leader, who is by all accounts severely injured, and they have a sort of a long, painstaking process of decision making. So it's possible that we're getting closer to a deal.” LISTEN ABOVE See omnystudio.com/listener for privacy information.

This week on Catalyst, Tammy is joined by Sezin Palmer, AI Solutions Leader at NTT DATA in North America. Sezin traces her impressive and unconventional journey from CIA analyst and Navy submarine warfare programs to building the National Health Mission area at Johns Hopkins' Applied Physics Lab from scratch, then leading health AI and data at EY. Tammy and Sezin dig into the democratization of AI and what it means that capabilities once locked behind years of data science training are now accessible to nearly anyone. They also discuss the thorny challenge of how organizations decide what not to build and why the hardest leadership problem right now isn't launching AI, it's knowing when to stop. Sezin also shares her vision for what has her most excited: the convergence of software, robotics, and biology. Please note that the views expressed may not necessarily be those of NTT DATALinks: Sezin Palmer Learn more about Launch by NTT DATASee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Episode 138 When One Plus One Equals Three: A Conversation with National Aphasia Synergy               In this episode you will discover: 1.  People with aphasia hold the map. At NAS, people with aphasia don't just have a seat at the table — they built the table. Real peer leadership changes everything about how an organization thinks and acts. 2.  Recovery is about more than speech. The isolation and psychological distress that follow aphasia are just as real as the communication challenges — and just as deserving of attention and support. 3.  Peer-befriending is life participation in action. When people with aphasia support one another through shared experience, that's not a supplement to good care — it is good care. 4.  Sinergia: one plus one equals three. When survivors and professionals work as true equals, something greater emerges than either could create alone. June is National Aphasia Awareness Month, and around here, that means it's time for one of my favorite podcast traditions. For the past few years running, we've spent this month in conversation with people who know aphasia from the inside — those living it every day. Today is no exception, and this one is a conversation I've genuinely been looking forward to.   Welcome to the Aphasia Access Conversations Podcast. I'm Katie Strong from Central Michigan University, where I lead the Strong Story Lab, and I'm a member of the Aphasia Access Podcast Working Group. Aphasia Access is dedicated to transforming services and environments so people with aphasia can participate more fully in life — and today's guests are living proof of exactly what that looks like.         Today I'm speaking with two leaders from National Aphasia Synergy — known as NAS — a peer-led nonprofit founded in 2021 by people with aphasia, for people with aphasia. NAS was built on the belief that those living with aphasia are best positioned to support others on the same journey. Through peer-befriending, technology empowerment, and community building, NAS works to end the isolation that so often follows a stroke — connecting people across the country through a shared sense of what they call Sinergia: the idea that when survivors and professionals work as true equals, one plus one equals three.   Today's conversation feels especially meaningful to me. I've had the privilege of seeing Trish and Amy in action at conferences like Aphasia Access and ASHA — learning from their presentations and watching their advocacy make ripples far beyond those conference walls. As someone who researches friendship and aphasia, I've followed the peer befriending movement closely — it began in the UK, and when I heard that NAS was bringing it to the United States, led by a peer organization, I thought: this is what life participation actually looks like.   Before we get into the conversation, let me tell you a bit more about our guests.   Trish Hambridge is the President and Founder of National Aphasia Synergy. Trish has lived with aphasia since her stroke in 2008, and that experience is the foundation of everything she has built. A former project manager for AppleCare, Trish has become not only a powerful advocate but a published researcher — partnering with research teams to influence the questions being asked and the evidence being built in our field. Her co-authored work spans game-based rehabilitation design, posttraumatic growth in aphasia, and the measurement of motivation and psychological needs in aphasia rehabilitation — all published in leading journals including the American Journal of Speech-Language Pathology. She has spoken at conferences including the Aphasia Access Leadership Summit, Aphasia Access Chautauqua and ASHA, serves on the Disability Advisory Committee in Dunedin, Florida, and is a member of Voices of Hope for Aphasia. Her vision brought NAS to life, and her leadership — in the clinic, in the research literature, and in the community — continues to shape it.   Amy Walters is the Vice President of National Aphasia Synergy. Amy has lived with aphasia since her stroke in 2018 — a stroke that, in a striking twist of fate, occurred while she was attending a neurosurgical conference. A Harvard graduate with a Master of Public Health from Johns Hopkins, Amy spent 30 years as a senior leader in the medical device industry before her stroke, and she has channeled that same expertise and drive into aphasia advocacy. She has presented at neurosurgical conferences to raise awareness, participates in aphasia groups across the country, and brings a remarkable combination of professional knowledge and lived experience to everything NAS does.   So — let's get into the conversation.   Katie Strong: Trish and Amy, welcome. I'm so excited to have you both here today and learn about what's going on in National Aphasia Synergy.   Trish Hambridge: Thank you for the chance to meet.   Amy Walters: We are so pleased to be here with the Aphasia Access Community. Katie Strong: Well, we're delighted that you are sharing your time and expertise with us. I wanted to get started by asking about National Aphasia Synergy. How was it created? Just wondering if you could share the origin story of the organization and how that concept of synergy or working together defines your mission. Trish Hambridge: Long time ago, I had a stroke, major stroke. But I was the same person then as I am now. I remember sitting on the hospital patio in San Jose and Karen, my good friend from college and speech therapist was there, and she was teaching everyone about aphasia. My friends and family were so patient. I remember my Dad talking to me and say, "You are stubborn." and I said, "Thank you!" Because that choice – being subborn - changed everything and gave me the chance to get my identity back. Katie Strong: So, Trish, just to verify, you're saying your stubbornness got you where you are right now. Trish Hambridge: Yes, but yes! Katie Strong: Love it. Trish Hambridge: Sorry to say, I have issues! But going back to the beginning, I had only had five words. Even my 'yes' and 'no' were flipped. Traditional homework is not my cup of tea. Shhh! Quiet, I'm lazy! I needed a better strategy, and I found it with P2Go. It's so much more than an app. It is the tool that gave me my voice back. Katie Strong: I love that, so if I'm understanding correctly, traditional homework is not for you, and that you really needed something that was technology based, which goes back to your expertise in your life, career to be able to really help you communicate, and it was the P2Go. Trish Hambridge: Yeah, yeah, is small, is so, is easy, my opinion. Katie Strong: Well, that's what we're here for today, is your opinion. Trish Hambridge: In 2016, a move to Dunedin, Florida changed everything. I joined Voices of Hope and finally found my community. Then the pandemic hit. But it couldn't stop our connection. We moved to Zoom. I want to be honest, though: some of my friends didn't make it through that storm. Their pain is part of this journey. We build this community in their honor. Katie Strong: Oh, that's really touching, you know. It is. It's hard, so many friends don't stay in our lives for many reasons, but aphasia can really be a challenge for friends sticking around. Trish Hambridge: Yeah, and the technology is not my cup of tea. Katie Strong: Wonderful, wonderful. Thank you for sharing that. Trish Hambridge: In 2021, I stepped up. I moved from a 'Lead Pathfinder' to the Founder of National Aphasia Synergy. I reached out to Debbie Yones, the big cheese of Voices of Hope. She and the Board Director gave me wise advice to help me grow. I didn't do it alone. My sister and my sister-in-law helped me think through the logistics. They helped me build the support for the nonprofit. Because of them, my vision became a reality. Katie Strong: So, your consultation with those important people to your life really helped National Aphasia Synergy become a reality. Trish Hambridge: Yeah. Finally, I asked Amy to join the mission. She became part of the organization. Now, we are moving forward together. Katie Strong: Thanks, Trish. I love that. Amy Walters: Thanks, Trish. Nine years ago, I had my stroke at the neurosurgical conference. Ironic, right? Yeah, the conference was in Colorado Springs. I was in a medically induced coma for 10 days and diagnosed with Global Aphasia. Then I was airlifted to the Shepherd Center in Atlanta, Georgia, where I had a craniotomy and cranioplasty. On the flight I remembered thinking, "Am I in a simulator? What's happening to me?"   Katie Strong: Wow! That sounds surreal! Amy Walters: My career was in clinical affairs for a medical neurosurgical device company, so I am professionally and personally familiar with neuroplasticity. I know how crucial neuroplasticity is to our physical, mental, and emotional recovery. National Aphasia Synergy was born from a deep need for collaborative survivor-led company. Katie Strong: The advocacy you're doing is really amazing, and I'm so excited for our listeners to be able to hear more about it. Amy Walters: Thank you. When we look at the aphasia community today, we see massive gaps. Most organizations are built for us, but they aren't led by us. The 'medical way' focuses only on the speech deficit, but it leaves a gaping hole in mental health, identity, and social connection. The research is heartbreaking: 40% to 60% of stroke survivors with aphasia experience chronic depression, and in early recovery, a staggering 93% experience high levels of psychological distress. This isn't just about the survivor—46% of our family members also face depression. Our mission is to bridge those gaps. We aren't just here to 'fix' speech; we are here to empower the whole person. We call it Sinergia—the Greek word for Synergy. It means we don't work in silos. We don't have 'experts' on one side and 'patients' on the other. We have a partnership where 1 plus 1 equals 3.   Katie Strong: I love it!   Amy Walters: We are moving away from the isolated patient model and toward a Sinergia where survivors and professionals work as equals to reclaim our lives. We are here to educate and empower our peers to use technology to reclaim their voices. But more importantly, we are here to promote peer-befriending. We reach out to those who are new to this path or struggling to find their way, because no one should walk this road alone. Katie Strong: I know, Amy, I just am so excited. I've been watching this peer befriending happen over in the UK, or reading about it, and hearing about it, and I was just so delighted when I heard that National Aphasia Synergy was taking this up and helping us to, to have a really solid connection. I think one of the things that breaks my heart the most is when I meet someone who has aphasia, who's been living with aphasia for a really long time, and they've never met anyone else who had aphasia. Amy Walters: Heartbreaking. Katie Strong: It really is. It really is. Amy Walters: Our goal is to develop a national community that encourages optimism. We believe a positive outlook isn't just a 'nice feeling'—it is a strategy for recovery. Katie Strong: Heck, yes! Amy Walters: At NAS, we don't just look for what's lost; we build on the strengths that remain. There were gaps in the Aphasia Community. Trish Hambridge: Speech Therapists and care partners are vital to recovery. They have good intentions, but the 'medical way' is often the wrong way. Katie Strong: Yeah, yeah, it's not quite the right way. Trish Hambridge: Many researchers only survey the Speech Therapists and the partners. But what about me? What about us? What am I, chopped liver? Think about the last time someone completely iced us out. It hurts, right? It honestly chips away at our sense of self, leaving us clueless as to where we actually fit in. Katie Strong: Yeah, so Trish, just to recap this for the listeners, you're saying when somebody ices you out, you're asking the listeners to reflect on how that really feels, Trish Hambridge: Yeah, I email [a researcher], and have offered [to be a part of their team] but they are like "Oh no, but sorry." Katie Strong: I hear, I hear you. Yeah and I think what you're bringing up - and you and Amy are bringing up such a great point that as the aphasia research community has not always included people with aphasia. Or they're only including people with mild aphasia versus more severe types of aphasia, so I love that you're calling this out and shining light on it. It's, it's time. Trish Hambridge Here's what the research tells us. Therapists and partners see the journey from the outside. But those of us living it? We know the honest truth. Katie Strong: Yeah, yeah, so as the clinicians, the therapists, and the care partners see that journey from the outside, and you all are living it for sure. Trish Hambridge: It is the 'Chicken and the Egg' problem: Does the partner change first? Or does the people with aphasia change? The answer is: The Environment. We must change the environment to find true recovery. We need to move from being 'patients' to being Lead Pathfinders. Katie Strong: Yes, so I love it. You're, you're flipping the script there and reclaiming your identity, or renegotiating it from that patient role to being a lead pathfinder. I love that terminology. Thank you. Thank you. One of you said this earlier that organizations are for people with aphasia, but National Aphasia Synergy is led by people with aphasia. Why is this distinction critical for the community to understand, and how does it change the way an organization is run? Amy Walters: Right, Katie. In the past, organizations were built for us, like a charity. But National Aphasia Synergy is different. We are led by people with aphasia. We are moving from 'being helped' to leading. This is more than an organization. It is a revolution of identity. At National Aphasia Synergy, we are flipping the script on leadership. Our Board makes decisions with one clear priority: putting voices with aphasia at the forefront. That means leaders like Trish, Bruce, and me are the ones making the big calls. We collaborate with wonderful professionals, like Kait, our SLP, Helen, our Financial and Secretarial support and Will Evans, our Volunteer Consultant. They are essential to our success. They ensure our communication is accessible and our business stays strong. I always think of our board meetings being like a United Nations meeting with "international representatives" (i.e., China, France, Japan, etc.) each of us is coming to the table with a different lived experience, different aphasia types, etc. We work together to "translate" and work through our differing communication styles. But make no mistake: The people with aphasia are the primary drivers of the vision. The professionals provide the tools, but we hold the maps.   Katie Strong: Such a great analogy. I love it and it also sounds like your work is fun too.   Amy Walters: Driving you crazy, but you mean you mean you mean, yeah. Hold the phone!   Katie Strong: Oh, that's great. I love it. Well, what does National Aphasia Synergy offer that others should know about? Trish Hambridge: Look at what we have built together: First, our Peer Befriending Program. A team of four SLPs and four people with aphasia worked as equals to create our training. Today, we have 15 volunteer Allies trained and ready to support the community. Katie Strong: I love it. So, 15 people with aphasia, volunteer Allies, have been trained as peer befrienders to go out and connect with other people who newly have aphasia. Trish Hambridge: Right, but anything like… Katie Strong: Or rather, anybody who has aphasia that they're wanting to connect with. Trish Hambridge: Come! Come! But we meet on Zoom.    Katie Strong: On Zoom, right? Yeah, absolutely. This is all virtual, which is amazing, you know, because you get a good reach, a really, a really great reach. What else is going on? Amy Walters: Second, our Aphasia & Mental Health Video. We have four excellent SLPs sharing the research, stats, resources and the power of neuroplasticity. And we also surveyed 10 people with aphasia to capture the honest truth of our emotional journeys and provide 10 essential tips for recovery. Trish Hambridge: I always start with a roadmap. But originally, we were filming something completely different. But three weeks before the shoot, I went to Debbie and asked: 'What do you think?' She said, 'There are enough basic videos out there... why doesn't NAS focus on Mental Health?' Katie Strong: Yeah, okay. So, you were doing all this planning, and then three weeks before the shoot, you went and talked to Debbie and said, "What do you think?" And she said, "There's already enough videos out there on basic aphasia, but not on mental health. I love it! Trish Hambridge: Yeah and so I agree!!! We agreed right away. We made a right turn...  And changed the plan on the fly! I ran a preview for my friends at Voices of Hope. They loved it, but they asked the killer question: 'Where is the actual resource? Where do we go for help?' Katie Strong: Trish, you are speaking to my heart here, and I know I'm one of those "outsider perspectives" as a clinician. But we just don't have great resources for mental health. It's really challenging. So, I love that your friends at Voices of Hope called you out on that. What happened after that? Amy Walters: That was the lightbulb moment, right? Trish Hambridge: Yeah, a video wasn't enough—we needed a map. So, we built the Aphasia and Mental Health Resources paper. The researchers and I had some serious back-and-forth debate, but that's how you get a solid plan. We ended up with something really cool: real tools for real people. Katie Strong: Love, love it! Trish Hambridge: Third, our Adaptive Growth Culture paper. This provides a brand-new map for recovery that the whole world can use to look past the 'broken parts.' Katie Strong: Yeah, Trish, I've heard you speak on this. That talk you gave it, ASHA. I'm going to say listeners, particularly clinicians, you should check this out, because we need to get our clients with aphasia, our lead pathfinders with aphasia to be able to  think in this sort of way, so yeah, Trish Hambridge: But like I have like the speech therapist and the caregiver, and people with aphasia -  it like, look right -- is the good plan. Katie Strong: Love it, fantastic, Amy Walters: Kait and I shared five powerful aphasia stories on video to show our diversity, our strength, our inhumanity, frankly. All of this lives on our National Synergy website. These aren't just projects, they are the proof that when people with aphasia lead, we create world that actually works for us. Katie Strong: Oh, this is fantastic. And we'll have links to your website in the show notes, but you can certainly Google National Aphasia Synergy, and the website pops right up. I've been exploring it for a little bit, but I was looking at it again this morning, and there's just such great, great stuff on there. So please go and check it out. Well, I'm curious, Amy and Trish, what's on the horizon for National Aphasia Synergy, and how can our listeners, whether they're Aphasia Access members or people living with aphasia get involved or support your work. Amy Walters: We are so proud of what we have built, but we are just getting started. This is our Call to Action. Trish Hambridge: We want the world to get excited about Mental Health!  Katie Strong: And I think get excited about your Adaptive Growth Culture too. Trish Hambridge: Yeah! We recently presented a poster at the Chautauqua virtual conference, and the feedback from Aphasia Access members was powerful. The keynote speaker, Dr. Nina Simmons-Mackie, spoke about moving from 'managing a condition' to 'owning a life.' That is exactly what we do! We focus on the strengths, the emotions, and the identity that the old medical model ignores. Katie Strong: Yeah, so okay. So, Trish, you, you were, I think you presented you National Aphasia Synergy presented a poster at the Chautauqua, the Aphasia Access Chautauqua recently. Trish Hambridge: First time presenting a poster! Katie Strong: I love it, I love it. Yep, and the feedback that you got from the Chautauqua attendees was spectacular, right? And that's when, and, and, and Dr. Simmons-Mackie or Nina Simmons Mackey took that idea and we wove it into her keynote at the end, right, and talked about how it's important for us to support people and people with aphasia and care partners move from managing a condition to owning a life. I mean, that that's powerful stuff. I love it! Trish Hambridge: I'm so honored. Katie Strong: Well, you are out there making an impact. Amy Walters: Thank you. We are building something historic, and we want you to be part of it. Here is how you can join the revolution: Trish Hambridge: To the speech therapists and researchers, Help us build our evidence base. We want the test that adapted growth culture map to prove how it improves mental health and builds confidence. Don't just watch from the sidelines—come test this with us! Soon, I'm taking the Adaptive Growth Culture to the global stage. I'll be at the International Aphasia  Rehabilitation Conference in Athens. Katie Strong: You'll be at the International Aphasia Rehabilitation Conference, or IARC, in… Trish Hambridge: Athens!! I am presenting our Adaptive Growth Culture Poster to the top minds in the field. Katie Strong: Fantastic. Trish Hambridge: We have built the roadmap. Now, the researchers will provide the data-driven proof. It is time to see the Adaptive Growth Culture in action. We are moving from lived experience to clinical evidence. Katie Strong: I love it, moving from lived experience to clinical evidence. Amy Walters: That's right, that's right, Trish. If you run a community group, a local program, or a support network, we want to connect with you. Help us build this referral network so that no one is left behind in isolation. We aren't just looking for 'places to go' to pass the time. We are looking for places where we can belong and grow. We are looking for communities that see our potential, not just our deficits. To my peers with Aphasia: Your voice is our power. Share your story or send us a shout-out with your favorite tips and tricks. We also need Buddies for our Peer Befriending program. Help us show the world that we are truly 'owning our lives.' To the Volunteers: We are looking for passionate people to join our Board of Directors. We specifically need one more person with aphasia, as well as SLPs, care partners, and friends. The only requirement? You must believe in the Adaptive Growth Culture. Whether you have the tools or you hold the map, there is a seat at the table for you. Visit us and let's grow together! Katie Strong: Amazing. I hope that our listeners will take you up on the offers that you just laid out there, and that they'll also go out there and share with others that they need to hook everybody up with National Aphasia Synergy. It's a great organization. I enjoyed learning about it more today. And Amy and Trish, I so appreciate you both being here with us and sharing your stories and the amazing work that's going on in National Aphasia Synergy. Trish Hambridge: Thank you. Aphasia Access is fantastic! Katie Strong: I'm glad that you're enjoying Aphasia Access, too. It's a great network, and it's great that we're having lots of communities continue to grow and blossom to support people living successfully with aphasia.   Amy Walters: Hear, Hear! Katie Strong: Thanks. You too. Amy Walters: Thank you. Katie Strong: Have fun in Greece. Trish Hambridge: Yay! Amy Walters: Jealous! Katie Strong: Me too, me too. Amy Walters: Bye, bye. Trish Hambridge: See you. Bye.   On behalf of Aphasia Access, thank you for listening. For references and resources mentioned in today's show, please see our show notes, available on our website at www.aphasiaaccess.org. There you can also become a member of our organization, browse our growing library of materials, and find out about the Aphasia Access Academy. If you have an idea for a future podcast episode, email us at info@aphasiaaccess.org. For Aphasia Access Conversations, here at Central Michigan University in the Strong Story Lab, I'm Katie Strong.     Resources   Below is a list of links to the National Aphasia Synergy (NAS) resources and other organizations as discussed:  NAS Website:  https://nationalaphasiasynergy.org NAS email:  info@nationalaphasiasynergy.org   NAS Facebook page:  https://www.facebook.com/WeRSynergy (to keep up with what's going on at NAS and for inspirational, adaptive growth mindset content) NAS YouTube Channel: https://www.youtube.com/@nationalaphasiasynergy1410 (to watch our Aphasia Stories series, learn about resources, and tune into our quarterly video newsletter, "The Synergy Turf" to hear real people with aphasia) NAS Adaptive Growth Culture paper: https://drive.google.com/file/d/1VIq0juI4FTPKqF0Cev8qZAI5I5po5ouO/view?usp=share_link NAS "You Have Options!" Paper:  https://drive.google.com/file/d/1PBgvb1mDrjnFASaK_dpGL2gnZND_CjaU/view?usp=share_link NAS Aphasia & Mental Health video: https://www.youtube.com/watch?v=GThkxrKbQTI NAS Aphasia & Mental Health Resource paper:  https://drive.google.com/file/d/1pXbFLtZJ8KZ9Pxpg3HVZHBEd_D7BnsED/view?usp=share_link NAS Aphasia Stories video series: https://youtube.com/playlist?list=PLk1GJP6QGrPDOapMhQlmAUBHfVb5-Mnfi&si=BIuoNmeu-TM-ab65NAS  Peer Befriending: To get involved with NAS Peer Befriending, contact  info@nationalaphasiasynergy.org o Flyer:  https://drive.google.com/file/d/1dCETc1pZck59mw6OgaEjZGnXWOcdSlCh/view?usp=sharing o Video:  https://youtu.be/0RNvCeh0BKM   Referenced resources and organizations: Proloquo2Go AAC App mentioned (what Trish uses):  https://www.assistiveware.com/products/proloquo2go Voices of Hope for Aphasia: https://www.vohaphasia.org/    

Cholesterol management, per new guidelines from the American College of Cardiology, is just one aspect of measures you can take to lower your risk for cardiovascular disease, the number one cause of death. Roger Blumenthal, a cardiologist at Johns Hopkins … What's involved in lowering your risk for cardiovascular disease? Elizabeth Tracey reports Read More »

New guidelines for managing cholesterol levels have recently been released by the American College of Cardiology. Cardiologist Roger Blumenthal at Johns Hopkins chaired the committee that wrote the guidelines, and says that in reviewing the data it became clear that … Certain groups of people seem to be missing out when it comes to optimizing cardiovascular disease prevention, Elizabeth Tracey reports Read More »

On this episode of The Jon Gordon Podcast, I sit down with Dr. John Gildea—a pioneering researcher on gut health, soil and healing.   Our conversation goes deeper than science, tracing Dr. Gildea's unlikely journey from the lab at the University of Virginia to becoming an integral voice in the movement to restore health through soil-based nutrition. Dr. Gildea shares how his partnership with Dr. Zach Bush set him on the path to groundbreaking discoveries in gut health. Together, we discuss the debilitating personal battle I faced with gut issues for over a decade, and how his research and soil-derived formula became the catalyst for my healing—a story echoed by countless others. Throughout the episode, we unpack the science behind gut barriers, explain how environmental toxins like glyphosate disrupt our health, and reveal why reconnecting to nature's intelligence can help the body heal itself from the inside out. Dr. Gildea demystifies the complex processes at play, explaining the pivotal role of NRF2 and the remarkable results he's witnessed firsthand—even in the most challenging cases. Whether you're struggling with chronic gut issues, curious about the root causes of inflammation, or seeking hope for true health, this conversation is a testament to breakthrough science and the power of nature's solutions. Tune in for an inspiring reminder that healing is possible and that there are answers waiting for those who refuse to give up. To get the ION product that healed my gut and changed my life go here: Gut Support Skin Support Pet Support ION Homepage SAVE 35% ON ION PRODUCTS NOW - SPECIAL OFFER Visit any of the special ION product links above and enter JONGORDON35 at checkout to save 35%   About Dr. Gildea: Dr. John Gildea Chief Science Advisor | ION* Dr. John Gildea is a Johns Hopkins-trained PhD and cellular biologist with more than 60 peer-reviewed publications across 20+ NIH-funded studies. His research career spans early HIV diagnostics, oncology, and foundational work in kidney physiology, with a particular focus on human-derived cell models to study nutrient absorption, cellular signaling, and the body's mechanisms for maintaining internal balance. As Chief Science Advisor at ION*, Dr. Gildea applies that depth of expertise to questions at the intersection of gut barrier integrity, environmental stress, and cellular response — helping translate rigorous science into meaningful insights for human health.   Here's a few additional resources for you… Do you feel called to share your story with the world? Check out Gordon Publishing  Follow me on Instagram: @JonGordon11 Every week, I send out a free Positive Tip newsletter via email. It's advice for your life, work and team. You can sign up now here and catch up on past newsletters. Ready to lead with greater clarity, confidence, and purpose? The Certified Positive Leader Program is for anyone who wants to grow as a leader from the inside out. It's a self-paced experience built around my most impactful leadership principles with tools you can apply right away to improve your mindset, relationships, and results. You'll discover what it really means to lead with positivity… and how to do it every day. Learn more here! Do you feel called to do more? Would you like to impact more people as a leader, writer, speaker, coach and trainer? Get Jon Gordon Certified if you want to be mentored by me and my team to teach my proven frameworks principles, and programs for businesses, sports, education, healthcare!

Some memoirs tell the story of a life. Others tell the story of survival, identity, and the invisible emotional currents that shape generations. In this episode, I'm joined by physician, healthcare leader, and author Mai Pham to discuss her debut memoir Bridge from Saigon. As a child refugee fleeing Saigon, Mai's journey carried her from war and displacement to institutions like Harvard and Johns Hopkins, eventually leading to influential work shaping Medicare and Medicaid policy. But beneath those achievements lies a deeply personal story about family history, psychological struggle, healing, and the search for belonging. This conversation explores immigration, trauma, medicine, resilience, identity, and what it means to build a bridge between past and present.

Sulforaphane, Detox Pathways, and the Science of Microplastic Removal Microplastics are building up inside your brain, blood, and reproductive tissue, and most detox protocols do nothing to remove them. This episode gives you the cellular science behind why toxins accumulate, which three detox pathways control your ability to excrete them, and what the latest research shows actually moves microplastics, heavy metals, BPA, and benzene out of your body.. -Watch this episode on YouTube for the full video experience: https://www.youtube.com/@DaveAspreyBPR -For next week, 25% off all Mara Labs products when you go to www.mara-labs.com/DAVE and use code DAVE at checkout. After June 11th, the code will return to the standard 15% off. Host Dave Asprey sits down with Dr. John Gildea, a Johns Hopkins-trained PhD with 60 scientific publications and over 20 NIH-funded studies, and David Roberts, co-founder of Mara Labs and co-creator of BrocElite, the only naturally derived stable form of sulforaphane available in a capsule. Together they bring decades of research-backed biohacking and functional medicine insight into one of the most pressing longevity conversations of our time. They break down the lysosome, your cell's built-in incinerator, and explain exactly why it gets clogged with microplastics, advanced glycation end products, and other toxins that won't break down. New research shows that sulforaphane triggers a process called lysosomal surface translocation, which releases those trapped particles so your body can finally excrete them. An in-house Mara Labs study confirmed the excretion pathway: microplastics come out in feces. In the original study, the individual measured the highest microplastic levels ever recorded, and a repeat study a year later showed dramatically lower baseline microplastic levels, suggesting consistent use compounds the benefit over time. You'll Learn: Why microplastics accumulate inside lysosomes and what sulforaphane does to release them How the three detox pathways, glutathione, glucuronidation, and sulfation, work together to remove every major class of toxin What an in-house study revealed about how and where microplastics actually leave the body How toxic estrogen metabolites form and why sulforaphane is the most effective natural tool to reroute them Why berberine supports sleep optimization, ketosis, and blocks a cancer growth pathway most drugs cannot touch How sulforaphane boosts BDNF and neuroplasticity at the cellular level What microplastic sources in your home, including your dryer, rugs, and receipts, are doing to your toxin load daily Why losing weight releases stored toxins and what to take to protect your brain and metabolism during fat loss How sulforaphane activates the same AMPK longevity pathways triggered by fasting without restricting food Thank you to our sponsors! - iRestore | Reverse hair loss at www.irestore.com/DAVE and get exclusive savings on the iRestore Elite, use code DAVE - HeartMath | Go to https://www.heartmath.com/dave to save 15% off. - Timeline | Go to timeline.com/dave and you'll get an additional 20% off your first month - Our Place | Stop cooking with toxic cookware and upgrade to Our Place today. With a 100-day risk-free trial, plus free shipping and returns, you can experience this game-changing cookware with zero risk. Visit: fromourplace.com/DAVE Use code: DAVE for 10% off sitewide 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: Dr. John Gildea, David Roberts, Mara Labs, BrocElite, sulforaphane, microplastics, microplastic removal, lysosome, lysosomal surface translocation, detox pathways, glutathione, glucuronidation, sulfation, Nrf2 pathway, AMPK, TFEB1, BDNF, neuroplasticity, heavy metals, BPA, benzene, estrogen metabolism, toxic estrogen, xenoestrogens, berberine, BerbaLite, ResveraLite, c-Myc, cancer and estrogen, sleep optimization, ketosis, broccoli sprouts, isothiocyanates, PEITC, watercress, phase two detox, microplastic excretion, indoor air quality, HEPA filter, dryer lint microplastics, BPA receipts, endocrine disruptors, fat loss and toxins, autism and sulforaphane, ADHD and focus, vivid dreams and BDNF, fasting mimicry, anti-aging, biohacking, longevity, functional medicine, supplements, human performance, brain optimization, metabolism, cellular detox Resources: • For next week, 25% off all Mara Labs products when you go to www.mara-labs.com/DAVE and use code DAVE at checkout. After June 11th, the code will return to the standard 15% off. • 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: 0:00 – Trailer 1:55 – Intro & Context 4:48 – Microplastics & Sulforaphane 12:39 – Broccoli Sprouts Formulation 15:20 – Lab Origin Story 26:01 – Reducing Toxin Exposure 37:06 – Estrogen, Hormones & Berberine 52:46 – Autism, ADHD & Brain Health 59:01 – Wrap-Up See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Guest host Joe Cirincione interviews David Rothkopf. Rothkopf is the host of the Deep State Radio podcast. He is also Chief Global Affairs Columnist at the Daily Beast and was formerly the editor-in-chief of Foreign Policy magazine. He has taught at Columbia, Georgetown and Johns Hopkins universities. He was the Deputy Undersecretary of Commerce in the Clinton Administration and is the author of ten books including, most recently, Traitor: A History of Betraying America from Benedict Arnold to Donald Trump. His newsletter "Need to Know" is available at davidrothkopf.substack.com. Cirincione talks with Rothkopf about what he calls the unfolding catastrophe of Trump's war on Iran, arguing the U.S. has repeatedly failed in Southwest Asia and that this conflict has achieved neither tactical nor strategic objectives, while causing greater-than-reported damage to U.S. bases and eroding trust in military and government accounts. Rothkopf says the war has weakened U.S. alliances, empowered Iran, Russia, and China, and further damaged America's global standing, while also tying U.S. policy to an increasingly destabilizing Israeli government. The conversation then shifts to domestic consequences, with Rothkopf alleging Trump has monetized the presidency through pervasive corruption, including favors, pardons, and an IRS-related settlement he calls theft from the Treasury. Rothkopf remains hopeful but warns against complacency, argues accountability and progress are linked, and urges resistance ahead of 2026 elections.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Get the free Core Drives in the Wild guide and see behavioral design applied to real products and services: professorgame.com/WildCD Episode Summary Eleanor Ross, Creative Director at Expert Theory and one of the youngest recipients of the National Training and Simulation Association's Top Under 40 award, breaks down how she designs wargames and simulations that put learners inside high stakes decisions instead of watching from the outside. She walks through the moment a Team USA group tried to buy Greenland mid game, the Logic, Function, Form framework she uses to build every simulation, and a year long Taiwan resilience exercise she ran for the Irregular Warfare Center. Listeners come away with two best practices that make any simulation stick, a debrief discipline and deliberate role reversal, plus a clear view of how AI tools now let a team produce news articles and role player materials in under ten minutes. Ross also makes the case that heavy topics like terrorism, invasion, and irregular warfare land harder when they are engaging, and that good design starts by deciding what people should feel when they walk out. About the Host Rob Alvarez is Head of Engagement Strategy, Europe at The Octalysis Group (TOG), a leading gamification and behavioral design consultancy. A globally recognized gamification strategist and TEDx speaker, he founded and hosts Professor Game, the #1 gamification podcast, and has interviewed hundreds of global experts. He designs evidence-based engagement systems that drive motivation, loyalty, and results, and teaches LEGO® SERIOUS PLAY® and gamification at top institutions including IE Business School, EFMD, and EBS University across Europe, the Americas, and Asia. Key Takeaways In an early Arctic simulation run as an alpha test for the Canadian Department of National Defense, a Team USA group went off script and tried to buy Greenland, a move no one had prepared for, which forced Ross to build the response live. Ross and her team at Expert Theory adjudicated that unplanned move and used their AI backend to produce news articles, tweets, and formatted materials for a role player in under ten minutes, a turnaround the wargaming community historically treated as impossible. Her Logic, Function, Form framework stacks design like a pyramid: Logic defines what players should know and feel on the way out, Function defines the actors and goals that get them there, and Form covers constraints like the 30 or 90 minute time box. A quality debrief is the most important best practice in simulation design, because the takeaways people carry out are set up by the structured discussion, not by the game itself. Putting participants in roles they would never hold, such as US military officers playing the Somali government or the US embassy in a Fort Bragg deployment game, forces the perspective shift that makes the lesson land. Ross builds her design philosophy on Rutger Bregman's Humankind and its claim that people are inherently good, using games to surface the nuances behind how opposing sides actually see themselves. Topics Covered 0:00 - A wargamer who hates video games 2:59 - Inside a wargame designer's week 4:18 - When Team USA tried buying Greenland 7:45 - Why failure is a junior mindset 13:02 - A Taiwan resilience wargame for DOD 17:26 - The Logic, Function, Form framework 20:34 - Best practices: debrief and role reversal 24:30 - The books behind her design philosophy 26:33 - Perspective taking through languages 29:27 - Making heavy topics engaging 31:12 - Her favorite game: Votes for Women 33:01 - Building games in six minutes with Providence Get the free Core Drives in the Wild guide and see behavioral design applied to real products and services: professorgame.com/WildCD About Eleanor Ross Eleanor Ross is Creative Director at Expert Theory, an AI powered simulation startup building immersive learning experiences for clients including the U.S. Department of Defense, Johns Hopkins, Duke, Georgetown, and Penn State. She designs and facilitates simulations that restore agency to learners by placing them inside complex, high stakes decisions, and her co-authored research with the National Counterterrorism Innovation, Technology and Education Center has shown that simulations measurably deepen learning while strengthening confidence, teamwork, and decision making. She chairs programming for the Women's Wargaming Network and is one of the youngest ever recipients of the National Training and Simulation Association's Top Under 40 award. Her work focuses on the Arctic and high north, irregular and gray zone warfare, and leadership. Find the Guest Online Expert Theory (website) Eleanor Ross on LinkedIn Expert Theory on LinkedIn Mentioned in This Episode The Art of Wargaming by Peter Perla Humankind by Rutger Bregman Votes for Women, Eleanor's favorite game (by Fort Circle Games) Proposed future guest: Yuna Wong Proposed future guest: John Curry Providence, Expert Theory's platform for building games in minutes Free Resources and Get in Touch Core Drives in the Wild: Professor Game Free Guide Get Daily Value on Your Email Let's chat about your gamification project YouTube LinkedIn Instagram Facebook Start Your Community on Skool for Free Ask a question

Editor's note: Download and listen to the audio version below and click here to subscribe to the Today in Manufacturing podcast.The Today in Manufacturing Podcast is brought to you by the editors of Manufacturing.net and Industrial Equipment News (IEN).This week's episode is brought to you by Scientific Cutting Tools (SCT).Working with customers that include NASA, Caterpillar and Johns Hopkins demands a combination of proven and new-age strategies and processes. SCT recently offered a look behind the curtain in detailing how listening to their customers and paying attention to key industry trends has established a legacy of innovative problem-solving and an undeniable focus on cutting edge production and product technologies.These same principles have kept the company competitive for more than 60 years in an increasingly crowded marketplace, and led to internal practices focused on attracting new talent while simultaneously retaining vital experience.To learn more about their secrets to long-term success, download this behind-the-scenes report, "Built on Precision, Grounded in Integrity," right now.Every week, we cover the three biggest stories in manufacturing, and the implications they have on the industry moving forward. This week:- Missing Sticker Triggers Recall for Thousands of Teslas- North Carolina Sues Vietnamese EV Maker After Ongoing Delays- SendCutSend Raises $110 Million to Build 'Anything Factories'In Case You Missed It- Robot With 20 Legs and Eyes Built to Move, See in Any Direction Instantly- Blue Origin's $600 Million Expansion Project to Boost Upper-Stage Production in Florida- Slate Auto Nabs Michigan Grant to Expand EV HQPlease make sure to like, subscribe and share the podcast. And to email the podcast, you can reach any of us at Jeff, Anna or David@ien.com, with “Email the Podcast” in the subject line. Subscribe to our daily and weekly newsletters.

When it comes to ideal LDL cholesterol levels in the blood, ideal is a bit of a moving target. Johns Hopkins cardiologist Roger Blumenthal, chair of an American College of Cardiology committee that has just updated cholesterol guidelines, says it … What LDL cholesterol level should you be aiming for? Elizabeth Tracey reports Read More »

Welcome back to the Audible Bleeding series: Landmark Papers in Vascular Surgery. In this episode, co-hosts John and Dr. Jesse Columbo are joined by our guest, Dr. Caitlin Hicks, to discuss one of the most studied—and most debated—topics in vascular surgery: asymptomatic carotid stenosis.   In this episode, we'll trace that evolution through three pivotal trials: ACAS and ACST-1, which established carotid endarterectomy as the standard of care; and the newly published CREST-2, which challenges us to reconsider everything we thought we knew. Along the way, we'll explore how advances in statin therapy, blood pressure control, and antiplatelet agents have fundamentally changed the natural history of this disease—and what that means for our patients today."   Links to Landmark Papers:  (ACAS) Endarterectomy for Asymptomatic Carotid Artery Stenosis   (ACST-1) 10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis: a multicentre randomised trial    (CREST-2) Medical Management and Revascularization for Asymptomatic Carotid Stenosis    Guests: Dr. Caitlin Hicks, MD (@CaitlinWHicks); Associate Fellowship Program Director, Vascular Surgery & Endovascular Therapy at Johns Hopkins and Director of Research   Hosts: John Culhane, MD (@JohnCulhaneMD); General Surgery Resident, Abrazo Health Dr. Jesse Columbo, MD; Assistant Professor of The Dartmouth Institute, Geisel School of Medicine, Dartmouth Follow us @audiblebleeding,   Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey. *Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device. 

What if some people diagnosed with chronic fatigue, fibromyalgia, autoimmune disease, anxiety, or even early Alzheimer's are actually dealing with an underlying infection that was never properly identified? Today, I'm sharing my conversation with Dr. Richard Horowitz, a board-certified internist who has treated more than 13,000 patients with Lyme and tick-borne disease over the last four decades, many of whom had already seen countless doctors and collected diagnoses like chronic fatigue syndrome, fibromyalgia, depression, anxiety, multiple sclerosis, and early dementia before discovering Lyme may have been part of the picture. Dr. Horowitz calls Lyme "the great imitator" because its symptoms can overlap with so many other conditions, and since 2016, Dr. Horowitz has published 11 papers on treatment approaches. In one of his latest studies, he and his colleagues explored a possible connection between Lyme disease and Alzheimer's biomarkers, reporting major improvements in certain inflammatory and cognitive-related markers after treatment. We discuss his broader "MSIDS" model, which looks at chronic illness through a much wider lens. Instead of looking for one single cause, the model examines multiple overlapping factors that may contribute to illness, including infections, toxins, gut dysfunction, nutrient deficiencies, sleep issues, immune imbalance, and inflammation. In this podcast, Dr. Horowitz and I discuss: Why Lyme disease is called "the great imitator" and how it can resemble chronic fatigue syndrome, fibromyalgia, multiple sclerosis, anxiety, depression, and Alzheimer's disease The often-overlooked migratory pain that is one of the hallmark symptoms of chronic Lyme The Lyme symptom questionnaire, which he developed and validated on 6,400 patients How research from Johns Hopkins and other universities changed our understanding of Lyme as a persistent infection Why Dr. Horowitz began using drugs like dapsone and rifampin in Lyme treatment protocols His published research on dapsone combination therapy and the improvements he has observed in patients His recent findings on Lyme disease and Alzheimer's biomarkers, including reductions in tau217 levels Dr. Horowitz's unique MSIDS model and the many overlapping factors that may drive chronic illness Why chronic illness rates continue rising and what conventional medicine may still be missing Why Dr. Horowitz believes recovery is possible, even for patients who have been sick for years  

In his weekly clinical update, Daniel Griffin and Vincent Racaniello comment on incidences of locally transmitted malaria in the US, mpox diagnostics, the latest developments surrounding hantavirus infections, and the Ebola outbreak in the Congo and Uganda including vaccine candidates before Dr. Griffin deep dives into the measles outbreak, recent statistics RSV, influenza and SARS-CoV-2 infections, the Wasterwater Scan dashboard, Johns Hopkins measles tracker, the measles outbreak in Texas in 2025, how to access and pay for Paxlovid, where to go for answers about long COVID-19, casual association of auto-antibodies and COVID complications and contacting your federal government representative to stop the assault on science and biomedical research. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode CDC Operational Guidance for Investigating Locally Acquired Mosquito-Transmitted Malaria — United States, 2026 (CDC: MMWR) Performance of five mpox antigen-based rapid diagnostic tests tested on lesion swabs from patients with suspected mpox from the Kinshasa province of DR Congo: a diagnostic accuracy study (LANCET: Infectious Diseases) Hantavirusdashboard (Hantavirus.up) Andes Hantavirus Outbreak on a Cruise Ship, 2026 (NEJM) "Super-Spreaders" and Person-to-Person Transmission of Andes Virus in Argentina (NEJM) Person-to-Person Transmission of Andes Virus in Hantavirus Pulmonary Syndrome, Argentina, 2014 (CDC: Emerging Infectious Diseases) Hantavirus on board with Prof. VincentRacaniello (microbeTV) Ebola dashboard (ebola.fyi) Epidemic of Ebola Disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda determined a public health emergency of international concern (WHO) WHO ramps up support to the Democratic Republic of the Congo's Ebola outbreak response (WHO: Democratic Republic of Congo) WHO chief says fast-moving Ebola epidemic is outpacing response efforts (Reuters) US CDC seeks staff for Ebola screening as outbreak response expands (Reuters) Trump Administration to Send Americans Exposed to Ebola to Kenya (NY Times) Single Immunization With a Monovalent Vesicular Stomatitis Virus–Based Vaccine Protects Nonhuman Primates Against Heterologous Challenge With Bundibugyo ebolavirus (JID) Vesicular Stomatitis Virus-Based Vaccines Protect Nonhuman Primates against Bundibugyo ebolavirus (PLoS Neglected Tropical Diseases) Vaccine experts debate options to combat outbreak of unusual Ebola strain (Science) NIAID Establishes Centers for Research in Emerging Infectious Diseases (NIAID.NIH) Inside the Race to Develop a Test for the Rare Andes Hantavirus (Wired) NIH terminates network aimed at stopping pandemics before they start (Science) These Researchers Would Be in Africa Fighting Ebola—but Trump Cut Their Funding (Wired) Wastewater for measles (WasterWater Scan) Measles cases and outbreaks (CDC Rubeola) Big outbreak, bright lights…Measles Dashboard(South Carolina Department of Public Health) Utah measles outbreak response (Utah Department of Health and Human Services) Utah Measles Dashboard (Utah Department of Health and Human Services) Tracking Measles Cases in the U.S. (Johns Hopkins) Measles vaccine recommendations from NYP (jpg) Weekly measles and rubella monitoring (Government of Canada) Measles (WHO) Get the FACTS about measles (NY State Department of Health) Measles (CDC Measles (Rubeola)) Measles vaccine (CDC Measles (Rubeola)) Presumptive evidence of measles immunity (CDC) Contraindications and precautions to measles vaccination (CDC) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM) Measles Vaccination: Know the Facts (ISDA: Infectious Diseases Society of America) Deaths following vaccination: what does the evidence show (Vaccine) Characteristics of Patients Hospitalized with Measles During an Outbreak — West Texas, January–March 2025 (CDC:MMWR) Influenza: Waste water scan for 11 pathogens (WastewaterSCan) USrespiratory virus activity (CDC Respiratory Illnesses) Respiratory virus activity levels (CDC Respiratory Illnesses) Flu vaccine recommendations: Vaccines and Related Biological Products Advisory Committee March 12, 2026 Meeting Announcement (FDA) WHO updates all 3 viral strains to be included in fall flu shots (CIDRAP) FDA vaccine advisers recommend adding subclade K to fall shots (CIDRAP) Weekly surveillance report: cliff notes (CDC FluView) OPTION 2: XOFLUZA $50 Cash Pay Option (xofluza) RSV: Waste water scan for 11 pathogens (WastewaterSCan) Respiratory Diseases (Yale School of Public Health) USrespiratory virus activity (CDC Respiratory Illnesses) RSV-Network (CDC Respiratory Syncytial virus Infection) Vaccines for Adults (CDC: Respiratory Syncytial Virus Infection (RSV)) Economic Analysis of Protein Subunit and mRNA RSV Vaccination in Adults aged 50-59 Years (CDC: ACIP) Respiratory Diseases (Yale School of Public Health) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 deaths (CDC) Respiratory Illnesses Data Channel (CDC: Respiratory Illnesses) COVID-19 national and regional trends (CDC) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) US FDA advisers to weigh updating 2026-27 COVID vaccines for XFG variant (Reuters) Where to get pemgarda (Pemgarda) EUAfor the pre-exposure prophylaxis of COVID-19 (INVIYD) Infusion center (Prime Fusions) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Drug interaction checker (University of Liverpool) Help your eligible patients access PAXLOVID with the PAXCESS Patient Support Program (Pfizer Pro) UnderstandingCoverageOptions (PAXCESS) Infectious Disease Society guidelines for treatment and management (ID Society) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) Managing healthcare staffing shortages (CDC) Anticoagulation guidelines (hematology.org) Daniel Griffin's evidence based medical practices for long COVID (OFID) Long COVID hotline (Columbia : Columbia University Irving Medical Center) The answers: Long COVID A causallink between autoantibodies and neurological symptoms in long COVID (Cell) Reaching out to US house representative Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.

In this episode of The Joys of Radiology, host Dr. Gautam Agarwal sits down with Dr. Erin Gomez, Assistant Professor of Radiology and Program Director of Diagnostic and Molecular Imaging Residencies at Johns Hopkins, for a conversation about building a meaningful life and career in medicine. Before becoming an award-winning radiologist and educator, Dr. Gomez was an engineering student working with NASA contractors at the Kennedy Space Center. What followed was an unexpected journey into radiology, where she discovered a passion for imaging, education, mentorship, and leadership. Together, they explore what brings joy to radiology, how great educators inspire the next generation of physicians, the evolving role of AI in radiology education, and the importance of creating a sustainable career without sacrificing the things that matter most outside of medicine. From teaching anatomy and mentoring residents to balancing academic medicine with family life, Dr. Gomez shares thoughtful insights on finding purpose, embracing growth, and leading with empathy. Most importantly, she leaves listeners with a simple but powerful piece of advice: "Run toward fear."

Two retired luminaries in geriatrics join us today to share their personal experiences. First, John Burton, a geriatrician and Director of the Division of Geriatric Medicine at Johns Hopkins for some 35 years, shares his journey moving into a Continuing Care Retirement Community (CCRC) during Covid.  You can read about John's early experiences in his JAGS commentary titled, "Waiting for the Other Shoe to Drop."  The tone is bleak.  John's experience since Covid, as you'll hear, is very positive.  Many of the concerns he raised about isolation have been addressed. Second, we hear from Bill Applegate, Geriatrician, retired faculty at Wake Forest, and former Editor in Chief of JAGS (Bill recruited Eric and me to join JAGS as editors about 10 years ago). Bill had a distinctly negative experience in two assisted living facilities (ALFs), which you can read about in his JAGS essay, titled, "My Journey Through Assisted Living Facilities." Bill is seriously concerned about the lack of national oversight, poor staffing, and financial motivations behind for-profit and private-equity owned ALFs. Finally, we hear from Melissa Aldridge, a former banker turned health services researcher, about the rise of private equity purchases of Assisted Living Facilities nationally.  This is a follow up to our prior podcast on private equity gobbling up hospices with Melissa, Lauren Hunt, and Krista Harrison. Melissa is concerned that private equity has a very short time frame to turn acquisitions profitable, and cutting staff is often their first move.  Further, private equity is financing these acquisitions with debt that is increasingly hard to trace and regulate. We talk about how private equity moving from purchasing fast food chains, toy stores, and hotels into CCRC, ALF, nursing home, and hospice ownership is a major concern.  This is not the same as Blackstone buying the Hilton and turning a profit.  These institutions provide healthcare, daily care needs, and community for a huge swath of older adults.  These concerns should trigger a higher level of scrutiny, oversight, and regulation than other industries. What can you do about this, dear listeners?  Listen to the end to find out! Thanks to Jerry Gurwitz for suggesting this podcast.  We appreciate your suggestions. Keep 'em coming. -Alex Smith   

In episode 180, we talk with Tad Stoermer about his book A Resistance History of the United States - the buried stories, the patriot mythology used to contain dissent, and the principles history offers us for meeting the moment we're living through right now.Tad Stoermer is a public historian who trained at the University of Virginia, Johns Hopkins, and Harvard, with a particular focus on Colonial and Revolutionary America. He is also a former congressional staffer and speechwriter, and he served in the US Army and Reserves as a reconnaissance scout. He currently lives in Denmark.Resources: * Tad's Website - Buy A Resistance History of the United States here!* Social Media* Instagram* TikTok* YouTube* BlueskyWe're bringing together digital creators from across the state to build a powerful digital organizing network called Ohio Creators for Progress. Support and donate to this effort below! ⬇️Connect with United SHE Stands:* Substack* Instagram* TikTok* YouTube* Threads* Buy us a coffee ☕️This episode was edited by Kevin Tanner. Learn more about him and his services here:* Website* Instagram This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.unitedshestands.com/subscribe

Changes to DNA that are added on top of the baseline order of its building blocks are known as epigenetics, and these changes are implicated in a number of diseases and conditions, including pancreas cancer. Now a Johns Hopkins study … Can epigenetics point the way to treatment for pancreas cancer? Elizabeth Tracey reports Read More »

Perhaps you recall from high school biology that you have 23 pairs of chromosomes. A Johns Hopkins study has shown that one arm of chromosome one, the biggest chromosome, is often copied many times in pancreas cancer, and that part … Can too many copies of a gene drive pancreas cancer? Elizabeth Tracey reports Read More »

There are too many copies of one arm of chromosome one in pancreas cancer, a Johns Hopkins study finds. William Nelson, director of the Kimmel Cancer Center at Hopkins, says the stage of tumor development where this finding was seen … What does too many copies of a part of a chromosome in pancreas cancer tell us? Elizabeth Tracey reports Read More »

Certain bacteria commonly found in the gut produce toxins that promote breast cancer, a Johns Hopkins study shows. Kimmel Cancer Center director William Nelson at Johns Hopkins says there is a pathway where such an association makes sense. Nelson: When … What do gut bacteria have to do with breast cancer? Elizabeth Tracey reports Read More »

Most people think feeling tired, foggy, inflamed, and “off” is just part of modern life.But what if your body is working overtime behind the scenes trying to protect you from a toxic load your grandparents never had to deal with?In this episode of the Kwik Brain podcast, I sit down with David Roberts and Dr. John Gildea, founders of Mara Labs, to unpack what modern toxins, chronic inflammation, and microplastics may be doing to your brain, gut, energy, and recovery.David Roberts' interest in this work began after his late wife, Mara, was diagnosed with breast cancer, a deeply personal experience that pushed him to look more closely at the science of cellular protection and detoxification. Dr. John Gildea is a Johns Hopkins-trained PhD and molecular biologist with decades of research experience in oxidative stress, gene expression, and the body's natural defense systems.We talk about what is really happening when your body feels slower to recover, why brain fog may be one of the earliest warning signs that your system is under stress, and how your detox pathways, inflammation levels, and gut barrier all play a role in how sharp or sluggish you feel.In this episode, you'll learn: ☑️ What sulforaphane is and why it matters for brain health, detoxification, and inflammation ☑️ How chronic inflammation differs from the kind your body uses for healing ☑️ Why brain fog may be linked to toxins, mitochondrial strain, and poor cellular cleanup ☑️ What microplastics are, where most exposure comes from, and why they are such a concern ☑️ How modern life may be overwhelming the body's built-in defense systems ☑️ Why detox is not about extreme cleanses but about supporting the pathways your body already uses ☑️ How gut integrity and tight junctions relate to toxic burden ☑️ Simple ways to reduce toxic exposure and support your body more effectivelyIf you've been feeling like your energy is lower, your thinking is less clear, or your body is not recovering the way it used to, this episode will help you understand what may be happening underneath the surface and what you can do to better support your brain and body in a high-stress, high-toxin world.

It's 1979, and Johns Hopkins has just shut down the first gender surgery clinic in the US. But investigations into the biological roots of gender identity are about to reopen those doors — and reshape how medicine thinks about sex, gender, and who gets to decide.CME: Take the CME Post-Test for this EpisodePublished On: 05/25/2026Duration: 11 minutes, 52 secondsChris Aiken, MD, and Kellie Newsome, PMHNP, have disclosed no relevant financial or other interests in any commercial companies pertaining to this

The "Community Meets Clinic" podcast series introduces clinicians and healthcare personnel specializing in rare neuroimmune disorders. In this episode hosted by Krissy Dilger of SRNA, we met Dr. Benjamin Greenberg of the UT Southwestern Medical Center. He outlined his translational research, including the Q Study, a Phase 1 trial assessing the safety and feasibility of transplanting human glial restricted progenitor cells into the spinal cord of people who have been diagnosed with transverse myelitis (TM) [05:49]. He also described research on immune-remodeling therapies for NMO aimed at reducing long-term immunosuppression. Dr. Greenberg illustrated multidisciplinary care at UT Southwestern and Children's Medical Center, emphasized options for second opinions and clinician-to-clinician remote consultation, and shared hopes for nervous system repair trials and curative immune therapies [07:18]. You can view Dr. Benjamin Greenberg's medical profile here:https://utswmed.org/doctors/benjamin-greenberg/Benjamin M. Greenberg, MD, MHS is a Professor and the Cain Denius Scholar in Mobility Disorders in the Department of Neurology [https://utswmed.org/why-utsw/departments/neurology/] at UT Southwestern Medical Center in Dallas, Texas. He currently serves as the Vice Chair of Translational Research and Strategic Initiatives for the Department of Neurology. He is also the interim Director of the Multiple Sclerosis Center [https://utswmed.org/locations/aston/multiple-sclerosis-and-neuroimmunology-clinic/] and the Director of the Neurosciences Clinical Research Center. In addition, he serves as Director of the Transverse Myelitis and Neuromyelitis Optica Program and the Pediatric Demyelinating Disease Program at Children's Medical Center [https://www.childrens.com/specialties-services/specialty-centers-and-programs/neurology/demyelinating-disease-program].Dr. Greenberg earned his medical degree at Baylor College of Medicine before completing an internal medicine internship at Chicago's Rush Presbyterian-St. Luke's Medical Center. He performed his neurology residency at the Johns Hopkins School of Medicine. He also holds an M.H.S. in molecular microbiology and immunology from the Bloomberg School of Public Health, as well as a bachelor's degree in the history of medicine – both from Johns Hopkins. Prior to his recruitment to UT Southwestern in 2009, Dr. Greenberg was on the faculty of the Johns Hopkins Division of Neuroimmunology, serving as the Director of the Encephalitis Center and Co-Director of the nation's first dedicated Transverse Myelitis Center.Dr. Greenberg splits his clinical time between adult and pediatric patients at William P. Clements Jr. and Zale Lipshy University Hospitals, Parkland, and Children's Medical Center. His research focuses on better diagnosing, prognosticating, and treating demyelinating diseases and nervous system infections. He also coordinates clinical trials to evaluate new treatments to prevent neurologic damage and restore function to affected patients.00:00 Welcome and Guest Intro01:41 Path to Neurology03:50 Why Neuroimmunology05:49 Research Focus and Trials07:18 Clinic Team and Referrals10:31 Self Care and Hobbies12:17 How the Clinic Can Help14:16 Hope for Future Therapies15:56 Wrap Up

In his weekly clinical update, Daniel Griffin and Vincent Racaniello discuss withdrawal of the ACIP charter published in April 2026, the first council meeting on antibiotic resistant bacteria, the latest developments surrounding hantavirus infections, and the Ebola outbreak in the Congo and Uganda before Dr. Griffin deep dives into the measles outbreak, recent statistics RSV, influenza and SARS-CoV-2 infections, the Wasterwater Scan dashboard, Johns Hopkins measles tracker, transmission of SARS-CoV-2 through the air including ventilation systems, how to access and pay for Paxlovid, where to go for answers about long COVID-19, early use of antiviral drugs for COVID-19 patients and contacting your federal government representative to stop the assault on science and biomedical research. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode US health department withdraws vaccine advisory panel charter (Reuters) Meeting of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (Federal Register) Andes Hantavirus Outbreak on a Cruise Ship, 2026 (NEJM) "Super-Spreaders" and Person-to-Person Transmission of Andes Virus in Argentina (NEJM) Person-to-Person Transmission of Andes Virus in Hantavirus Pulmonary Syndrome, Argentina, 2014 (CDC: Emerging Infectious Diseases) Hantavirus on board with Prof. VincentRacaniello (microbeTV) Hantavirus Doesn't Spread Easily, but Officials May Be Downplaying Risks (NY Times) Cross-binding antibodies capable of neutralising diverse hantaviruses are produced in response to Puumala virus infection (eBioMedicine) Hantavirus dashboard (Hantavirus.live) Visualizing the hantavirus cruise outbreak in maps and charts (CNN) Epidemic of Ebola Disease caused by Bundibugyo virus in the Democratic Republic of the Congo and Uganda determined a public health emergency of international concern (WHO) Ebola outbreak response intensifies in DRC and Uganda as cases mount (DG: Alerts) WHO ramps up support to the Democratic Republic of the Congo's Ebola outbreak response (WHO: Democratic Republic of Congo) Vaccine experts debate options to combat outbreak of unusual Ebola strain (Science) US promises to fund clinic established to treat Ebola (X-USForeignAssist) U.S.-Bound Flight Diverted to Canada Because of Ebola Restrictions (NY Times) Wastewater for measles (WasterWater Scan) Measles cases and outbreaks (CDC Rubeola) Big outbreak, bright lights…Measles Dashboard (South Carolina Department of Public Health) Utah measles outbreak response (Utah Department of Health and Human Services) UtahMeasles Dashboard (Utah Department of Health and Human Services) Tracking Measles Cases in the U.S. (Johns Hopkins) Measles vaccine recommendations from NYP (jpg) Weekly measles and rubella monitoring (Government of Canada) Measles (WHO) Get the FACTS about measles (NY State Department of Health) Measles(CDC Measles (Rubeola)) Measles vaccine (CDC Measles (Rubeola)) Presumptive evidence of measles immunity (CDC) Contraindications and precautions to measles vaccination (CDC) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM) Measles Vaccination: Know the Facts(ISDA: Infectious Diseases Society of America) Deaths following vaccination: what does the evidence show (Vaccine) Influenza: Waste water scan for 11 pathogens (WastewaterSCan) USrespiratory virus activity (CDC Respiratory Illnesses) Respiratory virus activity levels (CDC Respiratory Illnesses) Flu vaccine recommendations: Vaccines and Related Biological Products Advisory Committee March 12, 2026 Meeting Announcement (FDA) WHO updates all 3 viral strains to be included in fall flu shots (CIDRAP) FDA vaccine advisers recommend adding subclade K to fall shots (CIDRAP) Weekly surveillance report: cliff notes (CDC FluView) OPTION 2: XOFLUZA $50 Cash Pay Option(xofluza) RSV: Waste water scan for 11 pathogens (WastewaterSCan) Respiratory Diseases (Yale School of Public Health) US respiratory virus activity (CDC Respiratory Illnesses) RSV-Network (CDC Respiratory Syncytial virus Infection) Vaccines for Adults (CDC: Respiratory Syncytial Virus Infection (RSV)) Economic Analysis of Protein Subunit and mRNA RSV Vaccination in Adults aged 50-59 Years (CDC: ACIP) Respiratory Diseases (Yale School of Public Health) Maternal RSV Vaccination, Infant Nirsevimab, or Both: Interim Analysis of a Randomized Trial (Pediatrics) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 deaths (CDC) Respiratory Illnesses Data Channel (CDC: Respiratory Illnesses) COVID-19 national and regional trends (CDC) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) Potential airborne transmission of SARS-COV-2 through bathroom ventilation ducts associated with an outbreak in a residential building in Santander, Spain, 2020 (PLoS One) Where to get pemgarda (Pemgarda) EUAfor the pre-exposure prophylaxis of COVID-19 (INVIYD) Infusion center (Prime Fusions) Recent COVID-19 Vaccination and Risk of SARS-CoV-2 Transmission (JAMA Network OPEN) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Drug interaction checker (University of Liverpool) Help your eligible patients access PAXLOVID with the PAXCESS Patient Support Program (Pfizer Pro) UnderstandingCoverageOptions (PAXCESS) Infectious Disease Society guidelines for treatment and management (ID Society) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) Managing healthcare staffing shortages (CDC) Anticoagulation guidelines (hematology.org) Daniel Griffin's evidence based medical practices for long COVID (OFID) Long COVID hotline (Columbia : Columbia University Irving Medical Center) The answers: Long COVID Early antiviral use may lower risk of long COVID in mildly ill patients, aid recovery from infection (CIDRAP) Early-Phase Oral Antiviral Use and Post–COVID-19 Condition in Outpatients (JAMA Network OPEN) Impact of Early Oral Antiviral Use for Outpatients With COVID-19 on Healthcare Utilization and Recovery (ANCHOR-02) (International Journal of Infectious Diseases) Reaching out to US house representative Letters read on TWiV 1324 Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.

Groundbreaking Study Reveals Psilocybin Can CRUSH Smoking Addiction | Dr Matt Johnson Psilocybin Beats Nicotine Patches in BREAKTHROUGH Smoking Trial | Dr Matt Johnson Johns Hopkins Scientist Reveals Psilocybin OUTPERFORMS Patches for Smokers | Dr Matt Johnson Matt Johnson joins Rav Arora on The Illusion of Consensus to discuss his new JAMA Network Open study on psilocybin, nicotine patches, CBT and smoking cessation. A Johns Hopkins psychiatry and behavioural sciences professor, Johnson has been central to modern psychedelic research, including work on psilocybin for addiction, depression and end of life distress. He explains why one psilocybin session paired with CBT showed higher six month smoking abstinence rates than nicotine patch treatment with CBT, and what that could mean for tobacco use disorder. The discussion also covers vaping, nicotine harm reduction, the UK Tobacco and Vapes Bill, addiction treatment, mystical experiences, emotional breakthrough, neuroplasticity, agency and why psychedelics may help people change entrenched behaviour. Rav and his guest examine both the promise and the risks of psychedelic therapy, including bad experiences, vulnerable patients, clinical safeguards and the future of FDA approved addiction treatments. Link to Matt's Paper: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2846155 Subscribe to Rav's Substack for exclusive content: https://www.illusionconsensus.com/

Our focus today is on the search for the geriatrician identity, a continuation of the conversation we started with Jerry Gurtwitz on the Future of Geriatrics.  Today's conversation is prompted by multiple articles in JAGS: (1) an article by Jerry Gurwitz with a title the same as this podcast; (2) an article by Helen Fernandez on "Med-Geri", a new combined 4 year internal medicine residency and geriatrics fellowship track; and (3) an article by Mary Tinetti titled, "Mainstream or Extinction: Can Defining Who We Are Save Geriatrics?"  Of note, Mary's article is a follow up to her 2017 article in JAGS in which she wrote: Those outside the field have difficulty understanding what geriatrics is and what geriatricians do. We contribute to this lack of clarity. We are experts in complexity but are often bad at communicating simply. Our well-intentioned efforts to be inclusive and comprehensive lead to the creation of long, complex descriptions of what we do that further compromises understanding while eroding interest in, and support of, our field. Today we tackle this problem, discussing: A "funny if it wasn't so painful" video and JAGS article in which geriatricians from Johns Hopkins roamed the streets of Baltimore asking lay people "What is a geriatrician?"  The responses (something to do with Ben and Jerry's ice cream? Jury-atrician?) will make you laugh and cry at the same time. 4 different types of geriatricians as described by Jerry in his JAGS paper: the complexivist, the healthful longevitist, the syndromist, and the contextualist. As with the 4Ms, Ken couldn't help but add a 5th, the "identityist", arguing that maybe Geriatricians worry too much in public about their identity, and should instead focus in public on what unites them: shared sense of purpose and mission to focus on whole person care and what matters most to older adults. Ken gave a rousing talk on being a Geriatrician at the Society of General Internal Medicine that received a lengthy standing-ovation (and a Cubs Jersey with his name on it).  Innovative new programs such as Med-Geri and GeriPal fellowship as ways to bring more people into the profession. How to balance our effort between recruiting specialist geriatricians to the profession and teaching all clinicians geriatrics principles and skills.   A paper in JAGS by Richard G. Stefanacci and Ankur Patel in JAGS making the argument that a geriatrician "yields per-patient annual net cost savings of approximately $3495 (specialist consultation avoidance +$1500; ED reduction +$45; hospitalization reduction +$1950)..." and "The reason fee-for-service fails geriatricians is not that their skills are wrong for primary care—it is that the payment model is wrong for their skills. Payvider programs operating under capitation invert every structural disadvantage of fee-for-service. Under capitation, there are no RVUs. There is no penalty for spending 40 min with a complex patient. There is no revenue loss when the patient is dual-eligible rather than commercially insured—the capitated payment is the same regardless of original coverage source. And every unnecessary specialist referral, every avoidable hospitalization, every ED visit that could have been managed in-house represents a cost to the organization rather than a revenue stream." Stay until the end when Mary has one of the best answers yet (in over 400 podcasts!) to Eric's "if you had a magic wand" question. Enjoy! -Alex Smith

This special live episode of the FemTech Focus was recorded at the Johns Hopkins Bloomberg School of Public Health as part of a women's health innovation event.This panel explores what it actually takes to build in women's health—from identifying unmet clinical needs to navigating customer discovery, commercialization, regulation, fundraising, and equity in femtech innovation.The discussion features four innovators building next-generation solutions across pelvic health, menstrual health, fetal surgery, and digital maternal health.Moderator: Dr. Rosemary Morgan - Associate Professor, Department of International Health Johns Hopkins Bloomberg School of Public HealthDr. Morgan's work focuses on understanding how gender inequities shape health systems, healthcare access, and public health interventions globally. Her research spans sexual and reproductive health, gender analysis, and equity-centered global health systems research.

I have spent decades — decades — studying how people learn. I've read the research, I've built the frameworks, I'm literally getting a graduate degree in learning design from Johns Hopkins right now. And I still catch myself thinking: I need to know more before I'm ready to start.Ironic, right? Someone who studies learning... afraid to learn out loud.But here's what's wild: that fear? That "not ready yet" feeling? It turns out it's not a personal flaw. It's just... how learning actually works. And once I understood that, everything changed.So today I want to take you inside the framework we've built at Educator Forever — our approach to learning — and specifically, I want to talk about three ideas that I think will shift the way you think about learning anything.For all links and resources mentioned in this episode, head to the show notes: https://www.educatorforever.com/episode185.

Up to 1 in 5 people may have this condition and never know it and the diagnoses they've been handed instead, from PCOS to IBS to chronic fatigue, may all be pointing at the same hidden cause. In this episode, I sit down with Dr. Tania Dempsey, Johns Hopkins-trained internist and one of the leading researchers on Mast Cell Activation Syndrome, who tells me that 100% of her PCOS patients test positive for MCAS, and walks me through why mast cells may be the most overlooked driver of chronic illness in modern medicine. If you've been told your symptoms are idiopathic, or that nothing's wrong even though everything feels wrong, this is the conversation that finally connects the dots. CLICK HERE TO BECOME GARY'S VIP!: ⁠https://bit.ly/4ai0Xwg⁠ Get Dr. Tania Dempsey's audio book, “Mast Cell Matters”: ⁠https://bit.ly/4drrnOf⁠  Listen to Dr. Tania Dempsey on all your favorite platforms! YouTube: ⁠https://bit.ly/4dcVlqs⁠  Spotify: ⁠https://bit.ly/4dsS9G2⁠  Apple Podcasts: ⁠https://bit.ly/3PjGhy6⁠  Connect with Tania Dempsey Website: ⁠https://bit.ly/4dKXgTe⁠  YouTube: ⁠https://bit.ly/4dcVlqs⁠   Instagram: ⁠https://bit.ly/4f7kHrd⁠  Facebook: ⁠https://bit.ly/3R6sOdz⁠   LinkedIn: ⁠https://bit.ly/4ddPilv⁠   Thank you to our partners A-GAME: “ULTIMATE15” FOR 15% OFF: http://bit.ly/4kek1ij AION: “ULTIMATE10” FOR 10% OFF: https://bit.ly/4h6KHAD AIRES: "ULTIMATE20 " FOR 20% OFF: https://bit.ly/4a3Duze BAJA GOLD: "ULTIMATE10" FOR 10% OFF: https://bit.ly/3WSBqUa BODYHEALTH: “ULTIMATE20” FOR 20% OFF: http://bit.ly/4e5IjsV COLD LIFE: THE ULTIMATE HUMAN PLUNGE: https://bit.ly/4eULUKp CYMBIOTIKA: "ULTIMATE10" FOR 10% OFF: https://bit.ly/4tjyluP GENETIC METHYLATION TEST (UK ONLY): https://bit.ly/48QJJrk GENETIC TEST (USA ONLY): ⁠https://bit.ly/3Yg1Uk9 GOPUFF: GET YOUR FAVORITE SNACK!: https://bit.ly/4obIFDC H2TAB: “ULTIMATE10” FOR 10% OFF: https://bit.ly/4hMNdgg HEALF: 10% OFF YOUR ORDER: https://bit.ly/41HJg6S PEPTUAL: “TUH10” FOR 10% OFF: https://bit.ly/4mKxgcn SNOOZE: LET'S GET TO SLEEP!: https://bit.ly/4pt1T6V WHOOP: JOIN & GET 1 FREE MONTH!: https://bit.ly/3VQ0nzW Watch  the “Ultimate Human Podcast” every Tuesday & Thursday at 9AM EST: YouTube: ⁠https://bit.ly/3RPQYX8⁠ Podcasts: ⁠https://bit.ly/3RQftU0⁠ Connect with Gary Brecka Instagram: ⁠https://bit.ly/3RPpnFs⁠ TikTok: ⁠https://bit.ly/4coJ8fo⁠ X: ⁠https://bit.ly/3Opc8tf⁠ Facebook: ⁠https://bit.ly/464VA1H⁠ LinkedIn: ⁠https://bit.ly/4hH7Ri2⁠ Website: ⁠https://bit.ly/4eLDbdU⁠ Merch: ⁠https://bit.ly/4aBpOM1⁠ Newsletter: ⁠https://bit.ly/47ejrws⁠ Ask Gary: ⁠https://bit.ly/3PEAJuG⁠ Timestamps 00:00 ​Intro of Show 03:52 - The biology of mast cells 05:34 - Inflammation, allergies, and dystrophisms 09:00 - Connective tissue, POTS, and Ehlers-Danlos 09:40 - Gary's daughter and the toxic load 13:24 - Symptoms from head to toe 18:20 - GLP-1 receptors on mast cells 23:47 - Identifying the upstream triggers 27:38 - Treating viral and bacterial loads 31:35 - The herpes virus family and reactivation 35:47 - SOT therapy and targeted mRNA 38:17 - The immunofatigue theory of aging 45:03 - Therapeutic plasma exchange and detox 58:09 - Gut dysbiosis and the microbiome 1:00:58 - Cryptosporidium and parasite testing 1:06:30 - Hope and the path forward Disclaimer: This podcast is for informational purposes only and does not provide medical advice. It is not intended for diagnosing or treating any health condition. Always consult a licensed healthcare professional before making health or wellness decisions. Gary Brecka is the owner of Ultimate Human, LLC which operates The Ultimate Human podcast and promotes certain third-party products used by Gary Brecka in his personal health and wellness protocols and daily life and for which Ultimate Human LLC and / or Gary Brecka directly or indirectly holds an economic interest or receives compensation.  Accordingly, statements made by Gary Brecka and others (including on The Ultimate Human podcast) may be considered.  Learn more about your ad choices. Visit megaphone.fm/adchoices

In 1966, Johns Hopkins opened the first gender surgery clinic in the US. Thirteen years later, a single study shut it down. We examine what the research said, what it didn't say, and how new standards of care emerged from the ashes.CME: Take the CME Post-Test for this EpisodePublished On: 05/18/2026Duration: 13 minutes, 39 secondsChris Aiken, MD, and Kellie Newsome, PMHNP, have disclosed no relevant financial or other interests in any commercial companies pertaining to this

Once again, IL's Terry Foy and Nick Ossello press record during the fourth quarter of the final game of the weekend — this time it wasn't as dramatic as Duke closed out Georgetown, 16-6, to become the fourth team to punch its ticket to Saturday's NCAA Semifinals in Charlottesville, Va.Rewinding to Saturday, they begin with Syracuse's dramatic 13-11 win over North Carolina, replete with injury drama, an important missed (non-reviewable call), a field surface controversy and most importantly, vindication for the sport's biggest star? From there, they dive into Notre Dame's pull-away win over Johns Hopkins, highlighted by Josh Yago's legacy game. They unpack Princeton's similar pull-away win over Penn State to start Sunday, itself marked by injury drama.Last week was by far our most-listened to episode of the season. We really appreciate it and we hope all our new listeners enjoy this one, too!

What if I told you that after focal therapy, a normal PSA and a clean MRI can still mean prostate cancer is hiding in plain sight?That's the moment in this conversation that makes you stop—and rethink everything you've been told about “success” after focal therapy.In this episode, we're joined by Abhinav Sidana, MD, MPH, Associate Professor of Urology and Director of Prostate Cancer at University of Chicago Medicine, a nationally recognized urologic oncologist, clinical trial leader, and one of the architects shaping the future of focal therapy. Dr. Sidana has trained at AIIMS, Johns Hopkins, NIH, and now leads one of the most rigorous focal therapy programs in the country—backed by over 100 peer-reviewed publications and multiple active clinical trials.This is not a sales pitch for focal therapy. It's a clear-eyed look at what works, what doesn't, and what we still get wrong.In this episode, you'll learn:✅ Why MRI made focal therapy possible—and why it can still miss clinically significant disease✅ How biopsy strategy—fusion, mapping, or transperineal—directly affects recurrence risk✅ Why PSA is an unreliable signal after focal therapy—and what actually predicts failure✅ How short-term ADT may expand focal therapy to larger or higher-risk tumorsIf you're a patient, clinician, or researcher navigating prostate cancer decisions, this episode will fundamentally sharpen how you think about focal therapy—and its limits.00:00 Can MRI and PSA Miss Significant Cancer After Focal Therapy?04:00 Who Is a Good Candidate for Focal Therapy?06:30 Mapping Biopsies vs MRI Fusion Biopsies09:30 Transperineal vs Transrectal Biopsies11:00 What Is IRE (NanoKnife)?14:30 Who Is NOT a Candidate for Focal Therapy?18:00 Vapor Therapy & TULSA Pro23:00 Should Doctors Use Multiple Focal Therapy Technologies?25:30 Can Higher-Risk Prostate Cancer Be Treated with Focal Therapy?34:00 Does the Type of Energy Matter?37:00 Combining ADT with Focal Therapy40:30 How Tumor Size Impacts Eligibility45:30 Why MRI and PSA Are Imperfect After Treatment49:30 What Is PSA Recurrence After Focal Therapy?53:30 The Future of MRI, AI, and Surveillance57:30 Do Patients Need Repeat Biopsies Forever?___________________________________

Krissy Dilger of SRNA hosted Dr. Benjamin Greenberg of UT Southwestern to share updates on the Q Study, a Phase 1 trial assessing the safety and feasibility of transplanting human glial restricted progenitor cells into the spinal cord of people who have been diagnosed with transverse myelitis (TM). Dr. Greenberg cautioned the audience against stem cell tourism [00:03:03]. He described the decades-long development of the cell line and safety monitoring for this study [00:01:35]. He reported no safety signals prompting a trial pause and noted the FDA-approved expansion of eligibility from non-ambulatory participants to those who can walk with assistance, while efficacy results were not yet being shared [00:08:31]. Finally, Dr. Greenberg outlined potential next steps, including Phase 2 studies and expanded populations (e.g., MOGAD and NMOSD diagnoses), as well as future targets [00:17:02].Benjamin M. Greenberg, MD, MHS is a Professor and the Cain Denius Scholar in Mobility Disorders in the Department of Neurology [https://utswmed.org/why-utsw/departments/neurology/] at UT Southwestern Medical Center in Dallas, Texas. He currently serves as the Vice Chair of Translational Research and Strategic Initiatives for the Department of Neurology. He is also the interim Director of the Multiple Sclerosis Center [https://utswmed.org/locations/aston/multiple-sclerosis-and-neuroimmunology-clinic/] and the Director of the Neurosciences Clinical Research Center. In addition, he serves as Director of the Transverse Myelitis and Neuromyelitis Optica Program and the Pediatric Demyelinating Disease Program at Children's Medical Center [https://www.childrens.com/specialties-services/specialty-centers-and-programs/neurology/demyelinating-disease-program].Dr. Greenberg earned his medical degree at Baylor College of Medicine before completing an internal medicine internship at Chicago's Rush Presbyterian-St. Luke's Medical Center. He performed his neurology residency at the Johns Hopkins School of Medicine. He also holds an M.H.S. in molecular microbiology and immunology from the Bloomberg School of Public Health, as well as a bachelor's degree in the history of medicine – both from Johns Hopkins. Prior to his recruitment to UT Southwestern in 2009, Dr. Greenberg was on the faculty of the Johns Hopkins Division of Neuroimmunology, serving as the Director of the Encephalitis Center and Co-Director of the nation's first dedicated Transverse Myelitis Center.Dr. Greenberg splits his clinical time between adult and pediatric patients at William P. Clements Jr. and Zale Lipshy University Hospitals, Parkland, and Children's Medical Center. His research focuses on better diagnosing, prognosticating, and treating demyelinating diseases and nervous system infections. He also coordinates clinical trials to evaluate new treatments to prevent neurologic damage and restore function to affected patients.00:00 Welcome and Guest Intro01:35 Origins of Q Study02:46 Getting Cells Into Cord04:49 Phase One Trial Design06:31 Safety and Efficacy Measures08:31 Eligibility Expanded Criteria11:39 Screening and Selection14:05 Travel and Site Logistics15:15 Early Safety Findings17:02 Next Steps After Phase One19:01 Beyond Idiopathic Myelitis23:07 Damage Differences by Disease25:20 Optic Nerve and Brain Targets27:29 Expected Outcomes and Vision28:58 Final Thanks

David approaches microplastic exposure not from a place of fear—but from informed, practical wellness. With a background in public health and a deeply personal journey into cellular health after his late wife's cancer diagnosis, he brings both science and lived experience to the conversation.David holds a MPH from Johns Hopkins, a Masters in BME from the UVA, and a Bachelors in EE and BME from Duke. He founded Mara Labs after his late wife's cancer diagnosis sparked a deep dive into plant-based compounds and cellular protection. His personal health journey led directly to the development of BrocElite®— a stabilized sulforaphane supplement designed to support detoxification, mitochondrial health, and cellular resilience. David has more than 20 years of public health experience on three continents.

In his weekly clinical update, Daniel Griffin and Vincent Racaniello reviewed the latest developments surrounding the hantavirus outbreak, including new interim guidance from the Centers for Disease Control and Prevention for the management of infectious cases, whether the CDC may be downplaying the significance of the outbreak because of public backlash following the COVID-19 pandemic, before Dr. Griffin deep dives into the measles outbreak, recent statistics RSV, influenza and SARS-CoV-2 infections, the Wasterwater Scan dashboard, Johns Hopkins measles tracker, benefit of maternal vaccination against RSV for infants, efficacy and safety of a mRNA influenza vaccine  how to access and pay for Paxlovid, where to go for answers about long COVID-19, multisystem inflammatory syndrome in children and contacting your federal government representative to stop the assault on science and biomedical research. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Interim Guidance for Public Health Assessment and Management of People with Potential Exposure to Andes Virus Outbreak (CDC) Hantavirus in humans: a review of clinical aspects and management (LANCET: Infectious Diseases) "Super-Spreaders" and Person-to-Person Transmission of Andes Virus in Argentina (NEJM) Person-to-Person Transmission of Andes Virus in Hantavirus Pulmonary Syndrome, Argentina, 2014 (CDC: Emerging Infectious Diseases) Hantavirus on board with Prof. Vincent Racaniello (microbeTV) Transcript – Updateon CDC's Hantavirus Response 5/13/2026 (CDC) CDC Is Walking a Tightrope With Its Response to Hantavirus (Wall Street Journal) What Happened on the Hantavirus Cruise, According to a Doctor On Board (The Atlantic) Andes hantavirus outbreak on a cruise ship – an ESCMID Emerging Infections Subcommittee (EIS) rapid assessment (CMI: Clinical Microbiology and Infection) Wastewater for measles (WasterWater Scan) Measles cases and outbreaks (CDC Rubeola) Big outbreak, bright lights…Measles Dashboard(South Carolina Department of Public Health) Utah measles outbreak response (Utah Department of Health and Human Services) Utah Measles Dashboard (Utah Department of Health and Human Services) Tracking Measles Cases in the U.S. (Johns Hopkins) Measles vaccine recommendations from NYP (jpg) Weekly measles and rubella monitoring (Government of Canada) Measles (WHO) Get the FACTS about measles (NY State Department of Health) Measles (CDC Measles (Rubeola)) Measles vaccine (CDC Measles (Rubeola)) Presumptive evidence of measles immunity (CDC) Contraindications and precautions to measles vaccination (CDC) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM) Measles Vaccination: Know the Facts (ISDA: Infectious Diseases Society of America) Deaths following vaccination: what does the evidence show (Vaccine) Influenza: Waste water scan for 11 pathogens (WastewaterSCan) USrespiratory virus activity (CDC Respiratory Illnesses) Respiratory virus activity levels (CDC Respiratory Illnesses) Flu vaccine recommendations: Vaccines and Related Biological Products Advisory Committee March 12, 2026 Meeting Announcement (FDA) WHO updates all 3 viral strains to be included in fall flu shots (CIDRAP) FDA vaccine advisers recommend adding subclade K to fall shots (CIDRAP) Weekly surveillance report: cliff notes (CDC FluView) Efficacy and Safety of an mRNA Seasonal Influenza Vaccine in Adults (NEJM) OPTION 2: XOFLUZA $50 Cash Pay Option (xofluza) RSV: Waste water scan for 11 pathogens (WastewaterSCan) Respiratory Diseases (Yale School of Public Health) US respiratory virus activity (CDC Respiratory Illnesses) RSV-Network (CDC Respiratory Syncytial virus Infection) Vaccines for Adults (CDC: Respiratory Syncytial Virus Infection (RSV)) Economic Analysis of Protein Subunit and mRNA RSV Vaccination in Adults aged 50-59 Years (CDC: ACIP) Respiratory Diseases (Yale School of Public Health) Maternal RSV Vaccination, Infant Nirsevimab, or Both: Interim Analysis of a Randomized Trial (Pediatrics) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 deaths (CDC) Respiratory Illnesses Data Channel (CDC: Respiratory Illnesses) COVID-19 national and regional trends (CDC) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) Life lost due to the COVID-19 pandemic: A model-based cohort analysis of mortality displacement in the registered population of England (PLoS One) Where to get pemgarda (Pemgarda) EUAfor the pre-exposure prophylaxis of COVID-19 (INVIYD) Infusion center (Prime Fusions) Ensitrelvir for Covid-19 Postexposure Prophylaxis in Household Contacts (NEJM) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Drug interaction checker (University of Liverpool) Help your eligible patients access PAXLOVID with the PAXCESS Patient Support Program (Pfizer Pro) Understanding Coverage Options (PAXCESS) Infectious Disease Society guidelines for treatment and management (ID Society) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) Managing healthcare staffing shortages (CDC) Anticoagulation guidelines (hematology.org) Daniel Griffin's evidence based medical practices for long COVID (OFID) Long COVID hotline (Columbia : Columbia University Irving Medical Center) The answers: Long COVID Reaching out to US house representative Letters read on TWiV 1322 Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.

  Welcome! And thank you for listening. Today I sit down with Dr. Andrew Koutnik, an award-winning scientist committed to producing and translating cutting-edge research into real world solutions for health, disease management, and performance optimization. Specializing in type 1 diabetes and metabolic health, Andrew has worked with renowned institutions such as Harvard, Johns Hopkins, NASA, and the Department of Defense to develop actionable, evidence-based strategies for overcoming complex health challenges. In this episode we dig into the four-week metabolic adaptation window and why most research misses it, how elevated insulin quietly tanks your energy and recovery even if you think you are eating healthy, what actually happens to muscle glycogen on a ketogenic diet over time, and why the microbiome picture at 6 months looks completely different than it does at week one. We also get into exogenous ketones, continuous glucose monitoring, and why there is no single right diet, just options. Thank you for listening.  Keep the questions coming to jami@doctordulaney.com Website: doctordulaney.com Water distillers: https://mypurewater.com/?sld=jdulaney discount code: cleanwaterforsophie

The latest episode of the D‑Fly & Dixie Podcast arrives just in time for quarterfinal weekend, and the guys bring back longtime friend of the show Christian Swezey to help break down all four matchups. They open with a look back at a wild first round — including Johns Hopkins' gritty road win at Cornell, where the Blue Jays “won a playoff game on the road with a goalie who made three saves” and Luke Martin earned two bananas from the Blue Jays' banana crew. From travel‑day chaos to behind‑the‑scenes ops decisions, Christian shares what really shapes NCAA tournament success.The crew then dives into each quarterfinal, starting with Hopkins–Notre Dame, where the Irish's defensive backbone and the emergence of goalie Thomas Ricciardelli take center stage. They examine whether Syracuse can finally break through against UNC after two losses, debate Penn State–Princeton as potentially the weekend's best game, and unpack how Georgetown's toughness — galvanized by the team rallying around teammate James Caretta, who is battling cancer — has fueled the Hoyas' surge into the final eight.Packed with insight, storytelling, and quarterfinal stakes, it's one of the most comprehensive breakdowns of the season.GAME PREVIEWSSaturday, May 16Shuart Stadium, Hempstead, N.Y.Johns Hopkins (10-5) vs. No. 2 Notre Dame (11-2) | noon | ESPNU | ND -2.5/20.5No. 3 North Carolina (13-4) vs. No. 6 Syracuse (12-5) | 2:30 p.m. | ESPNU | UNC -1.5/23.5Sunday, May 17Delaware Stadium, Newark, Del. No. 8 Penn State (10-5) vs. No. 1 Princeton (14-2) | noon | ESPNU | Princeton -1.5/22.5Georgetown (11-4) vs. Duke (10-4) | 2:30 p.m. | ESPNU | Duke -1.5/23.5GIVE & GOIn this week's fashion-themed Give & Go, the episode closes with hot takes on best and worst uniforms in college lacrosse, sparked by Vermont's green‑and‑gold look and spiraling into a tour of fashion takes, from Hopkins' endless combinations to the "brutal" High Point and Richmond kits.

Susan Magsamen has spent her career arguing that creativity and aesthetic experiences are not luxuries, but biological necessities woven into how we heal, learn, and connect. A researcher, educator, and co-author of the New York Times bestseller Your Brain on Art, Susan has become one of the leading voices in the growing field of neuroaesthetics: the science of how the arts and sensory experiences shape the brain and body. Through her work with the International Arts + Mind Lab at Johns Hopkins and the NeuroArts Blueprint Initiative, she has helped bridge the gap between scientific research and real-world practice in healthcare, education, and community life. In this episode, Susan reflects on the winding path that led her into this emerging field and explains what the latest research reveals about the profound impact of arts engagement on human wellbeing. She also explores how arts organizations can better communicate their value, why community-centered approaches matter, and what it will take to make neuroaesthetics a mainstream part of public policy in the years ahead. —— LINKS: Your Brain on Art: https://www.yourbrainonart.com/ International Arts + Mind Lab at Johns Hopkins: https://www.artsandmindlab.org/ NeuroArts Blueprint Initiative: https://neuroartsblueprint.org/ Neuroarts Resource Center: https://www.neuroartsresourcecenter.com/home

Kevin Sabet debates Matt Johnson on the Illusion of Consensus podcast with host Rav Arora, covering Trump's psychedelic executive order, ibogaine, FDA approval, Right to Try, drug scheduling, and the future of psychedelic research. Sabet, a former White House drug policy advisor across the Clinton, Bush, and Obama administrations, argues for caution around psychedelics, marijuana policy, commercial incentives, and overstated medical claims. Johnson, a leading Johns Hopkins psychedelic researcher, responds on psilocybin studies, addiction treatment, depression, safety protocols, REMS, and why accelerated research may still follow the evidence. The discussion also covers Joe Rogan, RFK Jr., Marty Makary, Jay Bhattacharya, ketamine clinics, MDMA, MAPS, cannabis rescheduling, veteran suicide, and the risks of turning experimental drugs into public policy too quickly. Subscribe to Rav's Substack to get episodes straight to your inbox: https://www.illusionconsensus.com Chapters: 0:00 - Intro 2:05 - Sabet's Objection to Psychedelics 10:00 - Matt's Disagreement with Sabet 13:15 - Psychedelic Research Quality 21:10 - Kevin's Rebuttal 24:00 - Was Joe Rogan Wrong On Ibogaine's Efficacy 32:50 - Ibogaine Safety Concerns 40:50 - Could The Executive Order Go Too Far 46:10 - Rescheduling and FDA Approval

Special discounts up for AIE Melbourne (LS discount) and AIE World's Fair (group discounts up to 25% - CFPs still open for Autoresearch and Vertical AI) Cya there!Abridge did not start as an “GPT wrapper”. It was founded in 2018, years before the Cambrian explosion of AI application layer companies. OpenAI launched ChatGPT publicly on November 30, 2022 and by then, Abridge had already spent years doing the unglamorous work of building trust for one of the highest context, most important workflows in healthcare: the conversation between a patient and a clinician.Abridge's original wedge was clinical documentation. Listen to the visit, generate the note, reduce the clerical burden, and let clinicians spend more time with patients instead of the EHR. By focusing on how doctors actually document, how health systems actually buy, how EHR integration actually works, how clinicians verify outputs, and how missing context during a visit turns into downstream friction across billing, prior authorization, quality, and follow-up, the adoption of LLMs became a force multiplier on a workflow already optimized for sensitive context gathering.The company has scaled fast: Abridge says it is projected to support 80M+ patient-clinician conversations this year across 250 large and complex U.S. health systems, with support for 28+ languages and 50+ specialties. It raised $300M at a $5.3B valuation in June 2025, after a $250M round earlier that year.Today, Janie Lee and Chaitanya “Chai” Asawa of Abridge join us for another crossover pod with Redpoint's Jacob Effron (who is on the board of Abridge) to dive into how Abridge is building the clinical intelligence layer for healthcare starting with ambient documentation, then expanding into clinical decision support, prior authorization, payer/provider/pharma workflows, and eventually real-time agents that act before, during, and after the patient conversation. We go inside the product, data, infra, evals, workflow, privacy, and org design choices behind bringing AI into one of the highest-stakes enterprise environments from 100M+ medical conversations and specialty-specific evals to real-time alerts, EHR integration, de-identification, clinician-scientist teams, and why healthcare may solve some of the hardest AI problems first.We discuss:* Why Abridge started with clinical documentation, “pajama time,” and saving clinicians 10–20 hours a week* The transition from ambient scribe to clinical intelligence layer: save time, save money, and save lives* Why conversations between patients and clinicians may be the most important workflow in healthcare (patient visit summary feature)* Chai's “healthcare-coded Glean” framing: context is king, but healthcare raises the stakes on safety, evals, and rollout* Why Abridge wants AI to feel like “air conditioning”: always in the background, but only interrupting when it truly matters* The prior authorization example: turning a denied MRI weeks later into real-time guidance while the patient is still in the room* Why payer policies, EHR data, medical literature, and hospital-specific guidelines make the problem hard, and also create the moat* How Abridge thinks about ambient form factors: mobile, desktop, in-room devices, nursing workflows, multimodality, and future AR* The multi-sided healthcare customer: CMIOs, CFOs, CIOs, clinicians, patients, payers, and pharma* The hardest AI problem at Abridge: high-quality, low-latency, low-cost real-time support in a high-stakes clinical setting* When Abridge uses frontier models vs proprietary models, and why its unique data from medical conversations matters* Why “every agent is a coding agent underneath,” and how the EHR can be thought of as a filesystem for healthcare agents* How Abridge approaches personalization across individual doctors, specialties, and health systems* Why “AI slop” is AI without context, and how edits, memories, and clinician preferences create a data flywheel* Abridge's eval stack: LFDs, LLM judges, in-house clinicians, third-party evaluators, specialty-specific evals, and progressive rollout* HIPAA, PHI, de-identification, one-way anonymization, customer contracts, and learning from healthcare data safely* What changes when you operate at 100M+ conversations: reliability, cost, post-training, model routing, and infrastructure optimization* Why the same clinical conversation can serve doctors, patients, payers, pharma, and future clinical-trial workflows* How Abridge works with EHRs, and why deep interoperability is table stakes for clinician adoption* Why healthcare AI has regulatory tailwinds, why 80/20 does not work here, and why high-stakes domains may drive AI forward* Why Abridge embeds “clinician scientists” into product and eval teams* What Chai learned from Glean about search, quality, and durable AI infrastructure* Why the future of AI infra may look like context layers, event-driven systems, Kafka, Temporal, sockets, CRDTs, and tools built for humans* Why Janie changed her mind on “PRDs are dead,” and why crisp written clarity matters more in complex AI products* How Abridge uses Claude Code, Cursor, and coding agents internallyAbridge:* Website: https://www.abridge.com/* X: https://x.com/AbridgeHQJanie Lee:* LinkedIn: https://www.linkedin.com/in/janiejleeChaitanya “Chai” Asawa:* LinkedIn: https://www.linkedin.com/in/casawaTimestamps00:00:00 Introduction and what Abridge does00:02:05 From ambient documentation to clinical intelligence00:04:04 Clinical decision support and context as king00:06:57 Alert fatigue, proactive intelligence, and prior authorization00:12:36 Ambient AI form factors and healthcare customers00:16:59 The hardest AI problems in healthcare00:18:26 Frontier models, proprietary data, and model strategy00:21:07 The EHR as a filesystem for agents00:24:03 Personalization, memory, and clinician preferences00:30:40 Evals, LLM judges, and progressive rollout00:36:47 HIPAA, de-identification, and privacy00:39:21 100M conversations and operating at scale00:44:10 EHR integration and the clinical intelligence layer00:46:39 Healthcare regulation, latency, and high-stakes AI00:50:11 Clinician scientists and long-tail quality00:53:04 Lessons from Glean and durable AI infrastructure00:57:03 The future of agentic healthcare workflows00:57:34 PRDs, product clarity, and building serious AI products01:03:11 AI coding tools at Abridge01:04:06 OutroTranscriptIntroduction: Abridge, Clinical Intelligence, and the Latent Space x Unsupervised Learning CrossoverSwyx [00:00:00]: Okay. This is a special crossover Latent Space Unsupervised Learning pod.Jacob [00:00:07]: Very excited to do this.Jacob [00:00:08]: At this point, we get together once a year.Swyx [00:00:10]: Once a yearJacob [00:00:11]: And this is a fun occasion to get to do it on.Swyx [00:00:13]: I really wanted to talk to Abridge but I felt very underqualified because healthcare is not something we cover very intensely. It just so happens that Redpoint's our big investors and supporters of Abridge.Jacob [00:00:27]: Anytime you want to have a portfolio company on your podcastJacob [00:00:29]: Please, by all means.Swyx [00:00:31]: So we'll introduce our guests. Chai and Janie, welcome to the pod.Janie [00:00:34]: Thanks for having us.Chai [00:00:35]: Thank you.Janie [00:00:35]: We're excited to be here.Chai [00:00:36]: Thank you.Swyx [00:00:36]: So for listeners, what do you guys do, just to situate you guys in the company?Janie [00:00:42]: Abridge is a clinical intelligence layer for health systems. We really started with documentation and building for clinicians and as we think about reducing the burden that clinicians have, they're spending 10 to 20 hours a week on documentation. There's a massive doctor shortage in the country. We also think that conversations between patients and clinicians are probably the most important workflow in healthcare. It's where care is given and received but if you think about the 20% of our GDP that goes towards healthcare, almost everything is a derivative of that conversation, whether it's the claim, the payment, the actual diagnosis given, the treatment. And we've started with a conversation to reduce the burden for doctors on documentation but we're really excited about the path ahead as we become this broader clinical intelligence layer.Chai [00:01:34]: I'm Chai. I work on clinical decision support at Abridge.Swyx [00:01:37]: Yes.Chai [00:01:37]: And so as Janie said, we're uniquely situated where we started off with the clinical note. What I'm really excited about and where we're expanding towards is what are all the things you can do before the conversation, during the conversation and after the conversation if you did have access to all the context about patients, payer guidelines, medical literature and put that together and to serve, how healthcare could look fundamentally different.Swyx [00:02:01]: And that's the context engine that you guys have?Chai [00:02:04]: Yes.Swyx [00:02:04]: Is that what it's called? Okay.Swyx [00:02:05]: So historically, as I understand it, the company started in 2018. A lot of people would be familiar with the AI voice notes form factor that doctors would be “Well, do you consent to being recorded?” It replaces handwriting and what have you. But it sounds like more recently there's been a big transition in the company. Tell me about the broader transition.From Documentation to Clinical Intelligence: Save Time, Save Money, Save LivesJanie [00:02:26]: So from a transition perspective, we really think about our journey as The first act was: how do we help save time? And that's where a lot of that original product was.Swyx [00:02:37]: By the way, one of those interesting statsSwyx [00:02:39]: On your landing page was, doctors spend time after hours.Janie [00:02:43]: They call it pajama time.Swyx [00:02:44]: Why is that pajama time?Janie [00:02:46]: Doctors after work in their pajamasSwyx [00:02:48]: In their pajamas. OhJanie [00:02:49]: At home are just writing and catching up on their notes every day.Janie [00:02:53]: Some of our favorite customer love stories, we have a Slack channel called Love Stories. We have clinicians telling us, “Abridge has helped us, from retiring early or we're now finally able toJanie [00:03:06]: go home and eat dinner with our kids for the first time.”Chai [00:03:08]: Save the marriage in some cases.Swyx [00:03:10]: One of the quotes was “We're not divorcing anymore.”Swyx [00:03:12]: I'm asking, “Why?”Swyx [00:03:14]: Because they're working too much.Janie [00:03:16]: But, in terms of where we're going and where we're expanding, we really think about our second and third acts around how do we help health systems save and make more money. Health systems are operating with record-low operating margins. It's getting harder and harder to serve patients and they have regulatory, some tailwinds but also a lot of headwinds coming their way and AI is ripe for helping on the saving and make-more-money piece. And then ultimately, how do we help save lives? The fact that our software and our product is open millions of times a week before, during and after a patient walks in the room, gives us massive opportunity with products like clinical decision support, which Chai is building but so many others to improve patient outcomes and probably one of the most important workflows and problems to be going after right now.From Glean to Healthcare: Context Is KingJacob [00:04:04]: One thing that's interesting, Chai, is you came over to Abridge from Glean and clinical decision support, which for our listeners is, in the context of a visit, helping a doctor figure out the right type of care. It's really a search problem in many ways, going through lots of different data sources. Very analogous to your previous role as one of the earliest engineers over at Glean. I'm sure a lot of our listeners are curious what's similar about the problems that you're going after now and what feels different, now that you're in healthcare.Chai [00:04:33]: Very similar. Taking a step back, with every wave, there's a lot of very similar patterns that happen across different products. A lot of social networking products look the same. A lot of credit-based products look the same. And we're seeing that very similar in the agent era with many companies, of course, in Redpoint's portfolio and so forth. And the key insight between both companies is that you have amazing models but context is king. Context is what puts them to work. So I see it in a lot of ways, a lot of similarities in this is a healthcare-coded version of Glean but the differences are really interesting. A couple things that come to mind. First and foremost, the rigor of the setting we're in. The downside risk is extremely high here in healthcare. It can be fatal in some cases. You prescribe something that the patient is allergic to for example. Whereas at Glean, it's “Oh, you got the question wrong.” It wasn't the end of the world in most cases. And so what does that mean? That shapes our evaluation strategy, both offline evaluation, progressive rollout and there's a lot more we could go into there. Second thing that comes to mind is, vertical versus horizontal. In both cases, there's a large variance but when Glean is, it's a much more horizontal company, there's a variance of personas, companies that you're working with. We also have a variance of personas, different types of specialties, different hospital systems. But the variance is a little more narrow. So from a product perspective, you're able to focus far more, especially when you have a maturing technology and you're building new products that never existed before. It lets you go after them much more easily and especially in healthcare where so many problems were solved with labor and process, that it's extremely ripe for AI to keep helping augment and enable. And the final thing that's really interesting, Abridge specifically compared to many other companies in the AI area, is the modality we started with where we're ambient and we're always listening in the background. And many more AI products will go that way but it's how we started. And that's the greatest form of AI we can create, AI that's seamless. You're not looking at your screen. It's always there. It's always helping you out and being proactive. The Jarvis vision that, every hackathon I went to over the past decade, there was always a Jarvis competitor. But Abridge very much started from the opportunity and continues to go that way.Ambient AI and Alert Fatigue: When Should the Product Interrupt?Jacob [00:06:57]: One thing that is super interesting then from a product perspective is you have this always-on seamless in the background and then you have to decide when you break the wall almost and say, “Hey, clinician, you might not have thought about X,” or whatever it is that you want to do. And in healthcare traditionally there's been this idea of alert fatigue and a million pop-ups and then a doctor just ignores all of them. It's probably a pattern that a lot of builders are thinking through now. How do you think about the right way to intervene or to pop up in a doctor visit?Janie [00:07:26]: It's such a good question. Alerts are notorious in healthcare specifically. Over 90% of alerts are ignored. The first and most important thing is context is everything, as Chai alluded to and I also think about how do we go from being reactive alerting to really proactive intelligence at the point at which it matters most. One thing we like to say is we want our product to feel like air conditioning. It should be in the background just making things better and if there is something that has great clinical risk and we're acutely aware that intervening now and not later is incredibly important, we should decide to act. But if you think about proactive versus reactive, instead of alerting a clinician during a visit when they're with their patient having a pretty serious and sensitive conversation, how do we prep a clinician before they walk into the room with that patient? And so historically, clinicians might have to manually go through charts with a patient that they've had over the course of months or years and they'll try to suss out what are the things they should be doing. You can imagine a world with Abridge. We'll summarize all of the most recent context for you, tell you based on the reason for a visit the patient is coming in for the types of things you should be discussing. And so you're going into that conversation prepped rather than walking in cold to that patient visit and then having this product interrupt you five or 10 times throughout the visit. And there might be times where it's really important to interrupt. We have a product called Prior Authorization and so this is when you may go into a doctor's office with knee pain. They'll prescribe you an MRI and so many of us have had this experience before, where in four weeks you'll get a call saying, “Hey, Sean, that MRI that you were prescribed wasn't approved and why don't you come back in? We'll figure it out.” In a world with Abridge, we might choose to quietly but still alert a doctor in that visit. And alert is probably not even the word we would want to use. Before a patient leaves, we would want to tell the doctor, “Hey, Doctor, before Sean leaves, you should ask him, has he had physical therapy and has his pain lasted for more than six weeks? Because the Aetna plan that he's on in California requires six things. We've already confirmed four of them have been met ‘cause we have all the context. But these two last criteria, if you can address with Sean before he leaves the room, we could guarantee that your MRI is approved before you leave.” And so when you think about clinical usefulness, impact to the patient, there are instances in which if we can catch a doctor while the patient is still in the room, as we think about save time, save money, save lives, we get to check all of those boxes. But when doctors have 15 minutes between visits, we have to be really thoughtful about when it matters.Prior Authorization: Reducing Latency in CareChai [00:10:23]: There's this interesting product opportunity AI has is reducing latency in the world. For example, prior authorization is an example of where care gets delayed and so great AI can reduce that. And the problem with alerts before partially is a technical problem: the quality of your alerts really matters. They're going to get ignored if you get alerts that... Similarly in engineering, where they're noisy alerts that you can't act on. But if you can make really high-quality alerts with both the context, as Janie said, and really high-quality models, then you can create a whole other game.Janie [00:10:53]: And I really like that experience because it starts to tease apart, what makes this so hard and unique. One, to make that prior authorization example possible, think about all the data that you need to have. You need to integrate with the electronic health record to know all of the patient context. Do we have access to your previous labs, previous imaging? And then to match you and to know that you're on Aetna, we have to collect all of the different payer policies and they vary by state. Some of these payer policies live on websites. Some of them live in unstructured 50-page PDF files.Jacob [00:11:31]: I thought this episode wasJacob [00:11:31]: To make sure we didn't scare people from healthcare.Janie [00:11:34]: But when you think about the things that make it hard, it also gives you the moat.Janie [00:11:39]: And then the second is the AI and the model quality we need to be able to hang our hat on. And so the bar, similarly when I worked at Opendoor, I worked on pricing models. Every outlier wiped out the margins of 30 and so similarly here in healthcare, the bar for accuracy is so high. And then I'd say the last is workflow is everything. If insurance companies deploy AI, it typically happens too late and this is when you have the notorious comical examples of AI just fighting each other when it's too late. But if we can pull forward the use of both the AI but also the ability to solve problems when the patient's in the room, you can start to collapse what typically takes weeks or months after your visit, ideally down to minutes or real-time. And it's where healthcare is both very difficult but also extremely rewarding if you can crack it.Product Form Factors: Mobile, Desktop, In-Room Devices, and ARSwyx [00:12:36]: Just to get some baseline on the form factors, because I've seen some videos on your website and stuff. You guys talk a lot about ambient AI. Is it primarily on the phone? Is there any other form factor that people get Abridge in? Is there an Abridge room setup where it's always on? I don't know.Jacob [00:12:55]: An Abridge podcast studio.Janie [00:12:58]: Primary form factor is mobile and desktop. UsuallyJanie [00:13:00]: Clinicians are walking in and out of rooms with mobile but at the end of the day, when they're closing out their notes or wanting to prep for the day ahead, they might use desktop. We have been having a lot of really interesting partnership conversations with a lot of these in-room device companies as you think about the power of multimodality and even more data, as you think about all of what is not captured today. It is fascinating to think about, especially even as we go into building and scaling our nursing product. It's one where nurses constantly, as they're walking in to check in on a patient for two minutes or maybe even 30 seconds,Janie [00:13:43]: Starting an Abridge experience is probably going to take longer than the visit. And so what can we do with in-room devices that are always on starts to raise really interesting and fun product questions.Swyx [00:13:54]: I was thinking, the way in tech companies we have all these Google MeetSwyx [00:13:58]: And other things, we might as well set up entire rooms with just Abridge tech.Chai [00:14:02]: Very much. AR glasses and related form factors are also relevant: how do we bring the information to the clinician in real-time without a screen, while still letting them focus on the patient?Swyx [00:14:18]: Do you think they want that? I'm skeptical of AR, but I'm curious what you've tried.Chai [00:14:26]: Admittedly, it's not a near-term product roadmapChai [00:14:29]: By any means. I'm being far-fetched.Jacob [00:14:31]: There's some sick AR stuff for surgeries.Swyx [00:14:33]: Really?Jacob [00:14:33]: When people are trying to visualize, you're about to make an incision but you want to see, what the cut might look or what the body might look like inside and they can layer in imaging.Swyx [00:14:43]: That's cool.Chai [00:14:45]: At some point in the future.Janie [00:14:46]: But there are a lot of our largest customers and at the largest health systems integrating already and so even as we think about building into it, unlocks a lot of product capabilities.Swyx [00:14:57]: And just to establish the terminology. Sorry, and I know I'm asking basic questions somewhat for myself but also for the audience who might beHealth Systems, Buyers, Clinicians, Patients, and PayersSwyx [00:15:05]: Less integrated. When you say health systems, it's like the Johns Hopkins, the Kaiser Permanentes.Janie [00:15:09]: Mayos, the Kaisers of the world.Swyx [00:15:10]: These are your customers, right? And the outcome that you deliver for them is happier doctors, reduced cost of processing, reduced mistakes. It's weird in a sense that I feel like there's also, a secondary customer, the customer of the customer and I don't know if you — do you think about it that way?Janie [00:15:28]: The other interesting and complex part of building product is we have our buyers, who are the chief medical information officersJanie [00:15:39]: The chief financial officers, the CIOs of these large health systems. Our users today are clinicians but if you think about who downstream is impacted, it's patients. And so as we build, with every product in mind, we think about who we're building for, who the secondary user is and what does that mean either in terms of experience, security compliance, ROI that we have to make tangible. And so like you said, time savings is one of them. But for CFOs, they care a lot more than just time savings. We have to show for every dollar you put into Abridge, because you have more compliant documentation or because you have fewer queries coming from your billing team, we save or add real dollars to your bottom line or top line, are things that we're constantly thinking about because of the dynamic across all three sets of users.Chai [00:16:32]: There's a whole other axis too with the payers and pharmaChai [00:16:35]: as well. Connecting all these three big stakeholders in healthcare isSwyx [00:16:39]: Do the payers ever see your data? Sorry, the payers meaning the insurers, right?Chai [00:16:44]: Yes.Swyx [00:16:44]: They also see Abridge data?Chai [00:16:47]: NoSwyx [00:16:47]: Like the direct integration to you guysChai [00:16:48]: They wouldn't see the raw Abridge data but when you're working together on something like prior authorization, whatever information they need, we'd communicate to them.Jacob [00:16:59]: That's cool. I would love to dig into the AI side. You still have a lot of problems on the AI side. And so maybe to start at the highest level, what's one of the hardest problems you have to solve in AI at Abridge today?The Hardest AI Problems: Quality, Latency, and CostChai [00:17:11]: To make things simple, let's take, building off the prior auth example. So one thing Janie talked about is okay, this data is all over the place and there's this combinatorial explosion of procedures, payer policies and even sometimes different health systems. There can be some cross-product of all of these different considerations you have to take into account. But what's really hard about this problem is doing it real-time in the conversation. So, in any AI product, usually the three KPIs you care about are quality, latency and cost. Now, what we're saying is we want you to do this real-time in the conversation, guiding the clinician. How do we do it in a way that does not break the bank? But we're using — But we also need very intelligent models because you're working with this cross-product of data and this, all this context layer as well. So you need high intelligence and high-quality because you don't want the alert fatigue but you also need to be fast and cost-effective. And so that's where a lot of clever engineering goes. It's okay, without getting into all the details here, can you model these policies in some intermediate representation or other things that you can do that can make this problem tractable? And of course, the Pareto frontier is always changing but we are also trying to do this now.Model Strategy: Third-Party Models, Proprietary Data, and Medical ConversationsJacob [00:18:26]: What implications has that had for what you take off-the-shelf and say, “ what? We don't need to be world-class at X. We'll just take this from the model providers or from some infrastructure player,” and what you're “No, this is where we spend most of our time focused on”?Chai [00:18:38]: This is, the fun challenge in AI?Jacob [00:18:42]: It changes every three months? SoChai [00:18:42]: Of course, with the shifting landscape, we try to be extremely thoughtful on predicting the trends of where third-party models are going and where we can uniquely go. And, sometimes when you talk about AI models, we're the models are just going to get infinitely better. But I don't think... It may be in the grandness of time you could say that but, within every month, every quarter, there's specific ways they're getting better. They're training on a lot more, coding data to be better coding agents, for example. And soChai [00:19:14]: We have to think about where are the things that won't — unique data that we're uniquely training on or to step back a little, where is a proprietary model bringing advantage to us is if it can give higher quality or lower cost and latency for similar quality, very similar to many other companies. And when we can do that is when we have proprietary data. So, for example, we have on the order of eighty million or hundreds of millions now getting close to of medical conversations.Jacob [00:19:44]: It's insane.Chai [00:19:45]: This is a unique data set. And this data set, it's very interesting because this data set is effectively a large part of the trace between the patient and the provider. That's where the quote-unquote debugging happens in healthcare. We have these traces at scale, as in as, our CEOs even called it, an exhaust that comes out of our product. And so when you have these traces, that's how you can train better agents on certain use cases, whether it's your transcription diarization use cases or so on or like note generation models and we can do that much cheaper and faster. But we're always also working with these third-party model providers. We closely collaborate with them and that's how we predict where the trends are going. The thing that I think about a lot is that, I know that the model providers are going to train much more on agentic workflows and so forth, so that's great, so that you have a better agentic harness. But the other thing that's interesting is that the model providers, because a large class of the consumer model providers is healthcare queries, that they might, optimize to train a lot of healthcare data to encode the knowledge in its weights. And this is just a great thing for us as well, where the off-the-shelf models can keep bett-getting better at general healthcare information, such that what our strategy is, we have a constellation of models, we can use something for this, that and, we only care about, at the end of the day, the best product experience.EHR as File System: Agentic Workflows and Real-Time InterfacesJacob [00:21:07]: And, you have, overall capabilities improving. I'm curious, as these models get better, is there something you look at and you're “, three months ago, we really couldn't do that but God, the the latest models really allow us to do it”?Chai [00:21:19]: So here's something interesting that I've, been toying with. So all models are... This wasn't super obvious a year ago but now it's become clear and clear that almost every agent is a coding agent underneath the hood? So you give it whatever file system, it can write its own code and so forth. So when you think about within healthcare and the use case that we have, you can think of the EHR effectively like a file system. It's just — it's a storage of all this information. It's a lot of information there that cannot fit into the context window, at least of today's models and you want to use that context effectively for all these product use cases we're talking about. And so if you have better agents that can, manipulate data, read that data, treat it as a file system as we see they're going and we know model companies are investing this way, then that very directly benefits us.Swyx [00:22:09]: Yeah. Okay, cool. Again, just establishing basic things. But we're going back to the model stuff. I'm really interested in double-clicking more on the real-time, element, which is pretty important for both of you. Is it — Is real-time just batches of every one minute, every five minutes? Is that how we do it? Or is there some more native, genuinely real-time in the sense that OpenAI has a real-time API or Gemini has a real-time API?Chai [00:22:35]: Yeah. Yeah. So today it is more on the on the batch basis but there's interestingChai [00:22:41]: Prototypes that we have that we're still not fully, full time, voice in text out or in that sense. But, can you trigger your models, your agents or agentic workflows, depending on the right times in the conversation?Chai [00:22:58]: And so you can imagine, different techniques to bring this latency down and, you want to bring the feedback loop down as much as you can. And so a lot of clever engineering there without fully... Maybe one day we'll do full voice in and text out, train a model to do something like that.Swyx [00:23:15]: You do — People don't want voice in voice out?Chai [00:23:18]: Now we aren't creating experiences that are, during the conversation, inter — It's almost likeSwyx [00:23:25]: Might be too disruptiveChai [00:23:26]: Too disruptive until, who knows, maybe eventually you could have full voice agents once we — the quality and we improve the comfort of the technology. But right now gra — that change is much more gradual and it's more text focus, text out.Janie [00:23:42]: And so much of currently what our product is trying to do is allow a clinician to focus on their patient and maybe at some point but right now patients, clinicians don't want a third voice, at least in a literal voice in that room. And so how do we be there with all the contacts and information ready at hand when there's the right moment?Personalization: Individual Doctors, Specialties, and Health SystemsJacob [00:24:03]: Jenny, one thing I'm curious about is how you think about, personalization in the product. I imagine, every doctor is a special snowflake in their own way, has their own way they like to do things. There are probably a bunch of different approaches you could take to doing that, both within the model layer itself but then also just with clever prompting or engineering. How do youJacob [00:24:20]: Deliver on that?Janie [00:24:21]: It's such a good question. Personalization is massive for us. We think about personalization at three levels. The first is at the individual, the second is at the specialty level and then the third is at the health system or the organization level. To your point, there are a lot of individual preferences. You-When a note is produced, it almost is a reflection that is so deeply personal of a doctor's work and how they give care. And so do they have preferences on things like style? They might want bullets versus paragraphs, really concise versus comprehensive. They also might have phrases that they really like to use or the templates that they want every note to be structured. And, we see it in our feedback all the time. We want two spaces in between sentences or I refuse to use this tool. And so that's something that we've had to build in. And the tricky part is how do you make sure that stylistic preferences don't interrupt accuracy and quality and that's something that we've really had to refine and hone over time. Second is at the specialty level. A cardiologist note or workflow is going to look very different from a dermatologist workflow.Jacob [00:25:32]: I assume cardiology notes are the highest stakes for you guys, given your CEO is a cardiologist.Jacob [00:25:36]: It's “Oh my God, make sure we get this one.”Janie [00:25:37]: Shiv, our CEO, is still a practicing cardiologist. He rounds once a month. And so, first call when we want just quick and easy user feedback too.Janie [00:25:46]: But, specialties require a lot of personalization, both in terms of what does the product look and so we make sure that as new users onboard, we catch that and the product proportionally reflects that. But also on the back end, evals at the specialty level, they are hard-earned to calibrate and get. What does a really great dermatology note look like? What makes it complete? What makes it compliant and billable is very different than a primary care doctor. And so it's not just about what does the product experience look but on the back end tuning and really deepening our understanding for the specialists. What does great output look like? And that's, a problem that we need to calibrate internally, externally, online, offline but, takes lots of cycles but is necessary in a high-stakes environment. And then at the health system level, for products like clinical decision support, you have health systems who've spent years or decades refining their best practices and they want to know, “Hey, we love your clinical decision support product but how do we embed our own hospital guidelines into them to inform clinicians before, during or after a visit what brest — best practices should look like?” And as you think about, deepening moats as well, when health systems, trust us with that data, allow us to productize it and directly into the clinical workflow, makes us a really great partner to health systems who want to build something that truly meets their needs, their practicing guidelines.AI Slop, Memory, and Product Data FlywheelsChai [00:27:23]: And I want to add onto that. The for the clinical documentation problem, it's very similar to AI writing that doesn't feel like your own and then we call that slop. But the way I describe one framing of slop is like AI without context. But we have all that context and both the clinicians, can have it and can guide it. And so part of the other interesting exhaust for us is, memory is, one of these new systems recordsChai [00:27:49]: Almost.Janie [00:27:50]: And we also have all the edits people make on our product and when you think about a data flywheel and how we get better over time becomes really powerful as a mechanism to just going deeper in personalization.Jacob [00:28:04]: It's interesting. I love this idea of working with systems on the guidelines they built up over a long time. I feel like so many of the best AI app companies today are... The question is: How do you take the expertise that a law firm or a bank has built up over many years and then add that as context and also a special sauce over, a an AI tool? And so seems like y'all are really doing that very effectively.Janie [00:28:24]: We're now starting to have our customers ask, “What are other customers doing?”Janie [00:28:28]: “And how are they doing it?”Janie [00:28:30]: And as we think about having visibility across such a large set of care being delivered right now, a really interesting place we could also partner.Swyx [00:28:40]: I'm just curious. I — This may be a nothing question but, how different are health system guidelines from each other? Don't they all converge to the same thing? And if not, where do they differ?Chai [00:28:52]: At a really high level, they're going to talk about very similar things but the difference is probably in some more of the details. “Oh, you should refer to specialists only when XYZ conditions are met,” or so forth and maybe different organizations have different practices and guidelines around that. But high level, talking about similar things but the details are what, of course, that shapes the context and the decisions you make.Swyx [00:29:15]: And this all goes into the context engine and it might affect the notes but maybe not.Chai [00:29:21]: The — For these local pathways, we're definitely thinking about it a little more for our clinical decision support product.Chai [00:29:26]: So yeah.Swyx [00:29:27]: Which is your stuff, yeah.Swyx [00:29:28]: And then the memory which you raised, let's just tell us more about that. What have you tried in memory? What's the structure of the memory? What works? What doesn't work?Chai [00:29:38]: There's, of course, many different ways you could do memory, where it's okay, can you bake it into the model weights or can you do it in some external store? For us, what's interesting is, of course, when you think the models are rapidly changing, whether it's in-house or third-party, baking into the model weights, sometimes you worry that it could be a little throwaway. And so, how do you... You need to find a way that you decompose the problem, the preferences from the underlying models and so forth. The thing we're right now most both that's easiest to start with and we're excited about is having, a separate store for memory, where you have, for example, a memory sub-agent that's, working in the background, figuring out what are the important parts of the clinician's actions that we want to remember for the long term. And then you can also imagine, other things where in the — you have background jobs that are running that are collating these, memories similar to Sleep, of course and what other pattern, patterns products do as well. Learning over all these action, all the action data we have, again, note edits, the conversations they did and the actual transcripts.Evals: LFD, LLM Judges, and Clinical SafetyJacob [00:30:40]: What about evals? How in the world do you... It is such a complex product surface area. We would love to hear you riff on that and also how has that evolved? I'm sure you've gotten better at it, so any learnings along the way.Janie [00:30:50]: From an evals perspective, we, from day one when we build any new product or feature, we think about, what does good look like? And there are table stakes things like clinical safety but then you start to get deeper into what does good quality look like. And when you go into something like our core product, there's stuff like style and completeness and there's things like does this note become something that can be billable, which is very high stakes for a health system. We have a number of ways in which we get confidence for this. We have, internal in-house clinicians who do what we call an LFD process to give us our very first pass at is this or isn't this a good enough output, look at the effing data.Jacob [00:31:41]: LFD?Chai [00:31:42]: That's why I was smiling. I was “Is Janie going to mention what it stands for?”Jacob [00:31:46]: I was not... There's like a million acronyms.Jacob [00:31:48]: How am I supposed to know that I don't? So “Oh yeah, of course, an LFD.”Swyx [00:31:51]: I've never heard of LFDs.Chai [00:31:53]: It's a bridge for sure.Janie [00:31:55]: I got through three days and then I had to ask someone.Janie [00:31:58]: I thought it was just me that didn't knowJanie [00:32:01]: It's our internal process.Swyx [00:32:02]: But look at the data as a meme in ML, ‘cause you tend to not look at it. You just want to look at number go up.Chai [00:32:06]: Exactly.Swyx [00:32:07]: But yes.Janie [00:32:08]: But so, we make sure we look at the data and then as we think about all of the components of good output, we, one, create LLM judges across all of these and we make sure with annotated data and either internal or external evaluators, we feel like these judges are calibrated. And then depending on the stakes, we also work with in-house and third-party evaluators across all of these before we ship any big change. And the goal is, in terms of evolution, how do you go from this process taking months, down to weeks, down to days? Some of it is, a true science and ML problem. A lot of it's also just, hard operational work. Have you planned ahead in terms of what you need? Have you really optimized the capacity that you need across all of the different specialties you need? Have you gotten a really good sense of which third parties are great to work with for what use cases? This takes a lot of domain, expertise and, lots of mistakes and errors in figuring that out. And so as much of it is an ML problem, so much of it has also been operational gains that are hugely important, where domain-specific expertise is everything.Specialty-Level Evaluation and Progressive RolloutsJacob [00:33:23]: But it's funny, ‘cause I feel like people talk about healthcare like it's one giant market and the reality isJacob [00:33:26]: It's, dozens and dozens of sub-markets. And so it feels like in your evals you have to build that up across the board, probably.Swyx [00:33:34]: And is specialization the primary cardinality at... That's the word that comes to mind.Janie [00:33:40]: Sometimes, depending on the product or the use case. And so if we're making a note improvement or feature for a particular specialty, definitely but we have products that are for nurses. We have products that, are really aimed at making the document or the output a lot more billable. And so we'll want to work with coding teams and not necessary clinicians. And so likeJacob [00:34:05]: Coding meaning healthcare coding.Janie [00:34:06]: Yes. Yes.Jacob [00:34:07]: NotChai [00:34:07]: Yes. I see you.Swyx [00:34:07]: Other kinds.Janie [00:34:09]: But is this output proportional to the work that was delivered? Is there sufficient documentation to justify the amount that a health system may end up charging? And so, specialty sometimes but also domain, very different across all of the different products that we're working for. And building out that network is, not easy and is where a lot of our operational investments have gone into.Chai [00:34:35]: And I view a lot of analogies to self-driving cars here, where, part of it is we really want progressive rollout of features to test in the real world is this useful? Is this going to work? One big difference compared to past lives is before I'd build a product, maybe I'd alpha it and then I'd like GA it the next week, ‘cause I'm “Go, move fast, ship,” and whatnot. But the mentality is like you... I want to make contact with the reality as quick as possible but I want a progressive rollout. Because as much as I get as large of an offline eval set, I want the distribution of that to match real-life distribution. And over time, by rolling out early, similar to Waymo has a tagline, “The world's most experienced driver,” another thing that can, at least linearly increase for us is, both the size of our evaluation offline and online, that and it all feeds back.Janie [00:35:25]: Something that's been earned over time, speaking of evolution, is just the trust we've gotten with customers. Historically, a lot of these health systems, when they bring on new vendors, their release cycles are quarters, sometimes twice a year. We've gotten our customers onto monthly release cycles, which is pretty fast for health systems but what is more exciting over the last, call it, few quarters, has been, a subset of our customers have said, “We want to innovate with you. We trust you,” and we have a pretty, decent chunk of our customers who say, “We'll develop with you outside of these monthly release cycles. We have a higher tolerance. We know that the stakes are very high but we want to be the first ones using these products, giving you feedback.” And so for a pretty substantial set of our customers, we've been able to convince them to be able to ship, in this gradual way before GA. Something we talk about a lot internally is, trust is earned in drops, earned in buckets and so we still can't do what I used to do when I worked at Loom. We had 30 million users. I'd just be, rolling out experiments left and. The bar is still quite high for iterative rollout but because of the trust we've earned, we're able to learn at pretty high volume very quickly.Privacy, HIPAA, and De-IdentificationSwyx [00:36:45]: Your scale is still pretty huge.Swyx [00:36:47]: One thing I want to... We were going to go into scale? In a sec. One thing I wanted to call up, follow up on evals, which, again, just coming from a generalist engineer point of view, just thinking through what would people be scared of in doing this, the privacy and HIPAAJacob [00:37:00]: Elements of this. I have zero experience in that. What do you have to do? What is surprisingly not that bad?Chai [00:37:06]: So one thing that's really important here from a compliance perspective is very much that any of the data we use needs to be de-identified, any real-world data we use as a basis of online eval sets we're learning from. And so you have to — And there's, very clear, government guidelines, what counts as PHI. And so we've even have built models that can take, for example, a clinical transcript and remove all the key PHI indicators and so you have a scrubbed/de-identified version. And then once you... And so one thing that's important is first you've got to get confidence in that model in the first place? And prove that out. Because, now you have, multiple probabilistic systems on top of each other.Chai [00:37:46]: But once you have that, then you can train on it use it for evaluation and so forth, provided one of the cool things also that you can do from a business side is the right data contracting as well with your partners.Jacob [00:37:57]: Is the anonymization one way? Once it's done, you cannot undo it? Or is there someoneChai [00:38:01]: YesJacob [00:38:02]: Who holds the master key that can... Yeah, okay. So it's one way.Chai [00:38:05]: It's one way. Yeah.Jacob [00:38:06]: That's how it works. I just wanted to... Because, there's a lot of this, learning from feedback and everything that, you would want to debug more but you can't because you just physically don't allow yourself to.Janie [00:38:17]: Some of it's also written in our customer contracts in terms of who can or can't access PHI data, how long do we retain it,Jacob [00:38:27]: Very goodJanie [00:38:27]: Before it gets de-identified. And so we have a pretty high bar for who can access that PHI data, just to make sure that we always respect our customer data and privacy. But that's something that we partner with our customers on too, to make sure that as we want full, as close to precision as possible in that qualityJanie [00:38:48]: We can still use it.Jacob [00:38:50]: But it'll be fascinating to see how that space evolves? Because you think about, I used to work at a company that, did a lot of healthcare data in the cancer space and if you asked, the average cancer patient, “Hey, do you want people, do you want other patients to be able to learn-”Chai [00:39:03]: Take it.Jacob [00:39:03]: “... Learn from your experience?”Chai [00:39:04]: Take it all.Jacob [00:39:05]: They're “Please.”Jacob [00:39:06]: “I'd love, nothing more than for other people to be able to learn fromJacob [00:39:10]: The experience that I had.” And so in the past it was a lot harder to do that learning. But with this technology, that might really be practical and so it'll be fascinating to see how that continues to evolve.Chai [00:39:21]: There's so much in our data set of 100 million conversations.Chai [00:39:26]: You can imagine things like insights that you can give to the clinician. How could you, oh, how could you have reacted to this? In coaching or insights around, which treatments are effective or, like... Because you have this, again, this data source that was never captured before but that's, where, intuition or experience is created from, going back to this idea that the conversation is the agent of truth.Operating at Scale: Reliability, Cost, and Token EfficiencyJacob [00:39:46]: Back to the 100 million conversations, I feel like you have this insane scale that maybe only a few other AI app companies have and everyone else dreams of. So not everyone has had to confront this yet but maybe just talk about some of the challenges of operating at that scale and what, our listeners have to look forward to if they ever get to this level of scale.Chai [00:40:05]: At large and larger in scale, so of course there's a general, infrastructure reliability. When you... In any given startup, you're building the plane while it's flying. So there's some notion of that. But what gets interesting on the AI and ML side for sure is this, as you get at more and more scale, so one, you have the data to first and foremost do this. But, you start thinking about costs or infrastructure in a whole different way at scale versus, a prototype.Chai [00:40:34]: You can use the most expensive model, you can burn as many tokens as you want but when you're doing 100 million conversationsJacob [00:40:41]: Token max on leaderboards are less upsetting than that context.Chai [00:40:45]: . When you're doing that and so that comes for we have the data and we also have the team that's able to post-train based on this and you can optimize for efficiency, especially in areas where you believe that maybe a lot of the quality headroom is less so and you don't expect the other off-the-shelf models to go that way, such that you want to do, efficiency maximization, in terms of compute and tokens.Jacob [00:41:08]: I feel like you guys live in the future in some way where most use cases today are really just in use case discovery mode, where it's “God, I really hope I can find something that can get to scale,” and so you're always going to use the most powerful model. And then the few things that do get to this level of scale, you start to do those optimizations.Chai [00:41:22]: It's a natural trajectory where it's like zero-to-one, we're not talking about any of these optimizations.Chai [00:41:26]: But when maybe we're in the one-to-100 or so forth, then we're in optimization mode and, what works out really well is you've got all this data from zero-to-one that lets you do this.What Comes Next: The Conversation as the Shared Healthcare PlatformJacob [00:41:36]: That's fascinating. I feel like one thing that's so interesting about the Abridge footprint is that you're in the doctor-patient visit in real-time. I always like to say, there's like probably 50 years' worth of product you could build on top of that. What gets each of you, I don't know, what are you most excited about building, either in the short term or medium term or even, long down the line?Janie [00:41:53]: Something that I get really excited about is that the same conversation can serve so many stakeholders. If you think about the conversation, a doctor needs to know what is the documentation, how do I make sure that this fully represent the care I gave? A patient needs to know, “What the heck just happened? This was really overwhelming. What are my next steps?” A payer needs to know, was this the proper and appropriate care given? A pharma company might want to know why isn't this drug being properly used or is there a good candidate for this clinical trial that I'm about to run? And where I get excited is that our product and our platform and our infrastructure can be the same product across all of those things and start to what's today, separate, very expensive, complex systems that serve each one of these stakeholders in very different ways, start to collapse all of that into a singular platform that enables not just more efficiency across the board but also better outcomes for everyone. And, all of us experience healthcare in probably very painful ways and knowing that there is a world in which we can simplify a lot is really exciting to me and it all starts with the conversation.Chai [00:43:15]: It's interesting. Of it very similar to going back to the KPIs that any AI product cares about. How do you increase quality of care? How do you reduce latency to care? And how do you reduce costs? Which is a huge, in healthcareJacob [00:43:28]: They call it the triple aim in healthcare.Chai [00:43:30]: But very similar to building AI products and the thing that really excites me is when we talk about that latency piece, we talked about one example earlier of prior authorization, can you reduce the latency to care? But you can imagine so much more. Oh, as soon as the lab value gets updated, do you have like a background agent that, kicks off and uses all the context to be “Oh, hey, the patient should do this next,” for example. And of flagging that to the clinician who's always in the loop but reducing that latency, to care. And then you can imagine this is much further down the road but it's like even connecting that to the direct patient and the consumer. And so how can you, how can you build a bridge to all of these things?EHR Partnerships and the Clinical Intelligence LayerJacob [00:44:10]: Very cool. The connections piece is just an ever-growing thing. And one of the key partners is the EHR and I wonder what that relationship is like. Will they, look at this as, something that is valuable enough that they want to own someday?Janie [00:44:29]: Our partnerships with the EHR is, we know that we have to be extremely close partners with all the EHRs who we partner with. Being able to not only pull and push all of the data into the right places is, not only table stakes, if we can't do that, health systems don't want to use us. The second and the reality of today is clinicians spend a lot of their days in the EHR. So much of what allowed us to win in the largest health systems was pretty direct and, very close partnerships with some of the largest electronic health records that allowed us to pull and push data with APIs that weren't ready out of the box. And clinicians want to save clicks. Anytime we introduce a new product that, adds two clicks for them in their day, they're “We're not going to use it.”Janie [00:45:21]: They have 15-minute back-to-back appointments with their patients. They're spending, hours during pajama time doing documentation. Every second and every minute counts and so we really think about being deeply integrated into the EHR as also table stakes to getting real usage and adoption. And anything that we build or introduce, we really talk about earn the right internally a lot, which is we have to provide so much value or save so much time that people will use us. But those are the two things that are close to us, is we know that the product won't be used unless it is deeply interoperable.Chai [00:46:01]: And strategically, to your point, it's like what does EHR want to own versus us? EHRs are really focused on the clinical workflows and so forth but some of the things that we're talking about here, I do these traditionally are outside of the domain where it's oh, connecting pairs and providers together with provider policies or the clinical trial matching, as Janie brought up. And so these are, entirely — we position ourselves as building this entirely new intelligence, clinical intelligence layer across, again, providers, pharma and, payers.Chai [00:46:33]: And so that's a it's a whole different ballgame that we try to playChai [00:46:36]: In combination with them.Jacob [00:46:37]: But it's like a different layer of scope.Healthcare AI Regulation, Technical Depth, and What Changed Their MindsJacob [00:46:39]: I'm curious, you are both relatively newcomers to healthcare. People have these, there's lots of futuristic healthcare AI takes of “Oh, everything will look different.”, now that you've been in healthcare for a bit, you live at the edge of AI, what have you, changed your mind on around this, as you think about what healthcare looks like in ten, 20 years? Any updates to your mental model from the time being close to the problems?Chai [00:47:02]: One thing that IChai [00:47:04]: Was hesitant about before and it's a common thing when I'm trying to recruit engineers that people ask me around, is definitely oh, healthcare, heavily regulated space. And it is, rightfully so. You want to keep, the patients at the end of the day safe. But one of the interesting things that, is a that surprised me how much it is coming to the company is there's a lot of really favorable regulatory tailwinds as well. Where you think about, government really wants interoperability between all these systems that we talked about and so agents can access this information. The government just in January, the FDA released updated guidance on clinical decision support, what I work on in such a way that they used to have guidance from like 2022 that required you to have, mention all these options and do all these other things but it's a very forward and forward-looking way. And so for me, what's been really cool to work on is this, there's this very special moment both in AI in general, we all know that but there's a special moment also regulatory in healthcare as well.Janie [00:48:05]: One thing I would call out is for the very reasons things are higher stakes or, potentially considered more difficult in healthcare, it's where some of the hardest AI problems will get solved first, just because the bar is so high. When I first joined, I was “Oh, this is where we'll be on the tail end of where, all of the AI innovation will be able to be applied.” But when you think about, zero error evals or multi-step workflows that have really low tolerance, a lot of the innovation will happen here just because we have to or else we can't ship.Jacob [00:48:42]: ‘Cause like in other domains, you'd much rather just solve the 80%-is-good-enough problems firstJanie [00:48:46]: 80/20 doesn't work hereChai [00:48:48]: And building off that, traditionally, there was a bit of stigma that, oh, healthcare companies are not that interesting from a technical perspective or I've seen that or faced that myself. But these are really hard and fun problems from a pure technical perspective beyond just the impact. How do you bring the latency of this thing down and make it really high-quality?Reducing Latency: Clinical Workflows, Agents, and Implementation RealityJacob [00:49:07]: How do you bring the latency of things down?Chai [00:49:10]: Yeah. Yeah. Yeah. So okay, let's answer the latency question. And maybe hopefully not too redundant with some of the things I've said earlier but some part of it is with any latency, you have to like what is, what is really your bottleneck. In a lot of workflows, it's sometimes it's the model itself. And so that's where like our data flywheel, our post-training team and so forth come in so that can you make the models far more efficient. So that's one aspect of latency. But there's whole other aspects of latency where it's okay, on top of that, if you use a constellation of different models, can you use — can you first use like a — it's like thinking fast and slow. Can you use a cheap, fast model that triages and hands it off to a larger model where you get more intelligence and so forth and so all theseChai [00:49:56]: Clever tricks to make it work.Chai [00:49:58]: And by the way, we are totally — we also realize that the parameter frontier is changing and so these tricks will — may not get us to where we want to be in five years but we need to if we want to build a useful product right now.Jacob [00:50:11]: Should we go to the quick-fire or you want to ask more about Abridge? We can stuff everything that's not Abridge into the quick-fireSwyx [00:50:16]: I don't mind. I was — I feel like Janie was on the topic of more long tail stuff, which isSwyx [00:50:21]: Not the eighty/twenty thing and that really matters. And I'll —, if you have any tips or cool stories or just general approaches that have worked for you that's interesting to dig into.Janie [00:50:32]: One of them is even just how we staff our teams looks different than a traditional software engineering team, I'd say.Swyx [00:50:40]: Let's go.Clinician Scientists, Edge Cases, and Evals at ScaleJanie [00:50:41]: We have a bunch of folks with different roles who are clinicians and so we have this role called the clinician scientist and I heard one of our leaders refer to them as mutants recently. But they are people who've had clinical backgrounds, so MDs typically, who are also deeply technical, somewhere, on the spectrum of like a full stack engineer all the way to like extremely scrappy prompter. But having each of these people embedded within our teams instantly raises the bar for everything that we build because not only are they determining, is this product clinically useful but they're deeply embedded in our whole evals process. And so when we talk about LFDs, when we talk about what is our actual evaluation criteria, you don't want Chai or me creating what those are because we don't have clinical background. But is probably unique to Abridge but has been game changing. And when you think about where the puck is going, you have people build with clinical backgrounds who are technical and where AI tools are going, they just becomeJanie [00:51:53]: More and more, critical and like the killers of the team. And so that's one. And then the second is just the scale at which we do evals to catch that long tail up front before anything ever gets into production is something that we've pretty much like really started to fine-tune, both from a scale but when do we know we need to get several hundred versus several thousand offline responses, what helps us make that quick decision and make this less of an art and as much of a science as possible. But that's also been something we've had to tune over time.Swyx [00:52:27]: And you have partners who opted in to give you those evals.Janie [00:52:31]: So we work either internally or with third-party for offline evals and then we have customers who also agree to give us, whether it's like thumbs up, thumbs down to like choose this or that, a lot of data to get us to what is as close to fully confident as possible.Swyx [00:52:51]: The term that comes to mind isSwyx [00:52:53]: Like active learning on things where you're weak. I feel like it's a lost artSwyx [00:52:58]: Is a lot of the polish that comes into doing something like this.Janie [00:53:02]: Really.Chai [00:53:03]: Hundred percent.Lessons from Glean: Technical Foundations and AI App InfrastructureJacob [00:53:04]: Maybe, on a totally unrelated note, Chai, you had a very, storied run at Glean b

In this episode of Dismantling You, I sit down with Dr. Jennifer Kulp-Makarov, a Board-Certified Reproductive Endocrinologist and founder of Fleura Fertility, trained at Johns Hopkins and Yale. We dig into how traditional fertility clinics often rely on a one size fits all approach to IVF, and why that can actually backfire for women with low AMH or those trying to conceive over 40. Dr. Jennifer shares the patient experience that changed everything for her: a woman who gave up on growing her family because she thought aggressive, high dose IVF was her only option. That moment became the catalyst for her to build a practice centered on personalized protocols and her signature Goldilocks approach to stimulation, finding the just right dose of medication rather than defaulting to the highest one.We also explore cutting edge fertility innovations including ovarian PRP, which is showing promise in improving markers like AMH and antifollicle count, and rapamycin, an emerging treatment that may help protect egg reserves and delay menopause. Dr. Jennifer breaks down how FSH dosing plays a critical role in egg competence and why monitoring it throughout the cycle, not just at baseline, makes a real difference. We talk about how fertility care is evolving to better support LGBTQ individuals through inclusive language and treatment design, and how AI could soon help standardize ultrasound data and embryo analysis. We wrap up with Dr. Jennifer's rapid fire answers on the most underrated factor in fertility, the biggest mistake patients make when choosing a clinic, and the one belief she had to dismantle in her own career.__________________________________________________Key Highlights

In the last 20 years, there has been a dramatic change in our understanding of neuroplasticity — the brain's capacity to grow new neurons. In the last five years, we've learned that your hippocampus, the part of your brain responsible for learning and memory, can get bigger at any age. Majid Fotuhi, who teaches at Johns Hopkins, has been at the forefront of a new body of research demonstrating that lifestyle changes — tweaks to the way you exercise and eat, adjustments to your sleep and mindset — can improve your brain health no matter how old you are. They can even reverse early-stage Alzheimer's. His new book is The Invincible Brain, and the message is clear: with the right lifestyle and mindset changes, you can grow a bigger brain.

In his weekly clinical update, Dr. Griffin and Vincent Racaniello discuss the outbreak of Hantavirus on a cruise ship and its potential for person-person transmission, how cessation of funding for global health by the Trump administration has compromised American health and well being, as well as the description of paralytic poliomyelitis outbreaks in Central Africa associated with the administration of nOPV2, before Dr. Griffin deep dives into the measles outbreak, recent statistics RSV, influenza and SARS-CoV-2 infections, the Wasterwater Scan dashboard, Johns Hopkins measles tracker, association of ear infections in children with RSV, PEMGARDA authorized use for certain immunocompromised individuals where to find PEMGARDA, how to access and pay for Paxlovid, where to go for answers about long COVID-19, multisystem inflammatory syndrome in children and contacting your federal government representative to stop the assault on science and biomedical research. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Hantavirus Pulmonary Syndrome—The 25th Anniversary of the Four Corners Outbreak (CDC: Emerging Infectious Diseases) Outbreak of Hantavirus Infection in the Four Corners Region of the United States in the Wake of the 1997–1998 El Nino—Southern Oscillation (JID) Person-to-Person Transmission of Andes Virus in Hantavirus Pulmonary Syndrome, Argentina, 2014 (CDC: Emerging Infectious Diseases) Hantavirus cluster linked to cruise ship travel, Multi-country (WHO) Hantavirus (WHO) Ventilation Upgrade Reduces Fuel Consumption by 10 Percent in Cruise Ships(Halton) Person-to-Person Transmission of Andes Virus in Hantavirus Pulmonary Syndrome, Argentina, 2014 (CDC: Emerging Infectious Diseases) Incubation Period of Hantavirus Cardiopulmonary Syndrome (CDC: Emerging Infectious Diseases) At least 8 sickened in suspected hantavirus outbreak; Andes strain confirmed (CIDRAP) Hantavirus in humans: a review of clinical aspects and management (LANCET: Infectious Diseases) Cruise ship's hantavirus outbreak puts researchers in uncharted territory (Science) Hantavirus Response Shows How Trump Cuts Have Compromised U.S. Preparedness (NY Times) Hantavirus on board with Prof. Vincent Racaniello (microbeTV) Emergence of vaccine-derived poliovirus strains from the novel oral polio vaccine in the Central African Republic (mBio) TWiV 1319: An earful of SARS-CoV-2 (microbeTV) Poliomyelitis (polio) (WHO) The world's largest and ​highest-quality​​ first-party data company (Dynata) MMR vaccine hesitancy in a polarized information ecosystem: Results from a cross-sectional survey of US adults (Vaccine) CDC communication undermines trust in vaccines (Science) F.D.A. Blocked Publication of Research Finding Covid and Shingles Vaccines Were Safe (NY Times) Tick Bite Data Tracker (CDC: Ticks) Infectious Diseases (POPHIVE: Yale School of Public Health) The National Respiratory and Enteric VirusSurveillance System (NREVSS) (CDC: National Respiratory and enteric virus surveillance System) Wastewater for measles (WasterWater Scan) Measles cases and outbreaks (CDC Rubeola) Big outbreak, bright lights…Measles Dashboard (South Carolina Department of Public Health) Utah measles outbreak response (Utah Department of Health and Human Services) Utah Measles Dashboard (Utah Department of Health and Human Services) Tracking Measles Cases in the U.S. (Johns Hopkins) Measles vaccine recommendations from NYP (jpg) Weekly measles and rubella monitoring (Government of Canada) Measles (WHO) Get the FACTS about measles (NY State Department of Health) Measles vaccine (CDC Measles (Rubeola)) Presumptive evidence of measles immunity (CDC) Contraindications and precautions to measles vaccination (CDC) Measles (CDC Measles (Rubeola)) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM) Measles Vaccination: Know the Facts (ISDA: Infectious Diseases Society of America) Deaths following vaccination: what does the evidence show (Vaccine) Will the USA lose its measles elimination status? (LANCET) Influenza: Waste water scan for 11 pathogens (WastewaterSCan) US respiratory virus activity (CDC Respiratory Illnesses) Respiratory virus activity levels (CDC Respiratory Illnesses) Flu vaccine recommendations: Vaccines and Related Biological Products Advisory Committee March 12, 2026 Meeting Announcement (FDA) WHO updates all 3 viral strains to be included in fall flu shots (CIDRAP) FDA vaccine advisers recommend adding subclade K to fall shots (CIDRAP) Weekly surveillance report: cliff notes (CDC FluView) OPTION 2: XOFLUZA $50 Cash Pay Option(xofluza) RSV: Waste water scan for 11 pathogens (WastewaterSCan) Respiratory Diseases (Yale School of Public Health) US respiratory virus activity (CDC Respiratory Illnesses) RSV-Network (CDC Respiratory Syncytial virus Infection) Vaccines for Adults (CDC: Respiratory Syncytial Virus Infection (RSV)) Economic Analysis of Protein Subunit and mRNA RSV Vaccination in Adults aged 50-59 Years (CDC: ACIP) Respiratory Diseases (Yale School of Public Health) Impact of Respiratory Syncytial Virus Immunization on the Rate of Pediatric Acute Otitis Media: A Time-series Analysis (CID) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 deaths (CDC) Respiratory Illnesses Data Channel (CDC: Respiratory Illnesses) COVID-19 national and regional trends (CDC) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) Where to get pemgarda (Pemgarda) EUA for the pre-exposure prophylaxis of COVID-19 (INVIYD) Infusion center (Prime Fusions) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Drug interaction checker (University of Liverpool) Help your eligible patients access PAXLOVID with the PAXCESS Patient Support Program (Pfizer Pro) Understanding Coverage Options (PAXCESS) Infectious Disease Society guidelines for treatment and management (ID Society) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) Managing healthcare staffing shortages (CDC) Anticoagulation guidelines (hematology.org) Daniel Griffin's evidence based medical practices for long COVID (OFID) Long COVID hotline (Columbia : Columbia University Irving Medical Center) The answers: Long COVID Multisystem inflammatory syndrome in children (MIS-C), United States, 2023–2024 (CID) Current status and future perspectives on the mechanistic and pathophysiological understanding of long COVID (Communications Medicine) Reaching out to US house representative Letters read on TWiV 1320 Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.