Podcasts about Lancet

This show has been flagged as Clean by the host. -------------------- 01 Introduction This is the second follow up to my 8 part series on nuclear power. In this episode I will attempt to answer a question posed by brian in ohio in a comment on HPR4583. In that comment he said: 02 -------------------- Loving this series. Maybe Whiskey Jack could give some cost comparisons between large and small reactors. He could also give us a realistic look at nuclear plant safety/accidents compared to conventional power production. Looking forward to the episode on FORTH generation reactors ;-) -------------------- 03 End of quote. The first question I answered in my previous follow up, which was HPR4628. In this episode I will attempt to answer the second question, which was about the safety of nuclear power compared to other sources of electrical power generation. One of the HPR janitors encouraged me to make this episode, so I think we can thank him for getting another HPR episode made. 04 Defining the Scope First, let's define the scope of the question. This will cover electrical power generation only. Within that scope I will consider only the following sources of energy. 05 Coal Oil Natural Gas Hydroelectric Nuclear Wind Solar I won't cover geothermal, wave, or tidal power as these are only used in very small amounts and so there simply isn't enough literature on them to base a discussion on . 06 Foreshadow Conclusion I should mention right away that I cannot provide absolute answers to this question in the form of a nice, neat ranking table based on numbers from peer reviewed scientific sources. The reasons for this will become apparent, but to put it briefly, the data on which to base such a ranking simply doesn't exist. I will however provide context within which people can think about the issue. Wherever possible, I will provide links to the references that I used in the show notes so you can read further on this yourself. -------------------- 07 Energy Catastrophism versus Energy Uniformitarianism First though I need to go off on a slight geological detour in order to explain an important analogy that I will use. 08 In the 19th century there was a great debate among geologists over what is known as catastrophism versus uniformitarianism. In seeking to explain the origins of the earth and of the landscape that we see around us, there were two points of view. 09 One was "catastrophism". This is the belief that the mountains, valleys, and plains that we see around us were formed as a result of great catastrophes which occurred relatively recently in earth's history. This explanation was necessary in order to fit geological features into an earth that was believed to be only a few thousands of years old. This view was heavily influenced by religious belief. In this view Noah's flood was the great catastrophe and the fossils of dinosaurs were the remains of animals who had not been saved on the ark and so had died in the flood. 10 The other point of view was uniformitarianism. This was the hypothesis that the landscape we see around us can be explained by the very slow accumulation of very small changes over very long periods of time. For this to be true however, the earth had to be far older than the few thousand years that a literal reading of the bible would suggest. The earth in fact had to be many, many, millions of years old. 11 Eventually, the uniformitarian view won out and people understood that while some catastrophes can take place, the shape of the landscape is overwhelmingly due to small changes over very long periods of time. 12 How is this Relevant to this Episode You Ask? How this is relevant is that I will use this analogy to explain how we need to think about energy and safety. Very small numbers of deaths and injuries multiplied over many occurrences can add up to big numbers, comparable in scale or possibly even larger than a single catastrophe or even several of them. 13 I don't know if anyone else has used this analogy before, I have just thought of this when writing the script for this podcast. None the less, I think it is a very useful way of helping to understand the issues. 14 As an example of this, think about the well known case of the safety of flying versus the safety of travelling in your car. Air crashes are catastrophes that make the headlines. Automobile crashes are seldom more than local news at best. You have probably heard many times the claim that if you making a trip somewhere, you are safer to fly than to drive yourself in your car. 15 Example - Hydro versus Solar I will now present an example of this. Hydro electric power has some notable large scale catastrophes associated with it. Roof top solar power does not have any notable catastrophes that I am aware of. However, which is safer? 16 Hydro Catastrophes Here are three examples of hydro electric catastrophes in just one country, Italy. The Vajont Dam which collapsed in1963 An estimated 1,917 to 2,500 people died. The Sella Zerbino dam which collapsed in 1935. More than 100 people died. The Gleno Dam which collapsed in 1923. An estimated 350 people died. https://damfailures.org/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4997708/ 17 I haven't tried to compile a global list of the worst hydro electric dam collapses, as this sort of information is actually very difficult to find, even on web sites dedicated to dam failures. An additional problem is that information on whether a dam was used for electric power generation or not is often not available. 18 Dam failures where contradictory or insufficient information is available on whether there was an associated hydro power plant include the 1975 Banqian Dam failure, where death estimates range up to a quarter of a million. 19 Solar Panel Slow Accumulation Contrast this with roof top solar panels. Many small accidents can add up to big numbers as well. 20 Health and safety literature discussing solar panel safety mention things such as Falls from roofs. Electric shock. Arc flash (burns from electrical arcing). Normal electrical safety procedures which are based around locking out sources of energy do not work with solar panels which makes safety more difficult. Heat stress due to working exposed in the hot sun. Warning from US government on falls by solar panel installers. https://stacks.cdc.gov/view/cdc/228946 https://www.osha.gov/green-jobs/solar 21 Why We Cannot Compare the Two Hydro catastrophes are not well documented, but we can at least find records of some of the most notable ones. However, even those have very large variations in estimates of deaths. 22 Roof top solar deaths however are largely undocumented. The industry is largely unregulated. There is no central authority which accumulates many individual deaths or injuries. At best there are worker and public safety bodies who simply accumulate those statistics into general construction or household injuries. 23 Thus we have no reliable means of comparing the two energy sources on a comparable basis. We face the same problem with all other major electrical energy sources. So far as I am aware, there are no peer reviewed scientific studies which compare the relative safety of all of the major electrical energy sources we are considering here based on actual numbers. -------------------- 24 Safety Risks I will now try to list some the major hazards for each of energy sources we are considering. There is however limited data available. In many cases we just have reference to worker safety organizations as to what the hazards are. I will not attempt here to put numbers to these here. Categories 25 Coal, Oil, Natural Gas The hazards are Air pollution Mining and oil field accidents Pipeline explosions Transportation accidents. These- move a lot of material so these are significant. 26 Hydroelectric These include Dam collapse Drowning 27 Nuclear These include Radiation exposure 28 Wind These include Falls Confined space deaths (there is not much detail on this) Electric shock Ice throws (that is, throwing pieces of ice off the blades) This technology has a significant problem with people working alone which greatly increases risks associated with other dangers. 29 Solar These include Falls Electric shock Arc flash Heat stress 30 I have not tried to cover all possible risks associated with each category, just the ones which each industry considers to be the risks they concern themselves with. There does not exist any means by which risks of similar types are compared across different industries. 31 Reliability of Supply is Also Safety In a completely electrified net zero society, reliability of supply is a safety matter. People will die in very large numbers in cold climates if they do not have heat. If we have no fossil fuels, we need to also consider how reliably does a grid based on any of the options work. I have not seen anyone attempt to address this question and will not attempt to address it here. However, it must be addressed in any comprehensive attempt to rank safety. -------------------- 32 Studies or Articles on Estimates of Relative Safety Despite the difficulties of comparing the safety of different sources of energy, some people have attempted this anyway. Different estimates done at different times had different focuses, so unfortunately we do not have a nice set of studies that we can neatly use to cross check one another. I will however list the names and the authors and summarize the results. -------------------- 33 The Health Hazards of Not Going Nuclear By Dr. Petr Beckman Published in 1976 The author of this book tried to address the relative safety of different sources of energy in the mid 1970s. However, it is old at this point, so I won't bother digging through its pages to find his figures. 34 He mainly focused on comparing electric power generated with coal to nuclear. His conclusion was that if the goal was to prevent deaths or ill health in the process of generating electricity, then the logical conclusion was to replace coal fired power plants with nuclear. 35 The book was relatively well known at the time, as least as far as books on energy are concerned, so I thought it was still worth mentioning. I happen to have a copy of this book which I bought back in that time period It was the 8th printing of the book, so it would appear to have had relatively good sales. 36 The author did address the issue of what I have termed "catastrophism" in his comparison of different energy sources, although I don't know if he used this phrase. I don't know if he was the first to use this sort of analysis, but he certainly was very influential in terms of popularizing it. -------------------- 37 Risk of Energy Production by Herbert Inhaber Publication AECB 1119 March 1978 This study is a scientific paper from the same time period as the book "The Health Hazards of Not Going Nuclear". 38 He based his risk estimates largely on estimates of the amount of material which was used in the construction and operation of various power sources. While we could argue over whether or not this is a valid methodology, I think any such argument would be pointless as I think the age of the study alone renders it not relevant today anyway. Advancements in materials have changed the basis results significantly by now. However, as it exists I thought I would mention it to show that the idea of comparing energy sources to each other is not a new one. The author compared a wider variety of potential sources than Beckman did. 39 Here's his conclusions. He assumes equal amounts of energy produced by each method. The numbers are normalized such that the total sums to 100%. You can think of it in terms of what proportion of total deaths or injuries would result from each source if each were equally used. 40 Coal 27.5% Oil 25.6% Methanol 16.7% Wind 10.8% Solar photovoltaic 9.2% Thermal 8.1% Solar space heating 1.5% Ocean thermal 0.4% Nuclear 0.13% Natural Gas 0.08% 41 His natural gas estimate is drastically different from that of other authors. I am not going to worry about explaining it however, as the study is as I said old enough to be not very relevant anyway. I am mainly including this here out of historical interest. 42 As a footnote, the methanol he refers to would be synthesized from wood. This was a popular idea in that era as a means of providing liquid fuels for transportation. Practical battery electric cars in those days were strictly science fiction. 43 The ocean thermal category is a real blast from the past and I had forgotten all about that concept. It was a very popular idea at that time and was supposed to be *the* big and upcoming thing in renewable energy. It involved various means of attempting to extract energy from differences in water temperature at different depths in the ocean. It gradually faded away however, as despite great efforts being put into it, designs never proved to be practical. -------------------- 44 Electricity generation and health Anil Markandya, Paul Wilkinson Published in the Lancet, Vol 370, 15 September 2007 45 This is more recent than the previous one, although it is nearly 20 years old at this point. Unfortunately it doesn't cover wind or solar, just fossil fuels and nuclear. However it is still useful, and the Lancet is a very reputable peer reviewed journal. 46 I will present just the results rather than discussing the whole paper. The authors break it down into deaths among the public, occupational deaths, and air pollution related deaths, serious illness, and minor illness. 47 They break the energy sources down into lignite, coal, gas, oil, biomass, and nuclear. Lignite is a type of very low grade coal used mainly for electric power generation. In this paper biomass refers to energy crops and forest residues. 48 I will summarize the results by category rather than trying to describe a table that has 6 rows and 5 columns. All numbers are normalized in terms of deaths or cases per TWh. 49 Occupational deaths from accidents lignite 0.1 coal 0.1 gas 0.001 oil no data biomass - no data Nuclear is 0.019. 50 Deaths among the public from accidents lignite 0.02 coal 0.02 gas 0.02 oil 0.03 biomass no data Nuclear 0.003 51 Air pollution deaths lignite 32.6 coal 24.5 gas 2.8 oil 18.4 biomass 4.63 Nuclear 0.052 52 Air pollution serious illnesses lignite 298 coal 225 gas 30 oil 161 biomass 43 Nuclear 0.22 53 Air pollution minor illnesses lignite 17,676 coal 13,288 gas 703 oil 9,551 biomass 2,276 Nuclear no data 54 Natural gas edges out nuclear power slightly in terms of occupational safety, but in every other category nuclear is drastically lower in terms of ill effects than any of the alternatives. -------------------- 55 2020 Fatalities for US Roofers Increased 15% as Solar Roof Installations Increase Published in The Next Big Future July 6, 2021 by Brian Wang 56 This seems to be written by someone who has a popular science blog. I'm not familiar with it personally, but he addresses the subject so I'll list it. The title implies that it's all about rooftop solar, but he provides comparative numbers for the other energy sources of interest, so that is useful for our purposes. However, he doesn't describe his methodology, so we need to treat them with some caution. Here are his results These are deaths per thousand terawatt hours. 57 Coal - 100,000 Oil - 36,000 Natural gas - 4,000 Hydro - 1,400 Rooftop solar - 440 Wind - 150 Nuclear - 90 58 If we plot these numbers on a bar chart, coal and oil are so large that all of the others are squished to the bottom of the chart and are difficult to see at all. Let's therefore look at these in terms of orders of magnitude. Keep in mind that this is a logarithmic scale. This means that the difference between 4 and 5 is much greater in linear terms than the difference between 1 and 2. 59 Coal - 5 Oil - 4 Natural gas - 3 Hydro - 3 Rooftop solar - 2 Wind - 2 Nuclear - 1 60 Each of these numbers represents an order of magnitude, that is a power of ten. We can see that with rooftop solar, wind, and nuclear, the numbers are so close and the uncertainties are so great and their relative values so small compared to say coal that they can be seen as equivalent so far as safety is concerned. -------------------- 61 What are the safest and cleanest sources of energy? by Hannah Ritchie Published in Our World in Data First published in 2017, updated in 2022 and 2024 62 The author of this study addressed both deaths and greenhouse gas emissions. Deaths from accidents and air pollution are normalized to per TWh of electricity, while greenhouse gas emissions are normalized to GWh of electricity over the life cycle of the plant. 63 Here are the death figures. Coal 24.6 Oil 18.4 Biomass 4.6 Natural Gas 2.8 Hydro power 1.3 Wind 0.04 Nuclear 0.03 Solar 0.02 64 For greenhouse gas emissions the figures are Coal 970 tons Oil 720 tons Natural gas 440 tons Biomass 78 to 230 tons Solar 53 tons Hydro power 24 tons Wind 11 tons Nuclear 6 tons 65 If we take the death figures and rank them by order of magnitude as we did with the previous article, we get the following. 66 Coal - 4 Oil - 4 Biomass - 3 Natural Gas - 3 Hydro power - 3 Wind - 1 Nuclear - 1 Solar - 1 67 Keep in mind that the previous article covered only rooftop solar and not large industrial installations, and so is not directly comparable. Also the units are different, with the previous article being in terms of thousand TWh, and this one being in TWh. If we exclude solar (as the numbers are not comparable), Brian Wang's numbers are between 1.5 to 4 times higher than Ritchie's, except for hydro which are almost identical. I think this latter is due to both sets of numbers are dominated by one exceptionally big hydro accident. 68 Overall however, the relative rankings are quite comparable. Ritchie's numbers for deaths from coal, oil, and natural gas appear to be directly from the study by Markandya and Wilkinson mentioned above. For the benefit of those who are wondering, Ritchie specifically states that her numbers for nuclear include the Chernobyl and Fukushima accidents. -------------------- https://www.iaea.org/publications/magazines/bulletin/21-1/solar-power-more-dangerous-nuclear Direct link to file https://www.iaea.org/sites/default/files/publications/magazines/bulletin/bull21-1/21104091117.pdf https://ourworldindata.org/safest-sources-of-energy https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)61253-7/abstract https://www.nextbigfuture.com/2021/07/2020-fatalities-for-us-roofers-increased-15-as-solar-roof-installations-increase.html -------------------- 69 Conclusion from Studies Remember that in engineering terms, when comparing groups of numbers which contain both both very small numbers and one or more very large numbers, the differences between the small numbers are often not significant. The differences between the small numbers may be the product of our ability to measure these things rather than any real differences. 70 For example, in the article by Ritchie wind power would appear to be twice as dangerous as nuclear. However, the difference between them is 0.02 compared to 24.6 for coal. In other words, the difference between apparently "dangerous" wind and apparently "safe" nuclear is equivalent to 0.08% of the total for coal. It's therefore meaningless and a red herring to even worry about. 71 With the above taken into consideration, generally the different sources of energy fall into two broad categories in terms of number of deaths, injuries, and illnesses. The fossil fuels and biomass fall into one group and wind, solar, and nuclear into another group. 72 Hydro power would seem to fall into the higher risk category or at least somewhere between the two, but this I suspect is mainly due to one exceptionally large dam collapse in China, the Banqian Dam failure in 1975. This is mentioned as being specifically included in the article written by Ritchie. This was a multi-purpose dam, and information on this dam is difficult to find. It is not clear to me whether it had a hydro electric generator associated with either it or another dam that was part of the same system. 73 Some people therefor may argue for its exclusion from the numbers. Of course some people may argue for its inclusion anyway, as it was a dam regardless of whether it actually had an electric generator attached. If we exclude it, then I think the numbers for hydro power would fall into the same range as for nuclear, wind, and solar. 74 Most people would consider hydro power to be safe and clean enough regardless of this and I will rank it as such in any conclusions that I come to. As you can see, even if we have numbers, it can be a matter of opinion as to how to interpret them. -------------------- -------------------- 75 Taking a Systems Approach Now let's take a look at the broader energy picture today and into the future. Many countries in many parts of the world have committed to the concept of "Net Zero", which means eliminating carbon emissions on a net basis. Net zero essentially means the complete electrification of society. We must therefore have electrical energy on demand and at low cost. We must as a result of this look at complete electrical systems rather than individual sources in isolation. 76 At one time many electrical systems were entirely coal or entirely hydroelectric. This is no longer the case. There are now major amounts of wind and solar involved in many countries. However these are inherently intermittent. This means that other sources of energy are inherently also required to have a functional system. 77 If any particular solution inherently requires fossil fuels to meet part of the demand, then the safety, pollution, and climate issues relating to those fossil fuels have to be factored in to that complete system when trying to come up with a relative ranking. Talking about Individual sources in isolation are therefore meaningless in these countries. 78 There are battery systems, but these are mainly used to stabilize and regulate the grid plus to a lesser degree to smooth out short term daily peaks in demand. They do not have the ability to store large amounts of electricity on a large scale for an entire grid for days, weeks, and months to make up for intermittency. 79 So a serious attempt to rank sources of energy would need to look at a variety of representative countries and for each one come up with a plan that involves 'x' megawatts from source 'a', 'y' megawatts from source 'b', etc., and total up the values for each. 80 I am not aware of anyone who has studied this larger issue. However, the problem has to be addressed from this perspective in order for any answer to be useful. Not taking this into account is like ordering a diet soft drink to go with with a high calorie meal and assuring yourself that your plans to diet are fine. 81 This is not to imply there is anything inherently wrong with wind or solar. It does mean that if your goal is to achieve both net zero and a clean environment, you have to look at your entire energy system as a complete system rather than focusing on what you feel are the most reassuring parts of it while ignoring the rest. This does however add to the argument that it is in fact inherently very difficult to come up with a system of ranking energy sources for safety. -------------------- 82 Nuclear, Climate, and Clean Air - Contrasting Examples To give a tangible example we will now look at two different places that followed two divergent paths at roughly around the same time frame. These are the province of Ontario in Canada, and Germany. 83 Ontario had a mix of coal, hydro electric, and nuclear generating plants. Germany had a mix of coal, nuclear and natural gas plants. Ontario shut down their coal fired plants and kept their nuclear plants. Germany however shut down their nuclear plants and kept their coal fired plants. 84 The Phase Out of Coal in Ontario In 2003 Ontario decided to close all of its coal fired generating plants, which consisted of 19 units (that is boilers and turbines) totalling 8,800 MW. This phase out was completed by 2014. 85 Here are the figures for amount of power generated by each energy source in 2003 and 2014. Nuclear went from 42% to 60% Hydro went from 23% to 24% Gas went from 11% to 9% Coal went from 25% to 0% Non-hydro renewable went from 0% to 7%. 86 As you can see, the bulk of that replacement came from increased use of nuclear power. Furthermore, this did not result in simply replacing coal with natural gas. While gas is cleaner than coal, it still has emissions and if you recall from the studies that we looked at earlier, had an estimated death rate roughly 2 orders of magnitude greater than nuclear, solar, or wind. 87 To put this in more practical terms, at one time Toronto regularly had clouds of smog obscuring it, to a large extent due to these coal fired power plants With the phase out of coal, smog days went to zero in 2015 compared to 53 a decade earlier. The 2023 figures for Ontario show carbon emissions of 53 grams per kWh of electricity generated. We can use this as a rough benchmark comparison for total emissions. 88 The Phase out of Nuclear in Germany Until March of 2011, Germany generated one quarter of its electrical power from nuclear. Starting in 2011 however, they began shutting down their nuclear power plants. These were then phased out over the next decade. However, the coal plants were to be kept to 2038. In 2026 Germany began talking about increasing use of coal in order to save gas. In the same year the German chancellor Friedrich Merz stated that the phase out of nuclear was a quote “serious strategic mistake”. EU Commission President Ursula von der Leyen said it was "a strategic mistake for Europe to turn its back on a reliable, affordable source of low-emissions power". 89 I won't go into the details of the phase out, but let's look at some emissions numbers for Germany. If we look at the official numbers from the European Environmental Agency for 2024, for Germany their emissions were 298 grams per kWh of electricity generated. Recall that we are using emissions as a very rough guide to amount of air pollution, and that this has a direct effect on the safety of the overall electrical energy system. 90 So, who actually made their people safer, Ontario who phased out their coal plants and kept their nuclear plants, or Germany who phased out their nuclear plants and kept their coal plants? 91 If you want a comparison directly within Europe, then Germany has one of the highest rates of emissions per kWh of electricity generated, whereas France, who use mainly nuclear power, have one of the lowest at 43 grams per kWh of electricity generated. Again, who is making their people safer, Germany or France? 92 I don't want to make it sound like I am picking on Germany. I am also not going to tell them how they ought to run their country. However they provide a good real world example of how we need to look at things in overall context when we are thinking about the choices that we make. https://www.ontario.ca/page/end-coal https://www.cbc.ca/news/canada/windsor/smog-study-shows-significant-decreases-in-pollutants-in-ontario-1.4151183 https://www.eea.europa.eu/en/analysis/indicators/greenhouse-gas-emission-intensity-of-1 https://world-nuclear.org/information-library/country-profiles/countries-g-n/germany https://www.politico.eu/article/friedrich-merz-is-right-to-reject-germanys-nuclear-phase-out-says-iea-chief-fatih-birol/ https://www.politico.eu/article/germany-considers-ramping-up-coal-power-to-avert-energy-crisis/ https://www.iea.org/countries/estonia/electricity https://www.iea.org/countries/malta/electricity -------------------- 93 Conclusions As we can see, there don't appear to be an abundance of peer reviewed scientific studies that we can simply point to in order to answer the question of safety of all possible major different energy sources once and for all. Collecting the data to even attempt to answer the question is inherently very difficult as we cannot readily conduct experiments to answer the question, and sources of data are not collected or consolidated in a manner which can answer this question adequately. 94 The essence of the problem is that most energy industries are not as tightly regulated and monitored to the same degree that say nuclear power or commercial airliners are, so this data is simply not being systematically recorded. However, a number of people have attempted to make estimates. 95 Their conclusions would seem to be that nuclear, wind, and solar are roughly equivalent in terms of safety. All fossil fuels are much less safe than nuclear, wind, and solar, by as much as several orders of magnitude. 96 We can however say with a reasonable degree of certainty that if a country shut down their nuclear power plants and kept their fossil fuel plants, particularly coal, then they probably made their people less safe than if they had done things the other way around. 97 I hope that I have provided some context in which to think about the issue. Thanks again to brian in ohio for providing the question upon which this episode is based. -------------------- Provide feedback on this episode.

If you've ever wondered whether your daily walk is actually doing anything for your body, this episode is going to change how you walk for good. We're breaking down Japanese walking, also known as interval walking training, a research-backed method that alternates fast and slow walking in 3-minute bursts, backed by over two decades of peer-reviewed research out of Japan.Alisha Carlson walks through what the research actually shows about blood pressure, blood sugar, leg strength, and bone density, specifically for women over 35 navigating perimenopause, PCOS, or just a body that doesn't respond to exercise the way it used to. No gym. No equipment. No more all-or-nothing thinking. Just a smarter way to walk.What you'll learn:What Japanese walking (interval walking training) actually is, and the simple protocol behind itWhy interval walking improves peak aerobic capacity and leg strength more than walking at one steady paceHow a 10 mmHg drop in blood pressure translates to a real reduction in stroke riskWhat the latest research says about interval walking and bone density in postmenopausal womenWhy cardiorespiratory fitness is one of the strongest predictors of long-term health, and how walking improves itHow to structure your own interval walking routine, including how to break it into smaller chunks if 30 minutes at once isn't realisticThe identity shift that makes a sustainable walking habit actually stickThis episode is for you if...You're a woman over 35 who wants evidence-based movement, not trendsYou're in perimenopause or postmenopause and want to know what actually supports your bones, blood sugar, and blood pressureYou walk regularly already and want to know if a small change could make it more effectiveYou have PCOS or insulin resistance and want a low-barrier way to support blood sugarYou're stuck in the all-or-nothing mindset and want a sustainable, non-diet approach to movementKey research cited:Nemoto et al. (2007), Mayo Clinic Proceedings, 82(7): high-intensity interval walking training improved physical fitness and blood pressure in middle-aged and older adults.Nemoto et al. (2019), Mayo Clinic Proceedings, 679 participants, 5-month IWT study: found a 17% reduction in lifestyle-related disease score and a 14% increase in peak aerobic capacity.Morikawa et al. (2024), PLOS One, 234 postmenopausal women: found improvements in lumbar spine and femoral neck bone density among women with lower baseline bone density.Ettehad et al. (2016), The Lancet, 123 studies, 613,815 participants: every 10 mmHg reduction in systolic blood pressure reduced stroke risk by 27%.The Strong(HER) Way isn't another fitness program, it's a transformation from the inside out. Alisha works with women who are done dieting and done starting over, helping them build a sustainable, healthy relationship with food, their bodies, and movement, without the obsession.Ready to stop starting over? Explore the Fit + Fueled coaching program at thestrongherway.com/fitandfuel or connect on IG @thestrongherway.

On Iran, Hawk recaps the collapse of the Switzerland talks with JD Vance after Trump threatened the Iranian delegation on social media, and raises the point that Lebanon and Israel are not signatories to any negotiations despite being central parties to the ongoing conflict. He also covers the Supreme Court's new gun ruling tied to marijuana use, referencing commentary from Michael Popok, Lisa Graves, and Slate's Dahlia Lithwick and Mark Joseph Stern on Neil Gorsuch's reasoning. Hawk addresses the UFC fighter's remarks about Kamala Harris made at a White House event alongside Joe Rogan, and closes with election analyst Larry Sabato's outlook on 2026 Republican turnout, including Trump's successful primary purges of Thomas Massey, John Cornyn, Bill Cassidy, and Tom Tillis. SUPPORT & CONNECT WITH HAWK- Support on Patreon: https://www.patreon.com/mdg650hawk - Hawk's Merch Store: https://hawkmerchstore.com - Connect on TikTok: https://www.tiktok.com/@mdg650hawk7thacct - Connect on TikTok: https://www.tiktok.com/@hawkeyewhackamole - Connect on BlueSky: https://bsky.app/profile/mdg650hawk.bsky.social - Connect on Substack: https://mdg650hawk.substack.com - Connect on Facebook: https://www.facebook.com/hawkpodcasts - Connect on Instagram: https://www.instagram.com/mdg650hawk - Connect on Twitch: https://www.twitch.tv/mdg650hawk ALL HAWK PODCASTS INFO- Additional Content Available Here: https://www.hawkpodcasts.comhttps://www.youtube.com/@hawkpodcasts- Listen to Hawk Podcasts On Your Favorite Platform:Spotify: https://spoti.fi/3RWeJfyApple Podcasts: https://apple.co/422GDuLYouTube: https://youtube.com/@hawkpodcastsiHeartRadio: https://ihr.fm/47vVBdPPandora: https://bit.ly/48COaTB

CardioNerds (Amit and Dan), Billy Joe Mullinax, and Saahil Jumkhawala discuss the long term management of pulmonary embolism with Dr. Soophia Naydenov.  The episode focuses on the approach to patients who struggle with persistent symptoms like dyspnea and fatigue even after completing the acute phase of anticoagulation. This spectrum of disease, ranging from mild post-PE impairment to chronic thromboembolic pulmonary hypertension (CTEPH), requires a structured follow-up. The discussion covers the critical importance of identifying CTEPH early, the necessary timelines for follow-up, and the appropriate objective screening tools and invasive testing to guide patient care toward full functional recovery. Audio editing by CardioNerds academy intern, Grace Qiu. Dr. Dinu Balanescu and Dr. Billy-Joe Mullinax are Co-chairs for the CardioNerds PE Series, developed in collaboration with the PERT Consortium.   Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Pulmonary Embolism PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Acronyms PE: Pulmonary Embolism PERT: Pulmonary Embolism Response Team CTEPH: Chronic Thromboembolic Pulmonary Hypertension QL: Quality of Life VTE: Venous Thromboembolism DASH: D-dimer, Age, Sex, History of non-provoked PE (a risk score) CPET: Cardiopulmonary Exercise Testing PFTs: Pulmonary Function Tests VQ Scan: Ventilation-Perfusion Scan DOACs: Direct Oral Anticoagulants TPA: Tissue Plasminogen Activator (Thrombolytics) ECMO: Extracorporeal Membrane Oxygenation Pearls: Post-PE “Syndrome” is a Spectrum: It is more accurately a spectrum of disease (sequelae of PE) rather than a single syndrome, ranging from mild fatigue/dyspnea to the most severe form, CTEPH. Structured Follow-up is Mandatory: All PE survivors need a structured follow-up, typically with checkpoints at 3, 6, 12, and 16–24 months, with the primary goal being to detect CTEPH, the deadliest, yet potentially curable, disease on the spectrum. Screening Should Be Objective and Practical: When screening for persistent symptoms, use objective assessment tools like the Post-VTE Functional Status (PVFS) scale or the Modified Medical Research Council (MMR-C) scale, as highly comprehensive but cumbersome tools (like the PE Quality of Life questionnaire) may not be practical for routine clinical use. Recurrence Risk Scores Aid in Anticoagulation Duration: Simple scores like the DASH score or the HERDO2 score (for women) can provide guidance when considering the continuation versus discontinuation of anticoagulation after the initial treatment phase. Invasive Testing for Persistent Symptoms: If a patient remains symptomatic at the 6-month mark despite normal non-invasive testing (chest X-ray, ECG, PFTs, six-minute walk, echo, VQ scan, CPET), consider invasive testing such as Right Heart Catheterization (RHC) at rest or with exercise, or an invasive CPET. Notes: Notes drafted by Saahil Jumkhawala. 1. The Spectrum of Post-PE Disease The term “post-PE syndrome” should be used with caution, as it refers to a spectrum of disease rather than a single entity. This spectrum includes symptoms (sequelae) that exist in a patient’s life following an incidental PE event that they did not have before. On one extreme is Chronic Thromboembolic Pulmonary Hypertension (CTEPH): The definition is clear, but it is the most deadly type, though thankfully rare (2% to 4%). It involves a residual clot and pulmonary hypertension identifiable at rest. In the middle is Chronic Thromboembolic Disease (CTED): Patients may have residual defects seen on a VQ or CT scan, but they do not have pulmonary hypertension. On the other side is a milder disease, which can include fatigue, dyspnea, or a patient’s perceived impairment, where the definitions of CTEPH and CTED are not met, but the patient remains symptomatic. 2. Structured Follow-up and Screening for Post-PE Symptoms Structured follow-up is key for all PE survivors, though the structure may vary based on available resources (PCP, Cardiology, Pulmonary, or multidisciplinary clinic). Recommended Timeline for Follow-up: Data from studies like ELOPE and FOCUS suggest checkpoints at 3, 6, 12, and up to 16 to 24 months. This timeline is designed to identify patients who may develop CTEPH. 88% of patients who develop CTEPH will be identified within about a year. A structured follow-up can reduce the delay in CTEPH diagnosis from 10–12 months to 4–6 months. Personal Practice Note: A quick 2–3 week/30-day check-in is recommended for severely ill patients (e.g., those who had TPA, profound shock, or ECMO support) to ensure medication compliance, manage symptoms, and identify red flags. Screening Tools (Objective Assessment): The first step is an inventory of patient symptoms, leaning toward objective rather than subjective assessment. Recommended Simple Tools: Modified Medical Research Council (MMR-C) for dyspnea evaluation. Post-VTE Functional Status (PVFS) scale. The Pulmonary Embolism Quality of Life (QL) questionnaire is comprehensive but long, making it tedious and better suited for research. Future Utility: Technology (AI/electronic tools) may assist in administering these questionnaires before the clinic visit, presenting the information as a “dashboard” for the provider. 3. Management of Persistent Symptoms and Further Testing Initial Non-Invasive Tests (Often done at 3 months): Echocardiogram VQ Scan Full PFTs Six-minute walk CPET Further Evaluation for Persistent Symptoms (e.g., at 6 months): If non-invasive tests (Chest X-ray, ECG, CPET) are normal but symptoms persist, more invasive testing should be considered as the patient has not returned to baseline. Repeat VQ scan or echocardiogram if symptoms have changed. Right Heart Catheterization (RHC) at rest or with exercise. Invasive CPET. PA gram (Pulmonary Angiogram) to assess vasculature. 4. Recurrence Risk and Anticoagulation Duration The decision to continue or discontinue anticoagulation depends on the patient’s risk factors, the situation of the PE (provoked or unprovoked), presence of active cancer, and patient preference. Recurrence Risk Scores: Simple scores are preferred for practicality. DASH Score. HERDO2 Score (particularly for women). The Vienna Score can be considered if the question is whether to restart anticoagulation after a disruption. Role of D-dimer in Abbreviation: While D-dimer can be used to guide the decision to restart anticoagulation after a planned pause (if D-dimer is high, resume), patient symptoms are preferable to guide management decisions like early abbreviation. 5. Prevention of Post-PE Syndrome Currently, there is no clear tool known to prevent the post-PE syndrome/spectrum of disease. Best Current Advice for Prevention/Recovery: Anticoagulation compliance. Pulmonary rehabilitation, which aids in faster recovery. General precautions, such as smoking cessation and body weight management. Future Research: Ongoing trials are investigating whether acute management strategies (e.g., using thrombolytics in intermediate-risk PE) can prevent long-term sequelae. (The PYTHO trial did not show a reduced rate of CTEPH in intermediate-risk PE patients who received thrombolytics). References: Khan, F., Tritschler, T., Kahn, S. R., & Rodger, M. A. “Venous Thromboembolism.” The Lancet, vol. 398, no. 10294, 2021, pp. 64-77. doi:10.1016/S0140-6736(20)32658-1. Kearon, C., & Kahn, S. R. “Long-Term Treatment of Venous Thromboembolism.” Blood, vol. 135, no. 5, 2020, pp. 317-325. doi:10.1182/blood.2019002364. Kahn, S. R., & de Wit, K. “Pulmonary Embolism.” The New England Journal of Medicine, vol. 387, no. 1, 2022, pp. 45-57. doi:10.1056/NEJMcp2116489. Di Nisio, M., van Es, N., & Büller, H. R. “Deep Vein Thrombosis and Pulmonary Embolism.” The Lancet, vol. 388, no. 10063, 2016, pp. 3060-3073. doi:10.1016/S0140-6736(16)30514-1. Chopard, R., Albertsen, I. E., & Piazza, G. “Diagnosis and Treatment of Lower Extremity Venous Thromboembolism: A Review.” JAMA, vol. 324, no. 17, 2020, pp. 1765-1776. doi:10.1001/jama.2020.17272.

Episode OverviewFor the second time in two decades, a phase 3 trial has shown a statistically significant improvement over R-CHOP in newly diagnosed diffuse large B-cell lymphoma (DLBCL). In this episode, Eddie, Raj, and Ashwin sit down with Professor Charles Herbaux to unpack the data, debate the clinical implications, and ask the question that's on every hematologist's mind: is this enough to change practice?Background: Setting the Stage for TafasitamabBefore diving into frontMIND, the episode provides context on tafasitamab, a CD19-targeting monoclonal antibodyL-MIND (Phase 2 — relapsed/refractory DLBCL):81 patients with R/R DLBCLORR 58%, complete response rate 41%Established activity of tafasitamab + lenalidomide in the relapsed settinghttps://pubmed.ncbi.nlm.nih.gov/32511983/First-MIND (Phase 1b — frontline DLBCL, IPI 2–5):66 patients randomized: tafa-R-CHOP (n=33) vs. tafa-len-R-CHOP (n=33)ORR: 75.8% vs. 81.8%, respectivelySerious treatment-emergent adverse events: 42.4% vs. 51.5%Provided the signal (and the safety caution) to move to phase 3https://pubmed.ncbi.nlm.nih.gov/37369099/The frontMIND TrialDesign: Phase 3, double-blind, placebo-controlled randomized trialIntervention: R-CHOP + tafasitamab (12 mg/kg IV days 1, 8, 15 per cycle) + lenalidomide (25 mg/day, days 1–10 per cycle)Control: R-CHOP + placebosGCSF mandatory (given double-blind design); VTE prophylaxis (heparin or aspirin) mandatory given lenalidomideEnrollment: May 2021 – March 2023; 899 patients randomizedPrimary endpoint: Investigator-assessed progression-free survival (PFS)Patient Population:Age 18–80; DLBCL or high-grade B-cell lymphoma, IPI 3–5Median age: 65 years96% advanced stage; 54% bulky disease; 31% ECOG PS 2; 82% elevated LDH55% IPI 3 / aaIPI 2; 43% IPI 4–5 / aaIPI 38% double/triple hit — a high-risk subgroup included despite R-CHOP being the controlBroad histologic inclusion: transformed lymphoma, grade 3B FL, T-cell/histiocyte-rich LBCL, EBV+ DLBCL, ALK+ LBCL, HHV8+ DLBCL Note: On retrospective central review, ~7% of patients had a different histology (roughly half had FL grade 1–3A), underscoring the diagnostic challenges in DLBCL~40% received pre-phase steroids; 8% rituximab; 4% vincristine prior to cycle 1Key Efficacy Results(Primary analysis at median follow-up 35.2 months) | Endpoint | Tafa-Len-R-CHOP | R-CHOP | HR / p-value | 2-year PFS | 71.1% | 62.9% | HR 0.75, p=0.0194 | 3-year PFS | 67.3% | 60.7% | ~6.6% absolute difference | Overall Survival | — | — | HR 0.85, p=0.27 (immature)Points of Discussion:Absolute PFS benefit at 2 years: ~8.2%; at 3 years: ~6.6% — a modest but statistically significant improvementOS curves cross early, then separate slightly from ~18 months; data remain immatureEarly censoring observed: ~17% (intervention) and ~14% (control) censored by 9 months — raises questions about off-protocol therapySubgroup consistency: PFS benefit appeared consistent across prespecified subgroups; specific subgroups discussed in the episodeSafety Adverse Event | Tafa-Len-R-CHOP | R-CHOP | Fatal treatment-emergent AEs | 6% (26 pts) | 4% (17 pts) | Diarrhea (any grade) | 25% | 17% | Febrile neutropenia | 17% (incl. 1 death) | 13% | Grade ≥3 anemia | 24% | 17% | Grade ≥3 thrombocytopenia | 27% | 14%The addition of tafasitamab and lenalidomide to R-CHOP adds meaningful hematologic toxicity, particularly thrombocytopenia and anemia, as well as diarrhea and febrile neutropenia.Key Discussion Points from the EpisodeDid the early-phase L-MIND and First-MIND data justify bringing tafasitamab into the front-line setting, and was tafa-len-R-CHOP the right intervention arm to take forward?Is R-CHOP the appropriate control for a patient population that includes 8% double/triple hit lymphoma?What are the implications of using investigator-assessed PFS as the primary endpoint — and how critical is effective blinding to the integrity of that endpoint?How do we interpret the early OS curve crossing and currently non-significant OS benefit?Is the ~8% absolute PFS improvement at 2 years clinically meaningful enough to change practice — particularly given the added toxicity?How should we think about patient selection: who would you prioritize for tafa-len-R-CHOP over standard R-CHOP in clinical practice?What does frontMIND mean for the DLBCL treatment landscape alongside polatuzumab-R-CHP (POLARIX)?Resources & Further ReadingfrontMIND trial: Lenz et al. Lancet. https://pubmed.ncbi.nlm.nih.gov/42217458/POLARIX: Tilly H, et al. NEJM 2022About BloodCancerTalksBloodCancerTalks is a medical education podcast hosted by Raj, Ashwin, and Eddie, dedicated to the latest advances in hematologic malignancies. New episodes available wherever you listen to podcasts.Follow us on X/Twitter for episode updates and hematology/oncology content. 

In this episode of PICU Doc on Call, hosts Dr. Monica Gray and Dr. Pradip Kamat explore procedural sedation in the pediatric ICU. They cover sedation levels, pre-screening, risk stratification using ASA classifications, and medication selection tailored to each patient's hemodynamic and respiratory status. Through real-world case discussions involving respiratory failure, septic shock, and acute neurological decline, they highlight the importance of end-tidal CO2 monitoring and early adverse event recognition. Key takeaways include avoiding the term "conscious sedation," preparing rescue plans, and prioritizing patient safety through careful assessment and monitoring.Show Highlights:Definitions and levels of sedation (minimal, moderate, deep sedation, and general anesthesia)Importance of terminology in procedural sedationMonitoring sedation levels using scales like the Richmond Agitation-Sedation Scale (RASS)Pre-screening and risk stratification considerations for pediatric patientsASA physical status classification system for assessing patient riskUnique challenges of procedural sedation in critically ill childrenAdverse events associated with pediatric procedural sedation, particularly respiratory complicationsManagement strategies for specific cases requiring sedation (e.g., respiratory failure, septic shock)Importance of end-tidal CO2 monitoring during sedationKey takeaways for safe sedation practices in the pediatric ICU settingReferences: Nir Atlas; Rahul C. Damania; Pradip P. Kamat In Fuhrman & Zimmerman - Textbook of Pediatric Critical Care Chapter 135, 1624-1628Statement on Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia by Committee on Quality Management and Departmental Administration. Last Amended: October 23, 2024.Coté CJ, Wilson S; AMERICAN ACADEMY OF PEDIATRICS; AMERICAN ACADEMY OF PEDIATRIC DENTISTRY. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures. Pediatrics. 2019 Jun;143(6):e20191000. doi: 10.1542/peds.2019-1000. PMID: 31138666.xKrauss B, Green SM. Procedural sedation and analgesia in children. Lancet. 2006 Mar 4;367(9512):766-80. doi: 10.1016/S0140-6736(06)68230-5. PMID: 16517277.Sharif S, Kang J, Sadeghirad B, Rizvi F, Forestell B, Greer A, Hewitt M, Fernando SM, Mehta S, Eltorki M, Siemieniuk R, Duffett M, Bhatt M, Burry L, Perry JJ, Petrosoniak A, Pandharipande P, Welsford M, Rochwerg B. Pharmacological agents for procedural sedation and analgesia in the emergency department and intensive care unit: a systematic review and network meta-analysis of randomised trials. Br J Anaesth. 2024 Mar;132(3):491-506. doi: 10.1016/j.bja.2023.11.050. Epub 2024 Jan 6. PMID: 38185564.Smith, Heidi A. B. MD, MSCI (Chair)1,2; Besunder, James B. DO, FCCM3,4; Betters, Kristina A. MD1; Johnson, Peter N. PharmD, BCPS, BCPPS, FCCM, FPPA, FASHP5,6; Srinivasan, Vijay MBBS, MD, FCCM7,8; Stormorken, Anne MD9,10; Farrington, Elizabeth PharmD, FCCM11; Golianu, Brenda MD12,13; Godshall, Aaron J. MD14; Acinelli, Larkin CPNP-AC, ACHPN15; Almgren, Christina CPNP16; Bailey, Christine H. MD17; Boyd, Jenny M. MD18,19; Cisco, Michael J. MD20; Damian, Mihaela MD, MPH21,22; deAlmeida, Mary L. MD23,24; Fehr, James MD13,25; Fenton, Kimberly E. MD, FCCM14; Gilliland, Frances DNP, CPNP-AC/PC26,27; Grant, Mary Jo C. CPNP-AC, PhD, FAAN28; Howell, Joy MD29; Ruggles, Cassandra A. PharmD, BCCCP, BCPPS30; Simone, Shari DNP31,32; Su, Felice MD21,22; Sullivan, Janice E. MD33,34; Tegtmeyer, Ken MD, FAAP, FCCM35,36; Traube, Chani MD, FCCM29; Williams, Stacey CPNP-AC37; Berkenbosch, John W. MD, FAAP, FCCM (Chair)33,34. 2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility. Pediatric Critical Care Medicine 23(2):p e74-e110, February 2022. | DOI: 10.1097/PCC.0000000000002873Benzoni T, Agarwal A, Cascella M. Procedural Sedation. [Updated 2025 Mar 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551685/Kerson AG, DeMaria R, Mauer E, Joyce C, Gerber LM, Greenwald BM, Silver G, Traube C. Validity of the Richmond Agitation-Sedation Scale (RASS) in critically ill children. J Intensive Care. 2016 Oct 26;4:65. doi: 10.1186/s40560-016-0189-5. PMID: 27800163; PMCID: PMC5080705.Tel-Dan SF, Shavit D, Nates R, Samuel N, Shavit I. Emergency Physician-Administered Sedation for Thoracostomy in Children With Pleuropneumonia. Pediatr Emerg Care. 2021 Dec 1;37(12):e1209-e1212. doi: 10.1097/PEC.0000000000001975. PMID: 31929389.Cosgrove P, Krauss BS, Cravero JP, Fleegler EW. Predictors of Laryngospasm During 276,832 Episodes of Pediatric Procedural Sedation. Ann Emerg Med. 2022 Dec;80(6):485-496. doi: 10.1016/j.annemergmed.2022.05.002. Epub 2022 Jun 23. PMID: 35752522.Cravero JP, Blike GT, Beach M, Gallagher SM, Hertzog JH, Havidich JE, Gelman B; Pediatric Sedation Research Consortium. Incidence and nature of adverse events during pediatric sedation/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium. Pediatrics. 2006 Sep;118(3):1087-96. doi: 10.1542/peds.2006-0313. PMID: 16951002.

In this episode of Keeping Abreast, Dr. Jenn Simmons responds to Peter Attia's breast cancer screening episode (#396). Attia asks the right question: why are 42,000 women still dying of breast cancer every year? But his answer, more mammograms and MRI on top, is exactly wrong. Dr. Jenn breaks down, study by study, why that 40-year approach has never moved the death toll.Forty-two thousand women a year. That number has not moved since mammography went mainstream in the 1980s. Detection rates are up, diagnoses are up, and the death toll has not changed. We have been finding more cancer, calling more women patients, and watching the same number of them die. If you have ever scheduled your annual mammogram believing it was the most protective thing you could do, this episode will reframe everything you thought you knew.What You'll LearnWhy the breast cancer death toll has not moved in 40 years, and why more screening is the reasonWhy DCIS is not cancer, why mammography invented it, and what happens to a woman the moment it gets labeled "stage zero"Why an aggressive tumor is aggressive from the day it forms, and why finding it earlier on a mammogram does not change what it does nextWhy mammography catches the cancers least likely to kill you, and routinely misses the ones that willWhat happened when researchers followed 89,835 women for 25 years and compared annual mammography to doing nothing, and why you have never heard about itWhat the Cochrane review found after analyzing every randomized mammography trial ever run, and why Peter Attia addressed it in one sentenceWhy the WISDOM trial, the most significant recent evidence in this space and the one study Attia never mentions, is an indictment of everything he arguedWhy there is no standard radiation dose for a mammogram, and why the woman next to you in the waiting room may have received ten times less than you didWhat the FDA has formally documented about gadolinium staying in the brain and bones for years, and why the women being told to get it every six months are the last women who shouldWhy insulin resistance, chronic inflammation, and toxic burden are among the most powerful drivers of breast cancer risk, and why Attia's episode contained zero mention of any of themResources MentionedPeter Attia, Episode 396 on breast cancer screening: peterattiamd.com/breastcancerscreeningDr. Robin Berzin, founder of Parsley HealthMiller AB, et al. Twenty five year follow-up of the Canadian National Breast Screening Study. BMJ. 2014;348:g366.Gøtzsche PC, Jørgensen KJ. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2013;(6):CD001877.Zahl PH, et al. Results of the Two-County trial are not compatible with official Swedish breast cancer statistics. Danish Medical Bulletin. 2006;53(4):438–440.Nyström L, et al. Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet. 2002;359:909–19.Esserman LJ, et al. Risk-Based vs Annual Breast Cancer Screening: The WISDOM Randomized Clinical Trial. JAMA. 2026;335(9):763–774.FDA gadolinium-based contrast agent safety communications (2015, 2017, 2018), summarized in Fotenos A, FDA Pediatric Advisory Committee, Sept 2018.Kanda T, et al. High signal intensity in the dentate nucleus and globus pallidus and cumulative gadolinium dose. Radiology. 2014;270(3):834–841.Veenhuizen SGA, et al. Supplemental breast MRI for women with extremely dense breasts: DENSE trial. Radiology. 2021;299(2):278–286.Tabar L, et al. Reduction in mortality from breast cancer after mass screening with mammography. Lancet. 1985;325:829–32.To talk to a member of Dr. Jenn's team and learn more about working privately with Dr. Jenn visit: https://calendly.com/stephanie-1031/clarity-callTo get your copy of Dr. Jenn's book, The Smart Woman's Guide to Breast Cancer, visit: https://tinyurl.com/SmartWomansBreastCancerGuideTo purchase the auria breast cancer screening test go here https://auria.care/ and use the code DRJENN20 for 20% Off.Connect with Dr. Jenn:Website: https://www.jennsimmonsmd.com/Facebook: https://www.facebook.com/DrJennSimmonsInstagram: https://www.instagram.com/drjennsimmons/YouTube: https://www.youtube.com/@dr.jennsimmons

Coming to you from Women Deliver 2026 in Melbourne/Naarm, senior editor at The Lancet Global Health Gavin Cleaver speaks with Maria Antonieta Alcalde Castro, the new director general of the International Planned Parenthood Federation, about her decades of work and activism in the field and the current situation for SRHR. We also speak with Kinza Hasan, of Women Deliver, about the launch of her Feminist Health Systems Charter. We would like to acknowledge that this episode was recorded on the traditional land of the Wurundjeri Woi-Wurrung peoples of the Kulin Nation and we pay our respects to their elders past, present, and emerging. The Lancet global Health in conversation with...  is part of the Lancet Group podcast offering.  Editorial team: Editor-in-Chief Zoë Mullan, acting deputy editor Pingyue Jin, senior editors Shangrong Han, and Gavin Cleaver. Podcast editing: Matteo Simonetti Visit https://www.thelancet.com/multimedia to learn more.  Find the best science for better lives at thelancet.com Follow us today at... https://thelancet.bsky.social/ https://instagram.com/thelancetgroup https://facebook.com/thelancetmedicaljournal https://linkedIn.com/company/the-lancet https://youtube.com/thelancettv

Welcome back to the show, everybody! Today, we are diving deep into the intersection of maternal-fetal medicine and cardiology. We're tackling a condition that keeps every OB/GYN, MFM, and cardiologist up at night: Peripartum Cardiomyopathy, or PPCM. And to keep our clinical gears turning, we are framing this discussion squarely through the lens of Society for Maternal-Fetal Medicine (SMFM) Consult Series #73, which focuses on right and left heart failure in pregnancy, alongside the foundational data from ACOG Practice Bulletin #212. PPCM presents fundamentally as acute left heart failure with reduced ejection fraction. Think of the left ventricle as the primary engine pump of the systemic circulation. When it stalls, everything upstream gets backed up. While this was traditionally called IDIOPATHIC, newer data says otherwise. We are going to cover presentation, eval, care and prognosis. So, get your palpitations in check- here we go. 16% OFF TONA ACTIVE WEAR PROMO: https://tonaactive.com/discount/CHAPANOSPINOBG1. SMFM CS 73; 20252. ACOG PB 212; 20193. Arany Z. Peripartum Cardiomyopathy. The NEJM. 2024. 4. Sliwa K, Hilfiker-Kleiner D, Damasceno A, Al Farhan H, Goland S, Johnson MR, Bauersachs J. Peripartum cardiomyopathy. Lancet. 2025 Nov 22;406(10518):2483-2493. doi: 10.1016/S0140-6736(25)01451-5. Epub 2025 Oct 28. PMID: 41173010.

Geriatrician Dr. Mark Supiano joins the podcast to discuss the connection between heart and brain health. Citing multiple clinical trials, he breaks down what these studies and their findings mean for blood pressure management's effect on cognitive decline and how they directly impact both patients and clinicians. Guest: Mark A. Supiano, MD, geriatrician, University Hospital Geriatrics Clinic, professor, Internal Medicine, Utah School of Medicine Show Notes Read about the Systolic Blood Pressure Intervention Trial (SPRINT) Study on the National Heart, Lung, and Blood Institute website. Learn about the SPRINT MIND study in the Journal of the American Medical Association.  Read Dr. Supiano's study, “Hypertension in the Oldest Old,” published by the Journal of the American College of Cardiology: Advances on their website. Learn about the HYVET, STEP, SPRINT-HEART and China Rural Hypertension Control Project studies through their articles on the National Library of Medicine website. Learn about an ancillary study to SPRINT, “Changes in arterial stiffness under blood pressure control are independently associated with cognitive impairment,” on the National Library of Medicine website. Learn about the Systolic Hypertension in the Elderly Program (SHEP) study, published by Clinical and Experimental Hypertension, on the Taylor and Francis Online website. Learn about the ESPRIT study on The Lancet website. Learn more about Dr. Supiano on the University of Utah Health website.   Connect with us Find transcripts and more at our website. Email Dementia Matters: dementiamatters@medicine.wisc.edu Follow us on Facebook and Twitter. Subscribe to the Wisconsin Alzheimer's Disease Research Center's e-newsletter. Enjoy Dementia Matters? Consider making a gift to the Dementia Matters fund through the UW Initiative to End Alzheimer's. All donations go toward outreach and production. Learn about Dr. Chin's book, When Memory Fades: What to Expect at Every Stage, from Early Signs to Full Support for Alzheimer's and Dementia.

Chaque jour, en moins de 10 minutes, un résumé de l'actualité du jour. Rapide, facile, accessible.

The publication of CREST-2 has reignited one of the longest-standing debates in vascular medicine: should asymptomatic carotid stenosis still be treated invasively in the era of modern best medical therapy? In this episode, Laurence Bertrand and Rosalinda D'Amico discuss the trial with Barbara Rantner and Caitlin Hicks, exploring its methodology, controversial findings, and the implications for the management of asymptomatic carotid stenosis.Full name of guests:Dr. Barbara Rantner – TUM University Hospital, Munich, Chair of ESVS and DGG guideline writing committeeDr. Caitlin Hicks, Johns Hopkins University School of Medicine, Member of the writing committee ESVS and SVS guidelinesShownotes: Brott TG, Howard G, Lal BK, Voeks JH, Turan TN, Roubin GS, Lazar RM, Brown RD Jr, Huston J 3rd, Edwards LJ, Jones M, Clark WM, Chamorro Á, Llull L, Mena-Hurtado C, Heck D, Marshall RS, Howard VJ, Moore WS, Barrett KM, Demaerschalk BM, Sangha N, Aronow H, Foster M, Sternbergh WC 3rd, Shawl F, Lanzino G, Rapp J, Tran HS, Ecker R, Mackey A, Ali V, Given C 2nd, Teal P, Kashyap VS, Mukherjee D, Harrigan M, Silverman S, Koopmann M, Wadley VG, Zhang Y, Rhodes JD, Chaturvedi S, Meschia JF; CREST-2 Investigators. Medical Management and Revascularization for Asymptomatic Carotid Stenosis. N Engl J Med. 2026 Jan 15;394(3):219-231. doi: 10.1056/NEJMoa2508800. Epub 2025 Nov 21. PMID: 41269206; PMCID: PMC13148431.Halliday A, Bulbulia R, Bonati LH, Chester J, Cradduck-Bamford A, Peto R, Pan H; ACST-2 Collaborative Group. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy. Lancet. 2021 Sep 18;398(10305):1065-1073. doi: 10.1016/S0140-6736(21)01910-3. Epub 2021 Aug 29. PMID: 34469763; PMCID: PMC8473558.

Conversamos con Guillermo Paraje, académico de Economía de la Escuela de Negocios de la Universidad Adolfo Ibáñez, sobre un estudio publicado en la prestigiosa revista The Lancet que confirmó que la Ley de Etiquetados en Chile ayudó a reducir la obesidad infantil, a 10 años de la norma.

Inside the venom of a desert lizard, scientists found a molecule that does something the diet industry spent 50 years failing to do. It quietly switches off hunger. That molecule is now the most talked about drug on the planet, and it's sitting in the fridges of millions of people who couldn't explain how it works if you paid them.Dr Tom Buckley, 30 years in medicine and a professor at Sydney University, has looked at the evidence and called these drugs revolutionary.But what about "Ozempic face"? What if the wait comes back after you stop? Who should never touch these drugs? Dr Tom and Andrew get into the science so you finally have all the answers you need. 00:00 – A desert lizard that eats twice a year 03:32 – What a GLP-1 actually is, in plain English 07:36 – Ghrelin and leptin: hunger and fullness, explained 10:23 – The venom that cracked the hunger code 14:06 – Why your body is built to hold onto fat 15:19 – How to raise GLP-1 without a prescription 18:10 – Become the CEO of your body and brain 22:10 – You don't lose fat cells, they shrink 24:39 – "Ozempic face," and why you lose weight slowly 28:17 – The "Limitless" effect: cognitive horsepower 29:28 – 76 trials, 40,000 patients: the evidence 30:47 – Lancet 2024: heart attacks and strokes down 32:11 – Why Tom calls these drugs regenerative 34:18 – Who should never take it 35:23 – The side effects nobody mentions upfront 41:19 – On it and off it: what you have to get right 48:14 – Most regain 75% within a year of stopping 50:09 – Metabolic rebound: worse than where you started 52:51 – The hidden economy GLP-1s are reshaping 56:13 – Tom's cliff notesYou can find Dr Tom at his LinkedIn: https://www.linkedin.com/in/tom-buckley-06a76b98/ Use Code "PQPODCAST10" to get 10% off your Lumo Coffee order:https://lumocoffee.com/ Interested in sharing your story? Email Producer Shannon at support@performanceintelligence.com today with your story and contact details. Learn more about Andrew and Performance Intelligence: https://performanceintelligence.com/Find out more about Andrew's Keynotes : https://performanceintelligence.com/keynotes/Follow Andrew May: https://www.instagram.com/andrewmay/Watch the Performance Intelligence Podcast on Youtube: https://www.youtube.com/@performanceintelligencepodcastIf you enjoy the podcast, we would really appreciate you leaving a short review on Apple Podcasts, Spotify or Google Play. It takes less than 60 seconds and really helps us build our audience and continue to provide high quality guests.

Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/16-06-2026Nesta terça-feira, o boletim analisa um salto na neuromodulação de precisão, novos consensos no manejo do HIV e o panorama das doenças crônicas na América Latina. Abordamos um estudo da Nature sobre a nova geração de estimulação cerebral profunda adaptativa, capaz de ajustar estímulos em tempo real para reduzir quedas no Parkinson. Detalhamos o consenso da The Lancet que unifica a conduta diante de pacientes com HIV que mantêm carga viral persistentemente baixa. Por fim, trazemos no Radar um levantamento que aponta as patologias bucais como as condições mais comuns da nossa região, impactando diretamente o risco cardiovascular e o diabetes. Afya News. Informação médica confiável e atualizada no seu tempo.

Jacob och Erik diskuterar denna vecka två olika nyhetsartiklar, en i DN och en i SvD. Först ut är en artikel som Dagens Nyheter har återpublicerat från NY Times där man listar "Fem hälsorisker med för mycket protein". Punkterna berör dock nästan inte alls protein i sig utan istället listar man vissa livsmedel som innehåller protein som kan vara negativt i större mängder samtidigt som man lägger fram lite tveksamma jämförelser mellan olika kategorier av livsmedel. Efter det här diskuteras en artikel i SvD med titeln "Förbud och varningar bet på övervikt bland barn" som handlar om en nypublicerad artikel i The Lancet där man undersökt om små barns risk för övervikt förändrades när Chile införde en del regler kring skräpmat 2016. Studien finner en liten effekt på barnens risk men det är delar med studien som gör att resultaten är lite tveksamma. Bland annat tittade man bara på knappt 2 år efter förändringen och en tidigare studie har funnit att där var en dipp i barns vikt det första året efter förändringen men sen återgick trenden till den samma som tidigare. På Hälsoveckan by Tyngres instagram kan du hitta bilder relaterat till detta och tidigare avsnitt. Hålltider (00:00:00) Introsnack (00:04:13) DN ger fem olika varningar för protein (00:23:19) Chiles varningar för skräpmat påstås minska övervikt och fetma hos små barn

☎️ Book Your COMPLEMENTARY CONSULTATION and CALORIE CALCULATION Call: https://calendly.com/d/2p8-mxx-dgf/free-consultation-call-zoom⁠⁠⁠⁠⁠⁠PMOS guide: https://www.vitalityoet.com/pmosPCOS has officially been renamed PMOS - Polyendocrine Metabolic Ovarian Syndrome - published in The Lancet on May 12th, 2026, after 14 years of global collaboration. In this episode I share my own PMOS story - cortisol-induced, stress-driven, and masked by birth control for years.  What You'll LearnWhy PCOS was renamed PMOS and what each word in the new name actually meansStephanie's personal cortisol-driven PMOS story — and how birth control masked it for yearsWhat PMOS actually is, explained simply — androgens, the hormonal system, why symptoms happenThe four types of PMOS: insulin-resistant, adrenal/cortisol, inflammatory, and post-pillThe specific tests that reveal each type — including why fasting glucose misses most of themWhy the same diagnosis needs four different solutionsWhat the first move is for each type

Ryan & Mike take on ADHD kids' medication based on research and doctors, not social media. They cover untreated ADHD risks, debunk the psychiatrist myth, and put decisions with parents and prescribers.Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠{{chapters}}[00:00:00] Start[00:01:05] Why Parents Get Confused About Medication[00:03:40] The Risks of Untreated ADHD[00:06:46] Where Medication Misinformation Comes From[00:10:15] Do You Really Need a Child Psychiatrist?[00:13:34] Who Makes the Medication DecisionCitationsAmerican Academy of Child and Adolescent Psychiatry. (2020). Clinical use of pharmacogenetic tests in prescribing psychotropic medications for children and adolescents. https://www.aacap.org/aacap/Policy_Statements/2020/Clinical-Use-Pharmacogenetic-Tests-Prescribing-Psychotropic-Medications-for-Children-Adolescents.aspxAmerican Academy of Child and Adolescent Psychiatry. (2022). Attention-deficit/hyperactivity disorder: Parents' medication guide. https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/med_guides/ADHD_Medication_Guide-web.pdfAmerican Academy of Child and Adolescent Psychiatry. (n.d.). Pharmacogenetic testing. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Pharmacogenetic_Testing-128.aspxAmerican Psychiatric Association. (n.d.). What is ADHD? https://www.psychiatry.org/patients-families/adhd/what-is-adhdCenters for Disease Control and Prevention. (2024). Clinical care of ADHD. https://www.cdc.gov/adhd/hcp/treatment-recommendations/index.htmlDalsgaard, S., Leckman, J. F., Mortensen, P. B., Nielsen, H. S., & Simonsen, M. (2015). Effect of drugs on the risk of injuries in children with attention deficit hyperactivity disorder: A prospective cohort study. The Lancet Psychiatry, 2(8), 702–709. https://doi.org/10.1016/S2215-0366(15)00271-0Dalsgaard, S., Østergaard, S. D., Leckman, J. F., Mortensen, P. B., & Pedersen, M. G. (2015). Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: A nationwide cohort study. The Lancet, 385(9983), 2190–2196. https://doi.org/10.1016/S0140-6736(14)61684-6de Vries, W., Boer, M., Stevens, G. W. J. M., & van Dorsselaer, S. (2025). Exploring concept creep: Youth's portrayal of ADHD on TikTok. SSM Mental Health, 7, 100374.Harpin, V., Mazzone, L., Raynaud, J. P., Kahle, J., & Hodgkins, P. (2016). Long-term outcomes of ADHD: A systematic review of self-esteem and social function. Journal of Attention Disorders, 20(4), 295–305. https://doi.org/10.1177/1087054713486516Myer, N. M., Boland, J. R., & Faraone, S. V. (2018). Pharmacogenetics predictors of methylphenidate efficacy in childhood ADHD. Molecular Psychiatry, 23, 1929–1936.Shaw, M., Hodgkins, P., Caci, H., Young, S., Kahle, J., Woods, A. G., & Arnold, L. E. (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: Effects of treatment and non-treatment. BMC Medicine, 10, 99. https://doi.org/10.1186/1741-7015-10-99Wetterer, L. (2020). Attention-deficit/hyperactivity disorder: AAP updates guideline for diagnosis and management. American Family Physician, 102(1), 58–60.Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., & Zurhellen, W. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528Yeung, A., Ng, E., & Abi-Jaoude, E. (2022). TikTok and attention-deficit/hyperactivity disorder: A cross-sectional study of social media content quality. The Canadian Journal of Psychiatry, 67(12), 899–906. https://doi.org/10.1177/07067437221082854

Aaron Brown is a quantitative analyst, risk manager, and author of the new book Wrong Number: How to Extract Truth from a Blizzard of Quantitative Disinformation. https://amzn.to/4frmg3n He's also about to debate gun control at the Soho Forum in August — and his preparation for that debate is a pretty good preview of what's in the book. Topics include: why out of 28,000 gun control studies, the RAND Corporation found only 20 that weren't statistically crippled; the smoking analogy and what it tells us about legislation that runs ahead of evidence; why gun laws burden legitimate owners and not criminals; why we have a crime problem, not a gun problem; The Lancet paper that claimed US aid saved 92 million lives; how to spot three red flags that tell you a statistic is BS; and Wonder Bread's motto "Helps build strong bodies 12 ways" — which nobody ever actually wrote down. Get the book → Wrong Number: How to Extract Truth from a Blizzard of Quantitative Disinformation https://amzn.to/4frmg3n TIMESTAMPS: 0:00 — Intro — Aaron Brown and Wrong Number 0:34 — The Soho Forum gun control debate — and who he's up against 3:45 — The proposition: abolish all restrictions on adult firearm ownership 4:48 — Lou on navigating gun laws across state lines (NJ → PA → NY) 7:25 — The wide cultural divide: Scranton airport vs. any other airport with guns 9:04 — RAND Corporation: of 28,000 gun control studies, only 20 weren't crippled by errors 10:04 — The smoking analogy — legislation running ahead of the evidence 12:15 — Gun control laws only burden legitimate owners — not criminals 12:43 — The Glock switch ban and the AR-15 — targeting the popular, not the dangerous 15:18 — "Trump is a fascist" — and you want him to take the guns? 15:42 — Stop calling it a gun problem. It's a crime problem. 17:47 — We can identify the 1% of kids likely to commit 20–30% of violent crime 19:31 — Genetic markers for violence — and why that's controversial 20:48 — The Nordic prison model — does it work, and could it work here? 22:09 — Immigration data: why lumping everyone together gets you bad answers 25:20 — Lou's joke about open borders (for immigrants like his dad, not his cousins) 25:39 — Aaron's Jewish smuggler ancestors — blocked from junk dealing by licensing laws 27:04 — Did US aid really save 92 million lives? The Lancet paper that can't add up 29:13 — They saved 114% of the people — including 46M in China, which gets no aid 31:22 — Most published research findings are false — and we've known since 2005 32:42 — DOGE cuts and the "millions are dead" narrative 36:15 — Three red flags that tell you a statistic is BS 39:18 — Wonder Bread's "12 ways" — nobody ever wrote them down 40:18 — Outro — Wrong Number and the Soho Forum debate Watch full episodes on YouTube → https://www.youtube.com/watch?v=J4Vb53s4I0A&list=PLb5trMQQvT077-L1roE0iZyAgT4dD4EtJ Listen on Apple Podcasts → https://podcasts.apple.com/us/podcast/the-lou-perez-podcast/id1535032081 Listen on Spotify → https://open.spotify.com/show/2KAtC7eFS3NHWMZp2UgMVU  Lou's book — That Joke Isn't Funny Anymore: https://amzn.to/3VhFa1r  TheLouPerez.com |  info@thelouperez.com  Newsletter: https://substack.com/@louperez #Statistics #Misinformation #GunControl #USAID #AaronBrown #WrongNumber #SohoForum #LouPerezPodcast #LionsOfLiberty #DataLiteracy Learn more about your ad choices. Visit megaphone.fm/adchoices

Episode#337-Taped April 29, 2026 We talk about vaccines, pandemic preparedness and emerging infectious diseases. Vaccines remain one of the most powerful public health tools that we have. A 2024 Lancet study estimated that global immunization efforts saved 154 million lives over the past 50 years- that's about 6 lives every minute. Joining us is Dr. Amesh Adalja MD, a board-certified infectious diseases, critical care, emergency medicine, senior scholar at the Johns Hopkins Center for Health Security. He is also an affiliate of the Johns Hopkins Center for Global Health. Dr. Adalja will discuss with us evidence-based insights on vaccines and their importance in our lives and health and well-being. Are we pandemic prepared? And what can we do as individuals to protect ourselves and have long-term health protection. To get in touch with Amesh Adalja MD and learn all about him and his work, go to www.ameshadalja.com Check out Dr. Amesh Adalja www.ameshadalja.com It's All About Health & Fitness-Vicki Doe Fitness podcast Ranked on the Top 25 Midwest Fitness Podcasts to Listen to… with additional national recognition on the Top 100 US fitness podcast. Rate This Podcast Give us a 5-star review.  We appreciate you! Take this quick audience survey. Thank you! FREE Metabolic Makeover Masterclass Webinar Replay! Learn how to reset your metabolism, boost energy, and support sustainable weight loss using simple, science-backed strategies. Enroll in the Vicki Doe Fitness Academy to get instant access to the replay and begin your healthy living journey today. Vicki Doe Fitness-STORE Discover the Vicki Doe Fitness-STORE—your destination for stylish apparel, fitness gear, and wellness essentials like yoga mats, water bottles, candles, and premium supplements. Shop now and elevate your health journey! Resources *Note: Some of the resources below may be affiliate links, meaning Vicki Doe Fitness receives a commission (at no extra cost to you) if you use the link to make a purchase. Thank you for your support! Herbs and spices are the keys to delicious, flavorful, and sophisticated meals! FREE DOWNLOAD- Herbs and Spices Cheatsheet Let's get ECO-friendly.  Try ECOLunchbox.com ECOlunchbox specializes in stainless steel bento boxes, artisan fair trade lunch bags, napkins, snack sacks, and other eco-friendly lunchware. They are a certified green business.  ECOlunchbox is a consumer products company started by an eco mom in the San Francisco Bay Area. ECOLunchbox.com Go to our Resources page-   For the most recommended tools, you need to succeed on your healthy living journey!! Listen and share our podcast show- “It's All About Health & Fitness-” Vicki Doe Fitness Subscribe to Apple Podcast Subscribe on Stitcher Or on any of the platforms that you listen to your podcast! Watch & Subscribe on YouTube! Catch our latest health & wellness videos on YouTube at Vicki Haywood Doe – Vicki Doe Fitness YouTube-Vicki Haywood Doe-Vicki Doe Fitness Join us to receive a health wellness message!

From rubber bands and metal clips to fabric-covered elastics and slick buns, this episode explores how everyday accessories affects hair. We breakdown the mechanical and biological cost of tight, rough, or poorly chosen accessories, including breakage and hair loss.Tune in to learn how to choose better, style smarter, and protect your hair goals without losing your personality.Listen now and rethink your hair accessories.Download your free copy of the UTK-Podcast Hair Accessory Guide for hair accessory tips to support your hair goals.ReferencesBolduc, C., & Shapiro, J. (2001). "Management of hair loss." The Lancet, Vol. 357, Issue 9253, pp. 321-322. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)03630-1/fulltextDraelos, Z. D. (2010). "Essentials of Hair Care often neglected: Hair Cleansing." Journal of Cosmetic Dermatology, Vol. 9, Issue 4, pp. 312-315. https://onlinelibrary.wiley.com/journal/14732165Khumalo, N. P., et al. (2007). "Traction alopecia is caused by hair care practices." Journal of the American Academy of Dermatology, Vol. 57, Issue 2, pp. 221-230. https://www.jaad.org/article/S0190-9622(07)00583-1/fulltextMiteva, M., & Tosti, A. (2013). "Traction Alopecia." Dermatologic Clinics, Vol. 31, Issue 1, pp. 107-117. https://www.derm.theclinics.com/article/S0733-8635(12)00101-3/fulltextSwift, J. A. (1991). "The mechanics of fracture of human hair." Journal of the Society of Cosmetic Chemists, Vol. 42, pp. 1-18. https://library.scconline.org/v042n01/Send us Fan MailSend your questions about Afro-textured/coily hair to utkinhair@gmail.com.Check out your natural beauty hub, ÈYÍ DÁRA Naturals for natural hair care solutions.Follow us on instagram @utkpodcast

Aaron Brown is a quantitative analyst, risk manager, and author of the new book Wrong Number: How to Extract Truth from a Blizzard of Quantitative Disinformation. https://amzn.to/4frmg3n He's also about to debate gun control at the Soho Forum in August — and his preparation for that debate is a pretty good preview of what's in the book. Topics include: why out of 28,000 gun control studies, the RAND Corporation found only 20 that weren't statistically crippled; the smoking analogy and what it tells us about legislation that runs ahead of evidence; why gun laws burden legitimate owners and not criminals; why we have a crime problem, not a gun problem; The Lancet paper that claimed US aid saved 92 million lives; how to spot three red flags that tell you a statistic is BS; and Wonder Bread's motto "Helps build strong bodies 12 ways" — which nobody ever actually wrote down. Get the book → Wrong Number: How to Extract Truth from a Blizzard of Quantitative Disinformation https://amzn.to/4frmg3n TIMESTAMPS: 0:00 — Intro — Aaron Brown and Wrong Number 0:34 — The Soho Forum gun control debate — and who he's up against 3:45 — The proposition: abolish all restrictions on adult firearm ownership 4:48 — Lou on navigating gun laws across state lines (NJ → PA → NY) 7:25 — The wide cultural divide: Scranton airport vs. any other airport with guns 9:04 — RAND Corporation: of 28,000 gun control studies, only 20 weren't crippled by errors 10:04 — The smoking analogy — legislation running ahead of the evidence 12:15 — Gun control laws only burden legitimate owners — not criminals 12:43 — The Glock switch ban and the AR-15 — targeting the popular, not the dangerous 15:18 — "Trump is a fascist" — and you want him to take the guns? 15:42 — Stop calling it a gun problem. It's a crime problem. 17:47 — We can identify the 1% of kids likely to commit 20–30% of violent crime 19:31 — Genetic markers for violence — and why that's controversial 20:48 — The Nordic prison model — does it work, and could it work here? 22:09 — Immigration data: why lumping everyone together gets you bad answers 25:20 — Lou's joke about open borders (for immigrants like his dad, not his cousins) 25:39 — Aaron's Jewish smuggler ancestors — blocked from junk dealing by licensing laws 27:04 — Did US aid really save 92 million lives? The Lancet paper that can't add up 29:13 — They saved 114% of the people — including 46M in China, which gets no aid 31:22 — Most published research findings are false — and we've known since 2005 32:42 — DOGE cuts and the "millions are dead" narrative 36:15 — Three red flags that tell you a statistic is BS 39:18 — Wonder Bread's "12 ways" — nobody ever wrote them down 40:18 — Outro — Wrong Number and the Soho Forum debate Watch full episodes on YouTube → https://www.youtube.com/watch?v=J4Vb53s4I0A&list=PLb5trMQQvT077-L1roE0iZyAgT4dD4EtJ Listen on Apple Podcasts → https://podcasts.apple.com/us/podcast/the-lou-perez-podcast/id1535032081 Listen on Spotify → https://open.spotify.com/show/2KAtC7eFS3NHWMZp2UgMVU  Lou's book — That Joke Isn't Funny Anymore: https://amzn.to/3VhFa1r  TheLouPerez.com |  info@thelouperez.com  Newsletter: https://substack.com/@louperez #Statistics #Misinformation #GunControl #USAID #AaronBrown #WrongNumber #SohoForum #LouPerezPodcast #LionsOfLiberty #DataLiteracy Learn more about your ad choices. Visit megaphone.fm/adchoices

Get Myoscience Creatine and Magnesium (20% off) HERE: https://bit.ly/4ocjMbp  Pre-order Keto Flex Revised and get free bonuses: https://bit.ly/4wKG1sM    Men today are walking around with 20 to 30% less testosterone than their fathers had at the exact same age. Not because of disease. Because of five everyday habits that modern men think are completely normal. In this episode, I'm breaking down the five silent mistakes that are aging men faster than anything else right now, the science behind why they're so damaging, and the exact daily stack I personally use to fight back. I'm 41 years old and I've watched this happen to men I love. The decline doesn't announce itself. But it can be reversed. Key Takeaways: Men today have 20 to 30% less testosterone than men of the same age in 1988, per the Massachusetts Male Aging Study Grip strength predicts death more accurately than blood pressure, per a Lancet meta-analysis of 140,000 people One week of sleeping 5 hours or less drops testosterone by 10 to 15%, the equivalent of aging 10 to 15 years Sitting for long hours thins the memory center of the brain, and exercise does not offset this damage 85-year-olds gained muscle and reversed fiber-level aging in 12 weeks of resistance training in a Mayo Clinic study The five mistakes: stopping explosive movement, stopping brain challenges, ignoring muscle decline, neglecting recovery, and accepting decline as normal The simple daily stack: outdoor walks, heavy lifting twice a week, one gram of protein per pound of ideal body weight, 7+ hours of sleep, creatine, magnesium, and weekly brain challenges Find All The Ben Azadi Show Sponsorship Deals ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.ketokamp.com/sponsorship-deals Learn more about your ad choices. Visit megaphone.fm/adchoices

A guide to diagnosing, imaging, and managing acute renal colic and nephrolithiasis in the ED. Hosts: Brian Gilberti, MD Avir Mitra, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Nephrolithiasis.mp3 Download Leave a Comment Tags: Kidney Stones, Urology Show Notes 1. CLINICAL CORE & PHYSIOLOGIC FRAMEWORK Epidemiologic Risk Profiles Lifetime incidence parameters hover around 1 in 11, presenting with a prominent male sex skew. Peak demographic manifestation concentrated within the 30–60 age band. High-yield temporal parameter: 50% recurrence vector within a 5-year post-initial-insult window. Mineralogical Composition Vectors Calcium oxalate crystals represent the predominant structural matrix. Struvite configurations (magnesium ammonium phosphate matrix) account for 1–2% of cohorts. Struvite stones function explicitly as infection-driven configurations secondary to upper tract proliferation; higher distribution index noted in female cohorts. Etiological & Modifiable Relational Dynamics Profound systemic dehydration or low baseline fluid throughput states. High-sodium diet structures and heavy animal-protein consumption loads. Positive genetic/familial history variables. Relative risk modulation: Each variable independently operates to expand baseline risk by a factor of 2x to 3x. Pathophysiologic Symptom Complexes Acute, sudden-onset, maximum-intensity (10/10) unilateral flank pain. Classic structural radiation vector tracking downward toward the ipsilateral groin/genitourinary dermatomes. Distinctive behavioral marker: Renal colic pacing/writhing behavior with zero antalgic position availability. Concomitant autonomic triggers: Nausea and emesis manifest in 50% of acute presentations. Physical Exam Discordance Metrics Severe subjective distress contrasted with a characteristically soft, completely non-tender abdominal palpation exam. CVA tenderness is completely variable and lacks reliable negative predictive value. Atypical Presentation Classifications Vague, poorly localized abdominal pain presentations occurring in up to 20% of active cases. Isolated lower urinary tract irritative signs including acute frequency or severe urgency. Incidental & Asymptomatic Dynamics Silent intrarenal or ureteral stones found incidentally. Longitudinal tracking demonstrates up to 33.3% of initially asymptomatic cohorts convert to fully symptomatic renal colic within a multi-year tracking window. 2. EXCLUSION DIAGNOSES & CRITICAL PATHWAY RED FLAGS Vascular Mimics: AAA rupture/expansion. This is a mandatory exclusion pathway in elderly cohorts presenting with acute flank or back pain. Physical tracking requires active exploration for an expansile, pulsatile abdominal mass. Gynecologic Emergencies: Ruptured ectopic pregnancy. Demands universal screening protocols via rapid beta-hCG testing in all female patients of childbearing potential presenting with lower abdominal/pelvic localization. Infectious Upper Tract Decompensation: Acute uncomplicated pyelonephritis. Differentiated via persistent high spikes, high fevers, systemic shaking chills, and profound pyuria. Genitourinary Structural Crises: Acute testicular torsion. Mandates a thorough, explicit scrotal/testicular structural exam if the flank pain radiates into the scrotum. Gastrointestinal and Adnexal Torsional Confounds: Acute appendicitis variants, acute mesenteric/bowel ischemia, and ovarian torsion syndromes. 3. LABORATORY TESTING & PHYSIOLOGIC EVALUATION Urinalysis Interpretation Nuances Microscopic or gross hematuria presents in approximately 66% to 90% of acute cases. Critical Pathological Caveat: Complete absence of hematuria documented in 20% to 33.3% of confirmed, acute obstructing ureteral stones. Diagnostic rule: A pristine urinalysis with zero red blood cells is entirely insufficient to exclude acute ureterolithiasis. Urinary pH as a Composition Clue Consistently low urinary pH parameters (pH < 5.5) point strongly toward a uric acid crystalline composition. Elevated urinary pH parameters (pH > 7.5) indicate the presence of urease-producing microbial pathogens, pointing toward a struvite infection stone. Infectious Screening Metrics Active tracking for marked pyuria, positive leukocyte esterase, and bacterial nitrites to rule out an obstructed, infected upper urinary tract system. BMP Immediate quantification of baseline serum creatinine to establish accurate eGFR values. Targeting detection of post-renal AKI from bilateral obstruction, unilateral obstruction in a single functioning kidney, or severe volume depletion. CBC Evaluation for marked leukocytosis. Physiologic Nuance: Mild-to-moderate white blood cell count elevations frequently represent non-specific stress demargination driven by severe pain and repetitive vomiting. High-grade white blood cell shifts demand immediate exclusion of systemic bacteremia or an infected, obstructed urinary system. Adjunctive Lab Pathways Rapid qualitative urine hCG testing. Reflex urine culture execution whenever urinalysis metrics display significant inflammatory profiles or clinical suspicion of UTI is high. 4. IMAGING MODALITIES & ALGORITHMIC CLINICAL SELECTION Non-Contrast CT Diagnostics Gold standard; diagnostic sensitivity and specificity parameters exceed 95% for stones >2 mm. Provides precise quantification of stone diameter (mm), exact localization (proximal, mid, or distal ureter), and degree of secondary hydronephrosis. Excellent structural visualization for detecting or ruling out alternate retroperitoneal, vascular, or intra-abdominal pathologies. Contrast-Enhanced CT Protocols Indicated when alternative intra-abdominal surgical pathology is highly suspected over isolated renal colic. Retains diagnostic capability to identify urinary tract stones >3 mm even within contrast-enhanced phases. NCCT Structural Architecture Limitations Standard stone protocol CT scans are executed in a prone position without IV contrast enhancement. It does not opacify the ureteral lumen. Presents a cumulative radiation exposure penalty when utilized serially across recurrent ED presentations. POCUS / Radiology Ultrasound Direct stone visualization capabilities are modest, operating at approximately 50% to 60% sensitivity, and is highly dependent on anatomical positioning at the extreme proximal ureter or the UVJ. Secondary obstruction tracking: Demonstration of hydronephrosis operates at a high sensitivity of approximately 80%. POCUS Clinical Utility Metrics Eliminates ionizing radiation exposure and allows immediate, rapid real-time execution directly at the patient’s bedside. Confirmation of significant hydronephrosis within a classic clinical presentation yields high post-test probability for stone presence while lowering suspicion for vascular catastrophes like a AAA. KUB Radiography Extremely poor overall diagnostic sensitivity, hovering around 57%. Fails to image radiolucent configurations (pure uric acid matrices) or small stones measuring

Fontes do episódio aqui:⁠https://portal.afya.com.br/podcasts/afya-news/08-06-2026Nesta segunda-feira, o boletim analisa novas fronteiras oncológicas para os análogos de GLP-1, o avanço das terapias incretínicas combinadas e o impacto histórico da triagem neonatal no Brasil . Começamos com os estudos apresentados na ASCO que sugerem uma associação entre os agonistas de GLP-1 e a redução do risco de alguns tipos de cancro e da progressão tumoral. Detalhamos o ensaio clínico publicado no The Lancet sobre a combinação de cagrilintida e semaglutida (CagriSema), que demonstrou melhoria robusta no controlo glicémico e na perda de peso em doentes com diabetes tipo 2. Por fim, no Radar, celebramos os 25 anos do Teste do Pezinho no SUS, reforçando a importância do diagnóstico precoce e do aproveitamento da janela terapêutica neonatal. Afya News. Informação médica confiável e atualizada no seu tempo.

ThePrintPod: Alzheimer's may show up in blood yrs before symptoms appear—Lancet study offers hope of early diagnosis

One in six teenagers right now has measurable hearing loss, and almost nobody is talking about it. In this conversation with Brandon Sawalich of Starkey Hearing Technologies, we pull back the curtain on what Brandon calls a “quiet pandemic” driven by earbuds, concerts, and a generation blasting sound directly into their cochlea. If you're still pounding music through your earbuds on a daily basis, this episode is your wake-up call. CLICK HERE TO BECOME GARY'S VIP!: https://bit.ly/4ai0Xwg Connect with Brandon Sawalich Website: https://bit.ly/4mOv98w  Website: https://bit.ly/42ASAc4  Instagram: https://bit.ly/4cPsNlc  Facebook: https://bit.ly/42w3wb3  X: https://bit.ly/41TWYmr  LinkedIn: https://bit.ly/4u6JYFV  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  H2TABS: “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/4coJ8foX: 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 03:03 Link between Hearing and Brain Health 08:35 Hearing Loss is Irreversible 09:59 Hearing Aids: Technology 13:17 Causes of Hearing Loss and Tinnitus  18:39 Mitigating Tinnitus 20:34 Starkey Hearing Technologies 23:29 How Often Should You Test Your Hearing? 27:04 Risk Factors for Hearing Loss 32:13 Hearing Issues Change One's Personality 32:56 Connect with Brandon and Starkey 35:12 Lancet study: https://bit.ly/4ekLQ8V  35:52 What Does It Mean to You to Be an Ultimate Human? The information provided here is for general informational purposes only and should not be considered as medical or clinical advice. It is not intended to diagnose, treat, cure, or prevent any health condition, and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding a medical condition or health objectives. The use of any information provided is solely at your own risk, and the provider of this information is not liable for any consequences arising from its use.   Disclosure: Some links to certain products or services are affiliate links, meaning we may earn a commission. 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 promotional in nature. Learn more about your ad choices. Visit megaphone.fm/adchoices

Forget muscle repair. The reason sleep actually transforms your health is happening inside your skull every night — and it's not what Matthew Walker's TED Talk made famous. In this episode of Health Longevity Secrets, Robert Lufkin MD breaks down the real science of sleep: the glymphatic system that flushes beta-amyloid from your brain, the hippocampal "sharp wave ripples" that lock in memories, the slow-wave growth hormone pulse you can't make up, and the testosterone and insulin damage that happens in a single week of short sleep. He closes with the single most evidence-based intervention you can do tonight — and it's not melatonin. CHAPTERS: 00:00 — Why The "Sleep For Muscle Repair" Story Is Wrong 01:00 — Part 1: The Muscle Repair Myth (mTOR, Protein Synthesis, 24–48hr Window) 02:00 — Part 2: The Molecular Truth — The Glymphatic System 02:35 — The 60% Brain Cleaning Cycle (Xie 2013, Beta-Amyloid Clearance) 03:30 — Sharp Wave Ripples and Memory Consolidation in Deep Sleep 03:55 — How Sleep Onset Drives 70% of Your Nightly Growth Hormone 04:30 — Sleep Restriction Drops Testosterone 10–15% in One Week 05:00 — Part 3: The Hormonal Layer — Insulin, Cortisol, Ghrelin 05:15 — 4 Nights, 4 Hours: Prediabetes In Healthy Young Men (Spiegel 1999) 06:30 — Ghrelin, Leptin, and Why You Wake Up Hungrier 07:00 — Part 4: The Practical Tactic — Thermal Regulation 07:30 — The 2–3°F Core Temperature Drop That Triggers Sleep 08:00 — Why a Hot Shower 90 Minutes Before Bed Beats Melatonin 08:45 — The 65–68°F Bedroom Rule 09:15 — Part 5: The Reframe — Sleep Is Neurological, Not Muscular KEY TAKEAWAYS: • Muscle protein synthesis runs 24–48 hours post-workout and does not require sleep architecture — it requires amino acids, energy, and time. • During sleep, your brain's interstitial space expands ~60% to flush metabolic waste, including the beta-amyloid and tau proteins implicated in Alzheimer's. • ~70% of your daily growth hormone is released in the first slow-wave cycle — disrupt the first 90 minutes and you blunt the whole night. • Four nights of 4-hour sleep produced prediabetes-level insulin resistance in healthy young men (Spiegel et al., Lancet 1999). • A hot bath or shower 60–90 minutes before bed shortens sleep latency more reliably than melatonin (Haghayegh et al., Sleep Medicine Reviews 2019). Pair with a 65–68°F bedroom. STUDIES & SOURCES MENTIONED: • Xie L, et al., Science 2013 — Sleep drives beta-amyloid clearance via the glymphatic system — https://pubmed.ncbi.nlm.nih.gov/24136970/ • Spiegel K, Leproult R, Van Cauter E, Lancet 1999 — Sleep debt and metabolic/endocrine function (4-night 4-hour sleep restriction trial) — https://pubmed.ncbi.nlm.nih.gov/10543671/ • Leproult R, Van Cauter E, JAMA 2011 — 1 week of sleep restriction drops testosterone 10–15% in healthy young men — https://pubmed.ncbi.nlm.nih.gov/21632481/ • Haghayegh S, et al., Sleep Medicine Reviews 2019 — Warm shower/bath 1–2h before bed shortens sleep onset latency (meta-analysis of 13 trials) — https://pubmed.ncbi.nlm.nih.gov/31102877/ • Pontzer H, et al., Current Biology 2016 — Constrained total energy expenditure model — https://pubmed.ncbi.nlm.nih.gov/26832439/ • Walker M, "Why We Sleep" (book) — https://en.wikipedia.org/wiki/Why_We_Sleep ─────────────────────────────────

In this episode of Mind the Meds, Erica Marini, PharmD, highlights information from the European Stroke Organization Conference include encouraging data on asundexian(Bayer), a factor XIa inhibitor showing reduced recurrent ischemic stroke risk without increased bleeding, as well as positive results from three trials of tirofiban in acute ischemic stroke settings. On the multiple sclerosis (MS) front, Marini covers the FDA approval of ocrelizumab (Ocrevus; Genentech) for pediatric relapsing-remitting MS in children 10 and older, a new study supporting early use of high-efficacy agents in pediatric MS, and 2 Lancet publications on ocrelizumab — one examining higher weight-adjusted dosing (which did not improve disability progression) and one confirming benefit in a broader primary progressive MS population. She also briefly discusses PADOVA (NCT04777331), a phase 2b trial of prasinezumab in early Parkinson's disease, which failed to meet its primary end point.The bulk of the episode is a discussion with guest Millad Sobhanian, PharmD, BCPS, clinical pharmacy specialist in neurology at the University of Maryland, focused on Alzheimer disease. They cover dextromethorphan/bupropion (Auvelity; Axsome Therapeutics), newly approved in April 2026 for agitation associated with Alzheimer dementia. Sobhanian walks through key safety considerations—including additive NMDA antagonism if combined with memantine, cardiovascular risks from the bupropion component, and the ever-present black box warning on antipsychotics in dementia patients—while both note that the efficacy data, though statistically significant, shows modest clinical effect sizes compared to the threshold for meaningful within-patient change.The conversation then turns to lecanemab's subcutaneous initiation formulation (Leqembi Iqlik; Eisai, Biogen), whose FDA decision has been delayed to about August 2026 as regulators seek more data on bioavailability and ARIA monitoring in the at-home setting. Sobhanian shares his real-world perspective on anti-amyloid therapy, describing a patient population that is typically early-stage, high-functioning, and has a mean age of about 60 to 70 years, and emphasizing the pharmacist's role in expectation-setting around the modest but potentially cumulative slowing of cognitive decline. The episode closes with a thorough discussion of the April 2026 Cochrane review on amyloid-targeting monoclonal antibodies, which both Marini and Sobhanian find overly broad in its conclusions. They note limitations such as the inclusion of withdrawn agents like aducanumab (Aduhelm; Biogen), heterogeneous inclusion criteria across trials, and an 18-month study horizon that may be too short to capture the full benefit suggested by longer-term open-label extension data.Key Takeaways:1. New options for Alzheimer's agitation exist, but fit carefully into the treatment algorithm. Dextromethorphan/bupropion offers a novel NMDA-based mechanism for treating agitation in Alzheimer dementia, but its clinical effect size is modest, and it carries meaningful safety considerations—particularly around the bupropion component in elderly patients. Like all pharmacologic options in this space, it remains a later-line choice after nonpharmacologic interventions have been exhausted, and medication reconciliation is critical given its interaction potential with memantine and CYP2D6 inhibitors.2. Anti-amyloid therapies are imperfect but not ready to be written off. The April 2026 Cochrane review drew significant attention with its conclusion that anti-amyloid monoclonal antibodies produce only trivial cognitive benefits, but its findings are limited by the inclusion of older, withdrawn agents, heterogeneous trial populations, and an 18-month time horizon that may be too short to capture the full trajectory of benefit.3. The pharmacist's role in anti-amyloid therapy goes well beyond dispensing. As illustrated by Sobhanian's practice at the University of Maryland, clinical pharmacists embedded in neurology clinics play a critical role in patient selection, expectation-setting, ARIA counseling, and informed decision-making for patients considering anti-amyloid therapy—a complex, high-stakes treatment decision that these patients and their caregivers should never be navigating alone.

Someone in your family has it. You just don't know yet.1 in 3 adults in Kampala has high blood pressure right now. Diabetes has doubled in 10 years. And the patients living with it? Some of them told our guest, a world-class researcher, that they wish they had HIV instead.Because at least HIV has care.In this episode, we sit down with Dr. Francis Xavier Kasujja, Public Health Researcher at MRC UVRI and the London School of Hygiene & Tropical Medicine — a man who has spent 15 years quietly doing the work that is reshaping how Uganda treats its sickest people. His research has been published twice in The Lancet, the most prestigious medical journal in the world. And his findings helped change government health policy.But he didn't come here to talk about accolades.He came to tell you the truth.In this conversation, you'll discover;

Welcome to the latest episode (June 2026) of Diabetes Core Update, where every month Neil Skolnik, MD and John Russell, MD review the most important articles on diabetes, obesity, and cardiometabolic disease. This month on DOC Update: Shah S, et al. "Food Coloring Additives and Incidence of Type 2 Diabetes in the NutriNet-Santé Prospective Cohort Diabetes Care. 2026;49(6):1067–1077. doi.org/10.2337/dc25-2727 Hespanhol L, et al. "Automated Insulin Delivery Systems in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis." Diabetes Care. 2026;49(6):1134–1143. doi.org/10.2337/dc25-2435 Tatum K, et al. "Survival and Recurrence With GLP-1 Receptor Agonists in Breast Cancer." JAMA. Published Online: May 11, 2026 2026;9;(5):e2612133. doi:10.1001/jamanetworkopen.2026.12133 Winkler C, et al. "Screening Children for Early-Stage Type 1 Diabetes." JAMA. Published Online: May 21, 2026 doi:10.1001/jama.2026.6085 Würtz Yazdanfard P, Kosjerina V, Wood-Kurland H et al. "Effectiveness and Safety of Semaglutide in Type 1 Diabetes: A Danish Nationwide Cohort Study (2018–2024)" Lancet. Volume 66, 101716, July 2026. doi:10.1016/j.lanepe.2026.101716 Horn D, Aronne L, Wharton S et al. "Tirzepatide for maintenance of bodyweight reduction in people with obesity in the USA (SURMOUNT-MAINTAIN): a multicentre, double-blind, randomised, placebo-controlled trial." Lancet. Published online May 12, 2026. doi:10.1016/S0140-6736(26)00656-2 Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health For information about the American Diabetes Association's scholarly journals, visit diabetesjournals.org. For more about this podcast, click here.

Near-death experiences (NDE) are often described in spiritual, personal or even supernatural terms. But a new CMAJ article offers physicians a clinical entry point into understanding them as a distinct phenomenon that patients may report after cardiac arrest, critical illness or other life-threatening events.Dr. Blair Bigham and Dr. Mojola Omole speak with Dr. Andrés Delgado-Ron, a senior data analyst at Simon Fraser University's Faculty of Health Sciences and author of “Five things to know about near-death experiences”. He explains how NDEs differ from delirium or hallucinations, why they are often described as highly organized and vivid, and how veridical perceptions, where patients report details that can later be verified, raise important questions for researchers and clinicians.They also speak with Dr. Marieta Pehlivanova, research assistant professor of psychiatry and neurobehavioural science at the University of Virginia Division of Perceptual Studies, about how physicians respond when patients disclose these experiences. She explains why dismissive reactions can be harmful, how they may prevent patients from processing an event that feels profound, and why clinicians can validate the experience without needing to explain or endorse every aspect of it.For physicians, the message is practical: stay curious, listen without judgement and avoid automatically pathologizing or brushing aside a patient's account. Patients may need space to talk about what happened, and clinicians can offer that space while still maintaining scientific rigour.Lancet article discussed.Comments or questions? Text us.Join us as we explore medical solutions that address the urgent need to change healthcare. Reach out to us about this or any episode you hear. Or tell us about something you'd like to hear on the leading Canadian medical podcast.You can find Blair and Mojola on X  @BlairBigham and @DrmojolaomoleX (in English):  @CMAJ X (en français): @JAMC FacebookInstagram: @CMAJ.ca The CMAJ Podcast is produced by PodCraft Productions

Brjóstakrabbamein er algengasta tegund krabbameins hjá íslenskum konum og er nærri þriðjungur af öllum meinum sem greinast. Niðurstöður nýrrar alþjóðlegrar rannsóknar gefa til kynna að með erfðaprófum sé hægt að meta líkurnar á gagnsemi lyfjameðferðar. Slík erfðapóf eru notuð hér og Halla Þorvaldsdóttir framkvæmdastjóri Krabbameinsfélagsins segir að íslenskir sjúklingar njóti góðs af. Um 1.2 milljarðar Jarðarbúa, 1.200 milljónir karla, kvenna og barna, eru með geðsjúkdóma eða geðraskanir af einhverju tagi. Það eru nær tvöfalt fleiri en 1990. Það þýðir að geðraskanir eru algengasta heilbrigðisvandamál samtímans. Þetta er meginniðurstaða viðamikillar rannsóknar sem birt var í læknatímaritinu Lancet á dögunum. Bresk stjórnvöld birtu í dag skjöl í þremur bindum upp á um fimmtán hundruð síður með samskiptum sem tengjast sendiherratíð Peters Mandelsonsa í Bandaríkjunum. Ýmislegt í skjölunum er talið koma illa við Keir Starmer sem þegar sætir mikilli gagnrýni vegna skipunar Mandelsons.

Our editors – Marc Bonten, Erin McCreary, Anne-Grete Märtson, Angela Huttner, and Josh Davis – are back for part two of the ESCMID Global Late Breakers series, summarising five more late-breaking trials presented at ESCMID Global 2026. They discuss the trials' strengths and weaknesses, and whether their results should change practice. The five trials presented in this half of the series are listed below, and links to their respective sessions can be watched and rewatched on the ESCMID Global Virtual Platform. Links to corresponding abstracts and publications where available are provided as well.Conflict of interest/involvement in the trials:Marc Bonten was the chair of the E.mbrace trial's steering committeeJosh Davis is global co-lead of the SNAP trialJosh Davis was a site investigator on the E.mbrace trialAngela Huttner was an independent/unpaid member of the E.mbrace trial's steering committee and an investigator on the precursor phase 1 trial testing the E. coli vaccinePROCALBAN trial (Late-breaking clinical trials in sepsis management)Chowdhury F, et al. Use of Procalcitonin Point-Of-Care Testing to Guide De-Escalation of Antibiotic Therapy in Adult Sepsis Patients in a Tertiary Hospital in Bangladesh: A Randomised Controlled Open-Label Trial, Preprints with The Lancet, doi: 10.2139/ssrn.6541698BENEFICIAL trial (Late-breaking clinical trials in sepsis management) De Cock PA, et al. Bedside model-informed precision dosing of vancomycin in severely ill neonates and children in Belgium (the BENEFICIAL trial): a multicentre, randomised controlled trial. Lancet Child Adolesc Health, doi: 10.1016/S2352-4642(25)00385-2  SNAP trial (Late-breaking clinical trials in sepsis management) Bowen A. Adjunctive clindamycin for treatment of Staphylococcus aureus bacteraemia: a randomised controlled trial within the S. aureus Network Adaptive Platform (SNAP), abstractAdjunctive betamethasone treatment of hypoxemic adults hospitalised with Mycoplasma pneumoniae community-acquired pneumonia: an open-label, multicentre, randomised, controlled trial (Late-breaking research from The Lancet)Hagman K, et al. Adjunctive betamethasone treatment of hypoxaemic adults hospitalised with Mycoplasma pneumoniae community-acquired pneumonia: an open-label, multicentre, randomised, controlled trial. Lancet 2026, doi: 10.1016/j.lanepe.2026.101610E.mbrace trial (Vaccines: landmark trials and preventive immunisation)Cohen CA, et al. Randomised phase III trial of a 9-valent vaccine (ExPEC9V) for prevention of invasive Escherichia coli disease (IED) in older adults (E.mbrace), abstractThe Swiss multicentre phase 1, first-in-human trial testing the conjugate E. coli vaccine:Huttner A et al. Safety, immunogenicity, and preliminary clinical efficacy of a vaccine against extraintestinal pathogenic Escherichia coli in women with a history of recurrent urinary tract infection: a randomised, single-blind, placebo-controlled phase 1b trial. Lancet Infect Dis 2017: May;17(5):528-537

Jamie Prowse, Senior Editor at The Lancet Oncology, is joined by Dr Hedvig Hricak (Memorial Sloan Kettering Cancer Center, New York, NY, USA) and Dr Zachary Ward (Harvard TH Chan School of Public Health, Boston, MA, USA) to discuss Cancer workforce—a global crisis: a Lancet Oncology Commission. To discover more about the commission click here: www.thelancet.com/commissions-do/cancer-workforce. To read the full commission click here: https://doi.org/10.1016/S1470-2045(26)00065-3

Klein, W., Li, S., & Wood, S. (2023). A qualitative analysis of gaslighting in romantic relationships. Personal Relationships, 30(4), 1316-1340.Specifically talk about it around 25 minutes  and 42 minutes Klein, W., Wood, S., Forget, A. A., & Bartz, J. A. (2026). A historical review of gaslighting: Tracing changing conceptualizations within psychiatry and psychology. Clinical Psychology Review, 102742.Was under review when we filmed - accepted and early access now Klein, W., Wood, S., & Bartz, J. A. (2026). A theoretical framework for studying the phenomenon of gaslighting. Personality and Social Psychology Review, 30(2), 195-215.I call it the 2025 paper, cause it was accepted and early access online in 2025, but I guess now it gets 2026 in the citation info, because the issue its technical in is the January issue. Which is annoying, because it's cited as 2025 in some places lol. Info on other stuff I brought uphttps://www.amazon.ca/This-Your-Brain-Music-Obsession/dp/0452288525Barton, R., & Whitehead, J. A. (1969). THE GAS-LIGHT PHENOMENON. The Lancet, 293(7608), 1258–1260. https://doi.org/10.1016/S0140-6736(69)92133-3First psychiatric gaslighting paper, don't think its open access thoughStark, C. A. (2019). Gaslighting, misogyny, and psychological oppression. The monist, 102(2), 221-235.11 minute mark - reasonable disagreement - I thin it's open accessClark, A. (2013). Whatever next? Predictive brains, situated agents, and the future of cognitive science. Behavioral and Brain Sciences, 36(3), 181–204. https://doi.org/10.1017/S0140525X12000477Around the 19 minute mark de Bruin, L., & Michael, J. (2021). Prediction error minimization as a framework for social cognition research. Erkenntnis, 86(1), 1-20.Also around the 19 minute mark Friston, K. (2010). The free-energy principle: a unified brain theory?. Nature reviews neuroscience, 11(2), 127-138.Around the 22 min mark Ogunfowora, B., & Bourdage, J. S. (2026). Is My Boss Gaslighting Me? Uncovering the Nomological Network of Gaslighting In Leader-Employee Relationships. Journal of Management, 01492063261426014.Workplace gaslighting 29 minute markBashford, J., & Leschziner, G. (2015). Bed partner “gas-lighting” as a cause of fictitious sleep-talking. Journal of Clinical Sleep Medicine, 11(10), 1237-1238.Contemporary case study discussed around 30 minute mark Bellomare, M., Giuseppe Genova, V., & Miano, P. (2024). Gaslighting exposure during emerging adulthood: Personality traits and vulnerability paths. International journal of psychological research, 17(1), 29-39.Miano, P., Bellomare, M., & Genova, V. G. (2021). Personality correlates of gaslighting behaviours in young adults. Journal of Sexual Aggression, 27(3), 285-298.2 papers on personality and gaslighting - 35 minute mark Graves, C. G., & Samp, J. A. (2021). The power to gaslight. Journal of Social and Personal Relationships, 38(11), 3378-3386.Gaslighting and power  35 minute mark https://www.amazon.com/Gaslighting-Interrogation-Methods-Psychotherapy-Analysis/dp/1568218281Covert control  - 37 minute mark - cults 46 minute mark Support the show

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Fontes do episódio aqui: ⁠https://portal.afya.com.br/podcasts/afya-news/26-05-2026Nesta terça-feira, o boletim destaca o Dia Nacional de Combate ao Glaucoma, novos marcos terapêuticos e os desafios éticos da tecnologia na saúde. No bloco principal, reforçamos a importância do rastreio clínico oportuno do glaucoma na atenção primária para mitigar o risco de cegueira irreversível. Detalhamos a aprovação pela Anvisa do Vyalev®, uma terapêutica inovadora de infusão subcutânea contínua para o Parkinson avançado. Por fim, abordamos no Radar o alerta emitido pela The Lancet sobre o risco de a inteligência artificial ampliar as desigualdades estruturais nos sistemas de saúde. Afya News. Informação médica confiável e atualizada no seu tempo.

What if you could detect Alzheimer's years before any symptoms appeared and stop it?Dr. Yogesh Shah is a Board-Certified Geriatrician and Mayo Clinic-trained memory specialist who has spent 25 years focused entirely on the early detection and prevention of dementia. In this episode, he makes a case that every entrepreneur in their 40s and 50s needs to hear: the window to protect your brain is now. Not at 70. Not after a diagnosis.America spends 20% of its GDP on healthcare, and nearly all of it goes to disease management. Dr. Shah explains why that approach is failing, what Mild Cognitive Impairment is and why it matters, and how a new FDA-approved blood test can identify Alzheimer's pathology years before any symptoms appear. He walks through the 14 lifestyle factors identified in the Lancet study that can reduce dementia risk by up to 45%, and explains how monoclonal antibody infusions are now removing amyloid plaque from the brains of patients caught early enough.What you will walk away with: an understanding of why 40 to 50% of dementia cases go undiagnosed and the real-world consequences, what the new p-tau blood tests are and how to ask your doctor about getting one, which lifestyle factors carry the most risk weight for entrepreneurs, and why managing your LDL, sleep, social connection, and chronic conditions in midlife is the most important thing you can do for your future brain health.Connect with Dr. Yogesh Shah on LinkedIn Hosted by John St. Pierre and Rich Hoffmann, Entrepreneurs United is built for founders and leaders who want straight talk on building businesses that actually work. New episodes every week.https://entrepreneursunited.us/links/

Send us Fan MailO que você oferece nas primeiras semanas importa — e muitoQuatro estudos. Quatro perguntas que todo neonatologista e pediatra já enfrentou na prática. Voltamos a apresentar os artigos do livro 50 Estudos que Todo Neonatologista Deve Conhecer, dessa vez com os artigos que revolucionaram a nutrição neonatal.Qual fórmula dar a um prematuro quando o leite materno não está disponível? Promover o aleitamento de forma estruturada realmente muda desfechos clínicos? Leite doado é superior à fórmula para prematuros extremos? E como manejar a hipoglicemia neonatal sem separar mãe e bebê?Neste episódio da Incubadora, discutimos os ensaios de Lucas et al. no BMJ, o PROBIT no JAMA, o DoMINO no JAMA e o Sugar Babies no Lancet — estudos que, juntos, constroem um argumento difícil de ignorar: decisões tomadas nas primeiras horas e semanas de vida deixam marcas que aparecem no pulmão, no cérebro e no desenvolvimento anos mais tarde.1.     Randomised trial of early diet in preterm babies and later intelligence quotient  - https://pubmed.ncbi.nlm.nih.gov/9831573/2.     Promotion of Breastfeeding Intervention Trial (PROBIT) A Randomized Trial in the Republic of Belarus - https://pubmed.ncbi.nlm.nih.gov/11242425/3.     Effect of Supplemental Donor Human Milk Compared With Preterm Formula on Neurodevelopment of Very Low-Birth-Weight Infants at 18 Months A Randomized Clinical Trial - https://pubmed.ncbi.nlm.nih.gov/27825008/4.     Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial - https://pubmed.ncbi.nlm.nih.gov/24075361/Evidência, cuidado e contexto brasileiro — esse é o nosso roteiro. Não esqueça: você  pode ter acesso aos artigos do nosso Journal Club no nosso site: https://www.the-incubator.org/podcast-1Lembrando que o Podcast está no Instagram, @incubadora.podcast, onde a gente posta as figuras e tabelas de alguns artigos. Se estiver gostando do nosso Podcast, por favor dedique um pouquinho do seu tempo para deixar sua avaliação no seu aplicativo favorito e compartilhe com seus colegas. Isso é importante para a gente poder continuar produzindo os episódios. O nosso objetivo é democratizar a informação.Se quiser entrar em contato, nos mandar sugestões, comentários, críticas e elogios, manda um e-mail pra gente: incubadora@the-incubator.orgEvidência, cuidado e contexto brasileiro - esse é o nosso roteiro.

It's In The News, where we bring you the top diabetes stories and headlines happening now. Top stories this week: Dexcom shares details of its next generation CGM, T1D and GLP-1 studies, weight loss management on GLP-1 medications updates, all-in-one CGM and pump, and more! Announcing Community Commericals! Learn how to get your message on the show here. Learn more about studies and research at Thrivable here Please visit our Sponsors & Partners - they help make the show possible! Omnipod - Simplify Life All about Dexcom  All about VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Episode transcript: XX Dexcom announces some features of it's next generation CGM – the G8. We've been talking about this with CEO Jake Leach for a while now – it will be a 50% smaller with what they're calling advanced sensing capabilities. According to Leach, G8 will adapt to the physiologic variability of each user. It has additional technology built in, based on a new silicon chip design and algorithm. 15 day wear is now the baseline for all Dexcom sensors moving forward. At launch the G8 will only measure glucose but the plan is for a multi-analyte version to follow. That would measure ketones and potassium. Ketones we know – but potassium is very important for people with kidney and possible for people taking some diabetes meds. It's an interesting space to watch.. btw, analyte is just a medical word for the specific thing you're measuring – the target of the test you're running. we're going to hear that word a lot I think..   Looks like an FDA submission for the G8 next year.. with an outside the US launch the following year. https://www.drugdeliverybusiness.com/dexcom-unveils-next-gen-g8-cgm/ XX Glucotrack has submitted its implantable continuous blood glucose monitor (CBGM) for FDA IDE, that's investigational device exemption and would enable the company to initiate a U.S. clinical study for the fully implantable technology. Rutherford, New Jersey-based Glucotrack's device features no on-body external component. The company aims to offer it for three years of continuous, accurate blood glucose monitoring for a more convenient, less intrusive solution. Unlike traditional CGMs that measure glucose in interstitial fluid, the CBGM measures glucose levels directly from the blood. The implant goes five centimeters within the subclavian vein. Glucotrack's active implantable device has a small battery and some electronics that go just under the skin in the pectoral region. The location of the implant is not in a major vessel, but the implant can measure real-time glucose levels as pulsatile blood flows over the tip of the sensor. https://www.drugdeliverybusiness.com/glucotrack-submits-long-term-implantable-cbgm-fda-ide/ XX PharmaSens today announced the publication of data from the first clinical study evaluating its all-in-one insulin patch pump offering. The all-in-one pump pairs the Niaa Essential insulin patch pump with the SynerG continuous glucose monitor (CGM) sensor developed by Pacific Diabetes Technologies. However, this system would be one device that features both the pump and CGM technology.   PharmaSens and SiBionics also have a collaboration aimed at developing the all-in-one solution. They are jointly developing the next-generation Niia insulin patch pump with a SiBionics CGM. PharmaSens expects a second feasibility study in the second quarter to evaluate the next-generation pump with SiBionics' CGM.   PharmaSens says the clinical feasibility study of Niia demonstrated for the first time ever that the combined offering is, in fact, feasible. It believes its device addresses the need for alternatives to multi-device diabetes management. systems.   Aggregated MARD for the investigational device came in at 11.6%. A MARD target of less than 10% is considered ideal for CGM devices, but PharmaSens said that, in the context of the early feasibility study, the results were encouraging and provide evidence supporting the development of an all-in-one system. https://www.drugdeliverybusiness.com/pharmasens-efs-insulin-patch-pump-cgm/ XX   XX ViCentra launches the newest version of the Kaleido pump system in Europe. This is that small colorful pump, with Diabeloops algorithm and the Dexcom G7. It'll be in Germany and the Netherlands later this summer. https://hellokaleido.com/vicentra-announces-commercial-launch-of-new-smartphone-controlled-kaleido-automated-insulin-delivery-patch-pump-system/--   XX Diabeloop just got CE Mark approval for DBLG2 integrations – it's latest AID platform the company has kicked off the gradual European launch of the technology. It currently offers DBLG2 as a smartphone application on Android, with iOS integration coming soon. As you just heard, it's integrated with kaleido and the company says it plans to make additional configuration for DBLG2 with alternative pumps "available soon." Running on a user's smartphone, DBLG2 works as a self-learning algorithm. It continuously analyzes glucose data, calculates insulin needs in real time and automatically adjusts delivery. https://www.drugdeliverybusiness.com/diabeloop-fda-next-gen-algorithm-g7/   XX Among adults with type 1 diabetes (T1D), the initiation of GLP-1-based therapy was associated with a lower risk for all-cause death, several cardiovascular outcomes, all-cause hospitalisations, and hypoglycaemia, without a higher risk for diabetic ketoacidosis.   METHODOLOGY: Researchers in Greece conducted a retrospective cohort study utilising real-world data from a global health research network to evaluate the association between GLP-1-based therapy and cardiovascular and renal outcomes in adults with T1D. A total of 4088 patients receiving GLP-1-based therapies (median age, 43 years; 34.3% men) were propensity score matched with an equal number of patients not receiving the treatment. The risk for hypoglycaemia was lower with GLP-1-based therapy (hazard ratio, 0.72; P = .021); however, the risk for diabetic ketoacidosis did not differ significantly between the two groups. https://www.medscape.com/viewarticle/glp-1-drugs-tied-cardiovascular-benefits-t1d-2026a1000fbx   XX Eli Lilly and Company (NYSE: LLY) today announced detailed results from two late-phase trials showing that people with obesity maintained their weight loss long term with either Foundayo or lower-dose Zepbound after switching from higher doses of injectable incretin therapy. The findings from SURMOUNT-MAINTAIN and ATTAIN-MAINTAIN, were presented at the 33rd European Congress on Obesity (ECO) and published in The Lancet and Nature Medicine, respectively.   "Weight regain remains one of the biggest challenges in obesity care, and is often the result of treatment interruptions that cause biology to work against patients, undoing the progress they've made," said Louis J. Aronne, M.D., FACP, DABOM, founder and Chair Emeritus of the American Board of Obesity Medicine, former president of The Obesity Society, Fellow of the American College of Physicians, world-renowned obesity specialist and Lilly consultant. "These medicines can be used for long-term maintenance today, and results from SURMOUNT-MAINTAIN and ATTAIN-MAINTAIN provide additional evidence of their potential when switching from higher doses of injectable incretin therapy." https://investor.lilly.com/news-releases/news-release-details/lillys-foundayo-and-lower-dose-zepbound-helped-people-maintain XX Scientists in Sweden have developed a more reliable way to create insulin-producing cells from human stem cells. These lab-grown cells not only respond strongly to glucose but were also able to restore blood sugar control when transplanted into diabetic mice. When transplanted into diabetic mice, the cells gradually restored the animals' ability to regulate blood sugar. Long way to go, as we say with most of these mice studies. https://www.sciencedaily.com/releases/2026/05/260505234620.htm XX Interesting look at how the body controls sugar storage – apparently this finding challenges long-standing biology concepts and could open new directions for disease treatment. Published in Nature, the study describes a potential method for directly reducing glycogen, the stored form of sugar in the body. These scientists discovered that glycogen can be directly regulated by ubiquitin, a protein best known for marking damaged proteins for recycling or removal. The study is the first to show that ubiquitin can regulate glycogen in humans, overturning more than 50 years of scientific understanding. Excess glycogen is also associated with more common health problems, including diabetes, obesity, liver disease, and heart disease.       https://scitechdaily.com/scientists-just-rewrote-biology-hidden-mechanism-could-transform-diabetes-treatment/ XX A new Oklahoma law will give parents the option to have their children screened for Type 1 Diabetes.   The measure passed with overwhelming bipartisan support in the Legislature and takes effect Nov 1. Oklahoma consistently ranks among the states with the highest rates of diabetes and diabetes-related deaths. The law gives parents access to antibody testing that can detect risk years before symptoms develop, helping families take preventive action and avoid emergency room visits. https://journalrecord.com/2026/05/11/oklahoma-law-expands-access-type-1-diabetes-screening/ XX More to come including a new study trying to figure out why some people are more likely to develop diabetes, a look at cannabis and preventing metabolic disorders, and XX   A National Institutes of Health (NIH)-funded study has identified key differences in human pancreatic islet cells that may help explain why some people are more likely to develop diabetes. Researchers found that the mix of hormone-producing cells in the pancreas varies widely from person to person, and that variation plays a central role in how the body regulates blood sugar. The study involved a deep dive into islet cell function that is linked to donor traits associated with observable characteristics, or phenotype, such as sex, race and ethnicity, as well as genetic information, or genotype, including predicted ancestry and genetic risk for both type 1 and type 2 diabetes. The findings highlight that islet cell composition, rather than the physical size and shape of islets, is a key factor in regulating hormone release. The team found that the makeup of pancreatic islets plays a major role in how effectively they release insulin and glucagon — key hormones that regulate blood glucose. Islets with a higher proportion of insulin-producing beta cells showed stronger insulin secretion in response to various stimuli, while higher levels of alpha and delta cells were generally linked to reduced insulin output. In addition, the researchers found that islet hormone secretion is affected by donor traits, such as sex, race and ethnicity and their genetic makeup, including ancestry predicted from genetic testing and genetic risk for type 2 diabetes. Combined, the findings of the study have significant implications for understanding the factors that may predispose people to diabetes. "This study is the tip of the iceberg," said Dr. Evans-Molina. "We hope this dataset becomes useful to the entire diabetes research community and that researchers use it to answer questions about the genotype-phenotype correlation within these data."   https://www.nih.gov/news-events/news-releases/nih-funded-study-maps-human-pancreatic-islet-cells-offering-new-clues-diabetes-risk XX XX XX Research published recently in JAMA Network Open offers illuminating evidence suggesting there is a positive association between GLP-1 agonists—drugs commonly used to treat obesity and diabetes—and better outcomes among breast cancer patients.   "This study suggests that GLP-1 drugs may offer protective benefits potentially improving survival and recurrence risk in some female patients with breast cancer – whether this is related to weight control, improve cardiovascular health or other mechanisms remains to be studied," said study senior author Bernard F. Fuemmeler, Ph.D., MPH, associate director for population sciences and the Gordon D. Ginder, M.D., Chair in Cancer Research at VCU Massey Comprehensive Cancer Center.   Breast cancer patients who are also obese or have type 2 diabetes experience more aggressive cancer growth and worse outcomes. Prior studies have shown that weight loss treatment and surgery following a breast cancer diagnosis are associated with improved heart health and increased survival.   What are GLP-1 drugs? Glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Approved to treat type 2 diabetes in 2005 and weight management in 2021. Impacts on breast cancer survival and recurrence are still unclear. Since 2020, the use of these drugs has increased dramatically, where approximately 12% of Americans have used GLP-1s for weight loss, according to a RAND report.   The research findings Through a retrospective cohort study examining the electronic health records of more than 840,000 breast cancer patients who were diagnosed between 2006 and 2023, the results suggest there is a potential link between GLP-1 RAs and improved outcomes among breast cancer patients who are also obese or have type 2 diabetes.   GLP-1 RA use was associated with an overall lower risk of death from any cause over a 10-year follow-up period among breast cancer patients. Additionally, breast cancer survivors who used GLP1-RAs for diabetes or obesity had a significantly lower risk of their cancer returning over 10 years following their initial treatment.   "Our findings align with emerging preclinical research and contribute to a growing body of literature related to GLP-1 RA use in oncology settings," said study lead author Kristina L. Tatum, PsyD, MS, of the VCU School of Public Health.   What's next? Further studies are needed to understand the biological mechanisms, if any, between GLP-1 RAs and breast cancer outcomes. The research team intends to further evaluate these correlations through randomized clinical trials.   "Our study underscores the potential of GLP-1 RAs as an adjunct strategy for improving cancer-related outcomes among patients with breast cancer, although clinical trials are needed to inform effective therapeutic approaches and clinical decision making," Fuemmeler said. https://www.oncology-central.com/could-glp-1-receptor-agonists-improve-outcomes-for-breast-cancer-patients-with-obesity-or-with-type-2-diabetes/ XX Researchers at UC Riverside gave cannabis to obese mice and found that not only did the rodents lose weight, but when given a concentrated cannabis oil, the mice also saw striking benefits in their metabolic function. DiPatrizio said his team studied the issue to better understand why cannabis users show significant reductions in weight and risk for diabetes compared with nonusers. "We would think that chronic cannabis users would be eating more and weigh more, but it's just the opposite," DiPatrizio said. Scientists are increasingly examining the possibility that cannabis compounds could fight obesity or metabolic disorders like diabetes. Cannabinoids interact with the body's endocannabinoid system, which partially controls nearly every aspect of our physiology, including metabolism and appetite. That creates the possibility that targeting this widespread system could unlock new therapies for these conditions. https://www.sfgate.com/cannabis/article/cannabis-weight-loss-california-study-22255328.php XX A new campaign launched by diaTribe and Genentech aims to empower and educate people about diabetes-related eye disease. Here's what you can do today to protect your eye health. To help address these barriers, diaTribe and Genentech partnered to launch All Eyes on DME, a new campaign that aims to spread awareness and educate people at-risk for or living with diabetes-related eye conditions like DME. Also partnering in the campaign is actor and comedian Damon Wayans, who wanted to share his journey (and, of course, a joke or two) with type 2 diabetes to open up the conversation about what is often a stigmatized or less talked about topic: eye health and diabetes.   One of these important conversations happened recently at the All Eyes on DME launch in New York City, where Wayans joined a panel of experts, advocates, and people living with DME to talk about diabetes-related eye disease and how to help prevent it. https://www.alleyesondme.com/dme-in-the-spotlight.html https://diatribe.org/diabetes-complications/all-eyes-dme-new-campaign-spotlights-eye-health-and-diabetes

Today's episode is a little different because there is breaking news in the women's health world, and I think this is one of the more important shifts we've seen in a long time when it comes to how we understand female physiology. As of May 12th 2026, PCOS, which stands for Polycystic Ovarian Syndrome, has officially been renamed PMOS or Polyendocrine Metabolic Ovarian Syndrome. And before anybody rolls their eyes and thinks, okay, okay, so they changed the name. I want you to stay with me for a minute here, because this matters then what most people realize.  This came from a massive international consensus published in The Lancet involving researchers, clinicians, advocacy groups, and over twenty two thousand voices globally over the course of about fourteen years. And the reason this matters is because the old name PCOS centered the conversation almost entirely around the ovaries, when clinically, the condition has always been much bigger than that. For years, women have been told you don't have cysts, your ultrasound looks normal, your labs are fine, and meanwhile they are struggling with a plethora of symptoms like fat loss, resistance, irregular cycles, acne, hair thinning, blood sugar dysregulation, fatigue, fertility issues, mood shifts, sleep disruption inflammations, and symptoms that clearly extended far beyond reproductive health alone. And what I appreciate about this shift is that the biology did not suddenly change overnight. The language finally caught up with the physiology because many women diagnosed with PCOS never had visible ovarian cysts in the first place, and many women with ovarian cysts never had PCOS. Which tells us something very important. The ovaries were never the entire story, and I've spoken of this on previous podcasts. This new terminology, polyendocrine, metabolic ovarian syndrome, reflects something we've been discussing for years inside the SF coaching method, which is that women's health is deeply interconnected. Think hormones, metabolism, stress, physiology, sleep. These do not function in isolation. Everything speaks to everything. These systems work together and this shift toward PMOS finally acknowledges the crosstalk between the endocrine system, metabolism, reproductive function, inflammation, nervous system regulation, and overall physiological health. So today I want to break down what changed and why it matters.   Time Stamps:   (0:40) Breaking News In Women's Health (3:45) Why PCOS Was Confusing (6:45) The Shift To PMOS (12:25) Names Influence Clinical Focus (20:10) Previous Women's Health Shift I Previously Covered (24:10) The Systems Lens ----------  Apply for SF Coaching Method  https://sarahfechter.ac-page.com/sfhq-cc Complimentary Health Content  https://sarahfechter.ac-page.com/Health_Wellness_Community ----------  Follow Me On Instagram - https://www.instagram.com/sarahfechter.ifbbpro/   Check Out My Website - https://www.sarahfechter.com ----------  This Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, other professional health care services, or any professional practice of any kind. Any reliance on the information provided in this Podcast is done at your own risk and Sarah Fechter Fitness LLC expressly disclaims any and all liability or responsibility for any direct, indirect, incidental, special, consequential or other damages arising out of any individual use of, reference to, reliance on, or inability to use, this Podcast or the information presented in this Podcast. All contents and design for this Podcast are owned by Sarah Fechter Fitness LLC. Always consult your professional team before beginning any exercise or nutrition program.

Allergies have tripled - with hay fever, seasonal allergies, eczema and food intolerances now affecting millions of people. But why are allergy symptoms getting worse, and what does gut health have to do with it? In this episode, Adam Fox, a world-leading allergy Professor at King's College London, explains why allergies may be rising so fast, why many beliefs about allergies are wrong, and what new science reveals about your immune system, skin and gut. Professor Fox explores why some foods are more likely to trigger reactions, and why modern allergy science is increasingly focused on gut health. Adam also discusses why 90% of people told they are allergic to certain things may not actually be allergic, the difference between allergies and intolerances, and why some antihistamines may be doing you more harm than you realise. By the end of this episode, you will have some practical ways to manage hay fever and seasonal allergies, including which antihistamines experts now recommend avoiding, simple ways to reduce pollen exposure at home, and when allergy testing or desensitisation treatment may help. Adam explains how newer treatments are starting to retrain the immune system rather than simply suppress symptoms. If allergies barely existed a few hundred years ago, what changed? And could your gut now be shaping the way your immune system reacts to the world around you?

View This Week's Show NotesStart Your 7-Day Trial to Mobility CoachJoin Our Free Weekly Newsletter: The AmbushWhat if the biggest thing holding your health back isn't what you're doing, but how you're thinking about it? Most of us have been trained to see the body in silos: diagnose the problem, treat the symptom, move on. But what if that model is missing the bigger picture?In this episode of The Ready State Podcast, Dr. Jeffrey Bland – widely recognized as the father of functional medicine – joins Juliet and Kelly Starrett to unpack a more complete, systems-based approach to health. From a simple (and surprisingly accessible) blood test that can reveal your inflammatory status, to the real role of inflammation as both a healing response and a hidden driver of chronic disease, this conversation challenges everything you thought you knew about “being healthy.”Dr. Bland also shares the deeply personal story that reshaped his entire career and led him to question conventional medicine's focus on downstream symptoms instead of root causes.You'll walk away understanding why everyday choices – like sugar intake, sleep, stress, and even your sense of self-agency – play a far bigger role in longevity than most people realize. Because at the end of the day, health is something you actively create.What You'll Learn in This EpisodeWhy chronic inflammation is both a healing response and a hidden driver of diseaseHow a standard blood test (CBC) can reveal your body's inflammatory stateThe difference between treating symptoms vs. addressing root causes (upstream vs. downstream health)Why your body is a system – and not a set of isolated problems to fixHow everyday habits like sugar intake, stress, and sleep quietly accelerate agingKey Highlights: (0:00) Intro & Teaser Clips(0:35) Introducing Dr. Jeffrey Bland, Father of Functional Medicine(3:11) Dr. Bland Joins the Show / Earth Day Connection(3:50) How Dr. Bland's Career Began in 1970(7:33) What's Most Urgent for People to Understand About Health Today(9:13) Systems Thinking vs. Siloed Medicine(12:43) A Seismic Life Event That Changed Everything(15:19) Finding Purpose After Tragedy — The Birth of a Mission(17:35) Origins of the Term "Functional Medicine"(19:03) Functional Medicine in The Lancet — 1874(31:15) Understanding Good vs. Chronic Inflammation(38:30) The Ibuprofen Epidemic in Youth Athletes(39:59) The Functional Medicine Model: Antecedents, Triggers & Mediators(42:47) Big Bold Health & Testing for Inflammaging(43:33) The CBC with Differential — A $6 Test Everyone Already Has(45:08) The SIRI Index — Calculating Your Inflammatory Status(46:25) Immune Cells Renew Every 90–120 Days(56:03) The 850-Person Clinical Trial on Food & Immune Health(56:56) Tartary Buckwheat — A 3,500-Year-Old Immune Superfood(1:02:57) The Healthcare System Isn't Working — A Seismic Change Is Coming(1:08:13) Rapid Fire: Blue Zones & Eating a Rainbow of Polyphenols(1:09:47) The #1 Lever for Aging Well — Starting With How You See Yourself(1:10:56) Where to Find Dr. Jeff Bland & Closing ThoughtsHuge thanks to our sponsors, Kreatures of Habit, LMNT, and Momentous.

As I have said many times before, some podcast ideas come from REAL clinic encounters. In this episode, Dr Hanna V, our dedicated PGY1 on our call team, and I will answer TWO real questions which arose just today on morning rounds, on our service: 1. Does NORMOTENSIVE HELLP still need Mag Sulfate? And 2. Does an indwelling foley s/p iatrogenic bladder injury at CS require prophylactic antibiotic coverage for urinary infection? Yep: It's a BOGO sale on today's podcast- Buy ONE GET ONE! Listen in for details.1. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222.Obstetrics and Gynecology. 2020. Committee on Practice Bulletins—ObstetricsGuideline2. Woudstra DM, Chandra S, Hofmeyr GJ, Dowswell T.SR. Corticosteroids for HELLP (Hemolysis, Elevated Liver Enzymes, Low Platelets) Syndrome in Pregnancy.The Cochrane Database of Systematic Reviews. 2010. 3. Joshi D, James A, Quaglia A, Westbrook RH, Heneghan MA.Liver Disease in Pregnancy. Lancet. 2010. Review4. Rimaitis K, Grauslyte L, Zavackiene A, et al.Observational. Diagnosis of HELLP Syndrome: A 10-Year Survey in a Perinatology Centre. International Journal of Environmental Research and Public Health. 20195. Reau N, Munoz SJ, Schiano T.Guideline Liver Disease During Pregnancy.The American Journal of Gastroenterology. 2022. 6. ACG Clinical Guideline: Liver Disease and Pregnancy.The American Journal of Gastroenterology. 2016. Tran TT, Ahn J, Reau NS.7. ACOG Practice Bulletin No. 195: Prevention of Infection After Gynecologic Procedures. Obstetrics and Gynecology. 2018. Committee on Practice Bulletins—Gynecology Guideline8. Niels Johnsen, Hunter Wessells, Krystal Archer-Arroyo, et al. Best Practices Guidelines Management of Gentiunrinary Injuries.American College of Surgeons (2025). 20259. Fletke KJ, Jeong DH, Herrera AV . Urinary Catheter Management. American Family Physician. 2024..

Oh, What's in a Name? Irving F. Stein and Michael L. Leventhal first described the syndrome, originally known as Stein-Leventhal syndrome, in 1935, in the AJOG. They published a case series of seven women displaying a triad of symptoms, including hirsutism, amenorrhea (absent menstruation), and bilaterally enlarged polycystic ovaries. We now know that PCOS affects 1 in 8 women globally (170 million women of reproductive age worldwide), and that there are 4 main manifestations of the condition- reflecting its diverse phenotype. Now, as of 05/12/25, a collaboration across 56 leading academic, clinical, and patient organizations, as well as iterative global surveys that garnered responses from over 14,300 people with PCOS and multidisciplinary health professionals have endorsed a NEW term (Lancet) for this: polyendocrine metabolic ovarian syndrome. This is actually STAGE 7 of an 8 stage process Yep, 1-6 are already done). But hold on…this is not taking over tomorrow! There is a THREE-YEAR implementation strategy that has already gotten started and culminating in 2028. Listen in for details.1. Teede HJ, Khomami MB, Morman R, et al. Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process. The Lancet. Published online May 12, 2026. Accessed May 12, 2026. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00717-8/fulltext2. International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome; 20233. https://www.contemporaryobgyn.net/view/global-consensus-renames-pcos-to-polyendocrine-metabolic-ovarian-syndrome-pmos-?utm_campaign=42986360-COG%20-%20Breaking%20News&utm_medium=email&_hsenc=p2ANqtz--5Of8-OwjOeKLtknr8YdFbh9G8_c7iQqliHnMz2pYOpi2x4Pp8dRH6bSHjrQIqnth_fLPywQM2ByNp7via22VJ8yyLbg&_hsmi=418414457&utm_content=418414457&utm_source=hs_email4. Polyendocrine Metabolic Ovarian Syndrome: New name to improve diagnosis and care of condition affecting 170 million women worldwide. Monash University. News release. May 12, 2026. Accessed May 12, 2026. https://www.eurekalert.org/news-releases/1127647

For decades, a tight carotid stenosis felt like a ticking time bomb — a plaque waiting to throw an embolus and cause the next stroke. We were taught that severe narrowing meant surgery, and trials like ACAS and ACST-1 seemed to prove it. But medicine has changed. Statins, antiplatelets, tighter blood pressure control, even PCSK9 and GLP-1 therapies have quietly slashed stroke risk, and now newer data from CREST-2 suggest that for many asymptomatic patients, the knife — or the stent — may not add much at all. So if modern medical therapy works better than ever… who actually benefits from intervention anymore? Today, we unpack the evidence, the controversies, and how to counsel the patient who feels perfectly fine but has high-grade stenosis.Hosts: Carolyn Judge, Andrew Huang, Luciano Delbono, Frank Davis, Robert BeaulieuInstitution: University of Michigan, Department of Surgery, Section of Vascular SurgeryLearning objectives: Describe how modern intensive medical therapy has transformed the natural history of asymptomatic carotid stenosis and explain why contemporary patients experience substantially lower annual stroke risk than those in earlier eras. Interpret and compare the results of landmark trials—including ACAS, ACST-1, and CREST-2—to assess the relative benefits of medical therapy, endarterectomy, and stenting. Apply current evidence and guideline recommendations to patient care by selecting which asymptomatic patients are most likely to benefit from carotid revascularization versus optimized medical therapy alone. References:SVS Guidelines:Brook, R. D., et al. (2022). Society for Vascular Surgery clinical practice guidelines for management of extracranial carotid artery disease. Journal of Vascular Surgery, 75(1), e1–e67. https://doi.org/10.1016/j.jvs.2021.09.031CREST (1)Brott, T. G., Hobson, R. W., Howard, G., et al. (2010). Stenting versus endarterectomy for treatment of carotid-artery stenosis. New England Journal of Medicine, 363(1), 11–23. https://doi.org/10.1056/NEJMoa0912321CREST-2Brott, T. G., Howard, G., Fong, P., et al. (2024). Randomized trial of carotid artery stenting or carotid endarterectomy vs best medical therapy for asymptomatic carotid stenosis: CREST-2 results. [Manuscript in preparation]. ClinicalTrials.gov Identifier: NCT02089217. Retrieved from https://clinicaltrials.gov/ct2/show/NCT02089217ACST-1Halliday, A., Mansfield, A., Marro, J., et al. (2004). Randomised trial of carotid artery surgery for asymptomatic stenosis. Lancet, 363(9420), 1491–1502. https://doi.org/10.1016/S0140-6736(04)16153-1ACST-2Halliday, A., Bulbulia, R., Bonati, L. H., et al. (2021). Carotid artery stenting versus carotid endarterectomy in patients with asymptomatic carotid stenosis (ACST-2): A randomised trial. Lancet, 398(10291), 1065–1073. https://doi.org/10.1016/S0140-6736(21)01980-1ACASExecutive Committee for the Asymptomatic Carotid Atherosclerosis Study. (1995). Endarterectomy for asymptomatic carotid stenosis. JAMA, 273(18), 1421–1428. https://doi.org/10.1001/jama.1995.03520420033036Sponsor URL: https://www.goremedical.com/Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US