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Description:  Hosts Roz and Dr. Sanchez-Fueyo are joined by Alessia Giarraputo to discuss the key articles of the August issue of the American Journal of Transplantation. Alessia Giarraputo is a postdoc research fellow at Mass General Hospital and Harvard Medical School [3:38] Donor-reactive clonotypes are overrepresented in the urinary T cell repertoire during kidney transplant rejection and show distinct dynamics in the circulation [13:57] Organ-specific differences in the epidemiology of cytomegalovirus infections in high-risk (cytomegalovirus donor seropositive, recipient seronegative) solid organ transplant recipients with prolonged follow-up: A 10-year experience [22:17] Immune checkpoint inhibitors after liver transplantation: The role of immunosuppressive management [28:34] Expert consensus on the use of immune checkpoint inhibitors in the liver transplant setting: Guidance from the Liver Transplant Committee of the Italian Association for the Study of the Liver (AISF) [33:50] Outcomes of kidney transplants from pediatric donors with acute kidney injury

  Episode: 140 RAISING PPA assessment and treatment from the Ground Up: In Conversation with Jeanne Gallée     In this episode you will discover: · Assessment and Intervention Aren't Separate — Conversation itself can double as both. By listening closely and responding to what a client offers, in a "more art than science" way, clinicians gather meaningful data and provide support at the same time, rather than treating these as two distinct phases of care. · Rigid Testing Can Erase the Person Behind the Diagnosis — Traditional standardized assessments often serve the goals of an institution or research protocol more than the person being assessed. Frameworks like RAISE and the PACT scale shift the focus toward strengths, natural conversation, and what someone can still do, rather than repeatedly measuring decline. · PPA Needs Its Own Identity and Training Path — Because primary progressive aphasia sits uneasily between post-stroke aphasia care and traditional dementia care, clinicians often receive little formal training in it. A global survey found major gaps in education and confidence, underscoring the need for dedicated resources, like Dr. Gallée's PPA roadmap, built specifically for this population. Do you ever wish you could step back in time and undo the missteps and errors of the past? What if you had the opportunity to build something from the ground up? Certainly, knowing what you know now, you could begin in a better place. But of course, there's always pitfalls with new beginnings, even with the knowledge of lessons from the past. You could, however, make a positive impact on that new beginning. Welcome to the Aphasia Access Conversations podcast. I'm Jerry Hoepner, a professor from the University of Wisconsin Eau Claire, and co-facilitator of the Chippewa Valley Aphasia Camp, Blue Gold Brain Injury Group, Mayo Brain Injury Group, Young Persons Brain Injury Group, Brain In-Cog, and Thursday Night Poets. I'm also a member of the Aphasia Access Podcast Working Group. Aphasia Access strives to provide members with information, inspiration, and ideas about their aphasia care through a variety of educational resources. I'm privileged to introduce today's guest, Dr. Jeanne Gallée, who is a clinical scientist in the Department of Medicine at the University of Washington. Dr. Gallée is a licensed speech language pathologist practicing in the greater Washington state area. She completed her Bachelor of Arts in Cognitive and Linguistic Sciences at Wellesley College in 2016 and Doctor of Philosophy at Harvard University in Speech and Hearing Bioscience and Technology in 2021. She has been recognized as a Distinguished Early Career Professional by ASHA and a Distinguished Scholar by the Tavistock Trust for Aphasia. Her work is dedicated to improving assessment practices and functional outcomes for individuals living with aphasia and neurodegenerative conditions. Jerry Hoepner: Jeanne, it's really nice to see you again today, and to have this opportunity to have a conversation with you as a recent recipient of the Tavistock Scholar Program, and to talk about your work with individuals with primary progressive aphasia. So, thanks for being "on" today for the conversation. Jeanne Gallée: Thank you so much for having me, Jerry. I'm really honored to be here. Jerry Hoepner: Likewise, I'm really excited for this conversation, and as I just alluded to, I wanted to congratulate you on being awarded the first Tavistock Scholar with an emphasis doing work in primary progressive aphasia, and I thought maybe I could get your thoughts on being selected as a Tavistock Scholar. Jeanne Gallée: Thank you. It feels honestly incredibly remarkable in the sense that I think it represents a shift in how we're thinking about the separate diagnoses of progressive aphasia versus an aphasia that's due to an acute injury. And I'm really honored to be a part of that. I think there have been many discussions growing over the years, and I think we're seeing that shift in how we do think about addressing assessment and intervention and general care for people across the aphasia continuum. Jerry Hoepner: Agreed, I think there's been so much growth in the last five years in that area. I can remember at the outset of the pandemic, having discussions about "What do we do with people with primary progressive aphasia who were a part of our aphasia group? Should they be a part of our aphasia group? How do we pivot to that in an online context?" and it feels like we've come so far in our conversation about where primary progressive aphasia fits in in all of those different contexts. Jeanne Gallée: Right, I entirely agree, and I think the journey of my own work has already evolved in so many ways that I couldn't have imagined, like you say, five years ago I completed my doctoral work March 2021 and just seeing the phenomenal amounts of change that have really taken place since then has been incredible, and I feel very lucky to be part of that momentum right now. Jerry Hoepner: Absolutely, it's exciting to see these things move forward. And one of the differences that I see is primary progressive aphasia started out within the Life Participation Approach, just soundly from day one, as opposed to a lot of aphasia care, which has kind of evolved from this medical model, and how refreshing it is to see something built from the ground up. Done right, so to speak. I don't know if you have thoughts on that piece… Jeanne Gallée: No, I do. I think that's a really interesting point. I think I might be part of the camp that at times feels like progressive conditions get a little bit lost in the rehabilitation space, but I think you're absolutely right. I think the absence of pharmacological treatment, or a cure that has long standing effects for these progressive conditions has made rehabilitation specialists much more attuned to focusing on quality of life, life participation, maintaining autonomy, and so forth. So, I think I forget that perspective sometimes. Perhaps from the space that I work in, I tend to be in a more interdisciplinary environment where I feel on the opposite end. I'm often asked for justification for providing these types of services, and that fits in nicely with our previous discussion on how we do see that differentiation and how people with aphasia due to a progressive condition may be siloed from people who have the more quote unquote traditional aphasia symptoms. Jerry Hoepner: Yeah, that's a really good point. And you know, referring to those previous conversations we discussed that need for primary progressive aphasia to have a space of its own. It's tricky because it doesn't fit into post-stroke aphasia quite right, and it doesn't fit into the Alzheimer's and dementia world quite right. So, yeah, it's nice to see this developing in the Life Participation kind of context, really excited about Anna Volkmer's conference dedicated to primary progressive aphasia. Yeah, what an excellent point, that even though we feel like it's great to build it from the ground up, there's still people in that interdisciplinary context, who are very much looking at this, like,"Justify this. How is having conversations and doing activities with someone justifiable, as a, you know, as a skilled intervention?" Jeanne Gallée: Right. I think a lot of it comes back to misunderstandings about the scope of our profession. So, coming from the speech language pathology standpoint, we may have a perspective that other providers may not. And it's interesting, particularly when that confusion or disconnect happens in conditions that are communication led, where we see the symptoms primarily touching upon our ability to interact verbally or non-verbally to communicate. And it's fascinating, and I think speaking to that silo, we see PPA having been a relatively new and still considered very rare condition, but there's so much overlap with other conditions, right, in the kinds of symptoms that we see and there's so much where, as any speech pathologist with experience in acquired neurogenic communication disorders, we can see that we can apply our skill set, but again, likely due to the terminal nature of the condition, we end up seeing providers taking it a different route, or saying either there's only the pharmacological route, or we just let it lie or let it be as is, which we wouldn't do with any other condition. We wouldn't say that for someone with ALS. We would want to provide them the supports, even if they're temporary, to improve quality of life. So, it is an interesting, almost cultural phenomenon as well. I think. Jerry Hoepner: Yeah, that I think it's really fascinating, and I'm so glad you brought that up. It reminds me of kind of the phrase, the company we keep, right? It's easy to be amongst, you know, people who are in the [Life Participation Approach to Aphasia] LPPA world, who think the way that we think, and who do the way that we do. And I do a lot of work in the area of cognitive communication disorders with acquired brain injuries, and so forth, and there's been a remarkable shift in the last five years there as well towards a more Life Participation bio psychosocial approach, and some of the work that I've been passionate about for years has been more and more accepted. So you feel like when you're in that company of all of your people that everything's all good, but it also reminds me of something that my friend Natalie Douglas always says, which is that "We need to be out there amongst others who need to understand the importance of this kind of a perspective, and sharing that." And when you talked about those other professionals, I really didn't think about that until you said that. Right, really important to get them on the same page, and to help them understand why this is so important. Jeanne Gallée: Right? And I think that's where the conference that you mentioned, the first PPA only conference that's taking place this summer in London, is so special because one of the reasons why we were so motivated to have this type of a conference is that there wasn't really the space at the typical aphasiology conferences, and then the larger neurology-based conferences, or more broadly dementia-based conferences, also didn't quite feel like a home. I think, especially their studies of quality of life, in particular, we're really not seen as rigorous in those contexts. So, this conference, what's nice is that we have that uniting force of everyone being focused on PPA, but it's super interdisciplinary, and that I think will really promote some fantastic conversations. Jerry Hoepner: Wow, that's really encouraging and exciting to see that move forward. I'm not in the primary progressive aphasia world, although when we're at aphasia camp and things like that, certainly that's a part of my role. But as soon as I saw the call for papers come out, I'm, you know, texting and messaging all of my PPA folks to say, "Did you see this? This is great. Are you doing something?" It's very exciting. So, I'm excited to see where that moves in the future and to hear how things go this time around. That's great. Jeanne Gallée: Likewise, I'm really excited, and I do really believe it will lead to a whole future cascade of collaboration. Jerry Hoepner: Yeah, amazing. Well, before we delve into your amazing work, I've been reading your articles, and it's been just a pleasure to read it. I'm always impressed with how certain themes of importance can come across in different areas of our field, and it's been fun to see that. I wonder, because I'm looking at the list of collaborators, just some incredible collaborators on that list, in those papers, I'd love to hear a little bit about your mentorship, both in primary progressive aphasia and kind of thinking about the Life Participation quality of life kind of context as well. Jeanne Gallée: Yeah, I think in hindsight my mentorship experience seems more linear than it did in the moment. And I think it goes back to my original journey in my doctoral program. The program I was in, the Speech and Hearing Bioscience and Technology program at Harvard was a little bit different from others, where we didn't apply to work with a specific mentor, but truly just to get into the program. And they encouraged a pretty extensive shopping period to work with a variety of mentors to get a feel for topic area, mentorship style, and so traditionally first year students didn't even have any experiences, they just focused on the very time-intensive and rigorous coursework. I came in and started my first experience with Evelina Fedorenko at Massachusetts Institute of Technology, who had worked with an undergrad. And that I think from the get-go gave me a very holistic view. I think, of the ways in which we could think about language, and in particular, the language network. So, there I was working on MRI studies of what activations do we see in the language network. In response to linguistic stimuli. And we were working with undergrads at MIT who were all healthy between the ages of 18 through 30, and I just felt at a certain point that I had this growing interest towards thinking about what happens when something goes wrong. So when it's atypical processing of language. I first thought I might be interested in pediatric population, so I was all over the place, but through the partnership that my program had with the MGH Institute of Health Professionals, I ended up having this amazing opportunity to be mentored by Evelina Federenko, as well as Sophia Vallila Rohter at the Institute of Health Professions, as well as the Frontotemporal Disorders Unit at Mass General Hospital, through my actual clinical training. So I had this quite hefty consortium of mentors, and I think that has its own set of challenges, right? It's a little bit less mentor-directed and more on the student to say, "This is exactly what I want to work on." But I think that allowed me to build a network of experiences and mentors, and that just has bled into every experience I've had since then. I also think the pandemic, you brought that up before, had a huge role in this, and all of a sudden people were very, very open to virtual meetings and connections and wanted connection. I think everyone felt very stuck at home and wanted to find more people and to find meaning and Anna Volkmer and I had the opportunity to meet at the Academy of Aphasia in Macau in 2019. And honestly meeting her in our connection has been also one of those launching pads for me to really jump out into the world of international collaboration. So all that to say, I think a lot of chance encounters and just a lot of plunging into possible conversations head first has led to this phenomenal mentorship team. And a lot of people who I collaborate with now I see as my inadvertent mentors, and that includes Anna, that includes Maya Henry at UT Austin, Amy Mooney in Oregon, just people who have consistently volunteered their time to mentor me in ways in which I can only say I would have never expected. Jade Cartwright and I have had such a phenomenal collaboration over the past few years as well, where we just had the same interests, and Zoom allowing, we were able to build on those. Jerry Hoepner: That's really an amazing answer to that question. I love the term inadvertent mentors, because I just think that those are the best mentors, where you're as much a mentor to them as they are to you. And it's just this really reciprocal relationship, but it's also built on this organic, like passion and interest for the same kinds of topics. Where it's not forced and that's a really nice kind of look back on your entire process. I was also struck by the term "mentor shopping", or "mentor shopping period", whatever. And I think that's really great that you had an opportunity for that not to be so mentor-led, and I mean it clearly shows through when you talk about your clinical experience and how that was connected to your research experience, and kind of all used to create this amalgamation of who you are. I mean, it's clear in talking with you, it's clear in reading your work that you have that strong, multi prong kind of basis. It's not just research, it's not just this specific area of research, it's really broad and the clinical connection is there, so that makes a lot of sense when I hear you talk about that, for sure. Jeanne Gallée: Oh, thank you. Yeah, I think in hindsight, again, it seems more linear, and in the moment it sometimes felt a little wild, I will say, in terms of just wrangling what do I actually want to pursue, and how. And I'm still figuring that out. But I think this community of collaborators and mentors is truly what has kept me in the field and as well. Jerry Hoepner: Yeah, I think when you can connect with other people who are passionate about the work that you're doing. I can't imagine sitting at alone in my office doing a project, and I mean it's just so much more fun when you're doing it with other people. And other people who can expand the way that you think, which I'm sure everyone that you've mentioned on that list really does, when you can say, "Well, I think we should do it this way" and someone says, "Have you thought about…" and it just completely wrecks your world in a good way, "Like, oh my gosh, I didn't think about that, that's so exciting!" and then you just get into this back and forth. Yeah, very fun to hear about that. And again, it clearly shows through in the work that you do. In our previous conversations, you also mentioned this idea, and this again built on those clinical foundations that your initial mission was really to help develop interventions for people with primary progressive aphasia, and then you kind of got not off track, but inadvertently focused on working on assessments. You mentioned that there's just such a need, and this is so common in a lot of areas, but there's a need for more person-centered, ecologically valid strength-based assessment, and that the traditional measures just don't tell us enough. So, I'm really excited to talk about the work that you're doing on assessment, and how that brings us closer to what we need from an intervention standpoint, too. Jeanne Gallée: Yeah, so that really is at the heart of what has been my experience. Also, right from the get-go, we started talking about the differences, or the possible differentiation that the field has historically taken in thinking about post-stroke aphasia versus primary progressive aphasia. One of my first real PPA projects in my doctoral work was meant to be a naming treatment study for people living with PPA, and one of the roadblocks I kept hitting was also my mentors and reviewers telling me that I was trying to add too many things. And in that process I realized I don't think just using something that exists for post-stroke aphasia is going to be the best way to address the patients I'm seeing right now. And it's not because there's something wrong with that treatment. That treatment was not designed for these individuals. And that led to many more rabbit holes, and you know me really just feeling this existential crisis of "Well, why are we working on the stimuli that we are, and why are we asking questions about these ones?" And I have so much respect for the assessments that exist, and the individuals behind them, and the time they invested in making them. I am also of the belief that we can move forward and improve our processes. There are certain assessments that may be widely used and have so much again power behind them. You know, we have best associated certain assessments with characterizing a diagnosis, but what I ended up seeing in my placements and throughout my clinical work is that many assessments serve more of a mission of an institution or a research protocol than the person being assessed. And in the face of a person with a terminal condition who is using their precious time to serve you in that space, I just think it's so much more important, or that much more important, to really consider what is most functional for them. What will serve them? And how we, how can we give back to that person? And again, part of that emotion, I think, comes from having worked in many research-centered spaces, where someone might not get intervention afterwards, or they might not understand why they are participating in up to five hours of assessment, and I think that's where that passion for focusing on reprioritizing the patient or the client really came from. Jerry Hoepner: I think that attention to "what's in it for them", is really important and clearly based in kind of where your heart is at and where your clinical mindset is at. Because it's easy to go in and say, "Well, we need this data. We need all the data that we get." but to what end, right? Like, how is it going to help? And how is that going to give us any more information about how to help this person, then what they can't do, right? So, I appreciate that mindset a lot, you know. It makes me think, and this is a little off track, and we didn't talk about this question earlier, but what a shift it will be clinicians working with people with primary progressive aphasia, and how they'll be able to shift from using kind of the existing tools that were out there for other purposes to moving towards tools that are designed specifically for people with PPA, and maybe just a snapshot of your thoughts about that piece. Jeanne Gallée: So I think it's really important to know where the field comes from, the work in which it was grounded in. So, I think it, it makes sense to talk about standardized assessment scores. It makes sense to talk about, you know, the specific assessments that can help us quickly differentiate presentations or needs, right? So, using the symptom-led approach, can we identify specific behaviors really quickly in a standardized way? I think the issue comes in when we stop being dynamic in how we use them. It's very easy to use an assessment in a way that feels rote. It feels just like a test, and it's like you said, "just collecting data for the purpose of collecting data." And lose that aspect of humanity. And maybe I'm putting words in other clinicians' mouths, but especially when a certain condition is rare, like PPA is. You may not have very much experience with seeing someone with PPA, or any type of progressive condition, and feel really stuck and needing to be in the motivation of being really professional, sticking to a certain set of tests. "This feels right." Right, this is what someone told me to do. I can fill this out, and there's something very potentially vulnerable or scary about just going with your gut in those moments. And what Anna Volkmer and I have spoken about so often is just the power of having a conversation with someone, and seeing what you can learn from that conversation, not only about the person themselves, but their communication behaviors. And how you can get so much from that conversation, including the trust and comfort of the client in front of you. Jerry Hoepner: Absolutely, yeah. One of the things that I think about when you're talking about that is, in working with people with acquired brain injuries and traumatic brain injuries one of the things I've learned is they will tell you, or they will ask, right? They'll say, "What is this? "What kind of information is this giving you?" "Why do we have to do this stupid test?" And I think that's good. I think that's a mindset that we should have when we're thinking about all of the assessments that we do. Why are we doing this? Is this really necessary? And they're very willing to say, "If it's necessary, that's fine, I'll do it, but are you getting something from this that I'm not seeing?" Right, I love that question, and I think it speaks to what you just said, right? Like, there's so much information that we can gather from conversations, from our interactions with people, we should be thinking about getting that, and if we're doing something else, we should have a why directly following, yeah. Jeanne Gallée: Yes, the why is so important, and you're right. Sometimes we do just need to get certain information. I think for me, one of the most striking moments early on in my training was having small talk. You know, just conversation with a person with semantic variant primary progressive aphasia, and thinking, "Wow, this all feels quite typical. I'm curious about why they're here? What their testing will look like…" and then moving on to the Boston Naming Test and immediately seeing the challenges that came. That dichotomy is really helpful to have in those moments, but again, there's the argument of why are we asking about the name abacus, right? Why are we using that right now, and how does that represent how someone is performing functionally in their everyday life? Jerry Hoepner: Absolutely, yeah, totally. I agree. Can you share a little bit about the RAISE framework, which I really love, because it relates to the way that I think about assessment from the standpoint of counseling, like you build on relationships and connections. William Miller is famous for saying, "The last thing you should ever do at the beginning of a session is assessment." You're beginning of a relationship with someone, don't assess first thing. So, I love that piece, and then thinking about the pact, and I'll let you kind of expand those, but I'll let you unpack them – ha ha- but how that starts to move us towards intervention. Jeanne Gallée: Right. So the RAISE assessment framework was really built out of those conversations, and I guess realizations on my own part about that discomfort with the really rigid end that assessment can…I'll restate that. The rigidity that assessment can have, so again speaking to really, really standardized sets and rigid protocols of specific measures that someone uses, and like you said, having the experience of multiple research participants, as well as patients, asking "Why are we doing this? I know I'm not good at this. Why are we doing it again and again?" And in those moments, not feeling like I had the power to really justify exactly why we were doing everything, apart from, "Oh, this is important for the research study." Which it was, but just feeling like there was that aspect of humanity that was missing, and coming up with my own toolkit in those moments to fill in those blanks. So right after the completion of my PhD, Anna Volkmar and I started speaking a lot more about the power of conversational assessment. And then that led into conversations where we worked with Anne Whitworth, Deborah Hersh, and Jade Cartwright, where again, through the power of Zoom across all times. I was pregnant with my first, and meeting everyone usually at midnight my time. I already was nocturnal at that point!  Where we would just be discussing all of these issues, and what was amazing about this is that, particularly Anne and Deb come from more of the post-stroke aphasia world, and had these amazing principles grounded in those populations where Deborah Hersh had also really come forward with the concept of therapeutic assessment. So as you had said assessment and intervention shouldn't be separate, they belong together and coexist at all times if we're smart about it. And what we ended up doing, first informally and then formally through the more official Delphi process is coming up with a set of principles as a framework for assessment. So, to take a step away from, "Oh, it's just Lucy Goosey, we're having a conversation and chit chat." What we're actually promoting is a pretty structured set of principles to guide the ways in which we can cultivate assessment for individuals with PPA and their loved ones. Jerry Hoepner: Yeah, absolutely. I was kind of scanning on my computer, I was trying to think of the name. I love this name of the article, where it says, 'Please don't assess me to death, or something like that. Jeanne Gallée: Yes, yeah. Jerry Hoepner:  Yeah, and, and thinking about that whole entire process from beginning to end as a relationship, as you know, not discreetly assessment, not discreetly intervention, I think it's just really important. Can you talk a little bit about the PACT and kind of where that has moved things in terms of the assessment piece, but also kind of set a set up for intervention and what that looks like? Jeanne Gallée: Great, so the PACT the Progressive Aphasia Communication Toolkit kit builds off of what we put forth with the RAISE assessment framework. So with RAISE we promote that the relationship might be temporary, it might be a single interaction, or it might be long term, and we cultivate that through conversation and then the PACT is a set of scales that leverages that conversation, we take that natural or as natural as can be interaction and use it to come up with a concrete framework of communication strengths. So that might all sound very esoteric. To make that more concrete, there are four scales to the PACT. They're all clinician ratings, where the clinician is asked to look at a pre-recorded conversation that would occur naturally in a clinical or research context, and then on a scale from four to zero, rate the person speaking's strengths. So within the domains of speech and voice, as well as language and social pragmatics, as well as discourse, and the point or the purpose of that was to really anchor a person's communicative ability in one of these more natural environments with a provider. We collect so much phenomenal qualitative data, but at times it can feel challenging to quantify it and the hope with the PACT is that we can quantify our very real, possibly subjective evaluation of a person's communication at a certain moment in time. Jerry Hoepner: Yeah, and what I love about that, and you might have a slightly different thought about this, because you're deeper into it, but from an assessment standpoint, you can then do that all the way through. You can say, "Here's where they are this year, here's where they are next year, here's where they are the year after that, or you know, two years ago, or whatever your lens is at that point." You can do that without kind of this constant repeating of, "Okay, let's see how bad you are today compared to a year ago, or compared to two years ago." Just a very different mindset. And I love the focus on "What can you still do? What what's working? And how can we leverage what's working to really help you to actually communicate today?" As opposed to saying, "Oh boy, the ship is sinking." which is kind of the typical approach. Jeanne Gallée: Yes, that exactly what you're saying. The tendency tends to focus on what's no longer there. And while that might be helpful in clinical trials to characterize a person's performance diagnostically and the trajectory of a diagnosis over time. It really does not serve the person who goes home after the assessment, nor their loved ones to help them maintain that autonomy and quality of life, and also caregiver burden. And that is actually one of the points I really love about the PACT, is it builds on that RAISE aspect, that final tenant of evolution or adaptation over time. There's no repeat measure conflict here, where you know something might seem familiar. One of the unique parts of the PACT is that the clinician doesn't fill out the scale while they're talking to the person, they're really just recording them talking, so it is on the clinician side where, as often as they'd like to, they could implement the structured prompts of the PACT and then fill out the scale and see how performance might vary over time. They might see effects of context of the conversation, or the environment, or maybe the time of day, you know, phase of life, but it remains a way to use that really important information you gather through these conversations without recreating a testing environment frequently. Jerry Hoepner: I really love that framework. I think there's a lot of room for that to be used in other contexts as well. I just think it's really a wise way of thinking about it. I also, you just mentioned caregivers and caregiver burden in this context, and how does that fit into this entire RAISE framework, the PACT, and so forth. Jeanne Gallée: I think for both the RAISE assessment framework as well as the PACT the carers play an essential role in the sense that if they are available and present in the patient's life, then they are involved in the process. And so within the RAISE framework, the care partner is involved to provide feedback or to be given feedback, and in the PACT the same occurs, where if they are present at the time of the conversation, they are involved in the conversation. What I tend to do in the people I have piloted the PACT, I say come in as you would naturally, but then also take a step back. Let the person that with PPA that we're talking to take the lead, but I want you to interact as you would naturally. And then they're separately also asked to comment on the strengths that the person with PPA has. Their feedback is so integral because if they are present in a person's life, they play an essential role in promoting anything that we do work on in speech therapy. Jerry Hoepner: Absolutely, yeah, really well said. And I wanted to dig in, partly because I have envy of this figure, the roadmap figure for PPA, and I think it really sets up well for as we think about professionals out there too, like what's the roadmap, not just for the person and their partner, but what's the roadmap for clinicians, future clinicians, all of that. Maybe you can talk a little bit about that figure. Jeanne Gallée: I'd be delighted to. So, this was one of those, I would say classic for me moments where I had an idea and went to PowerPoint and started playing around with a visual of what I was thinking. The roadmap paper in no way is meant to be the only guide for how we can work with a person with PPA, but was really born out of discussions with Amy Mooney, as well as Zoe Ezzes, and Kristin Schafferr Mendez through the National Aphasia Association about the possible gaps in education or preparation a person might experience when first working with people living with PPA.  There are so many ways in which we could say, "Oh, just work on this exact task. Work on these.." and that can feel so lost and unanchored, unmoored moreover. And I wanted to provide the clinical toolkit that I've been using to help me think about my broader approach. So to not get lost in the weeds, but just generally think about what's my purpose here, what's my journey, and so at the center of this road that I created is the tenant of providing that person-centered care, like we aim to with the RAISE assessment framework, so really bringing it back to establishing that honest and holistic and person-centered relationship with your client and their care partners. And focusing on creating a journey that's unique to the client that I think can feel hard when there are so many unknowns with a condition like PPA, where you're always working with an interdisciplinary team. Which you may or may not have contact with. So the first part of this roadmap is really defining your role. Who are you as a professional, and what kinds of support can you provide, and part of defining your own role includes defining your role relative to the rest of the interdisciplinary team. How can you provide a different approach from the neurologist or the neuropsychologist who play vital but very different roles in a person's care journey? Part of that definition also includes advocating across professions, so a classic conundrum that people with communication-led disorders face is that they may not have certain challenges in other domains, but their communication results in a domino effect of difficulties. And so, as the speech language pathologist, coming up with ways in which you can provide supports to other providers or your client to improve their communication can be essential for that comprehensive care. That might include coming up with a communication notebook that has a single page related to specific questions or common topics when talking to the neurologist or the physical therapist or other providers. And then part of this roadmap includes referring out. So having the humility and confidence to say I can't help with this in the ways that you may need. I will either refer you to a specialist within our field or outside of our field to help with these specific aspects, and I think that's just responsible care. Jerry Hoepner: Absolutely. Really well described, and such a perfect. A segway to my next question. I always tell my students, assessment isn't just the first and last session that you're working with someone, and the same goes for intervention, right? It's not excluded from the beginning and the end, right? Like, you can't do intervention on day one, you can't do it on the last day, right? I think we kind of silo those things as well, you know, we assess and we intervene every day side by side. Can you share a little bit of your perspectives on this? And, and how that relates to kind of what we just talked about in terms of that roadmap? Jeanne Gallée: Yeah, I think part of the challenge with some of these concepts is that it's very helpful to have experience in working with individuals, whether it is through formal speech therapy or elsewhere, to feel comfort with the unknown. Because a lot of it relies on your ability to listen and to respond to what you notice. You may inadvertently put in assessment by asking follow-up questions to a point a person made when you were talking about their commute. Ad you may offer different technological supports or just visual supports to your client in that conversation in a way to build up supports to see, "Oh, do we see a difference in how they're responding to what I'm saying? And how I provide support? Or when I dial it back, do we see a completely different direction?" So, it is this beautiful, possibly more art than science approach of responding to what a person is giving you. And there are so many individual differences in all of us.  I always joke about how when I used to collect data on the picture description using both age match controls and people with PPA, I would almost burst out laughing when some of the controls provided responses, because I would get one to two sentences sometimes because see the difference in motivation. A person who does not have a communication concern, does not see the need to show exactly what they can do. And would benefit from some encouragement to show exactly how much they can say, whereas a person with PPA, who might have an Aphasia Quotient that recognizes their aphasia, might speak for five to 10 minutes to show exactly everything that they can accomplish. And so I think having that in your back pocket is really important when it comes to thinking about coming up with your recipe of all the ingredients of your assessment and intervention approach and counseling approach. So, I think that's where most of my work comes from, is that there is no one size fits all, but there are certain ingredients or components that we need to apply, and the exact ratios depend on the person you're working with. Jerry Hoepner: That is such a good description of dynamic assessment and intervention and how that I agree, probably more art than science. And that's hard for people who want a black and white answer, like "Step one…" but it's so true, and, and being effective in working in this context, that really moves us nicely into a recent paper that you did, those global perspectives on the management of PPA, and I was struck by the numbers here. Only 40% of respondents said that they had received training in primary progressive aphasia at their university, and they identified all of these needs, right, like online instruction, sample tools, and activity dealing with end of life care and trainings for end of life care. When you mentioned counseling, that totally relates to what we're up against in terms of counseling, right? No one feels confident or has very good self efficacy. Tey don't know if what you know the lines are, what part is theirs and what part is someone else. And I think just really important to like I said, lay out a roadmap and help people to understand what we were just talking about in terms of that art and science of how do you navigate this space when it has to be individualized for every person, and that can feel uncomfortable for a lot of people. So, I'd love to hear more of your thoughts on that, and kind of what you learned from that context. Jeanne Gallée: Yeah, so this research study. Was really an amazing endeavor on part of everyone who was involved. It felt like a grassroots effort to find the speech language pathologists around the world who aren't associated with a particular institution who do work with primary progressive aphasia. So of course it will never be a fully representative sample of every clinician who does so, but I do think we worked very hard to cast a wide net. So we used a snowball method. I contacted almost 40 institutions and governing bodies to find speech language pathologists who do have experience with PPA, because while more and more non-specialist providers will be seeing this patient population, we wanted to hear from the people who currently are in the field and creating their own expertise and toolkits to work with these individuals. So, what we found is that a lot of people are out on their own creating their own wheels, so to speak. And it just really led to that beautiful conclusion of now with the power of our globalization of education and sharing of resources, we can come up with a resource that's shared worldwide. Of course, there will be adaptations to fit different contexts, cultures, languages, but one of the issues has been that the systems of care for PPA have often relied upon very specific individuals. And that's reflected in the educational level. Even I was in the master's program between 2017 and 2019, I didn't hear about PPA formally in my coursework, and if it was mentioned we did not go into any of these aspects of specialized care. Part of that might have been because I didn't take very specific courses that then you know were optional or precluded, so I might have missed it, but I really didn't receive that education in the classroom. I received it through my clinical training, which I would argue is possibly even more valuable, right? You have that experiential training. But I think for clinicians who might want to transition in their careers, or you know, inadvertently in their place of work, are transitioning based on who shows up, that is a huge disservice. Jerry Hoepner: Yeah, agreed. And it's a complex issue, right, because I can remember actually teaching about this back before Tom [Sather] was in my department. I taught the aphasia class and the acquired cog class, and I was thinking, like, where do I talk about primary progressive aphasia? Do I talk about that in acquired com? Do I talk about that in aphasia? Do I do it in both? Where do I talk about end of life care, and like, how does that fit in, because that's, you know, at that point I was teaching dysphasia, too. Believe it or not, and I'm like, it's kind of there, it's kind of here, it's kind of, it's kind of in counseling, it's all right. So that makes it tricky to have kind of a uniform message when it's all over the place. And love to just get your thoughts on that too. Like, where do you put that stuff? Like, it's it's PPA, it's end of life care, it's aphasia, it's right, it's counseling, it's so many things at once. Jeanne Gallée: It is so many things at once, and I do think that speaks to the fact that it may well need its own class as part of progressive conditions. Jerry Hoepner: Yeah. Jeanne Gallée: But I do think a large part of what we share there is that understanding of we may also need to shift the identity of who we think about when we think about life care. And when we think about a progressive condition. Since a huge flavor, so to speak, of PPA is the fact that it is early onset, and especially with our cultural shifts, and you know, people starting families later in life. The face of a person with PPA looks very different from, at least in my childhood, of what looked like typical Alzheimer's disease dementia. And it's a younger, possibly more dynamic working person, possibly with little kids at home. And I think that's where that symptom-led approach has been most beneficial for my practice. Where we think about "What are you experiencing and how is it impacting your life?", rather than saying "This is the diagnosis, let's put you over here in this box." Jerry Hoepner: Yeah, the idea of putting it in a box and siloing things really resonates in this context, and I love what you said about identity, right? The identity - what we all have in our mind's eye when we think about end of life care is not the typical person with primary progressive aphasia. Like I can remember as an elementary school student visiting the nursing homes and singing to the residents and things like that, and this was not, this was not the group of people that we were thinking about in that context. Very, very different, and I just think that's a really good mindset shift to recognize how actually broad that is. I'm sure there's people listening to this who work in, you know, end of life pediatric care who want to slap me in the face right now, but right, we have such a different mindset when we're thinking about end of life care, and that reset that you just made super important. Jeanne Gallée: Yeah, yeah, and easier said than done, I think, As well as just seeing who shows up to the University of Washington support groups, and just the own perspectives that individuals bring there. But I think we can do it. I think, as a field, that will be the way in which we can become the best generalist provider, so to speak, where we take general principles of addressing symptoms or situations, and then apply those to diagnoses across the spectrum. Jerry Hoepner: Absolutely, really well said, and a great place to kind of wrap up our questions, but I want to give you the opportunity, are there points that you want to share before we kind of close our conversation? Things that we missed. Jeanne Gallée: I think the general thread throughout our conversation has just spoken to the power we do have as providers or researchers working with patients with primary progressive aphasia or related conditions, I think when we feel that our expertise in the newest theories or approaches might be lacking, we can always rely upon our empathy and full body listening, just to bring in elements that go across the lifespan, and that in of itself can lead to so many honest and transparent choices in our clinical care that can best serve our communities. I think we are much more empowered than we think we are. Jerry Hoepner: Absolutely, that's a really important thread through many places where clinicians feel uncomfortable. They've got it there and they just have to gain that confidence, and being empowered to step into those moments. Well said. Well, Jeanne it's been just a really fun conversation. I'm sure we could talk all afternoon, but I look forward to catching up to you at future conferences and things like that. It's been my pleasure to have this conversation. So, thank you for being a part of it. Jeanne Gallée: Right back at you, Jerry. Thank you so much. This has been a really fun conversation, and like you said, I hope to meet in person in the near future. Jerry Hoepner: Agreed. On behalf of Aphasia Access, thank you for listening to this episode of the Aphasia Access Conversations Podcast. For more information on Aphasia Access, and to access our growing library of materials, please go to www.aphasiaaccess.org. If you have an idea for a future podcast series or topic, email us at info at aphasia access.org Thanks again for your ongoing support of Aphasia Access.   Resources and Readings 1) The RAISE Assessment Framework: Gallée, J., Cartwright, J., Volkmer, A., Whitworth, A., & Hersh, D. (2023). "Please Don't Assess Him to Destruction": The R.A.I.S.E. Assessment Framework for Primary Progressive Aphasia. American journal of speech-language pathology, 32(2), 391–410. https://doi.org/10.1044/2022_AJSLP-22-00122  Gallée, J., Volkmer, A., Whitworth, A., Hersh, D., & Cartwright, J. (2024). Applications of the R.A.I.S.E. Assessment Framework to Support the Process of Assessment in Primary Progressive Aphasia. American journal of speech-language pathology, 33(5), 2280–2290. https://doi.org/10.1044/2024_AJSLP-24-00085 2) A roadmap for clinicians just starting to work with PPA: Gallée, J. (2023). A Roadmap to enhance care for people living with primary progressive Aphasia: What Can Be Done Now?. Perspectives of the ASHA Special Interest Groups, 8(5), 847-862. https://doi.org/10.1044/2023_PERSP-23-0002  3) Aspects of language functioning in early and late-onset Alzheimer's disease dementia: Gallée, J., Gibbons, L. E., Choi, S. E., Lee, M., Scollard, P., Trittschuh, E. H., Mez, J., Saykin, A. J., Foldi, N. S., Mukherjee, S., & Crane, P. K. (2025). Facets of language performance in early-onset and late-onset Alzheimer's disease dementia. Alzheimer's & dementia : the journal of the Alzheimer's Association, 21(9), e70705. https://doi.org/10.1002/alz.70705 4) The Progressive Aphasia Communication Toolkit (in production at Alzheimer's & Dementia, but here is the preprint): Gallée, J., Cartwright, J., Henry, M. L., Mooney, A. R., Stark, B. C., Volkmer, A., Dietz, A., Nakano, C., Battista, P., Beales, A., Beber, B. C., Cadório, I., Caldwell, M., Davies, K., Ezzes, Z., Gauch, M., Graney, T., Grobler, S., Haley, K. L., Hausmann, A., … Crane, P. K. (2025). The Progressive Aphasia Communication Toolkit (PACT): A Strengths-Based Approach to Multidomain Evaluation for Intervention. medRxiv : the preprint server for health sciences, 2025.11.25.25340904. https://doi.org/10.64898/2025.11.25.25340904 5) A global survey on SLP perspectives on the management of PPA: Gallée, J., Cartwright, J., Grasso, S., Jokel, R., Lavoie, M., McGowan, E., Pozzebon, M., Beber, B. C., Duboisdindien, G., Montagut, N., Norvik, M., Sugimoto, T., Townsend, R., Unger, N., Winsnes, I. E., & Volkmer, A. (2024). Global perspectives on the management of primary progressive aphasia. Scientific reports, 14(1), 19712. https://doi.org/10.1038/s41598-024-70156-5 6) Aspects of language functioning in early and late-onset Alzheimer's disease dementia: Gallée, J., Gibbons, L. E., Choi, S. E., Lee, M., Scollard, P., Trittschuh, E. H., Mez, J., Saykin, A. J., Foldi, N. S., Mukherjee, S., & Crane, P. K. (2025). Facets of language performance in early-onset and late-onset Alzheimer's disease dementia. Alzheimer's & dementia : the journal of the Alzheimer's Association, 21(9), e70705. https://doi.org/10.1002/alz.70705

Recorded on site at the ASGCT 2026 Annual Meeting in Boston, this mini-series introduces listeners to ASGCT members and the work driving progress across the cell and gene therapy field. In each episode, members are invited to share their backgrounds, discuss the current state of the field, and reflect on the value of ASGCT membership. This series of brief, engaging conversations will help listeners get to know the people, perspectives, and ideas shaping the ASGCT community. In this episode, host Ben McLeod of the ASGCT Communications Committee talks with Dr. Mark Deehan of MassGeneral Hospital. Dr. Deehan discusses being a new member of ASGCT and how receiving an ASGCT Career Development Award, funded by the Foundation for Angelman Syndrome Therapeutics (FAST), has advanced his lab work. Music: 'Origami' by Scott Buckley - released under CC-BY 4.0. www.scottbuckley.com.auShow your support for ASGCT!: https://asgct.org/membership/donateSee omnystudio.com/listener for privacy information.

Whole Health Wealth: The Money Mindset Shift That Changes EverythingGuest: Matt Paradise, Author, Financial Wellness Speaker and Liver Transplant Survivor Host: Julie Riga

HOST: Hildy Grossman, CO-HOST: Jordan Rich GUESTS: Lecia Sequist, MD and Allison Chang, MD, Ph.D. We are building on our previous "All in the Family" episode, with Jaclyn Lo Piccolo, MD, Ph.D., Pasi Janne, MD, Ph.D., of the Dana Farber Cancer Institute and Jill Feldman from EGFR Resisters. To look deeper into how a family history of lung cancer might increase the risk for other members, we invited Drs. Lecia Sequist and Allison Chang from Mass General Hospital to discuss their latest research on risk factors and the role of family history in lung cancer. We examine the current array of diagnostic tools—from CT scans to germline genetic testing—and the mystery of why some family members are more vulnerable to environmental pollutants than others. Tune in to see how Drs. Sequist and Chang are using AI- driven CT analysis to identify risk in those with a family history of lung cancer and learn if you qualify to participate in their

As one researcher told us: “We've engineered a world where the most distracting device ever made is also the one we use to listen to music in the car." A new study tries to measure the cost.   SOURCES: Bapu Jena, economist, physician, and professor at Harvard Medical School. Chris Worsham, pulmonary and critical-care physician at Mass General Hospital, health-policy and public-health researcher at Harvard Medical School. Vishal Patel, surgery resident at Brigham and Women's Hospital, researcher at Harvard Medical School.   RESOURCES: "Smartphones, Online Music Streaming, and Traffic Fatalities," by Vishal Patel, Christopher Worsham, Michael Liu, and Bapu Jena (NBER, 2026). Random Acts of Medicine: The Hidden Forces That Sway Doctors, Impact Patients, and Shape Our Health, by Anupam Jena and Christopher Worsham (2023). "Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings," by Bapu Jena, Vinay Prasad, Dana Goldman, and John Romley (JAMA Internal Medicine, 2015). "Road Crash Fatalities on US Income Tax Days," by Donald Redelmeier and Christopher Yarnell (JAMA, 2012). "Memories of colonoscopy: a randomized trial," by Donald Redelmeier, Joel Katz, and Daniel Kahneman (PAIN, 2003).   EXTRAS: "Why Is There So Much Fraud in Academia?" by Freakonomics Radio (2024). "Why Is Flying Safer Than Driving?" by Freakonomics Radio (2023). "Why Is the U.S. So Good at Killing Pedestrians?" by Freakonomics Radio (2023). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Protestors demonstrating in Boston after the U.S. and Israel declared war on Iran yesterday. President Trump is standing by his administration's decision to strike Iran. A man is in stable condition at Mass General Hospital after being electrocuted while working on power lines in Revere. Stay in "The Loop" with WBZ NewsRadio. See omnystudio.com/listener for privacy information.

Dr. Robert Waldinger, director of the Harvard Study of Adult Development, shares insights from the world's longest study on happiness, tracking over 2,500 people since 1938. The core finding: A good life comes from caring for your body and relationships, as warm connections predict health and longevity better than cholesterol levels at midlife. Privilege doesn't guarantee happiness, as inner-city participants matched Harvard men in well-being.Guest Introduction:Dr. Waldinger is a Harvard Medical School professor, psychiatrist, psychoanalyst, and Zen master who directs the 85+ year Harvard Study. His TED Talk has over 50 million views, and he co-authored The Good Life with Marc Schulz, distilling study lessons on connection. He teaches meditation globally and psychotherapy at Mass General Hospital.Connect With Guest:Website: robertwaldinger.com Book: The Good Life: Lessons from the World's Longest Scientific Study of Happiness.TED Talk: "What makes a good life? Lessons from the longest study on happiness".LinkedIn: Robert WaldingerWhat to do next: Click to grab our free guide, 10 Key Issues to Consider as You Explore Your Retirement Transition Please leave a review at Apple Podcasts. Join our Revolutionize Your Retirement group on Facebook.

In a special episode of TSC Now, Dan interviews Bridgett Langstaff, mom to Jude, a 17-year-old living with tuberous sclerosis complex (TSC) and epilepsy. Bridgett shares Jude’s diagnosis story and how they ultimately made their way to Mass General Hospital and Dr. Thiele. She also talks about Jude’s ongoing struggle with seizures, from infantile spasms as a baby, to partial seizures, to tonic clonic seizures as he started going through puberty, and she details their journey to achieve seizure control through multiple medications, the ketogenic diet, and surgery. Finally, she shares what it’s like as a parent to witness a prolonged seizure (one lasting longer than 3 minutes) and how and when they decide to administer rescue medication to stop a seizure. This podcast was sponsored by UCB Biopharma, in an effort to raise awareness of prolonged seizures. UCB was not involved in the content development for this podcast. UCB is currently running the STARS study, a clinical trial researching an investigational medication for people who experience prolonged epileptic seizures (i.e. lasting more than 3 minutes) who are over the age of 12. The STARS Study is testing an inhaler containing an investigational drug that has been designed to potentially stop a prolonged seizure once it has begun. If you are interested in learning more, visit www.starsepilepsystudy.com to learn more or contact a Patient Navigator to better understand this study at 470-523-2502.

What happens when an emergency medicine physician knows that the N95 mask she's wearing every day during the COVID-19 pandemic was invented by her great-grandfather over a century ago? Dr. Shan Liu joins me for a conversation that weaves together family legacy, innovation from the margins, and the power of storytelling to fight racism. Shan is an emergency medicine physician at Mass General Hospital, an associate professor at Harvard Medical School, and a children's book author. Her award-winning book, Masked Hero: How Wu Lien-teh Invented the Mask That Ended an Epidemic, tells the remarkable story of her great-grandfather who created the first respiratory mask during the 1910 Manchurian plague outbreak. Wu Lien-teh was the first Chinese Malaysian to study medicine at Cambridge, faced relentless racism throughout his career, and became the first Chinese person nominated for a Nobel Prize in medicine. Website: shanwuliu.com If you enjoy the show, please leave a ⭐⭐⭐⭐⭐ rating on Apple or a

In this episode, Alyssa and Nadia dive into a deeply personal conversation about aging, menopause, and what it means to be a woman as your body changes.Alyssa opens up about feeling younger than she looks at 48, sparking a discussion about how we perceive ourselves versus how we appear to others. The conversation quickly shifts to menopause and perimenopause — topics that dominate Alyssa's social media feed and conversations with friends her age. While hot flashes get all the attention, the reality includes forgetfulness, mood changes, sexual dysfunction, and vaginal dryness.Alyssa reveals that she missed her first period last month (and no, she's not pregnant). This milestone has her questioning whether to start hormone replacement therapy now or wait for symptoms. The research suggests HRT can protect brain health, bone density, and heart health — but Alyssa isn't someone who takes pills unless absolutely necessary.Nadia draws parallels between menopause symptoms and her own menstrual cycle experiences, noting how women are constantly attributing body changes, mood shifts, and physical symptoms to hormonal fluctuations. She reflects on doing multiple projects on women's health for school, discovering there's shockingly little research and funding in this area.The conversation takes a vulnerable turn as Alyssa grapples with what menopause means for her identity as a woman. Society has taught women that femininity means soft hair, a certain figure, attractiveness, and the ability to have babies. With menopause, many of these markers fade — hair thins, bodies change, fertility ends. It's messing with Alyssa's head, even though she knows logically these societal expectations shouldn't define her.Both agree that women face constant internal struggles and external pressures that men simply don't experience in the same way. But they also find empowerment in it — Nadia feels deeply in touch with her body because of her cycle, and Alyssa celebrates women's intuition, sensitivity, and the literal magic of creating human life.The episode wraps with Nadia sharing exciting news: she landed a co-op doing clinical research at Mass General Hospital, focusing on food insecurity, food banks, SNAP benefits, and Medicaid.TakeawaysLooking in the mirror can feel disorienting when you feel younger than you lookHot flashes are just the tip of the menopause iceberg — symptoms include forgetfulness, mood changes, pain with intercourse, and vaginal drynessHormone replacement therapy may protect brain health, bone density, and heart healthThere's a lack of research and funding for women's health issuesMenopause can trigger an identity crisis around femininity and societal expectations of womenWomen constantly attribute physical and emotional changes to hormonal fluctuations throughout their livesThe expectations and daily struggles women face are different from (though not necessarily harder than) what men experienceDespite the challenges, there's something empowering about being deeply in touch with your bodyWomen's intuition and the ability to create life are genuinely magicalChapters0:10–2:08 – Feeling Young But Looking Old 2:09–5:27 – Menopause on Social Media and the Symptoms No One Talks About 5:28–7:24 – Alyssa Misses Her First Period (And the Hormone Replacement Dilemma) 7:25–10:50 – Nadia's Perspective: Blaming Everything on Your Period 10:51–12:41 – What Menopause Means for Identity as a Woman 12:42–14:26 – Daily Internal Struggles: The Expectations Women Face 14:27–16:30 – The Magic of Being a Woman (Despite Everything) 16:31–17:51 – Nadia's Big News: Clinical Research Co-op at Mass General

Earlier this season, we visited the Ether Dome at the Massachusetts General Hospital to learn about the first public use of an anesthetic in surgery. On this bonus episode of The Object of History, we return to Mass General to visit the Paul S. Russell, MD Museum of Medical History and Innovation. MHS Podcast Producer Sam Hurwitz joins the Director of the Museum, Sarah Alger, for a tour where they examine some of the museum's most significant items related to the history of medicine. Learn more about episode objects here: https://www.masshist.org/podcast/season-4-bonus-episode-Russell-Museum  Email us at podcast@masshist.org. Listen to Episode 3 Episode Special Guest: Sarah Alger is the George and Nancy Putnam Director of Mass General Hospital's Paul S. Russell, MD Museum of Medical History and Innovation. She was a founding editor of Proto, a thought leadership publication that was sponsored by MGH for 17 years. This episode uses materials from: The Bond (Instrumental) by Chad Crouch (Attribution-NonCommercial 4.0 International)        Psychic by Dominic Giam of Ketsa Music (licensed under a commercial non-exclusive license by the Massachusetts Historical Society through Ketsa.uk)        Curious Nature by Dominic Giam of Ketsa Music (licensed under a commercial non-exclusive license by the Massachusetts Historical Society through Ketsa.uk)

BrainStorm wants to hear from you! Send us a text.Dr. Rachel Buckley of Mass General Hospital and Harvard Medical School discusses groundbreaking research revealing stark sex differences in Alzheimer's disease with BrainStorm host Meryl Comer. Her studies found that while men and women show similar levels of amyloid protein, women consistently display significantly higher levels of tau. This discovery has sparked a $50 million Welcome Leap Care grant aimed at cutting Alzheimer's lifetime risk among women by half.The episode clarifies widespread confusion about hormone replacement therapy, explaining that the problematic Women's Health Initiative study used outdated hormone formulations on women over 65—far past the optimal window for intervention. Dr. Buckley emphasizes that current evidence supports HRT use within certain parameters and stresses the importance of women advocating for themselves when experiencing perimenopause symptoms like brain fog and sleep disturbances. The research highlights menopause as a critical period that may influence Alzheimer's risk decades later.Support the show

In 2001, Salem-native Ron Gaudette was working as a pharmacist at Mass General Hospital and had recently joined a group called the International Medical Surgical Response Team, which provides critical care to areas impacted by disasters. This specialized volunteer team was soon deployed to the World Trade Center, making it Gaudette's inaugural mission. He spent 11 days at Ground Zero and shared his experiences 24 years later.

Dr. Mike Pistiner is not just an allergist and immunologist, he's also an allergy dad and fierce patient advocate. In this episode, Dr. Mike breaks down what allergies are, typical signs and symptoms and how they're treated. Have you been curious about when is the right time to use epinephrine? Then this episode is for YOU! Tune in today!Michael Pistiner, MD, MMSc is Director of Food Allergy Advocacy, Education and Prevention for the MassGeneral Hospital for Children, Food Allergy Center. He has a special interest in food allergy and anaphylaxis education and advocacy, infant food allergy management,  healthcare provider education, facilitating collaborations between the medical home and school health, and maintaining quality of life in children (and their families) with food allergies.  Dr. Mike is author of "Everyday Cool With Food Allergies", co-author of the "Living Confidently With Food Allergy" handbook, and co-founder and content creator of AllergyHome.org.Dr. Pistiner is a fellow in the American Academy of Pediatrics (AAP), where he is a member of the Section on Allergy and Immunology Executive Committee, Council on School Health and the Massachusetts Chapter of the AAP. He is also a member of the American Academy of Allergy Asthma & Immunology and the American College of Allergy, Asthma and Immunology.Additionally, he serves on the medical advisory board of Asthma & Allergy Foundation of America, New England Chapter and is a voluntary consultant for the Massachusetts Department of Public Health School Health Service Unit.To learn more about the Food Allergy Management Bootcamp at MassGeneral visit: https://www.massgeneral.org/children/food-allergies/food-allergy-management-boot-campTo learn more about the FAMP-It resource visit: https://famp-it.org/

Mike and Cam are excited to welcome Dr. Maureen Leonard back to the podcast! Dr. Leonard is Clinical Director of the Center For Celiac Research and Treatment at Mass General Hospital for Children (MGHfC) and an Assistant Professor of Pediatrics at Harvard Medical School (HMS). Dr. Leonard shares an update on her groundbreaking work on the CDGEMM study, which follows infants from birth through childhood to learn more about the many factors that can contribute to the development of celiac disease. She shares her thoughts on some of the other exciting advancements that are taking place in celiac research and treatment. Plus, Mike and Cam find out about how she navigates her busy life as a doctor living with celiac disease.

On today's Celiac Project Podcast:Mike and Cam are excited to welcome Dr. Maureen Leonard back to the podcast! Dr. Leonard is Clinical Director of the Center For Celiac Research and Treatment at Mass General Hospital for Children (MGHfC) and an Assistant Professor of Pediatrics at Harvard Medical School (HMS). Dr. Leonard shares an update on her groundbreaking work on the CDGEMM study, which follows infants from birth through childhood to learn more about the many factors that can contribute to the development of celiac disease. She shares her thoughts on some of the other exciting advancements that are taking place in celiac research and treatment. Plus, Mike and Cam find out about how she navigates her busy life as a doctor living with celiac disease.Listen to the full episode here: https://celiacprojectpodcast.libsyn.com/I would love to hear from you! Leave your messages for Andrea at contact@baltimoreglutenfree.com and check out www.baltimoreglutenfree.comInstagramFacebookGluten Free College 101Website: www.glutenfreecollege.comFacebook: http://www.Facebook.com/Glutenfreecollege Hosted on Acast. See acast.com/privacy for more information.

Vidcast:  https://www.instagram.com/p/DMYXNKuvaTI/Adolescent vapers taking the drug varenicline, branded as Chantix, were 8 times more likely to abandon the practice compared with those receiving behavioral counseling and a quit-vaping text program.  This the finding from a study by Harvard's Mass General Hospital psychiatrists studying addiction in young adults.Their trial included 261 adolescents 16 to 25 receiving either the test drug, a placebo drug, or conventional counseling over a 3 month period.   When the data were tabulated, 51% of those on varenicline had completely stopped vaping, compared with 14% in the placebo group, and about 6% receiving counseling.  The effect was lasting with more than half of the Chantix group remaining vape-free 6 months after stopping therapy.With 1.6 million American middle and high school kids vaping in 2024 according to the CDC, an effective medication to help drive vaping cessation is more than welcome.  Chantix is a prescription drug, so parents do speak with your child's pediatric team about obtaining it if your child has an e-cigarette habit to kick.https://jamanetwork.com/journals/jama/fullarticle/2833137#vaping #teens #chantix #varenicline #cessation

In this week's episode, we dig into two deceptively simple questions: When does someone become a cancer survivor, and should palliative care be in the business of caring for them? Spoiler: It's more complicated than it seems. We've invited two palliative care doctors to talk about survivorship with us: Laura Petrillo, a physician-researcher at Mass General Hospital and Harvard Medical School, and Laura Shoemaker, an outpatient palliative care doctor at the Cleveland Clinic. This episode is a must-listen for those navigating the evolving landscape of cancer care, and asking not just how we treat cancer, but how we support people who are living with it.  If you want some further reading on survivorship, check out some of these articles: A NEJM article titled “Time to Study Metastatic-Cancer Survivorship” A ASCO publication that includes a section on survivorship - Patient-Centered Palliative Care for Patients With Advanced Lung Cancer A webinar on survivorship - Blending Survivorship and Palliative Care (NCI)

Dr. John Sweetenham and Dr. Marc Braunstein highlight top research on hematologic malignancies from the 2025 ASCO Annual Meeting, including abstracts on newly diagnosed chronic phase CML, relapsed B-cell lymphoma, and multiple myeloma. Transcript Dr. John Sweetenham: Hello, and welcome to the ASCO Daily News Podcast. I'm your host, Dr. John Sweetenham. On today's episode, we'll be discussing promising advances in newly diagnosed chronic phase CML, relapsed B-cell lymphoma, multiple myeloma, and other hematologic malignancies that were presented at the 2025 ASCO Annual Meeting. Joining me for this discussion is Dr. Marc Braunstein, a hematologist and oncologist at the NYU Perlmutter Cancer Center. Our full disclosures are available in the transcript of this episode.  Marc, there were some great studies in the heme space at this year's Annual Meeting, and it's great to have you back on the podcast to highlight some of these advances. Dr. Marc Braunstein: Yes, I agree, John, and thank you so much for inviting me again. It's great to be here.  Dr. John Sweetenham: Let's start out with Abstract 6501. This was a study that reported on the primary endpoint results of the phase 3B ASC4START trial, which assessed asciminib versus nilotinib in newly diagnosed chronic phase CML. And the primary endpoint of this, as you know, was time to treatment discontinuation because of adverse events. Can you give us your insights into this study? Dr. Marc Braunstein: Absolutely. So, like you mentioned, you know, asciminib is an allosteric inhibitor of the BCR-ABL kinase that has activity in CML, and that includes patients with the T315I mutation that confers resistance to first- and second-generation TKIs. So, the ASC4FIRST study, which was published last year in the New England Journal of Medicine, showed superior efficacy of asciminib compared to investigator-selected first- or second-generation TKIs, actually leading to the FDA approval of asciminib in first-line CML. So, the authors of that study presented data at this year's ASCO meeting from the phase 3 ASC4START comparing safety and time to discontinuation due to adverse events of asciminib versus nilotinib, a second-generation TKI. So, 568 patients with newly diagnosed CML were randomized one-to-one to once-daily asciminib or twice-daily nilotinib. So, at a median follow-up of 9.7 months, about 11% in the asciminib group and 17% in the nilotinib group discontinued treatment, with significantly fewer discontinuations with asciminib due to adverse events. There was also a secondary endpoint of major molecular response, which was also better with asciminib. For example, the MR 4.5, which is a deep response, was 2.5% versus 0.4% favoring asciminib by week 12. So, I think in conclusion, these results build on the ASC4FIRST study, making the case for the superior safety and efficacy of asciminib versus other first- or second-generation TKIs in newly diagnosed CML. Dr. John Sweetenham: Thanks, Marc. Do you think this is going to change practice? Dr. Marc Braunstein: I think so. I think there are still some questions to be answered, such as what resistance mutations occur after first-line treatment with asciminib. But I think the sum of these studies really make the case for using asciminib upfront in CML. Dr. John Sweetenham: Okay, great. Thank you. And let's move on to our second abstract. This was Abstract 7015 and was reported from Mass General Hospital. And this was a study in patients with relapsed and refractory diffuse large B-cell lymphoma and reported the 2-year results of the so-called STARGLO study. This is a comparison of glofitamab, a T-cell engaging bispecific antibody, with gemcitabine and oxaliplatin in this group of patients. Can you tell us a little bit about your impressions of this study? Dr. Marc Braunstein: Absolutely. So just for background, the treatment landscape for relapsed/refractory large B-cell lymphoma is expanding, now with two bispecific antibodies targeting CD20 that are approved after two or more lines of therapy. Among these, glofitamab was approved in 2023 based on phase 2 data showing an objective response rate of 52%, with 39% complete responses in relapsed/refractory large B-cell lymphoma patients after a median of three prior lines of therapy. Distinguishing glofitamab from epcoritamab, the other approved bispecific, glofitamab was given for 12 cycles and then stopped. Additionally, when combined with gemcitabine and oxaliplatin in the phase 3 STARGLO study, there was significantly improved overall survival compared to rituximab plus gemcitabine and oxaliplatin in transplant-ineligible relapsed/refractory large B-cell lymphoma patients at a median follow-up of 11 months.  The authors of that study published last year in Lancet now present at ASCO this year the 2-year follow-up of the STARGLO study. Two hundred and seventy-four patients with a median of one prior line of therapy were randomized two-to-one to glofitamab plus GemOx versus rituximab plus GemOx, with the primary endpoint of overall survival. Here, the median overall survival was not reached versus 13.5 months, with a median PFS also significantly improved at about 14 months versus 4 months in the control. CRS of note in the glofitamab arm was mostly grade 1 or 2, with only about 2.3% grade 3 events. And three of the four patients had grade 1 or 2 neurotoxicity. So, John, putting this into context, I think it's encouraging that we now have randomized data showing the superiority of a bispecific plus chemotherapy over rituximab plus chemotherapy in transplant-ineligible patients. And while only 8% of the patients in the STARGLO study had prior anti-CD19 CAR T-cell therapy, I think this regimen could be considered in those patients who are ineligible for transplant or CAR T-cell therapy. Dr. John Sweetenham: Yeah, I agree. I think a couple of other compelling numbers to me were the fact that around 55% of these patients were alive at 2 years in the group who'd received glofitamab, and that almost 90% of those having that arm of the study who had a CR at the end of treatment were alive at 12 months. So, clearly, it's an active agent and also a kind of great off-the-shelf fixed-duration alternative in these relapsed and refractory patients. Dr. Marc Braunstein: I agree, and I would also note that the phase 3 SKYGLO study is looking at glofitamab plus Pola-R-CHP versus Pola-R-CHP alone. So, we may even be using these eventually in the first-line setting. Dr. John Sweetenham: Absolutely. Let's stay on the theme of diffuse large B-cell lymphoma and look at one other abstract in that space, which was Abstract 7000. This was a study from the HOVON group in the Netherlands, which looked at the prospective validation of end-of-treatment circulating tumor DNA in the context of a national randomized trial. What are your thoughts on this? Dr. Marc Braunstein: So, non-invasive liquid biopsies to detect and monitor cancers via circulating tumor-derived DNA or ctDNA, you know, is really emerging as a valuable tool in both solid and liquid tumors to understand disease biology, and also for drug development. So, to date, the most established application of ctDNA in lymphoma, I would say, is really for monitoring of minimal residual disease. So, in this correlative study by Steven Wang and colleagues in the HOVON group, they evaluated the prognostic significance of MRD status as assessed by ctDNA following first-line treatment with curative intent with either R-CHOP or dose-adjusted R-EPOCH. At the end of treatment, encouragingly, 76% of patients were MRD-negative, and 24% were MRD-positive. Now, of note, MRD-positive status at the end of treatment predicted inferior progression-free survival at 2 years, with only 28% of patients who are MRD-positive being progression-free versus 88% who are MRD-negative. And in fact, all the patients who failed to achieve a complete response after first-line treatment and were MRD-positive ultimately relapsed. So, circulating tumor cells are rarely found in large B-cell lymphomas, and so this study really builds on accumulating data that ctDNA has clinical value to detect residual disease with a non-invasive approach. So, there are many implications of how we could potentially use this to detect early signs of relapse, to potentially escalate treatment for consolidation if patients remain MRD-positive. So, I think this will eventually become utilized in clinical practice. Dr. John Sweetenham: Yeah, I agree. I think it's interesting that it provided an independent assessment of response, which was independent, in fact, of the results of PET-CT scanning and so on, which I think was very interesting to me. And the authors of the abstract actually commented in their presentation that they think this should be integrated as part of the standard response assessment now for patients with large B-cell lymphoma. Would you agree with that? Dr. Marc Braunstein: I would. For one thing, it allows repeated sampling. It's a non-invasive approach; it doesn't necessarily require a bone marrow biopsy, and it may have more sensitivity than conventional response measures. So, I think having a standardized system to assess ctDNA will be helpful, and definitely, I think this will be a valuable biomarker of disease response. Dr. John Sweetenham: Okay, great. Thanks. We're going to change gear again now, and we're going to highlight two abstracts in the multiple myeloma space. The first one of these is Abstract 7507. And this abstract reported on the long-term results of the CARTITUDE study for patients with relapsed and refractory multiple myeloma. What are your comments on this presentation? Dr. Marc Braunstein: So, this study actually got a lot of press, and I've already had multiple patients asking me about CAR T-cells as a result. Just as some background, CAR T-cells targeting BCMA, which is pretty much universally expressed on malignant plasma cells in myeloma, have really shown remarkable responses, especially in heavily pretreated patients, showing superior progression-free survival in both later and earlier phases of the disease, including in randomized studies in patients with second-line or beyond. So, the CARTITUDE-1 was really the original Phase 1/2 study of ciltacabtagene autoleucel, one of the two approved anti-BCMA CAR T-cell products, which was investigated in patients with a median of six to seven prior lines of therapy. So, these were patients who were pretty heavily pretreated. So, in the study presented by Voorhees at this year's ASCO meeting, this was the long-term follow-up at a median of 5 years from the one-time CAR infusion in these patients with a median of five prior lines of therapy. And remarkably, of the 97 patients, 33% remained progression-free at 5 years plus, without needing any further myeloma treatment during that time. And among those 33% of patients, 23% had high-risk cytogenetics, which we know are notoriously difficult to achieve responses in. What was interesting that they presented as correlative studies was there were some biomarkers that were distinguishing the patients who had the long PFS, including enrichment of more naive T-cells in the product, lower neutrophil-to-T-cell ratio, higher hemoglobin and platelets at baseline, and higher CAR T-cell levels relative to soluble BCMA levels. And the fact that they reported a median overall survival of 61 months in these really heavily pretreated patients, I think these data are impressive. I think we're going to continue to be using CAR T even earlier in the disease status than fifth or sixth line, as it was studied in CARTITUDE-1. There are even ongoing studies looking at first-line treatment with CAR T-cells. Dr. John Sweetenham: So, do you think that those 33% of patients who are disease-free at 5 years, do you think any of those are cured?  Dr. Marc Braunstein: That was one of the headlines in the press. I think if we're going to discuss things like "operational cures," where we're transforming myeloma into really a chronic disease, where patients can live practically a normal life expectancy, I think the measure of 5 years, especially in this population that was explored in CARTITUDE-1, I think we can call that close to a cure. Dr. John Sweetenham: Okay. Well, thank you. Exciting data, for sure. We're going to conclude today with another abstract in the multiple myeloma space. And this was Abstract 7500, which looked at an MRD, minimal residual disease-driven strategy following induction and transplant-eligible newly diagnosed multiple myeloma patients and reported on the primary endpoints of the phase 3 MIDAS trial. Can you walk us through this one, Marc? Dr. Marc Braunstein: Absolutely. It is a bit more complicated than the prior one we discussed because this is a randomized study with four arms. So, I'll start by saying that anti-CD38-based quadruplet regimens continue to show superior outcomes in both transplant-eligible and -ineligible newly diagnosed multiple myeloma patients. The MIDAS study mentioned is an open-label phase 3 trial with four arms in transplant-eligible newly diagnosed myeloma patients.  And initially, these patients were all treated with quadruplet therapy with the anti-CD38 antibody isatuximab combined with carfilzomib, lenalidomide, and dexamethasone in 718 newly diagnosed myeloma patients. So, they received the quadruplet regimen for six cycles and then were randomized based on their MRD status at 10 to the negative fifth following six cycles of induction. And that first randomization, if they were MRD-negative, was to either consolidation with six more cycles of the quadruplet regimen or transplant, autologous transplant, plus two cycles additionally of the quadruplet regimen. And both arms were followed by lenalidomide maintenance. The primary endpoint was MRD negativity at 10 to the negative sixth prior to entering the lenalidomide maintenance component. And in addition, the patients who were MRD-positive after induction were randomized to transplant plus two cycles of consolidation or a tandem autologous transplant. So, the median follow-up of the study was about 16 months, and the pre-maintenance rate of MRD negativity was high, between 84 to 86% between the two arms who were MRD-negative, which was not significantly different. And as far as the 233 patients who were MRD-positive, the pre-maintenance MRD negativity was also not significantly different at 40% for those who received autologous transplant, and 32% who received a tandem transplant. So, there's a lot of debate in the myeloma field about the evolving role of autologous transplant and whether transplant still plays a significant role in patients who are either MRD-negative after induction or who have deep remissions and are of standard risk. So, I think these data suggest that patients who are MRD-negative after induction with a quadruplet regimen studied here, which was Isa-KRd, plus consolidation, may possibly be able to forego consolidation with autologous transplant. And likewise, for those patients who are MRD-positive after induction, tandem transplant didn't seem to provide much of a benefit compared to single transplant, which is consistent with prior studies such as the StaMINA study. Dr. John Sweetenham: So, where do you think this leaves us, Marc? Are we going to need more studies before we have any definitive guidance on whether an autologous transplant is still appropriate for those patients who are MRD-negative? Dr. Marc Braunstein: Well, as clinicians, we want to do what's best for our patient. And in myeloma, the best we can do is to get as deep remissions as possible, meaning MRD negativity. And so, I think it's clear from the MIDAS study and others that quadruplet regimens provide the deepest remissions when given upfront. We can debate the role of autologous transplant. I think certainly the role of tandem autologous transplant is fading. But as far as a single autologous transplant as consolidation, I think it's reasonable as a goal to try to achieve MRD negativity after the transplant, especially for patients who remain MRD-positive after induction. Dr. John Sweetenham: Okay, great. Marc, thanks as always for sharing your insights on the heme malignancies studies from the ASCO meeting this year and for joining us on the ASCO Daily News Podcast. Always appreciate hearing your thoughtful and balanced input on these. Dr. Marc Braunstein: My pleasure. Thank you, John. Dr. John Sweetenham: And thank you to our listeners for joining us today. You'll find links to the abstracts discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts.   Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.  Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   Find out more about today's guest:  Dr. John Sweetenham Dr. Marc Braunstein   @docbraunstein     Follow ASCO on social media:   @ASCO on Twitter  ASCO on Bluesky  ASCO on Facebook   ASCO on LinkedIn     Disclosures:  Dr. John Sweetenham:  Consulting or Advisory Role: EMA Wellness  Dr. Marc Braunstein:  Consulting or Advisory Role: Pfizer, Bristol-Myers Squibb/Celgene, Adaptive Biotechnologies, GlaxoSmithKline, ADC Therapeutics, Janssen Oncology, Abbvie, Guidepoint Global, Epizyme, Sanofi, CTI BioPharma Corp  Speakers' Bureau: Janssen Oncology  Research Funding (Institution): Janssen, Celgene/BMS

Jerome was diagnosed with muscle invasive bladder cancer on January 29, 1997. The diagnosis was based on a transurethral resection surgery. Having done his research, he contacted a doctor at Harvard and Mass General Hospital about a clinical trial for a bladder sparing protocol. To Jermoe's surprise, Dr.Shipley called back and shared the protocol with Jerome's medical team and the treatment began a couple of weeks later. The treatment involved chemotherapy in conjunction with radiation therapy.  Jerome experienced several recurrences over the years, each time treating them with surgery and infusions. In 2018 a recurrence involved hospitalization and tubes were placed in each kidney. This time Jerome was faced with a decision to have a radical cystectomy or given the choice to do immunotherapy. By 2019 there was little evidence of bladder cancer and infusions continued, with no side effects. He still has a tube in one kidney and is otherwise thriving! email: Jerome@mountainsangha.org phone: 415-299-0428 website: www.mountainsangha.org Book: Healing with the 7 Principles of Mindfulness, by Jerome FreedmanHere is what Dr. Kelly Turner, PhD has to say about Healing with the 7 Principles of Mindfulness: “Dr. Freedman speaks from experience, both as a cancer survivor himself, and the father of a Radical Remission cancer survivor. His book, “Healing with the 7 Principles of Mindfulness” gives readers a nurturing, helping hand throughout the entire cancer journey, especially with regard to developing a meditation practice. –Kelly Turner, PhD, Author of the NYTimes Bestseller “Radical Remission: Surviving Cancer Against All Odds” Stop Cancer in Its Tracks: How to Embrace Mindfulness In Healing by Jerome Freedman ___________________________ To learn more about the 10 Radical Remission Healing Factors, connect with a certified RR coach or join a virtual or in-person workshop visit www.radicalremission.com. To watch Episode 1 of the Radical Remission Docuseries for free, visit our YouTube channel here.  To purchase the full 10-episode Radical Remission Docuseries visit Hay House Online Learning. To learn more about Radical Remission health coaching with Liz or Karla, Click Here Follow us on Social Media: Facebook  Instagram YouTube __________________________ Thank you to our friends from The Healing Oasis for sponsoring this episode of the podcast.  The Healing Oasis is a first of its kind in beautiful British Columbia, Canada where we encourage the body to heal from cancer using alternative therapies & cancer fighting meals at a wellness retreat center in nature. Our top naturopathic cancer doctor will prescribe a protocol tailored specifically for you. There's no place quite like it. Start your healing journey today! Learn More about The Healing Oasis by visiting these links: Website   Testimonials Video Overview

Episode OverviewIn this episode, Kristen interviews Erin Schultz, founder of Her Personal Finance, about building a successful niche business serving women in medicine, tech, and law. Erin shares her journey from Harvard Business School graduate to personal finance educator and financial planner, discussing how she built an audience on social media and the power of niching down.Guest BioErin Schultz is the founder of Her Personal Finance (founded in 2015). She's a Harvard Business School graduate who specializes in helping physicians and research scientists balance student loan payments with retirement savings. Her online classes are offered in partnership with Mass General Hospital, and she has helped hundreds of clients navigate hospital benefits and financial planning.Timestamps[00:00] Introduction to Erin Schultz[01:15] Erin's Journey from Harvard to Personal Finance[03:54] Building a Social Media Presence[04:58] Engaging with Content and Community[08:19] The Importance of Niching Down[10:33] Personal Stories and Professional Connections[19:31] Adapting Content for Different Platforms[22:34] Resources and Final ThoughtsKey Takeaways1. Niche down ruthlessly - Erin's focus on women in specific high-earning professions allows her to become a true expert2. Personal stories drive engagement - Educational content performs worse than personal narratives3. Be approachable, not traditional - Standing out from "dusty old guys from Fidelity"4. Repurpose content strategically - Same story, different formats for different platforms5. Address real pain points - Fertility costs, childcare planning, student loansConnect with Erin- Instagram: [@herpersonalfinance](https://instagram.com/herpersonalfinance)- LinkedIn: [Erin Schultz](https://linkedin.com/in/erinschultz)- Website: [herpersonalfinance.com](http://herpersonalfinance.com)- Bimonthly newsletter covering topics like car payments, 401(k)s, and student loans

A shooting outside Mass General Hospital shuts down roads for a time in Boston, the White House takes another shot at Harvard, and public defenders gather at the State House. Stay in "The Loop" with #iHeartRadio.

As artificial intelligence (AI) tools become increasingly mainstream, they can potentially transform neurology clinical practice by improving patient care and reducing clinician workload. Critically evaluating these AI tools for clinical practice is important for successful implementation. In this episode, Katie Grouse, MD, FAAN speaks with Peter Hadar, MD, MS, coauthor of the article “Clinical Applications of Artificial Intelligence in Neurology Practice” in the Continuum® April 2025 Neuro-ophthalmology issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Hadar is an instructor of neurology at Harvard Medical School and an attending physician at the Massachusetts General Hospital in Boston, Massachusetts. Additional Resources Read the article: Clinical Applications of Artificial Intelligence in Neurology Practice Subscribe to Continuum®: shop.lww.com/Continuum Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Guest: @PeterNHadar Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about subscribing to the journal, listening to verbatim recordings of the articles, and exclusive access to interviews not featured on the podcast. Dr Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Peter Hadar about his article on clinical applications of artificial intelligence in neurology practice, which he wrote with Dr Lydia Moura. This article appears in the April 2025 Continuum issue on neuro-ophthalmology. Welcome to the podcast, and please introduce yourself to our audience. Dr Hadar: Hi, thanks for having me on, Katie. My name is Dr Peter Hadar. I'm currently an instructor over at Mass General Hospital, Harvard Medical School, and I'm excited to talk more about AI and how it's going to change our world, hopefully for the better. Dr Grouse: We're so excited to have you. The application of AI in clinical practice is such an exciting and rapidly developing topic, and I'm so pleased to have you here to talk about your article, which I found to be absolutely fascinating. To start, I'd like to hear what you hope will be the key takeaway from your article with our listeners. Dr Hadar: Yeah, thank you. The main point of the article is that AI in medicine is a tool. It's a wonderful tool that we should be cautiously optimistic about. But the important thing is for doctors, providers to be advocates on their behalf and on behalf of their patients for the appropriate use of this tool, because there are promises and pitfalls just with any tool. And I think in the article we detail a couple ways that it can be used in diagnostics, in clinical documentation, in the workflow, all ways that can really help providers. But sometimes the devil is in the details. So, we get into that as well. Dr Grouse: How did you become interested in AI and its application, specifically in the practice of neurology? Dr Hadar: When I was a kid, as most neurologists are, I was- I nerded out on a lot of sci-fi books, and I was really into Isaac Asimov and some of his robotics, which kind of talks about the philosophy of AI and how AI will be integrated in the future. As I got into neurology, I started doing research neurology and a lot of folks, if you're familiar with AI and machine learning, statistics can overlap a lot with machine learning. So slowly but surely, I started using statistical methods, machine learning methods, in some of my neurology research and kind of what brought me to where I am today. Dr Grouse: And thinking about and talking about AI, could you briefly summarize a few important terms that we might be talking about, such as artificial intelligence, generative AI, machine learning, etcetera? Dr Hadar: It's a little difficult, because some of these terms are nebulous and some of these terms are used in the lay public differently than other folks would use it. But in general, artificial intelligence is kind of the ability of machines or computers to communicate independently. It's similar to as humans would do so. And there are kind of different levels of AI. There's this very hard AI where people are worried about with kind of terminator-full ability to replicate a human, effectively. And there are other forms of narrow AI, which are actually more of what we're talking about today, and where it's very kind of specific, task-based applications of machine learning in which even if it's very complex, the AI tools, the machine learning tools are able to give you a result. And just some other terms, I guess out there. You hear a lot about generative AI. There's a lot of these companies and different algorithms that incorporate generative AI, and that usually kind of creates something, kind of from scratch, based on a lot of data. So, it can create pictures, it can create new text if you just ask it. Other terms that can be used are natural language processing, which is a big part of some of the hospital records. When AI tools read hospital records and can summarize something, if it can translate things. So, it turns human speech into these results that you look for. And I guess other terms like large language models are something that also have come into prominence and they rely a lot on natural language processing, being able to understand human speech, interpret it and come up with the results that you want. Dr Grouse: Thank you, that's really helpful. Building on that, what are some of the current clinical applications of AI that we may already be using in our neurologic practice and may not even be aware that that's what that is? Dr Hadar: It depends on which medical record system you use, but a very common one are some of the clinical alerts that people might get, although some of them are pretty basic and they can say, you know, if the sodium is this level, you get an alert. But sometimes they do incorporate fancier machine learning tools to say, here's a red flag. You really should think about contacting the patient about this. And we can talk about it as well. It might encourage burnout with all the different flags. So, it's not a perfect tool. But these sorts of things, typically in the setting of alerts, are the most common use. Sorry, and another one is in folks who do stroke, there are a lot of stroke algorithms with imaging that can help detect where the strokes occur. And that's a heavy machine learning field of image processing, image analysis for rapid detection of stroke. Dr Grouse: That's really interesting. I think my understanding is that AI has been used specifically for radiology interpretation applications for some time now. Is that right? Dr Hadar: In some ways. Actually, my background is in neuroimaging analysis, and we've been doing a lot of it. I've been doing it for years. There's still a lot of room to go, but it's really getting there in some ways. My suspicion is that in the coming years, it's going to be similar to how anesthesiologists at one point were actively bagging people in the fifties, and then you develop machines that can kind of do it for you. At some point there's going to be a prelim radiology read that is not just done by the resident or fellow, but is done by the machine. And then another radiologist would double check it and make sure. And I think that's going to happen in our lifetime. Dr Grouse: Wow, that's absolutely fascinating. What are some potential applications of AI in neurologic practice that may be most high-yield to improve patient care, patient access, and even reduce physician burnout? Dr Hadar: These are separate sort of questions, but they're all sort of interlinked. I think one of the big aspects of patient care in the last few years, especially with the electronic medical record, is patients have become much more their own advocates and we focus a lot more on patient autonomy. So, they are reaching out to providers outside of appointments. This can kind of lead to physician burnout. You have to answer all these messages through the electronic medical record. And so having, effectively, digital twins of yourself, AI version of yourself, that can answer the questions for the patient on your off times is one of the things that can definitely help with patient care. In terms of access, I think another aspect is having integrated workflows. So, being able to schedule patients efficiently, effectively, where more difficult patients automatically get one-hour appointments, patients who have fewer medical difficulties might get shorter appointments. That's another big improvement. Then finally, in terms of physician burnout, having ambient intelligence where notes can be written on your behalf and you just need to double-check them after allows you to really have a much better relationship with the patients. You can actually talk with them one on one and just focus on kind of the holistic care of the patient. And I think that's- being less of a cog in the machine and focusing on your role as a healer would be actually very helpful with the implementation of some of these AI tools. Dr Grouse: You mentioned ambient technology and specifically ambient documentation. And certainly, this is an area that I feel a lot of excitement about from many physicians, a lot of anticipation to be able to have access to this technology. And you mentioned already some of the potential benefits. What are some of the potential… the big wins, but then also potential drawbacks of ambient documentation? Dr Hadar: Just to kind of summarize, the ambient intelligence idea is using kind of an environmental AI system that, without being very obtrusive, just is able to record, able to detect language and process it, usually into notes. So, effectively like an AI scribe that is not actually in the appointment. So, the clear one is that---and I've seen this as well in my practice---it's very difficult to really engage with the patient and truly listen to what they're saying and form that relationship when you're behind a computer and behind a desk. And having that one-on-one interaction where you just focus on the patient, learn everything, and basically someone else takes notes for you is a very helpful component of it. Some of the drawbacks, though, some of it has to do with the existing technology. It's still not at the stage where it can do everything. It can have errors in writing down the medication, writing down the exact doses. It can't really, at this point, detect some of the apprehensions and some of the nonverbal cues that patients and providers may kind of state. Then there's also the big one where a lot of these are still done by startups and other companies where privacy may be an issue, and a lot of patients may feel very uncomfortable with having ambient intelligence tools introduced into their clinical visit, having a machine basically come between the doctor and the patient. But I think that over time these apprehensions will lessen. A lot of the security will improve and be strengthened, and I think that it's going to be incorporated a lot more into clinical practice. Dr Grouse: Yeah, well, we'll all be really excited to see how that technology develops. It certainly seems like it has a lot of promise. You mentioned in your article a lot about how AI can be used to improve screening for patients for certain types of conditions, and that certainly seems like an obvious win. But as I was reading the article, I couldn't help but worry that, at least in the short term, these tools could translate into more work for busy neurologists and more demand for access, which is, you know, already, you know, big problems in our field. How can tools like these, such as, like, for instance, the AI fundoscopic screening for vascular cognitive risk factors help without adding to these existing burdens? Dr Hadar: It's a very good point. And I think it's one of the central points of why we wanted to write the article is that these AI in medicine, it's, it's a tool like any other. And just like when the electronic medical record came into being, a lot of folks thought that this was going to save a lot of time. And you know, some people would say that it actually worsened things in a way. And when you use these diagnostic screening tools, there is an improvement in efficiency, there is an improvement in patient care. But it's important that doctors, patients advocate for this to be value-based and not revenue-based, necessarily. And it doesn't mean that suddenly the appointments are shorter, that now physicians have to see twice as many patients and then patients just have less of a relationship with their provider. So, it's important to just be able to integrate these tools in an appropriate way in which the provider and the patient both benefit. Dr Grouse: You mentioned earlier about the digital twin. Certainly, in your article you mentioned, you know, that idea along with the idea of the potential of development of virtual chatbot visits or in-person visits with a robot neurologist. And I read all this with equal parts, I think excitement, but horror and and fear. Can you tell us more about what these concepts are, and how far are we from seeing technology like this in our clinics, and maybe even, what are the risks we need to be thinking about with these? Dr Hadar: Yeah. So, I mean, I definitely think that we will see implementation of some of these tools in our lifetime. I'm not sure if we're going to have a full walking, talking robot doing some of the clinical visits. But I do think that, especially as we start doing a lot more virtual visits, it is very easy to imagine that there will be some sort of video AI doctor that can serve as, effectively, a digital twin of me or someone else, that can see patients and diagnose them. The idea behind the digital twin is that it's kind of like an AI version of yourself. So, while you only see one patient, an AI twin can go and see two or three other patients. They could also, if the patients send you messages, can respond to those messages in a way that you would, based on your training and that sort of thing. So, it allows for the ability to be in multiple places at once. One of the risks of this is, I guess, overreliance on the technology, where if you just say, we're just going to have a chatbot do everything for us and then not look at the results, you really run the risk of the chatbot just recommending really bad things. And there is training to be had. Maybe in fifty years the chatbot will be at the same level as a physician, but there's still a lot of room for improvement. I personally, I think that my suspicion as to where things will go are for very simple visits in the future and in our lifetime. If someone is having a cold or something like that and it goes to their primary care physician, a chatbot or something like that may be of really beneficial use. And it'll help segment out the different groups of simple diagnosis, simple treatments can be seen by these robots, these AI, these machine learning tools; and some of the more complex ones, at least for the early implementation of this will be seen by more specialized providers like neurologists and subspecialist neurologists too. Dr Grouse: That certainly seems reasonable, and it does seem that the more simple algorithmic things are always where these technologies will start, but it'll be interesting to see where things can go with more complex areas. Now I wanted to switch gears a little bit in the article- and I thought this was really important because I see it as being certainly one of the bigger drawbacks of AI, is that despite the many benefits of artificial intelligence, AI can unfortunately perpetuate systemic bias. And I'm wondering if you could tell us a little bit more about how this happened? Dr Hadar: I know I'm beating a dead horse on this, but AI is a tool like any other. And the problem with it is that what you put in is very similar to what you get out. And there's this idea in computer science of “garbage in, garbage out”. If you include a lot of data that has a lot of systemic biases already in the data, you're going to get results that perpetuate these things. So, for instance, if in dermatologic practices, if you just had a data set that included people of one skin color or one race and you attempted to train a model that would be able to detect skin cancer lesions, that model may not be easily applicable to people of other races, other ethnicities, other skin colors. And that can be very damaging for care. And it can actually really, really hurt the treatments for a lot of the patients. So that is one of the, kind of, main components of the systemic biases in AI. The way we mitigate them is by being aware of it and actually implementing, I guess, really hard stops on a lot of these tools before they get into practice. Being sure, did your data set include this breakdown of sex and gender, of race and ethnicity? So that the stuff you have in the AI tool is not just a very narrow, focused application, but can be generalized to a large population, not just of one community, one ethnic group, racial group, one country, but can really be generalized throughout the world for many patients. Dr Grouse: The first step is being aware of it, and hopefully these models will be built thoughtfully to help mitigate this as much as possible. I wanted to ask as well, another concern about AI is the safety of private data. And I'm wondering, as we're starting to do things like use ambient documentation, AI scribe, and other types of technologies like this, what can we tell our patients who are concerned about the safety of their personal data collected via these programs, particularly when they're being stored or used with outside companies that aren't even in our own electronic medical records system? Dr Hadar: Yeah, it's a very good question, and I think it's one of the major limitations of the current implementation of AI into clinical practice, because we still don't really have great standards---medical standards, at least---for storing this data, how to analyze this data. And my suspicion is that at some point in the future, we're going to need to have a HIPAA compliance that's going to be updated for the 21st century, that will incorporate the appropriate use of these tools, the appropriate use of these data storage, of data storage beyond just PHI. Because there's a lot more that goes into it. I would say that the important thing for how to implement this, and for patients to be aware of, is being very clear and very open with informed consent. If you're using a company that isn't really transparent about their data security and their data sharing practices, that needs to be clearly stated to the patient. If their data is going to be shared with other people, reanalyzed in a different way, many patients will potentially consider not participating in an AI implementation in clinic. And I think the other key thing is that this should be, at least initially, an opt-in approach as opposed to an opt-out approach. So patients really have- can really decide and have an informed opinion about whether or not they want to participate in the AI implementation in medicine. Dr Grouse: Well, thank you so much for explaining that. And it does certainly sound like there's a lot of development that's going to happen in that space as we are learning more about this and the use of it becomes more prevalent. Now, I also wanted to ask, another good point that you made in your article---and I don't think comes up enough in this area, but likely will as we're using it more---AI has a cost, and some of that cost is just the high amount of data and computational processing needed to use it, as well as the effects on the environment from all this energy usage. Given this drawback of AI, how can we think about potential costs versus the benefits, the more widespread use of this technology? Or how should we be thinking about it? Dr Hadar: It's part of a balance of the costs and benefits, effectively, is that AI---and just to kind of name some of them, when you have these larger data centers that are storing all this data, it requires a lot of energy consumption. It requires actually a lot of water to cool these things because they get really hot. So, these are some of the key environmental factors. And at this point, it's not as extreme as it could be, but you can imagine, as the world transitions towards an AI future, these data centers will become huge, massive, require a lot of energy. And as long as we still use a lot of nonrenewable resources to power our world, our civilization, I think this is going to be very difficult. It's going to allow for more carbon in the atmosphere, potentially more climate change. So, being very clear about using sustainable practices for AI usage, whether it be having data centers specifically use renewable resources, have clear water management guidelines, that sort of thing will allow for AI to grow, but in a sustainable way that doesn't damage our planet. In terms of the financial costs… so, AI is not free. However, on a given computer, if you want to run some basic AI analysis, you can definitely do it on any laptop you have and sometimes even on your phone. But for some of these larger models, kind of the ones that we're talking about in the medical field, it really requires a lot of computational power. And this stuff can be very expensive and can get very expensive very quickly, as anyone who's used any of these web service providers can attest to. So, it's very important to be clear-eyed about problems with implementation because some of these costs can be very prohibitive. You can run thousands and you can quickly rack up a lot of money for some very basic analysis if you want to do it in a very rapid way, in a very effective way. Dr Grouse: That's a great overview. You know, something that I think we're all going to be having to think about a lot more as we're incorporating these technologies. So, important conversations I hope we're all having, and in our institutions as we're making these decisions. I wanted to ask, certainly, as some of our listeners who may be still in the training process are hearing you talk about this and are really excited about AI and implementation of technology in medicine, what would you recommend to people who want to pursue a career in this area as you have done? Dr Hadar: So, I think one of the important things for trainees to understand are, there are different ways that they can incorporate AI into their lives going forward as they become more seasoned doctors. There are clinical ways, there are research ways, there are educational ways. A lot of the research ways, I'm one of the researchers, you can definitely incorporate AI. You can learn online. You can learn through books about how to use machine learning tools to do your analysis, and it can be very helpful. But I think one of the things that is lacking is a clinician who can traverse both the AI and patient care fields and be able to introduce AI in a very effective way that really provides value to the patients and improves the care of patients. So that means if a hospital system that a trainee is eventually part of wants to implement ambient technology, it's important for physicians to understand the risks, the benefits, how they may need to adapt to this. And to really advocate and say, just because we have this ambient technology doesn't mean now we see fifty different patients, and then you're stuck with the same issue of a worse patient-provider relationship. One of the reasons I got into medicine was to have that patient-provider interaction to not only be kind of a cog in the hospital machine, but to really take on a role as a healer and a physician. And one of the benefits of these AI tools is that in putting the machine in medicine, you can also put the humanity back in medicine at times. And I think that's a key component that trainees need to take to heart. Dr Grouse: I really appreciate you going into that, and sounds like there's certainly need. Hoping some of our listeners today will consider careers in pursuing AI and other types of technologies in medicine. I really appreciate you coming to talk with us today. I think this is just such a fascinating topic and an area that everybody's really excited about, and hoping that we'll be seeing more of this in our lives and hopefully improving our clinical practice. Thank you so much for talking to us about your article on AI in clinical neurology. It was a fascinating topic and I learned a lot. Dr Hadar: Thank you very much. I really appreciate the conversation, and I hope that trainees, physicians, and others will gain a lot and really help our patients through this. Dr Grouse: So again, today I've been interviewing Dr Peter Hadar about his article on clinical applications of artificial intelligence in neurology practice, which he wrote with Dr Lydia Moura. This article appears in the most recent issue of Continuum on neuro-ophthalmology. Be sure to check out Continuum Audio episodes from this and other issues. And thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. Thank you for listening to Continuum Audio.

You can text us here with any comments, questions, or thoughts!In this episode, Kemi welcomes Dr. Allison Wu. Dr. Wu is Principal Investigator of the Wunderfull Lab. She is a clinician-researcher board certified in pediatric gastroenterology and nutrition as well as obesity medicine. Her research focuses on epidemiology and health services research in pediatric nutrition and obesity. She completed her fellowship in Pediatric Gastroenterology, Hepatology & Nutrition at Boston Children's Hospital and the Harvard-wide Pediatric Health Services Research Fellowship at Mass General Hospital for Children. She is also an alumnus of our Get That Grant® coaching program! Together, they explore Dr. Wu's unique journey that intertwines her love for science, nutrition, and working with children, shaped by her family's background in academia and the restaurant business. Join the conversation as Dr. Wu shares her experiences with coaching, her insights on how supportive environments can foster growth, confidence, and collaboration and the importance of grant writing in creating meaningful change. Conversation Highlights: Navigating maternity leave and career transitions The role of coaching in professional growth Building community and collaboration in academia The importance of intentionality in career development  Loved this convo? Please go find Dr. Wu on LinkedIn to show her some love!  

The first two episodes in this Healthcare is Hard podcast series on “Opportunities in Oncology” explored the relationship between academic medical centers and community care, with guests Dr. Stephen Schleicher from Tennessee Oncology, and Dr. Harlan Levine from City of Hope. For the third and final episode in the series, Dr. Daphne Haas-Kogan joined Keith Figlioli for a conversation that dives more deeply into patient care, innovations in care delivery and the opportunities for entrepreneurs.Dr. Haas-Kogan is Chair of the Department of Radiation Oncology at Mass General Hospital, Brigham and Women's Hospital, and Boston Children's Hospital. She is also the Willem and Corrie Hees Family Professor of Radiation Oncology at Harvard Medical School.Dr. Haas-Kogan received her undergraduate degree in biochemistry and molecular biology from Harvard University and her medical degree at UCSF. She completed her residency in radiation oncology at UCSF in 1997 and became vice-chair for research at UCSF in 2003, and educational program director in 2008. Dr. Haas-Kogan's laboratory research focuses on molecular underpinnings of brain tumors and pediatric cancers. She leads large multi-institutional initiatives funded by NIH/NCI, philanthropic organizations, and industry collaborators.For this episode of Healthcare is Hard, some of the topics Dr. Haas-Kogan discussed with Keith include:The collaborative approach to care. Dr. Haas-Kogan talked about how most people with cancer struggle with many other medical issues – some predating cancer diagnosis, some precipitated by the treatment itself – and how several care teams are required to treat the patient wholistically. She also discussed how important it is for academic medical centers and community hospitals to work together, the responsibilities each holds to the patient, and the goal of making sure patients receive the same exact care regardless of location.The precision of radiation oncology. There are generally three pillars of cancer treatment. The first is surgery to remove tumors, the second is medication to kill cancer cells with drugs, and the third is radiation therapy to destroy cancer cells. Dr. Haas-Kogan described how radiation oncology is, in many ways, a combination of surgical oncology and medical oncology. It requires the precision of surgery – especially when treating a tumor close to critical structures like the brain stem or spinal cord – but can also be applied in a single day or over the course of weeks, similar to medication. She discussed how this allows for unique collaboration between academic researchers and community physicians, along with opportunities for creative workforce solutions.AI in oncology. The impact artificial intelligence has already had on oncology would have been unimaginable five or 10 years ago, and Dr. Haas-Kogan says the opportunities for entrepreneurs in the space are huge. As an example of the impact AI has already made, she talked about how radiation oncologists traditionally spend hours defining exactly what they want treated and the dose of radiation required. But now, AI is doing most of that, saving physicians precious time. She talked about how medicine is an art and how treatment like this is very nuanced, so she very often makes changes after reviewing AI-generated recommendations. But she says advancements are coming quickly.To hear Dr. Haas-Kogan and Keith discuss these topics and more, listen to this episode of Healthcare is Hard: A Podcast for Insiders.

Kat Koppett is the Eponymous Founder of Koppett, a consultancy specializing in the use of improv and storytelling techniques to enhance individual and group performance. She has worked with diverse clients including Meta, Apple, Prezi, PwC, NASA, Havas Health, Mass General Hospital, the United Nations and the Clinton Global Initiative.Her book Training to Imagine: Practical Improvisational Theatre Techniques to Enhance Creativity, Teamwork, Leadership, and Learning , is considered a seminal work in the field of Applied Improv and is used by professionals around the world. She has given two TEDx talks on the use of improv to enhance non-theatrical performance.In 2019, Kat was the winner of the North American Simulation and Gaming Association (NASAGA)'s Ifill-Reynold's Lifetime Achievement Award. She is the co-director and a performing member of the Mopco Improv Theatre, a founding member and the current vice-president of the Applied Improvisation Network, and the co-host of the podcast, Performance Shift: The Art of Successfully Navigating Change.Give this a listen! Hosted on Acast. See acast.com/privacy for more information.

Dr. Ben Kleinstiver, whose lab is located at the Center for Genomic Medicine at Mass General Hospital, joins us to talk about programmable nucleases, genome editing, and the applications of this technology in the future of healthcare.

(00:00) The guys discuss the Four Nation’s Faceoff Tournament and Team USA’s and Bruins’ defenseman Charlie McAvoy being hospitalized at Mass General Hospital and will miss the championship game against Team Canada back in the United States on Thursday night. (11:31) Zo and Beetle address the news from yesterday about the Cincinnati Bengals putting the franchise tag on wide receiver Tee Higgins and what this means for the Patriots going forward with potentially pursuing a deal for the all-pro route-runner. (26:01) The guys discuss Mike Breer saying teams with cap space and draft picks should call the Cowboys about acquiring Micah Parsons and if the Patriots should be all-in on Parsons. (33:48) The guys finish out the hour by circling back to the Four Nation’s Faceoff and which nations should be represented in next year's rendition of the tournament.

In this episode, we visit the Bulfinch Building at the Massachusetts General Hospital to examine one of the most, if not the most, significant discoveries in modern medicine. Sarah Alger, the Director of the Paul S. Russell, MD Museum of Medical History and Innovation, shows us the hospital's Ether Dome where the first public surgery using an anesthetic was performed. Back at the MHS, we sit down with Chief Historian Peter Drummey and Curator of Art and Artifacts Emerita Anne Bentley to learn more about the contentious history of this innovation. Learn more about episode objects here: https://www.masshist.org/podcast/season-4-episode-3-painless-revolution Email us at podcast@masshist.org. Episode Special Guest: Sarah Alger is the George and Nancy Putnam Director of Mass General Hospital's Paul S. Russell, MD Museum of Medical History and Innovation. She was a founding editor of Proto, a thought leadership publication that was sponsored by MGH for 17 years. This episode uses materials from: The Bond (Instrumental) by Chad Crouch (Attribution-NonCommercial 4.0 International)        Psychic by Dominic Giam of Ketsa Music (licensed under a commercial non-exclusive license by the Massachusetts Historical Society through Ketsa.uk)        Curious Nature by Dominic Giam of Ketsa Music (licensed under a commercial non-exclusive license by the Massachusetts Historical Society through Ketsa.uk)

In this episode of BrainStorm host Meryl Comer continues her compelling interview with "Rockstar of Science" Dr. Rudy Tanzi, the pioneering Director of the Genetics and Aging Research Unit and Director of the McCance Center for Brain Health at Mass General Hospital. Dr. Tanzi unveils the secrets of brain health and Alzheimer's research. Exploring his innovative SHIELD framework, Dr. Tanzi offers practical strategies for cognitive wellness, from sleep and stress management to diet and lifelong learning.The episode takes an innovative turn with AI-generated questions that probe the challenges of Alzheimer's research. Dr. Tanzi provides candid insights into prevention, early intervention, and the future of medical science, sharing an unexpectedly optimistic view of combating cognitive decline. Blending scientific expertise with actionable advice, this episode is a must-listen for anyone interested in brain health, aging, and medical innovation.Support the show

Join BrainStorm host Meryl Comer as she kicks off 2025 with "Rockstar of Science" Dr. Rudy Tanzi, the pioneering Director of Genetics and Aging Research and Director of the McCance Center for Brain Health at Mass General Hospital. Dr. Tanzi delves into the new FDA-approved drugs, early cognitive blood tests, and why treating Alzheimer's should mirror our approach to heart disease by focusing on prevention long before symptoms appear. Drawing from his decades of research, Dr. Tanzi shares his vision for the future: a simple daily pill that could prevent Alzheimer's just like statins prevent heart disease. Whether you are concerned about brain health or fascinated by cutting-edge medical science, this episode offers hope and practical wisdom from one of the field's most influential voices. You don't want to miss it!Support the show

Like tens of millions of people, Stephen Dubner thought he had a penicillin allergy. Like the vast majority, he didn't. This misdiagnosis costs billions of dollars and causes serious health problems, so why hasn't it been fixed? And how about all the other things we think we're allergic to? SOURCES:Kimberly Blumenthal, allergist-immunologist and researcher at Mass General Hospital and Harvard Medical School.Theresa MacPhail, associate professor of science and technology studies at Stevens Institute of Technology.Thomas Platts-Mills, professor of medicine at the University of Virginia.Elena Resnick, allergist and immunologist at Mount Sinai Hospital. RESOURCES:Allergic: Our Irritated Bodies in a Changing World, by Theresa MacPhail (2023)."Evaluation and Management of Penicillin Allergy: A Review," by Erica S. Shenoy, Eric Macy, and Theresa Rowe (JAMA, 2019)."The Allergy Epidemics: 1870–2010," by Thomas Platts-Mills (The Journal of Allergy and Clinical Immunology, 2016)."Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy," by George Du Toit, Graham Roberts, et al. (The New England Journal of Medicine, 2015). EXTRAS:Freakonomics, M.D.

Chime In, Send Us a Text Message!In this episode, we explore the critical role of social determinants of health (SDOH) in stroke prevention and recovery with an incredible panel of experts from the Bugher Collaborative. Our guests include:Dr. Nirupama Yechoor, Principal Investigator at Mass General Hospital and leader of the Bugher Collaborative.Dr. Devanshi Choksi, neurologist and colleague of Dr. Yechoor at Mass General.Rachel Kitagawa and Sofia Constantinescu, neurology postgraduates from Yale University.We dive into:The Bugher Collaborative: Its mission, the partnership between Mass General, Yale, and UCSF, and how it addresses equity in stroke care.Research Highlights: Insights into how socioeconomic status, access to care, and community support affect stroke outcomes.Yale's Findings: Key demographic differences uncovered through their research and what they reveal about health equity.The Road Ahead: Next steps for the collaborative and their vision for improving stroke care.Magic Wand Wishes: What each guest would change to improve stroke prevention and recovery if they had unlimited resources.This conversation builds on our discussion of the 2024 ASA Stroke Prevention Guidelines, offering a deeper dive into the intersection of health equity and stroke care.Resources and Links:Learn more about the Bugher CollaborativeDr. Nirupama Yechoor's BioDr. Devanshi Choksi's BioRachel Kitagawa's BioSofia Constantinescu's BioSupport Our Show! Thank you for helping us to continue to make great content. We appreciate your generosity! Support the showShow credits:Music intro credit to Jake Dansereau. Our intro welcome is the voice of Caroline Goggin, a stroke survivor and our first podcast guest! Please listen to her inspiring story on Episode 2 of the podcast.Connect with Us and Share our Show on Social:Website | Linkedin | Twitter | YouTube | FacebookKnow Stroke Podcast Disclaimer: Our podcast and media advertising services are for informational purposes only and do not constitute the practice of medical advice, diagnosis or treatment.

Dr. Sandra Hassink is joined by Dr. Lauren Fiechtner, the Director of Nutrition at MassGeneral Hospital for Children in the Division of Gastroenterology and Nutrition. She is also the Associate Professor of Pediatrics at Harvard Medical School. Together they discuss early feeding and food introduction.   Related Resources: • Building a Foundation for Healthy Active Living Modules (tinyurl.com/bdd5tsu6) • Healthy Active Living From Birth to Age 2, Resource Portal (tinyurl.com/4e7zvfnd) • The Role of the Pediatrician in the Promotion of Healthy, Active Living (tinyurl.com/5n8xv2du)

We must all be compassionate. You never know what someone else is going through. - Keely Krantz Keely Krantz got her start in PR, eventually leading the launch of high-profile, global brands. A proud Boston College graduate, she was fortunate to have a mentor who had broken through glass ceilings and believed in passing it on. Says Keely “Janet Diederichs at Edelman Public Relations in Chicago challenged me to be someone I would never have aspired to if it hadn't been for her guidance. I learned to be bold and aggressive.” At the height of Keely's career, she became a mom and decided to stay at home with her kids, choosing parenthood and volunteerism over a career. It was this devotion to community and the greater good that inspired Keely and her husband Jason to make the largest gift in the history of Mass General Hospital cancer research history last year. Says Keely: “We don't want to see small, incremental changes. We want to see fundamental, monumental, landscape-changing breakthroughs in the treatment of cancer, and we are willing to take big risks at the Krantz Family Research Center on physician-scientists who have big, aggressive ideas. We want to swing for the fences.” A few months later, Keely launched her next big chapter as the founder of the O'Dell Women's Center www.odellwomenscenter.com in Springfield, Massachusetts. Named after her 98-year-old grandmother, who was a maternity nurse in the community for 40 years, the O'Dell Center is a first-of-its-kind in Springfield with 10,000 square feet of collaborative space that houses Dress for Success/Western Mass and other non-profits that advance educational and career opportunities for low-income women. In just one year, $250,000 in grants have been awarded. For Keely, this new chapter is the culmination of a story rooted in faith and the lessons of her parents. “Anything is possible” are three words I heard all the time when I was growing up. Says Keely. “I want to be a connector, surrounded by the mantra that respect and kindness go hand in hand. I want to do good.” For 23 minutes of inspiration, just hit that download button. #women #community #cancer @massgeneralcancercenter

David explains, "We went to the Simons Foundation and, with their support, have established a network in the United States. We have three collection sites: one at the UC Davis Mind Institute in Sacramento, one at UT Southwestern in Dallas, Texas, and one at the Mass General Hospital in Boston, where a postmortem brain donation can be sent. Those brains are then prepared in ways that will facilitate all kinds of research both now and in the future. We have developed this resource to foster autism research throughout the world. What we are seeing now that we've just celebrated our 10th anniversary is that we've collected nearly 400 brain donations so far, and we're seeing an increasing demand from researchers worldwide to get access to that resource." Dorothy elaborates, "I was the main support person for my older cousin, Gregory Blackstock, for a couple of decades. He needed a lot of executive function help. He lived on his own but couldn't make critical decisions very well. As long as everything went along without any hitch, he was generally fine. But as he got older and experienced more physical infirmities, then I needed to step up more. So then he was very obviously autistic, so it was kind of peripherally interesting to me." "One of his savant traits was that he was an incredible artist. He also spoke many languages that he picked up by ear. He had a perfect pitch and learned the accordion, but he could easily transfer that information to playing the organ and the piano. He had almost total recall of anything that crossed his path that interested him. And so, just being around him and being involved with furthering his artistic career gave me further insights about the people I met who were interested in autism."   #AutismBrainNet #BrainDonation #AutismResearch #Autism #BrainResearch autismbrainnet.org Listen to the podcast here

This is a conversation with Dr. David Amaral, a distinguished professor at the MIND Institute and scientific director of Autism BrainNet, and Dorothy Frisch, an activist and supporter of the program. Autism BrainNet is funded by the Simons Foundation to collect and study postmortem brain samples from individuals with autism to understand the neurological basis of the disorder better. Currently, there are no biomarkers for autism, so studying the brains and accomplishments of those who had autism can lead to a better understanding of the abilities and challenges seen on the autism spectrum. David explains, "We went to the Simons Foundation and, with their support, have established a network in the United States. We have three collection sites: one at the UC Davis Mind Institute in Sacramento, one at UT Southwestern in Dallas, Texas, and one at the Mass General Hospital in Boston, where a postmortem brain donation can be sent. Those brains are then prepared in ways that will facilitate all kinds of research both now and in the future. We have developed this resource to foster autism research throughout the world. What we are seeing now that we've just celebrated our 10th anniversary is that we've collected nearly 400 brain donations so far, and we're seeing an increasing demand from researchers worldwide to get access to that resource." Dorothy elaborates, "I was the main support person for my older cousin, Gregory Blackstock, for a couple of decades. He needed a lot of executive function help. He lived on his own but couldn't make critical decisions very well. As long as everything went along without any hitch, he was generally fine. But as he got older and experienced more physical infirmities, then I needed to step up more. So then he was very obviously autistic, so it was kind of peripherally interesting to me." "One of his savant traits was that he was an incredible artist. He also spoke many languages that he picked up by ear. He had a perfect pitch and learned the accordion, but he could easily transfer that information to playing the organ and the piano. He had almost total recall of anything that crossed his path that interested him. And so, just being around him and being involved with furthering his artistic career gave me further insights about the people I met who were interested in autism."   #AutismBrainNet #BrainDonation #AutismResearch #Autism #BrainResearch autismbrainnet.org Download the transcript here  

Nishi Vootukuru (@Nishi_Vootukuru) and Dr. Ezra Schwartz (@ezraschwartz10) interview Dr. William Shutze and Dr. Anahita Dua (@AnahitaDua) to discuss the Get a Pulse on PAD Campaign.   The Get a Pulse on PAD initiative (#PulseonPAD), launched in February, 2024, is a patient education and advocacy campaign designed to increase the understanding of peripheral artery disease's risk factors and potential symptoms.     Dr. Shutze is a vascular surgeon with Texas Vascular Associates in Dallas, Texas and the Secretary of the SVS. Dr. Shutze completed his medical studies at Baylor University after completing general surgery residency at University of Alabama in Birmingham. Dr. Shutze returned to Baylor to complete his vascular fellowship. Dr. Shutze is one of the Get a Pulse on PAD initiative's chairs and a leading expert in PAD. He has actively published in the field with over 100 abstracts and articles, with his most recent work focusing on prosthetics, and advocating for successful prosthetic referral after amputation.    Dr. Dua is a vascular surgeon at Mass General Hospital and associate professor at Harvard Medical School. At Mass General, she is the director of the Vascular Lab, co-director of the Peripheral Artery Disease Center and Limb Evaluation and Amputation Program (LEAPP), associate director of the Wound Care Center, director of the Lymphedema Center and director of clinical research for the division of vascular surgery. She serves as the Editor-in-Chief of Journal of Vascular Surgery-Vascular Insights. Dr. Dua completed her undergraduate medical studies at the Aberdeen University School of Medicine in Aberdeen, Scotland. She then completed her general surgery residency at the Medical College of Wisconsin and vascular fellowship at Stanford University Hospital. She holds multiple master's degrees including degrees in trauma sciences and business administration in healthcare management. She also completed certificate programs at the Massachusetts Institute of Technology in health economics and outcomes research as well as in drug and device development. Dr. Dua is a prolific researcher, researcher, and advocate, with much of her work centered on PAD. She furthers patient care not only through research but through her political work as Founder of the Healthcare for Action political action committee (PAC) and member of the SVS PAC Steering Committee.    Special thank you to Jacob Soucey (@JacobWSoucy)   Resources: https://www.secondscount.org/get-a-pulse-pad https://evtoday.com/news/pad-pulse-alliance-survey-highlights-disconnect-in-public-knowledge-of-pad-risks Association of Black Cardiologists (ABC) Society for Cardiovascular Angiography & Interventions (SCAI) Society of Interventional Radiology (SIR) CardioVascular Coalition (CVC) Outpatient Endovascular and Interventional Society (OEIS) https://vascular.org/advocacy/political-action-committee https://evtoday.com/articles/2021-may/the-arc-act-fighting-amputation-via-legislation https://evtoday.com/articles/2006-may/EVT0506_10.html#:~:text=The%20Screening%20Abdominal%20Aortic%20Aneurysm,screening%20as%20a%20Medicare%20benefit CLariTI Study: Natural Progression of High-Risk Chronic Limb-Threatening Ischemia Socioeconomic and hospital-related predictors of amputation for critical limb ischemia  ARC Act of Congress Painkiller: TV Series  Congressman Payne  SAAAVE Act   Follow us @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.  

In this Leveling Up Episode of the PRS Global Open Deep Cuts Podcast, Dr. John Semple discusses his unusual pathway into medicine, three dimensional thinking, prepectoral breast reconstruction, the use of allograft and synthetic meshes, fat grafting in radiated breasts, some tips to make fat harvest easier, how to be a good mentor and a good leader, and how he got involved in climate science. Read a recent classic PRS Global Open article by Dr. Semple and co-authors, “Patient Outcomes after Fat Grafting to the Radiated Chest Wall before Delayed Two-stage Alloplastic Breast Reconstruction”: https://bit.ly/SempleFatGrafting  Dr. John Semple is a Professor in the Department of Surgery at the University of Toronto, and the head of the division of plastic surgery at Women's College Hospital. He is also an adjunct faculty member at the wilderness Medicine Program at Mass General Hospital in Boston, and an adjunct professor at the Ontario College of Art and Design, where was a former chair of the Board of Governors. He trained in art at OCAD and became a fully trained medical illustrator, then went into medicine, training in plastic surgery at the University of Toronto and then completing a microsurgery fellowship at the Toronto General Hospital. He is a past president of the Canadian Society of Plastic Surgeons, and received the Lavina Lickley Lifetime achievement award form the department of surgery at the University of Toronto. He also has a keen interest in mountaineering - and has been to Everest North Col 4 times, and has published numerous papers on the effects of climate change in the Himalayas.  Your host, Dr. Puru Nagarkar, is a board-certified plastic and hand surgeon, and Assistant Professor of Surgery at the University of Texas Southwestern Medical Center in Dallas. #PRSGlobalOpen #DeepCutsPodcast #PlasticSurgery #LevelingUp

In this episode, Chris Koddermann interviews two members of the Center for the Neuroscience of Psychedelics at Mass General Hospital: founding director, author, and co-founder of three drug development companies, Dr. Jerry Rosenbaum; and psychiatrist and associate director and director of cognitive neuroscience, Sharmin Ghaznavi, MD, Ph.D. Rosenbaum and Ghaznavi bonded over an interest in rumination, and wondered: How could the plasticity-inducing effects of psychedelics change these negative loops people find themselves in? How important is the ability to break out of those loops – and learn new patterns – when our concept of self is so central to who we are? Ghaznavi is studying the effects of psilocybin on rumination and scanning patients at multiple times throughout the process to track data we still don't really have: how psychedelic-induced neuroplasticity changes over time, and why. They discuss: How much of a role the default mode network takes in the therapeutic benefits of psychedelics: Is it overblown? Hyperscanning, which involves scanning two individuals at the same time, looking for potential concordance in signal and/or an increased alliance between the therapist and patient The Schultes Legacy Project and the work of Stephen Haggarty to explore the potential of largely unstudied psychoactive plants Critiques of the recent ruling on Lykos and MDMA-assisted therapy and the clash between the FDA and the advisory committee: Were they really on the same page? The false dichotomy of neuroscience vs. patient experience: Does the subjective experience actually increase plasticity and other measurable benefits? and more! For links, head to the show notes page.

We kicked off the program with four news stories and different guests on the stories we think you need to know about!World Lung Cancer Day is coming up (8/1), and only 6% of Americans eligible for screenings actually get them. Dr. Efren Flores - thoracic radiologist at Mass General Hospital joined Dan to discuss.Boneless Chicken Wings Can Have Bones After All, Ohio Supreme Court Rules! John Rizvi – The Patent Professor and Dan review this ruling.Survey: 70% of parents say back-to-school shopping is too expensive! Bill Dendy – Financial Strategist looked at the expenses. New England athletes as they go for gold in the Paris Olympics! More than 40 athletes with local roots or college ties will vie for glory in this year's Games. Amin Touri Boston Globe Multiplatform Editor and Web Producer checked in! Ask Alexa to play WBZ NewsRadio on #iHeartRadio!

Anna Handorf, MD, sheds light on the innovative concept of Tiny Talks in the latest episode of the Faculty Factory Podcast. Tiny Talks serve as a novel medical education tool, designed to deliver concise, impactful virtual chalk talks. Dr. Handorf spearheaded Tiny Talks to help residents overcome scheduling conflicts that often lead to missed educational opportunities. The core objective of Tiny Talks is to distill lengthy lectures into brief, engaging presentations lasting seven minutes or less. Dr. Handorf is an instructor at Harvard Medical School and a pediatric hospitalist at Newton Wellesley Hospital in Newton, Massachusetts. As a former medical education research fellow at Mass General Hospital and Harvard Medical School, she penned an insightful article titled “Let's Chalk About It: Introducing the TinyTalks Curriculum, a Paradigm for Short, Virtual Chalk Talks,” published in Academic Medicine in March 2024. In this week's Faculty Factory Podcast interview, Dr. Handorf elaborates on the structured approach, encompassing a hook, frame, and delivery, essential for crafting an effective Tiny Talk. Learn More Follow Dr. Handorf: https://x.com/AnnaHandorf Email: ahandorf@mgb.org Read the article from Academic Medicine: https://journals.lww.com/academicmedicine/abstract/9900/let_s_chalk_about_it__introducing_the_tinytalks.816.aspx?utm_source=sfmc&utm_medium=email&utm_campaign=amexpress&utm_content=newsletter

This week, Dr. Scott Sigman sits down with Dr. Kevin Raskin, Associate Professor and Chief of Oncology at Mass General Hospital. Here, they discuss his training in musculoskeletal oncology, the passion and team approach he shares with his patients, and more.

Curious about the forces driving healthcare pricing and access? Join us for an enlightening conversation with Sarah Emond, President and CEO of the Institute for Clinical and Economic Review (ICER). Sarah's upbringing in a family passionate about policy and social justice laid the foundation for her impactful career in health policy. We explore her educational journey from Smith College to Brandeis University's Heller School, and how her professional experiences in clinical research and biopharmaceutical consulting shaped her path to ICER.Unravel the complex world of health technology assessment (HTA) in the US as Sarah breaks down the challenges and opportunities within a fragmented healthcare system. ICER's pivotal role in evaluating new medical technologies is discussed in depth, including its interactions with international agencies like the UK's NICE. Sarah sheds light on ICER's evolution from a small initiative within Mass General Hospital to a powerful voice in global HTA practices, emphasizing the importance of fair pricing, patient access, and sustainable innovation funding.Equity in healthcare takes center stage as Sarah introduces ICER's updated value assessment framework. Learn about new tools like the clinical trial diversity rating and the Health Improvement Distribution Index (HIDI) designed to promote representation of diverse populations in clinical trials. We also tackle the high costs and value-based pricing of innovative treatments, including gene and cell therapies, and the necessity of evolving payment systems to ensure continuous innovation. Tune in to gain a comprehensive understanding of the pressing challenges and future directions in healthcare pricing, equity, and access.Host David E. Williams is president of healthcare strategy consulting firm Health Business Group. Produced by Dafna Williams.

Dr. Alessio Fasano, who is considered the world's leading expert in celiac disease and gluten-related disorders, returns for his second appearance on STEM-Talk. Although just 2 million Americans have celiac disease, an estimated 20 million Americans suffer from gluten sensitivity. Alessio is a professor and director of the Mucosal Immunology and Biology Research Center at Massachusetts General Hospital. In addition to celiac disease and gluten-related disorders, Alessio's research is also focused on the microbiome, intestinal permeability and autoimmune disorders, which he discussed in his first interview on STEM-Talk, episode 20. Since Alessio's first appearance on STEM-Talk in 2016, he has published two books, “Gluten Freedom” and “Gut Feelings: The Microbiome and Our Health,” which we discuss in today's interview. We also talk to Alessio about an exciting new project that's bringing together an international consortium of researchers and scientists for a long-term study that will follow infants who are genetically at risk of developing celiac. Alessio is a researcher and physician who wears many hats. He is the director of the Center for Celiac Research and Treatment and chief of the Division of Pediatric Gastroenterology and Nutrition at Mass General Hospital. He also is a professor of pediatrics at Harvard Medical School and a professor of nutrition at Harvard's T.H. Chan School of Public Health. Show notes: [00:03:58] Marcas opens the interview welcoming Alessio back to STEM-Talk, mentioning that since his last appearance he has written two books: Gluten Freedom and Gut Feelings: The Microbiome and Our Health. Marcas asks Alessio how he became interested in pediatrics and gastroenterology. [00:05:42] Ken mentions that Alessio moved to the U.S. in the 1990s and spent 20 years in Maryland at the Center for Vaccine Development in Baltimore. Ken goes on to mention that while Alessio was there, he founded The Center for Celiac Research in 1996, and in 2003, Alessio accepted an offer to join Massachusetts General Hospital. Ken asks how that move came about. [00:08:53] Marcas asks about Alessio's early career working on cholera, where he discovered the zonula occuldens toxin, the bacteria that causes cholera. Marcas asks Alessio to talk about this finding and the insights he gleaned from it. [00:16:03] Ken asks about Alessio's discovery of zonulin, which is the molecule that modulates gut permeability in humans. Ken asks Alessio to share how this discovery led him to investigate celiac disease, which is triggered by gluten. [00:20:25] Ken asks Alessio what his thoughts are on why the medical community, historically, has not taken celiac disease seriously. [00:24:08] Marcas mentions that as we age, there is evidence that the gut becomes leakier, which is highly related to chronic inflammation. Marcas asks Alessio whether this happens to the gut over time due to diet and lifestyle rather than the typical aging process. [00:28:45] Ken mentions that there has been an increase in the diagnosis of celiac disease. Ken asks Alessio if that is due to an actual increase in the prevalence of the disease, or is it tied to a growing appreciation that clinicians have now for the disease? [00:29:32] Marcas mentions that Alessio's book, Gluten Freedom, which he co-authored with his colleague Susie Flaherty, was referred to by the Celiac Disease Foundation as “a must have,” and “an excellent reference for those with gluten related disorders.” Marcas asks Alessio about this reception to his book. [00:31:24] Marcas mentions that the only viable treatment for individuals with celiac disease has been a gluten-free diet, with pharmaceutical companies having had little interest until recently in investigating the disease. Now there are more than 20 drug therapies in development for celiac. Marcas asks Alessio about the progress being made to develop pharmacological interventions for celiac.

Dr. Lisa Wong joins us for Episodes 8...and 9! Marlon sits down with Dr. Lisa Wong, pediatrician, musician, arts advocate, and author. She is the Co-Founder of the Arts and Humanities Initiative at Harvard Medical School, pediatrician at Milton Pediatric Associates, and an assistant clinical professor of pediatrics at Harvard Medical School. Dr. Wong also co-founded and serves as associate co-director of the Arts and Humanities Initiative, and the former president and a current violinist in the Longwood Symphony Orchestra, Boston's medical community ensemble. 

America's military must return our service members back to society ready to lead. Special operators are given the best tools in the military to do their jobs. They're also completely immersed into the special forces lifestyle with almost no distractions. Yet when they leave service, they're often left to themselves to find the right tools and to figure out what training they need to be successful in the next chapter. Two of America's most important organizations have partnered to bring our Veterans the best tools and training all wrapped up into an immersive, life changing program. For the third episode of our 2023 Army Navy Game tailgate series Fran Racioppi sat down with retired Brigadier General Jack Hammond, CEO of Home Base. Home Base is founded and supported by the Boston Red Sox and Mass General Hospital; a formidable team dedicated to winning and solving the most complex challenges in medicine and athletic performance.Home Base provides leading edge clinical care to the medical challenges faced by our veterans; including the effects of prolonged blast exposure, mental trauma, diabetes and even cancer. Veterans train directly with the best medical and athletic performance professionals in the industry with one goal in mind; return our military personnel back to society ready to perform at the highest level and continue to lead others. Take a listen, watch or read our conversation…and whether you're from Beantown or not, this is a Red Sox game you want to be a part of. The Jedburgh Podcast and the Jedburgh Media Channel are an official program of The Green Beret Foundation. Learn more on The Jedburgh Podcast Website. Subscribe to us and follow @jedburghpodcast on all social media. Watch the full video version on YouTube. Highlights:0:00 Welcome to the Army Navy Game Tailgate3:50 Home Base is built by the Boston Red Sox & Mass General7:06 Two months of therapy in two weeks11:18 How Home Base is treating Operator Syndrome16:38 How to support Home Base17:50 Proven results of the programQuotes: “When you look at the opportunity with those two powerhouse organizations and what the potential is to actually bend the curve and make a difference; they had me at hello.” (5:30) “We have access to the best clinical resources in the world. Bar none.” (6:12) “We created this 14-day intensive clinical program…that compresses two years of therapy into two weeks.” (8:55)“We're gonna be able to figure out what are the downstream chronic illnesses associated with concussive injury.” (13:49) “If you don't have the tools to do a job, it's like a monkey trying to change a tire with a screwdriver.” (19:50)

What is silent reflux? Find out in this episode of the MindBodySpace podcast, hosted by Dr. Juna. Every last Friday of the month, she is joined by her guest Dr. April Hirschberg to discuss evidence backed ways to decrease stress and increase resilience. Dr. April is a board certified psychiatrist specializing in lifestyle and mind-body medicine at Mass General Hospital, Harvard Medical School. They delve into how stress management and healthy lifestyle choices play a critical role in combating mental and physical health issues. This episode particularly focuses on gastroesophageal reflux disease (GERD), its symptoms, consequences, and misdiagnosis. They share personal experiences and insights into how stress exacerbates digestive issues, the significance of the gut-brain axis, and the role of the enteric nervous system. Practical advice is offered on managing stress through breathing exercises, mindfulness, proper diet, hydration, and the importance of not eating late to prevent reflux. Additionally, they emphasize the critical nature of seeking medical advice for persistent symptoms and the benefits of incorporating movement and enjoyable activities into daily routines for overall well-being. 00:00 Unveiling the Mystery: Why Stop Eating Early? 00:16 Welcome to the MindBodySpace Podcast 00:21 Stress Management with Dr. Hirschberg 01:31 The Gut-Brain Connection and Stress Impact 01:47 Misdiagnosed Reflux 07:40 Lifestyle Changes and Managing Reflux 15:15 Mindful Eating and Stress Reduction Techniques 22:15 Embracing Movement and Self-Care for Digestive Health 27:32 Closing Thoughts and Encouragement --- Support this podcast: https://podcasters.spotify.com/pod/show/mindbodyspace/support

Tune in for a deep chat about psychedelic research, psychedelic assisted therapies, trauma healing, and more! Our guest Elowyn Samadhi, PhD (she/they) is a licensed clinical psychologist who specializes in the treatment of PTSD and other trauma-related disorders. She works in private practice and at Sage Integrative Health, a holistic psychedelic clinic in the Bay Area. Elowyn served as an independent rater for the Phase II and III MAPS MDMA trials for 4 years and began providing post-IV ketamine integration in 2015 at Mass General Hospital. She completed ketamine-assisted psychotherapy training with Polaris Insight Center and the MAPS MDMA-Assisted Therapy training. She also completed the UC-Berkeley Psilocybin Advanced Facilitator Training under the mentorship of Dr. Susana Bustos and is qualified to provide legal psilocybin services in Oregon. Dr. Samadhi serves as lead psilocybin therapist for the UCSD phantom limb pain clinical trial and has trained several of the co-therapists. She has guest lectured for Alchemy Community Therapy Center in Oakland and Beckley Academy, and supervises and mentors several psychedelic therapists-in-training. Elowyn is in her final year of the 3-year Somatic Experiencing training. Dr. Samadhi has a passion for teaching somatic therapy, safe and reparative touch work, as well as the ritual and spiritual praxis of guiding. Elowyn is biracial and bisexual and the bedrock of her spiritual path is non-dual, tantric, animistic, and pagan. We talk about psychedelic assisted healing modalities, the current research on psychedelics, MAPs, neuroplasticity, trauma healing,   Elowyn: https://www.elowynsamadhiphd.com/ https://tetheredhealing.com/   Past episode mentioned: https://slutsscholars.libsyn.com/198-the-war-on-drugs-with-ifetayo-harvey-of-thepoc-psychedelic-collective     FOLLOW US  Twitter Instagram Facebook Send questions, comments, stories, rants to: SlutsAndScholars@gmail.com Sluts And Scholars is a production of sluts and scholars media.   Loving disclaimer:  Sluts and Scholars is a podcast produced by Sluts & Scholars Media, LLC. It is a shame free educational podcast made for your entertainment and informational desires only. The podcast, any opinions we share, and any resources including social media and emails from us are not therapy, medical care or professional advice and do not create a patient-client relationship. None of the information, opinions, suggestions, resources or exercises mentioned in this podcast should be used without clearance from your health care provider. All opinions, information and ideas expressed by the guests are solely their own. If you need emergency mental health or medical help, please call 911 or 988 or go to your nearest emergency center. We hope you enjoy the show.