Podcast appearances and mentions of meta analysis

James and Cliff walk you through all the latest MTGFinance news including the weekly Meta Analysis, Fast Movers, Cards to Watch and go over the latest bannings and what they may impact.

Suplementacja kolagenem w ostatnich latach zyskała ogromną popularność. Jej zastosowanie upatruje się szczególnie w kontekście zdrowia skóry, włosów, czy stawów (a więc głównie w kosmetologii i sporcie). Biorąc pod uwagę jak ważny jest kolagen w naszym organizmie i, że wraz z wiekiem produkujemy mniej kolagenu, wydawać by się mogło to sensowne. Ale czy faktycznie? Co na to dowody naukowe? Czy suplementacja kolagenem może mieć sens? __

James and Cliff walk you through all the latest MTGFinance news including the weekly Meta Analysis, Fast Movers, Cards to Watch and get into the trenches on the latest price increases.

On this episode of the AMSSM (T: @TheAMSSM) Sports Medcast, host Dr. Devin McFadden, MD (T: @ArmySportsDoc), is joined by Dr. Adam Tenforde, MD (T: @AdamTenfordeMD), to discuss the a recently published manuscript titled “Bone Stress Injuries in Runners Using Carbon Fiber Plate Footwear.” In this conversation, Dr. Tenforde addresses the following topics related to the article: ● Explanation of the use of Carbon Fiber Plate (CFP) technology in footwear and why it's become so popular ● Addressing the rapid changes and progression of record-breaking performance in the running community as a result of this footwear ● Discussing his article featuring a case series of navicular bone stress injuries in runners using CFP footwear ● Providing some general recommendations for safely using CFP footwear, as well as raising awareness on the possible health concerns of this new technology Additional Resources: Bone Stress Injuries in Runners Using Carbon Fiber Plate Footwear https://link.springer.com/article/10.1007/s40279-023-01818-z Return to Sport Following Low-Risk and High-Risk Bone Stress Injuries: A Systematic Review and Meta-Analysis https://bjsm.bmj.com/content/early/2023/01/24/bjsports-2022-106328

This week the hosts cover the latest news on the origins of the COVID-19 pandemic, the newly authorized rapid at-home test for flu and COVID, and new RSV vaccines on the horizon. The hosts dive deep into a new Cochrane review about the effectiveness of masks against flu and COVID, and how it compares to other studies on how masks work.   “Based on the studies that are out there in controlled environments when individuals are masked properly, it does help stop the spread and it certainly protects those who are wearing the masks,” says Steven Newmark, Director of Policy at GHLF.   Among the highlights in this episode 00:57- Zoe and Steven kick off the episode by talking about the theory that COVID leaked from a lab in Wuhan, China   02:43- The FDA has recently authorized the first over-the-counter at-home test for flu and COVID   04:02- FDA advisors have voted to recommend the approval of the country's first RSV vaccine   05:28- Zoe and Steven talk about today's big news topic, the Cochrane meta-analysis that states masks aren't as effective as once thought   06:51- Steven walks us through some of the intricacies of the study   08:02- Zoe explains why the results of this study may not be what it seems   09:59- Steven shares the details of the experiments that determined the effectiveness of masks against COVID-19   12:13- After looking at studies that show the effectiveness of masks, Zoe and Steven discuss the shortcoming of the Cochrane Study   16:40- Steven and Zoe share their learnings from today's episode Contact Our Hosts Steven Newmark, Director of Policy at GHLF: snewmark@ghlf.org Zoe Rothblatt, Associate Director, Community Outreach at GHLF: zrothblatt@ghlf.org We want to hear what you think. Send your comments in the form of an email.See omnystudio.com/listener for privacy information.

In this episode, we discuss an updated review of 11 studies that seek to evaluate the effect of antidepressants on the risk of hip and vertebral bone fractures. Although the overall effect size seems large, the absolute risk increase might be small. Faculty: Jim Phelps, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CMEs: Quick Take Vol. 43 Antidepressants and Vertebral and Hip Risk Fracture: An Updated Systematic Review and Meta-Analysis

James and Cliff walk you through all the latest MTGFinance news including the weekly Meta Analysis, Fast Movers, Cards to Watch and dig into all the fresh reveals related to Commander Masters, March of the Machine and the Lord of the Rings Magic set.

Podcast:  Women's Health: Surgical Options for Weight Management    Evaluation and Credit:  https://www.surveymonkey.com/r/MedChat22    Target Audience             This activity is targeted toward primary care specialties.    Statement of Need  A recent study released indicated that approximately 35% of the population is Kentucky is obese; putting Kentucky in the top 10 list for obesity in the US. The negative effects of obesity on a patient's health increases decreases their quality of life, increases co-morbidities and risk of early death; therefore it is important for providers to be knowledgeable about viable surgical treatment options so that these can be discussed with patients.      This program will provide those that listen an overview of the different bariatric surgical procedure.  This will include the indications, contraindications as well as patient outcomes. This information will give providers information necessary to advice patients on viable surgical options for weight management.   Objectives    At the conclusion of this offering, the participant will be able to:    1.     Discuss the patient selection process / criteria for bariatric surgery. 2.     Describe different surgical options for weight management; including criteria, indications, contraindications and outcomes.  3.     Review appropriate pre- and post-operative management following bariatric surgery.   Moderator Ryan G. Nazar, M.D., EMHA Clinical Effectiveness Director, Quality Management Norton Medical Group   Speaker Jeffrey Allen, M.D. Bariatric Surgery Director of Bariatric Surgery for Norton Weight Management Services.     Moderator, Speaker and Planner Disclosures   The speaker, moderator and planners for this activity have no potential or actual conflicts of interest to disclose.     Commercial Support   There was no commercial support for this activity.    Physician Credits   American Medical Association   Accreditation  Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians.   Designation  Norton Healthcare designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.     Date of Original Release |January 2021  Course Termination Date | December 31, 2023 Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org     Resources for Additional Study     Jalal, Asif, Systematic Review and Meta-Analysis of Endoscopic Sleeve Gastroplasty with Comparison to Laparoscopic Sleeve Gastroectomy; Obesity Surgery (2020) 30:2754-2762. https://pubmed.ncbi.nlm.nih.gov/32304011/     Novikov, Aleksey, et. al.; Endoscopic Sleeve Gastroplasty, Laparoscopic Sleeve Gastrectomy, ad Laparoscopic Band for Weight Loss:  How Do They Compare? J. Gastroninest. Surg. (201) 22:267-273.  https://pubmed.ncbi.nlm.nih.gov/29110192/     Schroeder, Robin, M.D., et. al.; Treatment of Adult Obesity with Bariatric Surgery, American Academy of Family Physicians, 2016.   Sharaiha, Reem Z., et. al.; Five-Year Outcomes of Endoscopic Sleeve Gastroplasty for the Treatment of Obesity; Clinical Gastroenteroloy and Hepatology, Nov. 2020.     Sherf-Dagan, Shiri, et. al.; Nutritional Assessment and Preparation for Adult Bariatric Surgery Candidates: Clinical Practice; Advances in Nutrition, 10 October 2020. https://academic.oup.com/advances/advance-article/doi/10.1093/advances/nmaa121/5920778     

James and Cliff walk you through all the latest MTGFinance news including the weekly Meta Analysis, Fast Movers, Cards to Watch and our full set review of Phyrexia: All Will Be One for Pioneer, Modern, EDH and Legacy.

A client reports she has Sprengel's deformity and was told never to get massage or chiropractic. Nonetheless, she finds that massage is very helpful! What is Sprengel's deformity? And what are the questions we need to ask so we can make safe and effective clinical decisions? Spoiler alert: It's not as tricky as it sounds, and you'll find out on this episode of “I Have a Client Who . . .”   Sponsors:       Books of Discovery: www.booksofdiscovery.com       Advanced-Trainings: www.advanced-trainings.com   Host Bio:                    Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP's partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner's books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.                                      Recent Articles by Ruth:          “Working with Invisible Pain,” Massage & Bodywork magazine, November/December 2022, page 36, http://www.massageandbodyworkdigital.com/i/1481961-november-december-2022/38   “Unpacking the Long Haul,” Massage & Bodywork magazine, January/February 2022, page 35, www.massageandbodyworkdigital.com/i/1439667-january-february-2022/36.   “Chemotherapy-Induced Peripheral Neuropathy and Massage Therapy,” Massage & Bodywork magazine, September/October 2021, page 33, http://www.massageandbodyworkdigital.com/i/1402696-september-october-2021/34.             “Pharmacology Basics for Massage Therapists,” Massage & Bodywork magazine, July/August 2021, page 32, www.massageandbodyworkdigital.com/i/1384577-july-august-2021/34.         Resources:    Pocket Pathology: https://www.abmp.com/abmp-pocket-pathology-app   Kafadar, C. et al. (2016) ‘Omovertebral bone associated with Sprengel deformity presented with chronic cervical pain', The Spine Journal, 16(2), p. e43. Available at: https://doi.org/10.1016/j.spinee.2015.09.044.   Köhler, S. et al. (2021) ‘The Human Phenotype Ontology in 2021', Nucleic Acids Research, 49(D1), pp. D1207–D1217. Available at: https://doi.org/10.1093/nar/gkaa1043.   Sprengel's Deformity - Pediatrics - Orthobullets (no date). Available at: https://www.orthobullets.com/pediatrics/4038/sprengels-deformity (Accessed: 15 February 2023).   Zarantonello, P. et al. (2021) ‘Surgical Treatment of Sprengel's Deformity: A Systematic Review and Meta-Analysis', Children, 8(12), p. 1142. Available at: https://doi.org/10.3390/children8121142.   Wikimedia, authors Stelzer, John W.; Flores, Miguel A.; Mohammad, Waleed; Esplin, Nathan; Mayl, Jonathan J.; Wasyliw, Christopher Available at: https://commons.wikimedia.org/wiki/File:Klippel%E2%80%93Feil_syndrome_and_Sprengel%27s_deformity.png   About our Sponsor:   Massage Mentor Institute   In 2019, Diane Matkowski, aka the Massage Mentor, began a closed Facebook page for hosting discussions with industry leaders. These interviews gave her an idea for The Massage Mentor Institute and Jam Series workshops. The goal was to create various continuing education classes offered in one spot. The Institute is a space for massage therapists to learn different approaches and philosophies of bodywork and business classes. It's also home to the Shoulder, Hip, Neck, and Back Jam workshops. We believe that no one technique works for every human being. Our goal is to help you find your path. We have selected teachers we trust, admire, and believe will help you grow as a licensed massage therapist.   Website: themassagementorinstitute.com   Facebook Group: facebook.com/themassagementor   Instagram: @massagementorinstitute  

Episode Summary This week, I am speaking to Daryl Urbansaki, who spent years doing Meta-Analysis to finally study at least - on a scientific basis the ultimate key success factors in business that make money across the board! These business success factors are the ones you would want to take a list on! Key factors in small business success or any business may seem complicated to you, but the truth is, Daryl has had it summarised for you! While he's able to do half the battle for you, good and effective leadership is still crucial for it not to work against you and your business objectives. At the end of the day, concepts are only as good as the ones implementing them. Magic happens when you put your mind into it! Learn how you can integrate these critical success factors examples in your business, and navigate it to your advantage!Listen to this week's show and learn:  8 fail-proof key success factors in business that make money; Where do business owners struggle the most?; The single most important thing a business owner can focus on.  Episode Resources:  Best Business Coach Linkedin Mads Singers Free Management Training Join Mads Singers Management Group  Enjoyed Mads Singers' podcast? Check out these: #141: TaJuanna Taylor on Learning from Other Leaders and Mastering Your Skillset#34: Ludovic Vuillier on Effective Sales Framework#29: Melinda Byerley on Priorities and ManagementHave comments about the show?Hey, do you have ideas for topics you'd like Mads Singers on future episodes? He'd love to hear from you at mads@madssingers.com!

James and Cliff walk you through all the latest MTGFinance news including the weekly Meta Analysis, Fast Movers, Cards to Watch and a detailed discussion of the state of paper Magic the Gathering play in 2023.

Today we're talking about Biden's State of the Union address last night. We cover some of the funniest moments from the night – Biden gaffes included – but we also break down some of the topics he brought up, from the praise of abortion (cue roaring applause from the Democrats) to violence and gun control to taxes and oil. The Republicans were particularly heated throughout the speech, yelling back at the president's claims on fentanyl at the border and the GOP's supposed plans for Social Security. We debunk some of Biden's claims, and we take a look at Sarah Huckabee Sanders' response on behalf of the GOP. --- Timecodes: (00:40) State of the Union (05:45) Jill Biden kiss (07:54) Biden gaffs (11:13) Abortion (19:40) "Transgender young people" (24:52) Violence (28:04) Fentanyl (33:04) Social security (37:05) Taxing the rich (40:15) Oil (43:13) GOP response --- Today's Sponsors: Birch Gold — protect your future with gold. Text 'ALLIE' to 989898 for a free, zero obligation info kit on diversifying and protecting your savings with gold. EdenPURE — go to EdenPureDeals.com and use promo code 'ALLIE' to buy one, get one free (THIS WEEK ONLY)! A'Del — go to adelnaturalcosmetics.com and enter promo code "ALLIE" for 25% off your first order! Naturally It's Clean — visit https://naturallyitsclean.com/allie and use promo code "ALLIE" to receive 15% off your order. If you are an Amazon shopper you can visit https://amzn.to/3IyjFUJ. The promo code discount is only valid on their direct website at www.naturallyitsclean.com/Allie. --- Links: The Heritage Foundation: "Puberty Blockers, Cross-Sex Hormones, and Youth Suicide" https://www.heritage.org/gender/report/puberty-blockers-cross-sex-hormones-and-youth-suicide Criminal Justice Policy Review: "Do Crisis Intervention Teams Reduce Arrests and Improve Officer Safety? A Systematic Review and Meta-Analysis" http://www.gocit.org/uploads/3/0/5/5/30557023/sept_19_event_meta-analysis_crisis_intervention_training_for_police.pdf DEA: "Drug Enforcement Administration Announces the Seizure of Over 379 million Deadly Doses of Fentanyl in 2022" https://www.dea.gov/press-releases/2022/12/20/drug-enforcement-administration-announces-seizure-over-379-million-deadly NBC News: "Democrats scoff, boo, groan, glower at Trump's State of the Union" https://www.nbcnews.com/storyline/2018-state-of-the-union-address/democrats-scoff-boo-groan-glower-trump-s-state-union-n843146 Tax Foundation: "10 Common Tax Myths, Debunked" https://taxfoundation.org/taxedu-primer-10-common-tax-myths/ The Heritage Foundation: "In 1 Chart, How Much the Rich Pay in Taxes" https://www.heritage.org/taxes/commentary/1-chart-how-much-the-rich-pay-taxes --- Buy Allie's book, You're Not Enough (& That's Okay): Escaping the Toxic Culture of Self-Love: https://alliebethstuckey.com/book Relatable merchandise – use promo code 'ALLIE10' for a discount: https://shop.blazemedia.com/collections/allie-stuckey Learn more about your ad choices. Visit megaphone.fm/adchoices

Hailing from the Pacific Northwest - Bobby Barrz is a Rapper, Studio Engineer, A Leader, and the CEO & Creator of BigBet Studios. This talk from Bobby is free game. If you have dreams or goals or aspirations... you'll EAT listening to this conversation. Bobby comes from a place of truth and authenticity and doesn't sugar-coat or add baggage to his wisdom. He speaks from the heart and works hard to get where he is. He's here to drop barrz about winning and playing the game. He shares his journey and what he's been learning along the way and offers some amazing perspectives to young men and aspiring dream chasers. We talk about personal responsibility, learning from mistakes, giving ourselves grace, growing and gaining muscle to conquer larger obstacles as we expand, moving forward as a man, and staying motivated and disciplined. For Bobby, this isn't just about music, it's about building a brand and a legacy. We explore our writing styles as artists, we talk about finding your voice, processing life through story and art, inspiring other people through our work, being a good example for onlookers, putting yourself into the right position to answer the call when it comes, music as therapy, being a community with yourself, sacrifice, and being true to your aspirations. If you enjoyed the episode, send to a friend! - we'll see ya next episode. Checkout more of Bobby and Big Bet here - https://linktr.ee/bobbybarrz?fbclid=PAAab0CovjjM5N34BGRhBWTGk_4i65IA59W1cMR4pZlSrsytMJnG122AwNUiQ Whatcha not gon' do, is put yourself into a position to not answer the call when it comes. Get to work. Hit like and follow to stay up to date - for more content from the host, follow @jacobfromtheinternet

James and Cliff walk you through all the latest MTGFinance news including the weekly Meta Analysis, Fast Movers, Cards to Watch and a discussion of the new Secret Lair Winter Superdrop.

“Final Grade: C+: The program is not research based, IE most of the principles are not supported by the meta-analysis data.” - Nate JosephNate discusses his findings and how he does it! He says he is “just a teacher,” geeking out on the research. Tune in!! Article: https://www.teachingbyscience.com/fountas-and-pinnell-meta-analysisFollow Nate on Twitter: @NateJoseph19Nate's books: https://www.teachingbyscience.com/booksNate's blog: https://www.pedagogynongrata.com/The Literacy View is an engaging and inclusive platform encouraging respectful discussion and debate about current issues in education. Co-hosts Faith Borkowsky and Judy Boksner coach teachers, teach children to read, and hold master's degrees in education.Our goal is to leave listeners thinking about the issues and drawing their own conclusions.Get ready for the most THOUGHT-PROVOKING AND DELICIOUSLY ENTERTAINING education podcast!

Existe-t-il ou non une différence entre les sexes en matière de libido ? Combien de fois par jour les hommes et les femmes pensent au sexe ? Les hommes ont-ils vraiment plus de pulsions que les femmes ?  Comment fonctionne l'orgasme dans le cerveau d'un homme et d'une femme ? Durant une trentaine de minutes, on répond à toutes ces questions avec Thomas Messias du podcast Mansplaining !  Porno, orgasme ou libido : en mêlant mes connaissances neuroscientifiques aux approches sociologiques de Thomas, on évoque dans cet épisode les différences et similitudes des genres côté sexe. L'épisode propose de dépasser les idées reçues et d'ouvrir de nouvelles perspectives sur le sexe, le genre et le fonctionnement de l'être humain. ____________ Mansplaining : À propos du podcast Lancé en novembre 2018 par Slate Podcasts, Mansplaining, créé et animé par Thomas Messias, «homme blanc, cisgenre, hétérosexuel», s'est imposé comme une référence sur les questions de genre et les nouvelles masculinités. En s'appuyant sur des œuvres culturelles ou des sujets d'actualité, Thomas et ses invités interrogent les comportements masculins induits par les constructions et injonctions sociales et les réflexes systémiques. ____________ Sources :  «Les mille facettes de la sexualité», Thema (novembre 2022) «Virtual Reality Is Sexist: But It Does Not Have to Be», Stanney, Fidopiastis, Foster (31 janvier 2020) «Porn use and men's and women's sexual performance: evidence from a large longitudinal sample», Psychological Medicine (2022) «Sex drive: Theoretical conceptualization and meta-analytic review of gender differences», Frankenbach, Weber, Loschelder, Kilger, Friese (2022) «Couples' Sexual Communication and Dimensions of Sexual Function: A Meta-Analysis», Université du Texas (2019) «He is a Stud, She is a Slut! A Meta-Analysis on the Continued Existence of Sexual Double Standards», Personality and Social Psychology Review (2020) «A Meta-Analytic Review of Research on Gender Differences in Sexuality», Université du Wisconsin (1993-2007)

En mêlant les connaissances neurologiques d'Anaïs Roux du podcast Neurosapiens aux approches sociologiques de Thomas Messias, cet épisode spécial de Mansplaining évoque les différences et similitudes des genres côté sexualité. Existe-t-il ou non une différence entre les sexes en matière de libido? Comment fonctionne l'orgasme dans le cerveau d'un homme et d'une femme? Combien de fois par jour les hommes et les femmes pensent-ils au sexe? Existe-t-il des différences hommes-femmes dans les comportements sexuels? Basé sur des échanges de notes vocales des deux hosts, l'épisode propose de dépasser les idées reçues et d'ouvrir de nouvelles perspectives sur le sexe, le genre et le fonctionnement de l'être humain. Un mercredi sur deux, Mansplaining observe les masculinités à travers des œuvres culturelles et des faits d'actualité. Parce que la parole masculine est archi dominante, sauf lorsqu'il s'agit de remettre en question les privilèges des hommes. Références: «Les mille facettes de la sexualité», Thema (novembre 2022) «Virtual Reality Is Sexist: But It Does Not Have to Be», Stanney, Fidopiastis, Foster (31 janvier 2020) «Porn use and men's and women's sexual performance: evidence from a large longitudinal sample», Psychological Medicine (2022) «Sex drive: Theoretical conceptualization and meta-analytic review of gender differences», Frankenbach, Weber, Loschelder, Kilger, Friese (2022) «Couples' Sexual Communication and Dimensions of Sexual Function: A Meta-Analysis», Université du Texas (2019) «He is a Stud, She is a Slut! A Meta-Analysis on the Continued Existence of Sexual Double Standards», Personality and Social Psychology Review (2020) «A Meta-Analytic Review of Research on Gender Differences in Sexuality», Université du Wisconsin (1993-2007) Mansplaining est un podcast de Thomas Messias, produit par Slate.fr sous la direction de Christophe Carron et Benjamin Saeptem Hours. Production éditoriale: Benjamin Saeptem Hours et Nina Pareja, avec Léonard Billot, Clélia Simpson et Arthur Soria pour LACMÉ Production Réalisation et montage: Benjamin Saeptem Hours et Nina Pareja Musique: «Warm Sea», Savvier et «Keep on going», Joakim Karud Si vous aimez Mansplaining, pensez à l'exprimer en lui donnant la note maximale sur votre plateforme de podcast préférée, en en parlant autour de vous et en laissant plein de commentaires bienveillants sur les réseaux sociaux Suivez Slate Podcasts sur Facebook et Instagram (retrouvez-y aussi le compte de Mansplaining).

Drs. Robert Whittington and Jean Wong discuss the article “Association Between the FRAIL Scale and Postoperative Complications in Older Surgical Patients: A Systematic Review and Meta-Analysis” published in the February 2023 issue of Anesthesia & Analgesia.

Cliff rejoins James on cast to dive in on all the latest MTGFinance news including the weekly Meta Analysis, Fast Movers, Cards to Watch and notes on the latest Phyrexia: All Will Be One card reveals.

On Episode 24 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the January 2023 issue of Stroke: “Covert Brain Infarction as a Risk Factor for Stroke Recurrence in Patients With Atrial Fibrillation” and “Subarachnoid Hemorrhage During Pregnancy and Puerperium.” She also interviews Dr. Georgios Tsivgoulis about his article “Clinical, Neuroimaging, and Genetic Markers in Cerebral Amyloid Angiopathy-Related Inflammation: A Systematic Review and Meta-Analysis.” Dr. Negar Asdaghi:         Let's start with some questions. 1) When during pregnancy is an intracranial aneurysm at the highest risk of rupture? 2) What does the presence of covert brain infarcts mean in the setting of atrial fibrillation? 3) And, finally, how is the inflammatory form of cerebral amyloid angiopathy different from the classic CAA form, and why is it important to differentiate between the two? We'll be answering these questions and much more in today's podcast. We're covering the latest in cerebrovascular disorders, and this is the best in Stroke. Stay with us. Welcome back to another issue of the Stroke Alert Podcast. My name is Negar Asdaghi. I'm an Associate Professor of Neurology at the University of Miami Miller School of Medicine and your host for the monthly Stroke Alert Podcast. Together with my co-editors, Drs. Nastajjia Krementz and Eric Goldstein, here's our article selection for the month of January. Symptomatic intracerebral hemorrhage is a feared complication of reperfusion therapies in acute stroke, so there's a lot of interest in looking for predictors of development of this complication, especially when you're making decisions for pursuing endovascular therapy. For many years now, we've known about some of these predictors, such as presence of a large infarct core and high blood glucose levels. But in the recent years, other radiographic markers of tissue viability, such as a poor collateral status and unfavorable venous outflow profile, have been shown to be predictors of post-reperfusion hemorrhagic transformation. In this issue of the journal, we learn about another imaging marker that can potentially predict parenchymal hemorrhage occurrence post-endovascular therapy, which is high hypoperfusion intensity ratio, or HIR, as measured by perfusion imaging. What is HIR? It's a long name for a simple ratio that can easily be measured by dividing the volume of tissue with Tmax delay of over 10 seconds to the volume of tissue with Tmax delays of over 6 seconds. Simply put, Tmax 10 divided by Tmax 6. These volumes, as you know, are typically provided to us by almost all post-processing perfusion softwares, and so this ratio can be easily calculated in the acute setting. So, in this paper led by Dr. Tobias Faizy from University Medical Center in Hamburg and colleagues, we learned that higher hypoperfusion intensity ratios are strongly associated with parenchymal hemorrhage occurrence after endovascular therapy. So, in summary, HIR, that is a quantitative ratio, can be used as a marker to risk stratify patients that are undergoing endovascular therapy in terms of helping us predicting the risk of development of intracerebral hemorrhage after reperfusion therapies. In a separate study in this issue of the journal, we read a very interesting paper titled "Anti-Epileptic Drug Target Perturbation and Intracranial Aneurysm Risk." How are intracranial aneurysms even related to anti-epileptic drugs? Well, first of all, it's been known for a long time based on genome-wide association studies that there are multiple common genes that are associated with increased risk of intracranial aneurysm development. Now, some of the largest genetic studies to date have shown pleiotropy between genetic causes of development of intracranial aneurysms and genes encoding targets for anti-epileptic drugs. Now that's a fascinating finding because finding commonalities between these genes may help find new treatment targets for intracranial aneurysms. So, in this paper in this issue of the journal, the investigators from the University Medical Center in Utrecht found an association in the expression of anti-epileptic drug target gene CNNM2 and intracranial aneurysm risk. They found that certain anti-epileptic drugs, such as phenytoin, valproic acid, and carbamazepine, that are expected to lower CNNM2 levels in the blood may subsequently lead to a lower risk of development of intracranial aneurysms. And, of course, a reasonable follow-up study to this would be to investigate whether persons exposed to these anti-epileptic drugs have indeed a lower risk of unruptured intracranial aneurysms and subarachnoid hemorrhage, and how variation in CNNM2 expression can lead to development of aneurysms. Bottom line, CNNM2 may be a relevant drug target for treatment of cerebral aneurysms. As always, I encourage you to review these papers in detail in addition to listening to our podcast today. My guest on the podcast today is the Chairman of Neurology at the University of Athens, Dr. Georgios Tsivgoulis. He joins me all the way from Greece to talk about cerebral amyloid angiopathy-related inflammation, or CAA-ri. He's a remarkable researcher, and I can say with absolute confidence that we cannot find a better summary of this very tough topic elsewhere. He ends the interview with an intriguing account of the early description of dementia in Greek mythology. But first, with these two articles. What are covert brain infarcts, or CBIs? Are these the John Wick or the James Bond of the stroke world? After all, they operate undercover. They're ominous and attack without warning. That's probably why they're also called silent infarcts. Now, whatever we call them, we need to know how prevalent they are and what does their presence actually mean. Let's dive into this topic. For at least two centuries, if not longer, we've known about covert brain infarcts. Early description of these lesions is credited to Amédée Dechambre, a medical intern at Salpêtrière Hospital in Paris who noted that there are strokes that can cause symptoms like hemiplegia, but also strokes that are asymptomatic, or so he thought at the time. In the modern times, while we agree with our pathology forefathers that CBIs are different from symptomatic strokes, we also know that they are not entirely asymptomatic. The symptoms can be subtle and tend to sneak up on the patient, but what is clear is that amassing of covert brain infarcts results in an overall decline in cerebrovascular reserve of the brain. With the advent of neuroimaging, we now know that CBIs are age-dependent and prevalent, seen in almost 10 to 30% of even healthy adults, but much more prevalent in those with vascular risk factors, and they can be caused by nearly the entire spectrum of neurovascular disease, including large vessel, small vessel disorders, cardioembolism, and others. Now, how do these covert infarcts catch up in those with atrial fibrillation? Neuroimaging studies have shown that patients with A-fib, especially those untreated, have a higher percentage of embolic-appearing CBIs, and conversely, those with embolic formed pattern of CBIs are more likely to have undiagnosed A-fib. So the question is, what's the significance of CBI in those with confirmed A-fib? In this issue of the journal, Dr. Do Yeon Kim from Seoul National University and colleagues help us answer this question using the EAST-AF, which stands for East Asian Ischemic Stroke Patients With Atrial Fibrillation Study. So, the paper included over 1300 patients with A-fib and first-ever stroke without a prior history of TIA or stroke. And then they categorized these patients into those who had evidence of CBI on neuroimaging and those who didn't. So, what did they find? Forty-two percent of patients with A-fib and first-ever stroke had evidence of covert brain infarcts on neuroimaging. Let's think about it for a moment. These patients presented with what was thought to be their first-ever stroke, not knowing they already had some in their brain. Now, what makes things really worse is that over a quarter of these subjects had more than just one covert infarct. Not surprisingly, those with CBI tended to be older, had higher blood pressure, and had worse white matter hyperintensity burden. This is kind of expected and also not expected was the fact that most of these covert infarcts were actually embolic in pattern. Over 60% of them were embolic. Another 14% of cases had combined embolic and non-embolic-appearing CBIs. Now, overall, the one-year incidence of ischemic stroke and all-cause mortality was higher in those that had CBIs at baseline. When they started looking at the specific patterns of CBIs, those embolic-appearing CBIs had a threefold higher risk of recurrent ischemic stroke, whereas those with non-embolic-appearing covert infarcts had oddly a higher all-cause mortality rate but not recurrent ischemic stroke. And finally, just briefly, the authors noted that the addition of CBIs to the classic CHA2DS2-VASc score didn't meaningfully otherwise statistically improve the scoring metrics, so they left it at that. So, the take-home message is that 42% of A-fib patients presenting with first-ever stroke actually had prior strokes without even knowing based on this study. And most of these strokes were embolic-appearing, and these covert brain infarcts can be used as predictors of future clinical strokes in this population. Strokes should be the last thing to worry about when we think of pregnancy. In the United States, around 30 in 100,000 women, unfortunately, experienced a stroke during pregnancy, and between 6 to 8 in 100,000 deliveries are complicated by subarachnoid hemorrhage. What's the most common cause of pregnancy-associated subarachnoid hemorrhage? In the general population, close to 80% of subarachnoid hemorrhage cases are aneurysmal. Is this true for the pregnant population as well? And importantly, what's the contemporary incidence trend, risk factors, and outcomes of pregnancy-related subarachnoid hemorrhage? In this issue of the journal, Dr. Korhonen and Petra [Ijäs] and their colleagues from the Departments of Neurology and Obstetrics and Gynecology at Helsinki University Hospital will give us the answers to some of these questions through a nationwide population-based study in Finland. So, they looked at over one and a half million pregnant women who gave birth during a 30-year time period between 1987 to 2016. Subarachnoid hemorrhage was identified through appropriate ICD codes and then further adjudicated based on confirmatory information, including neuroimaging and data from lumbar puncture. A total of 57 cases of pregnancy-related subarachnoid hemorrhage was identified in this paper. The mean age of women was 33, ranging from 23 to 45, and the clinical presentation was typical for subarachnoid hemorrhage, including thunderclap headache and mild neurological symptoms. So, what did they find? So, first off, in terms of general observations, the overall incidence rate of pregnancy-related subarachnoid hemorrhage in this study was 3 over 100,000 deliveries. This is almost half the incidence rate reported from the nationwide registries in the United States. Seventy-seven percent of pregnancy-related subarachnoid hemorrhage cases were aneurysmal, so very similar to the general population. The other 23% were non-aneurysmal cases, but it's important to note that 40% of those non-aneurysmal cases also had vascular etiologies, so etiologies such as moyamoya syndrome, postpartum angiopathy, AVM, to name a few. Like non-pregnant patients with subarachnoid hemorrhage, the aneurysmal cases were sicker patients in general. They had a lower GCS at presentation, higher Hunt and Hess scores, and required more ICU admissions. The next finding is very important because it actually shows that development of subarachnoid hemorrhage during pregnancy significantly impacted obstetrical care. A total of 66% of women with subarachnoid hemorrhage during pregnancy ended up having a C-section and a high percentage of these cesarean sections were actually elective. This is in contrast with subarachnoid hemorrhages in the postpartum period where 67% of women had spontaneous vaginal deliveries. The other important finding of the paper was really highlighting the differences between pregnancy-related aneurysmal versus non-aneurysmal subarachnoid hemorrhages. We already talked about how, in general, aneurysmal cases had more severe neurological presentations, so, not surprisingly, they also had worse outcomes with a mortality rate of 16% for the aneurysmal subarachnoid hemorrhage cases, and only 68% of women with pregnancy-related aneurysmal subarachnoid hemorrhage reached a favorable outcome, which was defined in this study as modified Rankin Scale of 0 to 2. Other important differences included the fact that the incidence of aneurysmal subarachnoid hemorrhage increased towards the end of pregnancy and was highest in the third trimester. This ties in with the findings from prior studies all indicating that rupture of an aneurysm is most common in the third trimester. By contrast, the incidence of non-aneurysmal subarachnoid hemorrhage peaked in the second trimester in this study. And finally, in terms of risk factors, first let's talk about age. The incidence rate of pregnancy-associated subarachnoid hemorrhage increased with age of the mother. So, in this study, there were no cases noted amongst women aged below 20 years of age to an incident rate of 12 per 100,000 deliveries among women aged 40 years or over. So that's a fourfold increase from the overall incidence rate of pregnancy-related subarachnoid hemorrhage, and very important point that we learned from this paper. Apart from age, smoking beyond 12 weeks of gestation and hypertension were also independent factors associated with pregnancy-related subarachnoid hemorrhage. So, overall, hypertension, smoking are bad and are significant risk factors for pregnancy-related subarachnoid hemorrhage. And if we have to remember just one thing from this paper, let it be this one: The rupture of an aneurysm is most common in the third trimester of pregnancy. Cerebral amyloid angiopathy, or CAA, is an important cause of intracranial hemorrhage and refers to deposition of β-amyloid fibrils in the wall of the small- and medium-sized cerebral blood vessels, mostly involving cortical and leptomeningeal arteries. It is believed that the deposition of β-amyloid results in architectural disruption of the blood vessels, which then leads to perivascular leakage. That's the pathophysiological mechanism behind the development of cerebral microbleeds. And this process, of course, can cause frank vascular rupture resulting in cortical intracerebral hemorrhage or development of high-convexity subarachnoid hemorrhages. It is important to note that varying amounts of perivascular inflammation, that is inflammation surrounding β-amyloid-laden blood vessels, may be present in some CAA cases, rendering them the designation of inflammation-related CAA. However, frank vasculitic destruction of the vessel wall, such as what is found in amyloid-β-related angiitis, or ABRA, and primary angiitis of the central nervous system, is usually absent in most CAA-related inflammation cases. How these entities are best defined, diagnosed, and treated is subject of intense research. In this issue of the journal, in the study titled "Clinical, Neuroimaging, and Genetic Markers in CAA-Related Inflammation," Dr. Georgios Tsivgoulis and colleagues take us through a systematic review and meta-analysis of published studies of patients with CAA-related inflammation. I am joined today by Dr. Tsivgoulis himself to discuss this paper. He's a Professor of Neurology and Chairman of the Second Department of Neurology at the University of Athens School of Medicine. Dr. Tsivgoulis is the residency program director and the director of cerebrovascular fellowship program with extensive research and expertise in the field of stroke. Good morning, Georgios, and welcome to our podcast. Dr. Georgios Tsivgoulis: Good morning, Negar. I'm delighted to be here and delighted to present our findings, on behalf of all our co-authors. Dr. Negar Asdaghi:         Thank you very much for being here and congrats again on the paper. So, Georgios, let's start with this interest that's going on with using clinical and radiographic features to make the diagnosis of CAA-related inflammation in contrast to moving ahead and performing brain biopsy. Can you please start us off with a brief review of the newly proposed clinico-radiographic criteria for this condition, please? Dr. Georgios Tsivgoulis: Yes. As you mentioned, Negar, CAA-ri is a distinct, however, rare subset of cerebral amyloid angiopathy. Firstly, Greenberg and the Boston group published in Neurology in 2007 a paper highlighting that a diagnosis of a probable CAA-ri patient could be made on the basis of characteristic clinical and neuroimaging findings without requiring a biopsy. Following this observation, Chung and colleagues in 2010, in a seminal paper in JNNP, proposed the first diagnostic criteria for probable and definite CAA-ri. For the definite diagnosis, besides the typical clinical presentation with headache, encephalopathy, focal neurological signs and seizures, and the characteristic neuroimaging findings with T2 or FLAIR hyperintense asymmetric white matter lesions complicated with microbleeds and leptomeningeal or parenchymal gadolinium enhancement, and histopathological confirmation with amyloid deposition within cortical leptomeningeal vessels associated with perivascular, transmural or intramural inflammation was also required. The latest criteria developed in 2015 by Auriel and colleagues that were published in JAMA Neurology using a validation study modified the current criteria for the diagnosis of CAA-ri. In this paper, the author supported the use of empirical immunosuppressive therapy, avoiding brain biopsy, for patients meeting the criteria proposed for probable CAA-ri. They suggested that a brain biopsy should be considered in empirically treated patients who failed to respond to corticosteroid therapy within three weeks. The criteria by Auriel and colleagues are widely applicable in everyday clinical practice, and we also use this criteria for the inclusion of studies in our current meta-analysis. I would like to highlight for our audience that the latest criteria for CAA-ri were published in 2015 by Auriel and colleagues. However, these are different for the criteria for cerebral amyloid angiopathy than the latest criteria were published in 2022 in Lancet Neurology, OK? Dr. Negar Asdaghi:         Georgios, that was a great start for this interview. You had mentioned a lot of information here. I just want to highlight what you just said. So, we are using for this meta-analysis, the latest criteria in CAA-related inflammation published in JAMA by Auriel and colleagues. That's slightly different than, we're not referring to the 2022 criteria of cerebral amyloid angiopathy. It's an important distinction. We're going to talk about this a little more as we go through the interview, but I want to come back to your current paper and start from there. Can you please tell us about the importance of this paper, why doing a meta-analysis was important in your view, and tell us a little bit about the studies that were included in your paper? Dr. Georgios Tsivgoulis: Yes, thank you for that question. CAA-ri is an increasingly recognized entity since the recent diagnostic criteria by Auriel and colleagues published in 2015. In collaboration with the greater availability of the high-resolution MR, we can have now a reliable non-invasive diagnosis of possible or probable CAA-ri, avoiding the risk of brain biopsy. However, I need to highlight that the early diagnosis remains a great challenge for the clinicians and neurologists. Searching the literature, we observe that there is scarce data regarding the prevalence of the distinct clinical, neuroimaging, and genetic markers among patients diagnosed with CAA-ri. We believe that pooling all this information in the current meta-analysis would be very helpful for every clinician, increasing a comprehensive understanding of this rare cerebrovascular disorder. Consequently, we conducted this meta-analysis including 21 studies that recruited a total of 378 patients with CAA-ri. Our study involved only 4 prospective and 17 retrospective hospital-based cohorts of patients diagnosed with CAA-ri based on autopsy or biopsy or on the recent Auriel diagnostic criteria that do not require autopsy or biopsy. Due to limited data in the literature regarding this entity, we had to include only small cohort studies with at least five patients in our meta-analysis. We excluded case reports and case series with less than five patients. This is, by far, the largest available sample of CAA-ri patients in the literature. Dr. Negar Asdaghi:         OK, great. So, let me just recap this, more so for myself. So, we have 21 studies, and you excluded studies that included less than 5 patients. So, practically speaking, case reports. Dr. Georgios Tsivgoulis: Yes, and single-case reports. Dr. Negar Asdaghi:         Yes. And practically speaking, of the total number of patients that are included in this meta-analysis, you have 378 cases, and basically the diagnosis of CAA-related inflammation was either based on the newly proposed criteria or based on biopsy-confirmed or autopsy cases. Dr. Georgios Tsivgoulis: Which is the standard criteria. Dr. Negar Asdaghi:         So, now, I'm dying to ask you about these clinical and radiographic characteristics of patients with CAA-related inflammation in this meta-analysis. Dr. Georgios Tsivgoulis: The mean age of patients in the included studies was approximately 72 years old, and there was no obvious gender predominance. Fifty-two percent of the patients were of female sex. In our study, 70% of the included patients presented with cognitive decline, which was the most common neurological manifestation, while 50% of the total sample had focal neurological signs and 54% encephalopathy presentation. Symptoms such as headache and seizures were less common, 37 and 31% respectively. With regard to the radiological findings, hyperintense T2 FLAIR white matter lesions were very, very common in 98% of our patients, and they were also complicated with lobar cerebral microbleeds, with a prevalence of 96%, and these two were, by far, the most prevalent neuroimaging findings, that white matter hyperintensities coupled with a cerebral microbleed. The pooled prevalence rates of gadolinium-enhanced lesions was 54%, and also the prevalence of cortical superficial siderosis was 51%, which is also very high in this cohort of patients with CAA-ri. Dr. Negar Asdaghi:         OK. So many of the features Georgios said, you mentioned, from presence of white matter hyperintense lesions on T2 FLAIR to presence of cortical microbleeds or superficial siderosis, these features are also seen in patients with cerebral amyloid angiopathy. What are some of the important differentiating features between the two conditions? Dr. Georgios Tsivgoulis: Yes, this is an excellent clinical question. First of all, the lower age threshold for CAA-ri is 40 years old, whereas in cerebral amyloid angiopathy, the lower age threshold is 50 years. So, patients who are younger than 50 years can be diagnosed with CAA-ri, but they cannot be diagnosed with CAA. Another issue is that comparing the result of this meta-analysis with another recent meta-analysis focusing on CAA, on cerebral amyloid angiopathy, that our international multi-collaborative group published in Stroke in 2002, we also evaluated the presence of clinical phenotypes and radiological markers among patients with cerebral amyloid angiopathy. We have documented that transient focal neurological episodes are much more common in patients with cerebral amyloid angiopathy in contrast to patients with CAA-ri. These episodes, which are called TFNEs, transient focal neurological episodes, are attributed to cortical subarachnoid hemorrhage or cortical superficial siderosis. So, I think this is another important clinical distinction. The most important, however, differentiating features between the two entities are neuroimaging markers, in specific, in particular, T2 FLAIR hyperintense unifocal or multifocal lesions with mass effect. These are the most prevalent neuroimaging features among patients with CAA-ri, but they're very seldomly described in patients with cerebral amyloid angiopathy, in patients with CAA. Another characteristic neuroimaging finding very indicative of the inflammation is the leptomeningeal or parenchymal gadolinium enhancement. This finding has been very rarely described in patients with non-inflammatory cerebral amyloid angiopathy. So, the clinical distinction is not so solid. However, the neuroimaging distinction would provide us with very strong information that can help us differentiate these two conditions. Dr. Negar Asdaghi:         Excellent points, I have to say, golden points, not just excellent points. I'm going to try to recap this and see if I understood it correctly. So, for our listeners, we have two conditions that potentially have many common points. One is the cerebral amyloid angiopathy, and the second one, which is obviously the subject of this interview, is cerebral amyloid angiopathy-related inflammation. The most important differentiating factors between the two are actually the neuroimaging features, as Georgios mentioned. So, the first feature that was mentioned is presence of T2 FLAIR hyperintense lesions. Some of them are large and have actually mass effects. This feature is rarely seen in patients with CAA, and it's an important radiographic factor that is seen in patients with CAA-related inflammation. The second distinguishing feature was leptomeningeal enhancement, again, rarely seen in non-inflammatory CAA, but was seen in a significant proportion of patients with CAA-related inflammation. These were the neuroimaging features. You also mentioned two other factors. The median age of CAA-related inflammation was lower than CAA. That can be helpful. And also the entity of transient focal neurological episodes, or TFNE, is rarely seen in inflammatory cases of CAA, whereas it is described in cases with cerebral amyloid angiopathy and mostly related to development of either cortical subarachnoid hemorrhage or cortical superficial siderosis. I think I got this all, correct? Dr. Georgios Tsivgoulis: Excellent. Dr. Negar Asdaghi:         All right, so let's come now to the genetics of CAA. The apolipoprotein E gene is associated with the presence of amyloid angiopathy and development of lobar intracerebral hemorrhage, and we've learned about this in cases with cerebral amyloid angiopathy. Is there an association with ApoE, and did you find anything in this meta-analysis? Dr. Georgios Tsivgoulis: Another very exciting question. In 2007, there was a first report that the apolipoprotein ε4 homozygosity may be considered a risk factor for CAA-ri, and there was a strong correlation reporting a high prevalence of 77% of this apolipoprotein ε4 alleles among patients with CAA-ri. To justify this correlation, the hypothesis was that an underlying pathogenic mechanism, which increases the amyloid-β deposition and has a pro-inflammatory effect, may be suspected as the cause of this disorder. The largest, however, prospective cohort of CAA-ri patients conducted by Antolini and colleagues and was published in 2021 in Neurology, reported a much lower prevalence of apolipoprotein ε4 carriers accounting for 37%, 23% heterozygotes and 14% homozygotes. So, we also documented a pool prevalence of apolipoprotein ε4 homozygosity of 34%. So, we did not confirm the initial finding of 77%. However, in our meta-analysis, the homozygosity was 34%, and we need to have a cautious interpretation of these results because data is limited, and we need larger future population-based studies and in larger cohorts to evaluate the prevalence rate of these specific genetic markers. So, we can confirm an association between apolipoprotein ε4 homozygosity, however not as strong as originally reported in 2007. Dr. Negar Asdaghi:         OK. So, Georgios, thank you. And again, very important factor to keep in mind for our clinicians listening in. Unfortunately, based on what you mentioned, we don't have yet a genetic marker to, for sure, tell us if we're dealing with CAA-related inflammation, yes or no, as you mentioned. Just to recap, earlier on, there was studies to suggest a very strong association between apolipoprotein ε4 homozygosity and CAA-related inflammation. But later on, this was not confirmed by subsequent studies, and in your meta-analysis, you found 34% ApoE ε4 homozygosity amongst patients with CAA-related inflammation and could not confirm that original high association. OK, so with all of that, it's a lot of information. I have to go to the next question regarding controversies involving the levels of Aβ40, Aβ42, and P-tau proteins in CSF in the setting of CAA-related inflammation. Can you please tell us more about these biomarkers? Dr. Georgios Tsivgoulis: Yes. The overlap of Alzheimer's disease and CAA can be attributed to the coexistence of some degree of cerebrovascular amyloid deposition and amyloid plaque pathology, which is very common. And, of course, the evaluation of amyloid and tau proteins in CSF is of high significance for the prognosis and the evolution of CAA patients. In our previous review, we have summarized the literature and noticed that CSF concentrations of Aβ40 and, secondarily, Aβ42 were much lower in patients with cerebral amyloid angiopathy compared with Alzheimer's disease. Total tau and phospho-tau CSF levels were comparable to healthy controls in CAA and lower than patients with Alzheimer's disease. Moving now to CAA-ri, there were scarce data about these biomarkers amongst CAA-ri patients. The majority of the relevant studies have found relatively low levels of Aβ42 and Aβ40 in the CSF and high levels of P-tau. In the present meta-analysis, the pooled means of biomarker levels were based on the findings of only two studies with heterogeneity, and these limit substantially the validity of our observations. However, they confirm the previous reports indicating, as I said before, but I would like to repeat, low levels of Aβ42 and Aβ40 in the CSF and high levels of P-tau. Dr. Negar Asdaghi:         Perfect. So, thank you, Georgios. I'm going to recap what you said. So, we're talking about CSF biomarkers, and first what you mentioned is going back to the original studies concentrated on using these biomarkers as ways of differentiating between cerebral amyloid angiopathy and Alzheimer's disease. And very briefly, to recap what you said, in general, the levels of Aβ40 and, secondarily, Aβ42 was found to be much lower than the Alzheimer's levels in patients with CAA. Now coming to the inflammatory form of CAA, what you mentioned and what you found in this meta-analysis, practically speaking, confirmed that the levels of Aβ40 and Aβ42 in CSF are low and the levels of P-tau are high in this condition as well. So, one thing I want to ask as a secondary question to that is, that it sounds like these biomarkers are more or less similar in CAA and CAA -related inflammation, not that different. Is that correct? Dr. Georgios Tsivgoulis: It's absolutely correct. And I would also like to highlight a major limitation of the meta-analysis that we had available data from only two studies to pool the mean of these CSF biomarker levels. So, these results need to be acknowledged with caution, and we would love to repeat our meta-analysis after the publication of more studies and prospective cohorts measuring the CSF biomarkers in patients with CAA-ri. Dr. Negar Asdaghi:         OK. So, again, important to note, as you mentioned, that there's heterogeneity in data because of just paucity of information on this, but as we stand today, the biomarkers won't really help us in terms of differentiating between the two conditions that are CAA or CAA-related inflammation. And so, I think I've learned a lot from this interview myself, but I think we have to just talk briefly about the available therapies for CAA-related inflammation. Dr. Georgios Tsivgoulis: Yes. In our meta-analysis, we sought to summarize the available information regarding different therapeutic strategies and outcomes among CAA-ri patients. Our results supported our clinical experience indicating that corticosteroids represent the first-line treatment in these patients' outlook. Steroids have been associated with clinical and radiological improvement of the primary disease episode and decreased risk of subsequent relapses in patients with CAA-ri. Additional immunosuppressive therapies, including cyclophosphamide, mycophenolate mofetil, azathioprine, IVIG, or rituximab, have been also reported as adjunct therapies in selected cases with a more severe course of the disease. However, this is another limitation that needs to be acknowledged. That data regarding the treatment and the outcomes are limited and heterogeneous, which prevented us from drawing robust conclusions using a meta-analytical approach. And we believe that we need future cohort studies with prospective data validation in order to generate a proposal for a therapeutic algorithm management in these cases. Dr. Negar Asdaghi:         Thank you, Georgios. So, we have a condition that is now being more and more recognized. We now have criteria based on clinical and radiographic presentation features of patients that might help us with this diagnosis to differentiate it from cerebral amyloid angiopathy. And in terms of therapies, the idea is that the most studied drug is really just first-line therapy, that's corticosteroids. And then there's positive data regarding use of all other forms of immunosuppression, including, as you mentioned, cyclophosphamide, rituximab, and oral agents such as mycophenolate mofetil or azathioprine. We have limited information about those, but I want to highlight something you actually mentioned earlier on in the interview, which is the field is moving towards making these diagnoses based on clinical features and radiographic features that you had highlighted and actually giving patients immunosuppression early on and only move on to a biopsy if the patient had failed these therapies for a period of time, which you mentioned three weeks. So, I think it's important for us as clinicians to keep this evolving criterion and recommendations in mind. And before we end, I want to ask you a hypothetical question, Georgios. In your opinion, what's an ideal randomized trial for CAA-related inflammation in the future? Dr. Georgios Tsivgoulis: I think before going to the randomized, the ideal randomized trial for CAA-ri, and designing this trial, we need much more information regarding the underlying pathophysiological mechanisms. There are many unanswered questions. What is the diagnostic value of CSF biomarkers such as amyloid, we discussed earlier, and tau protein? And, of course, what is the value of CSF and the amyloid-β autoantibodies, if there is any? What is the value of genetic markers such as apolipoprotein E genotype and a correlation with the co-existing inflammation in CAA-ri? However, I don't want to defer this question. So, a typical answer would be that with regard to the ideal patients, we would want a young patient without comorbidities after the first manifestation of CAA-ri who has shown a good clinical and radiological response to corticosteroids in order to define the best second-line therapy. However, before answering all these questions in a clinical trial, if we can, I think that we need to understand the CSF and genetic biomarkers in order to uncover mechanisms regarding pathophysiology that can help us to design more targeted clinical trials studying novel disease-modifying treatments. Dr. Negar Asdaghi:         Thank you. Dr. Georgios, it's been a pleasure having you on the podcast, and I can say we've learned a lot. We look forward to having you back here and talk about that hypothetical randomized trial, and I'm sure one day hopefully will happen in our lifetime. Thank you for being here. Dr. Georgios Tsivgoulis: Thank you. Thank you for having me. It was a pleasure. Dr. Negar Asdaghi:         Thank you. Homer, the legendary Greek poet, described a case of dementia in his seminal work, The Odyssey, in the late eighth century before Christ. He described the cognitive decline of Odysseus's father, King Laertes. The detailed account of the king's mental decline, loss of short-term memory with retention of long-term memory combined with his depression and despair over the loss of his son, is dramatically accurate for a nearly 3,000-year-old description of dementia. Before I ended the interview, I had to use this opportunity to ask Georgios about lessons learned from ancient Greeks and this seemingly timeless disease. Dr. Georgios Tsivgoulis: Thank you for this question. King Laertes was indeed Odysseus's father, and it's a great paradigm describing dementia. However, the ancient history of dementia may be separated according to the Greek philosopher Posidonius in two periods. The first period is called dementia appearing due to old age, which is called in Greek, eros. And the second one is dementia appearing in other ages and mainly due to other reasons, called morosis. Posidonius of Rhodes was a Greek stoic philosopher of the second first century BC who strongly believed and suggested that morosis, which is that dementia appearing in younger ages due to other disorders, should be treated immediately after its onset. So, if I would like to end this podcast, I would just suggest that CAA-ri could be classified as morosis according to Posidonius. And what we could learn is that the early diagnosis is essential since the prompt initiation of corticosteroids should not be unreasonably delayed. Dr. Negar Asdaghi:         And this concludes our podcast for the January 2023 issue of Stroke. Please be sure to check this month's table of contents for the full list of publications, including a series of Focused Updates on post-stroke neurological recovery, from management of post-stroke attention deficit, neglect and apraxia to post-stroke memory decline. And with this, we end the start of our 2023 podcast series. Like all new things, a new beginning can come with new directions, and sometimes a new direction is all that we need. After all, as the legend has it, it was a direction of that falling apple back in the year 1666 that gave Isaac Newton the idea of the universal law of gravitation. Now, Isaac Newton has, without a doubt, given science some of its biggest discoveries in mathematics, physics, and astronomy. But most may not know that Newton had a pretty rough start in life. A January-born premature baby, he was thought not to survive the first few days of life. Newton had a difficult childhood, and at the age of 16, he was pulled out of school by his family and forced to become a farmer, a job he didn't like and he was miserably bad at. So, as we start a new year, let's remember that even the smartest people are not good at everything, and it does take time to find one's passion in life. Now, while things may not always be clear, what is clear is that a great way to find that center of gravity is, as always, staying alert with Stroke Alert. This podcast is produced by Wolters Kluwer and supported by the editorial team of Stroke. Our Stroke Alert podcast and production staff includes Danielle Cross, Eric Goldstein, Nastajjia Krementz, Ishara Ratnayaka, Erinn Cain, Rebecca Seastrong, and Negar Asdaghi. This program is copyright of the American Heart Association, 2023. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, visit AHAjournals.org.

Enjoy our evidence-based bite size segment with our CSO Natalie Adair Suazo. This week the topic is: Comparing the effect of concurrent resistance and endurance training with that of resistance training only on the development of maximal dynamic strength in three groups, untrained, moderately trained, and trained individuals.  Study: Development of Maximal Dynamic Strength During Concurrent Resistance and Endurance Training in Untrained, Moderately Trained, and Trained Individuals: A Systematic Review and Meta-analysis (2021) Results: The authors did find interference with concurrent training in lower body strength gains in trained but not untrained individuals, and it only appears to be an issue when the aerobic and resistance bouts are performed within a short interval of each other (< 20 min). So within the same training session, yes interference, but not when performed separately (> 2 hours). As mentioned, this is not the case for moderately trained or untrained individuals. In these populations, concurrent resistance and endurance training did not have a negative effect on lower-body strength development. Please include the full citation:    Petré, Henrik, et al. “Development of Maximal Dynamic Strength during Concurrent Resistance and Endurance Training in Untrained, Moderately Trained, and Trained Individuals: A Systematic Review and Meta-Analysis.” Sports Medicine, 22 Mar. 2021, 10.1007/s40279-021-01426-9.

Losing fat and building muscle is a hard goal to reach, but it doesn't have to be. In this episode, Nate and Kyle discuss the 2 Keys to gaining muscle and losing fat at the same time. The Meta-Analysis may have revealed some information on the topic. They will talk about several studies done in this area to help provide you with tips and strategies to build muscle and lose fat at the same time. Don't just wait around hoping for change. Listen to this informational episode to learn more!   Key Highlights: [00:01 - 07:03] Opening Segment The misconception or misinformation that protein is only for muscle building. The other studies compare traditional resistance training and high-resistance training. One key takeaway is that you have to have resistance training and has to be progressive.   [07:04 - 16:09] Amount Of Protein Consumption For Effective Muscle Gain All about building muscle, there are a lot of unknowns When it comes to people who want to gain muscle while also losing fat, a more-than-usual amount of protein has the best number.   [16:09 - 22:03] Can Sleep Help Gain Muscle And Lose Fat? The study has shown the results about having slept for 8 hrs. Vs. people who slept 7 hrs. less There are also studies about Ghrelin Levels or “hunger hormones.” Nate's strategies to be successful in knowing the amount of protein in the simplest way.   [22:03 - 27:14 ] Closing Segment The key takeaway is consistency in order to gain muscle and lose fat at the same time. The foundational piece is to get at least one gram of protein intake.   Key Quotes: “It's power of protein, but more than anything it's the power of just planning.” - Kyle Tyler “You have to have resistance training, and it has to be progressive.” - Nate Palmer “There's a lot of unknowns when it comes to building muscle.” - Nate Palmer Get leaner. Live Longer. Be Legendary. Here's how I can help you reach your goals! 1. Get coaching from Nate: https://www.milliondollarbodymethod.com/get-coaching 2. Start by understanding the science and simplicity of carb backloading for fat loss - go to GetNatesBook.Com. to get a free copy of Nate's bestseller “The Million Dollar Body Method” 3. Get more great tips to get leaner by connecting with me on Instagram @lowcarbhustle 4. Join the MDB Mastermind for just a buck! If you want accountability, coaching, and an amazing training program to get leaner, this is what you need. Go to nate.fit to find out more and get your first 2 weeks for just 1 dollar.   If you liked the show, please LEAVE A 5-STAR REVIEW, and share it on social media to get reposted to over 12k of the homies.

Commentary by Dr. Valentin Fuster

In this video, I'm going to reveal how fluoride in your water may be ruining your sleep, as well as how it causes memory problems and also drain your energy levels. Download Transcript 00:00  Introduction 01:00   The Case Against Fluoride 02:45   Low IQ levels and brain damage 03:28   Near infra-red radiation promotes melatonin 03:43   Melatonin in rice seedlings lowers fluoride uptake 03:56   Fluoride-free diet stimulates pineal growth 04:11    Melatonin protects brain and raises antioxidants 04:24   7 Ways to limit fluoride and make more melatonin 06:09   Why the drug companies, FDA, and CDC are silent about melatonin 06:46   How you can sleep great and have more energy and mental clarity LINKS MENTIONED Sleep, Interrupted: A Physician Reveals The #1 Reason Why So Many Of Us Are Sick And Tired. The Case Against Fluoride book.  Fluoride and Pineal Gland.  Developmental Fluoride Neurotoxicity: A Systematic Review and Meta-Analysis.  Flouride and Brain: A Review.  Impacts of Fluoride Neurotoxicity and Mitochondrial Dysfunction on Cognition and Mental Health: A Literature Review. Melatonin and the Optics of the Human Body.  Melatonin application reduces fluoride uptake and toxicity in rice seedlings by altering abscisic acid, gibberellin, auxin and antioxidant homeostasis.  Fluoride-Free Diet Stimulates Pineal Growth in Aged Male Rats. Melatonin ameliorates fluoride induced neurotoxicity in young rats: An In Vivo evidence.  Most Bottled Water is FILLED With Fluoride, Here's a complete list of brands to avoid. Fluoride In Tea: Black, Green, White, Herbal & More (Search 357+ Teas). Prescription Drugs That Contain Fluoride (Search 325+ Drugs). Cancer and Other Outcomes After Surgery With Fluoridated Anesthesia. Hooga Red Light Therapy Device.  COVID-19 early treatment: real-time analysis of 2,360 studies.  How You Can Sleep Great And Have More Energy and Mental Clarity In 90 Days. The 90-Day Sleep Diet. PRODUCTS & SERVICES Totally CPAP: A Sleep Physician's Guide to Restoring Your Sleep and Reclaiming Your Life  Sleep, Interrupted: A Physician Reveals The #1 Reason Why So Many Of Us Are Sick And Tired  How you can sleep great and have more energy and mental clarity. Dr. Park's The 90-Day Sleep Diet Want to un-stuff your stuffy nose? Read the e-book, How to Un-stuff Your Stuffy Nose: Breathe Better, Lose Weight, Sleep Great (PDF)  Your Health Transformation Workbook: Refresh, Restore, & Rejuvenate Your Life (online format)  Want to have more energy, sleep better, have less pain, and enjoy living again? Reserve a Virtual Coaching session today with Dr. Park    CONNECT WITH DR. PARK DoctorStevenPark.com doctorpark@doctorstevenpark.com For inquiries about interviews or presentations, please contact Dr. Park through his website at doctorstevenpark.com  DISCLAIMER This video is for general educational and informational purposes only. It is not to be taken as a substitute for professional medical advice, diagnosis, or treatment. Please consult with your doctor first before making any changes to your health, exercise, nutrition, or dietary regimen. Certain product links above will take you to Amazon.com. If you then go on to buy the product, Amazon will provide me with a small commission, which will not cost you anything.  

Facts about John: - He's given over $50 million to charity - Spent time in prison - rose from dirt poor to be a 1/3 of a billionaire - Singer/Songwriter who recorded with Grammy Winning Producers - Written two books - Lawyer, Environmentalist, Philanthropist, Taxi-Driver John Lefebvre is a poetically and externally successful man with a checkered past - he's been a taxi driver, a lawyer, a convict, an activist, a third of a billionaire, a musician, an author, an environmentalist, a philanthropist, and more. This multi-millionaire jailbird owned 27 percent of “The PayPal of online gambling”, he's worked with Grammy-winning music producers and he co-founded “DeSmog.com”, a blog dedicated to exposing climate misinformation campaigns John was a delight to speak with and we had a very interesting conversation with great responses and perspectives on every subject we roll through. He and I discuss some of the thoughts expressed in his books, generosity, wealth, perspectives of the mass, gratitude, success, ego, knowledge, sovereignty, transcendental meditation, marijuana, taxes, banks, freedom, government, the selfish wealthy, LSD, being wealthy, some exerts from John's recent book, glimpses of enlightenment, meaning, finding purpose, and enjoying the planet to save it. ‘With a multitude of unique experiences and insights, Johns mission is to use his stories and philosophies to help make the world a better place. He believes change starts now and wants to give the opportunity for others to learn from his experiences and live more fulfilling lives. John hopes to have people realize that there is no use in complaining, recognize how screwed up things may be, and identify how to move towards a brighter future for all of humanity.' Enjoy the convo and check out more of Johns's Work on his website here - https://www.johnlefebvre.com/ Pickup his most recent book here (also on audible!) - https://www.amazon.ca/Alls-Well-Where-Thou-Earth/dp/0995904200/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr= Books mentioned: 'The Immortality Key: The Secret History of the Religion with No Name' by Brian C. Muraresku, Some quotes from John amidst our convo: "Kids, don't drop acid until you're ready to be troubled" “Hoarding is the wanking of wealth” “The making love of wealth is the sharing of it” “When we're generous with people they don't bust our balls” “Here's the difficult part of my theory Jacob: we have to use force.” “The thing that is the most precious to me in my whole life has fallen into my lap, no more than it has into everybody's, and that thing is: being a conscious being in the universe.” “Be still, yet still be.” “Get out there and show some people some great music and then get back to work” (Full video available on YouTube) (Recorded 9/16/21)

In this episode, we review the current literature on the association between exercise and the risk for depression. Specifically, how much physical activity is associated with a lower risk for depression? We also discuss the World Health Organization recommendations for the ideal range of physical activity. Faculty: Jim Phelps, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CMEs: Quick Take Vol. 41 Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-Analysis

Derek and James bring you all the latest in Magic the Gathering news and MTGFinance intel including weekly online Meta Analysis, Fast Movers in paper and online, Cards to Watch and a detailed discussion of the March of the Machine: Aftermath set and the TCGPlayer 2022 Top Sellers list.

It's almost time for the Christmas edition of the BMJ to hit your doormats, and in this festive edition of Talk Evidence we're going to be talking Christmas research. Joining Helen and Juan, we have Tim Feeney, BMJ research editor and researcher into Surgical outcomes at Boston University. In this episode we'll be hearing about the health of footballers, and if a career in the sport predisposes Swedish players to substance use disorders. We'll hear about the performance of BMJ's editors, when it comes to assessing the impact of a paper. We'll find out if AI algorithms can pass UK radiology exams, misinformation and a belief that everything causes cancer, and finally, some tips from BMJ's statisticians to set the world right

Do you hate CPAP? Are you thinking about chucking your CPAP machine once and for all? In this video, I'm going to reveal five surprising reasons why you either can't or should not use CPAP, and when you have to think about looking for other options. Download Transcript ✅ CHAPTERS 00:00 Introduction 01:24 Weight gain 03:14 Bite changes 04:18 Expiratory palatal obstruction 06:00 Epiglottic laryngomalacia 07:18 Nasal Congestion 09:02 Nasal decongestion experiment 10:26 Summary ✅ LINKS MENTIONED Totally CPAP: A Sleep Physician's Guide to Restoring Your Sleep and Reclaiming Your Life Effects of CPAP on body weight in patients with obstructive sleep apnoea: a meta-analysis of randomised trials  Recent weight gain in patients with newly diagnosed obstructive sleep apnea  Can CPAP Make You Gain Weight? Craniofacial Changes After 2 Years of Nasal Continuous Positive Airway Pressure Use in Patients With Obstructive Sleep Apnea  The Effect of Nasal Surgery on Continuous Positive Airway Pressure Device Use and Therapeutic Treatment Pressures: A Systematic Review and Meta-Analysis Critical Appraisal and Meta-Analysis of Nasal Surgery for Obstructive Sleep Apnea  Should You Tape Your Mouth For Better Sleep? ✅ PRODUCTS & SERVICES Totally CPAP: A Sleep Physician's Guide to Restoring Your Sleep and Reclaiming Your Life  Sleep, Interrupted: A Physician Reveals The #1 Reason Why So Many Of Us Are Sick And Tired  How you can sleep great and have more energy and mental clarity. Dr. Park's The 90-Day Sleep Diet Want to un-stuff your stuffy nose? Read the e-book, How to Un-stuff Your Stuffy Nose: Breathe Better, Lose Weight, Sleep Great (PDF)  Your Health Transformation Workbook: Refresh, Restore, & Rejuvenate Your Life (online format)  Want to have more energy, sleep better, have less pain, and enjoy living again? Reserve a Virtual Coachingsession today with Dr. Park  ✅ CONNECT WITH DR. PARK DoctorStevenPark.com doctorpark@doctorstevenpark.com For inquiries about interviews or presentations, please contact Dr. Park through his website at doctorstevenpark.com ✅ DISCLAIMER This video is for general educational and informational purposes only. It is not to be taken as a substitute for professional medical advice, diagnosis, or treatment. Please consult with your doctor first before making any changes to your health, exercise, nutrition, or dietary regimen. Certain product links above will take you to Amazon.com. If you then go on to buy the product, Amazon will provide me with a small commission, which will not cost you anything.

It's our final podcast for the year, so we thought we'd do a bit of Q&A as well as just cover a number of recent happenings in the BFR and rehab spaces that we've participated in or supported. Thanks so much for listening and don't hesitate to send us questions or topics you'd like to hear us cover. Some of the papers referenced in our answers: Christiansen, D., & Bishop, D. J. (2022). Aerobic-interval exercise with blood flow restriction potentiates early markers of metabolic health in man. Acta Physiologica , e13769. Christiansen, D., Eibye, K. H., Hostrup, M., & Bangsbo, J. (2019). Blood flow-restricted training enhances thigh glucose uptake during exercise and muscle antioxidant function in humans. Metabolism: Clinical and Experimental, 98, 1–15. Salvador, A. F., De Aguiar, R. A., Lisbôa, F. D., Pereira, K. L., Cruz, R. S., & Caputo, F. (2016). Ischemic Preconditioning and Exercise Performance: A Systematic Review and Meta-Analysis. International Journal of Sports Physiology and Performance, 11(1), 4–14. Zaravar, L., Nemati, J., Rezaei, R., Jahromi, M. K., & Daryanoosh, F. (n.d.). Effect of Eight weeks Water Exercise with Blood Flow Restriction on Growth Hormone, Insulin-like Growth Factor-1 and Bone Metabolism in Elderly Women. https://spj.ssrc.ac.ir/article_2570_007f12d97cf861f568d84ad5e0783471.pdf Faltus, J., Owens, J., & Hedt, C. (n.d.). THEORETICAL APPLICATIONS OF BLOOD FLOW RESTRICTION TRAINING IN MANAGING CHRONIC ANKLE INSTABILITY IN THE BASKETBALL ATHLETE. https://doi.org/10.26603/ijspt20180552

This week on the podcast Mikki speaks to one of the OGs in the nutrition education space, Dr Alan Aragon. To say that he has been around a long while would be an understatement, and this isn't said in reflection of his age, more the years that he has spent creating and sharing nutrition content, in both the gym/fitness space and also in the academic space. In this interview, Mikki and Alan discuss his background in training and nutrition, before moving on to his book ‘flexible dieting' which is written for anyone wanting to optimise their body composition. They talk about a range of different concepts around weight loss, including his method of figuring out energy requirements for fat loss, what his protein recommendations are, how to track calories in a way that doesn't drive someone insane, how to calorie cycle appropriately and what ‘safe' weight loss is. And much more. Enjoy.Alan Aragon is a nutrition researcher and educator with over 30 years of success in the field. He is known as one of the most influential figures in the fitness industry's movement towards evidence-based information. His notable clients include Stone Cold Steve Austin, Derek Fisher, and Pete Sampras. Alan writes a monthly research review (AARR) providing cutting-edge theoretical and practical information. Alan's work has been published in popular magazines as well as the peer-reviewed scientific literature (list of publications here). He co-authored Nutrient Timing Revisited, the most-viewed article in the history of the Journal of the International Society of Sports Nutrition (JISSN). He also is the lead author of the ISSN Position Stand on Diets & Body Composition. Alan maintains a private practice designing programs for recreational & professional athletes — and of course regular people striving to be their best.Alan can be found at: alanaragon.com IG: @thealanaragon Tw: @TheAlanAragon Book: alanaragon.com/flexibledietingbookSome articles that Alan discusses:Clark, J. E. (2018). Periodization of exercise induces long-term weight loss while focusing strictly on improvements in cardiovascular and musculoskeletal fitness for individuals who are overfat. Sport Sciences for Health, 14(3), 517-530Devries, M. C., Sithamparapillai, A., Brimble, K. S., Banfield, L., Morton, R. W., & Phillips, S. M. (2018). Changes in Kidney Function Do Not Differ between Healthy Adults Consuming Higher- Compared with Lower- or Normal-Protein Diets: A Systematic Review and Meta-Analysis. The Journal of nutrition, 148(11), 1760–1775. https://doi.org/10.1093/jn/nxy197Ott, B., Skurk, T., Lagkouvardos, L., Fischer, S., Büttner, J., Lichtenegger, M., ... & Hauner, H. (2018). Short-term overfeeding with dairy cream does not modify gut permeability, the fecal microbiota, or glucose metabolism in young healthy men. The Journal of Nutrition, 148(1), 77-85.Contact Mikki:https://mikkiwilliden.com/https://www.facebook.com/mikkiwillidennutritionhttps://www.instagram.com/mikkiwilliden/https://linktr.ee/mikkiwillidenSave 20% on all NuZest Products with the code MIKKI20 at www.nuzest.co.nzSave 30% on Hoka One One with the code TEAMMIKKI at www.Hoka.co.nz

A solocast, for those guys who feel overwhelmingly anxious and depressed. Just set your armor down for a second and let me talk to you. I can only offer you my perspective, which is fueled by years of personal experience and learning about myself through books, lectures, videos, podcasts, conversations, determination, and action. I'm still on this 'mental health' path myself, but I know damn sure I'm not alone. Neither are you brother. You just have to start listening.

In today's episode, Greg and Eric discuss a new study reporting that 85% of highly cited meta-analyses in the field of strength and conditioning research contain at least one statistical error. The conversation covers common meta-analysis errors, how to spot them, and how to critically interpret meta-analyses. After that, Eric presents a segment on motivation and behavior change. He begins by reviewing evidence-based goal setting strategies, then discusses how we can leverage self-determination theory to get motivated to pursue our goals, and how we can lean on the COM-B (capability, opportunity, motivation, behavior) model to change behaviors in accordance with our goals. This leads to a unified, comprehensive, evidence-based model that covers goal setting, motivation, and behavior change from start to finish. SUPPORT THE PODCASTJoin the Research Spotlight newsletter: Get a two-minute breakdown of one recent study every Wednesday. Our newsletter is the easiest way to stay up to date with the latest exercise and nutrition science.MacroFactorIf you want to learn more about our MacroFactor diet app, check it out  here.To join in on the MacroFactor conversation, check out our Facebook group and subreddit.CoachingGet personalized training and nutrition plans from our expert coaches: Learn more hereMASS Research Review Subscribe to the MASS Research Review to get concise and applicable breakdowns of the latest strength, physique, and nutrition research – delivered monthly.SponsorsBulkSupplements: Next time you stock up on supplements,  be sure to use the promo code “SBSPOD” (all caps) to get 5% off your entire order at BulkSupplements.com.Sports Nutrition Association: Learn more or become a member of SNA. The Sports Nutrition Association is dedicated to ensuring the sustainable prosperity of the Sports Nutrition Profession, and they offer a unique pathway to robust insurance coverage for your sports nutrition business. TIME STAMPSIntro/Announcements (0:00)Origins of meta-analyses (6:15)New study on meta-analysis errors (11:53)https://link.springer.com/article/10.1007/s40279-022-01766-0The most common errors (17:10)Interpretation and conclusions (29:22)https://www.strongerbyscience.com/meta-analyses/Defining “motivation” (50:11)Goal setting (52:51)https://www.strongerbyscience.com/goal-setting/https://www.frontiersin.org/articles/10.3389/fpsyg.2018.01879/fullMotivation (1:00:43)Self-determination theory (1:06:07)https://selfdeterminationtheory.org/research/https://pubmed.ncbi.nlm.nih.gov/11392867/https://psycnet.apa.org/record/2021-68513-001Psychological needs (competence, relatedness, autonomy) (1:11:18)The COM-B model of behavior change (1:29:19)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096582/Practical application: a unified model combining goal hierarchies, self-determination theory, and the COM-B model of behavior change (1:37:30)

It's the start of a new era, as Omar and Eric sit down for episode 201. In this conversation, the two pick up where they left off from episode 200, tackling the Cult's questions that were too good, and too deep to cover last week. Specifically, we discuss how to compare the potential effects of dissimilar variables on hypertrophy, such as sleep, protein, and creatine using research. Further, we field questions on how you measure progress and deal with plateaus, and whether higher frequency training can provide unique advantages. 00:00 Introduction to a new era of Iron Culture (and reading comments) 15:11 Start of Q&A. Effect sizes in sport science research (protein, creatine, and sleep) and their application to practice Tagawa 2020 Dose-response relationship between protein intake and muscle mass increase: a systematic review and meta-analysis of randomized controlled trials https://pubmed.ncbi.nlm.nih.gov/33300582/ Morton 2018 A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults https://pubmed.ncbi.nlm.nih.gov/28698222/ Lanhers 2015 Creatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-Analyses https://pubmed.ncbi.nlm.nih.gov/25946994/ Lanhers 2017 Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/27328852/ Branch 2003 Effect of creatine supplementation on body composition and performance: a meta-analysis https://pubmed.ncbi.nlm.nih.gov/12945830/  Craven 2022 Effects of Acute Sleep Loss on Physical Performance: A Systematic and Meta-Analytical Review https://pubmed.ncbi.nlm.nih.gov/35708888/ 44:55 Advice for people who love the iron game but may not necessarily have the best genetics and life situation for it (reframing our view of strength standards that we compare ourselves to) 56:58 Which variable(s) to adjust when strength plateaus 1:05:03 How important is it to have a high volume for a specific muscle group in a single session vs across the week? Iron Culture Ep. 40- Training Frequency For Strength & Hypertrophy https://www.youtube.com/watch?v=VDNvJaNeDw4&t=13s Iron Culture Ep. 152-Effort vs Exertion, Frequency, and Qualitative Research (Q&A) https://www.youtube.com/watch?v=kCg_4tQzbC0 Greg Nuckols' in-house Meta https://www.strongerbyscience.com/frequency-muscle/ James Krieger's in-house Meta https://weightology.net/the-members-area/evidence-based-guides/set-volume-for-muscle-size-the-ultimate-evidence-based-bible/ Schoenfeld 2017 Dose-response relationship between weekly resistance training volume and increases in muscle mass: A systematic review and meta-analysis https://pubmed.ncbi.nlm.nih.gov/27433992/ Baz-Valle 2022 A Systematic Review of The Effects of Different Resistance Training Volumes on Muscle Hypertrophy https://pubmed.ncbi.nlm.nih.gov/35291645/ 1:12:40 Closing out (and Iron Culture TikTok??)

A charismatic-chameleon, A wisdom-filled wizard, A starry-eyed Scorpio, it's the great Roman Merrell! In this episode, I'm joined by an old friend to explore a bit of our past… recent and far far away. Roman has lived an interesting and adventurous life up to this point, and his perception of the world is a wonderful one to know. We catch up as Roman shares personal teachings and experiences from the last decade that have led him on a path of discovery and introspection about the universe. We speak astrology, the self, things we learned in our twenties, teens, and childhood, psychedelic experiences, being a Scorpio and an introvert, meta-perspective, voices in the head, alchemy, cognitive perception over the ages, being aware of awareness, various philosophies of the past, trauma, postcards to our Karmic family, lost lineage, retold histories, heightened intuition, fake crying, and much much more. I could've title this "Two Scorpio friends reconnect and talk about their place in the universe" but that didn't feel as catchy. If you love the wisdom and knowledge from Roman - check out his podcasts and art here: Rising From The Ashes Podcast: https://open.spotify.com/show/6fmYk1ZLuJSbCwVaPRZCns?si=9fece4a6688143d6 Moon Mysteries: https://open.spotify.com/show/7DLYhkZ1ZIsEiJNl2iTIOQ?si=a8671cec08654f36 GUSHMORR: https://open.spotify.com/artist/65iT1qNV8ArdVR3UL8zb8l?si=5VNX4p6QT4CjsLGXIZ5Mkw If you'd love to hear more convos between Roman and myself - let us know! comment, share, and follow - thanks for listening! Roman expands on the concept of: "Millionaires don't have Astrologers, billionaires do." "When I was a kid, I had this movie theatre in my head." "There were these nuns, they would walk in through my ear, they would go and sit down in the seats in my head, watching what I'm watching, commenting on what I'm seeing, and I couldn't of been more than nine or ten years old." "We are so in love with love, humans are love. Everything that we have down to our core, is a passion, it's a heartbeat, it's a feeling, and it's the vibration of unconditional love. When you separate all the layers, that's what it is. You get in tune with that by surrounding yourself with the things that make it easy for you to feel that love."