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Listen to ASCO's JCO Oncology Practice, Art of Oncology Practice article, "An Oncologist's Guide to Ensuring Your First Medical Grand Rounds Will Be Your Last” by Dr. David Johnson, who is a clinical oncologist at University of Texas Southwestern Medical School. The article is followed by an interview with Johnson and host Dr. Mikkael Sekeres. Through humor and irony, Johnson critiques how overspecialization and poor presentation practices have eroded what was once internal medicine's premier educational forum. Transcript Narrator: An Oncologist's Guide to Ensuring Your First Medical Grand Rounds Will Be Your Last, by David H. Johnson, MD, MACP, FASCO Over the past five decades, I have attended hundreds of medical conferences—some insightful and illuminating, others tedious and forgettable. Among these countless gatherings, Medical Grand Rounds (MGRs) has always held a special place. Originally conceived as a forum for discussing complex clinical cases, emerging research, and best practices in patient care, MGRs served as a unifying platform for clinicians across all specialties, along with medical students, residents, and other health care professionals. Expert speakers—whether esteemed faculty or distinguished guests—would discuss challenging cases, using them as a springboard to explore the latest advances in diagnosis and treatment. During my early years as a medical student, resident, and junior faculty member, Grand Rounds consistently attracted large, engaged audiences. However, as medicine became increasingly subspecialized, attendance began to wane. Lectures grew more technically intricate, often straying from broad clinical relevance. The patient-centered discussions that once brought together diverse medical professionals gradually gave way to hyperspecialized presentations. Subspecialists, once eager to share their insights with the wider medical community, increasingly withdrew to their own specialty-specific conferences, further fragmenting the exchange of knowledge across disciplines. As a former Chair of Internal Medicine and a veteran of numerous MGRs, I observed firsthand how these sessions shifted from dynamic educational exchanges to highly specialized, often impenetrable discussions. One of the most striking trends in recent years has been the decline in presentation quality at MGR—even among local and visiting world-renowned experts. While these speakers are often brilliant clinicians and investigators, they can also be remarkably poor lecturers, delivering some of the most uninspiring talks I have encountered. Their presentations are so consistently lackluster that one might suspect an underlying strategy at play—an unspoken method to ensure that they are never invited back. Having observed this pattern repeatedly, I am convinced that these speakers must be adhering to a set of unwritten rules to avoid future MGR presentations. To assist those unfamiliar with this apparent strategy, I have distilled the key principles that, when followed correctly, all but guarantee that a presenter will not be asked to give another MGR lecture—thus sparing them the burden of preparing one in the future. Drawing on my experience as an oncologist, I illustrate these principles using an oncology-based example although I suspect similar rules apply across other subspecialties. It will be up to my colleagues in cardiology, endocrinology, rheumatology, and beyond to identify and document their own versions—tasks for which I claim no expertise. What follows are the seven “Rules for Presenting a Bad Medical Oncology Medical Grand Rounds.” 1. Microscopic Mayhem: Always begin with an excruciatingly detailed breakdown of the tumor's histology and molecular markers, emphasizing how these have evolved over the years (eg, PAP v prostate-specific antigen)—except, of course, when they have not (eg, estrogen receptor, progesterone receptor, etc). These nuances, while of limited relevance to general internists or most subspecialists (aside from oncologists), are guaranteed to induce eye-glazing boredom and quiet despair among your audience. 2. TNM Torture: Next, cover every nuance of the newest staging system … this is always a real crowd pleaser. For illustrative purposes, show a TNM chart in the smallest possible font. It is particularly helpful if you provide a lengthy review of previous versions of the staging system and painstakingly cover each and every change in the system. Importantly, this activity will allow you to disavow the relevance of all previous literature studies to which you will subsequently refer during the course of your presentation … to wit—“these data are based on the OLD staging system and therefore may not pertain …” This phrase is pure gold—use it often if you can. NB: You will know you have “captured” your audience if you observe audience members “shifting in their seats” … it occurs almost every time … but if you have failed to “move” the audience … by all means, continue reading … there is more! 3. Mechanism of Action Meltdown: Discuss in detail every drug ever used to treat the cancer under discussion; this works best if you also give a detailed description of each drug's mechanism of action (MOA). General internists and subspecialists just LOVE hearing a detailed discussion of the drug's MOA … especially if it is not at all relevant to the objectives of your talk. At this point, if you observe a wave of slack-jawed faces slowly slumping toward their desktops, you will know you are on your way to successfully crushing your audience's collective spirit. Keep going—you are almost there. 4. Dosage Deadlock: One must discuss “dose response” … there is absolutely nothing like a dose response presentation to a group of internists to induce cries of anguish. A wonderful example of how one might weave this into a lecture to generalists or a mixed audience of subspecialists is to discuss details that ONLY an oncologist would care about—such as the need to dose escalate imatinib in GIST patients with exon 9 mutations as compared with those with exon 11 mutations. This is a definite winner! 5. Criteria Catatonia: Do not forget to discuss the newest computed tomography or positron emission tomography criteria for determining response … especially if you plan to discuss an obscure malignancy that even oncologists rarely encounter (eg, esthesioneuroblastoma). Should you plan to discuss a common disease you can ensure ennui only if you will spend extra time discussing RECIST criteria. Now if you do this well, some audience members may begin fashioning their breakfast burritos into projectiles—each one aimed squarely at YOU. Be brave … soldier on! 6. Kaplan-Meier Killer: Make sure to discuss the arcane details of multiple negative phase II and III trials pertaining to the cancer under discussion. It is best to show several inconsequential and hard-to-read Kaplan-Meier plots. To make sure that you do a bad job, divide this portion of your presentation into two sections … one focused on adjuvant treatment; the second part should consist of a long boring soliloquy on the management of metastatic disease. Provide detailed information of little interest even to the most ardent fan of the disease you are discussing. This alone will almost certainly ensure that you will never, ever be asked to give Medicine Grand Rounds again. 7. Lymph Node Lobotomy: For the coup de grâce, be sure to include an exhaustive discussion of the latest surgical techniques, down to the precise number of lymph nodes required for an “adequate dissection.” To be fair, such details can be invaluable in specialized settings like a tumor board, where they send subspecialists into rapturous delight. But in the context of MGR—where the audience spans multiple disciplines—it will almost certainly induce a stultifying torpor. If dullness were an art, this would be its masterpiece—capable of lulling even the most caffeinated minds into a stupor. If you have carefully followed the above set of rules, at this point, some members of the audience should be banging their heads against the nearest hard surface. If you then hear a loud THUD … and you're still standing … you will know you have succeeded in giving the world's worst Medical Grand Rounds! Final Thoughts I hope that these rules shed light on what makes for a truly dreadful oncology MGR presentation—which, by inverse reasoning, might just serve as a blueprint for an excellent one. At its best, an outstanding lecture defies expectations. One of the most memorable MGRs I have attended, for instance, was on prostaglandin function—not a subject typically associated with edge-of-your-seat suspense. Given by a biochemist and physician from another subspecialty, it could have easily devolved into a labyrinth of enzymatic pathways and chemical structures. Instead, the speaker took a different approach: rather than focusing on biochemical minutiae, he illustrated how prostaglandins influence nearly every major physiologic system—modulating inflammation, regulating cardiovascular function, protecting the gut, aiding reproduction, supporting renal function, and even influencing the nervous system—without a single slide depicting the prostaglandin structure. The result? A room full of clinicians—not biochemists—walked away with a far richer understanding of how prostaglandins affect their daily practice. What is even more remarkable is that the talk's clarity did not just inform—it sparked new collaborations that shaped years of NIH-funded research. Now that was an MGR masterpiece. At its core, effective scientific communication boils down to three deceptively simple principles: understanding your audience, focusing on relevance, and making complex information accessible.2 The best MGRs do not drown the audience in details, but rather illuminate why those details matter. A great lecture is not about showing how much you know, but about ensuring your audience leaves knowing something they didn't before. For those who prefer the structured wisdom of a written guide over the ramblings of a curmudgeon, an excellent review of these principles—complete with a handy checklist—is available.2 But fair warning: if you follow these principles, you may find yourself invited back to present another stellar MGRs. Perish the thought! Dr. Mikkael SekeresHello and welcome to JCO's Cancer Stories: The Art of Oncology, which features essays and personal reflections from authors exploring their experience in the oncology field. I'm your host, Mikkael Sekeres. I'm Professor of Medicine and Chief of the Division of Hematology at the Sylvester Comprehensive Cancer Center, University of Miami. What a pleasure it is today to be joined by Dr. David Johnson, clinical oncologist at the University of Texas Southwestern Medical School. In this episode, we will be discussing his Art of Oncology Practice article, "An Oncologist's Guide to Ensuring Your First Medical Grand Rounds Will Be Your Last." Our guest's disclosures will be linked in the transcript. David, welcome to our podcast and thanks so much for joining us. Dr. David JohnsonGreat to be here, Mikkael. Thanks for inviting me. Dr. Mikkael SekeresI was wondering if we could start with just- give us a sense about you. Can you tell us about yourself? Where are you from? And walk us through your career. Dr. David JohnsonSure. I grew up in a small rural community in Northwest Georgia about 30 miles south of Chattanooga, Tennessee, in the Appalachian Mountains. I met my wife in kindergarten. Dr. Mikkael SekeresOh my. Dr. David JohnsonThere are laws in Georgia. We didn't get married till the third grade. But we dated in high school and got married after college. And so we've literally been with one another my entire life, our entire lives. Dr. Mikkael SekeresMy word. Dr. David JohnsonI went to medical school in Georgia. I did my training in multiple sites, including my oncology training at Vanderbilt, where I completed my training. I spent the next 30 years there, where I had a wonderful career. Got an opportunity to be a Division Chief and a Deputy Director of, and the founder of, a cancer center there. And in 2010, I was recruited to UT Southwestern as the Chairman of Medicine. Not a position I had particularly aspired to, but I was interested in taking on that challenge, and it proved to be quite a challenge for me. I had to relearn internal medicine, and really all the subspecialties of medicine really became quite challenging to me. So my career has spanned sort of the entire spectrum, I suppose, as a clinical investigator, as an administrator, and now as a near end-of-my-career guy who writes ridiculous articles about grand rounds. Dr. Mikkael SekeresNot ridiculous at all. It was terrific. What was that like, having to retool? And this is a theme you cover a little bit in your essay, also, from something that's super specialized. I mean, you have had this storied career with the focus on lung cancer, and then having to expand not only to all of hematology oncology, but all of medicine. Dr. David JohnsonIt was a challenge, but it was also incredibly fun. My first few days in the chair's office, I met with a number of individuals, but perhaps the most important individuals I met with were the incoming chief residents who were, and are, brilliant men and women. And we made a pact. I promised to teach them as much as I could about oncology if they would teach me as much as they could about internal medicine. And so I spent that first year literally trying to relearn medicine. And I had great teachers. Several of those chiefs are now on the faculty here or elsewhere. And that continued on for the next several years. Every group of chief residents imparted their wisdom to me, and I gave them what little bit I could provide back to them in the oncology world. It was a lot of fun. And I have to say, I don't necessarily recommend everybody go into administration. It's not necessarily the most fun thing in the world to do. But the opportunity to deal one-on-one closely with really brilliant men and women like the chief residents was probably the highlight of my time as Chair of Medicine. Dr. Mikkael SekeresThat sounds incredible. I can imagine, just reflecting over the two decades that I've been in hematology oncology and thinking about the changes in how we diagnose and care for people over that time period, I can only imagine what the changes had been in internal medicine since I was last immersed in that, which would be my residency. Dr. David JohnsonWell, I trained in the 70s in internal medicine, and what transpired in the 70s was kind of ‘monkey see, monkey do'. We didn't really have a lot of understanding of pathophysiology except at the most basic level. Things have changed enormously, as you well know, certainly in the field of oncology and hematology, but in all the other fields as well. And so I came in with what I thought was a pretty good foundation of knowledge, and I realized it was completely worthless, what I had learned as an intern and resident. And when I say I had to relearn medicine, I mean, I had to relearn medicine. It was like being an intern. Actually, it was like being a medical student all over again. Dr. Mikkael SekeresOh, wow. Dr. David JohnsonSo it's quite challenging. Dr. Mikkael SekeresWell, and it's just so interesting. You're so deliberate in your writing and thinking through something like grand rounds. It's not a surprise, David, that you were also deliberate in how you were going to approach relearning medicine. So I wonder if we could pivot to talking about grand rounds, because part of being a Chair of Medicine, of course, is having Department of Medicine grand rounds. And whether those are in a cancer center or a department of medicine, it's an honor to be invited to give a grand rounds talk. How do you think grand rounds have changed over the past few decades? Can you give an example of what grand rounds looked like in the 1990s compared to what they look like now? Dr. David JohnsonWell, I should all go back to the 70s and and talk about grand rounds in the 70s. And I referenced an article in my essay written by Dr. Ingelfinger, who many people remember Dr. Ingelfinger as the Ingelfinger Rule, which the New England Journal used to apply. You couldn't publish in the New England Journal if you had published or publicly presented your data prior to its presentation in the New England Journal. Anyway, Dr. Ingelfinger wrote an article which, as I say, I referenced in my essay, about the graying of grand rounds, when he talked about what grand rounds used to be like. It was a very almost sacred event where patients were presented, and then experts in the field would discuss the case and impart to the audience their wisdom and knowledge garnered over years of caring for patients with that particular problem, might- a disease like AML, or lung cancer, or adrenal insufficiency, and talk about it not just from a pathophysiologic standpoint, but from a clinician standpoint. How do these patients present? What do you do? How do you go about diagnosing and what can you do to take care of those kinds of patients? It was very patient-centric. And often times the patient, him or herself, was presented at the grand rounds. And then experts sitting in the front row would often query the speaker and put him or her under a lot of stress to answer very specific questions about the case or about the disease itself. Over time, that evolved, and some would say devolved, but evolved into more specialized and nuanced presentations, generally without a patient present, or maybe even not even referred to, but very specifically about the molecular biology of disease, which is marvelous and wonderful to talk about, but not necessarily in a grand round setting where you've got cardiologists sitting next to endocrinologists, seated next to nephrologists, seated next to primary care physicians and, you know, an MS1 and an MS2 and et cetera. So it was very evident to me that what I had witnessed in my early years in medicine had really become more and more subspecialized. As a result, grand rounds, which used to be packed and standing room only, became echo chambers. It was like a C-SPAN presentation, you know, where local representative got up and gave a talk and the chambers were completely empty. And so we had to go to do things like force people to attend grand rounds like a Soviet Union-style rally or something, you know. You have to pay them to go. But it was really that observation that got me to thinking about it. And by the way, I love oncology and I'm, I think there's so much exciting progress that's being made that I want the presentations to be exciting to everybody, not just to the oncologist or the hematologist, for example. And what I was witnessing was kind of a formula that, almost like a pancake formula, that everybody followed the same rules. You know, “This disease is the third most common cancer and it presents in this way and that way.” And it was very, very formulaic. It wasn't energizing and exciting as it had been when we were discussing individual patients. So, you know, it just is what it is. I mean, progress is progress and you can't stop it. And I'm not trying to make America great again, you know, by going back to the 70s, but I do think sometimes we overthink what medical grand rounds ought to be as compared to a presentation at ASH or ASCO where you're talking to subspecialists who understand the nuances and you don't have to explain the abbreviations, you know, that type of thing. Dr. Mikkael SekeresSo I wonder, you talk about the echo chamber of the grand rounds nowadays, right? It's not as well attended. It used to be a packed event, and it used to be almost a who's who of, of who's in the department. You'd see some very famous people who would attend every grand rounds and some up-and-comers, and it was a chance for the chief residents to shine as well. How do you think COVID and the use of Zoom has changed the personality and energy of grand rounds? Is it better because, frankly, more people attend—they just attend virtually. Last time I attended, I mean, I attend our Department of Medicine grand rounds weekly, and I'll often see 150, 200 people on the Zoom. Or is it worse because the interaction's limited? Dr. David JohnsonYeah, I don't want to be one of those old curmudgeons that says, you know, the way it used to be is always better. But there's no question that the convenience of Zoom or similar media, virtual events, is remarkable. I do like being able to sit in my office where I am right now and watch a conference across campus that I don't have to walk 30 minutes to get to. I like that, although I need the exercise. But at the same time, I think one of the most important aspects of coming together is lost with virtual meetings, and that's the casual conversation that takes place. I mentioned in my essay an example of the grand rounds that I attended given by someone in a different specialty who was both a physician and a PhD in biochemistry, and he was talking about prostaglandin metabolism. And talk about a yawner of a title; you almost have to prop your eyelids open with toothpicks. But it turned out to be one of the most fascinating, engaging conversations I've ever encountered. And moreover, it completely opened my eyes to an area of research that I had not been exposed to at all. And it became immediately obvious to me that it was relevant to the area of my interest, which was lung cancer. This individual happened to be just studying colon cancer. He's not an oncologist, but he was studying colon cancer. But it was really interesting what he was talking about. And he made it very relevant to every subspecialist and generalist in the audience because he talked about how prostaglandin has made a difference in various aspects of human physiology. The other grand rounds which always sticks in my mind was presented by a long standing program director at my former institution of Vanderbilt. He's passed away many years ago, but he gave a fascinating grand rounds where he presented the case of a homeless person. I can't remember the title of his grand rounds exactly, but I think it was “Care of the Homeless” or something like that. So again, not something that necessarily had people rushing to the audience. What he did is he presented this case as a mysterious case, you know, “what is it?” And he slowly built up the presentation of this individual who repeatedly came to the emergency department for various and sundry complaints. And to make a long story short, he presented a case that turned out to be lead poisoning. Everybody was on the edge of their seat trying to figure out what it was. And he was challenging members of the audience and senior members of the audience, including the Cair, and saying, “What do you think?” And it turned out that the patient became intoxicated not by eating paint chips or drinking lead infused liquids. He was burning car batteries to stay alive and inhaling lead fumes, which itself was fascinating, you know, so it was a fabulous grand rounds. And I mean, everybody learned something about the disease that they might otherwise have ignored, you know, if it'd been a title “Lead Poisoning”, I'm not sure a lot of people would have shown up. Dr. Mikkael Sekeres That story, David, reminds me of Tracy Kidder, who's a master of the nonfiction narrative, will choose a subject and kind of just go into great depth about it, and that subject could be a person. And he wrote a book called Rough Sleepers about Jim O'Connell - and Jim O'Connell was one of my attendings when I did my residency at Mass General - and about his life and what he learned about the homeless. And it's this same kind of engaging, “Wow, I never thought about that.” And it takes you in a different direction. And you know, in your essay, you make a really interesting comment. You reflect that subspecialists, once eager to share their insight with the wider medical community, increasingly withdraw to their own specialty specific conferences, further fragmenting the exchange of knowledge across disciplines. How do you think this affects their ability to gain new insights into their research when they hear from a broader audience and get questions that they usually don't face, as opposed to being sucked into the groupthink of other subspecialists who are similarly isolated? Dr. David Johnson That's one of the reasons I chose to illustrate that prostaglandin presentation, because again, that was not something that I specifically knew much about. And as I said, I went to the grand rounds more out of a sense of obligation than a sense of engagement. Moreover, our Chair at that institution forced us to go, so I was there, not by choice, but I'm so glad I was, because like you say, I got insight into an area that I had not really thought about and that cross pollination and fertilization is really a critical aspect. I think that you can gain at a broad conference like Medical Grand Rounds as opposed to a niche conference where you're talking about APL. You know, everybody's an APL expert, but they never thought about diabetes and how that might impact on their research. So it's not like there's an ‘aha' moment at every Grand Rounds, but I do think that those kinds of broad based audiences can sometimes bring a different perspective that even the speaker, him or herself had not thought of. Dr. Mikkael SekeresI think that's a great place to end and to thank David Johnson, who's a clinical oncologist at the University of Texas Southwestern Medical School and just penned the essay in JCO Art of Oncology Practice entitled "An Oncologist's Guide to Ensuring Your First Medical Grand Rounds Will Be Your Last." Until next time, thank you for listening to JCO's Cancer Stories: The Art of Oncology. Don't forget to give us a rating or review, and be sure to subscribe so you never miss an episode. You can find all of ASCO's shows at asco.org/podcasts. David, once again, I want to thank you for joining me today. Dr. David JohnsonThank you very much for having me. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Show notes: Like, share and subscribe so you never miss an episode and leave a rating or review. Guest Bio: Dr David Johnson is a clinical oncologist at the University of Texas Southwestern Medical School.
Asian Battery Metals PLC managing director Gan-Ochir Zunduisuren talked with Proactive about the company's upcoming drilling activities at its Gambit Project in Mongolia. Zunduisuren confirmed that AZ9 is fully funded for its latest regional exploration program, which includes key targets MS1, MS2, and Copper Ridge. The MS1 and MS2 drill targets have never been drilled before. According to Zunduisuren, these are “coincidental, magnetic gravity and IP anomalies,” which may suggest a concealed magmatic system. He explained that this complements the ongoing exploration strategy at Oval and could help build a pipeline of future copper and nickel mineralization. Zunduisuren highlighted that at the Copper Ridge prospect, a previous drill hole intersected more than 137 metres of copper and gold mineralisation. He noted that the area “has a good potential for hosting independent systems,” and that the company will be following up with more drilling. Additionally, the exploration program will be expanding into the CA Far East area. The phase three drilling program at Oval continues in parallel, with all results — including lab assessments — expected by the second half of June. Zunduisuren said the company will provide the market with updates once data from both Oval and regional targets is available.
What if chronic diseases like cancer and Alzheimer's are caused by infections we've overlooked? We assume chronic disease is caused by genetics and / or lifestyle. However, evolutionary biologist Dr. Paul Ewald says latent viruses and pathogens play a critical hidden role in many diseases. For example, we already know that Human Papillomavirus (HPV) causes cervical cancer. And research indicates how the EBV virus shows up in Multiple sclerosis, and chlamydia pneumonia shows in Alzheimer's. Deeper investigation into viruses and disease is warranted and will help with better diagnosis and treatment.Dr. Paul Ewald is also the author of Plague Time: The New Germ Theory of Disease, and Evolution of Infectious diseases. Episode Show Notes: https://livelongerworld.com/p/pewaldFind me: https://x.com/aasthajs My longevity products: https://www.livelongerworld.com/p/2024TIMESTAMPS:0:00 Role of infection in chronic disease is neglected2:40 Role of viruses in Alzheimer's10:50 Connections between Alzheimer's, diabetes, cardiovascular disease15:57 Genes cannot explain the full reason for disease20:47 Strong association between Alzheimer's, chlamydia pneumonia, and APOE428:16 Multiple sclerosis and EBV virus35:08 Latent viruses may in fact be active & cause cancer41:41 Sexually- transmitted pathogens correlated with cancer46:50 Viruses that cause cancer (EBV & breast cancer)53:09 Hodgkin's lymphoma and virus57:15 Stanford study showing EBV as leading cause of MS1:00:19 Do viruses attack the mitochondria and cause cancer1:01:38 Glioblastoma and virus / antiviral treatment1:07:07 Virus vs. oncogenes causing cancer1:14:17 Breast cancer BRAC1 mutations & virus association1:15:59 Vaccines against viruses1:17:56 Practical steps if you test positive for infectious viruses1:24:57 Could cancer relapse be due to persistent virus1:27:48 Protect the immune system1:29:38 Areas Dr. Ewald is excited aboutAASTHA, LIVE LONGER WORLD:X: https://x.com/aasthajs Newsletter: https://livelongerworld.com/Instagram: https://www.instagram.com/aasthajs/PAUL EWALD LINKS:Plague Time: The New Germ Theory of Disease: https://amzn.to/3FXjOSuEvolution of Infectious diseases: https://amzn.to/3FYaqOvEpisode Show Notes: https://livelongerworld.com/p/pewaldALSO WATCH:Keto & Metabolic Therapy for Cancer | Dr. Thomas Seyfried: https://open.spotify.com/episode/7tYdjcJ3G4tqbAx9Z6Bix2?si=biOOH1e5RpeZduLJv2fPHw
A 4-PART BORDERLAND SPECIAL SERIES: EPISODE 4: THE ULTRA-VIOLENT RISE AND DRAMATIC FALL OF MS-13 On the southern border, there is a legal concept known as “reasonable fear.” If an asylum officer determines that a migrant has a “reasonable fear of persecution or torture” if returned to their home country, then removal procedures can be delayed. And, in the current border crisis, there's been no greater source of “reasonable fear” cases than the Mexican drug cartels and organized crime. In each episode we take a deep dive into the border crisis to find the primary players behind the violence, the scope of these transnational criminal enterprises, and the state of the narco wars. In this episode, host Vince ‘Rocoo' Vargas, looks the ultra-violent rise -- and dramatic fall -- of MS1-3. Check out the REASONABLE FEAR S.E.C. KIT available for pre-order at https://thisisironclad.com/products/sec?=RFTRAILER Learn more about your ad choices. Visit megaphone.fm/adchoices
Warning: This content addresses mental health issues, including research and narratives on suicide. Please take care while engaging with it and only proceed if you feel safe doing so. If you, or someone you love, is having thoughts of suicide, please contact 988. Help is available. Interviewer Lisa Meeks Interviewees John Ruddell Jennifer Ruddell Roja (friend of Jack Ruddell) Dr. Christine Moutier Dr. Jessi Gold Narrator Dr. Joseph Murray Description In this deeply moving episode, host Lisa Meeks introduces a special series dedicated to exploring the mental health crisis among medical trainees, with a focus on the tragic story of Dr. Jack Ruddell. Joined by Jack's parents, John and Jennifer Ruddell, and his close friend Roja, we delve into Jack's life, his struggles with depression and anxiety, and the immense pressures faced by medical students. Dr. Joseph Murray, a psychiatrist at Weill Cornell Medical College, provides expert insights into the high rates of burnout, depression, and suicide in the medical field. We also hear from Dr. Christine Moutier, Chief Medical Officer of the American Foundation for Suicide Prevention, and Dr. Jessie Gold, a respected psychiatrist and author, who discuss the unique challenges and cultural issues within medical training that contribute to mental health struggles. This episode aims to reduce the stigma surrounding mental health issues, encourage medical learners to seek help, and advocate for systemic changes in medical education to foster a more supportive and compassionate environment. Description of Series DWDI Special Series: Suicidality in Medical Training dives into the critical conversations around mental health, well-being, support systems, and the intense pressures faced during medical training. Through the power of storytelling, the series intertwines these broader themes with the deeply personal story of Dr. Jack Ruddell, a promising medical student who died by suicide. Jack's journey—his strengths, struggles, and the complexities leading to his untimely death—forms the emotional core of this five-part series, giving voice to the loved ones often excluded from these conversations. Alongside Jack's story, the series incorporates expert insights and data from the literature, offering a human perspective on burnout, depression, and suicide among medical trainees. With a commitment to improving mental health awareness and reducing the stigma around seeking help, the series presents a novel approach by centering personal narratives alongside expert analysis. It also explores actionable strategies for improving medical training environments and highlights the importance of institutional responses after a loss by suicide. Our mission is to reduce shame, encourage help-seeking among medical students struggling with depression, and ensure that every medical school is aware of the postvention resources offered by the American Foundation for Suicide Prevention (AFSP). Experts for the Series Christine Moutier, MD – Chief Medical Officer, American Foundation for Suicide Prevention Jessi Gold, MD – Chief Wellness Officer, University of Tennessee System; Author of How Do You Feel? David Muller, MD – Director, Institute for Equity and Justice in Health Sciences Education; Dean Emeritus, Icahn School of Medicine at Mt. Sinai; Author of the NEJM essay, Kathryn Srijan Sen, MD, PhD – Director, Eisenberg Family Depression Center; PI of the Intern Health Study Justin Bullock, MD, MPH – Fellow, University of Washington; Author of the NEJM article, Suicide, Rewriting My Story Stuart Slavin, MD, MEd – Vice President for Well-Being, ACGME Episode Release Schedule: September 17: Episode 102 – Honoring Dr. Jack Ruddell: A Story of Joy, Compassion, and Mental Health in Medical Training. September 17: Episode 103 – Suicide and Suicidality in Medical Training: Understanding the Crisis and its Causes. September 24: Episode 104 – Silent Struggles: Mental Health and Medical Education. September 26: Episode 105 – Repairing the System: How Do We Create Safe Environments? September 30: Episode 106 – Responding to Loss: Postvention and Support After a Suicide. Transcript Keywords: Suicide, Death, Mental health, Jack Ruddell, Medical training, Depression, Suicidality, Burnout, Anxiety, Medical trainees, American Foundation for Suicide Prevention, Tourette's, Disabilities, Medical education, Medical school, Discrimination, Academic pressure, Clinical practice, Imposter syndrome, Perfectionism, Shame, Mental disability, Learning challenges, Accommodations, High-stakes testing, Inclusivity, Stigma Resources: 24/7 Suicide & Crisis Hotline, call or text 988 or chat 988lifeline.org. How are you? By Jessi Gold National Office for Suicide Prevention: Language and suicide The American Foundation for Suicide Prevention References Johnson KM, Slavin SJ, Takahashi TA. Excellent vs Excessive: Helping Trainees Balance Performance and Perfectionism. J Grad Med Educ. 2023 Aug;15(4):424-427. doi: 10.4300/JGME-D-23-00003.1. PMID: 37637342; PMCID: PMC10449346. Bynum WE 4th, W Teunissen P, Varpio L. In the "Shadow of Shame": A Phenomenological Exploration of the Nature of Shame Experiences in Medical Students. Acad Med. 2021 Nov 1;96(11S):S23-S30. doi: 10.1097/ACM.0000000000004261. PMID: 34348391. Jain, Neera R. PhD, MS1; Stergiopoulos, Erene MD, MA2; Addams, Amy3; Moreland, Christopher J. MD, MPH4; Meeks, Lisa M. PhD, MA5. “We Need a Seismic Shift”: Disabled Student Perspectives on Disability Inclusion in U.S. Medical Education. Academic Medicine ():10.1097/ACM.0000000000005842, August 8, 2024. | DOI: 10.1097/ACM.0000000000005842 Meeks LM, Jain NR. Accessibility, Inclusion, and Action in Medical Education: Lived Experiences of Learners and Physicians with Disabilities. Washington, DC: Association of American Medical Colleges; 2018. Retrieved on September 14, 2024 from: https://store.aamc.org/accessibility-inclusion-and-action-in-medical-education-lived-experiences-of-learners-and-physicians-with-disabilities.html. Meeks, L. M., Pereira‐Lima, K., Plegue, M., Jain, N. R., Stergiopoulos, E., Stauffer, C., ... & Moreland, C. J. (2023). Disability, program access, empathy and burnout in US medical students: A national study. Medical education, 57(6), 523-534. Recommended Readings: Almutairi, H., Alsubaiei, A., Abduljawad, S., Alshatti, A., Fekih-Romdhane, F., Husni, M., & Jahrami, H. (2022). Prevalence of burnout in medical students: A systematic review and meta-analysis. International Journal of Social Psychiatry, 68(6), 1157-1170. Enns MW & Cox B. (2002) The Nature and Assessment of Perfectionism: A Critical Analysis. In: Flett GL, Hewitt PL, eds. Perfectionism: Theory, Research, and Treatment. American Psychological Association, 33-62. Goldman, M. L., Shah, R. N., & Bernstein, C. A. (2015). Depression and suicide among physician trainees: recommendations for a national response. JAMA psychiatry, 72(5), 411-412. Johnson, K. M., Slavin, S. J., & Takahashi, T. A. (2023). Excellent vs excessive: helping trainees balance performance and perfectionism. Journal of Graduate Medical Education, 15(4), 424-427. Meeks, L. M., Conrad, S. S., Nouri, Z., Moreland, C. J., Hu, X., & Dill, M. J. (2022). Patient And Coworker Mistreatment Of Physicians With Disabilities: Study examines mistreatment of physicians with disabilities. Health Affairs, 41(10), 1396-1402. Mirza, A. A., Baig, M., Beyari, G. M., Halawani, M. A., & Mirza, A. A. (2021). Depression and anxiety among medical students: a brief overview. Advances in Medical Education and Practice, 393-398. Pereira-Lima, K., Meeks, L. M., Ross, K. E., Marcelin, J. R., Smeltz, L., Frank, E., & Sen, S. (2023). Barriers to disclosure of disability and request for accommodations among first-year resident physicians in the US. JAMA Network Open, 6(5), e239981-e239981. Meeks LM, Ramsey J, Lyons M, Spencer AL, Lee WW. Wellness and work: mixed messages in residency training. J Gen Intern Med. 2019;34(7):1352-1355. PMID: 30924087 Meeks LM, Stergiopoulos E, Petersen KH. Institutional Accountability for Students With Disabilities: A Call for Liaison Committee on Medical Education Action. Acad Med. 2021 Oct. PMID: 34670236
In this episode, Stephanie talks about her first week as an MS1! She talks about finding friends, dealing with gunners, and her first cadaver lab!
Contributor: Megan Hurley, MD Educational Pearls: Heat cramps Occur due to electrolyte disturbances Most common electrolyte abnormalities are hyponatremia and hypokalemia Heat edema Caused by vasodilation with pooling of interstitial fluid in the extremities Heat rash (miliaria) Common in newborns and elderly Due to accumulation of sweat beneath eccrine ducts Heat syncope Lightheadedness, hypotension, and/or syncope in patients with peripheral vasodilation due to heat exposure Treatment is removal from the heat source and rehydration (IV fluids or Gatorade) Heat exhaustion Patients have elevated body temperature (greater than 38º C but less than 40º C) Symptoms include nausea, tachycardia, headache, sweating, and others Normal mental status or mild confusion that improves with cooling Treatment is removal from the heat source and hydration Classic heat stroke From prolonged exposure to heat Defined as a core body temperature > 40.5º C, though not required for diagnosis or treatment Presentation is similar to heat exhaustion with the addition of neurological deficits including ataxia Patients present “dry” Exertional heat stroke Prolonged exposure to heat during exercise Similar to classic heat stroke but the patients present “wet” due to antecedent treatment in ice baths or other field treatments Management of heat-related illnesses includes: Cooling Rehydration Evaluation of electrolytes Antipyretics are not helpful because heat-induced illnesses are not due to hypothalamic dysregulation References Casa DJ, McDermott BP, Lee EC, et al. Cold water immersion: the gold standard for exertional heatstroke treatment. Exerc Sport Sci Rev 2007; 35:141. Ebi KL, Capon A, Berry P, et al. Hot weather and heat extremes: health risks. Lancet 2021; 398:698. Epstein Y, Yanovich R. Heatstroke. N Engl J Med 2019; 380:2449. Gardner JW, JA K. Clinical diagnosis, management, and surveillance of exertional heat illness. In: Textbook of Military Medicine, Zajitchuk R (Ed), Army Medical Center Borden Institute, Washington, DC 2001. Khosla R, Guntupalli KK. Heat-related illnesses. Crit Care Clin 1999; 15:251. Lipman GS, Gaudio FG, Eifling KP, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Heat Illness: 2019 Update. Wilderness Environ Med 2019; 30:S33. Summarized by Jorge Chalit, OMSIII | Edited by Meg Joyce, MS1
Today we interview an MS1 who is celebrating making a budget for the first time. He said he wants to inspire others to do whatever they can to mitigate the financial burden of medical school. He shared that simply by having a budget he is actually spending less because he is more aware of where all of his money is going. We know that the earlier you get started becoming financially literate the better off you will be and this student is well on his way! After the interview we are talking about donor advised funds for Finance 101. At PKA Insurance Group Inc – Pradeep Audho, and Matthew Pedersen are independent brokers focusing on Disability and Life insurance. They excel in securing coverage for physicians, including those on visas like J1, H1B, etc. Protecting your family in the event of a disability or death is important. There is now an A+ rated carrier offering up to $10Million of Life insurance without labs. If you are very healthy with limited or no medical issues, approval is likely in 5 minutes. Reach out to PKA Insurance to discuss your Disability or Life insurance needs at https://www.whitecoatinvestor.com/pka 1-800-258-1018 - OR – emailing info@pkainsurance.com The White Coat Investor has been helping doctors with their money since 2011. Our free financial planning resource covers a variety of topics from doctor mortgage loans and refinancing medical school loans to physician disability insurance and malpractice insurance. Learn about loan refinancing or consolidation, explore new investment strategies, and discover loan programs specifically aimed at helping doctors. If you're a high-income professional and ready to get a "fair shake" on Wall Street, The White Coat Investor channel is for you! Be a Guest on The Milestones to Millionaire Podcast: https://www.whitecoatinvestor.com/milestones Main Website: https://www.whitecoatinvestor.com Student Loan Advice: https://studentloanadvice.com YouTube: https://www.whitecoatinvestor.com/youtube Facebook: https://www.facebook.com/thewhitecoatinvestor Twitter: https://twitter.com/WCInvestor Instagram: https://www.instagram.com/thewhitecoatinvestor Subreddit: https://www.reddit.com/r/whitecoatinvestor Online Courses: https://whitecoatinvestor.teachable.com Newsletter: https://www.whitecoatinvestor.com/free-monthly-newsletter
We have waited far too long but it's time to tackle lucha libre. This week we're watching Sangre Chicana vs. MS1 and Atlantis vs. Villano III.
Before Gergana was an MS1, she was in the military, and before that, she was a programmer. Listen to this nontrad student's unconventional story.
Ever wonder how bodies are handled after a nuclear accident? Radioactive corpses may be more common than you think, with certain cancer treatments leaving patients with radiation in their bodies after death. We're looking into guidelines for handling these situations, and what happens when they're not followed.Resources:"Here's why you shouldn't cremate radioactive dead people" by Beth Mole, ArsTechnica"Radiation Contamination Following Cremation of a Deceased Patient Treated With a Radiopharmaceutical" by Nathan Y. Yu, MD1; William G. Rule, MD1; Terence T. Sio, MD, MS1; et al- Journal of the American Medical Association"A Radioactive Dead Body Contaminated An Arizona Crematorium" by Zahra Hirji, BuzzfeedSafety Information, Lutathera website"Brachytherapy", my.clevelandclinic.orglutetium 177 medication profile, Lexicomp"Radiation Safety Concerns in Brachytherapy", nrc.gov"Richard Leroy McKinley- Specialist 4th Class, United States Army" by Michael Robert Patterson, Arlington National CemeteryUniversity Hospitals of Cleveland resources"Medical Examiners / Coroners: Information for Radiation Emergencies", Radiation Emergency Medical Management, US Department of Health and Human Services"Guidelines for Handling Decedents Contaminated with Radioactive Materials", CDC"SL-1: America's First Nuclear Disaster", Kyle Hill on YouTube
Sachin Narayan is the founder and former CEO of Cathartic, a non profit company that focuses on preventative health of under-resourced populations. He is recent graduate from the University of Southern California and is matriculating as an MS1 this fall at the Stanford School of Medicine. In this captivating podcast episode, join me as I Read more about Sachin Narayan—From Premed to a Purposeful Medical Career[…]
Contributors: Andrew White MD & Travis Barlock MD In this follow-up episode Dr. Andrew White, a practicing psychiatrist with an addiction medicine fellowship, and Dr. Travis Barlock, an emergency physician at Swedish Medical Center, discuss mental health holds, psychiatric placement, pharmacologic vs. non-pharmacologic treatments, and outpatient care of psychotic patients. If you missed it, be sure to listen to part I for details on the management of psychotic patients in the ED. Educational Pearls: Mental health holds should be approached on a case-by-case basis; this includes assessing safety risks immediately, over a 24-hour period, and chronically over the last few months. Lastly, collateral information is useful in assessing a mental health hold. What happens after patients get placed in inpatient psychiatry? Typically an antipsychotic is started; in the absence of metabolic risks, patients will often be started on Zyprexa, especially in oral dissolvable form. Doses of Zyprexa ODT start at 2.5 - 5 mg per day. If psychotic patients do not pose direct harm to the environment, they do not necessarily need to be medicated. However, patients will often need medication at some point; for example, some people may be calm during their psychosis but unable to feed themselves or perform other ADLs. The goal of pharmacologic treatment for psychosis is to save the brain; each episode of psychosis damages the brain. Oftentimes, patients will be started on long-acting injectables like aripiprazole or risperidone to give patients 30 days of treatment with one shot. Non-pharmacologic approaches to psychosis are challenging given the nature of the disease. There have been attempts at therapy for psychosis but not have not been hugely successful. Options for support include PT/OT, family support via organizations like NAMI, and other resources for families of patients with psychosis. Outpatient care of patients with psychosis includes contextualizing the events. For example, many people who experience brief psychotic episodes do not go on to develop schizophrenia so it is important to identify a prognosis. On the other hand, someone who has worsening symptoms over several months may require more aggressive treatment. The primary goal of outpatient management of older patients is to reduce the adverse effects of long-term treatments. The CATIE trial in the early 2000s showed that only 25% of people were on antipsychotics by the end of the trial; it is more important to engage patients than focus too much on medications' adverse effects. Summarized and edited by Jorge Chalit, OMSII | Studio production by Jeffrey Olson, MS1
Forever Young Radio Show with America's Natural Doctor Podcast
Talking Points with Dr. Mark Stengler NMD,MS1.) What age does Menopause generally start to show up?2.) What are the stages of Menopause? -Perimenopause-Menopause-Postmenopause3.) What's happening at each stage?4.) Why do some Women complain about Dryer or thinner skin and hair?5.) Is that connected to Estrogen?6.) Menopause and weight gain. Why is this happening?
How does our prison system take care of its many prisoners? What kind of environments do doctors who work with prisoners experience? What is it like to work in a prison? This and more with our beloved Dr. Hantz, MD, and our hosts Drew Richards, MS1 and Megan Smith, MS1.
Want to know what medical school is actually like? These four medical students are in different phases of their medical school programs and will provide you with their perspective based on their experience. On our panel we have...Emamoke Stephen Odafe is an MS1 at the Uniformed Services University of the Health and Sciences. Sarah Bradley, an MS2 at the Medical University of South Carolina. Luke Hendrix, an MS3 at UT Health San Antonio, MD program. And Yunus Tekin, a 4th year DO medical student at Burrell College of Osteopathic MedicineMentioned in this episode:Ad 2022 11 21 MSHQ BFCM
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.10.18.512791v1?rss=1 Authors: Truong, T., Johnston, S. M., Webber, K., Boekweg, H., Lundgren, C., Liang, Y., Nydegger, A., Xie, X., Payne, S. H., Kelly, R. T. Abstract: The sensitivity of single-cell proteomics (SCP) has increased dramatically in recent years due to advances in experimental design, sample preparation, separations and mass spectrometry instrumentation. Further increasing the sensitivity of SCP methods and instrumentation will enable the study of proteins within single cells that are expressed at copy numbers too small to be measured by current methods. Here we combine efficient nanoPOTS sample preparation and ultra-low-flow liquid chromatography with a newly developed data acquisition and analysis scheme termed wide window acquisition (WWA) to quantify greater than 3,000 proteins from single cells in fast label-free analyses. WWA is based on data-dependent acquisition (DDA) but employs larger precursor isolation windows to intentionally co-isolate and co-fragment additional precursors along with the selected precursor. The resulting chimeric MS2 spectra are then resolved using the CHIMERYS search engine within Proteome Discoverer 3.0. Compared to standard DDA workflows, WWA employing isolation windows of 8-12 Th increases peptide and proteome coverage by ~28% and ~39%, respectively. For a 40-min LC gradient operated at ~15 nL/min, we identified an average of 2,150 proteins per single-cell-sized aliquots of protein digest directly from MS2 spectra, which increased to an average of 3,524 proteins including proteins identified with MS1-level feature matching. Reducing the active gradient to 20 min resulted in a modest 10% decrease in proteome coverage. We also compared the performance of WWA with DIA. DIA underperformed WWA in terms of proteome coverage, especially with faster separations. Average proteome coverage for single HeLa and K562 cells was respectively 1,758 and 1,642 based on MS2 identifications with 1% false discovery rate and 3042 and 2891 with MS1 feature matching. As such, WWA combined with efficient sample preparation and rapid separations extends the depths of the proteome that can be studied at the single-cell level. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC
On this episode, we answer some questions that we have received from our social media. Some of these questions that we were asked & answered are:- How to Address Estrogen Dominance & High Cortisol- What to Do When You're Not Losing Weight in a Deficit - How to Further Your Knowledge About Hormones & Who to Seek Out for Help with This-How to Address High Anxiety During Pregnancy - Gaining too Much Weight in a Reverse Dieting Phase-How to Learn How to Read Labs -How to Increase Calories Properly & Keeping Weight Gain Minimal ............And more! We provided VERY in-depth answers to these questions, & we want to thank everyone who entrusts in us & our feedback/answers! We hope you enjoy this podcast! Interested in working with us or have questions? Reach out to us!Tarryn Nettles, MS1:1 Online Coaching, Lab Reviews, Mentoring IG: @tarryn_nettlestarryn@gtnutritionperformance.orgGillis Pellegrin, MS1:1 Online Coaching, Lab Reviews, Mentoring, Hormone Educator w/ ACS IG: @Gillis331coachgillis.ted1@gmail.com
For those in training and recently finished, we will learn how to maximize this season. We’ll spend the first half tackling topics like original motivation, long-haul stamina, pearls and pitfalls of living in community, debt, vision for one’s next step to the nations, and helping the needy now tensioned with investing in education to help others later. We pray this will infuse you with the hope of Christ and give you eyes to see this refining, exciting time as He does. For the second hour, we’ll divide into small discussion groups with those from your same stage of the journey (i.e., recent grads, residents, MS1-2, MS3-4, PA/NP, pre-med, RN, PT/OT/ST, dental; optional spouse group). With facilitators who have gone through it before, we’ll dive into the individualized questions you have and brainstorm how God might sustain you now and lead you in the upcoming season.
Take a listen to our outstanding MS1's as they ask our wellness expert questions and conundrums that can be encountered in medical education.
Family medicine holds a special place in Dr. Dupper's heart. This accidental class president and mother of two shares her struggles, successes, and the importance of becoming a Family Medicine physician. Episode hosted by Jon Oules, MS1, and Dr. Vy Han, MD.
Most med students are trained in biology, chemistry and physics but what about drawing, sculpting or music? It is called the art of medicine after all... Dr. Scali rejects the notion that the humanities and sciences are at odds with one another and instead shows us how art and medicine go hand in hand. This episode is hosted by our very own Henry-Tranton, Jr, MS1.
Writing - it is a skill necessary for novelists, editors, and journalists...but physicians? The big man on campus, Dean Lyons, is here to tell us just how critical the written word is for medical practitioners, especially when our world seems to be getting more virtual by the day. This episode is hosted by one of our very bright and talented medical students, Henry-Tranton, Jr., MS1.
One of our very own COVID-19 heroes, Inland Empire native and now podcast veteran Dr. Arabian, talks about the myriad of reasons he loves Arrowhead Regional Medical Center and why he has found a passion in Pulmonary Critical Care Medicine. We find out about the highs, lows, and everything in between about working in the medical ICU (MICU). This episode is hosted by one of our very awesome medical students, Jon Oules, MS1.
Phil is joined by fellow Segunda Caida founder and Death Valley Driver alum Tom Karro-Gassner to discusses the greatest match in wrestling history MS1 vs. Sangre Chicana
In this episode, I welcome Arushii Nadar, an MS1 from UT Southwestern. In this episode, we talk about her story, growing up, spending time between the US and India, working hard to be where she is today, and her vision for her future.
When Susie cries for help, Rooter Man comes to her rescue by teaching her how to get rid of fear. "For God has not given us a spirit of fear, but of power and of love and of a sound mind." 2 Tim. 1:7 MS1 #kids, #storiesforkids, #bedtimestoriesforkids, #biblelessonsforkids, #storiesforchristiankids, #roncarriewebb, #fishbytes4kids, #jesusname, #speakinjesusname, #boldness, #overcomefear, #nofearhere, #godswordgivesuspower, #bestronginthelord
When Susie cries for help, Rooter Man comes to her rescue by teaching her how to get rid of fear. MS1 #roncarriewebb, #fishbytes4kids
When Susie cries for help, Rooter Man comes to her rescue by teaching her how to get rid of fear. MS1
This week we have KGI alums, Season 1 co-hosts and future doctors Eyouab and Om share their insights, advice and revelations on the MS1 year and application cycle. Don't miss out on some inside scoops to medical school! Follow us on Instagram @nsecpodcast, and DM us if you need help with your medical school application! Intro/outro song: ‘Visions’ by LAKEY INSPIRED.
From studying powerpoint slides to UWorld questions, healthcare training doesn’t always leave room for creativity—and students notice. In parts 1 and 2 of our series on creativity in medicine, we’ve seen that creativity means something different to everyone, and our individual creativity is by definition unique and personal. For part 3, we wanted to hear how healthcare students specifically stay creative in this field, so we asked our classmates and friends to submit recordings telling or showing us why creativity is important to them. This episode features Andrea Rossman (MS2, Medical College of Wisconsin), Jake Khoussine (MS3, UWSMPH), Claire Beamish (MS3, UWSMPH), Meaghan Kenfield (MS3, UWSMPH), Jonathan Alicea (MS3, University of Puerto Rico), Rashea Minor (VM3, UWSMPH), Quynh Nguyen, (MS1, UWSMPH), Christie Cheng (MS3, UWSMPH), Rufus Sweeney (MS3, UWSMPH), and Nithin Charlly (MS3, UWSMPH) on creativity in healthcare education. Check out our instagram page at @wbyit_uwsmph to see some of the creative works discussed in this episode.
Dr. Barinder (Ricky) Hansra joins the show to share helpful tips for virtual interviewing. With interviews being conducted on Zoom and similar platforms this year, applicants must prepare and perform in new ways. The wisdom Dr. Hansra has gained from his experience matching into residency and two fellowships is sure to help!
In this episode, Jacob Schreiber interviews Devin Schweppe about the analysis of mass spectrometry data in the field of proteomics. They begin by delving into the different types of mass spectrometry methods, including MS1, MS2, and, MS3, and the reasons for using each. They then discuss a recent paper from Devin, Full-Featured, Real-Time Database Searching Platform Enables Fast and Accurate Multiplexed Quantitative Proteomics that involved building a real-time system for quantifying proteomic samples from MS3, and the types of analyses that this system allows one to do. Links: Full-Featured, Real-Time Database Searching Platform Enables Fast and Accurate Multiplexed Quantitative Proteomics (Devin K. Schweppe, Jimmy K. Eng, Qing Yu, Derek Bailey, Ramin Rad, Jose Navarrete-Perea, Edward L. Huttlin, Brian K. Erickson, Joao A. Paulo, and Steven P. Gygi) Benchmarking the Orbitrap Tribrid Eclipse for Next Generation Multiplexed Proteomics (Qing Yu, Joao A Paulo, Jose Naverrete-Perea, Graeme C McAlister, Jesse D Canterbury, Derek J Bailey, Aaron M Robitaille, Romain Huguet, Vlad Zabrouskov, Steven P Gygi, Devin K Schweppe) Improved Monoisotopic Mass Estimation for Deeper Proteome Coverage (Ramin Rad, Jiaming Li, Julian Mintseris, Jeremy O’Connell, Steven P. Gygi, and Devin K. Schweppe) Schweppe Lab Website (Hiring!)
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.10.29.359075v1?rss=1 Authors: Ivanov, M. V., Bubis, J. A., Gorshkov, V., Abdrakhimov, D. A., Kjeldsen, F., Gorshkov, M. V. Abstract: Proteome-wide analyses most often rely on tandem mass spectrometry imposing considerable instrumental time consumption that is one of the main obstacles in a broader acceptance of proteomics in biomedical and clinical research. Recently, we presented a fast proteomic method termed DirectMS1 based on MS1-only mass spectra acquisition and data processing. The method allowed significant squeezing of the proteome-wide analysis to a few minute time frame at the depth of quantitative proteome coverage of 1000 proteins at 1% FDR. In this work, to further increase the capabilities of the DirectMS1 method, we explored the opportunities presented by the recent progress in the machine learning area and applied the LightGBM tree-based learning algorithm into the scoring of peptide-feature matches when processing MS1 spectra. Further, we integrated the peptide feature identification algorithm of DirectMS1 with the recently introduced peptide retention time prediction utility, DeepLC. Additional approaches to improve performance of the DirectMS1 method are discussed and demonstrated, such as FAIMS coupled to the Orbitrap mass analyzer. As a result of all improvements to DirectMS1, we succeeded in identifying more than 2000 proteins at 1% FDR from the HeLa cell line in a 5 minute LC-MS1 analysis. Copy rights belong to original authors. Visit the link for more info
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.10.15.340638v1?rss=1 Authors: Guan, Y., Hu, J., Cao, W., Cui, W., Yang, F., Krisp, C., Lin, L., Zhang, M., Voss, H., Schuster, R., Yan, G., Fuh, M. M., Thaysen-Andersen, M., H. Packer, N., Shen, H., Yang, P., Schlüter, H. Abstract: Global in-depth analysis of N-glycosylation, as the most complex post-translational modification of proteins, is requiring methods being as sensitive, selective and reliable as possible. Here, an enhanced strategy for N-glycomics is presented comprising optimized sample preparation yielding enhanced glycoprotein recovery and permethylation efficiency, isotopic labelling for data quality control and relative quantification, integration of new N-glycan libraries (human and mouse), newly developed R-scripts matching experimental MS1 data to theoretical N-glycan compositions and bundled sequencing algorithms for MS2-based structural identification to ultimately enhance the coverage and accuracy of N-glycans. With this strategy the numbers of identified N-glycans are more than doubled compared with previous studies, exemplified by etanercept (more than 3-fold) and chicken ovalbumin (more than 2-fold) at nanogram level. The power of this strategy and applicability to biological samples is further demonstrated by comparative N-glycomics of human acute promyelocytic leukemia cells before and after treatment with all-trans retinoic acid, showing that N-glycan biosynthesis is slowed down and 57 species are significantly altered in response to the treatment. This improved analytical platform enables deep and accurate N-glycomics for glycobiological research and biomarker discovery. Copy rights belong to original authors. Visit the link for more info
Our BLM series continues as we speak with Felix Toussaint on activism and racial inequality in medicine. Felix is an MS1 at the American University of the Caribbean (AUC) School of Medicine on St. Maarten. At AUC he is involved in student government, the student-led wellness committee, Student Judiciary Committee, and works as an anatomy TA. Before starting medical school, Felix received a dual degree in Biology and Chemistry with a concentration in premedical sciences from Auburn University at Montgomery (AUM).
September is here, and the UC San Diego School of Medicine is once again, open for business. A few weeks ago, the School of Medicine welcomed its new MS1 class with an orientation that was partially in-person in the face of COVID-19. Haley Moss, Class President for the class of 2023, tells us what it was like for returning medical students to be planning the annual welcoming event for the next wave of Student Doctors in San Diego. Dear MS1's, this is undoubtedly an exciting but intense time for you. Just know that your fellow classmates, MS2s through MS4s, all have your back in this long journey ahead! --- Send in a voice message: https://anchor.fm/ucsdsom/message
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.09.11.293092v1?rss=1 Authors: Davies, V., Wandy, J., Weidt, S., van der Hooft, J. J. J., Miller, A., Daly, R., Rogers, S. Abstract: Tandem mass spectrometry (LC-MS/MS) is widely used to identify unknown ions in untargeted metabolomics. Data Dependent Acquisition (DDA) chooses which ions to fragment based upon intensity observed in MS1 survey scans and typically only fragment a small subset of the ions present. Despite this inefficiency, relatively little work has addressed the development of new DDA methods, partly due to the high overhead associated with running the many extracts necessary to optimise approaches in busy MS facilities. In this work, we firstly provide theoretical results that show how much improvement is possible over current DDA strategies. We then describe an in silico framework for fast and cost efficient development of new DDA acquisition strategies using a previously developed Virtual Metabolomics Mass Spectrometer (ViMMS). Additional functionality is added to ViMMS to allow methods to be used both in simulation and on real samples via an instrument application programming interface (API). We demonstrate this framework through the development and optimisation of two new DDA methods which introduce new advanced ion prioritisation strategies. Upon application of the here developed methods to two complex metabolite mixtures, our results show that they are able to fragment more unique ions than standard DDA acquisition strategies. Copy rights belong to original authors. Visit the link for more info
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.09.03.281543v1?rss=1 Authors: van Olst, L., Rodriguez-Mogeda, C., Picon-Munoz, C., Kiljan, S., James, R. E., Kamermans, A., van der Pol, S. M. A., Knoop, L., Drost, E., Franssen, M., Schenk, G., Geurts, J. J. G., Amor, S., Mazarakis, N. D., van Horssen, J., de Vries, H. E., Reynolds, R., Witte, M. E. Abstract: Meningeal inflammation strongly associates with demyelination and neuronal loss in the underlying cortex of progressive MS patients, contributing to clinical disability. However, the pathological mechanisms of meningeal inflammation-induced cortical pathology are still largely elusive. Using extensive analysis of human post-mortem tissue, we identified two distinct microglial phenotypes, termed MS1 and MS2, in the cortex of progressive MS patients. These phenotypes differed in morphology and protein expression, but both associated with inflammation of the overlying meninges. We could replicate the MS-specific microglial phenotypes in a novel in vivo rat model for progressive MS-like meningeal inflammation, with microglia present at 1 month post-induction resembling MS1 microglia whereas those at 2 months acquired an MS2-like phenotype. Interestingly, MS1 microglia were involved in presynaptic displacement and phagocytosis and associated with a relative sparing of neurons in the MS and animal cortex. In contrast, the presence of MS2 microglia coincided with substantial neuronal loss. Taken together, we uncovered that in response to meningeal inflammation, microglia acquire two distinct phenotypes that differentially associate with neurodegeneration in the progressive MS cortex. Our data suggests that these phenotypes occur sequentially and that microglia may lose their protective properties over time, contributing to neuronal loss. Copy rights belong to original authors. Visit the link for more info
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.08.30.274209v1?rss=1 Authors: Xu, I. Abstract: As a reliable and high-throughput proteomics strategy, data-independent acquisition (DIA) has shown great potential for protein analysis. However, DIA also imposes stress on the data processing algorithm by generating complex multiplexed spectra. Traditionally, DIA data is processed using spectral libraries refined from experiment histories, which requires stable experiment conditions and additional runs. Furthermore, scientists still need to use library-free tools to generate spectral libraries from additional runs. To lessen those burdens, here we present DIAFree, a library-free, tag-index-based software suite that enables both restrict search and open search on DIA data using the information of MS1 scans in a precursor-centric and spectrum-centric style. We validate the quality of detection by publicly available data. We further evaluate the quality of spectral libraries produced by DIAFree. Copy rights belong to original authors. Visit the link for more info
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768888 Serial Bone Density Measurement and Incident Fracture Risk Discrimination in Postmenopausal Women Carolyn J. Crandall, MD, MS1; Joseph Larson, MS2; Nicole C. Wright, PhD3; et al OBJECTIVE To assess whether a second BMD measurement approximately 3 years after the initial assessment is associated with improved ability to estimate fracture risk beyond the baseline BMD measurement alone. In this prospective observational study 7419 women from The Women’s Health Initiative with a mean (SD) follow-up of 12.1 (3.4) years Incident major osteoporotic fracture (ie, hip, clinical spine, forearm, or shoulder fracture), hip fracture, baseline BMD, and absolute change in BMD were assessed a second bone mineral density (BMD) assessment approximately 3 years after the initial measurement was not associated with improved risk discrimination, beyond the initial BMD assessment, between women who did and did not experience hip fracture or major osteoporotic fracture. . I hate this because it add nothing!! The uspstf came out in 2018 and said in their guidelines titled Screening for Osteoporosis to Prevent FracturesUS Preventive Services Task Force Recommendation Statement THEY SAID AND I QOUTE!! However, limited evidence from 2 good-quality studies found no benefit in predicting fractures from repeating bone measurement testing 4 to 8 years after initial screening. Do the trial we all want to see with follow up for 10 or 12 or 15 yrs or don’t do the trial you are just wasting time and money on what we already know! Next article Atypical Femur Fracture Risk versus Fragility Fracture Prevention with Bisphosphonates Nejm 196,129 women 50 years of age or older who were receiving bisphosphonates and who were enrolled in the Kaiser Permanente Southern California health care system; women were followed from January 1, 2007, to November 30, 2017 primary outcome was atypical femur fracture- usually defined as fractures in the subtrochanteric region and along the femoral diaphysis 277 atypical femur fractures occurred hazard ratio went from 8.86 at 3-5 yrs (95% confidence interval [CI], 2.79 to 28.20) up to 43.51 (95% CI, 13.70 to 138.15) for 8 years or more. (likely why guidelines say stop at 5 yrs or at least take a drug holiday) when you look at the data it appears to be exponential that longer you on a biphosphonate the more likely you are to have an atypical fracture. But the thing I like most about this study is a huge data set that tells us on average since there was 196,129 women, and 277 atypical femur fractures occurred then baseline normal is (1.74 fractures per 10,000 patient-years) They also used a computer model to try and figure out how many fractures were prevented and depending on your race at 5 years there were anywhere from 500-800 fracture prevented We don’t have information like what was the baseline dexa, how were these people started on bisphosphonate but we can say they do prevent fractures and if you are concerned about atypical fractures the data would say it happens about 1 in every 5000 women. https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21628 “All participants (GDG members, ACS staff, expert advisors) were required to disclose financial and nonfinancial (personal, intellectual, practice‐related) relationships and activities related to cervical cancer and screening that might be perceived as posing a conflict of interest.” The American Cancer Society (ACS) now says average-risk individuals should begin cervical cancer screening at age 25 — rather than at age 21, as recommended in 2012. The group's guideline update appears in CA: A Cancer Journal for Clinicians. The other major change from 2012: The preferred screening approach is primary human papillomavirus (HPV) testing (i.e., stand-alone testing for high-risk HPV types) every 5 years through age 65. If FDA-approved primary HPV testing is not available, then HPV-cytology cotesting every 5 years or cytology alone every 3 years is acceptable. Of note, there are currently two approved primary HPV tests, and access to them may be limited. The ACS says that cotesting or cytology alone "should be phased out once full access to primary HPV testing for cervical cancer screening is available without barriers." The guidance applies to all average-risk, asymptomatic people with a cervix, including transgender men who still have a cervix. Such individuals should be screened regardless of their HPV vaccination status or sexual history. Randomized, double-blind, placebo-controlled trial of intraarticular trans-capsaicin for pain associated with osteoarthritis of the knee. Stevens RM, Ervin J, Nezzer J, et al. Arthritis Rheumatol. 2019;71(9):1524-1533. doi: 10.1002/art.40894. double-blind, randomized, placebo-controlled trial of adult patients (45 to 80 years of age) with X-rays showing chronic OA, pain for at least two months, and mean pain score of 5 to 9 on a 0 to 10 scale. randomized to one of three groups group 1- 0.5 mg of capsaicin intraarticular group 2- 1 mg of capsaicin intraarticular (CNTX-4975) group 3- placebo control group. primary endpoint was area under the curve (AUC) for the change from baseline through week 12 in daily WOMAC (Western Ontario and McMaster Universities Arthritis Scale) pain with walking scores. -- FIRST RED FLAG- you can normally report your results as outcome at the end of the study (EOS) -- the pain was this, gave this drug and this was the pain at the END OF THE STUDY or you can report it as area under the curve. NOW area under the curve (AUC) is a summary measure that integrates serial assessments of a patient's endpoint over the duration of the study- so pain was this and gave medication then at 6 weeks pain was this then 12 weeks pain was this and 24 weeks pain was this- some will argue that this format means AUC better reflects the clinical course of the disease. they will say well looking at it in a single point in time doesnt tell me anything about the rest of the time and they are correct but when you look at multiple time periods it becomes very risky that you will maybe skew the data and say well we are going to look at results at week 12 but then once you get the results you say - ‘’ well look at these shiny results with improved awesome amazing results at week 24, who cares about week 12 we are not going to report on week 24” enough of that rant- back to the study- music as I mention the primary outcome was AUC at 12 weeks and not your typical pain scales, the authors results were “In this study, capsaicin provided dose-dependent improvement in knee OA-associated pain. capsaicin 1.0 mg produced a significant decrease in OA knee pain through 24 weeks; capsaicin 0.5 mg significantly improved pain at 12 weeks, but the effect was not evident at 24 weeks.” this is exactly what I am talking about! Your primary outcome was 12 weeks but you read the results and they brag about the results at 24weeks. it smells like- drug money and you are correct! Centrexion Therapeutics was the sponsor of the study, controlled the study and my guess is they manipulated the numbers because when you go to clinical trials.gov they dont say they are going to use area under the curve they just say the difference in pain score. They dont say they are going to use least square mean they just do it. this trial is a scam I suspect - after all they were only looking for a 0.45 effect size-- you have a ten point scale and you power the study to find a 0.45 difference-- the cool thing and annoying thing about powering your study is you have to power it for a change that you think is clinically important, there is no rules on how big your study has to be it just has to be big enough to rule in or rule out the effect you are looking for. THEY THOUGHT A 0.45 difference was a good outcome! and this is clear because when you look at the benefit there is a p value of 0.00001 which makes you think WOW this is so great till you realize the individuals that got placebo had a 2 point improvement in their pain scales and those that got the capsaicin injection had roughly a 2.7 improvement in their pain scale. for me this is a no go and I can promise you drug reps will be in your office pushing this, you will hear about it at conferences or maybe even your colleagues will say this is the hot new thing, and I will say it is hot, so hot I actually dropped this article in the trash right next to the 0.5mg and 1mg capasaicn injection.
our August episode features Maxine, an upcoming MS1 @weillcornell ! Maxine takes you through her traditional pre-med journey, how she found the courage to pursue what she loved, and how she’s been strong enough to be balanced along the way!
Drop iN Podcast Tworzony przez Graczy dla Graczy, a dziś Kenet, Kiwakoo, Badyl, Malibu oraz Rogaty opowiedzą Wam o tym w co grali – Carion, Paper Mario, Ghost of Tsushima oraz Days Gone 00:17:30 Prophesy od Sucker Punch00:29:40 Xbox Games Showcase01:23:30 Kolejne Pokazy Sony i MS1:33:29 Zapomniana gra od Sony Nasz Discord: https://discord.gg/WbspfW5 Kanał na YT: https://www.youtube.com/channel/UCxkfZ6zGyIJO72RMvX5n77w Jeśli chcecie, możecie nas wesprzeć tutaj: https://streamlabs.com/graczwatch/tip# Wpadnijcie też na naszą stronkę z newsami, podcastami i filmikami! www.geekgamer.pl
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.07.21.213876v1?rss=1 Authors: Meijer, M., Agirre, E., Kabbe, M., van Tuijn, C., Heskol, A., Falcao, A. M., Corces, M. R., Montine, T., Chen, X., Chang, H. Y., Castelo-Branco, G. Abstract: Multiple sclerosis (MS) is a disease characterized by a targeted immune attack on myelin in the central nervous system (CNS). We have previously shown that oligodendrocytes (OLs), myelin producing cells in the CNS, and their precursors (OPCs), acquire disease-specific transcriptional states in MS1,2. To understand how these alternative transcriptional programs are activated in disease, we performed single-cell assay for transposase accessible chromatin using sequencing (scATAC-seq) on the OL lineage in the experimental autoimmune encephalomyelitis (EAE) mouse model of MS. We identified regulatory regions with increased accessibility in oligodendroglia (OLG) in EAE, some of which in the proximity of immune genes. A similar remodeling of chromatin accessibility was observed upon treatment of postnatal OPCs with interferon-gamma (IFN-gamma), but not with dexamethasone. These changes in accessibility were not exclusive to distal enhancers, but also occurred at promoter regions, suggesting a role for promoters in mediating cell-state transitions. Notably, we found that a subset of immune genes already exhibited chromatin accessibility in OPCs ex vivo and in vivo, suggesting a primed chromatin state in OLG compatible with rapid transitions to an immune-competent state. Several primed genes presented bivalency of H3K4me3 and H3K27me3 at promoters in OPCs, with loss of H3K27me3 upon IFN-gamma treatment. Inhibition of JMJD3/Kdm6b, mediating removal of H3K27me3, led to the inability to activate these genes upon IFN-gamma treatment. Importantly, OLGs from the adult human brain showed chromatin accessibility at immune gene loci, particularly at MHC-I pathway genes. A subset of single-nucleotide polymorphisms (SNPs) associated with MS susceptibility overlapped with these primed regulatory regions in OLG from both mouse and human CNS. Our data suggest that susceptibility for MS may involve activation of immune gene programs in OLG. These programs are under tight control at the chromatin level in OLG and may therefore constitute novel targets for immunological-based therapies for MS. Copy rights belong to original authors. Visit the link for more info
Alejandro (@premed2med) is a recently accepted MS1 at the University of California- Irvine. We chat about his journey from community college up until his acceptance to medical school, as well as some advice for premedical students on how to be better prepared for the application cycle.
Nick (incoming MS1 at UCSF) and Michael (MS2 at UCLA) have a merry time talking about how the pandemic has affected different types of students. We go over the following: How COVID-19 affects those who are applying How COVID-19 affects those who are NOT applying Extracurricular Opportunities available to be done remotely, courtesy of my friend @MDMotivator BeMyEyes.Com Connects blind people with sighted volunteers ChemoAngels.com to support their “buddy” throughout their journey with cards, uplifting messages, supportive words and lots of positive energy. VolunteerMatch.org UNV.org volunteer for the UN CrisisTextLine.org Crisis counseling 7cups.com Free emotional support How you should plan for the coming year.
กรอบคิดติดยึด MS1 อุบัติเหตุปีใหม่ คิดแบบเก่า กลัวนายตำหนิตัวเลขสูง ตายติดอันดับโลกแบบเก่า
Puffs' o extrusión de cemento al ápice. ¿Son buenos o son malos? ¿En verdad demuestran el éxito de una Endodoncia? ¿Es el reflejo de un buen sellado? ¿Tu que opinas? -Articulo: The impact of sealer extrusion on endodontic outcome: A systematic review with meta-analysis. Anita Aminoshariae, DDS, MS1 ; and James C. Kulild, DDS, MS2 1 Department of Endodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA 2 Department of Endodontics, UMKC School of Dentistry, Kansas City, Missouri, USA. CONTACTO EndoNoteSpot@gmail.com --- Send in a voice message: https://anchor.fm/EndoNote/message
Dr. Nakul Singh joins the show to share his experience preparing for the ophthalmology match. He provides practical advice based on each of the various sections of the ERAS application.
Meet Steven and learn about his plan to help medical students match into competitive residencies! Also included are statistics from the NRMP 2018 Match.
Journal Club Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis PainThe SPACE Randomized Clinical Trial Subscribe to our mailing list * indicates required Email Address * Erin E. Krebs, MD, MPH1,2; Amy Gravely, MA1; Sean Nugent, BA1; et alAgnes C. Jensen, MPH1; Beth DeRonne, PharmD1; Elizabeth S. Goldsmith, MD, MS1,3; Kurt Kroenke, MD4,5,6; Matthew J. Bair4,5,6; Siamak Noorbaloochi, PhD1,2 Author Affiliations Article Information JAMA. 2018;319(9):872-882. doi:10.1001/jama.2018.0899 Download the PainExam App for iPhone and Android DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another's health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2018 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.
Dr. Rosenblum Summarizes Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain Subscribe to our mailing list * indicates required Email Address * Erin E. Krebs, MD, MPH1,2; Amy Gravely, MA1; Sean Nugent, BA1; et alAgnes C. Jensen, MPH1; Beth DeRonne, PharmD1; Elizabeth S. Goldsmith, MD, MS1,3; Kurt Kroenke, MD4,5,6; Matthew J. Bair4,5,6; Siamak Noorbaloochi, PhD1,2 Author Affiliations Article Information JAMA. 2018;319(9):872-882. AnesthesiaExam Podcast App For iPhone and Android DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another’s health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2018 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without
Andrew Widener, MS1, BRI chapter president at McGovern Medical School (University of Texas, Houston) discusses how he and other medical students are making a difference beyond the classroom. Mr. Widener shares about running a successful BRI chapter, and how BRI is the only free market organization encouraging medical students to engage in productive healthcare policy debate.
Allison is back! It's double Dr. Gray for today's episode about medical school. We talked about our experiences during the first two years of medical school. Links and Other Resources Full Episode Blog Post Check out my Premed Playbook series of books (available on Amazon), with installments on the personal statement, the medical school interview, and the MCAT. Related episode: Welcome to Your Third Year of Medical School. Related episode: Top 7 Things You Should Know as a Medical Student. Need MCAT Prep? Save on tutoring, classes, and full-length practice tests by using promo code “MSHQ” at Next Step Test Prep!
This week on Inspired Edinburgh we have Dean Reilly. After being diagnosed with multiple sclerosis in 2012 Dean has been on a mission to 'give MS a doing'. A self-confessed 'big unit' he has completed six marathons and is currently training for his seventh as well as having done a host of other endurance events and challenges. He won the Edinburgh Evening News Local Hero award and was the first recipient of a Kelly's Hero award from renowned Scottish presenter Lorraine Kelly. Dean talks in detail about his background, his diagnosis and battles with MS, his highs and lows, mental health, endurance challenges as well as success, purpose and legacy. An incredibly inspirational conversation with a truly remarkable person. 01.30 - Background and early life03.30 - Dean on his confidence05.20 - Being smart as a youngster09.00 - Getting a job 14.20 - Working in London16.30 - Financial services18.30 - British Gas19.30 - Being diagnosed with MS26.00 - Dealing with the news28.45 - What is MS?30.00 - Living with MS31.45 - The NHS33.00 - Accepting MS36.30 - Support from mates 38.30 - Looking at the positives39.30 - Taking on challenges and giving MS a doing45.00 - Picking someone to beat49.30 - Taking on a triathlon52.50 - Mighty deerstalker 54.00 - Fighting the King of the Gypsies56.35 - Struggles with MS and mental health59.30 - Getting help1.02.30 - A day out to the cinema1.04.00 - It's okay not to be okay1.06.00 - Being vulnerable 1.10.00 - Dean's purpose1.14.00 - Impacting the lives of others1.16.00 - Happiness and loving life 1.17.30 - Dean's legacy1.22.00 - Dean's definition of success1.24.00 - What would Dean say to his 20 year old self?1.26.30 - Changing anything in the world1.33.00 - Dean's letter to MS1.34.30 - Invisible illness1.36.00 - Owing MS thanks You can support Dean in the 2017 London Marathon at:https://www.justgiving.com/fundraising/DeanMS You can find Dean at:https://www.facebook.com/DeanVsMshttps://twitter.com/DeanvsMShttps://www.instagram.com/deanvsms2017 Like our Facebook page here: www.facebook.com/INSPIREDINBURGH
Con las distribuidoras rescatando material antiguo a causa de la Eurocopa o de la llegada del verano que vacía los cines, esta semana nos enfrentamos a la última de Wes Anderson, Moonrise Kingdom, a una peli sobre la invención del vibrador, Hysteria y a una de cárceles en el espacio, MS1: máxima seguridad. Además repasamos las noticias, os damos las habituales tres pis-tas y Sandra nos intentará colar la trola. Isaac nos traerá hoy otra peli de esas buenas que nos hará llorar pero no de emoción.
The Luchaworld Podcast returns with Episode #5 (2/17/12). Join Vandal & Fredo as they take a look back at MS1 and his classic encounter with Sangre Chicana, recent CMLL press conference debuting Diamante Azul, Blue Demon Jr's reaction to new CMLL character, Blue Panther vs. Negro Casas in a hair match (talk of the lightning match and the little things Blue Panther does so well), Prince Devitt, women's wrestling in Mexico, Superboy watching his son (Hijo del Superboy) wrestle, El Consejo (Mexico's NWO B-team), some big names returning to CMLL, El Hijo del Santo's lack of opponents, X-Project, the wacky trio of Great Kojika, Riho & Mr. #6 (from Japan), drum sets at wrestling shows, Los Cavernicolas, and more! Get all the lucha libre news at LuchaWorld.com!