Podcasts about natural experiments

In this episode, Aaron is joined by Drs. Christopher Worsham and Anupam B. Jena, professors at Harvard Medical School and authors of Random Acts of Medicine: The Hidden Forces That Sway Doctors, Impact Patients, and Shape Our Health. The three discuss natural experiments and the biases and outside forces that impact doctors and health policy.

Paul and Howard discuss how medicine is changing, and how some common procedures and ideas that were once accepted practice are being abandoned. They also talk about the merits of shouting at your legs, and whether it's possible to mainline red wine.Topics: Why some procedures become accepted practice, despite poor evidence The "six weeks" myth in recovering from a soft tissue injury Examples of common procedures being rethought, or abandoned altogether Some candidates for future medical reversals How the coronavirus is creating a natural experiment in which procedures are necessary Readings: Fear and surgical decision making Medical Reversal: Why We Must Raise the Bar Before Adopting New Technologies Natural experiments Bios:Paul Kedrosky is a frequently injured athlete who, when he isn't rehabbing, is also a venture investor. Howard Luks is a top sports orthopedic surgeon.Music & Disclaimers: Crossing the Chasm by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3562-crossing-the-chasm License: http://creativecommons.org/licenses/by/4.0/ Marty Gots A Plan by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4992-marty-gots-a-plan License: http://creativecommons.org/licenses/by/4.0/ Disclaimers apply and can be heard at the end of the episode.This is only an excerpt. To listen to the entire episode, as well as see show notes and full transcripts, subscribe at simplavida.com.

Dr. Anupam Jena is an economist, a physician, a podcaster, and the Joseph P. Newhouse Professor of Healthcare Policy at the Harvard Medical School. He's also the co-author, along with Dr. Christopher Worsham, of the newly published book Random Acts of Medicine: The Hidden Forces that Sway Doctors, Impact Patients, and Shape Our Health. Anupam, also known as Dr. Bapu, combines his medical training with curiosity about cause and effect to explore explanations for failures and successes in providing healthcare and how chance occurrences affect our health. Of particular interest is the power of natural experiments to enhance understanding of the effect of a treatment or drug within a larger universe than traditional randomized clinical trials.   Bapu elaborates, "One of the benefits of these natural experiments is that they are more generalizable. They tell us what might happen in a real world because you're exactly right. If a clinical trial is performed, it may be performed in a very particular geographic area, in a very particular type of patient that is not the same as the type of person who might take that medication in the real world." "I don't think that we should be making whole-scale treatment decisions without randomized trials. So those are the gold standard, and we need them to be there. They provide an important foundation." "But it's also important to know that they do have some limitations because we might not be able to do a randomized trial on every population person that we care about. That's where the natural experiments come in. I think they really are complements and not substitutes because once we have a sense that this medication does work based on randomized trials, then we can do natural experiments to say, "Well, they might work better or not as well in these particular populations of people." "So it's no surprise to people that randomness or chance does affect our health in ways that we can appreciate. For example, a child drowns in the swimming pool because, just by chance, someone gets distracted in the moment, or someone is hit by a car. Again, totally random events. In many cases, a cancer, when there are no risk factors, that's unpredictable and it's a chance event." #RandomActsofMedicine @DrBapuPod @AnupamBJena @DoubledayBook    Random Acts of Medicine Download the transcript here

Dr. Anupam Jena is an economist, a physician, a podcaster, and the Joseph P. Newhouse Professor of Healthcare Policy at the Harvard Medical School. He's also the co-author, along with Dr. Christopher Worsham, of the newly published book Random Acts of Medicine: The Hidden Forces that Sway Doctors, Impact Patients, and Shape Our Health. Anupam, also known as Dr. Bapu, combines his medical training with curiosity about cause and effect to explore explanations for failures and successes in providing healthcare and how chance occurrences affect our health. Of particular interest is the power of natural experiments to enhance understanding of the effect of a treatment or drug within a larger universe than traditional randomized clinical trials.   Bapu elaborates, "One of the benefits of these natural experiments is that they are more generalizable. They tell us what might happen in a real world because you're exactly right. If a clinical trial is performed, it may be performed in a very particular geographic area, in a very particular type of patient that is not the same as the type of person who might take that medication in the real world." "I don't think that we should be making whole-scale treatment decisions without randomized trials. So those are the gold standard, and we need them to be there. They provide an important foundation." "But it's also important to know that they do have some limitations because we might not be able to do a randomized trial on every population person that we care about. That's where the natural experiments come in. I think they really are complements and not substitutes because once we have a sense that this medication does work based on randomized trials, then we can do natural experiments to say, "Well, they might work better or not as well in these particular populations of people." "So it's no surprise to people that randomness or chance does affect our health in ways that we can appreciate. For example, a child drowns in the swimming pool because, just by chance, someone gets distracted in the moment, or someone is hit by a car. Again, totally random events. In many cases, a cancer, when there are no risk factors, that's unpredictable and it's a chance event." #RandomActsofMedicine @DrBapuPod @AnupamBJena @DoubledayBook    Random Acts of Medicine Listen to the podcast here

Scientifically sound, randomized experiments can be expensive and difficult to run. But there's an alternative: It turns out that certain real-life situations can also generate useful scientific data. The trick is finding them.In this episode of Choiceology with Katy Milkman, we look at how events outside of our control can create opportunities for so-called natural or accidental experiments. The organizers of a heroic airlift transporting thousands of Ethiopian Jews to Israel broke the record for the flight with the most passengers. It was 1994, and the clock was ticking for Israeli intelligence personnel and leaders of the Ethiopian Jewish community as they worked to transport as many people as possible before the civil war closed in on Addis Ababa. This desperate effort, dubbed Operation Solomon, would change the lives of the Ethiopian Jews in surprising and unintended ways. Stephen Spector is a professor of religions and culture and medieval English at Stony Brook University. He's also the author of Operation Solomon: The Daring Rescue of the Ethiopian Jews.Solomon Ezra is an active member of the Ethiopian and Jewish communities in Portland, Oregon, and was a ground operations leader during Operation Solomon. Donna Rosenthal is the author of The Israelis: Ordinary People in an Extraordinary Land.Next, Katy speaks with Steven Levitt about how to spot natural experiments and why they can provide such unique information about human behavior.Steven Levitt is the William B. Ogden Distinguished Service Professor of Economics at the University of Chicago, co-author of the bestselling book Freakonomics, and the host of a Freakonomics Radio podcast called People I Mostly Admire.Choiceology is an original podcast from Charles Schwab. For more on the series, visit schwab.com/podcast.If you enjoy the show, please leave a ⭐⭐⭐⭐⭐ rating or review on Apple Podcasts. Important DisclosuresAll expressions of opinion are subject to change without notice in reaction to shifting market conditions.The comments, views, and opinions expressed in the presentation are those of the speakers and do not necessarily represent the views of Charles Schwab.​Data contained herein from third party providers is obtained from what are considered reliable source. However, its accuracy, completeness or reliability cannot be guaranteed and Charles Schwab & Co. expressly disclaims any liability, including incidental or consequential damages, arising from errors or omissions in this publication. The policy analysis provided by the Charles Schwab & Co., Inc., does not constitute and should not be interpreted as an endorsement of any political party.All corporate names and market data shown above are for illustrative purposes only and are not a recommendation, offer to sell, or a solicitation of an offer to buy any security. Supporting documentation for any claims or statistical information is available upon request.Investing involves risk, including loss of principal.The book, How to Change: The Science of Getting from Where You Are to Where You Want to Be, is not affiliated with, sponsored by, or endorsed by Charles Schwab & Co., Inc. (CS&Co.). Charles Schwab & Co., Inc. (CS&Co.) has not reviewed the book and makes no representations about its content.(0823-30U5) 

Decoding the Hidden Factors in Healthcare: Dr. Anupam B. Jena on Natural Experiments and Patient Outcomes In the world of healthcare, some discoveries come from unexpected places. Dr. Anupam B. Jena's journey into the realm of natural experiments began with a simple comment from his wife. Little did he know, this offhand remark would unravel a hidden truth about healthcare outcomes. As a medical doctor and economist, Dr. Jena was no stranger to the complexities of the field. But it was his investigation into the impact of large events, like marathons, that revealed a startling twist. The findings were astonishing, shedding light on the often overlooked factors that shape our health. Brace yourself for the unexpected as we dive into the untold story behind healthcare outcomes... Brought to you by Hello Fresh. Use code passion 50 to get 50% off plus free shipping!  Brought to you by Lifeforce: Join me and thousands of others who have transformed their lives through Lifeforce's proactive and personalized approach to healthcare. Visit MyLifeforce.com today to start your membership and receive an exclusive $200 off. Brought to you by Indeed. Head to https://www.indeed.com/passionstruck, where you can receive a $75 credit to attract, interview, and hire in one place.   --► For information about advertisers and promo codes, go to: https://passionstruck.com/deals/  Like this show? Please leave us a review here -- even one sentence helps! Consider including your Twitter or Instagram handle so we can thank you personally! --► Prefer to watch this interview: https://youtu.be/jkdvwL30bzc  --► Subscribe to Our YouTube Channel Here: https://youtu.be/QYehiUuX7zs  Want to find your purpose in life? I provide my six simple steps to achieving it - passionstruck.com/5-simple-steps-to-find-your-passion-in-life/ Catch my interview with Marshall Goldsmith on How You Create an Earned Life: https://passionstruck.com/marshall-goldsmith-create-your-earned-life/  Watch the solo episode I did on the topic of Chronic Loneliness: https://youtu.be/aFDRk0kcM40  Want to hear my best interviews from 2023? Check out my interview with Seth Godin on the Song of Significance and my interview with Gretchen Rubin on Life in Five Senses. ===== FOLLOW ON THE SOCIALS ===== * Instagram: https://www.instagram.com/passion_struck_podcast * Facebook: https://www.facebook.com/johnrmiles.c0m  Learn more about John: https://johnrmiles.com/  Passion Struck is now on the AMFM247 broadcasting network every Monday and Friday from 5–6 PM. Step 1: Go to TuneIn, Apple Music (or any other app, mobile or computer) Step 2: Search for “AMFM247” Network

In this riveting episode of The BluePrint, we're joined by Dr. Anupam B. Jena, a renowned economist, physician, and the host of the Freakonomics, MD podcast. Dr. Jena shares his unique perspective on the intersection of economics, healthcare, and policy, and how these fields can influence our everyday lives. Dr. Jena's work revolves around the concept of natural experiments in healthcare, the economics of physician behavior, medical malpractice, and the economics of medical innovation. In our conversation, we delve into the importance of asking the right questions, the impact of stress on world leaders, and the intriguing concept of natural experiments. In this episode, you'll discover: The difference between seeing and looking in healthcare. How to cultivate the skill of asking interesting questions. The concept of natural experiments and how they can reveal hidden truths. The impact of stress on the lifespan of world leaders. The importance of creating space for innovation and creativity. Purchase Random Acts of Medicine Follow Dr. Jena on Twitter on both his personal and podcast account Sign up for Erik's weekly newsletter - Adaptation Join the AIM7 Beta Community Quotable moments: "We're trained to solve problems, but we're not trained to create or come up with the most interesting problems." - Dr. Anupam B. Jena "One idea once in a while that is really interesting and that's enough to do a lot with." - Dr. Anupam B. Jena "If this is something that I could talk to a total stranger about who's not at all in my field, would they get it, and would they wanna know more? And if so, that's a good starting point for me." - Dr. Anupam B. Jena "Winners of elections, national elections, they have about a two and a half year shorter life than runners up in those same elections who did not win." - Dr. Anupam B. Jena ABOUT THE BLUEPRINT PODCAST: The BluePrint Podcast is for busy professionals and Household CEOs who care deeply about their families, career, and health. Host Dr. Erik Korem distills cutting edge-science, leadership, and life skills into simple tactics optimized for your busy lifestyle and goals.   Dr. Korem interviews scientists, coaches, elite athletes, entrepreneurs, entertainers, and exceptional people to discuss science and practical skills you can implement to become the most healthy, resilient, and impactful version of yourself. On a mission to equip people to pursue audacious goals, thrive in uncertainty, and live a healthy and fulfilled life, Dr. Erik Korem is a High-Performance pioneer. He introduced sports science and athlete-tracking technologies to collegiate and professional (NFL) football over a decade ago. He has worked with the National Football League, Power-5 NCAA programs, gold-medal Olympians, Nike, and the United States Department of Defense. Erik is an expert in sleep and stress resilience. He is the Founder and CEO of AIM7, a health and fitness app that unlocks the power of wearables by providing you with daily personalized recommendations to enhance your mind, body, and recovery. SUPPORT & CONNECT Instagram - https://www.instagram.com/erikkorem/ Twitter - https://twitter.com/ErikKorem LinkedIn - https://www.linkedin.com/in/erik-korem-phd-19991734/ Facebook - https://www.facebook.com/erikkorem Website - https://www.erikkorem.com/ Newsletter - https://erikkoremhpcoach.activehosted.com/fSee omnystudio.com/listener for privacy information.

Fox News host Tucker Carlson's glowing review of Queen Elizabeth II's legacy divides Matthew Yglesias and Laura McGann this week. Matt gives credence to some of Carlson's points and makes the case that the British were comparatively “better” than other brutal imperialist powers. Laura points out that the British Empire was built on violence and slavery, and she questions Elizabeth's record.Suggested reads:Queen Elizabeth II is being attacked by some because she lived in a better time, Tucker Carlson @ Fox News How the World Became Rich: The Historical Origins of Economic Growth, Mark Jared Rubin and Mark Koyama Colonialism and Modern Income: Islands as Natural Experiments, James Feyrer and Bruce Sacerdote Republic, U.K. movement to replace the monarchy with an elected head of state (note: this is what Matt is referencing when he calls Laura a ‘republican;' it's in opposition to monarchists not Democrats)   Send us a bad take to review at badtakes@grid.news.For a transcript of an episode of Bad Takes, please email transcripts@grid.news.

Josh Angrist, David Card, and Guido Imbens shared the Nobel in 2021 for their pioneering work on natural experiments that, in the words of the committee, "revolutionised empirical research". Steve Pischke tells Tim Phillips about the history of natural experiments, and the impact of the methods pioneered by this year's Laureates. © Nobel Prize Outreach 2021 Ill. Niklas Elmehed

NSW reopens and spending takes off, the Great Resignation, a global tax deal and a Nobel Prize for natural experiments.

Carl and I dig into the opportunity generated by the Covid-19 pandemic to study natural experiments in sports. Many of the things we used to take for granted--stadiums full of fans, weekly travel schedules, consistent training opportunities--have been disrupted for some or all players, in tennis and other major sports. We consider what we can learn about home-court advantage, the predictability of results, the role of unchanging venues, and even the speed of play, by comparing pre-pandemic numbers with their corresponding figures since sports got back underway. We also wonder about the limitations of these sorts of studies, because there are always confounding variables. The biggest confounder of all: the pandemic itself.

Toby Wise is a postdoc at UCL and Caltech. He uses computational modelling and neuroimaging to study the mechanisms underlying anxiety and depression. I first encountered Toby when he and I published separate preprints on PsyArXiv on the same topic (risk perception for COVID-19) within a few hours of each other.In this conversation, we talk about doing research about COVID-19: why we decided to do it, practical considerations, and differences and similarities between our studies. We also talk about open science practices.BJKS Podcast is a podcast about neuroscience, psychology, and anything vaguely related, hosted by Benjamin James Kuper-Smith. New conversations every other Friday. You can find the podcast on all podcasting platforms (Apple/Google Podcasts, Spotify, etc.).Timestamps0:00:11: The origin of Toby's research project on risk perception about COVID-190:13:18: What Toby would do differently if he could go back in time0:20:45: Criticism of COVID-19 research0:29:17: How to do good science during natural experiments0:44:09: Open Code, (Jupyter/RMarkdown) Notebooks, and Python1:07:43: Comparing COVID responses across and within countries1:27:36: Practicalities of doing research on COVID-191:34:19: External validity of psychological research1:48:30: Toby's acute awareness of how unimportant his research is2:06:32: Simulations to ensure your study actually does what you want it to do2:14:34: Comparing Toby and Ben's COVID studiesToby's linksWebsite: https://tobywise.com/Twitter: https://twitter.com/toby_wiseGoogle Scholar: https://scholar.google.co.uk/citations?user=_PD-jwIAAAAJ&hl=enPodcast linksWebsite: https://bjks.buzzsprout.com/Twitter: https://twitter.com/BjksPodcastBen's linksWebsite: www.bjks.blog/Google Scholar: https://scholar.google.co.uk/citations?user=-nWNfvcAAAAJReferences/papers mentionedCamerer, C. F., Dreber, A., Holzmeister, F., Ho, T. H., Huber, J., Johannesson, M., ... & Altmejd, A. (2018). Evaluating the replicability of social science experiments in Nature and Science between 2010 and 2015. Nature Human Behaviour.Levitt, S. D., & List, J. A. (2007). What do laboratory experiments measuring social preferences reveal about the real world?. Journal of Economic perspectives.Korn, C. W., Sharot, T., Walter, H., Heekeren, H. R., & Dolan, R. J. (2014). Depression is related to an absence of optimistically biased belief updating about future life events. Psychological medicine.Kunz, L., Schröder, T. N., Lee, H., Montag, C., Lachmann, B., Sariyska, R., ... & Fell, J. (2015). Reduced grid-cell–like representations in adults at genetic risk for Alzheimer's disease. Science.Kuper-Smith, B. J., Doppelhofer, L. M., Oganian, Y., Rosenblau, G., & Korn, C. (2020). Optimistic beliefs about the personal impact of COVID-19. PsyArXiv.Shah, A. K., Mullainathan, S., & Shafir, E. (2012). Some consequences of having too little. Science.Shah, A. K., Mullainathan, S., & Shafir, E. (2019). An exercise in self-replication: Replicating Shah, Mullainathan, and Shafir (2012). Journal of Economic Psychology.Wise, T., Zbozinek, T. D., Michelini, G., Hagan, C. C., & Mobbs, D. (2020). Changes in risk perception and self-reported protective behaviour during the first week of the COVID-19 pandemic in the United States. Royal Society Open Science.

Jared Diamond, Camilla Townsend, Tom Holland and Emma Griffin talk to Rana Mitter. What lessons for the pandemic are there in looking back at times of upheaval in history from the rise and fall of the Aztec Empire to the move from rural to urban living in Britain's Industrial Revolution. Tom Holland's books include Rubicon: The Last Years of the Roman Republic; Dominion: The Making of the Western Mind; Persian Fire: The First World Empire and the Battle for the West. Camilla Townsend is the author of the book Fifth Sun: A New History of the Aztecs, which is one of the books shortlisted for the 2020 Cundill History prize. Emma Griffin is the author of books including Liberty's Dawn: A People's History of the Industrial Revolution and Bread Winner: An Intimate History of the Victorian Economy. She was chosen as a BBC/AHRC New Generation Thinker in 2012. Jared Diamond is the author of books including The World until Yesterday, Upheaval: How Nations Cope with Crisis and Change and Natural Experiments of History Producer: Luke Mulhall

Dr Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Dr Greg Hundley: And I'm Dr Greg Hundley, associate editor, Director of the Pauley Heart Center from VCU Health in Richmond, Virginia. Dr Carolyn Lam: Our feature paper today discusses trans-ethnic genome-wide association studies and the insights in the genetic architecture and heritability of long QT syndrome, a massive study that we will be digging into, but only after we talk a little bit about the other papers in this week's issue. And I'm going to start, Greg. Are you ready with your coffee? Dr Greg Hundley: I am. Dr Carolyn Lam: The first original paper really represents seminal work, showing that the endothelium can directly regulate obesity and insulin resistance. Now, as obesity develops, there is a decline in adipose tissue vascularity, which seems counterintuitive, and an increase in fibrosis. So authors, led by Dr Chen from the Irell and Manella Graduate School of Biological Sciences in the City of Hope, speculated that the reduction in vascularity in this adipose tissue might have an adverse effect on adipose tissue function. Now, these authors previously identified Argonaute-1, or AG01, a key component of microRNA-induced silencing complex, as a crucial regulator in hypoxia-induced angiogenesis. So in the current study, they aim to determine the AG01-mediated endothelial cell transcriptome, the functional importance of AG01-regulated endothelial function in vivo, and the relevance to adipose tissue function and obesity. A new mouse model with genetic deletion of AG01 in the endothelium was useful to investigate the importance of endothelial regulation of adipose tissue function. The findings were that in mice fed high fat, high sucrose diet, the suppression of endothelial AG01 promoted adipose tissue browning, and led to an anti-obesity phenotype. Endothelial cell AG01 thrombospondin-1 pathway was induced in the endothelium from human donors with insulin resistance. In total, this study suggests a novel mechanism, by which endothelial cells through AG01 thrombospondin-1 pathway controls vascularization and function of adipose tissues, insulin sensitivity, and whole-body metabolic state. Dr Greg Hundley: Interesting, Carolyn. So tell me about this clinically. Where do we take this from here? Dr Carolyn Lam: I thought you would ask. So endothelial dysfunction, per se, can cause metabolic dysregulation, rendering targeting dysfunctional endothelium, a potential therapeutic strategy to counteract obesity, and metabolic disorders. So this study really opens a door to that. Dr Greg Hundley: Very nice. Well, I've got another basic science paper, and it evaluates single-cell RNA sequencing to dissect the immunological network of autoimmune myocarditis. And it comes from Dr Jiangping Song from the State Key Laboratory of Cardiovascular Disease of Fuwai Hospital, and the National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences, and Peking Union Medical College. So Carolyn, the study aimed to investigate the immunological network during the transition from myocarditis to cardiomyopathy, and to identify the genes contributing to the inflammatory response to myocarditis. So mice were treated with myosin heavy chain alpha-peptides to generate an experimental autoimmune myocarditis model. The investigators performed single-cell RNA sequencing analysis of CD45 plus cells extracted from mouse hearts during different experimental autoimmune myocarditis phases, including normal control, acute inflammation, subacute inflammation, and then in the myopathy phase. Also, human heart tissues were collected from surgically removed hearts of patients who had undergone heart transplantation. Dr Carolyn Lam: So what did they find, Greg? Dr Greg Hundley: Well, Carolyn, a comparison of the single-cell RNA sequencing data from different experimental autoimmune myocarditis phases suggested that some cell clusters, such as macrophage cluster 2 and Th17 cells, were associated with the inflammatory response in the experimental autoimmune myocarditis model. The HIF1A expression level correlated with the extent of the inflammatory response, and PX-478, a HIF1A inhibitor, alleviated the inflammation during the different experimental autoimmune myocarditis phases. Immunohistochemical staining revealed that HIF1A expression was upregulated in autoimmune myocarditis from the tissue samples from the explanted hearts. Thus, the HIF1A inhibitor alleviated inflammatory cell infiltration, and that may serve as a potential therapeutic target in clinical practice. Dr Carolyn Lam: Wow. That is some serious clinical implications. Well, my next paper is really the first systematic echocardiographic evaluation of consecutive patients requiring hospitalization due to COVID-19, and it comes from Dr Topilsky and colleagues from Tel Aviv Medical Center. Dr Greg Hundley: So Carolyn, what did they find in this series? Dr Carolyn Lam: So among a hundred consecutive patients diagnosed with COVID-19 infection who underwent complete echocardiographic evaluation, within 24 hours of admission, only 32% had a normal echocardiogram at baseline. The most frequent abnormality was right ventricular dilatation or dysfunction. Among patients developing clinical deterioration during follow-up, which were 20% of these hospitalized patients, repeated echocardiograms showed further deterioration of the right ventricular parameters, probably related to increased pulmonary resistance. Five of these patients had deep vein thrombosis. Dr Greg Hundley: Carolyn, my next study comes from Dr Stephen Fremes, and it's a modeling study out of the University of Toronto. It modeled TAVR versus SAVR valve durability to determine the effects on life expectancy across a broad range of age. Dr Carolyn Lam: Interesting. And what were the results? Dr Greg Hundley: Well, based on their simulation models, the durability of TAVR valves must be 70% shorter than that of surgically replaced valves to result in reduced life expectancy in patients with similar demographics to recent trials. However, in younger patients, the threshold for TAVR valve durability was substantially higher. In younger patients, life expectancy was reduced when TAVR durability was 30%, 40% and 50% shorter than surgical valves in 40, 50 or 60-year-old patients, respectively. So Carolyn, these findings suggest that durability concerns should not influence the initial treatment decision regarding TAVR versus SAVR in older low-risk patients, based on current evidence supporting TAVR valve durability. However, in younger low-risk patients, valve durability must be weighed against other patient factors, such as life expectancy. Dr Carolyn Lam: Thanks Greg, for that summary. Well, let me tell you about other papers in this issue. There are a pair of letters to the editor by Dr Opotowsky, and a response by Dr Goldberg regarding the paper results of the Fontan Udenafil Exercise Longitudinal, or FUEL trial. There's a research letter by Dr Strik, Validating QT-Interval Measurement Using the Apple Watch ECG to Enable Remote Monitoring During the COVID-19 Pandemic. There are two On My Mind papers, the first, Telemedicine and Forgotten America by Dr Julien, and the second, The COVID-19 Pandemic: Ethical and Scientific Imperatives for "Natural" Experiments by Dr Lewis. Dr Greg Hundley: Very nice. Well, Carolyn, I've got a research letter evaluating the effect of evolocumab on atherogenic lipoproteins during the peri and early post-infarction period. It's a placebo-controlled randomized trial from Dr Gary Gerstenblith. Sarah Cuddy also worked through a tough case of cardiac amyloid when a fat biopsy was negative, but imaging studies of the heart suggested cardiac amyloid. Carolyn, I've also got an On My Mind piece, and it's entitled, Can Old Ally Defeat a New Enemy? And it's by Dr Paul Gurbel, and he discusses the use of inhaled aspirin to treat patients with COVID-19. And then finally, Carolyn, I have a prospective piece from Dr Robert Lefkowitz who discusses β-arrestin-biased angiotensin II receptor agonists for treatment of COVID-19. Well, Carolyn, what a great issue, and let's get onto that feature discussion. Dr Carolyn Lam: Yay. Let's go, Greg. Dr Greg Hundley: Well, listeners. Now we're turning to our feature discussion, and we are very fortunate to have Professor Connie Bezzina from Amsterdam University Medical Center to talk to us about her paper related to long QT syndrome. Welcome, Connie. And I was wondering, before we get started in discussing your paper, could you tell us a little bit about the background in this area? And then, what was the hypothesis that you wanted to address? Prof Connie Bezzina: So over the last 20 to 30 years, we've learned a lot about the genetic underpinnings of inherited cardiac disorders associated with sudden cardiac arrest. And basically, we've learned a lot about mutations in specific genes that co-segregate with these disorders within families. However, two outstanding features have remained unresolved. Essentially, the first unresolved issue is the fact that we observe, oftentimes, a low disease penetrance and variable disease expression within families, which means that not everybody within a family that carries a familial mutation is affected by the disorder. But two, so among those that are affected, some are affected more severely than others. So some people would have only the ECG abnormality, whereas other people, for instance, would have the ECG abnormality and arrhythmic events. And you could also have individuals, indeed, who don't even manifest any disease manifestations. This is one of the outstanding challenges. The other outstanding challenge is the fact that, despite extensive genetic testing of the known genes in some probands and some families, they remain genetically lucid, in that we don't find a likely genetic defect in a minority of families. And of course, that hinders genetic testing and implementation of genetic testing in such families. Dr Greg Hundley: What was the question you were going to answer with your study? And tell us a little bit about your study design and your study population. Prof Connie Bezzina: Yeah, so essentially, we figured that assigning these disorders to one large genetic defect might be an oversimplification of biological phenomenon. So we hypothesized that even in these Mendelian disorders, the inheritance of additional genetic factors alongside the familial mutation could contribute to risk. Of course, there will be other factors such as environmental factors, which we did not tackle in the study. The central hypothesis of the study was that common genetic variation, which is present in the germ population, could modulate the effect of the familial genetic defect of the Mendelian mutation. So in order to do this, we assembled a large consortium of investigators from multiple centers in Europe, in North America and Japan, worldwide, to bring together about 1700 probands with the long QT syndrome. So we tested this hypothesis in the long QT syndrome because we figured, among the rare inherited rhythm disorders, it's one of the more common disorders. Also, because each individual center has too few patients. To do this locally, we put this group of investigators together to come up with 1700 probands. The study design was a genome-wide association study with a case-control design, where we tested the association of millions of SNPs littered across the genome with susceptibility for the disorder. So this led us to identify three single-nucleotide polymorphisms that are associated with susceptibility for the long QT syndrome. What we immediately saw is that, actually, these three SNPs, perhaps not surprisingly at all, had been previously associated with the extent of the QT interval, with QT interval in the general population. This is not surprising, of course, because repolarization is a central part of physiological mechanism in the long QT syndrome. So this basically indicated overlap between genetic control of the QT interval in the germ population and susceptibility to the long QT syndrome. So the fact that the three SNPs that we identified as long QT syndrome susceptibility SNPs had been associated with QT interval duration in the germ population, we felt that that was pointing to assure genetic underpinnings between these two phenotypes. So we went on to investigate that by looking at the correlation between the odds ratio for long QT syndrome susceptibility and the effect that these SNPs have on QT interval in the germ population. And in fact, we found a very high correlation between those. So essentially, this pointed to sure genetic factors between QT interval in the germ population and long QT syndrome susceptibility. Of course, we wanted to look for disease variability. The next thing we wanted to do was whether these SNPs could actually explain disease variability. Now, this was perhaps the most disappointing part of the study, because when we constructed a polygenic risk score based on SNPs that impact on the QT in the germ population, we found no relation to QT interval among patients, and also no relation to life-threatening arrhythmic events among the patients. We think that this is because our patients... or probrands. They're primarily probands, so they are all more sick. So we didn't have enough variability in our patient set to identify an association with disease variability. And in fact, this is at variance with previous studies that tested individual SNPs, and even our own studies with smaller polygenic risk scores that did find an association between a polygenic risk score based on QT SNPs and QT prolongation and events among patients. So we think that this is certainly something to study further in the future, in larger patient sets where we not only have the probands, but also their relatives, their mutation-carrying relatives, which will give us a bigger variability to actually test this hypothesis. So we think that looking at probands actually was a very good design to find susceptibility variance but was not maybe a good design to find SNPs or polygenic risk scores to test their effect on disease variability. Dr Greg Hundley: It sounds like you've found certain gene low PSI that indicate a predilection for prolongation of the QT interval, but not necessarily are those gene low PSI consistent with who's going to experience an adverse cardiovascular event as a result of their genetic constitution. Is that a fair statement? Prof Connie Bezzina: Well, I think that the setting, because we had probands, they were the most sick people in their families. I think to have stronger conclusions on that, we need to test the polygenic risk scores in families where there are people who are differentially affected. Dr Greg Hundley: I see. I- Prof Connie Bezzina: We had too-narrow of a variability in a probands-only design, as opposed to a study where we would have probands who are severely affected and mutation-carrying relatives who are less severely affected. Dr Greg Hundley: Very nice. So that puts that clearly into context. This was a massive effort. You have quite a list of investigators, and you mentioned you had to gather so many sites. How would you conduct that next study? Would you need another large collection of individuals and many sites to take that on? Prof Connie Bezzina: Yes. I'm a geneticist, and geneticists always want larger, larger numbers, and I'm also one of those. So I'm interested in explaining as much as possible into individual variability. And I think to do that properly, I think we should go preferably for a similar design where we will approach the same centers. And hopefully, we can organize the next study, which will have these probands and their relatives. Dr Greg Hundley: Now, just quickly, for us working in the clinic, how should we approach genetic testing in patients with long QT? Prof Connie Bezzina: At the moment, I think our findings don't have an immediate impact. I think our findings tell us about the genetic architecture of the disorder. And actually, one thing I haven't gone into yet is the fact that what we also found is that patients who do not have mutations in the no-long QT genes, which were called mutation-negative, which are about 20% of all long QT syndrome probands, actually have a higher burden of these common variants that prolong the QT interval. So we think, actually, that mutation-negative long QT syndrome probands will not have a Mendelian large effect variant but will have perhaps a higher burden of these QT-prolonging alleles. Therefore, I think this has direct implications for clinical genetics of these patients, because if you have a proband in whom you don't find a mutation in the known genes, you could think that maybe it is not monogenic, which has implications because you don't have a single genetic defect to test on that family. One would need to keep follow-up of more family members until we understand more about the genetics of those individuals. Dr Greg Hundley: So Connie, this has been just a wonderful discussion. Any additional studies examining the genetic architecture of individuals that we need to think about for the future? Prof Connie Bezzina: Sure. So for long QT syndrome in particular, as additional SNPs that modulate the QT interval in the germ population are identified, it will be very important to incorporate these into larger polygenic risk scores, and see whether we could have a better discriminative capacity of such polygenic risk scores in discriminating between severely affected and less severely affected people, or who is more at risk for an arrhythmic event. Outside of long QT syndrome, I think there's a lot of work to be done with respect to the likely complex inheritance of many of these disorders that we previously considered to be Mendelian. So for instance, ongoing work in our group concerns Brugada syndrome, where we're seeing the same kind of thing, and hypertrophic cardiomyopathy, where we're seeing the same kind of inheritance. Dr Greg Hundley: Well listeners, on behalf of both Carolyn and myself, we look forward to catching you on the run next week. Take care. This program is copyright the American Heart Association 2020.

Paul and Howard discuss how medicine is changing, and how some common procedures and ideas that were once accepted practice are being abandoned. They also talk about the merits of shouting at your legs, and whether it's possible to mainline red wine. Topics: Why some procedures become accepted practice, despite poor evidence The "six weeks" myth in recovering from a soft tissue injury Examples of common procedures being rethought, or abandoned altogether Some candidates for future medical reversals How the coronavirus is creating a natural experiment in which procedures are necessary Readings: Fear and surgical decision making Medical Reversal: Why We Must Raise the Bar Before Adopting New Technologies Natural experiments Music: "Crossing the Chasm" Kevin MacLeod (incompetech.com) Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/ Disclaimers apply, and can be heard at the end of the episode.

Physician economist Anupam B. Jena advances the understanding of what works and what does not work in health care by using “natural experiments” and big data. He studies phenomena such as the economics of physician behavior and the physician workforce, health care productivity, and the economics of medical innovation. Bapu is the Ruth L. Newhouse Associate Professor of Health Care Policy at Harvard Medical School, an internist at Massachusetts General Hospital, and a Faculty Research Fellow at the National Bureau of Economic Research. He is the 2007 recipient of the Eugene Garfield Award by Research America for his work demonstrating the economic value of medical innovation in HIV/AIDS. In 2013, he was the first social scientist to win the NIH Director's Early Independence Award. His research and editorials have been featured in the New York Times, Washington Post, Wall Street Journal, Freakonomics, and NPR. He is also co-host of the podcast, Tradeoffs, which aims to make sense of the complicated, costly, and often counterintuitive world of health care. He spoke at TEDMED 2020 in Boston. Kali D Cyrus holds a BA in Psychology from Stanford University, an MPH in health policy & management from Emory University and an MD from the University of Illinois at Chicago. She completed her adult psychiatry residency training and served as a public psychiatry fellow at the Yale School of Medicine. Kali is currently an assistant professor in the Department of Psychiatry of Johns Hopkins School of Medicine. She worked on Capital Hill from 2017- 2018 as a health policy fellow in the Office of Senator Chris Murphy and was a Jeanne Spurlock congressional fellow.  View her recent work: How Racism is Causing Black and Latinx Communities to Die of COVID-19 at Higher Rates on NowThis News  

Modeling plays a key role in the development of the future car and in this new pandemic world in which we live. Preventing the spread of this disease permeates everything we do from how we manage our health to how we dine out, and even how we get around - everything is changing. While scientists race to find a vaccine and the world must adapts to a new normal, modeling and simulation help us predict how that new normal will unfold. Putting new systems in place and altering urban infrastructure is costly. Particularly during an economic shutdown, we need to make sure our decisions have the intended effect of keeping us safe as we return to some version of normality. So, what role does modeling play in helping us make those decisions, and who is doing the modeling? Join Ed Bernardon, host of The Future Car Podcast, discover how economists are shaping the models that try to predict the new normal.Our guest today is Ashley O'Donoghue, a Ph.D. economist at the Center for Healthcare Delivery Science at Beth Israel Deaconess Medical Center in Boston. She talks with us about some of the models that are currently being used to help us predict what the new normal might look like. She'll also help us answer one of life's great questions: What exactly does an economist do?Some Questions I Ask:What is the role of an economist in the healthcare sector? (3:02)When do you know your model is good enough? (6:35)Can models help us predict the future? (7:37) What is a “super spreader”? (11:10)Which environments are more likely to create super spreader events? (13:24)What You Will Learn:What an economist actually does (1:49)What we learn from “causal inference” (3:41)Examples of Natural Experiments in hospitals and what we can learn from data (4:56)What the current models are predicting about transportation (8:54)The unintended side effects of the pandemic in the healthcare sector (9:26)What changes cities are already making to adapt (10:01)Learn more about Ashley O'Donoghue:LinkedInTwitterSuper Spreader StudyHarvard Business Review on Ashley's ModelAI in Health CareLearn more about your host Ed Bernardon:LinkedinFuture Car: Driving a Lifestyle RevolutionMotorsports is speeding the way to safer urban mobilitySiemens Digital Industries Software Our GDPR privacy policy was updated on August 8, 2022. Visit acast.com/privacy for more information.

This podcast covers for transgender genetic gender behavior predisposition in the form of biomarkers and "natural experiments." Biomarkers include handedness, 2D4D finger length ratio and FTM anatomy.  Natural experiments include the saga of David Reimer and the effects of raising males with cloacl extrophy in the feminine gender behavior category. 

Mon, 25 Jan 2010 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/11066/ https://edoc.ub.uni-muenchen.de/11066/1/Sauter_Wolf_Nicolas.pdf Sauter, Wolf Nicolas ddc:330, ddc:300, Volkswirtschaftliche Fakultät

I remember telling my wife, the mathematician, that historians typically work on one time and place their entire careers. If you begin, say, as a historian of Russia in the 1600s (as I did), you are likely to end as a historian of Russia in the 1600s (I didn’t, but that’s another story). “You’ve got to be kidding,” she said. “Don’t historians get bored with their little time and place?” “Yes,” I replied. “Don’t they exhaust the topic and begin to work in circles?” “Yes, quite often” I replied. “Don’t they want to compare what they’ve learned about time/place X with time/place Y in order to better understand both X and Y?” “Probably,” I replied. “Then why,” she asked, “do historians continue to work the way they do?” It’s a good question, and one that deserves to be answered. On the one hand, ‘more and more about less and less’ has certainly enabled us–that is, the historical profession–to uncover a lot of the past that might have been forgotten. But, on the other hand, we’ve gone so far ‘inside baseball’ that we can’t and don’t talk to one another, let alone talk to colleagues in other disciplines or the public at large. There are exceptions, but they only improve the rule. In their very readable new book Natural Experiments of History (Harvard, 2010), Jared Diamond and James A. Robinson point out that this way of going about history is a lost opportunity. If historians would pull up for a moment and look around, they would discover a world of “natural experiments” that could both shed light on their particular time/place and speak to larger patterns in world history. More specifically, “natural experiments”–what historians usually call the “comparative method”–would permit them to speak about the general causes of the specific events they study. To my mind, that is a laudable goal and one that we should pursue. Knowledge, as we know, is difference. If all you know is Russia in the 1600s, then you won’t really know Russia in the 1600s. We should do what we tell our undergraduates to do: compare and contrast. Please become a fan of “New Books in History” on Facebook if you haven’t already. Learn more about your ad choices. Visit megaphone.fm/adchoices

I remember telling my wife, the mathematician, that historians typically work on one time and place their entire careers. If you begin, say, as a historian of Russia in the 1600s (as I did), you are likely to end as a historian of Russia in the 1600s (I didn’t, but that’s another story). “You’ve got to be kidding,” she said. “Don’t historians get bored with their little time and place?” “Yes,” I replied. “Don’t they exhaust the topic and begin to work in circles?” “Yes, quite often” I replied. “Don’t they want to compare what they’ve learned about time/place X with time/place Y in order to better understand both X and Y?” “Probably,” I replied. “Then why,” she asked, “do historians continue to work the way they do?” It’s a good question, and one that deserves to be answered. On the one hand, ‘more and more about less and less’ has certainly enabled us–that is, the historical profession–to uncover a lot of the past that might have been forgotten. But, on the other hand, we’ve gone so far ‘inside baseball’ that we can’t and don’t talk to one another, let alone talk to colleagues in other disciplines or the public at large. There are exceptions, but they only improve the rule. In their very readable new book Natural Experiments of History (Harvard, 2010), Jared Diamond and James A. Robinson point out that this way of going about history is a lost opportunity. If historians would pull up for a moment and look around, they would discover a world of “natural experiments” that could both shed light on their particular time/place and speak to larger patterns in world history. More specifically, “natural experiments”–what historians usually call the “comparative method”–would permit them to speak about the general causes of the specific events they study. To my mind, that is a laudable goal and one that we should pursue. Knowledge, as we know, is difference. If all you know is Russia in the 1600s, then you won’t really know Russia in the 1600s. We should do what we tell our undergraduates to do: compare and contrast. Please become a fan of “New Books in History” on Facebook if you haven’t already. Learn more about your ad choices. Visit megaphone.fm/adchoices

I remember telling my wife, the mathematician, that historians typically work on one time and place their entire careers. If you begin, say, as a historian of Russia in the 1600s (as I did), you are likely to end as a historian of Russia in the 1600s (I didn’t, but that’s another story). “You’ve got to be kidding,” she said. “Don’t historians get bored with their little time and place?” “Yes,” I replied. “Don’t they exhaust the topic and begin to work in circles?” “Yes, quite often” I replied. “Don’t they want to compare what they’ve learned about time/place X with time/place Y in order to better understand both X and Y?” “Probably,” I replied. “Then why,” she asked, “do historians continue to work the way they do?” It’s a good question, and one that deserves to be answered. On the one hand, ‘more and more about less and less’ has certainly enabled us–that is, the historical profession–to uncover a lot of the past that might have been forgotten. But, on the other hand, we’ve gone so far ‘inside baseball’ that we can’t and don’t talk to one another, let alone talk to colleagues in other disciplines or the public at large. There are exceptions, but they only improve the rule. In their very readable new book Natural Experiments of History (Harvard, 2010), Jared Diamond and James A. Robinson point out that this way of going about history is a lost opportunity. If historians would pull up for a moment and look around, they would discover a world of “natural experiments” that could both shed light on their particular time/place and speak to larger patterns in world history. More specifically, “natural experiments”–what historians usually call the “comparative method”–would permit them to speak about the general causes of the specific events they study. To my mind, that is a laudable goal and one that we should pursue. Knowledge, as we know, is difference. If all you know is Russia in the 1600s, then you won’t really know Russia in the 1600s. We should do what we tell our undergraduates to do: compare and contrast. Please become a fan of “New Books in History” on Facebook if you haven’t already. Learn more about your ad choices. Visit megaphone.fm/adchoices

Wed, 26 Jul 2006 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/5839/ https://edoc.ub.uni-muenchen.de/5839/1/Eife_Thomas_A.pdf Eife, Thomas ddc:300, ddc:330, Volkswirtschaftliche Fakultät