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Dr. Monty Pal and Dr. Jason Westin discuss the federal funding climate for cancer research and the persistent problem of drug shortages, two of the major concerns facing the oncology community in 2026. TRANSCRIPT Dr. Monty Pal: Hello and welcome to the ASCO Daily News Podcast. I am your host, Dr. Monty Pal. I am a medical oncologist and vice chair of academic affairs at the City of Hope Comprehensive Cancer Center in Los Angeles. There are always multiple challenges facing oncologists, and today, we discuss two of them that really stand out for 2026: threats to federal funding for cancer research and the persistent problem of drug shortages. I am thrilled to welcome Dr. Jason Westin, who believes that one way to meet these challenges is to get oncologists more involved in advocacy, and he will share some strategies to help us meet this moment in oncology. Dr. Westin is a professor in the Department of Lymphoma and Myeloma at the University of Texas MD Anderson Cancer Center, but he actually wears a lot of hats within ASCO. He is a member of the Board of Directors and has also previously served as chair of ASCO's Government Relations Committee. And he is also one of the inaugural members of ASCO's Political Action Committee, or PAC. He has testified before Congress about drug shortages and many other issues. Dr. Westin, I am really excited to have you on the podcast today and dive into some of these elements that will really impact our community in 2026. Thanks so much for joining us today. Dr. Jason Westin: Thank you for having me. Dr. Monty Pal: You've had such a range of experience. I already alluded to you testifying before Congress. You've actually run for office before. You wear so many different hats. I'm used to checking my PubMed every other day and seeing a new paper out from you and your group, and you publish in the New England Journal [of Medicine] on practice-setting standards and the diseases that you treat. But you've also done all this work in the domain of advocacy. I can't imagine that balancing that is easy. What has sort of motivated you on the advocacy front? Dr. Jason Westin: Advocacy to me is another way to apply our skills and help more people than just those that you're sitting across from at the time. Clinical research, of course, is a tool to try and take what we know and apply it more broadly to people that you'll never meet. And advocacy, I think, can do the same thing, where you can have a conversation with a lawmaker, you can advocate for a position, and that hopefully will help thousands or maybe even more people down the road who you'd never get to directly interact with. And so, I think it's a force multiplier in the same way that research can be. And so, I think advocacy is a wonderful part of how doctors care for our patients. And it's something that is often difficult to know where to start, but once people get into advocacy, they can see that the power, the rewarding nature of it is attractive, and most people, once they get going, continue with that through the rest of their career. Dr. Monty Pal: So, I'll ask you to expand on that a little bit. We have a lot of our younger ASCO members listening to this podcast, folks that are just starting out their careers in clinical practice or academia. Where does that journey begin? How do you get to the point that you're testifying in front of Congress and taking on these bigger sort of stances for the oncology community? Dr. Jason Westin: Yeah, with anything in medicine and in our careers, you have to start somewhere. And often you start with baby steps before you get in front of a panel of senators or other high-profile engagement opportunities. But often the first setting for junior colleagues to be engaged is doing things – we call them "Hill Days" – but basically being involved in kind of low-stakes meetings where you're with a group of peers, some of whom have done this multiple times before, and can get engaged talking to members of representatives' offices, and doing so in a way where it's a natural conversation that you're telling a story about a patient in your clinic, or that you're telling a personal experience from a policy that impacted your ability to deliver optimal care. It sounds stressful, but once you're doing it, it's not stressful. It's actually kind of fun. And it's a way that you can get comfort and skill with a group of peers who are there and able to help you. And ASCO has a number of ways to do that, both at the federal level, there's the Hill Day where we each April have several hundred ASCO members travel to Capitol Hill. There's also state engagement that can be done, so-called visiting at home, when representatives from the U.S. Congress or from state legislators are back in district. You can meet with your own representatives on behalf of yourself, on behalf of your organization, and advocate for policies in a way that can be beneficial to your patients. But those initial meetings that are in the office often they're low stakes because you could be meeting not with the representative but with their staff. And that staff sometimes is as young or even younger than our junior colleagues. These sometimes can be people in their 20s, but they're often extremely knowledgeable, extremely approachable, and are used to dealing with people who are new to advocacy. But they actually help make decisions within the office. So it's not a waste of time. It's actually a super useful way to engage. So, it's that first step of anything in life. The activation energy is always high to do something new. But I'd encourage people who are listening to this podcast already having some level of interest about it to explore ways that they could engage more. Dr. Monty Pal: You know, I have to tell you, I'm going to riff on what you just said for a second. ASCO couldn't make it any easier, I think, for folks to participate and get involved. So, if you're listening to this and scratching your head and thinking, "Well, where do I begin? How do I actually sign on for that meeting with a local representative?" Go to the ASCO ACT Network website. And I'll actually talk to our producer, Geraldine, to make sure we've got a link to that somewhere associated with this podcast after it's published, Jason, but I actually keep that on my browser and it's super easy. I check in there every now and then and see if there's any new policy or legislation that ASCO, you know, is sort of taking a stance on, and it gives me some fodder for conversation with my local representatives too. I mean, it's just an awesome, awesome vehicle. I'm going to segue right from there right to the issues. So, you and I are both at academic centers. You know, I think this is something that really pervades academia and enters into implications for general clinical practice. There's been this, you know, massive sort of proposal for decreased funding to the NCI and to the NIH and so forth. Tell us what ASCO is doing in that regard, and tell us perhaps how our community can help. Dr. Jason Westin: We live in interesting times, and I think that may be an understatement x 100. But obviously investments in research are things that when you're at an academic center, you see and feel that as part of your daily life. Members of Congress need to be reminded of that because there's a lot of other competing interests out there besides investing in the future through research. And being an elected representative is a hard job. That is something where you have to make difficult choices to support this, and that may mean not supporting that. And there's lots of good things where our tax dollars could be spent. And so, I'm sympathetic to the idea that there's not unlimited resources. However, ASCO has done an excellent job, and ASCO members have led the charge on this, of stating what research does, what is the benefit of research, and therefore why should this matter to elected representatives, to their staff, and to those people that they're elected to serve. And ASCO has led with a targeted campaign to basically have that message be conveyed at every opportunity to elected representatives. And each year on Hill Day, one of the asks that we have is to continue to support research: the NCI, NIH, ARPA-H, these are things that are always in the asks to make sure that there's appropriate funding. But effectively playing offense by saying, "It's not just a number on a sheet of paper, this is what it means to patients. This is what it means to potentially your loved ones in the future if you are in the opposite situation where you're not on the legislative side, but you're in the office receiving a diagnosis or receiving a difficult piece of news." We only have the tools we have now because of research, and each breakthrough has been years in the making and countless hours spent funded through the engine of innovation: clinical research and translational research. And so ASCO continues to beat that drum. You mentioned earlier the ACT Network. Just to bring that back again is a very useful, very easy tool to communicate to your elected representatives. When you sign up on the ASCO ACT website, you get emails periodically, not too much, but periodically get emails of, "This is a way you can engage with your lawmakers to speak up for this." And as you said, Monty, they make it as easy as possible. You click the button, you type in your address so that it figures out who your elected representatives are, and then it will send a letter on your behalf after like five clicks to say, "I want you to support research. I want you to vote for this particular thing which is of interest to ASCO and by definition to members of ASCO." And so the ACT Network is a way that people listening can engage without having to spend hours and significant time, but just a few clicks can send that letter to a representative in Congress. And the question could be: does that matter? Does contacting your senator or your elected representative do anything? If all they're hearing is somebody else making a different argument and they're hearing over and over again from people that want investments in AI or investments in something else besides cancer research, whatever it is, they may think that there's a ground shift that people want dollars to be spent over here as opposed to at the NIH or NCI or in federally funded research. It is important to continue to express the need for federal funding for our research. And so, it really is important for folks to engage. Dr. Monty Pal: 100%. One of the things that I think is not often obvious to a lot of our listeners is where the support for clinical trials comes from. You know, you've obviously run the whole gamut of studies as have I. You know, we have our pharmaceutical company-sponsored studies, which are in a particular bucket. But I would say that there's a very important and critical subset of studies that are actually government funded, right? NCI-funded clinical trials. If you don't mind, just explain to our audience the critical nature of the work that's being done in those types of studies and if you can, maybe compare and contrast the studies that are done in that bucket versus perhaps the pharmaceutical bucket. Dr. Jason Westin: Both are critical, and we're privileged that we have pharma studies that are sponsored and federally funded clinical research. And I think that part of a healthy ecosystem for us to develop new breakthroughs has a need for both. The pharma sponsored studies are done through the lens of trying to get an approval for an agent that's of interest so that the pharma company can then turn around and use that outside of a clinical trial after an FDA approval. And so those studies are often done through the lens of getting over the finish line by showing some superiority over an existing treatment or in a new patient population. But they're done through that lens of kind of the broadest population and sometimes relatively narrow endpoints, but to get the approval so that then the drug can be widely utilized. Clinical trials done through cooperative groups are sometimes done to try and optimize that or to try and look at comparative things that may not be as attractive to pharma studies, not necessarily going for that initial approval, but the fine tuning or the looking at health outcomes or looking at ensuring that we do studies in representative populations that may not be as well identified on the pharma sponsored trials, but basically filling out the gaps in the knowledge that we didn't gain from the initial phase 3 trial that led to the approval. And so both are critical. But if we only do pharma sponsored trials, if we don't fund federally supported research and that dries up, the fear I have, and many others have, is that we're going to be lacking a lot of knowledge about the best ways to use these great new therapies, these new immune therapies, or in my team, we do a lot of clinical trials on CAR T-cell therapies. If we don't have federally funded research to do the important clinical studies, we'll be in the dark about the best ways to use these drugs, and that's going to be a terrible shame. And so we really do need to continue to support federal research. Dr. Monty Pal: Yeah, there are no softball questions on this podcast, but I think everybody would be hard pressed to think that you and I would come on here and say, "Well, no, we don't need as much money for clinical trials and NCI funding" and so forth. But I think a really challenging issue to tackle, and this is something we thought to ask you ahead of the podcast, is what to do about the general climate of, you know, whether it's academic research or clinical practice here that seems to be getting some of our colleagues thinking about moving elsewhere. I've actually talked to a couple of folks who are picking up and moving to Europe for a variety of considerations, other continents, frankly. The U.S. has always been a leader when it comes to oncology research and, one might argue, research in general. Some have the mindset these days that we're losing that footing a little bit. What's your perspective? Are you concerned about some of the trends that you're seeing? What does your crystal ball tell you? Dr. Jason Westin: I am highly concerned about this. I think as you said, the U.S. has been a leader for a long time, but it wasn't always. This is not something that's preordained that the world-leading clinical research and translational research will always be done in the United States. That is something that has been developed as an ecosystem, as an engine for innovation and for job development, new technology development, since World War II. That's something that through intentional investments in research was developed that the best and brightest around the world, if they could choose to go anywhere, you wanted them to come to work at universities and academic places within the United States. And I think, as you said, that's at risk if you begin to dry up the investment in research or if you begin to have less focus on being engaged in research in a way that is forward thinking, not just kind of maintaining what we do now or only looking at having private, for profit sponsored research. But if you don't have the investment in the basic science research and the translational research and the forward-thinking part of it, the fear is that we lose the advantage and that other countries will say, "Thank you very much," and be happy to invest in ways to their advantage. And I think as you mentioned, there are people that are beginning to look elsewhere. I don't think that it's likely that a significant population of researchers in the U.S. who are established and have careers and families – I don't think that we're going to see a mass exodus of folks. I think the real risk to me is that the younger, up-and-coming people in undergraduate or in graduate school or in medical school and are the future superstars, that they could either choose to go into a different field, so they decide not to go into what could be the latest breakthroughs for cancer patients but could be doing something in AI or something in a different field that could be attractive to them because of less uncertainty about funding streams, or they could take that job offer if it's in a different country. And I think that's the concern is it may not be a 2026 problem, but it could be a 2036 or a 2046 problem that we reap what we sow if we don't invest in the future. Dr. Monty Pal: Indeed, indeed. You know, I've had the pleasure of reviewing abstracts for some of our big international meetings, as I'm sure you've done in the past too. I see this trend where, as before, we would see the preponderance of large phase 3 clinical trials and practice setting studies being done here in the U.S., I'm seeing this emergence of China, of other countries outside of the U.S. really taking lead on these things. And it certainly concerns me. If I had to sort of gauge this particular issue, it's at the top of my list in terms of what I'm concerned about. But I also wanted to ask you, Jason, in terms of the issues that are looming over oncology from an advocacy perspective, what else really sort of keeps you up at night? Dr. Jason Westin: I'm quite concerned about the drug shortages. I think that's something that is a surprisingly evergreen problem. This is something that is on its face illogical that we're talking about the greatest engine for research in the world being the United States and the investment that we've made in drug development and the breakthroughs that have happened for patients all around the world, many of them happen in the United States, and yet we don't necessarily have access to drugs from the 1970s or 1980s that are cheap, generic, sterile, injectable drugs. This is the cisplatins and the vincristines and the fludarabine type medications which are not the sexy ones that you see the ads in the magazine or on TV at night. These are the backbone drugs for many of our curative intent regimens for pediatrics and for heme malignancies and many solid tumors. And the fact that that's continuing to be an issue is, in my opinion, a failure to address the root causes, and those are going to require legislative solutions. The root causes here are basically a race to the bottom where the economics to invest in quality manufacturing really haven't been prioritized. And so it's a race to the cheapest price, which often means you undercut your competitor, and when you don't have the money to invest in good manufacturing processes, the factory breaks down, there's no alternative, you go into shortage. And this has been going on for a couple of decades, and I don't think there's an end in sight until we get a serious solution proposed by our elected officials. That is something that bothers me in the ways where we know what we should be doing for our patients, but if we don't have the drugs, we're left to be creative in ways we shouldn't have to do to figure out a plan B when we've got curative intent therapies. And I think that's a real shame.  There's obviously a lot of other things that are concerning related to oncology, but something that I have personally had experience with when I wanted to give a patient a CAR T-cell, and we don't have a supply of fludarabine, which is a trivial drug from decades ago in terms of the technology investments in genetically modified T-cells, to not then have access to a drug that should be pennies on the dollar and available at any time you want it is almost like the Air Force investing in building the latest stealth bomber, but then forgetting to get the jet fuel in a way that they can't use it because they don't have the tools that they need. And so I think that's something that we do need to have comprehensive solutions from our elected officials. Dr. Monty Pal: Brilliantly stated. I like that analogy a lot. Let's get into the weeds for a second. What would that proposal to Congress look like? What are we trying to put in front of them to help alleviate the drug shortages? Dr. Jason Westin: We could spend a couple hours, and I know podcasts usually are not set up to do that. And so I won't go through every part. I will direct you that there have been a couple of recent publications from ASCO specifically detailing solutions, and there was a recent white paper from the Senate Finance Committee that went through some legislative solutions being explored. So Dr. Gralow, ASCO CMO, and I recently had a publication in JCO OP detailing some solutions, more in that white paper from the Senate Finance. And then there's a working group actually going through ASCO's Health Policy Committee putting together a more detailed proposal that will be published probably around the end of 2026. Very briefly, what needs to happen is for government contracts for purchasing these drugs, there needs to be an outlay for quality, meaning that if you have a manufacturing facility that is able to deliver product on time, reliably, you get a bonus in terms of your contract. And that changes the model to prioritize the quality component of manufacturing. Without that, there's no reason to invest in maintaining your machine or upgrading the technology you have in your manufacturing plant. And so you have bottlenecks emerge because these drugs are cheap, and there's not a profit margin. So you get one factory that makes this key drug, and if that factory hasn't had an upgrade in their machines in 20 years, and that machine conks out and it takes 6 months to repair or replacement, that is an opportunity for that drug to go into shortage and causes a mad dash for big hospitals to purchase the drug that's available, leaving disparities to get amplified. It's a nightmare when those things happen, and they happen all the time. There are usually dozens, if not hundreds, of drugs in shortage at any given time. And this has been going on for decades. This is something that we do need large, system-wide fixes and that investment in quality, I think, will be a key part. Dr. Monty Pal: Yeah, brilliantly said. And I'll make sure that we actually include those articles on the tagline for this podcast as well. I'll talk to our producer about that as well.  I'm really glad you mentioned the time in your last comment there because I felt like we just started, but in fact, I think we're right at our close here, Jason, unfortunately. So, I could have gone on for a couple more hours with you. I really want to thank you for these absolutely terrific insights and thank you for all your advocacy on behalf of ASCO and oncologists at large. Dr. Jason Westin: Thank you so much for having me. I have enjoyed it. Dr. Monty Pal: Thanks a lot. And many thanks to our listeners too. You can find more information about ASCO's advocacy agenda and activities at asco.org. Finally, if you value the insights that you heard today on the ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Thanks so much. ASCO Advocacy Resources: Get involved in ASCO's Advocacy efforts: ASCO Advocacy Toolkit Crisis of Cancer Drug Shortages: Understanding the Causes and Proposing Sustainable Solutions, JCO Oncology Practice Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers:     Dr. Monty Pal   @montypal   Dr. Jason Westin @DrJasonWestin   Follow ASCO on social media:      @ASCO on X     ASCO on Bluesky    ASCO on Facebook      ASCO on LinkedIn      Disclosures:     Dr. Monty Pal:    Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview   Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical   Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis   Dr. Jason Westin: Consulting or Advisory Role: Novartis, Kite/Gilead, Janssen Scientific Affairs, ADC Therapeutics, Bristol-Myers Squibb/Celgene/Juno, AstraZeneca, Genentech/Roche, Abbvie, MorphoSys/Incyte, Seattle Genetics, Abbvie, Chugai Pharma, Regeneron, Nurix, Genmab, Allogene Therapeutics, Lyell Immunopharma Research Funding: Janssen, Novartis, Bristol-Myers Squibb, AstraZeneca, MorphoSys/Incyte, Genentech/Roche, Allogene Therapeutics

Did you know that a single crumb of bread is enough to cause an autoimmune response in children with celiac disease? Dr. Pankaj Vohra, Professor of Pediatrics and Board-Certified Pediatric Gastroenterologist, joins medical student Andrea Smith to discuss the evaluation and management of celiac disease, as well as essential guidance for following a gluten-free diet. Specifically, they will: Review the epidemiology of celiac disease and identify common symptoms and presentations of celiac disease Describe the pathophysiology of celiac disease including histopathological changes to the duodenum Identify diagnostic tests and criteria for diagnosing celiac disease in the pediatric population Identify common sources of gluten and the basics of identifying gluten on food labels Discuss typical management of celiac disease including appropriate screening tests and managing accidental gluten ingestion Special thanks to Dr. Rebecca Yang and Dr. Neeharika Bade for peer reviewing this episode. CME available free with sign up: Link coming soon! References: Bolia, R., & Thapar, N. (2023). Celiac Disease in Children: A 2023 Update. In Indian Journal of Pediatrics. Springer. https://doi.org/10.1007/s12098-023-04659-w Gidrewicz, D., Potter, K., Trevenen, C. L., Lyon, M., & Butzner, J. D. (2015). Evaluation of the ESPGHAN celiac guidelines in a North American pediatric population. American Journal of Gastroenterology, 110(5), 760–767. https://doi.org/10.1038/ajg.2015.87 Hill, I. D., Fasano, A., Guandalini, S., Hoffenberg, E., Levy, J., Reilly, N., & Verma, R. (2016). NASPGHAN clinical report on the diagnosis and treatment of gluten-related disorders. Journal of Pediatric Gastroenterology and Nutrition, 63(1), 156–165. https://doi.org/10.1097/MPG.0000000000001216 Husby, S., Koletzko, S., Korponay-Szabó, I., Kurppa, K., Mearin, M. L., Ribes-Koninckx, C., Shamir, R., Troncone, R., Auricchio, R., Castillejo, G., Christensen, R., Dolinsek, J., Gillett, P., Hróbjartsson, A., Koltai, T., Maki, M., Nielsen, S. M., Popp, A., Størdal, K., … Wessels, M. (2020). European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020. In Journal of Pediatric Gastroenterology and Nutrition (Vol. 70, Issue 1, pp. 141–156). Lippincott Williams and Wilkins. https://doi.org/10.1097/MPG.0000000000002497 Nenna, R., Tiberti, C., Petrarca, L., Lucantoni, F., Mennini, M., Luparia, R. P. L., Panimolle, F., Mastrogiorgio, G., Pietropaoli, N., Magliocca, F. M., & Bonamico, M. (2013). The celiac iceberg: Characterization of the disease in primary schoolchildren. Journal of Pediatric Gastroenterology and Nutrition, 56(4), 416–421. https://doi.org/10.1097/MPG.0b013e31827b7f64 Sahin, Y. (2021). Celiac disease in children: A review of the literature. In World Journal of Clinical Pediatrics (Vol. 10, Issue 4, pp. 53–71). Baishideng Publishing Group Co. https://doi.org/10.5409/wjcp.v10.i4.53 Salden, B. N., Monserrat, V., Troost, F. J., Bruins, M. J., Edens, L., Bartholomé, R., Haenen, G. R., Winkens, B., Koning, F., & Masclee, A. A. (2015). Randomised clinical study: Aspergillus niger-derived enzyme digests gluten in the stomach of healthy volunteers. Alimentary Pharmacology and Therapeutics, 42(3), 273–285. https://doi.org/10.1111/apt.13266 Schuppan, D., Mäki, M., Lundin, K. E. A., Isola, J., Friesing-Sosnik, T., Taavela, J., Popp, A., Koskenpato, J., Langhorst, J., Hovde, Ø., Lähdeaho, M.-L., Fusco, S., Schumann, M., Török, H. P., Kupcinskas, J., Zopf, Y., Lohse, A. W., Scheinin, M., Kull, K., … Greinwald, R. (2021). A Randomized Trial of a Transglutaminase 2 Inhibitor for Celiac Disease. New England Journal of Medicine, 385(1), 35–45. https://doi.org/10.1056/nejmoa2032441 Tack, G. J., van de Water, J. M. W., Bruins, M. J., Kooy-Winkelaar, E. M. C., van Bergen, J., Bonnet, P., Vreugdenhil, A. C. E., Korponay-Szabo, I., Edens, L., von Blomberg, B. M. E., Schreurs, M. W. J., Mulder, C. J., & Koning, F. (2013). Consumption of gluten with gluten-degrading enzyme by celiac patients: A pilot-study. World Journal of Gastroenterology, 19(35), 5837–5847. https://doi.org/10.3748/wjg.v19.i35.5837 Husby S, Koletzko S, Korponay-Szabó IR, et al. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease. J Pediatr Gastroenterol Nutr 2012; 54: 136–160

The weight loss medication debate has taken a fascinating turn as public figures continue to grapple with the decision to use drugs like Ozempic and Wegovy. Oprah Winfrey, one of America's most influential personalities, has found herself at the center of this conversation, and her stance reveals the complex relationship many people have with these powerful pharmaceutical tools. For years, Oprah publicly resisted using Ozempic, stating that she felt taking the medication would be taking the easy way out. However, she later revealed that she had lost forty pounds using a weight loss medication, creating a significant shift in her public messaging that sparked considerable backlash from critics who pointed out this apparent contradiction to her earlier statements about the easy way out.The emergence of GLP-1 drugs like semaglutide, marketed as Ozempic, has fundamentally changed how we think about weight management. These medications work by suppressing appetite while you are taking them and stabilizing blood sugar levels. The science behind these drugs is compelling. A landmark clinical trial from 2021 published in the New England Journal of Medicine tested once weekly semaglutide at two point four milligrams in adults with overweight or obesity. Participants lost far more weight than those on placebo, achieving the kind of weight loss previously seen only after bariatric surgery. Beyond weight reduction, research from 2023 and 2024 found that semaglutide reduced major cardiovascular events including heart attack and stroke in people with overweight or obesity and existing heart disease, effectively moving the drug out of cosmetic territory and into life saving potential for specific patients.However, the medication comes with significant downsides that listeners should understand. Gastrointestinal side effects are not rare but rather expected. Nausea, vomiting, constipation and diarrhea affect most users, with higher doses associated with increased risks of these symptoms. These side effects represent the number one reason people discontinue the medication. Additionally, once patients stop taking the drug, hunger signals return to normal, metabolism shifts back, and many people regain some or most of the weight they lost. This is why doctors emphasize the importance of long term lifestyle changes alongside medication use.Other public figures have shared their experiences with these drugs. Elon Musk revealed using Wegovy specifically for weight loss and fitness benefits, while Tracy Morgan joked openly about being on Ozempic and losing weight like crazy. Amy Schumer admitted to trying Ozempic but quit because side effects made daily life unbearable. Sharon Osbourne publicly discussed losing too much weight on Ozempic and struggling to regain it. These varied experiences highlight that individual responses to GLP-1 medications differ significantly.The broader cultural moment surrounding Ozempic reflects how normalized GLP-1 culture has become in recent years. Social media has accelerated speculation about whether various celebrities use these drugs, with some attributing every photograph showing weight loss to semaglutide use. This tendency reveals an important problem with how we discuss body changes and medical treatments in the public sphere. Weight fluctuations at any age can result from exercise, hormones, stress, camera angles, health events, fashion and styling choices, none of which require a prescription.Ozempic remains neither a miracle nor a menace but rather a powerful medical tool that can change lives for better or worse depending on how and why it is used. The medication should only be prescribed after proper screening for heart, kidney and endocrine issues. Doctors warn against taking it before major events like weddings or holidays, obtaining it through questionable online pharmacies, or using it purely for cosmetic transformation. These drugs require genuine medical supervision and serious consideration.Thank you for tuning in to this episode. Please come back next week for more in depth coverage of health and wellness topics. Thanks for listening, please subscribe, and remember, this episode was brought to you by Quiet Please podcast networks. For more content like this, please go to Quiet Please dot Ai.Some great Deals https://amzn.to/49SJ3QsFor more check out http://www.quietplease.aiThis content was created in partnership and with the help of Artificial Intelligence AI

A resistência bacteriana não é exclusividade dos Gram-negativos. Entre Staphylococcus, Streptococcus e Enterococcus, há um universo de mecanismos e desafios terapêuticos que continuam moldando a prática clínica.Neste episódio, o infectologista Carlos Kiffer e William Dunke revisitam os principais agentes Gram-positivos de relevância clínica, explorando o que mudou, o que preocupa e como a resistência segue evoluindo nos hospitais e na comunidade.Do alerta de Alexander Fleming, em 1945, aos cenários atuais de MRSA, pneumococos com sensibilidade reduzida e VRE, o episódio mostra como cada decisão terapêutica é parte da história — ainda em escrita — da resistência bacteriana.▶️ Assista e fortaleça seu raciocínio clínico frente às infecções por Gram-positivos.FLEMING, A. Penicillin Nobel Lecture, 1945. NobelPrize.org, 1945. Disponível em: https://www.nobelprize.org/prizes/medicine/1945/fleming/lecture/.LOWY, F. D. Staphylococcus aureus infections. New England Journal of Medicine, v. 339, n. 8, p. 520–532, 1998. doi:10.1056/NEJM199808203390806.WEINSTEIN, R. A.; HUSKINS, W. C. The changing epidemiology of Staphylococcus aureus. Clinical Infectious Diseases, v. 42, supl. 1, p. S40–S44, 2006. doi:10.1086/491709.BRASIL. MINISTÉRIO DA SAÚDE. Boletim Epidemiológico – Resistência Antimicrobiana em Staphylococcus, Streptococcus e Enterococcus. Brasília: MS, 2024. Disponível em: https://www.gov.br/saude/.LASSEN/INSTITUTO ADOLFO LUTZ. Monitoramento de resistência em pneumococos invasivos: Relatório SERAE 2024. São Paulo: Instituto Adolfo Lutz, 2024.ARAUJO, M. R.; RIBEIRO, V. B.; GALES, A. C. Vancomycin-resistant Enterococci in Brazil: epidemiology, clinical impact and control strategies. Brazilian Journal of Infectious Diseases, v. 27, n. 2, p. 91–102, 2023. doi:10.1016/j.bjid.2023.02.004.

Dr. Carlos Chaccour, physician scientist at the University of Navarra, noticed something fishy about a letter to the editor the New England Journal of Medicine received shortly after it published a paper of his on malaria treatment in July.The letter was riddled with strange errors such as critiques supposedly based on other research Chaccour himself had written. So he and his co-author Matthew Rudd decided to dig deeper.They analyzed patterns of letters to the editor over the last decade and found a remarkable increase in what they call "prolific debutantes" — new authors who suddenly had dozens, even hundreds of letters published, starting right around the time OpenAI's ChatGPT came out.Why would academics want to do this? Marketplace's Meghan McCarty Carino spoke with Chaccour to find out.

Dr. Carlos Chaccour, physician scientist at the University of Navarra, noticed something fishy about a letter to the editor the New England Journal of Medicine received shortly after it published a paper of his on malaria treatment in July.The letter was riddled with strange errors such as critiques supposedly based on other research Chaccour himself had written. So he and his co-author Matthew Rudd decided to dig deeper.They analyzed patterns of letters to the editor over the last decade and found a remarkable increase in what they call "prolific debutantes" — new authors who suddenly had dozens, even hundreds of letters published, starting right around the time OpenAI's ChatGPT came out.Why would academics want to do this? Marketplace's Meghan McCarty Carino spoke with Chaccour to find out.

Send us a message with this link, we would love to hear from you. Standard message rates may apply.Clear guidance on benefits, risks, and how the FDA's label changes shift conversations in the exam room about HRTNikki's Corner• Philly's first Michelin stars and what the tiers mean• Flying taxis in Dubai • A cold case solved by college criminology studentsLearning • What HRT is, routes of therapy, and who benefits• Reframing WHI-era fears with age and timing data• FDA label changes and clinical implications• Contraindications and safer use considerations• Women's health bias and the cost of not listening• Practical steps for shared decisions with cliniciansReferencesThe 2022 Hormone Therapy Position Statement of the North American Menopause Society. Menopause (New York, N.Y.). 2022;29(7):767-794. doi:10.1097/GME.0000000000002028.Management of Menopausal Symptoms: A Review. Crandall CJ, Mehta JM, Manson JE. JAMA. 2023;329(5):405-420. doi:10.1001/jama.2022.24140.Hormone Therapy for Postmenopausal Women. Pinkerton JV. The New England Journal of Medicine. 2020;382(5):446-455. doi:10.1056/NEJMcp1714787.Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women: US Preventive Services Task Force Recommendation Statement. Grossman DC, Curry SJ, Owens DK, et al. JAMA. 2017;318(22):2224-2233. doi:10.1001/jama.2017.18261.Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Persons: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. Gartlehner G, Patel SV, Reddy S, et al. JAMA. 2022;328(17):1747-1765. doi:10.1001/jama.2022.18324.Hormone Therapy in the Postmenopausal Years: Considering Benefits and Risks in Clinical Practice. Genazzani AR, Monteleone P, Giannini A, Simoncini T. Human Reproduction Update. 2021;27(6):1115-1150. doi:10.1093/humupd/dmab026.Hormone Therapy in Menopause: Concepts, Controversies, and Approach to Treatment. Flores VA, Pal L, Manson JE. Endocrine Reviews. 2021;42(6):720-752. doi:10.1210/endrev/bnab011.The Women's Health Initiative Randomized Trials and Clinical Practice: A Review. Manson JE, Crandall CJ, Rossouw JE, et al. JAMA. 2024;331(20):1748-1760. doi:10.1001/jama.2024.6542.Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Persons: US Preventive Services Task Force Recommendation Statement. Mangione CM, Barry MJ, NicSupport the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski

Today, Dr. Monica Gray, Dr. Pradip Kamat, and Rahul Damania discuss a critical case involving a 10-year-old boy who developed post-intubation desaturation. Using the DOPE mnemonic (Displacement, Obstruction, Pneumothorax, Equipment failure), they systematically troubleshoot the emergency, highlighting the importance of teamwork, capnography, and manual ventilation. The team emphasizes structured approaches, simulation training, and essential bedside tools to ensure rapid, effective management of acute deterioration in intubated children, turning a life-threatening crisis into a controlled, solvable situation.Show Highlights:Clinical case discussion of a ten-year-old boy with post-intubation desaturation in the pediatric ICUUse of the "DOPE" mnemonic (Displacement, Obstruction, Pneumothorax, Equipment failure) for troubleshootingSystematic approaches in emergency situations in pediatric critical careAssessment and management of sudden desaturation in intubated patientsEvaluation of potential causes of desaturation, including tube displacement and obstructionRole of equipment failure in acute deterioration and strategies to address itSignificance of continuous capnography and manual ventilation techniquesPrevention strategies for unplanned extubation in pediatric ICU settingsEmphasis on teamwork, communication, and simulation training in crisis managementReview of literature insights related to hypoxemia and equipment issues in pediatric intubationReferences:Topjian AA, et al. Part 4: Pediatric Basic and Advanced Life Support—2020 AHA PALS Guidelines. Circulation. 2020.Foundational pediatric resuscitation guidance endorsing early switch to manual ventilation and structured troubleshooting for the deteriorating intubated child.Cook TM, et al. Major complications of airway management in the UK: NAP4. British Journal of Anaesthesia. 2011.Seminal audit highlighting ICU/ED airway failures and the critical role of waveform capnography in preventing unrecognized esophageal intubation.Volpicelli G, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Medicine. 2012. High-impact consensus placing lung ultrasound at the bedside to rapidly diagnose pneumothorax during post-intubation deterioration.Prekker ME, et al. Video vs direct laryngoscopy for ED intubation—randomized trial. New England Journal of Medicine. 2023.NEJM RCT showing higher first-pass success with video laryngoscopy—relevant to preventing displacement/misplacement drivers of desaturation.Chrimes N, et al. Preventing unrecognised oesophageal intubation: consensus guideline. Anaesthesia. 2022.Modern, practice-changing guidance: sustained waveform capnography is the mainstay to exclude esophageal placement and avert catastrophic hypoxemia.

Escuchamos en redes sociales que suplementar omegas sería lo ideal para todos, vamos al a farmacia y encontramos una gran variedad que nos complica la decisión de cuál comprar. En este episodio te explico qué es este tipo de grasa, qué hace por tu salud y qué deberías revisar en la etiqueta a la hora de elegir. Suscríbete para más episodios donde traducimos la nutrición científica a tu vida real. Déjame en comentarios tus dudas o experiencias con el inositol. ¡Escríbenos! L.N Carla Paola AM ⚕ Envíame un WhatsApp 55 6325 6115. Búscame en Facebook, X e Instagram como @Nut.CarlaPaola #NutrieatContigo --------- Referencias: Bhatt, D. L., Steg, G. P., Miller, M., Brinton, E. A., Jacobson, T. A., Ketchum, S. B., … & Clearfield, M. (2019). Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. The New England Journal of Medicine, 380(17), 1678-1695. Ovid+1 Coelho, J. C., Pontes, F. R., Mila, A. L. A., & Machado, S. (2022). Efficacy of the omega-3 fatty acids supplementation on inflammatory biomarkers: An umbrella meta-analysis. [Journal name], [volume], [pages]. PubMed Hu, Y., You, Z., & Zhu, X. (2021). Effect of long-term marine ω-3 fatty acids supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes: A systematic review and meta-analysis. [Journal name], [volume], [pages]. PubMed Kou, S., & Hasan, A. (2021). Association between omega-3 fatty acid treatment and atrial fibrillation in cardiovascular outcome trials: A systematic review and meta-analysis. [Journal name], [volume], [pages].

When David Fajgenbaum nearly died of Castleman disease for the fifth time, he decided to take fate into his own hands. Using his medical training, he searched for an existing drug that might save his life—and found one. Now his organization, Every Cure, is scaling the same approach to uncover hidden treatments for other diseases with no known cure. David and Claudia discussed: How Every Cure is using AI to test 75 million possible disease-drug combinations The perverse incentives that keep generic drug repurposing in the shadowsWhy the hardest part of innovation isn't discovery, it's getting proven treatments into clinical practiceRepurposing existing drugs makes so much sense. But as David points out, there's no market for it:“Once a drug is generic.. the price is going to plummet… And even if you were to double the sales of your drug because you found a new disease area, now you've gone from 1% to 2% of what you got before… So there's no incentive whatsoever for our system to find a new use for a generic drug. Zero incentive.”Relevant LinksLearn more about Every CureRead David's book Chasing My Cure: A Doctor's Race to Turn Hope Into ActionWatch David's TEDTalk Listen to David's Podcast interview with Adam GrantGet info on the Dada2 FoundationWatch a video on Matt Might's story About Our GuestDavid Fajgenbaum, MD, MBA, MSc, is co-Founder & President of Every Cure and a physician-scientist at the University of Pennsylvania, where he is one of the youngest faculty members ever to receive tenure at Penn Medicine. He is also the national bestselling author of Chasing My Cure: A Doctor's Race to Turn Hope Into Action, which is being adapted into a film by Forrest Gump producer Wendy Finerman. During medical school, Fajgenbaum discovered a treatment that saved his own life and founded the Castleman Disease Collaborative Network. He has advanced 13 more repurposed treatments for cancers and rare diseases and co-founded Every Cure to unlock more hidden cures from existing medicines which has received over $100M from ARPA-H and TED's Audacious Project. He also serves on the Board of Directors for the Reagan-Udall Foundation for the FDA. One of the youngest recipients of multiple top NIH and FDA grants, Fajgenbaum has authored over 100 scientific papers in leading journals, including The New England Journal of...

Listen up - because your healthcare costs are about to increase! ACA tax credits are set to expire by the end of 2025, and millions are at risk of becoming uninsured. Learn about how our system leaves so many behind on how we got here, from Dr. Ricardo Nuila, author of “The People's Hospital: Hope and Peril in American Medicine.” He shared with the PT team about the Texas healthcare system, Medicaid, and more on living in the state with the highest uninsured rate in the country. Dr. Nuila works as an internal medicine doctor and hospitalist in his hometown of Houston, is an associate professor of medicine at Baylor College of Medicine, and has written for Texas Monthly, VQR, The New York Times Sunday Review, The Atlantic.com, and The New England Journal of Medicine. Learn more about Dr. Ricardo Nuila at https://www.ricardonuila.com.Thanks for listening! Learn more about Progress Texas and how you can support our ongoing work at https://progresstexas.org/.

Authors Drs. Jessica Ross and Alissa Cooper share insights into their JCO PO article, "Clinical and Pathologic Landscapes of Delta-Like Ligand 3 and Seizure-Related Homolog Protein 6 Expression in Neuroendocrine Carcinomas"  Host Dr. Rafeh Naqash and Drs. Ross and Cooper discuss the landscape of Delta-like ligand 3 (DLL3) and seizure-related homolog protein 6 (SEZ6) across NECs from eight different primary sites. TRANSCRIPT Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, podcast editor for JCO PO and an Associate Professor at the OU Health Stephenson Cancer Center. Today, I'm excited to be joined by Dr. Jessica Ross, third-year medical oncology fellow at the Memorial Sloan Kettering Cancer Center, as well as Dr. Alissa Cooper, thoracic medical oncologist at the Dana-Farber Cancer Institute and instructor in medicine at Harvard Medical School. Both are first and last authors of the JCO Precision Oncology article entitled "Clinical and Pathologic Landscapes of Delta-like Ligand 3 and Seizure-Related Homolog Protein 6 or SEZ6 Protein Expression in Neuroendocrine Carcinomas." At the time of this recording, our guest disclosures will be linked in the transcript. Jessica and Alissa, welcome to our podcast, and thank you for joining us today. Dr. Jessica Ross: Thanks very much for having us. Dr. Alissa Cooper: Thank you. Excited to be here. Dr. Rafeh Naqash: It's interesting, a couple of days before I decided to choose this article, one of my GI oncology colleagues actually asked me two questions. He said, "Rafeh, do you know how you define DLL3 positivity? And what is the status of DLL3 positivity in GI cancers, GI neuroendocrine carcinomas?" The first thing I looked up was this JCO article from Martin Wermke. You might have seen it as well, on obrixtamig, a phase 1 study, a DLL3 bi-specific T-cell engager. And they had some definitions there, and then this article came along, and I was really excited that it kind of fell right in place of trying to understand the IHC landscape of two very interesting targets. Since we have a very broad and diverse audience, especially community oncologists, trainees, and of course academic clinicians and some people who are very interested in genomics, we'll try to make things easy to understand. So my first question for you, Jessica, is: what is DLL3 and SEZ6 and why are they important in neuroendocrine carcinomas? Dr. Jessica Ross: Yeah, good question. So, DLL3, or delta-like ligand 3, is a protein that is expressed preferentially on the tumor cell surface of neuroendocrine carcinomas as opposed to normal tissue. It is a downstream target of ASCL1, and it's involved in neuroendocrine differentiation, and it's an appealing drug target because it is preferentially expressed on tumor cell surfaces. And so, it's a protein, and there are several drugs in development targeting this protein, and then Tarlatamab is an approved bi-specific T-cell engager for the treatment of extensive-stage small cell lung cancer in the second line. SEZ6, or seizure-like homolog protein 6, is a protein also expressed on neuroendocrine carcinoma cell surface. Interestingly, so it's expressed on neuronal cells, but its exact role in neuroendocrine carcinomas and oncogenesis is actually pretty poorly understood, but it was identified as an appealing drug target because, similarly to DLL3, it's preferentially expressed on the tumor cell surface. And so this has also emerged as an appealing drug target, and there are drugs in development, including antibody-drug conjugates, targeting this protein for that reason. Dr. Alissa Cooper: Over the last 10 to 15 years or so, there's been an increasing focus on precision oncology, finding specific targets that actually drive the cancer to grow, not just within lung cancer but in multiple other primary cancers. But specifically, at least speaking from a thoracic oncology perspective, the field of non-small cell lung cancer has completely exploded over the past 15 years with the discovery of driver oncogenes and then matched targeted therapies. Within the field of neuroendocrine carcinomas, including small cell lung cancer but also other high-grade neuroendocrine carcinomas, there has not been the same sort of progress in terms of identifying targets with matched therapies. And up until recently, we've sort of been treating these neuroendocrine malignancies kind of as a monolithic disease process. And so recently, there's been sort of an explosion of research across the country and multiple laboratories, multiple people converging on the same open questions about why might patients with specific tumor biologies have different kind of responses to different therapies. And so first this came from, you know, why some patients might have a good response to chemo and immunotherapy, which is the first-line approved therapy for small cell lung cancer, and we also sort of extrapolate that to other high-grade neuroendocrine carcinomas. What's the characteristic of that tumor biology? And at the same time, what are other targets that might be identifiable? Just as Jesse was saying, they're expressed on the cell surface, they're not necessarily expressed in normal tissue. Might this be a strategy to sort of move forward and create smarter therapies for our patients and therefore move really into a personalized era for treatment for each patient? And that's really driving, I think, a lot of the synthesis of this work of not only the development of multiple new therapies, but really understanding which tumor might be the best fit for which therapy. Dr. Rafeh Naqash: Thank you for that explanation, Alissa. And as you mentioned, these are emerging targets, some more further along in the process with approved drugs, especially Tarlatamab. And obviously, DLL3 was something identified several years back, but drug development does take time, and readout for clinical trials takes time. Could you, for the sake of our audience, try to talk briefly about the excitement around Tarlatamab in small cell lung cancer, especially data that has led to the FDA approval in the last year, year and a half? Dr. Alissa Cooper: Sure. Yeah, it's really been an explosion of excitement over, as you're saying, the last couple of years, and work really led by our mentor, Charlie Rudin, had identified DLL3 as an exciting target for small cell lung cancer specifically but also potentially other high-grade neuroendocrine malignancies. Tarlatamab is a DLL3-targeting bi-specific T-cell engager, which targets DLL3 on the small cell lung cancer cells as well as CD3 on T cells. And the idea is to sort of introduce the cancer to the immune system, circumventing the need for MHC class antigen presentation, which that machinery is typically not functional in small cell lung cancer, and so really allowing for an immunomodulatory response, which had not really been possible for most patients with small cell lung cancer prior to this. Tarlatamab was tested in a phase 2 registrational trial of about 100 patients and demonstrated a response rate of 40%, which was very exciting, especially compared with other standard therapies which were available for small cell lung cancer, which are typically cytotoxic therapies. But most excitingly, more than even the response rate, I think, in our minds was the durability of response. So patients whose disease did have a response to Tarlatamab could potentially have a durable response lasting a number of months or even over a year, which had previously not ever been seen in this in the relapsed/refractory setting for these patients. I think the challenge with small cell lung cancer and other high-grade neuroendocrine malignancies is that a response to therapy might be a bit easier to achieve, but it's that durability. The patient's tumors really come roaring back quite aggressively pretty quickly. And so this was sort of the most exciting prospect is that durability of response, that long potential overall survival tail of the curve really being lifted up. And then most recently at ASCO this year, Dr. Rudin presented the phase 3 randomized controlled trial which compared Tarlatamab to physician's choice of chemotherapy in a global study. And the choice of chemotherapy did vary depending on the part of the world that the patients were enrolled in, but in general, it was a really markedly positive study for response rate, for progression-free survival, and for overall survival. Really exciting results which really cemented Tarlatamab's place as the standard second-line therapy for patients with small cell lung cancer whose disease has progressed on first-line chemo-immunotherapy. So that has been very exciting. This drug was FDA approved in May of 2024, and so has been used extensively since then. I think the adoption has been pretty widespread, at least in the US, but now in this global trial that was just presented, and there was a corresponding New England Journal paper, I think really confirms that this is something we really hopefully can offer to most of our patients. And I think, as we all know, that this therapy or other therapies like it are also being tested potentially in the first-line setting. So there was data presented with Tarlatamab incorporated into the maintenance setting, which also showed exciting results, albeit in a phase 1 trial, but longer overall survival than we're used to seeing in this patient population. And we await results of the study that is incorporating Tarlatamab into the induction phase with chemotherapy as well. So all of this is extraordinarily exciting for our patients to sort of move the needle of how many patients we can keep alive, feeling functional, feeling well, for as long as possible. Dr. Rafeh Naqash: Very exciting session at ASCO. I was luckily one of the co-chairs for the session that Dr. Rudin presented it, and I remember somebody mentioning there was more progress seen in that session for small cell lung cancer than the last 30, 35 years for small cell, very exciting space and time to be in as far as small cell lung cancer. Now going to this project, Jessica, since you're the first author and Alissa's the last, I'm assuming there was a background conversation that you had with Alissa before you embarked on this project as an idea. So could you, again, for other trainees who are interested in doing research, and it's never easy to do research as a resident and a fellow when you have certain added responsibilities. Could you give us a little bit of a background on how this started and why you wanted to look at this question? Dr. Jessica Ross: Yeah, sure. So, as with many exciting research concepts, I think a lot of them are derived from the clinic. And so I think Alissa and I both see a good number of patients with small cell, large cell lung cancer, and then high-grade neuroendocrine carcinomas. And so I think this was really born out of a basic conversation of we have these drugs in development targeting these two proteins, DLL3 and SEZ6, but really what is the landscape of cancers that express these proteins and who are the patients that really might benefit from these exciting new therapies. And of course, there was some data out there, but sort of less than one would imagine in terms of, you know, neuroendocrine carcinomas can really come from anywhere in the body. And so when you're seeing a patient with small cell of the cervix, for example, like what are the chances that their cancer expresses DLL3 or expresses SEZ6? So it was really derived from this pragmatic, clinically oriented question that we had both found ourselves thinking about, and we were lucky enough at MSK, we had started systematically staining patients' tumors for DLL3, tumors that are high-grade neuroendocrine carcinomas, and then we had also more recently started staining for SEZ6 as well. And so we had this nice prospectively collected dataset with which to answer this question. Dr. Rafeh Naqash: Excellent. And Alissa, could you try to go into some of the details around which patients you chose, how many patients, what was the approach that you selected to collect the data for this project? Dr. Alissa Cooper: This is perhaps a strength but also maybe a limitation of this dataset is, as Jesse alluded to, our pathology colleagues are really the stars of this paper here because we were lucky enough at MSK that they were really forethinking. They are absolute experts in the field and really forward-thinking people in terms of what information might be needed in the future to drive treatment decision-making. And so, as Jesse had said, small cell lung cancer tumor samples reflexively are stained for DLL3 and SEZ6 at MSK if there's enough tumor tissue. The other high-grade neuroendocrine carcinomas, those stains are performed upon physician request. And so that is a bit of a mixed bag in terms of the tumor samples we were able to include in this dataset because, you know, upon physician request depends on a number of factors, but actually at MSK, a number of physicians were requesting these stains to be done on their patients with high-grade neuroendocrine cancers of of other histologies. So we looked at all tumor samples with a diagnosis of high-grade neuroendocrine carcinoma of any histology that were stained for these two stains of interest. You know, I can let Jesse talk a bit more about the methodology. She was really the driver of this project. Dr. Jessica Ross: Yeah, sure. So we had 124 tumor samples total. All of those were stained for DLL3, and then a little less than half, 53, were stained for SEZ6. As Alissa said, they were from any primary site. So about half of them were of lung origin, that was the most common primary site, but we included GI tract, head and neck, GU, GYN, even a few tumors of unknown origin. And again, that's because I think a lot of these trials are basket trials that are including different high-grade neuroendocrine carcinomas no matter the primary site. And so we really felt like it was important to be more comprehensive and inclusive in this study. And then, methodologically, we also defined positivity in terms of staining of these two proteins as anything greater than or equal to 1% staining. There's really not a defined consensus of positivity when it comes to these two novel targets and staining for these two proteins. But in the Tarlatamab trials, for some of the correlative work that's been done, they use that 1% cutoff, and we just felt like being consistent with that and also using a sort of more pragmatic yes/no cutoff would be more helpful for this analysis. Dr. Alissa Cooper: And that was a point of discussion, actually. We had contemplated multiple different schemas, actually, for how to define thresholds of positivity. And I know you brought up that question before, what does it mean to be DLL3 positive or DLL3 high? I think you were alluding to prior that there was a presentation of obrixtamig looking at extra-pulmonary neuroendocrine carcinomas, and they actually divvied up the results between DLL3 50% or greater versus DLL3 low under 50%. And they actually did demonstrate differential efficacy certainly, but also some differential safety as well, which is very provocative and that kind of analysis has not been presented for other novel therapies as far as I'm aware. I could be wrong, but as far as I'm aware, that was sort of the first time that we saw a systematic presentation of considering patients to be, quote unquote, "high" or "low" in these sort of novel targets. I think it is important because the label for Tarlatamab does not require any DLL3 expression at all, actually. So it's not hinging upon DLL3 expression. They depend on the fact that the vast majority of small cell lung cancer tumors do express DLL3, 85% to 90% is what's been demonstrated in a few studies. And so, there's not prerequisite testing needed in that regard, but maybe for these extra-pulmonary, other histology neuroendocrine carcinomas, maybe it does matter to some degree. Dr. Rafeh Naqash: Definitely agree that this evolving landscape of trying to understand whether an expression for something actually really does correlate with, whether it's an immune cell engager or an antibody-drug conjugate is a very evolving and dynamically moving space. And one of the questions that I was discussing with one of my friends was whether IHC positivity and the level of IHC positivity, as you've shown in one of those plots where you have double positive here on the right upper corner, you have the double negative towards the left lower, whether that somehow determines mRNA expression for DLL3. Obviously, that was not the question here that you were looking at, but it does kind of bring into question certain other aspects of correlations, expression versus IHC. Now going to the figures in this manuscript, very nicely done figures, very easy to understand because I've done the podcast for quite a bit now, and usually what I try to do first is go through the figures before I read the text, and and a lot of times it's hard to understand the figures without reading the text, but in your case, specifically the figures were very, very well done. Could you give us an overview, a quick overview of some of the important results, Jessica, as far as what you've highlighted in the manuscript? Dr. Jessica Ross: Sure. So I think the key takeaway is that, of the tumors in our cohort, the majority were positive for DLL3 and positive for SEZ6. So about 80% of them were positive for DLL3 and 80% were positive for SEZ6. About half of the tumors were stained for both proteins, and about 65% of those were positive as well. So I think if there's sort of one major takeaway, it's that when you're seeing a patient with a high-grade neuroendocrine carcinoma, the odds are that their tumor will express both of these proteins. And so that can sort of get your head thinking about what therapies they might be eligible for. And then we also did an analysis of some populations of interest. So for example, we know that non-neuroendocrine pathologies can transform into neuroendocrine tumors. And so we specifically looked at that subset of patients with transformed tumors, and those were also- the majority of them were positive, about three-quarters of them were positive for both of these two proteins. We looked at patients with brain met samples, again, about 70% were positive. And then I'd say the last sort of population of interest was we had a subset of 10 patients who had serial biopsies stained for either DLL3 or SEZ6 or both. In between the two samples, these patients were treated with chemotherapy. They were not treated with targeted therapy, but interestingly, in the majority of cases, the testing results were concordant, meaning if it was DLL3 positive to begin with, it tended to remain DLL3 positive after treatment. And so I think that's important as well as we think about, you know, a patient who maybe had DLL3 testing done before they received their induction chemo-IO, we can somewhat confidently say that they're probably still DLL3 positive after that treatment. And then finally, we did do a survival analysis among specifically the patients with lung neuroendocrine carcinomas. We looked at whether DLL3 expression affected progression-free survival on first-line platinum-etoposide, and then we looked at did it affect overall survival. And we found that it did not have an impact or the median progression-free survival was similar whether you were DLL3 positive or negative. But interestingly, with overall survival, we found that DLL3 positivity actually correlated with slightly improved overall survival. These were small numbers, and so, you know, I think we have to interpret this with caution, for sure, but it is interesting. I think there may be something to the fact that five of the patients who were DLL3 positive were treated with DLL3-targeting treatments. And so this made me think of, like in the breast cancer world, for example, if you have a patient with HER2-positive disease, it initially portended worse prognosis, more aggressive disease biology, but on the other hand, it opens the door for targeted treatments that actually now, at least with HER2-positive breast cancer, are associated with improved outcomes. And so I think that's one finding of interest as well. Dr. Rafeh Naqash: Definitely proof-of-concept findings here that you guys have in the manuscript. Alissa, if I may ask you, what is the next important step for a project like this in your mind? Dr. Alissa Cooper: Jesse has highlighted a couple of key findings that we hope to move forward with future investigative studies, not necessarily in a real-world setting, but maybe even in clinical trial settings or in collaboration with sponsors. Are these biomarkers predictive? Are they prognostic? You know, those are still- we have some nascent data, data has been brewing, but I think that we we still don't have the answers to those open questions, which I think are critically important for determining not only clinical treatment decision-making, but also our ability to understand sequencing of therapies, prioritization of therapies. I think a prospective, forward-looking project, piggybacking on that paired biopsy, you know, we had a very small subset of patients with paired biopsies, but a larger subset or cohort looking at paired biopsies where we can see is there evolution of these IHC expression, even mRNA expression, as you're saying, is there differential there? Are there selection pressures to targeted therapies? Is there upregulation or downregulation of targets in response not just to chemotherapy, but for example, for other sort of ADCs or bi-specific T-cell engagers? I think those are going to be critically important future studies which are going to be a bit challenging to do, but really important to figure out this key clinical question of sequencing, which we're all contemplating in our clinics day in and day out. If you have a patient, and these patients often can be sick quite quickly, they might have one shot of what's the next treatment that you're going to pick. We can't guarantee that every patient is going to get to see every therapy. How can you help to sort of answer the question of like what should you offer? So I think that's the key question sort of underlying any future work is how predictive or prognostic are these biomarkers? What translational or correlative studies can we do on the tissue to understand clinical treatment decision-making? I think those are the key things that will unfold in the next couple of years. Dr. Rafeh Naqash: The last question for you, Alissa, that I have is, you are fairly early in your career, and you've accomplished quite a lot. One of the most important things that comes out from this manuscript is your mentorship for somebody who is a fellow and who led this project. For other junior investigators, early-career investigators, how did you do this? How did you manage to do this, and how did you mentor Jessica on this project with some of the lessons that you learned along the way, the good and other things that would perhaps help other listeners as they try to mentor residents, trainees, which is one of the important things of what we do in our daily routine? Dr. Alissa Cooper: I appreciate you calling me accomplished. Um, I'm not sure how true that is, but I appreciate that. I didn't have to do a whole lot with this project because Jesse is an extraordinarily smart, driven, talented fellow who came up with a lot of the clinical questions and a lot of the research questions as well. And so this project was definitely a collaborative project on both of our ends. But I think what was helpful from both of our perspectives is from my perspective, I could kind of see that this was a gap in the literature that really, I think, from my work leading clinical trials and from treating patients with these kinds of cancers that I really hoped to answer. And so when I came to Jessica with this idea as sort of a project to complete, she was very eager to take it and run with it and also make it her own. You know, in terms of early mentorship, I have to admit this was the first project that I mentored, so it was a great learning experience for me as well because as an early-career clinician and researcher, you're used to having someone else looking over your shoulder to tell you, "Yes, this is a good journal target, here's what we can anticipate reviewers are going to say, here are other key collaborators we should include." Those kind of things about a project that don't always occur to you as you're sort of first starting out. And so all of that experience for me to be identifying those more upper-level management sort of questions was a really good learning experience for me. And of course, I was fantastically lucky to have a partner in Jesse, who is just a rising star. Dr. Jessica Ross: Thank you. Dr. Rafeh Naqash: Well, excellent. It sounds like the first of many other mentorship opportunities to come for you, Alissa. And Jessica, congratulations on your next step of joining and being faculty, hopefully, where you're training. Thank you again, both of you. This was very insightful. I definitely learned a lot after I reviewed the manuscript and read the manuscript. Hopefully, our listeners will feel the same. Perhaps we'll have more of your work being published in JCO PO subsequently. Dr. Alissa Cooper: Hope so. Thank you very much for the opportunity to chat today. Dr. Jessica Ross: Yes, thank you. This was great. Dr. Rafeh Naqash: Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so as you never miss an episode. You can find all ASCO shows at asco.org/podcasts. 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. Disclosures: Dr. Alissa Jamie Cooper Honoraria Company: MJH Life Scienes, Ideology Health, Intellisphere LLC, MedStar Health, Physician's Education Resource, LLC,  Gilead Sciences, Regeneron, Daiichi Sankyo/Astra Zeneca, Novartis,  Research Funding: Merck, Roche, Monte Rosa Therapeutics, Abbvie, Amgen, Daiichi Sankyo/Astra Zeneca Travel, Accommodations, Expenses: Gilead Sciences

This episode is for you if you're a parent, teacher, or health professional concerned about teens struggling with anxiety, acne, allergies, sleep issues, focus problems, or chronic inflammation.In 2005, the New England Journal of Medicine made a shocking prediction: our children might have shorter lifespans than us. Fast forward to 2025—nearly 1 in 2 kids now has a chronic condition. But it's not too late to change course.In today's powerful episode, we're joined by teen siblings Abdullah, Zain, Emaad, and Qasim Ansari — hosts of The Holistic Kids' Show and co-authors of the NEW book “The Teen Health Revolution” — who share their personal journey to eating healthier and turning the tide on chronic conditions, mental health, and lifestyle struggles in teens.What You'll Learn:✅Why ultra-processed foods are making kids sick (and how to break free)✅How real, colorful foods support the body, brain, skin, and mood✅Why changing teen eating habits takes time — and patienceThe harmful side effects of social media on teen well-being✅The role of nature, mindfulness, and gratitude in mental health✅How habit stacking makes healthy routines stickBuy The Book – The Teen Health Revolution:AMAZONBARNES AND NOBLEConnect with The Teen Health Revolution:https://www.instagram.com/holistickidsshow/https://www.youtube.com/@HolisticMomMDhttps://www.tiktok.com/tag/theholistickidsshowtheteenhealthrevolution.comYou May Also Like:Child Health at Risk: The Role of Ultra-Processed Food Shop Functional Moms Supplement Store, 25 PERCENT OFF top quality brands:https://us.fullscript.com/welcome/functional-momsThank you for listening, please FOLLOW the show on Apple Podcasts and Spotify. SUBSCRIBE to your YouTube channel:https://www.youtube.com/@functionalmomspodcast/#TeenHealth #ProcessedFood #MentalHealth #SkinHealth #HealthyHabits #AnxietyHelp #ParentingTips #HolisticHealth #KidsNutrition #MindBodySoul #ChronicIllness #GenZWellness #HealthyTeens #RealFoodRevolution

Welcome to Ozempic Weightloss Unlocked. Today, we are diving into the latest news and updates on Ozempic, a drug reshaping how we think about weight loss, health, and lifestyle.In the past year, millions of people have turned to Ozempic, part of a group of medications called GLP-1 receptor agonists. Originally created to manage blood sugar for people with type 2 diabetes, Ozempic's appetite-suppressing effects have made it a sought-after tool for weight management. According to the Pennington Biomedical Research Center, these medications were developed from a compound first found in the saliva of the Gila monster lizard. It is amazing to think that a hormone from a desert reptile is now changing lives in clinics around the world.One of the most important updates is accessibility. The White House recently announced a deal with drug makers Eli Lilly and Novo Nordisk to cut prices for Ozempic and related drugs. The average monthly cost, once more than one thousand dollars, could now be as low as fifty to three hundred fifty dollars a month, depending on your insurance. Kim Fisher of the UC Davis Innovation Institute for Food and Health says around one in eight adults in the United States—about forty-one million people—have already used GLP-1 drugs. Lower prices open the door for many more people to take advantage of these treatments.For listeners looking for alternatives to injections, there is more good news. Novo Nordisk recently released results from a study on an oral pill version of Ozempic's sister drug, Wegovy. The New England Journal of Medicine reports that this once-daily pill resulted in an average weight loss of sixteen point six percent—almost identical to the weekly injection. While the pill is not yet approved by the Food and Drug Administration, it may become a game-changer for those seeking a needle-free option. Novo Nordisk says they hope to set a new benchmark for oral weight loss medications pending approval.If you are wondering whether these drugs only affect the scale, the answer is no. According to research from UC Davis and the University of California San Diego, GLP-1 drugs not only promote weight loss, but may also offer broader health benefits. Some of the latest studies show that these medications can lower cardiovascular risk, benefit blood pressure, and even reduce the risk of major events like heart attacks and stroke.Researchers at UC San Diego found that GLP-1 use among people with colon cancer was tied to much lower death rates—fifteen point five percent for those on the drugs, versus thirty-seven point one percent for those who were not. While the exact reasons are still being studied, experts believe these medications reduce inflammation, improve insulin sensitivity, and might even directly inhibit the growth of cancer cells.The way GLP-1 drugs work is by mimicking a natural hormone produced in your gut after eating. They help your body feel full longer, lower blood sugar, and curb cravings—especially for sweets and fatty foods. Patients often report that the constant mental chatter about food is quieter, making it easier to stick to healthy habits.With all the benefits, it is important to mention common side effects. Many users experience nausea, vomiting, or diarrhea, particularly when starting or increasing doses. Doctors recommend pairing treatment with a nutrient-dense diet, regular exercise, and enough protein to help preserve muscle mass.Experts are also discussing the need for ongoing research into the long-term effects and best practices for managing side effects. As these drugs become more widely used, scientists are working to make sure weight loss translates into lasting improvements for health and well-being.That is all for today's episode of Ozempic Weightloss Unlocked. Thank you for tuning in. To stay up to date on the next wave of news and breakthroughs, remember to subscribe. This has been a quiet please production, for more check out quiet please dot ai. Some great Deals https://amzn.to/49SJ3QsFor more check out http://www.quietplease.aiThis content was created in partnership and with the help of Artificial Intelligence AI

Send us a message with this link, we would love to hear from you. Standard message rates may apply.We discuss a clear, practical guide to menopause, explaining what it is, why it happens, and how to manage the most common symptoms with everyday steps and evidence-based options. We set up next week's deep dive on hormone therap. • Defining menopause and typical timing• Why estrogen declines and bodywide effects• Common symptoms across sleep, mood, and metabolism• Hot flashes and night sweats frequency and duration• Vaginal and urinary symptoms that mimic UTIs• Bone density loss and changing heart risk• Lifestyle tactics that actually help• When to ask about hormonal and non-hormonal treatments• Teaser for hormone therapy update next weekSend us an email at yourcheckuppod@gmail.comReferences1. Menopause-Biology, Consequences, Supportive Care, and Therapeutic Options. Davis SR, Pinkerton J, Santoro N, Simoncini T. Cell. 2023;186(19):4038-4058. doi:10.1016/j.cell.2023.08.016.2. The Menopause Transition: Signs, Symptoms, and Management Options. Santoro N, Roeca C, Peters BA, Neal-Perry G. The Journal of Clinical Endocrinology and Metabolism. 2021;106(1):1-15. doi:10.1210/clinem/dgaa764.3. Management of Menopausal Symptoms: A Review. Crandall CJ, Mehta JM, Manson JE. JAMA. 2023;329(5):405-420. doi:10.1001/jama.2022.24140.4. Menopause. Davis SR, Lambrinoudaki I, Lumsden M, et al. Nature Reviews. Disease Primers. 2015;1:15004. doi:10.1038/nrdp.2015.4.5. Menopause: Physiology, Definitions, and Symptoms. Gatenby C, Simpson P. Best Practice & Research. Clinical Endocrinology & Metabolism. 2024;38(1):101855. doi:10.1016/j.beem.2023.101855.6. Reproductive Aging in Biological Females: Mechanisms and Immediate Consequences. Muhammad YA. Frontiers in Endocrinology. 2025;16:1658592. doi:10.3389/fendo.2025.1658592.7. Treating Menopause - MHT and Beyond. Davis SR, Baber RJ. Nature Reviews. Endocrinology. 2022;18(8):490-502. doi:10.1038/s41574-022-00685-4.8. Management of Perimenopausal and Menopausal Symptoms. Duralde ER, Sobel TH, Manson JE. BMJ (Clinical Research Ed.). 2023;382:e072612. doi:10.1136/bmj-2022-072612.9. Hormone Therapy for Postmenopausal Women. Pinkerton JV. The New England Journal of Medicine. 2020;382(5):446-455. doi:10.1056/NEJMcp1714787.10. An Empowerment Model for Managing Menopause. Hickey M, LaCroix AZ, Doust J, et al. Lancet (London, England). 2024;403(10430):947-957. doi:10.1016/S0140-6736(23)02799-X.11. Menopause. Carter AE, Merriam S. The Medical Clinics of North America. 2023;107(2):199-212. doi:10.1016/j.mcna.2022.10.003.Support the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski

Broadcast from KSQD, Santa Cruz on 11-13-2025: Dr. Dawn discusses a New England Journal of Medicine study examining radiation exposure from medical imaging in over 4 million children showing increased hematological cancer risk. Head and brain CTs deliver highest bone marrow doses, with under-1-year-olds receiving 20 milligrays compared to background radiation of 1 milligray yearly. The study found 3,000 cancers in 4 million children over roughly 10 years, with relative risk increasing 1.6-fold per CT scan. However, methodological flaws include combining US and Canadian cohorts with different data quality, potential reverse causation where imaging detected pre-existing cancers, and arbitrary 6-month latency assumptions are significant flaws in this study.. Despite small absolute risk increases given low baseline cancer rates, she encourages parents to question necessity of repeat scans and request alternatives like MRI when appropriate. She reports on cutting-edge CRISPR therapy using lipid nanoparticles to deliver molecular scissors targeting the ANGPTL3 gene controlling LDL cholesterol production. Recent setbacks in several other CRISPR trials raise issues for unexplained liver toxicity. Concerns include off-target gene editing effects and partially repaired DNA creating mutated proteins triggering autoimmune reactions. Dr. Dawn emphasizes restricting gene therapy to life-threatening genetic diseases with no alternatives until safety improves. Stanford scientists used AI model Evo trained on 9 trillion gene samples to design 300 new bacteriophages from scratch, with 16 phages successfully killing E. coli bacteria. AI tools now predict protein structures, design custom drugs, create antivenoms, invent antibiotics, and break down PFAS forever chemicals. The research represents evolution through computation and requires guardrails on AI's ability to manipulate biological structures. An emailer shares the Rosencare model where hotel chain owner Harris Rosen created self-insured health coverage featuring direct provider contracting, imaging facilities charging one-third to one-half traditional costs, transparent pharmacy benefit management, and zero or $5 primary care copays. Employees receive proactive screening for colonoscopies, mammograms, cholesterol, diabetes, and hypertension during clinic visits. Ninety percent of medicines including insulin cost nothing, with remaining drugs $0-25, and hospital admissions cost flat $750. The model saved $600 million while providing superior preventive care by eliminating insurance middlemen and focusing on early chronic disease detection when 75-85% of costs originate. Dr. Dawn explains abdominophrenic dyssynergia causing bloating unrelated to gas or food. The diaphragm descends and abdominal wall muscles relax, pushing organs forward after meals. CT scans showed lettuce-related bloating involved no intestinal gas changes but demonstrated this abnormal muscle reflex. Randomized trials showed biofeedback training with chest-lifting and abdominal wall contracting exercises before and after eating for four weeks improved symptoms 66%. She warns that constant bloating in postmenopausal women unrelated to eating requires ovarian cancer screening. She discusses how genes drive personality using dopamine receptor gene DRD4 polymorphisms as an example. The 7-repeat variant present in 48% of Americans creates receptors binding dopamine poorly, associating with ADHD, pathological gambling, alcoholism, drug dependence, and bulimia, plus personality traits of novelty-seeking, impulsiveness, and optimism. The 2-repeat DRD4 variant common in Asia correlates with lower anger and higher forgiveness. DRD2 variations enhance the memory of negative outcomes, creating pessimistic bias and avoidance behavior. She presents the KETO trial showing "lean mass hyper-responder phenotype" where very low-carbohydrate dieters averaging age 55 maintained LDL cholesterol of 272 for five years but showed identical coronary artery calcium scores and plaque burden as matched controls with LDL under 150. Despite extreme LDL elevation, the very low insulin levels from carbohydrate restriction prevent LDL oxidation, the inflammatory "loading" process enabling arterial damage. She concludes with unusual cancer symptom where recurrent pain in specific body locations after alcohol consumption, lasting 1-2 days, occurs in 5% of Hodgkin lymphoma patients and in other cancers when alcohol induced blood vessel dilation and inflammatory chemical release in cancer-containing lymph nodes causes pain after drinking.

Søren Thorgaard Skou (PT, MSc, PhD) has vast experience within the field of osteoarthritis and other chronic conditions and has been the principal investigator of several high-quality randomized controlled trials on surgical and non-surgical treatment, one of which was published in The New England Journal of Medicine (impact factor of 79.26), the highest ranked of all general medical journals. Currently, he is the principal investigator of a randomized, controlled trial of meniscal surgery vs. exercise therapy and education for young people with a meniscal tear (DREAM) and a 5-year EU-funded project (MOBILIZE, grant agreement No 801790) with the overall aim of improving health in people with more than one chronic condition (i.e. multimorbidity) through personalized exercise therapy and education. Furthermore, he is the co-lead of Exercise First, a research program funded by Region Zealand aimed at developing, testing and implementing initaitives that support that the individual patient received the right prevention and treatment at the right time and to increase self-management using e-health.  He is one of the main architects and leader of the implementation of the highly successful treatment program Good Life With osteoArthritis in Denmark (GLA:D) for patients with knee and hip osteoarthritis. Furthermore, he is a recipient of a prestigious ERC Starting Grant from the European Research Council, and a postdoc grant and a Sapere Aude Research Talent Award from the Independent Research Fund Denmark.  --- Follow Professor Søren Skou on Twitter https://twitter.com/STSkou He is affiliated with both University of Southern Denmark and the research unit PROgrez at Slagelse Hospital, Denmark (@PROgrezDK) _____________________ This podcast episode is sponsored by Fibion Inc. | Better Sleep, Sedentary Behaviour and Physical Activity Research with Less Hassle --- Collect, store and manage SB and PA data easily and remotely - Discover ground-breaking Fibion SENS --- SB and PA measurements, analysis, and feedback made easy.  Learn more about Fibion Research --- Learn more about Fibion Sleep and Fibion Circadian Rhythm Solutions. --- Fibion Kids - Activity tracking designed for children. --- Collect self-report physical activity data easily and cost-effectively with Mimove. --- Explore our Wearables,  Experience sampling method (ESM), Sleep,  Heart rate variability (HRV), Sedentary Behavior and Physical Activity article collections for insights on related articles. --- Refer to our article "Physical Activity and Sedentary Behavior Measurements" for an exploration of active and sedentary lifestyle assessment methods. --- Learn about actigraphy in our guide: Exploring Actigraphy in Scientific Research: A Comprehensive Guide. --- Gain foundational ESM insights with "Introduction to Experience Sampling Method (ESM)" for a comprehensive overview. --- Explore accelerometer use in health research with our article "Measuring Physical Activity and Sedentary Behavior with Accelerometers ". --- For an introduction to the fundamental aspects of HRV, consider revisiting our Ultimate Guide to Heart Rate Variability. --- Follow the podcast on Twitter https://twitter.com/PA_Researcher Follow host Dr Olli Tikkanen on Twitter https://twitter.com/ollitikkanen Follow Fibion on Twitter https://twitter.com/fibion https://www.youtube.com/@PA_Researcher

Welcome to Ozempic Weightloss Unlocked, where we decode the latest breakthroughs, news, and hidden truths about one of the world's most talked-about weight loss drugs. Today, the buzz is about change—how new research, fresh delivery methods, and evolving regulations are reshaping the Ozempic story. Let us start with what is most recent. There is a big development: needles may no longer be necessary. According to reporting in Popular Mechanics and new data published in The New England Journal of Medicine, Novo Nordisk, the maker of Ozempic and Wegovy, has released results for a daily oral version of semaglutide, the active ingredient in Ozempic. In their clinical trial, this pill matched the weight loss produced by the weekly injection, with an average of 16.6 percent reduction in body weight. About a third of participants lost more than 20 percent. While side effects like nausea and vomiting were reported at higher rates than placebo, this new pill could make using these drugs more accessible than ever.Access is also the hot topic in pricing. Until this year, monthly Ozempic prescriptions could cost up to $1,350 without insurance support. But after new negotiations, many users will soon pay $50 to $350 per month, depending on dosage and coverage. Lower prices are expected to make these drugs far more widely available.So, how well does Ozempic stack up in its primary role? Ozempic was first approved to treat type two diabetes, with weight loss as a major secondary effect. Harper Clinic Utah reports that, in clinical trials, people using Ozempic lost on average between 10 and 15 percent of their body weight over a little more than a year. But real world success depends on how consistently people use it and whether they also improve their diet and exercise habits.Now a common question—how does Ozempic compare to newer weight loss options like Zepbound and Wegovy? The main distinction is the active ingredient. Ozempic uses semaglutide, which triggers the body to release the hormone GLP-1, helping you feel fuller and slow digestion. Zepbound uses tirzepatide, which mimics both GLP-1 and a second hormone called GIP, and results from major trials suggest it can lead to more dramatic weight loss—up to 21 percent of body weight in some studies. However, Ozempic remains covered by insurance for diabetes, while Zepbound is less often covered.Beyond weight, a new area of research is exploring how Ozempic could affect long-term health conditions. According to ScienceDaily, a recent large-scale analysis found that when people stop using prescription weight loss drugs like Ozempic, they tend to regain much of their lost weight, underscoring the need for ongoing treatment or lifestyle change. But these medicines may do much more than affect weight. Recent studies at University of California San Diego found that people with colon cancer who were on GLP-1 drugs were less than half as likely to die within five years. Another new UVA study, covered by Fox News and ScienceDaily, points to dramatically lower death rates in cancer patients who use GLP-1 drugs like Ozempic—potentially because they lower inflammation and improve metabolic health.There is also new investigation about Ozempic's possible use in treating long COVID. According to research covered by ClickOnDetroit, anecdotal reports suggest that some people taking GLP-1 drugs for weight loss also experienced improvement in their post-COVID symptoms, and new clinical trials are underway.Despite these major advances, affordability and access remain challenges. The latest KFF Health Tracking Poll says that about one in eight adults in the United States are now taking a GLP-1 medication like Ozempic, Wegovy, or Zepbound. But half of those surveyed still find the drugs financially out of reach, even as prices are starting to come down.What does all this mean for lifestyle and health? The current scientific consensus is clear: these drugs do not replace needed changes in eating habits and physical activity. As physicians emphasize, Ozempic works best as part of a treatment plan that includes real lifestyle change.As you can see, Ozempic and drugs like it are not just a story about slimming down—they are opening doors to better health, new medical research, and greater access for millions. Thank you for tuning in to Ozempic Weightloss Unlocked. Make sure to subscribe so you do not miss the next episode covering the evolving science and your questions about Ozempic and weight loss. This has been a quiet please production, for more check out quiet please dot ai. Some great Deals https://amzn.to/49SJ3QsFor more check out http://www.quietplease.aiThis content was created in partnership and with the help of Artificial Intelligence AI

In the past week, breakthrough developments surrounding Ozempic and its use for weight loss have dominated health news, reflecting sweeping changes in both medical access and public perception. According to Popular Mechanics, Novo Nordisk, the pharmaceutical giant behind Ozempic and the similar injectable Wegovy, has just revealed the results of a major 71-week clinical study evaluating an oral pill form of semaglutide, the active ingredient in both Ozempic and Wegovy. This study, published in The New England Journal of Medicine, found that the daily pill achieved nearly the same results as the weekly injection, with participants losing an average of 16.6 percent of their body weight, far surpassing the 2.7 percent weight loss seen in the placebo group. About one third of those taking the pill lost more than 20 percent of their starting weight, signaling not just statistical significance but profound clinical impact. The trial also reported side effects consistent with earlier injectable versions, including increased incidences of nausea and vomiting, though these were not severe enough to derail the optimism surrounding the pill's future.Compounding these scientific advancements, the White House this week announced successful negotiations with both Eli Lilly and Novo Nordisk to dramatically reduce the cost of GLP-1 receptor agonists—the drug class of Ozempic, Wegovy, and Zepbound—which many insurance providers had previously excluded or charged full price for. Now, eligible patients may see their out-of-pocket costs plummet from over one thousand dollars per month to a much more accessible fifty to three hundred fifty dollars depending on dosage and coverage. According to comments from Kim Fisher at the UC Davis Innovation Institute for Food and Health, these price adjustments are expected to drive a swift increase in demand and medication use, with around one in eight adult Americans having already tried some form of GLP-1 therapy.Despite the popularity and transformative outcomes touted by both consumers and medical professionals, Ozempic and related drugs are not without controversy. While these medications have reshaped the landscape for obesity and diabetes treatment, as UC Davis reports, emerging evidence indicates a need for caution and individualized care. Some patients experience notable gastrointestinal effects such as nausea and diarrhea, largely because GLP-1 drugs alter how the gut processes food and signal fullness to the brain. In addition, while fat loss can be dramatic, experts highlight that up to one quarter of the total weight lost may be from lean muscle, underscoring the importance of physical activity and adequate protein to preserve strength. Another concern echoed this week involves bone health, as rapid weight loss and restricted nutrition may inadvertently reduce bone density, especially in older adults and postmenopausal women. Leading researchers emphasize that a successful and safe weight loss journey with Ozempic demands precision nutrition, attentive exercise regimens, and regular monitoring to minimize health risks and maximize wellbeing.The intersection of celebrity culture with the Ozempic phenomenon also drew fresh attention over the past week, especially regarding Oprah Winfrey's evolving relationship with the drug. Oprah, who has long shared her struggles with weight publicly, admitted in recent interviews that she initially resisted taking Ozempic, saying she felt it was the easy way out and preferred to focus on lifestyle change. According to AOL, she reflected on her internal conflict about using medical intervention for weight loss, underscoring how the rise of drugs like Ozempic has forced a cultural reckoning over what constitutes effort, discipline, and legitimacy in personal health. While some celebrity peers openly dismiss rumors or deny any use of weight loss drugs, Oprah's decision to speak candidly about her hesitation and subsequent experiences gives voice to a wider conversation happening both in Hollywood and across the nation. As more public figures reveal their choices, the stigma of using medication to address chronic weight struggles may begin to dissipate, helping others seek support without shame.In summary, the past week has marked a pivotal moment in the ongoing Ozempic story. The introduction of a highly effective oral pill, substantial price cuts via government negotiation, and ongoing public debate about safety, efficacy, and cultural perceptions have all contributed to growing momentum. Now, as clinicians and patients alike look ahead to a future where advanced weight management tools are both more accessible and potentially safer to use, the importance of personalized guidance and health literacy has never been clearer.Thanks for listening, please subscribe, and remember—this episode was brought to you by Quiet Please podcast networks. For more content like this, please go to Quiet Please dot Ai.Some great Deals https://amzn.to/49SJ3QsFor more check out http://www.quietplease.aiThis content was created in partnership and with the help of Artificial Intelligence AI

Carotid artery disease management has come a long way. From the days when every stroke meant an endarterectomy to a modern era defined by precision, evidence, and evolving technology. With advances in medical therapy and newer techniques like TCAR, the vascular surgeon has even more to consider when choosing the best treatment for carotid disease. Join us as we break down the major landmark trials NASCET, CREST and the Asymptomatic Carotid trials, and discuss how their findings shape our clinical decisions in practice today. Hosts: ·      Christian Hadeed -PGY 4 General Surgery, Brookdale Hospital Medical Center ·      Paul Haser -Division Chief, Vascular Surgery, Brookdale Hospital Medical Center ·      Andrew Harrington, Vascular surgery, Brookdale Hospital Medical Center ·      Lucio Flores, Vascular surgery, Brookdale Hospital Medical Center Learning Objectives: · Review the key findings and clinical implications of the NASCET, ACST, and CREST trials. · Discuss patient selection for carotid endarterectomy (CEA) vs carotid artery stenting (CAS). · Understand how age, calcification, and aortic arch anatomy affect stenting outcomes or choice between stent and CEA. · Identify how advances in medical therapy have influenced management of asymptomatic disease.  · Discuss appropriate screening/ follow up plans for patients who do not meet criteria for intervention References: -       North American Symptomatic Carotid Endarterectomy Trial Collaborators. (1991). Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. The New England Journal of Medicine, 325(7), 445–453. https://pubmed.ncbi.nlm.nih.gov/1852179/ -       Brott, T. G., Hobson, R. W. II, Howard, G., Roubin, G. S., Clark, W. M., Brooks, W., ... & Howard, V. J. (2010). Stenting versus endarterectomy for treatment of carotid-artery stenosis. The New England Journal of Medicine, 363(1), 11–23. https://pubmed.ncbi.nlm.nih.gov/20505173/ -       Halliday, A., Mansfield, A., Marro, J., Peto, C., Peto, R., Potter, J., & Thomas, D.; MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. (2004). Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: Randomized controlled trial. The Lancet, 363(9420), 1491–1502. https://pubmed.ncbi.nlm.nih.gov/15135594/ -       Halliday, A., Bulbulia, R., Bonati, L. H., Chester, J., Cradduck-Bamford, A., Peto, R., & Pan, H., & the ACST-2 Collaborative Group. (2021). Second asymptomatic carotid surgery trial (ACST-2): A randomised comparison of carotid artery stenting versus carotid endarterectomy. The Lancet, 398(10305), 1065-1073. https://doi.org/10.1016/S0140-6736(21)01910-3 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

In this solo episode, Darin reframes one of the most misunderstood forces in life — stress. Instead of seeing it as the enemy, he explores how stress is actually a messenger, guiding you back to alignment, safety, and awareness. Through science, spirituality, and lived experience, Darin breaks down how stress shows us where we're trying to control, where we're disconnected, and where our nervous system is calling for attention. He unpacks the layers of modern stress — from trauma and environment to community and purpose — and offers practical, embodied tools to restore calm, clarity, and resilience.     What You'll Learn 00:00:00 – Welcome to Super Life: Solutions for a Healthier Life and Better World 00:00:32 – Sponsor Spotlight: TheraSauna - Natural Healing Technologies (15% off with code Darrandai) 00:02:10 – The Super Life Podcast: Finding Contentment, Happiness, and Purpose 00:02:51 – Today's Topic: Stress - Reframing Stress as an Ally and Dashboard Light 00:04:54 – The "No Choice" Universe: Reconnecting to Infinite Possibilities 00:05:16 – The Reality of Stress: Statistics and the Impact of Chronic Stress 00:06:21 – Stress is Layered: Beyond a Single Cause, Addressing Chronic Stress 00:08:29 – Solutions for a Super Life: Safety over Calm and the Vagal Response 00:09:38 – The Inner Dialogue Layer: Trauma, Unconsciousness, and Spiritual Bypassing 00:11:47 – The Social Field Layer: Relationships, Community, and Finding Your Way Home 00:14:20 – Sponsor Spotlight: Bite Toothpaste - Sustainable, Non-Toxic Tabs (20% off with code Darin20) 00:16:35 – Creating Your Own Vision: Setting Boundaries with Media and Social Algorithms 00:17:29 – Finding Your Purpose: From Raising Children to Healing Injuries 00:18:35 – Environmental and Existential Stress Layers: Clutter, Noise, and Service 00:19:26 – Stress Load and Resiliency: Why Small Triggers Cause Blow-Ups 00:20:02 – Understanding the Dashboard Light: Acknowledging Unwillingness 00:20:35 – Safety as the Signal: Body Relaxation and Providing Inner Security 00:23:44 – Reframing Trauma: Was it the Protector You Needed at the Time? 00:25:00 – Releasing Trauma: Techniques, The Healing Code, and Waking the Tiger 00:26:06 – Finishing the Survival Response: Shaking, Crying, Screaming, and Stretching 00:26:38 – Stress as a Multiplier: Impact on Immune System, Heart, and Aging 00:28:10 – Stress Slows Repair: Inflammation, Cardiovascular Risk, and Cellular Aging 00:29:48 – The Integrative Approach: Changing Your Environments to Support Anti-Stress 00:30:07 – Actionable Stress Solutions: Circadian Rhythm, Nature, and Noise Reduction 00:30:44 – Actionable Stress Solutions: Gratitude, Conscious Breath, and Movement 00:31:32 – Energy Drains to Eliminate: Conflict, Clutter, Scrolling, and Late Caffeine 00:32:17 – Connecting to Greater Purpose: The Super Life Patreon Platform 00:32:54 – Morning/Night Questions: Letting Go, Creating, and Contributing 00:33:17 – Final Toolkit: Slow Breathing, Movement, Nature, Sauna, and Sleep 00:34:25 – The Invitation: Digging into all Layers of a Super Life on Patreon   Thank You to Our Sponsors Therasage: Go to www.therasage.com and use code DARIN at checkout for 15% off Bite Toothpaste: Go to trybite.com/DARIN20 or use code DARIN20 for 20% off your first order. Find More from Darin Olien: Instagram: @darinolien Podcast: SuperLife Podcast Website: superlife.com Book: Fatal Conveniences   Key Takeaway "Stress isn't your enemy — it's your compass. Every wave of tension points you back to what's asking for care, attention, and love. When you stop fighting stress and start listening to it, you don't just survive — you evolve."       Bibliography (selected, peer-reviewed) Sources: Gallup Global Emotions (2024); Gallup U.S. polling (2024); APA Stress in America (2023); Natarajan et al., Lancet Digital Health (2020); Orini et al., UK Biobank (2023); Martinez et al. (2022); Leiden University (2025). Cohen S, Tyrrell DA, Smith AP. Psychological stress and susceptibility to the common cold. N Engl J Med.1991;325(9):606–612. New England Journal of Medicine Cohen S, et al. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proc Natl Acad Sci USA. 2012;109(16):5995–5999. PNAS Kiecolt-Glaser JK, et al. Slowing of wound healing by psychological stress. Lancet. 1995;346(8984):1194–1196. The Lancet Kiecolt-Glaser JK, et al. Hostile marital interactions, proinflammatory cytokine production, and wound healing.Arch Gen Psychiatry. 2005;62(12):1377–1384. JAMA Network Tawakol A, et al. Relation between resting amygdalar activity and cardiovascular events. Lancet.2017;389(10071):834–845. The Lancet Epel ES, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA.2004;101(49):17312–17315. PNAS McEwen BS, Stellar E. Stress and the individual: mechanisms leading to disease. Arch Intern Med.1993;153(18):2093–2101. PubMed McEwen BS, Wingfield JC. Allostasis and allostatic load. Ann N Y Acad Sci. 1998;840:33–44. PubMed Felitti VJ, et al. Relationship of childhood abuse and household dysfunction to many leading causes of death in adults (ACE Study). Am J Prev Med. 1998;14(4):245–258. AJP Mon Online Edmondson D, et al. PTSD and cardiovascular disease. Ann Behav Med. 2017;51(3):316–327. PMC Afari N, et al. Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis.Psychosom Med. 2014;76(1):2–11. PMC Goyal M, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357–368. PMC Qiu Q, et al. Forest therapy: effects on blood pressure and salivary cortisol—a meta-analysis. Int J Environ Res Public Health. 2022;20(1):458. PMC Laukkanen T, et al. Sauna bathing and reduced fatal CVD and all-cause mortality. JAMA Intern Med.2015;175(4):542–548. JAMA Network Zureigat H, et al. Physical activity lowers CVD risk by reducing stress-related neural activity. J Am Coll Cardiol.2024;83(16):1532–1546. PMC Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med.2010;7(7):e1000316. PMC Chen Y-R, Hung K-W. EMDR for PTSD: meta-analysis of RCTs. PLoS One. 2014;9(8):e103676. PLOS Hoppen TH, et al. Network/pairwise meta-analysis of PTSD psychotherapies—TF-CBT highest efficacy overall.Psychol Med. 2023;53(14):6360–6374. PubMed van der Kolk BA, et al. Yoga as an adjunctive treatment for PTSD: RCT. J Clin Psychiatry. 2014;75(6):e559–e565. PubMed Kelly U, et al. Trauma-center trauma-sensitive yoga vs CPT in women veterans: RCT. JAMA Netw Open.2023;6(11):e2342214. JAMA Network Bentley TGK, et al. Breathing practices for stress and anxiety reduction: components that matter. Behav Sci (Basel). 2023;13(9):756. 

Søren Thorgaard Skou (PT, MSc, PhD) has vast experience within the field of osteoarthritis and other chronic conditions and has been the principal investigator of several high-quality randomized controlled trials on surgical and non-surgical treatment, one of which was published in The New England Journal of Medicine (impact factor of 79.26), the highest ranked of all general medical journals. Currently, he is the principal investigator of a randomized, controlled trial of meniscal surgery vs. exercise therapy and education for young people with a meniscal tear (DREAM) and a 5-year EU-funded project (MOBILIZE, grant agreement No 801790) with the overall aim of improving health in people with more than one chronic condition (i.e. multimorbidity) through personalized exercise therapy and education. Furthermore, he is the co-lead of Exercise First, a research program funded by Region Zealand aimed at developing, testing and implementing initaitives that support that the individual patient received the right prevention and treatment at the right time and to increase self-management using e-health.  He is one of the main architects and leader of the implementation of the highly successful treatment program Good Life With osteoArthritis in Denmark (GLA:D) for patients with knee and hip osteoarthritis. Furthermore, he is a recipient of a prestigious ERC Starting Grant from the European Research Council, and a postdoc grant and a Sapere Aude Research Talent Award from the Independent Research Fund Denmark.  --- Follow Professor Søren Skou on Twitter https://twitter.com/STSkou He is affiliated with both University of Southern Denmark and the research unit PROgrez at Slagelse Hospital, Denmark (@PROgrezDK) _____________________ This podcast episode is sponsored by Fibion Inc. | Better Sleep, Sedentary Behaviour and Physical Activity Research with Less Hassle --- Collect, store and manage SB and PA data easily and remotely - Discover ground-breaking Fibion SENS --- SB and PA measurements, analysis, and feedback made easy.  Learn more about Fibion Research --- Learn more about Fibion Sleep and Fibion Circadian Rhythm Solutions. --- Fibion Kids - Activity tracking designed for children. --- Collect self-report physical activity data easily and cost-effectively with Mimove. --- Explore our Wearables,  Experience sampling method (ESM), Sleep,  Heart rate variability (HRV), Sedentary Behavior and Physical Activity article collections for insights on related articles. --- Refer to our article "Physical Activity and Sedentary Behavior Measurements" for an exploration of active and sedentary lifestyle assessment methods. --- Learn about actigraphy in our guide: Exploring Actigraphy in Scientific Research: A Comprehensive Guide. --- Gain foundational ESM insights with "Introduction to Experience Sampling Method (ESM)" for a comprehensive overview. --- Explore accelerometer use in health research with our article "Measuring Physical Activity and Sedentary Behavior with Accelerometers ". --- For an introduction to the fundamental aspects of HRV, consider revisiting our Ultimate Guide to Heart Rate Variability. --- Follow the podcast on Twitter https://twitter.com/PA_Researcher Follow host Dr Olli Tikkanen on Twitter https://twitter.com/ollitikkanen Follow Fibion on Twitter https://twitter.com/fibion https://www.youtube.com/@PA_Researcher

When treating head and neck cancer, how can you tell the difference between true disease progression and pseudoprogression? In this episode of the BackTable Podcast, we discuss the practical implementation of the KEYNOTE-689 trial published in the New England Journal of Medicine, which demonstrated the benefit of adding neoadjuvant and adjuvant immunotherapy to standard head and neck cancer care. Our tumor board panel includes Dr. Mihir Patel, a head and neck surgeon from UNC Chapel Hill, Dr. Siddharth Sheth, a head and neck medical oncologist from UNC, Dr. Jennifer Johnson, a professor of medical oncology and otolaryngology at Sidney Kimmel Comprehensive Cancer Center, and Dr. Adam Luginbuhl, a head and neck surgical oncologist at Thomas Jefferson University. --- SYNPOSIS The doctors address the trial's practical implications, patient selection, case management, dealing with tumor progression, and the integration of multidisciplinary care. They also emphasize the importance of communication, real-world application of trial protocols, and the potential benefits and challenges of such therapies. --- TIMESTAMPS 00:00 - Introduction03:18 - Discussing the New Indication for Immunotherapy11:42 - Challenges and Practical Implementation22:48 - Managing Tumor Progression: A Case Study28:07 - Exploring Treatment Options: Surgery vs. Chemotherapy36:46 - Operational Challenges and Future Directions43:58 - Concluding Thoughts and Future Directions --- RESOURCES Keynote 689https://www.nejm.org/doi/full/10.1056/NEJMoa2415434

Medical imaging, like X-rays and CT scans, are routine, non-invasive and painless tools used by doctors to make diagnoses. But a recent study of about 4 million children published in the New England Journal of Medicine suggests that the radiation exposure from imaging could pose a risk for pediatric cancer. John Yang speaks with Dr. Rebecca Smith-Bindman, the study’s lead author, to learn more. PBS News is supported by - https://www.pbs.org/newshour/about/funders. Hosted on Acast. See acast.com/privacy

Medical imaging, like X-rays and CT scans, are routine, non-invasive and painless tools used by doctors to make diagnoses. But a recent study of about 4 million children published in the New England Journal of Medicine suggests that the radiation exposure from imaging could pose a risk for pediatric cancer. John Yang speaks with Dr. Rebecca Smith-Bindman, the study’s lead author, to learn more. PBS News is supported by - https://www.pbs.org/newshour/about/funders. Hosted on Acast. See acast.com/privacy

Since Democrats decided to shut down the government over Affordable Care Act subsidies, now's a good time for a deep dive into what they're even talking about. John Hopkins professor Dr. Ge Bai walks us through the ACA subsidies, the hidden mechanics behind the Affordable Care Act, and its illusion of "affordability." Dr. Bai shows us how regulations and subsidies have quietly reshaped the healthcare market - and how the free market can make it work for patients again. Ge Bai, PhD, CPA is a Professor of Accounting at Johns Hopkins Carey Business School and Professor of Health Policy & Management (joint) at Johns Hopkins Bloomberg School of Public Health. An expert on health care accounting, finance, and policy, Dr. Bai has testified before the House Ways and Means Committee and the Senate HELP Committee, written for the Wall Street Journal and the Washington Post, and published her studies in leading academic journals such as the New England Journal of Medicine, JAMA, and Health Affairs. Find her on X at @GeBaiDC and read her recent WSJ oped here: https://www.wsj.com/opinion/let-the-obamacare-enhanced-premium-subsidies-expire-16ef7e1b

Two-time Emmy and three-time NAACP Image Award-winning television Executive Producer Rushion McDonald interviewed Dr. Schenta D. Randolph.

Two-time Emmy and three-time NAACP Image Award-winning television Executive Producer Rushion McDonald interviewed Dr. Schenta D. Randolph.

Two-time Emmy and three-time NAACP Image Award-winning television Executive Producer Rushion McDonald interviewed Dr. Schenta D. Randolph.

A New England Journal of Medicine study showed a novel chemotherapy regimen, trastuzumab deruxtecan combined with pertuzumab, outperformed the current standard in treating HER2-positive advanced breast cancer, demonstrating better efficacy and tolerability with fewer traditional chemotherapy-related side effects. A JAMA Oncology study by Uppsala University revealed a modest increase in breast cancer risk with hormonal contraceptive use among over two million Swedish women, emphasizing the need for balanced counseling regarding risks and benefits. The REPAIR trial in Denmark, published in the British Medical Journal, demonstrated that a short course of antibiotics significantly reduced clinically important wound complications after vaginal delivery in women with episiotomies or second-degree tears, highlighting its potential benefit in postpartum care.

Vidcast:  https://www.instagram.com/p/DQdnYr9jZwV/An exciting, ground-breaking clinical study now shows that children born with a defective gene coding for a vital inner ear protein can have that gene  repaired and hearing restored. This phenomenally successful preliminary clinical trial was recently published in the New England Journal of Medicine.Genetic bioengineers at New York's Regeneron Pharmaceuticals loaded a normal copy of the otoferlin gene into a dual adeno-associated virus acting as a Trojan horse.  Twelve children, born without the ability to synthesize otoferlin protein, received the gene injection, dubbed DB-OTO therapy, into their inner ears at 3 clinical centers: Harvard's Mass. Eye and Ear Infirmary, UC San Diego's Children's Hospital, and University College London.  Otoferlin is necessary for the inner ear's ability to convert sound vibrations into electrical impulses.  At 24 weeks post-injection, 9 of the 12 children, 75%, regained measurable hearing.  Three, 25%, developed near normal hearing.  The gene therapy was well-tolerated without any significant side effects.This gene therapy, with further refinement and after larger clinical trials, may be a one-and-done treatment for one common form of congenital deafness. Cochlear implants will continue to be essential therapy for other types of genetic and acquired severe hearing losses pending development of other genetic and/or chemical cochlear modifications.https://www.nejm.org/doi/full/10.1056/NEJMoa2400521#deafness #children #congenital #otoferlin #dboto 

In "We Can Make a Difference," Dr. Osterholm and Chris Dall discuss the recent publication from CIDRAP's Vaccine Integrity Project, an upcoming collaboration between CIDRAP and NEJM Evidence, and the latest measles and respiratory virus data. Dr. Osterholm also answers an ID Query about how the government shutdown is impacting public health surveillance and shares another "This Week in Public Health History" segment. Updated Evidence for Covid-19, RSV, and Influenza Vaccines for 2025–2026 (Scott et al., New England Journal of Medicine) Vaccine Integrity Project - Response to HHS claims about vaccines (Oct 2025) Resources for vaccine and public health advocacy: Voices for Vaccines Families Fighting Flu Vaccinate Your Family Shot@Life Medical Reserve Corps Learn more about the Vaccine Integrity Project MORE EPISODES       SUPPORT THIS PODCAST

In this episode, Dr. Brendan McCarthy, Chief Medical Officer of Protea Medical Center, dives deep into estrone, one of the three key estrogens, and explains why understanding it is crucial for women's health. Learn about: The differences between estradiol, estriol, and estrone How estrone levels shift during perimenopause and menopause Why oral estrogen can dramatically increase estrone The impact of lifestyle factors like diet, body fat, stress, alcohol, and sedentary behavior on estrogen balance Practical tips to support healthy estrogen metabolism naturally Dr. McCarthy breaks down complex biochemistry in a clear, actionable way so you can take charge of your hormonal health.   Citations: 1. Bulun, Serdar E., et al. “Aromatase and Estrogen Biosynthesis in Adipose Tissue.” Endocrine Reviews, vol. 23, no. 3, 2002, pp. 305–342. 2. Labrie, Fernand, et al. “Importance of the Intracrinology of Estrogen Synthesis in Peripheral Tissues in Postmenopausal Women.” Journal of Steroid Biochemistry and Molecular Biology, vol. 118, nos. 4–5, 2010, pp. 273–279. 3. Sasano, Hironobu, and Toshihiko Harada. “Differential Expression of Aromatase and 17β-Hydroxysteroid Dehydrogenase Isoenzymes in Human Tissues.” Journal of Steroid Biochemistry and Molecular Biology, vol. 86, no. 3–5, 2003, pp. 327–333. 4. Yager, James D., and Nancy E. Davidson. “Estrogen Carcinogenesis in Breast Cancer.” New England Journal of Medicine, vol. 354, no. 3, 2006, pp. 270–282. 5. Cavalieri, Ercole L., and Eleanor G. Rogan. “Depurinating Estrogen-DNA Adducts, Mechanisms of Formation, and Prevention.” Clinical Cancer Research, vol. 16, no. 3, 2010, pp. 596–602. 6. Suba, Zsuzsanna. “Circulating Estrogens and Estrogen Metabolism in Obese Women.” Journal of Clinical Endocrinology and Metabolism, vol. 98, no. 11, 2013, pp. 4336–4344. 7. Simpson, Evan R., and Konstanze C. Pike. “Aromatase Expression in Adipose Tissue: Relationship to Obesity and Insulin Resistance.” Endocrinology, vol. 156, no. 9, 2015, pp. 3422–3435. 8. Key, Timothy J., et al. “Circulating Sex Hormones and Breast Cancer Risk Factors in Postmenopausal Women: Reanalysis of 13 Studies.” British Journal of Cancer, vol. 105, no. 5, 2011, pp. 709–722. 9. Stanczyk, Frank Z., et al. “Oral, Transdermal and Injectable Hormone Therapy: Pharmacokinetics and Effects on Estrone/Estradiol Ratios.” Menopause, vol. 24, no. 9, 2017, pp. 1080–1090. 10. Santen, Richard J., et al. “Estrogen Bioidentical Hormone Therapy: Route of Administration and Risk.” Journal of Clinical Endocrinology and Metabolism, vol. 105, no. 7, 2020, pp. 2062–2074. 11. Zeleniuch-Jacquotte, Anne, et al. “Postmenopausal Levels of Estrone, Estradiol, and Estrone Sulfate and Breast Cancer Risk.” Cancer Epidemiology, Biomarkers & Prevention, vol. 23, no. 8, 2014, pp. 1531–1539. 12. Dall, Gabriella V., and Christine L. Clarke. “Local Estrogen Biosynthesis and Signaling in Breast Cancer Progression.” Steroids, vol. 78, no. 7, 2013, pp. 639–646. 13. Heald, Anthony H., et al. “Relationships Between Serum Estrone, Insulin Resistance, and Adiposity in Postmenopausal Women.” Clinical Endocrinology, vol. 67, no. 3, 2007, pp. 340–345. 14. Kuiper, George G. J. M., et al. “Estrogen Receptor β Selectivity of Estriol and Implications for Tissue-Specific Effects.” PNAS, vol. 94, no. 17, 1997, pp. 9105–9110. 15. Michnovicz, Joseph J., et al. “Dietary Indoles and Estrogen Metabolism: Effects of Cruciferous Vegetable Intake.” Journal of Nutrition, vol. 134, no. 12, 2004, pp. 3479S–   Dr. Brendan McCarthy is the founder and Chief Medical Officer of Protea Medical Center in Arizona. With over two decades of experience, he's helped thousands of patients navigate hormonal imbalances using bioidentical HRT, nutrition, and root-cause medicine. He's also taught and mentored other physicians on integrative approaches to hormone therapy, weight loss, fertility, and more. If you're ready to take your health seriously, this podcast is a great place to start.  

In this episode of Thinking Thoracic, host Dr. Erin Gillaspie talks with Dr. Robert Lentz and Dr. Fabien Maldonado about the groundbreaking VERITAS trial, which is reshaping how clinicians diagnose lung cancer. Published in the New England Journal of Medicine, the VERITAS trial compared navigational bronchoscopy with CT-guided biopsy in a rigorous, randomized design, bringing much-needed evidence to interventional pulmonology. The discussion explores how the study was conceived, why robust device trials are vital to patient outcomes, and what the findings mean for the future of minimally invasive lung diagnostics.

Today we're thrilled to get to know Travis Zack, Chief Medical Officer of OpenEvidence. OpenEvidence is the world's leading medical information platform and the fastest growing applications for physicians in history. Over 40% of US clinicians leverage OpenEvidence for evidence based practice support that is directly embedded into their workflows.Through an array of strategic content partnerships (including the American Medical Association, The New England Journal of Medicine, The Journal of the American Medical Association, and all eleven JAMA specialty journals—such as JAMA Oncology and JAMA Neurology) OpenEvidence gives clinicians the power to search once, skip the scavenger hunt, and surface the science in seconds. Most recently, OpenEvidence has raised $200M in its Series C from Top Investors like Sequoia, GV Thrive, Kleiner Perkins and others!In this episode, we discuss how OpenEvidence is transforming access to medical evidence, the company's rapid growth and adoption by clinicians, its business model and journal partnerships, and the future roadmap for AI-powered clinical decision support.

Autism isn't new, but our understanding of it has changed dramatically. It's now recognized as a broad neurodevelopmental spectrum that shapes how millions of people perceive, process, and interact with the world. In this episode, we explore what autism is AND isn't, from its earliest signs in infancy to its deep genetic roots, and why misinformation about it continues to spread. We speak with three remarkable experts leading the field in early detection, genetics, and public education: DR. AMI KLIN, PhD, Director of the Marcus Autism Center at Emory University and a pioneer in early autism research, whose work shows autism can be identified in babies as young as two months old. DR. JOSEPH BUXBAUM, PhD, Director of the Seaver Autism Center at Mount Sinai and a global leader in autism genetics, uncovering hundreds of genes linked to the condition. DR. ANDREA LOVE, immunologist, microbiologist, and founder of ImmunoLogic, known for her clear, evidence-based communication about vaccines, immunity, and autism myths. Together, we discuss: • What autism really is, and how the definitions have evolved • How it develops in infancy (and why early diagnosis can be so critical) • The powerful genetic evidence behind autism • The persistence of vaccine myths, and how misinformation spreads • How technology like eye-tracking can detect autism early • The rise of “profound autism” and what it means for families • The future of genetics-based treatments and therapy Whether you're autistic yourself, a parent navigating a new diagnosis, or simply seeking understanding, we're thrilled to share this extensive, in-depth episode with you. This is... Your Brain On Autism. SUPPORTED BY: the 2026 NEURO World Retreat. A 5-day journey through science, nature, and community, on the California coastline: https://www.neuroworldretreat.com/ ‘Your Brain On' is hosted by neurologists, scientists, and public health advocates Ayesha and Dean Sherzai. ‘Your Brain On... Autism' • SEASON 6 • EPISODE 1 LINKS Dr. Ami Klin at Emory University: https://ctsn.emory.edu/faculty/klin-ami.html Dr. Ami Klin at Marcus Autism Center: https://www.marcus.org/about-marcus-autism-center/meet-our-leadership/ami-klin  Dr. Joseph Buxbaum at Mount Sinai: https://profiles.icahn.mssm.edu/joseph-d-buxbaum  Dr. Andrea Love's website: https://www.immunologic.org/ Dr. Andrea Love on Instagram: https://www.instagram.com/dr.andrealove  REFERENCES Autism Spectrum Disorder: A Review. JAMA, 2023. https://jamanetwork.com/journals/jama/article-abstract/2800182  Is There a Bias Towards Males in the Diagnosis of Autism? A Systematic Review and Meta-Analysis. https://link.springer.com/article/10.1007/s11065-023-09630-2  Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability. https://pubmed.ncbi.nlm.nih.gov/38592388/  Eye-Tracking–Based Measurement of Social Visual Engagement Compared With Expert Clinical Diagnosis of Autism. https://jamanetwork.com/journals/jama/fullarticle/2808996  Rare coding variation provides insight into the genetic architecture and phenotypic context of autism. https://www.nature.com/articles/s41588-022-01104-0  Rare coding variation illuminates the allelic architecture, risk genes, cellular expression patterns, and phenotypic context of autism. https://www.medrxiv.org/content/10.1101/2021.12.20.21267194v1  Andrew Wakefield and the fabricated history of the alleged vaccine-autism link. https://geneticliteracyproject.org/2024/04/29/andrew-wakefield-and-the-fabricated-history-of-the-alleged-vaccine-autism-link/ VACCINES & AUTISM 1. Major Cohort Studies Hviid et al., 2019 – Annals of Internal Medicine A nationwide study of 657,461 Danish children found no increased risk of autism in vaccinated children compared to unvaccinated peers — even among those with risk factors such as a sibling with autism. Ann Intern Med. 2019;170(8):513–520 Madsen et al., 2002 – New England Journal of Medicine In 537,303 Danish children, researchers found no difference in autism rates between vaccinated and unvaccinated groups, and no relationship with age, timing, or date of vaccination. NEJM. 2002;347:1477–1482 Jain et al., 2015 – Journal of the American Medical Association (JAMA) A U.S. cohort of 95,727 children — including those with siblings with autism — showed no link between MMR vaccination and autism risk, even in genetically predisposed children. JAMA. 2015;313(15):1534–1540 Madsen et al., 2003 – JAMA A study of 467,450 Danish children found no relationship between thimerosal-containing vaccines and autism. JAMA. 2003;290(13):1763–1766 DeStefano et al., 2022 – Vaccine A retrospective cohort of over 500,000 U.S. children with ASD found no increase in adverse events or worsening of autism-related symptoms following vaccination. Vaccine. 2022;40(16):2391–2398 2. Population-Level Epidemiologic Evidence Taylor et al., 1999 – The Lancet One of the earliest large epidemiological studies found autism prevalence was the same in vaccinated and unvaccinated children, and the age of onset was unrelated to the timing of MMR vaccination. Read: Lancet. 1999;353(9169):2026–2029 Institute of Medicine (U.S.) Immunization Safety Review, 2011 A global review of studies from the U.S., Denmark, Sweden, and the U.K. concluded there is no causal relationship between vaccination status and autism, and no plausible biological mechanism linking vaccines (including thimerosal) to ASD. Read: National Academies Press / PubMed 20669467 3. Systematic Reviews and Meta-Analyses Taylor et al., 2014 – Vaccine A comprehensive meta-analysis of 10 studies including over 1.2 million children found no association between vaccination and autism or ASD. Vaccine. 2014;32(29):3623–3629 Maglione et al., 2014 – Pediatrics Review of 67 high-quality studies covering the full U.S. immunization schedule concluded that vaccines are safe, adverse events are rare, and there is no link to autism, type 1 diabetes, or other chronic conditions. Pediatrics. 2014;134(2):325–337 Parker et al., 2004 – Pediatrics Systematic review of 10 primary studies examining thimerosal exposure found no relationship between vaccines and ASD. Authors noted that studies showing an association were methodologically flawed or biased, while robust studies consistently showed safety. Pediatrics. 2004;113(6):1904–1910 Offit & Hackett, 2003 – Clinical Infectious Diseases Review of immunology and epidemiology concluded that claims that vaccines “overwhelm” or “damage” the immune system are not biologically plausible based on how the immune system actually functions. Clin Infect Dis. 2003;46(9):1450–1456

Sasha K. Shillcutt, MD, MS, FASE is a tenured and endowed Professor and the Vice Chair of Strategy in the Department of Anesthesiology at the University of Nebraska Medical Center. She is a double-boarded cardiac anesthesiologist and is also CEO & Founder of Brave Enough, a community of thousands of women in healthcare where she teaches women how to advance through courses, coaching, and events. She leads conferences and retreats for professional women and is a certified coach for women leaders. Sasha is a well-published researcher in anesthesiology and gender equity, best-selling author, and international speaker. She speaks frequently to executives and leaders on the topics of professional resilience and wellbeing. Her TEDx talk titled Resilience: The Art of Failing Forward has been viewed by thousands of people. Her writing has been published in both the New England Journal of Medicine and JAMA. Her first book, Between Grit and Grace: How to be Feminine and Formidable, has sold thousands of copies and her second book, Brave Boundaries, is an international best seller. Her podcast, The Brave Enough Show, has over 315K downloads & she has coached hundreds of women leaders to thrive. Some of the topics we discussed were: Setting boundaries at work, in business, or entrepreneurshipSetting and keeping boundaries that serve you Common mistakes people make when setting up boundaries and how to avoid themHow to navigate situations where people are unhappy with the boundaries you setRecommendations for people on their journey of learning better boundariesHow to approach situations where you feel someone is setting an unreasonable boundaryBoundaries and time management And more!Learn more about me or schedule a FREE coaching call:https://www.joyfulsuccessliving.com/ Join the Voices of Women Physicians Facebook Group:https://www.facebook.com/groups/190596326343825/ Connect with Dr. Shilcutt: WEBSITE INSTAGRAM FACEBOOK TWITTER LINKEDIN 

Sasha K. Shillcutt, MD, MS, FASE is a tenured and endowed Professor and the Vice Chair of Strategy in the Department of Anesthesiology at the University of Nebraska Medical Center. She is a double-boarded cardiac anesthesiologist and is also CEO & Founder of Brave Enough, a community of thousands of women in healthcare where she teaches women how to advance through courses, coaching, and events. She leads conferences and retreats for professional women and is a certified coach for women leaders. Sasha is a well-published researcher in anesthesiology and gender equity, best-selling author, and international speaker. She speaks frequently to executives and leaders on the topics of professional resilience and wellbeing. Her TEDx talk titled Resilience: The Art of Failing Forward has been viewed by thousands of people. Her writing has been published in both the New England Journal of Medicine and JAMA. Her first book, Between Grit and Grace: How to be Feminine and Formidable, has sold thousands of copies and her second book, Brave Boundaries, is an international best seller. Her podcast, The Brave Enough Show, has over 315K downloads & she has coached hundreds of women leaders to thrive. Some of the topics we discussed were: Setting boundaries at workUnderstanding your pain points Setting up boundaries outside of the homeSetting boundaries with your phoneSetting boundaries with yourselfSetting boundaries for phones with teenagersDealing with situations where your boundaries are not being respectedSetting boundaries with the people you loveModeling setting healthy boundaries for your kids And more! Learn more about me or schedule a FREE coaching call:https://www.joyfulsuccessliving.com/ Join the Voices of Women Physicians Facebook Group:https://www.facebook.com/groups/190596326343825/ Connect with Dr. Shilcutt: WEBSITE INSTAGRAM FACEBOOK TWITTER LINKEDIN 

Send us a textIn this episode, we cover the anatomy and functions of the menisci, the mechanisms behind various types of meniscal tears, and clinical assessment techniques. We also discuss when to opt for conservative care versus surgical treatment, and reviews special tests and imaging standards like MRIs. Tune in to enhance your understanding of knee meniscal injuries and improve your clinical practice.00:00 Introduction to Bets Snacks Podcast00:23 Overview of Knee Meniscal Tears00:54 Anatomy and Function of the Menisci03:03 Types of Meniscal Tears05:58 Clinical Assessment Techniques08:15 Imaging and Diagnosis09:04 Conservative vs. Surgical Treatment12:03 Conclusion and Additional ResourcesBeamer BS, Walley KC, Okajima S, et al. (2017). Meniscal Repair vs Partial Meniscectomy: A Comparative Analysis of Clinical Outcomes. Arthroscopy, 33(9), 1635–1643.Englund M, Guermazi A, Gale D, et al. (2008). Incidental Meniscal Findings on Knee MRI in Middle-Aged and Elderly Persons. New England Journal of Medicine, 359(11), 1108–1115.Logerstedt DS, Scalzitti D, Risberg MA, et al. (2010). Knee Pain and Mobility Impairments: Meniscal and Articular Cartilage Lesions. Journal of Orthopaedic & Sports Physical Therapy (JOSPT) Clinical Practice Guidelines, 40(6), A1–A35.LaPrade RF, Geeslin AG, Everett CR, et al. (2015). Diagnosis and Treatment of Meniscal Injuries: A Review. Sports Health, 7(2), 147–154.Stensrud S, Risberg MA, Roos EM. (2012). Effect of Exercise Therapy on Meniscal Tear Outcomes in Middle-Aged Adults: A Randomized Controlled Trial. British Medical Journal (BMJ), 344:e533.Go to PT Final Exam using this link to access great studying options to conquer the NPTE!Support the showStay Connected! Make sure to hit follow now so you don't miss an episode! Got questions? Email me at ptsnackspodcast@gmail.com or leave feedback HERE. You can also join the email list HERE Need CEUs Fast?Time and resources short? Medbridge has you covered: Get over $100 off a subscription with code PTSNACKSPODCAST: Medbridge Students: Save $75 off a student subscription with code PTSNACKSPODCASTSTUDENT—a full year of unlimited access for less! Prepping for the NPTE? Get all the study tools you need to master it at PT Final Exam. Use code PTSnacks at checkout to get a discount! Want to Support the Show?Help me keep creating free content by: Sharing the podcast with someone who'd benefit. Contributing directly via the link...

Today, I'm joined by Dr. Lisa Shah, Chief Medical Officer at Twin Health.   Replacing population averages with personal biomarkers, Twin Health leverages digital twin technology to address root causes of metabolic conditions like obesity and diabetes.   In this episode, we discuss how machine learning is transforming disease management.   We also cover:   Building a GLP-1 off-ramp Balancing AI with human support Achieving a 71% diabetes reversal rate   Subscribe to the podcast → insider.fitt.co/podcast  Subscribe to our newsletter → insider.fitt.co/subscribe  Follow us on LinkedIn → linkedin.com/company/fittinsider    Twin Health's Website: www.twinhealth.com  Dr. Lisa Shah's LinkedIn: https://www.linkedin.com/in/lisa-shah-4a297b19/ Twin Health's Facebook: https://www.facebook.com/twinhealthusa/ Twin Health's Instagram: https://www.instagram.com/twinhealthusa Twin Health's LinkedIn: https://www.linkedin.com/company/twinhealth/   -   The Fitt Insider Podcast is brought to you by EGYM. Visit EGYM.com  to learn more about its smart workout solutions for fitness and health facilities.   Fitt Talent: https://talent.fitt.co/  Consulting: https://consulting.fitt.co/  Investments: https://capital.fitt.co/    Chapters: (00:00) Introduction (02:00) Digital twin technology explained and healthcare applications (04:15) Why digital twin technology is finally possible now (08:30) Turning 3K daily data points into actionable guidance (11:15) Balancing digital twin AI with human care team support (15:00) Clinical outcomes and New England Journal of Medicine study (19:15) Root cause solutions vs symptom management (21:15) Scaling from employer benefits to consumer prevention (24:00) Value-based care approach vs. direct-to-consumer model (27:15) Digital twin complexity across multiple health systems (31:00) Building trust through real-time feedback loops (33:00) Agentic AI applications in healthcare delivery (37:42) Future roadmap (40:15) Conclusion  

Sasha K. Shillcutt, MD, MS, FASE is a tenured and endowed Professor and the Vice Chair of Strategy in the Department of Anesthesiology at the University of Nebraska Medical Center. She is a double-boarded cardiac anesthesiologist and is also CEO & Founder of Brave Enough, a community of thousands of women in healthcare where she teaches women how to advance through courses, coaching, and events. She leads conferences and retreats for professional women and is a certified coach for women leaders. Sasha is a well-published researcher in anesthesiology and gender equity, best-selling author, and international speaker. She speaks frequently to executives and leaders on the topics of professional resilience and wellbeing. Her TEDx talk titled Resilience: The Art of Failing Forward has been viewed by thousands of people. Her writing has been published in both the New England Journal of Medicine and JAMA. Her first book, Between Grit and Grace: How to be Feminine and Formidable, has sold thousands of copies and her second book, Brave Boundaries, is an international best seller. Her podcast, The Brave Enough Show, has over 315K downloads & she has coached hundreds of women leaders to thrive. Some of the topics we discussed were:Taking care of everybody else without leaving room for yourselfPrioritizing your well-being by setting aside time just for youHow to set up boundariesWhat boundaries really areSetting up boundaries in your personal life (like with your partner, children, parents, siblings, friends, etc.)Communicating your boundaries with othersSetting up boundaries at workAnd more!Learn more about me or schedule a FREE coaching call:https://www.joyfulsuccessliving.com/Join the Voices of Women Physicians Facebook Group:https://www.facebook.com/groups/190596326343825/ Connect with Dr. Shilcutt: WEBSITEINSTAGRAMFACEBOOKTWITTERLINKEDIN 

Is your smartwatch just a fun gadget, or a serious medical device?  In this episode, Jonathan Wolf is joined by Dr. Malcolm Findlay, a leading consultant cardiologist, to explore the powerful health data available on your wrist. They decode the most misunderstood metric, Heart Rate Variability (HRV), and reveal how your wearable can provide clinical-grade insights into your heart's health. Dr. Findlay explains the counter-intuitive science behind HRV — why more ‘wobble' in your heartbeat is a sign of good health — and breaks down the two opposing nervous systems that control it. He shares the latest on how these devices can accurately detect serious conditions like atrial fibrillation and why he, as a cardiologist, trusts the ECG function on a consumer smartwatch to make diagnoses. For listeners who track their own data, this episode is a practical guide to what your numbers actually mean. Dr. Findlay explains how to interpret your personal HRV trends, what constitutes a significant change, and when you should use the ECG feature. He also debunks common myths about heart rate zones, revealing the level of exercise intensity that truly benefits your long-term health. The episode concludes with an empowering look at how this technology is shifting control into our own hands. Can a simple alert from your watch really help prevent a catastrophic event like a stroke? Discover which metrics matter most and how to use them to guide your wellness journey.

In this episode of Quah (Q & A), Sal, Adam & Justin coach four Pump Heads via Zoom. Mind Pump Fit Tip: 6 Ways to Destroy Your Testosterone. (2:38) Classic bad dad mistake. (26:56) The dangers of daily plastic exposure for kids. (29:45) Net positive or negative with these GLP-1 weight-loss drugs. (35:13) The more you know. (38:40) Shout out to @mdmotivator on Instagram. (42:01) Stay hydrated out there! (44:06) Billionaire chat.  (46:01) The grass-fed market is exploding! (51:23) #ListenerLive question #1 – Do you have any go-to methods or overlooked strategies for improving grip strength in the general population clients? (53:24) #ListenerLive question #2 – I am starting to get bored in the gym and want a new workout routine to switch things up.  Can you point me in the direction of something that would challenge me and still be fun for me to do? (1:03:37) #ListenerLive question #3 – I'd love to follow up on your first round of advice and get your guidance on breaking through this plateau so I actually look different next year. (1:12:18) #ListenerLive question #4 – Any advice on how I should train when I've been dealing with a chronic injury? (1:23:01) Related Links/Products Mentioned Ask a question to Mind Pump, live! Email: live@mindpumpmedia.com Get your free Sample Pack with any “drink mix” purchase! Find your favorite LMNT flavor or share it with a friend. Try LMNT risk-free. If you don't like it, give it away to a salty friend and we'll give you your money back, no questions asked! Visit DrinkLMNT.com/MindPump Visit Butcher Box for this month's exclusive Mind Pump offer!  ** Available for a limited time, a curated box pre-filled with Mind Pump's favorite cuts — no guesswork! Butcher Box members who sign up through Mind Pump will receive: $20 OFF their first box, Free chicken breast, ground beef, OR salmon in every box for a whole year! ** Flash Sale: MAPS Performance 50% off! ** Code ATHLETE50 at checkout. ** Mind Pump Store The Link Between Sleep and Testosterone Effect of partial and total sleep deprivation on serum testosterone in healthy males: a systematic review and meta-analysis Examining the effects of calorie restriction on testosterone concentrations in men: a systematic review and meta-analysis Mind Pump #2690: The NEW DIET Everyone Is Using For Fat Loss How a sedentary lifestyle reduces testosterone levels in men Correlation between serum zinc and testosterone Cortisol and testosterone dynamics following exhaustive endurance exercise Childhood plastic exposure could be fueling obesity, infertility, and asthma Lilly's oral GLP-1, orforglipron, demonstrated meaningful weight loss and cardiometabolic improvements in complete ATTAIN-1 results published in The New England Journal of Medicine Ozempic's hidden pregnancy risk few women know about A Runner Shattered the Stroller Mile World Record Baby strollers for Rolls-Royce Cullinan In Memoriam: The 31 Billionaires Who Died Over The Past Year Visit Luminose by Entera for an exclusive offer for Mind Pump listeners! ** Promo code MPM at checkout for 10% off their order or 10% off their first month of a subscribe-and-save. ** Mind Pump #2659: Eight Ways to Build a Crushing Grip & Strong Forearms & More (Listener Live Coaching) MAPS Prime Pro Webinar Trainer Bonus Series Episode 3: Assessments That Sell Training Mind Pump Podcast – YouTube Mind Pump Free Resources People Mentioned

These diseases - West Nile Virus, Lyme disease, and Rocky Mountain Spotted Fever - are named for the places where outbreaks happened. But they're also all things you get from being bitten by mosquitoes or ticks. Research: Balasubramanian, Chandana. “Rocky Mountain Spotted Fever (RMSF): The Deadly Tick-borne Disease That Inspired a Hit Movie.” Gideon. 9/1/2022. https://www.gideononline.com/blogs/rocky-mountain-spotted-fever/ Barbour AG, Benach JL2019.Discovery of the Lyme Disease Agent. mBio10:10.1128/mbio.02166-19.https://doi.org/10.1128/mbio.02166-19 Bay Area Lyme Foundation. “History of Lyme Disease.” https://www.bayarealyme.org/about-lyme/history-lyme-disease/ Caccone, Adalgisa. “Ancient History of Lyme Disease in North America Revealed with Bacterial Genomes.” Yale School of Medicine. 8/28/2017. https://medicine.yale.edu/news-article/ancient-history-of-lyme-disease-in-north-america-revealed-with-bacterial-genomes/ Chowning, William M. “Studies in Pyroplasmosis Hominis.("Spotted Fever" or "Tick Fever" of the Rocky Mountains.).” The Journal of Infectious Diseases. 1/2/1904. https://archive.org/details/jstor-30071629/page/n29/mode/1up Elbaum-Garfinkle, Shana. “Close to home: a history of Yale and Lyme disease.” The Yale journal of biology and medicine vol. 84,2 (2011): 103-8. Farris, Debbie. “Lyme disease older than human race.” Oregon State University. 5/29/2014. https://science.oregonstate.edu/IMPACT/2014/05/lyme-disease-older-than-human-race Galef, Julia. “Iceman Was a Medical Mess.” Science. 2/29/2012. https://www.science.org/content/article/iceman-was-medical-mess Gould, Carolyn V. “Combating West Nile Virus Disease — Time to Revisit Vaccination.” New England Journal of Medicine. Vol. 388, No. 18. 4/29/2023. https://www.nejm.org/doi/full/10.1056/NEJMp2301816 Harmon, Jim. “Harmon’s Histories: Montana’s Early Tick Fever Research Drew Protests, Violence.” Missoula Current. 7/20/2020. https://missoulacurrent.com/ticks/ Hayes, Curtis G. “West Nile Virus: Uganda, 1937, to New York City, 1999.” From West Nile Virus: Detection, Surveillance, and Control. New York : New York Academy of Sciences. 2001. https://archive.org/details/westnilevirusdet0951unse/ Jannotta, Sepp. “Robert Cooley.” Montana State University. 10/12/2012. https://www.montana.edu/news/mountainsandminds/article.html?id=11471 Johnston, B L, and J M Conly. “West Nile virus - where did it come from and where might it go?.” The Canadian journal of infectious diseases = Journal canadien des maladies infectieuses vol. 11,4 (2000): 175-8. doi:10.1155/2000/856598 Lloyd, Douglas S. “Circular Letter #12 -32.” 8/3/1976. https://portal.ct.gov/-/media/departments-and-agencies/dph/dph/infectious_diseases/lyme/1976circularletterpdf.pdf Mahajan, Vikram K. “Lyme Disease: An Overview.” Indian dermatology online journal vol. 14,5 594-604. 23 Feb. 2023, doi:10.4103/idoj.idoj_418_22 MedLine Plus. “West Nile virus infection.” https://medlineplus.gov/ency/article/007186.htm National Institute of Allergy and Infectious Disease. “History of Rocky Mountain Labs (RML).” 8/16/2023. https://www.niaid.nih.gov/about/rocky-mountain-history National Institute of Allergy and Infectious Disease. “Rocky Mountain Spotted Fever.” https://www.niaid.nih.gov/diseases-conditions/rocky-mountain-spotted-fever Rensberger, Boyce. “A New Type of Arthritis Found in Lyme.” New York Times. 7/18/1976. https://www.nytimes.com/1976/07/18/archives/a-new-type-of-arthritis-found-in-lyme-new-form-of-arthritis-is.html?login=smartlock&auth=login-smartlock Rucker, William Colby. “Rocky Mountain Spotted Fever.” Washington: Government Printing Office. 1912. https://archive.org/details/101688739.nlm.nih.gov/page/ Sejvar, James J. “West Nile virus: an historical overview.” Ochsner journal vol. 5,3 (2003): 6-10. https://pmc.ncbi.nlm.nih.gov/articles/PMC3111838/ Smithburn, K.C. et al. “A Neurotropic Virus Isolated from the Blood of a Native of Uganda.” The American Journal of Tropical Medicine and Hygiene. Volume s1-20: Issue 4. 1940. Steere, Allen C et al. “The emergence of Lyme disease.” The Journal of clinical investigation vol. 113,8 (2004): 1093-101. doi:10.1172/JCI21681 Steere, Allen C. et al. “Historical Perspectives.” Zbl. Bakt. Hyg. A 263, 3-6 (1986 ). https://pdf.sciencedirectassets.com/281837/1-s2.0-S0176672486X80912/1-s2.0-S0176672486800931/main.pdf World Health Organization. “West Nile Virus.” 10/3/2017. https://www.who.int/news-room/fact-sheets/detail/west-nile-virus Xiao, Y., Beare, P.A., Best, S.M. et al. Genetic sequencing of a 1944 Rocky Mountain spotted fever vaccine. Sci Rep 13, 4687 (2023). https://doi.org/10.1038/s41598-023-31894-0 See omnystudio.com/listener for privacy information.

Stress isn't just something to “manage” — it's a signal, a teacher, and often, an invitation to look deeper at our health, our choices, and our lives. In this solo episode, Darin reframes stress not as an enemy, but as a dashboard light pointing toward misalignments in our nervous system, environment, relationships, and purpose. Drawing on science, practical tools, and personal insight, Darin reveals how layered stress silently drains our vitality — and how to transform it into an ally for growth, healing, and deeper contentment. Whether it's hidden trauma, toxic environments, unresolved conflict, or the modern distractions constantly pulling at our attention, Darin lays out a roadmap to stop the leaks and reclaim the energy already within you. This episode is a powerful reminder: stress isn't the end of the story — it's the beginning of awareness, safety, and a super life.     What You'll Learn in This Episode [00:00] Introduction to the Super Life podcast [03:27] Why stress might not be your enemy [04:17] Stress as an ally: the signals it gives us about misalignment [04:32] The dashboard light metaphor: how stress reveals hidden issues [05:28] The illusion of “no choice” and the infinite possibilities always available [06:12] Global stress statistics and why most people underestimate their stress load [07:23] Hidden stress revealed through heart rate variability and physiology [08:23] Layered stress: how sleep, exercise, and poor choices compound each other [09:25] Safety vs. calm — why your nervous system craves safety first [10:15] Trauma and the unconscious mind: how old wounds drive our stress response [11:54] Inner narratives and negative self-talk as hidden stress multipliers [12:22] The role of community and your social field in stress and resilience [13:53] Relationships, honesty, and how your circle shapes your energy [14:55] Why boundaries around media and politics are vital for mental clarity [17:42] Finding micro-purpose when life feels overwhelming [18:52] Environmental layers of stress — light, air, and clutter [19:15] The existential layer: stress from living without service or purpose [20:12] Stress as a risk amplifier — how it undermines healing and health [20:55] The deeper truth of safety, connection, and higher power [23:00] Practical tools: breathing, grounding, nature, and conscious choices [24:01] Trauma reframed: not a problem, but a protector at the time [25:25] Lessons from Peter Levine and wild animals: releasing trauma physically [26:04] Questions to ask trauma: “What are you protecting me from?” [26:56] Stress as a multiplier of aging, disease, and poor outcomes [29:20] Why stress isn't a single cause — it's layered and chronic [30:18] Anti-stress strategies: circadian rhythm, nature, and gratitude [31:49] Energy leaks to avoid: clutter, poor food, scrolling, bad boundaries [32:22] What matters most: service, contribution, and alignment [33:28] Final toolkit: breathwork, movement, nature, sleep, and gratitude [34:38] The deeper invitation: step into sovereignty and live your SuperLife     Thank You to Our Sponsors: Manna Vitality: Go to mannavitality.com/  or use code DARIN20 for 20% off your order. Bite Toothpaste: Go to trybite.com/DARIN20 or use code DARIN20 for 20% off your first order.     Find More from Darin Olien: Instagram: @darinolien Podcast: SuperLife Podcast Website: superlife.com Book: Fatal Conveniences Check out my podcast with Dr. Amy Abbington     Key Takeaway “Stress is not the enemy. It's a dashboard light — a teacher showing you where you're out of alignment. When you reframe stress, you reclaim your energy and create space for healing, safety, and the joy of living a super life.”     Bibliography (selected, peer-reviewed) Sources: Gallup Global Emotions (2024); Gallup U.S. polling (2024); APA Stress in America (2023); Natarajan et al., Lancet Digital Health (2020); Orini et al., UK Biobank (2023); Martinez et al. (2022); Leiden University (2025). Cohen S, Tyrrell DA, Smith AP. Psychological stress and susceptibility to the common cold. N Engl J Med.1991;325(9):606–612. New England Journal of Medicine Cohen S, et al. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proc Natl Acad Sci USA. 2012;109(16):5995–5999. PNAS Kiecolt-Glaser JK, et al. Slowing of wound healing by psychological stress. Lancet. 1995;346(8984):1194–1196. The Lancet Kiecolt-Glaser JK, et al. Hostile marital interactions, proinflammatory cytokine production, and wound healing.Arch Gen Psychiatry. 2005;62(12):1377–1384. JAMA Network Tawakol A, et al. Relation between resting amygdalar activity and cardiovascular events. Lancet.2017;389(10071):834–845. The Lancet Epel ES, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA.2004;101(49):17312–17315. PNAS McEwen BS, Stellar E. Stress and the individual: mechanisms leading to disease. Arch Intern Med.1993;153(18):2093–2101. PubMed McEwen BS, Wingfield JC. Allostasis and allostatic load. Ann N Y Acad Sci. 1998;840:33–44. PubMed Felitti VJ, et al. Relationship of childhood abuse and household dysfunction to many leading causes of death in adults (ACE Study). Am J Prev Med. 1998;14(4):245–258. AJP Mon Online Edmondson D, et al. PTSD and cardiovascular disease. Ann Behav Med. 2017;51(3):316–327. PMC Afari N, et al. Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis.Psychosom Med. 2014;76(1):2–11. PMC Goyal M, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357–368. PMC Qiu Q, et al. Forest therapy: effects on blood pressure and salivary cortisol—a meta-analysis. Int J Environ Res Public Health. 2022;20(1):458. PMC Laukkanen T, et al. Sauna bathing and reduced fatal CVD and all-cause mortality. JAMA Intern Med.2015;175(4):542–548. JAMA Network Zureigat H, et al. Physical activity lowers CVD risk by reducing stress-related neural activity. J Am Coll Cardiol.2024;83(16):1532–1546. PMC Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med.2010;7(7):e1000316. PMC Chen Y-R, Hung K-W. EMDR for PTSD: meta-analysis of RCTs. PLoS One. 2014;9(8):e103676. PLOS Hoppen TH, et al. Network/pairwise meta-analysis of PTSD psychotherapies—TF-CBT highest efficacy overall.Psychol Med. 2023;53(14):6360–6374. PubMed van der Kolk BA, et al. Yoga as an adjunctive treatment for PTSD: RCT. J Clin Psychiatry. 2014;75(6):e559–e565. PubMed Kelly U, et al. Trauma-center trauma-sensitive yoga vs CPT in women veterans: RCT. JAMA Netw Open.2023;6(11):e2342214. JAMA Network Bentley TGK, et al. Breathing practices for stress and anxiety reduction: components that matter. Behav Sci (Basel). 2023;13(9):756.