Podcasts about new england journal

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

Après le cerveau, les géants de la tech s'attaquent désormais… à l'œil. Tandis qu'Elon Musk tente de soigner des pathologies neurologiques grâce à Neuralink, un ancien partenaire du milliardaire, Max Hodak, s'est lancé un défi tout aussi ambitieux : redonner la vue aux personnes atteintes de DMLA, la dégénérescence maculaire liée à l'âge, principale cause de cécité dans le monde. Et les premiers résultats sont spectaculaires.Une étude publiée dans le New England Journal of Medicine dévoile les conclusions d'un essai clinique mené sur 38 patients âgés de plus de 60 ans, tous atteints de DMLA avancée aux deux yeux. Chez 32 d'entre eux, l'implant a pu être testé sur une durée d'un an : 26 participants ont retrouvé une vision partielle, soit un taux de réussite de plus de 80 %. L'image perçue reste floue et en noir et blanc, mais elle permet de distinguer les formes et les mouvements — un bond de géant pour des patients auparavant aveugles.L'appareil en question est une minuscule puce de 2 millimètres sur 2, composée de micropanneaux photovoltaïques. Inséré chirurgicalement dans la rétine, il remplace les cellules mortes responsables de la cécité. Associé à des lunettes connectées, l'implant capte les images de l'environnement grâce à un faisceau de lumière infrarouge, puis les transforme en signaux électriques transmis au nerf optique. Le cerveau reconstitue alors une image — une prouesse qui imite le fonctionnement naturel de l'œil humain.Ce dispositif révolutionnaire a été mis au point par Science Corporation, la start-up fondée par Max Hodak après son départ de Neuralink. L'entreprise s'est appuyée sur les travaux de la société française Pixium Vision, pionnière dans les implants rétiniens, dont elle a racheté la technologie en 2024. Un mariage entre biologie et microélectronique qui ouvre la voie à une nouvelle génération de prothèses sensorielles. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

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 

A pivotal European clinical trial of a new electronic eye implant has seen remarkable results.  The study, published in the New England Journal of Medicine, showed 84% of participants were able to read letters, numbers and words using prosthetic vision through an eye that had previously lost its sight due to the untreatable progressive eye condition, geographic atrophy with dry age-related macular degeneration (AMD).  RNIB Connect Radio's Toby Davey was joined by Mahi Muqit, senior vitreoretinal consultant at Moorfields Eye Hospital and the Institute of Ophthalmology at University College London who lead the UK arm of the trial to explain more about the results of the study and the technology used too. There is more information about this new pioneering eye device on the following pages of the Moorfields Eye Hospital website which also includes a link to register on the Moorfields research portal, ROAM which will give you access to current and future research - https://www.moorfields.nhs.uk/about-us/news-and-blogs/news/pioneering-eye-device-restores-reading-vision-to-blind-eyes (Image shows the RNIB Connect Radio logo. On a white background ‘RNIB' written in bold black capital letters and underlined with a bold pink line. Underneath the line: ‘Connect Radio' is written in black in a smaller font)

Die Themen in den Wissensnachrichten: +++ Technische Lösung bei unheilbarer Augenkrankheit +++ Erstmals Stechmücken in Island entdeckt +++ Bestimmte Gene könnten anfällig machen für Cannabis-Konsum +++**********Weiterführende Quellen zu dieser Folge:Subretinal Photovoltaic Implant to Restore Vision in Geographic Atrophy Due to AMD, New England Journal of Medicine, 20.10.2025Mosquitoes arrive in Iceland, RUV, 20.10.2025Genome-wide association studies of lifetime and frequency of cannabis use in 131,895 individuals, Molecular Psychiatry, 13.10.2025Invariant HVC size in female canaries singing under testosterone: Unlocking function through neural differentiation, not growth, PNAS, 20.10.2025Oomycetes manipulate plant innate immunity through galacturonide oxidases, Nature Communications, 20.10.2025Alle Quellen findet ihr hier.**********Ihr könnt uns auch auf diesen Kanälen folgen: TikTok und Instagram .

A tuberculose do sistema nervoso central está entre as formas mais graves e desafiadoras da doença. Mesmo tratada, pode cursar com alta mortalidade e deixar sequelas importantes. Neste episódio, William Dunke e João Prats recebem o infectologista Leonardo Torioni, especialista em neuroinfectologia, para discutir o diagnóstico, a fisiopatologia e o manejo da meningite tuberculosa. A conversa aborda a relação com o HIV, os principais achados clínicos e laboratoriais e os desafios diagnósticos — do líquor à biologia molecular, passando por imagem, cultura e escore diagnóstico. Também são discutidos os pilares terapêuticos, o papel do corticoide, a importância do início precoce do tratamento e os limites da abordagem empírica diante de exames subótimos.▶️ Confira o episódio completo e aprofunde seu raciocínio clínico sobre uma das manifestações mais complexas e fatais da tuberculose.Referências do episódioReferência citada aos 02:19GLOBAL BURDEN OF DISEASE STUDY 2019. Global, regional, and national burden of meningitis, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology, v. 20, n. 11, p. 918–931, 2021. doi:10.1016/S1474-4422(21)00224-7.Referência citada aos 24:15WORLD HEALTH ORGANIZATION (WHO). Xpert MTB/RIF and Xpert MTB/RIF Ultra tests for the diagnosis of tuberculosis and rifampicin resistance. Geneva: WHO, 2021. Disponível em: https://www.who.int/publications/i/item/9789241550093.Referência citada aos 33:19THWAITES, G. E. et al. Diagnostic score for tuberculous meningitis: a systematic individual patient data meta-analysis. Clinical Infectious Diseases, v. 77, n. 8, p. 1172–1184, 2023. doi:10.1093/cid/ciad120.Referência citada aos 43:31TOROK, M. E. et al. Adjunctive dexamethasone in tuberculous meningitis. The New England Journal of Medicine, v. 351, n. 17, p. 1741–1751, 2004. doi:10.1056/NEJMoa040573.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog You will learn: What holds up new treatments for diseases and conditions How long the FDA sits on a known safe medical medication before it is released to the public. Why safe and effective drugs are NOT approved by the FDA Why doctors are forced to use medications off label How you can help During my 44 years of medical practice, I have encountered conditions for which there is no approved medication or surgical treatment available as recognized by the American College of OBGYN or the FDA. This situation can present challenges both for physicians managing these patients and for individuals seeking relief from their symptoms. This issue is not often addressed on Dr Oz, in the news, or at medical conferences. For many conditions, physicians wait for the development of approved medications or treatments, and in the meantime may inform patients that there is currently no treatment or cure available. Some doctors may attribute a patient's concerns to aging, stating that it is a universal experience. While this may be accurate, such explanations may not provide comfort to patients seeking solutions to their symptoms. This lack of helpful guidance can discourage individuals from seeking medical care when they feel their concerns are not acknowledged. This seems to result from insurance companies prioritizing cost savings by minimizing patient care.  Every year insurance companies decrease what they pay doctors for their services, while their expenses go up, and the Government requires more and more work behind the scenes like HIPPA, OSHA, and Clia requirements that costs more to deliver the same service.  If you have a problem with the time your doctor spends with you then blame the insurance companies whose profits rise every year…Soon doctors will do what I do and only take cash.  The practice of medicine is not working in a free market. While insurance limits the prescriptions of medication to those meds that are FDA Approved, the FDA and medical specialty colleges often delay approval of new, low-risk treatments for up to 20 years after their effectiveness is demonstrated. This lengthy process should be reconsidered to treat people who are ill and suffering, now. There is plenty of research in the medical journals that explain the safety of new and effective treatments that can save peoples' lives that are not FDA approved yet. The FDA is not interested in expediting the release of medication/ devices quickly to those people who need help now. They drag out the testing of a medicine that has been effective for years and may or may not approve it. On the flip side they have approved many drugs that later are found to have severe side effects, and they just change the warnings on the medication inserts. They don't take them off the market except in severe cases. Drugs that have worked treating patients successfully are being used but are not FDA approved. These “grandfathered drugs” don't need to go through the testing that new drugs go through because they work with few well-known risks. I use many if these medications because they are inexpensive for my patients and are often more effective than new meds for the same problem. One of the drugs that the FDA has not had to approve is Armour Thyroid, a natural thyroid replacement. My experience with treatments not approved by the FDA Armour Thyroid: Armour Thyroid (AT) has been prescribed by doctors to replace thyroid hormones for about 100 years. It is natural, made from Pig thyroid. It only comes from “medical Pigs” that are raised for medical purposes.  We use medical pigs for skin grafts, and other parts of the pig to treat human diseases like heart valve replacements.  Armour Thyroid is composed of the four thyroid hormones that humans make: T4, T3, T2, T1. The synthetic thyroid replacement, Synthroid/levothyroxine is only T4.  The active form of thyroid is T3, and it requires an enzyme to convert T4 into T3. If a person can't convert T4 into active T3 then nothing improves except the blood levels of T4, and TSH. The majority of women cannot convert T4 into T3. Therefore, if they take Synthroid or levothyroxine and their doctor only checks their TSH level and not the level of free T3 and free T4 to see if the Thyroid is working, then women are told that they are healed, yet they know they are not because none of their low thyroid symptoms are resolved. When this happens, doctors tell female patients that it is all in their heads and dismiss us when we tell them we are not cured with this synthetic T4 medication. Yet Synthroid is a chemical, and AT is natural from medical pigs, so the FDA is trying to Bann the only drug that has successfully treated millions of women. PS. Synthroid was not tested on women like many other drugs that were passed through the FDA before 2014! If you think this is a small problem, think again. Thyroid hormones are vital to human life, and the thyroid gland requires Iodine in the diet. The Midwest US has no Iodine in the soil or water. Therefore, this area is overburdened with hypothyroidism. I have been on AT for 50 years without complication and I have prescribed it thousands of times ever since I went into private practice.  AT works to relieve the symptoms of hypothyroidism for women and men, and it works better for women that the “new” drug Synthroid/levothyroxine, which is FDA approved. You ask how could the FDA approve a drug that doesn't successfully treat women? It is because Synthroid was not tested on women!  Until 2014 the FDA did not test women in the required drug trials.  AT works for us (women), Levothyroxine does not. Now the FDA wants to ban AT. It is not approved because it was around for decades before they started testing medications like they do now, and the history of successful treatment should stand on its own merit! Example 2: Bio-Identical Hormones BIH:  BIHs had not been approved by the FDA until recently and there was no announcement that they are now approved for women who have hormone deficiency symptoms or postmenopausal symptoms. Most doctors and women who have been afraid of the only hormones that can help them, bioidentical hormones, haven't yet been told that NOW, FINALLY the medical colleges and the FDA finally have quietly approved BI hormones.  There are no pure estradiol and pure testosterone pellets that are made by a drug company for women. My patients get their estradiol and testosterone pellets from a compounding pharmacy.  I have been prescribing BIH since 1985 without FDA approval because the oral estrogen formulations that were available at pharmacies caused weight gain and put women at high risk for blood clots. Non-oral BI hormones have fewer risks than FDA approved estrogens.  I waited more than 45 years for the FDA to approve BI hormones for treatment of women.  All those women in the last 45 years who were taking FDA approved estradiol and those who couldn't tolerate them have been harmed by FDA goals of never approving compounded or bio-identical hormones.  The delay has harmed 50% of American women. Example #3 Devices for Weight Loss I was involved in the discovery and testing of a unique device that stimulated acupuncture points with a TENS-unit-type patch connected to your cell phone for easy adjustment of your hunger or “fullness”. The FDA requires testing to approve any new device so the group of investors I was part of had to invest thousands of dollars for a device we already knew worked. The FDA told the investigators of all new devices who they should test, who they can't have in the study, and how long the testing should take. I found their parameters for the study of this device to be unrealistic. The women in our test group could not be taking hormones of any kind (birth control, ERT, HRT), and could not be on antidepressants, could not have diabetes or insulin resistance or be on any drug that assisted in weight loss. These women subjects had to be a certain BMI (level of obesity) and had to be tested repeatedly with weight and body composition measurements None of my patients who needed weight loss could participate.  Most GYN patients are on some medication or supplement, so the FDA made this study of our device so narrow that REAL WOMEN weren't tested! Sadly, we lost many women in the control group from the study because they were NOT losing weight while the ones on the device were obviously dropping pounds, so we had trouble maintaining test subjects. The testing phase of this simple device took 7 years! Our device works and no one will ever know about it or be able to use this non-medicinal weight loss device because when the FDA rejects your device you will be breaking the law if you produce and sell it directly to the public. It has no side effects or dangers..it just controls the amount you eat with stimulation of an acupuncture point. There are many ways to change this situation, and it takes years and billions of dollars to change the whole system of bringing treatments to patients quickly.  I'm afraid I won't see a revolution of the way we bring medicines and devices to market during my lifetime. Currently there is a 17-year delay between proving a drug or device works for a particular illness or condition and when it becomes available to doctors and patients. So what do we do in the meantime?  I seek treatments for patients who are unresponsive to traditional medicine by reading journals like Life Extension, that inform doctors and patients alike about new effective solutions for common medical complaints and diseases that the FDA has ignored or stymied with endless drug trials.  Life Extension Magazine highlights studies on new medications for diseases without an FDA approved solution and publicizes diagnostic tests often overlooked by mainstream publications because they are not yet FDA approved. The medical journals I read (New England Journal of Medicine, JAMA, Menopause, Metabolism and Endocrinology, Journal of Age management, to name a few) offer treatments for orphan diseases or even common problems that haven't been blessed by the FDA. It takes an average of 17 years from the culmination of research on a new drug, test or device until it is approved for use by the public! At the end of this Blog, I will give you a link to make your voice heard by signing a petition to shorten the approval of new treatments and medications from the average of 17 years to 3 years! My patients don't have time to wait for relief, and that may be the case for you as well. If you want to do something to help, please click this link and let the FDA know how you feel. Please sign a Petition to enact an amendment to the FOOD, DRUG and COSMETIC ACT, by going to: https://age-reversal.net/fda/

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 on Perspectives, we're talking about the future of healthcare and what it means to be a better ancestor. A special article in the New England Journal of Medicine Catalyst introduces the Better Ancestor Framework—a bold new approach to transforming a healthcare system that too often has been shaped by structural racism, and instead reimagining one rooted in healing, trust, and justice for all. The article's three authors driving this work are Dr. Somava Saha, Executive Director of WE in the World, Kellie Easton, President and CEO of Action4Equity, and Kenneth Reid, Chief Operating Officer at Action4Equity. My guest on the show today is Dr. Saha. Together, they're asking a powerful question: What kind of healthcare system do we want to leave behind for future generations? During this conversation, we'll explore their new Better Ancestor Framework, the cultural wisdom that inspired it, and how it's already helping communities across the country build a fairer, more humane healthcare system.

JCO PO author Dr. Asaf Maoz at Dana-Farber Cancer Institute shares insights into article, “Causes of Death Among Individuals with Lynch Syndrome in the Immunotherapy Era.” Host Dr. Rafeh Naqash and Dr. Maoz discuss the causes of death in individuals with LS and the evolving role of immunotherapy. 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 JCOPO articles. I'm your host, Dr. Rafeh Naqash, podcast editor for JCO Precision Oncology and Associate Professor Medicine, at the OU Health Stephenson Cancer Center. Today, I'm super thrilled to be joined by Dr. Asaf Maoz, Medical Oncologist at Dana-Farber Cancer Institute, Brigham and Women's Hospital, and faculty at the Harvard Medical School, and also lead author on the JCO Precision Oncology article entitled "Causes of Death Among Individuals with Lynch Syndrome in the Immunotherapy Era." This publication will be a concurrent publication with an oral presentation at the annual CGA meeting. At the time of this recording, our guest's disclosures will be linked in the transcript. Asaf, I'm excited to welcome you on this podcast. Thank you for joining us today. Dr. Asaf Maoz: Thank you so much for highlighting our paper. Dr. Rafeh Naqash: Absolutely. And I was just talking to you that we met several years back when you were a trainee, and it looks like you've worked a lot in this field now, and it's very exciting to see that you consider JCOPO as a relevant home for some of your work. And the topic that you have published on is of significant interest to trainees from a precision medicine standpoint, to oncologists in general, covers a lot of aspects of immunotherapy. So, I'm really excited to talk to you about all of this. Dr. Asaf Maoz: Me too, me too. And yeah, I think JCOPO has great content in the area of cancer genetics and has done a lot to disseminate the knowledge in that area. Dr. Rafeh Naqash: Wonderful. So, let's get started and start off, given that we have hosts of different kinds of individuals who listen to this podcast, especially when driving from home to work or back, for the sake of making everything simple, can we start by asking you what is Lynch syndrome? How is it diagnosed? What are some of the main things to consider when you're trying to talk an individual where you suspect Lynch syndrome? Dr. Asaf Maoz: Lynch syndrome is an inherited predisposition to cancer, and it is common. So, we used to think that, or there's a general notion in the medical community that it is a rare condition, but we actually know now from multiple studies, including studies that look at the general population and do genetic testing regardless of any clinical phenotype, that Lynch syndrome is found in about 1 in 300 people in the general population. If you think about it in the United States, that means that there are over a million people living with Lynch syndrome in the United States. Unfortunately, most individuals with Lynch syndrome don't know they have Lynch syndrome at the current time, and that's where a lot of the efforts in the community are being made to help detect more individuals who have Lynch syndrome. Lynch syndrome is caused by pathogenic germline variants in mismatch repair genes, MLH1, MSH2, MSH6, or PMS2, or as a result of pathogenic variants in EPCAM that cause silencing of the MSH2 gene. Dr. Rafeh Naqash: Excellent. Thank you for that explanation. Now, one of the other things I also realized, similar to BRCA germline mutations, where you require a second hit for individuals with Lynch syndrome to have mismatch repair deficient cancers, you also require a second hit to have that second hit result in an MSI-high cancer. Could you help us understand the difference of these two concepts where generally Lynch syndrome is thought of to be cancers that are mismatch repair deficient, but that's not necessarily true for all cases as we see in your paper. Can you tease this out for us a little bit more? Dr. Asaf Maoz: Of course, of course. So, the germline defect is in one of the mismatch repair genes, and these genes are responsible for DNA mismatch repair, as their name implies. Now, in a normal cell, we think that one working copy is generally enough to maintain the mismatch repair machinery intact. What happens in tumors, as you alluded to, is that there is a second hit in the same mismatch repair gene that has the pathogenic germline variant, and that causes the mismatch repair machinery not to work anymore. And so what happens is that there is formation of mutations in the cancer cell that are not present in other cells in the body. And we know that there are specific types of mutations that are associated with defects in mismatch repair mechanisms, and those are associated a lot of times with frameshift mutations. And we have termed them ‘microsatellites'. So there are areas in the genome that have repeats, for example, you know, if you have AAAA or GAGA, and those areas are particularly susceptible to mutations when the mismatch repair machinery is not working. And so we can measure that with DNA microsatellite instability testing. But we can also get a sense of whether the mismatch repair machinery is functioning by looking at protein expression on the surface of cancer cells and by doing immunohistochemistry. More recently, we're also able to infer whether the mismatch repair machinery is working by doing next-generation sequencing and looking at many, many microsatellites and whether they have this DNA instability in the microsatellites. Dr. Rafeh Naqash: Excellent explanation. As a segue to what you just mentioned, and this reminds me of some work that one of my good friends, collaborators, Amin Nassar, whom you also know, I believe, had done a year and a half back, was published in Cancer Cell as a brief report, I believe, where the concept was that when you look at these mismatch repair deficient cancers, there is a difference between NGS testing, IHC testing, and maybe to some extent, PCR testing, where you can have discordances. Have you seen that in your clinical experience? What are some of your thoughts there? And if a trainee were to ask, what would be the gold standard to test individuals where you suspect mismatch repair deficient-related Lynch syndrome cancers? How would you test those individuals? Dr. Asaf Maoz: We do sometimes see discordance, you know, from large series, the concordance rate is very high, and in most series it's over 95%. And so from a practical perspective, if we're thinking about the recommendation to screen all colorectal cancer and all endometrial cancer for mismatch repair deficiency, I think either PCR-based testing or immunohistochemistry is acceptable because the concordance rate is very high. There are rare cases where it is not concordant, doing multiple of the tests makes sense at that time. If you think about the difference between the tests, the immunohistochemistry looks at protein expression, which is a surrogate for whether there is mismatch repair deficiency or not, right? Because ultimately, the mismatch repair deficiency is manifested in the mutations. So if the PCR does not show microsatellite instability and now NGS does not show microsatellite instability, the IHC may be a false positive. At the end of the day, the functional analysis of whether there are actually unstable microsatellites either by PCR or by NGS is what I would consider more informative. But IHC again is an excellent test and concordant with those results in over 95% of cases. Now there is also an issue of sampling. It's possible that there's heterogeneity within the tumor. We published a case in JCOPO about heterogeneity of the mismatch repair status, and that was both by immunohistochemistry, but also by PCR. So there are some caveats and interpreting these tests does require some expertise, and I'm always happy to chat with trainees or whoever has an interesting or challenging case. Dr. Rafeh Naqash: Thanks again for that very easy to understand explanation. Now going to management strategies, could you elaborate a little bit upon the neo-adjuvant data currently, or the metastatic data which I think more people are familiar with for immunotherapy in individuals with MSI-high cancers? Dr. Asaf Maoz: Yeah, that's an excellent question and obviously a very broad topic. Individuals with Lynch syndrome typically develop tumors that are mismatch repair deficient or microsatellite unstable. And we have seen over the last 15 years or so that these tumors, because they have a lot of mutations and because these mutations are very immunogenic, we have seen that they respond very well to immunotherapy. And this has been shown across disease sites and has been shown across disease settings. And for that reason, immunotherapy was approved for MSI-high or mismatch repair deficient cancer regardless of the anatomic site. It was the first tissue-agnostic approval by the FDA in 2017. And so there are exciting studies both in the metastatic setting where we see individuals who respond to immunotherapy for many years, and one could wonder whether their cancer is going to come back or not. And also in the earlier setting, for example, the Cercek et al. study in the New England Journal from Sloan Kettering, where they showed that neoadjuvant immunotherapy can cause durable responses for rectal cancer that is mismatch repair deficient. And in that series, the patients did not require surgery or radiation, which is standard of care for rectal cancer otherwise. And there's also exciting data in the adjuvant space, as was presented in ASCO by Dr. Sinicrope, the ATOMIC study, and many more efforts to bring immunotherapy into the treatment landscape for individuals with MSI-high cancer, including individuals with Lynch syndrome. Dr. Rafeh Naqash: A lot of activity, especially in the neo-adjuvant and adjuvant space over the last two years or so. Now going to the actual reason why we are here is your study. Could you tell us why you looked at this idea of patients who had Lynch syndrome and died, and the reasons for their death? What was the thought that triggered this project? Dr. Asaf Maoz: As we were talking about, we now know that immunotherapy really has changed the treatment landscape for individuals with Lynch syndrome, and that most cancers that individuals with Lynch syndrome do have this mismatch repair deficiency. But we also know that individuals with Lynch syndrome can develop tumors that do not have mismatch repair deficiency, and we call them mismatch repair proficient or microsatellite stable. And there was a series from Memorial Sloan Kettering showing that in colorectal cancer, about 10% of the tumors that individuals with Lynch syndrome developed did not have mismatch repair deficiency. In addition to that, we anecdotally saw that some of our patients with Lynch syndrome died of causes that were not mismatch repair deficient tumors. We wanted to see how that has changed since immunotherapy was approved in a tissue-agnostic manner, meaning that we could look at this regardless of where the cancer started, because we would anticipate that if the tumor was mismatch repair deficient, the patient would be able to access immunotherapy as standard of care. Dr. Rafeh Naqash: Thank you. And then you looked at different aspects of correlations with regards to individuals that had an MSI-high cancer with Lynch syndrome or an MSS cancer with Lynch syndrome. Could you elaborate on some of the important findings that you identified as well as some of the unusual findings that perhaps we did not know about, even though the sample size is limited, but what were some of the unique things that you did identify through this project? Dr. Asaf Maoz: The first question was what cause is leading to death in individuals with Lynch syndrome? And we had 54 patients that we identified that had died since the approval of immunotherapy in 2017, 44 of which died of cancer-related causes. And when we looked at cancer-related causes of death, we wanted to know how many of those were due to mismatch repair deficient tumors versus mismatch repair proficient tumors or MS-stable tumors. And we found, somewhat surprisingly, that 43% of patients in our cohort actually died of tumors that were microsatellite stable or mismatch repair proficient, meaning of tumors that are not typically associated with Lynch syndrome. This is not entirely surprising as a cause of death because we know that immunotherapy does not typically work for tumors that are microsatellite stable. And so in the metastatic setting, there are much less cases of durable remissions with treatment. But it was helpful to have that figure as an important benchmark. There are previous studies about causes of death in Lynch syndrome, and particularly from the Prospective Lynch Syndrome Database in Europe. Those have provided really important information about cause of death by cancer site, but they typically don't have mismatch repair status and are more difficult to interpret in that regard. They also don't include a large number of individuals who have PMS2 Lynch syndrome, which is the most common, but least penetrant form of Lynch syndrome. Dr. Rafeh Naqash: As far as the subtype of pathogenic germline variants is concerned, did you notice anything unusual? And I've always had this question, and you may know more about this data, is: In the bigger context of immunotherapy, does the type of the pathogenic germline variant for Lynch syndrome associated MSI-high cancers, does that impact or have an association with the kind of outcomes, how soon a cancer progresses or how many exceptional responders perhaps with MSI-high cancers actually have a certain specific pathogenic germline variant? Dr. Asaf Maoz: That's an excellent question, and certainly we need more data in that space. We know that the type of germline mutation, or the gene in which there is a germline pathogenic variant, determines to a large degree the cancer risk, right? So we know that individuals who have germline pathogenic variants in MLH1 or MSH2 have a much higher colorectal cancer risk than, for example, PMS2. We know that for PMS2, the risks are more limited to colorectal and endometrial, and may be lower risk of other cancers. We also know that, you know, the spectrum of disease may change based on the pathogenic germline variants. For example, individuals who have MSH2 associated Lynch syndrome have more risk of additional cancers in other organs like the urinary tract and other less common Lynch-associated tumors. The question about response to therapy is one where we have much less information. There are studies that are trying to assess this, but I don't think the answer is there yet. Some of the non-clinical data looks at how many mutations there are based on the pathogenic variant and what the nature of those mutations are, whether they're more frameshift or others. But I think we still need more clinical data to understand whether the response to immunotherapy differs. It's also complicated by the fact that the immunotherapy landscape is changing, especially in the metastatic setting, now with the approval of combination ipilimumab and nivolumab for first-line treatment of colorectal cancer that is microsatellite unstable. But in our study, we did find that, as you would expect, there is an enrichment in MS-stable cancers among those with PMS2 Lynch syndrome. Again, our denominator is those who died, right? So this is not the best way to look at the question whether this is overall true, that is more addressed by the study that Sloan Kettering published. But we do see, as we would anticipate, that there are more microsatellite stable cancers among those with PMS2 Lynch syndrome that died. Dr. Rafeh Naqash: A lot to uncover there for sure. This study and perhaps some of the other work that you're doing is slowly advancing our understanding of some of these concepts. So I'd like to shift gears to a couple of provocative questions that I generally like to ask. The first is, in your opinion, and you may or may not have data to back this up, which is okay, and that's why we're having a conversation about it. In your opinion, do you think the type or the quality of the neoantigen is different based on the pathogenic germline variant and a Lynch syndrome associated MSI-high cancer? Dr. Asaf Maoz: I think there are some data out there that, you know, I can't cite off the top of my mind, but there are some data out there that suggest that that may be the case. I think the key question is the quality, right? I think that whether these differences that are found on a molecular level also translate to a clinical difference in response is something that is unknown at this moment. Some people hypothesize that if the tumor has less neoantigens, there's less of a response to immunotherapy. But I think we really need to be careful before making those assertions on a clinical level. I do think it's a really important question that needs to be answered, among others because, you know, in the colorectal space, for example, where we have both the option of doing ipilimumab with nivolumab and the option of doing pembrolizumab, we don't really know which patients need the CTLA-4 blockade versus which patients can receive PD-1 blockade alone and avoid the potential excess toxicity of the CTLA-4 blockade. There are a lot of interesting questions there that still need to be answered. And of course, individuals with Lynch syndrome are just a fraction of those individuals who have MSI-high cancer. So there's also the question about whether non-Lynch syndrome associated MSI-high cancer responds differently to immunotherapy than Lynch syndrome associated MSI-high cancer. A lot of very interesting questions in the field for sure. Dr. Rafeh Naqash: Absolutely. My second question is more about trying to understand the role of ctDNA, MRD monitoring in individuals with Lynch syndrome. If somebody has a germline, you know, Lynch syndrome MSI-high cancer, when you do a tumor-informed ctDNA assessment, what do you capture generally there? Because, and this question stems from a discussion I've had with somebody regarding EGFR lung cancer, since I treat individuals with lung cancer, and the concept generally is that even if the tissue showed EGFR, but for MRD monitoring, when you do a barcoded sequence of different tumor specific mutations, it's not actually the EGFR that they track in the blood when they do ctDNA assessment. But from a Lynch syndrome standpoint, if you have a germline, right, which is the first hit, and then you have the somatic in the tumor, which is the second hit, are you aware or have you tried to look into this where what is exactly being followed if one had to follow MRD in a Lynch syndrome MSI-high colorectal cancer? Dr. Asaf Maoz: I think a lot of the MRD assays are proprietary, and so we don't receive information about what the mutations that are being tracked are. In general, the idea is to track mutations that we would not expect to disappear as part of resistant mechanisms. We want these to be truncal mutations. We want these to be mutations in which resistance is not expected to result in reversion mutations. But what specifically is being tracked is something that I don't know because these assays, the tumor-informed ones, are proprietary, and we don't get the results regarding specific mutations. When it's circulating tumor DNA that is not necessarily tumor-informed, we do get those results, but that is less so about the specific selection of mutations. Dr. Rafeh Naqash: Thank you for clarifying that question to some extent, of course, as you said, we don't know a lot, and we don't know what we don't know. That's the most important thing that I've learned in the process of understanding precision medicine and genomics, and it's a very fast-paced evolving field. Last question related to your project, what is the next step? Are you planning any next steps as a bigger multicenter study or validation of some sort? Dr. Asaf Maoz: There are two big questions that this study raises. One, is this true across multiple other sites, right? Because this is a single center study, and we really need additional centers to look at their data and validate whether they are also seeing that a substantial portion of deaths in individuals with Lynch syndrome are attributable to mismatch repair proficient cancer. The other question is whether we can look at specifically MSI-high cancer versus MS-stable cancer and understand what the mortality rate for each of those are. From a clinical perspective, it's important to counsel individuals with Lynch syndrome about general cancer screening outside of mismatch repair deficient tumors and to understand that there is also a risk of mismatch repair proficient tumors and that treatment for those tumors would be different. There's a lot of work to be done in the future. Another major area of need is to see whether tumors that are microsatellite stable can be sensitized to immunotherapy, and that is beyond the Lynch syndrome field, but that is something that certainly would benefit these individuals with Lynch syndrome who develop mismatch repair proficient cancer. Dr. Rafeh Naqash: That's very interesting to hear, and we'll look forward to seeing some of those developments shape in the next few years. Now, I'd like to spend a minute, minute and a half on you specifically as a researcher, clinician, scientist. Could you briefly highlight - because I remember meeting you several years back as a trainee, with your interest in genomics, computational research - could you briefly tell us what led you to hereditary cancer syndromes based on your research and work? What are some of the things that you learned along the way that other early career investigators can perhaps take lessons from? Dr. Asaf Maoz: Big questions there, thanks for asking. I got interested in the field of hereditary cancer syndromes when I came to the United States and started doing lab research in Stephen Gruber's lab at the time at USC. He's now at City of Hope. And my interest was originally looking at immunotherapy and immunology, but I went to the case conferences where we were learning about individuals with hereditary cancer, and those were kind of earlier days where we were still trying to figure out how to test and what the implications for these individuals would be. And through fellowship, I was also very interested in that, and I did my senior fellowship years with Dr. Yurgelun here at Dana-Farber, who is the director of the Lynch Syndrome Center. And I I think it's the combination between being able to treat individuals based on precision medicine and what the germline mutation is, but also the ability to prevent cancer and to develop strategies to intercept cancer early that is really appealing to me in this field. It's also a great field to be in because it's a small field. If you come to the CGA-IGC meeting, you'll be able to interact with everyone. Everyone is super collaborative, super nice, and I really recommend it to trainees. The CGA-IGC annual meeting is really a great opportunity to learn more and experience some of the advancement specifically in the GI hereditary space. Lessons for trainees. I think there are a lot of lessons that I could think about, but I think finding strong and supportive mentors is one of the things that has helped me most. I think that just having close relationship with your mentor, having frequent discussions and honest discussions about what is feasible, what is going to make a difference for your patients and your research and what you want to focus on is really important. And so I think if I had to choose one thing, I would say choose a mentor that you trust, that you feel you have a good relationship with, and that has the availability to support you. Dr. Rafeh Naqash: Thank you so much for those insightful comments, and thank you for sharing with us your journey, your project, and some of your interesting thoughts on this concept of hereditary cancers. Hopefully, we'll see more of this work being published in JCOPO through your lab or work from others. Dr. Asaf Maoz: Thank you so much. I appreciate the opportunity to be here. 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 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.

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 

For decades, clinical trial recruitment has been the biggest challenge in the industry. Christine Senn, senior vice president of Site-Sponsor Innovation at Advarra, offers insights into why the struggle continues, such as delays in getting regulations updated after a quarter of a century, and how to overcome the deadlock in clinical trial recruitment that is tied to current obsolete marketing guidelines. Also, host Deborah Borfitz shares the latest on beta blockers, low dose aspirin lowering the risk of recurring colorectal cancer, repurposing drugs for breast cancer relapse prevention, remote participation research on why athletes and military members face higher ALS risk, and the first agentic AI platform for life sciences from Medable. Show Notes News Roundup Rethinking beta blockers Press release on the Mount Sinai website Subgroup analysis study in the European Heart Journal Aspirin lowers risk of colorectal cancer recurrence Study in The New England Journal of Medicine  CLEVER study to prevent breast cancer relapse Study in Nature Medicine News release on Penn Medicine website   Champion Insights ALS initiative News release on Answer ALS website Medable's Agent Studio Press release on the Medable website Disseminating research findings Systematic review in PLOS Medicine  Guest Christine Senn, Ph.D., senior vice president of site-sponsor innovation at Advarra The Scope of Things podcast explores clinical research and its possibilities, promise, and pitfalls. Clinical Research News senior writer, Deborah Borfitz, welcomes guests who are visionaries closest to the topics, but who can still see past their piece of the puzzle. Focusing on game-changing trends and out-of-the-box operational approaches in the clinical research field, the Scope of Things podcast is your no-nonsense, insider's look at clinical research today.

Send us a message with this link, we would love to hear from you. Standard message rates may apply. We unpack myths, the new stepwise approach, and why return to school should come before return to play.• what a concussion is• common and delayed symptoms including mood and sleep changes• immediate sideline steps• why “cocooning” is outdated and how light activity helps• individualized recovery timelines and risk of returning too soon• return-to-learn before return-to-play with simple accommodations• a staircase model for activity and symptom thresholds• helmets vs brain movement and the role of honest reporting• practical tips for coaches, parents, and student athletesCheck out our website, send us an email, share this with a friend or young student athlete who is playing some sports and might get a concussionReferencesBroglio SP, Register-Mihalik JK, Guskiewicz KM, et al. National Athletic Trainers' Association Bridge Statement: Management of Sport-Related Concussion. Journal of Athletic Training. 2024;59(3):225-242. doi:10.4085/1062-6050-0046.22.Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children. Lumba-Brown A, Yeates KO, Sarmiento K, et al. JAMA Pediatrics. 2018;172(11):e182853. doi:10.1001/jamapediatrics.2018.2853.Feiss R, Lutz M, Reiche E, Moody J, Pangelinan M. A Systematic Review of the Effectiveness of Concussion Education Programs for Coaches and Parents of Youth Athletes. International Journal of Environmental Research and Public Health. 2020;17(8):E2665. doi:10.3390/ijerph17082665.Gereige RS, Gross T, Jastaniah E. Individual Medical Emergencies Occurring at School. Pediatrics. 2022;150(1):e2022057987. doi:10.1542/peds.2022-057987.Giza CC, Kutcher JS, Ashwal S, et al. Summary of Evidence-Based Guideline Update: Evaluation and Management of Concussion in Sports: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013;80(24):2250-2257. doi:10.1212/WNL.0b013e31828d57dd.Halstead ME. What's New With Pediatric Sport Concussions? Pediatrics. 2024;153(1):e2023063881. doi:10.1542/peds.2023-063881.Halstead ME, Walter KD, Moffatt K. Sport-Related Concussion in Children and Adolescents. Pediatrics. 2018;142(6):e20183074. doi:10.1542/peds.2018-3074.Leddy JJ. Sport-Related Concussion. The New England Journal of Medicine. 2025;392(5):483-493. doi:10.1056/NEJMcp2400691.McCrea M, Broglio S, McAllister T, et al. Return to Play and Risk of Repeat Concussion in Collegiate Football Players: Comparative Analysis From the NCAA Concussion Study (1999–2001) and CARE Consortium (2014–2017). British Journal of Sports Medicine. 2020;54(2):102-109. doi:10.1136/bjsports-2019-100579.Scorza KA, Cole W. Current Concepts in Concussion: Initial Evaluation and Management. American Family Physician. 2019;99(7):426-434.Shirley E, Hudspeth LJ, Maynard JR. Managing Sports-Related Concussions From Time of Injury Through Return to Play. The Journal of the American Academy of Orthopaedic Surgeons. 2018;26(13):e279-e286. doi:10.5435/JAAOS-D-16-00684.Zhou H, Ledsky R, Sarmiento K, et al. Parent-Child Communication About ConcussSupport the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski

Vidcast:  https://www.instagram.com/p/DPa0nyEDeLQ/The drug is orforglipron, and it comes as a pill you swallow daily rather than as a shot you give yourself weekly.  Researchers at Canada's McMaster University tested the pill in a phase 3 gold standard randomized, double-blinded multinational study of 3127 subjects reported in the New England Journal of Medicine.The data at week 72 revealed that, for those taking the largest daily dose of 36 mg, 55% lost 10% or more of their body weight, 36% lost 15% or more, and 18% lost 20% or more.  Those on orforglipron also enjoyed better body composition stats, improved blood pressures, as well as better triglyceride and  non-HDL cholesterol numbers.The drug did have the same side effects as other peptide GLP-1 medications like semaglutide and tirzepatide.  Those included bloating, heartburn, nausea, constipation, and diarrhea.  The drug is convenient and a likely god-send for needle haters.https://www.nejm.org/doi/full/10.1056/NEJMoa2511774#glp1 #orforglipron #oral #dieting #weightloss

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.

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Anders Jeppsson, a cardiothoracic surgeon at Sahlgrenska University Hospital in Gothenburg, Sweden, about his paper on “Ticagrelor and Aspirin or Aspirin Alone After Coronary Surgery for Acute Coronary Syndrome,” published in The New England Journal of Medicine. Chapters 00:00 Intro  01:54 Ghana Mission Trip  06:23 JANS 1, Pig-to-Human Transplant  08:08 JANS 2, CABG Acute Type A AD  10:06 JANS 3, Chylothorax Lymph Node Management  11:22 JANS 4, ICU Resternotomy Adoption  13:38 JANS 5, Octogenarians Repair vs MV Surgery  15:10 Career Center  15:31 Video 1, MVR Patent Bilateral IMammary Grafts  16:36 Video 2, Repeat RA Thoracotomy  17:39 Video 3, Vascular Injuries in Robotics  19:12 Dr. Jeppsson Interview  33:30 EACTS 2025 & Upcoming Events  They began by providing an overview of the study, including the reason for conducting it, the expansion of the study to other Nordic countries, and its results. They also discuss the funding for the research and the recruitment process. Additionally, they cover dual antiplatelet therapy and compare this study with similar research. Finally, they explore registry-based studies and future research on ticagrelor and aspirin, or aspirin alone, following coronary surgery for acute coronary syndrome.  Joel also highlights recent JANS articles exploring whether protective coronary artery bypass grafting improves surgical outcomes in acute type A aortic dissection with coronary ostial involvement, the association of chylothorax with aggressiveness of lymph node management during pulmonary resection, if intensive care unit resternotomy should be practiced in all facilities that perform cardiac surgery, transcatheter edge-to-edge repair vs mitral valve surgery in octogenarians, and research using pig-to-human lung xenotransplantation into a brain-dead recipient.  In addition, Joel explores robotic mitral valve replacement in a patient with patent bilateral internal mammary grafts, repeat right axillary thoracotomy as a safe and feasible approach for repair of recurrent LAVVR after previous AVSD repair, and handling vascular injuries in robotic thoracic surgery. Before closing, Joel highlights upcoming events in CT surgery.    JANS Items Mentioned  1.) Protective Coronary Artery Bypass Grafting Improves Surgical Outcomes in Acute Type A Aortic Dissection With Coronary Ostial Involvement  2.) The Association of Chylothorax With Aggressiveness of Lymph Node Management During Pulmonary Resection  3.) Expert Opinion: Intensive Care Unit Resternotomy Should Be Practiced in All Facilities That Perform Cardiac Surgery  4.) Transcatheter Edge-to-Edge Repair Versus Mitral Valve Surgery in Octogenarians: Comparative Analysis of Safety, Durability, and Survival  5.) Pig-to-Human Lung Xenotransplantation Into a Brain-Dead Recipient  CTSNet Content Mentioned  1.) Robotic Mitral Valve Replacement in a Patient With Patent Bilateral Internal Mammary Grafts: A Case Video  2.) Repeat Right Axillary Thoracotomy Is a Safe and Feasible Approach for Repair of Recurrent LAVVR After Previous AVSD Repair   3.) Handling Vascular Injuries in Robotic Thoracic Surgery: Real-Life Cases Using a Fibrin-Based Hemostatic Technique  Other Items Mentioned  1.) Ticagrelor and Aspirin or Aspirin Alone After Coronary Surgery for Acute Coronary Syndrome   2.) Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani  3.) Career Center   4.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

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

The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity – The New England Journal of Medicine 2025. Discussion by:Guest:Anupryia Grover-Wenk, DOResident - Family Medicine Residency ProgramJefferson Health - Abington2. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2Diabetes. – The New England Journal of Medicine 2025.Discussion by: Guest:Samantha Traslaviña, DOResident– Family Medicine Residency ProgramJefferson Health – Abington3. Cycling and education intervention versus usual physiotherapy care for the treatment of hip osteoarthritis in the UK (CLEAT): a pragmatic, randomised, controlled trial. Lancet Rheumatology 2025. Discussion by: Guest:Sean Cleary, DO Resident– Family Medicine Residency Program Jefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.

Welcome to Ozempic Weightloss Unlocked, where we dive into the latest breakthroughs and controversies surrounding Ozempic, its medical use, and its impact on everyday wellness.The big headline this month is the arrival of a new pill form of semaglutide, the main ingredient in Ozempic. According to The New England Journal of Medicine, people who took this daily pill lost almost 14 percent of their body weight over 64 weeks, compared to just 2 percent for those on a placebo. Fifty percent of the patients shed at least 15 percent of their weight, with nearly a third losing 20 percent or more. Novo Nordisk, the company that makes Ozempic, announced even stronger results for those who stuck to their treatment plan, with close to 17 percent average weight loss. This pill, pending approval, could be a game changer for people who prefer not to take injections.On the injectable front, clinical trials featured in The Lancet indicate that a higher 7.2 milligram weekly dose of semaglutide in adults without diabetes led to almost 19 percent average weight loss, higher than what's seen with lower doses. These numbers highlight ongoing efforts to increase the effectiveness of Ozempic for those struggling with obesity.Yet, it's crucial to balance these promising results with real-world insights. The Mayo Clinic and NYU Langone Health recently compared Ozempic's results to traditional weight loss surgery, like gastric bypass and sleeve gastrectomy. Their research revealed that surgery is five times more effective than GLP-1 drugs such as Ozempic, with surgical patients losing an average of 58 pounds after two years versus just 12 pounds for those on the drug for six months. Experts also noted that only 30 percent of patients stick with GLP-1 drugs for longer than a year, and real-world weight loss may be lower than trial results suggest. Surgery, however, isn't without its risks, including potential infections, blood clots, and hernias, and requires strict diet and lifestyle changes afterward.Turning to genetics, Cleveland Clinic research shows that the effectiveness of Ozempic may depend on your DNA. A specific variant in the Neurobeachin gene seems to make some people much more responsive to these medications, leading to 82 percent higher odds of substantial weight loss. This new insight could help doctors tailor treatments so patients get therapies most suited to their genetic profile.Lifestyle stakes are high, and so are concerns about side effects and safety. Recent studies report that Ozempic may cause severe conditions such as gastroparesis, bowel blockages, pancreatic and kidney injuries, and vision problems. Even hair loss is emerging as a potentially significant side effect, especially for women—according to recent findings, female users experienced about twice the rate of hair loss compared to those not using Ozempic.Because of these risks, there are currently over two thousand active lawsuits against Novo Nordisk and other GLP-1 manufacturers, with ongoing multidistrict litigation. These lawsuits allege that the companies did not give enough warning about the dangers, and some patients claim life-changing or life-threatening complications.Compounded GLP-1 drugs, made in pharmacies rather than by pharmaceutical companies, became popular when Ozempic was in short supply. However, the FDA warns that compounded drugs can be risky because they're not evaluated for safety or effectiveness. While the shortage has officially ended, compounded formulations remain in circulation.If you are considering Ozempic—whether as a pill, injection, or a compounded version—talk with your healthcare provider and review your health history, genetic background, and lifestyle goals. Widespread interest has led to changing availability, promising new forms, and more transparent labeling, especially after recent updates about kidney and pancreatic risks.To sum up, Ozempic continues to make waves as both a treatment for diabetes and a potent tool for weight loss. With fresh news about new pill forms, higher effective doses, genetic influences, and ongoing legal cases, it's important to stay informed and make choices based on both science and your personal health needs.Thanks for tuning in to Ozempic Weightloss Unlocked. Don't forget to subscribe to stay up to date on the latest developments. 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

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.

Welcome back, listeners, to Ozempic Weightloss Unlocked. Today, we are uncovering the latest news and updates on Ozempic, from its medical applications to its influence on our daily lives and overall health.There is an exciting development in the world of weight loss medication: a pill form of Ozempic, known by its generic name semaglutide. According to The New England Journal of Medicine, those who took the daily semaglutide pill lost nearly fourteen percent of their body weight over sixty-four weeks, compared to just two percent for those who took a placebo. This makes oral semaglutide a potential game changer for those who prefer pills over injections, especially since the pill shows a safety profile similar to the injectable form. Dr. Sean Wharton, who led the recent clinical trial, explained that this oral option could greatly expand the number of people willing to try GLP-1 treatments for obesity.Following closely behind is orforglipron, a new GLP-1 pill developed by Eli Lilly. Fox News reports that in a recent clinical trial, participants taking the highest dose of orforglipron lost an average of more than twenty-seven pounds after a year and a half. Nearly sixty percent of those participants lost ten percent of their body weight, while just under forty percent lost at least fifteen percent. What is even more hopeful, according to the study published in The New England Journal of Medicine, is that those with pre-diabetes saw a sharp improvement in blood sugar levels, suggesting broad metabolic benefits. While the results are compelling, experts note that injectables like Ozempic still deliver slightly more dramatic results, yet many patients may prefer the convenience and ease of a pill.On a different front, research from The Cleveland Clinic has revealed that genetics may influence just how well Ozempic or similar drugs work for you. According to their study, a gene known as Neurobeachin appears to help determine how much weight a person might lose with GLP-1 medications. People with a responsive version of the gene were eighty-two percent more likely to have significant weight loss, while those with a non-responsive score were actually less likely to lose weight. Dr. Daniel Rotroff from the Cleveland Clinic suggests that in the near future, doctors could combine genetic testing with lifestyle and personal factors to tailor obesity treatment, making these therapies even more effective and personalized.Let us not forget the reason why Ozempic was developed in the first place. Originally designed and approved to help manage type two diabetes, Ozempic as well as its higher-dose sibling Wegovy, are now also used for chronic weight management. Both are part of a class called glucagon-like peptide-1 receptor agonists, or GLP-1s. These medications work by stimulating insulin production and helping the body manage appetite and digestion, leading to weight loss as a beneficial side effect. According to information from the Lawsuit Information Center, Ozempic is still mainly prescribed as a once-weekly injection, but with oral versions nearing approval, that could soon change.New treatments often come with questions about safety. According to the United States Food and Drug Administration, there has been increased concern about unapproved compounded versions of these GLP-1 drugs, which have been linked to hundreds of adverse event reports. This highlights the importance of using only medications that are properly prescribed and approved, as safety must always come first.Finally, there are ongoing investigations into rare but serious side effects, such as a risk of vision loss, and digestive issues like gastroparesis linked to GLP-1 drugs including Ozempic. For most people, side effects tend to be mild and include nausea and digestive discomfort, but it is crucial to talk to your doctor to understand the potential risks and benefits as this new generation of weight loss options emerges.That wraps up our update on Ozempic and the evolving world of GLP-1 weight loss therapies. Thanks for tuning in to Ozempic Weightloss Unlocked. Do not forget to subscribe for more insights, and as always, stay informed and stay healthy. 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

Multiple food allergies are a daily stressor for millions of families. From avoiding social events to fearing accidental exposures, it can feel like living in a constant state of alert. Until recently, there were no FDA-approved treatments that targeted more than one allergen at a time. In this episode, we break down the study: “Omalizumab for the Treatment of Multiple Food Allergies,” published in 2024 in the New England Journal of Medicine. Known as the OUtMATCH trial, it's the first large-scale study to show that omalizumab (Xolair), a biologic already used for asthma and hives, may help people with multiple food allergies by raising the threshold for reactions. We explain how omalizumab works by blocking IgE, the antibody that triggers allergic reactions, and how the study measured changes in reaction thresholds (the amount of an allergen a person can ingest before reacting). We also explore the trial design, results, safety profile, and what all of this means for the day-to-day management of food allergies. What we cover in our episode about OUtMATCH trial How omalizumab works to prevent allergic reactions: Learn how blocking IgE increases the amount of allergen needed to trigger symptoms, offering protection from small, accidental exposures. Who qualified for the OUtMATCH trial and why: Find out which patients were included and how eligibility impacted outcomes. What success looked like in this study: Understand how researchers defined protection across multiple allergens. Why not everyone responded the same to omalizumab: Explore the variability in results and what it means for clinical care. What else the study found beyond food challenges: Hear about safety findings, quality of life data, and the open-label extension.

Welcome to The Peptide Podcast. In this episode, we're unpacking the latest on retatrutide and how it measures up against semaglutide and tirzepatide.  If you want to support what we do, head over to our Partners Page. You'll find some amazing brands we trust—and by checking them out, you're helping us keep the podcast going.  https://pepties.com/partners/ We'll look closely at what the studies tell us so far — from overall weight loss to reductions in visceral fat and how much lean muscle mass is preserved. We'll also talk about where the evidence is solid, where it's still developing, and why cross-trial comparisons should be made with caution. What is retatrutide? So let's start with the basics—what is retatrutide? Retatrutide is a new type of weight-loss medication called a triple agonist. That sounds fancy, but what it really means is that it targets three hormone receptors in the gut and pancreas: GLP-1, GIP, and glucagon. Each of these plays a slightly different role in metabolism and appetite regulation. To break it down: GLP-1, which you might already know from drugs like semaglutide, mainly slows digestion, helps you feel full, and improves insulin sensitivity. GIP, which tirzepatide targets along with GLP-1, also helps regulate blood sugar and may improve how the body stores and burns fat. Retatrutide adds glucagon receptor activation on top of that, which seems to further boost fat burning. So how does this compare to semaglutide and tirzepatide? Semaglutide is a GLP-1-only drug, so it mainly works by reducing appetite and slowing gastric emptying. Tirzepatide is a dual agonist, hitting GLP-1 and GIP, which gives it a slightly stronger effect on blood sugar control and fat metabolism compared to semaglutide. Retatrutide goes one step further by adding glucagon activity, potentially giving more total fat loss. In other words, you can think of it like a spectrum: semaglutide hits one target, tirzepatide hits two, and retatrutide hits three—each additional receptor seems to enhance metabolic effects and fat loss in clinical trials. That's why people are excited about retatrutide, though it's still early, and we're waiting on larger studies to see exactly how it compares head-to-head with the others. And that's going to be key, since right now we don't have direct comparisons to other advanced therapies like semaglutide or tirzepatide in the published Phase 2 data. How does retatrutide compare to semaglutide and tirzepatide? Total body weight loss: Now let's put these three medications side by side and look at what the trials actually tell us about total body weight loss. Starting with retatrutide: in its Phase 2 obesity program, the numbers were unusually large, especially given the relatively short trial window. In the 48-week study, people on the higher doses—8 or 12 milligrams weekly—lost about 22 to 24% of their body weight on average. That's the result that really made headlines. It's worth noting that some trials report slightly different averages depending on the group studied—people with obesity but no diabetes versus people with type 2 diabetes—but across the board, that 48-week signal is consistently very strong. For comparison, let's step back to semaglutide at the 2.4 mg dose, which was tested in the pivotal STEP-1 trial. Over 68 weeks, participants lost about 15% of their body weight on average. That was a landmark finding when it was published in the New England Journal of Medicine—it essentially set the modern benchmark for what a GLP-1 monotherapy could do. Then we have tirzepatide, the dual GIP and GLP-1 agonist. The SURMOUNT-1 trial, which ran for 72 weeks, showed dose-dependent results: about 15% weight loss at 5 mg, 19.5% at 10 mg, and 20.9% at 15 mg, compared to only around 3% with placebo. Other obesity studies with tirzepatide have backed this up, especially at the higher doses. And in head-to-head comparisons with semaglutide, tirzepatide has consistently come out on top. So if we zoom out: retatrutide's Phase 2 data suggest the greatest average reductions—over 22%—in less than a year. Tirzepatide follows closely behind with around 21% over 72 weeks. And semaglutide shows very meaningful, but smaller, weight loss of around 15% over a similar time frame. The big caveat here is that these aren't perfect apples-to-apples comparisons. The trials differed in their length, the types of patients enrolled—some had type 2 diabetes, some did not—their baseline weights, and even the way results were reported. Plus, retatrutide is still in Phase 2 for obesity, whereas semaglutide and tirzepatide already have large Phase 3 programs and real-world data backing them up. Visceral fat reduction: Next, let's talk about visceral fat reduction—that's the deep fat that surrounds organs like the liver, pancreas, and intestines. It's particularly important because high levels of visceral fat are strongly linked to cardiometabolic disease. Starting with retatrutide, one of the Phase 2 substudies used DEXA scans to measure body composition in detail. At the higher doses—8 and 12 milligrams per week—participants saw visceral fat drop by about 29 to 31% over 48 weeks. That's a very large relative reduction in under a year and one of the reasons people are excited about retatrutide's potential not just for weight loss, but also for improving long-term metabolic health. How does that compare to the other drugs? With semaglutide, we also have DEXA and imaging substudies from the STEP program and follow-up mechanistic work. These consistently show meaningful visceral fat reductions, along with improvements in the ratio of lean to fat mass. The difference is that semaglutide studies typically report VAT changes as “significant and clinically relevant,” but they don't always publish one clear headline number that's directly comparable to retatrutide's ~30%. In other words, semaglutide definitely lowers visceral fat, but depending on the study and population, the exact percentage looks different. For tirzepatide, we also have imaging-based data from the SURMOUNT trials and related body-composition studies. These show that the majority of weight lost is fat mass—including a significant portion of visceral fat. Some analyses report reductions on par with what's seen with GLP-1 therapies, while others suggest tirzepatide may push a bit further. But again, the actual percentages vary depending on whether the study used DEXA, CT, or MRI, and on who was enrolled. The big caveat here is that we don't yet have a head-to-head imaging study comparing all three drugs in the same population with the same methods. Retatrutide's ~30% visceral fat drop is certainly eye-catching, but without that kind of standardized comparison, it's hard to say definitively whether it's truly better than semaglutide or tirzepatide. Lean muscle mass preservation: Now let's shift to lean mass preservation, which is just as important as total weight or fat loss. Across all of the modern obesity drug trials, one thing has been consistent: most of the weight people lose is fat, but some lean tissue is lost too. That's expected whenever you're in a sustained calorie deficit. The question is how much muscle is preserved, and how the proportions break down. With retatrutide, the DEXA substudy showed something reassuring. Even though people lost a lot of total weight and fat, the proportion of lean mass lost compared to total weight loss was similar to what we see with other therapies. In other words, the drug seems to drive large fat reductions without causing disproportionate muscle loss. Interestingly, the absolute amount of lean tissue lost in kilograms was pretty stable across different doses, even though fat loss varied quite a bit. That suggests the extra weight loss with higher doses is really coming from fat, not muscle. Looking at semaglutide, the STEP trials with DEXA scans reported the same general pattern. People lost more fat than lean mass, and when you adjust for the total weight loss, body composition actually improved. In fact, some analyses showed a slight increase in the percentage of body weight that was lean tissue, even though the absolute lean mass in kilograms went down. So again, it's not that muscle isn't affected—it is—but fat loss makes up the majority of the change. For tirzepatide, the SURMOUNT body-composition studies found that about 75% of the weight lost is fat and about 25% is lean mass. That split is very similar to what was seen in the placebo groups, which means the drug isn't shifting the balance unfavorably. It preferentially reduces fat, while lean mass preservation is in the same ballpark as semaglutide and retatrutide. Now, here's the important nuance: lean mass on a DEXA scan isn't just skeletal muscle. It includes water, organ tissue, and other components. So if someone loses 3 or 4 kilograms of “lean mass,” we don't know how much of that is functional muscle versus water or smaller organ size. That's why these numbers can be misleading if you take them at face value. And this is where lifestyle comes in. Resistance training and adequate protein intake are critical alongside medication. Lifting weights or doing bodyweight resistance work helps preserve functional muscle, while getting enough protein—typically somewhere in the range of 0.8 to 1 gram per pound per day depending on age and activity—supports muscle repair and maintenance. Every trial we've seen shows that the best outcomes, in terms of maintaining strength and function, come from pairing these drugs with exercise and nutrition strategies. That way, the unavoidable lean mass changes have far less impact on long-term metabolic health and performance. Limitations, biases, and what's missing (the critical context). No large, peer-reviewed head-to-head trials (yet) comparing retatrutide with semaglutide or tirzepatide for the same endpoints using identical imaging protocols. Most comparisons are cross-trial and therefore imperfect. Retatrutide Phase-2 was often compared to placebo or dulaglutide (in the T2D DEXA substudy) rather than to semaglutide or tirzepatide. A head-to-head (planned/registered) study vs tirzepatide is listed on ClinicalTrials.gov but results are not published yet. Different populations & durations. Some retatrutide data come from cohorts that include people with T2D or NAFLD; semaglutide STEP trials were often in people with obesity (without diabetes) and run longer (68 weeks), while tirzepatide SURMOUNT trials ran to 72 weeks. These differences change the absolute and percent outcomes. Funding and reporting bias. Many of the early retatrutide analyses are industry-funded (Eli Lilly), which is standard for drug development, but it requires us to carefully read methods, endpoints, and completeness of reporting. Independent replication and Phase-3 confirmation matter. Imaging method variation. VAT reported by DXA vs MRI vs CT are not directly interchangeable. Some trials report VAT area, others percent change; that complicates cross-trial percent comparisons.  Thanks for listening to The Peptide Podcast. If today's episode resonated, share it with a friend. Until next time, be well, and as always, have a happy, healthy week.

The latest developments surrounding Ozempic and weight loss continue to generate major interest and headlines, especially with new research and high-profile figures like Oprah Winfrey sharing personal experiences. In the past week, new clinical trial data and ongoing cultural conversations have kept this topic at the forefront.Researchers have revealed that a daily pill version of semaglutide—the active ingredient in Ozempic—can deliver weight loss results comparable to injectables. According to reporting in The New England Journal of Medicine, participants in a 64-week trial who took oral semaglutide lost over 16 percent of their baseline body weight, while those on a placebo lost just 2.7 percent. More than a third of those on the Ozempic pill achieved at least a 20 percent weight reduction. These findings indicate that more convenient alternatives to weekly injections could soon be available for people seeking medical weight management. Cardiovascular risk factors and physical function also improved among those taking the new pill, further supporting its potential for broader approval later in the year.While Ozempic is widely recognized for its effect on appetite—helping users feel full sooner and eat less—the discussion about its effectiveness versus other weight loss methods also remains active. Recent clinical data suggest that surgery still leads to substantially greater average weight loss over time. At New York University, researchers found that patients receiving bariatric surgery lost about 25 percent of their body weight over two years, compared to approximately 5 percent for those sticking with GLP-1 agonists like Ozempic. Factors such as medication adherence and long-term commitment play a massive role in these outcomes. In fact, studies estimate that up to 70 percent of patients may discontinue their weight loss medications within the first year. Experts say this underscores the importance of treating obesity as a chronic and complex disease rather than seeking a one-size-fits-all solution.Oprah Winfrey continues to shape the public conversation about medical weight loss, drawing both criticism and admiration for her openness and candor this week. On her podcast, Oprah confirmed she has used a GLP-1 agonist—though not specifying Ozempic by name—to quiet her mind's “food noise” and help manage her weight. She explained that the drug's effect of mimicking a natural hormone made her realize many people are not waging an internal battle with cravings but simply respond to true hunger and fullness cues. For decades, Oprah says she blamed herself for her struggles, thinking thinness was a matter of willpower or discipline, only to learn that biological predisposition can override even the strongest effort.As she approaches her seventieth birthday, Oprah's primary focus is on maintaining her health and vitality, not just the numbers on the scale. She has emphasized that the medication is one tool in a regimen that includes rigorous exercise, structured meal times, hydration, and dietary principles. In a recent interview, she stressed that there's no shortcut: she hikes daily, counts Weight Watchers points, and drinks a gallon of water each day. Oprah encourages listeners to understand that obesity is a disease based in the brain, and that shame and blame are harmful and misguided. The backlash she faced for admitting she takes medication—some critics say it is the “easy way out”—reflects larger societal debates about medical interventions, with Oprah herself challenging that narrative by sharing her experience of hard work and self-acceptance.Medical experts interviewed in national outlets continue to say that GLP-1 drugs like Ozempic can help people lose between 15 to 20 percent of their body weight when paired with lifestyle changes like healthy eating and physical activity. They caution that success is not just about taking a weekly injection or pill but requires sustained adherence and behavioral support. Side effects like nausea, vomiting, and stomach pain remain a consideration, and patients are advised to consult closely with their health care providers.Meanwhile, innovation in obesity management is accelerating. The upcoming oral formulations of semaglutide and similar molecules could make therapy more accessible and acceptable to a wider population. However, newer approaches, like targeting metabolic pathways beyond appetite control, are on the horizon and may ultimately change how weight is managed over the long term.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

Send us a message with this link, we would love to hear from you. Standard message rates may apply.Colon cancer screening saves lives by catching cancer early and even preventing it, yet only 69% of eligible adults are up to date with their screenings. We explore who needs screening, what tests are available, and how to choose the right one for you.• Most adults should start colon cancer screening at age 45, even if healthy• Family history may mean you need to start screening earlier• Stool-based tests like FIT and Cologuard are convenient home options• Colonoscopy remains the gold standard, allowing doctors to remove polyps• One in 23 men and one in 25 women will develop colorectal cancer• The best screening test is the one you'll actually completePlease get screened! Check with your doctor about which test is right for you based on your risk factors and preferences.References1. Screening for Colorectal Cancer in Asymptomatic Average-Risk Adults: A Guidance Statement From the American College of Physicians (Version 2). Qaseem A, Harrod CS, Crandall CJ, et al. Annals of Internal Medicine. 2023;176(8):1092-1100. doi:10.7326/M23-0779.2. AGA Clinical Practice Update on Risk Stratification for Colorectal Cancer Screening and Post-Polypectomy Surveillance: Expert Review. Issaka RB, Chan AT, Gupta S. Gastroenterology. 2023;165(5):1280-1291. doi:10.1053/j.gastro.2023.06.033.3. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. Davidson KW, Barry MJ, Mangione CM, et al. JAMA. 2021;325(19):1965-1977. doi:10.1001/jama.2021.6238.4. Colorectal Cancer Screening and Prevention. Sur DKC, Brown PC. American Family Physician. 2025;112(3):278-283.5. Increasing Incidence of Early-Onset Colorectal Cancer. Sinicrope FA. The New England Journal of Medicine. 2022;386(16):1547-1558. doi:10.1056/NEJMra2200869.6. From Guideline to Practice: New Shared Decision-Making Tools for Colorectal Cancer Screening From the American Cancer Society. Volk RJ, Leal VB, Jacobs LE, et al. CA: A Cancer Journal for Clinicians. 2018;68(4):246-249. doi:10.3322/caac.21459.7. Screening for Colorectal Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. Lin JS, Perdue LA, Henrikson NB, Bean SI, Blasi PR. JAMA. 2021;325(19):1978-1998. doi:10.1001/jama.2021.4417.8. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. Bibbins-Domingo K, Grossman DC, Curry SJ, et al. JAMA. 2016;315(23):2564-2575. doi:10.1001/jama.2016.5989.9. How Would You Screen This Patient for Colorectal Cancer? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center. Burns RB, Mangione CM, Weinberg DS, Kanjee Z. Annals of Internal Medicine. 2022;175(10):1452-1461. doi:10.7326/M22-1961.Support the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski

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. 

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners. This short episode covers the basics of electroconvulsive therapy.Hosts: Ravi Bhindi (CC3), Dr. Angad Singh (PGY2)Audio Editing: Dr. Angad Singh (PGY2)Show Notes: Dr. Angad Singh (PGY2)Time Stamps:(0:36) - What is ECT?(2:18) - Indications and efficacy(4:35) - Treatment course(4:32) - Combination treatment(6:33) - Medications to discontinue(8:16) - Contraindications(9:40) - Side effects(11:52) - Procedure(16:03) - SummaryResources:https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/electroconvulsive-therapyhttps://sunnybrook.ca/content/?page=psychiatry-electroconvulsive-therapy-ect-faqReferences:Andrade, C., Arumugham, S. S., & Thirthalli, J. (2016). Adverse Effects of Electroconvulsive Therapy. The Psychiatric clinics of North America, 39(3), 513–530.Brakemeier, E. L., Merkl, A., Wilbertz, G., Quante, A., Regen, F., Bührsch, N., van Hall, F., Kischkel, E., Danker-Hopfe, H., Anghelescu, I., Heuser, I., Kathmann, N., & Bajbouj, M. (2014). Cognitive-behavioral therapy as continuation treatment to sustain response after electroconvulsive therapy in depression: a randomized controlled trial. Biological psychiatry, 76(3), 194–202.Espinoza, R. T., & Kellner, C. H. (2022). Electroconvulsive therapy. New England Journal of Medicine, 386(7), 667-672.Gill, S., Hussain, S., Purushothaman, S., Sarma, S., Weiss, A., Chamoli, S., ... & Loo, C. K. (2023). Prescribing electroconvulsive therapy for depression: Not as simple as it used to be. Australian & New Zealand Journal of Psychiatry, 57(9), 1202-1207.Janjua, A. U., Dhingra, A. L., Greenberg, R., & McDonald, W. M. (2020). The efficacy and safety of concomitant psychotropic medication and electroconvulsive therapy (ECT). CNS Drugs, 34(5), 509-520.Jelovac, A., Kolshus, E., & McLoughlin, D. M. (2013). Relapse following successful electroconvulsive therapy for major depression: a meta-analysis. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 38(12), 2467–2474.Kolshus, E., Jelovac, A., & McLoughlin, D. M. (2017). Bitemporal v. high-dose right unilateral electroconvulsive therapy for depression: a systematic review and meta-analysis of randomized controlled trials. Psychological Medicine, 47(3), 518-530.Lam, R. W., Kennedy, S. H., Adams, C., Bahji, A., Beaulieu, S., Bhat, V., ... & Milev, R. V. (2024). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 Update on Clinical Guidelines for Management of Major Depressive Disorder in Adults: Réseau canadien pour les traitements de l'humeur et de l'anxiété (CANMAT) 2023: Mise à jour des lignes directrices cliniques pour la prise en charge du trouble dépressif majeur chez les adultes. The Canadian Journal of Psychiatry, 69(9), 641-687.Luchini, F., Medda, P., Mariani, M. G., Mauri, M., Toni, C., & Perugi, G. (2015). Electroconvulsive therapy in catatonic patients: Efficacy and predictors of response. World journal of psychiatry, 5(2), 182–192.Tess, A. V., & Smetana, G. W. (2009). Medical evaluation of patients undergoing electroconvulsive therapy. New England Journal of Medicine, 360(14), 1437-1444.Zolezzi M. (2016). Medication management during electroconvulsant therapy. Neuropsychiatric disease and treatment, 12, 931–939.For more PsychEd, follow us on Instagram (@psyched.podcast),  Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at psychedpodcast@gmail.com and visit our website at psychedpodcast.org.

Send us a message with this link, we would love to hear from you. Standard message rates may apply.The DASH diet offers a powerful, evidence-based approach to lowering blood pressure through nutritional changes rather than medication.• Stands for Dietary Approaches to Stop Hypertension• Focuses on fruits, vegetables, whole grains, lean proteins, and low-fat dairy• Limits sodium, saturated fat, added sugars, and processed meats• Can lower systolic blood pressure by 5-6 points and diastolic by 3 points• Recommends 4-5 servings each of fruits and vegetables daily• Suggests 6-8 servings of whole grains per day• Advises limiting sodium to 1,500mg daily for those with hypertension• Provides numerous meal ideas including oatmeal with berries, turkey sandwiches, and grilled salmon• Encourages using herbs and spices instead of salt for flavoring• Benefits extend beyond blood pressure to include improved cholesterol and weight managementFor more information about hypertension management, check out our previous episodes: episode 4 (explaining hypertension), episode 5 (lifestyle changes), episode 14 (common medications), and episode 33 (measuring blood pressure at home).References1. Diets. Yannakoulia M, Scarmeas N. The New England Journal of Medicine. 2024;390(22):2098-2106. doi:10.1056/NEJMra2211889.2. Treatment of Hypertension: A Review. Carey RM, Moran AE, Whelton PK. JAMA. 2022;328(18):1849-1861. doi:10.1001/jama.2022.19590.3. DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Chiavaroli L, Viguiliouk E, Nishi SK, et al. Nutrients. 2019;11(2):E338. doi:10.3390/nu11020338.4. Primary Prevention of ASCVD and T2DM in Patients at Metabolic Risk: An Endocrine Society* Clinical Practice Guideline. Rosenzweig JL, Bakris GL, Berglund LF, et al. The Journal of Clinical Endocrinology and Metabolism. 2019;104(9):3939-3985. doi:10.1210/jc.2019-01338.5. Recommended Dietary Pattern to Achieve Adherence to the American Heart Association/American College of Cardiology (AHA/ACC) Guidelines: A Scientific Statement From the American Heart Association. Van Horn L, Carson JA, Appel LJ, et al. Circulation. 2016;134(22):e505-e529. doi:10.1161/CIR.0000000000000462.6. Dietary Approaches to Stop Hypertension (DASH) for the Primary and Secondary Prevention of Cardiovascular Diseases. Bensaaud A, Seery S, Gibson I, et al. The Cochrane Database of Systematic Reviews. 2025;5:CD013729. doi:10.1002/14651858.CD013729.pub2.7. Popular Dietary Patterns: Alignment With American Heart Association 2021 Dietary Guidance: A Scientific Statement From the American Heart Association. Gardner CD, Vadiveloo MK, Petersen KS, et al. Circulation. 2023;147(22):1715-1730. doi:10.1161/CIR.0000000000001146.8. Dietary Approaches to Prevent and Treat Hypertension: A Scientific Statement From the American Heart Association. Appel LJ, Brands MW, Daniels SR, et al. Hypertension (Dallas, Tex. : 1979). 2006;47(2):296-308. doi:10.1161/01.HYP.0000202568.01167.B6.9. Dietary Approaches to Stop Hypertension (DASH): Potential Mechanisms of Action Against Risk Factors of the Metabolic Syndrome. Akhlaghi M. Nutrition Research Reviews. 2020;33(1):1-18. doi:10.1017/S0954422419000155.10. The Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on Metabolic Risk Factors in Patients With Chronic Disease: Support the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski

Back pain is one of the most common health problems in the world — but also one of the most mysterious. Scans don't always match symptoms, treatments don't always provide relief, and many people feel stuck with ongoing discomfort.In this episode, I explore chronic, non-specific low back pain through a biopsychosocial lens. Basically, we're looking beyond just the spine to understand how biology, psychology, and environment all shape the way pain is experienced.You'll hear about:What makes non-specific low back pain so puzzlingHow pain perception actually works (pain ≠ tissue damage)Why the biopsychosocial model is key to understanding painThe role of self-regulation in shaping pain responsesWhat research says about meditation for back painHow to reframe back pain when you feel like you're hitting a wallJournal prompts to reflect on your own experienceBy the end, you'll have a new way to think about back pain, one that expands the options for healing beyond the body alone.Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196(4286), 129–136. (Origin of the biopsychosocial model)Study on self-regulation and pain: Wager, T. D., et al. (2013). An fMRI-based neurologic signature of physical pain. New England Journal of Medicine, 368(15), 1388–1397. (and related follow-up studies on cognitive self-regulation impacting autonomic markers — you summarised one in your notes)Systematic review on meditation and back pain: Cramer, H., et al. (2022). Meditation for adults with non-specific low back pain: a systematic review and meta-analysis. (Included 8 RCTs, ~1,234 participants, moderate-certainty evidence of small benefits for disability and long-term pain

In this episode of the RWS Clinician's Corner, Margaret Floyd Barry takes us behind the scenes into the dynamic world of research and curriculum development in the functional health space. Margaret sits down with two of Restorative Wellness Solutions' powerhouse instructors, Ellen Lovelace and Paige Reagan, for a candid conversation about the challenges, surprises, and daily realities of translating emerging science into practical, safe, and effective tools for clinicians.   In this interview, we discuss:     -Specific ways that Ellen & Paige demonstrate curriculum leadership and research support for RWS   -How to respond to new studies or challenges to existing curriculum    -How to decide which sources to trust   -How to evaluate clinical research (red & green flags)   -Addressing research limitations and gaps    -Using research tools and AI in gathering evidence   The Clinician's Corner is brought to you by Restorative Wellness Solutions.  Follow us: https://www.instagram.com/restorativewellnesssolutions/    Connect with Ellen:  Website: www.abalancedtable.net Facebook: www.facebook.com/abalancedtable Instagram: www.instagram.com/abalancedtable   Connect with Paige: Website: www.naturallynourishedwellness.com Instagram: www.instagram.com/paigereaganntp   Timestamps: 00:00 From Russian Studies to Health Advocacy 07:56 Curriculum Accuracy and Depth Focus 12:57 Using AI for Study Validation 19:20 Evaluating Research Article Credibility 25:24 Animal Study Relevance and Limitations 28:03 "Pediatric Research Gaps in Drug Trials" 33:55 "Teaching Deepens Understanding" 41:17 Questioning AI for Balanced Answers 44:47 Effective Research Strategies and AI Limitations 52:04 Verify Before Believing Headlines 55:52 "Unpaywall: Access Free Academic Papers" 01:00:33 "The Clinician's Corner Podcast" Speaker bios: Ellen Lovelace, Lead Instructor & Curriculum Development Master RHP, MPH, FNTP, Board Certified in Holistic Nutrition® Ellen (she/her) has been actively working to educate and improve the public's health for almost 20 years. Ellen received her Masters in Public Health from The George Washington University, and went on to run everything from tuberculosis prevention programs in Russia to dental health education programs along the Texas/Mexico border. She was also the founding Executive Director of the women's health program at Stanford University. When Ellen became drawn to a more holistic model, she received her certifications as a Nutritional Therapy Consultant and a Master Restorative Health Practitioner. She is the owner of A Balanced Table Nutritional Therapy in San Jose, CA, her private functional nutrition practice. Ellen focuses on cutting through the confusion and nutrition “noise,” digging to the roots of clients' dysfunction, and figuring out the best way for them to eat, drink, and thrive. She uses the IRH functional analysis tools daily, and is excited to share her passion for these methods. Ellen believes that only by focusing on root causes, combined with whole foods nutrition, can true wellness be achieved. Ellen is also a passionate animal lover who volunteers at a wildlife rescue facility, and can often be found smelling of skunk while covered in Mastiff drool.    Paige Reagan, Instructor and Research Master RHP, FNTP Paige has spent most of her career working in Research and Development in the areas of clinical research, regulatory affairs, and medical writing. She has a wide range of experience in the therapeutic areas of cardiovascular health, pulmonary arterial hypertension, diabetes, bone health, osteoarthritis/rheumatoid arthritis, and urology, among others. Her work has contributed to numerous regulatory approvals as well as publications in major medical journals such as the New England Journal of Medicine, Lancet, Circulation, and American Heart Journal. Paige has since earned certifications as a Functional Nutritional Therapy Practitioner and Master Restorative Health Practitioner. She is owner of Naturally Nourished Wellness, a small practice specializing in gut health and the downstream effects of poor digestion. She strives to find balance between the holistic and mainstream approaches and aims to provide her clients with the best of both worlds, using her critical thinking skills from years in research combined with objective laboratory testing and her passion for the restorative power of whole foods and simple lifestyles. She spends her free time exploring the outdoors with her family, swinging kettlebells, and creating baked goods with healthier ingredients.   Keywords: functional nutrition, public health, research process, curriculum development, clinical research, regulatory affairs, medical writing, gastrointestinal healing, lab testing, food sensitivities, evidence-based practice, study design, randomized controlled trials, observational studies, animal studies, peer review, PubMed, Google Scholar, AI tools in research, ChatGPT, consensus, study citations, clinical anecdote, sample size, funding bias, meta-analysis, systematic reviews, biostatistics, clinical protocols, dietary supplements   Disclaimer: The views expressed in the RWS Clinician's Corner series are those of the individual speakers and interviewees, and do not necessarily reflect the views of Restorative Wellness Solutions, LLC. Restorative Wellness Solutions, LLC does not specifically endorse or approve of any of the information or opinions expressed in the RWS Clinician's Corner series. The information and opinions expressed in the RWS Clinician's Corner series are for educational purposes only and should not be construed as medical advice. If you have any medical concerns, please consult with a qualified healthcare professional. Restorative Wellness Solutions, LLC is not liable for any damages or injuries that may result from the use of the information or opinions expressed in the RWS Clinician's Corner series. By viewing or listening to this information, you agree to hold Restorative Wellness Solutions, LLC harmless from any and all claims, demands, and causes of action arising out of or in connection with your participation. Thank you for your understanding.  

Send us a message with this link, we would love to hear from you. Standard message rates may apply.The flu vaccine is our best defense against influenza, a contagious respiratory virus that causes millions of illnesses and thousands of deaths in the US each year. Despite being only 40-60% effective, the vaccine significantly reduces hospitalizations, outpatient visits, and deaths while protecting vulnerable populations who cannot be vaccinated.• Influenza causes 9-41 million illnesses, 140,000-960,000 hospitalizations, and 12,000-80,000 deaths annually in the US• Everyone aged six months and older should receive the flu vaccine yearly• The vaccine must be updated annually because the flu virus changes each year• Getting vaccinated helps protect vulnerable populations like infants and immunocompromised individuals• Common misconception that the vaccine causes flu is false – it cannot give you the flu• Only 40-46% of Americans get the flu vaccine annually despite its proven benefits• The best time to get vaccinated is before flu season begins, but getting it later still helps• Flu vaccination reduces strain on hospitals during peak seasonsGo get your flu shot today! It's the best way to protect yourself, your loved ones, and your neighbors ReferencesPrevention and Control of Seasonal Influenza With Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2022-23 Influenza Season. Grohskopf LA, Blanton LH, Ferdinands JM, et al. MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports. 2022;71(1):1-28. doi:10.15585/mmwr.rr7101a1. Copyright License: CC0.Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa. Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America. 2019;68(6):e1-e47. doi:10.1093/cid/ciy866.Influenza Vaccination. Treanor JJ. The New England Journal of Medicine. 2016;375(13):1261-8. doi:10.1056/NEJMcp1512870.Effects of Influenza Vaccination in the United States During the 2017-2018 Influenza Season. Rolfes MA, Flannery B, Chung JR, et al. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America. 2019;69(11):1845-1853. doi:10.1093/cid/ciz075.Vaccines for Preventing Influenza in Healthy Adults. Demicheli V, Jefferson T, Ferroni E, Rivetti A, Di Pietrantonj C. The Cochrane Database of Systematic Reviews. 2018;2:CD001269. doi:10.1002/14651858.CD001269.pub6.Recommendations for Prevention and Control of Influenza in Children, 2022-2023. Pediatrics. 2022;150(4):e2022059275. doi:10.1542/peds.2022-059275.Influenza. Uyeki TM. Annals of Internal Medicine. 2021;174(11):ITC161-ITC176. doi:10.7326/AITC202111160.Support the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski

Send us a textIn this episode of Causes or Cures, Dr. Eeks chats with Dr. Irene Papanicolas, Professor of Health Services, Policy and Practice at Brown University, about her recent New England Journal of Medicine paper examining the links between wealth and mortality across the United States and Europe.There's a lot of focus on longevity today, from biohackers chasing longer lives to new medical innovations. But how much does the money in your bank account matter when it comes to lifespan? And why do those relationships between wealth and health look different across countries?The study analyzed data from over 73,000 adults, exploring how wealth impacts lifespan within and across countries, including comparisons between the wealthiest and poorest quartiles, the concept of a “survivor effect,” and why even wealthy Americans may be dying earlier than poorer Europeans.We discuss:How “wealth” was defined in the study.The differences in life expectancy between the U.S. and Europe.What factors might explain why U.S. outcomes lag (diet, food environment, culture, lack of universal healthcare).Which European countries stood out for protecting longevity.Policy implications, and what interventions could have the biggest impact if implemented tomorrow. Read the full paper here: NEJM: Wealth, Mortality, and the U.S.–Europe GapIf you're curious about the intersections of wealth, health, and longevity, and want to understand what money can (and can't) buy when it comes to living longer, this episode is for you. Dr. Irene Papanicolas is a Professor of Health Services Policy and Practice at Brown University. A health economist and researcher, her work focuses on assessing how health systems perform and using international comparisons to inform policy. She leads the International Collaborative on Costs, Outcomes and Needs in Care (ICCONIC), a 16-country partnership studying care patterns and outcomes for high-need, high-cost patients. Dr. Papanicolas has published widely on health system performance and cross-country comparisons. You can contact Dr. Eeks at bloomingwellness.com.Follow Eeks on Instagram here.Or Facebook here.Or X.On Youtube.Or TikTok.SUBSCRIBE to her monthly newsletter here! (Now featuring interviews with top experts on health you care about!)Support the show

There's a lot of talk about the Mediterranean Diet, and when you think about this way of eating, olive oil usually comes to mind. Is this just a fad, or are there some facts to back up the claims of heart health, longevity and anti-inflammatory factors when people consume olive oil?Rob and Sandra review some evidence and look at factors that may influence why olive oil has this distinctive reputation. Predimed study from the  New England Journal of Medicine:"Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts" https://pubmed.ncbi.nlm.nih.gov/29897866/Episodes mentioned include:Nutrition Nuggets 81 - How to Use Olive Oil https://youtu.be/jpzzuzGJ6doEp 172. Do Dietary Fats Affect Inflammation?https://youtu.be/OOSLRwNBPG8Ep 23. Fats, Grease and Oils - Quality over Quantity: Lubricate the Body and Skin From Within https://youtu.be/otQdbY-s_voNutrition Nuggets 21 - Butter vs Margarinehttps://youtu.be/NIT8C3gw7NAEnjoying the show? Consider leaving a 5 star review, and/or sharing this episode with your friends and family :)Sign up for our newsletter on our website for weekly updates and other fun info. You can also visit our social media pages. We're on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, and⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ YouTube⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠.Your support helps fuel the stoke and keeps the show going strong every week. Thanks!Website: www.mywifethedietitian.comEmail: mywifetherd@gmail.com

Dr Azra Raza is a Professor of Medicine, Clinical Director of the Evans Foundation MDS Center, and Executive Director of The First Cell Coalition for Cancer Survivors at Columbia University in New York. She is the best-selling author of "The First Cell: And the human costs of pursuing cancer to the last". She started her research in Myelodysplastic Syndromes (MDS) in 1982 and moved to Rush University, Chicago, Illinois in 1992, where she was the Charles Arthur Weaver Professor in Oncology and Director, Division of Myeloid Diseases. The MDS Program, along with a Tissue Repository containing more than 50,000 samples from MDS and acute leukemia patients was successfully relocated to the University of Massachusetts in 2004 and to Columbia University in 2010. Before moving to New York, Dr Raza was the Chief of Hematology Oncology and the Gladys Smith Martin Professor of Oncology at the University of Massachusetts in Worcester. She has published the results of her laboratory research and clinical trials in prestigious, peer-reviewed journals such as The New England Journal of Medicine, Nature, Blood, Cancer, Cancer Research, the British Journal of Hematology, Leukemia, and Leukemia Research. Dr Raza serves on numerous national and international panels as a reviewer, consultant, and advisor and is the recipient of a number of awards.TIMESTAMPS:(0:00) - Introduction (0:50) - The First Cell: and the human costs of pursuing cancer to the last(4:10) - Defining Cancer(7:50) - A Cancer Paradigm Shift: Finding the First Cell(11:16) - "The Cure for Cancer"(19:05) - Azra's Journey, Development & Reception(24:40) - Hope, Honesty & Harm in a Clinical Setting(33:00) - Current Medical Politics vs Revolutionary Detections/Treatments(39:00) - Increasing Lifespan & Healthspan(43:01) - "Michael Levin Should Win The Nobel Prize!"(51:00) - A Good Life & a Good Death(56:00) - How Words distort our relationship with Disease(1:00:00) - How Disease & Death Shape Our Lives(1:05:40) - The First Cell Book(1:09:15) - A Better Healthcare System(1:12:27) - Conclusion EPISODE LINKS:- Azra's Website: https://azraraza.com- Azra's Books: https://azraraza.com/books- Azra's X: https://x.com/AzraRazaMD- Azra's YouTube: http://www.youtube.com/@AzraRazaMDCONNECT:- Website: https://tevinnaidu.com - Podcast: https://creators.spotify.com/pod/show/mindbodysolution- YouTube: https://youtube.com/mindbodysolution- Twitter: https://twitter.com/drtevinnaidu- Facebook: https://facebook.com/drtevinnaidu - Instagram: https://instagram.com/drtevinnaidu- LinkedIn: https://linkedin.com/in/drtevinnaidu=============================Disclaimer: The information provided on this channel is for educational purposes only. The content is shared in the spirit of open discourse and does not constitute, nor does it substitute, professional or medical advice. We do not accept any liability for any loss or damage incurred from you acting or not acting as a result of listening/watching any of our contents. You acknowledge that you use the information provided at your own risk. Listeners/viewers are advised to conduct their own research and consult with their own experts in the respective fields.

Send us a textCar accidents are the leading cause of death for kids, teens, and young adults — but so many are preventable. In this episode, I sit down with my dad, pediatrician Dr. Andrew Matthew (and the safest driver I know!), to talk about what parents and teens can do to stay safe on the road.Using information from this recent article:Motor Vehicle Crash Prevention, New England Journal of Medicine, Vol 393, Issue 5 (July 31 2025)We discuss:Why car accidents are the #1 cause of death for ages 5–29How texting while driving raises your crash risk 23-foldPractical tips for teaching teens to drive safelyThe truth about speeding, tailgating, and road rageWhen technology helps — and when it hurtsSmart ways to talk to kids about car safetyIf you've got a new driver at home, carpool often, or just want to be more mindful behind the wheel, this episode is full of practical, potentially life-saving tips.Your Child is Normal is the trusted podcast for parents, pediatricians, and child health experts who want smart, nuanced conversations about raising healthy, resilient kids. Hosted by Dr. Jessica Hochman — a board-certified practicing pediatrician — the show combines evidence-based medicine, expert interviews, and real-world parenting advice to help listeners navigate everything from sleep struggles to mental health, nutrition, screen time, and more. Follow Dr Jessica Hochman:Instagram: @AskDrJessica and Tiktok @askdrjessicaYouTube channel: Ask Dr Jessica If you are interested in placing an ad on Your Child Is Normal click here or fill out our interest form.-For a plant-based, USDA Organic certified vitamin supplement, check out : Llama Naturals Vitamin and use discount code: DRJESSICA20-To test your child's microbiome and get recommendations, check out: Tiny Health using code: DRJESSICA The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagno...

The Food and Drug Administration or FDA regulates roughly 78% of the US food supply. This includes packaged products, food additives, infant formula, ultra-processed foods, and lots more. However, an analysis by the Environmental Working Group found that 99% of new food ingredients enter our food supply through a legal loophole that skirts FDA oversight and seems, to me at least, to be incredibly risky. Today we're speaking with two authors of a recent legal and policy analysis published in the Journal Health Affairs. They explain what this loophole is and its risks and suggest a new user fee program to both strengthen the FDA's ability to regulate food ingredients and address growing concerns about food safety. Our guests are Jennifer Pomeranz Associate Professor of Public Health Policy and Management at New York University School of Global Public Health and Emily Broad, director of Harvard Law School Center for Health Law and Policy Innovation. Interview Summary So Jennifer, let's start with you, help our listeners understand the current situation with food ingredient oversight. And what is this legal loophole that allows food companies to add new ingredients without safety reviews. Sure. So, Congress passed the Food Additives Amendment in 1958, and the idea was to divide food additives and generally recognized as safe ingredients into two different categories. That's where the GRAS term comes from generally recognized as safe? ‘Generally Recognized As Safe' is GRAS. But it circularly defines food additives as something that's not GRAS. So, there's not actually a definition of these two different types of substances. But the idea was that the food industry would be required to submit a pre-market, that means before it puts the ingredient into the marketplace, a pre-market petition to the FDA to review the safety. And then the FDA promulgates a regulation for safe use of a food additive. GRAS ingredients on the other hand, initially thought of as salt, pepper, vinegar, are things like that would just be allowed to enter the food supply without that pre-market petition. The problem is the food industry is the entity that decides which category to place each ingredient. There's no FDA guidance on which category they're supposed to ascribe to these ingredients. What has happened is that the food industry has now entered into the food supply an enormous amount of ingredients under what we call the GRAS loophole, which is allowing it to just bring it to the market without any FDA oversight or even knowledge of the ingredient. So, in essence, what we're having now is that the food industry polices itself on whether to submit this pre-market petition for a food additive or just include it in its products without any FDA knowledge. When you said ‘enormous number of such things,' are we talking dozens, hundreds, thousands? Nobody knows, but the environmental working group did find that 99% of new ingredients are added through this loophole. And that's the concerning part. Well, you can look at some ultra-processed foods and they can have 30 or 40 ingredients on them. That's just one food. You can imagine that at across the food supply, how many things there are. And there are these chemicals that nobody can pronounce. You don't know what's going on, what they are, what they're all about. So, what you're saying is that the food industry decides to put these things in foods. There's some processing reason for putting them in. It's important that the public be protected against harmful ingredients. But the food industry decides what's okay to put in and what's not. Are they required to do any testing? Are there criteria for that kind of testing? Is there any sense that letting the industry police itself amounts to anything that protects the public good? Well, the criteria are supposed to be the same for GRAS or food additives. They're supposed to be meeting certain scientific criteria. But the problem with this is that for GRAS ingredients, they don't have to use published data and they can hold that scientific data to themselves. And you mentioned food labels, the ingredient list, right? That doesn't necessarily capture these ingredients. They use generic terms, corn oil, color additive, food additive whatever. And so, the actual ingredient itself is not necessarily listed on the ingredient list. There is no way to identify them and it's unknown whether they're actually doing the studies. They can engage in these, what are called GRAS panels, which are supposed to be experts that evaluate the science. But the problem is other studies have found that 100% of the people on these GRAS panels have financial conflicts of interest. Okay, so let me see if I have this right. I'm a food company. I develop a new additive to provide color or flavor or fragrance, or it's an emulsifier or something like that. I develop a chemical concoction that hasn't really been tested for human safety. I declare it safe. And the criteria I use for declaring it set safe is putting together a panel of people that I pay, who then in a hundred percent of cases say things are. That's how it works? I can't say that in a hundred percent of cases they say it's safe, but a hundred percent of the people have financial conflicts of interest. That's one of the major concerns there. Well, one can't imagine they would continue to be paid... Exactly. This sounds like a pretty shaky system to be sure. Emily: I wanted to add a couple other really quick things on the last discussion. You were saying, Kelly, like they're using a panel of experts, which indeed are paid by them. That would be best case in some cases. They're just having their own staff say, we think this is generally recognized as safe. And I think there's some examples we can give where there isn't even evidence that they went to even any outside people, even within industry. I think that the takeaway from all of that is that there's really the ability for companies to call all the shots. Make all the rules. Not tell FDA what they're doing. And then as we talked about, not even have anything on the label because it's not a required ingredient if it's, used as part of a processing agent that's not a substance on there. So I was feeling pretty bad when Jennifer is talking about these panels and the heavy conflict... Even worse. Of interest, now I feel worse because that's the best case. Totally. And one other thing too is just you kind of warmed this up by talking about this loophole. When we put an earlier article out that we wrote that was about just this generally recognized as safe, the feedback we got from FDA was this isn't a loophole. Why are you calling this a loophole? And it's pretty clear that it's a loophole, you know? It's big enough to drive thousands of ingredients through. Yes, totally. Emily, you've written about things like partially hydrogenated vegetable oils, trans fats, and red dye number three in particular. Both of which FDA has now prohibited in food. Can you walk us through those cases? You asked about partially hydrogenated oils or trans-fat, and then red dye three, which are two examples that we talk about a little bit in our piece. Actually, one of those, the partially hydrogenated oils was allowed in food through the generally recognized as safe definition. And the other was not. But they are both really good examples of another real issue that FDA has, which is that not only are they not doing a good job of policing substances going into food on the front end, but they do an even worse job of getting things out of food on the backend, post-market once they know that those substances are really raising red flags. And you raised two of the prime examples we've been talking about. With partially hydrogenated oils these are now banned in foods, but it took an extremely long time. Like the first evidence of harm was in the mid-nineties. By 2005, the Institute of Medicine, which is now the National Academies, said that intake of trans fat, of partially hydrogenated oils, should be as low as possible. And there was data from right around that time that found that 72,000 to 228,000 heart attacks in the US each year were caused by these partially hydrogenated oils. And on FDA's end, they started in early 2000s to require labeling. But it wasn't until 2015 that they passed a final rule saying that these substances were not generally recognized as safe. And then they kept delaying implementation until 2023. It was basically more than 20 years from when there was really clear evidence of harm including from respected national agencies to when FDA actually fully removed them from food. And red dye number three is another good example where there were studies from the 1980s that raised concerns about this red dye. And it was banned from cosmetics in 1990. But they still allowed it to be added to food. And didn't ban it from food until early this year. So early 2025. In large part because one of the other things happening is states are now taking action on some of these substances where they feel like we really need to protect consumers in our states. And FDA has been doing a really poor job. California banned red dye about 18 months before that and really spurred FDA to action. So that 20-year delay with between 72,000 and 228,000 heart attack deaths attributable to the trans fats is the cost of delay and inaction and I don't know, conflicts of interest, and all kinds of other stuff that happened in FDA. So we're not talking about something trivial by any means. These are life and death things are occurring. Yes. Give us another example, if you would, about something that entered the food supply and caused harm but made it through that GRAS loophole. The example that I've talked about both in some of the work we've done together and also in a perspective piece in the New England Journal of Medicine that really focused on why this is an issue. There was this substance added to food called tara flour. It came on the scene in 2022. It was in food prepared by Daily Harvest as like a protein alternative. And they were using it from a manufacturer in South America who said we have deemed this generally recognized as safe. Everything about that is completely legal. They deemed it generally recognized as safe. A company put it into food, and they sold that. Up until that point, that's all legal. What happened was very quickly people started getting really sick from this. And so there were, I think, about 400 people across 39 states got sick. Nearly 200 people ended up in the hospital, some of them with liver failure because of this toxicity of tara flour. And so FDA followed the thread they did help work with the company to do a voluntary recall, but it then took them two years, until May, 2024, to declare tara flour not generally recognized as safe. So I think, in some ways, this is a great example because it shows how it's so immediate, the impact of this substance that, again, was legally added to food with no oversight. In some ways it's a misleading example because I think so many of the substances in food, it's not going to be so clear and so immediate. It's going to be year over year, decade over decade as part of a full diet that these are causing cardiovascular risk, thyroid disease, cancer risk, those kinds of things. I'd love to hear from either of you about this. Why is FDA falling down on the job so badly? Is it that they don't have the money to do the necessary testing? Do they not have the authority? Is there not the political will to do this? Is there complete caving into the food industry? Just let them do what they want and we're going let it go? Jennifer: All of the above? Everything you just said? It's all of the above. Emily: Jen, do you wanna talk about the money side? Because that sort of gets to the genesis of the article we worked on, which was like maybe there's a creative solution to that piece. Yes, I'd love to hear about that because I thought that was a very creative thing that you guys wrote about in your paper. That there would be an industry user fee to help produce this oversight. Tell us what you had in mind with that. And then then convince me that FDA would appropriately use this oversight and do its job. So, the idea in the paper was proposing a comprehensive user fee program for the food branch of the FDA. The FDA currently collects user fees for all of human drugs, animal drugs, medical devices, etc. With Tobacco, it's a hundred percent funded by user fees. But food, it only gets 1% of its funding through user fees. And it's important to note user fees fund processes. They don't fund outcomes. It's not like a bribe. And the idea behind user fees and why industry sometimes supports them is actually to bring predictability to the regulatory state. It brings efficiency to reviews. And then this all allows the industry to anticipate timelines so they can bring products to market and know when they're going be able to do it. In the food context, for example, the FDA is required to respond to those food additives petitions that we talked about within 180 days. But they can't respond in time. And they have a lot of timelines that are required of them in the food context that they can't meet. They can't meet their timelines because they're so underfunded. So, we proposed a comprehensive user fee. But one of the main reasons that we think a user fee is important is to address the pre-market issues that I talked about and the post-market issues that Emily talked about. In order to close that GRAS loophole, first of all, FDA needs to either reevaluate its authorities or Congress needs to change its authorities. But it would need resources to be able to do something pre-market. Some of the ideas we had was that the user fee would fund some type of either pre-market review, pre-market notification, or even just a pre-market system where the FDA determines whether a proposed ingredient should go through the GRAS avenue, or through food additive petition. So at least that there will be some type of pre-market oversight over all the ingredients in the food supply. And then also the FDA is so severely lacking in any type of comprehensive post-market into play, they would have the resources to engage in a more comprehensive post-market review for all the ingredients. Could you see a time, and I bring this up because of lawsuits against the food industry for some of these additives that are going on now. The state attorney's generals are starting to get involved, and as you said, Emily, the some states are taking legislative action to ban certain things in the food supply. Do you think there could come a time when the industry will come to government pleading to have a user fee like this? To provide some standardization across jurisdictions, let's say? So, there's two things. The first is Congress has to pass the user fee, and historically, actually, industry has done exactly what you said. They have gone to Congress and said, you know what? We want user fees because we want a streamlined system, and we want to be able to know when we're bringing products to market. The problem in the context of food for the issues we're talking about is that right now they can use the GRAS loophole. So, they have very little incentive to ask for user fees if they can bring all their ingredients into the market through the GRAS loophole. There are other areas where a user fee is very relevant, such as the infant formula 90 day pre-market notification, or for different claims like health claims. They might want user fees to speed those things up, but in terms of the ingredients, unless we close the GRAS loophole, they'd have little incentive to actually come to the table. But wouldn't legal liability change that? Let's say that some of these lawsuits are successful and they start having to pay large settlements or have the State Attorneys General, for example, come down on them for these kinds of things. If they're legally liable for harm, they're causing, they need cover. And wouldn't this be worth the user fee to provide them cover for what they put in the food supply? Yes, it's great to have the flexibility to have all these things get through the loophole, but it'd be great as well to have some cover so you wouldn't have so much legal exposure. But you guys are the lawyers, so I'm not sure it makes sense. I think you're right that there are forces combining out in the world that are pushing for change here. And I think it's hard to disentangle how much is it that industry's pushing for user fees versus right now I think more willing to consider federal regulatory changes by either FDA or by Congress. At the state level this is huge. There's now becoming a patchwork across states, and I think that is really difficult for industry. We were tracking this year 93 bills in 35 states that either banned an additive in the general public, banned it in schools. Banned ultra-processed foods, which most of the states, interestingly, have all defined differently. But where they have had a definition, it's been tied to various different combinations of additives. So that's going on. And then I think you're right, that the legal cases moving along will push industry to really want clear and better standards. I think there's a good question right now around like how successful will some of these efforts be? But  what we are seeing is real movement, both in FDA and in Congress, in taking action on this. So interestingly, the Health Affairs piece that we worked on was out this spring. But we had this other piece that came out last fall and felt like we were screaming into the void about this is a problem generally recognized as safe as a really big issue. And suddenly that has really changed. And so, you know, in March FDA said they were directed by RFK (Robert F. Kennedy), by HHS (Health and Human Services) to really look into changing their rule on generally recognized as safe. So, I know that's underway. And then in Congress, multiple bills have been introduced. And I know there are several in the works that would address additives and specifically, generally recognized as safe. There's this one piece going on, which is there's forces coalescing around some better method of regulation. I think the question's really going to also be like, will Congress give adequate resources? Because there is also another scenario that I'm worried about that even if FDA said we're going now require at least notification for every substance that's generally recognized as safe. It's a flood of substances. And they just, without more resources, without more staff devoted to this, there's no way that they're going to be able to wade through that. So, I think that either the resources need to come from user fees, or at least partially from user fees, from more appropriations and I think, In my opinion, they are able to do that on their own. Even given where current administrative law stands. Because I think it's very clear that the gist of the statute is that FDA should be overseeing additives. And I think a court would say this is allowing everything to instead go through this alternative pathway. But I really think FDA's going to need resources to manage this. And perhaps more of a push from Congress to make sure that they really do it to the best of their ability. I was going to say there's also an alternative world where we don't end up spending any of these resources, and they require the industry just to disclose all the ingredients they've added to food and put it on a database. This is like low hanging fruit, not very expensive, doesn't require funding. And then the NGOs, I hope, would go to work and say, look at this. There is no safety data for these ingredients. You know, because right now we just can't rely on FDA to do anything unless they get more funding to do something. So, if FDA doesn't get funding, then maybe this database where houses every ingredient that's in the food supply as a requirement could be a low resource solution. Jennifer, I'll come back to you in a minute because I'd like to ask how worried should we be about all this stuff that's going into food. But Emily, let me ask you first, does FDA have the authority to do what it needs to do? Let's say all of a sudden that your wish was granted and there were user fees would it then be able to do what needs to be done? I think certainly to be able to charge these user fees in almost all areas, it right now doesn't have that authority, and Congress would need to act. There's one small area which is within the Food Safety Modernization Act for certain types of like repeat inspections or recalls or there's a couple other. FDA isn't charging fees right now because they haven't taken this one step that they need to take. But they do have the authority if they just take those steps. But for everything else, Congress has to act. I think the real question to me is because we now know so many of these substances are going through this GRAS pathway, the question is really can they do everything they need to do on their own to close that loophole? And again, my opinion is Congress could make it clear and if Congress were to act, it would be better. Like they could redefine it in a way that was much more clear that we are drawing a real line. And most things actually should be on the additive side of the line rather than the generally recognized as safe side of the line. But even with their current authority, with the current definition, I think FDA could at least require notification because they're still drawing a line between what's required for additives, which is a very lengthy pre-market process with, you know, a notice and comment procedure and all of these things. My take is FDA do what you can do now. Let's get the show on the road. Let's take steps here to close up the loophole. And then Congress takes time. But they definitely can even strengthen this and give a little more, I think, directives to FDA as to how to make sure that this loophole doesn't recur down the line. In talks that I've given recently, I've shown an ingredient list from a food that people will recognize. And I ask people to try to guess what that food is from its ingredient list. This particular food has 35 ingredients. You know, a bunch of them that are very hard to pronounce. Very few people would even have any idea at all what those ingredients do. There's no sense at all about how ingredient number 17 would interact with ingredient 31, etc. And it just seems like it's complete chaos. And I don't want to take you guys outside your comfort zone because your backgrounds are law. But Jennifer, let me ask you this. You have a background in public health as well. There are all kinds of reasons to be worried about this, aren't there? There are the concerns about the safety of these things, but then there's a concern about what these ultra-processed ingredients do to your metabolism, your ability to control your weight, to regulate your hunger and things like that. It sounds this is a really important thing. And it's affecting almost everybody in the country. The percentage of calories that are now coming from ultra-processed foods is over 50% in both children and adults. So it sounds like there's really reason to worry. Would you agree? Yes. And also, the FDA is supposed to be overseeing the cumulative effects of the ingredients and it doesn't actually enforce that regulation. Its own regulation that it's supposed to evaluate the cumulative effects. It doesn't actually enforce this. So by cumulative effects do you mean the chronic effects of long term use? And, having these ingredients across multiple products within one person's consumption. Also, the FDA doesn't look at things like the effect on the gut microbiome, neurotoxicity, even cancer risk, even though they're supposed to, they say that if something is GRAS, they don't need to look at it because cancer risk is relegated only to food additives. So here we're at a real issue, right? Because if everything's entering through the GRAS loophole, then they're not looking at carcinogen effects. So, I think there is a big risk and as Emily had said earlier, that these are sometimes long-term risks versus that acute example of tara flour that we don't know. And we do know from the science, both older and emerging science, that ultra-processed food has definite impact on not only consumption, increased consumption, but also on diet related diseases and other health effects. And by definition what we're talking about here are ultra-processed foods. These ingredients are only found in ultra-processed foods. So, we do know that there is cause for concern. It's interesting that you mentioned the microbiome because we've recorded a cluster of podcasts on the microbiome and another cluster of podcasts on artificial sweeteners. Those two universes overlap a good bit because the impact of the artificial sweeteners on some of them, at least on the microbiome, is really pretty negative. And that's just one thing that goes into these foods. It really is pretty important. By the way, that food with 35 ingredients that I mentioned is a strawberry poptart. Jennifer: I know that answer! Emily: How do you know that? Jennifer: Because I've seen Kelly give a million talks. Yes, she has. Emily: I was wondering, I was like, are we never going to find out? So the suspense is lifted. Let me end with this. This has been highly instructive, and I really appreciate you both weighing in on this. So let me ask each of you, is there reason to be optimistic that things could improve. Emily, I'll start with you. So, I've been giving this talk the past few months that's called basically like Chronic Disease, Food Additives and MAHA, like What Could Go Right and What Could Go Wrong. And so, I'm going give you a very lawyerly answer, which is, I feel optimistic because there's attention on the issue. I think states are taking action and there's more attention to this across the political spectrum, which both means things are happening and means that the narrative changing, like people are getting more aware and calling for change in a way that we weren't seeing. On the flip side, I think there's a lot that could go wrong. You know, I think some of the state bills are great and some of them are maybe not so great. And then I think this administration, you have an HHS and FDA saying, they're going to take action on this in the midst of an administration that's otherwise very deregulatory. In particular, they're not supposed to put out new regulations if they can get rid of 10 existing ones. There are some things you can do through guidance and signaling, but I don't think you can really fix these issues without like real durable legislative change. So, I'm sorry to be one of the lawyers here. I think the signals are going in the right direction, but jury is out a little bit on how well we'll actually do. And I hope we can do well given the momentum. What do you think, Jennifer? I agree that the national attention is very promising to these issues. The states are passing laws that are shocking to me. That Texas passing a warning label law, I would never have thought in the history of the world, that Texas would be the one to pass a warning label law. They're doing great things and I actually have hope that something can come of this. But I am concerned at the federal level of the focus on deregulation may make it impossible. User fees is an example of where they won't have to regulate, but they could provide funding to the FDA to actually act in areas that it has the authority to act. That is one solution that could actually work under this administration if they were amenable to it. But I also think in some ways the states could save us. I worry, you know, Emily brought up the patchwork, which is the key term the industry uses to try to get preemption. I do worry about federal preemption of state actions. But the states right now are the ones saving us. California is the first to save the whole nation. The food industry isn't going to create new food supply for California and then the rest of the country. And then it's the same with other states. So, the states might be the ones that actually can make some real meaningful changes and get some of the most unsafe ingredients out of the food supply, which some of the states have now successfully done. Bios Emily Broad Leib is a Clinical Professor of Law, Director of Harvard Law School Center for Health Law and Policy Innovation, and Founding Director of the Harvard Law School Food Law and Policy Clinic, the nation's first law school clinic devoted to providing legal and policy solutions to the health, economic, and environmental challenges facing our food system. Working directly with clients and communities, Broad Leib champions community-led food system change, reduction in food waste, food access and food is medicine interventions, and equity and sustainability in food production. Her scholarly work has been published in the California Law Review, Wisconsin Law Review, Harvard Law & Policy Review, Food & Drug Law Journal, and Journal of Food Law & Policy, among others. Professor Jennifer Pomeranz is a public health lawyer who researches policy and legal options to address the food environment, obesity, products that cause public harm, and social injustice that lead to health disparities. Prior to joining the NYU faculty, Professor Pomeranz was an Assistant Professor at the School of Public Health at Temple University and in the Center for Obesity Research and Education at Temple. She was previously the Director of Legal Initiatives at the Rudd Center for Food Policy and Obesity at Yale University. She has also authored numerous peer-reviewed and law review journal articles and a book, Food Law for Public Health, published by Oxford University Press in 2016. Professor Pomeranz leads the Public Health Policy Research Lab and regularly teaches Public Health Law and Food Policy for Public Health.

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On this week's Tech Nation, Frontline Stories from Ukraine's International Legion with Military Historian Dr. Shannon Monaghan, for Type I diabetics, the New England Journal of Medicine publishes early success with Sana Biotechnology's engineered insulin-producing cells without immunosuppressant drugs, and Daniel Kraft reports in on the BioTech Nation session from NextMed Health 2025.

[01:02:08] Meta AI Grooming ChildrenDiscussion of Meta's chatbot seducing vulnerable users and grooming children, raising alarms over how AI is weaponized for control. [01:10:12] Congress Uses Crisis to Push Digital IDCriticism of Senators using Meta's scandal to advance online ID systems instead of stopping child exploitation. [01:16:56] Larry Fink & BlackRock Control WEFAnalysis of BlackRock's Larry Fink taking over World Economic Forum power, enforcing ESG/DEI agendas, and forcing global corporate compliance. [01:43:07] Trump & Ukraine Peace DealCoverage of Trump's position on Ukraine peace negotiations, skepticism over EU/NATO motives, and fears of engineered perpetual war. [01:55:04] U.S./UK Boots on the GroundTrump assures “no American boots” in Ukraine but hints at air support; UK pushes to deploy ground forces immediately. [02:06:25] Vaccine-Autism Study ExposedChildren's Health Defense scientists challenge a 2002 New England Journal of Medicine study dismissing autism links, calling its math flawed and data manipulated. [02:16:31] Lawsuit Against CDC Over 72-Dose ScheduleA major lawsuit highlights the CDC's failure to test the combined childhood vaccine schedule, alleging constitutional violations and industry capture. [02:23:21] Texas Sues Eli Lilly for BriberyAttorney General Ken Paxton sues the pharma giant for bribing doctors to push high-profit drugs, drawing parallels to the opioid crisis. [02:32:13] Mercury Fillings & Global BansExposure of the American Dental Association's ties to toxic mercury amalgam fillings, contrasted with EU and global bans ignored by U.S. regulators. [02:55:23] Election Rigging & Gerrymandering TeaserClosing segment transitions into election rigging and gerrymandering, previewing corruption on both political sides. [03:01:12] Gerrymandering & Rigged ElectionsDiscussion on redistricting battles in California and Texas, showing how both parties manipulate maps to lock in control and eliminate real voter choice. [03:10:06] Usury: Biblical Condemnation & Modern ExploitationShift to economic corruption, exposing how usury was once banned in Christian and civil law, but now thrives through credit cards, mortgages, and payday loans. [03:47:14] Trump, Heaven & Zionist Third Temple PlansTrump claims foreign policy wins could earn him heaven; contrasted with Zionist efforts to breed red heifers and rebuild the Third Temple, seen as delusional legalism. [03:57:00] Zionism, Prophecy & Final WarningsClosing critique of Zionist attempts to “force God's hand” in prophecy, with warnings against false gospels and misplaced faith in political or religious schemes. Follow the show on Kick and watch live every weekday 9:00am EST – 12:00pm EST https://kick.com/davidknightshow Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHT Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-david-knight-show--2653468/support.

[01:02:08] Meta AI Grooming ChildrenDiscussion of Meta's chatbot seducing vulnerable users and grooming children, raising alarms over how AI is weaponized for control. [01:10:12] Congress Uses Crisis to Push Digital IDCriticism of Senators using Meta's scandal to advance online ID systems instead of stopping child exploitation. [01:16:56] Larry Fink & BlackRock Control WEFAnalysis of BlackRock's Larry Fink taking over World Economic Forum power, enforcing ESG/DEI agendas, and forcing global corporate compliance. [01:43:07] Trump & Ukraine Peace DealCoverage of Trump's position on Ukraine peace negotiations, skepticism over EU/NATO motives, and fears of engineered perpetual war. [01:55:04] U.S./UK Boots on the GroundTrump assures “no American boots” in Ukraine but hints at air support; UK pushes to deploy ground forces immediately. [02:06:25] Vaccine-Autism Study ExposedChildren's Health Defense scientists challenge a 2002 New England Journal of Medicine study dismissing autism links, calling its math flawed and data manipulated. [02:16:31] Lawsuit Against CDC Over 72-Dose ScheduleA major lawsuit highlights the CDC's failure to test the combined childhood vaccine schedule, alleging constitutional violations and industry capture. [02:23:21] Texas Sues Eli Lilly for BriberyAttorney General Ken Paxton sues the pharma giant for bribing doctors to push high-profit drugs, drawing parallels to the opioid crisis. [02:32:13] Mercury Fillings & Global BansExposure of the American Dental Association's ties to toxic mercury amalgam fillings, contrasted with EU and global bans ignored by U.S. regulators. [02:55:23] Election Rigging & Gerrymandering TeaserClosing segment transitions into election rigging and gerrymandering, previewing corruption on both political sides. [03:01:12] Gerrymandering & Rigged ElectionsDiscussion on redistricting battles in California and Texas, showing how both parties manipulate maps to lock in control and eliminate real voter choice. [03:10:06] Usury: Biblical Condemnation & Modern ExploitationShift to economic corruption, exposing how usury was once banned in Christian and civil law, but now thrives through credit cards, mortgages, and payday loans. [03:47:14] Trump, Heaven & Zionist Third Temple PlansTrump claims foreign policy wins could earn him heaven; contrasted with Zionist efforts to breed red heifers and rebuild the Third Temple, seen as delusional legalism. [03:57:00] Zionism, Prophecy & Final WarningsClosing critique of Zionist attempts to “force God's hand” in prophecy, with warnings against false gospels and misplaced faith in political or religious schemes. Follow the show on Kick and watch live every weekday 9:00am EST – 12:00pm EST https://kick.com/davidknightshow Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code KNIGHT Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-showOr you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-real-david-knight-show--5282736/support.

On this episode of The Jon Gordon Podcast, I sit down with Dr. Samuel Wilkinson from Yale for a truly fascinating and thought-provoking conversation about the intersection of science, faith, and evolution. Dr. Wilkinson shares the journey that inspired his book, Purpose: What Evolution and Human Nature Imply About the Meaning of Our Existence, and together we dig into some of life's deepest questions: Can science and spirituality really go hand in hand? How do evolution and faith both help shape our understanding of human purpose?   We unpack everything from the “dual potential” within human nature, our capacities for both selfishness and sacrificial love, to the mysteries of free will, consciousness, and whether our brains are actually wired to tune into higher frequencies like love, positivity, and connection. We also challenge some big assumptions about the origins of humanity, what really drives our instinct to help others (even at great personal cost), and why strong family bonds are central to both our biology and our society.   If you've ever wondered how science and spirituality might fit together, or questioned whether there's purpose woven into the process of evolution, this conversation is going to open your mind and encourage your spirit. Don't miss it!   About Dr. Samuel Wilkinson, Samuel T. Wilkinson is Associate Professor of Psychiatry at Yale University, where he also serves as Associate Director of the Yale Depression Research Program. He received his MD from Johns Hopkins School of Medicine. His articles have been featured in the New York Times, the Washington Post, and the Wall Street Journal. He has been the recipient of many awards, including Top Advancements & Breakthroughs from the Brain and Behavior Research Foundation; Top Ten Psychiatry Papers by the New England Journal of Medicine, the Samuel Novey Writing Prize in Psychological Medicine ( Johns Hopkins); the Thomas Detre Award (Yale University); and the Seymour Lustman Award (Yale University).   Here's a few additional resources for you… Follow me on Instagram: @JonGordon11 Order my new book 'The 7 Commitments of a Great Team' today! Every week, I send out a free Positive Tip newsletter via email. It's advice for your life, work and team. You can sign up now here and catch up on past newsletters. Join me for my Day of Development! You'll learn proven strategies to develop confidence, improve your leadership and build a connected and committed team. You'll leave with an action plan to supercharge your growth and results. It's time to Create your Positive Advantage. Get details and sign up here. Do you feel called to do more? Would you like to impact more people as a leader, writer, speaker, coach and trainer? Get Jon Gordon Certified if you want to be mentored by me and my team to teach my proven frameworks principles, and programs for businesses, sports, education, healthcare!

Today's solo episode is an urgent call to wake up to the crumbling systems all around us—healthcare, food, energy, water, housing, the environment and start reclaiming our power, one decision at a time. Darin peels back the curtain on how these systems were designed not to serve us, but to profit off our disconnection. But this isn't a rant—it's a roadmap. With grounded action steps, a rallying cry for sovereignty, and heartfelt encouragement, Darin offers a path forward to opt out of the Matrix and build a better reality together.     What You'll Learn: [00:00] Welcome & why this episode is different [02:11] These systems aren't broken they're failing us. Here's what we can do [03:21] Health or disease care? Why the system profits from your sickness [05:22] Micro vs. macro: how real food and policy change go hand-in-hand [08:11] Water: how tap water is filled with toxins and what to do about it [10:34] The dirty truth about power: fires, pollution, and the case for solar [12:59] From fossil fuels to microgrids: the real solutions that are being ignored [14:45] Food as poison: how ultra-processed foods hijack your biology [15:22] Cook at home. Buy local. And why your food choices matter more than ever [16:50] Shelter or sickness? How your home might be silently harming you [17:31] Flame retardants, VOCs, EMFs: what to reduce and how [18:45] Why you should turn off your Wi-Fi at night and use airplane mode [19:43] Healthcare or symptom care? The call for functional medicine and policy change [21:10] The environment is a mirror: species extinction, pollution, and the cost of convenience [22:45] Personal action: the power of conscious consumption and daily decisions [24:23] Take your power back: how to become the CEO of your life [25:27] It's not about complaining, it's about creating a new paradigm [27:04] Final thoughts: this is your invitation to live a SuperLife [28:30] A sneak peek into Darin's upcoming SuperLife community on Patreon     Thank You to Our Sponsor: Therasage: Go to www.therasage.com and use code DARIN at checkout for 15% off     Find More from Darin Olien: Instagram: @darinolien Podcast: SuperLife Website: https://superlife.com Book: Fatal Conveniences     Key Quote: “You are not powerless, no matter who you are. We are the creators. But first, we must see the system. If we don't see it, we don't change anything. Then we must opt out of these systems that are harming us and the environment, and opt into building a new one, one step at a time.”     Join the SuperLife Movement on Patreon: Be the first to get access to Darin's new SuperLife community on Patreon:

The incidence of early onset colorectal cancer (EOCRC) has been rising prompting the change in change in screening guidelines to 45 years of age for average risk patients. Join us for an in-depth discussion with guest speakers Dr. Andrea Cercek and Dr. Nancy You, where we provide a comprehensive look at the growing challenge of EOCRC. Hosts: - Dr. Janet Alvarez - General Surgery Resident at New York Medical College/Metropolitan Hospital Center - Dr. Wini Zambare – General Surgery Resident at Weill Cornell Medical Center/New York Presbyterian - Dr. Phil Bauer, Graduating Colorectal Surgical Oncology Fellow at Memorial Sloan Kettering Cancer Center  - Dr. J. Joshua Smith MD, PhD, Chair, Department of Colon and Rectal Surgery at MD Anderson Cancer Center - Dr. Andrea Cercek - Gastrointestinal Medical Oncologist at Memorial Sloan Kettering Cancer Center - Dr. Y. Nancy You, MD MHSc - Professor, Department of Colon and Rectal Surgery at MD Anderson Cancer Center Learning objectives:  - Describe trends in incidence of colorectal cancer, with emphasis on the rise of EOCRC. - Identify age groups and demographics most affected by EOCRC. - Summarize USPSTF recommendations for colorectal cancer screening. - Distinguish between screening methods (e.g., colonoscopy, FIT-DNA) and their sensitivity. - Understand treatment approaches for colon and rectal cancer (CRC) - Understand the role of mismatch repair (MMR) status in guiding treatment. - Outline the importance of genetic counseling and testing in young patients. - Discuss racial, ethnic, and socioeconomic disparities in CRC incidence and outcomes. - Describe the impact of cancer treatment on fertility and sexual health. -  Review fertility preservation options. - Identify the value of integrated care teams for young CRC patients. References: 1.         Siegel, R. L. et al. Colorectal Cancer Incidence Patterns in the United States, 1974–2013. JNCI J. Natl. Cancer Inst. 109, djw322 (2017). https://pubmed.ncbi.nlm.nih.gov/28376186/ 2.         Abboud, Y. et al. Rising Incidence and Mortality of Early-Onset Colorectal Cancer in Young Cohorts Associated with Delayed Diagnosis. Cancers 17, 1500 (2025). https://pubmed.ncbi.nlm.nih.gov/40361427/ 3.         Phang, R. et al. Is the Incidence of Early-Onset Adenocarcinomas in Aotearoa New Zealand Increasing? Asia Pac. J. Clin. Oncol.https://pubmed.ncbi.nlm.nih.gov/40384533/ 4.         Vitaloni, M. et al. Clinical challenges and patient experiences in early-onset colorectal cancer: insights from seven European countries. BMC Gastroenterol. 25, 378 (2025). https://pubmed.ncbi.nlm.nih.gov/40375142/ 5.         Siegel, R. L. et al. Global patterns and trends in colorectal cancer incidence in young adults. (2019) doi:10.1136/gutjnl-2019-319511. https://pubmed.ncbi.nlm.nih.gov/31488504/ 6.         Cercek, A. et al. A Comprehensive Comparison of Early-Onset and Average-Onset Colorectal Cancers. J. Natl. Cancer Inst. 113, 1683–1692 (2021). https://pubmed.ncbi.nlm.nih.gov/34405229/ 7.         Zheng, X. et al. Comprehensive Assessment of Diet Quality and Risk of Precursors of Early-Onset Colorectal Cancer. JNCI J. Natl. Cancer Inst. 113, 543–552 (2021). https://pubmed.ncbi.nlm.nih.gov/33136160/ 8.         Standl, E. & Schnell, O. Increased Risk of Cancer—An Integral Component of the Cardio–Renal–Metabolic Disease Cluster and Its Management. Cells 14, 564 (2025). https://pubmed.ncbi.nlm.nih.gov/40277890/ 9.         Muller, C., Ihionkhan, E., Stoffel, E. M. & Kupfer, S. S. Disparities in Early-Onset Colorectal Cancer. Cells 10, 1018 (2021). https://pubmed.ncbi.nlm.nih.gov/33925893/ 10.       US Preventive Services Task Force. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 325, 1965–1977 (2021). https://pubmed.ncbi.nlm.nih.gov/34003218/ 11.       Fwelo, P. et al. Differential Colorectal Cancer Mortality Across Racial and Ethnic Groups: Impact of Socioeconomic Status, Clinicopathology, and Treatment-Related Factors. Cancer Med. 14, e70612 (2025). https://pubmed.ncbi.nlm.nih.gov/40040375/ 12.       Lansdorp-Vogelaar, I. et al. Contribution of Screening and Survival Differences to Racial Disparities in Colorectal Cancer Rates. Cancer Epidemiol. Biomarkers Prev. 21, 728–736 (2012). https://pubmed.ncbi.nlm.nih.gov/22514249/ 13.       Ko, T. M. et al. Low neighborhood socioeconomic status is associated with poor outcomes in young adults with colorectal cancer. Surgery 176, 626–632 (2024). https://pubmed.ncbi.nlm.nih.gov/38972769/ 14.       Siegel, R. L., Wagle, N. S., Cercek, A., Smith, R. A. & Jemal, A. Colorectal cancer statistics, 2023. CA. Cancer J. Clin. 73, 233–254 (2023). https://pubmed.ncbi.nlm.nih.gov/36856579/ 15.       Jain, S., Maque, J., Galoosian, A., Osuna-Garcia, A. & May, F. P. Optimal Strategies for Colorectal Cancer Screening. Curr. Treat. Options Oncol. 23, 474–493 (2022). https://pubmed.ncbi.nlm.nih.gov/35316477/ 16.       Zauber, A. G. The Impact of Screening on Colorectal Cancer Mortality and Incidence: Has It Really Made a Difference? Dig. Dis. Sci. 60, 681–691 (2015). https://pubmed.ncbi.nlm.nih.gov/25740556/ 17.       Edwards, B. K. et al. Annual report to the nation on the status of cancer, 1975-2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer 116, 544–573 (2010). https://pubmed.ncbi.nlm.nih.gov/19998273/ 18.       Cercek, A. et al. Nonoperative Management of Mismatch Repair–Deficient Tumors. New England Journal of Medicine 392, 2297–2308 (2025). https://pubmed.ncbi.nlm.nih.gov/40293177/ 19.       Monge, C., Waldrup, B., Carranza, F. G. & Velazquez-Villarreal, E. Molecular Heterogeneity in Early-Onset Colorectal Cancer: Pathway-Specific Insights in High-Risk Populations. Cancers 17, 1325 (2025). https://pubmed.ncbi.nlm.nih.gov/40282501/ 20.       Monge, C., Waldrup, B., Carranza, F. G. & Velazquez-Villarreal, E. Ethnicity-Specific Molecular Alterations in MAPK and JAK/STAT Pathways in Early-Onset Colorectal Cancer. Cancers 17, 1093 (2025). https://pubmed.ncbi.nlm.nih.gov/40227607/ 21.       Benson, A. B. et al. Colon Cancer, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. J. Natl. Compr. Cancer Netw. JNCCN 19, 329–359 (2021). https://pubmed.ncbi.nlm.nih.gov/33724754/ 22.       Christenson, E. S. et al. Nivolumab and Relatlimab for the treatment of patients with unresectable or metastatic mismatch repair proficient colorectal cancer. https://pubmed.ncbi.nlm.nih.gov/40388545/ 23.       Dasari, A. et al. Fruquintinib versus placebo in patients with refractory metastatic colorectal cancer (FRESCO-2): an international, multicentre, randomised, double-blind, phase 3 study. The Lancet 402, 41–53 (2023). https://pubmed.ncbi.nlm.nih.gov/37331369/ 24.       Strickler, J. H. et al. Tucatinib plus trastuzumab for chemotherapy-refractory, HER2-positive, RAS wild-type unresectable or metastatic colorectal cancer (MOUNTAINEER): a multicentre, open-label, phase 2 study. Lancet Oncol. 24, 496–508 (2023). https://pubmed.ncbi.nlm.nih.gov/37142372/ 25.       Sauer, R. et al. Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer. N. Engl. J. Med. 351, 1731–1740 (2004). https://pubmed.ncbi.nlm.nih.gov/15496622/ 26.       Cercek, A. et al. Adoption of Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer. JAMA Oncol. 4, e180071 (2018). https://pubmed.ncbi.nlm.nih.gov/29566109/ 27.       Garcia-Aguilar, J. et al. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy. J. Clin. Oncol. 40, 2546–2556 (2022). https://pubmed.ncbi.nlm.nih.gov/35483010/ 28.       Schrag, D. et al. Preoperative Treatment of Locally Advanced Rectal Cancer. N. Engl. J. Med. 389, 322–334 (2023). https://pubmed.ncbi.nlm.nih.gov/37272534/ 29.       Kunkler, I. H., Williams, L. J., Jack, W. J. L., Cameron, D. A. & Dixon, J. M. Breast-Conserving Surgery with or without Irradiation in Early Breast Cancer. N. Engl. J. Med. 388, 585–594 (2023). https://pubmed.ncbi.nlm.nih.gov/36791159/ 30.       Jacobsen, R. L., Macpherson, C. F., Pflugeisen, B. M. & Johnson, R. H. Care Experience, by Site of Care, for Adolescents and Young Adults With Cancer. JCO Oncol. Pract. (2021) doi:10.1200/OP.20.00840. https://pubmed.ncbi.nlm.nih.gov/33566700/ 31.       Ruddy, K. J. et al. Prospective Study of Fertility Concerns and Preservation Strategies in Young Women With Breast Cancer. J. Clin. Oncol. (2014) doi:10.1200/JCO.2013.52.8877. https://pubmed.ncbi.nlm.nih.gov/24567428/ 32.       Su, H. I. et al. Fertility Preservation in People With Cancer: ASCO Guideline Update. J. Clin. Oncol. 43, 1488–1515 (2025). https://pubmed.ncbi.nlm.nih.gov/40106739/ 33.       Smith, K. L., Gracia, C., Sokalska, A. & Moore, H. Advances in Fertility Preservation for Young Women With Cancer. Am. Soc. Clin. Oncol. Educ. Book 27–37 (2018) doi:10.1200/EDBK_208301. https://pubmed.ncbi.nlm.nih.gov/30231357/ 34.       Blumenfeld, Z. How to Preserve Fertility in Young Women Exposed to Chemotherapy? The Role of GnRH Agonist Cotreatment in Addition to Cryopreservation of Embrya, Oocytes, or Ovaries. The Oncologist 12, 1044–1054 (2007). 35.       Bhagavath, B. The current and future state of surgery in reproductive endocrinology. Curr. Opin. Obstet. Gynecol. 34, 164 (2022). 36.       Ribeiro, R. et al. Uterine transposition: technique and a case report. Fertil. Steril. 108, 320-324.e1 (2017). 37.       Yazdani, A., Sweterlitsch, K. M., Kim, H., Flyckt, R. L. & Christianson, M. S. Surgical Innovations to Protect Fertility from Oncologic Pelvic Radiation Therapy: Ovarian Transposition and Uterine Fixation. J. Clin. Med. 13, 5577 (2024). 38.       Holowatyj, A. N., Eng, C. & Lewis, M. A. Incorporating Reproductive Health in the Clinical Management of Early-Onset Colorectal Cancer. JCO Oncol. Pract. 18, 169–172 (2022). ***Behind the Knife Colorectal Surgery Oral Board Audio Review: https://app.behindtheknife.org/course-details/colorectal-surgery-oral-board-audio-review 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://app.behindtheknife.org/listen