Podcasts about nih

In this episode of SleepTech Talk, we explore how patient involvement is reshaping the diagnosis and treatment of obstructive sleep apnea (OSA).Our guest, Chris Gouveia, MD, is a sleep apnea surgeon and otolaryngologist with training at NIH, Northwestern, and Stanford, currently practicing at Kaiser Permanente.Dr. Gouveia shares why involving patients more deeply in their diagnosis and therapy leads to better outcomes — and how offering multiple treatment pathways can dramatically improve the patient journey.We also take a forward-looking view at the future of sleep medicine, including how OSA diagnosis and therapy are evolving beyond a one-size-fits-all approach.⭐ In this episode, we discuss:Why patient engagement is critical in sleep apnea careHow shared decision-making improves adherence and outcomesExpanding therapy options beyond traditional CPAPThe role of surgery, technology, and personalized care in OSAWhat the future holds for sleep apnea diagnosis and treatmentDr. Gouveia is also the author of Night Shift, a Substack focused on sleep health and medicine, where he explores clinical insights and evolving trends in sleep care.This episode is essential listening for clinicians, sleep professionals, and patients who want to understand where sleep apnea care is headed next.ABOUT SLEEPTECH TALKSleepTech Talk brings together leaders in sleep medicine, technology, and innovation to explore the tools and trends shaping the future of sleep health.Catch the show on most podcast platforms or on YouTubewww.youtube.com/@sleeptechtalk A huge thanks to our sponsors:Medbridge Healthcare  : For Job Opportunities with MedBridge Healthcare visit: https://medbridgehealthcare.com/careers/Fisher & Paykel Healthcare  Discover how F&P full-face masks have led millions of people to a great night's sleep at https://www.fphcare.com/curiosityhttps://www.fphcare.com/us/homecare/sleep-apnea/React Health  https://www.reacthealth.com/More resources for clinicians can be found at Sleep Review Magazine  https://sleepreviewmag.com/Don't forget to Like, Share, and Comment! Subscribe to SleepTech Talk for more insights into sleep apnea, CPAP therapy, and innovations shaping the future of sleep care.Whether you're a sleep professional or a healthcare innovator, this episode explores the intersection of technology, patient care, and sleep medicine.Learn more about the show at https://www.sleeptechtalk.com/thetechroomCredits:Audio/ Video: Diego R Mannikarote; Music: Pierce G MannikaroteHosts: J. Emerson Kerr, Robert Miller, Gerald George MannikaroteCopyright: ⓒ 2025 SleepTech Talk ProductionsEpisode 114The views and opinions expressed by guests on SleepTech Talk are their own and do not necessarily reflect those of the podcast hosts or SleepTech Talk as a whole. This podcast is intended for educational and informational purposes only and should not be considered medical advice. Listeners are encouraged to consult with a qualified healthcare professional for any medical concerns or questions.Sleep apnea, obstructive sleep apnea, oral sleep appliance, inspire, surgery, sleep surgery, CPAP, AI, Artificial Intelligence

In this year-end episode of the Animal Wellness Podcast, host Joseph Grove is joined by Animal Wellness Action leaders to reflect on major wins for animals in 2025—and the critical fights ahead in 2026. • Jennifer Skiff, director of international programs, shares progress in the Kangaroos Are Not Shoes campaign, which has pushed major athletic brands away from kangaroo leather, and previews new international work restoring elephant migration corridors in southern Africa. • Don Green, political director, sounds the alarm on the dangerous Save Our Bacon Act, explaining how it would overturn voter-approved animal welfare laws, punish humane farmers, and undermine states' rights. • Kevin Chambers, lead investigator, details undercover investigations exposing cockfighting and dogfighting rings and explains how federal legislation could strengthen enforcement against organized animal cruelty. • Tami Drake, research and regulatory policy director, breaks down the major strides made by the FDA, CDC, and NIH towards more humane testing methods for drug development. The episode closes with Wayne Pacelle, president of Animal Wellness Action, who reflects on a banner year that included historic progress on ending animal testing, eliminating the school milk mandate, and reshaping corporate practices, while outlining the battles still ahead to protect wildlife and enforce new reforms. Helping animals helps us all—and this episode shows how real change happens. Mentioned in the Episode • Follow our Kangaroos Are Not Shoes work—including new publications such as upcoming report on kangaroo meat in the dogfood trade—bookmark this page. • Visit this link to action immediately to help defeat the Save Our Bacon Act. • Here is a video that shows the brutality of cockfighting. In particular, note the harsh treatment of birds who are still alive after the fight is over. (Note: The clip is disturbing to view.) • Care to support the work of Animal Wellness Action with $25 or any other amount? Please go here. The Animal Wellness podcast is produced by Animal Wellness Action and the Center for a Humane Economy. It focuses on improving the lives of animals in the United States and abroad through legislation and by influencing businesses to create a more humane economy. The show is hosted by veteran journalist and animal-advocate Joseph Grove.    www.animalwellnessaction.org www.centerforahumaneeconomy.org   Facebook: https://www.facebook.com/AnimalWellnessAction Facebook: https://www.facebook.com/centerforahumaneeconomy/ Twitter: https://twitter.com/AWAction_News Twitter: https://twitter.com/TheHumaneCenter   Instagram: https://www.instagram.com/animalwellnessaction/ Instagram: https://www.instagram.com/centerforahumaneeconomy/ LinkedIn: https://www.linkedin.com/company/animal-wellness-action/    YouTube: https://www.youtube.com/channel/UCI_6FxM4hD6oS5VSUwsCnNQ 

If you have ADHD or autism, research shows you're at a much higher risk for developing chronic pain — a connection many doctors and patients still don't know about. In this episode of Hyperfocus, we talk with a doctor who's trying to change that.Dr. Michael Lenz, a Wisconsin-based pain specialist, explains what the medical community is discovering about the connection between ADHD, autism, and chronic pain, including conditions like fibromyalgia and migraines. He also shares stories from his practice, including times when treating a patient's ADHD unexpectedly improved their chronic pain symptoms.For more on this topic:  Dr. Lenz's podcast and bookThe Weak Link: Hypotonia in Infancy and Autism Early Identification - PMCADHD-pain: Characteristics of chronic pain and association with muscular dysregulation in adults with ADHDOrder friend of the show Craig Thomas' book NIH study on joint hypermobility For a transcript and more resources, visit Hyperfocus on Understood.org. You can also email us at hyperfocus@understood.org. Understood.org is a nonprofit organization dedicated to empowering people with learning and thinking differences, like ADHD and dyslexia. If you want to help us continue this work, donate at understood.org/give Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Listen in as we talk with Dr. Kate Creevy about her fascinating and insightful path in veterinary medicine. She shares how decisions she didn't see as impactful at the time played crucial roles in her career development, and the important role of science and research for the future of human and animal kind. Plus, learn how a phone call that started with “I got this guy in genetics” led to her role as Co-Founder and Chief Veterinary Officer with the Dog Aging Project, and her advice to veterinary students and colleagues as a veterinary school professor. This is one of those episodes you will want to listen to, save, and listen to again. As always, we want to hear from YOU. Please share your thoughts by sending an email or joining the conversation.     Photo credit: Texas A&M University College of Veterinary Medicine & Biomedical Sciences photo, Dr Creevy with two Border Collies at different parts of their lifespan journey - Poet at age 3, and Sophie at age 14. GUEST BIO: Kate Creevy, DVM, MS, DACVIM-SAIM Dr. Creevy's educational path includes Georgetown University (BS), the University of Tennessee (DVM), the University of Minnesota (small animal rotating internship) and the University of Georgia (internal medicine residency and MS in Infectious Disease). Along the way she has worked in emergency practice in the Twin Cities and Washington DC, as well as academic emergency practice at UGA, and completed a Cancer Research Training Award Fellowship developing protocols for chimeric bone marrow transplantation in immunodeficient dogs at the NIH's National Cancer Institute. After ten years as a small animal internist on UGA's faculty, she joined the faculty at Texas A&M University's School of Veterinary Medicine where she is now a Professor in Small Animal Internal Medicine.  Dr. Creevy is the Chief Veterinary Officer for the Dog Aging Project, a multicenter, multidisciplinary research collaboration, with over 50,000 dogs enrolled across the US. The long-term goal of the Dog Aging Project is to understand the genetic and environmental determinants of healthy aging in companion dogs. In addition to her work on canine aging, Dr. Creevy's research interests include infectious disease, and the development of lifelong learning skills and critical thinking skills among professional students and early-career veterinarians.     LINKS AND INFORMATION: Dog Aging Project: https://dogagingproject.org/ University of Tennessee, College of Veterinary Medicine: https://vetmed.tennessee.edu/ University of Georgia, College of Veterinary Medicine: https://vet.uga.edu/ Texas A&M College of Veterinary Medicine: https://vetmed.tamu.edu/ One Health: https://www.who.int/health-topics/one-health#tab=tab_1 Zoobiquity book: https://www.zoobiquity.com/ Lessons in Chemistry book: https://www.goodreads.com/book/show/58065033-lessons-in-chemistry   If you like these podcast and want to hear more, please support these efforts through a donation to the VIN Foundation: https://vinfoundation.org/give/ You may learn more about the VIN Foundation, on the website, or join the conversation on Facebook, Instagram, LinkedIn, or signup for the newsletter. If you like this podcast, we would appreciate it if you follow and share. As always, we welcome feedback. If you have an idea for a podcast episode, we'd love to hear it!

2025 was a hard year for science. The Trump administration upended federal funding for all kinds of scientific pursuits, slashing budgets across agencies like NASA, NIH and NOAA. NPR's Rob Stein and Katia Riddle spoke to scientists and officials who worry that those cuts could cause the United States to lose its competitive edge as a global hub for research and innovation, and steer future generations away from careers in science. For sponsor-free episodes of Consider This, sign up for Consider This+ via Apple Podcasts or at plus.npr.org. Email us at considerthis@npr.org.This episode was produced by Michael Levitt, with audio engineering by Zo vanGinhoven. It was edited by Sarah Handel, Scott Hensley and Amina Khan. Our executive producer is Sami Yenigun.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Are you concerned about NIH funding for your research? Dr. Meg Bouvier, founder of Bouvier Grant Group, shares encouraging news: despite proposed cuts, Congress has protected NIH's nearly $50 billion budget with strong bipartisan support.  In this episode, Dr. Meg Bouvier explains how researchers can adapt their grant applications by reframing language to emphasize disease burden reduction and cost savings—without changing their core research direction. With nearly four decades of experience, including working as a staff writer for Francis Collins, she dispels myths about "forbidden terms" and offers practical strategies for navigating today's funding climate.  We also explore Meg's journey building a successful consulting business by hiring the right team. Her director of operations handles everything except Meg's zone of genius—allowing her to focus entirely on training researchers and analyzing grants. This principle applies whether you're pursuing funding or building a medical practice: stay at the top of your licensure and delegate everything else.  Key topics covered: NIH budget reality check, grant application strategies, team building, research development resources, adapting to funding climate changes, and balancing business ownership with meaningful work.  Read the full show notes, memorable quotes, and key takeaways.  

Eric welcomes Council on Foreign Relations President Mike Froman to discuss CFR's latest task force report on U.S. economic security. They explore the importance of AI, quantum computing and biotechnology as foundational technologies in today's strategic competition, the effort that China is investing in these technologies, and the market failures that have led the U.S. to underinvest in quantum and biotech. The conversation also covers supply chain vulnerabilities, human capital shortfalls in key areas of technology, and the tension in the Trump administration's effort to address China's growing technological dominance while simultaneously cutting funding for basic research at the NSF, NIH, and other institutions. U.S. Economic Security: Winning the Race for Tomorrow's Technologies: https://www.cfr.org/task-force-report/us-economic-security Mike Froman on Substack: https://mikefroman.substack.com/ Shield of the Republic is a Bulwark podcast co-sponsored by the Miller Center of Public Affairs at the University of Virginia.

Dr. Ryan Gober, Medical Science Liaison at Electromedical Products International (EPI). Dr. Gober shares his insights on the science behind Alpha-Stim, its clinical applications for anxiety, insomnia, and pain, and the role of non-invasive brain stimulation in mental health treatment.Electromedical Products International (EPI) is a medical device company specializing in developing neuromodulation technologies including its flagship product, Alpha-Stim.   Alpha-Stim is a FDA cleared medical device which utilizes a form of non-invasive electrical stimulation  to treat symptoms of anxiety, insomnia, and pain.  Ryan Gober is a Medical Science Liaison with EPI's Medical Affairs team responsible for sharing scientific and clinical information related to the Alpha-Stim device.  Prior to joining EPI, Ryan completed an NIH research fellowship followed by a PhD in translational neuroscience where he performed research on behavioral health conditions and developed an interest in non-pharmacological options for treating mental health conditions, leading him to join Alpha-Stim.  SHOWNOTES: 

Dr. Kirk Erickson is Director of Translational Neuroscience and Mardian J. Blair Endowed Chair of Neuroscience at the AdventHealth Research Institute, Neuroscience Institute. Dr. Erickson received his Ph.D. at the University of Illinois at Urbana-Champaign and was a post-doctoral scholar at the Beckman Institute for Advanced Science and Engineering. He was also a Professor of Psychology and Neuroscience at the University of Pittsburgh before starting at AdventHealth. Dr. Erickson's vast research program focuses on the effects of physical activity on brain health across the lifespan. This research has resulted in > 250 published articles and 15 book chapters. Dr. Erickson's research has been funded by numerous awards and grants from NIH, the Alzheimer's Association, and other organizations. He has been awarded a large multi-site Phase III clinical trial examining the impact of exercise on cognitive function in cognitively normal older adults. His research resulted in the prestigious Chancellor's Distinguished Research Award from the University of Pittsburgh. He was named a Fellow of the Academy of Behavioral Medicine Research in 2016, and a Distinguished Scientist Award by Murdoch University in 2018. He currently holds a Visiting Professor appointment at the University of Granada, Spain. Dr. Erickson was a member of the 2018 Physical Activity Guidelines Advisory Committee, and chair of the Brain Health subcommittee charged with developing the second edition of the Physical Activity Guidelines for Americans. His research has been featured in a long list of print, radio, and electronic media including the New York Times, CNN, BBC News, NPR, Time, and the Wall Street Journal.   This podcast episode is sponsored by Fibion Inc. | Better Sleep, Sedentary Behaviour and Physical Activity Research with Less Hassle --- Collect, store and manage SB and PA data easily and remotely - Discover ground-breaking Fibion SENS --- SB and PA measurements, analysis, and feedback made easy.  Learn more about Fibion Research --- Learn more about Fibion Sleep and Fibion Circadian Rhythm Solutions. --- Fibion Kids - Activity tracking designed for children. --- Collect self-report physical activity data easily and cost-effectively with Mimove. --- Explore our Wearables,  Experience sampling method (ESM), Sleep,  Heart rate variability (HRV), Sedentary Behavior and Physical Activity article collections for insights on related articles. --- Refer to our article "Physical Activity and Sedentary Behavior Measurements" for an exploration of active and sedentary lifestyle assessment methods. --- Learn about actigraphy in our guide: Exploring Actigraphy in Scientific Research: A Comprehensive Guide. --- Gain foundational ESM insights with "Introduction to Experience Sampling Method (ESM)" for a comprehensive overview. --- Explore accelerometer use in health research with our article "Measuring Physical Activity and Sedentary Behavior with Accelerometers ". --- For an introduction to the fundamental aspects of HRV, consider revisiting our Ultimate Guide to Heart Rate Variability. --- Follow the podcast on Twitter https://twitter.com/PA_Researcher Follow host Dr Olli Tikkanen on Twitter https://twitter.com/ollitikkanen Follow Fibion on Twitter https://twitter.com/fibion https://www.youtube.com/@PA_Researcher

Imagine a blueprint so ambitious it aims to remake the entire U.S. government in 180 days, placing the executive branch firmly under presidential control. That's Project 2025, the Heritage Foundation's 900-page Mandate for Leadership, published in April 2023, which outlines radical reforms for a conservative administration.At its core, the plan pushes the unitary executive theory, seeking to dismantle agency independence. According to the Heritage Foundation's document, it calls for replacing federal civil service workers with loyalists via Schedule F, a policy to strip protections from up to a million employees. The Department of Justice and FBI would answer directly to the White House, with the FBI director personally accountable to the president. Wikipedia details how it brands the DOJ a "bloated bureaucracy" pushing a "radical liberal agenda," proposing reforms to combat "anti-white racism" under the Civil Rights Act of 1964.Concrete examples abound. Project 2025 urges abolishing the Department of Education, Department of Homeland Security—replacing it with a streamlined immigration agency—and the Consumer Financial Protection Bureau. The National Labor Relations Board would shrink, making union organizing harder by eliminating card-check elections, as noted in the National Federation of Federal Employees' analysis. On health, it proposes Medicaid cuts like per-capita caps, stricter work requirements, and voucher options, while defunding NIH stem cell research. Tax reforms include corporate cuts and a flat individual income tax.Latest developments, as reported by Government Executive in April 2025, show execution accelerating under President Trump's Department of Government Efficiency, led by Elon Musk. Entire agencies like USAID face elimination, with tens of thousands fired—though courts have reinstated some, like Consumer Financial Protection Bureau staff. Health and Human Services plans 20,000 cuts, 25% of its workforce. Jenny Mattingley of the Partnership for Public Service warns this politicizes a traditionally nonpartisan civil service, undercutting services for rural areas and seniors.Experts like the ACLU highlight risks to reproductive, LGBTQ, and immigrant rights, while proponents argue it streamlines efficiency. The plan's scope—from fossil fuel favoritism to military aid in immigration enforcement—signals a governance overhaul.Looking ahead, key decision points loom: congressional battles over agency eliminations and Supreme Court challenges to workforce purges. As implementation unfolds, its full impact on American democracy remains a pivotal watchpoint.Thank you for tuning in, listeners. Come back next week for more.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

As 2025 closes, biopharma and healthcare are learning to live on shifting ground. In this special year-end episode of "The Top Line," Fierce reporters take stock of a year defined by federal research cuts, vaccine policy fights and leadership churn at the FDA, then push the conversation forward into the questions that will shape 2026. The through line is that uncertainty has become an operating environment, and the industry is recalibrating in real time. Fierce Biotech’s Gabrielle Masson, joined by Darren Incorvia, traces how funding decisions can narrow the pipeline years before the consequences are visible. Fierce Pharma’s Fraiser Kansteiner sits down with Angus Liu and Eric Sagonowsky to unpack the new center of gravity inside federal agencies, where vaccine recommendations, review norms and new FDA pilots are colliding with questions about capacity and outside influence. From there, Ben Adams and James Waldron bring the lens to Europe, where Jefferies in London captured a cautiously optimistic market still wrestling with tariffs, pricing pressure and investment hesitation. The episode closes with Fierce Healthcare’s Heather Landi and Paige Minemyer sharing their outlook on 2026, from the fight over ACA subsidies and Medicaid headwinds to the next phase of AI adoption, where the promise is real but the payoff may be slower, messier and more uneven than the hype suggests. To learn more about the topics in this episode: 'Unprecedented turmoil' engulfing FDA threatens public health: mRNA coalition speaks out FDA names Tracy Beth Høeg, fresh from vaccine safety probe, as acting head of drug center A dozen former FDA commissioners blast Prasad's proposed vaccine policy changes In letter to Makary, biotech CEOs push for FDA stability and say volatility threatens US innovation NIH grant cuts have disrupted hundreds of clinical trials, study finds 'Alternative history' of the NIH shows how a 40% budget cut may thwart new medicines House passes healthcare affordability bill without subsidy extension AMA: A look at concentration in commercial insurance, MA markets 2025 Outlook: Hospital finances show signs of stability, but rising costs will be a major headwind See omnystudio.com/listener for privacy information.

Kevin Hall, Ph.D., is a physicist-turned-nutrition scientist whose rigorous research has upended some of our most sacrosanct beliefs about metabolism, dieting, and weight loss. This conversation explores why diets fail, the truth behind the "slow metabolism" myth, how ultra-processed foods hijack our biology, and why the 800-pound gorilla driving the obesity epidemic isn't willpower—it's our toxic food environment. He also opens up about his decision to leave the NIH after 20 years due to political interference with his research. Kevin is an honest actor, always trying to set matters to rights amidst a hurricane of nutritional misinformation. Enjoy! Show notes + MORE Watch on YouTubeNewsletter Sign-Up Today's Sponsors: On: High-performance shoes & apparel crafted for comfort and style

Dr. Marissa Russo trained to become a cancer biologist. She spent four years studying one of the deadliest brain tumors in adults and built her entire research career around a simple, urgent goal: open her own lab and improve the odds for patients with almost no shot at survival. In 2024 she applied for an F31 diversity grant through the NIH. The reviewers liked her work. Her resubmission was strong. Then the grant system started glitching. Dates vanished. Study sections disappeared. Emails went silent. When she finally reached a program officer, the message was clear: scrub the DEI language, withdraw, and resubmit. She rewrote the application in ten days. It failed. She had to start over. Again. This time with her identity erased.Marissa left the lab. She found new purpose as a science communicator, working at STAT News through the AAAS Mass Media Fellowship. Her story captures what happens when talent collides with institutional sabotage. Not every scientist gets to choose a Plan B. She made hers count.RELATED LINKSMarissa Russo at STAT NewsNIH F31 grant story in STATAAAS Mass Media FellowshipContact Marissa RussoFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Join Josh Webster and Dr. Mark Edney as they break down the AUA's most significant health policy victories of 2025. From the historic removal of the FDA's black box warning on low-dose estrogen to progress on Medicare payment reform, NIH research funding, prior authorization relief, telehealth expansion, and prostate cancer screening advocacy, 2025 was a big year for the AUA. This special AUANews Inside Tract episode brings listeners inside the halls of Congress, highlights the AUA's growing influence in federal and state policy, outlines what's next, and how members can stay engaged as momentum builds for 2026.

Dr. Kirk Erickson is Director of Translational Neuroscience and Mardian J. Blair Endowed Chair of Neuroscience at the AdventHealth Research Institute, Neuroscience Institute. Dr. Erickson received his Ph.D. at the University of Illinois at Urbana-Champaign and was a post-doctoral scholar at the Beckman Institute for Advanced Science and Engineering. He was also a Professor of Psychology and Neuroscience at the University of Pittsburgh before starting at AdventHealth. Dr. Erickson's vast research program focuses on the effects of physical activity on brain health across the lifespan. This research has resulted in > 250 published articles and 15 book chapters. Dr. Erickson's research has been funded by numerous awards and grants from NIH, the Alzheimer's Association, and other organizations. He has been awarded a large multi-site Phase III clinical trial examining the impact of exercise on cognitive function in cognitively normal older adults. His research resulted in the prestigious Chancellor's Distinguished Research Award from the University of Pittsburgh. He was named a Fellow of the Academy of Behavioral Medicine Research in 2016, and a Distinguished Scientist Award by Murdoch University in 2018. He currently holds a Visiting Professor appointment at the University of Granada, Spain. Dr. Erickson was a member of the 2018 Physical Activity Guidelines Advisory Committee, and chair of the Brain Health subcommittee charged with developing the second edition of the Physical Activity Guidelines for Americans. His research has been featured in a long list of print, radio, and electronic media including the New York Times, CNN, BBC News, NPR, Time, and the Wall Street Journal.   This podcast episode is sponsored by Fibion Inc. | Better Sleep, Sedentary Behaviour and Physical Activity Research with Less Hassle --- Collect, store and manage SB and PA data easily and remotely - Discover ground-breaking Fibion SENS --- SB and PA measurements, analysis, and feedback made easy.  Learn more about Fibion Research --- Learn more about Fibion Sleep and Fibion Circadian Rhythm Solutions. --- Fibion Kids - Activity tracking designed for children. --- Collect self-report physical activity data easily and cost-effectively with Mimove. --- Explore our Wearables,  Experience sampling method (ESM), Sleep,  Heart rate variability (HRV), Sedentary Behavior and Physical Activity article collections for insights on related articles. --- Refer to our article "Physical Activity and Sedentary Behavior Measurements" for an exploration of active and sedentary lifestyle assessment methods. --- Learn about actigraphy in our guide: Exploring Actigraphy in Scientific Research: A Comprehensive Guide. --- Gain foundational ESM insights with "Introduction to Experience Sampling Method (ESM)" for a comprehensive overview. --- Explore accelerometer use in health research with our article "Measuring Physical Activity and Sedentary Behavior with Accelerometers ". --- For an introduction to the fundamental aspects of HRV, consider revisiting our Ultimate Guide to Heart Rate Variability. --- Follow the podcast on Twitter https://twitter.com/PA_Researcher Follow host Dr Olli Tikkanen on Twitter https://twitter.com/ollitikkanen Follow Fibion on Twitter https://twitter.com/fibion https://www.youtube.com/@PA_Researcher

In this episode, Dr. Paul Turek and I are talking about the latest research on isotretinoin aka Accutane (a medication traditionally used for acne) and its potential to restore sperm production in men who previously had no options. Our discussion explores the science behind this therapy, the real-world impact for patients, and what this means for the future of male fertility treatments. We also touch on the broader landscape of advances in male reproductive health, including the role of AI and the importance of early, expert evaluation. Read the full show notes on Dr. Aimee's website. In this episode, we cover: The story behind the recent study on isotretinoin and male infertility How vitamin A derivatives play a crucial role in sperm production The specifics of Dr. Turek's clinical trial with isotretinoin and its promising results Safety considerations and misconceptions about isotretinoin use in men How this therapy fits into the broader landscape of male fertility treatments The future of male fertility, including AI-driven advances and at-home diagnostics Practical advice for men and couples navigating infertility Resources: Turek Clinic Isotretinoin Study at NIH website Talk with Turek Podcast Contact Turek Clinic: San Francisco (415-392-3200), Los Angeles (310-499-9299) Egg Whisperer Show on YouTube Egg Whisperer Show on Spotify Do you have questions about IVF? Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, January 12, 2026, at 4 pm PST, where I'll explain IVF and Egg Freezing, and answer your questions live on Zoom. Other ways to connect with me: Visit my YouTube channel for more fertility tipsSubscribe to the newsletter to get updatesJoin Egg Whisperer SchoolRequest a Consultation with Dr. Aimee Dr. Aimee Eyvazzadeh is one of America's most well-known fertility doctors. Her success rate at baby-making gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org.

The lymphatic system, or lymphoid system, is one of the components of the circulatory system, and it serves a critical role in both immune function and surplus extracellular fluid drainage.  Components of the lymphatic system include lymph, lymphatic vessels and plexuses, lymph nodes, lymphatic cells, and a variety of lymphoid organs. The pattern and form of lymphatic channels are more variable and complex but generally parallel those of the peripheral vascular system. The lymphatic system partly functions to convey lymphatic fluid, or lymph, through a network of lymphatic channels, filter lymphatic fluid through lymph nodes and return lymphatic fluid to the bloodstream, where it is eventually eliminated. Nearly all body organs, regions, and systems have lymphatic channels to collect the various byproducts that require elimination . Liver and intestinal lymphatics produce about 80% of the volume of lymph in the body. Notable territories of the body that do not appear to contain lymphatics include the bone marrow, epidermis, as well as other tissues where blood vessels are absent. The central nervous system was long considered to be absent of lymphatic vessels until they were recently identified in the cranial meninges. Moreover, a vessel appearing to have lymphatic features was also discovered in the eye. The lymphatic system is critical in a clinical context, particularly given that it is a major route for cancer metastasis and that the inflammation of lymphatic vessels and lymph nodes is an indicator of pathology.  Structure The lymphatic system includes numerous structural components, including lymphatic capillaries, afferent lymphatic vessels, lymph nodes, efferent lymphatic vessels, and various lymphoid organs.  Lymphatic capillaries are tiny, thin-walled vessels that originate blindly within the extracellular space of various tissues. Lymphatic capillaries tend to be larger in diameter than blood capillaries and are interspersed among them to enhance their ability to collect interstitial fluid efficiently. They are critical in the drainage of extracellular fluid and allow this fluid to enter the closed capillaries but not exit due to their unique morphology. Lymphatic capillaries at their blind ends are composed of a thin endothelium without a basement membrane. The endothelial cells at the closed end of the capillary overlap but shift to open the capillary end when interstitial fluid pressure is greater than intra-capillary pressure. This process permits lymphocytes, interstitial fluid, bacteria, cellular debris, plasma proteins, and other cells to enter the lymphatic capillaries. Special lymphatic capillaries called lacteals exist in the small intestine to contribute to the absorption of dietary fats. Lymphatics in the liver contribute to a specialized role in transporting hepatic proteins into the bloodstream. The lymphatic capillaries of the body form large networks of channels called lymphatic plexuses and converge to form larger lymphatic vessels. Lymphatic vessels convey lymph, or lymphatic fluid, through their channels. Afferent (toward) lymphatic vessels convey unfiltered lymphatic fluid from the body tissues to the lymph nodes, and efferent (away) lymphatic vessels convey filtered lymphatic fluid from lymph nodes to subsequent lymph nodes or into the venous system. The various efferent lymphatic vessels in the body eventually converge to form two major lymphatic channels: the right lymphatic duct and the thoracic duct.  The right lymphatic duct drains most of the right upper quadrant of the body, including the right upper trunk, right upper extremity, and right head and neck. The right lymphatic trunk is a visible channel in the right cervical region just anterior to the anterior scalene muscle. Its origin and termination are variable in morphology, typically forming as the convergence of the right bronchomediastinal, jugular, and subclavian trunks, extending 1 to 2 centimeters in length before returning its contents to the systemic circulation at the junction of the right internal jugular, subclavian, and/or brachiocephalic veins.  The thoracic duct, also known as the left lymphatic duct or van Hoorne's canal, is the largest of the body's lymphatic channels. It drains most of the body except for the territory of the right superior thorax, head, neck, and upper extremity served by the right lymphatic duct. The thoracic duct is a thin-walled tubular vessel measuring 2 to 6 mm in diameter. The length of the duct ranges from 36 to 45 cm. The thoracic duct is highly variable in form but typically arises in the abdomen at the superior aspect of the cisterna chyli, around the level of the twelfth thoracic vertebra (T12). The cisterna chyli, from which it extends, is an expanded lymphatic sac that forms at the convergence of the intestinal and lumbar lymphatic trunks extending along the L1-L2 vertebral levels. The cisterna chyli is present in approximately 40-60% of the population, and in its absence, the intestinal and lumbar lymphatic trunks communicate directly with the thoracic duct at the T12 level. As a result, the thoracic duct receives lymphatic fluid from the lumbar lymphatic trunks and chyle, composed of lymphatic fluid and emulsified fats, from the intestinal lymphatic trunk. Initially, the thoracic duct is located just to the right of the midline and posterior to the aorta. It exits the abdomen and enters the thorax via the aortic hiatus formed by the right and left crura of the diaphragm, side by side with the aorta. The thoracic duct then ascends in the thoracic cavity just anterior and to the right of the vertebral column between the aorta and azygos vein. At about the level of the fifth thoracic vertebra (T5), the thoracic duct typically crosses to the left of the vertebral column and posterior to the esophagus. From here, it ascends vertically and usually empties its contents into the junction of the left subclavian and left internal jugular veins in the cervical region. To ensure that lymph does not flow backward, collecting lymphatic vessels and larger lymphatic vessels have one-way valves. These valves are not present in the lymphatic capillaries. These lymphatic valves permit the continued advancement of lymph through the lymphatic vessels aided by a pressure gradient created by vascular smooth muscle, skeletal muscle contraction, and respiratory movements. However, it is important to note that lymphatic vessels also communicate with the venous system through various anastomoses. Lymph nodes are small bean-shaped tissues situated along lymphatic vessels. Lymph nodes receive lymphatic fluid from afferent lymphatic vessels and convey lymph away through efferent lymphatic vessels. Lymph nodes serve as a filter and function to monitor lymphatic fluid/blood composition, drain excess tissue fluid and leaked plasma proteins, engulf pathogens, augment an immune response, and eradicate infection. Several organs in the body are considered to be lymphoid or lymphatic organs, given their role in the production of lymphocytes. These include the bone marrow, spleen, thymus, tonsils, lymph nodes, and other tissues. Lymphoid organs can be categorized as primary or secondary lymphoid organs. Primary lymphoid organs are those that produce lymphocytes, such as the bone marrow and thymus. Bone marrow is the primary site for the production of lymphocytes. The thymus is a glandular organ located anterior to the pericardium. It serves to mature and develop T cells, or thymus cell lymphocytes, in response to an inflammatory process or pathology. As individuals age, both their bone marrow and thymus reduce and accumulate fat. Secondary lymphoid organs serve as territories in which immune cells function and include the spleen, tonsils, lymph nodes, and various mucous membranes, such as in the intestines. The spleen is a purplish, fist-sized organ in the left upper abdominal quadrant that contributes to immune function by serving as a blood filter, storing lymphocytes within its white pulp, and being a site for an adaptive immune response to antigens. The lingual tonsils, palatine tonsils, and pharyngeal tonsils, or adenoids, work to prevent pathogens from entering the body. Mucous membranes in the gastrointestinal, respiratory, and genitourinary systems also function to prevent pathogens from entering the body. Lymph Lymphatic fluid, or lymph, is similar to blood plasma and tends to be watery, transparent, and yellowish in appearance. Extracellular fluid leaks out of the blood capillary walls because of pressure exerted by the heart or osmotic pressure at the cellular level. As the interstitial fluid accumulates, it is picked up by the tiny lymphatic capillaries along with other substances to form lymph. This fluid then passes through the lymphatic vessels and lymph nodes and finally enters the venous circulation. As the lymph passes through the lymph nodes, both monocytes and lymphocytes enter it.  Lymph is composed primarily of interstitial fluid with variable amounts of lymphocytes, bacteria, cellular debris, plasma proteins, and other cells. In the GI tract, lymphatic fluid is called chyle and has a milk-like appearance that is chiefly due to the presence of cholesterol, glycerol, fatty acids, and other fat products. The vessels that transport the lymphatic fluid from the GI tract are known as lacteals. Embryology The development of the lymphatic system is known from both human and animal, especially mouse studies. The lymphatic vessels form after the development of blood vessels, around six weeks post-fertilization. The endothelial cells that serve as precursors to the lymphatics arise from the embryonic cardinal veins. The process by which lymphatic vessels form is similar to that of the blood vessels and produces lymphatic-venous and intra-lymphatic anastomoses, but diverse origins exist for components of lymphatic vessel formation in different regions.  Six primary lymph sacs develop and are apparent about eight weeks post-fertilization. These include, from caudal to cranial, one cisterna chyli, one retroperitoneal lymph sac, two iliac lymph sacs, and two jugular lymph sacs. The jugular lymph sacs are the first to develop, initially appearing next to the jugular part of the cardinal vein. Lymphatic vessels then form adjacent to the blood vessels and connect the various lymph sacs. The lymphatic vessels primarily arise from the lymph sacs through the process of self-proliferation and polarized sprouting.  Stem/progenitor cells play a huge role in forming lymphatic tissues and vessels by contributing to sustained growth and postnatally differentiating into lymphatic endothelial cells. Lymphatic channels from the developing gut connect with the retroperitoneal lymph sac and the cisterna chyli, situated just posteriorly. The lymphatic channels of the lower extremities and inferior trunk communicate with the iliac lymph sacs. Finally, lymphatic channels in the head, neck and upper extremities drain to the jugular lymph sacs. Additionally, a right and left thoracic duct form and connect the cisterna chyli with the jugular lymph sacs and form anastomoses that eventually produce the typical adult form. The lymph sacs then produce groups of lymph nodes in the fetal period. Migrating mesenchyme enters the lymph sacs and produces lymphatic networks, connective tissue, and other layers of the lymph nodes. Function The lymphatic system's primary function is to balance the volume of interstitial fluid and convey it and excess protein molecules into the venous circulation. The lymphatic system is also important in immune surveillance, defending the body against foreign particles and microorganisms. It does so by conveying antigens and leukocytes to lymph nodes, where antigen-primed and targeted lymphocytes and other immune cells are conveyed into the lymphatic vessels and blood vessels. In addition, the system has a role in the absorption of fat-soluble vitamins and fatty substances in the gut via the gastrointestinal tract's lacteals within the villi and the transport of this material into the venous circulation.  Newly recognized lymphatic vessels are visible in the meninges relating to cerebrospinal fluid (CSF) outflow from the central nervous system. Finally, lymphatics may play a role in the clearance of ocular fluid via the lymphatic-like Schlemm canals. Clinical Significance Leaks of lymphatic fluid occur when the lymphatic vessels are damaged. In the abdomen, lymphatic vessel damage may occur during surgery, especially during retroperitoneal procedures such as repairing an abdominal aortic aneurysm. These leaks tend to be mild, and the vessels in the peritoneum and mesentery eventually absorb the lymphatic fluid or chyle. However, when the thoracic duct is injured in the chest, the chyle leak can be extensive. In most cases, conservative care with a no-fat diet (medium chain triglycerides) or total parenteral nutrition is unsuccessful. In most cases, if the injury to the thoracic duct was surgical, a surgical procedure is required to tie off the duct. If the thoracic duct is injured in the cervical region, then inserting a drainage tube and adopting a low-fat diet will help seal the leak. However, thoracic duct injury in the chest cavity usually requires drainage and surgery. It is rare for the thoracic segment of the thoracic duct to seal on its own. In terms of accumulation of chyle in the thorax (i.e., chylothorax), if a patient has an injury to the thoracic duct in the thorax below the T5 vertebral level, then fluid will collect in only the right pleural cavity. If the injury is to the thoracic duct in the thorax above the T5 vertebral level, then fluid will appear in both pleural cavities.   Other Issues The lymphatic system is prone to disorders like the venous and arterial circulatory systems. Developmental or functional defects of the lymphatic system cause lymphedema. When this occurs, the lymphatic system is unable to sufficiently drain lymphatic fluid resulting in its accumulation and swelling of the territory. Lymphedema, this swelling due to the accumulation of lymph, is classified as primary or secondary. Primary lymphedema is an inherited disorder where the lymphatic system development has been disrupted, causing absent or malformed lymphatic tissues. This condition often presents soon after birth, but some conditions may present later in life (e.g., at puberty or later adulthood). There are no effective treatments for primary lymphedema. Past surgical treatments were found to be mutilating and are no longer implemented. The present-day treatment revolves around compression stockings, pumps, and constrictive garments. Secondary lymphedema is an acquired disorder involving lymphatic system dysfunction that may result from many causes, including cancer, infection, trauma, or surgery. The treatment of secondary lymphedema depends on the cause. Oncological and other surgeries may result in secondary lymphedema due to the removal or biopsy of lymph nodes or lymphatic vessels. Non-surgical lymphedema may result from malignancies, obstruction within the lymphatic system, infection, or deep vein thrombosis. In most cases of obstructive secondary lymphedema, the drainage will resume if the inciting cause is removed, although some individuals may need to wear compressive stockings permanently. Also, physical therapy may help alleviate lymphedema when the extremities are involved. There is no absolute cure for lymphedema, but diagnosis and careful management can help to minimize complications. Lymphomas are cancers that arise from the cells of the lymphatic system. There are numerous types of lymphoma, but they are grouped into Hodgkin lymphoma and non-Hodgkin lymphoma. Lymphomas usually arise from the malignant transformation of specific lymphocytes in the lymphatic vessels or lymph nodes in the gastrointestinal tract, neck, axilla, or groin. Symptoms of lymphoma may include night sweats, fever, fatigue, itching, and weight loss. Cancers originating outside of the lymphatic system often spread via the lymphatic vessels and may involve regional lymph nodes serving the impacted organs or tissues. Lymphadenitis occurs when the lymph nodes become inflamed or enlarged. The cause is usually an adjacent bacterial infection but may also involve viruses or fungi. The lymph nodes usually enlarge and become tender. Lymphatic filariasis, or elephantiasis, is a very common mosquito-borne disorder caused by a parasite found in tropical and subtropical areas of the world, including Africa, Asia, the Pacific, the Caribbean, and South America. This condition involves parasitic microscopic nematodes (roundworms) that infect the lymphatic system and rapidly multiply and disrupt lymphatic function. Many infected individuals may have no outward symptoms, although the kidneys and lymphatic tissues may be damaged and dysfunctional. Symptomatic individuals may present with disfigurement caused by significant lymphedema and elephantiasis (thickening of the skin, particularly the extremities). The parasite may also cause hydrocele, an enlargement of the scrotum due to the accumulation of fluid, which may result from obstruction of the lymph nodes or vessels in the groin. Individuals presenting with symptoms have poorly draining lymphatics, often involving the extremities, resulting in huge extremities and marked disability. Lymphatic filariasis is the most common cause of disfigurement in the world, and it is the second most common cause of long-term disability.  (credits: NIH)

BrainStorm wants to hear from you! Send us a text.BrainStorm guest Vradenburg, Chairman and Founder of UsAgainstAlzheimer's, sits down with host Meryl Comer for a comprehensive look at the state of Alzheimer's research, advocacy, and care in 2025.Vradenburg addresses critical challenges facing the Alzheimer's community, including threats to NIH funding and the impact of funding instability on researchers and clinical trials. The discussion covers key advocacy efforts like the CHANGE Act and ASAP Act, which aim to make cognitive checkups and blood-based diagnostic tests more accessible through Medicare coverage. Vradenburg also highlights UsAgainstAlzheimer's expanding initiatives, from the BrainGuide platform offering direct-to-consumer cognitive assessments to educational programs training healthcare professionals on brain health.Looking forward, Vradenburg makes a bold prediction: within the next decade, we could see preventive treatments for Alzheimer's, potentially including a vaccine. This episode offers both a candid assessment of current challenges and an optimistic vision for the future of Alzheimer's prevention and treatment. This is a must listen episode!Produced by Susan Quirk and Amber RonigerSupport the show

Co-hosts Ryan Piansky, a graduate student and patient advocate living with eosinophilic esophagitis (EoE) and eosinophilic asthma, and Holly Knotowicz, a speech-language pathologist living with EoE who serves on APFED's Health Sciences Advisory Council, interview Fei Li Kuang, MD, PhD, an allergist and immunologist, at Northwestern Medicine, about receiving two APFED HOPE on the Horizon Grants. Disclaimer: The information provided in this podcast is designed to support, not replace, the relationship between listeners and their healthcare providers. Opinions, information, and recommendations shared in this podcast are not a substitute for medical advice. Decisions related to medical care should be made with your healthcare provider. Opinions and views of guests and co-hosts are their own.   Key Takeaways: [:50] Co-host Ryan Piansky introduces this episode, brought to you thanks to the support of Education Partners GSK, Sanofi, Regeneron, and Takeda. Ryan introduces co-host Holly Knotowicz.   [1:14] Holly introduces today's topic, two APFED HOPE on the Horizon Pilot Grant Projects and today's guest, Fei Li Kuang, MD, PhD, an Assistant Professor in the Division of Allergy and Immunology at Northwestern University Feinberg School of Medicine in Chicago, Illinois.   [1:42] Dr. Kuang is a physician-scientist who takes care of patients with eosinophilic disorders and also performs laboratory research on these disorders in her lab, often using patient samples. Holly thanks Dr. Kuang for joining us.   [2:05] As a child, Dr. Kuang always wanted to be a scientist. She is so grateful to live out her childhood dream, and it's because of the amazing people who have supported her, most importantly, her parents.   [2:29] In graduate school, Dr. Kuang studied B cells. When she went on to do an allergy fellowship, she thought she would study B cells and care for patients with B cell problems. Instead, she fell in love with allergy and eosinophilic disorders.   [2:50] Dr. Kuang is here, in part, because of the different mentors she has had, and in large part, because of the patients she has met along the way.   [3:20] Dr. Kuang had the opportunity to work with Amy Klion at the NIH in a clinical trial to treat patients with a drug that gets rid of eosinophils. She says it was a dream come true after her training.   [4:02] She says she learned so much about eosinophils, their unusual biology, and the mystery behind what they are here for. She got hooked.   [4:15] Dr. Kuang thinks the patients you meet in a clinical trial in a special place like NIH occupy a space in your heart that makes you want to keep working on the subject area.   [4:34] Patients in a clinical trial have given up a bunch of their time to travel to Bethesda, Maryland. For the trial Dr. Kuang participated in as a Fellow, it was a good year of their time to come out and do it.   [4:47] Dr. Kuang felt there were so many interesting questions, from an intellectual point of view, but there was also a real need from patients with chronic conditions. It was a beautiful opportunity to marry scientists with physicians in training.   [5:36] Dr. Kuang shares some knowledge about eosinophils. They are white blood cells that are in all of us. They have little pink packages or granules that "jumped out" in the light microscope almost 200 years ago, when we first identified them.   [6:00] Dr. Kuang says that animals, dating back to reptiles, and different species of dolphins, all have eosinophils. A veterinary scientist, Dr. Nicole Stacy of the University of Florida, has taken photos of eosinophils from all these different species.   [6:21] They've been around for a long time. What are they good for? What we know is that they are associated with disease conditions, such as asthma and others, including leukemia. Those were the classic first studies of eosinophils.   [6:42] Now, we have a different mindset about eosinophils from work by the late James Lee at Mayo Clinic, Arizona.   [6:58] Dr. Kuang credits Dr. Lee with suggesting that eosinophils not just cause us problems but also help treat parasitic infections, maintain tissue homeostasis, help wound healing, and tissue repair. That's a new area we are beginning to appreciate.   [7:41] Dr. Kuang says we need to be open-minded that in some circumstances, eosinophils may be helpful or innocent. Now we have tools to start to understand some of that. We need to collect information from patients being treated with medicines.   [8:10] Ryan tells of being diagnosed as a kid. Doctors explained to him that eosinophils fight parasites, but in some people, they get confused and attack the esophagus. That's EoE. That was easy to understand, but he knew that the researchers knew more.   [8:53] Ryan is grateful to the patient population around eosinophilic esophagitis, and is proud of APFED's support of patients and caregivers with HOPE Grants. APFED has the HOPE on the Horizon Research Program, entirely funded by community donations.   [9:13] To date, APFED has directed more than $2 million toward eosinophilic disease research initiatives through various grant programs. As a patient advocacy organization, APFED works with fantastic researchers who submit innovative research ideas.   [9:32] These research ideas go through an extensive and competitive peer-review process, supported by researchers and clinicians in the APFED community.   [9:42] Today, we're going to discuss two different projects supported by HOPE Pilot Grants with Dr. Kuang.   [10:00] Dr. Kuang thinks there are two ways these grant programs are important to patients. One is advancing research by nurturing seedling investigators. Dr. Kuang got her first grant when she was a Fellow. It was an incredible opportunity.   [10:25] These grant programs also nurture seedling ideas that don't have enough evidence yet to garner the larger NIH grants, and so forth. There are other sources for grants: pharmaceutical companies. The grant programs are for seeds.   [10:49] Patients need to know that there are new things that are given some chance of being tested out. Research takes some time, and the FDA process of getting a drug approved is long.   [11:04] For the newly diagnosed patient, it can feel overwhelming. It feels like there's a loss of control. Sometimes, participating in something like APFED, being part of a community, gives back a sense of control that is lost when you're handed a diagnosis.   [11:45] For patients who have had it for a long time, when they participate in research and become engaged in organizations like APFED, they know they may not directly benefit today, they may benefit later, but they hope future patients will benefit.   [12:21] That gives them a sense of control and hope that things will be better for the next generation. We all want that, especially in medicine, in something that we don't have a very deep understanding of.   [12:58] Dr. Kuang received two HOPE Pilot Grants, one in 2018 and one in 2022. The first grant was awarded when she was a Fellow at the NIH.   [13:05] That first grant explored some effects of eosinophilic depletion of pathogenic lymphocytes in hypereosinophilic syndrome and overlaps with EGIDs. Ryan asks for a broad overview of that research.   [13:25] When Dr. Kuang was a Fellow at the NIH, they were doing a Phase 2 clinical trial, looking at "blowing up" eosinophils in patients who have a lot of them, hypereosinophilic syndrome patients.   [13:39] They included patients who had eosinophilic GI disease, often beyond the esophagus. They may have esophageal involvement, but sometimes their stomach is impacted, sometimes their large bowel is impacted, with related symptoms.   [13:57] What Dr. Kuang and the team noticed in the trial was that just within that little group of patients, there were people who did well, and people who did much better than before, but would have recurrent symptoms, and with no eosinophils in their GI tissues.    [14:16] The researchers wanted to know what was causing these problems for the patient. If you take eosinophils away, what other factors will impact the immune system of the patient, semi-long-term?   [14:32] Their focus was on these groups of patients who had different responses. They looked at the white blood cells that had been previously described as being the responsible, "bad" T cells that lead to eosinophils in the gut.   [14:49] They found that the patients who had recurrent flares of the disease had more of the bad T cells, and the patients who responded well and never complained again about symptoms did not.   [15:03] That allowed researchers to identify that there were subsets of patients with the disease that they were calling the same thing.   [15:18] Dr. Kuang says that work also led them to find that those cells were being reported in patients who had food allergies for which they needed an epinephrine auto-injector.   [15:27] The researchers were curious whether that was just a food allergy issue, or only applied if you had food allergies and eosinophilic GI disease. That HOPE project allowed them to do a pilot study to look at food allergy patients, too. They did, and published it.   [15:45] They published that in patients who have a food allergy and have these T cells, the insides of those cells make different messages for the immune system than the ones that the researchers had previously described.   [16:01] In looking for why there were differences in those responses, they accidentally found that there were differences inside these cells in a completely different disease, which also had these T cells.   [16:21] Dr. Kuang says that the finding was kind of a surprise. If they had found anything in the eosinophilic GI disease patients, that would have been good. They also looked at the epithelial cells and the structure of the GI lining.   [16:42] Even though there were no eosinophils in the GI lining in the patients who had been treated with a biologic that depleted eosinophils, their GI lining still looked like the GI lining of patients who had eosinophilic GI disease.   [16:55] Dr. Kuang asked what was creating those spots. Our gut lining sheds, so there should have been an opportunity for the GI lining to turn over and look new. Something was there, making signals to create these spots. They did a different publication on that.   [17:21] The data from the HOPE Pilot study allowed Dr. Kuang to apply for larger grants. It allowed her to propose to the company that made this drug, when they did the Phase 3 trial, to insert into that special study the study on eosinophilic GI disease.   [17:48] Do patients with eosinophilic GI disease do better or worse on this drug, and how do the T cells look in that trial? That HOPE Grant gave Dr. Kuang the data to ask the drug company to give her money to study it in an international cohort of patients.   [18:17] There were only 20 patients in that first NIH trial, who gave a year of their life, coming to NIH all the time. They continued to be in the study until the drug was approved for asthma.   [18:28] Dr. Kuang says the main reason the company did the Phase 3 trial, which is expensive, and the market share is not huge because it's a rare disease, is that two of the patients went to bat for this disease population.   [18:47] The two patients went and showed the business people what they looked like before, what the drug had done for them, and how their lives had changed. It wasn't the doctors or the great paper from the trial, but the patients who convinced the company.   [19:01] Dr. Kuang says she was so floored by that and moved by what they did for the community. She is grateful.   [19:24] Since the Phase 3 trial, Dr. Kuang and the other researchers realized they had not fully studied the eosinophils. They had studied them in part. They found differences in response. This inspired the second APFED HOPE Pilot Grant.   [21:19] In 2022, Dr. Kuang received a two-year APFED HOPE Pilot Grant to examine how blood eosinophils in Eosinophilic Gastrointestinal Diseases differ from those of other eosinophilic diseases and how T cells in EGIDs differ from those in food allergies.   [21:49] Dr. Kuang says normally, the biggest place of residence for eosinophils is the GI tract. That's where they are normally seen in people who do not have eosinophilic disorders.   [21:59] People who have eosinophilic disorders that attack other parts of the body, asthma, and rarely, the heart. Dr. Kuang was curious to know why one person and not the other?   [22:15] Patients who have eosinophilic GI disease often ask, How do you know this high level in the blood is not going to attack my heart or my lungs in the future? Dr. Kuang does not know.   [22:29] Dr. Kuang says, looking at the cohort at the NIH, that for many patients who have both GI organ involvement and some other space, when they first went to see a provider, their first complaint was a GI condition.   [22:54] If the doctor had only diagnosed a GI condition, nothing else, that would have been wrong. Those patients may not have been monitored as well. A third of the patients originally presented like that.   [23:11] What that meant was that we should be paying attention to patients who have GI disease who have lots of eosinophils in their blood. Moving forward, if there are new complaints, we need to investigate. We can't forget they have that.   [23:27] Dr. Kuang asks, Wouldn't it be great if we had a better tool than needing to wait? Wouldn't it be great if we had a biomarker that said the eosinophils have switched their target location and are going somewhere else?   [23:41] One way to do that is to take different groups of eosinophils and look for differences between those that never target the GI tract and those that do. In patients who have EoE, the eosinophils only target or cause problems in the esophagus.   [23:58] Are their eosinophils any different than those of a healthy person, with none of these conditions? That was the goal of that study.   [24:10] T cells are another type of white blood cell. They contain a memory of foreign things they have encountered, which allows them to glom onto flu, COVID, peanuts, pollen, that kind of thing. They remember.   [24:32] Dr. Kuang says they learned that T cells, at least in the mouse model, are required in the development of eosinophilic esophagitis. The mice in the old study, where mice were forced to develop EoE, did not get EoE if you removed their T cells.   [24:50] In the first APFED HOPE grant study, Dr. Kuang found T cells in the blood and tissue of both EGIDs and food allergy patients, but the insides of the T cells were different. The food allergy patients were children recruited by a pediatric allergist.   [25:19] In the second APFED HOPE grant study, at Northwestern, Dr. Kuang recruited her adult food allergy patients. That was a way to validate what they found in the first study and move further to better characterize those T cells in the two different diseases.   [25:47] Dr. Kuang says we're at a point where we've recruited a lot of people. She says it's amazing what people are willing to do. It's very humbling.   [26:06] Dr. Kuang's team in the lab is really great, too. To accommodate patients, they would see them after work, if that's what they had to do to isolate eosinophils. So they did that, and now they are in the process of analyzing that data. It's really exciting.   [26:28] What's exciting is that they are seeing results that show that eosinophilic GI disease patients have circulating eosinophils that are different from the eosinophils of people who don't have GI involvement, and from people who have EoE.   [26:46] The EoE patients have eosinophils different from those of healthy donors. Dr. Kuang says there's a lot of promise for perhaps unique signatures that could help define these conditions; maybe someday without biopsying, but that's a long time away.   [27:16] Dr. Kuang says they will focus on some candidate targets and try to recreate some of that in a dish with eosinophils from healthy people.   [27:26] What are the signals that lead eosinophils to do this, and can we translate that back to available drugs that target certain cytokines or other pathways, and maybe give some insight to develop drugs that target other pathways for these diseases?   [28:17] Ryan thinks it's exciting that this research is narrowing in on not only the different symptoms, but also how the eosinophils are acting differently in these populations.    [28:44] Dr. Kuang is super excited about this research. You could imagine that all eosinophils are the same, but you don't know until you look. When they looked, using the newest technology, they found there were differences.   [29:33] Dr. Kuang says it is thought that T cells respond to triggers. We don't think eosinophils have a memory for antigens. T cells do. That's one of their definitions. When T cells react to a trigger, they give out messages through cytokines or by delivery.   [30:20] Those are the messages that recruit eosinophils and other cells to come and stir up some trouble.   [30:28] In the mouse model, where you don't have the T cells, and you don't get eosinophilic esophagitis in the particular way they made it happen in a mouse, that middle messenger is gone, so the eosinophils don't know where to go.   [30:44] With drugs that take out eosinophils, you think that you've gotten rid of the cell that creates all the problems. It shouldn't matter what the message says because there's no cell there to cause the damage.   [30:58] What Dr. Kuang learned is that, at least in certain eosinophilic GI diseases, that's not true. You erase the eosinophils from the picture, but that message is still coming.   [31:10] Who's carrying out the orders? Or is that message maintaining the wall of epithelial cells in a certain way that we didn't appreciate because the eosinophils were also there?   [31:24] It's important to study both, because one is the messenger and the other is one of the actors. Whether all of the actions taken by eosinophils are bad, or maybe some of them were meant to be good, we have yet to learn.   [31:40] At the moment, we're using it as a marker for disease activity, and that may change in the future, as we learn more about the roles of these cells in the process.   [31:50] We have drugs now that target eosinophils and drugs that target T cells. Dr. Kuang thinks it's important to study both and to study the impact of these drugs on these cells.   [32:02] You could theoretically use these drugs to understand whether, if someone responds to it, what happens to these cells, and if someone doesn't respond to it, what happens to these cells, and how this disease manifests in this flavor of patients.   [32:54] Dr. Kuang says, Often in science, we take a model. We think this works this way. Then, if this works this way, we expect that if we remove this, these things should happen. We did that with the first clinical trial, with NIH patients.   [33:10] It didn't quite happen the way we thought, so we had to go looking for explanations. These were unusual setbacks. Sometimes you have unusual findings, like the food allergy part.   [33:24] When Dr. Kuang went to Northwestern, she saw different cohorts of patients than she saw at NIH. She saw people who were seen every day, which is a different spectrum than those who are selected to be enrolled in a study protocol at the NIH.   [33:42] That broadened her viewpoint. It's maybe not all food-triggered. They were seeing adults who'd never had food allergies or asthma their whole life, and they had eosinophilic esophagitis suddenly as a 50-year-old. There's a significant group of them.   [34:10] What Dr. Kuang learned and tries to be open-minded about is that where you train, what sorts of patients you see, really shape your viewpoint and thinking about the disease process and the management process.   [34:24] Dr. Kuang says she was so lucky to have experienced that at a quaternary care referral center like the NIH and at an academic center like Northwestern, where there are fantastic gastroenterologists who see so many of these patients.   [34:56] Dr. Kuang and an Allergy Fellow knew they were going to get a wonderful data set from the NIH patients they had recruited, so they thought they had better look deeply at what had been learned before with older technology, with mice and people.   [35:13] They decided to gather previous research, and that ultimately got published as an article. From that research, they learned that people did things in many different ways because there was no standard. They didn't know what the standard should be.   [35:28] Different things you do to try to get eosinophils out of tissue impact how they look, in terms of transcript, gene expression, and what messages they make to define themselves as an eosinophil.   [35:43] They also learned that because eosinophils are hard to work with, they die easily, and you can't freeze them and work on them the next day; you can introduce issues in there that have to be accounted for.   [35:59] They learned that as an eosinophil research community, they ought to come up with some standards so that they can compare future studies with each other. Dr. Kuang says it was impossible to compare the old studies that used different premises.   [36:50] Dr. Kuang says we need to be proactive in creating the datasets in a standard way so that we can compare and have a more fruitful and diverse community of data. It's hard to use the old data.   [37:57] Dr. Kuang says they get fresh blood from patients, and because eosinophils are finicky, they need to be analyzed within four hours, or preserved in a way to save whatever fragile molecules are to be studied.   [38:19] If you let it sit, it starts dying, so you won't have as many of them, and they start changing because they're not in the body. Dr. Kuang experimented with putting a tube of blood on the bench and checking it with the same test every two hours. It changes.   [38:38] Four hours is a standard to prevent the eosinophils from dying. Patients need treatment. If a patient is hospitalized and needs treatment, Dr. Kuang's team needs to be there to get a sample before treatment is started.   [39:03] The treatment impacts it, changing the situation. Much of the treatment, initially, is steroids. When you give lots of steroids, the eosinophils go away. It's no good to draw their blood then.   [39:27] Dr. Kuang also gets a urine sample. The granules of the eosinophils can get into the urine. As they study people with active disease, they want to capture granule proteins in the urine as a less invasive way to monitor activity in different disease states.   [40:04] The patient just needs to give Dr. Kuang either arm and a urine sample.   [41:04] Dr. Kuang explains, you can count your eosinophils after four hours, but to study them, they have different flags of different colors and shapes. Those colors and shapes may mean that it's an activated eosinophil, or they may have other meanings.   [41:41] Dr. Kuang focused on markers that look at whether it's going to spill its granules and some traditional markers of activation.     [41:50] Everyone chooses a different marker of activation. So they decided to look at as many as they could. One marker is not sufficient. They seem to be different in different conditions. The markers are on the surface; you need to analyze them right away.   [42:20] Then, Dr. Kuang breaks open the eosinophils and grabs the messenger RNA. They preserve it to do sequencing to read out the orders to see what this eosinophil is telling itself to make. RNA chops up messages.   [43:00] When you open an eosinophil, a protein you find is RNA, which chops up messages, destroying parts of the cell. You want to save the message. There's a brief time to analyze the eosinophil. Dr. Kuang works to preserve and read the message.   [44:04] Dr. Kuang hopes someday to run a tube of blood, look at the flags on the eosinophils, and say, "I think your eosinophilic GI disease is active," or "You have a kind of eosinophilic GI disease we need to monitor more frequently for organ damage."   [44:38] If another patient doesn't have those flags, Dr. Kuang could say, "I think the chances that you're going to have involvement elsewhere are low." That can give reassurance to folks who are worried.   [45:15] Dr. Kuang hopes that someday we can understand better why some people have food allergies vs. eosinophilic GI disease. They both have T cells, but the T cells have different packages inside with messages to deliver.   [45:34] Every day, Dr. Kuang has to tell patients she doesn't have that answer. Someday, she hopes she can tell a patient she does have that answer.   [46:35] Dr. Kuang tells about an NIH grant she's excited about and the patients she recruits after therapy, or elimination diets, to examine eosinophils and T cells, to see the impacts their treatments or diets have had on eosinophilic GI disease.   [47:18] Dr. Kuang believes there will be predictors of who will respond to an elimination diet and who will respond to steroid therapy. She hopes one day to have that, rather than going through rounds of six to eight weeks followed by a scope.   [47:34] If you have an elimination diet for six to eight weeks, every time you add back a food, you have to do a scope. Dr. Kuang says it would be great if you could be more precise ahead of time for therapy.   [47:48] Dr. Kuang says these wonderful drugs selectively take out parts of the pathway in the immune system. They provide real-life opportunities to ask, why is this important in human biology and the human immune system?   [48:15] Dr. Kuang finds the knowledge itself fascinating and useful. She hopes it informs how we choose future drugs or therapeutic avenues to get the best we can out of what we've learned, so we have more targeted ways of treating specific diseases.   [48:48] Ryan is grateful for all the research happening for the eosinophilic disease community and all the patients participating in the research. He asks Dr. Kuang how a patient can participate in research.   [49:12] There are lots of ways to be involved in research. Dr. Kuang says her patients come away from participating in research feeling good about having done it.   [49:22] Answer a survey, if that's what you have bandwidth for. Where therapies are changing, being a part of a community is good for the community, for the future, but it's good for you, too. It's healing in ways that are not steroids or biologics.   [49:58] Being part of a community is healing in ways we all need when we feel alone and bewildered. You're not alone.   [50:12] There are many ways to participate: APFED, CEGIR, individual institutions, and clinical trials. They all have different amounts of involvement. It's worthwhile to participate, not only for future patients but for yourself. They're fantastic!   [50:56] Dr. Kuang talks about the privilege as a physician of working with APFED and other organizations to do this work.   [51:09] Holly thanks Dr. Kuang for sharing all of this research and exciting information.   [51:25] Dr. Kuang is excited about what her group is doing and is hopeful. Besides showing up for this disease, we have to show up for research, in general, in this country. It's a dark time for NIH research funding.   [51:55] Dr. Kuang asks the young listeners who are thinking of choosing a field to see the potential and get into it, study this, and believe that there's going to be a future with a more nurturing research environment.   [52:36] Dr. Kuang would hate to lose generations of scientists. She says that once she was a little girl who was trying to be a scientist. Her parents had no connections with scientists or doctors, but she was able to get into research, and she thinks you can, too.   [53:48] As a graduate student, Ryan has always been interested in trying to improve things, and he sees hope on the horizon. He's very grateful to the APFED community for supporting these research HOPE Pilot Grants.   [54:17] Ryan is very grateful to Dr. Kuang for joining us today.   [54:22] For our listeners who want to learn more about eosinophilic disorders, we encourage you to visit apfed.org and check out the links in the show notes.   [54:28] If you're looking to find a specialist who treats eosinophilic disorders, we encourage you to use APFED's Specialist Finder at apfed.org/specialist.   [54:37] If you'd like to connect with others impacted by eosinophilic diseases, please join APFED's online community on the Inspire Network at apfed.org/connections.   [54:57] Dr. Kuang thanks Ryan and Holly and says she enjoyed the conversation. Holly also thanks APFED's Education Partners GSK, Sanofi, Regeneron, and Takeda for supporting this episode.   Mentioned in This Episode: Fei Li Kuang, MD, PhD, Allergist and Immunologist, Northwestern Medicine   Grants and publications discussed: Apfed.org/blog/apfed-announces-2018-hope-apfed-hope-pilot-grant-recipient/ Apfed.org/blog/fei-li-kuang-hope-pilot-grant-award/  Pubmed.ncbi.nlm.nih.gov/39213186/ Pubmed.ncbi.nlm.nih.gov/37487654/   APFED on YouTube, Twitter, Facebook, Pinterest, Instagram Real Talk: Eosinophilic Diseases Podcast apfed.org/specialist apfed.org/connections apfed.org/research/clinical-trials   Education Partners: This episode of APFED's podcast is brought to you thanks to the support of GSK, Sanofi, Regeneron, and Takeda.   Tweetables:   "I think the patients that you meet in a clinical trial, especially in a special place like NIH, occupy a space in your heart — I don't mean to be all too emotional about this — that makes you want to keep working on the subject area." — Fei Li Kuang, MD, PhD   "When I was a Fellow at the NIH, we were doing a Phase 2 clinical trial, looking at, for want of a better word, "blowing up" eosinophils in patients who have a lot of them, hypereosinophilic syndrome patients." — Fei Li Kuang, MD, PhD   "We're at a point where we've recruited a lot of people. I've had patients drive from the northern part of Illinois … come down and give me blood. It's amazing what people want to do and are willing to do. It's very humbling, actually." — Fei Li Kuang, MD, PhD   "You erase the eosinophils from the picture, but that message is still coming. Who's carrying out the orders? Or is that message maintaining the wall of epithelial cells in a certain way that we didn't appreciate because the eosinophils were also there?" — Fei Li Kuang, MD, PhD   "We need to be proactive in creating the datasets in a standard way so that we can compare and have a more fruitful and diverse community of data." — Fei Li Kuang, MD, PhD   "I think it's worthwhile to participate [in a clinical trial], not only for the future people but for yourself." — Fei Li Kuang, MD, PhD   Guest Bio: Fei Li Kuang, MD, PhD, is currently an Assistant Professor in the Division of Allergy and Immunology at Northwestern University Feinberg School of Medicine in Chicago, IL. She is a graduate of the Albert Einstein College of Medicine Medical Scientist Training Program with both a PhD in Cell Biology/Immunology and an MD.  She completed her Internal Medicine Residency at Columbia University, New York Presbyterian Hospital in New York City, she did her Fellowship in Allergy and Immunology at the National Institute of Allergy and Infectious Disease (NIAID) in Bethesda, Maryland. She is a physician-scientist who takes care of patients with eosinophilic disorders and also performs laboratory research on these disorders in her lab, often using patient samples.

In this educational, refreshing, and beautifully hopeful episode, Wren, the creator of the Living Our Breast Lives Podcast, is joined by the incredible Metastatic Breast Cancer Thriver, Carolyn Leigh, the President of North Star Cancer Advocacy.In 2018, she was the third member of her family to be diagnosed with metastatic breast cancer, including her mother and uncle. After her metastatic diagnosis, she spent years studying the latest scientific understandings about the immune system and immunotherapies for cancer before launching North Star Cancer Advocacy in 2022 with the aim of providing information to the community and advocating for vast increases in NIH funding. The North Star Board of Directors and the MBC community recently raised $100k to further the research of combining Natural Killer cells (immune system cells) and one of the most promising breast cancer drugs in preclinical development, ErSO-TFPy.In this episode, join me as Carolyn breaks down: - How the inspirational Judy Perkins and TILs therapy reshaped her belief in what's possible- The moment she decided to found North Star- A simple breakdown of MHC I expression and why some immunotherapies succeed while others don't- A crash course in how immunotherapy actually works inside the body- Her mission to raise six figures for immunotherapy-driven clinical trials — and what real success would look like - How and where to access immunotherapy clinical trials- A raw conversation about allyship, momentum, and why the MBC movement can't depend solely on those living with the diseaseCarolyn isn't just an MBC advocate… she's a brilliant mind, a fierce researcher, the president of the North Star Cancer Research Foundation, and a woman determined to change the future of metastatic breast cancer!Living Our Breast Lives Information:Email: livingourbreastlivespodcast1@gmail.comInstagram: @livingourbreastlivesFounder: Wren MorrobelPersonal Instagram: @wren_morrPodcast Guest Speaker: Carolyn Leigh's Information:Email: NorthStarCancerAdvocacy@yahoo.comInstagram: @north.star.cancer.advocacy@north.star.cancer.researchFacebook: North Star Cancer Research FoundationWebsite: NorthStarCancerResearch.orgCRI Clinical Trial Finder:https://cri.careboxhealth.com/en-US/

In this episode, I'm joined by my longtime friend Ian Simon, Head of Biotechnology at Aspis Intelligence. Ian's path runs from grad school vaccine research at Yale to senior roles at the White House, HHS, NIH, the State Department, and the Office of Long Covid. We talk about de-risking young biotech companies, what Covid taught us about science and public health, and how new technologies like AI might change how we do science altogether. ⁠⁠⁠TPM E52 highlights >⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Episode 52 links:Ian Simon on LinkedInAspis Intelligence

Dr. Mary Talley Bowden, a well-regarded ENT specialist, became one of the most polarizing figures in American medicine after refusing to fall in line during COVID. When her off-label use of ivermectin went public, the backlash was immediate: her hospital suspended her, the medical board came after her, and she was thrust into a national firestorm. In this episode, she lays out the blueprint she says was used to punish dissenting physicians—how hospital systems, public-health agencies, and industry interests closed ranks to enforce a single narrative. She breaks down the conflicts of interest baked into the modern “medical-industrial complex,” and why she decided to fight rather than fold. From vaccine-injury cases to mandate battles to the unprecedented wave of medical censorship, Dr. Bowden pulls no punches. She takes aim at the NIH, FDA, major hospital systems, and the Biden administration—exposing what she sees as a system more interested in profit, control, and compliance than patient care.

Dr. Mary Talley Bowden, a well-regarded ENT specialist, became one of the most polarizing figures in American medicine after refusing to fall in line during COVID. When her off-label use of ivermectin went public, the backlash was immediate: her hospital suspended her, the medical board came after her, and she was thrust into a national firestorm.In this episode, she lays out the blueprint she says was used to punish dissenting physicians—how hospital systems, public-health agencies, and industry interests closed ranks to enforce a single narrative. She breaks down the conflicts of interest baked into the modern “medical-industrial complex,” and why she decided to fight rather than fold.From vaccine-injury cases to mandate battles to the unprecedented wave of medical censorship, Dr. Bowden pulls no punches. She takes aim at the NIH, FDA, major hospital systems, and the Biden administration—exposing what she sees as a system more interested in profit, control, and compliance than patient care.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The National Institutes of Health have historically funded scientists to find cures for diseases and protect public health. NIH funding has led to the discovery of immune therapies for cancer, antiviral treatments and prevention of HIV, and ground-breaking research into memory loss and Alzheimer's disease. After a year of funding cuts and freezes that have rocked the medical research field to its core, we catch up with leading researchers at the University of California to talk about the impact this has had on their work and our ability to fight humanity's most puzzling illnesses. Guests: Monica Gandhi, infectious disease expert and professor of medicine at University of California San Francisco - she is the director of the UCSF Gladstone Center for AIDS Research and the medical director of the San Francisco General Hospital HIV Clinic, Ward 86 Pamela Munster, professor of medicine at the University of California San Francisco; co-director, Center for BRCA Research, Medical Oncology; distinguished professor in Hereditary Cancer Research Megan Molteni, science writer, STAT News Joel Spencer, associate professor of Bioengineering, University of California Merced - his lab uses funding from NIH to study the thymus, with implications for cancer treatment and healthy aging Learn more about your ad choices. Visit megaphone.fm/adchoices

This is a free preview of a paid episode. To hear more, visit ianmsc.substack.comDr. Jay Bhattacharya is the director of the National Institutes of Health, the organization formerly run by Dr. Francis Collins and Dr. Anthony Fauci. But Dr. Bhattacharya's importance extends much further than “just” NIH. And his appointment there under the second Donald Trump administration marked a dramatic about-face for an organization that was instrumental in creating many of the issues and problems we faced as a society during the pandemic.Dr. Bhattacharya was one of the authors of the Great Barrington Declaration in 2020. That paper contained a blueprint for focused protection during the COVID-19 pandemic. Instead of locking down all society, Bhattacharya and his co-authors wrote, we should look to protect the most vulnerable. That's been proven prophetic, as the harms from lockdowns far exceeded any benefits.He also conducted a study in Silicon Valley early on in the lockdowns that identified COVID was far more prevalent in the community than people realized. That meant the virus was also far less deadly than organizations like the World Health Organization had suggested. He was skeptical about the efficacy of cloth masks, advocated for opening schools, and participated in a roundtable hosted by Florida Gov. Ron DeSantis in 2021 that illustrated how ineffectual the Anthony Fauci-doctrine had been. Around that same time, Bhattacharya also spoke out against vaccine mandates and other abuses, which decreased public confidence and trust in vaccines.In short, he was a voice of sanity in a sea of absurdity, proven right about nearly every pandemic-related policy. For his efforts, he was demonized, labeled, censored, and targeted by Collins and Fauci in emails. I had the exclusive opportunity to ask him about many of these issues, and what he's bringing to NIH that his predecessors didn't.Unmasked is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

There's something appealing and romantic about foraging and there's a special kind of calm that comes from working in your yard or garden.  But when plant encounters go wrong, you don't just get a bad taste in your mouth, it could be your last meal.Sources:CDC, News.com, KSBW, NIH, BBC, MDA State, Food Safety, Bon Appetit, Poison Control Utah, Local 12Support us on Patreon for as little as $1 a month, with benefits starting at the $3 tier!Follow us on Instagram at offthetrailspodcastFollow us on Facebook at Off the Trails PodcastIf you have your own outdoor misadventure (or adventure) story that you'd like us to include in a listener episode, send it to us at offthetrailspodcast@gmail.com  Please take a moment to rate and review our show, and a big thanks if you already have!**We do our own research and try our best to cross-reference reliable sources to present the most accurate information we can. Please reach out to us if you believe we have mispresented any information during this episode, and we will be happy to correct ourselves in a future episode.

Neil Klompas, President and CEO of Augurex, has a mission to improve the diagnosis of autoimmune diseases, with a primary focus on axial spondyloarthritis, a form of inflammatory back pain that is often misdiagnosed. The Augurex blood test SpineStat is designed to differentiate axSpA from mechanical back pain by identifying a specific biomarker present in axSpA. Currently, there is an average nine-year delay from the onset of symptoms to an accurate diagnosis of axSpA, causing irreversible spinal damage and years of using drugs and therapy with no benefit. Neil explains, "I think we're all familiar with back pain. Some of the NIH data and WHO data out there show that almost 28% of adult Americans live with chronic back pain, back pain lasting more than three months. It can be a real journey to figure out what the drivers are, with some patients really never getting resolution, resulting in pain management and, in some cases, even opioid pain management. But if you dive deeper into that category of back pain, there are really two broad classifications we can think about. We can think about mechanical back pain, which is due to lifting, twisting, sports injury, or maybe a car accident. But then there's this whole other category, as you indicated, called inflammatory back pain, which really has its roots in autoimmune, where the body's immune system is actually attacking itself. "   "Well, this is when the body's immune system attacks its peripheral joints. In inflammatory back pain, or as you said, axial spondyloarthritis, it's an autoimmune condition where the body's immune system actually attacks the spine. This can lead to pain increasing over time, new bone growth, fusion of the spinal cord, and permanent stiffness and loss of mobility. It's progressive. It keeps getting worse, and because it's an autoimmune condition. Simply stretching or swearing to take up yoga or getting a new pair of runners or doing PT or massage, while it might help with some of the symptoms, it's not going to slow down or stop the disease. The challenge with axSpA, with axial spondyloarthritis, is that while it's not really that well known or talked about in the media, it's actually more than twice as prevalent as rheumatoid arthritis, a condition which many people have heard about." #Augurex #AdvancedDiagnostics #AutoimmuneDiseases #axSpA #AxialSpondyloarthritis #BackPain augurex.com Listen to the podcast here

Neil Klompas, President and CEO of Augurex, has a mission to improve the diagnosis of autoimmune diseases, with a primary focus on axial spondyloarthritis, a form of inflammatory back pain that is often misdiagnosed. The Augurex blood test SpineStat is designed to differentiate axSpA from mechanical back pain by identifying a specific biomarker present in axSpA. Currently, there is an average nine-year delay from the onset of symptoms to an accurate diagnosis of axSpA, causing irreversible spinal damage and years of using drugs and therapy with no benefit. Neil explains, "I think we're all familiar with back pain. Some of the NIH data and WHO data out there show that almost 28% of adult Americans live with chronic back pain, back pain lasting more than three months. It can be a real journey to figure out what the drivers are, with some patients really never getting resolution, resulting in pain management and, in some cases, even opioid pain management. But if you dive deeper into that category of back pain, there are really two broad classifications we can think about. We can think about mechanical back pain, which is due to lifting, twisting, sports injury, or maybe a car accident. But then there's this whole other category, as you indicated, called inflammatory back pain, which really has its roots in autoimmune, where the body's immune system is actually attacking itself. "   "Well, this is when the body's immune system attacks its peripheral joints. In inflammatory back pain, or as you said, axial spondyloarthritis, it's an autoimmune condition where the body's immune system actually attacks the spine. This can lead to pain increasing over time, new bone growth, fusion of the spinal cord, and permanent stiffness and loss of mobility. It's progressive. It keeps getting worse, and because it's an autoimmune condition. Simply stretching or swearing to take up yoga or getting a new pair of runners or doing PT or massage, while it might help with some of the symptoms, it's not going to slow down or stop the disease. The challenge with axSpA, with axial spondyloarthritis, is that while it's not really that well known or talked about in the media, it's actually more than twice as prevalent as rheumatoid arthritis, a condition which many people have heard about." #Augurex #AdvancedDiagnostics #AutoimmuneDiseases #axSpA #AxialSpondyloarthritis #BackPain augurex.com Download the transcript here

Episode 5 of Standard Deviation with Oliver Bogler on the Out of Patients podcast feed pulls you straight into the story of Dr Ethan Moitra, a psychologist who fights for LGBTQ mental health while the system throws every obstacle it can find at him.Ethan built a study that tracked how COVID 19 tore through an already vulnerable community. He secured an NIH grant. He built a team. He reached 180 participants. Then he opened an email on a Saturday and learned that Washington had erased his work with one sentence about taxpayer priorities. The funding vanished. The timeline collapsed. His team scattered. Participants who trusted him sat in limbo.A federal court eventually forced the government to reinstate the grant, but the damage stayed baked into the process. Ethan had to push through months of paperwork while his university kept the original deadline as if the shutdown had not happened. The system handed him a win that felt like a warning.I brought Ethan on because his story shows how politics reaches into science and punishes the people who serve communities already carrying too much trauma. His honesty lands hard because he names the fear now spreading across academia and how young scientists question whether they can afford to care about the wrong population.You will hear what this ordeal did to him, what it cost his team, and why he refuses to walk away.RELATED LINKSFaculty PageNIH Grant DetailsScientific PresentationBoston Globe CoverageFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The dotEDU hosts look back at a year that reshaped higher education in ways few expected back in January. Mushtaq, Sarah, and Jon talk through their top five stories of 2025, including  the push to dismantle the Department of Education, the cuts at NIH and NSF, the sweeping changes in the One Big Beautiful Bill, and Congress's response to it all. Here are some of the links and references from this week's show:  Register now for ACEx, Feb. 25-28, 2026, in Washington, DC  Higher Education & The Trump Administration: Resources Trump Administration Higher Ed Executive Order Tracker Full coverage of the 2nd Trump administration from The Chronicle of Higher Education  The U.S. Is Funding Fewer Grants in Every Area of Science and Medicine The New York Times (sub. req.) | Oct. 3, 2025

 If you're a scientist, and you apply for federal research funding, you'll ask for a specific dollar amount. Let's say you're asking for a million-dollar grant. Your grant covers the direct costs, things like the salaries of the researchers that you're paying. If you get that grant, your university might get an extra $500,000. That money is called “indirect costs,” but think of it as overhead: that money goes to lab space, to shared equipment, and so on.This is the system we've used to fund American research infrastructure for more than 60 years. But earlier this year, the Trump administration proposed capping these payments at just 15% of direct costs, way lower than current indirect cost rates. There are legal questions about whether the admin can do that. But if it does, it would force universities to fundamentally rethink how they do science.The indirect costs system is pretty opaque from the outside. Is the admin right to try and slash these indirect costs? Where does all that money go? And if we want to change how we fund research overhead, what are the alternatives? How do you design a research system to incentivize the research you actually wanna see in the world?I'm joined today by Pierre Azoulay from MIT Sloan and Dan Gross from Duke's Fuqua School of Business. Together with Bhaven Sampat at Johns Hopkins, they conducted the first comprehensive empirical study of how indirect costs actually work. Earlier this year, I worked with them to write up that study as a more accessible policy brief for IFP. They've assembled data on over 350 research institutions, and they found some striking results. While negotiated rates often exceed 50-60%, universities actually receive much less, due to built-in caps and exclusions.Moreover, the institutions that would be hit hardest by proposed cuts are those whose research most often leads to new drugs and commercial breakthroughs.Thanks to Katerina Barton, Harry Fletcher-Wood, and Inder Lohla for their help with this episode, and to Beez for her help on the charts.Let's say I'm a researcher at a university and I apply for a federal grant. I'm looking at cancer cells in mice. It will cost me $1 million to do that research — to pay grad students, to buy mice and test tubes. I apply for a grant from the National Institutes of Health, or NIH. Where do indirect costs come in?Dan Gross: Research generally incurs two categories of costs, much as business operations do.* Direct or variable costs are typically project-specific; they include salaries and consumable supplies.* Indirect or fixed costs are not as easily assigned to any particular project. [They include] things like lab space, data and computing resources, biosecurity, keeping the lights on and the buildings cooled and heated — even complying with the regulatory requirements the federal government imposes on researchers. They are the overhead costs of doing research.Pierre Azoulay: You will use those grad students, mice, and test tubes, the direct costs. But you're also using the lab space. You may be using a shared facility where the mice are kept and fed. Pieces of large equipment are shared by many other people to conduct experiments. So those are fixed costs from the standpoint of your research project.Dan: Indirect Cost Recovery (ICR) is how the federal government has been paying for the fixed cost of research for the past 60 years. This has been done by paying universities institution-specific fixed percentages on top of the direct cost of the research. That's the indirect cost rate. That rate is negotiated by institutions, typically every two to four years, supported by several hundred pages of documentation around its incurred costs over the recent funding cycle.The idea is to compensate federally funded researchers for the investments, infrastructure, and overhead expenses related to the research they perform for the government. Without that funding, universities would have to pay those costs out of pocket and, frankly, many would not be interested or able to do the science the government is funding them to do.Imagine I'm doing my mouse cancer science at MIT, Pierre's parent institution. Some time in the last four years, MIT had this negotiation with the National Institutes of Health to figure out what the MIT reimbursable rate is. But as a researcher, I don't have to worry about what indirect costs are reimbursable. I'm all mouse research, all day.Dan: These rates are as much of a mystery to the researchers as it is to the public. When I was junior faculty, I applied for an external grant from the National Science Foundation (NSF) — you can look up awards folks have won in the award search portal. It doesn't break down indirect and direct cost shares of each grant. You see the total and say, “Wow, this person got $300,000.” Then you go to write your own grant and realize you can only budget about 60% of what you thought, because the rest goes to overhead. It comes as a bit of a shock the first time you apply for grant funding.What goes into the overhead rates? Most researchers and institutions don't have clear visibility into that. The process is so complicated that it's hard even for those who are experts to keep track of all the pieces.Pierre: As an individual researcher applying for a project, you think about the direct costs of your research projects. You're not thinking about the indirect rate. When the research administration of your institution sends the application, it's going to apply the right rates.So I've got this $1 million experiment I want to run on mouse cancer. If I get the grant, the total is $1.5 million. The university takes that .5 million for the indirect costs: the building, the massive microscope we bought last year, and a tiny bit for the janitor. Then I get my $1 million. Is that right?Dan: Duke University has a 61% indirect cost rate. If I propose a grant to the NSF for $100,000 of direct costs — it might be for data, OpenAI API credits, research staff salaries — I would need to budget an extra $61,000 on top for ICR, bringing the total grant to $161,000.My impression is that most federal support for research happens through project-specific grants. It's not these massive institutional block grants. Is that right?Pierre: By and large, there aren't infrastructure grants in the science funding system. There are other things, such as center grants that fund groups of investigators. Sometimes those can get pretty large — the NIH grant for a major cancer center like Dana-Farber could be tens of millions of dollars per year.Dan: In the past, US science funding agencies did provide more funding for infrastructure and the instrumentation that you need to perform research through block grants. In the 1960s, the NSF and the Department of Defense were kicking up major programs to establish new data collection efforts — observatories, radio astronomy, or the Deep Sea Drilling project the NSF ran, collecting core samples from the ocean floor around the world. The Defense Advanced Research Projects Agency (DARPA) — back then the Advanced Research Projects Agency (ARPA) — was investing in nuclear test detection to monitor adherence to nuclear test ban treaties. Some of these were satellite observation methods for atmospheric testing. Some were seismic measurement methods for underground testing. ARPA supported the installation of a network of seismic monitors around the world. Those monitors are responsible for validating tectonic plate theory. Over the next decade, their readings mapped the tectonic plates of the earth. That large-scale investment in research infrastructure is not as common in the US research policy enterprise today.That's fascinating. I learned last year how modern that validation of tectonic plate theory was. Until well into my grandparents' lifetime, we didn't know if tectonic plates existed.Dan: Santi, when were you born?1997.Dan: So I'm a good decade older than you — I was born in 1985. When we were learning tectonic plate theory in the 1990s, it seemed like something everybody had always known. It turns out that it had only been known for maybe 25 years.So there's this idea of federal funding for science as these massive pieces of infrastructure, like the Hubble Telescope. But although projects like that do happen, the median dollar the Feds spend on science today is for an individual grant, not installing seismic monitors all over the globe.Dan: You applied for a grant to fund a specific project, whose contours you've outlined in advance, and we provided the funding to execute that project.Pierre: You want to do some observations at the observatory in Chile, and you are going to need to buy a plane ticket — not first class, not business class, very much economy.Let's move to current events. In February of this year, the NIH announced it was capping indirect cost reimbursement at 15% on all grants.What's the administration's argument here?Pierre: The argument is there are cases where foundations only charge 15% overhead rate on grants — and universities acquiesce to such low rates — and the federal government is entitled to some sort of “most-favored nation” clause where no one pays less in overhead than they pay. That's the argument in this half-a-page notice. It's not much more elaborate than that.The idea is, the Gates Foundation says, “We will give you a grant to do health research and we're only going to pay 15% indirect costs.” Some universities say, “Thank you. We'll do that.” So clearly the universities don't need the extra indirect cost reimbursement?Pierre: I think so.Dan: Whether you can extrapolate from that to federal research funding is a different question, let alone if federal research was funding less research and including even less overhead. Would foundations make up some of the difference, or even continue funding as much research, if the resources provided by the federal government were lower? Those are open questions. Foundations complement federal funding, as opposed to substitute for it, and may be less interested in funding research if it's less productive.What are some reasons that argument might be misguided?Pierre: First, universities don't always say, “Yes” [to a researcher wishing to accept a grant]. At MIT, getting a grant means getting special authorization from the provost. That special authorization is not always forthcoming. The provost has a special fund, presumably funded out of the endowment, that under certain conditions they will dip into to make up for the missing overhead.So you've got some research that, for whatever reason, the federal government won't fund, and the Gates Foundation is only willing to fund it at this low rate, and the university has budgeted a little bit extra for those grants that it still wants.Pierre: That's my understanding. I know that if you're going to get a grant, you're going to have to sit in many meetings and cajole any number of administrators, and you don't always get your way.Second, it's not an apples-to-apples comparison [between federal and foundation grants] because there are ways to budget an item as a direct cost in a foundation grant that the government would consider an indirect cost. So you might budget some fractional access to a facility…Like the mouse microscope I have to use?Pierre: Yes, or some sort of Cryo-EM machine. You end up getting more overhead through the back door.The more fundamental way in which that approach is misguided is that the government wants its infrastructure — that it has contributed to through [past] indirect costs — to be leveraged by other funders. It's already there, it's been paid for, it's sitting idle, and we can get more bang for our buck if we get those additional funders to piggyback on that investment.Dan: That [other funders] might not be interested in funding otherwise.Why wouldn't they be interested in funding it otherwise? What shouldn't the federal government say, “We're going to pay less. If it's important research, somebody else will pay for it.”Dan: We're talking about an economies-of-scale problem. These are fixed costs. The more they're utilized, the more the costs get spread over individual research projects.For the past several decades, the federal government has funded an order of magnitude more university research than private firms or foundations. If you look at NSF survey data, 55% of university R&D is federally funded; 6% is funded by foundations. That is an order of magnitude difference. The federal government has the scale to support and extract value for whatever its goals are for American science.We haven't even started to get into the administrative costs of research. That is part of the public and political discomfort with indirect-cost recovery. The idea that this is money that's going to fund university bloat.I should lay my cards on the table here for readers. There are a ton of problems with the American scientific enterprise as it currently exists. But when you look at studies from a wide range of folks, it's obvious that R&D in American universities is hugely valuable. Federal R&D dollars more than pay for themselves. I want to leave room for all critiques of the scientific ecosystem, of the universities, of individual research ideas. But at this 30,000-foot level, federal R&D dollars are well spent.Dan: The evidence may suggest that, but that's not where the political and public dialogue around science policy is. Again, I'm going to bring in a long arc here. In the 1950s and 1960s, it was, “We're in a race with the Soviet Union. If we want to win this race, we're going to have to take some risky bets.” And the US did. It was more flexible with its investments in university and industrial science, especially related to defense aims. But over time, with the waning of these political pressures and with new budgetary pressures, the tenor shifted from, “Let's take chances” to “Let's make science and other parts of government more accountable.” The undercurrent of Indirect Cost Recovery policy debates has more of this accountability framing.This comes up in this comparison to foundation rates: “Is the government overpaying?” Clearly universities are willing to accept less from foundations. It comes up in this perception that ICR is funding administrative growth that may not be productive or socially efficient. Accountability seems to be a priority in the current day.Where are we right now [August 2025] on that 15% cap on indirect costs?Dan: Recent changes first kicked off on February 7th, when NIH posted its supplemental guidance, that introduced a policy that the direct cost rates that it paid on its grants would be 15% to institutions of higher education. That policy was then adopted by the NSF, the DOD, and the Department of Energy. All of these have gotten held up in court by litigation from universities. Things are stuck in legal limbo. Congress has presented its point of view that, “At least for now, I'd like to keep things as they are.” But this has been an object of controversy long before the current administration even took office in January. I don't think it's going away.Pierre: If I had to guess, the proposal as it first took shape is not what is going to end up being adopted. But the idea that overhead rates are an object of controversy — are too high, and need to be reformed — is going to stay relevant.Dan: Partly that's because it's a complicated issue. Partly there's not a real benchmark of what an appropriate Indirect Cost Recovery policy should be. Any way you try to fund the cost of research, you're going to run into trade-offs. Those are complicated.ICR does draw criticism. People think it's bloated or lacks transparency. We would agree some of these critiques are well-founded. Yet it's also important to remember that ICR pays for facilities and administration. It doesn't just fund administrative costs, which is what people usually associate it with. The share of ICR that goes to administrative costs is legally capped at 26% of direct costs. That cap has been in place since 1991. Many universities have been at that cap for many years — you can see this in public records. So the idea that indirect costs are going up over time, and that that's because of bloat at US universities, has to be incorrect, because the administrative rate has been capped for three decades.Many of those costs are incurred in service of complying with regulations that govern research, including the cost of administering ICR to begin with. Compiling great proposals every two to four years and a new round of negotiations — all of that takes resources. Those are among the things that indirect cost funding reimburses.Even then, universities appear to under-recover their true indirect costs of federally-sponsored research. We have examples from specific universities which have reported detailed numbers. That under-recovery means less incentive to invest in infrastructure, less capacity for innovation, fewer clinical trials. So there's a case to be made that indirect cost funding is too low.Pierre: The bottom line is we don't know if there is under- or over-recovery of indirect costs. There's an incentive for university administrators to claim there's under-recovery. So I take that with a huge grain of salt.Dan: It's ambiguous what a best policy would look like, but this is all to say that, first, public understanding of this complex issue is sometimes a bit murky. Second, a path forward has to embrace the trade-offs that any particular approach to ICR presents.From reading your paper, I got a much better sense that a ton of the administrative bloat of the modern university is responding to federal regulations on research. The average researcher reports spending almost half of their time on paperwork. Some of that is a consequence of the research or grant process; some is regulatory compliance.The other thing, which I want to hear more on, is that research tools seem to be becoming more expensive and complex. So the microscope I'm using today is an order of magnitude more expensive than the microscope I was using in 1950. And you've got to recoup those costs somehow.Pierre: Everything costs more than it used to. Research is subject to Baumol's cost disease. There are areas where there's been productivity gains — software has had an impact.The stakes are high because, if we get this wrong, we're telling researchers that they should bias the type of research they're going to pursue and training that they're going to undergo, with an eye to what is cheaper. If we reduce the overhead rate, we should expect research that has less fixed cost and more variable costs to gain in favor — and research that is more scale-intensive to lose favor. There's no reason for a benevolent social planner to find that a good development. The government should be neutral with respect to the cost structure of research activities. We don't know in advance what's going to be more productive.Wouldn't a critic respond, “We're going to fund a little bit of indirect costs, but we're not going to subsidize stuff that takes huge amounts of overhead. If universities want to build that fancy new telescope because it's valuable, they'll do it.” Why is that wrong when it comes to science funding?Pierre: There's a grain of truth to it.Dan: With what resources though? Who's incentivized to invest in this infrastructure? There's not a paid market for science. Universities can generate some licensing fees from patents that result from science. But those are meager revenue streams, realistically. There are reasons to believe that commercial firms are under-incentivized to invest in basic scientific research. Prior to 1940, the scientific enterprise was dramatically smaller because there wasn't funding the way that there is today. The exigencies of war drew the federal government into funding research in order to win. Then it was productive enough that folks decided we should keep doing it. History and economic logic tells us that you're not going to see as much science — especially in these fixed-cost heavy endeavors — when those resources aren't provided by the public.Pierre: My one possible answer to the question is, “The endowment is going to pay for it.” MIT has an endowment, but many other universities do not. What does that mean for them? The administration also wants to tax the heck out of the endowment.This is a good opportunity to look at the empirical work you guys did in this great paper. As far as I can tell, this was one of the first real looks at what indirect costs rates look like in real life. What did you guys find?Dan: Two decades ago, Pierre and Bhaven began collecting information on universities' historical indirect cost rates. This is a resource that was quietly sitting on the shelf waiting for its day. That day came this past February. Bhaven and Pierre collected information on negotiated ICR rates for the past 60 years. During this project, we also collected the most recent versions of those agreements from university websites to bring the numbers up to the current day.We pulled together data for around 350 universities and other research institutions. Together, they account for around 85% of all NIH research funding over the last 20 years.We looked at their:* Negotiated indirect cost rates, from institutional indirect cost agreements with the government, and their;* Effective rates [how much they actually get when you look at grant payments], using NIH grant funding data.Negotiated cost rates have gone up. That has led to concerns that the overhead cost of research is going up — these claims that it's funding administrative bloat. But our most important finding is that there's a large gap between the sticker rates — the negotiated ICR rates that are visible to the public, and get floated on Twitter as examples of university exorbitance — and the rates that universities are paid in practice, at least on NIH grants; we think it's likely the case for NSF and other agency grants too.An institution's effective ICR funding rates are much, much lower than their negotiated rates and they haven't changed much for 40 years. If you look at NIH's annual budget, the share of grant funding that goes to indirect costs has been roughly constant at 27-28% for a long time. That implies an effective rate of around 40% over direct costs. Even though many institutions have negotiated rates of 50-70%, they usually receive 30-50%.The difference between those negotiated rates and the effective rates seems to be due to limits and exceptions built into NIH grant rules. Those rules exclude some grants, such as training grants, from full indirect cost funding. They also exclude some direct costs from the figure used to calculate ICR rates. The implication is that institutions receive ICR payments based on a smaller portion of their incurred direct costs than typically assumed. As the negotiated direct cost falls, you see a university being paid a higher indirect cost rate off a smaller — modified — direct cost base, to recover the same amount of overhead.Is it that the federal government is saying for more parts of the grant, “We're not going to reimburse that as an indirect cost.”?Dan: This is where we shift a little bit from assessment to speculation. What's excluded from total direct costs? One thing is researcher salaries above a certain level.What is that level? Can you give me a dollar amount?Dan: It's a $225,700 annual salary. There aren't enough people being paid that on these grants for that to explain the difference, especially when you consider that research salaries are being paid to postdocs and grad students.You're looking around the scientists in your institution and thinking, “That's not where the money is”?Dan: It's not, even if you consider Principal Investigators. If you consider postdocs and grad students, it certainly isn't.Dan: My best hunch is that research projects have become more capital-intensive, and only a certain level of expenditure on equipment can be included in the modified total direct cost base. I don't have smoking gun evidence, it's my intuition.In the paper, there's this fascinating chart where you show the institutions that would get hit hardest by a 15% cap tend to be those that do the most valuable medical research. Explain that on this framework. Is it that doing high-quality medical research is capital-intensive?Pierre: We look at all the private-sector patents that build on NIH research. The more a university stands to lose under the administration policy, the more it has contributed over the past 25 years — in research the private sector found relevant in terms of pharmaceutical patents.This is counterintuitive if your whole model of funding for science is, “Let's cut subsidies for the stuff the private sector doesn't care about — all this big equipment.” When you cut those subsidies, what suffers most is the stuff that the private sector likes.Pierre: To me it makes perfect sense. This is the stuff that the private sector would not be willing to invest in on its own. But that research, having come into being, is now a very valuable input into activities that profit-minded investors find interesting and worth taking a risk on.This is the argument for the government to fund basic research?Pierre: That argument has been made at the macro-level forever, but the bibliometric revolution of the past 15 years allows you to look at this at the nano-level. Recently I've been able to look at the history of Ozempic. The main patent cites zero publicly-funded research, but it cites a bunch of patents, including patents taken up by academics. Those cite the foundational research performed by Joel Habener and his team at Massachusetts General Hospital in the early 1980s that elucidated the role of GLP-1 as a potential target. This grant was first awarded to Habener in 1979, was renewed every four or five years, and finally died in 2008, when he moved on to other things. Those chains are complex, but we can now validate the macro picture at this more granular level.Dan: I do want to add one qualification which also suggests some directions for the future. There are things we still can't see — despite Pierre's zeal. Our projections of the consequence of a 15% rate cap are still pretty coarse. We don't know what research might not take place. We don't know what indirect cost categories are exposed, or how universities would reallocate. All those things are going to be difficult to project without a proper experiment.One thing that I would've loved to have more visibility into is, “What is the structure of indirect costs at universities across the country? What share of paid indirect costs are going to administrative expenses? What direct cost categories are being excluded?” We would need a more transparency into the system to know the answers.Does that information have to be proprietary? It's part of negotiations with the federal government about how much the taxpayer will pay for overhead on these grants. Which piece is so special that it can't be shared?Pierre: You are talking to the wrong people here because we're meta-scientists, so our answer is none of it should be private.Dan: But now you have to ask the university lawyers.What would the case from the universities be? “We can't tell the public what we spend subsidy on”?Pierre: My sense is that there are institutions of academia that strike most lay people as completely bizarre.Hard to explain without context?Pierre: People haven't thought about it. They will find it so bizarre that they will typically jump from the odd aspect to, “That must be corruption.” University administrators are hugely attuned to that. So the natural defensive approach is to shroud it in secrecy. This way we don't see how the sausage is made.Dan: Transparency can be a blessing and a curse. More information supports more considered decision-making. It also opens the door to misrepresentation by critics who have their own agendas. Pierre's right: there are some practices that to the public might look unusual — or might be familiar, but one might say, “How is that useful expense?” Even a simple thing like having an administrator who manages a faculty's calendar might seem excessive. Many people manage their own calendars. At the same time, when you think about how someone's time is best used, given their expertise, and heavy investment in specialized human capital, are emails, calendaring, and note-taking the right things for scientists [to be doing]? Scientists spend a large chunk of their time now administering grants. Does it make sense to outsource that and preserve the scientist's time for more science?When you put forward data that shows some share of federal research funding is going to fund administrative costs, at first glance it might look wasteful, yet it might still be productive. But I would be able to make a more considered judgment on a path forward if I had access to more facts, including what indirect costs look like under the hood.One last question: in a world where you guys have the ear of the Senate, political leadership at the NIH, and maybe the universities, what would you be pushing for on indirect costs?Pierre: I've come to think that this indirect cost rate is a second-best institution: terrible and yet superior to many of the alternatives. My favorite alternative would be one where there would be a flat rate applied to direct costs. That would be the average effective rate currently observed — on the order of 40%.You're swapping out this complicated system to — in the end — reimburse universities the same 40%.Pierre: We know there are fixed costs. Those fixed costs need to be paid. We could have an elaborate bureaucratic apparatus to try to get it exactly right, but it's mission impossible. So why don't we give up on that and set a rate that's unlikely to lead to large errors in under- or over-recovery. I'm not particularly attached to 40%. But the 15% that was contemplated seems absurdly low.Dan: In the work we've done, we do lay out different approaches. The 15% rate wouldn't fully cut out the negotiation process: to receive that, you have to document your overhead costs and demonstrate that they reached that level. In any case, it's simplifying. It forces more cost-sharing and maybe more judicious investments by universities. But it's also so low that it's likely to make a significant amount of high-value, life-improving research economically unattractive.The current system is complicated and burdensome. It might encourage investment in less productive things, particularly because universities can get it paid back through future ICR. At the same time, it provides pretty good incentives to take on expensive, high-value research on behalf of the public.I would land on one of two alternatives. One of those is close to what Pierre said, with fixed rates, but varied by institution types: one for universities, one for medical schools, one for independent research institutions — because we do see some variation in their cost structures. We might set those rates around their historical average effective rates, since those haven't changed for quite a long time. If you set different rates for different categories of institution, the more finely you slice the pie, the closer you end up to the current system. So that's why I said maybe, at a very high level, four categories.The other I could imagine is to shift more of these costs “above the line” — to adapt the system to enable more of these indirect costs to be budgeted as direct costs in grants. This isn't always easy, but presumably some things we currently call indirect costs could be accounted for in a direct cost manner. Foundations do it a bit more than the federal government does, so that could be another path forward.There's no silver bullet. Our goal was to try to bring some understanding to this long-running policy debate over how to fund the indirect cost of research and what appropriate rates should be. It's been a recurring question for several decades and now is in the hot seat again. Hopefully through this work, we've been able to help push that dialogue along. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.statecraft.pub

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

Drs. Audrey Thurm and Latha Soorya join us to discuss key findings from the NIH-funded Natural History Study in Phelan-McDermid syndrome, including intellectual disability profiles, daily living skill growth, regression, and how caregiver input drives research. Learn how these discoveries are guiding clinical trials, behavioral therapy, and everyday care—and why your family's participation makes all the difference.

In this episode of The Eric Coffey Show, Eric reflects on why he left Florida to plant himself in the heart of federal activity—because real opportunity often sits closest to the fire. Joined by seasoned former senior executives from NIH, USDA, and major federal organizations, the conversation touches on the importance of showing up, investing in community, strengthening your credentials, and positioning yourself inside key socioeconomic and professional groups. Eric pulls back the curtain on why proximity, collaboration, and continuous self-development will determine who thrives as new coalitions and high-level industry connections are formed. Key Takeaways Proximity creates opportunity: Being close to federal decision-makers accelerates relationship-building and access. Sharpen your credentials: Use downtime to update certifications, join associations, and stay active in professional groups. Engage the ecosystem: Chambers, NCMA chapters, and socioeconomic organizations open doors most small businesses never tap into. Learn more: https://federalhelpcenter.com/ https://govcongiants.org/  Watch the full Youtube Live here: https://www.youtube.com/live/c7fV-oJd74k

Find More Great Info From Dr. Melanie Matheu Here: SUBSTACK: https://lilscience.substack.com TIKTOK:https://www.tiktok.com/@laughterinlight YOUTUBE: https://www.youtube.com/@LaughterInLight Hawk talks with immunologist Dr. Melanie Matthew about the upcoming flu season and the devastating impact of RFK Jr as HHS Secretary. Australia experienced record-setting influenza deaths this year, with flu killing more people than COVID. The H3N2 variant mutated to evade vaccine protection, leading to unprecedented hospitalizations. Japan declared a flu epidemic five weeks early, and similar patterns are emerging in the United States.Dr. Matthew explains why flu vaccination remains critical despite mutations, reducing hospitalizations by 30-40% in adults and 70-75% in children. The conversation shifts to RFK Jr's anti-vaccine policies at HHS, where he claims no vaccine is safe and effective despite having zero background in immunology or pediatrics. His appointment, along with Marty Makary at FDA and Jay Bhattacharya at NIH, represents a complete rejection of scientific reality in favor of political ideology.The discussion covers RFK Jr's role in 88 child deaths in Samoa from measles, his vitamin A recommendations causing liver damage in Texas children, and how VAERS data is being misrepresented. Dr. Matthew details the exodus of top scientists from NIH, cancelled research grants, and terminated clinical trials that will kill patients. Forever chemicals (PFAS) are being approved for pesticides while vaccine research funding gets slashed.America faces losing measles elimination status, rising preventable disease deaths, and compromised pandemic preparedness. The CDC's COVID vaccine guidance for pregnant women has been offline for months despite evidence linking infection to preterm births and neurological damage. This administration prioritizes grift over public health, with consequences spanning decades. SUPPORT & CONNECT WITH HAWK- Support on Patreon: https://www.patreon.com/mdg650hawk- Support Hawk's Merch Store: https://hawkmerchstore.com- Connect on TikTok: https://www.tiktok.com/@hawkeyewhackamole- Connect on BlueSky: https://bsky.app/profile/mdg650hawk.bsky.social- Connect on YouTube: https://www.youtube.com/@hawkpodcasts ALL HAWK PODCASTS INFO- Additional Podcasts Available Here: https://www.hawkpodcasts.com- Listen to Hawk Podcasts On Your Favorite Platform:Spotify: https://spoti.fi/3RWeJfyApple Podcasts: https://apple.co/422GDuLYouTube: https://youtube.com/@hawkpodcastsiHeartRadio: https://ihr.fm/47vVBdPPandora: https://bit.ly/48COaTBSimplecast: https://hawk-droppings.simplecast.com- Hawk Podcasts RSS Feed: https://feeds.simplecast.com/pPVtxSNJ

Dr. Nicola Hawley is an Associate Professor of Epidemiology at the Yale School of Public Health, where she also holds a secondary appointment in Anthropology. She serves as Associate Director for Dissemination and Implementation Science at the Yale Center for Clinical Investigation. Trained as a human biologist, Dr. Hawley is an internationally recognized expert in maternal and child health, with a focus on how early life experiences, from pregnancy through childhood, shape long-term risks for obesity and chronic disease. Her research bridges epidemiology, anthropology, and global health, using community-engaged and culturally grounded approaches to improve health outcomes in under-resourced and Indigenous settings. Much of her work centers in the Pacific, particularly in Sāmoa and American Sāmoa, where she leads NIH- and PCORI-funded studies on gestational and Type 2 diabetes, obesity prevention, and intergenerational health. She's also deeply committed to mentorship, helping train the next generation of global health and maternal-child health researchers. ------------------------------ Find the work discussed in this episode: Heinsberg LW, Loia M, Tasele S, Faasalele-Savusa K, Carlson JC, Anesi S, et al. (2025) Study protocol for the Health Outcomes in Pregnancy and Early Childhood (HOPE) Study: A mother-infant study in American Samoa. PLoS One 20(9): e0326644. https://doi.org/10.1371/journal.pone.0326644 ------------------------------ Contact the Sausage of Science Podcast and the Human Biology Association: Facebook: facebook.com/groups/humanbiologyassociation/, Website: humbio.org, Twitter: @HumBioAssoc Chris Lynn, Co-Host Website: cdlynn.people.ua.edu/, E-mail: cdlynn@ua.edu, Twitter:@Chris_Ly Courtney Manthey, Guest-Co-Host, Website: holylaetoli.com/ E-mail: cpierce4@uccs.edu, Twitter: @HolyLaetoli Anahi Ruderman, SoS Co-Producer, HBA Junior Fellow, E-mail: ruderman@cenpat-conicet.gob.ar

Top Stories for November 29th Publish Date: November 29th PRE-ROLL: SUGAR HILL ICE SKATING From the BG AD Group Studio Welcome to the Gwinnett Daily Post Podcast. Today is Saturday, November 29th and Happy Birthday to Vin Scully I’m Peyton Spurlock and here are your top stories presented by Gwinnett KIA Mall of Georgia. Piedmont Oncology Opens Early Detection Pancreatic Cancer Clinic, First of Its Kind in Georgia You can now use a digital driver’s license to buy beer, cigarettes in Georgia Musical events, attractions to get into the magical spirit of the holiday season All of this and more is coming up on the Gwinnett Daily Post podcast, and if you are looking for community news, we encourage you to listen daily and subscribe! Break 1: Kia Mall of Georgia STORY 1: Piedmont Oncology Opens Early Detection Pancreatic Cancer Clinic, First of Its Kind in Georgia Piedmont Oncology just opened Georgia’s first Early Detection Pancreatic Cancer Clinic, and honestly, it’s a big deal. Pancreatic cancer is brutal—13% five-year survival rate, no screening test, vague symptoms that sneak up on you. But this clinic? It’s here to change that. Dr. Andrew Page, the clinic’s medical director, says early detection is everything. “Education about risk factors is critical,” he explained. The clinic will focus on genetic counseling, research collaborations with NIH and Mayo Clinic, and, hopefully, developing a much-needed screening test. None of this would’ve happened without donors like Purple Pansies. Their support is saving lives. STORY 2: You can now use a digital driver’s license to buy beer, cigarettes in Georgia Big news for Georgians: you can now use a digital driver’s license to buy alcohol, tobacco, and other age-restricted items. Yep, your phone just got even more useful. The Georgia Department of Driver Services (DDS) announced the update Monday, calling it a “major step forward” in modernizing IDs. But here’s the catch: it’s up to individual businesses to accept them. No guarantees. Oh, and don’t try using a screenshot—doesn’t count. Retailers need a special mDL reader to scan the license, and staff still have to verify your age. Progress? Sure. Perfect? Not quite yet. STORY 3: Musical events, attractions to get into the magical spirit of the holiday season It’s that time again—holiday magic is everywhere, and Atlanta’s got no shortage of ways to celebrate. From concerts to tree lightings, here’s what’s happening: Holiday Shows at the FOX Theatre: Lauren Daigle’s Behold Christmas Tour (Dec. 4): Grammy-winning magic. Christmas Together (Dec. 6): Amy Grant, Cece Winans, and Michael W. Smith. A Drummer Boy Christmas (Dec. 8): for King + Country’s festive storytelling. Elf the Musical (Dec. 16–20): Buddy’s heartwarming journey. Nutcracker! Magical Christmas Ballet (Dec. 23–24): Ballet meets acrobatics. Festive Attractions: Stone Mountain’s Flight to the North Pole (Nov. 8–Jan. 4): Help Santa save Christmas. Garden of Lights (Nov. 15–Jan. 11): Stroll through dazzling displays. Georgia Aquarium Holidays (Nov. 14–Jan. 2): Twinkling lights, Santa, and sea life. Don’t miss these great events! We have opportunities for sponsors to get great engagement on these shows. Call 770.874.3200 for more info. We’ll be right back Break 2: Ingles Markets - DTL HOLIDAY STORY 4: Student loan change could drain nurse pipeline, Ga. dean warns Nursing is no longer considered a “professional degree” by the U.S. Department of Education, and nurses are, understandably, furious. The change, tied to the “One Big Beautiful Bill”, means nursing students can’t access the $200,000 loan cap reserved for professional programs. Instead, they’re stuck with a $100,000 limit—less than what many need to cover tuition. Linda McCauley, dean of Emory’s Nursing School, didn’t hold back: “In a time when we desperately need more nurses, why make it harder? It feels like they didn’t think this through.” The fallout? Fewer nurses, more debt, and a lot of frustration. STORY 5: Flight delays: Here are your rights when flying over the holidays in 2025 Stuck at the airport? Here’s a tip: if your flight’s delayed more than three hours (domestic) or six hours (international), you’ve got rights. Travel expert Katy Nastro says airlines must offer a refund or rebook you—your choice. But here’s the catch: no double-dipping. You can’t get both. And meal vouchers? Only if the delay’s the airline’s fault, like staffing or mechanical issues. Hotels? Depends on the airline. The Department of Transportation even published a guide for what airlines owe you. Pro tip: screenshots of your license don’t count for ID. Break 3: BUFORD HOLIDAY FESTIVAL STORY 6: Forsyth school board approves use of same alarm system in place at Apalachee High School Forsyth County schools are stepping up safety with a $2.4 million Centegix alarm system, approved by the Board of Education this week. You’ve probably heard of these “panic alarms”—they’re the same system credited with the quick response during the tragic Apalachee High School shooting last year. Teachers and staff wear a button they can press in emergencies, instantly alerting law enforcement without fumbling for a phone. The system also includes color-coded strobe lights for visual alerts, ensuring ADA compliance. The first year’s cost? $420,000, with the rest spread over five years. Safety, it seems, is getting an upgrade. STORY 7: Recall alert: Honda recalls 256K vehicles for loss of power software error Honda’s recalling over 256,000 vehicles—specifically 2023–2025 Accord Hybrids—because of a software glitch that could cause the car to lose power mid-drive. Not ideal, right? The issue? The integrated control module’s CPU might reset itself while you’re cruising along. Dealers will fix it for free, though, so there’s that. Honda says owners will get a heads-up by mail starting Jan. 5, but if you’re the impatient type (or just worried), you can call them at 888-234-2138. Oh, and if you’re curious, the recall number is TN2. Stay safe out there! We’ll have closing comments after this Break 4: THE SUGAR HILL HOLIDAY Signoff – Thanks again for hanging out with us on today’s Gwinnett Daily Post Podcast. If you enjoy these shows, we encourage you to check out our other offerings, like the Cherokee Tribune Ledger podcast, the Marietta Daily Journal, or the Community Podcast for Rockdale Newton and Morgan Counties. Read more about all our stories and get other great content at www.gwinnettdailypost.com Did you know over 50% of Americans listen to podcasts weekly? Giving you important news about our community and telling great stories are what we do. Make sure you join us for our next episode and be sure to share this podcast on social media with your friends and family. Add us to your Alexa Flash Briefing or your Google Home Briefing and be sure to like, follow, and subscribe wherever you get your podcasts. Produced by the BG Podcast Network Show Sponsors: www.ingles-markets.com www.kiamallofga.com 2025 Buford Holiday Festival & Parade All-In-One Flyer Holiday Celebration 2025 – City of Sugar Hill Ice Rink – Downtown Sugar Hill NewsPodcast, CurrentEvents, TopHeadlines, BreakingNews, PodcastDiscussion, PodcastNews, InDepthAnalysis, NewsAnalysis, PodcastTrending, WorldNews, LocalNews, GlobalNews, PodcastInsights, NewsBrief, PodcastUpdate, NewsRoundup, WeeklyNews, DailyNews, PodcastInterviews, HotTopics, PodcastOpinions, InvestigativeJournalism, BehindTheHeadlines, PodcastMedia, NewsStories, PodcastReports, JournalismMatters, PodcastPerspectives, NewsCommentary, PodcastListeners, NewsPodcastCommunity, NewsSource, PodcastCuration, WorldAffairs, PodcastUpdates, AudioNews, PodcastJournalism, EmergingStories, NewsFlash, PodcastConversations See omnystudio.com/listener for privacy information.

===== MDJ Script/ Top Stories for November 28th Publish Date:  November 28th    Commercial: From the BG AD Group Studio, Welcome to the Marietta Daily Journal Podcast.    Today is Friday, November 28th and Happy Birthday to Dave Righetti I’m Keith Ippolito and here are the stories Cobb is talking about, presented by Times Journal Flight delays: Here are your rights when flying over the holidays in 2025 Holiday lights on display in metro Atlanta ‘Elf The Musical’ coming to Fox Theatre for the Christmas season Plus, Leah McGrath from Ingles Markets on soy and oat milk All of this and more is coming up on the Marietta Daily Journal Podcast, and if you are looking for community news, we encourage you to listen and subscribe!  BREAK: INGLES 2 STORY 1: Flight delays: Here are your rights when flying over the holidays in 2025 Ever been stuck at the airport, staring at the departure board, wondering what your rights are? Turns out, there’s a “magic number” for delays: 3 hours for domestic flights, 6 for international. Hit that threshold, and airlines have to help—refund, rebook, your call. But here’s the catch: no extra compensation in the U.S. Some airlines, like Delta or Alaska, will throw in meal vouchers or even a hotel if it’s their fault (think staffing, not weather). Others? Not so generous. Pro tip: check your airline’s policy before you fly. And pack snacks. Always.  STORY 2: Holiday lights on display in metro Atlanta  The holidays are here, and metro Atlanta is lighting up—literally. Whether you’re cruising through a drive-thru wonderland or strolling under glowing canopies, there’s magic everywhere. Candy Rush at Six Flags (Marietta): A mile of lights, candy canes, and a gingerbread village. Sweet tooth? Satisfied. Nov. 14–Jan. 4. $39.99 per car. Fantasy in Lights at Callaway Gardens: Seven miles, 10 million lights, and Santa. Forbes loves it, and so will you. Nov. 14–Jan. 4. Tickets start at $24.99. Lanier Islands’ Magical Nights of Lights: Six miles of twinkling displays. Pure nostalgia. Nov. 15–Jan. 4. From $25. WildWoods: AGLOW at Fernbank: Glowing gardens, luminous dandelions, and interactive magic. Nov. 14–Feb. 28. From $16.95. Go make some memories! STORY 3: ‘Elf The Musical’ coming to Fox Theatre for the Christmas season Buddy the Elf is in town, and he’s bringing the holiday cheer! “Elf The Musical” is hitting the Fox Theatre stage Dec. 16-21, but Buddy’s not waiting till then to spread some Christmas magic. Catch him around Atlanta this weekend: Friday night at The Blind Elf Parlour Bar (5:30-7:30 p.m.), or Saturday at the Children’s Museum (10 a.m.-noon), the Georgia Festival of Trees (2-4 p.m.), and Atlantic Station’s Light the Station event (4-7:30 p.m.). So, grab your syrup and get ready—it’s gonna be festive! We have opportunities for sponsors to get great engagement on these shows. Call 770.799.6810 for more info.  We’ll be right back. Break: STRAND THEATRE STORY 4: Piedmont Oncology Opens Early Detection Pancreatic Cancer Clinic, First of Its Kind in Georgia  Piedmont Oncology just opened Georgia’s first Early Detection Pancreatic Cancer Clinic (EDC) at Piedmont Atlanta Hospital, and honestly, it’s a game-changer. Pancreatic cancer is brutal—only 13% of patients survive five years—but this clinic is here to change that. Why’s it so hard to catch early? No screening test exists, symptoms are vague, and many high-risk patients don’t even know they’re at risk. That’s where the EDC steps in: genetic counseling, cutting-edge research with NIH and Mayo Clinic, and a team laser-focused on early detection. “This is about saving lives,” said Dr. Andrew Page, the clinic’s medical director. STORY 5: More than 4 million expected to pass through Atlanta airport during Thanksgiving season Thanksgiving travel is in full swing, and Hartsfield-Jackson is bracing for over 4 million passengers. “It’s like our Super Bowl,” said General Manager Ricky Smith, half-joking but clearly ready for the chaos. The busiest day? Dec. 1, with 375,000 travelers expected—though that’s slightly down from last year, thanks to folks opting for road trips during the recent government shutdown. Still, the airport’s pulling out all the stops: new info totems, real-time TSA wait times, and extra security (some visible, some not). Smith’s advice? Arrive early, stay patient, and if something feels off, speak up. And now here is Leah McGrath from Ingles Markets on soy and oat milk We’ll have closing comments after this. Break: Ingles Markets 2 Signoff-   Thanks again for hanging out with us on today’s Marietta Daily Journal Podcast. If you enjoy these shows, we encourage you to check out our other offerings, like the Cherokee Tribune Ledger Podcast, the Marietta Daily Journal, or the Community Podcast for Rockdale Newton and Morgan Counties. Read more about all our stories and get other great content at mdjonline.com Did you know over 50% of Americans listen to podcasts weekly? Giving you important news about our community and telling great stories are what we do. Make sure you join us for our next episode and be sure to share this podcast on social media with your friends and family. Add us to your Alexa Flash Briefing or your Google Home Briefing and be sure to like, follow, and subscribe wherever you get your podcasts. Produced by the BG Podcast Network Show Sponsors: www.ingles-markets.com Strand Marietta – Earl and Rachel Smith Strand Theatre See omnystudio.com/listener for privacy information.

In this episode of "Swallow Your Pride," host Theresa Richard brings together a panel of NIH-funded researchers from the University of North Carolina at Chapel Hill to unpack the complexity of diagnosing and treating motor speech disorders after left-hemisphere stroke. Theresa Richard guides a conversation that demystifies the overlap between apraxia of speech, dysarthria, and aphasia, highlights the challenges clinicians face in acute and subacute care, and introduces innovative assessment tools designed to bring more objectivity and clarity to real-world practice. The team shares emerging findings, practical insights for SLPs across the continuum of care, and a look at how new perceptual and acoustic measures may shape the future of stroke-related speech assessment. Links mentioned in the show: UNC Center for Aphasia and Related Disorder's Lab website (includes information on our research and helpful therapy resources regarding aphasia, communication partner training, and aphasia-friendly print materials): https://www.med.unc.edu/healthsciences/sphs/card/ Tools Available for Speech Therapists for Assessment... Word Information Measure and Moving Average Type Token Ratio (Shiny App): https://unccard.shinyapps.io/WIM_MATTR/ Word Complexity Measure (Shiny App): https://unccard.shinyapps.io/shiny-woRdcomplex-2/ Word Complexity Measure Ratio (Shiny App): https://unccard.shinyapps.io/shiny-wcmRatio/ The post 385 – Navigating the Complexities of Speech Disorders After Stroke: A Deep Dive into Current Research and Practices appeared first on Swallow Your Pride Podcast.

Emily Cadiz is a teacher, musician, mom of three, and founder of Prelude Early Learning, home of Finnegan the Dragon. After a traumatic brain injury left her needing to relearn how to talk and walk, she rebuilt her skills through music and singing—an experience that inspired Prelude's music-based approach to teaching language and pre-reading. With 20+ years in education and master's degrees in education, special education, and music, Emily has created an NIH-supported program that's shown up to 250% growth in early literacy skills. In our talk, Emily dives deep into her accident and her history as an educator. She emphasizes why she advocates for inclusive music in classrooms, rather than traditional speech therapy. She also has some great advice for those transitioning from education to entrepreneurship.For all links and resources mentioned in this episode, head to the show notes: https://www.educatorforever.com/episode163.

Harvard president Alan Garber and National Institutes of Health head Jay Bhattacharya are two main characters at the heart of the national fight over the future of academia. Alan Garber has been cast as the defender of academic freedom and democracy; Jay Bhattacharya is Donald Trump's pick to lead the NIH, the agency withholding billions of dollars in research grants from Harvard. Oddly enough, the two men go way back: Garber was Bhattacharya's undergraduate thesis advisor and mentor in the late 1980s. This episode tells the story of how the two men found themselves adversaries — and what it means for the future of science. Find more On the Media every week, here: https://podcasts.apple.com/us/podcast/on-the-media/id73330715Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Shaun will NOT bow down to the Democrats demands! PLUS, Dr. Nick and Leah Wilson, authors of the upcoming book Reclaim Vitality: A Guide to Exit Conventional Medicine and Live Naturally, tells Shaun about the whole genome sequencing program the NIH is rolling out to collect every baby's entire genome sequence, funneling kids into biotech therapies, and their fight to shape public health policies so people can stand for their own health freedoms. And The Heritage Foundation's Dr. EJ Antoni discusses the possible implications of BlackRock owning both the meat packing and pharmaceutical industries, Obamacare subsidies, and Trump's meeting with NYC mayor-elect Zohran Mamdani. See omnystudio.com/listener for privacy information.

Send us a textA vaccine built for a virus might be whispering a powerful message to cancer care. We dig into a new Nature paper suggesting that mRNA COVID shots could enhance the effectiveness of checkpoint inhibitor immunotherapy—especially in non‑small cell lung cancer and melanoma—by acting as an immune alarm that sharpens anti‑tumor responses. The data is retrospective, not causal, so we break down why the signal is exciting, where confounders can hide, and what the next generation of trials must test: timing, vaccine type, biomarkers, and who stands to benefit most.From there, we switch gears to the first weeks of a dog's life. A small but detailed study of Australian breeders maps nine practical socialization steps—novel objects, varied surfaces, calibrated sound exposure, hands‑on handling, human visitors, other animals, off‑site trips, car rides, and rotating environments—that build confident, adaptable companions. We compare three rearing strategies, from uniform protocols to individual puppy plans, and connect these choices to fewer fear issues, better training outcomes, and smoother vet and grooming visits down the line.Journalist and author Melanie Kaplan joins us to share Hammy's story—a beagle rescued from a research lab—and the deeper reporting behind her book, Lab Dog: A Beagle and His Human Investigate the Surprising World of Animal Research. We talk about why beagles became the default lab dog, the emotional toll and resilience of retired animals, and the promising rise of non‑animal alternatives like organs‑on‑chips, human cell models, and computational toxicology. With FDA and NIH signaling support for methods that are more humane and more predictive, there's a real path to better science with less harm.If this conversation moved you or made you think, follow the show, share it with a friend who loves science and animals, and leave a quick review to help others find us.Links to Melanie's Book and SocialsHere is the link to all our socials and stuff!!!Support the showFor Science, Empathy, and Cuteness!Being Kind is a Superpower. All our social links are here!

Broadcast from KSQD, Santa Cruz on 11-20-2025: Dr. Dawn discusses GLP-1 inhibitors like Zepbound and semaglutide showing unexpected benefits for addiction treatment beyond diabetes and weight loss. Patients in rehab report these drugs mute cravings for alcohol, cocaine, and cigarettes. Multiple studies show reduced substance abuse rates in users, with VA and NIH conducting trials examining brain activity and responses to triggers. With 80,000 annual drug overdose deaths and 48 million Americans having substance abuse disorders, these medications may revolutionize addiction treatment by dampening brain reward circuitry, though costs threaten healthcare budgets. A Stanford twin study found those twins assigned a vegan diet had substantially lower cholesterol, insulin, and body weight compared to their omnivore twins after several months, with LDL dropping 15mg, four pounds more weight loss, and 20% lower insulin. Dr. Dawn explains how a fungal disease decimating Central American frog populations caused 500% malaria increases in some areas. The fungus kills frogs by blocking skin electrolytes until hearts stop, eliminating tadpoles that eat mosquito larvae. Ecosystem collapses followed with algae blooms and snake population drops. She provides other examples showing how species losses affect human health, emphasizing the "one health" movement recognizing ecosystem health as fundamental to human wellbeing. An Australian study found people aged 70+ who listen to or play music regularly had 39% lower dementia rates, though causation remains uncertain. Princeton research shows music activates multiple brain regions simultaneously. Learning instruments increases gray matter, and musical memory remains intact in advanced dementia since it's stored separately from other memories. A caller discusses how modern screen-based activities provide less multisensory engagement than past social experiences like dances. Another caller describes Grover's disease causing persistent itchy skin with no known cause. Dr. Dawn recommends an elimination diet removing common allergens for one month, then reintroducing individually to identify food sensitivities triggering immune responses. Dr. Dawn explains xenotransplantation advances with genetically edited pigs beginning full-scale kidney transplant trials. Companies use CRISPR to disable genes causing immune rejection and insert human genes promoting immune tolerance. With only 10% of global kidney patients receiving organs, these could provide unlimited supply. Other innovations include kidneys with thymus tissue to teach immune tolerance and external pig liver systems as transplant bridges. She concludes noting research showing female dogs remember and prefer humans who demonstrate competence at tasks, while male dogs show no preference.

Full Show Notes: https://bengreenfieldlife.com/drandrew Dr. Andrew Koutnik is a research scientist whose career bridges cutting-edge science, elite performance, and personal experience living with type 1 diabetes for over 17 years. His work focuses on how nutrition, metabolism, and lifestyle can be leveraged to maximize human health, performance, and resilience across diverse conditions—from chronic disease to extreme environments. Dr. Andrew Koutnik earned his Ph.D. in Medical Sciences (Molecular Pharmacology and Physiology) from the University of South Florida Morsani College of Medicine. Prior to joining FSU, Dr. Andrew Koutnik served as a Faculty/Principal Investigator at Sansum Diabetes Research Institute and Florida Institute for Human and Machine Cognition. His research has spanned over $70,000,000 in research funding, including NASA missions, U.S. Special Operations Command, Defense Advanced Research Projects, Office of Naval Research, Department of Defense, and NIH-funded clinical trials Episode Sponsors: LVLUP Health: I trust and recommend LVLUP Health for your peptide needs as they third-party test every single batch of their peptides to ensure you’re getting exactly what you pay for and the results you’re after! Head over to lvluphealth.com/BGL and use code BEN15 for a special discount on their game-changing range of products. Ketone-IQ: Ketones are a uniquely powerful macronutrient that can cross the blood-brain barrier and increase brain energy and efficiency. With a daily dose of Ketone-IQ, you'll notice a radical boost in focus, endurance, and performance. Save 30% off your first subscription order of Ketone-IQ at Ketone.com/BENG. CAROL Bike: The science is clear—CAROL Bike is your ticket to a healthier, more vibrant life. And for a limited time, you can get $100 off yours with the code BEN. Don't wait any longer, join over 25,000 riders and visit carolbike.com/ben today. Sunlighten: Sunlighten's patented infrared sauna technology delivers the highest quality near, mid, and far infrared wavelengths to reduce inflammation, boost mitochondrial function, enhance detox pathways, and optimize recovery—backed by 25+ years of clinically proven, non-toxic innovation. Save up to $1,400 at Sunlighten.com/BEN with code BEN. Gameday Men’s Health: Gameday Men's Health offers science-backed, physician-led men's health optimization with personalized protocols for testosterone, peptide therapy, ED treatment, and more—helping you perform at your best whether you're training hard or keeping up with life. Visit gamedaymenshealth.com/bengreenfield for a free testosterone test and consultation at a clinic near you. Boundless Bar: If you’re ready to fuel workouts, sharpen your focus, and support whole-body vitality, grab your Boundless Bars now at boundlessbar.com —and save 10% when you sign up for a Boundless Bar subscription.See omnystudio.com/listener for privacy information.

Dr. Rachel Gatlin entered neuroscience with curiosity and optimism. Then came chaos. She started her PhD at the University of Utah in March 2020—right as the world shut down. Her lab barely existed. Her advisor was on leave. Her project focused on isolation stress in mice, and then every human on earth became her control group. Rachel fought through supply shortages, grant freezes, and the brutal postdoc job market that treats scientists like disposable parts. When her first offer vanished under a hiring freeze, she doubled down, rewrote her plan, and won her own NIH training grant. Her story is about survival in the most literal sense—how to keep your brain intact when the system built to train you keeps collapsing.RELATED LINKS• Dr. Rachel Gatlin on LinkedIn• Dr. Gatlin's Paper Preprint• Dr. Eric Nestler on Wikipedia• News Coverage: Class of 2025 – PhD Students Redefine PrioritiesFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship email podcasts@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

What happens when a powerhouse research enterprise, a statewide health system, and a relentless push for access all meet at the same table? Our conversation with Dr. David Miller, CEO of Michigan Medicine, opens the door to a candid look at how precision care, digital tools, and financial reality collide—and how smart leadership turns that collision into progress.We dig into the new map of Michigan Medicine: the academic medical center in Ann Arbor, integrated hospitals in Lansing and West Michigan, and partnerships that extend specialty expertise across the state. Then we follow the research-to-care pipeline, from NIH-backed labs to clinical trials to real-world therapies. You'll hear how next-generation sequencing is making targeted cancer treatments more accessible, and why histotripsy—a noninvasive, ultrasound-based approach to treating liver tumors—is a model for bringing breakthroughs from engineering benches to exam rooms.Technology is more than a buzzword here. Dr. Miller explains how generative AI is cutting documentation time with ambient notes, speeding routine approvals, and supporting clinical decisions, all while keeping a human in the loop. We talk training the next wave of physicians to be technology fluent, and how virtual visits and remote monitoring expand access without trading away empathy. On payment and policy, we confront the hard parts: Medicaid churn, prior authorization friction, and the need for value-based insurance design that lowers barriers to high-value care. The throughline is simple and urgent—make it easier for patients to get the right care at the right time, and align incentives so innovation actually reaches people.If you care about healthcare that is precise, humane, and actually reachable, this conversation will give you a practical, hopeful blueprint. Subscribe, share with a friend who's navigating care, and leave a review to help more listeners find the show. Your feedback keeps this community sharp—and pushes the system toward what works.Support the showEngage the conversation on Substack at The Common Bridge!

Millions of dollars in federal grants have been terminated, throwing cutting-edge research at American universities into crisis. On this week's On the Media, meet the two men at the center of the fight over the future of academia.[0:00] Harvard president Alan Garber and National Institutes of Health director Jay Bhattacharya are at the heart of the national fight over the future of academia. Alan Garber has been cast as the defender of academic freedom and democracy; Jay Bhattacharya is Donald Trump's pick to lead the NIH, the agency withholding billions of dollars in research grants from Harvard. Oddly enough, the two men go way back: Garber was Bhattacharya's undergraduate thesis adviser and mentor in the late 1980s. This episode tells the story of how the two men found themselves adversaries — and what it means for the future of science.  On the Media is supported by listeners like you. Support OTM by donating today (https://pledge.wnyc.org/support/otm). Follow our show on Instagram, Twitter and Facebook @onthemedia, and share your thoughts with us by emailing onthemedia@wnyc.org.

Milk has long been sold as the key to strong bones, but research challenges that claim: many people don't tolerate dairy, calcium needs are lower than advertised, and higher milk intake doesn't necessarily prevent fractures. Politics and industry marketing helped set “three glasses a day,” even though healthy bones depend more on overall diet and lifestyle—things like vitamin D, movement, and avoiding soda, excess sugar, and stress that drive calcium loss. Dairy may be helpful for some diets, but it can also trigger bloating, acne, congestion, or digestive issues. The good news is that strong bones and good nutrition are still very doable without cow's milk—think leafy greens, sardines, almonds, chia, and sunshine for vitamin D. In this episode, I discuss, along with Dr. David Ludwig and Dr. Elizabeth Boham why bone health depends more on diet, lifestyle, and nutrient balance than on dairy. David S. Ludwig, MD, PhD, is an endocrinologist and researcher at Boston Children's Hospital, Professor of Pediatrics at Harvard Medical School, and Professor of Nutrition at the Harvard T.H. Chan School of Public Health. He co-directs the New Balance Foundation Obesity Prevention Center and founded the Optimal Weight for Life (OWL) program, one of the nation's largest clinics for children with obesity. For over 25 years, Dr. Ludwig has studied how diet composition affects metabolism, body weight, and chronic disease risk, focusing on low glycemic index, low-carbohydrate, and ketogenic diets. Called an “obesity warrior” by Time Magazine, he has championed policy changes to improve the food environment. A Principal Investigator on numerous NIH and philanthropic grants, Dr. Ludwig has published over 200 scientific articles and three books for the public, including the #1 New York Times bestseller Always, Hungry? Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women's Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN to save 15%. Full-length episodes can be found here:Why Most Everything We Were Told About Dairy Is Wrong Is It Okay To Eat Cheese And What Types Of Dairy Should You Avoid? Is Lactose Intolerance Causing Your Gut Issues?