In his weekly clinical update, Dr. Griffin discusses variant specific clinical performance of a SARS-CoV-2 rapid antigen test with focus on omicron VOC, ventilation in buildings, COVID-19 mortality among selective serotonin reuptake inhibitor users, risk of post-acute sequelae of SARS-CoV-2 infection associated with pre-coronavirus disease obstructive sleep apnea diagnoses, trajectories of the evolution of post COVID-19 condition, and efficacy of cognitive behavioral therapy targeting severe fatigue following COVID-19. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Virus variant clinical performance of a SARS-CoV-2 rapid antigen test (CID) Ventilation in buildings (CDC) COVID-19 mortality among SSRI users (CMI) Risk of post-acute sequelae of SARS-CoV-2 infection associated with sleep apnea (SLEEP) Trajectories of the evolution of post COVID-19 condition (IJID) Efficacy of cognitive behavioral therapy targeting fatigue following COVID-19 (CAD) Contribute to our FIMRC fundraiser at PWB Letters read on TWiV 1008 Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to email@example.com
In his weekly clinical update, Dr. Griffin discusses immunogenicity and tolerability of a bivalent virus-like particle norovirus vaccine candidate in children from 6 months up to 4 years of age, influenza hemagglutinin stem nanoparticle vaccine induces cross-group 1 neutralizing antibodies in healthy adults, COVID-19 surveillance after expiration of the public health emergency declaration, provisional mortality data, targeted vaccine messaging to promote COVID-19 vaccines for children and youth, vaccines and related biological products advisory committee meeting June 15, 2023 announcement, how to overhaul the CDC, impact of SARS-CoV-2 variants on inpatient clinical outcome, prevalence of post-coronavirus disease condition 12 weeks after Omicron infection compared with negative controls and association with vaccination status, gut bacteria cocktail helps long COVID, and gut microbiota‐derived symbiotic formula (SIM01) as a novel adjuvant therapy for COVID‐19. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Immunogenicity and tolerability of a bivalent norovirus vaccine in children (HVI) Influenza hemagglutinin stem nanoparticle vaccine induces neutralizing antibodies in healthy adults (STM) COVID-19 surveillance after expiration of the public health emergency declaration (CDC) Provisional mortality data (CDC) Targeted messaging to promote COVID-19 vaccines for children and youth (Pediatrics) Vaccines and biological products advisory committee meeting announcement (FDA) How to overhaul the C.D.C (NYTIMES) Impact of SARS-CoV-2 variants on inpatient clinical outcome (CID) Prevalence of post-COVID19 condition 12 weeks after Omicron infection and vaccination status (CID) Gut bacteria cocktail helps long COVID (MedPage) Gut microbiota‐derived synbiotic formula as a therapy for COVID‐19 (NIH) Contribute to our FIMRC fundraiser at PWB Letters read on TWiV 1006 Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to firstname.lastname@example.org
In today's episode, Emily speaks with historian, attorney, and diplomat Philip Zelikow, about the investigative report Lessons from the Covid War, authored by the COVID Crisis Group, which examines the U.S. response to COVID and provides valuable insights for how we can do better in the future. Find show notes, transcript, and more at thenocturnists.com.
With all the volatility surrounding the banking sector, the Fed raising rates and the continued debt ceiling debate, are consumers finally pulling back on spending? ----- Transcript -----Welcome to Thoughts on the Market. I'm Mike Wilson, Chief Investment Officer and Chief U.S. Equity Strategist for Morgan Stanley. Along with my colleagues bringing a variety of perspectives, I'll be talking about the latest trends in the financial marketplace. It's Monday, May 8th, at 11 a.m. in New York. So let's get after it. In this week's podcast, I will discuss three major topics on investors' minds. First quarter Earnings results, the Fed's decision to raise rates last week, and how the consumer is holding up in the face of a debt ceiling debate with no easy solutions. First, on earnings, the first quarter earnings per share beat consensus expectations by 6 to 7%. Furthermore, second quarter guidance is held up better than we expected coming into the quarter. That said, it's important to provide some context. First quarter estimates came down 16% over the past year, double the 20 year average decline over equivalent periods and a more manageable hurdle for companies to clear. Furthermore, the macro data improved in January and February as seasonal adjustments and easy comparisons, with the early 2022 break out of Omicron flattered the growth rate. Nevertheless, this improvement also helped earnings results on a year-over-year basis and provided a boost to company confidence about where we are in the cycle. Unfortunately, many of the leading macro data we track have fallen and are now pointing to a similar reacceleration in earnings per share growth that the consensus expects. Ironically, this comes as many companies position 2023 growth recoveries as being contingent on a solid macro backdrop. If one is to believe our leading indicators that point pointed downward trends in earnings per share surprise and margins over the coming months, stocks will likely follow that negative path lower. With regards to the Fed, Chair Powell pushed back on the likelihood of interest rate cuts that are now priced in the bond markets. While bonds and stocks faded after these comments, they closed the week on a strong note. We believe the equity market continues to expect the best of both worlds, interest rate cuts and durable growth. We view the likelihood of reacceleration in growth in conjunction with interest rate cuts is very low. Instead, we believe another chapter of our fire and ice narrative is possible. In other words, a tighter Fed even as growth slows towards recession. This would be a difficult environment for stocks. So what are consumers telling us? Today, we published our latest AlphaWise Consumer Survey. Consumers continue to expect a pullback in spending for most categories over the next six months. Consumers still plan to spend more on essentials like groceries and household supplies. However, they are looking to pull back on discretionary goods spending categories with the most negative net spending intentions are consumer electronics, leisure activities, home appliances and food away from home. Grocery is the only category where low and middle income consumers said they're planning to spend incrementally more over the next six months. They are not planning to spend more on any services categories. For high income consumers, travel is the only services category where spending intentions are positive and grocery is the only goods category where spending intentions are positive. Interestingly, the high income group indicated negative spending intentions for food away from home and leisure services. Bottom line, the consumer looks to finally be pulling back from an incredible two year run of spending. That was always unsustainable in our view. Some of this may be due to inflation and dwindling savings, but also the very public debate around the debt ceiling, which does not appear to have any easy solution. This is just another wildcard risk for stocks as we head into the summer. Thanks for listening. If you enjoy Thoughts on the Market, please take a moment to rate and review us on the Apple Podcast app. It helps for people to find the show.
In his weekly clinical update, Dr. Griffin discusses the U.S. Food and Drug Administration approving Arexvy: the first respiratory syncytial virus (RSV) vaccine approved for use in the United State, association between SARS-CoV-2 and metagenomic content of samples from the Huanan Seafood Market, researchers disagree over how bad it is to be reinfected and whether COVID-19 can cause lasting changes to the immune system, virtual care and emergency department use during the COVID-19 pandemic among patients of family physicians in Canada, vaccination with BCG-Denmark did not result in a lower risk of COVID-19 among health care workers than placebo, NVX-CoV2373 vaccine efficacy against hospitalization, comparative effectiveness of the SARS-COV-2 vaccines during Delta dominance, assessment of gender-specific COVID-19 case fatality risk per malignant neoplasm type, clinical outcomes following treatment for COVID-19 with Nirmatrelvir/Ritonavir and Molnupiravir among patients living in nursing homes, timing of intubation and ICU mortality in COVID-19 patients, real-life experience with Remdesivir for treatment of COVID-19 among older adults, and how long COVID brain fog and muscle pain are associated with longer time to clearance of SARS-CoV-2 RNA from the upper respiratory tract during acute infection. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode FDA approves Arexvy, the first RSV vaccine approved in the US (FDA) Association between SARS-CoV-2 and content of samples from the Huanan Seafood Market (bioRxiv) Researchers disagree over how bad it is to be reinfected with COVID-19 and lasting changes to the immune system (Nature) Virtual care and emergency department use during the COVID-19 Pandemic among patients of family physicians (JAMA) Vaccination with BCG-Denmark did not result in a lower risk of COVID-19 among health care workers (NEJM) NVX-CoV2373 vaccine efficacy against hospitalization (Vaccine) Comparative effectiveness of the SARS-COV-2 vaccines during Delta (Cell) Assessment of gender-specific COVID-19 case fatality risk (JAMA) Clinical outcomes following treatment for COVID-19 with Nirmatrelvir/Ritonavir and Molnupiravir (JAMA) Timing of intubation and ICU mortality in COVID-19 patients (BMC) Real-life experience with Remdesivir for treatment of COVID-19 (JAC) Long COVID brain fog and muscle pain are associated with longer time to clearance of SARS-CoV-2 RNA (Frontiers) Contribute to our FIMRC fundraiser at PWB Letters read on TWiV 1004 Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to email@example.com
CCO Infectious Disease Podcast
In this episode, Patrick W. G. Mallon, MB, BCh, PhD, FRACP, FRCPI, discusses new data on COVID-19 presented at ECCMID 2023, including:Treatment in special populationsREDPINE: remdesivir in people with renal impairment hospitalized for COVID-19 pneumoniaRemdesivir and readmission for COVID-19 in immunocompromised patientsMolnupiravir vs nirmatrelvir plus ritonavir for COVID-19 with hematologic malignancyManagement of patients with severe diseaseRECOVERY: higher-dose vs standard-dose corticosteroids for hospitalized patients with COVID-19Real-world study of tocilizumab vs baricitinib for severe COVID-19Novel antiviralsEnsitrelvirBemnifosbuvir Novel vaccinesNB2155AZD2816/AZD1222qNIV/CoV2373GRT-R910NVX-CoV2373 in people with HIVFaculty: Patrick W. G. Mallon, MB, BCh, PhD, FRACP, FRCPIProfessor of Microbial DiseasesCentre for Experimental Pathogen Host ResearchUniversity College DublinDublin, IrelandContent based on an online CME/CE program supported by independent educational grants from Gilead Sciences, Inc. and Novavax. Link to full program: bit.ly/3niXGJ6Link to downloadable slides: bit.ly/3LUFejG
We've heard many stories on Raise the Line about patients and their family members who, upon getting a rare disease diagnosis, build a non-profit organization from scratch to boost advocacy and research for the condition in question. This is obviously a pretty big hill to climb for people with no background in such things. Well, today we're going to learn about Beacon for Rare Diseases, a UK non-profit designed to provide the expertise and support needed to get a rare disease patient group off the ground, and to connect these groups with each other for the purpose of mutual education and support. “What we've seen is that people forming and building patient organizations can help really trigger a new community around that, and help drive the field forward,” Beacon CEO Dr. Rick Thompson tells host Shiv Gaglani. “What we want to do as an organization is help those patient groups form, to grow, and to professionalize their work.” Tune in to find out how Dr. Thompson's background in evolutionary biology, research and education impacts his work at Beacon, why rare diseases should be approached in the same way as cancer, and his interest in repurposing existing drugs for use in treating rare diseases. Mentioned in this episode: https://www.rarebeacon.org/
In this week's episode we'll review imbalances in gut microbiota may impact the efficacy and safety of immunochemotherapy in patients with diffuse large B-cell lymphoma. Next, the NFIA-ETO2 fusion, found exclusively in pediatric patients with pure erythroid leukemia, impairs the normal process of erythroid differentiation. Finally, we'll look at the effectiveness of nirmatrelvir plus ritonavir in patients with CLL infected with SARS-CoV-2 during the Omicron surge.
CCO Infectious Disease Podcast
In this episode, Renslow Sherer, MD, and Trinh P. Vu, PharmD, BCIDP, discuss strategies for managing ambulatory patients with acute or previous COVID-19 infection, including:Current COVID-19 landscapeRapid antigen tests and PCR testsRisk stratification of patients who have a positive SARS-CoV-2 testAntiviral treatment (nirmatrelvir + ritonavir, remdesivir, and molnupiravir)Long COVIDPresenters:Renslow Sherer, MDDirector, International HIV Training CenterProfessor of MedicineSection of Infectious Diseases and Global HealthDepartment of MedicineUniversity of ChicagoChicago, IllinoisTrinh P. Vu, PharmD, BCIDPClinical Pharmacy Specialist in Infectious DiseasesDepartment of Pharmaceutical ServicesEmory University Hospital MidtownAtlanta, GeorgiaTo download the slides: bit.ly/3oHKC09To view the full online program: bit.ly/4201xcO
“It is my deepest wish for all of my students to find me as a mentor and a coach,” says Beth Hendricks, RN, MSN and assistant professor at New Mexico State University School of Nursing. That can be traced back in part to a nursing educator early in her career who took that approach and built her confidence. Being devoted to paying that forward is one reason Hendricks is the winner of the 2022 Osmosis Raise The Line Faculty Awards in the RN-Nurse Practitioner category. Her student nominators describe her as both empathetic and driven to see them succeed, which is a deliberate balance Hendricks tries to strike. “Having their backs but also challenging them is the best method for connecting with students,” she tells host Michael Carrese. Check out this insightful conversation on how to motivate students to fight through “imposter syndrome,” the importance of learning to think like a nurse, and why she encourages students to find their unique learning style among many other tips for educators. Mentioned in this episode: www.osmosis.org/faculty-awards
The Omicron variant has been spinning off all sorts of sub variants during its 17 month long reign. The latest is XBB.1.16 - known also as Arcturus - and like its sibling sub variants doesn't seem to be all that different. But while Arcturus is busy trying to become the most popular sub variant of the month, we are undergoing another wave of infections. There are hundreds of people in hospitals around the country and it's continuing to affect how the health system operates. Also on the show: Is COVID going to the dogs?
CCO Infectious Disease Podcast
In this episode, Tracey Piparo, PA-C, and Renslow Sherer, MD, discuss cases of nonhospitalized patients with COVID-19, including:Young, healthy patient with no risk factorsYoung, healthy patient with risk factorsOlder patient with immunocompromiseOlder patient with renal dysfunctionPatient experiencing hypoxia Presenters: Tracey Piparo, PA-C Department of Palliative Medicine RJWBarnabas New Brunswick, New Jersey Renslow Sherer, MD Director, International HIV Training Center Professor of Medicine Section of Infectious Diseases and Global Health Department of Medicine University of Chicago Chicago, Illinois To download the slides: bit.ly/44cgH0qTo view the full online program: https://bit.ly/4201xcO
Christopher Lochhead Follow Your Different™
Over the last three years or so, we've all been through one of the craziest most challenging times in modern history. On today's episode, we have a conversation with Liz Hoffman on how we can take stock of what just happened, and how we can master ourselves during a time of Crisis. Liz Hoffman is a legendary author and journalist. She used to be a senior reporter at The Wall Street Journal, and now she's a business and finance editor at the new startup called Semafor.com. She's got a riveting new book out that I really enjoyed, called Crash Landing: The Inside Story of how the world's biggest companies survived an economy on the brink. We'll discuss more about this new book and much more in today's Follow Your Different, so stay tuned. You're listening to Christopher Lochhead: Follow Your Different. We are the real dialogue podcast for people with a different mind. So get your mind in a different place, and hey ho, let's go. Liz Hoffman on the early days of the pandemic, and how we are today Liz and Christopher discuss the emotional impact of the pandemic's early days, which they regard as a global trauma. She then talks about how the emotional pitch of those days helped her set the emotional tone of her book's characters. Christopher reflects on the dramatic changes in the world since then, as well as his sense of loss for lost time and loved ones. Liz agrees and mentions a recent article on the pandemic's delayed reckoning with global trauma. They then talk about the bumpy re-entry into the world and the pandemic's lingering effects, of whether we are post-pandemic or not. Liz Hoffman on the ending that never came Liz and Chris discussed how they, like many others, had hoped for a clear endpoint to the COVID-19 pandemic, but that it had remained elusive. And for Liz, there was an added layer of it as a reporter, looking for a conclusion to her work, but it never came. Christopher mentioned how both parties were hoping for a Hollywood-style ending, but the emergence of the Omicron variant dashed those hopes. Liz Hoffman believes that, as humans, people prefer clarity and closure, but the pandemic has been a long-term experience that defies easy categorization. The pacing of Liz's pandemic book reflects this, as it begins with a frenzy before settling into a long and uncertain funk. What legendary leaders do in times of crisis Christopher then asks Liz for insight on how leaders can rise to the occasion rather than crumble under pressure. Liz believes that making a large number of decisions quickly and efficiently, without over-analyzing, can be beneficial. She cites the CEO of Hilton, who pulled their credit lines from banks in early March and received $2 billion to get them through the crisis. Liz emphasizes the importance of making decisions early and anticipating what will happen next, rather than getting bogged down in lengthy decision-making processes. She also points out that leaders should never run a multinational corporation on instinct alone, yet there is frequently unnecessary "process fat" in corporate decision-making that can be trimmed off. To hear more from Liz Hoffman and how to master yourself in times of crisis, download and listen to this episode. Bio Liz Hoffman is the business and finance editor at Semafor. Previously, she was a senior reporter at The Wall Street Journal, where she covered financial markets, corporate dealmaking, and the machinations of Wall Street. A native of central Pennsylvania, Hoffman graduated from Tufts University and the Medill School of Journalism at Northwestern University. She lives in Brooklyn, New York. Links Connect with Liz Hoffman! Semafor | Twitter | LinkedIn | Crash Landing We hope you enjoyed this episode of Christopher Lochhead: Follow Your Different™! Christopher loves hearing from his listeners. Feel free to email him, connect on Facebook, Twitter, Instagram, and subscribe on iTunes!
In his weekly clinical update, Dr. Griffin discusses completeness and spin of medRxiv preprints and associated published abstracts of COVID-19 randomized clinical trials, lessons learned from a COVID-19 dog screening pilot in California K-12 schools, SARS-CoV-2 reinfection and severity of the disease, effectiveness of COVID-19 bivalent vaccine, Molnupiravir and risk of post-acute sequelae of COVID-19, risk of new-onset long Covid following reinfection with SARS-CoV-2, low vitamin D levels associated with long COVID syndrome in COVID-19 survivors, and clinical experience with the α2A-adrenoceptor agonist, guanfacine, and N-acetylcysteine for the treatment of cognitive deficits in “Long-COVID19”. Click arrow to play Download TWiV 1002 (27 MB .mp3, 44 min) Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Completeness and spin of medRxiv preprint and published abstracts of COVID-19 randomized clinical trials (JAMA) Lessons learned from a COVID-19 dog screening pilot (JAMA) SARS-CoV-2 reinfection and severity of the disease (Viruses) Effectiveness of COVID-19 bivalent vaccine (medRxiv) Molnupiravir and risk of post-acute sequelae of COVID-19 (BMJ) Risk of new-onset long Covid following reinfection with SARS-CoV-2 (medRxiv) Low vitamin D levels are associated with Long COVID in COVID-19 survivors (JCEM) Clinical experience with the α2A-adrenoceptor agonist, guanfacine, and N-acetylcysteine for treatment of Long-COVID19 (NIH) Contribute to our ASTMH fundraiser at PWB Letters read on TWiV 1002 Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to firstname.lastname@example.org
Earlier this month, the World Health Organization announced it was tracking a new COVID-19 “variant of interest,” XBB.1.16, which has spread to more than 30 countries, including the U.S. The variant, which is also known as Arcturus, genetically resembles the Omicron strain which drove a surge of infections and hospitalizations in Oregon that peaked in late January last year. According to a forecast prepared by Peter Graven, the lead data scientist at Oregon Health & Science University, the Arcturus variant and another variant, XBB.1.9, will drive a wave of new hospitalizations in Oregon that will peak at around 500 patients in late June. Still, Graven expects the state's hospital system to be able to handle any surge fueled by Arcturus which appears to be associated with relatively mild cases of infection. Peter Graven joins us to talk about the outlook for COVID and other respiratory illnesses such as RSV and the flu.
We've learned quite a bit on Raise the Line about at-home monitoring technology for chronic disease management, but on this episode we're going to explore the use of tech for a different aspect of the patient experience: post-surgical care. It's a significant issue because hospitals are incentivized to discharge patients as soon as possible, leaving many to recover at home with varying degrees of support. “The whole postoperative period is a huge black box of missing information. We really don't know how patients are doing after their surgery because we're not capturing the 24-7 experience the patient is living through,” says Dr. Sanjeev Suratwala, an orthopedic spine surgeon who co-founded Recuperet Health to fill that information gap. He tapped software engineer and management consultant Gary Arora to develop Recuperet's technology platform with the aim of keeping it simple for users. “You simply log in with your credentials. It's like watching Netflix on your browser. You don't need to download or install anything,” he tells host Michael Carrese. Patients wear Fitbits that track vital signs, and the system is designed to send alerts to providers -- and a patient-designated caretaker - if something seems concerning. Tune in to learn how Recuperet is leveraging AI and gamification as part of its approach, and how this solution can be broadened to other specialties beyond orthopedics. Mentioned in this episode: https://recuperet.io
“I noticed early on in my academic career that the traditional methods of engagement and the lecture was no longer working for millennials and Gen Z, which is the first generation to completely grow up being immersed in technology,” says Dr. Nicolene “Nikki” Lottering of Bond University in Queensland. That set the assistant professor of anatomy and forensic anthropologist on the path of determining how to use technology effectively without going too far. “For me, it's about the responsible use of technology to meet students halfway and harness that power to engage them and make them excited about what they're learning.” This thoughtful approach is one of the reasons Lottering is the winner of the 2022 Osmosis Raise the Line Faculty Award in the Anatomy and Physiology category. Another, according to her student nominators, is her compassion for her students. This became particularly pronounced during COVID which presented enormous challenges to educators and students alike. “I believe good education comes from a place of genuinely caring about your students,” she tells host Michael Carrese. “We can learn as a community and we can, through learning, find coping strategies as well. It's not always about the content, but it's actually about the community.” Don't miss this inspiring conversation from an educator with many insights on how to connect students to their learning and to each other. Mentioned in this episode: www.Osmosis.org/faculty-awards
Dr. Kevin Most of Northwestern Medicine drops by The Steve Cochran Show for his weekly roundup of medical news to help you live a happier, healthier life. This week, he talks about FDA finally approving the second omicron booster for people over the age of 65, early signs of Parkinson's, and Narcan vending machines becoming more common. Narcan vending machines – becoming more common 2,000 overdose deaths in Cook County in 2022, to put this in perspective there were 3,700 overdose deaths in Illinois, in all of 2021 Historically Narcan was used in Emergency Rooms for potential overdoses, in 2010 this drug was given to police officers to use as first responders Narcan is a nasal spray that can reverse the effects of an opioid overdose and save lives Narcan was made available without a prescription in 2021, you could buy from the pharmacist Narcan recently was approved for OTC status, meaning you would no longer need to talk to a pharmacist to purchase. Chicago recently placed a Narcan vending Machine on CTA Red Line Stop at 95th street This is not novel as Narcan is available in vending machines across the country including Las Vegas, New York, Detroit, West Virginia and many other sites Many college campuses have Narcan Vending machines on campus. The vast majority are free vend machines, requiring no money Included with the prescription is information on quitting and support groups The second Omicron Booster has finally been approved We discussed in the past how the UK and Canada had approved a second shot of the Omicron booster. This was based on the premise that the immunity wanes after 4-6 months since the last booster. Many received their first booster in the late fall and have been waiting for this recommendation FDA announced last Monday that a bivalent Omicron booster 2nd shot is now approved for those over the age of 65 and at least 4 months after your first booster It is also approved for immunocompromised 2 months after their initial bivalent booster FDA shows the immunity does wane, as shown by many studies, but this booster restores it The bivalent more accurate vaccine has now replaced the original vaccine For those who are completely unvaccinated a single shot of the Bivalent vaccine is now recommended, rater than the multiple doses of the original vaccine FDA will meet again in June to decide on next vaccine recommendations April is Parkinson's Awareness Month- New test for early diagnosis from Michael J Fox Foundation “Make the most of the advantage you get from being underestimated” This comment is from Michael J Fox, when asked about “his celebrity charity” Celebrities with Parkinson's Muhammad Ali Alan Alda Neil Diamond George Bush Rev Jesse Jackson Every 6 minutes a new patient will be diagnosed with Parkinson's Disease, 8.5 million people have Parkinson's First identified by Dr James Parkinson's in 1817- for years you were diagnosed by physical exam and then rated 1-5 We now have MRI tests that can support the diagnosis, but again the diagnosis is made after symptoms have started Parkinson's is a neuro degenerative disease that impacts a specific part of the brain Symptoms develop slowly over years and diagnosis is not made often until much later in the illness Common symptoms include tremor, slow movement, stiff limbs, gait and balance problems Unfortunately individuals with Parkinson's may also have depression, anxiety, sleep disorders and blood pressure issues We still do not know the cause, although there appears to be a genetic portion as well as some environmental causes We currently have no cure, but we have treatments including exercise, medications, brain stimulators Dopamine based drugs are the first line as individuals with PD have low levels of Dopamine, meds either increase dopamine or make it more efficient Unfortunately by the time individuals have motor symptoms, it is late in the disease and 60-80% of the specific neurons have been damaged. Big push now is to find a test that can identify this disease earlier, find it years before any symptoms and perhaps we can slow it. Last week, research out of the Michael J Fox Foundation have identified a protein in spinal fluid of people with PD as well as those with a high risk of developing PD This study showed the “Parkinson's Protein” ( alpha Syn -SAA) this is the first time they have identified this in a live PD patient. This abnormal protein was present in 93% of those tested who had PD, for reference point very few tests for neurologic illness are over 90% Also important was the False Positive rate was under 5%, meaning an individual who had a positive result in fact does not have the illness This test will identify patients well before they have any symptoms Knowing this is present, may lead to earlier diagnosis, it may also increase targeted treatment options, including more effective drugs Next steps are to see if this can lead to a less invasive way to test like a blood test or nasal swab As has been said before, you can build a high speed train but without tracks for it, you only have a high speed train, where is this headed next? The tracks are being laid Early signs of Parkinson's Tremor in finger, thumb or hand. This is often a tremor while at rest Small Handwriting, are the letters smaller, are the words crowded together Loss of smell Trouble sleeping- do you thrash around in bed Trouble walking- have you noticed your arms don't swing like they used to Stiffness or pain in the shoulder, hips Soft low voice, have people told you there has been a change in your voice Have you been told you have a serious or depressed look on your face even when not in a bad mood Dizziness or fainting- low blood pressure can be linked to Parkinson's Do your feet feel stuck to the floor, does the stiffness not resolve after moving. See omnystudio.com/listener for privacy information.
In his weekly clinical update, Dr. Griffin discusses an update on vaccine-derived poliovirus outbreaks, how the dream of wiping out polio might need a rethink, risk of death in patients hospitalized for COVID-19 vs seasonal Influenza in fall-winter, French Mpox cluster includes fully vaccinated patients, two individuals with potential Mpox virus reinfection, epidemiologic and clinical features of Mpox-associated deaths, FDA authorizes changes to simplify use of bivalent mRNA COVID-19 vaccines, SARS-CoV-2 during Omicron variant predominance among infants born to people with SARS-CoV-2, severe maternal morbidity and mortality of pregnant patients with COVID-19 infection during the early pandemic period in the US, sickness presenteeism in healthcare workers during the COVID-19 pandemic, ventilation improvements among k–12 public school districts, risk factors and vectors for SARS-CoV-2 household transmission, SARS-CoV-2 neutralizing antibodies after bivalent versus monovalent, durability of bivalent boosters against Omicron subvariants, Nirmatrelvir and risk of hospital admission or death in adults with COVID-19, evolving real-world effectiveness of monoclonal antibodies for treatment of COVID-19, effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support–free days in patients hospitalized with COVID-19, efficacy and safety of Anakinra plus standard of care for patients with severe COVID-19, higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support, risk of autoimmune diseases in patients with COVID-19, definition of post–COVID-19 condition among published research studies, and sleep disturbance severity and correlates in post-acute sequelae of COVID-19. Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of TWiV! Links for this episode Update on vaccine-derived poliovirus outbreaks (CDC) The dream of wiping out polio might need a rethink (NPR) Risk of death in patients hospitalized for COVID-19 vs influenza (JAME) French mpox cluster includes fully vaccinated patients (CIDRAP) Two individuals with potential Monkeypox reinfection (The Lancet) Epidemiologic and clinical features of Mpox-associated deaths (CDC) FDA authorizes changes to simplify use of Bivalent mRNA COVID-19 vaccines (FDA) Omicron variant predominance among infants born to people with SARS-CoV-2 (Pediatrics) Severe maternal morbidity and mortality of pregnant patients with COVID-19 (JAMA) Sickness presenteeism in healthcare workers during the COVID-19 pandemic (ICHE) Ventilation improvements among K–12 public school districts (CDC) Risk factors and vectors for SARS-CoV-2 household transmission (The Lancet) SARS-CoV-2 neutralising antibodies after bivalent vs monovalent (The Lancet) Durability of bivalent boosters against Omicron subvariants (NEJM) Nirmatrelvir and risk of hospital admission or death in adults with COVID-19 (BMJ) Real world effectiveness of Monoclonal Antibodies for treatment of COVID-19 (AIM) Study on ACE inhibitor and ARB effect on COVID-19 patient outcomes (JAMA) Efficacy and safety of Anakinra plus standard of care for patients with severe COVID-19 (JAMA) High-dose corticosteroids in non-ventilated COVID-19 patients with hypoxia (The Lancet) Risk of autoimmune diseases in patients with COVID-19 (eClinical) Definition of post–COVID-19 condition (JAMA) Sleep disturbance severity and correlates in Post-acute Sequelae of COVID-19 (JGIM) Contribute to our ASTMH fundraiser at PWB Letters read on TWiV 1001 Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to email@example.com
Photo: No known restrictions on publication. @Batchelorshow #Preview: #SpecialEdition: #Pandemic: New subvariant of Omicron 2021: Highly contageious: new symptomology: global: Arcturus. HenryMillerMD.org
Emmy Award-winning actress Julianna Margulies recently partnered with the New York's Museum of Jewish Heritage: A Living Memorial to the Holocaust, to help create the Holocaust Educator School Partnership. To date, the partnership has trained two university fellows to teach the history of the Holocaust to 1,700 middle and high school students in New York City Public Schools. In a poignant interview, Margulies shares her motivations for expanding the program, personal experiences of how antisemitism has affected her family, and reflections on her first visit to Israel and Yad Vashem. *The views and opinions expressed by guests do not necessarily reflect the views or position of AJC. ___ Episode Lineup: (0:40) Julianna Margulies ___ Show Notes: Learn more about: The Museum of Jewish Heritage's exhibit The Holocaust: What Hate Can Do The Holocaust Educator School Partnership Vote: Vote for The Forgotten Exodus at The Webby Awards: AJC.org/Webby Test your knowledge: Test your knowledge of antisemitism in America: Stopping antisemitism starts with understanding how dangerous it is. Take our quiz and learn how antisemitism impacts American Jewish life. Read: Breaking Down and Fighting Holocaust Trivialization: Holocaust trivialization is not always obvious; a casual observer might miss it without an understanding of the terms, symbols, and relevant history. Here is what you need to know. Listen: Surviving the Unimaginable: A Child's Story of the Holocaust: In this powerful episode, we sit down with Sam Harris, who is one of the youngest survivors of the Holocaust. As a young child, Sam watched in horror as his family was taken to Treblinka and murdered, but he and his two older sisters were able to beat the odds. Listen as Sam recounts the unimaginable struggles he faced during one of the darkest periods in human history and how his experience motivated him to play a central role in the founding of the Illinois Holocaust Museum. What to Know About Israel's Judicial Reform Effort and Protests: Last month, Israeli Prime Minister Benjamin Netanyahu pressed pause on a series of contentious judicial reforms that have triggered mass protests, condemnation from wide swaths of Israeli society, and expressions of concern from American leaders and Jewish organizations. Guest host Belle Yoeli, AJC's Chief Advocacy Officer, sits down with AJC's Chief Policy and Political Affairs Officer Jason Isaacson to discuss what this means for the future of the Middle East's only democracy. Follow People of the Pod on your favorite podcast app, and learn more at AJC.org/PeopleofthePod You can reach us at: firstname.lastname@example.org If you've enjoyed this episode, please be sure to tell your friends, tag us on social media with #PeopleofthePod, and hop onto Apple Podcasts to rate us and write a review, to help more listeners find us. __ Interview Transcript - Julianna Marguiles: Manya Brachear Pashman: Last year, Emmy Award winning actress Julianna Margulies hosted a Holocaust memorial special called “The Hate We Can't Forget", which featured the stories of four Holocaust survivors. In that documentary, Julianna sounded the alarm that Holocaust education across the country was severely lacking. After filming, Julianna partnered with the Museum of Jewish Heritage: a Living Memorial to the Holocaust here in New York, to help create the Holocaust Educator School Partnership, or HESP. Julianna is with us now to explain what that is and what she hopes it will accomplish. Julianna, welcome to People of the Pod. Julianna Margulies: Thank you so much for having me. Manya Brachear Pashman: So please tell our audience: what is the Holocaust Educator School Partnership or HESP? Julianna Margulies: HESP's an easier way to say it, actually Jack Kliger, who is the CEO of the Museum of Jewish Heritage, he calls he calls them the Hespians. So HESP is a program that I started with the Museum of Jewish Heritage after I hosted that CBS documentary on the Holocaust, when I realized how little education there was in our country. And with the rise of antisemitism and Holocaust deniers, I just felt, I felt despair, to be honest with you. I just thought it's ignorance, because people are not educated. And when you do not learn history, history repeats itself. And so after I hosted it I thought to myself, what can I do? I'm just one little person. I'm not a humongous star, but I have a bit of a platform. And I thought well, let me try and use my voice and the small platform that I have to make change. So luckily, I knew Jack Kliger. And I said, I hosted this Holocaust Remembrance documentary for CBS and MTV, and they paid me. I didn't even think I was gonna get paid to be honest with you, because it was, of course, a labor of love to do it. And I felt weird taking money for it. And so I took the hefty check that they gave me, and I said, let's figure out how to educate our children. Because these are seeds that you have to plant early. So that when these people become adults, this idea that conspiracy theories and the rest of it, they won't penetrate, because you already have that education and the knowledge inside of you to say, that's crazy, no. And also, it wasn't just about antisemitism. For me it was about–and this is how we're approaching it with HESP. It's about genocide. It's about racism. It's about homogenizing human beings. It is about putting people in a category who are different than you and saying you don't belong. So it really spans the spectrum of the entire world and all the people in it. For me, antisemitism is incredibly frightening because family members of mine were Holocaust survivors. I'm a Jew. I'm raising my son Jewish. And I just felt like I had a call to action after I hosted that documentary and watching the documentary, I learned a lot. But really, I think it's about hate. And as we like to say at HESP, never again. Manya Brachear Pashman: It's scary, right? Raising Jewish children is scary, as a mom, I mean, it's wonderful and rewarding and rich, but scary. Julianna Margulies: Well, it wasn't to me at all until I did this documentary and my girlfriend who lives right around the corner from me and her son goes to St. Ann's. She said, Well, how does your son get to school? I said, it takes the subway. We live downtown and he goes to school uptown. Her son goes to school in Brooklyn and she said, Oh, I won't let them on the subway. And I said, Why? And she said, Because he loves to wear his Star of David around his neck, and I'm afraid. And I just couldn't believe I was hearing those words. It's 2023. We live in New York City. And many people have asked me why I've started this program in New York City. Because isn't New York City the center of the Jews. They talk about that. The fact of the matter is, we're in the second semester of this program that I started, and it is shocking how many seventh, eighth and high school students do not know anything about the Holocaust. In fact, two weeks ago, one of my interns was teaching the hour course on the Holocaust and the history of the Holocaust, and an eighth grade boy up in the Bronx asked if there were any Jews still alive, after 6 million were killed. So that's where we're at. Manya Brachear Pashman: So it's an hour long course. But there's more to it than that. Can you kind of walk us through the components of this, this partnership? Julianna Margulies: Yes. So, we take college and graduate students who apply to the program in our first semester, it was just starting out, and we had to do, and it is a paid internship, where they take an eight-day crash course at the Museum of Jewish Heritage on teaching the Holocaust, through one of our professional Holocaust professors there, they then go to schools that we contact, and give, from seventh to eighth grade all the way through high school, one-hour classes, on what the Holocaust was, what it did to the Jewish race, and how it was part of what World War II is about? Manya Brachear Pashman: Do they step into the classroom and take the place of a teacher for a period basically? Julianna Margulies: So they come into the classroom, there, we talk to the principal first and the teachers and it's usually in a history period, it depends on the school's curriculum, and they step into the classroom. And they give this hour lesson and children get to ask questions. On occasion, although they are dying out now, we are able to bring in a Holocaust survivor. My idea now is, because the Holocaust survivors are dying out is, I would like to bring in the children and the grandchildren and the great-grandchildren of Holocaust survivors to tell the stories of their ancestors so that the stories don't get lost, and they don't die out. Because as we're seeing antisemitism isn't dying out. Manya Brachear Pashman: So does it go beyond the classroom, or does it stop there? Julianna Margulies: It does. So because it's affiliated with the Museum of Jewish Heritage, we desperately feel that no child money should never be an issue when it comes to education. So we then after the class, a lot of scheduling is involved, but they're so on it at the Museum of Jewish Heritage. But then we supply buses and bring the children to the museum, which is beautiful, it's downtown and all the exhibits are quite something right now. It's this incredible, The Hate We Know. And it shows the very beginning of before World War II happened and then you get to see this journey that they took all the way after. After the Holocaust and after World War II is over. So they get to go and experience what we were teaching in their class and they get to ask questions. And it's been really heartening because we had an eighth grade class. I forget if it was the Bronx or in Brooklyn, they were so taken by the class that was taught. They chose, for their eighth grade project, an entire exhibition based on the Holocaust and what Jews went through and it was absolutely just gut-wrenchingly beautiful. They made me so proud. They sent me all the pictures of it, I was away working. So I couldn't go. But these kids were beaming. And they felt like they were doing something. I think the idea for me of what HESP is, and any kind of Holocaust education, I think because there's such darkness surrounding it. And I can understand why parents would be nervous to let a seventh and eighth grader learn about it, I understand the fear. But what I'm trying to implement into the program, is this idea of heroes. Who are these heroes that stood up in the face of evil, Jews and non Jews alike. And right now, in our country, I actually feel it's more important that the non Jews are standing up for the Jews, the way that I marched for Black Lives Matter, the way that we all marched for women, you know, this is a universal problem. And we all need to stand behind it. And if all the communities that are so oppressed joined together, power in numbers, and let's look at it more as shining a light on something that will make you feel heroic, to stand up to evil. Manya Brachear Pashman: How many kids has the program reached so far? Julianna Margulies: I'll tell you what's been really amazing to watch. So the first semester, we were small. And we had our two interns who did an incredible job, and they reached over 1700 children, and I always look at any kind of philanthropy, the way I look at acting, which is if I'm on stage, and I reach just one person in the audience, then I've done my job. And that's how I feel about this program. So knowing that they've reached 1700 children, maybe half of them didn't care or weren't listening or weren't moved. But there certainly were a handful that were. And what it also did was, when I went to the museum to congratulate our interns, when they graduated, we publicized it and took some pictures. And our next semester, we had 20 applicants. And in fact, I was just talking with —AJC's been really helpful. They're helping me expand it throughout the country. But it was Laura Shaw Frank, who said, What I love about this, and she's a holocaust historian, she said is that it's young people teaching young people, because they respond, kids respond to young teachers. And so to have these 20, 21, 22 year old interns walking into a classroom, full of, you know, 9th graders, 10th graders, 11th graders, and talking at their level, is actually incredibly helpful. Manya Brachear Pashman: I learned something from the documentary. AJC has this wonderful resource called Translate Hate. It's a glossary that's online and it teaches people about antisemitic tropes and terms that have been around Yes, since the dawn of time. And new ones too. It's constantly updated. And I learned a new term in that documentary called Godwin's Law. And I hope that we add it to Translate Hate later this year. And Godwin's Law is: the longer an online conversation goes on, the likelihood of a comparison to Nazis or Adolf Hitler rises 100%. I thought that was so interesting. And so social media does play such a significant role in school children's lives. TikTok, Twitter, Snapchat, probably a few have been invented that I don't know about yet. What role do you believe social media companies should be playing in reining in this antisemitic rhetoric, if any role at all? Julianna Margulies: Well, I think that I think they need to be responsible for misinformation, and hate speech. I'm all for the First Amendment. But where do you draw the line? Where do you draw the line here? I mean, children are sponges. And you plant one little seed, and it can be a good seed or a bad seed. And it's also you know, social media is toxic. I know I'm not a big social media person. I had to join Instagram when I wrote my memoir, because Random House said, Wait, you're not on social media. So I joined the lesser of all evils, because I figured the only people following me on Instagram are people who like me, right? So I'm not gonna get a lot of hate mail there. Manya Brachear Pashman: Think again, Julianna. Julianna Margulies: I know, I know, I actually realized–don't read the comments. But I do believe that it is their job to filter out the hate and the misinformation, I really do. I do not think they should be allowed to. I'm going to peddle these incredibly damaging, and life threatening conspiracy theories. It's not helping anyone, it's making people more angry. I know how I feel just scrolling through Instagram. You know, I as an adult, who is not into any of it, and who feels very secure in who I am. And in my position in life with my family, and who I am as a person to my friends, and my child and my husband, I start feeling insecure. So if I, a confident woman in her 50s is feeling insecure, scrolling through Instagram, I can't imagine what it's doing to children. Manya Brachear Pashman: I love the way that you put it in the film, that just a little bit of Holocaust knowledge can actually be dangerous, that it's because it's just enough for someone to invoke it for political reasons or to make a point, but not enough to take responsibility and to try to prevent it from ever happening again. Was it important that this partnership that you are funding, be robust, be in depth, be more than just an hour long course? Julianna Margulies: Absolutely. I mean, obviously, it's very difficult to teach everything in an hour. So the idea is that those who hear about it and learn about it from that course, will further their interest in it, and that the schools will eventually realize this is something we need to teach. This should be a mandatory class in our history program, the same way we learn about how America was founded, you know, like this is just as important, especially because it's just not that long ago. You know, this, this is quite recent. If you look at the big scale of our world, and how many years it's existed. This is not that long ago. And I, I do believe that institutions, Holocaust museums, all over this country, are doing a tremendous job in showing what it was like, I mean, you know, we're, we're, we're doing an exhibition in October because it's the 80th anniversary of the Danish rescue. And at MGH they're doing an incredible job. I'm on the advisory board now. They're doing the Danish rescue, and it's for children and families. It's not, there's no age, it's age appropriate for everyone. And it's showing the heroes that saved 7200 Jews, and- Manya Brachear Pashman: If you could tell our listeners a little bit about what that Danish rescue is, what you're referring to. Julianna Margulies: So the Danish rescue. You know, it's interesting. I just read this book that Richard Kluger wrote, it's coming out in August, called “Hamlet's Children,” and it's all about the Danish rescue. And very few people know about it. I didn't before I read the book. So Denmark was in a very tricky place in World War II. They had made a treaty with Germany and they were in a place where they were Nazi occupied, but they had made a deal with King Christian had made a deal that the Nazis could not harm their Jews because they were their Danish brothers and sisters, and they were not to be touched. Now, here's a country that is under Nazi occupation. And they hated it. And they sort of were grinning and bearing it. And then towards the end, when the Nazis realized they were losing the war, when America came in, and England came into the war, and they realized that this was going to be a losing battle. The Danes realized that their Danish Jewish brothers and sisters were in trouble. And boatload by boatload at midnight, they rescued 7200 Jews to Sweden, which was neutral. I think what's so important about that story, and I think for people who have gone to Yad Vashem, in Jerusalem, where I just was this past December, to see all these points of light, what would have been had 6 million Jews not been murdered? Where would the life, where would the tree have gone? How far would it have grown? And the 7,200 Jews that were saved, their families have lived on. And it's to show- it's about the tree of life, which was being chopped down before it could even begin. And it's such a heroic story of how they did it. We even have the actual boat that we've refurbished. That's actually in Mystic, Connecticut, because we couldn't get it to New York yet, but we will eventually. It is such a sort of miraculous story. And it wasn't just adults who saved these, these Jews. Everybody in Denmark rose to the occasion. And when you go to Yad Vashem, I mean, I, I had just finished reading the book and I walked down the path of the righteous at Yad Vashem, and I saw a plaque. So for those of you listening who don't know what the path of the righteous is, it's the path of all the heroes, the non Jews that stood up to the Nazis and protected the Jews from the Nazis. And there was this beautiful plaque to the Danish rescue, and I just, you can't help but weep. I mean, it's— where are those heroes? And so that's the light I want to shine on HESP and our Hespians is that these are heroes, let's be heroes. What's amazing to me, is in my business, you know, I'm an actress and all the big movies are about heroes. So why aren't we turning that into- Okay, so that's what makes money, right? Heroes. So let's make this about being a hero. Not about being an antisemite, or whatever labels they have for people who love the Jewish people, who are Jews. Let's turn this into a moment of heroism, and change the narrative so that our children grow up wanting to be heroes. Manya Brachear Pashman: I want to hear more about this trip to Israel. I've encountered many Holocaust survivors who don't talk about their experience until they make a trip to Israel. And then they feel empowered, obligated to tell their horrific story. I'm curious what you witnessed, what you experienced in Israel, both at Yad Vashem, but also in the greater country at large. Julianna Margulies: Yeah, it was a magical experience. And we really crammed a lot in 10 days, because we wanted to make sure and when are we going to be back here? Let's do it. Right. So we actually hired a professor to take us around for 10 days. And really, we went to Tel Aviv, we went to the Negev, we went to Jerusalem. We even actually took a day trip to Jordan and went to Petra, which was mind boggling. We went to Masada. I mean, we did it all. We met with political consultants to try and understand the politics. And we went everywhere and learned about so much. And first of all, I think the thing that struck me the most– my sister was born in Jerusalem. In 1960, my big sister, and she, they left when she was one and I had never been to Israel, because we moved here. My parents moved back to New York. But I always felt this Oh, my sister was born in Jerusalem, I have to go. And we actually had meant to go for my son's Bar Mitzvah. But COVID happened and there was lockdown. So that didn't happen. Then the next year, we were gonna go and it was, Omicron. And so this year, it actually I'm glad I waited till he was 15. Because I actually think he got a lot more out of it. But one of the things that hit me the hardest was how young the country is. Manya Brachear Pashman: 75. Julianna Margulies: It is so young. Because I grew up in England for a great part of my life, and every time I'd come back home, I think how young our country is, like, God, it's so young here. You know, I love America. But some of the ideas, it's like, how can we move past this in, there's still this sort of, it's very young, we live in a young country, Israel is very young. But it's founded on such a strength of community and belonging. And I remember just landing in Tel Aviv, and I looked at my husband, we're walking through the airport. Now we are with our people, it's like, I've never felt like I belong more. Most people don't think I'm Jewish. Most people think I'm Greek or Italian because of my name. But I didn't grow up Jewish. You know, my mother, they're both 100% Jewish, but my mother's family tried to keep their Jewishness quiet. Because her grandmother, who had fled from Prussia, persecuted for being a Jew didn't want to cause any reason for someone to harm her. So they didn't celebrate Passover and Yom Kippur and Hanukkah. They just stayed very quiet. And they didn't talk about it. They spoke Yiddish and they had Jewish food but they didn't advertise their Jewishness, because that caused tremendous pain in their family. And so for me once I became an adult, I wasn't Bat Mitzvahed. And I married a Jewish man who said, I want to raise our son Jewish, and I want a Jewish wedding. And I said, Great, I'm in, let's do it. That's fine. Okay. But as I've sort of grown into the role of my life, as not just the actress and the independent woman, but also as part of a unit, part of a family. We do Shabbat on Fridays, even if it's just to light the candles, and to say goodbye to the workweek, and to say hello to our friends and family. Putting down phones. It's the tradition of Judaism. Because I'm not a religious person, I've always felt any kind of religion is a little bit sexist. And even though I played a Hasidic Jew in a movie years ago, called “The Price Above Rubies,” and I went to Boro Park and and I did some research on the women there because .. I guess I was confused as to why you would love this life, because to me, it felt suffocating, incredibly sexist, and demoralizing to be a Hasidic wife. And then to see their pride and joy in their work, and how they felt about themselves. Iit was quite eye opening. You know, I was judging, I was definitely judgy about it. And I learned a really good lesson, you know. But I have found tremendous joy in the traditions of our Jewish heritage. And our son knows, Friday nights, he can invite any friend over, but we're gonna, before the pizza comes, we're going to just do our blessings, light the candles, and kiss each other. There's something about tradition that is so lost in today's world, that gives a sense of meaning. And, and a route to the family. Manya Brachear Pashman: This has been a fascinating conversation. Julianna Margulies: Thank you. Manya Brachear Pashman: I know that it could go on for hours longer. But thank you so much for joining us. Julianna Margulies: Thank you for doing this podcast. I really love it. Manya Brachear Pashman: I really hope this program expands across the country. Julianna Margulies: Thank you so much for having me.
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