Podcasts about oregon health

Doctor Staci Whitman is a Functional Kids' Dentist in North Portland, Oregon. She is the founder of NoPo Kids Dentistry where she takes a whole-body, holistic, and functional approach with her patients. Her dentistry/practice is grounded by science and powered by love. Doctor Staci attended Tufts University School of Dental Medicine and worked as a general dentist for 2 years before earning a certificate in pediatric dentistry from Oregon Health & Science University (OHSU).  Today on the show we discuss: a hidden habit you're likely doing that can ruin your health, the impact of chewing and processed foods on facial development, nutritional foundations for oral and systemic health, Dr. Staci's problem with conventional oral care products, why fluoride has become so controversial, non-negotiable oral health habits and much more.  Today's sponsor: ⁠LivOn Labs⁠ Get a FREE carton of Lypo-Spheric® B Complex Plus ($56 value) with any full-price purchase from ⁠https://www.livonlabs.com⁠. This supplement has the B vitamins and minerals you need to turn food into sustained, natural energy throughout the day. Just add B Complex Plus and any other full-priced supplement to your cart and enter code BOPST24 at checkout. ⚠ WELLNESS DISCLAIMER ⚠ Please be advised; the topics related to health and mental health in my content are for informational, discussion, and entertainment purposes only. The content is not intended to be a substitute for professional advice, diagnosis, or treatment. Always seek the advice of your health or mental health professional or other qualified health provider with any questions you may have regarding your current condition. Never disregard professional advice or delay in seeking it because of something you have heard from your favorite creator, on social media, or shared within content you've consumed. If you are in crisis or you think you may have an emergency, call your doctor or 911 immediately. If you do not have a health professional who is able to assist you, use these resources to find help: Emergency Medical Services—911 If the situation is potentially life-threatening, get immediate emergency assistance by calling 911, available 24 hours a day. National Suicide Prevention Lifeline, 1-800-273-TALK (8255) or https://suicidepreventionlifeline.org. SAMHSA addiction and mental health treatment Referral Helpline, 1-877-SAMHSA7 (1-877-726-4727) and https://www.samhsa.gov Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome to our new series – the AI Journal Club! In this series, we'll cover some interesting studies and evidence-based applications of artificial intelligence in surgery in a case-based format. Surely AI can find a DVT by now … or can it? Stay tuned and find out! Hosts: - Ayman Ali, MD Ayman Ali is a Behind the Knife fellow and general surgery PGY-3 at Duke Hospital in his academic development time where he focuses on data science, artificial intelligence, and surgery. - Ruchi Thanawala, MD: @Ruchi_TJ Ruchi Thanawala is an Assistant Professor of Informatics and Thoracic Surgery at Oregon Health and Science University (OHSU) and founder of Firefly, an AI-driven platform that is built for competency-based medical education. In addition, she directs the Surgical Data and Decision Sciences Lab for the Department of Surgery at OHSU.  - Marisa Sewell, MD: @MarisaSewell Marisa Sewell is a general surgery PGY-4 at Oregon Health and Science University.  Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

S. R. Schulz lives in Portland, Oregon with his wife, three sons, and two dogs. He's been traveling to visit family in Croatia since 2010. He currently works as a family physician just outside Portland, Oregon, and is a faculty member at Oregon Health & Science University. His writing has been published online and in print, including McSweeney's, HAD, Rejection Letters, Maudlin House, Autofocus, and others. Supersymmetry is his first novel. Find him at srschulzwriting.com or at @authorseanschulz on instagram

 On Monday, Oregon Health and Science University and Legacy Health announced they are mutually walking away from an effort to combine the two healthcare organizations. The merger was first announced last August, when OHSU agreed to acquire 8 hospitals, $3 billion in assets and promised a whopping $1 billion in upgrades to Legacy facilities. The merger garnered scrutiny from a citizen review committee and public comments have reflected opposition to the deal. Amelia Templeton is OPB’s Healthcare reporter and has been following this story. She joins with the latest.

Listen in as our expert panel discusses medications for management of opioid use disorder. They'll review strategies to optimize buprenorphine use and clarify the role of methadone and naltrexone.Special guest:Tyler J. Varisco, PharmD, PhDUniversity of Houston College of Pharmacy Assistant Professor, Department of Pharmaceutical Health Outcomes and PolicyAssistant Director, The PREMIER CenterYou'll also hear practical advice from panelists on TRC's Editorial Advisory Board:Stephen Carek, MD, CAQSM, DipABLM, Clinical Associate Professor of Family Medicine for the Prisma Health/USC School of Medicine Greenville Family Medicine Residency Program at the University of South Carolina School of Medicine, GreenvilleCraig D. Williams, PharmD, FNLA, BCPS, Clinical Professor of Pharmacy Practice at the Oregon Health and Science UniversityFor the purposes of disclosure, Dr. Varisco reports a financial relationship [cardiology, inflammatory bowel disease] with HEALIX Infusion Therapy (research consultant).The other speakers have nothing to disclose.  All relevant financial relationships have been mitigated.This podcast is an excerpt from one of TRC's monthly live CE webinars, the full webinar originally aired in March 2025.TRC Healthcare offers CE credit for this podcast. Log in to your Pharmacist's Letter, Pharmacy Technician's Letter,or Prescriber Insights account and look for the title of this podcast in the list of available CE courses.Claim CreditThe clinical resources mentioned during the podcast are part of a subscription to Pharmacist's Letter, Pharmacy Technician's Letter, and Prescriber Insights: FAQ: Management of Opioid Use DisorderChart: Treatment of Opioid WithdrawalFAQ: Treatment of Acute Pain in Opioid Use DisorderFAQ: Meds for Opioid OverdoseSend us a textIf you're not yet a subscriber, find out more about our product offerings at trchealthcare.com. Follow, rate, and review this show in your favorite podcast app. Find the show on YouTube by searching for ‘TRC Healthcare' or clicking here. You can also reach out to provide feedback or make suggestions by emailing us at ContactUs@trchealthcare.com.

Beta-amyloids are substances linked to problems in the brain including Alzheimer's disease. When scientists injected mice with beta-amyloids, the substance left the brain faster when the animals were sleeping. β-淀粉样蛋白是与包括阿尔茨海默氏病在内的大脑问题有关的物质。 当科学家向小鼠注射β淀粉样蛋白时，该物质在动物睡觉时会更快地离开大脑。 It is not clear exactly how the system works. However, some research has shown that the movement of blood vessels might help move the waste-clearing fluid where it needs to go. 目前尚不清楚系统如何工作。 但是，一些研究表明，血管的运动可能有助于将废水清除液移动到需要的地方。 Finding the system in humans is not easy. Regular MRI scans can show some of the fluid-filled channels. But Piantino said the scans do not show their purpose. 在人类中找到系统并不容易。 常规的MRI扫描可以显示一些充满流体的通道。 但是Piantino说，扫描没有显示出其目的。 To find out more, his team at Oregon Health & Science University injected a substance called a tracer into five patients. The tracer “lit up” during MRI scans. Twenty-four to 48 hours later, the tracer material was seen moving through the brain using the channels as in the earlier research on mice. 为了了解更多信息，他在俄勒冈州健康与科学大学的团队向五名患者注入了一种名为示踪剂的物质。 示踪剂在MRI扫描过程中“点亮”。 二十四到48小时后，观察到示踪剂的材料使用通道在大脑中移动，就像对小鼠的早期研究一样。 Rochester's Dr. Maiken Nedergaard predicts that the study will increase interest in how brain waste clearance connects to people's health. 罗切斯特（Rochester）的Maiken Nedergaard博士预测，这项研究将增加对脑浪费清除如何与人们健康相关的兴趣。 But to test if better sleep or other treatments might really increase waste clearance and improve health, researchers "have to be able to measure glymphatic function in people,” said Dr. Jeff Iliff. He is with the University of Washington and has helped lead waste-clearance research. The question is whether the new study might point to ways of measuring the process. 但是，要测试更好的睡眠或其他治疗方法是否确实可以增加废物清除并改善健康状况，研究人员“必须能够衡量人们的同变功能，” Jeff Iliff博士说。 他在华盛顿大学任职，并帮助领导了废物清除研究。 问题是新研究是否可能指出测量过程的方法。Sleep is not the only question. For example, animal studies show that a blood pressure drug now used to treat the stress disorder called PTSD might improve glymphatic clearing. Iliff and Dr. Elaine Peskind plan to study this drug in a group of patients. 睡眠不是唯一的问题。 例如，动物研究表明，现在用来治疗称为PTSD的应激障碍的血压药物可能会改善胶囊清除。 Iliff和Elaine Peskind博士计划在一组患者中研究这种药物。 Larger studies in healthy people are also needed. 还需要在健康人中进行更大的研究。 In addition, Piantino, who used tracer chemicals in people, wants to find an easier, noninvasive test to follow the waste clearance. 此外，使用示踪剂化学物质的Piantino希望找到一个更容易，无创的测试来遵循废物清除。 “We cannot study all the questions by injecting people,” he said. 他说：“我们无法通过注入人来研究所有问题。”

Non-cystic fibrosis (CF) bronchiectasis, which affects approximately a half million people in the US, is a chronic lung condition that involves permanent bronchial dilation and inflammation; it is characterized by a productive cough and recurrent exacerbations. Author Alan F. Barker, MD, of Oregon Health and Science University joins JAMA Deputy Editor Kristin Walter, MD, MS, to discuss non-CF bronchiectasis. Related Content: Non–Cystic Fibrosis Bronchiectasis in Adults

A rare look inside the human brain might help to explain how it clears away waste. Scientists say the failure to clear away such waste can lead to Alzheimer's disease and other brain disorders. 人脑内部的罕见外观可能有助于解释它如何清除废物。 科学家说，未能清除这种废物会导致阿尔茨海默氏病和其他脑部疾病。 Brain cells use a lot of nutrients. This means they produce a lot of waste. Scientists believe the brain has special structures to take out this “cellular trash,” especially during sleep. They have reported observing this process happening in mice. But they had no clear evidence that this happens in humans.脑细胞使用大量营养。 这意味着它们会产生很多浪费。 科学家认为大脑具有特殊的结构，可以消除这种“细胞垃圾”，尤其是在睡眠期间。 他们报告说观察到小鼠发生的这一过程。 但是他们没有明确的证据表明这发生在人类中。 Recently published research appears to have identified a system, or network, of very small waste-clearing channels in the brains of living humans. The researchers used a special kind of imaging technology to study the network. 最近发表的研究似乎已经确定了活着的人类大脑中非常小的废物清除渠道的系统或网络。 研究人员使用一种特殊的成像技术来研究网络。 One of the researchers was Dr. Juan Piantino of Oregon Health & Science University. Piantino said the new research was important evidence. “We needed this piece to say this happens in humans, too,” he said. 研究人员之一是俄勒冈州健康与科学大学的胡安·皮安蒂诺（Juan Piantino）博士。 Piantino说，这项新研究是重要的证据。 他说：“我们需要这件作品也可以说这在人类中也会发生。” His team recently published its findings in Proceedings of the National Academy of Sciences. 他的团队最近在美国国家科学院会议录中发表了研究结果。 The brain is very active during sleep. During sleeping hours, the brain appears to clean itself. 大脑在睡眠期间非常活跃。 在睡眠时间里，大脑似乎会自身清洁。 That idea has gotten the attention of researchers. Losing a good night's sleep can cause people's thinking to be unclear. But a continuous lack of sleep is believed to increase the risk of the brain disorder dementia. 这个想法引起了研究人员的关注。 失去晚安的睡眠可能会导致人们的想法不清楚。 但是据信持续缺乏睡眠会增加脑部疾病痴呆症的风险。 How does the brain clean itself? 大脑如何清洁自己？ Over 12 years ago, scientists at the University of Rochester first reported finding a network they named the “glymphatic system.” Fluid from the brain, called cerebrospinal fluid, travels through channels surrounding blood vessels to carry waste out of the brain. 12年前，罗切斯特大学的科学家首先报道了一个网络，他们将其命名为“ Glymphatic System”。 来自大脑的液体（称为脑脊液）通过周围的血管周围的通道行驶，以将废物从大脑中带走。

S. R. Schulz lives in Portland, Oregon with his wife, three sons, and two dogs. He's been traveling to visit family in Croatia since 2010. He currently works as a family physician just outside Portland, Oregon, and is a faculty member at Oregon Health & Science University. His writing has been published online and in print, including McSweeney's, HAD, Rejection Letters, Maudlin House, Autofocus, and others. Supersymmetry is his first novel.  Find him at srschulzwriting.com or at @authorseanschulz on instagram 

On this month's installment of our Longevity Series, WHOOP Global Head of Human Performance, Principal Scientist, Dr. Kristen Holmes, sits down with Dr. Adrian Cois. Dr. Cois is an Australian-born Emergency Physician and Assistant Professor of Emergency Medicine, currently practicing in Portland, Oregon. Dr. Cois has an extensive background as a strength and conditioning coach, working with 5 professional Australian sports teams before completing his medical residency at Oregon Health and Science University. Dr. Cois joins the WHOOP podcast to discuss his TedX presentation on the cultural comparison of healthcare in Australia versus the United States and how this impacts longevity. Dr. Holmes and Dr. Cois discuss:(00:25) Dr. Cois's background in Medicine(01:47) Reframing Trauma in Emergency Care(05:26) Frontline Healthcare Workers' Challenges with Personal Health and Wellness (07:46) Cultural Differences between the US and Australia(10:28) Importance of Implementing Preventative Medicine (18:27) Areas for Improvement in the US Healthcare System(21:17) Best Methods to Motivate Individuals to Take Control of Their Health(25:29) The Existing Health Culture in Australia (30:04) Light Behavior and The Benefits of Time Spent Outside. (31:30) Lessons Americans Can Learn From Australians(33:58) Implementing Health Culture(35:12) The Relationship Between Sleep Quality and Shift Work (41:27) How Americans Can Improve Their Health (41:54) Habit Changes For Your Health Follow Dr. Adrian Cois:InstagramLinkedInSupport the showFollow WHOOP: www.whoop.com Trial WHOOP for Free Instagram TikTok X Facebook LinkedIn Follow Will Ahmed:Instagram X LinkedIn Follow Kristen Holmes: Instagram LinkedIn Follow Emily Capodilupo: LinkedIn

On the debut episode of the AMSSM Sports Medicine Primer Series (X: @TheAMSSM), host Dr. Stephen Luebbert, MD, MS, is joined by Dr. Jacqueline Brady, MD, to discuss how to manage a case of patellar dislocation in a basketball player. The goal of this new series is to be an audible study aid for anyone pursuing a career as a sports medicine physician and to prepare them for a sports medicine fellowship. Dr. Brady is an orthopedic sports medicine surgeon at Oregon Health & Science University in Portland, OR, where he is also the Associate Residency Program Director and Director of Orthopedic Simulation. Dr. Brady serves as Head Team Physician for Portland State University and performs research in the field of patellofemoral instability, multi-ligamentous knee injuries and arthroscopic skill-building in learners. Resources: Best Practices in Sports Medicine: AMSSM and AOASM Case Studies (2nd Edition): https://amssmstore.com/best-practices-in-sports-medicine-amssm-and-aoasm-case-studies-second-edition

Join us for an insightful conversation with Dr. Christine Tsai, a doctor, educator, and mentor whose career exemplifies excellence in medicine. Dr. Tsai is an associate professor of medicine and attending physician of hospital medicine at RUSH medical center. She completed her B.A. in biochemical sciences at Harvard, her M.D. at Columbia, and her residency in internal medicine at Oregon Health and Science University.Over her 12 years as a practicing physician, Dr. Tsai has demonstrated a devotion to medical education and clinical practice. She has served as the Director of Clinical Skills, Practitioner Role Leader, and the Internal Medicine Sub-Internship Co-Director, shaping both the preclinical and clinical curriculum at Rush Medical College. Dr. Tsai also embodies a passion for mentorship of numerous medical students, residents, and junior faculty members.Come along as the conversation merges from the technical to the philosophical.Host: Samantha ShihGuest: Christine (Steen) TsaiProduced By: Samantha ShihAlert & Oriented is a medical student-run clinical reasoning podcast dedicated to providing a unique platform for early learners to practice their skills as a team in real time. Through our podcast, we strive to foster a learning environment where medical students can engage with one another, share knowledge, and gain valuable experience in clinical reasoning. We aim to provide a comprehensive and supportive platform for early learners to develop their clinical reasoning skills, build confidence in their craft, and become the best clinicians they can be.Follow the team on X:A&OA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.

Helané Wahbeh, ND, MCR, is the Director of Research at the Institute of Noetic Sciences and an adjunct assistant professor at Oregon Health & Science University. Dr. Wahbeh is the author of some 90+ peer-reviewed publications and the book The Science of Channeling: Why You Should Trust Your Intuition. Her VET-MIND study was funded by the National Institutes of Health and examined the mechanisms of meditation for combat veterans with PTSD. Her current research interests include healing stress and trauma and extended human capacities. She is a Board Member and Past President of the Parapsychological Association and has been meditating for two decades.    Here she and Dawson discuss: Noetic Signature: experience of our inner wisdom How to differentiate from your ego and your higher self? Exercise: To what question would you like intuitive information? Noetic knowing shows up in one of 12 different ways Meditation: An introduction to the inner world The ability all humans have to access energy and information Types of channelings  Why studies correlate childhood trauma with psychic experiences and mediumship How two studies in UK found that psychic abilities run in families Study comparing the full genome of a psychic to controls Study discovery: a unique noncoding gene on chromosome 7 in the psychic group   To learn more about the Institute of Noetic Sciences: https://noetic.org/   Find Dawson's work at: http://dawsongift.com/   And to order Dawson's newest book, Spiritual Intelligence:  https://www.amazon.com/Spiritual-Intelligence-Activating-Circuits-Awakened/dp/160415294X/   #mindtomatter #blissbrain #spiritualintelligence #eft #meditation #highenergyhealth #channeling #intuition #noetic #ions 

The rise of Antisemitism on US college campuses continues to explode. Last week, Comesha Hart, an instructor at Portland Community College and nurse at Oregon Health and Science University Hospital in Portland, Oregon, was terminated from her employment because of violent threats against Jews.In an Instagram post, Comesha proclaimed her support for Hamas, confessed that she would never give medical attention to Jews because she “doesn't take care of animals,” stated that Jewish people are “vermin, dogs, and rats,” called for the destruction of Jews by saying “May they all meet their ancestors soon,” and justified the cold-blooded murder of Israeli hostages Shiri Bibas and her two children, Kfir and Ariel at the hands of Hamas terrorists.Join Aaron and guest Dexter Van Zile, editor of Focus on Western Islamism at The Middle East Forum, in a discussion about the rise of hatred toward Jews in the US and the recent deportations of pro-Hamas US college students who are calling for the destruction of the Jewish state.

Oregon Health & Science University began its Long COVID-19 clinic in 2021, a year into the pandemic as the first vaccines were just becoming widely available. We talked with doctors in the clinic in 2022, and we wanted to check back in to see what clinicians have learned after treating thousands of long COVID patients. Aluko Hope is a pulmonologist, critical care doctor and the medical director of OHSU’s Long COVID-19 program. Jen Arnold is a lead nurse with the program. They both join us to tell us what they’ve learned about caring for patients with long COVID in the last four years and what they hope to learn more about from the research that’s currently underway.

In this episode of the Brain & Life Podcast, co-host Dr. Katy Peters is joined by journalist Kat McGowan. In 2022, Kat was awarded a fellowship from the Alicia Patterson Foundation to cover caregiving and has been featured in Wired, Popular Science, Scientific American, Boston Globe, Audubon, and NPR. Kat discusses her experience with caregiving for her parents and how technology like robots helped in the caregiving relationship. Dr. Peters is then joined by Dr. Jeffrey Kaye, professor of neurology and biomedical engineering at Oregon Health and Science University, director of Layton Aging and Alzheimer's Disease Center, and director of the Oregon Center for Aging and Technology. Dr. Kaye explains what Alzheimer's disease is and how different types of technology are used in treatment and caregiving scenarios.   Additional Resources My Parents' Dementia Felt Like the End of Joy. Then Came the Robots A Robotic Pet Brings Joy to a Patient Who Has Dementia Promising Advances in Robotics-assisted Rehabilitation Therapies Lynda Carter Advocates for Those with Alzheimer's Disease   Other Brain & Life Podcast Episodes Finding Community in Caregiving with Kitty Norton Navigating Complicated Caregiving Journeys with Jacquelyn Revere Journalist, Producer Kitty Eisele's Honest Recount of Her Time as Caregiver We want to hear from you! Have a question or want to hear a topic featured on the Brain & Life Podcast? ·       Record a voicemail at 612-928-6206 ·       Email us at BLpodcast@brainandlife.org   Social Media: Kat McGowan @mcgowankat; Dr. Jeffrey Kaye @oshunews Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD

Liability waivers have been a hot topic in Oregon since a 2014 court ruling made them difficult for places like ski resorts and climbing gyms to enforce. Recreational business owners say their insurance rates have soared as a result, but trial lawyers say the waivers discourage operators from keeping their facilities safe.  House Bill 3140 would allow recreational businesses to require customers to sign a release for claims of “ordinary negligence,” making it harder for customers to sue. Operators say they need the additional protection from frivolous claims, but attorneys say Oregon law already protects against spurious lawsuits. Jim Zupancic is the board president of the Oregon Health & Fitness Alliance, which represents gyms, exercise studios and health clubs across the state. Gretchen Mandekor is the owner and lead trial attorney at Mandekor Law Firm. They join us to offer differing perspectives on this legislation.

This gender identity left them shell-shocked.A member of a state panel advising the director of Oregon's Health Authority (OHA) made a wild first impression at a meeting by proclaiming, “I use they, them and turtle for my pronouns.”JD Holt, who also goes by “JD Terrapin” on Facebook, made the declaration with a straight face while introducing themself at a virtual council meeting on Dec. 20.“Hello everybody, it's JD. I use they, them and turtle for my pronouns. I'm in the Springfield-Eugene area and I get to be part of the council,” Holt said enthusiastically.

Graduating from residency or fellowship to attending is a pivotal moment for surgeons in training. Jyoti D. Chouhan, DO, PharmD, MBA, FACS, from Oregon Health and Science University in Portland, talks with three of her colleagues about mentorship, tips to prepare for surgery, managing complications, work-life integration, and other advice to make the transition as smooth as possible.   Presented by the ACS Women in Surgery Committee, guests include: Tiffany Sinclair, MD, FACS Cheyenne Sonntag, MD, MS Irlna Trantchou, MD, FACS, FASCRS   Talk about the podcast on social media using the hashtag #HouseofSurgery.

Scientists at Oregon State University and Oregon Health and Science University have teamed up to find new ways to treat endometriosis, ovarian cancer and other health conditions using nanoparticles and magnetic fields. Joining us to tell us more about this fascinating research are OPB science reporter Jes Burns, who is also the host and producer behind the “All Science. No Fiction.” video series, and OPB cinematographer and editor Brooke Herbert. This episode was recorded with a live audience at the Tomorrow Theater in Portland.   You can see the video about the medical applications of magnetic nanoparticles here.   For more Evergreen episodes and to share your voice with us, visit our showpage. Follow OPB on Instagram, host Jenn Chávez and Oregon Field Guide. You can sign up for OPB’s newsletters to get what you need in your inbox regularly.   Don’t forget to check out our many podcasts, which can be found on any of your favorite podcast apps: Hush Timber Wars Season 2: Salmon Wars Politics Now Think Out Loud And many more! Check out our full show list here.

Cancer is not a singular disease but a category of hundreds, even thousands, of rare diseases with different molecular signatures and genetic roots. Cancer scientists are looking for a thousand perfect keys to pick a thousand stubborn locks. Today's episode is about the hardest lock of them all: pancreatic cancer. Cancer's power lives in its camouflage. The immune system is often compared to a military search and destroy operation, with our T cells serving as the expert snipers, hunting down antigens and taking them out. But cancer kills so many of us because it looks so much like us. Pancreatic cancer is so deadly in part because it's expert at hiding itself from the immune system. Now, here's the good news. This might be the brightest moment for progress in  pancreatic cancer research in decades—and possibly ever. In the past few years, scientists have developed new drugs that target the key gene mutation responsible for out of control cell growth. Recently, a team of scientists at Oregon Health and Science University claimed to have developed a blood test that is 85 percent accurate at early-stage detection of pancreatic cancer, which is absolutely critical given how advanced the cancer is by the time it's typically caught. And last month, a research center at Memorial Sloan Kettering published a truly extraordinary paper. Using mRNA technology similar to the COVID vaccines, a team of scientists designed a personalized therapy to buff up the immune systems of people with pancreatic cancer. Patients who responded to the treatment saw results that boggle the mind: 75 percent were cancer-free three years after their initial treatment. Not just alive, which would be its own minor miracle. But cancer-free. The mRNA vaccine, administered within a regimen of standard drugs, stood up to the deadliest cancer of them all and won. Today's guest is the head of that research center, the surgical oncologist Vinod Balachandran. The concept of a personalized cancer vaccine is still unproven at scale. But if it works, the potential is enormous. But again: Cancer does not exist, as a singular disease. Cancer is a category of rare diseases, many of which are exquisitely specific to the molecular mosaic of the patient. Cancers are personal. Perhaps in a few years, our cures for cancers will be equally personalized. If you have questions, observations, or ideas for future episodes, email us at PlainEnglish@Spotify.com. Host: Derek Thompson Guest: Vinod Balachandran Producer: Devon Baroldi Links:  Cancer Vaccine paper: https://www.nature.com/articles/s41586-024-08508-4 P.S. Derek wrote a new book! It's called 'Abundance,' and it's about an optimistic vision for politics, science, and technology that gets America building again. Buy it here: https://www.simonandschuster.com/books/Abundance/Ezra-Klein/9781668023488 Plus: If you live in Seattle, Atlanta, or the Raleigh-Durham-Chapel Hill area, Derek is coming your way in March! See him live at book events in your city. Tickets here: The Abundance Book Tour Learn more about your ad choices. Visit podcastchoices.com/adchoices

In this episode, listen in as our expert panel digs into identifying and treating acute bronchitis and community-acquired pneumonia. They'll discuss when antibiotics are appropriate, which antibiotics to use, and other management tips.You'll also hear practical advice from panelists on TRC's Editorial Advisory Board:Stephen Carek, MD, CAQSM, DipABLM, Program Director for the Prisma Health/USC School of Medicine Greenville Family Medicine Residency Program and Clinical Associate Professor at the University of South Carolina School of Medicine, GreenvilleAndrea Darby Stewart, MD, Associate Director, Honor Health Family Medicine Residency Program and Clinical Professor of Family, Community & Occupational Medicine at the University of Arizona College of Medicine - PhoenixCraig D. Williams, PharmD, FNLA, BCPS, Clinical Professor of Pharmacy Practice at the Oregon Health and Science UniversityNone of the speakers have anything to disclose.This podcast is an excerpt from one of TRC's monthly live CE webinars, the full webinar originally aired in January 2025.TRC Healthcare offers CE credit for this podcast. Log in to your Pharmacist's Letter, Pharmacy Technician's Letter, or Prescriber Insights account and look for the title of this podcast in the list of available CE courses.Claim CreditThe clinical resources mentioned during the podcast are part of a subscription to Pharmacist's Letter, Pharmacy Technician's Letter, and Prescriber Insights: Chart: Managing Community-Acquired Pneumonia and Aspiration Pneumonia in AdultsFAQ: Antibiotic Therapy: When Are Shorter Courses Better?Chart: Managing Cough and Cold SymptomsSend us a textCheck out our NEW podcasts. Rumor vs TruthYour trusted source for facts... where we dissect the evidence behind risky rumors and reveal clinical truths.Clinical CapsulesTRC editors break down the most impactful clinical developments - giving you clear, actionable takeaways in just minutes.If you're not yet a subscriber, find out more about our product offerings at trchealthcare.com. Follow, rate, and review this show in your favorite podcast app. Find the show on YouTube by searching for ‘TRC Healthcare' or clicking here. You can also reach out to provide feedback or make suggestions by emailing us at ContactUs@trchealthcare.com.

Dr. Jamie Lo, an Associate Professor at Oregon Health & Science University, and Dr. Adam Crosland, an Assistant Professor at Oregon Health & Science University, discuss the risks of substance use, particularly cannabis, in pregnancy.

An estimated 650,000 adults in Bangladesh suffer from blindness, according to researchers. At the end of November, Oregon Health & Science University ophthalmologist Beth Edmunds traveled to the country to teach local doctors a minimally-invasive operation for adults and children with glaucoma. She joins us to share what she took away from her time volunteering and what it was like operating in the world’s only flying teaching hospital. 

Twenty five years ago, the idea that our mental state and emotions influence our physical health was taboo. Today, it's common knowledge, and it's being studied extensively all over the world. In this episode, Dr. Helané Wahbeh, a clinically trained naturopathic physician and researcher, and the Director of Research at the Institute of Noetic Sciences, shares how our consciousness is a powerful tool that has an impact on the physical body.We talk about “little c” and “big C” consciousness, our understanding of how the soul and body are connected, mind-body awakening, surrendering your attachment to the outcome of having a baby, and more. When you apply her research to the fertility journey and learn to surrender, amazing things can happen for you. Key Topics/Takeaways:The difference between “little c” and “big C” consciousness. [5:04]Creating positive change through positive intentions. [8:14]The paradox of surrendering the outcome to manifest your desires. [13:11]The theories behind channeling, awakening, and mediumship. [14:09]Honoring your body through acknowledging its inherent consciousness. [28:37]How to tap into your inner wisdom. [30:30]Knowing your underlying motivations for your desires. [36:05]How to connect with Dr. Helané WahbehThe Science of Channeling Book: https://buff.ly/38DmeS1Profile: https://noetic.org/profile/helane-wahbeh/Helané Wahbeh's Bio:Helané Wahbeh, ND, MCR, is the Director of Research at the Institute of Noetic Sciences and an adjunct assistant professor in the Department of Neurology at Oregon Health & Science University. She completed her undergraduate degree at University of California Berkeley in Anthropology and Pre-Medicine. She obtained her clinical doctorate at the National University of Natural Medicine. She obtained her Master of Clinical Research from Oregon Health & Science University where she has been on faculty in the department of neurology since 2006. She also completed two post-doctoral research fellowships.Her VET-MIND study funded by the National Institutes of Health examined the mechanisms of meditation for combat veterans with PTSD. Her current research interests include healing stress and trauma, examining mechanisms of mind-body medicine, and rigorously studying extended human capacitiesDr. Wahbeh is the author of some 90+ peer-reviewed publications and the book The Science of Channeling: Why You Should Trust Your Intuition and the Force That Connects Us All. How to connect to Lorne Brown online and in person (Vancouver, BC)Acubalance.ca book virtual or in person conscious work sessions with Dr. Lorne Brown Lornebrown.comConscious hacks and tools to optimize your fertility by Dr. Lorne Brown:

Oregon Health & Science University has been facing a series of mounting challenges in recent months, including its proposed merger with Legacy Health, which is being reviewed by the Oregon Health Authority. If approved, OHSU would control five of the six hospitals in Multnomah County, according to a report issued by OHA last November.  OHSU has also had to contend with the departure of prominent executives such as the interim head of its health unit last month, and Dr. Brian Druker, a world renowned cancer researcher, who resigned in December as CEO of the Knight Cancer Institute. Among the reasons Druker shared with OPB for his decision included low staff morale, a lack of trust in OHSU’s leaders and the organization’s cost-cutting measures, such as its decision to lay off more than 500 employees.  Leading OHSU during this turbulent time is Steve Stadum. The board of directors appointed him as interim president in November, marking his return to the organization which he first worked at more than 25 years ago. Stadum joins us to share his vision for OHSU and how he aims to navigate its internal and external challenges, including threats to federally funded research from the new Trump administration.  

Guest: Elisa K. Boden, MD For many patients with Crohn's disease, surgery is necessary due to complications like strictures and fistulas. Dr. Elisa Boden explores risk factors and potential complications, which she spoke about at the 2025 Crohn's and Colitis Congress. Dr. Boden is an Associate Professor of Medicine in the Division of Gastroenterology and Hepatology at Oregon Health and Science University.

Guest: Elisa K. Boden, MD For patients with Crohn's disease who require surgery, a variety of risk factors are involved in postoperative recovery and disease control. Learn how prehabilitation programs and lifestyle modifications can reduce complications during and after surgery with Dr. Elisa Boden, an Associate Professor of Medicine in the Division of Gastroenterology and Hepatology at Oregon Health and Science University.

Dr. Sejal Hathi, Director of the Oregon Health Authority and an ASTHO Member, explains her state's bold initiative to eliminate health inequities; Kelsey Tillema, ASTHO Senior Workforce Analyst, tells us about a new resource ASTHO has to support workforce well-being; PublicHealthCareers.org could be where you find your next great hire; an ASTHO article outlines trends related to public health data modernization; and Dr. Brannon Traxler, Deputy Director of Health Promotion and Services and the Chief Medical Officer for the South Carolina Department of Public Health as well as an ASTHO Member, is the brand new Secretary and Treasurer for ASTHO's Board of Directors. Oregon Health Authority Web Page: Oregon Health Forward Journal of Public Health Management and Practice Article: Strategies for Enhancing Governmental Public Health Workforce Well-being and Retention ASTHO Web Page: PH-HERO Workforce Resource Center ASTHO Web Page: Modernizing Public Health Data and Protecting Privacy PublicHealthCareers.org ASTHO Web Page: Brannon Traxler  

In this special episode, Oregon Health & Sciences University (OHSU) Medical oncologist Dr. Guillaume (Will) Pegna recaps the North American Neuroendocrine Tumor Society (NANETS) 2024 Multidisciplinary NET Medical Symposium. He shares the latest developments in NET research and medical advances from the conference and how they matter to the NET patient community.MEET DR. GUILLAUME PEGNADr. Pegna is a medical oncologist specializing in caring for adults with neuroendocrine tumors (NETs). He is additionally interested and experienced in the management of rare tumors, including pheochromocytomas, paragangliomas and adrenocortical carcinomas, as well as other gastrointestinal cancers.Dr. Pegna is actively involved with clinical trials and cancer research to improve survival and quality of life for cancer patients and to better understand the biology of these diseases. He specializes in the use of chemotherapy, immunotherapy and multidisciplinary approaches to cancer care. Dr. Pegna finds it rewarding to help patients understand their disease, providing treatment options based on each individual patient and supporting them through their treatment journeys.For more information, visit LACNETS.org/podcast/41. For more information, visit LACNETS.org.

Austin Perlmutter, M.D., is a board-certified internal medicine physician and New York Times bestselling author. He is an expert in brain health, neuroinflammation, immunometabolism, and neuroplasticity. He received his medical degree from the University of Miami and completed his internal medicine residency at Oregon Health and Science University in Portland, Oregon. His focus is in helping others to improve decision-making and quality of life. He is also interested in methods of understanding and reducing burnout in the medical field. He is the co-author of Brain Wash. He is the host of the podcast Get The STUCK Out, where he examines things that keep us stuck through open minded questions and conversations. In our conversation, Dr. Perlmutter and I examine various reasons that a person's decision making can be biased by their biology in unhealthy ways, and what can be done about it. Practitioners who are facing clients who are noncompliant will benefit from listening to his explanation of the mechanisms of the connection between brain and systemic inflammation and the pathways that are involved in the blood-brain barrier, systemic immunity and the brain. We also explore common triggers and solutions of neuroinflammation, especially sleep deprivation, the effects of polyphenols in the context of immunometabolism, and the effects of smoke and air pollution, sedentary behavior, alcohol and sugar consumption on brain health. Dr. Perlmutter's insights clearly highlight his passion for educating people about the reasons that lifestyle medicine not only matters, but is critical to brain health and longevity. I'm your host, Evelyne Lambrecht, thank you for designing a well world with us.   Episode Resources: Dr. Austin Perlmutter - https://www.austinperlmutter.com/ Design for Health Resources: Designs for Health - https://www.designsforhealth.com/ Designs for Health Practitioner Exclusive Drug Nutrient Depletion and Interaction Checker - https://www.designsforhealth.com/drug-nutrient-interaction/ Visit the Designs for Health Research and Education Library which houses medical journals, protocols, webinars, and our blog. https://www.designsforhealth.com/research-and-education/education The Designs for Health Podcast is produced in partnership with Podfly Productions Chapters: 00:00 Intro. 01:50 Dr. Perlmutter is passionate about the substantial preventions and improvements breakthroughs in preventive health. 4:34 Austin's father Dr. David Perlmutter's career influenced, but didn't entirely dictate his writing and medical career path. 10:01 Is decision making based on psychology or biology? Dr. Perlmutter explains. 14:30 Sleep is the number one action that can positively or negatively impact brain function. 17:40 The mechanisms of the connection between brain and systemic inflammation. 23:02 Pathways that are involved in the blood-brain barrier, systemic immunity and the brain. 29:51 Common triggers and solutions of neuroinflammation, especially sleep deprivation. 36:06 Dedicated stress relief practices including meditation, movement, decreased screen time seeking professional health, and dietary changes. 42:20 The benefits of utilizing a continuous glucose monitor. 43:20 The effects of polyphenols in the context of immunometabolism. 51:30 Overt signals that alcohol consumption is creating a risk for brain health. 54:24 Sedentary behavior dramatically increases the risk for brain issues, these tactics will counter its effects. 58:10 Smoke and air pollutants as a driver of microglial activation and needed action steps. 1:10:45 Tactics for improving air quality in the home. 1:12:40 Top personal supplements, top health practices, and the muscle health priority that Dr. Perlmutter has changed his mind about.

Dr. Davin Ashraf is an Assistant Professor of Ophthalmology at the Casey Eye Institute (Oregon Health and Science University) in the division of Oculofacial Plastic Surgery. He acts as host in this episode of the Oculofacial Podcast. Dr. Robert Kersten is a Professor and ASOPRS Fellowship Program Director at the Moran Eye Center (University of Utah) within the division of Oculoplastic and Facial Plastic Surgery. Dr. Shravani Mikkilineni is an oculofacial surgeon in private practice at Consultants in Ophthalmic and Facial Plastic Surgery in the metro Detroit area. Dr. Emily Li is an Assistant Professor at the Wilmer Eye Institute (Johns Hopkins University). Episode Summary: Dive into the November-December 2024 issue of Oculofacial Plastic and Reconstructive Surgery (OPRS) as Dr. Davin Ashraf leads engaging discussions with expert colleagues Dr. Robert Kersten, Dr. Shravani Mikkilineni, and Dr. Emily Li. The episode covers cutting-edge topics and insightful research findings in oculoplastic surgery, providing listeners with an in-depth understanding of the latest surgical techniques and postoperative outcomes in the specialty. Dr. Robert Kersten initiates the podcast with an exploration of the phenylephrine test's influence on the outcomes of external levator advancement surgery. Key discussions revolve around the phenylephrine's role in selecting the appropriate approach to ptosis surgery and its implication for eyelid compliance. Following this, Dr. Shravani Mikkilineni highlights significant corneal astigmatism changes post-levator surgery, sparking considerations for toric intraocular lens surgery timing. Dr. Emily Li concludes the episode by presenting an innovative surgical technique to address punctal stenosis, prompting dialogue on traditional methods' efficacy. Together, these discussions offer a comprehensive look into evolving methodologies and patient management strategies in oculoplastic surgery. Key Takeaways: Phenylephrine Test Utilization: Dr. Kersten discusses how phenylephrine positive patients had better outcomes in external levator resection and challenges common practices involving phenylephrine tests. Corneal Astigmatism Considerations: Changes in corneal astigmatism post-levator surgery could impact future toric IOL procedures, emphasizing the need for careful preoperative evaluation. Novel Approach to Punctoplasty: The podcast explores traditional versus novel techniques in handling punctal stenosis, weighing practicality against surgical outcomes. Resources: Casey Eye Institute, Oregon Health and Science University Moran Eye Center, University of Utah Wilmer Eye Institute, Johns Hopkins University Consultants in Ophthalmic and Facial Plastic Surgery Explore this enlightening episode to gain valuable insights and stay informed about critical topics in the field of oculoplastic surgery. Be sure to tune in for future episodes filled with expert discussions and cutting-edge discoveries in ophthalmology.  

Animals such as grizzly bears and Arctic ground squirrels have evolved the ability to hibernate as a way to survive winter months of extreme cold. During hibernation, their core body temperatures drop and their heart rates and metabolic activities slow to conserve energy. They also consume less oxygen during this inactivity.    But what if you could make non-hibernating species – including humans - hibernate? How could you control hibernation as a therapy to help people recover from strokes or heart attacks, or administer it to astronauts to help them endure a yearslong trip to Mars? Scientists at Oregon Health & Science University have embarked on a first step to exploring these questions by inducing a state of hibernation in rats, which don’t normally hibernate. Joining us to discuss this research is Domenico Tupone, a research assistant professor of neurology at OHSU.

In this episode of All-Access Pass, we explore the intersection of health equity and patient access with Dr. Ryzell McKinney and Joel Hudnall from Vanderbilt University Medical Center, alongside Stephanie Schmidt from Oregon Health & Science University. The discussion centers on the role of preferred-language appointment reminders in improving care access for patients with limited English proficiency. Despite high hopes, research revealed that these reminders did not significantly increase attendance rates, highlighting the complexity of addressing access disparities.   The guests share insights into broader social determinants of health, such as income, education, and language, and discuss innovative strategies like clinician recruitment from marginalized communities and addressing dismissals from care. Together, they underscore that achieving equity in patient access is a multifaceted challenge requiring systemic solutions rather than isolated interventions. This episode serves as a thought-provoking exploration of the ongoing journey toward equitable access to care for all.   Focus: The complexities of health equity in patient access, highlighting research on preferred-language appointment reminders and the need for multifaceted strategies to address disparities.   Podcast Guests   Stephanie Schmidt, MS Senior Director, Ambulatory Care and Access Services Oregon Health & Science University   Joel Hudnall Epic Configuration Analyst Change Management, Strategic Access Support Vanderbilt University Medical Center   Ryzell McKinney, EdD Director, Access Technology Vanderbilt University Medical Center

Native American oncologist Dr. Amanda Bruegl and Dr. Noelle LoConte discuss culturally tailored interventions and the importance of community engagement to advance cancer prevention, diagnosis, and treatment for Native communities. TRANSCRIPT   ASCO Daily News: Hello and welcome to the ASCO Daily News Podcast. I'm Geraldine Carroll, a reporter for the ASCO Daily News. On today's episode, we'll be discussing cancer care for Native American communities who face unique challenges and disparities in accessing and receiving cancer care. I'm delighted to be joined by two oncologists who will be sharing their insights on ways to advance cancer prevention, diagnosis, and treatment through culturally tailored interventions and community-based programs for high-risk Native Americans whose issues are chronically overlooked in the healthcare system, according to experts. Dr. Amanda Bruegl is an associate professor of obstetrics and gynecology at the Oregon Health and Science University School of Medicine. She is a gynecologic oncologist at the OHSU Knight Cancer Institute and a citizen of the Oneida Nation and descendant of Stockbridge-Munsee. Dr. Noelle LoConte is an associate professor of medicine at the University of Wisconsin Madison Carbone Cancer Center where she also serves as a GI medical oncologist, geriatrician and leads community outreach.  Full disclosures are available in the transcript of this episode.  Dr. LoConte and Dr. Bruegl, it's great to have you on the podcast today. Dr. Noelle LoConte: Thanks so much for having me. Dr. Amanda Bruegl: Thank you for having us. ASCO Daily News: Dr. Bruegl, I'd like to start by asking you to tell us a bit about your background and how it has influenced your career and interests as a gynecologic oncologist. Dr. Amanda Bruegl: I grew up in Wisconsin and I have a Native parent and a non-Native parent. And so having an awareness of both cultural influences in my life has really shaped my interest in cancer prevention. Seeing the high rates of preventable death in cancer among Native populations in gynecologic cancers, in particular, has really driven me to dedicate my research career toward decreasing the morbidity and mortality of cervical cancer among Native women. ASCO Daily News: Well, can you tell us about your work in cancer prevention, specifically cervical cancer? The data shows that Native Americans in Oregon get cervical cancer one and a half times more than the general state population and die from it two times more often. What are the factors, the barriers, that are contributing to these high rates of cervical cancer? Dr. Amanda Bruegl: The data in Oregon is actually not just limited to Oregon.  Our group did some work in collaboration with the Northwest Portland Area Indian Health Board Tribal Epidemiology Center, and we found that, as you stated, the rates of cervical cancer are one and a half times that of non-Hispanic Whites and the rate of death is about twice. And that's true for the Pacific Northwest. And if you dig deeper into the literature, you see that these rates are true across Indian Country, sometimes worse. When we looked at the age groups, we found that older women had three times the rate of mortality. So looking at like 45 to 65. As I was looking through the literature to figure out, well, why is this, we found that there are very, very few funded studies that even look at this. We have a known persistent disparity that is chronically understudied and underfunded. And so I'm trying to do work in this arena to explore this further.  A follow up study that we did was looking at whether we are using the prevention tools. So it's common across the United States that we have two very powerful prevention tools. So participation in cervical cancer screening doesn't necessarily prevent cervical cancer, but you can have early detection of pre-invasive disease or detection of early-stage disease, which is highly curable. And then we also have HPV vaccination, something geared towards the youth in our communities across the U.S. HPV vaccination starting at age 9 with a goal of complete vaccination by the age of 12. So we looked at: Are we using these two tools in Indian Country? And what we found was that participation in cervical cancer screening, looking at who is up-to- date among Natives, and we found that overall the population had about 60% rates of up-to- date on cervical cancer screening compared to general US rates, which are in like the high 70s or low 80s. And then when we looked at that age group that has higher rates of mortality, we actually found that there's only about a 50% rate of up-to-date screening. So we know in one arena people aren't participating in screening. And there's a variety of different contributors to that. There's access to care. How far do you have to travel to get to a provider who will provide cervical cancer screening? Among Native women, there's an over 50% rate of history of sexual trauma, sexual violence, pelvic exam trauma. It's a huge barrier to coming in for this very sensitive exam. There is also mistrust with the medical system in general. There's high turnover of providers at Indian Health Service Clinics.  The clinic that I'm currently working at now, so I do outreach at a clinic one day a month and I'm the longest standing doc at that clinic and I'm a consultant who comes one day a month. I've been there since 2016. And so when you can't develop a relationship with a provider and develop trust and there's just this churn of new people every three to six months, developing a relationship to allow someone to feel comfortable with a very personal and private examination can be a huge barrier. On the HPV vaccination side, we found that the numbers for HPV vaccination were pretty optimistic. So the numbers have been going up since our study period started in 2015. The clinics in the Pacific Northwest that are serving Native populations are doing a great job with education, outreach and increasing the numbers. The group with the greatest rates of HPV vaccination are for people assigned female at birth in the 13-18 age group. They are the only group that is approaching the Healthy People 2030 goal. But there's still work to be done in this arena. Those are some big drivers of why this persistent disparity continues. ASCO Daily News: Absolutely. You mentioned some very serious barriers. Sexual trauma, mistrust, long distance to travel to clinics. Looking ahead, can you tell us about potential screening tools that could improve screening? And I also wanted to ask you about innovations you're excited about that could be potentially incorporated into practice to increase the ability and comfort of your patients to screening and access to HPV vaccination. Dr. Amanda Bruegl: So, in terms of cervical cancer screening and how to increase the rates, there are a number of different things in the literature broadly across populations that really show that knowledge and awareness of cervical cancer and cervical cancer screening guidelines is associated with guideline concordant care. And so ensuring that our patients in our communities know and understand what the recommendations are is very important. Efforts to provide education to women in the community, community stakeholders, and culturally tailored content can all be important for increasing the rates of cervical cancer participation.  Another thing that has the potential to really help improve screening rates is HPV self-collection. The FDA just recently approved HPV self-collection which can help empower an individual to do their own testing on their own body and not have someone else place a speculum in a private personal area where they're not comfortable. Some of the tribes in our region are starting to adopt this practice. And I just gave a talk to the regional Indian Health Service medical directors and have had really positive feedback about clinics working towards bringing this into their practice. I hope that the FDA can move forward with allowing patients to do this in the comfort of their own home. Sadly, the FDA in their evaluations decided it had to be a clinic administered test. So someone still has to go through the barrier of finding time to, if they have caregiver responsibilities or work, to have these responsibilities taken care of for someone else so they can drive to a clinic. So these barriers of transportation and caregiving are not addressed by this. It addresses some of the trauma, that barrier. And so I think in the US, we can do better about bringing this like FIT testing to our patients. I really hope and challenge our country to move forward with that a bit more. Geraldine Carroll: Thanks, Dr. Bruegl. I'll come back to you in a moment, but first I'd like to switch gears and address some of the challenges faced by Native communities in Wisconsin that were featured in a fascinating study presented by our guest, Dr. Noelle LoConte, at the recent ASCO Quality Care Symposium. The study found that radon levels in Native lands in Wisconsin were much higher than anticipated and may explain higher rates of lung cancer among Native communities in the state. Radon is the second leading cause of lung cancer in the U.S. So, Dr. LoConte, can you tell us more about this study and your incredible partnership with the Stockbridge-Munsee Band of the Mohican Nation Health Center in this work? Dr. Noelle LoConte: You bet. Thanks for the interest. First of all, I think it's just an incredible privilege to work with all of these communities. So, I wanted to say at the jump that this was a joint project led by the cancer center that I'm affiliated with, but also with the Stockbridge-Munsee community. They approved the project and they designed it with us, and they retain ownership of the data. Data sovereignty is an important issue when you're doing this work. But we came to them wanting to work on something around cancer. I actually thought maybe colorectal cancer screening. But in meeting with the health center and the tribal community members, it became clear that they were more concerned that they had intergenerational rates of cancer, and they felt that they were being poisoned by their land. And that brought me to the state Environmental Health Program. And we looked at some data and realized, one, their lung cancer rates were quite high, but two, their radon testing rates were quite low. And that that was a place where we thought we couldn't make some forward momentum.  So, we designed a program to educate around radon and radon testing and mitigation and then tested all the homes on the reservation. And we successfully tested all homes for radon and then successfully mitigated all the homes that tested over four picocuries per liter, which is the recommended level at which you should mitigate per the EPA, the Environmental Protection Agency. The statewide average for Wisconsin is 10% positive. And amongst homes that had a basement, which is thought to be the highest risk kind of dwelling in the Stockbridge-Munsee Reservation community, the positive rate was 77%. And when you take all the homes together because we had some homes with crawl spaces or slab foundation, it was around, I believe, 55% positive, so much higher than 10%. ASCO Daily News: Well, that data is just striking. Your study certainly illustrates the vital role that cancer centers can play in mitigating structural determinants of health among Native communities, such as with housing quality. Do you think this will inspire a similar approach in other regions of the country?  Dr. Noelle LoConte: Yeah, I think this work was possible because of philanthropy. It is very, very hard to get grant funding for mitigation, in particular. Mitigation is usually done once in the life of the dwelling, but it is very, very expensive. A cheap mitigation is $750, and many are many thousands of dollars especially when you're looking at very rural communities where there's not really a mitigator within hundreds of miles and you have to really negotiate to get somebody to come out there. Every cancer center that's designated by the National Cancer Institute has to have a community outreach and engagement unit or program. I would argue that rather than us generating reports describing disparities, that this kind of work to actually dismantle these determinants of health and move power back into the community is an ideal role for a cancer center. But the funding was definitely a tricky piece of it. And I would hope that we could either envision funding mechanisms that allow for this kind of direct service to communities, or we can continue to work with philanthropic agencies to fund this. ASCO Daily News: Well, looking through a wider lens at the experience of Native communities navigating cancer care, I'd like to ask each of you to comment on how you think the oncology community can better support and serve high-risk Native populations. What message would you like oncologists to take away from this discussion today? Dr. Bruegl, would you like to respond first? Dr. Amanda Bruegl: There's so many layers to needs in our communities. First and foremost, it's important to understand that American Indians and Alaska Natives are sovereign people, sovereign nations. We've been written into the US Constitution as citizens of our own tribes. And it's important to remember that when working with our populations. I think it's also really important to remember that there's treaty law that promised healthcare to our communities. And you see that we are underfunded in all aspects of healthcare, and it's a driver. And people on the healthcare side of things need to remember we represent the failures of the healthcare system to care for our Native communities. Whether or not you wake up in the morning with a goal to help, you have to remember that you represent the institution and the history of this country and are going to be asked to prove yourself in a genuine fashion. And that takes time.  I think for people who are in research, it's really important to think about how do you engage and partner with tribal communities so that we're not chronically left behind and left out of study? We seldom show up in the data, and we have to find our own data. Tribal epidemiology centers have been really paramount in helping tribes get access to their data and analyze their data. But you can see in trial after trial after trial, we're sort of shoved into the other box. And so it's so difficult to understand how the cancer story relates to us and how do we improve it? ASCO Daily News: Thank you, Dr. Bruegl. Dr. LoConte, would you like to comment on this as well? Dr. Noelle LoConte: Yeah. I had jotted down a few points. Many are going to be a little bit of a repetition here, but I think the overarching theme is that the goals for academic medicine often are not the goals of the community that you may be seeking to work in, and so being able to pivot was key to the success of my project, I think.  Can't underestimate the importance of trust. And trust takes a lot of time and a lot of showing up and a lot of being consistent and delivering on what you say you're going to do. And there's a lot of turnover in academic medicine. People leave institutions, move on for promotions. None of that is going to help strengthen these relationships. So I think institutions would be wise to invest in people that stay. I think there should be things like retention bonuses for those of us that stay in places and do community work. It's certainly not the sexy stuff. It's not what gets you in the Plenary at the ASCO Annual Meeting, for example, but I was beyond delighted that I was on the podium for the ASCO Quality Care Symposium. And I think continuing to elevate this work as meaningful and important work, just as important as clinical trials and new drugs, is really important.  I would like to second the motion or the thought that we need to support full funding for the Indian Health Services. It is a promise we made that we continue to underdeliver on that continues to harm patients every day, particularly in the latter half of the year when they run out of funding pretty consistently. For those of us that are non-Native doing this work, to know the history of the community that you're working in and be really mindful of that but also know the role that your institution played in propagating some of these harms. And I think we need more Native physicians that really will help to have concordance with patients and physicians. And so as much as we can support getting more Native folks starting really early – high school, middle school, interested in medicine and biomedical research, all the way through medical school residency fellowship would be really, really impactful. We have a program here founded by Amanda's husband called the Native American Center for Health Professions, or NACHP. It's really a feather in our cap here and I would love to see all medical schools have some sort of pathway program like that. We won't get out of this hole until we start to really take that seriously. ASCO Daily News: Well, thank you so much, Dr. LoConte and Dr. Bruegl for taking the time and showing up for Native communities, and all your work to advance cancer care. We are certainly very grateful for your time today and we will embed links to all of the studies discussed in the transcript of this episode. So thank you again, Dr. LoConte and Dr. Bruegl. Dr. Noelle LoConte: You're welcome. Dr. Amanda Bruegl: Thank you for having us. ASCO Daily News: And thank you to our listeners for your time today. Again, you'll find links to the studies we discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcasts. 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. Follow today's speakers:  Dr. Amanda Bruegl   Dr. Noelle LoConte @noelleloconte.bsky.social   Follow ASCO on social media:   @ASCO on Twitter   ASCO on Facebook   ASCO on LinkedIn   Disclosures:   Dr. Amanda Bruegl – No relationships to disclose Dr. Noelle LoConte: Consulting or Advisory Role: Abbvie, PDGx Research Funding: Exact Sciences  

According to the CDC, more than 2 million people in the U.S. are infected with hepatitis C. The bloodborne illness attacks the liver and can lead to cancer or death if left untreated. Injection drug use is the leading risk factor for hepatitis C, which is also more prevalent in rural counties where diagnosis and treatment can be hard to come by, especially for people experiencing homelessness.  Scientists at Oregon Health and Science University demonstrated a new strategy that could significantly boost the diagnosis and successful treatment of hepatitis C in rural communities. In a recently published study, they showed that peers with lived experience in drug use were able to successfully enroll and facilitate treatment for people who tested positive for hepatitis C in six rural Oregon counties using telemedicine, which was seven times more effective than referrals to clinics for in-person treatment. Joining us to talk about the results and the role peer specialists can play to combat the spread of hepatitis C is Dr. Andrew Seaman, an associate professor of medicine at OHSU, the medical director of HIV and hepatitis C services at Central City Concern and head of substance use disorder programs at Better Life Partners in New England.  

Vascular cognitive impairment is a common and often underrecognized contributor to cognitive impairment in older individuals, with heterogeneous etiologies requiring individualized treatment strategies.  In this episode, Katie Grouse, MD, FAAN speaks with Lisa C. Silbert, MD, MCR, FAAN, an author of the article “Vascular Cognitive Impairment,” in the Continuum December 2024 Dementia issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Silbert is is co-director at Oregon Alzheimer's Disease Research Center, a Gibbs Family Endowed professor of neurology, a professor of neurology at Oregon Health & Science University, a staff neurologist, director of Cognitive Care Clinic, and director of the Geriatric Neurology Fellowship Program at Portland Veterans Affairs Health Care System in Portland, Oregon. Additional Resources Read the article: Vascular Cognitive Impairment Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Full transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, which features conversations with Continuum's guest editors and authors who are the leading experts in their fields. Subscribers to the Continuum Journal can read the full article or listen to verbatim recordings of the article and have access to exclusive interviews not featured on the podcast. Please visit the link in the episode notes for more information on the article, subscribing to the journal, and how to get CME. Dr Grouse: This is Dr Katie Grouse. Today I'm interviewing Dr Lisa Silbert about her article on vascular cognitive impairment, which is part of the December 2024 Continuum issue on dementia. Welcome to the podcast and please introduce yourself to our audience.  Dr Silbert: Hi Katie. Thanks for having me here today. Like you mentioned, my name is Lisa Silbert. I am a behavioral neurologist at Oregon Health and Science University and my research focus is in the area of vascular contributions to cognitive impairment and dementia. Dr Grouse: It's such a pleasure to have you and I really enjoyed reading your article. Just incredibly relevant, I think, to most practicing general neurologists, and really to any subspecialty. I'd like to start by asking, what do you think is the main takeaway point of your article for our listeners?  Dr Silbert: Yeah. I think, you know, the field of vascular cognitive impairment has changed and evolved over the last several decades. And I would say the main take-home message is that vascular cognitive impairment or vascular dementia is no longer a diagnosis that is only considered in someone who's had acute decline following a clinical stroke. That we have to expand our awareness of vascular contributions to cognitive impairment and consider other forms of the disease that can cause a more subacute or slowly progressive form of cognitive impairment. And there are many, many forms of vascular cognitive impairment that present in a more slowly progressive manner. The other thing I would say as a major take-home message is that we know that cerebrovascular disease is a very common copathology with other forms of dementia and that it lowers one 's threshold for manifesting cognitive impairment in the context of multiple pathologies. And so, in this way, vascular cognitive impairment should be considered as a contributing and potentially modifiable factor in any dementia.  Dr Grouse: I found that last point just really, really fascinating. And also, you know, the reminder that a combination of pathologies are more common than any one. To your initial point, I'm actually curious, could you kind of outline for us how you approach diagnosing vascular cognitive impairment?  Dr Silbert: Yeah. So with everything in neurology, a lot of it comes down to the initial history taking. And so part of the work up always includes a very detailed history of the presentation of cognitive impairment. Any time there is an acute change in cognition, vascular contribution should be considered, particularly if it's in the context of a clinical stroke or some kind of event that might have lowered cerebral blood flow to the brain. And then having said that, I already mentioned there are many forms of vascular cognitive impairment that can mimic neurodegenerative disease in terms of its course. So being more slowly progressive. And so because of that neuroimaging, and in particular MRI, has become an extremely valuable tool in the workup of anyone who presents with cognitive impairment in order to evaluate contributions from cerebral vascular disease. And so, MRI is a really helpful tool when it comes to teasing out what may be contributing to a patient's clinical syndrome, as well as their other comorbid medical issues, including stroke risk factors and other kind of medical conditions that might contribute to reduce cerebral blood flow. Dr Grouse: I'd love to talk a little bit more about that. You know, as is often the case with neurologic disease associated with vascular pathology, the importance of prevention, you know, focusing on prevention of vascular diseases is so important. What are some things that we can make sure to focus on with our patients and, you know, particularly anything new to be aware of in counseling them? Dr Silbert: Yeah, I'm really glad you asked me that question because like I mentioned, you know, cerebral vascular disease is so common, it lowers one's threshold for cognitive impairment in the face of other age-related brain pathologies. And so, it's really important for all of us to focus on preserving our cognitive health, even starting in midlife. And so, there are a number of areas that I counsel my patients on when it comes to preserving cerebral health and maximizing cerebrovascular health. And so, these stem from the American Heart Association's Life's Essential 8 because we know that preserving cardiovascular health is likely going to also preserve cerebral vascular health. And so, some of the things that I'm very commonly discussing with my patients are controlling stroke risk factors such as blood pressure, blood sugars and cholesterol, maintaining a healthy weight, and then also working towards a lifestyle that includes a healthy diet, no smoking, regular exercise. And then new within the last couple years is also the recommendation that people get adequate sleep, which is something that hasn't been focused on previously. Dr Grouse: I was really interested in reading your article to learn about enlarged perivascular spaces and the role as a mediating factor in the interaction between through a vascular dysfunction and development and progression of neurodegenerative pathology. Can you elaborate on this further? Dr Silbert: So, this is an area that's still largely unknown in the field, and it's an area where there's a lot of emerging work being done. The short answer is, we really don't know with great certainty how it directly connects with accumulating Alzheimer's pathology. But there is some evidence to suggest that the perivascular space is involved in the clearance of toxic solutes from the brain, including Alzheimer's disease pathology. And so there's a lot of work looking at how potentially cerebrovascular risk factors might affect the clearance of those toxic solutes through the perivascular space, including pulse pressure changes that might occur with accumulating cerebrovascular disease and other potential contributors. But one thing I can say with more certainty is that the, you know, location of perivascular spaces is thought to help distinguish those who might have cognitive symptoms due to cerebrovascular disease versus due to cerebral amyloid angiopathy. Or I guess I should say location is helpful in terms of recognizing vascular contributions to cognitive impairment that's due to arteriolosclerosis versus that due to cerebral amyloid angiopathy. In so much that… when we see a lot of perivascular spaces in the basal ganglia in the subcortical structures, that is thought to be more associated with arteriolosclerosis and hypertension type related vascular cognitive impairment. Whereas when we see multiple perivascular spaces within the centrum semiovale, that tends to be more associated with cerebral amyloid angiopathy. Dr Grouse: That's so interesting. And on the topic ofcerebral amyloid angiopathy, you did go into this a good deal. And you know, I think I encourage everybody to revisit the article to remind themselves about, you know, the findings that can increase the suspicion of tribal amyloid angiopathy. However, you also talked about transient focal neurologic episodes, which I think is just a great reminder that, you know, these can occur in this setting and definitely not to miss. Tell us more about what to look for with these types of episodes.  Dr Silbert: Transit focal neurologic episodes can be very difficult to tease apart from a transient ischemic attack. And these transient focal neurologic episodes due to CAA can present in a number of different ways. And I think the important take home message for that is that in people who have neuroimaging evidence of CAA to inform them that they are at increased risk for having these focal neurologic episodes and that if they do present to a hospital or an emergency department with any kind of neurologic event, that those treating them are aware that they have evidence of CAA on their neuroimaging because the treatment of course is quite different. So, it's someone presenting with ATIA who has transient neurologic symptoms might be considered urgently to get a thrombolytic or, you know, TPA, whereas someone who has known cerebral amyloid angiopathy or suspected CAA, they likely already have microbleeds on their neuroimaging and in those cases thrombolytics and TPA would be contraindicated and not helpful in terms of the etiology of their neurologic symptoms. Dr Grouse: That's a really good point to make. And I think also in your article you mentioned the use of aspirin if you're suspecting ATIA versus a, you know, a transient amyloid related focal neurologic episode. You know, one you would treat with aspirin and the other one you wouldn't.  Dr Silbert: That's right.  Dr Grouse: Another sort of interesting topic you delved into was cerebral microinfarct and how this can also contribute to vascular impairment. Could you elaborate a little more on that? Dr Silbert: Yeah. So cerebral microinfarcts are kind of the hidden cause of or a hidden cause of vascular cognitive impairment. And it's extremely challenging because by definition they are not visible on routine clinical neuroimaging. It's something that we are more aware of based on pathological studies and neuroimaging studies that have been done at ultra-high field strength like 7T MRI. And so, we are just learning more about how prevalent they are in certain conditions and how we can only look at these after death when we're looking at brain tissue and then go back and realize that these play a significant role in cognitive decline when someone is alive. It's important to understand that we're probably only appreciating kind of the tip of the iceberg when we're evaluating a patient and looking at their neuroimaging. That what we're actually seeing on MRI are only the things that are actually quite relatively big and obvious. And that a lot of these neuroimaging features of vascular cognitive impairment are actually associated with pathologic features that we're missing such as microinfarcts. But the hope is that by treating all individuals, particularly those who already have signs of vascular cognitive impairment, by modulating their stroke risk factors and focusing on maintaining brain health, that those will, interventions will also reduce the incidence of microinfarcts. Dr Grouse: What do you think is the greatest inequity or disparity you see in treating patients with vascular cognitive impairment? Dr Silbert: I think the greatest disparity is- really starts way before I treat a patient. That relates to really focusing on healthy lifestyle factors early in life and being able to, you know, afford fruits and vegetables, and having the advantages of being able to exercise regularly, and just being aware that all of these things are extremely important before older age. So, these are things that, you know, I think more education and awareness and greater access to healthcare will definitely improve access to. Even preventative healthcare is a disparity and not available across all of the population and geographic locations. So, I think of the- all the dementias, vascular cognitive impairment probably has the greatest association with health and social disparities in terms of primary prevention and access to care.  Dr Grouse: All really important things to consider. I have to say when, you know, reading your article, dare I say I came away with a little bit of hope thinking, you know, even with, you know, how little we still, you know, or how much we still need to do to really learn how to fight Alzheimer's and, you know, prevent it and, and, you know, help with its progression. The idea that in so many cases, even just doing what we can to prevent the vascular or cognitive impairment can really help any type of dementia. That was really a strong message for me. Do you mind elaborating on that a little more?  Dr Silbert: No, not at all. I agree. I really am hopeful about the prevention and treatment of dementias and through the treatment and prevention of cerebrovascular disease. I think that is a true reality, just like, you know, as we were discussing before, the treatment and prevention of cerebrovascular disease really should be a part of the treatment of any type of cognitive impairment and recommendations for prevention of cognitive impairment. This is the, you know, one thing we know is largely modifiable and preventable in most cases. I think the, really the key thing is just education and making sure that people understand that these are things that really need to be, they need to be engaged in in midlife and that it's much harder to reverse these- the damages once you have them in later life. Having said that, I do think that there's greater awareness of maintaining healthy lifestyle and maintaining awareness of stroke risk factors. And I think we're already starting to see a reduction in dementia worldwide in several large population-based studies, and probably that is due to more attention to the modifying stroke risk factors. So, I agree with you, it's very encouraging.  Dr Grouse: Is there anything exciting on the horizon that you can tell us about that we should all be keeping our eyes out for? Dr Silbert: Yeah. So, you know, I'm really interested in this connection between vascular cognitive impairment and Alzheimer's disease. And it's a real area of exciting new research. And so I think we're going to have more answers as to how, whether and how, cerebrovascular disease is directly linked to accumulating neurodegenerative disease or neurodegenerative pathologies. The other area that's, I think, really exciting, that's moving forward, is the in the area of blood-based biomarkers for vascular cognitive impairment. As these emerge, we'll be able to really identify those at greatest risk for vascular cognitive impairment, but also identify novel mechanisms that lead to VCI that can be targeted for therapeutic intervention. Dr Grouse: Well, I'm really excited to see what's coming down the pipeline and what more we'll learn in this area. So, thank you so much for everything you've done to contribute to this field. Dr Silbert: Yeah.  Dr Grouse: I wanted to ask a little bit more about you. What drew you to this work?  Dr Silbert: Well, actually, so my very first published manuscript in medical school was a case report and review on MELAS, which is mitochondrial encephalopathy with lactic acidosis and strokelike syndrome. And so, I was really fortunate to have Dr Jose Biller, who is a renowned expert in stroke and cerebrovascular disorders, as my mentor for that paper. And so, that got me really interested in neuroimaging findings of cerebral vascular disease. And so when I was a fellow at Oregon Health and Science University, I was then really fortunate to  be able to work with Jeffrey Kaye's oldest old population. And in working with that population, I really became interested in their neuroimaging findings of these white matter lesions and just realizing how prevalent they were in that population, you know, it just led me to start investigating their clinical significance and etiology, which kind of led me along this path. Dr Grouse: You know, Lisa, thank you so much. I really learned a lot from your article, and I think our listeners will definitely find that it was very helpful for their practice. Thank you so much for joining us. Dr Silbert: Thank you so much, Katie. It's been really fun.  Dr Grouse: Again, today I've been interviewing Dr Lisa Silbert, whose article on vascular cognitive impairment appears in the most recent issue of Continuum on dementia. Be sure to check out Continuum audio episodes from this and other issues. And thank you to our listeners for joining today. Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/AudioCME. Thank you for listening to Continuum Audio.

Send us a textIn this episode, Ben and Daphna sit down with Dr. Cindy McEvoy, professor of pediatrics and director of neonatal research at Oregon Health & Science University, to discuss optimizing lung development in preterm infants. Dr. McEvoy shares insights from her research on the benefits of prolonged CPAP use in preterm infants, showing how it supports lung growth, improves alveolar volume, and enhances pulmonary function. She emphasizes the importance of education and proper CPAP application to maximize benefits while debunking myths about weaning protocols. This conversation highlights the potential of targeted respiratory strategies to improve long-term outcomes.As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Welcome to the first episode in a special three-part series of the Diabetes Core Update podcast, focused on heart screening in people with diabetes. Sponsored by Roche, this series explores "heart failure with preserved ejection fraction" (HFpEF), providing primary care clinicians and healthcare professionals with essential insights into screening, diagnosis, and management of this increasingly recognized condition. Episode Summary In this episode, host Dr. Neil Skolnik introduces the growing importance of HFpEF in diabetes care and is joined by two esteemed experts: Rodica Busui, MD, PhD, professor and chief of the division of endocrinology at the Oregon Health and Science University and past president of the American Diabetes Association for Medicine and Science. James Jannuzzi, MD, professor of medicine at Harvard Medical School, staff cardiologist at Massachusetts General Hospital, and senior cardiometabolic faculty at Baim Institute for Clinical Research. The discussion explores: HFpEF Basics: Definition, prevalence, and how it differs from heart failure with reduced ejection fraction (HFrEF). Pathophysiology: The multifactorial causes of HFpEF, including aging, obesity, diabetes, and more. Diabetes and HFpEF: Why HFpEF should be considered a major complication of diabetes alongside atherosclerotic and microvascular diseases. Screening Recommendations: Insights from the 2022 ADA/ACC Consensus Report, emphasizing early detection through biomarkers like NT-proBNP and annual testing for at-risk patients. Key Takeaways Epidemiology: HFpEF affects at least half of heart failure patients and is increasingly prevalent due to aging, obesity, and diabetes. Screening Guidelines: Every person with diabetes, especially those with chronic kidney disease, hypertension, or obesity, should be considered for HFpEF screening. Biomarkers: NT-proBNP thresholds are key tools for early diagnosis, with tailored considerations for obesity and other conditions. Prevention and Collaboration: Effective risk factor management and team-based care can prevent HFpEF progression and improve outcomes. Thank you for joining us on this first of a multipart series on early detection and treatment of heart failure with preserved ejection fraction. In the first part of this series, we focused on basics—epidemiology, pathophysiology, and staging—as well as the critically important new recommendations around screening people with diabetes for heart failure. In the second part of the series, we'll explore treatment strategies for HFpEF. This special edition of Diabetes Core Update is sponsored by Roche.

Have you ever wondered when it might be time to leave your job? Or how to keep repeating the same mistakes at work? Set yourself up for success? Make your voice heard? Create a healthy workplace for your team/employees? This episode is the virtual launch party for the "Millennials' Workbook for Navigating Workplace Politics" where we'll interview the co-authors, get a sneak peek into their framework and process, challenges for writing about these topics, and activities the audience can try right after listening. Have you just graduated from school and are entering the workforce for the first time? Are you a millennial who has a tough time gelling with older generations of coworkers? Are you interested in leveling-up at work, having your voice heard, or moving into a leadership position? In this episode, Dr. Brancu, the host of the Hard Skills talks with her co-authors of the Millennials Workbook for Navigating Workplace Politics about how the workbook can help put into practice the principles outlined in their original guide published in 2021 (Millennials Guide to Workplace Politics). The episode will also be their virtual launch party since the book comes out on this air date! We'll offer a sneak peek into talk what led to writing this workbook, how long it took, hiccups along the way, challenging decision points, and do a brief reading with several activities! Sarah A. Rose is a project manager and consultant with 15 years of experience working for nonprofit organizations aiming to improve quality of life through education and science. Upon entering the workforce, Sarah struggled to reconcile her multiple identities in corporate America. During her tenure at the American Psychological Association, she was offered numerous personal and professional opportunities, one of which is co-authoring this book. Sarah executes her work through a lens of diversity, equity, and inclusion. This stems from her multicultural and bilingual upbringing as a German-American in a military family. She graduated with bachelor's degrees in psychology and international studies. Sarah lives in Germany with her twin cats, Berlioz and Toulouse. Dr. Jennifer Wisdom is a licensed clinical psychologist and board-certified organizational psychologist. She is principal of Wisdom Consulting, a Senior Organization Development Psychologist with the Veterans Health Administration's National Center for Organization Development, and an Affiliated Professor at the Oregon Health and Science University. She has published and taught extensively on leadership and public health, including authoring the Millennials' Guides series. She has a PhD in Clinical Psychology and a Master's of Public Health in Biostatistics and Epidemiology.***IF YOU ENJOYED THIS EPISODE, CAN I ASK A FAVOR?We do not receive any funding or sponsorship for this podcast. If you learned something and feel others could also benefit, please leave a positive review. Every review helps amplify our work and visibility. This is especially helpful for small women-owned boot-strapped businesses. Simply go to the bottom of the Apple Podcast page to enter a review. Thank you!***LINKS MENTIONED IN EPISODE:Guest sites: https://www.linkedin.com/in/sarsonderhttps://www.linkedin.com/in/jenniferpeltwisdom/https://www.leadwithwisdom.com/booksBook series on Amazon: https://www.amazon.com/dp/B0CNRBP81H?binding=kindle_edition&searchxofy=true&ref_=dbs_s_aps_series_rwt_tkin&qid=1732221877&sr=8-1Our website: www.gotowerscope.com

Our latest podcast features Kevin Kwiecien, DMD, MS, who joins AGD Podcast host and vice president George Schmidt, DMD, FAGD, to address opportunities to create systems that build strong teams and enhance dental practice performance. Dr. Kwiecien has more than 25 years of private practice experience, most of which overlapped in academia. He shares tips he teaches on connecting clinical and practice management systems to ensure dental offices are performing optimally and creating growth opportunities. Dr. Kwiecien graduated from Oregon Health and Science University School of Dentistry and holds a master's degree in health care administration. He is the owner of K Squared Facilitation and the founder/coach at The CCO Solution. He was an assistant professor of restorative dentistry at the OHSU School of Dentistry and also had faculty roles at Spear Education and L. D. Pankey Institute, where he provided education to AGD constituents across the U.S. Listen now.

In this episode, Lyell K. Jones Jr, MD, FAAN, speaks with Lisa C. Silbert, MD, MCR, FAAN, who served as a guest editor of the Continuum® December 2024 Dementia issue. They provide a preview of the issue, which publishes on December 2, 2024. Dr. Jones is the editor-in-chief of Continuum: Lifelong Learning in Neurology® and is a professor of neurology at Mayo Clinic in Rochester, Minnesota. Dr. Silbert is co-director at Oregon Alzheimer's Disease Research Center, a Gibbs Family Endowed professor of neurology, a professor of neurology at Oregon Health & Science University, a staff neurologist, director of Cognitive Care Clinic, and director of the Geriatric Neurology Fellowship Program at Portland Veterans Affairs Health Care System in Portland, Oregon. Additional Resources Continuum website: ContinuumJournal.com Subscribe to Continuum: shop.lww.com/Continuum More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @LyellJ Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology, clinical review and CME journal from the American Academy of Neurology.  Thank you for joining us on Continuum Audio, a companion podcast to the journal.  Continuum Audio features conversations with the guest editors and authors of Continuum who are the leading experts in their fields. Subscribers to the Continuum Journal have access to exclusive audio content not featured on the podcast. If you're not already a subscriber, we encourage you to become one. For more information, please visit the link in the show notes.  Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum: Lifelong Learning in Neurology. Today I'm interviewing Dr Lisa Silbert, who recently served as Continuum's co-guest editor for our latest issue on dementia alongside Dr Lianna Apostolova. Dr Silbert is a professor in the Department of Neurology at Oregon Health and Science University of the School of Medicine in Portland, Oregon, where she's also the director of the Neuroimaging Core and now the co-director of the Alzheimer's Disease Research Center. She also serves as director of the dementia clinic at the VA Portland Healthcare System. Which, Dr Silbert, sounds like a lot of work? Anyway, welcome. I really appreciate you taking the time to join us today and co-guest editing this issue. Why don't you introduce yourself a little bit to our listeners?  Dr Silbert: Well, thank you so much for interviewing with me today and for inviting me to be the guest, co-guest editor of this issue. It's a really exciting time for dementia care and dementia research. As you already said, my name is Lisa Silbert. I'm in Oregon Health and Science University in Portland, Oregon. I've been involved in caring for dementia patients and their families for over twenty years now and been involved in a lot of really exciting research during that time. But I would say now is probably the most dynamic time in dementia research and care that I've seen. So, it's really, really exciting to be here.   Dr Jones: It really is an interesting time. So, I look back  in our last issue of Continuum focusing on dementia came out in 2022, which doesn't sound like that long ago, but a lot has changed, right? With the anti-amyloid monoclonals for Alzheimer's disease, new biomarkers and so on. And as the guest editor, you have this unique view, Dr Silbert, of the issue and the whole topic of dementia. As you were reading these really outstanding articles, what was the biggest “aha” moment for you or the biggest change in practice that you saw that's come up over the last couple of years?     Dr Silbert: I think, you know, in reading through the different manuscripts or chapters in this issue, it really struck home the advances that have been made throughout all the different areas of dementia. Not just- so, we hear a lot about Alzheimer's biomarkers and Alzheimer's treatments on the horizon, which is really exciting, but this is happening across other dementias as well. There's biomarkers on the horizon for a Lewy body disease and potentially for some of the frontaotemporal dementias. And so that to me really struck home as this is really, across the board, a change in the entire field that we're looking at.  Dr Jones: That is exciting. And I'd like to come back to some of those biomarker developments because I think that's an area where we've really been lacking in neurology as a specific way to diagnose those disorders. I think a topic which you just alluded to that a lot of our listeners and readers are thinking about are those antiamyloid monoclonal therapies for Alzheimer's disease. So, addicanumab, lecanumab and most recently the approval of donanemab. For these drugs specifically, how are you using them in your practice and how should our listeners be thinking about these drugs?  Dr Silbert: These are, you know, relatively new, really exciting new and emerging therapies for Alzheimer's disease. They are shown to remove amyloid from the brain. Patients who have clinical manifestations of Alzheimer's disease, and that is those in the stages of mild cognitive impairment or mild dementia. We are using lecanemab at Oregon Health and Science University through our therapeutics and clinical units. It's a really exciting time and it's a time where we have to be, also, cautious about who undergoes these therapies. So being really informed about the use, who's appropriate to undergo these therapies, what kind of safety tests need to be undergone, how do you assess risk in individual patients so that you can counsel them.  So, all of these factors need to be weighed in when you're making a decision about whether or not to treat a patient with a monoclonal antibody therapy. And specifically, we do neuroimaging to assess whether there are already the presence of microhemorrhages in the brain. We do genetic testing to look for APOE 4 genotypes that can increase the risk of Aria, which is amyloid-related imaging abnormalities. And all of these factors go into how we counsel patients and discuss whether or not to pursue treatment with monoclonal antibodies.    Dr Jones: So certainly a complex patient selection process and drug administration and monitoring of therapy for those patients.  And that- it brings to mind for me how we already have too few neurologists in the US. And now for a really prevalent disorder, Alzheimer's disease, we're making it a lot more complicated to deliver these new disease-modifying therapies. What do you think or what do you see as the role of the neurologists in caring for patients with dementia? And do these developments change that role?  Dr Silbert: For now, I think these developments make it even more important in a way that neurologists are involved in making a very specific clinical diagnosis of which dementia is playing a factor in the patient 's clinical presentation. I think one thing to note is with these emerging biomarkers, a lot of them can be positive before there are clinical symptoms and multiple etiologies are also very prevalent. And so just having one positive biomarker, it doesn't necessarily tell you what's going on with an individual patient. You need to take the whole picture into consideration. So, I think a really detailed evaluation by the neurologist, especially with these emerging therapies that have potential risks, is extremely important right now. Just getting a test is really not sufficient. You really have to take the entire clinical picture into account and know the ins and outs of the risks involved in these disease-modifying therapies.  Dr Jones: Which brings us back to something you mentioned earlier, right? Which is good news. We have on the horizon new potential biomarkers for other neurodegenerative causes of dementia. I can foresee and maybe I'm, you know, being an alarmist here, Dr Silbert, but if we have sensitive biomarkers for other neurodegenerative conditions, we know patients often have copathologies. Is that going to help clarify things? Is it going to confuse us? How is that going to work?  Dr Silbert: Well, I think ultimately, it's going to help clarify things. Because there are multiple pathologies that are common in age related cognitive impairment, any kind of additional specific input that we can get with different biomarkers is going to be helpful in putting the pieces together to come up with what's happening clinically with each individual patient. Ultimately, I think these biomarkers, they're not- any one biomarker isn't going to be a solution to diagnosis, but putting them together to help improve early and accurate diagnosis is really the goal here. Having a very early diagnosis, having a very accurate diagnosis will improve our ability to give prognosis and also improve effective treatment strategies moving forward. I think that these biomarkers have the promise in facilitating that for us.  Dr Jones: And progress is always a good thing. We just have to learn how to adapt and use the evidence appropriately. There have been and I think most of our listeners will be familiar with some of the controversies related to these, these new disease-modifying drugs for Alzheimer's disease. Do you want to walk us through a couple of those, and what are your thoughts about those controversies?  Dr Silbert: Yeah, these new therapies, they're very exciting for everyone in the field, but they, like you mentioned, they're not without their controversies. I think one controversy or one potential downside to these therapies is access to them. Like you already mentioned there, there's really not enough neurologists out there. There's not enough behavioral neurologists out there. There's limitations to infusion centers, sites and prescribers. Access to these therapies is is significantly limited. They are requiring infusions quite frequently. So, if you're not living near specialty care, you're not really able to feasibly undergo these kinds of treatments. Another controversy is the fact that the treatment effects are considered by some to be fairly modest when looking at the clinical data and in association with that, there are risks involved. Like I already mentioned, there's the amyloid-related imaging abnormalities, which sounds kind of like a benign thing, but they really consist of microhemorrhages that can lead to bigger hemorrhages and edema in the brain. These risks are relatively small - they are seeing more commonly in those who have a specific genotype, an APOE E 4 genotype - but they're risks nonetheless.  And so, there's controversy about the risk-benefit ratio and access to care with these new therapies.  Dr Jones: It's very exciting, but we should be cautious, right? I recall a few years ago as a program director, a neurology residency program director, interest in different areas of neurology would often follow developments in those areas, right? Lots of interest in autoimmune neurology when those developments would proceed in neuro oncology, etc. And I wonder if the therapeutic advances in in behavioral neurology and neurodegenerative cognitive disorders, I wonder if that's going to stimulate interest among our trainees to pursue behavioral neurology? Do you have a view on that or have you seen much change in interest in in this field?  Dr Silbert: You know, we are seeing a lot more interest in our trainees. The residents are very interested in these new therapies and how to apply them. And I'm really excited about that.  I'm hopeful that this will stimulate interest in the field. And we need those specialists, we need those sub specialists to undergo fellowship training in behavioral neurology and geriatric neurology so that we have more access to the subspecialty care and delivering these new therapies. So, I agree with you, I'm hopeful about it and I am seeing new interest in our trainees about these new therapies.  Dr Jones: We can hope so. And all the other fellowship directors will be anxious if neurology residents start leaving to go into behavioral neurology. But there's certainly demand. And I know that under the best of circumstances, dementia is so common. It's something that we have to care for in partnership with primary care and community resources. And these disease-modifying therapies capture a lot of attention, but it's really a small part of the continuum of care of these patients. And Dr Silbert as an expert, you know, if we put that disease-modifying therapy to the side for a second and just said, well, what are the biggest gaps in the care for patients with dementia? What do you see as those biggest gaps and, and what can we do to fix them at not just a neurology level, but at a societal level?  Dr Silbert: That's a big question. And you know, what I see almost every day are gaps in the support mechanisms for families who are caring for patients with dementia. These caregivers are under a lot of stress and oftentimes they just don't have the resources to take care of somebody who at some point will often need twenty-four hour care and supervision. Caregivers are older, usually of older age themselves and have their medical issues as well. And then we're just not doing a good job as a nation in in supporting patients and their families with like supportive care and respite care that's really needed. So, you know, I'm not just seeing and treating patients with dementia, but I'm seeing and I'm really trying to support and care for those who are taking care of patients with dementia. To me, that's the biggest gap in our system. Dr Jones: Yeah. And as I look through this issue of Continuum, we touched on not only the conventional topics in dementia and behavioral neurology. I'm really happy in hindsight that we have invited some discussion of the psychiatric symptoms in dementia, which I think are really important and often underrecognized and maybe undermanaged or mismanaged, and really also focusing on the caregiver burden and support services. We do have an article dedicated to that as well, and I think that'll be useful to our readers and listeners when we when we publish those podcasts. We we've heard this year especially a lot of public conversation about cognitive impairment and dementia. I sometimes wonder if that public attention is helpful and constructive for the population of patients with dementia. Sometimes I wonder if that conversation is counterproductive. What's your take on that?  Dr Silbert: You know, I think it's- it can be a mixed bag, but ultimately, it's in the conversation. We're talking about it. And I think that's only a good thing. There's more public awareness of it.  There is more interest in therapies. So, I think at the end of the day, talking about it, making it more prevalent in the ether, it stimulates the conversation and discussion. And even if there's controversies about it, we're talking about it. And I think that's kind of the first step in acknowledging that we need more support, we need more therapies.  Dr Jones: Yeah, I agree. And I think often patients with neurologic disorders and their caregivers and families often appreciate being seen.   Dr Silbert: Yeah, no, absolutely true. So, I'd say in regards to the monoclonal antibody treatments, you know, despite the controversies with these new treatments, I think there's a real promise and a real hope and a real excitement across a lot of behavioral neurologists, including myself, that this is just the beginning. That even if these first line, first generation therapies maybe have downsides, that there'll be second generation and third generation variations on these kinds of treatments that are going to be more accessible, have less side effects and hopefully be more clinically effective. And, and down the line, the other real hope for the field is that these maybe second generation therapies will actually delay the onset or prevent clinical manifestation of the disease. And that's the real goal here.  Dr Jones: And that's a great segue to the to the next thing I wanted to ask you about and you, you may have already answered the question. We talked about how we have and will have new biomarkers which will help us with diagnosis. We have hopefully the first phase in increasingly effective disease modifying therapies for Alzheimer, maybe prevent Alzheimer's disease. Wouldn't that be great? Are there any other things on the horizon that you see maybe for other neurodegenerative disorders from a therapeutic perspective? What do you, what do you think the next big thing will be in that area?  Dr Silbert: Well, that's a great question. I think, you know, there's a lot of exciting research in Lewy body dementia and targeting alpha synuclein pathologies. We really need biomarkers.  So, we're ways off from therapeutics, but I think there's a lot of exciting progress in that area.  Dr Jones: So, like many areas of neurology, there are rewarding and challenging aspects to the care of these patients. What  do you- what's the most rewarding aspect of your practice, Dr Silbert?   Dr Silbert: You know, a lot of… I hear from trainees over the years that, you know, they can't imagine or it's difficult for them to think about caring for patients who have a neurodegenerative disease that has no cure. But I feel like that's a lot of what neurologists do. We don't necessarily cure all diseases, but we treat the patient throughout their disease process. And to me that is extremely satisfying. You know, I enjoy listening to patients' stories and hearing about what they have been through over the years. And I really feel, like, appreciated for the care that I provide in giving not just an accurate diagnosis, which a lot of people come in lacking, but talking about future planning and, really, treatment throughout the course of the disease. And I was in clinic yesterday and talking to one of my patients' caregivers, and we were talking about a particularly difficult behavioral manifestation that her husband was going through. And we were talking through how to manage it. And she said to me, you know, Dr Silbert, I really feel like I have a partner in going through this disease. And you know, that's kind of what it's all about for me. So, to me, it's extremely rewarding field. It's also a very exciting field, especially right now with all these new biomarkers and treatments. So, I just think there isn't a better area of neurology to be involved in right now.   Dr Jones: What a great place to land and end the interview. And I hope our listeners and our readers really do enjoy this issue. It's really a fantastic, not just an update, but a survey of a very dynamic aspect of the field of neurology. And Dr Silbert, I want to thank you for joining us and thank you for such a thorough and fascinating discussion on caring for patients with dementia.    Dr Silbert: It was my pleasure. Thank you.    Dr Jones: Again, we've been speaking with Dr Lisa Silbert, co-guest editor, alongside Dr Leanna Apostolova for Continuum 's most recent issue on dementia. Please check it out, and thank you to our listeners for joining us today.  Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. Thank you for listening to Continuum Audio. 

David D. Clarke, MD is President of the Association for Treatment of Neuroplastic Symptoms. He is also Assistant Director at the Center for Ethics and Clinical Assistant Professor of Gastroenterology Emeritus both at Oregon Health & Science University (OHSU) in Portland, Oregon, USA. He is board-certified in Gastroenterology and Internal Medicine and practiced Gastroenterology in Portland from 1984 to 2009. During that time, he diagnosed and treated over 7000 patients whose symptoms were not explained by organ disease or injury. Dr. Clarke has lectured extensively on Neuroplastic Symptoms to health care professionals, graduate students, and the public across North America and in Europe. His book for patients, They Can't Find Anything Wrong!, was praised by a president of the American Psychosomatic Society as “truly remarkable” and named one of the five best mind-body books ever written by Brit & Co. He was the lead editor for the professional textbook Psychophysiologic Disorders and the companion textbook A Diagnostic Guide for Psychophysiologic Disorders. He has done hundreds of interviews for TV, Radio, and podcasts and was an Executive Producer of three documentary films about Neuroplastic Symptoms. Find more information https://www.symptomatic.me and purchase his book They Can't Find Anything Wrong!

* List of Discoveries Squeezing Evolution: Did you know that dinosaurs ate rice before rice evolved? That turtle shells existed forty million years before turtle shells began evolving? That insects evolved tongues for eating from flowers 70 million years before flowers evolved? And that birds appeared before birds evolved? The fossil record is a wonderful thing. And more recently, only a 40,000-year squeeze, Neanderthal had blood types A, B, and O, shocking evolutionists but expected to us here at Real Science Radio! Sit back and get ready to enjoy another instant classic, today's RSR "list show" on Evolution's Big Squeeze! Our other popular list shows include: - scientists doubting Darwin - evidence against whale evolution - problems with 'the river carved the canyon' - carbon 14 everywhere it shouldn't be - dinosaur still-soft biological tissue - solar system formation problems - evidence against the big bang - evidence for the global flood - genomes that just don't fit - and our list of not so old things! (See also rsr.org/sq2 and rsr.org/sq3!) * Evolution's Big Squeeze: Many discoveries squeeze the Darwinian theory's timeframe and of course without a workable timeframe there is no workable theory. Examples, with their alleged (and falsified) old-earth timeframes, include: - Complex skeletons existed 9 million years before they were thought to have evolved, before even the "Cambrian explosion".- Butterflies existed 10 million years before they were thought to have evolved. - Parrots existed "much earlier than had been thought", in fact, 25 million years before they were thought to have evolved. - Cephalopod fossils (squids, cuttlefish, etc.) appear 35 million years before they were able to propagate. - Turtle shells 40 million years before turtle shells began evolving - Trees began evolving 45 million years before they were thought to evolve - Spores appearing 50 million years before the plants that made them (not unlike footprints systematically appearing "millions of years before" the creatures that made them, as affirmed by Dr. Marcus Ross, associate professor of geology). - Sponges existed 60 million years before they were believed to have evolved. - Dinosaurs ate rice before it evolved Example - Insect proboscis (tongue) in moths and butterflies 70 million years before previously believed has them evolving before flowers. - Arthropod brains fully developed with central nervous system running to eyes and appendages just like modern arthropods 90 million years earlier than previously known (prior to 2021, now, allegedly 310mya) - 100 million years ago and already a bird - Fossil pollen pushes back plant evolution 100 million years. - Mammalian hair allegedly 100-million-years-old show that, "the morphology of hair cuticula may have remained unchanged throughout most of mammalian evolution", regarding the overlapping cells that lock the hair shaft into its follicle. - Piranha-like flesh-eating teeth (and bitten prey) found pushing back such fish 125 million years earlier than previously claimed   - Shocking organic molecules in "200 million-years-old leaves" from ginkgoes and conifers show unexpected stasis. - Plant genetic sophistication pushed back 200 million years. - Jellyfish fossils (Medusoid Problematica :) 200 million years earlier than expected; here from 500My ago. - Green seaweed 200 million years earlier than expected, pushed back now to a billion years ago!  - The acanthodii fish had color vision 300 million years ago, but then, and wait, Cheiracanthus fish allegedly 388 million years ago already had color vision. - Color vision (for which there is no Darwinian evolutionary small-step to be had, from monochromatic), existed "300 million years ago" in fish, and these allegedly "120-million-year-old" bird's rod and cone fossils stun researchers :) - 400-million-year-old Murrindalaspis placoderm fish "eye muscle attachment, the eyestalk attachment and openings for the optic nerve, and arteries and veins supplying the eyeball" The paper's author writes, "Of course, we would not expect the preservation of ancient structures made entirely of soft tissues (e.g. rods and cone cells in the retina...)." So, check this next item... :) - And... no vertebrates in the Cambrian? Well, from the journal Nature in 2014, a "Lower-Middle Cambrian... primitive fish displays unambiguous vertebrate features: a notochord, a pair of prominent camera-type eyes, paired nasal sacs, possible cranium and arcualia, W-shaped myomeres, and a post-anal tail" Primitive? - Fast-growing juvenile bone tissue, thought to appear in the Cretaceous, has been pushed back 100 million years: "This pushes the origin of fibrolamellar bone in Sauropterygia back from the Cretaceous to the early Middle Triassic..."- Trilobites "advanced" (not the predicted primitive) digestion "525 million" years ago - And there's this, a "530 million year old" fish, "50 million years before the current estimate of when fish evolved" - Mycobacterium tuberculosis 100,000 yr-old MRCA (most recent common ancestor) now 245 million- Fungus long claimed to originate 500M years ago, now found at allegedly 950 Mya (and still biological "the distant past... may have been much more 'modern' than we thought." :) - A rock contained pollen a billion years before plants evolved, according to a 2007 paper describing "remarkably preserved" fossil spores in the French Alps that had undergone high-grade metamorphism - 2.5 billion year old cyanobacteria fossils (made of organic material found in a stromatolite) appear about "200 million years before the [supposed] Great Oxidation Event". - 2.7 billion year old eukaryotes (cells with a nucleus) existed (allegedly) 1 billion years before expected - 3.5 billion year "cell division evidently identical to that of living filamentous prokaryotes." - And even older cyanobacteria! At 220 million years earlier than thought, per Nature's 3.7 billion year old dating of stromatolites! - The universe and life itself (in 2019 with the universe dated a billion, now, no, wait, two billion!, years younger than previously thought, that's not only squeezing biological but also astronomical evolution, with the overall story getting really tight) - Mantis shrimp, with its rudimentary color but advanced UV vision, is allegedly ancient. - Hadrosaur teeth, all 1400 of them, were "more complex than those of cows, horses, and other well-known modern grazers." Professor stunned by the find! (RSR predicts that, by 2030 just to put an end date on it, more fossils will be found from the geologic column that will be more "advanced" as compared to living organisms, just like this hadrosaur and like the allegedly 100M year old hagfish  fossil having more slime glands than living specimens.)  - Trace fossils "exquisitely preserved" of mobile organisms (motility) dated at 2.1 billion years ago, a full 1.5 billion earlier than previously believed - Various multicellular organisms allegedly 2.1 billion years old, show multicellularity 1.5 billion years sooner than long believed   - Pre-sauropod 26,000-pound dinosaur "shows us that even as far back as 200 million years ago, these animals had already become the largest vertebrates to ever walk the Earth." - The Evo-devo squeeze, i.e., evolutionary developmental biology, as with rsr.org/evo-devo-undermining-darwinism. - Extinct Siberian one-horned rhinos coexisted with mankind. - Whale "evolution" is being crushed in the industry-wide "big squeeze". First, geneticist claims whales evolved from hippos but paleontologists say hippos evolved tens of millions of years too late! And what's worse than that is that fossil finds continue to compress the time available for whale evolution. To not violate its own plot, the Darwinist story doesn't start animals evolving back into the sea until the cast includes land animals suitable to undertake the legendary journey. The recent excavation of whale fossils on an island of the Antarctic Peninsula further compresses the already absurdly fast 10 million years to allegedly evolve from the land back to the sea, down to as little as one million years. BioOne in 2016 reported a fossil that is "among the oldest occurrences of basilosaurids worldwide, indicating a rapid radiation and dispersal of this group since at least the early middle Eocene." By this assessment, various techniques produced various published dates. (See the evidence that falsifies the canonical whale evolution story at rsr.org/whales.) * Ancient Hierarchical Insect Society: "Thanks to some well-preserved remains, researchers now believe arthropod social structures have been around longer than anyone ever imagined. The encased specimens of ants and termites recently studied date back [allegedly] 100 million years." Also from the video about "the bubonic plague", the "disease is well known as a Middle Ages mass killer... Traces of very similar bacteria were found on [an allegedly] 20-million-year-old flea trapped in amber." And regarding "Caribbean lizards... Even though they are [allegedly] 20 million years old, the reptiles inside the golden stones were not found to differ from their contemporary counterparts in any significant way. Scientists attribute the rarity [Ha! A rarity or the rule? Check out rsr.org/stasis.] to stable ecological surroundings." * Squeezing and Rewriting Human History: Some squeezing simply makes aspects of the Darwinian story harder to maintain while other squeezing contradicts fundamental claims. So consider the following discoveries, most of which came from about a 12-month period beginning in 2017 which squeeze (and some even falsify) the Out-of-Africa model: - find two teeth and rewrite human history with allegedly 9.7 million-year-old teeth found in northern Europe (and they're like Lucy, but "three times older") - date blue eyes, when humans first sported them, to as recently as 6,000 years ago   - get mummy DNA and rewrite human history with a thousand years of ancient Egyptian mummy DNA contradicting Out-of-Africa and demonstrating Out-of-Babel - find a few footprints and rewrite human history with allegedly 5.7 million-year-old human footprints in Crete - re-date an old skull and rewrite human history with a very human skull dated at 325,000 years old and redated in the Journal of Physical Anthropology at about 260,000 years old and described in the UK's Independent, "A skull found in China [40 years ago] could re-write our entire understanding of human evolution." - date the oldest language in India, Dravidian, with 80 derivatives spoken by 214 million people, which appeared on the subcontinent only about 4,500 years ago, which means that there is no evidence for human language for nearly 99% of the time that humans were living in Asia. (Ha! See rsr.org/origin-of-language for the correct explanation.) - sequence a baby's genome and rewrite human history with a 6-week old girl buried in Alaska allegedly 11,500 years ago challenging the established history of the New World. (The family buried this baby girl just beneath their home like the practice in ancient Mesopotamia, the Hebrews who sojourned in Egypt, and in Çatalhöyük in southern Turkey, one of the world's most ancient settlements.) - or was that 130,000? years ago as the journal Nature rewrites human history with a wild date for New World site - and find a jawbone and rewrite human history with a modern looking yet allegedly 180,000-year-old jawbone from Israel which "may rewrite the early migration story of our species" by about 100,000 years, per the journal Science - re-date a primate and lose yet another "missing link" between "Lucy" and humans, as Homo naledi sheds a couple million years off its age and drops from supposedly two million years old to (still allegedly) about 250,000 years old, far too "young" to be the allegedly missing link - re-analysis of the "best candidate" for the most recent ancestor to human beings, Australopithecus sediba, turns out to be a juvenile Lucy-like ape, as Science magazine reports work presented at the American Association of Physical Anthropologists 2017 annual meeting - find skulls in Morocco and "rewrite human history" admits the journal Nature, falsifying also the "East Africa" part of the canonical story - and from the You Can't Make This Stuff Up file, NPR reports in April 2019, Ancient Bones And Teeth Found In A Philippine Cave May Rewrite Human History. :) - Meanwhile, whereas every new discovery requires the materialists to rewrite human history, no one has had to rewrite Genesis, not even once. Yet, "We're not claiming that the Bible is a science textbook. Not at all. For the textbooks have to be rewritten all the time!"  - And even this from Science: "humans mastered the art of training and controlling dogs thousands of years earlier than previously thought."- RSR's Enyart commented on the Smithsonian's 2019 article on ancient DNA possibly deconstructing old myths...  This Smithsonian article about an ancient DNA paper in Science Advances, or actually, about the misuse of such papers, was itself a misuse. The published research, Ancient DNA sheds light on the genetic origins of early Iron Age Philistines, confirmed Amos 9:7 by documenting the European origin of the biblical Philistines who came from the island of Caphtor/Crete. The mainstream media completely obscured this astounding aspect of the study but the Smithsonian actually stood the paper on its head. [See also rsr.org/archaeology.]* Also Squeezing Darwin's Theory: - Evolution happens so slowly that we can't see it, yet - it happens so fast that millions of mutations get fixed in a blink of geologic time AND: - Observing a million species annually should show us a million years of evolution, but it doesn't, yet - evolution happens so fast that the billions of "intermediary" fossils are missing AND: - Waiting for helpful random mutations to show up explains the slowness of evolution, yet - adaption to changing environments is often immediate, as with Darwin's finches Finches Adapt in 17 Years, Not 2.3 Million: Charles Darwin's finches are claimed to have taken 2,300,000 years to diversify from an initial species blown onto the Galapagos Islands. Yet individuals from a single finch species on a U.S. Bird Reservation in the Pacific were introduced to a group of small islands 300 miles away and in at most 17 years, like Darwin's finches, they had diversified their beaks, related muscles, and behavior to fill various ecological niches. So Darwin's finches could diversify in just 17 years, and after 2.3 million more years, what had they evolved into? Finches! Hear this also at rsr.org/lee-spetner and see Jean Lightner's review of the Grants' 40 Years. AND: - Fossils of modern organisms are found "earlier" and "earlier" in the geologic column, and - the "oldest" organisms are increasingly found to have anatomical, proteinaceous, prokaryotic, and eukaryotic sophistication and similarity to "modern" organisms AND: - Small populations are in danger of extinction (yet they're needed to fix mutations), whereas - large populations make it impossible for a mutation to become standard AND: - Mutations that express changes too late in an organism's development can't effect its fundamental body plan, and - mutations expressed too early in an organism's development are fatal (hence among the Enyart sayings, "Like evolving a vital organ, most major hurdles for evolutionary theory are extinction-level events.") AND: - To evolve flight, you'd get bad legs - long before you'd get good wings AND: - Most major evolutionary hurdles appear to be extinction-level events- yet somehow even *vital* organs evolve (for many species, that includes reproductive organs, skin, brain, heart, circulatory system, kidney, liver, pancreas, stomach, small intestines, large intestines, lungs -- which are only a part of the complex respiration system) AND: - Natural selection of randomly taller, swifter, etc., fish, mammals, etc. explains evolution yet - development of microscopic molecular machines, feedback mechanisms, etc., which power biology would be oblivous to what's happening in Darwin's macro environment of the entire organism AND: - Neo-Darwinism suggests genetic mutation as the engine of evolution yet - the there is not even a hypothesis for modifying the vast non-genetic information in every living cell including the sugar code, electrical code, the spatial (geometric) code, and the epigenetic code AND: - Constant appeals to "convergent" evolution (repeatedly arising vision, echolocation, warm-bloodedness, etc.) - undermine most Darwinian anatomical classification especially those based on trivialities like odd or even-toed ungulates, etc. AND: - Claims that given a single species arising by abiogenesis, then - Darwinism can explain the diversification of life, ignores the science of ecology and the (often redundant) biological services that species rely upon AND: - humans' vastly superior intelligence indicates, as bragged about for decades by Darwinists, that ape hominids should have the greatest animal intelligence, except that - many so-called "primitive" creatures and those far distant on Darwin's tee of life, exhibit extraordinary rsr.org/animal-intelligence even to processing stimuli that some groups of apes cannot AND: - Claims that the tree of life emerges from a single (or a few) common ancestors - conflict with the discoveries of multiple genetic codes and of thousands of orphan genes that have no similarity (homology) to any other known genes AND (as in the New Scientist cover story, "Darwin Was Wrong about the tree of life", etc.): - DNA sequences have contradicted anatomy-based ancestry claims - Fossil-based ancestry claims have been contradicted by RNA claims - DNA-based ancestry claims have been contradicted by anatomy claims - Protein-based ancestry claims have been contradicted by fossil claims. - And the reverse problem compared to a squeeze. Like finding the largest mall in America built to house just a kid's lemonade stand, see rsr.org/200 for the astounding lack of genetic diversity in humans, plants, and animals, so much so that it could all be accounted for in just about 200 generations! - The multiplied things that evolved multiple times - Etc. * List of Ways Darwinists Invent their Tree of Life, aka Pop Goes the Weasle – Head and Shoulders, Knees and Toes: Evolutionists change their selection of what evidence they use to show 'lineage', from DNA to fossils to genes to body plans to teeth to many specific anatomical features to proteins to behavior to developmental similarities to habitat to RNA, etc. and to a combination of such. Darwinism is an entire endeavor based on selection bias, a kind of logical fallacy. By anti-science they arbitrarily select evidence that best matches whichever evolutionary story is currently preferred." -Bob E. The methodology used to create the family tree edifice to show evolutionary relationships classifies the descent of organisms based on such attributes as odd-toed and even-toed ungulates. Really? If something as wildly sophisticated as vision allegedly evolved multiple times (a dozen or more), then for cryin' out loud, why couldn't something as relatively simple as odd or even toes repeatedly evolve? How about dinosaur's evolving eggs with hard shells? Turns out that "hard-shelled eggs evolved at least three times independently in dinosaurs" (Nature, 2020). However, whether a genus has an odd or even number of toes, and similar distinctions, form the basis for the 150-year-old Darwinist methodology. Yet its leading proponents still haven't acknowledged that their tree building is arbitrary and invalid. Darwin's tree recently fell anyway, and regardless, it has been known to be even theoretically invalid all these many decades. Consider also bipedalism? In their false paradigm, couldn't that evolve twice? How about vertebrate and non-vertebrates, for that matter, evolving multiple times? Etc., etc., etc. Darwinists determine evolutionary family-tree taxonomic relationships based on numbers of toes, when desired, or on hips (distinguishing, for example, dinosaur orders, until they didn't) or limb bones, or feathers, or genes, or fossil sequence, or neck bone, or..., or..., or... Etc. So the platypus, for example, can be described as evolving from pretty much whatever story would be in vogue at the moment...   * "Ancient" Protein as Advanced as Modern Protein: A book review in the journal Science states, "the major conclusion is reached that 'analyses made of the oldest fossils thus far studied do not suggest that their [allegedly 145-million year-old] proteins were chemically any simpler than those now being produced.'" 1972, Biochemistry of Animal Fossils, p. 125 * "Ancient" Lampreys Just Modern Lampreys with Decomposed Brain and Mouth Parts: Ha! Researches spent half-a-year documenting how fish decay. RSR is so glad they did! One of the lessons learned? "[C]ertain parts of the brain and the mouth that distinguish the animals from earlier relatives begin a rapid decay within 24 hours..." :) * 140-million Year Old Spider Web: The BBC and National Geographic report on a 140-million year old spider web in amber which, as young-earth creationists expect, shows threads that resemble silk spun by modern spiders. Evolutionary scientists on the otherhand express surprise "that spider webs have stayed the same for 140 million years." And see the BBC. * Highly-Credentialed Though Non-Paleontologist on Flowers: Dr. Harry Levin who spent the last 15 years of a brilliant career researching paleontology presents much evidence that flowering plants had to originate not 150 million years ago but more than 300 million years ago. (To convert that to an actual historical timeframe, the evidence indicates flowers must have existed prior to the time that the strata, which is popularly dated to 300 mya, actually formed.) * Rampant Convergence: Ubiquitous appeals to "convergent" evolution (vision, echolocation, warm-bloodedness, icthyosaur/dolphin anatomy, etc.), all allegedly evolving multiple times, undermines anatomical classification based on trivialities like odd or even-toed ungulates, etc. * Astronomy's Big Evolution Squeeze: - Universe a billion, wait, two billion, years younger than thought   (so now it has to evolve even more impossibly rapidly) - Sun's evolution squeezes biological evolution - Galaxies evolving too quickly - Dust evolving too quickly - Black holes evolving too quickly - Clusters of galaxies evolving too quickly. * The Sun's Evolution Squeezes Life's Evolution: The earlier evolutionists claim that life began on Earth, the more trouble they have with astrophysicists. Why? They claim that a few billion years ago the Sun would have been far more unstable and cooler. The journal Nature reports that the Faint young Sun paradox remains for the "Sun was fainter when the Earth was young, but the climate was generally at least as warm as today". Further, our star would shoot out radioactive waves many of which being violent enough to blow out Earth's atmosphere into space, leaving Earth dead and dry like Mars without an atmosphere. And ignoring the fact that powerful computer simulators cannot validate the nebula theory of star formation, if the Sun had formed from a condensing gas cloud, a billion years later it still would have been emitting far less energy, even 30% less, than it does today. Forget about the claimed one-degree increase in the planet's temperature from man-made global warming, back when Darwinists imagine life arose, by this just-so story of life spontaneously generating in a warm pond somewhere (which itself is impossible), the Earth would have been an ice ball, with an average temperature of four degrees Fahrenheit below freezing! See also CMI's video download The Young Sun. * Zircons Freeze in Molten Eon Squeezing Earth's Evolution? Zircons "dated" 4 to 4.4 billion years old would have had to freeze (form) when the Earth allegedly was in its Hadean (Hades) Eon and still molten. Geophysicist Frank Stacey (Cambridge fellow, etc.) has suggested they may have formed above ocean trenches where it would be coolest. One problem is that even further squeezes the theory of plate tectonics requiring it to operate two billion years before otherwise claimed. A second problem (for these zircons and the plate tectonics theory itself) is that ancient trenches (now filled with sediments; others raised up above sea level; etc.) have never been found. A third problem is that these zircons contain low isotope ratios of carbon-13 to carbon-12 which evolutionists may try to explain as evidence for life existing even a half-billion years before they otherwise claim. For more about this (and to understand how these zircons actually did form) just click and then search (ctrl-f) for: zircon character. * Evolution Squeezes Life to Evolve with Super Radioactivity: Radioactivity today breaks chromosomes and produces neutral, harmful, and fatal birth defects. Dr. Walt Brown reports that, "A 160-pound person experiences 2,500 carbon-14 disintegrations each second", with about 10 disintergrations per second in our DNA. Worse for evolutionists is that, "Potassium-40 is the most abundant radioactive substance in... every living thing." Yet the percentage of Potassium that was radioactive in the past would have been far in excess of its percent today. (All this is somewhat akin to screws in complex machines changing into nails.) So life would have had to arise from inanimate matter (an impossibility of course) when it would have been far more radioactive than today. * Evolution of Uranium Squeezed by Contrasting Constraints: Uranium's two most abundant isotopes have a highly predictable ratio with 235U/238U equaling 0.007257 with a standard deviation of only 0.000017. Big bang advocates claim that these isotopes formed in distant stellar cataclysms. Yet that these isotopes somehow collected in innumerable small ore bodies in a fixed ratio is absurd. The impossibility of the "big bang" explanation of the uniformity of the uranium ratio (rsr.org/bb#ratio) simultaneously contrasts in the most shocking way with its opposite impossibility of the missing uniform distribution of radioactivity (see rsr.org/bb#distribution) with 90% of Earth's radioactivity in the Earth's crust, actually, the continental crust, and even at that, preferentially near granite! A stellar-cataclysmic explanation within the big bang paradigm for the origin of uranium is severely squeezed into being falsified by these contrasting constraints. * Remarkable Sponges? Yes, But For What Reason? Study co-author Dr. Kenneth S. Kosik, the Harriman Professor of Neuroscience at UC Santa Barbara said, "Remarkably, the sponge genome now reveals that, along the way toward the emergence of animals, genes for an entire network of many specialized cells evolved and laid the basis for the core gene logic of organisms that no longer functioned as single cells." And then there's this: these simplest of creatures have manufacturing capabilities that far exceed our own, as Degnan says, "Sponges produce an amazing array of chemicals of direct interest to the pharmaceutical industry. They also biofabricate silica fibers directly from seawater in an environmentally benign manner, which is of great interest in communications [i.e., fiber optics]. With the genome in hand, we can decipher the methods used by these simple animals to produce materials that far exceed our current engineering and chemistry capabilities." Kangaroo Flashback: From our RSR Darwin's Other Shoe program: The director of Australia's Kangaroo Genomics Centre, Jenny Graves, that "There [are] great chunks of the human genome… sitting right there in the kangaroo genome." And the 20,000 genes in the kangaroo (roughly the same number as in humans) are "largely the same" as in people, and Graves adds, "a lot of them are in the same order!" CMI's Creation editors add that "unlike chimps, kangaroos are not supposed to be our 'close relatives.'" And "Organisms as diverse as leeches and lawyers are 'built' using the same developmental genes." So Darwinists were wrong to use that kind of genetic similarity as evidence of a developmental pathway from apes to humans. Hibernating Turtles: Question to the evolutionist: What happened to the first turtles that fell asleep hibernating underwater? SHOW UPDATE Of Mice and Men: Whereas evolutionists used a very superficial claim of chimpanzee and human genetic similarity as evidence of a close relationship, mice and men are pretty close also. From the Human Genome Project, How closely related are mice and humans?, "Mice and humans (indeed, most or all mammals including dogs, cats, rabbits, monkeys, and apes) have roughly the same number of nucleotides in their genomes -- about 3 billion base pairs. This comparable DNA content implies that all mammals [RSR: like roundworms :)] contain more or less the same number of genes, and indeed our work and the work of many others have provided evidence to confirm that notion. I know of only a few cases in which no mouse counterpart can be found for a particular human gene, and for the most part we see essentially a one-to-one correspondence between genes in the two species." * Related RSR Reports: See our reports on the fascinating DNA sequencing results from roundworms and the chimpanzee's Y chromosome! * Genetic Bottleneck, etc: Here's an excerpt from rsr.org/why-was-canaan-cursed... A prediction about the worldwide distribution of human genetic sequencing (see below) is an outgrowth of the Bible study at that same link (aka rsr.org/canaan), in that scientists will discover a genetic pattern resulting from not three but four sons of Noah's wife. Relevant information comes also from mitochondrial DNA (mtDNA) which is not part of any of our 46 chromosomes but resides outside of the nucleus. Consider first some genetic information about Jews and Arabs, Jewish priests, Eve, and Noah. Jews and Arabs Biblical Ancestry: Dr. Jonathan Sarfati quotes the director of the Human Genetics Program at New York University School of Medicine, Dr. Harry Ostrer, who in 2000 said: Jews and Arabs are all really children of Abraham … And all have preserved their Middle Eastern genetic roots over 4,000 years. This familiar pattern, of the latest science corroborating biblical history, continues in Dr. Sarfati's article, Genesis correctly predicts Y-Chromosome pattern: Jews and Arabs shown to be descendants of one man. Jewish Priests Share Genetic Marker: The journal Nature in its scientific correspondence published, Y Chromosomes of Jewish Priests, by scie

In this episode I discuss with Board Certified Urogynecologist, Dr. Sarah Boyles: Types of incontinenceTypical patient flow through medical system Impact of incontinence on quality of life Reasons why incontinence may developWhat you can expect at a urogynecology appointment Treatment options (pessary, physio, bulking agents, compression, surgery) Description of surgical optionsSurgical risks Post operative instructions How effective are bladder slings? Sarah Boyles is a board certified urogynecologist (FPMRS) with more than 15 years of clinical experience treating women with pelvic floor issues.  She attended medical school at the University of Pittsburgh followed by residency in Obstetrics & Gynecology at The Ohio State University.  She then completed a 3 year fellowship in Female Pelvic Medicine & Reconstructive Surgery at Oregon Health & Science University.  She has published extensively in her field and has been active in creating Quality Standards nationally through the American Urogynecologic Society.  She has been a “Top Doc” In Portland every year for the last 7 years and loves her clinical practice.She is passionate about educating women on their pelvic floor and especially urinary incontinence.  Over the pandemic, she began creating evidence-based content for women that is easy to obtain outside the doctor's office.  Her goal is to help women understand why they are leaking and recognize the spectrum of available and proven treatment options. Her more recent work, including her YouTube channel and podcast, focus on helping women improve their bladder function while they are waiting to be seen by a specialist.  Look for her new membership, which will provide detailed reviews on available incontinence products as well as a community and support, to open later this summer.  HOW TO LEARN MORE FROM SARAH:BLOG  thewomensbladderdoctor.com SOCIAL MEDIA  Instagram, Facebook and Pinterest @thewomensbladderdoctorYOUTUBE channel the women's bladder doctorPODCAST While you wait...ADDIIONAL RESOURCES ON BLADDER LEAKS46. Bladder leaks with cough, sneeze and exercise with Adrienne Sim52. Discussing bladder leaks, treatments and surgery with urologist, Dr. Jennifer LockeTHANK YOU TO THE EPISODE SPONSORSSRC Health: discount code and website: https://srchealth.com/?ref=Sto_l3PawmnH4. Discount Code: THEPELVICFLOORPROJECTURESTA:  https://uresta.com/. Discount Code: PELVICFLOORPROJECTThanks for joining me! Here is where you can find out how to work with me:  www.pelvicfloorprojectspace.com/Support the show

Under a waiver program, states can test new ways to offer Medicaid services.  For Oregon, that means some people on the Oregon Health Plan can get help with housing costs. Oregon is the first in the nation to roll out rental assistance as a statewide Medicaid benefit for eligible OHP members, according to the Oregon Health Authority.  People would need to have a qualifying risk factor to be eligible for the aid, which could include rental assistance for up to six months and help paying utility bills.  Steph Jarem is the 1115 waiver policy director for OHA. Andrea Bell is the Executive Director of Oregon Housing and Community Services. They join us with details of the program and what it means for Oregonians. 

It’s been a few years, but we are here with an update on acromegaly, covering prevalence, diagnosis, traditional treatment, new therapies, and current gaps in understanding. Host Aaron Lohr talks again with Maria Fleseriu, MD, professor of medicine and professor of neurological surgery at Oregon Health & Science University School of Medicine and director of OHSU’s Pituitary Center. Dr. Fleseriu also serves on the Board of Directors of the Endocrine Society. Show notes are available at https://www.endocrine.org/podcast/enp94-update-on-acromegaly — for helpful links or to hear more podcast episodes, visit https://www.endocrine.org/podcast

Menopause can present a wide range of symptoms, from hot flashes and sleep disturbances to brain fog and loss of bone density. Though several safe and effective therapies are available, many patients still aren’t receiving the help they need. A new study from Oregon Health & Science University found that more than 60% of respondents with moderate to severe menopause symptoms weren’t receiving any treatment. The primary reason they reported not engaging in treatment was that their clinician hadn’t recommended it to them. Maria Rodriguez is a professor of obstetrics and gynecology at OHSU and the director of the university’s Center for Reproductive Health Equity. Sara Cichowski is the university’s vice chair of gynecology and an assistant professor of obstetrics and gynecology. They both join us to talk more about the barriers to accessing menopause care in Oregon.

Do you prefer multistory episodes, single story episodes, or a mix? Let us know! In this episode of Discover Daily, we begin with Google DeepMind's Habermas Machine, an AI-driven mediation tool designed to help groups find consensus on divisive topics. By analyzing individual opinions and generating balanced group statements, the Habermas Machine has shown promising results in increasing agreement and facilitating more productive discussions.Next, we delve into the exciting revival of Scout Motors, a Volkswagen spinoff that has unveiled its first electric vehicles in over four decades. The Terra pickup truck and Traveler SUV blend iconic American design with cutting-edge electric technology, featuring impressive off-road capabilities, high-performance specs, and innovative features like the optional "Harvester" range-extender system.Finally, Alex and Sienna explore a groundbreaking discovery in neuroscience - the confirmation of a waste-clearance system in living human brains. Researchers at Oregon Health & Science University have visualized the glymphatic system, which uses cerebrospinal fluid to flush out toxic proteins associated with neurodegenerative diseases. This discovery opens up new possibilities for understanding and potentially treating conditions like Alzheimer's and Parkinson's disease, emphasizing the crucial role of sleep in maintaining brain health.From Perplexity's Discover Feed:https://www.perplexity.ai/page/deepminds-habermas-machine-B2rpSbXeTTmofdFV1qglsAhttps://www.perplexity.ai/page/scout-motors-ev-revival-.rLLLgAiQSaAc1jcsv_.WAhttps://www.perplexity.ai/page/brain-s-waste-clearance-system-5c5Tl5l0RLqAtaWdtP3SCAPerplexity is the fastest and most powerful way to search the web. Perplexity crawls the web and curates the most relevant and up-to-date sources (from academic papers to Reddit threads) to create the perfect response to any question or topic you're interested in. Take the world's knowledge with you anywhere. Available on iOS and Android Join our growing Discord community for the latest updates and exclusive content. Follow us on: Instagram Threads X (Twitter) YouTube Linkedin

In this episode, Anthony Mulholland, Chief Nursing Officer of Ambulatory Services at Oregon Health & Science University, shares his journey in nursing leadership and discusses key healthcare trends. He delves into innovations in care model redesign, technology integration, and vertical alignment, and how these are shaping the future of ambulatory care and patient access.