Podcasts about Osler

Guest: Sander Duncanson, managing partner, Calgary, Osler

Rob Osler returns to share the first book in his Harriet Morrow Investigates series: The Case of the Missing Maid. We discuss the parallels between the Progressive Era (1890-1920) and current events, writing an exemplary and queer woman in a historic setting, and the unfolding of the series. https://robosler.com/  http://www.wrotepodcast.com/rob-osler/ 

Dan Delmar, in for Aaron Rand, is joined by Monique Jerome-Forget, Special advisor for Osler, Hoskin & Harcourt LLP and former President of the Treasury Board, Minister of Finance, Minister of Infrastructure and Minister of Government Services under the Jean Charest Government.

Dr. Mary Hague-Yearl is the head librarian at the Osler Library of the History of Medicine at McGill University. Listen to Mary discuss ongoing programs at the Osler Library, the importance of studying the history of medicine and the ethical legacy of historical physicians.

Set in 1898, Harriet Morrow is 21, supports her 16-year-old brother, and has been accepted as the first female detective at the Prescott Agency. She's given one week to find Agnes, maid to the wealthy Pearl Bartlett, who lives in one of the Prairie Street mansions on the south side of Chicago. Harriet, who prefers wearing men's shoes and hats and has no intention of ever getting married, immediately notices that Agnes has been taken, probably by force, from her attic apartment. Harriet visits Agnes's family and neighborhood and riding her trusty bicycle begins searching for clues across the city while grappling with someone in the agency who is trying to sabotage her. If she doesn't solve the case, she'll be booted from the agency, and Harriet Morrow can't let that happen in Rob Osler's charming novel, The Case of the Missing Maid (Kensington Books Publishing 2024). Rob Osler was born and raised in Boise, Idaho and earned a B.A. in Philosophy at the University of Puget Sound in Tacoma, WA. Soon after, he moved to Chicago and began a decade-long career as an advertising copywriter, creating television campaigns for Kellogg's and Tropicana, among others. After a transition to brand strategy and returning to school for an MBA at the University of Washington in Seattle, he spent two decades in senior roles at agencies and corporations in Seattle and San Francisco. Writing throughout, his focus was on business communications and brand strategy, with published articles in The Journal of Brand Management. Rob turned to fiction writing in his fifties. His first-ever publication was a short story, ANALOGUE, set in Seattle's tech industry, published in Ellery Queen Mystery Magazine. The story won the 2022 Mystery Writers of America Robert L Fish Award. His debut novel, DEVIL'S CHEW TOY, also set in Seattle and published the following year, was a finalist for the 2023 Anthony, Agatha, Lefty, and Macavity Awards and was A Year's Best by CrimeReads. His second-ever published short story, MISS DIRECTION, set in Palm Springs, CA, and appearing again in Ellery Queen Mystery Magazine, was a finalist for the 2024 Edgar Allen Poe Awards. His new historical series “Harriet Morrow* Investigates,” set in Chicago during America's Progressive Era, launches with THE CASE OF THE MISSING MAID, which earned a Publishers Weekly Starred Review and is an Amazon Editors Pick for Best Mystery, Thriller & Suspense. After living in Boise, Chicago, and Seattle, Rob now resides in California with his husband and a tall gray cat, who, depending on the day, goes by the name Noodles, Mr. Chomps, or Monkey. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/new-books-network

Set in 1898, Harriet Morrow is 21, supports her 16-year-old brother, and has been accepted as the first female detective at the Prescott Agency. She's given one week to find Agnes, maid to the wealthy Pearl Bartlett, who lives in one of the Prairie Street mansions on the south side of Chicago. Harriet, who prefers wearing men's shoes and hats and has no intention of ever getting married, immediately notices that Agnes has been taken, probably by force, from her attic apartment. Harriet visits Agnes's family and neighborhood and riding her trusty bicycle begins searching for clues across the city while grappling with someone in the agency who is trying to sabotage her. If she doesn't solve the case, she'll be booted from the agency, and Harriet Morrow can't let that happen in Rob Osler's charming novel, The Case of the Missing Maid (Kensington Books Publishing 2024). Rob Osler was born and raised in Boise, Idaho and earned a B.A. in Philosophy at the University of Puget Sound in Tacoma, WA. Soon after, he moved to Chicago and began a decade-long career as an advertising copywriter, creating television campaigns for Kellogg's and Tropicana, among others. After a transition to brand strategy and returning to school for an MBA at the University of Washington in Seattle, he spent two decades in senior roles at agencies and corporations in Seattle and San Francisco. Writing throughout, his focus was on business communications and brand strategy, with published articles in The Journal of Brand Management. Rob turned to fiction writing in his fifties. His first-ever publication was a short story, ANALOGUE, set in Seattle's tech industry, published in Ellery Queen Mystery Magazine. The story won the 2022 Mystery Writers of America Robert L Fish Award. His debut novel, DEVIL'S CHEW TOY, also set in Seattle and published the following year, was a finalist for the 2023 Anthony, Agatha, Lefty, and Macavity Awards and was A Year's Best by CrimeReads. His second-ever published short story, MISS DIRECTION, set in Palm Springs, CA, and appearing again in Ellery Queen Mystery Magazine, was a finalist for the 2024 Edgar Allen Poe Awards. His new historical series “Harriet Morrow* Investigates,” set in Chicago during America's Progressive Era, launches with THE CASE OF THE MISSING MAID, which earned a Publishers Weekly Starred Review and is an Amazon Editors Pick for Best Mystery, Thriller & Suspense. After living in Boise, Chicago, and Seattle, Rob now resides in California with his husband and a tall gray cat, who, depending on the day, goes by the name Noodles, Mr. Chomps, or Monkey. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/literature

Set in 1898, Harriet Morrow is 21, supports her 16-year-old brother, and has been accepted as the first female detective at the Prescott Agency. She's given one week to find Agnes, maid to the wealthy Pearl Bartlett, who lives in one of the Prairie Street mansions on the south side of Chicago. Harriet, who prefers wearing men's shoes and hats and has no intention of ever getting married, immediately notices that Agnes has been taken, probably by force, from her attic apartment. Harriet visits Agnes's family and neighborhood and riding her trusty bicycle begins searching for clues across the city while grappling with someone in the agency who is trying to sabotage her. If she doesn't solve the case, she'll be booted from the agency, and Harriet Morrow can't let that happen in Rob Osler's charming novel, The Case of the Missing Maid (Kensington Books Publishing 2024). Rob Osler was born and raised in Boise, Idaho and earned a B.A. in Philosophy at the University of Puget Sound in Tacoma, WA. Soon after, he moved to Chicago and began a decade-long career as an advertising copywriter, creating television campaigns for Kellogg's and Tropicana, among others. After a transition to brand strategy and returning to school for an MBA at the University of Washington in Seattle, he spent two decades in senior roles at agencies and corporations in Seattle and San Francisco. Writing throughout, his focus was on business communications and brand strategy, with published articles in The Journal of Brand Management. Rob turned to fiction writing in his fifties. His first-ever publication was a short story, ANALOGUE, set in Seattle's tech industry, published in Ellery Queen Mystery Magazine. The story won the 2022 Mystery Writers of America Robert L Fish Award. His debut novel, DEVIL'S CHEW TOY, also set in Seattle and published the following year, was a finalist for the 2023 Anthony, Agatha, Lefty, and Macavity Awards and was A Year's Best by CrimeReads. His second-ever published short story, MISS DIRECTION, set in Palm Springs, CA, and appearing again in Ellery Queen Mystery Magazine, was a finalist for the 2024 Edgar Allen Poe Awards. His new historical series “Harriet Morrow* Investigates,” set in Chicago during America's Progressive Era, launches with THE CASE OF THE MISSING MAID, which earned a Publishers Weekly Starred Review and is an Amazon Editors Pick for Best Mystery, Thriller & Suspense. After living in Boise, Chicago, and Seattle, Rob now resides in California with his husband and a tall gray cat, who, depending on the day, goes by the name Noodles, Mr. Chomps, or Monkey. Learn more about your ad choices. Visit megaphone.fm/adchoices Support our show by becoming a premium member! https://newbooksnetwork.supportingcast.fm/historical-fiction

In his weekly clinical update, Dr. Griffin briefly discusses the E.coli outbreak associated with onions from McDonald's before deep diving into the announcement of Robert F Kennedy Jr. nomination for Secretary of Human and Health Services with highlights from MicrobeTV's own Vincent Racaniello and Paul Offit (Beyond the Noise), the global measles outbreak, underutilization of influenza antivirals for children and teens, the $350 million 2025 order for mpox vaccination, before reviewing the recent statistics on SARS-CoV-2 infection, the WasterwaterScan dashboard, the effectiveness of N95 mask, the interplay between transmission and immunity for virus spread, where to find PEMGARDA, and translational science being conducted to understand long COVID including ongoing clinical trials, development of animal models and how sex may affect outcomes. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Micky D's onions linked to E. coli outbreak….another reason to not eat fast food (CDC) RFK Jr. series…..does he get anything right? (FactCheck.org) Salk polio vaccine : a calculated risk? (BMJ) How to conduct a controlled vaccine trial (American Journal Public Health Nations Health) Safety and efficacy of BNT162b2 mRNA COVID-19 vaccine (NEJM) Another Safety and efficacy study: mRNA-1273 SARS-CoV-2 vaccine (NEJM) …..SERIOUSLY! can't RFK Jr get it correct? (FactCheck.org) ‘I've Come Home Today': RFK Jr. (the Defenders Children's Health Defense News & Views) Thank God for sensible people: Racaniello and Offit (microbeTV) RFK Jr. : MAN CAN'T YOU GET ANYTHING RIGHT? (Annenberg Public Policy Center: University of Pennsylvania) No harm in repeating Vinny! Thank God for sensible people: Racaniello and Offit (microbeTV) Did America think Trump-Kennedy through? …..really did you think this through? (microbeTV) Make American Healthy Again? ……I will have fries with that….SUPERSIZED! (Wall Street Journal) Keep the United States HEALTHY! (Safe Communities Coalition) Measles in the US (CDC Measles: Rubeola) The merry-go-around of measles (JID) It is a measles outbreak! (CDC Measles: Rubeola) 10.3 million measles infections in 2023….but no vaccine (WHO) Underutilization of influenza antiviral treatment among children and adolescents (CDC MMWR) Increase in influenza infection in children…..(CIDRAP) Influenza weekly surveillance report: clift notes (CDC FluView) $340 million doses of mpox vaccine ordered for 2025 (Reuters) Mpox in NYC (JID) Respiratory virus activity (CDC Respiratory Illnesses) COVID-19 deaths (CDC) COVID-19 national and regional trends (CDC) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) N95 Filtering Facepiece Respirator use (JAMA Open Network) The Risk of SARS-CoV-2 Transmission in Community Indoor Settings (JID) Lower levels of household transmission of SARS-CoV-2 VOC Omicron compared to Wild-type: an interplay between transmissibility and immune status (JID) Enhanced placental antibody transfer efficiency with longer interval between maternal RSV vaccination and birth (AJOG: American Journal of Obstetrics and Gynecology) Where to get pemgarda (Pemgarda) EUA for the pre-exposure prophylaxis of COVID-19 (INVIYD) Fusion center near you….if in NY (Prime Fusions) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Infectious Disease Society guidelines for treatment and management (ID Society) Perceptions and Barriers to Outpatient Antiviral Therapy for COVID-19 and Influenza as Observed by Infectious Disease Specialists (OFID) Drug–Drug Interactions with Nirmatrelvir/Ritonavir(Infectious Diseases and Therapy) Drug interaction checker (University of Liverpool) Real-world effectiveness of nirmatrelvir-ritonavir and molnupiravir  (CMI: Clinical Microbiology and Infection) Alleviation of COVID-19 Symptoms and Reduction in Healthcare Utilization Among High-Risk Patients Treated With Nirmatrelvir/Ritonavir (CID) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) When your healthcare provider is infected/exposed with SARS-CoV-2 (CDC) Managing healthcare staffing shortages (CDC) Steroids, dexamethasone at the right time (OFID) Anticoagulation guidelines (hematology.org) Daniel Griffin's evidence based medical practices for long COVID (OFID) Long-COVID Clinical Trials (RECOVER) Initiating Long Covid RECOVERy (Science Translational Medicine) Beyond acute SARS-CoV-2 infection in children (Science Translational Medicine) Long COVID and Osler's Web: Chronic Fatigue Syndrome (goodreads) Sex differences in post infection sequalae  (Science Translational Medicine) Symptoms after Lyme disease: What's past is prologue (Science Translational Medicine) Animal models of Long COVID (Science Translational Medicine) Therapies for Long COVID (Science Translational Medicine) Sex differences and immune correlates of Long Covid development, symptom persistence, and resolution (Science Translational Medicine) The Long COVID ISSUE (Science Translational Medicine) Letters read on TWiV 1168 Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv

On November 9th, 2024, the Canadian Government published a proposed policy to cap oil and gas sector emissions, known as Canada Gazette Part 1. While the final targets will not be set until 2026, the Government estimates that this policy, in conjunction with other policies, will reduce GHG emissions from the oil and gas sector by 35% in the early 2030s compared to 2019. When flexible compliance options are considered, actual emissions are targeted to decline by 19% from 2019 levels.This week, Sander Duncanson, Partner at Osler and Co-Chair of Osler's national Regulatory, Indigenous, and Environmental practice, joins the podcast. Osler is a leader in Canadian business law.Peter, Jackie and Sander discuss their concerns with the proposed policy. Topics covered include:The low likelihood of the regulation becoming final law.The potential for the policy to create winners and losers, market distortions, and other unintended consequences.The complexity of Canada's regulatory framework which reduces investment.Concerns that Canada and the United States are moving in opposite directions regarding carbon policy. Canada is increasing stringency, while the US is expected to reduce its carbon policy, thereby creating the threat of investment moving from Canada to the US (carbon leakage).The options to provide feedback on the proposed policy are available until January 8th, 2025.Content referenced in this podcast:Canada Gazette, Part I, Volume 158, Number 45: Oil and Gas Sector Greenhouse Gas Emissions Cap Regulations (November 9th, 2024)Consultation feedback can be provided within a series of online forms in the Gazette, Part 1 link above, by January 8th, 2025. Another option for feedback is to submit a “Notice of Objection” by the same date. More information on this option can be found under the heading “PROPOSED REGULATORY TEXT” in the Gazette.Peter Tertzakian's commentary in The Hub “DeepDive: It's time for a carbon policy time-out” (November 2nd, 2024)Osler's Blog “Federal government announces constitutionally questionable oil and gas sector emissions cap” (November 8th, 2024)Please review our disclaimer at:https://www.arcenergyinstitute.com/disclaimer/ Check us out on social media: X (Twitter): @arcenergyinst LinkedIn: @ARC Energy Research Institute Subscribe to ARC Energy Ideas PodcastApple Podcasts Amazon Music Spotify 

In this episode, Bridgett dives into the journey of embracing natural beauty through the transition to silver hair with Margaret Osler, creator of the Instagram account @aging_is_amazing, which has grown into a vibrant community of 158k followers. Known for her message, "Be natural, be authentic, be yourself, as you age beautifully, contentedly, and peacefully," Margaret shares how her silver curls have become a symbol of self-acceptance and freedom. She reflects on how embracing her natural beauty has deepened her confidence and led to a sense of peace, showing that beauty goes far beyond youth or external appearances.Bridgett and Margaret share their reflections on the pressure younger women face in today's beauty culture and how breaking away from societal expectations can lead to a more fulfilling life. With heartfelt advice for future generations, Margaret emphasizes that beauty comes from within and true authenticity shines brighter than any external ideal. This conversation invites us all to fall in love with the wisdom, freedom, and beauty that come with age and to model that authenticity for those who come after us.For more, you can follow the Beyond Beauty Project on Instagram & Youtube!Produced by Peoples Media Hosted on Acast. See acast.com/privacy for more information.

On this episode, we learn about oil and gas law from Vivek Warrier - the president of the Canadian Energy Law Foundation and partner with Osler's Calgary office. Topics: SCC's constitutionality decision regarding the Impact Assessment Act, emissions reduction targets, and Carbon Contracts for Difference. This program contains 30 minutes of substantive content for the Law Society of Ontario's CPD requirements. ⚫ How will large scale pipeline projects proceed in light of a new SCC constitutionality finding about the federal environmental assessment framework? (7:48)⚫ What do we know about the federal government's proposed regulations to cap oil and gas emissions? (18:48)⚫ How can a new tool, known as a Carbon Contracts for Difference, help to de-risk emission reduction projects? (27:20)⚫ Our Ask-Me-Anything segment, featuring questions submitted by patrons of the Lawyered community (35:13)⚫ What are some of the current/recent legal challenges facing major pipeline projects, like Trans Mountain? (36:00)

Mike uses the platforms of business coaching and leadership training to fulfill his passion: helping others maximize their own personal and professional value.   As a member of the 8150 Advisors team, Mike collaborates with private practice owners through strategic growth, creating next level leaders, operational efficiency, and team engagement. Several practices have doubled in practice value as result of their collaboration.  Prior to joining the 8150 team, Mike helped Rock Valley Physical Therapy grow from 26 to 52 locations as their first VP of Growth & Development. New patient volumes increased 210% during his six-year tenure where he was responsible for de novo and mature clinic growth. While serving as Director of Operations for Proaxis Therapy, he was an integral leader in developing physician relations, operational excellence, and a five-star patient experience. Dedicated to life-long learning, Mike earned a BS from Mount Union College, an MDiv with Leadership Specialization from Indiana Wesleyan University, and a DPT from the Duke University School of Medicine. Mike is a Certified Coach and DISC Personality Assessment Trainer through the Maxwell Leadership Team. Mike began his career at the Ohio State University Sports Medicine Center where his experiences included consulting with the US Army Special Forces, treating a Masters champion and several NFL draft picks. He has served APTA and PPS as a Federal Affairs Liaison, APTA Delegate, PPS Impact Editorial Board Member, and PPS Annual Conference presenter. In addition to his business ventures, Mike serves part-time as the Partner Relations Manager for Zoe Empowers.  Zoe is an empowerment-based program in India and nine African countries which transforms youth-led households to self-sufficiency in just three years.  He has led several trips to Rwanda, Kenya, and Malawi to allow US partners to see the program's impact.  Mike lives in Iowa and enjoys time with his wife Kim (also a PT!), their four boys, and two dogs.

On June 20, 2024, Bill C-59 received Royal Assent and officially became law, implementing its provisions into Canadian legislation. The Bill, along with Bill C-69, which was passed on the same day, introduced new subsidies to encourage investment in clean energy in Canada. Bill C-59 established the Clean Technology Investment Tax Credit and Carbon Capture, Utilization, and Storage Tax Credit. Bill C-69 created the Federal Indigenous Loan Guarantee, the Clean Technology Manufacturing Investment Tax Credit, and the Clean Hydrogen Investment Tax Credit. However, the positive impact of these new subsidies was overshadowed by the greenwashing regulations added late in the process for Bill C-59. The new greenwashing rules amend the Competition Act to require that claims made by companies about environmental, ecological, or climate change benefits can be verified. Because of the ambiguity of what is needed to comply with the rules, many energy companies have deleted all GHG emissions and other sustainability content from their websites, including annual sustainability reports and commitments to improve environmental performance in the future. This week on the podcast, our guest, Kaeleigh Kuzma, a Partner at Osler in the Competition, Trade, and Foreign Investment Group, explained the new greenwashing rules. Here are some of the questions Peter and Jackie asked Kaeleigh: Why is greenwashing included in the Competition Act? Can you explain the provisions? What does “proper substantiation in accordance with internationally recognized methodology” mean? Why are the rules so vague, and what is the process for clarity? Do these rules only affect oil and gas and other heavy-emitting companies, or do they also apply to clean energy companies? What is the process for filing a complaint against a company to the Competition Bureau? What are the methods of enforcement? Other content referenced in this podcast:   Osler's detailed multi-part guide on the Competition Act amendments, with a specific section on deceptive marketing practices and greenwashing, here. Text of Bill C-59, see 74.01 (1), including (b.1) and (b.2) Form to provide feedback to the Competition Bureau on the amendments to the Act Kevin  Krausert opinion “Ottawa's anti-greenwashing bill will cripple cleantech innovation” (June 20, 2024)Please review our disclaimer at: https://www.arcenergyinstitute.com/disclaimer/  Check us out on social media:  X (Twitter): @arcenergyinstLinkedIn: @ARC Energy Research Institute  Subscribe to ARC Energy Ideas Podcast Apple Podcasts Google Podcasts Amazon Music Spotify 

Today's special guest is Jen Osler-Bolton, Jen shares her incredible testimony of coming to know the Lord and her journey of grief as a widow and also about great joy in the Lord. Jen shares how she was able to trust in God's goodness even in the midst of tragedy and how she sought Him in her prayer closet. I sure was encouraged as Jen shared how she looks for God in everyday things and that she expects a response when she talks to Him. Jennifer also talks about discerning God's voice from the enemy and the importance of trusting that nothing is wasted in God's plan.   Connect with Jen Osler-Bolton: https://www.instagram.com/jjoslerbolton/ Connect with Christa Joy: You can support Christa Joy Ministries by purchasing a coffee. https://www.buymeacoffee.com/powerfulwhisper Christa's Books are available on Amazon or at Christa Joy Ministries website. •        Powerful Whispers Devotional. Amazon link https://a.co/d/2BTdofJ •        A Busy Mom's Prayer Journal. Amazon Link https://a.co/d/0jtiDaG Instagram: ⁠https://www.instagram.com/christajoyministries/

This week on the podcast, our guest is Stephen Poloz, former Governor of the Bank of Canada, Author, Special Advisor at Osler, and recently appointed by Finance Minister Chrystia Freeland to lead a working group to explore how to catalyze greater domestic investments by Canada's pension funds.  This is Stephen's second appearance on the podcast. The first was in 2022 after he released his book The Next Age of Uncertainty. Here are some of the questions Jackie and Peter asked Stephen: What precipitated the thesis that Canadian pensioners are better off with more investment in Canada? What can you say about the pension investment working group, the deliverable you are working towards, and the potential timing? Why has inflation been so persistent in Canada and globally? What are your expectations for Canadian interest rate announcements in the future? Carolyn Rogers, senior deputy governor of the Bank of Canada, recently said in a speech, it's time to “break the glass” and respond to Canada's productivity “emergency” – do you agree that productivity is an emergency? How important is free trade with the United States for Canada's economy? What are your thoughts on the Canadian government committing tens of billions of dollars to support the EV sector in Canada? Are you concerned about Canada's ongoing deficit budgets and growing debt levels?  Please review our disclaimer at: https://www.arcenergyinstitute.com/disclaimer/       Check us out on social media:      X (Twitter): @arcenergyinst LinkedIn: @ARC Energy Research Institute      Subscribe to ARC Energy Ideas Podcast  Apple Podcasts  Google Podcasts  Amazon Music  Spotify      

Greetings, & welcome back to the podcast. This episode we are joined by Mr. Brad Wall - 14th Premier of Saskatchewan, Principal at Flying W Consulting &  Partner at CW Cattle Co.Mr. Brad Wall is also a board member at Helium Evolution, Whitecap Resources, NexGen Energy, Maxim Power Corp, Canadian American Business Council & Special Advisor at Osler, Hoskin & Harcourt LLP & E3 Lithium. Mr.Brad Wall is a graduate of the University of Saskatchewan with an honors degree in Public Administration and an advanced certificate in Political Studies.Among other things we discussed Western taxation, encounters with Mr.Lougheed & common sense economic policy.Enjoy.Thank you to our sponsors.Without their support this episode would not be possible:Connate Water SolutionsEVA SoftwareGalatea TechnologiesNinepoint PartnersEnverusCanada Action Support the Show.

AI will save the NHS - but not the wya you think. The Sunday Times' tech correspondent Danny Fortson brings on Dom Pimenta, a cardiologist and co-founder of Tortus, to talk about the potential of its artificial intelligence interface (AI) for doctors (5:00), preventing burnout (11:00), naming the tool OSLER (18:30), how it works (20:45), why he became a doctor (26:00), founding a charity during Covid (29:15), quitting the NHS (32:45), getting Khosla Ventures to invest (35:35), trying to get the product into market (40:00), and AI's potential in medicine (45:00). Hosted on Acast. See acast.com/privacy for more information.

“When you think about that shark American ethos, playing to win … but then also having the Canadian kindness, I think that's where Canada and Canadians have a really big opportunity.” Simple Ventures CEO joins to discuss the motivations behind the launch of the venture studio, the power of geographical arbitrage, and the structural, cultural, and economic impediments to Canadian entrepreneurship. The BetaKit Podcast is presented by Osler, Hoskin and Harcourt LLP. Osler, the leading law firm for startups, high growth companies and investors in Canada, has released its third annual study of 486 anonymized Canadian venture capital and growth equity financings.

“I think it would be a mistake if we make Canada even less competitive at such an incredibly important moment in time for us to embrace competition and productivity.”  Michael Katchen (Wealthsimple) and Daniel Eberhard (Koho) join BetaKit editor-in-chief Douglas Soltys for a wide-ranging conversation on Canada's productivity, entrepreneurship, and competition crises. Financial innovation, open banking, Real-Time Rail, and capital gains taxes might also come up. Recorded live at INNOVATEwest. The BetaKit Podcast is presented by Osler, Hoskin and Harcourt LLP. Osler, the leading law firm for startups, high growth companies and investors in Canada, has released its third annual study of 486 anonymized Canadian venture capital and growth equity financings.

“The reality is this government cannot execute.” Sound the alarm! Matt Roberts (CMD Capital) and Ben Bergen (CCI) join for an emergency #Budget2024 podcast to discuss the capital gains tax increase, Minister Freeland's Friday meeting with tech leaders, and the level to which politics are intersecting with innovation policy. The BetaKit Podcast is presented by Osler, Hoskin and Harcourt LLP. Osler, the leading law firm for startups, high growth companies and investors in Canada, has released its third annual study of 486 anonymized Canadian venture capital and growth equity financings.

“I think what we're trying to do here is maybe celebrate and acknowledge all pathways into tech. Whatever sparked the inspiration.” Co-hosts Rob and Douglas peel back the curtain to reveal the gadgets, media, and moments that inspired their love of tech. Come, witness the retelling of their Immaculate Tech Conceptions while reliving your own on this full-blown nostalgia pod! The BetaKit Podcast is presented by Osler, Hoskin and Harcourt LLP. Osler, the leading law firm for startups, high growth companies and investors in Canada, has released its third annual study of 486 anonymized Canadian venture capital and growth equity financings.

Note: This podcast is a companion to the Ground Truths newsletter “A Big Week for GLP-1 Drugs”Eric Topol (00:06):It is Eric Topol with Ground Truths, and with me today is Dr. Daniel Drucker from the University of Toronto, who is one of the leading endocrinologists in the world, and he along with Joel Habener and Jens Juul Holst from the University of Copenhagen and Denmark, have been credited with numerous prizes of their discovery work of glucagon-like peptide-1 (GLP-1) as we get to know these family of drugs and he's a true pioneer. He's been working on this for decades. So welcome, Daniel.Daniel Drucker (00:43):Thank you.Eric Topol (00:45):Yeah, it's great to have you and to get the perspective, one of the true pioneers in this field, because to say it's blossom would be an understatement, don't you think?Daniel Drucker (00:57):Yeah, it's been a bit of a hectic three years. We had a good quiet 30 plus years of solid science and then it's just exploded over the last few years.Eric Topol (01:06):Yeah, back in 30 years ago, did you have any sense that this was coming?Daniel Drucker (01:14):Not what we're experiencing today, I think there was a vision for the diabetes story. The first experiments were demonstrating insulin secretion and patents were followed around the use for the treatment of GLP-1 for diabetes. The food intake story was much more gradual and the weight loss story was quite slow. And in fact, as you know, we've had a GLP-1 drug approved for people with obesity since 2014, so it's 10 years since liraglutide was approved, but it didn't really catch the public's attention. The weight loss was good, but it wasn't as spectacular as what we're seeing today. So this really has taken off just over the last three, four years.Eric Topol (01:58):Yeah, no, it's actually, I've never seen a drug class like this in my life, Daniel. I mean, I've obviously witnessed the statins, but this one in terms of pleiotropy of having diverse effects, and I want to get to the brain here in just a minute because that seems to be quite a big factor. But one thing just before we get too deep into this, I think you have been great to recognize one of your colleagues who you work with at Harvard, Svetlana Mojsov. And the question I guess is over the years, as you said, there was a real kind of incremental path and I guess was in 1996 when you said, well, this drug likely will inhibit food intake, but then there were gaps of many years since then, as you mentioned about getting into the obesity side. Was that because there wasn't much weight loss in the people with diabetes or was it related to the dose of the drugs that were being tested?Why Did It Take So Long to Get to Obesity?Daniel Drucker (03:11):Well, really both. So the initial doses we tested for type 2 diabetes did not produce a lot of weight loss, maybe 2-3%. And then when we got semaglutide for type 2 diabetes, maybe we were getting 4-5% mean weight loss. And so that was really good and that was much better than we achieved before with any glucose lowering drug. But a lot of credit goes to Novo Nordisk because they looked at the dose for liraglutide and diabetes, which was 1.8 milligrams once daily for people with type 2 diabetes. And they asked a simple question, what if we increase the dose for weight loss? And the answer was, we get better weight loss with 3 milligrams once a day. So they learn that. And when they introduced semaglutide for type 2 diabetes, the doses were 0.5 and 1 milligrams. But in the back of their minds was the same question, what if we increased the dose and they landed on 2.4 milligrams once a week. And that's when we really started to see that the unexpected spectacular weight loss that we're now quite familiar with.Eric Topol (04:16):Was there also something too that diabetics don't lose as much weight if you were to have match dose?Daniel Drucker (04:22):Yeah, that's a general phenomenon. If one goes from either diet to bariatric surgery, and certainly with weight loss medicines, we tend to see maybe two thirds to three quarters of the amount of weight loss in people with type 2 diabetes. We don't really understand it. The brain pathways are probably resistant to some of the pathways that are activated that lead to weight loss, and it's really an interesting observation that needs further study.The Brain EffectEric Topol (04:50):Yeah, it's fascinating really. And it might've at least in part, held up this progress that has been truly remarkable. Now, recently you published a paper among many, you're a very prolific scientist, of course, physician scientist, but back in December in Cell Metabolism was a very important paper that explored the brain gut axis, the ability to inhibit inflammation and the mechanism through Toll-like receptors that you were seeing that. So maybe you could summarize the fact that you saw this, you were quoted in this Atlantic piece by Sarah Zhang, the science behind Ozempic was wrong. The weight loss effects of GLP-1 drugs have little to do with the gut and basically claiming that it's related to the effects on the brain, which of course could be reduced inflammation, reduced or inhibiting centers of addiction craving, that sort of thing. So how do you interpret your recent results and ongoing studies regarding GLP-1's effect on the brain?Daniel Drucker (06:02):Sure, so to be clear, I don't think that was a quote. I never would've said the science behind Ozempic was wrong. I think that was a headline writer doing what they do best, which is catching people's attention. I think what I was trying to say is that where this field started with insulin secretion first and then weight loss second, those are clearly very important pharmacological attributes of GLP-1. But physiologically, if we take GLP-1 away or we take the receptor away, you don't really develop diabetes without GLP-1. You don't really gain a lot of weight without GLP-1. So physiologically it's not that important. Why do we have GLP-1 in the distal gut? I think physiologically it's there to defend against infection and reduce gut inflammation. But we noticed that GLP-1 reduces inflammation in many different places in the heart and blood vessels and in the liver and many organs where you don't see a lot of GLP-1 receptors and you don't see a lot of GLP-1 receptors on immune cells.Daniel Drucker (07:04):So that really led us to the question, well, how does it work and affect all these organs where we don't see a lot of the receptors? And that's where we landed on the brain. Obviously the nervous system can communicate with many different cell types in almost every organ. And we identified neurons that expressed the GLP-1 receptor, which when blocked abrogated or completely eliminated the ability of GLP-1 to reduce inflammation in the periphery in white cells or in lungs. So it's been known for some time that the brain can control the immune system. So this is just the latest piece in the puzzle of how GLP-1 might reduce inflammation.Eric Topol (07:49):And just to be clear, I was quoting the Atlantic headline, not you that you were quoted within that article, but this is something that's really interesting because obviously GLP-1 is made in the brain in certain parts of the brain, it's transient in terms of its half-life made from the gut. But when we give these drugs, these agonists, how does it get in the brain? Because isn't there a problem with the blood brain barrier?Daniel Drucker (08:22):So I don't think the drugs get into the brain very well. We have a lot of data on this, so people have done the classic experiments, they either make radioactive ligands or fluorescent ligands, and they look how much gets in it and not very much gets in beyond the blood-brain barrier. And we also have big drugs that are immunoglobulin based and they work really well, so they don't get into the brain very much at all. And so, the way I describe this is that GLP-1 talks to the brain, but it doesn't directly get into the brain to meaningful extent, it does communicate somewhat there are areas obviously that are accessible in the area of the stream and circumventricular organs, but most of the time we have this communication that's not well understood that results in the magic that we see. And there are some discussions around for the neurodegenerative disease story where GLP-1 is being looked at in Parkinson's disease and in people with Alzheimer's disease. Would you be able to get more benefit if you could get the drugs into the brain to a greater extent, or would you simply increase the adverse event profile and the adverse response? So really important area for study as we begin to go beyond diabetes and obesity.Eric Topol (09:41):Yeah, I mean as you're pointing out, there's two ongoing trials, pretty large trials in Alzheimer's, early Alzheimer's, which may be a little bit too late, but at any rate, testing GLP-1 to see whether or not it could help prevent progression of the disease. And as you also mentioned, diseases and Parkinson's. But I guess, so the magic as you referred to it, the gut -brain axis so that when you give the GLP-1 family of drugs, we'll talk more about the double and triple receptor in a moment, but when you give these drugs, how does the message you get from the gut to the brain would you say?Daniel Drucker (10:27):So pharmacologically, we can give someone or an animal the drug, it does reach some of the accessible neurons that have GLP-1 receptors, and they probably transmit signals deeper into the brain and then activate signal transduction. So one way to look at it, if you use c-fos, the protein, which is an immediate early gene, which is increased when we activate neurons, we see rapid activation of c-fos in many regions that are deep within the brain within minutes. And we know that GLP-1 is not getting directly to those neurons, but it's activating pathways that turn on those neurons. And so, there's probably a very intricate set of pathways that sense the GLP-1 and the accessible neurons and then transmit those signals deeper into the brain.Double and Triple Receptor AgonistsEric Topol (11:18):Okay, well that makes sense. Now, as this has been moving along in obesity from semaglutide to tirzepatide and beyond, we're seeing even more potency it appears, and we have now double and triple receptors adding into glucagon itself and the gastric inhibitory polypeptide, and there's mixed data. So for example, the Amgen drug has the opposite effect on GIP as does the dual receptor, but comes out with the same weight loss I guess. How do we understand, I mean you know these gut hormones inside and out, how do we get such disparate results when you're either blocking or revving up a peptide effect?Daniel Drucker (12:13):Yeah, it's a mystery. I always sort of joke that you've invited the wrong person because I don't fully understand how to reconcile this honestly. There are some theories you could say that tirzepatide may possibly desensitize the GIP receptor, and that would align with what the GIP receptor blocking component is. And so, I think we need a lot of research, we may actually never know in humans how to reconcile these observations. I think we can do the experiments in animals, we're doing them, other people are doing them to look at the gain and loss of function and use best genetics. But in humans, you'd have to block or activate these receptors in very specific populations for a long period of time with tools that we probably don't have. So we may not reconstruct. We may end up with Maritide from Amgen that's producing 15-20% plus weight loss and tirzepatide from Lilly, that's spectacular, that's producing more than 20% weight loss. And yet as you mentioned at the GIP level, they have opposite effect. So I don't think we fully understand. Maybe your next guest will explain it to you and invite me on. I'd be happy to listen.Eric Topol (13:27):Well, I don't know. I don't think anybody can explain it. You've done it as well as I think as possible right now. But then we have the triple receptor, which it seems like if you take that drug, you could just go kind of skeletal. It seems like there's no plateau and its effect, that is I guess is it retatrutide, is that the name of it?Daniel Drucker (13:47):Retatrutide, yeah.Eric Topol (13:48):Retatrutide, okay. And then of course we're going on with potentially oral drugs or drugs that last for a year. And where do you see all that headed?Daniel Drucker (14:00):So I think the way I describe innovation in this field is there are two buckets that we've talked about today. So one bucket is the new molecule, so we're going to have all kinds of different combinations that will be peptides, that will be small molecule orals, the NIH is funding innovative programs to see if we can develop cell-based factories that produce GLP-1. There are gene editing and gene therapy approaches. So there are going to be multiple different molecular approaches to delivering molecules that are better and hopefully easier to take maybe once monthly, maybe every six months. So that's really exciting. And the other obvious bucket is the disease that we're targeting, so we started off with type 2 diabetes. We're now firmly established in the obesity field. In your field, we've seen consistently positive cardiovascular outcome trials. We had a press release a few months ago in October - November saying that semaglutide reduces chronic kidney disease. We have trials underway with peripheral artery disease with Parkinson's disease, with Alzheimer's and a number of neuropsychiatric conditions. So I think we're going to see both innovation on the molecule side as well as expanding if the trials are positive, expanding clinical indication. So it's going to be a pretty exciting next couple of years.Eric Topol (15:21):Right, no question. And as you well know, just in the past week, the FDA gave the green light for using these drugs for heart failure with preserved ejection fraction, which was an important randomized trial that showed that. Now there's got to be some downsides of course there's no drug that's perfect. And I wanted to get your comments about muscle loss, potentially bone density reduction. What are the downsides that we should be thinking about with these drugs?Side EffectsDaniel Drucker (15:54):Sure, so the known side effects are predominantly gastrointestinal. So we have nausea, diarrhea, constipation and vomiting. And very importantly, if those side effects are severe enough that someone can't eat and drink for 24 hours, we need to tell them you have to seek medical attention because some people will get dehydrated and rarely get acute kidney injury. This is rare, but it's described in many of the outcome trials, and we definitely want to avoid that. Gallbladder events are probably one in several hundred to one in a thousand, and that can be anywhere from gallbladder inflammation to gallbladder stones to biliary obstruction. Don't fully understand that although GLP-1 does reduce gallbladder motility, so that may contribute. And then very rarely we're seeing reports of small bowel obstruction in some people difficult to sort out. We don't really see that in the large clinical trials, but we have to take people at there were, we haven't seen an imbalance in pancreatitis, we haven't seen an imbalance of cancer.Daniel Drucker (17:01):There is no evidence for clinically significant bone disease either at the level of reduced bone densities or more importantly at the level of fractures. And we have a lot of real world data that's looked at that. Now muscle losses is really interesting. So when the initial drugs were approved, they didn't produce much weight loss. We didn't think about it. Now that we're getting the 15 20% plus, the question is, will we see clinically significant sarcopenia? And I use the word clinically significant carefully. So we definitely see muscle lean mass loss on a DEXA scan, for example. But what we're not seeing so far are people who are saying, you know what my grip strength is weak. I can't get up off the chair. I have trouble reaching up into the cupboard. My exercise or walking capacity is limited. We're not seeing that. In fact, we're seeing the opposite.Daniel Drucker (17:53):As you might expect, people are losing weight, they're less achy, they can move more, they can exercise more. So the question is buried within that data, are there some individuals with real clinical sarcopenia? And as we get to 25% weight loss, it's very reasonable to expect that maybe we will see some individuals with clinical sarcopenia. So you're very familiar. There are half a dozen companies developing medicines to promote fat mass loss and spare muscle with or without semaglutide or tirzepatide. And this is a really interesting area to follow, and I don't know how it's going to turn out. We really have to see if we are going to see enough clinically significant muscle loss and sarcopenia to merit a new drug category emerge, so fascinating to follow us.Eric Topol (18:46):No, I'm so glad you reviewed that because the muscle loss, it could be heterogeneous and there could be some people that really have some substantial sarcopenia. We'll learn more about that. Now that gets me to what do we do with lifelong therapy here, Daniel, where are we going? Because it seems as though when you stop these drugs, much of the benefit can be not potentially all, but a substantial amount could be lost over time. Is this something that you would view as an insulin and other hormonal treatments or how do you see it?The Question of ReboundDaniel Drucker (19:26):Yeah, so it's fascinating. I think that traditional view is the one that you just espoused. That is you stop the drug, you regain the weight, and people are concerned about the rebound weight and maybe gaining more fat and having less favorable body composition. But if you look at the data, and it's coming very fast and furious. A few months ago, we saw data for a tirzepatide trial, one of the surmount obesity trials, the first author was Louis Aronne in New York and they gave people tirzepatide or placebo for 38 weeks. And then they either continue the tirzepatide or stop the tirzepatide. One year later, so no tirzepatide for one year, more than 40% of the people still managed to keep at least 10% of their weight off, which is more than enough in many people to bestow considerable metabolic health. So I think there are going to be people that don't need to take the medicines all the time for weight loss, but we must remember that when we're excited about heart attacks and strokes and chronic kidney disease, there's no evidence that you can stop the medicines and still get the benefits to reduce those chronic complications.Daniel Drucker (20:46):So we're going to have to get much more sophisticated in terms of a personalized and precision medicine approach and ask what are the goals? And if the goals are to reduce heart attack strokes and death, you probably need to stay on the medicine if the goals are to achieve weight loss so that you can be metabolically healthy, there may be a lot of people who can come off the medicine for considerable amounts of time. So we're just learning about this. It's very new and it's really exciting.Suppressing Inflammation as the Common ThreadEric Topol (21:11):Yeah, no question. And just going back to the inflammation story in heart disease, it was notable that there were biomarkers of reduced inflammation in the intervention trial before there was any evidence of weight loss. So the anti-inflammatory effects here seem to be quite important, especially with various end organ benefits. Would you say that's true?Daniel Drucker (21:35):Yeah, I think that's one of my favorite sort of unifying theories. If we step back for a minute and we come into this and we say, well, here's a drug that improves heart disease and improves liver inflammation and reduces chronic kidney disease and may have some effect on atherosclerosis and is being studied with promising results and neurodegenerative disease, how do we unify all that? And one way is to say all of these chronic disorders are characterized by a component of chronic inflammation. And Eric, it's fascinating. I get reports from random strangers, people who've been on tirzepatide or people who have been on semaglutide, and they tell me, and you'll be fascinated with this, they tell me, my post Covid brain fog is better since I started the drug. They send me pictures of their hands. These are people with chronic arthritis. And they say, my hands have never looked better since I started the drug. And they tell me they've had ulcerative colitis for years on biologics and all of a sudden it's in remission on these drugs. So these are case reports, they're anecdotes, but they're fascinating and quite consistent with the fact that some people may be experiencing an anti-inflammatory effect of these medicines.Eric Topol (22:55):And I think it's notable that this is a much more potent anti-inflammatory effect than we saw from statins. I mean, as you know, well they have an effect, but it's not in the same league, I don't think. And also the point you made regarding this is a very good candidate drug class for Long Covid and for a variety of conditions characterized by chronic inflammation. In fact, so many of our chronic diseases fit into that category. Well, this is fascinating, and by the way, I don't know if you know this, but we were both at Johns Hopkins at the same time when you were there in the early eighties. I was there as a cardiology fellow, but we never had a chance to meet back then.Daniel Drucker (23:41):So were you just ahead of Cricket Seidman and the whole team there, or what year was that?Eric Topol (23:46):Just before them, that's right. You were there doing, was it your internship?Daniel Drucker (23:50):I was doing an Osler internship. I think Victor McKusick loved to have a Canadian every year to recognize Osler, one of the great Canadians, and I was just lucky to get the slot that year.Eric Topol (24:04):Yeah, it's wild to have watched your efforts, your career and your colleagues and how much of a profound impact. If you were to look back though, and you were to put this into perspective because there were obviously many other hormones along the way, like leptin and so many others that were candidates to achieve what this has. Do you think there's serendipity that play out here or how do you kind of factor it all together?Daniel Drucker (24:38):Well, there there's always serendipity. I mean, for decades when people would write review articles on the neuropeptides that were important for control of hunger and satiety and appetite circuits, I would open the article, read it, and I'd say, darn, there's no GLP-1 on the figure. There's no GLP-1 or receptor on the figure, but there's leptin and agouti and the POMC peptides and all the melanocortin and so on and so forth, because physiologically, these systems are not important. As I mentioned, you don't see childhood obesity or genetic forms of obesity in people with loss of function mutations in the GLP-1 sequence or in the GLP-1 receptor. You just don't see a physiologically important effect for having low GLP-1 or having no GLP-1. And that's of course not the case for mutations in NPY or the melanocortin or leptin, et cetera.Other EffectsDaniel Drucker (25:36):But pharmacologically, it's been extraordinarily difficult to make drugs out of these other peptides and pathways that we talked about. But fortuitously or serendipitously, as you point out, these drugs seem to work and amazingly GPCRs are notoriously prone to desensitization. We use that in clinical medicine to turn off entire circuits. And thankfully what goes away with GLP-1 are the adverse effects. So nausea, vomiting, diarrhea, constipation, we see those during the first few weeks and then there's tachyphylaxis, and they generally go away in most people, but what doesn't go away through good fortune are the ability of GLP-1 to talk to those brain circuits and say, you know what? You're not hungry. You don't need to eat. You don't need to think about food. And that's just good luck. Obviously pharmacologically that's benefited all of us working in this area.Eric Topol (26:31):It's extraordinary to be able to get desensitized on the adverse effects and not lose the power of the benefit. What about addiction that is, whether it's alcohol, cigarettes, gambling, addictive behavior, do you see that that's ultimately going to be one of the principal uses of these drugs over time?Daniel Drucker (26:55):The liver docs, when I give a talk at a metabolic liver disease meeting, they say we love GLP-1 because not only might it take care of liver disease, but there are still some people that we see that are having problems with alcohol use disorders and it might also reduce that. And obviously there are tons of anecdotes that we see. If you go on social media, and you'll see lots of discussion about this, and there's a hundred or so animal paper showing that addiction related dependence behaviors are improved in the context of these medicines. But we don't have the clinical data. So we have a couple of randomized clinical trials, small ones in people with alcohol use disorder, very unimpressive data. We had a trial in people with smoking, didn't really see much, although interestingly, they noted that people drank less alcohol than they did the smoking trial. So there are dozens and dozens of trials underway now, many investigator initiated trials looking at whether it's nicotine or cocaine or cannabinoids or all kinds of compulsive behaviors. I think in the next 12 to 24 months, we're going to start to learn are these real bonafide effects that are seen in large numbers of people or are these just the anecdotes that we won't get a very good complete response. So it's really exciting neuroscience and we're going to learn a lot over the next couple of years.Eric Topol (28:20):Yeah, no, it's a fascinating area which just extends the things that we've been discussing. Now, let's say over time, over the years ahead that these drugs become because of the competition and various factors, perhaps in pill form or infrequent dosing, they become very inexpensive, not like they are today.Daniel Drucker (28:44):That'd be great speaking as a non-pharmaceutical physician.Eric Topol (28:48):Yeah, yeah, no, these companies, which of course as you well know, it accounts for the number one economy in Denmark and is having a big impact in Europe. And obviously Eli Lilly is now the most valued biopharma company in the world from all these effects are coming from this drug class, but let's just say eventually it's not expensive and the drug companies are not gouging and pleasing their investors, and we're in a different world. With all these things that we've been discussing, do you foresee a future where most people will be taking one form or another of this family of drugs to prevent all these chronic conditions that we've just been discussing independent of obesity, type 2 diabetes, the initial frontier? Do you think that's possible?Daniel Drucker (29:42):Yeah, I'm a very conservative data-driven person. So today we don't have the data. So if I was in charge of the drinking water supply in your neighborhood and I had unlimited free cheap GLP-1, I wouldn't dump it in there just yet. I don't think we have the data, but we have trials underway, as you noted for Alzheimer's disease, a challenging condition for our society with a huge unmet need if like fingers crossed, if semaglutide does show a benefit for people living with early Alzheimer's disease, if it helps for Parkinson's, if it helps for metabolic liver disease, there are also studies looking at aging, et cetera. So it's possible one day if we have a lot more data that we will begin to think, okay, maybe this is actually a useful medicine that should deserve much more exposure, but today we just don't have the data.Eric Topol (30:38):Absolutely. I couldn't agree more, but just wanted to get you kind of speculate on that a bit off script if you will, but what your thoughts were, because this will take a long time, get to that point, but you just kind of wonder when you have an absence of chronic significant side effects overall with these diverse and relatively potent benefits that cut across many organ systems and as you just mentioned, might even influence the aging process, the biologic process.Worsening InequitiesDaniel Drucker (31:10):There's another related sort of angle to this, which is that the accessibility of these medicines is very challenging even in well-developed countries, the United States, Europe, et cetera, and we have hundreds of millions of people in the global south and less well-developed economies that are also challenged by heart disease and diabetes and obesity and chronic kidney disease and liver disease. And I think we need to start having conversations and I think they are happening just like we did for HIV and just like we did for hepatitis and certainly we did very quickly for the Covid vaccines. We need to think out of the box and say we need to help people in other parts of the world who may not have access to the medicines in their current form and at their current pricing. And I think these are really important moral and ethical discussions that need to be happening now because soon we will have small molecules and the price will come down and we need to make sure it's not just people in well-developed countries that can afford access to these medicines. I think this is a great opportunity for pharmaceutical companies and the World Health Organization and other foundations to really think broadly about how we can benefit many more people.Eric Topol (32:29):I couldn't agree with you more and I'm so glad you emphasize that because we can't wait for these prices to come down and we need creative ways to bridge, to reduce inequities in a vital drug class that's emerged to have far more applicability and benefit than it was initially envisioned, certainly even 5, 10 years ago, no less 30 years ago when you got on it. So Daniel, I can't thank you enough for this discussion. Really a candid discussion reviewing a lot of the things we do know, don't know will know someday perhaps. I just want to note, I know so many people are cheering for you and your colleagues to get recognized further like by the Nobel folks in the years ahead. I think it's pretty darn likely and hopefully when we get a chance to visit again in the years ahead, we'll unravel some of the things that we discussed today that we didn't know the answers and that you as a really an authority and pioneer in the field. Also, I could admit that there's a ways to go to really understand the boundaries if there are boundaries here for how these drugs are going to be used in the years ahead.Daniel Drucker (33:51):Yeah, it's another great story for basic science and bench to bedside, and it's just another story where none of us could have predicted the outcomes that we're talking about today to their full extent. And so to the extent that we can convince our governments and our funding agencies to really fund discovery science, the benefits are never apparent immediately. But boy, do they ever come in spades later on in an unpredictable manner. And this is just a great example.Eric Topol (34:20):Yeah, I also would say that this work cracking the case of obesity, which has been a stumbling block, I ran a big trial with Rimonabant, which was a failure with the neuropsychiatric side effects and suicidal ideation that had to get dropped. And there's many others like that as you know, very well Fen-Phen, and a long list. And the fact that this could do what it's doing and well beyond just obesity is just spectacular. And what I think it does, what you just mentioned, Daniel, is the basic science work that led to this is I think an exemplar of why we should put in these efforts and not expect immediate benefits, dividends of those efforts. Because look what's happened here. If you can break through with obesity, imagine what lies ahead. So thanks so much for joining and we'll look forward to continuing to follow your work. I know you're publishing the same pace, exceptional prolific pace over many, many years, and I'm sure that's going to continue.Daniel Drucker (35:34):Well, I have a great team and so it's a pleasure me to go into work and talk to them every day.********************Thanks for listening to/reading Ground Truths.Please share if your found this podcast informative Get full access to Ground Truths at erictopol.substack.com/subscribe

Ever awakened and wondered where you are? And after a great night of passion with the hottest fellow? That's what happens with Hayden, teacher and blogger. And then there's a dog! I mean of course there is. Rob Osler gives the reader everything fun thing to keep you glued. Devil's Chew Toy is so delicious and the characters are so fun. Listen as we chat about his Agatha nominated Cozy Mystery.

Rob Osler returns to share his latest Hayden & Friends Mystery, Cirque du Slay! We discuss the importance of characters living their authentic lives and the growth of the "quozy" genre! https://robosler.com/  http://www.wrotepodcast.com/rob-osler/ 

Its symptoms are like those of a heart attack. We're talking about the vulnerable heart, on this week's Ageless Glamour Girls Podcast. February is National Heart Month, and we're revisiting a popular and very important episode: “Broken Heart Syndrome.”  It first aired in March of 2022 - our debut season.  Broken Heart Syndrome can happen when you experience sudden acute stress. And get this - a study published last year, suggests cases of the condition are increasing in middle-aged and older women. The good news is that it's treatable. The study's senior author, Dr. Susan Cheng of the Smidt Heart Institute at Cedars-Sinai in Los Angeles, joined us to discuss the findings and solutions.******************* GUEST: Dr. Susan Cheng BIO: Susan Cheng, MD, MMSc, MPH is the Erika J. Glazer Chair in Cardiovascular Health and Population Science, director of Cardiovascular Population Sciences, and director of Public Health Research in the Smidt Heart Institute at Cedars-Sinai. Dr. Cheng is a cardiologist, echocardiographer, and clinician-scientist who leads research programs aimed at uncovering the drivers of cardiovascular aging in women and men. She received her bachelor's degree from Harvard College, a medical degree from McMaster University, Master of Medical Science from MIT, and Master of Public Health from Harvard. Dr. Cheng completed Osler internal medicine training at the Johns Hopkins Hospital and cardiology training at the Brigham and Women's Hospital and Harvard Medical School, where she then served as cardiology faculty and associate director of the Cardiovascular Imaging Core Laboratory. She is co-director of the Framingham Heart Study Echocardiography Laboratory and co-director of the international Bioactive LipidsNet Consortium.Dr. Cheng has served on the editorial boards of major cardiovascular and imaging journals as well as on leadership committees for the American Heart Association and American College of Cardiology. She has chaired and contributed to the American Heart Association's scientific statements on research methods, heart disease statistics, and the cardiovascular care of older adults. Dr. Cheng has authored over 350 publications and her work has been recognized with multiple awards and supported by continuous NIH funding.https://researchers.cedars-sinai.edu/Susan.Cheng  Support the showHi! Welcome to the Ageless Glamour Girls Podcast! I'm your host, Marqueeta Curtis-Haynes, Founder and CEO of the Ageless Glamour Girls lifestyle brand, and the administrator of a private Facebook group called "The Ageless Café." I'm also now about to become a published author. Pre-sales just began for my book "Ageless Glamour Girls: Reflections on Aging" - an anthology featuring 13 phenomenal women. https://90daybookcreation.com/ageless-glamour-girls The AGG Podcast explores all things aging, to inspire and help empower women age 50+ to navigate this new season of transformation. Podcast episodes drop on Wednesdays. You can reach us at: info@agelessglamourgirls.com. Don't forget to subscribe to the podcast. And thanks for the love, Luvvies! Here's to Healthy Aging and Joyful Living!

This is a compilation of two episodes of Noir at the Bar! Seattle ! Hosts Alan R. Warren, John Copenhaver & Joe Goldberg!Tonight's readers are John Copenhaver reading from his 'Hall of Mirrors, Connie Berry from her ' A Collection of Lies, Tracy Clark reading from her novel 'Fall', Joe Clifford reading from his' Say My Name', James Hannah reading his short story 'They Shall Take Up Serpents', and Rob Osler reading his 'Cirque Du Slay'!Support this show http://supporter.acast.com/houseofmysteryradio. Become a member at https://plus.acast.com/s/houseofmysteryradio. Hosted on Acast. See acast.com/privacy for more information.

"Lifestyle Medicine - the new paradigm in Primary Healthcare" In this episode, my guest Dr. Foong Tsin Uin and I talk about Primary Healthcare  particularly Lifestyle Medicine -  a rapidly growing field of medicine that uses evidence-based lifestyle interventions to prevent, treat and manage chronic diseases. If you ask people what Primary Healthcare is, most shrug or respond "direct healthcare?" To be honest, not many people know what it is let alone understood it. Are Singaporeans getting the kind of healthcare we need? Well, in this episode, I am delighted to have Dr. Foong share with us the concept of it and introduce the medical approach of Lifestyle Medicine. Dr. Foong is the Director and Chief Medical Officer of Osler Health International. Her team of international doctors have looked after the global community of Singapore for many years. Dr. Foong obtained her medical degree from Royal Free & UCL Medical School in London in 2000. She went to complete her postgraduate training in general practice in London, earning her membership with the Royal College of General Practitioners (UK) in 2006. Later on, she underwent further training and obtained a Diploma in Dermatology from Cardiff University in 2012.Her practice within the international community in Singapore over the last 7 years has seen her practice grow as she delivers a holistic style approach to family practice – in particular looking after children from newborns upwards, and also in the field of mental health. Passionate about providing preventative health for Osler Health patients, Dr. Foong is also a member of the British Society of Lifestyle Medicine. Diving into the heart of what it truly means to progress and come together as a society in Singapore. she challenges the conventional wisdom that primary care providers and preventive approaches are always aligned. Dr. Foong introduces Osler Health Services and their uniqueness as a primary care provider. At the core of our discussion is the concept of coaching in healthcare. Dr. Foong illuminates the distinction between a 10 minute and a 45 minute consultation. She introduces us to personalized healthcare right in the first consultation which is one of a kind that makes Osler different. This episode takes you to understanding the importance of one's health and the accessibility of Primary Healthcare as well as the new paradigm - Lifestyle Medicine. Dr. Foong advocates self-advocacy in healthcare which means that you are a participant in your own healthcare, working in partnership with doctors, and allied health professionals. Seeing the relationship with your health care team as a partnership helps make you part of decision-making and the management of your diagnosis and treatment. Prepare to be inspired and challenged as Dr. Foong guides us into the path of true healthcare reform. It is a worthy listen! Connect with Osler Health at:https://osler-health.com/Dr. Foong at:https://sg.linkedin.com/in/dr-tsinuin-foongBe sure you are subscribed to this podcast to automatically receive your episodes:Apple PodcastBuzzsproutDeezerListen Notes Google Podcast Podcast AddictPodchaser StitcherSpotifySupport the show

An excerpt from THE LIFE OF SIR WILLIAM OSLER wherein Dr. Osler recalls his first meeting with the great poet Walt Whitman. The definitive two volume biography on the life of Sir William Osler. Written by the father of modern neurosurgery, Dr. Harvey Cushing, 100 years ago. Read by Edison McDaniels Listen to the full, unabridged audiobook running almost 60 hours at on.soundcloud.com/ydPxw An epic telling of the birth of modern clinical medicine, by those who lived it. An amazingly detailed look at the life of a gentleman and illustrious physician of the 19th century. An intimate tell of medical history during a time it moved from its rudiments of 3,000 years to the foundations of modern practice. And Williams Osler, the preeminent physician of his day and the father of modern clinical medicine, seems to have been at the heart of it all. This biography is written by another esteemed physician, Harvey Cushing, the father of modern neurosurgery. The two volumes together are 60 hours long, of which the first 10 hours are now available on SoundCloud. It is a work in progress. This is a fascinating, intimate look at the greatest period of discovery in medical history, with remembrances of the likes of Virchow, Pasteur, Sydenham, Lister, Koch, and many, many others. This will make a great gift for that medical man or woman in your life. Listen now! This book is read by Edison McDaniels, MD The entire two volume narration is 60 hours long.

In a landscape where the clamor for gender equality within the corporate sphere continues to resonate, voices like Deborah's emerge, not merely as echoes, but as formidable calls to action. As a corporate governance champion, community builder, and agent of change, Deborah Rosati is the founder of a social purpose company, Women Get On Board, which fervently strives to increase female representation on corporate boards.   Founded in 2015, Women Get On Board is straightforward in its mission to get more women on boards, nested in the belief that one woman on a board is token, two is presence, and three is a voice. This powerful mantra propels the organization's actions, as they ceaselessly work towards normalizing women's voices in boardrooms, turning Deborah's passion into a persistent and tangible pursuit for gender parity.   The pursuit is more than a simple agenda; it is backed by data and research supporting the notion that diverse boards result in better decision-making, innovation, and ethical governance. In the backdrop of 2023 statistics from Osler, it's clear that despite an uptick in numbers—with female representation on Canadian public company boards nearing 30%, up from 12% in 2015—there's a significant journey ahead to reach the ideal of 50%.   Debra's conviction is rooted in the belief that women bring unique 'power skills' to the table, beyond their technical proficiency. Collaboration, empathy, and a heightened level of emotional intelligence (EQ) are among these characteristics that women offer, enriching the boardroom with diverse perspectives and approaches.   As a testament to her goal, Deborah's work extends beyond Women Get On Board. She shares insights into her early professional experiences, her encounters with gender biases, and the relentless determination that paved her way to success in both her corporate career as well as her entrepreneurial endeavors. Her personal narrative underscores the critical importance of fostering an environment where all genders can contribute valuably, reinforcing that gender diversity isn't about singling out one group but about enriching the collective spectrum of human potential.   “More women on boards, better decision making, more innovative decisions, more ethical decisions. Women in their leadership roles can bring diversity and bring different skill sets."~Deborah   Deborah is such an amazing, kind thoughtful person.  She is at the top of her game and nothing is going to stop this powerhouse trailblazer.   She is all about female empowerment, collaboration, and elevating all women.  To know her is to experience everything that is good in the world. I love this rockstar! She is one of the most humble, authentic, salt-of-the earth humans I know!    Follow : Deborah Rosati Website: www.womengetonboard.ca LinkedIn: https://www.linkedin.com/company/wgobcanada/ LinkedIn: https://www.linkedin.com/in/deborahrosati/ Instagram: https://www.instagram.com/wgobcanada/?hl=en Instagram: https://www.instagram.com/deborah_rosati/?hl=en   #iamunbreakable #iam#unbreakable #unbreakablewoman #unbreakablewomen #iamunbreakablemagazine #iamunbreakablepodcast #iamunbreakableglobalmedia #empoweredwomenempowerwomen #empowerment #empoweredwomen #empower #empowerwomen #empoweryourself #girlpower #yearofthegirl  #BoardDiversity #WomenInLeadership #Leadership #Diversity

A review of the Cardiovascular System Examination, involving a systematic approach to help remember the key points, including trickier parts to remember like the JVP and Osler's Nodes vs Janeway Lesions.  Consider subscribing on YouTube (if you found any of the info useful!): https://www.youtube.com/channel/UCRks8wB6vgz0E7buP0L_5RQ?sub_confirmation=1Patreon: https://www.patreon.com/rhesusmedicineBuy Us A Coffee!: https://www.buymeacoffee.com/rhesusmedicineTimestamps:0:00 Cardiovascular System Exam Structure0:25 Preparation - WIPE Mnemonic0:57 Cardiovascular System Assessment - General Inspection1:44 Cardiovascular System Assessment - Specific Inspection6:18 Cardiovascular System Assessment - Auscultation8:28 Cardiovascular System Assessment - Palpation and Percussion10:24 Concluding the Examination ReferencesKennedy, S. PACES Medical Education Leeds (2023) Cardiovascular Examination. Available at https://www.medicaleducationleeds.com/paces/cardiovascular-examination/OSCE Stop. Cardiac Examination. Available at https://oscestop.education/clinical-examination/cardiac-examination/Baliga, R. R (2001) 250 Cases in Clinical Medicine. Available at https://archive.org/details/250casesinclinic0000bali_03edPotter, L. Geeky Medics (2023) Cardiovascular Examination. Available at https://geekymedics.com/cardiovascular-examination-2/Please remember this podcast and all content from Rhesus Medicine is meant for educational purposes only and should not be used as a guide to diagnose or to treat. Please consult a healthcare professional for medical advice. 

An excerpt from THE LIFE OF SIR WILLIAM OSLER wherein Dr. Osler lectures on the three great lessons of life. The definitive two volume biography on the life of Sir William Osler. Written by the father of modern neurosurgery, Dr. Harvey Cushing, 100 years ago. Read by Edison McDaniels Listen to the full, unabridged audiobook running almost 60 hours at https://on.soundcloud.com/ydPxw An epic telling of the birth of modern clinical medicine, by those who lived it. An amazingly detailed look at the life of a gentleman and illustrious physician of the 19th century. An intimate tell of medical history during a time it moved from its rudiments of 3,000 years to the foundations of modern practice. And Williams Osler, the preeminent physician of his day and the father of modern clinical medicine, seems to have been at the heart of it all. This biography is written by another esteemed physician, Harvey Cushing, the father of modern neurosurgery. The two volumes together are 60 hours long, of which the first 10 hours are now available on SoundCloud. It is a work in progress. This is a fascinating, intimate look at the greatest period of discovery in medical history, with remembrances of the likes of Virchow, Pasteur, Sydenham, Lister, Koch, and many, many others. This will make a great gift for that medical man or woman in your life. Listen now! This book is read by Edison McDaniels, MD The entire two volume narration is 60 hours long.

Jennifer candidly shares about losing her husband, Ryan, in the line of duty at the age of 36remarriage & blended familyfriendship with husband's ex-wife ❤️ “God's word is perfect. Then the world steps in and says we're entitled.”❤️ “My stepdaughters didn't have to like me. They didn't have to love me, because they didn't choose me.” ❤️ “I didn't let her fear of loving me stop me from loving her.” Connect with Jennifer… http://www.jenniferoslerbolton.com Check out the whole video on YouTube https://youtu.be/DzjNkVfk9LA You can find “Ordinary People Extraordinary Things” anywhere you listen to podcasts or Check out the links below....⬇️ https://www.buzzsprout.com/1882033 https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5idXp6c3Byb3V0LmNvbS8xODgyMDMzLnJzcw==?fbclid=IwAR247ak35J8RZi5b7yy5bLckHABNYCBnwYxGS0NU1spsVtKqsxhFH4PCaZM https://www.iheart.com/podcast/269-ordinary-people-extraordin-89553427/ Https://podcasts.apple.com/us/podcast/ordinary-people-extraordinary-things/id1596670894 https://open.spotify.com/show/5wVEm2IUT7lpVGBdbgqagd https://www.youtube.com/@GenNancy ordinarypeoplestories@gmail.com https://www.facebook.com/ordinarypeoplestory https://www.instagram.com/ordinarypeopleextraordinary/ Twitter: @storiesextra Any advice should be confirmed with a qualified professional.All rights reserved: Ordinary People Extraordinary ThingsStories shared by guests may not always be shared views of OPET

Episode: 3291 Dr. Osler's harmonious intersection of medicine and literature.  Today, Dr. Osler's Sympathetic Vibration.

Thanksgiving is upon us, the holidays beckon. Yet we are in a time when the world feels increasingly fraught. Recalibrate your joie de vivre with the warm and wise Margaret Osler of the social media account Aging is Amazing. Margaret uses her account to focus on the small wonders and beauty of daily life, share supportive affirmations, and celebrate the joys of natural aging. If you are looking for a moment of Zen in the maelstrom of your week, if you need a reminder that this season of life brings remarkable gifts—as we become slowly wiser, truer, and more content, this conversation is for you! SHOW NOTES + TRANSCRIPT acertainagepod.com FOLLOW A CERTAIN AGE: Instagram Facebook LinkedIn GET INBOX INSPO: Sign up for our newsletter AGE BOLDLY We share new episodes, giveaways, links we live, and midlife resources CONTACT US: katie@acertainagepod.comSee omnystudio.com/listener for privacy information.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/GRP865. CME credit will be available until November 8, 2024.Reversal of Misfortune: Practical Insights for Managing Uncontrolled FXa-Inhibitor–Related Bleeding In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca LP.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresCo-Chair/PlannerTruman J. Milling Jr., MD, FACEP, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AstraZeneca; Cellphire, Inc.; CSL Behring; and Octapharma USA, Inc.Honoraria from AstraZeneca; Cellphire, Inc.; CSL Behring; and Octapharma USA, Inc.Co-Chair/PlannerW. Frank Peacock, MD, FACEP, FACC, FESC, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Abbott; BRAINBox Solutions, Inc.; F. Hoffmann-La Roche Ltd; Instrument Labs; Janssen Pharmaceuticals, Inc.; Osler; Siemens; Spinchip AS; and Vifor Pharma, Inc.Grant/Research Support from BRAINBox Solutions, Inc. and Quidel Corporation.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/GRP865. CME credit will be available until November 8, 2024.Reversal of Misfortune: Practical Insights for Managing Uncontrolled FXa-Inhibitor–Related Bleeding In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent educational grant from AstraZeneca LP.Disclosure PolicyAll relevant conflicts of interest have been mitigated prior to the commencement of the activity.Faculty/Planner DisclosuresCo-Chair/PlannerTruman J. Milling Jr., MD, FACEP, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for AstraZeneca; Cellphire, Inc.; CSL Behring; and Octapharma USA, Inc.Honoraria from AstraZeneca; Cellphire, Inc.; CSL Behring; and Octapharma USA, Inc.Co-Chair/PlannerW. Frank Peacock, MD, FACEP, FACC, FESC, has a financial interest/relationship or affiliation in the form of:Consultant and/or Advisor for Abbott; BRAINBox Solutions, Inc.; F. Hoffmann-La Roche Ltd; Instrument Labs; Janssen Pharmaceuticals, Inc.; Osler; Siemens; Spinchip AS; and Vifor Pharma, Inc.Grant/Research Support from BRAINBox Solutions, Inc. and Quidel Corporation.Planning Committee and Reviewer DisclosuresPlanners, independent reviewers, and staff of PVI, PeerView Institute for Medical Education, do not have any relevant financial relationships related to this CE activity unless listed below.

49ers beat writer for the San Francisco Chronicle, Scott Osler, joins KNBR Tonight with F.P Santangelo to discuss the 49ers loss to the Bengals and what has been concerning with the team during their 3 game losing streak.See omnystudio.com/listener for privacy information.

49ers beat writer for the San Francisco Chronicle, Scott Osler, joins KNBR Tonight with F.P Santangelo to discuss the 49ers loss to the Bengals and what has been concerning with the team during their 3 game losing streak.See omnystudio.com/listener for privacy information.

CardioNerds (Drs. Amit Goyal, Matthew Delfiner, and Tiffany Dong) discuss infective endocarditis with distinguished clinician-educator Dr. Michael Cullen. We dive into the nuances of infective endocarditis, including native valve endocarditis, prosthetic valve endocarditis, and right-sided endocarditis. Notes were drafted by Dr. Tiffany Dong, and audio editing was performed by student Dr. Adriana Mares. The CardioNerds Beyond the Boards Series was inspired by the Mayo Clinic Cardiovascular Board Review Course and designed in collaboration with the course directors Dr. Amy Pollak, Dr. Jeffrey Geske, and Dr. Michael Cullen. CardioNerds Beyond the Boards SeriesCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes The physical exam is crucial in the evaluation of infective endocarditis and includes cardiac auscultation and a search for sequelae of endocarditis, such as immunologic and embolic phenomena. The modified Duke Criteria categorizes the diagnosis of infective endocarditis into four different buckets: definite endocarditis by pathology, definite endocarditis by clinical criteria, possible endocarditis, and rejected. The diagnosis of endocarditis may involve several different imaging modalities, including transthoracic echocardiogram, transesophageal echocardiogram, 4D CT, and nuclear imaging. For left-sided endocarditis, indications to operate include endocarditis due to S. aureus or fungi, heart failure, evidence of perivalvular complications, persistent bacteremia, and large vegetations. The management of endocarditis often involves multiple teams, including cardiology, infectious disease, addiction medicine, neurology, anesthesiology, and cardiothoracic surgery. Notes What signs/complications of endocarditis are apparent on physical exam and labs? A new or worsening cardiac murmur with possible signs of volume overload. Vascular phenomena encompass splinter hemorrhages, conjunctival hemorrhages, Janeway lesions, mycotic aneurysms, and TIA/strokes. Immunologic phenomena include glomerulonephritis, Roth spots, and Osler nodes. Positive blood cultures with 2-3 samples collected. Elevated inflammatory markers. How does the modified Duke criteria assist in the diagnosis of infective endocarditis? The modified Duke criteria separate the diagnosis of endocarditis into four categories: definite endocarditis by pathology, definite endocarditis by clinical criteria, possible endocarditis, and rejected endocarditis. Definitive endocarditis by pathology requires pathologic confirmation of “bugs under the microscope.” Definitive endocarditis by clinical criteria requires two major criteria, one major and two minor criteria, or all five minor criteria. Possible endocarditis requires one major and one minor or three minor criteria. Major criteria:Positive blood culture for typical organism Evidence of endocardial involvement (e.g., vegetation on echo) Minor CriteriaPredisposing clinical factors (e.g., intravenous drug use, known valvulopathy)FeverImmunologic phenomenaVascular phenomena Blood culture for atypical organism What is the role of TTE compared to TEE in endocarditis? TTE and TEE both have their roles in the workup for endocarditis. TTE can provide a baseline screen and yield a better understanding of ventricular size and function than transesophageal. The strength of TEE is the ability to visualize smaller vegetations along with perivalvular complications that may be missed on TTE. If clinical suspicion is high for endocarditis, repeat echocardiography is warranted. What are other tools to evaluate for endocarditis in prosthetic valves? TTE and TEE remain important and should be commonly utilized for the diagnosis of endocarditis.

On October 13th, Canada's top court ruled that Canada's federal Impact Assessment Act (also known as Bill C-69 and sometimes called the “no-more-pipelines act”) is unconstitutional, with a 5-2 decision. To learn more about the decision and the implications for major projects in Canada and future environmental policy, we welcome Sander Duncanson, Partner, Regulatory, Indigenous, and Environmental at Osler to the podcast. Osler is a Canadian business law firm.   Sander was one of the authors of “Supreme Court of Canada finds the federal Impact Assessment Act unconstitutional,” a briefing published by Osler the day of the ruling.    Next, on the podcast, we talk with Chris Severson-Baker, Executive Director of the Pembina Institute, a Canadian environmental organization.  Here are some of the questions Jackie and Peter asked Chris: Have affordability issues reduced the focus on climate as a top concern? Do you see scenarios, such as the IEA's Net Zero Scenario, which assume a rapid decline in oil and natural gas demand as realistic? Do you agree with Alberta's moratorium on new permits for renewable projects? In your opinion, does Canada's oil and gas industry need a cap on its greenhouse gas emissions? What is Pembina's position on developing Canada's LNG export market? Do you view the plan for Canada to reach net-zero electricity by 2035 as achievable? What are your expectations for the upcoming COP28 meeting in Dubai?  Other content referenced in this podcast:  Danielle Smith's statement about the Supreme Court Ruling on X (formerly Twitter) Pembina's 2023 Alberta Climate Summit on October 26 in Calgary  Please review our disclaimer at: https://www.arcenergyinstitute.com/disclaimer/ Check us out on social media:X (Twitter): @arcenergyinstLinkedIn: @ARC Energy Research InstituteSubscribe to ARC Energy Ideas PodcastApple PodcastsGoogle PodcastsAmazon MusicSpotify

Rob Osler writes mysteries featuring LGBTQ+ main characters. Book one of his “Hayden & Friends” series, Devil's Chew Toy, was a best first novel finalist for the 2023 Anthony, Macavity, Agatha, and Lefty Awards. Book two, Cirque du Slay, arrives early next year. Rob's first-ever publication, Analogue (Ellery Queen Mystery Magazine), won the 2022 Robert L Fish Award at the MWA Edgar Awards. Other shorts include Miss Direction (EQMM Sept/Oct 2023) and (The Angels Wanna Wear My) Red Shoes, (Brutal & Strange: Stories Inspired by Elvis Costello Songs from Down & Out Books, Dec 2023). On the horizon is book one of a new historical series, Harriet Morrow Investigates, set in Chicago and featuring a queer female detective during America's Progressive Era (Kensington Books, January 2025).From Podcast:Queer Crime Writers http://queercrimewriters.com/Ellery Queen https://www.elleryqueenmysterymagazine.com/Rob's Social Media:Facebook Page www.facebook.com/roboslerwriterTwitter www.twitter.com/roboslerInstagram www.instagram.com/roboslerwriterWebsite https://robosler.com/*****************About SinC:Sisters in Crime was founded in 1986 to promote the ongoing advancement, recognition and professional development of women crime writers. Through advocacy, programming and leadership, SinC empowers and supports all crime writers regardless of genre or place on their career trajectory.www.SistersinCrime.orgInstagram: https://www.instagram.com/sincnational/Twitter: https://twitter.com/SINCnationalFacebook: https://www.facebook.com/sistersincrimeThe SinC Writers' Podcast is produced by Julian Crocamo https://www.juliancrocamo.com/

Sandra Cohen returns to “The Future is Bright” podcast for part two of her interview with Chris and to tell the story of how she became an executive compensation attorney at Cohen & Buckmann pc. Her journey was a steady upward trajectory where her fierce sense of independence and ambition served her well at every step. A Midwestern girl, she moved to New York City right out of college, looking for a more cosmopolitan experience. Within five days, she secured a job in HR at Manufacturers Hanover thanks to an informational interview with a Washington University alumnae. Much of her business still comes from relationships she formed years ago, and Sandra advises young lawyers on long-term business development, taking initiative to form groups, and establishing yourself early on as a thought leader. Those with more experience should individuate themselves so that they aren't as reliant on their boss's view of their work. She explains what her job is and is not, what she still loves about it years later, and the unique challenges of the position.  Recognizing that most executives in HR were lawyers, she enrolled in Yale law and upon graduating got a job with the Canadian branch of Osler, Hoskin and Harcourt. Though she saw prime examples of female leaders at this firm who were able to admirably balance work and life, sometimes, Sandra confesses, it's not balanced at all. As she tells her students at NYU, for the sake of both your personal and professional success, choose your spouse wisely.   In between family and work, it's important to make time for fun. Hear Sandra discuss her hobbies– including a dedicated equestrian practice–and how she makes the best of New York's incomparable nightlife.  Quotes “I'm still fascinated by the psychology of it, how groups work and how office politics work. And that still informs part of my job as an executive comp, attorney, helping organizations find what's the right incentive for their company, and why are they pursuing the stock option plan, do they have the other pieces other than money also in place?” (7:31 | Sandra) “Find something that interests you enough to write about and talk about, so that you have shown thought leadership, create your own blog, if your law firm doesn't have one, it doesn't matter. Write on LinkedIn, you don't have to get published by a major publisher to show that you know what you're talking about.” (22:11 | Sandra) “It's not who you know, it's who knows you.” (23:00 | Sandra)  “I think business development is really like watering a tree…And if you want to be sort of strategic and calculating about it, it's like, okay, how do I get more people to have known me a long time.” (23:34 | Sandra)    Links Connect with Sandra Cohen: Website Bio https://cohenbuckmann.com/sandra-w-cohen LinkedIn Profile https://www.linkedin.com/in/sandracohenesq/ Top Seven Questions Executives Should Ask About Private Company Stock Options https://cohenbuckmann.com/insights/2020/7/13/top-seven-questions-executives-should-ask-about-private-company-stock-options Profits Interests 101: A Crash Course in Profits Interests https://cohenbuckmann.com/insights/2022/7/27/profits-interests-101-a-crash-course-in-profits-interests Connect with Chris Batz: LinkedIn: https://www.linkedin.com/in/chrisbatz/  Facebook: https://www.facebook.com/theliongroupkc  Instagram: @theliongroupllc Podcast production and show notes provided by HiveCast.fm  

I love having guests on, but even more I love it when I PERSONALLY know and love this person.  Today is such a situation. I met Jenn about 14 or 15 years ago during a gymnastics class our daughters were taking.  You know when you meet someone and you instantly love them...that was Jenn! Since then the Lord has walked her through some pretty intense trials...she's a mom to two kiddos with her first husband who was tragically killed and a stepmum to two daughters when she remarried their dad...who happens to be from Ireland...hence "step-mum".  She has a love and passion for the Lord that I envy and desire. She shared a post on IG the other day and I text her right away - I asked if she'd talk about intentionally prioritizing her marriage to all of you...because I know I am blessed by what she shares and I know you will be too! You can find Jennifer on IG - @jjoslerbolton Let's get started! xx, michelle ______________________________ I'm in a phase of simplification...as a result you can find me in three places... 1. HERE - the podcast! 2. Instagram - @itsmemichellecastro 3. Email - itsmemichellecastro@gmail.com BONUS: you can also find me living out my best DIY life over at @flipflopsandtablesaws on instagram.

Its symptoms are like those of a heart attack. We're talking about the vulnerable heart, on this week's Ageless Glamour Girls Podcast. As we continue our summer break, we're revisiting another popular and very important episode: “Broken Heart Syndrome.”  It first aired in March of last year - our debut season.  Broken Heart Syndrome can happen when you experience sudden acute stress. And get this - a study published last year, suggests cases of the condition are increasing in middle-aged and older women. The good news is it's treatable. The study's senior author, Dr. Susan Cheng of the Smidt Heart Institute at Cedars-Sinai in Los Angeles, joined us to discuss the findings and solutions.******************* GUEST: Dr. Susan Cheng BIO: Susan Cheng, MD, MMSc, MPH is the Erika J. Glazer Chair in Cardiovascular Health and Population Science, director of Cardiovascular Population Sciences, and director of Public Health Research in the Smidt Heart Institute at Cedars-Sinai. Dr. Cheng is a cardiologist, echocardiographer, and clinician-scientist who leads research programs aimed at uncovering the drivers of cardiovascular aging in women and men. She received her bachelor's degree from Harvard College, a medical degree from McMaster University, Master of Medical Science from MIT, and Master of Public Health from Harvard. Dr. Cheng completed Osler internal medicine training at the Johns Hopkins Hospital and cardiology training at the Brigham and Women's Hospital and Harvard Medical School, where she then served as cardiology faculty and associate director of the Cardiovascular Imaging Core Laboratory. She is co-director of the Framingham Heart Study Echocardiography Laboratory and co-director of the international Bioactive LipidsNet Consortium.Dr. Cheng has served on the editorial boards of major cardiovascular and imaging journals as well as on leadership committees for the American Heart Association and American College of Cardiology. She has chaired and contributed to the American Heart Association's scientific statements on research methods, heart disease statistics, and the cardiovascular care of older adults. Dr. Cheng has authored over 350 publications and her work has been recognized with multiple awards and supported by continuous NIH funding.https://researchers.cedars-sinai.edu/Susan.Cheng  Support the showHi! Welcome to the Ageless Glamour Girls Podcast! I'm your host, Marqueeta Curtis-Haynes, Founder and CEO of the Ageless Glamour Girls lifestyle brand, and the administrator of a private Facebook group called "The Ageless Café." The show explores all things aging, to inspire and help empower women age 50+ to navigate this new season of transformation. Podcast episodes drop on Wednesdays. You can reach us at: info@agelessglamourgirls.com. Don't forget to subscribe to the podcast. And thanks for the love, Luvvies!

BW was a 66-year-old woman who presented for an urgent visit to the general medicine clinic. She reported that she had been having dizziness for the last four days. When pressed, she said it occurred intermittently, being present more than absent. She could not identify any palliative or provocative features, and when asked about associated symptoms she said that she felt “bad and scared” when it was present. The doctor encouraged her, many times, to characterize the dizziness, and she could only say that when she had it, she felt dizzy.Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.Many a medical trainee has been humiliated on morning rounds after proclaiming that their presentation was wanting because the “patient was a poor historian.” Any attending worth her white coat will respond in one of the following ways:“There are no poor historians, just poor history-takers.”“You do realize, don't you, that the patient is not the historian? You are the historian.”“Did you consider the differential diagnosis of why you were unable to obtain a useful history?”I admit that, going for pith over constructive criticism, I employ the former two more than the latter one. There is a differential diagnosis for the patient who cannot describe the history of their medical concerns.Often, the inability of a doctor to obtain a history is actually a physical exam finding – an extremely non-specific finding, but a finding nonetheless. Psychiatric disease, dementia, and delirium (whose differential diagnosis itself is practically a textbook of medicine) will render a patient unable to provide an accurate history. I can recall dozens of “poor historians'' who became Robert Caro-esque once their hypercapnea, uremia, or alcohol withdrawal was treated.There are three other reasons that obtaining reliable and informative histories might be a struggle.1.      We think with languageThe first — the saddest, most troublesome, and probably most common – reason that patients are unable to provide a reliable history is because of their impaired language skills. Not only do we use language to communicate, we also use language to think. George Orwell wrote, “…if thought corrupts language, language can also corrupt thought.”[i]Those of us who failed to master language, usually through inadequate education, are unable to express their health concerns clearly. Sometimes, listening to a patient try to describe symptoms, I get the sense that the problem is more than expressive.BW was not an especially striking example of this for me, she was just one of the more recent. She also presented with a problem for which an accurate history is critical. The history of a patient's dizziness radically alters the differential diagnosis. We teach trainees that the first question to pose to a patient with dizziness is, “What do you mean, dizzy?” We tell the trainee to ask the question and then sit back and listen. More often than not, patients will describe their dizziness in a way that can be interpreted as lightheadedness, vertigo, unsteadiness, or a non-specific feeling of being unwell.[ii]As I interviewed BW, my sense was that she not only struggled to articulate what she was feeling but to figure it out herself. Beyond my frustration in having trouble caring for her, I considered the lifelong impact of leaving people educationally impoverished. Sure, we limit people's earning potential, but we also limit their internal life and their healthcare.2.      Anxiety affects how we experience symptomsVG is a patient I have seen for years, from his mid 30's to his early 60's. He has a few very mild chronic medical conditions and very severe anxiety disorder. He is a successful professional but struggles with intermittent episodes of health-related anxiety.Our interactions usually begin with an email or a phone call. VG will have become anxious about a new symptom. The symptom is real – joint pain, a rash, a new floater. The symptom has generated a web of worry about what it could portend. The worries are always baseless and would be amusing if they were not so clearly painful and disturbing to him.I have learned that for VG, as well as for many patients like him, these concerns require a visit. An accurate history cannot be obtained without seeing him. The anxiety clouds VG's experience of the symptom. The knee pain becomes excruciating, the rash ubiquitous, the floater debilitating. The response to simple questions -- Is the knee pain worse coming down the stairs? Where is the rash? Do you see the floater in one or both eyes? -- become unreliable. Seeing VG, providing some reassurance, and obtaining objective physical data is imperative.3.      Secondary gain“Listen to your patient; he is telling you the diagnosis” is is an Osler (or merely Oslerian) quotation. From the earliest days of our training we are taught to listen to our patients and believe what they are telling us. Our greatest sin in history taking is that we interrupt too soon and too often. We ask closed-ended and leading questions. When the answer to a question doesn't align with our hypothesis, we either ignore the response or doubt its veracity.However, patients are people and people lie. Patients exaggerate the symptoms of their sinus infection to get an antibiotic prescription. Patients tell you that their oxycodone or Ambien fell in the sink or toilet so they can get an early refill.[iii] I have had numerous people appear on my schedule with the chief concern of “chest pain” documented by the nurse. When I ask, “Tell me about your chest pain?” the patient responds, sheepishly, “I'm not actually here for chest pain but I really needed to see you and I knew that would get me in.”Some of these untruths are the proverbial chickens coming home to roost. Patients exaggerate symptoms because they fear they will not otherwise be taken seriously. They fear mild but troublesome or worrisome symptoms will be met with:“Let's just watch that.”“That doesn't really sound like it warrants treatment.”“If it hurts to bend your arm, don't bend your arm.”Most everyone learns at some point the factoid that 80% of diagnoses come from the medical history. However, contrary to a standardized test on which the medical history is presented in a paragraph of clean prose, it requires skill to obtain a medical history. A novice will take longer than an expert to extract a less accurate history. From some patients, however, not even an experienced physician can obtain a cogent medical history. This failure may be a clue to an underlying diagnosis. It may also be related to a person's education, their health-related anxiety, or their effort, conscious or unconscious, to influence the doctor. [i] Orwell obviously took this idea to in a frightening direction in 1984 describing a government that uses the control on language to control thought.[ii] We often jokingly describe this last type of dizzy as “dizzy dammit” – as in “I am just dizzy, dammit.”[iii] It is interesting that people only drop opiates, benzodiazepines, and stimulants in the sink. Nobody has every dropped an SSRI, statin, or antibiotic. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

THE LIFE OF SIR WILLIAM OSLER Written in 1924 by Harvey Cushing, MD (the father of modern neurosurgery) An epic telling of the birth of modern clinical medicine, by those who lived it. An amazingly detailed look at the life of a gentleman and illustrious physician of the 19th century. An intimate tell of medical history during a time it moved from its rudiments of 3,000 years to the foundations of modern practice. And Williams Osler, the preeminent physician of his day and the father of modern clinical medicine, seems to have been at the heart of it all. This biography is written by another esteemed physician, Harvey Cushing, the father of modern neurosurgery. The two volumes together are 60 hours long, of which the first 10 hours are now available on SoundCloud. It is a work in progress. This is a fascinating, intimate look at the greatest period of discovery in medical history, with remembrances of the likes of Virchow, Pasteur, Sydenham, Lister, Koch, and many, many others. This will make a great gift for that medical man or woman in your life. Listen now! This book is read by Edison McDaniels, MD The entire two volume narration is 60 hours long. Listen to more of this audiobook for free at soundcloud.com/edisonaudio/sets/151-the-life-of-william-osler Follow me on FACEBOOK: facebook.com/audiobook.narrator.edison.mcdaniels YOUTUBE: www.youtube.com/@EdisonAudio INSTAGRAM: www.instagram.com/surgeonwriter/ PODCAST: podcasts.apple.com/us/podcast/the-…st/id1547756675 Check out my other great titles on AUDIBLE! Just search for Edison McDaniels.

Wildix has positioned itself to stand out in the crowded communications crowded market. “We decided to go 100% to the channel, says Steve Osler, CEO Wildix. Recorded at the Wildix Partner Day Conference in Chicago, this podcast walks us through a top-level view of how Wildix has positioned itself to stand out in the crowded communications crowded market. The largest message of the conference and the podcast was Wildix's absolute focus on the channel, and on making each partnership really work. According to Osler that includes three big ideas: commitment to keeping the partner as the only customer facing presence, delivering to the customers unique experiences that are only offered by their Wildix partner, and offering products that keep the partner as the customer's problem solver. Osler walks us through the special retail solution called x-hoppers, a complete retail communications solution that uses AI and tackles head on retail challenges by engaging consumers and helping to maximize scarce labor resources. We learn how x-hoppers boosts sales and cuts labor time in unproductive tasks. We also hear about x-bees, a customer communications platform built to boost sales for clients that are more B2B, where other tactics are needed to engage business customers. Osler reports that his company has one of the lowest churn rates in the industry because Wildix supports their partners and continues to enable the channel to offer inventive solutions to their clients. Visit www.wildix.com  

For the week of June 14th, 2023, Episode 14 of Season No. 6, host Ted Stovin is joined by guest host Dustin Edwards.  Ted speaks with the President and Chairman of the Board for the Calgary Stampede and Partner, Bennett Jones Mr. Will Osler ahead of the 100 Years of Chuckwagon Racing at the Calgary Stampede which starts on July 7th this year. Will's cousin is Bret "The Hitman" Hart of the former Stampede Wrestling and WWF/WWE Fame so there are a few stories about that as well as Will's time at the C Lazy S and his path to being President.    For more episodes of COWBOY SH!T™️ and to shop all things, Cowboy Shit, visit CowboyShit.ca

Dr. Turner Osler studied anthropology at Princeton, before becoming a surgeon and research epidemiologist. After 30 years working at the University of Vermont's trauma center, Dr. Osler left the operating room and began a career as a research epidemiologist, which required hours of sitting at a computer, resulting in unrelenting back pain. Being an expert on the spine, he decided to try to design a chair that would work with, rather than against human anatomy and physiology. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit chrisryan.substack.com/subscribe

By Davy Crockett Thomas Joseph Osler (1940-2023) of Camden, New Jersey, was a mathematician, former national champion distance runner, and author. His published running training theories have made a deep impact on distance running for multiple generations. His book, Serious Runner's Handbook became a classic book on running. He was the first to verbalize in a way that was really understandable to most athletes. Runner's World wrote, "Tom Osler was among those who helped push and pull America toward the running mania of the 1970s." His pioneer 1976 24-hour run in New Jersey brought renewed focus on the 24-hour run in America. He won multiple national championships and was inducted into the Road Runners Club of America Hall of Fame. During his running career, he ran in more than 2,100 races of various distances. Of his youth, Osler said, “I was a sickly little kid at 12 or 13 and didn't have many friends. This annoyed me, so I decided to leap head-first into every sport there was. I was terrible. I came home night after night looking like an ad for the Blue Cross." He was an excellent student, but purposely lowered his grades for a while in order to fit in as a “regular guy.” He said, "One day a bunch of us decided to see who could run the most around a field and to my shock I could out jog everybody. So that's when I realized I was born to be a runner!" His gang in his neighborhood picked distance running as "that day's form of athletic torture." When he was still 13 in 1954. He jumped in head-first and started to run. He learned about track from his brother-in-law and discovered that there were races of a mile and further. He also learned about the current local running hero and Olympian, Browning Ross (1924-1998). Browning Ross wins the 1954 AAU 30K Championship. Young Tom Osler on left. "I read in the newspaper that there was going to be this big race in Atlantic City, the National 30-kilometer championship and it was going to start and finish on the Boardwalk at Steel Pier. I got myself a bus ticket and went down there and stood in front of Steel Pier and waited for this race. I remember thinking that runners must be very powerful people—big muscles, well developed like Mr. Atlas! And what shows up but all these skinny people. It was a national championship, but I doubt it had more than 20 or 25 people in it. That's how it was in those days. Browning Ross showed up and I couldn't believe what a small rather insignificant looking human being this hero of mine that I'd read so much about was. The race was several laps, so you saw them come by several times." Someone asked Osler to hold the string at the finish line as Ross won the race and he got in the finishing picture. Osler said, "I lived in a row house in Camden, New Jersey and there was a Mack truck factory at the end of the block that we estimated occupied a quarter of a mile. So, I ran around the block four times. My brother-in-law looked at the kitchen clock to time it and it came out to something like six and a half or seven minutes. We figured with a year's training we could probably get it down to a good racing speed. Which I did." He had dreams he would be the first person to break the four-minute mile. He said, “When you are young, you have dreams that seem very attainable. Every day, I went out and ran four times around the block as fast as I could. So, in a year I went out for the track team as a sophomore at Camden High and was their best miler-- I ran a 5:10. I was the only person running year-round that I knew of. In 1954, England's Roger Bannister was the first to break the four-minute mile barrier, which crushed Osler's dream. His best mile was 4:54, which was disappointing to him, but he was one of the best high school milers in Camden. He finished his first marathon when he was 16 years old with a time of 3:27. In high school, he excelled in his classes, especially in the sciences.