Podcasts about perelman school

Grant funding by the National Science Foundation has been cut by more than half this year, bringing the foundation's science funding to its lowest level in decades. Katrina Miller, who covers science for the New York Times, joins Host Flora Lichtman to unpack the cutbacks and discuss where the funding changes might lead.And, the FDA has cleared a blood test to help diagnose Alzheimer's disease. The first-of-its-kind test measures the levels of amyloid and tau proteins in a patient's blood, two major biomarkers of the disease. Alzheimer's researcher Jason Karlawish joins Flora to explain this new diagnostic tool and what it means for patients.Guests:Katrina Miller is a science reporter for The New York Times based in Chicago.Dr. Jason Karlawish is a professor of medicine, medical ethics and health policy, and neurology at the University of Pennsylvania's Perelman School of Medicine, and co-director of the Penn Memory Center, based in Philadelphia, Pennsylvania.Transcripts for each segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

The Rich Zeoli Show- Hour 4: 6:05pm- On Thursday, the Trump Administration threatened to withhold federal funding from several sanctuary cities—including Philadelphia, New York City, Los Angeles, and Chicago—if they don't comply with federal law enforcement authorities seeking to crackdown on illegal immigration and the deportation of dangerous migrants residing in the country unlawfully. 6:15pm- While appearing on CNN, White House Deputy Chief of Staff Stephen Miller absolutely destroyed host Pamela Brown when she attempted to downplay border security and the deportation of potentially dangerous migrants who entered the U.S. unlawfully. 6:30pm- Friday marked Elon Musk's last day leading the Department of Government Efficiency (DOGE). President Donald Trump praised Musk's work, highlighting several instances of federal waste that were discovered under his leadership: $101 million for DEI contracts at the Department of Education, $59 million for illegal alien hotel rooms in New York City, $45 million for DEI scholarships in Burma, $42 million for social and behavioral change in Uganda, $20 million for Arab Sesame Street, and $8 million for making mice transgender. As a thank you, Trump presented Musk with a golden key to the White House. 6:40pm- Dr. Stanley Goldfarb—Chairman of Do No Harm & a Professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania—joins The Rich Zeoli Show to discuss Penn Medicine's decision to stop performing sex-change surgeries on children. They will, however, continue to prescribe irreversible puberty blockers for children.

Paul Offit, MD, Director of the Vaccine Education Center at the Children's Hospital of Philadelphia and the Maurice R. Hilleman Professor of Vaccinology, Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania, identifies himself as a "vaccine skeptic"–someone who demands data and evidence–which he believes is the appropriate stance for medical professionals and regulators.After the Cutter incident in 1955, which resulted in 250 cases of polio caused by batches of polio vaccine containing live polio virus given to the public, the FDA took up this mantle in evaluating vaccines. He warns that public discourse has moved dangerously past healthy skepticism into harmful cynicism, particularly through conspiracy theorists who dismiss scientific evidence by claiming researchers are "in the pocket of Big Pharma." This cynicism threatens public health as vaccine-preventable diseases like measles and pertussis are re-emerging due to declining vaccination rates, with polio potentially following if immunization continues to decrease.Host⁠⁠⁠⁠⁠Lori Ellis⁠⁠⁠⁠⁠, Head of Insights, BioSpaceGuestsPaul Offit, MD, Director of the Vaccine Education Center, Children's Hospital of Philadelphia; Maurice R. Hilleman Professor of Vaccinology and a Professor of Pediatrics, Perelman School of Medicine, University of PennsylvaniaDisclaimer: The views expressed in this discussion by guests are their own and do not represent those of their organizations.

In this special episode on wisdom, Zac and Jay sit down with Dr. Sheldon Goldberg — known affectionately as Dr. G — a pioneering interventional cardiologist whose medical career spans over five decades. Dr. Goldberg serves as Clinical Professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania and Director of Cardiovascular Education and Research at Pennsylvania Hospital. With over 150 publications, 8,000 citations, and a central role in the groundbreaking STRESS trial that helped establish the use of coronary stents, Dr. Goldberg's impact on the field is both deep and lasting.Together, they explore not just the evolution of cardiology — from the earliest days of interventional procedures to today's cutting-edge treatments — but also the deeper lessons he's learned about healing, resilience, and what keeps the human heart beating in more ways than one.The conversation moves from the hard truths about smoking, alcohol, and lifestyle choices to a candid critique of America's broken medical system. Dr. Goldberg reflects on the emotional toll of medicine, the difficulty of balancing work and family, and why humility and human connection matter more than ever in an era increasingly dominated by AI and corporate healthcare.Zac and Jay also dig into the personal: What does a man who's saved thousands of lives regret? What keeps him motivated? And what would he tell the next generation of doctors who are stepping into a vastly different world?This is a rich, revealing, and profoundly human conversation about medicine, mortality, and meaning.Connect with Zachttps://www.instagram.com/zwclark/https://www.linkedin.com/in/zac-c-746b96254/https://www.tiktok.com/@zacwclarkhttps://www.strava.com/athletes/55697553https://twitter.com/zacwclarkIf you or anyone you know is struggling, please do not hesitate to contact Release:(914) 588-6564releaserecovery.com@releaserecovery

Click here to send us a topic idea or question for Weekend Wisdom.Do you want to raise kids who you will like and want to hang out with as adults? Listen to this interview with Dr. Ginsburg, a pediatrician at Children's Hospital of Philadelphia and professor of pediatrics at U Penn's Perelman School of Medicine. He is the author of Lighthouse Parenting: Raising Your Child With Loving Guidance for a Lifelong Bond, and the founder of the Center for Parent and Teen Communication.In this episode, we discuss:Definition of Lighthouse Parenting (7 key elements):StabilityModeling & KnowingCommunicatingProtectingResilience & ThrivingPreparationReliabilityBenefits of Lighthouse/Balanced ParentingMisunderstanding of attachment/trauma-sensitive parenting as permissive parenting.Self-care as the foundation of Lighthouse Parenting, “Stability: Finding Your Footing.” Why start there? Why is self-care critical to being a balanced parent?6 key elements of self-care and examples of how each might look for parents and caregivers who feel they cannot prioritize self-care:Love and friendshipsSleepExercise/MovementRelaxation strategiesExpress emotionsRecognize and reach for supportOffer 1 or 2 practical tips for parenting with this lifelong bond in mind for parents with: Elementary-aged kidsTweens and teensYoung adults (college or early career age)Support the showPlease leave us a rating or review. This podcast is produced by www.CreatingaFamily.org. We are a national non-profit with the mission to strengthen and inspire adoptive, foster & kinship parents and the professionals who support them.Creating a Family brings you the following trauma-informed, expert-based content: Weekly podcasts Weekly articles/blog posts Resource pages on all aspects of family building

In a conversation with CancerNetwork®, Oluwadamilola “Lola” Fayanju, MD, MA, MPHS, FACS, discussed the key findings from a study she published in JAMA Network Open, which demonstrated that most patients with inflammatory breast cancer do not receive all available types of guideline-concordant care they are eligible for. Additionally, data showed disparities regarding receipt of modality-specific therapy among patients who were Black, Asian, Hispanic, or other racial minority populations. Based on these findings, Fayanju highlighted potential next steps for mitigating these gaps in care for certain patients with breast cancer. These strategies included revising stringent inclusion criteria for clinical trial enrollment, which may disproportionately exclude racial minority populations who have higher rates of diabetes or other medical conditions. Fayanju also emphasized educating clinicians across different oncology specialties to recognize how different populations present with inflammatory breast cancer and better understand the context in which patients receive treatment. “I hope [the study] makes some people angry…Frustration can be a wonderful fuel,” Fayanju stated regarding her research. “[By] recognizing that there isn't as much guideline-concordant care receipt amongst all people as there should be and the hope that's provided when we achieve concordant care, we can mitigate and eliminate racial disparities. I hope [that] will motivate people to think about how we can get more guideline-concordant care to more people and how we can incorporate diverse populations in the development of guidelines for concordant care at the beginning. Then, how can we also develop treatments that achieve efficacious results across diverse populations?” Fayanju is the Helen O. Dickens Presidential Associate Professor, chief in the Division of Breast Surgery at Penn Medicine, surgical director of Rena Rowan Breast Center, director of Health Equity Innovation at Penn Center for Cancer Care Innovation (PC3I), and senior fellow at Leonard Davis Institute of Health Economics (LDI), Perelman School of Medicine at the University of Pennsylvania. Reference Tadros A, Diskin B, Sevilimedu V, et al. Trends in guideline-concordant care for inflammatory breast cancer. JAMA Netw Open. 2025;8(2):e2454506. doi:10.1001/jamanetworkopen.2024.54506

Send us a textIn this conversation, Dr. Paul Offit and pediatrician Jessica Hochman discuss the importance of vaccinations, the challenges of vaccine hesitancy among parents, and the need for nuanced conversations in public health. They explore the impact of the COVID-19 pandemic on public trust, and the science behind vaccination schedules. The discussion emphasizes the importance of understanding parental concerns while advocating for the safety and efficacy of vaccines. About Paul A. Offit, MD!Paul A. Offit, MD, is Director of the Vaccine Education Center and professor of pediatrics in the Division of Infectious Diseases at Children's Hospital of Philadelphia. He is the Maurice R. Hilleman Professor of Vaccinology at the Perelman School of Medicine at the University of Pennsylvania.Dr. Offit is an internationally recognized expert in the fields of virology and immunology, and was a member of the Advisory Committee on Immunization Practices to the Centers for Disease Control and Prevention. He is a member of the Food and Drug Administration Vaccines and Related Biological Products Advisory Committee, and a founding advisory board member of the Autism Science Foundation and the Foundation for Vaccine Research, a member of the Institute of Medicine and co-editor of the foremost vaccine text, Vaccines.He is a recipient of many awards including the J. Edmund Bradley Prize for Excellence in Pediatrics from the University of Maryland Medical School, the Young Investigator Award in Vaccine Development from the Infectious Disease Society of America, a Research Career Development Award from the National Institutes of Health, and the Sabin Vaccine Institute Gold Medal.Dr. Offit has published more than 160 papers in medical and scientific journals in the areas of rotavirus-specific immune responses and vaccine safety. He is also the co-inventor of the rotavirus vaccine, RotaTeq, recommended for universal use in infants by the CDC. For this achievement, Dr. Offit received the Luigi Mastroianni and William Osler Awards from the University of Pennsylvania School of Medicine, the Charles Mérieux Award from the National Foundation for Infectious Diseases, and he was honored by Bill and Melinda Gates during the launch of their Foundation's Living Proof Project for global health.In 2009, Dr. Offit received the President's Certificate for Outstanding Service from the American Academy of Pediatrics. In 2011, he received the Humanitarian of the Year Award from the BiologicDr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner. For more content from Dr Jessica Hochman:Instagram: @AskDrJessicaYouTube channel: Ask Dr JessicaWebsite: www.askdrjessicamd.com-For a plant-based, USDA Organic certified vitamin supplement, check out : Llama Naturals Vitamin and use discount code: DRJESSICA20-To test your child's microbiome and get recommendations, check out: Tiny Health using code: DRJESSICA Do you have a future topic you'd like Dr Jessica Hochman to discuss? Email Dr Jessica Hochman askdrjessicamd@gmail.com.The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.

Dr. Russell Ramsay is a co-founder of the Penn Adult ADHD Treatment and Research Program, and served as professor of clinical psychology in the department of psychiatry of the Perelman School of Medicine at the University of Pennsylvania.He is author of many books on ADHD, his most recent book is Rethinking Adult ADHD: Helping Clients Turn Intentions into Actions (2020). In addition he has a popular blog on psychology today, rethinking adult ADHD. Find out more about Dr. Ramsay here - https://www.cbt4adhd.com/about/In today's episode we discuss, what it means to be diagnosed with ADHD, how patients should consider whether or not to take medication, how ADHD can be treated psychologically, how CBT should be adapted for ADHD, how people can improve their focus and much more. Interviewed by Dr. Alex Curmi. Dr. Alex is a consultant psychiatrist and a UKCP registered psychotherapist in-training.Alex's latest Guardian article: https://www.theguardian.com/books/2025/mar/31/the-big-idea-should-you-trust-your-gutTedX conference tickets: https://tedxlondonbusinessschool.co.uk/If you would like to invite Alex to speak at your organisation please email alexcurmitherapy@gmail.com with "Speaking Enquiry" in the subject line.Alex is not currently taking on new psychotherapy clients, if you are interested in working with Alex for focused behaviour change coaching , you can email - alexcurmitherapy@gmail.com with "Coaching" in the subject line.Give feedback here - thinkingmindpodcast@gmail.com - Follow us here: Twitter @thinkingmindpod Instagram @thinkingmindpodcast Tiktok - @thinking.mind.podcast 

In this fascinating interview, Dr. Matt Bernstein explains the groundbreaking and fast developing field of metabolic psychiatry, and outlines the ways diet, exercise, and other lifestyle factors can radically transform mental health outcomes. He explains why metabolic dysfunction is  common to all manifestations of poor mental health, and why metabolic intervention can have profound benefits to all mental health disorders. Dr. Matt Bernstein is Chief Medical Officer at EllenHorn Clinic, where he pursues alternative ways to help individuals achieve their best levels of functioning and happiness without relying solely on traditional psychiatric approaches, instead focussing on metabolism, nutrition, circadian-rhythm, biology, mind-body and exercise, He is also Chief Executive Officer at Accord, a residential clinic implementing metabolic psychiatry approaches to mental health, and is  one of the leading voices in the emerging field of metabolic psychiatry.  Dr. Bernstein received his medical degree from the Perelman School of Medicine at the University of Pennsylvania. He then trained at the MGH McLean Psychiatry Residency Program, where he served as chief resident and psychiatrist-in-charge, and later as assistant medical director of its schizophrenia and bipolar inpatient programme.  In this episode, learn why metabolism and mitochondrial health is at the core of our mental health, why merely reducing symptoms is not the desired outcome, and how Dr. Matt Bernstein helps his patients function at their best and happiest in everyday life. Discover why diet is the most powerful intervention, and why behavioural choices, such as exercise, mind-body practices and circadian-rhythm alignment, deepen healing by improving metabolism.    In this episode learn about: How Dr. Matt Bernstein discovered metabolic psychiatry and why it is so effective  in treating  mental health conditions, including psychosis, schizophrenia, bipolar disorder, depression, addictions, eating disorders, OCD, ADHD, and more. How metabolic psychiatry works without traditional psychiatric approaches, and why mainstream medicine often falls short in addressing the root-causes of mental health issues. Why the treatment goal is for patients to thrive in everyday life, rather than merely reducing symptoms. The link between metabolic dysfunction and mental health: how metabolic imbalances contribute to depression, anxiety, and treatment-resistant chronic disorders. How lifestyle interventions can reverse metabolic dysfunction: the role of ketogenic diets, exercise and circadian rhythms in improving metabolic and mental health. Key data and case studies that highlight the potential of metabolic psychiatry to transform mental health, and ways evidence is beginning to reveal that metabolic treatments outperform pharmaceuticals. How improving mitochondrial function boosts neurotransmitter function, BDNF, GABA-glutamate ratio, while reducing neuroinflammation and decreasing oxidative stress. Why mitochondrial health is fuelled by ketosis, and why good mitochondrial health profoundly improves our metabolism and mental health symptoms. Ways a ketogenic diet is a ‘miracle drug', and how it can cure treatment-resistant mental health disorders and reduce anxiety and depression. What a ‘clean' ketogenic diet looks like: the importance of high-quality whole foods and the targeted roles of fibre, proteins, cholesterol, and fats in optimising brain health. How to reach ketosis as a vegetarian or vegan, and practical guidance for those following plant-based diets. Root causes of poor mitochondrial health: how childhood trauma, toxins, pollutants, nutrient deficiencies, ultra-processed foods, sugar, and circadian rhythm dysregulation impact metabolism and mental health. An overview of Dr. Matt Bernstein's 4-week minimum residential programme Accord, and how the programme uses diet, mind-body practices and circadian rhythm alignment to improve metabolism as the main intervention for improved mental health. Why over testing and over supplementing can become part of the problem, and is avoided in the programme. How treatment strategies are tailored to the individual: why personalised interventions require ongoing support, why the process can be challenging, but why the effort can be incredibly rewarding.

Genetic testing plays a key role in the evaluation of epilepsy patients. With the expanding number of choices for genetic tests and the complexity of interpretation of results, genetic literacy and knowledge of the most common genetic epilepsies are important for high-quality clinical practice. In this episode, Gordon Smith, MD, FAAN speaks Sudha Kilaru Kessler, MD, MSCE, author of the article “Epilepsy Genetics,” in the Continuum February 2025 Epilepsy issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Kessler is an associate professor of neurology and pediatrics at Perelman School of Medicine at the University of Pennsylvania and Children's Hospital of Philadelphia in Philadelphia, Pennsylvania. ADDITIONAL RESOURCES Read the article: Epilepsy Genetics Subscribe to Continuum: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the Academy of Neurology: aan.com SOCIAL MEDIA facebook.com/continuumcme @ContinuumAAN  Host: @gordonsmithMD Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, which features conversations with Continuum's guest editors and authors who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article and have access to exclusive interviews not featured on the podcast. Please visit the link in the episode notes for more information on the article, subscribing to the journal, and how to get CME. Dr Smith: Hello, this is Dr Gordon Smith. Today I've got the great pleasure of interviewing Dr Sudha Kessler about her article on epilepsy genetics, which appears in the February 2025 Continuum issue on epilepsy. Sudha, welcome to the podcast and please introduce yourself to our audience. Dr Kessler: Oh, thank you so much. I'm Sudha Kessler. I am a pediatric epileptologist here at the Children's Hospital of Philadelphia and the University of Pennsylvania. Dr Smith: Tell us a little bit about yourself. Are you a geneticist too, or how did you get into this particular topic? Dr Kessler: Yes, I want to emphatically say that I am not a geneticist. I'm not an expert in epilepsy genetics at all. I take care of all sorts of patients with epilepsy. I actually do mostly epilepsy surgery-related care. But this part of epilepsy is, every year, increasingly important to our everyday practice. And I think it's fascinating, often a little daunting. I think I was asked to get involved with this article as a non-expert to help translate from the experts to the rest of us. Dr Smith: We're going to get there, because one of the things you do a really good job of in the article is talking about genetic concepts that are germane to everything we do. And I think you're an expert. You do it in a way that I understood. So, I'd like to get there, but- and this is a really hot area. For instance, I really loved your figure that shows the arc of discovery of genetic causes for epilepsy. It's really breathtaking, something we wouldn't have thought possible that long ago. And it's also a lot to digest. And so, I wonder if maybe we can begin by thinking about a framework and, for instance, you talk about these different groups of disorders. And one that seems to be particularly impacted by this unbelievable A-rated discovery. Our developmental and epileptic encephalopathies, or DEEs. What can you tell our listeners about that group of disorders? Dr Kessler: Sure. I think that, you know, most of what we think about in epilepsy genetics now has to do with disorders that are attributable to changes in a single gene. Genetics is obviously much more complicated than that, but that's still where we are in the stage of discovery. And the graph in the article is definitely one to take a look at because it represents the explosion that we've had in our understanding of single gene disorders leading to epilepsy and related manifestations. The DEEs are a group of disorders where any individual disorder is fairly rare, but as a group they are not that rare, and very impactful because they often cause epilepsy at a very young age. And either as a consequence of seizures or as a consequence of the underlying pathophysiology of that gene change, they are typically associated with really significant developmental impairments for a child 's entire life. Dr Smith: My understanding is that there's therapeutic development going on in this space. So, the early recognition of these genetic testing offers the promise of very impactful treatment---like we now do for SMA, for instance---early in the disease course. Dr Kessler: I think that's right. That's one of the most exciting parts of this field is that so much, just around the corner, for drug development, therapy development in this area. And as you can imagine, with a lot of these disorders, earlier intervention is likely to be much more impactful than later intervention when a lot of the developmental consequences are sort of… you know, when the cat 's already out of the bag, so to speak. Dr Smith: Yeah. So, this is really transformational and something that everyone who takes care of kids with epilepsy needs to know about, it seems. So on the other extreme, I guess, there are the self-limited epilepsies. I didn't really know about this in terms of genetic discovery, but can you talk about those disorders? Dr Kessler: Yeah, sure. I mean, I think some of these are the classic childhood epilepsy syndromes that we think about like childhood absence epilepsy or what we used to call benign romantic epilepsy and now call self-limited epilepsy of childhood with centrotemporal spikes. It's a mouthful, shortened to SeLECTS. Those are the epilepsies that occur typically in previously healthy children, that affects them for a few years and often remits so that epilepsy is just age-limited and doesn't continue for life. They clearly have genetic influences because they tend to run in families, but the genetics of them is not generally single gene associated. And so, we haven't actually explained why most of those kids actually get epilepsy. I think that'll be sort of another interesting area of discovery that will help us even understand some really fundamental things about epilepsy, like, why does this syndrome start at this age and tend to resolve by adolescence? Dr Smith: And the other thing I found interesting is disorders that I might have thought going into it would have a defined genetic cause or some of the disorders that there are not. So JME, for instance, or childhood absence, which is a little counterintuitive. Dr Kessler: It's completely counterintuitive. We call them genetic generalized epilepsies, and we know that they run in families, but we still know so little. I would say of all of the disorders that are mentioned in this article, that is the group where I think we have explained the genetic underpinnings the least well. Dr Smith: Yeah. Isn't that interesting? It's… wasn't it Yogi Berra who said, it's hard to predict things, particularly the future? So… Dr Kessler: Yes. Dr Smith: Who would have thought? So, we've talked a lot about kids. What about adults? You know, what role does genetic testing play in adults who have unexplained epilepsy? Dr Kessler: Yeah, I think that that is also a really important emerging area of knowledge. I think many epileptologists may think of genetic epilepsy as being solely pediatric. There are definitely not how many of these disorders can manifest for the first time in adulthood. Not only that, many of our children with childhood onset epilepsy that is due to a genetic problem grow up to become adults and will then need adult epilepsy care. In order to take care of both of those groups, it's really important for all epileptologists, including those that take care of adults, to have some knowledge of the potential impact of genetic testing. And how do you even approach thinking about it? Dr Smith: The message I guess I'm getting is if our listeners take care of patients with epilepsy, no matter how old those patients are, they need to be familiar with this. And the other message I'm getting is, it sounds like there are a lot of patients who really need genetic testing. And this came through in one aspect of your article that I found really interesting, right? So, what are the recommendations on genetic testing? So, the National Society of Genetic Counselors, as I understand it, said everyone needs genetic testing, right? Which I mean, they're genetic counselors, so. Which is great. In the International League Against Epilepsy, they recommended a more targeted approach. So, what's your recommendation? Should we be testing anyone with unexplained epilepsy, or should we be focusing on particular populations? Dr Kessler: Well, I guess I think about it as a gradation. There are certain populations that really deserve genetic testing, where it is going to be absolutely critical. You know, it's very likely that it will be critical knowledge to their care. If you diagnose somebody with epilepsy and you do imaging and that imaging does not reveal an answer, meaning you don't see a tumor or you don't see an old stroke or some other sort of acquired lesion, the next pillar of testing for understanding underlying etiology is genetic testing. That is the point at which I typically send my patients, and that's whether they're refractory or not. I think in the past some people felt that only patients with refractory epilepsy deserve or require testing. I think the reason why not to limit it to that population is that what's on a person's mind with epilepsy, or a family's mind with epilepsy, is what's going to happen to my child or to me in the future? And if genetic testing can shed some light on that, that will have a huge impact on that person's life. Dr Smith: You've got great cases in your article, which, I just want to give you a compliment. The information and entertainment, frankly, for per page: off the charts. It's not a long article, packed with useful information. And, I mean, some of your cases are great examples of patients who are heading down the surgical epilepsy path and you discovered, nope, there's a genetic cause that really impacted their care. What's the yield, right? The number of patients that you send genetic testing on for epilepsy, what percentage come back positive for a relevant sequence variant that you think is either causing or contributing to their epilepsy? Dr Kessler: That's a great question. I think that is actually still in flux because it depends on the population of patients that are being sent for testing, obviously, and then also on what testing is being done. So, I know in at least one large recent meta-analysis, the overall yield was 17%. And somebody hearing that number might think, oh, that's not very high, but it's actually very comparable to the yield for imaging. And we all do MRIs and patients that have new-onset epilepsy where the yield of MRI testing is about 20%  or so. So, quite comparable. And then with children with DEEs, the yield is much, much higher than that. Dr Smith: So, 17% is actually a really great diagnostic yield. When I think of my yield and doing genetic testing on patients who have an axonal CMT phenotype, right? I mean that's better than what I get. So, good for you. That's exciting. Dr Kessler: It's interesting. I think that maybe an assumption might be that you're working somebody up. You do a genetic test, it reveals a difference, and thus surgery is off the table. It's actually quite different than the head, which is that some results may make surgery be even more “on the table” because you might find a gene that is known to be associated with a propensity to vocal cortical dysplasia, for example. And you may take a good second look at that person's MRI imaging or do other imaging to reveal the MRI invisible vocal cortical dysplasia. Dr Smith: Outstanding point. Let's talk a little more about the genetic testing itself. So, we've got all these genes. We understand when to test. What do you do? For instance, last night I just looked at the company that we use for most of our neuromuscular testing and they have a genetic epilepsy next gen panel with, I don't know, three hundred and twenty genes, right? Do you use that kind of panel? Do you go directly to a whole EXO? What's the right approach? Dr Kessler: Yeah, I think that that is quite dynamic right now, meaning that recommendations seem to change often enough that I rely on help. I have the enormous good luck of working here at CHOP where there is a fantastic epilepsy genetics group that I can easily refer to, and I know not everyone has that resource. The current recommendation is to start with an exome if that is available and is covered by that patient's insurance. When exome is not available, then the next best thing is a gene panel. You know, in recent years there have been a lot of sponsored gene panels, meaning free to the patient, administered by a company that then, you know, has other uses for compiled or grouped genetic data. And I think that as long as all of that can be clearly explained to a patient, and- along with all of the other things so you have to explain to a patient before doing genetic testing, about the pluses and minuses of doing it, I think that you sort of go for the best test you can that's available to that patient. Dr Smith: The sponsored programs can be very, very helpful, particularly from a payer or a patient payment perspective. And so, I guess the lesson there is it's great if you got the resources and CHOP to help you decide, but better to get whatever panel you can get than to do nothing; or, of course, refer to a center if you're not comfortable. Dr Kessler: And also, just know that these things change often enough that if it's been a couple of years and you might want to recheck whether the EXO is available to that patient or whether a gene panel can be sent that includes more than they had eight years ago. Dr Smith: So, are there situations to go to the other extreme where you just do targeted sanger sequencing? Like, just sequence the specific gene of interest?  Dr Kessler: Yeah, absolutely. I'm still a big proponent of thinking clinically about a patient. If there are clues in that patient's history, exam, imaging, anything that gives you some sense of the disorder that this patient might have. And I think a classic example would be tuberous sclerosis. If you see an infant who has new onset spasms, you see hypopigmented macules on their skin and their MRI shows a tuber, you know, also known as a focal cortical dysplasia, then sure, send the targeted sequencing for the TSC1 and TSC2 genes. Dr Smith: And Rett syndrome?  Dr Kessler: And Rett syndrome would be another example. And there are many examples where, if you feel like you have a good sense of what the disorder is, I think it's completely acceptable to send the targeted testing.  Dr Smith: So, I'm going to get further down the rabbit hole and get to from easier to harder. I always get confused about things like chromosomal microarrays or, like, karyotypes and rings and stuff like that. What role do these tests play and what do our listeners need to know about them? Dr Kessler: Yeah, I think that it is really important to have at least some knowledge of what each test can't tell you. I tell my medical students at my residence that all the time. With anything in medicine, you should know what you're asking of a test and what answers a test can tell you and can't tell you. It is baseline knowledge before requesting anything. And if you don't know, then it's best to ask. So, chromosomal microarray is used when you think that there is a large-scale derangement in a bunch of genes, meaning there is a whole section of a chromosome missing---that would be deletion, or that that information is duplicated or is turned around in a, you know, in a translocation. That is what- the kinds of things that that test can tell you. I think of doing a microarray when a child has not just epilepsy and intellectual disability, but also has, for example, other organ systems involved, because sections of chromosome can include many, many, many different genes and it can affect the body in larger ways. That's often when I think about that. So, a child with multiple congenital anomalies. Karyotype, which we think of as the most old-fashioned way of looking at our genes, still has some utility because it is useful for looking at a specific situation where the ends of arm of a chromosome get cut off and get sticky and then stick to each other and make a ring. For example, ring chromosome 20 is a disorder which can cause epilepsy, particularly hard-to-treat frontal lobe epilepsy, and that sometimes doesn't show up until adolescence or even early adulthood. That's just one example of something that karyotype can tell you.  Dr Smith: And it goes without saying, but just to emphasize, these are things that you would miss completely on a next generation panel or a next genome? Dr Kessler: That's correct. Because this isn't about sequencing. This is about large structures. You know, with my patients, it's sometimes, I think, very hard to explain. It's hard enough to explain it to other physicians who aren't in genetics, but it's a whole other undertaking to explain it to families who may not have a lot of literacy about cell biology or genetics or, you know, anything related to that. So, I often rely on analogies. And one analogy I use is that if you're- all of your genetic information is like a book, that book is split into chapters and those are the chromosomes. And you can be missing entire paragraphs or have paragraphs duplicated. And that would be the kind of thing that we would be looking for with the chromosomal microarray with sequencing or, you know, with sequencing, we're looking for spelling of words, and we can look at one word at a time. That would be targeted sequencing. Or we can look at many, many words at a time. And that would be next gen sequencing.  Dr Smith: I just want to say that you are the genetic whisperer. You know, translator. I love it.  Dr Kessler: You can continue using it down to the level of explaining the possibility of a variant of unknown significance, which I think is sometimes difficult to explain. So, I often will say, I know how the word color is spelled: C O L O R. But sometimes in other places it will be spelled C O L O U R and that's still the same word, that's still color. That's just what we would call a population variant. If it is spelled C O M O R, that changes meaning; that is not a word, and that is probably a pathogenic variant. But if it gets misspelled and it's K O L O R, then I'm not sure. Could that be a variant that means something different or not. And so that I would call that a variant of unknown significance, meaning its impact is to be determined. Dr Smith: So, I was going to ask you about variant calling, but you'd beat me to the punch. And that's a great metaphor that I will definitely remember. All right, here's another concept that I think people often find challenging, which is read depth. Can you tell us about reading depth or sequence depth?  Dr Kessler: Yes, hopefully I can. Again, not an expert here, but as I understand it, the way next gen sequencing works is that pieces of DNA are getting read. And the number of times any given nucleotide is read in this process is the read depth. It basically just translates to the number of times the processor, the machinery of doing this, pays attention to anyone site. The reason it's important is that the process by which this reading is done can sometimes result in errors. The greater your depth, the more times something is read, the less likely you are to have a mistake.  Dr Smith: In either direction. So, you're presumably less likely to have a false positive or false negative. Yep, again, very well explained. You know, I've got a lot of other questions I want to ask you, but I do want to be respectful of our listeners' time. I wonder if we could pivot a little bit and just let's go back to where we began. Really exciting time, right? Amazing. And you've been doing this long enough. I'm sure you didn't think when you started that it was going to look like this. What does the future look like? I mean, we talked a little bit about therapeutics, but the world's changing fast. Five, ten years from now, what's your hope for that?  Dr Kessler: Oh, that's such a great question. You know, we are at the point with genetic epilepsies that gene-based therapies, either antisense oligonucleotide-based therapies or viral vector-based gene therapies, are actually now being developed and administered in trial situations to actual patients. And so, it always feels like we're on the cusp, but I think actually now we really are on the cusp of having gene-based therapies for genetic epilepsies. I think that there is still so much to sort out, both from basic scientific point and from a practical administering these things to patients and what are the potential long term consequences.For example, unlike medications, which are therapies that you can stop if there are adverse effects, often administering a gene therapy is a one-and-done thing that can't be retracted. Thinking even about the ethical framework of that and the framework of explaining to patients that we don't know the ten, twenty-year consequences of that, is part of the informed consent process, for example. So, there's still so much work that is going to be transformational, not just from the, you know, the big picture, but from developing all, you know, from going through all of these steps to really make these kinds of therapies a reality. Dr Smith: Well, it's really amazing. And, you know, we're seeing this in multiple different areas in neurology. So, well done. You run the child neurology residency program there, I understand. I try to snoop on people before I talk to them because we haven't met before this. And you're obviously a very a very good educator. Thank you so much for talking with me today. I don't spend a lot of time in epilepsy, but every time I do one of these, I kind of want to go back and do something different because it's such a neat field. Thank you.  Dr Kessler: You're welcome. It was my pleasure.  Dr Smith: Again, today I've been interviewing Dr Sudha Kessler about her article on epilepsy genetics, which is truly outstanding. This article appears in the most recent issue of Continuum on epilepsy. Be sure to check out Continuum audio episodes from this and other issues. And thank you, listeners, for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use this link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

The #1 killer in the world is heart disease—it doesn't matter who you are or where you live, this killer doesn't discriminate. But does it have a code? And could it be cracked with the right technology? Tune in to discover: Why all of our cells would burst without cholesterol, but what happens when there's too much of it How CRISPR/Cas9 technology could hold the key to permanently low cholesterol levels (without the need for injections or pills), and a cure for sickle cell anemia What lipid nanoparticles are, how they can be used to deliver genes to specific organs in the body, and why this is significant Dr. Kiran Musunuru is a cardiologist, professor of medicine, and director of the Genetic and Epigenetic Origins of Disease Program at Perelman School of Medicine, University of Pennsylvania. As the leading cause of death globally, he believes heart disease is the preeminent global health threat of the 21st century, and the greatest challenge facing the medical profession today. And this is driving him to take action. Dr. Musunuru explains that, despite immense efforts put forth by some of the brightest scientists and doctors over the course of decades, treatment options for heart disease remain limited, mostly to cholesterol-lowering drugs. But he also explains how this is changing in light of the more recent revolution in genetics—namely, the completion of the Human Genome Project. What's the genetic difference between those who develop heart disease and those who don't? What genes influence heart health and disease, and could therapies based on this information prevent heart disease altogether? These are the types of questions that Dr. Musunuru says can now be answered, and he's doing just that. Listeners will learn about the genetics behind heart disease and cholesterol levels, the details of Dr. Musunuru's research and most recent findings, what the future of heart disease treatment and prevention might hold, and much more. Learn more at https://www.med.upenn.edu/cvi/musunuru-laboratory.html. Episode also available on Apple Podcasts: http://apple.co/30PvU9 Upgrade Your Wallet Game with Ekster!  Get the sleek, smart wallet you deserve—and save while you're at it! Use coupon code FINDINGGENIUS at checkout or shop now with this exclusive link: ekster.com?sca_ref=4822922.DtoeXHFUmQ5  Smarter, slimmer, better. Don't miss out!

Welcome to the What's Next! Podcast with Tiffani Bova.     This week I'm giving another listen to a conversation I shared with Professor Christian Terwiesch and I'm eager to share it with you! Christian is a Professor in Wharton's Operations and Information Management department, co-director of Penn's Mack Institute for Innovation Management, and also holds a faculty appointment at Penn's Perelman School of Medicine. He is the co-author of Matching Supply with Demand, a widely used textbook in Operations Management. He launched the first Massive Open Online Course (MOOC) in business on Coursera based on the book and since its inception, more than half a million students have enrolled. His first management book, Innovation Tournaments, details a new process-based approach to innovation and has inspired innovation tournaments around the world. His latest book, Connected Strategies, combines his expertise in the fields of operations, innovation, and strategy to help companies take advantage of digital technology leading to new business models. In addition to his teaching and his research, Professor Terwiesch is the host of “Work of Tomorrow,” a national radio show on Sirius XM 132.     THIS EPISODE IS PERFECT FOR… anyone wanting to become more innovative or bring a culture of innovation to their organization, as well as those wanting to get a pulse on new business models shaping how organizations interact with customers today.    TODAY'S MAIN MESSAGE… we have to find different ways of delighting our customers. How do we do that? Through innovation and continuous connection. Professor Terwiesch maintains that innovation is a cultural process that can be managed. That is the power of the Innovation Tournament, it leaves room for that magic spark to fly while giving it direction and structure. Beyond Innovation Tournaments, it's about becoming continuously connected. This connection enables new ways of delighting the customer and also allows organizations to provide more value to the customer, potentially at a lower cost. The purpose of a connected strategy and a continuous relationship is not only to get data but also to do a better job for the customer.    WHAT  I  LOVE  MOST… I love that Christian has identified these new business models that are fundamentally changing the way organizations interact with their customers.     Running Time: 30:47    Subscribe on iTunes     Find Tiffani Online: LinkedIn Facebook X    Find Christian Online: LinkedIn  Connected-Strategy Website Work of Tomorrow Podcast    Christian's Book:  Connected Strategy Book 

In this episode of Girls with Grafts, Rachel and Amber sit down with Dr. Shaun Mendenhall, a board-certified hand and plastic surgeon specializing in pediatric burn care and reconstructive surgery.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Hank Mayer, MD Patients with neuromuscular conditions often exhibit respiratory symptoms that impact their airway clearance and gas exchange, making it increasingly difficult for them to breathe. However, effective assessment techniques and early intervention can help mitigate the progression of this dysfunction, potentially keeping patients from needing extended recovery time or even inpatient care. Joining Dr. Charles Turck to discuss the importance of informed, proactive intervention for respiratory symptoms in patients with neuromuscular conditions is Dr. Hank Mayer. Dr. Mayer is the Medical Director of the Pulmonary Function Laboratory at the Children's Hospital of Philadelphia and a Professor of Clinical Pediatrics at the University of Pennsylvania's Perelman School of Medicine.

A 2019 report showed that police violence is a leading cost of death for young Black men in the United States. About one in every 1,000 Black men can expect to be killed by the police, with the highest risk amongst all ethnic groups and genders between the ages of 20 and 35 years old. Police violence has been identified as a public health issue among public health experts as well as advocates and activists. What role, then, do doctors and pediatricians have in preparing patients and their families to be aware of this public health risk? On today's show, we're in conversation with two pediatricians who led the research of a recent peer-reviewed research letter, titled “Pediatrician Perspectives on Incorporating Discussion of Police Encounters Into Anticipatory Guidance for Black Youth and Their Caregivers“. Dr Jeffrey Eugene is a pediatrician and adolescent medicine specialist, working with the Children's Hospital of Philadelphia as well as Philadelphia FIGHT Community Health Centers. His clinical expertise is in adolescent and young adult primary care, gender affirming medical care, sexual and reproductive health, medical care for youth living with HIV, and eating disorders. Dr George Dalembert, is a pediatrician at the Children's Hospital of Philadelphia (CHOP) and an Assistant Professor of Clinical Pediatrics at the Perelman School of Medicine. Additionally, he serves on the Governance as well as Diversity, Equity, and Inclusion Committees of the Pennsylvania chapter of American Academy of Pediatrics. He is also an author on the report that we're discussing today. Read their research here: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2829145 — Subscribe to this podcast: https://plinkhq.com/i/1637968343?to=page Get in touch: lawanddisorder@kpfa.org Follow us on socials @LawAndDis: https://twitter.com/LawAndDis; https://www.instagram.com/lawanddis/ The post The Public Health Risk of Police Violence and Pediatric Responsibility w/ Dr Jeffrey Eugene & Dr George Dalembert appeared first on KPFA.

The first 45 minutes of this conversation are FREE! Listen to the extended version of this episode when you subscribe to Patreon here. Dr. Mara Gordon joins the pod to share what it means to be a size-inclusive physician and why it's time to rethink weight in medicine. We discuss why it's harmful to center medical care on a patient's weight, the stigma and negative health consequences of medical providers prescribing intentional weight loss, how to advocate for yourself with your physician, declining to be weighed at the doctor's, why BMI is so problematic, caring for and treating diagnoses without weight loss, and her thoughts on the GLP-1 hype. Mara also opens up about what she regrets as a physician prior to finding fat-positive medicine, and how she came to see the harms of anti-fat bias and diet culture more broadly.  In the EXTENDED version (a bonus episode that you can find at www.patreon.com/fullplate), Mara answers questions about: her concerns about GLP-1s like Ozempic, and what we can do to think about them differently how larger bodied humans can advocate for themselves at the doctor's office without giving the unwritten message that they're “noncompliant” or don't care about their health how to deal with being told weight loss will help a specific health condition (like diabetes, joint pain, sleep apnea) why folks in larger bodies need to receive the same treatments offered to thin-bodied folks how “obesity” as a pathological condition has its roots in the pharmaceutical industry, and it started in the 90s   More about Dr. Mara Gordon: Dr. Gordon is a family physician and writer based in Philadelphia. She worked in public health in Tanzania and Malawi before returning to the Philadelphia area to attend medical school at the Perelman School of Medicine at the  University of Pennsylvania, where she was awarded the Zervanos Family Medicine Award for a medical student going into family medicine. She cares for patients of all ages at the Cooper Family Medicine office at the Kroc Center in Camden. She loves working with medical students in preclinical and clinical educational settings. She teaches selectives in Narrative Medicine and Audio Storytelling and co-directs the Narrative Medicine Scholarly Concentration. She continues to write professionally about issues in contemporary medicine. Learn more about her here.    Check out Medical Students for Size Inclusivity here.  You can read more of Mara's work here: maragordonmd.com Here's more about AWSIM: www.weightinclusivemedicine.org Support the show on Patreon: Enjoying this podcast? Please support the show on Patreon for bonus episodes, community engagement, and access to "Ask Abbie" at Patreon.com/fullplate Join the Full Plate Patreon right here! Group program: Good news! Enrollment is open for Abbie's next group program: Looking for more support and concrete steps to take to heal your relationship with food and your body? Apply for Abbie's next 10-week group program: https://www.abbieattwoodwellness.com/group-coaching Group membership: Already been at this anti-diet culture thing for a while, but want community and continued learning? Apply for Abbie's monthly membership: https://www.abbieattwoodwellness.com/circle-monthly-group Social media: Find the show on Instagram: @fullplate.podcast Find Abbie on Instagram: @abbieattwoodwellness Podcast Cover Photography by Anya McInroy Podcast Administrative Support by Alexis Eades Podcast Editing by Brian Walters This podcast is ad-free and support comes from our Patrons on Patreon: Patreon.com/fullplate

About two years ago, we released a podcast with Dr. Thomas Wadden of the University of Pennsylvania describing work on a new generation of medications to treat diabetes and obesity. They were really taking the field by storm. Since then, much more is known since many additional studies have been published and so many people have been using the drugs. So many, in fact, the market value of the Danish company, Novo Nordisk, one of the two major companies selling the drugs, has gone up. It is now greater than the entire budget of the country of Denmark. This single company is responsible for about half of Denmark's economic expansion this year. So, a lot of people are now taking the drugs and this is a great time for an update on the drugs. And we're fortunate to have two of the world's leading experts join us: Dr. Wadden, Professor of Psychology and Psychiatry at the University of Pennsylvania School of Medicine and the inaugural Albert J. Stunkard Professor of Psychiatry at Penn. Joining us as well as Dr. Robert Kushner, a physician and professor of medicine at Northwestern University and a pioneer in testing treatments for obesity. Interview Summary Tom, you and I were colleagues at Penn decades ago. And I got frustrated the treatments for obesity didn't work very well. People tended to regain the weight. And I turned my attention to prevention and policy. But you hung in there and I admired you for that patience and persistence. And Bob, the same for you. You worked on this tenacious problem for many years. But for both of you, your patience has been rewarded with what seems to me to be a seismic shift in the way obesity and diabetes can be treated. Tom, I'll begin with you. Is this as big of a deal as it seems to me? Well, I think it is as big of a deal as it seems to you. These medications have had a huge impact on improving the treatment of type 2 diabetes, but particularly the management of obesity. With older medications, patients lost about 7 percent of their starting weight. If you weighed 200 pounds, you'd lose about 15 pounds. That was also true of our best diet and exercise programs. You would lose about 7 percent on those programs with rigorous effort. But with the new medications, patients are now losing about 15 to 20 percent of their starting body weight at approximately one year. And that's a 30-to-40-pound loss for a person who started at 200 pounds. And with these larger weight losses, we get larger improvements in health in terms of complications of obesity. So, to quote a good friend of mine, Bob Kushner, these medications have been a real game changer. Thanks for putting that in perspective. I mean, we're talking about not just little incremental changes in what treatments can produce, which is what we've seen for years. But just orders of magnitude of change, which is really nice to see. So, Bob what are these medications that we're talking about? What are the names of the drugs and how do they work? Well, Kelly, this transformation of obesity really came about by finding the target that is really highly effective for obesity. It's called the gut brain axis. And when it comes to the gut it's starting off with a naturally occurring gut hormone called GLP 1. I think everyone in the country's heard of GLP 1. It's released after we eat, and it helps the pancreas produce insulin, slows the stomach release of food, and reduces appetite. And that's where the obesity story comes in. So pharmaceutical companies have taken this hormone and synthesized it, something similar to GLP 1. It mimics the action of GLP 1. So, you could actually take it and give it back and have it injected so it augments or highlights this hormonal effect. Now, that same process of mimicking a hormone is used for another gut hormone called GIP that also reduces appetite. These two hormones are the backbone of the currently available medication. There's two on the market. One is called Semaglutide. That's a GLP 1 analog. Trade name is Wegovy. Now, it's also marketed for diabetes. Tom talked about how it is used for diabetes and increases insulin. That trade name is Ozempic. That's also familiar with everyone around the country. The other one that combined GLP 1 and GIP, these two gut hormones, so it's a dual agonist, the trade name for obesity is called Zep Bound, and the same compound for diabetes is called Mounjaro. These are terms that are becoming familiar, I think, to everyone in the country. Tom mentioned some about the, how much weight people lose on these drugs, but what sort of medical changes occur? Just to reiterate what Tom said, I'll say it in another way. For Semaglutide one third of individuals are losing 20 percent of their body weight in these trials. For Tirzepatide, it even outpaces that. And I got a third of individuals losing a quarter of their body weight. These are unheard of weight losses. And with these weight losses and these independent effects from weight, what we're seeing in the trials and in the clinic is that blood pressure goes down, blood sugar goes down, blood fats like triglyceride go down, inflammation in the body goes down, because we marked that with CRP, as well as improvement in quality of life, which we'll probably get to. But really interesting stuff is coming out over the past year or two or so, that it is improving the function of people living with congestive heart failure, a particular form called a preserved ejection fraction. We're seeing improvements in sleep apnea. Think of all the people who are on these CPAP machines every night. We're seeing significant improvements in the symptoms of sleep apnea and the apneic events. And lastly, a SELECT trial came out, that's what it was called, came out last year. Which for the very first time, Kelly, found improvements in cardiovascular disease, like having a heart attack, stroke, or dying of cardiovascular disease in people living with obesity and already have cardiovascular disease. That's called secondary prevention. That, Tom, is the game changer. Bob, I'd like to go back to Tom in a minute but let me ask you one clarifying question about what you just said. That's a remarkable array of biological medical benefits from these drugs. Just incredible. And the question is, are they all attributable to the weight loss or is there something else going on? Like if somebody lost equal amounts of weight by some other means, would these same changes be occurring? Those studies are still going on. It's very good. We're thinking it's a dual effect. It's the profound amount of weight loss, as Tom said. Fifteen to 21 to even 25 percent of average body weight. That is driving a lot of the benefits. But there also appear to be additional effects or weight independent effects that are working outside of that weight. We're seeing improvements in kidney function, improvement in heart disease, blood clotting, inflammation. And those are likely due to the gut hormone effect independent of the weight itself. That still needs to be sorted out. That's called a mitigation analysis where we try to separate out the effects of these drugs. And that work is still underway. Tom, one of the most vexing problems, over the decades that people have been working on treatments for obesity, has been long term results. And I'm curious about how long have people been followed on these drugs now? What are the results? And what was the picture before then? How do what we see now compared to what you saw before? The study that Bob just mentioned, the SELECT trial followed people for four years on Semaglutide. And patients achieve their maximal weight loss at about one year and they lost 10 percent of their weight. And when they were followed up at four years still on treatment, they still maintained a 10 percent weight loss. That 10 percent is smaller than in most of the trials, where it was a 15 percent loss. But Dr. Tim Garvey showed that his patients in a smaller trial lost about 15 percent at one year and while still on medication kept off the full 15 percent. I think part of the reason the weight loss in SELECT were smaller is because the study enrolled a lot of men. Men are losing less weight on this medication than women. But to your question about how these results compare to the results of earlier treatment, well with behavioral treatment, diet, and exercise back in the 70s beyond, people lost this 7 or 8 percent of weight. And then most people on average regain their weight over one to three years. And the same was true of medication. People often stopped these earlier medications after 6 to 12 months, in part because they're frustrated the losses weren't larger. Some people were also worried about the side effects. But the long and short is once you stop taking the medication, people would tend to regain their weight. And some of this weight regain may be attributable to people returning to their prior eating and activity habits. But one of the things we've learned over the past 20 years is that part of the weight regain seems to be attributable to changes in the body's metabolism. And you know that when you lose weight, you're resting metabolic rate, which is the number of calories your body burns at rest to maintain basic bodily functions. Your resting metabolic rate decreases by 10 to 15 percent. But also, your energy expenditure, the calories you burn during exercise decreases. And that may decrease by as much as 20 to 30 percent. So, people are left having to really watch their calories very carefully because of their lower calorie requirements in order to keep off their lost body weight. I think one thing these new drugs may do is to attenuate the drop both in resting metabolic rate and energy expenditure during physical activity. But the long and short of it is that if you stay on these new medications long term, you'll keep off your body weight. And you'll probably keep it off primarily because of improvements in your appetite, so you have less hunger. And as a result, you're eating less food. I'd like to come back to that in a minute. But let me ask a question. If a person loses weight, and then their body starts putting biological pressure on them to regain, how come? You know, it's disadvantageous for their survival and their health to have the excess weight. Why would the body do that? Well, our bodies evolved in an environment of food scarcity, and our physiology evolved to protect us against starvation. First, by allowing us to store body fat, a source of energy when food is not available. And second, the body's capacity to lower its metabolism, or the rate at which calories are burned to maintain these basic functions like body temperature and heart rate. That provided protection against food scarcity. But Kelly, you have described better than anybody else that these ancient genes that regulate energy expenditure and metabolism are now a terrible mismatch for an environment in which food is plentiful, high in calories, and available 24 by 7. The body evolved to protect us from starvation, but not from eating past our calorie needs. And so, it's this mismatch between our evolution and our appetite and our body regulation in the current, what you have called toxic food environment, when you can eat just all the time. I guess you could think about humans evolving over thousands of years and biology adapting to circumstances where food was uncertain and unpredictable. But this modern environment has happened really pretty rapidly and maybe evolution just hasn't had a chance to catch up. We're still existing with those ancient genes that are disadvantageous in this kind of environment. Bob back to the drugs. What are the side effects of the drugs? Kelly, they're primarily gastrointestinal. These are symptoms like nausea, diarrhea, constipation, heartburn, and vomiting. Not great, but they're generally considered mild to moderate, and temporary. And they primarily occur early during the first four to five months when the medications are slowly dose escalated. And we've learned, most importantly, how to mitigate or reduce those side effects to help people stay on the drug. Examples would be your prescriber would slow the dose escalation. So. if you're having some nausea at a particular dose, we wait another month or two. The other, very importantly, is we have found that diet significantly impacts these side effects. When we counsel patients on these medications, along with that comes recommendations for dietary changes, such as reducing fatty food and greasy food. Reducing the amount of food you're consuming. Planning your meals in advance. Keeping well hydrated. And very importantly, do not go out for a celebration or go out to meals on the day that you inject or at least the first two days. Because you're not going to tolerate the drug very well. We use that therapeutically. So, if you want to get control on the weekends, you may want to take your injection on a Friday. However, if weekends are your time out with friends and you want to socialize, don't take it on a Friday. Same thing comes with a personal trainer, by the way. If you're going to have a personal trainer on a Monday where he's going to overwork you, don't take the injection the day before. You'll likely be nauseated, you're not eating, you're not hydrating. So actually, there's a lot that goes into not only when to take the dose and how to take the dose, but how to take it to the best ability to tolerate it. Two questions based on what you said. One is you talked about these are possible side effects, but how common are they? I mean, how many people suffer from these? Well, the trials show about 25 to 45 percent or so of individuals actually say they have these symptoms. And again, we ask them mild, moderate, severe. Most of them are mild to moderate. Some of them linger. However, they really do peak during the dose escalation. So, working with your prescriber during that period of time closely, keeping contact with them on how to reduce those side effects and how you're doing out of medication is extremely important. And the second thing I wanted to ask related to that is I've heard that there's a rare but serious potential side effect around the issue of stomach paralysis. Can you tell us something about that? I mentioned earlier, Kelly, that these medications slow gastric emptying. That's pretty much in everybody. In some individuals who may be predisposed to this, they develop something called ileus, and that's the medical term for gastric paralysis. And that can happen in individuals, let's say who have a scleroderma, who have longstanding diabetes or other gastrointestinal problems where the stomach really stopped peristalsis. In other words, it's moving. That's typically presented by vomiting and really unable to move the food along. We really haven't seen much of that. We looked at the safety data in a SELECT trial that Tom mentioned, which was 17,000 individuals, about 8,000 or so in each group. We really did not see a significant increase in the ileus or what you're talking about in that patient population. Okay, thanks. Tom had alluded to this before, Bob, but I wanted to ask you. How do you think about these medicines? If somebody takes them, and then they stop using the medicines and they gain the weight back. Is that a sign that the medicine works or doesn't work? And is this the kind of a chronic use drug like you might take for blood pressure or cholesterol? That's a great way of setting up for that. And I like to frame it thinking of it as a chronic progressive disease, just like diabetes or hypertension. We know that when you have those conditions, asthma could be another one or inflammatory bowel disease, where you really take a medication long term to keep the disease or condition under control. And we are currently thinking of obesity as a chronic disease with dysfunctional appetite and fat that is deposited in other organs, causing medical problems and so on. If you think of it as a chronic disease, you would naturally start thinking of it, like others, that medication is used long term. However, obesity appeared to be different. And working with patients, they still have this sense 'that's my fault, I know I can do it, I don't want to be on medication for the rest of my life for this.' So, we have our work cut out for us. One thing I can say from the trials, and Tom knows this because he was involved in them. If we suddenly stop the medication, that's how these trials were definitely done, either blindly or not blindly, you suddenly stop the medication, most, if not all of the participants in these trials start to regain weight. However, in a clinical practice, that is not how we work. We don't stop medication suddenly with patients. We go slowly. We down dose the medication. We may change to another medication. We may use intermittent therapy. So that is work that's currently under development. We don't know exactly how to counsel patients regarding long term use of the medications. I think we need to double down on lifestyle modification and counseling that I'm sure Tom is going to get into. This is really work ahead of us, how to maintain medication, who needs to be on it long term, and how do we actually manage patients. Tom, you're the leading expert in the world on lifestyle change in the context of obesity management. I mean, thinking about what people do with their diet, their physical activity, what kind of thinking they have related to the weight loss. And you talked about that just a moment ago. Why can't one just count on the drugs to do their magic and not have to worry about these things? Well, first, I think you can count on the drugs to do a large part of the magic. And you may be surprised to hear me say that. But with our former behavioral treatments of diet and exercise, we spent a lot of time trying to help people identify how many calories they were consuming. And they did that by recording their food intake either in paper and pencil or with an app. And the whole focus of treatment was trying to help people achieve a 500 calorie a day deficit. That took a lot of work. These medications, just by virtue of turning down your appetite and turning down your responsiveness to the food environment, take away the need for a lot of that work, which is a real blessing. But the question that comes up is, okay, people are eating less food. But what are they eating? Do these medications help you eat a healthier diet with more fruits and vegetables, with lean protein? Do you migrate from a high fat, high sugar diet to a Mediterranean diet, or to a DASH like diet? And the answer is, we don't know. But obviously you would like people to migrate to a diet that's going to be healthier for you from a cardiovascular standpoint, from a cancer risk reduction standpoint. One of the principal things that people need to do on these medications is to make sure they get plenty of protein. And so, guidance is that you should have about 1 gram of dietary protein for every kilogram of body weight. If you're somebody who weighs 100 kilograms, you should get 100 grams of protein. And what you're doing is giving people a lot of dietary protein to prevent the loss of bodily protein during rapid weight loss. You did a [00:20:00] lot of research with me back in the 80s on very low-calorie diets, and that was the underpinning of treatment. Give people a lot of dietary protein, prevent the loss of bodily protein. The other side of the equation is just physical activity, and it's a very good question about whether these medications and the weight loss they induce will help people be more physically active. I think that they will. Nonetheless for most people, you need to plan an activity schedule where you adopt new activities, whether it's walking more or going to the gym. And one thing that could be particularly helpful is strength training, because strength training could mitigate some of the loss of muscle mass, which is likely to occur with these medications. So, there's still plenty to learn about what is the optimal lifestyle program, but I think people, if they want to be at optimal health will increase their physical activity and eat a diet of fruits and vegetables, leaner protein, and less ultra processed foods. Well, isn't it true that eating a healthy diet and being physically active have benefits beyond their impact on your ability to lose the weight? You're getting kind of this wonderful double benefit, aren't you? I believe that is true. I think you're going to find that there are independent benefits of being physical activity upon your cardiovascular health. There are independent benefits of the food that you're eating in terms of reducing the risk of heart attack and of cancer, which has become such a hot topic. So, yes how you exercise and what you eat makes a difference, even if you're losing weight. Well, plus there's probably the triple one, if you will, from the psychological benefit of doing those things, that you do those things, you feel virtuous, that helps you adhere better as you go forward, and these things all come together in a nice picture when they're working. Tom, let's talk more about the psychology of these things. You being a psychologist, you've spent a lot of time doing research on this topic. And of course, you've got a lot of clinical experience with people. So as people are losing weight and using these drugs, what do they experience? And I'm thinking particularly about a study you published recently, and Bob was a coauthor on that study that addressed mental health outcomes. What do people experience and what did you find in that study? I think the first things people experience is improvements in their physical function. That you do find as you've lost weight that you've got less pain in your knees, you've got more energy, it's easier to get up the stairs, it's easier to play with the children or the grandchildren. That goes a long way toward making people feel better in terms of their self-efficacy, their agency in the life. Big, big improvement there. And then, unquestionably, people when they're losing a lot of weight tend to feel better about their appearance in some cases. They're happy that they can buy what they consider to be more fashionable clothes. They get compliments from friends. So, all of those things are positive. I'm not sure that weight loss is going to change your personality per se, or change your temperament, but it is going to give you these physical benefits and some psychological benefits with it. We were happy to find in the study you mentioned that was conducted with Bob that when people are taking these medications, they don't appear to be at an increased risk of developing symptoms of depression or symptoms of suicidal ideation. There were some initial reports of concern about that, but the analysis of the randomized trials that we conducted on Semaglutide show that there is no greater likelihood of developing depression or sadness or suicidal ideation on the medication versus the placebo. And then the FDA and the European Medicines Agency have done a full review of all post marketing reports. So, reports coming from doctors and the experience with their patients. And in looking at those data the FDA and the European Medicines Agency have said, we don't find a causal link between these medications and suicidal ideation. With that said, it's still important that if you're somebody who's taking these medications and you start them, and all of a sudden you do feel depressed, or all of a sudden you do have thoughts like, maybe I'd be better off if I weren't alive any longer, you need to talk to your primary care doctor immediately. Because it is always possible somebody's having an idiosyncratic reaction to these medications. It's just as possible the person would have that reaction without being on a medication. You know, that, that can happen. People with overweight and obesity are at higher risk of depression and anxiety disorders. So, it's always going to be hard to tease apart what are the effects of a new medication versus what are just the effects of weight, excess weight, on your mood and wellbeing. You know, you made me think of something as you were just speaking. Some people may experience negative effects during weight loss, but overall, the effects are highly positive and people are feeling good about themselves. They're able to do more things. They fit in better clothes. They're getting good feedback from their environment and people they know. And then, of course, there's all the medical benefit that makes people feel better, both psychologically and physically. Yet there's still such a strong tendency for people to regain weight after they've lost. And it just reinforces the fact that, the point that you made earlier, that there are biological processes at work that govern weight and tendency to regain. And there really is no shame in taking the drug. I mean, if you have high blood pressure, there's no shame in taking the drug. Or high cholesterol or anything else, because there's a biological process going on that puts you at risk. The same thing occurs here, so I hope the de-shaming, obesity in the first place, and diabetes, of course, and then the use of these medications in particular might help more people get the benefits that is available for them. I recommend that people think about their weight as a biologically regulated event. Very much like your body temperature is a biologically regulated event, as is your blood pressure and your heart rate. And I will ask people to realize that there are genetic contributors to your body weight. just as there are to your height. If somebody says, I just feel so bad about being overweight I'll just talk with them about their family history of weight and see that it runs in the family. Then I'll talk to them about their height. Do you feel bad about being six feet tall, to a male? No, that's fine. Well, that that's not based upon your willpower. That's based upon your genes, which you received. And so, your weight, it's similarly based. And if we can use medications to help control weight, cholesterol, blood pressure, blood sugar, let's do that. It's just we live in a time where we're fortunate to have the ability to add medications to help people control health complications including weight. Bob, there are several of the drugs available. How does one think about picking between them? Well, you know, in an ideal medical encounter, the prescriber is going to take into consideration all the factors of prescribing a medication, like any other medication, diabetes, hypertension, you name the condition. Those are things like contraindication to use. What other medical problems does the patient have that may benefit the patient. Patient preferences, of course and side effects, safety, allergies, and then we have cost. And I'll tell you, Kelly, because of our current environment, it's this last factor, cost, that's the most dominant factor when it comes to prescribing medication. I'll have a patient walk in my room, I'll look at the electronic medical record, body mass index, medical problems. I already know in my head what is going to be the most effective medication. That's what we're talking about today. Unfortunately, I then look at the patient insurance, which is also on the electronic medical record, and I see something like Medicaid or Medicare. I already know that it's not going to be covered. It is really quite unfortunate but ideally all these factors go into consideration. Patients often come in and say, I've heard about Ozempic am I a candidate for it, when can I get it? And unfortunately, it's not that simple, of course. And those are types of decisions the prescriber goes through in order to come to a decision, called shared decision making with the patient. Bob, when I asked you the initial question about these drugs, you were mentioning the trade name drugs like Mounjaro and Ozempic and those are made by basically two big pharmaceutical companies, Novo Nordisk and Eli Lilly. But there are compounded versions of these that have hit the scene. Can you explain what that means and what are your thoughts about the use of those medications? So compounding is actually pretty commonly done. It's been approved by the FDA for quite some time. I think most people are familiar with the idea of compounding pharmacies when you have a child that must take a tablet in a liquid form. The pharmacy may compound it to adapt to the child. Or you have an allergy to an ingredient so the pharmacy will compound that same active ingredient so you can take it safely. It's been approved for long periods of time. Anytime a drug is deemed in shortage by the FDA, but in high need by the public, compounding of that trade drug is allowed. And that's exactly what happened with both Semaglutide and Tirzepatide. And of course, that led to this compounding frenzy across the country with telehealth partnering up with different compounding pharmacies. It's basically making this active ingredient. They get a recipe elsewhere, they don't get it from the company, they get this recipe and then they make the drug or compound it themselves, and then they can sell it at a lower cost. I think it's been helpful for people to get the drug at a lower cost. However, buyer beware, because not all compounded pharmacies are the same. The FDA does not closely regulate these compounded pharmacies regarding quality assurance, best practice, and so forth. You have to know where that drug is coming from. Kelly, it's worth noting that just last week, ZepBound and Mounjaro came off the shortage list. You no longer can compound that and I just read in the New York Times today or yesterday that the industry that supports compounding pharmacies is suing the FDA to allow them to continue to compound it. I'm not sure where that's going to go. I mean, Eli Lilly has made this drug. However, Wegovy still is in shortage and that one is still allowed to be compounded. Let's talk a little bit more about costs because this is such a big determinant of whether people use the drugs or not. Bob, you mentioned the high cost, but Tom, how much do the drugs cost and is there any way of predicting what Bob just mentioned with the FDA? If the compounded versions can't be used because there's no longer a shortage, will that decrease pressure on the companies to keep the main drug less expensive. I mean, how do you think that'll all work out? But I guess my main question is how much these things cost and what's covered by insurance? Well first how much do the drugs cost? They cost too much. Semaglutide, known in retail as Wegovy, is $1,300 a month if you do not have insurance that covers it. I believe that Tirzepatide, known as ZepBound, is about $1,000 a month if you don't have insurance that covers that. Both these drugs sometimes have coupons that bring the price down. But still, if you're going to be looking at out of pocket costs of $600 or $700 or $800 a month. Very few people can afford that. The people who most need these medications are people often who are coming from lower incomes. So, in terms of just the future of having these medications be affordable to people, I would hope we're going to see that insurance companies are going to cover them more frequently. I'm really waiting to see if Medicare is going to set the example and say, yes, we will cover these medications for anybody with a BMI of 40 or a BMI of 35 with comorbidities. At this point, Medicare says, we will only pay for this drug if you have a history of heart attack and stroke, because we know the drug is going to improve your life expectancy. But if you don't have that history, you don't qualify. I hope we'll see that. Medicaid actually does cover these medications in some states. It's a state-by-state variation. Short of that, I think we're going to have to have studies showing that people are on these medications for a long time, I mean, three to five years probably will be the window, that they do have a reduction in the expenses for other health expenditures. And as a result, insurers will see, yes, it makes sense to treat excess weight because I can save on the cost of type 2 diabetes or sleep apnea and the like. Some early studies I think that you brought to my attention say the drugs are not cost neutral in the short-term basis of one to two years. I think you're going to have to look longer term. Then I think that there should be competition in the marketplace. As more drugs come online, the drug prices should come down because more will be available. There'll be greater production. Semaglutide, the first drug was $1,300. Zepbound, the second drug Tirzepatide, $1,000. Maybe the third drug will be $800. Maybe the fourth will be $500. And they'll put pressure on each other. But I don't know that to be a fact. That's just my hope. Neither of you as an economist or, nor do you work with the companies that we're talking about. But you mentioned that the high cost puts them out of reach for almost everybody. Why does it make sense for the companies to charge so much then? I mean, wouldn't it make sense to cut the price in half or by two thirds? And then so many more people would use them that the company would up ahead in the long run. Explain that to me. That's what you would think, for sure. And I think that what's happened right now is that is a shortage of these drugs. They cannot produce enough of them. Part of that is the manufacturing of the injector pens that are used to dispense the drug to yourself. I know that Novo Nordisk is building more factories to address this. I assume that Lilly will do the same thing. I hope that over time we will have a larger supply that will allow more people to get on the medication and I hope that the price would come down. Of course, in the U. S. we pay the highest drug prices in the world. Fortunately, given some of the legislation passed, Medicare will be able to negotiate the prices of some of these drugs now. And I think they will negotiate on these drugs, and that would bring prices down across the board. Boy, you know, the companies have to make some pretty interesting decisions, don't they? Because you've alluded to the fact that there are new drugs coming down the road. I'm assuming some of those might be developed and made by companies other than the two that we're talking about. So, so investing in a whole new plant to make more of these things when you've got these competitor drugs coming down the road are some interesting business issues. And that's not really the topic of what we're going to talk about, but it leads to my final question that I wanted to ask both of you. What do you think the future will bring? And what do you see in terms of the pipeline? What will people be doing a year from now or 2 or 5? And, you know, it's hard to have a crystal ball with this, but you two have been, you know, really pioneers and experts on this for many years. You better than anybody probably can answer this question. Bob, let me start with you. What do you think the future will bring? Well, Kelly, I previously mentioned that we finally have this new therapeutic target called the gut brain axis that we didn't know about. And that has really ushered in a whole new range of potential medications. And we're really only at the beginning of this transformation. So not only do we have this GLP 1 and GIP, we have other gut hormones that are also effective not only for weight loss, but other beneficial effects in the body, which will become household names, probably called amylin and glucagon that joins GLP 1. And we not only have these monotherapies like GLP 1 alone, we are now getting triagonists. So, we've got GIP, GLP 1, and glucagon together, which is even amplifying the effect even further. We are also developing oral forms of GLP 1 that in the future you could presumably take a tablet once a day, which will also help bring the cost down significantly and make it more available for individuals. We also have a new generation of medications being developed which is muscle sparing. Tom talked about the importance of being strong and physical function. And with the loss of lean body mass, which occurs with any time you lose weight, you can also lose muscle mass. There's drugs that are also going in that direction. But lastly, let me mention, Kelly, I spend a lot of my time in education. I think the exciting breakthroughs will not be meaningful to the patient unless the professional, the provider and the patient are able to have a nonjudgmental informative discussion during the encounter without stigma, without bias. Talk about the continuum of care available for you, someone living with obesity, and get the medications to the patient. Without that, medications over really sit on the shelf. And we have a lot of more work to do in that area. You know, among the many reasons I admire the both of you is that you've, you've paid a lot of attention to that issue that you just mentioned. You know, what it's like to live with obesity and what people are experiencing and how the stigma and the discrimination can just have devastating consequences. The fact that you're sensitive to those issues and that you're pushing to de-stigmatize these conditions among the general public, but also health care professionals, is really going to be a valuable advance. Thank you for that sensitivity. Tom, what do you think? If you appear into the crystal ball? What does it look like? I would have to agree with Bob that we're going to have so many different medications that we will be able to combine together that we're going to see that it's more than possible to achieve weight losses of 25 to 30 percent of initial body weight. Which is just astonishing to think that pharmaceuticals will be able to achieve what you achieve now with bariatric surgery. I think that it's just, just an extraordinary development. Just so pleased to be able to participate in the development of these drugs at this stage of career. I still see a concern, though, about the stigmatization of weight loss medications. I think we're going to need an enormous dose of medical education to help doctors realize that obesity is a disease. It's a different disease than some of the illnesses that you treat because, yes, it is so influenced by the environment. And if we could change the environment, as you've argued so eloquently, we could control a lot of the cases of overweight and obesity. But we've been unable to control the environment. Now we're taking a course that we have medications to control it. And so, let's use those medications just as we use medications to treat diabetes. We could control diabetes if the food environment was better. A lot of medical education to get doctors on board to say, yes, this is a disease that deserves to be treated with medication they will share that with their patients. They will reassure their patients that the drugs are safe. And that they're going to be safe long term for you to take. And then I hope that society as a whole will pick up that message that, yes, obesity and overweight are diseases that deserve to be treated the same way we treat other chronic illnesses. That's a tall order, but I think we're moving in that direction. BIOS Robert Kushner is Professor of Medicine and Medical Education at Northwestern University Feinberg School of Medicine, and Director of the Center for Lifestyle Medicine in Chicago, IL, USA. After finishing a residency in Internal Medicine at Northwestern University, he went on to complete a post-graduate fellowship in Clinical Nutrition and earned a Master's degree in Clinical Nutrition and Nutritional Biology from the University of Chicago. Dr. Kushner is past-President of The Obesity Society (TOS), the American Society for Parenteral and Enteral Nutrition (ASPEN), the American Board of Physician Nutrition Specialists (ABPNS), past-Chair of the American Board of Obesity Medicine (ABOM), and Co-Editor of Current Obesity Reports. He was awarded the ‘2016 Clinician-of-the-Year Award' by The Obesity Society and John X. Thomas Best Teachers of Feinberg Award at Northwestern University Feinberg School of Medicine in 2017. Dr. Kushner has authored over 250 original articles, reviews, books and book chapters covering medical nutrition, medical nutrition education, and obesity, and is an internationally recognized expert on the care of patients who are overweight or obese. He is author/editor of multiple books including Dr. Kushner's Personality Type Diet (St. Martin's Griffin Press, 2003; iuniverse, 2008), Fitness Unleashed (Three Rivers Press, 2006), Counseling Overweight Adults: The Lifestyle Patterns Approach and Tool Kit (Academy of Nutrition and Dietetics, 2009) and editor of the American Medical Association's (AMA) Assessment and Management of Adult Obesity: A Primer for Physicians (2003). Current books include Practical Manual of Clinical Obesity (Wiley-Blackwell, 2013), Treatment of the Obese Patient, 2nd Edition (Springer, 2014), Nutrition and Bariatric Surgery (CRC Press, 2015), Lifestyle Medicine: A Manual for Clinical Practice (Springer, 2016), and Obesity Medicine, Medical Clinics of North America (Elsevier, 2018). He is author of the upcoming book, Six Factors to Fit: Weight Loss that Works for You! (Academy of Nutrition and Dietetics, December, 2019). Thomas A. Wadden is a clinical psychologist and educator who is known for his research on the treatment of obesity by methods that include lifestyle modification, pharmacotherapy, and bariatric surgery. He is the Albert J. Stunkard Professor of Psychology in Psychiatry at the Perelman School of Medicine at the University of Pennsylvania and former director of the university's Center for Weight and Eating Disorders. He also is visiting professor of psychology at Haverford College. Wadden has published more than 550 peer-reviewed scientific papers and abstracts, as well as 7 edited books. Over the course of his career, he has served on expert panels for the National Institutes of Health, the Federal Trade Commission, the Department of Veterans Affairs, and the U.S. House of Representatives. His research has been recognized by awards from several organizations including the Association for the Advancement of Behavior Therapy and The Obesity Society. Wadden is a fellow of the Academy of Behavioral Medicine Research, the College of Physicians of Philadelphia, the Obesity Society, and Society of Behavioral Medicine. In 2015, the Obesity Society created the Thomas A. Wadden Award for Distinguished Mentorship, recognizing his education of scientists and practitioners in the field of obesity.

Dr. Julia Ann Koretski, a psychiatrist and Digital Editor of the Journal of Clinical Psychopharmacology (JCP), leads a conversation about the guest editorial “Ethics in Psychedelic Science: Promises and Responsibilities” with its author, Dominic Sisti, PhD, a medical ethicist from the Perelman School of Medicine at the University of Pennsylvania, and a JCP podcast panel of Editor-in-Chief Dr. Anthony Rothschild and Associate Editor Dr. Richard Balon. Dr. Sisti provides an overview of recent regulatory actions in this area and summarizes the history of “utopian hype” in the field. The editorial and the podcast discussion detail what elements are required to build a solid ethics infrastructure for psychedelics research and clinical delivery that is free of hype and bias. Sisti advises moving ahead with caution, while noting that “the range of potentially treatable conditions is wide—including PTSD, major depression, anxiety disorder, obsessive compulsive disorder, anorexia nervosa, and substance use disorders.” The guest editorial is published in the January-February 2025 issue of JCP.

Dr. Julia Ann Koretski, a psychiatrist and Digital Editor of the Journal of Clinical Psychopharmacology (JCP), leads a conversation about the guest editorial “Ethics in Psychedelic Science: Promises and Responsibilities” with its author, Dominic Sisti, PhD, a medical ethicist from the Perelman School of Medicine at the University of Pennsylvania, and a JCP podcast panel of Editor-in-Chief Dr. Anthony Rothschild and Associate Editor Dr. Richard Balon. Dr. Sisti provides an overview of recent regulatory actions in this area and summarizes the history of “utopian hype” in the field. The editorial and the podcast discussion detail what elements are required to build a solid ethics infrastructure for psychedelics research and clinical delivery that is free of hype and bias. Sisti advises moving ahead with caution, while noting that “the range of potentially treatable conditions is wide—including PTSD, major depression, anxiety disorder, obsessive compulsive disorder, anorexia nervosa, and substance use disorders.” The guest editorial is published in the January-February 2025 issue of JCP.

What role can AI play in mental health care? Let's talk about it! In this year's final episode of Informatics in the Round, we explore how AI can assist both patients seeking diagnoses and treatments for mental health disorders as well as therapists looking to improve their clinical practice. While AI offers exciting possibilities, we also address important concerns around data privacy, potential bias, and the need to maintain human connection in the therapeutic process. It was a fitting discussion to to wrap up our year of AI-themed episodes. For our expert consultant, we invited Dr. Torrey Creed, an Associate Professor of Psychiatry at the University of Pennsylvania's Perelman School of Medicine and founder of the Penn Collaborative for CBT and Implementation Science. As an NIH-funded researcher, her work focuses on creating pragmatic and sustainable strategies to increase access to high-quality mental health care, especially in low-resourced communities. She also serves as the Senior Implementation Consultant for Lyssn.io, which leverages AI to help scale multiple aspects of clinical care. We also welcomed back one of our favorite musicians, Jane Bach, to bring her perspective! Jane is an award-winning songwriter who has written for some of the biggest names in music, including Reba McEntire, Tammy Wynette, Collin Raye, and JoDee Messine. She was also recently inducted into the New York State Country Songwriters Hall of Fame. We wanted to spend some time in this episode honoring our friend, Nolan Neal, who passed away in summer of 2022. Nolan was upfront about his struggles with mental health, and we want to dedicate this episode to him. Nolan, thank you for sharing your life with us through your music. We hope this episode can help serve others like you and make a contribution to providing better mental health care to all. Mentioned in the episode: -"Shadow of the Man I Used to Be" by Nolan Neal -Nolan Neal on America's Got Talent -"Already Gone" written by Jane Bach, performed by Natalia Malo Make sure to follow our Instagram, X, Bluesky, Threads, and TikTok accounts so you can stay up to date on all our new content. Thanks for listening! Instagram: @infointhernd X/Twitter: @infointhernd Bluesky: @infointhernd.bsky.social Threads: @infointhernd TikTok: @infointhernd Website: https://www.kevinbjohnsonmd.net/

Send us a textDr. Matthew Bernstein is Accord's chief executive officer and one of the leading voices in the emerging field of metabolic psychiatry. He is a well-respected clinical psychiatrist for more than 25 years.After graduating summa cum laude from Columbia University in New York, N.Y., with a bachelor's degree in English literature, he received his medical degree from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, PA. Dr. Bernstein then trained at the MGH McLean Psychiatry Residency Program in Belmont, Mass., where he served as chief resident. He remained at McLean Hospital after residency as a psychiatrist-in-charge and later served as assistant medical director of its schizophrenia and bipolar inpatient program.Dr. Bernstein has developed his passion for community-based care as the chief medical officer at Ellenhorn, a sister program of Accord, where he has pursued alternative ways (such as a focus on metabolism, nutrition, circadian-rhythm biology and exercise) to help individuals achieve their best levels of functioning without relying solely on traditional psychiatric approaches.Central to Accord's mission is the enhancement of metabolic health, recognizing its profound impact on mental well-being. Their focus lies in crafting personalized plans centered around enhancing metabolic health through nutrition, exercise, mind-body practices and circadian rhythm alignment.With a full-time chef at their service, clients not only enjoy expertly prepared meals but also receive hands-on culinary education. Regular consultations with our nutritionist/dietitian ensure that each client's plan is finely tuned to their unique requirements.In addition to serving on the clinical advisory board at Metabolic Mind, Dr. Bernstein is known for organizing the first-ever public conference on metabolic psychiatry in 2023.Find Dr. Matthew Bernstein at-https://accordmh.com/TW- @AccordMetabolicLK- @Accord MHFind Boundless Body at- myboundlessbody.com Book a session with us here!

New research into the uses of Psychedelic drugs in the fields of mental health and addiction raises several issues, especially when it comes to how these drugs are regulated by the federal government. Dr. Dominic Sisti, Associate Professor of Medical Ethics & Health Policy in the Perelman School at the University of Pennsylvania, and Holly Fernandez-Lynch, Associate Professor of Medical Ethics and an Associate Professor of Law at the University of Pennsylvania joined The Spark to discuss challenges of crafting guidelines for the ethical use of psychedelics. Listen to the podcast to hear the discussion. Support WITF: https://www.witf.org/support/give-now/See omnystudio.com/listener for privacy information.

Guest: Mateo Bustamante Idiopathic multicentric Castleman disease (iMCD) is a rare, life-threatening condition. Early diagnosis through excisional biopsies is key for speeding up treatment and improve patient outcomes. Learn more with Mateo Bustamante, a Senior Clinical Data Analyst at the Center for Cytokine Storm Treatment and Laboratory at University of Pennsylvania's Perelman School of Medicine.

In this episode, hosts Drs. Jason Silverman and Jennifer Lee sit down with Dr. Nikhil Pai on the early life development of the gut microbiome and its impacts on pediatric health and disease. Dr. Pai is an Associate Professor of Pediatrics at the Perelman School of Medicine and a pediatric gastroenterologist at the Children's Hospital of Philadelphia. Learning objectives:To understand the early life influences on microbiome development.To review the influence of our microbiome on various aspects of health and specific diseases.To review various modalities for influencing the microbiome including prebiotics, probiotics, antibiotics and more. Links:Season 2 Episode 24: Stacy Kahn - Fecal Microbiota TransplantationSupport the showThis episode may be eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Bluesky, Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

In this episode, Dr. Sergio Zanotti discusses the application of behavioral economics to clinical practice, specifically choice framing in ICU goals-of-care Meetings. He is joined by Dr. Joanna Hart, a pulmonary critical care physician and assistant professor of medicine at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. She is also a core faculty member of the Palliative and Advanced Illness Research Center and is affiliated with the Center for Health Incentives and Behavioral Economics. Additional Resources: Clinician's Use of Choice Framing in ICU Family Meetings. Joanna L Hart et al. Crit Care Med 2024: https://pubmed.ncbi.nlm.nih.gov/38912880/ Using Default Options and Other Nudges to Improve Critical Care. Scott Halpern. Crit Care Med 2019: https://pmc.ncbi.nlm.nih.gov/articles/PMC5826616/ Books mentioned in this episode: Demon Copperhead. By Barbara Kingsolver: https://bit.ly/4hYCqQv Thinking Fast and Slow. By Daniel Kahneman: https://bit.ly/4i3eknK Nudge. By Richard H. Thaler, et al.: https://bit.ly/3YUqxlG

In this episode of the Award-winning PRS Journal Club Podcast, 2024 Resident Ambassadors to the PRS Editorial Board – Rami Kantar, Yoshi Toyoda, and Amanda Sergesketter- and special guest, Scott Bartlett, MD, discuss the following articles from the November 2024 issue: “Loop-Neurorrhaphy Technique for Preventing Bone Resorption and Preserving Lower Lip Sensation in Mandibular Reconstruction Using Vascularized Iliac Bone Flap: A Single-Center Randomized Clinical Trial” Shi, Zhang, Zhang, et al. Read the article for FREE: https://bit.ly/MandReconLoop Special guest, Dr. Scott Bartlett, is the former chair of Plastic Surgery at the Children's Hospital of Philadelphia and is the director of the craniofacial program at CHOP where he also holds The Mary Downs Endowed Chair in Pediatric Craniofacial Treatment and Research, in addition to being a Professor of Plastic Surgery at The Perelman School of Medicine at The University of Pennsylvania. He obtained his medical degree at Washington University in St. Louis followed by plastic surgery training at The Massachusetts General Hospital, Harvard Medical School, and pediatric and craniomaxillofacial surgery fellowship at The Children's Hospital of Philadelphia. Dr. Bartlett is an international authority in craniofacial surgery and won the AAPS Clinician of the Year award in 2023. READ the articles discussed in this podcast as well as free related content: https://bit.ly/JCNov24Collection

Enhance your patient care skills with this season covering select AGA Clinical Practice Updates. This episode shares key insights from the AGA Clinical Practice Update: Diet and Nutritional Therapies (published in the March 2024 issue of Gastroenterology). This episode is hosted by Dr. Jana Al Hashash, chair of the AGA Clinical Practice Update Committee. She is joined by authors -Dr. David Binion, professor of medicine and co-director of the IBD Center, director of nutrition support service, at UPMC Presbyterian Hospital and University of Pittsburgh; co-author of CPU -Dr. James Lewis, professor of medicine and epidemiology at the Perelman School of Medicine at the University of Pennsylvania ; co-author of CPU -Ms. Kelly Issokson, registered dietitian and clinical coordinator of digestive diseases at Cedars-Sinai in Los Angeles To access the full Clinical Practice Update, visit www.gastro.org/CPU.

Step into the world of TYK2 research. Discover the concept of the TYK2 pathway and explore how TYK2 mediates the cytokines that are drivers in certain immune-mediated inflammatory diseases, including psoriasis. Join our conversation as we delve into the latest findings, illuminating the path toward better understanding.   Brought to you by: Bristol Myers Squibb   Christine Cornejo, MD is the Director, Dermatology Medical Engagement Lead at Bristol Myers Squibb. She graduated summa cum laude from The Pennsylvania State University with a degree in biomedical engineering and received her medical degree from the Perelman School of Medicine at the University of Pennsylvania. She completed her dermatology residency, serving as chief resident, and fellowship in cutaneous oncology at the University of Pennsylvania. After her training, she became an Instructor at Harvard Medical School and joined the Department of Dermatology at Brigham and Women's Hospital and Dana-Farber Cancer Institute. She served as the Director of Confocal Microscopy and specialized in melanoma and high-risk skin cancer management.     

In this episode of the Award-winning PRS Journal Club Podcast, 2024 Resident Ambassadors to the PRS Editorial Board – Rami Kantar, Yoshi Toyoda, and Amanda Sergesketter- and special guest, Scott Bartlett, MD, discuss the following articles from the November 2024 issue: “A National Assessment of Racial and Ethnic Disparities in Cleft Lip Repair” by Peck, Parsaei, Jazayeri, et al. Read the article for FREE: https://bit.ly/RacialCleftLipRepair Special guest, Dr. Scott Bartlett, is the former chair of Plastic Surgery at the Children's Hospital of Philadelphia and is the director of the craniofacial program at CHOP where he also holds The Mary Downs Endowed Chair in Pediatric Craniofacial Treatment and Research, in addition to being a Professor of Plastic Surgery at The Perelman School of Medicine at The University of Pennsylvania. He obtained his medical degree at Washington University in St. Louis followed by plastic surgery training at The Massachusetts General Hospital, Harvard Medical School, and pediatric and craniomaxillofacial surgery fellowship at The Children's Hospital of Philadelphia. Dr. Bartlett is an international authority in craniofacial surgery and won the AAPS Clinician of the Year award in 2023. READ the articles discussed in this podcast as well as free related content: https://bit.ly/JCNov24Collection

In this episode of the Award-winning PRS Journal Club Podcast, 2024 Resident Ambassadors to the PRS Editorial Board – Rami Kantar, Yoshi Toyoda, and Amanda Sergesketter- and special guest, Scott Bartlett, MD, discuss the following articles from the November 2024 issue: “Predictors of Postoperative Diplopia following Orbital Fracture Repair in Adults” by Hassan, Yoon, Er, et al. Read the article for FREE: https://bit.ly/DiplopiaOFractures Special guest, Dr. Scott Bartlett, is the former chair of Plastic Surgery at the Children's Hospital of Philadelphia and is the director of the craniofacial program at CHOP where he also holds The Mary Downs Endowed Chair in Pediatric Craniofacial Treatment and Research, in addition to being a Professor of Plastic Surgery at The Perelman School of Medicine at The University of Pennsylvania. He obtained his medical degree at Washington University in St. Louis followed by plastic surgery training at The Massachusetts General Hospital, Harvard Medical School, and pediatric and craniomaxillofacial surgery fellowship at The Children's Hospital of Philadelphia. Dr. Bartlett is an international authority in craniofacial surgery and won the AAPS Clinician of the Year award in 2023. READ the articles discussed in this podcast as well as free related content: https://bit.ly/JCNov24Collection

If you're an ASOPRS Member, Surgeon or Trainee and are interesting in hosting a podcast episode, please submit your idea by visiting: asoprs.memberclicks.net/podcast About the Guests: Dr. Bradford Lee Associate Clinical Professor at the University of Hawaii School of Medicine and private practitioner in Honolulu. Chair of the DEI (Diversity, Equity, and Inclusion) Committee for ASOPRS. Dr. Andrea Kossler Associate Professor of Ophthalmology, Stanford University School of Medicine Director of Oculofacial Plastic Surgery and Orbital Oncology at Stanford University. Board member of the Women in Ophthalmology and LATINOUS. Dr. Cesar A. Briceño Chief of Oculoplastics at Shea Eye Institute, University of Pennsylvania. Assistant Dean for Diversity and Cultural Affairs at the Perelman School of Medicine, UPenn. Dr. Eydie G. Miller-Ellis Chief of the Glaucoma Service at the University of Pennsylvania. Co-director of the RAB Venable Excellence in Research Project for the NMA. Dr. John Ng Division Chief and Professor of Oculofacial Plastic, Orbital, and Reconstructive Surgery at Casey Eye Institute, Oregon Health & Science University. Incoming Vice President of Aesoppers and future President. Episode Summary: Dive into an engaging panel discussion on Diversity, Equity, and Inclusion (DEI) within the sphere of ophthalmology, specifically exploring its role in oculoplastic surgery. Hosted by Dr. Bradford Lee and Dr. Andrea Kossler, this episode of Top offers profound insights into the initiatives promoting more inclusive and equitable practices in ophthalmology associations and medical education institutions. With esteemed panelists like Dr. Cesar Briceño, Dr. Eydie G. Miller-Ellis, and Dr. John Ng, the conversation shifts focus on innovative programs like the DEI Committee for ASOPRS, which prioritizes inclusion, access, and diversity for both practitioners and patients. The episode explores the intersection of DEI and patient care, highlighting how diverse medical professionals contribute to an enriched healthcare delivery model, thereby mitigating disparities in vision health care. The insightful contributions also touch upon the importance of justice within DEI efforts, as well as the significance of recognizing intersectionality among trainees and patients, which brings emphasis to the unseen and complicated layers impacting healthcare accessibility and delivery. Key Takeaways: The DEI Committee for ASOPRS is actively fostering inclusion and access through travel and research grants, as well as mentorship programs to promote diverse career pathways in ophthalmology. Diversity improves patient care outcomes by fostering a workforce that understands and respects varied cultural and socioeconomic backgrounds. Institutions must strive to create equitable support systems for trainees from diverse backgrounds to ensure they can excel in specialized fields like oculoplastic surgery. Addressing intersectionality is crucial in understanding the multifaceted barriers faced by diverse groups, ensuring a more comprehensive approach in medical research and education. Programs like the RAB Venable Excellence in Research Project aim to increase genetic representation in clinical trials, crucial for advancing targeted treatments. Listeners are encouraged to delve deeper into this vital discussion on DEI within ophthalmology by tuning in to the full episode. Stay connected for more insightful and enlightening conversations from our series.  

Dr. Atheendar Venkataramani, MD, PhD is an Associate Professor in the Department of Medical Ethics and Health Policy at the Perelman School of Medicine and a board-certified general internist at the University of Pennsylvania Presbyterian Medical Center. He is also Director of the Opportunity for Health Lab.    Dr. Venkataramani obtained his PhD in Health Policy in Economics from Yale University in 2009 and his MD from Washington University in St. Louis in 2011. He completed his residency in Internal Medicine-Global Primary Care at the Massachusetts General Hospital (MGH) in 2015.   In this podcast, Dr. Venkataramani speaks about an interdisciplinary approach to medicine, his own research into the economic and social factors which impact health, the importance of self-reflection during one's career, and much more.  White Coat Story is a podcast series for school students to gain first-person insights into the practice of medicine, and what it takes to get there.

Same may think of the pathologist's toolbox as only the microscope and their eyes, but in reality today's pathologists are using more and more molecular methods like NGS and PCR in additional to their traditional tools. Meet Parker Wilson, MD, PhD. Parker is a faculty member Perelman School of Medicine at the University of Pennsylvania, focused on using modern molecular tools to investigate chronic kidney disease. He explains his work phenomenally, both from the general aspects, all the way down to the molecular methods, which include digital PCR. We learn about chronic kidney disease and the interesting genetic mutations associated with it, which Parker and his team are finding, include chromosomal loss. For this application, we hear how dPCR is adept at quantifying chromosome ratios within tissues, and is able to help them spot variations of only a single percent or two. Our career corner portion uncovers an academic and career path with uncertainty and challenges one might not expect. Parker helps normalize these challenges and underscores the value of mentors in helping navigate them successfully. In the end, you have a phenomenally intelligent physician scientists sharing his exciting work and his insightful career development advice.Visit the Absolute Gene-ius pageto learn more about the guests, the hosts, and the Applied Biosystems QuantStudio Absolute Q Digital PCR System. 

George Cooper is joined by Perry Elliott, Professor of Cardiovascular Medicine at University College London, UK, and Anjali Owens, Associate Professor of Medicine in the Division of Cardiology at the Perelman School of Medicine of the University of Pennsylvania, USA. Following an incredible symposium session at the 2024 European Society of Cardiology (ESC) Congress, they discuss case studies and real-world evidence relating to hypertrophic cardiomyopathy and the use of mavacamten.

We sit down with Roy Hamilton, a professor of neurology, psychiatry, and physical medicine and rehabilitation at the University of Pennsylvania. Roy shares insights from his research on using non-invasive brain stimulation to help individuals with cognitive problems caused by neurological disorders. We dive into common misconceptions about cognitive aging, explore proactive steps to maintain brain health, and discuss the strong connection between heart health and brain function. Mentioned on the show: BrainWorks: https://mcknightbrain.org/brainworks/ Roy Hamilton is a professor of neurology, psychiatry, and physical medicine and rehabilitation at the Perelman School of Medicine at the University of Pennsylvania. He is currently a trustee of the McKnight Brain Research Foundation, director of the Penn Laboratory for Cognition and Neural Stimulation, and director of the Penn Brain Science, Translation, Innovation, and Modulation Center. He discusses the KevinMD article, "Working with your patients to promote healthy brain aging." Our presenting sponsor is DAX Copilot by Microsoft. Do you spend more time on administrative tasks like clinical documentation than you do with patients? You're not alone. Clinicians report spending up to two hours on administrative tasks for each hour of patient care. Microsoft is committed to helping clinicians restore the balance with DAX Copilot, an AI-powered, voice-enabled solution that automates clinical documentation and workflows. 70 percent of physicians who use DAX Copilot say it improves their work-life balance while reducing feelings of burnout and fatigue. Patients love it too! 93 percent of patients say their physician is more personable and conversational, and 75 percent of physicians say it improves patient experiences. Help restore your work-life balance with DAX Copilot, your AI assistant for automated clinical documentation and workflows. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended GET CME FOR THIS EPISODE → https://www.kevinmd.com/cme I'm partnering with Learner+ to offer clinicians access to an AI-powered reflective portfolio that rewards CME/CE credits from meaningful reflections. Find out more: https://www.kevinmd.com/learnerplus

In this enlightening episode of The Reflective Mind Podcast, Dr. Reid speaks with Dr. Mara Gordon, a pioneer in the field of size-inclusive medicine. Dr. Gordon shares insights into her comprehensive approach to healthcare that prioritizes patients of all body sizes.We delve into how size-inclusive medicine goes beyond the numbers on a scale, focusing on holistic patient care, individualized treatment plans, and the importance of addressing weight bias in the medical field. Dr. Gordon discusses the impact of size discrimination, and practical strategies for other healthcare professionals to foster a more inclusive environment.Join us for an eye-opening conversation that redefines what it means to provide compassionate and equitable care. Whether you're a healthcare professional, a patient, or simply curious about how to make the medical system more inclusive, this episode offers valuable perspectives and actionable insights.Thanks for reading A Mind of Her Own! Subscribe for free to receive new posts and support my work.Medical Students for Size-Inclusive Medicine can be found at https://sizeinclusivemedicine.org/our-story/Authors Recommended in Episode:* Lindy West* Roxane Gay* Kiese LaymonDr. Reid on Instagram: @jenreidmdThanks for listening to The Reflective Mind Podcast! Listening is free for all, so please share it with everyone!Also check out Dr. Reid's regular contributions to Psychology Today: Think Like a ShrinkDr. Mara Gordon is a family physician and writer based in Philadelphia. Her writing has appeared on NPR, in the New York Times, the Atlantic, the Philadelphia Inquirer, STAT News, and elsewhere. Please check out her newsletter, Chief Complaint, for more reflections on medicine, parenting, gender, and fatphobia.Dr. Gordon worked in public health in Tanzania and Malawi before returning home to attend medical school at the Perelman School of Medicine at the University of Pennsylvania. She stayed at Penn for residency training in Family Medicine and Community Health and was the 2018-2019 Health & Media Fellow at National Public Radio.She is now on the faculty at Cooper Medical School of Rowan University in Camden, NJ, where she serves as a primary care physician for patients of all ages and teach medical students. Seeking a mental health provider? Try Psychology TodayNational Suicide Prevention Lifeline: 1-800-273-8255Dial 988 for mental health crisis supportSAMHSA's National Helpline - 1-800-662-HELP (4357)-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.Disclaimer:The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit amindofherown.substack.com

In this episode of SEE HEAR FEEL, Dr. Rosalie Elenitsas from the University of Pennsylvania shares her extensive experience in dermatopathology. She discusses her career journey, the importance of daily consensus conferences, learning from junior colleagues, and managing work-life balance. Dr. Elenitsas also offers valuable advice on building a support system, continuous learning, dealing with errors, and the significance of simple yet effective practices in both professional and personal life.00:00 Introduction and Guest Introduction01:12 Personal Anecdote: Learning to Ride a Bike02:08 Advice for a Successful Career05:15 Work-Life Balance and Support Systems08:52 Dealing with Errors and Continuous Improvement13:08 Conclusion and Final ThoughtsDr. Rosalie Elenitsas, MD is the Herman Beerman Professor of Dermatology and Pathology and the Director of the Penn Cutaneous Pathology Services since 1999 at the Perelman School of Medicine at the University of Pennsylvania. Dr. Elenitsas has been a faculty member at Penn since 1991 and has been director of the Dermatopathology Fellowship Program since 1998; she recently transferred the directorship to Emily Chu just this year. She has published more than 200 manuscripts/chapters, and has given more than 100 invited lectures. She is associate editor of Lever's Histopathology of the Skin and the past president of the Pennsylvania Academy of Dermatology and past president of the American Society of Dermatopathology (ASDP). She received the Nickel Award for teaching in Dermatopathology by the ASDP, and has also been elected to the Academy of Master Clinicians at Penn Medicine, a coveted honor for practicing physicians in the Penn health system. 

BUFFALO, NY- August 12, 2024 – A new research perspective was published in Oncotarget's Volume 15 on July 16, 2024, entitled, “Targeting the multifaceted BRAF in cancer: New directions.” In cancer patients, BRAF-targeting precision therapeutics are effective against Class I BRAF alterations (p.V600 hotspot mutations) in tumors such as melanoma, thyroid cancer, and colorectal cancer. However, numerous non-Class I BRAF inhibitors are also in development and have been explored in various cancers. Researchers Eamon Toye, Alexander Chehrazi-Raffle, Justin Hwang, and Emmanuel S. Antonarakis from the Masonic Cancer Center, University of Minnesota-Twin Cities, Department of Medicine, University of Minnesota-Twin Cities, Perelman School of Medicine, University of Pennsylvania, and the City of Hope Comprehensive Cancer Center in Duarte, California, discuss the diverse forms of BRAF alterations found in human cancers and the strategies used to inhibit them in patients with cancers of various origins. As part of their conclusion, the researchers highlighted that Class I BRAF inhibitors represent a landmark achievement in precision oncology, as demonstrated by the recent tissue-agnostic FDA approval of dabrafenib/trametinib for patients with metastatic BRAF p.V600E-mutant solid tumors. Additionally, the accelerated approval of tovorafenib for patients with relapsed/refractory BRAF-altered pediatric low-grade glioma underscores the therapeutic potential of this and other next-generation strategies targeting aberrant MAPK signaling. DOI - https://doi.org/10.18632/oncotarget.28612 Correspondence to - Emmanuel S. Antonarakis - anton401@umn.edu, and Justin Hwang - jhwang@umn.edu Video short - https://www.youtube.com/watch?v=3dRWRvOnssc Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28612 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, BRAF, MAPK, pan-cancer, precision oncology, genomics About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

Differences in treatment delivery and receipt are estimated to account for about 50 percent of the racial disparities seen in breast cancer-associated mortality.  In this latest episode of Investigating Breast Cancer, Dr. Lola Fayanju discusses her work to understand how to close this gap. BCRF investigator since 2023, Dr. Fayanju, is an associate professor in the Perelman School of Medicine at the University of Pennsylvania and chief of the division of breast surgery for the University of Pennsylvania Health System.

In this episode of Talk Nerdy, Cara is joined by Dr. Paul A. Offit, MD. He is the director of the Vaccine Education Center, an attending physician in the Division of Infectious Diseases at the Children's Hospital of Philadelphia, and a professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania. We discuss his 2021 book, “You Bet Your Life: From Blood Transfusions to Mass Vaccinations—The Long and Risky History of Medical Innovations.” Follow Paul: @DrPaulOffit

In this episode, I explore the role of phototherapy in treating psoriasis and how it compares to the more commonly discussed biologics. I'm joined by Dr. Joel Gelfand, the Director of the Center for Clinical Sciences in Dermatology and Psoriasis and Phototherapy Treatment Center at the University of Pennsylvania's Perelman School of Medicine. Dr. Gelfand has made significant contributions to our understanding of phototherapy's effectiveness for psoriasis patients. Together, we delve into the nuances of how phototherapy works, its benefits, and its place in modern dermatological care. Tune in to gain valuable insights from our conversation. Connect with me across Social: Instagram:https://www.instagram.com/drhannahkopelman/ TikTok: https://www.tiktok.com/@drhankopelman Twitter: https://twitter.com/drhankopelman Pinterest: https://www.pinterest.com/drhankopelman/ Personal Site: https://www.hannahkopelman.com The content of this podcast is for entertainment and educational purposes only. This content is not meant to be a substitute for medical advice or treatment for any medical condition. --- Send in a voice message: https://podcasters.spotify.com/pod/show/hannah-kopelman/message

Steven Loscalzo, MD, FAAP is an Attending Physician in the Division of Pediatric Critical Care Medicine and an Assistant Professor of Anesthesiology, Critical Care, and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. He completed his residency and chief residency in Pediatrics at St. Christopher's Hospital for Children, followed by a critical care fellowship at the Children's Hospital of Philadelphia. He is now an attending physician in the Division of Critical Care Medicine at Children's Hospital of Philadelphia.Elorm Avakame, MD, MPP recently completed his Pediatric Critical Care Medicine fellowship at New York-Presbyterian Hospital/Columbia University Medical Center. His areas of professional interest include clinical teaching in the ICU and mentoring and professional identity formation. This August, he will begin his faculty career as an attending physician in the Department of Anesthesiology and Critical Care Medicine at Children's Hospital of Philadelphia.Learning Objectives: By the end of this podcast, listeners should be able to:Define “emotional intelligence” and discuss relevant conceptual frameworks.Identify examples of emotional intelligence competencies.Describe existing data supporting the importance of emotional intelligence in clinical practice.Discuss strategies for teaching emotional intelligence competencies in critical care training.Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & ZacSupport the Show.How to support PedsCrit:Please complete our Listener Feedback SurveyPlease rate and review on Spotify and Apple Podcasts!Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show. Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.

In this episode, hosts Drs. Temara Hajjat and Peter Lu talk to Dr. Arun Singh about some of the challenges we face when caring for children with celiac disease. Dr. Singh is Co-Director and Research Program Director of the Center for Celiac Disease at the Children's Hospital of Philadelphia and an Assistant Professor in the Perelman School of Medicine at the University of Pennsylvania.Learning Objectives:Understand the latest gluten challenge recommendations to help facilitate celiac disease diagnosis.Recognize the differences between various celiac serologies.Recognize resources available to children diagnosed with celiac disease and their families.References:Gluten Challenge: Singh A, et al. A Clinician's Guide to Gluten Challenge. J Pediatr Gastroenterol Nutr. 2023 Dec 1;77(6):698-702. SAGE Guidelines: https://celiac.org/schoolmanagementplan/College Toolkit: https://www.beyondceliac.org/living-with-celiac-disease/school/info-for-college-students/https://www.beyondceliac.org/wp-content/uploads/2020/08/College-Toolkit.pdfSupport the Show.This episode is eligible for CME credit! Once you have listened to the episode, click this link to claim your credit. Credit is available to NASPGHAN members (if you are not a member, you should probably sign up). And thank you to the NASPGHAN Professional Education Committee for their review!As always, the discussion, views, and recommendations in this podcast are the sole responsibility of the hosts and guests and are subject to change over time with advances in the field.Check out our merch website!Follow us on Twitter, Facebook and Instagram for all the latest news and upcoming episodes.Click here to support the show.

The Rich Zeoli Show- Hour 4: 6:05pm- Biden's Economy: While speaking with the press, Federal Reserve Chairman Jerome Powell conceded that the Labor Department may be “overstating” the number of jobs added in the United States. Zero Hedge writes: “While the [Labor Department's] Establishment Survey [from last Friday] did indeed report that 272K ‘jobs' were added, this number also included multiple job holders; stripping those out, we get that the actual number of ‘employed' workers plunged by 408K...” You can read the full article here: https://www.zerohedge.com/markets/fed-chair-powell-admits-biden-admin-overstating-jobs 6:10pm- Anders Hagstrom of Fox News writes: “A fleet of Russian warships entered Cuban waters on Wednesday as they prepare to hold military drills in the Caribbean. The deployment is likely a warning to President Biden after he gave approval for Ukrainian forces to strike some targets within Russia using U.S. weaponry, according to Rebekah Koffler, strategic intelligence analyst and author of ‘Putin's Playbook.' Russian President Vladimir Putin is telling Washington, ‘we can touch you,' Koffler said.” You can read the full article here: https://www.foxnews.com/politics/putin-fleet-warships-cuba-direct-warning-biden-experts-say 6:25pm- Ocean Train! While speaking with the press in Italy, President Joe Biden seemed to suggest there will soon be a train that will cross the Indian Ocean…what? 6:45pm- REPLAY: Dr. Stanley Goldfarb—Chairman of Do No Harm & Professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania—joins The Rich Zeoli Show to discuss the California State Senate's Bill AB1955 which allows schools to promote gender affirmation of students without parental notification, despite evidence-based medicine suggesting this practice is problematic. You can learn more about Do No Harm here: https://donoharmmedicine.org

The Rich Zeoli Show- Full Episode (06/13/2024): 3:05pm- While appearing at a joint press conference with Ukrainian President Volodymyr Zelenskyy during the G7 Summit in Italy, President Joe Biden denied that he was considering a pardon or commutation for his son Hunter. Earlier in the week, a jury in Wilmington, Delaware found Hunter Biden guilty on three felony charges related to lying on a background-check he submitted when acquiring a firearm in October of 2018. According to reports, the president's son could face up to 25-years in prison and a fine up to $750,000. 3:20pm- Don't miss 1210 WPHT's next Politics and Pints with New York Times best-selling author Jack Carr—hosted by Rich! Tuesday, June 25th from 7:30 to 8:45pm ET at Zlock Performing Arts Center Bucks County Community College in Newtown, Pennsylvania. You can find more information and tickets here: https://www.audacy.com/1210wpht/events/politics-and-pints-with-jack-carr 3:30pm- On Thursday, Donald Trump spoke with House and Senate leadership on Capitol Hill. During a press conference following the meeting, the former president stated: “There is tremendous unity in the Republican party. We want to see a strong military. We want to see a strong military. We want to see money not wasted all over the world. We don't want to see Russian ships right off the coast of Florida.” 3:35pm- According to Michael Scherer of The Washington Post, Democratic donor groups are attempting to “lure young voters” to the polls by providing them with beer and birth control. Rich says this reminds him of when former New York City Mayor Bill de Blasio bribed NYC residents to get the COVID-19 vaccine by offering free French fries. You can read the full article here: https://www.washingtonpost.com/politics/2024/06/11/democratic-efforts-lure-young-voters-include-beer-birth-control/ 3:40pm- Dr. Stanley Goldfarb—Chairman of Do No Harm & Professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania—joins The Rich Zeoli Show to discuss the California State Senate's Bill AB1955 which allows schools to promote gender affirmation of students without parental notification, despite evidence-based medicine suggesting this practice is problematic. You can learn more about Do No Harm here: https://donoharmmedicine.org 4:05pm- While appearing at joint press conference with Ukrainian President Volodymyr Zelenskyy during the G7 Summit in Italy, President Joe Biden denied that he was considering a pardon or commutation for his son. He explained, “I am extremely proud of my son, Hunter. He has overcome an addiction. He's one of the brightest, most decent men I know.” Earlier in the week, a jury in Wilmington, Delaware found Hunter Biden guilty on three felony charges related to lying on a background-check he submitted when acquiring a firearm in October of 2018. According to reports, the president's son could face up to 25-years in prison and a fine up to $750,000. Could this be used as an excuse for Biden to step aside as the Democrat nominee for president? According to an election forecast model from The Economist, Republican presidential candidate Donald Trump has a 66-in-100 chance of beating President Joe Biden in the 2024 election. Similarly, The Hill believes Trump has a 56-in-100 chance of winning. 4:30pm- During an interview with Dana Bash on CNN, South Dakota Governor Kristi Noem suggested that Republican presidential candidate Donald Trump should pick a woman to be his running mate. Rich notes that there is no chance she's still in contention for Vice President after her disastrous memoir. 4:40pm- Rich tells Andrew that he hates Bon Jovi, Sean Connery didn't even attempt to hide his Scottish accent in The Hunt for Red October, and Matt gets yelled at for not getting Lunden Roberts—the mother of one of Hunter Biden's children who is actively promoting a new book—on the show yet. 5:00pm- Milo Morris—the Bucks County Chairman for Black Conservative Foundation—joins The Rich Zeoli Show to talk about an upcoming “Flag Day Birthday Rally” for Republican presidential candidate Donald Trump. It's scheduled for tomorrow (Friday, 6/14) from 4pm to 6pm at Old Doylestown Courthouse on the Corner of N. Main and E. Court Street in Doylestown, Pennsylvania. 5:20pm- While speaking with CNN host Kaitlan Collins, New York Times reporter Maggie Haberman said that voters just don't seem to be interested in the guilty verdict in Donald Trump's “hush money” case. 5:25pm- While speaking with Abby Phillip, former CNN anchor Brian Stelter argued that it's not unreasonable to think Donald Trump will “punish” journalists if he becomes president again. Plus, Congresswoman Alexandria Ocasio Cortez recently revealed that she believes Trump wants to throw her in jail! 5:30pm- Who was the best James Bond: Sean Connery? Daniel Craig? Pierce Brosnan??? Rich, Matt, and Andrew debate. Plus, according to reports, Aaron Taylor Johnson is supposed to be the new Bond. 5:40pm- The New York Post Editorial Board writes that the New York Times is still unwilling to admit that Hunter Biden's laptop is real! You can read the full editorial here: https://nypost.com/2024/06/12/opinion/ny-times-still-cant-admit-hunter-bidens-laptop-is-real-whats-it-going-to-take/ 5:50pm- Brent Scher of The Daily Wire writes: “The Covenant School shooter obsessed in her private journal over her desire to be a man, fantasizing about having an ‘imaginary penis' and lamenting that so-called gender affirming treatments weren't available to her, according to images of her journal obtained by The Daily Wire.” You can read the full article here: https://www.dailywire.com/news/covenant-journal-revealed-my-imaginary-penis?topStoryPosition=1 6:05pm- Biden's Economy: While speaking with the press, Federal Reserve Chairman Jerome Powell conceded that the Labor Department may be “overstating” the number of jobs added in the United States. Zero Hedge writes: “While the [Labor Department's] Establishment Survey [from last Friday] did indeed report that 272K ‘jobs' were added, this number also included multiple job holders; stripping those out, we get that the actual number of ‘employed' workers plunged by 408K...” You can read the full article here: https://www.zerohedge.com/markets/fed-chair-powell-admits-biden-admin-overstating-jobs 6:10pm- Anders Hagstrom of Fox News writes: “A fleet of Russian warships entered Cuban waters on Wednesday as they prepare to hold military drills in the Caribbean. The deployment is likely a warning to President Biden after he gave approval for Ukrainian forces to strike some targets within Russia using U.S. weaponry, according to Rebekah Koffler, strategic intelligence analyst and author of ‘Putin's Playbook.' Russian President Vladimir Putin is telling Washington, ‘we can touch you,' Koffler said.” You can read the full article here: https://www.foxnews.com/politics/putin-fleet-warships-cuba-direct-warning-biden-experts-say 6:25pm- Ocean Train! While speaking with the press in Italy, President Joe Biden seemed to suggest there will soon be a train that will cross the Indian Ocean…what? 6:45pm- REPLAY: Dr. Stanley Goldfarb—Chairman of Do No Harm & Professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania—joins The Rich Zeoli Show to discuss the California State Senate's Bill AB1955 which allows schools to promote gender affirmation of students without parental notification, despite evidence-based medicine suggesting this practice is problematic. You can learn more about Do No Harm here: https://donoharmmedicine.org

The Rich Zeoli Show- Hour 1: 3:05pm- While appearing at a joint press conference with Ukrainian President Volodymyr Zelenskyy during the G7 Summit in Italy, President Joe Biden denied that he was considering a pardon or commutation for his son Hunter. Earlier in the week, a jury in Wilmington, Delaware found Hunter Biden guilty on three felony charges related to lying on a background-check he submitted when acquiring a firearm in October of 2018. According to reports, the president's son could face up to 25-years in prison and a fine up to $750,000. 3:20pm- Don't miss 1210 WPHT's next Politics and Pints with New York Times best-selling author Jack Carr—hosted by Rich! Tuesday, June 25th from 7:30 to 8:45pm ET at Zlock Performing Arts Center Bucks County Community College in Newtown, Pennsylvania. You can find more information and tickets here: https://www.audacy.com/1210wpht/events/politics-and-pints-with-jack-carr 3:30pm- On Thursday, Donald Trump spoke with House and Senate leadership on Capitol Hill. During a press conference following the meeting, the former president stated: “There is tremendous unity in the Republican party. We want to see a strong military. We want to see a strong military. We want to see money not wasted all over the world. We don't want to see Russian ships right off the coast of Florida.” 3:35pm- According to Michael Scherer of The Washington Post, Democratic donor groups are attempting to “lure young voters” to the polls by providing them with beer and birth control. Rich says this reminds him of when former New York City Mayor Bill de Blasio bribed NYC residents to get the COVID-19 vaccine by offering free French fries. You can read the full article here: https://www.washingtonpost.com/politics/2024/06/11/democratic-efforts-lure-young-voters-include-beer-birth-control/ 3:40pm- Dr. Stanley Goldfarb—Chairman of Do No Harm & Professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania—joins The Rich Zeoli Show to discuss the California State Senate's Bill AB1955 which allows schools to promote gender affirmation of students without parental notification, despite evidence-based medicine suggesting this practice is problematic. You can learn more about Do No Harm here: https://donoharmmedicine.org

Dr. Kim Waddell is an Assistant Professor in Physical Medicine and Rehabilitation at the University of Pennsylvania's Perelman School of Medicine as well as a faculty member with the Center for Health Incentives and Behavioral Economics, a Senior Fellow in the Leonard Davis Institute of Health Economics, and Research and Innovation Manager in the Penn Medicine Nudge Unit at the University of Pennsylvania. In addition, Kim is a Research Health Scientist at the VA Center for Health Equity Research and Promotion. Kim's research focuses on behavior change and how to help motivate people to make decisions that are more aligned with their longer term goals. She is particularly interested in physical activity and using approaches from behavioral science to motivate adults who have had a stroke or have Parkinson's disease to increase their daily activity. Another area that Kim is interested in is designing clinical decision support systems and ways to improve decision making to make sure that people are getting the right amount of the right kind of rehabilitation after stroke. When she's not working, Kim tries to go running as often as possible to clear her head and disconnect from technology. She also enjoys cooking, particularly trying new recipes, as well as watching local sports teams and traveling. Kim received her BS in Health Science from Truman State University and her Master's degree in Occupational Therapy from the University of North Carolina at Chapel Hill. She then attended Washington University in St. Louis where she earned her PhD in Movement Science and her Master's degree in Clinical Investigation. Kim conducted postdoctoral research at the VA and Penn before joining the faculty there. Recently, she was awarded the 2024 Academy of Behavioral Medicine Research's Early-Stage Investigator Award, and in our interview, she shares more about her life and science.

Ever since the book "Lifespan" came out from Dr David Sinclair, everyone and their dog and has been supplementing with nicotinamide mononucleotide and nicotinamide riboside and an effort to increase our levels in the body.NAD is essential to life. No energy production can happen without NAD. NAD Also decreases as we age so the question has always been should we and can we increase our NAD levels. As usual in biology it's very complicated and as the science has developed we have learned many new detailed insights.  Here is an update on the latest in that science. In this episode of "Pushing The Limits" I have the wonderful privilege of interviewing one of the world's leading researchers in NAD metabolism, sirtuin genes and metabolic health Professor Joseph Baur. Professor at the Perelman School of Medicine of the University of Pennsylvania, How can you increase NAD+ levels? And do higher NAD+ levels really lead to better metabolic health? What does the research say on their benefits for Longevity. We cover this critical pathway in-depth looking what the research is saying and what it currently isn't and what we have still to learn. We look into mice studies and then also where the human research is at. We cover the salvage pathway as well as the Preiss Handler pathway. The possible role of the Microbiome and in NAD metabolism. We also discussed the various NAD pools and why the mitochondria maybe a key in a NAD pool. We discuss the transporter for NAD into the mitochondria that was recently discovered by Prof Baur and other labs. We discuss also the possible risk factors and how we can mitigate these. We look at where the research is at in relation to cancer and NAD Metabolism. The role of CD 38 as a voracious consumer of in NAD and how lowering CD38 in the body may be even more beneficial than taking the precursor enzymes. We discuss also why CD38 increases as we age and what we can do about it and the role of senolytics. How we can increase the NAMPT enzyme so we recycle more of our NAD And whether we need to support our methylation donors when we are supplementing with the likes of NMB and NR.   If you are fascinated by longevity science and want to know how you can optimise your health moving forward then this is the episode for you! Want to try NMN, TMG and quercetin to support your healthy NAD metabolism you can find them in my shop   Personalised Health Optimisation Consulting with Lisa Tamati Lisa offers solution focused coaching sessions to help you find the right answers to your challenges. Topics Lisa can help with:  Lisa is a Genetics Practitioner, Health Optimisation Coach, High Performance and Mindset Coach. She is a qualified Ph360 Epigenetics coach and a clinician with The DNA Company and has done years of research into brain rehabilitation, neurodegenerative diseases and biohacking. She has extensive knowledge on such therapies as hyperbaric oxygen,  intravenous vitamin C, sports performance, functional genomics, Thyroid, Hormones, Cancer and much more. She can assist with all functional medicine testing. Testing Options Comprehensive Thyroid testing DUTCH Hormone testing Adrenal Testing Organic Acid Testing Microbiome Testing Cell Blueprint Testing Epigenetics Testing DNA testing Basic Blood Test analysis Heavy Metals  Nutristat Omega 3 to 6 status and more  Lisa and her functional medicine colleagues in the practice can help you navigate the confusing world of health and medicine . She can also advise on the latest research and where to get help if mainstream medicine hasn't got the answers you are searching for whatever the  challenge you are facing from cancer to gut issues, from depression and anxiety, weight loss issues, from head injuries to burn out to hormone optimisation to the latest in longevity science. Book your consultation with Lisa    Join our Patron program and support the show Pushing the Limits' has been free to air for over 8 years. Providing leading edge information to anyone who needs it. But we need help on our mission.  Please join our patron community and get exclusive member benefits (more to roll out later this year) and support this educational platform for the price of a coffee or two You can join by going to  Lisa's Patron Community Or if you just want to support Lisa with a "coffee" go to  https://www.buymeacoffee.com/LisaT to donate $3   Lisa's Anti-Aging and Longevity Supplements  Lisa has spent years curating a very specialized range of exclusive longevity, health optimizing supplements from leading scientists, researchers and companies all around the world.  This is an unprecedented collection. The stuff Lisa wanted for her family but couldn't get in NZ that's what it's in her range. Lisa is constantly researching and interviewing the top scientists and researchers in the world to get you the best cutting edge supplements to optimize your life.   Subscribe to our popular Youtube channel  with over 600 videos, millions of views, a number of full length documentaries, and much more. You don't want to miss out on all the great content on our Lisa's youtube channel. Youtube   Order Lisa's Books Lisa has published 5 books: Running Hot, Running to Extremes, Relentless, What your oncologist isn't telling you and her latest "Thriving on the Edge"  Check them all out at  https://shop.lisatamati.com/collections/books   Perfect Amino Supplement by Dr David Minkoff Introducing PerfectAmino PerfectAmino is an amino acid supplement that is 99% utilized by the body to make protein. PerfectAmino is 3-6x the protein of other sources with almost no calories. 100% vegan and non-GMO. The coated PerfectAmino tablets are a slightly different shape and have a natural, non-GMO, certified organic vegan coating on them so they will glide down your throat easily. Fully absorbed within 20-30 minutes! No other form of protein comes close to PerfectAminos Listen to the episode with Dr Minkoff here:    Use code "tamati" at checkout to get a 10% discount on any of their devices.   Red Light Therapy: Lisa is a huge fan of Red Light Therapy and runs a Hyperbaric and Red Light Therapy clinic. If you are wanting to get the best products try Flexbeam: A wearable Red Light Device https://recharge.health/product/flexbeam-aff/?ref=A9svb6YLz79r38   Or Try Vielights' advanced Photobiomodulation Devices Vielight brain photobiomodulation devices combine electrical engineering and neuroscience. To find out more about photobiomodulation, current studies underway and already completed and for the devices mentioned in this video go to www.vielight.com and use code “tamati” to get 10% off     Enjoyed This Podcast? If you did, subscribe and share it with your friends! If you enjoyed tuning in, then leave us a review and share this with your family and friends. Have any questions? You can contact my team through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts.  To pushing the limits, Lisa and team

The Context of White Supremacy welcomes Dr. Micki Burdick. Research Project Manager at the University of Pennsylvania's Perelman School of Medicine, Dr. Burdick examines reproductive justice, rhetoric and Racism/White Supremacy. She and WNBA number one draft pick Caitlin Clark are White Women and University of Iowa alumni. Gus found her 2024 report, “Let's Make the Womb Safe Again”: Ethnographic Explorations of White Evangelical Women's Language of Reproductive Injustice. This recent publication examines how White Women skillfully use words to shape reproductive policy. However, Gus was able to research further and located Dr. Burdick's 2023 dissertation, Spectacular Surveillance: Gender, White Christian Nationalism, and Evangelical Women in the Pro-Life Movement. This is a far more comprehensive treatment of the history and evolution of White Women's Work to shape thinking about and legal restrictions regarding sexual behavior and production of offspring. Dr. Burdick submits that White Women have been the foundation of the White evangelical-backed opposition to abortion. Their "pro-life" rhetoric consciously and subconsciously reifies that White Lives. Matter. In fact, they support the System of White Supremacy while employing Racial Showcasing to deceptively portray themselves as being in support of all human life and Justice. Non-white listeners should note the number of times that Dr. Burdick isolates Racism to the benefits from being classified as White. She's in a #TragicArrangement and we discussed how White Supremacy/Racism impacts this "relationship" as well. #WordMasters #TheCOWS15Years INVEST in The COWS – http://paypal.me/TheCOWS Cash App: https://cash.app/$TheCOWS CALL IN NUMBER: 605.313.5164 CODE: 564943#

In the past few years pharmaceutical companies have developed a string of new Alzheimer's drugs called anti-amyloids, which target amyloid plaques in patients' brains. These plaques are one of the key biomarkers of the disease.The first of these drugs, Aduhelm, was approved by the FDA in 2021 amid enormous controversy. The FDA approved the drug despite little evidence that it actually slowed cognitive decline in patients. Biogen, the maker of Aduhelm, pulled the plug on further research or sales of the drug last month.In January 2023 The FDA approved another anti-amyloid medication from Biogen, lecanemab, sold under the brand name Leqembi. This time, there was much stronger evidence. Clinical trial results showed that the drug showed a modest improvement in cognitive decline in the early phases of the disease. But the drug comes with risks, including brain swelling and bleeding.Most recently, at the beginning of March, the FDA delayed approval of another anti-amyloid drug, donanemab, created by Eli Lilly. The FDA said it will be conducting an additional review to further scrutinize the study design and efficacy data.From the outside looking in, these Alzheimer's drugs appear to be mired in controversy. How well do they actually work? And why has there been so much back and forth with the FDA?To answer those questions and more, guest host Arielle Duhaime-Ross talks with Dr. Jason Karlawish, professor of medicine, medical ethics and health policy, and neurology at the University of Pennsylvania's Perelman School of Medicine, and co-director of the Penn Memory Center.Transcripts for each segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.