Podcasts about pmid

Today, we are tackling a massive grey area in obstetrics/maternal-fetal medicine: What happens after early fetal growth restriction resolves? When a baby bounces back on the growth chart during the second or third trimester, are they completely out of the woods? Or is there a hidden, lingering risk we aren't talking about enough? To find out, we're doing a deep dive into two major publications that dropped just this month, in August 2026 in sister journals (AJOG and AJOG MFM). Both are retrospective, both ask the exact same burning question…and get this: they arrive at completely opposing conclusions. How is that possible? Listen in for details. 1. Melamed B, Mei-Dan E, Aviram A. Sonographic fetal weight estimation percentiles should be interpreted with caution in the second trimester. Int J Gynaecol Obstet. 2026 May;173(2):930-939. doi: 10.1002/ijgo.70693. Epub 2025 Nov 25. PMID: 41288086.2. Ramos SZ, Has P, Gimovsky AC, Danilack VA, Savitz DA, Lewkowitz AK. Outcomes among Neonates after a Diagnosis of Persistent or Transient Fetal Growth Restriction Delivered at Term. Am J Perinatol. 2024 May;41(S 01):e1470-e1477. doi: 10.1055/a-2051-3859. Epub 2023 Mar 9. Erratum in: Am J Perinatol. 2024 May;41(S 01):e1478. doi: 10.1055/s-0044-1786526. PMID: 36894159; PMCID: PMC10562520.3. Keller N, Jackson F, Abelman S .Neonatal morbidity following resolution of fetal growth restriction diagnosed at second-trimester anatomy ultrasound. American Journal of Obstetrics & Gynecology MFM, 2026; Aug 8. 4. Cenac LA, Wodoslawsky S, Patel V, McLaren Jr. R, Aghai ZH, Makhamreh MM, Al-Kouatly HB, Persistent, Resolved, and Absent Fetal Growth Restriction: A Comparison of Neonatal Outcomes, American Journal of Obstetrics and Gynecology (2026), doi: https:// doi.org/10.1016/j.ajog.2026. Aug 19

Post-race recovery is not the avoidance of training. Rather, it is a crucial component of a well-periodized training plan, especially for a marathon or half marathon. In this episode, we first examine the physiological impact of racing a marathon or half marathon on the body. Then, we detail how to approach a recovery phase, including what can enhance or impair recovery after a race.In this episode, you'll learn:✅ What happens to your body after you run a marathon✅ Should you do a recovery run after the race?✅ How to structure a recovery phase after a half marathon✅ How to recover after a marathon✅ How to improve your post-race recovery✅ Health risks during the recovery phaseTread Lightly Running is hosted and researched by Amanda Brooks and Laura Norris, MSc. Production, show notes, and graphics by Laura Norris.References

Contributor: Aaron Lessen, MD Educational Pearls: Big question in cardiac arrest: is the rhythm shockable? Shockable: ventricular fibrillation (VF) and pulseless ventricular tachycardia Non-shockable: asystole and pulseless electrical activity (PEA) Rhythm classification is typically based on ECG, but echocardiography can directly visualize myocardial fibrillation Occult VF: a rhythm that appears non-shockable on ECG but demonstrates VF on echocardiography A 2025 multicenter prospective study looked at 811 patients with out-of-hospital cardiac arrest 5.3% had occult VF detected by echocardiography Of the patients with occult VF:  81.4% had PEA on ECG 18.6% had asystole on ECG Patients with occult VF were less likely to receive defibrillation because their ECG suggested a nonshockable rhythm Clinical takeaway: echocardiography during cardiac arrest may reveal a potentially shockable rhythm hiding behind an apparently nonshockable ECG This identifies a subset of cardiac arrest patients who would otherwise be managed as PEA or asystole based on ECG   References Gaspari R, Adhikari S, Gleeson T, Kapoor M, Lindsay R, Noble V, Nomura JT, Weekes A, Theodoro D. Occult Ventricular Fibrillation Visualized by Echocardiogram During Cardiac Arrest: A Retrospective Observational Study From the Real-Time Evaluation and Assessment for Sonography-Outcomes Network (REASON). J Am Coll Emerg Physicians Open. 2025 Jan 13;6(1):100028. doi: 10.1016/j.acepjo.2024.100028. PMID: 40012664; PMCID: PMC11853361.   Summarized by Meg Joyce, MS3 | Edited by Meg Joyce & Ahmed Abdel-Hafiz, NREMT-P   Donate: https://emergencymedicalminute.org/donate/  

You have likely encountered the advice that all you need to do to run better is to run more. Is training really that simple? In this episode, we discuss high volume running: why people do it, who it works for, and who should skip it. We examine the research and assess unique situations such as busy athletes, beginners, masters athletes, and injury-prone runners. You will also learn how to safely increase and support high volume training, so that you can secure the biggest driver: consistent training over years.Thank you to our sponsors:✨ Tailwind: Complete sport nutrition made simple, including hydration mixes, high-carb sport drinks, endurance fuel, and recovery mixes. Use code TREADLIGHTLY20 at https://tailwindnutrition.com/TREADLIGHTLY for 20% off your first purchase.In this episode, you'll learn:✅ How “high volume” running is defined (and why pace impacts it)✅ The benefits of high volume training✅ How to safely increase running volume✅ Who will not benefit from higher volume training?✅ Is there a point where you should lower your training volume?Tread Lightly Running is hosted and researched by Amanda Brooks and Laura Norris, MSc. Production, show notes, and graphics by Laura Norris.References

Do you listen to your bees? Beekeepers rely heavily on sight when inspecting a colony, along with touch and even smell. But in this installment of Bee Science with Dr. Dewey Caron, Dewey asks us to consider another source of information—the remarkable world of sound and vibration produced by honey bees. Honey bees live in an acoustic world that extends well beyond the familiar buzz we hear around a colony. Dewey explores how bees produce sound through their flight muscles and how they perceive airborne vibrations through their antennae and substrate-borne vibrations through their legs. He also explains why a queenless colony can sound noticeably different from a queenright colony and how experienced beekeepers can sometimes recognize changes within a colony simply by listening. Dewey then returns to the waggle dance, exploring research showing that sound and vibration are important components of honey bee communication. Recruits aren't simply following a dancer—they are receiving vibroacoustic information that helps communicate the distance to a food source. The science gets even more fascinating as Dewey examines stop signals, predator warnings, learning among young dancers, and acoustic communication in other honey bee species. Finally, Dewey traces the history of using colony sounds to understand bee behavior, from Eddie Woods' pioneering Apidictor in the 1950s to today's digital sensors, sophisticated microphones, and machine-learning systems designed to interpret what's happening inside a colony without unnecessarily opening the hive. The next time you're working your bees, don't just look. Listen. Your colony may be telling you more than you realize. This is Part One of Dewey's exploration of sound in honey bees. In Part Two, he'll return to some of the specialized sounds associated with swarming and communication. Notes and references: Mea McNeil https://americanbeejournal.com/sounds-of-the-hive-part-1/ Towne W.F., Kirchner, W,H. 1989. Hearing in honey bees: detection of air-particle oscillations. Science. 12;244(4905):686-8. doi: 10.1126/science.244.4905.686. PMID: 17740340. Mario Vallejo-Marín. 2018. Buzz pollination: studying bee vibrations on flowers. https://doi.org/10.1111/nph.15666 Claudi Roller. 2025. Honey  Bee Sensory Superpowers: Hearing. https://www.buddhabeeapiary.com/blog/honey-bee-sound Ferrari, S., Silva, M., Guarino, M., Berckmans, D. 2008.  Monitoring of swarming sounds in bee hives for early detection of the swarming period. Computers and Electronics in Agriculture 64(1), 72–77 Arnia Discussion: https://forum.honeyflow.com/t/want-to-spy-on-your-bees-the-arnia-is-coming-the-arnia-is-coming/7669 ______________ Brought to you by Betterbee – your partners in better beekeeping.   Betterbee is the presenting sponsor of Beekeeping Today Podcast. Betterbee's mission is to support every beekeeper with excellent customer service, continued education and quality equipment. From their colorful and informative catalog to their support of beekeeper educational activities, including this podcast series, Betterbee truly is Beekeepers Serving Beekeepers. See for yourself at www.betterbee.com _______________ We hope you enjoy this podcast and welcome your questions and comments in the show notes of this episode or: questions@beekeepingtodaypodcast.com Thank you for listening!  Podcast music: Be Strong by Young Presidents; Epilogue by Musicalman; Faraday by BeGun; Walking in Paris by Studio Le Bus; A Fresh New Start by Pete Morse; Wedding Day by Boomer; Christmas Avenue by Immersive Music; Red Jack Blues by Daniel Hart; Bolero de la Fontero  by Rimsky Music; Perfect Sky by Graceful Movement; Original guitar background instrumental by Jeff Ott. Beekeeping Today Podcast is an audio production of Growing Planet Media, LLC ** As an Amazon Associate, we may earn a commission from qualifying purchases Copyright © 2026 by Growing Planet Media, LLC

Chuck and Chris review 6 recent Journal of Hand Surgery articles with a variety of topics.  Tune in and see below.1) Arends GR, van Kooij YE, Stern BZ, Hovius SER, Wouters RM; Hand-Wrist Study Group; de Ridder WA. Understanding Why Certain Patients With Hand and Wrist Conditions Are Dissatisfied Despite Achieving Their Expressed Personal Improvement Goals Anchored at Satisfaction: A Qualitative Study. J Hand Surg Am. 2026 Jun;51(6):687-697. doi: 10.1016/j.jhsa.2025.12.009. Epub 2026 Jan 29. PMID: 41609542.2) Lee SH, Kim MB, Lee YH. Surgical Management of Delayed Mallet Finger Fractures Using Combined Two-Extension Block Kirschner Wire and Dorsal Counterforce Techniques. J Hand Surg Am. 2026 May;51(5):555-563. doi: 10.1016/j.jhsa.2025.12.019. Epub 2026 Jan 29. PMID: 41609545.3) Lunasin RM, Capell W, Kaufman KR, Shin AY. Rethinking Muscle Testing: Dynamic EMG Studies of Elbow Positioning as a Differentiator of Pronator Teres and Quadratus Functions. J Hand Surg Am. 2026 Apr;51(4):437.e1-437.e8. doi: 10.1016/j.jhsa.2025.09.013. Epub 2025 Oct 29. PMID: 41159989.4) Morisaki S, Yoshii K, Tsuchida S, Oda R, Takahashi K. Comparison of Manual Tie and Knotless Suture Anchor Techniques in Arthroscopic Transosseous Foveal Repair of the Triangular Fibrocartilage Complex. J Hand Surg Am. 2026 May;51(5):503-510. doi: 10.1016/j.jhsa.2026.01.021. Epub 2026 Mar 4. PMID: 41778936.5) Mwangi J, Henriquez AR, Varney CR, Yu R, Kim JK, Baker RL Jr, Pidgeon T, Hammert WC. Suture-Button Suspensionplasty Does Not Provide a Sustained Functional Advantage Over Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis. J Hand Surg Am. 2026 Jun;51(6):623-630. doi: 10.1016/j.jhsa.2026.02.019. Epub 2026 Apr 3. PMID: 41934451.6) Surke C, Del Rosario PA, Huntington LS, Ek ETH, Tham SK, Ackland D. Fracture Fixation in an Unstable Scaphoid Fracture Model: A Biomechanical Comparison of Double Screw Osteosynthesis With Two Common Bone Graft and Fixation Techniques. J Hand Surg Am. 2026 Apr;51(4):391.e1-391.e8. doi: 10.1016/j.jhsa.2025.09.007. Epub 2025 Oct 25. PMID: 41137815.See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities.The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/.As always, thanks to @iampetermartin for the amazing introduction and concluding music.For additional links, the catalog.  Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

Send us Fan MailThe full week of Journal Club in one place. Monday, the PLaNT trial of prophylactic CPAP for late preterm infants born by cesarean, with senior author Dr. Edgardo Szyld. Tuesday, whether parental holding during therapeutic hypothermia changes feeding and length of stay. Wednesday, the Connection Study, the first live biotherapeutic product tested under an IND, and what it means for probiotics returning to the NICU. Thursday, a handheld light probe that reads bowel through the skin to catch NEC before the X-ray does. Friday, Dr. Dinushan Kaluarachchi on the respiratory severity score and what its trajectory tells us.----First-in-human pilot study of broadband optical spectroscopy (BOS) as noninvasive surveillance for necrotizing enterocolitis (NEC). Dodd AC, Lehane AJ, Lee A, Hurlock A, Su Y, Ilahi I, Lautz TB, Backman V, Goldstein SD.J Pediatr Surg. 2026 May;61(5):162978. doi: 10.1016/j.jpedsurg.2026.162978. Epub 2026 Feb 3.PMID: 41643767Association of parental holding during therapeutic hypothermia and NICU outcomes for infants with hypoxic-ischemic encephalopathy. Nguyen TT, Glass HC, Chan N, Taketa E, Pineda R, Cornet MC, Miller MJ.J Perinatol. 2026 Jun 22. doi: 10.1038/s41372-026-02753-3. Online ahead of print.PMID: 42332041Live biotherapeutic product IBP-9414 (L. reuteri) in very low birth weight infants: the Connection Study. Neu J, Del Moral T, Guthrie SO, Hudak ML, Indrio F, Kim JH, Kronström A, Martin CR, Modi N, Rastad J, Schnitzer TJ, Singh R, Strömberg S, Szajewska H, Thuresson M, Caplan M.Pediatr Res. 2026 Feb 20. doi: 10.1038/s41390-026-04826-7. Online ahead of print.PMID: 41721054Prophylactic CPAP at Cesarean Birth in Late-Preterm Newborns: A Multicenter RCT. Shah BA, DeShea L, Schmölzer GM, Josephsen JB, Fabres J, Wetzel EA, Rykovich H, Thomas A, Law B, Garrido C, Szyld E.Pediatrics. 2026 Aug 1;158(2):e2025070998. doi: 10.1542/peds.2025-070998.PMID: 42457181 Clinical Trial.Association Between Delivery Room Continuous Positive Airway Pressure and Neonatal Outcomes in Late Preterm and Term Infants: A Systematic Review and Meta-Analysis. Chin Y, Hill M, Sett A, Thomas N, Razak A.J Paediatr Child Health. 2026 Jul 28. doi: 10.1111/jpc.70516. Online ahead of print.PMID: 42517258 Review.Bronchopulmonary Dysplasia Definition Based on Respiratory Severity Score. Kaluarachchi DC, Peebles PJ, Lasarev MR, Guthrie SO, Laughon MM.Pediatr Pulmonol. 2026 Jul;61(7):e71750. doi: 10.1002/ppul.71750.PMID: 42478108 Free PMC article. No abstract available.Respiratory severity score patterns by birth gestational age among a cohort of extremely preterm infants. Peebles PJ, Lasarev MR, Guthrie SO, Laughon MM, Keller RL, Kaluarachchi DC.J Perinatol. 2026 Jun 29. doi: 10.1038/s41372-026-02778-8. Online ahead of print.PMID: 42374145 No abstract available.Respiratory severity score as a predictor for need for tracheostomy in infants with severe bronchopulmonary dysplasia. Kaluarachchi NM, Afah Annah S, Lasarev MR, Peebles PJ, Kaluarachchi DC.J Perinatol. 2026 Jun 25. doi: 10.1038/s41372-026-02720-y. Online ahead of print.PMID: 42350618 No abstract available.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Send us Fan MailThe respiratory severity score is one multiplication most of us already do in our heads, mean airway pressure times FiO2. This week Dr. Dinushan Kaluarachchi joins Journal Club to walk through three papers built on it, RSS trajectories across gestational age in the PROP cohort, an RSS based grading of BPD at 36 weeks, and RSS after 40 weeks as a predictor of tracheostomy. He also talks about writing that last paper with his son, a high school junior, and why a brief communication is a realistic on-ramp for students. Plus a preview of two upcoming trials, including surfactant given through a supraglottic airway.https://www.nature.com/collections/ejaffajdhi----Bronchopulmonary Dysplasia Definition Based on Respiratory Severity Score. Kaluarachchi DC, Peebles PJ, Lasarev MR, Guthrie SO, Laughon MM.Pediatr Pulmonol. 2026 Jul;61(7):e71750. doi: 10.1002/ppul.71750.PMID: 42478108 Free PMC article. No abstract available.Respiratory severity score patterns by birth gestational age among a cohort of extremely preterm infants. Peebles PJ, Lasarev MR, Guthrie SO, Laughon MM, Keller RL, Kaluarachchi DC.J Perinatol. 2026 Jun 29. doi: 10.1038/s41372-026-02778-8. Online ahead of print.PMID: 42374145 No abstract available.Respiratory severity score as a predictor for need for tracheostomy in infants with severe bronchopulmonary dysplasia. Kaluarachchi NM, Afah Annah S, Lasarev MR, Peebles PJ, Kaluarachchi DC.J Perinatol. 2026 Jun 25. doi: 10.1038/s41372-026-02720-y. Online ahead of print.PMID: 42350618 No abstract available.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Today on the Yoga Medicine Podcast, Tiffany Cruikshank and co-host Katja Bartsch explore the latest research on strength training during pre- and post-menopause. Using a newly published systematic review and meta-analysis of 126 studies involving more than 4,000 women, they unpack what the evidence actually says about building strength and improving body composition in different stages of reproductive aging. Together, Tiffany and Katja separate common myths from current research, discussing progressive overload, lean muscle, body composition, estrogen, and why strength gains remain possible well into midlife and beyond. They also explore why consistency and enjoyment may be just as important as the specific type of resistance training you choose, offering practical takeaways for yoga practitioners, teachers, and anyone looking to age well.  "When we intervene, when we start to create a plan... the capacity to build strength is the same." — Tiffany Cruikshank. — What You'll Learn: Overview of the latest research on strength training across the female lifespan [01:25] Why strength gains remain possible after menopause [08:47] Body composition changes with strength training [16:25] Why enjoyment and consistency are key to long-term success [21:36] Current research gaps and unanswered questions [27:07] Shifting the focus from weight loss to feeling and functioning your best [31:08] How yoga complements strength training for lifelong health [32:34] — Links Mentioned: Watch this episode on YouTube Isenmann E, Geisler S, Havers T, Siegert F, Hemke F, Held S. It's never too late: The impact of resistance training on strength and body composition in females across the lifespan - A systematic review and meta-analysis. J Sci Med Sport. 2026 Mar 18:S1440-2440(26)00096-4. doi: 10.1016/j.jsams.2026.03.002. Epub ahead of print. PMID: 41963141. — Learn More: Find the full show notes at YogaMedicine.com/podcast-173. Learn more about insider tips, online classes or information on our teacher trainings at YogaMedicine.com. To support our work, please leave us a 5 star review with your feedback on iTunes/Apple Podcasts or wherever you listen to podcasts. 

In this Wellness Tech installment, Jonathan Mendoza, DC, APRN, NP-C — Nurse Doza — explains why red light panels have become a daily fixture in his clinic and his home. He covers how red and near-infrared wavelengths reach the mitochondria to support healthy ATP production, why panels deliver solar-style input without UV exposure, how he personally uses violet light to wind down at night, and what the emerging 40Hz gamma-frequency research does and does not yet show in humans. FEATURED PARTNER LightpathLED builds veteran-owned red and near-infrared light therapy panels. Nurse Doza uses one daily and highlights this brand specifically because it offers more than a single red setting — it includes violet-spectrum output and adjustable frequency, including a 40Hz option he notes he hasn't found on other consumer panels. Shop: https://lightpathled.com Code: NURSEDOZA (discount applied at checkout) Current promo:Select Diesel Gen3 panels ship with a free stand — verify at checkout, promos change Join the School of Doza The School of Doza is a paid health-education community with live group consults every **Wednesday at 1 PM Central**, plus courses, protocols, and direct access to Nurse Doza. Start your free trial: https://www.schoolofdoza.com --- 5 Key Takeaways 1. Red and near-infrared light interact with your mitochondria, not just your skin.These wavelengths are absorbed by cytochrome c oxidase in the electron transport chain, which supports healthy ATP production — the mechanism researchers call photobiomodulation. 2. A panel delivers solar-style light input without the UV load.Most people spend the majority of daylight hours indoors under light their cells don't recognize. Red light panels are one way to add that input without the burn risk that comes with UV exposure. 3. Panels are low-friction to use. No undressing required — Nurse Doza sits in front of his and lets it hit his forehead. He uses sessions in the two-to-five-minute range as his own personal routine, not a prescribed protocol. 4. Violet light sits at the opposite end of the visible spectrum from red. Nurse Doza reports using violet output in the evening as part of his wind-down. This is his subjective experience — violet-specific calming effects are not yet well established in the peer-reviewed literature. 5. The 40Hz frequency setting is an area of active research, not settled science. Gamma-frequency entrainment at 40Hz has been studied for its effects on brain activity, but the most-cited amyloid findings are from animal models and have published author corrections. Interesting, worth following — not a treatment. Citations: 1. de Freitas LF, Hamblin MR. **Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy.** *IEEE Journal of Selected Topics in Quantum Electronics.* 2016. PMID: 28070154 — https://pubmed.ncbi.nlm.nih.gov/28070154/ 2. Hamblin MR. **Mechanisms and Mitochondrial Redox Signaling in Photobiomodulation.** *Photochemistry and Photobiology.* 2018. PMID: 29164625 — https://pubmed.ncbi.nlm.nih.gov/29164625/ 3. Maghfour J, Ozog DM, Mineroff J, Jagdeo J, Kohli I, Lim HW. **Photobiomodulation CME Part I: Overview and Mechanism of Action.** *Journal of the American Academy of Dermatology.* 2024. PMID: 38309304 — https://pubmed.ncbi.nlm.nih.gov/38309304/ 4. Nairuz T, Cho S, Lee JH. **Photobiomodulation Therapy on Brain: Pioneering an Innovative Approach to Revolutionize Cognitive Dynamics.** *Cells.* 2024. PMID: 38891098 — https://pubmed.ncbi.nlm.nih.gov/38891098/ 5. Iaccarino HF, Singer AC, Martorell AJ, et al. **Gamma frequency entrainment attenuates amyloid load and modifies microglia.** *Nature.* 2016;540:230–235. PMID: 27929004 · PMCID: PMC5656389 — https://pmc.ncbi.nlm.nih.gov/articles/PMC5656389/    *Note: animal-model study. Two author corrections have since been published (2018, 2024).* Bonus — sleep and LED light therapy: Liao YH, Tai CJ, Ming JL, Lin LH, Chien LY. **The Effectiveness of Low-Level LED Light Therapy for Sleep Problems, Psychological Symptoms, and Heart Rate Variability in Shift-Work Nurses: A Randomized Controlled Trial.** *Journal of Nursing Management.* 2025. PMID: 40557249 — https://pubmed.ncbi.nlm.nih.gov/40557249/

Have you experienced False Hope Syndrome? Without telling you exactly what that is, I'm going to let you know chances are good that you have. I have certainly done so in more than one area of my life! False Hope Syndrome runs rampant in relation to weight loss. Listen in, learn exactly what it is and how to keep yourself safe from falling into the disappointment associated with False Hope Syndrome as you move forward in losing and maintaining weight loss.The Weight Loss Winformation Podcast gives you essential psychological information to help you lose weight and more importantly, to help keep you at a healthy weight for your body! No matter how you are working to lose weight and no matter how much weight you want to lose, Weight Loss Winformation will keep you moving in a positive direction. Let's get started because well… Why Weight? (get it? Pun intended… )?Resources:·      BariAfterare: www.bariaftercare.com·      Connie Stapleton PhD website: www.conniestapletonphd.com·      BariAftercare website: https://www.conniestapletonphd.com/bariaftercare·      BariAftercare Facebook page (for members only): https://www.facebook.com/groups/BariAftercare·      Kevin Stephens: Your Bariatric Buddy   https://www.facebook.com/groups/yourbariatricbuddy/people·      Instagram: @ (Caleshia Haynes)·      Instagram: @therealbariboss (Tabitha Johnson)·      Instagram @drsusanmitchell (Dr. Susan Mitchell)·      Instagram: @lauraleepreston (Laura Preston)·      ProCare Vitamins (10% off with code ConnieStapleton)·      Rob DiMedio: https://www.busybariatrics.com/·      Dr. Joan Brugman: drjbrugman@outlook.com·      Dr. Nestor de la Cruz-Munoz on Linked In: https://www.linkedin.com/in/drdelacruzmunoz/From: How Much Weight Will You Lose After Bariatric Surgery? Nestor de la Cruz-Munoz MD, FACS, DABOMJuly 12, 2026 The Evidence Is Clear — And It's Not What Most Patients Expecto    The AACE/TOS/ASMBS guidelines are explicit: Very few preoperative factors are sufficiently predictive to give a precise individual weight loss number.This means the honest answer is not a number — it's a range.The Real Weight Loss Ranges by ProcedureThe most reliable metric is total weight loss percentage (TWL) — not excess weight loss.Sleeve Gastrectomy (SG)·       23–25% TWL at 1 year·       17–19% TWL at 5 years·       PCORnet (65,000+ patients): 18.8% TWL at 5 yearsRoux‑en‑Y Gastric Bypass (RYGB)·       28–31% TWL at 1 year·       21–26% TWL at 5 years·       20–27% TWL at 10 years·       PCORnet: 25.5% TWL at 5 years·       SM‑BOSS RCT: 27.5% TWL at 10 yearsOne‑Anastomosis Gastric Bypass (OAGB)·       Highest early TWL·       Emerging evidence suggests greater long‑term durability than SG and RYGB·       Randomized TrialsBy‑Band‑Sleeve RCT (3‑year outcomes):·       RYGB: 26.8% TWL·       Sleeve: 19.4% TWL·       Band: 14.0% TWLWeight regain after cessation of medication for weight management: systematic review and meta-analysiso   West S, Scragg J, Aveyard P, Oke JL, Willis L, Haffner SJP, Knight H, Wang D, Morrow S, Heath L, Jebb SA, Koutoukidis DA. Weight regain after cessation of medication for weight management: systematic review and meta-analysis. BMJ. 2026 Jan 7;392:e085304. doi: 10.1136/bmj-2025-085304. PMID: 41500720; PMCID: PMC12776922.o   https://pubmed.ncbi.nlm.nih.gov/41500720/·       The primary anti-obesity medications (AOMs) highlighted in this high-level study are newer incretin mimetics, specifically:o   Semaglutide (a GLP-1 receptor agonist)o   Tirzepatide (a GIP/GLP-1 receptor co-agonist)The Rebound Effect: High-Level EvidenceThis January 2026 systematic review and meta-analysis published in The BMJ synthesized data from 37 studies involving 9,341 participants, providing robust, high-level clinical evidence on what happens after stopping these medications:·       Rapid Return to Baseline: On average, patients return to their baseline weight within 1.7 years after stopping any weight management medication.·       Accelerated Regain for GLP-1/GIP Drugs: For those stopping semaglutide or tirzepatide, the rebound is even faster—returning to baseline weight in just 1.5 years.·       Faster than Behavioral Programs: The rate of weight regain after medication cessation is significantly faster than the regain observed after finishing behavioral weight management programs.·       Reversal of Health Benefits: Stopping these therapies also rapidly reverses their positive, beneficial effects on cardiometabolic markers.·       These findings emphasize that using these medications short-term without a more comprehensive, long-term approach to weight management leads to a rapid reversal of both weight loss and cardiometabolic improvements, and this is the real benefit we can offer to our patients: a long-term plan that can and should be updated on the course of their chronic disease and its natural course. Nothing in obesity treatment should be absolutely static.·      How to overcome past dieting failures. By Kristen A. Carter MSo   https://www.psychologytoday.com/us/blog/health-and-human-nature/202103/false-hope-syndrome-reveals-big-problem-dieting·      Getting Real: Warning Signs of False Hope Syndrome. by Dan J. Tomasulo PhD., TEP, MFA, MAPPo   https://www.psychologytoday.com/us/blog/the-healing-crowd/202209/getting-real-warning-signs-of-false-hope-syndrome·      Expected Weight Loss From Gastric Bypass – Calculatoro   https://www.obesitycoverage.com/weight-loss-surgeries/gastric-bypass/how-much-can-i-expect-to-lose·      Expected Weight Loss (after Sleeve)o   https://www.obesitycoverage.com/gastric-sleeve-reference-manual/

In dieser Folge spreche ich über die spannende Verbindung zwischen deinem Darm und deinem Kiefer. Was hat dein Darm eigentlich mit deinem Kiefer zu tun? Auf den ersten Blick würde man wahrscheinlich sagen: gar nichts. Doch genau diese Verbindung schauen wir uns in dieser Folge genauer an. Dabei geht es um aktuelle Erkenntnisse aus den Bereichen Schmerz, chronischer Schmerz, Immunologie und Neurowissenschaften und darum, welche Rolle der Darm und seine Wechselwirkungen mit anderen Systemen des Körpers dabei spielen können. Und natürlich gibt es auch wieder unseren Smoothie der Woche: Der grüne Sommer-Smoothie – ein frisches und sommerliches Rezept zum Nachmachen. Hier findest du das Rezept und Video dazu:  https://www.instagram.com/stefanienicolekapp/ Kieferwissen Web: www.kieferwissen.de   Quellenangaben:   Pak R., Cho M., Pride K., Abd-Elsayed A. (2024): The Gut Microbiota and Chronic Pain. Current Pain and Headache Reports, 28(4), 259–269. PMID: 38345694. Übersichtsarbeit zur Rolle des Darmmikrobioms bei chronischen Schmerzen und zur Darm-Hirn-Achse.    pubmed.ncbi.nlm.nih.gov   Manske S. et al. (2024): The Microbiome's Role in Chronic Pain and Inflammation. Frontiers in Pain Research. Beschreibt den Zusammenhang zwischen Dysbiose, systemischer Entzündung und Schmerzverstärkung.    PMC   Morreale C. et al. (2022): Microbiota and Pain: Save Your Gut Feeling. International Journal of Molecular Sciences, 23(6), 3078. Erklärt, wie Darmbakterien Entzündungs- und Schmerzbahnen beeinflussen können.    NIH   Ustianowska K. et al. (2022): The Role of the Human Microbiome in the Pathogenesis of Pain. International Journal of Molecular Sciences, 23(20), 12315. Diskutiert zentrale Sensibilisierung, Mikroglia und immunologische Mechanismen bei chronischen Schmerzen.  pmc.ncbi.nlm.nih.gov   Lou L. et al. (2025): Gut Microbiota as a Modulator and Therapeutic Target for Chronic Pain. Pharmacological Research. Aktuelle Übersicht zu zentralen und peripheren Wirkmechanismen des Mikrobioms bei chronischen Schmerzen.  pubmed.ncbi.nlm.nih.gov

CardioNerds (Dr. Apoorva Gangavelli, Dr. Rebecca Garber, and Dr. Tina Reddy), discuss pre-pregnancy risk stratification and counseling with Dr. Katy Young across a range of risks.  This episode was produced as part of the CardioNerds Academy curriculum by House Einthoven under the guidance of House Chief, Dr. Apoorva Gangavelli and Academy Program Director, Dr. Gurleen Kaur. A matching review article will be published in US Cardiology Review, the official journal of CardioNerds. This discussion was planned in collaboration with the Mayo Clinic Cardiovascular Board Review Course. Audio editing by CardioNerds intern, Dr. Patrick Pekyi-Boateng. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Notes:  Why is pregnancy considered a “physiologic stress test,” and why does risk extend beyond delivery? Blood volume, heart rate, and cardiac output rise while systemic vascular resistance falls, peaking in the late second/early third trimester; underlying (even undiagnosed) heart disease can be unmasked or worsened. Postpartum (“fourth trimester”) is a high-risk period, not a safe zone – fluid shifts, rising SVR, and bleeding risk can precipitate decompensation in patients with heart failure, pulmonary hypertension, valvular disease, or aortopathy. Adverse pregnancy outcomes (hypertensive disorders, gestational diabetes, preterm birth, fetal growth restriction, peripartum cardiomyopathy) are markers of future cardiovascular risk and warrant long-term preventive follow-up. What is the practical framework for approaching pre-pregnancy cardiovascular risk? Four broad categories: (1) patients who may need cardiac screening before pregnancy, (2) patients needing risk-factor/medication optimization, (3) known cardiovascular disease where pregnancy is reasonable with structured risk stratification, and (4) high-risk disease where pregnancy may need to be delayed, modified by intervention, or discouraged. Testing should be targeted, not blanket – reserved for symptoms, abnormal exam, concerning family history, or reduced functional capacity. How is risk stratified in patients with known cardiovascular disease? Use a combination of tools per 2025 ESC guidelines: mWHO 2.0 (broad maternal risk category), CARPREG II (additional predictors of maternal cardiac events), and ZAHARA (useful in congenital heart disease). Key lesion-specific factors: aortic size/growth, valve severity, ventricular function, symptoms, blood pressure, and family history of dissection. Translate risk into practical terms for patients rather than leading with a numerical score. Which cardiovascular medications require review before conception? ACE inhibitors, ARBs, and ARNIs should be transitioned off before pregnancy; statins, MRAs, and SGLT2 inhibitors also need review. DOACs are contraindicated in pregnancy and lactation; mechanical valve anticoagulation requires individualized shared decision-making, as no strategy is risk-free for mother and fetus. Medication changes are best made proactively, before conception, rather than reactively. This is not an exhaustive list! The medication list needs to be reviewed carefully. Which conditions carry high or prohibitive risk in pregnancy? Pulmonary arterial hypertension, Eisenmenger syndrome, severe ventricular dysfunction, prior peripartum cardiomyopathy with residual LV dysfunction, severe left-sided obstructive valve disease (e.g., severe mitral stenosis), mechanical valves, significant aortopathy, cyanotic congenital heart disease, and Fontan physiology. Common theme: limited cardiovascular reserve and high risk of decompensation, thrombosis, arrhythmia, heart failure, aortic dissection, or death. These patients need expert multidisciplinary evaluation before pregnancy. Severe mitral stenosis is poorly tolerated because tachycardia shortens diastolic filling time and raises left atrial pressure, risking pulmonary edema and decompensation. When should genetic testing or counseling be offered? Consider when a diagnosis may be inherited or affect the patient, pregnancy, or family members: inherited cardiomyopathies, aortopathies, channelopathies, select congenital heart disease, and some pulmonary hypertension syndromes. Recurrence risk of congenital heart disease in offspring is roughly 6-10% when the mother has CHD; fetal echocardiography should be offered. How should contraception be approached in high-risk cardiac patients? Frame contraception as part of the cardiac care and reproductive safety plan to prevent unplanned high-risk pregnancy. Long-acting reversible contraception is often preferred; progestin-only methods are generally safer than estrogen-containing options with thrombosis risk, pulmonary hypertension, or mechanical valves. What are key delivery-planning considerations for cardiac patients? Vaginal delivery is preferred unless there is an obstetric indication for cesarean or a specific cardiac reason (e.g., unstable maternal status, therapeutic INR) to avoid labor. Planning should address delivery location, anesthesia involvement, telemetry needs, fluid management, and postpartum monitoring, clearly communicated across the multidisciplinary team in advance. How should clinicians counsel patients when pregnancy is discouraged but strongly desired? Acknowledge the patient’s goals and the emotional weight of the conversation; separate the goal (family building) from the timeline (safety now vs. after optimization). If pregnancy remains prohibitively risky, discuss alternatives for family building and ensure adequate patient support. What are the key gaps and future directions in cardio-obstetric risk stratification? Current risk tools (mWHO, CARPREG II, ZAHARA) provide common language but do not fully capture functional status, prior pregnancy history, or how risk evolves over time. Future direction: individualized, dynamic risk prediction incorporating imaging, biomarkers, exercise capacity, and social drivers of health, with better long-term links between pregnancy complications and cardiovascular prevention. References 1. European Society of Cardiology. 2025 ESC Guidelines for the management of cardiovascular disease and pregnancy. 2. Mehta LS, et al. Cardiovascular Considerations in Caring for Pregnant Patients: A Scientific Statement From the American Heart Association. Circulation. 2020;141:e884-e903. PMID: 32362133. doi:https://doi.org/10.1161/CIR.0000000000000772 3. ACOG Practice Bulletin No. 212. Pregnancy and Heart Disease. Obstet Gynecol. 2019;133(5):e320-e356. PMID: 31022123. doi:https://doi.org/10.1097/AOG.0000000000003243

In this Complex Care Journal Club podcast episode, Ms. Emily Johnson and Dr. Florence Gagné discuss a scoping review of interventions to assess social needs for children with medical complexity. They describe the different approaches to screening and intervention in the five included studies, implications for practice, and opportunities to engage social workers in research. SPEAKERS Emily Johnson, MSW, LICSW Clinical Social Worker Boston Children's Hospital Florence Gagné, MD Pediatrician Montréal Children's Hospital HOST Kristina Malik, MD Assistant Professor of Pediatrics Medical Director Pediatrician, Special Care Clinic‌‌ ‌University of Colorado School of Medicine KidStreet Children's Hospital Colorado DATE Initial publication date: August 11, 2026. JOURNAL CLUB ARTICLE Johnson ER, Hadge SM, Wachter SM, Gagné F. Interventions to assess social needs for children with medical complexity and their families: A scoping review. Patient Educ Couns. 2026;148:109555. doi:10.1016/j.pec.2026.109555. OTHER ARTICLES REFERENCED Ming DY, Jones KA, Sainz E, Tkach H, Stewart A, Cram A, Morreale MC, Dizon S, deJong NA. Feasibility of implementing systematic social needs assessment for children with medical complexity. Implement Sci Commun. 2021 Nov 21;2(1):130. doi: 10.1186/s43058-021-00237-3. PMID: 34802465; PMCID: PMC8606226. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/3sgvpf2qjsvt9zqxvf37xspz/Gagne_and_Johnson_Final_Transcript_8-3-26 Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6. Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Johnson ER, Gagné F, Malik K. Screen and Intervene: Meeting Social Needs for Children with Medical Complexity. 08/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/screen-and-intervene-meeting-social-needs-for-children-with-medical-complexity.

Join Dr. Clancy  and his guests, Drs. Ganesan and Mangala, as they discuss what is known about the microbiome, its relation to disease and how we can promote a healthy microbiome. Episode Transcript CE Credit Available Host: Gerard Clancy, MD Senior Associate Dean for External Affairs Professor of Psychiatry and Emergency Medicine University of Iowa Carver College of Medicine Guests: Sukirth Ganesan, DDS, PhD, MPH Centennial Research Associate Professor Director of the Advanced Education Program in Periodontics University of Iowa College of Denistry and Dental Clinics Ashutosh Mangalam, PhD Professor of Pathology Interdisciplinary Graduate Program in Molecular Medicine University of Iowa Carver College of Medicine Financial Disclosures:  Dr. Gerard Clancy, his guests, and Rounding@IOWA planning committee members have disclosed no relevant financial relationships. Nurse: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this activity for a maximum of 1.00 ANCC contact hour. Physician: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this enduring material for a maximum of 1.00 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Providers: A certificate of completion will be available after successful completion of the course. (It is the responsibility of licensees to determine if this continuing education activity meets the requirements of their professional licensure board.) References/Resources:  Shahi SK, Ghimire S, Jensen SN, Lehman PC, Rux AG, Sinha S, Borcherding N, Tanas MR, Gibson-Corley KN, Ganesan SM, Karandikar NJ, Mangalam AK. IL-17A deficiency in HLA-DR3 transgenic mice enriches beneficial Prevotella species in gut to promote Tregs and reduce CNS autoimmunity. Microbiome. 2026 Jun 29;14(1):176. doi: 10.1186/s40168-026-02394-w. PMID: 42374500 Lehman PC, Ghimire S, Price JD, Ramer-Tait AE, Mangalam AK. (2023) Diet-microbiome-immune interplay in multiple sclerosis: Understanding the impact of phytoestrogen metabolizing gut bacteria. Eur J Immunol. Nov; 53(11):e2250236. DOI: 10.1002/eji.202250236. PMID: 37673213. Mendoza-Leon MJ, Mangalam AK, Regaldiz A, Gonzalez-Madrid E, Rangel-Ramirez MA, Alvarez-Mardonez OA, Vallejos OP, Mendez C, Bueno SM, Melo-Gonzalez F, Duarte Y, Opazo MC, Kalergis AM, Riedel CA. (2023) Gut microbiota short-chain fatty acids and their impact on the host thyroid function and diseases. Front Endocrinol (Lausanne). Jun 30; 14:1192216. DOI: 10.3389/fendo.2023.119226. PMID: 37455925. PMCID: PMC10349397.

Digital surgery has morphed from buzzword into ubiquitous high-impact technology. In this episode, the BTK MIS team steps into the rapidly evolving ecosystem of cameras, sensors, robotics, and software that are turning surgical operations into structured, analyzable datasets. From AI segmentation to real-time telepresence, don't miss this opportunity to catch up on what's new and what's next, what's exciting and what's terrifying, just on the horizon of your surgical career. Hosts: ·      James Jung, MD, PhD, Assistant Professor of Surgery, Duke University·      Jacob Greenberg, MD, EdM, MIS Division Chief and Vice Chair for Education, Duke University·      Zachary Weitzner, MD, Minimally Invasive and Bariatric Surgery Fellow, Duke University, @ZachWeitznerMD·      Joey Lew, MD, MFA, Surgical resident PGY-3, Duke University, @lew__actuallyLearning Goals: By the end of this episode, listeners will be able to:·      Define “digital surgery” and describe its core components, including video capture, instrumentation, robotics, data analytics, and system connectivity. ·      Discuss current and emerging applications of digital surgery in surgical education, including video-based self-assessment, procedural segmentation, and structured feedback models. ·      Describe how digital tools can be used to improve OR efficiency and resource utilization, including instrumentation usage, operative time analysis, and workflow optimization. ·      Summarize current telepresence and teleproctoring technologies and their clinical use cases, including augmented reality–based collaboration across institutions and geographic boundaries. ·      Identify key ethical, legal, and operational challenges in digital and tele-surgery, including credentialing, cross-state licensure, liability, and trust in remote expertise. ·      Discuss how digital surgery may reshape surgical training and competency-based assessment, including implications for autonomy, deliberate practice, and feedback frequency. ·      Recognize future directions of digital surgery integration, including predictive analytics, simulation using patient-specific imaging, and AI-assisted intraoperative decision support.References:  Balvardi S, Semsar-Kazerooni K, Kaneva P, et al. Validity of video-based general and procedure-specific self-assessment tools for surgical trainees in laparoscopic cholecystectomy. Surg Endosc. 2023;37(3):2281-2289. doi:10.1007/s00464-022-09466-6 [https://pubmed.ncbi.nlm.nih.gov/36307525/] Hospital Utilizes Intraoperative Idle Time Metrics to Improve Surgical Safety and Efficiency. Theator | The Surgical Intelligence Company. Accessed March 20, 2026. https://theator.io/customer-story/hospital-utilizes-intraoperative-idle-time-metrics-to-improve-surgical-safety-and-efficiency/ Campbell KK, Abreu AA, Zeh HJ, et al. Using OR Black Box Technology to Determine Quality Improvement Outcomes for In-situ Timeout and Debrief Simulation. Ann Surg. 2026;283(1):122. doi:10.1097/SLA.0000000000006438 [https://pubmed.ncbi.nlm.nih.gov/38317208/] Al Abbas AI, Meier J, Daniel W, et al. Impact of team performance on the surgical safety checklist on patient outcomes: an operating room black box analysis. Surg Endosc. 2024;38(10):5613-5622. doi:10.1007/s00464-024-11064-7 [https://pubmed.ncbi.nlm.nih.gov/39069926/] Proximie's telepresence platform helps surgeons across the globe grow and exchange experience in real-time. World Health Expo Insights. Accessed March 20, 2026. https://www.worldhealthexpo.com/insights/telemedicine/proximie-s-telepresence-platform-helps-surgeons-across-the-globe-grow-and-exchange-experience-in-real-time Hassan AE, Desai SK, Georgiadis AL, Tekle WG. Augmented reality enhanced tele-proctoring platform to intraoperatively support a neuro-endovascular surgery fellow. Interv Neuroradiol. 2022;28(3):277-282. doi:10.1177/15910199211035304 [https://pubmed.ncbi.nlm.nih.gov/34538166/] SAGES Digital Surgery Working Group; Ali JT, Yang G, Green CA, Reed BL, Madani A, Ponsky TA, Hazey J, Rothenberg SS, Schlachta CM, Oleynikov D, Szoka N. Defining digital surgery: a SAGES white paper. Surg Endosc. 2024 Feb;38(2):475-487. doi: 10.1007/s00464-023-10551-7. Epub 2024 Jan 5. PMID: 38180541. [https://pubmed.ncbi.nlm.nih.gov/38180541/] Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewOBGYN Oral Board Review Coures: https://behindtheknife.org/course/obgyn-oral-board-reviewEPA Playbook: https://behindtheknife.org/course/epa-playbookSurgical Instrument Flashcards: https://behindtheknife.org/course/surgical-instrument-flashcardsABSITE Review: https://behindtheknife.org/course/absite-2026-exam-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Send us Fan MailLate preterm babies born by cesarean fill our NICUs, and most of them are there for respiratory distress that resolves in a day or two. Could 20 minutes of CPAP in the operating room keep them out? This week on Journal Club, Ben and Daphna break down the PLaNT trial, a five center randomized pilot of prophylactic CPAP at 5 to 6 cm of water in spontaneously breathing infants born at 34 to 36 weeks by cesarean. They then sit down with senior author Dr. Edgardo Szyld to talk pneumothorax risk, the 35 to 36 week subgroup, consenting families, and what PLaNT 2 must prove.----Prophylactic CPAP at Cesarean Birth in Late-Preterm Newborns: A Multicenter RCT. Shah BA, DeShea L, Schmölzer GM, Josephsen JB, Fabres J, Wetzel EA, Rykovich H, Thomas A, Law B, Garrido C, Szyld E.Pediatrics. 2026 Aug 1;158(2):e2025070998. doi: 10.1542/peds.2025-070998.PMID: 42457181 Clinical Trial.Association Between Delivery Room Continuous Positive Airway Pressure and Neonatal Outcomes in Late Preterm and Term Infants: A Systematic Review and Meta-Analysis. Chin Y, Hill M, Sett A, Thomas N, Razak A.J Paediatr Child Health. 2026 Jul 28. doi: 10.1111/jpc.70516. Online ahead of print.PMID: 42517258 Review.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Dr. Kurt Olding shares with us the latest published recommendations for conservative treatment for spinal stenosis. Dr. Kurt Olding has been in practice for over 40 years, opening Minster Chiropractic Center in 1986 after graduating from National College of Chiropractic in Lombard, IL in 1984. Through the years Dr. Kurt has enjoyed treating all age groups, from infants to athletes and parents to grandparents. He took special interest in sports medicine during his early years in practice, completing 300 hours of continuing education through the Certified Chiropractic Sports Physician program. Dr. Kurt earned Cox® Technic certification in 2009. In 2012 he began co-instructing the technique, and since 2015 has been a full-time instructor alongside Dr. James Cox, Dr. Ralph Kruse, and Dr. George Joachim. Through his work with Cox® Technic, Dr. Kurt has had several exciting opportunities. In March of 2016, he taught Cox® Technic in Bern, Switzerland as part of the Swiss Chiropractic Academy's "technique series" program. Later that month, he presented research on Cox® Technic with his mentor Dr. James Cox at the annual Association of Chiropractic Colleges Research Agenda Conference. Dr. Kurt co-authored a paper published in the June 2016 edition of the Journal of Chiropractic Medicine titled Chiropractic Distraction Spinal Manipulation on Post-surgical Continued Low Back and Radicular Pain patients: A Retrospective Case Series. In 2015, Dr. Kurt became board certified as a Chiropractic Orthopedist, and a Fellow of the Academy of Chiropractic Orthopedists (FACO). He is also a board member of the Academy of Chiropractic Orthopedists, serving since early 2016. Dr. Kurt and his wife Jackie are Minster natives. They have three children: Sunni, Kregg, and Jack. Sunni and her husband Tyler joined the practice in 2014. Resources: Minster Chiropractic Center kurt.olding@gmail.com Find a Back Doctor thebackdoctorspodcast.com The Cox 8 Table by Haven Medical References: Young I, Dunning J, Butts R, Bliton P, Zacharko N, Garcia J, Mourad F, Charlebois C, Gorby P, Fernández-de-Las-Peñas C. Spinal manipulation and electrical dry needling as an adjunct to conventional physical therapy in patients with lumbar spinal stenosis: a multi-center randomized clinical trial. Spine J. 2024 Apr;24(4):590-600. doi: 10.1016/j.spinee.2023.12.002. Epub 2023 Dec 14. PMID: 38103739. Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ, Furlan AD, Stuber K, Ahmed A, Cancelliere C, Adeboyejo A, Ornelas J. Non-operative treatment for lumbar spinal stenosis with neurogenic claudication: an updated systematic review. BMJ Open. 2022 Jan 19;12(1):e057724. doi: 10.1136/bmjopen-2021-057724. PMID: 35046008; PMCID: PMC8772406.   Schneider MJ, Ammendolia C, Murphy DR, Glick RM, Hile E, Tudorascu DL, Morton SC, Smith C, Patterson CG, Piva SR. Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis: A Randomized Clinical Trial. JAMA Netw Open. 2019 Jan 4;2(1):e186828. doi: 10.1001/jamanetworkopen.2018.6828. PMID: 30646197; PMCID: PMC6324321.   Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE, Chernish G, Cox JM, Gliedt JA, Haskett D, Jensen RK, Marchand AA, Tomkins-Lane C, O'Shaughnessy J, Passmore S, Schneider MJ, Shipka P, Stewart G, Stuber K, Yee A, Ornelas J. Non-Surgical Interventions for Lumbar Spinal Stenosis Leading To Neurogenic Claudication: A Clinical Practice Guideline. J Pain. 2021 Sep;22(9):1015-1039. doi: 10.1016/j.jpain.2021.03.147. Epub 2021 Apr 12. PMID: 33857615.   Comer C, Williamson E, McIlroy S, Srikesavan C, Dalton S, Melendez-Torres GJ, Lamb SE. Exercise treatments for lumbar spinal stenosis: A systematic review and intervention component analysis of randomised controlled trials. Clin Rehabil. 2024 Mar;38(3):361-374. doi: 10.1177/02692155231201048. Epub 2023 Sep 16. PMID: 37715644; PMCID: PMC10829420.   Bise CG, Schneider M, Freburger J, Fitzgerald GK, Switzer G, Smyda G, Peele P, Delitto A. First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization. Phys Ther. 2023 Sep 1;103(9):pzad067. doi: 10.1093/ptj/pzad067. PMID: 37379349.   Hernandez-Martínez J, Cid-Calfucura I, Vásquez-Carrasco E, Perez-Carcamo J, Herrera-Valenzuela T, Aravena-Sagardia P, Barramuño-Medina M, Valdés-Badilla P. Timed Up-and-Go as a predictor of fracture risk: a systematic review and meta-analysis in a population of over 1.6 million people. Front Public Health. 2026 May 11;14:1841017. doi: 10.3389/fpubh.2026.1841017. PMID: 42200137; PMCID: PMC13199231.   Henn MC, Rae A, Fecker AL, McIntyre M, Larsen A, Wright J. A Nationwide Survey of the Spine Education of Medical Students. Cureus. 2026 Apr 4;18(4):e106443. doi: 10.7759/cureus.106443. PMID: 42093772; PMCID: PMC13139429.   James G, Ahern B, Goodwin W, Goss B, Hodges P. ISSLS Prize in Basic Science 2025: Structural changes of muscle spindles in the multifidus muscle after intervertebral disk injury are resolved by targeted activation of the muscle. Eur Spine J. 2025 May;34(5):1600-1613. doi: 10.1007/s00586-025-08646-x. Epub 2025 Jan 15. Erratum in: Eur Spine J. 2025 May;34(5):2046. doi: 10.1007/s00586-025-08744-w. PMID: 39810036.   Gong G, Yan Z, Lai Q, You P, Yu P, Li X, Wang Z, Lin S, Dai Y, Jiang H, Liu J. Inflammation preservation strategy: reconciling pain control and disc resorption in lumbar disc herniation. Front Immunol. 2025 Sep 2;16:1653681. doi: 10.3389/fimmu.2025.1653681. PMID: 40963597; PMCID: PMC12436131.

The noise in women's fitness has never been louder—and if you're wondering who to trust, you're not alone.  Every scroll seems to deliver a new expert, a new rule, or a new warning that contradicts the last one, leaving many women feeling more confused than confident.  Let's cut through the hype to help you understand why these conflicting messages exist and how to evaluate them without getting pulled into the latest trend. You'll learn a practical way to separate evidence from opinion so you can make informed decisions that actually support your health, strength, and longevity.  Instead of adding to the noise in women's fitness, this conversation gives you the clarity and confidence to focus on what truly matters If this episode made you flip your workout routine — share it!

Alexander Aarvold from the University Hospital Southampton joins the show this month to discuss his eagerly anticipated publication on the outcomes of the incomplete acetabuloplasty (or “pelletoplasty”) as an adjunctive treatment during open reduction of developmental hip dislocations. The group also discusses recent publications on treatment of infant femur fractures, open forearm fractures, and the outcomes of periacetabular osteotomy in skeletally immature patients. Your hosts are Carter Clement from Children's Hospital Colorado, Julia Sanders from Children's Hospital Colorado, and Will Morris from Scottish Rite in Dallas. Music by A.A. Aalto.  Aarvold A, Uren N, Rhodes A, Elliott KG, Lindisfarne EA, Carsi B, Clarke NMP. Growth Stimulating Minimal Acetabuloplasty, Alongside Hip Open Reduction: A Simpler One-stop Operative Treatment for Developmental Dysplasia of the Hip. J Pediatr Orthop. 2026 Apr 16. doi: 10.1097/BPO.0000000000003259. Epub ahead of print. PMID: 41988894. https://pubmed.ncbi.nlm.nih.gov/41988894/  Murphy-Zane MS, Keeter C, Baumann A. Hip Abduction Brace Is an Effective Treatment Alternative for Femur Fractures in Infants 12 Months and Younger. J Pediatr Orthop. 2026 Jul 1;46(6):e535-e541. doi: 10.1097/BPO.0000000000003172. Epub 2025 Nov 25. PMID: 41490478; PMCID: PMC13232693.  https://pubmed.ncbi.nlm.nih.gov/41490478/ Kronk TA, Steiner RP, Ritzman TF, Floccari LV. Surgical Treatment of Pediatric Open Forearm Fractures: A Comparison of Outcomes With or Without Internal Fixation. J Pediatr Orthop. 2026 Jul 1;46(6):e524-e528. doi: 10.1097/BPO.0000000000003159. Epub 2025 Nov 5. PMID: 41191825. https://pubmed.ncbi.nlm.nih.gov/41191825/ Pun SY, Kha ST, Park MO, Richey AE, Pham NS, Millis MB. Is the Bernese Periacetabular Osteotomy Safe for the Treatment of Acetabular Dysplasia When the Triradiate Cartilage is Still Open? A Preliminary Study. J Pediatr Orthop. 2026 Jul 1;46(6):335-341. doi: 10.1097/BPO.0000000000003275. Epub 2026 May 5. PMID: 42084192. https://pubmed.ncbi.nlm.nih.gov/42084192/

In this School of Doza episode, Nurse Doza opens the Metabolic Series with the adrenal glands — and why you may feel tired all day, crash between 2 and 4 PM, and wake up unrested. He explains how chronic stress can keep the body stuck in fight-or-flight, why that pattern is hard to shift, and the daily levers he leans on: belly breathing, less screen time at night, and morning sunlight. Then he breaks down Zen by MSW Nutrition — adrenal glandular plus four adaptogens — for stress support. FEATURED PARTNER Zen by MSW Nutrition is built in three layers rather than a single botanical: **125 mg of adrenal glandular tissue** (bovine, sourced from Argentina), **four standardized adaptogens** — Asian ginseng, rhodiola, eleuthero, and schisandra — plus **cofactor nutrients** (vitamin C, B6 as P5P, and pantothenic acid). Licorice rounds out the 9-ingredient formula. It's the supplement Nurse Doza reaches for when the goal is supporting the adrenal glands and the body's stress response, instead of layering more caffeine on top of a depleted system.

Cannabinoid Hyperemesis Syndrome (CHS) continues to be a major clinical challenge in the emergency department. Patients present with severe abdominal pain, intractable vomiting, and significant fluid and electrolyte derangements. CHS often affects people who have been using cannabis routinely for months to years – it can be difficult for patients to understand that their symptoms are related to cannabis.  Today, emergency pharmacist Haley Burhans joins us to discuss first-line treatments, fluid management, discharge strategies, and how to navigate these tough bedside conversations. First-Line Therapies: Haldol vs. Droperidol Haloperidol (Haldol): Supported by the HAVOC trial (haloperidol vs. placebo), which showed a reduction in symptoms and ED length of stay. Droperidol: Highly effective alternative with similar dopaminergic mechanism of action. May carry a lower risk of extrapyramidal symptoms compared to haloperidol.  Capsaicin Cream: addresses the TRPV1 pathway thought to drive CHS. Patients often dislike it as it causes a burning sensation on the skin and can be inadvertently spread to eyes or face. Can be an option if symptoms persist after trying the above meds and hot showers aren't feasible.  Backup Options & Anti-Emetics Alternative Dopaminergic Agents: Metoclopramide or prochlorperazine can be used. Standard Anti-Emetics (e.g., Ondansetron): Serotonergic anti-emetics generally fail to address the underlying CHS pathway. However, a single dose of ondansetron given alongside a butyrophenone (haloperidol/droperidol) is reasonable if you suspect co-existing etiologies. QTc Prolongation Warning: Chronic vomiting leads to electrolyte depletion. Combining anti-emetics and haloperidol or droperidol increases the risk of QTc prolongation. Baseline EKG: Not strictly required for every low-risk patient, but strongly recommended for patients with multiple risk factors (e.g., co-ingestion/use of methadone, history of heart failure, or severe baseline bradycardia). Fluid Resuscitation & Electrolyte Management CHS patients can vomit to the point of severe dehydration and profound electrolyte/acid-base derangements. Fluid Selection: Normal Saline (NS): A solid choice for initial volume resuscitation when sodium and chloride are severely depleted. Lactated Ringer's (LR): Ideal as a follow-up or maintenance fluid because it contains a small amount potassium. Potassium Repletion: Oral repletion may not be tolerated in the acute setting. Consider IV potassium repletion in the ED, followed by oral home supplementation once nausea is controlled. Magnesium: While acute vomiting primarily drives potassium loss, consider IV magnesium if Mg is low or there is concern for QTc prolongation. Discharge Planning: What to Send Home Low-Dose Olanzapine ODT: Send the patient home with 2.5 mg Olanzapine ODT (orally disintegrating tablets). Why it works: It dissolves instantly on the tongue, bypassing the stomach, and provides extended dopaminergic coverage over the multi-day washout period.  Pharmacokinetics Pearl: Infrequent user THC half-life: ~1.3 hours (cleared in 5–6 hours). Chronic user THC half-life: THC accumulates in adipose tissue. In heavy users, therapeutic levels can persist for up to 2 weeks, driving prolonged receptor dysregulation even after cessation. Navigating the Bedside Conversation Explaining to a chronic user that their daily cannabis—the very thing they use to relieve nausea—is causing their illness requires empathy and validation. Explain the Neurological Link: Cannabis acts on receptors throughout the entire body, including the brain's nausea center and the nervous system of the gut. Chronic, heavy saturation can paradoxically overload these pathways. Validate Their Experience: Acknowledge how counterintuitive it feels: “I know it's hard to believe that something you've used for years to feel better is causing this, but long-term daily use can change how your body processes it.” Set Realistic Expectations: Reiterate that symptoms will not resolve overnight. Even after stopping, it takes time for the pathways to recalibrate. What do you find most helpful for treating CHS? How do you have these difficult conversaions with your patients? Share your experience with us on social media @empulsepodcast or at ucdavisem.com Hosts: Dr. Julia Magaña, Professor of Pediatric Emergency Medicine at UC Davis Dr. Sarah Medeiros, Professor of Emergency Medicine at UC Davis Guests: Haley Burhans, PharmD, Emergency Medicine Clinical Pharmacist at UC Davis Resources: Borgundvaag B, Bellolio F, Miles I, et al. Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE-4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department. Acad Emerg Med. 2024 May;31(5):425-455. doi: 10.1111/acem.14911. PMID: 38747203. Rech MA, Shalaby M, Gage KA, Gottlieb M. Managing Cannabinoid Hyperemesis Syndrome. Ann Emerg Med. 2026 Jun;87(6):717-722. doi: 10.1016/j.annemergmed.2025.12.024. Epub 2026 Feb 3. PMID: 41632059. *** Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.

In a world where technology promises to simplify our lives, how do those of us with ADHD – notorious for our resistance to structure – harness that promise without abandoning our critical thinking or our humanity? Join me for this conversation with my client, Elizabeth Meyer - professor, coach, and self-described AI skeptic, who offers a roadmap for experimenting wisely with AI-powered tools, while staying loyal to our own brains, values, and need for connection. When Elizabeth was first offered the opportunity to sign up for my digital clone, Di AI, she hesitated. Then she did something unexpected - she designed an experiment to put Di AI and herself to the test. Elizabeth brought a scientist's rigor to the experience – scheduling regular sessions, setting clear goals, and running timers to structure her use, all to observe how the tool impacted her behaviors and mindset. The episode explores:How Elizabeth structured the experiment (including the infamous decision matrix and her “wildly unrealistic expectations”)Surprising (sometimes maddening) moments where AI reflected “stupid common sense” she'd never consideredWhat ghosting an AI tool taught her about the difference between digital and human accountabilityThe unexpected role of values alignment and motivation for us “rebels”Cautionary tales about outsourcing too much trust—or too much of ourselves—to technologyWhy critical thinking and intentionality are the only way these tools ever work for ADHD-ish brainsElizabeth and I share both the wins and the “facepalm” moments, plus an actionable tip sheet for anyone skeptical (or hopeful) about using AI for habit-building and organization.Her pro tip: Judge the tool by the quality of questions it asks youDon't Miss:Elizabeth's three-question framework (adapted from Naturalistic Decision-Making) for deciding when and how to engage with AI tools—so you never cede too much power to an algorithm If you're tired of empty promises from productivity apps—or want a peek at what a scientifically-minded ADHD brain learns from kicking the tires on new tech—this episode is for you.Fun FactElizabeth shared a story about her 15-year-old niece who, when asked where they should go for dinner, responded: “I don't know. Let me ask Chat.” The future is here and apparently it's hungry for chatbot inputYour turn! Make it practical: Use Di AI to help implement a tactic you picked up from the podcast, track specific goals, and follow up on progress.Know your “why”: Consider the reason you are looking for accountability and fit AI into your schedule where you need a champion (hello, bookkeeping!) If you haven't signed up for Di AI yet - what are you waiting for? Here is the link to sign up for free. Grab Elizabeth's Tip Sheet for making the most of Di AI (or any AI app)About today's guest:Elizabeth Meyers is an informatics professor, consultant, and owner of Deep Dive Strategies, where she advises early-stage startups and small companies on strategy and product design.Driven by a fascination with how humans navigate complex environments, Elizabeth specializes in Naturalistic Decision Making (NDM), studying how experts make high-stakes choices in real-world settings. As an entrepreneur who respects both human expertise and technology, she blends her deep background in technology and information science to explore how experts interact with AI. Mentioned in this episode:Conditions for intuitive expertise: a failure to disagree. Kahneman D, Klein G. Am Psychol. 2009 Sep;64(6):515-26. doi: 10.1037/a0016755. PMID: 19739881. Naturalistic Decision Making Conference Michael Webb PresentationAdam Mastroianni - “Bag of Words” post on SubstackDALL- E AI image generator Ep #281: Find Your Flow: 3 Focus Days Models for ADHD Brains Ep #212: Get More Done: How to Focus with ADHD & Take Real ActionThe Four Tendencies - Elizabeth is a Rebel. What are YOU? Identifying Your Core Values - self assessment Jodie Cook, Founder of Coach Vox Your ADHD-ish™ host, Diann Wingert Diann Wingert is a former therapist turned coach, speaker, and consultant who blends her expertise in entrepreneurship and neurodiversity to help others thrive. Host of the top-rated ADHD-ish™ podcast and creator of The ADHD-ish™ Method, Diann works with ADHD-ish™ business owners who are ready to create stand-out, sought-after, profitable businesses based on their unique brilliance.Loved this episode? Leave a review and tell us why! © 2026 ADHD-ish™ Podcast. Intro music by Ishan Dincer / Melody Loops / Outro music by Vladimir / Bobi Music / All rights reserved.

Send us Fan MailDescription: An immersive reading of Morning Tea by Michael L. Wynn with reflection on atrial fibrillation, strokes, space and time.Website:https://anauscultation.wordpress.comWork: https://www.neurology.org/doi/10.1212/WNL.0000000000214487 References:Wynn ML. Morning Tea. Neurology. 2025 Dec 23;105(12):e214487. doi: 10.1212/WNL.0000000000214487. Epub 2025 Nov 20. PMID: 41264895.

Traditional business coaching falls short when late-night decision-making spirals hit, leaving many ADHD entrepreneurs feeling isolated and tired of generic productivity advice. As a stubbornly self-sufficient business owner, your urgent questions, pivot ideas, and friction points rarely line up with a pre-scheduled coaching call.In this episode, Diann Wingert shares how her digital clone, Di AI, serves as a 24/7 thought partner to streamline your ADHD business strategy and lighten your daily cognitive load. Discover how on-demand support improves ADHD decision making, strengthens entrepreneur accountability, and optimizes ADHD business operations all without losing the essential human connection.EPISODE HIGHLIGHTS & TIMESTAMPS:00:00 — Introduction: AI Tools for the ADHD Entrepreneur03:15 — Testing Digital Coaching and ADHD Decision Making08:40 — Business Systems for ADHD Entrepreneurs14:20 — Managing Cognitive Load in Business and Tech19:50 — AI vs Human Entrepreneur Accountability25:10 — ADHD Productivity for Entrepreneurs: Evaluating AI31:05 — ADHD Executive Function in Business and Values35:00 — Roadmap for Business Owners with ADHDThe episode explores:How Elizabeth structured the experiment (including the infamous decision matrix and her “wildly unrealistic expectations”)Surprising (sometimes maddening) moments where AI reflected “stupid common sense” she'd never consideredWhat ghosting an AI tool taught her about the difference between digital and human accountabilityThe unexpected role of values alignment and motivation for us “rebels”Cautionary tales about outsourcing too much trust—or too much of ourselves—to technologyWhy critical thinking and intentionality are the only way these tools ever work for ADHD-ish brainsElizabeth and I share both the wins and the “facepalm” moments, plus an actionable tip sheet for anyone skeptical (or hopeful) about using AI for habit-building and organization.Her pro tip: Judge the tool by the quality of questions it asks youDon't Miss:Elizabeth's three-question framework (adapted from Naturalistic Decision-Making) for deciding when and how to engage with AI tools—so you never cede too much power to an algorithmIf you're tired of empty promises from productivity apps—or want a peek at what a scientifically-minded ADHD brain learns from kicking the tires on new tech—this episode is for you.Fun FactElizabeth shared a story about her 15-year-old niece who, when asked where they should go for dinner, responded: “I don't know. Let me ask Chat.” The future is here and apparently it's hungry for chatbot inputYour turn! Make it practical: Use Di AI to help implement a tactic you picked up from the podcast, track specific goals, and follow up on progress.Know your “why”: Consider the reason you are looking for accountability and fit AI into your schedule where you need a champion (hello, bookkeeping!)If you haven't signed up for Di AI yet - what are you waiting for? Here is the link to sign up for free.Grab Elizabeth's Tip Sheet for making the most of Di AI (or any AI app)About today's guest:Elizabeth Meyers is an informatics professor, consultant, and owner of Deep Dive Strategies, where she advises early-stage startups and small companies on strategy and product design.Driven by a fascination with how humans navigate complex environments, Elizabeth specializes in Naturalistic Decision Making (NDM), studying how experts make high-stakes choices in real-world settings.As an entrepreneur who respects both human expertise and technology, she blends her deep background in technology and information science to explore how experts interact with AI.Mentioned in this episode:Conditions for intuitive expertise: a failure to disagree. Kahneman D, Klein G. Am Psychol. 2009 Sep;64(6):515-26. doi: 10.1037/a0016755. PMID: 19739881.Naturalistic Decision Making Conference Michael Webb PresentationAdam Mastroianni - “Bag of Words” post on SubstackDALL- E AI image generator Ep #281: Find Your Flow: 3 Focus Days Models for ADHD Brains Ep #212: Get More Done: How to Focus with ADHD & Take Real ActionThe Four Tendencies - Elizabeth is a Rebel. What are YOU? Identifying Your Core Values - self assessment Jodie Cook, Founder of Coach Vox Your ADHD-ish™ host, Diann Wingert Diann Wingert is a former therapist turned coach, speaker, and consultant who blends her expertise in entrepreneurship and neurodiversity to help others thrive.Host of the top-rated ADHD-ish™ podcast and creator of The ADHD-ish™ Method, Diann works with ADHD-ish™ business owners who are ready to create stand-out, sought-after, profitable businesses based on their unique brilliance.Loved this episode? Leave a review and tell us why! © 2026 ADHD-ish™ Podcast. Intro music by Ishan Dincer / Melody Loops / Outro music by Vladimir / Bobi Music / All rights reserved.

In this episode, we bring a nuanced, science-based approach to many hot topics in running right now. What causes muscle cramps? Does Pilates count as strength training? Should slower runners wear carbon plated shoes? Is it possible to overfuel on long runs? Our goal is to provide individualized guidance, rather than click-baity universalized proclamations. In this episode, we provide our informed takes on:✅ What actually causes muscle cramps (according to science)✅ If taking walk breaks discounts a marathon effort✅ If back of pack and midpack runners benefit from carbon plated shoes✅ Why Pilates does not replace resistance training✅ Is there such a thing as overfueling on long runs?Tread Lightly Running is hosted and researched by Amanda Brooks and Laura Norris, MSc. Production, show notes, and graphics by Laura Norris.References

Send us Fan MailIn this prospective study, Adrianne and Nim dig into an area with almost no normative pediatric data: right ventricular diastolic function. Comparing 57 infants with RV pressure overload after intervention for pulmonic stenosis or tetralogy of Fallot to 134 healthy controls, the authors found a consistent pattern, reduced beat-to-beat variability, a higher atrial contribution to filling, and an E/A ratio inversion that was nearly universal in the CHD group versus about half of controls. It's one of the first real attempts to define what a right-sided diastolic pattern actually looks like in this population. But without a comparison against cardiac catheterization, the hosts agree the findings are hypothesis-generating at best, a starting point for a multi-parametric approach, not a reason to skip an invasive workup.----Echocardiographic Markers of Right Ventricle Diastolic Dysfunction in Neonates and Infants with Congenital Heart Disease. Cantinotti M, Capponi G, Scalese M, Palladino E, Giordano R, Franchi E, Viacava C, Corana G, Marchese P, Pizzuto A, Assanta N, Santoro G. J Clin Med. 2025 Dec 23;15(1):98. doi: 10.3390/jcm15010098. PMID: 41517351 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Send us Fan MailIn this small prospective pilot study, Adrianne and Nim explore a domain rarely discussed on rounds, how a mother's cardiovascular function in preeclampsia shapes her newborn's circulatory transition. Using maternal echo and neonatal electrical cardiometry across 13 mother-baby dyads, the authors found an inverse relationship: the worse the mother's cardiac function, the higher the neonate's cardiac output, though vascular tone barely budged. It's a compelling hypothesis about placental strain and fetal adaptation. But Nim pushes back hard on the methodology, pairing this paper with a companion study showing electrical cardiometry consistently overestimates cardiac output in neonates, and questioning why daily echoes were performed on these babies but the results never reported.----Linking maternal and neonatal circulation in preeclampsia. Piani F, Annesi L, Degli Esposti D, Vincenzi S, De Crescenzo S, Della Gatta AN, Simonazzi G, Corvaglia L, Martini S.Am J Physiol Heart Circ Physiol. 2026 Mar 1;330(3):H708-H716. doi: 10.1152/ajpheart.00945.2025. Epub 2026 Jan 12.PMID: 41525138 Free article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Join Jenn Dawson and Mitchell Hanson for some quick-hitting "research hot takes!"Topical Therapies Supporting Links and Articleshttps://nextstepsinderm.com/derm-topics/expanding-the-treatment-landscape-for-atopic-dermatitis-hidradenitis-suppurativa-and-chronic-hand-eczema/https://www.dermatologytimes.com/view/advancing-topical-stewardship-and-expanding-nonsteroidal-optionshttps://www.arcutis.com/arcutis-announces-publication-of-positive-long-term-safety-and-efficacy-data-with-zoryve-roflumilast-cream-0-05-for-treatment-of-mild-to-moderate-atopic-dermatitis-in-children-ages-2-5/Social Unrest Leads to Access Barriers Supporting Links and ArticlesC. L. Presley, J. Meisenheimer VII, C. W. Rundle, S. Maguiness, I. A. Maher, and A. J. M. Anderson, “Social Unrest and Its Implications on the Pediatric Dermatological Patient: Lessons From a Single Center Academic Dermatology Department,” Pediatric Dermatology (2026): 1–2, https://doi.org/10.1111/pde.70260.Mukerjee K, Shah S, Falusi O. State Policies and Access to Care for Immigrant Children—Implications for Pediatric Health Outcomes. JAMA Netw Open. 2025;8(12):e2545833. doi:10.1001/jamanetworkopen.2025.45833Skin of Color in Pediatric Dermatology Supporting Links and ArticlesDondi, A., Ranieri, A., Andreozzi, L., Leuzzi, M., D'Alanno, G., Pierantoni, L., Zama, D., Battelli, E., Calegari, R., Borghesi, A., Lanari, M., & Neri, I. (2026). Skin of Color in Pediatric Dermatology: A Cross-Sectional Retrospective Analysis Addressing Inclusive Diagnosis and Care. Life (Basel, Switzerland), 16(4), 578. https://doi.org/10.3390/life16040578Fagan E, Reagen C, Ituarte B, Shet P, Shaver-Dominguez N, Harter N, Wei EX, Oudenhoven M. Trends in Pediatric Representation Within Skin of Color Dermatology Literature: A Decade-Long Analysis. Pediatr Dermatol. 2026 Jan-Feb;43(1):95-97. doi: 10.1111/pde.16038. Epub 2025 Aug 13. PMID: 41611238.This episode is presented by Disc Medicine. Although Disc Medicine provided funding for this PeDRA Pearls Podcast, the contents of the podcast were developed independently by PeDRA. Learn more about Disc Medicine.

That feeling of not quite recognising yourself after your baby arrives has a biological explanation. Pregnancy reshapes the structure of the brain, and those changes can still be measured years down the track. What you're experiencing is your brain doing exactly what it's built to do.If you've ever said out loud that you feel like a different person since becoming a mum, you're describing something researchers can now see on a scan. Understanding what's happening in there changes how the whole experience feels.In this episode of The Science of Motherhood, Dr Renee White sits down with Dr Elseline Hoekzema, neuroscientist and head of the Pregnancy Brain Lab at Amsterdam University Medical Center, to unpack what pregnancy does to the maternal brain. Together they explore the changes to brain tissue first mapped in 2017, what those changes mean for how you think and feel, and what shifts differently the second time around.Elseline also works through the questions that flooded in after Renee shared her research on Instagram, covering what might happen with a third or fourth baby, spacing between siblings, pregnancy loss, and what changes for fathers and adoptive parents. She's honest about how much this field still has left to uncover.You'll Hear About:What happens to grey matter during pregnancyWhy the changes peak in the third trimesterHow a second pregnancy rewires different brain networksWhat the research shows about perinatal depressionWhy your instincts are worth listening toYour brain has been quietly reorganising itself to meet the exact demands of the life you're now living. Knowing that gives you something solid to hold onto on the days you feel furthest from yourself.Share this with a friend who's been saying she doesn't feel like herself since having her baby. And subscribe so you don't miss an episode of The Science of Motherhood.Resources & Links

In this episode of *Pediatric Critical Care Insights*, Dr. Monica Gray and Dr. Pradip Kamat chat about how capnography, specifically end-tidal CO2 monitoring, is used in the pediatric ICU. They walk through a real-life case of a 9-year-old with respiratory failure from influenza A, showing how ETCO2 monitoring helps confirm endotracheal tube placement, guides ventilation, spots cardiac arrest, and even helps assess the quality of CPR. Along the way, they break down how to interpret capnography waveforms, discuss different types of devices, and explain the key physiological concepts. The episode is packed with practical, bedside tips for intensivists caring for critically ill kids.Show Highlights:Importance of capnography (end-tidal CO2 monitoring) in the pediatric intensive care unit (PICU)Clinical case study of a 9-year-old boy with respiratory failure due to influenza AUse of capnography for confirming endotracheal tube placement and assessing ventilation statusDetection of cardiac arrest and guidance for CPR quality through ETCO2 monitoringOverview of capnography physics and physiology, including terminology distinctionsTypes of capnography: mainstream vs. sidestream, and their applications in pediatric patientsAssumptions for accurate ETCO2 approximation of arterial CO2 and conditions affecting this relationshipAnalysis of capnography waveform phases and their clinical significancePrognostic value of ETCO2 during cardiac arrest and its correlation with patient outcomesPractical applications of ETCO2 monitoring in critical care, focusing on airway, breathing, and circulation managementReferences:Noninvasive respiratory monitoring and assessment of gas exchange. David F. Butler; Kenneth A. Schenkman. Fuhrman and Zimmerman's Pediatric Critical Care, 43, 483-491.e3Humphreys S, Schibler A, von Ungern-Sternberg BS. Carbon dioxide monitoring in children—A narrative review of physiology, value, and pitfalls in clinical practice. Pediatr Anaesth. 2021;31:839–845. https://doi.org/10.1111/pan.14208Lasa JJ, Dhillon GS, Duff JP, et al. Part 8: Pediatric Advanced Life Support: 2025 American Heart Association and American Academy of Pediatrics Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics. 2026;157(1):e2025074351O'Flaherty. Capnography: principles and practice. London: BMJ Publishing Group; 1994.Aminiahidashti H, Shafiee S, Zamani Kiasari A, Sazgar M. Applications of End-Tidal Carbon Dioxide (ETCO2) Monitoring in Emergency Department; a Narrative Review. Emerg (Tehran). 2018;6(1):e5. Epub 2018 Jan 15. PMID: 29503830; PMCID: PMC5827051.

Automated waitlists are quickly becoming a key component of modern ambulatory access strategies, but what separates successful implementations from the rest?In this special edition of the All Access Pass podcast, Elizabeth Woodcock, Molly Siegel, and Chris Profeta discuss their newly published peer-reviewed research in the Journal of Medical Internet Research: Automated Waitlists for Ambulatory Appointment Scheduling: A Multi-Site, Mixed-Methods Evaluation.Drawing on data from health systems across the country, the team explores what the research revealed about implementation, adoption, patient outcomes, and the organizational factors that drive success. From lower missed appointment rates and flexible configuration to leadership support, implementation science, and the digital divide, this conversation offers practical insights for access leaders looking to optimize their scheduling strategies.Join us as we turn research into reality and discuss what automated waitlists mean for the future of patient access.Woodcock E, Profeta C, Siegel M. Automated Waitlists for Ambulatory Appointment Scheduling: Multisite, Mixed Methods Evaluation. J Med Internet Res. 2026 Jul 23;28:e90091. doi: 10.2196/90091. PMID: 42492053; PMCID: PMC13395261.https://pmc.ncbi.nlm.nih.gov/articles/PMC13395261/*For internal reference, here is the data from the article: Thirty-six (IQR 30.0-44.0) days of improvement were realized. Accepted waitlist offers brought the patient's appointment date forward by 36 (IQR 30.0-44.0) calendar days from the original appointment, thus shortening the lag time for the patient. There were eight (IQR 6.3-24.1) calendar days between the offer acceptance date and the offered appointment date.

You likely have heard both sides of the debate, as one side argues that sodium supplementation is overrated, while the other side shills sports drinks with a full gram of sodium. In this episode, we dive into the research to present you with a nuanced, science-backed discussion on the widely varying sodium needs of runners. You will learn how to determine your sweat rate and sodium needs, if sodium will prevent muscle cramps, and more.Thank you to our sponsors:✨ Tailwind: Complete sport nutrition made simple, including hydration mixes, high-carb sport drinks, endurance fuel, and recovery mixes. Use code TREADLIGHTLY20 at https://tailwindnutrition.com/TREADLIGHTLY for 20% off your first purchase.In this episode, you'll learn:✅ Sweat rate vs sweat concentration✅ The role that sodium plays in hydration, carbohydrate absorption, and more✅ If sodium supplementation prevents muscle cramps✅ How to know if sweat testing is appropriate or not✅ The signs and symptoms of too much and too little sodium✅ If sodium pre-loading works before a race✅ Ideal sources for sodium supplementation during runs✅ Why too low sodium can be dangerousTread Lightly Running is hosted and researched by Amanda Brooks and Laura Norris, MSc. Production, show notes, and graphics by Laura Norris.References

Dr. Rosy Boa discusses what happens when you take a break from pole, covering both physiological detraining and the emotional side of returning. She emphasizes not beating yourself up and notes that feeling awful after missing one class can signal an unhealthy dependency, suggesting support for possible exercise addiction. Aerobic capacity tends to noticeably drop after about two weeks away, while strength loss is slower and depends on training status and age: very trained lifters may not show measurable 1RM decreases until around 32 weeks, untrained individuals can lose strength after a 10-week break, and adults 74–86 may see strength and balance declines after two weeks. Returning typically takes about half the break time, and strength is often easier to rebuild due to “muscle memory,” with evidence that people can catch up to peers who never took a break.Interested in training online with Rosy? Check out the Science of Slink membership: https://scienceofslink.com/Chapters:01:36 Be Kind About Breaks04:40 Detraining Timelines Overview09:41 Rebuilding and Muscle Memory11:15 Catching Up After Breaks13:38 Personal Trick Loss Story15:31 Final TakeawaysCitations: Cumming, K.T., Reitzner, S.M., Hanslien, M., Skilnand, K., Seynnes, O.R., Horwath, O., Psilander, N., Sundberg, C.J. and Raastad, T. (2024), Muscle memory in humans: evidence for myonuclear permanence and long-term transcriptional regulation after strength training. J Physiol, 602: 4171-4193. https://doi.org/10.1113/JP285675 Encarnação, I. G., Viana, R. B., Soares, S. R., Freitas, E. D., de Lira, C. A., & Ferreira-Junior, J. B. (2022). Effects of detraining on muscle strength and hypertrophy induced by resistance training: A systematic review. Muscles, 1(1), 1-15. Halonen EJ, Gabriel I, Kelahaara MM, Ahtiainen JP, Hulmi JJ. Does Taking a Break Matter-Adaptations in Muscle Strength and Size Between Continuous and Periodic Resistance Training. Scand J Med Sci Sports. 2024 Oct;34(10):e14739. doi: 10.1111/sms.14739. PMID: 39364857. Toraman, N. F., & Ayceman, N. (2005). Effects of six weeks of detraining on retention of functional fitness of old people after nine weeks of multicomponent training. British journal of sports medicine, 39(8), 565-568

In this episode of The Birth Lounge Podcast, HeHe sits down with pelvic floor physical therapist Hayley Kava, founder of UMA Pelvic Health, to tackle one of the most common pregnancy complaints that doesn't get nearly enough attention: SI joint pain. If you've been told pregnancy pain is "just part of it," this conversation is your reminder that you don't have to simply suffer through it. Hayley explains what's actually happening in your pelvis during pregnancy, why SI joint pain develops, and how your pelvic floor, core, ribcage, breathing, and overall movement patterns all work together. Together, HeHe and Hayley break down why treating the pelvis in isolation often misses the bigger picture, how pregnancy hormones and your changing biomechanics influence pain, and why small changes to the way you move, stand, breathe, and rest can make a huge difference. They also discuss practical tools like SI belts, belly support bands, Pilates balls, yoga blocks, and gentle movement strategies, along with when those tools can help... and when they might not. Hayley also shares why pelvic floor physical therapy isn't just about internal exams (and yes, those are always optional), how to build a supportive birth team, and why individualized care is one of the best investments you can make during pregnancy. Whether you're already dealing with pelvic pain or hoping to prevent it, this episode is packed with practical, evidence-based strategies to help you move more comfortably, feel more supported, and better understand your changing body throughout pregnancy. 00:00 Stop Blaming Pelvic Floor 01:03 Pelvic Floor Basics 01:56 Meet Hayley Kava 03:19 Why SI Pain Matters 06:43 SI Joint Anatomy 09:18 Normal Asymmetry Patterns 12:20 Pubic Pain and Rolling 15:52 Inhibit Then Retrain 17:56 Rubiks Cube Body Model 20:10 Stop Bracing to Sneeze 21:34 Pregnancy Posture Fixes 25:31 Preparing for Labor Moves 29:14 Build Your Care Team 33:39 Pregnancy Compensation Patterns 34:36 Spotting Habitual Postures 36:46 Mindful Pain Check Ins 38:29 Shifting Stance And Sitting 41:29 Tension Beyond Pelvic Floor 43:23 Guarding And SI Joint Myths 46:16 Ribs Hip And Big Picture 47:57 Internal Exam Is Optional 50:38 Daily Tools And Movement 56:43 Services Access And Wrap Up   Guest Bio: Hayley became a pelvic floor therapist in 2017 after a birth injury opened her eyes to the limitations in traditional pelvic rehab. Hayley took her Postural Restoration and Sports Medicine background and dug deep into the literature. Over the years developing an integrative whole person method to treat the pelvic floor. She has become passionate about sharing this method with not only her clients and staff but to the masses via social media, online classes and various trainings for clinicians looking to take a different approach to pelvic rehab. You can learn more about those offerings at hayleykavapt.com   SOCIAL MEDIA: Connect with HeHe on Instagram: https://www.instagram.com/tranquilitybyhehe/  Connect with Hayley on IG: https://www.instagram.com/hayleykavapt/ BIRTH EDUCATION: Learn how to stay in control of your birth and reduce the risk of unnecessary interventions in our Avoid a C-Section Webinar. HeHe breaks down the cascade of interventions, explains what's really happening in the hospital, and shares practical strategies to protect your birth plan, advocate for yourself, and navigate labor with confidence. Perfect for anyone who wants a positive, informed hospital birth experience: https://www.thebirthlounge.com/csection Feeling nervous about speaking up in labor? Our Scripts for Advocacy give you the exact words to handle the most common conversations that can make or break your birth experience. From declining unnecessary interventions to asking the right questions about procedures, these scripts empower you to stay in control, speak confidently, and protect your birth plan — even when the pressure is on. Think of it as your personal toolkit for advocating like a pro, so you can focus on your baby, not the stress: https://www.thebirthlounge.com/Scripts-for-Advocacy And if you haven't grabbed it yet… Snag my free Pitocin Guide to understand the risks, benefits, and red flags your provider may not be telling you about, so you can make informed, powerful decisions in labor: https://www.thebirthlounge.com/pitocin Join The Birth Lounge for judgment-free, evidence-based childbirth education from HeHe that shows you exactly how to navigate hospital policies, avoid unnecessary interventions, and have a trauma-free labor experience, all while feeling wildly supported every step of the way: https://www.thebirthlounge.com/ Want prep delivered straight to your phone? Download The Birth Lounge App for bite-sized birth and postpartum tools you can use anytime, anywhere: https://www.thebirthlounge.com/app   LINKS AND RESEARCH MENTIONED: www.umapelvichealth.com www.hayleykavapt.com Kiapour A, Joukar A, Elgafy H, Erbulut DU, Agarwal AK, Goel VK. Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain. Int J Spine Surg. 2020 Feb 10;14(Suppl 1):3-13. doi: 10.14444/6077. PMID: 32123652; PMCID: PMC7041664. Joukar, Amin MS∗; Shah, Anoli MS∗; Kiapour, Ali PhD∗; Vosoughi, Ardalan Seyed MS∗; Duhon, Bradley MD†; Agarwal, Anand K. MD∗; Elgafy, Hossein MD∗; Ebraheim, Nabil MD∗; Goel, Vijay K. PhD∗. Sex Specific Sacroiliac Joint Biomechanics During Standing Upright: A Finite Element Study. SPINE 43(18):p E1053-E1060, September 15, 2018. | DOI: 10.1097/BRS.0000000000002623

What if one tiny molecule played the central role in your blood pressure, heart health, brain function, exercise performance, and even your risk of diabetes and Alzheimer's disease? Dr Nathan Bryan believes that molecule is nitric oxide. And he walks the walk, having used his N101 products for decades testing shows his endothelial health to be of someone half his biological age! This is an incredible, illuminating podcast that deserves worldwide attention.Dr. Nathan Bryan has been involved in nitric oxide research for the past 25 years and has made many seminal discoveries in the field. His many seminal discoveries have resulted dozens of issued US and International patents and the product technology resulting from his discoveries and inventions has improved patient care worldwide. His companies and product technology are responsible for more than one billion dollars in product sales worldwide. Bryan is an international leader in molecular medicine and nitric oxide biochemistry.Contact: Website - https://n1o1.comJoin us as we explore:The secret power of nitric oxide - the root causes of deficiency, the #1 symptom of insufficiency and why it's molecularly a hormone.Nitric oxide's causation to diabetes, cardiovascular disease and Alzheimer's disease.Eliminating deadly soft arterial plague with nitric oxide lozenges.Why most nitric oxide promoting supplements are false marketing.How your toothpaste and mouth wash are destroying your nitric oxide.How exercise creates nitric oxide.The key enzyme for nitric oxide and how to keep it in high supply.Mentions Podcast - Dr Robert Elliot, https://podcasts.apple.com/za/podcast/the-made-to-thrive-show/id1509452847?i=1000718543359 Podcast - Dr John Osborne, https://podcasts.apple.com/za/podcast/the-made-to-thrive-show/id1509452847?i=1000766332388Study - Elrod JW, Calvert JW, Gundewar S, Bryan NS, Lefer DJ. Nitric oxide promotes distant organ protection: evidence for an endocrine role of nitric oxide. Proc Natl Acad Sci U S A. 2008 Aug 12;105(32):11430-5. doi: 10.1073/pnas.0800700105. Epub 2008 Aug 6. PMID: 18685092; PMCID: PMC2516252Support the showFollow Steve's socials: Instagram | LinkedIn | YouTube | Facebook | Twitter | TikTokSupport the show on Patreon:As much as we love doing it, there are costs involved and any contribution will allow us to keep going and keep finding the best guests in the world to share their health expertise with you. I'd be grateful and feel so blessed by your support: https://www.patreon.com/MadeToThriveShowSend me a WhatsApp to +27 64 871 0308. Disclaimer: Please see the link for our disclaimer policy for all of our content: https://madetothrive.co.za/terms-and-conditions-and-privacy-policy/

If you've scrolled through your feeds recently, you've probably seen the video that's causing a stir: a prominent infertility doctor sharing her “Hot Take” personal observations on social media, claiming that IUDs are a hidden cause of intrauterine adhesions- or severe uterine scar tissue. Now, Listen. It is completely natural to see a specialist standing in a white coat making a passionate claim and think, "Wow, should I be worried about my birth control?" But here is the reality we need to establish right out of the gate: a handful of individual cases shared online is the very definition of anecdotal evidence. It does not fulfill the criteria of rigorous scientific observation. When we pull back from the algorithm and look at the actual clinical data involving millions of IUD users worldwide, the science shows us something completely different. In fact, large-scale studies demonstrate that IUDs do not cause this scarring—and historically, certain models have actually been used to prevent the uterine walls from sticking together during post-surgical healing. So today, we are separating the scrolling panic from the actual science. We have REA data from the recent FACT (Fertility After Contraceptive Termination) study from 2021 (AJOG). We're breaking down what the data really says, why the internet loves a medical scare, and the true, proven causes of intrauterine adhesions. 1. Abel MK, Wald K, Cedars MI, Noel M. Uterine Synechiae After Intrauterine Device Use: A Case Series. Journal of Assisted Reproduction and Genetics. 2021. 2. Chung E, Wang F, Zhang J, Strug M, Aghajanova L, Lathi R. The impact of prior hormonal intrauterine device (IUD) use on endometrial lining thickness in the fertility clinic setting: a retrospective cohort study. J Assist Reprod Genet. 2026 Jun 25. doi: 10.1007/s10815-026-03950-x. Epub ahead of print. PMID: 42347902.3. Peipert JF, Zhao Q, Schreiber CA, Teal S, Turok DK, Natavio M, Cordon S, Daggy J. Intrauterine device use, sexually transmitted infections, and fertility: a prospective cohort study. Am J Obstet Gynecol. 2021 Aug;225(2):157.e1-157.e9. doi: 10.1016/j.ajog.2021.03.011. Epub 2021 Mar 11. PMID: 33716075.

Antenatal corticosteroids are a MAJOR win in the management of preterm labor. An initial course of antenatal corticosteroids has been shown to reduce morbidity and mortality in patients with preterm prelabor rupture of membranes. For patients who remain undelivered after the initial course of antenatal corticosteroids, it is uncertain whether a booster course of antenatal corticosteroids reduces neonatal morbidity or increases the infection risk. The ACOG, in its current guidance, has concluded that the current evidence is insufficient to make a recommendation. Corticosteroids, especially at the doses given, are also powerful immunosuppressants. When you administer that first course, you accept a minor, calculated risk for a massive, proven benefit. But when you introduce a second course of steroids into a uterine environment that has already been ruptured and exposed to vaginal flora for weeks, you are pouring fuel on the fire. PLUS, the environment for the fetus with prolonged preterm prelabor rupture of membranes is unique. PPPROM, the chronic exposure to ruptured membranes and the resultant oligohydramnios is theorized to trigger a kind of stress response in the fetus- so the baby may make their own endogenous corticosteroid flare. So, rescue steroids after an initial course of steroids in PPROM cases has remained controversial but we have updated data that has provided new insights. In this episode, we will highlight an RCT from 2023 and a more recent systematic review and meta-analysis from May 2026 on this very subject. Listen in for details. 1. Garite TJ, Kurtzman J, Maurel K, Clark R; Obstetrix Collaborative Research Network. Impact of a 'rescue course' of antenatal corticosteroids: a multicenter randomized placebo-controlled trial. Am J Obstet Gynecol. 2009 Mar;200(3):248.e1-9. doi: 10.1016/j.ajog.2009.01.021. Erratum in: Am J Obstet Gynecol. 2009 Oct;201(4):428. PMID: 19254583.2. Tenbrink E, Quain A, Rone V, Harris K, Hadley E, Haas D, Shanks A. Risk of Neonatal Sepsis With Rescue Steroids in Preterm Premature Rupture of Membranes. Cureus. 2023 Apr 6;15(4):e37207. doi: 10.7759/cureus.37207. PMID: 37159785; PMCID: PMC10163895.3. Melamed N, Murphy KE, Pylypjuk C, et al. Timingof Antenatal Corticosteroid Administration and Neonatal Outcomes. JAMA Netw Open. 2025;8(5):e2511315. 4. Porreco R, Garite TJ, Combs CA, Maurel K, Huls CK, Baker S, Fortner KB, Longo SA, Nageotte M, Lewis D, Tran L; Obstetrix Collaborative Research Network. Booster course of antenatal corticosteroids after preterm prelabor rupture of membranes: a double-blind randomized trial. Am J Obstet Gynecol MFM. 2023 May;5(5):100896. doi: 10.1016/j.ajogmf.2023.100896. Epub 2023 Feb 14. PMID: 36796641.5. Da Costa Y, Ramanathan V, Oliveira JA, Brito J, Yousif A. Repeat versus Single Course of Antenatal Corticosteroid in Management of Preterm Premature Rupture of Membranes: A Systematic Review and Meta-analysis. Am J Perinatol. 2026 May;43(7):925-932. doi: 10.1055/a-2708-5314. Epub 2025 Oct 9. PMID: 41067234

The long run is a staple of training plans from the 5K to ultra - but why? In this episode, we discuss the science of long runs, including the physiological adaptations, progressions, specificity and more. Plus, we answer your questions about why sleep is difficult after a long run, if walk breaks are okay, and if you treadmill long runs at a lower heart rate are better than outdoors.Thank you to our sponsors:✨ Mizuno: Shop Mizuno's newest bouncy supertrainer: https://runtothefinish.com/neovista3/In this episode, you'll learn:✅ Why long runs are beneficial✅ If fueling your long runs compromises adaptations✅ How to progress your long runs✅ How often you should do long runs at goal race pace✅ Cardiac drift, cadence, and other things to pay attention to on long runs✅ Terrain specificity during long runsIf you enjoyed this episode, you may like:

Send us Fan MailVitamin K refusal has crossed 5%. That's one in twenty babies, and the curve is bending the wrong way. Ben and Eli work through a new Pediatrics case review that opens with a warning shot, that hemorrhagic presentation in an infant should no longer be a diagnostic mystery, alongside a JAMA letter tracking refusal from 2.9% in 2017 to 5.2% in 2024. Eighty-one times the risk. Intracranial hemorrhage in most late-onset cases. Twenty percent mortality. They talk about the halo effect on other refusals, the ICD code you should be using, and why this conversation belongs in the obstetrics office, not the nursery.----Vitamin K Deficiency Bleeding After Refusal: A Sentinel Event in a Misinformation Era. Jacobs JW, Booth GS, Wheeler AP, Adkins BD.Pediatrics. 2026 May 1;157(5):e2026075994. doi: 10.1542/peds.2026-075994.PMID: 41916583 No abstract available.Trends in Vitamin K Administration Among Infants. Scott K, Miller E, Culhane JF, Greenspan J, Handley SC, Lo JY, Knake LA, McKenney KM, Burris HH, Dysart K.JAMA. 2026 Jan 20;335(3):272-274. doi: 10.1001/jama.2025.21460.PMID: 41359326 Free PMC article.Babies Are Bleeding to Death as Parents Reject a Vitamin Shot Given at Birth https://www.propublica.org/article/more-parents-decline-vitamin-k-shot-newbornsSupport the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

The Bakri Postpartum Balloon was described and first used clinically in 1999 by Dr. Younes N. Bakri (Georgia, USA). It is intended to treat postpartum hemorrhage (PPH). In the United States, it received its first major FDA clearance (via 510(k) for commercial marketing) on April 17, 2002. Manufacturer guidelines for the Bakri (Cook Medical) state that the balloon may be left indwelling for a maximum of 24 hours, but the determination of removal time is left to the clinician once “bleeding is controlled and the patient is stable.” However, the optimal duration of intrauterine balloon tamponade placement remains unclear. One retrospective cohort study from AJOG (Einerson et al) of 274 women found no significant difference in PPH outcomes when intrauterine balloon tamponade was left in place for 2–12 hours, compared with more than 12 hours. However, only 30 women had the intrauterine balloon tamponade placement for 10 hours or less. And remember, this was not a prospective trial looking at a minimum of 2 hours, 2 hours was just the lower margin of the “short duration” group. Now, a new RCT (with authors from Denver and Vermont) published in the July 2026 Green Journal provides new data. In this first of its kind pragmatic, randomized trial of noninferiority, a 6-hour duration of intrauterine balloon tamponade usage for postpartum hemorrhage (PPH) control was compared with an 18-hour duration. Listen in for details. 1. Durfee, J., Adkins, K., Heyborne, K., Larrea, N., & Schultz, C. (2026). Intrauterine Balloon Tamponade Duration for Postpartum Hemorrhage: A Randomized Controlled Trial. Obstetrics & Gynecology, 148(1), 113–120. https://doi.org/10.1097/AOG.00000000000062952. Garabedian C, Prats C, Seco A, Deneux-Tharaux C, Rozenberg P, Berveiller P. Duration of Intrauterine Balloon Tamponade in Post-Partum Haemorrhage Management After Vaginal Delivery: A Secondary Cohort Analysis From the French TUB Trial. BJOG. 2026 Jan;133(1):123-131. doi: 10.1111/1471-0528.18345. Epub 2025 Sep 1. PMID: 40888007; PMCID: PMC12676195.3. Einerson BD, Son M, Schneider P, Fields I, Miller ES. The association between intrauterine balloon tamponade duration and postpartum hemorrhage outcomes. Am J Obstet Gynecol 2017;216:300.e1–5.

Testosterone for women: what the evidence actually shows vs. what social media is selling you. Testosterone has become the hormone every midlife woman is told she is missing: the third hormone lost at menopause, the fix for brain fog, low energy, stubborn weight, and thinning muscle. The science tells a different and more reassuring story. In this episode, Dr. Ayesha Sherzai sits down with Professor Susan Davis, MBBS, FRACP, PhD, the clinician-researcher and academic endocrinologist who gathered much of the data and helped write the global guidelines, to separate what the research supports from what is simply being sold. Your Brain On... Testosterone [Season 7, Episode 7] Get our FREE NEURO Plan Brain Health Playbook: https://thebraindocs.com/playbook In this episode: Why testosterone does not crash at menopause the way estrogen does, and what actually changes across a woman's life What the research shows about testosterone and memory, brain fog, and dementia risk The real story on testosterone for muscle, bone, and anti-aging claims Why women tend to gain a little weight on testosterone rather than lose it The one use with genuine evidence behind it: low sexual desire after menopause that causes real distress Why more is not better, and what high-dose testosterone actually does What is really inside compounded creams, injections, and testosterone pellets sold at med spas Why routine testosterone blood testing generates bills and anxiety rather than answers Why there is no such thing as testosterone deficiency in women How to tell an evidence-based clinician from a sales pitch What genuinely protects a woman's aging brain, and why connection matters more than any hormone Professor Susan Davis is a consulting endocrinologist at Monash University in Melbourne, where she directs a leading women's health research program. She has studied testosterone in women since the 1990s and is the lead author of the Global Consensus Position Statement on the Use of Testosterone Therapy for Women, endorsed by the International Menopause Society, The Endocrine Society, and menopause and obstetric societies around the world. References: Does testosterone crash at menopause? Wang Y, Islam RM, Bond M, Davis SR. Testosterone and pre-androgens by age and menopausal stage at midlife: findings from a cross-sectional study. EBioMedicine. 2025;121:105972. PMID: 41106025. Davis SR, Bell RJ, Robinson PJ, et al. Testosterone and estrone increase from the age of 70 years: findings from the Sex Hormones in Older Women Study. J Clin Endocrinol Metab. 2019;104(12):6291–6300. PMID: 31408149. Islam RM, Bell RJ, Handelsman DJ, Robinson PJ, Wolfe R, Davis SR. Longitudinal changes over three years in sex steroid hormone levels in women aged 70 years and over. Clin Endocrinol (Oxf). 2021;94(3):443–448. PMID: 33351205. Does testosterone improve memory or protect against dementia? Sultana F, Davis SR, Wolfe RS, McNeil JJ, Islam RM. Associations between blood sex hormones, cognitive decline and incident dementia in community-dwelling older Australian women: a prospective cohort study. Climacteric. 2025;28(4):446–455. PMID: 40085743. Sultana F, Islam RM, Davis SR. Associations between declining testosterone concentrations and cognitive performance in community-dwelling older Australian women: a prospective cohort study. Climacteric. 2026;29(1):46–52. What does testosterone therapy actually do? Islam RM, Bell RJ, Green S, Page MJ, Davis SR. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. Lancet Diabetes Endocrinol. 2019;7(10):754–766. PMID: 31353194. What do the global guidelines say? Davis SR, Baber R, Panay N, et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab. 2019;104(10):4660–4666. PMID: 31498871. Can a blood test diagnose low testosterone? Wang Y, Islam RM, Hodge A, Handelsman DJ, Karim MN, Bond M, Davis SR. Associations between testosterone and pre-androgens and sexual function: findings from the Australian Women's Midlife Years Study. Fertility and Sterility. 2026. Get our FREE NEURO Plan Brain Health Playbook: https://thebraindocs.com/playbook Hosted by Drs. Ayesha & Dean Sherzai. Subscribe to The Synapse (free weekly newsletter): https://thebraindocs.com/newsletter  Follow @TheBrainDocs on Instagram

Join us as we discuss research on mental health and wellbeing in the surgical workforce with Drs. Yang and Collins. The episode explores key findings from recent national surveys showing that nearly one in seven surgeons report suicidal ideation in the past year, with depression, anxiety, and PTSD affecting 15–20% of the surgical population. The conversation highlights protective factors—professional fulfillment, resilience, self-valuation, and connection—while distinguishing between healthy resilience and normalized suffering. Dr. Yang and Dr. Collins discuss systemic barriers including time constraints, out-of-pocket mental health costs, and persistent stigma, alongside actionable institutional interventions: protecting dedicated wellbeing time, establishing peer support and psychological first aid programs, ensuring free mental health access, and expanding research to understand what helps surgeons thrive. The episode emphasizes that self-care is essential to patient safety and invites listeners to become advocates, engage with the literature, and help drive culture change within their institutions. For more information about the AAS wellbeing survey, please email Dr. Yang at CJYANG@MGH.HARVARD.EDU.Host:   Steven Thornton, MD (General Surgery Resident at Duke University) Agnes Premkumar (General Surgery Resident at Creighton) Guests: Jeff Yang, MD (Massachusetts General Hospital) Reagan Collins, MD (University of Pennsylvania) Publications Discussed: Hughes TM, Collins RA, Cunningham CE. Depression and Suicide Among American Surgeons-A Grave Threat to the Surgeon Workforce. JAMA Surg. 2024 Jan 1;159(1):7-8. doi: 10.1001/jamasurg.2023.4658. PMID: 37792380. [https://pubmed.ncbi.nlm.nih.gov/37792380/] Collins RA, Herman T, Snyder RA, Haines KL, Stey A, Arora TK, Geevarghese SK, Phillips JD, Vicente D, Griggs CL, McElroy IE, Wall AE, Hughes TM, Sen S, Valinejad J, Alban A, Swan JS, Mercaldo N, Jalali MS, Chhatwal J, Gazelle GS, Rangel E, Yang CJ, Donelan K, Gold JA, West CP, Cunningham C. Unspoken Truths: Mental Health Among Academic Surgeons. Ann Surg. 2024 Mar 1;279(3):429-436. doi: 10.1097/SLA.0000000000006159. Epub 2023 Nov 23. PMID: 37991182. [https://pubmed.ncbi.nlm.nih.gov/37991182/]  Yaghmour NA, Bynum WE 4th, Hafferty FW, Könings KD, Richter T, Brigham TP, Nasca TJ. Causes of Death Among US Medical Residents. JAMA Netw Open. 2025 May 1;8(5):e259238. doi: 10.1001/jamanetworkopen.2025.9238. Erratum in: JAMA Netw Open. 2025 Jul 1;8(7):e2523489. doi: 10.1001/jamanetworkopen.2025.23489. PMID: 40366660; PMCID: PMC12079293. [https://pubmed.ncbi.nlm.nih.gov/40366660/] Nasca BJ, Hunt ML, Ramirez RT, Eng JS, Li RD, Agarwal G, Bilimoria KY, Hu YY. One is too many: suicidality among general surgery residents. Acad Med. 2025 Dec 24:wvaf105. doi: 10.1093/acamed/wvaf105. Epub ahead of print. PMID: 41819820. [https://pubmed.ncbi.nlm.nih.gov/41819820/] Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Send us Fan MailIn this Journal Club, Ben and Daphna dig into two new papers on PDA management in our smallest patients. First, the SMART-PDA pilot RCT from Souvik Mitra and colleagues, which uses comprehensive hemodynamic screening to selectively treat high-volume shunts in infants born before 26 weeks, and whose striking Bayesian signal for reduced pulmonary hemorrhage and NEC stopped the trial early. Then a companion JAMA Network Open comparative effectiveness study across four pharmacotherapy regimens. Along the way, Ben shares hemodynamics pearls from his Montreal training: why left ventricular output, LA:Ao ratio, and transductal velocity matter more than PDA diameter alone.----Selective early medical treatment of the patent ductus arteriosus in extremely low gestational age infants: a pilot randomised controlled trial (SMART-PDA). Mitra S, Hebert A, Castaldo MP, Disher T, El-Naggar W, Dhillon S, Alhassen Z, Koo J, Katheria AC, Hyderi A, Kumaran K, Ting J, Surak A, Larocque J, Pepper D, Hornberger L, Makoni M, Weisz DE, Jain A, Bacchini F, Cameron-Nola AJJ, Hatfield T, Dorling J, McNamara PJ, Thabane L.Arch Dis Child Fetal Neonatal Ed. 2026 May 18:fetalneonatal-2026-330462. doi: 10.1136/archdischild-2026-330462. Online ahead of print.PMID: 42150872Pharmacologic Therapies for Patent Ductus Arteriosus in Extremely Preterm Infants. Mitra S, Jain A, Ting JY, Ben Fadel N, Drolet C, Abou Mehrem A, Soraisham AS, Jasani B, Louis D, Lapointe A, Dorling J, Khurshid F, Hyderi A, Kumaran K, Toye J, Harabor A, Weisz DE, Stavel M, Morin A, Bhattacharya S, Lalitha R, Afifi J, Augustine S, Castaldo MP, Hatfield T, Su YC, Shah PS; Canadian Neonatal Network Investigators.JAMA Netw Open. 2026 Jun 1;9(6):e2617477. doi: 10.1001/jamanetworkopen.2026.17477.PMID: 42262753 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Gonadal hormones have a complicated influence on appetite. Estradiol generally suppresses appetite, whereas progesterone opposes estradiol's action such that their combined presence represents a high-risk hormonal milieu for Binge Eating (BE). Testosterone is thought to be associated with increased BE in females but appears protective in males. In some reports, combination oral contraceptive (COC) use has been linked to greater BE-related appetitive processes (e.g., food intake). Now, we have 2 recent, back-to-back publications (June 2026 in JAMA Network Open, and July 2026 in Appetite) that have examined the relationship of hormonal contraception on binge eating behavior. These found seemingly opposing conclusions. Listen in for details. 1. Klump KL, Di Dio AM, Anaya C, et al. Combined Oral Contraceptive Use and Binge Eating. JAMA Netw Open. 2026;9(6):e2619047. doi:10.1001/jamanetworkopen.2026.190472. Katz JM, Yan R, Beltz AM, Gearhardt AN. Associations between reproductive hormonal milieus and binge eating: The roles of sex and hormonal contraceptive use. Appetite. 2026 Jul 1;222:108547. doi: 10.1016/j.appet.2026.108547. Epub 2026 Mar 20. PMID: 41866083.3. Bass L, Prostináková T, Silang KG, Griffiths-Gray A, McQuilliam S, Mahon E, Whitehead A, Johnson KO. Does it hold weight? The perceived effects of contraceptive use on weight status in females: A mixed-methods study. PLoS One. 2025 Dec 29;20(12):e0339323. doi: 10.1371/journal.pone.0339323. PMID: 41460817; PMCID: PMC12747328.

Listener discretion is advised! (explicit) References: McGovern B, Garan H, Ruskin JN. Precipitation of cardiac arrest by verapamil in patients with Wolff-Parkinson-White syndrome. Ann Intern Med. 1986 Jun;104(6):791-4. doi: 10.7326/0003-4819-104-6-791. PMID: 3706931. Strasberg B, Sagie A, Rechavia E, Katz A, Ovsyscher IA, Sclarovsky S, Agmon J. Deleterious effects of intravenous verapamil in Wolff-Parkinson-White patients and atrial fibrillation. Cardiovasc Drugs Ther. 1989 Jan;2(6):801-6. doi: 10.1007/BF00133211. PMID: 2488095. UK Paramedic Assaults: https://collegeofparamedics.co.uk/COP/COP/News/2025/AACE_Calls_For_Further_Interventions.aspx#:~:text=New%20data%20shows%20UK%20ambulance,15%25%20on%20the%20previous%20year.

REBEL Rundown Key Points Mastery Learning: A unique educational framework focusing on achieving high competence with minimal variability among learners. Deliberate Practice: Involves learner-driven improvement, guided by expert feedback and breaking skills down into micro steps. Psychological Safety: Essential in mastery learning, allowing open feedback without fear or shame, enhancing growth. Embrace the productive struggle!  Practice to Prevent Skill Decay and Improve Clinically: Application of mastery learning principles helps maintain high proficiency levels in both common and rare procedures. Click here for Direct Download of the Podcast. Previously Covered and Related Content: REBEL MIND: The Dunning-Kruger EffectREBEL MIND: Growth vs Fixed Mindset Introduction Welcome back to Rebel MIND, the podcast where we sharpen the person behind the practitioner. MIND stands for Mastering Internal Negativity during Difficulty. This series emphasizes productivity, provider performance, and team optimization to ensure we are at our best during high-pressure situations. In this episode, host Dr. Kim Bambach chats with master educator Dr. Jennifer Yee about the science of performance through mastery learning and deliberate practice. Jennifer Yee, DO is an associate residency program director for OSU Emergency Medicine, the OSU EM director for assessment and evaluation, and an associate professor of emergency medicine.  She is from Akron, Ohio and earned her bachelor degree from Ohio University and her medical degree through the Ohio University College of Medicine. Her residency training was completed through Summa Akron City Hospital. After serving as chief resident, she completed a simulation medicine fellowship at Summa.She completed Northwestern's Designing and Implementing Simulation-Based Mastery-Learning Curricula, as well as Ohio State's Master of Art's program in Biomedical Education. She established a mastery-based procedural curriculum for OSU’s EM residency program before creation of an institution-wide mastery-based central venous catheter (CVC) curriculum for all housestaff expected to place CVCs during their clinical training. Cognitive Question How can use the principles of mastery learning as better benchmark for learning, performance, and patient safety? How can we practice deliberately? What is Mastery Learning? Unlike traditional clinical training, which is time-bound (e.g., “you are competent after a 3-year residency” or “after 10 chest tubes”), Mastery Learning is outcome-bound. The goal is to get every single learner from their unique baseline to an identical, objectively high level of performance with minimal variation. In this framework, learners start with a pre-brief, followed by baseline assessment, targeted debrief, deliberate practice, and a final evaluation using a checklist with a strict minimum passing standard (often set via methods like the Mastery Angoff). The mastery learning framework has been shown to improve patient safety.The Northwestern Central Line Study: Research demonstrated that requiring residents to achieve a set benchmark on a simulator prior to clinical performance led to fewer needle passes, a decrease in mechanical complications (such as accidental arterial punctures), and a subsequent reduction in catheter-associated infection rates in the intensive care unit.High-Acuity, Low-Occurrence (HALO) Procedures: Studies have demonstrated that for rare, critical procedures like emergency cricothyrotomies or transvenous pacing, baseline testing shows that very few trainees can meet a standard passing score initially. However, following targeted simulation training and deliberate practice, 100% of participants successfully achieved the minimum standard required to perform the procedure competently. The Anatomy of Deliberate Practice We often assume experience or confidence equals competence, but humans are notoriously poor self-assessors (plug for our Dunning-Kruger episode!). True deliberate practice isn’t just repeating a task for 10,000 hours; it is purposeful, learner-driven micro-skill improvement guided by an expert coach.High-Quality Feedback: Avoid vague phrases like “good job” or “read more.” Effective coaching relies on strictly objective, real-time observations (e.g., “I am watching your needle angle. If you enter the skin more steeply, you will hit the vessel faster”).Embrace a Growth Mindset: Stripping away your ego to be silently watched and critiqued  is inherently awkward. Normalize deliberate practice to create psychological safety. Overcoming this requires building an environment centered on patient safety, where baselines are treated as data points rather than judgments. True growth happens with the “productive struggle”.Adaptive Expertise: True mastery means moving past a rigid checklist. It requires learners to understand the reasoning behind their actions and anticipate next steps, complications, and plot twists in real time. Immediate Action Steps for Your Next Shift **Reflect on Personal Goals**: Identify specific clinical skills you wish to improve and set objectives.  **Seek Expert Feedback**: Find a mentor or coach for guided practice and objective feedback on your skills.  **Cultivate Psychological Safety**: Foster an environment where discussing mistakes and receiving feedback is viewed as growth rather than criticism.  **Practice Adaptively**: Introduce scenarios with atypical anatomy,  complications, plot twists to better prepare for real-world complexity.  Conclusion By focusing on specific skill improvement and welcoming constructive feedback, clinicians can build competence and confidence, ultimately improving performance and patient safety. Effective mastery learning hinges on creating psychologically safe learning environments, engaging in focused deliberate practice, and leveraging expert feedback. This approach can be applied to clinical procedural excellence as well as many other skills, including communication and team dynamics. Clinical Bottom Line Mastery learning is an outcome-bound framework to reach a high standard of performance and deliberate practice is the tool that can help you achieve that high performance through expert feedback. Further Reading Barsuk JH, et al.Dissemination of a simulation-based mastery learning intervention reduces central line-associated bloodstream infections. BMJ Quality & Safety. Sep 2014.PMID: 24632995Klein MR, et al.Developing simulation-based mastery learning curricula for emergency medicine skills training. AEM Education and Training. Jun 2025.PMID: 40521339 Meet the Authors Kim Bambach, MD Assistant Professor of Emergency Medicine The Ohio State University Wexner Medical Center, Columbus, OH Jennifer Yee, DO Associate Professor of Emergency Medicine, Associate Program Director The Ohio State University Wexner Medical Center, Columbus, OH Showing Slide 1 of 2 The post REBEL MIND – Mastery Learning and Deliberate Practice appeared first on REBEL EM - Emergency Medicine Blog.

Are you noticing that you are tired all the time and cannot seem to hit your paces in training? Those are not symptoms to ignore. Sometimes, these are signs of low ferritin levels that warrant bloodwork and a doctor visit. In this episode, we examine the research on low ferritin and running, including the causes, how to treat, and how to prevent low ferritin.Thank you to our sponsors:✨ Mizuno: Shop Mizuno's newest bouncy supertrainer: https://runtothefinish.com/neovista3/In this episode, you'll learn:✅ Why general population reference ranges for iron are not appropriate for endurance athletes✅ Why iron and ferritin levels matter so much for runners✅ Signs and symptoms of low ferritin levels in runners✅ Why runners are so prone to low ferritin levels✅ How long it takes for iron levels to increase✅ What impacts your iron intake and absorptionReferences

Placenta previa has an incidence of about 0.4% to 0.5% (or 1 in 200 to 1 in 250 deliveries). Anterior placenta previa poses a unique obstacle in fetal extraction at CS: Is it best to transect (enter) the placenta or to cause a marginal abruption at the placental edge for fetal extraction? In this episode we will review an upcoming “Surgeon's Corner” in the AJOG (July 2026) which provides some tips and tricks for this very issue.1. Verspyck E, Douysset X, Roman H, Marret S, Marpeau L. Transecting versus avoiding incision of the anterior placenta previa during cesarean delivery. Int J Gynaecol Obstet. 2015 Jan;128(1):44-7. doi: 10.1016/j.ijgo.2014.07.020. Epub 2014 Aug 27. PMID: 25218131.2. Nieto-Calvache AJ, Palacios-Jaraquemada JM, Basanta N, Suarez-Revelo MA, Benavides-Calvache JP, Meade P, Lopez-Franco MJ, Burgos-Luna JM. How to avoid placental transection during low transverse cesarean delivery for anterior placenta previa. Am J Obstet Gynecol. 2026 Jul;235(1):225-228. doi: 10.1016/j.ajog.2026.02.032. Epub 2026 Feb 25. PMID: 41759607.

As colorectal cancer rates rise among younger adults, surgeons are increasingly caring for patients with rectal cancer who are pregnant or hoping to preserve future fertility. With more individuals delaying childbearing, balancing effective cancer treatment with fertility preservation and maternal–fetal safety has become an important clinical challenge. This timely topic was recently highlighted by Dr. Sharon Suwanabol during a presentation at the American Society of Colon and Rectal Surgeons annual meeting 2026. In this episode, we explore the intersection of rectal cancer, fertility, and pregnancy through a multidisciplinary, case-based discussion. We review how surgery, chemotherapy, and pelvic radiation can affect fertility and sexual function in both men and women, and why early counseling and referral to reproductive endocrinology specialists are essential. The discussion also emphasizes that evaluation and treatment during pregnancy can often be performed safely, with care individualized based on tumor stage, gestational age, and the patient's goals and values. Hosts and discussants ·      Dr. Betelhem Yohannes, General surgery resident at the University of Washington ·      Dr. Griffen Allen, General surgery resident at the University of Washington  ·      Dr. Raga Siddharthan, Assistant Professor of Surgery in the Section of Colorectal Surgery at the University of Washington  ·      Dr. Stacey Cohen, Professor in the Division of Hematology and Oncology at the University of Washington and a gastrointestinal medical oncologist at Fred Hutch Cancer Center, specializing in colorectal and other GI cancers. Learning objectives ·      Describe the impact of rectal cancer surgery on fertility, sexual function, and future childbearing potential. ·      Review the effects of chemotherapy and pelvic radiation on reproductive health and fertility preservation. ·      Discuss available fertility preservation strategies and the importance of early pre-treatment counseling and referral. ·      Recognize the diagnostic challenges of rectal cancer during pregnancy, including overlapping gastrointestinal symptoms. ·      Review appropriate staging and workup considerations for suspected rectal cancer in pregnant patients. ·      Discuss multidisciplinary management strategies for rectal cancer during pregnancy, including individualized treatment sequencing. ·      Examine ethical and patient-centered considerations when balancing maternal cancer treatment and fetal outcomes. References  Siegel RL, Wagle NS, Star J, Kratzer TB, Smith RA, Jemal A. Colorectal cancer statistics, 2026. CA Cancer J Clin. 2026;76(2):e70067. doi:10.3322/caac.70067 [https://pubmed.ncbi.nlm.nih.gov/38240409/] Pregnancy at Age 35 Years or Older: ACOG Obstetric Care Consensus No. 11. Obstet Gynecol. 2022;140(2):348-366. doi:10.1097/AOG.0000000000004873 [https://pubmed.ncbi.nlm.nih.gov/35640237/] Stal J, YI SY, Cohen-Cutler S, et al. Fertility Preservation Discussions Between Young Adult Rectal Cancer Survivors and Their Providers: Sex-Specific Prevalence and Correlates. Oncologist. 2022;27(7):579-586. doi:10.1093/oncolo/oyac052 [https://pubmed.ncbi.nlm.nih.gov/35708892/] Druvefors E, Myrelid P, Andersson RE, Landerholm K. Female and Male Fertility after Colectomy and Reconstructive Surgery in Inflammatory Bowel Disease: A National Cohort Study from Sweden. J Crohns Colitis. 2023;17(10):1631-1638. doi:10.1093/ecco-jcc/jjad079 [https://pubmed.ncbi.nlm.nih.gov/37341355/] Ito M, Tsukada Y, Watanabe J, et al. Long-term survival and functional outcomes of laparoscopic surgery for clinical stage I ultra-low rectal cancers located within 5 cm of the anal verge: A prospective phase II trial (Ultimate trial). Ann Surg. Published online April 1, 2024. doi:10.1097/SLA.0000000000006290 [https://pubmed.ncbi.nlm.nih.gov/38629555/] Teh WT, Stern C, Chander S, Hickey M. The impact of uterine radiation on subsequent fertility and pregnancy outcomes. Biomed Res Int. 2014;2014:482968.  Johnson GGRJ, Park J, Helewa RM, Goldenberg BA, Nashed M, Hyun E. Total neoadjuvant therapy for rectal cancer: a guide for surgeons. Can J Surg. 2023 Apr 21;66(2):E196-E201. doi: 10.1503/cjs.005822. PMID: 37085291; PMCID: PMC10125160. [https://pubmed.ncbi.nlm.nih.gov/37085291/] Naren G, Guo J, Bai Q, Fan N, Nashun B. Reproductive and developmental toxicities of 5-fluorouracil in model organisms and humans. Expert Rev Mol Med. 2022 Jan 31;24:e9. doi: 10.1017/erm.2022.3. PMID: 35098910; PMCID: PMC9884763. [https://pubmed.ncbi.nlm.nih.gov/35098910/] National Comprehensive Cancer Network. (2026). NCCN Clinical Practice Guidelines in Oncology: Rectal Cancer (Version 2.2026). Retrieved from NCCN Guidelines for Rectal Cancer [https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1449] Oktay, Kutluk M.D., Ph.D.. Expert Commentary on Fertility Preservation in Colorectal Cancers: Current State and Practical Tips for the Cancer Practitioner. Diseases of the Colon & Rectum 63(6):p 726-727, June 2020. | DOI: 10.1097/DCR.0000000000001688 [https://pubmed.ncbi.nlm.nih.gov/32479532/] Stal J, YI SY, Cohen-Cutler S, et al. Fertility Preservation Discussions Between Young Adult Rectal Cancer Survivors and Their Providers: Sex-Specific Prevalence and Correlates. Oncologist. 2022;27(7):579-586. doi:10.1093/oncolo/oyac052 [https://pubmed.ncbi.nlm.nih.gov/35708892/] Gentile G, Ciccarone M. Management of fertility preservation in young female patients with gastrointestinal cancer: A case series and systematic literature review. Curr Probl Cancer. 2025;57:101221. doi:10.1016/j.currproblcancer.2025.101221 [https://pubmed.ncbi.nlm.nih.gov/39598263/] Saif MW. Management of colorectal cancer in pregnancy: a multimodality approach. Clin Colorectal Cancer. 2005;5(4):247-256. doi:10.3816/ccc.2005.n.035 [https://pubmed.ncbi.nlm.nih.gov/16183863/] Rogers JE, Dasari A, Eng C. The Treatment of Colorectal Cancer During Pregnancy: Cytotoxic Chemotherapy and Targeted Therapy Challenges. Oncologist. 2016 May;21(5):563-70. doi: 10.1634/theoncologist.2015-0362. Epub 2016 Mar 21. PMID: 27000464; PMCID: PMC4861360. [https://pubmed.ncbi.nlm.nih.gov/27000464/] Jiang Q, Hua H. Fertility in young-onset colorectal patients with cancer: a review. 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