Podcasts about PubMed

Vom Erholungs- und Wassersportgebiet zum Ursprung für Extremwetterereignisse: Wie beeinflussen die Ozeane unsere Gesundheit? Die Ozeane bedecken etwa 70 Prozent der Erdoberfläche und trotzdem geraten sie zu oft in Vergessenheit. Denn: Geht es den Meeren schlecht, hat das auch teils dramatische Folgen für uns Menschen. Dabei denken wir vor allem an Inselstaaten wie Kiribati, die durch den Klimawandel existenziell bedroht sind, da sie wenige Meter über dem Meeresspiegel liegen und dadurch extrem anfällig sind für Überflutungen. Doch auch tiefergelegene Gebiete in Europa sind bedroht - und nicht nur das: Die Meere sind in großen Gebieten krank. Im Gespräch mit Host Beke Schulmann erklärt Synapsen-Autorin Yasmin Appelhans, woran der Patient Ozean leidet: Was machen beispielsweise Überfischung und Munitionsreste in der Ostsee mit dem Wasser - und wie wirken sie sich auf unsere Gesundheit aus? Auf welche Extremwetterereignisse müssen wir uns künftig einstellen? Wie steht es um die Artenvielfalt? Und gibt es überhaupt Hoffnung auf Besserung? HINTERGRUNDINFORMATIONEN Naturgeräusche helfen bei der Entspannung: https://doi.org/10.1038/srep45273 Fan L, Baharum MR. The effect of exposure to natural sounds on stress reduction: a systematic review and meta-analysis. Stress. 2024;27(1): 2402519. https://doi.org/10.1080/10253890.2024.2402519 Ozeangeräusche helfen gegen Tinnitus, nach Bypass-OP oder mit Verkehrslärm klarzukommen: https://doi.org/10.1016/j.ctim.2019.05.005 The effects of ocean sounds on sleep after coronary artery bypass graft surgery - PubMed https://doi.org/10.1121/10.0012222 Buch zum "Blue Mind": https://www.hirzel.de/blue-mind/9783777628417 Menschen, die am Meer leben, leben länger: https://doi.org/10.1016/j.envres.2025.121981 Der Ocean Health Index: https://oceanhealthindex.org/ Aufruf von Deutscher Physikalischer und Deutscher Meteorolologischer Gesellschaft zum Klimaschutz: https://www.dpg-physik.de/veroeffentlichungen/aktuell/2025/klimaforschende-wenden-sich-an-die-deutsche-politik Ozeanversauerung beeinflusst menschliche Gesundheit: https://doi.org/10.3390/ijerph17124563. Polar Engineering: https://doi.org/10.3389/fsci.2025.1527393. Hier geht's zum neuen Podcast ARD Klima Update: https://1.ard.de/ARD_Klima_Update?cp=synapsen Hier geht's zur Synapsenseite: https://www.ndr.de/nachrichten/podcastsynapsen100.html Hier geht's zu ARD Gesund: https://www.ndr.de/ratgeber/gesundheit Habt ihr Feedback oder einen Lifehack aus der Welt der Wissenschaft? Schreibt uns gerne an synapsen@ndr.de.

Vom Erholungs- und Wassersportgebiet zum Ursprung für Extremwetterereignisse: Wie beeinflussen die Ozeane unsere Gesundheit? Die Ozeane bedecken etwa 70 Prozent der Erdoberfläche und trotzdem geraten sie zu oft in Vergessenheit. Denn: Geht es den Meeren schlecht, hat das auch teils dramatische Folgen für uns Menschen. Dabei denken wir vor allem an Inselstaaten wie Kiribati, die durch den Klimawandel existenziell bedroht sind, da sie wenige Meter über dem Meeresspiegel liegen und dadurch extrem anfällig sind für Überflutungen. Doch auch tiefergelegene Gebiete in Europa sind bedroht - und nicht nur das: Die Meere sind in großen Gebieten krank. Im Gespräch mit Host Beke Schulmann erklärt Synapsen-Autorin Yasmin Appelhans, woran der Patient Ozean leidet: Was machen beispielsweise Überfischung und Munitionsreste in der Ostsee mit dem Wasser - und wie wirken sie sich auf unsere Gesundheit aus? Auf welche Extremwetterereignisse müssen wir uns künftig einstellen? Wie steht es um die Artenvielfalt? Und gibt es überhaupt Hoffnung auf Besserung? HINTERGRUNDINFORMATIONEN Naturgeräusche helfen bei der Entspannung: https://doi.org/10.1038/srep45273 Fan L, Baharum MR. The effect of exposure to natural sounds on stress reduction: a systematic review and meta-analysis. Stress. 2024;27(1): 2402519. https://doi.org/10.1080/10253890.2024.2402519 Ozeangeräusche helfen gegen Tinnitus, nach Bypass-OP oder mit Verkehrslärm klarzukommen: https://doi.org/10.1016/j.ctim.2019.05.005 The effects of ocean sounds on sleep after coronary artery bypass graft surgery - PubMed https://doi.org/10.1121/10.0012222 Buch zum "Blue Mind": https://www.hirzel.de/blue-mind/9783777628417 Menschen, die am Meer leben, leben länger: https://doi.org/10.1016/j.envres.2025.121981 Der Ocean Health Index: https://oceanhealthindex.org/ Aufruf von Deutscher Physikalischer und Deutscher Meteorolologischer Gesellschaft zum Klimaschutz: https://www.dpg-physik.de/veroeffentlichungen/aktuell/2025/klimaforschende-wenden-sich-an-die-deutsche-politik Ozeanversauerung beeinflusst menschliche Gesundheit: https://doi.org/10.3390/ijerph17124563. Polar Engineering: https://doi.org/10.3389/fsci.2025.1527393. Hier geht's zum neuen Podcast ARD Klima Update: https://1.ard.de/ARD_Klima_Update?cp=synapsen Hier geht's zur Synapsenseite: https://www.ndr.de/nachrichten/podcastsynapsen100.html Hier geht's zu ARD Gesund: https://www.ndr.de/ratgeber/gesundheit Habt ihr Feedback oder einen Lifehack aus der Welt der Wissenschaft? Schreibt uns gerne an synapsen@ndr.de.

Tired of conflicting fitness and health advice online and not sure what to trust? Amy Hudson and Dr. James Fisher dive deep into how to separate fact from fiction in health, exercise, and wellness. In today's episode, they unpack how to spot trustworthy research, avoid hype, and make smart decisions for your fitness journey. They break down the biggest myths, why social media isn't enough, and how a personal trainer can guide you to results that actually stick. Amy starts by explaining why most people feel overwhelmed by fitness advice online. Dr. Fisher explains that not all research is unbiased—big companies often fund studies to sell products. You have to ask, "Who benefits from this claim?" This is the first step to spotting marketing dressed as science. Amy covers why magic bullet fitness solutions are everywhere, but progress takes hard work. She explains why shortcuts rarely work and how to focus on what actually delivers results. For Dr. Fisher, experts don't know everything, and the more you learn, the more you realize you don't know much. He shares how to stay humble, curious, and avoid overconfidence in fitness claims. Amy and Dr. Fisher agree that one viral Instagram post doesn't make a method true. You need to question the hype, check the evidence, and avoid being swept up in trends. Amy walks you through how to do it without stress. Before trying a new routine you saw online, check in with a personal trainer. They can help you interpret research and apply it safely.  Dr. Fisher reveals why lab-based studies often don't reflect real-world outcomes. Just because something works in a controlled setting doesn't mean it works for you.  Amy and Dr. Fisher cover how AI tools like ChatGPT can help you find solid research quickly—but only if you ask the right questions. Look for references, meta-analyses, and reviews.  Scrolling on Facebook isn't research. Facebook and social media are designed to sell, not educate. If your goals matter, scrolling alone won't get you the answers you need. Before adding a new exercise or routine, check the evidence. Ask yourself, "Does research support this?" and "What contradicts it?" These two questions save time and frustration. According to Dr. Fisher, people tend to seek confirmation rather than truth. If you only look for evidence that supports your beliefs, you miss the bigger picture. He explains how to uncover research that challenges you. Wonder why fitness fads come and go so quickly? Amy explains that many are just marketing campaigns in disguise. She shares how to spot trends that are hype versus those backed by science. Dr. Fisher explains that big research can be misleading when the funder has an agenda. Even credible-looking studies can push products. He teaches how to critically evaluate who benefits from the research. Dr. Fisher covers how hard work beats shortcuts every time. He explains why real fitness results require consistency and how to identify programs that actually deliver. Dr. Fisher reveals that using Google Scholar or PubMed isn't as complicated as it seems. He walks you through finding studies, reviews, and meta-analyses to make your own evidence-based decisions. For Amy, working with a personal trainer, coach, or medical expert is still the safest way to reach your goals. Social media can't replace personalized guidance. Amy explains how to combine online research with real-world support.     Mentioned in This Episode: The Exercise Coach - Get 2 Free Sessions! Submit your questions at StrengthChangesEverything.com The Signal and the Noise: Why So Many Predictions Fail--but Some Don't by Nate Silver     This podcast and blog are provided to you for entertainment and informational purposes only. By accessing either, you agree that neither constitute medical advice nor should they be substituted for professional medical advice or care. Use of this podcast or blog to treat any medical condition is strictly prohibited. Consult your physician for any medical condition you may be having. In no event will any podcast or blog hosts, guests, or contributors, Exercise Coach USA, LLC, Gymbot LLC, any subsidiaries or affiliates of same, or any of their respective directors, officers, employees, or agents, be responsible for any injury, loss, or damage to you or others due to any podcast or blog content.

Dr. Don and Professor Ben talk about the risks of consuming in date but fizzy grapefruit juice from a mechanically stressed container. Dr. Don - not risky

Do the many clinical trials into high-dose vitamin C prove it can actually treat the common cold and cancer, rather than just boost the immune system? Why is there ongoing scepticism? Why are multifactorial chronic diseases so hard to study in clinical trials? What is the right dosage to get the best results from vitamin C?In this episode we have the often misunderstood topic of Vitamin C as an antioxidant to get clear on, particular the high-dose approach and particularly delivered intravenously. Despite a very clear consensus that Vitamin C is a great booster to immune function, research that shows that it helps fight the common cold or flu have been dismissed by doctors and medical researchers; as well as claims that higher doses can increase its efficacy. Other claims that Vitamin C can help fight cardio-vascular disease and even cancer have been with even greater scepticism. So what exactly can vitamin C do to assist our immune function to fight disease, and why is there so much confusion about the answer given the high quantity of clinical trials data?Fortunately today's guest has exactly the right skill set and research knowledge to separate the science from the here-say, medical doctor and orthomolecular medicine researcher, Dr. Richard Z Cheng. Dr. Cheng has a PhD in biochemistry and molecular biology; he's served as a doctor in the US military; he has consulted for the National Cancer Institute, and presented at the National Institute of Health (NIH); he has conducted clinical trials; He is the editor in Chief of the Orthmolecular Medicine New Service; He is also a fellow of the American Academy of Anti- Aging medicine; and has run anti-aging and regenerative medicine clinics in both China and the US for over 20 years.What we discuss:00:00 Intro05:15 Most animals produce Vitamin C in the body, but not primates.06:00 Oxidation & Redox: Giving or receiving an electron.11:00 After reducing oxidation the body recycles it back into vitamin C.14:00 Teamwork: sharing electrons between nutrients and vitamins.18:20 Conventional consensus: good for prevention but not treatment.21:00 Over 80K papers on Vit C on Pub Med!21:30 Linus Pauling Intravenous Vitamin C for cancer and heart disease.27:00 Shortening of common cold and lowering of symptoms - Harri Hemila.29:00 Low dose studies dilute the data on the efficacy of the high dose studies.31:00 Intravenous treatment allows much higher doses safely.33:00 Differences in absorption between IV and oral application.35:20 Pro-oxidant effect only possible at IV high dose.36:30 IV clinical trials.39:20 Cytokine storm cascades in acute respiratory distress.44:00 High Dose IV Vitamin C saved lives in China during Covid 19.50:00 Attacks following Richard's NIH presentation on Vitamin C during covid.57:00 Cardio vascular disease - Vit. C research history.01:01:00 Collagen Synthesis for vascular walls & Vitamin C deficiency.01:07:20 Is the taboo for life style medicine lifting?01:09:30 Issues of gold standard RCT trials not working for multifactorial integrative interventions.01:16:00 Recommendations for preventative use of Vitamin C for listeners. References:E Cameron & Linus Pauling - 'Supplemental ascorbate in the supportive treatment of cancer: Prolongation of survival times in terminal human cancer', 1976E.T. Creagan, 'Failure of high-dose vitamin C (ascorbic acid) therapy to benefit patients with advanced cancer', 1979Harri Hemilä - over 200 meta-analyses and clinical trialsPing Chen et al. 'Pharmacokinetic Evaluation of Intravenous Vitamin C'Richard Z Cheng, ‘Can early and high intravenous dose of vitamin C prevent and treat coronavirus disease 2019 (COVID-19)?'KU Cancer Center researchers announce study of high-dose intravenous vitamin C to treat muscle-invasive bladder cancer, 2024National Cancer Institute overview of IV Vitamin C cancer research.

In this solo episode, Darin reframes one of the most misunderstood forces in life — stress. Instead of seeing it as the enemy, he explores how stress is actually a messenger, guiding you back to alignment, safety, and awareness. Through science, spirituality, and lived experience, Darin breaks down how stress shows us where we're trying to control, where we're disconnected, and where our nervous system is calling for attention. He unpacks the layers of modern stress — from trauma and environment to community and purpose — and offers practical, embodied tools to restore calm, clarity, and resilience.     What You'll Learn 00:00:00 – Welcome to Super Life: Solutions for a Healthier Life and Better World 00:00:32 – Sponsor Spotlight: TheraSauna - Natural Healing Technologies (15% off with code Darrandai) 00:02:10 – The Super Life Podcast: Finding Contentment, Happiness, and Purpose 00:02:51 – Today's Topic: Stress - Reframing Stress as an Ally and Dashboard Light 00:04:54 – The "No Choice" Universe: Reconnecting to Infinite Possibilities 00:05:16 – The Reality of Stress: Statistics and the Impact of Chronic Stress 00:06:21 – Stress is Layered: Beyond a Single Cause, Addressing Chronic Stress 00:08:29 – Solutions for a Super Life: Safety over Calm and the Vagal Response 00:09:38 – The Inner Dialogue Layer: Trauma, Unconsciousness, and Spiritual Bypassing 00:11:47 – The Social Field Layer: Relationships, Community, and Finding Your Way Home 00:14:20 – Sponsor Spotlight: Bite Toothpaste - Sustainable, Non-Toxic Tabs (20% off with code Darin20) 00:16:35 – Creating Your Own Vision: Setting Boundaries with Media and Social Algorithms 00:17:29 – Finding Your Purpose: From Raising Children to Healing Injuries 00:18:35 – Environmental and Existential Stress Layers: Clutter, Noise, and Service 00:19:26 – Stress Load and Resiliency: Why Small Triggers Cause Blow-Ups 00:20:02 – Understanding the Dashboard Light: Acknowledging Unwillingness 00:20:35 – Safety as the Signal: Body Relaxation and Providing Inner Security 00:23:44 – Reframing Trauma: Was it the Protector You Needed at the Time? 00:25:00 – Releasing Trauma: Techniques, The Healing Code, and Waking the Tiger 00:26:06 – Finishing the Survival Response: Shaking, Crying, Screaming, and Stretching 00:26:38 – Stress as a Multiplier: Impact on Immune System, Heart, and Aging 00:28:10 – Stress Slows Repair: Inflammation, Cardiovascular Risk, and Cellular Aging 00:29:48 – The Integrative Approach: Changing Your Environments to Support Anti-Stress 00:30:07 – Actionable Stress Solutions: Circadian Rhythm, Nature, and Noise Reduction 00:30:44 – Actionable Stress Solutions: Gratitude, Conscious Breath, and Movement 00:31:32 – Energy Drains to Eliminate: Conflict, Clutter, Scrolling, and Late Caffeine 00:32:17 – Connecting to Greater Purpose: The Super Life Patreon Platform 00:32:54 – Morning/Night Questions: Letting Go, Creating, and Contributing 00:33:17 – Final Toolkit: Slow Breathing, Movement, Nature, Sauna, and Sleep 00:34:25 – The Invitation: Digging into all Layers of a Super Life on Patreon   Thank You to Our Sponsors Therasage: Go to www.therasage.com and use code DARIN at checkout for 15% off Bite Toothpaste: Go to trybite.com/DARIN20 or use code DARIN20 for 20% off your first order. Find More from Darin Olien: Instagram: @darinolien Podcast: SuperLife Podcast Website: superlife.com Book: Fatal Conveniences   Key Takeaway "Stress isn't your enemy — it's your compass. Every wave of tension points you back to what's asking for care, attention, and love. When you stop fighting stress and start listening to it, you don't just survive — you evolve."       Bibliography (selected, peer-reviewed) Sources: Gallup Global Emotions (2024); Gallup U.S. polling (2024); APA Stress in America (2023); Natarajan et al., Lancet Digital Health (2020); Orini et al., UK Biobank (2023); Martinez et al. (2022); Leiden University (2025). Cohen S, Tyrrell DA, Smith AP. Psychological stress and susceptibility to the common cold. N Engl J Med.1991;325(9):606–612. New England Journal of Medicine Cohen S, et al. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proc Natl Acad Sci USA. 2012;109(16):5995–5999. PNAS Kiecolt-Glaser JK, et al. Slowing of wound healing by psychological stress. Lancet. 1995;346(8984):1194–1196. The Lancet Kiecolt-Glaser JK, et al. Hostile marital interactions, proinflammatory cytokine production, and wound healing.Arch Gen Psychiatry. 2005;62(12):1377–1384. JAMA Network Tawakol A, et al. Relation between resting amygdalar activity and cardiovascular events. Lancet.2017;389(10071):834–845. The Lancet Epel ES, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA.2004;101(49):17312–17315. PNAS McEwen BS, Stellar E. Stress and the individual: mechanisms leading to disease. Arch Intern Med.1993;153(18):2093–2101. PubMed McEwen BS, Wingfield JC. Allostasis and allostatic load. Ann N Y Acad Sci. 1998;840:33–44. PubMed Felitti VJ, et al. Relationship of childhood abuse and household dysfunction to many leading causes of death in adults (ACE Study). Am J Prev Med. 1998;14(4):245–258. AJP Mon Online Edmondson D, et al. PTSD and cardiovascular disease. Ann Behav Med. 2017;51(3):316–327. PMC Afari N, et al. Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis.Psychosom Med. 2014;76(1):2–11. PMC Goyal M, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357–368. PMC Qiu Q, et al. Forest therapy: effects on blood pressure and salivary cortisol—a meta-analysis. Int J Environ Res Public Health. 2022;20(1):458. PMC Laukkanen T, et al. Sauna bathing and reduced fatal CVD and all-cause mortality. JAMA Intern Med.2015;175(4):542–548. JAMA Network Zureigat H, et al. Physical activity lowers CVD risk by reducing stress-related neural activity. J Am Coll Cardiol.2024;83(16):1532–1546. PMC Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med.2010;7(7):e1000316. PMC Chen Y-R, Hung K-W. EMDR for PTSD: meta-analysis of RCTs. PLoS One. 2014;9(8):e103676. PLOS Hoppen TH, et al. Network/pairwise meta-analysis of PTSD psychotherapies—TF-CBT highest efficacy overall.Psychol Med. 2023;53(14):6360–6374. PubMed van der Kolk BA, et al. Yoga as an adjunctive treatment for PTSD: RCT. J Clin Psychiatry. 2014;75(6):e559–e565. PubMed Kelly U, et al. Trauma-center trauma-sensitive yoga vs CPT in women veterans: RCT. JAMA Netw Open.2023;6(11):e2342214. JAMA Network Bentley TGK, et al. Breathing practices for stress and anxiety reduction: components that matter. Behav Sci (Basel). 2023;13(9):756. 

Dans cet épisode de Feel Good, Sandra Veziano nous emmène à la découverte d'une hormone dont on parle trop peu : la mélatonine. Souvent réduite à son rôle de “pilule naturelle du sommeil”, cette molécule est en réalité un pilier fondamental de notre santé globale.Produite par la glande pinéale mais aussi par l'intestin, la mélatonine agit comme un véritable chef d'orchestre biologique : elle régule nos rythmes circadiens, favorise la régénération cellulaire, soutient l'immunité et protège le cerveau du stress oxydatif. Des études de Harvard Medical School et PubMed confirment même son rôle dans la prévention du vieillissement prématuré et des troubles métaboliques.Mais notre mode de vie moderne l'épuise : écrans tardifs, repas copieux du soir, carences en magnésium ou stress chronique bloquent sa production.Sandra décrypte ces mécanismes avec pédagogie et partage des gestes simples pour la réactiver naturellement : lumière du matin, dîner léger, micronutriments essentiels et surtout… un vrai retour à la nuit paisible.Un épisode lumineux, qui nous rappelle que le sommeil n'est pas une pause — c'est une renaissance cellulaire.

In this illuminating conversation of Be It Till You See It, aesthetic nurse and biohacker Rachel Varga joins Lesley Logan to discuss how to achieve lasting radiance by aligning health, mindset, and beauty. She shares how lowering inflammation, managing stress, and purifying your environment can help you look and feel your best—proving that confidence and feeling at peace are the real anti-aging secrets.If you have any questions about this episode or want to get some of the resources we mentioned, head over to LesleyLogan.co/podcast https://lesleylogan.co/podcast/. If you have any comments or questions about the Be It pod shoot us a message at beit@lesleylogan.co mailto:beit@lesleylogan.co. And as always, if you're enjoying the show please share it with someone who you think would enjoy it as well. It is your continued support that will help us continue to help others. Thank you so much! Never miss another show by subscribing at LesleyLogan.co/subscribe https://lesleylogan.co/podcast/#follow-subscribe-free.In this episode you will learn about:How Rachel's nursing career evolved into a holistic approach to beauty and biohacking.The science behind lowering inflammation to boost vitality and radiance.Why redefining vanity as self-respect empowers confidence and self-care.Everyday habits that support graceful aging through stress management and sleep.How cultivating peace and integrity supports inner and outer radiance.Episode References/Links:The School of Radiance Website - theschoolofradiance.comPromo Code: LesleyLogan15 for 15% off one-on-one sessions, tutorial, and membershipSchool of Radiance Podcast - https://www.theschoolofradiance.com/podcastsInstagram: @RachelVargaOfficial - https://www.instagram.com/rachelvargaofficialGuest Bio:Rachel Varga, BSN, RN, CANS, is a Double Board Certified Aesthetic Nurse Specialist. Since 2011, Rachel has been offering medical aesthetic rejuvenation in the specialty of Oculoplastics and is known for providing a natural and healthy-looking transformation and educating through her show "The School of Radiance" podcast. She has performed over 20,000 rejuvenation procedures and is also a trainer for other practitioners on rejuvenation procedures including medical grade skin care, laser skin rejuvenation, injectables including neuromodulators and dermal fillers, and slowing aging in general. Rachel is passionate about delivering the highest standard of care, with a focus on what the patient's specific rejuvenation goals are, and a tailored approach to suit their needs, values, and lifestyle. She has published multiple research articles on rejuvenation protocols for the eyelids, jawline, and overall skin health transformation. Rachel is known for her gentle touch, natural-looking results, and making her patients feel comfortable, and at ease with her caring bedside manner that originated in pediatric nursing before beginning her career in medical aesthetics in 2011. She will guide you in creating your customized rejuvenation plan and skincare routine to achieve your goals through one-on-one sessions, expert 7-week seasonal skincare tutorials, and year-long membership for the deeper layers of being beautifully radiant at TheSchoolofRadiance.com. Rachel Varga is one of the first to blend Western approaches to skin care and rejuvenation, functional insights, and biohacking optimization strategies. By blending the best of these worlds and observing what her most radiant patients are doing she will also help guide you on your path to healthy skin and vibrancy for many years… If you enjoyed this episode, make sure and give us a five star rating and leave us a review on iTunes, Podcast Addict, Podchaser or Castbox. https://lovethepodcast.com/BITYSIDEALS! DEALS! DEALS! DEALS! https://onlinepilatesclasses.com/memberships/perks/#equipmentCheck out all our Preferred Vendors & Special Deals from Clair Sparrow, Sensate, Lyfefuel BeeKeeper's Naturals, Sauna Space, HigherDose, AG1 and ToeSox https://onlinepilatesclasses.com/memberships/perks/#equipmentBe in the know with all the workshops at OPC https://workshops.onlinepilatesclasses.com/lp-workshop-waitlistBe It Till You See It Podcast Survey https://pod.lesleylogan.co/be-it-podcasts-surveyBe a part of Lesley's Pilates Mentorship https://lesleylogan.co/elevate/FREE Ditching Busy Webinar https://ditchingbusy.com/Resources:Watch the Be It Till You See It podcast on YouTube! https://www.youtube.com/channel/UCq08HES7xLMvVa3Fy5DR8-gLesley Logan website https://lesleylogan.co/Be It Till You See It Podcast https://lesleylogan.co/podcast/Online Pilates Classes by Lesley Logan https://onlinepilatesclasses.com/Online Pilates Classes by Lesley Logan on YouTube https://www.youtube.com/channel/UCjogqXLnfyhS5VlU4rdzlnQProfitable Pilates https://profitablepilates.com/about/Follow Us on Social Media:Instagram https://www.instagram.com/lesley.logan/The Be It Till You See It Podcast YouTube channel https://www.youtube.com/channel/UCq08HES7xLMvVa3Fy5DR8-gFacebook https://www.facebook.com/llogan.pilatesLinkedIn https://www.linkedin.com/in/lesley-logan/The OPC YouTube Channel https://www.youtube.com/@OnlinePilatesClasses Episode Transcript:Rachel Varga 0:00  I take this approach of longer lasting beauty through biohacking, because when we reduce inflammation and toxins on all fronts, we then set our body up for success, for being our most radiant versions. And the more radiant we are, the more high vibe we are, the more we can get what we desire out of life, in both our personal and professional lives, and be great people, because our bodies are operating properly.Lesley Logan 0:32  Welcome to the Be It Till You See It podcast where we talk about taking messy action, knowing that perfect is boring. I'm Lesley Logan, Pilates instructor and fitness business coach. I've trained thousands of people around the world and the number one thing I see stopping people from achieving anything is self-doubt. My friends, action brings clarity and it's the antidote to fear. Each week, my guest will bring bold, executable, intrinsic and targeted steps that you can use to put yourself first and Be It Till You See It. It's a practice, not a perfect. Let's get started. Lesley Logan 1:11  Hi, Be It babe. Okay, this is gonna be a really fun conversation. I wanted to have this conversation for a while, and it's really like, I'm intrigued by all this, right? I want to, I want to actually look and feel good for as long as possible, but not in like, a crazy, like, change how I look dramatic way, but like, as in a no, this is like, I want to look like me. And so when I met our guest today, because I was on her amazing podcast, Rachel Varga, she's the host of the School of Radiance, and I was like, oh, I vibe with this person. I really like what they're saying. It's intelligent. It's from a place of research and science and methodologies, and she is so knowledgeable about biohacking and things we can do when it comes to med spas and what we're doing with to support ourselves and how we feel and how we look, and then we go on a wide range of topics. We don't hit everything I want to talk about, so I'm going to have to do this again. But I really think you're going to, one, learn a ton and have a lot of permission get granted, because maybe it's not something you have to do to you, maybe it's something you would get to do around you, or maybe it's about changing something in your environment, right? So now I'm going to let Rachel Varga give you all of her amazing wisdom. Lesley Logan 2:26  All right, Be It babe, this conversation is one I've been really wanting to have, but it had to be with a special person, and so I've been waiting the 500 plus episodes to find the person who we can have a conversation about radiance and how we how our how we can age the way we want to, and look good doing it without feeling like we're being vain or going too far. And so Rachel Varga is our guest today. Rachel, can you tell, can you tell everyone who you are and what you rock at? Rachel Varga 2:51  Yes, Lesley, so great to be here, and we had a fantastic interview on my show recently, the School of Radiance podcast. And, so technically, I'm a nurse, and I've been an esthetics nurse since 2011 so I've been in the game for the rejuvenation side of things for a while. Been in that game, published research papers. You can look my name up on PubMed, Rachel Varga, you'll see my eye rejuvenation papers, jawline rejuvenation papers. And then I also teach other doctors and nurses internationally how to do rejuvenation from the non surgical side of things that like injectables. And I know we're going to talk a little bit about that, what we can do that's cleaner options, what's actually going to work and give us the results that we desire. And so I love to teach, and I love to talk about what we can actually do at home. So on this podcast, we'll talk about the lifestyle side of things, and kind of delineate what we can do at home and then what's available in the clinic. But I take this approach of longer lasting beauty through biohacking, because when we reduce inflammation and toxins on all fronts, we then set our body up for success, for being our most radiant versions. And the more radiant we are, the more high vibe we are, the more we can get what we desire out of life, in both our personal and professional lives, and be great people, because our bodies are operating properly.Lesley Logan 4:23  I love this because I love that you can they it's almost like a there's a few different prongs. So if you're someone who's like, I don't want to do surgery, I don't want to do the injectables like people start to look like cat ladies at some point. And I'm sure that's not all injectables do that. I'm sure there's a point which one could stop. But the idea that we there's things we could do at home, it sounds why wouldn't you, like, Why? Why wouldn't you want to do something at home? So before we get into that, though, I do want to kind of know, like, did you always want to get into esthetics? Was this something that you could wear, like, interested as a kid? Like, were you doing makeup? Like, how? Like, what was the journey that got you here?Rachel Varga 4:59  Yeah. Okay, well, practically speaking, my mom's an RN, and I saw how hard she worked, but I also saw that it was a great job. It's a great way to be in that nurturing, supportive, healthy role in the family. It's like something happens to the kiddos, like you know what's going on, or your partner or yourself. It's just great knowledge to have from a nursing perspective for yourself and those you love. My father's are carpenter and so I always had this eye for, oh, that bumper is a little not so straight, or that picture is a little canted. So I had this eye for symmetry and proportions from that, and then also the health side of things. But I saw my mother really struggle as a night nurse. And she did night nursing, so shift work, it's just brutal in extended care for her pretty well entire career, she got breast cancer. She was, at one point, weighed 220 pounds. So she was the type of woman, great woman over gave, did the shift work. So I learned early in my career that I didn't want to be that kind of nurse. And did Pediatric Nursing, pediatric ICU care for a couple years. And during that time in my nursing education, I'd had a few rejuvenation procedures myself too, both surgically and non surgically, and to myself, the aftercare information like the pre post care wasn't great, and for me, going through nursing training, I was obviously watching all the vlogs online. There aren't really a lot of professionals actually talking about this stuff, and I think it's kind of interesting, and people want to know how to get the most out of what they're investing in in the clinic, and, of course, at home, and how to recover before and after non surgical or non surgical rejuvenation options. And thought I wanted to be a doctor. So did all the med school prerequisites, chem, Organic Chem, biochem. And while I was doing prerequisites and applying to med school, which I did for one year, I got a job as an esthetics nurse, did my injectable training, started in ocular plastics in 2011 and just loved the field. I loved the pace. The hours were great, and I would get access to anything and everything. Then something happened. I met my good friend Dave Asprey. Actually helped get his face ready for superhuman so when you look at that book cover, that's my work. Oh, what's this biohacking stuff? This is pretty cool. Started to do some of it myself, cold plunging, intermittent fasting, more protein, adding antioxidants, amino acids, all sorts of great stuff that's in the biohacking world, red light therapy. And then I was in two car crashes. I had to really lean into the biohacking and recovery side of things and supplementation so that I wasn't hurting all the time, and so that I would recover faster. And partner has been a pro athlete as well, so very in tune with the athletic recovery side of things too. Then something interesting happened. The better I cared for myself from an inflammation perspective, I didn't need as much rejuvenation. Scars were fading after just a couple of days post breakout, instead of for months, and I'd have to laser that redness away. I didn't need to do neuromodulators every three months, I would actually go anywhere from like, a year to a year and a half in between.Lesley Logan 8:45  For the people who are like, what's a neuromodulator,Rachel Varga 8:49  The brand names that you probably know about are Botox, Xeomin, Dysport, Nuceiva, Jeuveau. There's always new ones growing up. So the technical term for those is neuromodulators. And then I also started to notice, oh, wow, I'm not burning in the sun in 10 minutes anymore. These deoxidants, this reducing inflammation, is actually allowing me to go outside and enjoy my life more. And I as a researcher, put together a paper for the biohacking community a couple years ago. What are some of the biohacks that actually can support slowing aging in sort of like a methodical framework, kind of way, because there's so many bright, shiny objects in the in the biohacking and wellness space, like, what actually should we start with?Lesley Logan 9:42  This is insane. So this journey that you went on, like, first of all, you met the person. Like, yeah, you were like, you just met them. And then you needed what they had. Like, thank goodness you met them, because you put, who knows how long would have taken you to stumble upon biohacking in that way. And then it got you to see how it worked on the things that you already do. I can it's interesting to me because, like, I think some people in your field would be like, what is the need for me if I could just biohack my way to blemish-free skin that can be out in the sun, you know what I mean. But obviously, like, there's, there's kind of a place for everything. You know, there's also like, what works for you and what helps with what you need. And so I love the idea for those at home who are like, well, what are some like, what are like? Maybe they could Google what an antioxidant is. But like, what are some things that they should be thinking about when it comes to inflammation and things that can affect how they look? Because I think sometimes people go, Oh, I'm just older. And we were taught like, Oh, you're 40, so now you're 50. Like, these things happen. But from what I understand in biohacking, you can actually do a whole lot. It's not about the age, it's kind of about what you're eating and what you're doing.Rachel Varga 10:54  Yeah, you could actually test instead of guess what your biological age is. And I do this usually about once a year, and my biological age, last time I tested it was nine years younger than my chronological age. So doing something right. Lesley Logan 11:11  I love that. Rachel Varga 11:14  When I started to speak on the anti aging, the functional, integrative and wellness sides of things, being an aesthetic nurse, like a traditionally trained nurse, and then in the specialty of aesthetic medicine, I was kind of the odd one out, a little bit misunderstood, especially in the rare community that I'm in, people didn't really get it. It's more like a California and Florida kind of thing, where people in there, in those states in particular, really big into anti aging medicine, and so that was a bit tough for me. But you know what, some of us were just pioneers in the space. And Dave is more of a disruptor, and I'm more of like an encourager. If I can do it, you can do it too. Lesley Logan 11:59  Yeah. And I think, like, you know, the I, what a great place where you can go, okay, here are your options. We can do these things, and here's how often you'd have to do them, and we can absolutely do them, or we can do this thing, and then this is how often, or you could also do this at home. And then it would make whatever we're doing here would support that, or it would reduce your need for that, is that what I'm hearing, like, the biohacking, like, really supports what you do?Rachel Varga 12:26  Bingo. So for me to speak on things, because I am a traditionally trained RN, I have to be able to speak on things that are published in the literature. There wasn't really anything, and I knew this worked. I would see it in my before and after photos. See, you know, 70 to 90 year olds looking fantastic, and they barely need anything. They were aging better. So the jawline paper that I wrote, I basically put in that paper an algorithm for rejuvenation, starting with skin care, then getting into maybe at home peels and at home dermarolling, doing some in-clinic lasers for reds, browns and collagen, you know, resurfacing pore size, polishing the skin, and then the non surgical injectables. So say you guys all probably hear the word Botox, so neuromodulators and fillers and then surgery. So to start from a space of least invasive, you know, do some things, see if you're happy with those results, you might not need the surgery, but surgery definitely does have a place, coming from ocular plastic surgery for the eyelids. And so I wrote a paper on that, basically an algorithm do least invasive to most invasive, and then the Oxidative Stress Status and Its Impacts on Skin Aging paper that was more like a framework of what's the lifestyle stuff that we can do to actually clean up and purify our environment by purifying our air, water, lighting, electromagnetics, testing, instead of guessing the foods that we're eating and then getting into detoxing. And when you do all those things, you should actually be able to get better results from your treatments. And if you go on message boards for people that have issues after injectables or lasers, chances are there was a degree of autoimmune conditions running in the background, or their toxic bucket was really full. They had rejuvenation bucket tipped over, and they had a manifestation of some underlying things that were happening. And then also, during the process of writing those papers, I came across some data. This is why it's not a nice to do. It's a need to do, to look after yourself, that autoimmune conditions, or, more precisely, deaths of unknown causes, which I reached back to the source of you know, what does this category actually mean, autoimmune condition or someone passing away before diagnosis, it actually doubled in 2019 compared to the data six years earlier in Canada, this is Canadian information, and then it doubled again in 2021. So autoimmune stuff for skin is like, eczema, psoriasis, those are typically the skin stuff that we see. Lesley Logan 15:25  It's interesting that you brought that up because it is like, I think people are like, there's so many people with autoimmune it's like, well, now that we know what to test for. The thing about tests, that's the thing, when we it was all, there, it has probably been there for a really long time. The doubling in such a short period of time is scary, but also it, you know, if the tests weren't right arranging or the doctors don't know to test for these things. But I love that you brought that. I like how you bring that up. It's like if you had stuff run in the background, if you were already inflamed, and then you do something that can add to that, like, it is just like the needle that broke the haystack. And so then the things get the blame when it's a whole host of things that are going on. And so I think this is really cool. You know it's and I don't want to be ignorant, so I think it's really, to me, what I find interesting is that, like, I would never have associated a biohacker with someone who would also be doing any of these treatments. Like I would, you know what I mean? Like, I think people think you're either nothing goes in your body except for these things, or you're, like, whatever, It's a free rein, I can do whatever I want. And so to find someone who sits in the middle, I actually think it gives people a lot more permission. And I actually one of the things I want to talk with you about is, like, just permission, like, I think a lot of people feel bad or feel embarrassed or feel like they shouldn't talk about that they want to make any changes to how they look, because we do live in a place now where, thankfully, people are more accepting and people have been taught to not hate their bodies like we should love our bodies. In fact, your body is listening to you. So part of biohacking would actually be to not talk about the things you don't like about your body because your body's listening. But how can we think about like is it vain for us to want to want to change things on our face, or to want to look a little younger, to want to look a little fresher? Is that? Is that a bad thing? Like, should we not be wanting to change these things? We just be happy with how we look?Rachel Varga 17:11  I think that there's a similarity here with this concept of imposter syndrome. Everyone who starts to do something new is like, Oh my gosh. I don't know of like, Can I do this? Am I gonna get laughed at? I think it's that's just as common as the shadow side of beauty, which is, is this vain? Am I doing something that's selfish to care for myself? One of the reframes that I love to talk about is self-care, self-love. I get so many sweet downloads when I'm doing my skincare, I'm blow drying my hair, I'm doing my beautification, my makeup, putting on a cute outfit, looking at myself in the mirror, it's like, Oh, wow. I had three hours of sleep last night. How the heck do I look this good? Well, there's some biohacks that I did to hack a bad sleep and why I had a bad sleep, which is hilarious. So we can definitely talk about that. But the vanity component is essentially the shadow side of beauty and radiance at its core. So I love to investigate the psychological, the energetic things behind everything as well, because everything is energy. And we're seeing a shift now, though. In about 2018, a number of my clients started to ask me, Rachel, what can I do for healthier skin I want to improve my skin health. So I really started to notice the shift. And then now fast forward to the year that we are in now, every med spa, well, the ones that are, you know, up with the current times, are doing things like NAD infusions, they're offering weight loss, they're offering hormone support, and all of these different things that we're now seeing a really exciting time in the med spa industry, the functional space, integrative and biohacking space, coming together. It's almost like this bifurcation point a couple years ago, but I did see the writings on the wall back in about 2018 that this was going to happen, and now this is what the most notable med spas in the world are doing, is they're incorporating all these things because people want to go to a one-stop shop and not necessarily just look at rejuvenation as being vain, but a form of self-care. They're doing other things as well that they're investing time and energy in, or they might have a health spending account that makes them feel better, because when you feel better, you look better, and when you look better, you feel better. So what I like to suggest, if someone is really grappling with, okay, money's tight or I feel vain about doing this, feel like that money should go to my kids or whatever. But if something's bothering you for a while, say, for example, lines between the brows, or lines to the forehead, or hooded upper eyelids, lower eye bags, melasma, pigmentation, red acne scars, large pores, acne scarring, losing sharpness to the jaw, lines, jowls, fullness to the neck, the list goes on. But if something is really bothering you and you're looking at yourself in the mirror, be like, I really love to do something about that, because it's the one thing that kind of bugs me. I think that the benefit of knowing that, hey, there are some really great health non surgical, or surgical things that we can do to actually support those things. But my angle is, okay, what's the least toxic thing that we can do to give the best results? What is going to give the most long term benefits? So that's why sometimes surgery, like eyelid surgery, is one of the most common surgeries performed to remove excess eyelid tissue. That's actually probably even going to cost less money than trying to do all these other non surgical things, and you have a longer result. So it just depends on everybody's situation. But the vanity thing is something I think every single person grapples with, if they're completely honest with themselves, and then they do it. They do their rejuvenation, they bump up their at home skincare routine, they purify their environment, like, Oh, I feel better. I'm gonna keep doing this, because it's something I do for myself, kind of like getting your (inaudible) you always feel so much better after you have, you know, fresh highlights or whatever. Lesley Logan 21:36  Yeah, yeah. Well, I think, like, there's a difference between doing something because you think it's going to get you people's reaction from people, and doing something for yourself. You know, I think if you are do making changes to yourself, because for other people, that would be a problem, but if you're doing it for yourself, like you said, you don't like the way your pores are. I have my mom, she has talked about the eyelid surgery, and I saw her recently in person. I was like, Oh, poor thing. I don't know. Can you see? Get like, you know, like, and that's not a vain thing. It's also like a necessity, necessity thing, but also like in being it till you see it, some of these things are taking up so much brain space that they're holding us back from coming out and showing people who we are like, if you're not putting yourself out there because you have a scar or you have you don't like the way something looks, that that does bother me, because it does mean that the world is missing out on what your gift is. You know, there are people that you're the only person who can do what you do, and if you're hiding yourself for whatever reason, then that is a bummer, because those people miss out on it and they end up getting swindled by somebody else. So I, I'm of the place, like, if it's for you and it's going to help you show up as the best version of yourself, like, you know, you really do have to look, look into that. But I also love your approach of, like, what's the least invasive, least toxic, most long lasting. And I think if we, I think if we go with that approach, as opposed to quick fixes, then we all, and that goes for everything, not just even for the things you do with your face.Rachel Varga 23:11  100% Oh, you touched on so many beautiful things. So we're gonna back this, because there's some nuggets here for everybody. What happens when you go into the wild, you know, if you're, if you're anything like me, you're working from home, you're going to the gym, you're going to the grocery store, going to church, you know, some work in social events, but that's kind of what the lifestyle looks like. But when we and sometimes I want speeches, and that's super fun, I get all glammed up when you go out into the wild and you see two kinds of people, you see the one person that I just have my hair and, like, a cute little dancer's button I got my workout outfit on. You would love it. It's, like, very Pilates appropriate. Lesley Logan 23:56  I saw it when you (inaudible) I was like, that's so cute. I need a little shawl for my my one my jumpsuit.Rachel Varga 24:02  Oh and I love my body, and I work hard. I lift weights, work on the flexibility, stability, cardio, strength, all those things. I feel fantastic because it brings me in my body as well. W e're very grounding at the end of the day, when you see that individual that they got a little bit of makeup on, they brush their hair, they don something cute, even if it's a little bun, and they have a smile, and they're bright, and they're connecting. Compared to the other person that's just schlepping it. They got their PJ pants on or their sweat pants, they're not put together at all, and they just look like they legitimately rolled out of bed. It's like, okay, something's going on with that person. Oh, this person's really showing up for themselves. They're, you know, putting effort into their appearance. What that actually communicates when you show the world that you're valuable because you value yourself, that's powerful. And if you're showing the world that you just rolled out of bed, your life's a mess, people aren't actually going to value you in the same way. I know that sounds really brutal, but you will be more valued in your relationships. In the professional space, you'll have better relationships. You'll probably be able to make more money, because there's also research to show that people actually who care for themselves the way that they look, earn higher income. But the cool part here that you touched on for you know, reactions for other people is it for yourself. I've seen that where ladies have come to me and their boyfriends in the waiting room and they say, I want to get my lips done. And their lips are already like fantasy lips, if you know what I mean. And I just say to them, no, that's gonna go. If I do anymore, it's gonna really put your lips out of the ideal ratios that actually creates beautiful lips. So you're not a candidate for this treatment. Obviously, there's some body dysmorphia that can have too. However, when we do rejuvenation in a way that looks natural, feels good for us. You know, the body's just like, yes, I want to do this. But thinking about it for a while, it helps to build confidence. Something very interesting about confidence, actually, is that the more confident we are, the better able we're going to be in showing up and building our community. And community is a deep survival need. We're not meant to go through life on our own. We're not meant to over give. We're meant to be supported and receive from those around us, and obviously have it be reciprocated. But the there's the value component, there's the confidence component, there's the community component as well. So there's a lot of really beautiful things actually, about beauty and what it does to our lives.Lesley Logan 27:00  Yeah, and I do, I find it's like, so I used to work at a studio when I lived in L.A., I'd have to, like, leave the house and obviously, how I run and how I shop at the gym, different things, but anything before 7 a.m. that's what different. But when I would go to my studio, I would get dressed to work, go to work, I would teach the whole thing. When I started working from home, I noticed like, oh, I'm not in front of the camera today, so I would just kind of like, still be in the same clothes I did my walk and my workout in, and I was like, starting to slowly feel down about myself and having to give myself more pep talks. And I was doing my fake eyelashes, and they kept getting bigger and wrong, and I kept giving them feedback. And I was like, I don't really like how this is looking. So then I got rid of the fake eyelashes, and now I'm like, well, now I'm a bald eagle, and now I think I'm over at and and I was like, hold on. I also could learn how to do makeup for my natural lashes, and I could get dressed each day, like, how would if I got dressed each day? And what I realized is, by using the clothes in my closet and getting dressed and having a routine of putting my makeup on and and things like that. All those things actually made me feel better. So that whole little haze that, like cloud that was kind of like following around, kind of like an oppression commercial. I don't know if you havethem in Canada, but we have them here, where they're, like, trying to sell you like this cloud that just like hovers over this girl as she walks around, the cloud's gone. I was like, oh, over time, I slowly became used to not doing these things that felt like a waste of time or like not a big deal who's seeing me, and the more I actually spent time with myself. It's not to go back to the vanity topic, It's not vain. It actually just made it easier for me to show up as myself and put myself out there. Because I wasn't going, Oh God, my hair is a mess. Like, like, I, like, got ready for the day, just like, as if I went out into the world to go to work. And so I would say, like, it's really easy for us to go, oh, the world expects us to look a certain way. And really, I actually think the world is quite obsessed with people who are confidently walking in front of them, people who are confidently walking in a room like it. Actually, I'm always amazed, like the people who are famous or infamous and things like that, like some of them, I would never consider like a natural form of beauty, but people are excited about them because they're so calm they walk in, they have their head held high. And so I think if we just go back to like, what are you doing for yourself to help you show up to be the person you want to be, like, those things can't be wrong.Rachel Varga 29:25  Very well said, the, I love this show so much. I love connecting with you, Lesley, I think you're fantastic. You're hitting the nail on the head of, like, really deep topics around beauty and rejuvenation and not enough people are kind of talking about this stuff, the concept of feeling down and self-talk. Let's break that down for a second. A lot of us say, Oh, my fine lines and wrinkles, or, you know, my elevens, or my acne scars, or from an injury perspective, because a lot of you listening are ahletic and sometimes injuries can happen when you're doing new things and pushing your limits and building your strength and your resilience and your readiness and adaptability and all those good things. So instead of saying my whiplash, I detach from it, and I don't say my I say, oh, you know, I'm experiencing this or, Oh, I have a blemish, but I'm not reinforcing it into my identity, because a lot of people have these things that they reinforce into their identity, and then it's like, stuck in their field, if you will. Now we're gonna go just a little bit woo.Lesley Logan 30:39  Oh, you know, we used to only be a one woo show, and considering where the world is right now, Brad and I have gone two woos. We're woo woo in it.Rachel Varga 30:50  Yeah, very much grounded in the 3d science, I published papers. I just the other day, was teaching 60 doctors in Vancouver. Super fun. I just can't help but notice this group of patients that I observed in my career. This is why I talk about radiance, men and women aged 60 to 90 that had never done any rejuvenation. They would come to see me, either on a video call like this, or in the clinic, and I would look at them and be like, Wow, you look fantastic. Like, yeah, you know a couple of things like, bother me. I'd love to do something about it, but it was just how they carried themselves. So I started to kind of unpack this. What is this? What is this that I'm noticing it's like this inner glow, this inner vibration, and what are the components in their life that are contributing to that, which you can ground to the key determinants of health, which are recognized globally as being important factors to determining how healthy you're probably going to be depending on the environment around you. They had a certain vibe to them. Their skin shown differently. Their voice was different. They were very present. They had a family life, they had a spiritual practice. They had hobbies, they had a community. So I coined this radiance, and then I started to dive into some Ayurvedic texts, and came across the definition of radiance, which I think is one of the best definitions of that word that I've ever come across. It's the electromagnetic projection of all of your body systems. The radiant body is the 10th body, and then we have our body, mind, spirit, energy. There's some other bodies in there, but the radiant body is basically that electromagnetic projection of you and a reflection of how all your operating systems are running into the world. And when you begin to hone and cultivate this radiant energy, it's kind of like you become a queen, and you enter a room and everybody notices you for all the right reasons, you become a magnet. And with that, when you step into that very powerful, radiant, queen, feminine and (inaudible) energy, you also repel vibes of certain people that aren't going to be in your highest it's like you're a magnet, but you're also very attractive.Lesley Logan 33:22  Yeah, just like magnets also repel the other side. Rachel Varga 33:25  Exactly. Yes. So magnetic to the right people, the right situations, the right opportunities, and telling yourself (inaudible) oh, you know, there's great things coming just around the corner that are better than I even imagined. And I say that all the time, and it happens all the time. So this becomes you. You become like this force. And one of the most cool things about this as a woman is you get respected, and you are revered by men, not just idolized for looking a certain way, but actually respected and revered, and this is getting into some of the more powerful layers of beauty and radiance. And what you mentioned with your self talk, you probably felt some guilt and shame, right? And those are the lowest vibrations we can possibly sit in. The highest ones are peace love, joy, then there's pre enlightenment, then there's enlightenment. So peace, love, joy, channel your inner (inaudible) that is actually setting the stage for all of your cells and inner machinery and operating systems and field, the human biofield, is an emerging body of science to shine brighter, to slow aging, to feel better, to look better.Lesley Logan 34:47  I love this, and I really do believe in it, because there was years ago I listened to a podcast where they said your cells are listening to you, and how you talk about yourself is what you produce. So if you, going back to your like, my scars, my this, it's so important that you do, you don't hold on to those things, because the body is listening and like they actually did some scientific studies, multiple ones. One of them was they took these people, they blindfolded them, they set them in a chair. They were in a room where they could hear a fire burning, right? And they could hear this hot and they could hear like this, when you put, like, water goes right, that whole thing. And they're like, okay, we're gonna take this (inaudible) and we're gonna brand you, right? And these people are like, Oh my God, they're telling, they're describing what the branding mark is going to be. All these things. I don't even know how they clear this, because it sounds like trauma and torture and all the things, however they did it. And what they would do is they would like make the sound, and then they touch the person with a pen, a pen, and the person develop the welt in the shape of the description of what the branding was going to be. Right? Like, now, whether it lasts or not, wasn't part of the thing, but like they the body was like, so prepared for what it was told it was going to become. And another doctor was trying to figure out if it was a scraping of the knee or the drain of the knee that actually was healing these knee issues. So of course, he has to take three groups of people, one where nothing happens, one where they scrape and one where they drain, and then compare the three and the people who had nothing they were just put into they were put under anesthesia. They played, they played a video of a knee surgery happening so that they would hear in their subconscious they were sent to do all the same post surgical protocol as everyone else. They had the same results as the people who had had surgery, because they told themselves, I had surgery, my knee is fixed, and their body did these things. And so I became so conscious of like, what are we actually talking to ourselves about? Because before we go into all the things we could do to change our bodies, before we go into the biohacking foods, and then what type of treatments we could do, how you're talking to yourself, is literally free. It's a, it's a, it's a free thing you can change. It costs nothing.Rachel Varga 37:01  when you think of a monk, what are they doing all the time? Lesley Logan 37:03  Oh, we get to see them in Cambodia all the time. They are meditating and they're praying. They give blessings. That's what they're doing, just sitting there meditating.Rachel Varga 37:15  And you said something very profound, giving. Lesley Logan 37:19  Blessings. Rachel Varga 37:23  Who you are, depending on what really your reason is for being here. For mine, it's really to activate and initiate men and women around me to be their best versions. I'm very clear on that. So for me and my presence, that's how I serve. That's how I offer. It's how can we be in this state where we engage with others and we brighten their day, we say something kind to them, the way that we move through life is like an offering and a blessing. We first need to fill our cup first, though, that's very important. One of the things that you can channel next time you're in your Pilates or a heavy lifting situation, I do this all the time at the gym. I actually do breath work because for activity as women, especially if you're around that pre perimenopausal, perimenopausal, menopausal and postmenopausal, the body's going through transmissions, and what breaks down collagen and elastin quickly is elevated cortisol, which results in a drop of estrogen. When estrogen falls, collagen, elastin, fall too the more at peace you are, the more in that parasympathetic state you are, the less you're in the sympathetic state with high cortisol, adrenaline, you're going to age slower. You're going to have a slowness of the collagen elastic breakdown. And you could actually just do things to stimulate it, right? Like good skincare, sunscreen on the high real estate areas, mineral only at home, dermarolling, in clinic, lasers to get that collagen back up. Consuming collagen is also great. 10 to 12 grams a day is what's in the literature to actually create those visible skin changes in a month. But what I do when I work out is something hilarious, and I actually did bench press with the bodybuilder gym (inaudible) crew at the gym. I was included. They respect me. They revere me. They see my dedication and hard work. So, you know, I was right there with them get it spotted and encouraged, and here I am elevating their presence as well. But when I work out, and I was actually sharing this with one of the bodybuilders, because they'll do like smelling salts to get them in the sympathetic state, which could be good for the masculine, but for the feminine, we don't want that. We want to keep that cortisol down, what I do, actually, between sets of working out, is go right into parasympathetic breathing. Breathe in for four seconds, hold it for four seconds, exhale for four seconds. And you can do this, do like four to five cycles of that. You can drop into that at any point during the day when you get some news of a task that you need to do. I run like 13 businesses. So there's always, you know, these kind of small fires, and I have to figure out, like, who to delegate what I need to do, blah, blah, blah. But there's always something. So no matter what, I just always drop into that. Have those dates, have that honey, so I have that glycogen. Take those adaptogens to support the adrenals. Do the self care. But the biggest thing, I think, for beauty and slowing aging is, what do you think creates peace?Lesley Logan 41:05  What do I think creates peace? In someone's life?Rachel Varga 41:07  Yeah, what do you think creates peace in someone's life? Lesley Logan 41:10  Oh, my gosh. Well, I don't, to be honest, my mind is (inaudible) a few places. One, good sleep, that helps with peace. Two, not taking things personally, that could take, I think that could cover a lot of things. Maybe the whole four agreements would create peace and then self love.Rachel Varga 41:29  That's beautiful. What actually builds our confidence when you make a decision and we're happy with those decisions that we're making, or making them out of integrity. People who make really bad decisions, they have to live with guilt and shame, and they have terrible sleep. They're tossing and turning, and they got night sweats. All sorts of stuff goes on in someone's nervous system when they constantly have that guilt and shame, operating in the background. Ask for forgiveness, but move towards operating in integrity in every single thing that you do, you will have more peace because you're making better decisions. I wouldn't I can't picture a monk acting out of integrity, right? That's like against their code. So to have that, I just think it's gorgeous. Not taking things personally is also great. So you're recognizing that not everybody is taking as good care of you. You might have different values or lifestyles or what's important to you. So not taking things personally and just kind of witnessing that everyone's on their own journey, and just let go, but just have that knowing that the decisions you're making are out of integrity, and self love is such a beautiful component to that as well because you're telling your body when you're doing your skincare in the am and pm, you're washing your face, you're putting great things on that aren't toxic, and you're doing a lot of the personal development stuff as well, to be the best human that you can be, to be the best woman partner that success in your career, and just be a light in the world and think that and bring beauty. Literally, I've done this. I've just had a terrible day, something's going on, and I put on a cute outfit, do my hair and makeup, and I go engage with someone. They're like, Wow, you look so pretty today. It was like, it brightens my day. My beauty brightened their day. And then send and receive. I give them a compliment of something that I see is beautiful in them, too.Lesley Logan 43:35  Yeah, oh my gosh. You know, so many good things. And there was like five, five other things I wanted to get to in today's episodes. We're just gonna have to have you back. We're just gonna have to have you back because I was like, really hoping we could talk about, like, is Gua Sha really working? What are the things I should be doing? So we're just gonna have to do this again, and we're gonna take a brief break and find out how people can find you, follow you, work with you. And you already gave us some good stuff, but some Be It Action Items. Lesley Logan 43:58  All right, Rachel, where do they hang out? Where do you hang out? Where can people like stalk you in the best way, get more information, work with you, talk with you, where can we send them?Rachel Varga 44:08  Absolutely, I hang out on Instagram. I love to engage with those who are you? They say yes to themselves. They know they're worth it, and they're curious about some of the different options I share a ton of very entertaining education, like, I shared some sleep stuff like, why (inaudible) sleeps because I took creatine too late after my workout. But how did I hack that not so great sleep? I took a little bit more in the next day because it fires up your ATP, anyways, funny stuff like that. As a biohacker and also in the med spa space is over @RachelVargaOfficial, that's my Instagram handle. And then the podcast, really great show, the School of Radiance podcast. And then theschoolofradiance.com is my website, where you can book a one-on-one. You can join my seasonal skin tutorials, where I actually show you how to do Gua Sha, do your skincare, your makeup, your dermarolling peels, retinols, what rejuvenation is great to do that time of year, so basic and advanced stuff over six weeks, great. Not a YouTube tutorial. It's way better. Lesley Logan 45:13  I'm already in. I'm like, hold on, I need to. Rachel Varga 45:15  Super fun, super fun, right? And then the membership is more of that high level. How do we actually activate this radiance and stuff so we can enjoy our lives better and make more money in the process? Those are the two key metrics you're gonna get benefits from.Lesley Logan 45:30  Amazing. You guys, we have a promo code for you in the show notes and everything, so make sure that you check that out. I already have an appointment booked because I am really excited. And it's, again, not because of it's like, oh, I'm trying to be vain. I'm trying to be something that the world wants. No, it's so that when I look in the mirror, I feel awesome about myself, and I can show up more and more and do all the things. And so I'm just so grateful that our paths crossed. You have given us a lot of great tips. Ladies, get on the creatine. Okay, it's really amazing. There's tons of research. Oh yeah, muscles also, just like, apparently, tons of work on the Alzheimer space, which I'm very excited about. Thank God I've been doing creatine for years. But bold, executable, intrinsic or targeted steps our listeners can take to be it till they see it. What do you have for us? Rachel Varga 46:16  Yeah, the skincare checklist, actually, over at theschoolofradiance.com when you sign up for my newsletter, I have a free 30 minute biohacking lesson too, and use promo code LesleyLogan15 for 15% off of your one-on-one here with m. Creatine, creatine, creatine, yes, high protein, one gram to 1.5 grams of protein per pound of body weight, huge when I started to lift heavy and do those two things, and keep up with the flexibility, mobility that just gave me more inner power, activation, if you will, great for the skin too, and caring for yourself, not just your skincare, not just your rejuvenation, but purifying your environment, air, water, lighting, electromagnetics, eating the right food, then detoxing is a key part, but it's what we do every single day.Lesley Logan 47:07  I love that you brought those things up, because I do a lot of people go on detox all the time, but they don't fix their don't check their water problem. When I lived in L.A., all the water stuff said the pipes were great. Everything is great. You guys, I had arsenic and cadmium in my system. So how, right? So we had to, like, we lived in a 500 square foot apartment and had, like, a $5,000 water system put in, and yes, I took it with me when we moved. But I think it's really important so that you all can support things. Right? These are things you can do at home, with your for yourself and in your environment to help you feel really good. So I am obsessed with these tips. I really am obsessed with you. I can't wait for more conversations together and how people are going to use these tips in your life. You guys, let us know. Tag Rachel Varga, tag the Be It Pod. Share this with the friend who needs to hear it. Sometimes we have friends who are actually overly picking on themselves, and maybe I actually think the words that we talked about here today can really support that and help them understand like, you know what is needed, what is necessary, what is helpful, and then also, if you're starting to feel a little bit out of it yourself, like I, I'm gonna tell you right now, it's really okay to care about how you want to put your hair or how you want to dress, because those things actually help us show up more in the world. And we're we are allowed to take up space. So Rachel, thank you so, so much. And until next time everyone, Be It Till You See It. Lesley Logan 48:23  That's all I got for this episode of the Be It Till You See It Podcast. One thing that would help both myself and future listeners is for you to rate the show and leave a review and follow or subscribe for free wherever you listen to your podcast. Also, make sure to introduce yourself over at the Be It Pod on Instagram. I would love to know more about you. Share this episode with whoever you think needs to hear it. Help us and others Be It Till You See It. Have an awesome day. Be It Till You See It is a production of The Bloom Podcast Network. If you want to leave us a message or a question that we might read on another episode, you can text us at +1-310-905-5534 or send a DM on Instagram @BeItPod.Brad Crowell 49:06  It's written, filmed, and recorded by your host, Lesley Logan, and me, Brad Crowell.Lesley Logan 49:10  It is transcribed, produced and edited by the epic team at Disenyo.co.Brad Crowell 49:15  Our theme music is by Ali at Apex Production Music and our branding by designer and artist, Gianfranco Cioffi.Lesley Logan 49:22  Special thanks to Melissa Solomon for creating our visuals. Brad Crowell 49:25  Also to Angelina Herico for adding all of our content to our website. And finally to Meridith Root for keeping us all on point and on time.Support this podcast at — https://redcircle.com/be-it-till-you-see-it/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

In this illuminating episode of The Thought SNOB Podcast, Paula Swope — Author, Speaker, and Chopra-Certified Life Coach — shares a quick yet highly effective morning ritual that blends neuroscience with spiritual discipline. Grounded in research from Nature Neuroscience and PubMed, Paula explains how simply exposing yourself to natural sunlight each morning can reset your circadian rhythm, calm the amygdala, and elevate your mood and energy. Listeners are guided through a step-by-step practice that includes morning light exposure, intentional affirmations, and a brief visualization designed to “seal your energy in gold.” The result? Less reactivity, more alignment, and a calmer nervous system before the day even begins. This short, actionable routine requires no equipment, no cost — only consistency and awareness. Paula's signature approach combines science, mindfulness, and energy work to help listeners reprogram their brains and reclaim their mornings, one ray of light at a time.

The Blasters & Blades PodcastWe had some super smart people to talk about what medical technology might look like in the future and the things we should consider. I wrangled Dr. Brent Roeder, Jana S Brown (aka Jena Rey), JR Wise and Dr. Rob Hampson on the podcast and we flew the nerd flag higher than normal today. It was a brainiac paradise kinda show, one I think you're going to enjoy! This was a fun interview, so check out this episode. Lend us your eyes and ears, you won't be sorry!! Co-Hosts: JR Handley (Grunt)Jana S Brown (Chief Shenanigator)We work for free, so if you wanna throw a few pennies our way there is a linked Buy Me A Coffee site where you can do so. Just mention the podcast in the comments when you donate, and I'll keep the sacred bean water boiling!Support the Show: https://www.buymeacoffee.com/AuthorJRHandleyOur LinkTree: https://linktr.ee/blastersandbladespodcastToday's SponsorDeath's Knight by Matthew T Summers & Jena Rey: https://www.amazon.com/Deaths-Knight-War-Lich-Jena/dp/1952415047Coffee Brand Coffee AffiliateSupport the Show: https://coffeebrandcoffee.com/?ref=y4GWASiVorJZDb10% Discount Code: PodcastGruntsFollow Dr. Brent Roeder on social mediaUnder ConstructionBut if you're brave enough, search for his name in Pub Med!Follow Jana S Brown on social mediaJana's Amazon: https://www.amazon.com/stores/Jana-S.-Brown/author/B015VJV7JWJana's Website: www.opalkingdompress.comJana's Facebook: www.facebook.com/janasbrownwritesJana's LinkTree: https://linktr.ee/opalkingdompressFollow Jena Rey on social mediaJena's Amazon: https://www.amazon.com/stores/Jena-Rey/author/B08XSCHXYXJena's Facebook: www.facebook.com/jenareyFollow JR Wise on social mediaJR's Amazon: https://www.amazon.com/stores/author/B0D8GDZZPZJR's Website: https://www.jrwise.com/homeJR's Facebook: https://www.facebook.com/thewiseauthor/JR's Instagram: https://www.instagram.com/thewiseauthor/JR's TikTok: https://www.tiktok.com/@thewiseauthorJR's Substack: https://substack.com/@thewiseauthorThe Kinetic Front Line Collective: https://www.kineticfrontline.com/Follow Dr. Rob Hampson on social mediaRob's Amazon Page: https://www.amazon.com/stores/author/B07JKN63DHRob's Simon & Schuster Page: https://www.simonandschuster.com/authors/Robert-E-Hampson/162787546 Rob's Baen Page: https://www.baen.com/allbooks/category/index/id/4978Rob's Website: http://rehampson.com/Rob's Facebook: https://www.facebook.com/rob.hampson2 Follow Baen Books on social mediaBaen's Website: https://www.baen.com/Baen's Facebook: https://www.facebook.com/BaenBooks#scifishenanigans #scifishenaniganspodcast #bbp #blastersandblades #blastersandbladespodcast #podcast #scifipodcast #fantasypodcast #scifi #fantasy #books #rpg #comics #fandom #literature #comedy #veteran #army #armyranger #ranger #scififan #redshirts #scifiworld #sciencefiction #scifidaily #scificoncept #podcastersofinstagram #scificons #podcastlife #podcastsofinstagram #scifibooks #awardwinningscifi #newepisode #podcastersofinstagram #podcastaddict #podcast #scifigeek #scifibook #sfv #scifivisionaries #firesidechat #chat #panel #fireside #religionquestion #coffee #tea #coffeeortea #CoffeeBrandCoffee #JRHandley #NickGarber #MadamStabby #JanaSBrown #JenaRey #OpalKingdomPress #MedicalTechnologyOfTheFuture #MedicalTechnology #Future #TechnologyOfTheFuture #futurism #BrentRoeder #JRWise #DrRobHampson #DrRobertEHampson #RobHampson #RobertEHampson Baen #BaenPublishing #BaenBooks #BaensBar #memory #EvilPenguin #SpeakerToLabAnimals #6MillionDollarMan #BionicMan #SixMillionDollarMan #LearningDisabilityImplant #nanite #StarTrekPill #newkidney #DrBones #StimPacks #Tricorder #TheLittleBlackBag #shortstory #CyrilMKornbluth #AstoundingScienceFictionMagazine #FalloutFranchise #NukaCola #DrPepper #Sarsaparilla #RedWine #NoseCoke #DryRedWine #RedWineWhore #DARPA #XPrize #wearabledevice #BVLarson #UndyingMercenary #StrangeNewWorlds #HALOLegends #HALO #geneediting #CRISPer

Guten Tag, liebe Freundinnen und Freunde der Gewichtsreduktion! Zugegeben, im Moment sind wir sehr inkretinmimetisch unterwegs, greifen etliche Publikationen zu GLP-1-Rezeptor-Agonisten auf. Wir gehen streng davon aus, dass das weniger mit einem persönlichen Bauch-Bias zu tun hat als vielmehr mit einem Publikationsbias: Allein in diesem Jahr sind per 5. November in Pubmed bereits 5.062 Veröffentlichungen gelistet. Wie geloben Besserung und werden wieder andere Themen bringen! Aber diese heutige Episode muss sein, denn die jüngste Auswertung der SELECT-Studie zu ▼ Semaglutid (Wegovy® und Ozempic®) von Novo Nordisk hat ein so großes Medienecho erhalten, dass eine Einordnung nötig scheint.

That juicy tomato in your salad or the spicy kick of your favorite peppers — could they be quietly turning up your pain dial?In this episode of Migraine Heroes Podcast, host Diane Ducarme explores the controversial role of the nightshade family — tomatoes, peppers, eggplants, and potatoes — in migraine and chronic pain. Are they healing, harmful, or simply misunderstood?In this episode, you'll learn:

What if one side of your body suddenly stopped moving — and your doctor said, “It's a migraine”?Hemiplegic migraines are rare, disorienting, and often confused with strokes. They challenge everything you think you know about how your brain, body, and energy connect.In this episode of Migraine Heroes Podcast, hosted by Diane Ducarme, we explore the science and the story behind this rare form of migraine — one that blurs the line between neurology and mystery. Together, we look at how the body can temporarily lose its flow, and how to gently help it find its rhythm again.In this episode, you'll learn:

Have you ever heard of Senolytics? It's the latest breakthrough in aging and longevity science that I honestly had not heard about until learning about Qualia Senolytic. That's what I'm SO excited to welcome todays guest, naturopathic physician Dr. Gregory Kelly, the VP of product development at Qualia Life, and author of the book Shape Shift. He was the editor of the journal Alternative Medicine Review and has been an instructor at the University of Bridgeport in the College of Naturopathic Medicine, where he taught classes in Advanced Clinical Nutrition, Counseling Skills, and Doctor-Patient Relationships. Dr. Kelly has published hundreds of articles on natural medicine and nutrition, contributed three chapters to the Textbook of Natural Medicine, and has more than 30 journal articles indexed on Pubmed. His areas of expertise include nootropics, anti-aging and regenerative medicine, weight management, sleep and the chronobiology of performance and health. In this episode, Dr. Kelly and I discuss why you should care about cellular senescence and how its different from autophagy, the hallmarks of aging, the, and how you can age better at a cellular level by helping your body naturally eliminate senescent cells. Suggested Resources:Qualia Life (you can use the code wellnstrong for a discount!Dr. Gregory Kelly Qualia Senolytic Placebo-Controlled Clinical Study ResultsSenolytic drugs: from discovery to translationSend me a text!Kyoord makes small-batch Greek olive oils that are exceptionally rich in polyphenols—powerful compounds shown to fight inflammation, support brain health, and protect against chronic disease. It's the brand I personally use and trust daily, and you can try it yourself at kyoord.com with code WELLNSTRONG for 10% off your first order. This episode is proudly sponsored by: SizzlefishLet's talk about fueling your body with the best nature has to offer. If you're looking for premium, sustainable seafood delivered straight to your door, you need to check out Sizzlefish! Head to sizzlefish.com and use my code “wellnstrong” at checkout for an exclusive discount on your first order. Trust me, you're going to taste the difference with Sizzlefish!Join the WellnStrong mailing list for exclusive content here!Want more of The How To Be WellnStrong Podcast? Subscribe to the YouTube channel. Follow Jacqueline: Instagram Pinterest TikTok Youtube To access notes from the show & full transcripts, head over to WellnStrong's Podcast Page

Send us a textI unpack what “ultra-processed” really means, why these foods are so easy to overeat, what the best evidence shows (including metabolic-ward studies), and how I personally navigate them without fear or perfectionism. Key topics & evidence (in plain English):What counts as “ultra-processed”? I walk through the NOVA system—useful, not perfect—and where borderline items (frozen meals, boxed mixes) fit. See an overview of NOVA classifications here. How we got here: post-WWII abundance of refined flour, cheap sugars, oils, and a cultural push for convenience—now ~60% of the U.S. diet comes from UPFs (study). Additives: stabilizers, emulsifiers, preservatives, and colors are generally recognized as safe (GRAS). I explain why, on their own, they're probably not the main health issue. The bigger problem: UPFs are energy-dense, engineered for bliss (fat/sugar/salt + perfect texture), and easy to eat quickly—driving higher calorie intake.  • Metabolic-ward crossover trial: +~508 kcal/day when participants ate UPFs vs minimally processed (Cell 2019). • Overweight adults in a crossover design: +~814 kcal/day on the UPF week (PubMed). • Another recent crossover RCT reports ~300 kcal/day higher on UPFs (Nature Medicine 2025). What I recommend (and what I do):Prioritize whole foods most of the time; shop the perimeter; cook when you can. Canned tomatoes/beans and frozen fruits/peas are fine helpers. If weight, diabetes, or blood pressure are concerns, be extra cautious with UPFs—they're designed to be irresistible and calorie-dense. Moderation wins: I enjoy favorites (yes, even boxed mac 'n' cheese and crunchy peanut butter) without letting them dominate my plate. Takeaways you can use today:Build meals around minimally processed proteins, veggies, fruits, and beans; let convenience items support—not star—in your diet. Watch “calorie-dense + easy to overeat” combos (chips, sweets, fast food). If you have them, portion once, then put the package away. If symptoms or inflammation are puzzling you, try a short UPF-light experiment (2–4 weeks) and see how you feel. If this episode helped, please follow and leave a quick review—and share it with a friend who's curious about UPFs. For my newsletter and resources, visit drbobbylivelongandwell.com.

In patients with heart failure, remote hemodynamic monitoring can identify health changes long before symptoms appear, contributing to slower disease progression, improved patient outcomes, and reduced rehospitalizations. Learn more about current and future technology that can support better patient health, and the role of nurses in patient education and monitoring. Guests: Linda Park, PhD, MS, FNP-BC, FAAN, FAHA, FPCNA, and Eryn Bryant, MSN, APRN-CNP, FPCNA.PCNA Heart Failure Tools: https://pcna.net/health-topics/heart-failure/Tele-HF study: https://www.jacc.org/doi/10.1016/j.jchf.2015.07.017 CHAMPION Trial (CMEMs after CRT): Pulmonary Artery Pressure-Guided Management of Patients With Heart Failure and Reduced Ejection Fraction https://www.acc.org/latest-in-cardiology/clinical-trials/2015/12/29/12/44/championJournal of American College of Cardiology paper, Remote Monitoring and Heart Failure Scientific Statement: https://www.jacc.org/doi/10.1016/j.jacc.2023.04.010 European Society of Cardiology consensus statement: https://doi.org/10.1093/eurheartjsupp/suae116BMAD trial: BMAD Trial: Wearable Remote Monitor Reduces Hospital Readmission Risk in HF Patients - American College of Cardiology: https://www.acc.org/Latest-in-Cardiology/Articles/2023/03/01/22/45/mon-830am-bmad-acc-2023 GUIDE-HF trial (CMEMS, Lancet): Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial - The Lancet: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01754-2/abstractESCAPE trial (using RHC / pulm art pressures to guide therapy during ADHF: Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: the ESCAPE trial - PubMed: https://pubmed.ncbi.nlm.nih.gov/16204662/MONITOR-HF trial (improved QOL and functional status w/ CMEMs): Remote haemodynamic monitoring of pulmonary artery pressures in patients with chronic heart failure (MONITOR-HF): a randomised clinical trial - The Lancet: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)00923-6/abstract MONITOR-HF: Pulmonary artery pressure monitoring in chronic heart failure: effects across clinically relevant subgroups in the MONITOR-HF trial | European Heart Journal | Oxford Academic: https://academic.oup.com/eurheartj/article/45/32/2954/7668040MONITOR-HF (summary in ACC): Remote Hemodynamic Monitoring of Pulmonary Artery Pressures in Patients With Chronic Heart Failure - American College of Cardiology: https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2023/07/18/17/21/monitor-hfHeartLogic: HeartLogic Multisensor Algorithm Identifies Patients During Periods of Significantly Increased Risk of Heart Failure Events: https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.117.004669SCALE-HF-1 Trial (bodyport scale to predict worsening HF trends): Use of a Cardiac Scale to Predict Heart Failure Events: Design of SCALE-HF 1 | Circulation: Heart Failure: https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.122.010012See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Send us a textIs your neck pain getting worse as the weather cools down? You're not alone — every fall, more Rockford residents visit chiropractors for stiff, sore necks.In this episode, Dr. Brant Hulsebus from Hulsebus  Rockford Chiropractic in Rockford, IL explains why colder air and posture changes trigger neck tension, and how chiropractic care restores movement and reduces pain safely.You'll also hear about a new 2025 PubMed study showing how spinal adjustments improve head and neck movement control in people with chronic neck pain.In This Episode:Why fall weather increases neck and shoulder tensionWhat your posture says about your neck alignmentHow chiropractors evaluate and treat neck painWhat new research reveals about spinal manipulationMyths vs. facts about chiropractic neck adjustments

Send us a textIs your neck pain getting worse as the weather cools down? You're not alone — every fall, more Rockford residents visit chiropractors for stiff, sore necks.In this episode, Dr. Brant Hulsebus from Hulsebus  Rockford Chiropractic in Rockford, IL explains why colder air and posture changes trigger neck tension, and how chiropractic care restores movement and reduces pain safely.You'll also hear about a new 2025 PubMed study showing how spinal adjustments improve head and neck movement control in people with chronic neck pain.In This Episode:Why fall weather increases neck and shoulder tensionWhat your posture says about your neck alignmentHow chiropractors evaluate and treat neck painWhat new research reveals about spinal manipulationMyths vs. facts about chiropractic neck adjustments

Send us a textToday, I'm joined by Dr. William LaValley — one of the world's leading researchers and medical doctors in the field of integrative cancer treatment.Dr. LaValley has spent decades combining the latest discoveries in molecular biology with evidence-based, integrative therapies for cancer. He draws upon the vast database of research available through PubMed to identify the anti-cancer potential of natural compounds and repurposed, or off-label, pharmaceutical drugs.Since earning his M.D. in 1986, Dr. LaValley has developed sophisticated, evidence-driven databases mapping the molecular pathways of cancer. These insights have allowed him to design personalized treatment protocols that complement — rather than replace — conventional chemotherapy and radiation therapy.In this episode, we'll discuss how understanding molecular biology helps identify new targets for treatment, how repurposed drugs can work synergistically with standard therapies, and what the future of integrative oncology looks like.You can find him at:www.Lavalleymdprotocols.com#IntegrativeOncology #CancerResearch #MolecularMedicine #RepurposedDrugs #FunctionalMedicine #CancerTreatment #FitRxPodcast

Biust – symbol kobiecości, źródło życia, przyjemności i emocjonalnej równowagi. To obszar, który często traktujemy wyłącznie fizycznie – pielęgnując jego jędrność, kształt czy atrakcyjność. A jednak to coś znacznie więcej.W tym odcinku zapraszam Cię do odkrycia biustu jako mapy kontaktu ze sobą – miejsca, w którym spotykają się ciało, emocje i energia. To przestrzeń, która uczy nas czułości wobec siebie, zaufania do własnej intuicji i świadomej obecności w kobiecym ciele.Zrozumiesz, jak biust wspiera nie tylko naszą fizjologię, ale też delikatną równowagę hormonalną i emocjonalną. Jak poprzez dotyk, oddech i uwagę możemy przywrócić mu blask – i sobie samej poczucie pełni.Ciało pamięta każdy gest troski. Jeśli po tym odcinku czujesz, że chcesz dać sobie więcej obecności i czułości — w opisie zostawiam linki do miejsc, które w tym wspierają: facemodeling.pl i BABUU.PLTo przestrzenie, w których dotyk staje się terapią, a pielęgnacja — spotkaniem z własnym ciałem, zdrowiem i urodą.Dla tych z Was, które chcą zadbać o swój biust jeszcze głębiej – z miłością i troską – przygotowałam 30% zniżki na wszystkie programy pielęgnacyjne biustu- te do pielęgnacji domowej i te profesjonalne do gabinetu.Użyj hasła BRA30 przy zakupie i pozwól sobie na odrobinę świadomej kobiecości każdego dnia.Literatura wspomniana w odcinku:Touch for socioemotional and physical well-being: A review Czasopismo: Developmental Review DOI: 10.1016/j.dr.2009.10.001 PubMed ID: 20434965Autor: Stephen W. PorgesTytuł: The polyvagal perspectiveCzasopismo: Biological PsychologyRok: 2007Tom: 74, numery 2–3, strony 116–143DOI: 10.1016/j.biopsycho.2006.06.009PubMed ID: 17049418Bezpośredni link do źródła na PubMed: https://pubmed.ncbi.nlm.nih.gov/17049418/Montaż: Eugeniusz Karlov

In this solo episode, Darin takes on the “beef tallow” craze that's been sweeping the wellness world — exposing the industry manipulation, environmental costs, and scientific inaccuracies behind the trend. From skincare to supplements, companies are selling animal byproducts as miracle cures — but what's really happening behind the scenes? Darin dives into the industrial rendering process, the hidden pollution of factory farming, and the false “ancestral” marketing that's convincing people to buy into a billion-dollar rebrand of waste. This episode isn't about guilt — it's about truth, awareness, and sovereignty. Because when you know how the system really works, you can choose differently.     What You'll Learn 00:00:00 – Why Darin decided to peel back the layers on the beef tallow trend 00:01:00 – What tallow actually is: industrially rendered animal fat from slaughterhouse byproducts 00:03:00 – The dirty details: high-heat rendering, bleaching, deodorizing, and chemical refining 00:06:00 – The hidden foundation of factory farming and the myth of “ancestral” sourcing 00:08:00 – The human and environmental toll of the tallow supply chain — pollution, stress, and labor exploitation 00:10:00 – Marketing manipulation: how “natural” language disguises industrial exploitation 00:12:00 – Science check: why tallow isn't nutritionally superior to seed oils 00:14:00 – The clinical data: saturated vs. polyunsaturated fats and heart health 00:16:00 – The real safety issues — prion disease, contaminants, oxidation, and hidden toxins 00:18:00 – Why skincare claims are unproven — no data shows tallow outperforms plant oils 00:20:00 – The illusion of “zero-waste”: how byproduct economics fuel more slaughter 00:22:00 – What “natural” actually costs — to the planet, animals, and human health 00:24:00 – The path forward: transparency, awareness, and choosing regenerative alternatives 00:26:00 – The SuperLife perspective: stop calling destruction natural — awareness is the first step toward change     Thank You to Our Sponsors Fatty15: Get an additional 15% off their 90-day subscription Starter Kit by going to fatty15.com/DARIN and using code DARIN at checkout. EnergyBits: 100% spirulina and chlorella tablets delivering pure food nutrition. Use code SUPERLIFE for 20% off at energybits.com.     Find More from Darin Olien: Instagram: @darinolien Podcast: SuperLife Podcast Website: superlife.com Book: Fatal Conveniences     Key Takeaway “Let's stop calling destruction natural. When we stop buying into exploitation, we stop funding it — and that's when change begins for the animals, for the planet, and for us.”     Bibliography / Key References Meatscience.org, “Rendering 101” (industry rendering overview) FAO / Codex Alimentarius, edible fats and oils specifications (MIU, peroxide, etc.) Sölens / rendering-industry chemical supplier blogs (on refining aids, odor control) FDA/EPA dioxin/PCB in fats monitoring programs AHA/ACC (American Heart Association / American College of Cardiology) review on saturated vs unsaturated fats and cardiovascular disease PubMed articles on prion resistance to rendering Derm & cosmetic reviews on tallow/animal fats in skincare Industry & environmental NGO reports on factory farming's greenhouse gas, water, land use, manure pollution, worker conditions

Send us a textCancer is the second leading cause of death, and while it sparks fear for good reason, 40% of cases are preventable. In this episode, I outline six practical, evidence-based steps that can help reduce your risk.We begin by understanding which cancers are most common based on gender—breast, colon, and lung in women; prostate, colon, and lung in men. While some rare cancers (like pancreatic or ovarian) evoke greater fear, the focus here is on the ones we're more likely to face and can meaningfully act on.Next, I break down risk factors into two categories. Some are unavoidable—your sex, age, or family history. For example, if a close relative had breast or colon cancer, early screening or genetic testing may be warranted. However, only about 5–10% of cancers are directly linked to inherited genetic mutations (American Cancer Society).The more empowering list? Avoidable risk factors—where our actions matter most. Smoking remains the leading modifiable cause of cancer, responsible for about 19% of all cases. Excess weight and obesity account for another 8% and are especially tied to hard-to-treat cancers like pancreatic and ovarian (ScienceDirect) and PubMed). Visceral fat appears more predictive than BMI alone. Alcohol, especially in large quantities, is also linked to liver, GI, and breast cancers.Some risks are cancer-specific. HPV causes nearly all cervical cancers, and melanoma is largely driven by UV exposure. Air pollution, especially particulate matter, may slightly increase lung cancer risk (ASCO Global Oncology).Step three is to act on what you can. Quit smoking, aim for a healthy weight, wear sun protection, and ensure your kids get their routine HPV and Hepatitis B vaccines. Exercise plays a major role too—high activity levels correlate with 10–20% lower risk of several major cancers (JAMA). In colon cancer survivors, regular exercise reduced recurrence by 30% (PubMed).Step four is awareness: don't ignore new symptoms like unexplained bleeding or lumps. Early detection can be life-saving.Step five is screening. If you're 45 or older, colonoscopy is now recommended. Women should get regular mammograms and PAP smears, and individuals with smoking history may benefit from lung CT scans. For rarer cancers with family history, targeted screenings may apply. I also address why whole-body MRIs and liquid biopsies aren't ready for routine use.Step six? Don't put your hope in supplements. Large trials show omega-3s, vitamin D, beta carotene, and vitamin C offer no real protective benefit (NEJM VITAL Study, Meta-analysis on Vitamin C, JNCI on aspirin).Takeaways: You can reduce your cancer risk by modifying lifestyle factors like smoking, weight, and activity. Don't delay screenings—they catch cancers early when treatment is most effective. And remember: no supplement replaces proven preventive strategies.Visit drbobbylivelongandwell.com for more evidence-based tools, and listen to the full episode for actionable steps to help you live long and well.

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog If you are female who is menopausal and you have experienced your OBGYN or internist drawing your blood to check your hormone levels, (Estradiol, and LH and FSH) to see if you are menopausal or to see what your estradiol level is while on HRT, you may have heard your doctor tell you that your estradiol level is too high. That is what I would like to talk about today….. This often occurs when my patients take the blood work I order to another doctor who doesn't know anything about estrogen and just looks at the reference range on the lab sheet. Most of you have heard me talk about the fact that lab reports must be interpreted by the treating physician, because what is written on the lab sheet isn't tailored to your situation. The lab reference ranges for menopausal women are based on women who don't take any hormones, very low estradiol and high LH and FSH, which is not healthy and is the level that causes women overwhelming hot flashes and painful periods. Estradiol blood tests have a list of numbers that don't reflect the healthy estradiol level, but a level that makes women miserable. After I replace a woman's estradiol, their tests show blood levels of a young healthy woman who is pre-menopausal, and that brings them back to feeling like themselves. “I have my life back!  Estradiol and Testosterone Pellets have cured all my symptoms (low libido, hot flashes, poor interrupted sleep, bladder spasms, depression, and I feel like myself again!” No other hormone replacement brings estradiol blood levels to (60-250ng/ml), patches, creams and gels just stop one symptom, hot flashes.  There is a reason that your doctor doesn't know about hormones. The education that OBGYNs get in residency effects what they recommend to their patients for life, and they have very little training about hormones which means that no one is taking care of the hormones for women, and bioidentical estradiol is never discussed because it is not approved by the FDA which is why I DO!  I have made it my business to know everything about women's hormones and have prescribed them to women for over 45 years.  Therefore, when I am told that the primary care or internal medicine doctor told one of my patients that their estradiol and estrone are “too high”, I am dismayed.    Women must think about the fact that when they feel normal after menopause treatment, then that is the best treatment for them.  My patients become better, healthier, and their relationships are more fulfilling with Estradiol replacement, and I know the range the Estradiol should be within (60-250), the same as when we were fertile and young. Estradiol taken non-orally (patch, cream or pellet) is safe and does not cause breast cancer or liver cancer or cause blood clots. What Should I Tell My Doctor about my estrogen replacement? Therefore, If your doctor tells you to stop estradiol, you can tell him that estradiol replacement decreases all causes of death in Menopausal women, it decreases heart disease, bladder disease, bladder infections, osteoporosis, and dementia/Alazheimer's Disease! Tell him or her that, they can stop worrying about your Estrogen because you are being prescribed it by a doctor who knows how to manage hormones. Breast Cancer Patients There is another type of patient who I often see in my office. Breast Cancer patients with estradiol receptors are taken off their estrogen, and they are given an estrogen blocker like Tamoxifen® (oral) or Anastrazole (Arimidex®) to get rid of the estrogen in their body which is to “starve” breast cancer cell that may have seeded other tissues in the body. These patients are miserable. I treat them with Testosterone pellets only and monitor their Estrogens. That works until their doctor sees an Estradiol level that is in the premenopausal range in a patient who hasn't had an estradiol pellet in a year.  E2 pellets are tiny and friable, and they can't last longer than 6 months. What happens when the oncologist freaks them out saying it is the Estradiol pellet causing the E2, E1 levels. They are upset but this is estradiol from other sources (not the ovaries). Here are the facts: Estradiol pellets are 2-3 mm in size. They dissolve by blood flowing around the pellet located in the fat. Estradiol pellets dissolve completely over 3-4 months in most women. We cannot see them by ultrasound at 4 months. Therefore, a year later a woman who has estradiol over 60 The oncologist is not a hormone specialist and doesn't know the other sources of estradiol and estrone in the body. a prescribed amount of Estradiol (E2) is given every 4 months. The medium dose of E2 is 25mg and it lasts 120 – 180 days The size of an estradiol pellet = 2×2 mm Causes Of Continuing High Estrogen In a Woman Long After She Stops E2 Pellets: Tamoxifen given for Breast Cancer is an Estrogen and also an Estrogen Receptor modulator, but is really an Estrogen, which turns off the receiving end for E2 (the cellular receptors) so the breast cancer cannot be stimulated by circulating estrogens, but the rest of the body is. When on Tamoxifen it is not the pellets that are raising the blood level of E2, E1, it is the Medication. When someone is on Tomoxifen all their other organs are stimulated by estrogens from Tamoxifen, but the Breasts are not. That means that the estrogen in the blood is from the medication Tamoxifen and not the previous pellets. Obesity increases body fat and E2 is made in the fat and the less fat the lower the Estrone and estradiol. Other Medications and supplements can increase the E2 and E1 in the circulation but rarely help with menopausal symptoms. Your doctor should know what medications you can't take if you are trying to get rid of estradiol and estrone usually prior to Breast Cancer therapy. Drinking alcohol can prevent the liver from processing the estrogen that is meant to be removed normally so it builds up in the circulation. Liver disease causes an increase in E1 as well. Some medications increase estrogens in the body, but do not relieve symptoms of menopause, so have you doctor review your other medications you take. High intake of soy, edamame, soy nuts, soy in nut milk, Tofu, and other vegan (fake meat) is made of soy and soy is a phytoestrogen which can cause uterine bleeding but doesn't help the symptoms of menopause. Soy is in everything so read the labels. Genetic Diseases can cause high estrogen in menopausal women who are not taking estradiol for their symptoms.   Some women have an aromatase defect, which is genetic and can't be cured but can be treated with anastrazole or Arimidex, the same medication. This means that they convert Testosterone into estradiol and estrone. Even before menopause women have very low testosterone, so this is not obvious when they come to my office. The test for the gene defect is very expensive and this is not a common occurrence.  We diagnose this when a woman's estrogen is too high for the dose she is taking, AND her testosterone ran out too fast! We treat that condition with a testosterone + anastrazole pellet in the normal dose of T, and it corrects the conversion of T into E2, E1. Oral anastrazole also called Arimidex blocks that conversion too and is tolerated better by men but women get arthritis symptoms. DIM can treat this genetic conversion by blocking the enzyme at a different place than Arimidex. Fat Loss through dieting releases the estradiol stored in the body fat   Obesity and weight loss can cause estradiol and estrone to be high in the blood. Estrogen is made and stored in fat tissue.  The more you have, the more E1 and E2 you have in your fat.  Obesity can store the hormone and slowly release it which fools us and makes us think we are seeing pellet E2 nd E1. The more fat you have the more estrogens you make! When people lose fat under the supervision of a doctor, they usually have somewhat rapid weight loss.  This floods the blood with both estradiol, estrone, and triglycerides.  It takes longer to clear the estrogens because the liver is also processing fat. PubMed https://pubmed.ncbi.nlm.nih.gov Does reducing body fat reduce estrogen? Making some lifestyle changes may help lower your estrogen levels. Your provider may recommend that you: Decrease your percentage of body fat. Decreasing your body fat can reduce the amount of estrogen that your fat cells secrete. Feb 9, 2022 Above is what your doctor should think about when diagnosing you for high estradiol long after a pellet is gone.  There are some ovarian and adrenal specific problems that are also possible to be the reason E2, E1 are increased. I hope this gives you ammunition to discuss with the doctors who don't know anything about hormones, estradiol and menopausal women.  Tell them what you know to be true and stop blaming a 2mmx2mm pellet that can't physically last more than 120 day.

Dr. Hope Rugo and Dr. Giuseppe Curigliano discuss recent developments in the field of bispecific antibodies for hematologic and solid tumors, including strategies to optimize the design and delivery of the immunotherapy. TRANSCRIPT Dr. Hope Rugo: Hello and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I am your host, Dr. Hope Rugo. I am the director of the Women's Cancers Program and division chief of breast medical oncology at the City of Hope Cancer Center. I am also the editor-in-chief of the Educational Book. Bispecific antibodies represent an innovative and advanced therapeutic platform in hematologic and solid tumors. And today, I am delighted to be joined by Dr. Giuseppe Curigliano to discuss the current landscape of bispecific antibodies and their potential to reshape the future of precision oncology. Dr. Curigliano was the last author of an ASCO Educational Book piece for 2025 titled, "Bispecific Antibodies in Hematologic and Solid Tumors: Current Landscape and Therapeutic Advances." Dr. Curigliano is a breast medical oncologist and the director of the Early Drug Development Division and chair of the Experimental Therapeutics Program at the European Institute of Oncology in Milan. He is also a full professor of medical oncology at the University of Milan. You can find our disclosures in the transcript of this episode. Dr. Curigliano, Giuseppe, welcome and thanks for being here. Dr. Giuseppe Curigliano: Thanks a lot for the invitation. Dr. Hope Rugo: Giuseppe, I would like to first ask you to provide some context for our listeners on how these novel therapeutics work. And then perhaps you could tell us about recent developments in the field of bispecific antibodies for oncology. We are at a time when antibody-drug conjugates (ADCs) are all the rage and, trying to improve on the targeting of specific antigens, proteins, receptors in the field of oncology is certainly a hot and emerging topic. Dr. Giuseppe Curigliano: So, thanks a lot. I believe really it was very challenging to try to summarize all the bispecific antibodies that are under development in multiple solid tumors. So, the first thing that I would like to highlight is the context and the mechanism of action of bispecific antibodies. Bispecific antibodies represent a groundbreaking advancement in cancer immunotherapy, because these engineered molecules have the unique ability to target and simultaneously bind to two distinct antigens. That is why we call them bispecific. So typically, one antigen is expressed on the tumor cell and the other one is expressed on the immune effectors, like T-cell or natural killer cells. So this dual targeting mechanism offers several key advantages over conventional monoclonal antibodies because you can target at the same time the tumor antigen, downregulating the pathway of proliferation, and you can activate the immune system. So the primary mechanism through which bispecific antibodies exert their therapeutic effects are: First, T-cell redirecting. I mean, many bispecific antibodies are designed to engage tumor-associated antigens like epidermal growth factor receptor, HER2, on the cancer cell and a costimulatory molecule on the surface of T-cell. A typical target antigen on T-cell is CD3. So what does it mean? That you activate the immune system, immune cells will reach the tumor bed, and you have a dual effect. One is downregulating cell proliferation, the other one is activation of the immune system. This is really important in hematological malignancies, where we have a lot of bispecifics already approved, like acute lymphoblastic leukemia or non-Hodgkin lymphoma.  The second, in fact, is the engagement of the tumor microenvironment. So, if you engage immune effector cells like NK cells or macrophages, usually the bispecific antibodies can exploit the immune system's ability to recognize and kill the immune cells, even if there is a lack of optimal antigen presentation.  And finally, the last mechanism of action, this may have a role in the future, maybe in the early cancer setting, is overcoming immune evasion. So bispecific antibodies can overcome some of the immune evasion mechanisms that we see in cancer. For example, bispecific antibodies can target immune checkpoint receptors, like PD-L1 and CTLA-4. Actually, there is a bispecific under development in breast cancer that has a dual targeting on vascular endothelial growth factor receptor and on PD-L1. So you have a dual effect at the same time. So, what is really important, as a comment, is we need to focus first on the optimal format of the bispecific, the optimal half-life, the stability, because of course even if they are very efficient in inducing a response, they may give also a lot of toxicities. So in clinical trials already, we have several bispecifics approved. In solid tumors, very few, specifically amivantamab for non-small cell lung cancer, but we have a pipeline of almost 40 to 50 bispecifics under development in multiple solid tumors, and some of them are in the context of prospective randomized trials. Dr. Hope Rugo: So this is really a fascinating area and it's really exciting to see the expansion of the different targets for bispecific antibodies. One area that has intrigued me also is that some of the bispecifics actually will target different parts of the same receptor or the same protein, but presumably those will be used as a different strategy. It's interesting because we have seen that, for example, in targeting HER2. Dr. Giuseppe Curigliano: Oh, yes, of course. You may consider some bispecifics like margetuximab, I suppose, in which you can target specifically two different epitopes of the same antigen. This is really an example of how a bispecific can potentially be more active and downregulating, let us say, a pathway, by targeting two different domains of a specific target antigen. This is an important point.  Of course, not all the bispecifics work this way, because some of the target antigen may dimerize, and so you have a family of target antigen; an example is epidermal growth factor receptor, in which you have HER1, HER2, HER3, and HER4. So some of them can inhibit the dimerization between one target antigen and the other one, in order to exert a more antiproliferative effect. But to be honest, the new generation of them are more targeting two different antigens, one on the tumor and one on the microenvironment, because according to the clinical data, this is a more efficient way to reduce proliferation and to activate the immune system. Dr. Hope Rugo: Really interesting, and I think it brings us to the next topic, which is really where bispecific antibodies have already shown success, and that is in hematologic malignancies where we have seen very interesting efficacy and these are being used in the clinic already. But the expansion of bispecific antibodies into solid tumors faces some key challenges. It's interesting because the challenges come in different shapes and forms. Tell us about some of those challenges and strategies to optimize bispecific antibody design, delivery, patient selection, and how we are going to use these agents in the right kind of clinical trials. Dr. Giuseppe Curigliano: This is really an excellent question because despite bispecific antibodies having shown a remarkable efficacy in hematological malignancies, their application in solid tumors may have some challenges. The first one is tumor heterogeneity. In hematological malignancy, you have a clear oncogene addiction. Let us say that 90% of the cells may express the same antigen. In solid tumors, it is not the same. Tumor heterogeneity is a typical characteristic of solid tumors, and you have high heterogeneity at the genetic, molecular, and phenotypic levels. So tumor cells can differ significantly from one another, even if within the same tumor. And this heterogeneity sometimes makes it difficult to identify a single target antigen that is universally expressed in an hematological malignancy. So furthermore, sometimes the antigen expressed on a tumor cell can be also present on the normal tissue. And so you may have a cross-targeting. So let's say, if you have a bispecific against epidermal growth factor receptor, this will target the tumor but will target also the skin with a lot of toxicity. The second challenge is the tumor microenvironment. The solid tumor microenvironment is really complex and often immunosuppressive. It is characterized by the presence of immunosuppressor cells like the T regulators, myeloid derived suppressor cells, and of course the extracellular matrix. All these factors hinder immune cell infiltration and also may reduce dramatically the effectiveness of bispecific antibodies. And as you know, there is also an hypoxic condition in the tumor. The other challenge is related to the poor tumor penetration. As you know also with antibody-drug conjugate, only 1 to 3% of the drug will arrive in the tumor bed. Unlike hematological malignancies where tumor cells are dispersed in the blood and easily accessible, the solid tumors have a lot of barriers, and so it means that tumor penetration can be very low. Finally, the vascularity also of the tumor can be different across solid tumors. That is why some bispecifics have a vascular endothelial growth factor receptor or vascular endothelial growth factor as a target. Of course, what do we have to do to overcome these challenges? First, we have to select the optimal antigen. So knowing very well the biology of cancer and the tumor-associated antigens can really select a subgroup of epitopes that are specifically overexpressed in cancer cells. And so we need to design bispecifics according to the tumor type. Second, optimize the antibody format. So there are numerous bispecific antibody formats. We can consider the dual variable domain immunoglobulin, we specified this in our paper. The single chain variable fragments, so FC variable fragments, and the diabodies that can enhance both binding affinity and stability. And finally, the last point, combination therapies. Because bispecific antibodies targeting immune checkpoint, we have many targeting PD-1 or PD-L1 or CTLA-4, combined eventually with other immune checkpoint inhibitors. And so you may have more immunostimulating effect. Dr. Hope Rugo: This is a fascinating field and it is certainly going to go far in the treatment of solid tumors. You know, I think there is some competition with what we have now for antibody-drug conjugates. Do you see that bispecifics will eventually become bispecific ADCs? Are we going to combine these bispecific antibodies with ADCs, with chemotherapy? What is the best combination strategy do you think looking forward? Dr. Giuseppe Curigliano: So, yes, we have a bispecific ADC. We have actually some bispecifics that are conjugated with a payload of chemotherapy. Some others are conjugated with immunoactivation agents like IL-2. One of the most effective strategies for enhancing bispecific activity is the combination therapy. So which type of combination can we do? First, bispecific antibodies plus checkpoint inhibitors. If you combine a bispecific with an immune checkpoint, like anti-PD-1, anti-PD-L1, or anti-CTLA-4, you have more activity because you have activation of T-cells, reduction of immunosuppressive effect, and of course, the capability of this bispecific to potentiate the activity of the immune checkpoint inhibitor. So, in my opinion, in a non-small cell lung cancer with an expression of PD-L1 more than 50%, if you give pembrolizumab plus a bispecific targeting PD-L1, you can really improve both response rate and median progression-free survival.  Another combination is chemotherapy plus bispecific antibodies. Combining chemotherapy with bispecific can enhance the cytotoxic effect because chemotherapy induces immunogenic cell death, and then you boost with a bispecific in order to activate the immune system. Bispecific and CAR T-cells, until now, we believe that these are in competition, but this is not correct. Because CAR T-cells are designed to deliver an activation of the immune system with the same lymphocytes engineered of the patients, with a long-term effect. So I really do not believe that bispecifics are in competition with CAR T-cells because when you have a complete remission induced by CAR T-cell, the effect of this complete remission can last for years. The activity of a bispecific is a little bit different. So there are some studies actually combining CAR T-cells with bispecifics. For example, bispecific antibodies can direct CAR T-cells in the tumor microenvironment, improving their specificity and enhancing their therapeutic effect.  And finally, monoclonal antibody plus bispecific is another next generation activity. Because if you use bispecific antibodies in combination with existing monoclonal antibodies like anti-HER2, you can potentially increase the immune response and enhance tumor cell targeting. In hematological malignancies, this has been already demonstrated and this approach has been particularly effective. Dr. Hope Rugo: That's just so fascinating, the whole idea that we have these monoclonal antibodies and now we are going to add them to bispecifics that we could maybe attach on different toxins to try and improve this, or even give them with different approaches. I suppose giving an ADC with a bispecific would sort of be similar to that idea of giving a monoclonal antibody with the bispecific. So it is certainly intriguing. We also will need to understand the toxicity and cost overall and how we are going to use these, the duration of treatment, the assessment of biomarkers. There are just so many different aspects that still need to be explored.  And then with that idea, can you look ahead five or ten years from now, and tell us how you think bispecific antibodies will shape our next generation cancer therapies, how they will be incorporated into precision oncology, and the new combinations and approaches as we move forward that will help us tailor treatment for patients both with solid tumors and hematologic malignancies? Are we going to be giving these in early-stage disease in solid tumors? So far, the studies are primarily focusing on the metastatic setting, but obviously one of the goals when we have successful treatments is to move them into the early stage setting as quickly as possible. Dr. Giuseppe Curigliano: Let us try to look ahead five years rather than ten years, to be more realistic. So, personally I believe some bispecifics can potentially replace current approaches in specifically T-cell selected population. As we gather more data from ongoing clinical trials and we adopt a deeper understanding of the tumor immuno microenvironment, of course we may have potentially new achievement. A few days ago, we heard that bispecifics in triple negative breast cancer targeting VEGF and PD-L1 demonstrated an improvement in median progression-free survival.  So, how to improve and to impact on clinical practice both in the metastatic and in the early breast cancer setting or solid tumor setting? First, personalized antigen selection. So we need to have the ability to tailor bispecific antibody therapy to the unique tumor profile of individual patients. So the more we understand the biology of cancers, the more we will be able to better target. Second, bispecific antibodies should be combined. I can see in the future a potential trial in which you combine a bispecific anti-PD-L1 and VEGF with immune checkpoint inhibitor selected also to the level of expression of PD-L1, because integration of antibody bispecific with a range of immunotherapies, and this cannot be only immune checkpoint inhibitors, but can be CAR T-cells, oncolytic viruses, also targeted therapy, will likely be a dominant theme in the coming years. This combination will be based on the specific molecular and immuno feature of the cancer of the patient.  Then we need an enhanced delivery system. This is really important because you know now we have a next generation antibody. An example are the bicyclic. So you use FC fragment that are very short, with a low molecular weight, and this short fragment can be bispecific, so can target at the same time a target antigen and improving the immune system. And so the development of this novel delivery system, including also nanoparticles or engineered viral vectors, can enhance the penetration in the tumor bed and the bioavailability of bispecific antibodies. Importantly, we need to reduce toxicity. Until now, bispecifics are very toxic. So the more we are efficient in delivering in the tumor bed, the more we will reduce the risk of toxicity. So it will be mandatory to reduce off-target effects and to minimize toxicity.  And finally, the expansion in new indication. So I really believe you raised an excellent point. We need to design studies in the neoadjuvant setting in order to better understand with multiple biopsies which is the effect on the tumor microenvironment and the tumor itself, and to generate hypotheses for potential trials or in the neoadjuvant setting or in those patients with residual disease.  So, in my opinion, as we refine design, optimize patient selection, and explore new combination, in the future we will have more opportunity to integrate bispecifics in the standard of care. Dr. Hope Rugo: I think it is particularly helpful to hear what we are going to be looking for as we move forward to try and improve efficacy and reduce toxicity. And the ability to engineer these new antibodies and to more specifically target the right proteins and immune effectors is going to be critical, of course, moving forward, as well as individualizing therapy based on a specific tumor biology.  Hearing your insights has been great, and it really has opened up a whole area of insight into the field of bispecifics, together with your excellent contribution to the ASCO Educational Book. Thank you so much for sharing your thoughts and background, as well as what we might see in the future on this podcast today. Dr. Giuseppe Curigliano: Thank you very much for the invitation and for this excellent interview. Dr. Hope Rugo: And thanks to our listeners for joining us today. You will find a link to the Ed Book article we discussed today in the transcript of this episode. It is also, of course, on the ASCO website, as well as on PubMed. Please join us again next month on By the Book for more insightful views on the key issues and innovations that are shaping modern oncology. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Follow today's speakers:       Dr. Hope Rugo  @hope.rugo  Dr. Giuseppe Curigliano @curijoey Follow ASCO on social media:       @ASCO on X (formerly Twitter)       ASCO on Bluesky      ASCO on Facebook       ASCO on LinkedIn       Disclosures:      Dr. Hope Rugo:   Honoraria: Mylan/Viatris, Chugai Pharma  Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer  Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx  Dr. Giuseppe Curigliano: Leadership: European Society for Medical Oncology, European Society of Breast Cancer Specialists, ESMO Open, European Society for Medical Oncology Honoraria: Ellipses Pharma Consulting or Advisory Role: Roche/Genentech, Pfizer, Novartis, Lilly, Foundation Medicine, Bristol-Myers Squibb, Samsung, AstraZeneca, Daiichi-Sankyo, Boerigher, GSK, Seattle Genetics, Guardant Health, Veracyte, Celcuity, Hengrui Therapeutics, Menarini, Merck, Exact Sciences, Blueprint Medicines, Gilead Sciences Speakers' Bureau: Roche/Genentech, Novartis, Pfizer, Lilly, Foundation Medicine, Samsung, Daiichi Sankyo, Seagen, Menarini, Gilead Sciences, Exact Sciences Research Funding: Merck Travel, Accommodations, Expenses: Roche/Genentech, Pfizer, Daiichi Sankyo, AstraZeneca      

Can sharing personal stories at work really boost your well-being and productivity? In my latest solo episode, I explore the fascinating dynamics of self-disclosure in the workplace, drawing insights from recent research. Discover how sharing positive experiences can elevate emotional well-being, enhance work energy, and foster deeper connections with colleagues, while venting about negative experiences might have the opposite effect.We also examine the motivations behind why we share, including connecting, venting, or seeking advice, and how they impact our well-being. To close, we consider the intriguing interplay of mismatched intentions, where what we are looking for is not returned and how Craig also unpacks the intriguing concept of response mismatches, where the intention to connect can be misaligned and strategies we can use, as both a sharer and listener, to avoid this unfortunate outcome.Tune in as explore an issue that we all face and learn evidence-based practices that can deepen the quality of our communication and connection.What You'll Learn- How sharing positive experiences can boost your energy and strengthen connections with colleagues- The potential downsides of venting- The crucial role of intentions in self-disclosure; why we share impacts what we receive in return- The role of intention in improving the quality of our conversations- How to avoid misalignment between our intentions and our impactKEYWORDSPositive Leadership, Group Dynamics, Positive Communication, Self-Disclosure, Emotional Well-being, Mental Health, Managing Professional Relationships, Lead with Intention, High-Quality Conversations, Team Success, The Power of Vulnerability, Emotional Regulation, Support, CEO SuccessRESOURCESDo you have a minute? The cognitive and emotional consequences of self-disclosures at work - PubMed: https://pubmed.ncbi.nlm.nih.gov/40424152/

“It's 5pm and your Consultant (attending) has headed off home. A patient arrives in the resuscitation room blood spurting from a stab wound in the armpit. Join Roisin – a junior Major Trauma fellow, Prash – a surgical trainee, Max – a senior trauma surgery fellow, and Chris – a Consultant trauma surgeon, as we talk through decision making from point of injury to aftercare in this challenging trauma surgical case”. • Hosts: Bulleted list of host names, including title, institution, & social media handles if indicated 1.     Mr Prashanth Ramaraj. General Surgery trainee, Edinburgh rotation. @LonTraumaSchool 2.     Dr Roisin Kelly. Major Trauma Junior Clinical Fellow, Royal London Hospital.  3.     Mr Max Marsden. Resuscitative Major Trauma Fellow, Royal London Hospital. @maxmarsden83 4.     Mr Christopher Aylwin. Consultant Trauma & Vascular Surgeon and Co-Programme Director MSc Trauma Sciences at Queen Mary University of London. @cjaylwin • Learning objectives: Bulleted list of learning objectives. A)    To become familiar with prehospital methods of haemorrhage control in penetrating junctional injuries. B)     To recognise the benefits of prehospital blood product resuscitation in some trauma patients. C)     To follow the nuanced decision making in decision for CT scan in a patient with a penetrating junctional injury. D)    To describe the possible approaches to the axillary artery in the context of resuscitative trauma surgery. E)     To become familiar with decision making around intraoperative systemic anticoagulation in the trauma patient. F)     To become familiar with decision making on type of repair and graft material in vascular trauma. G)    To recognise the team approach in holistic trauma care through the continuum of trauma care. • References: Bulleted list of references with PubMed links. 1.    Perkins Z. et al., 2012. Epidemiology and Outcome of Vascular Trauma at a British Major Trauma Centre. EJVES. https://www.ejves.com/article/S1078-5884(12)00337-1/fulltext 2.    Ramaraj P., et al. 2025. The anatomical distribution of penetrating junctional injuries and their resource implications: A retrospective cohort study. Injury. https://www.injuryjournal.com/article/S0020-1383(24)00771-X/ 3.    Smith, S., et al. 2019. The effectiveness of junctional tourniquets: A systematic review and meta-analysis. J Trauma Acute Care Surg. https://journals.lww.com/jtrauma/abstract/2019/03000/the_effectiveness_of_junctional_tourniquets__a.20.aspx 4.    Rijnhout TWH, et al. 2019. Is prehospital blood transfusion effective and safe in haemorrhagic trauma patients? A systematic review and meta-analysis. Injury. https://www.injuryjournal.com/article/S0020-1383(19)30133-0/ 5.    Davenport R, et al. 2023. Prehospital blood transfusion: Can we agree on a standardised approach? Injury. https://www.injuryjournal.com/article/S0020-1383(22)00915-9. 6.    Borgman MA., et al. 2007. The Ratio of Blood Products Transfused Affects Mortality in Patients Receiving Massive Transfusions at a Combat Support Hospital. J Trauma Acute Care Surg. https://journals.lww.com/jtrauma/fulltext/2007/10000/the_ratio_of_blood_products_transfused_affects.13.aspx 7.    Holcomb JB., et al. 2013. The Prospective, Observational, Multicenter, Major Trauma Transfusion (PROMMTT) Study. Comparative Effectiveness of a Time-Varying Treatment With Competing Risks. JAMA Surgery. https://jamanetwork.com/journals/jamasurgery/fullarticle/1379768 8.    Holcomb JB, et al. 2015. Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 vs a 1:1:2 Ratio and Mortality in Patients With Severe Trauma. The PROPPR Randomized Clinical Trial. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2107789 9.    Davenport R., et al. 2023. Early and Empirical High-Dose Cryoprecipitate for Hemorrhage After Traumatic Injury. The CRYOSTAT-2 Randomized Clinical Trial. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2810756 10.   Baksaas-Aasen K., et al. 2020. Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): a randomized, controlled trial. ICM. https://link.springer.com/article/10.1007/s00134-020-06266-1 11. Wahlgren CM., et al. 2025. European Society for Vascular Surgery (ESVS) 2025 Clinical Practice Guidelines on the Management of Vascular Trauma. EJVES. https://esvs.org/wp-content/uploads/2025/01/2025-Vascular-Trauma-Guidelines.pdf 12. Khan S., et al. 2020. A meta-analysis on anticoagulation after vascular trauma. Eur J Traum Emerg Surg. https://link.springer.com/article/10.1007/s00068-020-01321-4 13. Stonko DP., et al. 2022. Postoperative antiplatelet and/or anticoagulation use does not impact complication or reintervention rates after vein repair of arterial injury: A PROOVIT study. Vascular. https://journals.sagepub.com/doi/10.1177/17085381221082371?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed 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/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate 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-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Friday, September 26, 2025. Week 39.   In this episode of Syngap10, we continue the conversation from Episode 183, sharing the latest milestones and moments with our SYNGAP1 community.   DSC has announced! DSC (part of RDCRN, part of NCATS, part of NIH) also announced and continues to raise profile of SYNGAP1 Related Disorders (SRD) Key post https://www.linkedin.com/posts/curesyngap1_86-million-nih-grant-renews-support-for-activity-7373870761230589952-aV1M #RDCRN List with #DSC https://ncats.nih.gov/research/research-activities/rdcrn/consortia   In addition to that, the DSC was formally announced, and will result in five years of SYNGAP1 securing a spot on the map.  This was because of an SRF grant years ago!  Grant https://curesyngap1.org/blog/syngap-research-fund-announces-308-000-multidisciplinary-biomarker-grant-to-boston-childrens-hospital/   Pubmed is at 44! (+2 v ‘23, -10 v ‘24, 2nd place) https://pubmed.ncbi.nlm.nih.gov/?term=syngap1&filter=years.2025-2025&timeline=expanded&sort=date&sort_order=asc   Cell Paper on AAV in Mice: https://www.linkedin.com/posts/boaz-levi-07387741_aav-delivery-of-full-length-syngap1-rescues-activity-7376306391537532928-iT9u    Last week was a CB Conf in Nashville, attended by KAH and VA, thank you to both.  KAH in Staff yesterday, the hardest thing is not seeing Joey.  ☹️  Thanks to MS for going too. MS https://www.linkedin.com/posts/melissasmith1_raredisease-patientadvocacy-syngap1-activity-7374408667091333120-Udp0/ KAH https://www.linkedin.com/posts/kathryn-syngap-research-fund_the-combinedbrain-conference-in-nashville-activity-7374639535021928448-gWB4    Two big upcoming events: Scramble in SC on October 4th https://www.linkedin.com/posts/julie-miles-4294322ba_scramble-for-syngap-activity-7370558331611971585-iw0A    CURE SYNGAP1 Conference 2025 in Atlanta https://curesyngap1.org/events/conferences/cure-syngap1-conference-2025-hosted-by-srf/   SOCIAL MATTERS - 4,371 LinkedIn.  https://www.linkedin.com/company/curesyngap1/  - 1,440 YouTube.  https://www.youtube.com/@CureSYNGAP1    - 11,292 Twitter https://twitter.com/cureSYNGAP1  - 45k Insta https://www.instagram.com/curesyngap1/    COMPANIES WITH NAMED ASSETS FOR SYNGAP1 $CAMP $3.00 at close on 9/23   Episode 184 of #Syngap10 #CureSYNGAP1 #Advocate #PatientAdvocacy #UnmetNeed #SYNGAP1 #SynGAP #SynGAProMMiS

Friday, September 26, 2025. Week 39.   DSC has announced! DSC (part of RDCRN, part of NCATS, part of NIH) also announced and continues to raise profile of SYNGAP1 Related Disorders (SRD) Key post https://www.linkedin.com/posts/curesyngap1_86-million-nih-grant-renews-support-for-activity-7373870761230589952-aV1M #RDCRN List with #DSC https://ncats.nih.gov/research/research-activities/rdcrn/consortia   In addition to that, the DSC was formally announced, and will result in five years of SYNGAP1 securing a spot on the map.  This was because of an SRF grant years ago!  Grant https://curesyngap1.org/blog/syngap-research-fund-announces-308-000-multidisciplinary-biomarker-grant-to-boston-childrens-hospital/   Pubmed is at 44! (+2 v ‘23, -10 v ‘24, 2nd place) https://pubmed.ncbi.nlm.nih.gov/?term=syngap1&filter=years.2025-2025&timeline=expanded&sort=date&sort_order=asc   Cell Paper on AAV in Mice: https://www.linkedin.com/posts/boaz-levi-07387741_aav-delivery-of-full-length-syngap1-rescues-activity-7376306391537532928-iT9u   Last week was a CB Conf in Nashville, attended by KAH and VA, thank you to both.  KAH in Staff yesterday, the hardest thing is not seeing Joey.  ☹️  Thanks to MS for going too. MS https://www.linkedin.com/posts/melissasmith1_raredisease-patientadvocacy-syngap1-activity-7374408667091333120-Udp0/ KAH https://www.linkedin.com/posts/kathryn-syngap-research-fund_the-combinedbrain-conference-in-nashville-activity-7374639535021928448-gWB4   Two big upcoming events: Scramble in SC on October 4th https://www.linkedin.com/posts/julie-miles-4294322ba_scramble-for-syngap-activity-7370558331611971585-iw0A   CURE SYNGAP1 Conference 2025 in Atlanta https://curesyngap1.org/events/conferences/cure-syngap1-conference-2025-hosted-by-srf/   SOCIAL MATTERS - 4,371 LinkedIn.  https://www.linkedin.com/company/curesyngap1/ - 1,440 YouTube.  https://www.youtube.com/@CureSYNGAP1 - 11,292 Twitter https://twitter.com/cureSYNGAP1 - 45k Insta https://www.instagram.com/curesyngap1/   COMPANIES WITH NAMED ASSETS FOR SYNGAP1 $CAMP $3.00 at close on 9/23   Episode 184 of #Syngap10 #CureSYNGAP1 #Advocate #PatientAdvocacy #UnmetNeed #SYNGAP1 #SynGAP #SynGAProMMiS

Nodari Rizun joins me to talk about Shilajit resin, which has been trending in the supplement space in recent years. The use of Shilajit for health purposes has been around for centuries. Nodari shares what Shilajit resin does in the human body, why it may or may not be something useful for you, and why it is just now becoming mainstream in the supplement area.Nodari stresses the importance of quality and innovation in the products we consume, not just supplements but all foods. He also explains why it can be easy to get caught up in too many bio-hacking ideas instead of focusing on the ones that actually work for us.Nodari Rizun is the founder of Pürblack, a civil rights attorney, and a published researcher with articles on PubMed.Research Shilajit resin and other Pürblack products at www.purblack.com and follow on Instagram @purblackofficial Visit ConfidenceThroughHealth.com to find discounts to some of our favorite products.Follow me via All In Health and Wellness on Facebook or Instagram.Find my books on Amazon: No More Sugar Coating: Finding Your Happiness in a Crowded World and Confidence Through Health: Live the Healthy Lifestyle God DesignedProduction credit: Social Media Cowboys

Stress isn't just something to “manage” — it's a signal, a teacher, and often, an invitation to look deeper at our health, our choices, and our lives. In this solo episode, Darin reframes stress not as an enemy, but as a dashboard light pointing toward misalignments in our nervous system, environment, relationships, and purpose. Drawing on science, practical tools, and personal insight, Darin reveals how layered stress silently drains our vitality — and how to transform it into an ally for growth, healing, and deeper contentment. Whether it's hidden trauma, toxic environments, unresolved conflict, or the modern distractions constantly pulling at our attention, Darin lays out a roadmap to stop the leaks and reclaim the energy already within you. This episode is a powerful reminder: stress isn't the end of the story — it's the beginning of awareness, safety, and a super life.     What You'll Learn in This Episode [00:00] Introduction to the Super Life podcast [03:27] Why stress might not be your enemy [04:17] Stress as an ally: the signals it gives us about misalignment [04:32] The dashboard light metaphor: how stress reveals hidden issues [05:28] The illusion of “no choice” and the infinite possibilities always available [06:12] Global stress statistics and why most people underestimate their stress load [07:23] Hidden stress revealed through heart rate variability and physiology [08:23] Layered stress: how sleep, exercise, and poor choices compound each other [09:25] Safety vs. calm — why your nervous system craves safety first [10:15] Trauma and the unconscious mind: how old wounds drive our stress response [11:54] Inner narratives and negative self-talk as hidden stress multipliers [12:22] The role of community and your social field in stress and resilience [13:53] Relationships, honesty, and how your circle shapes your energy [14:55] Why boundaries around media and politics are vital for mental clarity [17:42] Finding micro-purpose when life feels overwhelming [18:52] Environmental layers of stress — light, air, and clutter [19:15] The existential layer: stress from living without service or purpose [20:12] Stress as a risk amplifier — how it undermines healing and health [20:55] The deeper truth of safety, connection, and higher power [23:00] Practical tools: breathing, grounding, nature, and conscious choices [24:01] Trauma reframed: not a problem, but a protector at the time [25:25] Lessons from Peter Levine and wild animals: releasing trauma physically [26:04] Questions to ask trauma: “What are you protecting me from?” [26:56] Stress as a multiplier of aging, disease, and poor outcomes [29:20] Why stress isn't a single cause — it's layered and chronic [30:18] Anti-stress strategies: circadian rhythm, nature, and gratitude [31:49] Energy leaks to avoid: clutter, poor food, scrolling, bad boundaries [32:22] What matters most: service, contribution, and alignment [33:28] Final toolkit: breathwork, movement, nature, sleep, and gratitude [34:38] The deeper invitation: step into sovereignty and live your SuperLife     Thank You to Our Sponsors: Manna Vitality: Go to mannavitality.com/  or use code DARIN20 for 20% off your order. Bite Toothpaste: Go to trybite.com/DARIN20 or use code DARIN20 for 20% off your first order.     Find More from Darin Olien: Instagram: @darinolien Podcast: SuperLife Podcast Website: superlife.com Book: Fatal Conveniences Check out my podcast with Dr. Amy Abbington     Key Takeaway “Stress is not the enemy. It's a dashboard light — a teacher showing you where you're out of alignment. When you reframe stress, you reclaim your energy and create space for healing, safety, and the joy of living a super life.”     Bibliography (selected, peer-reviewed) Sources: Gallup Global Emotions (2024); Gallup U.S. polling (2024); APA Stress in America (2023); Natarajan et al., Lancet Digital Health (2020); Orini et al., UK Biobank (2023); Martinez et al. (2022); Leiden University (2025). Cohen S, Tyrrell DA, Smith AP. Psychological stress and susceptibility to the common cold. N Engl J Med.1991;325(9):606–612. New England Journal of Medicine Cohen S, et al. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proc Natl Acad Sci USA. 2012;109(16):5995–5999. PNAS Kiecolt-Glaser JK, et al. Slowing of wound healing by psychological stress. Lancet. 1995;346(8984):1194–1196. The Lancet Kiecolt-Glaser JK, et al. Hostile marital interactions, proinflammatory cytokine production, and wound healing.Arch Gen Psychiatry. 2005;62(12):1377–1384. JAMA Network Tawakol A, et al. Relation between resting amygdalar activity and cardiovascular events. Lancet.2017;389(10071):834–845. The Lancet Epel ES, et al. Accelerated telomere shortening in response to life stress. Proc Natl Acad Sci USA.2004;101(49):17312–17315. PNAS McEwen BS, Stellar E. Stress and the individual: mechanisms leading to disease. Arch Intern Med.1993;153(18):2093–2101. PubMed McEwen BS, Wingfield JC. Allostasis and allostatic load. Ann N Y Acad Sci. 1998;840:33–44. PubMed Felitti VJ, et al. Relationship of childhood abuse and household dysfunction to many leading causes of death in adults (ACE Study). Am J Prev Med. 1998;14(4):245–258. AJP Mon Online Edmondson D, et al. PTSD and cardiovascular disease. Ann Behav Med. 2017;51(3):316–327. PMC Afari N, et al. Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis.Psychosom Med. 2014;76(1):2–11. PMC Goyal M, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357–368. PMC Qiu Q, et al. Forest therapy: effects on blood pressure and salivary cortisol—a meta-analysis. Int J Environ Res Public Health. 2022;20(1):458. PMC Laukkanen T, et al. Sauna bathing and reduced fatal CVD and all-cause mortality. JAMA Intern Med.2015;175(4):542–548. JAMA Network Zureigat H, et al. Physical activity lowers CVD risk by reducing stress-related neural activity. J Am Coll Cardiol.2024;83(16):1532–1546. PMC Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med.2010;7(7):e1000316. PMC Chen Y-R, Hung K-W. EMDR for PTSD: meta-analysis of RCTs. PLoS One. 2014;9(8):e103676. PLOS Hoppen TH, et al. Network/pairwise meta-analysis of PTSD psychotherapies—TF-CBT highest efficacy overall.Psychol Med. 2023;53(14):6360–6374. PubMed van der Kolk BA, et al. Yoga as an adjunctive treatment for PTSD: RCT. J Clin Psychiatry. 2014;75(6):e559–e565. PubMed Kelly U, et al. Trauma-center trauma-sensitive yoga vs CPT in women veterans: RCT. JAMA Netw Open.2023;6(11):e2342214. JAMA Network Bentley TGK, et al. Breathing practices for stress and anxiety reduction: components that matter. Behav Sci (Basel). 2023;13(9):756. 

Can you really trust the science behind fitness and wellness? On this episode of the “NASM-CPT Podcast,” host, and NASM Master Instructor, Rick Richey, dives deep into the world of peer reviewed scientific research—unpacking what it is, how it's done, and why it matters for anyone serious about health, fitness, and personal training. Is all research created equal? Are randomized controlled trials really the “gold standard”? And just who are these so-called “peers” deciding what gets published and what doesn't? Rick takes you behind the scenes of the research process: from journals and methodology to the rigorous checks that keep scientists honest. He even shares a personal story about making a mistake in his own dissertation—revealing how errors get caught, what happens next, and why transparency is essential. Wondering if you can trust resources like PubMed, or curious if your favorite strength & conditioning principles are truly evidence-based? This episode delivers clear, honest answers. Perfect for trainers, fitness enthusiasts, and anyone who's ever wondered if they should believe the latest “groundbreaking” study, this conversation arms you with the tools to spot reliable science, identify real experts, and see through the flashy fads on social media. Hit play to discover if peer reviewed research really deserves your trust—and why critical thinking is your best fitness companion. Subscribe, rate, and share for more science-backed insight from the front lines of exercise science! If you like what you just consumed, leave us a 5-star review, and share this episode with a friend to help grow our NASM health and wellness community! The content shared in this podcast is solely for educational and entertainment purposes. It is not intended to be a substitute for professional advice, diagnosis, or treatment. Always seek out the guidance of your healthcare provider or other qualified professional. Any opinions expressed by guests and hosts are their own and do not necessarily reflect the views of NASM. Introducing NASM One, the membership for trainers and coaches. For just $35/mo., get unlimited access to over 300 continuing education courses, 50% off additional certifications and specializations, EDGE Trainer Pro all-in-one coaching app to grow your business, unlimited exam attempts and select waived fees. Stay on top of your game and ahead of the curve as a fitness professional with NASM One. Click here to learn more. ttps://bit.ly/4ddsgrm

In this episode of the RWS Clinician's Corner, Margaret Floyd Barry takes us behind the scenes into the dynamic world of research and curriculum development in the functional health space. Margaret sits down with two of Restorative Wellness Solutions' powerhouse instructors, Ellen Lovelace and Paige Reagan, for a candid conversation about the challenges, surprises, and daily realities of translating emerging science into practical, safe, and effective tools for clinicians.   In this interview, we discuss:     -Specific ways that Ellen & Paige demonstrate curriculum leadership and research support for RWS   -How to respond to new studies or challenges to existing curriculum    -How to decide which sources to trust   -How to evaluate clinical research (red & green flags)   -Addressing research limitations and gaps    -Using research tools and AI in gathering evidence   The Clinician's Corner is brought to you by Restorative Wellness Solutions.  Follow us: https://www.instagram.com/restorativewellnesssolutions/    Connect with Ellen:  Website: www.abalancedtable.net Facebook: www.facebook.com/abalancedtable Instagram: www.instagram.com/abalancedtable   Connect with Paige: Website: www.naturallynourishedwellness.com Instagram: www.instagram.com/paigereaganntp   Timestamps: 00:00 From Russian Studies to Health Advocacy 07:56 Curriculum Accuracy and Depth Focus 12:57 Using AI for Study Validation 19:20 Evaluating Research Article Credibility 25:24 Animal Study Relevance and Limitations 28:03 "Pediatric Research Gaps in Drug Trials" 33:55 "Teaching Deepens Understanding" 41:17 Questioning AI for Balanced Answers 44:47 Effective Research Strategies and AI Limitations 52:04 Verify Before Believing Headlines 55:52 "Unpaywall: Access Free Academic Papers" 01:00:33 "The Clinician's Corner Podcast" Speaker bios: Ellen Lovelace, Lead Instructor & Curriculum Development Master RHP, MPH, FNTP, Board Certified in Holistic Nutrition® Ellen (she/her) has been actively working to educate and improve the public's health for almost 20 years. Ellen received her Masters in Public Health from The George Washington University, and went on to run everything from tuberculosis prevention programs in Russia to dental health education programs along the Texas/Mexico border. She was also the founding Executive Director of the women's health program at Stanford University. When Ellen became drawn to a more holistic model, she received her certifications as a Nutritional Therapy Consultant and a Master Restorative Health Practitioner. She is the owner of A Balanced Table Nutritional Therapy in San Jose, CA, her private functional nutrition practice. Ellen focuses on cutting through the confusion and nutrition “noise,” digging to the roots of clients' dysfunction, and figuring out the best way for them to eat, drink, and thrive. She uses the IRH functional analysis tools daily, and is excited to share her passion for these methods. Ellen believes that only by focusing on root causes, combined with whole foods nutrition, can true wellness be achieved. Ellen is also a passionate animal lover who volunteers at a wildlife rescue facility, and can often be found smelling of skunk while covered in Mastiff drool.    Paige Reagan, Instructor and Research Master RHP, FNTP Paige has spent most of her career working in Research and Development in the areas of clinical research, regulatory affairs, and medical writing. She has a wide range of experience in the therapeutic areas of cardiovascular health, pulmonary arterial hypertension, diabetes, bone health, osteoarthritis/rheumatoid arthritis, and urology, among others. Her work has contributed to numerous regulatory approvals as well as publications in major medical journals such as the New England Journal of Medicine, Lancet, Circulation, and American Heart Journal. Paige has since earned certifications as a Functional Nutritional Therapy Practitioner and Master Restorative Health Practitioner. She is owner of Naturally Nourished Wellness, a small practice specializing in gut health and the downstream effects of poor digestion. She strives to find balance between the holistic and mainstream approaches and aims to provide her clients with the best of both worlds, using her critical thinking skills from years in research combined with objective laboratory testing and her passion for the restorative power of whole foods and simple lifestyles. She spends her free time exploring the outdoors with her family, swinging kettlebells, and creating baked goods with healthier ingredients.   Keywords: functional nutrition, public health, research process, curriculum development, clinical research, regulatory affairs, medical writing, gastrointestinal healing, lab testing, food sensitivities, evidence-based practice, study design, randomized controlled trials, observational studies, animal studies, peer review, PubMed, Google Scholar, AI tools in research, ChatGPT, consensus, study citations, clinical anecdote, sample size, funding bias, meta-analysis, systematic reviews, biostatistics, clinical protocols, dietary supplements   Disclaimer: The views expressed in the RWS Clinician's Corner series are those of the individual speakers and interviewees, and do not necessarily reflect the views of Restorative Wellness Solutions, LLC. Restorative Wellness Solutions, LLC does not specifically endorse or approve of any of the information or opinions expressed in the RWS Clinician's Corner series. The information and opinions expressed in the RWS Clinician's Corner series are for educational purposes only and should not be construed as medical advice. If you have any medical concerns, please consult with a qualified healthcare professional. Restorative Wellness Solutions, LLC is not liable for any damages or injuries that may result from the use of the information or opinions expressed in the RWS Clinician's Corner series. By viewing or listening to this information, you agree to hold Restorative Wellness Solutions, LLC harmless from any and all claims, demands, and causes of action arising out of or in connection with your participation. Thank you for your understanding.  

Neuropathyct.com1) Symptoms usually creep forward More numbness, burning, pins-and-needles, and sensitivity changes over time. (NINDS)2) Sleep gets hammered Neuropathic pain commonly disrupts sleep, which then worsens pain perception the next day. (ScienceDirect, PMC)3) Balance confidence drops; fall risk rises Loss of sensation and vibration sense increases falls and near-falls—especially in older adults. (PMC, PubMed, Frontiers)4) Foot problems can snowball (especially with diabetes) Delayed care → unnoticed injuries/ulcers → infection → higher chance of amputation if things progress. (NCBI, PMC)5) Daily function and quality of life shrink People report limits in walking, standing, hobbies, and overall well-being. Mood and anxiety often worsen. (Nature, PMC)6) Heavier reliance on pain meds without addressing nerve function Drugs like gabapentin/pregabalin/duloxetine may help pain for some, but results vary and they don't restore nerve function. (Patients should never change meds without their prescriber.) (ScienceDirect, Mayo Clinic Proceedings, PMC)7) Hidden injuries are easier to miss Reduced sensation means burns, cuts, or shoe-related wounds can go unnoticed and worsen. (This podcast welcomes your feedback here are several ways to reach out to me. If you have a topic you would like to hear about send me a message. I appreciate your listening. Dr. Brian Mc Kayhttps://twitter.com/DarienChiro/https://www.facebook.com/ChiropractorBrianMckayhttps://chiropractor-darien-dr-brian-mckay.business.sitehttps://podcasts.apple.com/us/podcast/not-just-chiropractor-for-stamford-darien-norwalk-new/id1503674397?uo=4Core Health Darien-Dr.Brian Mc Kay 551 Post RoadDarien CT 06820203-656-363641.0833695 -73.46652073GMP+87 Darien, Connecticuthttps://youtu.be/WpA__dDF0O041.0834196 -73.46423349999999https://darienchiropractor.comhttps://darienchiropractor.com/darien/darien-ct-understanding-pain/Find us on Social Mediahttps://chiropractor-darien-dr-brian-mckay.business.site https://www.youtube.com/channel/UCNHc0Hn85Iiet56oGUpX8rwhttps://docs.google.com/spreadsheets/d/1nJ9wlvg2Tne8257paDkkIBEyIz-oZZYy/edit#gid=517721981https://goo.gl/maps/js6hGWvcwHKBGCZ88https://www.youtube.com/my_videos?o=Uhttps://www.linkedin.com/in/darienchiropractorhttps://www.facebook.com/ChiropractorBrianMckayhttps://sites.google.com/view/corehealthdarien/https://sites.google.com/view/corehealthdarien/home

Sunday, September 7, 2025. Week 37. Why does CURE SYNGAP1 aka SRF matter?  Do PAGS make a difference? Heck yes. Empower Families - Support.  Educate.  Activate.  Coordinate. Use Money Catalytically - Tax advantage.  Pool.  Manage.  Make Catalytic.  Focus.  Manage. Partner with Science & Medicine - Push forward.  Connect efforts.  Focus on Tx.  Work in Clinic. Leverage Ecosystem.  Industry.  PAGs.  Superpags (CB, GG, ELF). Ensure Continuity.  Our kids will outlast us.  Our energy wanes.  Life happens.  Cure SYNGAP1 never stops focusing on the biggest challenge in our lives: SRD. Because you VOLUNTEER  Join us: https://curesyngap1.org/volunteer-with-srf/    Gala video: Look at those faces.https://www.youtube.com/watch?v=d6dCSBq27Gc   Friday: Beacon of Hope September 12, 2025 - Boston, MA cureSYNGAP1.org/Beacon25   Scramble for SYNGAP October 4, 2025 - Greer, SC cureSYNGAP1.org/Scramble

Are You Using the Wrong Sized Cuff?Welcome to the Hypertension Resistant to Treatment Podcast, the #1 Hypertension Podcast in the world, with listeners from more than 152 countries who depend on our content. We are your primary resource for obtaining straightforward, practical, evidence-based information about high blood pressure management, regardless of your situation as a patient, healthcare provider, or family member. High blood pressure isn't always simple. The condition known as resistant hypertension affects many people who have high blood pressure that does not respond to medication or lifestyle changes. The medical field identifies treatment-resistant hypertension as a demanding yet vital medical condition that doctors encounter in their practice. The Hypertension Resistant to Treatment Podcast, website, and YouTube channel highlight the most challenging cases because these individuals have attempted multiple solutions without achieving any resolution. This podcast is here for them, but also for anyone touched by high blood pressure. Whether you're just starting your journey with prehypertension, you're living with long-standing hypertension, or you're a provider searching for better strategies to help your patients.The right place exists for those seeking answers, motivation, and success tools. The podcast Hypertension Resistant to Treatment presents blood pressure information in an easy-to-understand format that helps people control their condition. The Hypertension Resistant to Treatment podcast is hosted by Dr. Tonya Breaux-Shropshire, PhD, DNP, MPH, FNP-BC. Pubmed, Research Gate, UAB Alumni, and Research SymposiumFree Blood Pressure Log App without adsBest Blood Pressure Paper LogAHA Blood Pressure Paper LogSend us a text Support the showSupport the podcast by subscribing using this link: click here. We appreciate your support, thank you! Log your blood pressure and share with your provider (click here). Copyright Disclaimer under section 107 of the Copyright Act 1976, allowance is made for “fair use” for purposes such as criticism, comment, news reporting, teaching, scholarship, education, and research.Royalty-free music: Turn on My Swag 2 Epidemic Sound****Disclaimer: This podcast is for educational purposes only and is not medical advice. Always consult your own healthcare provider about your health. The views shared are those of the host and guests, and do not represent any other organization.”

Why Wrist Blood Pressure Monitors Could  Be Dangerous. (Watch Before You Buy!).Welcome to the Hypertension Resistant to Treatment Podcast, the #1 Hypertension Podcast in the world, with listeners from more than 152 countries who depend on our content. We are your primary resource for obtaining straightforward, practical, evidence-based information about high blood pressure management, regardless of your situation as a patient, healthcare provider, or family member. High blood pressure isn't always simple. The condition known as resistant hypertension affects many people who have high blood pressure that does not respond to medication or lifestyle changes. The medical field identifies treatment-resistant hypertension as a demanding yet vital medical condition that doctors encounter in their practice. The Hypertension Resistant to Treatment Podcast, website, and YouTube channel highlight the most challenging cases because these individuals have attempted multiple solutions without achieving any resolution. This podcast is here for them, but also for anyone touched by high blood pressure. Whether you're just starting your journey with prehypertension, you're living with long-standing hypertension, or you're a provider searching for better strategies to help your patients.The right place exists for those seeking answers, motivation, and success tools. The podcast Hypertension Resistant to Treatment presents blood pressure information in an easy-to-understand format that helps people control their condition. The Hypertension Resistant to Treatment podcast is hosted by Dr. Tonya Breaux-Shropshire, PhD, DNP, MPH, FNP-BC. Pubmed, Research Gate, UAB Alumni, and Research SymposiumFree Blood Pressure Log App without adsBest Blood Pressure Paper LogAHA Blood Pressure Paper LogSend us a text Support the showSupport the podcast by subscribing using this link: click here. We appreciate your support, thank you! Log your blood pressure and share with your provider (click here). Copyright Disclaimer under section 107 of the Copyright Act 1976, allowance is made for “fair use” for purposes such as criticism, comment, news reporting, teaching, scholarship, education, and research.Royalty-free music: Turn on My Swag 2 Epidemic Sound****Disclaimer: This podcast is for educational purposes only and is not medical advice. Always consult your own healthcare provider about your health. The views shared are those of the host and guests, and do not represent any other organization.”

Friday, August 29th, 2025. Week 35. 5th Annual Gala was a great success! cureSYNGAP1.org/Gala5 Sad to miss it?  Join us in Boston or South Carolina. Deadline for Boston is 9/3 for tickets. Beacon of Hope September 12, 2025 - Boston, MA cureSYNGAP1.org/Beacon25 Scramble for SYNGAP October 4, 2025 - Greer, SC cureSYNGAP1.org/Scramble   SRF is active in Lisbon at #IEC2025 thank you KD, JA, VA!  Hi Dr. Knowles! We are at Booth #17 https://www.linkedin.com/posts/victoria-arteaga-26913433_syngap1-familyjourney-resilience-activity-7366951726001606657-6pcM #Bexicaserin News: New data from the PACIFIC Study, LP352-202, Open Label Extension (OLE) will be presented at the 36th International Epilepsy Congress (IEC) in Lisbon, Portugal (Aug 30 - Sept 3, 2025). The full results of the open label extension (OLE) of the Phase 1b/2a PACIFIC trial investigating bexicaserin for the treatment of patients with Developmental and Epileptic Encephalopathies (DEEs), will be presented for the first time at the International Epilepsy Annual Congress   Bexicaserin, which has been granted Breakthrough Therapy designation by the FDA, demonstrated reductions in countable and total motor seizure frequency in the extension study comparable to reductions seen in the Phase 1b/2a PACIFIC trial, reinforcing durability of response and validating its progression to Phase 3 trials.   Additional data will be presented from the audiogenic seizure model and the GAERS absence epilepsy model, investigating sudden unexpected death in epilepsy (SUDEP), and seizure reduction respectively.   During the OLE, a median reduction of 59.3% in countable motor seizure frequency was observed, with 55% of participants experiencing reductions of ≥50% compared to the baseline before the PACIFIC trial.   This trial, EMERALD and other studies all at https://curesyngap1.org/resources/studies/   See and comment on Vicky's recent post on her 7 year SYNGAP1-iversary: https://www.linkedin.com/posts/victoria-arteaga-26913433_syngap1-familyjourney-resilience-activity-7366951726001606657-6pcM    Join Citizen Health, we are at 275!  We should double that. https://www.citizen.health/partners/srf   DSCIII Renewed to include SYNGAP1 alongside TSC, SHANK3 (aka PMD) and PTEN.     CFC Starts on 9/1 https://curesyngap1.org/events/fundraisers/combined-federal-campaign-2025/  

Friday, August 22nd, 2025. Week 34. The 5th Annual Gala is happening now!  https://www.linkedin.com/posts/curesyngap1_syngap1-curesyngap1-galaforsyngap1-activity-7363593302312402944-W_TZ cureSYNGAP1.org/Gala5   Sad to miss it?  Join us in Boston or South Carolina. Beacon of Hope September 12, 2025 - Boston, MA cureSYNGAP1.org/Beacon25 Scramble for SYNGAP October 4, 2025 - Greer, SC cureSYNGAP1.org/Scramble   Stoke Therapeutics indicates they will have a target for SYNGAP-1 in 2026! https://investor.stoketherapeutics.com/news-releases/news-release-details/stoke-therapeutics-reports-second-quarter-2025-financial-results 12 Aug 2025 “Lead optimization is underway to identify a clinical candidate for the treatment of SYNGAP-1 in 2026. SYNGAP-1 is a severe and rare genetic neurodevelopmental disease.”   Just over 20 FDA approved Oligos and siRNAs today.  We are still so early. https://www.advancingrna.com/doc/moving-beyond-solid-phase-synthesis-the-momentum-of-oligonucleotide-manufacturing-0001   Congrats to Monica E. & Grann Therapeutics, seeing a child dosed for the first time with a novel medicine was remarkable. https://www.grannpharma.com/press-releases The SYNGAP1 Village: How Extended Family Can Provide Vital Support https://curesyngap1.org/blog/syngap1-village-extended-family-can-provide-support/   Here's a fun topic to discuss with your family, brain donation.  https://www.autismbrainnet.org/ 55yo with Dravet, lots of insights, Brava to Dr. Andrade and team! https://onlinelibrary.wiley.com/doi/10.1111/epi.18613   SRF joins with CHOP, Wistar and other Philly-area research institutions with a letter to urge legislators to reject NIH cuts. 8/20/25 Letter can be viewed in SRF Public-facing drive  https://drive.google.com/file/d/1HHmCAuRYAQxb_1DtMtkQTz3H8__g9zKq/view?usp=drive_link Philadelphia Inquirer picked up the story 8/20/25  https://www.inquirer.com/health/medical-research-institutions-reject-nih-cuts-20250820.html    More on #Elopement: Alarms, Roofs, Resonated.  Keep talking to doctors about this.  Post is up to 139 Votes, percentages little changed,  join the conversation on FB. https://www.facebook.com/groups/syngap/posts/1734514154096968/ #S10e178 - https://www.youtube.com/watch?v=OiRnXxh0wfY    Conference is in 103 Days https://curesyngap1.org/events/conferences/cure-syngap1-conference-2025-hosted-by-srf/   Pubmed is at 38! https://pubmed.ncbi.nlm.nih.gov/?term=syngap1&filter=years.2025-2025&timeline=expanded&sort=date&sort_order=asc   SHARE BLOOD TO THE SRF BIOBANK AT CB! https://curesyngap1.org/blog/fueling-research-syngap1-combinedbrain-biorepository-roadshow/    VOLUNTEER  Join us: https://curesyngap1.org/volunteer-with-srf/    SOCIAL MATTERS - 4,285 LinkedIn.  https://www.linkedin.com/company/curesyngap1/  - 1,420 YouTube.  https://www.youtube.com/@CureSYNGAP1    - 11,294 Twitter https://twitter.com/cureSYNGAP1  - 46k Insta https://www.instagram.com/curesyngap1/    NEWLY DIAGNOSED? Next New Family Webinar - Tuesday Sept. 9th, 2025, 5 PM Pacific scheduled! https://curesyngap1.org/resources/webinars/webinar-105-syngap-research-fund-quarterly-webinar-new-syngap1-family-orientation/   Resources https://curesyngap1.org/syngap1-resources-for-newly-diagnosed-families   Podcasts, give all of these a five star review! https://cureSYNGAP1.org/SRFApple   https://podcasts.apple.com/us/channel/syngap1-podcasts-by-srf/id6464522917    Episode 179 of #Syngap10  #Advocate #PatientAdvocacy #UnmetNeed #SYNGAP1 #SynGAP #SynGAProMMiS

Tony (11, M) Story.  Now we sleep with the alarm on every night.   Elopement:  involves leaving a safe or supervised area without permission. poses a risk to the individual's safety. can occur in various settings. is a common behavior in individuals with ASD. Virginie (10, M) Stories and Service Dog.   Single Mom (9, M) heading to the judge and calls me asking for papers.  Here you go…   Let's note that Elopement was masked behind broader buckets and I think this is a miss.  We need to name and discuss this very challenging behavior.   FB Survey.  4 hours.  100+ votes, 100 comments.   https://www.facebook.com/groups/syngap/posts/1734514154096968/ 76% of respondents eloped (35% F, 41% M) 24% didn't (17% F, 7% M)   11 F, no elopement at home - but sometimes tries to elope while at school. C ( has always been an eloper - kid has a sixth sense for when someone leaves the door unlocked C elopes and age 16 years old H 9 girl constantly running away B-7.5 years old Girl - 3 Fourteen. She doesn't anymore, but used to. Not to the degree that other families struggle, but we definitely had to keep an extra close eye/ear. Had bells on all our doors, etc. Did get a call from our neighbor once while I was making dinner saying that S had just walked into her house, that she was safe, and was helping to give their baby a bath. Thankfully they were very good friends and took it in stride. (S was about four at the time.) Boys age 7. He has for awhile Boy, age 8.5. Just started eloping more so recently, in the last year. 11, girl Boy age 15 13 year old girl Girl-3 Ty 10 elopes since he can walk. It's our biggest problem. Boy age 8 but has been doing it for a while Age 7, girl. Boy - 14y/o Boy age 9… he's a track star! Boy age 12, has eloped since he could walk/run. It probably peaked around age 6 and got better with meds. Elopement is less frequent now but scarier now that he's older and higher. Boy 10. Always has wandered and will still now run off knowing he's not suppose to Any chance he gets 13 My boy (22 y/o) always was and is now a master of escape, he can hear if I turn the key in the door, front door has an alarm fitted just in case Boy , 25 the risk is high because he looks typical 25 yo female, requiring alarms, cameras,and specialized door locks.  In a state that says that these measures are unlawful restraint and invasion of privacy   Frazier, 2025. Extremely High finding as a Symptom of SYNGAP1.  See Table 2 of Quantifying neurobehavioral profiles across neurodevelopmental genetic syndromes and idiopathic neurodevelopmental disorders https://onlinelibrary.wiley.com/doi/10.1111/dmcn.16112   McKee, 2025.  Notes the significantly heightened enrichment of Autistic Behavior and Behavioral Abnormality vs. Rett, Angelman or Epilepsy cohorts.  See Figure 2B of Clinical signatures of SYNGAP1-related disorders through data integration. https://www.gimjournal.org/article/S1098-3600(25)00066-8/abstract   Cunnanne, notes impulsivity (which is a euphemism for elopement if I have ever heard one) and has three quotes in Table 1 (see below), but also notes in Figure 2 that both ASD and lack of danger awareness came up in almost every interview.  See SYNGAP1-Related Intellectual Disability: Meaningful Clinical Outcomes and Development of a Disease Concept Model Draft.  https://papers.ssrn.com/sol3/papers.cfm?abstract_id=5098346   Impulsivity quotes:   Runs toward streets - “He wouldn't stop himself from running into the road. He climbs things in that house that you're like‘oh my god, how are you going to get out of that?'”   Jumps into pools - “He would walk into a pond. We were at the pool the other day…and he just walked off the edge and just fell into the water and was like… he would have just drowned.”   Runs toward crowds - “She was a bolter. So that was always scary. We had a few scares where you look away for a moment, I mean, we always had somebody with her, but it could be a moment's time and it's like where'd you go, you thought she was right there.”   FUNDRAISING 3 events in 3 states… https://mailchi.mp/curesyngap1.org/3-events-1-mission-support-syngap1-families-this-fall?e=e95ed9a1c4  Gala for SYNGAP1 August 22, 2025 - Farmingdale, NJ cureSYNGAP1.org/Gala5 Beacon of Hope September 12, 2025 - Boston, MA cureSYNGAP1.org/Beacon25 Scramble for SYNGAP October 4, 2025 - Greer, SC cureSYNGAP1.org/Scramble   Also, Conference is in 107 Days https://curesyngap1.org/events/conferences/cure-syngap1-conference-2025-hosted-by-srf/   STUDIES - MATTER https://docs.google.com/presentation/d/1yRPHMRY3pXPgbOacDM9Sr906VejdJWsonUWvqRD9VVI/edit?usp=sharing    Pubmed is at 37 (One a week!) https://pubmed.ncbi.nlm.nih.gov/?term=syngap1&filter=years.2025-2025&timeline=expanded&sort=date&sort_order=asc   SHARE BLOOD TO THE SRF BIOBANK AT CB! Read here for more information: https://curesyngap1.org/blog/fueling-research-syngap1-combinedbrain-biorepository-roadshow/    VOLUNTEER  Join us: https://curesyngap1.org/volunteer-with-srf/    SOCIAL MATTERS - 4,283 LinkedIn.  https://www.linkedin.com/company/curesyngap1/  - 1,420 YouTube.  https://www.youtube.com/@CureSYNGAP1    - 11,303 Twitter https://twitter.com/cureSYNGAP1  - 46k Insta https://www.instagram.com/curesyngap1/    NEWLY DIAGNOSED? Next New Family Webinar - Tuesday Sept. 9th, 2025, 5 PM Pacific scheduled! https://curesyngap1.org/resources/webinars/webinar-105-syngap-research-fund-quarterly-webinar-new-syngap1-family-orientation/   Resources https://curesyngap1.org/syngap1-resources-for-newly-diagnosed-families   Podcasts, give all of these a five star review! https://cureSYNGAP1.org/SRFApple   https://podcasts.apple.com/us/channel/syngap1-podcasts-by-srf/id6464522917    Episode 178 of #Syngap10  #Advocate #PatientAdvocacy #UnmetNeed #SYNGAP1 #SynGAP #SynGAProMMiS

No longer simply known as that chalky powder gym bros take for bigger muscles…creatine is currently undergoing a significant metamorphosis. Though, what happens during this final stage could forever define the creatine market! While creatine was first discovered in muscle tissue in 1832, it took another 160 years before a new era of sports nutrition was created from the pivotal creatine supplementation human study conducted by Dr. Roger Harris. And after Linford Christie, the Barcelona Olympic Games gold medal winning sprinter at 100 meters, mentioned the powerful effects of creatine supplementation in an August 1992 newspaper article...the first commercial creatine supplement hit retail store shelves a year later and quickly gained popularity and widespread adoption among male athletes and fitness enthusiasts. Though, over the next almost quarter-century…it was a relatively boring growth period for the creatine market, with continued research solidifying the ingredient's effectiveness in muscle strength enhancement. Yet, it's this pupation developmental stage, which creatine has been undergoing lately…that very well could be what leads to substantial change across the marketplace, as the scientific flywheel is still spinning quickly! And that's because while many nutraceutical ingredients were popularized within that shadowy niche of sports nutrition, an ever-growing body of research with positive results has broadened use cases and expanded demographics…making them almost must-have staples for everyone. Nevertheless, researchers proving through studies that this nutraceutical ingredient has more than one purpose…isn't all that commercially impactful when you consider that only a microscopic percentage of the consumer market peruses PubMed frequently. Said another way…when a new creatine study gets published on the Internet, does it make a sales register ring? If you picked up on my adaption of the “tree falls in the forest” philosophical thought experiment, then you might guess where I'm going next…as I believe the final “adult” metamorphic stage will be defined by CPG entrepreneurs translating the evolving scientific flywheel of creatine into business ventures. By leveraging a consumer-centric strategic process of questioning, thinking, and subsequently experimenting across various go-to-market roadmaps…entrepreneurs can (and will) successfully reframe creatine, broaden use cases, and discover many new audiences beyond the gym. Though, the final portion of my latest first principles content will explore a few areas that will undoubtedly drive the future of the creatine market…from branding to formats (i.e. creatine gummies) and broadened use cases (and occasions).

We all want more energy — but what if your fatigue isn't about sleep, diet, or exercise at all? In this solo episode, Darin O'Lien uncovers the invisible drains on your vitality that most people never notice. From blue light to toxic relationships, hidden mold, micro-stress loops, EMF exposure, and even unresolved trauma stored in your body, Darin reveals how your life force is being stolen — and how to take it back. You'll learn the overlooked ways your time, attention, and biology are constantly depleted — and the exact SuperLife Energy Seal Protocol Darin uses to plug those leaks, reclaim his vitality, and live fully charged.     What You'll Learn in This Episode 00:00 – Introduction & Episode Overview Darin introduces the concept of hidden energy leaks and why most fatigue isn't just about lack of sleep. 03:05 – Energy Deposits vs. Withdrawals How every interaction, choice, and environment either builds or depletes your life force. 04:33 – The Overlooked Energy Drains The most common — and invisible — ways energy slips away without your awareness. 06:58 – Blue Light & Circadian Rhythm Disruption The science of how nighttime screen use suppresses melatonin and wrecks your sleep quality. 09:06 – Ultra-Processed Foods & Energy Impact Why “dead calorie” foods cause fatigue and how to build an energy-supportive plate. 11:33 – Hydration & Water Quality Why dehydration is the #1 cause of fatigue, and the importance of filtering and mineralizing your water. 15:06 – Micro-Stress Loops & Mental Background Apps How unresolved thoughts quietly drain your energy — and how to shut them down. 17:28 – Toxic Relationships & Social Friction The measurable toll hostile interactions take on your health and recovery. 19:10 – Indoor Air Quality & Mold Exposure How unseen environmental toxins mimic chronic fatigue symptoms. 21:27 – EMF Exposure & Device Overload The overlooked stressor disrupting your sleep, nervous system, and cellular health. 23:14 – Stillness Breaks & Nature Time The proven stress-relieving effects of short nature “pills” and mindfulness pauses. 25:41 – Past Trauma & Recapitulation How unresolved experiences trap your life force — and the Toltec method to reclaim it. 30:39 – The SuperLife Energy Seal Protocol Darin's complete daily checklist to stop leaks and recharge vitality. 33:08 – Darin's Daily Rituals How he integrates energy-protective practices into his everyday life. 35:33 – Closing Thoughts Why energy isn't something you gain — it's what's left when you stop the leaks.     Thank You to Our Sponsors: Fatty15: Get an additional 15% off their 90-day subscription Starter Kit by going to fatty15.com/DARIN and using code DARIN at checkout. Therasage: Go to www.therasage.com and use code DARIN at checkout for 15% off     Find More from Darin Olien: Instagram: @darinolienPodcast: superlife.com/podcastsWebsite: superlife.comBook: Fatal Conveniences     Key Takeaway "Energy isn't something you get — it's what remains when you stop the leaks."      Bibliography · Chang AM et al. Evening use of light-emitting eReaders… PNAS, 2015. · Hall KD et al. Ultra-processed diets cause excess calorie intake… Cell Metabolism, 2019. · Ganio MS et al. Mild dehydration impairs vigilance… Br J Nutr, 2011. · McEwen BS. Allostatic load and stress physiology. Ann NY Acad Sci, 1999. · Kiecolt-Glaser JK et al. Hostile behavior slows wound healing… Arch Gen Psychiatry, 2005. · CDC/NIOSH. Health problems in damp buildings. · Satish U et al. CO₂ and decision-making. Environ Health Perspect, 2012. · WHO. Electromagnetic fields and public health. · Hunter MCR et al. Nature pill and stress relief. Front Psychol, 2019. · Levine P. Somatic experiencing and trauma discharge. PubMed, 2012. · · Somatic trauma & release: Levine P. Waking the Tiger; “Trauma creates a permanent imprint… the body can be retrained to discharge it.” (pubmed.ncbi.nlm.nih.gov) · · Recapitulation (Toltec lineage): Ruiz DM. The Four Agreements; narrative recounting as energy reclamation. (Ancestral wisdom, narrative psychology) · · Narrative therapy integration: White M. “Externalizing the problem, reclaiming identity.” (Case-based evidence, therapeutic outcomes) · · (And prior citations as listed—circadian, UPF, hydration, air, mindfulness, social, EMF, stillness—remain intact.)

Dr. Hope Rugo and Dr. Kamaria Lee discuss the prevalence of financial toxicity in cancer care in the United States and globally, focusing on breast cancer, and highlight key interventions to mitigate financial hardship. TRANSCRIPT  Dr. Hope Rugo: Hello, and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I'm your host, Dr. Hope Rugo. I'm the director of the Women's Cancer Program and division chief of breast medical oncology at the City of Hope Cancer Center, and I'm also the editor-in-chief of the Educational Book. Rising healthcare costs are causing financial distress for patients and their families across the globe. Patients with cancer report financial toxicity as a major impediment to their quality of life, and its association with worse outcomes is well documented. Today, we'll be discussing how patients with breast cancer are uniquely at risk for financial toxicity. Joining me for this discussion is Dr. Kamaria Lee, a fourth-year radiation oncology resident and health equity researcher at MD Anderson Cancer Center and a co-author of the recently published article titled, "Financial Toxicity in Breast Cancer: Why Does It Matter, Who Is at Risk, and How Do We Intervene?" Our full disclosures are available in the transcript of this episode.  Dr. Lee, it's great to have you on this podcast. Dr. Kamaria Lee: Hey, Dr. Rugo. Thank you so much for having me. I'm excited to be here today. I also would like to recognize my co-authors, Dr. Alexandru Eniu, Dr. Christopher Booth, Molly MacDonald, and Dr. Fumiko Chino, who worked on this book chapter with me and did a fantastic presentation on the topic at ASCO this past year. Dr. Hope Rugo: Thanks very much. We'll now just jump into the questions. We know that rising medical costs contribute to a growing financial burden on patients, which has [GC1]  [JG2]  been documented to contribute to lower quality-of-life, compromised clinical care, and worse health outcomes. How are patients with breast cancer uniquely at risk for financial toxicity? How does the problem vary within the breast cancer population in terms of age, racial and ethnic groups, and those who have metastatic disease? Dr. Kamaria Lee: Breast cancer patients are uniquely at risk of financial toxicity for several reasons. Three key reasons are that breast cancer often requires multimodal treatment. So this means patients are receiving surgery, many receive systemic therapies, including hormonal therapies, as well as radiation. And so this requires care coordination and multiple visits that can increase costs. Secondly, another key reason that patients with breast cancer are uniquely at risk for financial toxicity is that there's often a long survivorship period that includes long-term care for toxicities and continued follow-ups, and patients might also be involved in activities regarding advocacy, but also physical therapy and mental health appointments during their prolonged survivorship, which can also add costs. And a third key reason that patients with breast cancer are uniquely at risk for financial toxicity is that the patient population is primarily women. And we know that women are more likely to have increased caregiver responsibilities while also potentially working and managing their treatments, and so this is another contributor. Within the breast cancer population, those who are younger and those who are from marginalized racial/ethnic groups and those with metastatic disease have been shown to be at an increased risk. Those who are younger may be more likely to need childcare during treatment if they have kids, or they're more likely to be employed and not yet retired, which can be disrupted while receiving treatment. And those who are racial/ethnic minorities may have increased financial toxicity due to reasons that exist even after controlling for socioeconomic factors. And some of these reasons have been shown to be increased risk of job or income loss or transportation barriers during treatment. And lastly, for those with metastatic breast cancer, there can be ongoing financial distress due to the long-term care that is needed for treatment, and this can include parking, transportation, and medications while managing their metastatic disease. Dr. Hope Rugo: I think it is really important to understand these issues as you just outlined. There has been a lot of focus on financial toxicity research in recent years, and that has led to novel approaches in screening for financial hardship. Can you tell us about the new screening tools and interventions and how you can easily apply that to clinical practice, keeping in mind that people aren't at MD Anderson with a bunch of support and information on this but are in clinical practice and seeing many, many patients a day with lots of different cancers? Dr. Kamaria Lee: You're exactly right that there is incredible nuance needed in understanding how to best screen for financial hardship in different types of practices. There are multiple financial toxicity tools. The most commonly used tool is the Comprehensive Score for Financial Toxicity, also known as the COST tool. In its full form, it's an 11-item survey. There's also a summary question as well. And these questions look at objective and subjective financial burden, and it uses a five-point Likert scale. For example, one question on the full form is, "I know that I have enough money in savings, retirement, or assets to cover the cost of my treatment," and then patients are able to respond "not at all" to "very much" with a threshold score for financial toxicity risk. Of course, as you noted, one critique of having an 11-item survey is that there's limited time in patient encounters with their providers. And so recently, Thom et al validated an abbreviated two-question version of the COST tool. This validation was done in an urban comprehensive cancer center, and it was found to have a high predictive value to the full measure. We note which two questions are specifically pulled from the full measure within the book chapter. And this is one way that it can be easier for clinicians who are in a busier setting to still screen for financial toxicity with fewer questions. I also do recommend that clinicians who know their clinic's workflow the best, work with their team of nurses, financial navigators, and others to best integrate the tool into their workflow. For some, this may mean sending the two-item survey as a portal message so that patients can answer it before consults. Other times, it could mean having it on the tablet that can be done in the clinic waiting room. And so there are different ways that screening can be done, even in a busy setting, and acknowledging that different practices have different amounts of resources and time. Dr. Hope Rugo: And where would people access that easily? I recognize that that information is in your chapter, or your article that's on PubMed that will be linked to this podcast, but it is nice to just know where people could easily access that online. Dr. Kamaria Lee: Yes, and so you should be able to Google ‘the COST measure', and then there is a website that also has the forms as well. So it's also beyond the book chapter, Googling ‘the COST measure', and then online they would be able to find access to the form. Dr. Hope Rugo: And how often would you do that screening? Dr. Kamaria Lee: So, I think it's definitely important that we are as proactive as possible. And so initially, I recommend that the screening happens at the time of diagnosis, and so if it's done through the portal, it can be sent before the initial consult, or again, however, is best in the workflow. So at the time of diagnosis and then at regular intervals, so throughout the treatment process, but then also into the follow-up period as well to best understand if there's still a financial burden even after the treatments have been completed. Dr. Hope Rugo: I wonder if in the metastatic setting, you could do it at the change of treatment, you know, a month after somebody's changed treatment, because people may not be as aware of the financial constraints when they first get prescribed a drug. It's more when you hear back from how much it's going to cost. And leading into that, I think it's, what do you do with this? So, you know, this cost conversation is really important. You're going to be talking to the patient about the cost considerations when you, for example, see that there are financial issues, you're prescribing treatments. How do we implement impactful structured cost conversations with our breast cancer patients, help identify financial issues, and intervene? How do we intervene? I mean, as physicians often we aren't really all that aware, or providers, of how to address the cost. Dr. Kamaria Lee: Yes, I agree fully that another key time when to screen for financial toxicity is at that transition between treatments to best understand where they're at based off of what they've received previously for care, and then to anticipate needs when changing regimens, such as like you said in the metastatic setting. As we're collecting this information, you're right, we screen, we get this information, and what do we do? I do agree that there is a lack of knowledge among us clinicians of how do we manage this information. What is insurance? How do we manage insurance and help patients with insurance concerns? How do we help them navigate out-of-pocket costs or even the indirect costs of transportation? Those are a lot of things that are not covered in-depth in traditional medical training. And so it can be overwhelming for a lot of clinicians, not only due to time limitations in clinic, but also just having those conversations within their visit. And so what I would say, a key thing to note, is that this is another area for multidisciplinary care. So just as we're treating patients in a multidisciplinary way within oncology as we work with our medical oncology, surgical colleagues across the board, it's knowing that this is another area for multidisciplinary care. So the team members include all of the different oncologists, but it also includes team members such as financial counselors and navigators and social workers and even understanding nonprofit partners who we have who have money that can be set aside to help reduce costs for certain different aspects of treatment. Another thing I will note is that most patients with breast cancer often say they do want to have these conversations still with their clinicians. So they do still see a clinician as someone that can weigh in on the costs of their treatment or can weigh in on this other aspect of their care, even if it's not the actual medication or the radiation. And so patients do desire to hear from their clinicians about this topic, and so I think another way to make it feel less overwhelming for clinicians like ourselves is to know that even small conversations are helpful and then being knowledgeable about within your institution or, like I said, outside of it with nonprofits, being aware of who can I refer this patient to for continued follow-up and for more detailed information and resources. Dr. Hope Rugo: Are those the successful interventions? It's really referring to financial navigators? How do people identify? You know, in an academic center, we often will sort of punt this to social workers or our nurse navigators. What about in the community? What's a successful intervention example of mitigating financial toxicity? Dr. Kamaria Lee: I agree completely that the context at which people are practicing is important to note. So as you alluded to, in some bigger systems, we do have financial navigators and this has been seen to be successful in providing applications and assisting with applications for things such as pharmaceutical assistance, insurance applications, discount opportunities.  Another successful intervention are financial toxicity tumor boards, which I acknowledge might not be able to exist everywhere. But where this is possible, multidisciplinary tumor boards that include both doctors and nurses and social workers and any other members of the care team have been able to effectively decrease patients' personal spending on care costs and decrease co-pays through having a dedicated time to discuss concerns as they arise or even proactively. Otherwise, I think in the community, there are other interventions in regards to understanding different aspects of government programs that might be available for patients that are not, you know, limited to an institution, but that are more nationally available, and then again, also having the nonprofit, you know, partnerships to see other resources that patients can have access to.  And then I would also say that the indirect costs are a significant burden for many patients. So by that, I mean even parking costs, transportation, childcare. And so even though those aren't interventions necessarily with someone who is a financial navigator, I would recommend that even if it's a community practice, they discuss ways that they can help offset those indirect costs with patients with parking or if there are ways to help offset transportation costs or at least educate patients on other centers that may be closer to them or they can still receive wonderful care, and then also making sure that patients are able to even have appointments scheduled in ways that are easier for them financially.  So even if someone's receiving care out in the community where there's not a financial navigator, as clinicians or our scheduling teams, sometimes there are options to make sure if a patient wants, visits are more so on one day than throughout the week or many hours apart that can really cause loss of income due to missed work. And so there are also kind of more nuanced interventions that can happen even without a financial navigation system in place. Dr. Hope Rugo: I think that those are really good points and it is interesting when you think about financial toxicity. I mean, we worry a lot when patients can't take the drugs because they can't afford them, but there are obviously many other non-treatment, direct treatment-related issues that come up like the parking, childcare, tolls, you know, having a working car, all those kinds of things, and the unexpected things like school is out or something like that that really play a big role where they don't have alternatives. And I think that if we think about just drug costs, I think those are a big issue in the global setting. And your article did address financial toxicity in the global setting. International financial toxicity rates range from 25% of patients with breast cancer in high-income countries to nearly 80% in low- and middle-income countries or LMICs. You had cited a recent meta-analysis of the global burnout from cancer, and that article found that over half of patients faced catastrophic health expenditures. And of course, I travel internationally and have a lot of colleagues who are working in oncology in many countries, and it is really often kind of shocking from our perspective to see what people can get coverage for and how much they have to pay out-of-pocket and how much that changes, that causes a lot of disparity in access to healthcare options, even those that improve survival. Can you comment on the global impact of this problem? Dr. Kamaria Lee: I am glad that you brought this up for discussion as well. Financial toxicity is something that is a significant global issue. As you mentioned, as high as 80% of patients with breast cancer in low- and middle-income countries have had significant financial toxicity. And it's particularly notable that even when looking at breast cancer compared to other malignancies around the world, the burden appears to be worse. This has been seen even in countries with free universal healthcare. One example is Sri Lanka, where they saw high financial toxicity for their patients with breast cancer, even with this free universal healthcare. But there were also those travel costs and just additional out-of-hospital tests that were not covered. Also, literature in low- and middle-income countries shows that patients might also be borrowing money from their social networks, so from their family and their friends, to help cover their treatment costs, and in some cases, people are making daily food compromises to help offset the cost of their care. So there is a really large burden of financial toxicity generally for cancer globally, but also specifically in breast cancer, it warrants specific discussion. In the meta-analysis that you mentioned, they identified key risk factors of financial toxicity globally that included people who had a larger family size, a lower income, a lack of insurance, longer disease duration, so again, the accumulation of visits and costs and co-pay over time, and those who had multiple treatments. And so in the global setting, there is this significant burden, but then I will also note that there is a lack of literature in low-income countries on financial toxicity. So where we suspect that there is a higher burden and where we need to better understand how it's distributed and what interventions can be applied, especially culturally specific interventions for each country and community, there's less research on this topic. So there is definitely an increased need for research in financial toxicity, particularly in the global setting. Dr. Hope Rugo: Yes, and I think that goes on to how we hope that financial toxicity researchers will have approaches to large-scale multi-institutional interventions to improve financial toxicity. I think this is an enormous challenge, but one of the SWOG organizations has done some great work in this area, and a randomized trial addressing cancer-related financial hardship through the delivery of a proactive financial navigation intervention is one area that SWOG has focused on, which I think is really interesting. Of course, that's going to be US-based, which is how we might find our best paths starting. Do you think that's a good path forward, maybe that being able to provide something like that across institutions that are independent of being a cancer only academic center, or more general academic center, or a community practice? You know, is finding ways to help patients with breast cancer and their families understand and better manage financial aspects of cancer care on a national basis the next approach? Dr. Kamaria Lee: Yes, I agree that that is a good approach, and I think the proactive component is also key. We know that patients that are coming to us with any cancer, but including breast cancer, some of them have already experienced a financial burden or have recently had a job loss before even coming to us and having the added distress of our direct costs and our indirect costs. So I think being proactive when they come to us in regards to the additional burden that their cancer treatments may cause is key to try to get ahead of things as much as we can, knowing that even before they've seen us, there might be many financial concerns that they've been navigating.  I think at the national level, that allows us to try to understand things at what might be a higher level of evidence and make sure that we're able to address this for a diverse cohort of patients. I know that sometimes the enrollment can be challenging at the national level when looking at financial toxicity, as then we're involving many different types of financial navigation partners and programs, and so that can maybe make it more complex to understand the best approaches, but I think that it can be done and can really bring our understanding of important financial toxicity interventions to the next level. And then the benefit to families with the proactive component is just allowing them to feel more informed, which can help decrease anticipation, anxiety related to anticipation, and allow them to help plan things moving forward for themselves and for the whole family. Dr. Hope Rugo: Those are really good points and I wonder, I was just thinking as you were talking, that having some kind of a process where you could attach to the electronic health record, you could click on the financial toxicity survey questions that somebody filled out, and then there would be a drop-down menu for interventions or connecting you to people within your clinic or even more broadly that would be potential approaches to manage that toxicity issue so that it doesn't impact care, you know, that people aren't going to decide not to take their medication or not to come in or not to get their labs because of the cost or the transportation or the home care issues that often are a big problem, even parking, as you pointed out, at the cancer center. And actually, we had a philanthropic donor when I was at UCSF who donated a large sum of money for patient assistance, and it was interesting to then have these sequential meetings with all the stakeholders to try and decide how you would use that money. You need a big program, you need to have a way of assessing the things you can intervene with, which is really tough. In that general vein, you know, what are the governmental, institutional, and provider-level actions that are required to help clinicians do our best to do no financial harm, given the fact that we're prescribing really expensive drugs that require a lot of visits when caring for our patients with breast cancer in the curative and in the metastatic setting? Dr. Kamaria Lee: At the governmental level, there are patient assistant programs that do exist, and I think that those can continue and can become more robust. But I also think one element of those is oftentimes the programs that we have at the government level or even institutional levels might have a lot of paperwork or be harder for people with lower literacy levels to complete. And so I think the government can really try to make sure that the paperwork that is given, within reason, with all the information they need, but that the paperwork can be minimized and that there can be clear instructions, as well as increased health insurance options and, you know, medical debt forgiveness as more broad just overall interventions that are needed. I think additionally, institutions that have clinical trials can help ensure that enrollment can be at geographically diverse locations. Some trials do reimburse for travel costs, of course, but sometimes then patients need the reimbursement sooner than it comes. And so I think there's also those considerations of more so upfront funds for patients involved in clinical trials if they're going to have to travel far to be enrolled in that type of care or trying to, again, make clinical trials more available at diverse locations.  I would also say that it's important that those who design clinical trials use what is known as the “Common Sense Oncology” approach of making sure that they're designed in minimizing the use of outcomes that might have a smaller clinical benefit but may have a high financial toxicity. And that also goes to what providers can do, of understanding what's most important to a particular patient in front of them, what outcomes and what benefit, or you know, how many additional months of progression-free survival or things like that might be important to a particular patient and then also educating them and discussing what the associated financial burden is just so that they have the full picture as they make an informed decision. Dr. Hope Rugo: As much as we know. I mean, I think that that's one of the big challenges is that as we prescribe these expensive drugs and often require multiple visits, even, you know, really outside of the clinical trial setting, trying to balance the benefit versus the financial toxicity can be a huge challenge. And that's a big area, I think, that we still need help with, you know. As we have more drugs approved in the early-stage setting and treatments that could be expensive, oral medications, for example, in our Medicare population where the share of cost may be substantial upfront, you know, with an upfront cost, how do we balance the benefits versus the risk? And I think you make an important point that discussing this individually with patients after we found out what the cost is. I think warning patients about the potential for large out-of-pocket cost and asking them to contact us when they know is one way around this. You know, patients feeling like they're sort of out there with a prescription, a recommendation from their doctor, they're scared of their cancer, and they have this huge share of cost that we didn't know about. That's one challenge, and I don't know if there's any suggestions you have about how one should approach that communication with the patient. Dr. Kamaria Lee: Yes, I think part of it is truly looking at each patient as an individual and asking how much they want to know, right? So we all know that patients, some who want more information, some want less, and so I think one way to approach that is asking them about how much information do they want to know, what is most helpful to them. And then also, knowing that if you're in a well-resourced setting that does have the social workers and financial navigators, also making sure it's integrated in the multidisciplinary setting and so that they know who they can go to for what, but also know that as a clinician, you're always happy for them to bring up their concerns and that if it's something that you're not aware of, that you will connect them to the correct multidisciplinary team members who can accurately provide that additional information. Dr. Hope Rugo: Do you have any other additional comments that you'd like to mention that we haven't covered? I think the idea of a financial toxicity screen with two questions that could be implemented at change of therapy or just periodically throughout the course of treatment would be a really great thing, but I think we do need as much information on potential interventions as possible because that's really what challenges people. It's like finding out information that you can't handle. Your article provides a lot of strategies there, which I think are great and can be discussed on a practice and institutional level and applied. Dr. Kamaria Lee: Yeah, I would just like to thank you for the opportunity to discuss such an important topic within oncology and specifically for our patients with breast cancer. I agree that it can feel overwhelming, both for clinicians and patients, to navigate this topic that many of us are not as familiar with, but I would just say that the area of financial toxicity is continuing to evolve as we gather more information on most successful interventions and that our patients can often inform us on, you know, what interventions are most needed as we see them. And so you can have your thinking about it as you see individual patients of, "This person mentioned this could be more useful to them." And so I think also learning from our patients in this space that can seem overwhelming and that maybe we weren't all trained on in medical school to best understand how to approach it and how to give our patients the best care, not just medically, but also financially. Dr. Hope Rugo: Thank you, Dr. Lee, for sharing your insights with us today. Our listeners will find a link, as I mentioned earlier, to the Ed Book article we discussed today in the transcript of this episode. I think it's very useful, a useful resource, and not just for providers, but for clinic staff overall. I think this can be of great value and help open the discussion as well. Dr. Kamaria Lee: Thank you so much, Dr. Rugo. Dr. Hope Rugo: And thanks to our listeners for joining us today. Please join us again next month on By the Book for more insightful views on topics you'll be hearing at Education Sessions from ASCO meetings and our deep dives into new approaches that are shaping modern oncology. Thank you. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:       Dr. Hope Rugo  @hope.rugo  Dr. Kamaria Lee @ lee_kamaria Follow ASCO on social media:       @ASCO on X (formerly Twitter)       ASCO on Bluesky      ASCO on Facebook       ASCO on LinkedIn       Disclosures:      Dr. Hope Rugo:   Honoraria: Mylan/Viatris, Chugai Pharma  Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer  Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx    Dr. Kamaria Lee: No relationships to disclose  

Today's guest, Amita Sharma, shares her deeply personal experience with perimenopause in the corporate world, the mental health toll it took, and how she turned that struggle into NourishDoc, a global wellness platform for women 40 and over. This award-winning episode of Sh!t That Goes On In Our Heads brings you a powerful, eye-opening conversation about the intersection of menopause, mindfulness, and mental health. With over 2 million downloads, we are proud to be the 2024 People's Choice Podcast Award Winner for Health and the 2024 Women in Podcasting Award Winner for Best Mental Health Podcast. We want to hear from YOU. Drop us a voice message or leave your thoughts at:https://castfeedback.com/67521f0bde0b101c7b10442a Mental Health Quote:"The sooner you embrace yourself, the sooner you start living your truth. Otherwise, you're just wearing a mask." — Amita Sharma What This Episode CoversAmita opens up about the invisible toll of perimenopause, from brain fog and depression to sleep deprivation and lost libido—all while trying to survive in a high-stakes, male-dominated tech career. We explore how mindfulness, acupuncture, holistic nutrition, and boundary-setting became her survival tools, and how that journey became the seed for NourishDoc. This comprehensive wellness platform helps thousands of midlife women worldwide. SEO Keywords:Menopause mental health, perimenopause anxiety, midlife women support, mindfulness for menopause, holistic wellness, mental health for women over 40, Amita Sharma, NourishDoc Meet Our Guest: Amita SharmaA former high-tech executive turned wellness innovator, Amita Sharma is the founder of NourishDoc. Her lived experience as a perimenopausal woman in corporate America ignited a mission to support other women through the mental and physical chaos of midlife. NourishDoc offers integrative, evidence-based programs for women 35+, tackling sexual health, menopause symptoms, mental clarity, and long-term chronic condition prevention. Amita's Links:Website: http://www.nourishdoc.com/Facebook: https://www.facebook.com/Nourishdoc/X (Twitter): https://x.com/nourishdocYouTube: https://www.youtube.com/@nourishdocInstagram: http://www.instagram.com/nourish_docLinkedIn: https://www.linkedin.com/in/amita-sharma-nourishdoc/ Key Takeaways: Perimenopause isn't just hot flashes—it deeply impacts mental health, identity, and daily functioning. Holistic wellness tools, such as yoga, journaling, and red-light therapy, can help restore balance. There's a serious education gap in healthcare—many doctors are not trained to recognize or treat perimenopause. Actionable Tips from Amita: Track your symptoms and advocate for testing—don't wait for your doctor to connect the dots. Start mindfulness and journaling daily to help process changes and center yourself. Explore integrative therapies, such as acupuncture, dietary changes, and vaginal health supplements, to enhance quality of life.   Important Chapters & Timestamps00:00 – Intro & Meet Amita03:00 – From Architecture to High-Tech to Holistic Health07:00 – What Perimenopause Really Feels Like12:00 – Mental Health Impact: Depression, Anxiety & Fog16:00 – Cultural Stigma & Workplace Silence22:00 – Loss of Libido, Intimacy, and Sexual Health28:00 – How NourishDoc Empowers Women35:00 – Systemic Gaps in Women's Healthcare43:00 – Amita's Advice to Her Younger Self References: NourishDoc Research & Programs – http://www.nourishdoc.com/ WHO and NIH studies on menopause-related mental health PubMed clinical research (as referenced by Amita)   Subscribe, Rate, and Review!Love what you heard? Don't forget to subscribe for more bold, unfiltered stories about the real stuff going on in our heads. Please take a moment to rate & review us on your favorite podcast platform or on our website:https://goesoninourheads.net/add-your-podcast-reviews For feedback, stories, or shoutouts, visit:https://castfeedback.com/67521f0bde0b101c7b10442a #MentalHealthPodcast #MentalHealthAwareness #PerimenopauseSupport #MidlifeWomenWellness#MenopauseJourney #NourishDoc #AmitaSharma #Grex #DirtySkittles #MindfulnessHealing#HormoneHealth #WomenOver40 #HolisticMentalHealth #AnxietySupport #BurnoutRecovery#SelfCareTips #PodcastForWomen #ChronicConditionPrevention #Podmatch #HealthEquityForWomen ***************************************************************************If You Need Support, Reach OutIf you or someone you know is facing mental health challenges, please don't hesitate to reach out to a crisis hotline in your area. Remember, it's OK not to be OK—talking to someone can make all the difference.United States: Call or Text 988 — 988lifeline.orgCanada: Call or Text 988 — 988.caWorldwide: Find a HelplineMental Health Resources and Tools: The Help HubStay Connected with G-Rex and Dirty SkittlesOfficial Website: goesoninourheads.netFacebook: @shltthatgoesoninourheadsInstagram: @grex_and_dirtyskittlesLinkedIn: G-Rex and Dirty SkittlesJoin Our Newsletter: Sign Up HereMerch Store: goesoninourheads.shopAudio Editing by NJz Audio

In this episode, we're breaking down the four pillars of wellness: sleep, energy balance, lifestyle habits, and stress management. You'll learn why quality sleep is the foundation for hormone balance and recovery, how to build sustainable energy throughout your day, and simple lifestyle anchors that help you feel more grounded and consistent. We'll also dive into proven tools to manage stress — from breathwork to boundaries — so you can build resilience and stay steady even in busy seasons. Whether you're looking to reset your routine or deepen your wellness habits, this episode will meet you where you are.www.trainmk.com@melissa_kendter

Send us a Text Message (please include your email so we can respond!)Episode 70! In this episode we have a special guest, Wes Ely, join us to talk about A2B or "Dexmedetomidine- or Clonidine-Based Sedation Compared With Propofol in Critically Ill Patients" by Walsh et al published in JAMA May of 2025. A long discussion but a good one, don't miss this one!Pubmed: https://pubmed.ncbi.nlm.nih.gov/40388916/JAMA: https://jamanetwork.com/journals/jama/article-abstract/2834276Editorial: https://jamanetwork.com/journals/jama/article-abstract/2834277If you enjoy the show be sure to like and subscribe, leave that 5 star review! Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

July 16, 2025. Week 29. What is a natural history study (NHS)?  And why do we care? We care because we haven't done this before, heal those born with disease. Natural history studies, which examine the progression of a disease over time, can be either retrospective or prospective. Retrospective studies analyze existing data, like medical records, while prospective studies collect new data over time. Both types are valuable for understanding a disease's course and informing research and treatment strategies. ⁠NHS are critical for clinical trial design.  Size and Quality matter.  Validated scales are better than PROs regardless of what the current rhetoric is. What's going on now? USA - https://curesyngap1.org/resources/studies/syngap1-ProMMiS/ - 135+ over three sites, some with FOUR visits, and counting - Adding GCP - Collaborating with world class institutions and excellent clinicians at Stanford, Children's Colorado and, of course, CHOP. USA - https://Citizen.Health/partners/srf has almost 300 patients! Retrospective Health Data. USA - https://rare-x.org/syngap1/ is where we collect PROs. Australia - Dr. Sheffer is running a study, talk to her or Dani. Latin America - SYNGAP1 Argentina with others joining. Europe - https://www.patre.info/syngap1/  Key takeaways for Industry SYNGAP1 is well positioned to work with… Vlasskamp and Wiltrout are published, Citizen Health is growing & ProMMiS is truly exceptional – and growing, and Rare-X is collecting eight key PROs.   Additionally, there are significant international efforts in Australia, Latin America & Europe. Census: https://curesyngap1.org/blog/syngap1-census-2025-update-55-in-q2-2025-total-1636/  If you are in industry and thinking about starting another NHS for your asset, please don't.  Please instead partner with existing PAGs and NHS studies in your key geographies to move faster, have bigger N and not waste precious patients time, we need to accelerate drug development not slow it down by diluting patients and clinicians between too many studies. Baseline papers on SYNGAP1: 1998 - Huganir - SynGAP: a synaptic RasGAP that associates with the PSD-95/SAP90 protein family - https://pubmed.ncbi.nlm.nih.gov/9581761/ 2009 - Michaud - Mutations in SYNGAP1 in autosomal nonsyndromic mental retardation - https://pubmed.ncbi.nlm.nih.gov/19196676/ 2013 - Carvill - Targeted resequencing in epileptic encephalopathies identifies de novo mutations in CHD2 and SYNGAP1 - https://pubmed.ncbi.nlm.nih.gov/23708187/ 2019 - Vlasskamp - SYNGAP1 encephalopathy: A distinctive generalized developmental and epileptic encephalopathy - https://pubmed.ncbi.nlm.nih.gov/30541864/ 2023 - Rong - Adult Phenotype of SYNGAP1-DEE - https://pubmed.ncbi.nlm.nih.gov/38045990/ 2024 - Wiltrout - Comprehensive phenotypes of patients with SYNGAP1-related disorder reveals high rates of epilepsy and autism - https://pubmed.ncbi.nlm.nih.gov/38470175/ Pubmed is at 28 (so less than one a week…) https://pubmed.ncbi.nlm.nih.gov/?term=syngap1&filter=years.2025-2025&timeline=expanded&sort=date&sort_order=asc   CURE SYNGAP1 CONNECT https://curesyngap1.org/curesyngap1connect/   SHARE BLOOD TO THE SRF BIOBANK AT CB! Read here for more information: https://curesyngap1.org/blog/fueling-research-syngap1-combinedbrain-biorepository-roadshow/    VOLUNTEER  Join us: https://curesyngap1.org/volunteer-with-srf/    SOCIAL MATTERS - 4,238 LinkedIn.  https://www.linkedin.com/company/curesyngap1/  - 1,400 followers with 575 Videos on YouTube.  https://www.youtube.com/@CureSYNGAP1    - 11,302 Twitter https://twitter.com/cureSYNGAP1  - 46k Insta https://www.instagram.com/curesyngap1/    NEWLY DIAGNOSED? New families have resources here! https://syngap.fund/Resources      Podcasts, give all of these a five star review! https://cureSYNGAP1.org/SRFApple   https://podcasts.apple.com/us/channel/syngap1-podcasts-by-srf/id6464522917    Episode 175 of #Syngap10  #RareDisease #PatientAdvocacy #SYNGAP1 #SynGAP #ProMMiS

Resistant starch acts more like fiber than starch—and may offer unique benefits for blood sugar, gut health, and more. In this episode, we break down the different types, where to find them, and how they compare to other sources of fiber.Transcript: https://nutrition-diva.simplecast.com/episodes/resistant-starch-your-questions-answered/transcriptMentioned in this episode: Episode 915, Multi-grain vs whole grainEpisode 560, Fiber 2.0—Fiber's New Science of Health-Boosting BenefitsEpisode 728, Tapping into the many benefits of resistant starchesReferences:Wang, Y., Chen, J., Song, Y.-H., Zhao, R., Xia, L., Chen, Y., Cui, Y.-P., Rao, Z.-Y., Zhou, Y., Zhuang, W., & Wu, X.-T. (2019). Effects of the resistant starch on glucose, insulin, insulin resistance, and lipid parameters in overweight or obese adults: a systematic review and meta-analysis. PubMed. https://pubmed.ncbi.nlm.nih.gov/31168050/Yuan, H. C., Meng, Y., Bai, H., Shen, D. Q., Wan, B. C., & Chen, L. Y. (2018). Meta-analysis indicates that resistant starch lowers serum total cholesterol and low-density cholesterol. PubMed. https://pubmed.ncbi.nlm.nih.gov/29914662/ New to Nutrition Diva? Check out our special Spotify playlist for a collection of the best episodes curated by our team and Monica herself! We've also curated some great playlists on specific episode topics including Diabetes and Gut Health! Also, find a playlist of our bone health series, Stronger Bones at Every Age. Have a nutrition question? Send an email to nutrition@quickanddirtytips.com.Follow Nutrition Diva on Facebook and subscribe to the newsletter for more diet and nutrition tips. Find out about Monica's keynotes and other programs at WellnessWorksHere.comNutrition Diva is a part of the Quick and Dirty Tips podcast network. LINKS:Transcripts: https://nutrition-diva.simplecast.com/episodes/Facebook: https://www.facebook.com/QDTNutrition/Newsletter: https://www.quickanddirtytips.com/nutrition-diva-newsletterWellness Works Here: https://wellnessworkshere.comQuick and Dirty Tips: https://quickanddirtytipscom

It's 2 a.m. The on-call resident's voice is shaky. The CT shows an 18cm abdominal aortic aneurysm with a Type 1B endoleak. There's gas in the sac, fluid in the belly, and the patient has a defibrillator on both sides of his chest. Is it a rupture? A graft infection? An aortoenteric fistula? All of the above? You're the vascular surgeon, what do you do?  This episode dives deep into decision-making when EVAR fails, when infection strikes, and when the patient might not survive a definitive repair. Let's talk about what happens when clinical textbooks meet real-world chaos. Hosts: ·      Christian Hadeed -PGY 4 General Surgery, Brookdale Hospital Medical Center ·      Paul Haser -Division chief, Vascular Surgery, Brookdale Hospital Medical Center ·      Andrew Harrington, Vascular surgery, Brookdale Hospital Medical Center ·      Lucio Flores, Vascular surgery, Brookdale Hospital Medical Center Learning objectives: · Understand the clinical implications and management of late EVAR complications, including Type 1B endoleak and aortoenteric fistula. · Explore the decision-making process in critically ill patients with multiple comorbidities and infected aortic grafts. · Compare endovascular vs open surgical approaches in the setting of infected AAA, and when each is appropriate. · Recognize the role of multidisciplinary collaboration in complex vascular cases. · Discuss the ethical considerations and goals-of-care planning in high-risk, potentially terminal vascular patients. · Highlight the importance of long-term surveillance after EVAR and the consequences of noncompliance. References ·       Karl Sörelius et al.Nationwide Study of the Treatment of Mycotic Abdominal Aortic Aneurysms Comparing Open and Endovascular Repair.Circulation. 2016;134(22):1822–1832. PubMed: https://pubmed.ncbi.nlm.nih.gov/27799273/ pubmed.ncbi.nlm.nih.gov+15pubmed.ncbi.nlm.nih.gov+15researchgate.net+15 ·       PARTNERS Trial (OVER Trial).Outcomes Following Endovascular vs Open Repair of Abdominal Aortic Aneurysm: A Randomized Trial.JAMA. 2009;302(14):1535–1542. PubMed: https://pubmed.ncbi.nlm.nih.gov/19826022/ pubmed.ncbi.nlm.nih.gov+6pubmed.ncbi.nlm.nih.gov+6jamanetwork.com+6 ·       B.T. Müller et al.Mycotic Aneurysms of the Thoracic and Abdominal Aorta and Iliac Arteries: Experience with Anatomic and Extra-anatomic Repair in 33 Cases.J Vasc Surg. 2001;33(1):106–113. PubMed: https://pubmed.ncbi.nlm.nih.gov/11137930/ sciencedirect.com+5pubmed.ncbi.nlm.nih.gov+5periodicos.capes.gov.br+5 ·       Chung‑Dann Kan et al.Outcome after Endovascular Stent Graft Treatment for Mycotic Aortic Aneurysm: A Systematic Review.J Vasc Surg. 2007 Nov;46(5):906–912. PubMed: https://pubmed.ncbi.nlm.nih.gov/17905558/ researchgate.net+15pubmed.ncbi.nlm.nih.gov+15pubmed.ncbi.nlm.nih.gov+15 ·       Hamid Gavali et al.Outcome of Radical Surgical Treatment of Abdominal Aortic Graft and Endograft Infections Comparing Extra‑anatomic Bypass with In Situ Reconstruction: A Nationwide Multicentre Study.Eur J Vasc Endovasc Surg. 2021;62(6):918–926. PubMed: https://pubmed.ncbi.nlm.nih.gov/34782231/ pubmed.ncbi.nlm.nih.gov+6pubmed.ncbi.nlm.nih.gov+6diva-portal.org+6  Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen

Joint aches. Softer muscles. Saggy skin. Brain fog.  Dealing with these not-so-fun issues in midlife? Trust me, you're not the only one. But… these changes aren't “just a part of getting older”. In this podcast, I'm joined by the brilliant Dr. Greg Kelly, Senior VP of Product Development at Qualia Life and a leader in anti-aging and cellular health, to unpack the powerful concept of cellular senescence, also known as “zombie cells.”  These cells don't die when they should, sticking around to cause inflammation, slow down your metabolism, and accelerate aging in your skin, joints, muscles, and brain.  The good news? You're not powerless! Dr. Kelly shares how senolytics—natural compounds that help your body clear out zombie cells—can dramatically shift how you age, supporting your body's innate ability to regenerate.  If you've been feeling like your body is betraying you, this episode will bring hope and science-backed strategies to help you feel vibrant, clear-headed, and strong again. Tune in now! Gregory Kelly N.D. Dr. Gregory Kelly is a naturopathic physician, the SVP of Product Development at Qualia Life, and the author of the book Shape Shift. He was the editor of the journal Alternative Medicine Review and has been an instructor at the University of Bridgeport in the College of Naturopathic Medicine. Dr. Kelly has published hundreds of articles on natural medicine and nutrition, contributed three chapters to the Textbook of Natural Medicine, and has more than 30 journal articles indexed on PubMed. IN THIS EPISODE Enhancing longevity AND wellness in your later years  What are zombie cells, and how do they contribute to aging?  Main parts of the body impacted by zombie or senescent cells  Senolytics and how they work against zombie cells in the body  Qualia Senolytics and the science and research behind them Top non-negotiable supplements for optimal health  Enhancing women's hormonal and reproductive longevity  How to get Qualia Senolytic NOW at a discounted rate!  QUOTES “As these zombie cells accumulate wherever in our body, our joints, our skin, our brain, our muscle tissues, our fat tissues, they cause both local problems and systemic problems.”  “They scanned a whole bunch of different compounds, both plant extracts and actual medications, and came up with two that, especially when combined together, worked really well to get these zombie cells to finally go through cellular death.” “These people all had some degree of joint discomfort, and what we saw was about a 60% improvement over three dosing cycles. So this seemed like it made a big benefit.” RESOURCES MENTIONED Get your Qualia Life Senolytic at 15% off HERE!  Qualia Life Website   Qualia Life Instagram  Qualia Life YouTube Channel  Pre-order my new book: The Perimenopause Revolution HERE  RELATED EPISODES  #653: Mitochondria, Menopause & Metabolism: The Cellular Secret to More Energy After 40 with Dr. Felice Gersh #649: How To Reverse Your Biological Age + 5 Science-Backed Longevity Tips Every Woman Should Know with Leslie Kenny 640: Unveiling The Essential Role of Minerals For Cellular Energy And Detoxification with Caroline Alan 655: The Hidden Truth About Perimenopause That No One's Talking About (And Why It Changes Everything About How You Age)