Podcasts about randomized

In the ruins of a fallen tower, the crew of the Little Snail found themselves (and their egos) battered and bruised. Worse, Elena, Veile, and Nicky found themselves missing one ingredient to the special stew that was their group: Jonathan! Where had he been taken? And could it, perhaps, lead them towards the eternal flame which they were sent to retrieve?  This week on Perpetua: The Shadow of the Dragon Tower Pt. 4 Perpetua Guide [In Progress v.01] - Some Feedback [Page 01 of 03] Alukard83 Hey, this FAQ rules! Normally I buy the official guide but they want FIFTY dollars for this one, and I just don't have that sorta cash right now, so this is a lifesaver.  HOWEVER, your map on the final puzzle area in the Dragon Tower isn't right at ALL. Not sure what you were on when you made it, but it's totally wrong. Otherwise, keep up the good work XD TheUnforgivenIII Yeah I was coming here to post the same thing. This guide sucks bigtime. In my opinion, it's PROOF you should not be releasing this guide without finishing the full game first, because you're going to be in such a hurry that you're going to make stupid mistakes like this (or maybe even make things up entirely, which is my guess.) Take the FAQ down because it doesn't have any REAL answers in it. CarlsSr That's not what OP said, Unforgiveniii. Your bias is showing. FriendOfNei Thanks for the kudos Alukard, but listen, I loaded the save FIVE TIMES and checked it again and again and it's right. I don't know what YOU'RE on but maybe you're the one who is mistaken. As for you, Unforgiven, you're not even worth my keystrokes. XxZelgadyskXx I'm not OP or the FAQ writer but we did some testing over in the IRC channel it turns out that the bomb placement is RANDOMIZED for every player. So the FAQ isn't *wrong* it's just not right for anyone except for Nei. n.n;;;;   Hosted by Austin Walker (austinwalker.bsky.social) Featuring Ali Acampora (ali-online.bsky.social), Art Martinez-Tebbel (amtebbel.bsky.social), Jack de Quidt (notquitereal.bsky.social), and Andrew Lee Swan (swandre3000.bsky.social) Produced by Ali Acampora Music by Jack de Quidt (available on bandcamp) Cover Art by Ben McEntee (https://linktr.ee/benmce.art) With thanks to Amelia Renee, Arthur B., Aster Maragos, Bill Kaszubski, Cassie Jones, Clark, DB, Daniel Laloggia, Diana Crowley, Edwin Adelsberger, Emrys, Greg Cobb, Ian O'Dea, Ian Urbina, Irina A., Jack Shirai, Jake Strang, Katie Diekhaus, Ken George, Konisforce, Kristina Harris Esq, L Tantivy, Lawson Coleman, Mark Conner, Mike & Ruby, Muna A, Nat Knight, Olive Perry, Quinn Pollock, Robert Lasica, Shawn Drape, Shawn Hall, Summer Rose, TeganEden, Thomas Whitney, Voi, chocoube, deepFlaw, fen, & weakmint This episode was made with support from listeners like you! To support us, you can go to friendsatthetable.cash.

Drs. Amy Crockett (@amyhcrockett), Ben Ereshefsky (@brainofbpharm), and Pamela Bailey (@pamipenem) join Dr. Julie Ann Justo (@julie_justo) to discuss new treatment strategies for management of intraamniotic infections, also known as chorioamnionitis. They discuss whether it is time to move away from the combination of ampicillin, gentamicin, and/or clindamycin, alternative antibiotic regimens to consider, and stewardship strategies to approach this practice change at a local level. References: Basic stats/epi on chorioamnionitis: Romero R, et al. Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques. J Perinat Med. 2015 Jan;43(1):19-36. doi: 10.1515/jpm-2014-0249. PMID: 25720095. ACOG 2017 Guideline for IAI: Committee Opinion No. 712: Intrapartum Management of Intraamniotic Infection. Obstet Gynecol. 2017 Aug;130(2):e95-e101. doi: 10.1097/AOG.0000000000002236. PMID: 28742677. ACOG 2024 Update on clinical criteria for IAI: ACOG Clinical Practice Update: Update on Criteria for Suspected Diagnosis of Intraamniotic Infection. Obstetrics & Gynecology 144(1):p e17-e19, July 2024. doi: 10.1097/AOG.0000000000005593 Helpful review with more recent microorganisms : Jung E, et al. Clinical chorioamnionitis at term: definition, pathogenesis, microbiology, diagnosis, and treatment. Am J Obstet Gynecol. 2024 Mar;230(3S):S807-S840. doi: 10.1016/j.ajog.2023.02.002. PMID: 38233317. Cochrane Review: Chapman E, et al. Antibiotic regimens for management of intra-amniotic infection. Cochrane Database Syst Rev. 2014 Dec 19;2014(12):CD010976. doi: 10.1002/14651858.CD010976.pub2. PMID: 25526426. Helpful recent review on intrapartum infections: Bailey, P, et al_._ Out with the Old, In with the New: A Review of the Treatment of Intrapartum Infections. Curr Infect Dis Rep. 2024;26:107–113 doi: 10.1007/s11908-024-00838-8. Role of genital mycoplasmas in IAI: Romero R, et al. Evidence that intra-amniotic infections are often the result of an ascending invasion - a molecular microbiological study. J Perinat Med. 2019 Nov 26;47(9):915-931. doi: 10.1515/jpm-2019-0297. PMID: 31693497. Regimens without enterococcal coverage with similar clinical outcomes: Blanco JD, et al. Randomized comparison of ceftazidime versus clindamycin-tobramycin in the treatment of obstetrical and gynecological infections. Antimicrob Agents Chemother. 1983 Oct;24(4):500-4. doi: 10.1128/AAC.24.4.500. PMID: 6360038. Bookstaver PB, et al. A review of antibiotic use in pregnancy. Pharmacotherapy. 2015 Nov;35(11):1052-62. doi: 10.1002/phar.1649. PMID: 26598097. Updated review in pregnancy, includes data on frequency of antibiotic use in pregnancy: Nguyen J, et al. A review of antibiotic safety in pregnancy-2025 update. Pharmacotherapy. 2025 Apr;45(4):227-237. doi: 10.1002/phar.70010. Epub 2025 Mar 19. PMID: 40105039. Locksmith GJ, et al. High compared with standard gentamicin dosing for chorioamnionitis: a comparison of maternal and fetal serum drug levels. Obstet Gynecol. 2005 Mar;105(3):473-9. doi: 10.1097/01.AOG.0000151106.87930.1a. PMID: 15738010. Clindamycin CDI Risk: Miller AC, et al. Comparison of Different Antibiotics and the Risk for Community-Associated Clostridioides difficile Infection: A Case-Control Study. Open Forum Infect Dis. 2023 Aug 5;10(8):ofad413. doi: 10.1093/ofid/ofad413. PMID: 37622034. Impact of penicillin allergy on clindamycin use & cites 47% clindamycin resistance per CDC among GBS: Snider JB, et al. Antibiotic choice for Group B Streptococcus prophylaxis in mothers with reported penicillin allergy and associated newborn outcomes. BMC Pregnancy Childbirth. 2023 May 30;23(1):400. doi: 10.1186/s12884-023-05697-0. PMID: 37254067. Clindamycin anaerobic coverage data: Hastey CJ, et al. Changes in the antibiotic susceptibility of anaerobic bacteria from 2007-2009 to 2010-2012 based on the CLSI methodology. Anaerobe. 2016 Dec;42:27-30. doi: 10.1016/j.anaerobe.2016.07.003. PMID: 27427465. Older PK study of ampicillin & gentamicin for chorioamnionitis: Gilstrap LC 3rd, Bawdon RE, Burris J. Antibiotic concentration in maternal blood, cord blood, and placental membranes in chorioamnionitis. Obstet Gynecol. 1988 Jul;72(1):124-5. PMID: 3380500. Paper putting out the call for modernization of OB/Gyn antibiotic regimens: Pek Z, Heil E, Wilson E. Getting With the Times: A Review of Peripartum Infections and Proposed Modernized Treatment Regimens. Open Forum Infect Dis. 2022 Sep 5;9(9):ofac460. doi: 10.1093/ofid/ofac460. PMID: 36168554. Vanderbilt University Medical Center experience with modernizing OB/Gyn infection regimens: Smiley C, et al. Implementing Updated Intraamniotic Infection Guidelines at a Large Academic Medical Center. Open Forum Infect Dis. 2024 Sep 5;11(9):ofae475. doi: 10.1093/ofid/ofae475. PMID: 39252868. Prisma Health/University of South Carolina experience with modernizing OB/Gyn infection regimens: Bailey P, et al. Cefoxitin for Intra-amniotic Infections and Endometritis: A Retrospective Comparison to Traditional Antimicrobial Therapy Regimens Within a Healthcare System. Clin Infect Dis. 2024 Jul 19;79(1):247-254. doi: 10.1093/cid/ciae042. PMID: 38297884.

The FiltrateJoel TopfAC GomezSophia AmbrusoNayan AroraSpecial Guest Charles Edelstein, MD, PhD Professor, Medicine-Renal Med Diseases/HypertensionExtra-Special GuestMichelle Rheault, MD Professor of Pediatrics, University of MinnesotaEditing bySimon and Joel TopfThe Kidney Connection written and performed by by Tim YauShow NotesKDIGO ADPKD Guidelines:WebsiteGuideline PDFExecutive Summary PDFNephJC coverageConsortium for Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP)Hy's Law (Wikipedia) has three components:ALT or AST by 3-fold or greater above the upper limit of normalAnd total serum bilirubin of greater than 2× the upper limit of normal, without findings of cholestasis (defined as serum alkaline phosphatase activity less than 2× the upper limit of normal)And no other reason can be found to explain the combination of increased aminotransferase and serum total bilirubin, such as viral hepatitis, alcohol abuse, ischemia, preexisting liver disease, or another drug capable of causing the observed injuryMeeting this definition yields a very high risk of fulminant kidney failure (76% in one series)Clinical Pattern of Tolvaptan-Associated Liver Injury in Subjects with Autosomal Dominant Polycystic Kidney Disease: Analysis of Clinical Trials Database (PubMed) Two of 957 patients on tolvaptan met Hy's law criteria. None had fulminant kidney failure.Effects of Hydrochlorothiazide and Metformin on Aquaresis and Nephroprotection by a Vasopressin V2 Receptor Antagonist in ADPKD: A Randomized Crossover Trial (PubMed) Patients had a baseline urine volume on tolvaptan of 6.9 L/24 h. Urine volume decreased to 5.1 L/24 h with hydrochlorothiazide and to 5.4 L/24 h on metformin.TEMPO 3:4 Tolvaptan in Patients with Autosomal Dominant Polycystic Kidney Disease (NEJM)Reprise Trial Tolvaptan in Later-Stage Autosomal Dominant Polycystic Kidney Disease ( NEJM | NephJC )Unified ultrasonographic diagnostic criteria for polycystic kidney disease by Edelstein in JASN (PubMed)Tolvaptan and Kidney Function Decline in Older Individuals With Autosomal Dominant Polycystic Kidney Disease: A Pooled Analysis of Randomized Clinical Trials and Observational Studies (PubMed)Charles' draft choice Recommendation 4.1.1.1: We recommend initiating tolvaptan treatment in adults with ADPKD with an estimated glomerular filtration rate (eGFR) ‡25 ml/min per 1.73 m2 who are at risk for rapidly progressive disease (1B).Sophia's draft choice Recommendation 1.4.2.1: We recommend employing the Mayo Imaging Classi cation (MIC) to predict future decline in kidney function and the timing of kidney failure (1B).Progression to kidney failure in ADPKD: the PROPKD score underestimates the risk assessed by the Mayo imaging classification (Frontiers of Science)AC's draft choice Recommendation 9.2.1: We recommend targeting BP to ≤ 50th percentile for age, sex, and height or ≤ 110/70 mm Hg in adolescents in the setting of ADPKD and high BP (1D).HALT-PKD Blood Pressure in Early Autosomal Dominant Polycystic Kidney Disease (NEJM)Nayan's draft choice Recommendation 6.1.2: We recommend screening for ICA in people with ADPKD and a personal history of SAH or a positive family history of ICA, SAH, or unexplained sudden death in those eligible for treatment and who have a reasonable life expectancy (1D).Screening for Intracranial Aneurysms in Patients with Autosomal Dominant Polycystic Kidney Disease (CJASN)Surgical Clipping Versus Endovascular Coiling in the Management of Intracranial Aneurysms (PubMed) Clipping is associated with a higher rate of occlusion of the aneurysm and lower rates of residual and recurrent aneurysms, whereas coiling is associated with lower morbidity and mortality and a better postoperative course.Joel's editorial pick Recommendation 6.1.1: We recommend informing adults with ADPKD about the increased risk for intracranial aneurysms (ICAs) and subarachnoid hemorrhage (1C).Joel's first draft pick The bring out your dead pick:Recommendation 4.3.1: We recommend not using mammalian target of rapamycin (mTOR) inhibitors to slow kidney disease progression in people with ADPKD (1C).Recommendation 4.4.1: We suggest not using statins specfiically to slow kidney disease progression in people with ADPKD (2D).Recommendation 4.5.1: We recommend not using metformin specifically to slow the rate of disease progression in people with ADPKD who do not have diabetes (1B).Recommendation 4.6.1: We suggest that somatostatin analogues should not be prescribed for the sole purpose of decreasing eGFR decline in people with ADPKD (2B).Perfect match: mTOR inhibitors and tuberous sclerosis complex (Orphanet Journal of Rare Diseases)Navitor Pharmaceuticals Announces Janssen Has Acquired Anakuria Therapeutics, Inc. (BioSpace) This is press release about acquiring the mTor1 inhibitor.Joel's second draft pick Recommendation 4.2.1.1: We suggest adapting water intake, spread throughout the day, to achieve at least 2–3 liters of water intake per day in people with ADPKD and an eGFR ≥ 30 ml/min per 1.73 m2 without contraindications to excreting a solute load (2D).Nayan's bonus draft Practice Point 4.7.1: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) should not be used to slow eGFR decline in people with ADPKD.Open-Label, Randomized, Controlled, Crossover Trial on the Effect of Dapagliflozin in Patients With ADPKD Receiving Tolvaptan (KIReports)SMART Trial of GLP-1ra in non-diabetics: Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial (PubMed)Tubular SecretionsNayan: Landman on Paramount Plus (IMDB)Sophia: PassNayan: steps in with The Pitt on HBO (Wikipedia)Charles: The White Lotus, Yellowstone 1923, Poirot (IMDB)AC: The PittMichael Crichton's Estate Sends The Pitt to the Courtroom (Vulture)Joel: I Must Betray you by Ruta Sepetys (Amazon)

Take a sneak peak at this month's Fertility & Sterility! Articles discussed this month are:   4:08 Classification system of human ovarian follicle morphology: recommendations of the National Institute of Child Health and Human Development - sponsored ovarian nomenclature workshop  12:32 Impact of Prednisone on Vasectomy Reversal Outcomes (iPRED Study): Results from a Randomized, Controlled Clinical Trial 21:38 Triggering oocyte maturation in IVF treatment in normal responders: a systematic review and network meta-analysis 33:57 Parental Balanced Translocation Carriers do not have Decreased Usable Blastulation Rates or Live Birth Rates Compared to Infertile Controls  45:28 A re-look at the relevance of TSH and thyroid autoimmunity for pregnancy outcomes: Analyses of RCT data from PPCOS II and AMIGOS View Fertility and Sterility May 2025, Volume 123, Issue 5:  https://www.fertstert.org/issue/S0015-0282(25)X0004-2 View Fertility and Sterility at https://www.fertstert.org/

Host Roz is joined by Timucin Taner, MD, PhD and Dami Ko, PhD to discuss the key articles of the May issue of the American Journal of Transplantation. Dr. Timucin Taner is a professor of surgery at Mayo Clinic, Rochester, MN. Dr. Dami Ko is an assistant professor at the School of Nursing at Northeastern University. [02:51] Development and validation of the Neuro-Score: a specific scale to detect and monitor cognitive impairment in kidney or liver transplant recipients Editorial: Cognitive impairment after liver and kidney transplant: An easy way to check [14:16] Randomized trial investigating the utility of a liver tissue transcriptional biomarker in identifying adult liver transplant recipients not requiring maintenance immunosuppression [20:46] Donor-specific immune senescence as a candidate biomarker of operational tolerance following liver transplantation in adults: Results of a prospective, multicenter cohort study Editorial: Acquired immune tolerance 2.0 [29:10] Major histocompatibility complex and peptide specificity underpin CD8+ T cell direct alloresponse Editorial: Direct and indirect allorecognition—not so different after all?

En lo último en salud y fitness edición de abril 2025, damos un paseo por las últimas tendencias, investigaciones y noticias en el mundo de la salud y el fitness.En este episodio hablaremos de temas desde cómo la cafeína afecta tu rendimiento (y por qué a veces parece que ya no funciona), hasta la última información sobre los suplementos de omega-3 para el cuidado de tus ojos. También veremos datos nuevos sobre los monitores de glucosa que te harán repensar algunas cosas, y pondremos sobre la mesa la verdad sobre los medicamentos GLP-1 y su efecto en tu músculo.Atajos del episodio: 02:56 - ¿Tomar cafeína todos los días te vuelve inmune a sus efectos para el ejercicio?106:47 - ¿Usas lágrimas artificiales? Mejor dale a tus ojos lo que realmente necesitan211:50 - La glucosa no es tan predecible como pensabas318:16 - GLP-1 y pérdida de peso: ¿también estás perdiendo músculo?423:19 - Más omega-3 y omega-6, menos grasa corporal (sí, leíste bien: omega-6 también)5Referencias: 1.      Khodadadi, D., Azimi, F. & Moghanlou…, A. E. Habitual Caffeine Consumption and Training Status Affect the Ergogenicity of Acute Caffeine Intake on Exercise Performance. Sports … (2025).2.      Hong, S., Woo, M., Eom, Y., Kim, H. K. & Yoon…, K. C. A Multicenter, Randomized, Clinical Trial Assessing the Effect of rTG-Omega 3 Supplementation on Meibomian Gland Dysfunction Patients after Cataract Surgery rTG …. Journal of Ocular … (2025).3.      Hengist, A., Ong, J. A., McNeel, K., Guo, J. & Hall, K. D. Imprecision nutrition? Intraindividual variability of glucose responses to duplicate presented meals in adults without diabetes. The American Journal of … (2025).4.      Beavers, K. M., Cortes, T. M., Foy, C. M. & Dinkla…, L. G LP1Ra‐based therapies and DXA‐acquired musculoskeletal health outcomes: a focused meta‐analysis of placebo‐controlled trials. … (2025).5.      Yang, Z. et al. Omega-3 and omega-6 fatty acids: Inverse association with body fat percentage and obesity risk. Nutrition Research (2025).

Send us a textShort Summary: The flaws of nutrition epidemiology with Dr. John SpeakmanAbout the guest: John Speakman, PhD is a professor at the University of Aberdeen and runs a lab in Shenzhen, China, focusing on energy balance, obesity, and aging. Note: Podcast episodes are fully available to paid subscribers on the M&M Substack and everyone on YouTube. Partial versions are available elsewhere. Transcript and other information on Substack.Episode Summary: Dr. John Speakman explores the pitfalls of nutrition epidemiology, a field that links diet to health outcomes like cancer and obesity but often produces contradictory results. They discuss flawed methods like 24-hour recalls and food frequency questionnaires, which rely on memory and are prone to bias, and introduce Speakman's new tool using doubly labeled water to screen implausible dietary data. The conversation highlights systematic biases, such as under-reporting by heavier individuals, and emerging technologies like photo diaries and AI for better dietary tracking.Key Takeaways:Nutrition epidemiology studies often contradict each other due to unreliable methods.Common techniques like 24-hour recalls & food frequency questionnaires suffer from memory issues, portion size issues, and systematic biases, often underestimating food intake.Heavier individuals (higher BMI) under-report food intake more, skewing associations between diet & obesity.Speakman's tool, based on 6,500 doubly labeled water measurements, predicts energy expenditure to flag implausible dietary survey data.Emerging technologies, like smartphone photo diaries and AI food identification, promise more accurate dietary tracking than traditional surveys.Randomized controlled trials, not surveys, provide the most reliable dietary insights; single-day intake surveys linked to outcomes years later are dubious.Speakman advises ignoring most nutrition epidemiology headlines due to their inconsistency and lack of prognostic value for behavior change.Related episode:Support the showAll episodes, show notes, transcripts, etc. at the M&M Substack Affiliates: Lumen device to optimize your metabolism for weight loss or athletic performance. Use code MIND for 10% off. Readwise: Organize and share what you read. Athletic Greens: Comprehensive & convenient daily nutrition. Free 1-year supply of vitamin D with purchase. KetoCitra—Ketone body BHB + potassium, calcium & magnesium, formulated with kidney health in mind. Use code MIND20 for 20% off any subscription. MASA Chips—delicious tortilla chips made from organic corn and grass-fed beef tallow. No seed oils or artificial ingredients. Use code MIND for 20% off. For all the ways you can support my efforts

Another wild and completely randomised D&D adventure from our live show at Athventure Con, where we let the crowd decide not only our characters, but our story too! Check out everything we do here:https://linktr.ee/hearthfiretaleswww.hearthfiretales.comA big thank you to Ben Clifford for stepping in and helping us out! Ben is a player on D8 Dungeon and the DM for Homebrew Quest! Check out his work there and stay tuned for season 2 of it, "coming soon?" (his words!) over on their Youtube ChannelOf course, a huge thank you to Athventure Con too for inviting us down and letting us do our crazy thing! If you're in Ireland and want an amazing TTRPG convention to go to, we cannot recommend Athventure Con enough! Check out their website www.athventurecon.ie for more details on how to attend! -----------------------------------------------------------------------------------------------------Credits: GM: Dylan McKnight - Hearthfire Tales - https://linktr.ee/DylananddragonsSir Flexology - Jim Tuohy - Hearthfire Tales - https://bsky.app/profile/quigon-jim.bsky.socialBark Kent - Ben Clifford - Homebrew Quest - https://www.instagram.com/benjourmesamis/Video and Audio provided by Riverside Television - https://www.riversidetelevision.com/Filmed at Loughrea Hotel - Athventure Con III - February 2025.

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: Eli Lilly will start a lcinical trial for tirzepatide for people with type 1 diabetes, more details on Dexcom's 15 day G7 sensor, Ozepmic pill form tested, type 5 diabetes identified and more! Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom   Check out VIVI Cap to protect your insulin from extreme temperatures The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX Our top story this week.. Eli Lilly takes the first steps toward getting tirzepatide approved for people with type 1 diabetes. Tirzepatide is sold under the brand names Mounjaro for type 2 and Zepbound for obesity. The main purpose of this study is to find out how well and how safely tirzepatide works in adults who have type 1 diabetes and obesity or are overweight. Participation in the study will last about 49 weeks. Official Title A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study Evaluating the Efficacy and Safety of Tirzepatide Once Weekly Compared to Placebo in Adult Participants With Type 1 Diabetes and Obesity or Overweight This is a big deal because, even though many people with type 1 are able to get a prescription for tirzepatide, it's not approved for T1D and so insurers won't usually cover it.   https://clinicaltrials.gov/study/NCT06914895 XX The use of drugs like Ozempic, Wegovy and Zepbound in people with type 1 diabetes has risen sharply over the past decade, a new study finds, even though there's little information on the drugs' safety and effectiveness for the condition. The family of medications called GLP-1 receptor agonists includes drugs like Wegovy, Zepbound, Ozempic, Mounjaro and Victoza. But the clinical trials of these medications specifically excluded people with type 1 diabetes, who are dependent on the hormone insulin to survive because they can't make enough of their own. Drugmakers feared that using the GLP-1 medications with insulin might raise the chance of dangerously low blood sugar events, or hypoglycemia, and were unwilling to take the risk of studying them in people with type 1.   For the study, which was published last month in the journal Diabetes, Obesity, and Metabolism, researchers at Johns Hopkins University reviewed the medical records of more than 200,000 people with type 1 diabetes from 2008 to 2023. They grouped the data in three-year periods, starting with October 2008 to September 2011 and ending with October 2020 to September 2023. GLP-1 medication use spiked, as well. Among adults with the highest category of obesity, about 4% used GLP-1 medications in 2008, and 33% did by 2023 – an 800% increase. But these are anecdotal reports and may not reflect instances in which people have side effects or complications like low blood sugar, which can be life-threatening. But Shin says what's really needed is information from randomized, double-blinded studies, in which participants are followed forward in time and given either a drug or a placebo. https://www.cnn.com/2025/04/09/health/glp-1-type-1-diabetes-study/index.html   XX Later this month the FDA will conduct a final meeting regarding a new, investigational compound (sotagliflozin) soda-GLIFF-a-zin that has been shown to Improve QoL and Reduce Long-term Complications for people with type 1 diabetes (T1D). The patient advocacy group Taking Control of Your Diabetes (TCOYD.org) is working to inform the T1D community about sotagliflozin - and to encourage people to sign a Change.org petition directed towards FDA.  Last fall, the FDA declined to approve sotagliflozin due to concerns about a potential increased risk of diabetic ketoacidosis (DKA), despite this being a condition that people with T1D on insulin face and manage daily. While TCOYD respects FDA's caution, the group stands by T1D patients and their physicians who, as a team, balance risks and benefits every day. https://tcoyd.org/petition/ XX Dexcom receives FDA approval for it's G7 with 15 day wear. We have an interview with Chief Operating Officer Jake Leach coming up on Tuesday – we talk about the planned roll out of this sensor, what else has changed, and the fine print in the press release – it says    “A study was conducted to assess the sensor life where 73.9% of sensors lasted the full 15 days. When using the product per package labeling, approximately 26% of sensors may not last for the full 15 days.   https://investors.dexcom.com/news/news-details/2025/Dexcom-G7-15-Day-Receives-FDA-Clearance-the-Longest-Lasting-Wearable-and-Most-Accurate-CGM-System/default.aspx?utm_source=www.diabetech.info&utm_medium=referral&utm_campaign=dexcom-g7-15-day-sensor-gets-fda-cleared-but-will-it-actually-last-that-long   XX Glucotrack is joining something called  FORGETDIABETES bionic pancreas initiative, - this is an European Union project that aims to develop a long-term automated insulin delivery system for type 1 diabetes patients. Glucotrack's Continuous Blood Glucose Monitor (CBGM) will be integrated into the system to provide real-time glucose readings. The initiative's goal is to create a bionic invisible pancreas that eliminates the need for therapeutic actions and reduces psychological burden.   The architecture of BIP encompasses a ground-breaking, lifelong lasting implanted ip glucose nanosensor; a radically novel ip hormone delivery pump, with unique non-invasive hormone refill with a magnetic docking pill and non-invasive wireless battery recharge; an intelligent closed-loop hormone dosing algorithm, optimized for ip sensing and delivery, individualized, adaptive and equipped with advanced self-diagnostic algorithms.     Pump refilling through a weekly oral recyclable drug pill will free T1D subjects from the burden of pain and awkward daily measurement and treatment actions. Wireless power transfer and data transmission to cloud-based data management system round-up to a revolutionary treatment device for this incurable chronic disease. key feature of BIP is to be fully-implantable and life-long lasting thanks to novel biocompatible and immune-optimized coatings guaranteeing long-term safety and stability https://www.stocktitan.net/news/GCTK/glucotrack-to-participate-in-forgetdiabetes-a-prominent-european-cjjldjb0dq7h.html XX A newly recognised form of diabetes, called Type 5, was announced this week at the World Congress of Diabetes 2025. A global task force will investigate this less-understood condition, which differs from Type 1 and Type 2 diabetes. Type 5 diabetes affects people who are underweight, lack a family history of diabetes and do not show the typical symptoms of Type 1 or Type 2 diabetes. The condition was first observed in the 1960s and referred to as J-type diabetes, after being detected in Jamaica. It was classified by the World Health Organisation in 1985, but removed in 1998 due to lack of physiological evidence. At the time, experts believed it to be a misdiagnosed case of Type 1 or 2 diabetes. New research has since confirmed that Type 5 is different. https://economictimes.indiatimes.com/news/new-updates/a-new-type-of-diabetes-has-been-found-by-scientists-and-it-doesnt-show-the-typical-symptoms-of-type-1-or-type-2/articleshow/120276658.cms?from=mdr   XX Oral semaglutide cuts major heart risks in people with type 2 diabetes by 14%, offering a powerful pill-based option. A new clinical trial, co-led by endocrinologist and diabetes specialist John Buse, MD, PhD, and interventional cardiologist Matthew Cavender, MD, MPH, at the UNC School of Medicine, has demonstrated that the oral form of semaglutide significantly lowers the risk of cardiovascular events in individuals with type 2 diabetes, atherosclerotic cardiovascular disease, and/or chronic kidney disease. Results from the rather large, international trial were published in the New England Journal of Medicine and presented at the American College of Cardiology's Annual Scientific Session & Expo in Chicago, Illinois.     The effect of oral semaglutide on cardiovascular outcomes was consistent with other clinical trials involving injectable semaglutide, but more trials are needed to determine if one method may be more effective than the other at reducing major cardiovascular events. https://scitechdaily.com/new-pill-form-of-semaglutide-shows-major-benefits-for-people-with-diabetes/ XX April 14 (UPI) -- The U.S. Food and Drug Administration on Monday warned consumers and pharmacies that fake versions of Ozempic, a drug to treat Type 2 diabetes, have been found in the United States. Novo Nordisk, the Danish-headquartered manufacturer, informed the FDA on April 3 that counterfeit 1-milligram injections of semaglutide were being distributed outside its authorized supply chain. The FDA and Novo Nordisk are testing the fake products to identify whether they're safe. Patients are asked to obtain Ozempic with a valid prescription through state-licensed pharmacies and check the product for any signs of counterfeiting. People in possession of the fake product are urged to call Novo Nordisk customer care at 800-727-6500 Monday through Friday from 8:30 a.m. to 6 p.m. EDT and report it to the FDA's criminal activity division's website. Side effects can be reported to FDA's MedWatch Safety Information and Adverse Event Reporting Program (800-FDA-1088 or www.fda.gov/medwatch) as well as to Novo Nordisk, at 800-727-6500. https://www.upi.com/Health_News/2025/04/14/FDA-fake-Ozempic-drugs-Novo-Nordisk/6841744666854/ XX Can a digital lifestyle modification program reduce diabetes risk? A new study shows that the lifestyle intervention significantly reduced 10-year diabetes risk among prediabetics by nearly 46% and increased the diabetes remission rate, highlighting the importance of lifestyle changes. However, the study was not a randomized trial, and participation in the lifestyle intervention was voluntary, which may introduce selection bias. The study evaluated 133,764 adults, categorizing them as diabetic (7.5%), prediabetic (36.2%), and healthy (56.3%), based on fasting glucose and HbA1c levels. https://www.news-medical.net/news/20250414/Digital-lifestyle-program-cuts-diabetes-risk-by-4625-in-prediabetics-study-of-130k2b-adults-reveals.aspx XX Chrissy Teigan is speaking out about her son's type 1 diagnosis – teaming up with Sanofi to encourage people to screen early for Type 1 diabetes.   Teigen got a crash course in the risks of undiagnosed Type 1 diabetes when her 6-year-old son, Miles, was hospitalized with complications of the autoimmune disease last year. The family knew nothing about Type 1 diabetes when Miles was diagnosed during an unexpected medical emergency, Teigen said in a Tuesday announcement. “We were confused and scared when Miles was first diagnosed,” she said in a statement. “There is no doubt in my mind that knowing in advance would have made a positive impact for Miles, me, and our entire family. I want everyone to hear me when I say: stay proactive and talk to your doctor about getting yourself or your loved ones screened for type 1 diabetes today!”   Teigen shared her family's story in a two-minute video on ScreenForType1.com, a Sanofi website that discusses how to get screened for the condition. Miles' diagnosis made Teigen feel like she “went from a mom to a doctor overnight,” she said. That experience is why Teigen said she is “begging you: Do this one thing, and screen yourself and your family for Type 1 diabetes.” https://www.fiercepharma.com/marketing/sanofi-signs-chrissy-teigen-diabetes-screening-campaign XX Dr. Richard Bernstein – best known for his advocacy around low carb diets for people with diabetes – died this week at the age of 90. Born in 1934 in Brooklyn, New York, he was diagnosed with type 1 at age 12. In the 1970s he adapted a blood glucose monitor for home use and helped pioneer home glucose monitoring. He published multiple books on Diabetes including the #1 selling Diabetes book on Amazon.Com “Dr. Bernstein's Diabetes Solution: A Complete Guide to Achieving Normal Blood Sugars” and “Diabetes Type II: Living a Long, Healthy Life Through Blood Sugar Normalization”.  He practiced and saw patients right up until his death.

Dr. Judith Cook (University of Illinois Chicago) joins Dr. Dixon and Dr. Berezin to discuss an intervention designed to help improve financial literacy and competency and reduce economic strain for people receiving services for psychiatric disorders. Transcript 00:57     Psychiatric services research 02:05     Clinical work and Thresholds 03:46     Current role 04:23     Why does financial wellness matter for this population? 06:43     Psych rehab 08:05     Spending triggers 10:59     A psych rehab framework 12:53     Financial wellness 14:10     Beyond trans-diagnostic 16:24     The curriculum 20:10     Receiving a good financial education 21:32     Top line findings of the trial 25:07     The emotional context of financial wellness 25:55     Trained peer instructors 27:34     Policymaker takeaways 30:30     Financial literacy does not imply financial wellness 32:07     Small goals towards financial wellness  Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org

Un nouvel épisode du Pharmascope est disponible! Dans ce 154e épisode à saveur psychoactive, Nicolas, Isabelle et Olivier reçoivent un nouvel invité pour discuter de cannabis. Cette première partie est consacrée à discuter des composantes du cannabis, des différents cannabinoïdes pharmaceutiques et de leur efficacité en douleur neuropathique.  Les objectifs pour cet épisode sont les suivants: Discuter des composantes du cannabis et des cannabinoïdes pharmaceutiques Discuter de l'efficacité des cannabinoïdes dans le traitement de la douleur neuropathique Comparer les données d'efficacité et d'innocuité des cannabinoïdes en douleur neuropathique Ressources pertinentes en lien avec l'épisode  Mücke M, Phillips T, Radbruch L, Petzke F, Häuser W. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2018 Mar 7;3(3):CD012182. Hansen JS et coll. Cannabis-Based Medicine for Neuropathic Pain and Spasticity-A Multicenter, Randomized, Double-Blinded, Placebo-Controlled Trial. Pharmaceuticals (Basel). 2023 Jul 28;16(8):1079. Ware MA, Fitzcharles MA, Joseph L, Shir Y. The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. Anesth Analg. 2010 Feb 1;110(2):604-10. Skrabek RQ, Galimova L, Ethans K, Perry D. Nabilone for the treatment of pain in fibromyalgia. J Pain. 2008 Feb;9(2):164-73. Bell AD et coll. Clinical Practice Guidelines for Cannabis and Cannabinoid-Based Medicines in the Management of Chronic Pain and Co-Occurring Conditions. Cannabis Cannabinoid Res. 2024 Apr;9(2):669-687. Busse JW et coll. Medical cannabis or cannabinoids for chronic pain: a clinical practice guideline. BMJ. 2021 Sep 8;374:n2040. Wang L et coll. Medical cannabis or cannabinoids for chronic non-cancer and cancer related pain: a systematic review and meta-analysis of randomised clinical trials. BMJ. 2021 Sep 8;374:n1034. Allan GM et coll. Simplified guideline for prescribing medical cannabinoids in primary care. Can Fam Physician. 2018 Feb;64(2):111-120. Allan GM et coll. Systematic review of systematic reviews for medical cannabinoids: Pain, nausea and vomiting, spasticity, and harms. Can Fam Physician. 2018 Feb;64(2):e78-e94.

Send us a textWelcome back Rounds Table Listeners! We are back today with our Classic Rapid Fire Podcast! This week, Dr. John Fralick and guest host Dr. Chunpeng Nie discuss two recent papers: resmetirom for the treatment of Nonalcoholic Steatohepatitis (NASH)—now known as Metabolic Dysfunction-Associated Steatohepatitis (MASH)—with liver fibrosis, and the effect of a Mediterranean diet on disease activity, inflammation, and the gut microbiome in patients with ulcerative colitis. Two papers, here we go!A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis (0:00 – 10:17)A Mediterranean Diet Pattern Improves Intestinal Inflammation Concomitant with Reshaping of the Bacteriome in Ulcerative Colitis: A Randomised Controlled Trial (10:18– 15:45)And for the Good Stuff:Shoutout to all the MTU teams supporting their R1's! (15:46 – 16:20).For the 1st time in Canada, surgeons put teeth in patients' eyes to restore sight (16:21 – 17:56)Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Sacubitril/Valsartan vs ACE Inhibitors or ARBs: A Systematic Review and Meta-Analysis of Randomized Trials

En lo último en salud y fitness edición de marzo 2025, damos un paseo por las últimas tendencias, investigaciones y noticias en el mundo de la salud y el fitness. En esta edición tenemos un menú variado: vamos a ver qué dice la ciencia sobre proteína animal vs vegetal para ganar músculo, cómo el ejercicio regular puede ayudarte a mantener la inflamación a raya conforme envejeces, y por qué más cafeína no siempre significa mejor rendimiento. También analizaremos si el alpha-GPC realmente mejora tu desempeño mental y físico, y veremos qué hay de cierto en eso de que el té verde protege tu cerebro.   Atajos del Episodio 02:05 -¿Es mejor la proteína animal o vegetal para ganar músculo?1 05:00 – El ejercicio durante toda la vida puede contrarrestar la inflamación crónica asociada con la edad2 09:21 – Más cafeína no siempre es mejor: lo que un grupo de kickboxers nos enseñó3 12:21 – ¿Alpha-GPC mejora el rendimiento mental y físico? La ciencia aún no está convencida4 15:56 – ¿El té verde protege tu cerebro? La ciencia dice que sí, pero con reservas5   Referencias:  1.      Reid-McCann, R. J., Brennan, S. F. & Ward…, N. A. Effect of Plant Versus Animal Protein on Muscle Mass, Strength, Physical Performance, and Sarcopenia: A Systematic Review and Meta-analysis of Randomized …. Nutrition … (2025). 2.      Pérez-Castillo, I. M., Rueda, R. & Bouzamondo…, H. Does Lifelong Exercise Counteract Low-Grade Inflammation Associated with Aging? A Systematic Review and Meta-Analysis. Sports Medicine (2025). 3.      Saremi, M., Shahriari, F. & Hemmatinafar…, M. Low-Dose Caffeine Supplementation Is a Valuable Strategy for Increasing Time to Exhaustion, Explosive Power, and Reducing Muscle Soreness in …. Current Developments … (2025). 4.      Kerksick, C. M. Acute Alpha-Glycerylphosphorylcholine Supplementation Enhances Cognitive Performance in Healthy Men. Nutrients (2024). 5.      Zhou, S., Zhu, Y., Ren, N., Wu, M. & Liu, Y. The Association Between Green Tea Consumption and Cognitive Function: A Meta-Analysis of Current Evidence. Neuroepidemiology (2025).

In this episode, Dr. Valentin Fuster summarizes the March 25, 2025, issue of the JACC, which focuses on advancements in electrophysiology. Highlights include groundbreaking studies on leadless pacemakers, atrial fibrillation treatments, and appropriate use criteria for cardiac devices, with key papers exploring the safety of pacemaker retrieval, the role of electrograms in ablation procedures, and long-term outcomes for left atrial appendage occlusion devices.

In this episode, Dr. Valentin Fuster summarizes the March 25, 2025, issue of the JACC, which focuses on advancements in electrophysiology. Highlights include groundbreaking studies on leadless pacemakers, atrial fibrillation treatments, and appropriate use criteria for cardiac devices, with key papers exploring the safety of pacemaker retrieval, the role of electrograms in ablation procedures, and long-term outcomes for left atrial appendage occlusion devices.

Randomized Comparison Trial of Rehabilitation Very Early for Infants with Congenital HemiplegiaRoslyn N Boyd, Susan Greaves, Jenny Ziviani, Iona Novak, Nadia Badawi, Kerstin Pannek, Catherine Elliott, Margaret Wallen, Catherine Morgan, Jane Valentine, Lisa Findlay, Andrea Guzzetta, Koa Whittingham, Robert S Ware, Simona Fiori, Nathalie L Maitre, Jill Heathcock, Kimberley Scott, Ann-Christin Eliasson, Leanne SakzewskiPMID: 39477009 DOI: 10.1016/j.jpeds.2024.114381Free articleAbstractObjective: To compare efficacy of constraint-induced movement therapy (Baby-CIMT) with bimanual therapy (Baby-BIM) in infants at high risk of unilateral cerebral palsy.Study design: This was a single-blind, randomized-comparison-trial that had the following inclusion criteria: (1) asymmetric brain lesion (2) absent fidgety General Movements, (3) Hammersmith Infant Neurological Examination below cerebral palsy cut-points, (4) entry at 3-9 months of corrected age, and (5) greater than 3-point difference between hands on Hand Assessment Infants (HAI). Infants were randomized to Baby-CIMT or Baby-BIM, which comprised 6-9 months of home-based intervention. Daily dose varied from 20 to 40 minutes according to age (total 70-89.2 hours). Primary outcome measure was the HAI after intervention, with secondary outcomes Mini-Assisting Hand Assessment and Bayley III cognition at 24 months of corrected age.Results: In total, 96 infants (51 male, 52 right hemiplegia) born median at 37-weeks of gestation were randomized to Baby-CIMT (n = 46) or Baby-BIM (n = 50) and commenced intervention at a mean 6.5 (SD 1.6) months corrected age. There were no between group differences immediately after intervention on HAI (mean difference MD 0.98 HAI units, 95% CI 0.94-2.91; P = .31). Both groups demonstrated significant clinically important improvements from baseline to after intervention (Baby-BIM MD 3.48, 95% CI 2.09-4.87; Baby-CIMT MD 4.42, 95% CI 3.07-5.77). At 24 months, 64 infants were diagnosed with unilateral cerebral palsy (35 Baby-CIMT, 29 Baby-BIM). Infants who entered the study between 3 and 6 months of corrected age had greater change in HAI Both Hands Sum Score compared with those who entered at ≥6 months of corrected age (MD 7.17, 95% CI 2.93-11.41, P = .001).Conclusions: Baby-CIMT was not superior to Baby-BIM, and both interventions improved hand development. Infants commencing intervention at greater than 6 months corrected age had greater improvements in hand function.https://pubmed.ncbi.nlm.nih.gov/39477009/

This week we're doing something very different!  By Patron request, we're playing a classic SNES game, The Legend of Zelda : A Link to the Past, but we're playing it with a randomizer.  Items are moved around, meaning you'll tackle this game in a different order, with different weapons and items than you're used to, and it's a very different experience. Here's the directions we had : https://www.youtube.com/watch?v=82dogTS1KT4 (Not our video!) and then create your file over here : https://alttpr.com/en We discuss the game itself first, and then our experience with the randomizer, and then of course take on some listener mail. Join us over on our Discord to discuss games, food, or really anything over at https://discord.gg/pb76x32uWY __________________________ If you would like additional bonus episodes of Retrovaniacs or to request a game we must cover, our Patreon is located here : https://www.patreon.com/user?u=21041333 If you enjoy this podcast, why not write a review wherever you download it from? It's easy, and helps people find us by accident. Find everything Retrovaniacs at http://www.retrovania.net Intro song is "8-Bitter" by Subtastics, and is used with permission, mainly because Jeremy P is in that band.  

Send us a textEarly hydrocortisone verses placebo in neonatal shock- a double blind Randomized controlled trial.Dudeja S, Saini SS, Sundaram V, Dutta S, Sachdeva N, Kumar P.J Perinatol. 2025 Feb 13. doi: 10.1038/s41372-025-02222-3. Online ahead of print.PMID: 39948354As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

In this episode of Audible Bleeding, Jamila, Anh, and Naveed discuss the LifeBTK Trial with Principal Investigator Dr. Brian DeRubertis, where we discuss the new Abbott Esprit everolimus-eluting resorbable scaffold for the below-knee popliteal space. Guest: Dr. DeRubertis, is the Principal Investigator of the LIFE-BTK trial. He is the Chief of the Division of Vascular & Endovascular Surgery at New York-Presbyterian and Weill Cornell Medicine in New York City. Audible Bleeding Team Dr. Jamila Hedhliis a general surgery resident at the University of Illinois. Anh Dang, (@QuynhAnh_Dang), is a fourth year medical student at the University of Pennsylvania.  Dr. Naveed A. Rahman, (@naveedrahmanmd), is a Vascular Surgery Fellow at the University of Maryland.    References: Drug-Eluting Resorbable Scaffold versus Angioplasty for Infrapopliteal Artery Disease (LIFE-BTK). Advances in Endovascular Treatment of CLTI: Insights From the LIFE-BTK Trial. Diversity, Equity, and Inclusion in the LIFE-BTK Trial Evaluating the Esprit™ BTK Drug-Eluting Resorbable Scaffold for the Treatment of Infrapopliteal Lesions in Patients with Chronic Limb-Threatening Ischemia, VIVA 2024. Sirolimus-eluting stents vs. bare-metal stents for treatment of focal lesions in infrapopliteal arteries: a double-blind, multi-centre, randomized clinical trial (YUKON). Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease (DESTINY).  A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the sirolimus-eluting stent in patients with ischemic peripheral arterial disease (ACHILLES). Sex Differences in Outcomes Following Endovascular Treatment for Symptomatic Peripheral Artery Disease: An Analysis From the K- VIS ELLA Registry. Drug-Coated vs Uncoated Percutaneous Transluminal Angioplasty in Infrapopliteal Arteries: Six-Month Results of the Lutonix BTK Trial.  Paclitaxel-Coated Balloon in Infrapopliteal Arteries: 12-Month Results From the BIOLUX P-II Randomized Trial (BIOTRONIK'S-First in Man study of the Passeo-18 LUX drug releasing PTA Balloon Catheter vs. the uncoated Passeo-18 PTA balloon catheter in subjects requiring revascularization of infrapopliteal arteries).  The IN.PACT DEEP Clinical Drug-Coated Balloon Trial: 5-Year Outcomes.     Follow us @audiblebleeding Learn more about us at  https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

Commentary by Dr.  Jian'an Wang

In this podcast, Dr. Valentin Fuster discusses the Target for NA trial, which compares biodegradable polymer stents to second-generation drug-eluting stents for coronary intervention. While the results showed the biodegradable stents were non-inferior in preventing target lesion failure, questions remain regarding their real-world performance and procedural handling in clinical practice.

OPTION - Randomized Comparison of Left Atrial Appendage Closure with Oral Anticoagulation after Catheter Ablation for Atrial Fibrillation (OPTION)

DRAMI: Randomized Comparison of Puncture Success Rate Between Distal Radial Access and Transradial Access in Patients With ST-Elevation Myocardial Infarction

En lo último en salud y fitness edición de enero 2025, vamos a hablar sobre algunos temas que van desde cómo pequeños cambios en nuestra rutina diaria pueden tener un gran impacto en nuestra salud, hasta el sorprendente papel del chocolate oscuro en el rendimiento deportivo. También veremos cómo combinar el ayuno intermitente con el ejercicio puede ser una estrategia efectiva para perder peso, y analizaremos qué dice la ciencia sobre el momento ideal para consumir proteína después de entrenar. Y para cerrar, echaremos un vistazo a una hierba tradicional que está ganando atención por sus efectos en la claridad mental y el estado de ánimo. Atajos del episodio: 01:36 - El Poder de Interrumpir el Sedentarismo1 04:55 - Chocolate Oscuro: ¿Un Impulso Secreto para los Corredores?2 07:37 - Ayuno Intermitente y Ejercicio para Perder Peso3 09:56 - ¿Es la proteína post entrenamiento la clave para el aumento de fuerza?4 14:51 - El poder de la ashwagandha: Un Impulso Natural para la Mente y el Ánimo5   Referencias:  1.      Yin, M., Xu, K., Deng, J., Deng, S. & Chen…, Z. Optimal Frequency of Interrupting Prolonged Sitting for Cardiometabolic Health: A Systematic Review and Meta‐Analysis of Randomized Crossover Trials. … Journal of Medicine … (2024). 2.      Vordos, Z., Deli, I., Anifanti, M., Kluzek, S. & Koutlianos…, N. The Effect of Dark Chocolate Consumption on Arterial Function in Endurance Male Runners: Prospective Cohort Study. Sports (2024). 3.      Cheng, X., Sun, S., Chen, M., Zhou, X. & Rao…, M. Evaluating the efficacy of intermittent fasting and exercise combinations for weight loss: A network meta‐analysis. Obesity … (2024). 4.      Reljic, D., Zieseniss, N., Herrmann, H. J. & Neurath…, M. F. Protein Supplementation Increases Adaptations to Low-Volume, Intra-Session Concurrent Training in Untrained Healthy Adults: A Double-Blind, Placebo …. Nutrients (2024). 5.      Kale, S., Lopresti, A., Suri, R. & Garg…, N. Safety and Efficacy of Ashwagandha Root Extract on Cognition, Energy and Mood Problems in Adults: Prospective, Randomized, Placebo-Controlled Study. Journal of Psychoactive … (2024).

Proximity to innovation often gives rise to further innovation. This trend is especially true in interventional radiology. Dr. Gregg Alzate (interventional radiologist in San Diego, California) joins host Dr. Ally Baheti to share his career pearls for early and mid-career IRs, and how he came to pioneer the Alzate Retrograde Antegrade Maneuver (A-RAM). --- This podcast is supported by: Reflow Medical https://www.reflowmedical.com/ --- SYNPOSIS Dr. Alzate starts by sharing his early influences, including his time with interventional radiology giant Dr. Harold Coons. The doctors also cover the importance of proper vessel access techniques, innovative approaches to limb salvage, and how to address complex chronic total occlusions (CTOs). Dr. Alzate then goes on to give us a thorough walkthrough of the A-RAM. The episode concludes with Dr. Alzate's closing thoughts on being open to adopt new techniques, the impact of strong mentorship, and importance for consuming and sharing knowledge. --- TIMESTAMPS 00:00 - Introduction 03:05 - Dr. Alzate's Journey 25:52 - A-RAM Technique 34:26 - CTO's and Heavy Calcium 40:16 - Moral Injury in Medical Practice 43:35 - Honoring Dr. Harold Coons 46:23 - Closing Thoughts and Reflections --- RESOURCES Ohki, Takao et al. “Long-term results of the Japanese multicenter Viabahn trial of heparin bonded endovascular stent grafts for long and complex lesions in the superficial femoral artery.” Journal of vascular surgery vol. 74,6 (2021): 1958-1967.e2. https://www.jvascsurg.org/article/S0741-5214(21)01011-9/fulltext Kedora, John et al. “Randomized comparison of percutaneous Viabahn stent grafts vs prosthetic femoral-popliteal bypass in the treatment of superficial femoral arterial occlusive disease.” Journal of vascular surgeryvol. 45,1 (2007): 10-6; discussion 16. https://www.jvascsurg.org/article/S0741-5214(06)01612-0/fulltext

TRISCEND II: Randomized Comparison of Transcatheter Valve Replacement vs. Optimal Medical Therapy for Severe Tricuspid Regurgitation

Introduction (00:00 - 03:00) Dr. Valentin Fuster introduces the focus of the January 28, 2025, issue of JACC on transcatheter tricuspid valve interventions. He emphasizes the growing importance of addressing symptomatic tricuspid regurgitation, a major predictor of morbidity and mortality, and explores potential treatments that aim to improve quality of life and decrease hospitalizations. Transcatheter Tricuspid Valve Repair (03:00 - 20:30) Fuster discusses two key studies: the TRILUMINATE randomized trial and a large European registry. While the TRILUMINATE trial demonstrated significant quality of life improvements using the TriClip device, it did not show a reduction in mortality or heart failure hospitalizations, suggesting the need for longer follow-up in future studies. Meanwhile, the European registry highlights the effectiveness of the Pascal device, showing significant symptomatic improvements and tricuspid regurgitation reduction in high-risk patients. Transcatheter Tricuspid Valve Replacement (20:30 - 35:00) Fuster moves on to discuss the TRISCEND II pivotal trial on transcatheter tricuspid valve replacement. Like the previous repair methods, it primarily improves health status without significantly reducing mortality or hospitalizations, as shown in the trial's findings. He also mentions an excellent state-of-the-art review on this intervention featured in JACC. Imaging in Transcatheter Valve Interventions (35:00 - 45:00) This section highlights the importance of imaging in transcatheter valve interventions. Fuster presents a new project under the leadership of Dr. Kalyanam Shivkumar, aimed at enhancing cardiac anatomy and function resources, supporting advancements in cardiovascular treatments. Conclusion (45:00 - 55:00) Dr. Valentin Fuster wraps up the podcast by summarizing the key takeaways: while current transcatheter interventions show promise in improving symptoms and quality of life for patients with severe tricuspid regurgitation, long-term follow-up is crucial to fully understand their impact on survival and heart failure hospitalizations.

ACCESS TAVI: Randomized Comparison of Strategies for Vascular Access Closure After Transcatheter Aortic Valve Implantation

In this episode, Dr. Valentin Fuster discusses the findings of a major randomized trial examining the use of drug-coated balloons (DCB) in treating side branch stenosis during coronary bifurcation procedures. The study suggests that DCBs offer better one-year outcomes compared to non-coated balloons, showing a significant reduction in myocardial infarction rates, but highlights ongoing challenges in managing bifurcation lesions, especially considering the high cost and potential risks.

Clinical research is undergoing a revolution in light of new demands for speed and opportunities from a technological standpoint. These trends have given rise to a debate about the quality and clinical meaning of traditional methods of investigations versus modern types of clinical studies to collect real world evidence. This debate at the 3rd annual Medical Affairs Innovation Olympics #MAIO2024 in a unique and exciting format with a live poll at the conclusion, features an animated discussion from three speakers: Rashad Massoud, MD, MPH, CEO of Rashad Massoud Associates, LLC., globally recognized healthcare quality expert, physician, formerly visiting faculty at the T.H. Chan School of Public Health; Suzanne Pavon (moderator), Doctor of Pharmacy, Board Member at Iethico, former Vice President of Pharmacovigilance and Quality at Argenx; and Sana Syed, Senior Medical Director - Clinical Lead at Sanofi and public health expert formerly at T.H. Chang School of Public Health. Debate Objectives: ● To discuss the utility of RCTs in research and learning ● To discuss the challenges in translating RCT findings into the real-world environment ● To review the utility of the RCT approach to facilitate real world implementation ● To review the impact of the RCT approach for impact and limitations ● To discuss alternative research methods for research and learning ● To conclude with the research approaches that fit best for clinical trials and the real world; indicating a need for an adaptive, dual approach. 0:00 Alloutcoach Intro Music 0:09 Episode Highlight 3:09 Innovation Olympics Introduction 4:44 Debate Rules & Introduction 6:30 RCTs are the Gold Standard for Research and Learning - For the Motion - Sana Syed 8:12 The Scientific Method - Standard RCT Design 9:46 Rare Disease Case Study 11:38 Translating Biology vs Translating Real World Factors 14:34 Diversity of patients critical for data to represent populations 18:50 RCTs are NOT the Gold Standard for Research: Against the Motion - Rashad Massoud 20:27 Properties of an RCT 21:19 Other Research Questions to Eliminate Other Factors that may influence the results 24:13 Access Questions and Outcomes of Interest - Discovery and Delivery 24:48 Agency for Healthcare Research and Quality (AHRQ) - ~17 yrs to translate data into real world 26:33 Efficacy vs. Effectiveness Research 31:02 Concluding Remarks - case study in which RCT designs are not beneficial 35:30 Question: Health Avatar and AI to create real and virtual control arm Using virtual control arm using real world databases using Bayesian statistical methods 39:23 Case study to emphasize Harnessing Tacit knowledge 42:02 Comment: Weaknesses in generating data we can translate into populations 43:44 Question: Are we creating RCTs from virtual patients or classical RCT design? 47:34 Final Comments - For the Motion, Sana Syed Clinical Studies and Scientific Method - adjustments in diverse patient recruitment tactics 49:31 Final Comments - Against the Motion, Rashad Massoud 53:14 Live Voting Results

TARGET IV International Multicenter Randomized Assessment of the Firehawk® Rapamycin Eluting Coronary Stent System

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.       Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. Welcome to another episode of "Ditch the Lab Coat," the podcast where we delve into science-based skepticism and medical insights. I'm your host, Dr. Mark Bonta, and today's episode is an eye-opener for anyone curious about men's health, specifically testosterone. I'm joined by Dr. Adam Millar, a leading expert who will help us navigate the complexities and common misconceptions surrounding this vital hormone.We'll discuss the optimal timing and conditions for measuring testosterone levels, the overprescription concerns, and the often overlooked role of the pituitary gland in testosterone production. We'll also touch on hypogonadism and its impact on testosterone and sperm production. Our conversation will differentiate between evidence-based medical advice and the often misleading claims from social media influencers.Dr. Millar will share insights from high-quality studies, including the pivotal Traverse trial, and highlight the importance of informed decision-making when it comes to testosterone therapy. We'll explore natural ways to boost testosterone and the potential risks of unwarranted treatments.Whether you're considering testosterone therapy or just want to understand more about what drives these discussions, this episode is packed with valuable information. So, sit back and get ready to ditch the lab coat for some straightforward, evidence-based talk on testosterone. Don't forget to check out our blog at ditchthelabcoat.com for more resources and share this episode to spread the knowledge!05:11 - Growing interest and increasing prescriptions for testosterone worldwide.08:31 - Non-uniform hypogonadism diagnosis complicates treatment decisions.12:30 - Symptoms alone are not reliable indicators of low testosterone.15:23 - Testosterone production occurs in Leydig cells, stimulated by LH.17:26 - Semen analysis helps assess sperm production and fertility.21:40 - Testosterone boosts energy and strength but can impair fertility.24:39 - Potential harms of testosterone include reproductive and cardiovascular issues.28:17 - Discussion on testosterone's necessity; symptoms are often nonspecific.31:53 - Is testosterone's effect truly objective or just placebo?35:08 - Exploring the role of testosterone in men's health and aging.39:35 - Testosterone gel is not linked to increased heart issues.41:41 - Randomized studies suggest testosterone may not cause harm.47:19 - Valuable conversation emphasizing informed health guidance.50:19 - Empowering the audience to research and make informed decisions.51:33 - Closing discussion on testosterone; visit ditchthelabcoat.com.

Get 20% off the New 2nd Generation Tone Device HERE with the code VANESSA In this groundbreaking episode of The Optimal Protein Podcast, we dive into a fascinating new randomized controlled trial published in Obesity (link to study) that explores the impact of carbohydrate consumption on ketosis and hunger regulation. Key Topics Discussed: • Study Overview: The methodology and key findings of this recent trial, which evaluates how carbohydrates affect ketone production and appetite. • Carbs and Ketosis: Why carbohydrates are inherently “anti-ketogenic” and how they disrupt the metabolic state of ketosis. • Hunger Regulation: Evidence from the study that links higher carbohydrate intake to increased hunger levels and how this impacts weight management strategies. • Practical Implications: What these findings mean for those pursuing ketogenic or low-carb diets for fat loss, body recomposition, and improved metabolic health. • Satiety and Protein: How prioritizing protein can help counteract the hunger-inducing effects of carbs while supporting sustainable fat loss. Why This Episode Matters: This study provides compelling evidence that supports the ketogenic approach to nutrition by highlighting the direct relationship between carbohydrate intake and hunger signaling. Whether you're a seasoned low-carb enthusiast or someone curious about the benefits of keto, this episode offers valuable insights and actionable takeaways. Links and Resources: • Full Study: Carbs Are Anti-Ketogenic • Follow @ketogenicgirl for updates on the latest studies and strategies to optimize protein intake and metabolic health.  Follow @optimalproteinpodcast on Instagram to see visuals and posts mentioned on this podcast. Link to join the facebook group for the podcast: https://www.facebook.com/groups/2017506024952802/   Thank you to our sponsor:   Bioptimizers Magnesium Breakthrough is one of the only supplements I take with me when I travel as it is so important to me! Save 10% OFF with the code VANESSA at bioptimizers.com/vanessa - This podcast content does not constitute an attempt to practice medicine and does not establish a doctor-patient relationship. Please consult a qualified healthcare provider for medical advice and personal health questions. Prior to beginning a new diet you should undergo a health screening with your physician to confirm that a new diet is suitable for you and to out any conditions and contraindications that may pose risks or are incompatible with a new diet, including by way of example: conditions affecting the kidneys, liver or pancreas; muscular dystrophy; pregnancy; breast-feeding; being underweight; eating disorders; any health condition that requires a special diet [other conditions or contraindications]; hypoglycemia; or type 1 diabetes. A new diet may or may not be appropriate if you have type 2 diabetes, so you must consult with your physician if you have this condition. Anyone under the age of 18 should consult with their physician and their parents or legal guardian before beginning such a diet. Use of Ketogenic Girl podcasts & videos are subject to the Ketogenicgirl.com Terms of Use and Medical Disclaimer. All rights reserved. If you do not agree with these terms, do not listen to, or view any Ketogenic Girl podcasts or videos.

SENIOR RITA – Older Patients with Non-ST Segment Elevation Myocardial Infarction Randomized Interventional Treatment Trial

Send us a textIn this episode, Dr. Bobby tackles the often perplexing world of health headlines. From bold claims about intermittent fasting to the benefits of wearing socks to bed, he breaks down how to evaluate these headlines critically. With nine key questions to ask about a headline, insights into the hierarchy of evidence, and two practical examples, Dr. Bobby provides listeners with tools to discern fact from fiction in health journalism.And, your Health Type influences how you might use information.  Take the Health QuizJoin the Mastermind Workshop Waitlist here:  the Live Long and Well JumpstartKey Topics Covered:Understanding Health Headlines:Should you believe a health headline?  How do you decide whether it is likely to be true, or not adequately based upon evidence?Common examples of sensational headlines and their flaws.Nine Essential Questions to Evaluate Headlines:Is the article published in a reputable outlet by a science writer?Was the headline based on actual scientific studies or just an expert's opinion?Is the study published in a peer-reviewed journal, or was it just presented at a meeting?What journal was it published in, and what is its impact factor?Who conducted the study, and where?How large was the study population?What type of study was it? (Randomized controlled trial vs. observational vs. model-based.)Was there an editorial discussing the study's limitations?Does the headline sound "too good to be true"?Hierarchy of Evidence:From most likely credible to least likelycredible:Meta-analyses.Randomized controlled trials (RCTs).Observational studies.Case series.Expert guidelines.Individual expert opinions.Explanation of each and when to trust them.Examples of Health Studies:Intermittent Fasting and Heart Risk: Why the headline about a 91% increased risk of death was flawed.Meal Replacement Shakes: Insights from a Chinese randomized trial and its limitations.The Problem of Data Manipulation (P-Hacking):How over-analysis of databases can lead to misleading conclusions.The importance of recognizing correlation vs. causation in studies.Takeaways for Listeners:Use the 9 Questions Framework to critically evaluate health headlines and articles.Understand that the type of study (e.g., RCT vs. observational) significantly impacts its credibility.Remember that sensational headlines often oversimplify or distort study findings.Stay skeptical of small studies or ones with vague methodologies.Engage with Dr. Bobby:Have a confusing health headline you'd like Dr. Bobby to analyze? Send it in!Take the health type quiz at DrBobbyLiveLongAndWell.com to better understand how your approach to wellness influences your perception of health information.Don't forget to leave a review on Apple Podcasts, Spotify, or wherever you listen!

Join us as we dive back into the world of psychedelic medicine with anesthesiologists Boris Heifets and Theresa Lii, who share intriguing new data that sheds light on how ketamine and placebo effects may interact in treating depression.We explore provocative questions like: How much of ketamine's antidepressant effect comes from the drug itself versus the excitement of being in a psychedelics trial? What do we know about how placebo actually works in the brain? And should we view the placebo effect as a feature rather than a bug in psychiatric treatment?Join us as we examine the complex interplay between psychoactive drugs, the brain's own opioid system, and the healing power of hope in mental health care.Related researchPreprint: Opioids Diminish the Placebo Antidepressant Response: A Post Hoc Analysis of a Randomized Controlled Ketamine Trial (medRxiv, 2024)Randomized trial of ketamine masked by surgical anesthesia in patients with depression (Nature Mental Health, 2023)Related episodesPsychedelics, placebo, and anesthetic dreams | Boris Heifets (Part 1) Psychedelics Inside Out: How do LSD and psilocybin alter perception? | Boris Heifets (Part 2)OCD and Ketamine | Carolyn RodriguezPsychedelics and Empathy: Why are psychiatrists taking a fresh look at MDMA? | Rob MalenkaRelated newsResearchers find response to ketamine depends on opioid pathways, but varies by sex (Stanford Medicine, 2024)The rebirth of psychedelic medicine (Wu Tsai Neuro, 2023)Can Psychedelic Drugs Treat Physical Pain? (Scientific American, 2022)Scientists Say A Mind-Bending Rhythm In The Brain Can Act Like Ketamine (NPR, 2020)Get in touchWe're doing some listener research and we want to hear from your neurons! Email us at at neuronspodcast@stanford.edu if you'd be willing to help out, and we'll be in touch with some follow-up questions.Episode CreditsThis episode was produced by Michael Osborne at 14th Street Studios, with production assistance by Morgan Honaker. Our logo is by Aimee Garza. The show is hostSend us a text!Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience. Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.

HEALTH NEWS   ·         Korean Red Ginseng Extract Powder Mitigates Fasting And Postprandial Hyperglycemia in Type 2 Diabetic Mice ·         Individualized Homeopathic Medicinal Products in the Treatment of Post-COVID-19 Conditions: A Double-Blind, Randomized, Placebo-Controlled, Feasibility Trial ·         'Water on the knee' could be early sign of Lyme disease  ·         Modern science uncovers brain-boosting power of ancient spice coriander and its key compound linalool ·         While more is better, even moderate amounts of exercise may reduce risk for common heart condition ·         An emotional connection: Study finds heart rate variability syncs between dogs and owners

Todd Cartee, MD interviewed by Carlos A. Garcia, MD

Author Robert W. Yeh, MD, FACC, and JACC Associate Editor Celina M. Yong, MD, FACC, discuss the results of the TARGET-IV NA trial. In the trial, 1720 patients with stable or acute coronary syndromes were randomized to undergo PCI with a BP-SES or any commonly used 2nd generation DES. At 12 months, BP-SES was non-inferior to control DES for the primary endpoint of Target Lesion Failure (cardiac death, target vessel-related myocardial infarction (MI), or ischemia-driven target lesion revascularization) which occurred in 3.4% of the BP-SES arm versus 3.3% in the control arm; p-value for non-inferiority. Secondary endpoints were also similar between groups.

Author Shao-Liang Chen, MD, FACC, and JACC Associate Editor Celina M. Yong, MD, FACC, discuss patients with simple and true coronary bifurcation lesions undergoing provisional stenting. Main vessel stenting with a DCB for the compromised side branch resulted in a lower 1-year rate of the composite outcome compared with an NCB intervention for the side branch. The high rates of periprocedural myocardial infarction, which occurred early and did not lead to revascularization, are of unclear clinical significance.

JACC Associate Editor Celina M. Yong, MD, FACC, and JACC: Case Reports Editor in Chief Gilbert H. L. Tang, MD, MSc, MBA, FACC, discuss this paper published in JACC and presented at TCT. TRILUMINATE Pivotal is the first randomized, controlled trial evaluating transcatheter edge-to-edge repair (T-TEER) for severe tricuspid regurgitation (TR). Adaptive design randomized 572 subjects in the primary or subsequent cohorts. Subjects were elderly with atrial fibrillation and prior HFH. Primary endpoint was met at 1 year with a larger win ratio for T-TEER driven by KCCQ improvement with no significant differences in mortality and tricuspid valve surgery or HFH.

Public Health Careers podcast episode with Eric J. Daza, DrPH, MPS

If you're looking to heal leaky gut and to strengthen your gut lining, there are a couple of different components to consider. Luckily, we have a new, science-based supplement that provides several lines of defense for your gut health. In this episode, I'll explain the best nutrients for your gut lining, and why Gut Rebuild Nutrients is the perfect all-around supplement for healing. 

Date: October 7, 2024 Reference: Nguyen et al. Comparison of Nebulized Ketamine to Intravenous Subdissociative Dose Ketamine for Treating Acute Painful Conditions in the Emergency Department: A Prospective, Randomized, Double-Blind, Double-Dummy Controlled Trial. Annals of EM 2024. Guest Skeptic: Dr. Brendan Freeman is an emergency medicine physician, assistant professor of emergency medicine, and medical education […] The post SGEM#457: Inhale – Nebulized or IV Ketamine for Acute Pain? first appeared on The Skeptics Guide to Emergency Medicine.

Palmitic acid, a saturated fat concentrated in meat and dairy, can boost the metastatic potential of cancer cells through the fat receptor CD36. Randomized controlled trials show that lowering saturated fat intake can lead to improved breast cancer survival.

In this episode, we spotlight editorials and abstracts from the Journal of Vascular Surgery Cases, Innovates, and Techniques (JVS-CIT). Editorials and Abstracts are read by members of the SVS Social Media Ambassadors.   Readers: David Ebertz (@EbertzDavid) Kori Snider (@KoriSnider) Nabeeha Khan (@Nabeeha_Khan_)   Hosts: John Culhane (@Johnculhanemd) Nishi Vootukuru (@Nishi_Vootukuru)   Reference Articles: Sutureless endovascular bypass technique in long femoropopliteal occlusions Technical feasibility and device stability of the Gore Excluder iliac branch endoprosthesis as abdominal aortic bifurcated device Retrograde aortic dissection during thoracic endovascular aortic repair: How to prevent and treat Retroperitoneal approach for ilio-superior mesenteric artery bypass: Technique and case series Randomized controlled trials in emergency settings: Taking a HEADSTART on acute type A aortic dissection trials Presentation and management of true aneurysms of the pancreaticoduodenal arcade with concomitant celiac artery stenosis using the endovascular approach Regarding “Aortic rupture during STABILISE (stent-assisted balloon-induced intimal disruption and relamination in aortic dissection repair) technique” Temporary mesenteric venous shunting for portal vein reconstruction: A novel technical adjunct   Follow us @audiblebleeding   Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey. *Gore is a financial sponsor of this podcast, which has been independently developed by the presenters and does not constitute medical advice from Gore. Always consult the Instructions for Use (IFU) prior to using any medical device.  

In this episode, we spotlight editorials and abstracts from the Journal of Vascular Surgery Cases, Innovates, and Techniques (JVS-CIT). Editorials and Abstracts are read by members of the SVS Social Media Ambassadors.   Readers: David Ebertz (@EbertzDavid) Kori Snider (@KoriSnider) Nabeeha Khan (@Nabeeha_Khan_)   Hosts: John Culhane (@Johnculhanemd) Nishi Vootukuru (@Nishi_Vootukuru)   Reference Articles: Sutureless endovascular bypass technique in long femoropopliteal occlusions Technical feasibility and device stability of the Gore Excluder iliac branch endoprosthesis as abdominal aortic bifurcated device Retrograde aortic dissection during thoracic endovascular aortic repair: How to prevent and treat Retroperitoneal approach for ilio-superior mesenteric artery bypass: Technique and case series Randomized controlled trials in emergency settings: Taking a HEADSTART on acute type A aortic dissection trials Presentation and management of true aneurysms of the pancreaticoduodenal arcade with concomitant celiac artery stenosis using the endovascular approach Regarding “Aortic rupture during STABILISE (stent-assisted balloon-induced intimal disruption and relamination in aortic dissection repair) technique” Temporary mesenteric venous shunting for portal vein reconstruction: A novel technical adjunct   Follow us @audiblebleeding   Learn more about us at https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

Research about menopause right now is finally beginning to really get its moment. Or is it? What's something you can trust? And what's stated as “science-based” or “science-backed”? What can you trust and what should you question? Think of this as a crash course in Research 101. In fact, I think that was a required course my first semester in grad school. The content is as important or more today when you have influencers talking about studies, in fact sponsoring their own to back up their products. You see both experts and influencers on line and are left to sort out one from the other yourself. Questions We Answer in this Episode: How to know if a source is credible? [00:36:00] What determines a peer-reviewed journal? [00:18:50] Are all studies on PubMed or Science Direct peer-reviewed? [00:36:00] Are all studies from Google Scholar (AI) peer-reviewed? [00:37:00] What makes some research studies better than others? [00:04:50] In short this will be a bit like a vocabulary lesson so you can filter news regarding research about menopause for yourself. The  spoiler alert is this: the gold standard in health research are those that are interventional, randomized, double-blind, placebo-controlled studies. In the planning stages and then results and discussion these things will be considered and determined: Reliability is at least 3 independent experiments giving the same results. Relevant to you with subjects just like you. Recency is often within the last 10 years with exception Validity is about how well findings apply to those not in the study. (discussion is about communicating things that may interfere with it being applicable to a diagnosis or a protocol or treatment) Confidence level aiming at 95% confidence level requires a result across a large number of subjects to show it Sample size A good maximum sample size is often around 10% of the population, as long as it doesn't exceed 1,000 people. At least 100 subjects. Larger than 30, less than 500. The answers vary considerably. What you should expect: Written for professionals Authors names and a contact included Bibliography included Peer-reviewed journal How do you know if it's a peer-reviewed journal? Go to the journal (not the article to find out). The journal website includes information for authors about the publication process. A board of experts review and evaluate before acceptance for publication in peer-reviewed journals. Two Additional Terms to Know Regarding Research About Menopause Qualitative - descriptive is more loosely gathered data that might be polls or surveys and interpreting the responses without giving a percentage. This might also come from a review of literature which isn't actually conducting a study but is reviewing a pool of studies to seek common denominators about the research methods and results. Quantitative - based on numbers and is going to result in for instance a percent of muscle lost on average each decade, or over 80% of women describe libido issues. Mixed -  including both There are many types of studies starting with observational and interventional. Observational studies look at what effects habits, beliefs or events affect certain outcomes. For instance, a study that reported an association between increased meat eating and cancer. However, the study was conducted based on a survey where participation was compensated. Participants in such studies may be motivated by the ease of collecting $20 for reporting their habits but might be consuming hot dogs and bologna and Spam, unlike you who are choosing other options that are organic, grass-fed and finished wild options. The headlines? Satisfy a great need by the media to get views, clicks and engagement. Interventional studies, just as it sounds, provide some kind of imposed change to subjects. For instance, providing an example on research about menopause, a study published in Obesity on post menopausal women in a weight loss program divided groups into long sleepers vs short sleepers. They compared results from the change in sleep while other conditions (eating and exercise) were controlled. Though this may not fall directly under current research about menopause, a recently published study in JAMA in July 2024 found older adults (av age 71) who lifted heavy weights for 1 year retained their strength for 4 years while those doing moderate weight training did not. This was a randomized longitudinal study. Types of Research About Menopause Longitudinal vs Cross sectional Looking at the same co-hort over time checking in periodically to see what results occur vs look at different segments of the population one time. In research about menopause, perhaps none is more well-known than The Nurses Health Study. It is a longitudinal observational study looking at the effects of certain habits over time. Some of Dr Loren Fishman's studies on 12 yoga poses have been longitudinal studies showing increase in bone density over time. Some also were retrospective looking back at what happened in women who had done yoga more than every other day. New studies that would take specific poses and see which of those were most beneficial would be prospective, or  going forward in time. Active treatment vs placebo studies are where all receive the treatment vs some subjects receive the actual drug or treatment and others receive a placebo sugar pill. Sometimes this is an exercise intervention. Where the actual protocol tested is resistance training exercise and the placebo also does resistance training but without protocol Control group means that a subset group does not have the treatment or follow protocol. For instance in Fishman's studies an experimental group would have done the yoga poses and a control group was also post menopausal but did not do the yoga poses. Open vs Blind/Double Blind: everyone knows who is in which group (experimental, placebo or control) vs subjects or researchers don't know vs neither researchers nor subjects know which is which. Randomized control vs case control References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188693/#:~:text=The validity of a research,associations%2C interventions%2C and diagnosis. https://jamanetwork.com/journals/jama/article-abstract/2821225 Other Episodes You Might Like: Living Longer is NOT the Goal: Research on Longevity: https://www.flippingfifty.com/living-longer/ Science that Makes Exercise Essential for Menopause Health: https://www.flippingfifty.com/exercise-essential-for-menopause-health/ Boost Weight Loss with Exercise and Eating Timing: Science Studies: https://www.flippingfifty.com/boost-weight-loss-with-exercise-and-eating-timing-science-studies/ Resources: Hot Not Bothered Challenge: https://www.flippingfifty.com/hot-not-bothered-challenge-2023/ Stronger: https://www.flippingfifty.com/get-stronger/

First up this week on the show, uncounted kilometers of fences are strung across the globe. Researchers know they interfere with wildlife migrations and sometimes make finding food and safety difficult for animals. But they don't know where all these fences are. Freelancer science journalist Christine Peterson joins host Sarah Crespi to discuss how artificial intelligence and aerial photos could help create fence inventories and eventually reopen spaces for native species.   Next, Azizi Seixas, interim chair of the University of Miami Miller School of Medicine's department of informatics and health data science and a professor in the department of psychiatry and behavioral sciences, discusses his review on decentralized randomized trials. Randomized, controlled trials based in a research center or centers have long been the gold standard for determining the effectiveness of a medical intervention. This week on the podcast, Seixas argues that distributed research designs with home-based measurements and reporting have the potential to speed up research, allow greater participation, and make the results of studies more equitable.   This week's episode was produced with help from Podigy.   About the Science Podcast   Authors: Sarah Crespi, Christine Peterson   About the Science Podcast: https://www.science.org/content/page/about-science-podcast Learn more about your ad choices. Visit megaphone.fm/adchoices