Podcasts about randomized

We sit down with Pokemaster JoCat to learn a thing to or about the wild world of Nuzlockes! JoCat is fresh off their own Pokemon Journey and shares all the required rules for our upcoming Soul Silver / Heart Gold adventure. But It doesn't stop there: Garrett and Kyle have built the tech to take this adventure to the next level. Our upcoming Soul Link adventure will be also Randomized. Jocat has a few tips and house rules that might elevate some pressure, but it's going to be an uphill battle with our terribily outdated knowledge. We also open some random starters to get a feel for the meta and what we will need to know. Supportourbromance.com and all your pulls will be Garchomp.

In this episode of The Lead, host Christopher C. Cheung, MD, MPH, FHRS, is joined by Edward P. Gerstenfeld, MD, MS, FHRS, and Paul C. Zei, MD, PhD, FHRS, to discuss the journal article, A Prospective Randomized Multicenter Global Study Comparing Pulsed Field Ablation versus Anti-Arrhythmic Drug Therapy as a First Line Treatment for Persistent Atrial Fibrillation (AVANT GUARD). Together, they review the study design and findings, examining pulsed field ablation and anti-arrhythmic drug therapy as first-line treatment approaches for patients with persistent atrial fibrillation. Learning Objectives Review the design and key findings of the AVANT GUARD study comparing pulsed field ablation with anti-arrhythmic drug therapy as first-line treatment for persistent atrial fibrillation. Discuss the potential role of pulsed field ablation as an initial treatment strategy for patients with persistent atrial fibrillation. Examine the comparative considerations of ablation-based and pharmacologic approaches in the management of persistent atrial fibrillation.   Podcast Contributors: Host: Christopher C Cheung, MD, MPH, FHRS       Guests: Edward P. Gerstenfeld, MD, MS, FHRS and Paul C Zei, MD, PhD, FHRS   Disclosures: Christopher C Cheung, MD, MPH, FHRS Honoraria/Speaking/Consulting Fee: Medtronic, Inc., Biotronik, Biosense Webster, Inc., Abbott Edward P. Gerstenfeld, MD, MS, FHRS Honoraria/Speaking/Consulting Fee: Medtronic, Inc., Biosense Webster, Inc., Abbott, Boston Scientific, Varian Medical Systems Other Non-Financial Relationships: Adagio Medical, Boston Scientific, Abbott Medical Research: Abbott Medical Officer, Trustee, Director, Committee Chair, or Other Fiduciary Role: American College of Cardiology Paul C Zei, MD, PhD, FHRS Honoraria/Speaking/Consulting Fee/Speaker's Bureau: Varian Medical Systems, Biosense Webster, Inc., Abbott, Boston Scientific, APT Medical Research: Biosense Webster, Inc.

This week, please join authors Rasha K. Al-Lamee and Fiyyaz Ahmed-Jushuf as well as Associate Editor Emmanouil Brilakis as they discuss the article "Determining the Physiological Threshold for Angina (ORBITA-FIRE): A Double-Blind, Randomized, Placebo-Controlled Study." For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20260608.559074

Think energy, digestion, and weight. In this episode, Nurse Doza breaks down berberine — the metabolism-supporting supplement that helps regulate blood sugar, support a healthy insulin response, and improve cholesterol (LDL, HDL, total). Discover why MSW Nutrition's Berberine Plus is 5x more absorbable in the gut, how to dose it morning and night, and why it works at the level of your gut microbiome. The berberine supplement your metabolism has been waiting for. Featured Partner: MSW Nutrition — Berberine Plus MSW Nutrition's Berberine Plus delivers dihydroberberine (DHB) — the bioactive, highly absorbable form of berberine sourced from Berberis aristata — so you get berberine's full metabolic benefits at a fraction of the dose, without the gut upset that comes from mega-dosing standard berberine. That enhanced absorption is exactly why it's the berberine supplement Nurse Doza reaches for to support blood sugar, digestion, and weight — as discussed in this episode.

On this MOCK DRAFT episode of the Smark Out Moment Smack Talk podcast, we take part in a randomized WWE Generations Mock Draft featuring roster pools from 1986 WWF, 1996 WWF, 2006 WWE, 2016 WWE and 2026 WWE. Each host builds a fantasy roster through era-based wheel spins and wildcard picks to see who ends up with the best overall lineup.

After 70 episodes, I've noticed a pattern that keeps showing up in every corner of longevity, wellness, and medicine: people don't fail because they “don't care.” They fail because the signal is buried under hype, and because perfectionism makes the basics feel impossible to sustain. So I step back and share a simple framework  for living long and well: treat evidence like a compass, treat hype like a detour, and treat perfectionism like a parking brake.I walk through how to read health evidence without getting lost. Randomized controlled trials vs observational studies, replication, meta-analyses, and the most important filter of all: are we looking at meaningful outcomes like fewer heart attacks, better function, clearer thinking, and longer life, or are we just watching biomarkers move. We also revisit how research in stable coronary artery disease forced a shift away from the intuitive “fix the plumbing” story and back toward the unglamorous risk factors that actually drive health.Then we get practical about what to do when averages don't map cleanly onto you. Using sleep and melatonin as an example, we explain a careful N-of-1 approach, including the power of stopping and restarting so you can tell whether a change truly helps. From there, we break down the “hype equation” using mitochondrial health and NAD claims to show how plausible mechanisms, credentials, anecdotes, and incentives can make weak evidence feel strong.Finally, we make the case for “good enough” health: the 80-20 moves that deliver most of the benefit, plus the mindset that leaves room for joy. If this helps, subscribe, share it with a friend who's tired of wellness noise, and leave a review so more people can find the compass.Send us Fan Mail

Commentary by Dr. Jian'an Wang.

Dr. Jason Tucciarone and Dr. Alan Schatzberg (Stanford University, Stanford, CA) join AJP Audio to discuss the use of low-dose buprenorphine as an adjunctive therapy to extend the anti-suicidal effects of ketamine treatment in patients with major depressive disorder and suicidal ideation.  AJP Editor-in-Chief Dr. Ned Kalin joins to discuss the rest of the June issue of the Journal, which takes a close look at issues surrounding suicide and severe depression. 01:20     Tucciarone and Schatzberg interview 03:36     Disparity between effects on suicidal ideation and antidepressant ratings 05:36     Ethics of placebo and ketamine in patients with suicidal ideation 08:28     Immediate clinical implications 11:40     Limitations 14:10     Further research 16:19     Kalin interview 16:24     Tucciarone et al. 20:39     Rovers et al. 24:30     Jelen et al. Transcript Board-certified psychiatrists, if you're seeking meaningful inpatient work with real clinical autonomy, consider becoming the Clinical Director for a 16-bed behavioral health hospital in Fergus Falls or Bemidji, Minnesota. You'll lead a supportive interdisciplinary team, enjoy predictable work-life balance, and have opportunities for teaching and mentorship without RVU pressure or third-party billing. Learn more on APA's Career Center, JobCentral, by searching Direct Care and Treatment – State of Minnesota. Direct Care and Treatment – State of Minnesota:  bit.ly/DCTClinicalDirector Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Episode Summary: In this episode, I look at diet soda, artificial sweeteners, and the real-world question that matters most: compared with what, at what dose, for whom, and at what tradeoff?Diet Coke, Twinkies, and the Questions That MatterI start with a memory from medical training: a cardiology professor walking around with a Diet Coke in one hand and a Twinkie in his pocket. Was he making a smart tradeoff, or fooling himself? That image captures the artificial sweetener debate well. A diet soda may be a useful substitute if it replaces a sugary drink, but it becomes less compelling if it simply gives us permission to eat more ultra-processed foods.The cleanest case for artificial sweeteners is substitution. In the CHOICE trial, adults who replaced caloric beverages with water or diet drinks lost a modest amount of weight over six months, suggesting that noncaloric beverages can help when they replace sugar-sweetened drinks.  The SWITCH trial similarly found that people assigned to non-nutritive sweetened beverages did at least as well as those assigned to water after a 52-week weight management program. I also explore the common fears around artificial sweeteners. The cancer concern has roots in older animal studies involving very high doses, but the National Cancer Institute notes that the saccharin bladder cancer mechanism seen in rats does not apply to humans, and saccharin was removed from the U.S. carcinogen list in 2000.  A large French observational study, NutriNet-Santé, did find a small association between artificial sweetener intake and cancer risk, especially aspartame and acesulfame-K, but observational studies can't prove causation and are vulnerable to residual confounding. On weight gain and glucose metabolism, the evidence is less alarming than the headlines. Randomized trials do not support the idea that diet soda inevitably causes weight gain. And in the SODAS trial, replacing artificially sweetened beverages with water in adults with type 2 diabetes did not improve glycemic measures, which weakens the claim that diet drinks secretly worsen blood sugar control. The microbiome question is interesting but not settled. A well-known 2014 study suggested artificial sweeteners could alter the gut microbiome and glucose tolerance, but much of that evidence came from mice and a very small human experiment.  More recently, the SWEET study found that sweeteners and sweetness enhancers, when used within a healthy diet, supported weight-loss maintenance and were linked with beneficial gut microbiome shifts in adults with overweight or obesity. The real issue may not be whether Diet Coke is “good” or “bad.” Water wins the purity contest. But food and drink also provide pleasure, ritual, and sustainability. If a diet soda helps someone avoid sugar and enjoy lunch, that may be a reasonable bargain. But if it becomes a permission slip for a daily Twinkie, we should pay attention. Ultra-processed foods matter because in a controlled feeding study, people ate about 500 more calories per day when eating an ultra-processed diet. TakeawaysAsk the better question: not “Is diet soda good or bad?” but “Compared with what, at what dose, for whom, and at what tradeoff?”Artificial sweeteners appear most useful when they replace sugar-sweetened drinks, and less useful when they replace water.Diet soda may be a reasonable pleasure for many people, but it is worth noticing whether it helps reduce sugar—or simply makes the Twinkie in your pocket easier to justify.Send us Fan Mail

On Episode 64 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the May 2026 issue of Stroke: "Nanoplastics and Microplastics and Their Link to Increasing Stroke Risk" and "Increased Risk of Ischemic Events in Patients With Stroke Treated With Clopidogrel and a P-CAB or PPI." She also interviews Dr. James Grotta on the article "Glenzocimab Efficacy and Safety Added to Intravenous Thrombolysis With or Without Mechanical Thrombectomy in Patients With Acute Ischemic Stroke—ACTISAVE: A Prospective, Randomized, Double-Blind Study." For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20260514.12542

This week, please join author Jean-Luc Vachiery and Associate Editor Kelly Chin as they discuss the article "Sotatercept for Combined Post- and Precapillary Pulmonary Hypertension Associated With Heart Failure: Results From the Phase 2, Randomized, Placebo-controlled CADENCE Study." For the episode transcript, visit:  https://www.ahajournals.org/do/10.1161/podcast.20260511.411136

For decades, a tight carotid stenosis felt like a ticking time bomb — a plaque waiting to throw an embolus and cause the next stroke. We were taught that severe narrowing meant surgery, and trials like ACAS and ACST-1 seemed to prove it. But medicine has changed. Statins, antiplatelets, tighter blood pressure control, even PCSK9 and GLP-1 therapies have quietly slashed stroke risk, and now newer data from CREST-2 suggest that for many asymptomatic patients, the knife — or the stent — may not add much at all. So if modern medical therapy works better than ever… who actually benefits from intervention anymore? Today, we unpack the evidence, the controversies, and how to counsel the patient who feels perfectly fine but has high-grade stenosis.Hosts: Carolyn Judge, Andrew Huang, Luciano Delbono, Frank Davis, Robert BeaulieuInstitution: University of Michigan, Department of Surgery, Section of Vascular SurgeryLearning objectives: Describe how modern intensive medical therapy has transformed the natural history of asymptomatic carotid stenosis and explain why contemporary patients experience substantially lower annual stroke risk than those in earlier eras. Interpret and compare the results of landmark trials—including ACAS, ACST-1, and CREST-2—to assess the relative benefits of medical therapy, endarterectomy, and stenting. Apply current evidence and guideline recommendations to patient care by selecting which asymptomatic patients are most likely to benefit from carotid revascularization versus optimized medical therapy alone. References:SVS Guidelines:Brook, R. D., et al. (2022). Society for Vascular Surgery clinical practice guidelines for management of extracranial carotid artery disease. Journal of Vascular Surgery, 75(1), e1–e67. https://doi.org/10.1016/j.jvs.2021.09.031CREST (1)Brott, T. G., Hobson, R. W., Howard, G., et al. (2010). Stenting versus endarterectomy for treatment of carotid-artery stenosis. New England Journal of Medicine, 363(1), 11–23. https://doi.org/10.1056/NEJMoa0912321CREST-2Brott, T. G., Howard, G., Fong, P., et al. (2024). Randomized trial of carotid artery stenting or carotid endarterectomy vs best medical therapy for asymptomatic carotid stenosis: CREST-2 results. [Manuscript in preparation]. ClinicalTrials.gov Identifier: NCT02089217. Retrieved from https://clinicaltrials.gov/ct2/show/NCT02089217ACST-1Halliday, A., Mansfield, A., Marro, J., et al. (2004). Randomised trial of carotid artery surgery for asymptomatic stenosis. Lancet, 363(9420), 1491–1502. https://doi.org/10.1016/S0140-6736(04)16153-1ACST-2Halliday, A., Bulbulia, R., Bonati, L. H., et al. (2021). Carotid artery stenting versus carotid endarterectomy in patients with asymptomatic carotid stenosis (ACST-2): A randomised trial. Lancet, 398(10291), 1065–1073. https://doi.org/10.1016/S0140-6736(21)01980-1ACASExecutive Committee for the Asymptomatic Carotid Atherosclerosis Study. (1995). Endarterectomy for asymptomatic carotid stenosis. JAMA, 273(18), 1421–1428. https://doi.org/10.1001/jama.1995.03520420033036Sponsor URL: https://www.goremedical.com/Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

We are living through one of the most significant shifts in medicine in generations, and most people don't fully understand what it means. Dr. Christle Guevarra joins me to zoom out on the entire GLP-1 landscape; from the drug's origins as a modest diabetes treatment in 2005 to today's third-generation medications still moving through clinical trials, and what all of it means for the future of obesity, performance, and longevity.

Ever wonder why two “identical” diets lead to totally different results? We dig into the thermic effect of food and the overlooked power of food structure to show how digestion cost, fiber, and processing change what your body actually gets from each bite. Calories don't arrive for free, your body must work to chew, digest, and metabolize them, and that work varies by macronutrient and by how intact or processed a food is.We break down why fat is cheap to process, protein is expensive, and carbs sit on a spectrum shaped by fiber and the food matrix. Then we zoom out to the real-world package: whole foods slow eating, engage satiety signals, and often deliver fewer net calories even when the label matches. Think whole nuts versus peanut butter, intact grains versus refined flour, and solid foods versus liquid calories. Randomized controlled trials back it up: when people eat freely, ultra-processed diets drive faster eating, higher energy density, and hundreds of extra calories per day, while minimally processed meals naturally curb intake without strict rules.You'll leave with practical, doable strategies. Build meals around plant proteins like beans, lentils, chickpeas, tofu, and soy. Favor fiber-rich fruits, vegetables, whole grains, nuts, and seeds that raise digestion's energy cost and help you feel full on fewer calories. Choose solid over liquid when you can, and aim for an 80–20 balance that treats ultra-processed foods as a dose issue, not an enemy. Small differences in thermic effect and eating pace add up over months and years, nudging weight, metabolic health, and longevity in your favor.If this conversation helped reframe how you think about calories and metabolism, follow the show, share it with a friend, and leave a quick review to help others find it. Got a swap you're trying this week? Tell us, we love hearing your wins.Go check out my website for tons of free resources on how to transition towards a healthier diet and lifestyle.You can download my free plant-based recipes eBook and a ton of other free resources by visiting  the Digital Downloads tab of my website at https://www.plantbaseddrjules.com/shopDon't forget to check out my blog at https://www.plantbaseddrjules.com/blog You can also watch my educational videos on YouTube at https://www.youtube.com/channel/UCMpkQRXb7G-StAotV0dmahQCheck out my upcoming live events and free eCourse, where you'll learn more about how to create delicious plant-based recipes: https://www.plantbaseddrjules.com/Go follow me on social media by visiting my Facebook page and Instagram accountshttps://www.facebook.com/plantbaseddrjuleshttps://www.instagram.com/plantbased_dr_jules/Last but not least, the best way to show your support and to help me spread my message is to subscribe to my podcast and to leave a 5 star review on Apple and Spotify!Thanks so much!Peace, love, plants!Dr. Jules 

John Mandrola offers an ACC recap of 5 big trials—Hi-PEITHO, PROTAVI, ORBITA-CTO, CHIPS-BCIS3 and CHAMPION AF This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I Catheter Based Fibrinolysis of Pulmonary Embolism –Hi PEITHO Fibrinolysis Treatment Validated in Large Trial for Acute Intermediate-Risk PE https://www.medscape.com/viewarticle/fibrinolysis-treatment-validated-large-trial-acute-2026a10009im Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolism (HI PEITHO) https://www.nejm.org/doi/full/10.1056/NEJMoa2516567 National Early Warning Score (NEWS) https://www.england.nhs.uk/ourwork/clinical-policy/sepsis/nationalearlywarningscore/ II PRO-TAVI trial Deferral of percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation (PRO-TAVI) 10.1016/S0140-6736(26)00308-9 External Link PCI in Patients Undergoing Transcatheter Aortic-Valve Implantation (Notion 3) https://www.nejm.org/doi/full/10.1056/NEJMoa2401513 III ORBITA CTO Sham vs PCI for Angina Relief Tightly Blinded Trial Confirms PCI Reduces Angina in Obstructive Occlusion https://www.medscape.com/viewarticle/tightly-blinded-trial-confirms-pci-reduces-angina-2026a10009ob A Randomized, Placebo-Controlled Trial of Chronic Total Occlusion Percutaneous Coronary Intervention in Stable Angina - ORBITA-CTO https://www.jacc.org/doi/10.1016/j.jacc.2026.03.027 ORBITA 1 10.1016/S0140-6736(17)32714-9 External Link ORBITA 2 https://www.nejm.org/doi/full/10.1056/NEJMoa2310610 DECISION CTO https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.118.031313 EuroCTO https://doi.org/10.1093/eurheartj/ehy220   IV CHIPS BCIS3 Impella Supported High-Risk PCI Adoption Before Evidence: CHIP-BCIS3 Humbles Impella https://www.medscape.com/viewarticle/adoption-before-evidence-chip-bcis3-humbles-impella-2026a10009jh Left Ventricular Unloading in High-Risk PCI (CHIP BCIS3) https://www.nejm.org/doi/full/10.1056/NEJMoa2515704 Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock (DanGer Shock) https://www.nejm.org/doi/full/10.1056/NEJMoa2312572 V CHAMPION AF – Watchman vs DOAC in Patients With AF CHAMPION-AF Trial Finds LAAC an Alternative for NOAC in Lower-Risk Patients https://www.medscape.com/viewarticle/champion-af-trial-finds-laac-alternative-noac-lower-risk-2026a10009ij Six Reasons Why CHAMPION-AF Should Not Change Practice https://www.medscape.com/viewarticle/six-reasons-why-champion-af-should-not-change-practice-2026a10009i7 Left Atrial Appendage Closure or Anticoagulation for Atrial Fibrillation (CHAMPION AF) https://www.nejm.org/doi/full/10.1056/NEJMoa2517213 Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation (CLOSURE AF) https://www.nejm.org/doi/full/10.1056/NEJMoa2513310 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Nurse Doza doesn't always eat lunch — but he never skips protein and animal fat. In this episode, he breaks down why he reaches for clean, 100% grass-fed beef jerky as his go-to midday snack, how the ingredients in Lineage Provisions meat sticks — grass-fed beef, organic apple cider vinegar, and salt — actively support blood sugar, reduce inflammation, and help with weight management. Because what you snack on matters more than you think. Featured Partner: Lineage Provisions Lineage Provisions delivers exactly what Nurse Doza looks for in a snack: 100% grass-fed beef made with just three clean ingredients — grass-fed beef, organic apple cider vinegar, and salt. No fillers, no seed oils, no inflammatory junk that undoes the work you're already putting into your health. Their grass-fed beef jerky and liver meat sticks are the snack Nurse Doza trusts when he skips lunch and still needs to keep his blood sugar stable, energy up, and inflammation down. If you vote with your dollar, vote for ingredients that actually work for your body.

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published original research paper on Intracoronary Vasoactive Therapy for No-Reflow During Primary PCI: A Network Meta-Analysis of Randomized Trials.

https://www.tadeclinicagem.com.br/guia/Confira a promoção especial para o plano anual do Guia TdC: Receba em casa o Card de Consulta Rápida no Plantão, com os temas: IOT, ACLS, ATB, ECG, trombólise e reposição eletrolítica.Receba em casa o porta-crachá (tirante para crachá) do TdC.Ganhe R$ 50 OFF (de 449 por 399,00)7 primeiros dias inteiramente grátisUse o CUPOM: GUIADZEROAline Campos e Pedro Magno convidam João Pedro Noronha para discutir o novo Guideline de Tromboembolismo Pulmonar da AHA/ACC 2026. Referências: 1. Writing Committee Members* et al. “2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.” Circulation, 10.1161/CIR.0000000000001415. 19 Feb. 2026, doi:10.1161/CIR.00000000000014152. Meyer, Guy et al. “Fibrinolysis for patients with intermediate-risk pulmonary embolism.” The New England journal of medicine vol. 370,15 (2014): 1402-11. doi:10.1056/NEJMoa13020973. Konstantinides, Stavros V et al. “2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS).” European heart journal vol. 41,4 (2020): 543-603. doi:10.1093/eurheartj/ehz4054. Zhang, Robert S et al. “Composite Pulmonary Embolism Shock Score and Risk of Adverse Outcomes in Patients With Pulmonary Embolism.” Circulation. Cardiovascular interventions vol. 17,8 (2024): e014088. doi:10.1161/CIRCINTERVENTIONS.124.0140885. Barco, Stefano et al. “Prognostic value of right ventricular dysfunction or elevated cardiac biomarkers in patients with low-risk pulmonary embolism: a systematic review and meta-analysis.” European heart journal vol. 40,11 (2019): 902-910. doi:10.1093/eurheartj/ehy8736. Kjaergaard, J et al. “Randomized trial of low-dose -, ultrasound assisted thrombolysis or heparin for pulmonary embolism.” Cardiovascular research, cvag038. 29 Jan. 2026, doi:10.1093/cvr/cvag0387. Dudzinski, David M et al. “Assessment of Right Ventricular Strain by Computed Tomography Versus Echocardiography in Acute Pulmonary Embolism.” Academic emergency medicine : official journal of the Society for Academic Emergency Medicine vol. 24,3 (2017): 337-343. doi:10.1111/acem.13108

Program notes:0:37 HIV treatment monthly injections1:37 Long acting and effective2:37 Some didn't come for monthly injections3:16 COVID-19 vaccination and preeclampsia rate4:16 In two successive cohorts during pandemic5:16 Pre-existing morbidity 58% reduction6:15 COVID-19 cytokine storm?6:45 Monkeypox treatment7:45 Randomized to placebo or smallpox drug8:50 Menstrual blood to test for HPV9:50 Minipad essentially the same as clinician collection10:45 Can make it cost effective?11:49 End

Join Digital Education Committee member and podcast host Melissa E. Middeldorp, MPH, PhD, along with this week's guest contributors, Nino Isakadze, MD, MHS, and Geraldine A. Lee, PhD, FESC for this week's episode. The POP-AF trial was a prospective, randomized controlled study evaluating whether a nurse-led, integrated lifestyle intervention before AF ablation improves outcomes. A total of 145 patients with symptomatic paroxysmal or persistent AF and at least one modifiable risk factor were randomized to either standard pre-ablation care or a structured, multidisciplinary lifestyle program targeting weight loss, physical activity, alcohol reduction, smoking cessation, blood pressure, lipid and glycemic control, and obstructive sleep apnea treatment. After pulsed-field pulmonary vein isolation, patients were followed for 12 months. The primary endpoint, a composite of repeat ablations and cardioversions was reduced by 51% in the intervention group (IRR 0.49, 95% CI 0.30–0.78). Successful index ablation without antiarrhythmic drugs was also significantly higher (76% vs 53%). Notably, these benefits were achieved with an average weight loss (~5.5%), suggesting that comprehensive, personalized risk-factor management meaningfully enhances rhythm control outcomes when implemented before ablation.  Read the Article   Learning Objectives Understand how a structured, nurse-led integrated lifestyle intervention before AF ablation significantly reduces repeat procedures and cardioversions compared with standard care. Evaluate the role of comprehensive risk-factor modification which includes weight, blood pressure, alcohol use, and OSA management improves rhythm control outcomes in patients undergoing PVI.    Article Authors Jasper Vermeer, Tineke Vinck-de Greef, Maarten van den Broek, Bianca de Louw, Gijs van Steenbergen, Dennis van Veghel, Lukas Dekker Podcast Contributors Melissa E. Middeldorp, MPH, PhD Nino Isakadze, MD, MHS Geraldine A. Lee, PhD, FESC   All relevant financial relationships have been mitigated. Host and Contributor Disclosure(s): M. Middeldorp Nothing to disclose.   N. Isakadze Research: Apple, Inc., Itamar Medical Board Membership: Boston Scientific   G. Lee Research: H2020 (EHRA-PATHS)   Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner): S. Sailor: No relevant financial relationships with ineligible companies to disclose.

There is enormous heterogeneity in clinical outcomes and severity of septic shock, with some patients needing only supportive care in the ICU and others progressing to multiorgan system failure and death. How can clinicians identify patients at higher risk of death? In this episode of the Society of Critical Care Medicine (SCCM) Podcast, host Marilyn Bulloch, PharmD, BCPS, FCCM, is joined by John A. Kellum, MD, FCCM, to discuss high endotoxin activity as a possible endotype for septic shock. Dr. Kellum's article, “Organ Failure, Endotoxin Activity, and Mortality in Septic Shock,” was published in the September 2025 compendium of Critical Care Explorations. Dr. Kellum is a professor and director of the Center for Critical Care Nephrology, as well as vice chair for the Department of Critical Care Medicine, at the University of Pittsburgh in Pittsburgh, Pennsylvania, USA. The study used a novel biomarker called the endotoxin activity assay (EAA) to detect endotoxin in the blood. While the EAA is not good at identifying patients who are at risk for sepsis, Dr. Kellum said that, when combined with organ failure, it identifies patients at high risk for endotoxic septic shock. In the study, these patients had a mortality rate of 60%. Neither the EAA nor the anti-endotoxin therapy is readily available. And, although endotoxic septic shock is rare, occurring in only a quarter of patients with septic shock, Dr. Kellum hopes that, through precision medicine, segmenting this population into treatable subgroups may allow better diagnostics and opportunities to develop or repurpose therapies in the future. This episode is sponsored by Prenosis. Resources referenced in this episode: Organ Failure, Endotoxin Activity, and Mortality in Septic Shock (Molinari  L, et al. Crit Care Explor. 2025;7:e1308) Derivation, Validation, and Potential Treatment Implications of Novel Clinical Phenotypes for Sepsis (Seymour CW, et al. JAMA. 2019;321:2003-2017) Safety and Efficacy of Polymyxin B Hemoperfusion (PMX) for Endotoxemic Septic Shock in a Randomized, Open-Label Study (TIGRIS) (ClinicalTrials.gov. ID NCT03901807. Last update posted January 9, 2026)

In this episode of Surgical Readings, host Rick Greene, MD, FACS, connects with Lejla Hadzikadic-Gusic, MD, MS, FACS, for an engaging conversation about a study that is reshaping the way surgeons localize nonpalpable malignant breast disease. Dr. Hadzikadic-Gusic discusses her randomized trial, published in the Annals of Surgery (A Randomized, Single-Center, Superiority Trial of Radioactive Seed Location versus Wire Localization for Malignant Breast Disease), comparing two commonly used localization methods: traditional wire placement and radioactive seed technique. Listeners will hear how her team set out to answer an important question in breast surgery: Can we improve the patient experience without compromising clinical outcomes? While both techniques performed similarly in achieving clear surgical margins, the study uncovered compelling differences in what matters to patients and care teams. Tune in to learn how radioactive seed localization led to higher satisfaction, less anxiety, and greater convenience for patients—and offered workflow advantages for surgeons. Talk about the podcast on social media using the hashtag #SurgicalReadings   Copyright © 2026 by the American College of Surgeons (ACS). All rights reserved.   The contents of these materials may be cited in academic publications but otherwise may not be reproduced, disseminated, or transmitted in any form by any means without the express written permission of ACS. These materials may not be resold nor used to create revenue-generating content by any entity other than the ACS without the express written permission of the ACS. The contents of these materials are strictly prohibited from being uploaded, shared, or incorporated in any third-party applications, platforms, software, or websites without prior written authorization from the ACS. This restriction explicitly includes, but is not limited to, the integration of ACS content into tools leveraging artificial intelligence (AI), machine learning, large language models, or generative AI technologies and infrastructures.

A lot of therapies address the context in which nonsuicidal self-injury (NSSI) and self-harm may occur, but only a few treatments have been designed to address NSSI specifically. In this episode, we dive into one of these treatments: Emotion Regulation Group Therapy (ERGT). Drs. Kim Gratz and Matthew Tull from the University of Toledo in Ohio walk us through in significant detail each of the 90-minute 14 sessions of ERGT. You can purchase their book "Acceptance-based emotion regulation therapy: A clinician's guide to treating emotion dysregulation and self-destructive behaviors using an evidence-based therapy drawn from ACT and DBT" on Amazon here or at New Harbinger Publications here.  Connect with Dr. Gratz on LinkedIn here and Dr. Tull here. Below are links to their research on ERGT referenced in this episode: Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with Borderline Personality Disorder. Behavior Therapy, 37(1), 25-35. Gratz, K. L., & Tull, M. T. (2011). Extending research on the utility of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality pathology. Personality Disorders: Theory, Research, and Treatment, 2(4), 316–326. Gratz, K. L., Tull, M. T., & Levy, R. (2014). Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Psychological Medicine, 44, 2099–2112. Gratz, K. L., Bardeen, J. R., Levy, R., Dixon-Gordon, K., L., & Tull, M. T. (2015). Mechanisms of change in an emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder. Behaviour Research and Therapy, 65, 29-35. Sahlin, H., Bjureberg, J., Gratz, K. L., Tull, M. T., Hedman, E., Bjarehed, J., Jokinen, J., Lundh, L., Ljotsson, B., & Hellner, C. (2017). Emotion regulation group therapy for deliberate self-harm: A multi-site evaluation in routine care using an uncontrolled open trial design. BMJ Open, 7(10), e016220. Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "Best 20 Clinical Psychology Podcasts" and by Welp Magazine in their "20 Best Injury Podcasts."

In this episode of The Behavioral View, Nissa Van Etten, Olivia Teal, Elizabeth Barajas, and Yagnesh Vadgama discuss the evolution of outcomes-based care within applied behavior analysis (ABA). Drawing from extensive experience in both clinical practice and payer systems, Vadgama outlines the differences between traditional fee-for-service models and outcomes-based care frameworks. The panel explores how standardized assessments, aggregate data analysis, and empirically supported dosing recommendations can create greater alignment between providers and payers while maintaining individualized clinical decision-making. The discussion addresses administrative burden, prior authorization processes, value-based payment arrangements, caregiver involvement, social determinants of health, and interdisciplinary collaboration. Emphasis is placed on transparency, data-driven decision making, and protecting the integrity of behavior analytic practice while demonstrating measurable outcomes at both the individual and population levels. This course provides practical insight into how outcomes-based care models may shape the future of ABA service delivery. To earn CEUs for listening, click here, log in or sign up, pay the CEU fee, + take the attendance verification quiz to generate your certificate! Don't forget to subscribe and follow and leave us a rating and review. Show Notes:   References  Frazier, T. W., Youngstrom, E. A., Speer, L., Embacher, R., Law, P., Constantino, J., Findling, R. L., Hardan, A. Y., & Eng, C. (2014). Validation of proposed DSM-5 criteria for autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 53(1), 28–40. https://doi.org/10.1016/j.jaac.2013.10.012  Frazier, T. W., Klingemier, E. W., Beukemann, M., Speer, L., Markowitz, L., Parikh, S., & Strauss, M. S. (2021). Development and validation of the Autism Impact Measure (AIM). Journal of Autism and Developmental Disorders, 51, 3407–3421. https://doi.org/10.1007/s10803-020-04795-1  Smith, P. C., Sagan, A., Siciliani, L., & Figueras, J. (2023). Building on value-based health care: Towards a health system perspective. Health Policy, 138, 104918. https://doi.org/10.1016/j.healthpol.2023.104918    AI.Measures Scientific Support   Ferguson, E. F., Frazier, T. W., Hardan, A. Y., & Uljarević, M. (2025). Challenging behavior domains in individuals with neurodevelopmental genetic syndromes: The role of psychological features. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 0(1), 1-12      Frazier, T. W., Huba, K., Frazier, A. R., Womack, R. A., Youngstrom, E. A., Chetcuti, L., Hardan, A. Y., & Uljarevic, M. (2025). Maximizing accurate detection of divergence from normative expectation in behavioral intervention outcome assessment. Research in Autism, 126, 202646.      Frazier, T. W., Youngstrom, E. A., Frazier, A. R., & Uljarevic, M. (2025). A critical appraisal of the measurement of adaptive social communication behaviors in the behavioral intervention context. Behavioral Sciences, 15(6), 722      Frazier, T.W., Helton, M., Akouri, C., Chetcuti, L., Uljarevic, M. (2025) Identifying Reliable Change In Outcome Assessments for Behavioral Intervention. Behavioral Interventions.      Frazier, T. W., Dimitropoulos, A., Abbeduto, L., Armstrong-Brine, M., Kralovic, S., Shih, A., Hardan, A. Y., Youngstrom, E. A., Uljarevic, M., Verbal Beginnings, T. (2024). Psychometric evaluation of the Autism Symptom Dimensions Questionnaire. Developmental Medicine and Child Neurology.      Frazier, T. W., Busch, R. M., Klaas, P., Lachlan, K., Jeste, S., Kolevzon, A., Loth, E., Harris, J., Speer, L., Pepper, T., Anthony, K., Graglia, J. M., Delagrammatikas, C., Bedrosian-Sermone, S., Beekhuyzen, J., Smith-Hicks, C., Sahin, M., Eng, C., Hardan, A. Y., & Uljarevic, M. (2023). Development of informant-report neurobehavioral survey scales for PTEN hamartoma tumor syndrome and related neurodevelopmental genetic syndromes. Am J Med Genet A, 191(7), 1741-1757. https://doi.org/10.1002/ajmg.a.63195      Frazier, T. W., Crowley, E., Shih, A., Vasudevan, V., Karpur, A., Uljarevic, M., & Cai, R. Y. (2022). Associations between executive functioning, challenging behavior, and quality of life in children and adolescents with and without neurodevelopmental conditions. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2022.1022700      Frazier, T. W., Dimitropoulos, A., Abbeduto, L., Armstrong-Brine, M., Kralovic, S., Shih, A., Hardan, A. Y., Youngstrom, E. A., Uljarevic, M., & Quadrant Biosciences - As You Are Team. (2023). The Autism Symptom Dimensions Questionnaire: Development and psychometric evaluation of a new, open-source measure of autism symptomatology. Developmental Medicine and Child Neurology. https://doi.org/10.1111/dmcn.15497      Frazier, T. W., Dimitropoulos, A., Abbeduto, L., Armstrong-Brine, M., Kralovic, S., Shih, A., Hardan, A. Y., Youngstrom, E. A., Uljarevic, M., Womack, R., Wolf, D., Chappell, N., & Verbal Beginnings Team. (2024). Psychometric Evaluation of the Autism Symptom Dimensions Questionnaire (ASDQ). Developmental Medicine and Child Neurology.      Frazier, T. W., Hyland, A. C., Markowitz, L. A., Speer, L. L., & Diekroger, E. A. (2020). Psychometric evaluation of the revised child and family quality of life questionnaire (CFQL-2). Research in Autism Spectrum Disorders, 70. https://doi.org/https://doi.org/10.1016/j.rasd.2019.101474      Frazier, T. W., Khaliq, I., Scullin, K., Uljarevic, M., Shih, A., & Karpur, A. (2022). Development and psychometric evaluation of the open-source challenging behavior scale. Journal of Autism and Developmental Disabilities. https://doi.org/https://doi.org/10.1007/s10803-022-05750-5      Frazier, T. W., Krishna, J., Klingemier, E., Beukemann, M., Nawabit, R., & Ibrahim, S. (2017). A Randomized, Crossover Trial of a Novel Sound-to-Sleep Mattress Technology in Children with Autism and Sleep Difficulties. J Clin Sleep Med, 13(1), 95-104. https://doi.org/10.5664/jcsm.6398      Frazier, T. W., Busch, R. M., Klass, P., Crowley, E., Lachlan, K., Jeste, S., Kolevzon, A., Loth, E., Harris, J., Pepper, T., Anthony, K., Graglia, J. M., Helde, K., Delagrammatikas, C., Bedrosian-Sermone, S., Smith-Hicks, C., Sahin, M., Eng, C., Hardan, A. Y., . . . Uljarevic, M. (2024). Quantifying Neurobehavioral Profiles across Neurodevelopmental Genetic Syndromes and Idiopathic Neurodevelopmental Disorders. Developmental Medicine and Child Neurology. https://doi.org/https://doi.org/10.1111/dmcn.16112      Uljarevic, M., Cai, R. Y., Hardan, A. Y., & Frazier, T. W. (2022). Development and validation of the Executive Functioning Scale. Front Psychiatry, 13, 1078211. https://doi.org/10.3389/fpsyt.2022.1078211      Uljarevic, M., Spackman, E. K., Cai, R. Y., Paszek, K. J., Hardan, A. Y., & Frazier, T. W. (2022). Daily living skills scale: Development and preliminary validation.   Frazier, T. W., Helton, M., Akouri, C., Chetcuti, L., & Uljarevic, M. (2025). Identifying reliable change in outcome assessments for behavioral interventions. Behavioral Interventions, 40, e70007. https://doi.org/https://doi.org/10.1002/bin.70007    Resources  CentralReach. (n.d.). AI Measures (AIM). https://centralreach.com 

Randomized controlled trials. Cohort studies. Abstracts. Methods sections.If your brain starts spinning just hearing those words, you're not alone.In this episode, I'm joined by Dr. Carlene Starck, a protein biochemist and nutrition scientist, to help clinicians who aren't researchers learn how to spot high-quality research in a world full of misinformation.Together, we walk through how a researcher evaluates a paper, what matters, what doesn't, and why social media influencers often get the science wrong. We even unpack a real paper that went viral online to show how misleading conclusions can spread when studies are misquoted or misunderstood.In this episode, you'll learn:A clear explanation and examples of the hierarchy of evidenceWhat information you can (and can't) get from an abstractWhy the methods section matters (even though many of us skip it)How sample size, study design, and bias affect conclusionsA simple framework for quickly assessing whether a paper is high qualityHere's the article we analyzed: A prospective birth cohort study on cord blood folate subtypes and risk of autism spectrum disorder - PubMedConnect with Carlene on LinkedInStarck ScienceAny Questions? Send Me a MessageSupport the showConnect with Colleen:InstagramLinkedInSign up for my FREE Newsletter - Nutrition hot-topics delivered to your inbox each week. Disclaimer: This podcast is a collection of ideas, strategies, and opinions of the author(s). Its goal is to provide useful information on each of the topics shared within. It is not intended to provide medical, health, or professional consultation or to diagnosis-specific weight or feeding challenges. The author(s) advises the reader to always consult with appropriate health, medical, and professional consultants for support for individual children and family situations. The author(s) do not take responsibility for the personal or other risks, loss, or liability incurred as a direct or indirect consequence of the application or use of information provided. All opinions stated in this podcast are my own and do not reflect the opinions of my employer.

Five articles from the February 2026 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles this month are: Intraoperative Zoledronic Acid for Arthroscopic Rotator Cuff Repair: Short-Term Results From a Prospective, Randomized, Placebo-Controlled Phase II Trial Dermal Allograft Augmentation for Open Gluteus Medius Repair: A Case Series at 2-Year Follow-up Prediction of Contralateral Patellar Instability After Ipsilateral Medial Patellofemoral Ligament Reconstruction Arthroscopic Primary Labral Reconstruction in the Hip: Minimum 10-Year Outcomes With a Nested Propensity-Matched Control Using a Residual Pivot Shift as the Indication to Perform a Lateral Extra-articular Tenodesis During ACL Reconstruction Using Autologous Hamstring Grafts Is Associated With Improved Surgical Outcomes: A Retrospective Review of 4755 Cases Click here to read the articles.

 How to Naturally Boost Testosterone Data-backed ways to boost testosterone. (2:01) 1. Exercise. (3:18) 2. Sleep. (11:56) 3. Vitamin D. (16:51) 4. Zinc. (20:57) 5. Magnesium. (21:55) 6. Other supps/recommendations: (Fenugreek, Ashwagandha, Shilajit, Tonkat Ali, and red-light therapy.) (23:03) Related Links/Products Mentioned Boost Testosterone Guide: http://mindpumpmedia.com/testosterone-guide  Visit Crisp Power for an exclusive offer for Mind Pump listeners! ** Code MINDPUMP10 for 10% OFF. Give your snack game a serious upgrade. Crisp Power Protein Pretzels deliver super crunchy and delicious snacks that are up to 28g of protein, low carb, zero sugar, and high in fiber! ** January Promotion: Code NEWYEAR50 at checkout for 50% off the following programs: MAPS Starter, Transform, Anabolic, and Performance! Visit: http://mapsjanuary.com/  Mind Pump Store Various Factors May Modulate the Effect of Exercise on Testosterone Levels in Men Endogenous transient doping: physical exercise acutely increases testosterone levels-results from a meta-analysis Sleep and Testosterone: The Essential Connection for Optimal Health Association Between Vitamin D Deficiency and Testosterone Levels in Adult Males: A Systematic Review Effect of Zinc on Testosterone Levels and Sexual Function of Postmenopausal Women: A Randomized Controlled Trial Zinc status and serum testosterone levels of healthy adults Effect of fenugreek extract supplement on testosterone levels in male: A meta‐analysis of clinical trials A Randomized, Double-Blind, Placebo-Controlled, Crossover Study Examining the Hormonal and Vitality Effects of Ashwagandha (Withania somnifera) in Aging, Overweight Males Tongkat Ali benefits, dosage, and side effects - Examine Mind Pump Podcast – YouTube Mind Pump Free Resources  

This week, please join author Mathew S. Maurer as he discusses the article "Coramitug, a Humanized Monoclonal Antibody for the Treatment of Transthyretin Amyloid Cardiomyopathy: A Phase 2, Randomized, Multicenter, Double-Blind, Placebo-Controlled Trial." For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20260126.13097

Kick off 2026 with the January episode of RAPM Focus, where RAPM Social Media Editor Alopi Patel, MD, converses with Josh Gleicher, MD, MSc, FRCPC, and Hermann dos Santos Fernandes, MD, PhD, following the September 2025 publication of their original research paper, “Outpatient continuous adductor canal block (CACB) for total knee arthroplasty: a double-blinded randomized placebo-controlled trial.” Dr. Gleicher is a staff anesthesiologist and regional anesthesia expert at Mount Sinai Hospital in Toronto, Canada. He completed his anesthesiology training and fellowship in regional anesthesia at the University of Toronto and holds a master's degree in quality improvement and patient safety. Dr. Gleicher has extensive experience leading clinical trials in acute postoperative pain, with multiple funded studies and recognized expertise in anesthesia research. He is also a co-developer of the ISAFE technique for adductor canal catheter placement. In his spare time, he enjoys skiing and spending time with his wife and three kids. Dr. dos Santos Fernandes is a specialist in anesthesiology and pain management, trained at University of São Paulo, where he also achieved his PhD and completed a post-doctorate program. He has fellowship training in regional anesthesia and medical education at Mount Sinai Hospital, University of Toronto, and holds multiple certifications, including the superior title in anesthesiology and European diploma in anesthesiology and intensive care. Currently, he is an assistant professor at the University of Toronto and a staff anesthesiologist at Mount Sinai Hospital, with research and clinical focus on regional anesthesia. A retired basketball player and aspiring tennis player, he likes to travel with the family in his free time. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

Dr. Rena Malik, urologist and pelvic surgeon, addresses common questions about testosterone replacement therapy (TRT) and prostate cancer risk, urinary incontinence in women—including causes, symptoms, and treatment options like pelvic floor exercises—and explains the role of penile Doppler ultrasounds for evaluating erectile dysfunction. This evidence-based Ask Me Anything episode also covers practical advice for improving quality of life and emphasizes the importance of personalized, physician-guided care in sexual and urinary health. Become a Member to Receive Exclusive Content: renamalik.supercast.com Schedule an appointment with me: https://www.renamalikmd.com/appointments Videos mentioned in podcast: https://www.youtube.com/watch?v=vbXUdNxXyqc https://www.youtube.com/watch?v=tRAKyM_n-ik ▶️Chapters: 0:00 Introduction 00:47 Testosterone replacement therapy cancer risk 01:38 Low testosterone and prostate cancer 02:11 The Traverse trial findings 03:09 Testosterone and prostate cancer growth 04:27 Other risks of testosterone therapy 05:06 Randomized controlled trials explained 06:39 Stress urinary incontinence in women 13:19 Penile Doppler ultrasound 18:27 Podcast wrap-up and subscribe Let's Connect!: WEBSITE: http://www.renamalikmd.com YOUTUBE: https://www.youtube.com/@RenaMalikMD INSTAGRAM: http://www.instagram.com/RenaMalikMD TWITTER: http://twitter.com/RenaMalikMD FACEBOOK: https://www.facebook.com/RenaMalikMD/ LINKEDIN: https://www.linkedin.com/in/renadmalik PINTEREST: https://www.pinterest.com/renamalikmd/ TIKTOK: https://www.tiktok.com/RenaMalikMD ------------------------------------------------------ DISCLAIMER: This podcast is purely educational and does not constitute medical advice. The content of this podcast is my personal opinion, and not that of my employer(s). Use of this information is at your own risk. Rena Malik, M.D. will not assume any liability for any direct or indirect losses or damages that may result from the use of information contained in this podcast including but not limited to economic loss, injury, illness or death. Learn more about your ad choices. Visit megaphone.fm/adchoices

The FiltrateJoel Topf‍ ‍@kidneyboy.bsky.social‬ (COI)Sophia Ambruso @sophia-kidney.bsky.socialSwapnil Hiremath @hswapnil.medsky.social and on LinkedInSpecial Guests Jonathan Barratt Professor of Renal Medicine, University of Leicester Google Scholar (COI: all the companies)Editing and Show Notes byNayan Arora @captainchloride.bsky.socialThe Kidney Connection written and performed by Tim YauShow NotesProteinuria Reduction as a Surrogate End Point in Trials of IgA Nephropathy (Aliza Thompson, 2019 PubMed)The number, quality, and coverage of randomized controlled trials in nephrology (PubMed 2004)A Randomized, Controlled Trial of Rituximab in IgA Nephropathy with Proteinuria and Renal Dysfunction (PubMed 2017)BLISS Belimumab in lupus nephritis (NephJC | PubMed)The Phase 2 trial of atacicept A phase 2b, randomized, double-blind, placebo-controlled, clinical trial of atacicept for treatment of IgA nephropathy (PubMed)The phase 3 trial of atacicept, the subject of this podcast A Phase 3 Trial of Atacicept in Patients with IgA Nephropathy (PubMed | NephJC)The use of Gd-IgA1 in the Testing Trial Role of Systemic Glucocorticoids in Reducing IgA and Galactose-Deficient IgA1 Levels in IgA Nephropathy (PubMed)If you can't get enough Jon Barratt, take a look at his grand rounds at The University of Ottawa. Updates to the KDIGO Guidelines for the treatment of IgA nephropathy, with Prof Jonathan Barratt (YouTube)Tubular SecretionSwapnil Hiremath Pluribus on Apple TV (Wikipedia)Jon Barratt Lynyrd Skynyrd (Wikipedia) Slow Horses (Wikipedia) on AppleTVJoel Topf the new ASN

On episode #95 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the weeks of 11/20/25 – 12/3/25. Host: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, RSS, email Become a patron of Puscast! Links for this episode Viral Early low-dose dexamethasone is associated with shorter acute symptom duration in Chikungunya virus infection: a retrospective cohort study (BMC Infectious Diseases) Noninferiority of One HPV Vaccine Dose to Two Doses (NEJM) Evidence to Action — Single-Dose HPV Vaccination and Cervical HPV Infection (NEJM) Daily Mosnodenvir as Dengue Prophylaxis in a Controlled Human InfectionModel (NEJM) Universal Hepatitis B Vaccination at Birth—Risks of Revising the recommendation (JAMA) Correlates of HIV-1 control after combination immunotherapy (Nature) Human-to-Human Rabies Transmission via Solid Organ Transplantation from a Donor with Undiagnosed Rabies — United States, October 2024–February 2025 (CDC: MMWR) Cytomegalovirus-specific cell-mediated immunity for prediction of post-prophylaxis CMV disease in a phase 3 trial of letermovir vs valganciclovir prophylaxis in donor CMV-seropositive recipient CMV-seronegative kidney transplant recipients (CID) An Analysis of Cytomegalovirus-Specific Cell-Mediated Immunity in a Phase 3, Randomized, Placebo-Controlled Trial of Letermovir Prophylaxis in Cytomegalovirus-Seropositive Recipients of an Allogeneic Hematopoietic Cell Transplant (CID) Bacterial Infectious Diseases Society of America (IDSA) Position Statement: Why IDSA Did Not Endorse the Community-Acquired Pneumonia Guidelines 2025 Update (CID) Lyme DiseaseIncidence in Massachusetts, 2012-2024 (JAMA: Open Network) Fungal The Last of US Season 2 (YouTube) Aspergillosis-Attributable Mortality in the United States: Analysis of Death CertificateData (CID) Oral itraconazole versus oral voriconazole for treatment-naive patients with chronic pulmonary aspergillosis in India (VICTOR-CPA trial): a single-centre, open-label, randomised, controlled, superiority trial (LANCET: Infectious Diseases) Parasitic Loa loa encephalopathy following treatment with benzimidazole derivatives: A systematic review (OFID) Music is by Ronald Jenkees Information on this podcast should not be considered as medical advice.

In this Thoracic Surgery episode of Behind the Knife we enjoy a conversation with world-renowned thoracic surgeon and educator, Dr. Stephen Yang, as he takes us through 30 years of experience divulging his personal tips, tricks, and pitfalls to avoid when tackling the technical nuances of mastering robotic segmentectomies. Hosts:  Dr. Stephen C. Yang, MD -  professor of surgery and medical oncology The Johns Hopkins Hospital Dr. Kyla D. Rakoczy, MD - PGY3 General Surgery Resident at The Johns Hopkins Hospital Learning Objectives: Understand the utility of segmentectomies for peripheral T1N0 non-small-cell-lung cancer  How to prepare for robotic segmentectomy using CT scans and 3D reconstructions  Learn where to place your ports and how to optimize intra-operative techniques to minimize complications after robotic segmentectomy  References: Kang MW. Evolution of Lung Cancer Surgery: Historical Milestones, Current Strategy, and Future Innovations. J Chest Surg. 2025 May 5;58(3):79-84. doi: 10.5090/jcs.25.025. Epub 2025 Apr 15. PMID: 40230346; PMCID: PMC12066400. https://pubmed.ncbi.nlm.nih.gov/40230346/ Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg. 1995 Sep;60(3):615-22; discussion 622-3. doi: 10.1016/0003-4975(95)00537-u. PMID: 7677489. https://pubmed.ncbi.nlm.nih.gov/7677489/ Pastorino U, Valente M, Bedini V, Infante M, Tavecchio L, Ravasi G. Limited resection for Stage I lung cancer. Eur J Surg Oncol. 1991 Feb;17(1):42-6. PMID: 1995356. https://pubmed.ncbi.nlm.nih.gov/1995356/ Liu L, Aokage K, Chen C, Chen C, Chen L, Kim YH, Lee CY, Liu C, Liu CC, Nishio W, Suzuki K, Tan L, Tseng YL, Yotsukura M, Watanabe SI. Asia expert consensus on segmentectomy in non-small cell lung cancer: A modified Delphi study. JTCVS Open. 2023 Apr 7;14:483-501. doi: 10.1016/j.xjon.2023.03.013. PMID: 37425437; PMCID: PMC10328970. https://pubmed.ncbi.nlm.nih.gov/37425437/ Galvez C, Bolufer S, Lirio F, Recuero JL, Córcoles JM, Socci L, Cabañero A, López I, Sánchez D, Figueroa S, Salcedo JG, Campo-Cañaveral JL, Genovés M, Hernando F, Moldes M, Blanco A, Azcarate L, Rivo E, Viti A, Mongil R. "Complex segmentectomies: Comparison with simple and effect of experience on postoperative outcomes". Eur J Surg Oncol. 2025 Jul;51(7):109748. doi: 10.1016/j.ejso.2025.109748. Epub 2025 Mar 5. PMID: 40064065. https://pubmed.ncbi.nlm.nih.gov/40064065/ Perroni G, Veronesi G. Robotic segmentectomy: indication and technique. J Thorac Dis. 2020 Jun;12(6):3404-3410. doi: 10.21037/jtd.2020.02.53. PMID: 32642266; PMCID: PMC7330783. https://pubmed.ncbi.nlm.nih.gov/32642266/ Montagne, F., Dhainaut, C., & Benhamed, L. M. (n.d.). Pre-operative 3D reconstruction—let's first anticipate the surgical procedure. Video-Assisted Thoracic Surgery. Retrieved November 13, 2025, from https://vats.amegroups.org/article/view/7889/html Shimizu K, Nakazawa S, Nagashima T, Kuwano H, Mogi A. 3D-CT anatomy for VATS segmentectomy. J Vis Surg. 2017 Jul 1;3:88. doi: 10.21037/jovs.2017.05.10. PMID: 29078650; PMCID: PMC5637987. https://pubmed.ncbi.nlm.nih.gov/29078650/ Zhang O, Alzul R, Carelli M, Melfi F, Tian D, Cao C. Complications of Robotic Video-Assisted Thoracoscopic Surgery Compared to Open Thoracotomy for Resectable Non-Small Cell Lung Cancer. J Pers Med. 2022 Aug 12;12(8):1311. doi: 10.3390/jpm12081311. PMID: 36013260; PMCID: PMC9410342. https://pubmed.ncbi.nlm.nih.gov/36013260/ Lee BE, Altorki N. Sub-Lobar Resection: The New Standard of Care for Early-Stage Lung Cancer. Cancers (Basel). 2023 May 25;15(11):2914. doi: 10.3390/cancers15112914. PMID: 37296877; PMCID: PMC10251869. https://pubmed.ncbi.nlm.nih.gov/37296877/ Zhang Y, Liu S, Han Y, Xiang J, Cerfolio RJ, Li H. Robotic Anatomical Segmentectomy: An Analysis of the Learning Curve. Ann Thorac Surg. 2019 May;107(5):1515-1522. doi: 10.1016/j.athoracsur.2018.11.041. Epub 2018 Dec 19. PMID: 30578780. https://pubmed.ncbi.nlm.nih.gov/30578780/ Peeters M, Jansen Y, Daemen JHT, van Roozendaal LM, De Leyn P, Hulsewé KWE, Vissers YLJ, de Loos ER. The use of intravenous indocyanine green in minimally invasive segmental lung resections: a systematic review. Transl Lung Cancer Res. 2024 Mar 29;13(3):612-622. doi: 10.21037/tlcr-23-807. Epub 2024 Mar 27. PMID: 38601441; PMCID: PMC11002498. https://pubmed.ncbi.nlm.nih.gov/38601441/ Altorki N, Wang X, Damman B, Mentlick J, Landreneau R, Wigle D, Jones DR, Conti M, Ashrafi AS, Liberman M, de Perrot M, Mitchell JD, Keenan R, Bauer T, Miller D, Stinchcombe TE. Lobectomy, segmentectomy, or wedge resection for peripheral clinical T1aN0 non-small cell lung cancer: A post hoc analysis of CALGB 140503 (Alliance). J Thorac Cardiovasc Surg. 2024 Jan;167(1):338-347.e1. doi: 10.1016/j.jtcvs.2023.07.008. Epub 2023 Jul 18. Erratum in: J Thorac Cardiovasc Surg. 2025 Apr;169(4):1181. doi: 10.1016/j.jtcvs.2024.12.011. PMID: 37473998; PMCID: PMC10794519. https://pubmed.ncbi.nlm.nih.gov/37473998/ 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

This week, join author Hans-Josef Feistritzer and Associate Editor Stefan James as they discuss the article "Peri-Interventional Anesthesia Strategies for Transcatheter Aortic Valve Implantation: A Multicenter, Randomized, Controlled, Noninferiority Trial."   For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20251201.586148

Dr. Suresh Durgam (Intra-Cellular Therapies, a Johnson & Johnson Company, Bedminster, NJ) joins AJP Audio to discuss a phase 3 randomized controlled trial looking at the use of the antipsychotic medication lumateperone as adjunctive to antidepressant therapy in the treatment of patients with major depressive disorder. Afterwards, AJP Editor-in-Chief Dr. Ned Kalin discusses the rest of the December issue of the Journal. 00:48   Durgam interview 03:09   Mechanism of action 04:44   Patient-reported outcomes 06:31   Immediate clinical implications 07:32   Limitations 08:08   Further research 09:25   Kalin interview 09:38   Durgam et al. 13:09   Lin et al. 17:22   Brodsky et al. Transcript Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Today, I am delighted to be joined by a friend and colleague, Mike Mutzel.  Mike has a master's in Clinical Nutrition from the University of Bridgeport. He is a graduate of the IFM, applies functional medicine in clinical practice, and is a consultant lecturer who teaches leading-edge science in a concise format for progressive clinicians to prevent chronic diseases.  In our discussion, Mike and I unpack the benefits of creatine monohydrate, highlighting the importance of ensuring the products we use are free of impurities. We explain how creatine monohydrate gets created, answer many listener questions, and describe current research specific to creatine monohydrate, discussing ways to support bone health, navigate dosing, and how to troubleshoot.  This conversation with Mike Mutzel is truly invaluable, and I look forward to having him back on the podcast to dive a little deeper into the science.  IN THIS EPISODE, YOU WILL LEARN: How creatine supports energy production across muscles, the brain, and other organ systems Why vegetarians and vegans should take creatine What to consider when choosing high-quality creatine supplements Dosing strategies based on diet, exercise, sleep, and individual needs How taking creatine with electrolytes while exercising can improve absorption Benefits of supplementing with amino acids alongside creatine for illness, recovery, or when protein intake is low Adjusting your creatine dosage for sleep, travel, or exercise demands How creatine supports bone and muscle health  The value of creatine for the eyes and ears Connect with Cynthia Thurlow   Follow on X, Instagram & LinkedIn Check out Cynthia's website Submit your questions to support@cynthiathurlow.com Connect with Mike Mutzel On his website YouTube Instagram High Intensity Health Podcast Creatine Research: Creatine in Women's Health: Bridging the Gap From Menstruation Through Pregnancy to Menopause Effects of Creatine and Resistance Training on Bone Health in Postmenopausal Women Creatine Supplementation (3 g/d) and Bone Health in Older Women: A 2-Year, Randomized, Placebo-Controlled Trial Creatine Supplementation in Depression: A Review of Mechanisms, Efficacy, Clinical Outcomes, and Future Directions The Effects of 8-Week Creatine Hydrochloride and Creatine Ethyl Ester Supplementation on Cognition, Clinical Outcomes, and Brain Creatine Levels in Perimenopausal and Menopausal Women (CONCRET-MENOPA): A Randomized Controlled Trial

The FiltrateJoel Topf‍ ‍@kidneyboy.bsky.social‬ (COI)Sophia Ambruso @sophia-kidney.bsky.socialSwapnil Hiremath @hswapnil.medsky.social and on LinkedInSpecial Guests Jonathan Barratt Professor of Renal Medicine, University of Leicester Google Scholar (COI: all the companies)Editing and Show Notes byNayan Arora @captainchloride.bsky.socialThe Kidney Connection written and performed by Tim YauShow NotesProteinuria Reduction as a Surrogate End Point in Trials of IgA Nephropathy (Aliza Thompson, 2019 PubMed)The number, quality, and coverage of randomized controlled trials in nephrology (PubMed 2004)Updated here (PubMed | NephJC discussion)A Randomized, Controlled Trial of Rituximab in IgA Nephropathy with Proteinuria and Renal Dysfunction (PubMed 2017)BLISS Belimumab in lupus nephritis (NephJC | PubMed) The Phase 2 trial of atacicept A phase 2b, randomized, double-blind, placebo-controlled, clinical trial of atacicept for treatment of IgA nephropathy (PubMed)The phase 3 trial of atacicept, the subject of this podcast A Phase 3 Trial of Atacicept in Patients with IgA Nephropathy (PubMed | NephJC)Christos' Bluesky post:https://bsky.app/profile/christosargyrop.bsky.social/post/3m5bsujwg3s2q The use of Gd-IgA1 in the Testing Trial Role of Systemic Glucocorticoids in Reducing IgA and Galactose-Deficient IgA1 Levels in IgA Nephropathy (PubMed)If you can't get enough Jon Barratt, take a look at his grand rounds at The University of Ottawa. Updates to the KDIGO Guidelines for the treatment of IgA nephropathy, with Prof Jonathan Barratt (YouTube)Tubular SecretionSwapnil Hiremath Pluribus on Apple TV (Wikipedia)Jon Barratt Lynyrd Skynyrd (Wikipedia) Slow Horses (Wikipedia) on AppleTVJoel Topf the new ASN

In this World Shared Practice Forum Podcast, Dr. Vinay Nadkarni discusses emergent tracheal intubation in pediatric critical care. Drawing from the NEAR4KIDS registry and comparing with recent adult-focused evidence, Dr. Nadkarni discusses the challenges of airway management in children, emphasizing the importance of patient-specific physiology. He highlights how patient positioning and equipment choices can improve intubation outcomes. Additionally, the episode explores the benefits of video laryngoscopy and apneic oxygenation. This content is pertinent for healthcare professionals seeking to enhance their understanding of pediatric airway management, offering practical insights supported by recent research. LEARNING OBJECTIVES - Compare pediatric and adult emergency tracheal intubation evidence and practices - Explore the role of the NEAR4KIDS registry in improving pediatric intubation practices - Identify effective strategies to enhance first-attempt success in tracheal intubations - Assess the impact of patient positioning and equipment choices on intubation outcomes - Evaluate the benefits of video laryngoscopy and apneic oxygenation in pediatric settings AUTHORS Vinay Nadkarni, MD, MS Professor, Anesthesiology Critical Care and Pediatrics University of Pennsylvania Perelman School of Medicine Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: November 25, 2025. ARTICLES REFERENCED - DeMasi SC, Casey JD, Semler MW. Evidence-based Emergency Tracheal Intubation. Am J Respir Crit Care Med. 2025;211(7):1156-1164. doi:10.1164/rccm.202411-2165CI - Garcia-Marcinkiewicz AG, Kovatsis PG, Hunyady AI, et al. First-attempt success rate of video laryngoscopy in small infants (VISI): a multicentre, randomised controlled trial. Lancet. 2020;396(10266):1905-1913. doi:10.1016/S0140-6736(20)32532-0 - Hagberg CA, Artime CA, Aziz MF, eds. Hagberg and Benumof's Airway Management. 5th ed. Philadelphia, PA: Elsevier; 2023. - Khanam D, Schoenfeld E, Ginsberg-Peltz J, et al. First-Pass Success of Intubations Using Video Versus Direct Laryngoscopy in Children With Limited Neck Mobility. Pediatr Emerg Care. 2024;40(6):454-458. doi:10.1097/PEC.0000000000003058 - Waheed S, Kapadia NN, Jawed DR, Raheem A, Khan MF. Randomized controlled trial to assess the effectiveness of apnoeic oxygenation in adults using a low-flow or high-flow nasal cannula with head side elevation during endotracheal intubation in the emergency department. BMC Res Notes. 2025 Jul 1;18(1):264. doi: 10.1186/s13104-025-07328-7. Erratum in: BMC Res Notes. 2025 Sep 8;18(1):384. doi: 10.1186/s13104-025-07412-y. PMID: 40598378; PMCID: PMC12219693. TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/mr2657n4ckgpz7g3tw37gbx/202511_WSP_Nadkarni_transcript Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Nadkarni V, Burns JP. Pediatric Intubation Practices: Insights from NEAR4KIDS. 11/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/pediatric-intubation-practices-insights-from-near4kids-by-v-nadkarni-openpediatrics.

The VICTORY Trial - A Randomized, Multicenter, Non-Inferiority Comparison

This week, join author Jonas Oldgren and Associate Editor Torbjørn Omland as they discuss the article "Biomarker-Based ABC-AF Risk Scores for Personalized Treatment to Reduce Stroke or Death in Atrial Fibrillation: A Registry-Based Multicenter, Randomized, Controlled Study." For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20251124.61165

Broadcast from KSQD, Santa Cruz on 11-13-2025: Dr. Dawn discusses a New England Journal of Medicine study examining radiation exposure from medical imaging in over 4 million children showing increased hematological cancer risk. Head and brain CTs deliver highest bone marrow doses, with under-1-year-olds receiving 20 milligrays compared to background radiation of 1 milligray yearly. The study found 3,000 cancers in 4 million children over roughly 10 years, with relative risk increasing 1.6-fold per CT scan. However, methodological flaws include combining US and Canadian cohorts with different data quality, potential reverse causation where imaging detected pre-existing cancers, and arbitrary 6-month latency assumptions are significant flaws in this study.. Despite small absolute risk increases given low baseline cancer rates, she encourages parents to question necessity of repeat scans and request alternatives like MRI when appropriate. She reports on cutting-edge CRISPR therapy using lipid nanoparticles to deliver molecular scissors targeting the ANGPTL3 gene controlling LDL cholesterol production. Recent setbacks in several other CRISPR trials raise issues for unexplained liver toxicity. Concerns include off-target gene editing effects and partially repaired DNA creating mutated proteins triggering autoimmune reactions. Dr. Dawn emphasizes restricting gene therapy to life-threatening genetic diseases with no alternatives until safety improves. Stanford scientists used AI model Evo trained on 9 trillion gene samples to design 300 new bacteriophages from scratch, with 16 phages successfully killing E. coli bacteria. AI tools now predict protein structures, design custom drugs, create antivenoms, invent antibiotics, and break down PFAS forever chemicals. The research represents evolution through computation and requires guardrails on AI's ability to manipulate biological structures. An emailer shares the Rosencare model where hotel chain owner Harris Rosen created self-insured health coverage featuring direct provider contracting, imaging facilities charging one-third to one-half traditional costs, transparent pharmacy benefit management, and zero or $5 primary care copays. Employees receive proactive screening for colonoscopies, mammograms, cholesterol, diabetes, and hypertension during clinic visits. Ninety percent of medicines including insulin cost nothing, with remaining drugs $0-25, and hospital admissions cost flat $750. The model saved $600 million while providing superior preventive care by eliminating insurance middlemen and focusing on early chronic disease detection when 75-85% of costs originate. Dr. Dawn explains abdominophrenic dyssynergia causing bloating unrelated to gas or food. The diaphragm descends and abdominal wall muscles relax, pushing organs forward after meals. CT scans showed lettuce-related bloating involved no intestinal gas changes but demonstrated this abnormal muscle reflex. Randomized trials showed biofeedback training with chest-lifting and abdominal wall contracting exercises before and after eating for four weeks improved symptoms 66%. She warns that constant bloating in postmenopausal women unrelated to eating requires ovarian cancer screening. She discusses how genes drive personality using dopamine receptor gene DRD4 polymorphisms as an example. The 7-repeat variant present in 48% of Americans creates receptors binding dopamine poorly, associating with ADHD, pathological gambling, alcoholism, drug dependence, and bulimia, plus personality traits of novelty-seeking, impulsiveness, and optimism. The 2-repeat DRD4 variant common in Asia correlates with lower anger and higher forgiveness. DRD2 variations enhance the memory of negative outcomes, creating pessimistic bias and avoidance behavior. She presents the KETO trial showing "lean mass hyper-responder phenotype" where very low-carbohydrate dieters averaging age 55 maintained LDL cholesterol of 272 for five years but showed identical coronary artery calcium scores and plaque burden as matched controls with LDL under 150. Despite extreme LDL elevation, the very low insulin levels from carbohydrate restriction prevent LDL oxidation, the inflammatory "loading" process enabling arterial damage. She concludes with unusual cancer symptom where recurrent pain in specific body locations after alcohol consumption, lasting 1-2 days, occurs in 5% of Hodgkin lymphoma patients and in other cancers when alcohol induced blood vessel dilation and inflammatory chemical release in cancer-containing lymph nodes causes pain after drinking.

Carotid artery disease management has come a long way. From the days when every stroke meant an endarterectomy to a modern era defined by precision, evidence, and evolving technology. With advances in medical therapy and newer techniques like TCAR, the vascular surgeon has even more to consider when choosing the best treatment for carotid disease. Join us as we break down the major landmark trials NASCET, CREST and the Asymptomatic Carotid trials, and discuss how their findings shape our clinical decisions in practice today. 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: · Review the key findings and clinical implications of the NASCET, ACST, and CREST trials. · Discuss patient selection for carotid endarterectomy (CEA) vs carotid artery stenting (CAS). · Understand how age, calcification, and aortic arch anatomy affect stenting outcomes or choice between stent and CEA. · Identify how advances in medical therapy have influenced management of asymptomatic disease.  · Discuss appropriate screening/ follow up plans for patients who do not meet criteria for intervention References: -       North American Symptomatic Carotid Endarterectomy Trial Collaborators. (1991). Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. The New England Journal of Medicine, 325(7), 445–453. https://pubmed.ncbi.nlm.nih.gov/1852179/ -       Brott, T. G., Hobson, R. W. II, Howard, G., Roubin, G. S., Clark, W. M., Brooks, W., ... & Howard, V. J. (2010). Stenting versus endarterectomy for treatment of carotid-artery stenosis. The New England Journal of Medicine, 363(1), 11–23. https://pubmed.ncbi.nlm.nih.gov/20505173/ -       Halliday, A., Mansfield, A., Marro, J., Peto, C., Peto, R., Potter, J., & Thomas, D.; MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. (2004). Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: Randomized controlled trial. The Lancet, 363(9420), 1491–1502. https://pubmed.ncbi.nlm.nih.gov/15135594/ -       Halliday, A., Bulbulia, R., Bonati, L. H., Chester, J., Cradduck-Bamford, A., Peto, R., & Pan, H., & the ACST-2 Collaborative Group. (2021). Second asymptomatic carotid surgery trial (ACST-2): A randomised comparison of carotid artery stenting versus carotid endarterectomy. The Lancet, 398(10305), 1065-1073. https://doi.org/10.1016/S0140-6736(21)01910-3 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

Mindfulness Training and Stress Reactivity in Substance Abuse: Results from a Randomized, Controlled Stage I Pilot StudyIn this episode, Dr. Jud delves into groundbreaking research comparing mindfulness training (MT) and cognitive behavioral therapy (CBT) for individuals with substance use disorders. This pilot study investigates the role of mindfulness in managing stress and addiction, highlighting its potential to reduce psychological and physiological stress responses. Learn how MT could become a viable treatment option alongside traditional therapies, the challenges faced during the study, and what these findings mean for the future of addiction treatment.Reference: Brewer, J. A., Sinha, R., Chen, J. A., Michalsen, R. N., Babuscio, T. A., Nich, C., ... & Rounsaville, B. J. (2009). Mindfulness Training and Stress Reactivity in Substance Abuse: Results from a Randomized, Controlled Stage I Pilot Study. Substance Abuse, 30(4), 306-317. DOI: 10.1080/08897070903250241Let's connect on Instagram

Summary In this episode, Ryan Bucciantini and Jason Leydon discuss the importance of structured programming in training, contrasting systems versus chaos. They explore the role of variance in exercise selection and the need for individualized program design. The conversation highlights the significance of having a game plan, understanding the timeline of training seasons, and the pitfalls of constantly varied programming without purpose. They emphasize the value of mentorship and the challenges of online programming in the fitness industry.   Takeaways   Structured programming is crucial for effective training. Variance in exercise selection can enhance athlete development. Individualized program design is essential for progress. Constantly varied programming should have a purpose. Mentorship is valuable for developing programming skills. Online programming presents unique challenges. Understanding training season timelines is important. A game plan is necessary for successful training. Exercise variation should target specific athlete needs. Communication with athletes is key to program success.   Topics    Mastering Training Systems: From Chaos to Structure The Art of Exercise Variance in Programming Why Individualized Program Design Matters Avoiding the Pitfalls of Randomized Training Mentorship: A Key to Programming Success Navigating the Challenges of Online Programming Training Timelines: Planning for Success The Importance of a Game Plan in Training Targeted Exercise Variation for Athletes Effective Communication in Program Design   Sound bites "Structured programming is crucial for effective training." "Variance in exercise selection enhances athlete development." "Individualized program design is essential for progress." "Constantly varied programming should have a purpose." "Mentorship is valuable for developing programming skills." "Online programming presents unique challenges." "Understanding training season timelines is important." "A game plan is necessary for successful training." "Exercise variation should target specific athlete needs." "Communication with athletes is key to program success."   Chapters 00:00:00 Introduction to Training Systems 00:00:00 The Role of Variance in Exercise 00:00:00 Importance of Individualized Program Design 00:00:00 Challenges of Online Programming 00:00:00 Mentorship and Skill Development 00:00:00 Planning Training Timelines  

Whether to close the capsule at the conclusion of hip arthroscopy remains a matter of great debate.  Prior data has been mixed. Dr. Bjarne Mygind-Klavsen from Aarhus University Hospital in Denmark joints us to discuss the results of his team's randomized controlled study comparing interportal capsulotomy closure versus no closure at 1 year following hip arthroscopy.

November 2025 Journal Club Podcast Title: Thrombectomy for Patients With Large-Volume Ischemic Stroke: A Systematic Review and Meta-Analysis of 6 Randomized Trials To read journal article: https://journals.lww.com/neurosurgery/fulltext/2025/11000/thrombectomy_for_patients_with_large_volume.5.aspx Author: Mark Harrigan Guest Faculty: David Altschul Moderator: Zachary Sorrentino Committee Co-Chair: Kimberly Hoang

Why are we still treating acute uncomplicated diverticulitis with antibiotics? There is plenty of evidence from several randomized controlled trials demonstrating that symptomatic management alone yields similar results. If we should continue prescribing antibiotics for acute uncomplicated diverticulitis, which patients should undergo treatment and when? Join Drs. Jared Hendren, Elissa Dabaghi, Joseph Trunzo, Ajaratu Keshinro, and David Rosen as they discuss the management of uncomplicated diverticulitis while reviewing groundbreaking literature. Hosts: -Jared Hendren, MD Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio - Elissa Dabaghi, MD Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio - Joseph Trunzo, MD Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio Social Media Handle: X/Twitter @joseph_trunzo - Ajaratu Keshinro, MD Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio Social Media Handle: X/Twitter- @AJKesh - David Rosen, MD Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio Social Media Handle: X/Twitter- @davidrrosenmd Learning Objectives: By the end of this episode, listeners will be able to: 1.     Identify criteria for managing acute uncomplicated diverticulitis without antibiotics based on recent literature 2.     Define uncomplicated and complicated diverticulitis 3.     Discuss nuanced management decisions of patients with uncomplicated diverticulitis to determine when antibiotics may be appropriate for management References: 1.     Azhar, N., Aref, H., Brorsson, A., Lydrup, M.‑L., Jörgren, F., Schultz, J. K., & Buchwald, P. (2022). Management of acute uncomplicated diverticulitis without antibiotics: Compliance and outcomes – a retrospective cohort study. BMC Emergency Medicine, 22(1), Article 28. https://doi.org/10.1186/s12873‑022‑00584‑X  2.     Mora‑López, L., Ruiz‑Edo, N., Estrada‑Ferrer, O., Piñana‑Campón, M. L., Labró‑Ciurans, M., Escuder‑Perez, J., Sales‑Mallafré, R., Rebasa‑Cladera, P., Navarro‑Soto, S., Serra‑Aracil, X., & DINAMO‑study Group. (2021). Efficacy and safety of nonantibiotic outpatient treatment in mild acute diverticulitis (DINAMO‑study): A multicentre, randomised, open‑label, noninferiority trial. Annals of Surgery, 274(5), e435–e442. https://doi.org/10.1097/SLA.0000000000005031 3.     Daniels, L., Ünlü, Ç., de Korte, N., van Dieren, S., Stockmann, H. B., Vrouenraets, B. C., Consten, E. C., van der Hoeven, J. A., Eijsbouts, Q. A., Faneyte, I. F., Bemelman, W. A., Dijkgraaf, M. G., & Boermeester, M. A. (2017). Randomized clinical trial of observational versus antibiotic treatment for a first episode of CT‑proven uncomplicated acute diverticulitis. British Journal of Surgery, 104(1), 52‑61. https://doi.org/10.1002/bjs.10309 4.     Chabok, A., Påhlman, L., Hjern, F., Haapaniemi, S., & Smedh, K.; AVOD Study Group. (2012). Randomized clinical trial of antibiotics in acute uncomplicated diverticulitis. British Journal of Surgery, 99(4), 532–539. https://doi.org/10.1002/bjs.8688 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

I sat down with Dr. Layne Norton, PhD, one of the most respected names in evidence-based fitness and nutrition, to cut through the noise that dominates our feeds. If you've ever been confused by conflicting advice from influencers, or wondered how to separate hype from science, this conversation is for you.Layne walks us through how to actually read research, spot red flags, and apply the right evidence to your own health and performance. We talk about adherence, why consistency beats hacks, how to think about n=1 experimentation, and why muscle is way more than just something that moves your body—it's one of the most powerful protectors of long-term health.If you want to stop guessing and start making decisions that are backed by data (and not just feelings), you'll love this episode. Listen in, and you'll walk away with a practical blueprint for training smarter, fueling better, and staying resilient—without falling for the myths.Timeline Mitopure Gummies: GET 20% Off Now!

What's best for skin closure at C-Section? Staples or suture? This debate has raged for over 20 years. Past data has shown greater odds of wound complications with metal staples compared to suture. But new a meta-analysis from June 2025 is challenging the prior results. In this episode, we will explore the data from 2010 to present day. PLUS, we will summarize a separate meta-analysis examining if wound dressing removal is tied to any wound complication. This was just published July 15, 2025 in the “Pink” journal. Listen in for details. 1. 2010: Basha SL, Rochon ML, Quiñones JN, Coassolo KM, Rust OA, Smulian JC. Randomized controlled trial of wound complication rates of subcuticular suture vs staples for skin closure at cesarean delivery. Am J Obstet Gynecol. 2010 Sep;203(3):285.e1-8. doi: 10.1016/j.ajog.2010.07.011. PMID: 20816153.2. 2015: Mackeen AD, Schuster M, Berghella V. Suture versus staples for skin closure after cesarean: a metaanalysis. Am J Obstet Gynecol. 2015 May;212(5):621.e1-10. doi: 10.1016/j.ajog.2014.12.020. Epub 2014 Dec 19. PMID: 25530592.3. Jan 2025: Gabbai D, Jacoby C, Gilboa I, Maslovitz S, Yogev Y, Attali E. Comparison of complications and surgery outcomes in skin closure methods following cesarean sections. Arch Gynecol Obstet. 2025 Jul;312(1):125-129. doi: 10.1007/s00404-024-07911-6. Epub 2025 Jan 25. PMID: 39862268; PMCID: PMC12176926.4. June 2025: Post-cesarean skin closure with metal staples versus subcuticular suture in obese patients: A systematic review and meta-analysis of randomized controlled trials. Luis Sanchez-Ramos et al (Univ Florida). https://onlinelibrary.wiley.com/doi/pdf/10.1002/pmf2.700615. DRESSING REMOVAL: July 15, 2025: Leshae A Cenac, Serena Guerra, Alicia Huckaby, Gabriele Saccone, Vincenzo Berghella. Early Wound Dressing (soft gauze/tape dressing) Removal after Cesarean Delivery: A Meta-Analysis of Randomized Trials: Short title: early wound dressing removal after cesarean, American Journal of Obstetrics & Gynecology MFM, 2025; https://doi.org/10.1016/j.ajogmf.2025.101739.6. https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf

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.