Podcasts about randomized

In this Supplement Ingredient Series episode, Nurse Doza breaks down bovine adrenal gland — a glandular supplement with over a century of use, rooted in the ancestral practice of eating organ meat for nutrients the body needs to function. He explains how cortisol dysregulation can show up as afternoon crashes, mood shifts, and restless nights, and why adrenal glandular is paired with adaptogens and B vitamins in a three-in-one formula built to support the stress response. FEATURED PARTNER Zen (Stress Relief) by MSW Nutrition is the bovine adrenal gland formula Nurse Doza reaches for himself — and the reason is the ingredient itself, which is genuinely hard to find on a shelf. One capsule delivers 125 mg of adrenal gland tissue sourced from Argentina, paired with four standardized adaptogens (Asian ginseng, rhodiola, eleuthero, and schisandra), plus vitamin C, vitamin B6 as P5P, and pantothenic acid. That's the three-in-one Nurse Doza describes in this episode: glandular, adaptogens, and B vitamins in one capsule, formulated to support the body's stress response and steadier daily energy.

Randomized interventional trials are necessary to establish cause and effect.

Sign up for my free newsletter/1 page action plansIn this episode of Live Long and Well, Dr. Bobby looks at the evidence behind breakfast—not as a slogan, but as a real-life question: what problem is breakfast solving?For some people, breakfast may help with blood sugar, protein intake, morning exercise, or avoiding late-day overeating. For others, skipping breakfast may work perfectly well. And for many adults, “breakfast” may really mean coffee—which can improve alertness and exercise performance, but is not the same as food, protein, fiber, or fuel.Dr. Bobby also explores where the breakfast slogan came from, including its ties to cereal companies, health reformers, and early public relations campaigns. The episode then compares breakfast, lunch, and dinner through three practical questions:Does this meal help my body and health?Weight, blood sugar, disease risk, protein, and muscle.Does this meal help me perform today?Exercise, energy, focus, cognition, and school performance.Does this meal help me live well?Family rhythm, connection, and the social meaning of meals.The conclusion: there is probably no single “most important meal” for everyone. The best meal is the one that helps you live the day you are actually trying to live.In this episodeWhy “breakfast is the most important meal” may be more marketing than medical factWhat observational studies suggest about breakfast skipping and heart disease riskWhy healthy-user bias makes breakfast research trickyWhat randomized trials show about breakfast, skipping breakfast, weight loss, and metabolismHow chrononutrition raises a better question: are we eating too much too late?Why coffee may help you skip breakfast—but does not replace breakfast nutritionallyWhen eating before morning exercise mattersWhat we know about breakfast, cognition, and school performance in childrenWhy “hangry” may be realHow breakfast, lunch, and dinner each serve different rolesHow to decide whether breakfast matters for youKey takeawaysBreakfast does not magically turn on your metabolism.Randomized trials do not show that simply adding breakfast leads to meaningful weight loss.Skipping breakfast is not automatically harmful.It may work well for some people, especially if it reduces total calories without causing overeating later.The observational data are complicated.Breakfast skippers often look less healthy in long-term studies, but they may also smoke more, sleep less, exercise less, work irregular schedules, or eat more late at night.Chrononutrition gives breakfast its strongest argument.The body may handle calories better earlier in the day than late at night. The issue may be less “everyone must eat breakfast” and more “be careful about pushing most calories to the evening.”Coffee is not breakfast.Coffee may improve alertness and exercise performance, and it may reduce appetite for a while. But it is not protein, fiber, or fuel.Kids are different.For a hungry child, breakfast may matter for learning readiness, behavior, and attention.Exercise changes the answer.For a short, easy workout, coffee and water may be enough. For a long run, long ride, intervals, or race-like effort, food or carbohydrate may help.Dinner may win the connection argument.Shared meals are strongly linked with well-being. Dinner may not be best for blood sugar, but it may be powerful for family, friendship, and decompression.Lunch deserves more respect.Lunch may be the underrated meal that prevents the 3 p.m. slump and the 9 p.m. snack attack.A practical experimentRather than adopting a slogan, try a personal experiment.For two weeks, eat a real breakfast with protein, fiber, and minimal added sugar. Track your hunger, mood, exercise quality, afternoon energy, evening snacking, and sleep.Then, if it is safe for you, try two weeks of delaying or skipping breakfast while keeping your coffee/caffeine routine consistent.Ask yourself:Do I feel better or worse?Do I eat less overall—or make it up later?Are my workouts better or worse?Am I sharper or more irritable?Does skipping breakfast lead to a chaotic dinner?Am I still getting enough protein?The question is not whether breakfast works in theory. The question is whether breakfast works for you.Who should be more cautious about skipping breakfast?Be more careful with breakfast skipping if you are a child or adolescent, pregnant, diabetic, prone to low blood sugar, have a history of eating disorders, do long or intense morning workouts, or struggle to get enough protein—especially as an older adult.Dr. Bobby's bottom lineFor me, breakfast is not the most important meal most days.If I have a long workout ahead, I eat breakfast. Coffee alone is not enough.If I am just writing, reading, or working in the morning, coffee may be enough until I am actually hungry.And if I am eating with family or friends, breakfast matters for a different reason. Sometimes the table matters more than the eggs.Maybe breakfast is not the most important meal of the day.Maybe it is the most marketed.The most important meal is the one that helps you live the day you are actually trying to live.

In the early hours of November 2007, Amadou Cisse, a 29-year-old University of Chicago chemistry graduate student, was walking home when Demetrius Warren, then 17, and Benjamin Williams, 21, approached him. According to trial testimony, Warren pointed a gun at Cisse while Williams attempted to grab his backpack. A struggle ensued, and Warren shot Cisse in the chest. Cisse died from the wound.“Behind every news headline and every statistic, there is a mom who has just lost the most important person in their life,” says Jens Ludwig, a University of Chicago economics professor and director of its Crime Lab. “And in this particular case … Warren is currently spending 150 years downstate in the Illinois Department of Corrections. So in this case, two moms lost the most important people in their lives.”Delivering the 2026 Wildavsky Lecture in Public Policy at UC Berkeley's Goldman School of Public Policy this past April, Ludwig, author of Unforgiving Places: The Unexpected Origins of American Gun Violence, argues that both major political parties misdiagnose gun violence as a deliberate, rational choice, when in fact it's almost always an impulsive one."Both sides of that debate implicitly think that before anybody ever pulls a trigger, they're engaging in some sort of deliberate, rational weighing of pros and cons,” he says. But in reality, he contends, roughly 80% of gun homicides stem from everyday arguments that rapidly escalate in brief, uncalculated moments. Drawing on insights from behavioral economics, Ludwig says there are several low-cost, scalable tools — from youth programs and de-escalation training for police to simple urban fixes like greening vacant lots — that deliver meaningful public-safety gains. He points to “Becoming a Man,” a school-based group counseling program that helps teenage boys slow down their thinking in high-stakes situations. Randomized research trials found that it reduced participants' violent-crime arrests by up to 50% — evidence, he argues, that communities don't need to wait for sweeping political overhauls to make real progress.Listen to the episode, read the transcript and watch a video of the lecture on UC Berkeley News (news.berkeley.edu/podcasts/berkeley-talks).Music by by HoliznaCC0.Detail of a mural by Kyle Holbrook and local youth in Miami, Florida. (Photo by Terence Faircloth via Flickr) Hosted on Acast. See acast.com/privacy for more information.

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

Lords: Gabe https://store.steampowered.com/app/4076590/GAARL__Gabes_Action_Arcade_RogueLike/ Andrew https://pancelor.com/ Topics: Building your own synthesizer will not save you any money Clipboard proprioception The latest podcast description length drama Fig, 6. “I I I Strong Stronger Strongest” Braggadocio Rap Rerebrace, by Douglas Kearney https://poems.com/poem/fig-6-i-i-i-strong-stronger-strongest-braggadocio-rap-rerebrace/ Esper says: "Comic lettering is certainly done digitally these days, but there's a lot of traditional and even hybrid lettering too. A whole world out there." Conversations in real life vs. discord Having “over a decade of experience in the interior design industry” Microtopics: Gabe's Action Arcade Roguelike. Spelunky with less secrets and more upgrades. Randomized item behavior. Tasteful Pranking. Using earbuds as earplugs in a pinch. The short but wrong description. Timed Mashing Games. A building that exists continuously. Why would you pay someone else to do something that you can do yourself? A 70%-complete noise maker. Deliberately building your modular synthesizer to be incompatible with every modular standard so you're not tempted to buy any modules. Synthesizers as folk instruments, every one unique and owned by a weird uncle. SDL taking your sine wave and making it pretty. An online MIDI thing which is pretty annoying. Video: it has so much more data than audio. How to make your audio engine samples play at the right time. Electricity: it just happens. Hitting undo on the breadboard when you blow up some capacitors. Making a synthesizer by drawing a circuit with a graphite pencil. Being old enough to have once seen a PCB that was laid out by hand. Having something important in your clipboard and knowing you'd better put it somewhere soon before it's lost. Sending files to your phone over the local Wi-Fi. Parts of your body you doing trust. Prodding the clipboard until it reluctantly copies the text like a surely teenager. Emailing support and slowly realizing that support is actually the guy who makes the decisions. What life could be like if venture capital didn't exist. Putting a warning on the 4001st M&M. How to send an edible arrangement without knowing someone's address. Inventing something that already exists. Inventing a process and thinking "that's too simple to work" but later you find out it does and has a name. Getting sick of using a rhyming dictionary to write poems so you just cut and paste a list of rhyming words right into the poem. A poem that it feels wrong to read aloud. What is a line break but moving to a new place where the next word starts? A poem that is approved by the Comics Code Authority. How all the comic book letterers came to have the exact same handwriting. A word that starts with a through e and ends with song. Talking online vs. talking in person. Trying to quietly talk to your neighbor in discord voice chat. Why Discord doesn't allow you to place voice chats participants in Dolby 7.1 space. Tuning your proximity happening settings. Three people pairing off and having two conversations at once. The next talk show guest coming out and everybody moving one chair over. That time Andy Richter tried to have a side conversation with Norm MacDonald while Conan O'Brien was talking to the next guest. That thing where two people are hard to tell apart because their voices are similar to each other. Your e-commerce platform giving your image a random four digit number. Choosing guests based on whose voice compliments yours. Being on a weekly video game podcast and realizing you'd better play some goddamn video games this week or you won't have anything to talk about. Changing topics when there are three minutes left on the show. Trying to finish recording the show when your laptop is at 7% battery life. An incredible way to pull rank. Telling the airline employee that you work in aerospace and you deserve more leg room. Promising your Kickstarter backers to go to Denny's for lunch. Bluesky handles that are a palindrome of themselves.

Can a drug-eluting bladder device change the treatment algorithm for BCG-unresponsive non–muscle invasive bladder cancer (NMIBC)? In this episode of BackTable Urology, Dr. Ruchi Talwar interviews Dr. Sarah Psutka to explore the emerging role of a novel intravesical device that delivers sustained gemcitabine therapy for patients refusing or ineligible for cystectomy. They highlight new FDA-approved treatment options, real-world workflow considerations, and the clinical potential for continuous intravesical chemotherapy in a crowded therapeutic landscape. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Johnson & Johnson https://www.inlexzohcp.com/ --- Timestamps 00:00 - Introduction02:40 - Why Focus on TAR-20005:35 - Device Basics07:05 - Dosing Schedule Explained11:17 - SUNRISE-01 Trial Results15:07 - Patient Selection and Contraindications20:52 - Indications for Device Removal23:26 - Clinic Workflow Learning Curve25:56 - Tips for Insertion and Device Deployment28:52 - Cystoscopy Findings and Surveillance Protocol32:16 - Treatment Sequencing38:43 - Future Trial and Research Directions45:16 - Biomarkers, AI, and Personalizing Care46:35 - Cost, Supportive Care, and Patient Burden48:42 - Closing Thoughts --- More about this episode The conversation dives into patient selection, preparation, and side effect management for TAR-200, as well as the key findings from the SUNRISE-01 trial. Dr. Psutka discusses dosing schedules, when to remove the device, and how to handle complications like UTI, hematuria, and LUTS. The episode also covers surveillance protocols, the impact on clinic operations, and the importance of balancing vigilant cancer surveillance with patient burden. Finally, they touch on future directions, including biomarkers, AI-assisted pathology, and optimizing the timing of cystectomy and supportive care for a more personalized approach to NMIBC. --- Resources TAR-200 for Bacillus Calmette-Guérin–Unresponsive High-Risk Non–Muscle-Invasive Bladder Cancer: Results From the Phase IIb SunRISe-1 Studyhttps://ascopubs.org/doi/10.1200/JCO-25-01651 SUO 2024: SunRISe-5: A Phase III, Randomized, Open-label Study of TAR-200 Compared with Intravesical Chemotherapy After Bacillus Calmette-Guerin in Recurrent, High-risk, Non-muscle Invasive Bladder Cancer SUO 2024: SunRISe-5: A Phase III, Randomized, Open-label Study of TAR-200 Compared with Intravesical Chemotherapy After Bacillus Calmette-Guerin in Recurrent, High-risk, Non-mushttps://www.urotoday.com/conference-highlights/suo-2024/suo-2024-bladder-cancer/156723-suo-2024-sunrise-5-a-phase-iii-randomized-open-label-study-of-tar-200-compared-with-intravesical-chemotherapy-after-bacillus-calmette-guerin-in-recurrent-high-risk-non-muscle-invasive-bladder-cancer.htmlcle Invasive Bladder Cancer Gemcitabine Intravesical System Plus Cetrelimab or Cetrelimab Alone as Neoadjuvant Therapy in Muscle-Invasive Bladder Cancer: SunRISe-4 Primary Analysis and Biomarker Resultshttps://ascopubs.org/doi/10.1200/JCO-25-02382 INLEXZO - SunRISe-3 Studyhttps://www.jnjmedicalconnect.com/products/inlexzo/medical-content/inlexzo-sunrise-3-study --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

In this episode of The Lead, host Tina Baykaner, MD, MPH, is joined by Christopher Kowalewski, MD, and Marco Perez, MD, to discuss the journal article, Atrial Fibrillation Screening According to Genetic Risk: A Secondary Analysis of the Randomized LOOP Study. Together, they review findings from this secondary analysis of the LOOP Study and explore the relationship between genetic risk and atrial fibrillation screening. Learning Objectives Review the key findings from the secondary analysis of the randomized LOOP Study examining atrial fibrillation screening according to genetic risk. Discuss the relationship between genetic risk and atrial fibrillation screening as evaluated in the study. Explore the potential implications of incorporating genetic risk into atrial fibrillation screening strategies.   Host: Tina Baykaner, MD, MPH Guests: Christopher Kowalewski, MD and Marco Perez, MD   Disclosures: T. Baykaner Honoraria/Speaking/Consulting Fee: Volta Medical, Medtronic, Pacemate, Johnson & Johnson, Abbott Medical, Boston Scientific Research: NIH, Boston Scientific   C. Kowalewski No relevant disclosures   M. Perez Ownership/Partnership/Principal: QALY Honoraria/Speaking/Consulting Fee: Boston Scientific, Biotronik Research: Apple, Inc. Other/Stock Options Privately Held

Roughly half of the average American's daily calories now come from ultra-processed foods — and cutting them out changes how you feel faster than you'd expect. Nurse Doza breaks down five shifts that show up within weeks: steadier blood sugar and energy, a healing gut, lower inflammation, clearer thinking, and hunger hormones that finally reset. Learn what really separates processed from ultra-processed food, and why just two weeks of whole food can change everything. Featured Product: Boost by MSW Nutrition When you're riding the ultra-processed blood-sugar roller coaster, energy is the first casualty — the mid-afternoon crash, the brain fog, the reach for the next quick fix. Boost is the multivitamin you can actually feel: 2,500 mcg of methylated B12, a full multivitamin plus B-complex, electrolytes, and plant-based antioxidants including S-acetyl-L-glutathione. Clean, slow-release energy from one stick in water — no added sugar, no crash — so real food finally has a fair shot at steadying you out.

Krebsforscher Dr. Moritz Przybilla erklärt, warum sich Krebs meist über viele Jahre entwickelt, welche Rolle Alter, erbliche Veranlagung, Rauchen, Infektionen, Alkohol, Körpergewicht und Bewegung spielen und was an Mythen wie „Zucker füttert Krebs“, Fasten oder ketogener Ernährung dran ist. Außerdem sprechen wir über Biopsien, Immuntherapie, personalisierte Krebsmedizin und die Forschung an Krebsimpfstoffen – und darüber, warum eine Erkrankung niemals eine Frage persönlicher Schuld ist. ------------------------------------------------------------------------ Dominiks Buch zur pflanzenbasierten Sporternährung im UTB-Verlag: https://www.utb.de/doi/book/10.36198/9783838560328 Dominiks Gesundheitscommunity: www.gsundes-hannover.de Dominiks Online-Knie-Kurs: https://gsundes-hannover.de/knieschmerzen/ Dominiks Online-Rücken-Kurs: https://copecart.com/products/34bd5abb/checkout Marcs veganes Online-Fitness-Coaching: https://vegainer-academy.com/ Marcs Online-Kurs: https://www.copecart.com/products/a50f88f2/checkout Moritz Instagram-Kanal: https://www.instagram.com/dr.moritzprzy/?hl=de ------------------------------------------------------------------------ Dieser Podcast wird unterstützt von der Firma Watson Nutrition. Die Firma bietet als einzige umfassend laborgeprüfte Nahrungsergänzungsmittel für eine optimierte Nährstoffversorgung. Zum Angebot zählen Multi-Supplemente, Mono-Supplemente, Sportsupplemente wie Kreatin oder auch Proteinriegel, Shakes und essenzielle Aminosäuren Mit dem Code veganperformance erhältst du 5 % Rabatt auf deine Bestellung.  Zur Firmenwebseite: Watson Nutrition ------------------------------------------------------------------------ Redaktionelle Anmerkungen 00:34:26: Nicht 99 Prozent der DNA sind „ohne Funktion“. Rund 98,5–99 Prozent sind nicht proteincodierend; Teile davon erfüllen regulatorische und strukturelle Aufgaben. 01:40:15–01:41:12: Verarbeitetes Fleisch ist IARC-Gruppe 1, rotes Fleisch dagegen Gruppe 2A. Richtig erklärt wird anschließend, dass die Gruppe die Stärke der Evidenz und nicht die Größe des Risikos beschreibt. 01:40:50–01:41:12: Die Kombinationspille enthält Östrogen und ein Gestagen. Ihre IARC-Einstufung muss organspezifisch erklärt werden: Für einige Krebsarten bestehen Risikoerhöhungen, während das Risiko für Eierstock- und Gebärmutterkörperkrebs sinkt. 01:10:01–01:10:27: Dass Vaping künftig zu „hohen Lungenkrebsraten“ führen werde, bleibt eine Prognose. Eine aktuelle Bewertung hält nikotinhaltige E-Zigaretten zwar für wahrscheinlich krebserregend, bezeichnet das tatsächliche Ausmaß künftiger Krebsfälle aber ausdrücklich als noch unbekannt. Quellenverzeichnis Blass, E., & Ott, P. A. (2021). Advances in the development of personalized neoantigen-based therapeutic cancer vaccines. Nature Reviews Clinical Oncology, 18(4), 215–229. Bouvard, V., Loomis, D., Guyton, K. Z., Grosse, Y., El Ghissassi, F., Benbrahim-Tallaa, L., Guha, N., Mattock, H., & Straif, K. (2015). Carcinogenicity of consumption of red and processed meat. The Lancet Oncology, 16(16), 1599–1600. de Martel, C., Georges, D., Bray, F., Ferlay, J., & Clifford, G. M. (2020). 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Hallmarks of cancer: New dimensions. Cancer Discovery, 12(1), 31–46. Havel, J. J., Chowell, D., & Chan, T. A. (2019). The evolving landscape of biomarkers for checkpoint inhibitor immunotherapy. Nature Reviews Cancer, 19(3), 133–150. International Agency for Research on Cancer. (2012). A review of human carcinogens: Part A. Pharmaceuticals (IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 100A). Lei, J., Ploner, A., Elfström, K. M., Wang, J., Roth, A., Fang, F., Sundström, K., Dillner, J., & Sparén, P. (2020). HPV vaccination and the risk of invasive cervical cancer. The New England Journal of Medicine, 383(14), 1340–1348. Ligibel, J. A., Bohlke, K., May, A. M., Clinton, S. K., Demark-Wahnefried, W., Gilchrist, S. C., Irwin, M. L., Late, M., Mansfield, S., Marshall, T. F., Meyerhardt, J. A., Thomson, C. A., Wood, W. A., & Alfano, C. M. (2022). Exercise, diet, and weight management during cancer treatment: ASCO guideline. 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Science, 331(6024), 1565–1570. Sremanakova, J., Sowerbutts, A. M., & Burden, S. (2018). A systematic review of the use of ketogenic diets in adult patients with cancer. Journal of Human Nutrition and Dietetics, 31(6), 793–802. Stewart, B. W., Marshall, H., Bonevski, B., Griffin, H. J., Hopkins, A. M., Itchins, M., Mazza, C. J., Modi, N. D., Ryan, M., Varlow, M., & Sitas, F. (2026). The carcinogenicity of e-cigarettes: A qualitative risk assessment. Carcinogenesis, 47(1), Article bgag015.

In this episode of RAPM Focus, Editor-in-Chief Brian Sites, MD, discusses the optimal analgesic approach for reducing postoperative pain following ambulatory hip arthroscopy with Laura Girón Arango, MD, Joanne Tan, MBBS (Hons), FRACP, and Sinéad Campbell, MB, BCh, BAO, FCAI. Their conversation follows the March 2026 publication of their original research paper, “Analgesic efficacy of the ultrasound-guided pericapsular nerve group (PENG) block for ambulatory hip arthroscopy: a randomized controlled double-blind trial.” Hip arthroscopy is an increasingly common outpatient surgical procedure where postoperative pain can be severe. Peripheral nerve blocks have been evaluated for analgesia following hip arthroscopy; however, there is no consensus on an optimal technique that provides effective local anesthetic-based postoperative analgesia without motor blockade. In this study, the investigators hypothesized that the pericapsular nerve group (PENG) block would provide effective motor-sparing analgesia following ambulatory hip arthroscopy, randomizing 94 patients undergoing outpatient hip arthroscopy to receive either a preoperative pain block with 20ml of 0.5% ropivacaine or a sham procedure. Dr. Laura Girón Arango is a staff anesthesiologist at Toronto Western Hospital and Women's College Hospital, and an assistant professor at the University of Toronto. Her clinical and academic work focuses on regional anesthesia and point of care ultrasound. Her research has centered on motor-sparing regional anesthesia techniques for hip and knee surgery, including the PENG, iPACK, and adductor canal blocks. Additional areas of interest include perioperative diaphragm ultrasound assessment and the use of gastric ultrasound to evaluate aspiration risk, particularly in patients receiving GLP-1 receptor agonists. Through this work, she aims to advance perioperative safety, improve individualized pain management, and promote the integration of ultrasound into routine anesthetic practice.  Dr. Joanne Tan is a consultant anesthetist, regional anesthesia lead, and regional anesthesia fellowship supervisor at the Royal Adelaide Hospital in Adelaide, Australia, and a clinical lecturer at the Adelaide University. She completed a regional anesthesia fellowship at the Toronto Western Hospital and University of Toronto, and neuroanesthesia and upper GI fellowships at the Royal Adelaide hospital. Her interests include regional anesthesia, POCUS, neuroanesthesia, quality improvement, medical education, and making memes.  Dr. Sinéad Campbell is a staff anesthesiologist at Toronto Western and Women's College Hospital in Toronto, and an assistant professor at the University of Toronto. Her clinical practice focuses on regional anesthesia and neuroanesthesia. Her research interests include regional anesthesia and perioperative cognitive impairment. She is actively involved in clinical education, with a focus on teaching ultrasound-guided regional anesthesia and practical perioperative decision-making to trainees. *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.

CardioNerds co-chairs Dr. Dinu Balanescu and Dr. Billy Joe Mullinax, along with FIT lead Dr. Shiavax Rao, discuss the evolving landscape of randomized controlled trials in pulmonary embolism with Dr. Jay Giri, interventional cardiologist, Associate Professor of Medicine, and Director of the Cardiovascular Catheterization Laboratories at the Hospital of the University of Pennsylvania. This episode examines the historical evidence behind systemic thrombolysis, the emergence of catheter-directed therapies and mechanical thrombectomy, and the landmark RCTs – STORM-PE, PEERLESS, HI-PEITHO, and PEERLESS II – that are reshaping intermediate-risk PE management. The discussion highlights challenges in PE trial design, the critical importance of clinical deterioration as an endpoint, and why this era represents an unprecedented wave of evidence generation in PE. Audio editing for this episode was performed by CardioNerds Intern, Dr. Julia Marques Fernandes. Dr. Dinu Balanescu and Dr. Billy-Joe Mullinax are Co-chairs for the CardioNerds PE Series, developed in collaboration with the PERT Consortium.   Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Pulmonary Embolism PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls: Systemic thrombolysis in intermediate-risk PE reduces hemodynamic decompensation but at the cost of ~1.5–2% intracranial hemorrhage risk – a near-zero net benefit that has driven the search for safer catheter-based alternatives. “Focus on clinical deterioration, not mortality” – Due to crossover design in contemporary PE RCTs, control-arm patients who decompensate are rescued with advanced therapies, biasing mortality toward the null. Clinical deterioration is the most informative endpoint to watch in HI-PEITHO, PRAGUE-26, and PEERLESS II. HI-PEITHO is the first large RCT to demonstrate that catheter-directed fibrinolysis plus anticoagulation significantly reduces the composite of PE-related death, cardiorespiratory decompensation, or PE recurrence versus anticoagulation alone (RR 0.39; 95% CI 0.20–0.77; P=0.005), with no intracranial hemorrhage in either arm. The four major upcoming/recently reported PE RCTs (HI-PEITHO, PRAGUE-26, PEERLESS II, PE-TRACT) enroll progressively different risk populations – from the most enriched (HI-PEITHO) to the most permissive (PE-TRACT, which includes intermediate-low risk patients) – enabling a nuanced understanding of which patients benefit most from intervention. PE device clearance follows a fundamentally different FDA pathway than structural heart devices (single-arm safety/efficacy studies vs. mandated RCTs), yet market forces and clinical need have ultimately driven industry and government to sponsor large-scale RCTs – a lesson in how evidence development can evolve organically alongside regulatory frameworks. Notes: Notes drafted by Dr. Shiavax Rao. Question #1: What is the current evidence behind advanced PE therapies? Systemic thrombolysis: Sixteen RCTs over 40 years (1972–2014) enrolling nearly 2,000 patients have studied systemic thrombolysis in intermediate-risk PE. The landmark PEITHO trial (n=1,006) showed that tenecteplase reduced the composite of death or hemodynamic collapse (2.6% vs. 5.6%; P=0.015), driven primarily by reduced hemodynamic decompensation (1.6% vs. 5.0%; P=0.002). However, this came at the cost of increased major bleeding (6.3% vs. 1.5%; P

Randomized evidence suggests that routinely used mucoactive therapies may no longer have a role in mechanically ventilated ICU patients, while a large comparative effectiveness study indicates GLP-1 receptor agonists may offer superior cardiovascular and atrial fibrillation outcomes compared with SGLT2 inhibitors in patients with both AF and type 2 diabetes. We also highlight a promising blood-based RNA biomarker panel that may predict Alzheimer's symptom onset several years before cognitive decline, potentially improving patient selection for emerging disease-modifying therapies.

Drs. James Dinardo and Hubert A. Benzon discuss the article "Intravenous Lidocaine for Postoperative Pain in Children Undergoing Tonsillectomies: A Double-Blinded, Randomized, Placebo-Controlled Trial" published in the July 2026 issue of Anesthesia & Analgesia.

Love the podcast? Send us a text!When many people hear the words "clinical trial," they immediately think of a last resort.But that's one of the biggest misconceptions in breast cancer care.In this episode of Breast Cancer Conversations, host Laura Carfang sits down with Dr. Ada Waks, breast medical oncologist and clinical investigator at Dana-Farber Cancer Institute, to demystify clinical trials and explain how they are shaping the future of breast cancer treatment.Dr. Waks cares for patients across all stages of breast cancer while leading clinical research that helps develop tomorrow's treatments. Together, Laura and Dr. Waks discuss how clinical trials work, who they are designed for, and why patients should consider asking about them much earlier in their treatment journey.In this episode, you'll learn: What a clinical trial actually is  The difference between Phase I, II, and III trials  Randomized vs. blinded clinical trials  Why clinical trials are not just for patients who have run out of treatment options  How new breast cancer drugs become FDA-approved  What informed consent really means  How patient safety is protected  Why clinical trial participants often receive additional monitoring and support  How to find clinical trials that may be right for you  The future of personalized breast cancer treatment Whether you're newly diagnosed, living with metastatic breast cancer, navigating survivorship, or supporting a loved one, this episode provides an accessible introduction to one of the most important—and most misunderstood—aspects of cancer care.About Today's GuestDr. Ada Waks is a breast medical oncologist and clinical investigator at Dana-Farber Cancer Institute and an Assistant Professor of Medicine at Harvard Medical School. She divides her time between caring for patients with breast cancer and leading clinical research focused on developing safer, more effective, and more personalized treatments. Dr. Waks also co-directs Dana-Farber's breast oncology clinical trials program, helping bring innovative therapies from the laboratory to patients.Support the showListener FeedbackIf this episode resonated with you, we invite you to leave a review on Apple Podcasts or Spotify.You can also click the link in the show notes that says "Love this episode? Send us a text" to share feedback.Messages are completely anonymous.If you would like us to follow up directly, please include your email address in your message so we can respond.Latest News: Join our Mailing List - New content drops every Monday! Discover FREE programs, support groups, and resources from SurvivingBReastCancer.org! Become a Breast Cancer Conversations+ Member! Sign Up Now. Enjoying our content? Please consider supporting our work. 

Ep. #812 | One of the most critical habits for improving erections, and a simple mental approach to help you get it done.Inquiries: contact@holisticalpha.comStudiesKhera M, Bhattacharyya S, Miller LE. (2023). Effect of aerobic exercise on erectile function: Systematic review and meta-analysis of randomized controlled trials. Journal of Sexual Medicine.https://academic.oup.com/jsm/article/20/12/1369/7301709https://pubmed.ncbi.nlm.nih.gov/37814532/Gerbild H, Larsen CM, Graugaard C, Areskoug Josefsson K. (2018). Physical activity to improve erectile function: A systematic review of intervention studies. Sexual Medicine.https://pmc.ncbi.nlm.nih.gov/articles/PMC5960035/Silva AB, Sousa N, Azevedo LF, et al. (2017). Physical activity and exercise for erectile dysfunction: Systematic review and meta-analysis. British Journal of Sports Medicine.https://pubmed.ncbi.nlm.nih.gov/27707739/Esposito K, Giugliano F, Di Palo C, et al. (2004). Effect of lifestyle changes on erectile dysfunction in obese men: A randomized controlled trial. JAMA.https://jamanetwork.com/journals/jama/fullarticle/198993Begot I, Peixoto TC, Gonzaga LR, et al. (2015). A home-based walking program improves erectile dysfunction in men with an acute myocardial infarction. American Journal of Cardiology.https://pubmed.ncbi.nlm.nih.gov/25727080/Maio G, Saraeb S, Marchiori A. (2010). Physical activity combined with PDE5 inhibitor therapy improves erectile function more than medication alone.https://pubmed.ncbi.nlm.nih.gov/20367777/Bacon CG, Mittleman MA, Kawachi I, Giovannucci E, Glasser DB, Rimm EB. (2006). A prospective study of risk factors for erectile dysfunction. Journal of Urology.https://pubmed.ncbi.nlm.nih.gov/16753404/Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. (2000). Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. Journal of Urology.https://pubmed.ncbi.nlm.nih.gov/10731462/Dorey G, Speakman M, Feneley R, Swinkels A, Dunn C. (2004). Randomized controlled trial of pelvic floor muscle exercises and biofeedback for erectile dysfunction. BJU International.https://pubmed.ncbi.nlm.nih.gov/15527607/Chen Z, et al. (2024). Effect of different physical activities on erectile dysfunction: A systematic review and network meta-analysis. Andrology.https://onlinelibrary.wiley.com/doi/full/10.1111/andr.13682

Send us Fan MailIn this double-blind randomized controlled trial from northern India, Nim and Adrianne review whether early hydrocortisone reduces 14-day all-cause mortality in preterm infants with fluid-refractory shock. The primary outcome showed no statistically significant difference between groups, though an 11 percent absolute reduction in mortality in the hydrocortisone group raised clinical interest. A major limitation was the high rate of open-label steroid crossover, with over 70 percent of both groups ultimately receiving hydrocortisone. The study highlights the difficulty of achieving equipoise when clinicians already believe strongly in a therapy, and raises important questions about study design in neonatal shock research.----Early hydrocortisone verses placebo in neonatal shock- a double blind Randomized controlled trial. Dudeja S, Saini SS, Sundaram V, Dutta S, Sachdeva N, Kumar P.J Perinatol. 2025 Mar;45(3):342-349. doi: 10.1038/s41372-025-02222-3. Epub 2025 Feb 13.PMID: 39948354 Clinical Trial.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Could GLP-1 weight loss be costing you muscle instead of just fat? GLP-1 medications can be powerful tools, but they are not a free pass to simply eat less and hope for the best. In this episode, I'm showing you why protein, resistance training, recovery, and targeted muscle support are essential if you want to lose fat while protecting your metabolism. My goal is to help you use these tools the right way, so the weight you lose is actually the weight you want to lose. What you'll learn: (00:00) Weight loss on GLP-1 medications can inadvertently destroy your metabolism if you fail to take a muscle-first approach. (00:47) Women over forty frequently lose critical lean tissue underneath the surface without realizing why their weight loss attempts backfire. (02:45) Severe caloric deficits drop your automatic protein intake, making it essential to deliberately plan your target goals rather than relying on suppressed hunger cues. (03:38) Randomized controlled trials confirm that higher dietary protein actively preserves and can even build lean mass during significant energy restriction. (04:27) Meta-analyses evaluating thousands of adults reveal that a striking 25% to 40% of the weight shed from GLP-1 medications comes from lean mass instead of body fat. (05:17) Protecting your fat-burning engine requires aiming for a daily target of 0.7 to 1 gram of protein per pound of ideal body weight. (05:58) Essential amino acids rich in leucine act as a vital booster to trigger muscle protein synthesis when low appetite makes whole foods difficult to consume. (10:51) Preserving long-term metabolic health demands three distinct lifestyle practices: making protein non-negotiable, practicing consistent resistance training, and optimizing deep sleep recovery. Love the podcast? Here's what to do: Subscribe to the podcast. Leave a review. Text a screenshot to me at 813-565-2627 and wait for a personal reply because your voice is so important to me. Full show notes (including all links mentioned): https://jjvirgin.com/glpmuscle Learn more about your ad choices. Visit megaphone.fm/adchoices

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.

Send us Fan Mail You are not lazy. You are not undisciplined. The habit system you were given was just not built for how human beings actually work. In this episode of Healthy Mind, Healthy Life, host Avik sits down with Roger Webb, a 30-year student of human behavior and the subconscious mind, to take apart the myths that have been quietly defeating people for decades, and replace them with something grounded in how the brain actually changes. Roger shares what he observed over years as a motivational speaker, what he saw break down once people left the room, and what he built instead. If you have failed at habits more times than you can count and started to believe that lasting change just is not available to you, this conversation is the one worth listening to. About the Guest: Roger Webb is a 30-year student of human behavior and the subconscious mind, a former motivational speaker, a single father who raised five children, and the creator of Random Habit, a neuroscience-inspired habit-building app launching in 2026. His work focuses on removing the willpower-and-discipline framework from habit formation and replacing it with randomized dopamine mechanics and identity-based design that work with the brain rather than against it. Key Takeaways: Habit failure is a design problem, not a character flaw. Ninety-two percent of people fail their New Year's resolutions within one month, and that is not a reflection of who they are. It is a reflection of systems built around an unrealistic version of what it means to be human. The subconscious is not the enemy. When habits break down, the subconscious is doing exactly what it is supposed to do: protecting you from things that feel like failure and pain. The solution is not more willpower, it is a smarter system. Routine creates boredom, and boredom kills habits. Predictable reminders and check-box trackers cause the brain to disengage. The subconscious needs novelty and unpredictability to stay awake and engaged. Randomized dopamine is a real and repeatable tool. Random reminders, called Sparks in Roger's app, keep the brain alert and curious. Pairing those with a dopamine reward on completion creates the neural reinforcement that makes habits actually stick. Willpower gets you out of the gate, but it will not carry you across the finish line. It is a starting resource, not a long-term strategy. Once boredom or life interruptions set in, a different mechanism is needed. You were never the problem. The design was. Releasing self-blame and finding a system built for real, imperfect human beings is the actual first step. Connect With Roger Webb: Website: https://randomhabitapp.com/  Instagram: @RandomHabitapp App launching Spring 2026 on iOS and Android, available via waitlist at https://randomhabitapp.com/  Episode Chapters: [00:00] What If Everything You Know About Habits Is Wrong? — The cold open that reframes it all [06:32] Welcome and Guest Introduction — Avik introduces Roger Webb and today's conversation [08:07] The Stage Could Move People But Not Hold Them — What Roger saw after the workshops ended [09:55] The Myths That Have Done the Most Damage — The 21-day rule, discipline narratives, and why they persist [12:09] What Happens at the Subconscious Level When Habits Break — The real reason people quit [15:33] Random Habit and the Neuroscience of Sparks — How randomized dopamine rewires behavior [20:23] Life Will Keep Moving the Goalpost — Sustainable change in a non-linear world [22:29] One More Time — Roger's direct message to everyone who has been too hard on themselves   Want to be a guest on Healthy Mind, Healthy Life? DM on PM - Send me a message on PodMatch DM Me Here: https://www.podmatch.com/hostdetailpreview/avik Disclaimer: This episode is produced for educational and informational purposes only. All views expressed by the guest are their personal opinions alone and do not represent the views of the host or Healthy Mind by Avik™. The Network does not verify, endorse, or assume responsibility for any guest statements. Nothing in this episode constitutes medical, legal, financial, or professional advice, please consult a qualified professional before making any decisions. Listeners are encouraged to engage critically and independently with all content do not consume blindly. Use this content as a starting point for your own reflection and research, not as a substitute for professional guidance. Third-party content is referenced under fair use for informational purposes only. Guest speakers are solely responsible for their own statements. If you have concerns about any content, please contact us here By listening, you acknowledge and accept this disclaimer in full. Read detailed disclaimer here. Healthy Mind By Avik™️ is a global platform redefining mental health as a necessity, not a luxury. Born during the pandemic, it's become a sanctuary for healing, growth, and mindful living. Hosted by Avik Chakraborty, storyteller, survivor, and wellness advocate. With over 6500+ episodes and 200K+ global listeners, we unite voices, break stigma, and build a world where every story matters.

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)

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.

 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  

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

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

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

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