Podcasts about randomized trial

If you've tried to book a therapy appointment, you know there's a shortage of mental health professionals. It's not unusual to have to wait weeks or months for an appointment. So, with the rise of platforms like Chat GPT, could we harness AI technology for talk therapy purposes to treat things like depression and anxiety? We were extremely skeptical that this topic would even warrant a full episode on the Happy Eating Podcast. But, as you've heard us confess before, we are sometimes pleasantly surprised once we dig into the research. So, did we change our mind after researching this topic? References or Studies Mentioned:    Therabot AI Chatbox (https://www.trytherabot.com/)    Randomized Trial of a Generative AI Chatbot for Mental Health Treatment When ELIZA meets therapists: A Turing test for the heart and mind   Thank you for listening to The Happy Eating Podcast. Tune in weekly on Thursdays for new episodes! For even more Happy Eating, head to our website!  https://www.happyeatingpodcast.com Learn More About Our Hosts:  Carolyn Williams PhD, RD: Instagram: https://www.instagram.com/realfoodreallife_rd/ Website: https://www.carolynwilliamsrd.com Facebook: https://www.facebook.com/RealFoodRealLifeRD/ Brierley Horton, MS, RD Instagram: https://www.instagram.com/brierleyhorton/ Got a question or comment for the pod? Please shoot us a message!  happyeatingpodcast@gmail.com Produced by Lester Nuby OE Productions  

If you've tried to book a therapy appointment, you know there's a shortage of mental health professionals. It's not unusual to have to wait weeks or months for an appointment. So, with the rise of platforms like Chat GPT, could we harness AI technology for talk therapy purposes to treat things like depression and anxiety? We were extremely skeptical that this topic would even warrant a full episode on the Happy Eating Podcast. But, as you've heard us confess before, we are sometimes pleasantly surprised once we dig into the research. So, did we change our mind after researching this topic? References or Studies Mentioned:    Therabot AI Chatbox (https://www.trytherabot.com/)    Randomized Trial of a Generative AI Chatbot for Mental Health Treatment When ELIZA meets therapists: A Turing test for the heart and mind   Thank you for listening to The Happy Eating Podcast. Tune in weekly on Thursdays for new episodes! For even more Happy Eating, head to our website!  https://www.happyeatingpodcast.com Learn More About Our Hosts:  Carolyn Williams PhD, RD: Instagram: https://www.instagram.com/realfoodreallife_rd/ Website: https://www.carolynwilliamsrd.com Facebook: https://www.facebook.com/RealFoodRealLifeRD/ Brierley Horton, MS, RD Instagram: https://www.instagram.com/brierleyhorton/ Got a question or comment for the pod? Please shoot us a message!  happyeatingpodcast@gmail.com Produced by Lester Nuby OE Productions  

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update   discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.    Intensive Blood-Pressure Control in Patients with Type 2 Diabetes 2.    Cardioprotective Glucose-Lowering Agents and Dementia Risk A Systematic Review and Meta-Analysis 3.    A Randomized Trial of Automated Insulin Delivery in Type 2 Diabetes 4.    Screening for Metabolic Dysfunction–Associated Steatotic Liver Disease–Related Advanced Fibrosis 5.    Risk of Urogenital Infections in People With Type 2 Diabetes Initiating SGLT2i Versus GLP-1RA in Routine Clinical Care   For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health

A Randomized Trial of Automated Insulin Delivery in Type 2 Diabetes - LinkCurso “Da Infertilidade ao Puerpério” - Link---Nova Android & iOS app MGFamiliar - ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Link⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠---Subscreva o Podcast MGFamiliar para não perder qualquer um dos nossos episódios. Além disso, considere deixar-nos uma revisão ou um comentário no Apple Podcasts ou no Spotify.---MusicSpring In My Step · Silent Partner - Link—Este podcast destina-se a médicos e os conteúdos nele partilhados não devem ser usados para decisões individuais sem aconselhamento médico. Para tal, consulte seu médico.

Rachel Nesbit talks about the effects of mandating mental health treatment for probationers. “The Role of Mandated Mental Health Treatment in the Criminal Justice System” by Rachel Nesbit. OTHER RESEARCH WE DISCUSS IN THIS EPISODE: “Calgary Diversion Program: A Community-Based Alternative to Incarceration for Mentally Ill Offenders” by Craig Mitton, Liz Simpson, Leslie Gardner, Fran Barnes, and Gerald McDougall. “Mental Health Treatment and Criminal Justice Outcomes” by Richard G. Frank and Thomas G. McGuire. “Thinking, Fast and Slow? Some Field Experiments to Reduce Crime and Dropout in Chicago" by Sara B. Heller, Anuj K. Shah, Jonathan Guryan, Jens Ludwig, Sendhil Mullainathan, and Harold A. Pollack. “Effectiveness of Using Incentives to Improve Parolee Admission and Attendance in Community Addiction Treatment” by Michael L. Prendergast, Elizabeth A. Hall, Jason Grossman, Robert Veliz, Liliana Gregorio, Umme S. Warda, Kory Van Unen, and Chloe Knight. “A Randomized Trial of the Effectiveness of Using Incentives to Reinforce Parolee Attendance in Community Addiction Treatment: Impact on Post-treatment Outcomes” by Elizabeth A. Hall, Michael L. Prendergast, and Umme Warda. “A Randomized Trial of Probation Case Management for Drug-involved Women Offenders” by Joseph Guydish, Monica Chan, Alan Bostrom, Martha A. Jessup, Thomas B. Davis, and Cheryl Marsh. “The First 90 Days Following Release from Jail: Findings from the Recovery Management Checkups for Women Offenders (RMCWO) Experiment” by Christy K. Scott and Michael L. Dennis. "Can Recidivism Be Prevented From Behind Bars? Evidence From a Behavioral Program" by William Arbour. Probable Causation Episode 102: William Arbour. “Reducing the Burden of Mental Illness on the Criminal Justice System: Evidence from Light-Touch Outreach” by Mary Kate Batistich, William N. Evans and David C. Phillips. Probable Causation Episode 67: David Phillips. “Mental Health and Criminal Involvement: Evidence from Losing Medicaid Eligibility” by Elisa Jácome. Probable Causation Episode 60: Elisa Jácome. "In-Kind Welfare Benefits and Reincarceration Risk: Evidence from Medicaid" by Marguerite Burns and Laura Dague. Probable Causation Episode 103: Marguerite Burns and Laura Dague.

We've had many discussions about the technical aspects of vertebroplasty and kyphoplasty on BackTable MSK. However, in this episode, we take a deeper look into the history of these procedures, exploring early research controversies and the challenges that threatened their existence. Our host, Dr. Jacob Fleming, is joined in the BackTable Studio by interventional neuroradiologist Dr. Joshua Hirsch, who was in San Diego for the ASSR 2025 meeting. Dr. Hirsch is the Chief of the Interventional Spine Service at Massachusetts General Hospital. --- This podcast is supported by: Medtronic MVP https://www.medtronic.com/en-us/healthcare-professionals/products/spinal-orthopedic.html#aq=%40pagetype%3D%22product-model%22&cq=%40products_category%3D%22Spinal%20and%20orthopedic%22%20OR%20%40ontology_isa%3D%22Spinal%20and%20orthopedic%22 --- SYNPOSIS Dr. Hirsch begins by outlining the historical origins of radiologists using cement injection and how this practice evolved into vertebroplasty. He then highlights early research on the procedure, focusing on key 2009 NEJM papers that sparked both scientific and public controversy, leading to setbacks in research and disparities in access to life-changing care. Since that time, newer studies have demonstrated the clear benefits of spinal augmentation for patients with vertebral insufficiency fractures, including Dr. Hirsch's own research showing a mortality benefit compared to nonsurgical treatment. Overall, the doctors discuss how far this field has advanced and the exciting developments currently in progress. --- TIMESTAMPS 00:00 - Introduction 03:09 - Historical Origins of Vertebroplasty 07:08 - Development and Evolution of Vertebroplasty 10:21 - Controversy Over 2009 Randomized Control Trials 16:35 - Disparities in Access to Vertebroplasty 21:01 - Dr. Hirsch's Research on Mortality Benefit of Vertebroplasty 32:31 - Opportunities for Patient Education 35:29 - Vertebroplasty vs. Kyphoplasty 37:34 - Challenges in Research Interpretations and Insurance Coverage 42:26 - Future Directions in Vertebral Augmentation --- RESOURCES Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects (Jensen et al, 1997): https://pmc.ncbi.nlm.nih.gov/articles/PMC8337380/ Simplicity of randomized, controlled trials of percutaneous vertebroplasty (Hirsch et al, 2003): https://pubmed.ncbi.nlm.nih.gov/16880881/ INvestigational Vertebroplasty Efficacy and Safety Trial (INVEST): a randomized controlled trial of percutaneous vertebroplasty (Gray et al, 2007): https://pubmed.ncbi.nlm.nih.gov/18096050/ A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures (Buchbinder et al, 2009): https://pubmed.ncbi.nlm.nih.gov/19657121/ A Randomized Trial of Balloon Kyphoplasty and Nonsurgical Management for Treating Acute Vertebral Compression Fractures (FREE) (Meirhaeghe et al, 2013): https://pmc.ncbi.nlm.nih.gov/articles/PMC3678891/ A Randomized Trial of Vertebroplasty for Osteoporotic Spinal Fractures (Kallmes et al, 2009): https://www.nejm.org/doi/full/10.1056/NEJMoa0900563 A Randomized Trial of Epidural Glucocorticoid Injections for Spinal Stenosis (Friedly et al, 2014): https://www.nejm.org/doi/full/10.1056/NEJMoa1313265 Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): a multicentre, randomised, double-blind, placebo-controlled trial (Clark et al, 2016): https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31341-1/abstract Number Needed to Treat with Vertebral Augmentation to Save a Life (Hirsch et al, 2020): https://pmc.ncbi.nlm.nih.gov/articles/PMC6975314/ Major Medical Outcomes With Spinal Augmentation vs Conservative Therapy (McCullough et al, 2013): https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1710123 Harvey L. Neiman Policy Institute: https://www.neimanhpi.org/

Send us a textDiese Woche geht es im Journal Club um die Behandlung von PONV durch Kaugummikauen: Darvall, J; De Silva, A; von Ungern-Sternberg, B et al.  on behalf of the CHEWY Trial Group and the ANZCA Clinical Trials Network. Chewing Gum to Treat Postoperative Nausea and Vomiting in Female Patients: A Multicenter Randomized Trial. Anesthesiology 142(3):p 454-464, March 2025. | DOI: 10.1097/ALN.0000000000005283Mit im Studio dabei: Sophie He, wissenschaftliche Mitarbeiterin der Klinik für Anästhesiologie am UKHD. 

Introduction: The Problem We Can't Ignore We live in a world where the food we eat is supposed to nourish us, but what if it's actually making us sick? Pesticides, soil degradation, and nutrient-depleted crops are all part of our modern food system, contributing to rising cases of neurological disorders, metabolic diseases, and immune dysfunction. The research is clear: exposure to certain pesticides has been linked to cognitive decline, Parkinson's disease, and an increased cancer risk. At the same time, the way we farm today is stripping our food of the vital nutrients our ancestors took for granted. So, the question isn't just about avoiding chemicals—it's about finding food that truly fuels life. The solution? Organic, regenerative, and locally grown produce. Let's break down the science and give you real reasons why it's never been more important to care about where your food comes from.     The Science Behind Pesticides and Health Risks  The Hidden Dangers of Conventional Farming Pesticide residues in conventional food contribute to long-term health risks, including cognitive decline and neurodevelopmental disorders in children. According to Holzman (2012) in Organic Food Conclusions Don't Tell the Whole Story, "Pesticide dietary risk is a function of many factors, including the number of residues, their levels, and pesticide toxicity." (Holzman, 2012).  Organophosphate pesticides, commonly used in industrial agriculture, have been directly linked to Parkinson's disease. As Mie et al. (2017) state in Human Health Implications of Organic Food and Organic Agriculture, "Epidemiological studies have reported adverse effects of certain pesticides on children's cognitive development at current levels of exposure." (Mie et al., 2017).  Pregnant women consuming conventional produce showed higher levels of pyrethroid insecticides in their bodies compared to those eating organic. Curl et al. (2019) in Effect of a 24-week Randomized Trial of an Organic Produce Intervention found that "3-Phenoxybenzoic acid (3-PBA, a biomarker for pyrethroids) concentrations were significantly higher in conventional produce consumers compared to organic consumers." (Curl et al., 2019).      The Cancer Connection The International Agency for Research on Cancer has classified several pesticides used in conventional farming—such as glyphosate and malathion—as likely carcinogens. Hemler et al. (2018) in Organic Foods for Cancer Prevention—Worth the Investment? found that "Participants with the highest frequency of organic food consumption had a 25% lower risk of being diagnosed with cancer during follow-up compared with those with the lowest frequency." (Hemler et al., 2018).     The Nutrient Density Solution: More Than Just Pesticide-Free  Higher Nutrients in Organic & Regenerative Foods  Organic fruits and vegetables contain higher levels of vitamin C, essential minerals like magnesium and iron, and more powerful antioxidants. Maloney (2014) in Comparative Study on Nutritional Quality and Detection of Pesticide Residues states, "Organic foods are better in taste, appearance, firmness, and nutrient content when compared to conventional foods." (Maloney, 2014). Organically grown produce has 20-40% higher levels of antioxidants than conventionally grown produce, which help protect against inflammation and chronic diseases. According to Mie et al. (2017), "Differences in the composition between organic and conventional crops include a modestly higher content of phenolic compounds in organic fruit and vegetables." (Mie et al., 2017).     The Simple Steps to Better Food Go Organic Whenever Possible – Reduce your pesticide exposure and increase the nutrient density of your food.  Support Local & Regenerative Farms – Look for farmers using soil-restoring practices that make food healthier.  Grow Your Own – Even a small backyard garden or balcony pot can produce pesticide-free, nutrient-rich food.  Buy Seasonal Produce – Seasonal food is fresher, richer in nutrients, and often grown closer to home. Prioritize the Dirty Dozen – If you can't go 100% organic, at least choose organic versions of the most pesticide-laden produce, like strawberries, spinach, and apples.     Conclusion: Take Back Control of Your Health  Our food choices today impact our health for decades to come. Science shows that organic, regenerative, and locally grown food isn't just a trendy choice—it's a necessity. From reducing pesticides to boosting essential nutrients, switching to better food sources is one of the most powerful steps you can take to live a longer, healthier life.  So, are you ready to make the change?     Bibliography: Holzman, D. (2012). Organic Food Conclusions Don't Tell the Whole Story. Environmental Health Perspectives.  Curl, C., et al. (2019). Effect of a 24-week Randomized Trial of an Organic Produce Intervention. Environment International.  3. Mie, A., et al. (2017). Human Health Implications of Organic Food and Organic Agriculture. Environmental Health.      What You'll Learn in This Episode: (00:00:00) Introduction – Why this episode could change the way you eat forever. (00:03:07) Does Buying Organic Really Matter? – The truth about pesticides and chemicals in food. (00:05:08) The Rise of Ultra-Processed & Chemical-Laden Foods – What's actually making us sick? (00:07:00) How Conventional Farming Stripped Our Food of Nutrients – The hidden crisis in modern agriculture. (00:09:18) The Pesticide Problem – How chemicals in food are linked to neurological disorders, metabolic disease, and immune dysfunction. (00:12:10) The Research on Pesticides & Disease – Shocking studies on cognitive decline, Parkinson's, and cancer risk. (00:14:30) Why Organic & Regenerative Farming Is the Future – It's about more than just avoiding chemicals. (00:17:50) Nutrient Density vs. Food Volume – Why eating more food doesn't mean you're getting enough nutrition. (00:20:21) Final Thoughts & How to Make the Shift Today – Small changes that make a big difference.     Thank You to Our Sponsors: Therasage: Go to www.therasage.com and use code DARIN at checkout for 15% off Fatal Conveniences Book: Everything you think is safe—your food, home, and daily habits—could be slowly killing you. Fatal Conveniences exposes the hidden dangers in everyday life and shows you how to reclaim your health. Pick up a copy by visiting the link for Fatal Conveniences.     Find More From Darin: Website: darinolien.com Instagram: @darinolien Book: Fatal Conveniences     Key Takeaway: "The food system is broken, but you don't have to be a victim of it. Choosing organic, nutrient-rich, and regenerative food is the best investment in your long-term health."

Five articles from the February 2025 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are, “A Prospective, Randomized Trial of the Modified Jobe Versus Docking Techniques With Gracilis Autograft for Ulnar Collateral Ligament Reconstruction in the Elbow,” “Sex-Based Differences in the Arthroscopic Treatment of Femoroacetabular Impingement Syndrome: 10-Year Outcomes With a Nested Propensity-Matched Comparison,” “The Effects of Inaccurate Femoral Tunnel Placement During Medial Patellofemoral Ligament Reconstruction on Midterm Clinical Outcomes in Treatment of Recurrent Patellar Dislocation,” “Intra-articular Injections of CXCR4-Overexpressing Human Cartilage–Derived Progenitor Cells Improve Meniscus Healing and Protect Against Posttraumatic Osteoarthritis in Immunocompetent Rabbits,” and “Reconstruction of the Superior Capsule Using Peroneus Longus Tendon Graft Combined With Transposition of Biceps Tendon for Irreparable Massive Rotator Cuff Tears.” Click here to read the articles.

Looking at the REVIVED-BCIS2 results, Divaka Perera and C. Michael Gibson discuss the relationship between myocardial viability, PCI, and outcomes.

This episode focuses on a study that looks at how confidence in managing daily challenges (self-efficacy) and having support from others (social support), affect the overall well-being of people on hemodialysis and hemodiafiltration.

In this episode, join Dr. Argy Stampas and host Elizabeth-Sarah Bile as we discuss the article “Reduction of Overactive Bladder Medications in Spinal Cord Injury with Self-Administered Neuromodulation: A Randomized Trial”. Tune in to discover how this research can improve bladder function and health in individuals with spinal cord injuries.

Like tens of millions of people, Stephen Dubner thought he had a penicillin allergy. Like the vast majority, he didn't. This misdiagnosis costs billions of dollars and causes serious health problems, so why hasn't it been fixed? And how about all the other things we think we're allergic to? SOURCES:Kimberly Blumenthal, allergist-immunologist and researcher at Mass General Hospital and Harvard Medical School.Theresa MacPhail, associate professor of science and technology studies at Stevens Institute of Technology.Thomas Platts-Mills, professor of medicine at the University of Virginia.Elena Resnick, allergist and immunologist at Mount Sinai Hospital. RESOURCES:Allergic: Our Irritated Bodies in a Changing World, by Theresa MacPhail (2023)."Evaluation and Management of Penicillin Allergy: A Review," by Erica S. Shenoy, Eric Macy, and Theresa Rowe (JAMA, 2019)."The Allergy Epidemics: 1870–2010," by Thomas Platts-Mills (The Journal of Allergy and Clinical Immunology, 2016)."Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy," by George Du Toit, Graham Roberts, et al. (The New England Journal of Medicine, 2015). EXTRAS:Freakonomics, M.D.

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update   discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.     Results from a Randomized Trial of Intensive Glucose Management Using CGM Versus Usual Care in Hospitalized Adults with Type 2 Diabetes: the “TIGHT” Study 2.     Tirzepatide for Obesity Treatment and Diabetes Prevention  3.     Intensive Blood-Pressure Control in Patients with Type 2 Diabetes 4.     Association of Insulin Resistance With Radiographic Lung Abnormalities and Incident Lung Disease 5.     Association Life-course Associations between Ambient Fine Particulate Matter and the Prevalence of Prediabetes and Diabetes 6.     Semaglutide in Persons with Obesity and Knee Osteoarthritis   For more information about each of ADA's science and medical journals, please visit www.diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health

Commentary by Dr.  Jian'an Wang.

ECLIPSE: A Large-Scale, Randomized Trial of Orbital Atherectomy vs. Conventional Balloon Angioplasty in Severely Calcified Coronary Arteries Prior to DES Implantation

JACC Heart Failure Associate Editor Sean Pinney, MD, discusses a recently published original research paper that explores the results of a randomized controlled trial to test whether evolocumab reduces the burden of cardiac allograft vasculopathy.

In this episode, Dr. Valentin Fuster reviews two pivotal phase three trials from China assessing the efficacy of the new monoclonal antibody, Katisha, for treating non-familial hypercholesterolemia. With significant reductions in LDL cholesterol and a long-acting, flexible dosing regimen, these studies promise a novel therapeutic option for patients struggling with cholesterol management and adherence to traditional treatments.

We recently implemented a "push-dose" norepinephrine protocol at MCHD and have already learned some valuable lessons. Join us for some vasopressor pharmacology and protocol review, accompanied by some of our new teaching points that have arisen following the protocol's release into the wild. REFERENCES: 1. Berkenbush, M., Singh, L., Sessa, K., & Saadi, R. (2024). Scoping Review: Is Push-Dose Norepinephrine a Better Choice? The western journal of emergency medicine, 25(5), 708–714. 2. Permpikul, C., Tongyoo, S., Viarasilpa, T., Trainarongsakul, T., Chakorn, T., & Udompanturak, S. (2019). Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER). A Randomized Trial. American journal of respiratory and critical care medicine, 199(9), 1097–1105.

Send us a textIn this episode of the Curious Neuron Podcast, Cindy Hovington speaks with Dr. Erin O'Connor, Ph.D., about the complexities of the mother-child relationship, the importance of attachment theory, and the impact of parental stress on parenting styles. We discuss the significance of sensitivity and responsiveness in parenting, the challenges of separation anxiety, and the role of community support for parents. The conversation also touches on the teacher-child relationship, the importance of social-emotional learning, and the effects of parental accommodation behaviors on child development.Erin is the Director of New York University's Early Childhood Education program, Erin is a Full Professor and holds a Doctorate in Human Development and Psychology from the Harvard Graduate School of Education. She is also Chief of Education at Cooper - a platform designed to bring together parents, researchers, and teachers around issues of child development. She is also the co-host of the parenting podcast, Parenting Understood, which can be found on Apple and Spotify. Watch on YouTube:https://youtu.be/QZJcq6r_9K0Sources: Long-Term Effects of Social-Emotional Learning on Academic Skills: Evidence from a Randomized Trial of INSIGHTSA randomized-controlled examination of the effect of cognitive reappraisal instruction on maternal accommodation of child anxiety symptomsTrajectories of teacher–child relationships across kindergarten and first grade: The influence of gender and disruptive behaviorGet your FREE 40-page well-being workbook:https://tremendous-hustler-7333.ck.page/reflectiveparentstarterkitJoin our membership, The Reflective Parent Club to learn how to manage your emotions and model this for your child. Use code PODCAST 20 to get 20% off any membership and get 2 FREE WEEKS to try it outhttps://curiousneuron.com/join-our-club/Get 1:1 coaching https://forms.gle/u8ENfn8CLbcMAZT36Please leave a rating for our podcast on Apple Podcasts or Spotify! Email me at info@curiousneuron.comInstagram:https://www.instagram.com/curious_neuron/Facebook group:https://www.facebook.com/groups/theemotionallyawareparent/THANK YOU TO OUR SPONSORS! Get some discounts using the links belowThank you to our main supporters the Tanenbaum Open Science Institute at The Neuro and the McConnell Foundation. Discounts for our community! Pok Pok app. Click on the link below to get 50% off an entire year of this amazing open-ended play app for kids! ...

The Filtrate:Jennie LinJoel TopfJosh WaitzmanSwapnil HiremathWith Special GuestsPedro TeixeiraJay KoynerEditor Sophia AmbrusoShow NotesThe article: A Randomized Trial of Intravenous Amino Acids for Kidney ProtectionNephJC SummaryKDIGO Clinical Practice Guideline for Acute Kidney Injury (PDF)Steve Coca study Evaluation of Short-Term Changes in Serum Creatinine Level as a Meaningful End Point in Randomized Clinical Trials (PubMed)Using Nephrocheck to prevent AKI: Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomized controlled trial (PubMed)Brenner's Review of protein intake and renal hemodynamics: Dietary Protein Intake and the Progressive Nature of Kidney Disease: — The Role of Hemodynamically Mediated Glomerular Injury in the Pathogenesis of Progressive Glomerular Sclerosis in Aging, Renal Ablation, and Intrinsic Renal Disease (NEJM)Husain-Syed a look at preoperative renal functional reserve and risk of AKI: Preoperative Renal Functional Reserve Predicts Risk of Acute Kidney Injury After Cardiac Operation (PubMed)Dana Fuhrman review of renal functional reserve: The Role of Renal Functional Reserve in Predicting Acute Kidney Injury (PubMed)Use of SGLT2i prevented AKI in the placebo controlled trials. Clinical Adverse Events Associated with Sodium-Glucose Cotransporter 2 Inhibitors: A Meta-Analysis Involving 10 Randomized Clinical Trials and 71 553 Individuals (PubMed)Assessment of P values for demographic data in randomized controlled trials (PubMed)Tubular SecretionsSwapnil The Lord of the Rings: Rings of Power Season 2 on Amazon Prime (Wikipedia)Josh Fortnite (Website)Pedro CRRT Academy at University of Alabama Birmingham (Website)Jay Koyner Slow Horses on AppleTV (Wikipedia)Jennie Linn #KidneyWk Run Club Friday 10/25 at 6:15 am PST Meet in front of Sally's Fish House ~2 miles. Easy pace (10-12 min/mile) (Strava)Joel Topf Your Honor on Netflix (Wikipedia)

JAACAP October 2024: Contributing Editor Dr. Rana Elmaghraby interviews Dr. Gregory A. Aarons about measurement-based care (MBC), which collects session-by-session symptom data from patients and provides clinicians with feedback on treatment response.

Back in episode 80 we discussed a feasibility study out of Salt Lake City that showed IM epi resulted in 3-minute faster administration in cardiac arrest. It was underpowered to show survival, however. Fortunately, the great folks in Salt Lake City is back with a larger bite at the statistical apple. Dr Jarvis discusses the background around what we know about epinephrine in cardiac arrest (briefly, for once), walks us through this new study, and puts it in context of modern clinical practice. Citations.1. Palatinus HN, Johnson MA, Wang HE, Hoareau GL, Youngquist ST: Early intramuscular adrenaline administration is associated with improved survival from out-of-hospital cardiac arrest. Resuscitation. 2024;August;201:110266.2. Perkins GD, Ji C, Deakin CD, Quinn T, Nolan JP, Scomparin C, Regan S, Long J, Slowther A, Pocock H, et al.: A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest. N Engl J Med. 2018;August 23;379(8):711–21.3. Okubo M, Komukai S, Callaway CW, Izawa J: Association of Timing of Epinephrine Administration With Outcomes in Adults With Out-of-Hospital Cardiac Arrest. JAMA Netw Open. 2021;August 10;4(8):e2120176.4. Hubble MW, Tyson C: Impact of Early Vasopressor Administration on Neurological Outcomes after Prolonged Out-of-Hospital Cardiac Arrest. Prehosp Disaster Med. 2017;June;32(3):297–304.5.  Pugh AE, Stoecklein HH, Tonna JE, Hoareau GL, Johnson MA, Youngquist ST: Intramuscular adrenaline for out-of-hospital cardiac arrest is associated with faster drug delivery: A feasibility study. Resuscitation Plus. 2021;September;7:100142.

JACC: CardioOncology Editor-in-chief, Bonnie Ky, MD, MSCE, FACC and Yichao Xiao, MD discuss the study design, findings, future research questions and the potential clinical impact on the management of blood pressure in cancer survivors.

First TAVI vs. SAVR Randomized Trial in Younger Low-Risk Patients with Severe Tricuspid or Bicuspid Aortic Valve Stenosis: Results from NOTION-2

In this episode of the School for School Counselors podcast, host Steph Johnson addresses the expanding role of school counselors in behavior intervention, emphasizing the need for a trauma-informed approach. She discusses common concerns counselors have about behavior intervention, including the misconception of equating it to discipline, time constraints, and the fear of being misutilized. Steph urges counselors to rethink their approach by identifying the origins of problematic behavior and addressing systemic issues rather than relying on one-stop solutions. She also highlights the importance of mindful language use and empowering students as peer mentors to foster a supportive school environment. Finally, she introduces the upcoming topics in the podcast and the resources available in the School for School Counselors mastermind group.00:00 Introduction and Podcast Welcome00:14 The Role of School Counselors in Behavior Intervention01:29 Challenges and Concerns in Behavior Intervention02:25 Rethinking Behavior Intervention Strategies[03:00 Celebrating a Podcast Milestone]04:02 Addressing the Root Causes of Behavior08:55 The Power of Language in Behavior Intervention13:03 Empowering Students as Change Agents17:27 Final Thoughts and Upcoming Topics**********************************References/Resources:McCormick, M. P., Cappella, E., O'Connor, E. E., & McClowry, S. G. (2015). Do Intervention Impacts on Academic Achievement Vary by School Climate? Evidence from a Randomized Trial in Urban Elementary Schools. Society for Research on Educational Effectiveness.https://files.eric.ed.gov/fulltext/ED562123.pdfPaquette, D. and Ryan, J. (2015). Bronfenbrenner's Ecological Systems Theory. National Dropout Prevention Center. https://dropoutprevention.org/wp-content/uploads/2015/07/paquetteryanwebquest_20091110.pdfWade, L., Leahy, A. A., Babic, M. J., Beauchamp, M. R., Smith, J. J., Kennedy, S. G., ... & Lubans, D. R. (2022). A systematic review and meta-analysis of the benefits of school-based, peer-led interventions for leaders. Scientific Reports, 12(1), 21222. https://www.nature.com/articles/s41598-022-25662-9.pdf**********************************Our goal at School for School Counselors is to help school counselors stay on fire, make huge impacts for students, and catalyze change for our roles through grassroots advocacy and collaboration. Listen to get to know more about us and our mission, feel empowered and inspired, and set yourself up for success in the wonderful world of school counseling.Hang out in our Facebook groupJump in, ask questions, share your ideas and become a part of the most empowering school counseling group on the planet! (Join us to see if we're right.)Join the School for School Counselors MastermindThe Mastermind is packed with all the things your grad program never taught you IN ADDITION TO unparalleled support and consultation. No more feeling alone, invisible, unappreciated, or like you just don't know what to do next. We've got you!Did someone share this podcast with you? Be sure to subscribe for all the new episodes!!

Our Editor in Chief Sue Yom hosts a discussion of two related articles, "Diagnostic CT-Enabled Planning (DART): Results of a Randomized Trial in Palliative Radiation Therapy" and its accompanying editorial, "'Sim-free' Palliative Radiation Therapy Greatly Reduces Time Burden for Patients." Guests are Melissa O'Neil, MSc, MRT(T), an Advanced Practice Radiation Therapist and Leader of the Rapid Response Clinic at London Health Sciences Center in Canada, who was the first author of the DART trial publication, as well as Dr. Katrina Woodford, Lead Radiation Therapist Clinician Scientist at the Peter MacCallum Cancer Centre, Honorary Senior Fellow at the University of Melbourne and Adjunct Senior Lecturer at Monash University, and first author of the accompanying editorial.

This week, please join author Hiroyuki Daida and Associate Editor Amit Khera as they discuss the article "A Randomized Trial for Evaluation in Secondary Prevention Efficacy of Combination Therapy−Statin and Eicosapentaenoic Acid (RESPECT-EPA)." For the episode transcript, visit: https://www.ahajournals.org/do/10.1161/podcast.20240804.906883

Audio Commentary by Dr. Valentin Fuster, Emeritus Editor in Chief

JAACAP July 2024: Contributing Editor Dr. Rana Elmaghraby interviews Dr. Jordan A. Freeman on a Hybrid Type-II Implementation-Effectiveness trial conducted in Sierra Leone where researchers tested a Collaborative Team Approach (CTA) for delivering an evidence-based mental health intervention, the Youth Readiness Intervention (YRI), within a youth entrepreneurship program.

Community-Based Cluster-Randomized Trial to Reduce Opioid Overdose Deaths The New England Journal of Medicine  HEALing (Helping to End Addiction Long-term Initiative) Communities Study (HCS) investigators examined the potential of the community-engaged, data-driven Communities That HEAL (CTH) intervention to reduce the rate of opioid-related overdose deaths in highly affected communities. Intervention communities implemented hundreds of strategies to expand opioid overdose education and naloxone distribution, the use of medications for opioid use disorder, and safety measures for prescription opioid use, as well as communication campaigns to support these efforts. Although there were no significant between-group differences in the rate of opioid-related overdose deaths, the trial showed that the CTH community-engaged intervention, with its leveraging of community coalitions and a data-driven approach, can bring about meaningful progress in implementing evidence-based practices.   Read this issue of the ASAM Weekly Subscribe to the ASAM Weekly Visit ASAM

Commentary by Dr. Valentin Fuster

Kelley Kidwell, PhD, professor of biostatistics, University of Michigan, discusses Sequential, Multiple Assignment, Randomized Trial Designs with JAMA Statistical Editor Roger J. Lewis, MD, PhD. Related Content: Sequential, Multiple Assignment, Randomized Trial Designs

Commentary by Dr. Valentin Fuster

In part 2 of this series, Dr. Jeff Ratliff and Dr. Maureen Leehey discuss non-motor symptoms such as sleep and cognition in patients with Parkinson disease taking a cannabis extract versus placebo.  Show reference: https://movementdisorders.onlinelibrary.wiley.com/doi/10.1002/mds.29768 

Dr. Jeff Ratliff and Dr. Maureen Leehey discuss the short-term efficacy and tolerability of high-CBD/low-THC cannabis extract on the motor symptoms in patients with Parkinson disease. Show reference: https://movementdisorders.onlinelibrary.wiley.com/doi/10.1002/mds.29768   

Dr. Jeff Ratliff talks with Dr. Maureen Leehey about the short-term efficacy and tolerability of high-CBD/low-THC cannabis extract on the motor symptoms in patients with Parkinson disease.  Read the related article in the International Parkinson and Movement Disorder Society.  This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information. Disclosures can be found at Neurology.org.

A New Podcast from Obstetrics & Gynecology, featuring members from the Editorial Team and contributing authors, each month as they highlight the latest research and practice updates in the field. This episode features an interview with Dr. Sarahn Wheeler, author of “Obstetric Racial Disparities in the Era of the A Randomized Trial of Induction Versus Expectant Management (ARRIVE) Trial and the Coronavirus Disease 2019 (COVID-19) Pandemic.”

Sue Yom, our Editor-in-Chief, co-hosts with Dr. Salma Jabbour, Deputy Editor at the Red Journal and Professor, Vice Chair of Clinical Research and Faculty Development, and Clinical Chief of the Department of Radiation Oncology at Rutgers University. Guests include Drs. Amar Kishan, Professor, Vice Chair of Clinical and Translational Research, and Chief of the Genitourinary Oncology Service, and Minsong Cao, Professor, Vice Chair of Academic Mission Development, and Director of the Medical Physics Residency Training Program, who were supervising authors on a new study published this month, Quantifying Intrafraction Motion and the Impact of Gating for Magnetic Resonance Imaging-Guided Stereotactic Radiation therapy for Prostate Cancer: Analysis of the Magnetic Resonance Imaging Arm From the MIRAGE Phase 3 Randomized Trial. We also welcome Dr. Lauren Henke, Associate Professor of Radiation Oncology and Director of Gastrointestinal Radiation Oncology at the University Hospitals, Case Western Reserve University, who authored an editorial this month entitled Undoing the Layers: Magnetic Resonance Imaging/Advanced Image Guidance and Adaptive Radiation Therapy.

Howie and Harlan are joined by Lucila Ohno-Machado, the Yale School of Medicine's deputy dean for biomedical informatics. She explains how expanding use of data science, informatics, AI, and technology could enable doctors to spend more time with patients. Harlan celebrates mentorship while marking the death of Irwin Birnbaum, a mentor to many in his time as COO of the Yale Medical School and long after retiring. Howie discusses the mixed evidence from a study on vaping as a tool for helping cigarette smokers quit. Links: “Lucila Ohno-Machado, MD, PhD, MBA, Will Lead Biomedical Informatics and Data Science” “Lucila Ohno-Machado: Yale Medicine Profile” “Halıcıoğlu Data Science Center” “2024 AI in Medicine Symposium at Yale School of Medicine” “Doctors Vs. ChatGPT: Which Is More Empathetic?” “Irwin M. Birnbaum Obituary” “What is a mentor?” “A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy” “Episode 78, Health and Veritas: Elizabeth Arleo: Advice for Working Mothers from a Women's Health Specialist”

In this episode: Jon's longer that usual discussion is about Duty-Hour flexibility in surgical training. Length: 30:35 min Authors: Bilimoria KY, Chung JW, Hedges LV, Dahlke AR, Love R, Cohen ME, Hoyt DB, Yang AD, Tarpley JL, Mellinger JD, Mahvi DM, Kelz RR, Ko CY, Odell DD1, Stulberg JJ, Lewis FR. Publication details: National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training. The New England Journal of Medicine. 2016 Feb;[ePub ahead of print] PubMed Link

Drs. Neeraj Agarwal and Todd Morgan discuss CONTACT-02, KEYNOTE-564, CheckMate-67T, and other notable studies featured at the 2024 ASCO Genitourinary Cancers Symposium, as well as additional key abstracts in prostate, kidney, and bladder cancers that will significantly influence clinical practice. TRANSCRIPT Dr. Neeraj Agarwal: Hello, and welcome to the ASCO Daily News Podcast. I'm Dr. Neeraj Agarwal, the director of the Genitourinary Oncology Program and professor of medicine at the Huntsman Cancer Institute at the University of Utah, and editor-in-chief of ASCO Daily News. Today, we'll be discussing practice-changing abstracts and other key advances in GU oncology featured at the 2024 ASCO Genitourinary Cancers Symposium. Joining me for this discussion is Dr. Todd Morgan, the chair of this year's ASCO GU. Dr. Morgan is a urologic surgeon, chief of urologic oncology at Michigan Medicine, and a professor of urology at the University of Michigan. Our full disclosures are available in the transcript of this episode, and the disclosures of all guests on the podcast can be found at asco.org/DNpod. Todd, thank you for joining us today. Dr. Todd Morgan: Thanks so much, Neeraj. It's an honor to be here and I'm just thrilled to be able to do this with you. Dr. Neeraj Agarwal: Thank you. So, the GU meeting showcased significant advancements across the spectrum of GU malignancies. Can you tell us about the hot topics that captured the headlines this year? What did you find exciting this year at the ASCO GU Symposium? Dr. Todd Morgan: The theme of this year's meeting was "20 Years of Advancing Science and Transforming Patient Care," and this reflected ASCO GU's incredible milestone in GU cancer research over the last 2 decades. We were thrilled to welcome over 5,200 attendees from over 70 countries, and, believe it or not, there were more than 875 abstract submissions, compared to more than 300 in the meeting's first year. Most of the participants were present in person and that was fantastic. It enabled great networking opportunities and opportunities for experts, trainees, and mentees to exchange knowledge and ideas. Without a doubt, ASCO GU remains the annual meeting in our field, and it's amazing to hear the breadth and depth of the state-of-the-art science that's presented at this meeting, and so much of it impacts patient care the second that you return home. Additionally, the meeting's focus on diversity and interactivity, networking, multidisciplinary collaboration, and evidence-based care were absolutely phenomenal from my standpoint. We had a lunch session for women's networking that was a huge success—the first time we've done that. The keynote lecture by Dr. Cheryl Lee that talked about ensuring adequate representation in clinical trials was a huge hit, and we had tremendous positive feedback from that lecture. There were also multiple featured sessions on different diagnostic and therapeutic challenges in localized, recurrent, and advanced GU cancers. And, Neeraj, my personal favorite during the symposium is always the Trainee and Early-Career Networking Luncheon on the first day and then the additional networking luncheons on the 2 following days. I had great conversations with a ton of trainees and junior faculty, and I feel so fortunate for the opportunity to get to know the future superstars in our field. So I'd like to kick it back to you for a second because the first day started with a focus on prostate cancer and some of the key clinical trials. A great example is Abstract 17, which was the second oral presentation delivered, and really congratulations to you, Neeraj, on sharing the exciting data from the CONTACT-02 trial which we were eagerly awaiting. And I'd love to get your thoughts on the data that you presented. Could you tell us more about that trial? Dr. Neeraj Agarwal: Yes, Todd, I agree with you. It was such an exciting conference overall, and thank you for your leadership of this conference. So let's talk about the CONTACT-02 trial. It was a phase 3 randomized trial assessing the combination of cabozantinib and atezolizumab versus a second NHT in patients with metastatic castration-resistant prostate cancer after progression on one NHT. This patient population had to have extrapelvic soft tissue metastases, which could be liver metastases, lung metastases, or lymph nodal metastases, and about up to a quarter of patients had liver metastases. And overall, this was a high-risk patient population which was randomized to, as I said, cabozantinib plus atezolizumab versus a second line NHT. And these patients had received a prior NHT, mostly in the mCRPC setting.  The co- or dual primary endpoints were overall survival and progression-free survival (PFS). And a unique thing was that PFS was assessed only by RECIST 1.1 because, as per our discussions with regulatory authorities, the trial was focused on soft tissue metastases because of questions in the past that cabozantinib can affect bone lesions in an artifactual fashion, possibly concerns. That's why the PCWG 3 criteria were not used as the primary endpoint, but, of course, indeed used as another key endpoint, so we have information on both. Anyway, coming back to the endpoint 1:1 randomization. The randomization was stratified by presence or absence of liver metastases, prior docetaxel chemotherapy, and the setting in which NHT was given (mCSPC or CRPC). The PFS or primary endpoint was significantly improved with a 35% reduction in risk of progression or death with the cabozantinib-atezolizumab combination versus second NHT. And there was a trend for overall survival, with a hazard ratio of 0.79 favoring the cabozantinib-atezolizumab combination. Interestingly, all subgroups benefitted, regardless of age, region, site of metastases, but we decided to choose three clinical subgroups of interest such as patients with liver metastases, patients with prior docetaxel chemotherapy in the castration-sensitive setting, and bone metastases, and all these subgroups seemed to be benefitting with the strongest signal in the liver metastasis subgroup, with a 57% reduction in risk of progression or death, which I would argue we have never seen with any combination or any regimen in the metastatic prostate cancer setting yet, barring some targeted therapies in very selected patients. But overall, across the non-biomarker-selected patients, we have never seen this kind of signal. Toxicity — no discussion is complete without discussing toxicity, so I would like to highlight that. Safety signal — there were no new safety signals. The most common grade 3-4 adverse events were hypertension in 7%, anemia in 6%, which were similar in both arms, and, of course, diarrhea and fatigue in 4% each. And if we look at the secondary endpoints, such as time to chemotherapy and time to symptomatic skeletal events, they tended to favor the cabozantinib-atezolizumab. To sum it up, cabozantinib-atezolizumab showed a significant PFS benefit, with a 35% reduction in risk of progression or death, with a trend for overall survival in this patient population with an unmet need. So thank you so much, Todd, for allowing me to summarize the results of this trial. Dr. Todd Morgan: Yeah, wow. That's so impressive, and not surprising that you could so fluidly go right through all that data. Amazing. We heard some discussion of the NHT control arm in this trial. Could you discuss that for a bit? Because it obviously has implications on the similar control arm of other ongoing trials in this setting. Dr. Neeraj Agarwal: Absolutely. Pretty much all trials, every trial which has recently been reported or started in metastatic castrate-resistant prostate cancer have a similar second NHT arm. Whether there were multiple immunotherapy trials which we have just reported, or new trials which are starting or just started enrolling patients. And the reason for that is no randomized trial has ever shown superiority of docetaxel chemotherapy over a second NHT after failure of prior NHT in the mCRPC setting. That's number one. If you look at NHT as a control, it is accepted by health authorities globally with multiple recent trials which are just starting also having NHDR and it would not have been possible without the approval of global regulatory authorities across the world.  Then, if you look at the recently reported trial in the mCRPC setting with prior treatment with an NHT, there is an indication that chemotherapy may not be superior to NHT. For example, in the KEYNOTE-641 trial in patients with mCRPC with prior NHT, randomizing patients to enzalutamide plus pembrolizumab versus enzalutamide, the median PFS with enzalutamide was 9 months. This is very similar with docetaxel in patients randomized to docetaxel plus pembrolizumab versus docetaxel; the median PFS with docetaxel is 8 months or 8.3 months. And lastly, if you really want to have a comparison of chemotherapy with NHT which has been done after progression on NHT and docetaxel chemotherapy, so later line of mCRPC setting, that is the CARD trial, as you can imagine, cabazitaxel versus NHT, especially in patients with visceral metastasis, which was the point of discussion. For example, people may not feel comfortable randomizing patients to NHT compared to taxane. The hazard ratio for PFS supporting cabazitaxel was 0.79, so almost a 0.80 PFS hazard ratio, which we have never seen turning out to be a clinically significant benefit. So, if you combine all these data together, I think it was absolutely acceptable to us as investigators to have a second NHT as the control arm. And of course, when we are consenting the patient, we have to keep alternatives in mind, and we do talk about those alternatives with the patients. And if alternatives seem more applicable, we should not be talking to patients about those clinical trials or a given clinical trial in the clinic. I'm glad you brought this up, Todd, because this control NHT arm is not an issue with this trial, but all trials which should be presented in GU ASCO in the future meetings in the coming years. So, thank you. Dr. Todd Morgan: Yeah, thank you. It's such an important topic and controversy at some level, but it's a difficult problem to think about and obviously highly relevant to all the trials that we're looking at. Congrats again on that trial, that's tremendous. There was another important randomized phase 3 trial and it covers radiotherapy in patients with high-risk localized prostate cancer. Can you give us your insights on that one? Dr. Neeraj Agarwal: Yeah, Todd, I think you are referring to LBA259, titled "Long-term Results of Dose Escalation of Radiation Therapy from 70 Gy to 80 Gy Combined with Long-term Androgen Deprivation Therapy in High-risk Prostate Cancer: The GETUG-AFU 18 Randomized Trial." As you mentioned, in this randomized phase 3 trial, Dr. Christophe Hennequin and colleagues randomized patients with high-risk prostate cancer, which means they had to have either clinical stage T3 or T4 disease, or PSA ≥20 nanograms per milliliter, or a Gleason score between 8 and 10. These patients were randomized to receive ADT for 3 years combined with either dose-escalated intensity-modulated radiotherapy. So, I'd like to highlight, this was in the context of IMRT in the dose of 80 Gy or a conventional dose of 70 Gy. Now, you can argue that more people are using more than 70 Gy nowadays, but across the world, the conventional dose is still considered 70 Gy. So, 80 Gy versus 70 Gy were tested. Patients also had to have negative lymph node status on CT scans and MRI. The primary endpoint was biochemical progression-free survival or clinical progression-free survival at 5 years following the ASTRO Phoenix definition. Secondary endpoints – and these are quite important secondary endpoints – include overall survival, acute and late toxicity, and quality of life. The best part is that this trial met its primary endpoint with a 44% reduction in risk of biochemical or clinical progression or death in the dose-escalation radiotherapy arm compared with the conventional radiotherapy arm. Interestingly, a significant 52% improvement in prostate cancer-specific survival and a 39% improvement in overall survival was observed in the dose-escalated arm. So, 80 Gy continued to be superior to 70 Gy IMRT across the primary and secondary endpoints. Now, the best part is, regarding the toxicity profile, there was no significant difference between the 2 arms, with 78% of patients in the higher dose arm and 76% of patients in the conventional arm experiencing grade 2 or more toxicities. Dr. Todd Morgan: Great summary and really important, great news for our patients. Of course, it's a slightly different setting as it's high-risk localized prostate cancer. I checked in with our radiation oncologists at the University of Michigan after that [presentation] because I couldn't remember exactly where we are in terms of dose on these patients. And they were like, “Yeah, we've been doing 80 to 90 Gy for several years,” so it's great having this data to support that. And I think, as you said, the field at many centers has already moved that way. And again, the key takeaway from this abstract would be that IMRT, in combination with long-term androgen deprivation therapy, is effective and safe and increases not only the biochemical or clinical PFS rate, but also the cancer-specific survival and overall survival, again, in high-risk localized prostate cancer patients. And it does not appear to increase long-term toxicity. So really important. It'd be great to switch gears and discuss kidney cancer, if that's okay, and talk about some key abstracts in that field. What do you think? Dr. Neeraj Agarwal: There were so many exciting data in all cancers, which is amazing. So, Todd, could tell us about the LBA359, which I thought was one of the most impactful abstract presentations in the ASCO GU this year. It was titled, “Overall Survival Results from the Phase 3 KEYNOTE-564 Study of Adjuvant Pembrolizumab Versus Placebo for Treatment of Clear Cell Renal Cell Carcinoma (ccRCC)."   Dr. Todd Morgan: Yeah, this was a really big moment in our field, complete with a mid-presentation round of applause that was well deserved. And so this abstract was presented by Dr. Toni Choueiri from Dana-Farber Cancer Institute, and it included patients with clear cell renal cell carcinoma at intermediate high or high risk of recurrence, meaning that they had positive nodal disease or negative nodal disease with PT 2 and grade 4, or sarcomatoid features, or stage PT 3 or 4. These patients underwent nephrectomy with or without metastasectomy less than 12 weeks before randomization and had not received prior systemic therapy for clear cell RCC. Patients were randomized to receive either pembrolizumab 200 milligrams or placebo IV every three weeks for at least 17 cycles, or until disease recurrence, intolerable toxicity, or withdrawal of consent. Disease-free survival by investigator assessment was the primary endpoint, and overall survival was a key secondary endpoint. In this abstract, Dr. Choueiri and colleagues report results of the third prespecified interim analysis with a median follow-up of around 57 months in 496 patients receiving pembrolizumab and 498 patients receiving placebo. So, just as a reminder to the audience here, the first interim analysis reported at a median follow-up of 24 months and showed a significant reduction of 32% in the risk to recurrence or death in patients in the pembrolizumab arm. Then subsequently in November of 2021, the FDA approved pembrolizumab for the adjuvant treatment of patients with RCC who are at intermediate high or high risk of recurrence following nephrectomy or following nephrectomy and resection of metastatic lesions. At that time, though, overall survival data were still immature. So, at the third prespecified interim analysis with a median follow-up of around 57 months, pembrolizumab showed, for the first time in an adjuvant RCC setting, improved overall survival with a 38% reduction in the risk of death. The estimated OS rate at 48 months was 91.2% with pembrolizumab and 86% with placebo. Furthermore, the OS benefit was observed across key subgroups, including patients with non-metastatic disease, patients with metastatic but no evidence of disease, patients with PDL-1 combined positive score less than or greater than or equal to one, and patients with presence or absence of sarcomatoid features. In each of these subgroups, the forest plot looks really impressive. And the DFS benefit was similar to previously reported interim analyses with a hazard ratio of 0.72. Also, no new safety signals with pembrolizumab were observed so just tremendous data. Dr. Neeraj Agarwal: Thank you, Todd, for such a great summary of these very important results. So the key message from this abstract, as you said, is that after a median follow-up of around 57 months, which is a long follow-up, adjuvant pembrolizumab demonstrates a statistically significant and clinically meaningful improvement in overall survival versus placebo in patients with RCC at high risk of disease recurrence after surgery. And this is, by the way, the first phase 3 study to show improved overall survival with any adjuvant therapy in RCC. Basically, this means we should continue to use adjuvant pembrolizumab or at least bring it up in our discussion with our patients who are in a similar situation with high-risk RCC after surgery. So this is great news overall. Todd, there was another kidney cancer abstract, LBA360, which compared, interestingly, subcutaneous nivolumab with intravenous nivolumab in patients with metastatic renal cell carcinoma. Could you please give us your insight about this abstract?   Dr. Todd Morgan: Sure. Really interesting study. Really interesting data that were presented. So as you mentioned, CheckMate 67T was a multicenter, randomized, open-label phase three study led by Dr. Saby George and colleagues that evaluated pharmacokinetics and objective response rate non-inferiority of subcutaneous nivolumab versus IV nivolumab in patients with locally advanced or metastatic clear cell RCC. So patients with measurable disease that progressed during or after 1 to 2 prior systemic regimens and who did not receive a prior immuno-oncology treatment were randomized 1-1 to receive either subcutaneous nivolumab 1200 milligrams every 4 weeks or IV nivolumab 3 milligrams per kilogram every two weeks until disease progression, unacceptable toxicity, withdrawal of consent, completion of two years of treatment, or death. The coprimary pharmacokinetics endpoints for non-inferiority testing were time-average serum concentration over the first 28 days and minimum serum concentration at steady state determined by a population pharmacokinetics analysis. A key secondary endpoint was objective response rate by independent review. So in 248 patients receiving subcutaneous nivolumab and 247 patients receiving IV nivolumab, non-inferiority for the coprimary pharmacokinetics and key-powered secondary objective response rate endpoints were met. The relative risk ratio for objective response rate was 1.33. The median PFS by independent review was 7.23 months in the subcutaneous group and 5.65 months in the IV group. Treatment-related serious adverse events occurred in 6.5% of patients in each group, and study drug toxicity led to 3 deaths in the subcutaneous group and 1 death in the IV group. These results could support using subcutaneous nivolumab as a new option to improve healthcare efficiency, especially since the average injection time with subcutaneous nivolumab was less than 5 minutes. I think we all know what issues are going on in infusion beds across the country, including, I'm sure, your center and mine. Dr. Neeraj Agarwal: Yes, absolutely. I think this is great news for our patients, Todd. Thank you. This shows that we are not only improving therapeutic options and diagnostic tools, but maybe we're also on the right track towards more practical administration routes, assisting in addressing the treatment burden and improving the efficiencies of healthcare systems. We love to have this option available for our patients, especially those who are pressed for time. So, Todd, would you like to move on to bladder cancer now?  Dr. Todd Morgan: Yeah, Neeraj, that'll be fantastic. I'm sure listeners would love to hear more about LBA530. Could you tell us more about this one, Neeraj? Dr. Neeraj Agarwal: Of course. I think this abstract is titled "Enfortumab Vedotin in Combination with Pembrolizumab Versus Chemotherapy in Previously Untreated, Locally Advanced or Metastatic Urothelial Carcinoma: Subgroup Analysis Results from EV-302," which was a global phase three study and was presented by Dr. Michiel Van Der Heijden. As our audience may recall, the EV-302 trial was presented at the ESMO 2023 meeting by Dr Tom Powles and the results were very exciting where, for the first time, a combination outperformed traditional gemcitabine-cisplatin chemotherapy. In this trial, patients with previously untreated with metastatic advanced urothelial carcinoma were randomized 1-1 to receive a 3-week cycle of a combination of enfortumab vedotin, which, as we know, is an antibody-drug conjugate targeting nectin-4 expressed on the cancer cells and pembrolizumab, which is a PD-1 inhibitor, versus gemcitabine and cisplatin or carboplatin, which were, until recently, the standard of care in this setting, and continue to be so in many countries in the world. The combination of enfortumab and pembrolizumab reduced the risk of progression or death by 55% and reduced the risk of death by 53% in the overall population. So consistent decrease in the hazard ratios for PFS and OS, and consistent improvement in overall survival and PFS in that previously reported presentation in the ESMO 2023. Now, based on these results, this combination was recently approved by the FDA in December 2023 for patients with advanced or metastatic urothelial carcinoma. So now the abstract, which was presented at the ASCO GU 2024 meeting, reported the results of a prespecified subgroup analysis. Select secondary endpoints included objective responses, duration of response, and safety. In 442 patients receiving the combination of enfortumab vedotin plus pembrolizumab, and a similar number of patients receiving chemotherapy both PFS and OS were higher for the combination of EV and pembro among prespecified subgroups such as race, platinum eligibility, PDL-1 expression, metastatic site, involvement of the liver or kidney function. Interestingly, the combination of EV and pembro reduced the risk of death by 53% in patients with visceral metastasis and 54% in patients with node-only metastasis. The improvement in PFS seems to be consistent regardless of the site of metastasis. In patients with moderate to severe renal function, the risk of death was reduced by 50% in patients receiving combination therapy. This is one of the best findings of these results because we always face challenges in treating patients with suboptimal kidney function and we cannot use cisplatin. Overall, EV plus pembro continues to show superior efficacy compared to platinum-based regimens across subgroups across the subgroups across the site of metastasis regardless of kidney function and so on. Dr. Todd Morgan: Yeah, just amazing data. I love hearing you spell it out like that. So, thank you again for the opportunity for me to sit here with you and listen to you talk about these data. It's impressive that we have been able to expand our therapeutic arsenal for urothelial carcinoma with an immune-targeting regimen that can spare our patients potential side effects of chemotherapy. What would your final takeaway on this abstract be? Dr. Neeraj Agarwal: I agree with you, Todd. I would add that the OS benefit was consistently observed across these select prespecified subgroups, including those historically associated with poor prognosis. The results of this new analysis support the finding of primary results, which indicate that EV plus pembro is a potentially new standard of care for patients with newly diagnosed, locally advanced, or metastatic urothelial carcinoma. Before we wrap up the bladder cancer session and the podcast, Todd, could you please give us insights about LBA531? Dr. Todd Morgan: Yeah, absolutely. I loved getting to hear this abstract presented. This one is titled “Ambassador,” known as the AMBASSADOR trial aligns A031501, a phase 3 randomized adjuvant study of pembrolizumab in muscle-invasive and locally advanced urothelial carcinoma versus observation, that was presented by Dr. Andrea Apolo. It's an open-label, randomized, phase 3 trial that included patients with muscle-invasive urothelial carcinoma of the bladder, upper tract, or urethra. Eligible patients had pathologic tumor stage T2 or greater and/or positive pathologic nodal disease or positive margins at surgery following neoadjuvant chemotherapy, or patients with pathologic tumor stage T3 or greater and/or positive pathologic nodal disease or positive margins at surgery without prior neoadjuvant chemotherapy, and who were cisplatin ineligible or declined adjuvant cisplatin-based therapy. These patients were randomized one to one to either receive pembrolizumab 200 milligrams every 3 weeks for 1 year or observation. The dual primary endpoints were disease-free survival and overall survival. Secondary objectives included evaluation of DFS and OS in PDL-1 positive and negative patients and assessing safety. A total of 354 patients were enrolled to receive pembrolizumab and 348 to the observation arm, and 21% of the patients in the observation arm received a subsequent immune checkpoint inhibitor. At a median follow-up of 22.3 months for DFS, the median disease-free survival in the pembrolizumab arm was 29 months, while it was only 14 months in the observation arm with a hazard ratio of 0.69. At the interim analysis, OS data showed only a trend toward better outcomes in the pembrolizumab arm, which did not, however, reach statistical significance, with a median of 50.9 months in the pembrolizumab arm and 55.8 months in the observation arm with a hazard ratio of 0.98. These results could nevertheless have been impacted by the subsequent treatment of patients in the observation arm with an immune checkpoint inhibitor, especially after the FDA approval of nivolumab in 2021 for patients with muscle-invasive urothelial carcinoma, based on results of the CheckMate 274 trial. In terms of the safety profile, grade three or more adverse events occurred in 48.4% of patients in the pembrolizumab arm and 31.8% of patients in the observation arm. Dr. Neeraj Agarwal: That's great, Todd. This is such a great summary of this trial, and this is exciting news for our patients with muscle-invasive urothelial carcinoma. I'm hoping that pembrolizumab will be another option for our patients when we are discussing adjuvant immunotherapy in the clinic, moving forward very soon. With that, we have covered several abstracts addressing prostate, bladder, and kidney cancer, significantly influencing our medical practices, at least at the current moment or in the near future. Todd, thank you for sharing your insights today. These are undoubtedly exciting updates for all members of the GU oncology community, and we are grateful for your valuable contribution to the discussion. Many thanks. Dr. Todd Morgan: Thanks, for having me, Neeraj; this was really fun. I'm just really proud and excited to still be part of this field, to be part of the GU oncology field, and it continues to be exciting for all the folks who are coming up. Dr. Neeraj Agarwal: Indeed. And thank you to our listeners for joining us today. You will find links to the abstracts discussed today on the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review, and subscribe wherever you get your podcasts. Thank you very much.   Disclaimer: The purpose of this podcast is to educate and inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   Find out more about today's speakers:   Dr. Neeraj Agarwal @neerajaiims   Dr. Todd Morgan @wandering_gu   Follow ASCO on social media:   @ASCO on Twitter     ASCO on Facebook     ASCO on LinkedIn       Disclosures:    Dr. Neeraj Agarwal:    Consulting or Advisory Role: Pfizer, Bristol-Myers Squibb, AstraZeneca, Nektar, Lilly, Bayer, Pharmacyclics, Foundation Medicine, Astellas Pharma, Lilly, Exelixis, AstraZeneca, Pfizer, Merck, Novartis, Eisai, Seattle Genetics, EMD Serono, Janssen Oncology, AVEO, Calithera Biosciences, MEI Pharma, Genentech, Astellas Pharma, Foundation Medicine, and Gilead Sciences    Research Funding (Institution): Bayer, Bristol-Myers Squibb, Takeda, Pfizer, Exelixis, Amgen, AstraZeneca, Calithera Biosciences, Celldex, Eisai, Genentech, Immunomedics, Janssen, Merck, Lilly, Nektar, ORIC Pharmaceuticals, Crispr Therapeutics, Arvinas   Dr. Todd Morgan: Consulting or Advisory Role: Myriad Genetics, MDxHealth, TerumoBCT Research Funding (Institution): Prostate Cancer Foundation, National Institutes of Health, Department of Defence, GenomeDX Biosciences, Myriad Genetics, MDxHealth  

Commentary by Dr. Valentin Fuster

2024 SCCM Congress: Tuesday Special Guests: Karen Berger, PharmD, FASHP, FCCM, BCCCP, BCPS Melanie Smith Condeni, PharmD, FCCM, BCPS, BCCCP Julie Farrar, PharmD, BCCCP Lama Nazer, PharmD, BCPS Joanna Stollings, PharmD, FCCP, FCCM, BCPS, BCCCP Andy Webb, PharmD, BCCCP 03:05: Star Research Presentation: “Effect of Antipsychotics on Agitation in ICU Delirium: Secondary Analysis of a Randomized Trial” featuring Joanna Stollings 10:43: Star Research Presentations: “Procalcitonin and Antimicrobial Utilization in Critically Ill Cancer Patients with Sepsis (PRO-CAN)” & “Diagnostic and Prognostic Value of Procalcitonin in Critically Ill Cancer Patients with Sepsis” featuring Lama Nazer 25:32: Clinical Pharmacy and Pharmacology (CPP) Year in Review presenter and moderator roundtable discussion featuring Karen Berger, Melanie Smith Condeni, Julie Farrar, and Andy Webb 2024 SCCM Congress website: https://congress2024.sccm.org PharmacyToDose.com  @PharmacyToDose  PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

Commentary by Dr. Valentin Fuster

Host Dr. Michael Blankstein interviews paper author Dr. Aaron Nauth. This paper was presented at the 2023 OTA Annual Meeting. For additional educational resources visit https://ota.org/

Dr. Ajit Limaye and Dr. Camille Kotton (@KottonNelson) join Dr. Erin McCreary (@ErinMcCreary) to discuss fascinating updates in the CMV space including new RCTs for prevention, vaccines, and more! Learn why a little "hair of the dog" might be a good thing, how great T cells are, and the trials we still need. References: CAPSIL study: Effect of Preemptive Therapy vs Antiviral Prophylaxis on Cytomegalovirus Disease in Seronegative Liver Transplant Recipients With Seropositive Donors: A Randomized Clinical Trial - PubMed (nih.gov) Extended CAPSIL data: Association of CMV DNAemia with Long-Term Mortality in a Randomized Trial of Preemptive Therapy (PET) and Antiviral Prophylaxis (AP) for Prevention of CMV Disease in High-Risk Donor Seropositive, Recipient Seronegative (D+R-) Liver Transplant Recipients - PubMed (nih.gov) Kidney transplant review: A Systematic Review and Meta-analysis of Optimized CMV Preemptive Therapy and Antiviral Prophylaxis for CMV Disease Prevention in CMV High-Risk (D+R-) Kidney Transplant Recipients - PubMed (nih.gov) Letermovir vs Valganciclovir for Prevention in Kidney Transplant: Letermovir vs Valganciclovir for Prophylaxis of Cytomegalovirus in High-Risk Kidney Transplant Recipients: A Randomized Clinical Trial - PubMed (nih.gov) Learn more about the Society of Infectious Diseases Pharmacists: https://sidp.org/About Twitter: @SIDPharm (https://twitter.com/SIDPharm) Instagram: @SIDPharm (https://www.instagram.com/sidpharm/) Facebook: https://www.facebook.com/sidprx LinkedIn: https://www.linkedin.com/company/sidp/ SIDP welcomes pharmacists and non-pharmacist members with an interest in infectious diseases, learn how to join here: https://sidp.org/Become-a-Member Listen to Breakpoints on iTunes, Overcast, Spotify, Listen Notes, Player FM, Pocket Casts, Stitcher, Google Play, TuneIn, Blubrry, RadioPublic, or by using our RSS feed: https://sidp.pinecast.co/ Check out our podcast host, Pinecast. Start your own podcast for free with no credit card required. If you decide to upgrade, use coupon code r-7e7a98 for 40% off for 4 months, and support Breakpoints.

Show notes at pharmacyjoe.com/episode863. In this episode, I’ll discuss an article about cefepime vs piperacillin-tazobactam in adults hospitalized with acute infection. The post 863: Does This Randomized Trial Settle the Increased AKI from Piperacillin-Tazobactam Question? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode863. In this episode, I’ll discuss an article about cefepime vs piperacillin-tazobactam in adults hospitalized with acute infection. The post 863: Does This Randomized Trial Settle the Increased AKI from Piperacillin-Tazobactam Question? appeared first on Pharmacy Joe.

Stigall briefly responds today to the Hunter Biden gun charges yesterday as well as the breaking news the UAW has gone on strike with some big demands. Check out the Harrumph Society for much more commentary while he's been on the road. Enjoy the wrap on the week with thoughtful conversations with brilliant folks: Wall Street Journal Editor at Large Gerard Baker and his new book "American Breakdown," former AG of Kansas Phil Kline warns of the Secretaries of State across the country plotting to keep Trump off the ballot entirely if he's successful in securing the GOP nomination, Dr. Marty McCary discusses the new wave of COVID and his impressions of the latest booster push, and Stella Morobito who wrote the most important book of the lockdown era "The Weaponization of Loneliness" discusses a possible return to lockdowns. - For more info visit the official website: https://chrisstigall.com Instagram: https://www.instagram.com/chrisstigallshow/ Twitter: https://twitter.com/ChrisStigall Facebook: https://www.facebook.com/chris.stigall/ Listen on Spotify: https://tinyurl.com/StigallPod Listen on Apple Podcasts: https://bit.ly/StigallShowSee omnystudio.com/listener for privacy information.