Podcasts about randomized trial

Dr. Vamsi Velcheti and Dr. Nate Pennell discuss novel treatment approaches in small cell and non-small cell lung cancer that were featured at the 2025 ASCO Annual Meeting. TRANSCRIPT Dr. Vamsi Velcheti: Hello, I'm Dr. Vamsi Velcheti, your guest host of the ASCO Daily News Podcast. I'm a professor of medicine and chief of hematology and oncology at the Mayo Clinic in Jacksonville, Florida. The 2025 ASCO Annual Meeting featured some exciting advancements in small cell lung cancer, targeted therapies for non-small cell lung cancer, and other novel [treatment] approaches. Today, I'm delighted to be joined by Dr. Nate Pennell to discuss some of the key abstracts that are advancing the lung cancer field. Dr. Pennell is the co-director of the Cleveland Clinic Lung Cancer Program and also the vice chair of clinical research at the Taussig Cancer Institute. Our full disclosures are available in the transcript of this episode. Nate, it's great to have you back on the podcast. Thanks so much for being here. Dr. Nate Pennell: Thanks, Vamsi. Always a pleasure. Dr. Vamsi Velcheti: Let's get started, and I think the first abstract that really caught my attention was Abstract 8516, “The Randomized Trial of Relevance of Time of Day of Immunotherapy for Progression-Free and Overall Survival in Patients With Non-Small Cell Lung Cancer.” What are your thoughts about this, Nate? Dr. Nate Pennell: I agree. I thought this was one of the most discussed abstracts, certainly in the lung cancer session, but I think even outside of lung cancer, it got some discussion. So, just to put this in perspective, there have been a number of publications that have all been remarkably consistent, and not just in lung cancer but across multiple cancer types, that immunotherapy, immune checkpoint inhibitors, are commonly used. And all of them have suggested, when looking at retrospective cohorts, that patients who receive immune checkpoint inhibitors earlier in the day – so in the morning or before the early afternoon – for whatever reason, appear to have better outcomes than those who get it later in the day, and this has been repeated. And I think many people just sort of assumed that this was some sort of strange association and that there was something fundamentally different from a prognostic standpoint in people who came in in the morning to get their treatment versus those who came later in the afternoon, and that was probably the explanation. The authors of this randomized trial actually decided to test this concept. And so, about 210 patients with previously untreated advanced non-small cell lung cancer were randomly assigned to get chemo and immune checkpoint inhibitor – either pembrolizumab or sintilimab – and half of them were randomly assigned to get the treatment before 3 PM in the afternoon, and half of them were assigned to get it after 3 PM in the afternoon. And it almost completely recapitulated what was seen in the retrospective cohorts. So, the median progression-free survival in those who got earlier treatment was 13.2 months versus only 6.5 months in those who got it later in the day. So, really enormous difference with a hazard ratio of 0.43, which was statistically significant. And perhaps even more striking, the median overall survival was not reached in the early group versus 17.8 months in the late group with a hazard ratio of 0.43, also highly statistically significant. Even the response rate was 20% higher in the early patients; 75% response rate compared to 56% in the late-time-of-day patients. So very consistent across all measures of efficacy with pretty good matched characteristics across the different groups. And so, I have to tell you, I don't know what to make of this. I certainly was a skeptic about the retrospective series, but now we have a prospective randomized trial that shows essentially the same thing. So, maybe there is a difference between getting treated in the morning, although I have yet to hear someone give a very good mechanistic explanation as to why this would be. What were your thoughts on this? Dr. Vamsi Velcheti: It's indeed fascinating, Nate, and I actually think this was a very interesting abstract. Really, I was caught off guard looking at the data. I mean, if it were a drug, we would be so excited, right? I mean, with those kind of survival benefits. I don't know. I think circadian rhythm probably has something to do with it, like different cytokine profiles at the time of administration. I mean, who knows? But I think it's a randomized trial, and I think I would expect to see a mad rush for treatment appointments early in the morning given this, and at least I want my patients to come in first thing in the morning. It'll be interesting to see. Dr. Nate Pennell: It's important to point out that in this study, everyone got chemo and immunotherapy. And, at least in our cancer center, most patients who are getting platinum-doublet chemotherapy and immunotherapy actually do get treated earlier in the day already, just because of the length of the infusion appointment that's needed. So it really is oftentimes people getting single-agent immunotherapy who are often getting the later, shorter visits. But if you have a choice, I think it would be very reasonable to have people treated earlier in the day. And I do think most of the impressions that I got from people about this is that they would like to see it reproduced but certainly well worth further investigation. And I personally would like to see more investigation into what the rationale would be for this because I still can't quite figure out, yes, if you got it at, say, you know, 5 PM, that's later in the day and I can understand that maybe your immune system is somewhat less receptive at that point than it would be in the morning. But because these checkpoint inhibitors have such long half-lives, it's still in your system the next morning when your immune system is supposedly more receptive. So I don't quite understand why that would be the case. Well, let's move on to the next study. I would like to hear your thoughts on Abstract 8515, “Plasma-Guided, Adaptive First-Line Chemoimmunotherapy for Non-Small Cell Lung Cancer.” Dr. Vamsi Velcheti: Yeah, this was another abstract that seems to be really interesting in my opinion. I think there's kind of a lot of emphasis lately on ctDNA and MRD-based assays to monitor disease. In the lung cancer space, we haven't had a lot of clinical trials looking at this prospectively, and this was one of those pilot studies where they looked at circulating free DNA (cfDNA)-based response-adaptive strategy for frontline patients who are PD-L1 positive. So, patients started with pembrolizumab monotherapy, and based on plasma molecular response after 2 cycles, those patients without response received early treatment intensification with a platinum doublet. So the approach essentially was to reduce the chemotherapy exposure in patients who respond to immunotherapy. And only about 17.5% of the patients on the trial received chemotherapy based on lack of molecular response. So, in this trial, what they found was patients with the cfDNA response had a markedly improved PFS of 16.4 months versus 4.8 months. So essentially, like, this is a really nice study to set a foundation on which we have to do larger studies to incorporate molecular markers trying to look at cfDNA response to inform treatment strategy, either escalation or de-escalation strategies. So, I thought it was a very interesting study. Dr. Nate Pennell: Yeah. I mean, we always have this question for patients, “Should they get immunotherapy alone or combined with chemo?” and I think this certainly is intriguing, suggesting that there may be ways you can monitor people and perhaps rescue those that aren't going to respond to single agent. I'd like to see a randomized trial against, you know, this strategy, perhaps against everyone getting, say, chemoimmunotherapy or make sure that you're not potentially harming people by doing this strategy. But I agree, it's time to move beyond just observing that cell-free DNA is prognostic and important and start using it to actually guide treatment. Dr. Vamsi Velcheti: Yeah, and I would just caution though, like, you know, I think we need more data, but, however, it's certainly a very interesting piece of data to kind of help inform future trials. So, there was another abstract that caught my attention, and I think this would be a very interesting abstract in the EGFR space. Abstract 8506, "Patritumab Deruxtecan (HER3-DXd) in Resistant EGFR-Mutant Advanced Non-Small Cell Lung Cancer Patients After Third-Generation EGFR TKI," it's the HERTHENA-Lung02 study. What do you think about the results of this study? Dr. Nate Pennell: Yeah, this was, I would say, very widely anticipated and ultimately a little disappointing, despite being a positive trial. So, these are patients with EGFR-mutant non-small cell lung cancer who have progressed after a third-generation EGFR TKI like osimertinib. This is really an area of major unmet need. We do have drugs like amivantamab in this space, but still definitely an area where essentially patients move from having a highly effective oral therapy to being in the realm of chemotherapy as their best option. So, this HER3 antibody-drug conjugate, patritumab deruxtecan, had some good single-arm data for this. And we're sort of hoping this would become an available option for patients. This trial was designed against platinum-doublet chemotherapy in this setting and with a primary endpoint of progression-free survival. And it actually was positive for improved progression-free survival compared to chemo with a hazard ratio of 0.77. But when you look at the medians, you can see that the median PFS was only 5.8 versus 5.4 months. It was really a modest difference between the two arms. And on the interim analysis, it appeared that there will not be a difference in overall survival between the two arms. In fact, the hazard ratio at the interim analysis was 0.98 for the two arms. So based on this, unfortunately, the company that developed the HER3-DXd has withdrawn their application to the FDA for approval of the drug, anticipating that they probably wouldn't get past approval without that overall survival endpoint. So, unfortunately, probably not, at least for the near future, going to be a new option for these patients. Dr. Vamsi Velcheti: Yeah, I think this is a space that's clearly an unmet need, and this was a big disappointment, I should say. I think all of us were going into the meeting anticipating some change in the standard of care here. Dr. Nate Pennell: Yeah, I agree. It was something that I was telling patients, honestly, that I was expecting this to be coming, and so now, definitely a bit of a disappointment. But it happens and, hopefully, it will still find perhaps a role or other drugs with a similar target. Certainly an active area. Well, let's leave the EGFR-mutant space and move into small cell. There were a couple of very impactful studies. And one of them was Abstract 8006, “Lurbinectedin Plus Atezolizumab as First-Line Maintenance Treatment in Patients With Extensive-Stage Small Cell Lung Cancer, Primary Results from the Phase III IMforte Trial.” So, what was your impression of this? Dr. Vamsi Velcheti: Yeah, I think this is definitely an interesting study, and small cell, I remember those days when we had barely any studies of small cell at ASCO, and now we have a lot of exciting developments in the small cell space. It's really good to see. The IMforte trial is essentially like a maintenance lurbinectedin trial with atezolizumab maintenance. And the study was a positive trial. The primary endpoint was a PFS, and the study showed improvement in both PFS and OS with the addition of lurbinectedin to atezolizumab maintenance. And definitely, it's a positive trial, met its primary endpoint, but I always am a little skeptical of adding maintenance cytotoxic therapies here in this setting. In my practice, and I'd like to hear your opinion, Nate, most patients with small cell after 4 cycles of a platinum doublet, they're kind of really beaten up. Adding more cytotoxic therapy in the maintenance space is going to be tough, I think, for a lot of patients. But also, most importantly, I think this rapidly evolving landscape for patients with small cell lung cancer with multiple new, exciting agents, actually like some FDA-approved like tarlatamab, also like a lot of these emerging therapeutics like I-DXd and other ADCs in this space. You kind of wonder, is it really optimal strategy to bring on like another cytotoxic agent right after induction chemotherapy, or do you kind of delay that? Or maybe have like a different strategy in terms of maintenance. I know that the tarlatamab maintenance trial is probably going to read out at some point too. I think it's a little challenging. The hazard ratio is also 0.73. As I said, it's a positive trial, but it's just incremental benefit of adding lurbi. And also on the trial, we need to also pay attention to the post-progression second-line treatments, number of patients who received tarlatamab or any other investigational agents.  So I think it's a lot of questions still. I'm not quite sure I'd be able to embrace this completely. I think a vast majority of my patients might not be eligible anyway for cytotoxic chemotherapy maintenance right away, but yeah, it's tough. Dr. Nate Pennell: Yeah. I would call this a single and not a home run. It definitely is real. It was a real overall survival benefit. Certainly not surprising that a maintenance therapy would improve progression-free survival. We've known that for a long time in small cell, but first to really show an overall survival benefit. But I completely agree with you. I mean, many people are not going to want to continue further cytotoxics after 4 cycles of platinum-doublet chemo. So I would say, for those that are young and healthy and fly through chemo without a lot of toxicity, I think certainly something worth mentioning. The problem with small cell, of course, is that so many people get sick so quickly while on that observation period after first-line chemo that they don't make it to second-line treatment. And so, giving everyone maintenance therapy essentially ensures everyone gets that second-line treatment. But they also lose that potentially precious few months where they feel good and normal and are able to be off of treatment. So, I would say this is something where we're really going to have to kind of sit and have that shared decision-making visit with patients and decide what's meaningful to them. Dr. Vamsi Velcheti: Yeah, I agree. The next abstract that was a Late-Breaking Abstract, 8000, “Overall Survival of Neoadjuvant Nivolumab Plus Chemotherapy in Patients With Resectable Non-Small Cell Lung Cancer in CheckMate-816.” This was a highly anticipated read-out of the OS data from 816. What did you make of this abstract? Dr. Nate Pennell: Yeah, I thought this was great. Of course, CheckMate-816 changed practice a number of years ago when it first reported out. So, this was the first of the neoadjuvant or perioperative chemoimmunotherapy studies in resectable non-small cell lung cancer. So, just to review, this was a phase 3 study for patients with what we would now consider stage II or stage IIIA resectable non-small cell lung cancer. And they received three cycles of either chemotherapy or chemotherapy plus nivolumab, and that was it. That was the whole treatment. No adjuvant treatment was given afterwards. They went to resection. And patients who received the chemoimmunotherapy had a much higher pathologic complete response rate and a much better event-free survival. And based on this, this regimen was approved and, I think, at least in the United States, widely adopted.  Now, since the first presentation of CheckMate 816, there have been a number of perioperative studies that have included an adjuvant component of immunotherapy – KEYNOTE-671, the AEGEAN study – and these also have shown improved outcomes. The KEYNOTE study with pembrolizumab also with an overall survival benefit. And I think people forgot a little bit about CheckMate-816. So, this was the 5-year overall survival final analysis. And it did show a statistically and, I think, clinically meaningful difference in overall survival with the 3 cycles of neoadjuvant chemo-nivo compared to chemo with a hazard ratio of 0.72. The 5-year overall survival of 65% in the chemo-IO group versus 55% with the chemo alone. So a meaningful improvement. And interestingly, that hazard ratio of 0.72 is very similar to what was seen in the peri-operative pembro study that included the adjuvant component. So, very much still relevant for people who think that perhaps the value of those neoadjuvant treatments might be really where most of the impact comes from this type of approach. They also gave us an update on those with pathologic complete response, showing really astronomically good outcomes. If you have a pathologic complete response, which was more than a quarter of patients, the long-term survival was just phenomenal. I mean, 95% alive at 5 years if they were in that group and suggesting that in those patients at least, the adjuvant treatment may not be all that important.  So, I think this was an exciting update and still leaves very much the open question about the importance of continuing immunotherapy after surgery after the neoadjuvant component. Dr. Vamsi Velcheti: Yeah, I completely agree, Nate. I think the million-dollar question is: “Is there like a population of patients who don't have complete response but like maybe close to complete response?” So, would you like still consider stopping adjuvant IO? I probably would not be comfortable, but I think sometimes, you know, we all have patients who are like very apprehensive of continuing treatments. So, I think that we really need more studies, especially for those patients who don't achieve a complete CR. I think trying to find strategies for like de-escalation based on MRD or other risk factors. But we need more trials in that space to inform not just de-escalation, but there are some patients who don't respond at all to a neoadjuvant IO. So, there may be an opportunity for escalating adjuvant therapies. So, it is an interesting space to watch out for. Dr. Nate Pennell: No, absolutely. Moving to KRAS-mutant space, so our very common situation in patients with non-small cell lung cancer, we had the results of Abstract 8500, “First-Line Adagrasib With Pembrolizumab in Patients With Advanced or Metastatic KRASG12C-Mutated Non-Small Cell Lung Cancer” from the phase 2 portion of the KRYSTAL-7 study. Why was this an interesting and important study? Dr. Vamsi Velcheti: First of all, there were attempts to kind of combine KRASG12C inhibitors in the past with immune checkpoint inhibitors, notably sotorasib with pembrolizumab. Unfortunately, those trials have led to like a lot of toxicity, with increased especially liver toxicity, which was a major issue. This is a phase 2 study of adagrasib in combination with pembrolizumab, and this is a study in the frontline setting in patients with the G12C-mutant metastatic non-small cell lung cancer. And across all the PD-L1 groups, the ORR was 44%, and the median PFS was 11 months, comparable to the previous data that we have seen with adagrasib in this setting. So it's not like a major improvement in clinical efficacy. However, I think the toxicity profile that we were seeing was slightly better than the previous trials in combination with sotorasib, but you still have a fair amount of transaminitis even in the study. At this point, this is not ready for clinical primetime. I don't think we should be using sotorasib or adagrasib in the frontline or even in the second line in combination with checkpoint inhibitors. Combining these drugs with checkpoint inhibitors in the clinical practice might lead to adverse outcomes. So, we need to wait for more data like newer-generation G12C inhibitors which are also being studied in combination, so we'll have to kind of wait for more data to emerge in this space. Dr. Nate Pennell: I agree, this is not immediately practice changing. This is really an attempt to try to combine targeted treatment with immune checkpoint inhibitor. And I agree with you that, you know, it does appear to be perhaps a little bit better tolerated than some of the prior combinations that have tried in this space. The outcomes overall were not that impressive, although in the PD-L1 greater than 50%, it did have a better response rate perhaps than you would expect with either drug alone. And I do think that the company is focusing on that population for a future randomized trial, which certainly would inform this question better. But in the meantime, I agree with you, there's a lot of newer drugs that are coming along that potentially may be more active and better tolerated. And so, I'd say for now, interesting but we'll wait and see. Dr. Vamsi Velcheti: Yeah, so now moving back again to small cell. So, there was a Late-Breaking Abstract, 8008. This is a study of tarlatamab versus chemotherapy as second-line treatment for small cell lung cancer. They presented the primary analysis of the phase III DeLLphi-304 study. What do you think about this? Dr. Nate Pennell: Yeah, I thought this was really exciting. This was, I would say, perhaps the most important lung study that was presented. Tarlatamab is, of course, the anti-DLL3 bispecific T-cell engager compound, which is already FDA approved based on a prior single-arm phase II study, which showed a very nice response rate as a single agent in previously treated small cell lung cancer and relatively manageable side effects, although somewhat unique to solid tumor docs in the use of these bispecific drugs in things like cytokine release syndrome and ICANS, the neurologic toxicities. So, this trial was important because tarlatamab was approved, but there were also other chemotherapy drugs approved in the previously treated space. And so, this was a head-to-head second-line competition comparison between tarlatamab and either topotecan, lurbinectedin, or amrubicin in previously treated small cell patients with a primary endpoint of overall survival. So, a very well-designed trial. And it did show, I think, a very impressive improvement in overall survival with a median overall survival in the tarlatamab group of 13.6 months compared to 8.3 months with chemotherapy, hazard ratio of 0.6. And progression-free survival was also longer at 4.2 months versus 3.2 months, hazard ratio of 0.72. In addition to showing improvements in cancer-related symptoms that were improved in tarlatamab compared to chemotherapy, there was actually also significantly lower rates of serious treatment-related adverse events with tarlatamab compared to chemotherapy. So, you do still see the cytokine release syndrome, which is seen in most people but is manageable because these patients are admitted to the hospital for the first two cycles, as well as a significant number of patients with neurologic side effects, the so-called ICANS, which also can be treated with steroids. And so, I think based upon the very significant improvement in outcomes, I would expect that this should become our kind of standard second-line treatment since it seems to be much better than chemo. However, tarlatamab is definitely a new drug that a lot of places are not used to using, and I think a lot of cancer centers, especially ones that aren't tied to a hospital, may have questions about how to deal with the CRS. So, I'm curious your thoughts on that. Dr. Vamsi Velcheti: Yeah, thank you, Nate. And I completely agree. I think the data looked really promising, and I've already been using tarlatamab in the second-line space. The durability of response and overall, having used tarlatamab quite a bit - like, I participated in some of the early trials and also used it as standard of care - tarlatamab has unique challenges in terms of like need for hospitalization for monitoring for the first few treatments and make sure, you know, we monitor those patients for CRS and ICANS. But once you get past that initial administration and monitoring of CRS, these patients have a much better quality of life, they're off chemotherapy, and I think it's really about the logistics of actually administering tarlatamab and coordination with the hospital and administration in the outpatient setting. It's definitely challenging, but I think it definitely can be done and should be done given what we are seeing in terms of clinical efficacy here. Dr. Nate Pennell: I agree. I think hospital systems now are just going to have to find a way to be able to get this on formulary and use it because it clearly seems to be more effective and generally better tolerated by patients. So, should move forward, I think. Finally, there's an abstract I wanted to ask you about, Abstract 8001, which is the “Neoadjuvant osimertinib with or without chemotherapy versus chemotherapy alone in resectable epidermal growth factor receptor-mutated non-small cell lung cancer: The NeoADAURA Study”. And this is one that I think was also fairly highly anticipated. So, what are your thoughts? Dr. Vamsi Velcheti: You know, I wasn't probably surprised with the results, and I believe we were all expecting a positive trial, and we certainly were handed a positive trial here. It's a phase III trial of osimertinib and chemotherapy or osimertinib in the neoadjuvant space followed by surgery, followed by osimertinib. It's a global phase 3 trial and very well conducted, and patients with stage II to stage IIIB were enrolled in the study. And in the trial, patients who had a neoadjuvant osimertinib with or without chemotherapy showed a significant improvement in major pathologic response rates over chemotherapy alone. And the EFS was also positive for osimertinib and chemotherapy, osimertinib monotherapy as well compared to chemotherapy alone. So overall, the study met its primary endpoint, and I think it sheds light on how we manage our patients with early-stage lung cancer. I think osimertinib, we know that osimertinib is already FDA approved in the adjuvant space, but what we didn't really know is how was osimertinib going to work in the neoadjuvant space. And there are always situations, especially for stage III patients, where we are on the fence about, are these patients already close to being metastatic? They have, like, almost all these patients have micrometastatic disease, even if they have stage III. As we saw in the LAURA data, when you look at the control arm, it was like a very short PFS. Chemoradiation does nothing for those patients, and I think these patients have systemic mets, either gross or micrometastatic disease at onset. So, it's really important to incorporate osimertinib early in the treatment course. And I think, especially for the locally advanced patients, I think it's even more important to kind of incorporate osimertinib in the neoadjuvant space and get effective local control with surgery and treat them with adjuvant. I'm curious to hear your thoughts, Nate. Dr. Nate Pennell: I am a believer and have long been a believer in targeted adjuvant treatments, and, you know, it has always bothered me somewhat that we're using our far and away most effective systemic therapy; we wait until after they go through all their pre-op treatments, they go through surgery, then they go through chemotherapy, and then finally months later, they get their osimertinib, and it still clearly improves survival in the adjuvant setting. Why not just start the osimertinib as soon as you know that the patient has EGFR-mutant non-small cell lung cancer, and then you can move on to surgery and adjuvant treatment afterwards? And I think what was remarkable about this study is that all of these patients almost - 90% in each arm - went to surgery. So, you weren't harming them with the neoadjuvant treatment. And clearly better major pathologic response, nodal downstaging, event-free survival was better. But I don't know that this trial is ever going to show an overall survival difference between neoadjuvant versus just surgery and adjuvant treatment, given how effective the drug is in the adjuvant setting. Nonetheless, I think the data is compelling enough to consider this, certainly for our N2-positive, stage IIIA patients or a IIIB who might be otherwise surgical candidates. I think based on this, I would certainly consider that. Dr. Vamsi Velcheti: Yeah, and especially for EGFR, like even for stage IIIB patients, in the light of the LAURA study, those patients who do not do too well with chemoradiation. So you're kind of delaying effective systemic therapy, as you said, waiting for the chemoradiation to finish. So I think probably time to revisit how we kind of manage these locally advanced EGFR patients. Dr. Nate Pennell: Yep, I agree. Dr. Vamsi Velcheti: Nate, thank you so much for sharing your fantastic insights today on the ASCO Daily News Podcast. It's been an exciting ASCO again. You know, we've seen a lot of positive trials impacting our care of non-small cell lung cancer and small cell lung cancer patients. Dr. Nate Pennell: Thanks for inviting me, Vamsi. Always a pleasure to discuss these with you. Dr. Vamsi Velcheti: And thanks to our listeners for your time today. You will find links to all of the abstracts discussed today in the transcript of the episode. Finally, if you value the insights that you hear from the ASCO Daily News Podcast, please take a moment to rate, review, subscribe wherever you get your podcast. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. More on today's speakers:    Dr. Vamsi Velcheti   @VamsiVelcheti    Dr. Nathan Pennell   @n8pennell   Follow ASCO on social media:     @ASCO on Twitter     ASCO on Facebook     ASCO on LinkedIn   ASCO on BlueSky   Disclosures:   Dr. Vamsi Velcheti:   Honoraria: ITeos Therapeutics   Consulting or Advisory Role: Bristol-Myers Squibb, Merck, Foundation Medicine, AstraZeneca/MedImmune, Novartis, Lilly, EMD Serono, GSK, Amgen, Elevation Oncology, Taiho Oncology, Merus   Research Funding (Inst.): Genentech, Trovagene, Eisai, OncoPlex Diagnostics, Alkermes, NantOmics, Genoptix, Altor BioScience, Merck, Bristol-Myers Squibb, Atreca, Heat Biologics, Leap Therapeutics, RSIP Vision, GlaxoSmithKline   Dr. Nathan Pennell:     Consulting or Advisory Role: AstraZeneca, Lilly, Cota Healthcare, Merck, Bristol-Myers Squibb, Genentech, Amgen, G1 Therapeutics, Pfizer, Boehringer Ingelheim, Viosera, Xencor, Mirati Therapeutics, Janssen Oncology, Sanofi/Regeneron    Research Funding (Inst): Genentech, AstraZeneca, Merck, Loxo, Altor BioScience, Spectrum Pharmaceuticals, Bristol-Myers Squibb, Jounce Therapeutics, Mirati Therapeutics, Heat Biologics, WindMIL, Sanofi 

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

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.