Podcasts about rct

At the end of April 2025, we released an episode summarizing the ERAS update for 2025. In that episode/update, we summarized the data on extended spectrum prophylactic antibiotics at cesarean section in patients living with obesity. The ERAS protocol recognized the value of oral cephalexin and metronidazole for 48 hours in patients with obesity who receive single agent Cephalosporin prophylaxis preop. Now, a new (RCT) publication soon to be released in the Green Journal, evaluates whether using dual agent pre-op prophylaxis (ancef and zithromax) together with post op oral cephalexin and metronidazole has benefit in reduction of SSI composite risk. Does this help? When is too much prophylactic antibiotics, just too much? Listen in for details.

Hosts Mitsuaki Sawano, MD, co-host Nobuhiro Ikemura, MD, welcome Kentaro Kamiya, PhD, from Kitasato University, to discuss the ACTIVE-ADHF trial, a landmark multicenter RCT on early cardiac rehabilitation in acute decompensated heart failure. The study found that initiating exercise-based rehab during hospitalization significantly improved physical function, quality of life, and activity levels at discharge—even in non-frail patients—without increasing adverse events. Dr. Kamiya emphasizes that early rehab can prevent functional decline and support recovery, challenging assumptions about who benefits from acute-phase intervention and offering globally relevant evidence grounded in Japan's unique clinical setting.

Devenu team manager du RCT depuis sa retraite en 2023, Mathieu Bastareaud se confie sur son nouveau quotidien. Il raconte sa relation avec Pierre Mignoni, avec qui il est lié depuis dix ans, et son rôle auprès de l'effectif actuel. Il revient aussi sur sa non-sélection pour la Coupe du monde 2019, son départ à New York et sur le retour de son ami Ma'a Nonu dans le Var. Un podcast présenté par Léa Leostic, avec Maxime Raulin.Hébergé par Ausha. Visitez ausha.co/politique-de-confidentialite pour plus d'informations.

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

Dr. Jonathan Howard and Wendy Orent examine the alarming elevation of wellness influencer Casey Means as Surgeon General nominee, despite lacking a medical license or conventional medical credibility. They delve into Vinay Prasad's appointment as head of vaccine regulation, scrutinizing his past critiques of RCT deficiencies—and the impossible standards he now sets for himself. The episode also investigates the troubling rise of an autism registry, likened to authoritarian categorization, and NIH's internal collapse under Jay Bhattacharya, whose leadership is marked by mass layoffs and denial of responsibility. With science policy veering into cronyism, dismantling, and performative governance, the episode argues that we're witnessing a historic erosion of public health leadership—led not by scientists, but social media provocateurs. Connect with us further on https://sciencebasedmedicine.org/author/jonathanhoward/  The Fine Print The content presented in the "We Want Them Infected" Podcast and associated book is intended for informational and educational purposes only.  The views and opinions expressed by the speakers, hosts, and guests on the podcast do not necessarily reflect the views of the creators, producers, or distributors. The information provided in this podcast should not be considered as a substitute for professional medical, scientific, or legal advice. Listeners and readers are encouraged to consult with relevant experts and authorities for specific guidance and information. The creators of the podcast and book have made reasonable efforts to ensure that the information provided is accurate and up to date. However, as the field of medical science and the understanding of the COVID-19 pandemic continue to evolve, there may be new developments and insights that are not covered in this content. The creators are not responsible for any errors or omissions in the content or for any actions taken based on the information provided. They disclaim any liability for any loss, injury, or damage incurred by individuals who rely on the content. Listeners and readers are urged to use their judgment and conduct their own research when interpreting the information presented in the "We Want Them Infected" podcast and book. It is essential to stay informed about the latest updates, guidelines, and recommendations related to COVID-19 and vaccination from reputable sources, such as government health agencies and medical professionals. By accessing and using the content, you acknowledge and accept the terms of this disclaimer. Please consult with appropriate experts and authorities for specific guidance on matters related to health, science, and the COVID-19 pandemic.

Yasmin Kawar, MTA, RCT, is a Jordanian-Canadian music therapist and counselling therapist. Yasmin specializes in working with clients in addiction recovery, as well as persons impacted by addiction, trauma & abuse, ADHD, anxiety/depression, and the criminal justice system. Yasmin works to meet clients where they are in their life journey to collaboratively explore challenges, develop personal insights & resources, and creatively mobilize chaos into positive empowered change. Yasmin serves as President for the executive board of the Atlantic Association for Music Therapy, and Secretary on the board of the Creative Arts in Counselling Chapter of the Canadian Counselling and Psychotherapy Association.This conversation was a celebration of cross-training, client-centred approach, and connection within the landscape of music therapy. Yasmin's Links:AAMT - https://www.atlanticassociationmt.com/Psychology Today - https://www.psychologytoday.com/ca/therapists/yasmin-kawar-halifax-ns/976910-- Subscribe to the Able Voice Podcast, leave us a review and connect with us (⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@ablevoicepodcast⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ @synergymusictherapy⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠) to share your experiences and takeaways. We release new episodes every other Sunday between the end of January and end of August.AVP Theme Music by: Christopher Mouchette. Follow him on⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Soundcloud (Chris Mouchette)⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠.Episode audio edited by: Justis Krar (⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@immvproductions⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠)Rate and review the podcast on Apple Podcasts here:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://podcasts.apple.com/us/podcast/able-voice-podcast/id1505215850⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

This week we are re-releasing our first ever proper episode on two RCT's exploring the question of whether there is a difference between ACL reconstruction and non-operative management!Please note, this epidsode does not constitute medical advice.

Welcome back to the podcast! We've got three papers this month covering the breadth of Emergency Care presentations and locations; from prehospital arrests, ketamine for analgesia in trauma and those complex elderly patients presenting with abdominal pain. First up we look at the use of prehospital thrombolysis for out of hospital cardiac arrest, something some critical care services are using for suspected PEs and MIs. But what are the outcomes for these patients and how accurate are the clinical suspicions that lead to the thrombolysis? Next up we look at an excellent prehospital RCT, PACKMaN, on the use of ketamine vs morphine for patients with pain following trauma. Is ketamine safe? Is it superior? And what is the side effect profile of each of these approaches? We're also lucky enough to have the lead author, Mike Smyth, come on to give his thoughts on the paper and what it might mean for clinical practice Finally we have a think about abdominal pain in the elderly population. Without a cause for the pain being found this can feel like a very high risk group of patients to discharge. Our final paper helps quantify that risk further, inform our decision making and identify factors that are associate with an increased morbidity and mortality. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon & Rob

Sykefraværet i norsk arbeidsliv har skutt i været, og mange diskuterer og leter etter årsaker. Men hva kan vi egentlig gjøre med det? I dagens episode har vi besøk av Andreas Lycke,  CEO i Able Education, som deler hvordan individuell helseveiledning kan redusere sykefravær og styrke livskvalitet på arbeidsplassen. Andreas gir  oss  innsikt i hvilke helsefremmende aktiviteter som virker, hvordan vanecoaching fungerer i praksis, og hva bedrifter kan gjøre annerledes. Vi snakker også om hvordan individuell oppfølging kan skape både bedre helse og sterkere tilhørighet på jobben.Andreas deler med oss:Hvordan personlig helseveiledning har ført til en gjennomsnittlig 50 % reduksjon i sykefravær i store norske virksomheter.Hvorfor indre motivasjon og små, konkrete mål er nøkkelen til varige livsstilsendringer.Hva Europas største sykefraværsstudie (RCT-studie sammen med SINTEF) vil undersøke om effekten av helseveiledning.Hvordan følelsen av å bli sett og støttet har en direkte effekt på den mentale helsen til ansatte.Hvilke praktiske, lavterskel helseråd du kan ta i bruk allerede i dag!Andreas er blant annet sertifisert vanecoach og har gjestet HR-podden tidligere (episode 69, hvordan få til de vanene du ønsker deg i hverdagen). Lytt og bli inspirert til å tenke nytt om helse på jobb!-------------Om dagens gjest:Andreas Lycke er sertifisert vanecoach, fysioterapeut og spesialist i atferdsendring. Han leder sertifiseringen av helseveiledere, er fast ekspert på motivasjon og livsstilsendring i VG og har utgitt boken Vaner som varer. Andreas brenner for bærekraftig vaneendring som hjelper folk å skape god livskvalitet og helhetlig helse – både på jobben og hjemme. Han er særlig opptatt av hvordan vi kan bruke dokumenterte metoder for å redusere sykefravær, styrke folkehelsen og gi flest mulig et bedre liv. Vil du vite mer om Andreas, sjekk ut: https://www.vanecoach.no/________ Vil du ha e-post med ukens fagtips og personlig invitasjon til webinarer fra Leonda? Ja takk! Liker du det du hører? Trykk på følg i din podcast app så får du beskjed når nye ukentlige episoder legges ut.

WHAT A HAUL FOR THE SEAHAWKS! John Schneider worked his magic with a draft that had Mike MacDonald's stamp all over it.Join Mitch & Josh Live as they discuss the Seahawks 2025 Draft Masterclass, including:

This NFL Draft Day the 12 Talk Podcast bring you something special! Mitch & Josh talk all about the NFL Draft with some amazing guests to talk all about:

What do you do when most trials suggest benefit for an intervention, but then a new trial suggests harm? We thought steroids in pneumonia was a settled question, but REMAP-CAP had other plans!We also review a new RCT for BP targets in patients with hypertension and diabetes, a new aldosterone synthase inhibitor for hypertension, and reduced dose apixaban for cancer-associated thrombosis. Hydrocortisone for Severe CAP (REMAP-CAP)Predicting Benefit of Corticosteroids in PneumoniaIntensive BP Control in Patients with Diabetes (BPROAD)Lorundrostat for Uncontrolled Hypertension (ADVANCE-HTN)Reduced Dose Apixaban for Cancer Associated Thrombosis (API-CAT)Music from Uppbeat (free for Creators!): https://uppbeat.io/t/soundroll/dope License code: NP8HLP5WKGKXFW2R

There have been various publications and commentaries published on “evidence-based” cesarean section techniques. Still, one of the persistent controversies on abdominal wall closure relates to the rectus. With transverse fascial entries, should we close/reapproximate the rectus or not? In June 2025, a new RCT looking at this very issue will be printed in the European J Obstetrics Gynecology and Reproductive Biology. Listen in for details.

Dans cet épisode, les Causeries reviennent sur la victoire contre Clermont.Mais débriefent aussi les news de la semaine : les prolongations annoncées, la communication du club en nette progression, la folle rumeur Menoncello alimentée par le joueur lui-même, mais aussi le débat de la semaine sur la fin de saison bouillante du RCT. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Oudemuziekkenner Kees Koudstaal presenteert de mooiste en recentste CD’s met oude en klassieke muziek. Dit keer zijn dat maar liefst 5 nieuw verschenen albums, met als uitvoerenden: Ensemble Il Caravaggio o.l.v. Camille Delaforge, Le Caravansérail o.l.v. Bertrand Cuiller, Quartetto Vanvitelli en Keiko Shichijo. 1. Jean-Philippe Rameau (1683-1764) – Uit Pigmalion, acte de ballet, RCT 52: […]

Au programme de ce 32ème numéro de la saison:- Les transferts (Clermont, Menoncello, Serin...)- Les déclarations de Mourad Boudjellal - Les déclarations de S.Chabal- W6N - La France bat le Pays de Galles- Pro D2 - 26e journée- La Challenge Cup (LOU et Racing92)- Kamoulox (Joseph, Paris-Roubaix, Tremblement de terre)- Le TRAIN de la CHAMPIONS CUP- DEBAT DEBILE: UBB ou RCT, qui pour challenger Toulouse ?

Die Hälfte der Menschheit hat keinen Zugang zu sicherer, sauberer Sanitärversorgung. Doch Wasserklosetts sind nicht die Lösung. Wie also müssen wir umdenken?  Unsere Autorin Lena Bodewein hat als Korrespondentin in Südostasien an vielen Orten gesehen, was für Auswirkungen eine mangelnde Sanitärversorgung hat: Ohne Toiletten können sich Infektionskrankheiten verbreiten - 800 Kinder unter fünf Jahren sterben täglich an Durchfallerkrankungen. Aber auch Antibiotikaresistenzen spielen eine Rolle, Frauen sind mehr Gewaltverbrechen ausgesetzt, Mädchen gehen oft nicht zur Schule. Im Gespräch mit Host Lucie Kluth erklärt Lena, warum Forschende sich mit dem Problem auch kulturell beschäftigen und was für ungewohnte Lösungsansätze es gibt. Denn unser Abwasserkonzept lässt sich nicht einfach auf den globalen Süden übertragen, viel zu viel Trinkwasser wird dabei vergeudet. Die Recherche für diesen Podcast führt uns an Orte, die besser riechen als gedacht, zu Technologien, die Namen von Popstars tragen - und Unternehmern, die Kalauer lieben.  HINTERGRUNDINFORMATIONEN: 1. Pickering, Amy J et al.: Effect of a community-led sanitation intervention on child diarrhoea and child growth in rural Mali: a cluster-randomised controlled trial
The Lancet Global Health, Volume 3, Issue 11, e701 - e711. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00144-8/fulltext 2. Sharma Waddington H, Masset E, Bick S, Cairncross S.: Impact on childhood mortality of interventions to improve drinking water, sanitation, and hygiene (WASH) to households: Systematic review and meta-analysis. PLoS medicine. 2023 Apr 20;20(4): e1004215. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004215 3. Cameron L, Olivia B S, Shah M.: Scaling up Sanitation: Evidence from an RCT in Indonesia. Journal of Development Economics 138(2019)1–16. https://www.sciencedirect.com/science/article/pii/S0304387818316298 4. Orgill-Meyer J, Pattanayak SK: Improved sanitation increases long-term cognitive test scores. World Development. 2020 Aug 1;132:104975. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3418412 5. Studie der German Toilet Organization über deutsche Schultoiletten: https://media.germantoilet.org/pages/schulen/toiletten-machen-schule-studie/2242471965-1692953784/tms_studie_2022-2023.pdf 6. Gu, Y., Zhou, W., Zheng, T. et al.: Health effects and externalities of the popularization of sanitary toilets: evidence from Rural China. BMC Public Health23, 2225 (2023). https://doi.org/10.1186/s12889-023-17192-4 7. Nunbogu AM, Elliott SJ: Characterizing gender-based violence in the context of water, sanitation, and hygiene: A scoping review of evidence in low-and middle-income countries. Water Security. 2022 Apr 1;15:100113. https://www.sciencedirect.com/science/article/abs/pii/S2468312422000049?via%3Dihub Mehr Wissenschaft bei NDR Info: https://www.ndr.de/nachrichten/info/sendungen/wissenschaft-und-bildung/index.html

Die Hälfte der Menschheit hat keinen Zugang zu sicherer, sauberer Sanitärversorgung. Doch Wasserklosetts sind nicht die Lösung. Wie also müssen wir umdenken?  Unsere Autorin Lena Bodewein hat als Korrespondentin in Südostasien an vielen Orten gesehen, was für Auswirkungen eine mangelnde Sanitärversorgung hat: Ohne Toiletten können sich Infektionskrankheiten verbreiten - 800 Kinder unter fünf Jahren sterben täglich an Durchfallerkrankungen. Aber auch Antibiotikaresistenzen spielen eine Rolle, Frauen sind mehr Gewaltverbrechen ausgesetzt, Mädchen gehen oft nicht zur Schule. Im Gespräch mit Host Lucie Kluth erklärt Lena, warum Forschende sich mit dem Problem auch kulturell beschäftigen und was für ungewohnte Lösungsansätze es gibt. Denn unser Abwasserkonzept lässt sich nicht einfach auf den globalen Süden übertragen, viel zu viel Trinkwasser wird dabei vergeudet. Die Recherche für diesen Podcast führt uns an Orte, die besser riechen als gedacht, zu Technologien, die Namen von Popstars tragen - und Unternehmern, die Kalauer lieben.  HINTERGRUNDINFORMATIONEN: 1. Pickering, Amy J et al.: Effect of a community-led sanitation intervention on child diarrhoea and child growth in rural Mali: a cluster-randomised controlled trial
The Lancet Global Health, Volume 3, Issue 11, e701 - e711. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00144-8/fulltext 2. Sharma Waddington H, Masset E, Bick S, Cairncross S.: Impact on childhood mortality of interventions to improve drinking water, sanitation, and hygiene (WASH) to households: Systematic review and meta-analysis. PLoS medicine. 2023 Apr 20;20(4): e1004215. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004215 3. Cameron L, Olivia B S, Shah M.: Scaling up Sanitation: Evidence from an RCT in Indonesia. Journal of Development Economics 138(2019)1–16. https://www.sciencedirect.com/science/article/pii/S0304387818316298 4. Orgill-Meyer J, Pattanayak SK: Improved sanitation increases long-term cognitive test scores. World Development. 2020 Aug 1;132:104975. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3418412 5. Studie der German Toilet Organization über deutsche Schultoiletten: https://media.germantoilet.org/pages/schulen/toiletten-machen-schule-studie/2242471965-1692953784/tms_studie_2022-2023.pdf 6. Gu, Y., Zhou, W., Zheng, T. et al.: Health effects and externalities of the popularization of sanitary toilets: evidence from Rural China. BMC Public Health23, 2225 (2023). https://doi.org/10.1186/s12889-023-17192-4 7. Nunbogu AM, Elliott SJ: Characterizing gender-based violence in the context of water, sanitation, and hygiene: A scoping review of evidence in low-and middle-income countries. Water Security. 2022 Apr 1;15:100113. https://www.sciencedirect.com/science/article/abs/pii/S2468312422000049?via%3Dihub Mehr Wissenschaft bei NDR Info: https://www.ndr.de/nachrichten/info/sendungen/wissenschaft-und-bildung/index.html

Strength training is often associated with bodybuilding, but its benefits go far beyond muscle growth. Research shows that strength training supports cardiovascular health, enhances brain function, and is a strong predictor of longevity. In this episode, Professor Andy Galpin joins us to break down the science behind strength training and show how anyone can incorporate it into their daily routine—without spending hours in the gym. We begin by exploring why strength matters, not just for physical appearance but for overall health and longevity. Andy revisits key insights from his last appearance on the podcast, demonstrating how grip strength is linked to life expectancy. Next, we tackle one of the biggest barriers to strength training: time and access. Jonathan steps in as the test subject while Andy walks him through an efficient, full-body workout that can be done at home with minimal equipment. Listeners will learn essential techniques, from proper form to breathing and injury prevention. Finally, we discuss what happens in the body post-workout and the importance of building a sustainable routine. Andy shares practical advice on nutrition, recovery, and how to create a strength training habit that delivers long-term results.

Join here for an insightful discussion with Federico Pappalardo, MD and Sanket Dhruva, MD, FACC on the groundbreaking ALT-SHOCK 2 RCT, the largest randomized trial on intra-aortic balloon pump therapy in heart failure cardiogenic shock. Learn about the trial's key findings, implications for clinical practice, and the future of mechanical circulatory support in this critically ill patient population.

HEALTH NEWS     Melatonin makes old bones stronger CoQ10, nicotinamide riboside improve blood markers in people with kidney disease  More on antioxidants and lung cancer Testing for just three genes could help prevent 75% of avoidable side effects for certain medications Researchers find ways purple corn could lower risk of diseases Glucosamine-chondroitin combination shows anti-inflammatory potential: RCT data

Send us a textIn this episode, I had the pleasure of speaking with Dr Ilana Levene, who is now a Neonatology subspeciality trainee at Oxford, England. Ilana has done some fantastic work on exploring the important topic of human milk expression. She described her randomized control trial in using relaxing techniques to facilitate human milk expression in the NICU. She shared the challenges that she had in conducting her RCT. We also talked about RCTs with negative results and how negative results are also important in conducting research. Ilana has now created a website with printables for parents and staff in the NICU on human milk expression. This can be assessed for free here : http://www.hifn.org/printable . Ilana also shared her interest in perinatal equity and shared details on her project Spectrum which involves gathering photos of the lactating breast conditions/chest from people with a wide spectrum of skincolours. These will be provided as a free educational image library. Currently she is chairing a priority setting partnership for LGBTQIA+ perinatal care. As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Sibeal Pays A Visit.Book 3 in 18 parts, By FinalStand. Listen to the ► Podcast at Explicit Novels.It is selfish to believe that your family will always love you. At some point you will be asked to earn it{Right where we left off}It was H-hour plus four. A Thai soldier fired another burst from his T A R 21. The other four soldiers around him did the same. They were using an overturned car as cover. He saw movement at a building across the street to his right. He fired off another few rounds. The figure fell to the ground. By hard-earned experience, he realized the enemy soldier had probably dived for cover, not been hit."Time to fall back. One block back," he hoped he didn't sound too shrill. "You two go first," he indicated the two townsfolk. His battalion major had drafted them minutes after the attack began. Any organized supply depot had been an open invitation for an artillery strike, so he had called for civilians to help carry the ammunition loads instead. These two had been attached to his platoon. Now they were with him.They nodded, hefted up the crate of 5.56mm and sprinted toward the rear while his men gave them cover fire. They made it. He named off two of his other men. It was their turn to go. After their sprint to safety, it was time for him and the last two to go. They ran past some terribly close flanking fire, but all made it.This Thai soldier wasn't the squad leader, or even the squad's second in command. He was a lowly Phon Thahan (Private, not 1st Class). Those two men were already dead. No, he was a common soldier who found other men listening to his orders so, by default, he was in command. His initial squad of ten had shrunk down to three. The fourth man had been part of the regimental staff, a driver, sent into the firefight to replace losses. He still could point and shoot, which was all that mattered at the moment.At the next block he found the two civilians. His men dumped their empty clips on them, then positioned themselves for the next enemy rush. The leader of this ad hoc force took the driver over to the far corner of the building they sheltered behind. Too often, going inside buildings was a death trap. The enemy would corner you then call in their artillery."Guard this corner," he told the driver. "I'll be checking up on you." The frightened soldier nodded, then took up his post. Now he had a few seconds to consider his position. He was running out of town to retreat through. Behind him lay open fields. Just then he saw the tale-tell site of a Dragon Anti-Tank missile firing from the next raised roadway to his rear-right.He couldn't see if it hit anything. There was no huge explosion. Still, it indicated that other elements of his battalion were in the fight. From what little briefing he had been given when the attack started, the major had placed his heavy machine guns and recoilless rifles on each flank to stop the enemy's mobile forces from getting around his command and surrounding them.Little did the soldier understand he was involved in a textbook defense by foot-bound infantry versus armored opponents. His two townsmen were busy shoving bullets into the thirty round magazines. His men had already engaged the enemy to the front. Gone were the cries of 'got him'. No one gave a damn anymore. They were too exhausted to care. Now they counted the comrades they had left, not the possible number of enemy out there.Six minutes later he heard the sound of death coming his way."Everyone down," he screamed a second before an artillery round flattened their shelter. For a few moments all he could do was gaze up at the heavens. His body hurt, his ears were ringing and the belief that he could stop now, he had given it his best shot and his part in this battle were over.He pulled himself and examined what he had left. He wasn't hurt if you didn't count the blood coming out his ears. He couldn't say the same for his companions. One of the townsmen had the top of his head torn off, his soulless eyes gazing up to the forever. One of his men had a smoking chunk of meat where his spine should have been. A second one was nursing a bad leg wound.The third soldier? He was already up and firing. The second townsmen was a bit dazed, yet looked like he could carry on. The soldier crouch-ran to check on the driver. He was laying on his belly. For a second he mourned for that fellow then the man got off a burst, then scooted back. He had been 'playing possum' in order to draw some enemy out. He was alive and fighting."We have got to get out of here," he told the man. "Get to the elevated road across the field then provide cover fire for the rest of us." The driver acknowledged the command, fired off one more burst then bolted for the field. The Thai made his way back to his other survivors. He gave them the same order, the civilian first.The wounded man? He couldn't make it with that leg wound and if any of the others carried him they would most likely die too."Cover us as long as you can," he ordered. The wounded shoulder crawled to the corner to relieve the only standing soldier."Go," he ordered that man. Off he sprinted. The leader placed two spare clips next to the wounded man, wished him luck, then it was his turn to sprint to safety. Close to the end, a few bullets hurried him along. He found the others had made it unwounded as well. The townsman was already shoving more bullets into the empty magazines.To his right was the remnants of the squad with the recoilless rifle and a light machine gun. To his left was a group of six Thahan Phran, paramilitary border guards. He rejoined the firing line. The enemy had overrun the buildings closest to them and were faced with the same quandary he had just overcome, the open field. When a man tapped his shoulder he nearly jumped out of his skin.It was his company commander."You've been doing well. I'm placing you in command of this section. We have a Carl Gustav (another version of a recoilless rifle) in the trees over there," the Captain pointed to the right. Hold this position as long as you can. Help is on the way."Before this fight, the soldier had dreaded this officer. He had been so pompous, so spit-and-polished and arrogant. Now he saw different qualities in the man. He was cool under fire, had his mind on the bigger picture of the fight and the discipline he had instilled in his men was paying dividends the private soldier hadn't appreciated at that time."You are Sip Tho (corporal) now," the officer told him. With that declaration, the common foot soldier had inherited 13 more men, the squad of seven to his right and the six Thahan Phran to his left. Combined with his two that made something more like a combat command. The Captain made his way back up the line. The Thai didn't have long to appreciate his promotion. Smoke shells began detonating between his position and the town, obscuring the place."Remember," he shouted. "Short, controlled bursts and only shoot at something that you know is out there!" With that, he had established his command of the situation. Several explosions detonated in the wooded position. Half a minute later, a tank appeared and pumped another H E into the position. In doing so, it exposed its side to Thai's section.The two men manning his Dragon launcher looked his way. It was a shot at a 45 degree angle and any heavy weapons fire would bring about all kinds of hate."Fire," he ordered. The man aiming the device took a few seconds then let loose. The rocket didn't penetrate the side, but it did knock a track out."Now we are going to get it," the Thai mumbled.A few heartbeats later, a larger TOW missile slammed into it from a position to his command's rear. This time the tank blew up. Of equal importance to the soldier's mind, there were men behind him and that could only mean, the second regiment had finally arrived. He was sure he wouldn't be falling back any further, giving the invaders one more inch of sacred Thai soil. It also meant his men would most likely live to see the end of the day. That mattered too.  It was H-hour plus six. Two hour earlier, elements of the Vietnamese People's Army's 314th Mechanized regiment and 206th Tank Regiment with the Mobile battalion of the Laotian 1st Division and the Khanate's Laos Force Command slammed into Khon Kaen. By that time, the small city had already seen its share of hell. Khanate forces had stormed the regional airport with an aerial assault at 4:10 AM that morning.There were no dedicated combat troops in Khon Kaen. It was the HQ for both the Royal Thai 3rd Division and its component 1st regiment. That had resulted in a see-saw battle until the relief force arrived from the north. After that, resistance had collapsed. Over three hundred men surrendered. A hundred miles to the north forces in the town of Udon Thani, battalions of the 1st and 2nd regiments of the 3rd Division were still in combat with Laotian and Vietnamese forces. The final outcome of that battle had yet to be decided.What did matter was that the entire command structure of northeast of Thailand had been neutered. There were five more battalions out there that had no idea what to do next. They suffered from sporadic air attacks, but nothing serious was coming their way.What none of them were aware of was that a Far North Force out of the Laotian highlands had broken a battalion of the Royal Thai's 6th Infantry Division, taken Roi Et and severed the communications between the two formations. At Roi Et, the Khanate armored spearhead had left elements of the 2nd Regiment of Lao's 4th Division to hold the airport and was blazing a trail westward along Highway 23, to the south/rear of those five battalions.South of Roi Et, two other Thai battalions were grudgingly giving ground to a regiment of Vietnam's 305th Division plus the 270th Combat Engineers and 16th Artillery Brigade. What mattered was that those forces were drawing off the efforts of the 6th Divisions to counteract the invasion.The 6th Division had its own litany of woes. It was the subject of a dozen pinpricks. The division's commander had lost contact with the other two divisions under the 2nd Army's command. He had enemy forces to his north around Amnat Charoen, he'd lost contact with this 1st regiment HQ at Roi Et.His second regiment, at Ubon Ratchathani, was heavily engaged with the Alliance's North Force. His 3rd regiment, spread out along the southern approaches to his life line, Highway 24, had discovered small teams of Special Forces at every bridge and crossing, making every attempt at creating a unified front costly and ultimately futile.The 2nd Army's HQ and supply hub were at Nakhon Ratchasima. They were under attack, the airport had fallen and the sole mechanized regiment (minus one battalion) was having a terrible time retaking it. They were presently incapable of coming to his defense, since their third battalion had already been called to the capital to put down unrest/enemy forces.He finally made his decision. The remnants of the 1st regiment were to retire westward over the back roads towards the division headquarters at the Si Sa Ket Railway Station. The second regiment was to hold in place until sunset. Using all of the division's remaining assets, he was going to secure Highway 24 so that his command could retire using that path before they were cut off and defeated one regiment at the time.  It was H-hour plus seven. For one of the drivers in a Khanate Heavy Mountain Supply Zuun, there wasn't much to love about this mission. He was a truck driver with a weapon, not a true foot soldier. He was content with his role in logistics, which was why his current mission scared the crap out of him. He wasn't in an armored vehicle and was accompanied by only one Fast Zuun ~ by its very nature a lightly armored unit. Now he was driving deep into enemy territory with a truckload of Karin freedom fighters, who also were lightly equipped.He had already reached the first goal, the town of San Buri, 270 kilometers behind enemy lines and only 60 kilometers from downtown Bangkok. There was a fear that his own air force would mistake then for an enemy supply column and shoot them up. Then there was the fear that some rear echelon troops would find the convoy suspicious and fill his unarmed vehicle with holes. His luck held, the enemy were looking to the north and east, not at a group of trucks heading south.Soldiers from the rebel faction of the Thai Royal Army were stationed in each vehicle to cover any conversation with the local constabulary that might come up. The cover story was that the unit was driving with a purpose ~ the capital was under attack and they were reinforcements using back roads to avoid airstrikes ~ the phone network was a mess and the fact that the plan was so audacious, the normal police officers didn't feel the need to slow the military trucks down.The last phase was pure madness. They rolled down Road 304 at 80 kph. Every time they approached a checkpoint, the unit's commander called in a hopefully faux airstrike, on both them and the Thai soldiers. That made it plausible for the convoy to race forward as the troops around them were too busy diving for cover to stop them. If anything, the defenders thought those truck drivers were the bravest men they'd ever seen.At the end of the journey, they rolled across the Road 304 Bridge over the Chao Praya River, then dispersed. Each truck disgorged 16 Karin fighters, for a total of 560. To that was added the 100 members of the Fast Zuun and 35 drivers, three Tigr's and 59 combat troops. Miracles of miracles, they found the capital to be in total chaos.  It was H-hour plus 6 and a half. The Turkish Khanate commander of 100 looked south in the direction of In Buri. He was already in the 'spread chaos' phase of his operation. The central part of In Buri was the junction of Highways 11 and 32. Somewhere to the far north, friendly units were fighting their way to him. Forces retreating south, or reinforcements from Bangkok would have to pass through his position. He commandeered some passing civilian vehicles and created barricades on all three sides of the T-cloverleaf.Before long, the ground elements of an Airmobile Zuun had joined him. That allowed him to deploy several two-man observer teams over the surrounding countryside. He left two AFV's on the bridge and camouflaged the others in the best ambush points he could think of. Then, he waited.  It was H-hour plus eight. For Julia Atwood, this was the culmination of twenty-five years working in Asia, covering a host of military conflicts and both natural and man-made humanitarian disasters. She'd gotten a tip two days earlier that Bangkok Thailand was going to be the place to be. Since she wasn't a known anti-government reporter, her entry into the country had been easy enough.She had spent the previous day picking a city guide, luckily finding one she knew well, and looking around for sources of information about 'trouble'. What she found was a quiet city on the edge of an explosion. The police, paramilitary forces and the military had everything battened down tight. At the same time, the population was extremely anxious over the upcoming loyalist offensive against the rebel northwest.The military had clamped down on all information coming out of the prospective war zones while exhorting on all forms of mass media the sacred traditions of Thai national identity and the need for law and order. That made the hairs on the back of Julia's neck tingle. It spoke of an upcoming shit storm. Still, Day One had been a bust. Few people wanted to talk about what was going on; all known opposition leaders were in prison or in exile.She had awakened early in the morning to the sound of heavy weapons fire. She had been in enough war zones to know the difference between grenades exploding, or pistol, assault rifle, machine gun, and tank fire. She was hearing tank fire, which made no sense. The Thai army didn't need to use their tank's big guns to fire at anything the opposition could bring to bear.She slipped out the back of her hotel to avoid any possible police minder, gathered up her guide and went hunting for the story. Twice she barely avoided roving army patrols. What immediately occurred to her was these soldiers didn't seem to know what was going on. They were jumpy (not good) and nervous (great for a story).Her trained ears and years of instinct led her to one of the eyes of the storm. Julia's jaw nearly dropped open. There were Central Asian men riding around in Russian equipment surrounded by throngs of hundreds, possibly thousands, of Thai 'Red Shirt' protestors marching on a police barricade. Several leaders of the movement had bullhorns and were communicating with the police. It was a tense situation.Julia forced her way to the BMP-3M, then shouted up at the commander standing in the copula. She tried Uzbek. The man looked her way."No. I'm Kazak. My Uzbek isn't very good," he replied. Julia's Kazak wasn't the best in the world, but she endeavored to make it work."What are you doing here?""I could ask you the same thing," the man smiled. "We are part of the Alliance effort to bring about democratic change in this country." Julia knew he was spouting the party line."What are you really doing here?" she pressed."I have no idea," he chortled. "I don't speak this language, don't know who these people are and only found out where Thailand was two days ago.""Are there a lot of you here?""Not really.""How did you get here?""We landed at the airport. We are a portion of an airmobile Zuun."Just then one of the protestors tried to get the unit leader's attention. He kept repeating something."He wants you to advance on the police line and look menacing," she translated."Okay," the Khanate officer shrugged. "That I can do."He spoke rapid fire Kazak, which Julia couldn't quite follow. Her ride lurched forward, the crowd parted and she could see the blood drain out of the police commander's face. Without looking her way, the Kazak spoke to Julia."Tell them they have thirty seconds to put down their arms or I'm going to shred the lot of them."Julia thought about it for a second. She was recording this exchange on her camcorder. She knew this was straying dangerously close to becoming a participant, not a reporter. She translated to the Thai young man. He sprinted toward the police and relayed the message. She had no idea what a 100mm fragmentation shell would do, had an idea how bloody a 30mm auto-cannon could get and had great familiarity with the effectiveness of 12.7 & 7.62mm machine guns.The lead protestor had a rapid discussion with the lead policeman, bowing and begging for this situation to be resolved peacefully. The countdown reached eight when the officer indicated his acquiescence. The mob didn't surge forward victoriously. Julia slapped the turret to get the Kazak's attention."You don't need to fire.""I understand that," the man acknowledged. It wasn't over though. Another protestor, a woman, waved for the Kazak's attention. Since she wasn't alone in doing so, the man hadn't noticed her. What she was saying did get Julia's attention."She is saying that tanks are on the way!" she shouted at the man in the copula."Which direction?" he inquired. Julia confirmed the information relayed by the girl, who double checked with the person on the other end of her phone, worked out the terrain in her head, then drew a quick map on her palm."They are coming up the road one block up. They are heading north toward us.""Clear out the crowd," he responded evenly. He once more ordered his unit to action. One of the Tigr's raced forward and disgorged its men close to the next corner then the vehicle withdrew."What do you plan to do?" she asked."Do what I came here to do, kill the enemy.""But they have tanks.""Fortunately I have things that kill tanks," he grinned."Do you mind if I stick around?""It is your life," he shrugged. The BMP moved forward to the point where, with its barrel turned sideways, the vehicle was just short of exposing itself. He was busy talking to someone else.Seconds later, one of the Khanate soldiers at the corner launched a grenade up the street, then two others opened fire with their assault rifles. They ducked back around the corner right as a larger caliber machine gun chewed up the wall as well as the street in front of her. Two other soldiers fired off flares into the sky."You might want to get down," the Kazak advised her. Julia nodded, jumped off and ran to the corner to join the other troopers. She edged around the corner, leading with her camcorder. Sure enough, up the street was an honest-to-God tank, with others behind it. One of the foot-bound Kazaks was busy shouting at the others. Once more, a soldier fired a grenade at the tank, to no visible effect. This time he apparently got the response the Kazaks wanted.The tank's big gun fired. One of the troopers, mindful of Julia, grabbed her as they propelled themselves to the ground. The world exploded. Julia was doing a quick check of her well-being when she heard the BMP race forward, barrel turned perpendicular down the street and then it fired. Julia barely caught it all on her camera. The IFV had fired an anti-tank missile out of its main gun. The oncoming tank was a Ukrainian made T-84 Oplot.It exploded; the turret flying away in a curtain of flame. This time it was the blast that blew Julia to the ground. A Kazak soldier hefted her up and pulled her to safety. He was truly pissed when she dodged back into the danger zone to retrieve her camcorder. She sighed happily when she found it undamaged. The BMP rolled back behind cover."Get down," the Kazak ground pounder growled. "It is about to get a whole lot worse.""How?" she looked at him."Well, now that we have stopped the column from moving," he grinned like a maniac. That wasn't much of an answer. Then she noted all the Kazaks clutching at the concrete sidewalks. She did likewise. Seconds later, she heard the jets. 'Oh God', she gulped. She'd seen more than her fair share of airstrikes. She had never been this close to one.Out of the corner of her eye she noticed the Thai crowd moving closer."Get down," she screamed in Thai. "Get Down!"Others repeated her warning and the crowed went down to their knees. Then came the thunder. Julia could barely make out the whoosh of missiles before the detonating rockets and missiles shook her world.A stubby-winged jet raced past her vision. The pilot had gotten so damn close to the building tops she could make out every feature of his aircraft. This level of caution where civilians were concerned was surprisingly unlike the Khanate. She tried to stand, but the soldier next to her had wrapped an arm around her."They come in twos," he cautioned her.Sure enough another series of explosions rocked her surroundings. No sooner had she gotten to her feet, the Kazak commander shouted,"They are coming around for another pass, then we go!"A series of passes followed with the jets using auto-cannons on whomever was left out there.Julia pushed away from her guardian and rushed up to the BMP officer."Wait," she called to him. Stunningly, he waited, looking at her. "Let the crowd save the survivors. This is their struggle too.""If the soldiers fire on them there will be little I can do," he responded."Give them a chance."Against all her expectations, he did. The crowd moved to discover the carnage visited on their oppressors, and fellow countrymen.  It was H-hour plus eight. The Thai tank commander was close to the end of his rope. He'd been fighting since sunrise. Defend, attack, withdraw to a defensive position then wait for the order to counterattack. His platoon had dwindled down to his sole surviving tank. His company no longer acted as a separate entity. Now his battalion, barely a company in strength, operated as a fire brigade, shoring up his beleaguered battle group.The last attack, backed by air power, had shattered his unit. He fell back, literally backing into a second story building to avoid the ever-present Alliance attack helicopters. From his vantage point he could see a column of armored vehicles rolling down Highway 11. He was debating which one he would fire on first when he noticed a jeep coming his way. Onboard were three Thai soldiers, rebels.The jeep rolled right up to his hiding spot. The man in the back dismounted and he walked right up to the tank."Can we talk?" the man inquired. The tank commander kept him covered with this machine gun."What do you have to say, traitor?" he barked."I come to request,""We will not surrender," he growled."We are not asking you to surrender," the man corrected him. "We are asking you to let the war pass you by.""Why should I?""If you fight, you will be destroyed. The Thai army will need to rebuild when this is over and we must be strong. If you throw your life away, we will all be weaker."The tank commander had to think that over. If he began firing on that armored column he would be striking a mighty blow for his country. He would also be sentencing him and his men to death."There will be no surrender?""No sir," the man insisted.The rebel soldier made some sense. The Thai military would have to rebuild when this catastrophe was over. He and his men had done their part."We will stay here for a while," the tank commander informed the rebel."Very well," the soldier bowed. He remounted his jeep and drove away."We are going to stay here a while," he addressed his crewmen. "Get a bite to eat and a drink of water."His men hesitated for a moment."Now, while we have the chance."The men hopped to. They had their orders. They would worry about the morality of their actions later.  It was H-hour plus nine. The men in the Royal Thai Army's high command were finally getting ahold of the big picture. The good news was the Third Army's offensive was grinding to a halt along a line stretching along Highway 1 from Tham Pet Tham Tong Forest in the east to Chai Nat on the Chao Praya River in the west. It was accepted as fact that the 3rd Cavalry and 11th Infantry divisions could hold the line.West of the Chao Praya was a chaotic mess of small garrisons involved in raids and counter-raids. It was deemed unlikely the Alliance forces could push forward any further in that direction either. It also meant that they couldn't pull units from that region to reinforce any of their other trouble points and they had a few.That was most of the good news.Another piece of good news was the1st Army's 2nd Infantry Division had stopped the invasion force they were facing only a few kilometers over the frontier in the area of Watthana Nakhon District. As soon as they had gathered the majority of the division together, they would be mounting a counter-offensive with the intention of overwhelming that force and destroying it.After that, it only got worse.In the area of the 2nd Army, the 3rd Infantry Division and the 2nd Cavalry Division had virtually ceased to exist as cohesive forces. Two battalions of the 3rd Division were retreating south into the 6th Division's area. The 2nd Cavalry division had been reduced pre-battle to one mechanized regiment. That regiment was gone and with it, the supply routes for the 2nd Royal Thai Army.Inside that zone, the 6th Infantry Division still existed, but it was in a world of trouble. They had lost control of Highway 24, their primary supply/evacuation route, and were relentlessly being driven out of Ubon Ratchathani. Even with the slowly arriving battalions of the 3rd Division, the 6th could barely muster two combat-effective regiments and those were running short of fuel and ammunition. The 6th had become a static force, too large to be overwhelmed, too immobile to press the enemy out, or save themselves from a slow strangulation. Had they their assigned tank battalion, but they didn't.The 1st Army's 9th Division was in the worst shape. They had gathered into one elliptical shaped perimeter centered on Chanthaburi and were down to four battalions and two tanks. Technically, they had another battalion, except the 1st Army command had ordered that into Bangkok to aid in suppressing the rebel movement. The 9th Division was surrounded, under attack from the land, sea (the Indian Navy had joined the fight) and air. Their commanding general expected to be wiped out before sunset.And Bangkok?It was turning into a typhoon scale disaster. They had finally determined that there were eight small Khanate platoons roaming the city, seemingly at will. The 1st Division had finally located and destroyed one of those, along with a dozen protestors who chose to fight by their side. The others were still at large and causing trouble.That wasn't the worst of it though. The plan had been to pacify outlying neighborhoods and work their way in to the worst areas. That had started out effectively, then suddenly they had lost the northwestern and southeastern sectors. In the northwest, there were Karin fighters killing, or capturing police and paramilitary strongpoints.In the southeast, it was much worse. Unknown armored troops from the 9th Division's rear area had come seeping in along the riverfront. They seemed to be everywhere at once, surprising roadblocks and checkpoints then ambushing the forces sent to restore order. They were a cancer pushing into a city already short on reserves.There were public displays of defiance going out over the international news, surgical air strikes and a growing sense among the rank and file 'Guardians of the Public Order' that they were on the losing side. There were reports of police turning their backs on the unrest, directing traffic and arresting petty criminals instead.The Royal Thai Army in Bangkok still had over 50,000 men under its command. They were sure they were facing less than a thousand hardcore militants, yet they were losing control of the streets. Part of that was caused by the military being tied down to certain strategic areas they had to hold. They had to protect over a dozen buildings and, as they had painfully learned, a platoon wouldn't do.The Government House had been temporarily overrun and Parliament had been shelled. Channel 3 had been hijacked and the forces sent to take it back had been subject to intense helicopter attacks and driven back. They'd killed two such craft, but that only seemed to make the Alliance troops angrier. This was what a death by a thousand cuts felt like. This was worse than bad, because it looked bad on media going out all over the world.  It was H-hour plus twelve. The commander of the MARCOS had finally taken the time to eat. He was in the Maleenont Towers section of Khlong Toei, Bangkok. It had been his masterstroke, seizing the Channel 3 station. He wasn't sure who the eight shady characters who showed up with the VIPs were and he didn't really care. What did matter was while the VIP's fought like wildcats in private they were putting on a unified front while on TV.One of the VIPs was the former civilian Prime Minister of Thailand. The other guys seemed to hate her guts, but were willing to work with her to overthrow the generals. What he did care about was the nearly five hundred men under his command plus a dozen helicopters and jets somewhere above, waiting to swoop in and help when the next government attack materialized.He had to give them this much, the police forces had guts, not a lot of brains, but plenty of guts. Their counter-terrorism unit had known their stuff, but they didn't have any effective anti-tank weapons and he had a half dozen tanks. Whenever the army got feisty, he called up 'Shiva's Fist' ~ his men's joking reference to the Khanate air support. Those bastards not only killed you, they came back around and killed your corpse too.He got a call from the perimeter. Some of those Karin fighters had crossed half the city to join them. The Indian officer had thought that part of the Khanate plan was utter madness, yet here they were, shooting up the place in a manner only highly experienced insurgents could. Those guys didn't even want to hang around. They were asking for more ammo. The locals were giving them all the food and water they needed.At nine, once it was truly dark, the Khanate was promising to drop off a few tons of whatever they need plus some more medivac units. He was down nine men dead and twenty-seven wounded badly enough they need to be removed. The Khanate had lost four times as many. All in all, the overthrow of a military regime was turning out to not be as difficult as he thought it would be. He was waiting to be surprised.  It was H-hour plus fifteen. The fighting had died down and now the main activity was the Thai civic authorities fighting the fires burning in Saraburi. The Khanate Commander of 1000 looked over his shoulder at the burning city. It hadn't been much of a fight, mainly a few rear echelon forces from the Royal Thai 2nd Army and some paramilitaries.He wasn't in the town. The majority of his troopers had already rolled down to the junction of Highways 1 and 33. He had communication with other elements farther west on Highway 32 at Ang Thong and to the northwest at the junction of Highways 1 and 32. The offensive operations was essentially over for his command. That was just as well. He was running low on petrol. He still had plenty of ammunition though.They were sitting on the lifeline for the 1st Army's 3rd Cavalry and 11th Division to the north and the 2nd Division to the east. The 6th Division was too far in his rear to matter and the 9th Division was facing annihilation along the coast. It was very dark now, but the air force was still active. Some pilots were flying their sixteenth mission of the day.For most of the day, the Khanate Air Force had concentrated on his axis of advance and the battle in Bangkok. The Vietnamese Air Force had concentrated on the hapless 9th Division. In reality, the Alliance was almost at the end of its tether.His combined Laos and Far North Task Forces were spent. The North and Cambodian Task Forces had the 6th Division pinned down. The South Task Force had done the same with the 9th. Only the Central Task Force facing the 2nd Division appeared to be in serious trouble.None of those formations were actually near defeat, though many of them wouldn't realize that until morning. Only the 3rd Army's two task force had consisted of more than 5,000 hastily gathered troops and most of those were Cambodians, Laotians and Vietnamese. To that the Khanate had added 50 mobile Zuuns spread over ten task forces and another 50 airmobile, parachute and airlifted units ~ less than ten thousand men and women spread over all fronts.The cold, hard reality for him was that not a single loyalist Thai unit had been destroyed. The 3rd and 9th infantry divisions has been battered, that was true. The majority of their mobile forces, the 2nd and 3rd cavalry divisions, still existed as a potent force. The 11th and 2nd infantry divisions were also out there, but they were all cut off from the capital. And in this elegant global play, the one theater that mattered was Bangkok.In the morning, if they came for him, the loyalist Thai's were going to discover that offense was a lot more painful that defense. Only the 2nd Division bothered him. The forces to the north were too heavily engaged with the rebel Thai 3rd Army to dispatch more than a battalion his way and he would gobble up a battalion.It would be too much to ask the battered Alliance Center Task Force to keep the 2nd Division occupied. From what he had heard, they were on the verge of disintegration after a powerful Loyalist counterattack. He did have patrols on the 304 and 359 Roads in case their commander got creative. What those few men lacked in vehicles, they would compensate for with air power.The Khanate Air Force was a 24/7, all-weather operation. They had lost 40 aircraft to enemy action and a further forty to mechanical malfunction. Losses in helicopters was also high. But there were still enough of both to get the job done. Now all he had to do was wait for the Americans to arrive.  It was H-hour plus seventeen.There were only three major acts left in this macabre play before the eyes of the world. A squadron of 12 Tu-22M bombers found two of the 2nd Division's regiments sneaking to the west. The Thais had done this with as much secrecy as they could. Unfortunately, their move was one of only two option left to the Loyalist Royal Thai Army.Option One, the most likely one, had the 2nd Division attacking the Khanate troops south of Saraburi. It would not only give the 2nd Division freedom of movement, it would establish supply lines to the divisions currently holding the rebel Thai Third Army at bay. It was the predictable choice.The Khanate U A V were out there, scouting for them and when they spotted the three columns using the backroads to approach their attack positions, they relayed that information to a not-so-distant A-50E/I. The squadron of waiting bombers had incredible endurance and had been circling the suspected target area for three hours. They broke up into groups of six then into groups of two. The first two lined up on their targets then unleashed their lethal cargo.Each plane dropped sixty-nine 250 kg bombs. That was138 bombs with a combined explosive power of 75,900 lbs. spread out over three-quarters of a mile. The A-50 assessed the damage for 7 minutes before sending the second set of two in. Another 138 bombs. Another 75,900 lbs. of death. The third group wouldn't be needed. In ten minutes the fighting power of the 2nd Royal Thai Infantry Division had evaporated.Option Two? That called for the 1st Infantry Division, with her added units, to sally forth from Bangkok and rescue the trapped elements of their other divisions. That would have entailed abandoning large areas of the capital to the protestors and the tiny groups of invaders that were helping them. No one thought they would do that and they were right. Had they been wrong, there was another squadron of bombers waiting for them.  It was H-hour plus nineteen. The Thai Phon Thahan-turned-Sip Tho looked out into the darkness. Four hours ago he was anticipating crossing the Cambodian border and burning down their town for a change. Now, now it was wait-and-see. The majority of the division had withdrawn for a long night march to the west. From what he had gathered, the 2nd Army had been pummeled and it was once again the time for the 2nd Division to save the day.He spotted movement in front of him. He glanced over to his 'sniper', a Thahan Phran who was the best shot in his unit and had a taste for the task. The man had the target in his sights."I come to parlay," the voice in the darkness shouted in less than perfect Thai. The Thai soldier had to think what that meant. His instinct was to shoot the man. His training taught him to not make choices above his pay grade."Advance. Don't do anything stupid," he called out. To the man next to him he whispered, "Go get the Captain." The man slunk away. No one alive in the unit stood up to do anything. You even pissed crouched down. The man coming toward him was a Cambodian. It was evident in both his gear and accent. "What do you want?""We want a truce," the man replied. He remained very erect, his hands in the air and only made slow, careful movements."I should shoot you," he growled."That would be unfortunate for both of us. I would, of course, be dead, and my allies would open up with our artillery."The conversation was truncated by the captain's arrival. They went through much of the same routine, absent the 'I should kill you part' and the counter-threat. The captain turned to the Thai soldier."Blindfold and bind this man's hands then take him to the Phan Ek (Colonel). Let him figure this out."Without the soldier saying anything the Captain added, "This could be a ruse. I must stay here. Hurry."He nodded, took a shirt from one of the civilian volunteers, cut it into strips then blindfolded and bound the man."If you so much as sneeze, I'll put a bullet in your head," he warned the man."I understand," the Cambodian replied. The soldier took the Cambodian one block behind the lines, spun the man around several times, then led him toward the command bunker. He spun him around twice more before making his final approach. A wounded junior officer met him at the entrance."Come on," he took custody of the man. Having nothing else to do and not having been ordered to release the prisoner, the soldier followed along.The Regimental Commander had the man un-blindfolded. His hands remained bound."What do your masters want?" the Major snapped."They want a truce," the Cambodian blinked in the sudden bright light."You invaded us without a declaration of war. That makes you criminals, not combatants.""We attacked at the request of the legitimate authority in Thailand, the Commanding General of the Royal Thai Third Army.""Those men are rebels and you will not refer to them as anything but," the Phan Ek insisted."Very well. My Commander wishes to let you know that our mobile hospital has arrived. We wish to exchange prisoners and place our facilities at your disposal as well.""The Royal Thai army will be there soon enough," the Major glowered."Unlikely. Our Khanate allies have informed us that most of your division was destroyed on the road. You have one battered regiment and a handful of tanks. You are not going anywhere."The soldier wanted to slap the smug smile off the man's face."I do not have the authority to hand over prisoners until their status as POWs or criminals has been established," the senior officer countered."If you consider our men criminals, we will treat your men like traitors.""Are you threatening me?""Yes. A fact you should be aware of is that the Khanate has been flying in reinforcements since noon and we have five more armored, mechanized and artillery Zuuns to attack with. Come sunrise, we will be coming at you again unless we have a truce.""Now you are threatening us again," the Phan Ek pointed out."I am explaining the realities of your situation, nothing more," the Cambodian countered. "Our task force commander believes that further violence will be futile. You have done your job and we have done ours.""And your job was to keep us occupied so you could rape and pillage other parts of our country?""No sir. The Alliance forces have been operating under very strict guidelines. The Thai people are our allies and we are a liberating force," the Cambodian replied."You consider this town 'liberated'? You've destroyed it," the Phan Ek noted."It was unfortunate that you chose to fight us here."The Colonel studied the man silently for thirty seconds."I will agree to a two hour truce. That should allow me to contact my superiors for further clarification on my mission. We will hand over any critically injured 'invaders'. You will return any POW's you are holding in exchange.""Agreed," the Cambodian immediately responded."Just like that? It is really within your authority to make such a deal?""As I said earlier Phan Ek, we believe the fighting is over. We don't need your captured men. We would like to see as many as our comrades live as possible. No matter what your commanders say, the fact remains that if you come out of these ruins, you will be slaughtered. You know that. I know that. Peace is the only avenue that leads to any level of success. Today, today, both our forces did what our commanders told us to do. The dying should stop.""Go. The truce will take effect in, fifteen minutes ~ 12:12 am. We will transfer prisoners and wounded at your point of entry. We will both give a warning whistle fifteen, ten, five and one minute before the truce ends at 2:12 am. Do you understand?"The Cambodian repeated the terms of the truce. He was bound up then sent back with the Sip Tho."Do you really think this is the end of the fighting," he asked his blind captive."On the lives of my children I hope so," the man sighed. "I led 88 men into battle this morning and now I'm down to 46 effectives. I have lost too many already for a battle that wasn't in my nation's best interest. I am tired of the killing.""Me too," the Thai said a moment later. After he delivered him to the Captain on the front lines, the man was unbound."Good luck," he found himself saying."Good luck for both of us," the Cambodian gave a weary smile. "May we not meet again.""If I see you again, I will kill you.""I feel the same way," the man chuckled. "We are both soldiers doing what more powerful men have commanded us to do. I don't know about you, but I have had enough." Several Thai soldiers nodded. They had driven the enemy off Thai soil. Continuing the fight didn't seem to have much of a point.  

Dr. Phillip Bennett, a co-director of the March of Dimes Prematurity Research Center at Imperial College London, discusses a historic randomized controlled trial (RCT) that will test a vaginal probiotic's ability to reduce preterm birth risk.

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The JournalFeed podcast for the week of March 17-21, 2025.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Wednesday Spoon Feed:In a RCT of 550 patients with intermediate-risk PE, those who received large-bore mechanical thrombectomy (LBMT) were less likely to suffer clinical decompensation than those who received catheter-directed thrombolysis (CDT).Thursday Spoon Feed:Patients with potentially difficult airways were oxygenated and ventilated in the operating room via an endotracheal tube in the pharynx, which could be applied to a ‘can't intubate, can't oxygenate (CICO)' scenario.

Roger Seheult, MD of MedCram examines a multicenter double blinded RCT on the effects of vitamin D on multiple sclerosis. See all Dr. Seheult's videos at: https://www.medcram.com/ (This video was recorded on March 17th, 2025) Roger Seheult, MD is the co-founder and lead professor at https://www.medcram.com He is Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine and an Associate Professor at the University of California, Riverside School of Medicine. MEDCRAM WORKS WITH MEDICAL PROGRAMS AND HOSPITALS: MedCram offers group discounts for students and medical programs, hospitals, and other institutions. Contact us at customers@medcram.com if you are interested. MEDIA CONTACT:  Media Contact: customers@medcram.com Media contact info: https://www.medcram.com/pages/media-c... Video Produced by Kyle Allred FOLLOW US ON SOCIAL MEDIA: https://www.facebook.com/MedCram https://twitter.com/MedCramVideos https://www.instagram.com/medcram DISCLAIMER: MedCram medical videos are for medical education and exam preparation, and NOT intended to replace recommendations from your doctor.

Send us a textIn today's episode I discuss...-Who is at highest risk of RCT's-Clinical Exam vs MRI-Pain vs function-Advice we might give patients trying to decide if surgery is appropriate and so much more!

Last time we spoke about the fall of Mandalay. Fierce battles raged over northern Luzon as General Clarkson's forces advanced, capturing key locations while Colonel Volckmann's guerrillas targeted enemy positions. The challenging terrain favored Japanese defenses, creating fierce resistance. Despite this, American troops steadily progressed, securing hills and towns. By mid-March, the 38th Division's relentless push led to significant Japanese losses. The brutal history of POW massacres fueled American resolve, leading to further victories in the region, American forces, led by Major-General Jens Doe were given the task of invading Palawan. Despite facing fortified defenses and rough terrain, the 41st Division advanced under artillery and air support. Meanwhile, in Burma, British-Indian forces clashed with the Japanese, capturing key positions and repelling assaults. As tensions rose in French Indochina, the Japanese executed a coup, disarming French forces and establishing puppet governments. The conflict intensified, reshaping the region's power dynamics. This episode is the Fall of Iwo Jima Welcome to the Pacific War Podcast Week by Week, I am your dutiful host Craig Watson. But, before we start I want to also remind you this podcast is only made possible through the efforts of Kings and Generals over at Youtube. Perhaps you want to learn more about world war two? Kings and Generals have an assortment of episodes on world war two and much more  so go give them a look over on Youtube. So please subscribe to Kings and Generals over at Youtube and to continue helping us produce this content please check out www.patreon.com/kingsandgenerals. If you are still hungry for some more history related content, over on my channel, the Pacific War Channel you can find a few videos all the way from the Opium Wars of the 1800's until the end of the Pacific War in 1945.  Today we are picking up on Iwo Jima. By March 10, General Schmidt's Marine forces had finally breached the determined enemy defenses to reach the northeastern shore of the island. However, there were still some Japanese strongholds to eliminate in the central and southern areas. One of these was Cushman's Pocket, named after the commander of the 2nd Battalion, 9th Marines, and located around a devastated ridge overlooking the sea, which housed the stubborn resistance southwest of Hill 362C. The other stronghold, held by General Senda's remaining troops, was established on March 11 after General Cates initiated his final push southeast toward the sea. Consequently, while Colonel Wensinger's 23rd Marines advanced quickly to the coast, Colonel Lanigan's 25th Marines struggled to make headway, as they were quickly halted by intense rocket, mortar, and small-arms fire from Senda's pocket. Unbeknownst to the Americans, Senda had committed suicide on March 8 following the failure of his banzai counterattack, leaving the disorganized Japanese forces in the pocket without leadership. Meanwhile, General Rockey's 5th Marine Division had advanced all the way to General Kuribayashi's last line of defense in northern Iwo Jima, where the battered defenders were prepared to make their final stand. Following a 50-minute preparation involving air, naval, and artillery support on March 11, Colonel Liversedge's 28th Marines launched their attack on the left with three battalions in line, while Colonel Wornham's 27th Marines attacked on the right with four battalions. However, fierce resistance soon forced the combat to close quarters, resulting in the Marines advancing only a few yards—up to 50 yards—across the front. To the right, while the 21st Marines advanced northward to connect with the 5th Division, Colonel Kenyon's 9th Marines resumed their assaults on Cushman's Pocket. The 1st and 3rd Battalions effectively eliminated all resistance in the eastern sector, completely sealing off the area controlled by the Japanese. On March 12, these battalions launched an attack westward toward Cushman's Pocket, with Colonel Withers' 3rd Battalion serving as a holding force on the opposite flank. However, the Marines faced strong opposition and could only advance slowly against the camouflaged enemy positions. To the north, Rocky's units continued to face intense resistance, with Liversedge making no progress and Wornham achieving only minor advances. An intelligence officer with the 5th Division estimated that a minimum of 1,000 Japanese troops were defending the northern end of the island, and stated ". . . there is no shortage of manpower, weapons, or ammunition in the area the Japanese have left to defend." The entire northern tip of the island seemed to be honeycombed with caves and passageways. When a 500-pound bomb landed in the mouth of a cave near Kitano Pint, a big puff of smoke blew out the side of a cliff over 400 yards away, and another bomb landing in a cave entrance in the same area caused a ring of smoke and dust to come up through the ground for a radius of 200 yards around the point of impact. Meanwhile, to the south, the 25th Marines pressed eastward while Colonel Jordan's 3rd Battalion contained the pocket from the north. Supported by tanks, flamethrowers, bazookas, anti-tank grenades, and 60mm mortars, Lanigan's troops engaged in fierce combat with the heavily fortified Japanese forces in the pocket for four days. During this time, Jordan's 2nd Battalion cleared the beach road, allowing the Shermans to move behind the pocket. On March 13, as Withers' 3rd Battalion returned to the 21st Marines, Kenyon's 1st and 3rd Battalions continued their offensive from the east, making significant gains that reduced Cushman's Pocket to 250 yards. Meanwhile, following a successful water-borne reconnaissance of Kama and Kangoku Rocks the previous afternoon, an armored amphibian company landed on these islets without encountering any resistance. At the same time, Rocky's weary Marines maintained pressure on the ridge above the gorge, achieving only slight gains on the right. Fortunately, by March 14, it seemed that the slow, arduous progress of the past three days had enabled the 27th Marines to push through the last strong enemy positions along the northeastern side of the island. As a result, Liversedge was instructed to hold position while the 26th and 27th Marines advanced north and northwest against lighter resistance, successfully gaining up to 1,000 yards by March 15.After armored dozers hacked paths forward, tanks were able to lend support. The flame tanks were particularly effective during this phase and provided "the one weapon that caused the Japanese to leave their caves and rock crevices and run." Army planes flew the last air support missions of the operation on 14 March when five P-51's dropped fire bombs (gasoline and diesel oil mixture) and strafed in front of 3/27 from 1030 to 1100. From then on, the narrow confines of the area of operations prevented use of those planes that had performed so well in supporting ground troops. Artillery and destroyers continued to furnish limited support, firing a preparation for RCT 26 on 15 March and performing night harassing and illumination missions. Meanwhile, operations against Cushman's Pocket entered their final phase on March 14, when Kenyon's 1st and 3rd Battalions finally breached the last enemy defenses by nightfall and completed the cleanup of the pocket two days later. On March 15, Lanigan redirected the main focus of the attack on Senda's pocket to the south, ordering the two battalions in the center to engage aggressively, resulting in a gain of approximately 200 yards and a deep penetration into the left flank of the Japanese's strongest positions. During the night, enemy forces attempted to infiltrate Marine lines from the south, but each attempt was detected and thwarted. Lanigan launched his final assault on March 16, facing only small, isolated pockets of resistance that were quickly eliminated as his battalions advanced toward the beach road. That day, with organized resistance in the 3rd Division's area of operations coming to an end, the 21st Marines were deployed to relieve the 27th Marines on the right flank to continue the northwest attack. With strong naval and artillery support, Withers' 1st Battalion encountered light resistance in its sector on the right, while the 2nd Battalion faced tougher opposition from scattered enemy positions. Nevertheless, both battalions reached the coastline at Kitano Point by the afternoon and began mopping up. To the left, Colonel Graham's 26th Marines also advanced cautiously northwest, with tanks effectively neutralizing enemy positions as the Marines gained about 400 yards. Despite the presence of 500 determined enemy troops still resisting in the western section of Kitano Point and the draw to the southwest, Iwo Jima was officially declared secured by the end of the day. However, on March 17, the battle for the gorge commenced as the 26th Marines advanced under moderate rifle fire, reaching the northern coast before shifting their focus southwestward to confront the gorge in front of the 28th Marines. The gorge in which the last resisting Japanese were now cornered was rocky and steep-sided, approximately 700 yards long and between 200 and 500 yards wide. Rock outcrops cut this ravine into other minor draws that constituted major obstacles to all types of movement. The entire area was ideally suited to the type of last ditch defense the Japanese had adopted. All routes into the main gorge were swept by heavy and accurate fire from machine guns and rifles concealed in cave positions in the cliffs and outcrops. The plan for attacking this strong point called for the 28th Marines, with attached elements of the 5th Pioneer Battalion and Division Reconnaissance Company, to hold the southern rim along the steep cliffs, while the reinforced 26th Marines worked in from the north and east. For the next nine days exhausted Marines carried out a battle of attrition against the thoroughly entrenched enemy. Advances into the east end of the ravine were measured in yards as each cave had to be sealed off before further progress could be made. Flame-thrower tanks, armored bulldozers, and infantry combined operations to provide the power and teamwork necessary to penetrate the last stronghold. As they gradually pushed down the ravine, resistance concentrated around a large concrete structure built into a knoll near the eastern end. After two days of assaults that silenced the supporting positions, engineers used bulldozers to seal a door on the north side and then demolished the structure with five charges totaling 8,500 pounds of explosives. Nevertheless, the battle of attrition persisted, and it wasn't until the end of March 24 that the pocket was reduced to an area of about 50 by 50 yards at the northwest end of the draw. The following morning, units of the 28th Marines, which had taken full responsibility for the pocket, reached the coastal cliffs to finally eliminate the last remnants of resistance in the gorge. On March 20, the 147th Regiment, set to take over the defense of Iwo Jima, arrived from New Caledonia, and by March 24, it had relieved the 21st Marines to establish night ambushes and patrols. The Japanese defenders fought tenaciously until the very end, choosing death over surrender. However, Kuribayashi had one final assault planned. In the pre-dawn darkness of March 26, the final act of the tragedy was performed. Between 200 and 300 Japanese troops from Death Valley and other scattered positions on the west coast silently crept through the ravines of the 5th Division sector headed for a tented area between Airfield No. 2 and the sea occupied by a mixture of Seabees, Air Force personnel, Shore Parties and AA Gunners. Most of them were sleeping, secure in the knowledge that the battle was virtually over. In a coordinated three-pronged attack against unsuspecting Marines and Air Force ground crews, aiming to create maximum chaos and destruction. Kuribayashi and his men stealthily cut through tents, bayoneted sleeping soldiers, and threw hand grenades, resulting in the deaths of around 44 Airmen and 9 Marines. The noise soon alerted troops from the surrounding area, and Marines from a nearby Pioneer Battalion, african american troops from a Shore Party, and soldiers from the 147th Infantry joined battle in a frenzy of shooting, punching, kicking and stabbing. Once the initial surprise wore off, the defenders retaliated, engaging in a chaotic hand-to-hand combat until the 5th Pioneer Battalion quickly organized a defensive line and halted the attack. Dawn revealed the full extent of the carnage in the ruined encampment: 44 Airman and 9 Marines lay dead with a further 119 wounded; of the attackers 262 were killed and 18 captured. Lt Harry Martin of the 5th Pioneers had hurriedly organized a defense line during the attack and single-handedly killed four enemy machine gunners before dying himself. He was to be Iwo Jima's final Medal of Honor hero, bringing the total to an incredible 27.  The circumstances of General Kuribayashi's death have always been shrouded in mystery. Over the years various sources have suggested that he died in the fighting around Death Valley or that he killed himself in his HQ. According to General Kuribayashi's son, Taro: “It seems that it was after sunset on March 25 to the dawn of the 26th that surviving Imperial Japanese forces were obliged to stand still under the US onslaught and showering shells. Under such circumstances, he had his sword in his left hand and ordered the chief staff officer, Colonel Takaishi, who was beside him, 'Send snipers to shoot'. Sargent Oyama heard the order. Oyama, who was seriously wounded in the last combat, fell unconscious, was hospitalized by the US and after having served as a POW came back and testified the dreadful account of the night to me. My father had believed it shameful to have his body discovered by the enemy even after death, so he had previously asked his two soldiers to come along with him, one in front and the other behind, with a shovel in hand. In case of his death he had wanted them to bury his body there and then. It seems that my father and the soldiers were killed by shells, and he was buried at the foot of a tree in Chidori Village, along the beach near Osaka Mountain. Afterwards General Smith spent a whole day looking for his body to pay respect accordingly and to perform a burial, but in vain.” Following the destruction of this final force, the capture and occupation phase of the Iwo Jima operation was declared complete. Over 34 days of combat, approximately 18,000 Japanese soldiers were killed, and 216 were taken prisoner, while the American side suffered heavy losses: 6,821 killed, 19,217 wounded, and 137 tanks destroyed. On April 4, the 147th Regiment took over full responsibility for the ground defense of Iwo Jima as the Marines were departing the island. Throughout April and May, aggressive patrols and ambushes by infantrymen resulted in an additional 867 prisoners and 1,602 Japanese killed, with the Americans losing 15 killed and 144 wounded. Meanwhile, General LeMay's 21st Bomber Command continued its firebombing campaign against Japan. After the successful Tokyo Great Air Raid and a less effective attack on Nagoya, LeMay decided to send 301 B-29s on the afternoon of March 13 to strike Osaka. Despite having to use radar bombing due to cloud cover, American bombardiers achieved a denser and more uniform bombing pattern than the impressionistic methods employed in Nagoya. This resulted in the destruction of 8.1 square miles in the city's core, including commercial and industrial areas, and caused 13,129 civilian casualties, with the loss of 2 bombers and 13 others damaged. Keeping up the intensity of the firebombing campaign, LeMay dispatched 307 B-29s to attack Kobe on the night of March 16. They faced 314 enemy interceptors, which proved ineffective against the Superfortresses unleashing fire over the port. Consequently, the fire on March 17 spiraled out of control, obliterating the eastern half of the business district and devastating a significant industrial zone to the southeast, including the Kawasaki shipyards. Japanese statistics show that the destruction was appalling. About 500 industrial buildings were destroyed, 162 damaged. The loss of 65,951 houses left 242,468 persons homeless. Police reported 2,669 dead or missing and 11,289 injured. Although the destruction was devastating for the Japanese, LeMay was disheartened to find that only 2.9 square miles of the city had burned. To complete his campaign, LeMay sent 313 bombers back to Nagoya on the night of March 19, utilizing radar techniques to cover a large portion of the city. This resulted in the burning of 3 square miles, including the Nagoya arsenal, freight yards, and Aichi's engine works. With an average of 380 aircraft, the 21st Bomber Command conducted 1,595 sorties over 10 days, dropping a total of 9,365 tons of bombs. The results far exceeded expectations, as the B-29s left a trail of destruction across four major cities, decimating 32 square miles and destroying numerous critical targets. Thus, LeMay's strategy proved successful, leading to incendiary area bombing becoming standard practice in the future. The focus now shifts from the Central Pacific to the South Pacific, where we need to address the ongoing Australian operations in New Britain. Following the capture of Milim and Ea Ea in January, General Ramsay's 5th Division aimed to continue its limited advances to the north. To secure crossings over the Ip River and patrol towards Henry Reid Bay, the entire 6th Brigade began moving to the Kiep-Milim area on January 26, completing this relocation by February 11. Concurrently, the 14th/32nd Battalion had advanced beyond the Ip and was conducting patrols towards Kalai Plantation, where they faced enemy resistance. The 36th Battalion also moved forward to Mavelo Plantation, leading to retaliatory actions against the new Australian outpost at Baia. In response, Ramsay dispatched stronger patrols to the Sai River throughout February, successfully establishing a new defensive line along the Mavelo River by the month's end. Returning to Wide Bay, after a series of aggressive patrols and nighttime ambushes, the 14th/32nd Battalion managed to reach Kamandran Mission by mid-February. The Australians continued to advance, and by the end of the month, the 19th Battalion, which had replaced the 14th/32nd at Gogbulu Creek, secured crossings over the Mevelo River and patrolled east toward the Wulwut River. On March 3, Ramsay ordered the 6th Brigade to cross the Wulwut and capture the Waitavalo Ridge. Two days later, the 19th Battalion initiated the assault but struggled to push more than one company across the river due to fierce enemy resistance. On March 6, following an artillery bombardment, another company successfully crossed and quickly seized Cake Hill. The next day, Lone Tree Hill was taken following another round of artillery bombardment. By March 10, Moose Hill, Young's Hill, and Perry's Knoll had also been captured. In the days that followed, Australian artillery began to suppress enemy mortars as infantry moved toward Kath's Hill. By mid-March, the 14th/32nd Battalion replaced the 19th Battalion, and on March 16, the Australians resumed their offensive, facing fierce resistance but successfully encircling Bacon Hill. The assault continued the next day as the 14th/32nd fought to reach the summit of the hill. On 18th March the mortar fire was intensified from the few remaining enemy positions, and it seemed that the Japanese were firing off their ammunition while they could. The attack was resumed. When Corporal Martin's section was halted on the steep spur by fire from three posts he jumped up shouting, "They can't do that to me", and went on alone, firing posts, killing five, before he himself was hit. The decisive attack was launched through this foothold. By 3 p.m. all the Japanese had been cleared from Bacon Hill; and a patrol from Kath's, under Lieutenant Lamshed,3 penetrated to a knoll 800 yards to the east and found no enemy there. No Japanese now remained in the Waitavalo-Tol area. In the five days from the 16th to the 20th 4 officers and 53 others had been killed or wounded.  In the following days, patrols ventured deep into enemy territory but found few stragglers. On March 21, the 19th Battalion took over again and advanced toward the Bulus and Moondei Rivers. On March 28, Ramsay ordered the 13th Brigade to relieve the 6th Brigade, a transition that was completed by April 12. Following the capture of Waitavalo Ridge, there were four months of infantry patrolling and routine maintenance by other troops, with the 16th Battalion patrolling forward to Jammer Bay in this area. Additionally, looking west, a company from the 36th Battalion successfully landed north of the Sai on March 30 but could not proceed to the Matalaili River due to heavy rains. However, Japanese positions there were heavily bombarded by aircraft and the sloop Swan, prompting the defenders to withdraw to the Toriu River in April. Meanwhile, Brigadier King's 16th Brigade advanced to the Ninahau River by March 12, while Brigadier Moten's 17th Brigade continued its westward push through the Torricelli Mountains, aiming to capture the Japanese base at Maprik. Throughout March, the 2/7th Battalion executed several successful ambushes from their new bases at Ilahop, Balangabadabil, and Bombeta, while Hayforce advanced through Sinahau to the north of Utumugu and eastward to Tatimba. By early March, Moten had cleverly led the enemy to believe that the primary offensive would be launched by the 2/10th Commando Squadron from the north via Ami. As a result, the Japanese bolstered their forces in that area, successfully driving back Australian patrols from Chaulak, Gwanginan, and Wambak. On March 13, the commando outpost at Milak came under attack, with the Japanese gradually encircling the position in the following days but failing to overcome the defenders' steadfast resistance. Fortunately, by March 17, patrols had restored communication lines, and two days later, the enemy pressure finally subsided. During this time, smaller Japanese forces also targeted the commando outposts at Murak and Aupik, but the defenders managed to repel these attacks as well. However, as the 2/10th was completely exhausted, the 2/6th Battalion was dispatched to relieve the commandos in late March amid a new wave of Japanese assaults. Meanwhile, the 2/7th Battalion was engaged in assaults on the fortified enemy positions at Ilaheta, which fell on March 20. The Australians then turned their attention to the Aupik villages, successfully focusing their efforts on the west bank of the Ninab River by the end of March, coinciding with Hayforce's crossing of the Amuk River. In the following three days, the 2/7th Battalion cleared all opposition along the eastern side of the Ninab in preparation for the final push toward Maprik. Consequently, General Miyake's 78th Regiment was ultimately compelled to retreat toward Jamei. Looking further north, King decided to initiate his advance towards But. By mid-March, a company from the 2/2nd Battalion had crossed the Ninahau on March 14 and quickly moved through Bai and Ultan. Although the Australian advance faced a strong enemy position that delayed progress for two days, the 2/2nd ultimately broke through Manib Creek, catching the defenders off guard and swiftly capturing the But airfield on March 17. Following this, the Australians patrolled the foothills and the Old German Road towards the Dagua airfield, encountering minimal resistance. Consequently, on March 21, the 2/2nd advanced rapidly again, successfully taking Dagua while the 2/1st Battalion moved in to secure But. At this stage, Japanese resistance along the coast was light, as General Adachi had focused on the Maprik district, which could produce more food. With the main enemy forces now concentrated in the hills to the south, King directed the 2/2nd to clear the foothills south of Dagua and eliminate the enemy in the Tokoku Pass, while the 2/3rd Battalion launched a flanking attack in the Mabam River-Hamsuk-Yalaminuni area. The 2/2nd then patrolled deep towards Magahen and Wonginara Mission, facing strong resistance at the 1410 Feature. On March 24, they finally captured the feature, while another patrol reached Wonginara without encountering enemy forces. However, in the final days of March, the Australians struggled to advance against the strong resistance of the Japanese defenders on the Wonginara Track, although one patrol successfully probed towards Kauremerak Hill. On April 2, following intense air and artillery bombardments, the 2/2nd Battalion finally managed to break through to Tokoku Pass, which was secured the next day. Meanwhile, another patrol advanced south from Dagua to the Autogi-Walanduum area and then to the coast near Kofi. The 2/3rd Battalion moved south from Feature 1410 towards the Mabam River and Wonginara Mission, successfully eliminating a series of Japanese ridge positions by April 6. The 2/1st Battalion patrolled deep into the hills south and west of But, completely clearing the area by April 1 while also pushing eastward to capture Saburuman. Concurrently, the 2/3rd Machine-Gun Battalion advanced to the upper Ninahau, effectively clearing the region up to a north-south line about two miles beyond Muguluwela by the end of March. In early April, the machine-gunners successfully cleared the Marabus area and connected with the 2/1st Battalion. Finally, it was time to shift focus to Bougainville to continue covering the Australian offensives on the island. As previously noted, Brigadier Stevenson's 11th Brigade had secured the Tsimba Ridge area, while Brigadier Field's 7th Brigade was advancing south towards the Puriata River. The swift capture of Mosigetta and the unexpected secondary landing at Toko had already compelled the Japanese to retreat behind the river amid a command crisis. The Japanese policy of resisting the southward advance more strongly even if it entailed heavier casualties failed to impose the hoped-for delay of the Australians. Nevertheless the Japanese leaders considered that the 13th Regiment's "swift damaging hit-and-run tactics" were well executed. However, Mosigetta was at length abandoned and a withdrawal south of the Puriata ordered. The landing at Toko was unexpected and caused an acceleration of this withdrawal. There now occurred a major crisis in the Japanese command. The young reserve officers were highly critical of the conduct of the campaign and blamed the policies of the older professional officers for the constant reverses. This criticism became so outspoken that, in February, a number of the younger officers were relieved of their commands; perhaps partly as an outcome of this crisis, General Hyakutake suffered a paralysis of his left side. General Kanda took command of the 17th Army and Lieutenant-General Akinaga Tsutomu, Chief of Staff of the Army, succeeded him in command of the 6th Division. "This change of command was regarded favourably by the younger officers, but it soon became apparent that Kanda intended to pursue the same policy as Hyakutake. Kanda was a shrewd, hard, fussy little professional soldier of long experience. He was steeped in tradition and a ruthless commander, but even his bitterest critics admitted his capabilities. Akinaga… was a dyed in the wool militarist and a strict disciplinarian. Unused to an active command he was plunged into a situation which was a little out of his depth. One of his staff stated that he spent too much time doing a corporal's job in his forward battalions to be a good divisional commander." In late February, General Bridgeford's forces advanced toward the Puriata, facing only minor rearguard positions. The 25th Battalion captured Barara on February 22 and a five-acre garden two days later, while the 61st Battalion took control of another garden measuring 600 by 400 yards near the river on March 1. Meanwhile, the 2/8th Commando Squadron was sent to secure the Makapeka area, successfully taking Commando Ridge and a ford across the Makapeka River by March 5. With General Savige aiming to reach the Hari River next, Bridgeford promptly ordered the 7th Brigade to move to the Hongorai River line. As a result, Field planned to initiate his main advance on March 11, utilizing the 25th Battalion and the 2/8th Commando Squadron, while the 61st Battalion pushed forward toward Horinu. In response, Kanda dispatched the 23rd Regiment to bolster the 13th at the front, preparing both units for a full-scale counterattack should the Australians cross the Puriata, aiming to delay the enemy long enough to finalize preparations for a decisive battle along the Silibai-Porror Rivers. By March 5, the 25th Battalion had already crossed the river and swiftly captured Slater's Knoll, which soon came under enemy mortar fire. Patrols were sent ahead and found that the 13th Regiment was poised to fiercely contest the Australian advance. Although the northern flank of the 25th Battalion would be effectively contained along the Buin Road on March 11, two Australian companies managed to maneuver through Tokinotu to the south, reaching Hiru Hiru by the end of the day. One of these companies moved along the eastern side of the Buin Road toward Slater's Knoll, but from March 15 to 17, they faced a heavy counterattack that ultimately forced them to withdraw. In response, Field initiated a strong offensive along the Buin Road on March 19, managing to push the Japanese back to some rear positions. Following a significant air and artillery bombardment, the attack resumed on March 22, successfully overcoming all enemy resistance. Meanwhile, the commandos advanced to Nihero, where they began extensive patrols southward towards Unanai, Hari, and the Buin Road. During one of these patrols, they captured detailed orders for a large-scale Japanese offensive planned for early April. As a result, Bridegeford decided to pause his offensive and send the 15th Brigade along with a tank squadron to Toko to reinforce his perimeter. On March 28 and 29, before Akinaga's main assault, the Japanese conducted a series of raids on the Australian lines of communication and rear areas, all of which were successfully repelled by vigilant defenders. On March 30, the 13th Regiment launched several strong attacks against the 25th Battalion, all of which were costly for the attackers and repelled, while the armored squadron advanced toward Tokinotu. Just as the tanks reached the front, the Japanese initiated another wave of fierce attacks against the 25th Battalion on March 31, which were thankfully repelled with the support of the armored units. Consequently, on April 1, two companies advanced again, establishing a perimeter 1,000 yards south of Slater's Knoll. That evening, and for the following three days, Akinaga launched a series of raids to facilitate the arrival of the 23rd Regiment for a renewed assault. In the early hours of April 5, the Japanese began infiltrating the Australian perimeter, launching a vigorous two-pronged assault on Slater's Knoll later that morning. The 23rd Regiment attacked about 1,000 yards to the right of the 13th and north-east of it. The attack failed, Kawano was killed and the regiment withdrew south to the rear of the 13th. The 13th Regiment with 600 men made the main attack from north and east.  Until 6.20 a.m. wave after wave charged forward and was brought low. Some Japanese fell within four yards of the weapon-pits. The artillery sent over accurate defensive fire, registered the previous day. At dawn the surviving Japanese were heard digging in on dead ground. As the light became clearer, the Australians saw that "enemy dead lay, literally, in heaps in front of the wire", and bodies could be seen scattered over an area some 200 yards square. It was gruesome evidence of the efficient siting of weapons and choice of fields of fire in preparation for expected attack. The attackers were ordered to dig in until darkness and make full use of grenades and mortars. However, in the afternoon, tanks and artillery fire drove the Japanese from the positions they had gained, and the Japanese commander accepted defeat. All three battalion commanders in the 13th were killed. After Akinaga had reported his failure Kanda said to his Chief of Staff, Colonel Yoshiyuki Ejima: "It would not have happened if I had been in command. The enemy right flank was wide open. I would have severed his life line and controlled Toko. We could have delayed the enemy for three months."  Concurrently, around 100 Japanese troops attacked the two forward companies along the Buin Road but were similarly repelled with ease. Following the unsuccessful counteroffensive by Akinaga, Slater's Knoll received reinforcements while the remaining Japanese forces were being dealt with, resulting in 620 Japanese fatalities since March 28, compared to 189 Australian casualties. However, Bridgeford could not capitalize on this victory due to the prolonged supply line, which temporarily halted his offensive. As a result, while the 2/8th Commando Squadron moved forward along the Commando Road, the 13th Brigade began to relieve the battered 7th Brigade under Field on April 13. Meanwhile, in the northern sector of the 11th Brigade area, the 26th Battalion launched a significant advance northward on February 21, successfully overrunning the Lalum-Downs' Ridge area by March 8. Two companies then advanced further north to secure the crossing of the Nagam River. On March 13, another company landed near the southern edge of Soraken Plantation and quickly pushed the enemy back behind the Nagam. Australian patrols harassed the Japanese forces at Horseshoe Knoll until March 20, when they finally withdrew. Simultaneously, the 26th Battalion eliminated the remaining enemy positions at the Compton River and secured the Soraken Peninsula, while the Taiof and Saposa Islands were also captured off the coast. The next battalion to take over the forward positions was the 31st/51st Battalion. Perhaps the outstanding patrol leader in the 31st/51st was Lieutenant Reiter, who led out 3 patrols which killed 10 out of the 78 Japanese killed by this battalion's forays. One of these patrols was named by the battalion "the raid on Reiter's Ridge". Reiter and 15 men were given the task of harassing the Japanese occupying a prominent ridge just east of Sisivie and discovering their strength. They departed from Keenan's Ridge at 17:30 on March 27, bivouacked at a former artillery observation post and moved on at 03:00 next morning for a dawn attack. At 06:00 “the patrol moved in, and throwing grenades and firing LMG occupied a small knoll (its report stated). 2 Japanese were killed and 1 pillbox containing LMG destroyed. Patrol raced down narrow neck to a wide clearing in which several huts were sighted. Phosphorus and HE grenades were thrown. In a matter of seconds 4 more Japanese killed (2 in slit trenches, 1 as he ran and another while abluting). 2 were wounded by phosphorus grenades. 3 huts were blazing and 1 (considered to be an ammunition dump) blew up. Enemy opened up with one LMG and 15 rifles and patrol pulled out with 1 man wounded.” Instead of hastening them away Reiter assembled his men nearby in concealment and watched the enemy. At length Japanese began to move about again, and soon they were washing clothes, chopping wood and performing other tasks. There were from 25 to 30 enemy in the post. The Australians watched throughout the morning and at 12:30 opened fire with all their weapons. 2 Japanese were killed and 4 more huts set on fire. The enemy fired back, and at 01:15 Reiter withdrew his men and returned to Keenan's Ridge leaving an ambush on the enemy's track. The ambush party returned later and reported that it had seen no movement.  On the 29th, the day after Reiter's return, a platoon of the 1st New Guinea Infantry Battalion under Lieutenant Martin set out for Buritsiotorara along the Wakunai River. There they found three huts and a large garden with seven Japanese moving about unarmed. Throwing grenades and firing from the hip the native soldiers attacked and killed all seven. Three more who emerged from a hut were chased and killed. Three of the dead men were found to be lieutenants; three machine-guns were cap-tured. Next day at Aviang, 1,200 yards away, seven more Japanese were seen, of whom three including another lieutenant were killed and the others fled. I would like to take this time to remind you all that this podcast is only made possible through the efforts of Kings and Generals over at Youtube. Please go subscribe to Kings and Generals over at Youtube and to continue helping us produce this content please check out www.patreon.com/kingsandgenerals. If you are still hungry after that, give my personal channel a look over at The Pacific War Channel at Youtube, it would mean a lot to me. The battle for Iwo Jima had come to a bitter end. The lessons learnt on Iwo Jima would become guidelines for the Battle of Okinawa in April and would influence allied plans for the invasion of the Japanese home islands. The war planners would later notably take into account that around a third of the troops committed to Iwo Jima, and later again at Okinawa, had been killed or wounded and that they could expect far more in Japan.

On today's episode we're focusing on hip preservation with Dr. Andrea Spiker. We have some great articles for you that contribute well to our conversation on femoroacetabular impingement or “FAI”, hip dysplasia and the arthroscopic and open surgical treatments for these conditions. As always, links to all of the papers that we discuss on this show can be found on our podcast website – www.thesportsdocspod.comWe'll start off our discussion today with an article from the June 2018 issue of The Lancet titled “Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome.” This multicenter RCT included 348 patients across 28 hospitals in the UK and compared conservative treatment with physical therapy to surgical treatment with hip arthroscopy. The authors reported that while both groups improved after treatment, patients who underwent hip arthroscopy for treatment of FAI demonstrated significantly greater improvement in hip-related quality of life compared to patients who had nonsurgical treatment. Then, from the September issue of AJSM this year, we review an article titled “Progression of Osteoarthritis at Long-term Follow-up in Patients Treated for Symptomatic Femoroacetabular Impingement with Hip Arthroscopy Compared with Nonsurgically Treated Patients.” Aaron Krych and team at the Mayo Clinic reported significantly less progression of arthritic changes in surgical patients compared to non-op. Seven percent of patients in the surgical group ultimately underwent a total hip replacement compared to 12% in the non-op group. Risk factors for failure of non-op treatment included male sex, presence of a CAM morphology, increased age and initial arthritic joint changes at diagnosis.  We are joined today by Dr. Andrea Spiker, a board-certified orthopedic surgeon at the University of Wisconsin-Madison who is dual fellowship trained in sports medicine and hip preservation. She is a team physician for UW Badger Athletics and provides head orthopedic coverage for the UW Men's and Women's Basketball teams. She is also the Program Director of the UW Orthopedic Surgery Sports Medicine Fellowship Program. Dr. Spiker is an active member in numerous orthopedic societies including AAOS, AOSSM and AANA, and has published extensively on the topic of hip preservation, so we're very excited to hear all that she has to share on this topic today.

Dr. E is joined by one of the world's foremost experts in Tendinopathy, Dr. Peter Malliaras from Tendinopathyrehab.com. Peter has been "successfully" using shockwave therapy on a number of tendinopathy conditions for over 10 years. He recently authored a very well done RCT with a convincing placebo version. The results were surprising. What do you think? Would this make you rethink using shockwave therapy for tendinopathy?Untold Physio Stories is sponsored by⁠Comprehend PT⁠- Leave Comprehend PT running in the background or record audio when you have time. The AI based SOAP note generator does the rest! No need for accuracy or exact wording! It's a game changer and will give you more time with your patients! Use code MMT50 to save 50% off your first month. Free trial available at sign up!⁠⁠The Eclectic Approach Network⁠⁠ - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out ⁠⁠EDGE Mobility System⁠⁠'s Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.com

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

Recorded at the CEPR Paris Symposium. Everywhere in the world there is still a stigma around periods. That can lead to bullying or exclusion in schools. Girls are stressed, and that affects their ability to study. In Madagascar, an RCT set out to end the stigma by discussing menstruation openly and seeking out Young Girl Leaders who could help their peers understand what was happening, and why it shouldn't be a source of embarrassment or shame. Karen Macours of the Paris School of Economics tells Tim Phillips about the extraordinary effect of the programme on mental health and graduation rates.

Polycystic Ovarian Syndrome is more common than most people realize and with more far-reaching implications than it would initially seem. Guest co-host Robyn Flynn joins Dr. Chris Labos to talk about it's potential impact on fertility, cardiovascular health, and according to Robyn, that it's more painful than childbirth?!? We're going to have to look into that one.   You can also check out Robyn's podcast, Rebel Mom Boss https://open.spotify.com/show/4uMAsJS9ySR47iGYw8ExDo?si=bc68ddfcb0bd4f3f    Become a supporter of our show today either on Patreon or through PayPal! Thank you! http://www.patreon.com/thebodyofevidence/ https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE   Email us your questions at thebodyofevidence@gmail.com.   Editor:    Robyn Flynn Theme music: “Fall of the Ocean Queen“ by Joseph Hackl Rod of Asclepius designed by Kamil J. Przybos Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause-cancer   Obviously, Chris not your doctor (probably). This podcast is not medical advice for you; it is what we call information.   References: 1) Dutch Twin study about the role of genetics in PCOS:   10.1210/jc.2005-1494   2) Cochrane review on meds that improve fertility https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003053.pub6/full   3) RCT of diet to restore fertility https://academic.oup.com/jcem/article-abstract/88/2/812/2845309?redirectedFrom=fulltext   4) Benefits of weight loss prior to fertility treatment 10.1210/jc.2016-1659 5) Letrozole vs. clomiphene for fertility treatment https://www.nejm.org/doi/full/10.1056/NEJMoa1313517 6) Metformin as a fertility treatment 10.1001/jamanetworkopen.2020.11995  

The book Crooked by Cathryn Jackobson Ramin is a must-read book for anyone who works with back pain patients or is considering a back surgery for low back pain.   I talk about research the author mentioned and some other research that will blow your mind.   Crooked is available on Audible if you prefer an audio book.  https://www.cathrynjakobsonramin.com/   The Value of Magnetic Resonance Imaging of The Lumbar Spine to Predict Low-Back Pain in Asymptomatic Subjects   The catastrophization effects of an MRI report on the patient and surgeon and the benefits of ‘clinical reporting': results from an RCT and blinded trials   Online Courses: https://richardhazel.podia.com  

Silent cerebral embolism after LAAC, AI in ECG rhythm analysis, anti-thrombotic strategies in patients with AF and CAD, and subclinical AF are the topics John Mandrola, MD, covers in today's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I. Silent Cerebral Embolism after LAAC JAHA Case Series  https://www.ahajournals.org/doi/10.1161/JAHA.124.037968 JACC  https://doi.org/10.1016/j.jacc.2018.12.039 II. AI Transforming Rhythm Monitor Reading Johnson and colleagues RCT https://www.nature.com/articles/s41591-025-03516-x III. Anticoagulation Alone or OAC plus antiplatelets in patients with CAD and AF Rashedi and colleagues Meta-analysis https://doi.org/10.1016/j.jacc.2024.12.030 AQUATIC https://clinicaltrials.gov/study/NCT04217447 IV. DOAC for Subclinical AF – A Subgroup Analysis of ARTESIA Anticoagulation Uncertainty in Embolic Stroke of Undetermined Source https://www.medscape.com/viewarticle/anticoagulation-uncertainty-embolic-stroke-undetermined-2024a1000h5e Lancet Neurology Subgroup Analysis of ARTESIA 10.1016/S1474-4422(24)00475-7 ARTESIA https://www.nejm.org/doi/full/10.1056/NEJMoa2310234 NOAH https://www.nejm.org/doi/full/10.1056/NEJMoa2303062 RE-SPECT ESUS https://www.nejm.org/doi/full/10.1056/NEJMoa1813959 NAVIGATE ESUS https://www.nejm.org/doi/full/10.1056/NEJMoa1802686 You may also like: The Bob Harrington Show with the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Accelerators co-host Dr. Matt Spraker is joined by radiation oncologists Drs. Bobby Koneru and Mudit Chowdhary for an update on low dose radiotherapy for osteoarthritis! Dr. Koneru is a radiation oncologist in Freeport, IL and prolific social media educator on benign indications. Dr. Chowdhary is a radiation oncologist at Northside Hospital in Atlanta, Georgia, and a friend of TAP (see his prior episodes).We start by discussing their ASTRO 2024 panel on benign indications for radiotherapy; it sounds like there was a lot of knowledge sharing among those getting started with these treatments.Bobby and Mudit share how they built a referral network for their successful practices.We close by discussing some practical tips and recommended educational resources. Here are some other things we discussed in the show, or links that may be helpful in building your benign radiotherapy practice: Matt's LDRT & Benign Resource ListRadiotherapy Academy for Benign Diseases (RT-ABC)Makarova et al., RCT showing LDRT reduces disability risk in OAEnglish Translation of the DEGRO-AG “Radiotherapy of Benign Diseases”TAP reviews LDRT with Dr. Austin Dove Alvarez et al., Radiotherapy for Benign Conditions Contouring AtlasLDRT for arthritis PRIMR videoThe Accelerators Podcast is a Photon Media production. 

Send us a textTake the Health Type QuizCoaching with Dr. Bobby hereEpisode Summary:Detox programs promise to rid your body of toxins, boost your energy, and restore balance—but is there any credible science behind them? In this episode, we break down the claims, explore the evidence (or lack thereof), and discuss why detox diets and supplements may be more about profit than actual health benefits.Key Topics Covered:

Welcome back to February 2025's papers podcast! This month we're exploring papers on seizure management, oxygen strategies in trauma, along with transfusion strategies in patients with traumatic brain injuries. First up we look at at a paper exploring the potential benefit of adding ketamine into the strategy for treating patients with status epilepticus. Does it help to more reliably terminate seizures and what can we take from the paper? Trauma courses frequently mention the use of high flow oxygen in the management of trauma patients. But recent evidence in non-trauma patients has questioned whether we should be more targeted with oxygen therapy to optimise outcomes in other conditions. We take a look at an RCT looking to answer the question of which out of liberal or targeted oxygen therapy in trauma is the best approach. Finally we look at another RCT, this time focussing on traumatic brain injury and the transfusion strategy we should take to those who are anaemic. This is a really interesting paper, with great methodology and a lot to talk about from the conclusion!

The JournalFeed podcast for the week of Jan 27-31, 2025.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Tuesday Spoon Feed:There was no difference in patient centered outcomes between trauma patients who received either restrictive or liberal oxygen therapy in this RCT.Thursday Spoon Feed:Patients wearing hospital gowns during simulated hospital visits reported increased feelings of vulnerability and disempowerment compared to patients wearing personal clothes.

In episode 598, James and Mike continue to talk with David Gardner about the issue of insomnia. We discuss his latest, very cool, Your Answers When Needing Sleep (YAWNS NB) randomized clinical trial. YAWNS was a pragmatic, open-label, minimum-contact, RCT where people with long-term use of benzodiazepines and current or past insomnia were randomly allocated […]

Join Henry, Kate, Mark and Gary as they discuss 4 new POEMs: an RCT of mindfulness for chronic pain, use of methotrexate (huh?) for pain relief in adults with knee DJD, a new way to eradicate H., and oral resveratrol for adults with painful DJD of the knee  (you know, the stuff from red wine). And a quiz: what actually are the benefits of lower BP targets? Links Mindfulness for chronic pain:  https://pubmed.ncbi.nlm.nih.gov/39158851/ Methotrexate for OA:  https://pubmed.ncbi.nlm.nih.gov/39074374/ Eradicating H. pylori: https://pubmed.ncbi.nlm.nih.gov/38906695/ Resveratrol for OA: https://www.ncbi.nlm.nih.gov/pubmed/39137167 Cochrane Review: Blood pressure targets in adults with hypertension.

In today's episode, Greg and Patrick talk about instrumental variables: what they are, how they help to make causal claims, and the many assumptions and challenges associated with them. Along the way they also mention: Festival of Side Dishes, pilot turkeys, gutsy bagpipes, charter schools, drama kids, RCT wieners, Space Force, licking a rainbow, Duranimals, draft lotteries, shoelace color, buttress, mother-in-lawing, and kazoo duets. Stay in contact with Quantitude! Web page: quantitudepod.org TwitterX: @quantitudepod YouTube: @quantitudepod Merch: redbubble.com

During World War Two, a Japanese American battalion became one of the most decorated army units in US military history. The 442nd Regimental Combat Unit earned more than 4,000 Purple Hearts and seven Presidential Unit Citations for extraordinary heroism in battle.The unit was set up in 1943, just over a year after Japan bombed the US naval base at Pearl Harbour. Following the attack, 120,000 Japanese Americans living on the west coast were sent to internment camps, but many were keen to show their loyalty to the US.They volunteered to join the 442nd RCT and fight in Europe. Hundreds of recruits came from the camps, while thousands of others were from the Japanese American community in Hawaii.Among them was 19-year-old Matsuichi Kusatsu. His son Clyde tells Jane Wilkinson about how the unit fought prejudice to prove their loyalty, and a warning, this story includes racist language of the time.Actor Clyde stars in the BBC World Service drama Purple Heart Warriors. To hear this six-part season search for Dramas, wherever you get your BBC podcasts. Eye-witness accounts brought to life by archive. Witness History is for those fascinated by the past. We take you to the events that have shaped our world through the eyes of the people who were there. For nine minutes every day, we take you back in time and all over the world, to examine wars, coups, scientific discoveries, cultural moments and much more. Recent episodes explore everything from football in Brazil, the history of the ‘Indian Titanic' and the invention of air fryers, to Public Enemy's Fight The Power, subway art and the political crisis in Georgia. We look at the lives of some of the most famous leaders, artists, scientists and personalities in history, including: visionary architect Antoni Gaudi and the design of the Sagrada Familia; Michael Jordan and his bespoke Nike trainers; Princess Diana at the Taj Mahal; and Görel Hanser, manager of legendary Swedish pop band Abba on the influence they've had on the music industry. You can learn all about fascinating and surprising stories, such as the time an Iraqi journalist hurled his shoes at the President of the United States in protest of America's occupation of Iraq; the creation of the Hollywood commercial that changed advertising forever; and the ascent of the first Aboriginal MP.(Photo: Matsuichi Kusatsu in 1944. Credit: Family photo)

Carbohydrate metabolism and metabolic health have become central themes in the science of nutrition, with questions about fuel utilization, the impact of different diets, and the potential of ketone supplements driving new research. As researchers continue to uncover how the body adapts to various energy sources, there are emerging insights into how glucose tolerance, glycogen utilization, and even ketogenic diets influence not only physical performance but also long-term health outcomes. Understanding how the body responds to different energy sources, particularly in relation to carbohydrate restriction, brings crucial context to popular nutrition strategies and the potential benefits—or trade-offs—they offer. In this episode, Professor Javier Gonzalez joins to discuss these topics in detail, exploring the latest findings on how dietary choices affect athletic performance, chronic disease risk, and the mechanisms underlying metabolic adaptations. You will gain insight into topics like reactive hypoglycemia, carbohydrate oxidation, and why individualized responses to diet matter. Timestamps [01:36] Understanding carbohydrate metabolism [06:33] The role of glucose in metabolic health [09:59] Exercise and glucose dynamics [17:35] Carbohydrate intake and athletic performance [25:03] Diet impact on exercise and metabolism [30:44] Pre-workout carbohydrates and reactive hypoglycemia [35:31] Recent study: Ketogenic diet vs. sugar restriction [41:09] Future research directions in metabolic health [45:07] Ketone esters and their role in exercise performance [49:22] Carbohydrate metabolism and common misconceptions Links Go to episode page Join the Sigma email newsletter for free Subscribe to Sigma Nutrition Premium Enroll in the next cohort of our Applied Nutrition Literacy course Paper: Ketogenic diet but not free-sugar restriction alters glucose tolerance, lipid metabolism, peripheral tissue phenotype, and gut microbiome: RCT