Podcasts about rct

In this episode of the Prolonged Field Care Podcast, Dennis sits down with Dr. Andre Cap to unpack the evolving role of calcium in trauma resuscitation. What started as the “new hotness” in forward blood transfusion protocols has become far more nuanced. They discuss the dangers of both hypocalcemia and hypercalcemia, how citrate in all blood products binds ionized calcium, cardiac effects, recent observational data showing worse outcomes with hypercalcemia, and practical guidance for when, how, and how much calcium to give in austere and prolonged field care environments.Whether you're running a Role 2, working prolonged field care, or just trying to keep your patient alive until definitive care, this episode challenges long-held assumptions and offers field-practical recommendations.Key Takeaways:All blood products contain citrate, which binds ionized calcium — expect hypocalcemia with significant transfusion.Both hypo- and hypercalcemia are bad; recent data shows hypercalcemia is associated with worse mortality than hypocalcemia.Current TCCC guidance (1g calcium after first unit) was written to fix under-use; it may now be too aggressive in some scenarios.Give calcium after blood products, not before. Consider waiting until after 2+ units in most cases.Slow IV push (over ~5 minutes) through a confirmed good peripheral line; calcium chloride is a vesicant — use caution (gluconate is safer).Avoid calcium chloride via IO if possible. Titrate to clinical response when monitoring isn't available.In refractory shock you can give more, but don't give calcium as a standalone resuscitation drug — it can be harmful without volume replacement.Ideal future state: Bring i-STAT capability forward when feasible and get better RCT data.Perfect for medics, PAs, physicians, and anyone managing hemorrhagic shock in austere environments.Links:⁠www.prolongedfieldcare.org⁠ | @prolonged_field_carePodcast Chapters (with Timestamps):00:00 – Intro & Welcome00:39 – Why Calcium Became “The New Hotness” in Trauma Care01:18 – The Joint Trauma System Audit That Started It All03:46 – Citrate in Every Blood Product – The Science Behind the Bind05:44 – Why We Actually Care: Cardiac Repolarization, Contractility & Vascular Tone08:49 – Hypocalcemia vs Hypercalcemia in Trauma Patients10:21 – Shocking New Data: Hypercalcemia Carries Higher Mortality13:14 – TCCC Guidelines – After First Unit? Is This Too Aggressive?14:03 – When Should You Actually Give Calcium in the Field?19:34 – Clinical Triggers Without Monitoring + Dosing Strategy24:56 – Safety First: IV Patency, Calcium Chloride vs Gluconate, IO Concerns28:44 – When to Stop Giving Calcium & Avoiding Over-Correction32:00 – Historical Lessons: When Calcium Alone Made Things Worse33:39 – Practical PFC Recommendations & Final Thoughts38:04 – Closing & Where to Find MoreFor more content, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.prolongedfieldcare.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Consider supporting us: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon.com/ProlongedFieldCareCollective⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ or ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.lobocoffeeco.com/product-page/prolonged-field-care⁠⁠⁠

Les superfoods sont partout. Mais que disent vraiment les études ? Je décortique le système — et ce qui produit des résultats mesurables après 40 ans.[[ Sources ]]Cochrane/revue maca 2010 (Shin et al.)https://pubmed.ncbi.nlm.nih.gov/20691074Vitamine D et testostérone (méta-analyse positive)https://link.springer.com/article/10.1007/s12020-020-02482-3Vitamine D et testostérone (méta-analyse RCT, pas d'effet)https://onlinelibrary.wiley.com/doi/10.1111/and.13343Wankhede et al. 2015, ashwagandha/force/testostéronehttps://jissn.biomedcentral.com/articles/10.1186/s12970-015-0104-9Compilation études KSM-66 (cortisol, sommeil, cognition)https://qidosha.com/en-ee/blogs/qidosha-academy-en/study-based-overview-of-therapeutic-uses-of-organic-ksm-66-ashwagandha-extract-5-withanolidesSpiruline, teneur en ferhttps://www.darwin-nutrition.fr/en/tips/spirulina-iron[[ Accompagnement ]]

Antenatal corticosteroids are a MAJOR win in the management of preterm labor. An initial course of antenatal corticosteroids has been shown to reduce morbidity and mortality in patients with preterm prelabor rupture of membranes. For patients who remain undelivered after the initial course of antenatal corticosteroids, it is uncertain whether a booster course of antenatal corticosteroids reduces neonatal morbidity or increases the infection risk. The ACOG, in its current guidance, has concluded that the current evidence is insufficient to make a recommendation. Corticosteroids, especially at the doses given, are also powerful immunosuppressants. When you administer that first course, you accept a minor, calculated risk for a massive, proven benefit. But when you introduce a second course of steroids into a uterine environment that has already been ruptured and exposed to vaginal flora for weeks, you are pouring fuel on the fire. PLUS, the environment for the fetus with prolonged preterm prelabor rupture of membranes is unique. PPPROM, the chronic exposure to ruptured membranes and the resultant oligohydramnios is theorized to trigger a kind of stress response in the fetus- so the baby may make their own endogenous corticosteroid flare. So, rescue steroids after an initial course of steroids in PPROM cases has remained controversial but we have updated data that has provided new insights. In this episode, we will highlight an RCT from 2023 and a more recent systematic review and meta-analysis from May 2026 on this very subject. Listen in for details. 1. Garite TJ, Kurtzman J, Maurel K, Clark R; Obstetrix Collaborative Research Network. Impact of a 'rescue course' of antenatal corticosteroids: a multicenter randomized placebo-controlled trial. Am J Obstet Gynecol. 2009 Mar;200(3):248.e1-9. doi: 10.1016/j.ajog.2009.01.021. Erratum in: Am J Obstet Gynecol. 2009 Oct;201(4):428. PMID: 19254583.2. Tenbrink E, Quain A, Rone V, Harris K, Hadley E, Haas D, Shanks A. Risk of Neonatal Sepsis With Rescue Steroids in Preterm Premature Rupture of Membranes. Cureus. 2023 Apr 6;15(4):e37207. doi: 10.7759/cureus.37207. PMID: 37159785; PMCID: PMC10163895.3. Melamed N, Murphy KE, Pylypjuk C, et al. Timingof Antenatal Corticosteroid Administration and Neonatal Outcomes. JAMA Netw Open. 2025;8(5):e2511315. 4. Porreco R, Garite TJ, Combs CA, Maurel K, Huls CK, Baker S, Fortner KB, Longo SA, Nageotte M, Lewis D, Tran L; Obstetrix Collaborative Research Network. Booster course of antenatal corticosteroids after preterm prelabor rupture of membranes: a double-blind randomized trial. Am J Obstet Gynecol MFM. 2023 May;5(5):100896. doi: 10.1016/j.ajogmf.2023.100896. Epub 2023 Feb 14. PMID: 36796641.5. Da Costa Y, Ramanathan V, Oliveira JA, Brito J, Yousif A. Repeat versus Single Course of Antenatal Corticosteroid in Management of Preterm Premature Rupture of Membranes: A Systematic Review and Meta-analysis. Am J Perinatol. 2026 May;43(7):925-932. doi: 10.1055/a-2708-5314. Epub 2025 Oct 9. PMID: 41067234

The Bakri Postpartum Balloon was described and first used clinically in 1999 by Dr. Younes N. Bakri (Georgia, USA). It is intended to treat postpartum hemorrhage (PPH). In the United States, it received its first major FDA clearance (via 510(k) for commercial marketing) on April 17, 2002. Manufacturer guidelines for the Bakri (Cook Medical) state that the balloon may be left indwelling for a maximum of 24 hours, but the determination of removal time is left to the clinician once “bleeding is controlled and the patient is stable.” However, the optimal duration of intrauterine balloon tamponade placement remains unclear. One retrospective cohort study from AJOG (Einerson et al) of 274 women found no significant difference in PPH outcomes when intrauterine balloon tamponade was left in place for 2–12 hours, compared with more than 12 hours. However, only 30 women had the intrauterine balloon tamponade placement for 10 hours or less. And remember, this was not a prospective trial looking at a minimum of 2 hours, 2 hours was just the lower margin of the “short duration” group. Now, a new RCT (with authors from Denver and Vermont) published in the July 2026 Green Journal provides new data. In this first of its kind pragmatic, randomized trial of noninferiority, a 6-hour duration of intrauterine balloon tamponade usage for postpartum hemorrhage (PPH) control was compared with an 18-hour duration. Listen in for details. 1. Durfee, J., Adkins, K., Heyborne, K., Larrea, N., & Schultz, C. (2026). Intrauterine Balloon Tamponade Duration for Postpartum Hemorrhage: A Randomized Controlled Trial. Obstetrics & Gynecology, 148(1), 113–120. https://doi.org/10.1097/AOG.00000000000062952. Garabedian C, Prats C, Seco A, Deneux-Tharaux C, Rozenberg P, Berveiller P. Duration of Intrauterine Balloon Tamponade in Post-Partum Haemorrhage Management After Vaginal Delivery: A Secondary Cohort Analysis From the French TUB Trial. BJOG. 2026 Jan;133(1):123-131. doi: 10.1111/1471-0528.18345. Epub 2025 Sep 1. PMID: 40888007; PMCID: PMC12676195.3. Einerson BD, Son M, Schneider P, Fields I, Miller ES. The association between intrauterine balloon tamponade duration and postpartum hemorrhage outcomes. Am J Obstet Gynecol 2017;216:300.e1–5.

Send us Fan MailIn this Journal Club, Ben and Daphna dig into two new papers on PDA management in our smallest patients. First, the SMART-PDA pilot RCT from Souvik Mitra and colleagues, which uses comprehensive hemodynamic screening to selectively treat high-volume shunts in infants born before 26 weeks, and whose striking Bayesian signal for reduced pulmonary hemorrhage and NEC stopped the trial early. Then a companion JAMA Network Open comparative effectiveness study across four pharmacotherapy regimens. Along the way, Ben shares hemodynamics pearls from his Montreal training: why left ventricular output, LA:Ao ratio, and transductal velocity matter more than PDA diameter alone.----Selective early medical treatment of the patent ductus arteriosus in extremely low gestational age infants: a pilot randomised controlled trial (SMART-PDA). Mitra S, Hebert A, Castaldo MP, Disher T, El-Naggar W, Dhillon S, Alhassen Z, Koo J, Katheria AC, Hyderi A, Kumaran K, Ting J, Surak A, Larocque J, Pepper D, Hornberger L, Makoni M, Weisz DE, Jain A, Bacchini F, Cameron-Nola AJJ, Hatfield T, Dorling J, McNamara PJ, Thabane L.Arch Dis Child Fetal Neonatal Ed. 2026 May 18:fetalneonatal-2026-330462. doi: 10.1136/archdischild-2026-330462. Online ahead of print.PMID: 42150872Pharmacologic Therapies for Patent Ductus Arteriosus in Extremely Preterm Infants. Mitra S, Jain A, Ting JY, Ben Fadel N, Drolet C, Abou Mehrem A, Soraisham AS, Jasani B, Louis D, Lapointe A, Dorling J, Khurshid F, Hyderi A, Kumaran K, Toye J, Harabor A, Weisz DE, Stavel M, Morin A, Bhattacharya S, Lalitha R, Afifi J, Augustine S, Castaldo MP, Hatfield T, Su YC, Shah PS; Canadian Neonatal Network Investigators.JAMA Netw Open. 2026 Jun 1;9(6):e2617477. doi: 10.1001/jamanetworkopen.2026.17477.PMID: 42262753 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

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

New results from first-of-its-kind randomized controlled trial on a ketogenic diet for schizophrenia and bipolar disorder with psychosis offer important insights into metabolic psychiatry and mental health treatment.In this interview, Dr. Bret Scher sits down with Dr. Julie Milder to walk through the study results, recently published in Schizophrenia Bulletin. As the first RCT in psychosis-spectrum conditions to publish in the peer-reviewed literature, it's an important step toward understanding how metabolic interventions may play a role in serious mental illness.Key insights from the study:In the 1-month randomized portion of the trial, the ketogenic group showed significant improvements in metabolic health markers compared to diet-as-usualPsychiatric symptoms trended toward improvement, but were not statistically significant at 1 monthParticipants who opted into the ketogenic extension part of the study (4 total months of keto), saw improvements in depression, cognition, and positive and negative symptoms.In this video, Dr. Milder also breaks down important additional context about the limitations of the study, including the length of the randomized portion of the trial and the variance in dietary support between the two diet groups.This study adds to growing evidence linking metabolic health and psychiatric conditions and explores whether ketogenic therapy may play a role in addressing underlying mechanisms.

This is an episode from VoxDev's new podcast series, Ideas in Development. This series has a separate podcast feed, where you can find every episode of Oliver Hanney's conversations on evidence.YouTube: https://www.youtube.com/watch?v=EacHFVRt9p4 Apple Podcasts: https://podcasts.apple.com/us/podcast/has-development-economics-lost-its-way/id1866874059?i=1000775748550 Spotify: https://open.spotify.com/episode/2Lcy3FrbBuoE2nj3cnhOAm?si=76aedb574426479e Audioboom: https://audioboom.com/posts/8924691-has-development-economics-lost-its-way Substack: https://ideasindevelopment.substack.com/p/has-development-economics-lost-its What should development economists be working on – and how does their work actually reach the people making decisions?Rachel Glennerster, President of the Center for Global Development, whose career spans the research and policy sides of development, joins Oliver Hanney to discuss her proposal for a radical simplification of aid, why she feels the micro-macro debate is largely a false one, the messy but vital process of building consensus, and what impactful careers look like in economics.In this wide-ranging conversation, we cover the Smart Buys evidence panels in education and how cross-disciplinary consensus gets built, her three-box framework for evidence-based policymaking, why AI tools move too fast for RCT-based procurement, and what it would take to fix development economics' concentration problem.

The episode explains how to use minoxidil for hair loss, emphasizing that it supports follicles and prolongs the anagen phase but does not block DHT (with topical dutasteride mentioned as a scalp-focused DHT option). It reviews evidence that 5% topical minoxidil is optimal (better than 2% and superior to 10%), works best on the crown/vertex, and should be applied to the scalp—not the hair—with expectations set for gradual results and possible early shedding. Twice-daily topical use is recommended unless combined with 0.01% tretinoin, which can make once-daily use similarly effective, though irritation can occur. Microneedling combined with minoxidil is strongly recommended based on a 2013 RCT, with guidance on depth (0.5–1.0 mm), frequency, and waiting 12–24 hours (or longer with tretinoin) before applying minoxidil. The episode also compares oral minoxidil dosing, notes a 2024 RCT showing similar outcomes to topical at 5 mg, and details systemic side effects, monitoring, and cautions including pet toxicity with topical use.   Full Hair Loss Podcast — Wnt vs DHT https://www.youtube.com/watch?v=bswq-Qhfebs   Minoxidil + Microneedling — 2013 Study https://pmc.ncbi.nlm.nih.gov/articles/PMC3746236/   5% vs 2% Topical Minoxidil https://pubmed.ncbi.nlm.nih.gov/12196747/   5% vs 10% Topical Minoxidil https://pubmed.ncbi.nlm.nih.gov/31403367/   Minoxidil + 0.01% Tretinoin Study https://pubmed.ncbi.nlm.nih.gov/17902730/   Oral vs Topical Minoxidil — 2024 Study https://pmc.ncbi.nlm.nih.gov/articles/PMC11007651/   Topical Dutasteride Study https://pmc.ncbi.nlm.nih.gov/articles/PMC12405733/   Topical Minoxidil Drug Information https://medlineplus.gov/druginfo/meds/a689003.html   Oral Minoxidil Drug Information https://medlineplus.gov/druginfo/meds/a682608.html   Tretinoin Drug Information https://medlineplus.gov/druginfo/meds/a682437.html   Dutasteride Drug Information https://medlineplus.gov/druginfo/meds/a603001.html   Minoxidil Toxicity in Dogs and Cats https://pubmed.ncbi.nlm.nih.gov/34370845/   Sildenafil / Viagra Drug Information https://medlineplus.gov/druginfo/meds/a699015.html   Tadalafil / Cialis Drug Information https://medlineplus.gov/druginfo/meds/a604008.html   Show Notes   00:00 Welcome to the Hart2Heart Podcast 00:45 Minoxidil Basics 01:43 DHT And What It Misses 03:07 How Minoxidil Works 03:55 Best Areas To Treat 04:30 Choosing The Right Strength 05:55 Once Or Twice Daily 08:28 Applying It Correctly 10:10 Microneedling Protocol 15:17 Formulations And Routine 18:14 Topical Side Effects 19:34 Shedding And Pet Safety 20:44 Oral Minoxidil Overview 22:53 Dosing And Risks 27:39 Combining Oral And Topical 28:36 Final Takeaways The Hart2Heart podcast is hosted by family physician Dr. Michael Hart, who is dedicated to cutting through the noise and uncovering the most effective strategies for optimizing health, longevity, and peak performance. This podcast dives deep into evidence-based approaches to hormone balance, peptides, sleep optimization, nutrition, psychedelics, supplements, exercise protocols, leveraging sunlight, and de-prescribing pharmaceuticals — using medications only when absolutely necessary. Beyond health science, we explore the intersection of public health and politics, exposing how policy decisions shape our health landscape and what actionable steps people can take to reclaim control over their well-being. Guests range from out-of-the-box thinking physicians such as Dr. Casey Means (author of "Good Energy") and Dr. Roger Sehult (Medcram lectures) to public health experts such as Dr. Jay Bhattacharya (Director of the National Institutes of Health (NIH) and Dr. Marty Mckary  (Commissioner of the Food and Drug Administration (FDA) and high-profile names such as  Zuby and Mark Sisson (Primal Blueprint and Primal Kitchen). If you're ready to take control of your health and performance, this podcast is for you.We cut through the jargon and deliver practical, no-BS advice that you can implement in your daily life, empowering you to make positive changes for your well-being. Connect with Dr. Mike Hart Instagram: @drmikehart Twitter: @drmikehart Facebook: @drmikehart

New evidence from the first-ever RCT shows ketogenic therapy can rapidly improve metabolic health in schizophrenia-spectrum and bipolar I disorders, and shows early signals of psychiatric improvement.In this video, Dr. Bret Scher breaks down this newly published study led by Dr. Judith Ford at UCSF: the first randomized controlled trial with peer-reviewed results investigating ketogenic therapy in people with schizophrenia-spectrum disorders and bipolar-1 disorder with psychotic features.You'll learn:How the study was designed (a 1-month randomized phase plus an optional 3-4 month single-arm extension)What happened in the first 30 days (clear improvements in metabolic markers; psychiatric outcomes showed trends that did not reach statistical significance in the randomized portion)What improved over longer follow-up in the extension phase (encouraging changes in metabolic health, cognition, and psychiatric measures)Why this matters for patients and families today, and what future, longer controlled trials need to confirmPublished in Schizophrenia Bulletin and funded by the NIMH and Baszucki Group, this study adds to the growing literature on the potential benefit of ketogenic therapy for psychiatric disorders.These results indicate the need for larger, extended randomized controlled trials to test the safety and efficacy of ketogenic therapy in patients living with serious mental illness.

Whether it's joint pain, fatigue, brain fog, poor sleep, hot flushes or anxiety, it can feel frustrating when symptoms linger long after treatment ends. For many people, supplements seem like a logical place to look for menopause support, but with endless products, conflicting advice and cupboards full of half-used bottles, how do you know what's actually worth taking?In this episode, I am once again joined by leading oncologist, researcher and integrative medicine specialist Professor Robert Thomas to explore the role supplements may play in supporting health and wellbeing after cancer.Make sure to have pen and paper ready, as I think you'll need it!In this episode, we discuss:Why so many cancer survivors turn to supplementsHow to identify what symptoms you're actually trying to supportWhich supplements have anti-cancer properties?Which supplements help with joint pain?Supplements that may help with sleepThe role of vitamin D, probiotics and omega-3What should I NOT have too much of?The debate around multivitamins after cancerCommon supplement mistakes that waste moneyCreatine: what we know and what we still don't know for cancer survivorsOne of the most powerful messages from this conversation is that there is rarely one magic supplement. Instead, the best results often come from understanding your symptoms, focusing on overall health and making informed decisions based on evidence rather than marketing.Episode Highlights:00:00 Introduction05:06 Discussing supplements with oncologists08:34 Discussing supplement safety and benefits11:13 Improving gut health in menopause16:03 Concerns about multivitamins and antioxidants17:52 Discussing supplements and deficiencies20:57 Understanding Mineral Intake from Food25:44 Discussing creatine vs collagen benefitsResourcesKeep Healthy: keep-healthy.com and https://keep-healthy.com/polyphenols/Rob's bestselling book "How to Live"About Dr Robert ThomasDr Robert Thomas is a Consultant Oncologist, Professor of Nutritional and Sports Science, researcher, author and Head of Integrative Oncology at UCLH. His work focuses on helping people combine conventional cancer treatments with evidence-based lifestyle strategies to improve outcomes and quality of life.He also leads a research unit that has designed landmark scientific studies which provide the evidence that guide nutritionists, support groups, doctors and patients across the World.As well as mainstream oncology studies, the team focuses on randomised trials that evaluate the impact of exercise, diet, gut health and natural therapies on cancer, long covid and exercise performance, menopause and cancer.This included 5 RCT's addressing hormone related symptons after breast cancer including patient choice as a primary end point.His latest two double blind RCTs, discovered that boosting dietary phytochemicals (with Yourphyto) and gut health (with Yourgutplus) slowed prostate cancer progression, improved erectile function and urinary symptoms and improved three key biomarkers of longevity.Dani's links:Join my NEW blog ‘Still Becoming' on Substack: https://substack.com/@danibinnington?r=1osz6a&utm_campaign=profile&utm_medium=profile-pageBuy my book ‘Navigating Menopause After Cancer': https://amzn.eu/d/07dUoYBbJoin the 12th September Thames Bridges Trek: https://fundraiseformenopauseandcancer.raiselysite.com/thamesbridgestrekultrachallengeSet up your own fundraiser: https://fundraiseformenopauseandcancer.raiselysite.com/fundraisingideasMentioned in this episode:Fundraiser Walk: And walk: https://fundraiseformenopauseandcancer.raiselysite.com/thamesbridgestrekultrachallenge Substack: https://danibinnington.substack.com/

Send us Fan MailNeonatal sepsis physiology, steroids, vasopressors, and moms.gov. A full week on The Incubator Journal Club.Adrianne and Nim open with a retrospective study from Toronto challenging the assumption that hypoxemic respiratory failure in septic preterm infants is driven by elevated pulmonary vascular resistance. The data points instead to left ventricular dysfunction as a key contributor, raising questions about the reflex to reach for nitric oxide first.Nim then reviews a double-blind RCT from northern India evaluating early hydrocortisone versus placebo in neonatal fluid-refractory shock. The primary outcome did not reach statistical significance, but an 11 percent absolute reduction in mortality and a 70 percent open-label crossover rate tell a story of their own.Adrianne closes the journal club with a double-blind RCT comparing norepinephrine to dopamine for neonatal septic shock, finding no significant difference in shock reversal at 30 minutes, though significant methodological limitations make the findings hard to act on.Eli and Ben close the week on Neo News with a look at the newly launched moms.gov and what clinicians should know before their patients bring it up.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Ebook: https://drive.google.com/file/d/1AUsxg05dXkKFeAa64kC0u16XynnSx68o/view?usp=drive_link Episode Description: Every peptide conversation right now is about GLP-1 drugs, BPC-157, and TB-500. Nobody is talking about the one with 50 years of published research that your body is already making and losing as you age. GHK-Cu is a naturally occurring tripeptide that declines by 60% between the ages of 20 and 60. That decline tracks directly with the loss of skin elasticity, slower wound healing, thinning hair, reduced collagen production, and rising inflammation. In randomized controlled trials it has outperformed Rogaine for hair growth, shown a 55% reduction in visible wrinkles, and been documented to positively affect the expression of over 4,000 human genes. Dr. G calls it his favorite peptide, and his partner uses it on her face every day. In this episode, you will learn:  • How GHK-Cu works as a copper delivery vehicle at the cellular level, why it modulates gene expression across 31% of the human genome, and what that means for tissue repair, inflammation, and biological aging  • The head to head randomized controlled trial where GHK-Cu outperformed minoxidil for hair count, follicle size, and the active growth phase of the hair cycle  • Exactly what to look for when buying GHK-Cu cream, why the peptide is chemically fragile, what packaging and pH range to require, and the red flags that tell you to walk away from a product Timestamps: 0:00 - Intro 1:44 - What GHK-CU Actually Is and How It Was First Discovered in 1973 3:10 - Why a 60% Decline in GHK-CU Between Ages 20 and 60 Tracks Directly With Aging 4:40 - What Makes GHK-CU Different From Every Other Popular Peptide 6:00 - How It Stimulates Collagen, Elastin & the Extracellular Matrix 7:15 - The Human Trial Showing a 51% Increase in Collagen Density From Topical Application 8:00 - The 4,000 Genes GHK-CU Affects (And What the Broad Institute Found) 9:30 - Anti-Inflammatory Effects: Why This Matters for Biological Aging 10:30 - Wound Healing, Angiogenesis & Tissue Repair Across Skin, Bone, Gut and Liver 11:30 - The 2022 RCT: 55.7% Reduction in Visible Wrinkles After 12 Weeks 12:30 - Hair Growth: Outperforming Minoxidil in a Head-to-Head Randomized Trial 14:30 - Why the Lower Dose (50mg/ml) Outperformed the Higher Dose 15:30 - Safety Profile, Contraindications & the "Copper Uglies" Explained 17:00 - How to Buy GHK-CU: Concentration, Packaging, pH & What to Avoid Learn more about your ad choices. Visit megaphone.fm/adchoices

Can turmeric really help with joint pain, inflammation and gut health after cancer? And why are so many people being told to avoid it?In this fascinating conversation, I sit down with leading oncologist, researcher and integrative medicine expert Professor Robert Thomas to unpack the science behind turmeric, gut health and cancer recovery.Prof Thomas shares why he believes many patients are receiving outdated advice about turmeric, explains where concerns about tamoxifen interactions originated, and explores what the latest research actually tells us. Together, we discuss the role of gut health in long-term wellbeing, why exercise remains one of the most powerful tools available after cancer, and how lifestyle medicine can work alongside conventional cancer treatments.In this episode, we discuss:The surprising evidence behind turmeric and cancerWhy turmeric became controversial in breast cancer careThe difference between turmeric, curcumin and supplementsGut health, inflammation and the microbiomeManaging joint pain and menopausal symptoms after cancerExercise as a tool to improve cancer outcomesHow integrative oncology combines medical treatment with lifestyle strategiesCommon myths surrounding supplements and cancerResourcesKeep Healthy: keep-healthy.com and https://keep-healthy.com/polyphenols/Rob's bestselling book "How to Live"Episode Highlights:00:00 Introduction09:33 Discussing hormone therapy options12:30 Discussing health and patient advocacy15:00 Discussing menopause treatments20:06 Turmeric's rise in health circles22:24 Antioxidant and anti-inflammatory benefits24:21 Curcumin study and dosage discussion28:01 Addressing turmeric's cancer misconceptions32:28 Simplifying Supplement ChoicesAbout Prof Robert Thomas:Thomas is a Consultant Oncologist, Professor of Nutritional and Sports Science, author, researcher and Head of Integrative Oncology at UCLH. He has published extensively on lifestyle medicine, cancer prevention and survivorship, and is passionate about helping patients make informed decisions about their health using evidence-based approaches.He also leads a research unit that has designed landmark scientific studies which provide the evidence that guide nutritionists, support groups, doctors and patients across the World.As well as mainstream oncology studies, the team focuses on randomised trials that evaluate the impact of exercise, diet, gut health and natural therapies on cancer, long covid and exercise performance, menopause and cancer.This included 5 RCT's addressing hormone related symptons after breast cancer including patient choice as a primary end point.His latest two double blind RCTs, discovered that boosting dietary phytochemicals (with Yourphyto) and gut health (with Yourgutplus) slowed prostate cancer progression, improved erectile function and urinary symptoms and improved three key biomarkers of longevity.Connect with us:For more information and resources visit our website: www.menopauseandcancer.org Or follow us on Instagram @menopause_and_cancerJoin our Facebook group: www.facebook.com/groups/menopauseandcancerchathub Mentioned in this episode:Substack: https://danibinnington.substack.com/ Fundraiser Walk: https://fundraiseformenopauseandcancer.raiselysite.com/thamesbridgestrekultrachallenge

The FiltrateJoel Topf kidneyboy.bsky.socialSwapnil Hiremath @hswapnil.medsky.social Pedro Teixeira @nephcrit.bsky.socialSpecial GuestsEwout J. Hoorn, Professor of Medicine Erasmus MC, Netherlands. One of the primary authors.Harish Seethapathy, Assistant physician at Massachusetts General HospitalEditingVipin VergheseThe Kidney Connection written and performed by Timothy YauShow Notes A Randomized Trial of Targeted Hyponatremia Correction in Hospitalized Patients in NEJM Evidence, in PubMed, in NephJCSeethapathy: Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis in NEJM EvidenceMacMillan: Osmotic Demyelination Syndrome in Patients Hospitalized with Hyponatremia in NEJM EvidenceSALSA: Risk of Overcorrection in Rapid Intermittent Bolus vs Slow Continuous Infusion Therapies of Hypertonic Saline for Patients With Symptomatic Hyponatremia: The SALSA Randomized Clinical Trial in JAMA Internal MedicineSALT 1 and 2: Tolvaptan, a Selective Oral Vasopressin V2-Receptor Antagonist, for Hyponatremia in NEJM Hyponatremia registry: Current treatment practice and outcomes. Report of the hyponatremia registry in Kidney InternationalThe Richard Sterns' article on the lower mortality with more severe hyponatremia: Mortality and Serum Sodium: Do Patients Die from or with Hyponatremia? in CJASNThe European Hyponatremia Guidelines: Clinical practice guideline on diagnosis and treatment of hyponatraemia in The European Journal of EndocrinologyThe American Hyponatremia Guidelines: Diagnosis, Evaluation, and Treatment of Hyponatremia: Expert Panel Recommendations in American Journal of MedicineTreating hyponatremia: damned if we do and damned if we don't by Tom Berl in Kidney InternationalProspective (clamp) versus reactive (rescue) DDAVP in hyponatremia: Safety and efficacy of proactive versus reactive administration of desmopressin in severe symptomatic hyponatremia: a randomized controlled trial in Nature Scientific Reports and as covered in PBFluidsHelbert Rondon's RCT of urea Urea for Chronic Hyponatremia on ClinicalTrials.govTubular SecretionsSwapnil: Catfishing on CatNet: A Novel by Naomi Kritzer (Amazon)Harish: Disney CruiseEdward: Flesh: A Novel (Booker Prize Winner) by David Szalay (Amazon)Pedro: Scrubs reboot (IMDB)Joel: KIDNEYcon

Nurse Doza breaks down five signs your gut microbiome may be off — a history of antibiotics, brain fog, autoimmune issues, relentless sugar cravings, and not pooping every day. He explains how gut bacteria help shape neurotransmitters, blood sugar, and natural GLP-1, why so many issues trace back to the gut, and the simple steps — fasting, fermented foods, fish oil, and the Good Poops Protocol — that can help rebuild it from the inside out. FEATURED PARTNER — Good Poops Protocol (MSW Nutrition) This episode centers on rebuilding the gut microbiome, and the Good Poops Protocol is the bundle Nurse Doza built for exactly that — Gut, Liver Boost, and Berberine Plus working together over 60 days to support the intestinal lining, healthy bile flow, and blood-sugar metabolism. Berberine and L-glutamine are both studied for supporting the body's own GLP-1 production, making the protocol a practical starting point for the digestive issues discussed in this episode.

How can local authorities make better, fairer decisions using evidence that everyone can understand and contribute to? In this episode of Gerrin' On Wi' It on the Research and Innovation Podcast, host Lauren Cox is joined by Zoe Lancelott and Rhianydd Davies from the Rhondda Cynon Taf Health Determinants Research Collaboration (HDRC). Together, they explore “The Evidence Pie” — a simple but powerful tool designed to demystify evidence and create a shared language for decision-making across organisations. Built around six equal slices — professional knowledge, academic research, impact measurement, organisational data, population data, and lived experience — the Evidence Pie encourages a balanced, non-hierarchical approach where every perspective matters. Zoe and Rhianydd share how the tool emerged from a need to translate research into practical, everyday council work, and how it's helping embed evidence-informed decision-making across services. From tackling health inequalities and poverty to improving collaboration between councils, communities, and researchers, the conversation highlights how making evidence accessible can drive real change. This episode was recorded on Wednesday 20 May 2026. If you would like to get in touch, please contact contact@y-pern.org.uk. A transcript of this episode is available. Y-PERN is funded by the UKRI's Research England Development (RED) Fund; YPIP is funded by the UKRI's Economic and Social Research Council. About the speakers: Zoe Lancelott has over 30 years' experience of delivering and managing services for children, young people and families in the public, private and voluntary sectors. Living and working in the South Wales Valleys, Zoe has a keen interest in the role of early intervention and prevention in reducing barriers to education, engagement and opportunity faced by individuals and communities and redressing health inequalities. To her role as the Head of the Rhondda Cynon Taf Health Determinants Research Collaboration, Zoe brings a proven track record of strong strategic leadership, partnership working, delivering multi-million pound change programmes across local government services, public and third sector partners and transforming traditional Council services within both Education and Social Care spheres to deliver measurable outcomes for children, young people and families. Rhianydd Davies is Rhondda Cynon Taf (RCT) Health Determinants Research Collaborations (HDRC)'s Organisational Development Lead and she's been working in the council and Human Resources for over 20 years. She previously managed the training and occupational health teams and sat as senior management partner for HR within that team. She brings a huge amount of knowledge and experience of RCT council and its organisational development. So along with the rest of the team at RCT HDRC, Zoe and Rhianydd's work is crucial in driving evidence-based decision making at all levels within the council, aiming to break the cycle of poverty, and improving the life chances of the most disadvantaged residents. Lauren is the Communications and Engagement Manager for The Yorkshire Policy Innovation Partnership (YPIP). She has over 5 years of experience working with the voluntary, community, faith, and social enterprise (VCFSE) sector across Luton and Bedfordshire in roles with the local authority and within a criminal justice charity. Lauren's career has been centred around collaboration and partnerships and facilitating spaces and environments for voices to be heard. Lauren will be joining Leeds Institute for Societal Futures in July 2026 as the External Engagement Manager. Related content / relevant links: Health Determinant Research Collaboration Rhondda Cynon Taf (HDRC RCT) Make a Change RCT Introducing The Evidence Pie RCT HDRC Evidence Pie Creating a common language around evidence

Lion’s Mane Mushroom and Brain Health: What Four Clinical Trials Actually Found Many stroke survivors and people managing cognitive decline more broadly eventually ask the same question: Is there anything beyond physiotherapy and medication that can actively support brain healing? Not symptom management. Actual repair. Lion’s Mane mushroom (Hericium erinaceus) is one compound that has gathered genuine clinical attention. It is not a cure, the human trial evidence is still limited in scale, and it is not a replacement for the fundamentals of brain health. But the mechanism is unusual, the safety profile is consistently good, and for anyone serious about their brain, the research warrants an honest look. Why Lion’s Mane Is Neurologically Unusual Most supplements that claim to support brain health cannot cross the blood-brain barrier, the tightly regulated membrane that controls what enters the brain. Without crossing it, any direct effect on brain tissue is limited. Lion’s Mane contains two families of bioactive compounds found almost nowhere else in nature. Hericenones come from the fruiting body, the visible mushroom. Erinacines come from the mycelium, the root-like underground network. Both stimulate the production of Nerve Growth Factor (NGF) and Brain-Derived Neurotrophic Factor (BDNF). These are proteins the brain uses to grow new neurons, maintain existing ones, and strengthen the connections between them. Crucially, erinacine A, one of the key mycelium compounds, has been confirmed in preclinical studies to cross the blood-brain barrier. That is not a trivial distinction. It is one of the reasons researchers have taken this mushroom seriously. “These are proteins your brain uses to grow new neurons, maintain existing ones, and build and strengthen the connections between them. They are, in a very real sense, your brain’s repair and maintenance crew.” — Bill Gasiamis What the Human Clinical Trials Found Four published human clinical trials have examined Lion’s Mane. Here is what each found: Mori et al. (2009): In a randomised, double-blind, placebo-controlled trial, 30 older adults with mild cognitive impairment (MCI) took Lion’s Mane supplement or placebo for 16 weeks. The Lion’s Mane group showed significantly better cognitive function scores at weeks 8, 12, and 16. When supplementation stopped, scores declined again within four weeks, suggesting the effect was tied to ongoing intake, not a placebo response. Saitsu et al. (2019): A multicenter RCT tested 12 weeks of oral Lion’s Mane in older adults. Participants in the treatment group showed significant improvement on the Mini-Mental State Examination (MMSE) compared to placebo. No adverse effects were observed. Nagano et al. (2010): A 4-week RCT using Lion’s Mane-enriched cookies found significant reductions in self-reported depression and anxiety in women compared to placebo, suggesting effects extend beyond cognition to mood and emotional regulation, possibly via the gut-brain axis. Docherty et al. (2023): A double-blind pilot study from Northumbria University tested 41 healthy young adults aged 18–45. After a single dose, participants performed significantly faster on the Stroop task, a measure of cognitive processing speed and flexibility. After 28 days, there was a trend toward reduced subjective stress. This was a small study, and results should be interpreted cautiously, but it suggests Lion’s Mane effects are not limited to populations already experiencing cognitive decline. The Stroke-Specific Preclinical Data For stroke survivors, the preclinical research adds another dimension. In a 2014 animal study, erinacine A reduced brain infarct volume by 22–44% in ischemic stroke models (depending on dose), and significantly lowered pro-inflammatory cytokines, including IL-1β, IL-6, and TNF-α markers of the neuroinflammatory cascade that follows stroke. A 2022 study found that erinacine A helps preserve glutamate clearance in the brain after ischemic injury. Excess glutamate is one of the key mechanisms of neuronal death after stroke, so anything that helps regulate it post-injury is clinically relevant. These are animal studies. They do not translate directly to human outcomes. But they provide a biological rationale that supports why clinical researchers are now investigating Lion’s Mane in neurological recovery contexts. What the Research Does Not Yet Tell Us The limitations matter, and any honest assessment must include them. All four human trials are relatively small, none exceeds 100 participants. We do not yet have large-scale, long-term RCTs in stroke survivor populations specifically. The optimal dose, duration, and form (fruiting body vs mycelium vs dual extract) have not been established in human trials. Direct confirmation that erinacines cross the blood-brain barrier in humans rather than in animal models does not yet exist. Bill says it directly in the video: “The human trial data is still relatively limited in scale. We need larger, longer trials.” Practical Questions to Raise with Your Doctor If you are considering Lion’s Mane supplementation, the following questions are worth raising with your neurologist or GP: Is it safe alongside my current medications? Theoretical interactions exist with anticoagulants (warfarin, aspirin, clopidogrel) and antidepressants, not confirmed in human trials, but worth disclosing. Anyone on blood thinners following a stroke should have this conversation before starting. What form should I look for? Products should specify standardised hericenone content (fruiting body extract) or erinacine A content (mycelium extract). Products listed only as “mycelial biomass on grain” typically contain very low levels of active compounds and high levels of starch from the growth substrate. If the label does not specify active compound content, treat that as a quality flag. Are there any trials I could join? ClinicalTrials.gov lists current recruiting studies for Hericium erinaceus and cognitive function worth checking if you are interested in contributing to the evidence base. More information: https://recoveryafterstroke.com/book | Support the podcast: https://patreon.com/recoveryafterstroke *This blog is for informational purposes only and does not constitute medical advice. Please consult your doctor before making any changes to your health or recovery plan. The post Can a Mushroom Help Your Brain Heal? The Science Says Maybe appeared first on Recovery After Stroke.

Prehospital blood is one of the hottest debates in trauma resuscitation — and the evidence just got a lot more interesting. In this episode, Drs. Patrick Georgoff and Ayman Ali sit down with Dr. Ed Barnard, UK defense professor of emergency medicine and author of the landmark SWIFT trial, and Dr. Juan De Chesney, trauma surgeon and pioneer in prehospital blood programs, to break down what we actually know about getting blood to patients before they hit the doors. The SWIFT trial — the largest prehospital whole blood RCT to date — found no superiority of whole blood over component therapy, but the story is far more nuanced than a negative headline suggests. From the logistics of carrying blood on a helicopter to the stark reality that only 1.8% of US ground EMS carries any blood products at all, this conversation exposes both the progress and the enormous gaps that remain. Hosts: Ayman Ali, MD: Ayman Ali is a Behind the Knife fellow and general surgery PGY-4 at Duke Hospital.  Patrick Georgoff, MD @georgoff: Patrick Georgoff is faculty in the Department of Surgery at the Duke University School of Medicine where he serves as an Associate Professor of Trauma, Acute, and Critical Care Surgery and Trauma Medical Director. He is a leading educator and creator for Behind the Knife, a premier digital education platform and podcast advancing surgical training through innovative, high-yield multimedia content. Juan Duchesne, MD: Juan Duchesne is a trauma surgeon and Professor of Surgery serving as the Trauma Medical Director and Division Chief at the University of Mississippi Medical Center. His pioneering contributions to the field—particularly in whole blood and balanced resuscitation practices—have been honored with numerous accolades.  Ed Barnard, PhD FRCEM FIMC RCSEd, @edbarn @DefProfEM: Ed Barnard is an emergency physician and UK Defence Professor of Emergency Medicine, RCEM/NIHR Associate Professor, and Affiliated Assistant Professor at the University of Cambridge. He has sub-specialty training in pre-hospital and academic emergency medicine and possesses extensive experience in trauma, anaesthesia, and critical care across both civilian and military settings. His contributions to the field have been honored with five national research awards and a PhD - undertaken with the US Army in San Antonio, TX. This episode was sponsored by Teleflex, a global provider of medical devices. Learn more at teleflex.com and at the Teleflex Trauma and Emergency Medicine LinkedIn page. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.  If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listenBehind the Knife Premium: https://behindtheknife.org/premiumOral Board Review: https://behindtheknife.org/oral-boardOral Board Simulator: https://behindtheknife.org/oral-board/simulatorGeneral Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-reviewTrauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlasDominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkshipDominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotationVascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-reviewColorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-reviewSurgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-reviewCardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-reviewDownload our App:Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US

Tune in to this AI-powered Deep Dive to unpick the question that changes how we think about long-term lens clarity!  Does IOL material really matter for keeping the capsule clear? In this high-energy clinical breakdown, we dissect a landmark 12-month randomised controlled trial (RCT) by Naderi et al. from the Journal of Cataract & Refractive Surgery. Two identical lens designs by Rayner are pitted directly against each other - the hydrophilic RayOne 600C versus the hydrophobic RayOne 800C - to isolate material performance like never before.  In just a few minutes, you'll discover:  How the hydrophilic 600C and hydrophobic 800C stack up when edge and haptic variables are completely eliminated.  The cutting-edge methodology used to map PCO with extreme accuracy.  The preliminary 12-month data on visually significant PCO and Nd:YAG laser capsulotomy rates - and what this means for your practice efficiency and patient satisfaction.  Please note: Ahead of open access to this clinical paper becoming available, subscribers of JCRS can access the full study here: Journal of Cataract & Refractive Surgery This podcast was created with the assistance of artificial intelligence. While every effort has been made to ensure accuracy, listeners are encouraged to refer to the original publications for complete details. 

Galactagogues and medications to boost milk production. Everything from oats to fenugreek to lactation cookies and prescription medications like metoclopramide and domperidone. Also, cow's milk protein allergy, reflux and baby's spit-up, the safety of alcohol while breastfeeding, and how to handle other prescription medications. Natalie Borden, an international board certified lactation consultant, joins Chris to debunk breastfeeding myths. 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 is not your doctor (probably). This podcast is not medical advice for you; it is what we call information. References: Internet survey on patient use of lactation aides: https://pubmed.ncbi.nlm.nih.gov/37236347/ Cochrane 2020 on galactogogues: https://pubmed.ncbi.nlm.nih.gov/32421208/ 2023 RCT on lactation cookies: https://pubmed.ncbi.nlm.nih.gov/36921902/ The LactMed database: https://www.ncbi.nlm.nih.gov/books/NBK501922/

Download Porter Here: https://app.adjust.com/21bhdnwtGuest Suggestion Form: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://forms.gle/bnaeY3FpoFU9ZjA47⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Disclaimer: This video is intended solely for educational purposes and opinions shared by the guest are his personal views. We do not intent to defame or harm any person/ brand/ product/ country/ profession mentioned in the video. Our goal is to provide information to help audience make informed choices. The media used in this video are solely for informational purposes and belongs to their respective owners.(00:00) - Intro(02:55) - Why Are Only the Rich Getting Richer in India?(08:51) - Middle-Class Indians' Salary Range(13:27) - Should We Replace Humans Because of AI?(18:30) - India: 6th Largest Economy but Still Poor(25:33) - What Is an RCT?(29:37) - What Is Economics?(32:14) - Understanding the Indian Economy Using a Pressure Cooker(39:56) - How Are Guava, Anemia & Economics Related?(43:35) - What Is the Poverty Trap Curve?(50:43) - Why Does He Think Giving Freebies to Poor People Is Good?(59:19) - Why Don't Many Rich People Give to Charity?(1:02:15) - Why Do People Say Freebie Politics Is Ruining the Country?(1:07:57) - Why Does He Think Tax Havens Should Be Banned?(1:17:37) - Is a Closed Economy Good for Growth?(1:19:27) - Why Is India Poorer Than Japan Despite Almost the Same GDP?(1:22:56) - Why Did He Write the Paper "Marry for What"?(1:25:48) - Is Universal Basic Income the Future?(1:29:09) - Why Is There Inequality Even in Jails?(1:30:59) - Why Doesn't He Take GDP Seriously?(1:34:39) - BTS(1:35:23) - OutroIn today's episode, we sit down with Abhijit Banerjee, Nobel Laureate & Author, Economist & Co-Founder - JPAL to break down everything Indians get wrong about poverty, inequality, and the future of work.He also explains his Kenya experiment where a 2-year lumpsum beat 12 years of monthly transfers, the 17-year West Bengal study that showed one free cow made women 40% richer, the 140-study metaanalysis proving freebies make people work MORE not less, and why even a Nobel Laureate calls his own success "mostly luck."A complete masterclass on how the economy actually works from the man who built the world's most rigorous method for studying it.Subscribe for more such conversations.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠About Raj ShamaniRaj Shamani is an Entrepreneur at heart that explains his expertise in Business Content Creation & Public Speaking. He has delivered 200+ speeches in 26+ countries. Besides that, Raj is also an Angel Investor interested in crazy minds who are creating a sensation in the Fintech, FMCG, & passion economy space.To Know More,Follow Raj Shamani On ⤵︎Instagram @RajShamani ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.instagram.com/rajshamani/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Twitter @RajShamani ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://twitter.com/rajshamani⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook @ShamaniRaj ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.facebook.com/shamaniraj⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠LinkedIn - Raj Shamani ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/in/rajshamani/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠About Figuring OutFiguring Out Podcast is a Candid Conversations University where Raj Shamani brings raw conversations with the Top 1% in India.

Welcome back for the next journey of The Family Express Podcast with Kathryn de Bruin, LMFT and Ronda Evans, LMFT where our destination is resilient and connected families. Our guest stoday are Sara Lamb, MEd, RCT, CCC and Devonne Strachan, M.S.W., R.S.W. They will speak about parental alliance in EFFT.Kathryn de Bruin is an ICEEFT Certified EFT Trainer. Kathryn and Ronda are both licensed marriage and family therapists, EFT supervisors and therapists, and AAMFT Approved Supervisors.You can follow Kathryn de Bruin, LMFT atFacebook  YouTube  IG  Yelp  Google +  Twitter  WebsiteYou can follow Ronda Evans, LMFT atFacebook   Facebook   IG  WebsiteYou can reach Sara Lamb at www.saralamb.ca You can reach Devonna Strachan at https://www.westbridgeassociates.ca/associates/devonne-strachan/

Randomised Controlled trial of Vision Intervention for Seeing Impaired Babies: Learning through Enrichment (VISIBLE RCT)

This week, primary care doctors Mark Ebell, Kate Rowland, Henry Barry and Gary Ferenchick discuss four new studies: whether water is better than diet drinks in diabetes, a new RCT of Paxlovid for COVID in contemporary patients, to switch or not to switch antiplatelet agents after a stroke, and the latest AHA 2026 dietary advice for heart health.Drinks for diabetes: ttps://pubmed.ncbi.nlm.nih.gov/41369640/ Antiplatelet agents after stroke on aspirin: https://pubmed.ncbi.nlm.nih.gov/41347302/ New Paxlovid trial: https://pubmed.ncbi.nlm.nih.gov/42019019/ AHA 2026 dietary guidance: https://pubmed.ncbi.nlm.nih.gov/41914202/

Summary: Hidradenitis Suppurativa (HS) is one of dermatology's most complex and underrecognized conditions and the treatment landscape is changing fast. In this episode, Dr. Faranak Kamangar sits down with Dr. Hadar Lev-tov, Associate Professor at the University of Miami, Director of the Wound Healing Fellowship, and Immediate Past President of the Hidradenitis Suppurativa Foundation, for a rapid-fire review of everything happening in the HS world right now. Dr. Lev-tov covers the currently approved therapies, the exciting drugs moving through Phase 3 trials, and the groundbreaking science linking microplastics to HS inflammation. He also shares his candid take on GLP-1s in HS management and what the future of dermatology looks like when treatments work so well that doctors can finally focus on the whole patient. Whether you're a resident just learning HS or a seasoned dermatologist trying to keep up with a fire-hose pipeline, this one is for you. Topics Covered: - Approved HS biologics: bimekizumab, secukinumab, adalimumab & biosimilars - Off-label use of infliximab (IV and subcutaneous) in severe HS - Phase 3 pipeline: remibrutinib, povorcitinib, sonelokimab (nanobodies) - CAR T-cell therapy and the possibility of curing inflammatory skin disease - Microplastics, nicastrin, and a landmark Nature Communications paper on HS - GLP-1s in HS: what we know, what we don't, and Dr. Levtov's clinical approach - The HS Foundation's research grants, HS Academy, wound care referral tool, and prior authorization templates - The future of dermatology as lifestyle medicine Resources Mentioned: - https://www.nature.com/articles/s41467-025-65789-7  - HS Foundation website & prior authorization templates: https://www.hs-foundation.org/ - HS Academy (free weekend for residents): https://www.hs-foundation.org/hs-academy - Integrative Dermatology Symposium: integrativedermatologysymposium.com - LearnSkin: learnskin.com This podcast is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider. Key Takeaways: 1. Validate HS patients the moment they walk in. They've often been dismissed or bounced between providers for years. Simply saying "I understand what you're going through" builds trust immediately and makes the visit more productive. 2. The approved HS treatment arsenal is growing. Bimekizumab and secukinumab (IL-17 inhibitors) are now approved, and adalimumab — including biosimilars — remains a valuable option. Clinical experts are using biosimilars with confidence. 3. Subcutaneous infliximab is an emerging option. Available off-label in the US, new data from French centers shows a protocol: standard IV induction at weeks 0, 2, and 6, then switching to subcutaneous injections every two weeks at week 10 — but only once the patient is in strong remission. 4. Three major drugs are in or completing Phase 3 trials. Remibrutinib (BTK inhibitor, already approved for chronic spontaneous urticaria), povorcitinib (JAK1 inhibitor), and sonelokimab (a nanobody targeting IL-17A and IL-17F) are all reporting promising results and moving toward FDA application. 5. Nanobodies are a technology to watch. Derived from camelid antibody fragments, nanobodies like sonelokimab can be engineered to target multiple pathways simultaneously in a smaller, more modular molecule — expect to see them across dermatology. 6. Half-life extenders could mean one injection per year. Already emerging in psoriasis, these extended-dosing biologics are heading toward HS — a potential game-changer for patient adherence. 7. CAR T-cell therapy may one day cure inflammatory skin disease. Currently being studied in lupus and rheumatoid arthritis, the protocols are becoming more practical, and the technology is edging toward dermatology. 8. Microplastics may potentiate HS inflammation. A Nature Communications paper by Dr. Luis Garza (Hopkins) found that plastic-associated endocrine disruptors block nicastrin in fibroblasts, amplifying HS-related inflammation. This doesn't prove causation, but it reveals a meaningful environmental link — and highlights the underappreciated role of fibroblasts in HS scarring. 9. GLP-1s in HS: promising but not proven as monotherapy. There's no RCT yet. Dr. Levtov's clinical approach: stabilize HS with a biologic first, then consider adding a GLP-1 as part of a comprehensive plan that includes diet and resistance training. He has seen outcomes go both ways. 10. The HS Foundation is an underutilized resource. Their website offers a clinic finder, wound care referral service, prior authorization templates (one-click Word documents), research grants, the HS Academy (free, all-expenses-paid weekend for residents), and career development awards in partnership with the Dermatology Foundation. Chapters: 0:00 – Introduction & Dr. Lev-tov's Background 0:49 – The #1 Clinical Tip for Seeing HS Patients 1:44 – Approved HS Treatments: IL-17 Inhibitors, Adalimumab & Biosimilars 2:40 – Off-Label Infliximab: IV and the New Subcutaneous Protocol 4:21 – Phase 3 Pipeline: Remibrutinib, Povorcitinib & Sonelokimab (Nanobodies) 6:00 – Half-Life Extenders & One-Injection-Per-Year Future 7:01 – CAR T-Cell Therapy: Could We Cure Inflammatory Skin Disease? 7:36 – Research Funding & HS Foundation Grants 8:43 – HS Foundation Tools: Prior Auth Templates, Clinic Finder & HS Academy 10:15 – Microplastics, Nicastrin & the Nature Communications Paper 13:22 – What This Means for Fibroblasts and HS Scarring 14:20 – Celebrating Dermatology Science & Clinician-Scientists 15:32 – GLP-1s & HS: What's the Evidence? 17:18 – Dr. Lev-tov's Clinical Approach to GLP-1 Requests 19:06 – The Future of Dermatology: Becoming Lifestyle Doctors 21:28 – The Integrative Dermatology Symposium & LearnSkin Certificate Program 22:50 – Closing Remarks

Send us Fan MailOpioid withdrawal dosing, intranasal breast milk, human milk fortification in Japan, neonatal dysphagia, and vaccine policy. A full week on the Incubator Journal Club.Ben opens with the Optimized NOW trial in JAMA: symptom-based dosing reduced time to medical readiness for discharge by nearly two and a half days in NOWS infants managed with Eat Sleep Console, and allowed 65% of pharmacologically treated infants to avoid scheduled opioids entirely.Daphna reviews a small RCT out of Turkey showing improved cerebral oxygenation and favorable vital sign trends after intranasal breast milk administration in preterm infants, adding to the growing tolerability data for this intervention.Ben then covers the JASMINE trial, a Phase 3 RCT in Japan showing significantly better weight gain velocity with an exclusive human milk diet in very low birth weight infants.Daphna closes with a retrospective cohort study on FEES-confirmed dysphagia in preterm infants. Of those who met criteria for evaluation, every single one had laryngeal penetration and 57% were aspirating.Ben and Eli close the week on the quiet dismantling of vaccine infrastructure in the US and what it means for the populations in your NICU.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

In this episode of Joint Ventures, hosts Jack Arnold, MBBS, PhD, an academic clinical lecturer in rheumatology at the University of Leeds, and Rihards Buss, MD, a consultant rheumatologist at Freeman Hospital, Newcastle, turn from osteoarthritis to the inflammatory arthritides — examining what early data in rheumatoid arthritis (RA), psoriatic arthritis (PsA), and lupus can and cannot yet tell us about the role of GLP-1 receptor agonists in disease modification.“Everyone is talking about [GLP-1 RAs] and what it can do for our patients. Much more evidence is needed to be much more better understanding about increasing effects beyond weight loss is needed. And I think that evidence will be just coming out very rapidly, year by year… but I think this is not the case where we're going to wait for strong evidence, good quality RCT data before we start to start to use them,” Buss said.

Send us Fan MailDeep-dive into a 2026 cardiology review paper claiming seed oils reduce inflammation, exposing misrepresentations of cited clinical trials, and detailing how oxidized Ω-6 fats trigger inflammation.Companion article: Click HERETOPICS DISCUSSED:Seed Oil Profiles: Typical seed oils like sunflower are high in linoleic acid (omega-6 PUFA), while canola is higher in monounsaturated fats and resembles olive oil.Review Paper Critique: The 2026 JACC review falsely claims sunflower oil reduce inflammation like olive oil, citing an RCT that showed benefits only for canola and olive.RCT Analysis: In Iranian women with metabolic issues, switching to canola or olive oil lowered CRP by increasing MUFA and decreasing PUFA intake; sunflower oil produced no change.CRP Biology: CRP responds to oxidized lipids and cellular damage patterns, rising with exercise or infection and marking oxidized Ω-6 metabolites in modern diets.Oxidized Lipids: Ω-6 fats in LDL and cardiolipin oxidize easily, generating 4-HNE, MDA, and other signals that trigger immune clearance, similar to bacterial threats.Sterile Inflammation: High dietary linoleic acid causes chronic immune activation without pathogens, potentially contributing to metabolic and cardiovascular issues.PRACTICAL TAKEAWAYS:Prioritize monounsaturated fats from olive or avocado oil over high-linoleic seed oils like standard sunflower or soybean for lower oxidative stress potential.Check labels for high-oleic versions of sunflower oil, which shift the profile toward monounsaturated fats.Evaluate nutrition claims by examining original studies and fatty acid compositions rather than accepting review summaries at face value.Support the showHealth Products by M&M Partners:AquaTru: Water filtration devices that remove microplastics, metals, bacteria, and more from your drinking water. Through link, $100 off AquaTru Carafe, Classic & Under Sink Units; $300 off Freestanding models.OmegaQuant: At-home blood testing to see fatty acid profiles, including omega-3 fatty acids. Use link to see options and support M&M.SiPhox Health: Comprehensive, cost-effective bloodwork from the comfort of home. Use code TRIKOMES for 20% off.KetoCitra—Ketone body BHB + electrolytes formulated for kidney health. Use code MIND20 for 20% off any subscription (cancel anytime)SporesMD: Premium mushrooms products (gourmet mushrooms, nootropics, research). Use code 'nickjikomes' for 20% off.For all the ways you can support my efforts

Discover how the "Brain Energy Gap" drives cognitive decline and how ketones can rescue starving neurons. Dr. Stephen Cunnane explains the science of metabolic health, the BENEFIC trial, and how to fuel a hybrid brain for long-term longevity.Is Alzheimer's actually a fuel shortage in the brain? In this interview, world-renowned researcher Dr. Stephen Cunnane breaks down the "Brain Energy Gap", a critical metabolic deficit where the brain loses its ability to utilize glucose efficiently as we age. While this energy gap can lead to Mild Cognitive Impairment (MCI) and Alzheimer's, Dr. Cunnane's groundbreaking research, including the landmark BENEFIC trial, shows that ketones can bypass this blockage to provide a vital backup fuel source.We dive deep into the hybrid brain concept, exploring how Medium Chain Triglycerides (MCTs) and specific dietary shifts can "rescue" cognitive function by doubling brain ketone uptake. Dr. Cunnane also discusses the "double jeopardy" of insulin resistance and why managing metabolic health is the most promising frontier for preventing neurodegeneration. Whether you are interested in brain health, longevity, or the clinical applications of ketogenic metabolic therapy, this technical deep dive offers essential insights into the future of healthy aging

Jonathan Howard and Wendy Orent call this week their "Red Wedding": within days, FDA Commissioner Marty Makary resigned, Vinay Prasad was pushed out of CBER, Tracy Beth Hoeg was fired, and Senator Bill Cassidy lost his Louisiana primary. The hosts argue this is not a tragedy but a long-foretold collapse — a group of physicians who built careers as COVID-era contrarian podcasters discovering that running a regulatory agency is fundamentally different from posting about one. Howard works through the wreckage: Makary's reported approval of flavored nicotine products days before his ouster, the FDA's treatment of the rare disease community, the leaked memo claiming pediatric COVID vaccine deaths that career staff refused to sign off on, and the broader pattern of "regulatory whiplash" that drove the agency into dysfunction. The episode then turns to who is still standing — Jay Bhattacharya at NIH, Robert F. Kennedy Jr. at HHS — and what Kennedy is reportedly doing to vaccines from behind the scenes via Martin Kulldorff's review effort. Throughout, the hosts return to a single thesis: the skills that made Makary, Prasad, Hoeg, and Cassidy famous during COVID — opinion, tweeting, posturing — do not translate into running institutions, and the medical commentators who vouched for them (John Mandrola, Adam Cifu) have lost any remaining credibility. Key Topics Discussed Bill Cassidy's primary loss and the cost of the Kennedy confirmation vote Cassidy's earlier vote to convict Trump after January 6 followed by his decisive vote advancing RFK Jr. as HHS Secretary. Howard and Orent's view that Cassidy's promise to "keep Kennedy in line" was hollow from the start. What Cassidy's defeat signals about Trump's grip on the Republican base in Louisiana — and the hosts' read that his lame-duck status may give him cover to block the next round of HHS nominees. Marty Makary's resignation and the "worst FDA Commissioner in 25 years" framing The Stat News piece characterizing Makary's tenure, and the reporting that flavored nicotine was the precipitating issue with Trump's tobacco-industry donors. Howard's counterpoint: Makary reportedly approved a batch of electronic nicotine delivery systems (ENDS) on May 5, 2026 — the weekend before he resigned — undercutting the "principled stand" narrative. The pattern of selfie videos, public-facing performance, and what former FDA staff describe as hostile management of career scientists. Makary's pre-FDA record: the "medical error is the third leading cause of death" claim, Omicron as "nature's vaccine," "Omicold," herd immunity calls in May 2021, and the Nazi-bioweapon Lyme disease theory amplification. Vinay Prasad, regulatory whiplash, and the rare disease community How Prasad's stated preference for randomized controlled trials translated into rejection of rare disease therapies — and the disconnect between calling for RCTs on Twitter and the practical impossibility of running them for small patient populations. Right-to-try advocates, the libertarian wing of MAHA (Senator Ron Johnson), and why they turned on Prasad. Howard's point: Pfizer's halted COVID vaccine RCT in 50–65-year-olds is the case study — the trials Prasad demanded couldn't actually be enrolled. Tracy Beth Hoeg, the leaked pediatric deaths memo, and the Maryanne Demasi interview Hoeg's insistence she was fired, not resigned, and her interview with Brownstone Institute–adjacent journalist Maryanne Demasi. Her claim that the chaos at the FDA was "created by the media" rather than real. The memo alleging 10 pediatric deaths from the COVID vaccine that career FDA staff would not sign off on — and Howard's contrast with the J&J/thrombosis response, where nine deaths produced immediate, transparent action. Hoeg's role in the Denmark-style vaccine schedule rollback memo alongside Makary. The Makary–Prasad ZDoggMD clip on FDA "vindictiveness" — and the irony Audio pulled from a pre-appointment Prasad/Makary appearance describing the FDA as "erratic," "capricious," and politically pressured. Howard's read: every criticism they leveled at the Biden-era FDA describes their own tenure — political pressure from Trump, demoted career staff, inconsistent standards. The Peter Marks / Marion Gruber / Phil Krause booster episode reframed in light of what followed. John Mandrola, Adam Cifu, and the cost of vouching Mandrola's "Can We Give the New FDA's Leadership a Chance?" piece a year earlier — and the line about Prasad and Makary inducing companies to run proper RCTs, set against Pfizer's halted trial. Howard's account of an email exchange with Cifu following Cifu's visit to NYU — Howard's offer of a serious content-level conversation, and Cifu's decline. The broader "medical conservatives" project and what the hosts argue has happened to its credibility. Jay Bhattacharya, NIH, and the resignation letter from departing staff The letter from a senior NIH scientist on Bhattacharya's leadership — political termination of grants, deals institutions are making to recover funding, and Bhattacharya's silence. Howard and Orent's read on Bhattacharya's visible deterioration and his retreat into Great Barrington nostalgia. Kennedy's behind-the-scenes vaccine review and Martin Kulldorff The New York Times reporting (Christina Jewett and Sheryl Gay Stolberg) on Kennedy's vaccine inquiry being led by Kulldorff. Howard's pushback on the framing of Kulldorff as merely "a critic of restrictions and mandates" — and the 2020 record of his herd-immunity-through-infection advocacy, including his Stockholm "almost at herd immunity" claim in April 2020. The hosts' concern that the COVID amnesia project lets pandemic-era pro-infection figures re-enter regulatory power with their record sanitized. Casey Means, Surgeon General nomination withdrawal, and MAHA fracturing The withdrawn Surgeon General nomination and what it signals. The Robert Malone vs. Makary public falling-out over the unreleased pediatric deaths data. Why the MAHA coalition — held together by shared COVID grievance — is coming apart now that COVID has receded from headlines. Notable Moments On Cassidy: "He betrayed his oath as a physician, he betrayed the American people, and he's going down into the ignominious dust." — Wendy Orent On the Makary–Prasad–Hoeg trio: "The same skill sets that catapulted these guys to power — essentially being excellent podcasters — do not translate into leading a government agency of tens of thousands of employees that regulates 20 percent of the US economy." — Jonathan Howard On the legacy: "These guys are now cautionary tales for medical students. I would love to teach a course called 'Be the Opposite of Bill Cassidy, Marty Makary, Vinay Prasad, and Tracy Beth Hoeg.'" — Jonathan Howard On Bhattacharya: "His soul has been totally corrupted by the people who he teamed up with. You also see it in his face. He's not the same person that took the position." — Jonathan Howard References Mentioned in the Episode Stat News — "Why Marty Makary Was the Worst FDA Commissioner in 25 Years" Vinay Prasad's 2016 Stat News rebuttal of Makary's "medical error" claim David Gorski (Science-Based Medicine, 2016) — rebuttal of the medical-error-as-third-leading-cause-of-death claim Jonathan Howard, Science-Based Medicine — recent piece compiling Makary's COVID-era statements New York Times — Christina Jewett and Sheryl Gay Stolberg on Kennedy's vaccine inquiry Washington Post — "Ouster of RFK's Allies Tests MAHA-Trump Alliance" Ben Mazer, The Atlantic — on whether Makary and Prasad enacted lasting change Francis Lee — In COVID's Wake Alfred Crosby — America's Forgotten Pandemic Maryanne Demasi interview with Tracy Beth Hoeg MedPage Today — Makary and Prasad, "The Importance of Humility in Medicine" People Referenced Marty Makary — outgoing FDA Commissioner Vinay Prasad — former CBER Director Tracy Beth Hoeg — fired FDA official Senator Bill Cassidy (R-LA) — lost primary Robert F. Kennedy Jr. — HHS Secretary Jay Bhattacharya — NIH Director Martin Kulldorff — leading Kennedy's vaccine review Peter Marks — former CBER Director, Operation Warp Speed Bob Kadlec — Operation Warp Speed David Kessler — former FDA Commissioner (referenced) Marion Gruber and Phil Krause — former FDA vaccine reviewers John Mandrola and Adam Cifu — "medical conservative" commentators Robert Malone — anti-vaccine activist Casey Means — withdrawn Surgeon General nominee Senator Ron Johnson (R-WI) Representative Jake Auchincloss — opened FDA whistleblower line Art Caplan — bioethicist (retirement) Erica Schwartz — CDC Director nominee, unconfirmed  

Outside of pregnancy, guidelines emphasize diabetes self-management education and support to facilitate informed decision making, self-care behaviors, problem solving, and active collaboration with health care professionals. This includes, in those with good health literacy, the concept of patient-led self-titration of basal insulin results which has data that it improves glycemic management compared with clinician-led titration for type 2 diabetes among nonpregnant adults. But what about for GDM? Can patient's self manage their BASAL insulin? In this episode, we will review a new RCT published in April 2026 in the Green Journal on this very subject. As novel as this is, it is not the first to report on this as it was also published (retrospective study in the UK) in 2022. This is a novel approach to insulin in GDM but there are some questions that remain. Listen in for details.1. Boonpattharatthiti K, Wechkunanukul K, Mayang N, et al . Comparison of Insulin Titration Strategies for Glycemic Control in Type 2 Diabetes: A Systematic Review and Network Meta-Analysis.Diabetes Care. 2025. 2. Valent, Amy M. DO, MCR; Barbour, Linda A. MD, MSPH. Insulin Management for Gestational and Type 2 Diabetes in Pregnancy. Obstetrics & Gynecology 144(5):p 633-647, November 2024. | DOI: 10.1097/AOG.00000000000056403. Wang, Xiao-Yu MD; Gabbe, Steven MD; Landon, Mark B. MD; Venkatesh, Kartik K. MD, PhD et al. Patient-Led Insulin Titration for Glycemic Management With Gestational Diabetes Mellitus: A Randomized Controlled Trial. Obstetrics & Gynecology 147(4):p 501-509, April 2026. 4. McGovern AP, Hirwa KD, Wong AK, et al. Patient-led rapid titration of basal insulin in gestational diabetes is associated with improved glycaemic control and lower birthweight. Diabet Med. 2022;39:e14926. doi: 10.1111/dme.14926

Does GABA Actually Help With Sleep? What the Research Says for Brain Injury Recovery Someone in our community recently asked me about GABA for sleep. They’d seen it recommended online, understood that sleep was critical for their recovery, and wanted to know whether the supplement was worth exploring or just noise. It’s a genuinely good question. And it deserves a proper answer. In this post, I’m going to walk you through what GABA is, what the clinical research actually shows about its effect on sleep, why the blood-brain barrier debate matters (and why it might not derail the whole argument), and what the evidence says about the relationship between sleep and brain recovery. By the end, you’ll have enough to have an informed conversation with your medical team. I’m not a doctor. I’m a three-time haemorrhagic stroke survivor who has spent years researching the science of brain recovery and interviewing hundreds of clinicians and survivors on the Recovery After Stroke podcast. What I offer is a careful read of the evidence, not a clinical prescription. What Is GABA and Why Does It Matter for Sleep? GABA (gamma-aminobutyric acid) is the brain’s primary inhibitory neurotransmitter. If your nervous system were a car, GABA is the brake pedal. It reduces neuronal excitability, quiets cortical arousal, suppresses the brain’s primary arousal centre (the locus coeruleus), and modulates the HPA axis, the stress-response system that drives cortisol. Most sedative medications work by amplifying GABA activity. Benzodiazepines, for instance, bind to GABA-A receptors to increase chloride channel opening, producing their calming effect. GABA isn’t doing something unusual here – it’s doing something fundamental. The question with supplemental oral GABA is more specific: Does taking GABA as a capsule or powder actually produce meaningful neurological effects? What Does the Research Show? Finding 1 — Oral GABA Reduces Sleep Latency (and EEG Can Measure It) A 2015 clinical trial published in the Journal of Nutritional Science and Vitaminology by Yamatsu and colleagues used EEG measurement, actual brainwave monitoring, rather than self-reported sleep questionnaires. One hundred milligrams of oral GABA shortened sleep latency (time to fall asleep) by 5.3 minutes compared to placebo. That might sound modest. But for someone lying awake for 30–40 minutes each night, it’s a meaningful shift. Crucially, this was objective neurophysiological data, not a survey response. (PMID: 26052150) Finding 2 — A 90-Day RCT Showed Improved Sleep Efficiency and Mood A 2024 randomised double-blind placebo-controlled trial published in the Journal of Dietary Supplements (Guimarães et al.) gave 200 mg of GABA daily for 90 days to sedentary overweight women also undergoing an exercise program. The GABA group showed significantly improved Pittsburgh Sleep Quality Index (PSQI) scores, significantly reduced depression scores, and improved heart rate variability, a marker of parasympathetic nervous system activity. The HRV finding is particularly interesting. It suggests GABA may be doing something broader than simply reducing sleep latency – it appears to support the overall physiological state that makes rest restorative. (PMID: 38321713) Finding 3 — But a High-Dose RCT Found No Effect Here’s where intellectual honesty matters. A 2023 Dutch RCT (de Bie et al.) published in the American Journal of Clinical Nutrition gave participants 500 mg of GABA three times daily, 1,500 mg/day total, and found no significant effect on self-reported sleep quality. Fasting plasma GABA wasn’t significantly elevated either, raising real bioavailability questions at that dose. This isn’t a reason to dismiss GABA entirely. It is a reason to pay attention to the dose. The evidence base supports 100–300 mg, not 1,500 mg. Higher is not better, and the non-linear dose response is clinically important. (PMID: 37495019) The Blood-Brain Barrier Debate — and Why the Gut May Be the Point The most common objection to oral GABA supplementation is this: GABA is a zwitterion at physiological pH, meaning it has low lipophilicity and poor predicted ability to cross the blood-brain barrier via passive diffusion. So if it can’t get into the brain directly, how does it produce neurological effects? The emerging explanation involves the gut-brain axis. The enteric nervous system, your gut’s own neural network, has GABA receptors. When oral GABA activates these enteric receptors, it can signal the brain via vagal afferents without needing to cross the BBB at all. Think of it as a side door rather than the front entrance. Supporting this: a 2024 RCT (Li et al.) found that a probiotic strain engineered to increase gut GABA production significantly improved objective sleep duration as measured by wearable devices, alongside reduced cortisol and suppressed HPA axis activity. The mechanism wasn’t direct CNS access – it was gut-brain signalling. (PMID: 39385735) The BBB debate doesn’t negate the clinical effect. It changes how we understand the mechanism. Why Sleep Is Not Optional in Brain Recovery This is the part that I think gets underweighted in recovery conversations — and the research is unambiguous. A 2026 large retrospective cohort study (Muhtar et al., Sleep Medicine) matched over 35,000 stroke patients and found that post-stroke insomnia was associated with a 29% higher risk of post-stroke cognitive impairment and a 30% higher risk of all-cause dementia. The association with Alzheimer’s disease was also significant. (PMID: 41924789) A 2024 observational study from Monash University and Alfred Health (Smith et al.) found that in stroke rehabilitation patients, poor sleep quality was significantly associated with higher fatigue severity and lower salivary BDNF gene expression. BDNF (brain-derived neurotrophic factor) is one of the primary molecular drivers of neuroplasticity. Less BDNF means a less receptive environment for the neurological rewiring that rehab is trying to build. (PMID: 38802847) And then there’s the glymphatic system: the brain’s waste-clearance mechanism that is most active during deep sleep. Poor sleep means reduced clearance of metabolic byproducts, including proteins associated with neurodegeneration. This is not a theoretical risk. It is an active, ongoing process. Sleep is not passive recovery. It is one of the primary mechanisms of recovery. What to Do With This Information Here are three practical steps if you’re exploring GABA for sleep: 1. Measure your sleep baseline first. Use the Pittsburgh Sleep Quality Index (freely available online) before you make any changes. Understanding whether you’re struggling with latency, duration, or quality will determine what you actually need to address. 2. If you trial GABA, choose the right form and dose. Look for PharmaGABA — naturally fermented GABA, derived from Lactobacillus hilgardii, which has the strongest clinical evidence base. A dose of 100–300 mg taken 30–60 minutes before bed is consistent with the positive studies. Avoid very high doses; the null result at 1,500 mg/day is important context. Important drug interaction note: If you are taking benzodiazepines, anticonvulsants (gabapentin, pregabalin, valproate), or any other GABAergic medication, discuss GABA supplementation with your prescriber before adding it. The additive sedative effect is a real risk. The same applies if you drink alcohol regularly. 3. Don’t skip the foundation. Sleep hygiene interventions, consistent sleep and wake times, a dark and cool room, and no screens in the 60 minutes before bed, are consistently among the highest-leverage sleep interventions in the literature. GABA may provide a genuine incremental benefit. But it cannot compensate for a fundamentally disrupted sleep environment. The Bottom Line The evidence for GABA and sleep is more substantive than I expected when I started researching it. The EEG data is real. The 90-day RCT showed meaningful clinical outcomes. The gut-brain axis mechanism is biologically plausible and now has direct RCT support. And the consequences of poor sleep in neurological recovery are not trivial – they are quantifiable, significant, and, to a degree, addressable. GABA is not a guaranteed fix. Individual responses vary. The research is not yet definitive at the level of large multi-centre trials in neurological populations. But as one tool in a comprehensive approach to sleep quality alongside good sleep hygiene, appropriate medical support, and consistent rehabilitation, the case for cautious exploration is reasonable. The next step is a conversation with your neurologist, GP, or rehab physician. Take the research with you if it’s useful. Research References All studies cited in this post are retrievable via PubMed: Yamatsu et al. — GABA sleep latency EEG clinical trial (2015) — PMID: 26052150 Guimarães et al. — GABA 200mg RCT, sleep efficiency + mood (2024) — PMID: 38321713 de Bie et al. — GABA high-dose RCT, null sleep result (2023) — PMID: 37495019 Li et al. — Gut-brain GABA axis and sleep RCT (2024) — PMID: 39385735 Muhtar et al. — Post-stroke insomnia and cognitive decline cohort (2026) — PMID: 41924789 Smith et al. — Sleep, BDNF, and fatigue in stroke rehabilitation (2024) — PMID: 38802847 This post is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making changes to your supplementation or treatment plan. If you or someone you care about is recovering from a stroke, brain injury, or any neurological condition, the Recovery After Stroke podcast and this blog exist for you. Subscribe on YouTube @BillGasiamis, or visit Recovery After Stroke to find episodes, resources, and community. The post GABA, Sleep, and Brain Health – Neurological Recovery appeared first on Recovery After Stroke.

Hyperemesis gravidarum (HG) represents the most severe end of the nausea and vomiting of pregnancy spectrum. It has a reported incidence of approximately 0.3–3% of pregnancies and is the most common cause of hospitalization in early pregnancy and the second most common cause of hospitalization in pregnancy overall. In June 2024, the ACOG published a Clinical Expert series summarizing the inpatient management of HG. In that guidance, it describes mirtazapine as an “alternative pharmacologic” option. How effective is this medication compared to ondansetron? A new study (published ahead of print on 12/30/25 and officially out June 2026), out of Denmark, sheds some new light on this medication. This trial is the first double-blind RCT comparing mirtazapine to ondansetron AND placebo. Although a BIG limitation of this study exists (which we will discuss), it does provide some interesting insights. Listen in for details.1. (ACOG CES) Clark, Shannon M. MD; Zhang, Xue MD; Goncharov, Daphne Arena MD. Inpatient Management of Hyperemesis Gravidarum. Obstetrics & Gynecology 143(6):p 745-758, June 2024. | DOI: 10.1097/AOG.00000000000055182. Ostenfeld, AnneDroogh, Marjoes et al.Mirtazapine or ondansetron for hyperemesis gravidarum. A randomized placebo-controlled trial. American Journal of Obstetrics & Gynecology, June 2026

Send us Fan MailCerebral oxygenation, staffing economics, delivery room scoring, neurodevelopmental prognostication, and public health — a full week on the Incubator Journal Club.Ben walks through the NIRTURE trial, a single-device RCT testing cerebral oximetry-guided care in infants born under 29 weeks. The intervention dramatically reduced the burden of cerebral hypoxia and hyperoxia compared to standard care. Secondary clinical outcomes were neutral and neurodevelopmental follow-up is still pending. The question of whether stabilizing cerebral oxygenation actually moves the needle for these babies remains unanswered.Daphna covers a brief communication from the Journal of Perinatology on what happens to billing and productivity when NICUs shift to 24-hour in-house attending coverage. Clinical FTE went up, work RVUs went down — and the reason is counterintuitive. Attendings present overnight were weaning babies faster. Better care, less revenue. The coding system was not built to capture that.Ben then pairs the 5-minute Apgar with umbilical artery pH in very preterm infants using EPICE cohort data. When both are low, risk is highest. When they compete, the Apgar wins.Daphna rounds out Journal Club with a systematic review showing that combining EEG and brain MRI outperforms either tool alone for neurodevelopmental prognostication in preterm infants.The week closes with Ben and Eli on the sweeping domestic and international public health funding cuts — and what they mean for the vulnerable populations in your NICU.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Spencer Jones, Founder of XO Medtech and MedtechVendors.com, shares how frontline nursing experiences led him to patent vascular access innovations and ultimately take devices from idea to FDA clearance and product launch. Spencer walks through learning business fundamentals through accelerators, raising early funding, and building sales and distribution networks, then explains why launching a digital-first, AI-native ecosystem has enabled faster, leaner execution than traditional medtech pathways. Spencer also discusses leadership, clear communication, and why AI adoption is essential to accelerate and de-risk early-stage medtech.  Guest links: https://www.linkedin.com/in/medtech-innovation/ | www.xomedtech.com | https://medtechvendors.com/  Charity supported: Polaris Project Interested in being a guest on the show or have feedback to share? Email us at theleadingdifference@velentium.com.  PRODUCTION CREDITS Host & Editor: Lindsey Dinneen Producer: Velentium Medical   EPISODE TRANSCRIPT Episode 080 - Spencer Jones [00:00:00] Lindsey Dinneen: Hi, I'm Lindsey and I'm talking with MedTech industry leaders on how they change lives for a better world. [00:00:09] Diane Bouis: The inventions and technologies are fascinating and so are the people who work with them. [00:00:15] Frank Jaskulke: There was a period of time where I realized, fundamentally, my job was to go hang out with really smart people that are saving lives and then do work that would help them save more lives. [00:00:28] Diane Bouis: I got into the business to save lives and it is incredibly motivating to work with people who are in that same business, saving or improving lives. [00:00:38] Duane Mancini: What better industry than where I get to wake up every day and just save people's lives. [00:00:42] Lindsey Dinneen: These are extraordinary people doing extraordinary work, and this is The Leading Difference. Hello, and welcome back to another episode of The Leading Difference podcast. I'm your host Lindsey, and today I'm delighted to welcome to the show Spencer Jones. Spencer is the founder at XO Medtech and MedTechvendors.com. He is an RN, MedTech entrepreneur with 12 years of med device leadership. He's a two time med device CEO with 10 plus patents under his belt and has taken devices from idea to FDA clearance and product launch. Spencer has built sales and distribution networks, led product development teams, and raised over 10 million in VC and Angel Capital. Spencer founded XO MedTech in 2024 to create a digital first medtech ecosystem, deploy AI native tools for medtech operators through medtechvendors.com and cultivate the next generation of medtech innovators. All right, Spencer, welcome to the podcast. Thanks for being here. [00:01:43] Spencer Jones: Thank you for having me, Lindsey. I'm very, very excited to be here. Like it's, it's always more fun to be a guest than it is to host the pod, so absolutely thrilled to be a guest on the pod. Thank you for having me. [00:01:54] Lindsey Dinneen: Of course. Absolutely. Well, yeah, let's just, if you won't, don't mind just sharing a little bit about yourself, your background and what led you to medtech. [00:02:04] Spencer Jones: Yeah. Born and raised in Arkansas. I've lived, I traveled a ton and lived in Memphis and whatnot, but grew up in a healthcare household. Dad did anesthesia for, what was it, 36 years or something at the same place. So I thought I was gonna be a CRNA, like actually started pre-med. Took chemistry my freshman year while I was, you know, it was just, I got a C and I was like, maybe, maybe med school's not for me. But but anyways, did the nursing school thing, got out, started working, pretty quickly, knew if you've ever spent any amount of time in frontline healthcare, you just kind of get, it's like a barrage of things that suck. It's just, especially nursing, the devices you're using are commoditized. Like just the workflows are bad. You know, people, it's, healthcare is very broken. Every, it's no secret. Everybody says that. Everybody knows that. So anyways, I noticed pretty quickly that hey, like why isn't this better? Why can't this be like this? And, you know, kind of had that mindset. And before I could even go through like critical care enough to apply to a CRNA school, ended up patenting some devices in the vascular access space. Really leveraged accelerator programs and the entrepreneurial support organizations that were in my area, in my region to, I call it that get that dirt money, which is like the before the seed, you know, your pre kind of, your pre-seed /seed you know, before the pre-seed money. And, and also like the business training, right? Like I wasn't formally trained on business stuff like that. So did that. Did the venture capital hamster wheel a little bit, took a, you know, device through class two de novo clearance. Was doing ride-alongs training, sales reps, doing marketing stuff, you know, managing our ip, managing clinical you know, 300 patient RCT that we had to do in the middle of COVID, launched the product and then past couple years, I left, left that company in 2022. Products still on the market and they got, you know, clearance in, in Europe now and et cetera, et cetera. But just been working more in laparoscopic spine or laparoscopic surgery orthopedic spine and then doing some like consulting projects and, and things like that. And then yeah, XO Medtech and Medtech Vendors that's been. You know, for the past two years, like a big focus. And I know we're gonna talk more about that, but yeah. So it's just been, it's been a great journey. Medtech is one of my --I love it and hate it at the same time, but I wouldn't wanna be doing anything else, frankly. So. [00:04:17] Lindsey Dinneen: Awesome. That's a great intro. Okay. You were, I really, I enjoyed how you sort of went straight from okay, so, so "I, you know, started the career, started in the industry, and then I, I, you know, got a bunch of patents." What were the ideas for the patents? Where did those come from? If we could just go back, how did that, what was that inspiration like? [00:04:39] Spencer Jones: Yeah. So I was night shift, med-surg, big, pretty big hospital in Little Rock. It was like one of the, one of the bigger ones in Little Rock, St. Vincent's, which is like CHI, St. Vincent, et cetera. And like one of my patients --well the, the very first one was a dual lumen peripheral IV. A patient has a peripheral IV in, I need to get a blood draw. They're like, "Go stick his other arm." I'm like, "Why can't we get it out of his, you know, IV that's in his, that's in his forearm?" And, and they were like, "Well, you, you know, you don't want to contaminate, you know, the thing." And I was like, "Oh, okay. That kind of makes sense." And I was like, well, PICC lines have two lumens. So you know, I was like, why couldn't, you know, why couldn't we just have a second lumen on, you know? And I was like, do those exist? And they didn't really exist. There was kind of one that existed, but it was more of like a longer extended dwell peripheral and you know, you kind of needed ultrasound to place it. You didn't really place, you know, normal nurses on the floor weren't gonna place it. And so I kind of, that one was just sheer-- I experienced something that I was like, "Dude, you're kidding me. There's gotta be a better way to do this." You know what I mean? And you know, kind of similar approach in that one. We, you know, that was the very first one so I was like doing these drawings on note cards and then like meeting with a patent attorney and I was like, did that provisional filing and wrote the patent myself and the claims and all this stuff. And the guy thought I was like, just " Okay, yeah, I'll, I'll file the provisional for you, bro, whatever." Filed the provisional, you know, ended up like going to a different attorney 'cause that guy was kind of just not taking me seriously. And so, ended up going to a different person, filed a non-pro provisional, started raising all this money, and that original attorney reached out later, was like, "Oh, so glad, glad to see blah, blah, blah." I was like, "Yeah, yeah, whatever." But then the second one, I, which was Safe Break Vascular, had the, it's kind of similar. Patient was like, had patients pulling out their IVs, pulling out lines, you know, and it's a million things. It's, it's walkie talkie, so like Alzheimer's, dementia, memory care type stuff. You, it's TBIs, it's agitation, sundowners. It's, you're coming off medication, you're drowsy, you forget, you're hooked up. You need to go to the bathroom. You trip on it. The nurse trips on the tubing. There's like a million reasons how, you know. Where mechanical force can get applied to an IV line. And same thing, I was just like, man, like this, it, it feels holding on for dear life is like the wrong approach because skin is only so strong. You get skin tears. Adhesives, you only want them to be so, you know, so, so strong. And it just, you know, it, wrapping it up, then you can't assess the site, you can get infiltration. So it didn't feel like any of the options we had were great. That one, I started to do patent research literally on the floor at the hospital. Like that night. I was like, I, 'cause I knew enough then found someone that had patented it. Like same exact concept. It was a nurse. And design was bad. Like the design, it had springs in it and it was just like not manufacturable and not a good design, but there were like conceptually it was like spot on. And then there were some elements of it that I was like, this would be very useful to have if I was gonna like actually do this. So me and somebody I'd met, and in accelerator program, we bought the patent from 'em for 20 grand which was a steal of a deal. It was like 10K up front, 10K after 18 months. And yeah. And then we turned around and raised a, you know, million dollar seed round within like, within nine months after acquiring the patent, got into an accelerator, ZeroTo510, shout out to them. But acquired the patent in February. Got it, or March, got into ZeroTo510, April. Went there in May, closed our seed round of a million in December, so it was like a nine month, yeah, ordeal. [00:08:03] Lindsey Dinneen: Wow. That's okay. That's awesome. I love the story. I love the fact that it was from boots on the ground going, "Okay, I see this problem. There's gotta be a better solution." That's super cool. So. All right, so you have these patents, you're going and you're working with accelerators. Can you tell us a little bit about what that experience was like, especially since you mentioned, you know, you didn't necessarily have the business background, so there was, there was probably a bit of a learning curve to that whole, you know, how do you get your idea from your, your note card drawing to commercialization. So I'd just love to hear about your experience. [00:08:35] Spencer Jones: Yeah. The, so I did one accelerator before ZeroTo510. It, I basically did two within about a year, a year of each other. It was like back to back to back. But the first one I did, it was industry agnostic. So it was just a lot of like mentorship and lean canvas startup methodology kind of business practice stuff like accounting 101, you know, building financial forecasts and models and like all of that stuff. So I really learned a ton about kind of just non device specific stuff there. Obviously I was learning a ton about device stuff along the way, but then once I got to ZeroTo510, that's when things kind of like really, you know-- and I had, I had won, I won that first accelerator. It was like a competition, and so I had 150K. And I was like, "Oh wow. So maybe, maybe this is gonna be a career path," 'cause I was still working full-time as a nurse and then I got into the second one. ZeroTo510 was amazing. Allan Daisley was running it. James Bell was like the co-director, I think, and it was like bootcamp. It was like, you know, 8:00 AM to 5:00 PM. It was like sessions and mentor hours and office hours and " Alright, we're done with that. You guys work on this for an hour and a half, we're gonna come back and talk about like the finished product and you better have it done." You know what I mean? And it was every day. I lived up at this building. It was amazing sponge mode. You know, it was one of those environments where you're just like constantly soaking it in and learning and learning and like you can feel your brain expanding like every day. You know, you wake up excited. And that one was amazing. Met a ton of people that I still work with today. You know, met my co-founder at XO Medtech. Met him at that accelerator. But yeah, it was just, that one was amazing. I was like, life changing. Came back from that and I was like, "This is what I was meant to do." I felt like I you know, found my calling. And so, yeah, shout out to the people there that you know, we're a part of that. [00:10:20] Lindsey Dinneen: Love it. Excellent. So, okay, so you found your co-founder for XO Medtech, and this is great because I wanted to dive into that. So, so you've, you've now successfully taken like several products to market and of course you have a lot of other great industry experience. What was, how was it different starting XO Medtech and Medtech Vendors than perhaps other things that you'd done in the past? [00:10:47] Spencer Jones: Yeah. You know, I'm gonna say it was way easier just to be honest. I mean, I mean, you know, I think we, we were doing a lot. We started building XO Medtech in 2022, 2023, and at that time a lot of it was like, it was really focused on the community and the training platform and the resources and kind of all the videos and things that we put in there. Which I still like to this day, will stand on it, that like there, if you're an early stage innovator and you're, you wanna like kind of internally like level yourself up, right? There's no better place than like XO Medtech and the training and inside there to do that, right? But, but yeah, it was we started doing it at a time when AI was starting to become, like Chat GBT, what was it, four was coming out or whatever. So we started it kind of before the wave and then as we were continuing to build it in like 2023 which was like the meat of us building it. It was like kind of starting to become more of a thing, but we still weren't really using it that much. But then as we really went into kind of like launch and growth mode in 2024, it was just like a huge tailwind and like being able and, and it continues to be. But like not having to raise, you know, three, four, $5 million to get a business off the ground and to get to a point where you can start selling something is just incredible. I mean, like we are, we are so agile and can move so quickly and, you know, we don't have any investors. We don't want any investors. So like our speed at which we can move is unbelievable. And coming from somewhere where it's " Oh, you wanna put out something for marketing? Route it through the quality management system and like maybe it goes out in two weeks." You know, we can go from like idea to feature in a week. You know what I mean, you know, let alone like idea to like press release, right? That's 10 minutes if we want to be, right? So really it's just, it's a lot easier and this takes nothing away. There's some incredibly rewarding parts of kind of my, like my medtech journey and stuff like that, like the day we got FDA clearance and, and X, Y, and z whatever date, you know, first sale and getting our first GPO contract. But it's, it's definitely more I would say day to day, just like the exhilarating agility, excitement type stuff that you like, don't really get with with me. And I'm not, I'm not taking anything away from, I'm still a medtech person through and through and I'm sure at some at some point I'll you know, do another device. We're developing another device at Lapovations, so, in combo spine. So my hands are still in it, but I love, love, love what we do at XO Medtech. It's so much fun. [00:13:11] Lindsey Dinneen: Awesome. Well, I love hearing that. So tell us a little bit about both XO Medtech and Medtech Vendors and yeah, their, their focuses. [00:13:21] Spencer Jones: Yeah. So I think, you know, like I said, we started XO Medtech and it's, it's a online community. So think like Skool, like S-K-O-O-L School or Circle, or there's some other Mighty Networks, like one of the-- we use Circle-- but you know, it's whether you're ideation or just like curious about medtech all the way through like series A really, you know, we've got, you know, there's community feed, people are posting. I mean, we posted you know, Project Medtech, you know, event stuff, discounts a lot of exclusive stuff where, I think we added, it was like three or $4,000 worth of discounts. Like just for being like once you join XO Medtech. But then there's that primary feed people, it's like a massive exchange of value and it's it's not like LinkedIn. There's no promotion. Like we base, we will take your post down if you're like nakedly promoting your own stuff or your services, whatever. The whole point of it is to be massive exchange of value. So you know, "Hey, we did some like really cool testing, ETO sterilization testing on coil tubing to see how it retained its memory. Here's what we found, your pictures," you know what I mean? Just stuff like that where it's like kind of giving people behind the, behind the curtain peaks at your own organizations or that kind of, those, those moments of alpha, those nuggets that you've found and just sharing it so you can have you know, and they're doing the same and everybody's better for it. But then we have a training course and then some other like mini courses, probably a couple dozen downloadable resources. So these are like, you know, prebuilt, proformas, budget forecasts, you know, IP stuff, due diligence type stuff, like stuff to help you with, get your data room beef, you know, beefed up and looking good. And we do videos. There's some live events every now and then. So, so that was very focused on the founder side, you know what I mean, like the entrepreneur side. We, you know, my co-founder used to run a med device, venture studio, so like doing like business engineering, business development, engineering, you know, kind of market related stuff for like early stage, largely like clinician and inventors and stuff like that. He used to run a, a, a group that did that. And we knew we wanted to kind of start to do more offerings that kind of for that side of the table, like the CDMO contract manufacturer design and development group side of the table. So we launched, we started building MedTechVendors.com and launched it in 2025, February, 2025. And then did kinda a relaunch with adding some like agentic AI features in I think at the end of the summer last year. But it, but at its core, I always say this analogy, it's like Angie's List, right? You know, Angie's List, what do they do? Well, it connects people with local pros. Allows them to like, evaluate, engage them really easily, you know, get, get their stuff done quickly from trusted people. You know what I mean? So we have the same approach. We help device teams, and that could be device teams at large, medium, small, or startup organizations or tech transfer offices, whoever we help those device teams find, evaluate, and engage contract manufacturers, CDMOs testing facilities, design and development groups, one man band engineers, whatever through the platform. We have an an ag agentic AI chat. So like it'll ask you questions about your device. It'll start recommending, "Hey, do you need this? Do you need these types of services? Are you looking for this type of vendor? This type of vendor?" It pre-populates forms. It generates matches for you. You can review each vendor's profile, one click get email intros or request quotes, and we're adding some some really cool additional features around some different like skills that you can run. So, think like a reimbursement skill or market a, you know, different predicate device selection skill, whatever. And so those are all gonna be like linked up to the to this kind of AI agent. I don't wanna say too much 'cause we're still building it. I'm like really excited about, but there's other things that we're adding to it. The ability to do quote, visualization you know, and trying to make it kind of a, you know, a home away from home, a hub where you can track execution, get things done, engage vendors, and kind of evolve it more laterally in kind of the lifecycle journey. Not just " Hey, I'm looking for a vendor," 'cause that's a very acute point in time in a, you know, in a person's journey. But trying to expand it out to say the period of time when you're doing X and Y and Z and looking for a vendor so we can get some really was sticky, more sticky use and add more value. So, that was that. And we've started really focusing on some more like intimate, I would say, engagements with CDMOs contract manufacturers focused on giving their sales and marketing teams massive, massive leverage using AI and ai, AI native tools. [00:17:35] Lindsey Dinneen: Awesome. That's really cool. Yeah. Okay, so going back a little bit to the, to XO Medtech, I know you know you, you mentioned that there's a lot of resources available, but one of the things that I think is super cool, and I would love if you just share a little bit more about this, is you have a course that-- i don't remember the name off the top of my head-- but it's basically sort of Medtech Innovation 101. It's, I think... [00:18:00] Spencer Jones: Yeah, The Playbook. [00:18:00] Lindsey Dinneen: Call it like-- The Playbook! And you call it like the MBA for somebody who needs to learn. So can you just share the value of that and sort of what, what made you go, "Okay. I have, you know, the expertise in all these different areas enough to be able to share the journey from start to finish." [00:18:19] Spencer Jones: Yeah, absolutely. I think like the, the value there partially comes-- I mean, I think speaking about the value, you gotta speak about kind of like why there was a gap there, like how it, why it didn't exist, whatever. There's just a lot of really bad content in medtech. You know, there's a lot of stuff that reads I mean, there's guidance documents, you know, ISO and this and that. Like those are tough reads, right? And then, you know, the, the content around " "here's how you really fundamentally apply these guidance documents and here's how all this fits together." And it just felt like everything was I don't know what the opposite of like inside baseball is, right? Like that kind of " Hey, here's what you really need to know." Whatever the opposite of that is, is how medtech content felt like to me everywhere. It was just like polished press releases, really, like consulting speak. You know, "You gotta be strategic with your analysis." It's okay "You know, you know, you gotta find your champions." "How do I find them? What do I tell them? You know, how do I engage them?" So it was just, that was the big gap. So I think the value, what we tried to do with The Playbook was, you know, give, like I said, pre-seed all the way through Series A, the right information, like the right depth, on the right topics in the right order with the right assets, so resources, downloads, all that stuff along the way so that you can go cradle to grave on this, basically be a novice, or we've had people that have launched products and gone through it and they were like, "Holy crap, I wish I would've had this five years ago." But the whole idea is to basically not make you a supreme expert on any one of those topics. There's 46 different lessons, 47, and like you can get through each one in probably 20 minutes, right, 15 minutes. But not to make you an expert on each individual topic, but to give you like a dangerous level of information on any one, and then make you able to dive deeper on any of them, you know, very quickly and easily. So like when you meet with your, you know, a regulatory consultant or an IP attorney, or go down the list, you are not, they're not saying words you don't know for the most part. You're not paying them $300 an hour or $500 an hour to educate you on definitions and concepts. Right? You're, you're applying principles and evaluating strategy versus " What's that again? Like, how does this, what's the timeline for that?" 'Cause that you know, that's just not good for anybody. You know, so, so that, that's kinda the main, the main value prop thrust of it. And I just, I frankly didn't think it existed, but proof's in the pudding. Like we've sold it to accelerator programs, we've sold it to hospital, you know, innovation departments. We've sold it to incubators, like trade associations that have like their like kind of innovation arms. It works. Like when people do it, it works. It's funny-- we can talk about this too-- but like the, you can lead a horse to water thing. It's funny how many people say they want to be entrepreneurs and say they wanna be innovators and really they just want to just yap. And they don't actually wanna put the time in. I'm telling you, it's like crazy how many, you know, fake entrepreneurs there are out there. But it's okay. It's okay. You know, like there has to be, I think there needs to be some cleaving or weaning or calving of the herd to some degree because we've got, I don't know, and maybe we need to develop 'em more, but it's, it is frustrating seeing it firsthand when it's like "You have a really cool device, but you are so uninvestible and you have no interest in being coachable that it just hurts me." [00:21:30] Lindsey Dinneen: Oh yeah, absolutely. No, I love that you've done that resource and yes, super excited to see hopefully a lot of innovation actually happen and be successful as a result of that. So with, you know, okay, so you have, you have this community now and I'm wondering if there are any moments that kind of stand out to you, maybe as you've built the company, also Medtech Vendors that kind of enforce, "Wow, I am, I am in the right place at the right time." [00:22:00] Spencer Jones: You know, I definitely-- you know, it's, it's, it's really, there's not, I would say, any huge singular moments. I mean, we've had people like get business from coming on the XO Medtech podcast. You know, we've had people meet new clients, new strategic partners type stuff, like in the XO Medtech community. I mean, I've made a ton of friends in the XO Medtech community, people that I talk to you know, every, every week or two you know, Brad Shirley, I'll mention him. He's fantastic. And like I've learned from him, he's learned from me. We've both learned stuff from the community. I, I, I really do think it's though, it's like it's, you know, those-- whether it's a LinkedIn DM or you know, somebody messaging me in XO and they're like, "Hey, I just went through this lesson. It was like, so good. You know, blah, blah, blah." And I think those little things honestly like power me, power me up, give me juice, give me energy. You know, and, and like reading, we, we did a ton of, I mean we probably got 30 people that did kind of like a pre- and post- assessment and they gave their feedback on The Playbook so we could refine it like as we were, you know, after launch and all that stuff 'cause we're constantly trying to improve it. And have reading the testimonials and people just being like, yeah, like "This is, this is killer." People that are brand new, people that have been in the industry for 20 years that went through it. I think so, I think, I think it's kinda like a myriad of those things. I would say some of the stuff on-- and that's on the XO Medtech -- I think some of the stuff on the Medtech Vendor side and what we're doing with, you know, kind of campaigns and the tools that we're developing and the work that we're doing there, like we are fully an AI native organization. Like it, like we, it there is just not at all like a significant amount of people in medtech using AI to like actually do not in their products. I don't care about that. Like I'm talking about like in their day-to-day operations and, and whatnot and like we're trying to change that. And so like in that respect, like we will come out with things, you know, release features, release products, build custom tools for CDMOs and you know, the looks on their faces and like how amazed that they are at X, Y, and Z. And sometimes it's like stuff where it's hey, I'm like building them a just showing them how to do something with not even a tool that we built and like they're blown away. And anyways, all of that stuff, I feel like, man, like this is where I'm supposed to be because like. We, we've gotta make MedTech a more attractive investment opportunity. We've gotta compress the development cycles and the cost to develop and the time to develop and get things to market. You know, and I look at AI drug discovery for the pharma world as like a huge way that that's happening. But we have to have that similar type of like, when you to engage with this, it will be good for our ecosystem and industry as a whole, becoming more investible, becoming more cash efficient and all that stuff because you've seen other sectors, you know, software is taking money from early stage medtech, like nobody's business. You know, people are investing AI and you know, I just looked at the annual report from like HSBC, the Venture Report, and like me, early stage medtech funding continues to be down. You know what I mean? So we just gotta do something like, I, I feel like it's an existential, it's an existential issue for early stage medtech to get better at being scrappy and using AI. [00:25:03] Lindsey Dinneen: And there's so much opportunity there. Yeah, I love that you're helping to promote that. So you've gotten to lead a number of different companies now and through very challenging milestones. And so I'm curious, how has your own leadership philosophy developed over the course of your career so far? [00:25:24] Spencer Jones: Oh, what a good question. You know, I, I hate to say this, but I've almost gotten more cynical, you know. [00:25:30] Lindsey Dinneen: Okay. [00:25:31] Spencer Jones: Well, and it, it's, it's like I try to be very protective of my time and like protective of the time of the people that I work with, right. You know, and that doesn't mean I'm not willing to like go the extra mile and whatnot, but I think it's about respecting people's time. Right? And, and you know, I think honestly my leadership philosophy, I think a lot of it revolves around just like incredibly clear communication and like staying above the fray. No riff-raff, just just executing and moving fast and like keeping expectations really high, because I feel like when you've got complacency, you know, at the top, it just, it like doubles every rung of the ladder lower that you go in the org chart or whatever. You know, so I think like pace, you know, pace and hyper clear communication, like no subversive or passive aggressive or anything. It's just like straight up, like I'll just exactly tell you if I wasn't happy with something or whatever, but I just, I don't know, like I feel, I feel like you know, leadership style too, like I think, I think it, so much of it boils down to communication for me. It's just like really, really clearly communicating and like making sure that people understand what good work looks like and what a, them doing a good job looks like, and where... Yeah, I think, I think being clear about expectations, really clearly communicating those expectations around like work product, what it should look like, how fast it should get done, how many updates I need, or how many questions I expect to get as you're doing this, what resources I expect you to expend and explore before you come to me with something you could Google. Like all of that stuff, but honestly, I, it, it's kind of a tough question thinking in like the more immediate past, just because I feel like there's been such like, almost like a flattening of org charts, frankly, with the way that we're using technology and AI these days where I feel like in the companies I'm operating in right now, like it's mainly just principles and like lower level stuff, like we're either delegating to AI agents or delegating to like VAs that are in a different country or something, you know what I mean? And, and so there's just been a big flattening. You know, seven years ago, six years ago, I was managing, you know, new grads outta college, two or three at a time, and, you know, having to like, have these kind of like, you know, like brotherly, you know, like talks with, you know, these types of things, " Hey, like you really gotta do this" and like coaching and stuff like that, i, you know, there's a, we have to have that stuff. I'm just not in, in organization and honestly, the organizations I'm in right now in startup world I just feel I don't know. Like I, I feel like we're, I haven't seen that and I, I know a lot of organizations that are small and nimble and whatever, and I feel like the org charts are getting real flat in terms of like people that are getting managed, you know, it's a lot of agents getting managed, frankly. [00:28:21] Lindsey Dinneen: Yeah. Yeah, yeah. Interesting. Yeah, that, that's a really interesting insight too. But I really do think that to your point of coaching and mentorship and how much of a difference that makes, but especially, I was just on this conversation earlier today of the critical importance I feel that there is about establishing expectations across the board, whether it's your clients, your employees, your coworkers, just making sure that everybody's on the same page is such a critical aspect of, of setting yourself up for success. So yeah, I love that you touched on that 'cause like I said, literally earlier today. [00:29:00] Spencer Jones: Yeah. And, and can I, can I, quick aside here. It's, it's on topic, but before we move on, I mean, I, I'm not the first person to think this or say this, but I'll, I'll die on this hill. The more you use AI when, when you're using it the right way, right, the better leader and better specifically, the better communicator you'll become, right? Why? So much of interpersonal office drama, bad management, bad leadership is like what we talked about, right? It's poor communication. It's expecting people assumed something or had knowledge they didn't, right? It's not letting them know what you really wanted, what good work looks like, all that stuff. This is all context engineering, right, which is just a similar to prompt engineering, but context engineering is kind of the other more important piece these days with AI. What do I mean by that? Like I'm gonna give a prompt to a chat. Is it in just like a virgin chat or is it in a project? What context, what documents, skills, reference templates, et cetera, access to code bases does that project have, right? What am I telling it to do? How am I breaking that down? How am I, you know, big, high level goal? What do I want it to do? What does the output need to look like? How deep do I want it to go? Right? Like, how many questions I say, "Ask me like five or six questions" when I'm prompting, right, if I want that, right? Give, so giving the other person right in that space to say " What questions do you have?" Right? The, the, the best people at context engineering and leveraging AI in that way end up becoming more, better and better and better communicators because it's-- I mean, yes, you're talking to a machine, but at the same way, like those principles a hundred percent apply to good professional communication. So I'll die on that hill. There's a lot of people that are like brain rott using AI. It's " what's the weather today?" And you know, "how many calories does mayonnaise have?" And those people are not, you know, they're, they're not improving their leadership communication by using app, but the people actually doing it right a hundred percent are, [00:30:52] Lindsey Dinneen: Yes, I could not agree more. I think that is one of the coolest things that AI has taught me personally is-- to your point, to be a better communicator, to be clearer with the way that I communicate, to avoid assumptions that the other person, say, knows what I'm talking about or, or does have the context behind why I asked the question the way I did, or all those kinds of things. So I, I could not agree with you more. Yeah. And it's exciting to see how it continues to evolve. Okay. [00:31:22] Spencer Jones: Yeah. And why, real quick, why, like the AI models, especially with the reasoning models and stuff, Opus 4.6, all this stuff, telling them why they're doing something and why doing it, doing a certain task within that project flow is important is proving to be more effective than telling them how. And I think that's something where, you know, you tell someone what to do, they may do it, but if you tell them and make them believe why it's important, they do it that way, they're really gonna do it that way. [00:31:49] Lindsey Dinneen: Yeah. Love that so much. Okay. All right, so pivoting the conversation a little bit, just for fun. Imagine that you were to be offered a million dollars to teach a masterclass on anything you want, could be within your industry, but doesn't have to be. What would you choose to teach? [00:32:05] Spencer Jones: Does this, assume-- I have a question. Does this assume that I'm already I'm already capable and you know, have enough expertise to actually teach this class? Or is it like I choose this topic, I'm now an expert in that and I get to teach it? [00:32:19] Lindsey Dinneen: I like, I like I like both options, but I'm gonna go with option B because you have a million dollars to play with, right, so you could build up the expertise. Yeah. [00:32:29] Spencer Jones: You know, I would still say like building AI tools, AI agent systems, you know, skills and subagents and these flows and, and really tactically executing that for medtech. And that that goes from founder, you know, innovator to service provider, reg, quality ,reimbursement, like all the way up through sales and marketing and then like CDMO teams, you know, doing contract manufacturing, doing this. Like I, I just, I'm so passionate about it and I, I just see that there's so much untapped opportunity that that is the thing I think, and, and like we, we are doing that not a masterclass, but like we are working with groups to do some of that. But, I just, it's just so, so, so, so much opportunity to do it. And I think there's like weird structural reasons why it's not being adopted the same, you know, at the same clip it is in other industries. But you know, medtech's very rules-based game. You know, you've got your guidance docs, you've got your predicate devices, you've got your clinical trial protocols, you've got your stats analysis. You got your, you know, X, Y, Z hospitals get paid a certain way. Like lots of formulas, lots of reference material, lots of guidance docs. You know, it's very kind of rules and order based system in a lot of ways. And biology has its own kind of, prescriptive way that things happen, right? So I just feel like it's so primed for it. And anyways, I, I just, I wanna see it adopted more so we can see like what's happening with software now, where, you know, the cost to build and, you know, produce and get software to market has com has almost collapsed, but compressed to, you know, from like months, maybe years to, you know, days and weeks and, you know, you got a $200, 250 bucks worth of like software subscriptions, Claude this, that, the other, you can get it done in a week if you, you know, two weeks if you put your mind to [00:34:21] Lindsey Dinneen: Yeah. Yeah. No, that would be an incredible masterclass. I like it. All right. And then how do you wish to be remembered after you leave this world? [00:34:30] Spencer Jones: Oof. God, what a good question, Lindsey. You know, I hope to be remembered at all. [00:34:35] Lindsey Dinneen: Yeah. [00:34:36] Spencer Jones: You know, 'cause I, I'm definitely one of those people that's " nobody cares, nobody's thinking about you." You know, you may have, I, I mean, I think there's like some healthy main character syndrome that people can have that gives 'em confidence, but at the end of the day, no one cares. They're just, everyone's thinking about themselves. But if I am remembered, which I hope to be I wanna be viewed as like someone that was, I'd say, loved their family was a good dad, good husband. I would say brought people joy, was like fun to be around, but like from a interested in other people sense, you know, you know, genuinely cared about people. But I would say that on the professional side, like somebody that you know, would like consistently just delivered an absurd amount of value whether it was, you know, running a business or coaching and developing people at a company or working on behalf of clients or trying to make a positive change. I would say impactful and valuable, you know, with the work that I'm doing. That's, that's, that's how I wanna be remembered. I mean, we don't have big, I don't wanna be a unicorn billion dollar company. No, we have no desire to do that. We don't even have a, a desire to get acquired at any point. We're not raising money, you know, we've, we've deliberately chosen to bootstrap it. You know, we frankly just wanna employ really awesome smart people that we work with, you know, pay everybody well. And like I said, add a absurd amount of value you know, and joy to the people and the clients that we work with and like work at the company with, you know what I mean? [00:36:05] Lindsey Dinneen: Yeah. Yeah, that's a absolutely wonderful legacy to aspire to. I love it. All right. And then final question. What is one thing that makes you smile every time you see or think about it? [00:36:19] Spencer Jones: Oh, I gotta be, I've got a 1-year-old kid. Banks. Banks Austin Jones. So it's gotta be him, and my wife of course. One thing that makes me smile though, every time I see it, oh... you know, I am, I'll cry at a good TikTok, so I'm so I guess that's like a form of smiling, you know? But I'm a pretty big softie, honestly. You know, this is gonna sound weird, but it's kind of those moments where you know, people usually strangers and usually people that don't look like each other, just show humanity to each other. And that could be like holding a door open for somebody. It could be small things, you know what I mean? But I really love seeing those moments and capturing them like candidly, you know? Just you know, oh, I was in a restaurant, I saw this thing happen. You know? I really love that these days. [00:37:09] Lindsey Dinneen: Yeah. Yeah. We all need more of that these days too, so, yeah. Love it. Alright, well, Spencer, this has been a, a fantastic conversation. I really appreciate you and your time today. I love what you're building in the medtech industry and cultivating community and resources and providing value. So just thank you for everything you're doing to change lives for a better world. [00:37:34] Spencer Jones: Thank you. Can I ask you a question? I feel like you were so good, like with the questions and kind coming on the back of like my responses, but I have a question for you like what? You know, what about the medtech space, like most excites you? It can be a specific technology, it can be a specific, you know, company doing something. It can be anything, but what's most exciting to you, kind of looking at 2026 and, you know, kind of in the realm of medtech broadly. [00:38:00] Lindsey Dinneen: Yeah. Oh, I love that question. So I love this industry in general, but there, there's something really special about the energy of being around people who truly care about making a difference. Part of the reason I started The Leading Difference was because I, when I first joined, had sort of noticed this sort stigma from people from the outside who weren't very familiar with the innovation, what it takes to get from, you know, drawing to commercialization. Just didn't, just didn't know. And there was this stigma that people were here just for the money. And then I started meeting all of these incredible change makers who they had personal stories of what they were seeing, or a family member was impacted. And I just loved the fact that there were so many cool people doing such cool things and getting to play a small role in that was the coolest thing in the world. So, you know, I, I say I happily stumbled into medtech five years ago and found my people and my happy place, haven't looked back. I love it. I love being around people who are genuinely trying to do good things in the world. And I hear about new and you know, new ideas every day, and I get excited probably almost equally about most of them because it's just cool to see. So I don't know. Does that answer your question? [00:39:29] Spencer Jones: No, it, it does. I mean, it, it really the, it all comes back to the patient at the end of the day. And I definitely, I, I feel like when people think of like medical device stuff, like their minds immediately go to like Stryker sales reps or something, you know what I'm saying? And there's just so much more to it than that. And there's one of my favorite things about medtech is like the personalities, you know, like you got your wacky, you got your wacky inventors and you know, you got your straight laced regulatory people. But when you get to know 'em, they're, they're absolutely hilarious. You know, you got your attorneys, you got your like, and I, every industry, every industry has their personalities. But I think medtech, you know, you got your beef head sales reps that are like posting " What's up guys? I'm here in the locker room in my scrubs" and like "Motivation Monday." You're like, "Oh my God." But it's just like all these personalities and you go to these conferences and you just see 50 of the same person, but they're each different, they have their own dreams and conflicts and ideas and whatever, but they're still like so in the same box in some ways. I think that's one of the funnier, like funnier things about medtech that just makes it quirky, you know? [00:40:30] Lindsey Dinneen: I love it. And I also love the amount of respect that I see shared amongst people of very, very different backgrounds and areas of expertise. And that was one of the things that made me fall in love with the industry too. I was like, I, for instance, you know, I'm in, I'm in marketing and business development, so I play a very small role in, in sharing about these devices. But people, the engineers that I work with and the consultants that I work with, and everybody in the ecosystem is always just " Wow, well, I can't do what you're doing. And so I think what you're doing is fantastic." And so there's just, there's this mutual respect that I think is super cool about being here too. So yeah, I'm a fan. [00:41:08] Spencer Jones: Yeah, I agree. I agree. We could, we could keep going for, for days... [00:41:12] Lindsey Dinneen: I know. [00:41:13] Spencer Jones: ...On this. I really, I know, I know we have to wrap it, but but yeah. Well, Lindsey, thank you for having me. Seriously, this was a blast. And you know, I'll just maybe like quick sign off plug or something here. If anybody that's listening to this is like interested in, leveraging AI, leveraging AI in medtech or for you personally or whatever, follow me on LinkedIn and post a lot of content about it. You know, talk about it a lot on the podcast. But then if you're, if you're on the founder side, if you're an innovator, like join XO Medtech. If you're on the CDMO side, if you're, you know, on a sales and marketing team, contract manufacturer, CDMO, even like signed development groups, that kind of stuff like, you are like, "We know we need to be using AI to better leverage X, Y, Z, or do this thing. We have all these, we have HubSpot and this thing and that thing, and none of it works together well and we've got too many tools." Whatever. Just hit me up. Let's have a conversation. We're doing some absolutely incredible things leveraging AI, giving these sales and marketing teams like crazy leverage. So yeah, just drop a dm. I'd love to talk to you. [00:42:08] Lindsey Dinneen: Awesome. Sounds good. And we are so honored to be making a donation on your behalf as a thank you for your time today to the Polaris Project, which is a non governmental organization that works to combat and prevent sex and labor trafficking in North America. So thank you for choosing that organization to support, and we wish you continued success as you work to change lives for a better world. Looking forward to seeing the future of all the good things that you're doing. All right. Bye. [00:42:41] Dan Purvis: The Leading Difference is brought to you by Velentium Medical. Velentium Medical is a full service CDMO, serving medtech clients worldwide to securely design, manufacture, and test class two and class three medical devices. Velentium Medical's four units include research and development-- pairing electronic and mechanical design, embedded firmware, mobile app development, and cloud systems with the human factor studies and systems engineering necessary to streamline medical device regulatory approval; contract manufacturing-- building medical products at the prototype, clinical, and commercial levels in the US, as well as in low cost regions in 1345 certified and FDA registered Class VII clean rooms; cybersecurity-- generating the 12 cybersecurity design artifacts required for FDA submission; and automated test systems, assuring that every device produced is exactly the same as the device that was approved. Visit VelentiumMedical.com to explore how we can work together to change lives for a better world.

Episode SummaryWomen have up to 70-80% lower creatine stores than men — and most of us have never been told that. In this episode Lisa digs into what that means for your brain, sleep, mood, muscles, and energy, and why creatine may be one of the most underreported tools in women's health right now.What You'll LearnWhat creatine actually is and why it matters beyond the gymWhy women have lower creatine stores — and why that gap widens in perimenopauseHow creatine supports brain energy (ATP) and what happens when levels run lowThe research on creatine and memory, processing speed, and mental clarityWhy creatine may reduce depression symptoms — more so in women than menCreatine and sleep: the adenosine mechanism, the 2024 women's RCT, and the 2025 perimenopause findingsThe University of Kansas Alzheimer's pilot studyCreatine + resistance training for muscle and bone health over 40How much to take: 5g for general health vs. 10g for brain-specific benefitsStart HereReady to heal your metabolism? thinlicious.com/happyStudies ReferencedCognitive Function & MemoryXu et al. (2024) — Creatine & Cognitive Function: Systematic Review & Meta-Analysis. Frontiers in Nutrition.Depression in WomenLyoo et al. (2012) — Creatine Augmentation for SSRI in Women With Major Depression. American Journal of Psychiatry.Systematic Review & Meta-Analysis: Creatine for Depression (2025). British Journal of Nutrition.SleepDworak et al. (2017) — Creatine Reduces Sleep Need & Homeostatic Sleep Pressure in Rats. Journal of Sleep Research.Aguiar Bonfim Cruz et al. (2024) — Creatine Improves Sleep in Naturally Menstruating Females. Nutrients.Gordji-Nejad et al. (2024) — Single Dose Creatine Improves Cognition During Sleep Deprivation. Scientific Reports.Hall et al. (2025) — Creatine + Resistance Training in Peri/Postmenopausal Women: Sleep, Cognition, Strength. JISSN.Alzheimer's DiseaseSmith et al. (2025) — Creatine Monohydrate Pilot in Alzheimer's: Brain Creatine & Cognition. Alzheimer's & Dementia.Brain Dosing: The Case for 10gDechent et al. (1999) — Creatine Increases Brain Creatine by 8.7% in Human Neuroimaging Study. American Journal of Physiology.Candow et al. — Higher Creatine Doses for Brain Bioenergetics. Journal of Psychiatry and Brain Science.Dr. Rhonda Patrick on 10g brain dosing (@foundmyfitness)Medical Disclaimer: For educational purposes only. Not medical advice. Always consult your doctor before starting any new supplement.

Listener feedback from the DanGer Shock investigators, complete vs staged revascularization, polygenic risk scores, and quality improvement failure in an RCT are the topics John Mandrola, MD, discusses in this week'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 Listener Feedback DanGer Shock Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2312572 CHIP-BCIS 3 Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2515704 II Immediate Complete vs Staged Revascularization in STEMI Meta-analysis: Timing of Complete Revasc in Patients with STEMI and Multivessel Disease https://www.ahajournals.org/doi/10.1161/CIRCINTERVENTIONS.126.016601 COMPLETE Trial https://www.nejm.org/doi/full/10.1056/NEJMoa1907775 FULL REVASC Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2314149 iMODERN Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2512918 III Polygenic Risk Scores for Prediction Polygenic Risk Report in US-Based Hospitals for 8 CV Conditions  https://www.jacc.org/doi/10.1016/j.jacc.2026.03.035 IV Practice Improvement Policies Undergo the Proper Test – Randomization Quality Improvement on Hospitalizations and Health Outcomes for People with CHD https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.125.012904 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

In this episode of the Mr Barton Maths podcast, Craig sits down with Bibi Groot, behavioural scientist at Eedi, to unpack the rigorous research behind their ed-tech work. Bibi traces her journey from the UK's Behavioural Insights Team — where she applied frameworks like EAST (Easy, Attractive, Social, Timely) to public policy — to becoming Eedi's first behavioural scientist after a stint completing a PhD at UCL and having twins. The conversation builds methodically from the fundamentals of randomised control trials (and why they're so notoriously difficult to run well in schools) through the headline results of Eedi's two-year, 20-school RCT showing that students using the platform gained the equivalent of two to four extra months of progress, before diving into the much-publicised Google DeepMind collaboration. That study, run with LearnLM and a human-in-the-loop safety net, found that an AI tutor matched a human tutor on immediate question success and actually outperformed humans on short-term transfer questions — likely because the AI was relentlessly Socratic where time-pressured human tutors tended to short-circuit students' metacognition. Bibi closes by previewing Eedi's much larger four-arm follow-up trial (running until July 2026) testing whether deep student context beats strong pedagogy alone, plus exciting new pilots bringing DQR and WhatsApp-delivered AI tutoring to learners in Guyana, India, and Sub-Saharan Africa. Visit the show notes here: podcast.mrbartonmaths.com/221-building-an-ai-tutor-with-google-deepmind-with-bibi-groot-eedis-chief-impact-officer

Near-Infrared Light Therapy After Stroke: Does the Science Hold Up? A viewer reached out recently with a question I have been getting more frequently: Does near infrared light therapy actually help the brain recover after stroke? It is a fair question — the claims circulating online range from cautiously promising to outright extraordinary. In this post, I am going to cut through the noise and look at what the peer-reviewed research actually shows. What is Near-Infrared Light Therapy? Near infrared (NIR) light therapy — also called photobiomodulation (PBM) or transcranial photobiomodulation (tPBM) when applied to the head — uses specific wavelengths of light (typically 630-1100 nm) to penetrate tissue and interact with cells at a biological level. This is not a tanning lamp or a heat lamp. The mechanism is specific: NIR light at the right wavelengths is absorbed by cytochrome c oxidase, a key enzyme in mitochondrial energy production. When stimulated, cytochrome c oxidase increases ATP synthesis — essentially giving cells more energy to carry out repair and function. For neurons recovering from ischaemic or haemorrhagic stroke, the theory is compelling: damaged brain cells that are energy-starved might benefit from an additional energy stimulus. The Mechanism: What the Biology Says The cytochrome c oxidase pathway is well-established in photobiology. What is less settled is whether light at therapeutic intensities can penetrate the skull deeply enough to reach relevant brain structures. Skull and scalp tissue absorb and scatter light substantially. Transcranial delivery requires sufficient power density (irradiance) at the source and long enough exposure to accumulate meaningful fluence (energy dose) at depth. Studies using ex vivo human skull specimens suggest that only 1-3% of surface irradiance reaches cortical tissue at clinically relevant depths — and deeper subcortical structures receive even less. This does not make tPBM ineffective — it means dosing is everything. And most consumer devices do not disclose their irradiance or fluence specifications, which makes comparing them to clinical trials nearly impossible. What the Research Shows Animal Studies: Encouraging Signals Several well-designed rodent studies have demonstrated that tPBM applied within hours to days of stroke onset reduces infarct volume, improves functional recovery, and modulates neuroinflammation. A 2019 study by Thunshelle et al. found tPBM reduced lesion size in ischaemic stroke models and improved neurobehavioural scores. Animal models are useful for mechanistic insights. However, rodent skulls are thinner and brain structures are more superficial than in humans — so translational accuracy is limited. Human Clinical Trials: More Complicated The human evidence is where the story becomes nuanced. The NeuroThera Effectiveness and Safety Trial (NEST-1 and NEST-2) were the most prominent early RCTs. NEST-1 (2007) reported positive outcomes for acute ischaemic stroke patients treated within 24 hours. However, NEST-2 (2009), a larger double-blind RCT with 660 patients, failed to replicate those results on its primary outcome measure. NEST-3 was halted early in 2013 after an interim analysis showed it was unlikely to meet its primary endpoint. What went wrong? Researchers identified several issues: heterogeneous stroke populations, inconsistent dosing protocols, and the fundamental challenge of transcranial light delivery in adults with varying skull thickness and tissue composition. More recent work has shifted focus. A 2023 review by Zomorrodi et al. examined pulsed tPBM and found preliminary evidence for cognitive and neurological benefits in traumatic brain injury and neurodegeneration — but noted the absence of large, well-powered RCTs in stroke specifically. The Consumer Device Problem Here is where I have to be direct with anyone considering purchasing a NIR device for home use. Clinical studies use medical-grade devices with precisely calibrated irradiance, typically 10-700 mW/cm2 at the source, with controlled exposure times to achieve specific fluence targets (often 0.9-36 J/cm2). Consumer devices vary enormously — and most do not publish their specifications at all. Buying a NIR cap or helmet marketed for brain wellness is not equivalent to receiving the protocol used in clinical research. This does not mean it is harmful. It means we do not know whether you are getting a therapeutic dose, a sub-therapeutic dose, or anything in between. The Stakes If you are in recovery from a stroke or brain injury and you are exploring every option — which I completely understand — the risk here is not primarily financial. The risk is investing hope, time, and energy into something that may or may not be delivering what clinical trials suggest is therapeutic. The opportunity, on the other hand, is real: the underlying biology is sound, and the research pipeline is active. This is an area worth watching closely. Three Actionable Steps Talk to your neurologist or rehab physician before purchasing any device. Ask specifically whether tPBM has been considered in your care plan and what the current clinical guidance is. If you want to explore the evidence yourself, search PubMed (pubmed.ncbi.nlm.nih.gov) for transcranial photobiomodulation stroke — filter for systematic reviews and RCTs published after 2018 for the most current picture. Check ClinicalTrials.gov (clinicaltrials.gov) for active trials recruiting stroke survivors for tPBM studies. Participation in a trial gives you access to a properly calibrated protocol and contributes to the evidence base. What Recovery Can Look Like When the brain is given the right conditions — adequate sleep, nutrition, rehabilitation, reduced inflammation, and potentially adjunct therapies that the evidence supports — healing happens in ways that can surprise both patients and clinicians. I have spoken with hundreds of stroke survivors on this channel who found approaches that contributed meaningfully to their recovery. Not a single one found a shortcut. But many found tools — used thoughtfully, in partnership with their medical team — that made a genuine difference. That is what this channel is about: doing the work so you can make informed decisions. References Lampl Y et al. Infrared laser therapy for ischemic stroke: a new treatment strategy. Stroke. 2007;38(6):1843-9. PMID: 17463313. pubmed.ncbi.nlm.nih.gov/17463313 Zivin JA et al. Effectiveness and Safety of Transcranial Laser Therapy for Acute Ischemic Stroke (NEST-2). Stroke. 2009;40(4):1359-64. PMID: 19233936. pubmed.ncbi.nlm.nih.gov/19233936 Thunshelle C, Hamblin MR. Transcranial Low-Level Laser (Light) Therapy for Brain Injury. Photomed Laser Surg. 2016;34(12):587-598. PMID: 27854434. pubmed.ncbi.nlm.nih.gov/27854434 Zomorrodi R et al. Pulsed Near Infrared Transcranial and Intranasal Photobiomodulation Significantly Modulates Neural Oscillations. Sci Rep. 2019;9(1):6309. PMID: 31004089. pubmed.ncbi.nlm.nih.gov/31004089 Bill Gasiamis is a stroke survivor and the host of the Recovery After Stroke podcast. He is not a medical professional. Nothing in this post constitutes medical advice. Always consult your treating physician before starting any new therapy. The post Near-Infrared Light Therapy After Stroke: Does the Science Hold Up? appeared first on Recovery After Stroke.

Using wearables (think Apple watch, fitbit, phone) in your plan of care can amplify your outcomes. Join Dustin Jones as he discusses a recent RCT that used wearables in cardiac rehabilitation that had some pretty wild results. We'll discuss HOW to do this in clinic with your patients to get better results. We'll also troubleshoot common barrier to implementation. You can catch the live video recording here in the ICEphysio app - https://app.ptonice.com/c/ptonice-daily-show/wearables ---- Want to make sure you stay up to date in all things Geriatrics in less than 3 minutes every other week? Join thousands of others in our free MMOA Digest Email list - https://institute-of-clinical-excellence.kit.com/a3837f54b7  

Après un hiver très compliqué, les Toulonnais vont mieux et sont sur une série de quatre victoires de suite, une première cette saison. Cela tombe bien car ils seront face à un défi de taille samedi : le Leinster, en demi-finales de Coupe des champions. Peuvent-ils gagner à Dublin et l'embellie du RCT peut-elle durer ? Débat dans «Crunch». Un podcast présenté par Léa Leostic avec Jean-François Paturaud et Elio Bono. Enregistrement : Marie-Amélie Motte.Hébergé par Ausha. Visitez ausha.co/politique-de-confidentialite pour plus d'informations.

In this video, Dr. Ruscio discusses 6 powerful tools to reset and calm a dysregulated nervous system. The tools he discusses include vagus nerve stimulation via the ear, resonance breathing, electrolytes / sodium optimization, a vibration tool called Apollo Neuro, an audio-visual stimulation device called BrainTap, and grounding. Each tool offers a uniquely beneficial input into the nervous system to help restore a healing, parasympathetic state.   ✅ Start healing with us! Learn more about our virtual clinic:  https://drruscio.com/virtual-clinic/  

Evidence-based practice has a blind spot: not in the research itself, but in how we rank one form of knowledge above all others. In this episode, I sit down with physiotherapist and PhD candidate Matt Low to unpack what he calls epistemic fluency, the ability to move between different forms of clinical knowledge depending on what the situation actually requires. We cover why population-based research gives you a map but not your patient's territory, how Aristotle's three forms of knowledge apply directly to clinical reasoning, and why the biopsychosocial model functions better as an analytical tool than a practice guide. We also dig into the Back Cafe — a 3-arm RCT on lumbar spinal fusion rehab that compared a progressive training program, a video program, and a social cafe setting run by a senior physiotherapist. At the 2-year follow-up, the back-cafe group outperformed the training group on pain and beat both other groups on daily task performance. The study raises hard questions about what the active ingredient in rehabilitation actually is. This is Part 1 of 2. LINKS Join Modern Pain ProMatt Low's blogBack Cafe study (PubMed)CauseHealth (Matt's network)*********************************************************************

What if you could know 20 YEARS before symptoms appear whether you're heading for Alzheimer's? And what if there was a proven way to reverse early cognitive decline? In this episode, I sit down with my dear friend Dr. Dave Jenkins — the leading Dr. Dale Bredesen Protocol practitioner in the Southern Hemisphere — to unpack the p-Tau 217 blood test revolution and the stunning results from Bredesen's latest randomised controlled trial. Dr. Dave breaks down how a simple finger-prick blood test can now detect the Alzheimer's process with 95% certainty up to TWO DECADES before memory symptoms begin. This isn't diagnosing Alzheimer's — it's diagnosing the process, which means you have 20 years to intervene. We dive into Bredesen's 2024 multi-site RCT showing the ReCODE precision medicine protocol is 6–7x MORE POWERFUL than the best Alzheimer's drug currently available in America (lecanemab) — a drug with devastating side effects including brain bleeds and even death. Dr. Dave shares real clinical insights from his Bali longevity practice including the 30–60 "holes in the roof" driving cognitive decline, cutting-edge peptides (Semax, Selank, Cerebrolysin, Dihexa), bioregulators, and his personal experience with Klotho gene therapy that took his memory scores from the 70th to the 97th percentile in just 6 weeks. This is essential listening for anyone with a family history of Alzheimer's, anyone watching a loved one decline, and anyone who wants to take brain health seriously BEFORE it becomes a crisis. ⏰ CHAPTERS: [to be generated after edit]

This week's stories: *Bartonella Hides in Cat Scratches — and It Might Be Why You Feel Like Garbage A stealth bacterial infection transmitted by everyday cat scratches and flea dirt has been quietly linked to chronic fatigue, brain fog, and neurological symptoms for decades. Dave breaks down how Bartonella slips past standard testing, why it's almost never on a conventional doctor's radar, and the specific PCR protocol you need to actually find it. Sources: https://pubmed.ncbi.nlm.nih.gov/ *High Tyrosine Levels May Be Cutting Years Off Men's Lives A Mendelian randomization study of 270,000 UK Biobank participants found that elevated tyrosine is causally linked to nearly a full year of lost lifespan in men — with zero effect in women. The culprit appears to be an inflammatory oxidation pathway that men metabolize very differently. Dave examines what this means for every guy stacking L-tyrosine nootropics or eating high-protein keto. Sources: https://pubmed.ncbi.nlm.nih.gov/41045493/ https://www.aging-us.com/news-room/high-tyrosine-levels-linked-to-shorter-lifespan-in-men https://www.usnews.com/news/health-news/articles/2026-02-27/study-suggests-one-common-amino-acid-may-affect-how-long-men-live *Blue Light Blocking Contact Lenses Are a Legitimate Vision Upgrade ALTIUS Vision's tinted contact lenses aren't just blue light filters — they cut chromatic aberration by 53% and improve motion tracking and contrast sensitivity in ways that software filters simply can't replicate. Dave covers the mechanism, who benefits most (screen workers, TBI recovery, gamers), and how to find a provider. Sources: https://altiusvision.com/chromatic-aberration/ https://altiusvision.com/science-of-altius/ https://www.westvalleyvision.com/-altius--performance-tinted-contact-lenses *Taurine Plus B Vitamins Actually Moves the Needle on Motivation A randomized crossover trial found that a daily stack of taurine, B6, folate, and B12 sustained effort-reward motivation and cut cognitive lapses significantly compared to placebo — and the mechanism runs through glutathione production in brain astrocytes. Dave breaks down why this combo works when either ingredient alone doesn't. Sources: https://pubmed.ncbi.nlm.nih.gov/41889717/ https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2026.1711478/full https://www.nutraingredients.com/Article/2026/03/23/taurine-and-b-vitamins-bost-motivation-and-focus/ *30 Seconds of Smelling Flowers Resets Your Nervous System Research out of the Monell Chemical Senses Center confirms what your grandmother knew: a slow, deep floral inhale measurably lowers heart rate and activates the parasympathetic nervous system — and it works because olfaction bypasses the cortex entirely and hits the limbic system directly. Dave makes the case for building a daily scent ritual. Sources: https://time.com/ https://www.southtabor.com/healthy-living-tip-stop-and-smell-the-flowers/ This episode is designed for biohackers, longevity seekers, and high-performance listeners who want mechanism-level clarity on infection-driven cognitive decline, amino acid optimization, sensory performance, and evidence-based supplementation. Host Dave Asprey connects emerging clinical research, Mendelian randomization data, and real-world protocols into actionable frameworks for extending healthspan and sharpening performance. New episodes every Tuesday, Thursday, Friday, and Sunday. Keywords: Bartonella cat scratch infection, Bartonella brain fog chronic fatigue, stealth bacterial infection biohacking, tyrosine lifespan men, L-tyrosine risk men longevity, Mendelian randomization amino acid aging, blue light blocking contacts, ALTIUS vision chromatic aberration, performance contact lenses TBI, taurine B vitamins motivation RCT, taurine folate brain health, glutathione astrocytes focus, smelling flowers heart rate stress, olfaction parasympathetic nervous system, floral scent limbic system, biohacking news, longevity research 2026 Thank you to our sponsors! - GOT MOLD? | Go to http://gotmold.com/shop and use DAVE10 to save 10% and see what's in your air. - MASA Chips | Go to https://www.masachips.com/DAVEASPREY and use code DAVEASPREY for 25% off your first order. - iRestore | Grow thicker, healthier hair back naturally. Use code DAVE at irestore.com. Resources: • Get My 2026 Clean Nicotine Roadmap | Enroll for free at https://daveasprey.com/2026-clean-nicotine-roadmap/ • Get My 2026 Biohacking Trends Report: https://daveasprey.com/2026-biohacking-trends-report/ • Dave Asprey's Latest News | Go to https://daveasprey.com/ to join Inside Track today. • Danger Coffee: https://dangercoffee.com/discount/dave15 • My Daily Supplements: SuppGrade Labs (15% Off) • Favorite Blue Light Blocking Glasses: TrueDark (15% Off) • Dave Asprey's BEYOND Conference: https://beyondconference.com • Dave Asprey's New Book – Heavily Meditated: https://daveasprey.com/heavily-meditated • Join My Substack (Live Access To Podcast Recordings): https://substack.daveasprey.com/ • Upgrade Labs: https://upgradelabs.com Timestamps: 00:00 – Intro 00:37 – Bartonella & Cat Scratch Disease 02:06 – Tyrosine & Lifespan in Men 03:37 – Tinted Contacts & Visual Processing 05:56 – Taurine & Motivation 07:25 – Floral Scent & Nervous System Reset See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Platelet-rich plasma (PRP) injections do not have formal FDA approval for specific clinical indications. PRP is regulated as an autologous blood product and is used "off-label" in clinical practice. However, there is substantial clinical evidence supporting its use for certain dental surgeries and musculoskeletal conditions, particularly lateral epicondylitis, knee osteoarthritis, and plantar fasciitis. The American Medical Society for Sports Medicine notes that PRP is primarily used to treat tendinopathies and osteoarthritis, though clinical efficacy results remain mixed due to variability in PRP formulations and preparation methods. As of now, there are no FDA approved uses for PRP for gynecologic use, although there has been some evidence of possible benefit in vulvar dermatoses and possiblt ovarian function enhancement. But what about its use in the vagina for sexual pleasure? Injecting into the anterior vaginal wall (around the famed G-Spot location) is nothing new. Over a decade ago, a TV show introduced the masses to the “G-Spot amplication” shot which injected collagen to that area. But there was no data for this. Well, we are back to this idea in a new RCT in the Green Journal. Can PRP light up the vaginal fires of pleasure? Listen in for details. 1. Clarke, Bayley MD; Gaddam, Neha MD; Garcia, Bobby MD; Iglesia, Cheryl B. MD; Podolsky, Robert PhD; Dieter, Alexis A. MD. Vaginal Injection of Platelet-Rich Plasma for Sexual Function: A Randomized Controlled Trial. Obstetrics & Gynecology ():10.1097/AOG.0000000000006256, March 19, 2026. | DOI: 10.1097/AOG.00000000000062562. Finnoff JT, Awan TM, Borg-Stein J, et a American Medical Society for Sports Medicine Position Statement: Principles for the Responsible Use of Regenerative Medicine in Sports Medicine. Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine. 2021. 3. Alsousou J, Ali A, Willett K, Harrison P. The Role of Platelet-Rich Plasma in Tissue Regeneration.Platelets. 2012.

This episode examines whether unprocessed red meat has a causal role in (1) type 2 diabetes risk and intermediate measures of glucose intolerance (insulin resistance, beta cell dysfunction, glycemic markers) and (2) cardiovascular disease (CVD) risk. While there is commonly observed risk signal from observational cohorts, there exist short-term randomized controlled trials (RCTs) that show largely null effects on glucose homeostasis. This had led to differing opinions and interpretations of the evidence base. Some feel that in the context of an otherwise healthy diet, there isn't much to suggest concern about consuming unprocessed red meat. While others are of the view that there does exist a risk and that limiting or even avoiding consumption is prudent. The crucial concept of replacement effects is discussed. Increasing red meat intake always means decreasing something else or increasing total energy intake. Therefore, interpreting evidence requires specifying the comparator food(s), the background dietary pattern, the dose, the cut (lean vs fatty), and how the meat is prepared. To discuss their interpretations of this contentious evidence base, Dr. Mario Kratz and Dr. Gil Carvalho join the podcast to go through the studies most directly related to these questions. Timestamps [06:20] Red meat's impact is debated [10:54] Mechanisms linking meat to diabetes [15:31] Cohort evidence on diabetes risk [24:43] Differences between cohorts and threshold effects [33:13] RCT evidence and substitution trials [45:49] Why comparator foods matter [50:43] RCT examples and mixed results [01:00:30] Is there cardiovascular risk beyond saturated fat? [01:08:10] Epidemiology patterns and dose thresholds [01:11:36] Personal recommendations and risk tolerance [01:16:19] Key ideas Related Resources Go to episode page (study links, guest bios, additional resources) Join the Sigma email newsletter for free Subscribe to Sigma Nutrition Premium Enroll in the next cohort of our Applied Nutrition Literacy course Mario's YouTube channel: Nourished By Science Gil's YouTube channel: Nutrition Made Simple!

In today's episode, we'll dive into a brand new study that's hot off the press—an RCT exploring the short-term effects of manual therapy combined with functional magnetic stimulation (FMS) for patients suffering from lumbar disc herniations with radiculopathy. If you see patients with leg pain, numbness, or MRI-confirmed disc issues, this research offers fresh insight into conservative care and multimodal treatment approaches.Research: Short-Term Effects of Manual Therapy Combined with Functional Magnetic Stimulation in Individuals with Lumbar Disk Herniation with Radiculopathy: A Randomized Clinical TrialSpecial Offers for Listeners: Learn more about Diabetes Reversal Group and become a licenseeSave $500 and Get a Free Cart- Learn more at Shockwave Center of America Today!Leander Tables- Save $1,000 on the Series 950 Table using the code EBC2025 — their most advanced flexion-distraction tableNovoPulse OA Recovery Program- learn more herePatient Pilot by The Smart Chiropractor is the fastest, easiest to generate weekly patient reactivations on autopilot…without spending any money on advertising. Click here to schedule a call with our team.Our members use research to GROW their practice. Are you interested in increasing your referrals? Discover the best chiropractic marketing you aren't currently using right here!

Beta-blocker in non-obstructive hypertrophic cardiomyopathy, a head-to-head apixaban vs rivaroxaban RCT, diltiazem vs metoprolol combined with DOAC, and the accuracy of smart watches for AF are the topics John Mandrola, MD, discusses in this week'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 Listener Feedback EMPATICC trial https://academic.oup.com/eurheartj/article/47/9/1034/8242490 II Beta-blocker in Non-obstructive HCM BB vs Calcium Channel Blocker in Non-obstructive HCM https://doi.org/10.1016/j.jacc.2025.11.028 RCT of Metoprolol in Patients With Obstructive HCM https://doi.org/10.1016/j.jacc.2021.07.065 III Apixaban vs Rivaroxaban for Bleeding Risk COBRRA Trial https://www.nejm.org/doi/full/10.1056/NEJMoa2510703 AMPLIFY Trial (Apixaban) https://www.nejm.org/doi/10.1056/NEJMoa1302507 EINSTEIN Trial (Rivaroxaban) https://www.nejm.org/doi/full/10.1056/NEJMoa1007903 IV Diltiazem vs Metoprolol When Combined with DOAC Risk for Bleeding in AF Patients Using Apixaban or Rivaroxaban With Diltiazem https://www.acpjournals.org/doi/10.7326/ANNALS-25-01408 V Actual Clinical Use of Smart Watches CIRCA-DOSE Original Trial https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.042622 Wearable Smartwatches for AF Detection After Ablation https://doi.org/10.1093/europace/euaf280 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