Podcasts about rct

The Derm on RheumNow podcast is a review of recent citations and content curated for dermatologists – addressing Psoriasis, PsA, CLE, vasculitis, HS, CTD skin disorders. dermatology drugs, biologics, andJAK inhibitors - their use, efficacy and side effects. Features Dr. Jack Cush, Editor at RheumNow.com. Show Notes: Latest #s: EHR estimates from 6 large US medical systems, estimated prevalence of autoimmune Dz (AID) to be 15 million (4.6% US population); 34% have 2+ AID. Women have 2x risk. Sex ratio of 1.7:1 F:M. https://buff.ly/fYgRfZ0 POETYK PsA-1: Deucravacitinib in Biologic-Naïve PsA POETYK PsA-1 trial tested the disease modifying efficacy of deucravacitinib, a tyrosine kinase 2 (TYK2) inhibitor, in PsA patients and was shown to be superior vs to placebo for clinical responses, patient-reported outcomes, https://t.co/VjwpCVKPz0 MoonLake announced positive phase 3 data from its IZAR-1 RCT using its dual A/F IL-17 inhibitor sonelokimab, showing significant responses at week 16: 66% ACR20, 42% ACR50, 41% minimal disease activity (MDA), & 61% PASI90 at week 16. a 2nd IZAR-2 PsA RCT is in progress https://t.co/eX0cxekRKG British Dermatology Biologics registry (BADBIR) 18976 #PSO pts had incidence serious infxns (SIE) 28 SEI/1000 Pt-Yrs; higher if they had prior infxn (79/1000 PYs). SIE signif lower w/ RIZankizumab (HR 0.74-.80) vs BROAD, ETN, other standards Rxs. SIE deaths rare (1.81/1000 PYs) https://t.co/GTr3DLCVXs 39 studies compared Juvenile systemic sclerosis (jSSc) & adult SSc. 935 jSSc vs 15,451 aSSc pts; jSSc had more diffuse cutaneous dz (70% vs 41%), more overlap myositis (33% vs. 5%), arthritis (33% vs 18%), digital ulcers (51% vs 20%), less renal crisis (0% vs 6%) & lower mortality jSSc (7.7% vs. 20.4%) https://t.co/vflarmwSyv Italian SPRING cohort of #SSc pts found only 5.3% (of 1689 pts) without the typical scleroderma pattern on nailfold change by NVC. They had milder dz, with less vascular dz (pitting scars 33 vs 48%), telangiectasias (52 vs 74%), calcinosis 3.4 vs 12%) & higher DLCOs at 12, 24, https://t.co/AoNAhVYfII Review of CAR-T 29 trials in systemic sclerosis (SSc): 27/29 target CD19 (other CD20, BCMA), 20/29 autologous. Only 2 RCTs; 1 w/ RTX comparator. Most included CREST. Schetts largest series had 6 dcSSc w/ skin/lung improvements. Need fewer & larger multicenter RCTs https://t.co/Me28HbaFhR SLE & Dermatomyositis rashes maybe classically red or violaceous in Whites,but different in people of color, where erythema often appears brown/violaceous, Gottron papules can be mistaken for "dry skin." This delays dx, especially in anti-MDA5+ RP-ILD, where rash may be the https://t.co/Savx5IOTcG Yesterday the EMA approved upadacitinib (Rinvoq) for the Treatment of Adults and Adolescents with Non-Segmental Vitiligo - the 1st therapy approved for the most common form of vitiligo. Based on positive results from the Phase 3 Viti-Up trials https://t.co/MMv5LjZclQ 3 Rx are FDA approved for hidradenitis supprativa (secukinumab, adalimumab, bimekizumab). New JAK1i Povorcitinib in STOP-HS1 and STOP-HS2 ph 3 PCTs (608/619 pts). Povo showed HiSCR50 ~42% vs PBO 29% @wk12. AE: acne, pharyngitis https://t.co/n3FJUOjNuo

This week's pod has everything: 1. DDI information and dosing for daraxonrasib, now FDA approved and commercially available for pancreatic cancer 2. A new standard of care (?) in HER(+) gastric cancers, and more nuance on HER2 positivity. And lots of diarrhea. 3. The largest RCT in primary CNS lymphoma Download the Oncology Learning Companion: https://www.kelleycpharmd.com/learning-oncology-companion-oncopharm

Today, we are taking a deep dive into a medical truth thatsounds completely counterintuitive, almost upside down, based on everything you think you know about women's health. But here's the kicker: it's actually nothing new at all. For over two decades, ever since the landmark Women'sHealth Initiative (WHI) study made global headlines back in 2002, the blanket narrative surrounding menopausal hormone therapy has been clear and persistent: hormones equal breast cancer risk. But there is a massive asterisk in thatscience that got completely lost in the media noise. While combination therapy with conjugated equine estrogens paired with medroxyprogesterone acetate (CEE +MPA) did show an increased risk, the story for estrogen-only therapy (mainly CEE) in women wh had a hysterectomy is entirely different. In fact, an overwhelming mountain of growing data shows that estrogen-only therapy is protectiveagainst both breast cancer incidence and breast cancer mortality. In this episode, we're unpacking the latest high-level evidence that cements this crucial distinction. We'll examine the broad statistical landscape, including a comprehensive meta-analysis by Qing et al. (officially set for the December 2026 issue of Annals of Medicine, following its ahead-of-print release in March 2026). Their work breaks down how randomized controlled trial data consistentlypoint to estrogen-only therapy having a protective effect, in stark contrast to combination therapy. We'll also dive into a brand-new Clinical Perspective published in mid-August 2026 in Obstetrics & Gynecology (the Green Journal) by Drs. Andrew Kaunitz and Jason Wright. They call urgent attention to this phenomenon, highlighting RCT meta-analyses that demonstrate a 23% reduction in breast cancer incidence with estrogen alone (RR = 0.77), alongside striking cohort data showing a dramatic risk reduction even in high-risk populations, like carriers of the BRCA mutation.  Listenin for details.1.     Wu Q, Shen L, Hu S, Yang R, Wang Y, Xue D, SunY, Ma H, Dai Z. Relationship between menopausal hormone therapy and incidencerisk of breast cancer: systematic review and meta-analysis. Ann Med. 2026Dec;58(1):2640244. doi: 10.1080/07853890.2026.2640244. Epub 2026 Mar.2.     Kaunitz, Wright. Menopausal Estrogen Therapy andRisk of Breast Cancer. Obstet Gynecol. Aug 20263.     Chlebowski RT, Aragaki AK, Pan K, et al.Randomized Trials of Estrogen-Alone and Breast Cancer Incidence: AMeta-Analysis. Breast Cancer Research and Treatment. 2024. 4.     Writing Group for the Women's Health InitiativeInvestigators. (2002). Risks and benefits of estrogen plus progestin in healthypostmenopausal women: Principal results from the Women's Health Initiativerandomized controlled trial. JAMA, 288(3), 321–333.

Nasal strips have been a fixture in pharmacy aisles and on athletes' faces for decades, sold on the promise of easier breathing, but the peer-reviewed evidence often tells a different story than the packaging does. We put nasal strips and internal dilators through the RCT wringer and sort out what these devices can and can't actually do, from your bedroom to the finish line. In this episode we will:Break down what the highest-quality evidence — a 2026 meta-analysis of 17 studies and nearly 500 patients — actually found for AHI, oxygen saturation, and sleep architecture across all nasal dilator typesSit with the placebo-strip finding out of the University of São Paulo, and what it reveals about the gap between subjective "I slept better" and objective, PSG-measured outcomesCompare internal dilators like Mute against external strips, and call out where manufacturer-cited stats diverge from the independent literatureHead onto the field and track: two competing systematic reviews on whether strips help runners and athletes, and why "very low certainty" evidence still shapes what gets marketed to youTo find out more about this week's podcast sponsor BreatheUp, please use the following link: https://breatheup.com/Original intro music Vigilanteology by Abhinav Singh (copyright 2026) Original outro music Vigilanteology (reprise) by Abhinav Singh (copyright 2026)Produced by: Maeve WinterMusic by: Dr. Abhinav Singh (@sleep_vigilante), all rights reservedMoreTwitter: @drchriswinterIG: @drchriwinterThreads: @drchriswinterBluesky: @drchriswinterThe Sleep Solution and The Rested ChildThanks for listening and sleep well!

Hosts: Ed Jones (Owner – Nutrition World) & Clint Powell A variety of topics to living a healthy life Presented by: Nutrition World www.nutritionw.com Broadcasting from the Nooga Dentistry Studio www.noogadentistry.com Production of: Whitfield Media Group www.vitalhealthradio.com Title: Beyond Cholesterol: The Heart Health Markers That Matter [0:00:00] – Intro: Lettuce Contamination, Social Media & Local Business Impact Discussion of “fear of lettuce,” limited to 15 states (not Tennessee) How social media amplifies food scares Local “Build a Salad” restaurant going out of business and timing around lettuce scare [0:04:39] – Back-to-School Immune Support: Oral Probiotics & Iodine Nasal Spray Back-to-school season and rise in colds/sicknesses Oral probiotics for kids: oral microbiome, throat/sinus benefits Iodine nasal spray for parents and teachers: safety, use during school/gym, personal routines of Ed and Clint [0:08:04] – Supplement Industry & Big Pharma Buyouts Thorne bought by Procter & Gamble for $3.8B History of pharma mocking “granola/hippie” supplement culture, now buying brands Many acquired supplement brands failing under pharma ownership Difference between pharma customers and nutraceutical users (education, mindset) Nutrition World's preference for privately owned brands [0:14:00] – Life Lessons from Flying & Racing: Doing the Hard but Right Thing Ed's story: practicing engine-out landings, re-learning best glide speed Insight: sometimes you must “point the nose down” (do the counterintuitive hard thing) to survive Clint's race-car analogy: “you go where you look” – look down the track, not at the wall [0:18:01] – Food Label Claims: Olive Oil vs. Avocado Oil Products UC Davis testing of products “made with olive oil” – most passed authenticity tests Avocado-oil-labeled products often failing purity tests Takeaway: be more skeptical of “made with avocado oil” claims [0:18:31] – Prostate Cancer & “Treating the Terrain,” Not Just the Tumor Dr. Gio (prostate-focused naturopath): focus on the ground cancer grows in Historical context from Stephen Paget's work on tumor “soil and seed” Lifestyle “soil-building” recommendations: Resistance training, walking 150 minutes/week Waist circumference < half your height Sleep, stress reduction, nutraceuticals, nutrient-dense diet [0:21:58] – Multivitamins, Carotid Stenosis & Functional Benefits COSMOS study: Centrum multivitamin and patients with carotid narrowing Reported improvements in physical function (walking, climbing stairs) and symptoms (shortness of breath, fatigue) Ed's extrapolation: better-designed multis (True Grace, Life Extension, etc.) likely offer even more benefit [0:22:30] – Post-Infectious Cough: Honey + Instant Coffee vs. Prednisone Double-blind RCT comparing: Honey + instant coffee paste Prednisone Guaifenesin Honey + instant coffee dramatically outperformed prednisone in reducing persistent cough frequency Discussion of guaifenesin's role, safety, and its regulatory history in health food vs. pharmacy channels [0:30:12] – Prednisone, COVID & Anxiety: Personal Case Story Guest Dr. Curt Dearing shares: Followed COVID protocol including prednisone Developed severe, prolonged anxiety afterward (twice) Realization that prednisone triggered it Ed's summary of prednisone side effects: bone loss, cataracts, muscle wasting, weight gain; okay short term, risky long term [0:33:30] – Cardiovascular Disease, Statins, & New Drug Lifendra (PCSK9 Inhibitor Pill) CV disease framed as leading cause of death for most people Introduction of Lifendra (oral PCSK9 inhibitor, from Merck) as “breakthrough” LDL-lowering drug Comparison with Repatha (injectable PCSK9 inhibitor) Curt's key points: Lifendra lowers LDL but does not show reduction in cardiovascular death, heart attack, or stroke (per Merck's own wording so far) Repatha's trial data: minimal impact on non-fatal events; no reduction in CV deaths vs. placebo Very high cost (~$300+/month out of pocket; heavy insurance burden) Critique of LDL obsession in cardiology Need to ask: Why is the cardiovascular system inflamed and oxidized? Ed & Curt's “terrain” model: Bad inputs: ultra-processed food, toxins, poor sleep, chronic stress, lack of sun/movement Missing inputs: nutrient-dense foods, minerals, omega-3s, organ meats, sunlight, sleep, movement Example of amlodipine: lowers BP numbers but may increase arterial calcification (calcium channel blocker) For people unwilling to change lifestyle, drugs may offer marginal benefit—but not true health [0:41:05] – Curt's Book & Lab Markers That Matter More Than LDL-C Curt's book: “Beyond Cholesterol: The Ultimate Guide to Testing and Supplements for Heart Health” Emphasis on better markers: ApoB, LDL particle size/number, calcium score, etc. Book's Amazon performance briefly noted (new release bestseller in its category) [0:44:32] – Alternatives to Statins & PCSK9s: Bergamot & Lifestyle Curt's hierarchy: Lifestyle (diet, exercise, stress, sleep) Targeted supplements like bergamot (citrus extract): lowers harmful particles such as ApoB and supports “good” LDL function Only then consider pharmaceuticals, and very selectively Skepticism about recommending Lifendra at all; strong bias toward non-drug approaches [0:45:28] – Dr. Wolfson, Mold, and Cardiovascular Terrain Ed & Curt's respect for Dr. Jack Wolfson, “The Natural Heart Doctor” Mention of mold as a major, under-recognized driver of cardiovascular disease Reference to Dr. Wolfson's educational resources and upcoming podcast plans [0:48:04] – Key Takeaways on Lifendra & Heart Prevention Strategy Lifendra will not fix: seed oils, glyphosate exposure, mold, bad sleep, chronic stress Terrain-building priorities: Real food, omega-3s, sunlight Toxin reduction Mitochondrial support Foundational supplements Contrast: drugs = band-aids with side effects; nutraceuticals = “side benefits” when used correctly [0:52:28] – Wrap-Up Ed mentions Sprouts selling lab-grown meat and his strong opposition Update on Oura Ring: now tracking nighttime blood pressure and importance of BP dipping Listener story: young man post–heart surgery credits Nutrition World's education and support with changing his life Final thanks to Dr. Dearing and closing outro  The post Radio Show / Podcast – August 9, 2026 first appeared on Vital Health Radio.

Cette interview est disponible en vidéo sur Youtube !Cédric Beal, Directeur du centre de formation, et Pierre Mignoni, Directeur du rugby du Rugby Club Toulonnais, ont accordé un long entretien aux Causeries de la Rade dans lequel ils décryptent la nouvelle stratégie du RCT basée sur une identité réaffirmée, la place grandissante de la formation au club et les corrections qu'ils ont apporté dans le staff et le fonctionnement de l'équipe pour performer cette saison. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Jared is joined by Tim Cook who is Senior Lecturer in Physiotherapy at the University of Chichester, Advanced Physiotherapy Practitioner in the NHS, and doctoral researcher to discuss their new paper with Prof. Jeremy Lewis in the Journal of Manual & Manipulative Therapy: "Rethinking strength testing in rotator cuff-related shoulder pain: a clinical tradition that lacks muscle." Tim explains what pushed him to question routine strength testing in busy clinical practice, despite guidelines recommending it, and the pair dig into whether weakness is a cause of shoulder pain, a consequence of it, or something else altogether. They look at what subacromial anaesthetic injection studies reveal about pain versus true force output, and Tim reframes the classic "weak and painful shoulder" as the "flexible but painful shoulder," drawing parallels to other oversimplified clinical narratives like posture and core stability. They also make the case for when strength testing can still earn its keep; patient engagement, expectation violation, building confidence, and sporting or return-to-performance populations such as ACL limb symmetry index, before turning to Goodhart's Law and the risk of chasing the test rather than the outcome, and why isolated isometric tests may not translate to real-world, endurance-based shoulder tasks. Tim closes out with an update on his PhD: a reliability RCT on strength and pain-free assessment currently in press, and an upcoming scoping review on the proposed mechanisms of exercise for RCRSP. Key resources Cook, T., Lewis, J., & Powell, J. (2026). Rethinking strength testing in rotator cuff-related shoulder pain: a clinical tradition that lacks muscle. Journal of Manual & Manipulative Therapy, 34(3), 193–198. https://doi.org/10.1080/10669817.2026.2663623 Register for the complete shoulder online course Melbourne workshop details Connect with Jared: Jared on Instagram: @‌shoulder_physio Jared on X: @‌jaredpowell12 Tim on Instagram: @Timcookphysio See our Disclaimer here: The Shoulder Physio - Disclaimer

We talk with Eleanor Williams from the Australian Centre for Evaluation about making evaluation fast, rigorous, and genuinely useful for public service decisions. We move from a 40,000-person employment services RCT to the practical steps that make testing possible, then unpack why transparency and mixed methods matter when the stakes are high. Along the way we discuss:turning a mutual obligation debate into a 'fact question'  through a large three-arm randomised controlled trialwhy a null result can be a powerful policy signalthe enablers that make responsive RCTs feasible, from systems to leadership to ethics and consenthow ACE partners with departments through a hub-and-spoke model, secondments, and capability buildingplanning evaluation from day one using program logic and theory of changeseparating program cost from evaluation cost to make smarter investment decisionspublishing and normalising evidence through the ACE Evaluation Libraryusing developmental evaluation and test-and-learn without getting stuck refining measures foreverwhat decision makers value under time pressure, including “killer stats” plus narrative and qualitative insightimproving services with small, fast trials like pre-call SMS nudges at Services AustraliaMentioned in this episode:Australian Centre for EvaluationACE Evaluation Library, hosted on the Australian Policy ObservatoryThe Magenta BookAnthony Costello, The Social EdgeThis podcast was recorded on Kaurna land, and we recognise Kaurna elders past and present. Always was, always will be.Now for some appropriately bureaucratic disclaimers....While we have tried to be as thorough in our research as busy full time jobs and lives allow, we definitely don't guarantee that we've got all the details right.Please feel free to email us corrections, episode suggestions, or anything else, at thewestminstertraditionpod@gmail.com.Thanks to PanPot audio for our intro and outro music. 'Til next time!

HEALTH NEWS   Review finds blueberry and grape polyphenols may improve vascular health Plant compound shows promise for treating rheumatoid arthritis at its source, study finds Screen Time at Ages 1 and 6 Linked to Lasting Learning and Memory Effects Some caffeinated drinks are linked to poorer memory Study: Morning Exercise Linked to Lower Daily Calorie Intake Compared to Evening Workouts   Review finds blueberry and grape polyphenols may improve vascular health Universidad Católica de Murcia (Spain), July 27 2026 (News-Medical) A recent review published in the journal Nutrients examined the evidence on the effects of blueberries, grapes, and their bioactive compounds on cardiovascular risk markers. In the present study, a comprehensive systematic literature search was conducted to identify randomized controlled trials (RCTs), systematic reviews, and meta-analyses published from January 2015 through April 2026.  Two systematic reviews and meta-analyses reported that grape polyphenols at doses exceeding 500 mg/day for at least 12 weeks significantly reduced C-reactive protein levels, while the other reported improvements in vascular function or BP in 84% of the human studies it assessed, including a significant reduction in systolic BP. One found a modest reduction in BP and improvement in endothelial function with flavan-3-ol foods, such as tea, apples, cocoa, and grape-derived products. Moderate- and high-quality RCTs reported improvements in lipid peroxidation, lipid profiles, flow-mediated dilation, diastolic BP, and paraoxonase activity. Resveratrol and blueberry RCTs mainly reported endothelial and vascular benefits, such as improved nitric oxide production and flow-mediated dilation and reduced BP and inflammatory markers. One high-quality RCT involving older men with metabolic syndrome showed significant improvements in arterial stiffness and endothelial function after six months of daily blueberry consumption.     Plant compound shows promise for treating rheumatoid arthritis at its source, study finds Guangzhou University of Chinese Medicine, July 27 2026 (Natural News) A plant-derived compound called obakulactone (OL) reduced swelling, inflammation and joint damage in rats with rheumatoid arthritis, according to a study published in Engineering.   The compound, a tetracyclic triterpenoid from the bark of Phellodendri cortex, also rebalanced immune activity and corrected disrupted fatty acid metabolismd. P. cortex has been used in traditional medicine and contains OL along with other constituents, Researchers tested OL in rats with rheumatoid arthritis, administering low, medium and high doses for 21 days. Treatment significantly reduced joint swelling and helped restore the normal structure of cartilage and the synovium, the tissue lining the joints, according to the report.   Blood tests showed dose-dependent decreases in inflammatory molecules including IL-1, IL-6, IL-17 and TNF, as well as rheumatoid arthritis markers RF, CCP-Ab, CRP and MMP-3, officials said. The compound also reduced abnormally high levels of CD3+ T cells and CD68+ macrophages within the joints and shifted macrophages from a proinflammatory M1 state toward an anti-inflammatory M2 state.   Screen Time at Ages 1 and 6 Linked to Lasting Learning and Memory Effects National University of Singapore & Zhejiang University (China), July 28, 2026 (SciTech Daily) A study that tracked children from age 1 through age 8 found that greater screen viewing time, especially during infancy and near the start of school, was associated with lower academic performance at age 9 and weaker working memory at age 10.5. The results indicate that when children use screens may matter as much as how long they spend using them. The World Health Organization (WHO) and the American Academy of Pediatrics advise avoiding screens before 18 to 24 months and limiting viewing to less than one hour per day between ages 2 and 5. Many children exceed those recommendations, yet previous research on screens and cognitive development has produced inconsistent results. The analysis included 502 children followed from infancy into middle childhood. Higher screen viewing during particular stages was associated with poorer academic results and weaker working memory later on. The clearest and most consistent relationships appeared during infancy and near school entry, suggesting that these may be especially sensitive periods for cognitive development. Children with greater total screen exposure across childhood also generally performed less well in school. Together, the findings suggest that both the timing and overall amount of viewing may have implications for learning and memory.   Some caffeinated drinks are linked to poorer memory Applied Science Private University (Jordan), July 28 2026 (News-Medical) A recent study in the Journal of Education and Health Promotion examined the association between caffeine-containing products and memory performance, anxiety, and stress among university students in Jordan. 204 students were ultimately included in the study.  Mild psychological distress was the most common category, with 38.2% reporting such symptoms. About four in ten reported mild depression, and over a quarter experienced moderate anxiety. Only a small minority showed severe or extremely severe stress. Caramel or nut-filled chocolate was the most frequently consumed item, reported by 54.9% of students, followed by Arabic coffee (40.2%) and red tea (35.8%). Milk chocolate was also popular, typically consumed once or twice a day. Dark chocolate was less common, while American coffee and green tea were less popular, and decaffeinated coffee was rarely chosen. Overall DASS scores, representing depression, anxiety, and stress symptoms, showed positive correlations with the consumption of dark chocolate, American/instant coffee, decaffeinated coffee, and red tea, indicating these items were linked to higher psychological distress scores. Memory ability was negatively associated with higher intake of American coffee, Arabic coffee, and soft drinks.  The authors note that chocolate and green tea also contain bioactive compounds such as cocoa flavanols and L-theanine, which may have contributed to these associations alongside caffeine.   Study: Morning Exercise Linked to Lower Daily Calorie Intake Compared to Evening Workouts Copenhagen University Hospital (Denmark), July 27 2026 (Natural News)   A new study has found that morning exercise was associated with lower calorie consumption throughout the day compared to evening workouts, according to the research. Participants who exercised in the morning consumed about 400 fewer calories at the post-workout meal and roughly 547 fewer calories over the full 24-hour period, the study reported.   The study, which involved 35 healthy young adults. Each participant completed 30 minutes of treadmill running multiple times under varying conditions: morning fasted, evening fasted for 12 hours or 6 hours, and morning or evening fed, the study stated. The repeated-measures design enabled researchers to compare the same person's responses across different scenarios, officials said. After evening sessions, participants reported higher hunger, a stronger desire to eat, and lower fullness compared to morning sessions, the study found. Those who worked out in the evening consumed about 400 more calories at the post-workout meal and roughly 547 more calories over the full day, according to the research.   The appetite advantage was attributed to circadian rhythms, researchers said. The hunger hormone ghrelin naturally rises in the evening, while satiety hormones are more active in the morning,.

Heart disease kills one person every 40 seconds. That number hasn't changed in 30 years. Dr. John Osborne, a preventive cardiologist with two doctorates and 29 years in practice, has spent his career on a single question: why do we screen for cancers that kill a few percent of us and do nothing for the disease that kills 40%? In this episode, Jeremy and Jason sit down with Dr. Osborne to get the real story on cardiac CT with AI — the imaging technology that can detect, quantify, and track arterial plaque at sub-millimeter resolution, years before symptoms appear. If you track your bloodwork, wear a fitness device, or consider yourself health-forward — this is the conversation that fills the gap nobody warned you about.(Note: This episode was originally published March 16th, 2026)Guest Link:https://clearcardio.com/Key Moments:00:00 — Dr. Osborne's case for preventive cardiology: why heart disease is the most under-screened killer02:43 — How cardiac CT evolved from "iPhone 0.5" to the 2026-era AI-powered tool he uses today05:35 — Why he gave up stress tests and heart caths in 2005 and never looked back08:16 — What AI actually adds: seeing and quantifying plaque invisible to the human eye, down to 0.1 cubic millimeters10:13 — When insurance pays for cardiac CT — and when it doesn't (the preventive gray zone)14:50 — The “cardiac colonoscopy” concept: the case for screening before symptoms, not after18:11 — Coronary artery calcium score: the accessible $100 starting point, and what it can and can't tell you31:54 — Lifestyle essentials: the 50% of risk that's modifiable regardless of genetics35:00 — Family history decoded: why your sibling's heart history matters more than your parents'36:12 — Nicotine myth-busting: Dr. Osborne on the "health guru" nicotine fad and why he thinks it's dangerous38:05 — Supplements under scrutiny: natokinase, fish oil, red yeast rice — what the actual RCT data says

What if a patient who is years — even decades — out from their stroke could still make meaningful gains in their affected arm? In this episode, host Erin Gallardo, PT, DPT, NCS, talks with Mason Hearn, PT, DPT, NCS, about Vivistim, the FDA-approved paired vagus nerve stimulation system for chronic ischemic stroke, and why the "paired" piece — stimulation delivered in the same moment as intensive, task-specific therapy — is what makes it work. Mason breaks down the triple-blinded RCT behind the device, why patients an average of three years post-stroke saw two to three times greater improvement on the Fugl-Meyer, and how the real-world results coming out of clinics are landing even higher. This episode gets into what the protocol actually asks of patients (90-minute sessions, three times a week, 300–500 reps), how at-home "swiping" turns everyday tasks like getting dressed or cutting into a baked potato into neuroplasticity-building practice, who is and isn't a candidate, and how therapists can think about screening and advocacy without feeling like they're "referring someone for surgery." It's a hopeful, practical conversation about giving chronic stroke survivors real agency over the next stage of recovery and the clinicians who can open that door for them. Learn more at: Vivistim.com https://www.vivistimacademy.com/ Here is the safety profile: http://www.Vivistim.com/safety  

Open vs partial nephrectomy, and open vs robotic prostatectomy - two large randomised trials that did not change surgical practice! Just as important to examine these in GU Cast Journal Club as to examine pivotal trials that did change practice. Today we discuss the EORTC Today we discuss the EORTC 30904 RCT looking at kidney cancer surgery (Eur Urol 2011), and the Brisbane randomised trial of open vs robotic prostatectomy conducted (Lancet 2016). We are delighted to welcome back our GU Cast Journal Club Editors, Dr Carlos Delgado (Mexico City, MEX), and Dr Elena Berg (Munich, GER), along with main GU Cast Hosts, Renu Eapen and Declan Murphy. AN emotional one as Carlos is heading home to Mexico soon! Links to papers below:1. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma Eur Urol 2011 2. Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study Lancet 2016Even better on our YouTube channelAbout GU Cast Journal Club:Each month, two papers are discussed, each of which are of importance to the GU Oncology community. These may be recent papers, or occasionally we will chose a classic landmark paper in GU Oncology. The objective is to draw attention to important papers in GU Oncology, and critique these in a robust manner. The key target audience is trainees working in Urology, Medical Oncology, Radiation Oncology, Nuclear Medicine, and diagnostic specialties such as Radiology and Pathology. But any of our regular audience are likely to enjoy this Journal Club series.

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

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

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.

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three new pieces of research and a special interview later on discussing the recommendations of the National Screening Committee on prostate cancer screening in the UK.First up for research: nasal sprays versus the common cold. The BJGP reports on longer-term findings through this simple intervention. Can it help this age-old problem?Second, new kid on the block, orforglipron - could it replace SGLT2 inhibitors for management of type 2 diabetes?Third, home-based hypnotherapy. Can it help children struggling with functional abdominal pain or IBS? We have a RCT to tell us. Finally, our interview with Dr Liz Bancroft, consultant nurse in oncogentics research, and Natalia Norori, interim Head of Data and Evidence at Prostate Cancer UK join us to discuss the new recommendations from the National Screening Programme with targeted screening of men with BRCA2, why they made this recommendation and how this affects us in general practice, plus what we need to know for our patients about the government-backed trial, TRANSFORM.ReferencesProstate Cancer UK Information on NSC decisionProstate Cancer UK Health Professional NSC FAQsNational Screening Committee report on prostate cancer screeningBJGP Nasal sprays for the common coldLancet Nasal Sprays original paperLancet Orforglipron vs dapagliflozin and T2DMBJGP Hypnotherapy in children for abdo painNational Screening Committee report on prostate cancer screeningwww.nbmedical.com/podcast

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.

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/

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

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!

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

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  

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/  

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.