Podcasts about rct

We have covered Low Dose Aspirin (LDA) for pre-natal preeclampsia prevention MANY times before. But here's a good clinical question: Since preeclampsia can also pop-up in the first 6 weeks postpartum (pp), should we continue it in the immediate pp interval? There is a new publication, an RCT, in the AJOG that looked to answer this- and we will highlight that publication in this episode. PLUS, we will briefly summarize a separate publication from the American J Perinatology back in 2023 that also provided some clinical insights on this topic. Listen in for details.1. The association between postpartum aspirin use and NT-proBNP levels as a marker for maternal cardiac health: a randomized-controlled trial; July 2025 (AJOG): https://www.sciencedirect.com/science/article/pii/S00029378250047522. Christenson E, Stout MJ, Williams D, Verma AK, Davila-Roman VG, Lindley KJ. Prenatal Low-Dose Aspirin Use Associated with Reduced Incidence of Postpartum Hypertension among Women with Preeclampsia. Am J Perinatol. 2023 Mar;40(4):394-399. doi: 10.1055/s-0041-1728826. Epub 2021 May 3. PMID: 33940641.3. Mendoza M, Bonacina E, Garcia-Manau P, et al. Aspirin Discontinuation at 24 to 28 Weeks' Gestation in Pregnancies at High Risk of Preterm Preeclampsia: A Randomized Clinical Trial. JAMA. 2023;329(7):542–550. doi:10.1001/jama.2023.0691

Comments or feedback? Send us a text! Clinicians will often hear their clients express deeply felt needs, only to admit they've never shared them with their partner—usually due to fear of vulnerability or a defensive, adversarial dynamic that makes intimacy feel unsafe.  In today's episode, we are joined by Dr. James Cordova—Professor of Psychology at Clark University and creator of The Relationship Checkup—to discuss his new book, The Mindful Path to Intimacy. Dr. Cordova's book offers a powerful framework for understanding and transforming these relational patterns through the lens of mindfulness, compassion, and shared vulnerability.In our conversation, we explore:Why intimacy is often more terrifying than people expect—and why it's worth the riskHow mindfulness can serve as both a spiritual and relational practiceThe idea that attention is the most basic form of loveWhy many couples shift from infatuation to frustration, and what can be done about itHow interpersonal neurobiology helps us understand the push-pull of closeness and withdrawalWays to navigate shame, trauma histories, and fear of being fully seen in loveWhat distinguishes couples who flourish from those who simply coexist. Dr. James Cordova is a Professor of Psychology at Clark University and the creator of The Relationship Checkup, a pioneering, preventative intervention designed to assess and strengthen couples' relationships before problems escalate. He has led major research initiatives—including a $1.3M Department of Defense-funded RCT with Lt. Colonel Jeffrey Cigrang and a $1M NIH grant—demonstrating the model's effectiveness in both military and civilian populations. As founder and president of Arammu: The Relationship Checkup, Inc., Dr. Cordova is scaling this approach nationwide, training over 1,000 military counselors and integrating the model into primary care. He is the author of The Marriage Checkup, The Story of Mu, and The Mindful Path to Intimacy, the latter of which offers mindfulness-based tools for cultivating emotional and spiritual connection.To learn more about Dr. Cordova and his work, visit:https://relationshipcheckup.comOr check out his latest book, The Mindful Path to Intimacy, from Guilford Press.

In this enlightening episode of The Birth Lounge podcast, HeHe dives into the world of skincare during pregnancy with nurse practitioner Claire O'Bryan, founder of The Skin Clique. They explore the surprising fact that most skincare ingredients are not regulated by the FDA and discuss what it truly means for a product to be 'clean'. They tackle common pregnancy skincare concerns such as melasma, acne, and the safety of popular ingredients like retinoids and salicylic acid. The episode also touches on the controversial topics of Botox, fillers, and the efficacy of supplements like collagen in skincare. Claire provides practical advice on crafting an effective, simple daily skincare routine and the importance of sunscreen, while addressing misconceptions about the need for sunscreen. Tune in to get evidence-based answers to your burning skincare questions and learn how to navigate the complexities of beauty products safely in pregnancy and beyond. 00:00 Introduction to Skincare Safety 02:00 Common Skincare Concerns During Pregnancy 03:50 Interview with Claire O'Bryan 04:51 Skincare Regimens and Fads 07:20 Pregnancy-Safe Skincare Ingredients 11:06 Acne Treatments During Pregnancy 15:33 Retinol Alternatives and Supplements 20:37 Daily Skincare Routine Essentials 25:16 Sunscreen Myths and Facts 34:51 Effective Sunscreen Reapplication 35:42 Blue Light Protection in Sunscreens 36:32 Impact of Screen Time on Skin 38:39 Understanding Botox and Fillers 44:32 Botox Safety During Pregnancy and Nursing 50:36 Microneedling and Skincare During Pregnancy 01:01:34 Preventing and Treating Stretch Marks 01:06:18 Conclusion and Final Thoughts   Guest Bio: Claire O'Bryan is a dynamic nurse practitioner and entrepreneur dedicated to empowering women and amplifying the voices of female healthcare leaders globally. Her mission extends beyond traditional medical aesthetics – she's reshaping how we think about healthcare delivery while paving the way for women in leadership. As the co-founder of Skin Clique, Claire continues to help revolutionize the medical aesthetics industry through a groundbreaking concierge model. Since launching Skin Clique in 2019, what began as a vision for more accessible skin health has grown into a nationwide network of 1,000 skilled providers across 43 states. This expansion reflects not just business success but a transformation in how people access professional treatments and skincare. It is the modern approach to skin health.   INSTAGRAM: Connect with HeHe on IG   Connect with Claire on IG   BIRTH EDUCATION: Join The Birth Lounge here for judgment-free childbirth education that prepares you for an informed birth and how to confidently navigate hospital policy to have a trauma-free labor experience: https://www.thebirthlounge.com/   Download The Birth Lounge App for birth & postpartum prep delivered straight to your phone: https://www.thebirthlounge.com/app-download-page   LINKS MENTIONED: www.claireobryan.com www.skinclique.com: Use code Claire10 for a discount!    Pregnancy safe skincare:  https://shopmy.us/collections/549485   Collagen meta analysis:  https://pmc.ncbi.nlm.nih.gov/articles/PMC10180699/?utm_source   ACOG  https://www.acog.org/womens-health/faqs/toxic-chemicals-steps-to-stay-safer-before-and-during-pregnancy   ACOG Skin Conditions https://www.acog.org/womens-health/faqs/skin-conditions-during-pregnancy   Retinol VS Bakuchiol in a double blind RCT  https://pubmed.ncbi.nlm.nih.gov/29947134/   Systematic Review of Retinol VS Bakuchiol  https://pubmed.ncbi.nlm.nih.gov/36176207/   Collagen  https://pmc.ncbi.nlm.nih.gov/articles/PMC10180699/  

Dans cet épisode 100 très spécial des Causeries de la Rade, nous accueillons Cédric Beal, Directeur du Centre de Formation du RCT et Coach des Espoirs !Bilan de la saison passée, évolution des jeunes qui arrivent chez les Pros, joueurs phénomènes, anecdotes et recrutement, rien n'est laissé au hasard ! Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-440 Overview: Explore current and emerging treatments for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a debilitating condition with no known cause or cure. Learn how oxaloacetate may offer new hope for patients struggling with ME/CFS, and gain practical guidance to support informed, evidence-based conversations with your patients. Episode resource links: Cash A, Vernon SD, Rond C, Bateman L, et al. RESTORE ME: a RCT of oxaloacetate for improving fatigue in patients with myalgic encephalomyelitis/chronic fatigue syndrome. Front Neurol. 2024 Nov 27;15:1483876.  Cash A, Kaufman DL. Oxaloacetate Treatment For Mental And Physical Fatigue In Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long-COVID fatigue patients: a non-randomized controlled clinical trial. J Transl Med. 2022 Jun 28;20(1):295.  CDC ME/CFS Basics Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-440 Overview: Explore current and emerging treatments for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), a debilitating condition with no known cause or cure. Learn how oxaloacetate may offer new hope for patients struggling with ME/CFS, and gain practical guidance to support informed, evidence-based conversations with your patients. Episode resource links: Cash A, Vernon SD, Rond C, Bateman L, et al. RESTORE ME: a RCT of oxaloacetate for improving fatigue in patients with myalgic encephalomyelitis/chronic fatigue syndrome. Front Neurol. 2024 Nov 27;15:1483876.  Cash A, Kaufman DL. Oxaloacetate Treatment For Mental And Physical Fatigue In Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Long-COVID fatigue patients: a non-randomized controlled clinical trial. J Transl Med. 2022 Jun 28;20(1):295.  CDC ME/CFS Basics Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Guest: Alan M. Ehrlich, MD, FAAFP   Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com  

Welcome back to Papers of the Month! Three more papers to both inform and challenge our practice across the spectrum of emergency care. First up we look at a systematic review and meta-analysis on noradrenaline vs adrenaline for our medical post-ROSC patients; what evidence exists out there and should we all be delivering noradrenaline as our first line treatment for those with shock? Next up a paper to really challenge the treatment algorithm for status epilepticus in paediatrics, with an RCT of midazolam and ketamine versus midazolam alone. There are some huge differences here in the form of termination rates and some great discussion to be had around the specifics of the paper and how that might translate into future practice. Finally we look at a paper assessing the impact of i.m. versus i.v. metoclopramide for migraines and acute severe headaches. The paper looks at the impact of length of stay within the Emergency Department and also the efficacy of the treatment. Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon & Rob

Jamie Hartmann-Boyce and Nicola Lindson interview Lauren McMillan, University of Stirling about her project evaluating the effectiveness of an e-cigarette intervention for smoking cessation at centres for people experiencing or at risk of homelessness. Associate Professor Jamie Hartmann-Boyce and Associate Professor Nicola Lindson discuss the new evidence in e-cigarette research and interview Lauren McMillan from the Institute for Social Marketing and Health (ISMH) at the University of Stirling. In the June podcast Lauren discusses Project SCeTCH - a cluster RCT that evaluates the effectiveness of an e-cigarette intervention vs usual care at centres for people experiencing or at risk of homelessness. The study measures smoking abstinence over a 6 month follow-up period and includes embedded process and economic evaluations. If effective, the results will be used to inform the larger-scale implementation of offering e-cigarettes throughout centres for people experiencing or at risk of homelessness to aid smoking cessation. Lauren is part of the research team, led by Dr Allison Ford at the University of Stirling, that conducted the process evaluation of the SCeTCH trial . The main SCeTCH trial was led by Professor Lynne Dawkins (London Southbank University) and Dr Sharon Cox (University College London). This podcast is a companion to the electronic cigarettes Cochrane living systematic review and Interventions for quitting vaping review and shares the evidence from the monthly searches. Our search for the EC for smoking cessation review carried out on 1st June 2025 found 1 ongoing study: https://clinicaltrials.gov/study/NCT06948058 Our search for our interventions for quitting vaping review up to 1st June 2025 found 2 new (DOI 10.1093/ntr/ntaf112; 10.1016/j.amepre.2025.107664) and 2 linked papers (DOI: 10.2196/72002; 10.1016/j.cct.2025.107958) For further details see our webpage under 'Monthly search findings': https://www.cebm.ox.ac.uk/research/electronic-cigarettes-for-smoking-cessation-cochrane-living-systematic-review-1 For more information on the full Cochrane review of E-cigarettes for smoking cessation updated in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010216.pub9/full For more information on the full Cochrane review of Interventions for quitting vaping published in January 2025 see: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD016058.pub2/full This podcast is supported by Cancer Research UK.

“To navigate proof, we must reach into a thicket of errors and biases. We must confront monsters and embrace uncertainty, balancing — and rebalancing —our beliefs. We must seek out every useful fragment of data, gather every relevant tool, searching wider and climbing further. Finding the good foundations among the bad. Dodging dogma and falsehoods. Questioning. Measuring. Triangulating. Convincing. Then perhaps, just perhaps, we'll reach the truth in time.”—Adam KucharskiMy conversation with Professor Kucharski on what constitutes certainty and proof in science (and other domains), with emphasis on many of the learnings from Covid. Given the politicization of science and A.I.'s deepfakes and power for blurring of truth, it's hard to think of a topic more important right now.Audio file (Ground Truths can also be downloaded on Apple Podcasts and Spotify)Eric Topol (00:06):Hello, it's Eric Topol from Ground Truths and I am really delighted to welcome Adam Kucharski, who is the author of a new book, Proof: The Art and Science of Certainty. He's a distinguished mathematician, by the way, the first mathematician we've had on Ground Truths and a person who I had the real privilege of getting to know a bit through the Covid pandemic. So welcome, Adam.Adam Kucharski (00:28):Thanks for having me.Eric Topol (00:30):Yeah, I mean, I think just to let everybody know, you're a Professor at London School of Hygiene and Tropical Medicine and also noteworthy you won the Adams Prize, which is one of the most impressive recognitions in the field of mathematics. This is the book, it's a winner, Proof and there's so much to talk about. So Adam, maybe what I'd start off is the quote in the book that captivates in the beginning, “life is full of situations that can reveal remarkably large gaps in our understanding of what is true and why it's true. This is a book about those gaps.” So what was the motivation when you undertook this very big endeavor?Adam Kucharski (01:17):I think a lot of it comes to the work I do at my day job where we have to deal with a lot of evidence under pressure, particularly if you work in outbreaks or emerging health concerns. And often it really pushes the limits, our methodology and how we converge on what's true subject to potential revision in the future. I think particularly having a background in math's, I think you kind of grow up with this idea that you can get to these concrete, almost immovable truths and then even just looking through the history, realizing that often isn't the case, that there's these kind of very human dynamics that play out around them. And it's something I think that everyone in science can reflect on that sometimes what convinces us doesn't convince other people, and particularly when you have that kind of urgency of time pressure, working out how to navigate that.Eric Topol (02:05):Yeah. Well, I mean I think these times of course have really gotten us to appreciate, particularly during Covid, the importance of understanding uncertainty. And I think one of the ways that we can dispel what people assume they know is the famous Monty Hall, which you get into a bit in the book. So I think everybody here is familiar with that show, Let's Make a Deal and maybe you can just take us through what happens with one of the doors are unveiled and how that changes the mathematics.Adam Kucharski (02:50):Yeah, sure. So I think it is a problem that's been around for a while and it's based on this game show. So you've got three doors that are closed. Behind two of the doors there is a goat and behind one of the doors is a luxury car. So obviously, you want to win the car. The host asks you to pick a door, so you point to one, maybe door number two, then the host who knows what's behind the doors opens another door to reveal a goat and then ask you, do you want to change your mind? Do you want to switch doors? And a lot of the, I think intuition people have, and certainly when I first came across this problem many years ago is well, you've got two doors left, right? You've picked one, there's another one, it's 50-50. And even some quite well-respected mathematicians.Adam Kucharski (03:27):People like Paul Erdős who was really published more papers than almost anyone else, that was their initial gut reaction. But if you work through all of the combinations, if you pick this door and then the host does this, and you switch or not switch and work through all of those options. You actually double your chances if you switch versus sticking with the door. So something that's counterintuitive, but I think one of the things that really struck me and even over the years trying to explain it is convincing myself of the answer, which was when I first came across it as a teenager, I did quite quickly is very different to convincing someone else. And even actually Paul Erdős, one of his colleagues showed him what I call proof by exhaustion. So go through every combination and that didn't really convince him. So then he started to simulate and said, well, let's do a computer simulation of the game a hundred thousand times. And again, switching was this optimal strategy, but Erdős wasn't really convinced because I accept that this is the case, but I'm not really satisfied with it. And I think that encapsulates for a lot of people, their experience of proof and evidence. It's a fact and you have to take it as given, but there's actually quite a big bridge often to really understanding why it's true and feeling convinced by it.Eric Topol (04:41):Yeah, I think it's a fabulous example because I think everyone would naturally assume it's 50-50 and it isn't. And I think that gets us to the topic at hand. What I love, there's many things I love about this book. One is that you don't just get into science and medicine, but you cut across all the domains, law, mathematics, AI. So it's a very comprehensive sweep of everything about proof and truth, and it couldn't come at a better time as we'll get into. Maybe just starting off with math, the term I love mathematical monsters. Can you tell us a little bit more about that?Adam Kucharski (05:25):Yeah, this was a fascinating situation that emerged in the late 19th century where a lot of math's, certainly in Europe had been derived from geometry because a lot of the ancient Greek influence on how we shaped things and then Newton and his work on rates of change and calculus, it was really the natural world that provided a lot of inspiration, these kind of tangible objects, tangible movements. And as mathematicians started to build out the theory around rates of change and how we tackle these kinds of situations, they sometimes took that intuition a bit too seriously. And there was some theorems that they said were intuitively obvious, some of these French mathematicians. And so, one for example is this idea of you how things change smoothly over time and how you do those calculations. But what happened was some mathematicians came along and showed that when you have things that can be infinitely small, that intuition didn't necessarily hold in the same way.Adam Kucharski (06:26):And they came up with these examples that broke a lot of these theorems and a lot of the establishments at the time called these things monsters. They called them these aberrations against common sense and this idea that if Newton had known about them, he never would've done all of his discovery because they're just nuisances and we just need to get rid of them. And there's this real tension at the core of mathematics in the late 1800s where some people just wanted to disregard this and say, look, it works for most of the time, that's good enough. And then others really weren't happy with this quite vague logic. They wanted to put it on much sturdier ground. And what was remarkable actually is if you trace this then into the 20th century, a lot of these monsters and these particularly in some cases functions which could almost move constantly, this constant motion rather than our intuitive concept of movement as something that's smooth, if you drop an apple, it accelerates at a very smooth rate, would become foundational in our understanding of things like probability, Einstein's work on atomic theory. A lot of these concepts where geometry breaks down would be really important in relativity. So actually, these things that we thought were monsters actually were all around us all the time, and science couldn't advance without them. So I think it's just this remarkable example of this tension within a field that supposedly concrete and the things that were going to be shunned actually turn out to be quite important.Eric Topol (07:53):It's great how you convey how nature isn't so neat and tidy and things like Brownian motion, understanding that, I mean, just so many things that I think fit into that general category. In the legal, we won't get into too much because that's not so much the audience of Ground Truths, but the classic things about innocent and until proven guilty and proof beyond reasonable doubt, I mean these are obviously really important parts of that overall sense of proof and truth. We're going to get into one thing I'm fascinated about related to that subsequently and then in science. So before we get into the different types of proof, obviously the pandemic is still fresh in our minds and we're an endemic with Covid now, and there are so many things we got wrong along the way of uncertainty and didn't convey that science isn't always evolving search for what is the truth. There's plenty no shortage of uncertainty at any moment. So can you recap some of the, you did so much work during the pandemic and obviously some of it's in the book. What were some of the major things that you took out of proof and truth from the pandemic?Adam Kucharski (09:14):I think it was almost this story of two hearts because on the one hand, science was the thing that got us where we are today. The reason that so much normality could resume and so much risk was reduced was development of vaccines and the understanding of treatments and the understanding of variants as they came to their characteristics. So it was kind of this amazing opportunity to see this happen faster than it ever happened in history. And I think ever in science, it certainly shifted a lot of my thinking about what's possible and even how we should think about these kinds of problems. But also on the other hand, I think where people might have been more familiar with seeing science progress a bit more slowly and reach consensus around some of these health issues, having that emerge very rapidly can present challenges even we found with some of the work we did on Alpha and then the Delta variants, and it was the early quantification of these.Adam Kucharski (10:08):So really the big question is, is this thing more transmissible? Because at the time countries were thinking about control measures, thinking about relaxing things, and you've got this just enormous social economic health decision-making based around essentially is it a lot more spreadable or is it not? And you only had these fragments of evidence. So I think for me, that was really an illustration of the sharp end. And I think what we ended up doing with some of those was rather than arguing over a precise number, something like Delta, instead we kind of looked at, well, what's the range that matters? So in the sense of arguing over whether it's 40% or 50% or 30% more transmissible is perhaps less important than being, it's substantially more transmissible and it's going to start going up. Is it going to go up extremely fast or just very fast?Adam Kucharski (10:59):That's still a very useful conclusion. I think what often created some of the more challenges, I think the things that on reflection people looking back pick up on are where there was probably overstated certainty. We saw that around some of the airborne spread, for example, stated as a fact by in some cases some organizations, I think in some situations as well, governments had a constraint and presented it as scientific. So the UK, for example, would say testing isn't useful. And what was happening at the time was there wasn't enough tests. So it was more a case of they can't test at that volume. But I think blowing between what the science was saying and what the decision-making, and I think also one thing we found in the UK was we made a lot of the epidemiological evidence available. I think that was really, I think something that was important.Adam Kucharski (11:51):I found it a lot easier to communicate if talking to the media to be able to say, look, this is the paper that's out, this is what it means, this is the evidence. I always found it quite uncomfortable having to communicate things where you knew there were reports behind the scenes, but you couldn't actually articulate. But I think what that did is it created this impression that particularly epidemiology was driving the decision-making a lot more than it perhaps was in reality because so much of that was being made public and a lot more of the evidence around education or economics was being done behind the scenes. I think that created this kind of asymmetry in public perception about how that was feeding in. And so, I think there was always that, and it happens, it is really hard as well as a scientist when you've got journalists asking you how to run the country to work out those steps of am I describing the evidence behind what we're seeing? Am I describing the evidence about different interventions or am I proposing to some extent my value system on what we do? And I think all of that in very intense times can be very easy to get blurred together in public communication. I think we saw a few examples of that where things were being the follow the science on policy type angle where actually once you get into what you're prioritizing within a society, quite rightly, you've got other things beyond just the epidemiology driving that.Eric Topol (13:09):Yeah, I mean that term that you just use follow the science is such an important term because it tells us about the dynamic aspect. It isn't just a snapshot, it's constantly being revised. But during the pandemic we had things like the six-foot rule that was never supported by data, but yet still today, if I walk around my hospital and there's still the footprints of the six-foot rule and not paying attention to the fact that this was airborne and took years before some of these things were accepted. The flatten the curve stuff with lockdowns, which I never was supportive of that, but perhaps at the worst point, the idea that hospitals would get overrun was an issue, but it got carried away with school shutdowns for prolonged periods and in some parts of the world, especially very stringent lockdowns. But anyway, we learned a lot.Eric Topol (14:10):But perhaps one of the greatest lessons is that people's expectations about science is that it's absolute and somehow you have this truth that's not there. I mean, it's getting revised. It's kind of on the job training, it's on this case on the pandemic revision. But very interesting. And that gets us to, I think the next topic, which I think is a fundamental part of the book distributed throughout the book, which is the different types of proof in biomedicine and of course across all these domains. And so, you take us through things like randomized trials, p-values, 95 percent confidence intervals, counterfactuals, causation and correlation, peer review, the works, which is great because a lot of people have misconceptions of these things. So for example, randomized trials, which is the temple of the randomized trials, they're not as great as a lot of people think, yes, they can help us establish cause and effect, but they're skewed because of the people who come into the trial. So they may not at all be a representative sample. What are your thoughts about over deference to randomized trials?Adam Kucharski (15:31):Yeah, I think that the story of how we rank evidence in medicines a fascinating one. I mean even just how long it took for people to think about these elements of randomization. Fundamentally, what we're trying to do when we have evidence here in medicine or science is prevent ourselves from confusing randomness for a signal. I mean, that's fundamentally, we don't want to mistake something, we think it's going on and it's not. And the challenge, particularly with any intervention is you only get to see one version of reality. You can't give someone a drug, follow them, rewind history, not give them the drug and then follow them again. So one of the things that essentially randomization allows us to do is, if you have two groups, one that's been randomized, one that hasn't on average, the difference in outcomes between those groups is going to be down to the treatment effect.Adam Kucharski (16:20):So it doesn't necessarily mean in reality that'd be the case, but on average that's the expectation that you'd have. And it's kind of interesting actually that the first modern randomized control trial (RCT) in medicine in 1947, this is for TB and streptomycin. The randomization element actually, it wasn't so much statistical as behavioral, that if you have people coming to hospital, you could to some extent just say, we'll just alternate. We're not going to randomize. We're just going to first patient we'll say is a control, second patient a treatment. But what they found in a lot of previous studies was doctors have bias. Maybe that patient looks a little bit ill or that one maybe is on borderline for eligibility. And often you got these quite striking imbalances when you allowed it for human judgment. So it was really about shielding against those behavioral elements. But I think there's a few situations, it's a really powerful tool for a lot of these questions, but as you mentioned, one is this issue of you have the population you study on and then perhaps in reality how that translates elsewhere.Adam Kucharski (17:17):And we see, I mean things like flu vaccines are a good example, which are very dependent on immunity and evolution and what goes on in different populations. Sometimes you've had a result on a vaccine in one place and then the effectiveness doesn't translate in the same way to somewhere else. I think the other really important thing to bear in mind is, as I said, it's the averaging that you're getting an average effect between two different groups. And I think we see certainly a lot of development around things like personalized medicine where actually you're much more interested in the outcome for the individual. And so, what a trial can give you evidence is on average across a group, this is the effect that I can expect this intervention to have. But we've now seen more of the emergence things like N=1 studies where you can actually over the same individual, particularly for chronic conditions, look at those kind of interventions.Adam Kucharski (18:05):And also there's just these extreme examples where you're ethically not going to run a trial, there's never been a trial of whether it's a good idea to have intensive care units in hospitals or there's a lot of these kind of historical treatments which are just so overwhelmingly effective that we're not going to run trial. So almost this hierarchy over time, you can see it getting shifted because actually you do have these situations where other forms of evidence can get you either closer to what you need or just more feasibly an answer where it's just not ethical or practical to do an RCT.Eric Topol (18:37):And that brings us to the natural experiments I just wrote about recently, the one with shingles, which there's two big natural experiments to suggest that shingles vaccine might reduce the risk of Alzheimer's, an added benefit beyond the shingles that was not anticipated. Your thoughts about natural experiments, because here you're getting a much different type of population assessment, again, not at the individual level, but not necessarily restricted by some potentially skewed enrollment criteria.Adam Kucharski (19:14):I think this is as emerged as a really valuable tool. It's kind of interesting, in the book you're talking to economists like Josh Angrist, that a lot of these ideas emerge in epidemiology, but I think were really then taken up by economists, particularly as they wanted to add more credibility to a lot of these policy questions. And ultimately, it comes down to this issue that for a lot of problems, we can't necessarily intervene and randomize, but there might be a situation that's done it to some extent for us, so the classic example is the Vietnam draft where it was kind of random birthdays with drawn out of lottery. And so, there's been a lot of studies subsequently about the effect of serving in the military on different subsequent lifetime outcomes because broadly those people have been randomized. It was for a different reason. But you've got that element of randomization driving that.Adam Kucharski (20:02):And so again, with some of the recent shingles data and other studies, you might have a situation for example, where there's been an intervention that's somewhat arbitrary in terms of time. It's a cutoff on a birth date, for example. And under certain assumptions you could think, well, actually there's no real reason for the person on this day and this day to be fundamentally different. I mean, perhaps there might be effects of cohorts if it's school years or this sort of thing. But generally, this isn't the same as having people who are very, very different ages and very different characteristics. It's just nature, or in this case, just a policy intervention for a different reason has given you that randomization, which allows you or pseudo randomization, which allows you to then look at something about the effect of an intervention that you wouldn't as reliably if you were just digging into the data of yes, no who's received a vaccine.Eric Topol (20:52):Yeah, no, I think it's really valuable. And now I think increasingly given priority, if you can find these natural experiments and they're not always so abundant to use to extrapolate from, but when they are, they're phenomenal. The causation correlation is so big. The issue there, I mean Judea Pearl's, the Book of Why, and you give so many great examples throughout the book in Proof. I wonder if you could comment that on that a bit more because this is where associations are confused somehow or other with a direct effect. And we unfortunately make these jumps all too frequently. Perhaps it's the most common problem that's occurring in the way we interpret medical research data.Adam Kucharski (21:52):Yeah, I think it's an issue that I think a lot of people get drilled into in their training just because a correlation between things doesn't mean that that thing causes this thing. But it really struck me as I talked to people, researching the book, in practice in research, there's actually a bit more to it in how it's played out. So first of all, if there's a correlation between things, it doesn't tell you much generally that's useful for intervention. If two things are correlated, it doesn't mean that changing that thing's going to have an effect on that thing. There might be something that's influencing both of them. If you have more ice cream sales, it will lead to more heat stroke cases. It doesn't mean that changing ice cream sales is going to have that effect, but it does allow you to make predictions potentially because if you can identify consistent patterns, you can say, okay, if this thing going up, I'm going to make a prediction that this thing's going up.Adam Kucharski (22:37):So one thing I found quite striking, actually talking to research in different fields is how many fields choose to focus on prediction because it kind of avoids having to deal with this cause and effect problem. And even in fields like psychology, it was kind of interesting that there's a lot of focus on predicting things like relationship outcomes, but actually for people, you don't want a prediction about your relationship. You want to know, well, how can I do something about it? You don't just want someone to sell you your relationship's going to go downhill. So there's almost part of the challenge is people just got stuck on prediction because it's an easier field of work, whereas actually some of those problems will involve intervention. I think the other thing that really stood out for me is in epidemiology and a lot of other fields, rightly, people are very cautious to not get that mixed up.Adam Kucharski (23:24):They don't want to mix up correlations or associations with causation, but you've kind of got this weird situation where a lot of papers go out of their way to not use causal language and say it's an association, it's just an association. It's just an association. You can't say anything about causality. And then the end of the paper, they'll say, well, we should think about introducing more of this thing or restricting this thing. So really the whole paper and its purpose is framed around a causal intervention, but it's extremely careful throughout the paper to not frame it as a causal claim. So I think we almost by skirting that too much, we actually avoid the problems that people sometimes care about. And I think a lot of the nice work that's been going on in causal inference is trying to get people to confront this more head on rather than say, okay, you can just stay in this prediction world and that's fine. And then just later maybe make a policy suggestion off the back of it.Eric Topol (24:20):Yeah, I think this is cause and effect is a very alluring concept to support proof as you so nicely go through in the book. But of course, one of the things that we use to help us is the biological mechanism. So here you have, let's say for example, you're trying to get a new drug approved by the Food and Drug Administration (FDA), and the request is, well, we want two trials, randomized trials, independent. We want to have p-values that are significant, and we want to know the biological mechanism ideally with the dose response of the drug. But there are many drugs as you review that have no biological mechanism established. And even when the tobacco problems were mounting, the actual mechanism of how tobacco use caused cancer wasn't known. So how important is the biological mechanism, especially now that we're well into the AI world where explainability is demanded. And so, we don't know the mechanism, but we also don't know the mechanism and lots of things in medicine too, like anesthetics and even things as simple as aspirin, how it works and many others. So how do we deal with this quest for the biological mechanism?Adam Kucharski (25:42):I think that's a really good point. It shows almost a lot of the transition I think we're going through currently. I think particularly for things like smoking cancer where it's very hard to run a trial. You can't make people randomly take up smoking. Having those additional pieces of evidence, whether it's an analogy with a similar carcinogen, whether it's a biological mechanism, can help almost give you more supports for that argument that there's a cause and effect going on. But I think what I found quite striking, and I realized actually that it's something that had kind of bothered me a bit and I'd be interested to hear whether it bothers you, but with the emergence of AI, it's almost a bit of the loss of scientific satisfaction. I think you grow up with learning about how the world works and why this is doing what it's doing.Adam Kucharski (26:26):And I talked for example of some of the people involved with AlphaFold and some of the subsequent work in installing those predictions about structures. And they'd almost made peace with it, which I found interesting because I think they started off being a bit uncomfortable with like, yeah, you've got these remarkable AI models making these predictions, but we don't understand still biologically what's happening here. But I think they're just settled in saying, well, biology is really complex on some of these problems, and if we can have a tool that can give us this extremely valuable information, maybe that's okay. And it was just interesting that they'd really kind of gone through that kind process, which I think a lot of people are still grappling with and that almost that discomfort of using AI and what's going to convince you that that's a useful reliable prediction whether it's something like predicting protein folding or getting in a self-driving car. What's the evidence you need to convince you that's reliable?Eric Topol (27:26):Yeah, no, I'm so glad you brought that up because when Demis Hassabis and John Jumper won the Nobel Prize, the point I made was maybe there should be an asterisk with AI because they don't know how it works. I mean, they had all the rich data from the protein data bank, and they got the transformer model to do it for 200 million protein structure prediction, but they still to this day don't fully understand how the model really was working. So it reinforces what you're just saying. And of course, it cuts across so many types of AI. It's just that we tend to hold different standards in medicine not realizing that there's lots of lack of explainability for routine medical treatments today. Now one of the things that I found fascinating in your book, because there's different levels of proof, different types of proof, but solid logical systems.Eric Topol (28:26):And on page 60 of the book, especially pertinent to the US right now, there is a bit about Kurt Gödel and what he did there was he basically, there was a question about dictatorship in the US could it ever occur? And Gödel says, “oh, yes, I can prove it.” And he's using the constitution itself to prove it, which I found fascinating because of course we're seeing that emerge right now. Can you give us a little bit more about this, because this is fascinating about the Fifth Amendment, and I mean I never thought that the Constitution would allow for a dictatorship to emerge.Adam Kucharski (29:23):And this was a fascinating story, Kurt Gödel who is one of the greatest logical minds of the 20th century and did a lot of work, particularly in the early 20th century around system of rules, particularly things like mathematics and whether they can ever be really fully satisfying. So particularly in mathematics, he showed that there were this problem that is very hard to have a set of rules for something like arithmetic that was both complete and covered every situation, but also had no contradictions. And I think a lot of countries, if you go back, things like Napoleonic code and these attempts to almost write down every possible legal situation that could be imaginable, always just ascended into either they needed amendments or they had contradictions. I think Gödel's work really summed it up, and there's a story, this is in the late forties when he had his citizenship interview and Einstein and Oskar Morgenstern went along as witnesses for him.Adam Kucharski (30:17):And it's always told as kind of a lighthearted story as this logical mind, this academic just saying something silly in front of the judge. And actually, to my own admission, I've in the past given talks and mentioned it in this slightly kind of lighthearted way, but for the book I got talking to a few people who'd taken it more seriously. I realized actually he's this extremely logically focused mind at the time, and maybe there should have been something more to it. And people who have kind of dug more into possibilities was saying, well, what could he have spotted that bothered him? And a lot of his work that he did about consistency in mass was around particularly self-referential statements. So if I say this sentence is false, it's self-referential and if it is false, then it's true, but if it's true, then it's false and you get this kind of weird self-referential contradictions.Adam Kucharski (31:13):And so, one of the theories about Gödel was that in the Constitution, it wasn't that there was a kind of rule for someone can become a dictator, but rather people can use the mechanisms within the Constitution to make it easier to make further amendments. And he kind of downward cycle of amendment that he had seen happening in Europe and the run up to the war, and again, because this is never fully documented exactly what he thought, but it's one of the theories that it wouldn't just be outright that it would just be this cycle process of weakening and weakening and weakening and making it easier to add. And actually, when I wrote that, it was all the earlier bits of the book that I drafted, I did sort of debate whether including it I thought, is this actually just a bit in the weeds of American history? And here we are. Yeah, it's remarkable.Eric Topol (32:00):Yeah, yeah. No, I mean I found, it struck me when I was reading this because here back in 1947, there was somebody predicting that this could happen based on some, if you want to call it loopholes if you will, or the ability to change things, even though you would've thought otherwise that there wasn't any possible capability for that to happen. Now, one of the things I thought was a bit contradictory is two parts here. One is from Angus Deaton, he wrote, “Gold standard thinking is magical thinking.” And then the other is what you basically are concluding in many respects. “To navigate proof, we must reach into a thicket of errors and biases. We must confront monsters and embrace uncertainty, balancing — and rebalancing —our beliefs. We must seek out every useful fragment of data, gather every relevant tool, searching wider and climbing further. Finding the good foundations among the bad. Dodging dogma and falsehoods. Questioning. Measuring. Triangulating. Convincing. Then perhaps, just perhaps, we'll reach the truth in time.” So here you have on the one hand your search for the truth, proof, which I think that little paragraph says it all. In many respects, it sums up somewhat to the work that you review here and on the other you have this Nobel laureate saying, you don't have to go to extremes here. The enemy of good is perfect, perhaps. I mean, how do you reconcile this sense that you shouldn't go so far? Don't search for absolute perfection of proof.Adam Kucharski (33:58):Yeah, I think that encapsulates a lot of what the book is about, is that search for certainty and how far do you have to go. I think one of the things, there's a lot of interesting discussion, some fascinating papers around at what point do you use these studies? What are their flaws? But I think one of the things that does stand out is across fields, across science, medicine, even if you going to cover law, AI, having these kind of cookie cutter, this is the definitive way of doing it. And if you just follow this simple rule, if you do your p-value, you'll get there and you'll be fine. And I think that's where a lot of the danger is. And I think that's what we've seen over time. Certain science people chasing certain targets and all the behaviors that come around that or in certain situations disregarding valuable evidence because you've got this kind of gold standard and nothing else will do.Adam Kucharski (34:56):And I think particularly in a crisis, it's very dangerous to have that because you might have a low level of evidence that demands a certain action and you almost bias yourself towards inaction if you have these kind of very simple thresholds. So I think for me, across all of these stories and across the whole book, I mean William Gosset who did a lot of pioneering work on statistical experiments at Guinness in the early 20th century, he had this nice question he sort of framed is, how much do we lose? And if we're thinking about the problems, there's always more studies we can do, there's always more confidence we can have, but whether it's a patient we want to treat or crisis we need to deal with, we need to work out actually getting that level of proof that's really appropriate for where we are currently.Eric Topol (35:49):I think exceptionally important that there's this kind of spectrum or continuum in following science and search for truth and that distinction, I think really nails it. Now, one of the things that's unique in the book is you don't just go through all the different types of how you would get to proof, but you also talk about how the evidence is acted on. And for example, you quote, “they spent a lot of time misinforming themselves.” This is the whole idea of taking data and torturing it or using it, dredging it however way you want to support either conspiracy theories or alternative facts. Basically, manipulating sometimes even emasculating what evidence and data we have. And one of the sentences, or I guess this is from Sir Francis Bacon, “truth is a daughter of time”, but the added part is not authority. So here we have our president here that repeats things that are wrong, fabricated or wrong, and he keeps repeating to the point that people believe it's true. But on the other hand, you could say truth is a daughter of time because you like to not accept any truth immediately. You like to see it get replicated and further supported, backed up. So in that one sentence, truth is a daughter of time not authority, there's the whole ball of wax here. Can you take us through that? Because I just think that people don't understand that truth being tested over time, but also manipulated by its repetition. This is a part of the big problem that we live in right now.Adam Kucharski (37:51):And I think it's something that writing the book and actually just reflecting on it subsequently has made me think about a lot in just how people approach these kinds of problems. I think that there's an idea that conspiracy theorists are just lazy and have maybe just fallen for a random thing, but talking to people, you really think about these things a lot more in the field. And actually, the more I've ended up engaging with people who believe things that are just outright unevidenced around vaccines, around health issues, they often have this mountain of papers and data to hand and a lot of it, often they will be peer reviewed papers. It won't necessarily be supporting the point that they think it's supports.Adam Kucharski (38:35):But it's not something that you can just say everything you're saying is false, that there's actually often a lot of things that have been put together and it's just that leap to that conclusion. I think you also see a lot of scientific language borrowed. So I gave a talker early this year and it got posted on YouTube. It had conspiracy theories it, and there was a lot of conspiracy theory supporters who piled in the comments and one of the points they made is skepticism is good. It's the kind of law society, take no one's word for it, you need this. We are the ones that are kind of doing science and people who just assume that science is settled are in the wrong. And again, you also mentioned that repetition. There's this phenomenon, it's the illusory truth problem that if you repeatedly tell someone someone's something's false, it'll increase their belief in it even if it's something quite outrageous.Adam Kucharski (39:27):And that mimics that scientific repetition because people kind of say, okay, well if I've heard it again and again, it's almost like if you tweak these as mini experiments, I'm just accumulating evidence that this thing is true. So it made me think a lot about how you've got essentially a lot of mimicry of the scientific method, amount of data and how you present it and this kind of skepticism being good, but I think a lot of it comes down to as well as just looking at theological flaws, but also ability to be wrong in not actually seeking out things that confirm. I think all of us, it's something that I've certainly tried to do a lot working on emergencies, and one of the scientific advisory groups that I worked on almost it became a catchphrase whenever someone presented something, they finished by saying, tell me why I'm wrong.Adam Kucharski (40:14):And if you've got a variant that's more transmissible, I don't want to be right about that really. And it is something that is quite hard to do and I found it is particularly for something that's quite high pressure, trying to get a policymaker or someone to write even just non-publicly by themselves, write down what you think's going to happen or write down what would convince you that you are wrong about something. I think particularly on contentious issues where someone's got perhaps a lot of public persona wrapped up in something that's really hard to do, but I think it's those kind of elements that distinguish between getting sucked into a conspiracy theory and really seeking out evidence that supports it and trying to just get your theory stronger and stronger and actually seeking out things that might overturn your belief about the world. And it's often those things that we don't want overturned. I think those are the views that we all have politically or in other ways, and that's often where the problems lie.Eric Topol (41:11):Yeah, I think this is perhaps one of, if not the most essential part here is that to try to deal with the different views. We have biases as you emphasized throughout, but if you can use these different types of proof to have a sound discussion, conversation, refutation whereby you don't summarily dismiss another view which may be skewed and maybe spurious or just absolutely wrong, maybe fabricated whatever, but did you can engage and say, here's why these are my proof points, or this is why there's some extent of certainty you can have regarding this view of the data. I think this is so fundamental because unfortunately as we saw during the pandemic, the strident minority, which were the anti-science, anti-vaxxers, they were summarily dismissed as being kooks and adopting conspiracy theories without the right engagement and the right debates. And I think this might've helped along the way, no less the fact that a lot of scientists didn't really want to engage in the first place and adopt this methodical proof that you've advocated in the book so many different ways to support a hypothesis or an assertion. Now, we've covered a lot here, Adam. Have I missed some central parts of the book and the effort because it's really quite extraordinary. I know it's your third book, but it's certainly a standout and it certainly it's a standout not just for your books, but books on this topic.Adam Kucharski (43:13):Thanks. And it's much appreciated. It was not an easy book to write. I think at times, I kind of wondered if I should have taken on the topic and I think a core thing, your last point speaks to that. I think a core thing is that gap often between what convinces us and what convinces someone else. I think it's often very tempting as a scientist to say the evidence is clear or the science has proved this. But even on something like the vaccines, you do get the loud minority who perhaps think they're putting microchips in people and outlandish views, but you actually get a lot more people who might just have some skepticism of pharmaceutical companies or they might have, my wife was pregnant actually at the time during Covid and we waited up because there wasn't much data on pregnancy and the vaccine. And I think it's just finding what is convincing. Is it having more studies from other countries? Is it understanding more about the biology? Is it understanding how you evaluate some of those safety signals? And I think that's just really important to not just think what convinces us and it's going to be obvious to other people, but actually think where are they coming from? Because ultimately having proof isn't that good unless it leads to the action that can make lives better.Eric Topol (44:24):Yeah. Well, look, you've inculcated my mind with this book, Adam, called Proof. Anytime I think of the word proof, I'm going to be thinking about you. So thank you. Thanks for taking the time to have a conversation about your book, your work, and I know we're going to count on you for the astute mathematics and analysis of outbreaks in the future, which we will see unfortunately. We are seeing now, in fact already in this country with measles and whatnot. So thank you and we'll continue to follow your great work.**************************************Thanks for listening, watching or reading this Ground Truths podcast/post.If you found this interesting please share it!That makes the work involved in putting these together especially worthwhile.I'm also appreciative for your subscribing to Ground Truths. All content —its newsletters, analyses, and podcasts—is free, open-access. I'm fortunate to get help from my producer Jessica Nguyen and Sinjun Balabanoff for audio/video tech support to pull these podcasts together for Scripps Research.Paid subscriptions are voluntary and all proceeds from them go to support Scripps Research. They do allow for posting comments and questions, which I do my best to respond to. Please don't hesitate to post comments and give me feedback. Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past two years.A bit of an update on SUPER AGERSMy book has been selected as a Next Big Idea Club winner for Season 26 by Adam Grant, Malcolm Gladwell, Susan Cain, and Daniel Pink. This club has spotlighted the most groundbreaking nonfiction books for over a decade. As a winning title, my book will be shipped to thousands of thoughtful readers like you, featured alongside a reading guide, a "Book Bite," Next Big Idea Podcast episode as well as a live virtual Q&A with me in the club's vibrant online community. If you're interested in joining the club, here's a promo code SEASON26 for 20% off at the website. SUPER AGERS reached #3 for all books on Amazon this week. This was in part related to the segment on the book on the TODAY SHOW which you can see here. Also at Amazon there is a remarkable sale on the hardcover book for $10.l0 at the moment for up to 4 copies. Not sure how long it will last or what prompted it.The journalist Paul von Zielbauer has a Substack “Aging With Strength” and did an extensive interview with me on the biology of aging and how we can prevent the major age-related diseases. Here's the link. Get full access to Ground Truths at erictopol.substack.com/subscribe

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Les Causeries de la Rade font le bilan (calmement, en se remémorant chaque instant) de la saison avec Pierre Mignoni, et se projettent avec lui sur le recrutement et sur le visage du RCT la saison prochaine ! Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Last time we spoke about the victory at Okinawa.. As American forces led by General Buckner advanced, they captured strategic key points, driving the Japanese into a desperate retreat. Despite overwhelming odds, the remaining Japanese defenders, embodying the samurai spirit, fought to the bitter end, hoping to gain time for their homeland's defenses. On June 21, faced with inevitable defeat, Generals Ushijima and Cho chose to commit seppuku in honor of their duty. Their tragic decision underscored the deep commitment to their cause, an adherence to the warrior code. By this point, countless Japanese soldiers surrendered, acknowledging the futility of their fight. As the month drew to a close, the Americans secured Okinawa, a hard-won victory shadowed by staggering casualties, more than 107,000 Japanese lives lost and significant American losses. This battle not only symbolized the relentless spirit of those who fought but also the tragic costs of war, forever etched in history as a vivid reminder of sacrifice and the haunting price of conflict. This episode is Liberation of Luzon Welcome to the Pacific War Podcast Week by Week, I am your dutiful host Craig Watson. But, before we start I want to also remind you this podcast is only made possible through the efforts of Kings and Generals over at Youtube. Perhaps you want to learn more about world war two? Kings and Generals have an assortment of episodes on world war two and much more  so go give them a look over on Youtube. So please subscribe to Kings and Generals over at Youtube and to continue helping us produce this content please check out www.patreon.com/kingsandgenerals. If you are still hungry for some more history related content, over on my channel, the Pacific War Channel you can find a few videos all the way from the Opium Wars of the 1800's until the end of the Pacific War in 1945.  For most, the battle of Okinawa basically ends the Pacific War, but the truth is the war was raging all over the place. The second most noticeable place would be Luzon, where the remnants of General Yamashit'as 14th Area Army were still resisting in the northern and eastern mountain ranges. Yet here too, the curtains were beginning to fall. As we last left off, it was mid-April 1945, and the fierce struggle for the liberation of Luzon was reaching a critical phase. General Eichelberger's 8th Army was actively engaged in offensives across the Visayas and Mindanao, while General Krueger's 6th Army focused its might on two primary sectors in Luzon. The stakes were high, the liberation of Luzon was crucial for securing Manila and restoring the Filipino government that had been disrupted by the war. In the northern sector, General Swift's 1st Corps was grappling with General Yamashita's formidable Shobu Group, who were entrenched in this mountainous terrain, making the fighting particularly arduous. Meanwhile, General Hall's 11th Corps was applying relentless pressure on the opposing Shimbu Group, led by General Yokoyama, in the vital areas east of Manila. Starting in the northern reaches of Luzon, we find General Clarkson's 33rd Division making tangible advances, having secured Route 11 up to Camp 3, as well as segments of the Galiano Road and the Tuba Trail. This area, known for its treacherous paths and thick jungle, posed significant challenges, but the troops pressed on. Northward, General Beightler's 37th Division was also on the move, with its 129th Regiment overcoming all enemy resistance along Route 9, reaching the critical town of Sablan by April 14. Not to be overlooked, Colonel Volckmann's guerrilla 121st Regiment had carved a path up Route 4 to the strategically important Bessang Pass, known for its rugged terrain that offers a natural defense. General Mullins' 25th Division was making notable progress towards Balete Pass, gaining crucial footholds on Crump Hill and Myoko Ridge. These positions were essential as they provided elevated vantage points over the surrounding valleys. On the western front, General Gill's 32nd Division had successfully secured the western Salacsac Pass but still faced stiff enemy positions in the eastern pass, where Japanese forces were well-prepared to defend. With the arrival of the bulk of the 37th Division in early April, Swift was poised to launch a dynamic two-division drive towards Baguio, a city nestled in the mountains that had become a strategic goal due to its position and resources. While Clarkson's units continued to engage in patrol actions in the Arboredo, Agno, and Ambayabang River valleys, there was limited progress in these areas. However, the 129th Regiment initiated a decisive attack on Sablan on April 11, successfully breaching Japanese defenses there by April 14. On that pivotal day, the 148th Regiment took charge of securing Route 9 through Calot, a vital corridor for advancing troops. Meanwhile, the 130th Regiment encountered fierce resistance as it pushed west of Asin along the Galiano Road, exemplifying the tenacity of Japanese forces determined to hold their ground. As the battle raged, General Yamashita was already strategizing to evacuate Baguio. By April 19, he made the decision to relocate to the Bambang front, leaving Major-General Utsunomiya Naokata, one of his trusted chiefs of staff, in command of the remaining forces.  Despite the growing pressure on Route 9, the Japanese command seemed out of touch by the second week of April 1945. They inaccurately assessed that the primary thrust of General Swift's 1st Corps would come along Route 11, allowing them to become complacent. This misplaced confidence led to a failure to redeploy troops to counter the increasing threat on their right flank. Instead of fortifying their defenses, they appeared to adopt an inexplicable, almost defeatist attitude, unusual for a military as disciplined as the Imperial Japanese Army. Compounding this lack of urgency was the intense effort from the 14th Area Army headquarters to evacuate civilians and supplies from Baguio, a city perched high in the Cordillera Central mountain range. This evacuation served as a clear signal that the situation was deteriorating, yet the Japanese command remained strangely passive. Yamashita's mindset regarding the unfolding crisis was evident when he made personal preparations to depart for the Bambang front on April 19. In a move echoing his earlier strategy for the Bambang area, he established an independent command for the Baguio front before his departure. Utsunomiya's responsibilities also included nominal command over the 19th Division, stationed north of Baguio, but his control was hampered by significant communication difficulties that plagued the Japanese forces. The first notable action Utsunomiya took was to relieve the 58th Independent Mixed Brigade from the 23rd Division's control, seeking to streamline command. Under Yamashita's directive to hold Baguio for as long as possible before retreating to a new defensive line, Utsunomiya issued an order for all troops along the existing Main Line of Resistance  "hold out to the last man." His tone betrayed the grim reality, coming across as almost ironic given the mounting pressures they faced. Meanwhile, General Sato's 58th Independent Mixed Brigade was frantically working to fortify defenses along Route 9, southeast of Calot. However, their efforts came too late to prevent the 148th Regiment from swiftly capturing Yagyagan on April 15, gaining a crucial foothold in the area. In response to this setback, Sato began sending reinforcements to the Irisan Gorge starting April 16, apparently under Utsunomiya's orders. This narrow, treacherous gorge, surrounded by steep cliffs, was seen as a pivotal point for a last-ditch defense. The Japanese troops managed to repel the initial assaults from the 148th Regiment on April 17, but as night fell, the Americans executed a series of enveloping maneuvers, ultimately securing Ridge A. The following morning, the 148th seized Ridge C; however, their frontal assaults against Ridge B were met with fierce resistance and ended in failure. On April 19, the tide began to turn. After a devastating air strike and concentrated artillery fire that neutralized most of the Japanese positions on Ridge F, the Americans finally captured Ridge B. Concurrently, other American units seized Hills D and E, effectively cutting off the Japanese retreat route. The relentless pressure continued, and the next day, Ridges F and G were subjected to intense attacks, which ultimately resulted in their capture. This relentless campaign forced the Japanese to withdraw to Ridge H, where they continued to regroup. After heavy bombardment, the Irisan Gorge was finally cleared on April 21, sending the surviving defenders scrambling in retreat. As these operations unfolded, the 130th Regiment was busy repositioning two battalions from the Galiano Road to the junction of the Yagyagan Trail along Route 9, poised to mount a coordinated attack on Asin from both the east and west. On April 22, they launched their offensive, catching the Japanese defenders by surprise and effectively dismantling their defenses. By the afternoon of April 23, the Galiano Road was opened for American forces, marking a significant advancement in their campaign. Concurrently, the 129th Regiment had taken over operations from the 148th Regiment and advanced against only scattered resistance, making significant progress as far southeast as the junction of the highway and the Galiano Road. However, their advance was ultimately halted due to concerns about a potential threat from the north. Seizing on this hesitation, General Utsunomiya decided to leave small delaying forces at Trinidad and Baguio, while initiating a general withdrawal to the north and northeast. With Utsunomiya's defensive lines weakened, American patrols were able to enter Baguio on April 24, met with surprisingly little resistance. By April 26, the 129th had effectively secured most of the city, facing only negligible opposition. Simultaneously, elements from the 123rd and 130th Regiments worked diligently to eliminate the remaining Japanese defenses on nearby Mount Calugong, along the Tuba Trail, and on Mount Mirador, ensuring the area was cleared for further American operations. Despite these American successes, Utsunomiya managed to escape with approximately 10,000 troops to the Baguio-Aritao supply road, a crucial evacuation route for Japanese forces. As the end of April approached and into the first days of May, the 37th Division continued to mop up the surrounding areas, further securing Trinidad. Meanwhile, the 33rd Division also pressed forward, capturing the Balinguay-Itogon-Pitican sector, enhancing their control over the region. Looking eastward, General Gill's demoralized 32nd Division was still engaged in fierce fighting through the Salacsac Pass, hampered in their advance along the Villa Verde Trail.  During the second week of April 1945, observers from the 6th Army headquarters reported alarming morale issues within the 32nd Division, echoing concerns that General Krueger had personally noted during previous visits to the front lines. The soldiers of the 126th and 128th Regiments were on the brink of complete mental and physical exhaustion. Front-line troops, many of whom had spent significant time overseas, were becoming overly cautious, possibly from the toll of constant combat. Conversations among the men frequently centered around one urgent topic: their rotation back to the United States. The once aggressive spirit characteristic of these combat troops was waning rapidly. With dwindling numbers and pervasive personnel issues, it was clear that the division would struggle to mount any spectacular gains in the coming days. If they couldn't quicken their pace along the critical Villa Verde Trail, reaching their objective, Santa Fe, by the targeted date of June 1 appeared increasingly unlikely. Delays would be catastrophic; they risked being trapped on the trail by the heavy rains of the impending wet season, which typically began in late May. Such circumstances would severely hinder their ability to withdraw and salvage their equipment from the treacherous mountainous terrain. Meanwhile, the Japanese forces retained key terrain advantages, allowing them to economically utilize their troops and reinforce their front lines almost at will. In stark contrast, the rugged landscape severely restricted the 32nd Division's maneuverability, forcing them to repeatedly launch costly frontal assaults with their diminishing strength. While terrain and weather conditions presented significant challenges, the growing personnel crisis loomed as a critical factor likely to further limit the division's progress in the days ahead. Compounding their challenges, General Iwanaka's reconstituted 2nd Tank Division had suffered heavy casualties, leaving General Konuma unable to provide further reinforcements. On April 17, the rested 127th Regiment finally began its move to relieve the beleaguered 128th Regiment at the western pass, launching operations to clear the last remnants of Japanese forces from the Hill 506-507 area. Although Hill 506B fell rapidly on April 19, and Hill 507C was captured three days later, American forces struggled to completely clear Hill 507D until May 2, underscoring the tenacity of the Japanese defenders. Despite the challenges, enough ground had been cleared by April 26 for the 2nd Battalion to initiate a drive east along and south of the Villa Verde Trail, aiming for the strategically important Hill 508. The Japanese forces, sensing this new threat, responded with fierce counterattacks from both the east and north, managing to delay the American capture of Hill 508 until April 29. The intense fighting illustrated the importance of this elevation, which offered vital visibility over the surrounding landscapes. In the days that followed, the 2nd Battalion expanded its control over Hill 508, establishing a defensive block on the Villa Verde Trail to the north while successfully repelling a series of heavy Japanese counterattacks. Meanwhile, the 3rd Battalion made significant strides by attacking and capturing Hill 509, further consolidating American positions in the area. Simultaneously, the 2nd Battalion of the 126th Regiment launched an offensive south from Hill 511, seizing Hill 515 on April 24. They advanced into the area north of Hill 508 while the 1st Battalion navigated through the rugged terrain of Hills 513 and 514, pressing southward to Hill 516. Their advance culminated in the capture of the crest of Hill 525, where they established a critical block on the Villa Verde Trail. However, the cost of these advances was significant. Due to the heavy losses incurred during these operations, the barely rested 128th Regiment began the process of relieving the exhausted 126th on May 3. Shortly after, the 128th's 2nd Battalion launched an assault southeast, successfully capturing Hill 526 on May 7, while some elements initiated a drive towards Hill 527. To the further east, General Mullins' 25th Division was persistently pushing its Santa Fe offensive against stubborn Japanese resistance. In a stroke of fortune, a successful aerial reconnaissance mission revealed that ground located just 1,000 yards west of their position might offer a more favorable route of advance to Balete Ridge, providing a welcome alternative to the challenging Myoko mass itself. On April 22, a reconnaissance force from the 27th Regiment successfully moved undetected to the southern slope of Balete Ridge, positioning themselves for a critical advance. The following day, the rest of the 2nd Battalion began to push toward Lone Tree Hill, while other units continued to exert pressure on the entrenched Japanese defenses at Myoko. Moving forward with enthusiasm and encountering negligible resistance, the Americans reached Lone Tree Hill on April 25, effectively bypassing the main concentrations of enemy forces. By April 27, the 2nd Battalion had advanced an impressive half mile beyond Lone Tree Hill, with its forward elements only three-quarters of a mile from Balete Pass. However, they were compelled to halt their advance due to the potential threat of an enemy counterattack looming on the horizon. Meanwhile, on April 23, the 35th Regiment began its ascent up Kapintalan Ridge, steadily making progress despite the challenging terrain. By April 27, their leading troops had reached a prominent knob located midway between Route 5 and Lone Tree Hill. The 161st Regiment was also making strides, continuing its attack northward towards Kembu Ridge, where they successfully secured Hill 4625 and the entirety of Highley Ridge by April 28. On that same day, the 27th Regiment began reinforcing their positions on Lone Tree Hill, while elements of the 2nd Battalion initiated a southwest push along Kapintalan Ridge to support the 35th Regiment advancing up Route 5. However, they encountered a formidable strongpoint and were only able to gain 350 yards of new ground northeast from the knob. Simultaneously, elements of the 27th Regiment advanced a modest 500 yards southwest by May 4, indicating the ongoing struggle. That morning, the 1st Battalion of the 161st Regiment seized the southeastern nose of Kembu Ridge, securing a valuable tactical position. At the same time, the 2nd Battalion pushed troops onto the ridge, extending their reach half a mile to the northwest, further consolidating American control in the area. As a breakthrough appeared imminent, General Krueger began dispatching Beightler's 37th Division to the Bambang front on May 2, with all elements of the division departing the Baguio area just three days later. With these reinforcements securing his rear and taking control of the Myoko massif, General Mullins ordered the 27th and 161st Regiments to concentrate their forces for a coordinated attack aimed at enveloping Balete Pass from both the east and west. On May 5, the 161st swiftly broke through Kembu Ridge and advanced to Haruna Ridge, while the 27th Regiment pushed west-northwest along Wolfhound Ridge. However, they faced fierce resistance, gaining only 350 yards against tenacious Japanese defenders. On May 8, Company I successfully launched a southwest offensive from their stronghold along a bare-crested ridge, while Company A deployed on Kenbu Ridge and began ascending the final sections of the Digdig River gorge. The following day, these two companies finally made contact with each other and linked up with the 161st on Haruna Ridge. By May 10, Wolfhound Ridge was secured, coinciding with elements of the 35th Regiment completing the clearance of Route 5 from Kapintalan to the pass. In the meantime, the 35th Regiment, along with units from the 27th, continued their assault on Kapintalan Ridge, which was ultimately secured by May 13. Meanwhile, the 148th Regiment renewed its attacks on Myoko Ridge, where Japanese resistance began to collapse by May 11. With these gains, Balete Pass was now secure. The Americans had incurred 565 men killed and 1,745 wounded during the drive, while General Okamoto's 10th Division experienced catastrophic losses, with nearly 7,000 men killed and a complete breakdown of their control and communications. Reflecting on the situation in Salacsac, by May 8, the Japanese position was deteriorating rapidly. In response, General Iwanaka made the critical decision to dispatch troops aimed at cutting the supply line to the 2nd Battalion of the 128th Regiment, with the intention of safeguarding his main stronghold at Mount Imugan. On that day, the 1st Battalion of the 128th Regiment began to push eastward, facing strong resistance, while elements of the 2nd Battalion moved west from Hill 526, struggling to make any significant progress. By May 10, Japanese forces successfully severed the track between Hills 525 and 516, forcing much of the 128th and one battalion of the 127th Regiment to allocate considerable resources to eliminate the Japanese pocket that had formed in that area. Meanwhile, the 33rd Division was left disheartened as it found itself assigned a holding mission to secure the Baguio-Bauang-San Fernando area. Their operations were limited to minor local gains and long-range reconnaissance, which did little to impact the overall situation.  During May 1945, the only significant action undertaken by the 33rd Division took place along a trail connecting Santa Rosa in the Ambayabang Valley to Tebbo, located on the Agno River five miles south of Pitican. The division focused its efforts on clearing Japanese forces from the high ground situated between the main trail and the upper reaches of the Ambayabang Valley. On May 9, a battalion of the 130th Regiment advanced south from Baguio via Pitican and reached Tebbo, only to find the barrio abandoned. Meanwhile, on May 5, the 136th Regiment began its advance up the Ambayabang Valley. Approximately three miles south of Tebbo, they became embroiled in a ten-day battle, resulting in the deaths of a few hundred Japanese troops. However, these enemy forces posed little threat to the 33rd Division, their primary mission being to block American attacks toward the Baguio-Aritao supply road from the south. As the rainy season approached, 1st Corps and the 33rd Division had long since abandoned plans to use the valley as a route of advance against the Japanese supply lines. Consequently, the 136th Regiment relinquished the terrain it had gained along the valley and the trail to Tebbo almost immediately after capturing it. By May 15, all troops of the 33rd Division began their withdrawal, a challenging task compounded by heavy rains that had transformed the Pitican-Tebbo trail and the trails in the Ambayabang Valley into quagmires. The final destruction of the Japanese blocking force in the valley had little impact on the strategic plans or dispositions of 1st Corps or the Shobu Group, as the Japanese quickly replenished their outposts. By the end of May, the 33rd Division was left executing reconnaissance missions without significant enemy contact or major advances. The division remained in a state of restless anticipation, awaiting developments on the Bontoc and Bambang fronts before the 6th Army would authorize a new drive deeper into the rugged mountains of northern Luzon. Turning to the north, the guerrilla 121st Regiment achieved a significant victory on April 21 by overrunning the last Japanese positions on Lamagan Ridge. About a week later, they completed their occupation of Lower Cadsu. However, during the first part of May, the 121st Regiment faced formidable challenges as they advanced over steep terrain against increasingly fortified Japanese defenses, bolstered by reinforcements from General Ozaki's 19th Division. In the south, Hall's 11th Corps made good progress throughout mid-April, successfully pushing General Yokoyama's 41st Army, previously known as the Shimbu Group, further east from Manila. Concurrently, General Hurdis' 6th Division continued its offensive against the Kobayashi Detachment at Wawa Dam, achieving a notable success by securing the crest of Mount Mataba on April 17, marking a significant tactical gain in the ongoing battle. Despite General Hurdis' hopes to swiftly advance against Mount Pacawagan and Wawa Dam, persistent personnel issues forced him to halt any offensive actions until the 145th Regiment could relieve the 20th Regiment in the Montalban area. The 145th eventually began its assault on Pacawagan on April 21. However, even with effective supporting fire that destroyed much of the enemy's defenses, American forces struggled to secure a foothold on the mountain until the end of the month. Meanwhile, the 1st and 63rd Regiments continued to hold their occupied ground until they were relieved late in April by the 151st and 152nd Regiments of General Chase's 38th Division, which then officially assumed control of the offensive operations. In the southern part of Manila, significant water supply problems prompted General Hall to redeploy General Wing's 43rd Division northward in preparation for an offensive against Ipo Dam.  By mid-April 1945, an acute water shortage had developed within the city of Manila. General MacArthur informed General Krueger about the dire situation, noting that south of the Pasig River, Manila had access to no water sources except for that supplied by Army tank trucks and shallow, often contaminated wells. This shortage significantly hampered sewage disposal throughout the city, as water pressure from the overtaxed Novaliches Reservoir, the only reliable source was insufficient to carry off waste. As a result, flush toilets were frequently clogged, forcing many citizens to resort to using gutters and esteros for defecation. Restaurants and nightclubs, which were heavily frequented by off-duty American troops, struggled to maintain even minimum sanitary standards. The situation was exacerbated by a steady influx of military units and civilians into the metropolitan area, raising concerns about the imminent threat of severe epidemics breaking out in the city. On April 19, MacArthur suggested to Krueger that the 6th Army could resolve Manila's water supply crisis by seizing "the reservoir in the Montalban area." He inquired how soon the installation could be captured. This query puzzled Krueger, who was aware that the only true reservoirs linked to the Manila water system were located west of the Marikina River and had been under American control since February. Furthermore, Krueger understood that Wawa Dam, the nearest water supply installation to Montalban, was no longer connected to the metropolitan system. He subsequently asked MacArthur if by "reservoir in the Montalban area," he meant Ipo Dam, the only major water installation still in Japanese hands. Krueger's question seemingly led to further examination of Manila's water system at General Headquarters, Southwest Pacific Area (GHQ SWPA). On April 22, MacArthur radioed back to Krueger, confirming that Ipo Dam was indeed the preferred objective. He emphasized that capturing the Ipo installation would effectively solve Manila's water supply problems. Upon receiving this directive, Krueger ordered the 11th Corps to launch a drive on Ipo Dam as soon as possible. This shift in forces meant the 112th Cavalry Regiment had to move south to take over the vacated positions. General Wing conducted a reconnaissance-in-force that revealed the Kawashima Force's defenses south of Route 52 were considerably weaker than those around the main highway. In light of this intelligence, the plan for assault was set into motion. On the night of May 6, the 103rd Regiment was ordered to advance towards Mount Katitinga and prepare to attack the dam. Supporting this effort, the 172nd Regiment would strike across a two-mile-wide front to the left of the 103rd towards the dam, while the 169th Regiment was tasked with demonstrating along Route 52 to pin down Japanese forces in the Bigti region. Additionally, Marking's Fil-American Yay Regiment at Norzagaray was to make a feint drive eastward north of the Angat River, targeting Mount Kabuyao. During the first three days of May, General Chase conducted probing attacks in preparation for a concerted offensive aimed at Wawa Dam, which was set to begin on May 4. Simultaneously, General Yokoyama observed what he believed to be a slowdown in enemy progress, leading him to conclude that American forces must be redeploying northward or evacuating from Luzon entirely. This prompted him to prepare a limited counteroffensive, consisting of a series of harassing and delaying actions designed to pin down enemy forces on this front. Consequently, Yokoyama was not anticipating a major offensive on May 4. However, on that day, the 145th Regiment managed to gain up to 1,000 yards along the northern and northeastern slopes of Pacawagan, while the 152nd Regiment advanced approximately 500 yards northward along Woodpecker Ridge. Although these territorial gains were not monumental, Yokoyama became increasingly concerned about the strength of the American attacks and made the urgent decision to launch his counteroffensive. As Japanese forces hurried to reposition for their counterattacks, the 145th Regiment struck eastward, successfully seizing the rocky summit of Mount Binicayan. Meanwhile, the 152nd continued its efforts along Woodpecker Ridge. This coordinated assault completely surprised General Kobayashi's troops, rendering their planned counterattack impossible as they were forced to shift their focus to defending their critical positions. In the southern sector, General Kawashima dispatched one battalion toward Montalban; however, the heavy air assaults that preceded Wing's offensive made it impossible for the Japanese unit to organize effectively for their attack. Adding to the Japanese troubles, the remnants of the Noguchi Force were unable to provide any significant reinforcements. Despite the surprise and disarray among the Japanese defenders, they could not prevent the 145th from capturing the crest of Binicayan on May 9. The troops stationed on Woodpecker Ridge experienced some success by halting the advance of the 152nd and initiated a week of increasingly aggressive dawn and dusk raids starting on May 14. Recognizing the futility of the ongoing conflict, which had resulted in over 1,300 Japanese casualties, General Yokoyama ordered an immediate withdrawal of all units involved on May 15. However, these orders would not reach the front lines until a week later. In the meantime, capitalizing on the element of surprise achieved during the night attack on May 6, General Wing launched an offensive that made excellent progress. The 103rd Regiment rapidly gained control of the western slopes of Katitinga and advanced swiftly along the ridgeline toward Hill 1000. Meanwhile, the 172nd Regiment reached the foot of a rocky ridge two miles southeast of Bigti, and the Marking Regiment encountered no resistance as it marched over seven miles eastward, ultimately halting just a mile and a half northwest of Kabuyao. The only significant resistance encountered occurred at Hill 535, where elements of a guerrilla unit were repelled by Japanese defenders. The unexpectedly weak Japanese opposition prompted the 43rd Division to sustain its offensive momentum without pause. By May 11, the 103rd had secured Hills 805 and 810, while the 172nd was probing Japanese defenses on Fork Ridge and advancing to the southwestern slopes of rocky Hill 815. The Marking Regiment had successfully overrun Kabuyao, though they were unable to capture Four-Corner Hill. At this point, Japanese resistance began to stiffen as American forces clashed with General Kawashima's main defenses. In response, Wing ordered the 169th Regiment to mount a limited attack on Osboy Ridge and directed the Marking guerrillas to launch a strong assault toward Ipo. Supported by artillery, Colonel Marcus Augustin succeeded in breaking through Four-Corner Hill on May 12, marking a critical turning point in the offensive. Unaware of Kawashima's precarious situation, Yokoyama directed the Kawashima Force to initiate a new counterattack against the left and left rear of the 38th Division, deeming the situation for the Kobayashi Force to be more critical. As a result, Kawashima was compelled to divert one battalion for this unnecessary assault, which weakened the Japanese defenses. This strategic miscalculation enabled General Wing to make significant gains on May 13, with the 103rd Regiment capturing Hill 860, the 172nd clearing much of Hill 815, and the Marking guerrillas seizing the summit of Hill 803. The extent of these advances prompted Kawashima to ultimately disregard Yokoyama's orders and recall his assault battalion. This battalion promptly mounted a counterattack against the Americans in a futile attempt to regain lost ground, managing only to restrict the 103rd and 172nd Regiments to minor gains on May 14. Simultaneously, Colonel Augustin's patrols crossed the Angat River unopposed, discovering that the dam remained intact and the powerhouse on the south bank was largely undamaged. However, the patrol force, too weak to hold these installations, retreated before dawn to the crest of Hill 803, where the remainder of the regiment was occupied with mopping up remaining resistance. Looking further south, General Griswold's 14th Corps had already secured most of southern Luzon and had successfully landed General MacNider's 158th Regiment in the Bicol Peninsula. In response, the remnants of the Fuji Force and the depleted Kogure Detachment decided to evacuate the open Santa Maria Valley, opting to retreat to more defensible positions at the Kapatalin Sawmill. This allowed Griswold to move the 7th and 8th Cavalry Regiments into the valley, with the former beginning a drive along Route 455 on May 6. Following a heavy air and artillery bombardment, the cavalrymen launched their assault on the sawmill on May 9 and swiftly overran the enemy defenses by mid-afternoon. After a brief pause to reorganize, the 7th Cavalry advanced up Route 455, leaving their vehicles behind, and reached Lamon Bay by May 13. Meanwhile, on the Bicol Peninsula, progress had been agonizingly slow throughout late April. It wasn't until April 28 that the Cituinan Hills were fully secured, leading to the collapse of organized Japanese resistance in the region. Following this, the 158th Regiment began moving northwestward toward Iriga and San Agustin, rapidly overrunning the remaining weak enemy positions along Route 1. Progress continued to be painfully slow, and it was not until 28 April that organized Japanese resistance finally collapsed. The task of clearing the Cituinan Hills cost the 158th Infantry approximately 40 men killed and 235 wounded; the Japanese lost almost 700 men killed in the region. Although the 158th RCT did not know it, the reduction of the Cituinan Hills marked the end of large-scale organized resistance on the Bicol Peninsula, where no more than 1,400 Japanese remained alive as of the end of April. Simultaneously, the 5th Cavalry Regiment captured Calauag on April 14 and began a two-pronged advance toward San Agustin by the end of the month. On May 2, San Agustin was finally taken as elements of both regiments converged there. Guerrillas had informed XIV Corps, which acquired control of the 158th RCT on 22 April, that a Japanese force of some 2,500 men was dug in along the slopes of Mt. Isarog, an extinct volcano centering eight miles northeast of San Agustin. This report the 5th Cavalry and 158th Infantry proved false in a series of patrol actions between 2 and 15 May. The next day, the 16th, General MacNider radioed to General Griswold that the Bicol Peninsula was secure and that no signs of organized Japanese resistance remained. The two regiments continued patrolling for some weeks until, on 6 June, the 5th Cavalry returned to southern Luzon. The 158th RCT busied itself with the problem of reorganizing and equipping guerrilla forces and in mid-June turned over responsibility for further mopping up to the Filipinos. To that time the operations to clear the Bicol Peninsula had cost the USArmy units involved approximately 95 men killed and 475 wounded. The Japanese had lost over 2,800 killed and 565 captured, including 350 Formosan labor troops whom the Japanese Army had left to fend for themselves. I would like to take this time to remind you all that this podcast is only made possible through the efforts of Kings and Generals over at Youtube. Please go subscribe to Kings and Generals over at Youtube and to continue helping us produce this content please check out www.patreon.com/kingsandgenerals. If you are still hungry after that, give my personal channel a look over at The Pacific War Channel at Youtube, it would mean a lot to me. In June 1945, amidst the Pacific War, American forces sought to liberate Luzon from General Yamashita's entrenched troops. Under Generals Eichelberger and Krueger, the 8th Army faced fierce resistance in the mountains and vital routes. As Japanese defenders struggled, the Americans advanced strategically, leading to fierce battles across treacherous terrain.  The turning point came with the seizure of Baguio, crucial for the campaign.

Dans ce dernier debrief de la saison, les Causeries de la Rade reviennent sur l'élimination contre l'UBB pour comprendre les clés du match, et proposent un bilan de la saison du RCT ! Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Dans cet épisode, l'équipe des Causeries revient sur la qualification pour les demi-finales du RCT, acquise face à Castres ! Dans une semaine, un énorme morceau : l'UBB ! L'occasion de revenir aussi sur la défaite en finale des Espoirs de Cédric Beal, au terme d'une superbe saison, et sur les infos transferts de la semaine ! Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

What's the point of having a job? Clearly, to make money for ourselves and our families. But is it possible for us to discover some bigger purpose or meaning at work. And, if we do, who benefits? That's the idea that a multinational organisation had when it called in a team of economists to analyse its internal programme called “Find your Purpose” (FYP). The resulting RCT set out to measure whether FYP changed how employees behaved at work, whether it helped them enjoy their jobs, and whether it increased profits too. Oriana Bandiera of London School of Economics and CEPR was one of those economists. She tells Tim Phillips how she took the programme and found her purpose, why FYP increased the quit rate but improved productivity, and why employees who took the programme stopped worrying about their work-life balance. 

In this episode, Tina sits down with Nir Salomon, co-founder of Evinature and director of the Integrative Gastroenterology Unit at Sheba Medical Center. Nir shares the origin story behind curQD, a scientifically backed supplement designed to support those living with inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease. They dive into the personalized, integrative approach his team uses, the clinical research supporting curQD, and how it's helping patients worldwide. Nir also introduces Exhale, a new product aimed at reducing stress and supporting gut-brain health. Here's what you'll learn: - What is the CurQD Protocol and how does it work? - The science behind Evinature's Gut Health Assessment - Is it safe to take long-term? - Does it work differently for Ulcerative Colitis vs. Crohn's Disease? - The type of results patients are seeing - How stress and the nervous system affect symptoms - Why Nir believes UC remission doesn't need to be a lifetime struggle Take Evinature's Gut Health Assessment: https://shop.evinature.com/953 Connect with Tina Haupert: https://carrotsncake.com/ Facebook: Carrots 'N' Cake https://www.facebook.com/carrotsncake Instagram: @carrotsncake https://www.instagram.com/carrotsncake YouTube: Tina Haupert https://www.youtube.com/user/carrotsncake Pinterest: Carrots 'N' Cake Hormone Testing & Nutrition Coaching https://www.pinterest.com/carrotsncake/ About Tina Haupert: Tina Haupert is the owner of Carrots ‘N' Cake as well as a Certified Nutrition Coach and Functional Diagnostic Nutrition Practitioner (FDN-P). Tina and her team use functional testing and a personalized approach to nutrition to help women find balance within their diets while achieving their body composition goals. Connect with Nir Salomon: https://evinature.com/ Facebook: https://www.facebook.com/evinature Instagram: https://www.instagram.com/evinature/ Tiktok: https://www.tiktok.com/@evinature LinkedIn: https://www.linkedin.com/company/evinature/ About Nir Salomon: Founder & Director of the Integrative Gastroenterology unit at Sheba Medical Center. Co-founder and Head of R&D at Evinature. After founding the Integrative Gastroenterology unit at Sheba Medical Center, Nir Salomon launched a decade-long research project with Professor Shomron Ben-Horin to advance the full potential of neutraceutical therapies for Inflammatory Bowel Disease. From 2011 to 2022, Salomon led a series of successful trials on the combined use of gut-directed curcumin and Qing Dai (CurQD®) on patients with UC, earning prestigious awards for “breakthrough innovation” and “clinical merit” in his work. His multi-center, international, investigator-initiated RCT on CurQD® was presented at the Crohn's and Colitis Foundation of America (CCFA), where it was awarded Poster of Distinction. In 2021, Salomon and Ben-Horin founded Evinature in partnership with Sheba Medical Center, (one of Newsweek's top 10 hospitals) to provide affordable, accessible, and effective therapies to IBD patients. Salomon lectures worldwide, advocating integrative, evidence-based therapies at prominent medical conferences. He is currently building a global network of leading IBD doctors to facilitate collaborative research projects in the field of nutraceuticals with an aim to advance medical accessibility for patients worldwide.

This week the boys are joined by Jonathan Ratzel, the NFL International Fan of Year. A 12 from Germany who embodies the spirit of the Seahawks and has some stories to tell us.We'll be talking all about:

Send us a textWhat really helps prevent injuries—and what should you do when one inevitably strikes? In this episode, I use my friend Tim's pickleball injury as a jumping-off point to explore what the evidence actually says about ice, rest, NSAIDs, stretching, and more.When Tim skipped his warm-up and pulled a calf muscle, it raised a question many of us face: was it avoidable? While ancient wisdom and modern influencers often shout conflicting advice, this episode sorts through the noise to uncover what's evidence-backed, what's outdated, and what might actually delay healing. For pain, yes, ice works—cooling slows nerve conduction and can help with comfort, as seen in this study of ankle injuries. But does it reduce inflammation in a helpful way? Possibly not. Some research suggests that vasoconstriction may hinder the delivery of reparative cells and removal of waste, as noted in this trial.The evolution from RICE to PEACE to MEAT and even PEACE & LOVE reflects our shifting understanding. A meta-analysis of 22 randomized trials found no conclusive benefit of ice when added to compression or elevation. As for NSAIDs like ibuprofen, the Cochrane Review revealed no significant advantage over acetaminophen in pain relief or swelling reduction—and no clear evidence they speed up recovery.What about rest? Surprisingly, prolonged rest may do more harm than good. The Deyo study and later NEJM data show that continued normal activity (within pain tolerance) results in faster recovery than either bed rest or structured exercises, at least for acute low back pain—offering insights that might extend to other strains or sprains.Can you prevent injuries altogether? Static stretching (think toe touches) doesn't show strong support in RCT reviews, and while a recent meta-analysis found a small reduction in muscle injuries, the impact was modest. Dynamic stretching remains inconclusive according to current evidence.The takeaway? When treatments or prevention strategies are studied over and over yet results remain ambiguous, it likely means any real benefit is small—a principle I call “Dr. Bobby's Law of Many Studies.” Compare that with fall prevention in older adults: 66 RCTs involving 47,000 people showed strength and balance training significantly reduces falls by 20–30%. When something works, it tends to show up clearly and consistently.Takeaways: If you're injured, ice and NSAIDs can ease discomfort—but don't count on them to speed up healing. Resting too much may slow recovery; try gentle movement instead. Stretching might help a bit with prevention, but don't expect miracles. Evidence

Send us a text*Causal Inference From Human Behavior, Reproducibility Crisis & The Power of Causal Graphs*Is Jonathan Heidt right that social media causes the mental health crisis in young people?If so, how can we be sure?Can other disciplines learn something from the reproducibility crisis in Psychology, and what is multiverse analysis?Join us for a conversation on causal inference from human behavior, the reproducibility crisis in sciences, and the power of causal graphs!------------------------------------------------------------------------------------------------------Audio version available on YouTube: https://youtu.be/YQetmI-y5gMRecorded on May 16, 2025, in Leipzig, Germany.------------------------------------------------------------------------------------------------------*About The Guest*Julia Rohrer, PhD, is a researcher and personality psychologist at the University of Leipzig. She's interested in the effects of birth order, age patterns in personality, human well-being, and causal inference. Her works have been published in top journals, including Nature Human Behavior. She has been an active advocate for increased research transparency, and she continues this mission as a senior editor of Psychological Science. Julia frequently gives talks about good practices in science and causal inference. You can read Julia's blog at https://www.the100.ci/*Links*Papers- Rohrer, J. (2024) "Causal inference for psychologists who think that causal inference is not for them" (https://compass.onlinelibrary.wiley.com/doi/10.1111/spc3.12948)- Bailey, D., ..., Rohrer, J. et al (2024) "Causal inference on human behaviour" (https://www.nature.com/articles/s41562-024-01939-z.epdf)- Rohrer, J. et al (2024) "The Effects of Satisfaction with Different Domains of Life on GenInspiring Tech Leaders - The Technology PodcastInterviews with Tech Leaders and insights on the latest emerging technology trends.Listen on: Apple Podcasts SpotifySupport the showCausal Bandits PodcastCausal AI || Causal Machine Learning || Causal Inference & DiscoveryWeb: https://causalbanditspodcast.comConnect on LinkedIn: https://www.linkedin.com/in/aleksandermolak/Join Causal Python Weekly: https://causalpython.io The Causal Book: https://amzn.to/3QhsRz4

Editors of CMI Comms, Josh Davis, Erin McCreary and Emily McDonald return for round 2 taking turns to summarise and discuss late-breaker trials presented at ESCMID Global 2025 in Vienna, and whether or not these trials should change your practice. Part 2 covers the ALABAMA trial exploring the safety of penicillin-allergy delabelling using the penicillin allergy assessment pathway, the SOLARIO trial investigating short (≤7 days!) versus long (≥4 weeks) antibiotic courses for orthopaedic infections, the EAGLE-1 trial assessing oral gepotidacin for gonorrhoea, a randomised clinical trial (RCT) from Thailand on oral fosfomycin as carbapenem-sparing, de-escalating therapy in complicated UTIs, and a double-blind RCT from Israel comparing neutralising plasma to placebo for West Nile fever.    This episode was peer reviewed by Dr. Emanuele Rando of Hospital Universitario Virgen Macarena, Seville, Spain and is the second of this two-part series covering selected clinical trials presented at ESCMID Global 2025.  Late-breaker trialsSandoe J, et al. Penicillin allergy assessment pathway versus usual clinical care for primary care patients with a penicillin allergy record to assess safety, de-labelling and antibiotic prescribing: The ALABAMA randomised controlled trialAngkanavisan K, et al. Oral fosfomycin after carbapenems as de-escalating therapy in complicated urinary tract infection: A randomisedcontrolled trialCanetti M, et al. Neutralising plasma versus placebo for hospitalised patients with West Nile fever: a double-blind randomised controlled trialDudareva M, et al. Short or long antibiotic regimes in orthopaedics: the SOLARIO multicentre randomised controlled trialWilson, J. Phase 3 randomised trial of oral gepotidacin for the treatment of uncomplicated gonorrhoea (EAGLE-1) ReferencesIDSA. Public Comment: IDSA Guideline on Management and Treatment of Complicated Urinary Tract Infections; 19 Feb - 19 March 2025.Mostashari F, et al. Epidemic West Nile encephalitis, New York, 1999. Lancet. 2001. doi: 10.1016/S0140-6736(01)05480-0Angus DC. Optimizing the Trade-off Between Learning and Doing in a Pandemic. JAMA. 2020. doi: 10.1001/jama.2020.4984Dudareva M. In: The 42nd Annual Meeting of the European Bone & Joint Infection Society. Barcelona, Spain: 26-28 Sept 2024. Li HK, et al. Oral versus Intravenous Antibiotics for Bone and Joint Infection (OVIVA). NEJM. 2019 doi: 10.1056/NEJMoa1710926

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

Lancet 1999;353:2001-07Background: Beta-blockers directly reduce cardiac contractility and myocardial oxygen demand. For decades, they were avoided in patients with acute and chronic heart failure over concerns they would facilitate decompensation of the condition. The therapeutic cornerstones of treatment, prior to the modern era of clinical trials, focused on managing symptoms and quality of life with diuretics and inotropic agents like digoxin; however, new paradigms were arising that focused on addressing neurohormonal mechanisms of chronic disease that were over-activated in the failing heart. The first major success came with inhibition of the renin angiotensin aldosterone system with angiotensin converting enzyme inhibitors whose effect on mortality for patients with mild and severe forms of chronic heart failure were demonstrated in the V-HEFT II, CONSENSUS, and SOLVD trials. Additional benefits were demonstrated with the mineralocorticoid receptor antagonist spironolactone in the RALES trial. These drug classes primarily work by reducing afterload and volume retention. Appreciating why they work for improving cardiac performance and managing symptoms in heart failure patients is straightforward when we consider the major factors that effect cardiac stroke volume - preload, afterload and contractility; however, it is also noteworthy the effects these agents have on sudden death. How beta-blockade benefits the failing heart is less obvious (outside prevention of sudden death). Mechanistic studies in patients with chronic heart failure have consistently shown that when beta blockers are used for more than 1 month, left ventricular function improves. Beta blocker therapy appears to restore the density of beta-adrenergic receptors after they have been downregulated by the chronic overactivity of the sympathetic nervous system. The first major placebo-controlled RCT to demonstrate a mortality benefit used the non-selective beta blocker carvedilol. The trial was small and not originally designed to test mortality and was stopped early without clearly predefined stopping rules. Furthermore, 8% of total patients selected for participation in the trial were excluded prior to randomization after a 2 week, open-label run-in phase with the study drug, which saw 2% of all patients experience worsening heart failure or death representing 24 patients (the difference in total deaths between groups was 9 when the trial was stopped). The Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF) was the first large scale trial designed to test the hypothesis that beta-blockade with metoprolol controlled/extended release (CR/XL) added to optimum medical therapy reduces mortality in patients with chronic systolic heart failure.Patients: Patients were recruited from 313 sites in 13 European countries and the United States. Eligible patients were men and women between the age of 40 to 80 years with symptomatic heart failure (NYHA class II-IV) for >/= 3 months before randomization. They had to be on a diuretic and ACE inhibitor for at least 2 weeks. Other drugs, including digoxin, could also be used. Patients also had to have an EF of /=68 beats per minute.Patients were excluded if: they had an MI or unstable angina within 28 days; had an indication or contraindication for treatment with beta-blocker; beta blockade within 6 weeks; heart failure due to systemic disease (i.e., amyloidosis) or alcohol abuse; scheduled or performed cardiac transplant; an ICD; procedures such as CABG or PCI planned or performed in the past 4 months; 2nd or 3rd degree AV block unless a pacemaker was present; unstable or decompensated heart failure defined by pulmonary edema or hypoperfusion or supine systolic BP 25% deviation of the number of observed versus expected consumed placebo tablets during the run-in period.Baseline characteristics: The mean age of patients was 64 years and approximately 78% were male. Slightly more than 30% of patients were above the age of 70. The average EF was 28%. The average SBP was 130 mmHg and heart rate was 82 bpm. Most patients had mild to moderate heart failure, with 41% in NYHA Class II, 56% in Class III, and only 3% in Class IV. Ischemic cardiomyopathy accounted for 65% of cases and nonischemic causes accounted for 35%. Most patients were on an ACE inhibitor or ARB (95%) and diuretic (90%). Digoxin was used in 63%. Trial procedures: Prior to randomization, the study was preceded by a single-blind, 2-week placebo run-in period. Patients meeting eligibility were then randomized to placebo or metoprolol CR/XL. The starting dose of placebo or metoprolol CR/XL was 12.5 mg daily for patients in NYHA class III or IV and 25 mg daily for patients in NYHA class II. The dose was doubled every 2 weeks until the target dose of 200 mg daily was reached. Patients were followed every 3 months.Endpoints: The primary outcome was all-cause mortality. It was estimated that 3,200 patients would need to be followed for 2.4 years to detect a 30% relative reduction in mortality based on annual mortality rate of 9.4% in the placebo group. This would achieve at least 80% power with a 2-sided alpha of 0.04. Patients were recruited faster then planned and so the final sample size of 3,991 patients increased the power of the study.The study was monitored by an independent safety committee and predefined stopping rules for efficacy were based on all-cause mortality, done when 25%, 50%, and 75% of expected deaths had occurred. Results: The trial was stopped early after the 2nd preplanned interim analysis when 50% of expected deaths had occurred. The mean duration of follow-up at the time of stopping was 1 year. The mean daily dose of metoprolol CR/XL was 159 mg once daily, with 87% receiving 100 mg or more and 64% receiving the target dose of 200 mg daily. In the placebo group, the corresponding values were 179 mg daily, 91% and 82%. The study drug was discontinued permanently in 14% of patients in the metoprolol group and 15% in the placebo group. Six months after randomization, heart rate decreased by 14 bpm in the metoprolol group compared to only 3 bpm in the placebo group. Systolic blood pressure decreased less in the metoprolol group (-2.1 vs 3.5 mmHg).Compared to placebo, metoprolol significantly reduced all-cause mortality (7.3% vs 10.8%; RR 0.66; 95% CI 0.53—0.81). Cardiovascular mortality accounted for 91% of all deaths; with sudden death accounting for 58% and death from worsening heart failure accounting for 24% of all deaths. All 3 of these causes of death were significantly reduced by metoprolol. The relative and absolute effects on death were greatest for patients with NYHA class III heart failure.Conclusions: In this trial of stable patients with mild to moderate chronic systolic heart failure, who were optimized on an ACEi or ARB and diuretic, metoprolol CR/XL significantly reduced all-cause mortality. Approximately 30 patients would need to be treated with metoprolol compared to placebo for 1 year to prevent 1 death. This trial represents a significant win for beta blockade in patients with chronic systolic heart failure. While the NNT in this trial is slightly higher than in SOLVD, it is important to appreciate that follow-up time in SOLVD was more than 3x longer. Limitations to external validity in this trial include the run-in period and stringent inclusion and exclusion criteria. Our enthusiasm is also tempered by early stopping, which has been found to be associated with false positive or exaggerated results but this concern is mitigated to some extent in this trial because the rules for early stopping were clearly defined in the protocol.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Can the ketogenic diet help kids with bipolar disorder? We are excited to announce new research is finally exploring this question.The ketogenic diet was first discovered over 100 years ago for children with epilepsy. Could ketogenic therapy also improve mental health outcomes for youth with serious conditions like bipolar disorder? Dr. Kirk Nylen joins Dr. Bret Scher to discuss two groundbreaking studies underway that are tackling this question head-on.In this episode, they dive into:

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

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

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

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

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

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

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

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