Podcasts about section chief

On this edition of Inside the 1581, we address the recent measles outbreak and the critical role vaccinations play in safeguarding our children and communities. Rich Rasmussen, President and CEO of the Oklahoma Hospital Association, hosts a timely conversation with Dr. Stephanie DeLeon, Associate Chief Medical Officer for Children's Services at OU Health and Section Chief of Pediatric Hospital Medicine at the OU College of Medicine, and Dr. Donna Tyungu, Pediatric Infectious Disease Physician at Oklahoma Children's Hospital and Section Chief of Pediatric Infectious Diseases at the OU College of Medicine. Together, they explore the causes behind the resurgence of measles in Oklahoma, the serious complications it can cause—especially in young children—and how health care leaders can build trust to combat vaccine hesitancy and protect public health.www.insidethe1581.com

On this edition of Inside the 1581, we address the recent measles outbreak and the critical role vaccinations play in safeguarding our children and communities. Rich Rasmussen, President and CEO of the Oklahoma Hospital Association, hosts a timely conversation with Dr. Stephanie DeLeon, Associate Chief Medical Officer for Children's Services at OU Health and Section Chief of Pediatric Hospital Medicine at the OU College of Medicine, and Dr. Donna Tyungu, Pediatric Infectious Disease Physician at Oklahoma Children's Hospital and Section Chief of Pediatric Infectious Diseases at the OU College of Medicine. Together, they explore the causes behind the resurgence of measles in Oklahoma, the serious complications it can cause—especially in young children—and how health care leaders can build trust to combat vaccine hesitancy and protect public health.www.insidethe1581.com

This week we bring together urologists and radiologists to work towards a shared goal of innovating on kidney cancer care. Dr. Jason Abel, Professor of Urology and Radiology at the University of Wisconsin, and Dr. Louis Hinshaw, Section Chief of Abdominal Imaging Intervention at the University of Wisconsin, join our host Dr. Ruchika Talwar for a multidisciplinary conversation regarding the treatment of renal tumors. --- SYNPOSIS Their discussion covers the history and benefits of collaboration between urology and interventional radiology (IR), advances in image-guided procedural technologies, and the importance of teamwork in improving patient outcomes. The episode also considers the encouraging, but limited data in IR treatments such as microwave ablation and discusses the lasting role for surgery. Finally, Dr. Abel and Dr. Hinshaw share their experiences in establishing a successful interdisciplinary kidney cancer program. Ultimately, they conclude that the future of renal tumor treatment lies not in silos, but in collaboration. --- TIMESTAMPS 00:00 - Introduction 04:04 - Collaboration Between Urologists and Interventional Radiologists 05:58 - Advancements in Ablation 10:05 - Patient Selection 15:19 - Technical Considerations 26:57 - Post-Ablation Surveillance and Recurrence Management 33:19 - Conclusion

This week we bring together urologists and radiologists to work towards a shared goal of innovating on kidney cancer care. Dr. Jason Abel, Professor of Urology and Radiology at the University of Wisconsin, and Dr. Louis Hinshaw, Section Chief of Abdominal Imaging Intervention at the University of Wisconsin, join our host Dr. Ruchika Talwar for a multidisciplinary conversation regarding the treatment of renal tumors. --- SYNPOSIS Their discussion covers the history and benefits of collaboration between urology and interventional radiology (IR), advances in image-guided procedural technologies, and the importance of teamwork in improving patient outcomes. The episode also considers the encouraging, but limited data in IR treatments such as microwave ablation and discusses the lasting role for surgery. Finally, Dr. Abel and Dr. Hinshaw share their experiences in establishing a successful interdisciplinary kidney cancer program. Ultimately, they conclude that the future of renal tumor treatment lies not in silos, but in collaboration. --- TIMESTAMPS 00:00 - Introduction 04:04 - Collaboration Between Urologists and Interventional Radiologists 05:58 - Advancements in Ablation 10:05 - Patient Selection 15:19 - Technical Considerations 26:57 - Post-Ablation Surveillance and Recurrence Management 33:19 - Conclusion

Join us in this episode as we explore the groundbreaking Medication for Addiction Treatment (MAT) Order Set at UC San Diego Health. This innovative system helped them earn CHIME's top "Digital Health Most Wired" Level 10 status in 2024. What You'll Learn: The motivation behind the creation of UC San Diego's MAT Order Set. How interdisciplinary collaboration led to a comprehensive care model. Implementation details and integration of additional screenings. Data demonstrating reduced hospital readmissions and increased buprenorphine usage. Challenges and lessons learned during the implementation process. Educational impacts on medical resident training and future directions. MODERATOR: Gregory R. Polston, MD Clinical informaticist, Associate Medical Director, Center for Pain Medicine, UC San Diego Health Section Chief of the pain service, VA Medical Center La JollaBio: Dr. Polston is a board-certified anesthesiologist with expertise in pain medicine and clinical informatics at UC San Diego Health. He serves as Associate Medical Director at the Center for Pain Medicine and Section Chief of the pain service at the VA Medical Center La Jolla. Dr. Polston specializes in opioids and risk monitoring for acute and chronic pain, promoting a comprehensive approach to pain management that involves patient engagement and diverse therapeutic methods. His research focuses on chronic opioid therapy, placebos, and electronic medical records.GUEST: Laura Bamford, MD, MSCE Clinical Professor of Medicine Division of Infectious Diseases and Global Public Health Clinical Professor of Medicine Medical Director Owen Clinic Co-Director Clinical Investigations Core San Diego Center for AIDS Research Division of Infectious Diseases and Global Public Health University of California, San Diego Bio: Laura completed her Internal Medicine residency at Columbia University Medical Center and Infectious Diseases fellowship at the Hospital of the University of Pennsylvania where she also received a Master of Science in Clinical Epidemiology. She's a Clinical Professor of Medicine in the Division of Infectious Diseases and Global Public Health and Medical Director of the HIV Medicine Owen Clinic. Her clinical and research interests include HIV and HCV treatment and prevention in people who use drugs. She's passionate about delivering patient-centered care and research with a low barrier and harm reduction approach. With funding from the Ryan White HIV/AIDS Program Part F Special Projects of National Significance, she founded a HIV primary care clinic in 2013 within Philadelphia's syringe service program. She was selected as a member of the Mayor's Task Force to Combat the Opioid Epidemic in Philadelphia in 2017 and testified in federal court in 2019 as a fact witness on behalf of Safehouse, Philadelphia's proposed opioid overdose prevention site. She currently provides substance use disorder treatment integrated into HIV primary care at Owen Clinic and is a member of the UCSD Addiction Medicine/Pain Medicine Committee and the UCSD Opioid Use Disorder Task Force. She also serves as the coordinator of the newly mandated substance use disorder rotation at UCSD for all Internal Medicine residents and was recently appointed to the Board of Directors at Stepping Stone San Diego which specializes in substance use treatment in the LGBTQ+ community. GUEST: Carla Marienfeld, MD, DFAPA, FASAM Clinical Professor, University of California, San Diego Bio: Carla Marienfeld, MD, DFAPA, FASAM, Clinical Professor at UC San Diego, Medical Director Substance Treatment and Recovery (STAR) Program, Program Director UC San Diego Addiction Psychiatry Fellowship is board-certified in psychiatry, addiction psychiatry, and addiction medicine. She has authored over four dozen publications and edited four addiction treatment related books. 

Host: Nathan Falk, MD, MBA, FAAFP Guest: Ashwin Basavaraj, MD Early recognition and diagnosis of non-tuberculosis mycobacteria (NTM) and bronchiectasis are key for optimal patient management. However, these conditions are often misdiagnosed as COPD or asthma, leading to significant challenges and delays in treatment. Join Drs. Nate Falk and Ashwin Basavaraj as they share perspectives on accurately diagnosing NTM and bronchiectasis with early symptom recognition, a thorough patient history, and testing. Dr. Falk is a board-certified family medicine physician, a Professor and Founding Residency Director for Family Medicine at Florida State University in partnership with BayCare Health System, and the Assistant Dean for Graduate Medical Education at Florida State University. Dr. Basavaraj is an Associate Professor of Medicine at New York University Grossman School of Medicine, the Director of the Bronchiectasis and NTM Education Program at NYU Langone Health, and the Section Chief of Pulmonary, Critical Care, and Sleep Medicine at Bellevue Hospital Center. This program is produced in partnership with the American College of CHEST Physicians and is sponsored by Insmed Incorporated.

Whither Ireland-US relations? The second term of Donald Trump has been eventful. After just weeks in office, the US president has alienated some of the most pro-American governments in Europe with his interventions in the war in Ukraine and his moves towards an accommodation with the aggressor in the conflict, Russia. He has also promised tariffs on goods from the European Union and strongly criticised EU laws and regulations being applied to American companies operating in the bloc. The next edition of IIEA insights will look at how this upheaval in transatlantic relations is affecting Ireland's traditionally close ties with the US and how those ties might change over the next four years with Larry Donnelly, Law lecturer and columnist with the Journal.ie; Brian Jensen, retired US diplomat and former Section Chief at the US embassy in Ireland; Niamh King, Director of the Aspen Security Forum; and Fergal O'Brien, Executive Director at Ibec.

On Today's episode of Transforming Healthcare with Dr. Wael Barsoum, we're honored to have Paul Krakovitz, MD,  who is a visionary healthcare executive, physician, and innovator with over 20 years of experience shaping the future of medical operations and strategy. From leading high-impact hospital expansions to pioneering innovations in healthcare delivery, Paul's career is marked by transformative leadership and a relentless drive for excellence. As an Executive in Residence with Cressey and Company, Paul is dedicated to creating meaningful change in healthcare through private market investments. Previously, he served as the Desert Region President at Intermountain Health, where he oversaw a $2.6 billion region, driving growth, innovation, and operational efficiency in both fee-for-service and full-risk healthcare models. Paul's leadership extends beyond operations. As a seasoned board member and thought leader, he has contributed to healthcare and business sectors through over 60 publications, more than 160 international lectures, and three medical device patents. His expertise has been sought by state advisory councils and has earned him accolades such as Castle Connolly's "Top Doctor" and finalist recognition for the 2023 “Business Leader of the Year” by the Las Vegas Global Economic Alliance. With a background that spans clinical care, strategic leadership, and innovation, Paul has held key roles at Cleveland Clinic and Intermountain Health, achieving significant growth, operational efficiency, and cost savings. He also played a pivotal role during the COVID-19 pandemic as a Section Chief for Intermountain Healthcare's Incident Command Operations. Beyond his professional accomplishments, Paul's dedication to fostering strong relationships and empowering teams is evident in his personable leadership style. Join us as we delve into Paul's journey, exploring how he balances strategic innovation, community impact, and personal passions to make a lasting difference in healthcare.

California Department of Health Care Services' Joanna Aalboe joins the show to share about the continued evolution of California Advancing and Innovating Medi-Cal (CalAIM)/Medi-Cal transformation as well as how managed care organizations (MCOs) will start to be measured in 2025 and beyond.

The Lowest Moral Denominator.By FinalStand. Listen to the Podcast at Explicit Novels.Those who declare war are willing to kill as many as it takes to reach their goal.(The Lowest Moral Denominator)My first week at Havenstone, I'd biked to work alone on most days and I'd enjoyed that. I'd have treasure it more if I had glimpsed my future. I loved people, not crowds. I knew about violence, yet I had no affection for it. I was a confirmed bachelor. Now I was staring down both barrels of marriage. I had had also become a walking arsenal with a lethal omnipresent entourage.This situation was so fucked up that I had to stop by Caitlin's place just to see Aya. My favorite sprite gave me a hug and reminded me that I had to do what I could, not worry about what I couldn't do. She was my 9 year old Svengali. She was my little Valkyrie. In truth, she was the only woman knew I loved and that was the love of a father for his daughter.On the elevator ride up to the penthouse suite of the Midtown Hilton, I thought about Dad. What would Ferko Nyilas do in my shoes? It would be easy for someone who didn't know him to imagine my dad getting up on his high moral horse and telling me to just do the right thing, except that wasn't him. What he'd tell me was to not pass the buck. I had to deal with this, unless I knew someone else who could and would do it better.It wasn't about 'being a man'; it was being a member of the Human Race. We all pitched in and got the job done, or it didn't get done, and millions died because we refused to accept any responsibility for what was going on. That was my Dad, 'do what you can' and 'never be afraid to ask for help if you need it'. After the age of ten, he never told me I had to do anything. He'd tell me what needed to be done and leave it at that.So I wouldn't forget the pictures I knew I'd be seeing before too long, the innocent dead. If the sorrow broke me, it broke me. Until it did, I could not turn away. I had to 'do what I could'. That put me heading to a meeting at three o'clock in the afternoon in the penthouse suite.After my non-breakfast with Iskender, we had driven straight to Havenstone, where I demanded an immediate, private meeting with Katrina. This wasn't an info-dump and then out the door. No, I was part of the process now, one of those fools who were responsible for the lives of others. Katrina and I had argued about compartmentalizing my terrifying news.Her reasoning was clear. We were at war with the Seven Pillars. The basis of the 7P strength was China, so anything bad that happened to China was good for the Amazon Host. I nixed that. It was Katrina's job to think about our security. It was mine to juggle how we related to the rest of the planet. Absent the Golden Mare's opposition, Katrina couldn't stop me from doing my job as I saw fit.The Golden Mare was out of immediate contact, so we moved forward on my proposal. Katrina called Javiera, validated Vincent's call, and then suggested she bring in someone from the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) at Ft. Detrick. Katrina wouldn't tell her why.I dispatched Delilah to talk to her MI-6 guy while I made my way to Nicole Lawless's law offices. I need to talk to my Aunts. An hour later, I dismissed a somewhat piqued Nicole from the room, then laid out the upcoming crisis to my Mom's clones. I hesitated a minute before dropping the other bomb, Grandpa Cáel was back.Was I sure? I countered with, "Do you know who Shammuramat was?"Why, yes they did; Grandpa had a bust of her in his main office."Well, she's back, in the flesh and that spells all kinds of problems".The six aunts present agreed. They invited me to fly to Europe with five of them. Much to their surprise and joy, I agreed. I told them I would be a party of twelve with plenty of firepower. They were less pleased about that.I exited that scene, only to engage in another, somewhat unrelated, bit of diplomacy. I met with Brooke and Libra for lunch. They brought Casper, who was seeing a specialist in New York and had expressed an interest in seeing me again. Into that volatile mix, I placed my request: 'Could Brooke put up a friend for a couple of weeks while I made other arrangements?'Yes, this was a 'bizarre' friend. Yes, this was a violently bizarre friend. Yes, she walked around with enough weaponry to scare a seasoned SWAT officer. And yes, she was a mass murderer. Cool,, if I agreed to stop by and see how this 'friend' was doing, and gave Libra advance notice too, then they were fine with it.Thus Shammuramat, Sakuniyas, Saku became Brooke's roommate. Insane? Not really. Putting Saku inside Havenstone on a regular basis was going to result in a blood bath. Saku was abrasive and she was a criminal in the minds of her 'sisters'. This gave her an 'out', some space and time with a civilized person who she couldn't emotionally bowl over.If Saku got physical with Brooke, we both understood that House Ishara was going to cancel her return performance. Amazons could defend themselves, so we were fair game for her rude behavior. Brooke couldn't, so she was hopefully out of bounds. Saku had agreed to the arrangement without comment.She'd already figured out that no other Amazons wanted her around and there simply wasn't room at my place. With that chore done, I was able to see Miyako off before her flight to Tokyo by way of Seattle. Selena was with her, but not going. Miyako did have three Amazons in case things got rough.The Marda House guard woman looked mature and humorless. Her age wasn't a problem. She was a grandmother, yet if she thought she couldn't keep up, she'd have taken herself to the cliffs before now. It turned out she had been in Executive Services before returning to House Marda. My diplomat, I didn't know her, but she seemed eager enough. The member of House Ishara was a brand new recruit named Jenna.She was from Acquisitions and spoke seven Asian languages, including Japanese. She looked absolutely thrilled to be heading off into danger. I instructed the younger two to obey the Mardan. In private, I 'advised' the Mardan that our main mission was to be of aid to the ninja. Information gathering would be secondary. More Amazons were on the way. She gave me a nod.For this critical mid-afternoon meeting at the Midtown Hilton, Wiesława lead the way off the elevator. Buffy went next, then me and finally Saku. Delilah and Vincent had already arrived with their appropriate factions. Katrina took a separate elevator, with Elsa and Desiree. Pamela was, somewhere. After she'd pointed out a half-dozen people from four different agencies in the lobby, she told me to not wait while she went to the bathroom.At the door of the Penthouse were two familiar faces from the NYPD, Nikita Kutuzov and her partner, Skylar Montero. When Javiera's investigation followed me to New York, they had been drafted into the taskforce."Hey ladies," I smiled. My last meeting with Nikita hadn't gone well."Cáel," Nikita smiled back. "How have you been?""More trouble than normal," I shook her hand."We can tell," Skylar relaxed somewhat. As Nikita's partner, she had to know that our relationship had soured when she started investigating me. Katrina's group came up."I think you are the last to arrive," Nikita informed us. This time, Desiree was the first one through the door. I could hear the conversation trail off. Wiesława went next, then Katrina, me, Buffy, Saku and finally Elsa. I decided to toss 'civilized' behavior out the window seconds after entering. Virginia Maddox of the FBI, the initiator of the Amazon children's airlift, was here.I hugged her and after a moment, she hugged me back."Priya says hey and," she blushed slightly, "she's counting the days, all forty-five of them.""Don't forget, I owe you," I grinned then patted her shoulder. Javiera was next."Cáel," she headed my familiarity off. She was a Federal Prosecutor after all."This is the head of this taskforce, Jonas Baker (deep breath) Associate Deputy Undersecretary of Analysis for Homeland Security {ADUAHS} (deep breath)." I extended my hand, so he shook it. He looked somewhat annoyed by this whole encounter. Javiera was duly nervous because of his poor initial attitude. The introductions went around.Half way through it, Pamela showed up, from where, I didn't know. Delilah, her MI-6 boss and the British professional killer Chaz were there, much to the chagrin of the Americans. Vincent was there with Javiera. Cresky was representing the CIA plus there was ATF, ICE, Riki Martin (?) from the State Department and a man in a civil servant's salary suit and a military demeanor, Captain Moe Mistriano."Fine," Mr. Baker began. "I hope you aren't wasting our time." His gaze flicked between Katrina and me."May the Blessed Isis bring understanding to our meeting," I intoned, in old Egyptian."What was that?" Baker turned on me."Praying for guidance," I replied. Isis wasn't in the Amazon pantheon, but I could sure use her help at this point. Baker was going from put-out to pissed-off. If that is how they wanted to play it, their choice. "Are you the specialist from Ft. Detrick?" I asked the Captain."Yes, I am and I hope this is worth my time as well," he gave me a steady gaze. Oh, I really needed that."Anthrax, China," I stated and weighed his response. Oh yeah, I had his attention now, which meant his bio-warfare unit had some idea about what was happening in China."Care to enlighten me?" Baker inquired. He had gauged his medical expert's reactions as well and he didn't like what the biological warfare specialist was not saying."Mr. Baker," the Captain decided to go first. "Roughly fifty-five hours ago, we got wind that there was a massive Anthrax outbreak in Western China. Xinjiang, Qinghai, Gansu, Ningxia and Nei Mongol administrative regions have all reported outbreaks."Holy Shit!" Riki Martin gasped. Her dark, whip-like, Hispanic features noticeably paled."That sounds suspiciously like bio-terrorism," Jonas Baker turned on me."You'd be right about that," I refused to evade. "It is and it is about to get a whole lot worse.""The PRC has a robust vaccine program," the Captain stated. "That is why they aren't making a public stink about it. They have the problem well under control.""Damn, " I closed my eyes and lowered my head. In some deep section of my mind, I had fanned the feeble flames of hope that somehow, the Earth  and  Sky program had derailed. "That is the 'whole lot worse' I was talking about. The terrorists aren't terrorists. They, ""What do you mean they are not terrorists," Baker snapped. "They, ""Shut up and let the man speak," Katrina said calmly."Who are you again?" he glared at Katrina. "If you aren't part of the solution, you are part of the problem and I'm here to make sure this problem is dealt with. I am not here to play footsie with you. I am going to be asking some tough questions and you had better answer them.""I'm Cáel's boss," Katrina smiled. "Since we came here to help you and you don't want to let us speak, we are leaving. Cáel."The Amazons didn't turn and leave. No, we backed up toward the door."You can't start talking about an ongoing terrorist threat and then walk out the door," Baker argued."Javiera, I apologize," I looked her way. "Mr. Baker, Javiera's a smart cookie. I'm sure she's given you every bit of information that has come across her desk. That means you know we consider ourselves an independent nation-state without borders. You can't intimidate us. We feel no obligation to obey your legal system and we operate internationally," I kept going."Now, as we are trying to repay Javiera's kindness in our time of need, you are treating us like criminals currying favors. Blow it out your ass, you pompous bureaucrat" I concluded. "We aren't the problem here.""If that's the way you want it," he shrugged. "Javiera, arrest them." Pause."Sir, you do realize that if I give that order, there is a good likelihood they will resist with force?" Javiera replied calmly. Baker looked around the room."We outnumber them and these are law enforcement officers," he insisted. "Now, ""I wouldn't count on that 'outnumbered' thing," Delilah chimed in.Chaz and MI-6 dude didn't seem to be onboard with his plan. "I have reason to believe Cáel has information on a highly virulent weaponized Anthrax program. If our US allies aren't interested, Her Majesty's government certainly will be." That did interest the MI-6 senior officer."That is all the more reason to put these people into federal custody," Baker stated."Then what, Mr. Associate Deputy?" Chaz said. "Are you going to torture them for time sensitive data? In my military service, I've met some truly hard characters. Some people you can put a gun to their child's head and they'll tell you what you want to know. Not this group. They'll memorize your face and wait for a chance to make you pay, whether you kill the kid, or not.""That's my read on them as well," Agent Vincent Loire added."Mr. Baker, I worked under you when we were both in Counter-terrorism," Virginia spoke up. "I think you are mishandling this. Invoke the Patriot Act and all we get is a roomful of statues. I've fought beside these, Amazons and I'm reaffirming my report to Ms. Castello (Javiera), they do not believe their behavior is wrong.At some point in their fifties, they commit ritual suicide. They make their twelve year old daughters fight for their lives. They murder their male infants. Sir, they are an alien society, indoctrinated at birth to believe they are spiritual inheritors of the ancient Amazons mentioned by Homer during the time of the Iliad.They fanatically believe in a pantheon of goddesses and possess very little inclination for integration. They think they are superior to everyone in this room, except for Cáel, he's an oddity," Virginia pleaded."That legion of crimes is yet another reason to arrest them," Baker just wouldn't give up."What you have described, Agent Maddox is a right wing nut cult, like the Branch-Davidians at Waco. Arrest them.""What are the charges?" Javiera's face blanked out."Conspiracy to commit terrorist acts; aiding and abetting an international terrorist organization," Baker snapped."Everyone, put down your firearms and blades," Katrina ordered. I didn't have the status to give that order except to my own. For that matter,"Team, disarm," Elsa commanded her Security Detail people. Technically, Katrina couldn't order those girls to forego their primary mission, defend the Host. Out came the guns.The group of us went over to one wall, put our backs to it and sat down. Pro forma, Virginia, Vincent and the ATF guy drew their firearms. By this time, both Riki and the Captain looked ready to explode."Tell us what you know about this terrorist conspiracy and, " Baker said."We invoke our Right to Council," I raised my hand."You are being charged under the Patriot Act, smart-ass," Baker sneered. "We can hold you indefinitely if we can show a risk to National Security, such as a terrorist attack in China.""I apologize for dragging you into this," I turned to Katrina. "You too, Saku." Saku shrugged."I told you there is no benefit in helping 'these people'," Katrina comforted me. She meant non-Amazons and it was rather sad that it was looking like she was right and I was wrong."Unless you want to grow old and grey in Guantanamo, I suggest you start talking now," Baker threatened.There was no bravado on our part. We didn't zone out, or ignore him. We looked at him the same way we would a yappy dog while continuing to scan the room. Being disarmed didn't make us defenseless. It merely limited our options."Sir," Riki tapped Baker."If the People's Republic of China finds out we withheld details of a terrorist attack on their soil, that would be BAD, with a capital 'B'.""I have to call this in," the Captain shook his head."Wait until we have active intelligence," Baker said. The Captain completed his call."I don't work for you, Sir. I work for the Department of Defense and that man," the Captain pointed at me, "strung two words together he shouldn't have. Now, I don't know any of you people. I was told to come here, so here I am. I do know, Sir, that you are ignoring the advice from your experts about the expected results of standard interrogation techniques.You are acting on two assumptions which I find to be fictitious," the Captain was clearly furious. "First, you seem to think this won't get out, and you are wrong. Why? We have no idea who these people have talked with. We can only believe that any person outside of their organization can use that revelation for their own ends. Secondly, you haven't grasped the extent of the emergency.Chinese citizens are already starting to drop dead as we speak. This variant of Anthrax is highly contagious, fast-acting, and appears to be incredibly fatal. No nation on Earth has enough Anthrax vaccine on hand to protect their entire population, and that still implies that the vaccines we currently have will work on this new bacteria. Need I go on?"Then Captain Mistriano went back to talking softly with his companions back at Ft. Detrick. The MI-6 chief made his own call. This was his job after all. Before Baker could even start to threaten the Brit, Delilah and Chaz had their guns out, though pointed down. The US law enforcement operatives were far more leery of challenging agents of a friendly foreign power."I will make sure to tack on charges for all those deaths you are facilitating," Baker piled it on. "The US government might find it necessary to send you to the People's Republic of China to face charges there. After all, you claim to not be US citizens." None of us responded verbally. We looked at him. We certainly heard him speak, but his '

In this episode, Lukas Voss talks with Dr. Ryan Fulton, Section Chief at Carilion Children's General Pediatrics and Assistant Professor at Virginia Tech Carilion School of Medicine. They discuss AI, technology's impact on patient care, and the future of medicine. Tune in for key insights on advancing clinical practice.This episode is sponsored by Microsoft (Nuance).

In this episode, Lukas Voss talks with Dr. Ryan Fulton, Section Chief at Carilion Children's General Pediatrics and Assistant Professor at Virginia Tech Carilion School of Medicine. They discuss AI, technology's impact on patient care, and the future of medicine. Tune in for key insights on advancing clinical practice.This episode is sponsored by Microsoft (Nuance).

A leader for conducting rigorous randomized trials of humans along with animal models for understanding nutrition and metabolism, Dr. Kevin Hall is a Senior Investigator at the National Institutes of Health, and Section Chief of the Integrative Physiology Section, NIDDK. In this podcast, we reviewed his prolific body of research a recent publications. The timing of optimizing our diet and nutrition seems apropos, now that we're in in the midst of the holiday season!Below is a video snippet of our conversation on his ultra-processed food randomized trial.Full videos of all Ground Truths podcasts can be seen on YouTube here. The current one is here. If you like the YouTube format, please subscribe! The audios are also available on Apple and Spotify.Note: I'll be doing a Ground Truths Live Chat on December 11th at 12 N EST, 9 AM PST, so please mark your calendar and join!Transcript with links to publications and audioEric Topol (00:05):Well, hello. This is Eric Topol with Ground Truths, and I'm really delighted to have with me today, Dr. Kevin Hall from the NIH. I think everybody knows that nutrition is so important and Kevin is a leader in doing rigorous randomized trials, which is not like what we usually see with large epidemiologic studies of nutrition that rely on food diaries and the memory of participants. So Kevin, it's really terrific to have you here.Kevin Hall (00:34):Thanks so much for the invitation.Ultra-Processed FoodsEric Topol (00:36):Yeah. Well, you've been prolific and certainly one of the leaders in nutrition science who I look to. And what I thought we could do is go through some of your seminal papers. There are many, but I picked a few and I thought we'd first go back to the one that you published in Cell Metabolism. This is ultra-processed diets cause excessive caloric intake and weight gain. (Main results in graph below.) So maybe you can take us through the principle findings from that trial.Kevin Hall (01:10):Yeah, sure. So that was a really interesting study because it's the first randomized control trial that's investigated the role of ultra-processed foods in potentially causing obesity. So we've got, as you mentioned, lots and lots of epidemiological data that have made these associations between people who consume diets that are very high in ultra-processed foods as having greater risk for obesity. But those trials are not demonstrating causation. I mean, they suggest a strong link. And in fact, the idea of ultra-processed foods is kind of a new idea. It's really sort of appeared on the nutrition science stage probably most prominently in the past 10 years or so. And I first learned about this idea of ultra-processed foods, which is really kind of antithetical to the way most nutrition scientists think about foods. We often think about foods as nutrient delivery vehicles, and we kind of view foods as being the fraction of carbohydrates versus fats in them or how much sodium or fiber is in the foods.Kevin Hall (02:17):And along came this group in Brazil who introduced this new way of classifying foods that completely ignores the nutrient composition and says what we should be doing is classifying foods based on the extent and purpose of processing of foods. And so, they categorize these four different categories. And in the fourth category of this so-called NOVA classification scheme (see graphic below) , they identified something called ultra-processed foods. There's a long formal definition and it's evolved a little bit over the years and continues to evolve. But the basic ideas that these are foods that are manufactured by industries that contain a lot of purified ingredients made from relatively cheap agricultural commodity products that basically undergo a variety of processes and include additives and ingredients that are not typically found in home kitchens, but are typically exclusively in manufactured products to create the wide variety of mostly packaged goods that we see in our supermarkets.Kevin Hall (03:22):And so, I was really skeptical that there was much more about the effects of these foods. Other than that they typically have high amounts of sugar and saturated fat and salt, and they're pretty low in fiber. And so, the purpose of this study was to say, okay, well if there's something more about the foods themselves that is causing people to overconsume calories and gain weight and eventually get obesity, then we should do a study that's trying to test for two diets that are matched for these various nutrients of concern. So they should be matched for the macronutrients, they should be matched for the sugar content, the fat, the sodium, the fiber, and people should just be allowed to eat whatever they want and they shouldn't be trying to change their weight in any way. And so, the way that we did this was, as you mentioned, we can't just ask people to report what they're eating.Kevin Hall (04:19):So what we did was we admitted these folks to the NIH Clinical Center and to our metabolic ward, and it's a very artificial environment, but it's an environment that we can control very carefully. And so, what we basically did is take control over their food environment and we gave them three meals a day and snacks, and basically for a two-week period, they had access to meals that were more than 80% of calories coming from ultra-processed foods. And then in random order, they either received that diet first and give them simple instructions, eat as much as little as you want. We're going to measure lots of stuff. You shouldn't be trying to change your weight or weight that gave them a diet that had no calories from ultra-processed foods. In fact, 80% from minimally processed foods. But again, both of these two sort of food environments were matched for these nutrients that we typically think of as playing a major role in how many calories people choose to eat.Kevin Hall (05:13):And so, the basic idea was, okay, well let's measure what these folks eat. We gave them more than double the calories that they would require to maintain their weight, and what they didn't know was that in the basement of the clinical center where the metabolic kitchen is, we had all of our really talented nutrition staff measuring the leftovers to see what it was that they didn't eat. So we knew exactly what we provided to them and all the foods had to be in our nutrition database and when we compute what they actually ate by difference, so we have a very precise estimate about not only what foods they chose to ate, but also how many calories they chose to eat, as well as the nutrient composition.And the main upshot of all that was that when these folks were exposed to this highly ultra-processed food environment, they spontaneously chose to eat about 500 calories per day more over the two-week period they were in that environment then when the same folks were in the environment that had no ultra-processed foods, but just minimally processed foods. They not surprisingly gained weight during the ultra-processed food environment and lost weight and lost body fat during the minimally processed food environment. And because those diets were overall matched for these different nutrients, it didn't seem to be that those were the things that were driving this big effect. So I think there's a couple of big take homes here. One is that the food environment really does have a profound effect on just the biology of how our food intake is controlled at least over relatively short periods of time, like the two-week periods that we were looking at. And secondly, that there's something about ultra-processed foods that seem to be driving this excess calorie intake that we now know has been linked with increased risk of obesity, and now we're starting to put some of the causal pieces together that really there might be something in this ultra-processed food environment that's driving the increased rates of obesity that we've seen over the past many decades.Eric Topol (07:18):Yeah, I mean I think the epidemiologic studies that make the link between ultra-processed foods and higher risk of cancer, cardiovascular disease, type 2 diabetes, neurodegenerative disease. They're pretty darn strong and they're backed up by this very rigorous study. Now you mentioned it short term, do you have any reason to think that adding 500 calories a day by eating these bad foods, which by the way in the American diet is about 60% or more of the average American diet, do you have any inkling that it would change after a few weeks?Kevin Hall (07:54):Well, I don't know about after a few weeks, but I think that one of the things that we do know about body weight regulation and how it changes in body weight impact both metabolism, how many calories were burning as well as our appetite. We would expect some degree of moderation of that effect eventually settling in at a new steady state, that's probably going to take months and years to achieve. And so the question is, I certainly don't believe that it would be a 500 calorie a day difference indefinitely. The question is when would that difference converge and how much weight would've been gained or lost when people eventually reached that new plateau? And so, that's I think a really interesting question. Some folks have suggested that maybe if you extrapolated the lines a little bit, you could predict when those two curves might eventually converge. That's an interesting thought experiment, but I think we do need some longer studies to investigate how persistent are these effects. Can that fully explain the rise in average body weight and obesity rates that have occurred over the past several decades? Those are open questions.Eric Topol (09:03):Yeah. Well, I mean, I had the chance to interview Chris van Tulleken who wrote the book, Ultra-Processed People and I think you might remember in the book he talked about how he went on an ultra-processed diet and gained some 20, 30 pounds in a short time in a month. And his brother, his identical twin brother gained 50, 60 pounds, and so it doesn't look good. Do you look at all the labels and avoid all this junk and ultra-processed food now or are you still thinking that maybe it's not as bad as it looks?Kevin Hall (09:38):Well, I mean I think that I certainly learned a lot from our studies, and we are continuing to follow this up to try to figure out what are the mechanisms by which this happen. But at the same time, I don't think we can throw out everything else we know about nutrition science. So just because we match these various nutrients in this particular study, I think one of the dangers here is that as you mentioned, there's 60% of the food environment in the US and Great Britain and other places consist of these foods, and so they're unavoidable to some extent, right? Unless you're one of these privileged folks who have your backyard garden and your personal chef who can make all of your foods, I'm certainly not one of those people, but for the vast majority of us, we're going to have to incorporate some degree of ultra-processed foods in our day-to-day diet.Kevin Hall (10:24):The way I sort of view it is, we really need to understand the mechanisms and before we understand the mechanisms, we have to make good choices based on what we already know about nutrition science, that we should avoid the foods that have a lot of sugar in them. We should avoid foods that have a lot of saturated fat and sodium. We should try to choose products that contain lots of whole grains and legumes and fruits and vegetables and things like that. And there's some of those, even in the ultra-processed food category. I pretty regularly consume a microwavable ready meal for lunch. It tends to be pretty high in whole grains and legumes and low in saturated fat and sugar and things like that. But to engineer a food that can heat up properly in a microwave in four minutes has some ultra-processing technology involved there. I would be pretty skeptical that that's going to cause me to have really poor health consequences as compared to if I had the means to eat homemade French fries every day in tallow. But that's the kind of comparison that we have to think about.Eric Topol (11:36):But I think what you're touching on and maybe inadvertently is in that NOVA class four, the bad ultra-processed foods, there's a long, long list of course, and some of those may be worse than others, and we haven't seen an individual ranking of these constituents. So as you're alluding to what's in that microwave lunch probably could be much less concerning than what's in these packaged snacks that are eaten widely. But I would certainly agree that we don't know everything about this, but your study is one of the most quoted studies ever in the ultra-processed food world. Now, let me move on to another trial that was really important. This was published in Nature Medicine and it's about a plant-based diet, which is of course a very interesting diet, low-fat versus an animal-based ketogenic diet. Also looking at energy intake. Can you take us through that trial?Plant-Based, Low Fat Diet vs Animal-Based, Low Carbohydrate Ketogenic DietKevin Hall (12:33):Sure. So it's actually interesting to consider that trial in the context of the trial we just talked about because both of these diets that we tested in this trial were relatively low in ultra-processed foods, and so both of them contained more than a kilogram of non-starchy vegetables as a base for designing these, again, two different food environments. Very similar overall study design where people again were exposed to either diets that were vegan plant-based diet that was really high in starches and was designed to kind of cause big insulin increases in the blood after eating the meals. And the other diet had very, very few carbohydrates of less than 10% in total, and we built on that kind of non-starchy vegetable base, a lot of animal-based products to kind of get a pretty high amount of fat and having very low carbohydrates. Both diets in this case, like I mentioned, were pretty low in ultra-processed foods, but what we were really interested in here was testing this idea that has come to prominence recently, that high carbohydrate diets that lead to really large glucose excursions after meals that cause very high insulin levels after meals are particularly obesogenic and should cause you to be hungrier than compared to a diet that doesn't lead to those large swings in glucose and insulin and the prototypical case being one that's very low in carbohydrate and might increase the level of ketones that are floating around in your blood, which are hypothesized to be an appetite suppressant. Same sort of design, these minimally processed diets that one was very high in carbs and causes large swings in insulin and the other that's very low in carbs and causes increases in ketones.Kevin Hall (14:22):We ask people, again, while you're in one food environment or the other, don't be trying to gain weight or lose weight, eat as much or as little as you'd like, and we're going to basically measure a lot of things. They again, don't know what the primary outcome of the study is. We're measuring their leftovers afterwards. And so, the surprise in this particular case was that the diet that caused the big swings in glucose and insulin did not lead to more calorie consumption. In fact, it led to about 700 calories per day less than when the same people were exposed to the ketogenic diet. Interestingly, both food environments caused people to lose weight, so it wasn't that we didn't see the effect of people over consuming calories on either diet, so they were reading fewer calories in general than they were when they came in, right. They're probably eating a pretty ultra-processed food diet when they came in. We put them on these two diets that varied very much in terms of the macronutrients that they were eating, but both were pretty minimally processed. They lost weight. They ended up losing more body fat on the very low-fat high carb diet than the ketogenic diet, but actually more weight on the ketogenic diet than the low-fat diet. So there's a little bit of a dissociation between body fat loss and weight loss in this study, which was kind of interesting.Eric Topol (15:49):Interesting. Yeah, I thought that was a fascinating trial because plant-based diet, they both have their kind of camps, you know.Kevin Hall (15:57):Right. No, exactly.Immune System Signatures for Vegan vs Ketogenic DietsEric Topol (15:58):There are people who aren't giving up on ketogenic diet. Of course, there's some risks and some benefits and there's a lot of interest of course with the plant-based diet. So it was really interesting and potentially the additive effects of plant-based with avoidance or lowering of ultra-processed food. Now, the more recent trial that you did also was very interesting, and of course I'm only selecting ones that I think are particularly, there are a lot of trials you've done, but this one is more recent in this year where you looked at vegan versus ketogenic diets for the immune signature, immune response, which is really important. It's underplayed as its effect, and so maybe you can take us through that one.[Link to a recent Nature feature on this topic, citing Dr. Hall's work]Kevin Hall (16:43):Yeah, so just to be clear, it's actually the same study, the one that we just talked about. This is a secondary sort of analysis from a collaboration we had with some folks at NIAID here at the NIH to try to evaluate immune systems signatures in these same folks who wonder what these two changes in their food environment. One is vegan, high carbohydrate low-fat diet and the other, the animal-based ketogenic diet. And again, it was pretty interesting to me that we were able to see really substantial changes in how the immune system was responding. First of all, both diets again seem to have improved immune function, both adaptive and innate immune function as compared to their baseline measurements when they came into the study. So when they're reading their habitual diet, whatever that is typically high in ultra-processed foods, they switched to both of these diets.Kevin Hall (17:39):We saw market changes in their immune system even compared to baseline. But when we then went and compared the two diets, they were actually divergent also, in other words, the vegan diet seemed to stimulate the innate immune system and the ketogenic diet seemed to stimulate the adaptive immune system. So these are the innate immune system can be thought of. Again, I'm not an immunologist. My understanding is that this is the first line defense against pathogens. It happens very quickly and then obviously the adaptive immune system then adapts to a specific pathogen over time. And so, this ability of our diet to change the immune system is intriguing and how much of that has to do with influencing the gut microbiota, which obviously the gut plays a huge role in steering our immune system in one direction versus another. I think those are some really intriguing mechanistic questions that are really good fodder for future research.Eric Topol (18:42):Yeah, I think it may have implications for treatment of autoimmune diseases. You may want to comment about that.Kevin Hall (18:51):Yeah, it's fascinating to think about that the idea that you could change your diet and manipulate your microbiota and manipulate your gut function in a way to influence your immune system to steer you away from a response that may actually be causing your body damage in your typical diet. It's a fascinating area of science and we're really interested to follow that up. I mean, it kind of supports these more anecdotal reports of people with lupus, for example, who've reported that when they try to clean up their diet for a period of time and eliminate certain foods and eliminate perhaps even ultra-processed food products, that they feel so much better that their symptoms alleviate at least for some period of time. Obviously, it doesn't take the place of the therapeutics that they need to take, but yeah, we're really interested in following this up to see what this interaction might be.Eric Topol (19:46):Yeah, it's fascinating. It also gets to the fact that certain people have interesting responses. For example, those with epilepsy can respond very well to a ketogenic diet. There's also been diet proposed for cancer. In fact, I think there's some even ongoing trials for cancer of specific diets. Any comments about that?Kevin Hall (20:10):Yeah, again, it's a really fascinating area. I mean, I think we kind of underappreciate and view diet in this lens of weight loss, which is not surprising because that's kind of where it's been popularized. But I think the role of nutrition and how you can manipulate your diet and still you can have a very healthy version of a ketogenic diet. You can have a very healthy version of a low-fat, high carb diet and how they can be used in individual cases to kind of manipulate factors that might be of concern. So for example, if you're concerned about blood glucose levels, clearly a ketogenic diet is moderating those glucose levels over time, reducing insulin levels, and that might have some positive downstream consequences and there's some potential downsides. Your apoB levels might go up. So, you have to kind of tune these things to the problems and the situations that individuals may face. And similarly, if you have issues with blood glucose control, maybe a high carbohydrate diet might not be for you, but if that's not an issue and you want to reduce apoB levels, it seems like that is a relatively effective way to do that, although it does tend to increase fasting triglyceride levels.Kevin Hall (21:27):So again, there's all of these things to consider, and then when you open the door beyond traditional metabolic health markers to things like inflammation and autoimmune disease as well as some of these other things like moderating how cancer therapeutics might work inside the body. I think it's a really fascinating and interesting area to pursue.Eric Topol (21:55):No question about it. And that also brings in the dimension of the gut microbiome, which obviously your diet has a big influence, and it has an influence on your brain, brain-gut axis, and the immune system. It's all very intricate, a lot of feedback loops and interactions that are not so easy to dissect, right?Kevin Hall (22:16):Absolutely. Yeah, especially in humans. That's why we rely on our basic science colleagues to kind of figure out these individual steps in these chains. And of course, we do need human experiments and carefully controlled experiments to see how much of that really translates to humans, so we need this close sort of translational partnership.On the Pathogenesis of Obesity, Calories In and Calories OutEric Topol (22:35):Yeah. Now, you've also written with colleagues, other experts in the field about understanding the mechanisms of pathogenesis of obesity and papers that we'll link to. We're going to link to everything for what we've been discussing about calories in, calories out, and that's been the longstanding adage about this. Can you enlighten us, what is really driving obesity and calories story?Kevin Hall (23:05):Well, I co-organized a meeting for the Royal Society, I guess about a year and a half ago, and we got together all these experts from around the world, and the basic message is that we have lots of competing theories about what is driving obesity. There's a few things that we all agree on. One is that there is a genetic component. That adiposity in a given environment is somewhere between 40% to 70% heritable, so our genes play a huge role. It seems like there's certain genes that can play a major role. Like if you have a mutation in leptin, for example, or the leptin receptor, then this can have a monogenic cause of obesity, but that's very, very rare. What seems to be the case is that it's a highly polygenic disease with individual gene variants contributing a very, very small amount to increased adiposity. But our genes have not changed that much as obesity prevalence has increased over the past 50 years. And so, something in the environment has been driving that, and that's where the real debates sort of starts, right?Kevin Hall (24:14):I happen to be in the camp that thinks that the food environment is probably one of the major drivers and our food have changed substantially, and we're trying to better understand, for example, how ultra-processed foods which have risen kind of in parallel with the increased prevalence of obesity. What is it about ultra-processed foods that tend to drive us to overconsume calories? Other folks focus maybe more on what signals from the body have been altered by the foods that we're eating. They might say that the adipose tissue because of excess insulin secretion for example, is basically driven into a storage mode and that sends downstream signals that are eventually sensed by the brain to change our appetite and things like that. There's a lot of debate about that, but again, I think that these are complementary hypotheses that are important to sort out for sure and important to design experiments to try to figure out what is more likely. But there is a lot of agreement on the idea that there's something in our environment has changed.Kevin Hall (25:17):I think there's even maybe a little bit less agreement of exactly what that is. I think that there's probably a little bit more emphasis on the food environment as opposed to there are other folks who think increased pollution might be driving some of this, especially endocrine disrupting chemicals that have increased in prevalence. I think that's a viable hypothesis. I think we have to try to rank order what we think are the most likely and largest contributors. They could all be contributing to some extent and maybe more so in some people rather than others, but our goal is to try to, maybe that's a little simple minded, but let's take the what I think is the most important thing and let's figure out the mechanisms of that most important thing and we'll, number one, determine if it is the most important thing. In my case, I think something about ultra-processed foods that are driving much of what we're seeing. If we could better understand that, then we could both advise consumers to avoid certain kinds of foods because of certain mechanisms and still be able to consume some degree of ultra-processed foods. They are convenient and tasty and relatively inexpensive and don't require a lot of skill and equipment to prepare. But then if we focus on the true bad guys in that category because we really understand the mechanisms, then I think that would be a major step forward. But that's just my hypothesis.Eric Topol (26:43):Well, I'm with you actually. Everything I've read, everything I've reviewed on ultra-processed food is highly incriminating, and I also get frustrated that nothing is getting done about it, at least in this country. But on the other hand, it doesn't have to be either or, right? It could be both these, the glycemic index story also playing a role. Now, when you think about this and you're trying to sort out calories in and calories out, and let's say it's one of your classic experiments where you have isocaloric proteins and fat and carbohydrate exactly nailed in the different diets you're examining. Is it really about calories or is it really about what is comprising the calorie?Kevin Hall (27:29):Yeah, so I think this is the amazing thing, even in our ultra-processed food study, if we asked the question across those people, did the people who ate more calories even in the ultra-processed diet, did they gain more weight? The answer is yes.Kevin Hall (27:44):There's a very strong linear correlation between calorie intake and weight change. I tend to think that I started my career in this space focusing more on the metabolism side of the equation, how the body's using the calories and how much does energy expenditure change when you vary the proportion of carbs versus fat, for example. The effect size is there, they might be there, but they're really tiny of the order of a hundred calories per day. What really struck me is that when we just kind of changed people's food environments, the magnitude of the effects are like we mentioned, 500 to 700 calories per day differences. So I think that the real trick is to figure out how is it that the brain is regulating our body weight in some way that we are beginning to understand from a molecular perspective? What I think is less well understood is, how is that food intake control system altered by the food environment that we find ourselves in?The Brain and GLP-1 DrugsKevin Hall (28:42):There are a few studies now in mice that are beginning to look at how pathways in the brain that have been believed to be related to reward and not necessarily homeostatic control of food intake. They talk to the regions of the brain that are related to homeostatic control of food intake, and it's a reciprocal sort of feedback loop there, and we're beginning to understand that. And I think if we get more details about what it is in our foods that are modulating that system, then we'll have a better understanding of what's really driving obesity and is it different in different people? Are there subcategories of obesity where certain aspects of the food environment are more important than others, and that might be completely flipped in another person. I don't know the answer to that question yet, but it seems like there are certain common factors that might be driving overall changes in obesity prevalence and how they impact this reward versus homeostatic control systems in the brain, I think are really fascinating questions.Eric Topol (29:43):And I think we're getting much more insight about this circuit of the reward in the brain with the food intake, things like optogenetics, many ways that we're getting at this. And so, it's fascinating. Now, that gets me to the miracle drug class GLP-1, which obviously has a big interaction with obesity, but of course much more than that. And you've written about this as well regarding this topic of sarcopenic obesity whereby you lose a lot of weight, but do you lose muscle mass or as you referred to earlier, you lose body fat and maybe not so much muscle mass. Can you comment about your views about the GLP-1 family of drugs and also about this concern of muscle mass loss?Kevin Hall (30:34):Yeah, so I think it's a really fascinating question, and we've been trying to develop mathematical models about how our body composition changes with weight gain and weight loss for decades now. And this has been a long topic, one of the things that many people may not realize is that people with obesity don't just have elevated adiposity, they also have elevated muscle mass and lean tissue mass overall. So when folks with obesity lose weight, and this was initially a pretty big concern with bariatric surgery, which has been the grandfather of ways that people have lost a lot of weight. The question has been is there a real concern about people losing too much weight and thereby becoming what you call sarcopenic? They have too little muscle mass and then they have difficulties moving around. And of course, there are probably some people like that, but I think what people need to realize is that folks with obesity tend to start with much higher amounts of lean tissue mass as well as adiposity, and they start off with about 50% of your fat-free mass, and the non-fat component of your body is skeletal muscle.Kevin Hall (31:45):So you're already starting off with quite a lot. And so, the question then is when you lose a lot of weight with the GLP-1 receptor agonist or with bariatric surgery, how much of that weight loss is coming from fat-free mass and skeletal muscle versus fat mass? And so, we've been trying to simulate that using what we've known about bariatric surgery and what we've known about just intentional weight loss or weight gain over the years. And one of the things that we found was that our sort of expectations for what's expected for the loss of fat-free mass with these different drugs as well as bariatric surgery, for the most part, they match our expectations. In other words, the expected amount of fat loss and fat free mass loss. The one outlier interestingly, was the semaglutide study, and in that case, they lost more fat-free mass than would be expected.Kevin Hall (32:44):Now, again, that's just raising a little bit of a flag that for whatever reason, from a body composition perspective, it's about a hundred people underwent these repeated DEXA scans in that study sponsored by Novo Nordisk. So it's not a huge number of people, but it's enough to really get a good estimate about the proportion of weight loss. Whether or not that has functional consequences, I think is the open question. There's not a lot of reports of people losing weight with semaglutide saying, you know what? I'm really having trouble actually physically moving around. I feel like I've lost a lot of strength. In fact, it seems to be the opposite, right, that the quality of the muscle there seems to be improved. They seem to have more physical mobility because they've lost so much more weight, that weight had been inhibiting their physical movement in the past.Kevin Hall (33:38):So it's something to keep an eye on. It's an open question whether or not we need additional therapies in certain categories of patients, whether that be pharmacological, there are drugs that are interesting that tend to increase muscle mass. There's also other things that we know increase muscle mass, right? Resistance exercise training, increase this muscle mass. And so, if you're really concerned about this, I certainly, I'm not a physician, but I think it's something to consider that if you go on one of these drugs, you might want to think about increasing your resistance exercise training, maybe increasing the protein content of your diet, which then can support that muscle building. But I think it's a really interesting open question about what the consequences of this might be in certain patient populations, especially over longer periods of time.Dietary Protein, Resistance Exercise, DEXA ScansEric Topol (34:30):Yeah, you've just emphasized some really key points here. Firstly, that resistance exercise is good for you anyway. And get on one of these drugs, why don't you amp it up or get it going? The second is about the protein diet, which it'd be interesting to get your thoughts on that, but we generally have too low of a protein diet, but then there are some who are advocating very high protein diets like one gram per pound, not just one gram per kilogram. And there have been studies to suggest that that very high protein diet could be harmful, but amping up the protein diet, that would be a countering thing. But the other thing you mentioned is a DEXA scan, which can be obtained very inexpensively, and because there's a variability in this muscle mass loss if it's occurring, I wonder if that's a prudent thing or if you just empirically would just do the things that you mentioned. Do you have any thoughts about that?Kevin Hall (35:32):Yeah, that's really a clinical question that I don't deal with on a day-to-day basis. And yeah, I think there's probably better people suited to that. DEXA scans, they're relatively inexpensive, but they're not readily accessible to everyone. I certainly wouldn't want to scare people away from using drugs that are now known to be very effective for weight loss and pretty darn safe as far as we can tell, just because they don't have access to a DEXA scanner or something like that.Eric Topol (36:00):Sure. No, that makes a lot of sense. I mean, the only reason I thought it might be useful is if you're concerned about this and you want to track, for example, how much is that resistant training doing?Kevin Hall (36:13):But I think for people who have the means to do that, sure. I can't see any harm in it for sure.Continuous Glucose Sensors?Eric Topol (36:19):Yeah. That gets me to another metric that you've written about, which is continuous glucose tracking. As you know, this is getting used, I think much more routinely in type one insulin diabetics and people with type 2 that are taking insulin or difficult to manage. And now in recent months there have been consumer approved that is no prescription needed, just go to the drugstore and pick up your continuous glucose sensor. And you've written about that as well. Can you summarize your thoughts on it?Kevin Hall (36:57):Yeah, sure. I mean, yeah, first of all, these tools have been amazing for people with diabetes and who obviously are diagnosed as having a relative inability to regulate their glucose levels. And so, these are critical tools for people in that population. I think the question is are they useful for people who don't have diabetes and is having this one metric and where you target all this energy into this one thing that you can now measure, is that really a viable way to kind of modulate your lifestyle and your diet? And how reliable are these CGM measurements anyway? In other words, do they give the same response to the same meal on repeated occasions? Does one monitor give the same response as another monitor? And those are the kinds of experiments that we've done. Again, secondary analysis, these trials that we talked about before, we have people wearing continuous glucose monitors all the time and we know exactly what they ate.Kevin Hall (37:59):And so, in a previous publication several years ago, we basically had two different monitors. One basically is on the arm, which is the manufacturer's recommendation, the other is on the abdomen, which is the manufacturer's recommendation. They're wearing them simultaneously. And we decided just to compare what were the responses to the same meals in simultaneous measurements. And they were correlated with each other thankfully, but they weren't as well predictive as you might expect. In other words, one device might give a very high glucose reading to consuming one meal and the other might barely budge, whereas the reverse might happen for a different meal. And so, we asked the question, if we were to rank the glucose spikes by one meal, so we have all these meals, let's rank them according to the glucose spikes of one device. Let's do the simultaneous measurements with the other device.Kevin Hall (38:53):Do we get a different set of rankings? And again, they're related to each other, but they're not overlapping. They're somewhat discordant. And so, then the question becomes, okay, well if I was basically using this one metric to kind of make my food decisions by one device, I actually start making different decisions compared to if I happen to have been wearing a different device. So what does this really mean? And I think this sort of foundational research on how much of a difference you would need to make a meaningful assessment about, yeah, this is actionable from a lifestyle perspective, even if that is the one metric that you're interested in. That sort of foundational research I don't think has really been done yet. More recently, we asked the question, okay, let's ignore the two different devices. Let's stick to the one where we put it on our arm, and let's ask the question.Kevin Hall (39:43):We've got repeated meals and we've got them in this very highly regimented and controlled environment, so we know exactly what people ate previously. We know the timing of the meals, we know when they did their exercise, we know how much they were moving around, how well they slept the night before. All of these factors we could kind of control. And the question that we asked in that study was, do people respond similarly to the same meal on repeated occasions? Is that better than when you actually give them very different meals? But they match overall for macronutrient content, for example. And the answer to that was surprisingly no. We had as much variability in the glucose response to the same person consuming the same meal on two occasions as a whole bunch of different meals. Which suggests again, that there's enough variability that it makes it difficult to then recommend on for just two repeats of a meal that this is going to be a meal that's going to cause your blood glucose to be moderate or blood glucose to be very high. You're going to have to potentially do this on many, many different occasions to kind of figure out what's the reliable response of these measurements. And again, that foundational research is typically not done. And I think if we're really going to use this metric as something that is going to change our lifestyles and make us choose some meals other than others, then I think we need that foundational research. And all we know now is that two repeats of the same meal is not going to do it.Eric Topol (41:21):Well, were you using the current biosensors of 2024 or were you using ones from years ago on that?Kevin Hall (41:27):No, we were using ones from several years ago when these studies were completed. But interestingly, the variability in the venous measurements to meal tests is also very, very different. So it's probably not the devices per se that are highly variable. It's that we don't really know on average how to predict these glucose responses unless there's huge differences in the glycemic load. So glycemic load is a very old concept that when you have very big differences in glycemic load, yeah, you can on average predict that one kind of meal is going to give rise to a much larger glucose excursion than another. But typically these kind of comparisons are now being made within a particular person. And we're comparing meals that might have quite similar glycemic loads with the claim that there's something specific about that person that causes them to have a much bigger glucose spike than another person. And that we can assess that with a couple different meals.Eric Topol (42:31):But also, we know that the spikes or the glucose regulation, it's very much affected by so many things like stress, like sleep, like exercise. And so, it wouldn't be at all surprising that if you had the exact same food, but all these other factors were modulated that it might not have the same response. But the other thing, just to get your comment on. Multiple groups, particularly starting in Israel, the Weizmann Institute, Eran Segal and his colleagues, and many subsequent have shown that if you give the exact same amount of that food, the exact same time to a person, they eat the exact same amount. Their glucose response is highly heterogeneous and variable between people. Do you think that that's true? That in fact that our metabolism varies considerably and that the glucose in some will spike with certain food and some won't.Kevin Hall (43:29):Well, of course that's been known for a long time that there's varying degrees of glucose tolerance. Just oral glucose tolerance tests that we've been doing for decades and decades we know is actually diagnostic, that we use variability in that response as diagnostic of type 2 diabetes.Eric Topol (43:49):I'm talking about within healthy people.Kevin Hall (43:53):But again, it's not too surprising that varying people. I mean, first of all, we have a huge increase in pre-diabetes, right? So there's various degrees of glucose tolerance that are being observed. But yeah, that is important physiology. I think the question then is within a given person, what kind of advice do we give to somebody about their lifestyle that is going to modulate those glucose responses? And if that's the only thing that you look at, then it seems like what ends up happening, even in the trials that use continuous glucose monitors, well big surprise, they end up recommending low carbohydrate diets, right? So that's the precision sort of nutrition advice because if that's the main metric that's being used, then of course we've all known for a very long time that lower carbohydrate diets lead to a moderated glucose response compared to higher carbohydrate diets. I think the real question is when you kind of ask the issue of if you normalize for glycemic load of these different diets, and there are some people that respond very differently to the same glycemic load meal compared to another person, is that consistent number one within that person?Kevin Hall (45:05):And our data suggests that you're going to have to repeat that same test multiple times to kind of get a consistent response and be able to make a sensible recommendation about that person should eat that meal in the future or not eat that meal in the future. And then second, what are you missing when that becomes your only metric, right? If you're very narrowly focused on that, then you're going to drive everybody to consume a very low carbohydrate diet. And as we know, that might be great for a huge number of people, but there are those that actually have some deleterious effects of that kind of diet. And if you're not measuring those other things or not considering those other things and put so much emphasis on the glucose side of the equation, I worry that there could be people that are being negatively impacted. Not to mention what if that one occasion, they ate their favorite food and they happen to get this huge glucose spike and they never eat it again, their life is worse. It might've been a complete aberration.Eric Topol (46:05):I think your practical impact point, it's excellent. And I think one of the, I don't know if you agree, Kevin, but one of the missing links here is we see these glucose spikes in healthy people, not just pre-diabetic, but people with no evidence of glucose dysregulation. And we don't know, they could be up to 180, 200, they could be prolonged. We don't know if the health significance of that, and I guess someday we'll learn about it. Right?Kevin Hall (46:36):Well, I mean that's the one nice thing is that now that we have these devices to measure these things, we can start to make these correlations. We can start to do real science to say, what a lot of people now presume is the case that these spikes can't be good for you. They must lead to increased risk of diabetes. It's certainly a plausible hypothesis, but that's what it is. We actually need good data to actually analyze that. And at least that's now on the table.Eric Topol (47:04):I think you're absolutely right on that. Well, Kevin, this has been a fun discussion. You've been just a great leader in nutrition science. I hope you'll keep up your momentum because it's pretty profound and I think we touched on a lot of the uncertainties. Is there anything that I didn't ask you that you wish I did?Kevin Hall (47:23):I mean, we could go on for hours, I'm sure, Eric, but this has been a fascinating conversation. I really appreciate your interest. Thank you.Eric Topol (47:30):Alright, well keep up the great stuff. We'll be following all your work in the years ahead, and thanks for joining us on Ground Truths today.**************************************Footnote, Stay Tuned: Julia Belluz and Kevin Hall have a book coming out next September titled “WHY WE EAT? Thank you for reading, listening and subscribing to Ground Truths.If you found this fun and informative please share it!All content on Ground Truths—its newsletters, analyses, and podcasts, are free, open-access.Paid subscriptions are voluntary. All proceeds from them go to support Scripps Research. Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past two years. I welcome all comments from paid subscribers and will do my best to respond to them and any questions.Thanks to my producer Jessica Nguyen and to Sinjun Balabanoff for audio and video support at Scripps Research.Note on Mass Exodus from X/twitter:Many of you have abandoned the X platform for reasons that I fully understand. While I intend to continue to post there because of its reach to the biomedical community, I will post anything material here in the Notes section of Ground Truths on a daily basis and cover important topics in the newsletter/analyses. You can also find my posts at Bluesky: @erictopol.bsky.social, which is emerging as an outstanding platform for sharing life science. Get full access to Ground Truths at erictopol.substack.com/subscribe

This is a new experiment we're trying at the Rhodes Center Podcast. From time to time, going forward, instead of focusing on one expert and their latest research, Mark will take a deeper dive into one issue (or one question) that's been bothering him. Future episodes will examine the politics of immigration and the persistence of inequality. But the first episode in this new series will explore a topic especially near and dear to Mark: inflation. Specifically, the stories we tell about what causes inflation, how those stories affect our efforts to curb it, and who wins and loses depending on which stories our leaders believe. In the first half of this episode, Mark talks with economist Nicolò Fraccaroli about a book he and Mark wrote called “Inflation: A Guide for Users and Losers” (coming out in Spring 2025). In the second half, Mark talks with economist Claudia Sahm about the history of inflation, the role central banks play in it, and what's lost when we try to take politics and politicians out of the inflation debate. (One thing to note: both of these conversations were recorded before the election, but the ideas explored in these conversations are just as relevant now as ever.)Guests on this episode:Nicolò Fraccaroli is an economist at the World BankClaudia Sahm is Chief Economist for New Century Advisors and former Section Chief at the Federal Reserve's Board of GovernorsLearn more about the Watson Institute's other podcasts

Over the past three years, several seemingly frozen conflicts (Sudan, Russia/Ukraine, Israel/Gaza, Armenia/Azerbaijan, etc) have broke out into hot conflicts that are challenging the current international order. There is, however, one of the longest standing potential flashpoints that has not entered the fray, but is listed as one issue that could embroil the world. That is the unresolved issue of cross-strait relations between the People's Republic of China (PRC) and the Republic of China (ROC), also known as the island of Taiwan. For more than seventy years, the question of who controls Taiwan has simmered just under the surface of geopolitical tensions, as the PRC continues to claim control of Taiwan, while recognizing that reunification is necessary (the juxtaposition here is insightful). The ROC continues to maintain that the political status of Taiwan can only be decided by the people of Taiwan, who currently support maintaining the status quo (having their own democracy, while not openly trying to claim full independence). In this episode we speak with Director General Charles Liao of the Taiwan Economic and Cultural Office in Boston. As the US and Taiwan do not maintain official relations, they do not maintain an embassy or series of consulates throughout the US, so these offices act as the representatives of the ROC in the US. Listen to gain insights into the current state of cross-strait relations and how the ROC views their relationship with the PRC. This becomes increasingly important as the PRC continues to ramp up military drills surrounding Taiwan, increasing the chances for a miscalculation or accident that can lead to all out war. In an age where military might has returned to the global stage as a way to resolve conflicts, the question of Taiwan and how to encourage a diplomatic resolution remains one of the most important of the day.As mentioned in the podcast introduction, if you are interested in learning more about what foreign policy might look like as the United States enters a second term for President Trump, please watch our conversation with Dan Negrea of the Atlantic Council and co-Author of "We Win, They Lose: Republican Foreign Policy and the New Cold War". You can watch the RECORDING HERE.Charles Liao is the Director-General of Taipei Economic and Cultural Office in Boston. Prior to assuming his current position on August 3rd 2023, Mr. Liao was Deputy Secretary-General of the Taiwan Council for U.S. Affairs, seconded to Foreign Minister's Office, from 2020 to 2023.From 2014 to 2020, Mr. Liao served in Washington, D.C. as First Secretary and then Deputy Director at the Taipei Economic and Cultural Representative Office in the United States. He was Section Chief in the Department of East Asian and Pacific Affairs at the Ministry of Foreign Affairs from 2010 to 2013. From 2004 to 2010, Mr. Liao served as Senior Consular Officer at the Taipei Economic and Cultural Office in Los Angeles.Mr. Liao earned a Bachelor of Arts in Diplomacy from National Chengchi University in 1999. Mr. Liao is married to Nicole Chang and they have two daughters, Norah and Carice.

Description: In this virtual tumor board episode of Lung Cancer Considered, host Dr. Stephen Liu leads a discussion on the management of a patient with metastatic squamous NSCLC. Listen to the episode to learn how the guests would approach this case. Guest: Dr. Pilar Garrido is an Associate Professor of Medical Oncology at Universidad de Alcalá in Madrid, Spain, and the Head of the Thoracic Tumours Section at the University Hospital Ramón y Cajal X: @Piuchagarrido Guest: Dr. Jared Weiss is a Professor of Medicine and Section Chief of Thoracic and Head & Neck Oncology at the University of North Carolina, Chapel Hill, N.C. @DrJaredWeiss

Tommy checks in with Dr. Michelle Moore, Associate Professor of Clinical Psychiatry at LSU Health New Orleans and serves as Section Chief for Psychology

Welcome to Med Tech Gurus! Today, we have two exceptional guests who are revolutionizing the field of bariatric surgery. First, we have Dr. Jon L. Schram, Section Chief and Medical Director of Bariatric Surgery at Corewell Health. With a distinguished career, Dr. Schramm has been pivotal in advancing surgical techniques and improving patient outcomes. He is also a lead author on a recent study published in Obesity Surgery, showcasing the clinical benefits of the Titan SGS stapler. Joining him is James Ferguson, President and General Manager, Surgical at Teleflex. James has a robust background in medical device innovation and played a key role in developing and commercializing the Titan SGS stapler. His career spans multiple leadership roles, where he has driven product innovation, market expansion, and operational excellence in the med tech sector. In this episode, we'll dive into the evolution of gastric sleeve surgery, explore how the Titan SGS stapler is setting new standards in bariatric surgery, and discuss the impact of GLP-1 drugs on clinical practices. Get ready for a fascinating conversation filled with cutting-edge insights and practical takeaways from two leaders at the forefront of surgical innovation!

For the first (and maybe last) time ever Ben, Katie, and Erik are LIVE in this special episode of Colorado Water Talk. The team is joined by Heather Dutton, General Manager of the San Luis Valley Water Conservancy District, Robert Sakata, Agricultural Water Policy Advisor for the Colorado Department of Agriculture, and Russ Sands, Section Chief for CWCB's Water Supply and Planning Section to discuss all things Roundtables. Links from the Show: cwcb.colorado.gov

Send us a textIn this episode of MedStar Health DocTalk, we explore the critical aspects of breast cancer detection and the intricacies of mammography with Dr. Michelle Townsend Day, Chair of the Department of Radiology and Section Chief of Breast Imaging at MedStar Good Samaritan and MedStar Union Memorial Hospitals. Hosted by Debra Schindler, this episode delves into the advancements in breast imaging, the significance of early detection, and the challenges faced in diagnosing breast cancer, particularly in women with dense breast tissue. Dr. Townsend Day provides a comprehensive overview of the different types of mammograms, including 2D and 3D mammography, and explains the role of artificial intelligence in enhancing diagnostic accuracy. She also discusses the importance of understanding breast density and the implications of the recent FDA amendment to the Mammography Quality Standards Act. The conversation covers various imaging modalities, including ultrasound, MRI, and contrast-enhanced mammography, and their applications in breast cancer screening and diagnosis. Listeners will gain valuable insights into the role of radiologists in the diagnostic process, the importance of patient advocacy, and the potential impact of family history on breast cancer risk. Dr. Townsend Day emphasizes the need for regular self-exams and the significance of early detection in improving outcomes for breast cancer patients. For more information on mammograms or to schedule one, visit medstarhealth.org/mammogram.For more episodes of MedStar Health DocTalk, go to medstarhealth.org/doctalk.

This spotlight is on Dr. Patricia Byers, MD, FACS. She is a Professor and Section Chief in Surgical Nutrition and Metabolic Surgery at the Ryder Trauma Center/Jackson Memorial Hospital in Miami, FL. Dr. Byers became interested in nutrition while working in trauma and critical care, where she saw the impact of nutrition support on this patient population. She credits her career development to mentors like Drs. Stanley Dudrick, Bruce Bistrian, and Miguel Echenique. Dr. Byers also discusses the importance of a multidisciplinary team in the care of patients receiving nutrition support, and how all members of the team are able to learn and grow from each other. She highlights the minimal nutrition training that surgical residents receive and yet surgical patients can benefit the most from nutrition support. In her institution, she makes sure that her surgical residents are exposed to their nutrition support team and gain experience in writing orders for TPN. Dr. Byers is an active member of ASPEN and contributes to various committees, including the Physician Engagement Committee. She encourages others to get involved in ASPEN to promote their careers in nutrition. Physician Spotlight is a forum for outstanding Senior Leaders, Young Rising Stars, and International Colleagues in the field of nutrition to discuss important topics and ideas that impact patient care. Visit the ASPEN Physician Community at www.nutritioncare.org/physicians

Ellen Essick, Section Chief for the NC Healthy Schools Section at the North Carolina Department of Public Instruction, explains the results of North Carolina's Youth Risk Behavior Survey; Byron Lobsinger, Environmental Health Emergency Planner for the Department of Public Health in Georgia, recaps the impacts Hurricane Debby had on his state; ASTHO along with NACCHO and the CDC has published an article focused on lessons learned from the Public Health Disability Specialists program;  ASTHO, with support from the EPA, has created four Community Action Plan Templates for state and territorial health agencies to address children's environmental health; and the CDC has issued a Health Alert Network Health Advisory about current increases in human parvovirus B19 activity. North Carolina Department of Public Instruction Web Page: NC Youth Risk Behavior Surveys show improvement in student mental health ASTHO Blog Article: Preparing for and Responding to Infectious Disease Threats Following Hurricanes ASTHO Blog Article: Responding to Environmental Health Threats Following Hurricanes ASTHO Blog Article: Why It's Never Too Early to Prep for Hurricane Season Journal of Public Health Management & Practice Article: Best Practices and Lessons Learned From the Public Health Disability Specialists Program – Addressing the Needs of People With Disabilities During COVID-19 ASTHO Resource: Community Action Plan Templates for Children's Environmental Health CDC Web Page: Increase in Human Parvovirus B19 Activity in the United States

Hi, I'm Jody Sweetin, and welcome to Season 4 of Awkward Conversations. This season, we provide parents with practical advice on raising happy, healthy, substance-free kids. Our focus will be on building resilience, and confidence, and empowering kids to make smart choices. We'll feature our amazing co-host, Amy McCarthy from Harvard's Boston Children's Hospital, and have discussions featuring our expert guests, including Richard Lucy, a Senior Prevention Program Manager from the DEA, and Joseph Bozenko, a Senior Research Chemist from the DEA. They will discuss critical topics such as the current fentanyl crisis, the importance of parent-child bonding, and the significant role of education and awareness. We highlight resources like GetSmartAboutDrugs.com and One Pill Can Kill, and discuss harm reduction strategies like naloxone. Remember, the only wrong conversation is the one you don't have with your kids. Key Takeaways: Fentanyl is a powerful synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine.    It is being increasingly laced into counterfeit pills and other drugs, leading to a rise in accidental overdoses.    The DEA is working to raise awareness of the dangers of fentanyl through its One Pill Can Kill campaign.    There are resources available to help parents talk to their children about drugs, such as Get Smart About Drugs.com. Naloxone is a medication that can reverse an opioid overdose and is available over-the-counter in many states.      TIME STAMPS / IN THIS EPISODE: [00:00] Welcome to Season 4 of Awkward Conversations [01:14] Meet the Hosts and Guests [02:23] The Fentanyl Crisis: A Terrifying Reality [03:31] Understanding the Fentanyl Epidemic [10:01] Raising Awareness and Prevention Efforts [16:42] The Role of Technology in the Crisis [21:08]Harm Reduction Strategies: Naloxone and Test Strips [25:30]Final Thoughts and Resources for Parents [31:03] Preview of Next Week's Episode: The Faces of Fentanyl    BIOS: Jodie Sweetin is an actress, author, and advocate, best known for her role as Stephanie Tanner on the iconic sitcom "Full House" and its sequel "Fuller House". In 2009 she penned her memoir, "unSweetined", which chronicles her journey through addiction and into recovery. With her frank and open approach, Jodie has emerged as a compelling speaker and advocate who now seeks to use her platform and experiences to educate others and reduce the stigma associated with addiction and recovery. @jodiesweetin   Amy McCarthy, LICSW, is a Director of Clinical Social Work at Boston Children's Hospital's Division of Addiction Medicine. She has been working in the Adolescent Substance Use and Addiction Program since 2019 @amymccarthylicsw   Richard Lucey has more than three decades of experience at the state and federal government levels working to prevent alcohol and drug use and misuse among youth and young adults, especially college students. He currently serves as a senior prevention program manager in the Drug Enforcement Administration's Community Outreach and Prevention Support Section. Rich plans and executes educational and public information programs, evaluate program goals and outcomes, and serves as an advisor to the Section Chief and other DEA officials on drug misuse prevention and education programs. Rich formerly served as special assistant to the director for the federal Center for Substance Abuse Prevention, and worked as an education program specialist in the U.S. Department of Education's Office of Safe and Drug-Free Schools.   Joe Bozenko is a Senior Research Chemist with the DEA's Special Testing and Research Laboratory at Dulles, Virginia, and a Scientific Advisor to DEA's Special Operations Division. He's been with the DEA for 21 years and investigates synthetic drug manufacturing around the world. Mr. Bozenko has processed some of the largest methamphetamine laboratories in the world, traveled extensively, and has authored and presented many reports and scientific articles pertaining to the clandestine synthesis of controlled substances. Mr. Bozenko is closely involved with science-related officer safety and leads DEA's handheld instrumentation testing and evaluation. In addition to this, Mr. Bozenko has also been instrumental in he development of the DEA's High-Hazard Level ‘A' Clandestine Laboratory Response Training Program. Mr. Bozenko is also charged with the specialized analysis of selected fentanyl, methamphetamine, and MDMA samples, both domestic and international, for intelligence purposes. Mr. Bozenko holds both a Baccalaureate and Master's Degrees in Chemistry and is an Adjunct Professor of Chemistry at Shepherd University.   Elks: As a 150-year-old organization, they are 100% inclusive with a membership of close to 1 million diverse men and women in over 2,000 Lodges nationally, and while they consider themselves faith based, they are nondenominational and open to all creeds. The Elks have always prided themselves on civic duty, and the Elks Drug and Alcohol Prevention (DAP) program is the nation's largest all volunteer Kids Drug & Alcohol Use Prevention program. The Elks are also strong supporters of our brave men and women in the military, having built and donated the nation's first VA Hospital to the U.S. government. The Elks have donated more than $3.6 billion in cash, goods, and services to enrich the lives of millions of people!    DEA: The United States Drug Enforcement Administration was created in 1973 by President Nixon after the government noticed an alarming rise in recreational drug use and drug-related crime. A division of the Department of Justice, DEA enforces controlled substances laws by apprehending offenders to be prosecuted for criminal and civil crimes. DEA is the largest and most effective antidrug organization in the world, with 239  domestic locations in 23 field divisions and 91 international field divisions in 68  countries.   Resources/Links SAMHSA | Help and Treatment: https://bit.ly/3DJcvJC Get Smart About Drugs: https://bit.ly/45dm8vY   DEA Website: https://bit.ly/44ed9K9 DEA on Instagram: https://bit.ly/3KqL7Uj DEA on Twitter: https://bit.ly/44VvEUt DEA on Facebook: https://bit.ly/440b6ZY DEA YouTube Channel: https://bit.ly/3s1KQB6   Elks Kid Zone Website: https://bit.ly/3s79Zdt Elks Drug Awareness Program Website: https://bit.ly/44SunO6 Elks DAP on Twitter: https://bit.ly/45CfpvR Elks DAP on Facebook: https://bit.ly/3Qw8RKL Elks DAP on YouTube: https://bit.ly/444vMQq   Awkward Conversations on Instagram: https://bit.ly/3QCEmTl Awkward Conversations on TikTok: no https://bit.ly/44cMKMH   Jodie Sweetin's Links Jodie's Instagram: https://www.instagram.com/jodiesweetin/ Jodie's TikTok: https://www.tiktok.com/@jodiesweetin?lang=en   Amy McCarthy's Links Amy's Instagram: https://www.instagram.com/amymccarthylicsw/ Boston Children's Hospital Instagram: https://www.instagram.com/bostonchildrens/?hl=en Boston Children's Hospital Addiction Medicine: https://www.childrenshospital.org/departments/addiction-medicine   Richard Lucey's Links https://www.linkedin.com/in/rich-lucey-7795a33/ https://www.instagram.com/deahq/   Joseph Bozenko's Links https://www.linkedin.com/in/joebozenko/ https://www.instagram.com/deahq/  

Dr. Esther Sternberg shares insights from her book, "Well at Work," emphasizing the power of gratitude in daily life. Drawing from various traditions, she highlights the practice's significance and its role in reducing stress. Dr. Sternberg suggests stepping outside amidst the busyness of work to embrace gratitude for the surroundings and meaningful relationships. This mindfulness practice not only calms the stress response but also activates brain pathways associated with positive emotions. Through an Oscar Wilde quote, she reminds listeners of the transformative effect of focusing on the positive amidst life's challenges. Dr. Sternberg's wisdom offers a pathway to peace and hope in any workspace.https://esthersternberg.comIG: @dresternbergFB: https://www.facebook.com/esther.sternberg.73Dr. Sternberg holds the Andrew Weil Chair for Research in Integrative Medicine and is Research Director for the Andrew Weil Center for Integrative Medicine at the University of Arizona at Tucson.Before joining UA, Dr. Sternberg served for 26 years in the NIH Intramural Research Program as Senior Scientist and Section Chief of Neuroendocrine Immunology and Behavior at the National Institute of Mental HealthHer books Healing Spaces: The Science of Place and Well-Being and The Balance Within: The Science Connecting Health and Emotions are scientifically based inspirations for laypersons and professionals alike.Healing Spaces was recognized by the President of the American Institute of Architects as an inspiration for the AIA's Design and Health Initiative.Her latest book WELL at WORK: Creating Wellbeing in Any Workspace takes workplace wellbeing in the post-COVID era.In 2009, Dr. Sternberg created and hosted a PBS Television special

Interviewer: Dr. Peter Poullos Interviewees: Emmanuel Asenso, DO, Allison Kessler, MD, MSc, Joseph Samona, DDS, Satendra Singh, MD   Description:  This episode of the DWDI podcast brings together four incredible individuals for a live recording session during the 5th annual SMADIE conference on April. The panel featured Emmanuel Ascenso, Dr. Joe Simona, Dr. Satendra Singh, and Dr. Allison Kessler, all of whom had previously been interviewed on the podcast and had garnered significant listenership. Each guest shared their personal and professional journeys, highlighting their experiences as healthcare professionals with disabilities. Throughout the episode, the guests touched on themes of mentorship, intersectionality, and the importance of allies in driving change. They also highlighted the need for tailored feedback, proactive advocacy, and the power of sharing personal stories to educate and empower others. The episode underscored the significance of acceptance, education, and cross-movement solidarity in creating a more inclusive healthcare environment.   Key Words: ADA, Accommodation, Clinical Work, Ableism, Storytelling, Podcast, DocsWithDisabilities, Stuttering, SCI, Deaf, Physical Disability. Transcript: https://bit.ly/DWDI_Ep_96_Transcript  Docs With Disabilities Original Interview Episodes Linked Bio's:  Dr. Emmanuel Asenso Jr is a second-year resident physician in the combined Family Medicine and Preventive Medicine residency program at Johns Hopkins and MedStar Franklin Square in Baltimore, MD. He was born and raised in Northern Virginia to Ghanaian immigrant parents. He completed his undergraduate studies at Virginia Tech, completed his Masters in Public Health from George Washington University in DC, and then completed medical school at Rowan University SOM in New Jersey. He is a person with a childhood-onset fluency disorder, also known as stuttering. Navigating a communication disorder throughout training has been challenging, rewarding, and full of lessons. He is passionate about supporting marginalized people and advocating for health equity through primary care and public health. He is also interested in the intersectionality between racism and people with disabilities.    Allison Kessler, MD, MSc, is the Section Chief of Renée Crown Center for Spinal Cord Innovation. She is board-certified in Physical Medicine & Rehabilitation (PM&R) and Spinal Cord Injury (SCI) Medicine. Dr. Kessler is the Associate Director of Shirley Ryan AbilityLab's SCI Medicine Fellowship. She holds appointments at Northwestern University Feinberg School of Medicine as Assistant Professor in the Department of PM&R.  Bonus: Behind the white coat interview   Dr. Joseph Samona graduated from the University of Michigan School of Dentistry and completed AEGD residency at the University of Texas Health San Antonio. He currently works as an associate in private practice in the Metro Detroit area. He is also profoundly Deaf and is a strong advocate for the Deaf and Hard of Hearing community who are underrepresented in the dental field. He have given lectures at several dental schools and local dental organizations on effective communication with the Deaf and Hard of Hearing community.  He also developed a project where he created a series of educational videos about oral health in American Sign Language on YouTube to increase accessibility to oral health care.  He is currently a member of the American Academy of Cosmetic Dentistry, Academy of General Dentistry, and American Dental Association.   Satendra Singh, MD, serves as the Director Professor and Coordinator of the Enabling Unit at the University College of Medical Sciences, Delhi, India. Additionally, he holds the role of Co-chair of the International Council for Disability Inclusion in Medical Education and is a steering committee member of the Health Humanities Consortium. As a disability justice advocate, he has spearheaded numerous policy reforms, notably the inclusion of disability rights as mandatory competencies in the new medical curriculum in India. He serves as the organizational head of Doctors with Disabilities: Agents of Change in India, a nationwide group of health professionals with disabilities dedicated to social justice. Furthermore, he is a member of the core group on disability at the National Human Rights Commission. Bonus: We Don't Shy Away From Our Disability: Dr Satendra Singh  

Kieran talks with Eliza Odom, former Section Chief of the FBI's Counterterrorism Division, about the top terror threats the bureau is currently focused on. While having since become deputy assistant director of the FBI's Weapons of Mass Destruction Directorate, Eliza discusses the seven units within the Counterterrorism Division she once oversaw, particularly focusing on the Financial Targeting and Analysis Unit, and its role interdicting terror funding. While deeply concerned about the actions of home-grown extremists, Eliza also details the need for global cooperation and vigilance from the private sector to address the rising threat of cross border financed terror attacks in the wake of war in the Middle East.

June 17, 2024 ~ Dr. Nayana Dekhne, Section Chief and Breast Surgery Fellowship Director, Marilyn and Walter Wolpin Breast Center joins Anthony Bellino at Oakland Hills Country Club.

In this episode of the Brawn Body Health and Fitness Podcast, Dan is joined by Dr. Gabriel Petruccelli to discuss biceps injury examination, assessment, imaging, surgical and rehab considerations. Gabriel L. Petruccelli is an accomplished board-certified orthopaedic surgeon specializing in arthroscopy, sports medicine, shoulder replacements and general orthopaedics. Dr. Petruccelli joined Greater Washington Orthopaedic Group, PA in 2012, with three locations: Rockville, Silver Spring and  GermanTown, Maryland. Dr. Petruccelli is a Maryland native, who graduated from The Heights School in Potomac, where he played basketball and soccer. Dr. Petruccelli graduated from the George Washington University with a Bachelor of Science degree in Exercise Science before receiving a certificate in Physiology at the Virginia Commonwealth University. He completed his medical degree from Ross University School of Medicine in Barbados in 2006 before relocating to New York City to complete his Internship and Orthopaedic residency at New York Medical College-St. Vincent's Catholic Medical Center/ Kingsbrook Jewish Medical Center in 2011. In 2012, Dr. Petruccelli relocated to the west coast to complete his fellowship with the San Diego Arthroscopy and Sports Medicine Fellowship. There he honed and specialized his skills within the field of sports medicine and open shoulder surgery.  Also, during his time there, he worked closely with Major League Baseball's San Diego Padres. He also assisted the team physician for the San Diego State Aztecs. Given the opportunity to research, he published surgical technique videos for national orthopaedic society meetings that year. Dr. Petruccelli has received the Top Doctors Washingtonian Magazine Award in 2017, 2018 & 2019. Since 2016, he has been the Section Chief of the Department of Orthopaedics at Adventist Healthcare Shady Grove Medical Center. Dr. Petruccelli supports the athletic programs as the team physician at Georgetown Preparatory School and supporting his high school alma mater, The Heights School. He also gives valuable educational talks throughout the community. Dr. Petruccelli's main focus is to help each individual get back to their normal daily life and activities as soon as possible with top quality and very personalized orthopaedic care. He takes great pride in listening to his patients and understanding their needs. He works closely with his carefully selected physical therapists to ensure a safe and quick rehabilitation protocol and recovery. Outside of the medical office, Dr. Petruccelli values spending time with his wife and children. He also enjoys, exercise, music, travel and cutting hair. For more on Dr. Petruccelli, be sure to check out @dr.petruccelli on Instagram or click here: https://www.gwog.com/provider/gabriel-l-petruccelli-md-faaos *SEASON 5 of the Brawn Body Podcast is brought to you by Isophit. For more on Isophit, please check out isophit.com and @isophit - BE SURE to use coupon code brawnbody10 at checkout to save 10% on your Isophit order! Episode Sponsors: MoboBoard: BRAWNBODY10 saves 10% at checkout! AliRx: DBraunRx = 20% off at checkout! https://alirx.health/ MedBridge: https://www.medbridgeeducation.com/brawn-body-training or Coupon Code "BRAWN" for 40% off your annual subscription! CTM Band: https://ctm.band/collections/ctm-band coupon code "BRAWN10" = 10% off! GOT ROM: https://www.gotrom.com/a/3083/5X9xTi8k Red Light Therapy through Hooga Health: hoogahealth.com coupon code "brawn" = 12% off Ice shaker affiliate link: https://www.iceshaker.com?sca_ref=1520881.zOJLysQzKe Make sure you SHARE this episode with a friend who could benefit from the information we shared! Check out everything Dan is up to, including blog posts, fitness programs, and more by clicking here: https://linktr.ee/brawnbodytraining Liked this episode? Leave a 5-star review on your favorite podcast platform! --- Send in a voice message: https://podcasters.spotify.com/pod/show/daniel-braun/message Support this podcast: https://podcasters.spotify.com/pod/show/daniel-braun/support

In this episode of the PRS Global Open Keynotes podcast, Dr. Thomas Imahiyerobo discusses the value of virtual surgical planning in many types of surgery for craniosynostosis This episode discusses the following PRS Global Open article: The Role of Virtual Surgical Planning in Surgery for Complex Craniosynostosis by Thomas A. Imahiyerobo, Alyssa B. Valenti, Sergio Guadix, Myles LaValley, Paul A. Asadourian, Michelle Buontempo, Mark Souweidane and Caitlin Hoffman. Read the article for free on PRSGlobalOpen.com: https://bit.ly/TheRoleofVRPlanning Dr. Thomas Imahiyerobo is the Director of Cleft and Craniofacial Surgery as well as being Section Chief of Pediatric Plastic Surgery at Columbia University in New York. Your host, Dr. Damian Marucci, is a board-certified plastic surgeon and Associate Professor of Surgery at the University of Sydney in Australia. #PRSGlobalOpen #KeynotesPodcast #PlasticSurgery

In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ramsey Al-Hakim about the inception and journey of Auxetics, a med-tech company innovating in the vein stent market. Dr. Al-Hakim is the co-founder of Auxetics and the Section Chief of the Division of Interventional Radiology at Scripps Hospital in San Diego, CA. Dr. Al-Hakim covers the initial challenges of understanding the market and securing capital, the clinical significance of addressing stent-adjacent stenosis, and the process of developing a stent with a negative Poisson effect to counteract it. Dr. Al-Hakim highlights Auxetics' approach to combining cutting-edge interventional technologies with world-class imaging tools for enhanced procedural efficiency in venous interventions. The company's progress through benchtop work, animal testing, and plans for first-in-human studies outside the U.S., aiming for commercialization within the next four to five years, is also outlined. Contributions from key figures in the vascular community and the role of mentorship and perseverance in navigating the complexities of medical device innovation are discussed as well. --- CHECK OUT OUR SPONSORS Varian, a Siemens Healthineers company https://www.siemens-healthineers.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:11 - The Market and Problem Solving 12:13 - Journey of Creating a Stent 22:28 - Birth of Auxetics 26:53 - Learning Process and Support from the University 29:16 - Building the Dream Team 33:01 - Starting a Company 36:42 - Challenges and Triumphs of Fundraising 37:44 - Current Status and Future Plans 45:32 - Importance of Community and Mentorship --- RESOURCES Auxetics: https://www.auxeticsinc.com In-stent restenosis and stent compression following stenting for chronic iliofemoral venous obstruction: https://pubmed.ncbi.nlm.nih.gov/34174500/ Venous Stenosis Animal Model Utilizing Endovenous Radiofrequency Ablation: https://pubmed.ncbi.nlm.nih.gov/30717966/ The Messy Middle: Finding Your Way Through the Hardest and Most Crucial Part of Any Bold Venture: https://www.amazon.com/Messy-Middle-Finding-Through-Hardest/dp/0735218072

In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. Ramsey Al-Hakim about the inception and journey of Auxetics, a med-tech company innovating in the vein stent market. Dr. Al-Hakim is the co-founder of Auxetics and the Section Chief of the Division of Interventional Radiology at Scripps Hospital in San Diego, CA. Dr. Al-Hakim covers the initial challenges of understanding the market and securing capital, the clinical significance of addressing stent-adjacent stenosis, and the process of developing a stent with a negative Poisson effect to counteract it. Dr. Al-Hakim highlights Auxetics' approach to combining cutting-edge interventional technologies with world-class imaging tools for enhanced procedural efficiency in venous interventions. The company's progress through benchtop work, animal testing, and plans for first-in-human studies outside the U.S., aiming for commercialization within the next four to five years, is also outlined. Contributions from key figures in the vascular community and the role of mentorship and perseverance in navigating the complexities of medical device innovation are discussed as well. --- CHECK OUT OUR SPONSORS Varian, a Siemens Healthineers company https://www.siemens-healthineers.com/ Reflow Medical https://www.reflowmedical.com/ --- SHOW NOTES 00:00 - Introduction 03:11 - The Market and Problem Solving 12:13 - Journey of Creating a Stent 22:28 - Birth of Auxetics 26:53 - Learning Process and Support from the University 29:16 - Building the Dream Team 33:01 - Starting a Company 36:42 - Challenges and Triumphs of Fundraising 37:44 - Current Status and Future Plans 45:32 - Importance of Community and Mentorship --- RESOURCES Auxetics: https://www.auxeticsinc.com In-stent restenosis and stent compression following stenting for chronic iliofemoral venous obstruction: https://pubmed.ncbi.nlm.nih.gov/34174500/ Venous Stenosis Animal Model Utilizing Endovenous Radiofrequency Ablation: https://pubmed.ncbi.nlm.nih.gov/30717966/ The Messy Middle: Finding Your Way Through the Hardest and Most Crucial Part of Any Bold Venture: https://www.amazon.com/Messy-Middle-Finding-Through-Hardest/dp/0735218072

What does it mean to “have your affairs in order”? Usually, this concept comes up after someone has died or diagnosed with a serious illness. “Did they/do they have their affairs in order?”  What "affairs" are they referring to? Financial allocations? Healthcare power of attorney? Living will? The “legacy contact” for your iPhone?? It's human to want to put off these decisions/plans since it forces us to confront our own mortality. It's not uncommon to have the occasional existential crisis, and certainly those feelings are less than pleasant... How can we make these things less scary and daunting? What if you had a “doctor friend” to help explain end-of-life planning? Do you think you'd be willing to take action if you understood your options better? Well, in today's episode, we did just that! We have a wonderful expert in the field of Palliative Care to help us understand how to navigate end-of-life care, both for ourselves and for the loved ones in our lives. Welcome, Matthew Tyler, MD! Dr. Tyler was a fellowship-trained in Hospice and Palliative Medicine at Northwestern University. He is the Section Chief of Hospice and Palliative care at Ascension Healthcare. He has been providing care for patients in their homes, in the clinic, and in the hospital for over a decade.  He also has a BIG social media presence, with the Instagram and YouTube handle of “How To Train Your Doctor”, where he provides meaningful, kind, information regarding palliative care, hospice, and general end-of-life questions for everyone. His website, howtotrainyourdoctor.com, provides support and resources for navigating serious illness, and is totally free, and so incredibly helpful! Topics covered in today's episode include: What is "hospice"? How is it different than "palliative care"? How does someone qualify for hospice care? Is it covered by insurance? Where is hospice care provided? In a hospital? Nursing home? At home? What is a "healthcare power of attorney"? What is a "living will"? How can you create one? Does "advance directive" mean the same thing? What does "DNR" mean? Are there other options other than "do everything" and "DNR"? What is "respite care"? Dr. Tyler recommends the following resources: PREPARE for your care- a free online resources to navigate end-of-life care. Five Wishes- tools to guide decision-making for end-of-life care options. The Medicare website "find hospice providers near me". Thanks for tuning in, folks! and please sign up for our "PULSE CHECK" monthly newsletter! Signup is easy, right on our website page, and we PROMISE we will not spam you! We just want to send you cool articles, videos and thoughts :) For more episodes, limited edition merch, or to become a Friend of Your Doctor Friends (and more), follow this link! This includes the famous "Advice from the last generation of doctors that inhaled lead" shirt :) Also, CHECK OUT AMAZING HEALTH PODCASTS on The Health Podcast Network   Find us at: Website: yourdoctorfriendspodcast.com  Email: yourdoctorfriendspodcast@gmail.com  Connect with us: @your_doctor_friends (IG) Send/DM us a voice memo/question and we might play it on the show! @yourdoctorfriendspodcast1013 (YouTube) @JeremyAllandMD (IG, FB, Twitter) @JuliaBrueneMD (IG) @HealthPodNet (IG)

Attackers lock up Azure accounts with MFA. Bank of America alerts customers to a third party data breach. Malicious cyber activity targets elections worldwide. CISA highlights a vulnerability in Roundcube Webmail. Lawmakers introduce a bipartisan bill to enhance healthcare cybersecurity. Siemens and Schneider Electric address multiple industrial vulnerabilities. Perception in tech gender parity still has a ways to go. Dave Bittner speaks with Guests Andrew Scott, Associate Director of China Operations at CISA, and Brett Leatherman, Section Chief for Cyber at the FBI, about Chinese threat actor Volt Typhoon. And the scourge of online obituary spam.  Remember to leave us a 5-star rating and review in your favorite podcast app. Miss an episode? Sign-up for our daily intelligence roundup, Daily Briefing, and you'll never miss a beat. And be sure to follow CyberWire Daily on LinkedIn. CyberWire Guest Guests Andrew Scott, Associate Director of China Operations at CISA, and Brett Leatherman, Section Chief at FBI, discussing  PRC/Volt Typhoon advisory and living off the land guidance. Read the press release on “U.S. and International Partners Publish Cybersecurity Advisory on People's Republic of China State-Sponsored Hacking of U.S. Critical Infrastructure.” Selected Reading Ongoing campaign compromises senior execs' Azure accounts, locks them using MFA (Ars Technica)  Bank of America warns customers of data breach after vendor hack (BleepingComputer) Global Malicious Activity Targeting Elections is Skyrocketing (Security Affairs) CISA Warns Of Active Attacks on Roundcube Webmail XSS Vulnerability (CISA) Bipartisan Senate Bill Requires HHS to Bolster Cyber Efforts (Gov Info Security) ICS Patch Tuesday: Siemens Addresses 270 Vulnerabilities (SecurityWeek)  Four in five men in tech say women are treated equally, as women criticise ‘invisible challenges' (Euronews) The rise of obituary spam (The Verge)  Share your feedback. We want to ensure that you are getting the most out of the podcast. Please take a few minutes to share your thoughts with us by completing our brief listener survey as we continually work to improve the show.  Want to hear your company in the show? You too can reach the most influential leaders and operators in the industry. Here's our media kit. Contact us at cyberwire@n2k.com to request more info. The CyberWire is a production of N2K Networks, your source for strategic workforce intelligence. © 2023 N2K Networks, Inc. Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Peter A. McCullough was born in Buffalo, New York, on the 29th of December 1962. During high school, he and his family moved to Wichita Falls in Texas and later settled in GrapevineHe then moved to Kansas City, Missouri, to serve as Section Chief of Cardiology of the University of Missouri-Kansas City School of Medicine, Truman Medical Centers. After his time in Missouri, Dr. McCullough returned to Michigan to serve as a Consultant Cardiologist at the Beaumont Hospital, and also as Chief, Division of Nutrition and Preventive Medicine Division of Cardiology. Dr. McCullough's book is The Courage to Face Covid-19 and The Next Wave is Brave check it out today.  In this episode, Brad and Dr. Peter McCullough discuss what happened and why in 2020. Tune into the INSIDE scoops Bombs:  Are you ready for the truth  

Enrico Novelli MD, is a classical (benign) hematologist, the Section Chief of the Benign Hematology, and an Associate Professor of Medicine at the University of Pittsburgh Medical Center. He is the Medical Director of the UPMC Adult Sickle Cell Disease Program. He obtained his medical degree from the University of Milan, Italy in 1996. He was a postdoctoral fellow at Johns Hopkins University, where he developed expertise in cellular biology and gene therapy. Subsequently, he pursued his residency and fellowship at UPMC, where he joined as faculty after graduating. He has numerous publications about vascular dysfunction in sickle cell disease and serves as a scientific reviewer for many journals, the National Institutes of Health and the American Heart Association. “It's an important component of mentoring; things you may not necessarily teach formally but that you can communicate through nonverbal behavior.” Illustrating the importance of learning “beyond our horizons” through mentors who showed him lessons outside of the classroom, Dr. Enrico Novelli joins us in another episode of The Medicine Mentors. Tune in as we learn about his journey from Italy to the States and how he continues to lead by showing “optimism, excitement, and faith” in every mentoring opportunity. Pearls of Wisdom:   1. It's easy to feel stuck in a situation but with new experiences come new perspectives, be sure to broaden your horizons and seek new challenges on your journey.  2. A good mentoring relationship requires a fine balance of two energies. A mentor should inspire passion and curiosity while remaining on the sidelines, and a mentee must be receptive to feedback and be coachable in order to grow. 3. It's important to ask yourself sooner rather than later what your long-term career goals are. Finding a niche can require some experimentation, especially in academia. No matter the direction, success requires a plan. 

T. Markus Funk, a Partner at Perkins Coie in Denver, Colorado, was a Section Chief with the U.S. State Department in the Balkans, following the war in Kosovo, where he represented the United States in diplomatic negotiations and participated in the restructuring of Kosovo's post-war justice system.  Markus graduated from Northwestern School of Law, and later received a doctorate in law from the University of Oxford, where he taught as a law professor.  Markus was also a federal prosecutor in Chicago, where he prosecuted members of the Chicago mafia, most notably in a case called Operation Family Secrets, the subject of our discussion today. 

Years of Service: 1994-PresentJohn began his career in law enforcement in 1994 as an Import Specialist. In 1997, John became a Special Agent with the U.S. Customs Service where he was stationed in Seattle, Washington, and New York City. During his time in New York, HSI, or Homeland Security Investigations was created and John soon had a new agency to work for. John spent time in Bogota Colombia as the Assistant Attaché and began rising through the ranks of HSI. John was stationed in Washington DC as a Section Chief, as well as an Assistant Special Agent in Charge and Deputy Special Agent in Charge in Miami, Florida. In 2020, John was promoted to Special Agent in Charge in Honolulu, Hawaii where he is in charge of the State of Hawaii, four U.S. Territories, three Freely Associated States, and 12 Pacific Island nations. During his career, John has worked on cases involving narcotics, money laundering, and terrorism including an investigation with direct ties to Osama Bin Laden.

The Sahm Rule is an indicator that detects recessions in real-time based on changes in the unemployment rate. This rule was proposed by Claudia Sahm, a former Federal Reserve economist and a leading expert on macroeconomic policy.Today, we learn about the Sahm Rule and more!In this episode, Ryan Detrick & Sonu Varghese speak with Claudia Sahm, Independent Macroeconomist Consultant, about the Sahm Rule, unemployment, and the current economic landscape. They explore the Sahm Rule as an indicator of recessions, the impact of COVID-19 on the economy, and insights from Claudia's time at the Federal Reserve.They discuss: The origin of the Sahm Rule and its purpose as an indicator of recession based on the national unemployment rateThe mismatch between the supply of workers and the demand for jobsThe importance of shelter inflation in the Consumer Price Index The current situation of low unemployment and strong wage growthInsights on the Federal Reserve's hiking and cutting policiesThe potential impact of recent productivity growth on long-term investmentsThe biggest macroeconomic surprise for 2024The poor sentiment despite the economy performing wellAnd more!Resources:Any questions about the show? Send it to us! We'd love to hear from you! factsvsfeelings@carsongroup.com Connect with Claudia Sahm: LinkedIn: Claudia SahmTwitter (X): @Claudia_SahmSubstack: Claudia SahmConnect with Ryan Detrick: LinkedIn: Ryan DetrickConnect with Sonu Varghese: LinkedIn: Sonu VargheseAbout our guest:Claudia Sahm is an economist, formerly director of macroeconomic policy at the Washington Center for Equitable Growth, and a Section Chief at the Board of Governors of the Federal Reserve System. She is best known for the development of the Sahm Rule, a Federal Reserve Economic Data indicator for identifying recessions.

Brent Yonk is an Assistant Section Chief for the FBI Counterterrorism Division's Technology and Data Innovation Section. In this role, he oversees a large technical and analytical workforce and a contract portfolio of over $120M with the responsibility for the development of novel technology solutions supporting international and domestic terrorism investigations and other critical incidents around the world. Prior to his current role, Brent served as the FBI's In-Q-Tel Interface Center Director leading the Bureau's commercial scouting, testing and evaluation of emerging technologies. He also previously served as the Program Manager for Enterprise IT Infrastructure Modernization helping to set the strategic direction for building a robust, adaptable, and resilient technology backbone. This led to the investment of over $250M in upgrades and improvements across the FBI's IT footprint. Brent also serves as an Adjunct Faculty for the FBI Academy instructing and facilitating courses in leadership, organizational change, and project management. He is also a certified emotional intelligence coach who specializes in helping his clients strengthen their self-awareness and interpersonal abilities to increase resiliency, enhance leadership, and improve performance. Prior to joining the FBI, Brent spent nearly 10 years working in the private sector with several Fortune 500 companies in the areas of organizational change management and workforce development. He currently resides in Huntsville, AL with his wife and two daughters. Host/Interviewer: M. Troy Bye, Owner, Our Town Podcast Website: https://ourtownpodcast.net Spotify Channel: https://spoti.fi/3QtpT8z Audio available on all platforms - just search for "Our Town Podcast" Follow us on social media: LinkedIn: http://bit.ly/41rlgTt Facebook: https://bit.ly/ourtownpodcast Instagram: https://www.instagram.com/ourtownpodcast/Clip from upcoming episode Episode Timeline: 00:00 Start 01:15 Branding 03:08 Special Agent Requirements 08:05 AFROTECH 2023 13:00 Executive Order on AI 15:30 Transparency 19:25 Headhunter 22:12 Bureau PR 26:30 Interviewing 28:06 New HQ 35:11 HSV Not an Option 39:22 Staff Rotation Assignments 41:07 Pro Competency 47:22 Performance 51:00 Purpose 58:26 Empowerment 58:15 Building a Team --- Support this podcast: https://podcasters.spotify.com/pod/show/m-troy-bye/support

Brent Yonk is an Assistant Section Chief for the FBI Counterterrorism Division's Technology and Data Innovation Section. In this role, he oversees a large technical and analytical workforce and a contract portfolio of over $120M with the responsibility for the development of novel technology solutions supporting international and domestic terrorism investigations and other critical incidents around the world. Prior to his current role, Brent served as the FBI's In-Q-Tel Interface Center Director leading the Bureau's commercial scouting, testing and evaluation of emerging technologies. He also previously served as the Program Manager for Enterprise IT Infrastructure Modernization helping to set the strategic direction for building a robust, adaptable, and resilient technology backbone. This led to the investment of over $250M in upgrades and improvements across the FBI's IT footprint. Brent also serves as an Adjunct Faculty for the FBI Academy instructing and facilitating courses in leadership, organizational change, and project management. He is also a certified emotional intelligence coach who specializes in helping his clients strengthen their self-awareness and interpersonal abilities to increase resiliency, enhance leadership, and improve performance. Prior to joining the FBI, Brent spent nearly 10 years working in the private sector with several Fortune 500 companies in the areas of organizational change management and workforce development. He currently resides in Huntsville, AL with his wife and two daughters. Host/Interviewer: M. Troy Bye, Owner, Our Town Podcast Website: https://ourtownpodcast.net Spotify Channel: https://spoti.fi/3QtpT8z Audio available on all platforms - just search for "Our Town Podcast" Follow us on social media: LinkedIn: http://bit.ly/41rlgTt Facebook: https://bit.ly/ourtownpodcast Instagram: https://www.instagram.com/ourtownpodcast/Clip from upcoming episode #shorts Episode Timeline: 00:00 Start 00:10 Swimming Career 03:45 Cache Valley 06:37 Brent Yonk Signature 09:13 Composer/Integrator 13:27 FBI Fit 15:20 Career Progression 22:20 Grind/Part-Time Job 29:13 D.C. 35:50 6 Questions 44:30 HSV Favorites 47:50 Shoutouts --- Support this podcast: https://podcasters.spotify.com/pod/show/m-troy-bye/support

This episode features Dr. Daniel Laurie, Section Chief of Pulmonary Medicine at St Barnabas Hospital. Here, he discusses his background and key insights into the treatments and causes of COPD, asthma, lung cancer, & allergies. *The opinions expressed within this podcast are solely Dr. Laurie's and do not reflect the opinions and beliefs of any institution.*

On the CBS News Weekend Roundup with Stacy Lyn, Holly Williams reports from Tel Aviv on the turmoil in Israel and Gaza. And who will be the next Speaker of the House? Our Nikole Killion reports. It's Breast Cancer Awareness month. In the Kaleidoscope, we learn about the disparities between black and white women when it comes to this disease. We with Dr. Vivian Bea, the Section Chief of Breast Surgical Oncology at NewYork- Presbyterian Brooklyn Methodist Hospital and a breast surgeon at Weill Cornell Medicine.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

JCDC Partnerships International, which sits within CISA's cybersecurity division, works with 150 partners worldwide with the goal of sharing and exchanging critical information allowing the U.S. to respond to cyber threats faster, protect the country's critical infrastructure more effectively and relay that information to its international counterparts to do the same. Patricia Soler, Section Chief for JCDC Partnerships International at CISA, discusses the mechanisms that a fast-growing organization like CISA needs to have in place to process large volumes of information that can be shared with public and private sectors and its international partners. She also talks about CISA's ransomware notifications that alert organizations of a ransomware attack before the damage occurs.

Dr. Sameer Vohra, Director of the Illinois Department of Public Health, details the state's back-to-school vaccination campaign; Terry Tincher, Section Chief for the CDC's Chemical Demilitarization Program, marks a big milestone for the program; and American Indian and Alaska Native communities are at higher risk of COVID-19 complications. Illinois Department of Public Health News Release: IDPH Unveils "Don't Wait, Get Your Kids Up-To-Date" Campaign to Remind Parents of Back-To-School Vaccinations Chemical Weapons Convention Webpage Public Health Review Podcast Episode: Bridging the Gap: Ensuring Vaccine Equity for Native Communities

In this episode of the Brawn Body Podcast, Dan is joined by Dr. Gabriel Petruccelli from Greater Washington Orthopaedic Group to discuss rotator cuff injuries, surgical considerations, reverse total shoulder, & more! Gabriel L. Petruccelli is an accomplished board-certified orthopaedic surgeon specializing in arthroscopy, sports medicine, shoulder replacements and general orthopaedics. Dr. Petruccelli joined Greater Washington Orthopaedic Group, PA in 2012, with three locations: Rockville, Silver Spring and  GermanTown, Maryland. Dr. Petruccelli is a Maryland native, who graduated from The Heights School in Potomac, where he played basketball and soccer. Dr. Petruccelli graduated from the George Washington University with a Bachelor of Science degree in Exercise Science before receiving a certificate in Physiology at the Virginia Commonwealth University. He completed his medical degree from Ross University School of Medicine in Barbados in 2006 before relocating to New York City to complete his Internship and Orthopaedic residency at New York Medical College-St. Vincent's Catholic Medical Center/ Kingsbrook Jewish Medical Center in 2011. In 2012, Dr. Petruccelli relocated to the west coast to complete his fellowship with the San Diego Arthroscopy and Sports Medicine Fellowship. There he honed and specialized his skills within the field of sports medicine and open shoulder surgery.  Also, during his time there, he worked closely with Major League Baseball's San Diego Padres. He also assisted the team physician for the San Diego State Aztecs. Given the opportunity to research, he published surgical technique videos for national orthopaedic society meetings that year. Dr. Petruccelli has received the Top Doctors Washingtonian Magazine Award in 2017, 2018 & 2019. Since 2016, he has been the Section Chief of the Department of Orthopaedics at Adventist Healthcare Shady Grove Medical Center. Dr. Petruccelli supports the athletic programs as the team physician at Georgetown Preparatory School and supporting his high school alma mater, The Heights School. He also gives valuable educational talks throughout the community. Dr. Petruccelli's main focus is to help each individual get back to their normal daily life and activities as soon as possible with top quality and very personalized orthopaedic care. He takes great pride in listening to his patients and understanding their needs. He works closely with his carefully selected physical therapists to ensure a safe and quick rehabilitation protocol and recovery. Outside of the medical office, Dr. Petruccelli values spending time with his wife and children. He also enjoys, exercise, music, travel and cutting hair. For more on Dr. Petruccelli, be sure to check out @dr.petruccelli on Instagram or click here: https://www.gwog.com/provider/gabriel-l-petruccelli-md-faaos Episode Sponsors: MoboBoard: BRAWNBODY10 saves 10% at checkout! AliRx: DBraunRx = 20% off at checkout! https://alirx.health/ MedBridge: https://www.medbridgeeducation.com/brawn-body-training or Coupon Code "BRAWN" for 40% off your annual subscription! CTM Band: https://ctm.band/collections/ctm-band coupon code "BRAWN10" = 10% off! PurMotion: "brawn" = 10% off!! TRX: trxtraining.com coupon code "TRX20BRAWN" = 20% off GOT ROM: https://www.gotrom.com/a/3083/5X9xTi8k Red Light Therapy through Hooga Health: hoogahealth.com coupon code "brawn" = 12% off Ice shaker affiliate link: https://www.iceshaker.com?sca_ref=1520881.zOJLysQzKe Training Mask: "BRAWN" = 20% off at checkout https://www.trainingmask.com?sca_ref=2486863.iestbx9x1n Make sure you SHARE this episode with a friend who could benefit from the information we shared! Check out everything Dan is up to, including blog posts, fitness programs, and more by clicking here: https://linktr.ee/brawnbodytraining Liked this episode? Leave a 5-star review on your favorite podcast platform --- Send in a voice message: https://podcasters.spotify.com/pod/show/daniel-braun/message Support this podcast: https://podcasters.spotify.com/pod/show/daniel-braun/support

Dr. Tracy Hull is the Section Chief of Inflammatory Bowel Disease in the Department of Colorectal Surgery at Cleveland Clinic. Dr. Hull also holds the Thomas and Sandra Sullivan Family Endowed Chair in Inflammatory Bowel Disease. She joins this episode of the Butts and Guts podcast to share updates in inflammatory bowel disease (IBD) treatment and what you need to know about the disease.

Healthcare leaders from Geisinger, Intermountain Health, UNC Health and TytoCare join Eric to discuss how AI and machine learning transform the member journey and empower members to take a more active role in their health. Our experts share successful strategies and best practices your healthcare organization can implement to change the member experience.    Hear the following case studies and learn how: Intermountain Health physicians use AI to diagnose pneumonia Geisinger leverages AI and machine learning to identify patients at higher risk for colon cancer to ensure they go for a colonoscopy UNC Health determines which patients are best suited for home health care vs. the hospital with AI and machine learning TytoCare drives better patient adoption of virtual care technologies with AI   Panelists:  Nathan Dean, MD, Section Chief of Pulmonary and Critical Care Medicine, Intermountain Medical Center Rachini Moosavi, Chief Analytics Officer, UNC Health Karen M. Murphy, PhD, RN, EVP/Chief Innovation and Digital Transformation Officer, Geisinger Ohad Pollak, Chief Marketing Officer, TytoCare Bios: https://www.brightspotsinhealthcare.com/events/how-ai-is-changing-patient-engagement   This episode is sponsored by TytoCare TytoCare is a virtual healthcare company that enables leading health plans and providers to deliver remote healthcare to the whole family through its Home Smart Clinic. Combining a cutting-edge, easy-to-use, FDA-cleared device with AI-powered guidance and diagnostic support, the Home Smart Clinic enables the whole family to conduct remote physical exams with a doctor, replicating in-clinic exams for immediate answers from home. TytoCare drives utilization rates that are five times higher than traditional telehealth services; reduces the total cost of care by an average of five percent; diverts ED visits by an average of 10.8%; and has a high average NPS of 83. The Home Smart Clinic includes Tyto Engagement Labs™, a proven framework of engagement journeys designed for successfully deploying and adopting the solution. To complete its offering, TytoCare also provides the Pro Smart Clinic, for professional settings outside the home to serve rural clinics, schools, workplaces, and more. TytoCare serves over 220 major health systems and health plans in the U.S., Europe, Asia, Latin America, and the Middle East. For more information, visit us at tytocare.com.

This episode was recorded in front of a live audience on July 19th, 2023, at the Adloscent Health Conference in Phoenix, Arizona. My guests are Veenod Chulani, Section Chief of Adolescent Medicine at Phoenix Children's Hospital, and Beheir Thompson, Adolescent Health Program Coordinator for Affirm. Along with their colleagues, Vinny and Beheir are working to bring professionals together to advance health equity for youth. Their insights on what adolescent-centered care entails, why it is important, and what steps you can take to become more effective when working with youth are addressed. More information about Vinny, Beheir, and the Arizona Alliance for Adolescent Health is talkingaboutkids.com.

Abxs, vasopressors, pharmaceuticals, chemotherapy all save the physical lives of cancer patientsBut what about their quality of lifeTheir sleepTheir painTheir nauseaHow can we support their suffering? Dr karen Moody is the Director of Pediatric Palliative and Supportive Care and Section Chief of Pediatric Palliative, Rehabilitative, and Integrative Medicine at a prominent children's cancer hospital..  She uses different modalities like acupuncture and reiki to help alleviate pain in her patients.

In this episode the Endocrine Surgery team at BTK goes over two cases to review the American Association of Endocrine Surgeons Guidelines for Adrenalectomy.  Dr. Michael Yeh is a Professor of Surgery at UCLA and serves as Section Chief of the UCLA Endocrine Surgery program which he established.  Dr. Masha Livhits is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department Dr. James Wu is an Assistant Professor of Surgery at UCLA and works in the Endocrine Surgery Department  Dr. Na Eun Kim is an Endocrine Surgery Fellow at UCLA in his first year of fellowship Dr. Rivfka Shenoy is a PGY-5 General Surgery Resident at UCLA who has completed two years of research  Dr. Max Schumm is a PGY-5 General Surgery Resident at UCLA who has completed two years of research. He is a future endocrine surgeon.  Important Papers  Yip L, Duh QY, Wachtel H, Jimenez C, Sturgeon C, Lee C, Velázquez-Fernández D, Berber E, Hammer GD, Bancos I, Lee JA, Marko J, Morris-Wiseman LF, Hughes MS, Livhits MJ, Han MA, Smith PW, Wilhelm S, Asa SL, Fahey TJ 3rd, McKenzie TJ, Strong VE, Perrier ND. American Association of Endocrine Surgeons Guidelines for Adrenalectomy: Executive Summary. JAMA Surg. 2022 Oct 1;157(10):870-877. doi: 10.1001/jamasurg.2022.3544. PMID: 35976622; PMCID: PMC9386598. Schumm M, Hu MY, Sant V, Kim J, Tseng CH, Sanz J, Raman S, Yu R, Livhits M. Automated extraction of incidental adrenal nodules from electronic health records. Surgery. 2023 Jan;173(1):52-58. doi: 10.1016/j.surg.2022.07.028. Epub 2022 Oct 4. PMID: 36207197. M. Conall Dennedy, Anand K. Annamalai, Olivia Prankerd-Smith, Natalie Freeman, Kuhan Vengopal, Johann Graggaber, Olympia Koulouri, Andrew S. Powlson, Ashley Shaw, David J. Halsall, Mark Gurnell, Low DHEAS: A Sensitive and Specific Test for the Detection of Subclinical Hypercortisolism in Adrenal Incidentalomas, The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 3, 1 March 2017, Pages 786–792, https://doi.org/10.1210/jc.2016-2718 Amar, L., Pacak, K., Steichen, O. et al. International consensus on initial screening and follow-up of asymptomatic SDHx mutation carriers. Nat Rev Endocrinol 17, 435–444 (2021). https://doi.org/10.1038/s41574-021-00492-3 **Fellowship application link: https://forms.gle/PiKM2MMQpE5jSAeW7 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.   If you liked this episode, check out other endocrine episodes here: https://behindtheknife.org/podcast-category/endocrine/