Podcast appearances and mentions of Stephen Harrison

In this episode of Talking History:The social history of death and dying, with historian and bereavement counsellor Molly ConisbeeVietdamned: How the World's Greatest Minds Put America on Trial, with historian Clive WebbAnd Alexander The Great: Lives and Legacies, with Stephen Harrison of Swansea University.

In this gripping episode, we hear a detailed account from an eyewitness right at the heart of the tense NATO and Russian confrontation in Kosovo in 1999 at Pristina Airport. NATO General Wesley Clark had ordered the British to use force to remove Russian forces, however British General Mike Jackson refused with the immortal words “Sir, I'm not going to start World War Three for you”. Former BRIXMIS officer Stephen Harrison was a British Army liaison officer to the Russians and the translator at the complex and fraught negotiations at the airport. He provides a blow-by-blow account from the detailed notes he took at the time. Further info and videos https://coldwarconversations.com/episode402/ Stephen's previous episodes: Arrested 11 times, plus 3 shooting incidents - a BRIXMIS officer's diary Pt 1 https://pod.fo/e/13af96 Imprisoned in a Soviet Military gaol - a BRIXMIS officer's diary Pt 2 https://pod.fo/e/13ca90 The fight to preserve Cold War history continues and via a simple monthly donation, you will give me the ammunition to continue to preserve Cold War history. You'll become part of our community, get ad-free episodes, and get a sought-after CWC coaster as a thank you and you'll bask in the warm glow of knowing you are helping to preserve Cold War history. Just go to ⁠https://coldwarconversations.com/donate/⁠ If a monthly contribution is not your cup of tea, we welcome one-off donations via the same link. Find the ideal gift for the Cold War enthusiast in your life! Just go to ⁠https://coldwarconversations.com/store/⁠ Follow us on BlueSky ⁠https://bsky.app/profile/coldwarpod.bsky.social⁠ Follow us on Threads ⁠https://www.threads.net/@coldwarconversations⁠ Follow us on Twitter ⁠https://twitter.com/ColdWarPod⁠ Facebook ⁠https://www.facebook.com/groups/coldwarpod/⁠ Instagram ⁠https://www.instagram.com/coldwarconversations/⁠ Youtube ⁠https://youtube.com/@ColdWarConversations⁠ Love history? Join Intohistory ⁠https://intohistory.com/coldwarpod Learn more about your ad choices. Visit podcastchoices.com/adchoices

00:00:00 Surf's Up, Season 6, Episode 6.On April 23, 2024, our colleague and co-founder, Stephen Harrison, passed away suddenly. This week, Surfing the MASH Tsunami remembers Stephen with two of his closest associates and continues our annual MASH Drug Development roundtable held in his honor. 00:00:04:24 - A Deep Dive into Drug Development, Part 2The second portion of the Drug Development roundtable primarily focuses on three key issues. The first, uptake of resmetirom, starts with Naim Alkhouri discussing his experience in the Arizona Liver Health Clinics with over 650 patients in the year since resmetirom was approved and shifts to the various European panelists (Jörn Schattenberg, Louise Campbell and Sven Francque) estimating when it might be approved in their countries and how widely it might be reimbursed.  The second topic, incretin agonists, focuses on exciting prospects for other incretin agonists in development, as well as some semaglutide combination therapies. The third, NIT clinical trials, covers prospects that non-biopsy clinical trials might be approved sometime in the near future.00:16:20 - Remembering Stephen Harrison I: An Interview with Summit Clinical Research CEO Gail HinksonSummit CEO Gail Hinkson joins Roger Green for the first time on SurfingMASH to discuss her business partner. Gail discusses how the two originally formed Pinnacle Clinical Research and how Pinnacle led to Summit. She proceeds to discuss the current size and reach of both Pinnacle and Summit. Focusing on Summit, Gail describes the company as an Integrated Research Organization (IRO), highlighting its distinct role within the MASH firmament. In the final section of the interview, Gail discusses how Stephen's personality, goals, and vision continue to live on at Summit today.00:34:31 - Remembering Stephen Harrison II: An Interview with Naim Alkhouri Announcing That He Is Joining SummitNewly announced Summit Chief Academic Officer Naim Alkhouri joins this episode for a second time, but in a very different role. Naim discusses his personal history with Stephen and what he loved and respected about his "dear friend." He then makes a major announcement: he is joining Summit as Chief Academic Officer. He shares the many elements of this role, particularly his excitement that Summit can become the entity that educates a wide range of healthcare and commercial professionals on what MASH is and how it is treated. The scope of this vision, combined with what Gail discussed, portrays a level of energy, ambition and vision worthy of Stephen Harrison.00:55:55 - ConclusionAs part of this memorial week, Roger Green forgoes the usual business report, which will return next week.

This conversation is the opening segment of SurfingMASH's April discussion, in memory of Stephen A. Harrison, on drug development. In addition to co-hosts Jörn Schattenberg, Louise Campbell and Roger Green, panelists include hepatologists and key opinion leaders Sven Francque and Naim Alkhouri. This opening discussion focuses on exciting advances in one drug class (FGF-21s) and, more broadly, on exploring ways to treat cirrhosis. As Naim points out in his opening comment, these two issues— cirrhosis as a challenge and FGF-21s as a possible solution path —intersect in clear and exciting ways. He notes that the FGF-21 efruxifermin has been reported to have significant improvement in patients with cirrhosis, while the FGF-21 pegozafermin has shared positive results in a small cohort of patients. He also notes that a third FGF-21, efimosfermin alfa, has results in advanced non-cirrhotic MASH that suggest potential for similar efficacy in patients with cirrhosis, but this must be studied and confirmed in clinical trials. He mentions that resmetirom may also be showing signs of efficacy in some patients with cirrhosis. The entire package, he says, is a "game changer."Jörn notes that we are having parallel advances in treatment for advanced, non-cirrhotic patients. Sven concurs and comments that we are seeing effects that are not strictly related to metabolic disease. There is exceptional power that we can demonstrate one-level regression in sicker patients. The three agree that, at the same time, we are seeing cirrhosis trials that will lead to outcomes data; outcomes trials in non-cirrhotic medications may not be far away.Roger asks whether we are making progress in treating patients living with decompensated cirrhosis. Sven discusses what we are learning about treating portal hypertension, which is an important benefit unrelated to fibrosis regression. Simply improving portal hypertension will have an impact on endpoints. Naim points out that some ongoing trials include patients with cirrhosis, including survodutide and belapectin. Louise notes it will require "great P.R." to reverse some of the current perceptions about cirrhosis, but that this is "great." Naim states that even today, we have "a lot to offer" patients with portal hypertension or other symptoms of decompensation. As he concludes, he notes that this is underappreciated today. 

00:00:00 - Surf's Up: Season 6 Episode 5Host Roger Green briefly describes this episode's three sections and introduces Roundtable guests. The Roundtable panel shares groundbreakers. 00:10:39 - Roundtable: A Deep Dive Into Drug Development, Part OneThe opening portion of this month's roundtable centers around two issues: exciting data for FGF-21s and, more generally, treating patients with cirrhosis. Naim Alkhouri sets the tone in his opening comments, which start by focusing on the exciting SYMMETRY data from efruxifermin and then hones in on FGF-21s and resmetirom in cirrhosis. The rest of the conversation features Jörh Schattenberg, Sven Francque and Naim discussing therapies in development for compensated and decompensating cirrhosis.00;24:44 - Newsmaker: Naga Chalasani on Real-World Experience Prescribing ResmetiromNaga joins Roger to discuss the paper Early Experience with resmetirom to treat Metabolic Dysfunction-Associated Steatohepatitis With Fibrosis in a Real-World Setting from his group at Indiana University, which his group authored and Hepatology Communications recently posted. The paper, based on IU Health's experience with its first 113 resmetirom patients, shares the group's practical experience developing processes to work closely with the specialty pharmacies dispensing resmetirom and, finally, concludes that a more engaged patient management strategy might reduce drug discontinuation to a level comparable with clinical trials.  00:47:21 - Expert: Scott Friedman on Gene Therapy, Diversity of Stellate Cell Types, Other Basic Liver ScienceScott and Roger cover a range of basis science topics in a fast-moving 19-minute discussion. It starts with Scott discussing the increasing acceptance that gene therapy is an acceptable way to treat a range of liver diseases, many of which are orphan or ultra-orphan but, in fact, include potential gene therapies for non-cirrhotic MASH and MASH cirrhosis. He notes that in addition to classic gene therapy, which introduces protective gene variants into the systems of patients with the risky variants, gene therapy is now looking to introduce FGF-21 into patients through genetic modification. From there, the conversation covers CAR-T therapy, the increasing ability to identify many different types of stellate cells and the idea that the most effective therapy for eary fibrosis, advanced fibrosis and cirrhosis might require fundamentally different kinds of interventions. The two final elements are the idea that what we now call "MASH" may be several diseases with different etiologies with similar manifestations and a passionate call for all of us to support maintaining NIH funding in whatever ways we can.01:06:45 - Business ReportAs Roger copes with his laryngitis, AI voices deliver an abbreviated business report 

Mike talks with Stephen Harrison about why authoritarian governments hate Wikipedia and Georgia talks with Kyle Chayka about how to have fun on the internet. Also: Kidpix!–Become a Never Post member at https://www.neverpo.st/ for access to extended and bonus segments, and our side shows like “Slow Post”, “Posts from the Field” and “Never Watch”–Call us at 651 615 5007 to leave a voicemailDrop us a voice memo via airtableOr email us at theneverpost at gmail dot comSee what interstitials we need submissions for–Intro Linksubuweb.comPoetica: Three Sound Poets: Jaap Blonk, Amanda Stewart, Christian Bok (2014)), ubuweb.comSkilled technologists are being forced out of government, Don MoynihanGSA eliminates 18F, NextGovDoppelgänger: New disinformation campaigns spreading on social media through Russian networks, IntrinsecNEW REPORT: Russian propaganda may be flooding AI models, American Sunlight ProjectKevin Rose, Alexis Ohanian acquire Digg, TechCrunch–Authoritarians vs WikipediaCensorship of Wikipedia, Wikipedia.orgFind Stephen:SourcenotesStephen's novel, The EditorsStephen on Bluesky–Are We Having Fun Yet?Find Kyle: Twitter Bluesky InstagramKyle at The New YorkerTitanium Daydream (also on YouTube and Instagram) Read Kyle's book Filterworld: How Algorithms Flattened Culture–Never Post's producers are Audrey Evans, Georgia Hampton and The Mysterious Dr. Firstname Lastname. Our senior producer is Hans Buetow. Our executive producer is Jason Oberholtzer. The show's host is Mike Rugnetta.Oh! to be almost loquaciousRather than fatally overloquacity's edgeExcerpt of #36 the-faux-ailing-abacus by Wayne KoestenbuamNever Post is a production of Charts & Leisure ★ Support this podcast ★

Interview by Kris PetersHouse of Protection, the new venture from Stephen Harrison and Aric Improta, serves as a sanctuary for those who surrender to impulse. Abandoning any regard for tradition and form, they followed a feeling and unearthed a sound that sees them push their limits further than ever before. Bridging the not so disparate worlds of hardcore, electronica, and punk, the two forged a space for boundless creativity and a community fuelled by chaos.The band is a project created by formerly two-thirds of Fever 333 (Stephen & Aric), they're signed to Red Bull Records and backed & produced by legendary producer and ex-Bring Me The Horizon keyboardist Jordan Fish AND are featured on Architects upcoming album. House Of Protection are in Australia for the first time, supporting Bad Omens with Poppy across the nation, and HEAVY caught up with Stephen & Aric not long before their recent show at Brisbane's Riverstage."It's been awesome so far," Aric began. "Honestly, we didn't really know what to expect, especially walking up because Bad Omens audience looks very much like a Bad Omens audience (laughs). They are there for that band, but they have been really receptive. It's cool to be on such an eclectic tour because it doesn't feel competitive. It just feels like everybody's expressing themselves honestly, and that's always a cool situation to walk in to."In the full interview, we spoke about the tour and how it is going, the band's formation from the ashes of Fever 333, their musical direction, getting the mix of styles right in the creative process, their recent EP track by track, plans to come back to Australia and more.Become a supporter of this podcast: https://www.spreaker.com/podcast/heavy-music-interviews--2687660/support.

Send us a textWriter and tech laywer, Stephen Harrison's work has appeared in The New York Times, The Washington Post, The Atlantic, WIRED, and many others. In this episode we discuss his latest novel, creative process, AI, and much more.His latest novel, a thriller, THE EDITORS is out now. THE EDITORS takes readers behind the scenes of a fictionalized version of Wikipedia called Infopendium, where the facts seen near the top of most Google searches are the result of cooperation and curation between dozens, even hundreds of volunteer editors, but where what is written can also spark fierce battles between the editors and sway the truth for millions.Morgan Wentworth, a recently laid-off freelance reporter, stumbles into this unseen world after witnessing a cyber attack at the Global Infopendium Conference in New York. Determined to delve deeper into the world of the editors and uncover the truth about the hacker, she finds herself caught amidst the competing interests of billionaires, foreign governments, and individual editors from around the world. And with a global pandemic brewing, the importance of who controls Infopendium only increases.https://www.stephenharrison.com/ Visit the Self-Care Institute at https://www.selfcareinstitute.com/ Support the showVisit www.creativepeacemeal.com to leave a review, fan voicemail, and more!Insta @creative_peacemeal_podcastFB @creativepeacemealpodBonfire https://www.bonfire.com/store/creative-peacemeal/Redbubble CPPodcast.redbubble.comCreative Peacemeal READING list here Donate to AhHa!Broadway here! Donate Dachshund Rescue of Houston here Interested in the Self-Care Institute with Dr. Ami Kunimura? Click here Interested in Corrie Legge's content planner? Click here to order!

Rev'd Stewart Perry and Dr. Stephen Harrison

Fri, 27 Sep 2024 10:00:00 GMT http://relay.fm/paperplaces/6 http://relay.fm/paperplaces/6 Kerry Provenzano Stephen Harrison joins Kerry to discuss his career as a columnist, and the process of writing his Wikipedia-themed novel, 'The Editors'. They cover different methods of getting ready to write, including Stephen's essential 'tuning up' time. Stephen Harrison joins Kerry to discuss his career as a columnist, and the process of writing his Wikipedia-themed novel, 'The Editors'. They cover different methods of getting ready to write, including Stephen's essential 'tuning up' time. clean 2638 Stephen Harrison joins Kerry to discuss his career as a columnist, and the process of writing his Wikipedia-themed novel, 'The Editors'. They cover different methods of getting ready to write, including Stephen's essential 'tuning up' time. This episode of Paper Places is sponsored by: Hinze Pens: Custom hand made fountain pens, made using traditional methods. Use code PAPERPLACES for 15% off. Guest Starring: Stephen Harrison Links and Show Notes: Support Paper Places with a Relay FM Membership Submit Feedback Relay for St Jude - St. Jude Children's Research Hospital The Bridport Prize for Memoir Subscribe to Kerry's Substack Stephen's Slate Column Wallace Stephens (Poet) Ulysses: Writing app Obsidian: Notetaking app Save the Cat! Writes a Novel: The Last Book On Novel Writing You'll Ever Need Hemingway's advice on writing History of the New York City Subway Stephen's first piece for The New York Times Inkshares: The writing competition Stephen Harrison entered (and won!) Subscribe to Stephen's Substack, Source Notes Stephen's website

Fri, 27 Sep 2024 10:00:00 GMT http://relay.fm/paperplaces/6 http://relay.fm/paperplaces/6 Pitching to the New York Times, Writing Competitions and Tuning Up, with Stephen Harrison 6 Kerry Provenzano Stephen Harrison joins Kerry to discuss his career as a columnist, and the process of writing his Wikipedia-themed novel, 'The Editors'. They cover different methods of getting ready to write, including Stephen's essential 'tuning up' time. Stephen Harrison joins Kerry to discuss his career as a columnist, and the process of writing his Wikipedia-themed novel, 'The Editors'. They cover different methods of getting ready to write, including Stephen's essential 'tuning up' time. clean 2638 Stephen Harrison joins Kerry to discuss his career as a columnist, and the process of writing his Wikipedia-themed novel, 'The Editors'. They cover different methods of getting ready to write, including Stephen's essential 'tuning up' time. This episode of Paper Places is sponsored by: Hinze Pens: Custom hand made fountain pens, made using traditional methods. Use code PAPERPLACES for 15% off. Guest Starring: Stephen Harrison Links and Show Notes: Support Paper Places with a Relay FM Membership Submit Feedback Relay for St Jude - St. Jude Children's Research Hospital The Bridport Prize for Memoir Subscribe to Kerry's Substack Stephen's Slate Column Wallace Stephens (Poet) Ulysses: Writing app Obsidian: Notetaking app Save the Cat! Writes a Novel: The Last Book On Novel Writing You'll Ever Need Hemingway's advice on writing History of the New York City Subway Stephen's first piece for The New York Times Inkshares: The writing competition Stephen Harrison entered (and won!) Subscribe to Stephen's Substack, Source Notes Stephen's website

All links and images for this episode can be found on CISO Series. This week's episode is hosted by me, David Spark (@dspark), producer of CISO Series and Mike Johnson, CISO, Rivian. Joining us is Stephen Harrison, CISO, MGM Resorts International. In this episode: Understanding the AI attack surface Low code, low security? Chief information storytelling officer Finding the right partners Thanks to our podcast sponsor, Vectra AI! Vectra AI is the only extended detection and response (XDR) with AI-driven Attack Signal Intelligence. Vectra AI's attack signal intelligence platform uses AI to find attacks on networks, identities, clouds and GenAI tools. Learn more at vectra.ai/showme.

00:00:00 - Surf's Up: Season 5 Episode 25 On July 20, Clinical Gastroenterology and Hepatology released the paper, Expert Panel Recommendations: Practical Clinical Applications for Initiating and Monitoring Resmetirom in Patients with MASH/NASH and Moderate to non-cirrhotic Advanced Fibrosis. Corresponding author Maru Rinella joins the Surfers to share key points from the recommendations and offer her thoughts on what lay behind them.00:02:26 - Introduction and GroundbreakerThe highlight was Louise's groundbreaker: having become a full Fellow in the Roal College of Physicians.00:06:28 - Introducing the paperRoger starts by discussing the importance of this paper and listing the questions the panel will address during the episode. Maru provides a history of developing the paper. Jörn praises its timeliness. 00:08:59 - Treating the "Right" patients; Using the "Right" testsJörh asks why the authors changed the patient definition from a histological one to at-risk MASH patients confirmed by NITs. Maru said the authors sought to follow the FDA guidance on NITs and patient targets. They considered adding liver enzymes or confirmatory VCTE to the protocol, but demurred because not every clinical could execute such a recommendation. Jörn asks whether the authors considered requiring three metabolic risk factors. Roger notes that this question implies a need to prioritize patients, which is a factor in Europe but not the U.S. This paper takes a more U.S-based perspective, which is to set a threshold for use.  00:14:21 - The Decision Not to Discuss CostThe authors did not address costs because they anticipated steep reductions over time. The panel compares the MASH case to HCV. In HCV, the combination of high drug costs and large number of warehoused patients drove prioritization over time. 00:16:34 - Relative paucity of warehoused MASH patients Maru suggests relatively few MASH patients are warehoused. Louise asks whether many U.S. insurers are controlling access by requiring liver biopsy. Maru reports she has not encountered this personally and  estimates it might affect ~5% of cases so far. 00:19:05 - Rationale for Patient SelectionMaru explains the rationale for an F2 threshold for patient selection: patients with fibrosis >= F2 show a demonstrable decline in long-term survival. The rationale for excluding cirrhosis patients? Resmetirom is not yet proven to help patients with cirrhosis. Jörn notes, the MAESTRO-OUTCOMES trial is running and will generate consequential data on cirrhosis. 00:22:11 - Value of Stabilizing Disease without ImprovementMaru notes that the paper focused strongly on how to stabilize patients because the drug is safe and stabilization has real-world benefits.. She points out that patient advocates strongly recommend this focus. All this led to the paper's recommendation to discontinue only upon progression.  00:25:12 - The importance of incremental learningThe group agrees that these recommendations comprise a base that will be strengthened over time as individual providers gain experience with the drug. 00:30:06 - Wrapping upPanelists touch briefly on the value of loose discontinuation rules, how patients feel about starting therapy, how to handle drug interactions, and how the paper is used in the US vs. other countries. In closing, the group remembers Stephen Harrison's unique contributions one more time.00:37:55 - Question of the WeekWhich of the paper's two striking recommendations -- using multiple NITs to qualify patients and continuing therapy unless and until a patient shows signs of disease progression -- will have greater impact on how physicians treat patients?00:38:44 - Business ReportSummer schedules, value of the business report, the vault discussion.

This week, Surfing the MASH Tsunami looks back on interviews Roger Green conducted during the EASL Congress itself. This conversation with SurfingMASH co-host and Tawazun Health Founder and Clinical Director Louise Campbell took place on the first day of the Congress.Roger's first interview with Louise took place at the end of Thursday, the opening day of the formal Congress and the first day of research presentations and posters. She starts by describing the "really nice vibe" of the meeting, dampened by the fact that Stephen Harrison was not there, and is no longer with us.The first session Louise chose to discuss was the previous day's Patient Advocate session. To her, the key point was to learn a key question that every provider should share with every patient once a year. She mentioned briefly the one presentation from the day's General Session she was able to attend, a retrospective analysis of the predictive value of VCTE.Next, Louise discussed two sessions she attended that delivered powerful, somewhat novel messages. The first was a symposium sponsored by Novo Nordisk that looked at using the liver "to manage cardiometabolic side" through the liver "rather than focusing on liver disease." The second was the "Healthy Livers, Healthy Lives" presentation that presented "very startling figures" about healthcare costs and lack of productivity in the US and how and why India has targeted this disease aggressively. After Louise and Roger both commented on the building momentum in MASLD and mentioned why they believe this is happening, Louise noted how many conversations about AI and quicker population detection were occurring despite the lack of ability to act on these today. This let Roger recall his major takeaway from the Preview episode (S5 E17), which was the emerging importance of data development and large datasets. He mentioned a paper from the Karolinska Institute that Hannes Hagstrom discussed in that episode.

In this conversation from July 2023, Stephen Harrison, Jörn Schattenberg and Roger Green discuss the implications of presentations on the FGF-21 agent efruxifermin and the dual GLP/glucagon agonists pemvidutide and efinopegdutide. Here is the description Roger wrote for the original conversation:In this session, conversation shifts from resmetirom to Mazen Noureddin's "NASH Monopoly" game and focuses on the value of FGF-21s and glucagon agents. Stephen posits two comments about GLP-1s. First, there is now adequate data suggesting that GLP-1s will not melt away all liver fat and as a result lead to dramatic fibrosis regression. Second, we know from a small sub-cohort of patients in Akero's SYMMETRY trial that patients already on fairly low doses of GLP-1s saw what Stephen describes as an 'incredible' and incremental benefit for the FGF-21 agent, efruxifermin. The group notes that while glucagon dual and treble agents are likely to produce dramatically more robust results in weight loss and liver defatting than GLP-1s alone, they still seem unlikely to 'usurp the need for other types of agents.' From here discussion considers the FGF-21 class. Stephen notes that two drugs, efruxifermin and pegozafermin, have demonstrated significant efficacy against fibrosis. As the conversation concludes, the panelists agree that earlier, more aggressive screening to arrest cirrhosis will become pivotal and will not occur until the right drug becomes available. 

00:00:00 Surf's Up, Season 5 Episode 20Naim Alkhouri and Mazen Noureddin join co-hosts Jörn Schattenberg and Roger Green to discuss major drug development stories from the EASL Congress 2024. They pay tribute to Stephen Harrison and proceed to groundbreakers.00:08:16 - Presentations on ResmetiromMazen shares a paper he presented looking at resmetirom dose-response. The 100mg dose performed better than the 80mg dose. Jörn notes that the most important element of the study might be the demonstrated 36-month effect.  00:14:19- Implications of Different Analytical Modes Naim compares different modes of analysis. Intent to Treat, which treats all non-completers as failures, will produce lower rates of response than a "completer" or "modified Intent to Treat" analysis, which either eliminates non-completers or assigns them placebo-level response. 00:16:12 - The "Twin-Cretins"Jörn coined  the name "Twin-cretins" for agents with GLP-1 agonism plus another incretin effect. Tirzepatide is a GLP/GIP while survodutide, pemvuditide, and efinopegdutide, are GLP/glucagons. Naim reviews the tirzepatide late-breaker presentation, which showed high rates of MASH resolution, but, as a completer analysis, might not have proven whether a GLP/GIP can achieve significant fibrosis regression.  Naim notes that Stephen doubted strongly this was possible, but that bariatric surgery's effect creates a paradox. Mazen concurs, and states he is more confident in the GLP/glucagon agents. Jörn agrees. 00:23:09 - Implications of widespread GLP useRoger asks how widespread prior patient use of incretins will affect prescribing. Naim states that many of his Rezdiffra MASH patients have been on GLP-1 already.  He describes a key difference between the three GLP/glucagon agents in development. 00:24:20 - The previous GLP/glucagon studiesNaim expresses his excitement about glucagon agents in general. He mentions that the efinopegdutide study included a semaglutide cell, which showed a further reduction in liver fat compared to the GLP-1 agent. 00:26:44 - Safety of survodutide in cirrhosisJörn comments on the high level of tolerability in the survodutide trials. Mazen shares his high hopes for GLP/glucagons and the triple agents. He reviews survodutide data from the NEJM article.  00:29:41 - FGF-21s, starting with efrux data Focus shifts to FGF-21s. Mazen shares data from the efruxifermin late-breaker, a 96-week, triple biopsy study showing dramatic, sustained one- and two-level fibrosis improvement. Jörn notes the design demonstrates durability, which Roger finds particularly encouraging given the pegbelfermin experience. Naim  adds that a sustainable two-stage drop in fibrosis might position FGF-21 as induction therapy before long-term oral maintenance.   00:35:28 - Is a drug-based MASH "cure" possible? Mazen wonders whether sustained FGF-21 efficacy might return livers to their "normal" state, almost like a "cure." Jörn briefly discusses pegozafermin, and Mazen notes that a third FGF-21 is in development.   00:42:22 - Wrap-up The panel covers three other agents: the FASN inhibitor, denifenstat, Ionis's DGAT-2 antisense inhibitor, ION224, and Takeda's TAK-227, a TG2 inhibitor, plus the results of SPECIAL, a study evaluating the effect of bariatric surgery on people with cirrhosis. After these, Roger asks Mazen and Jörn what they consider likely to be the biggest story at AASLD in November.  00:53:03 - Question of the Week Given this discussion, Roger asks what are likely to be the three most prescribed medications for MASH five years from now.  00:53:36 - Business Report The next EASL Congress review episodes, how to attend recording sessions live, and a vault discussion from last year's EASL Congress wrap-up. 

00:00:00 - Surf's Up: Season 5 Episode 19During EASL Congress 2024, US-based Roger Green, conducted interviews with Mike Betel, Louise Campbell (twice) and Sven Francque from Milano. These interviews focused on the major MASLD themes and presentations at the event. 00:04:14 - Conversation with Mike Betel beginsOn Wednesday, the first afternoon of the meeting, Mike Betel joined Roger from the convention center. The first part of the conversation centered  on the Patient Advocate session that Mike chaired with Shira Zelber-Sagi. The session's goal was to discuss barriers to addressing unmet needs in a clinical setting and explore potential solutions. Mike's key takeaway: patients around the world are having challenges getting personal attention and time from their treaters. The rest of this interview touched briefly on other sessions Mike attended. 00:15:23 - First conversation with Louise Campbell Roger's first interview with Louise took place late on Thursday. She described the "really nice vibe" of the meeting, dampened by the fact that Stephen Harrison is no longer with us.The first session Louise chose to discuss was the previous day's Patient Advocate session. To her, the key point was to learn a key question that every provider should share with every patient once a year. She briefly mentioned the one presentation from the day's General Session she was able to attend:  analysis of the predictive value of VCTE.00:19:53 - Philosophically important presentationsLouise discussed two sessions that delivered powerful, somewhat novel messages. The first was a symposium sponsored by Novo Nordisk about how SLD treatment could "manage the cardiometabolic side...rather than focusing on liver disease." The second was the "Healthy Livers, Healthy Lives" presentation which presented "very startling figures" about SLD impact on US healthcare costs and productivity and how and why India has targeted this disease aggressively. 00:26:29 - Building momentum and energy around AI Louise and Roger both observed that momentum is building in MASLD and mentioned why they believe this is happening, 00:33:05 - Second conversation with Louise beginsTwo days later, Louise and Roger conducted a second conversation, which focused on her enthusiasm for the updated Clinical Practice Guidelines and their practical implications. 00:36:12 - CPG session implicationsLouise said this session had "blown her mind" with its forward-thinking style and recommendations. Her favorite point? The guidelines mentioned resmetirom even before it was approved in Europe.   00:44:07 - Thoughts about medicationsRoger suggested that CPG aligned broadly with the drug presentations in the Late Breaker and General sessions. Collectively, those highlighted drugs with an array of modes of action and strengths across the metabolic continuum.  00:46:09 - Thoughts about devicesRoger asked whether Louise believed that, over time, the diagnostic focus would shift from liver stiffness and CAP to in-office PDFF. Louise discusses why this might be difficult.00:51:48 - Conversation with Sven beginsThis conversation, which took place 90 minutes after the final gavel, started with Sven praising the "vibrant hepatology community" evident at the meeting. From there, the discussion covered the Clinical Practice Guidelines, major drug development presentations and other categories. The conversation is fairly short, but packed with information and insight. 01:06:42 - Question of the WeekRoger asks what kinds of support and education primary care will need to step into a leading role in treating SLD.01:07:13 - Business ReportPlans for the next month, growth of the SurfingMASH Community, a special surprise instead of the Vault.

In this excerpt from last July, Stephen Harrison shares results of the FASCINATE-2 study as part of SurfingMASH's larger coverage of exciting drug trials presented at The EASL Congress. The original writeup reads:This month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This is the second session focusing on drug development, and specifically, on several presentations for exciting drugs in development. In doing so, the Big Band of Surfers (Stephen Harrison, Jörn Schattenberg, Louise Campbell and Roger Green) are joined by Mazen Noureddin for a fascinating conversation which covers plenty of compelling clinical trial data.Jörn preludes this discussion by noting just how much important drug development research was released at this year's EASL Congress. Stephen proceeds from here to detail positive Phase 2b FASCINATE-2 clinical trial interim data for fatty acid synthase (FASN) inhibitor, denifanstat, as presented at EASL Congress by Rohit Loomba. In the process, Stephen elucidates why the idea of a FASN inhibitor is so exciting. It blocks de novo lipogenesis, which means it can have effects on inflammation and possibly direct fibrosis inhibition. Previously in Season 4, Episode 32, it was discussed why inflammation, which is tied to liver volume, might be a critical component to better understand for therapuetic development and the wider scope of liver health. From here, Stephen goes on to describe the trial, starting with basic design and sharing the MRI-PDFF and biomarker data that was presented at the EASL Congress. He finishes with safety and efficacy data and a general comment that the trial demonstrated, 'the drug is doing what it's intended.'

This is the second half of Roger Green's conversation with Dimitar Tonev. It focuses largely on some of the elements of Stephen's personality that made him so unique and a role model within the community. Dimitar discusses one more innovation Stephen brought to MASLD clinical trials: recruiting in neighborhoods that received lower levels of medical care and then, within those communities, recruiting within families. Roger harkens back to the recruitment issue to tell the story that Stephen and he started SurfingMASH to educate sponsors and sites about the ability to keep trials running in a site network like Summit. To Dimitar, one thing that made Stephen special was his "enormous capacity to work long hours," to the degree that left Dim "wondering how this is even humanly possible." He mentions early clinic starts, 4 a.m. text messages, and other related of-hours items. Roger shares a story he heard at the funeral about Stephen stating that he didn't sleep much but slept"very efficiently." Dimitar and Roger agree about the energy and enthusiasm Stephen devoted to everything he did. Dimitar tells a story about Stephen flying over the Atlantic with his family. You'll have to listen to learn it. He goes on to discuss Stephen's passion for working on minor diseases that were unlikely to ever pay off in terms of money or prestige and, finally, how Stephen boosted Dim's self-image by presenting a couple of Dim's slides during a presentation at a major meeting.

This conversation includes the first half of Jörn Schattenberg's and Roger Green's interview with Donna Cryer. While the question is about Stephen's most outstanding contribution to MASLD, the focus is more on his remarkable ability to trigger increased awareness of MASH in many different ways.Roger starts the conversation by asking Jörn and Donna to describe one outstanding contribution (okay, maybe two) that Stephen made to the field of MASLD. Jörn talks about Stephen's role as integrator, talking to all different kinds of players, designing trials, focusing on issues and needs of patients, regulators, investors. To Jörn, Stephen was "a lens focusing that something that was needed to spark the fire..." Picking up on this insight, Roger asks specifically about Stephen's role in the founding of NAIL-NIT (along with Mazen Noureddin). Jörn harkens back to Stephen's earlier work on the LITMUS Cohort Study and contributions to the field to describe the process that led him and Mazen to start NAIL-NIT, and notes the consortium's tremendous success to date.Continuing this theme, Donna describes Stephen's ability to bring people together and his providing "unique space for having smaller, intimate conversations: when necessary. She cites NASH-TAG, another event he co-founded, as a meeting designed specifically for this purpose and a remarkably fertile place for making progress on big issues.  Roger recalls Stephen bringing Donna to the early podcast to describe International NASH Day 2021, and goes on to comment that Stephen was the rare individual who embodied Malcolm Gladwell's three legs of the Social Virus stool: scientist, innovator and salesman. Although he doesn't say so in the interview, the implication is that Stephen's ability to play all these roles at once has sped the social awareness of MASLD and MASH and the efforts to advance solutions.Finally, Roger recalls Stephen becoming "ticked" during an early SurfingMASH episode on the FDA's first Complete Response Letter for obeticholic acid as proof of his passion for the work.

The conversation shares the first half of Roger Green's interview with Dimitar Tonev, whose tribute comment to Stephen Roger shared in a recent SurfingMASH weekly newsletter. Because this is Dimitar's first appearance on SurfingMASH, he starts by telling the audience a bit about his history, including the fact that he came to know Stephen from the viral hepatitis days. As his "one unique thing," Dimitar mentions his proficiency as a skier, which leads Roger to ask about his description of Stephen in the SurfingMASH note as a "clumsy skier." Dim states that Stephen's form wasn't the best but that he skied with energy and passion. He goes on to tell a different story about how he broke Stephen's glasses the first time they met and how Stephen was able to laugh about it with him. Dimitar describes the "really impressive way" Stephen developed his process for recruiting patients into what were then called NASH studies through the "first iterations of Summit," the idea of a site network. In response to a question from me, he described the pre-screening pathway as one element of the "secret sauce," and the use of portable FibroScan devices as another. He goes on to describe that Stephen's sites could recruit 8x as many patients per month as a typical CRO, which is why the Summit network has become a preferred provider to many CROs and why no one has yet been able to replicate his success. 

This conversation includes the second half of Jörn Schattenberg's and Roger Green's interview with Donna Cryer. It focuses largely on Stephen's inclusive approaches towards bringing stakeholders to pivotal discussions. Donna starts this conversation by noting an important thing she learned early in her career: when patients, advocates and physicians work together, their collective power is far more than the sum of their individual impacts. She commends Stephen as one KOL who always made certain that patient voices (including Donna's) and organizations had seats and voices at the table. She says, "I will be forever grateful for all the times he held space..." to that Donna and other patients/advocates could be involved in a major discussion. Jörn concurs and notes that this podcast was a key element in sharing different stakeholders' perspectives throughout the entire MASLD community, particularly during the COVID-19 pandemic when meetings were held virtually.  Finally, Roger notes that Stephen sought to include allied health providers the same way Donna describes him including patients and advocates.When Roger asked for "Harrisonisms", Donna does not offer a specific one. Roger recalls Stephen's surprise that Roger knew the meaning of the phrase "Hoddy Toddy" to Ole Miss grads and how he quickly integrated phrases of others into his own conversations and presentations. WIth that, the interview ends.

Global Liver Institute Founder and CEO Donna Cryer and hepatology researcher and industry executive Dimitar Tonev join Jörn Schattenberg and Roger Green to share memories of our co-founder and  MASLD leader Stephen Harrison.  00:00:00 - Surf's Up: Season 5 Episode 16Standard lead-in, including quotes from panelists00:02:55 - IntroductionRoger describes the structure of this episode.00:04:04 - Conversation with Donna and Jörn, including groundbreakers Good personal and professional news from Donna, Jörn and Roger.00:07:32 - Stephen's most outstanding contribution to MASLDIn response to Roger's question, Jörn describes the breadth of Stephen's contributions and interests. To Jörn, Stephen was "a lens focusing that something that was needed to spark the fire." Roger asks him to discuss  Stephen's role in founding NAIL-NIT. Jörn's answer covers Stephen's earlier work on the LITMUS Cohort Study and other contributions to the field as well as  NAIL-NIT. 00:10:34 - Personal notes about StephenDonna continues this theme by speaking to Stephen's ability to bring people together and his providing "unique space for having smaller, intimate conversations: when necessary. Roger talks about Stephen bringing Donna to the early podcast to describe International NASH Day 2021 and comments that Stephen was the rare individual who embodied Malcolm Gladwell's three legs of the Social Virus stool. 00:14:33 - Stephen's advocacy of patient advocates and allied providersDonna discusses having learned early in her career about the synergistic power of patients, advocates and physicians. She commends Stephen as one KOL who always made certain that patient advocates and organizations had seats and voices at the table, 00:19:06 - "Harrisonisms" and Harrison storiesDonna did not have Harrisonisms. Roger recalled Stephen's surprise that Roger knew the meaning of the phrase "Hoddy Toddy" and how he quickly integrated phrases of others. WIth that, the interview ends.00:21:39 - Meet Dimitar TonevDimitar starts off by telling the audience a bit about his history. His "one unique thing" is about his competence as a skier. This leads Roger to ask about his description in the SurfingMASH note of a "clumsy skier." Dim states that Stephen's form wasn't the best but that he skied with energy and passion. He goes on to tell a story about breaking Stephen's glasses the first time they met and how Stephen was able to laugh about it with him.00:26:41 - Stephen's visionary approach to trial recruitment Dimitar describes how Stephen developed his process for recruiting patients into what were then called NASH studies through the "first iterations of Summit," the idea of a site network. 00:31:19 - Another Harrison innovationDim discusses one more innovation: recruiting in neighborhoods that received lower levels of medical care and then recruiting within families. Roger shares that this podcast started to educate sponsors and researchers about the ability to keep trials running in a site network like Summit. 00:34:35 - What made Stephen Special and Wrap-UpTo Dim, Stephen special was his in his "enormous capacity to work long hours,"  Dim and Roger agree about the energy and enthusiasm Stephen devoted to everything he did. 00:37:48 - Special Stephen storiesDim tells a story about Stephen flying over the Atlantic with his family. You'll have to listen to learn it. He goes on share two more special stories about Stephen. .  00:43:29 -Question of the WeekRoger asks listeners who attended DDW last weekend which paper or presentation struck them most forcefully, and why.00:44:02 - Business reportThis week's news on the Stephen Harrison memorial, our new private membership list, upcoming episodes, and listener updates.

SurfingMASH's last year-end interview with Stephen Harrison took place in 2022. Louise Campbell and Roger Green join Stephen to discuss a promising year in MASH drug development and the podcast itself. At the time, this was the description of the interview posted in Buzzsprout:In the Season 3 NAFLD Year-in-Review conversations series, Surfers Jörn Schattenberg, Louise Campbell and Roger Green embark on a string of interviews with a handful of Key Opinion Leaders who made headlines and advances in Fatty Liver disease in 2022. In this exclusive segment, podcast co-founder and former co-host, Stephen Harrison, joins Louise and Roger to discuss the year-in-review as recorded before Madrigal's breaking announcement of the Phase 3 MAESTRO-NASH results last week.From the outset, Stephen admits there were “a lot of pleasant surprises” this year, alluding to the multiple positive Phase 2 trial results among other recent press releases. He anticipates several exciting modes of action becoming available in the imminent future. The interview goes on to look at advancements made in methodology of interpreting liver biopsies, understanding the limitations of biopsy and degrees of mitigation in response to those shortcomings. Stephen also offers in-depth investigation into the uptake of NITs as conditional clinical trial endpoints, something he sees as a process whose momentum keeps growing and strengthening.Throughout this session, Stephen provides speculation as to what the promising new year holds for the Fatty Liver field. In his words, 2022 revealed “the most incremental advances in the field of NASH in the past decade.” He adds that, like this year, 2023 is primed to be pivotal. Surf on for the full-length, insight-laden interview with a remarkable physician and Principal Investigator making tremendous contributions to the pursuit of putting a major dent in Fatty Liver. 

Manal Abdelmalek and Naim Alkhouri join co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to reflect on the greatest professional accomplishments of co-founder and former co-host Dr. Stephen Harrison.Naim Alkhouri starts this conversation by describing the two prospective epidemiology papers Stephen co-authored at San Antonio Military Medical Center in 2011 and 2021, an innovative design that provided early estimates of the breadth of MASLD and MASH in an asymptomatic population. He goes on to discuss Stephen's work on FAST and other NITs and finishes by remembering Stephen's exceptional work in drug development, culminating in the recent FDA approval of Rezdiffra. Manal Abdelmalek starts her comments  by recalling that Stephen developed the BARD score and, years later, celebrated that it had been supplanted by better tests. After commenting on his impact in drug development, she describes him as "visionary" and says Stephen was "not a one man show. He thought about networks and collaborations and how to move a field forward with speed and agility." Louise Campbell also reflects back on the BARD score and the process by which Stephen came to accept that the nomenclature change was a necessary thing. She closes her comments by reflecting on his persistence and innovation in drug development and finishes with a Harrisonisms about the value of failure and learning in the development of the product WD-40.  Finally, Roger Green discusses how Stephen's desire to tear apart his failures and learn from them resulted in the landmark paper that challenged how biopsies were being read and interpreted in clinical trial design, and also agrees with an earlier comment from Manal about how innovative the original design for Pinnacle Clinical Research was.

Manal Abdelmalek and Naim Alkhouri join co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to share personal memories of co-founder and former co-host Dr. Stephen Harrison. Naim Alkhouri starts the conversation by describing how he met his "friend and mentor," Stephen. He recalls coming to San Antonio in 2017 to work with a different research group and contacting Stephen. Stephen told Naim he had "made the wrong decision" by not joining his team instead. Nonetheless, Naim persisted, and the two began a rich, rewarding friendship and research experience, which Naim describes in greater detail.Jörn Schattenberg says that Naim's story resonates with him. Stephen "support[ed] younger people in the field," including Jörn when he was starting his career in Germany. Historically, there had been challenges in conducting clinical trials in Germany, but Stephen worked with Jörn to overcome these and create a stable structure and base for conducting MASH trials. Jörn notes that the relationship Naim described applies not only to the two of them, but also to many other young researchers. Manal Abdelmalek recalls meeting Stephen in the earliest days of MASH, when a few young researchers shared posters in a "dark corner" of an AASLD meeting. Manal was impressed by Stephen's energy, warmth, curiosity and confidence that what was then called NAFLD would be "big" someday. Louise Campbell recalls meeting Stephen in the early days of SurfingMASH and always being appreciative of his support for nurses and allied professionals and the role they play in patient treatment. She goes on to note that the SurfingMASH podcast's growth affirmed the vision that Stephen and Roger Green had when they started the podcast.Finally, Roger Green shares his story of meeting Stephen at NASH-TAG 2019 and being impressed with how his energy suffused the entire space. Roger goes on to describe the process by which he and Stephen started the podcast and decided to expand its scope. 

Manal Abdelmalek and Naim Alkhouri join co-hosts Jörn Schattenberg, Louise Campbell and Roger Green to rshare some of their favorite "Harrisonisms" - words, phrases and verbal memes associated with co-founder and former co-host Dr. Stephen Harrison.Naim Alkhouri starts by stating two of his favorite Harrisonisms, two that SurfingMASH listeners know well: "is the juice worth the squeeze?" and "Keep It Simple, Stupid." He goes on to add one that never appeared on the podcast, "FAIL stands for First Attempt In Learning," which he used frequently in discussed failed clinical trials. Manal Abdelmalek  shares several phrases she describes as "words to live by." Two of these are "don't you don't take yourself too seriously " and "There will be failures. The worst ones possible are those that you don't grow and learn from." She discusses how human, approachable and down-to-earth Stephen was, and closes with a story about him ordering a hamburger and "American French Fries" at a gourmet restaurant in Paris because that was all he really wanted to eat. Louise Campbell shared a Harrisonism she heard for the first time at Stephen's funeral about the difference between wisdom and knowledge: "Wisdom was knowing that a tomato was a fruit, and knowledge was knowing not to put it in a fruit salad." She goes on to comment on the joy he took in living a life of service.Finally, Roger adds two favorites of his own: "the liver is the canary in the coal mine," and that when Roger heard Stephen ask whether the juice was worth the squeeze, he always followed it with "is the view worth the climb?" Roger goes on to tell a story about Stephen's older brother, Ken, responding personally to every social media post-mortem to Stephen he could find because it is what Stephen would have done, and Ken's comment about Stephen's basic humility and dedicating his accomplishments to "God's glory." Finally, Naim tells about story about Stephen's interest in wine and Naim's in shopping and how they merged in a single vignette about Stephen and his daughter Anna Lauren in Paris.

The sudden passing on April 23 of our co-founder and colleague Stephen Harrison sent shock waves throughout the global SLD community. This week, Manal Abdelmalek and Naim Alkhouri join Jörn Schattenberg, Louise Campbell and Roger Green to remember and pay tribute to an exceptional leader, role model and human being.00:00:00 - Surf's Up: Season 5 Episode 14Episode introduction, including brief quotes taken directly from panelists. 00:03:11 - IntroductionRoger introduces the podcast. The three key opinion leaders, Jörn Schattenberg, Manal Abdelmalek and Naim Alkhouri, discuss their fast-paced, high intensity travel schedules.00:04:41 - Groundbreaker: a special memory of StephenIn place of a traditional SurfingMASH groundbreaker, Roger asks each panelist to share a special memory of Stephen. In turn, panelists discuss how they got to know Stephen and/or the role he has played in their lives. Summaries cannot do the emotion of these recollections justice.00:17:30 - One Harrison accomplishment Roger asks the group each to describe an accomplishment that Stephen has left the field. Each panelists provided at least 2 or 3, with no redundancy.00:23:52 - "Harrisonisms" and wrap-up In closing, Roger asks panelists each to provide a favorite "Harrisonism." Answers varied, although every group member recalled Stephen's question, "Is the juice worth the squeeze."00:33:33 - Question of the WeekRoger asks how listeners feel their lives or work were affected by Stephen Harrison, either directly or indirectly. 00:33:56 - Business Report This week's news on our new newsletter, future conversations, and the Vault, plus more on how we plan to honor Stephen.

On April 23, the global MASLD community lost one of its giants when SurfingMASH Co-founder Stephen Harrison passed away unexpectedly. Co-hosts Louise Campbell and Roger Green and guests Jeff McIntyre and Mike Betel each share a memory of Stephen. Jeff McIntyre starts this conversation by remembering Stephen as a fellow Southerner and, in addition to his many professional accomplishments, a person who could cut through high-level discussions with a "pithy little West Texas saying" that would make a complex or abstract concept clear. Mike Betel starts his comments by talking about Stephen's older brother, Ken, who wrote personal messages back to every comment he could find on social media, which was a remarkable task in its own right. Mike discusses how often he heard Stephen speak and how many times he interviewed Stephen for various Fatty Liver Alliance posts or events. Mike concludes with a story about Stephen talking for five minutes while Mike's audio was malfunctioning and then doing a second take remarkably similar to the first. Louise discusses being on the podcast with Stephen for years and regrets that he will never cook her a deep-fried turkey. She recalls his hobby of building elaborate sand structures on the beach with his family while he ran around the world, putting a large dent in MASLD. Roger starts by describing the first time he saw Stephen at NASH-TAG 2019 and how his larger-than-life presence and exceptional energy suffused a room of 200 people. He continues by using a favorite "Harrisonism" about being thankful that they didn't stop after WD-39 because WD-40 was the 40th effort to create the product we know today, and comments that for Stephen as Principal Investigator, Rezdiffra was his WD-40. Finally, Roger says he "just lost it" when reading the Walt Whitman poem "O Captain, My Captain," which Scott Friedman posted on LinkedIn as a tribute to Stephen.After the personal comments, Roger says that next week's episode will be a tribute to Stephen from some of his closest friends in the global MASLD community.

Fatty Liver Alliance Founder and President Mike Betel and Global Liver Institute Vice President for Liver Programs Jeff McIntyre join Louise Campbell and Roger Green to preview the premier MASH event for patient advocates, now known as Global Fatty Liver Day, which falls on June 13.00:00:00 - Surf's Up: Season 5 Episode 13 Episode introduction, including brief quotes taken directly from panelists. 00:02:37 - Introduction/Remembering Stephen HarrisonRoger introduces the podcast. Each panelist shares a memory of Stephen Harrison.00:11:44 - Groundbreaker Each panelist shares one piece of good news from the previous week.00:15:18 - Jeff Discusses Global Fatty Liver Day Jeff starts by discussing how GLI came to its 2024 theme:  "Act Now. Get Screened." Roger comments that this will require health systems to expand in scale and sophistication and shares Naim Alkhouri's critique (Season 4, Episode 50.3) of the current approach. He asks if US reimbursement policy is sufficiently developed and what patients can do. Jeff replies, "Get Screened."00:25:46 - Fatty liver and obesity Jeff notes the popularity and widespread discussion around anti-obesity medications, which also have effects on MASH. He expresses concerns that all this will lead to reduced focus on the liver. 00:26:43 - UK and AUSLouise discusses activities in her two homes.  Rather than focusing on liver disease, she prefers "poor liver health," which leads to cardiovascular disease and extra-hepatic cancers. 00:31:10 - Scanning patients as educational toolMike asks Louise to comment on scanning as an educational activity. Louise discusses the ability to generate an effective description and activate conversation when she delivers scan results right at the time of the patient visit. She then discusses the next steps if the first one doesn't work.00:35:40 - Challenges and barriers for patients To Jeff, the previous conversation between Louise and Michael provides "a really great synopsis" of the challenges and barriers to patient diagnosis and care. He announces that the GLI is planning to release its first Best Practices in Policy report.  These challenges are more complex due to the need to find solutions for diagnosis and health system follow-through that will work around the world. 00:43:10 - Battles around healthy lifestyle policies Jeff describes two challenging US health policy cases: the VA's decision (later reversed) to require biopsy for Rezdiffra and giant food companies lobbying to include added sugar as a healthy food item. Louise links the sugar question to "a big to-do" in the UK about children's teeth and access to dentists because poor dental health drives a 7x increase in the risk of liver cancer and advocates for generalized dietician training. 00:47:56 - The liver as elephant Roger cites the parable of the blind people touching the elephant as a metaphor for a myopic view of liver health. He advocates teaching "the whole elephant" to healthcare professionals. Louise proposes an action point of "rule the liver out" before testing for related diseases. Roger suggests this is a dual mandate. For patients: Act Now. Get Screened. For providers, Rule the Liver Out. 00:51:21 - Initiatives for Global Fatty LIver Day and wrap-up In lieu of a final question, Roger asks panelists to describe one specific initiative that is part of Global Fatty Liver Day. Mike and Jeff each describe screening activities.00:58:13 - Question of the Week Roger asks what listeners can do in their work to support the two simple mandates: act now, get screened, and rule the liver out. 00:58:44 - Business ReportThis week's news on audience metrics, future episodes and this week's Vault conversation.

In this conversation, the panel discusses challenges in MASH Drug Development that are centered around efficacy endpoints and NAS scoring.This conversation starts with Will Alazawi suggesting that the MASH clinical trial field suffers from the previous experience with Hepatitis C, where medications became capable of eradicating disease in a fairly linear fashion. He suggests that MASH trials undervalue the value of simply preventing progression, which leads Sven Francque to note that preventing progression to cirrhosis is now accepted by regulators as an endpoint. Roger Green refers to last week's episode (S5 – E11), in which Michael Charlton said he would continue Rezdiffra therapy for any patient exhibiting a lack of progression, and that a clinically valuable efficacy measure must be applicable to true clinical practice. Roger goes on to recall Sven's earlier comment that having the NAS score as a co-endpoint complicates the challenge of proving efficacy because the scale is relatively blunt and not well suited to the task at hand. He suggests that an activity score focused on inflammation and ballooning might function better than one including steatosis. Jörn Schattenberg suggests that this depends on the drug's Mode of Action. Sven reminds the group that Stephen Harrison presented a paper at AASLD suggesting the approach Sven describes: splitting NAS into separate steatosis and activity scores, with the activity score based on lobular inflammation and ballooning. Roger asks whether the widely reported challenges in coding ballooning will render this method less valuable. Sven says it might, and states the challenge stems from the lack of detail in the scoring system. Louise Campbell suggests that in addition to stabilizing MASH, endpoints might look at related metabolic diseases that poor liver health can affect. Will agrees, noting that many patients may be on other metabolic agents at the outset of a trial or, more challenging, the definition of "good practice" might change during the trial, which can add variability to the sample. He wonders whether differences in placebo rates can provide insight on this issue. Roger recalls a comment from Dean Tai of HistoIndex (S4 - E50.4) that some HistoIndex AI-driven analyses produce consistent placebo rates of ~33%, with efficacy rates far higher. 

In this conversation, Sven Francque and William Alazawi join Jörn Schattenberg, Louise Campbell, and Roger Green to review papers co-authored by Sven in 2023 and Jörn in 2020 to discuss what failure has taught us about future MASH drug development.00:00:00 - Surf's Up: Season 5 Episode 12Roger comments briefly on Stephen Harrison's passing and explains why this episode will be more sedate than usual.00:01:45 - IntroductionOpening comments from panelists.00:02:28 - GroundbreakersEach panelist shares one piece of good news from the previous week (NOTE: This was recorded before Stephen's death.)00:05:10 - Sven Francque on the State of the Graveyard in 2023Sven starts by noting how different the world is now than when he co-authored this paper in 2023. He goes on to describe three key issues in successful trials that are as relevant now as when the episode was written.00:10:59 - Efficacy endpoint challengesThe group discusses an array of challenges: that fibrosis regressions is a high bar, that patient heterogeneity presents a dilemma for trial recruitment, and that NAS score presents its own challenges. 00:18:29 - Thinking more broadly about metabolic valuesLouise suggests that in addition to stabilizing MASH, endpoints might look at related metabolic diseases that poor liver health can affect. The group considers whether placebo rates can provide guidance and reconsiders the regression and response rate issues, noting the differences between RCT patients and those in usual clinical practice.  00:28:05 - Lessons from 2020 Graveyard articleRoger asks what we have learned since 2020. Jörn points to improved consistency in reading biopsy results and greater diligence in analyzing pre-clinical data before rushing into larger late-stage trials. 00:31:49 - Implications for metabolic agents on MASH therapies Roger returns to the issue of complex drug effects, noting a recent tirzepatide Phase 3 trial on dual agonist's effect on obstructive sleep apnea. Louise notes that apnea correlates highly with SLD. Louise and Will discuss the importance of educating more physician specialties about liver health. Will discusses a presentation he made to an academic session on MASH at the Diabetes UK conference the previous week and noted that it was well-attended.00:36:05 - Looking aheadRoger asks what insights investors and others might take from this discussion. To Jörn,  (i) we now know how to get a drug approved, and (ii) drugs in development today may be potent enough to overcome issues that challenged earlier agents. Sven adds that in future years, the use of incretin double-agonists and triple-agonists will change the nature of therapy. 00:42:23 - Wrap-up and closing questionLouise asks whether we are thinking broadly enough about older agents in MASH, using a recent study on low-dose aspirin (S5 - E11.) . Jörn and Roger each raise a practical challenge for such a trial.  After a brief digression, Roger asks his closing question: how will having a drug approved affect the conduct of trials going forward. Answers vary and present a complex picture. you'll have to listen to learn00:51:45 - Question of the WeekThe question asks for the greatest hurdle left to overcome that will improve the percent of MASH agents achieving approval and, separately, speed approval times.00:52:14 - Back-end reportThis report includes Roger's usual weekly comment on Ukraine and Israel, followed by a tribute to Stephen Harrison. This episode was recorded the day before Stephen Harrison's untimely passing. His influence on this entire podcast was massive. Three years after he ended his co-hosting stint, there are at least two references to his research, insights, or what we called "Stephenisms" during our first anniversary episode.

Earlier in this episode, the panel discusses different prescribing models for MASH drugs, triggered by Roger Green's question about whether MASH prescribing will resemble an oncology model. This conversation, from the EASL Congress 2023 wrap-up episodes, takes a very different view of the relationship between MASH and oncology.The conversation includes Jörn Schattenberg, Stephen Harrison and Roger Green. The original post has an excellent description:This conversation starts with a discussion about the importance of treating early stage cirrhosis patients. Jörn suggests that with new agents in place we may soon be looking to treat other patient populations such as, for example, those with HCC. In such instances NASH drugs will become adjuvant therapy to improve treatment against the primary disease target. Stephen agrees, noting that we will need a better test to diagnose HCC and, once available, there will be fewer presentations of advanced HCC because we will have treated more of them earlier with better agents and adjuvant therapies. Again, all this will await the approval of NASH and ideally cirrhosis drugs in the future. Roger asks how to identify the 20 to 30% of HCC patients who develop cancer before NASH. Stephen suggests it depends largely on NIT development. From there the panelists each share final thoughts around what the session has yet to cover that is important. Stephen comes up with a new idiom and Jörn speculates a new concept. Listen to the session to find out what they are.

This conversation between Scott Friedman, Laurent Castera, Louise Campbell and Roger Green covers what the panelists found exciting, important or striking about the presentations covering NITs, artificial intelligence and bariatric surgery at TLM2023. The conversation starts with Roger discussing a presentation in which Stephen Harrison shared HistoIndex data from the MAESTRO-NASH trial for resmetirom. HistoIndex's proprietary methods produced results suggesting 34% improvement in the placebo group vs. 54% in the treatment group. More interesting, Dean Tai from HistoIndex suggested to Roger in a private conversation that this 1/3 placebo success rate holds fairly common across trials using these methods. Given that bariatric surgery studies suggest a five-year gap from successful surgery to fibrosis regression, the one-year standard requested by FDA for conditional approval might lead us to understate drug efficacy for resmetirom and later New Drug Applications submitted under these criteria.Laurent discusses a study from Phillipe Mathurin's group in France that demonstrates among bariatric surgery patients, MASH resolution and fibrosis regression lead to improved outcomes. His point: it is important that this study confirms the idea that MASH resolution and fibrosis regression do, in fact, lead to fewer Major Adverse Liver Outcomes, or MALO.The conversation shifts to NITs and the value of biomarkers in proving that a drug is working. Laurent notes that no single market is sufficiently reliable and that we will need a cluster of tests to evaluate any given drug. As an example, he cites the impact of BMI on liver stiffness as a confounder that does not exist in other tests like ELF. Scott asks about HepQuant; Laurent has limited experience but finds the idea conceptually appealing. Scott notes that the slow rollout and low budget might be responsible for the lack of market and academic interest. Laurent focuses on a specific poster looking at a database of 16,000 patients over two years. The study shows that an increase in liver stiffness, AGILE-3 or AGILE-4 score all correlate with MALOs.  What the study doesn't address, and Laurent points up will be key to learn, is whether declines in these measures correlate with improved outcomes among declining patients. 

Hepatology researchers and key opinion leaders Profs. Laurent Castera and Scott Friedman join Louise Campbell and Roger Green in the final element of our review coverage of TLM 2023. This far-ranging conversation moves beyond MASLD/NAFLD and MASH/NASH to consider an array of topics.The episode starts with Roger asking the other guests for their general impressions of the meeting. Three key insights: 1.    "Pre-pandemic" levels of interaction and discussion among attendees2.     Online meeting app was a "fail", becoming a topic of conversation in its own right while fostering confusion3.    In the "frenzy" about the anticipated resmetirom approval and other MASH drugs approaching market,  we shouldn't overlook that patients with PBC will soon have two new exciting PPAR agents, elafibranor and seladelpar. As Scott notes, we also learned about promising modes of action for PSC so, overall, a promising meeting for rare cholestatic diseases. The rest of this discussion covers multiple topics, key among them:  ·      Impact of FGF-21 and FGF-19 agents on patients with compensated cirrhosis. Roger is optimistic that agents might provide improvement. Scott is more pessimistic because we do not have agents addressing the unique mechanistic challenges in cirrhosis vs. advanced fibrosis. Both agree that agents on the horizon can buy time until curative or regressive medications arrive. ·      AI-based analysis. Roger bridges to Stephen Harrison's presentation of HistoIndex analysis of resmetirom that produces an estimate of 54% efficacy vs. 34% placebo. He comments that given this analysis and that bariatric surgery studies tell us fibrosis regression may take five years, the FDA one-year standard might be so stringent as to be misleading. ·      Bariatric surgery. Laurent refers to a presentation from Phillippe Mathurin's group demonstrating that in patients post-bariatric surgery, MASH resolution and fibrosis regression clearly lead to improved outcomes. ·      NITs. Laurent discusses a poster from a multi-country 16,000-patient cohort that did not confirm liver stiffness as leading to a decline in MALO over a two-year period but anticipates more robust findings over time. ·      VCTE-based analysis. Louise discusses two posters with analyses based on FibroScan. The first, from the Virginia Commonwealth University and the VA, found that liver stiffness correlates with success in liver transplant and that CAP can predict the risk of future MI in these patients. She notes that CAP of 270 served as "its own parameter" in predicting time to mortality. ·      Nomenclature. Roger notes that a Saturday morning session resolved the two most pivotal outstanding issues about the effect of nomenclature change on scientific development. FDA signaled that the agency views old and new nomenclature terms as interchangeable. NIMBLE and LITMUS analysis determined that patient mapping is also interchangeable.·      Impact of triple-agents. Presentations at this conference confirm that triple agents addressing GLP-1, glucagon and GIP can have bariatric surgery-level impact on liver fat and reduce the entire disease burden. Interspersed between these topics are a range of insights on cirrhosis disease models, regulatory slowness in moving on from current conditional efficacy metrics, treater supply vs. patient demand, "stigma", and basic science. This is a high-level view of an information-dense conversation. Listen to learn more and hear all the details.  

From English Bulldogs to Frenchies Part 2... we continue this conversation on the second half of this podcast!Instagram: pawptart_da_frenchieInstagram: bigfootbulldogsFacebook: Chelsea HarrisonFacebook: Stephen Dylan HarrisonFacebook: Joshua Jackson This Saturday! Oct 21, 2023...  Prima Vista Event Center 402 N Inler Ave, Lubbock, Tx!!! Break The Silence End Domestic Violence Bully Fun Show/ Car Show! Bully Fun Show, Dog Costume Contest and Bully Stack Off!!! For info on the dog show reach out to Adrian or Christina @ The Working Dogg Supply 806-368-7050 for info on the car show contact Soli @ 806-782-1621 or Juanita @ 806-782-8892. Doors open up at 10 am for set up!If you have any questions, comments or concerns or would like to be a  part of the podcast please email us at thedawgfellaspodcast@gmail.com. Also make sure you follow us on our social media accounts to stay up to date with the podcast and our special guests and other cool things we have going on! IG: @The_DawgFellas_PodcastIG: @txbulliemafiaIG: @mobtiebulliesIG: @mobtiefrenchiesIG: @interstate_27_frenchiesIG: @noserope_lyfeFB: The DawgFellas PodcastFB: MobTie BulliesFB: Gabriel Tbm VillarrealFB: RJ MartinezFB: Anthony Ray ZimmerleFB: Amito ZerrataFB: Gabriel Flores

From English Bulldogs to Frenchies, being a part of creating an awesome line of English Bulldogs and on their way to creating an awesome line of Frenchies, Chelsea & Stephen chop it up with us on this weeks episode!!! Ric Flair... Big Rope... Frozen Bigfoot Straws plus much more!!!Instagram: pawptart_da_frenchieInstagram: bigfootbulldogsFacebook: Chelsea HarrisonFacebook: Stephen Dylan HarrisonFacebook: Joshua Jackson This Saturday! Oct 21, 2023...  Prima Vista Event Center 402 N Inler Ave, Lubbock, Tx!!! Break The Silence End Domestic Violence Bully Fun Show/ Car Show! Bully Fun Show, Dog Costume Contest and Bully Stack Off!!! For info on the dog show reach out to Adrian or Christina @ The Working Dogg Supply 806-368-7050 for info on the car show contact Soli @ 806-782-1621 or Juanita @ 806-782-8892. Doors open up at 10 am for set up!If you have any questions, comments or concerns or would like to be a  part of the podcast please email us at thedawgfellaspodcast@gmail.com. Also make sure you follow us on our social media accounts to stay up to date with the podcast and our special guests and other cool things we have going on! IG: @The_DawgFellas_PodcastIG: @txbulliemafiaIG: @mobtiebulliesIG: @mobtiefrenchiesIG: @interstate_27_frenchiesIG: @noserope_lyfeFB: The DawgFellas PodcastFB: MobTie BulliesFB: Gabriel Tbm VillarrealFB: RJ MartinezFB: Anthony Ray ZimmerleFB: Amito ZerrataFB: Gabriel Flores

If you missed this year's Paris NASH meeting, you missed some exciting presentations featuring fresh, pivotal insights about Fatty Liver diseases and some new approaches to learning about this disease. For this episode From the Vault, we take a look back at what has by far been the most downloaded episode in the history of the podcast: S2-E46 - Highlights from Paris NASH 2021. Jörn Schattenberg and Stephen Harrison combine to provide a robust synopsis of the meeting while Roger Green asks a few questions and keeps the discussion in-bounds:10:20 – Jörn introduces Paris NASH and discusses some of its basics, followed by introduction of Session 1: Epidemiology and the Public Response14:07 – Stephen discusses potential for integrating home healthcare visits into clinical trials17:15 – Session 2: Clinical Aspects17:52 – “NASH does come in different flavors.” Are we thinking about NASH with sufficient granularity?20:32 – NASH pathogenesis and its link to other metabolic diseases21:32 – Session 3: Deep dive into fibrosis24:30 – Talk on “Innovations in imaging assessment in fibrosis” raises pivotal questions about advances we can make in cellular-level understanding26:57 – Talk from Scott Friedman on “Common mechanisms, molecular evolution and resolution of fibrosis in NASH” yields several key ideas28:45 – The importance of understanding stellate cell subtypes33:37 – Jörn and Stephen select some key moments from Day Two35:45 – Innovations in clinical trial bring researchers to consider competing risks and challenges in determining causes of mortality in NASH trials40:26 – Session 8, “Global NASH,” describes the size and scale of the NASH challenge around the worldIf you have questions or comments around the contents of this episode or the FDA workshop on NITs, drug development or any other themes addressed in this week, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

In Season 4, Episode 41, the surfers (Jörn Schattenberg, Louise Campbell and Roger Green) review highlights from the FDA's NIT workshop in three seperate interview sessions with guests Naim Alkhouri, Laurent Castera and Veronica Miller. Each guest participated in some form at the meeting and shares slightly differing but incredibly insightful perspectives.This conversation is the first part of the Surfer's interview with Veronica. Veronica starts by commending FDA for organizing the workshop and indicates that now we all need to process the data. Roger asks Veronica what FDA might have done better, and she indicates they might have offered more feedback about how far they feel the field has come. She notes that there are many steps ahead and that the FDA needs to be more cautious. She also felt that the mix of data presentations and panel discussions worked well. She points to ballooning and its challenges as the clearest point needing change and then went back to Dr. Johnson's question about “why are we validating a surrogate with a surrogate?” Roger shares a comment from S1E12 after the first OCA Complete Response Letter and how a regulatory consultant elicited a strong reaction from Stephen Harrison for the same comment. This leads Louise to ask whether we should look to broaden our target outcomes beyond the liver. Veronica notes that we have traditionally looked in an organ-specific way but wonders whether the new nomenclature will focus more attention on metabolic disease, although the topic was not really addressed. As the conversation ends, Roger asks Veronica whether approaches like NAIL-NIT respond to the “surrogate of a surrogate” question. Veronica says that might be right and that other groups like NIMBLE and LITMUS are looking at similar issues, although they sometimes compare to biopsy (which is what drove the surrogate of a surrogate comment in the first place.)Plenty more ideas are explored as this is both a fascinating and pivotal workshop which covers a range of topics on NITs with presentations by the some of the field's most innovative and knowledgable contributors. If you have questions or comments around the workshop, NITs, drug development or any other themes addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Last week SurfingNASH offered a final re-focus on an episode that originally aired during Season 1. Continuing on the focus around allied health, this session dives into the role of nurses, physicians and allied health professionals in supporting NASH patients - a topic of increasing relevance as the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals. Specifically, the group explores whether healthcare systems can be as effective as companies like Noom and WeightWatchers. This fascinating conversation features ideas shared by Stephen Harrison, Peter Traber (Chief Medical Officer at Selecta Biosciences ), Louise Campbell and Roger Green. Roger begins by framing the discussion around three questions: 1) For allied professionals how much of their focus lies in maintaining and enhancing wellness as compared to treating illness? 2) How do these two concepts differ both in the minds of professionals and in terms of what information and guidance they present to patients? 3) What are the keys in supporting patients' focus on wellness, both during the office visit and afterwards? Louise responds based on her own experience as she recently moved out of the NHS to focus on more early stages of the disease, where it's ultimately easier to change behavior and encourage wellness and preventative practices in general. Louise connects the idea that liver patients tend not to get information until later in their disease to the announcement that the British government made on creating a far reaching policy around obesity and its likely impact on patient health. In response to one of the questions from Roger, Louise goes on to discuss how we present information in ways that empower patients to take better care of themselves. Done right, this can extend beyond the individual patients and to their families and other supporters. Peter agrees and comments based on his own past experiences in medical practice. He notes that patients have extensive care teams with multiple areas of expertise and patients are best served when the care team members actually act as a team (keeping in mind especially that 2020 was mid-pandemic).If you have questions or comments around our From the Vault series, allied health, education or any other ideas addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com. The Surfing the NASH Tsunami will be back next week with more original content.Stay Safe and Surf On!

This week SurfingNASH continues to offer a final re-focus on an episode that originally aired during Season 1. Similar to last week's focus on allied health, this session dives into the role of nurses, physicians and allied health professionals in supporting NASH patients - a topic of increasing relevance as the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals. Specifically, the group explores whether healthcare systems can be as effective as companies like Noom and WeightWatchers. The fascinating conversation features ideas and critical concepts shared by Stephen Harrison, Peter Traber (Chief Medical Officer at Selecta Biosciences ), Louise Campbell and Roger Green.If you have questions or comments around our From the Vault series, allied health, education or any other ideas addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com. The Surfing the NASH Tsunami will be back next week with more original content. Stay Safe and Surf On!

SurfingNASH is offering something different for Season 4, Episode 37 while the co-hosts are off enjoying a well-deserved holiday amid a busy year. Rather than leaving a gap in the podcast's program, this week we are revisiting an episode From the Vault that, now more than ever, maintains its relevance. As the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals, education and educational resources are critically needed. This session, led by Louise Campbell, focuses on the roles that allied health can play in prevention, early stage management and clinical trial recruitment for NAFLD/NASH. Allied health is our primary interface for the education and support within the clinical setting of patients with any disease. Allied health professionals are a vastly experienced resource supporting both physicians and patients in the delivery of care and efficacy. Stephen Harrison also joins Louise and guest panelists (Kathryn Jack, Michele Clayton, Pam O'Donoghue and Patrizia Kunzler) to consider the many ways that liver nurses and advanced nursing practitioners can do more to support NASH education and patient management and where they should fit into the paradigm. This conversation explores the need for and value of patient education in the NASH Patient Care process. It starts with almost a tangential request that some of the money budgeted for expensive systemic HCC therapies in the UK be rededicated to patient education earlier in the treatment process. From there, the conversation shifts to consider the value of the need for early-stage treatment strategies in poorer countries that are never likely to be able to afford the expense of drugs or treatment modalities. In the end, each panelist describes a change she would like to see in the next 2-3 years.If you have questions or comments around our From the Vault series, allied health, education or any other ideas addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

SurfingNASH is offering something different for Season 4, Episode 37 while the co-hosts are off enjoying a well-deserved holiday amid a busy year. Rather than leaving a gap in the podcast's program, this week we are revisiting an episode From the Vault that, now more than ever, maintains its relevance. As the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals, education and educational resources are critically needed. This session, led by Louise Campbell, focuses on the roles that allied health can play in prevention, early stage management and clinical trial recruitment for NAFLD/NASH. Allied health is our primary interface for the education and support within the clinical setting of patients with any disease. Allied health professionals are a vastly experienced resource supporting both physicians and patients in the delivery of care and efficacy. Stephen Harrison also joins Louise and guest panelists (Kathryn Jack, Michele Clayton, Pam O'Donoghue and Patrizia Kunzler) to consider the many ways that liver nurses and advanced nursing practitioners can do more to support NASH education and patient management and where they should fit into the paradigm. In this conversation, we meet the four key nursing opinion leaders who have joined Louise and Stephen and learn about the broad sets of skills and experiences each brings to the table. At the start of the episode, Stephen responds to a question that a patient e-mailed to SurfingNASH.com during the previous week. If you have questions or comments around our From the Vault series, allied health, education or any other ideas addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com. Stay Safe and Surf On!

SurfingNASH is offering something different for Season 4, Episode 37 while the co-hosts are off enjoying a well-deserved holiday amid a busy year. Rather than leaving a gap in the podcast's program, this week we are revisiting an episode From the Vault that, now more than ever, maintains its relevance. As the field grapples with new nomenclature for liver disease and the imminence of therapeutic approvals, education and educational resources are critically needed. This session, led by Louise Campbell, focuses on the roles that allied health can play in prevention, early stage management and clinical trial recruitment for NAFLD/NASH. Allied health is our primary interface for the education and support within the clinical setting of patients with any disease. Allied health professionals are a vastly experienced resource supporting both physicians and patients in the delivery of care and efficacy. Stephen Harrison also joins Louise and guest panelists (Kathryn Jack, Michele Clayton, Pam O'Donoghue and Patrizia Kunzler) to consider the many ways that liver nurses and advanced nursing practitioners can do more to support NASH education and patient management and where they should fit into the paradigm. This conversation explores the different challenges that liver nurses and advanced practitioners face when providing NASH patient education. It starts with Stephen noting that this weeks' reported results from Madrigal's MAESTRO-NAFLD Phase 3 trial promises a day when we can reduce HCC and cirrhosis if we can counsel patients early enough in the process. From there, the conversation shifts to consider the different specialties that can play a role, including not only hepatologists and nurses but also podiatrists, bariatricians, endocrinologists, and gynecologists. The rest of the conversation covers an array of prospective educational tools and the need for specific education that hits specific key points.If you have questions or comments around our From the Vault series, allied health, education or any other ideas addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Eugene Holmes (1932 – 2007), baritone supreme, should be remembered as one of the most significant voices of the Twentieth Century and a Black singer on a par with the most revered and celebrated. Though he participated in the creation of some important work (including by Gian Carlo Menotti, Gunther Schuller, and Frederick Delius), and performed with San Francisco Opera, the Wiener Staatsoper, New York City Opera, and the Metropolitan Opera Regional Company, his career remained centered for more than thirty years at his home company, the Deutsche Oper am Rhein. The rare recorded documents that we have of Eugene Holmes, including two self-produced LPs of spirituals and three different recordings of Delius's rare opera Koanga (two of them live), reveal a voice of rare magnitude, range, power, and sensitivity, qualities which made him one of the premier Verdi baritones of his day. But due to a number of factors, including his modesty and his unwillingness to travel far from home, he did not achieve the international recognition that he deserved. I have pulled together all of the recorded material of Eugene Holmes that I could find, and present excerpts from these varied sources. Guest vocalists appearing opposite Holmes include sopranos Claudia Lindsey, Gwyneth Jones, and Barbara Carter, and tenors János B. Nagy and Giorgio Aristo. In the production of this podcast, I was greatly aided by reminiscences provided by his colleagues Bonita Hyman, the German-based African American mezzo-soprano; Stephen Harrison, the retired musical director of the Deutsche Oper am Rhein; and Heribert Klein, member of the committee of UNICEF Deutschland, an organization to which Eugene Holmes was deeply committed. Countermelody is a podcast devoted to the glory and the power of the human voice raised in song. Singer and vocal aficionado Daniel Gundlach explores great singers of the past and present focusing in particular on those who are less well-remembered today than they should be. Daniel's lifetime in music as a professional countertenor, pianist, vocal coach, voice teacher, and journalist yields an exciting array of anecdotes, impressions, and “inside stories.” At Countermelody's core is the celebration of great singers of all stripes, their instruments, and the connection they make to the words they sing. By clicking on the following link (https://linktr.ee/CountermelodyPodcast) you can find the dedicated Countermelody website which contains additional content including artist photos and episode setlists. The link will also take you to Countermelody's Patreon page, where you can pledge your monthly support at whatever level you can afford. Bonus episodes available exclusively to Patreon supporters are currently available and further bonus content including interviews and livestreams is planned for the upcoming season.

Nobody wrote about the “good life” more beautifully than Horace (65-8 BCE). In numerous writings, the Roman poet shared his wisdom on how to use virtue as a key to unlocking contentment and, therefore, happiness in our daily lives. Today, Ryan presents a selection of Horace's ideas in the second half of the “The Search For the Good Life” chapter in the How to Be Content installment of Princeton University Press's Ancient Wisdom for Modern Readers series, translated by Stephen Harrison.✉️ Sign up for the Daily Stoic email: https://dailystoic.com/dailyemailCheck out the Daily Stoic Store for Stoic inspired products, signed books, and more.

For many people, happiness is associated with contentment: being around family, enjoying work, having enough. But what are the secrets to obtaining a contented life in a world of materialistic excess and personal pressures?One of Rome's greatest and most influential poets, Horace (65-8 BCE) shared his wisdom about this question in his writings. In How to Be Content, Stephen Harrison, a leading authority on the poet, provides fresh, contemporary translations of poems from across Horace's works that continue to offer important lessons about the good life, friendship, love, and death.In this episode Ryan presents an excerpt of that book which specifically focuses on the idea of passion, and how the drive to obtain more and more can come between us and the good life.✉️ Sign up for the Daily Stoic email: https://dailystoic.com/dailyemailCheck out the Daily Stoic Store for Stoic inspired products, signed books, and more.

Today's episode is an excerpt from Stephen Harrison's How To Be Content: An Ancient Poet's Guide for an Age of Excess published by Princeton University Press. In this chapter Horace talks about being content with what you have, the different philosophical ideas that lead us to living “the good life.” and more.