Podcasts about Systematic review

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You're mid-combo, nailing your choreography, and suddenly—snap! The floor shifts beneath you, pain shoots up your leg, and your rehearsal dreams hit pause. This week on Performers Happiness in the Arts (PHARTS), Jenna Kantor, PT, DPT—dance medicine specialist and performer—dives deep into one of the most common and frustrating injuries for musical theatre artists: the ankle sprain. Whether you're a dancer landing from a tour jeté, a singer gliding across stage in character heels, or an actor pivoting during a quick scene change, your ankles are the unsung heroes of your performance. Learn how to spot the difference between a mild twist and a true sprain, why these injuries happen so often onstage, and what the science says about your recovery timeline. We'll also unpack research showing that up to 70% of dancers experience an ankle injury during their career (Steinberg et al., Tel Aviv University, 2011) and discuss how even minor sprains can affect balance, mobility, and confidence long after the swelling fades. This episode walks you through: The anatomy behind a sprain (why the ATFL is always in the spotlight) What the healing phases really look like for performers How to safely return to turns, jumps, and stage movement Evidence-based prevention tools that keep you performing pain-free ✨ Referenced Research: Steinberg, N., Hershkovitz, I., et al. (2011). Injuries in Dancers: Prevalence and Patterns. Tel Aviv University, Israel. Fong, D. T.-P., et al. (2009). A Systematic Review on Ankle Injury and Sprain in Sports. Sports Medicine, 39(1), 73–94. Garrick, J. G. (2017). Ankle Sprains and Chronic Instability in Athletes. Clinics in Sports Medicine, 36(1), 13–28.

A headline like “weight loss drugs may reduce breast cancer risk” grabs attention fast, but the real story lives in the fine print. We take you through a new Penn Medicine study that observed lower breast cancer rates among women with overweight or obesity who used GLP-1 medications, then we translate what that finding actually means in plain language. Observational data can reveal a signal worth studying, but it cannot prove the medication caused the outcome, and that distinction matters for your decisions and your expectations. We also zoom out to the bigger why: obesity is not just about body size. Fat tissue is biologically active, shaping chronic inflammation, estrogen exposure after menopause, insulin resistance, and even how well the immune system spots abnormal cells. Those pathways help explain why obesity is linked to many cancers, including postmenopausal breast cancer, and why researchers are curious whether effective obesity treatment could shift risk over time. Then we get practical. We review what stronger evidence from randomized controlled trials says so far: GLP-1 drugs like Ozempic, Wegovy, Mounjaro, and Zepbound do not appear to increase breast cancer risk in the available trial data, even though most trials were not designed to study cancer outcomes for many years. We also discuss why newer studies seem most suggestive for hormone receptor positive breast cancer, along with the leading theories: weight loss itself, improved metabolic health and insulin signaling, reduced inflammation, and the still-unclear possibility of direct GLP-1 effects in cancer biology. If you like evidence-based medicine with real-world context (and a little Philly-life banter), subscribe, share this episode with a friend, and leave a review so more people can find the show. What question do you want answered next about GLP-1s, obesity treatment, or cancer risk?ReferencesRisk for Cancer With Glucagon-Like Peptide-1 Receptor Agonists and Dual Agonists : A Systematic Review and Meta-Analysis. Ko A, Chang YC, Bahar F, et al. Annals of Internal Medicine. 2025;. doi:10.7326/ANNALS-25-02237.Do GLP-1 Receptor Agonists Increase the Risk of Breast Cancer? A Systematic Review and Meta-Analysis. Piccoli GF, Mesquita LA, Stein C, et al. The Journal of Clinical Endocrinology and Metabolism. 2021;106(3):912-921. doi:10.1210/clinem/dgaa891.Glucagon-Like Peptide 1 Receptor Agonists and Cancer Risk: The Good, the Bad and the Unknown. Mannucci E, Dicembrini I. Nature Reviews. Clinical Oncology. 2026;23(6):459-470. doi:10.1038/s41571-026-01135-0.GLP-1 Agonists Are Associated With a Significant Reduction in Breast Cancer Incidence in Women. McDonald ES, Gillis LB, Gabriel P, et al. JCO Oncology Practice. 2026;:101200OP2600485. doi:10.1200/OP-26-00485.GLP-1 therapy and hormone receptor–positive breast cancer risk and survival: A real-world analysis.. Shah Z, Hundal J, Afridi S, et al. Journal of Clinical Oncology. 2026;44(Suppl 16):10548. doi:10.1200/JCO.2026.44.16_suppl.10548.Survival and Recurrence With GLP-1 Receptor Agonists in Breast Cancer. Tatum KL, Dahman B, Stevenson A, et al. JAMA Network Open. 2026;9(5):e2612133. doi:10.1001/jamanetworkopen.2026.12133.Association of Glucagon-Like Peptide-1 Receptor Agonists With Risk of Cancers-Evidence From a Drug Target Mendelian Randomization and Clinical Trials. Sun Y, Liu Y, Dian Y, et al. International Journal of Surgery (London, England). 2024;110(8):4688-4694. doi:10.1097/JS9.0000000000001514.GLP-1 receptor agonists and breast cancer risk in type 2 diabetes.. Guo Cheng and Amanda Ward. Journal of Clinical Oncology. 2025;43(Suppl 16):10557. doi:10.1200/JCO.2025.43.16_suppl.10557.Glucagon-Like Peptide-1 Analogues and Risk of Breast Cancer in Women With Type 2 Diabetes: Population Based Cohort Study Using the UK Clinical Practice Research Datalink. Hicks BM, Yin H, Yu OH, et al. BMJ (Clinical Research Ed.). 2016;355:i5340. doi:10.1136/bmj.i5340.GLP-1 Receptor Agonists and Cancer: Current Clinical Evidence and Translational Opportunities for Preclinical Research. Valencia-Rincón E, Rai R, Chandra V, Wellberg EA. The Journal of Clinical Investigation. 2025;135(21):e194743. doi:10.1172/JCI194743.Send us a (voice ) message with this link, we would love to hear from you. Standard message rates may apply.Support the showProduction and Content: Edward Delesky, MD, DABOM & Nicole Aruffo, RNArtwork Rebrand and Avatars:Vantage Design Works (Vanessa Jones) Website: https://www.vantagedesignworks.com/Instagram: https://www.instagram.com/vantagedesignworks?igsh=aHRuOW93dmxuOG9m&utm_source=qrOriginal Artwork Concept: Olivia Pawlowski

Welcome back, everyone. Today we're diving into one of the most hotly debated topics in obstetrics- should we be treating preeclampsia without severe features with antihypertensive medications during expectant management? Now, if you've been following the literature- and our show, you know that the landmark CHAP trial changed the game for chronic hypertension in pregnancy. It showed us that targeting a blood pressure below 140 over 90 reduces serious maternal complications, without harming the baby. That was a big deal. But here's the thing, CHAP studied chronic hypertension. Then there was the CHIP trial- that also found that tight control of gestational hypertension and nonproteinuric chronic hypertension was also beneficial. These did not address preeclampsia without severe features, and yet, the ripple effects of that trial have sparked a global conversation about whether we should be extending those same treatment principles to women with preeclampsia who don't yet have severe features. And this is where it gets really interesting, because the guidelines don't agree. In the United States, ACOG and the Society for Maternal-Fetal Medicine still say: hold off on antihypertensives unless blood pressures hit the severe range at 160/110. But step outside the US, and you'll find the World Health Organization, the International Society for the Study of Hypertension in Pregnancy, FIGO, NICE, and Hypertension Canada all recommending treatment at 140 over 90, regardless of whether the diagnosis is chronic hypertension, gestational hypertension, or preeclampsia. So who's right? And more importantly what does this mean for the patient sitting in front of you right now, at 34 weeks, with a blood pressure of 150 over 95, some proteinuria, but no severe features? Today, we're going to break this down. We'll review the controversy, walk through the divergent guidelines, and most importantly talk about the real, practical implications that favor treating these patients during expectant management. Because when you're watching someone with preeclampsia, waiting for the right time to deliver, there's a strong argument that controlling their blood pressure isn't just reasonable…may be protective. So grab your coffee, settle in, and let's get into it.1. Society for Maternal-Fetal Medicine Statement: Antihypertensive Therapy For mild chronic Hypertension in Pregnancy-The Chronic Hypertension And Pregnancy Trial. American Journal of Obstetrics and Gynecology. 2022. Society for Maternal-Fetal Medicine; Publications Committee. 2. Preeclampsia. The New England Journal of Medicine. 2022. Magee LA, Nicolaides KH, von Dadelszen P.3. Antihypertensive Drug Therapy for Mild to Moderate Hypertension During Pregnancy.The Cochrane Database of Systematic Reviews. 2018. Abalos E, Duley L, Steyn DW, C.4. Prevention and Treatment of Maternal Stroke in Pregnancy and Postpartum: A Scientific Statement From the American Heart Association. Stroke. 2026. Miller EC, Bello NA, Chen PR, et al.5.Hypertension in Pregnancy: Diagnosis, Blood Pressure Goals, and Pharmacotherapy: A Scientific Statement From the American Heart Association. Hypertension. 2022. Garovic VD, Dechend R, Easterling T, et al.

Full article: Interreader Agreement for Individual Ancillary Features in LI-RADS CT/MRI Version 2018: A Systematic Review and Meta-Analysis LI-RADS CT/MRI ancillary features may vary in their ease of application. Jordon Kondo, MD, is joined by Luke Ginocchio, MD, to discuss the AJR article by Jung et al. exploring interreader agreement of LI-RADS ancillary features. 

And the evidence is catching up!For most of autism's diagnostic history, clinicians have repeated some version of the same number: autism is about four times more common in boys than in girls. That number has shaped which children get screened, which symptoms get recognized, and which ones get explained away as anxiety or shyness or a hormonal thing. Generations of autistic women and girls have been missed because the people doing the looking were taught to look for boys.In this episode, I walk through a 2026 study published in the BMJ that followed 2.7 million Swedish birth records over 35 years. The findings suggest the four-to-one ratio is collapsing — and in adolescent and adult diagnosis, it has either evened out or flipped. Autistic women were never rare. We were just being missed.Topics covered include:Why the four-to-one male-to-female ratio has dominated autism research and clinical practiceWhat "masking" or "camouflaging" means, and why it has cost so muchThe biological vs. diagnostic explanations for the apparent gender gap — and what this study tells us about bothWhy this looks like a catch-up effect rather than a sudden surge in autistic girlsWhat this means for autistic adults who got missed for decadesIf you'd like to know more about topics discussed in this episode, check out:"Time Trends in the Male to Female Ratio for Autism Incidence: Population Based, Prospectively Collected, Birth Cohort Study" by Caroline Fyfe et al."What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis" by Rachel Loomes et al."'Putting on My Best Normal:' Social Camouflaging in Adults With Autism Spectrum Conditions" by Laura Hull et al."Clinical Characteristics and Problems Diagnosing Autism Spectrum Disorder in Girls" by Hannah Young et al. Theme music: "Everything Feels New" by Evgeny Bardyuzha. All episodes written and produced by Kristen Hovet.Send in your questions or thoughts via email or audio or video recording for a chance to be featured on the show! My email address is otherautism@gmail.com Large files can be sent for free via WeTransfer. Buy me a coffee!Buy The Other Autism merch. Use code FREESHIP for free shipping on orders over $75 USD! The views, opinions, and experiences shared by guests on this podcast are their own and do not necessarily reflect those of the host or production team. The content is intended for informational purposes only and should not be taken as medical or professional advice. Please consult with a qualified healthcare provider before making any decisions related to your health, fitness, or wellness. 

If you enjoy this episode, we're sure you will enjoy more content like this on The Occult Rejects.  In fact, we have curated playlists on occult topics like grimoires, esoteric concepts and phenomena, occult history, analyzing true crime and cults with an occult lens, Para politics, and occultism in music. Whether you enjoy consuming your content visually or via audio, we've got you covered - and it will always be provided free of charge.  So, if you enjoy what we do and want to support our work of providing accessible, free content on various platforms, please consider making a donation to the links provided below.  Thank you and enjoy the episode!Links For The Occult Rejectshttps://linktr.ee/theoccultrejectsOccult Research Institutehttps://www.occultresearchinstitute.org/Cash Apphttps://cash.app/$theoccultrejectsVenmo@TheOccultRejectsBuy Me A Coffeebuymeacoffee.com/TheOccultRejectsPatreonhttps://www.patreon.com/TheOccultRejectsBibliographyThe Mechanics of Magick: Singing Bowls and the Ritual Physics of ResonanceCore Singing Bowl ResearchStanhope, Jessica, and Philip Weinstein. “The Human Health Effects of Singing Bowls: A Systematic Review.” Complementary Therapies in Medicine 51 (2020): 102412. Use for the honesty frame: promising findings around mental health and cardiovascular measures, but limited evidence and need for stronger study design.Cai, Yiqing, Guo-Yan Yang, Yibo Liu, Xiang-yun Zou, Heng Yin, Xinyan Jin, Xue-han Liu, Chenlu Wang, Nicola Robinson, and Jian-Ping Liu. “Therapeutic Effects of Singing Bowls: A Systematic Review of Clinical Studies.” Integrative Medicine Research 14, no. 2 (2025): 101144. Use for the newer clinical overview. Important correction: this appears as 101144, not 101176. Good for anxiety, depression, sleep quality, cognition, autistic behavior, and EEG-related outcomes while still keeping the evidence cautious.Lin, F. W., et al. “Effects of Tibetan Singing Bowl Intervention on Psychological and Physiological Health in Adults: A Systematic Review.” 2025. Useful as another recent review angle, especially for psychological health, physiological measures, HRV, and brainwave-related discussion. Keep it secondary behind Stanhope and Cai.Landry, Jayan Marie. “Physiological and Psychological Effects of a Himalayan Singing Bowl in Meditation Practice: A Quantitative Analysis.” American Journal of Health Promotion 28, no. 5 (2014): 306–309. Use for the controlled relaxation study: 51 participants, randomized crossover design, singing bowl exposure or silence before directed relaxation.Goldsby, Tamara L., Michael E. Goldsby, Mary McWalters, and Paul J. Mills. “Effects of Singing Bowl Sound Meditation on Mood, Tension, and Well-Being: An Observational Study.” Journal of Evidence-Based Complementary & Alternative Medicine 22, no. 3 (2017): 401–406. Use for reductions in tension, anger, fatigue, depressed mood, anxiety, and stress after singing bowl meditation. Good, but frame as observational, not definitive.Rio-Alamos, Cristina, et al. “Acute Relaxation Response Induced by Tibetan Singing Bowl Sounds: A Randomized Controlled Trial.” European Journal of Investigation in Health, Psychology and Education 13, no. 2 (2023): 317–328. Use for Tibetan singing bowl treatment compared with progressive muscle relaxation and a waiting-list control in anxious nonclinical adults.Walter, Nina, et al. “Neurophysiological Effects of a Singing Bowl Massage.” Medicina 58, no. 5 (2022): 594. Use for EEG, ECG, and respiration during singing bowl massage; the authors interpret the results as a shift toward a more mindful or meditative state.Goldsby, Tamara L., et al. “Mood, Emotional, and Spiritual Well-Being Interrelationships.” Religions 13, no. 2 (2022). Useful follow-up for spiritual well-being, emotional interpretation, and how people understand sound-healing experiences.Sound, Anxiety, HRV, and Brainwave CautionMallik, Adiel, and Frank A. Russo. “The Effects of Music & Auditory Beat Stimulation on Anxiety: A Randomized Clinical Trial.” PLOS ONE 17, no. 3 (2022): e0259312. Use this carefully for the broader point that sound-based treatments can reduce somatic and cognitive state anxiety. Do not use it as proof that singing bowls automatically entrain brainwaves.Ingendoh, Ruth Maria, Ella S. Posny, and Angela Heine. “Binaural Beats to Entrain the Brain? A Systematic Review of the Effects of Binaural Beat Stimulation on Brain Oscillatory Activity, and the Implications for Psychological Research and Intervention.” PLOS ONE 18, no. 5 (2023): e0286023. Very useful caution source. Use it when warning against overclaiming “brainwave entrainment” and frequency-healing claims.Vilímek, et al. 2022. Low-frequency sound / HRV / vibroacoustic-related research. Use cautiously if you want to discuss low-frequency vibration, body sensation, and autonomic response. I'd keep this as a secondary source unless you want a dedicated paragraph on vibroacoustics.Physics, Resonance, and CymaticsTerwagne, Denis, and John W. M. Bush. “Tibetan Singing Bowls.” Nonlinearity 24, no. 8 (2011): R51–R66. Use for the physics section: wall vibrations, water-surface waves, Faraday-wave effects, droplet motion, and the visible demonstration of resonance.Jenny, Hans. Cymatics: A Study of Wave Phenomena and Vibration. Newmarket, NH: MACROmedia, 2001. Use carefully for visual sound-pattern history. Good for imagery and occult imagination, but don't overuse it as clinical proof.Rossing, Thomas D. The Science of Sound. 3rd ed. San Francisco: Addison Wesley, 2002. Useful general acoustics source for resonance, overtones, vibration, sound waves, and instrument physics.Sound Baths, Wellness Culture, and Modern RitualSobo, Elisa J. “Sound Baths, Trauma Talk, and the Wellness Paradox in the USA.” Medical Anthropology 43, no. 5 (2024): 367–382. Excellent for the modern sound-bath/wellness-culture angle, especially trauma language, nervous-system talk, ritual performance, and how providers frame sound baths.Sobo, Elisa J. “A Beginner's Guide to Sound Baths — What They Are, How to Choose a Good One and What the Research Shows.” The Conversation (2024). Useful for accessible show-note language and ethical/practical framing.Sobo, Elisa J. “Healing Vibrations.” Anthropology News 64, no. 5 (2023): 28–32, 49. Good anthropology/public-facing source for sound healing and wellness culture.Tibetan Singing Bowls, History, and Cultural CommodificationGrimes, Samuel. “Where Did ‘Tibetan' Singing Bowls Really Come From?” Tricycle (2020). Use for the contested-history section. Strong source for questioning popular origin stories around “Tibetan” singing bowls.Joffe, Ben. “Anthropology and Tibetan Buddhism / Cultural Commodification / Tibetan Mystique.” 2015. Use for the larger argument about how Tibetan/Himalayan aura gets packaged in Western spiritual markets. Good support for the “Tibet as imagined storehouse of hidden wisdom” point.Scheidegger, Daniel A. “Tibetan Ritual Music.” Use for actual Tibetan Buddhist ritual sound: bells, cymbals, long horns, drums, chant, and liturgical soundscape. This helps separate real Tibetan ritual sound from overblown modern singing-bowl mythology.Lopez, Donald S. Prisoners of Shangri-La: Tibetan Buddhism and the West. Chicago: University of Chicago Press, 1998. Excellent support for Western romanticization of Tibet.Bishop, Peter. The Myth of Shangri-La: Tibet, Travel Writing, and the Western Creation of Sacred Landscape. Berkeley: University of California Press, 1989. Very useful for the “Tibet as fantasy geography” angle.Ritual, Sound, and Religious ExperienceEliade, Mircea. Shamanism: Archaic Techniques of Ecstasy. Princeton: Princeton University Press, 1964. Use carefully. Good for altered-state technologies and ritual sound/trance, but don't treat it as the final word on shamanism.Rouget, Gilbert. Music and Trance: A Theory of the Relations Between Music and Possession. Chicago: University of Chicago Press, 1985. Excellent for sound, music, trance, possession, rhythm, and ritual performance.Becker, Judith. Deep Listeners: Music, Emotion, and Trancing. Bloomington: Indiana University Press, 2004. Strong source for deep listening, music, emotion, trance, and the body.Husserl, Edmund. On the Phenomenology of the Consciousness of Internal Time. Useful if you want to get philosophical about tone, decay, waiting, and how sound reveals time.Ihde, Don. Listening and Voice: Phenomenologies of Sound. Albany: SUNY Press, 2007. Good for sound as experience, listening, voice, and embodied perception.Placebo, Meaning Response, and Healing RitualMoerman, Daniel E. Meaning, Medicine and the “Placebo Effect.” Cambridge: Cambridge University Press, 2002. Use for “meaning response” instead of treating placebo as “fake.”Benedetti, Fabrizio. Placebo Effects: Understanding the Mechanisms in Health and Disease. Oxford: Oxford University Press, 2009. Useful for placebo mechanisms, expectation, physiology, and therapeutic context.Kaptchuk, Ted J., and Franklin G. Miller. “Placebo Effects in Medicine.” New England Journal of Medicine 373 (2015): 8–9. Good short medical source for placebo effects as real psychobiological phenomena.Csordas, Thomas J. The Sacred Self: A Cultural Phenomenology of Charismatic Healing. Berkeley: University of California Press, 1994. Useful for healing, embodiment, ritual, and religious experience.Embodied Cognition, Extended Mind, and Ritual ToolsClAlso want to remind people about the website, if you're into reading we have tons of information by multiple contributors, and we got t-shirts up on the site if you're interested. Fun fact, the art is all based on the eyeball. A

Sie sind so wichtig für unsere psychische Gesundheit, und doch vernachlässigen wir Hobbys oft. Aber was hält uns eigentlich auf: Keine Zeit, noch nicht das richtige gefunden - oder vielleicht die Angst, nicht gut genug zu sein? Leon und Atze sprechen heute darüber, warum die besten Hobbys merkwürdig sind, wieso wir uns mehr Mittelmäßigkeit zutrauen sollten, und wie man das passende Hobby für sich findet. Fühlt euch gut betreut Leon & Atze Instagram: https://www.instagram.com/leonwindscheid/ https://www.instagram.com/atzeschroeder_offiziell/ Mehr zu unseren Werbepartnern findet ihr hier: https://linktr.ee/betreutesfuehlen Tickets: Atze: https://www.atzeschroeder.de/#termine Leon: https://leonwindscheid.de/tour/ Quellen Was die Deutschen in ihrer Freizeit machen, lässt sich im “Freizeitmonitor 2025” nachlesen: https://www.stiftungfuerzukunftsfragen.de/freizeit-monitor-2025/ Das Paper des amerikanischen Psychiaters über Hobbys während des zweiten Weltkriegs: Menninger, W. C. (1942). Psychological aspects of hobbies: A contribution to civilian morale. American Journal of Psychiatry, 99(1), 122-129. In der Süddeutschen Zeitung schreibt Christina Berndt über Hobbys: https://www.sueddeutsche.de/wissen/hobbys-glueck-arbeit-vorbild-freizeit-li.3325267?reduced=tr Die Idee der “atelischen” Aktivitäten stammt von dem Philosophen Kieran Setiva, nachzulesen im Buch “4000 Wochen: Das Leben ist zu kurz für Zeitmanagement” von Oliver Burkeman Das Review zu Hobbys: Fancourt, D., Aughterson, H., Finn, S., Walker, E., & Steptoe, A. (2021). How leisure activities affect health: a narrative review and multi-level theoretical framework of mechanisms of action. The Lancet Psychiatry, 8(4), 329-339. Die Längsschnittstudie zum Effekt von Hobbys auf Depressionen: Fancourt, D., Opher, S., & de Oliveira, C. (2020). Fixed-effects analyses of time-varying associations between hobbies and depression in a longitudinal cohort study: support for social prescribing?. Psychotherapy and Psychosomatics, 89(2), 111-113. Das Review zur Wirksamkeit von Verhaltensaktivierung bei Depression: Uphoff, E., Ekers, D., Robertson, L., Dawson, S., Sanger, E., South, E., ... & Churchill, R. (2020). Behavioural activation therapy for depression in adults. Cochrane Database of Systematic Reviews, (7). Von der “grindification” der Hobbys spricht der Youtuber “Alastair” in diesem Video: https://www.youtube.com/watch?v=UHAqhP8EeYQ Die Verteidigung der Mittelmäßigkeit von Tim Wu in der New York Times: https://www.nytimes.com/2018/09/29/opinion/sunday/in-praise-of-mediocrity.html Zum Trend der “cozy” Hobbys im Guardian: https://www.theguardian.com/lifeandstyle/2025/sep/04/crafts-are-like-medicine-gen-z-and-the-rapid-rise-of-cosy-hobbies The Atlantic über Produktivität von Hobbys: https://www.theatlantic.com/family/archive/2022/01/history-hobbies-america-productivity-leisure/621150/ Goethe-Institut über den Hobby-Boom während der Pandemie: https://www.goethe.de/prj/mis/de/lei/21904663.html Redaktion: Mia Mertens Produktion: Murmel Productions

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

In this episode, Dr. Brendan McCarthy dives deep into the psychology of ultra-processed foods, compulsive eating, shame, and why so many people feel trapped in unhealthy food cycles. This conversation goes far beyond calories and willpower. Dr. McCarthy explains how ultra-processed and hyper-palatable foods are intentionally engineered to drive repeat consumption, how emotional memories and stress shape cravings, and why shame-based nutrition advice often makes the problem worse instead of better. Topics covered in this episode include: • How ultra-processed foods affect the brain • Why compulsive eating is learned — and can be unlearned • The connection between trauma, stress, and food cravings • The difference between guilt and shame • How marketing and emotional associations shape eating habits • Why “clean eating” language can be harmful • The neuroscience of cravings, dopamine, serotonin, and reward • What real freedom with food actually looks like • Why self-compassion matters in healing If you've ever felt trapped in cycles of emotional eating, binge eating, food guilt, or shame around nutrition, this episode is for you.  

As I have said many times before, some podcast ideas come from REAL clinic encounters. In this episode, Dr Hanna V, our dedicated PGY1 on our call team, and I will answer TWO real questions which arose just today on morning rounds, on our service: 1. Does NORMOTENSIVE HELLP still need Mag Sulfate? And 2. Does an indwelling foley s/p iatrogenic bladder injury at CS require prophylactic antibiotic coverage for urinary infection? Yep: It's a BOGO sale on today's podcast- Buy ONE GET ONE! Listen in for details.1. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222.Obstetrics and Gynecology. 2020. Committee on Practice Bulletins—ObstetricsGuideline2. Woudstra DM, Chandra S, Hofmeyr GJ, Dowswell T.SR. Corticosteroids for HELLP (Hemolysis, Elevated Liver Enzymes, Low Platelets) Syndrome in Pregnancy.The Cochrane Database of Systematic Reviews. 2010. 3. Joshi D, James A, Quaglia A, Westbrook RH, Heneghan MA.Liver Disease in Pregnancy. Lancet. 2010. Review4. Rimaitis K, Grauslyte L, Zavackiene A, et al.Observational. Diagnosis of HELLP Syndrome: A 10-Year Survey in a Perinatology Centre. International Journal of Environmental Research and Public Health. 20195. Reau N, Munoz SJ, Schiano T.Guideline Liver Disease During Pregnancy.The American Journal of Gastroenterology. 2022. 6. ACG Clinical Guideline: Liver Disease and Pregnancy.The American Journal of Gastroenterology. 2016. Tran TT, Ahn J, Reau NS.7. ACOG Practice Bulletin No. 195: Prevention of Infection After Gynecologic Procedures. Obstetrics and Gynecology. 2018. Committee on Practice Bulletins—Gynecology Guideline8. Niels Johnsen, Hunter Wessells, Krystal Archer-Arroyo, et al. Best Practices Guidelines Management of Gentiunrinary Injuries.American College of Surgeons (2025). 20259. Fletke KJ, Jeong DH, Herrera AV . Urinary Catheter Management. American Family Physician. 2024..

If you enjoy this episode, we're sure you will enjoy more content like this on The Occult Rejects.  In fact, we have curated playlists on occult topics like grimoires, esoteric concepts and phenomena, occult history, analyzing true crime and cults with an occult lens, Para politics, and occultism in music. Whether you enjoy consuming your content visually or via audio, we've got you covered - and it will always be provided free of charge.  So, if you enjoy what we do and want to support our work of providing accessible, free content on various platforms, please consider making a donation to the links provided below.  Thank you and enjoy the episode!Links For The Occult Rejectshttps://linktr.ee/theoccultrejectsOccult Research Institutehttps://www.occultresearchinstitute.org/Cash Apphttps://cash.app/$theoccultrejectsVenmo@TheOccultRejectsBuy Me A Coffeebuymeacoffee.com/TheOccultRejectsPatreonhttps://www.patreon.com/TheOccultRejectsPrimary / traditional texts and core religious sourcesĀnāpānasati Sutta (MN 118), translated by Thanissaro Bhikkhu, Access to Insight. Best primary source for Buddhist mindfulness of breathing.“Ḏekr / Dhikr,” Encyclopaedia Iranica. Strong source for Sufi remembrance, rhythmic repetition, posture, and breathing-linked practice.“Hesychasm,” Encyclopaedia Britannica. Good general source for the Christian contemplative tradition of stillness, uninterrupted prayer, and the Jesus Prayer.“Saint Gregory Palamas,” Encyclopaedia Britannica. Useful for the role of bodily posture and controlled breathing in Hesychast prayer.Crowley, Aleister. Liber E vel Exercitiorum. Primary text for Crowley's explicit inclusion of “Pranayama – Regularisation of the Breathing” in occult training.Crowley, Aleister. Book Four, Part 1. Useful for Crowley's statement that pranayama is useful in “quieting the emotions and appetites.”Historical / religious context“Prana,” Encyclopaedia Britannica. Best short source for the deep Indian background: prāṇa, the five prāṇas, and breath as vital force.“Pranayama,” Encyclopaedia Britannica. Best short source for classical Yoga: pranayama as the fourth limb aimed toward samādhi.“Hatha Yoga,” Encyclopaedia Britannica. Useful for the force-oriented turn: bodily mastery, purification, and regulation of breathing.“Qi,” Encyclopaedia Britannica. Good for Daoist and Chinese background: qi as psychophysical energy and breath-linked vital force.“Qigong,” Encyclopaedia Britannica. Useful for qigong as a discipline combining movement, breathing, and mental concentration.“Are Kabbalistic Meditations all about Ecstasy?” in Hermes Explains (Cambridge). Strong academic source for Abraham Abulafia and ecstatic Kabbalah.“Classical Kabbalah, Its History and Symbolic Universe.” Useful academic source noting ecstatic Kabbalah's breathing exercises, postures, and developed techniques.Neuroscience / physiology / altered statesAshhad, Kam, Del Negro, and Feldman. “Breathing Rhythm and Pattern and Their Influence on Emotion.” Annual Review of Neuroscience (2022). One of the best overview papers for the whole episode.Yackle et al. “Breathing control center neurons that promote arousal in mice.” Science (2017). Key source for the preBötzinger complex / calm-vs-arousal section.Schottelkotte and Dutschmann. “Forebrain control of breathing: Anatomy and potential functions.” Frontiers in Neurology (2022). Best source for cortex, amygdala, hippocampus, hypothalamus, and thalamus in breathing control.Krohn et al. “The integrated brain network that controls respiration.” eLife (2023). Strong review for respiration as part of a larger integrated brain network.Heck et al. “Breathing as a fundamental rhythm of brain function.” Human MEG work on respiration-modulated brain oscillations across frequency bands and brain regions.(Note: the specific MEG paper surfaced in earlier research as the respiration-modulated oscillations study; the review sources above are the strongest anchors for that section.)Zelano et al. “Nasal Respiration Entrains Human Limbic Oscillations and Modulates Cognitive Function.” Journal of Neuroscience (2016). One of the most important human papers in the whole script.Schreiner et al. “Respiration modulates sleep oscillations and memory reactivation in humans.” Nature Communications (2023). Best source for the sleep-spindle / memory-reactivation section.Zaccaro et al. “How Breath-Control Can Change Your Life: A Systematic Review on Psychophysiological Correlates of Slow Breathing.” Frontiers in Human Neuroscience / PMC version (2018). Best broad source for slow breathing under 10 breaths per minute.Shao, Man, and Lee. “The Effect of Slow-Paced Breathing on Cardiovascular and Emotion Functions: A Meta-Analysis and Systematic Review.” Mindfulness (2024). Useful for the stabilizing-road section.Kozhevnikov et al. “Neurocognitive and Somatic Components of Temperature Increases during g-Tummo Meditation.” PLoS ONE (2013). Best source for vase breathing and inner-heat claims.Zhang et al. “Hyperventilation in neurological patients: from physiology to outcome evidence.” Useful source for hypocapnia, cerebral vasoconstriction, and reduced cerebral blood flow.Havenith et al. “Decreased CO2 saturation during circular breathwork supports emergence of altered states of consciousness.” Communications Psychology (2025). The key modern paper for circular breathwork and altered-state onset. Also want to remind people about the website, if you're into reading we have tons of information by multiple contributors, and we got t-shirts up on the site if you're interested. Fun fact, the art is all based on the eyeball. Now let me introduce the rest of the panel and guests.

If you enjoy this episode, we're sure you will enjoy more content like this on The Occult Rejects.  In fact, we have curated playlists on occult topics like grimoires, esoteric concepts and phenomena, occult history, analyzing true crime and cults with an occult lens, Para politics, and occultism in music. Whether you enjoy consuming your content visually or via audio, we've got you covered - and it will always be provided free of charge.  So, if you enjoy what we do and want to support our work of providing accessible, free content on various platforms, please consider making a donation to the links provided below.  Thank you and enjoy the episode!Links For The Occult Rejectshttps://linktr.ee/theoccultrejectsOccult Research Institutehttps://www.occultresearchinstitute.org/Cash Apphttps://cash.app/$theoccultrejectsVenmo@TheOccultRejectsBuy Me A Coffeebuymeacoffee.com/TheOccultRejectsPatreonhttps://www.patreon.com/TheOccultRejects1. Patel, A. K., et al. *Physiology, Sleep Stages*. StatPearls / NCBI Bookshelf, 2024.2. Jensen, O., & Mazaheri, A. “Shaping Functional Architecture by Oscillatory Alpha Activity: Gating by Inhibition.” *Frontiers in Human Neuroscience*, 2010.3. Cavanagh, J. F., & Shackman, A. J. “Frontal Midline Theta Reflects Anxiety and Cognitive Control: Meta-Analytic Evidence.” *Journal of Physiology-Paris*, 2015.4. Axmacher, N., et al. “Cross-Frequency Coupling Supports Multi-Item Working Memory in the Human Hippocampus.” *PNAS*, 2010.5. Lacaux, C., et al. “Sleep Onset Is a Creative Sweet Spot.” *Science Advances*, 2021.6. Horowitz, A. H., et al. “Targeted Dream Incubation at Sleep Onset Increases Post-Sleep Creative Performance.” *Scientific Reports*, 2023.7. Caporro, M., et al. “Functional MRI of Sleep Spindles and K-Complexes.” *Clinical Neurophysiology*, 2012.8. Ng, T., et al. “Bayesian Meta-Analysis Reveals the Mechanistic Role of Slow Oscillation-Spindle Coupling in Sleep-Dependent Memory Consolidation.” *eLife*, 2025.9. Datta, K., et al. “Electrophysiological Evidence of Local Sleep During Yoga Nidra Practice in Young Male Volunteers.” *Frontiers in Neurology*, 2022.10. Jensen, M. P., et al. “Brain Oscillations, Hypnosis, and Hypnotizability.” *American Journal of Clinical Hypnosis*, 2015.11. Huels, E. R., et al. “Neural Correlates of the Shamanic State of Consciousness.” *Frontiers in Human Neuroscience*, 2021.12. Ingendoh, R. M., et al. “Binaural Beats to Entrain the Brain? A Systematic Review...” *PLOS ONE*, 2023.13. Páez, A., et al. “Sleep Spindles and Slow Oscillations Predict Cognition and Biomarkers of Neurodegeneration in Mild to Moderate Alzheimer's Disease.” *Alzheimer's & Dementia*, 2025.14. Askitopoulou, H. “Sleep and Dreams: From Myth to Medicine in Ancient Greece.” *Journal of Anesthesia History*, 2015.15. Pavli, A. “Asclepieia in Ancient Greece: Pilgrimage and Healing.” *Journal of Integrative Medicine and Research*, 2024.Also want to remind people about the website, if you're into reading we have tons of information by multiple contributors, and we got t-shirts up on the site if you're interested. Fun fact, the art is all based on the eyeball. Now let me introduce the rest of the panel and guests.

For many years, the topic of whether a polarized or pyramidal training intensity distribution is more effective for endurance athletes has been hotly debated. Arturo Casado, PhD, is one of the foremost researchers in this area (and former European Champion in the 1500 metres). Today, Arturo dissects what the science really says in 2026: whether there is a winner, and if not, what are the athlete-specific, event-specific, and other variables that impact which training distribution will bring the best results. We also discuss specific training models from Canova to Norwegian from both scientific and practical perspectives, and bring it all together with practical advice relevant for amateur triathletes and runners.  HIGHLIGHTS AND KEY TOPICS:  The science and practice of training intensity distributions. Who should use polarized versus pyramidal TIDs and when?  How do factors such as athlete level, age and sex, sport or modality, distance or event, periodization and more impact the choice of training intensity distribution? The science and practise of different training models in distance running, including Lydiard, Kenyan, Canova, Norwegian, Coe and more How do best practices differ between amateur athletes and elite runners and triathletes?   Practical tips and takeaways DETAILED EPISODE SHOWNOTES:  We have detailed shownotes for all of our episodes. The shownotes are basically the podcast episode in written form, that you can read in 5-10 minutes. They are not transcriptions, but they are also not just surface-level overviews. They provide detailed insights and timestamps for each episode, and are great especially for later review, after you've already listened to an episode.  The shownotes for today's episode can be found at https://scientifictriathlon.com/tts695/ LINKS AND RESOURCES:  Arturo's ResearchGate, Instagram and World Athletics profiles  Effects of polarized, pyramidal, and combined training periodisations with Luca Filipas, PhD | EP#328 - study mentioned in the interview Michele Zanini (part 2) | EP#394 - the Renato Canova training method Training Periodization, Methods, Intensity Distribution, and Volume in Highly Trained and Elite Distance Runners: A Systematic Review Casado et al. 2022 World-Class Long-Distance Running Performances Are Best Predicted by Volume of Easy Runs and Deliberate Practice of Short-Interval and Tempo Runs - Casado et al. 2021 Does Lactate-Guided Threshold Interval Training within a High-Volume Low-Intensity Approach Represent the “Next Step” in the Evolution of Distance Running Training?- Casado et al. 2023 Pacing strategies in men's and women's world- record marathon performances and Olympic Games and World Championship's winning performances - Casado et al. 2024 Training Intensity Distribution, Volume, Periodization, and Performance in Elite Rowers: A Systematic Review - Zhong et al. 2025 Which Training Intensity Distribution Intervention will Produce the Greatest Improvements in Maximal Oxygen Uptake and Time-Trial Performance in Endurance Athletes? A Systematic Review and Network Meta-analysis of Individual Participant Data - Rosenblat et al. 2025 WHAT SHOULD I LISTEN TO NEXT? If you enjoyed this episode, I think you'll love the following related episodes: John Davis – Coaching, physiology, and running calculators | EP#464 [Triathlon Science] Durability decoded – a 2025 perspective with Michele Zanini, PhD Gabriele Gallo, PhD – The Science of Cycling Performance | EP#441 You can find our full episode archives here, where you can filter for categories such as Training, Racing, Science & Physiology, Swimming, Cycling, Running etc. You can also find separate archives for specific series of episodes I've done, specifically Q&A episodes, TTS Thursday episodes, and Beginner Tips episodes.  LEARN MORE ABOUT SCIENTIFIC TRIATHLON:  The Scientific Triathlon website is the home of That Triathlon Show and everything else that we do Contact us through our contact form or email me directly (note - email/contact form messages get responded to much more quickly than Instagram DMs) Subscribe to our Newsletter Follow us on Instagram Learn more about our coaching, training plans, and training camps. We have something to offer for everybody from beginners to professionals.  HOW CAN I SUPPORT THAT TRIATHLON SHOW (FOR FREE)?  I really appreciate you reading this and considering helping the show! If you love the show and want to support it to help ensure it sticks around, there are a few very simple things you can do, at no cost other than a minute of your time.  Subscribe to the podcast in your podcast app to automatically get all new episodes as they are released. Tell your friends, internet and social media friends, acquaintances and triathlon frenemies about the podcast. Word of mouth is the best way to grow the podcast by far!  Rate and review the podcast (ideally five stars of course!) in your podcast app of choice (Spotify and Apple Podcasts are the biggest and most important ones). Share episodes online and on social media. Share your favourite episodes in your Instagram stories, start a discussion about interesting episodes on forums, reference them in your blog or Substack.  SPONSORS: Precision Fuel & Hydration produce our favourite gels, sports drinks, and electrolyte and carbohydrate products here at That Triathlon Show and Scientific Triathlon. Use the free Fuel & Hydration Planner to get a personalised plan for your carbohydrate, sodium and fluid intake in your next event, and get 15% off your first 2026 order by using the code TTS2026 at checkout. Rouvy is hands down the most complete indoor cycling platform for triathletes. Among their thousands of beautiful bike courses from all around the world, all filmed in stunning quality, they have over 75 IRONMAN and IRONMAN 70.3 race courses plus 20+ Challenge Family courses, so you can pre-ride your race from home. Real gradients, real visuals, and real feel! 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Bibliography: 1.. 2019 Systematic Review of Published Cases: https://doi.org/10.1111/dme.14050 2. Mass General Data & Publication: https://jamanetwork.com/journals/jamaoncology/fullarticle/2822927 3. Japanese Claims Data & Pub: https://doi.org/10.1111/jdi.14362 Check out the Oncology Insights Newsletter: www.kelleycpharmd.com/newsletter-oncopharm

The diagnosis of fetal growth restriction can be made with an isolated abdominal circumference less than the 90th percentile. So is the opposite true? Does a fetal abdominal circumference (isolated) of greater than 90% qualify for “LGA” fetus? In this episode we're going to explain why, although it is logically correct, it is diagnostically incorrect. An isolated abdominal circumference on ultrasound of greater than 90% is however a strong predictive risk factor for one delivery finding. Listen in for details.1. Macrosomia: ACOG Practice Bulletin, Number 216. Obstetrics and Gynecology. 20202. Canavan TP, Hill LM.. Sonographic Biometry in the Early Third Trimester: A Comparison of Parameters to Predict Macrosomia at Birth. Journal of Clinical Ultrasound : JCU. 2015. 3. Culliney KA, Parry GK, Brown J, Crowther CA. Regimens of Fetal Surveillance of Suspected Large-for-Gestational-Age Fetuses for Improving Health Outcomes.The Cochrane Database of Systematic Reviews. 2016.

Send us Fan MailDescription: An immersive reading of Sommelier by by Suraj Bala with reflection on reflection, death, resurrection, candles and em dashes. Work:Poem: https://jamanetwork.com/journals/jamaoncology/article-abstract/2839156Bala S. Sommelier. JAMA Oncol. 2025;11(11):1399. doi:10.1001/jamaoncol.2025.2896References: Meditation for the Primary and Secondary Prevention of Cardiovascular Disease. Rees K, Takeda A, Court R, et al. The Cochrane Database of Systematic Reviews. 2024;2:CD013358. doi:10.1002/14651858.CD013358.pub2.Meditation Programs for Psychological Stress and Well-Being: A Systematic Review and Meta-Analysis. Goyal M, Singh S, Sibinga EM, et al. JAMA Internal Medicine. 2014;174(3):357-68. doi:10.1001/jamainternmed.2013.13018.Inner Engineering Practices and Advanced 4-Day Isha Yoga Retreat Are Associated With Cannabimimetic Effects With Increased Endocannabinoids and Short-Term and Sustained Improvement in Mental Health: A Prospective Observational Study of Meditators. Sadhasivam S, Alankar S, Maturi R, et al. Evidence-Based Complementary and Alternative Medicine : eCAM. 2020;2020:8438272. doi:10.1155/2020/8438272.Systematic Review for the Medical Applications of Meditation in Randomized Controlled Trials. Kim DY, Hong SH, Jang SH, et al. International Journal of Environmental Research and Public Health. 2022;19(3):1244. doi:10.3390/ijerph19031244.

Have you ever had a close call falling asleep because you were exhausted from working your EMS shift? While we often acknowledge fatigue in EMS as an issue, we must do more to address and operationalize the education, policy, and system design of this dangerous problem. Hosts Maia Dorsett, Rob Lawrence and Hilary Gates are joined by fatigue expert P. Daniel Patterson, PhD, NRP, Associate Professor in the Department of Emergency Medicine at the University of Pittsburgh along with Stephanie Louka, MD, EMT, an EMS physician at the Virginia Commonwealth University Medical Center. Stephanie shares a gripping firsthand story of a post-shift crash where she became a patient. The episode explores the science—and the lived reality—of fatigue in EMS.  From the biology of fatigue to evidence-based strategies like tactical napping and sleep banking, this episode challenges educators and leaders to rethink how we prepare clinicians not just to treat patients, but to survive the job.  You'll hear how leaders must confront the cultural and organizational barriers of this issue to keep crews, patients and the public safe. Fatigue isn't just a wellness issue—it's a safety issue. What will you change after listening? Ginger Locke highlights the episode's key points with her "Mindset Minute." Mentioned in the episode: 2024 Systematic Review of Evidence-Based Guidelines for Prehospital Care https://pubmed.ncbi.nlm.nih.gov/39373357/ The EMS Educator is published on the first Friday of every month! Be sure to turn on your notifications so you can listen as soon as the episode drops, and like/follow us on your favorite platform. Check out the Prodigy EMS Bounty Program! Earn $1000 for your best talks! Get your CE at www.prodigyems.com. Follow @ProdigyEMS on FB, YouTube, TikTok & IG.

The Psych Review is back with the first episode of 2026 and the first episode of Season 9! The crew is lead by Greg through a deep dive into potential side effects that can occur in relation to stimulant use. We discuss changes in ADHD assessment and management over the years, and potential consequences related to the increasing use of stimulant medications (including psychosis).The reference for this episode is:Greg: Salazar de Pablo, Gonzalo et al. Occurence of Psychosis and Bipolar Disorder in Individuals with Attention-Deficit/Hyperactivity Disorder Treatment with Stimulants - a Systematic Review and Meta-Analysis. JAMA Psychiatry. 2025 ;82(11):1103-1112.The Psych Review was brought to you by Call to Mind, a telepsychiatry service that you can learn more about at www.calltomind.com.au. The original music in our podcast was provided by the very talented John Badgery, and our logo was designed by the creative genius of Naz.

Ever noticed your head starts throbbing before the first drop of rain falls?It's not in your imagination. Your brain may be acting like a living weather barometer.In this episode of Migraine Heroes Podcast, Diane Ducarme explores why shifting skies so often means shifting pain. Blending neuroscience with Eastern medicine, this episode unpacks how changes in barometric pressure ripple through your nervous system long before the storm arrives.You'll discover:

In this episode, we're diving into the hot topic of protein sparing modified fasting (PSMF) and why short, strategic “3-day sprints” can be a powerful metabolic reset. Ali shares how these brief hypocaloric phases may help accelerate body fat loss while supporting anti-inflammatory processes and increasing autophagy, the body's natural cellular cleanup system.  The literature consistently shows that most diets fail long term, with weight regain common within five years, and often much sooner with more aggressive interventions like GLP-1 medications or surgical approaches. In this conversation we explore who may benefit from protein sparing fasts, who should avoid them, where supplements fit in and how to implement this strategy. We also discuss research on autophagy. Also in this episode:  Beat the Bloat FREE Masterclass 4/7 Beat the Bloat Program starts 4/21 What is a protein sparing modified fast? A Systematic Review of Evidence on the Use of Very Low Calorie Diets in People with Diabetes - PubMed The protein-sparing modified fast for obese patients with type 2 diabetes What does a day of fasting this way look like? A protein sparing fast can be broken into 1 meal and 2 snacks or 2 meals or even 3 meals, but I typically do: Coffee with Pure Collagen and ½ scoop Whey Protect with 1 Tbsp heavy cream (26g protein, 150 cal) 1 jar FOND (15g protein 60 cal) 6oz filet of wild salmon (300 cal 33g pro) 1 jar of FOND  (15g protein 60 cal)  Naturally Nourished Teas Thoughts on dry fasting or water fasting  Does protein disrupt autophagy? A high protein meal does not change autophagy in human blood In Defense of Protein Effects Of Oral Glutamine on Inflammatory and Autophagy Responses in Cancer Patients Treated With Abdominal Radiotherapy: A Pilot Randomized Trial Bone Broth benefits Glycine Relieves Intestinal Injury by Maintaining mTOR Signaling and Suppressing AMPK, TLR4, and NOD Signaling in Weaned Piglets after Lipopolysaccharide Challenge Curcumin induces autophagy, inhibits proliferation and invasion by downregulating AKT/mTOR signaling pathway in human melanoma cells - PubMed Who should consider PSMF and who should not?  What supplements support PSMF? Detox Packs Multidefense  Relax and Regulate Berberine Boost Calm and Clear GabaCalm  

Jest kultowa scena w filmie Lejdis, w której bohaterka mówi że empatia to taka zupa z Azji, a ja sobie myślę, że w popkulturze stała się niestrawnym wywarem sto razy przemielonym przez ledwo drożne trzewia i zdarza się, że rozumiemy ją mylnie. Więc na warsztat dzisiaj bierzemy umiłowane, odmieniane przez przypadki słowo EMPATIA.Wielkie i gromkie brawa dla Patronów i Patronek, bo to właśnie oni ten odcinek wyprodukowali. Za ich ciężko zarobione pieniądze powstał ten podcast ku uciesze, mam nadzieję, wszystkich słuchających, zróbcie proszę hałas w komentarzach i subach oraz wszelkich formach wirtualnej sympatii (nie mylić z empatią - posłuchajcie, zrozumiecie ;) )Montaż: Eugeniusz KarlovLITERATURA:Cuff, B. M. P., Brown, S. J., Taylor, L., & Howat, D. J. (2016). Empathy: A Review of the Concept. Emotion Review, 8(2), 144-153.Elliott, R., Bohart, A. C., Watson, J. C., & Greenberg, L. S. (2011). Empathy. Psychotherapy, 48(1), 43–49. https://doi.org/10.1037/a0022187Humphrey, R. H. (2013). The benefits of emotional intelligence and empathy to entrepreneurship. Entrepreneurship Research Journal, 3(3), 287-294.McDonald, E. M., Tobin, K. E., Cooper, A. M., & Tully, E. C. (2026). A Systematic Review and Meta‐Analysis of Social Media Use and Empathy in Adolescence. Journal of Adolescence.Mossner, C., & Walter, S. (2024). Shaping Social Media Minds: Scaffolding Empathy in Digitally Mediated Interactions?. Topoi, 43(3), 645-658.Rumble, A. C., Van Lange, P. A., & Parks, C. D. (2010). The benefits of empathy: When empathy may sustain cooperation in social dilemmas. European Journal of Social Psychology, 40(5), 856-866.

What should you actually do when you're chronically sleep deprived?If you're a parent, shift worker, insomniac, or coach people who are, you've probably asked yourself whether training is helping or harming you.In this episode, I dive into the research on acute and chronic sleep restriction and its effects on:• Cognitive performance• Strength and endurance• Hormonal signalling (testosterone, AMPK, mTOR)• Mood and perceived health• Recovery and long-term adaptationWe examine a 2025 systematic review and meta-analysis of 45 experimental studies (from 18,127 initially identified papers) looking at sleep deprivation and performance. We unpack one of the longest chronic sleep restriction protocols to date (6 weeks of restricted weekday sleep with weekend “recovery”), and what that tells us about cumulative sleep debt.We also explore:• Why early waking may impair cognition differently than going to bed late• Whether moderate aerobic exercise can offset some cognitive effects of sleep loss• What experimental data show about testosterone under sleep restriction• Why resistance training under chronic sleep deprivation may require adjustment• The difference between narrative reviews and higher-quality meta-analytic evidenceEssentially, we look at how to train intelligently when sleep is broken, short, or unpredictable, and what the science can (and cannot) tell us right now.Main ReferenceSystematic Review & Performance Effects[2025 Systematic Review & Meta-Analysis on Sleep Deprivation and Performance – 45 Experimental Studies]Chronic Sleep Restriction with Weekend RecoverySmith et al. (2021). Chronic sleep restriction during a 6-week protocol with weekend recovery and cumulative sleep debt analysis.

In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast, we take a structured, evidence-based approach to the acute treatment of migraine in children and adolescents. From confirming the diagnosis and screening for concerning features to optimizing outpatient therapy and executing a protocolized emergency department strategy, this episode walks through what works. We review the role of NSAIDs and triptans, clarify how IV fluids and ketorolac fit into care, and provide a stepwise framework for dopamine antagonists, valproate bridge therapy, DHE protocols, steroids, discharge planning, and admission decisions. Practical dosing, reassessment timing, and family-centered communication strategies are emphasized throughout. Learning Objectives Recognize the clinical features of pediatric migraine and distinguish it from secondary causes of headache. Implement a stepwise, evidence-based emergency department approach to acute pediatric migraine, including appropriate medication selection and timing of reassessment. Develop safe discharge and follow-up plans by defining treatment endpoints, minimizing medication overuse, and identifying patients who require referral or inpatient management. References 1. Oskoui M, Pringsheim T, Holler-Managan Y, et al. Practice Guideline Update Summary: Acute Treatment of Migraine in Children and Adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2019;93(11):487-499. doi:10.1212/WNL.0000000000008095. 2. Patterson-Gentile C, Szperka CL. The Changing Landscape of Pediatric Migraine Therapy: A Review. JAMA Neurology. 2018;75(7):881-887. doi:10.1001/jamaneurol.2018.0046. 3. Bachur RG, Monuteaux MC, Neuman MI. A Comparison of Acute Treatment Regimens for Migraine in the Emergency Department. Pediatrics. 2015;135(2):232-238. doi:10.1542/peds.2014-2432. 4. Ashina M. Migraine. The New England Journal of Medicine. 2020;383(19):1866-1876. doi:10.1056/NEJMra1915327. 5. Richer L, Billinghurst L, Linsdell MA, et al. Drugs for the Acute Treatment of Migraine in Children and Adolescents. The Cochrane Database of Systematic Reviews. 2016;4:CD005220. doi:10.1002/14651858.CD005220.pub2. Transcript This transcript was generated using Descript automated transcription software and has been reviewed and edited for accuracy by the episode's author. Edits were limited to correcting names, titles, medical terminology, and transcription errors. The content reflects the original spoken audio and was not substantively altered. And today we're gonna talk about the acute treatment of migraine headache in children and adolescents. This is bread and butter for the PED, requires precise diagnosis and evidence-based treatment. We're gonna talk about making that diagnosis, red flags, outpatient and ED treatment, as well as some second-line agents, admission decisions, and a whole lot more. So migraine in children is defined by three criteria, and at least five attacks lasting two to 72 hours. So you gotta have at least two of the following: pulsating or throbbing quality, moderate to severe intensity, aggravation by routine activity, and a unilateral location. Although in children, it's often bilateral, plus at least one of nausea or vomiting and photophobia and/or phonophobia. In children headaches are frequently bilateral, bifrontal, bitemporal. The duration might be shorter than adults, especially in kids under second or third grade. And you may have to infer whether or not they have photophobia from their behavior. Like does the child close their eyes or wanna go into a dark room? In the emergency department, we're often diagnosing based on pattern recognition plus exclusion of dangerous secondary causes. Or even more often than that, the patient comes in and says, I've got a migraine. Before I move on to treatments, let's talk about some red flags where you might wanna pause and not just jump to migraine therapy. And the mnemonic SNOOP can be helpful here. And it stands for S for systemic symptoms such as fevers, myalgia, weight loss, or another S, secondary risk factors such as an immune deficiency, cancer, pregnancy, N for neurologic signs, papilledema, focal deficit, confusion, seizures. O onset sudden, or thunderclap. Migraines are often a little more gradual than that. The other O is older age, or technically younger age too, younger than five years or older than 50. Hopefully those patients are not coming into the pediatric emergency department. And then pattern changes, these new symptoms in a previously stable pattern. Don't ignore that. And precipitants, you know, is it worse with Valsalva, position change, or under significant exertion? If these signs are present, you'll probably wanna take a pause and just not throw migraine treatment at the patient. If they're stable, MRI is the preferred imaging modality, but a very sick patient, it'd be okay to get a head CT. If you've got a normal neurologic exam, there's no red flags. Again, you don't need routine imaging for migraine headaches. So let's talk about treatment. So hopefully patients have actually started to treat their headache before they arrive in the emergency department. If they haven't, it's a good idea to have some triage protocols in place. So ibuprofen, 7.5 to 10 milligrams per kilogram, 10 milligrams per kilogram is superior to placebo and it's superior to acetaminophen at two hours. So that's what we would use. Early treatment's critical. So ideally within the first hour of onset. So that's why triage protocols help. We'll give kids 10 mg per kg of ibuprofen and like 30 ounces of Gatorade. Blue is often the first Gatorade choice, though that's not an evidence-based statement. You can also use naproxen, but most of the studies are on ibuprofen. If NSAIDs fail, many adolescents and some older children will be prescribed triptans. The best evidence currently supports sumatriptan plus naproxen or zolmitriptan nasal spray. Rizatriptan is FDA approved down to age six. Adolescents respond to these agents better than younger children, and the route matters. The nasal formulations help when nausea is prominent. Families should be counseled to treat early, use weight-appropriate dosing, and avoid using acute medications more than 10 days per month. Often patients will have already taken an NSAID and a triptan before they get to the ED, and that's where we get into the treatment of refractory migraine. Now this is most of the patients that I will see, and before we push medications, let's briefly review ED treatment goals. You either want the patient headache free. Back to their baseline or mild descending pain. So a pain score of one to three. If you don't reach one of those endpoints and it's not agreed upon with the patient and their family, you've not completed treatments. You should do a reassessment within one hour after each intervention. And let's face it, if you're not reassessing within an hour and defining treatment goals, you're not practicing protocolized migraine care. So in the emergency department, many of you may be familiar with the migraine cocktail. So what is that? In general, it's a dopaminergic agent such as prochlorperazine or metoclopramide plus ketorolac, plus IV fluids. Let's take a look at all three of those components and see if you can guess which one is actually the one that can abort the migraine. So fluids are commonly given in pediatric migraine, but they alone do not treat it. They're helpful. Many patients have been throwing up or a bit dehydrated, but there are small randomized trials that show essentially no meaningful pain reduction in patients that get IV fluids alone. Well, what about ketorolac? Toradol, like that's the first thing you give to a kid with a kidney stone, right? It does help, but it's really adjunctive. So the main first-line agents for refractory or status migrainosus in the emergency department are the dopamine antagonists, and the first-line treatment for most patients is prochlorperazine or Compazine. The dose is 0.15 milligram per kilogram IV. The max is 10 milligrams. This is the backbone of ED migraine care. And why do they work? Well, migraines aren't just some random vascular headache. This is an inherited disorder with central pain pathways gone awry. Dopamine plays a large role in that pain, nausea, hypersensitivity, amplification of symptoms and more that, frankly, I won't get into this podcast because molecules hurt my head. The dopamine antagonists treat the headache, they reduce the nausea, and they just tamp down this process. Overall, the response rates approach 85%. Some studies have suggested that the response rate is about 77% at an hour and 90% at three hours. If you add the ketorolac and IV fluids, you get your response rate up to about 93 to 94%. These agents really do work well together. There have been randomized trials comparing IV prochlorperazine versus ketorolac. 85% of prochlorperazine patients achieved headache relief versus only 55% of ketorolac patients. So ketorolac helps, but really it's the prochlorperazine. Metoclopramide, or Reglan, is used in a lot of centers as well. There are some smaller studies in children and adolescents that show that prochlorperazine is more effective, but if kids have an adverse reaction, more on that in a moment, or they prefer metoclopramide because they've responded to it in the past, it's okay to go with it as well. Right. So what does it actually look like when you give the migraine cocktail to a patient? I think it's important to explain to patients and families what to expect, and if this is a teenager, I'm talking to them directly. I mean, they're getting the medication first and foremost. I tell them that the most effective way to treat their headache is with an IV. This often causes lots of angst, even in older teenagers. The medication just does not get to the brain as effectively and fast enough if you take it by mouth. Many patients who get the dopaminergic agents, so prochlorperazine, will invariably feel jittery or anxious or like they gotta move or like they got ants in their pants. I tell them to expect this so they're not surprised and worried when it happens. I tell them that once they start feeling that way, it means the medicine is probably working. They need to hit the nurse button and we're gonna get them up and have them take a walk. This fixes it for the majority of patients just getting up and moving. In adult centers, even with the initial administration of the prochlorperazine or as sort of a reflexive response to any of those symptoms, they just give a slug of IV Benadryl. There's some studies in adolescents especially that this may decrease the effectiveness of the IV agents you're giving in the first place, and it may also increase return rates to the ED. So I will use IV diphenhydramine if getting up and moving around isn't working, or if the distress is significant, or if the patient clearly indicates they've needed it in the past. So if after the migraine cocktail, the patient has met their pain goals and the reassessment is favorable, they can go home to outpatient follow-up. How about if the headache got better, but not all the way? It's usually when the initial migraine cocktail didn't achieve the pain endpoints fully, like it helped partially. If the dopamine blockade didn't do anything, valproate is unlikely to rescue the case. And so valproate works on GABA and it stabilizes some of these pain processes, but the dopaminergic agent needs to have done something first for valproate to work. Per the most common protocol, you give an initial dose of IV valproate, then you discharge the patient home on Depakote ER. So oral valproic acid under 10 years old or under 50 kilograms, 250 milligrams PO twice a day for two weeks, or older than 10 or greater than 50 kilos, 500 milligrams twice a day for two weeks. This is the extended release and it's most helpful if you give the first oral dose in the emergency department. So that's why it's very important to build this protocol in advance. If you don't have IV valproate, then don't just give the patient oral valproate, and definitely don't prescribe an oral course for discharge. All right, well, what about DHE? Dihydroergotamine for refractory or status migrainosus? Generally, this is only given at pediatric centers where you have neurology coverage. It's contraindicated if you've had another dose of DHE within 14 days, or you've had any triptan of any sort within 24 hours, and you must obtain a pregnancy test in adolescent females before giving it. The dosing for less than 30 kilograms is 0.5 milligram. At least 30 kilograms is one milligram. You give 50% of the dose over three minutes, then the remaining 50% over 30 minutes. If this is gonna work, the patients are gonna start feeling wretched at first. They're gonna get very nauseous and they're gonna vomit. They're gonna have flushing, and you'll see transient hypertension. Most of that resolves within the hour in most centers. If you're committing to DHE, you're kind of bringing the patient into the hospital anyway, though some facilities will have DHE done in the emergency department with close outpatient follow-up. Either way, it's really best practice to involve child neurology if you're giving DHE. Alright, well what about steroids? They give those in grownups too, right? Steroids really only have a role for recurrence prevention in children. So for kids that have a history of returning within 72 hours for rebound headache, you can give dexamethasone 0.6 milligram per kilogram IV dose, the max of 10 milligrams. You do not discharge them home on a steroid prescription or a Medrol dose pack or something else, and this can cut the recurrence risk down a bit. There's other therapies out there like magnesium and ketamine. There's just not enough evidence there. And the purpose of this episode is to discuss the therapies that have good evidence behind them and should be part of protocols across the country. Some patients are unfortunately not responsive to emergency department therapy and need admission. The main inpatient therapy is the DHE protocol. If they're not DHE eligible, they haven't tolerated it well or it's unavailable, admission's unlikely to help them unless they just need some IV fluids to help them get back up on their feet. You should consult neurology if the headache goals are not met after maximizing ED therapy for advice. And we should definitely avoid opioids. They don't treat patients with migraines. They increase recurrence risk. They increase revisit rates. Again, the dopamine antagonist prochlorperazine, it's superior for sustained relief when families ask about them, and fortunately they're asking about opioids far less. We use medications that treat the migraine pain pathways and signaling. We don't just wanna mask the pain. All right, so that's all I've got on the acute management of migraine headaches, especially in the emergency department. Remember that migraine care in the ED should be protocolized and evidence-based. IV fluids are supportive. Prochlorperazine is the first line, or you can use metoclopramide as well. Ketorolac is an adjunctive therapy. Valproate is next line. If you've gotta escalate, and DHE is specialized therapy, you can start in the ED, but most of these patients are getting admitted. Dexamethasone or steroids in children can reduce recurrence risk, but they're not really part of the acute management. You should definitely define the endpoints and structurally and systematically reassess patients at an hour. The goal is to get them feeling better to a defined endpoint and to restore function. There is evidence-based pediatric emergency migraine care. You should understand that, plus how to explain why these agents are being given and some of the side effects to patients and families. I find that that approach increases your likelihood of buy-in and success. Alright, so that's it for this episode on the Acute Management of Migraine Headaches in Children and Adolescents. I hope you found it helpful and I can pretty much guarantee that you're gonna see a patient with a migraine on your next shift. If you've got any feedback or comments, send them my way. If you like this episode, leave a review on your favorite podcast site. It helps more people find the show. Or recommend it to a colleague. If there's other topics that you'd like to hear, send them my way for the Pediatric Emergency Medicine podcast. This has been Brad Sobolewski. See you next time.    

In this episode, I speak with Stephen Abu and Enobong Obong about their work "A Systematic Review of Augmented and Virtual Reality for STEM Learning: Engagement, Cognitive Load, and Transfer Outcomes" 

852. Fermented dairy may affect cholesterol differently than butter or processed meats—but it's not a free pass. Here's what the evidence actually shows about yogurt, cheese, saturated fat, and LDL cholesterol.ReferencesDairy Fats and Cardiovascular Disease: Do We Really Need to Be Concerned? - PMCMilk and Dairy Product Consumption and Cardiovascular Diseases: An Overview of Systematic Reviews and Meta-Analyses - ScienceDirectEffect of cheese consumption on blood lipids: a systematic review and meta-analysis of randomized controlled trials - PubMedHarnessing the Magic of the Dairy Matrix for Next-Level Health Solutions: A Summary of a Symposium Presented at Nutrition 2022Dairy and Cardiovascular Disease: A Review of Recent Observational Research - PMCFermented dairy product consumption and blood lipid levels in healthy adults: a systematic reviewNew to Nutrition Diva? Check out our special Spotify playlist for a collection of the best episodes curated by our team and Monica herself! We've also curated some great playlists on specific episode topics including Staying Strong as We Age, Diabetes, Weight Loss That Lasts and Gut Health! Also, find a playlist of our bone health series, Stronger Bones at Every Age. Have a nutrition question? Send an email to nutrition@quickanddirtytips.com.Follow Nutrition Diva on Facebook and subscribe to the newsletter for more diet and nutrition tips. Find out about Monica's keynotes and other programs at WellnessWorksHere.comNutrition Diva is a part of the Quick and Dirty Tips podcast network.   New to Nutrition Diva? Check out our special Spotify playlist for a collection of the best episodes curated by our team and Monica herself! We've also curated some great playlists on specific episode topics including Staying Strong as We Age, Diabetes, Weight Loss That Lasts and Gut Health! Also, find a playlist of our bone health series, Stronger Bones at Every Age. Have a nutrition question? Send an email to nutrition@quickanddirtytips.com.Follow Nutrition Diva on Facebook and subscribe to the newsletter for more diet and nutrition tips. Find out about Monica's keynotes and other programs at WellnessWorksHere.comNutrition Diva is a part of the Quick and Dirty Tips podcast network. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

"It's important to clarify that most patients will experience and at least some side effects—and often several. So prevention really means reducing severity, complications, and long-term impact rather than avoiding side effects altogether. This process starts before radiation begins and continues throughout the treatment and includes dental evaluation, baseline swallowing assessments, and thorough patient education," ONS member Astrid Amoresano, RN, OCN®, lead oncology nurse specialist at New York Proton Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about side effects of radiation for head and neck cancer. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by February 13, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to radiation side effects in people with head and neck cancer. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Cancer Symptom Management Basics series Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices Episode 128: Manage Treatment-Related Radiodermatitis With ONS Guidelines™ ONS Voice articles: Highly Localized, Precision Radiation Therapies Require Nurses to Drive Care Coordination, Patient Education IMRT Shows Similar Quality-of-Life Outcomes to Proton Therapy in Head and Neck Cancer How to Handle Even the Worst Radiation Therapy Side Effects ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) ONS courses: ONS/ONCC® Radiation Therapy Certificate™ ONS Oncology Symptom Management Clinical Journal of Oncology Nursing articles: The Role of Advanced Practice Providers in Radiation Oncology in 2025 Systematic Review of Malnutrition Risk Factors to Identify Nutritionally At-Risk Patients With Head and Neck Cancer Effects of a Nurse-Initiated Telephone Care Path for Pain Management in Patients With Head and Neck Cancer Receiving Radiation Therapy Radiation-Induced Skin Dermatitis: Treatment With CamWell® Herb to Soothe® Cream in Patients With Head and Neck Cancer Receiving Radiation Therapy ONS Radiation Learning Library ONS Symptom Intervention Resources ONCC: Radiation Oncology Certified Nurse (ROCN™) American Cancer Society CA: A Cancer Journal for Clinicians article: American Cancer Society Head and Neck Cancer Survivorship Care Guideline Cancer Survivors Network: Head and neck cancer Head and neck cancer resources Radiation therapy resources American Society of Radiation Oncology National Cancer Institute: Common Terminology Criteria for Adverse Events (CTCAE) National Comprehensive Cancer Network To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Many tumors in the region are very radiosensitive, and radiation can be used either as definitive treatment or after surgery to reduce the risk of reoccurrence, but in many cases, radiation is combined with chemotherapy to improve local control. Because so many vital structures are located in this small complex area, radiation allows us to treat the cancer while minimizing the need for extensive or disfiguring surgery." TS 2:40 "The most common acute side effects of head and neck radiation: effects to the mouth, the throat, the skin, and the energy level. Patients often experience a mucositis, pain or sore throat, difficulty swallowing, dry mouth, or thick saliva, and taste changes. Skin irritation and redness in the treatment field is also common and can progress to dry and moist desquamation. Fatigue is another frequent side effect and tends to build as treatment progresses. Emotional and psychological distress are also very common in this patient population and can have an impact on daily function and quality of life. Side effects usually develop gradually, often beginning in the second and third week of radiation and may be more severe or have an earlier onset in patients receiving concurrent chemotherapy." TS 4:02 "Pain management is essential so patients can continue eating and drinking. Supporting the energy level and maintaining hydration are also key, as fatigue and dehydration can significantly worsen other side effects. Oral care protocols help manage mucositis and nutrition support may include supplements or enteral feeding if needed." TS 11:24 "Sexual health might not be the first thing nurses think of in regard to head and neck radiation. … But even though radiation for head and neck cancer doesn't involve the reproductive organs, it can still have a significant impact on sexual health and intimacy. Like fatigue, pain, dry mouth, changes in speech and visible changes in appearance can all affect body image and relationships." TS 14:52 "One of the common misconceptions is that side effects end when radiation ends. In reality, some effects peak afterward or become long term. Xerostomia, or dry mouth, and taste changes are good examples. While some patients improve, others adjust to a new normal where dry mouth and altered taste are permanent." TS 19:53

This episode describes what complex Post Traumatic Stress disorder (cPTSD) is, how it's diagnosed, and how it's different to similar disorders like PTSD and borderline personality disorder. This episode was inspired by the angry comments on Dr. Kibby's latest reel on spotting emotion dysregulation in borderline personality disorder. When someone has a history of childhood trauma and they struggle with intense emotions, self-esteem issues, and relationship problems- what disorder do they have? In this episode, Dr. Kibby delves into the criteria for complex PTSD, which is still not an official disorder in the DSM-V. Yet, so many people struggle with symptoms from long, painful histories of trauma that has shaped their entire lives and personalities.Dr. Kibby also discusses the nuanced differences between Complex PTSD and Borderline Personality Disorder, revealing how trauma shapes self-esteem, relationships, and emotional regulation in surprising ways. If you've ever wondered why these disorders often overlap—and how understanding their distinctions can transform healing—you'll want to hear this.Dr. Kibby shares her own experiences with online criticism around trauma representation, sparking a deeper conversation about stigma and bias in mental health. She dives into the hidden intricacies of CPTSD, explaining why it's often overlooked in the DSM-5 but recognized worldwide, and how prolonged trauma affects the brain's ability to process memories, dissociate, and regulate emotions.She also talks about how how trauma, whether overt or subtle, can lead to complex self-protection mechanisms that impact every aspect of life. Then she finishes with listing the best evidence-based treatments, from prolonged exposure to cognitive processing therapy and DBT, tailored for each disorder's unique challenges. She emphasizes the power of compassion and personalized treatment over stigma, advocating for a mental health field that treats all disorders with empathy and respect. Why diagnosis isn't about labels- it's a pathway to personalized healing and recovery.Resources:Sarr, R., Quinton, A., Spain, D., & Rumball, F. (2024). A Systematic Review of the Assessment of ICD‐11 Complex Post‐Traumatic Stress Disorder (CPTSD) in Young People and Adults. Clinical psychology & psychotherapy, 31(3), e3012.Simon, J. J., Spiegler, K., Coulibaly, K., Stopyra, M. A., Friederich, H. C., Gruber, O., & Nikendei, C. (2025). Beyond diagnosis: symptom patterns across complex PTSD and borderline personality disorder. Frontiers in Psychiatry, 16, 1668821.

In this episode host, Erin Gallardo, PT, DPT, NCS speaks with Chris McElderry, PT, DPT, NCS about how dry needling can be used in neuro rehab, particularly for people post-stroke. Chris explains why he pursued dry needling, how using it in PT differs from acupuncture, and walks through what a typical session looks like, including safety, side effects, and billing considerations. He shares clinical examples of using dry needling to address spasticity, hypertonicity, pain, and range of motion limitations, and discusses current research on short-term effects for spasticity and pain reduction. Erin and Chris also clarify the differences between spasticity and hypertonicity, touch on contracture management, and highlight where dry needling can be a useful adjunct—not a standalone cure—in helping neuro clients move and feel better. Follow Chris McElderry, PT, DPT, NCS @theneuroguy_dpt  Ebrahimzadeh M, Nakhostin Ansari N, Abdollahi I, Akhbari B, Dommerholt J. Changes in Corticospinal Tract Consistency after Dry Needling in a Stroke Patient. Case Rep Neurol Med. 2024 Sep 14;2024:5115313. doi: 10.1155/2024/5115313. PMID: 39309410; PMCID: PMC11416164. Fakhari Z, Ansari NN, Naghdi S, Mansouri K, Radinmehr H. A single group, pretest-posttest clinical trial for the effects of dry needling on wrist flexors spasticity after stroke. NeuroRehabilitation. 2017;40(3):325-336. doi: 10.3233/NRE-161420. PMID: 28222554. Fernández-de-Las-Peñas C, Pérez-Bellmunt A, Llurda-Almuzara L, Plaza-Manzano G, De-la-Llave-Rincón AI, Navarro-Santana MJ. Is Dry Needling Effective for the Management of Spasticity, Pain, and Motor Function in Post-Stroke Patients? A Systematic Review and Meta-Analysis. Pain Med. 2021 Feb 4;22(1):131-141. doi: 10.1093/pm/pnaa392. PMID: 33338222. Núñez-Cortés R, Cruz-Montecinos C, Vásquez-Rosales P, et al. Effectiveness of dry needling in the treatment of spasticity in stroke patients: A systematic review. J Body Mov Ther. 2020;24(3):113-122. Suputtitada A, et al. Emerging theory of sensitization in post-stroke muscle spasticity: Implications for dry needling and other interventions. Front Rehabil Sci. 2023;4:1169087. Valencia-Chulián R, Heredia-Rizo AM, Moral-Munoz JA, Lucena-Anton D, Luque-Moreno C. Dry needling for the management of spasticity, pain, and range of movement in adults after stroke: A systematic review. Complement Ther Med. 2020 Aug;52:102515. doi: 10.1016/j.ctim.2020.102515. Epub 2020 Jul 16. PMID: 32951759.

Dr. Peter Rippey covers the No. 8 article of 2024, titled “High-Intensity Interval Training and Cardiorespiratory Fitness in Adults: An Umbrella Review of Systematic Reviews and Meta-Analyses,” which was originally published in the Scandinavian Journal of Medicine & Science in Sports in May 2024. Dr. Jeremy Schroeder serves as the series host. Dr. Rippey is a member of the Top Articles Subcommittee, and this episode is part of an ongoing mini journal club series highlighting each of the Top Articles in Sports Medicine from 2024, as selected for the 2025 AMSSM Annual Meeting. High-Intensity Interval Training and Cardiorespiratory Fitness in Adults: An Umbrella Review of Systematic Reviews and Meta-Analyses: https://onlinelibrary.wiley.com/doi/10.1111/sms.14652

The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. USDA Dietary Guidelines 2025-2030. Discussion by: Guest:Phillip Leiberman, MDResident Family Medicine Residency Program Jefferson Health - Abington2. The Effect of Substituting Wate for Artificially Sweetened Beverages on Glycemic and Weight Measures in People With Type 2 Diabetes: The Study of Drinks With Artificial Sweeteners (SODAS), a Randomized Trial – Diabetes Care 2025. Discussion by: Guest:Neil Skolnik, MDProfessor of Family and Community MedicineSidney  Kimmel  Medical College Thomas Jefferson UniversityAssociate Director - Family Medicine Residency ProgramJefferson Health – Abington3. Caffeinated Coffee Consumption or Abstinence to Reduce Atrial Fibrillation The DECAFRandomized Clinical Trial – JAMA 2025. Discussion by: Guest:Neil Skolnik, MDProfessor of Family and Community MedicineSidney  Kimmel  Medical College Thomas Jefferson UniversityAssociate Director - Family Medicine Residency ProgramJefferson Health – Abington4. Exercise for the Treatment of Depression. Cochrane Database of Systematic Reviews 2026 Discussion by:Guest:Aaron Sutton - Behavioral Specialist Family Medicine Residency ProgramChief Wellness Officer for Graduate Medical Education Jefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.

We have learned a lot about extended spectrum coverage of prophylactic antibiotics for cesarean section. The landmark C/SOAP trial randomized 2,013 women undergoing nonelective cesarean delivery to azithromycin 500 mg IV plus standard prophylaxis versus placebo, demonstrating a 51% reduction in the composite outcome of endometritis, wound infection, or other infection. Adjuvant Zmax (plus standard first-generation cephalosporin) is now recognized as evidence-based antibiotic coverage for intrapartum cesarean, cesarean with ruptured membranes, and patients with obesity. This last patient characteristic comes from the ERAS latest update. But what is ZMAX is not available? Is there an evidence-based peri-op alternative in these cases? Does Gent and Clinda cover mycoplasma/Ureaplasma? What about postop flagyl? Listen in for details. 1. Tita AT, Szychowski JM, Boggess K, et al. Adjunctive Azithromycin Prophylaxis for Cesarean Delivery. The New England Journal of Medicine. 2016. 2. Yang M, Yuan F, Guo Y, Wang S. Efficacy of Adding Azithromycin to Antibiotic Prophylaxis in Caesarean Delivery: A Meta-Analysis and Systematic Review. International Journal of Antimicrobial Agents. 2022. 2. ACOG Practice Bulletin No. 199: Use of Prophylactic Antibiotics in Labor and Delivery. Obstetrics and Gynecology. 2018. Committee on Practice Bulletins-Obstetrics 3. Martingano D, Nguyen A, Nkeih C, Singh S, Mitrofanova A. Clarithromycin Use for Adjunct Surgical Prophylaxis Before Non-Elective Cesarean Deliveries to Adapt to Azithromycin Shortages in COVID-19 Pandemic. PloS One. 2020. 4. Valent AM, DeArmond C, Houston JM, et al. Effect of Post–Cesarean Delivery Oral Cephalexin and Metronidazole on Surgical Site Infection Among Obese Women: A Randomized Clinical Trial. The Journal of the American Medical Association. 2017. 5. Wood, G. E., et al. "In Vitro Susceptibility of Mycoplasma genitalium to Nitroimidazoles." Antimicrobial Agents and Chemotherapy 6. https://www.cdc.gov/std/treatment-guidelines/mycoplasmagenitalium.htm

Welcome to The Mental Breakdown and Psychreg Podcast! Today, Dr. Berney and Dr. Marshall discuss recent research that demonstrates what happens to children when parents are frequently distracted by their own electronic devices. Read the articles from Systematic Reviews here and from Child Development here. You can now follow Dr. Marshall on twitter, as well! Dr. Berney and Dr. Marshall are happy to announce the release of their new parenting e-book, Handbook for Raising an Emotionally Healthy Child Part 2: Attention. You can get your copy from Amazon here. We hope that you will join us each morning so that we can help you make your day the best it can be! See you tomorrow. Become a patron and support our work at http://www.Patreon.com/thementalbreakdown. Visit Psychreg for blog posts covering a variety of topics within the fields of mental health and psychology. The Parenting Your ADHD Child course is now on YouTube! Check it out at the Paedeia YouTube Channel. The Handbook for Raising an Emotionally Health Child Part 1: Behavior Management is now available on kindle! Get your copy today! The Elimination Diet Manual is now available on kindle and nook! Get your copy today! Follow us on Twitter and Facebook and subscribe to our YouTube Channels, Paedeia and The Mental Breakdown. Please leave us a review on iTunes so that others might find our podcast and join in on the conversation!

Cold plunges are everywhere, and the way people talk about them, you'd think they're a miracle cure for your brain, body, and soul. But in an age of algorithm-fueled evangelism, when a ritual becomes this ubiquitous and loud, we have to ask: how much of the buzz is backed by science… and how much is just marketing? In this episode, we explore the neuroscience of cold exposure: what's real, what's overstated, and why this "discomfort" has become a billion-dollar industry. We discuss: Why cold plunges went viral, and how wellness movements often devolve into identity-driven cultures The difference between cold exposure itself and the monetized "cold plunge movement" What constitutes a "cult" (and how pseudoscience forms around partial truths) The real physiological cold shock response Why the mental "high" after a plunge doesn't automatically equal long-term brain benefit The cardiovascular risks that rarely get discussed, especially for people with underlying heart disease What the research suggests about soreness, pain reduction, and muscle growth (including why cold immersion can blunt hypertrophy) The real story behind brown fat Who should avoid cold plunges altogether (asthma, arrhythmias, coronary disease, vascular conditions) Joining us for this conversation is investigative journalist and bestselling author Scott Carney (What Doesn't Kill Us, The Wedge), who has spent years inside the cold exposure world, first as a skeptic, then as a believer, and eventually as a critic of the culture that formed around it. His work reveals what happens when discomfort becomes identity, and when unfounded "social media science" outruns real science. Your Brain On... is hosted by neurologists, scientists, and public health advocates Drs. Ayesha and Dean Sherzai. SUPPORTED BY: the 2026 NEURO World Retreat. A 5-day journey through science, nature, and community, on the California coastline: neuroworldretreat.com Your Brain On... Cold Plunges • SEASON 6 • EPISODE 7 REFERENCES Cold Water Immersion, Muscle Adaptation, and Recovery Roberts, L. A., Raastad, T., Markworth, J. F., Figueiredo, V. C., Egner, I. M., Shield, A., Cameron-Smith, D., Coombes, J. S., & Peake, J. M. (2015). Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training. Journal of Physiology, 593(18), 4285–4301. https://doi.org/10.1113/JP270570 Bleakley, C. M., McDonough, S. M., & MacAuley, D. C. (2004). The use of ice in the treatment of acute soft-tissue injury: A systematic review of randomized controlled trials. American Journal of Sports Medicine, 32(1), 251–261. https://doi.org/10.1177/0363546503260757 Leeder, J., Gissane, C., van Someren, K., Gregson, W., & Howatson, G. (2012). Cold water immersion and recovery from strenuous exercise: A meta-analysis. British Journal of Sports Medicine, 46(4), 233–240. https://doi.org/10.1136/bjsports-2011-090061 White, G. E., & Wells, G. D. (2013). Cold-water immersion and other forms of cryotherapy: Physiological changes potentially affecting recovery from high-intensity exercise. Sports Medicine, 43(8), 695–706. https://doi.org/10.1007/s40279-013-0055-8 Kellmann, M., Bertollo, M., Bosquet, L., Brink, M., Coutts, A. J., Duffield, R., Erlacher, D., Halson, S. L., Hecksteden, A., Heidari, J., Kölling, S., Meyer, T., Mujika, I., Robazza, C., Skorski, S., Venter, R., & Beckmann, J. (2018). Recovery and performance in sport: Consensus statement. International Journal of Sports Physiology and Performance, 13(2), 240–245. https://doi.org/10.1123/ijspp.2017-0759 Inflammation, Pain, and Perceived Recovery Hohenauer, E., Taeymans, J., Baeyens, J. P., Clarys, P., & Clijsen, R. (2015). The effect of post-exercise cryotherapy on recovery characteristics: A systematic review and meta-analysis. PLoS ONE, 10(9), e0139028. https://doi.org/10.1371/journal.pone.0139028 Costello, J. T., Culligan, K., Selfe, J., & Donnelly, A. E. (2012). Muscle, skin and core temperature after –110°C cold air and 8°C water treatment. PLoS ONE, 7(11), e48190. https://doi.org/10.1371/journal.pone.0048190 Brown Adipose Tissue (BAT) – Human Imaging & Metabolism van Marken Lichtenbelt, W. D., Vanhommerig, J. W., Smulders, N. M., Drossaerts, J. M., Kemerink, G. J., Bouvy, N. D., Schrauwen, P., & Teule, G. J. (2009). Cold-activated brown adipose tissue in healthy men. New England Journal of Medicine, 360(15), 1500–1508. https://doi.org/10.1056/NEJMoa0808718 Virtanen, K. A., Lidell, M. E., Orava, J., Heglind, M., Westergren, R., Niemi, T., Taittonen, M., Laine, J., Savisto, N. J., Enerbäck, S., & Nuutila, P. (2009). Functional brown adipose tissue in healthy adults. New England Journal of Medicine, 360(15), 1518–1525. https://doi.org/10.1056/NEJMoa0808949 Betz, M. J., & Enerbäck, S. (2015). Human brown adipose tissue: What we have learned so far. Diabetes, 64(7), 2352–2360. https://doi.org/10.2337/db15-0146 Autonomic Nervous System, HRV, and Cold Exposure Mourot, L., Bouhaddi, M., Regnard, J., Tordi, N., & Rouillon, J. D. (2008). Cardiac autonomic control during short-term exposure to cold water in humans. European Journal of Applied Physiology, 104(3), 541–547. https://doi.org/10.1007/s00421-008-0810-3 Janský, L., Pospíšilová, D., Honzová, S., Uličný, B., Šrámek, P., Zeman, V., & Kamínková, J. (1996). Immune system of cold-exposed and cold-adapted humans. European Journal of Applied Physiology, 72(5–6), 445–450. https://doi.org/10.1007/BF00242276 Cardiovascular Stress and Cold Shock Tipton, M. J., Collier, N., Massey, H., Corbett, J., & Harper, M. (2017). Cold water immersion: Kill or cure? Experimental Physiology, 102(11), 1335–1355. https://doi.org/10.1113/EP086283 Tipton, M. J., & Bradford, C. (2014). Cold water immersion and cold shock response. Extreme Physiology & Medicine, 3(1), 1–10. https://doi.org/10.1186/2046-7648-3-7 Whole-Body Cryotherapy (Distinct From Cold Plunges) Costello, J. T., Baker, P. R., Minett, G. M., Bieuzen, F., Stewart, I. B., & Bleakley, C. (2015). Whole-body cryotherapy (extreme cold air exposure) for preventing and treating muscle soreness after exercise in adults. Cochrane Database of Systematic Reviews, 2015(9), CD010789. https://doi.org/10.1002/14651858.CD010789.pub2 LINKS Scott Carney's website: https://www.scottcarney.com/ FOLLOW US Join NEURO World: https://neuro.world/ Instagram: https://www.instagram.com/thebraindocs YouTube: https://www.youtube.com/thebraindocs More info and episodes: TheBrainDocs.com/Podcast

Ever had a migraine that seemed to strike out of nowhere — and later noticed your digestion had been off, your appetite weird, or your belly unusually tight? It's not random. It's a conversation. Because your gut and your brain are constantly talking, and when that dialogue breaks down, migraine often steps in.In this episode of Migraine Heroes Podcast, host Diane Ducarme unpacks the hidden ways your microbiome shapes inflammation, mood, sensitivity, and migraine pain. With a blend of neuroscience, real-world data, and Eastern medicine wisdom, we decode what your gut has been trying to tell you long before the migraine hits.You'll discover:

Dr. Jim Dunlap discusses one of the honorable mention articles of 2024, titled “Does Headgear Prevent Sport-Related Concussion? A Systematic Review and Meta-Analysis of Randomized Controlled Trials Including 6,311 Players and 173,383 Exposure Hours,” which was originally published in Sports Health. Dr. Jeremy Schroeder serves as the series host. Dr. Dunlap is a member of the Top Articles Subcommittee, and this episode is part of an ongoing mini journal club series highlighting each of the Top Articles in Sports Medicine from 2024, as selected for the 2025 AMSSM Annual Meeting. Does Headgear Prevent Sport-Related Concussion? A Systematic Review and Meta-Analysis of Randomized Controlled Trials Including 6311 Players and 173,383 Exposure Hours: https://journals.sagepub.com/doi/10.1177/19417381231174461

Dorian Varović is a coach and a researcher, currently working on his PhD on muscle length and regional muscle hypertrophy.He and his colleagues also recently conducted a very interesting study comparing regular resistance training and isometrics for hypertrophy.In this conversation, we delve into all these topics:The latest research on the importance of training muscles at long muscle lengthsHow training at long muscle lengths may or may not affect regional hypertrophyAre isometrics as good as regular training for growth?… And more!Links and resources:“Does Muscle Length Influence Regional Hypertrophy? A Systematic Review and Meta-Analysis” - https://pubmed.ncbi.nlm.nih.gov/40570881/ “The effects of long muscle length isometric versus full range of motion isotonic training on regional quadriceps femoris hypertrophy in resistance-trained individuals” - https://pubmed.ncbi.nlm.nih.gov/40911904/ Connect with Dorian on Instagram @varovicdorian: https://www.instagram.com/varovicdorian/Follow his research on ResearchGate: https://www.researchgate.net/profile/Dorian-Varovic-2 Apply for coaching with him: https://docs.google.com/forms/d/e/1FAIpQLSeGiZCo7fG8d78dCHgOHvgeu1dCh7AKL-sfRpw478MmGZtWxw/viewform?usp=send_form Sign up for one on one coaching with me: ⁠https://www.fittotransformtraining.com/coaching.html⁠Follow me on Instagram @nikias_fittotransform: ⁠http://instagram.com/nikias_fittotransform/⁠Visit my website: ⁠https://www.fittotransformtraining.com⁠Sign up for my free newsletter: ⁠https://mailchi.mp/157389602fb0/mailinglist⁠Subscribe to my YouTube channel: https://www.youtube.com/@nikias_fittotransform Sign up for the No Quit Kit email series on retraining your mindset for long-term fat loss success: ⁠https://mailchi.mp/4b368c26baa8/noquitkitsignup⁠Take my free “Should You Cut or Bulk First?” quiz: https://nikias-dddr9p81.scoreapp.com/ 

As I was listening to an episode of the Ludology podcast recently, one focused on games and health, I started to think about how much the people we play with influence our gameplay experience. Selecting board games based on the audience is much more important than we may like to believe. Get it wrong, and you have one player rebelling and playing opposite to expectations, another disengaging completely, and the overall mood shifting from playful enjoyment to uncomfortable tension. In this article, I want to discuss how a mismatch can impact the enjoyment of the whole group, alter the tone of reviews, and even affect playtest outcomes.Read the full article here: https://tabletopgamesblog.com/2025/12/30/socially-afflicted-how-people-affect-gameplay-experience-topic-discussion/Useful LinksLudology podcast episode 351, Better Health Through Gaming: https://ludology.libsyn.com/ludology-351-better-health-through-gamingPandemic review: https://tabletopgamesblog.com/2020/01/18/pandemic-saturday-review/Amit Bar's and Tobias Otterbring's study “The role of culture and personality traits in board game habits and attitudes” in the Journal of Retailing and Consumer Services: https://www.sciencedirect.com/science/article/pii/S0969698921000722Qian Zhang's, JiaLe Ruan's and DingYong Xiong's study “Differential effects of exposure to cooperative versus competitive games on sharing behavior in young children" in Frontiers in Psychiatry: https://pmc.ncbi.nlm.nih.gov/articles/PMC12268353/Bez Shahriari's reflections on playtesting behaviour: https://en.wikipedia.org/wiki/Bez_ShahriariBoard Game Design Lab: https://boardgamedesignlab.com/Mahiro Egashira's, Daisuke Son's and Arisa Ema's study “Serious Game for Change in Behavioral Intention Toward Lifestyle Related Diseases” in JMIR Serious Games: https://pubmed.ncbi.nlm.nih.gov/35188465/Ramy Hammady's and Sylvester Arnab's review “Serious Gaming for Behaviour Change, A Systematic Review” in Information: https://www.mdpi.com/2078-2489/13/3/142MusicIntro Music: Bomber (Sting) by Riot (⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/audiolibrary/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠)Music: "Epic Inspiration" by AShamaluevMusic.Website: https://www.ashamaluevmusic.comMusic: "Galaxy" by AShamaluevMusic.Website: https://www.ashamaluevmusic.comMusic: "Legend" by AShamaluevMusic.Website: https://www.ashamaluevmusic.comSupportIf you want to support this podcast financially, please check out the links below:Ko-Fi: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://ko-fi.com/TabletopGamesBlog⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Patreon: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.patreon.com/tabletopgamesblog⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://tabletopgamesblog.com/support/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Testosterone is everywhere in menopause conversations right now, often framed as a solution for everything from low energy and brain fog to bone health and longevity. In this episode, Dr. Sarah Court breaks down what actually matters when it comes to testosterone for menopausal women, separating social media hype from clinical evidence. The real questions are not whether women have testosterone or whether levels change with age, but whether testosterone should be prescribed, for whom, and what the data truly supports.Using current consensus guidelines, this episode explains why testosterone has one narrow, evidence-based indication, hypoactive sexual desire disorder, and why claims about mood, energy, cognition, bone health, and longevity are not supported by high-quality research. Dr. Court also walks through how testosterone is prescribed in the real world, why the lack of FDA-approved products for women creates problems, and what the safety data does and does not tell us about long-term risks. If you have heard confident claims about testosterone as a menopause cure-all, this episode provides the context you need to evaluate those messages with clarity and skepticism.FOLLOW @MovementLogicTutorials on InstagramMovement Logic: Free Barbell Mini CourseInstagram: Professor Susan DavisInstagram: Dr. Kelly CaspersonGlobal Consensus Position Statement on the Use of Testosterone Therapy for Women — Davis et al., 2019, Journal of Clinical Endocrinology & MetabolismISSWSH Clinical Practice Guideline on Systemic Testosterone for Women — Parish et al., 2021Testosterone Therapy for Women, Systematic Review & Meta-analysis(Lancet Review) — Islam et al., 2019Androgen Therapy in Women, A Reappraisal — Davis & Wahlin-Jacobsen, 2015Kelly Casperson blog post — Testosterone Can Help With Libido, Energy, Focus, & More During MenopauseYou Are Not Broken Podcast — Kelly Casperson, MDYouTube Short: Testosterone and Bone HealthYouTube Short: Testosterone, Motivation & Vitality

On this episode of the Sports Medicine Primer Series, host Dr. Zainab Shirazi, MD, continues the conversation with Dr. Adam Tenforde, MD, discussing how to manage a case of hip pain in a 25-year-old recreational weightlifter. The goal of this ongoing series is to provide an audio study aid for anyone pursuing a career as a sports medicine physician and to prepare them for a sports medicine fellowship. Dr. Tenforde is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. He is a sports medicine physician at the Spaulding National Running Center – one of the only centers in the United States exclusively dedicated to the diagnosis and treatment of running-related injuries. He has the unique perspective of being both a doctor and a former professional runner who was an All-American at Stanford University, where he contributed to three NCAA National Team Championships and later qualified for the Olympic trials. Dr. Shirazi is an Attending Physician at Women's Health, Sports & Performance (WHSP) Medical in Brighton, MA, and a dual board-certified physician in Sports Medicine and Physical Medicine & Rehabilitation. She has a passion for advancing the health and performance of female athletes and specializes in the non-operative management of musculoskeletal and sports-related injuries, providing comprehensive care for athletes of all ages and abilities.   Resources Mountjoy M, Ackerman KE, Bailey DM, et al. 2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). Br J Sports Med. 2023;57(17):1073-1097. doi:1136/bjsports-2023-106994 Kraus E, Tenforde AS, Nattiv A, et al. Bone stress injuries in male distance runners: higher modified Female Athlete Triad Cumulative Risk Assessment scores predict increased rates of injury. Br J Sports Med. 2019;53(4):237-242. doi:1136/bjsports-2018-099861 Hoenig T, Ackerman KE, Beck BR, et al. Bone stress injuries. Nat Rev Dis Primers. 2022;8(1):26. doi:1038/s41572-022-00352-y Nattiv A, Kennedy G, Barrack MT, et al. Correlation of MRI grading of bone stress injuries with clinical risk factors and return to play: a 5-year prospective study in collegiate track and field athletes. Am J Sports Med. 2013;41(8):1930-1941. doi:1177/0363546513490645 Hoenig T, Tenforde AS, Strahl A, Rolvien T, Hollander K. Does Magnetic Resonance Imaging Grading Correlate With Return to Sports After Bone Stress Injuries? A Systematic Review and Meta- analysis. Am J Sports Med. 2022;50(3):834-844. doi:1177/0363546521993807 Barrack MT, Fredericson M, Tenforde AS, Nattiv A. Evidence of a cumulative effect for risk factors predicting low bone mass among male adolescent athletes. Br J Sports Med. 2017;51(3):200-205. doi:1136/bjsports-2016-096698 Robertson GA, Wood AM. Femoral Neck Stress Fractures in Sport: A Current Concepts Review. Sports Med Int Open. 2017;1(2):E58-E68. doi:1055/s-0043-103946 Fredericson M, Roche M, Barrack MT, et al. Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners. BMJ Open Sport Exerc Med. 2023;9(2):e001545. doi:1136/bmjsem-2023-001545 Roche M, Nattiv A, Sainani K, et al. Higher Triad Risk Scores Are Associated With Increased Risk for Trabecular-Rich Bone Stress Injuries in Female Runners. Clin J Sport Med. 2023;33(6):631-637. doi:1097/JSM.0000000000001180 Burke LM, Ackerman KE, Heikura IA, Hackney AC, Stellingwerff T. Mapping the complexities of Relative Energy Deficiency in Sport (REDs): development of a physiological model by a subgroup of the International Olympic Committee (IOC) Consensus on REDs. Br J Sports Med. 2023;57(17):1098-1108. doi:1136/bjsports-2023-107335 Tenforde AS, Barrack MT, Nattiv A, Fredericson M. Parallels with the Female Athlete Triad in Male Athletes. Sports Med. 2016;46(2):171-182. doi:1007/s40279-015-0411-y Hoenig T, Eissele J, Strahl A, et al. Return to sport following low-risk and high-risk bone stress injuries: a systematic review and meta-analysis. Br J Sports Med. 2023;57(7):427-432. doi:1136/bjsports-2022-106328 Nattiv A. Stress fractures and bone health in track and field athletes. J Sci Med Sport. 2000;3(3):268-279. doi:1016/s1440-2440(00)80036-5 Nattiv A, Armsey TDJ. Stress injury to bone in the female athlete. Clin Sports Med. 1997;16(2):197-224. doi:1016/s0278-5919(05)70017-x Nattiv A, De Souza MJ, Koltun KJ, et al. The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part 1: Definition and Scientific Basis. Clin J Sport Med. 2021;31(4):335-348. doi:1097/JSM.0000000000000946 Fredericson M, Kussman A, Misra M, et al. The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part II: Diagnosis, Treatment, and Return-To-Play. Clin J Sport Med. 2021;31(4):349-366. doi:1097/JSM.0000000000000948

The second stage of labor, characterized by active pushing and the descent of the fetal head, can be a challenging and prolonged phase for both mother and baby. Various interventions have been explored to optimize this stage, and one such technique involves the application of vaginal lubricants. The rationale behind this approach is to reduce friction between the fetal head and the birth canal, potentially leading to smoother and faster delivery. Does this seemingly simple technique work? Does the ACOG mention this in the CPG 8 from January 2024? What does the latest research tell us about its effectiveness in assisting or speeding up the birthing process? Listen in for details.1. Yang Q, Cao X, Hu S, Sun M, Lai H, Hou L, Wang Q, Wu C, Wu Y, Xiao L, Luo X, Tian J, Ge L, Shi L. Lubricant for reducing perineal trauma: A systematic review and meta-analysis of randomized controlled trials. J Obstet Gynaecol Res. 2022 Nov;48(11):2807-2820. doi: 10.1111/jog.15399. Epub 2022 Aug 16. PMID: 36319196.2. ACOG: First and Second Stage Labor Management Clinical Practice Guideline Number 8: January 20243. Aquino CI, Saccone G, Troisi J, Zullo F, Guida M, Berghella V. Use of lubricant gel to shorten the second stage of labor during vaginal delivery. J Matern Fetal Neonatal Med. 2019 Dec;32(24):4166-4173. doi: 10.1080/14767058.2018.1482271. Epub 2018 Jun 27. PMID: 29804505.4. Beckmann MM, Stock OM. Antenatal Perineal Massage for Reducing Perineal Trauma. The Cochrane Database of Systematic Reviews. 2013;(4):CD005123. doi:10.1002/14651858.CD005123.pub3.

On this episode of the Sports Medicine Primer Series, host Dr. Zainab Shirazi, MD, is joined by Dr. Adam Tenforde, MD, to discuss how to manage a case of hip pain in a 25-year-old recreational weightlifter. The goal of this ongoing series is to provide an audio study aid for anyone pursuing a career as a sports medicine physician and to prepare them for a sports medicine fellowship. Dr. Tenforde is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. He is a sports medicine physician at the Spaulding National Running Center – one of the only centers in the United States exclusively dedicated to the diagnosis and treatment of running-related injuries. He has the unique perspective of being both a doctor and a former professional runner who was an All-American at Stanford University, where he contributed to three NCAA National Team Championships and later qualified for the Olympic trials. Dr. Shirazi is an Attending Physician at Women's Health, Sports & Performance (WHSP) Medical in Brighton, MA, and a dual board-certified physician in Sports Medicine and Physical Medicine & Rehabilitation. She has a passion for advancing the health and performance of female athletes and specializes in the non-operative management of musculoskeletal and sports-related injuries, providing comprehensive care for athletes of all ages and abilities.   Resources Mountjoy M, Ackerman KE, Bailey DM, et al. 2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). Br J Sports Med. 2023;57(17):1073-1097. doi:1136/bjsports-2023-106994 Kraus E, Tenforde AS, Nattiv A, et al. Bone stress injuries in male distance runners: higher modified Female Athlete Triad Cumulative Risk Assessment scores predict increased rates of injury. Br J Sports Med. 2019;53(4):237-242. doi:1136/bjsports-2018-099861 Hoenig T, Ackerman KE, Beck BR, et al. Bone stress injuries. Nat Rev Dis Primers. 2022;8(1):26. doi:1038/s41572-022-00352-y Nattiv A, Kennedy G, Barrack MT, et al. Correlation of MRI grading of bone stress injuries with clinical risk factors and return to play: a 5-year prospective study in collegiate track and field athletes. Am J Sports Med. 2013;41(8):1930-1941. doi:1177/0363546513490645 Hoenig T, Tenforde AS, Strahl A, Rolvien T, Hollander K. Does Magnetic Resonance Imaging Grading Correlate With Return to Sports After Bone Stress Injuries? A Systematic Review and Meta- analysis. Am J Sports Med. 2022;50(3):834-844. doi:1177/0363546521993807 Barrack MT, Fredericson M, Tenforde AS, Nattiv A. Evidence of a cumulative effect for risk factors predicting low bone mass among male adolescent athletes. Br J Sports Med. 2017;51(3):200-205. doi:1136/bjsports-2016-096698 Robertson GA, Wood AM. Femoral Neck Stress Fractures in Sport: A Current Concepts Review. Sports Med Int Open. 2017;1(2):E58-E68. doi:1055/s-0043-103946 Fredericson M, Roche M, Barrack MT, et al. Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners. BMJ Open Sport Exerc Med. 2023;9(2):e001545. doi:1136/bmjsem-2023-001545 Roche M, Nattiv A, Sainani K, et al. Higher Triad Risk Scores Are Associated With Increased Risk for Trabecular-Rich Bone Stress Injuries in Female Runners. Clin J Sport Med. 2023;33(6):631-637. doi:1097/JSM.0000000000001180 Burke LM, Ackerman KE, Heikura IA, Hackney AC, Stellingwerff T. Mapping the complexities of Relative Energy Deficiency in Sport (REDs): development of a physiological model by a subgroup of the International Olympic Committee (IOC) Consensus on REDs. Br J Sports Med. 2023;57(17):1098-1108. doi:1136/bjsports-2023-107335 Tenforde AS, Barrack MT, Nattiv A, Fredericson M. Parallels with the Female Athlete Triad in Male Athletes. Sports Med. 2016;46(2):171-182. doi:1007/s40279-015-0411-y Hoenig T, Eissele J, Strahl A, et al. Return to sport following low-risk and high-risk bone stress injuries: a systematic review and meta-analysis. Br J Sports Med. 2023;57(7):427-432. doi:1136/bjsports-2022-106328 Nattiv A. Stress fractures and bone health in track and field athletes. J Sci Med Sport. 2000;3(3):268-279. doi:1016/s1440-2440(00)80036-5 Nattiv A, Armsey TDJ. Stress injury to bone in the female athlete. Clin Sports Med. 1997;16(2):197-224. doi:1016/s0278-5919(05)70017-x Nattiv A, De Souza MJ, Koltun KJ, et al. The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part 1: Definition and Scientific Basis. Clin J Sport Med. 2021;31(4):335-348. doi:1097/JSM.0000000000000946 Fredericson M, Kussman A, Misra M, et al. The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part II: Diagnosis, Treatment, and Return-To-Play. Clin J Sport Med. 2021;31(4):349-366. doi:1097/JSM.0000000000000948

Date: December 4, 2025 Guest Skeptic: Dr. Jestin Carlson – Long-time listener, second-time guest.   Reference: Reinaud et al. Reporting of Noninferiority Margins on ClinicalTrials.gov: A Systematic Review. JAMA Netw Open. 2025 Case: You are working with a resident who asks you about a new thrombolytic they heard about on the SGEM for acute ischemic stroke.  […] The post SGEM#495: Tell Me Lies, Tell Me Sweet Little Lies – Reporting of Noninferiority Margins on ClinicalTrials.gov. first appeared on The Skeptics Guide to Emergency Medicine.

So, we already covered safety skills on land. But what about safety in the water? Drowning is one of the most common causes of death in children and those numbers increase significantly for autistic children. In this episode we review the research on how to teach water safety skills. Would you believe, a lot of them include teaching how to swim? That plus other skills that every child should learn and the most effective ways to teach them. This episode is available for 1.0 LEARNING CEU. Articles discussed this episode: Martin, C. & Dillenberger, K. (2019).  Behavioural Water Safety and Autism: a Systematic Review of Interventions. Review Journal of Autism and Developmental Disorders, 6, 356-366. doi: 10.1007/s40489-019-00166-x Levy, K. M., Ainsleigh, S. A., & Hunsinger-Harris, M. L. (2017). Let's go under! Teaching Water Safety Skills using a behavioral treatment package. Education and Training in Autism and Developmental Disabilities, 52, 186-193. doi: 10.1177/215416471705200208 Tucker, M. & Ingvarsson, E. (2021). Teaching water safety skills to children with autism spectrum disorders. Behavioral Interventions, 36, 535-549. doi: 10.1002/bin.1791 If you're interested in ordering CEs for listening to this episode, click here to go to the store page. You'll need to enter your name, BCBA #, and the two episode secret code words to complete the purchase. Email us at abainsidetrack@gmail.com for further assistance.

Send us a message with this link, we would love to hear from you. Standard message rates may apply.Clear guidance on benefits, risks, and how the FDA's label changes shift conversations in the exam room about HRTNikki's Corner• Philly's first Michelin stars and what the tiers mean• Flying taxis in Dubai • A cold case solved by college criminology studentsLearning • What HRT is, routes of therapy, and who benefits• Reframing WHI-era fears with age and timing data• FDA label changes and clinical implications• Contraindications and safer use considerations• Women's health bias and the cost of not listening• Practical steps for shared decisions with cliniciansReferencesThe 2022 Hormone Therapy Position Statement of the North American Menopause Society. Menopause (New York, N.Y.). 2022;29(7):767-794. doi:10.1097/GME.0000000000002028.Management of Menopausal Symptoms: A Review. Crandall CJ, Mehta JM, Manson JE. JAMA. 2023;329(5):405-420. doi:10.1001/jama.2022.24140.Hormone Therapy for Postmenopausal Women. Pinkerton JV. The New England Journal of Medicine. 2020;382(5):446-455. doi:10.1056/NEJMcp1714787.Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women: US Preventive Services Task Force Recommendation Statement. Grossman DC, Curry SJ, Owens DK, et al. JAMA. 2017;318(22):2224-2233. doi:10.1001/jama.2017.18261.Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Persons: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. Gartlehner G, Patel SV, Reddy S, et al. JAMA. 2022;328(17):1747-1765. doi:10.1001/jama.2022.18324.Hormone Therapy in the Postmenopausal Years: Considering Benefits and Risks in Clinical Practice. Genazzani AR, Monteleone P, Giannini A, Simoncini T. Human Reproduction Update. 2021;27(6):1115-1150. doi:10.1093/humupd/dmab026.Hormone Therapy in Menopause: Concepts, Controversies, and Approach to Treatment. Flores VA, Pal L, Manson JE. Endocrine Reviews. 2021;42(6):720-752. doi:10.1210/endrev/bnab011.The Women's Health Initiative Randomized Trials and Clinical Practice: A Review. Manson JE, Crandall CJ, Rossouw JE, et al. JAMA. 2024;331(20):1748-1760. doi:10.1001/jama.2024.6542.Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Persons: US Preventive Services Task Force Recommendation Statement. Mangione CM, Barry MJ, NicSupport the showSubscribe to Our Newsletter! Production and Content: Edward Delesky, MD & Nicole Aruffo, RNArtwork: Olivia Pawlowski

A Systematic Review and Meta-Analysis of Psychosocial Interventions for Persons with Comorbid Anxiety and Substance Use DisordersIn this episode, Dr. Jud dives into the comprehensive findings of a meta-analysis on psychosocial interventions for individuals facing the dual challenge of anxiety and substance use disorders. This research sheds light on the efficacy of treatments like cognitive behavioral therapy (CBT), motivational interviewing, and integrated care in addressing anxiety, alcohol consumption, and substance use. Join us as we explore the transformative potential of these interventions, the complexities of treating co-occurring conditions, and the pressing gaps in research for broader substance categories like opioids and methamphetamines.Reference: Nardi, W. R., Kelly, P., Roy, A., Becker, S., Brewer, J., & Sun, S. (2024). A systematic review and meta-analysis of psychosocial interventions for persons with comorbid anxiety and substance use disorders. Journal of Substance Use and Addiction Treatment, 165, 209442. DOI: 10.1016/j.josat.2024.209442Let's connect on Instagram

In this solo episode, Darin Olien explores one of the most overlooked yet revealing health topics: the truth about wisdom teeth. What if removing your wisdom teeth isn't just unnecessary — but harmful? What if this long-standing dental ritual has more to do with profits than prevention, and its removal may even disconnect us from our body's natural energy flow? From evolutionary biology to energetic meridians, Darin unpacks why wisdom teeth might hold more "wisdom" than modern dentistry admits — and how to make truly informed choices for yourself or your kids.     What You'll Learn in This Episode [00:00:00] Welcome to SuperLife – Darin introduces the show's mission: real solutions for a healthier, more sovereign life [00:00:32] Sponsor – ENERGYbits Spirulina & Chlorella: why Darin takes them daily for clean cellular fuel [00:01:52] Today's focus – "The wisdom in wisdom teeth": are we pulling them too soon and for the wrong reasons? [00:02:24] Why this topic matters – Darin's personal story of keeping all four wisdom teeth and what that revealed [00:03:31] The cultural norm – How mass extraction became a teenage "rite of passage" [00:04:01] Our ancestors and evolution – Bigger jaws, tougher food, and natural spacing [00:05:00] The breathing connection – How mouth breathing and modern diets may cause jaw constriction [00:06:01] The science gap – Cochrane review shows no strong evidence for routine removal [00:06:46] The silent epidemic – 10 million wisdom teeth removed yearly in the U.S., costing $3 billion [00:07:17] Permanent damage – 11,000 people a year experience nerve injury from unnecessary surgery [00:08:04] When removal is necessary – infection, cysts, tumors, or impaction (and how to know the difference) [00:08:33] The second opinion rule – Why you should always consult a holistic or biological dentist [00:09:11] Questioning authority – Extraction as an automatic response vs. an evidence-based decision [00:11:19] Follow the money – How profit motives keep unnecessary procedures alive [00:12:15] Cultural conditioning – "Just pull them" and how fear has shaped dentistry [00:12:47] Watchful waiting – Why monitoring can be a wise, legitimate option [00:12:58] The energetic layer – How teeth connect to meridians, organs, and your body's electrical system [00:13:46] Ancient knowledge – TCM and Ayurveda understood these energy flows long before modern medicine [00:14:03] The spiritual symbolism – Wisdom teeth as a rite of passage into maturity and integration [00:14:17] Energy interconnection – Removing one element affects the entire energetic system [00:15:05] The Western blind spot – Our medical model ignores the body's bioelectric reality [00:15:39] The real risks – Nerve damage, chronic pain, and post-surgical trauma are far more common than discussed [00:15:57] Economics over evidence – How financial incentives outweigh long-term wellness [00:16:08] The forgotten holistic view – Why true healing means considering biology, energy, and emotion together [00:16:22] What you can do – Get informed, ask questions, and don't rush to extraction [00:16:44] Empowerment checklist – Imaging, second opinions, and trusting your intuition [00:17:02] Keep your power – Don't give your health decisions away to "white coats" or outdated systems [00:17:24] If surgery is unavoidable – Do it consciously: prepare, recover, and restore energetically [00:17:50] Pre/post-surgery support – Rest, meditation, and mineral-rich nutrition [00:18:02] The deeper truth – Wisdom teeth represent the intersection of biology, energy, and consciousness [00:18:23] Final message – Stay informed, stay connected, and embrace the wisdom in your own body     Thank You to Our Sponsors EnergyBits: Get 20% off your entire order by going to https://energybits.com/ and using code DARIN at checkout. Our Place: Toxic-free, durable cookware that supports healthy cooking. Go to their website at fromourplace.com/darin and get 35% off sitewide in their largest sale of the year.     Find More from Darin Olien: Instagram: @darinolien Podcast: SuperLife Podcast Website: superlife.com Book: Fatal Conveniences Join the SuperLife Patreon for extended episodes, private Q&As, and Darin's personal health protocols: https://patreon.com/darinolien     Key Takeaway "The body is not broken — it's intelligent. When we rush to extract, cut, or suppress without understanding, we lose connection to the deeper wisdom it's offering. Sometimes the smartest thing you can do is wait, listen, and trust the design that created you."     Bibliography of Referenced Studies Cochrane Review (Systematic Review) Study Title: Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth Author/Source: Ghaeminia H, et al. Publication: Cochrane Database of Systematic Reviews 2020; CD003879 Key Finding: There is insufficient evidence to support or refute the routine removal of asymptomatic impacted wisdom teeth, and no eligible studies reported on the effects of removal on health-related quality of life. Public Health Critique on Prophylactic Extraction Study Title: The Prophylactic Extraction of Third Molars: A Public Health Hazard Author: Jay W. Friedman, DDS, MPH Publication: American Journal of Public Health (AJPH), 2007; 97(9):1554–1559 Key Finding: Approximately two-thirds of extractions may be unnecessary, calling mass extraction a "silent epidemic of iatrogenic injury." M3BE Study Study Title: Prophylactic vs. symptomatic third molar removal: effects on patient postoperative morbidity Key Finding: Older patients are more at risk for complications (such as nerve injury and persistent pain), confirming that removal has real consequences. Clinical Guidelines (AAOMS) Source: American Association of Oral and Maxillofacial Surgeons (AAOMS) Title: Third Molar Surgical Guidelines Key Finding: Identifies Pericoronitis as one of the most common indications for surgical removal. Pathology Studies (Cysts/Tumors) Subject: Odontogenic cysts associated with impacted third molars Key Finding: While rare, cysts can erode jawbone and damage neighboring teeth, making this a valid medical reason for removal. Retrospective Complications Study Study Title: Retrospective Oman study: Complications of Third Molar Extraction Key Finding: Referenced in the context of risks and complications associated with extraction.

Ready to finally break free from alcohol—and stop the cycle of numbing? Start your journey today with the Refresh & Reboot: 30 Day Alcohol-Free Challenge. This self-paced program gives you daily guidance, mindset tools, and video support from Sara to help you thrive through your first 30 days without alcohol. Podcast listeners get 20% off with code PODCAST20 at checkout.

Here is a real-world clinical case with a tricky differential: Our team recently readmitted a patient 6 days postpartum/post C-section (which was done for ICP and fetal macrosomia at close to 4500 grams, with A2GDM). She had elevated blood pressures, a frontal headache, some midepigastric pain/RUQ discomfort. Pretty clear picture right: sounds like preeclampsia (PreE) with severe features based on BP elevation and symptoms. So, we started her on mag-sulfate per protocol. Well, her transaminases were in the 400-600s, which was significantly higher than they were at delivery. They then peaked the next day at 900! OK, it still meets criteria for PreE with severe features. But could this also be postpartum Acute fatty Liver of Pregnancy (AFLP)? The clinical picture of these 2 conditions may overlap but there are distinct differences here. AFLP is potentially fatal, so we have to get that diagnosis correct. How can we distinguish AFLP from PreE with severe features or HELLP? Listen in for details.1. https://www.preeclampsia.org/the-news/health-information/acute-fatty-liver-of-pregnancy-can-be-confused-with-preeclampsia-and-hellp-syndrome2. Yemde A Jr, Kawathalkar A, Bhalerao A. Acute Fatty Liver of Pregnancy: A Diagnostic Challenge. Cureus. 2023 Mar 26;15(3):e36708. doi: 10.7759/cureus.36708. PMID: 37113350; PMCID: PMC10129069.3. Maalbi O, Elachhab N, Elkabbaj A, Arfaoui M, Hindi S, Lahbabi S, Oudghiri N, Tachinante R. Management of Acute Fatty Liver of Pregnancy: A Retrospective Study of 12 Cases Compared With Data in the Literature. Cureus. 2025 Jun 11;17(6):e85753. doi: 10.7759/cureus.85753. PMID: 40656400; PMCID: PMC12247011.4. Siwatch S, De A, Kaur B, et al. Safety and Efficacy of Plasmapheresis in Treatment of Acute Fatty Liver of Pregnancy-a Systematic Review and Meta-Analysis.Frontiers in Medicine. 2024;11:1433324. doi:10.3389/fmed.2024.1433324.5. Sarkar M, Brady CW, Fleckenstein J, et al.6. Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases.Hepatology (Baltimore, Md.). 2021;73(1):318-365. doi:10.1002/hep.31559.STRONG COFFEE PROMO: 20% Off Strong Coffee Company https://strongcoffeecompany.com/discount/CHAPANOSPINOBG

Autism isn't new, but our understanding of it has changed dramatically. It's now recognized as a broad neurodevelopmental spectrum that shapes how millions of people perceive, process, and interact with the world. In this episode, we explore what autism is AND isn't, from its earliest signs in infancy to its deep genetic roots, and why misinformation about it continues to spread. We speak with three remarkable experts leading the field in early detection, genetics, and public education: DR. AMI KLIN, PhD, Director of the Marcus Autism Center at Emory University and a pioneer in early autism research, whose work shows autism can be identified in babies as young as two months old. DR. JOSEPH BUXBAUM, PhD, Director of the Seaver Autism Center at Mount Sinai and a global leader in autism genetics, uncovering hundreds of genes linked to the condition. DR. ANDREA LOVE, immunologist, microbiologist, and founder of ImmunoLogic, known for her clear, evidence-based communication about vaccines, immunity, and autism myths. Together, we discuss: • What autism really is, and how the definitions have evolved • How it develops in infancy (and why early diagnosis can be so critical) • The powerful genetic evidence behind autism • The persistence of vaccine myths, and how misinformation spreads • How technology like eye-tracking can detect autism early • The rise of “profound autism” and what it means for families • The future of genetics-based treatments and therapy Whether you're autistic yourself, a parent navigating a new diagnosis, or simply seeking understanding, we're thrilled to share this extensive, in-depth episode with you. This is... Your Brain On Autism. SUPPORTED BY: the 2026 NEURO World Retreat. A 5-day journey through science, nature, and community, on the California coastline: https://www.neuroworldretreat.com/ ‘Your Brain On' is hosted by neurologists, scientists, and public health advocates Ayesha and Dean Sherzai. ‘Your Brain On... Autism' • SEASON 6 • EPISODE 1 LINKS Dr. Ami Klin at Emory University: https://ctsn.emory.edu/faculty/klin-ami.html Dr. Ami Klin at Marcus Autism Center: https://www.marcus.org/about-marcus-autism-center/meet-our-leadership/ami-klin  Dr. Joseph Buxbaum at Mount Sinai: https://profiles.icahn.mssm.edu/joseph-d-buxbaum  Dr. Andrea Love's website: https://www.immunologic.org/ Dr. Andrea Love on Instagram: https://www.instagram.com/dr.andrealove  REFERENCES Autism Spectrum Disorder: A Review. JAMA, 2023. https://jamanetwork.com/journals/jama/article-abstract/2800182  Is There a Bias Towards Males in the Diagnosis of Autism? A Systematic Review and Meta-Analysis. https://link.springer.com/article/10.1007/s11065-023-09630-2  Acetaminophen Use During Pregnancy and Children's Risk of Autism, ADHD, and Intellectual Disability. https://pubmed.ncbi.nlm.nih.gov/38592388/  Eye-Tracking–Based Measurement of Social Visual Engagement Compared With Expert Clinical Diagnosis of Autism. https://jamanetwork.com/journals/jama/fullarticle/2808996  Rare coding variation provides insight into the genetic architecture and phenotypic context of autism. https://www.nature.com/articles/s41588-022-01104-0  Rare coding variation illuminates the allelic architecture, risk genes, cellular expression patterns, and phenotypic context of autism. https://www.medrxiv.org/content/10.1101/2021.12.20.21267194v1  Andrew Wakefield and the fabricated history of the alleged vaccine-autism link. https://geneticliteracyproject.org/2024/04/29/andrew-wakefield-and-the-fabricated-history-of-the-alleged-vaccine-autism-link/ VACCINES & AUTISM 1. Major Cohort Studies Hviid et al., 2019 – Annals of Internal Medicine A nationwide study of 657,461 Danish children found no increased risk of autism in vaccinated children compared to unvaccinated peers — even among those with risk factors such as a sibling with autism. Ann Intern Med. 2019;170(8):513–520 Madsen et al., 2002 – New England Journal of Medicine In 537,303 Danish children, researchers found no difference in autism rates between vaccinated and unvaccinated groups, and no relationship with age, timing, or date of vaccination. NEJM. 2002;347:1477–1482 Jain et al., 2015 – Journal of the American Medical Association (JAMA) A U.S. cohort of 95,727 children — including those with siblings with autism — showed no link between MMR vaccination and autism risk, even in genetically predisposed children. JAMA. 2015;313(15):1534–1540 Madsen et al., 2003 – JAMA A study of 467,450 Danish children found no relationship between thimerosal-containing vaccines and autism. JAMA. 2003;290(13):1763–1766 DeStefano et al., 2022 – Vaccine A retrospective cohort of over 500,000 U.S. children with ASD found no increase in adverse events or worsening of autism-related symptoms following vaccination. Vaccine. 2022;40(16):2391–2398 2. Population-Level Epidemiologic Evidence Taylor et al., 1999 – The Lancet One of the earliest large epidemiological studies found autism prevalence was the same in vaccinated and unvaccinated children, and the age of onset was unrelated to the timing of MMR vaccination. Read: Lancet. 1999;353(9169):2026–2029 Institute of Medicine (U.S.) Immunization Safety Review, 2011 A global review of studies from the U.S., Denmark, Sweden, and the U.K. concluded there is no causal relationship between vaccination status and autism, and no plausible biological mechanism linking vaccines (including thimerosal) to ASD. Read: National Academies Press / PubMed 20669467 3. Systematic Reviews and Meta-Analyses Taylor et al., 2014 – Vaccine A comprehensive meta-analysis of 10 studies including over 1.2 million children found no association between vaccination and autism or ASD. Vaccine. 2014;32(29):3623–3629 Maglione et al., 2014 – Pediatrics Review of 67 high-quality studies covering the full U.S. immunization schedule concluded that vaccines are safe, adverse events are rare, and there is no link to autism, type 1 diabetes, or other chronic conditions. Pediatrics. 2014;134(2):325–337 Parker et al., 2004 – Pediatrics Systematic review of 10 primary studies examining thimerosal exposure found no relationship between vaccines and ASD. Authors noted that studies showing an association were methodologically flawed or biased, while robust studies consistently showed safety. Pediatrics. 2004;113(6):1904–1910 Offit & Hackett, 2003 – Clinical Infectious Diseases Review of immunology and epidemiology concluded that claims that vaccines “overwhelm” or “damage” the immune system are not biologically plausible based on how the immune system actually functions. Clin Infect Dis. 2003;46(9):1450–1456