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J&J Looks for Partners to Ramp Up Supply of Covid-19 Vaccine

Bloomberg Daybreak

01:04 min | 11 hrs ago

J&J Looks for Partners to Ramp Up Supply of Covid-19 Vaccine

"And Johnson is looking for manufacturing partners to increase supply of its covert 19 vaccine. Johnson and Johnson CEO Alex Gorsky tells Bloomberg. He wants enough shots for 20 million Americans. By the end of the month. Korsky spoke with Bloomberg's David Westin, Let's listen into some of that conversation now. You've got eyes understand About four million doses ready to go. They came out of your Dutch facility are their manufacturing issues in Baltimore? Are you concerned at all about that? Now Look where we're on track with our plans. We do have approximately 4,000,003 40.9 that are literally on trucks right now being rolled out in the United States. We expect to do 20 million in March. On Look over the next several weeks. We've got to go through regulatory approvals on a few other processes. But then will you expect to hit a very strong cadenzas? I mentioned earlier so that we could be doing We will have done 100 million doses by the end of June and near a billion by the end of 2021 in route to a path of almost two billion by 2022.

Alex Gorsky Korsky David Westin Bloomberg Johnson Baltimore United States
What your partner needs to know and learn about the menopause transition

Women's Health By Heather Hirsch

05:16 min | Last week

What your partner needs to know and learn about the menopause transition

"Special podcast. And this is an episode that I would love for you to share with your husbands your partners or excetera off because while I spent a lot of time helping women understand menopause, I think it's really important that we help men understand menopause and the hormonal changes that go along with menopause very commonly in my office. I see patients really distressed about the way that menopause has affected their relationships and there's no relationship. That's more important than your marriage long-term partner, especially when you live together and especially when one of you is going through a lot of changes this could even be same-sex Partners if one of you is going through menopause and what isn't yet? So this whole episode is really about what your partner needs to know about menopause. I calling it. This one's for the boys just cuz men don't really go through menopause. And so there's a lot wrong. They won't understand. So I'm going to do ten things that men should know about menopause if your dude and you're listening in thumbs up. This is going to be really helpful. That's why I want to do this song cast. I want you to know that there's many other men who are facing similar situations with their spouses and that your wife is not alone and hopefully she's sick help in some ways either by finding a doctor or maybe it's even just this podcast. That would be totally cool if it was so first thing to know is number one. I want you to educate yourself. There's no better way to educate yourself then listening to this podcast. I know I keep plugging that but that's because it's going to be pretty informative. There's lots of information on my website, which is Heather Hirsch md.com and I also really like speaking of women's health. Com, there's lots of other chatrooms and support groups, but I've gone on those as well and I'm not sure if all the information is always accurate so long Educate yourself. There's lots of books out there that I really like. There's the Cleveland Clinic guide to menopause. There's many menopause books that are on the shelves. Now. I know what you're thinking and I know the answer probably not going to go to your closest Barnes and Noble and buy a 300-page menopause book and read it from cover to cover. Maybe we'll but the majority of you won't so even just listening to this or birth listening to your wife about what she has learned will help you to educate yourself because if you know what she's going to go through and if you know that this is a physiologic and normal response to changing hormone levels, you're going to hopefully be more understanding and what she's going through the more understanding you are the easier this transition and these changes will be for you and your wife and I want you to have a long-lasting relationship in a long marriage. So understanding what both of you is going through is really helpful. I always tell my female patients that men y'all have the same thing. Steady sex hormones your whole life women are hormones go up and down every month and then in perimenopause they go wonky and then in menopause they crash and burn so it's not fair. It's kind of kind of not exactly the same for both sexes. So educating yourself Super Key. Okay on a number to call. This one is most arguably arguably me the most important but it didn't want to start with this one. Number two is understand the changes in Sex and intimacy between you and your partner and the physiologic changes in your partner. This is what I tell my patients on a daily basis at menopause, you lose all your eggs. And therefore you can't get pregnant again. Now, the the purpose of the sex drive is to reproduce and after you've had your children or maybe you haven't had children, but you've gone through menopause and you no longer can reproduce you're not going to seek that out like you do food. Her and shelter, you're just not now on top of that. There can be some changes in the vagina. I know I'm going to say it. There can be dryness and pain with intercourse a vagina and this has nothing to do with you. This is the physiologic changes of the loss of estrogen in the vagina. So if you think about those two things number one. And you don't have to drive like you used to and number two, it's painful your wife is or your partner is not going to be really motivated to engage in that activity, or maybe if she is not as much as before. She's already had her children now men, they're always trying to get pregnant. They're never going to get pregnant. They never lose their testosterone. So naturally there can be a shift in their computer change the desire for intercourse a lot of women come in super distressed saying they feel so bad for their husband they feel so guilty about it. And the thing is is some dead. Nurse don't understand. This doesn't mean they're not interested in you a lot of my patients will say my husband is a hunk and he's super sexy and I really love him and I love cuddling and I love kissing but when it comes to intercourse, sometimes it hurts. I'd rather just watch TV. I'd rather read a book or I'd rather just go to sleep. That doesn't mean she doesn't love you. And that doesn't mean she's

Heather Hirsch Cleveland Clinic Barnes
Vaccine Distribution: An Equity Challenge

Short Wave

09:28 min | 13 hrs ago

Vaccine Distribution: An Equity Challenge

"Okay paying we are talking vaccine equity in the pandemic and just a quick note. We are focusing a just here in the united states for this episode. So let's start with some top line numbers three covid. Nineteen vaccines have been authorized for emergency. Use in the us one very recently. How many people have actually been vaccinated so far well. Since vaccine distribution started in mid december around fifty million people have gotten at least one dose of a covid nineteen vaccine that includes about twenty five million people who got into doses means they've been fully vaccinated with either the pfizer or madonna vaccines. And that's some real progress over the past few months. Still just around eight percent of the total. Us population has been fully vaccinated. So there's still a long way to go. yeah i mean. Do we have any demographics on who the people who got the vaccine are like. Do we have any data on race or ethnicity well. Last week i spent some time at a cdc conference which was online and a bunch of public officials talked about it including dr marcela nunez smith who we heard from earlier. People of color are getting vaccinated rates below their representation in the general population. We know these challenges reflect longstanding deeply rooted systemic rallies. But here's the thing. The data that she's talking about is still pretty limited. You know so far race. Nothing to see. Data have only been collected for about half of the shots given out. Wow only half the thought i mean. There's a little bit frustrating. That's that's not enough data. Yeah it's it's really not and the biden administration pointed this out themselves and they acknowledged that it's pretty abysmal. Doctor rachelle will lansky. She's head of the centers for disease control and prevention and she says the problem is coming from a couple of different directions. Individuals may choose not to report. It may not be required of or requested by providers and some providers as well as jurisdictions have restrictions on data sharing so some of these data gaps are due to the fact that we have inconsistent systems around data gathering. Which you know is something that has been in quite a bit with this pandemic. Yeah that's certainly part of it and there's reasons why people might not want to share their personal information about race ethnicity especially people of color you know. The federal government has a long history of exploiting and under serving minority communities and that extends to this day but now there are government officials saying that. It's up to them to try and convince people that it's important to give their information. Here's neurath shaw. Health official in the state of maine in public health. What gets measured gets managed and if we measure the right things then we will manage the right issues if we measure the wrong things. Then the did that we collect. That may not bear resemblance to current present. Elf challenges is actually what we will end up managing. Yeah so early. On in fact vaccine distribution the only metric that was available was the number of doses sent out in the number of doses administered which basically measured speed and so if the biden harris administration wants to achieve both and equity with axiom distribution. They're going to have to get more comprehensive data on race ethnicity to get a handle on the problem. Yeah i mean. I want to talk about what the biden administration is doing specifically to address this issue of a vaccine but first let's talk about some of the ways. The general rollout has put. Vulnerable communities added disadvantage. Because that's definitely happening. Yeah and to be honest. It's been hard for everyone including health reporters to keep up with the changes that are happening. Daily and weekly with axiom distribution. I mean every single state has its own rules about who qualifies and had a sign up. Obviously that confusion is compounded. If the information isn't coming to you in the language you speak or you don't have access to computers and email and even for people who may have read up on how to book an appointment. It's taken them hours to actually research in book one. So if you don't have time to figure that out and if you don't have access to transportation or time off work to get an appointment and was places you probably haven't been able to get vaccinated yet. Yeah i mean and that's when you know for sure that you want the vaccine. Exactly dr christian rumors. He's a physician and executive that family health centers of san diego. He points out that people also have questions that are very specific to their own circumstances and we want those answered before they feel like they can make an informed decision to actually get vaccinated. Here he is speaking to. My colleague yuki noguchi residency is not just one thing. And in many cases. They're very unique to their own situation. Like i just got treated for cancer. Or i'm on a certain medication or i've had an allergy in the past and those are questions that'll be answered most likely from talking one on one with a medical professional or some other trusted person. Which again if you're part of an underserved community is hard to access. If you don't have the time to seek out those answers it'll be much easier if the vaccines and the resources were coming directly to you right right okay. So ping what has the biden administration specifically announced or done to address vaccine equity so at that. Cdc conference. dr marcellina smith acknowledged that this is a huge issue. And it's not gonna be easily solved. Must attend the underlying social structures arborist as we look ahead to building resilience into our recovery. What we do believe now. Is that the way we get american vaccinating and the emphasis he placed reaching the hardest hit communities attached just as important as being the goals the number of people that's needed so their strategy to get to those goals basically amounts to increasing a couple of different things number one the number of vaccines available number two the number of people giving vaccines and number three. The number of places people can get vaccinated and specific to equity. They've launched a few fema supported mass vaccination sites. These are huge operations set up in stadiums and parking lots that are aiming to give at six thousand shots a day and they're putting some of these in places that score high on something called the social vulnerability right which is a cdc measurement of how vulnerable community is based on social factors like poverty for example. They've also started sending vaccines directly community health centers which serve around thirty million people over. All many whom are rural belong to minority groups or are low income and the centers can also offer outreach in different languages and support for signing up. I mean are they also leaning on non-medical sites to i mean like i know working with community leaders and partners be especially effective. Yeah well they're also talking about sending out that nation trucks to job sites and setting up clinics and local churches and high school gyms and ymca's those non-medical sites that you were talking about and these community clinics might not be serving thousands of people a day but they will make the vaccine available and convenient for people in those communities to get gosh so the vibe administration is really trying to take a both and approach. They're supporting mass vaccination sites to get a lot of people vaccinated quickly and they're also realizing that some people will take more time and more effort to reach so they're also trying to figure out ways to gather better data and target underserved areas. Okay so you know. Most of what we've been talking about today paying as the government is handling this which i would argue is the most important facet but i mean. Is there a sense of individual responsibility here. I know there are a bunch of stories out there about people line jumping or like going into communities outside their own to vaccines how we have all heard the stories and it's hard to say how much it's happening but it does make people feel like the system isn't working you know and what bioethicists have said to me is. That cheating happens for sure but it's probably not happening enough to undermine the system overall i mean. Is that all kind of a short term problem. I mean there's a huge demand right at this point and not enough supply but the hope is that you know in the coming weeks or months the situation will change as vaccine manufacturing and distribution ramp up even further right. Yeah and that's been the hope all along. I mean for weeks now. We've been hearing about a flood of vaccines that will be coming online in the near future. That will make it less. Cut throat to vaccine appointment and we're not there yet but there are some promising signs. The government has now ordered a total of six hundred million doses of pfizer in modern of vaccines to be delivered by the end of july. Which is enough to cover three hundred million people and that's more than all the adults in the us right right. Plus we've got the newly authorized. John jay vaccine which will eventually make a difference right and getting all these shots in urgent right now because we're kind of in a race between vaccinations and variants. Which means that. The more people protect right now. The fewer people will catch the virus and the fewer chances the virus will have to keep mutating in ways that might make it avai the vaccines and the treatments. We've developed so that's why it's still super super important to keep the other measures that prevent the virus from spreading double masking staying physically distant. You know we're all excited about vaccines but health. Experts are saying right now that in the middle of the vaccination campaign is not the time to let up our guard okay pingpong we appreciate you as always thank you for coming on the show things so much. Mattie appreciate you to

Biden Administration Centers For Disease Control An Dr Marcela Nunez Smith Rachelle Will Lansky Neurath Shaw Biden Harris Administration United States Dr Christian Yuki Noguchi Pfizer Dr Marcellina Smith Madonna ELF Federal Government Maine Confusion Allergy CDC San Diego
Johnson & Johnson rolls out one-dose COVID-19 vaccine

THE NEWS with Anthony Davis

00:38 sec | 14 hrs ago

Johnson & Johnson rolls out one-dose COVID-19 vaccine

"Johnson and johnson shipped out nearly four million doses of its newly authorized. One shot covid nineteen vaccine on sunday night to be delivered to states for you starting today. But the efforts come with strong warnings from health officials against reopening too quickly as warren corona virus variants spread on monday. The head of the cdc doctor rochelle walinsky urgently warn state officials and ordinary americans. Not to let down their god saying she is really worried about reports that more states rolling back. The exact public health measures that we have recommended.

Johnson Warren Corona Rochelle Walinsky CDC
Learn How to Break Away From the Pack & Standout In a Busy Marketplace with Dr. Joel Kahn

Healthcare Business Secrets

05:17 min | Last week

Learn How to Break Away From the Pack & Standout In a Busy Marketplace with Dr. Joel Kahn

"Welcome to healthcare business. Secrets show where we interview industry leaders and break down exactly how they dominated the markets you can live from the best and can w revenue w impact and w time off and this episode was speaking. Joel can joel. Otherwise known as america's healthy hot dog is a graduate of the university of michigan. School of medicine is a clinical professor of medicine at wayne state university school of medicine a frequent lecturer and author on topics of vegan nutrition health heart disease reversal and has written several books about alternative nutrition and hothouse. He's had been a guest and commentator amy. Tv shows podcasts. Magazines m practices at the concept of a cardiac longevity is very unpracticed in michigan. Welcome to the show joe. Thank you so much excited to share with the audience. Yeah so i wanted to kind of give out with some background on you. And and how you got into the space because you've kind of gone down a different role than maybe stanford medicine and things teaches. Unfortunately not because of any time in the in the slammer or any problems with my license in a somewhat thoughtful various er- pigeon Course but i grew up in detroit michigan Talking now from the suburb in detroit michigan attended university in ann arbor. Michigan graduated top of my class medical school. But i knew from about a swallow wanted to be a heart moved to dallas moved to kansas city out and training with the best skills and particularly treating heart attacks with angioplasty instead. You have some wonderfully people from australia. New zealand in the my mentor in kansas city was from all actually a dislike from new zealand allah but when visit i'll be of the difference between the do another very different entry but nineteen ninety way before you were born. I imagine or at least run it. I join back in detroit. Michigan big practice. And i was the guy running a night treating sick people coronary Cardiac cath lab artists. But i was even back then very interested in the other part the About our of health which is prevention nutrition. Lifestyles sleep stress. Nutraceutical supplements the whole thing. Much more light perhaps naturopathy and chiropractic. So i was always reading on my own incorporating little tidbits been using coenzyme q ten of people for thirty years my college or and then i'll percolating along as very happy guy got a chance to look down to. The university mentioned developed a preventive cardiology program. But i knew that there was something else that i really had an energy for something else. I mean that was doing wonderful. Things are day is the same thing every day. When wonderful big over i went back to university in two thousand twelve a whole year doing a university based courses integrative cardiology natural gas and pretty much nutrition thing adnan stunning that for decades. But i didn't know all the nutraceutical isn't about chemistry testing and the epa genetics and the protonix and we can use fancy words. I graduated and of course. I say in traditional practice but i ultimately with some thought took a big breath five years ago and says you know what i've done enough cath lab emergencies. That mouse running three hassles on the weekend alone. A great practice. I one focus on prevention and i looked around the country. I could barely find in the united states preventive cardiology practice. That was not attuned to only prescription. Drugs are printing preventive cardiology practices more precision more prescription. I wanted to about more health lifestyle disease reversal. I gleaned from various people what i could kinda created a model. I left the insurance system. You wanna have a sleepless night. As a physician who's always had a whole room full of baylor's and medicare and blue cross as we call in the united states and others and tell people in the city of detroit that is not beverly hills los angeles by a reasonably prosperous busy city with auto industry. But i don't take insurance. I can't even take your insurance them out of the system and launched in five years ago and yes. There's always challenges. My tears thought that maybe. I did. Have alcohol rounds. Drug problem slices. Is he doing all as they didn't understand. It has been the best decision. I don't think would have been as meaningful if i didn't pay the price. All those years of doing traditional medicine I'm respected because know what heart catheterization angioplasty bypass Medications use them when needed by I'm very much dedicate myself as upstream cardiologists. I'm the salmon trying to go upstream. Everybody else is going the other direction. But there's a lot of people out there and you know. I i'm sure for practice that are looking or a different path. They're just tired and they feel tired too many drugs too. Many ten minute appointments with dr the game now. It's a good nurse or a physician since i've provided alternative of time education a different approach. And it's so gratifying. Amin that i'm sixty one years old. I don't know what the word retires. Because i love what i do day after day today

Detroit Michigan Wayne State University School Kansas City New Zealand University Of Michigan United States School Of Medicine Joel Heart Disease Ann Arbor Heart Attacks AMY JOE Dallas Adnan Australia EPA
Pfizer's vaccine trial data holds up in the real world

Bloomberg Daybreak

05:03 min | 5 d ago

Pfizer's vaccine trial data holds up in the real world

"More again on the pandemic and the promising news about vaccines that Seems to continue to pile up of late. We're joined now by Dr Amos, a doll jah, senior scholar at the Johns Hopkins Center for Health Security and a professor of the Johns Hopkins Bloomberg School of Public Health. It's always good to get your insights doctor and I want to get your take on this latest study out of Israel that seems to verify the clinical data we got on the Fizer vaccine that it seems to be Just about a super effective in the real world as it is in lab settings. What do you make of this pure reviewed study? This is great news because we always know that it's one thing when you're in a clinical trial, and you've got a lot of protocols and certain people who volunteer for those clinical trials, and then you move from that setting to the real world where things can be a little bit more messy. Are there a lot of variables that might not have been accounted for in the clinical trial, and that's what we really understand how effective the vaccine is moving from F ethical efficacy Studies to Real world Effective ists. I think this is good news, and it really cemented the fact that these vaccines are the passport and the way we get our lives back and put this pandemic to rest doesn't make you think that vaccines could get us to herd immunity that it'll be vaccines alone. That could get us to that step that we all want to see. Do you think that vaccines will eventually get us to herd immunity? But it won't be vaccines alone because already one third of the population in the U. S likely has some level of immunity from prior infection. Herd immunity, although it's a major milestone to reach. It's not the only thing I think to me the biggest The biggest milestone would be vaccinating are vulnerable populations completely so that this virus can never cause serious illness, hospitalization or death again that it could never threaten hospital capacity. I think we were will get there first. And then eventually herd immunity will will come. So I think the key is really taming this virus, making an unable to cause serious disease. And that's why our vaccine allocation process is geared towards those who are most likely to have severe disease. And I think we'll get there first. Before we hit hurted me. Did he speak about vulnerable populations? Doctor? I wonder if you're also thinking about the racial disparity that we continue to see in the vaccine distribution effort we saw Further evidence of that on the Bloomberg vaccine tracker just yesterday. What's it going to take to sort of bridge the gap between black populations receiving the vaccine and white populations? It's going to be very, very challenging. And I think that The more people that get back stated. The more people in those communities that are vaccine hesitant or afraid to get back there because they're on trusting of the of the vaccine or public health authorities. The more they see people get vaccinated and nothing untoward happened. I think the better it is. But I do think we need specific outreach to those programs to those individuals specific programs that really trying address their concerns almost on individual basis, because if that group does not get back stated they still represent they represent some of the people that are most risk for. Of your disease. They're disproportionately the ones who've died from this. We have to do better in order to put this pandemic to an end. And I think it's going to be challenging. And I think we're gonna need the innovative solutions. We're going to the community leaders to really Show people the data and be very transparent about how effective these vaccines have been in go through all of the safety data and hopefully persuade them to get vaccinated at much higher rates than they have been. Our last minute here. What's your level of concern about some of the latest variants we're seeing reports on with there's a New York Times report just this morning about a variant in New York City that seems to be spreading pretty rapidly and could blunt the effectiveness of vaccines. Yeah, it's hard to know exactly how to take all the news of the variance. We know that this virus has been making variants as soon as it jumped into humans and most very instead from made headlines have never made The New York Times Because they didn't change the way the virus behave. But there are some that appeared to have made the virus more contagious. Some that have Changed the way the virus interacts with the immune system and those air more concerning, But I do think when you look at our vaccine data against these areas, including ones that are more Troublesome like the one that they call the South African variant of the resilient variant. The vaccine's still do remarkably well on what matters. Preventing severe illness, hospitalization and death. So I do think that the goal when it comes to these variants is to stay ahead of them by accelerating vaccination programs to the fastest possibles rate. Some of these various don't pose a problem, but I think we need to do better attracting them and understanding them. But not everyone that you see is going to rise to prominence and I think we're getting better now at tracking them. Sequencing, and so you're going to hear more about various, but not all of them are going to be of the same important that it's gonna take some time. Specifically all of that.

Dr Amos Johns Hopkins Center For Healt Johns Hopkins Bloomberg School U. Israel The New York Times New York City
CDC launches VaccineFinder tool to locate COVID-19 vaccine providers

Morning Edition

03:37 min | 5 d ago

CDC launches VaccineFinder tool to locate COVID-19 vaccine providers

"19 vaccine, But you can't find one help could be on the way. The Centers for Disease Control and Prevention has just launched an online search tool in partnership with Boston Children's Hospital. Help people identify which facilities have supplies of the vaccine. It's called vaccine finder dot org's. This initial launch is limited to certain providers in most states, NPR's Selena Simmons, Duffin has details. When you put in your zip code at vaccine, find her dot org's. You see an interactive map showing local pharmacies that get Cove in 19 vaccine doses from the federal government. You also see whether they have doses in stock. If you live in Alaska, Indiana, Iowa or Tennessee, you're in luck. Because in those states, the maps show more places administering Cove in 19 vaccines. Not just pharmacies, but private hospitals and clinics and public health sites, ideas to show vaccine providers that are open to the public. How to contact them how to book an appointment. And kind of show the daily inventory status of people are clearing where there's vaccine and where there isn't That's John Brownstein, the founder of Vaccine Finder and chief information officer at Boston Children's Hospital, he says. After this initial launch, more providers in more places are expected to join in in the coming days and weeks. That scene finder is actually not new. It began nine years ago. It all started after each one. Anyone where we want to figure out how to provide the population with the best possible insights and where vaccine was in their communities, and since then We have been building this platform usually showing people where to get the seasonal flu shot or travel vaccines, Bronstein says. In recent months, a team of about three dozen people has been working feverishly to launch this tool toe work for people looking for covert 19 vaccines. While navigating the fact that at this moment, vaccine supplies relatively low and eligibility is limited, both of which constrained how useful the tool is. In case the Kaiser Family Foundation says she wishes this tool had been around a few weeks ago. In the meantime, many states have created their own provider maps people can use, and that's added to this confusing patchwork. This idea has a lot of potential, but I think there's still some questions about what will it be like in practice. There are also concerns about how many providers will put their information on vaccine finder and whether the providers will really update their inventory every 24 hours. I've seen finders John Brown seen acknowledges. This is not a silver bullet. What we're trying to do is add a resource into the mix to help consumers. Of course not all problems get solved with a new website. And he says they have partnerships to put vaccine find her info about where vaccine providers are located and who has shot's available in lots of different places online from Google maps to the traffic app ways too Good are ex, so it's not just about coming in the website, but meeting consumers where they are. Are on making sure that anybody who's looking for a vaccine knows where to find them. The supply of Corona virus vaccine doses is growing. The Biden administration says it's now sending out over 16 million doses a week and increase of more than 70% since inauguration. Assuming that trend continues, more shots will be available and more providers like clinics and even doctors. Offices will be able to begin distributing vaccine doses as well. So people can look forward to a time when Cove in 19 vaccine doses are abundant and everyone is eligible. And you might even be able to ask your smart speaker to find a clinic nearby with vaccine doses and stock and head over to get your shot. Selena Simmons Duffin

Boston Children's Hospital Centers For Disease Control An Selena Simmons Duffin John Brownstein Vaccine Finder NPR Bronstein Federal Government Alaska Tennessee Iowa Indiana Kaiser Family Foundation FLU John Brown Biden Administration Google Selena Simmons Duffin
Pinning Down Prostate Cancer

Medicine, We're Still Practicing

06:31 min | 2 weeks ago

Pinning Down Prostate Cancer

"Well i of course. Our hosts quadruple board. Certified doctor of internal medicine pulmonary disease critical care and neuro critical care and still fighting on the frontlines over the war on. Covid my very good friend. Dr steven tae back. How you doing steve. I'm well thank you as you've heard joining us from johns hopkins medicine. Doctor kenneth pinta. He's the director of research for the james buchanan. Brady urological institute. He's the co director prostate cancer research program for the sidney kimmel cancer center. He's a professor of urology. He's a professor of oncology. he's a professor of pharmacology and molecular sciences. Welcome dr to. What do you do with all your spare time can. This is not meant to be a softball question. But it's going to sound that way. I'm trying to understand from your inside. Perspective. what is it about the environment you work in a johns hopkins that produces these kind of outcomes. These ratings and the international recognition part of it is tradition. Johns hopkins was founded as the first research university in the united states and we've always placed the tripartite mention of patient care education to students and research on equal footing. So that we're always seamlessly combining those and the other piece of tradition is johns hopkins hospital in the medical school itself. We defined american medicine at johns hopkins with william oastler. Starting out saying we're gonna do medicine differently. Use the term. Medical residents started at johns hopkins. Because ostler made. The doctors live in the hospital to be trained in. So that's where the term came from. You know we have this dome at the hospital. With with the wings of the building and medicine rounds what referred to the fact that they would go round and round the dome to the different wards. And you know we carry that sort of tradition with pride and people love to work there and we've always attracted really smart people who love madison in love taking care of people and really love combining that with the research that powers the next generation of medicines. Forward dr parton. Your department chair talked about. While other hospitals use reports for urological surgery hopkins actually makes their own. Robots isn't making davinci robot. No we use a commercial robots like everyone else but what we are doing is creating the next generation of robots to work with mri machines. We have danced in. Our department is making a special robot that does that. The hopkins whiting school of engineering is developing the next generation of robots to integrate imaging with robotic surgery. A lot of that is not just hardware. it's software we're living in a pretty high tech era. We've come a long way in medicine but still so many men die of prostate cancer. What are we messing up here in. We have to do to fix this. So you know in this time of covid and so many people dying of kobe. You know it's an infectious disease. We gotta do better and we tend to forget about these other illnesses that are plaguing the planet you know if you look around the world. Ten million people a year are dying of cancer in the us. Six hundred thousand people are dying of cancer. Thirty thousand men die of prostate cancer. Every year and cancer of all kinds including prostate cancer is curable if you find it in time because we can do surgery or radiation in jewelry you but unfortunately in about fifty thousand men per year we find the cancer too late. We find the cancer. After it is escape the prostate and metastatic cancer virtually of all kinds is incurable and prostate cancer. Unfortunately metastasized spreads to the bones as first sight and it causes a lot of problems for guys in the bones including pain and eventually kills them and we can talk about how that happens but essentially we fail because we don't cure people because we don't find the cancer in time. Let me ask you a question about that. Actually because i've been quoted by colleagues that if you're fifty years old you have a fifty percent chance that you actually have prostate cancer and at sixty sixty percent chance that you've probably already have prostate cancer and so on and so forth and it would beg the question. Would it not make sense to prophylactically. Remove the prostate. And then obviously the the major impediment to that is the major side effects. What does the thought process about that in. Where are we in terms technologically of mitigating the terrible side effects of impotence and incontinence. So i think there's two aspects to that question steve that we just need to touch on because the other thing you hear. All the time is that oh prostate cancer. You don't have to worry about it. You're going to die with it not from it. You know we do see that. Eighty percent man age eighty if you look in their prostates. If they've gotten killed by a car accident you'll see prostate cancer. So essentially prostate cancer exists in two forms one form. Is this indolent slow growing low grade cancer. That probably shouldn't even be called the cancer. But it still is in we find it by screening and and those are the guys that can be treated with active surveillance. We don't need to treat their cancers where a lot smarter about that now than we were even a few years ago. The other kind of cancer is the aggressive prostate cancer. That is not the kind you find on all types whereas the kind that's growing quickly that we have to get out before it spreads so prostate cancer is definitely has a hereditary component. If you have a father or an uncle who had prostate cancer your your risk of developing prostate cancer is double if you have to family members. It's quadruples you had three family members. You're gonna get it so it is familial. There are some genetic drivers. Like vr rca to that lead to a higher incidence of prostate cancer. And we definitely say if you've have family history us should start screening sooner.

Prostate Cancer Pulmonary Disease Dr Steven Tae Cancers Kenneth Pinta Brady Urological Institute Sidney Kimmel Cancer Center First Research University William Oastler Johns Hopkins Dr Parton Johns Hopkins Medicine James Buchanan Hopkins Whiting School Of Engi Johns Hopkins Hospital Ostler Metastatic Cancer Steve
Fauci to Americans: 'When your turn to get vaccinated comes up, get vaccinated'

Mark Levin

00:25 sec | Last week

Fauci to Americans: 'When your turn to get vaccinated comes up, get vaccinated'

"House covert expert Dr Anthony Fauci says new research suggests that people who get vaccinated might be less likely to spread the coronavirus even if they become infected when your turn to get vaccinated comes up. Get vaccinated. It's not only good for you and your family and your community. It will have a very important impact on the dynamics of the outbreak in our country, she says. More research is needed to

Dr Anthony Fauci
Transforming Healthcare With Rebecca Love

Outcomes Rocket

05:55 min | 2 weeks ago

Transforming Healthcare With Rebecca Love

"Welcome back to the outcomes rocket. Everyone saw marquez here. Today i have the privilege of hosting rebecca love. She is a nurse. Entrepreneur inventor author. Tech's speaker and i nurse featured on ted dot com and part of the inaugural nursing panel featured at south by south two thousand eighteen. Rebecca was the first director of nurses innovation and entrepreneurship in the united states at northeastern school of nursing the funding initiative in the country designed to empower nurses as innovators and entrepreneurs where she founded the nurse hackathon the movement as lead to transformational change in the nursing profession in two thousand nineteen rebecca with a group of leading nurses the world founded and is president of sand sale the society of nurse scientists innovators entrepreneurs and leaders a nonprofit that quickly attained recognition by the united nations as an affiliate member to the on. Rebecca is an experienced nurse entrepreneur founding hire nurses dot com and twenty thirteen which was acquired in two thousand eighteen by realto in the uk where she served as the managing director of us markets until its acquisition and twenty nineteen currently rebecca serves as the principal of clinical innovation at optimize rx. She's passionate about empowering nurses and creating communities to help nurses innovate create and collaborate start businesses and inventions to transform healthcare. Such a privilege to have you here. Rebecca i'm really excited to touch on this very important topic of nurses going to be with you. Thank you for having me absolutely. And so rebecca. You've done some really neat things in your healthcare career and you know before we jump into the actual details of what we're gonna talk about. I love to hear more about you than and what what keeps you inspired in in your healthcare career. I think that being a background and being a nurse And washing with the front lines going for and doing on a daily basis especially in the face of i think every day i wake up. I'm inspired by those nurses to go out selflessly to transform and take care of individuals that most of I would wonder if we would cross that. Threshold and nursing was a second career choice for me in life and it was inspired because my mom really encouraged me to pursue nursing. Because she said that. Although there's a whole bunch of great leaders in other areas we needed really strong nursing leadership to sort of transform the future of the profession. And i took it very seriously after becoming immersed in watching certain challenges that was basically in the profession. I don't know if you know. Some of the statistics but percents of nursing graduates leave the bedside within two years of practice which is nearly the largest exodus of any profession out there and we are facing potential nursing shortage of vermillion nurses in the united states. And i think what motivates me is. How can we stop that accident. And how can we secure this profession at the future of healthcare And i think. I'm still motivated by both that here that there may not be nurses by the bedside in the future as much as i am inspired to transform. What a career for nursing. Looks like that me inspire the best to choose that profession debt. And you know. I wasn't aware that's a. That's a pretty big number of of nurses leaving and also want to say thanks to all the nurses listening or if you have somebody in your family your friends that are nurses at the front line. As as rebecca mentioned it's tough and especially during this pandemic The importance of what you do is critical so so yeah let's kick things off with a thank you and yes a rebecca. Why why so many people like white white is so many people eat nursing. Yeah there's there's some interesting study that are being collaborated on this entire thing. Why thirty to fifty percent of them are leaving the bedside within cheers of practice and my dad asked me this question. He that he the. Cfo honey when you graduated with your finance degree. Were you expecting to carry the same level of responsibility as cfo laughed and he instead. Of course not. And i said well welcomes the world of nursing where you graduate you enter the profession and not only. Are you carrying an incredible boat and patience upon you. But you're expected to carry the same kind of patient and responsibility as nurses with thirty or fifty years of experience. So i think one is incredible dichotomy of being put into a world. Where even if you have little training you're going to deal with those two patients. And then secondly i think one of the biggest factors is that the profession of nursing if you call it a profession has not been cultivated along a career progression and think younger nurses that are entering the profession realized. I don't know if you've noticed. But over course a twenty year career the average increase of salary of nurses only one point five percents a year which is half the cost of the increase in wages or salaries on the average american But more importantly there is no career development. So it's not as though when you start out as financial assistance and you progress ups eventual pointed the being the cfo and nursing. The first day of your career can very much look like the last day of your career thirty years later and i think that because healthcare has focused a very long time that the roles of nurses are to be by the bedside and that that job that has driven position is not in and of itself that they've never focused on. What are the career and the ambitions of the nurse by the bedside new ford so suddenly two years into a nurse his career. They're working in day night holiday weekend rotation they've had an increase of salary of about three percent and of them are patients that are constantly dying or sick and being called to work in and they don't know where their career is going in comparison to the friends that they have chosen other careers. Who are working monday through friday. Have five weeks of vacation and are steaming. The world where these nurses aren't sure what's going on. I think there's a couple downwards playing trends. But i think those are two of the largest.

Rebecca Rebecca Love Northeastern School Of Nursing Society Of Nurse Scientists In Realto Marquez United States United Nations Tech UK Ford
Why you should get off pellet injections.

Women's Health By Heather Hirsch

04:33 min | 2 weeks ago

Why you should get off pellet injections.

"If you hear any of that noise during this episode, that's why this episode today. I wanted to talk about pellet injections as well as the other non compounded non-fda-approved hormone therapy regimens that are out there. And specifically I want to talk about this because I want to explain a little bit more behind the Boom in this industry and the dangers of using these types of medications and then ultimately why and how to get yourself off of them. And if you have a friend in a similar scenario how to talk her out of it as well. I certainly she could listen to this episode. But my dream is that you also gleam some background information that can help explain this to someone else because when we can explain it to someone else that means we can learned it. So for many of you who've been listening to my show for a long time now, you know that there was a lot of misleading information from the initial results of the women's health study or the Women's Health Initiative that came out in the early two thousands. If you had not already listened to my podcast episode on the Women's Health Initiative. It's a few episodes down so scroll back and I would definitely listen to that before you complete listen to this cuz it will put it in a lot of context but because of those fears from the use of commercially available conjugated equine estrogen, which was pregnant at the time and it's combination buddy madrasi progesterone acetate which is the progesterone component. If you had an intact uterus there grew a new field of air quotes safe and are quote dead. What month are P. Now if you really think about it? This was a pretty ingenious move people who were looking to invest or to make money or who were burned out of their traditional either academic positions or some of these folks were pharmacists or other Allied Healthcare professionals looked around and said, ah, there's an easier for women in menopause who don't feel good. There's a niche to help women with vague symptoms. There's a niche that women are going to fill they're going to do not do anything. They can to improve the look and feel of their bodies their sexuality their hair their weight anything and we certainly live in a society. We're getting a miracle cure is a really great marketing tool. So these Wellness clinics formed now, I use the term Wellness clinics, but it could be a hormone Club. It could be an anti-aging Clinic any kind of along those lines type of Clinic these clinics formed and they were providing a service that academic professionals or clinicians and doctors were no longer feeling they were so confused about the results of hormone therapy, they grew fearful and then that trickle down into not teaching young doctors how to prescribe hormone therapy or have those conversations. And so it just simply disappeared. It seemed from Doctor's hands and went into these Wellness clinics home. Now, these Wellness clinics really jumped on the term bioidentical bioidentical is a slang term and it means estradiol now again, you can probably heard me say that you can get estradiol which is a plant-based estrogen but is is a prescription estrogen in an FDA-approved commercially available product from home. Clinician but these women's clinics really jumped on the use of the word bioidentical. These are marketing terms right simply put marketing terms anything that sounds like body identical bioidentical natural plant-based these all sound like they're supposed to be healthy just naturally we envision sun flowers and plants or herbs and things that seem so much more natural so much more safe life with the problem is is that that imagery is just downright wrong. It's a really great marketing tool that we've all been marketed to since our first day on this earth and its really a big problem. Now these clinics really

Women's Health Initiative FDA
Speaking From the Heart with SLP Lauren Sharpe-Payne

The WoMed

06:54 min | 2 weeks ago

Speaking From the Heart with SLP Lauren Sharpe-Payne

"Lauren. Welcome to the wo- med. Thank you in fact i to be here so for those of you who don't know morin. Sharp pain is a speech pathologist. And i have been dying to get speech. Pathologist on the wool med. So when you tell people what you do what's the first thing that they automatically assume. No people automatically assume i work with kids. I just can't sit kids and teach them how to say either s.'s. Or their ps. And i mean with all this do that but i actually work with adults since i think. The stereotype with speech pathology sitting down playing games working on different sounds But there's so much more to it than that so yeah well. I'll admit one of my good friends is literally dreading the day that her two year olds list goes away. It's really cute though because right now. Her z's literally come from the back of her mouth. Like all the kerr molars and she's just adorable. It's really cute it is. Oh my gosh yeah so you mentioned that you work with adults so did you. Is that kind of where you got started with. Everything or your passion really was but actually started my career working with kids. I worked with kids for about two years. Two and a half years and i liked it initially But i quickly found out. Just it wasn't like farc me like it wasn't my passionate area and so i worked really hard to kind of tradition over to the medical side of each pathology and i started working at outpatient rehab. I was seeing a lot of patients who had had strokes in like traumatic brain injuries and swallowing disorders. And i really found that that was really my passion and that's really what made me feel fulfilled at the end of the day. And so that's what i've been doing. Ever since that point. I love that i feel like i. I mean the only real interactions and stuff that i've had working with with speech was i used to work in the nikko. Nice and so. We'd have speech consoles all the time you know. We had like paralyzed vocal. Cords or you know. Cleft lip or palate premiums just couldn't quite figure out how to suck swallow breathe. Exactly yeah echo cool. Yeah so there's just it just sounds like there's so many different fields within so p. wrote there are there are. Mike said i think most of the time. Most people associate s. l. p. With you know working with kids like in the school. I think the school was really popular. But like you said there's so many different areas you know. We can work in hospital. We can work in nursing homes and you know fools and fire practices. So there's there's really a lot of different options in terms of you know where we can work which is really cool. So what led you into this career like how did you first hear about it and you know get interested in it so it's funny excellent to be a lawyer up until my senior year of high school and i remember i had already declared my major and a second of sociology class in high school and their story about the young girl. Her name was genie. I don't know if you've heard the story. But she was locked away for twelve years that her parents never interacted with hers. Get no human interaction and yeah it was. I saw that and like she had no communication at mike whatsoever and so she worked with the speech therapist and he was able to communicate. It wasn't all verbal. Nonverbal buys using pictures. But i thought that was so neat that there was something out there. You could help people communicate and the rest is history. I just fell in love from that point. that's really beautiful So greenwich some little video. Yeah what's the school pathway lake like do you guys have to clinicals. is it Like a bachelors. Is it a doctoral degree. Now or like how like if you're going to coach someone through eight or tell someone you know what they're in for. Yeah so it's four. Years of undergrad And then you have to go to graduate school so for me. My program was in graduate school. But if you don't have speech as an undergraduate degree typically a two and a half maybe three years for the graduate program and then after that your life and your certify after a nine month period. There's no doctoral degree right now. That recommended or like that's required to be a speech pathologist but you can most certainly get them back degree that not in my pets whatsoever But after getting your master's degree through what all the clinical fellowship here and so that nine months after you graduate where you're essentially practicing. Slc like getting a salary and everything. But you're still technically under supervision and so after that nine months Once you have all of your hours your than a certified speech pathologist so you don't need any supervision or you know no one's giving you feedback just kinda on your own completely after that point. Wow yeah is there different routes that you take if you want to be more on the medical side of things versus you know in schools or or working with pedes a good question so i know in graduate school. We do externships so typically if there are two externships one is medical. One is typically pediatrics. might be in the school. There might be private practice. But i know that's alive. Students really kind of narrow down where they want to be in terms of their career so a lot of students. We'll just try to warm more relationships with people a medical they feel like they wanna pursue medical side or vice versa with school side and then with the clinical fellowship years so that nine month period actor graduation many students will try and get their cf wire the clinical fellowship your and that desired area of speech that way after they're done they can't hopefully get a medical job or a pediatric job. You know what they don't need this revision to

Morin Lauren Nikko Mike
Biden administration to undo Medicaid work requirements

Pacifica Evening News

01:16 min | 2 weeks ago

Biden administration to undo Medicaid work requirements

"They Biden administration is moving to roll back Medicaid work requirements in this latest effort to undo a controversial trump era policy. Federal health officials plan today to inform 10 states that they would revote permissions granted by the Trump administration to impose such requirements. That's according to a Biden official is spoke on condition of anonymity. Officials were also set to withdraw the past administrations invitation for states. To apply for approval for work requirements. The move, which was first reported by the Wall Street general, follows an executive order Biden signed last month that directed officials to review and remove barriers to Medicaid coverage. Medicaid is, say $600 billion federal state program that covers about 70 million people from pregnant women and newborns to disabled people and elderly nursing home residents. Under the Obama era Affordable Care Act, states gained the option of expanding the program. Too many low income adults previously ineligible. More than 12. Million people have gained coverage. As a

Biden Administration Trump Administration Biden Barack Obama
Frailty Is A Thing?

Fading Memories: Alzheimer's Caregiver Support

05:33 min | 3 weeks ago

Frailty Is A Thing?

"I am excited today to introduced to you dr mucci. She has the coolest instagram page. That you're ever gonna wanna watch so her pages linked in the show notes and we are going to discuss. Frailty today which. Until i ran into her. I didn't even know an actual medical thing. So thank you for joining me. Have i so i just thought frailty meant you know i have a very good definition of frailty. I just thought it meant that you started losing the ability to move freely. And then you've told me that there's actual stages and it's a medical thing so why don't you start by telling everybody what frailty actually is to a medical doctor a right. Thank you very much for the kind introduction jets and so frankly is very commonly used announced a families look after all people and they just say oh mommy's a bit freia and she's slowed down a little bit out. Of course they chum failty in medical world as means completely different thing and their definition official definition knees highly if they reduce physiological reserves allocco physiological reserves. This means and why is it important to understand while this happens. As a result of amalgamation wolf three major factors as a result of aging process amalgamated with age related diseases we accumulate over the life span as less side effects of medications. Let me give you an example. What this means. So recent example for my clinical practice beatrice is ninety two year old lady. She's quite fit. Well lead independently. She before the lockdown. Actually it was running classes in a swimming pool oval senior citizens so very engaged with her community and leaving a beautiful life with quote a good quality of life however decreases ninety two and in the lost two three years. Should he'd have a few medical problems into stroke clinic with couple of meanest strobes diagnoses on. Jain ah should also has a little bit okay. High blood pressure. Some kidney disease muggle problems. None of them are actually bad enough to impact on. Have day to day functioning. She takes madison's will. These conditions is on block thin as full day mini strokes or cholesterol tablets. So she's functioning will and then one day should develops really a bad kid named action or you're north talked infection and it was bad enough for her to be a stylized in hospital and what happened. She became very confused. Deal various and rather than spending just two three days in hospital For intravenous antibiotics shea had two weeks admission in hospital because have confusion was resolving and of course what happens told their doubts if they spend a lot of time in in bed completely condition muscles wasted away by them. Homeless admission is keen swimmer. Could not stand to go into a rehabilitation facility and it was good two months before she actually returned home and she was not back to normal cell sure required carrozza assistance required Family to help. And that's what frailities. It's their amalgamation. She did not know that. Race frail have family did not understand why mom sophie to while swimming the day before teaching her class next day hunterston agen and actually swearing which Merited before in. How confused state why this will happen into. It was very traumatic for the families. And that's what i said. I explained frame because of course as a result of a previous mini strokes should have reduced brain reserves and urinary infection. Eat infection there are toxins in the body which up poisoning the brain. Now in you. And i we might not have a major program but had strokes if so bring presents lou and should develop a confusion shays ninety two age related changes to the boogie moss and muscles. Do you know on net. After the age of fifty we use about one to two percent muscle mass every year. So just imagine when you come to ninety two remember. She's actually switch. It wasn't bad But you can't go against the nature so there you go mini strokes causing reduced brain reserves. Shays ninety two year old with reduction in her muscle mass spending two weeks hostile bat eligible kidney problem on the background and of course urinary tract infection led to deterioration that and have completed different individual at the

Dr Mucci Carrozza Swimming Kidney Disease Confusion Madison Shea Urinary Infection Sophie LOU Shays
Rewiring and Resiliency for Better Health with Nicole Waters

Outcomes Rocket

05:43 min | 2 weeks ago

Rewiring and Resiliency for Better Health with Nicole Waters

"Today i have the privilege of hosting nicole waters on the podcast. She is a natural health practitioner who utilizes integrative techniques for mind body spirit integration. She created her own stress management program utilizing mind body relaxation neuro harmonizing breath work and neuro linguistic programming to guide our clients to overcome stress patterns and rewire into powerful states of living. Nicole also provides consultations utilizing food medicine as well as emotional wellness consultations. She believes everyone has the opportunity to thrive in their life and through education and support. She has seen people turn their lives around. Three hundred. sixty degrees. Nicole has been in the area of wellness for over twenty years. It was her own struggles with stress anxiety and health imbalances that allowed her to search out and find new ways to live healthy and well. Nicole enjoys working with clients to teach self healing tools and techniques needed for clients to transform their lives into ones. They enjoy living. She has experienced in both conventional as well as medicine before starting her own business. She was in corporate america within the healthcare market for over twenty. Nine years she's a natural health practitioner Licensed professional coach a certified rakia professional and a registered yoga teacher. So she's got a lot to offer us today around the subject of wellness nicole. Such a privilege to have you with us today. Oh it's my privileges thank you for having me saul absolutely so before we get into the nuts and bolts and You know what you guys do. Tell us a little bit about you. And what exactly inspires your work in healthcare while i think you know when miraculous things come about for a for each of us when we know what our life's work is it kind of happens interesting way and sometimes we're like what are we doing here. What's how is this happening. But you know for me it was. You know my own health journey. That started some ways of looking at medicine differently health differently wellbeing what that means and just taking a kind of a different path. You know i was somebody who i was. Now it's been over. Twenty years was diagnosed with a health condition. Ulcer at an early age. That was when i was thirty and just some of the things that had come up about. That was just something that i wasn't willing to do and i just started to dig in look at some other ways of going about it and i think that this happens with different people you now. You're just like that doesn't seem to vibe too well. And what are some of the other routes to go and You know. I think that's really were coming into a time. As far as inspiration with healthcare so much has changed within healthcare and people are really on looking at getting to the root of what's going on and maybe not so much of going for a quick fix on one eight to really know why they're feeling the feelings. They are why their body is feeling such a way why they have these sort of annul. Host of imbalances are things that are showing up. Maybe not going that quick fix route anymore. Because it hasn't really you know maybe it's been more like a band aid instead of just really finding out what's going deeper and deeper and that's really. What kind of inspires me. I inspire people to help them understand a variety of things that i want struggled with for example like fighter flight or adrenaline. And cortisol know. We're in a situation where people are very highly stressed and i was one of those as well. I think i came out of the womb stressed. I was in that situation and we don't a lot of times go into You know when when you see Practitioner that they really talk about. They say oh eat better or exercise more or something like that but but why is that. Why is there this constant strive cycle that happens and then how do we really get out from underneath it so that was a piece of it and then also i'm really inspired by talking to people about their thoughts. You know how their thoughts play a tremendous role in one house. You know i'm sure you know this. You know. I mean it's anyone who's doing anything and business. The sometimes you just gotta be pumping yourself up right on on how to move through things and so thoughts play a big role. And how often is that. Maybe talked about you know in traditional healthcare and then getting back to the way our ancestors ate and the way that we used to eat and how food impacts our body and how it you know creates such a bigger connection to our inner world in ourselves and loving ourselves knots to give ourselves fuel instead of just picking up a box you know of something that's been fortified and then also i'd say like emotions. Emotions are really part. I think most people have learned in their life to not address the motions that it's a old conditioning. Like oh just kind of stuff it in there unless you've gone down a different paradigm but that's really getting broken into now. I mean i think we can look at our world and say that you know. It's very important to be a dresser emotions in a healthy way so that it's not you know going out in projecting on other people and so these are all like very important pieces of like a whole picture which i say well being being well which is more than just the body. It's about the whole person. And so i love that i love that. Were going into different areas within the whole you know the whole person emotion the mind the feelings a you know the body things like that so very very important to inspires.

Nicole Saul Ulcer America
Pregnant COVID-19 survivors appear to pass protective antibodies on to their babies

Science Facts & Fallacies

02:43 min | 2 weeks ago

Pregnant COVID-19 survivors appear to pass protective antibodies on to their babies

"Let's talk about this next story. As i said. I'm very encouraged by it. So pregnant women pass on antibodies to their children who were then apparently based on the early data immune to infection. So what's going on here. Well this says evidence builds that pregnant women pass on covert antibodies to newborns in. This was a new york times article. They really pass it onto the unborn because it says to newborns but they're passing it through the placenta which is a pre birth situation except for a few minutes but the basic idea is that you can apparently pass protective antibodies through the placenta For covid which is really great and this came from an article in Jama pediatrics. Which i think they really should just call jammies with. I mean better. The basic ideas that Women are transferring. Antibodies their fetuses and the earlier. That you encounter the antigen in this case. I guess they're talking about infection. The more antibody is transmitted to the fetus. And this has a lot of profound amply profound implications because what it says is is that vaccination on pregnant women may be very important and may have protective effects on the fetus. And the problem is that in all of the studies that this happened that were done the pfizer and the modern of studies. They didn't include pregnant women. In the cohort. A couple of women became pregnant while in the study and there are no adversities but There were no tests that were done on pregnant women and that remains something to be seen. So what would they learned from. Natural infection seems to be really good evidence that it'll be a good thing to vaccinate pregnant women. Yeah as i said very very encouraging news now one other thing that they mentioned in passing in the study was that none of the babies Became infected now. They can't one hundred percent rule out the that maybe an unborn child will get this. If the mothers sick but from the evidence we have so far it looks like mothers get infected and they can't pass it to their children. Is that correct that right. That's right it doesn't it doesn't look like there is viral transmission through the placenta but it appears as though the antibody can do it. So it's a. It's a very selective filter placentas are weird and That's a looks like that's the case

Newborns New York Times Pfizer
A Conversation With Suki with Punit Singh Soni, CEO

The Voice of Healthcare

04:21 min | 3 weeks ago

A Conversation With Suki with Punit Singh Soni, CEO

"We are joined by a special guest today from a company that's making some waves and creating some ripple effect while they're doing it. They're ceo puneet joins us today. Caen introduce yourself. Tell us about sukey dot ai and star with your vision and how you gotta go in plus madeline reid. Thank you for having me on the on the show. It's a pleasure to be here talking about this journey. I start by giving you a very quick background on on where i come from. I have all of three years of experience in healthcare so many of the folks who are interested in healthcare listening and probably have way more to teach me tonight. I have to say A my background is google. Most of it is from google. I was Before enterprise software startup it some venture investing Which i strongly recommend you not do if you want to actually build a company and be an operator and I in google in the search team then ended up actually running the mobile apps group for little bit Welcome games Social which you know has a whole different story it probably a good subject for different podcast And then we tried. Motorola was actually astern software. Their software product management. So did that for a little bit built a bunch of very interesting phones. One of them was the. I always on wise form. You could say okay moto x. navigate me to starbucks and this was before alexa. And siri and google assistant other things. Were even a a Even idea and so I kinda saw the evolution of boys and You know the whole voice tack especially when it comes to listening and ambient all of these things from the days when it was very early on And i ended up actually going to. India was the chief product officer flip guard which is india's largest e-commerce company. Came back and thought it would be very interesting to see how they apply some of this voice technology in alternative another spaces beyond dispute consumer. I had this thesis That the largest most interesting influential tech of emory ever is going to be in healthcare. Now i don't know if it's going to be now or five years from now or a decade from now but but i do believe that there is a very interesting company especially with the evolution of machine learning and artificial intelligence. And that's going to happen in in this space. And so that was the genesis in some ways of expirations in healthcare Obviously happy to tell you a lot more about you know how we chose this idea but that was basically how we got into a into the space and ended up putting together sukey. Yes ended up actually running Software product management at motorola and built a bunch of different phones. As part of it one phone that was probably very much well received in the market was moto x. Which was d. I always on phone. You could say things. Like ok moto x. Navigate we do starbucks and it will do that. This was before alexa and siri and the assistant from google even ideas. And so i've kind of seen a ambient passive listening and conversational voice from the days when it was barely technology and not really even a product and so ended up finishing motorola going to india. Where i was running a product for india's largest e-commerce company came back After we sold it to walmart. And i had this idea that there must be a way to use this trend that we're seeing machine learning and boys and why and apply that to healthcare

Ceo Puneet Joins Madeline Reid Google Caen Motorola Siri India Starbucks Alexa Walmart
Homeless seniors get COVID-19 vaccine in Los Angeles

Tim Conway Jr.

00:29 sec | 2 weeks ago

Homeless seniors get COVID-19 vaccine in Los Angeles

"Have been using Papa vaccine clinics to get shots to homeless people on Skid Row L. A mission operations director Kimberly Natalia 71 people got their first shot of the Madonna vaccine. What we know is that Not on Lee with the covert vast scene. There's underlying issues in this community. We definitely need to focus in on the health and wellness. She says. Outreach teams went 10 to tent and shelter to shelter to tell people over 65. They were eligible for the shot. The

Kimberly Natalia LEE
Black coffee can be good for your heart, studies show

10 10 WINS 24 Hour News

00:31 sec | 3 weeks ago

Black coffee can be good for your heart, studies show

"Heard any studies about coffee being bad for your heart disregard those today's study says. Black coffee can be good for your heart terms and conditions apply, the American Heart Association says. Daily drinking of one or more cups of plain caffeinated coffee without sugar or dairy was associated with a long term reduced risk of heart failure. But the same was not true of decaffeinated coffee, which in fact was instead found to contribute to an increased risk of heart failure. This study. If you'd like to peruse it is in the ahh journal circulation heart failure.

American Heart Association Heart Failure
A psychologist explains the limits of human compassion

Short Wave

08:09 min | 3 weeks ago

A psychologist explains the limits of human compassion

"Psychologist. Paul slavic says to understand psychic numbing. We have to look at how humans make decisions in analyze risk. it's not just this. Straightforward cost benefit analysis in what social scientists have have learned through observation and experiment is that We've got another way of analyzing risk and that's through our gut feelings which is a very sophisticated way that our brain can process risk information in fraction of a second week in size up a situation decide whether to run away or to approach it or whatever. You know that the problem is that our feelings are. They aren't good at quantitative assessment and our feelings are energized by a single individual at risk. What we call a singularity effect and individualize very important but the problem is that if there are two people at risk that does not feel twice as concerning as if there are one it may be a bit more concerned but not twice as much as the numbers increase. We've become even more and more insensitive. So if i tell you that they're eighty seven people endangered in some situation. You'll be concerned then. I said oh wait a minute. I made a mistake. There are eight people whom you won't feel any different. Feeling system is just not able to differentiate in a different feeling for eight eighty seven right and then as we studied this we found. It's even even worse than than this insensitivity as the numbers increase sometimes we begin to lose sensitivity. Not just that. We don't differentiate between one large number and another we care less. The numbers are so large. They're just you know they don't convey any feeling and we have a a phrase for what we've observed In this respect and that is the moore who died the less we care. Yeah so i mean it kind of sounds like you know what you're saying in situations like this pandemic that our feelings may actually kind of deceive us. In a way with with risk taking absolutely our feelings deceive us and they deceive us not only with regard to the pandemic. They deceive us with regard to the seriousness of genocide and mass atrocities. That have been taking place around the world continuously since the end of world war two and the holocaust when we vowed never again. Would we allow this to happen. And well it happens over and over again And we we often turn our backs to their. These are just statistics of faraway people. And we they don't convey the emotion that's necessary to motivate us to action so there's a lot of ways in which our feelings deceive us. Our feelings deceive us with regard to thinking about climate change. You know where we've got a major catastrophic changes in all sorts of climate affects. There's going to be hugely influential. And we're not doing what we should to mitigate or prevent this from happening right right. Okay paul so is there any way around this you know. What can we do as individuals t get beyond the psychic numbing. Well the the first step is awareness you know. And that's what i i. I see as the first implication of are working to try to get these findings known so people are sensitive and aware of these and then the second step is okay. Now what what can i do about it. And the There are a number of things i as individuals we need to slow down in our thinking. We're we're giving information like this. We need to pause not just go to a quick intuitive feeling about it but to think a little bit more carefully about what the reality is beneath the surface of these numbers. We need to pay attention to stories of individuals who are representative of the larger problem and people in the in the media needs to be giving us information about individuals and stories Not just the statistics are important. They should be there but we also need stories about individual lives that are impacted by what we're concerned about. Yeah yeah you know as a as a science communicator and a journalist this makes me think about some of the research that you've done around this right like how reporting statistics about mass casualties. Don't always move people to act. I'm thinking about your research on the infamous photograph of ellen. Kurdi the child who drowned fleeing syria. Tell me about that work. So the syrian war began in two thousand eleven. The government of serious started to attack people who are protesting for various reasons against the government and it got quite violent and by two thousand and fifteen Some two hundred and fifty thousand people have died in the syrian war. Many of them civilians and there was little interest in that and we could. We could assess the level of interest by looking for example under google searches for syria or refugees. And you see it was flat and near near zero for four years and then that changed overnight when the picture of the boy and the beach went viral around the world and you. Some people started searching for syria for refugees and so forth. We we found an even more important indicator of how this one photograph woke people up to something that they should have been alert to because of two hundred and fifty thousand deaths and millions of refugees that were spawned by the conflict there and we found that the donations for example to the red cross in sweden Were greatly Impacted by that picture and so one might ask. Why does it take a photograph to motivate us. Why isn't thousands of deaths enough and again illustration of the fact of the psychic numbing. You know that these are just numbers and we relate much more strongly to stories and images very powerful example of that. We also found that it didn't last forever. I mean over the next month the that donations started to decrease again and the searches. Google started to decrease. And what i think that showed. Is that when you have very important events like this happening. That a dramatic incident or event or photograph can wake us up and it gives us a window of opportunity that's That's very important and enduring that window. That's when things need to happen both at the individual level or also at the societal level were were officials now they have the opportunity to do something that makes a difference. We're we're seeing another moment like that in the aftermath of the The attack on the capital when suddenly were awake to right wing extremism which has been around for the. It's not that his new. And i think we've been sort of a complacent we've been very complacent about same thing with racial injustice and the black lives matter movement of of the summer in certain events were dramatic and they cut through the complacency that existed so all of these events gives us a window of opportunity when we were ready to act and s when things can happen share. You know like you said part of this is realizing when action needs to be taken an taking that action and one thing that you've talked about. Is that people have to get past this. Full sense of efficacy. Right that idea that when a problem is this big what you do. Does it really matter but you know actually does you know especially in this pandemic yes. We have to recognize the fact that even partial solutions to a problem can save whole lives as we even. If you can't do it all we should be demotivated from doing what we can do.

Paul Slavic Syria Kurdi Moore Paul Ellen Google Red Cross Sweden Government
South Africa suspends vaccinations as worries grow over AstraZeneca shot

NBC Nightly News

01:32 min | 3 weeks ago

South Africa suspends vaccinations as worries grow over AstraZeneca shot

"There's new concern about the south. African will only a few have been confirmed here. South africa suspended. Its rollout of a vaccine that only offers minimal protection within. Here's cure simmons in the race to get shots in the arms of americans a warning from south africa which just froze its rollout investors a vaccine. It's an example of how things can go very wrong very quickly of two thousand people that found astra zeneca much less effective against the south african variance offering minimal protection against even mild disease. Astor's annika isn't yet authorized in america. The us has ordered. Three hundred million doses. The other vaccines are still effective against the variance for now but as corona virus encounters people with antibodies to survive by figuring out a way to evade the immune response and every new infection is a chance for it to mutate more so if the virus rages in areas where people already have antibodies. The risk of mutation goes op. Research program is not focused on these variants asking the question. Can we develop vaccines specific. Those areas very quickly in the uk health workers going door to door and effort to test track and control the south african variant. Tonight's astor's is pushing back saying based on it studies. It believes its vaccine will still protect against severe

Astra Zeneca Mild Disease Simmons South Africa Annika Astor United States UK
Next Generation Patient Support, Fostering Community with Jeff Wandzura

Outcomes Rocket

05:30 min | 3 weeks ago

Next Generation Patient Support, Fostering Community with Jeff Wandzura

"Welcome back to the outcomes. Rocket saul marquez. Here today. I have the privilege of hosting mr jeff. One zero. he is the chief. Growth officer accusatio. Jeff is a pharmacist by trade digital health geek at heart and an angel investor in healthcare executive after two successful exits with his previous digital health ventures and a tenure as an executive at one of the largest specialty pharmacy infusion clinic an patients program networks he currently serves as the chief growth officer of curation networks excited to to host them today. He's gonna talk about how they're providing next generation patient support on their platform. Jeff such a pleasure to have you here for saw. Thanks for missile. I've been listened to your podcast for some time now to be included with some of the pioneers of the digital healthcare space. Thank you man. I appreciate that and you guys are doing some some fascinating work so before we dive into ratio and and how you guys are making a difference. Tell us a little bit more about you and and your healthcare journey what what keeps you in the game is. I was exposed to the healthcare space fairly early on in my journey has as we want a family pharmacy over the years and we're acutely time in pharmacy school at came to realize patient outcomes are less defined but yet saudi contraptions by healthcare professionals and more so by small ledges that drive incremental behavior change on a day-to-day basis so throughout that time again been involved in a number of digital health ventures kind of seen the platform and i guess the ecosystem evolve over time and announced Putting the rubber to the road and seeing how we can further catalyze this digital transformation within the space at is exciting and the opportunity to to provide value has never been greater. You know were becoming more consumer focus in healthcare at an. It's an exciting time as you. And i were connecting here before the podcast jobs talked to us a little bit about what you guys are up to jerry show and and how xactly you're adding value to the healthcare ecosystem yet. No it's a good question so maybe to kick things off one of the fundamental problems facing digital health platforms and healthcare more. Broadly is a consistent. Engagement and long taylor. Attention of the users. So those users representing patients family members caregivers to a number of different user roles and and other industries have leveraged social impure support in a very compelling way which has a high engagement and retention factor. So really the question is how can we responsibly. Blend these two in a way that makes sense for the healthcare setting and create a dedicated platform in which we can start to listeners regulatory in privacy compliant way and this is what's really inhibited. The growth and the trajectory of peer to peer support in these settings. So how can we start to again. Take into account the intricacies of the healthcare environment and drive that different types of a behavioral nudges along the way because when you saw that engagement retention challenge he had the best opportunity to drive behavior in positive behavior change on a day to day basis. So what we do at career show is create regulatory in privacy compliant pure pure networks and we'd go to mark with our customers so this represents the life sciences space to providers to payers to government agencies on how they can create customized brand in configure -able platforms that represent the brand and they're offering again to provide peer to peer support in a way that makes sense of the healthcare ecosystem. Really interesting. because i mean as we sit today it things are fragmented. There's you know been kind of like a gravitation toward facebook and facebook communities. Obviously all the issues with facebook that that we know of Proved that that's not really maybe not the best place to do this type of work. So so you guys are offering something with high security and opportunity to to collaborate securely so talk to us a little bit about how. You're making a difference. Yeah as a question so what we do and again just to go. Pats the pricing regulatory concerns. And you really just unpack a little bit. as to why that's been inhibitor. A blocker on for the full utilization from health rico system. And as you mentioned these. These groups are organically formed proliferating within these traditional social context. But all the stakeholders saying i have an inability connect with my patients and support them in a different way. Just give him the channel that we're drafting so when it comes to how we're making an impact again as it has three core levers that we're leveraging so one is matching pure appears in a very intelligent and analytic way so this is bringing in demographic clinical in psychographic information to say helping patients in the community who are going through similar challenges as you and our earth thesis. The more points of intersection overlap. You have an individual the more likely you are to form a long lasting relationship in bond that drives those daily disease management behaviors nonni habit hyg that higher attention factor with the peer to peer support. That's offered this is allowing us again to personalize the content and it sounds like a bit of a misnomer oxymoron but masked personalization. So how can you start. Meet patients where they are and we haven't hygiene factors the pure support the opens up new lever new opportunity to interact whether it be content programming interventions and as well as coming full circle on the types of health trackers that are applicable to that particular community disease state or the particular molecule or therapy that we're helping to support as a digital companion type of app so what patients are looking for is that anonymity tied to the condition so obviously personal health information comes with a number of complexities on how to maintain again full control over in having that type of buying from the patient community as well as from the pharmaceutical in life sciences sector doesn't okay does a number of hoops to jump through from pharmacovigilance or an adverse event reporting

Saul Marquez Mr Jeff Curation Networks Jeff Facebook Jerry Taylor
'New chance at life': Man gets face and hands in rare transplant surgery

10 10 WINS 24 Hour News

01:11 min | 3 weeks ago

'New chance at life': Man gets face and hands in rare transplant surgery

"Story of survival in the will to continue. A New Jersey man is recovering after receiving a rare face and hands transplant. It was July of 2018 when Jodie Mayer was severely burned in a car crash. He was coming home from work overnight on Route 22 in hillside after he fell asleep at the wheel. This was an overwhelming recovery in his chance to live was not good, but after 20 surgeries Started moving forward to the point where Dr Syria and why you lend Goan consider him for the first ever double hand and face transplant. They went forward last summer, a team of 140 doctors and other medical staff. Surgery lasting 24 hours to Mayo 22 years old has gone from using his feet to put on a socks to thinking about life in the future Now Even though I'm still recovering and gaining back my shrink. I've been able tol back too many activities I love such as Playing with my dog and show happy with the results by transplant. An incredible will to live combined with an incredible medical breakthrough. Glenn

Jodie Mayer Dr Syria New Jersey Mayo Glenn
Dr. Bob Berenson Discusses Healthcare's Pricing Problem and Potential Remedies (February 18th)

The Healthcare Policy Podcast

04:22 min | Last week

Dr. Bob Berenson Discusses Healthcare's Pricing Problem and Potential Remedies (February 18th)

"This series is part of an ongoing to your effort by more than a dozen hospital. Ceos from the round the us urge congress to take up significant healthcare policy reform legislation largely by calling for the creation of a national commission on health care reform. It is our intent that these policy reforms discuss during these interviews demonstrate our desire for substantive national reform moreover that these interviews help to further inform congressional members and committee staff as they worked to craft legislation to improve healthcare delivery and financing during the next congress our motivation straightforward while before the onset of the covid nineteen pandemic. We were adamant that race age and or economic circumstances should not be defined as pre existing conditions. Nor do we accept the premise. That americans should be resigned to live. Shorter lives in poor health. We invite you to listen to or to read the transcripts of all eight interviews. If you'd like to provide comment you can do so via the contact information at the conclusion of these interviews. Welcome to the second interview in the series of eight concerning federal healthcare policy reform again. I'm david cosso. Any discussion of health care. Reform must include examining healthcare pricing. What drives healthcare spending health care prices within discussed the topic is urban institute. Fellow and former three med pack. Michener dr robert berenson dr berenson. Welcome a pleasure to be here david. Dr berenson's complete by is posted with this interviews. Audio file and transcript briefly on background as has been well documented. Us healthcare prices. Moreover in commercial markets have for decades been significantly higher than in comparative countries. In addition us healthcare market suffer y price heterogeneity or significant price discrepancy till us healthcare spending per capita spending and spending growth are in multiples of other rich countries. Despite the fact among others america's do not consume more health care services for example in two thousand nineteen. The spent approximately two and a half times. The per capita always d. average while there's been and will remain debate regarding how to best calculate prices or interpret price signals there is consensus use. Healthcare suffers a significant pricing. Problem as you've reiner and his colleagues concluded in a widely reference two thousand and three article it is quote unquote. The prices stupid among numerous other problems. High priced healthcare as dr wolff discussed in the preceding interview explains are significant health disadvantaged again americans suffer or bear high disease burden resulting in our living shorter lives. So that bob. As intro or background as i just noted. Us healthier has a price problem. I didn't explain what accounts for this. So that's my first question. What accounts for our pricing problem. Well i want to just say that While researchers and policy once understand that we have a pricing problem and particularly fra for hospitals to a lesser extent for other health for health professionals Public policy hasn't in any significant way address the problem. There's a lot of discussion about pharmaceutical prices and legislation to address it pharmaceuticals represent about ten percent of the total health. Bill hospitals represent forty five percent of the total health bill and with health professionals together over sixty percent of the health bill. And and so the first thing to just understand is deserves policy action not just documentation of what the problem is. And why do we have. Such a problem is because we have at this point broken markets At one time insurers and hospitals negotiated fairly equally To arrive at a price for paying for the hospital services but over

National Commission On Health David Cosso Michener Dr Robert Berenson Dr Berenson Congress United States Dr Wolff Reiner David BOB
Bringing Hope for Heart Failure with CCM Therapy with Simos Kedikoglou, CEO of Impulse Dynamics

Outcomes Rocket

05:56 min | 7 hrs ago

Bringing Hope for Heart Failure with CCM Therapy with Simos Kedikoglou, CEO of Impulse Dynamics

"Here. Today i have the privilege of hosting the outstanding seamus Glue he is the chief executive officer at impulse dynamics he became the ceo and twenty thirteen and working with the board and management team. He's responsible for defining and executing their corporate strategy during his tenure. The company has obtained approvals and launch the optimize or device globally with sales and clinical work in the us. Europe china japan australia. Brazil and india cmos was previously a corporate vice president of business development for boston scientific with responsibility for acquisitions licensing and distribution deals in the us and really globally cmos was an associate partner with mckinsey and company as well prior to that in the us advising clients in healthcare mergers and acquisitions. He holds his medical degree from the university of athens greece and his nba with distinction from harvard. Business school and a master of public health from harvard as well and on top of that all a cfo carter holder so Just an impressive leader in healthcare. And today he's gonna be talking to us about the work that he and his team are doing at impulse dynamics Cmos such a pleasure to have you here today. Thank you very much sean. It's great to be here. Thank you and so you know you are In from the uk and a love that you know the work you guys are doing from there is translatable. You know the nih and there's a lot of learning that we could do in the us health system and overall just In general across the globe. But you know before we dive into the work that you're doing at impulse than amex tell us a little bit about you and what inspires your work in. Healthcare against cat is eight phil to work in because you cannot do well for our employees for shareholders for the people of the impulse team by doing good for the patients getting the best thing for the patient galloping damage what inspires every day. We have quite a lot of Gauged on our website where patients themselves are talking with them or they spontaneously talked about how we have been able to change. That lives in. This is very motivating. That he's Everybody wants to have professional fulfillment but seeing this patient at being able to play with the grandchildren go shopping. Were their partner win. The davis likud then is something we find very motivating. Yeah for sure. And it's just a an amazing time to be able to do it. We do in health care and so talk to us about your company and how exactly you guys are adding value to the healthcare ecosystem. Yes they now makes has developed. Ccm technology which is for patients in with caught fire. We had intervention had feigned grew. Having implantable device is for those patients that have exhausted financial statement by that not yet sick enough to qualify for a heart transplant or a full replacement off the palm of device. This is a lot of patience. Six or seven million patients globally. Roughly one one and a half in the united states and these the hatfield epidemic is growing fast the american heart estimates that is growing aspect four percent but he had a number of grocery four percent but he had are very valid our patients they can walk at most one flight of stairs. They can walk a thousand feet and then they stopped short of breath. They edit three from deep official daily life. They cannot go to church or the synagogue. They cannot go shopping. They cannot spend time with family went. We do is to try to help them to leave the latch that we have developed so extensive clinical trials and genetic development a device that makes them be to enjoy life again and we have immortal that the hope is here and i think this is how we think we're adding value now. We have also shown on many occasions that will reduce there okay. The frequency of their visits to the hospital the space course very much and so we save on resources. We have a detached of technology allows them to go for long without the pledge. Michelle we do. Take into account the economics. We actually value to the system but we also create value to the patients themselves by to join that lives. Now that's fantastic and simos so the so the work you guys doing. Obviously you guys have brought the technology to the us really globally. You're based in europe. But sounds like you're making a big difference here would you say makes. Ccm therapy just different or unique and what it's able to provide to patients show the communist based out of the united states and the technology brain development has been done in the united states. You jesse is unique is that we are helping people through a completely different way before People getting mushroom shorter treatment. Obviously everybody will exist for excitement before they concede that any device but instead of moving to the very invasive transplants ridiculous divides thinks that costs hundreds of thousands of dollars Ways for the patient we have stimulate or show. Take very unique concept we had. We had to develop survey stake in more than twenty years of research and more than obligations that basically trains the myocardium eight single it like when you go to the treadmill and you Start getting exercise overtime over the three months winter. You start feeling better. It's a very similar without device to very simple implant. It's now the fifth generation of the infants advantage simply for forty five minutes at basis typically. Go back out the same day at home and they don't even need anesthesia for implantation. Just like the dacian. This feeling better. They see the effect building up and This is what they consider. Unique is not only that it's a completely different not replacing the

Seamus Glue Impulse Dynamics United States University Of Athens Harvard Mckinsey NIH Brazil NBA Greece Boston Sean Japan Europe Australia India China Davis UK