Shiv Gaglani

🎥 Our newest Beneath the Surface with Joel M Gelfand MD MSCE is now live! In this edition Dr. Gelfand gets in deep with Roxana Daneshjou about AI 🤖 and it's role in dermatology practice, as well as what's on the horizon. Key Takeaways 👉 AI is here to stay and needs to be harnessed safely and appropriately for the medical community. 👉 Physicians can be on the forefront of how to best integrate AI into practice. Hansa Bhargava MD Healio Penn Medicine, University of Pennsylvania Health System University of Pennsylvania Perelman School of Medicine Stanford University School of Medicine

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AI meets Rheumatology: ChatGPT and patient response optimization Large language models like ChatGPT, trained on vast text data, are revolutionizing healthcare by understanding and generating human-like language.

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To get the best background for reading of this extraordinary contribution by RUSS GONNERING for Brownstone Institute, I suggest to read before "Divided Legacy" (Vols. I-IV) by Dr. Harris Coulter (1932-2009). + Divided Legacy: Volume I: The Patterns Emerge: Hippocrates to Paracelsus, + Divided Legacy: Volume II: Progress and Regress: J.B. Van Helmont to Claude Bernard + Divided Legacy, Volume III: The Conflict Between Homeopathy and the American Medical Association: Science and Ethics in American Medicine 1800 - 1910  + Divided Legacy, Volume IV: A History of the Schism in Medical Thought Quote: "Divided Legacy (Vols. I-IV) is a history of Western medical philosophy from the time of Hippocrates to the twentieth century, treating it as a unified system of thought rather than a series of fortuitous discoveries. Dr. Coulter interprets the development of medical ideas as the product of a conflict between two opposed systems of thought, Empiricism and Rationalism."

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New Prof G Conversations: Marty Makary M.D., M.P.H., renowned surgeon and professor at Johns Hopkins, public health expert, and NYT bestselling author, joins me to discuss his latest book, “Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health.” We go over the issue of overmedication, weight loss drugs, and the food industrial complex. Listen: https://lnkd.in/eqW9rur7

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Here's what's happening in the Kidneyverse - your monthly dose of kidney innovation news, funding, policy, and reasons for optimism.💫👇🏼 Full update goes out next week: 📰 https://lnkd.in/egGsNwqs -- TOPICS: 🟪 Discovery & Innovation 🟦 Market Insight 🟨 Policy & Regulation 🟥 Community Voices -- STORIES: 🟪 The team at 34 Lives just rescued their first human kidney that had been deemed not usable for transplant! The company is on a mission to decrease the number of kidneys in the US that are recovered with the intent to transplant but subsequently not used. (h/t Kevin Longino) 🟪 Toku Eyes just received FDA Breakthrough Device designation for its MyKidneyAI product that uses #AI to analyze retinal images from routine eye exams to detect CKD risk in people with diabetes. (h/t Ehsan Vaghefi) 🟦 Outset Medical, Inc. announced it has received FDA 510(k) clearance of TabloCart™ with prefiltration! (h/t Fierce Healthcare) 🟨 CMS announced the proposed Increasing Organ Transplant Access Model earlier this week. The mandatory model is designed to support better outcomes for people living with kidney disease by incentivizing an increased number of kidney transplants. (h/t SMIT PATEL💊📲) 🟨 A newly introduced bill would provide funding for staff assistance and more training options for home dialysis. The legislation proposes covering the cost of in-home health care support staff for up to 90 days with an add-on payment to the dialysis payment bundle. (h/t Kerstin Leuther, PhD) 🟨 The Apple Watch AFib feature just became the first #digitalhealth product to receive FDA approval under the MDDT program. It will be used as a tool to assess atrial fibrillation burden estimates within clinical studies. (h/t Jaydeo Kinikar) 🟥 On May 6, 2024, the Kidney Health Initiative convened a 50+ person vascular access workshop to identify opportunities and challenges for much-needed innovations with POVs shared b/n care partners, patients, and clinical care teams with entrepreneurs, companies, investors, NIDDK, and FDA. (h/t Mark David Lim, Ph.D. PMP) 🟥 For those following the latest VBC and CKCC news, a comment thread on Nishant Jalandhara's latest post is an insightful collection of diverse POVs on what's happening in the space. It includes both high-level guiding wisdom and in-the-weeds candor on what it takes to participate in these models. (Much) more to come on this front via Signals From [Space]. 🟥 An article in MedCity News talks about the polarizing rhetoric around digital health these days. Authors Alyssa Jaffee and Mona Siddiqui, MD, MPH, MSE share thoughts on the early innings for #healthtech with examples like NOCD, Jasper Health, GroundGame.Health, Waymark, and Author Health. *** Each month I send out a recap of dozens of headlines like these, a few closer looks, and visuals of the month. Which resonated with you? Let us know in the comments below (and say hi next week at NKF👋🏼). 👉🏼 https://lnkd.in/egGsNwqs

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As I’ve said before, tuition free medical school does NOT change what physicians do as a career and is NOT an effective way to enhance primary care. Kudos to Bloomberg for putting income restrictions on his historic gift to The Johns Hopkins University covering tuition for students by restricting the tuition assistance to families who earn less than $300K/year. But when it comes to incentivizing med school students to go into under-staffed specialties like primary care, we have learned that free tuition is not the solution. What's more, at this point, it’s not clear that free med school tuition increases more minorities or other under-represented groups going into medicine. The US needs more doctors, especially from certain backgrounds and in certain specialties. Free tuition is great, but it needs to be more specifically targeted with strings attached. #healthcareonlinkedin #medicalschool #medicalschooltuition #primarycare #physicianshortage #tuitionfree

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Today, the US Senate Committee on Health, Education, and Labor Pensions (HELP), led by Chairman Sen. Bernie Sanders (I, Vermont) and Ranking Member Sen. Bill Cassidy, MD (R, Louisiana), held discussions on tackling the growing issue of medical debt in the United States. 💰 The Scale of Medical Debt: High care costs and inadequate insurance coverage have burdened millions with crippling medical debt, the leading cause of bankruptcy, amounting to $220 billion in total debt. 🏥 Potential Solutions Discussed: Universal Health Care Coverage: Some witnesses suggested implementing Medicare for All. In Wayne County, MI, a similar program uses $7 million to eliminate up to $700 million in medical debt. Strengthening Consumer Protections: This includes improving price transparency, reforming programs like 340B, and enhancing patient education about insurance coverage. Promoting Competition: Witness Ge Bai, PhD, emphasized the need for policies promoting competition, rather than consolidating market power among large health care systems. Expanding Medicaid Coverage: Especially for children, to prevent the accumulation of medical debt. Removing Medical Debt from Credit Reports: To prevent long-term financial harm. Capping Interest Rates on Medical Debt: To stop excessive accumulation over time. 📖 Read more about the Senate HELP Committee's discussion on medical debt solutions on AJMC - The American Journal of Managed Care! #MedicalDebt #HealthcareReform #USHealthcare #SenateHELPCommittee #UniversalHealthcare #HealthEquity #PolicyReform

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Fair argument in favor of AI-enabled diagnosis. World Health Organization has even more alarming stats: Nearly 7 million children die due to misdiagnosis, even when their diseases are preventable. But the question remains: Would AI-enabled diagnosis outperform human diagnosis? This is yet to be seen in practice. #AI #misdiagnosis #freelancemedicalwriter #medicalwriting #healthcare

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"Curiosity is the gateway to empathy. If we are curious about others, then we can form empathy, accompany them on their journey through their stories, and hopefully then offer better healthcare." Thank YOU Dr. Neal Baer, Co-Director of Harvard University's Master of Science in Media, Medicine & Health Program, for providing YOUR #EdUp insights!

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China is grappling with a new virus outbreak, the Human Metapneumovirus (HMPV), five years after the COVID-19 crisis. The virus, causing flu-like and COVID-like symptoms, is spreading rapidly, overwhelming hospitals and healthcare systems. Alongside HMPV, multiple viruses, including Influenza A and Mycoplasma pneumoniae, are circulating, putting additional strain on children's hospitals and health services. #China #India #covid #pandemic #health #safety

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A study meant to serve as a tie-breaker between two major trials of a heart clip made by Abbott may end up stimulating more debate among cardiologists. Results of the RESHAPE-HF 2 trial, presented at the European Society of Cardiology meeting and published in the New England Journal of Medicine on Saturday, showed that the clip improved health status and lowered hospitalizations due to heart failure, but did not reduce the number of deaths. The device is meant to treat patients with mitral regurgitation, a condition where blood leaks backward into the left heart chamber. It can cause uncomfortable symptoms like fatigue and in severe cases, can lead to heart failure. Abbott’s device, called the MitraClip, works by clipping the mitral valve’s leaflets together to prevent blood leakage. Cardiologists are split on whether the results of the trial recommend broader use of the device. Some were heartened by the improvement in health status and reduction in hospitalizations, others were concerned by the lack of a mortality benefit. Read more here: https://lnkd.in/eXFDYCc4

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Almost five years since the onset of the pandemic, we’re still navigating its lasting shadow: long COVID. As life-altering symptoms persist for millions, our healthcare system continues to fall short in providing the solutions so desperately needed. To truly help these patients reclaim their lives, we have to rethink our approach. Rather than symptom relief alone, we need to prioritize robust clinical studies that investigate how existing medications can influence immune responses and address the underlying causes of long COVID. It's past time to align our efforts with the realities of those still suffering. NPR #healthcareonlinkedin #longcovid #covid19

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From the New York Society of Cosmetic Scientists, an interesting read entitled, “Aging Is Rusting. How Do We Address Rusting in Skin?” @ https://lnkd.in/egRkcjcv Here’s a snippet… Here’s a hot flash you may not have heard before. You’re not aging. You’re rusting. As we get older, we start to face a complexion that looks duller, dingy, cloudier, less luminous. And more unevenly discolored. The reason? Iron is the most abundant transition metal in human body and the best-known driving force behind oxygen free radical formation. Yes, the irony of iron is that iron is the element essential for building strong structures and machines but can also be the cause of their deterioration through rust. Oxidative damage a.k.a. – rusting is due to two distinct but surprisingly related functions: the build-up of iron in the skin as we get older coupled with a slowing of the skin’s natural exfoliation process. These result in iron staying in the skin for 56 days instead of 28 days as skin turnover time. When body iron storage increases, skin too is exposed to higher levels of iron, which in turn can cause oxidative damage as the excess iron reacts with UVA. The result: skin aging and photoaging is accelerated. For example, ferritin is the iron storage protein for excess iron with a capacity of binding up to 4,500 atoms of iron per ferritin. It consists of heavy (H) and light (L) chain subunits. It was shown that ferritin can be immediately degraded by UVA doses of 100 and 250 kJ/m2, releasing large amounts of iron for producing oxygen free radicals. In a cell culture model, increased iron and UVA were found to significantly increase an enzyme called collagenase-1. Increased activity of collagenase-1 increases collagen degradation, causing wrinkles initially and skin thinning when we get older. Like rust on metal, higher levels of iron when exposed to UV radiation, blue light, air pollutants and irritants from other sources results in increased oxidative damage in skin. If you’ve ever seen a rusty bicycle, you know the corrosive damage the environment has on metal. Oxidative stress begets skin-aging yellowing, dullness, dark spots and discolorations as well as wrinkles, loss of elasticity and other signs of aging. Until now, antioxidants have been the only defense to attempt to neutralize oxidants after they are formed. Chelation can be used to sequester “free” iron, but it cannot compete to take away from iron in ferritin. The antioxidant and chelation approaches are retroactive and often too late. They can only battle the symptoms, but they do not treat the underlying cause. A novel class of actives termed De-ironizing Inducers Technology (DII®) can do what no free-radical neutralizing antioxidant or chelation can do. Pearl Powder, a soft form of calcium carbonate, absorbs the released iron ions by exchanging them with calcium ions and, thus, removes skin-rusting iron deposits.

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Interesting study published in The Lancet, Regional Health The notion of providing data upon “reasonable request” has, paradoxically, turned into an inside joke and a meme in the scientific community, which highlights the gap between policy and practice. While the pretext often cited for this guarded approach is the protection of sensitive patient information—a concern universally respected—the reality frequently belies this justification. In many cases, accessing anonymized datasets becomes an insurmountable challenge even with no perceivable risk to patient privacy. In 2022, researchers in Croatia contacted 1792 authors to gauge whether their data were truly available upon request; 93% of authors ignored the email or denied sharing. Individual scientists often face mixed incentives for data sharing, influenced by research domain, methods, and resources, highlighting the need for more supportive infrastructures and clear benefits to encourage open science practices.' https://lnkd.in/en8tXTDx

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