Episodios

  • Episode 183: Michael Schmidt discusses the challenges of building a space-faring civilization

    Episode 183: Michael Schmidt discusses the challenges of building a space-faring civilization
    Jun 24 2025
    Today we have the second installment of our interview with Dr. Michael A. Schmidt, the founder, CEO, and Chief Scientific Officer of Sovaris Aerospace, a company focused on assessments and solutions applied to humans in space and extreme environments on Earth. In today’s interview, we talk to Michael about NASA’s plans to send humans to Mars and build permanent colonies on the Moon and Mars. We also talk to Michael about his recent book, “Building a Space-Faring Civilization,” which addresses the challenges of civilian spaceflight and the construction of space settlements. In part one of our interview, Episode 182, we talked with Michael about his pioneering work in the field of precision medicine and how he has used it to improve the cognitive and physical performance of astronauts as well as NBA, NFL players and Special Operations forces. In addition to his work with Sovaris, Michael also is a professor of aerospace medicine at the University of Central Florida College of Medicine, one of the few programs in the U.S. that offers a medical residency in aerospace medicine. Show notes: [00:03:00] Dawn picks up our interview from where we left off in part one, discussing the Human Research Program for Civilian Spaceflight. She goes on to mention that Chris Mason at Cornell University has a biobank of 1,500 samples across 22 astronauts and seven missions, and that these samples will lead to deeper insights on the effects of spaceflight on humans. Dawn switches gears to ask Michael about the cognitive and physical challenges of spaceflight over long duration missions. [00:13:03] Following up on the cognitive challenges of long duration spaceflight, Ken mentions that the hippocampus, the primary memory center of the brain, has a relatively low radiation threshold compared to other tissues in the brain. Ken asks Michael to touch on the vulnerability of specialized brain tissues to radiation, particularly in the context of a long duration spaceflight to Mars. [00:21:53] Ken mentions that it is understood that the APOE4/4 genotype is associated with impaired cognitive performance under certain circumstances and an elevated risk of dementia. While it is currently unknown whether APOE4/4 has any correlation of increased risk associated with cognitive impact resultant from environmental exposure due to spaceflight, Ken highlights the concern with sending APOE4/4-positive astronauts on long duration spaceflights without knowing the risks. [00:29:26] Ken notes the worsened cognitive impacts resultant from medical radiation, and while therapeutic radiation is different than radiation experienced by astronauts, these results give some indication of the effects astronauts might experience. [00:33:27] Dawn mentions that we recently had planetary scientist and director of NASA’s Haughton-Mars project, Pascal Lee, on the podcast, who explained his view that since there are so many engineering and biological challenges with going to Mars, we should take a more measured approach to a Mars mission, perhaps even beginning with a roundtrip to Mars rather than landing on our first visit. Dawn asks Michael what his thoughts are on this approach. [00:37:29] Ken shifts the discussion to the subject of one of Mars’ moons, Phobos, and its potential role in a Mars mission. [00:40:30] Dawn pivots to talk about Michael’s Book “Building a Space-Faring Civilization: Advancing the Renaissance of Science, Medicine and Human Performance in Civilian Spaceflight.” Dawn asks Michael to talk about the chapter concerning the question of space radiation from the standpoint of precision medicine. [00:55:12] Dawn asks Michael to talk about the lack of appreciation people have for the fact that a Mars mission would be the most dangerous thing we’ve ever done. [00:59:06] Ken mentions that Michael has worked with a lot of organizations, including Space X, which has a program, the Space X Mars Colonization Program,
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    1 h y 35 m
  • Episode 182: Michael Schmidt discusses the application of precision medicine to human spaceflight

    Episode 182: Michael Schmidt discusses the application of precision medicine to human spaceflight
    Jun 2 2025
    Today we have Dr. Michael A. Schmidt, the founder, CEO, and Chief Scientific Officer of Sovaris Aerospace, a company focused on assessments and solutions applied to humans in space and extreme environments on Earth. Michael is also a professor of aerospace medicine at the University of Central Florida College of Medicine, one of the few programs in the U.S. that offers a medical residency in aerospace medicine. Michael is known for his work pioneering the field of precision medicine. He uses molecular analytics, coupled with physiologic and behavioral assessments, to facilitate human performance and resilience on Earth as well as in the extreme environment of space. His work covers a spectrum from NASA, the NFL, the NBA, U.S. Olympic teams, Nike, SpaceX, Axiom Space, NASCAR, Special Operations, the Naval Submarine Medical Research Lab, the Mayo Clinic, and others. We had a long and fascinating conversation with Michael and decided to break the interview into two parts. This episode focuses on Michael’s background and the cognitive and physical challenges astronauts experience in spaceflight. We also dive into the many ways that precision medicine is facilitating human performance and resilience here on Earth. In part two of our conversation, Michael talks about his work with NASA and SpaceX on the challenges of civilian spaceflight and the future of Mars exploration, including the construction of permanent colonies on the Moon and Mars. You won’t want to miss that conversation. Show notes: [00:03:59] Dawn opens our interview mentioning that Michael grew up in Minnesota in a small farming community, asking if it’s true that he sometimes had to do chores in 20- to 30-degree weather. [00:06:50] Dawn asks if it is true that Michael fell in love with science at a young age, even building telescopes at the age of 11. [00:08:00] Dawn asks Michael what it was that led him to become so fascinated with space specifically. [00:08:58] Dawn asks if Michael ever thought about becoming an astronaut. [00:10:09] Ken asks if it is true that Michael was a big reader as a child. [00:11:21] Dawn asks Michael to talk about his childhood athletic interests. [00:11:55] Dawn asks how it was that a high school quarterback from a small town in Minnesota ended up at university in the United Kingdom. [00:13:38] Ken asks Michael what years he worked at NASA Ames Research Center. [00:14:51] Ken mentions that when Michael was at NASA Ames, he did work collecting molecular and physiologic assessments of humans using NASA’s 20-G centrifuge. Ken asks Michael to talk about the centrifuge and how he used it in his studies of hypergravity. [00:17:49] Ken comments on the fact that pieces of equipment like NASA’s 20-G centrifuge are a precious scientific resource, and when they cease functioning, unfortunately, they are unlikely to be replaced. [00:19:40] Ken and Michael discuss the fact that microgravity, despite being one of the most pressing effects on astronaut health, is the one of the least addressed problems in human spaceflight. [00:21:48] Ken explains that Michael is the founder, CEO and Chief Scientific Officer of a company called Sovaris Aerospace, which is focused on assessments and solutions applied to humans in space and extreme environments on Earth. Ken asks Michael where the idea came from to found this company. [00:24:35] Dawn explains that since the human genome was first sequenced, there has been an acceleration of genome-based technologies that have made it possible to consider a person’s genetic makeup, both in healthcare and optimizing performance. Dawn asks Michael to talk about the work he does applying genomics to human spaceflight. [00:28:52] Dawn asks about Michael’s direction of the molecular profiling and precision medicine efforts for the Golden State Warriors during their record-breaking 73-9 season [00:32:57] Dawn mentions that Michael published a review in the journal Meta...
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    1 h y 15 m
  • Episode 181: Ken Forbus talks about AI and his development of the Structure Mapping Engine

    Episode 181: Ken Forbus talks about AI and his development of the Structure Mapping Engine
    May 13 2025
    Our guest today is Dr. Ken Forbus, the Walter P. Murphy Professor of Computer Science and a Professor of Education at Northwestern University. Joining Dr. Ken Ford to co-host today’s interview is Dr. James Allen, who was IHMC’s associate director until he retired a few years ago. James is a founding fellow of the American Association for Artificial Intelligence and a perfect fit for today’s discussion with Dr. Forbus, who, like James, is an AI pioneer. Back in 2022, James was named a fellow by the Association for Computational Linguistics, an organization that studies computational language processing, another field he helped pioneer. Dr. Forbus also is a Fellow of the Association for the Advancement of Artificial Intelligence and was the inaugural winner of the Herbet A. Simon Prize for Advances in Cognitive Systems. He is well-known for his development of the Structure Mapping Engine. In artificial intelligence and cognitive science, the Structure Mapping Engine is a computer simulation of analogy and similarity comparisons that helped pave the way for computers to reason more like humans. Show Notes: [00:03:07] Ken opens the interview with Dr. Forbus by asking if it is true that he had an unusual hobby for a nerdy kid growing up. [00:04:18] James mentions that Dr. Forbus’ family moved often when he was younger and asks how that affected him. [00:05:18] Ken mentions that when Dr. Forbus was in high school, he filled his free time reading about psychology and cognition before eventually coming across some articles on AI. Ken asks Dr. Forbus to talk about this experience and what happened next. [00:07:49] James asks Dr. Forbus if he remembers the first computer he owned. [00:09:17] Ken asks Dr. Forbus if there was anything, other than its reputation, that led him to attend MIT. [00:10:09] James mentions that for the past few decades, Dr. Forbus has been working on developing “human like” AI systems. While much of AI research and development has been focused on meeting the standard of the Turing test, James asks Dr. Forbus why he is not a fan of the Turing test. [00:12:24] Ken mentions that Dr. Forbus received his Ph.D. from MIT in 1984, the same year that Apple released the first Macintosh, which was rolled out with a famous Super Bowl ad. This computer was the first successful mouse driven personal computer with a graphical interface. Ken asks Dr. Forbus what he remembers about that ad, and what his reaction to it was at the time. [00:13:22] James mentions that 1984 was also the year that Dr. Forbus made his first splash in the AI world with his paper on qualitative process theory. James goes on to explain that at the time, qualitative reasoning regarding quantities was a major problem for AI. In his paper, Dr. Forbus proposed qualitative process theory as a representational framework for common sense physical reasoning, arguing that understanding common sense physical reasoning first required understanding of processes and their effects and limits. James asks Dr. Forbus to give an overview of this paper and its significance. [00:18:10] Ken asks Dr. Forbus how it was that he ended up marrying one of his collaborators on the Structure Mapping Engine project, Dedre Gentner. [00:19:14] James explains that Dedre’s Structure Mapping Theory explains how people understand and reason about relationships between different situations, which is central to human cognition. James asks Dr. Forbus how Dedre’s theory was foundational for the Structure Mapping Engine (SME). [00:25:19] Ken mentions how SME has gone through a number of changes and improvements over the years, as documented in Dr. Forbus’ 2016 paper “Extending SME to handle large scale cognitive modeling.” Ken asks, as a cognitive model, what evidence Dr. Forbus has used to argue for the psychological and cognitive plausibility of SME. [00:30:00] Ken explains that many AI systems rely on deep learning,
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    1 h y 26 m
  • Episode 180: Pascal Lee on NASA’s ambitions to send humans to the Moon and Mars

    Episode 180: Pascal Lee on NASA’s ambitions to send humans to the Moon and Mars
    Apr 9 2025
    Today we have planetary scientist Dr. Pascal Lee and STEM-Talk host Dr. Ken Ford in a wide-ranging conversation about NASA’s ambitions to return humans to the Moon as a stepping stone to sending astronauts to Mars. Pascal is making his third appearance on STEM-Talk. Much of his research focuses on asteroids, impact craters, and the future human exploration of Mars. Pascal and Ken have a lively discussion about the growing momentum for space exploration. Pascal is a researcher at the SETI Institute, a not-for-profit NASA program focused on searching for extraterrestrial intelligence in an effort to understand and explain the origin and nature of life in the universe. He also is the co-founder and chairman of the Mars Institute, and director of the Haughton-Mars Project at NASA Ames Research Center. Last year, Pascal received significant news coverage for his discovery of a giant volcano along with a possible sheet of buried glacier ice in the eastern part of Mars' Tharsis volcanic province. This was the first geological find of this magnitude since the other major volcanos on Mars were discovered back in the 1970s. Show notes: [00:03:06] Ken welcomes Pascal back to STEM-Talk and starts our interview by mentioning the developments in space exploration over the past few years, including civilian space missions, NASA’s Artemis program which aims to send humans back to the moon, and commitments to a manned mission to Mars. Given Pascal’s career in advancement of space exploration, Ken asks if Pascal is excited by these recent developments. [00:04:43] Ken explains that for a couple of decades Pascal has spent his summers visiting Devon Island in the Canadian arctic archipelago, which is the largest uninhabited land on Earth. When Pascal was last on STEM-Talk, his annual trip to Devon Island was cancelled due to COVID-19. Devon Island has unique geological characteristics that are in some ways similar to those on Mars. Since 2001, Devon Isalnd has been the home of the Haughton Mars Project (HMP). Ken asks Pascal to talk about the advances in this project since his last appearance on STEM-Talk. [00:07:59] Ken mentions that while much conversation has been centered on a human trip to Mars, a mission to return humans to the Moon and establish a permanent base is a more immediately feasible goal in the short term. Ken asks Pascal to talk about the importance and significance of such a mission. [00:12:06] On the topic of a Moon base, Ken explains that NASA’s Artemis project aims to send humans to the south pole of the Moon. Pascal has written a paper on that topic titled “An Off-Polar Site Option for the NASA Artemis Space Camp.” Ken asks Pascal what he sees as the primary weakness in the south pole location. [00:20:25] Ken agrees with Pascal’s perspective on sending humans to the lunar south pole, and the two discuss the problems with focusing human space exploration on romantic ideas such as “living off the land.” [00:22:24] Ken follows up on the previous questions by mentioning that in Pascal’s aforementioned paper, he suggests setting up a lunar base at the floor of the Clavius crater. Ken asks Pascal to talk about Clavius and why it is a potentially good permanent location for a moon base. [00:27:56] Ken asks Pascal how confident he and the community at large is in the Sophia finding of water. [00:29:00] Ken notes that contemporary interest in human space exploration appears tied to current geopolitical issues, much like the first space race between the US and USSR. Today, interest in space travel is closely linked with relations between the US and China. Ken asks Pascal to discuss this and how he believes the US should view this current situation. [00:35:43] Ken asks Pascal what he knows about the China’s current plans for a lunar mission. [00:34:36] Ken talks about a meeting at IHMC that addressed power-beaming to the lunar surface. [00:39:01] Ken notes that there is a lot of talk the...
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    1 h y 22 m
  • Episode 179: JP Errico explains how vagus-nerve stimulation reduces inflammation and chronic diseases

    Episode 179: JP Errico explains how vagus-nerve stimulation reduces inflammation and chronic diseases
    Mar 5 2025
    Today we have JP Errico, a scientist and inventor whose work focuses on neuroimmunology and the many ways it impacts cellular metabolism, inflammation, mental health and how we age. He recently joined IHMC as a Senior Research Scientist. JP is particularly known for his research on vagus-nerve stimulation and is the author of the book, The Vagus-Immune Connection: Harness Your Vagus Nerve to Manage Stress, Prevent Immune Dysregulation, and Avoid Chronic Disease. He also is the co-host of the podcast, The Health Upgrade. JP has more than 250 patents and is the founder of ElectroCore, a company that specializes in neuromodulation and noninvasive vagus-nerve stimulation. He has an undergraduate degree in aeronautical engineering from the Massachusetts Institute of Technology and worked at Lincoln Laboratories. JP also holds graduate degrees in both law and mechanical/materials engineering from Duke University. Show notes: [00:03:08] Tim opens our interview mentioning that as a child JP was focused on both sports and academics. [00:04:50] Tim talks about how hard it is to find quality math and science education today similar to what JP experienced at his high school. [00:05:16] Tim asks JP what it was that led him to pursue an undergraduate degree at MIT. [00:05:53] Tim asks if it was always JP’s plan to go into aeronautical engineering. [00:07:22] Tim mentions that as a kid, JP would scour bookstores and libraries for textbooks on physics and quantum mechanics and asks JP if there were any books that particularly inspired him. [00:10:12] Ken mentions that after MIT, JP went to Duke University where he pursued mechanical engineering and also went to law school. Given this workload, Ken asks if JP ever had any free time while studying at Duke. [00:13:26] Tim mentions that while JP was in law school, he got a job at a patent firm. After obtaining his law degree, JP’s uncle called and offered JP an opportunity. [00:17:42] Tim explains that JP’s career has focused on neuroimmunology, or the study of how the nervous system and immune system interact. Neuroimmunology affects a wide range of health factors including inflammation, mental health and aging. Tim also explains that JP has recently authored a book on neuroimmunology titled “The Vagus Immune Connection: Harness Your Vagus Nerve to Manage Stress, Prevent Immune Dysregulation and Avoid Chronic Disease.” Tim asks JP to touch on the key features of neuroimmunology that people should be aware of. [00:21:59] Tim asks JP to touch on the epigenetic factors regarding neuroimmunology. [00:25:01] Since JP brought up Dr. Kevin Tracey’s work, Ken mentions that Kevin was recently interviewed on STEM-Talk episode 172 and encourages listeners to listen to that episode for more context on the vagus nerve and neuroimmunology. [00:25:48] JP talks about how he stumbled upon the idea of how stimulating a nerve may have the same clinical benefit that sometimes occurs as a result of cutting a nerve. [00:28:16] Tim talks about the unintended consequences he observed as surgeon when he cut a patient’s vagus nerve. [00:30:50] Ken mentions that another area where JP has had impact with respect to stimulating the vagus nerve is the treatment of asthma and asks JP to talk about his findings in this area. [00:40:10] Tim notes that after JP knew that non-invasive approaches to vagus-nerve stimulation were possible, he went on to optimize a delivery device. These efforts resulted in a device called gamaCore. Tim asks JP to talk about this device and how it works. [00:43:27] Tim asks JP to talk about what it feels like for patients to have their vagus nerve stimulated. [00:44:50] Ken asks if JP thinks that his and others’ work in vagus-nerve stimulation inspired the development of similar devices for orthopedic pain, where the device is implanted near the nerve on the knee or other area experiencing pain.
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    1 h y 17 m
  • Episode 178: Karl Herrup discusses the shortcomings of Alzheimer’s research

    Episode 178: Karl Herrup discusses the shortcomings of Alzheimer’s research
    Feb 5 2025
    Today we have Dr. Karl Herrup, a neurobiologist known for his investigations into the roles that DNA damage and noncoding genetic variants have in Alzheimer’s disease. Joining Ken today to interview Karl is Dr. Tommy Wood, a visiting scientist here at IHMC. Tommy also is an associate professor of pediatrics and neuroscience at the University of Washington, where he focuses on brain health across lifespan. He has been our guest several times on STEM-Talk and we will have links to those interviews in our show notes for today’s episode. After more than a century of research, the underlying cause of Alzheimer’s remains a mystery. For the past few decades, the leading theory has been the amyloid cascade hypothesis, which proposes that abnormal amyloid plaques in the brain are the central cause of the disease. Today we talk to Karl about his lab and research as well as his view that the amyloid cascade hypothesis is not only flawed, but also could be holding back research for a cure of Alzheimer’s. A professor of neurobiology and an investigator in the Alzheimer’s Disease Research Center at the University of Pittsburgh School of Medicine, Herrup is the author of How Not to Study a Disease: The Story of Alzheimer’s. Show notes: [00:03:50] Tommy asks Karl what he was like as a kid to open the interview. [00:04:36] Tommy asks Karl about his educational environment growing up. [00:05:10] Ken mentions that Karl went to Brandies University originally with the intent of becoming a physician and asks Karl what happened to change his mind. [00:06:14] Ken asks Karl if it is true that his father was disappointed with Karl’s decision to abandon medical school in favor of genetics. [00:07:02] Tommy mentions that Karl began researching genetics in the late 1960s when researchers were just beginning to unravel the secrets of DNA. Tommy asks Karl to discuss why this was such an exciting time to study genetics. [00:08:38] Tommy asks Karl what prompted him to pursue a PhD in neuroscience. [00:11:34] Continuing on the theme of happy accidents, Ken asks if it was also an accident that led to Karl moving to Switzerland for a second post-doc. [00:12:36] Ken asks Karl to expound on his experience taking an overseas post-doc, which was not a common practice in the 1970s. [00:14:11] Ken mentions that Karl has seemed to benefit in his life from the combination of preparation and the willingness to explore opportunities that present themselves. [00:15:00] Tommy mentions that when Karl arrived back in the US from Switzerland, he accepted a faculty position at Yale and asks him to discuss this experience. [00:17:06] Tommy mentions that after Yale, Karl had several faculty appointments, including a seven-year stint in Hong Kong, and asks Karl to talk about that experience. [00:21:36] Tommy asks Karl why, in 2019, he moved back to his hometown to become a professor of neurobiology at the University of Pittsburgh and co-investigator at the university’s Alzheimer’s research center. [00:24:45] Ken asks Karl to talk about his lab at the University of Pittsburgh, which focuses on the biology of neurodegeneration. [00:26:32] Ken asks Karl if there was anything specific that caused him to shift his focus at this stage in his career so heavily towards Alzheimer’s research. [00:28:21] Tommy comments on Karl’s hypothesis of the aging brain, noting that it would make sense for the same processes involved in the developing brain to relate to what we see in the aging brain, as these processes are continuous throughout the lifespan. [00:29:54] Tommy pivots to talk about Karl’s book, entitled “How Not to Study a Disease: The Story of Alzheimer’s” for which Karl interviewed a number of experts and colleagues, asking each one to define Alzheimer’s disease in their own words. [00:30:51] Tommy reiterates the point that we still do not have a universally accepted definition of Alzheimer’s disease and asks Karl wh...
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    1 h y 30 m
  • Episode 177: Frank Butler talks about revolutionizing combat casualty care

    Episode 177: Frank Butler talks about revolutionizing combat casualty care
    Jan 16 2025
    Today we have Dr. Frank Butler, a retired Navy Undersea Medical Officer and an ophthalmologist who served as a Navy SEAL platoon commander prior to attending medical school. Just a few weeks after our interview, President Joe Biden awarded Frank a Presidential Citizens Medal during a White House ceremony. The medal is one of the highest honors a civilian can receive and recognized Frank’s many contributions to civilian and military trauma care. Frank is credited with founding Tactical Combat Causality Care, also known as TC Three, which has transformed battlefield medical care and saved thousands of lives. TCCC is now used throughout the U.S. military and much of the world. In today’s interview, we talk to Frank about his recent book, “Tell Them Yourself: It’s Not Your Day to Die,” which describes the challenges and improvements TCCC has experienced over the past three decades. Frank spent most of his 26-year career in Navy Medicine supporting the Special Operations community. He served a five-year stint as a Diving Medical Research officer at the Navy Experimental Diving Unit in Panama City, Fla., where he helped develop many of the diving techniques and procedures used by Navy SEALs today. Show notes: [00:03:31] Dawn opens the interview asking Frank what it was like growing up in Savannah, Ga., in the 50s and 60s. [00:04:40] Dawn asks Frank about his father, who was an industrial engineer, and who became director of urban housing in Savannah during a time when the city was developing public housing. [00:05:47] Ken asks Frank if it’s true that most of his family went into the medical field. [00:06:33] Ken asks Frank about his experience attending a Navy SEALs demonstration during his sophomore year of college. [00:08:09] Dawn asks Frank about his experience going through Navy SEAL training, particularly the Basic Underwater Demolition SEALs School. [00:09:29] Dawn asks if it’s true that five people in Frank’s family have become Navy SEALs. [00:10:08] Ken explains that after Frank left the SEALs in 1975, he had to figure out what to do next with his life. Frank talks about what led to his decision to go to medical school. [00:11:14] Ken asks Frank how he ended up at Jacksonville Naval Hospital to do an internship in family medicine. [00:11:46] Dawn explains that after Frank’s internship, he was assigned to the Navy Experimental Dive Unit. She asks him to talk about this experience. [00:12:25] Frank talks about some of the projects he worked on during this period. [00:14:43] Ken asks Frank how he decided on ophthalmology as his surgical specialization. [00:15:47] Dawn asks Frank what his experience as a resident at Bethesda Naval Hospital was like. [00:16:52] Dawn explains that after Frank completed his residency, he was assigned to Pensacola Naval Hospital. Dawn asks Frank how he ended up becoming the biomedical research director for the Navy SEALs. [00:18:48] Ken mentions that Frank worked on several important projects as research director for the SEALs, including battlefield trauma care, a tactical athlete program, improved treatment of decompression sickness, and the Navy SEAL nutrition guide. Ken begins by asking Frank to talk about his work on the tactical athlete program. [00:20:33] Dawn explains that another one of Frank’s projects as research director for the SEALs was the design of the Navy special warfare decompression computer. Dawn asks Frank to explain what a decompression computer does for a diver. [00:21:35] Dawn asks Frank to elaborate on the process of designing this decompression computer and the algorithm as well as the process of getting it approved for the Navy. [00:23:31] Ken asks Frank to talk about a program he worked on to promote refractive surgery. While this program was initially designed to improve combat vision for SEALs, the program has expanded to all active-duty service members, including aviators.
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    1 h y 33 m
  • Episode 176: JoAnn Manson on Women’s Health Initiative, menopause and her findings on hormone therapy

    Episode 176: JoAnn Manson on Women’s Health Initiative, menopause and her findings on hormone therapy
    Dec 20 2024
    Today our guest is Dr. JoAnn Manson, an endocrinologist, epidemiologist, and Principal Investigator of several research studies, including the landmark Women’s Health Initiative. She is a highly cited researcher and was one of the physicians featured in the National Library of Medicine’s exhibition, History of American Women Physicians. Her primary research interests include clinical prevention trials of nutritional and lifestyle factors related to heart disease, diabetes, and cancer and the role of endogenous and exogenous estrogens as determinants of chronic disease. Show notes: [00:02:53] Dawn kicks off the interview by asking JoAnn what it was that drew her to endocrinology. [00:04:33] Ken asks how the things JoAnn witnessed in her early medical practice influenced her interest in disease prevention. [00:05:51] Dawn asks JoAnn to discuss how her mother, who suffered from ovarian cancer, influenced JoAnn’s focus on women’s health. [00:06:40] Dawn asks JoAnn what prompted her interest in clinical research. [00:08:06] Noting the difference between public health and laboratory medical research, Dawn asks JoAnn what the most valuable thing is that she learned from her master’s and Ph.D. work in public health at Harvard. [00:09:10] Ken mentions that while JoAnn and many others are interested in the prevention of disease, our healthcare system does not seem focused on prevention. Ken goes on to asks if this was part of what led JoAnn to work on the Nurses’ Health Study. [00:10:17] Ken asks JoAnn to give an overview of the Nurses’ Health Study for listeners who may not be familiar. [00:11:41] Dawn explains that the Nurses’ Health Study found that women taking hormone therapy had a lower risk of heart disease and a reduction in all-cause mortality. Dawn asks JoAnn to talk about this finding. [00:15:00] Ken asks JoAnn what the impact of the Nurses’ Study has been on public health and women’s health in general. [00:16:29] Dawn asks JoAnn about her experience being a principal investigator in the Women’s Health Initiative starting in 1993. [00:18:17] Ken asks JoAnn to give context regarding how the Women’s Health Initiative (WHI) was designed, how the women were recruited, and what the specific questions were that the study aimed to answer. [00:21:34] Dawn mentions that the three interventions that were evaluated in the WHI were hormone therapy; calcium and vitamin D supplementation; and a low-fat diet. Dawn starts by asking JoAnn about the hormone therapy interventions, and how it was decided which hormone therapies to test. [00:24:25] Dawn asks JoAnn to give some context to the finding from the WHI that women taking the combination of conjugated estrogen and medroxyprogesterone acetate had higher risks of breast cancer and stroke. [00:27:01] Ken asks if the worse outcomes from hormone therapy for older women was due to their advanced age, or the hormone therapy itself. [00:30:25] Ken asks JoAnn to talk about the risk factors for breast cancer that were uncovered by the WHI. [00:35:38] Dawn explains that because of the WHI’s findings, it is more common to use transdermal estradiol, as opposed to the oral form evaluated in the original trial. Dawn asks JoAnn to explain how the different ways these hormone formulations are processed in the body affects the risk benefit ratio. [00:39:04] Dawn asks if these transdermal estradiol treatments might have benefits regarding cognitive decline. [00:43:26] Ken asks JoAnn for her thoughts on the overuse and potential misuse of the term ‘bioidentical hormones.’ Ken goes on to note that the term has seemingly become more related to marketing and further distanced from clinical science. [00:46:48] Dawn asks JoAnn to talk about the role that perimenopausal birth control decisions can play in the management of hot flashes for women in their 40s and 50s. [00:49:14] Ken shifts the conversation to discuss the second pillar of the WHI,
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    1 h y 21 m