STEM-Talk

Today we have our good friend and colleague Dr. Andrew Koutnik on the show. Andrew is a research scientist who studies the influence of nutrition and metabolism on health, disease and performance. He specializes in Type 1 diabetes and works with a wide range of people to improve their metabolic health and athletic performance. Andrew is a visiting research scientist at IHMC and has worked with Harvard, Johns Hopkins, NASA, and the Department of Defense to develop evidence-based strategies for overcoming complex health challenges. He is a graduate of Florida State University and earned his Ph.D. in medical sciences at the University of South Florida, where he worked with another good friend of ours, Dr. Dominic D’Agostino, who has been a previous STEM-Talk guest. Show notes: [00:02:50] Dawn welcomes Andrew to the show and asks him about his website, andrewkoutnik.com, the quote on the site’s homepage “Demystifying complex science to help you thrive in your health journey,” and the tagline “Challenging the status quo of metabolic health, human performance, and the management of type1 diabetes.” [00:05:31] Ken asks Andrew how old he was when he first learned he had Type 1 diabetes. [00:08:32] Dawn asks why Andrew believes his Type 1 diabetes is one of his life’s ultimate assets? [00:12:51] Ken mentions that Andrew grew up in Tallahassee and that despite suffering from childhood obesity, he was relatively athletic as a child. Ken asks Andrew to talk about his childhood. [00:14:20] Dawn asks Andrew to talk about the weight-loss journey he underwent as a teenager. [00:17:25] Dawn shifts gears to ask Andrew about how he got into science, mentioning that when he was younger, he never saw himself becoming a scientist. [00:20:19] Dawn asks if it is true that Andrew was the sort of kid who would constantly asked questions. [00:22:11] Dawn asks Andrew if it is true that after enrolling at Tallahassee Community College, it took him a while to decide on his major. [00:22:58] Ken asks Andrew to talk about the impact that his undergraduate anatomy and physiology class and professor had on his journey. [00:24:44] Ken mentions that after graduating from FSU, Andrew went to the University of South Florida where he worked with Dominic D’Agostino, who is both a previous STEM-Talk guest and a current colleague of Andrew’s. Ken asks Andrew how he met Dom. [00:27:46] Dawn asks Andrew how he came to work in Dom’s lab. [00:29:00] Dawn asks Andrew if his wife is still in touch with her former roommate, who connected Andrew and Dom. [00:29:21] Ken asks Andrew to touch on some of the research he did with Dom while he was pursuing his Ph.D. [00:31:49] Dawn shifts gears to talk about Andrew’s work in metabolic health and Type 1 diabetes. Dawn explains that a study published by the University of North Carolina found only 12 percent of Americans were metabolically healthy. Additionally, researchers from the Friedman School of Nutrition Science and Policy at Tufts University found in 2022 that only 6.8 percent of Americans had good cardiometabolic health. Dawn asks Andrew how he works with people who want to improve their metabolic health. [00:34:19] Ken asks Andrew for his thoughts on the sentiment that a ketogenic diet is hard to sustain. [00:36:55] Ken mentions that  Andrew was part of a review that looked at carbohydrate restriction for diabetes, which is a practice that had been in use since the 1700s. It fell out of favor once insulin was discovered in the 1920s. Ken goes on to explain that carbohydrate restrictive diets, like the ketogenic diet, have regained popularity for the treatment and management of diabetes, weight-loss and a range of other health issues such as migraines, cancer and depression. Ken asks Andrew to first explain the history of carb-restrictive diets as a treatment of diabetes. [00:39:43] Ken asks Andrew to talk more about the aforementioned 2021 review and its argument in favor of a medical nutrition therapy for diabetes management. [00:47:21] Dawn quotes a passage from the American Diabetes Association website that reads, “Before insulin was discovered in 1921, people with diabetes didn’t live for long. There wasn’t much doctors could do for them. The most effective treatment was to put patients with diabetes on very strict diets with minimal carbohydrate intake. This could buy patients a few extra years but couldn’t save them. Harsh diets, some prescribed as little as 450 calories a day, sometimes caused patients to die of starvation.” Dawn asks Andrew if he feels that this quote discourages the use of carb-restriction and medical nutrition therapy for diabetes management. [00:49:22] Dawn asks Andrew how the treatment of diabetes went from the use of insulin being prescribed along with carbohydrate restriction, to purely pharmacological interventions. [00:50:59] Dawn asks Andrew to talk about the significance of the fact that carbohydrates are the only macronutrient directly digested into glucose, making carbs the main determinant of postprandial glycemia and insulin requirements, which creates a mismatch between insulin kinetics and glucose. [00:55:29] Ken pivots to talk about the work of Jeff Volek at Ohio State University, one of the founders of Virta health, and our guest on STEM-Talk episodes 43, and 149. Ken goes on to explain that Virta offers nutrition-based approaches to losing weight and reversing diabetes. Virta has an impressive track record of success with Type 2 diabetes. The average weight loss for those using Virta’s system is 31 pounds, and enrollees reduced their medications by 63 percent. Ken asks Andrew why these are such impressive achievements. [00:57:07] Dawn asks Andrew about the concerns people have about low carbohydrate diets for diabetes. [01:00:24] Dawn asks, given that total medical costs for diabetes in the US is approaching a billion dollars a day, if Andrew could discuss how research into medical nutrition therapy for diabetes should become a priority. [01:02:44] Dawn pivots to talk about Andrew’s work in optimizing human performance, mentioning that he recently put out an article on Substack titled “Revolutionizing Sports Nutrition: New Insights on Low-Carb vs High-Carb Diets in Strenuous Exercise Performance.” Dawn explains that this article was based on a study Andrew and his colleagues published challenging the conventional thinking that carbohydrates were essential to athletic performance. Dawn asks Andrew to talk about the origins of the conventional wisdom that carb-loading is essential for athletic performance. [01:06:21] Ken asks Andrew to talk about the physiology behind the potential of low-carb diets to improve athletic performance in certain contexts. [01:08:47] Dawn asks Andrew to give an overview of his 2023 paper titled: “Low and High Carbohydrate Isocaloric Diets on Performance Fat Oxidation, Glucose and Cardiometabolic Health in Middle-Aged Males.” [01:13:41] Ken comments on how active, athletic and outwardly healthy-looking people being prediabetic is likely more common than people think. [01:15:35] Ken comments that this incidence of prediabetes in athletes appears to be most common in endurance athletes. [01:17:04] Ken explains that Andrew released a study earlier this year looking at the performance of triathletes who are adapted to very low-carb diets, as well as very high-carb diets. Ken goes on to explain that this study examined the belief that very low-carb diets would impair prolonged performance during strenuous exercise. Ken asks Andrew to explain the design of this study. [01:20:27] Ken explains that the aforementioned study produced three key findings, which he asks Andrew to walk listeners through. [01:23:48] Dawn notes that the ketogenic diet has become more popular in recent years, and that in response one can see numerous “keto-friendly” versions of typically high-carb foods, like breads and ice creams. Dawn asks Andrew what his take is on such products. [01:27:50] Ken asks Andrew if it is true that he has some interesting research findings coming down the pipeline soon. [01:28:36] Dawn wraps up our interview by asking Andrew if it’s true that he taken up jujitsu. Links: Andrew Koutnik bio Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Dawn Kernagis bio

Dawn and Ken tackle a wide range of intriguing listener questions. They debate the merits of print versus digital reading and how screens affect our brains. A fascinating discussion on grip strength emerges, linking it to longevity. They also delve into ketamine's potential in depression treatment, comparing it to its FDA-approved counterpart, esketamine. The hosts critique nutritional studies and explore the role of AI in healthcare, emphasizing accuracy and context. To top it off, a poignant commencement speech highlights self-invention and living with purpose.

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, dedicated to the establishment of a permanent colony on Mars. Space X’s founder Elon Musk recently made a statement to his employees that in 20 years he anticipates having a million people colonizing Mars. Ken asks Michael to elaborate on the difficulties entailed with not just a sortie mission to Mars but attempting to establish a permanent presence there. [01:03:38] Ken notes the effect that lofty ideas about colonizing Mars have on people is a lack of appreciation for the tremendous difficulty of the task before us. Ken notes that when we do make it to Mars, the appreciation for the monumental accomplishment that it will be could be seen as inadequate by a public fed ideas about colonizing Mars in the next 20 years. [01:11:08] Dawn notes that one of the most underappreciated, yet critical, components of long duration spaceflight is the psychology of team dynamics. Considering the isolation and close quarters environment of a spacecraft, how teams interact and how they will mediate conflict is an important problem to consider. [01:13:59] Dawn shifts gears to talk about Michael’s co-editor for his book, Dr. Marianne Legato, an emeritus professor of clinical medicine and Columbia University, and a practicing internal medicine specialist in New York City known for her sex-specific medicine and research. Dawn asks Michael how he and Marianne met. [01:16:33] Dawn asks Michael, with respect to his and Marianne’s work on sex and gender differences, how the challenges that men and women face in spaceflight differ. [01:23:31] Dawn comments on Michael’s fascinating career and asks him if it is what he envisioned for himself when he was in college. [01:27:05] Ken wraps up our interview by asking Michael what advice he has for students and young researchers just starting their careers. Links: Michael Schmidt bio Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Dawn Kernagis bio  

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 Metabolomics in 2013 that looked at the use of omics-based analyses and their potential to enhance astronaut safety and performance. Dawn goes on to say that omics allows us to identify differences in humans responsible for different responses to extreme conditions. Dawn asks Michael to talk about this review and what he learned in terms of the risk profile of individual astronauts and how personalized medicine could mitigate some of the risks. [00:42:01] Ken circles back to the heterogeneity of responses to exercise in space, a phenomenon that is seen on Earth as well. Ken notes that while large populations of astronauts don’t yet exist to be studied, large populations and their response to exercise can be studied on Earth, such as Marcas Bamman’s current NIH-funded multicenter exercise study with aging populations here at IHMC. Here Michael talks about his work creating “digital twins” of astronauts to model exposure to extreme environments on personalized digital models of astronauts. [00:46:04] Ken mentions that the difference between digital twin models in engineering and digital twins used in biomedicine is that engineered systems are nearly fully understood and can therefore be modeled with great accuracy and completeness, while there is much more unknown in biological systems. [00:48:15] Ken asks Michael, given all the confounds and environmental stressors in spaceflight, how confident can we be that omics analyses performed on Earth will provide useful insights about performance in space. [00:54:13] Dawn pivots to discuss Michael’s work as president of the Human Research Program for Civilian Space Flight, the purpose of which is to address the widespread needs that civilians will face as space travelers. [01:01:03] Ken shifts gears to ask Michael to talk about the specific cognitive and physical challenges that humans will face in long duration spaceflight, such as a flight to Mars. [01:10:05] Ken mentions that APOE4/4 positive patients see increased risk of cognitive decline from therapeutic radiation on Earth. Ken notes that while therapeutic radiation is different from the radiation experienced by astronauts, this still poses worrying prospects for APOE4/4 positive astronauts. [01:11:28] Ken and Michael discuss the importance of developing both biological and engineering countermeasures to hazardous exposure to astronauts in space. Links: Michael Schmidt bio Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Dawn Kernagis bio    

Ken Forbus, a distinguished professor at Northwestern University and a pioneer in AI, discusses his journey from a nerdy kid to a leader in cognitive science. He shares anecdotes about his childhood and how family relocations influenced his passion for AI. The conversation highlights the Structure Mapping Engine's role in teaching computers to reason like humans. Forbus also explores advancements in analogical reasoning, the challenges of knowledge capture in education, and the future of AI in the workforce, advocating for balanced methodologies in tech development.

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 these days about not not only traveling to Mars, but also colonizing Mars. Ken asks Pascal where he believes this sentiment is coming from and what are some of the challenges associated with colonizing Mars. [00:46:48] Ken notes that last year Elon Musk made an announcement to his SpaceX employees that he expects 1 million people to be living on Mars in the next 20 years. Ken asks Pascal what his thoughts are on this. [00:53:28] Ken asks Pascal to talk about a paper he published discussing a previously unrecognized volcano on Mars. Given that it was generally accepted for decades that all the volcanos had been accounted for, Ken asks Pascal to talk about the story of his recent discovery. [01:02:44] Ken pivots to a discussion of the Moons of Mars, specifically Phobos, asking Pascal to talk about the nature of this Moon. [01:07:42] Ken mentions that docking on Phobos and then going from Phobos to Mars would likely be a safer strategy for early Mars missions than landing directly on Mars from Earth. [01:12:30] Ken starts a discussion about Perseverance, as well as the new Japanese mission that may bring back Mars rocks from Phobos. Ken asks Pascal about Perseverance’s collection Mars’ of rock samples that NASA plans for a mission to bring those Mars rocks to Earth. Ken asks it is worth the cost of a mission to collect these samples and what we might learn if we are successful in getting these samples to Earth. [01:17:09] Ken wraps up our interview asking Pascal what year it was that he started working at NASA Ames, which turns out to be the same year Ken started working at NASA Ames. Links: Pascal Lee bio Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page  

JP Errico, a scientist and inventor specializing in neuroimmunology, discusses his groundbreaking work on vagus nerve stimulation. He shares insights into how this technique can significantly reduce inflammation and alleviate chronic diseases. JP delves into the intricate connections between the nervous and immune systems, linking autonomic regulation to mental health and aging. His innovative approach aims to create non-invasive solutions for serious health issues, showcasing the transformative power of lifestyle choices on overall well-being.

Dr. Karl Herrup, a neurobiologist and author of 'How Not to Study a Disease: The Story of Alzheimer’s,' delves into the critical flaws of the amyloid cascade hypothesis in Alzheimer’s research. He argues that this longstanding theory may be hindering real progress toward a cure. Joined by Dr. Tommy Wood, they discuss the complexities of diagnosing Alzheimer’s, the roles of DNA damage, and the need for innovative approaches to treatment. Herrup emphasizes the importance of rethinking research methods to better understand this multifaceted disease.

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. [00:26:26] Dawn explains that Tactical Combat Casualty Care (TCCC) has been an incredible transformation in battlefield trauma care, with literature indicating that the protocols have saved thousands of lives. TCCC is now used throughout the US military and much of the rest of the world. Dawn goes on to ask about Frank’s book “Tell Them Yourself: It’s Not Your Day to Die,” which documents how TCCC has evolved over the three decades since it was first introduced, as well as the trials and tribulations the program endured. [00:28:04] Ken asks Frank to elaborate on the assertion in his book that, save for the use of helicopters in place of horse drawn carriages, pre-hospital battle trauma care was essentially the same as it was during the Civil War prior to TCCC. [00:30:05] Following up on the discussion of tourniquets, Ken mentions his memory of the outright ban of tourniquets in the Navy during his time in the service. [00:31:07] Ken asks Frank how he was able to take his realization that something needed to be done about battlefield trauma care and turn that into a Navy project. [00:32:58] Dawn asks Frank how, as program manager, he approached the conduct of the TCCC research project. [00:35:03] Dawn asks Frank why, even though the TCCC paper came out in 1996, TCCC was still not widely used in the U.S. military at the beginning of the war in Afghanistan. [00:36:14] Frank recalls the first unit to implement TCCC. [00:37:10] Dawn asks what other units followed as early adopters. [00:39:26] Dawn asks Frank how he helped implement TCCC throughout the special operations community. [00:43:11] Ken mentions that some units did particularly well in adopting TCCC and others struggled. Given this, Ken asks if the operational leader’s priority regarding TCCC impacts the implementation of it in the unit. [00:44:31] Ken asks Frank to speak on the adoption and implementation of TCCC in the rest of the military outside of the special operations communities. [00:47:32] Dawn asks Frank how he updated his recommendations for TCCC as new evidence from the war came in. [00:50:31] Ken asks Frank, other than tourniquets, what medical advancements to battlefield trauma care did TCCC usher in. [00:54:31] Ken mentions that while the TCCC innovation of carrying whole blood and performing pre-hospital blood transfusions has saved countless lives, the innovation still is not ubiquitous in the military or for civilian first responders. Ken asks Frank to talk about the complexities of a ubiquitous adoption of this practice, and what can be done to push it forward. [01:00:06] Dawn asks, in addition to tourniquets and whole blood, what are some of the TCCC innovations that are now being widely used in the civilian world. [01:03:19] Ken pivots to a discussion about ketamine. Ken notes that the U.S. military, as well as the militaries in other countries, have used ketamine as an anesthetic, especially since the war in Afghanistan.  Ken notes that the civilian world has been slow to adopt ketamine as a drug for pain relief. Frank gives his thoughts broadly on the use of ketamine as an anesthetic and his belief that it will become more common in civilian EMS units over the next five to 10 years. [01:07:34] For listeners who are interested in learning more about the medical uses of ketamine, Ken recommends Episode 165 with Dr. Jonathan Edwards. [01:09:03] Ken and Frank have a tangential discussion about ketamine as a treatment for suicidal ideation and depression. [01:11:11] Ken asks Frank, given that the TCCC protocols have been widely adopted in every area of the military, what is the basic level of competence in TCCC that every service member should have. [01:14:26] Ken asks Frank to speak to the situation in Ukraine with respect to combat casualty care. [01:17:23] Looping back to Frank’s book “Tell Them Yourself: It’s Not Your Day to Die,” Dawn asks why Frank took up the task of writing it. [01:21:20] Dawn asks Frank about the significance of the book’s title. [01:22:04] Dawn mentions that many people speak about how compelling the first chapter of Frank’s book is. Dawn asks Frank to talk about the writing process for this chapter. [01:25:05] Dawn mentions that one of Frank’s co-authors for his book is Dr. Kevin O’Connor, who is currently the physician to the president. Given that Frank was in the Navy and Dr. O’Connor was in the Army, Dawn asks Frank how the two of them met. [01:26:42] As we near the end of our interview, Ken asks Frank if he has any final insights to share about battlefield trauma care. [01:28:11] Ken comments on the importance of Frank’s book as a marker, so we don’t forget hard won lessons during times of peace. [01:29:47] Dawn closes our interview with Frank by mentioning that he is an avid diver and asks him what his favorite spot to dive is. Links: Frank Butler Presidential Citizens Medal Frank Butler IHMC lecture and bio Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Dawn Kernagis bio  

Dr. JoAnn Manson, an acclaimed endocrinologist and epidemiologist known for her pivotal role in the Women’s Health Initiative, dives into vital discussions on women's health. She shares how her mother's battle with ovarian cancer fueled her passion for preventative care. The talk explores the complexities of hormone therapy in menopause, emphasizing tailored approaches and the societal shift needed towards prevention. Manson also highlights dietary impacts on breast cancer and heart disease, advocating for lifestyle changes to enhance women's overall well-being.