In this exciting episode, Mitch Belkin and Daniel Belkin speak with Professor Michael Levin about bioelectricity, the electrical potentials that cells use to communicate with one another. Professor Levin argues that bioelectricity is the software of cellular communication and is the medium through which we can control top-down modular programs for cancer prevention, limb regeneration, and birth defect repair. This interview covers how he co-created Xenobots; how somatic cells function like neurons; how his work incorporates insights from Karl Friston on collective intelligence and the free energy principle; and his dream of building an anatomic compiler, a theoretical biological-design program that would allow users to produce any anatomic configuration of any organism using bioelectricity.Who is Michael Levin?Professor Michael Levin is a biologist at Tufts University, where he investigates informational storage and processing in biological systems. He received a dual Bachelor’s in computer science and biology at Tufts. He then received his PhD in Genetics from Harvard where he characterized the molecular-genetic mechanisms of embryologic left-right asymmetry. Nature lists this discovery on its 100 milestones of developmental biology of the century. Currently, he is the director of the Tufts Center for Regenerative and Developmental Biology and the Allen Discovery Center at Tufts University. He is the co-editor in chief of the journal Bioelectricity, the founding associate editor of Collective Intelligence, and he sits on the editorial advisory board of Laterality. He has published more than 350 papers. References:Professor Michael Levin’s lab website“Molecular bioelectricity: how endogenous voltage potentials control cell behavior and instruct pattern regulation in vivo”Review of Left-Right AsymmetryXenobotsIon flows and regenerationPaper on Harold Burr’s work on Bioelectricity in the 1930sBioelectric controls of cell proliferation: Ion channels, membrane voltage and the cell cycleTwitter: @DrMichaelLevin______________________What is the External Medicine Podcast?The External Medicine Podcast explores some of the most exciting ideas in medicine. Co-hosted by Daniel Belkin, MD, and Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this episode, Mitch Belkin and Daniel Belkin speak with Daniel Burka about his work at Resolve to Save Lives and the project Simple.org, a hypertension reduction application. They discuss the importance of iterative building processes that trial various ideas and then quantifiably measure success. Daniel Burka stresses the importance of understanding the goals of all users--physicians, patients, public healthcare experts--when designing successful healthcare applications.Who is Daniel Burka?Daniel Burka is the director of product and design at Resolve To Save Lives, where he works on the web-based, open-source hypertension reduction application Simple.org. Previously, he was a Design Partner at Google Ventures, the Creative Director for Digg.com, and the Director of Design for Tiny Speck which later became Slack. Among many notable projects, he designed the Firefox logo and Mozilla’s website.What is Resolve to Save Lives?Resolve to Save Lives is an initiative to prevent 100 million cardiovascular deaths over the next 30 years. The initiative is funded by Bloomberg Philanthropies, the Bill & Melinda Gates Foundation, Gates Philanthropy Partners, and the Chan Zuckerberg Foundation. Methods to reduce deaths include hypertension reduction, trans fat elimination, and sodium reduction initiatives. In addition, Resolve to Save Lives aims to increase epidemic preparedness.What is Simple.org?Simple.org is a project of Resolve to Save Lives. It is an ultralight weight electronic health record system designed to manage patients with hypertension and diabetes. As of January 2022, 1.4 million patients in India, Bangladesh, and Ethiopia use the application.References:Daniel Burka's websiteTwitter: @dburkaSimple.orgMedium article on ultralight weight EHRsDaniel Burka's book recommendations for designers ______________________What is the External Medicine Podcast?The External Medicine Podcast explores some of the most exciting ideas in medicine. Co-hosted by Daniel Belkin, MD, and Mitch Belkin, MD.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this interview, Mitch Belkin and Daniel Belkin speak with Stephan Guyenet, PhD, about Glucagon-like peptide-1 (GLP-1) and Semaglutide. They discuss GLP-1’s mechanisms of action, Anthony Sclafoni’s experiments on food reinforcement and nutrient receptors in the small intestines. Finally, they touch on some exciting new weight loss drugs that may replace semaglutide and potentially even bariatric surgery.Who is Stephan Guyenet?Dr. Stephan Guyenet received his PhD in Neurobiology and Behavior from the University of Washington. Afterward, he completed a postdoctoral fellowship in the neuroscience of obesity. He is the author of the book The Hungry Brain. Dr. Guyenet is the founder & director of Red Pen Reviews, which publishes expert reviews of popular nutrition books with structured semi-quantitative evaluations. In addition, he is a senior researcher at GiveWell where he conducts cost effectiveness analyses on water quality interventions and malnutrition treatments in low income countries.What is GLP-1 ?Glucagon-like peptide-1 is a hormone produced by the intestines. It is an incretin, meaning it signals the pancreas to increase insulin secretion in a glucose-dependent manner. Initially, GLP-1 agonists were developed for the treatment of diabetes. In both animal and human models, it was discovered that GLP-1 agonists suppress food intake, which led to weight loss. This discovery spurred its use in obesity trials, including STEP 1. Citations for Stephan Guyenet:@WHsourceThe Promise and Impact of the Next Generation of Weight Loss DrugsNEJM - Once-Weekly Semaglutide in Adults with Overweight or ObesitySafety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2·4 mg for weight management: a randomised, controlled, phase 1b trialDanuglipron (PF-06882961) in type 2 diabetes: a randomized, placebo-controlled, multiple ascending-dose phase 1 trialDiabetes Prevention Program - 58% reduction in progression from pre-diabetes to diabetes.Stephanguyenet.comMarch 2021 article in Works in Progress______________________What is the External Medicine Podcast?The External Medicine Podcast explores some of the most exciting ideas in medicine. Co-hosted by Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this interview, Mitch Belkin and Daniel Belkin speak with Brown Economics Professor Emily Oster about the studies behind breastfeeding recommendations, the dramatic increase in the U.S. C-section delivery rate over the last half century, and how she approaches analyzing studies. Who is Emily Oster?Emily Oster is the Royce Family Professor of Teaching Excellence and Professor of Economics at Brown University where she studies health, behavioral, and development economics. She received her PhD from Harvard University and taught at the University of Chicago Booth School of Business. She is the author of three popular books on pregnancy and parenting: Expecting Better, Cribsheet, and The Family Firm. References:In our podcast, we reference the following papers, ideas, and talks:The 2007 TED Talk on AIDS in Africa by Professor Emily OsterA paper in which Professor Oster argues that the the increased ratio of men to women in Asia could be explained in part by Hepatitis B infection (2005)Another paper in which she retracts the claims of her previous paper (Hepatitis B Does Not Explain Male-Biased Sex Ratios in China) (2008)The Term Breech Trial - Lancet (2000)Door-to-Balloon timeAmy Finkelstein paper on Source of Geographic Variation in Healthcare spending: evidence from patient migrationJudith Rich Harris Argument - The Nurture AssumptionProfessor Emily Oster’s Parent Data SubstackErrata:In the introduction, we accidentally say Academy of Pediatrics at one point when we meant to say American Academy of Pediatrics.In the introduction, we state that one reason for C-section delivery is “protracted vaginal delivery”. We meant to say “protracted labor” defined as the arrest of cervical dilation prior to vaginal delivery.______________________What is the External Medicine Podcast?The External Medicine Podcast explores some of the most exciting ideas in medicine. Co-hosted by Daniel Belkin, MD, and Mitch Belkin, MD.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this interview, Mitch Belkin and Daniel Belkin speak with Katherine Flegal about the relationship between BMI and excess mortality. Dr. Flegal's publication of two papers in JAMA led to substantial controversy among obesity researchers. They discuss the data regarding the U-shaped mortality curve, the history of BMI, as well as the politicization of science.Who is Katherine Flegal?Katherine Flegal is an epidemiologist and former senior scientist at the CDC's National Center for Health Statistics. She is one of the most cited scientists in the field of obesity epidemiology. After receiving a bachelor's from UC Berkley, a PhD from Cornell, and an MPH from Pittsburgh, she worked in the biostatistics department of University of Michigan prior to working at the CDC in the National Center for Health Statistics.Dr. Flegal worked on the National Health and Nutrition Examination Survey (NHANES), which is a comprehensive data set of nationally representative cross-sectional data from the US that combines interviews, physical exams, and laboratory tests along with demographic, socioeconomic, and dietary data. Her 2005 analysis of the NHANES data set and her 2013 meta-analysis demonstrated that people who are “overweight” (defined as a BMI between 25 and 30) have significantly lower all cause mortality compared to people who are “normal weight” (BMI 18.5 - 24.9). In addition, her publications showed no significant difference in mortality between people who have a BMI of 30-35 and people who are normal weight.ReferencesThe Obesity Wars and the Education of a Researcher: A Personal Account (Progress in Cardiovascular Diseases, 2021)Excess deaths associated with underweight, overweight, and obesity (JAMA, 2005)Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index CategoriesA Systematic Review and Meta-analysis (JAMA, 2013) ______________________What is the External Medicine Podcast?The External Medicine Podcast explores some of the most exciting ideas in medicine. Co-hosted by Daniel Belkin, MD, and Mitch Belkin, MD.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

In this interview, Mitch Belkin and Daniel Belkin speak with Dr. Karl Fristonabout his proposed free energy principle and how it applies to various psychiatric and neurological disorders including schizophrenia, depression, autism, and Parkinson’s. They also touch on the disconnection hypothesis of schizophrenia, how theories of schizophrenia have evolved over the last two centuries, and the relationship between schizophrenia and autism.Who is Karl Friston?Dr. Karl Friston is a professor of neuroscience at University College London and an authority on brain imaging. He is the 20th most-cited living scientist with over 260,000 citations for his works. After studying natural sciences at Cambridge, he completed his medical studies at King’s College Hospital in London and worked for 2 years in an inpatient psychiatric facility on the outskirts of Oxford, where treated patients suffering from schizophrenia.Dr. Friston has developed a number of statistical tools for analyzing data from the brain, including statistical parametric mapping (SPM), voxel-based morphometry (VBM) or dynamic causal modeling (DCM). His mathematical contributions include variational Laplacian procedures and generalized filtering for hierarchical Bayesian model inversion. ______________________What is the External Medicine Podcast?The External Medicine Podcast explores some of the most exciting ideas in medicine. Co-hosted by Daniel Belkin, MD, and Mitch Belkin, MD.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

This conversation was recorded on June 24th, 2021. In this interview, Mitch Belkin and Daniel Belkin speak with Dr. Johnson about fructose and its relationship to fat storage. They discuss uric acid as a cause of kidney inflammation and essential hypertension, how glucose intake can trigger endogenous fructose production, and the relationship between salt and obesity. Finally, they touch on the evolutionary history of uric acid metabolism and the potential role for fructokinase inhibitors in treating metabolic disease.[Listen to our second podcast with Rick Johnson here]Who is Rick Johnson?Dr. Johnson is a Professor of Nephrology at the University of Colorado School of Medicine. He is one of the world’s leading experts on fructose. His research focuses on the role of fructose and uric acid in obesity, diabetes, hypertension, and kidney disease. He has over 700 publications, in journals including JAMA and the NEJM. He is also the author of two books for a general audience, The Fat Switch and The Sugar Fix.ReferencesUric Acid levels predicts future hypertensionUric acid and its relationship with pediatric hypertension Randomized Trial - Allopurinol on hypertensive adolescents Endogenous fructose production and kidney inflammationHigh salt diet and endogenous fructose production in miceHow osmolality of soup increases blood pressure Fructose, Uricase, and the Back-to-Africa Hypothesis Books:1. The Fat Switch2. The Sugar Fix ______________________What is the External Medicine Podcast?The External Medicine Podcast explores some of the most exciting ideas in medicine. Co-hosted by Daniel Belkin, MD, and Mitch Belkin, MD. Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

This conversation with Dr. John Mandrola was recorded on July 11th, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Dr. Mandrola about a 2019 article he co-authored entitled The Case for Being a Medical Conservative. They discuss concerns about vaccine-induced myocarditis in children, vaccine mandates, and whether the AMA and other physician organizations should take sides on controversial political issues. Who is John Mandrola?Dr. John Mandrola is a practicing cardiac electrophysiologist and a regular columnist for theheart.org on Medscape. He hosts the fantastic “This Week in Cardiology” podcast and is a blogger at drjohnm.org. He completed his medical training in Internal Medicine, Cardiology and Electrophysiology at Indiana University. References:The CAST trial RECOVERY TrialMedscape – CardiologyMedscape – General MedicineBlogSubstackThis Week In Cardiology PodcastTwitter: @drjohnm______________________What is the External Medicine Podcast?The External Medicine Podcast explores some of the most exciting ideas in medicine. Co-hosted by Daniel Belkin, MD, and Mitch Belkin, MD.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

This conversation with Yuri Deigin was recorded on June 25th, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Yuri about aging, which he argues is fundamentally an epigenetic phenomenon. We discuss partial reprogramming using Yamanaka factors, evolutionary explanations of aging, and recent in vivo experiments which suggest that aging is partially reversible. We also touch on mRNA vaccines, specifically to address allegations about the cytotoxicity of the spike protein and concerns about infertility discussed on Bret Weinstein’s Dark Horse Podcast with Steve Kirsch and Robert Malone, MD, recorded on June 11th 2021.Who is Yuri Deigin?Yuri Deigin is a biotech entrepreneur with a background in pharmaceutical development. He received degrees in computer science and mathematics from the University of Toronto and an MBA from Columbia University. He is the CEO of Youthereum Genetics, a company which aims to translate epigenetic rejuvenation therapies to humans. Yuri was an early proponent of the SARS-CoV-2 lab leak hypothesis, the idea that the virus may have inadvertently escaped from a lab. In April 2020, he published a detailed genomic analysis of SARS-CoV-2. In that article, Yuri discusses the virus’s furin cleavage site, genetic similarities and differences with its closest relative (RaTG13), and the similarities between the virus’s receptor binding motif and that of a pangolin respiratory virus. He also explores the gain-of-function research program at the Wuhan Institute of Virology. Unfortunately, we did not have time in this conversation to delve into this hotly debated topic.References:Universal methylation age across mammalian speciesPartial reprogramming of Progeria miceDavid Sinclair paper on restoring vision in miceUri Manor Lab spike protein paper Large doses of Spike Protein Induce Acute Lung Injury in MicePfizer ADME study (translated from Japanese) Vaccine Adverse Event Reporting System (VAERS) FAQ re: requirement to report deaths, other serious adverse eventsHow frequently are side effects reported to VAERS?More on Yuri:Medium article on SARS-CoV-2 OriginsYuri’s twitter: @ydeigin_____________________________________What is the External Medicine Podcast?The External Medicine Podcast explores some of the most exciting ideas in medicine. Co-hosted by Daniel Belkin, MD, and Mitch Belkin, MD.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon

This conversation with Dr. Bryan Carmody was recorded on June 21st, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Dr. Carmody about the history of the USMLEs, the value of standardized test scores, and the arms race in the residency admissions process. They touch on conflict of interest in medical education and the rising cost of medical schools among other topics.If you enjoy this episode, please follow us on twitter @ExMedPod and subscribe to our newsletter.Who is Bryan Carmody?Dr. Bryan Carmody is a pediatric nephrologist at Eastern Virginia Medical School. He has made a name for himself as a critic of certain aspects of medical education and the residency application process. For years, he has argued that USMLE Step 1 should go pass-fail and that Step 2 CS should be eliminated — both of these events happened in the last year and a half. Campbell’s law:Campbell’s law comes from Donald Campbell, a psychologist and social scientist from the mid-20th century.In 1976, Campbell wrote: “Achievement tests may well be valuable indicators of general school achievement under conditions of normal teaching aimed at general competence. But when test scores become the goal of the teaching process, they both lose their value as indicators of educational status and distort the educational process in undesirable ways.” For instance, there are now entire school curricula devoted to improving test scores. This obviously wasn’t the original intention. References:Radiology Journal Article: “Do residency selection factors predict radiology resident performance?” This article finds a fairly modest association between USMLE score and discordance rates between preliminary resident reads of radiologic findings and the final attending interpretation. This was for residents at UPMC. https://pubmed.ncbi.nlm.nih.gov/29239834/Paul Graham: The podcast references his essay, The Lesson to Unlearn.More on Dr. Carmody:Youtube video on capping residency applications: Dr. Carmody’s Youtube channelTwitter link: @jbcarmody Sheriff of Sodium blog____________________________________________________What is the External Medicine Podcast?The External Medicine Podcast explores some of the most exciting ideas in medicine. Co-hosted by Daniel Belkin, MD, and Mitch Belkin, MD.Support the showFollow us at @ExMedPod Subscribe to our Youtube channelConsider supporting us on Patreon