MD Newsline Metabolic Brief

In this episode of MD Newsline, Dr. Dillon Bannis, an OB-GYN practitioner based in the South Side of Chicago, shares his insights on the evolving challenges and innovations in obstetric and gynecological care. Dr. Bannis explores how listening, collaboration, and technology are reshaping the patient experience—from prenatal care and delivery practices to addressing health disparities and integrating AI into medicine.

With a strong emphasis on patient-centered communication, interdisciplinary collaboration, and technological integration, Dr. Bannis highlights how practitioners can balance innovation with compassion in women's healthcare.

Episode Highlights:

Bridging the Gap Between Innovation and Implementation Dr. Bannis discusses the lag between medical innovation and real-world practice, citing examples such as updated cervical cancer screening guidelines. He stresses that while medicine continues to advance rapidly, implementation often lags behind, emphasizing the need for better education, awareness, and adaptability among clinicians.

The Power of Listening in Patient Care According to Dr. Bannis, listening is one of the most underrated skills in medicine. By prioritizing patient voices, physicians can build stronger relationships and facilitate shared decision-making, leading to more trusting and effective care outcomes.

Advances in Obstetric Technology Dr. Bannis highlights promising innovations aimed at reducing maternal morbidity and mortality, particularly through hemorrhage prediction and prevention technologies. These tools, he explains, are transforming labor and delivery outcomes across practices.

Cultural Competence and Birth Planning Drawing from his experience working alongside certified nurse midwives, Dr. Bannis advocates for respecting patients' birth preferences, whether it's squatting, all-fours positions, or doula-assisted births. He believes honoring cultural diversity in birthing methods contributes to better physical and emotional outcomes.

Collaborative Care for High-Risk Pregnancies In complex cases involving oncology or high-risk pregnancies, Dr. Bannis underscores the importance of seamless communication between community and academic hospitals. He explains that efficient information sharing and inter-institutional collaboration can prevent medical errors and ensure no patient "falls through the cracks."

Socioeconomic Factors and Health Disparities Dr. Bannis addresses how socioeconomic status affects access to prenatal care, nutrition, and birth outcomes. He calls for systemic efforts to tackle the social determinants of health and to make preventive screening more accessible to underserved populations.

Empowering Patients Through Technology He emphasizes the importance of giving patients ownership of their medical records and using digital tools for education and engagement. By involving families and support systems, technology can enhance adherence, understanding, and long-term health outcomes.

AI and the Future of Medical Communication Dr. Bannis envisions AI as a bridge between medical jargon and patient comprehension—translating complex medical notes into accessible summaries and breaking down language and cultural barriers. He also discusses how AI can streamline research and accelerate innovation in women's health.

From Doulas to Robotics: The Expanding Role of Innovation Dr. Bannis explores the complementary roles of doulas, midwives, and robotic-assisted surgeries in modern OB-GYN care. He highlights that the field is moving from invasive solutions like hysterectomy toward minimally invasive and patient-preserving approaches, including uterine fibroid embolization.

Key Takeaway:

Dr. Dillon Bannis emphasizes that true progress in women's health lies at the intersection of empathy and innovation. By actively listening to patients, embracing technological advancement, and addressing health disparities, practitioners can create a more equitable, efficient, and compassionate healthcare system for all.

Resources:

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In this episode of MD Newsline, Dr. Wanda Averhart, a general pediatrician and obesity medicine specialist, explores the complex causes and lifelong impacts of childhood obesity, emphasizing how early feeding practices, maternal health, and social disparities shape children's long-term outcomes.

Dr. Averhart provides a comprehensive look at how environmental, cultural, and biological factors contribute to rising obesity rates among children—especially in underrepresented communities. She discusses the importance of infant feeding patterns, maternal diabetes and stress, and access to nutrition in determining early weight trajectories. Her insights reveal that addressing obesity begins before birth, and that family education and community-based interventions are key to prevention.

Episode Highlights:

Understanding Childhood and Infant Obesity Dr. Averhart explains that while "infant obesity" isn't technically defined, early feeding habits play a crucial role in a child's risk for obesity. Factors such as maternal health during pregnancy, feeding type, and cultural feeding practices all influence growth and metabolic outcomes.

The Role of Feeding Practices and Culture From breastfeeding and formula feeding to early solid food introduction, Dr. Averhart emphasizes how cultural norms and parental beliefs shape feeding behavior. Introducing solid foods too early—especially high-sugar or fried foods—can increase obesity risk later in life.

Environmental and Socioeconomic Factors She discusses how food deserts, limited access to fresh produce, and economic barriers make it difficult for many families to follow nutritional guidelines. Dr. Averhart highlights programs like WIC and SNAP that can provide critical nutritional support.

Maternal Health and Stress Dr. Averhart outlines how maternal obesity, diabetes, and stress can biologically influence a child's future weight and metabolism through hormonal pathways like cortisol. She also connects maternal mental health to early childhood nutrition and caregiving quality.

The Rise of Pediatric Comorbidities She notes an alarming increase in fatty liver disease, hypertension, and prediabetes among children—conditions once rare in pediatrics. These comorbidities disproportionately affect Black and Hispanic children and those from low-income households.

Emerging Treatments and Future Research Dr. Averhart discusses the growing field of pediatric obesity treatment, including the use of GLP-1 receptor agonists (like semaglutide) in adolescents. However, she stresses that compassion, education, and prevention remain the most effective strategies.

Key Takeaway: Dr. Averhart calls on healthcare providers to approach obesity with empathy and understanding, recognizing it as a chronic, relapsing condition. She encourages clinicians to combine medical management, cultural awareness, and community engagement to support children and families most at risk.

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Connect with Dr. Wanda Averhart: Here

In this episode of MD Newsline, Dr. Sassan Mirfakhraee, adult endocrinologist and associate professor at the University of Texas Southwestern Medical Center, shares groundbreaking insights into the management of adrenal insufficiency. At the Endocrine 2025 conference, Dr. Mirfakhraee presented his research on utilizing insulin pumps to deliver hydrocortisone—an innovative off-label approach that is showing promising results for patients who remain symptomatic on oral therapy.

He explains how this strategy better mimics the body's natural cortisol rhythm, improves quality of life, and reduces ER visits and hospitalizations for patients with persistent symptoms. Dr. Mirfakhraee also outlines patient selection criteria, training protocols, safety considerations, and the potential for remote monitoring via pump data.

This conversation highlights the importance of personalized care in endocrinology, bridging innovation with clinical practice to improve outcomes for patients with challenging conditions.

Episode Highlights:

New Approach to Adrenal Insufficiency Dr. Mirfakhraee introduces the use of insulin pumps for hydrocortisone infusion, addressing limitations of oral steroids that often fail to fully resolve symptoms.

Mimicking Cortisol's Natural Rhythm The pump allows for overnight delivery and tailored boluses, reducing symptoms such as dizziness, nausea, fatigue, and morning crashes that patients often face with oral therapy.

Patient Selection and Benefits He outlines which patients may benefit most—those with persistent symptoms, frequent adrenal crises, malabsorption issues, or shift-work challenges—while ensuring other conditions are ruled out.

Remote Monitoring and Safety Insulin pumps enable cloud-based data sharing, allowing clinicians to monitor dosing, adjustments, and stress dosing remotely. While generally safe, clinicians must remain vigilant for issues like skin infections or infusion interruptions.

Training and Quality of Life Through support from diabetes educators, patients learn how to manage pump settings and troubleshoot. Many report dramatic improvements—returning to work, engaging in family life, and regaining independence.

Future Research Needs Dr. Mirfakhraee stresses the need for standardized pump settings, broader data collection, and insurance approval pathways to make this therapy more accessible.

Key Takeaway:

Insulin pump-based hydrocortisone delivery offers a promising new avenue for patients with adrenal insufficiency who remain symptomatic on oral therapy. By improving quality of life, reducing crises, and allowing for tailored dosing, this approach may represent a paradigm shift in endocrine care.

Resources:

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Connect with Dr. Sassan Mirfakhraee: Here

In this episode of MD Newsline, Dr. Alyson K. Myers, endocrinologist and Associate Chair for Faculty Mentoring and Community Engagement at Montefiore in the Bronx, dives into one of the most pressing and underrecognized complications of diabetes: diabetic foot ulcers (DFUs) and the devastating risk of amputations. She discusses the intersection of clinical care, social determinants of health, and healthcare disparities, while also highlighting emerging technologies and multidisciplinary clinic models designed to reduce risks and improve patient outcomes. Drawing on her extensive experience in diabetes management and community engagement, Dr. Myers emphasizes both the urgent need for systemic change and the practical tools clinicians can use today to protect their patients. Episode Highlights:

High Amputation Risk in Diabetic Foot Ulcers Dr. Myers shares sobering statistics, noting that 44% of patients who present with a diabetic foot ulcer undergo an amputation within five years. This reality highlights the urgency of early screening, prevention, and intervention in diabetes care. She stresses that DFUs are not only medical complications but also markers of systemic inequity and missed opportunities for prevention.

The Role of Social Determinants of Health Dr. Myers explores how socioeconomic status, racial disparities, and provider bias profoundly shape patient outcomes. In the Bronx and other underserved areas, patients often face delays in diagnosis, limited access to care, and inconsistent follow-up, all of which contribute to worse outcomes. She emphasizes the importance of addressing these systemic barriers alongside clinical treatment.

Innovative Technology for Prevention Emerging tools, such as thermal-sensing mats and sensor-equipped socks, offer promising ways to identify foot ulcers before they progress. These devices can detect subtle temperature changes that indicate early tissue damage, allowing patients and providers to intervene earlier. Dr. Myers highlights the potential of technology to improve adherence and reduce disparities by making self-care more accessible.

Building Multidisciplinary DFU Clinics Dr. Myers describes the creation of a multidisciplinary DFU clinic in the Bronx, modeled after programs at institutions like Stanford. By integrating endocrinology, podiatry, vascular surgery, infectious disease, and behavioral health, this model ensures that patients receive comprehensive, coordinated care. She explains how this approach can drastically reduce amputation rates and improve long-term patient outcomes.

Patient and Caregiver Education Education remains a cornerstone of DFU prevention. Dr. Myers emphasizes strategies such as ensuring patients wear proper footwear, involving caregivers and family members in diabetes care, and simplifying self-care routines. She points out that community-based education and culturally sensitive approaches are essential for building trust and improving adherence.

Advocacy and Policy Change Beyond clinical care, Dr. Myers stresses the importance of advocacy and systemic reform. She calls for insurance coverage expansion for proven therapies, including GLP-1 receptor agonists and PAD (peripheral arterial disease) screenings, which can significantly improve outcomes. Her message is clear: reducing disparities in diabetes care requires action at every level—from the exam room to healthcare policy.

Key Takeaway:

Diabetic foot ulcers are a leading cause of amputation, yet they remain preventable with the right tools and care models. Through early detection technologies, multidisciplinary clinics, culturally sensitive education, and equitable access to therapies, healthcare providers can dramatically improve patient outcomes and close persistent gaps in diabetes care.

Resources:

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Connect with Dr. Alyson K. Myers:LinkedIn

In this episode of MD Newsline, Dr. Rachael Sood, a diabetes nurse practitioner and certified diabetes care and education specialist from New Orleans, Louisiana, shares her insights from the 85th American Diabetes Association Scientific Sessions. As the founder of The Diabetes Collective, Dr. Sood discusses the evolution of diabetology—a specialized field focused solely on the identification, treatment, and management of diabetes across all patient populations.

Dr. Sood explores how personalized diagnostics, innovative technology, and education-driven care models are reshaping outcomes for patients with type 1, type 2, and prediabetes. She highlights the importance of accurate diagnosis, the role of genetic predisposition, and why clinicians must move beyond relying solely on hemoglobin A1C levels to ensure proper disease identification and management.

Episode Highlights:

Transforming the Diagnosis and Management of Diabetes Dr. Sood explains the principles of diabetology and how it differs from traditional endocrinology. She emphasizes comprehensive assessment, including antibody screening, glucose monitoring, and the integration of genomic insights to accurately distinguish between type 1 and type 2 diabetes.

Technology as a Game-Changer in Diabetes Care Dr. Sood shares how continuous glucose monitors (CGMs) and insulin pumps have revolutionized real-time patient engagement. These smart biosensors empower patients to understand how lifestyle, stress, and nutrition directly affect glucose levels, fostering self-awareness and adherence to treatment plans.

Overcoming Clinical Inertia and Patient Barriers She highlights the need to address clinical inertia, encouraging clinicians to adapt treatment plans as patients' needs evolve. Dr. Sood underscores the importance of patient education, empathy, and collaboration with family and community networks to improve adherence and reduce care fatigue.

Breakthroughs in Treatment and Research Reporting from the ADA conference, Dr. Sood discusses the promising results of Vertex Pharmaceuticals' islet cell therapy, which shows evidence of restoring natural insulin production in type 1 diabetes. She also explains the role of TZLD (teplizumab) in delaying the onset of type 1 diabetes, potentially changing the disease trajectory for high-risk patients.

Next-Generation Therapies and GLP-1 Innovation Dr. Sood breaks down the expanding role of GLP-1 receptor agonists—from glucose regulation to benefits in cardiovascular health, weight management, and chronic kidney disease. She reveals data on the new CagreSema combination therapy, which combines semaglutide with an amylin analog, showing over 20% weight reduction and improved metabolic outcomes.

Insurance and Access Challenges Dr. Sood addresses the ongoing struggle of insurance coverage, prior authorizations, and high costs for new medications, offering practical advice for clinicians and patients to navigate access through manufacturer programs and cash-based options.

Key Takeaway: Dr. Sood emphasizes that diabetes care is entering a transformative era—one defined by early detection, patient empowerment, and precision medicine. With new therapies, technologies, and care models emerging rapidly, collaboration among clinicians, patients, and innovators will be essential to achieving long-term success in diabetes prevention and management.

Link & Resources:

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Connect with Dr. Rachael Sood: Here

In this episode of MD Newsline, Dr. Sarimar Agosto Salgado, Oncologic Endocrinologist at Moffitt Cancer Center, shares insights from a panel discussion at the AACE 2025 conference on the complexities of advanced thyroid cancer. She explores case-based approaches to recurrent, radioactive iodine-refractory disease and introduces the evolving strategy of re-differentiation therapy—a promising method for resensitizing tumors to radioactive iodine.

Dr. Salgado also highlights real-world challenges including diagnostic errors, late referrals, and the need for greater access to multidisciplinary care.

Episode Highlights:

Understanding Radioactive Iodine-Refractory Disease Dr. Salgado explains that a subset of thyroid cancer patients no longer respond to radioactive iodine due to disease progression. For these patients, careful monitoring, local therapies like SBRT, or systemic treatments become necessary depending on the tumor's growth and location.

Re-differentiation Therapy Explained She introduces re-differentiation—a technique using short-term targeted therapy (e.g., BRAF inhibitors) to restore the tumor's ability to uptake radioactive iodine. This allows for additional rounds of treatment and may delay or reduce the need for long-term systemic therapy.

The Role of Real-World Data and Registries Because prospective clinical trials remain limited, Dr. Salgado advocates for collecting data through real-world registries and academic collaborations. These efforts may help define optimal timing, predictive markers, and response indicators for re-differentiation therapy.

Challenges in Diagnosis and Timely Referral Dr. Salgado reflects on misdiagnosed cases, including rare thyroid variants confused with neuroendocrine tumors. She emphasizes the importance of early referral to expert centers before treatment limits available options.

Access and Equity in Advanced Thyroid Cancer Many patients lack access to high-volume thyroid teams, leading to missed opportunities. Dr. Salgado urges clinicians to prioritize expert pathology review, molecular testing, and full-neck imaging to avoid delays in diagnosis and care.

Key Takeaway:

Advanced thyroid cancer is complex and often underestimated. Early referral, precision strategies like re-differentiation, and equitable access to expert teams are critical to improving outcomes and expanding hope for patients with this challenging disease.

Resources & Links:

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Connect with Dr. Sarimar Agosto Salgado: Here

In this episode of MD Newsline, Dr. Omolara G. Adeniran, an endocrinologist practicing in Florida, shares her frontline experience addressing the complex realities of diabetes management, technology hesitancy, and healthcare disparities. Drawing on insights from the American Association of Clinical Endocrinology (AACE) conference, Dr. Adeniran discusses lipodystrophy, CGM technology, and how to navigate social determinants of health in real-world patient care.

Episode Highlights:

Recognizing Lipodystrophy and Treatment Overlap

Dr. Adeniran highlights a key learning from the conference—a lecture on differentiating lipodystrophy from Cushing syndrome, a diagnostic challenge due to overlapping features. She shares how improved understanding of this rare condition can lead to significant improvement in comorbidities like severe insulin resistance and hypertriglyceridemia once correctly identified and treated.

Breaking Down Technology Barriers with CGMs Continuous glucose monitoring (CGM) remains underutilized due to patient fears and insurance limitations. Dr. Adeniran explains her approach: providing demo models, offering trial periods, and giving reassurance about data privacy to help patients gain comfort with technology and improve their diabetes self-management.

Navigating Insurance, Food Access, and Cultural Habits Insurance coverage, food deserts, and cultural food practices remain major obstacles. Dr. Adeniran shares strategies for working with patients in lower-resource settings, including promoting portion control, pragmatic dietary substitutions, and encouraging family involvement in nutrition and care.

Engaging Patients in Shared Decision-Making From discussing A1C levels to blood pressure trends, Dr. Adeniran emphasizes making data relatable. She walks patients through lab comparisons over time and links clinical numbers to how they feel—helping them take ownership of their health. Emotional support and patient storytelling help reinforce behavior change.

The Power of Listening and Small Steps According to Dr. Adeniran, patient progress starts with empathetic listening. She urges clinicians to hear the small clues that lead to big breakthroughs. Whether managing obesity, thyroid conditions, or diabetes, she believes in celebrating small wins and meeting patients where they are—both medically and personally.

Key Takeaway:

Effective endocrine care hinges on trust, technology, and tailored solutions. From CGM adoption to dietary adjustments, empowering patients with education and empathy is key to closing gaps and improving outcomes.

Resources & Links:

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Connect with Dr. Omolara Adeniran: Here

In this episode of MD Newsline, Dr. Kamrun Naher, an endocrinologist based in Brooklyn, shares two compelling case studies that highlight how seemingly psychiatric symptoms and subtle complaints can conceal serious endocrine disorders. She recounts a rare case where suicidal behavior and insomnia led to the discovery of a neuroendocrine tumor in the pancreas, as well as a cluster of unexpected diagnoses of pheochromocytoma—a rare tumor of the adrenal glands.

Dr. Naher underscores the need for multidisciplinary collaboration, greater awareness among providers, and earlier patient education to prevent delayed diagnoses and potentially life-threatening complications.

Episode Highlights:

Unmasking a Neuroendocrine Tumor

A patient initially treated for psychiatric symptoms—including depression and insomnia—was ultimately found to have hypoglycemia-induced neuroendocrine tumor in the pancreas. Dr. Naher explains how a cascade of symptoms and an incidental CT scan led to a life-changing diagnosis and surgical treatment.

Mental Health vs. Medical Misdiagnosis This case prompts a broader discussion on the importance of not attributing all behavioral health crises to psychiatric origins. Symptoms like insomnia and depression may sometimes be manifestations of metabolic or endocrine issues such as insulin-producing tumors.

Pheochromocytoma in the Real World Dr. Naher reflects on a series of pheochromocytoma cases she diagnosed within one month—despite never seeing any during her fellowship. The episodic symptoms—palpitations, sweating, and chest pain—were often dismissed as normal or unrelated. These cases show how pattern recognition and detailed patient questioning can make a diagnostic difference.

Preventing Missed Diagnoses Through Simple Questions Dr. Naher advocates for providers to ask patients: "What feels unusual or not normal to you?" This one question, she argues, could bring hidden symptoms to light and lead to earlier detection of rare but serious conditions.

Data Collection and Global Awareness She also shares her vision for creating a global hub for rare case data, aiming to gather insight from providers worldwide to better identify trends, recognize genetic syndromes like MEN1, and promote broader awareness.

Key Takeaway:

Not every psychiatric symptom is psychiatric in origin. Early intervention, cross-disciplinary collaboration, and asking the right questions can uncover life-threatening endocrine disorders—and change the course of care.

Resources & Links:

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Connect with Dr. Kamrun Naher: Here

In this episode of MD Newsline, Dr. Jamie Almandoz, Associate Professor at UT Southwestern Medical Center and Medical Director of the Weight Wellness and Obesity Medicine Program, discusses the evolving science of post-bariatric weight management, the rising use of GLP-1 medications, and the role of multidisciplinary care in treating obesity as a chronic illness. He shares practical insights into weight regain after bariatric surgery, how medications can support long-term outcomes, and the importance of nutrition, mental health, and individualized care.

Episode Highlights:

Understanding Post-Bariatric Weight Regain Dr. Almandoz explains why obesity is not cured by surgery and how weight regain—up to 40% on average—is common due to metabolic adaptation, hormonal shifts, and anatomical changes. He emphasizes the need to redefine success by health improvement, not just weight loss.

The Role of GLP-1 and Incretin Therapies GLP-1 receptor agonists and other medications have become powerful tools in obesity management. Dr. Almandoz discusses their potential to support both pre- and post-surgical patients, how they affect hunger and calorie intake, and their limitations, including malnutrition risks and bone density concerns.

Nutrition and Long-Term Risks Dr. Almandoz warns of malnutrition and lean mass loss among patients using potent weight-loss medications, especially when combined with low-quality diets. He highlights the need for dietary counseling, micronutrient screening, and follow-up—particularly for postmenopausal women and those with chronic illness.

Multidisciplinary Care and Mental Health From registered dietitians to primary care providers, a coordinated care team is key. Dr. Almandoz advocates for mental health screening, SMART goal-setting, and destigmatized obesity treatment, recognizing that each patient's health goals and progress vary.

Personalized and Precision Medicine in Obesity As newer medications target different biological pathways, Dr. Almandoz calls for a precision approach to obesity care—matching treatment combinations to the individual's physiology, comorbidities, and life context, rather than applying a one-size-fits-all model.

Key Takeaway:

Obesity is a chronic disease requiring lifelong care. Neither surgery nor medication alone is curative—personalized, multidisciplinary strategies that address nutrition, mental health, and physical health are essential to improving outcomes and quality of life.

Resources & Links:

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Connect with Dr. Jamie Almandoz: LinkedIn

In this episode of MD Newsline, Dr. Janelle Duah, a specialist in internal medicine, obesity, and lifestyle medicine, discusses the evolving understanding of obesity as a chronic disease rather than a personal failing. She explains the neurobiological, physiological, psychological, and environmental factors that contribute to weight gain, highlighting why traditional methods of diet and exercise alone often fail. Dr. Duah also explores the latest FDA-approved weight loss medications, the impact of gut microbiome on obesity, and how personalized treatment plans can lead to better patient outcomes. Episode Highlights:

Understanding Obesity as a Chronic Disease

Obesity is no longer seen as simply a result of poor diet and lack of exercise. It is now recognized as a chronic, relapsing disease influenced by genetics, hormones, gut microbiome, and environmental factors. The brain's hypothalamus regulates body weight through a set point that is affected by external inputs such as food quality, stress levels, medications, and even media exposure. This obesogenic environment makes weight management more complex than ever.

The Gut Microbiome's Role in Weight Regulation

Dr. Duah explains how gut bacteria composition differs between individuals with obesity and those with normal weight, influencing metabolism, inflammation, and energy storage. Research has even explored fecal microbiota transplants as a potential intervention, though diet and lifestyle adjustments remain key in optimizing gut health. She highlights the importance of fiber intake, reducing inflammatory foods, and supporting beneficial gut bacteria for effective weight management.

Treatment Options: Medications and Beyond

The landscape of obesity treatment has expanded significantly, with FDA-approved medications proving to be effective alternatives to surgery. GLP-1 receptor agonists, such as Ozempic (semaglutide) and Zepbound (tirzepatide), have revolutionized obesity management by helping patients lose 15–40% of their body weight while also benefiting metabolic health. Dr. Duah discusses the benefits and limitations of weight loss medications, including their impact on hormones, cognitive function, and inflammation-related conditions like PCOS and perimenopause.

The Future of Obesity Treatment

Looking ahead, Dr. Duah envisions a future where obesity is fully recognized as a medical condition, leading to greater insurance coverage for effective treatments. She hopes to see fewer weight-related comorbidities, reduced stigma, and better education for both patients and healthcare providers. She also emphasizes the importance of personalized medicine in tailoring treatments to each individual's genetics, lifestyle, and health goals. Key Takeaway: Obesity is a chronic disease influenced by genetics, hormones, gut health, and environmental factors—not just diet and exercise. New treatments, including GLP-1 medications, offer effective weight management solutions. Greater awareness, personalized care, and improved access to treatments can help reduce obesity-related health risks.

Resources & Links:

Website: MD Newsline Newsletter: Subscribe Here

Connect with Dr. Janelle Duah: Yale School of Medicine