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The episode starts with Louise sounding an alarm about the rate of growth for cirrhosis and bridging or advanced cirrhosis. She is concerned that as more data is collected, an increasing number of lives fail to be served with the passage of time. She then mentions a talk by Oxana Drapkina from Session 1 about how the Russian system operates. On the surface, this sounds to be more efficient than Western approaches.

Next, Jeff and Jörn share their thoughts and satisfaction on the closing session, in which both participated. The diversity of regional challenges and the varied positions of the panelists led to a lively and far-reaching discussion. In response to a question from Jörn, Jeff expands on what he learned while working on food policy in the Obama White House.

In the final part of this episode, Roger raises a few issues of interest. He discusses the ability to educate and work more quietly in Congress than in public venues. He also mentions the value of educating physicians to think of Fatty Liver issues when treating other metabolic patients. Louise joins to consider the idea that while different specialties look down organ silos, reality often presents an integrated metabolic challenge.