Excessive Daytime Sleepiness (EDS), a condition affecting approximately one-third of Americans, has traditionally been linked to insufficient sleep, disorders like obstructive sleep apnea (OSA), or medication side effects. However, recent research suggests that our eating habits and body chemistry could play a much more significant role than previously thought . A groundbreaking study, published in Lancet eBioMedicine  and led by scientists from Mass General Brigham and Beth Israel Deaconess Medical Center, has identified specific molecules in the blood, known as metabolites, that correlate directly with EDS . These metabolites, influenced by both diet and hormones, reveal a complex interplay between lifestyle, biology, and daytime alertness. To ensure consistency, the findings were replicated in other large studies in the U.S., U.K., and Finland, reinforcing their validity. The research team analyzed nearly 900 metabolites from blood samples of almost 6,000 participants in the Hispanic Community Health Study/Study of Latinos, complementing this information with questionnaires measuring how often people fall asleep during the day. They identified seven metabolites linked to EDS , plus three additional ones that differed by sex. The most notable results include: Lower risk of EDS:   Omega-3 and omega-6 fatty acids , nutrients abundant in Mediterranean-style diets, were associated with a reduced risk of daytime sleepiness. Additionally, lipids such as linoleic acid and sphingomyelins showed a negative association with EDS. Higher risk of EDS:  Certain compounds like tyramine , found in fermented or overripe foods, correlated with higher rates of EDS, especially in men. Hormonal influence:  Links were also observed between sex hormones like progesterone  and sleep-related processes such as melatonin production, underlining the role of hormones in regulating sleep-wake cycles. Steroid hormone biosynthesis was a central process in the biological pathways connected with EDS. These discoveries suggest that diet and genetics may be important factors in EDS . Tariq Faquih, lead author of the study, emphasizes that understanding these biological mechanisms brings us closer to identifying the early signs of EDS and developing new ways to help patients. EDS is more than just an annoyance; it has been linked to an increased risk of cardiovascular disease, obesity, and diabetes . Current treatment strategies typically focus on improving sleep hygiene, treating sleep apnea with CPAP machines, or adjusting medications. However, this new research opens the door to alternative intervention strategies, such as dietary changes or medications targeting specific metabolites . Although the study has some limitations, such as the difficulty in interpreting the exact values of metabolites and the use of questionnaires instead of sleep lab testing, researchers plan future clinical trials to evaluate whether dietary adjustments or supplement use can reduce symptoms . In summary, the research highlights that sleepiness may not depend solely on the amount of time we spend in bed, but also on what is happening inside our bodies, influenced by a variety of lifestyle choices . 🔖 Sources Seven blood metabolites associated with excessive daytime sleepiness Excessive Daytime Sleepiness Might Be Linked to Our Diets, According to Our Blood Extra Tired During the Day? Certain Fats May Help

A deadly Legionnaires' outbreak  has shaken Central Harlem, raising the death toll to five  and affecting 108 people , with 14 individuals still hospitalized. New York City faces one of its worst situations since the 2015 outbreak, which claimed 16 lives. Legionnaires' is a severe form of pneumonia  caused by Legionella  bacteria. While the bacteria naturally occur in streams, creeks, and lakes, they can proliferate to dangerous levels in warm, artificial environments such as hot tubs, humidifiers, fountains, pools, and, crucially for this outbreak, cooling towers . Health officials believe most of the sick individuals became ill after inhaling bacteria sprayed from these towers. To date, 12 cooling towers  across 10 properties in Central Harlem have tested positive for Legionella  bacteria, including locations like Harlem Hospital. All affected towers have been drained, cleaned, and disinfected. However, an analysis revealed that all but one of these locations had cooling towers that were either behind on mandatory testing or had not been inspected by the city in the past year. The city is still awaiting DNA sequencing results to conclusively link the bacteria from the towers to the ongoing infections. Legionnaires' symptoms, which typically appear between two days and two weeks after exposure, resemble those of the flu : fever, chills, muscle aches, headaches, dry cough, and shortness of breath. Gastrointestinal symptoms such as nausea and diarrhea can also occur. While most healthy people exposed do not get sick, high-risk groups  include individuals aged 50 and older, current and former smokers, and those with weakened immune systems or chronic conditions like cancer, lung disease, diabetes, or kidney and liver failure. The disease tends to worsen during the first week, and severe cases can lead to lung failure and heart damage; approximately one out of every 10 people who gets sick will die . It is important to note that Legionnaires' is not contagious from person to person . Health officials anticipate possible additional cases  as people become aware and seek medical attention. Despite this, the number of new cases has begun to decline, suggesting the source has been contained. The city has assured residents that it is safe to continue drinking water, bathing, showering, cooking, and using air conditioning . Dr. Emily Abdoler advises anyone living or working in an affected area to consult a healthcare provider immediately if they develop symptoms  such as a cough or fever. Treatment involves antibiotics , and the sooner they are started, the more effective the treatment will be. Most people who take antibiotics will recover. Legionnaires' cases have been rising over the past two decades in the U.S., with factors such as aging water systems and inadequate maintenance contributing to the increase. Authorities emphasize that the disease is completely preventable . In 2015, New York implemented a law requiring all building owners to register their water cooling towers and maintain them regularly to prevent and control Legionella  growth. Given the severity of the outbreak, a lawyer representing affected individuals called the death toll "shocking," arguing that building owners must be held accountable. A lawsuit against the construction company believed to be responsible for the outbreak is expected. Vigilance and early medical attention are crucial during this peak Legionella  season. 🔖 Sources Fifth person dies in Legionnaires' disease outbreak in Harlem as cases rise to 108 Fifth death in Central Harlem linked to Legionnaires' disease Legionnaires’ Disease Sickens Over 60 in New York. Here’s What to Know

Leading health organizations, including the American Heart Association (AHA)  and the American College of Cardiology (ACC) , have published their new 2025 guidelines for the prevention, detection, evaluation, and management of high blood pressure in adults. These guidelines, which replace those from 2017, place significant emphasis on early intervention  and lifestyle modifications  to combat a condition that affects nearly half of U.S. adults and is the leading cause of death worldwide. Dr. Daniel W. Jones, chair of the guideline writing committee, stresses that high blood pressure is the most common and most modifiable risk factor for heart disease. The new recommendations aim to help clinicians tailor strategies across a patient's lifespan to reduce the impact of heart disease, kidney disease, Type 2 diabetes, and dementia. The new guidelines highlight some key points. Blood Pressure Criteria:  Categories remain consistent: normal (less than 120/80 mm Hg), elevated (120-129/80 mm Hg), stage 1 hypertension (130-139/80-89 mm Hg), and stage 2 hypertension (≥140/≥90 mm Hg). Early Medication Intervention:  Drug therapy is recommended if blood pressure remains at or above 130/80 mm Hg after 3-6 months of lifestyle changes. For patients with diabetes, chronic kidney disease, or an elevated 10-year cardiovascular disease risk, pharmacological treatment should begin immediately. PREVENT™ Risk Calculator:  A significant new addition is the use of the AHA's PREVENT™ risk calculator to estimate 10- and 30-year cardiovascular disease risk. This tool integrates cardiovascular, kidney, and metabolic health, and even zip code as a proxy for social determinants of health. Link to Cognitive Health:  The guidelines reinforce evidence that high blood pressure is a risk factor for cognitive decline and dementia, recommending a systolic target of less than 130 mm Hg to prevent these conditions. The guidelines reaffirm the crucial importance of a healthy lifestyle, including: Sodium Reduction:  Limit intake to less than 2,300 mg/day, ideally moving towards 1,500 mg/day. Alcohol Consumption:  Ideally, no alcohol; if consumed, no more than two drinks per day for men and one for women. Stress Management:  Incorporate exercise, meditation, breathing control, or yoga. Healthy Weight:  Aim for at least a 5% body weight reduction if overweight or obese. Heart-Healthy Diet:  Follow a pattern like the DASH eating plan, rich in fruits, vegetables, whole grains, and low-fat dairy. Physical Activity:  At least 75-150 minutes weekly of aerobic exercise and/or resistance training. Home Monitoring:  Recommended to confirm diagnosis and track progress. Regarding medication, the possible addition of newer therapies such as GLP-1 medications  is suggested for some patients with hypertension, overweight, or obesity. Additionally, recommendations for managing blood pressure during and after pregnancy  have been updated, including treatment with certain medications starting at 140/90 mm Hg and consideration of low-dose aspirin for preeclampsia. Continuous postpartum and annual monitoring is also emphasized for women with a history of pregnancy-associated hypertension. Finally, the guidelines include changes to initial laboratory testing, such as the now universal recommendation for the urine albumin/creatinine ratio for all patients with high blood pressure. These updates aim for a more personalized and proactive approach to blood pressure management, vital for long-term heart and brain health. 🔖 Sources New 2025 guidelines focus on early intervention and lifestyle to manage high blood pressure BP Meds Should Begin Promptly, New ACC/AHA Guidelines Say Top 10 Things to Know About the New AHA/ACC High Blood Pressure Guideline New ACC/AHA Guideline Addresses Prevention, Detection, Evaluation and Management of High Blood Pressure

The healthcare sector  has always occupied a unique and often paradoxical space on Wall Street. It is a world where the altruistic mission of saving lives intersects with the cold, hard calculus of profit and loss. Its performance is tied not just to economic cycles, but to the very essence of human existence: disease, discovery, and the relentless pursuit of longer, healthier lives. This intrinsic link to our most fundamental needs gives the sector a defensive reputation, yet it is also a hotbed of speculative frenzy and innovation, capable of creating immense wealth and devastating losses. The history of healthcare on Wall Street  is a dramatic story of scientific breakthroughs, regulatory battles, demographic shifts, and world-altering pandemics. Content⁉️ 1️⃣ The Early Heartbeats 2️⃣ The Bio-Revolution 3️⃣ The New Millennium 4️⃣ The Ultimate Catalyst 5️⃣ The Future 🔖 Key Takeaways The Early Heartbeats: The Dawn of the History of Healthcare on Wall Street While the concept of healthcare is ancient, its life as a publicly-traded investment sector is a 20th-century phenomenon. The earliest entrants to the stock market were established pharmaceutical  and medical supply companies. Firms like Johnson & Johnson (which went public in 1944), Pfizer, and Merck, many of which began as small apothecaries in the 19th century, had grown into industrial powerhouses by the post-World War II era. In these early days, these companies were seen as stable, almost utilitarian investments. They produced essential goods like antibiotics, vaccines, and surgical dressings. Their growth was steady, fueled by an expanding population, rising life expectancies, and a growing trust in scientific medicine. Investors were drawn to their reliable earnings and consistent dividends. These were not the high-flying stocks of the future; they were the dependable blue-chips of the healthcare world, forming the bedrock of a sector that was just beginning to show its potential. The Bio-Revolution: A New DNA for Wall Street The 1970s and 1980s triggered a seismic shift that would forever change the healthcare investment landscape: the birth of biotechnology . The discovery of recombinant DNA technology opened up a new frontier. For the first time, scientists could engineer living organisms to produce novel drugs and therapies. This wasn't just an incremental improvement; it was a revolution. Companies like Genentech (founded in 1976) and Amgen (founded in 1980) became the pioneers of this new age. Their IPOs were met with a level of investor hysteria previously unseen in the sector. These companies often had no products and no profits, only the promise of groundbreaking science. Investing in biotech  was a bet on the future, a high-stakes gamble that a single successful drug could lead to blockbuster returns. Genentech's IPO in 1980 is legendary; its stock price rocketed from $35 to a high of $88 within the first hour of trading, a phenomenon dubbed "the pop." This era established a new paradigm: the high-risk, high-reward biotech venture, where stock prices were driven by clinical trial data, FDA approval  news, and the sheer power of hope and hype. Echoes of Ruin: Flatlining on Wall Street This speculative boom also introduced the sector to its first major "moment of ruin." The early 1990s served as a harsh reality check. President Bill Clinton’s push for comprehensive healthcare reform  sent a shockwave of fear through the market. The threat of price controls and increased government regulation caused a brutal sell-off in pharmaceutical and biotech stocks, which had enjoyed years of unchecked growth. Investors panicked, and the "biotech bubble" burst. Many fledgling companies, unable to secure funding in the now-hostile environment, went bankrupt. It was a stark reminder that in healthcare, the stroke of a legislative pen in Washington D.C. can be as impactful as a breakthrough in a laboratory. This period taught investors a crucial lesson about the sector's vulnerability to political risk. The New Millennium: Mergers, Genomics, and Maturation As the market recovered and entered the new millennium, the healthcare sector began to mature. The completion of the Human Genome Project in 2003 ushered in the era of genomics , sparking a new wave of investment in companies focused on personalized medicine and genetic diagnostics. This period was also characterized by a frenzy of mergers and acquisitions (M&A) . As big pharmaceutical companies faced patent cliffs—the expiration of patents on their blockbuster drugs—they began acquiring smaller, innovative biotech firms to replenish their pipelines. This M&A activity provided massive paydays for early investors in successful biotechs and reshaped the industry into the consolidated landscape we see today. Furthermore, the passage of Medicare Part D in 2006, a federal program to subsidize the costs of prescription drugs for seniors, provided another significant tailwind, dramatically expanding the market for many pharmaceutical products. The Ultimate Catalyst: COVID-19 and the Vaccine Race No event has highlighted the critical importance and market-moving power of the healthcare sector more than the COVID-19  pandemic. The global crisis of 2020 was both a moment of profound ruin and unprecedented opportunity. In March 2020, as the world locked down, global markets crashed, and healthcare stocks were not spared in the initial panic. However, what followed was one of the most remarkable rallies in stock market history, centered squarely on the healthcare sector. The race for a vaccine became the single most-watched event on the planet. Companies like Moderna , Pfizer , and its German partner BioNTech  went from being relatively known pharmaceutical players to household names. Their stock prices soared on every positive news release from their clinical trials. An investment in Moderna at the start of 2020 would have yielded staggering returns by the end of the year. The pandemic underscored the sector's dual nature. While hospitals and non-essential procedure providers suffered, the companies providing the tools to fight the virus—diagnostics, therapeutics, and vaccines—experienced a once-in-a-generation boom. The world's attention was fixed on the pronouncements of CEOs and the data from clinical trials. Never before had the fate of the global economy and human society been so directly tethered to the success of a handful of healthcare companies. The pandemic truly showed the world the pulse of the market, with every beat and flutter of the healthcare sector dictating the rhythm of the recovery. The Future: AI, Health Tech, and New Challenges Today, the healthcare sector stands at another crossroads. The post-pandemic world is grappling with new challenges, including inflation and renewed regulatory scrutiny on drug pricing. Yet, innovation continues at a blistering pace. Artificial intelligence (AI)  is revolutionizing drug discovery, promising to shorten timelines and reduce costs. The health tech  sub-sector is booming, with digital health platforms, wearable devices, and telehealth services becoming increasingly integrated into our lives. Personalized medicine, once a distant dream, is now a reality for treating certain cancers and rare diseases. The history of healthcare on Wall Street is a compelling narrative of human ingenuity and market dynamics. It reflects our greatest fears and our most profound hopes. From the steady dividends of early pharmaceutical giants to the speculative fervor of the biotech revolution and the world-stopping urgency of the COVID-19 pandemic, the sector has proven to be as volatile as it is vital. It remains a place where investors can do well by doing good, but where the risks are as potent as the potential rewards. Its story is far from over, and its rhythm will continue to be a crucial indicator of the health of our world and our wealth. 🔖 Key Takeaways Defensive and Innovative:  The healthcare sector combines the stability of providing essential services with the high-growth potential of scientific innovation, making it a unique component of any investment portfolio. Driven by Catalysts:  Unlike other sectors, healthcare stock prices are heavily influenced by specific binary events, such as FDA approval , clinical trial results, and scientific breakthroughs. Vulnerable to Regulation:  Political and regulatory changes, particularly regarding healthcare reform  and drug pricing, represent a significant and recurring risk for the sector, capable of causing major downturns. The Rise of Biotech:  The emergence of biotechnology  in the 1980s fundamentally changed the sector, introducing a high-risk, high-reward investment model based on future scientific promise. M&A is a Major Force:  Large-scale mergers and acquisitions  are a constant feature of the industry, as large companies acquire smaller innovators to fuel growth and replenish drug pipelines. Pandemic as an Accelerator:  The COVID-19  pandemic acted as an unprecedented catalyst, highlighting the sector's critical importance and creating enormous value in vaccine and diagnostics companies in record time. The Future is Tech-Driven:  The next chapter of healthcare investing will likely be dominated by technology, with AI in drug discovery , digital health tech , and personalized medicine leading the way.

Education is a fundamental right and an essential condition for the development of children, adolescents, and adults. However, the rapid pace of technological change complicates the adaptation of educational systems and significantly impacts how students learn, teachers teach, and parents engage. In all countries, a demonstrated and applied pedagogical methodology is used, tailored to their political, ideological, economic, geographic, and social conditions. This is why there is a noticeable difference between the educational systems of one country and another. The mission of the U.S. Department of Education is to ensure equal access to education, promote educational excellence nationwide, and improve the teaching and learning system. Although there is no national education law, each state is responsible for organizing, administering, and evaluating its own educational system. In the country, there are three types of educational institutions: - Public Educational Centers: These are schools with free enrollment for all students. - Private Educational Centers: These are institutions with paid enrollment for all students. - Charter Schools: These are autonomous public and free schools. Content⁉️ 1️⃣Organization of Teaching 2️⃣Differences Between University and College 3️⃣Grading System 4️⃣Evaluation System Organization of Teaching Education in the United States is organized by levels within the educational system, which, at the federal level, consists of: - Preschool Education: This includes daycare and preschool. Daycare starts after the child is a few months old, and preschool can begin from the age of two. This education is not mandatory and focuses on preparing children for the school environment and developing basic social and cognitive skills.   - Elementary Education: This level, also known as elementary school, is mandatory and starts at age 5 or 6, depending on the state. It teaches fundamental skills in reading, writing, and mathematics, as well as basic concepts in science, art, social studies, and physical education. This level is divided into grades, from kindergarten to fifth or sixth grade, depending on the school district.   - Grade 1: Children aged 6.   - Grade 2: Children aged 7.   - Grade 3: Children aged 8.   - Grade 4: Children aged 9.   - Grade 5: Children aged 10. - Secondary Education:   - Middle School (or Junior High School): Students attend middle school from grade 6 to grade 8 and may have different teachers throughout the day. They learn subjects such as English, mathematics, science, and social studies.     - Grade 6: Students aged 11.     - Grade 7: Students aged 12.     - Grade 8: Students aged 13.     - High School: This level is mandatory and classes are organized by subjects: English, Mathematics, Science, and Social Studies (U.S. history, world history, and civics). It also helps in preparation for college and the workforce.     - Grade 9: Students aged 14.     - Grade 10: Students aged 15.     - Grade 11: Students aged 16.     - Grade 12: Students aged 17.   - Higher Education: For higher education, after finishing high school, students can choose between College and University. These terms can sometimes cause confusion among parents and students when selecting the right institution. Differences Between University and College - University: A university is a higher education institution authorized to confer various academic degrees, offering undergraduate (Bachelor's), graduate (Master's), and professional (Doctoral) programs in different fields of study.   - College: A college, often referred to as a community college or junior college, offers undergraduate programs focusing on specific fields of study, providing associate degrees and certifications. Colleges are smaller institutions, generally cheaper than universities, and offer two-year programs with general education, technical education, and vocational training, preparing students for immediate employment.   According to the National Center for Education Statistics (NCES), there are approximately 7,021 universities in the United States, many of which are among the most prestigious in the world, making it the top destination for international students. Over one hundred thousand students move annually to pursue higher education due to the wide range of opportunities and the quality of teaching and learning processes. Grading System In the United States, education is compulsory for all students up to the age of 16, and the evaluation system in U.S. schools is expressed in both numerical and letter grades (A, B, C, D, and F), with additional symbols (+) or (-). F is the lowest grade, C is the passing grade, and A is the highest grade.   Each letter grade corresponds to specific numerical values: - A: Represents a range between 100 and 90 points, indicating excellent performance. - B: Represents a range between 80 and 89 points, indicating very good performance. - C: Represents a range between 70 and 79 points. - D: Represents a range between 60 and 69 points. - F: Represents a range between 0 and 59 points.   Grade conversions between numerical and letter grades can vary by system, discipline, and state.   Student understanding is evaluated on a 100-point scale, based on percentages. For example, if a student correctly answers 3 out of 5 questions, they receive a numerical score of 60%. Additionally, the Grade Point Average (GPA) is calculated by dividing the total points earned in all classes by the total credit hours, expressed on a scale from 0 to 4.0. This numerical average is converted to letters as follows: - A: 4.0 - A-: 3.7 - B+: 3.3 - B: 3.0 - B-: 2.7 - C+: 2.3 - C: 2.0 - C-: 1.7 - D+: 1.3 - D: 1.0 - D-: 0.7 - F: 0.0 It is also important to note that evaluation standards may vary. For example, two students from different schools with the same GPA of 3.3 might be assessed differently by universities based on the rigor of their respective academic programs. In addition to all this, there are some aspects to consider when analyzing evaluations. For example, two students from different schools who wish to enter the same university might both have a GPA of 3.3. However, one student comes from a prestigious school with rigorous academic programs, while the other comes from an average secondary school. Due to the varying standards in their education, the university might evaluate their scores differently. Evaluation System In the United States, the evaluation system is divided into three types of written tests:   - Tests: These are exams that cover several topics and have multiple-choice answers, lasting for the entire class period. - Final Written Exams: These are used to measure what students have learned at the end of each semester. - Quizzes: These are short evaluations covering material discussed in a single class, typically lasting no more than 30 minutes, and are often administered without prior notice.   It is important to explain that students can advance to the next year with a failed subject without having to repeat the course, but they must pass the failed exams. This approach allows students to continue their education without unnecessary delays. However, it is crucial that students use the time allocated for retaking these exams effectively. They should take advantage of any available resources, such as tutoring or study groups, to ensure they thoroughly understand the material.

Hey, fellow nurses! Yadi, CRC here. After countless 12-hour shifts, miles walked on unforgiving hospital floors, and more aching feet than I care to remember, I've learned one thing for sure: the right  shoes aren't just a comfort, they're a necessity. They're practically part of our PPE! Investing in good shoes is investing in your own health and career longevity, helping prevent the fatigue and back pain that plague so many of us.    I've spent hours (when I wasn't on my feet!) scouring Amazon, focusing on shoes highly rated by nurses like us . Based on features we all look for – comfort, support, slip-resistance, durability, and how easy they are to wipe down after... well, you know... I've picked my top contenders. I've broken them down into two lists: the 'Top 5 Best Overall' for that perfect balance, and the 'Top 5 Most Comfortable' for those shifts where cushioning is king. Let's dive in! Content⁉️ 1️⃣ Top 5 Best Nursing Shoes Overall 2️⃣ Best Overall Nursing Shoes Summar y 3️⃣ Honorable mentions 🔖Conclusion Shoes 👟 1.Brooks Ghost 15/16 2.Hoka Bondi 8 3.Dansko Professional Clog 4.Clove Classic 5.Skechers Work Squad SR 6.On Cloud 5 7.New Balance Fresh Foam Roav Top 5 Best Nursing Shoes Overall on Amazon This list focuses on shoes that strike a great balance between style and comfort. They need to be comfortable for long hours, supportive enough to prevent aches, durable enough to last, easy to clean, and, crucially, slip-resistant to prevent those unpredictable spills. 1. Brooks Ghost 15/16 Description:  A popular neutral running shoe often recommended for healthcare workers. It features an engineered air mesh upper for breathability and 3D Fit Print for structure. It's even a certified PDAC A5500 Diabetic shoe and carries the APMA Seal of Acceptance. You'll find it in plenty of colors and widths.    Key Features:  The Ghost 15 uses DNA LOFT v2 cushioning, while the newer Ghost 16 boasts nitrogen-infused DNA LOFT v3 – both offering a soft, lightweight feel. A Segmented Crash Pad ensures smooth transitions from landing to toe-off, and the Ghost 16 adds a durable RoadTack rubber outsole. It has a traditional 12mm heel-to-toe drop.    Why It's a Top Pick:  It's clear why so many nurses recommend the Ghost. It leverages advanced running shoe technology, designed for impact absorption and energy return, which translates incredibly well to the demands of long hours walking on hard hospital floors. Reviewers consistently praise its comfort ("most comfortable sneaker I have ever had" ), support, and lightweight feel, making it great for long shifts. It has racked up thousands of 5-star Amazon ratings, and the APMA Seal adds extra confidence in its foot health benefits.    Potential Drawbacks:  Some find the Ghost 16 a bit short or tight in the toe box, so consider trying a half-size up. One reviewer working 12-14-hour warehouse shifts needed extra insoles for the Ghost 15. They can also be pricier than some other options.    Brooks Ghost 15/16 2. Hoka Bondi 8 Description:  This is Hoka's maximum cushioning running shoe, known for its incredibly plush feel. It features an engineered mesh upper, a partially gusseted tongue, and an Ortholite hybrid sockliner. It also boasts the APMA Seal of Acceptance and comes in various colors and widths.    Key Features:  The star is the ultralight, resilient foam midsole providing maximum cushioning. An extended heel geometry creates a soft, balanced ride, while the meta-rocker design encourages a smooth stride. It also has a removable cushioned insole.    Why It's a Top Pick:  The Bondi 8's popularity, despite its size, highlights how much nurses value maximum cushioning for those long shifts. If you prioritize a plush feel to combat foot fatigue and pain on hard floors, this shoe delivers. It's frequently recommended by nurses and NPs, often described as "walking on clouds" and exceptionally comfortable for 12-13-hour shifts. Its cushioning is also praised for helping with foot pain and providing support.    Potential Drawbacks:  Some reviewers find it bulky. It's one of the more expensive options. The extreme cushioning might feel less stable than firmer shoes for some users.    Hoka Bondi 8 3. Dansko Professional Clog Description:  An iconic work clog instantly recognizable in healthcare settings, known for durability and robust support. Usually features leather uppers (easy to wipe clean!), a padded instep collar, and a roomy, reinforced toe box. Comes in a huge variety of colors and patterns.    Key Features:  The signature feature is the PU outsole with a rocker bottom, designed to propel you forward and absorb shock. It has a wide heel for stability and an anatomically contoured midsole. The XP 2.0 version offers upgrades like lighter weight, certified slip-resistant outsoles, and removable memory foam footbeds with arch support.    Why It's a Top Pick:  Dansko's longevity speaks volumes. Many nurses swear by them for comfort over long shifts (12+ hours), excellent arch support, and sheer durability – they last for years. The wipeable leather upper is a huge plus for hygiene. It's a trusted choice that many nurses return to. The focus on biomechanics for prolonged standing is evident in its design.    Potential Drawbacks:  They can feel heavy, especially the original models. Getting the fit right can be challenging – reviews mention them running big, small, or tight across the instep. They are an investment (pricey), and some need a break-in period. The style isn't for everyone.    Dansko Professional Clog 4. Clove Classic Description:  A modern sneaker specifically designed for  healthcare professionals. It features an easy slip-on/off elastic lace system with pull tabs and is made from wipeable, fluid-resistant Clarino™ microfiber fabric. Available in many colors and has the APMA Seal of Acceptance.    Key Features:  Fluid-resistance and easy cleaning are major selling points. It boasts a slip-resistant outsole, lightweight construction, odor-fighting properties, and is squeak-free. Offers cushioning and support, with a 36mm heel cushion. The material is designed to stretch slightly and mold to your feet.    Why It's a Top Pick:  Clove represents a direct response to nurses' needs, aiming to combine the practicality of traditional clogs (easy cleaning, fluid resistance) with the comfort of modern sneakers. Recommended by multiple nurses in reviews, it's praised for comfort, support, slip resistance, and that crucial wipe-clean feature. The healthcare-specific design and stylish options are appealing.    Potential Drawbacks:  They come with a premium price tag ($145 mentioned). Fit can be an issue; some found them tight around the ankles or needed to size up. One highly negative review called them uncomfortable and overpriced, causing foot pain quickly, indicating that individual fit and comfort experiences can vary significantly.    Clove Classic Clove Classic 5. Skechers Work Squad SR Description:  A popular slip-on work sneaker aimed at service industries, featuring a synthetic upper often treated with Scotchgard for stain resistance. Widely available on Amazon in various colors.    Key Features:  Certified slip-resistant traction outsole. Memory Foam cushioned insole for step-in comfort. Lightweight and flexible sole. Electrical Hazard (EH) safe design.    Why It's a Top Pick:  Its massive popularity on Amazon (tens of thousands of ratings)  suggests it meets the needs of many on-their-feet workers, including nurses. The combination of immediate comfort (especially the memory foam), lightweight feel, slip-resistance, and affordable price point makes it a strong value proposition. The slip-on design adds convenience.    Potential Drawbacks:  Durability is a concern, with some reviewers reporting the shoes fell apart within months. Slip resistance gets mixed reviews, particularly on greasy or soapy floors. Fit can be inconsistent (snug/wide), and memory foam can compress over time. It seems you might trade longevity for upfront comfort and price.  Skechers Work Squad SR Best Overall Nursing Shoes Summary Shoe Name Type Approx. Price Key Pro Key Con Brooks Ghost 15/16 Sneaker $$$ Balanced comfort, support, smooth ride Fit issues for some, Price Hoka Bondi 8 Sneaker $$$ Maximum cushioning, plush comfort Bulky, Price Dansko Professional Clog $$$ Durability, Arch support, Easy clean Heavy, Fit issues, Price Clove Classic Sneaker $$$ Designed for HCWs, Fluid-resistant, Comfy Price, Fit variability, Comfort debated Skechers Work Squad SR Sneaker $ Affordable comfort, Lightweight, Non-slip Durability concerns, Fit issues Honorable mentions On Cloud 5 Description:  Stylish, very lightweight sneaker with breathable mesh and speed laces.    Comfort Features:  The primary comfort driver seems to be its extremely lightweight feel due to Zero-Gravity foam. The CloudTec® pods provide cushioning. The speed-lacing system offers easy slip-on convenience. Breathable, often antimicrobial mesh upper.    Why It Excels in Comfort:  Nurses praise its lightweight, responsive feel, making feet feel less fatigued over long shifts. Many find it comfortable immediately. The slip-on style is convenient for busy shifts. Its stylish look is a bonus.    Potential Drawbacks:  Significant durability concerns reported by nurses (falling apart quickly). Elastic laces can be too tight. Sole pods can trap debris. Traction on wet surfaces may be lacking. Arch support may be insufficient for some. Expensive, especially considering potential durability issues.    On Cloud 5 New Balance Fresh Foam Roav' Road Description: Casual athletic sneaker with Fresh Foam midsole and supportive Ultra Heel.    Comfort Features:  Fresh Foam midsole provides an ultra-cushioned yet lightweight ride. The Ultra Heel design offers a snug, supportive fit. Breathable synthetic/mesh upper with bootie construction for easy on/off and comfort. Good arch support noted by reviewers.    Why It Excels in Comfort:  This shoe receives high praise for comfort, often described as "walking on a cloud". Nurses specifically mention wearing them comfortably for 12+ hour shifts without pain. The combination of plush cushioning, lightweight feel, and supportive fit makes it a strong contender. Often available at a good price point.    Potential Drawbacks:  Durability concerns, particularly ripping in the toe area after a few months. Initial tightness was reported by some.   New Balance Fresh Foam Roav 🔖 Conclusion Finding the right nursing shoes on Amazon is more than just comfort – it's about protecting yourself and staying energized through those demanding shifts. Whether you prioritize all-around performance or maximum cushioning, Amazon offers great options that fellow nurses have put to the test. Remember, the 'best' shoe is the one that fits your  feet, meets your  needs, and  aligns with your  budget. Consider your arch type (do you need extra support like Danskos or Hokas offer?), whether you need a wide width (available in Brooks, Hoka, NB Roav, some Skechers), and what features matter most to you – is it wipe-clean durability like Dansko or Clove, maximum plushness like Hoka, balanced performance like Brooks, or affordable comfort like Skechers or Sticky?    Take care of your feet, colleagues – they carry you through so much. Stay safe, stay comfortable, and keep making a difference!

The global public health crisis of obesity is witnessing significant advancements with new therapies that unravel the body's complex hormonal mechanisms. Recent studies shed light on how the surprising GIPR's dual action for weight loss , through both activation and blockade of the glucose-dependent insulinotropic polypeptide receptor (GIPR), promises more effective treatments with less frequent dosing. One of the most notable developments is AMG 133 (maridebart cafraglutide) , an innovative bispecific molecule. This compound was engineered by conjugating a fully human monoclonal anti-human GIPR antagonist antibody to two glucagon-like peptide-1 (GLP-1) analogue agonist peptides. Preclinical trials in obese mice and monkeys demonstrated its ability to reduce body weight and improve metabolic markers , including decreased food intake, blood glucose, insulin, and lipids. A phase 1 clinical study in humans with obesity confirmed these promising findings. AMG 133 showed an acceptable safety and tolerability profile , along with pronounced, dose-dependent weight loss  that was maintained for up to 150 days after the last dose in multiple ascending dose cohorts. The most common side effects were mild gastrointestinal symptoms, such as nausea and vomiting, which generally resolved within 48 hours after initial administration. Its prolonged half-life, approximately 14 to 24 days, allows for less frequent dosing—every 4 weeks—representing a significant improvement compared to other treatments that require daily or weekly injections. What has puzzled scientists is how both activation (agonism) and blockade (antagonism) of GIPR can promote weight loss when combined with GLP-1 activation. New research has solved this mystery: GIPR agonists and antagonists achieve weight loss through completely different and independent brain mechanisms . GIPR agonists  require intact GIPR signaling in gamma aminobutyric acid (GABA)-releasing neurons (GABAergic neurons) in the brain for their effects. On the other hand, GIPR antagonists  do not depend on this neuronal pathway. Instead, their effect is intrinsically linked to functional GLP-1R signaling , activating similar pathways in the hindbrain, a key region for appetite control and energy balance. Furthermore, a recent study has revealed a fundamental explanation for the greater efficacy of GIPR/GLP-1R co-agonists (such as tirzepatide). GIPR signaling in oligodendrocytes (OLs) in the brain's median eminence (ME) increases vascular permeability  at this critical blood-to-neuron interface. This, in turn, facilitates the access of GLP-1R agonists to the brain , allowing them to reach appetite-regulating neurons and thus amplifying their appetite-suppressing and weight-loss effects. These discoveries not only validate the combined approach of GIPR antagonism and GLP-1R agonism for treating obesity but also pave the way for the development of more specific and potent drugs . The future of obesity medicine looks promising, with therapies that act more intelligently and durably on the body and brain. 🔖 Sources GIPR signaling opens brain’s gate for GLP-1 weight-loss therapy A GIPR antagonist conjugated to GLP-1 analogues promotes weight loss with improved metabolic parameters in preclinical and phase 1 settings More state Medicaid programs consider covering GLP-1 drugs GIP receptor shows surprising dual action: Both activation and blockade support weight loss

For millions suffering from chronic knee pain due to osteoarthritis, a new hope is emerging on the medical horizon: genicular artery embolization (GAE) . This minimally invasive procedure is positioning itself as a promising alternative  or a bridge for those not yet ready for or eligible for total knee replacement surgery. Knee osteoarthritis, a condition affecting an estimated 5 million people and with 24 million cases diagnosed annually in the U.S., occurs when the protective cartilage in the joint wears away, causing bones to rub against each other, leading to severe pain, swelling, and stiffness. While treatments like pain medications, steroid injections, or physical therapy can offer relief, many patients eventually consider replacement surgery, a procedure not suitable for everyone, especially those with severe obesity, poorly controlled diabetes, or who are on dialysis. GAE is a procedure performed by interventional radiologists, typically under light sedation, in less than two hours, and on an outpatient basis. Using X-ray guidance, a catheter less than 1 millimeter in diameter is threaded into the arteries of the knee. A dye is injected to identify abnormal arteries that grow into the knee joint and contribute to inflammation and pain. Then, a temporary agent of oil and dye or biocompatible microspheres are injected to specifically block these vessels. By reducing excessive blood flow, inflammation and the nerve growth that drive knee pain are diminished. This process helps alleviate painful symptoms without damaging healthy tissue. The University of Chicago Medicine (UChicago Medicine) launched a pilot study in 2022, becoming the first in the Midwest U.S.—and among the first in the country—to offer GAE. Dr. Osman Ahmed, an interventional radiologist, reported more than 100 procedures with overwhelmingly positive outcomes . A study by NYU Langone Health, published in the Journal of Vascular Interventional Radiology  in August 2025, showed that more than 60% of the 25 participants experienced significant improvements  one year after the procedure. This study also found a notable decrease in blood levels of biomarkers  such as Vascular Endothelial Growth Factor (VEGF) and Interleukin 1 Receptor Antagonist (IL-1Ra), suggesting that GAE could be modifying the disease process, not just alleviating pain. Dr. Ryan Hickey, co-investigator of the NYU Langone Health study, emphasizes the urgent need for less invasive treatments for osteoarthritis. GAE is particularly suited for patients with moderate to severe pain that doesn't respond to first-line therapies and who seek to delay or avoid surgery . While GAE does not cure osteoarthritis or regrow cartilage, real-world data suggest a technical success rate of up to 100% , with many patients experiencing significant pain relief for 12 months or longer. Researchers continue to study the exact duration of benefits and the best candidates for the procedure, but initial results are encouraging. The risks associated with GAE are minimal and include bleeding, infection, temporary skin discoloration, and mild pain at the incision site. In summary, genicular artery embolization represents a significant advance  in the management of knee pain due to osteoarthritis, offering a viable and effective option to improve patients' quality of life. 🔖 Sources Genicular artery embolization relieves chronic knee pain caused by osteoarthritis An alternative to knee replacement surgery? NIH-funded study is testing a procedure for osteoarthritis knee pain What Is the Success Rate of Genicular Artery Embolization?

In a bold move to redefine its place in the world and combat the challenges of an aging demographic, Japan has heavily invested in regenerative medicine and stem cell research . What began with an innovative scientific discovery has transformed into a national strategy for vitality and global relevance. The spark of this "awakening" ignited in 2006 when Dr. Yamanaka Shinya of Kyoto University successfully reprogrammed ordinary skin cells into induced pluripotent stem cells (iPSCs) . These cells possess the remarkable ability to transform into virtually any body tissue, without the need for embryos, thereby circumventing bioethical and biological barriers. Following Dr. Yamanaka's Nobel Prize in 2012, the Japanese government redoubled its support, pouring subsidies and grants into laboratories and startup ventures. Then-Prime Minister Abe Shinzo articulated this vision in 2013, committing to create a " society of good health and longevity " and to export this model globally, declaring that regenerative medicine would be the "key". This ambition translated into policy, with the government in April 2014 accelerating the approval of iPSC treatments for patients after preliminary trials. The results have been swift. In 2014, Dr. Takahashi Masayo, who collaborated on the iPSC discovery, led the world's first clinical trial  to treat age-related macular degeneration (AMD), a common cause of blindness. Her team cultivated iPSC-derived retinal cells, shaped them into delicate sheets, and successfully grafted them onto the worn eye of an elderly patient in Kobe. Governmental approval for these pioneering trials was given on July 19, 2013. More recently, Dr. Takahashi Jun, also from Kyoto University, has led a trial with seven Parkinson's patients, where dopamine-producing neurons grown in the lab from adult skin cells are showing efficacy. In addition, two promising startups, Heartseed and Cuorips, are addressing heart diseases. Heartseed injects iPSCs directly into weakened hearts, having treated its first patient in 2023. Cuorips, for its part, applies thin sheets of cultivated heart muscle onto damaged tissue, with eight patients reporting milder symptoms and none having worsened. Cuorips has already filed for domestic regulatory approval. Despite these advancements, the path has not been without challenges. The scandal involving researcher Obokata Haruko in 2014, with manipulated data and the suicide of her mentor, sowed doubt and skepticism about research ethics. Questions persist regarding the speed of regulation and the robustness of the therapies. However, for Japan, stem cells represent more than a medical cure; they are a "soft sovereignty" and a "subtle statecraft"  for its relevance and resilience in a century marked by demographic challenges. The nation invests 110 billion yen (1 billion dollars)  in regenerative medicine, viewing it not only as a health issue but as a diplomatic asset . In essence, Japan hopes that by mastering the science of extending life, it can also extend its own relevance on the world stage. Stem cells offer the promise that Japan's story, despite challenges, still has many chapters left to write. 🔖 Sources Japan govt approves stem cell clinical trials Japan’s government on Friday gave its seal of approval to the world’s first clinical trials using stem cells harvested from a patient’s own body. Japan’s Stem Cell Awakening