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Physician Burnout, Sheet Pan Recipes, and Bird Flu in Cats · Morning Medical with Dr. Chow

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Welcome to Morning Medical with Doctor Chow, your daily dose of the latest in medical and
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health news from around the globe.
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I'm Doctor Chi-Ming Chow, and today, we're diving into the pressing issue of physician
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burnout, a concern that's gaining increasing attention in the medical community.
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A recent survey, conducted in 2023 and published in JAMA Internal Medicine, highlights
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the ongoing challenges that physicians face, particularly those related to staffing
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shortages.
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Nearly half of the surveyed physicians reported experiencing burnout, and a significant portion
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of them were working on incompletely staffed teams at least a quarter of the time.
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This study underscores how these staffing issues, lingering from the pandemic era,
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continue to affect the healthcare workforce.
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The survey involved 970 physicians and revealed that 47.9 percent met the criteria for burnout.
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Of these, 26.4 percent indicated a likely or definite intent to reduce their clinical work
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hours, while 15.4 percent considered leaving their current organization within the next
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year.
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These statistics are concerning, as they suggest a potential wave of physician turnover
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and reduced availability of clinical services.
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The study further showed that the likelihood of burnout was significantly higher among those
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working on incompletely staffed teams.
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For instance, 61.1 percent of physicians in this category reported burnout, compared to
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35.8 percent who had better staffing.
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Similarly, intentions to reduce clinical hours and leave their organizations were more
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prevalent among those facing understaffing issues.
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Doctor Lisa Rotenstein from the University of California San Francisco, who led the study,
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emphasized the critical role that strong, complete teams play in supporting physicians.
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She urged healthcare leaders to assess their staffing practices to ensure teams are
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adequately staffed, which is vital for delivering quality care and maintaining the
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health of the workforce.
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The study also raises questions about how other aspects of medical teams might influence
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burnout and whether similar patterns exist in smaller practices.
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While the research provides a focused assessment of the link between staffing levels
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and burnout, it highlights the need for further exploration into policies and interventions
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that could bolster staffing and reduce burnout.
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It's clear from these findings that the healthcare system still faces significant
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challenges post-pandemic.
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Addressing these issues is crucial not only for the well-being of physicians but also for the
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overall quality of care provided to patients.
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As we move forward, exploring innovative solutions to these staffing woes will be
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essential in supporting our medical professionals and ensuring a resilient
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healthcare system.
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Let's shift gears from the heavy topic of physician burnout to something a bit more
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light-hearted but equally important for our daily lives: cooking.
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Today, we're exploring why the humble sheet pan might just be the secret to making every meal
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of the day easier than ever before.
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Lisa Lillien, famously known as "Hungry Girl," has been a culinary force for over two decades,
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amassing a collection of kitchen gadgets like air fryers and slow cookers.
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However, when it comes to simplifying kitchen tasks, she swears by one tool above all others:
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the sheet pan.
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Lillien, although not a dietitian or nutritionist, has a wealth of experience in
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creating easy, delicious recipes that have broad appeal.
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She says, "Sheet pans really are an MVP of the kitchen because you can place something on the
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pan, pop it in the oven, and you can go about your day." Unlike some of those bulky
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appliances, a sheet pan is affordable, often costing less than twenty dollars, and does not
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take up precious counter space.
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The beauty of sheet pans, according to Lillien, is their versatility.
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Whether you're baking, roasting, or even broiling, a sheet pan can handle it all.
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Plus, they are easy to clean, and their raised edges help contain any spills or drips.
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In her latest book, "Hungry Girl Sheet Pan Cookbook: One-Pan Wonders Under 400 Calories,"
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Lillien showcases a variety of under-400-calorie recipes that span breakfast,
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lunch, dinner, snacks, sides, and even desserts.
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Her philosophy is to make smarter, better food choices accessible to everyone, without the
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need for expensive or exclusive ingredients.
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For breakfast, Lillien offers a clever twist on pancakes.
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Instead of the traditional method, which can be tricky to cook evenly, she suggests making
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pancake bars on a sheet pan.
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Simply prepare your favorite pancake batter, pour it onto a lined sheet pan, sprinkle with
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toppings like berries or chocolate chips, and bake.
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The result?
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Perfectly cooked pancake squares that can be enjoyed immediately, refrigerated, or frozen
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for later.
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Moving on to lunch, Lillien's sheet pan In-N-Out Burger copycat Animal-Style Burger
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Patties offer a delightful alternative to fast food.
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By preparing burger patties and fries on sheet pans, you can recreate the taste of your
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favorite fast food meals at home, without the need for a deep fryer or grill.
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For dinner, Lillien recommends her Honey Mustard Pretzel Salmon with Roasted Carrots.
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This dish highlights the multitasking power of the sheet pan, allowing you to cook both the
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main dish and sides simultaneously.
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The recipe combines the richness of salmon with the tangy sweetness of honey mustard and the
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salty crunch of crushed pretzels, delivering a flavorful and balanced meal.
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Lillien's approach to sheet pan cooking is all about making life easier while still enjoying
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delicious, healthy meals.
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Whether it's breakfast, lunch, or dinner, the sheet pan proves to be an invaluable tool in
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the kitchen, simplifying meal prep and cleanup.
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Today, we're taking a closer look at a promising development in the treatment of
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resistant hypertension.
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A recent study from South Korea, published in JAMA, has shown that amiloride, a long-standing
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diuretic, is just as effective as spironolactone in lowering blood pressure for
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individuals with resistant hypertension.
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This is particularly noteworthy because spironolactone has been the go-to medication
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for this condition, despite its side effects.
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The trial was conducted across 14 sites in South Korea and involved 118 participants with
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resistant hypertension, who did not achieve desired blood pressure levels even after a
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fixed-dose triple therapy.
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The participants were randomized to receive either spironolactone or amiloride.
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The results were encouraging, showing that 12 weeks into the trial, both groups experienced
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significant reductions in their home-measured systolic blood pressure.
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Specifically, the mean decrease in systolic blood pressure was 13.6 millimeters of mercury
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for those taking amiloride and 14.7 millimeters of mercury for those on spironolactone.
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This difference was not statistically significant, indicating that amiloride was
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noninferior to spironolactone in its effectiveness.
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Moreover, the safety profile of amiloride was favorable, with only one case of
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hyperkalemia-related discontinuation and no instances of gynecomastia, a side effect
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associated with spironolactone.
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The study's findings suggest that amiloride can be considered a viable alternative to
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spironolactone for patients who cannot tolerate the latter's side effects.
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Amiloride's effectiveness appears to be consistent regardless of aldosterone levels,
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making it a versatile option for managing resistant hypertension.
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This is contrasted with spironolactone, whose efficacy may vary depending on the degree of
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aldosterone excess in patients.
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The editorial accompanying the study emphasized the importance of having multiple therapeutic
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options for resistant hypertension, especially as nearly half of patients with true resistant
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hypertension still struggle to meet blood pressure goals even with current treatments.
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The editorialists highlighted the potential for integrating newer medication classes and
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interventions into treatment plans, which could further improve outcomes for these patients.
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While the trial provides promising insights, the researchers noted some limitations.
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They did not examine the effects of higher doses of amiloride and spironolactone, and the
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results may not be applicable to individuals with chronic kidney disease, as those with
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lower kidney function were excluded from the study.
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Despite these limitations, the trial marks a significant step forward in expanding the
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arsenal of treatments available for resistant hypertension.
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As a deadly bird flu outbreak sweeps through wild and domestic bird populations globally,
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researchers have identified an alarming trend that could bring the virus closer to humans: a
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significant increase in infections among pet cats and other feline species.
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While avian influenza—commonly known as bird flu—has long been a concern for poultry and
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wild bird populations, infections in mammals, especially pets like cats, have historically
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been rare.
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But that appears to be changing fast, new research warns.
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A systematic review, published in Open Forum Infectious Diseases, found a surge in bird flu
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virus infections among cats worldwide—both indoor and outdoor—particularly linked to the
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emergent H5N1 strain.
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The trend, experts warn, could signal an increased risk of the virus jumping from
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animals to humans.
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The review, conducted by researchers at the University of Maryland, analyzed 20 years of
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scientific data on bird flu in felines, from 2004 to 2024.
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It documented more than 600 cases across 18 countries, with more than 300 fatalities.
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Researchers found a sharp rise in domestic cat infections over the last few years,
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specifically in 2023 and 2024.
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The more cats that get infected with H5N1, the more it creates a potential pathway for
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zoonotic spillover of the virus to and from humans, the review warned.
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The review's authors estimate that this phenomenon is underreported in the scientific
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literature and argue that increased surveillance among domestic cats is urgently
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needed.
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In the United States, bird flu infections have increasingly been reported in domestic cats.
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According to the U.S.
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Department of Agriculture, 126 cats have tested positive for the virus since 2022, with about
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half of those cases occurring in 2024.
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Many of the infected cats were exposed through contaminated food or raw milk.
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For example, in November 2024, two pet cats in California died after drinking raw milk that
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had been contaminated with the virus.
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While Canada has not officially reported any bird flu infections in cats, that does not mean
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they have not occurred.
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Shayan Sharif, a professor and associate dean with the Ontario Veterinary College at the
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University of Guelph, mentioned there has been at least one confirmed fatal case of avian
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influenza in a dog in Oshawa, Ontario.
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Canada has also documented bird flu infections in other domestic animals and wild mammals,
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fueling concerns about the virus’s ability to spread across species.
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"H5N1 is already known to infect cats, domestic cats, and also other feline species like
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tigers, mountain cats, either kept in captivity or the wild," Sharif said.
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"What we did not actually know was how susceptible cats can be to H5N1, specifically
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this particular new clade 2.3.4.4b.
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It has become quite apparent that domestic cats are, in fact, susceptible to H5N1."
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Given how closely cats live with humans, researchers wanted to find out how widespread
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bird flu infections might be in feline populations.
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The review showed that nearly two-thirds of all known feline infections were in domestic cats,
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and of those, 71 percent did not survive.
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The main culprit is the newer H5N1 strain, clade 2.3.4.4b, which first showed up in cats
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in 2022 and has spread rapidly since.
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Most cats caught the virus by eating infected birds or raw meat, but some got sick after
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drinking raw milk from infected dairy cows.
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Interestingly, cases of H5N1 clade 2.3.4.4b recently reported by the Colorado Health
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Department included two indoor-only domestic cats with no known exposure to infected
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animals.
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This observation raises concerns regarding new and unknown transmission routes of avian
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influenza to domestic cats.
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Although very rare, cat-to-human transmission of the virus has been reported.
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For example, in 2016, an outbreak of avian influenza happened among cats in New York City
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animal shelters, and more than 100 cats were infected.
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A veterinarian who had close, prolonged, unprotected exposure to the respiratory
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secretions of infected cats contracted the virus.
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Sharif said the risk of transmission from cats to humans remains very low, but added it is
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still important to stay vigilant during this outbreak.
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"In case of avian influence, unfortunately, it can be quite lethal in cats," he said.
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"There are neurologic signs, such as tremors and seizures.
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There have also been indications that they can go blind, unfortunately."
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If you suspect your cat is showing symptoms, he recommends contacting your local veterinarian
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immediately.
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In the meantime, the researchers of the review are calling on wider surveillance among
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domestic canines to determine how widespread the virus is, in order to appropriately assess
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the risk of spillover to humans and other animals.
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In our final segment today, we're exploring how you can harness the power of movement to
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support both your physical and mental health.
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It's a topic that's been gaining traction as more people realize the interconnectedness of
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the mind and body.
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Dana Santas, a certified strength and conditioning specialist and mind-body coach,
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has shared insights on how you can create a fitness routine that not only strengthens your
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body but also supports your mental well-being.
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We all know that exercise is beneficial for our bodies, but it's equally important for managing
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mental health.
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Yet, many people still view physical fitness and mental wellness as separate goals.
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Dana Santas argues that this perspective misses the mark, as exercise can be a powerful tool
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for improving mental health when approached with intentionality.
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Research consistently shows that regular physical activity can ease symptoms of anxiety
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and depression, improve sleep quality, and enhance executive functioning, which are all
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crucial for maintaining emotional regulation and overall mental health.
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However, not all movement is created equal in terms of mental health benefits.
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The type of movement and how you approach it can make a significant difference.
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As a mind-body coach in professional sports, Santas has helped athletes build not only
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strong and mobile bodies but also mental resilience.
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She emphasizes the importance of mindful movement—being present during exercise, using
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intentional breathing, and training in ways that support the nervous system.
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This approach can help anyone improve how they move and feel every day.
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The brain and body are deeply connected through the nervous system, with the vagus nerve
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playing a key role.
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This nerve influences heart rate, digestion, mood, and emotional regulation.
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By exercising with focused, deep breathing, you stimulate the vagus nerve, activating the
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parasympathetic nervous system—the "rest and recover" state.
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This can calm the mind, lower stress, and improve focus, shifting the body out of
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"fight-or-flight" mode.
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Santas suggests incorporating mindful breathing into your workout routine.
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Before you start, use diaphragmatic breathing to connect with your body.
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During your workout, focus on your breath to enhance mobility and posture, and exhale during
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exertion to activate core control.
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After your workout, practice extended exhales to promote relaxation and recovery.
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It's also essential to balance the intensity of your workouts.
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While high-intensity sessions have their benefits, overdoing them can elevate stress
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levels and impair recovery.
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Integrating lower-intensity activities like walking, yoga, and breath-focused mobility can
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help maintain resilience and emotional regulation while preventing injury.
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Regardless of the type of exercise, being mentally present is crucial.
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This means focusing on the quality of your movement, paying attention to alignment, and
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being aware of how your body feels.
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When your mind starts to wander, use your breath to bring yourself back to the present
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moment.
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This presence transforms every exercise into an opportunity to build both physical skill and
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mental clarity.
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Finally, Santas encourages incorporating mental check-ins before, during, and after workouts.
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Taking a moment to assess how you feel can turn your fitness practice into a tool for emotional
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regulation, not just physical conditioning.
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This approach helps you listen to your body's needs and adjust your routine accordingly,
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ensuring that your fitness practices support your overall well-being.
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As we wrap up today's episode, remember that a mind-body fitness routine is not about doing
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less; it's about doing what serves you more completely.
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By training with awareness, incorporating breath and mobility, and respecting your
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nervous system's needs, you'll not only feel stronger but also more focused, resilient, and
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grounded in everyday life.
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Thank you for joining me on Morning Medical with Doctor Chow.
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Until next time, take care and stay healthy!