Weight Management at Kaiser: What's Covered?

Uhler lost more than 30 pounds and reversed her pre-diabetes through the program at Kaiser Permanente. “I feel so much better now, not to mention I look a lot better too and lost a lot of weight,” said Barbara Uhler, a 73-year-old Kaiser Permanente member and DPP participant. Those who did develop Type 2 diabetes delayed the onset of the disease by about four years. For example, a study of more than 1,200 individuals in Sweden with cognitive symptoms showed that a blood test improved the accuracy of diagnosis.273 Without the blood test, primary care physicians were accurate 61% of the time in diagnosing Alzheimer's based on standard diagnostic tests and practices. For example, advances in the identification of biomarkers for Alzheimer's disease make it possible to identify individuals who may qualify for clinical trials of treatments that target these biomarkers and prevent or delay the onset of symptoms. The risk of dementia increases with the number of TBIs sustained.243, 244, 245 In addition, studies have found that people with a history of TBI who develop dementia do so at a younger age than those without a history of TBI.251, 252 Whether TBI causes dementia, other conditions that lead to dementia or both is being investigated.

Health plan costs - what to know

It is currently not possible to determine with certainty which symptoms an individual is experiencing are due to which cause of dementia. In addition, many research groups are working on blood tests for Alzheimer's disease. Researchers have identified many brain changes that may interfere with communication at the synapses and contribute to the neuronal damage and death seen in Alzheimer's. A healthy adult brain has billions of neurons, each with long, branching extensions. The brain changes of Alzheimer's disease include the excessive accumulation of the protein fragment beta‐amyloid and of an abnormal form of the protein tau.

• This year’s negotiations mark the third round of the program and would mean a total of 40 drugs with lower prices for Medicare enrollees.
• A survey of 1,702 U.S. adults age 45 and older was conducted from November 7‐18, 2024.
• At Kaiser Permanente, we offer programs to help you lose weight, manage conditions, and improve your health and well-being.
• Furthermore, although the −5.8% weight loss at 5 years can be described as modest, this is one of the few studies that had the ability to describe a population of this size.
• Kaiser Permanente -- a managed-care consortium -- offers a medically supervised weight-loss plan to help you reach and maintain your long-term weight goals.
• Wegovy (semaglutide) is a medication for chronic weight management designed to be used with a healthy diet and exercise.

Within 30 days of surgery, there is a small risk of serious problems such as a blood clot or infection. Some people fall into a cycle of losing and gaining weight. These medicines may reduce the risk of a heart attack and stroke.

• Context engineering systems require sophisticated specialization mechanisms for diverse domains including healthcare, legal analysis, scientific research, education, and engineering applications, each presenting unique requirements for knowledge integration, reasoning patterns, safety considerations, and regulatory compliance.
• Available lipid concentrations were captured using the KPNC electronic health records and the laboratory databases.
• In terms of BC risk factors, 4.5% of the women had extremely dense breasts, 16.0% had a family history of BC, 2.0% had AH or LCIS, and 1.6% had a genetic predisposition for BC.
• With a focus on preventive care, our health and wellness resources help you — and your community — thrive in mind, body, and spirit.
• There may be restrictions, such as a prior authorization or step therapy.
• However, please note that refunds for prior months will not be issued.2.

Here, we aimed to investigate is these reductions in ISN in later chemotherapy cycles occurred in previous trials of efbemalenograstim alfa and with different chemotherapy regimens. An additional endpoint of the phase III trial was the incidence of severe neutropenia (ISN; grade 4, ANC 9/L) across all chemotherapy cycles, which demonstrated significant reductions in ISN at later cycles. The study met the primary end point, demonstrating that a single dose of efbemalenograstim alfa was noninferior to pegfilgrastim, decreasing the duration of severe neutropenia in cycle 1. Among the 14 patients who developed MRONJ, 8 (57.1%) had received zoledronic acid, 4 (28.6%) ibandronate, and 2 (14.3%) denosumab. Further investigation is needed to determine if pts with BrM and/or LMD may be at an increased risk of OI or ILD, however, 26.7% of pts with a decreased lymphocyte count at T-DXd initiation developed ILD, suggesting a potential correlation. This study aims to address this gap by evaluating the safety profile of RIB in combination with a non-steroidal aromatase inhibitor (NSAI) as first-line (1L) therapy in both younger and older patients with HR+/HER2− ABC, based on routine clinical practice in Spain. In this study, we profiled the landscape of AS events in nine pairs of matched primary and relapsed breast tumors from patients treated with TAM-based therapy. Women aged ≥18 years with Stage I-II HR+/HER2-negative breast cancer who underwent surgery and initiated adjuvant endocrine therapy were eligible. Patients were included if they initiated chemotherapy after ≥2 prior lines of ET-based treatment (with or without targeted agents) or within 6 months of starting first-line ET + CDK4/6i (primary endocrine resistance) in the mBC setting. Trust calibration and transparency mechanisms represent critical research areas for ensuring appropriate human reliance on AI systems while maintaining human agency and decision-making authority. Web agent evaluation frameworks reveal significant challenges in human-AI collaboration, particularly in complex task scenarios requiring sustained interaction and coordination. Sophisticated human-AI collaboration frameworks require deep understanding of human cognitive processes, communication preferences, trust dynamics, and collaboration patterns to enable effective hybrid teams that leverage complementary strengths.

Impact of Dexamethasone Premedication Timing on Infusion Reactions in HER2 Positive Breast Cancer

You'll have the support of your health care team to make these changes. Weight-loss surgery may be an option for people who have not been able to lose weight or improve weight-related health problems with diet, exercise, and medicines. Bariatric surgery is surgery to help people lose weight and improve health problems related to weight. Other over-the-counter (OTC) products that claim to help with weight loss haven't been proven to be safe or effective and may be harmful. Participation in the study is 12-months and completely voluntary. To learn more about the project, you can watch a 30-minute video showing one family’s experience with the study and the impact on their health and diet. Kaiser’s TransforMe in-person program, which previously included an out-of-pocket fee, has been postponed until further notice due to staffing shortages. To begin your weight management journey, contact your Kaiser PCP. This means all care must be coordinated through Kaiser providers, within Kaiser facilities, and managed by your designated Kaiser Primary Care Provider (PCP). Key themes included emotional overwhelm, fear of recurrence, identity disruption, body image distress, professional delays, loneliness, and a desire to feel “normal” again.The framework includes three nonlinear, cyclical phases reflecting the evolving emotional experience of young survivors. Thematic analysis of participant narratives was conducted by a licensed mental health counselor and a multidisciplinary team to identify common psychosocial challenges. These findings underscore the urgent need for structured, peer-informed mental health support. In our 2025 survey of 46 young survivors, 93% reported distress when reminded of cancer-related events, 84% experienced intrusive thoughts, 73% had sleep disturbances, 69%reported flashbacks, and over 80% expressed discomfort with physical changes. The programs cater to a wide range of needs, from individuals with minimal weight loss goals to those requiring medical interventions. The Kaiser program is divided into three phases, which is typical of a medical weight loss plan. Kaiser Permanente — a managed-care consortium — offers a medically supervised weight-loss plan to help you reach and maintain your long-term weight goals. The primary outcome was receipt of at least one mammogram within 15 months of diagnosis. The majority of patients (65.9%) kept fully or partial working, and all of them described adjustments to do so. Almost 41.0% intended to maintain full time job, 31.8% planned to keep it partially and 27.3% desired to halt it during treatment. Patients worked 36.5 hours per week in average , and 70.5% were socially secured. Around 52.3% patients underwent neoadjuvant CT.Nearly 29.5% and 57.0% of patients had total or partial participation in family income, respectively. While Healthy Balance suits those exploring foundational changes, the Medical program better serves individuals needing stronger external structure and facing greater weight-related challenges. For those asking “how to maintain weight loss after initial success? Both programs promote self-awareness 🧘‍♂️, mindful eating practices 🍎, and stress-reduction techniques as part of holistic well-being, aligning with broader trends in integrative health approaches.

Patient choices

Context engineering provides efficient alternatives to resource-intensive traditional approaches by enabling intelligent content filtering and direct knowledge transmission through carefully crafted prompts 630, 670. Few-shot learning implementations through carefully selected demonstration examples yield substantial performance gains, including 9.90% improvements in BLEU-4 scores for code summarization and 175.96% in exact match metrics for bug fixing . Context engineering delivers substantial performance improvements through techniques like retrieval-augmented generation and superposition prompting, achieving documented improvements including 18-fold enhancement in text navigation accuracy, 94% success rates, and significant gains from careful prompt construction and automatic optimization across specialized domains 267, 768, 681. Commercial deployment compounds these challenges through repeated context processing that introduces additional latency and token-based pricing costs . This involves sophisticated attention mechanisms, memory management techniques, and architectural innovations that enable models to maintain contextual coherence over vastly extended input sequences. For stage I breast cancer, the model had a CV sensitivity of 63% (57%-68%) in the training data, and 63% (44%-80%) in the test set, both at a 90% specificity.Conclusions. The test set was obtained from a different sample source and consisted of blood samples from 92 female patients with breast cancer and 98 individuals with no known diagnosis of cancer (mean age 60 years ± 10.8 S.D.). Here we developed a cell-free RNA and AI-based assay to detect breast cancer across the range of tumor stages and sizes and analyzed it in a separate, independent test set.Methods. Emerging blood-based biomarkers for early cancer detection and monitoring have the potential to augment existing image-based screening technologies in high-risk populations including dense breasts. In accelerometry data, we observed increased physical activity from baseline to post-intervention at four months, and evidence that activity was more effectively maintained by the exercise group compared to standard care over four research assessments.Future DirectionsA future randomized efficacy trial will test REJOIN among BCS aged ≥60 within one year of initiating AI therapy.

• For instance, a survey of Master of Social Work graduates from 2017 to 2019 revealed that only 4.2% specialized in aging or gerontology.832 Nonetheless, 20% to 48% of social work students expressed high interest in working with older adults.833, 834, 835, 836, 837 This discrepancy may be due to the profession's broad scope, which may direct student interest toward social issues rather than age‐specific populations.838
• An ANN model was established to predict PMRT benefit population based on patients with T2N0/T2N1.
• However, these medications can cause gastrointestinal side effects, and weight loss is typically only maintained during active use; additionally, insurance coverage remains a significant barrier for many pediatric patients.
• The cost of the groceries is calculated based on your family size, generally between $110 and $190 per week.
• Subgroup and meta-regression analyses evaluated the impact of ADC type, payload, dose, BC subtype, drug-antibody ratio (DAR), and line of therapy.
• Context engineering provides efficient alternatives to resource-intensive traditional approaches by enabling intelligent content filtering and direct knowledge transmission through carefully crafted prompts 630, 670.
• Before enrolling, consider your goals, budget, and the potential insurance coverage you may receive.
• The coverage depends on the specific insurance plan and the individual’s policy.
• As one example of collaborative dementia care, the Alzheimer's and Dementia Care Program is a health systems‐based model in which nurse practitioners with extensive training in dementia care, known as dementia care specialists (DCSs), co‐manage care with PCPs and community‐based partners.
• Despite its impact on quality of life, discussions and management strategies are often lacking in routine care.

In January 2023, T-DXd was re-classified as highly emetogenic by the US National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for antiemesis with a recommendation to use a triplet/quadruplet anti-emetic drug (AED) regimen as prophylaxis at treatment initiation to prevent therapy induced nausea and vomiting. Cryotherapy and compression therapy have shown promise in reducing CIPN, but prospective randomized data are scarce. HCPs reported that 88% of patients treated with any ADCs in an average month receive antiemetic prophylaxis; however, only 39% of HCPs report exclusively using a guideline-recommended NK1 RA regimen with T-DXd or SG. NV reported by HCPs in this survey was much lower than in the T-DXd and SG clinical trials; HCPs reported that 30%, 25% and 15% of their BC patients treated with T-DXd experience N and/or V during the acute (0-24 hours), delayed (days 2-5), and long-delayed (beyond day 5) phases, respectively. The majority 13 (87%) underwent a change in systemic therapy at time of CNS disease diagnosis, with 60% changing to an ADC at the time of CNS diagnosis or progression. Excluding those with de novo CNS disease, the median interval from time of metastatic diagnosis to development of CNS metastasis mets was 3 months (0-22 months). Antibody-drug conjugates (ADCs) have been shown to penetrate the central nervous system (CNS); however, little is known about the response of ADCs in MpBC, particularly in patients with CNS disease. The top 5 misdiagnoses (52% of all misdiagnoses) were benign breast condition (18%), bone related condition (18%), another type of BC (6%), diagnostic delay (7%), and primary GI cancer (3%). An IRB-approved survey was administered to patients with mILC via social media, advocacy organizations, and conferences to assess patients’ history, symptoms, diagnosis, and the impact of misdiagnosis or delays on treatment.

Tips for Getting Started with Weight Loss Kaiser

Pts were included based on ICD-9/10 codes for MBC, documentation of ADC use, and keywords related to scalp cooling discussion/ use in provider notes. Further randomized trials are warranted to confirm these preliminary findings and refine CIA management protocols. A 50% success rate for Grade ≤1 alopecia, along with complete hair regrowth by 3 months, suggests enhanced efficacy compared to previous studies involving scalp cooling alone. Compared to historical data from PAXMAN-only users, the onset of alopecia appeared delayed. No adverse events related to the use of HairRepro MEDI α were observed.Hair loss typically began 4 to 6 weeks after the first chemotherapy dose.

• CHIP is enriched in patients exposed to cytotoxic therapies—particularly anthracyclines and alkylating agents—which may drive the selection and expansion of clones harboring high-risk mutations, notably in TP53 and PPM1D, genes involved in the DNA damage response.
• Granulocyte-colony stimulating factor (G-CSF) was used at any time in 59% and 38% of patients and as primary prophylaxis in 20% and 10% pts in the SG and chemo groups, respectively.
• Skin toxicity occurred in 29 patients (26.4%), and the median time to skin toxicity onset was 84 days (range, 3-498).
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• This suggests that using more sensitive local staging at diagnosis may allow earlier identification and treatment of synchronous disease that would otherwise manifest as early ipsilateral or contralateral events.
• Once you qualify and undergo weight loss surgery, having realistic expectations and dedication to maintaining a healthy lifestyle is crucial.
• While the spectrum and frequency of pathogenic and targetable alterations aligned with existing data, 2L samples showed higher TF (as measured by hVAF) and a greater burden of somatic variants, reflecting evolving molecular complexity.
• That software allegedly transmitted sensitive data, including IP addresses, medical search terms, and personal histories, to Google, Microsoft, Meta, and X (formerly Twitter), without patient consent.

Our team consists of physicians and licensed nurse practitioners who possess the qualifications to prescribe medications, order lab tests, and evaluate your symptoms and health objectives. You may take our quiz to see if you qualify for maintenance therapy! ‍Whether you're looking for personalized guidance, assistance with medication access, or support in adopting healthier habits, our monthly membership offers a comprehensive solution to help you thrive on your wellness journey. The focus remains on long-term health improvement through nutrition awareness 🥗, physical activity 🏃‍♂️, stress reduction 🧘‍♂️, and behavioral strategies 🔍. The organization provides multiple pathways tailored to different needs, from community-based education to physician-led interventions. We’re with you every step of the way with proven results and personalized guidance to reach your weight goals. There are many programs and resources out there to help, but which can you trust? The Mid-Atlantic Permanente Medical Group is the largest multispecialty medical group in the Washington, DC, and Baltimore areas and exclusively treats Kaiser Permanente members. But many had relatively serious or unpleasant side effects.Wegovy, however, helped patients lose an average of 15% of their body weight over 68 weeks in the main clinical trial that led to its approval. It may help to join a weight-loss program or visit a health care professional, such as a nutrition or weight-loss specialist. Eligible patients without diabetes lost an average of 15% of their body weight (-33.6 lbs) in a 68-week clinical trial evaluating 2.4 mg semaglutide, when paired with diet and exercise. You may need to show proof of participation in a physician-supervised weight-management program.For Type 2 diabetes treatment, you’ll likely need to provide proof of your diagnosis. Of course, the greatest benefit of the Kaiser Diet comes from its ability to make it easy to lose weight in a hurry. Using the Kaiser Diet will help you see an immediate drop in your weight, increasing your satisfaction with the whole dieting process and making it more likely that you’ll stick with it long-term. According to the Kaiser Diet principle, each food is on the list for a reason, and they’ll all combine to create the great weight-loss effect participants are looking for. Using this ratio in combination with BRFSS data, the Alzheimer's Association was able to determine the percentage of adults in all states and the District of Columbia who are caregivers for individuals living with Alzheimer's or another dementia. Beyond education, the Alzheimer's Association also collaborates with state and local public health departments, tribal health organizations, health systems and other stakeholders to establish population‐based strategies covering risk reduction, early detection and diagnosis, and quality of care. The health care community can learn from approaches used in clinical research settings, where presymptomatic biomarker information is carefully disclosed to study participants and care partners.281, 1074 A pattern has been observed of participants in research studies sharing biomarker test results with their care partners, a practice that may well continue when test results are available in the clinic.1066, 1074 Possible ethical considerations are heightened by the anticipated FDA approval of these tests for use in primary care settings, where health care professionals may not be as familiar with the critical distinction between detection and diagnosis as specialists are, nor as equipped to accurately convey this to patients as they weigh the benefits and risks of such tests. The Alzheimer's Association provides a range of resources to support health systems and clinicians in these critical areas, including materials on early detection and diagnosis, management of Alzheimer's and other dementias, care planning and support services. Due to its sharp dose gradient and favorable side effect profile future studies will focus on further shortening treatment time for patients. For those patients on the phase II trial protocol, 40 Gy dose was delivered in 5 fractions to the clinical target volume (CTV) with a minimum 30 Gy dose to the planning target volume (PTV). Purpose/objectiveThe GammaPod is a breast-specific stereotactic radiotherapy device capable of delivering ablative doses with sharp gradients through precise breast localization. Pembrolizumab in combination with weekly paclitaxel demonstrated promising clinical activity and manageable safety as first-line chemotherapy in TMB-enriched HR+/HER2- MBC patients. A 12-month washout period was used to identify patients with newly diagnosed mBC based on the presence of ≥2 medical claims with diagnosis codes for the primary BC followed by ≥2 claims with diagnosis codes for secondary neoplasms, excluding breast, skin, or lymph nodes. Patients with the ILC subtype, who account for 10-15% of all breast cancer patients, show unique clinicopathological characteristics. BACKGROUNDDetection of a PIK3CA mutation (PIK3CAmut) is a prerequisite for treatment with currently approved PI3K inhibitors in breast cancer (BC). For these patients, options are limited primarily to chemotherapy, with almost one-third not surviving to receive the second line of post ET-based treatment. Covering them for weight loss could raise premiums for all plan members, even those who don’t use them. If the request for GLP-1 is for weight loss, verify that your BMI measurements are accurate. If you don’t qualify for a GLP-1 medication for weight loss, you might qualify for the same or a similar medication for another FDA-approved condition. Ask your insurer for the coverage criteria or medical necessity guidelines for the GLP-1 medication you want. Chronic irAEs were assessed using CTCAE v5.0 criteria and defined as immune-related toxicities persisting beyond 12 weeks after pembrolizumab discontinuation, regardless of grade, starting from grade ≥2 (i.e., requiring medical intervention or impacting daily life). However, the increasing use of ICIs in real-world settings raises concerns about chronic immune-related adverse events (irAEs), defined as toxicities persisting more than 12 weeks after treatment discontinuation. A real-time safety workflow was implemented, with pre-specified criteria for halting treatment and escalation to the next block of treatment.

• It’s important to take good care of each to have complete health.
• Although this result may need validation in a prospective analysis it seems very improbable that the breast biopsy itself has a negative impact on quality of life.
• This is expected to change, as systems have been established to track the health outcomes of people receiving these medications.
• “The metric we try to use is value,” said James Gelfand, senior vice president for health policy at the ERISA Industry Committee, which represents large, self-insured employers.
• Data for more recent years are still being compiled, but one study found that deaths due to all dementias, including Alzheimer's, decreased between March 2021 and February 2022, in particular among residents of nursing homes and long‐term care facilities.491
• Eligible pts for the study were adults with a confirmed diagnosis of HR+/HER2-low mBC who had ≥2 documented visits and a CDK4/6 inhibitor(i) +/- ET in the first-line metastatic setting.
• Task-oriented agents utilize memory to perform complex autonomous operations with minimal human intervention, employing LLMs as controllers extended through multimodal perception, tool utilization, and external memory .
• While the coverage criteria are stringent, and additional costs may apply, Kaiser’s coverage can make a significant difference for those who meet the medical necessity requirements.
• They can outline what to expect regarding any potential refunds based on your individual situation.

Both patients and caregivers shared concerns about the impact of MBC on their individual health and its impact on the dyad. Participants contrasted MBC with patients’ previous cancer diagnoses, which typically included a shorter, intense period of treatment followed by a return to normalcy. Interviews were audio-recorded and transcribed; transcripts were imported into the qualitative data management program MAXQDA and analyzed using an adapted framework method. Using a dyadic approach, this study explored how patients with MBC and their caregivers perceive a MBC diagnosis and subsequent caregiving needs over time on an individual and dyadic level. The programs' multi-pronged approach, encompassing medical supervision, behavioral counseling, nutritional guidance, and group support, is designed to address the complexities of weight loss and empower individuals in their journey. Kaiser Permanente's weight loss programs represent a valuable resource for individuals seeking to achieve and maintain a healthy weight. It is essential to approach any weight loss program with realistic expectations and to carefully consider the potential benefits and drawbacks. The program aims to equip individuals with the knowledge and skills to maintain their weight loss and live a healthier lifestyle.

• While bariatric surgery is an important part of our weight loss program, it is just one tool to help you reach your long-term goal of sustainable weight loss.
• Retrieval-Augmented Generation bridges the gap between parametric knowledge and dynamic information access by integrating external knowledge sources with language model generation.
• One study investigated breast edema in oncoplastic surgery, reporting this as a risk factor.
• “Joining Healthy Balance helped me lose weight in a way that feels realistic and sustainable.
• Insurance coverage for GLP-1 agonists when used for weight loss varies widely.
• In addition, several treatments are available to help with symptoms, and two are available that change the underlying biology of Alzheimer's and slow disease progression.
• While ET is an effective treatment for breast cancer, the two administration modes may generate disparate burdens and benefits on patients’ everyday lives.

As one example of collaborative dementia care, the Alzheimer's and Dementia Care Program is a health systems‐based model in which nurse practitioners with extensive training in dementia care, known as dementia care specialists (DCSs), co‐manage care with PCPs and community‐based partners. Table 11 presents state‐by‐state data on the health status of dementia caregivers, and Table 12 compares the percentages of dementia caregivers, non‐dementia caregivers and non‐caregivers who report having a specific chronic health condition. A longitudinal study of the monetary value of family caregiving for people with dementia found that the overall value of daily family care increased 18% with each additional year of providing care, and that the value of this care further increased as the care recipient's cognitive abilities declined.579 More research is needed to estimate the future value of family care for people with Alzheimer's disease and other dementias as the U.S. population continues to age, particularly since many existing economic studies only consider primary caregivers when there are often multiple relatives and others helping an older person with dementia.510, 580

• Losing weight is about more than just taking the pounds off.
• Your prescriber can write a letter of medical necessity.
• Multivariable linear regressions estimated associations between NMDoH factors and QOL, controlling for sociodemographic and clinical covariates.
• Begin by discussing your weight loss goals and concerns with your primary care physician.
• Cost savings were the result of (1) a smaller spike in costs immediately before and after diagnosis during the MCI phase compared with the higher‐cost dementia phase, and (2) lower medical and long‐term care costs for individuals who have diagnosed and managed MCI and dementia compared with individuals with unmanaged MCI and dementia.
• In operational terms, TIR-based agents serve as intelligent orchestrators that systematically interweave cognitive processing with external resource engagement to achieve targeted outcomes .
• At baseline, each patient completed PROMIS assessments for Pain Interference, Sleep Disturbance, Anxiety, and GI Nausea & Vomiting, as well as an intake survey covering health history and other personal information.
• Due to data / sample sharing restrictions, 43 pts from China were excluded from an otherwise global population.

In this real-world analysis, first-line CDK4/6i & AI treatment showed numerically higher OS by 14.6 months in HER2-low patients compared to HER2 IHC 0 tumors whereas in patients who received CDK4/6i&F at more advanced setting of their metastatic disease, OS did not differ by HER2 status. The current study aims to develop a clinical diagnostic assay to guide optimal treatment for patients with MBC using digital patient organoid (DPO). Currently FDA-approved ADCs such as trastuzumab deruxtecan (T-DXd) or sacituzumab govitecan (SG) are routinely used in clinical practice, but data on optimal sequencing of these agents for individual patients are lacking. In silico analysis was performed using multiple independent breast cancer patient datasets. Cortesi et al reported outcomes of Pembrolizumab and Carboplatin combination in 16 patients with gBRCA-m, HR+ m metastatic breast cancer. Efficiency metrics examine temporal aspects through response time (duration for information retrieval and utilization) and adaptation time (period required for new information storage) . These comprehensive evaluation approaches reveal significant challenges while pointing toward promising research directions that could unlock new capabilities for memory-enhanced agents. Memory evaluation frameworks have emerged as critical components for systematically assessing LLM agent capabilities across multiple dimensions, reflecting the multifaceted nature of memory in intelligent systems. Tool-augmentation paradigms validate effectiveness in complex task decomposition while leveraging world interaction tools, with memory-enhanced agents becoming central to modern AI systems performing complex tasks through natural language integration of planning, tool use, memory, and multi-step reasoning 247, 356, 1091, 34. Memory technology evolution addresses fundamental context window limitations through RAG, which combines parametric and non-parametric memory for language generation using pre-trained seq2seq models and dense vector indices 1209, 591. The majority (22) of patients had visceral and bony disease, while 6 patients had bone-only disease and 2 only had visceral disease. Notably, 11 patients continued abemaciclib for more than 180 days before experiencing progression or death, whereas 6 patients had disease progression within 90 days of initiation. All 20 patients received 2600 cGy to the whole breast in 5 fractions, and 8 of those patients received a single fraction boost dose of 520 cGy. Among patients completing 36-month follow-up, no ipsilateral breast tumor recurrences occurred. These provide ongoing learning and community – important ingredients for staying interested, focused and excited about taking good care of your health. You’ll engage in weekly classes, medical supervision, and regular labs while enrolled. This is a medically-supervised meal replacement program. Our partial program focuses on nutrition, fitness and stress management. Our full and modified program includes an exploration of your relationship with food, eating and weight. The long duration of illness before death contributes significantly to the public health impact of Alzheimer's disease because much of that time is spent in a state of severe disability and dependence. A person who lives from age 70 to age 80 with Alzheimer's dementia will spend an average of 40% of this time in the severe stage.487 Much of this time will be spent in a nursing home (see the Use and Costs of Health Care, Long‐Term Care and Hospice section). Studies indicate that people age 65 and older survive an average of four to eight years after a diagnosis of Alzheimer's dementia, yet some live as long as 20 years with Alzheimer's dementia.15, 16, 17, 18, 19, 20, 21, 22, 23 This reflects the slow, insidious and uncertain progression of Alzheimer's. What is clear is that for at least the first years of the pandemic, having Alzheimer's or another dementia made older adults more vulnerable to COVID‐19 and increased the risk of dying from COVID‐19.

Does my insurance plan cover compounded GLP-1 medications?

Some contributing factors to RBr were low libido (27.0%), sexual dissatisfaction (19.0%), prejudiced body image (22.2%), and difficulties in communication (20.6%). 58% received ovarian function suppression and 24.7% a target-therapy (24.1% iCDK4/6). 13.6% had HER2+ tumors, 14.8% metastatic disease, and 6.8% in situ carcinomas. Identify family members or friends who will support your weight loss efforts. This change could lower the risk for some chronic diseases such as heart disease, prediabetes, and type 2 diabetes. Consider why you want to lose weight, whether it's because heart disease runs in your family or you want to be more physically active. Prospective, breast cancer-specific studies are needed to validate CHIP as a predictive biomarker and inform its integration into personalized cardio-oncology management strategies. These findings demonstrate that efbemalenograstim alfa may be more effective at preventing severe, life-threatening neutropenia at later chemotherapy cycles, which has meaningful implications for real-world breast cancer patients that are likely to receive chemotherapy for longer durations. For advanced breast cancer, Seven and 2 patients received T-DM1 as first and later-line therapy, respectively. This study aims to explore metastatic breast cancer (MBC) patients’ experiences with ET by describing the burdens (including challenges to administration and adherence), benefits, and preference of oral and IM ET. While ET is an effective treatment for breast cancer, the two administration modes may generate disparate burdens and benefits on patients’ everyday lives. States such as Florida with larger populations of older people will have a larger burden of mortality due to Alzheimer's—a burden that appears smaller relative to other states when the rates are adjusted for age. Standard diagnostic criteria (the NINCDS‐ADRDA criteria from 1984) were used to diagnose Alzheimer's dementia. Because the more stringent threshold for dementia in HRS‐HCAP may miss people with mild Alzheimer's dementia, the Association believes that the larger CHAP estimates may be a more relevant estimate of the burden of Alzheimer's dementia in the United States. This is because the more recent study used updated Census projections and incorporated information from Hispanic/Latino American individuals. Census.293 The number, 7.2 million, is higher than estimated from previous study that also combined CHAP and U.S. Information on oncological treatments and tumor characteristics was extracted from medical records. Mindfulness-based interventions have been proposed as integrative strategies to support mental health and well-being in this population. The perfect adherence in the online group (100%) emphasized the potential for virtual programs to fit into patients’ lives, especially for those balancing responsibilities or facing geographic limitations (9). Additionally, for patients reporting use of a step counter, the average daily step count for Chinese Americans was 6592 compared to 8432 for NHWs. Of these individuals, nearly half live alone, perhaps making it more difficult to ask for and receive informal care.510 Among caregivers of spouses with dementia who are at the end of life, close to half provide care without the help of other family or friends.511 Among the reasons shared by caregivers for providing assistance to a person with Alzheimer's or another dementia are the desire to keep a family member or friend at home (65%), close proximity to the person with dementia (48%), and the caregiver's perceived obligation to the person with dementia (38%).A10 In addition, caregivers often indicate love and a sense of duty when describing what motivates them to assume care responsibilities for a relative or friend living with dementia.508 In 2024, caregivers of people with Alzheimer's or other dementias provided an estimated 19.2 billion hoursA8 of informal—that is, unpaid—assistance, a contribution valued at $413.5 billion.A9 This is approximately 64% of the net value of Walmart's total revenue in fiscal year 2024 ($648.1 billion)503 and nearly 16 times the total revenue of McDonald's in 2023 ($25.9 billion).504 The total lifetime cost of care for someone with dementia was estimated at $405,262 in 2024 dollars.505 Seventy percent of this lifetime cost of care is borne by family caregivers in the forms of unpaid caregiving and out‐of‐pocket expenses for items ranging from medications to food for the person with dementia. Eighty‐three percent of the help provided to older adults in the United States comes from family members, friends or other unpaid caregivers.501 Nearly half of all unpaid caregivers (48%) who provide help to older adults do so for someone with Alzheimer's or another dementia.502 More than 11 million Americans provide unpaid care for people with Alzheimer's or other dementias.A7 Table 9 provides details about unpaid caregivers.

• A study of racial and ethnic differences in health care spending using the Medical Expenditure Panel Survey found similar patterns in unadjusted total spending.1034 However, after adjusting for socioeconomic characteristics and functional status, total health care spending did not differ significantly among groups.
• Wegovy (semaglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist that was FDA approved in 2021 for chronic weight management.
• The KP model of care relies on clinical assessment of BMI, brief positive conversations between patient and clinician, agreement on a next-step behavior change or program referral, and arrangement of follow-up.
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• This clinical benefit, as well as toxicity profiles, comorbid conditions, physician familiarity, and pt-specific factors, may influence initial selection and switching patterns in clinical practice.
• To be eligible, patients had to survive and reside in Denmark for at least one year after diagnosis.
• By organizing these disparate fields into a single, coherent taxonomy, this survey aims to elucidate the fundamental relationships between them, providing a holistic map of how context is generated, processed, managed, and utilized to steer the next generation of intelligent systems.
• Knowledge graph integration addresses structured information retrieval through frameworks like KAPING, which retrieves relevant facts based on semantic similarities and prepends them to prompts without requiring model training 48, 673.

IWL follows six key principles that help reset metabolism, prevent weight regain, and support sustainable weight loss. Overall, research shows that quick weight loss without structured follow-up leads to a higher likelihood of regaining weight. IWL isn’t about weight loss weeks sandwiched between ‘diet' life and ‘real life’. In fact, a meta-analysis suggests that intensive intervention during the maintenance phase increases success in retaining weight loss over time. Our Options program prepares you for metabolic and bariatric surgery and provides you with ongoing support. You may have tried to lose weight before, or maybe you’re thinking about it for the first time. Losing weight is about more than just taking the pounds off. They offer structured, science-backed frameworks to build healthier habits. If you're looking for preventive support and qualify as a member, start with the free Healthy Balance or Omada DPP programs ✅. Others, such as Ozempic and Victoza, are sometimes prescribed off-label for weight loss. Some GLP-1 agonists, like Zepbound, Wegovy, and Saxenda (liraglutide), are FDA approved for chronic weight management. Ozempic (semaglutide), Victoza (liraglutide), and Wegovy (semaglutide) are popular medications used to treat Type 2 diabetes or help with weight loss. Muscle mass is crucial for metabolism and overall weight loss because it not only aids in weight loss but also influences overall weight. In this section we discuss risk factors for cognitive decline and dementia generally, recognizing that it is unclear whether these are risk factors for Alzheimer's disease specifically. Because Alzheimer's is the most common cause of dementia, modifiable risk factors for dementia are often assumed to support a link between the risk factors and Alzheimer's disease specifically. However, there is growing awareness that more research is needed to disentangle risk factors that are specific to Alzheimer's disease from those that are specific to other causes of dementia.73 As mentioned earlier, most people living with dementia have the brain changes of Alzheimer's disease as well as one or more other causes of dementia. The mean score on participant preference for self-testing with Liberty versus the standard of care was 4.2/5 with 5 representing a strong preference for self-testing with Liberty (median 4.5). Exploratory endpoints included patient experience of training, self-testing, ease of use and recommendation to other patients. Historically, the need for in-clinic testing has presented logistical challenges for patients, reduced the efficiency of service delivery and delayed identification of complications such as febrile neutropenia, anemia and thrombocytopenia. In this case, ER either fully (ER driven) or partially (ER co-driven) drives the disease. Understanding how PIK3CA H1047R mutant interacts with the aging microenvironment is important for elucidating age-related susceptibility and may enlighten age-specific therapeutic strategies. As a baseline, a radiomics-based method using the intensity thresholds and texture features was developed. We implemented a 3D U-Net with attention blocks and deep supervision, trained with a combined loss and extensive data augmentation. If you are interested in exploring weight loss medication options with Kaiser Permanente, here are some steps you can take⁚ Factors such as diabetes, heart disease, sleep apnea, and certain types of cancer may influence the decision. It is currently approved for type 2 diabetes and is also being studied for its potential as a weight loss medication. Within the set of NCDCIS cases, image findings on the mammogram, patient reported symptoms and contrast enhancement type were obtained. The exams were interpreted by one of 15 MQSA certified Radiologists across two clinical sites from June 19, 2018 to December 31, 2024. A few small retrospective studies have shown that CEM detects pure DCIS and mixed DCIS and invasive disease, but there has not been a focus on NCDCIS. Advantages of CEM over MRI include lower false positive rates, lower cost and greater patient acceptance. The ability to detect NCDCIS is important for cancer staging and surgical planning in the effort to obtain negative margins at lumpectomy. There is an unmet need for novel therapeutic approaches to overcome resistance mechanisms and improve outcomes in patients with ER+/HER2- ABC with ESR1-mutated tumors progressing after ET+CDK4/6i. ESR1 mutations are a common type of acquired resistance that emerges in 40-50% of patients in the metastatic setting after prolonged aromatase inhibitor exposure. These findings highlight the need to optimize post CDK4/6 treatment strategies.

• Average per‐person payments for health care and long‐term care services (hospital, outpatient, physician and other medical provider, nursing home, skilled nursing facility, hospice and home health care) and prescription medications were higher for Medicare beneficiaries with Alzheimer's or other dementias than for Medicare beneficiaries without dementia in the same age group (Table 18).A13,941
• Direct care workers provide assistance with activities of daily living (ADLs), such as bathing, eating, toilet care and mobility.
• Wegovy is FDA-approved for weight management.
• Kaiser Permanente, a large integrated healthcare system, offers a range of services to support weight management.
• Due to their cost, however, coverage of GLP-1s for obesity treatment in Medicaid, ACA Marketplace plans, and most large employer firms remains limited, and GLP-1 coverage in Medicare for treatment of obesity is prohibited under current law.
• Out‐of‐pocket costs include Medicare deductibles, copayments and coinsurance; other health insurance premiums, deductibles, copayments and coinsurance; and services not covered by Medicare, Medicaid or other sources of support.
• It is important to understand that the metal tiers only reflect the difference in cost sharing, not the types of care we provide.

Approximately 80% of breast cancers (BCa) expresses estrogen receptor-α (ER), and ER+ BCa most frequently metastasizes to the bone. Phase 2 was a 45-minute accredited activity focused on clinical evidence, AE mitigation, and patient-centered treatment planning. Clinicopathological data including age at diagnosis, metastaticpresentation (de novo vs recurrent), ER/PR via IHC, Her2 status, patient comorbidities, and priorchemotherapy were recorded. 80 (16.4%) experienced weight gain and 48 (9.8%) experienced weight loss at 12 months compared to baseline. Half of Americans (50%) would want to know if they had Alzheimer's disease even before experiencing symptoms, and nearly 1 in 3 (29%) would want to know at the point where they are experiencing minor symptoms (Figure 21). Americans overwhelmingly viewed early diagnosis of Alzheimer's disease as important (99%), with nearly 4 in 5 (79%) indicating that early diagnosis of Alzheimer's disease is very important (Figure 20). Worry about developing Alzheimer's disease (left panel); Knowledge of Alzheimer's disease and related conditions (right panel).

2. Brain changes of Alzheimer's disease

Implementation paradigms encompass prompt-based methods requiring no additional training and training-based approaches optimizing models through reinforcement learning for strategic tool invocation 648, 1318, 965. Unlike static approaches, Agentic RAG treats retrieval as dynamic operation where agents function as intelligent investigators analyzing content and cross-referencing information 648, 162. RAG and agent workflows align through query rewriting corresponding to semantic comprehension, while retrieval phases correspond to planning and execution . These systems leverage reflection, planning, tool use, and multi-agent collaboration to manage retrieval strategies dynamically and adapt workflows to complex task requirements .

How Rapid Is Weight Loss With Farxiga? A Doctor Explains Timeline

Despite this growing concern, limited data exist on the scope and nature of symptom-related misinformation in the context of BC. However, unregulated nature of these platforms enables the rapid dissemination of health-related misinformation, which can influence patient behavior and decision-making. Financial difficulties (25.7), and symptoms related to surgery, such as breast (23.3) and arm (31.9) pain were also not impactful. Global health status (71.4) and physical and role functioning (76.9 and 71.8) were relatively well preserved in this cohort. Higher scores indicated a better quality of life for functioning domains/general health status, and a greater symptom burden. Logistic regression identified predictors of delay, and a point-based risk score—the TIDE Score (Treatment Initiation Delay Estimator)—was developed using significant socioeconomic and clinical variables. While socioeconomic disparities are well documented, there is no standardized tool to identify patients at high risk for treatment delays. Although up to 50% of patients experience clinically significant symptoms of anxiety or depression, mental health and emotional support services remain underutilized. Weight loss may indicate more advanced disease, while weight gain could increase cardiometabolic risks. Post-treatment weight change was defined as the percentage difference between weight reported near diagnosis and at the 2-year follow-up.

Options Program for Metabolic and Bariatric Surgery

Major advances in technology are optimizing the time and effectiveness of the dementia care workforce. These actions have included but are not limited to overhauling training and credentialing systems, designing new career development opportunities, implementing reimbursement rate increases tied to increased compensation, and developing new recruitment campaigns and pipeline programs.934, 935 The challenge will be to sustain these investments into the future, as the need for direct care services continues to escalate. To address inequities in dementia care, CMS is actively seeking safety‐net organizations that provide care to underserved communities, including disproportionately Black/African American and Hispanic communities, to participate in the GUIDE Model. (As of January 1, 2024, Medicare reimbursed approximately $268 to physicians and other eligible billing practitioners, through billing code 99483, for providing a comprehensive clinical visit that resulted in a written care plan; the rate may be geographically adjusted.795, 929, 930) However, as noted, use of this benefit has been limited, likely because providers, especially in smaller practices and rural areas, are insufficiently aware of the appropriate billing codes, and/or may be billing for similar services under different codes.797, 931 In the future, providers could be better informed about these codes. All 3 patients with steatosis underwent dose reduction due to other capecitabine toxicities (hand-foot syndrome in 2 patients, general condition deterioration requiring weight-based dose adjustment in 1 patient), resulting in resolution of CT steatosis in 2 patients. For those referred for further evaluation, clinical and mammographic data, including BI-RADS classification and breast density, were reviewed. This platform has demonstrated high sensitivity and specificity for detection of early stage disease across several cancer types. Early detection of breast cancer saves lives, yet mammography—the current standard for screening—has well-documented limitations. Memory Systems enable LLMs to transcend stateless interactions by implementing persistent information storage, retrieval, and utilization mechanisms. Modern frameworks incorporate dynamic knowledge retrieval methods enabling continuous strategy adjustment based on evolving input and contextual information, enhancing interactivity and semantic understanding while increasing applicability across cross-domain integration . Scalability solutions incorporate distributed processing architectures with efficient data partitioning, query optimization, and fault tolerance mechanisms adapting to changing stream conditions 1040, 35. Dynamic retrieval mechanisms advance over static approaches by continuously updating strategies during generation, adjusting goals and semantic vector spaces in real-time based on generation states and identified knowledge gaps . Integration of streaming data introduces complications as traditional architectures demonstrate poor accuracy with frequently changing information and decreased efficiency as document volumes grow . Outcomes of interest include ipsilateral breast tumor recurrence (IBTR), disease-free survival (DFS), overall survival (OS), radiation toxicities (graded by CTCAE v5.0), and physician-reported (Harvard scale) cosmetic outcomes. We used logistic regression to elucidate associations between development of humeral head fractures and radiation exposure, usage of boost radiation, and hormonal therapy among other studied variables. Forty-one patients received radiotherapy alone, and 48 received concurrent radiotherapy and pembrolizumab. However, combining radiotherapy with pembrolizumab may increase the risk of toxicities, particularly cardiac, and its long-term safety profile remains poorly characterized. Standardized photographs of patients were taken after completion of adjuvant whole breast RT, and cosmesis was evaluated using standardized scoring systems. If you practice healthy eating habits and are active enough to stay healthy, then a few extra pounds are not bad for your health unless you have other medical problems. Many people who weigh a few extra pounds are still at a healthy weight. A healthy weight is the weight you reach when you're active and eating healthy foods. While some programs may seem less expensive initially, they might not offer the same comprehensive support and medical oversight that Kaiser provides, which can lead to more sustainable results. These can include fees for optional services such as personalized meal plans, specialized supplements, or advanced diagnostic tests that might be recommended based on individual health needs. Patients who received radiotherapy to the oral cavity or jaw were excluded from the study. The majority of respondents with MBC obtained information about sexual health from social media, although a lower percentage compared to those with non-MBC (66.7% vs 80.5%). Given the chronic nature of MBC and ongoing treatments, sexual health concerns may be especially complex and underrecognized in this population. AYAs use multiple methods to manage symptoms and concerns that vary in effectiveness, highlighting the need for diverse methods tailored to evolving patient needs alongside personalized survivorship care delivery to improve patient quality of life. Unpaid caregivers of people with Alzheimer's or other dementias provided care valued at more than $5 billion in each of 27 states. In 2024, the 11.9 million family and other unpaid caregivers of people with Alzheimer's or other dementias provided an estimated 19.2 billion hours of unpaid help. When a person with Alzheimer's or another dementia moves to an assisted living residence or a nursing home, the help provided by his or her family caregivers usually changes from the comprehensive care summarized in Table 8 to providing emotional support, interacting with residential care staff and advocating for appropriate care. In addition, as new therapies for Alzheimer's and other dementias develop, the composition and size of the dementia care workforce must continue to evolve. One specific training model is the Alzheimer's and Dementia Care ECHO® (Extension for Community Healthcare Outcomes) Program, which pairs PCPs with multidisciplinary specialist teams through telementoring to develop PCPs' knowledge and confidence in dementia care. Complementing this training, language‐concordant and culturally tailored resources and referrals are needed to help overcome the misunderstandings, biases, misdiagnoses and related disparities experienced by people of color and other individuals in minority populations who are living with dementia and by their families.918, 919, 920, 921, 922, 923

Feasibility of accelerated partial breast irradiation (APBI) following neoadjuvant systemic therapy and lumpectomy

Here we evaluate the impact of MRD surveillance on quality of life among patients with EBC through investigating anxiety, depression, fear of recurrence, and patient comprehension. This risk was not confined to a specific regimen and is likely multifactorial in nature. The pooled incidence of MN-pCT was 0.31%(chemotherapy) and 0.23% (no-chemotherapy). Patients received oral chidamide (30 mg twice weekly for four consecutive weeks in a 4-week cycle) combined with intramuscular fulvestrant (500 mg on days 1 and 15 of cycle one, followed by day 1 of each subsequent 28-day cycle) until disease progression or intolerance. A pivotal phase 3 trial is ongoing to address the high unmet medical need in ER+/HER2− mBC after progression on CDK4/6i plus ET. Following 14 days of triplet therapy all tumors retained ER and BCL2 positivity however a reduction or loss in PR staining was observed in all samples. Five pts had visceral metastases and 11 pts had non-visceral or bone-only metastases.The CBR (rate of confirmed complete or partial response or stable disease at 24 wks) was 93% (14/15 pts). Four pts had received prior therapy in the metastatic setting; 1st line aromatase inhibitor (3 pts) and chemotherapy and tamoxifen (1 pt). However, rigorous evaluations of its effectiveness in supporting meaningful functional gains—particularly those prioritized by patients themselves—remain limited. In this patient, the coexistence of malignancy, prior radiation, and ESRD may have played a synergistic role in disease development. The patient declined surgical intervention and opted for continued follow-up with dermatology and the wound care. Surgical excision was deemed high-risk due to the extensive resection area required, with concerns regarding poor wound healing, dehiscence, and recurrence.