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Approximately 40% of men older than 50 have urinary frequency or urgency that affects their quality of life. Author John T. Wei, MD, MS, of the University of Michigan Department of Urology and JAMA Deputy Editor Mary M. McDermott, MD, discuss diagnosis and management of these symptoms in older men. Related Content: Lower Urinary Tract Symptoms in Men

Text us a question and we'll answer it on the podcast...Dr. Jon Finn explores striking parallels between the Industrial Revolution and today's AI Revolution, highlighting the unprecedented competition to human brainpower that AI represents. Unlike the Industrial Revolution that unfolded over a century, the AI Revolution is happening in just 2-5 years, with predictions being realized faster than expected.• First-time ever competition to human brainpower through neural networks that can work 24/7• Industrial Revolution created jobs while the AI Revolution is eliminating them even in financially strong companies• Henry Bessemer's steel-making technology that reduced production time from 4 days to 15 minutes serves as a historical parallel• Approximately 100,000 tech sector jobs lost to AI this year already• Companies are reallocating savings from human roles into building AI workforces• Understanding history, particularly the Industrial Revolution, helps us prepare for AI changes• Optimizing our brain states is key to becoming "AI winners" rather than being displacedYou're only ever one Brain State habit away from transformation.

Listen to today's podcast... Approximately 1 in 5 seniors say that they are lonely.  People can become lonely for any number of reasons, regardless of their age. Some people are lonely because they don't feel like they fit in, while others may become lonely after the death of a loved one. Other people might just suffer from an illness that doesn't allow them to see many people. When my boys were little, they were blessed to have 3 sets of grandparents and 3 sets of great-grandparents.  Life was busy with two little ones, but we made it a point of visiting each of the great grandparents.  Sometimes the boys would complain, and we would have to explain that not everyone's lives were busy like ours.  Grandmas and Grandpas loved us and looked forward to us visiting.  It made them happy.  It doesn't take much to cheer up the lonely and make a difference. Take One Action Today To Build Your #Resiliency!  Here are today's Tips For Building Resiliency and Celebrating Cheer Up The Lonely Day: Let your friend or family member know that you are thinking about them.  Send them a message, call them on the phone, or go for a visit. We need physical contact, but giving a hug may not be appropriate at this time.  Did you know that giving 5 people a hug every day can lower your own stress level by 25%. Look for other ways to get connected. Ask what they need.  It's ok to ask.  And if they are not sure, let them know that you are there when they need you. If you like today's wellness tips, let me know. You can leave me a review on amazon or through your #alexa app. Discover how to take small steps towards a healthier, happier, less-stressed you by visiting my website at worksmartlivesmart.com #mentalhealth #hr

We'll be turning our attention to Mark chapter six today, where we see the heart of God and some valuable principles that can help us as we set out to serve God.  Approximately fifteen to twenty five thousand hungry people, and just five loaves and two fish.  The disciples of Christ saw this as a problem, but Jesus saw it as an opportunity.

How to talk to those affected by misinformation. Dealing with the consequences of those affected by misinformation Conspiracy theorists tend to operate in polarised echo chambers, closing them off to other source. Approximately 25% of the population are susceptible to conspiratorial ideation, something many of us realised during the pandemic in family Whatsapp Groups.Speaking to Ivan this morning was Dr David Robert Grimes, Author and disinformation expert .

Shoot us a Text.Happy July 4th! Today, Chris Reeves joins Paul and Kyle to celebrating the most amazing industry in the most amazing country in the world.Here's some fun facts about this July 4th:72.2 million Americans are expected to travel 50+ miles from home between June 28 and July 6, marking a new record. 61.6 million will travel by car, making it the busiest Independence Day on the roads. 5.84 million air travelers are anticipated, with domestic airfare averaging $260 round trip—the lowest in four years. A 10-person cookout now averages $99, the highest on record, with beverages and meats comprising 64% of the total costTotal fireworks revenue is estimated at $2.3 billion in 2025, with consumer sales at $1.6 billion and professional displays at $700 million. Approximately 285 million pounds of fireworks are expected to be consumed, with 95% imported from China.Plus Chris brings a people-focused story to the show today:American teacher Mark Fogel was arrested in Russia 3 years ago, and released in February this year.Shults Ford and Dealer Richard Bazzy in Pittsburgh gifted Mark a brand-new F-150 as a celebration of him coming home.Join Paul J Daly and Kyle Mountsier every morning for the Automotive State of the Union podcast as they connect the dots across car dealerships, retail trends, emerging tech like AI, and cultural shifts—bringing clarity, speed, and people-first insight to automotive leaders navigating a rapidly changing industry.Get the Daily Push Back email at https://www.asotu.com/ JOIN the conversation on LinkedIn at: https://www.linkedin.com/company/asotu/

jQuery(document).ready(function(){ cab.clickify(); }); Original Podcast with clickable words : Contact: irishlingos@gmail.com €31 million worth of cocaine seized in west Cork. Luach €31 milliún de chócaon faighte in iarthar Chorcaí. Gardaí have arrested four men over a large haul of drugs found in Co. Cork this morning. Tá ceathrar fear gafa ag na Gardaí faoi lear mór drugaí a fuarthas i gCo Chorcaí ar maidin inniu. Approximately €31 million worth of cocaine was seized when Gardaí stopped a van in the Courtmacross area of the west of the county. Fuarthas luach thart ar €31 milliún de chócaon nuair a stop na Gardaí veain i gceantar Chúirt Mhic Shéafraidh in iarthar an chontae. Two men in their thirties and forties were arrested on the member and are being held at a Garda station in Co. Cork. Gabhadh beirt fhear sna tríochaidí agus sna daichidí ar an mball agus tá siad faoi choinneáil i stáisiún Gardaí i gCo Chorcaí. The other two men were caught on a rigid inflatable boat off the coast of Waterford. Gbhadh an bheirt fhear eile ar bhád righin inséidte amach ó chósta Phort Láirge. Those two are also in their thirties and forties. Sna tríochaidí agus sna daichidí atá an bheirt sin freisin. In a statement, the Gardaí said that customs officers, the Naval Service, the Air Corps and members of the local Garda Síochána were involved in the operation. I ráiteas, dúirt na Gardaí go raibh oifigigh chustaim, an tSeirbhís Chabhlaigh, an tAerchór agus comhaltaí den Gharda Síochána áitiúil páirteach sa bheart. RTÉ News and Current Affairs Nuacht agus Cúrsaí Reatha RTÉ

N Engl J Med 2004;351:2049-2057Background: Endothelial dysfunction, reduced nitric oxide availability, and increased oxidative stress occur in patients with heart failure and contribute to cardiac remodeling. In the V-HeFT I trial, combining isosorbide dinitrate (a nitric oxide donor) with hydralazine (an antioxidant) improved outcomes in patients with systolic heart failure. However, its long-term effectiveness in patients already receiving neurohormonal blockade was unclear.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Racial differences exist in heart failure prevalence, mechanisms, and outcomes. Patients who identify as Black may have a less active renin–angiotensin system and lower nitric oxide availability. Prior analyses suggested that Black patients respond well to isosorbide dinitrate + hydralazine and respond less to Angiotensin Converting Enzyme Inhibitors (ACEi). For example, in a subgroup analysis of the V-HeFT I trial, isosorbide dinitrate + hydralazine reduced mortality in Black but not White patients.The African-American Heart Failure Trial (A-HeFT) sought to assess the efficacy of isosorbide dinitrate + hydralazine in Black patients with systolic heart failure.Patients: Patients were eligible if they self-identified as Black (defined as African decent), and had NYHA class III or IV heart failure for at least 3 months. The left ventricular ejection fraction had to be 35% or less or less than 45% if the ventricle was dilated. In addition, patients had to be on guideline medical therapy for at least 3 months.Patients were excluded if they had acute coronary syndrome or stroke within 3 months, cardiac surgery or percutaneous coronary intervention within 3 months, significant valvular disease, hypertrophic or restrictive cardiomyopathy plus many others.Baseline characteristics: Patients were recruited from 161 centers in the United States. The trial randomized 1,050 patients – 518 randomized to receive isosorbide dinitrate + hydralazine and 532 to receive placebo.The average age of patients was 57 years and 60% were men. The average left ventricular ejection fraction was 24% and the average left ventricular internal diastolic diameter was 6.5 cm. The cause of cardiomyopathy was ischemic in 23% of the patients, hypertensive in 39%, idiopathic in 26%, and other causes constituted the rest. The NYHA class was III in 96% of the patients. The average systolic blood pressure was 126 mm Hg.Approximately 40% had diabetes, 17% had chronic kidney disease and 17% had atrial fibrillation.At the time of enrollment, 90% were taking a diuretic, 69% were taking an ACEi, 17% were taking an angiotensin receptor blocker, 74% were taking a beta-blocker, 39% were taking spironolactone and 60% were taking digoxin.Procedures: The trial was double-blinded. Patients were randomized in a 1:1 ratio to receive fixed-dose combination of isosorbide dinitrate + hydralazine or to receive placebo. The initial dose was one tablet taken three times daily, containing either placebo or a combination of 37.5 mg of hydralazine and 20 mg of isosorbide dinitrate. If no side effects, the dose was increased to two tablets three times a day.Patients had follow up by phone every month and clinic visits every 3 months.Endpoints: The primary endpoint was a composite of weighted values of all-cause mortality, first hospitalization for heart failure within 18 months, and change in quality of life at 6 months. Quality of life was assessed using the Minnesota Living with Heart Failure Questionnaire, a 21-question self-administered questionnaire in which scores range from 0 to 5, with higher scores reflecting worse quality of life.The table below summarizes how the weighted score for the primary outcome was calculated.Analysis was performed based on the intention to treat principle. The main manuscript did not mention the estimated number of events for sample size calculation but did mention that 1,100 patients would provide sufficient power with a p

Darryl Anka Channeling Bashar - Join the Sixth Hybrid Race AwakeningDarryl Anka is an American spiritual medium and filmmaker best known for channeling an entity named Bashar. According to Anka, Bashar is an extraterrestrial being from the planet Essassani, located approximately 500 light-years away in the direction of the Orion constellation. Anka describes Bashar as existing in a parallel reality and time frame that we perceive as the future. (Reddit, rationalwiki.org)Anka's journey into channeling began after he reported witnessing two daylight UFO sightings in the 1970s. These experiences led him to explore UFO phenomena and the paranormal. Approximately ten years later, he attended a channeling class, during which he claims to have received a telepathic message from Bashar. This experience prompted him to begin channeling Bashar, a practice he has continued since the 1980s. (rationalwiki.org, bashar.org)Through Anka, Bashar conveys teachings that focus on personal empowerment and the nature of reality. Key concepts include the idea that all possible realities exist simultaneously and that individuals can shift between these realities by changing their beliefs and attitudes. Bashar emphasizes the importance of acting on one's highest excitement without attachment to specific outcomes, suggesting this approach aligns individuals with their true purpose.Anka has shared Bashar's messages through various mediums, including live seminars, books, and documentaries. One notable documentary is "First Contact," which explores Anka's experiences and the messages conveyed by Bashar. While Anka's work has garnered a following, it has also faced skepticism. Critics question the veracity of his claims and the authenticity of channeling extraterrestrial entities. Nonetheless, Anka continues to share Bashar's teachings, focusing on themes of self-empowerment and the exploration of consciousness.

Laura Pedernuzzo shares her experiences living with multiple disabilities and provides invaluable insights into disability advocacy. She explains how both visible and invisible disabilities shape her daily interactions with the world, highlighting the unique challenges of each.• Living with cerebral palsy creates physical barriers, but the fatigue it causes is often misunderstood• People with borderline personality disorder are often mischaracterised as manipulative when they're simply trying to cope with intense emotions.• The concept of "crip time" acknowledges that disabled people don't have "the same 24 hours" as non-disabled people.• Approximately 44% of Australians have low literacy levels, making accessible communication essential.• Easy Read uses simple language and images to make information accessible to people with low literacy.• Continued COVID-19 precautions are vital for creating truly inclusive spaces• Small actions like acknowledging access needs show disabled people they matter and their needs aren't burdens but rights.

Did you know that for the first 15 years of your mortgage, you're working mostly for the taxman, not your future wealth? It's a startling claim, but one backed by data from the Housing Industry Association — and it sheds new light on why housing affordability is getting worse, not better. Today, I'm joined by Tim Reardon, Chief Economist at the HIA, to unpack this extraordinary insight. We explore how government taxes and regulatory charges are silently front-loading the cost of home ownership, inflating house prices, and burdening Aussie families before they've even laid a brick. And while there's some good news on the horizon — with interest rate cuts expected to drive a recovery in home building — the longer-term challenges are immense. Think taxes, planning bottlenecks, and a construction industry on its knees due to chronic underbuilding and workforce shortages. Whether you're a property investor, homeowner, or policymaker, this conversation will leave you thinking differently about the hidden forces shaping the housing market — and why just building more homes won't be enough.   Takeaways  ·         The first 15 years of mortgage repayments primarily cover taxes. ·         Approximately 50% of the cost of a new house is attributed to taxes and fees. ·         Government policies significantly impact housing supply and affordability. ·         Subsidizing first home buyers does not address the root causes of housing unaffordability. ·         The 1.2 million homes initiative requires substantial policy changes to succeed. ·         Foreign investment is crucial for increasing housing supply. ·         Build-to-rent projects are not currently providing affordable housing options. ·         Interest rates directly influence the volume of new home building. ·         Labor availability is a significant challenge for the construction industry. ·         Policy reforms are necessary to improve housing supply and affordability.   Chapters  01:12 Understanding Mortgage Repayments and Taxes 04:54 Challenges in Housing Supply and Infrastructure 09:00 Government Schemes and Their Limitations 10:39 The 1.2 Million Homes Initiative 14:41 The Future of Build-to-Rent Projects 17:01 Market Dynamics and Housing Affordability 20:27 Structural Challenges in the Housing Industry 23:18 Conclusion and Future Outlook   Links and Resources: Answer this week's trivia question here- www.PropertyTrivia.com.au ·         Win a hard copy of How to Grow a Multi-Million Dollar Property Portfolio – in your spare time. ·         Everyone wins a copy of a fully updated property report – What's ahead for property for 2025 and beyond   Get the team at Metropole to help build your personal Strategic Property Plan Click here and have a chat with us Michael Yardney – Subscribe to my Property Update newsletter here  Tim Reardon HIA Chief Economist  Get a bundle of eBooks and Reports at www.PodcastBonus.com.au   Also, please subscribe to my other podcast Demographics Decoded with Simon Kuestenmacher – just look for Demographics Decoded wherever you are listening to this podcast and subscribe so each week we can unveil the trends shaping your future.

On this episode Bryn talks to film maker and campaigner Barak Laub about his documentary Volunteers Needed and the discovery he made when travelling Nepal.  Approximately 80% of children in orphanages have at least one living parent, so why, in some parts of the world, are orphan numbers dropping whilst orphanages are increasing in number? Is it possible that well-meaning travellers looking to volunteer in an orphanage are actually part of the problem? Find our more about Barak and his campaign at: https://www.volunteersneededthefilm.com/   This podcast was produced by Blue Bear Coffee Co. and narrated by Bryn Frere-Smith. Follow us at: @bluebearcoffeeco @brynfreresmith   Books referred to in the Pod: The Jungle - Upton Sinclair Bad Aid - Dambisa Moyo Where Helping Hurts - Steve Corbett & Brian Fikkert   Theme tune, Spotless Rose by Matt Tinsley

Hi This is Brad Weisman - Click Here to Send Me a Text MessageZach Tsakiris, founder of FastWill.com, explains how his online platform makes creating wills and trusts accessible and affordable compared to traditional legal services that often overcharge for basic estate planning documents.• Approximately 60% of Americans don't have wills, leaving critical decisions about children, assets, and healthcare to the government • Without a will or trust, the state decides who raises your children and how assets are distributed when you die• Revocable living trusts aren't just for the wealthy - they help bypass probate court and offer more control• Estate planning includes customizable options for pets, social media accounts, and even funeral song selections• Remote notarization ensures documents can't be disputed and eliminates the need to visit a bank• Users can store documents digitally, make updates as life changes, and access a nationwide network of attorneys• FastWill also offers a B2B platform for financial advisors to provide estate planning services to clientsVisit FastWill.com today to create, sign and notarize your estate planning documents from home.#fastwills #trusts #wills #estateplanning #thebradweismanshow ---Welcome to The Brad Weisman Show, where we dive into the world of real estate, real life, and everything in between with your host, Brad Weisman!

I was invited to participate in a job search panel at St. Xavier University along with James Miller (who coordinated the event), Lauren Milligan, Nathan Peck, and Dr. Vincent Alexander Davis. Approximately 30-40 students attended and asked questions in areas such as resumes, career changes, job scams, networking, and other related topics listed below. This […]

Last time we spoke about the victory at Okinawa.. As American forces led by General Buckner advanced, they captured strategic key points, driving the Japanese into a desperate retreat. Despite overwhelming odds, the remaining Japanese defenders, embodying the samurai spirit, fought to the bitter end, hoping to gain time for their homeland's defenses. On June 21, faced with inevitable defeat, Generals Ushijima and Cho chose to commit seppuku in honor of their duty. Their tragic decision underscored the deep commitment to their cause, an adherence to the warrior code. By this point, countless Japanese soldiers surrendered, acknowledging the futility of their fight. As the month drew to a close, the Americans secured Okinawa, a hard-won victory shadowed by staggering casualties, more than 107,000 Japanese lives lost and significant American losses. This battle not only symbolized the relentless spirit of those who fought but also the tragic costs of war, forever etched in history as a vivid reminder of sacrifice and the haunting price of conflict. This episode is Liberation of Luzon Welcome to the Pacific War Podcast Week by Week, I am your dutiful host Craig Watson. But, before we start I want to also remind you this podcast is only made possible through the efforts of Kings and Generals over at Youtube. Perhaps you want to learn more about world war two? Kings and Generals have an assortment of episodes on world war two and much more  so go give them a look over on Youtube. So please subscribe to Kings and Generals over at Youtube and to continue helping us produce this content please check out www.patreon.com/kingsandgenerals. If you are still hungry for some more history related content, over on my channel, the Pacific War Channel you can find a few videos all the way from the Opium Wars of the 1800's until the end of the Pacific War in 1945.  For most, the battle of Okinawa basically ends the Pacific War, but the truth is the war was raging all over the place. The second most noticeable place would be Luzon, where the remnants of General Yamashit'as 14th Area Army were still resisting in the northern and eastern mountain ranges. Yet here too, the curtains were beginning to fall. As we last left off, it was mid-April 1945, and the fierce struggle for the liberation of Luzon was reaching a critical phase. General Eichelberger's 8th Army was actively engaged in offensives across the Visayas and Mindanao, while General Krueger's 6th Army focused its might on two primary sectors in Luzon. The stakes were high, the liberation of Luzon was crucial for securing Manila and restoring the Filipino government that had been disrupted by the war. In the northern sector, General Swift's 1st Corps was grappling with General Yamashita's formidable Shobu Group, who were entrenched in this mountainous terrain, making the fighting particularly arduous. Meanwhile, General Hall's 11th Corps was applying relentless pressure on the opposing Shimbu Group, led by General Yokoyama, in the vital areas east of Manila. Starting in the northern reaches of Luzon, we find General Clarkson's 33rd Division making tangible advances, having secured Route 11 up to Camp 3, as well as segments of the Galiano Road and the Tuba Trail. This area, known for its treacherous paths and thick jungle, posed significant challenges, but the troops pressed on. Northward, General Beightler's 37th Division was also on the move, with its 129th Regiment overcoming all enemy resistance along Route 9, reaching the critical town of Sablan by April 14. Not to be overlooked, Colonel Volckmann's guerrilla 121st Regiment had carved a path up Route 4 to the strategically important Bessang Pass, known for its rugged terrain that offers a natural defense. General Mullins' 25th Division was making notable progress towards Balete Pass, gaining crucial footholds on Crump Hill and Myoko Ridge. These positions were essential as they provided elevated vantage points over the surrounding valleys. On the western front, General Gill's 32nd Division had successfully secured the western Salacsac Pass but still faced stiff enemy positions in the eastern pass, where Japanese forces were well-prepared to defend. With the arrival of the bulk of the 37th Division in early April, Swift was poised to launch a dynamic two-division drive towards Baguio, a city nestled in the mountains that had become a strategic goal due to its position and resources. While Clarkson's units continued to engage in patrol actions in the Arboredo, Agno, and Ambayabang River valleys, there was limited progress in these areas. However, the 129th Regiment initiated a decisive attack on Sablan on April 11, successfully breaching Japanese defenses there by April 14. On that pivotal day, the 148th Regiment took charge of securing Route 9 through Calot, a vital corridor for advancing troops. Meanwhile, the 130th Regiment encountered fierce resistance as it pushed west of Asin along the Galiano Road, exemplifying the tenacity of Japanese forces determined to hold their ground. As the battle raged, General Yamashita was already strategizing to evacuate Baguio. By April 19, he made the decision to relocate to the Bambang front, leaving Major-General Utsunomiya Naokata, one of his trusted chiefs of staff, in command of the remaining forces.  Despite the growing pressure on Route 9, the Japanese command seemed out of touch by the second week of April 1945. They inaccurately assessed that the primary thrust of General Swift's 1st Corps would come along Route 11, allowing them to become complacent. This misplaced confidence led to a failure to redeploy troops to counter the increasing threat on their right flank. Instead of fortifying their defenses, they appeared to adopt an inexplicable, almost defeatist attitude, unusual for a military as disciplined as the Imperial Japanese Army. Compounding this lack of urgency was the intense effort from the 14th Area Army headquarters to evacuate civilians and supplies from Baguio, a city perched high in the Cordillera Central mountain range. This evacuation served as a clear signal that the situation was deteriorating, yet the Japanese command remained strangely passive. Yamashita's mindset regarding the unfolding crisis was evident when he made personal preparations to depart for the Bambang front on April 19. In a move echoing his earlier strategy for the Bambang area, he established an independent command for the Baguio front before his departure. Utsunomiya's responsibilities also included nominal command over the 19th Division, stationed north of Baguio, but his control was hampered by significant communication difficulties that plagued the Japanese forces. The first notable action Utsunomiya took was to relieve the 58th Independent Mixed Brigade from the 23rd Division's control, seeking to streamline command. Under Yamashita's directive to hold Baguio for as long as possible before retreating to a new defensive line, Utsunomiya issued an order for all troops along the existing Main Line of Resistance  "hold out to the last man." His tone betrayed the grim reality, coming across as almost ironic given the mounting pressures they faced. Meanwhile, General Sato's 58th Independent Mixed Brigade was frantically working to fortify defenses along Route 9, southeast of Calot. However, their efforts came too late to prevent the 148th Regiment from swiftly capturing Yagyagan on April 15, gaining a crucial foothold in the area. In response to this setback, Sato began sending reinforcements to the Irisan Gorge starting April 16, apparently under Utsunomiya's orders. This narrow, treacherous gorge, surrounded by steep cliffs, was seen as a pivotal point for a last-ditch defense. The Japanese troops managed to repel the initial assaults from the 148th Regiment on April 17, but as night fell, the Americans executed a series of enveloping maneuvers, ultimately securing Ridge A. The following morning, the 148th seized Ridge C; however, their frontal assaults against Ridge B were met with fierce resistance and ended in failure. On April 19, the tide began to turn. After a devastating air strike and concentrated artillery fire that neutralized most of the Japanese positions on Ridge F, the Americans finally captured Ridge B. Concurrently, other American units seized Hills D and E, effectively cutting off the Japanese retreat route. The relentless pressure continued, and the next day, Ridges F and G were subjected to intense attacks, which ultimately resulted in their capture. This relentless campaign forced the Japanese to withdraw to Ridge H, where they continued to regroup. After heavy bombardment, the Irisan Gorge was finally cleared on April 21, sending the surviving defenders scrambling in retreat. As these operations unfolded, the 130th Regiment was busy repositioning two battalions from the Galiano Road to the junction of the Yagyagan Trail along Route 9, poised to mount a coordinated attack on Asin from both the east and west. On April 22, they launched their offensive, catching the Japanese defenders by surprise and effectively dismantling their defenses. By the afternoon of April 23, the Galiano Road was opened for American forces, marking a significant advancement in their campaign. Concurrently, the 129th Regiment had taken over operations from the 148th Regiment and advanced against only scattered resistance, making significant progress as far southeast as the junction of the highway and the Galiano Road. However, their advance was ultimately halted due to concerns about a potential threat from the north. Seizing on this hesitation, General Utsunomiya decided to leave small delaying forces at Trinidad and Baguio, while initiating a general withdrawal to the north and northeast. With Utsunomiya's defensive lines weakened, American patrols were able to enter Baguio on April 24, met with surprisingly little resistance. By April 26, the 129th had effectively secured most of the city, facing only negligible opposition. Simultaneously, elements from the 123rd and 130th Regiments worked diligently to eliminate the remaining Japanese defenses on nearby Mount Calugong, along the Tuba Trail, and on Mount Mirador, ensuring the area was cleared for further American operations. Despite these American successes, Utsunomiya managed to escape with approximately 10,000 troops to the Baguio-Aritao supply road, a crucial evacuation route for Japanese forces. As the end of April approached and into the first days of May, the 37th Division continued to mop up the surrounding areas, further securing Trinidad. Meanwhile, the 33rd Division also pressed forward, capturing the Balinguay-Itogon-Pitican sector, enhancing their control over the region. Looking eastward, General Gill's demoralized 32nd Division was still engaged in fierce fighting through the Salacsac Pass, hampered in their advance along the Villa Verde Trail.  During the second week of April 1945, observers from the 6th Army headquarters reported alarming morale issues within the 32nd Division, echoing concerns that General Krueger had personally noted during previous visits to the front lines. The soldiers of the 126th and 128th Regiments were on the brink of complete mental and physical exhaustion. Front-line troops, many of whom had spent significant time overseas, were becoming overly cautious, possibly from the toll of constant combat. Conversations among the men frequently centered around one urgent topic: their rotation back to the United States. The once aggressive spirit characteristic of these combat troops was waning rapidly. With dwindling numbers and pervasive personnel issues, it was clear that the division would struggle to mount any spectacular gains in the coming days. If they couldn't quicken their pace along the critical Villa Verde Trail, reaching their objective, Santa Fe, by the targeted date of June 1 appeared increasingly unlikely. Delays would be catastrophic; they risked being trapped on the trail by the heavy rains of the impending wet season, which typically began in late May. Such circumstances would severely hinder their ability to withdraw and salvage their equipment from the treacherous mountainous terrain. Meanwhile, the Japanese forces retained key terrain advantages, allowing them to economically utilize their troops and reinforce their front lines almost at will. In stark contrast, the rugged landscape severely restricted the 32nd Division's maneuverability, forcing them to repeatedly launch costly frontal assaults with their diminishing strength. While terrain and weather conditions presented significant challenges, the growing personnel crisis loomed as a critical factor likely to further limit the division's progress in the days ahead. Compounding their challenges, General Iwanaka's reconstituted 2nd Tank Division had suffered heavy casualties, leaving General Konuma unable to provide further reinforcements. On April 17, the rested 127th Regiment finally began its move to relieve the beleaguered 128th Regiment at the western pass, launching operations to clear the last remnants of Japanese forces from the Hill 506-507 area. Although Hill 506B fell rapidly on April 19, and Hill 507C was captured three days later, American forces struggled to completely clear Hill 507D until May 2, underscoring the tenacity of the Japanese defenders. Despite the challenges, enough ground had been cleared by April 26 for the 2nd Battalion to initiate a drive east along and south of the Villa Verde Trail, aiming for the strategically important Hill 508. The Japanese forces, sensing this new threat, responded with fierce counterattacks from both the east and north, managing to delay the American capture of Hill 508 until April 29. The intense fighting illustrated the importance of this elevation, which offered vital visibility over the surrounding landscapes. In the days that followed, the 2nd Battalion expanded its control over Hill 508, establishing a defensive block on the Villa Verde Trail to the north while successfully repelling a series of heavy Japanese counterattacks. Meanwhile, the 3rd Battalion made significant strides by attacking and capturing Hill 509, further consolidating American positions in the area. Simultaneously, the 2nd Battalion of the 126th Regiment launched an offensive south from Hill 511, seizing Hill 515 on April 24. They advanced into the area north of Hill 508 while the 1st Battalion navigated through the rugged terrain of Hills 513 and 514, pressing southward to Hill 516. Their advance culminated in the capture of the crest of Hill 525, where they established a critical block on the Villa Verde Trail. However, the cost of these advances was significant. Due to the heavy losses incurred during these operations, the barely rested 128th Regiment began the process of relieving the exhausted 126th on May 3. Shortly after, the 128th's 2nd Battalion launched an assault southeast, successfully capturing Hill 526 on May 7, while some elements initiated a drive towards Hill 527. To the further east, General Mullins' 25th Division was persistently pushing its Santa Fe offensive against stubborn Japanese resistance. In a stroke of fortune, a successful aerial reconnaissance mission revealed that ground located just 1,000 yards west of their position might offer a more favorable route of advance to Balete Ridge, providing a welcome alternative to the challenging Myoko mass itself. On April 22, a reconnaissance force from the 27th Regiment successfully moved undetected to the southern slope of Balete Ridge, positioning themselves for a critical advance. The following day, the rest of the 2nd Battalion began to push toward Lone Tree Hill, while other units continued to exert pressure on the entrenched Japanese defenses at Myoko. Moving forward with enthusiasm and encountering negligible resistance, the Americans reached Lone Tree Hill on April 25, effectively bypassing the main concentrations of enemy forces. By April 27, the 2nd Battalion had advanced an impressive half mile beyond Lone Tree Hill, with its forward elements only three-quarters of a mile from Balete Pass. However, they were compelled to halt their advance due to the potential threat of an enemy counterattack looming on the horizon. Meanwhile, on April 23, the 35th Regiment began its ascent up Kapintalan Ridge, steadily making progress despite the challenging terrain. By April 27, their leading troops had reached a prominent knob located midway between Route 5 and Lone Tree Hill. The 161st Regiment was also making strides, continuing its attack northward towards Kembu Ridge, where they successfully secured Hill 4625 and the entirety of Highley Ridge by April 28. On that same day, the 27th Regiment began reinforcing their positions on Lone Tree Hill, while elements of the 2nd Battalion initiated a southwest push along Kapintalan Ridge to support the 35th Regiment advancing up Route 5. However, they encountered a formidable strongpoint and were only able to gain 350 yards of new ground northeast from the knob. Simultaneously, elements of the 27th Regiment advanced a modest 500 yards southwest by May 4, indicating the ongoing struggle. That morning, the 1st Battalion of the 161st Regiment seized the southeastern nose of Kembu Ridge, securing a valuable tactical position. At the same time, the 2nd Battalion pushed troops onto the ridge, extending their reach half a mile to the northwest, further consolidating American control in the area. As a breakthrough appeared imminent, General Krueger began dispatching Beightler's 37th Division to the Bambang front on May 2, with all elements of the division departing the Baguio area just three days later. With these reinforcements securing his rear and taking control of the Myoko massif, General Mullins ordered the 27th and 161st Regiments to concentrate their forces for a coordinated attack aimed at enveloping Balete Pass from both the east and west. On May 5, the 161st swiftly broke through Kembu Ridge and advanced to Haruna Ridge, while the 27th Regiment pushed west-northwest along Wolfhound Ridge. However, they faced fierce resistance, gaining only 350 yards against tenacious Japanese defenders. On May 8, Company I successfully launched a southwest offensive from their stronghold along a bare-crested ridge, while Company A deployed on Kenbu Ridge and began ascending the final sections of the Digdig River gorge. The following day, these two companies finally made contact with each other and linked up with the 161st on Haruna Ridge. By May 10, Wolfhound Ridge was secured, coinciding with elements of the 35th Regiment completing the clearance of Route 5 from Kapintalan to the pass. In the meantime, the 35th Regiment, along with units from the 27th, continued their assault on Kapintalan Ridge, which was ultimately secured by May 13. Meanwhile, the 148th Regiment renewed its attacks on Myoko Ridge, where Japanese resistance began to collapse by May 11. With these gains, Balete Pass was now secure. The Americans had incurred 565 men killed and 1,745 wounded during the drive, while General Okamoto's 10th Division experienced catastrophic losses, with nearly 7,000 men killed and a complete breakdown of their control and communications. Reflecting on the situation in Salacsac, by May 8, the Japanese position was deteriorating rapidly. In response, General Iwanaka made the critical decision to dispatch troops aimed at cutting the supply line to the 2nd Battalion of the 128th Regiment, with the intention of safeguarding his main stronghold at Mount Imugan. On that day, the 1st Battalion of the 128th Regiment began to push eastward, facing strong resistance, while elements of the 2nd Battalion moved west from Hill 526, struggling to make any significant progress. By May 10, Japanese forces successfully severed the track between Hills 525 and 516, forcing much of the 128th and one battalion of the 127th Regiment to allocate considerable resources to eliminate the Japanese pocket that had formed in that area. Meanwhile, the 33rd Division was left disheartened as it found itself assigned a holding mission to secure the Baguio-Bauang-San Fernando area. Their operations were limited to minor local gains and long-range reconnaissance, which did little to impact the overall situation.  During May 1945, the only significant action undertaken by the 33rd Division took place along a trail connecting Santa Rosa in the Ambayabang Valley to Tebbo, located on the Agno River five miles south of Pitican. The division focused its efforts on clearing Japanese forces from the high ground situated between the main trail and the upper reaches of the Ambayabang Valley. On May 9, a battalion of the 130th Regiment advanced south from Baguio via Pitican and reached Tebbo, only to find the barrio abandoned. Meanwhile, on May 5, the 136th Regiment began its advance up the Ambayabang Valley. Approximately three miles south of Tebbo, they became embroiled in a ten-day battle, resulting in the deaths of a few hundred Japanese troops. However, these enemy forces posed little threat to the 33rd Division, their primary mission being to block American attacks toward the Baguio-Aritao supply road from the south. As the rainy season approached, 1st Corps and the 33rd Division had long since abandoned plans to use the valley as a route of advance against the Japanese supply lines. Consequently, the 136th Regiment relinquished the terrain it had gained along the valley and the trail to Tebbo almost immediately after capturing it. By May 15, all troops of the 33rd Division began their withdrawal, a challenging task compounded by heavy rains that had transformed the Pitican-Tebbo trail and the trails in the Ambayabang Valley into quagmires. The final destruction of the Japanese blocking force in the valley had little impact on the strategic plans or dispositions of 1st Corps or the Shobu Group, as the Japanese quickly replenished their outposts. By the end of May, the 33rd Division was left executing reconnaissance missions without significant enemy contact or major advances. The division remained in a state of restless anticipation, awaiting developments on the Bontoc and Bambang fronts before the 6th Army would authorize a new drive deeper into the rugged mountains of northern Luzon. Turning to the north, the guerrilla 121st Regiment achieved a significant victory on April 21 by overrunning the last Japanese positions on Lamagan Ridge. About a week later, they completed their occupation of Lower Cadsu. However, during the first part of May, the 121st Regiment faced formidable challenges as they advanced over steep terrain against increasingly fortified Japanese defenses, bolstered by reinforcements from General Ozaki's 19th Division. In the south, Hall's 11th Corps made good progress throughout mid-April, successfully pushing General Yokoyama's 41st Army, previously known as the Shimbu Group, further east from Manila. Concurrently, General Hurdis' 6th Division continued its offensive against the Kobayashi Detachment at Wawa Dam, achieving a notable success by securing the crest of Mount Mataba on April 17, marking a significant tactical gain in the ongoing battle. Despite General Hurdis' hopes to swiftly advance against Mount Pacawagan and Wawa Dam, persistent personnel issues forced him to halt any offensive actions until the 145th Regiment could relieve the 20th Regiment in the Montalban area. The 145th eventually began its assault on Pacawagan on April 21. However, even with effective supporting fire that destroyed much of the enemy's defenses, American forces struggled to secure a foothold on the mountain until the end of the month. Meanwhile, the 1st and 63rd Regiments continued to hold their occupied ground until they were relieved late in April by the 151st and 152nd Regiments of General Chase's 38th Division, which then officially assumed control of the offensive operations. In the southern part of Manila, significant water supply problems prompted General Hall to redeploy General Wing's 43rd Division northward in preparation for an offensive against Ipo Dam.  By mid-April 1945, an acute water shortage had developed within the city of Manila. General MacArthur informed General Krueger about the dire situation, noting that south of the Pasig River, Manila had access to no water sources except for that supplied by Army tank trucks and shallow, often contaminated wells. This shortage significantly hampered sewage disposal throughout the city, as water pressure from the overtaxed Novaliches Reservoir, the only reliable source was insufficient to carry off waste. As a result, flush toilets were frequently clogged, forcing many citizens to resort to using gutters and esteros for defecation. Restaurants and nightclubs, which were heavily frequented by off-duty American troops, struggled to maintain even minimum sanitary standards. The situation was exacerbated by a steady influx of military units and civilians into the metropolitan area, raising concerns about the imminent threat of severe epidemics breaking out in the city. On April 19, MacArthur suggested to Krueger that the 6th Army could resolve Manila's water supply crisis by seizing "the reservoir in the Montalban area." He inquired how soon the installation could be captured. This query puzzled Krueger, who was aware that the only true reservoirs linked to the Manila water system were located west of the Marikina River and had been under American control since February. Furthermore, Krueger understood that Wawa Dam, the nearest water supply installation to Montalban, was no longer connected to the metropolitan system. He subsequently asked MacArthur if by "reservoir in the Montalban area," he meant Ipo Dam, the only major water installation still in Japanese hands. Krueger's question seemingly led to further examination of Manila's water system at General Headquarters, Southwest Pacific Area (GHQ SWPA). On April 22, MacArthur radioed back to Krueger, confirming that Ipo Dam was indeed the preferred objective. He emphasized that capturing the Ipo installation would effectively solve Manila's water supply problems. Upon receiving this directive, Krueger ordered the 11th Corps to launch a drive on Ipo Dam as soon as possible. This shift in forces meant the 112th Cavalry Regiment had to move south to take over the vacated positions. General Wing conducted a reconnaissance-in-force that revealed the Kawashima Force's defenses south of Route 52 were considerably weaker than those around the main highway. In light of this intelligence, the plan for assault was set into motion. On the night of May 6, the 103rd Regiment was ordered to advance towards Mount Katitinga and prepare to attack the dam. Supporting this effort, the 172nd Regiment would strike across a two-mile-wide front to the left of the 103rd towards the dam, while the 169th Regiment was tasked with demonstrating along Route 52 to pin down Japanese forces in the Bigti region. Additionally, Marking's Fil-American Yay Regiment at Norzagaray was to make a feint drive eastward north of the Angat River, targeting Mount Kabuyao. During the first three days of May, General Chase conducted probing attacks in preparation for a concerted offensive aimed at Wawa Dam, which was set to begin on May 4. Simultaneously, General Yokoyama observed what he believed to be a slowdown in enemy progress, leading him to conclude that American forces must be redeploying northward or evacuating from Luzon entirely. This prompted him to prepare a limited counteroffensive, consisting of a series of harassing and delaying actions designed to pin down enemy forces on this front. Consequently, Yokoyama was not anticipating a major offensive on May 4. However, on that day, the 145th Regiment managed to gain up to 1,000 yards along the northern and northeastern slopes of Pacawagan, while the 152nd Regiment advanced approximately 500 yards northward along Woodpecker Ridge. Although these territorial gains were not monumental, Yokoyama became increasingly concerned about the strength of the American attacks and made the urgent decision to launch his counteroffensive. As Japanese forces hurried to reposition for their counterattacks, the 145th Regiment struck eastward, successfully seizing the rocky summit of Mount Binicayan. Meanwhile, the 152nd continued its efforts along Woodpecker Ridge. This coordinated assault completely surprised General Kobayashi's troops, rendering their planned counterattack impossible as they were forced to shift their focus to defending their critical positions. In the southern sector, General Kawashima dispatched one battalion toward Montalban; however, the heavy air assaults that preceded Wing's offensive made it impossible for the Japanese unit to organize effectively for their attack. Adding to the Japanese troubles, the remnants of the Noguchi Force were unable to provide any significant reinforcements. Despite the surprise and disarray among the Japanese defenders, they could not prevent the 145th from capturing the crest of Binicayan on May 9. The troops stationed on Woodpecker Ridge experienced some success by halting the advance of the 152nd and initiated a week of increasingly aggressive dawn and dusk raids starting on May 14. Recognizing the futility of the ongoing conflict, which had resulted in over 1,300 Japanese casualties, General Yokoyama ordered an immediate withdrawal of all units involved on May 15. However, these orders would not reach the front lines until a week later. In the meantime, capitalizing on the element of surprise achieved during the night attack on May 6, General Wing launched an offensive that made excellent progress. The 103rd Regiment rapidly gained control of the western slopes of Katitinga and advanced swiftly along the ridgeline toward Hill 1000. Meanwhile, the 172nd Regiment reached the foot of a rocky ridge two miles southeast of Bigti, and the Marking Regiment encountered no resistance as it marched over seven miles eastward, ultimately halting just a mile and a half northwest of Kabuyao. The only significant resistance encountered occurred at Hill 535, where elements of a guerrilla unit were repelled by Japanese defenders. The unexpectedly weak Japanese opposition prompted the 43rd Division to sustain its offensive momentum without pause. By May 11, the 103rd had secured Hills 805 and 810, while the 172nd was probing Japanese defenses on Fork Ridge and advancing to the southwestern slopes of rocky Hill 815. The Marking Regiment had successfully overrun Kabuyao, though they were unable to capture Four-Corner Hill. At this point, Japanese resistance began to stiffen as American forces clashed with General Kawashima's main defenses. In response, Wing ordered the 169th Regiment to mount a limited attack on Osboy Ridge and directed the Marking guerrillas to launch a strong assault toward Ipo. Supported by artillery, Colonel Marcus Augustin succeeded in breaking through Four-Corner Hill on May 12, marking a critical turning point in the offensive. Unaware of Kawashima's precarious situation, Yokoyama directed the Kawashima Force to initiate a new counterattack against the left and left rear of the 38th Division, deeming the situation for the Kobayashi Force to be more critical. As a result, Kawashima was compelled to divert one battalion for this unnecessary assault, which weakened the Japanese defenses. This strategic miscalculation enabled General Wing to make significant gains on May 13, with the 103rd Regiment capturing Hill 860, the 172nd clearing much of Hill 815, and the Marking guerrillas seizing the summit of Hill 803. The extent of these advances prompted Kawashima to ultimately disregard Yokoyama's orders and recall his assault battalion. This battalion promptly mounted a counterattack against the Americans in a futile attempt to regain lost ground, managing only to restrict the 103rd and 172nd Regiments to minor gains on May 14. Simultaneously, Colonel Augustin's patrols crossed the Angat River unopposed, discovering that the dam remained intact and the powerhouse on the south bank was largely undamaged. However, the patrol force, too weak to hold these installations, retreated before dawn to the crest of Hill 803, where the remainder of the regiment was occupied with mopping up remaining resistance. Looking further south, General Griswold's 14th Corps had already secured most of southern Luzon and had successfully landed General MacNider's 158th Regiment in the Bicol Peninsula. In response, the remnants of the Fuji Force and the depleted Kogure Detachment decided to evacuate the open Santa Maria Valley, opting to retreat to more defensible positions at the Kapatalin Sawmill. This allowed Griswold to move the 7th and 8th Cavalry Regiments into the valley, with the former beginning a drive along Route 455 on May 6. Following a heavy air and artillery bombardment, the cavalrymen launched their assault on the sawmill on May 9 and swiftly overran the enemy defenses by mid-afternoon. After a brief pause to reorganize, the 7th Cavalry advanced up Route 455, leaving their vehicles behind, and reached Lamon Bay by May 13. Meanwhile, on the Bicol Peninsula, progress had been agonizingly slow throughout late April. It wasn't until April 28 that the Cituinan Hills were fully secured, leading to the collapse of organized Japanese resistance in the region. Following this, the 158th Regiment began moving northwestward toward Iriga and San Agustin, rapidly overrunning the remaining weak enemy positions along Route 1. Progress continued to be painfully slow, and it was not until 28 April that organized Japanese resistance finally collapsed. The task of clearing the Cituinan Hills cost the 158th Infantry approximately 40 men killed and 235 wounded; the Japanese lost almost 700 men killed in the region. Although the 158th RCT did not know it, the reduction of the Cituinan Hills marked the end of large-scale organized resistance on the Bicol Peninsula, where no more than 1,400 Japanese remained alive as of the end of April. Simultaneously, the 5th Cavalry Regiment captured Calauag on April 14 and began a two-pronged advance toward San Agustin by the end of the month. On May 2, San Agustin was finally taken as elements of both regiments converged there. Guerrillas had informed XIV Corps, which acquired control of the 158th RCT on 22 April, that a Japanese force of some 2,500 men was dug in along the slopes of Mt. Isarog, an extinct volcano centering eight miles northeast of San Agustin. This report the 5th Cavalry and 158th Infantry proved false in a series of patrol actions between 2 and 15 May. The next day, the 16th, General MacNider radioed to General Griswold that the Bicol Peninsula was secure and that no signs of organized Japanese resistance remained. The two regiments continued patrolling for some weeks until, on 6 June, the 5th Cavalry returned to southern Luzon. The 158th RCT busied itself with the problem of reorganizing and equipping guerrilla forces and in mid-June turned over responsibility for further mopping up to the Filipinos. To that time the operations to clear the Bicol Peninsula had cost the USArmy units involved approximately 95 men killed and 475 wounded. The Japanese had lost over 2,800 killed and 565 captured, including 350 Formosan labor troops whom the Japanese Army had left to fend for themselves. I would like to take this time to remind you all that this podcast is only made possible through the efforts of Kings and Generals over at Youtube. Please go subscribe to Kings and Generals over at Youtube and to continue helping us produce this content please check out www.patreon.com/kingsandgenerals. If you are still hungry after that, give my personal channel a look over at The Pacific War Channel at Youtube, it would mean a lot to me. In June 1945, amidst the Pacific War, American forces sought to liberate Luzon from General Yamashita's entrenched troops. Under Generals Eichelberger and Krueger, the 8th Army faced fierce resistance in the mountains and vital routes. As Japanese defenders struggled, the Americans advanced strategically, leading to fierce battles across treacherous terrain.  The turning point came with the seizure of Baguio, crucial for the campaign.

THE LANCET 2003;362:772-776Background: Angiotensin converting enzyme inhibitors (ACEi) reduce mortality and morbidity in patients with systolic heart failure (see CONSENSUS and SOLVD trials). However, registry data showed that up to 20% of patients with systolic heart failure were not taking ACEi. One of the frequent causes for intolerance to ACEi is cough. Angiotensin converting enzyme inhibitors work by blocking the conversion of angiotensin I to angiotensin II, a key step in the renin–angiotensin–aldosterone system (RAAS). Angiotensin II receptor blockers were tolerated in patients with systolic heart failure who were intolerant to ACEi. However, data on long term effectives as an alternative to ACEi were lacking.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM)-Alternative trial sough to assess if the angiotensin-receptor blocker (ARB) candesartan, could improve outcomes in patients with systolic heart failure who are intolerant to ACEi.Patients: Eligible patients had left ventricular ejection fraction of 40% or less and NYHA class II, III or IV symptoms of at least 4 weeks duration. Patients had also to be intolerant to ACEi.Exclusion criteria were not provided in the main manuscript.Baseline characteristics: Patients were recruited from 618 centers in 26 countries. The trial randomized 2,028 patients – 1,013 randomized to receive candesartan and 1,015 to receive placebo.The average age of patients was 67 years and 68% were men. The average left ventricular ejection fraction was 30%. Cardiomyopathy was ischemic in 68% of the patients. The NYHA class was II in 48% of the patients, III in 49% and IV in 4%.Approximately 50% had hypertension, 27% had diabetes, 61% had prior myocardial infarction, 9% had stroke, 25% had atrial fibrillation and 14% were current smokers.At the time of enrollment, 85% were taking a diuretic, 46% were taking digoxin, 55% were taking beta-blockers and 24% were taking spironolactone.The most common reasons for ACEi intolerance were cough in 72% of the patients, hypotension in 13%, renal dysfunction in 12% and angioedema or anaphylaxis in 4%.Procedures: The trial was double-blinded. Patients were assigned in a 1:1 ratio to receive candesartan starting at 4 or 8mg once daily or placebo. The treatment was doubled every two weeks to a target dose of 32mg once daily.After randomization, follow up occurred at 2, 4, and 6 weeks, 6 months and every 4 months thereafter.Endpoints: The primary outcome was a composite of cardiovascular death or heart failure hospitalizations. All deaths were classified as cardiovascular unless there was a clear non-cardiac cause.Analysis was performed based on the intention-to-treat principle. The estimated sample size to have 80% power at 5% alpha was 2,000 patients. The sample size calculation assumed 18% relative risk reduction in the primary outcome with candesartan assuming a 15% annual event rate in the placebo arm.Results: The median follow up time was 34 months. The mean candesartan daily dose was 23mg at 6 months.Candesartan reduced the primary endpoint of cardiovascular death or heart failure hospitalizations (33.0% vs 40.0%, adjusted HR: 0.70, 95% CI: 0.60 – 0.81; p< 0.001). Candesartan reduced the individual components of the primary outcome - (21.6% vs 24.8%; p= 0.02) for cardiovascular death and (20.4% vs 28.2%; p< 0.001) for heart failure hospitalizations. All-cause death was also lower with candesartan (26.2% vs 29.2%, adjusted HR: 0.83, 95% CI: 0.70–0.99; p= 0.033). The number of patients who had any hospitalization as well as the total number of hospitalizations were numerically but not statistically significantly lower with candesartan (60.2% with candesartan vs 63.3%; p= 0.16) and (1,718 vs 1,835; p= 0.06).Candesartan was associated with more hypotension (3.7% vs 0.9%), more increase in creatinine (6.1% vs 2.7%) and more hyperkalemia (1.9% vs 0.3%). Angioedema occurred in three patients in the candesartan group and none in the placebo group. Cough occurred in two patients taking candesartan and four taking placebo.Authors reported no significant subgroup interactions, however, a corresponding graph was not provided.Conclusion: In patients with systolic heart failure who are intolerant to ACEi, candesartan reduced the primary composite outcome of cardiovascular death or heart failure hospitalizations with a number needed to treat of approximately of 14 patients over 34 months of follow up. Candesartan also reduced all-cause death with a number needed to treat of approximately 33 patients. Adverse events including hypotension, increase in creatinine and hyperkalemia were more common with candesartan.The reduction in the primary endpoint with candesartan was significant and offers an alternative for patients who are unable to tolerate ACEi. Of note, 72% of the patients enrolled in the trial were intolerant to ACEi due to cough. This trial did not include a head-to-head comparison between ARBs and ACEi, and therefore does not address which agent should be preferred as first-line therapy. Only 24% of participants were receiving spironolactone. The combination of ARBs with spironolactone, may increase the risk of adverse events, particularly hyperkalemia and kidney injury.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

The City of Greater Geelong is converting the municipality's green waste into compost, which is then used to grow produce at the botanical gardens. This produce is donated to a local social supermarket to help feed those in need. Every month, Hamdieh Mohmmadi buys food from this Geelong social supermarket by exchanging vouchers for groceries. “We save money for electricity, fuel and gas and home and kids,” explains Mohmmadi. Each year, across 57 of Victoria's 79 councils, around 750,000 tons of organic material are collected from green bins. By turning green waste into compost locally, the City of Greater Geelong is leading the way. “The waste that we're creating, rather than going into landfill, is actually creating nutrients, going into food supply, and going back to the residents that we have that are most in need in Geelong,” explains Emma Sinclair of the City of Greater Geelong. First, it's manually sorted to remove any contaminants. Next, it's ground into smaller pieces before a machine is used to mix and irrigate the material. It's then piled up to mature, after which it's broken down further and bagged. “Landfill space is really expensive. We also don't want to send organic matter to landfill because it generates methane,” explains Andrew Lucas of the City of Greater Geelong. The Geelong Botanic Gardens is provided with about 2,000 tons of material. “Those garden beds that have it in it have performed a lot better than the ones that don't,” says horticulturist Liam Kelly. Approximately four crates of produce are donated to Geelong Foodshare every two weeks. Geelong is one of the Victorian councils that received funding from Sustainability Victoria to boost the use of compost made from green waste within the community. The goal is to expand this initiative to other local government areas to help feed those in need. “The more we can invest in turning those resources back into new products, like composts and like mulch, the better value we get out of those,” concludes Matt Genever of Sustainability Victoria. The state government's goal is to divert 80% of waste from landfills by 2030. This article was provided by The Associated Press.

Organisations often find themselves trapped in an infinite loop. Typically hailed as an "infinity loop" or "patching loop,” it's differentiated by a continuous cycle of fixing problems, patching, and redoing data pipelines just to maintain operations.“It's a trap that many financial institutions, banks, insurance companies, and more fall into. This loop or this cycle is a process of focusing on fixing problems, patching,” describes Errol Rodericks.In this episode of the Don't Panic It's Just Data podcast, Errol Rodericks, Product & Solutions Marketing and Sales Enablement Specialist at Denodo, discusses the challenges faced by financial services in steering the infinity loop of reactive data management. He emphasises the importance of breaking free from this cycle to achieve real innovation and success in AI-led initiatives. The conversation explores the significance of AI-ready data, the journey from bronze to gold data products, and how Denodo helps bridge the last-mile gap in data management. The Cost of Poor Data"The cost of poor data isn't just bad decisions. It's the decisions you never knew you could make. You never get around to that."This statement sets the stage for the podcast. It captures the profound effect of being stuck in a reactive data mode and how organisations can overcome it. Rodericks believes that financial services are entirely missing out on strategic opportunities that could redefine their market position.While many financial institutions have invested heavily in centralised lakehouse architectures like Snowflake or Databricks. These alone are not enough. They often struggle to deliver the trusted, real-time insights that Gen AI and business teams require. Missed Opportunities to Measurable OutcomesIt becomes more challenging for financial institutions to deliver adequate Gen AI real-time data insights when dealing with the "missing mile" of data. Approximately 30 per cent of crucial data is often overlooked or inaccessible. To overcome the Gen AI challenges, Denodo facilitates logical data management. The firm provides direct access to live, relevant, and governed data when it's needed. It becomes critical for achieving measurable outcomes with AI-led initiatives.For Chief Financial Officers (CFOs), Rodericks offered a succinct but powerful message – "Modern finance isn't about reports... It's about your ability to predict, to personalise, and to prevent – the three Ps."TakeawaysThe infinity loop is a trap for financial institutions.Reactive data handling leads to missed insights and customer churn.Breaking out of the infinity loop is essential for innovation.AI projects often fail due to unreliable data inputs.AI-ready data must be trusted, timely, contextual, and reusable.The journey from bronze to gold data products is strategic.Ownership of data products is crucial for success.Timeliness of data is critical in financial services.Denodo provides real-time access to data without copying it.Modern finance focuses on prediction, personalisation, and prevention.Chapters00:00 Understanding the Infinity Loop in Financial Services04:23 Breaking Free from the Infinity Loop06:03 The Cost of Firefighting Mode09:14 The Importance of AI-Ready Data19:42 The Journey from Bronze to Gold Data Products22:53 Bridging the Last Mile Gap27:06 Real-World Examples of

WE ARE LIVING IN SERIOUS TIMES ACROSS THE WORLD RIGHT NOW. RUSSIA AND UKRAINE (5,000 WEEKLY DYING IN WAR)HAMAS' EVIL MASSACRE IN ISRAEL ON OCTOBER 7, 2023, APPROXIMATELY 1200 DEATHS251 HOSTAGES TAKEN TO GAZA82 CONFIRMED DEAD NOW146 FREED OR RESCUED23 ARE STILL BELIEVED TO BE ALIVEIRAN AND ISRAEL ARE AT WAR WITH ONE ANOTHER (WHAT IS THE PROPHETIC MEANING)AMBASSADOR MIKE HUCKABEE PERSONALLYAMBASSADOR HUCKABEE COMMUNICATED THAT OVER 700,000 AMERICANS LIVE IN ISRAEL9.5 MILLION PEOPLE LIVE IN ISRAELPRAY FOR ISRAELGENESIS 12:1-31 Now the Lord said[a] to Abram, “Go from your country[b] and your kindred and your father's house to the land that I will show you. 2 And I will make of you a great nation, and I will bless you and make your name great, so that you will be a blessing. 3 I will bless those who bless you, and him who dishonors you I will curse, and in you all the families of the earth shall be blessed.”PSALM 122:6-96 Pray for the peace of Jerusalem!    “May they be secure who love you!7 Peace be within your walls    and security within your towers!”8 For my brothers and companions' sake    I will say, “Peace be within you!”9 For the sake of the house of the Lord our God,    I will seek your good.

This Day in Legal History: Abington School District v. SchemppOn this day in legal history, June 17, 1963, the U.S. Supreme Court decided Abington School District v. Schempp, a landmark case concerning the constitutional boundaries between church and state. The case arose when Edward Schempp, a Unitarian from Pennsylvania, challenged a state law that required public schools to begin each day with Bible readings. The Schempp family argued that this practice violated the Establishment Clause of the First Amendment, which prohibits the government from endorsing or establishing religion.In an 8–1 decision, the Court ruled in favor of the Schempps, holding that the mandatory Bible readings were unconstitutional. Justice Tom C. Clark, writing for the majority, emphasized that while the government must remain neutral toward religion, the school's policy amounted to state-sanctioned religious exercise. The ruling did not ban the Bible from public schools altogether but clarified that its use must be educational, not devotional.This decision built on the precedent set in Engel v. Vitale (1962), which struck down mandatory prayer in schools, and it reinforced a broader interpretation of the separation of church and state. The ruling provoked strong reactions across the country, with many viewing it as an attack on traditional religious values, while others saw it as a vital protection of individual liberties in a pluralistic society.The case remains a cornerstone in Establishment Clause jurisprudence, shaping debates over religion in public education for decades. It also marked a pivotal moment in the Warren Court's broader effort to expand civil liberties through constitutional interpretation.The American Bar Association (ABA) has filed a lawsuit against the Trump administration, accusing it of using executive orders to intimidate major law firms based on their past clients and hiring choices. Filed in federal court in Washington, D.C., the lawsuit argues that these actions violate the U.S. Constitution and have created a chilling effect on the legal profession. The ABA claims Trump's actions hindered its ability to secure legal representation, especially in cases opposing the federal government.The suit comes after four law firms successfully challenged similar executive orders, with judges temporarily or permanently blocking enforcement. One of these firms, Susman Godfrey, is now representing the ABA in this new case. Despite court setbacks, nine firms have agreed to provide nearly $1 billion in free legal services to the Trump administration to avoid similar targeting.White House spokesperson Harrison Fields dismissed the ABA's lawsuit as “frivolous,” asserting presidential authority over security clearances and federal contracting. The ABA also alleges the administration has threatened its accreditation authority and slashed funding, particularly in areas like training legal advocates for domestic violence victims.American Bar Association sues to block Trump's attacks on law firms | ReutersThe U.S. Department of Justice is undergoing a significant restructuring under the Trump administration, marked by mass resignations, staff reductions, and departmental overhauls. Approximately 4,500 DOJ employees have accepted buyouts through the administration's deferred resignation program, known as “Fork in the Road,” which allows for paid leave through September before official departure. These exits, along with planned eliminations of 5,093 positions, are expected to save around $470 million and reduce the DOJ's workforce from roughly 110,000.The administration's proposed budget for the next fiscal year aims to reshape the DOJ in line with conservative priorities. This includes dismantling the tax division—once staffed by over 500 people—and distributing its enforcement functions across the civil and criminal divisions. Despite some added funding to these divisions, they are also set to reduce attorney headcounts. The move has drawn backlash from former DOJ and IRS officials, who warned it could undermine tax enforcement. The DOJ's top tax official resigned earlier this year in protest.Political leadership changes have also prompted an exodus from the civil rights division, where two-thirds of career attorneys have either resigned or been reassigned. Cuts are also planned for the Environment and Natural Resources Division and other oversight bodies, such as the DOJ Inspector General's office and the Community Relations Service.Other structural shifts include folding INTERPOL's U.S. office into the U.S. Marshals Service, closing multiple field offices, and launching a new firearm rights restoration initiative. The administration has also proposed merging the ATF with the DEA and cutting the FBI's budget by over half a billion dollars.Justice Department to Lose 4,500 Staffers to Buyout Offers (1)Justice Department to Eliminate Tax Unit as Workforce ShrinksThe NCAA's $2.8 billion settlement—approved earlier this month—has reignited momentum in Congress for national legislation to address key issues in college athletics, particularly around antitrust liability, name, image, and likeness (NIL) compensation, and student-athlete classification. Beginning July 1, colleges can directly pay athletes, marking a historic shift that has intensified calls for a federal framework to standardize these changes.The settlement, which also includes back pay for nearly 400,000 athletes, has been described as a stabilizing force in the chaotic NIL landscape. It is now being used by the NCAA to push Congress for a liability shield to prevent further antitrust lawsuits. Although several NIL reform bills have been proposed in the past, none have passed. Two current bills—the bipartisan SPORTS Act and the GOP-led SCORE Act—aim to balance athlete rights with regulatory uniformity while clarifying that student-athletes are not employees.The SCORE Act would create revenue-based limits on athlete pay and involve multiple House committees, while the SPORTS Act focuses on educational support and fair market value benchmarks for NIL deals. Both would preempt state laws and address core NCAA concerns.Despite the settlement, legal uncertainty remains. Female athletes have already filed appeals challenging the deal under Title IX, and further litigation is expected. Experts note that any legislation granting an antitrust exemption—similar to the unique one held by Major League Baseball—would face judicial skepticism and political resistance.NCAA's $2.8 Billion Settlement Gets Congress Moving Toward FixesIn my column this week I write a bit about how a tax amnesty program in Illinois might provide a roadmap for the rest of the nifty fifty. Illinois' new remote seller amnesty program offers a strategic and replicable model for encouraging tax compliance among previously noncompliant businesses. By waiving penalties and interest and applying a simplified, flat 9% tax rate across the state's many local jurisdictions, the program lowers the barriers to voluntary disclosure. This approach addresses the core problem of the “compliance paradox,” where businesses avoid coming clean for fear of triggering audits. In contrast to fear-based enforcement, Illinois' model promotes intelligence-based compliance, exchanging amnesty for valuable insights into evasion tactics and tools.The program's design could be adapted to brick-and-mortar businesses engaged in sales suppression through tools like zapper software. If these businesses were offered amnesty in return for disclosing how they evaded taxes—such as revealing the software they used and methods employed—states could use this intelligence to improve enforcement. Such disclosures would turn voluntary compliance into a form of strategic reconnaissance, identifying enforcement blind spots and bad actors.Illinois' policy doesn't just recoup lost revenue; it also creates opportunities to map the ecosystem of tax evasion tools and techniques. By incentivizing transparency and simplifying compliance, the initiative provides a blueprint for other states facing fiscal pressure and looking to modernize tax enforcement.Illinois Remote Seller Amnesty Program Offers Roadmap for States This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.minimumcomp.com/subscribe

Approximately 750 people joined in a peaceful rally Saturday on Cortez's Main Street to protest the policies of the Trump administration.

It's The Ranch It Up Radio Show! Join Jeff Tigger Erhardt, Rebecca Wanner AKA BEC and their crew as they talk about selling cattle the superior way, through Superior Livestock Auction's Corn Belt Classic.  Plus auctioneering champions have been crowned, market recaps, cattle for sale and lots more on this all new episode of The Ranch It Up Radio Show. Be sure to subscribe on your favorite podcasting app or on the Ranch It Up Radio Show YouTube Channel. Season 5, EPISODE 241 Superior Livestock Auction Hosts Corn Belt Classic The summer video feeder calf sale season is here and kicks off with the Corn Belt Classic hosted by Superior Livestock Auctions.  Approximately 105,000 head of cattle are slated to sell June 17 & 18 at South Sioux City, Nebraska.  Be sure to check the deadlines for their next big video feeder calf sale, The Week In The Rockies.  Check out their listings for the Corn Belt Classic HERE! American Angus Association Decides To Retain Grant Funds. The petition demanding the American Angus Association return the $4.85 million to the Bezos Earth Fund is now closed. Before the petition closed, the AAA board voted unanimously to retain the funds. You can read the letter from the American Angus Association Board of Directors HERE! Dean Edge Named WLAC Champion Livestock Auctioneer Dean Edge from Rimbey, Alberta has been named the 2025 World Livestock Auctioneering Champion.  Joining Dean in the winner's circle was Reserve Champion Brennin Jack and Runner Up Preston Smith. We also recognized Steve Goedert for having the high score interview and Tyler Bell for being the Audrey K. Banks Rookie of the Year. Featured Experts in the Cattle Industry Roger Janes - Hi Tech Marketing & Superior Livestock Auctions https://superiorlivestock.com/ Follow on Facebook: @SuperiorLivestockAuction Mark Vanzee – Livestock, Equine, & Auction Time Expert https://www.auctiontime.com/ https://www.livestockmarket.com/ https://www.equinemarket.com/ Follow on Facebook: @LivestockMkt | @EquineMkt | @AuctionTime Kirk Donsbach – Financial Analyst at StoneX https://www.stonex.com/ Follow on Facebook: @StoneXGroupInc Shaye Koester – Host of Casual Cattle Conversation https://www.casualcattleconversations.com/ Follow on Facebook: @cattleconvos Contact Us with Questions or Concerns Have questions or feedback? Feel free to reach out via: Call/Text: 707-RANCH20 or 707-726-2420 Email: RanchItUpShow@gmail.com Follow us: Facebook/Instagram: @RanchItUpShow YouTube: Subscribe to Ranch It Up Channel: https://www.youtube.com/c/RanchItUp Catch all episodes of the Ranch It Up Podcast available on all major podcasting platforms. Discover the Heart of Rural America with Tigger & BEC Ranching, farming, and the Western lifestyle are at the heart of everything we do. Tigger & BEC bring you exclusive insights from the world of working ranches, cattle farming, and sustainable beef production. Learn more about Jeff 'Tigger' Erhardt & Rebecca Wanner (BEC) and their mission to promote the Western way of life at Tigger and BEC. https://tiggerandbec.com/ Industry References, Partners and Resources For additional information on industry trends, products, and services, check out these trusted resources: American Gelbvieh Association: https://gelbvieh.org/ Imogene Ingredients: https://www.imogeneingredients.com/ Allied Genetic Resources: https://alliedgeneticresources.com/ Westway Feed Products: https://westwayfeed.com/ Medora Boot: https://medoraboot.com/ Transova Genetics: https://transova.com/ Axiota Animal Health: https://axiota.com/multimin-campaign-landing-page/ Wrangler: https://www.wrangler.com/ Rural Radio Network: https://www.ruralradio147.com/ RFD-TV: https://www.rfdtv.com/ Wulf Cattle: https://www.wulfcattle.com/ Jorgensen Land & Cattle: https://jorgensenfarms.com/

This Day in Legal History: Loving v. Virginia On June 12, 1967, the U.S. Supreme Court issued its landmark decision in Loving v. Virginia, striking down state laws that banned interracial marriage. The case arose when Richard Loving, a white man, and Mildred Loving, a Black and Indigenous woman, were sentenced to a year in prison for marrying each other in Washington, D.C., then returning to their home in Virginia, which criminalized interracial unions under its Racial Integrity Act of 1924. The couple's challenge to their conviction eventually reached the nation's highest court.In a unanimous decision, the Supreme Court held that Virginia's anti-miscegenation law violated the Equal Protection and Due Process Clauses of the Fourteenth Amendment. Chief Justice Earl Warren, writing for the Court, stated that the freedom to marry is a “vital personal right,” and restricting that freedom on the basis of race was “directly subversive of the principle of equality at the heart of the Fourteenth Amendment.” The Court emphasized that classifications based solely on race are “odious to a free people” and cannot stand.The decision invalidated laws in 16 states that still prohibited interracial marriage at the time, cementing Loving v. Virginia as a major victory in the civil rights movement. It not only reinforced the constitutional commitment to racial equality but also laid critical groundwork for later decisions involving personal liberty, including Obergefell v. Hodges, which legalized same-sex marriage in 2015.A U.S. federal judge ruled that the Trump administration cannot detain Columbia University student and pro-Palestinian activist Mahmoud Khalil based on U.S. foreign policy concerns. The decision, issued by Judge Michael Farbiarz in Newark, found that using a rarely applied immigration law to justify Khalil's detention violated his free speech rights. Khalil, whose green card was revoked in March, has been in detention since then and was the first foreign student arrested amid the pro-Palestinian campus protests following the October 7 Hamas attack on Israel.The court found that Khalil was suffering irreparable harm due to the damage to his career and the chilling effect on his speech. While the ruling bars Khalil's deportation under the foreign policy provision, it does not require his immediate release, allowing the administration until Friday to appeal. Khalil's wife, Dr. Noor Abdalla, urged his immediate return to their home in New York, where she cares for their newborn son.Neither the State Department nor the Justice Department commented. The case reflects tensions over U.S. responses to student activism amid global political conflicts, particularly as Trump-era policies are used to target protesters. The foreign policy provision invoked allows deportation of non-citizens if their presence is seen as harmful to U.S. interests, but the court found it unconstitutional in this case.US foreign policy no basis to detain Columbia protester Khalil, judge rules | ReutersCalifornia is taking the Trump administration to court over the deployment of U.S. Marines to Los Angeles amid escalating protests against President Donald Trump's immigration policies. Approximately 700 Marines are set to join 4,000 National Guard troops to support federal agents and protect government property, sparking backlash from state officials who argue the move is illegal and inflammatory. California Governor Gavin Newsom, along with other state and local leaders, contends the deployment violates the state's rights and unnecessarily escalates tensions.The protests, which began in response to a wave of immigration raids, have spread to cities including New York, Chicago, and Washington, D.C., and are expected to intensify with over 1,800 demonstrations planned for the weekend. Demonstrators in Los Angeles have largely remained peaceful, though incidents of violence and aggressive police responses have been reported. A federal judge in San Francisco will hear arguments Thursday as California seeks a restraining order to halt the military's law enforcement involvement.The Marines have completed crowd control and de-escalation training but are operating under Title 10 of U.S. law, which authorizes limited military involvement in civilian matters. They are permitted to detain individuals interfering with federal duties but are not supposed to engage in regular policing. Trump defended the deployment, calling it essential to maintaining order, while critics, including national Democrats, have called it a dangerous overreach.Marines prepare for Los Angeles deployment as protests spread across USA group of current and former female athletes is appealing the NCAA's $2.8 billion antitrust settlement, arguing that the deal violates Title IX by disproportionately compensating male athletes. Approved by a federal judge on June 6, the settlement allocates 90% of back pay damages to men, largely benefiting football and basketball players. The objectors, represented by attorney John Clune, argue this breakdown reflects a $1.1 billion miscalculation and discriminates against women in violation of federal law.The appeal, filed in the U.S. Court of Appeals for the Ninth Circuit, is the first formal challenge to a settlement touted as a major victory for student-athletes. Clune said the agreement lacks meaningful support for women's sports, including basketball and Olympic disciplines, and warned that schools are already discussing cutting programs as a result of the deal's financial structure.Critics of the appeal, including settlement attorney Jeffrey Kessler, claim the Title IX objection is misplaced in an antitrust case and will delay compensation for over 100,000 athletes. Still, the challenge raises questions about gender equity in how the NCAA compensates athletes for past name, image, and likeness (NIL) restrictions.While the total settlement amount isn't being disputed, the appeal could impact future policies around compensation, roster limits, and salary caps. The NCAA says it's continuing with implementation, but the appeal introduces legal uncertainty into an already complex shift in college athletics.NCAA $2.8 Billion Deal Gets Appealed Over Title IX Issues (1)Donald Trump's legal team is attempting to fast-track an appeal of his New York felony conviction by moving the case toward the U.S. Supreme Court. Trump was convicted in Manhattan on 34 counts of falsifying business records related to hush money payments made to adult film actress Stormy Daniels, marking the first time a former or current president has been found guilty of a felony. His attorneys returned to court this week to argue the state case should be shifted to federal jurisdiction.They contend that Trump's actions were connected to his official duties as president and thus should be handled in federal court, where they believe he might receive a more favorable legal environment. The 2nd U.S. Circuit Court of Appeals is currently weighing the request, which Trump hopes will pave the way for a rapid review by the Supreme Court.The legal maneuvering is part of a broader strategy to challenge the legitimacy of the New York state trial and delay sentencing or any other consequences. Trump maintains that the case is politically motivated and that the charges are being used to interfere with his political agenda.Trump Seeks Quick Path to Supreme Court in Hush Money Appeal (1) This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.minimumcomp.com/subscribe

THE LANCET 2003;362:767-771Background: Angiotensin II which plays a role in ventricular remodeling and progression of heart failure can be produced by pathways independent of angiotensin convening enzyme. Preliminary studies showed that the combination of angiotensin II blockers with angiotensin-converting enzyme inhibitors (ACEi) improves hemodynamics and reduces ventricular remodeling.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM)-Added trial sough to assess if adding the angiotensin-receptor blocker (ARB), candesartan, to ACEi could improve outcomes in patients with systolic heart failure.Patients: Eligible patients had left ventricular ejection fraction of 40% or less within the previous 6 months, and NYHA class II, III or IV symptoms. Patients with NYHA class II symptoms had to have cardiac-related hospitalization within 6 months. Patients also had to have treatment with ACEi at a constant dose for at least 30 days.Exclusion criteria were not provided in the main manuscript.Baseline characteristics: Patients were recruited from 618 centers in 26 countries. The trial randomized 2,548 patients – 1,276 randomized to receive candesartan and 1,272 to receive placebo.The average age of patients was 64 years and 79% were men. The average left ventricular ejection fraction was 28%. Cardiomyopathy was ischemic in 62% of the patients. The NYHA class was II in 24% of the patients, III in 73% and IV in 3%.Approximately 48% had hypertension, 30% had diabetes, 56% had prior myocardial infarction, 9% had stroke, 27% had atrial fibrillation and 17% were current smokers.At the time of enrollment, 90% were taking a diuretic, 58% were taking digoxin, 55% were taking beta-blockers, 17% were taking spironolactone and all but two patients were taking ACEi.Procedures: The trial was double-blinded. Patients were assigned in a 1:1 ratio to receive candesartan starting at 4 or 8mg once daily or placebo. The treatment was doubled every two weeks to a target dose of 32mg once daily.After randomization, follow up occurred at 2, 4, and 6 weeks, 6 months and every 4 months thereafter.Endpoints: The primary outcome was a composite of cardiovascular death or heart failure hospitalizations. All deaths were classified as cardiovascular unless there was a clear non-cardiac cause.Analysis was performed based on the intention-to-treat principle. The estimated sample size to have 80% power at 5% alpha was 2,300 patients. The sample size calculation assumed 16% relative risk reduction in the primary outcome with candesartan assuming an 18% annual event rate in the placebo arm.Results: The median follow up time was 41 months. The mean candesartan daily dose was 24mg at 6 months.Candesartan reduced the primary endpoint of cardiovascular death or heart failure hospitalizations (37.9% vs 42.3%, adjusted HR: 0.85, 95% CI: 0.75 – 0.96; p= 0.01). Candesartan reduced the individual components of the primary outcome - (23.7% vs 27.3%; p= 0.021) for cardiovascular death and (24.2% vs 28.0%; p= 0.018) for heart failure hospitalizations. There was no significant reduction in all-cause death (29.5% with candesartan vs 32.4%; p= 0.105). The number of patients who had any hospitalization was similar in both groups (66.8% with candesartan vs 67.5%; p= 0.7), however, the total number of hospitalizations was lower with candesartan (2,462 vs 2,798; p= 0.023).Serum creatinine at least doubled in 7% of the patients in the candesartan group vs 6% in the placebo group. In the subset of patients taking spironolactone, serum creatinine at least double in 11% of the patients taking candesartan compared to 4% of the patients taking placebo.Hyperkalemia, defined as serum potassium of 6 mmol/L or higher, occurred in 3% of the patients in the candesartan group vs 1% in the placebo group. In the subset of patients taking spironolactone, hyperkalemia occurred in 4% of the patients taking candesartan compared to 1% of the patients taking placebo.There were two cases of angioedema in the candesartan group and three in the placebo group. All patients were taking an ACEi.There were no significant subgroup interactions, including in patients taking both beta-blockers and ACEi at baseline.Conclusion: In patients with systolic heart failure, adding candesartan to an ACEi reduced the primary composite outcome of cardiovascular death or heart failure hospitalizations with a number needed to treat of approximately of 23 patients over 41 months of follow up. The total number of all-cause hospitalizations was reduced by 336 with candesartan. All-cause death was not significantly reduced with candesartan.While the results of the trial appear impressive, the high number of adverse outcomes with candesartan in patients taking spironolactone is concerning. Spironolactone led to significant reduction in all-cause mortality in patients with systolic heart failure, as seen in the RALES trial, and should be prioritized over adding candesartan. Notably, fewer than 20% of patients in the trial were on spironolactone at baseline; if more had been, the incremental benefit of candesartan would likely have been reduced due to an increased risk of adverse effects from triple neurohormonal blockade (ACEi, ARBs, and mineralocorticoid receptor antagonists). Furthermore, spironolactone acts by blocking the aldosterone receptor, which is downstream in the renin–angiotensin–aldosterone system. Since candesartan blocks angiotensin II upstream in the same pathway, simultaneous inhibition at multiple points may lead to diminishing benefit.Finally, the differences observed in the subgroup of patients on beta-blockers between this trial and Val-HeFT remain unclear and may simply reflect the play of chance. As we previously discussed, patients receiving both an ACEi and beta-blockers had worse outcomes with valsartan in the Val-HeFT trial.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

The Tragically Hip Top Forty Countdown: Song 19 – Jeff from BellevilleWelcome back, Hip faithful. This week on the Countdown, I'm joined by one of our most beloved Sunday Evening Jam regulars — the witty, wise, and wonderfully loquacious Jeff from Belleville. You know him. You love him. And if you've ever caught a live stream where he was in the comments, you've probably laughed out loud.But today? Today, we go deeper.Jeff takes us back to his teenage years, up in a century-old Belleville coach house where Road Apples first took hold and never let go. From bootleg tapes and roadside attractions to mosh pits, surprise shows, and backstage encounters — Jeff's Hipstory spans 31 shows and countless life moments tied to the soundtrack of this band.Along the way, we talk memory, meaning, and mortality — including the two cardiac arrests Jeff survived (yes, you read that right), and the unexpected video message he received from Paul Langlois while recovering. This episode reminds us why we do this show in the first place: for the love, for the connection, for the community.We even get a bonus English Lit breakdown of King Lear — and how defiance, irony, and Shakespearean tragedy might be woven into one of the Hip's most poetic tracks. (And yeah, we manage to keep the actual title of that track on the DL. You're welcome.)

Cold Open [into silence]Friend, I haven't done this before. Usually I talk autism & neurodiversity with you. But I'm very concerned about events unfolding this weekend...I've seen these patterns emerge before. In other countries. Authoritarian countries¹.I have no plan of action to suggest. It's happening too fast for me to process… in my slow, deep AuDHD² way.All I could think to do… is share my concerns with friends who care.[Music 8 bars]IntroWelcome to Trigger Warnings… a new project of AutisticAF Out Loud podcast.I'm Johnny Profane. Your fiercely divergent guide to what's actually happening in the news.Gimme 10 minutes? I'll give you my neurodivergent world.Today: Military deployments in two cities, legal challenges mounting, and one burning question: Are we witnessing democratic norms under assault in real time?For an ever deeper dive, I've included footnotes and further reading in the transcript on subStack.Content Note: civil unrest, military deployment, law enforcement actions, concerns about democratic institutions + experiences & opinions of one autistic voice... in my 70s.PodcastFriend,I haven't done this before. Usually I talk autism & neurodiversity with you.But I'm very concerned about events unfolding this weekend... and a fair number of you have asked for my neurodivergent take on larger national & global issues.So, after thinking long & hard... about risks.. I still must share.This weekend, federal agents raided workplaces across Los Angeles County. They arrested 121 people³.Protests followed. Police responded with tear gas⁴ & rubber bullets against demonstrators⁵.On Saturday, President Trump deployed 2,000 National Guard⁶ troops to Los Angeles County. On questionable Constitutional grounds⁷. As the Supreme Court recessed.His administration called the protests an "insurrection⁸." And threatened to deploy Marines⁹.At the same time, Washington D.C. is filling with military equipment.7 million pounds of hardware¹⁰.28 tanks. 70 tons each¹¹.Rocket launchers.7,000 military personnel¹².This equipment arrived by train from Texas. It now sits near the National Mall¹³.Officials say this is for an Army anniversary parade celebrating Trump's birthday¹⁴.The largest military display in the capital in decades.These events happen as Trump faces significant legal challenges. Courts have blocked over 180 of his administration's initiatives¹⁵.Governor Newsom called the Los Angeles deployment "purposefully inflammatory." He said it would "escalate tensions¹⁶."[Music 8 bars… overlapping 4 second break in speech]I find the timing troubling.Military force against protesters in one city. Unprecedented massive military assets staged in the capital. Simultaneous with significant legal pressure & civil unrest.All within 72-hours.These are documented facts. They concern me deeply.I've seen these patterns emerge before. In other countries. Authoritarian countries.False crises involving vulnerable targets… like migrants… as victims. Used as a fig leaf for declaring martial law¹⁷.I have no plan of action to suggest. It's happening too fast for me to process… in my slow, deep AuDHD way.All I could think to do… is share my concerns with friends who care.Maybe you too?[Music 8 bars]OutroTrigger Warnings is a new project of AutisticAF Out Loud. Reporting on real-world issues, from a neurodivergent perspective.We often recognize patterns others miss. In times like these, that perspective? Essential.If this podcast resonates, share it. The more the world hears neurodivergent voices, the greater my hopes for our future.We believe no one should have to pay to be autistic. Many neurodivergent people can't afford subscription content.Your Ko-Fi tip of any amount helps keep this resource free for them.Or join our paid subscriber community at johnnyprofaneknapp.substack.com for ongoing support. Links in description.A big shoutout to my wife, Kimmie, for her great song, Freedom Blvd. That link is in the description, too.[Music]help.Binge on the most authentic autistic voice in podcasting.7 decades of raw truth, real insights, zero yadayada.#AutisticAF Out Loud Newsletter is a reader-supported publication. Click to receive new posts free. To support my work, consider becoming a paid subscriber.FootnotesEducational Context¹ Authoritarian countries: Nations where power is concentrated in a single leader or small group, often characterized by limited political freedoms, restricted civil liberties, and the use of military force to control civilian populations.² AuDHD: A term combining ADHD (Attention Deficit Hyperactivity Disorder) and autism, used by people who are both autistic and have ADHD. Many neurodivergent individuals process information more slowly but with greater depth and pattern recognition.³ 121 people arrested: Immigration and Customs Enforcement (ICE) conducted multiple workplace raids across Los Angeles County on Friday, June 6, 2025. ICE officially reported 44 administrative arrests at three locations during Friday operations, with the total reaching 121 across the broader week-long operation. Sources: Al Jazeera, Los Angeles Times, CBS Los Angeles, Times of India⁴ Tear gas: Chemical compounds that cause temporary irritation to eyes, nose, mouth and lungs, used by law enforcement for crowd control. Federal agents and LAPD used tear gas, flash-bang grenades, and pepper spray against protesters gathering outside federal buildings where detained individuals were being processed. Sources: Al Jazeera, New York Times, ABC News, NBC Los Angeles⁵ Rubber bullets and police response: Less-lethal ammunition designed to incapacitate rather than kill, though they can cause serious injuries. Federal law enforcement and LAPD officers in riot gear used rubber bullets, pepper balls, and flash-bang grenades to disperse crowds protesting immigration raids. Sources: ABC News, NBC Los Angeles, Sky News, USA Today⁶ National Guard: Part-time military forces that normally serve under state governor authority but can be federalized by the president. Trump deployed 2,000 California National Guard troops to Los Angeles without Governor Newsom's request - the first such federalization without governor consent since 1965. Sources: Reuters, New York Times, Washington Post⁷ Constitutional grounds: Trump invoked Section 12406 of Title 10 U.S. Code, which allows federal deployment when there is "invasion, rebellion, or inability to execute federal law." Legal scholars debate whether immigration protests constitute legitimate grounds for this rare federal override of state authority. Sources: New York Times, Washington Post, Steve Vladeck Legal Analysis⁸ "Insurrection" declaration: The Trump administration characterized Los Angeles protests as an "insurrection" to justify military deployment. White House Deputy Chief of Staff Stephen Miller used this term, though legal experts question whether immigration protests meet the historical definition of insurrection. Sources: Times of India, Mother Jones⁹ Marines threat: Defense Secretary Pete Hegseth stated that active-duty Marines at Camp Pendleton were "on high alert" and could be deployed "if violence continues." This would represent a significant escalation beyond National Guard deployment to using active military forces against civilians. Sources: Los Angeles Times, USA Today, ReutersMilitary Hardware Documentation¹⁰ 7 million pounds of hardware: The Army's 250th anniversary parade features approximately 7 million pounds of military equipment being transported by train from Fort Cavazos, Texas to the Washington D.C. area for the June 14, 2025 celebration. Sources: CNN, The Hill, The Morning News¹¹ 28 tanks, 70 tons each: The parade includes 28 M1A1 Abrams tanks, each weighing approximately 70 tons (140,000 pounds). These main battle tanks are equipped with 120mm smoothbore cannons and represent America's primary armored fighting vehicle. Sources: CNN, The Hill, Stars and Stripes, Reuters¹² 7,000 military personnel: Approximately 6,600-7,000 soldiers from various states are participating in the parade and festival, with over 150 vehicles and 50 aircraft involved in the celebration. Sources: Associated Press, The Hill, Reuters, Army Aviation Heritage Foundation¹³ Equipment near National Mall: Military vehicles and equipment are staged in West Potomac Park adjacent to the National Mall, with steel plates being laid on roads to protect infrastructure during the parade route along Constitution Avenue. Sources: CNN, The Morning News¹⁴ Army anniversary and Trump's birthday: The U.S. Army's 250th anniversary (established June 14, 1775) coincides exactly with President Trump's 79th birthday on June 14, 2025. Army officials state the anniversary celebration was planned independently, with the parade component added at Trump's request. Sources: Associated Press, Reuters, Washington tourism guideLegal and Political Context¹⁵ 180+ court blocks: As of June 6, 2025, federal courts have issued at least 180 rulings temporarily blocking Trump administration initiatives, representing an unprecedented level of judicial pushback against executive actions in the first months of his second term. Sources: New York Times Legal Tracker, USA Today, Fox News¹⁶ Newsom's statements: California Governor Gavin Newsom called Trump's National Guard deployment "purposefully inflammatory" and warned it would "escalate tensions." He formally requested the withdrawal of federal troops, calling the deployment a "serious breach of state sovereignty." Sources: Politico, Reuters, Deadline¹⁷ Martial law: The temporary replacement of civilian government with military authority, typically declared during emergencies. While Trump has not formally declared martial law, legal experts note the military deployment patterns and rhetoric raise concerns about potential steps toward military control of civilian areas. Sources: ACLU Analysis, Steve Vladeck Legal Commentary This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit johnnyprofaneknapp.substack.com/subscribe

Send us a text  Attorney Ken W. Good joins us from Texas on this week's episode. Ken has over 25 years experience handling and assisting in multimillion dollar cases that cover a wide spectrum of areas including business and medical liability claims, products liability, patent cases, toxic tort and surety and fidelity bonds.  Ken has argued important cases before the Supreme Court of Texas and the Texas Court of Criminal Appeals.        Approximately 15 years ago, Ken was hired by a bondsman to assist in setting aside 45 default judgments and when this was completed word of mouth spread and this area has grown into a statewide practice representing insurance companies to underwrite bail bonds.                                          We discuss current issues in a somewhat spirited way about catch & release policies, immigration laws, “ open borders “, Habeas Corpus, ICE raids,and soft on crime issues in the inner city. While we might not agree on every issue we try to find some common ground by discussing there issues.                     Ken hosts The Bail Post podcast and has written the book Good On Bail. For more information on Ken visit https://www.thebailpost.com/                             #California #NewYork #DonaldJTrump #ICE #immigration #OpenBorders Follow us at Reality Redemption on Facebook, Instagram, Threads, BlueSky and Tik Tok

Kate Adie introduces stories from Ukraine, Chile, Indonesia, and France.Ukraine's audacious drone raid on Russian airbases was met with disbelief that such an attack was even possible. Operation ‘Spider's Web' was 18 months in the planning, and caused huge damage to Russia's bomber fleet. But as Paul Adams discovered, civilians in Kyiv are uneasy about celebrating this success, fearful of how Russia might respond.Approximately one fifth of Ukraine is currently under Russian occupation. Russia doesn't allow foreign journalists to enter the occupied territories, but the BBC's Olga Malchevska has been corresponding in secret with Ukrainian civilians in Crimea, through which she learned of the risks they face for small acts of resistance.During the rule of Chilean dictator Augusto Pinochet in the 70s and 80s, thousands of babies were illegally kidnapped and adopted by couples abroad. Today, many of Chile's ‘stolen children' are in a race against time to trace their aging mothers. Jane Chambers was there as one mother and daughter reunited.The coral reefs of Raja Ampat in Indonesia are among the most beautiful on Earth, but last year suffered a mass bleaching event which left reefs in some regions resembling white desert plains. Mark Stratton reports from West Papua where locals are worried that over-tourism is making the reefs even more vulnerable.And we're in Normandy in Northern France, where this week the 81st anniversary of the D-Day landings was commemorated. Each year, commemorations take on greater significance as the number of war veterans able to attend declines. Ash Bhardwarj visited one village keeping their memory alive.Series Producer: Serena Tarling Production Coordinators: Katie Morrison & Sophie Hill Editor: Richard Fenton-Smith

Neoborn Caveman explores the complex internal dynamics of Ukraine during its ongoing conflict with Russia, revealing deep-seated ethnic, political, and historical tensions that threaten the nation's unity. The Ukrainian Armed Forces (AFU) are not a monolithic entity but consist of diverse factions with varying visions of national identity, ranging from democratic western alignment to ultra-nationalist ideologies. These divisions are rooted in Ukraine's complex historical context, including Soviet-era border shifts and the legacy of nationalist movements like that of Stepan Bandera.NC highlights the role of groups like the Azov unit, which originated as a volunteer battalion in 2014 and has since evolved into a significant military formation with nationalist leanings. Neoborn examines how Russia's invasion has mobilized approximately 100,000 citizens into territorial defense units, creating a network of half-military groups with diverse political agendas. These groups, while united against Russian aggression, harbor potential for internal conflict due to their varied perspectives on Ukraine's future and national identity.As peace negotiations potentially loom, the podcast warns of a dangerous potential for internal fragmentation. The proliferation of weapons, coupled with deep-seated ethnic tensions and historical grievances, creates a volatile environment where disarmament seems nearly impossible. The greatest risk, according to the analysis, lies in the peace process itself, with factions like the Azov Brigade potentially rejecting territorial concessions and turning their weapons inward, threatening to unravel Ukraine's hard-fought social cohesion.Support us and grab Canada's Mirage (https://www.amazon.com/dp/B0DRYV6VJJ) or The Digital Trap (https://www.amazon.com/dp/B0DYWKLK2R/) and become a member: https://www.patreon.com/TheNeobornCavemanShowKEY TAKEAWAYS:• Ukraine's internal ethnic and political divisions threaten its unity, with tensions rooted in complex historical borders and identities shaped by Soviet-era territorial changes• The Ukrainian Armed Forces contain multiple factions with conflicting visions, ranging from Western-aligned democratic ideals to ultra-nationalist ethnic nationalism• The Azov unit represents a controversial nationalist military group with historical ties to far-right ideology, complicating Ukraine's internal cohesion and external perception• Approximately 100,000 citizens joined territorial defense units since 2022, creating diverse half-military groups with varied political agendas that could pose risks to post-war stability• Potential peace negotiations risk triggering internal conflict, as some military factions may reject territorial concessions and potentially turn weapons against each other• Russia's invasion narrative of protecting Russian-speaking Ukrainians is partially rooted in genuine ethnic tensions and documented minority persecution incidents• The proliferation of weapons and autonomous military groups makes comprehensive disarmament extremely challenging, increasing the potential for post-war internal violence• Stepan Bandera's complex historical legacy remains divisive, symbolizing anti-Soviet resistance in western Ukraine while simultaneously fueling Russian propaganda about Ukrainian 'fascism'Free speech marinated in comedy.........Humanity centered satirical takes on the world & news + music - with a marble mouthed host.Free speech marinated in comedy.Supporting Purple Rabbits. Hosted on Acast. See acast.com/privacy for more information.

N Engl J Med 2001;345:1667-1675Background: Angiotensin II is a peptide hormone that is part of the renin–angiotensin–aldosterone system (RAAS). Angiotensin II is a potent vasoconstrictor and growth-stimulating hormone. Data suggested that it plays a role in ventricular remodeling and progression of heart failure. Although treatment with angiotensin-converting enzyme inhibitors (ACEi) reduce angiotensin II levels, physiologically active levels of angiotensin II may persist despite long-term therapy.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The Valsartan Heart Failure Trial (Val-HeFT) sough to assess whether the angiotensin-receptor blocker valsartan, could reduce mortality and morbidity when added to optimal medical therapy in patients with systolic heart failure.Patients: Eligible patients had left ventricular ejection fraction less than 40% and left ventricular dilation, in addition to having clinical heart failure for at least 3 months with NYHA class II, III or IV symptoms. Patient also had to have been receiving a fixed-dose drug regimen for at least two weeks, that could include ACEi, diuretics, digoxin, and beta-blockers.There were many exclusion criteria. We mention some here: Postpartum cardiomyopathy, acute myocardial infarction within 3 months, coronary artery disease likely to require intervention, serum creatinine >2.5 mg/dL and life expectancy less than 5 years.Baseline characteristics: Patients were recruited from 302 centers in 16 countries. The trial randomized 5,010 patients – 2,511 randomized to receive valsartan and 2,499 to receive placebo.The average age of patients was 63 years and 80% were men. The average left ventricular ejection fraction was 27%. Cardiomyopathy was ischemic in 57% of the patients. The NYHA class was II in 62% of the patients, III in 36% of the patients and IV in 2%.Approximately 26% had diabetes and 12% had atrial fibrillation.At the time of enrollment, 86% were taking a diuretic, 67% were taking digoxin, 35% were taking beta-blockers, and 93% were taking ACEi.Procedures: The trial was double-blinded. The trial had an initial run-in period for 2 - 4 weeks where patients received placebo twice daily. This was performed to confirm patients' eligibility, clinical stability and compliance.Patients were assigned in a 1:1 ratio to receive valsartan or placebo. Randomization was stratified according to whether or not they were receiving a beta-blocker.Valsartan was started at a dose of 40 mg twice a day, and the dose was doubled every two weeks to the target dose of 160 mg twice a day. Placebo doses were adjusted in a similar way.Follow up occurred at 2, 4, and 6 months and every 3 months thereafter.Endpoints: The trial had two primary end points. The first was all-cause mortality. The second was the combined end point of mortality and morbidity, which was defined as cardiac arrest with resuscitation, hospitalization for heart failure, or administration of intravenous inotropic or vasodilator drugs for four hours or more without hospitalization.The estimated sample size was 5,000 patients. The sample size calculation assumed 20% relative risk reduction in mortality with valsartan assuming 906 patients would die during the trial. This sample size would provide the trial 90% power at 0.02 alpha. Alpha was 0.02 instead of the traditional 0.05 since the trial had two primary endpoints and to adjust for the interim analyses.Results: The target valsartan dose of 160 mg twice a day was achieved in 84% of the patients. The reduction in systolic blood pressure was greater with valsartan vs placebo – mean of 5.2 ± 15.8 mm with valsartan compared to 1.2 ± 14.8 mm Hg with placebo, at 4 months.All-cause mortality was not different between both groups (19.7% with valsartan vs 19.4% with placebo, RR: 1.02, 95% CI: 0.88 – 1.18; p= 0.80). The second co-primary endpoint was reduced with valsartan (28.8% vs 32.1%, RR: 0.87, 95% CI: 0.77 – 0.97; p= 0.009). This was driven by reduction in hospitalizations for heart failure (13.8% vs 18.2%). Cardiac arrest with resuscitation was 0.6% with valsartan and 1.0% with placebo. All-cause hospitalization was numerically lower with valsartan, however, this was not statistically significance (2,856 vs 3,106; p= 0.14). The mean change in ejection fraction was higher with valsartan (4.0% vs 3.2%; p= 0.001). More patients had improvement in NYHA classification with valsartan (23.1% vs 20.7%; p

Michaux State Forest is the place I spend the most time outdoors. Located about 30 miles from where I live, it's where I hike and camp. It's where I bring visitors to show off the South Mountain region. It's where I breath in fresh air and explore the beauty of the Commonwealth. It's my safe place away from the goings-on of Harrisburg. But that safety was shattered in April 2025. I received text messages from friends telling me that Michaux was on fire. Then, news came that there were two fires. And they were spreading. With wind and no rain in the forecast it became evident that the situation could get bad quickly.Over the following two weeks, I'd see photos and videos of the fires spreading across the forest I loved. Friends were evacuated from their homes. Roads were closed. Massive clouds of smoke billowed across the area. People were scared. The beautiful landscape I loved was on fire and there was nothing I could do but watch. But thanks to incredibly brave firefighters and with a little help from the weather, the Thompson Hollow and Hammond Rocks fires were extinguished in 14 days. Over 150 fire companies from 10 Pennsylvania and Maryland counties battled the blaze. Approximately 2,700 acres were destroyed by the wildfires. Luckily, no homes or private property was damaged and only two people suffered minor injuries. And, predictably, a determination was made that the fires were human caused, like 99 percent of all wildfires.Here's the thing. While the situation was scary for many in the area – even for us 40 minutes from the fires – this is a common occurrence in Pennsylvania. There's between 1,000 and 2,000 wildfires every year in Commonwealth. And the majority of those wildfires occur in the spring. These fires so close to home was a sobering reminder of the ever-present danger of wildfires. With Michaux still charred from the fires, I wanted to know more about wildfires and the wildland firefighters that have to put them out. On this episode, I speak with Mike Kern. Mike is the Chief Forest Fire Warden for the Pennsylvania Department of Conservation and Natural Resources. Be sure to support our 2025 sponsors:Keystone Trails AssociationPurple Lizard MapsPennsylvania Parks and Forests FoundationSisters' SunflowersSupport the showVisit our website to learn more about the podcast, to purchase merch and to find out about our incredible sponsors. Follow us on Instagram and Meta to stay connected. Hosting, production and editing: Christian AlexandersenMusic: Jon SauerGraphics: Matt Davis

//The Wire//2300Z June 2, 2025////PRIORITY////BLUF: MAJOR ESCALATION IN RUSSIA AS UKRAINE STRIKES RUSSIA'S STRATEGIC BOMBER FORCE. MOLOTOV ATTACK OCCURS IN COLORADO.// -----BEGIN TEARLINE------International Events-Russia: At approximately 11:00pm Moscow time Sunday evening, Ukraine conducted a large-scale drone attack on military bases throughout Russia. Approximately 5-8 commercial cargo vehicles parked near critical military bases throughout the nation. Once parked, the drivers of these vehicles opened secret hatches cut into the tops of the cargo containers, from which dozens of Ukrainian drones were deployed in rapid succession. Within moments, these drones struck targets at several Russian military installations, ranging from airfields to supply depots.As of right now, four Russian airbases have been confirmed to be struck during the attacks: Ivanovo, Dyagilevo, Belaya, and Olenya Air Bases were all struck overnight.Various targets at Severomorsk and Severodvinsk Naval Bases appear to also have been struck, however this is unconfirmed at this time. Voskresensk Air Base is also claimed by some sources to have been struck during this attack, but this is also unconfirmed.All total, the initial assessment of battle damage indicates a total loss of 3x Tu-95 BEAR H bombers, with 5x more being damaged. Ukrainka Air Base was also targeted by Ukrainian drones, however this attack failed due to the defenses at this location.Ukraine has claimed credit for the attack, and has openly stated that the United States was made aware of the attack before it took place. The United States has denied these claims.-HomeFront-Colorado: Yesterday afternoon an arson attack took place in Boulder. Local authorities state that an assailant attacked a pro-Israel protest/demonstration in the vicinity of the historic Boulder County Courthouse. The attacker approached the protesters, using improvised incendiary devices to inflict burns on approximately 5x people attending the small demonstration. Concerning casualties, 2x victims were burned severely, and a several others suffered minor burns. The attacker has been identified as Mohammed Soliman, and authorities have claimed he is an illegal immigrant (specifically, a visa overstay) from Egypt.AC: Reports vary on the method of the attack; some sources claim the assailant used some sort of improvised flamethrower device, others state that he used Molotov cocktails in his attack. Either way, video evidence of the attack confirms the assailant was holding two Molotovs in his hands after the attack was conducted. Additionally, Soliman's statements during the fray also indicate he conducted the attack in support of the Palestinian movement. Considering the recent shift in federal agencies' priorities concerning this issue, the fallout of this incident is probably going to be a very big deal in many different ways.Oregon: Yesterday afternoon a mass stabbing attack was reported at the Union Gospel Mission in Salem. 11x people were wounded in the attack, and the assailant was detained at the scene.AC: Very few details have come to light regarding this incident, and the assailant has not been identified yet. However, this facility is a homeless shelter, so at the moment the most likely theory is that the attack is the result of a mental health incident.-----END TEARLINE-----Analyst Comments: From time to time, a new aspect of modern war comes to light that changes the dynamic of the modern battlespace in ways that most of us cannot possibly fathom. This happened over the weekend in Russia. While the drone attack on Russian airfields was not a new tactic by any means, it is expressly for this reason that this attack was special: most nations around the world have been waiting for someone to try this attack vector, and now it's actually happened.While the

Yall the prison system needs to be reformed immediately . I understand prison is a punishment but what about rehabilitation?? Approximately 2 million people are incarcerated right now half probably wrongfully convicted and a huge number who probably are serving life. Some of these people made 3 seconds mistakes and now have to suffer for the rest of their life. I understand punishment but who tf is the judicial system to be judges of life????? Idk I got so much to say but one day I will reform the prison system starting first with our communities

According to data from the Federal Bureau of Investigation (FBI) and other crime statistics sources, Approximately 1 million residential burglaries are reported annually in the United States.This averages out to about 2,740 burglaries per day nationwide.Most burglaries last 8 to 10 minutes, with burglars looking for quick, easy-to-access valuables like cash, jewelry, firearms, and electronics. Today, we are going to learn ways to make our stuff harder for burglars to find, as well as keeping nosy visitors from knowing what we have, as we talk about How to Hide Things in Plain SightMentioned In This Episode:Muirhead Canning1791 Gunleather.com (Use discount code PREP15)Expanded Show NotesDownload The Episode HereIf you find value in the podcast, would you be willing to give back a little?You can do that one of several ways.     Go to our support page               OR     By starting your Amazon shopping from our website? --->  CLICK HERE        (We earn from qualifying Amazon purchases)Contact us:Practical PreppingWebsiteOur Sponsors:Practical Prepping CoursesMuirhead Cannery   (541) 298-1660 WebsiteProLine Digital GroupWebsiteEmailPodcast music written and recorded by Krista LawleyWebsite design and hosting by ProLine Digital Group.Podcasts Copyright 2025, P3 Media Group, LLC, and Practical Prepping Podcast

Send us a textCindy Murphy shares the heartbreaking story of her son Tristan, who struggled with schizophrenia and died by suicide while incarcerated after being handed a chainsaw during a prison work detail. Through her grief, Cindy has become a powerful advocate for mental health reform in the criminal justice system, working to pass the Tristan Murphy Act in Florida.• Tristan developed schizophrenia in his 30s, unusually late compared to typical onset in teens or early 20s• After his first psychotic episode, Tristan spent 8 months in jail before being declared incompetent to stand trial• When properly medicated, Tristan functioned well and maintained a relationship with his children• Florida ranks #1 in mental health needs but #49 in providing mental health services• The Tristan Murphy Act aims to identify mental health issues within 24 hours of arrest and divert people to treatment• Approximately 30% of prison inmates have mental health issues• New treatments like long-acting injectable medications can help people with schizophrenia maintain stability• The documentary "The Warehouse: The Life and Death of Tristan Murphy" is available on YouTubeIf you know anyone that would like to tell their story, send them to tonymantor.com/contact with their information so one day they may be a guest on our show. Please tell everyone everywhere about Why Not Me ? Embracing Autism and Mental Health Worldwide The World, the conversations we're having, and the inspiration our guests give to everyone that you are not alone in this world.https://tonymantor.comhttps://Facebook.com/tonymantorhttps://instagram.com/tonymantorhttps://twitter.com/tonymantorhttps://youtube.com/tonymantormusicintro/outro music bed written by T. WildWhy Not Me the World music published by Mantor Music (BMI)

On Donald Trump's first day in office, he signed an Executive Order directing all parts of the federal government to take steps to stop the development of offshore wind. This has left people wondering: what's the future for offshore wind? Spoiler: it's unclear. Citing his executive order, on April 16, the Bureau of Ocean Energy Management issued a stop work order for Empire Wind, a fully-permitted wind project off New York. Included in the rationale for the stop work order is a discredited conspiracy theory that offshore wind development was responsible for a spate of whale deaths. (A claim that has been thoroughly debunked although still commonly cited by anti-wind activists.) After the stop work order was issued, California Attorney General Rob Bonta and 17 other attorneys general filed a lawsuit to challenge the legality of Trump's anti-wind executive order. Humboldt's own EPIC, together with a coalition of other environmental organization, have filed an amicus brief in the litigation against the Trump executive order too. Approximately a month later, the Trump Administration lifted its stop work order. Why? They won't say. But despite uncertain federal waters, the Humboldt Bay Harbor District and the State of California continue to move forward on work for other necessary infrastructure to develop offshore wind. The Humboldt Bay Harbor District is continuing to develop its "green port" for build and service wind turbines. And the California Independent Systems Operator has selected a developer to build new transmission lines to service the project.Breaking down all of these events and more is Matt Simmons, Climate Attorney at EPIC. Have a question about offshore wind? Visit northcoastoffshorewind.org, a product of EPIC, Humboldt Waterkeeper, Blue Lake Rancheria, and the Redwood CORE Hub at the Humboldt Area Foundation. Support the show

In this episode, our guests talk about perimenopause and how more needs to be done to support community college employees with the challenges associated with it.  Approximately 50% of the population experiences perimenopause, and for many of these individuals—colleagues and leaders alike—this natural process brings physical and emotional symptoms that can disrupt workplace performance for years. A 2023 Korn Ferry survey of over 8,000 women found that 47% experienced symptoms affecting their work, with the majority feeling unsupported by their organizations around their perimenopausal needs. Symptoms like hormone fluctuations, hot flashes, and brain fog can hinder productivity and negatively impact career progression, absenteeism, and turnover, particularly among senior leadership. Unfortunately, many individuals are unaware of whom to approach about these issues, and few institutions have developed inclusive policies to address them.  Our guests are: Aliesha Crowe, vice president of academic affairs at Northwood Technical College Kristen Raney, president of Northeast Wisconsin Technical College 

Send us a textDr. Damaris Maria Grossman welcomes Joe Berg, creator of protein-packed grass-fed beef snacks, and his strategic partner John Engelson to discuss integrative health and clean protein options.• Joe Berg shares his journey from 35-year tech industry veteran to EMT volunteer to energy healer• Joe developed ability to sense which foods would benefit different individuals• His daughter prophetically suggested "Joburg" as a business name years before he entered food industry• COVID-19 shutdown created opportunity to build a 20,000 square foot facility focused on clean beef snacks• John Engelson brings background as founder of "You Are What You Eat" and pioneer in health food sections• Products contain no sugar, no junk ingredients, no nitrates/nitrites, and no preservatives• Maltodextrin in many snacks has glycemic index 40% higher than table sugar• Joe lost 12 pounds in one week eating only his protein snacks• Approximately 85% of population struggles with insulin resistance• Small dietary changes can create significant health improvements• Intermittent fasting (12-14 hours daily) beneficial for most people• Each bag contains equivalent protein to a six-ounce steak• Products have one-year shelf life despite containing no preservativesUse code DAMARIS15 for 15% off at joburgmeats.com Support the showSponsor Affiliates Empowering Wellness Through Evidence-Based Education https://www.atecam.com/ Get YOUR Own Joburg Protein Snacks Discount Code: Damaris15 Or Damaris18 Feeling need to Lose Weight & Become metabolically Healthy GET METABOLIC COURSE GLP 1 REseT This course is designed for individuals looking to optimize their metabolic health through integrative and functional medicine approaches. Whether you're on a GLP-1 medication or seeking natural ways to enhance your metabolic function, this course provides actionable steps, expert insights, and a personalized roadmap sustainable wellness. Are you feeling stressed, tired, or Metabolism imbalanced? Take advantage of our free mindful steps to help improve your well-being.ENJOY ONE OF our Books Mindful Ways Health Wealth & Life https://stan.store/Mindfullyintegrative Join Yearly membership ALL IN O...

Lancet 1999;353:2001-07Background: Beta-blockers directly reduce cardiac contractility and myocardial oxygen demand. For decades, they were avoided in patients with acute and chronic heart failure over concerns they would facilitate decompensation of the condition. The therapeutic cornerstones of treatment, prior to the modern era of clinical trials, focused on managing symptoms and quality of life with diuretics and inotropic agents like digoxin; however, new paradigms were arising that focused on addressing neurohormonal mechanisms of chronic disease that were over-activated in the failing heart. The first major success came with inhibition of the renin angiotensin aldosterone system with angiotensin converting enzyme inhibitors whose effect on mortality for patients with mild and severe forms of chronic heart failure were demonstrated in the V-HEFT II, CONSENSUS, and SOLVD trials. Additional benefits were demonstrated with the mineralocorticoid receptor antagonist spironolactone in the RALES trial. These drug classes primarily work by reducing afterload and volume retention. Appreciating why they work for improving cardiac performance and managing symptoms in heart failure patients is straightforward when we consider the major factors that effect cardiac stroke volume - preload, afterload and contractility; however, it is also noteworthy the effects these agents have on sudden death. How beta-blockade benefits the failing heart is less obvious (outside prevention of sudden death). Mechanistic studies in patients with chronic heart failure have consistently shown that when beta blockers are used for more than 1 month, left ventricular function improves. Beta blocker therapy appears to restore the density of beta-adrenergic receptors after they have been downregulated by the chronic overactivity of the sympathetic nervous system. The first major placebo-controlled RCT to demonstrate a mortality benefit used the non-selective beta blocker carvedilol. The trial was small and not originally designed to test mortality and was stopped early without clearly predefined stopping rules. Furthermore, 8% of total patients selected for participation in the trial were excluded prior to randomization after a 2 week, open-label run-in phase with the study drug, which saw 2% of all patients experience worsening heart failure or death representing 24 patients (the difference in total deaths between groups was 9 when the trial was stopped). The Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF) was the first large scale trial designed to test the hypothesis that beta-blockade with metoprolol controlled/extended release (CR/XL) added to optimum medical therapy reduces mortality in patients with chronic systolic heart failure.Patients: Patients were recruited from 313 sites in 13 European countries and the United States. Eligible patients were men and women between the age of 40 to 80 years with symptomatic heart failure (NYHA class II-IV) for >/= 3 months before randomization. They had to be on a diuretic and ACE inhibitor for at least 2 weeks. Other drugs, including digoxin, could also be used. Patients also had to have an EF of /=68 beats per minute.Patients were excluded if: they had an MI or unstable angina within 28 days; had an indication or contraindication for treatment with beta-blocker; beta blockade within 6 weeks; heart failure due to systemic disease (i.e., amyloidosis) or alcohol abuse; scheduled or performed cardiac transplant; an ICD; procedures such as CABG or PCI planned or performed in the past 4 months; 2nd or 3rd degree AV block unless a pacemaker was present; unstable or decompensated heart failure defined by pulmonary edema or hypoperfusion or supine systolic BP 25% deviation of the number of observed versus expected consumed placebo tablets during the run-in period.Baseline characteristics: The mean age of patients was 64 years and approximately 78% were male. Slightly more than 30% of patients were above the age of 70. The average EF was 28%. The average SBP was 130 mmHg and heart rate was 82 bpm. Most patients had mild to moderate heart failure, with 41% in NYHA Class II, 56% in Class III, and only 3% in Class IV. Ischemic cardiomyopathy accounted for 65% of cases and nonischemic causes accounted for 35%. Most patients were on an ACE inhibitor or ARB (95%) and diuretic (90%). Digoxin was used in 63%. Trial procedures: Prior to randomization, the study was preceded by a single-blind, 2-week placebo run-in period. Patients meeting eligibility were then randomized to placebo or metoprolol CR/XL. The starting dose of placebo or metoprolol CR/XL was 12.5 mg daily for patients in NYHA class III or IV and 25 mg daily for patients in NYHA class II. The dose was doubled every 2 weeks until the target dose of 200 mg daily was reached. Patients were followed every 3 months.Endpoints: The primary outcome was all-cause mortality. It was estimated that 3,200 patients would need to be followed for 2.4 years to detect a 30% relative reduction in mortality based on annual mortality rate of 9.4% in the placebo group. This would achieve at least 80% power with a 2-sided alpha of 0.04. Patients were recruited faster then planned and so the final sample size of 3,991 patients increased the power of the study.The study was monitored by an independent safety committee and predefined stopping rules for efficacy were based on all-cause mortality, done when 25%, 50%, and 75% of expected deaths had occurred. Results: The trial was stopped early after the 2nd preplanned interim analysis when 50% of expected deaths had occurred. The mean duration of follow-up at the time of stopping was 1 year. The mean daily dose of metoprolol CR/XL was 159 mg once daily, with 87% receiving 100 mg or more and 64% receiving the target dose of 200 mg daily. In the placebo group, the corresponding values were 179 mg daily, 91% and 82%. The study drug was discontinued permanently in 14% of patients in the metoprolol group and 15% in the placebo group. Six months after randomization, heart rate decreased by 14 bpm in the metoprolol group compared to only 3 bpm in the placebo group. Systolic blood pressure decreased less in the metoprolol group (-2.1 vs 3.5 mmHg).Compared to placebo, metoprolol significantly reduced all-cause mortality (7.3% vs 10.8%; RR 0.66; 95% CI 0.53—0.81). Cardiovascular mortality accounted for 91% of all deaths; with sudden death accounting for 58% and death from worsening heart failure accounting for 24% of all deaths. All 3 of these causes of death were significantly reduced by metoprolol. The relative and absolute effects on death were greatest for patients with NYHA class III heart failure.Conclusions: In this trial of stable patients with mild to moderate chronic systolic heart failure, who were optimized on an ACEi or ARB and diuretic, metoprolol CR/XL significantly reduced all-cause mortality. Approximately 30 patients would need to be treated with metoprolol compared to placebo for 1 year to prevent 1 death. This trial represents a significant win for beta blockade in patients with chronic systolic heart failure. While the NNT in this trial is slightly higher than in SOLVD, it is important to appreciate that follow-up time in SOLVD was more than 3x longer. Limitations to external validity in this trial include the run-in period and stringent inclusion and exclusion criteria. Our enthusiasm is also tempered by early stopping, which has been found to be associated with false positive or exaggerated results but this concern is mitigated to some extent in this trial because the rules for early stopping were clearly defined in the protocol.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

Contributor: Travis Barlock, MD Educational Pearls: Wheezing is classically heard in asthma and COPD, but it can be the result of a wide range of processes that cause airflow limitation Narrowed bronchioles lead to turbulent airflow → creates the wheezing Crackles (rales) suggest pulmonary edema which is often due to heart failure Approximately 35% of heart failure patients have bronchial edema, which can also produce wheezing COPD and heart failure can coexist in a patient, and both of these diseases can cause wheezing It's vital to differentiate whether the wheezing is due to the patient's COPD or their heart failure because the treatment differs Diagnosing wheezing due to heart failure (cardiac asthma): Symptoms: orthopnea, paroxysmal nocturnal dyspnea Diagnostic tools: bedside ultrasound Treatment: diuresis and BiPAP for respiratory support Not all wheezing is asthma Consider heart failure in the differential and tailor treatment accordingly References 1. Buckner K. Cardiac asthma. Immunol Allergy Clin North Am. 2013 Feb;33(1):35-44. doi: 10.1016/j.iac.2012.10.012. Epub 2012 Dec 23. PMID: 23337063. 2. Hollingsworth HM. Wheezing and stridor. Clin Chest Med. 1987 Jun;8(2):231-40. PMID: 3304813. Summarized by Meg Joyce, MS1 | Edited by Meg Joyce & Jorge Chalit, OMS3 Donate: https://emergencymedicalminute.org/donate/  

In freight technology news, ⁠load board provider DAT announced its acquisition of payments platform Outgo⁠ last week. This strategic move aims to integrate the entire freight transaction process into the DAT One ecosystem, with a key benefit being that carriers can now potentially get paid much faster, sometimes within just 15 minutes. Outgo, founded in 2022 by former Uber and Convoy technologists, focused on bundling banking, factoring, and payment services, including a "fractional factoring" model giving carriers more control. This acquisition is seen as positioning DAT to become the freight industry's central exchange platform, competing with others like Triumph Financial who are also building their ecosystems. Turning to maritime trade, the ⁠Port of Long Beach recorded its strongest April on record⁠ last month. The port handled 867,493 twenty-foot equivalent units (TEUs), representing a 15.6% year-over-year increase attributed to importers frontloading tariff-affected cargo. Imports saw a significant 15.1% year-over-year rise, while exports slightly declined. Even with this record, the port anticipates a more than 10% drop-off in imports in May, with effects expected beyond the docks. In Washington D.C., lawmakers are processing a large volume of input from the trucking sector. The Department of Transportation (DOT) received ⁠over 900 recommendations for regulatory removal⁠ as part of implementing executive orders to cut bureaucracy. Approximately 30% of these recommendations came directly from the trucking industry and addressed regulations affecting drivers and carriers. Finally, mark your calendars for upcoming Freight Waves TV programming, including ⁠The Stockout⁠ and ⁠What the Truck?!?⁠. You can also find details on the Fraud Fighters Award winners and information on the upcoming ⁠Domestic Supply Chain Summit⁠ this week. Learn more about your ad choices. Visit megaphone.fm/adchoices

Approximately one third of our lives are spent working, which translates to over 90,000 hours over a lifetime. Not only is that, but many of us find our identity in our work and achievements, and when the career basket falls over at some point in our lives, it can create quite a mess. Join us this Sunday as Pastor Brandon discusses Paul's perspective on how he views his own resume in relation to a relationship with Jesus.

When it comes to raising a family, American Robins have got it down. Approximately eight days after the male and female mate, the female builds the nest.  A few days later, she lays eggs. She sits on the eggs for 18 hours a day, and the eggs hatch in about three weeks. Both parents feed the nestlings until they fledge, then Mom and Dad feed them for another three weeks, until the kids are on their own. Whew! Time for a break, right? Not a chance. Most robins raise two sets of young each season, and sometimes a third.This show brought to you by The Bobolink Foundation.More info and transcript at BirdNote.org.Want more BirdNote? Subscribe to our weekly newsletter. Sign up for BirdNote+ to get ad-free listening and other perks. BirdNote is a nonprofit. Your tax-deductible gift makes these shows possible.

Approximately 80% of orange cats are males, including the four orange cats owned by the Short Wave team. Scientists have long suspected that orange color was a sex-linked trait — hiding somewhere on the X chromosome. Now, scientists at Stanford University and Kyushu University in Japan have characterized the mutation responsible for orange cat coloration. Both groups published their results in the journal Cell Biology this week. Have a question about the animals all around us? Email us at shortwave@npr.org — we'd love to hear from you!Listen to Short Wave on Spotify and Apple Podcasts.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Send us a textThe IEEE MTTS International Microwave Symposium attracts over 9,000 attendees and 500+ exhibitors to share cutting-edge developments in RF, microwave, and advanced packaging technologies. Tim Hancock and Jim Buckwalter from the IMS committee explain why this premier event, taking place in San Francisco's Moscone Center from June 15-20, has become increasingly relevant to professionals in advanced packaging and heterogeneous integration.• Approximately 15% of accepted papers directly address packaging and heterogeneous integration topics• Papers undergo rigorous double-blind review with an in-person committee meeting to ensure highest quality content• Technical focus includes laminate technology, chip stacking, thermal management, and other critical packaging technologies• Special workshops address 3D heterogeneous integration, millimeter-wave phased arrays, and advanced packaging solutions• Exhibition floor features 500+ companies providing networking opportunities and technology discovery• Student programs include design competitions, volunteer opportunities, and dedicated sessions for underrepresented groups• Early bird registration ends May 16th with regular registration continuing at ims-ieee.orgRegister at ims-ieee.org to secure your spot and book accommodations before they fill up.THE 2025 IEEE MTT-S IMSThe 2025 IEEE MTT-S IMS is the largest event for RF and microwave professionals in the world.Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the showBecome a sustaining member! Like what you hear? Follow us on LinkedIn and TwitterInterested in reaching a qualified audience of microelectronics industry decision-makers? Invest in host-read advertisements, and promote your company in upcoming episodes. Contact Françoise von Trapp to learn more. Interested in becoming a sponsor of the 3D InCites Podcast? Check out our 2024 Media Kit. Learn more about the 3D InCites Community and how you can become more involved.

Crisis Point, 3min., Romania Directed by Valentin Raileanu As a result of resource depletion, a virus outbreak stripping the afflicted of what makes them human and finally, war, humanity's sovereignty has fallen. In dwindling numbers, the survivors have been driven out of their homes in the search for safety, while a former soldier travels through the toxic environment in search of a cure. https://www.instagram.com/vali_stunt Get to know actor Diana Gheorghe What motivated you to make this film? Valentin Raileanu, a talented and successful stuntman, fight choreographer, camera operator, and my mentor in this wonderful field, has always had a passion for filmmaking and a wealth of insane ideas to bring to life. This passion led him to explore the subtleties of being a film director. When he proposed the idea of a post-apocalyptic short to me, I immediately knew we had to do it. I fell in love with the concept of showcasing a violent and harsh reality as a consequence of human recklessness. It was also a great opportunity for me to put my newly learned stunt skills to the test. Since I was young, I've loved acting and dreamed of participating in film festivals with my own projects. Even though this isn't our first project together, it is the first one we're submitting to festivals. From the idea to the finished product, how long did it take for you to make this film? Approximately 10 weeks in total, give or take a few days. Pre-production lasted 5 weeks (for choreography, camera rehearsal, and preview), followed by 1 week of shooting, and another 4 weeks for post-production (editing and FX). Subscribe to the podcast: https://twitter.com/wildsoundpod https://www.instagram.com/wildsoundpod/ https://www.facebook.com/wildsoundpod

Story at-a-glance Approximately 10% to 15% of Americans suffer from irritable bowel syndrome (IBS), a functional gastrointestinal disorder characterized by unpredictable symptoms that disrupt daily life Recent research reveals that psychological stress trains your body to misidentify safe foods as threats. This rewires your immune and nervous systems to produce pain responses in the gut Stress increases mast cell activity in the gut, which leads to nerve hypersensitivity and immune system changes that trigger IBS symptoms like bloating, pain, and altered digestion When stress becomes chronic, hormones like cortisol and CRF impair digestion, damage the gut lining, and throw off your microbial balance, worsening IBS symptoms Managing IBS involves comprehensive lifestyle strategies, including stress reduction techniques like mindfulness, exercise, improving sleep, and supporting gut health through diet and potential supplements

* Grabs 155 Mesa, AZ (August 20, 2017) * Nick speaks with Chris Sleigher and Kasey Beal about a grab they made on August 20, 2017 * Chris Sleigher (current BC), Captain at the time of the grab. * Kasey Beal (current Chief 1 of Golden [CO] FD, BC at the time of the grab. * Mesa Fire And Medical Department. * August 20, 2017, single-story, ordinary construction. * Approximately five minutes between arrival, time, and victim removal. * The weight of the victim was over 300 pounds. * The removal method was performing the Denver drill out of an elevated window. * Some of the takeaways were the IC was able to have tactical patience and understand the impacts of the flow path and victim removal. Trusting and training your cruise and departmental support and expect expectations through standard operation procedures. * YouTube video of Fairview Fire Review...https://youtu.be/Es67SVABGc0 * Takeaways-Ensure the 3-deep model for resources on working fires, especially with persons reported, backfill ambulances or rescues for firefighters, drop CyanoKits on smoke inhalation victims (us or them) strong command presence, predictable deployment of resources, commit on deck crews to support search, rescue and fire control, Plan B isn't Plan A harder.

Send us a textTim Murphy, former congressman and psychologist, shares his journey advocating for mental health reform through the Helping Families in Mental Health Crisis Act and highlights the systemic failures in America's approach to serious mental illness.• Serious mental illness requires different treatment approaches than general mental health concerns• Current Medicaid restrictions only allow 15-day hospital stays with a 190-day lifetime limit• HIPAA laws often prevent necessary communication between doctors and families of mentally ill patients• Approximately 40% of prison inmates have serious mental illness, with jails becoming de facto psychiatric facilities• SAMHSA (Substance Abuse and Mental Health Services Administration) lacks accountability for billions in spending• Schizophrenia alone costs America approximately $380 billion annually across healthcare, criminal justice, and social services• Assisted Outpatient Treatment provides court-ordered care for those with severe mental illness who lack insight into their condition• Mental health advocacy requires specific, actionable requests to legislators rather than general appeals• Reform needs include lifting hospital bed restrictions, modifying HIPAA laws, and implementing stronger program accountabilityVisit drtimmurphy.com to read articles with plans for advocacy and reform in mental health policy.https://tonymantor.comhttps://Facebook.com/tonymantorhttps://instagram.com/tonymantorhttps://twitter.com/tonymantorhttps://youtube.com/tonymantormusicintro/outro music bed written by T. WildWhy Not Me the World music published by Mantor Music (BMI)

Send us a textPsychotherapist Haley Graham shares her journey from pharmacist to mental health advocate after her son's struggle with school led her to found the Bounce Brighter Futures Foundation. Her personal experience with neurodivergence drives her passion for supporting children, parents, and teachers through therapeutic storytelling and compassionate understanding.• Founded Bounce Brighter Futures Foundation in 2019, now supporting 90 families weekly with 12 therapists• Approximately 50% of children seeking support are neurodivergent (autistic or ADHD)• School attendance difficulties often stem from not belonging in the system rather than just peer bullying• Cautions against therapists inadvertently teaching autistic children to mask better• Uses storytelling with woodland animals to help children explore mental health challenges• Created "Shadow Monster" story as metaphor for facing anxiety and OCD• Developing new book based on interviews with late-identified autistic adults• Believes autism itself isn't the problem—fitting into society creates mental health challenges• Emphasizes curiosity about children's experiences rather than trying to fix them• Advocates for thoughtfulness and empathy when supporting neurodivergent individualsFind Haley Graham on LinkedIn, Instagram (hayleygrahauthor), and at Bounce Brighter Futures website.https://tonymantor.comhttps://Facebook.com/tonymantorhttps://instagram.com/tonymantorhttps://twitter.com/tonymantorhttps://youtube.com/tonymantormusicintro/outro music bed written by T. WildWhy Not Me the World music published by Mantor Music (BMI)