Caroline had an 18-year career at the World Bank, where she worked as Managing Director in charge of Operational Policy; Chief of Staff; and Vice President for External Affairs. She subsequently joined UBS as Group Managing Director to spearhead the firm's sustainability policy and investment products. Today, despite being part of the NGO sector herself, she expresses her views candidly and notes that NGOs can improve how they manage their carbon emissions, report on their carbon footprint and provide visibility on their path to net zero. She is cautious not to generalise and, indeed, mentions that NGOs directly working on environmental issues tend to be ahead of the curve in having robust climate commitments; but many others in the NGO sector are behind the curve. Caroline references the United Kingdom's FCDO (Foreign, Commonwealth & Development Office) and their recent mandate requesting to know the carbon footprint of organisations that are implementing their projects. In her view, NGOs will be under increased pressure from governments, donors and employees to present more robust commitments to net zero and provide visibility on the path they will take to get there. Visit The Do One Better Podcast website at Lidji.org for information on nearly 150 interviews with remarkable thought leaders. Please subscribe, follow and share widely. Thank you!
HOUR 4: Meghan Ottolini is in today with Merloni and Fauria. Christian argues that the Bucs, and Bruce Arians have the coaching advantage over the Pats and Bill Belichick. Patriots fans respond on the phones 9-30-21 See omnystudio.com/listener for privacy information.
Will the progressive wing of the Democratic party make it all or nothing on infrastructure? Rep. Ilhan Omar joined us to articulate their position. See omnystudio.com/listener for privacy information.
The secret to avoiding paying taxes -- get rich! A new report out from the Treasury points fingers at the richest 1-percent of Americans as the worst tax dodgers -- so we'll go In Depth. Remember when Texas was supposed to be trending more Democratic, evolving into a "purple" state? Instead, Texas is passing some of the most conservative laws in the country. Is the lone star state doing its best to start the next American civil war? And the Biden administration announced ambitious goals to get nearly half of the country's electricity from solar power by 2050 -- how realistic is that plan? Welcome to the pandemic, "Mu" COVID variant. It's the latest COVID mutation making headlines, but what's the actual threat? We will hear an argument, from a Christian theologian, against the use of religious exemptions to get out of taking COVID vaccines. And at the end of today's show we continue on with the recall candidates; with Republican Assemblyman Kevin Kiley, trying to break through a chaotic field. Learn more about your ad choices. Visit podcastchoices.com/adchoices
HOUR 2: The Red Sox are dealing with major COVID issues in addition to struggling to win baseball games. WEEI.com's Andy Hart argues Bill Belichick did a disservice to Cam Newton & Mac Jones. Is there more pressure on Bill or Mac? Christian hosts today's "Apology of the Day" 9-1-21 See omnystudio.com/listener for privacy information.
Deborah Fillman is a mother and writer who, shocked by the treatment of her daughters in public education, has done her research and decided that public schools are beyond reformation, and should be abolished. Find her on twitter @insomnochick, on youtube at The Reason We Learn and on locals https://thereasonwelearn.locals.com If you're interested in homeschool resources visit the Homeschool Legal Defense Association at https://hslda.org Support this channel by sharing your favorite episodes with your local contractors and journeyman, or by sending tips through https://www.paypal.me/benjaminboyce
Hour 2: Damien Woody thinks Mac Jones is a better passer than Cam Newton and would rather have Mac start. Wiggy argues that If Cam Newton and Mac Jones are the same from a talent standpoint in training camp, why not start Cam since he has more experience and can run the ball better? See omnystudio.com/listener for privacy information.
Craig announces a nefarious plan to destroy a certain well-known comedian, while Aleksa listens to Sky News' 'Uncancelled' special and makes a shocking discovery about the nation's least watched news channel. Also, Charles previews the supposedly imminent Moderna vaccine, Zander somehow survives Tokyo 2020, and Bec hand-crafts a fresh crop of artisanal news headlines. See acast.com/privacy for privacy and opt-out information.
• Today's Top Story: Who is the Trans City Council Member going after a Local Owner's Star Wars Store for posting a message saying if you have a d*ick, you are not a chick? Let's react to obviously set up video https://nypost.com/2021/08/06/store-owner-gets-in-heated-exchange-with-transgender-woman-over-sign/ • Today's In Depth Book Report: US Gold Medalist Tamyra Mensah-Stock. She is winning over the nation with her success in Tokyo and her love of country. Let's learn so much more about her with Adam Glexy https://www.instagram.com/mensahtamyrastock • Today's Go Home Internet, You're Drunk: The Internet is going OFF over an interracial couple's Slavery Themed Pre Wedding Photoshoot. Are they cool or are they fool – ish? Ashley Minor will fill us in https://www.blackenterprise.com/the-internet-goes-off-over-interracial-couples-slavery-themed-pre-wedding-photoshoot/ • Today's Featured Guest: Laurel Judd of Pure Sweat + Float Studio Now in Clarksville. So what is Float Therapy and how can it make you healthier and looking younger? Laurel will explain it all https://www.puresweatfloatstudio.com/clarksville • So All of this and much more, today on The Joe Padula Show, absolutely. Become a monthly Supporter of Free Speech for exclusive content, videos and merchandise https://www.facebook.com/theJoePadulashow/support Lawyer Wayne, know your rights, know your options. https://www.lawyerwayne.com/ O'Connor's Irish Pub and Grill – Eat, Drink, Play https://www.facebook.com/oconnorsfun Waterdogs SCUBA & Safety – Get away and Go Dive https://www.waterdogs-scuba.com/ Oak Grove Racing, Gaming & Hotel https://www.oakgrovegaming.com/ Art Link Clarksville https://www.artlinkclarksville.com/ #TalkRadio #JoePadula #Veterans #FtCampbell #Comedy #LocalNews #Nashville #Clarksville #Absolutely #PartyWithaPurpose #Tennessee #TheJoePadulaShow #officeNOWClarksville #iHeartRadio --- Support this podcast: https://anchor.fm/joe-padula/support
Yasmine Mohammed is an ex-Muslim Canadian educator, human rights activist and author who is critical of Islam. Mohammed, who escaped a forced, abusive marriage to an Al-Qaeda operative, became an advocate for women's rights through her non-profit organization Free Hearts, Free Minds. She is a member of the Center for Inquiry Speaker's Bureau and on the board of advisory for the Brighter Brains Institute. Through her initiative Free Hearts, Free Minds she supports closeted ex-Muslims from Muslim-majority countries and co-ordinates an online campaign called #NoHijabDay against World Hijab Day. She also has a website. Mohammed has been interviewed by Sam Harris, Seth Andrews, and several news outlets from multiple countries, and in 2019 self-published the book Unveiled: How Western Liberals Empower Radical Islam. MUSICAL GUEST: SHANE THOMAS Shane Thomas is still in his early 20s, but his extraordinary story started when he was 3. He insisted he could play the piano at that age despite never having touched one in his short life, apart from a tendency to play an imaginary one on the carpet. Shane finally got his hands on a piano aged 7, sat down at the keys and immediately starting playing all sorts of recognisable tunes with both hands. Within weeks he was composing his own pieces. A month later he made his first public performance and was nominated for the national Talented Youngster of The Year Award. The top prize in the Music for Youth Awards then followed. By the time he was 9, despite not having had a piano lesson, he achieved Grade 8, having skipped Grades 1 to 7. He was playing all the classics, just about any contemporary pop song and was even arranging them in a classical style. Shane was asked to appear on The One Show where Jamie Cullum exclaimed ‘he's amazing!'. The Daily Telegraph hailed Shane as a ‘mini Mozart'. At 11 Shane became the youngest composer to be given his own publishing deal with a major publisher – EMI Music. This led to invitations for Shane to play in front of 10,000 people at Castle Howard, at a private dinner for the then Prime Minister's wife Cherie Blair and even being endorsed by royalty. And then everything stopped. Shane's mother had walked out of the family home never to be seen again (she is now in prison). This left Shane, his father Clayton and two little siblings to fend for themselves. Clayton, himself a former pro musician and teacher had to singlehandedly look after the family unit. Priority was given to Shane's education, leaving any potential musical career behind. Money was not just short, it was non-existent at times. Sometimes they were sat in the dark, without electricity. Suddenly with Shane now well into his teens, the media remembered him. The BBC set him the challenge of composing and performing a symphony for the BBC Northern Orchestra within 8 weeks and Shane completed it in half the time. He performed it in front of a disbelieving audience of several hundred and the BBC cameras. Shortly after this Channel 4 picked up on Shane's extraordinary story and produced a documentary called ‘Extraordinary Teens – Young Gifted and Broke'. So where are we now? Decca Records went on to release two singles in 2017 and his track ‘The Ruins' hit No.2 in the Classical iTunes chart. Bucks Music Group then signed him to a publishing contract in 2018 and have been building him as a composer/artist since then. 10 years on from his original publishing deal at EMI Music , he could now more accurately be grouped with the likes of Ludovico Einaudi, Nils Frahm and Hans Zimmer. What is extraordinary about Shane is that, as well as composing melodies that have such immediate ear-worms, he does so by evoking such strong emotional links and themes. His team have identified that Shane can become one of the most exciting and prolific new artists at a time when playlists are so in need of new composers of great original music.
It is time to move away from a "reactive isolationist response" and lower the draw bridge to the outside world, according to one health expert. In an editorial for the Internal Medicine Journal Auckland University Professor of Medicine Des Gorman argues for a dedicated pandemic response agency as we move to next phase of our Covid-19 recovery. The agency would develop a pandemic plan, border and quarantine management, tracing and isolation capacity. Next week the Prime Minister will reveal her thinking around border restrictions and how the vaccination rollout could change that. Professor Gorman discusses the issue with Lisa Owen.
NYT Essay Argues Non-Citizens Should Vote, Saying It Would Help Democrats, FORCE GOP To Pander Left. The essay says there is no good reason for non citizens to be barred from voting. Across the US more and more non citizens are already getting the right to vote in municipal and school board elections. The left argue that even illegal immigrants should have the right to vote. In the end this means the entire system will erode as the Biden border crisis already saw more than 1 million illegal immigrants arrested this year so far. If Democrats keep allowing illegal immigrants into the US they will gain more congressional seats or maybe even turn red states blue as congressional seats are apportioned based on total population no US citizen population. #Democrats #IllegalImmigrants #BorderCrisis Learn more about your ad choices. Visit megaphone.fm/adchoices
Did you know that the book of Job was actually the first written book in the Bible? Long before Genesis was ever written. Ever get confused on the timeline of how things happened? Have you ever got confused and said that Noah split the Red Sea? Today, we continue to walk through a Chronological order of the Bible, in Joe's simple, easy to understand way. If you've never done a Bible Study, this is the place to start. It will help make sense of the entire Bible. Make sure to go back and start with Part 1. which aired on June 13, 2021. You'll be so glad you did! Also, please SHARE this podcast with your friends!
32,000. That's how many websites went down today at the same time. Bank sites. Airline sites. Delivery sites. They all went down for the same reason. And THAT is the problem and THAT is the issue. We'll go In Depth. Voices in favor of mandatory Covid vaccinations growing louder. We will speak with one of those voices here in California. We'll also go to Alabama where just 30-percent of the population is vaccinated, COVID infections are spreading wider and still, there's widespread distrust of the vaccines. We'll tell you about what the NFL is doing about Covid vaccines.. We will take you to Tokyo where the Olympics officially gets underway tomorrow---as Covid cases in Japan climb. And ancient viruses, frozen in a glacier, discovered by researchers----------what could possibly go wrong? Learn more about your ad choices. Visit podcastchoices.com/adchoices
Jul 21 – Stock market trading is moving to the blockchain, argues a new 94-page report by industry experts across the globe, and this trend is only going to continue until all assets ultimately end... Subscribe to our premium weekday podcasts: https://www.financialsense.com/subscribe
Standup Comedian, Songwriter, and Guitarist Amiracle met up with us in Vegas to tell Charlie Wilson about the time he got heckled by crackheads during a stand-up comedy show, and the super mature way he responded. Do Tell with Laugh After Dark Podcast is hosted by Charlie Wilson and Produced by CSLA Podcasting New podcast episodes every week on YouTube and all podcasting platforms. Watch episodes of Laugh After Dark on Amazon: https://linktr.ee/laughafterdark S O C I A L #DoTellPodcast @LaughAfterDark @CharlieWilsonTV @Amiracle_Comedian @CreativeStudiosLA L I N K S www.laughafterdark.com www.charliewilsontv.com www.creativestudiosla.com
President Joe Biden has nominated Los Angeles Mayor Eric Garcetti to be the next ambassador to India, but who will be Garcetti's replacement if he's confirmed? Former Mayor Antonio Villaraigosa says he's up for the job, and if tapped, he's not afraid to make big, bold moves. Plus, another native son, saxophonist Kamasi Washington, discusses making music during the lockdown and his upcoming show at the Hollywood Bowl. GET IN TOUCH Want to ask Alex a question? Visit the SoCal in 17 page On Twitter using hashtag #SOCALIN17 or her handle @alexcoheninla IN THIS EPISODE Kamasi Washington's upcoming show at the Hollywood Bowl Kamasi Washington's live performance of BECOMING at the Hollywood Bowl in 2020
The Bill of Rights provides a great number of protections for accused and convicted criminals: it promises trial by jury; it prohibits “cruel and unusual” punishment. And in this system, defendants are presumed innocent until proven guilty. Yet few criminal indictments today are actually decided by a full trial; instead, prosecutors have many points of leverage, and defendants have strong incentives to plead guilty. Are these tools and incentives good for constitutional government? Judge Jed Rakoff, of the U.S. District Court for the Southern District of New York, recently published a book arguing for major reforms: “https://us.macmillan.com/books/9780374289997 (Why the Innocent Plead Guilty and the Guilty Go Free: And Other Paradoxes of Our Broken Legal System).” On April 29, 2021, he participated in a https://www.aei.org/events/why-the-innocent-plead-guilty-and-the-guilty-go-free-a-book-event-with-judge-jed-s-rakoff/ (public web event) with https://www.aei.org/profile/adam-j-white/ (Adam), to discuss the limits of forensic science, prosecutors' advantages over defense during trials, and other ways the criminal justice system is falling short. The recording of their conversation is today's podcast episode.
Los Angeles has a new logo! No, it's not the seal of the city........and you can be forgiven if you never realized that we had a logo to begin with........but the city of angels has some new branding and it's got a very nostalgic, 80's vibe to it -- will it work? We'll go In Depth. Former President Trump is filing lawsuits against Facebook, Twitter and YouTube arguing that the social media giants violated his rights when they booted him off of their platforms. And the Olympics are set to begin in Tokyo in less than three weeks -- right when the city will be put in a state of emergency, thanks to the COVID outbreak. So you, your family, and your teenage kids are all fully vaccinated against --- but your youngest child, still too young, is attending summer camp. How worried should you be with the Delta variant out there? We're taking a closer look at working mothers, who after carrying a lot of the responsibility during lockdown ... are getting left behind in the economic recovery. And how does a 4-day work week sound to you? Research suggests it might be just as productive as working the full five. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Attorney Rich Lenkov of Bryce Downey & Lenkov and “Legal Face-Off” joins John Williams to explain why Kyle Rittenhouse’s lawyers are arguing self-defense. Then, Rich breaks down the arrest of a man from Iowa who had a rifle in his hotel room at the W in Chicago.
Attorney Rich Lenkov of Bryce Downey & Lenkov and “Legal Face-Off” joins John Williams to explain why Kyle Rittenhouse’s lawyers are arguing self-defense. Then, Rich breaks down the arrest of a man from Iowa who had a rifle in his hotel room at the W in Chicago.
The hearing to determine whether twenty-seven-year-old Bailey Boswell will be the first woman to be sentenced to death in Nebraska opened this morning at the Saline County Courthouse. A jury found the woman guilty of assisting Aubrey Trail with killing and dismembering Sydney Loofe in the couple's apartment in Wilber.Boswell's attorney, Todd Lancaster, told the court he intends to raise questions about whether the Nebraska's prison system has the capability of housing an individual woman in isolation without violating the constitutional prohibition on cruel and unusual punishment.
In this One Quick Story, Kristina Wong of Breitbart News reviews the latest examples of military wokeness and argues military leaders are "scared" of the "woke mob" on Twitter.VISIT OUR SPONSOR!X-Chair is the most comfortable office chair you'll ever find! Its patented Dynamic Variable Lumbar (DVL) support technology is great! X-Chair is now $100 off, visit xchairkyle.com to order and use code XWHEELS for FREE X-Wheel Blade Casters!
Bert's friends are in an unproblematic relationship. It's one of the easiest relationships they've ever been in, but there's one problem. When they drink together, they get into huge arguments with one another. So what does this say about their relationship? Is there a problem they are unknowingly avoiding? See acast.com/privacy for privacy and opt-out information.
Scott Sumner is a monetary economist with the Mercatus Center. He famously argued in late 2008 that the Fed was too tight with monetary policy, and eventually he has convinced many economists of his views. In this episode he explains why interest rates and even monetary aggregates are not good indicators of the stance of monetary policy, whereas NGDP growth is much better. Mentioned in the Episode and Other Links of Interest: Scott Sumner's https://www.mercatus.org/scholars/scott-sumner (Mercatus page). His blog, https://www.themoneyillusion.com/ (The Money Illusion). Scott argues https://www.themoneyillusion.com/the-feds-risky-and-reckless-tight-money-policy/ (the Fed through 2012 had been tight). Scott's older book https://www.amazon.com/gp/product/1598131508/ref=as_li_qf_asin_il_tl?ie=UTF8&tag=consultingbyr-20&creative=9325&linkCode=as2&creativeASIN=1598131508&linkId=145e17cb1eaa8e8e164146a3e46febfa (The Midas Paradox). Scott's forthcoming book https://www.amazon.com/gp/product/022677368X/ref=as_li_qf_asin_il_tl?ie=UTF8&tag=consultingbyr-20&creative=9325&linkCode=as2&creativeASIN=022677368X&linkId=07ee3f1e6e1b000aea8fcaa3adf1cd7d (The Money Illusion). #Commissions Earned (As an Amazon Associate I earn from qualifying purchases.) https://cdn.mises.org/Review%20of%20The%20Midas%20Paradox%20Financial%20Markets,%20Government%20Policy%20Shocks,%20and%20the%20Great%20Depression%20by%20Scott%20Sumner.pdf (Bob's review) of The Midas Paradox and https://mises.org/wire/market-monetarists-and-ngdp-targeting (his assessment of Market Monetarism). EconTalk https://www.econtalk.org/belongia-on-the-fed/ (interview with Michael Belongia) (which brings up Milton Friedman's critical comments about NGDP targeting). http://bobmurphyshow.com/contribute (Help support) the Bob Murphy Show. The audio production for this episode was provided by http://podsworth.com/ (Podsworth Media).
On this ID the Future from the vault, Dr. Dominic Halsmer, Dean of the College of Science and Engineering at Oral Roberts University, continues discussing his peer-reviewed paper “The Coherence Of An Engineered World,” published in the International Journal of Design & Nature and Ecodynamics. Listen in as Dr. Halsmer explains some of the aesthetic arguments for design from beauty in science, engineering, and the study of humanity. How do modularity, specificity, adaptability, durability, and other aspects of engineering systems argue for intelligent design in nature? Tune in to find out. Source
On this ID the Future from the vault, Dr. Dominic Halsmer, a Senior Professor of Engineering at Oral Roberts University, discusses his peer-reviewed paper, “The Coherence Of An Engineered World,” published in the International Journal of Design & Nature and Ecodynamics. Listen in as Halsmer describes signs of engineering he sees in nature, explains to host Casey Luskin some of the ways the universe appears strikingly bio-friendly, and tells why he’s convinced these various lines of evidence suggest intelligent design. Source
As a neuroscientist and psychology professor at Columbia University who studies the immediate and long-term effects of illicit substances, Carl Hart believes that all drugs — including heroin, methamphetamines, and cocaine — should be legalized. Steve talks to Carl about his new book, Drug Use for Grown-Ups, and Carl tells Steve why decriminalizing drugs is as American as apple pie.
Chapter Three: How the proximal tubule is like Elizabeth Warren and other truths my friends from Boston taught me References for Chapter 3: Faisy C, Meziani F, PLanquette B et al. Effect of Acetazolamide vs. Placebo on Duration of Invasive Mechanical Ventilation among patients with chronic obstructive pulmonary disease: a randomized clinical trial. JAMA 2016 https://pubmed.ncbi.nlm.nih.gov/26836730/This randomized controlled double blinded multi-center study of acetazolamide to shorten the duration of mechanical ventilation (known as DIABLO) there was no statistically significant difference (though it may have been underpowered to do so).Salazar H, Swanson J, Mozo K, White AC, Cabda MM Acute Mountain sickness impact among travelers to Cusco, Peru J Travel Med 2012 https://pubmed.ncbi.nlm.nih.gov/22776382/ Investigators found that altitude sickness is common and alters travel plans for 1 in 5 travelers but was prescribed infrequently.Buzas GM and Supuran CT. Journal of enzyme inhibition and medicinal chemistry 2015 https://www.tandfonline.com/doi/full/10.3109/14756366.2015.1051042This review describes the use of acetazolamide to treat peptic ulcers and how it was later learned that H. pylori have carbonic anhydrase NORDIC idiopathic intracranial Hypertension Study Writing Committee. The effect of acetazolamide on visual function in patients with idiopathic intracranial hypertension and mild visual loss: the idiopathic intracranial hypertension treatment trial. JAMA 2014 https://pubmed.ncbi.nlm.nih.gov/24756514/In this multi-centered trial, acetazolamide and low sodium weight reduction diet improved mild visual loss more than diet alone. Mullens W et al. Rationale and design of the ADVOR (acetazolamide in decompensated heart failure with volume overload trial) Eur J Heart Failure 2018 https://pubmed.ncbi.nlm.nih.gov/30238574/This reference explains the rationale for this ongoing trial.Gordon CE, Vantzelfde S and Francis JM. Acetazolamide in Lithium-induced nephrogenic diabetes insipidus NEJM 2016 https://www.nejm.org/doi/full/10.1056/NEJMc1609483A case report of efficacy of acetazolamide in a patient with severe polyuria.Zehnder D et al. Expression of 25-hydroxyvitamin D-1alpha hydroxylase in the human kidney. JASN 1999 This report explores the activity in the enzyme in nephron segments and suggests that the distal nephron may play an important part in the formation of 1,25 vitamin D https://jasn.asnjournals.org/content/10/12/2465Outline: Chapter 3 - This is chapter three, kind of the first real chapter of the book- Proximal Tubule- Reabsorbs 55-60% of the filtrate - Active sodium resorption - 65% of the sodium - 55% of the chloride - 90% of HCO3 - 100% glucose and amino acids - Passive water resorption - Water resorption is isosmotic - Secretion of - Hydrogen - Organic anions - Organic cations - Anatomy - S1, S2, S3 can be differentiated by peptidases - S1 more sodium resorption and hydrogen secretion, high capacity - S2 more organic ion secretion - Cell model - Basolateral membrane - Na-K-ATPase powers all the resorption - Luminal membrane - 100 liters a day crosses the proximal tubule cells - Microvilli to increase surface area - Microvilli has brush border which has carrier proteins as well as carbonic anhydrase - Water permeable, so sodium resorption leads to water resorption - Aquaporin-1 (sounds like this transporter is unique to the proximal tubule and RBC) - HCO3 is reabsorbed early, along with Na, resulting in increased chloride concentration which passively reabsorbed via paracellular route. - Tight junction has only one strand (on freeze fracture) as opposed to 8 in distal nephron - The Na-K-ATPase - Lower activity than in the LOH and distal nephron - Maintained intracellular Na at effective concentration of 30 mmol/L - Interior of the cell is negative due to 3 sodium out and 2 K in, then K leaks back out. - 3 Na out for 2 K in - An ATP sensitive K outflow channel on the basolateral membrane - Increased ATP slows potassium eflux - The idea is if Na-K slows, ATP will accumulate and this will slow K leaving, because there is less potassium entering. - K channel is ATP sensitive, ATP antagonizes K leak. - Highly favorable ELECTROCHEMICAL gradient for sodium to flow into the cell through the luminal membrane - Must be via a channel or carrier - Cotransporters - Amino acids - Phosphate - Glucose - Called secondary active transport - Countertransporters - Only example is H excretion - Basolateral membrane - Na-3HCO3 transporter - Powered by the negative charge in the cell- Chloride resorption - Formate chloride exchanger - Formate combines with hydrogen in the lumen, becomes neutral formic acid, and is reabsorbed where the higher pH causes it to dissociate and recycle again. - Dependent on continued H+ secretion - Chloride moves across basolateral membrane thanks to Cl and KCl transporters, taking advantage of negative intracellular charge- Passive mechanisms of proximal tubule transport - Accounts for one third of fluid resorption - Mechanism - Early proximal tubule resorts most of the bicarb and less of the chloride - Tubular fluid gets a high chloride concentration - Chloride flows through the tight junction down its concentration gradient - Sodium and water follow passively behind - Water moves osmotically into intercellular space from tubular fluid even though the osmolalities are equal since chloride is an ineffective osmole, so tonicity is not the same. ****** - Argues that bicarb is primarily important solute for passive resorbtion - Acetazolamide blocks Na and chloride resorption - Similar thing happens with metabolic acidosis where less bicarb is available to drive passive resorbtion of Na and Cl - Summary - Other than Na-K-ATPase Na-H antiporter main determinant of proximal Na and water resorption - 1. Direct bicarb resorption - Preferential bicarb resorbtion proximally drives passive chloride resorption - Drives active the formate exchanger for chloride resorption- Neurohormonal influence - AT2 drives a lot of Na resorption, primarily in S1 segment - Does not have a net effect on H-CO3 movement - Dopamine antagonizes sodium resorption - Blocks both Na-K-ATPase and - Na H antiporter- Capillary uptake - Starlings. Again - Low hydraulic pressure due to glomerular arteriole - High plasma on oncotic pressure from loss of the filtrate - The two together promote resorption - There maybe movement from interstitial back into tubular fluid (back diffusion) conflicting data- Glomerular tubular balance - The fractional tubular reabsorption remains constant despite changes in GFR (tubular load) - It is essential the GFR is matched by resorption - The rise in capillary osmotic pressure with increased GFR via increased filtration fraction is one mechanism of GT balance - Glomerular tubular balance os one of three mechanisms that prevents fluid delivery from exceeding the resorptive capacity of the tubules - GT balance - TG feedback - Autoregulation - GT balance can be altered if patients are volume overloaded or depleted - Closes this section with a story of a kid born without a brush border - Primacy of sodium in proximal tubule activity - Discusses bicarb resorbtion - There is no Tm for Bicarb as long as volume overload is prevented, in rats can rise over 60! - If you give NaHCO3 you get volume overload and the Tm I about 60 - Glucose - S1 and S2 have high capacity, low affinity glucose resorption - S3 has high affinity 2 Na fo every glucose - Tm glucose is 375 mg/min - For a GFR of 125t that comes out to 300mg/dL - 125 ml/min * 3mg/ml (300 mg/dL) = 375 mg/min - Functionally this is 200 mg/dL due to splay - Urea - Only 50-60 of filtered urea is excreted - Calcium Loop and distal tubule - Phosphate - 3Na-Phosphate high affinity transporters late in proximal tubule - three types of Na-Phos transporters, type 2 are the most important - regulated by PTH and plasma phosphate - PTH suppresses Phos resorption -Metabolic acidosis also reduces phosphate resorption (good to have phosphate in the tubule to soak up H+ - Decreased tubular pH converts HPO42- to H2PO4- which has lower affinity for phosphate binding site - Mg Loop and distal tubule - Uric AcidWhy do I love acetazolamide?- I love the proximal tubule- Many uses- Often forgottenMOA- Inhibit carbonic anhydraseMain effects- Renal: less bicarb reabsorption (ie less H secretion) à more distal Na/bicarb delivery à hypokalemic metabolic acidosis- Brain: reduce CSF production, reduce ICP/IOP, aqueous humor- Pulm: COPDNotes- Tolerance develops in 2-3 days- Sulfonamide derivative- Highly protein bound, eliminated by kidneys Source: Buzas and upuran, JEIMC, 2016S Data:1968 - High altitudeHigh altitude usually results in respiratory alkalosisAcetazolamide – lessens symptoms of altitude sickness (insomnia, headache) which occur because of periodic breathing/apnea1979- NEJM study took 9 mountaineers asleep at 5360 meters à improvement in sleep, improved SaO2 from 72 to 78.7 mmHg, reduce periodic breathing, increased alveolar ventilation (pCO2 change from 37 mmHg to 30.8mm Hg)1950s - Seizures/migrainesCAI reduces pH (more H intracellularly), K movement extracellularly à hyperpolarization and increase in seizure thresholdWeak CAI (Topamax, zonisamide) but not though to be important mechanism of antiseizure effect (topamax enhances inhibitory effect of GABA, block voltage dependent Na and Ca channels)Pulmonary/COPDThought to help with the metabolic alkalosis and as a respiratory stimulant to increase RR, TV, reduce ventilator timeIn 2001 Cochrane review – no difference in clinical outcomes, but did reduce pH and bicarb minimallyDIABLO study (RCT) on ventilated COPD patients – no difference in median duration of mechanical ventilation despite correction of metabolic alkalosisHigh altitude erythropoiesis (Monge disease)First described in 1925 via Dr. Carlos Monge Medrano (Peruvian doctor), seen in people living > 2500-3000 meters (more common in South America than other high altitude areas)Usually chronic altitude sickness with HgB > 21 g/dL + chronic hypoxemia, pHTNAcetazolamide – reduces polycythemia because induces a met acidosis à increases ventilation and arterial PPO2 and SaO2 à blunts erythropoiesis and reduces HCT and improves pulmonary vascular resistanceGI ulcersWhen H2 and PPI available, less useHistory: 1932 – observed alkaline tide, presumed existence of gastric CA (demonstrated in 1939)Acetazolamide was used to inhibit acid secretion in 1960s, ulcer symptoms, with reversible metabolic acidosis, BUT lots of SE (electrolyte losses, used Na/K/Mg salts to help, renal colic, headache, fatigue, etc)Later found H. Pylori encodes for two different CasHelps to acclimatize to acidic environmentBasically, the Ca changes CO2 into H+ and HCO3They also have a urease which produces NH3The NH3 binds with H+, leaving an alkaline environment for them to live inInhibition of CA with acetazolamide is lethal for pathogen in vitro1940sFound there was CA in pancreasThought acetazolamide to reduce volume of secretions from NGT (output from exocrine pancreas) Source: Human Anatomy at Colby Blog Diuretic resistanceIf develop hyperchloremic metabolic alkalosis, short course of acetazolamide + spironolactone (b/c need distal Na blockage) à can helpMay help with urine alkalization (ie uric acid stone) but increases risk of calcium phosphate stonesADVOR trial acetazolamide in HF exacerbation in Belgiumuse may help to prevent new episode, lower total diuretic doseCSF reduction (pseudotumor cerebri)Reduces CSF by as much as 48% when > 99.5% of CA in choroid plexus is inhibitedNORDIC trial (acetazolamide v. placebo) – improvement in visual symptoms especially if advanced papilledema, and reduced opening pressure)Side note also used off label to help with increased ICP and CSF leaks, as alternative to VP shunts, repeat LPs, etc Source: Eftekari et al, Fluid Barriers CNS, 2019.
HOUR 1: Celtics beat a good Suns team but Glenn is not impressed. He argues Phoenix would be #1 in the East; Sox spoil great outing from Pivetta 4-23-21 See omnystudio.com/listener for privacy information.
Do you have a child who seems to enjoy arguing with you? Do you have a hard time not engaging in the argument? Join Ginger Hubbard and Katy Morgan for another edition of “Ask Ginger” (also known as “Q & A Day”) as they discuss how to handle an older child who argues and is disobedient. *** For show notes and episode downloads, go to GingerHubbard.com/Podcast *** Sponsors for this episode: Lifeline Child | lifelinechild.org Dwell | dwelldifferently.com Not Consumed | notconsumed.com Rainbow Resource Center | rainbowresource.com
6PM - Nicole Jennings: Dispute in Washington state capital over claim of $1.1 billion in potential unemployment fraud // Democratic lawmakers to introduce bill to expand Supreme Court to 13 justices // House Panel Advances Bill to Study Reparations in Historic Vote // Why we shouldn’t be afraid of nightmares // I Tried the App That ‘Makes You Trip’ – and It Was Surprisingly Good // Man Fined for Farting On Cop Argues Farts Are Protected Forms of Expression See omnystudio.com/listener for privacy information.
Tuesday Morning Left Guard is back! Matthew Coller and ex-Viking offensive lineman Jeremiah Sirles break down the Vikings' options with the 14th overall pick by making Sirles argue against every other position outside of offensive line. Would he be willing to make an exception for a top quarterback? How about if the Vikings could trade down and get a wide receiver? Should they just go best player available? Which spot would he make an exception for? Plus they talk about Garrett Bradbury's 2021 season and the biggest freaks Sirles ever played against.
Dr. John Jaquish is an innovator, thought leader in the biomedical fitness market, and a Wall Street Journal best-selling author of the book "Weight Lifting Is a Waste of Time." His objective? To challenge you to rethink how you burn fat and add muscle. His journey into life sciences began when his mother was diagnosed with osteoporosis while he was studying for his master’s degree. That's what led him to invent OsteoStrong, a bone-density building medical device used to fight osteoporosis, which is now in 130 clinics in 8 different countries. The X3 Bar is his most recent invention. At 6’0” and 240 pounds, he has a zero-carb diet and works out 10 minutes a day, 6 days a week. He claims that, along with an unconventional diet, by using the X3 for only 10 minutes a day you can have the body of someone who spends hours in the gym every week. Tune in to our conversation as Dr. Jaquish dives into his research-based but controversial approaches to strength training, muscular development, and diet. He also addresses the criticisms he’s received online. Subscribe to get all the latest podcast-related content: https://www.youtube.com/user/EscapeFitness Connect with Escape Fitness online and on social below: Website: https://www.escapefitness.com Facebook: https://www.facebook.com/Escapefitness Instagram: https://www.instagram.com/escapefitness Twitter: https://www.twitter.com/escapefitness LinkedIn: https://www.linkedin.com/company/escape-fitness
Unclear what George Floyd said about drugs while detained by police; EU mises first key vaccination target for elderly and health care workers; Biden moves up vaccine deadline, all adults eligible by April 19; Sources: Rep. Gaetz sough preemptive pardon during end of Trump presidency, but request never seriously considered; Mississippi Secy of State decries “woke” students and “uninformed” people being “forced” to vote; “Huddle” illuminates the power of women coming together; One-on-one with Brooke Baldwin on her new book “Huddle”; Restaurants face a nationwide ketchup shortage due to Covid To learn more about how CNN protects listener privacy, visit cnn.com/privacy
Environmental problems are well-known and have been for decades, so why are we still edging towards a global catastrophe? Environmentalist Graham Saul believes it comes down to a message problem — mainly because environmentalism doesn’t have a single, coherent, unified message that people can grasp. *This episode originally aired on November 23, 2018.
Holmberg's Morning Sickness - Thursday March 25, 2021
In a nation reeling from two mass shootings in just six days, senators are already arguing over gun control as Biden is pushing lawmakers to finally pass some legislation. We discus that and more with Colorado Governor Jared Polis, Parkland shooting survivor Sam Zeif, Philip Rucker, Courtney Subramanian, Carmen Best, Al Franken, and Dr. Irwin Redlener.
A computer that can participate in live debates against human opponents.In this episode:00:43 AI DebaterAfter thousands of years of human practise, it’s still not clear what makes a good argument. Despite this, researchers have been developing computer programs that can find and process arguments. And this week, researchers at IBM are publishing details of an artificial intelligence that is capable of debating with humans.Research Article: Slonim et al.News and Views: Argument technology for debating with humans10:30 Research HighlightsThe sea slugs that can regrow their whole body from their severed head, and evidence of high status women in ancient Europe.Research Highlight: Now that’s using your head: a sea slug’s severed noggin sprouts a new bodyResearch Highlight: A breathtaking treasure reveals the power of the woman buried with it12:56 Briefing ChatWe discuss some highlights from the Nature Briefing. This time, the next generation of gravitational wave detectors, and why 2020 was a record-breaking year for near-Earth asteroids.Nature News: Record number of asteroids seen whizzing past Earth in 2020Science: Giant gravitational wave detectors could hear murmurs from across universeSubscribe to Nature Briefing, an unmissable daily round-up of science news, opinion and analysis free in your inbox every weekday. See acast.com/privacy for privacy and opt-out information.
Standard economic analysis suggests that even large-scale immigration doesn't hurt native citizens economically. But couldn't the newcomers change the culture and political climate to hurt liberty? In his latest book, economist Ben Powell argues that this too is a baseless fear. Mentioned in the Episode and Other Links of Interest: The https://youtu.be/DxX1PxTbkgY (YouTube version) of this interview. Ben Powell's book (co-authored with Alex Nowrasteh) https://www.amazon.com/Wretched-Refuse-Political-Immigration-Institutions/dp/1108477631 (Wretched Refuse?: The Political Economy of Immigration and Institutions). Ben Powell's earlier appearance on https://www.bobmurphyshow.com/episodes/ep-47-economist-ben-powell-reports-on-his-tour-of-socialist-countries/ (ep. 47). http://bobmurphyshow.com/contribute (Help support) the Bob Murphy Show. The audio production for this episode was provided by http://podsworth.com/ (Podsworth Media).
Tonight: As Covid relief heads to a vote, how one half of Congress is ignoring a crisis in favor of viral content. Then, Chris talks to tax fraud prosecutors about what the Manhattan DA is looking for now in regards to Trump’s taxes. Plus, an exclusive interview with the newly confirmed Secretary of Energy Jennifer Granholm. And as the perpetrators of Trump's disgraceful family separation policy try to create a new controversy, Jacob Soboroff on what's really happening at the border.Guests: Mayor David Holt, Ankush Khardori, Danya Perry, Secretary Jennifer Granholm, Jacob Soboroff
Van Lathan and Rachel Lindsay discuss recent pictures of Clare Crawley and Dale Moss together (2:00), Cam Newton’s argument with a camper at his 7-on-7 tournament (10:00), Deion Sanders allegedly getting his belongings stolen after Jackson State’s victory (21:00), new details coming out about Malcolm X’s death (28:00), and Lakeith Stanfield’s bizarre feud with Charlamagne Tha God (46:00), and more.