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Is the time ripe for Japanese growth stocks? Donald Farquharson is Baillie Gifford's head of Japanese equities and knows the market better than most. In the latest episode of Short Briefings on Long Term Thinking he draws on a recent visit to the country to explain why conditions seem favourable for a cohort of domestic companies with long-term mindsets. Background There's a sense of renewed confidence and enthusiasm in the air in Japan. The country is home to the world's second-largest market for equities after the US, but it doesn't get a corresponding degree of attention from international investors. The reason is partly because of the nation's past weak economic performance. But a recovery is underway, and critically, many of its growth stocks have strong balance sheets, big ambitions and a positive story to tell. In this episode, Baillie Gifford partner Donald Farquharson draws on his experience of investing in Japan since 1990 to explain why he's particularly optimistic about the opportunities ahead for a select group of companies. They include the medical equipment maker Olympus, the car components manufacturer DENSO and the takeover advisory service Nihon M&A Center.He also shares why he thinks some misunderstand Japan and why it's no coincidence that many of the companies he backs are founder-run.Resources: Discovering the unsung superstars of Japanese technologyFrom Yahoo! to Z Holdings: the evolution of an online pioneerJapan: the small businesses with big opportunitiesInvesting in Japan: distance lends perspectiveDonald Farquharson's LinkedIn pageAiming High: Masayoshi Son, Softbank Group and Disrupting Silicon ValleyPast podcasts Timecodes:00.00      Introduction01:40        Investing in Japan in the 1990s03:00        ‘Undiscovered' Japan03:55        How banks and other businesses changed05:30      A sustainable recovery?06:45        An exciting time for growth companies07:45        Strong balance sheets08:15        Olympus and endoscopes09:45        Diversity on the board11:00      Nihon M&A Center and company takeovers12:50        DENSO, a major supplier to Toyota and others14:30        Toyota City, home to one million people15:35        Competition for car batteries16:30      Baillie Gifford's advantage in Japan17:45        Looking beyond the headlines18:20      Book recommendation: Masayoshi Son and Aiming High19:45        Investing in founder-led firms Follow us via:TwitterLinkedInEmail Companies mentioned include:DENSOKoganei Country ClubNihon M&S CenterOlympusPanasonicROHM SemiconductorSoftbankToyota

Ahead of New York Fashion Week, The Washington Post's Rachel Tashjian speaks with BoF's founder and editor-in-chief Imran Amed about how the industry is changing post-pandemic. Background:There's a good reason why New York Fashion Week isn't the all important agenda-setter it once was, according to Rachel Tashjian, a fashion writer for The Washington Post. US consumers, she says, now take their fashion cues from influencers and social media as much as they do the runway. “Some of the more interesting things happening in American fashion are just outside of fashion week,” says Tashjian. “I just wonder if American designers feel like, is this [New York Fashion Week] really worth it for me to be doing? Is this where my audience is?”This week on The BoF Podcast, Imran Amed, BoF's founder and editor-in-chief, sits down with Tashjian to discuss her perspective on the state of the fashion industry today and her expectations for the evolution of NYFW in a post-Covid world.Key Insights:As some established brands look beyond NYFW to connect with customers to showcase their designs, Tashjian believes this shift has opened up space for emerging designers. “These smaller or more emerging brands are dominating [NYFW] because we don't have a lot of the larger brands showing,” says Tashjian.That relationship will be seen up-close at NYFW this season, Tashjian predicts. Because of the ongoing SAG-AFTRA strike, which leaves actors unable to promote their films, Tashjian says celebrities will dominate the front row. “This is going to be kind of an unprecedented season in terms of celebrity presence at fashion week because, with the strikes going on, these are things that celebrities can promote these relationships that they have with fashion brands,” she says.How celebrities embrace fashion can impact how the public perceives them, as well, says Tashjian. “Fashion has this really interesting ability to recontextualise someone we think we know really well,” she says. “Margot Robbie during the Barbie Press tour, wearing these fun, campy Schiaparelli [looks] and hot pink Chanel. All of a sudden we're thinking, ‘Oh, this is a woman who has a really fun and playful understanding of fashion.'”Tashjian believes the role of fashion criticism is different than it was in years past. “Perhaps because of the availability of fashion, we need critics more than ever before,” she says. “I think about my role as to provide an insider perspective or context. I was actually at this show and here's how it felt to be sitting in that room.”Tashjian is also known for her newsletter, Opulent Tips, which she began when she was working at GQ. In the newsletter she discussed womenswear, products and smaller brands she admired. “I felt like it could be kind of fun to have a little space where I can talk about those things and maybe introduce those brands to some people who maybe wouldn't come across them,” she says. Additional Resources:The BoF Podcast | Karl Lagerfeld at the Met: Designer, Polymath, Jigsaw Puzzle: Andrew Bolton's latest curatorial miracle celebrates the creative process of one of fashion's greatest icons. Bolton sits down with Tim Blanks for BoF's latest podcast.The Newsletter Fashion Insiders Can't Get Enough of: Rachel Tashjian, a Washington Post writer releases an exclusive newsletter each Sunday, with her take on fashion, culture and the industry at large. Hosted on Acast. See acast.com/privacy for more information.

Sam Jacobs believes leading with kindness is the only way to lead. He is the Founder & CEO of Pavilion, a community-powered learning platform for go-to-market leaders and teams. Sam launched Pavilion as Revenue Collective in 2016 and bootstrapped the company to $10M in ARR before taking on a $25M growth financing round in early 2021, led by Elephant Ventures and GTM Fund. Pavilion is powered by an international community of more than 10,000 sales, marketing, RevOps, and successful leaders from the world's fastest-growing companies. Everyone at Pavillion teaches new skills, forges meaningful connections, and helps companies grow. Pavilion University leverages a proprietary Immersive Learning Framework™ to fuse structured training with ongoing social learning and just-in-time resources that drive results. Prior to Pavilion, Sam spent 15 years as a senior revenue leader at VC-backed companies in the New York area, including Gerson Lehrman Group, Axial, Livestream/Vimeo, The Muse, and Behavox. Episode in a Tweet: You will find success when you understand your values and what brings you joy. I found joy in helping people I care about and respect achieve their personal goals; nothing is more rewarding. Background: “There's a better way to do business.” This belief is what inspired Sam Jacobs to start his company, Pavillion. Sam says, “We've been taught that business is cutthroat — but it doesn't have to be. Pavilion is proof that building a business on foundational values, centering reciprocity, and coming from kindness works.” During this week's episode of Reflect Forward, Sam and I discuss the power of values, networking, and finding what brings you joy and doing it. Same talks about his book, Kind Folks Finish First, the story of how Pavillion came to be after being fired from his 5th job. After seeing his tenure as a revenue leader shrink, he was inspired to look at the long game and stop being transactional. Sam shares the process he went through to find his mission and how joy, kindness and respect drives everything he does. This is an introspective and fun conversion that I know you'll enjoy. Have a listen and let me know what you think! How to find Sam: Website: www.joinpavilion.com Website: https://www.joinpavilion.com/kind-folks-finish-first LinkedIn: https://www.linkedin.com/in/samfjacobs/ Follow me on Instagram or LinkedIn. Subscribe to my podcast Reflect Forward on iTunes Or check out my new YouTube Channel, where you can watch full-length episodes of Advice From a CEO! And if you are looking for a keynote speaker or a podcast guest, click here to book a meeting with me to discuss what you are looking for!

PreambleMy wife and I recently packed our bags and relocated to New Jersey! Texas was good for us but now we are on to our next adventure in Greater New York City. Would love to meet up if you are in the area. It’s been fascinating observing people’s reactions when I say I work in crypto. Some acquaintances immediately start walking me through their crypto portfolio while others clutch their pearls and flee for dear life. Jokes aside, I am often the first person they have met who works in the space. Sometimes, I get the sense they don’t quite know what to make of me. Crypto’s unsettling reputation has not been helped by the recent market downturn, hacks, and bankruptcies. My singular refrain has been that “the underlying technology could solve real-world problems, focus on that”. But you can’t bury your head in the sand and ignore the world around you. If you fail to study history, then you are bound to repeat the same mistakes. We are living through the early days of Crypto’s history. Let’s learn from this moment lest we fall prey to the same dragons. Heartache 💔Celsius - a prominent centralized crypto lending company - filed for bankruptcy on July 13, 2022. Customers had been unable to withdraw their funds since June 12, 2022. It now looks unlikely that they will ever reclaim all their funds. Some devastated customers have written letters to the judge presiding over the bankruptcy proceedings. These letters are gut-wrenching. Here are excerpts from two of them:But how did we get here?Celsius: Background🔎Celsius was founded in 2017 by Alex Mashinsky (CEO), Daniel Leon (former COO, now Chief Strategy Officer), and Nuke Goldstein (CTO) in Hoboken NJ. Celsius provides customers with high interest-bearing accounts for cryptocurrencies and crypto-collateral-backed loans. High interest-bearing crypto accountsExample 1: Johnny cashed out some of his cash savings and stock investments to buy 1 bitcoin on Coinbase. He then sees an ad from Celsius offering 17% interest rates for customers who deposit bitcoin with the company. He looks at his regular bank account and is reminded that Bank of America is only offering 0.1% interest. It’s a no-brainer! Johnny moves his 1 bitcoin from Coinbase to Celsius to earn high interest. Crypto-collateral-backed loansExample 2: The price of bitcoin has more than doubled. Johnny is feeling good about his investment. Time to finally buy that engagement ring he has been eyeing. The price of bitcoin is $50k but he only needs $10k. However, Johnny doesn’t want to sell his bitcoin because he believes the price will be much higher in the future. Step 1: He transfers 0.3BTC valued at $15k as collateral for a $10k cash loan.Note: (a) There are no interest payments on the loan but he has 1-year to pay it back. (b) There are no credit checks because the loan is overcollateralized with a loan to value (LTV) ratio of 67% => $10k loan / $15k crypto collateral. Step 2: Celsius will monitor the LTV ratio as the price of bitcoin continues to fluctuate. If the price of bitcoin drops deeply, Johnny will have 24 hours to add more collateral or pay down the loan if the LTV hits the predetermined threshold ex 90%. If Johnny fails to bring the LTV back to an acceptable range say ~67% within the prescribed time then Celsius has the right to sell his collateral for cash. Besides lending, Celsius generated revenue from token sales, bitcoin mining, and discretionary trading of cryptocurrencies. As of June 2022, Celsius had lent out $8 billion to customers and had $12 billion in assets under management. The company had 450 employees and reportedly 1.7 million account holders. How did it go wrong?⚡TLDR: Celsius CEO said the company went bankrupt due to “..certain poor asset deployment decisions”. Basically, weak risk management. Unfortunately, this does not appear to be an isolated incident, rather, tales of poor decision-making and under-resourcing are emerging from different parts of the organization. On the surface, the main thrust of Celsius business model was sound. It’s the same model that banks have used for centuries: pay interest to depositors then loan those funds out to another entity at a higher interest rate. Then you simply profit off the difference in interest rates. Celsius grew rapidly by offering up to a 17% interest rate on crypto deposits. At its peak, it had $24B of assets under management. This helped it raise $750M in Nov 2021 at $3.3B valuation. That fundraising round was led by the second largest pension fund in Canada. But it all came crashing down when Celsius filed for bankruptcy due to the $1.2B hole in its balance sheet. Celsius reported its total assets were $4.3B but total liabilities were $5.5B. Of the $5.5B liabilities, Celsius owes its customers $4.7B but does not have the assets to pay them. The company only has $125M cash on hand. Much of the $4.3B of assets are said to be Celsius’ holdings of its own crypto token which has dropped in value from a peak of $7.7 in June 2021 to $0.9 in July 2022. There are questions about the current market value of the $4.3B listed assets and fears the actual is lower than what has been reported. Where did risk management fail?We are still learning about the failures that led to Celsius bankruptcy. Here’s what I have gathered thus far: 1. Failure of leadershipCelsius executives reportedly told the Chief Human Resource Officer NOT to run background checks on the incoming CFO, Yaron Shalem. This is a major red flag 🚩 In Nov 2021, Shalem was arrested in Israel and charged with money laundering at his previous company. Perhaps stronger controls could have identified a CFO who might have steered Celsius away from taking on increasing levels of risk. But ultimately the CEO is responsible. 2. Under resourcing Disruptors don’t color within the lines. They dream up new industries and take risks executing their visions. This is the nature of technological disruption. Uber and Airbnb are great examples of disruptors who launched products ahead of supporting laws, rules and regulations. The Silicon Valley swagger to move quickly and break things has produced results….but one wonders if it is a fit for financial services. Celsius reportedly only had 3 compliance professionals serving 1.7 million account holders. Some banks serving fewer customers might have 10 to 30x compliance professionals. A former Celsius compliance employee shared how the department was seen as a cost center and not a strategic partner for the business. One could extrapolate and imagine that the same attitude of under-resourcing likely applied to risk management too. 3. Poor fund managementCelsius CEO said in retrospect, they made poor fund deployment decisions. These decisions primarily fall into two camps: (a) over-leveraged positions and (b) over-exposure to stETH. (a) Over—leveraged positions: Celsius loaned out depositors’ funds on MakerDAO, a decentralized lending platform. One loan is ~$550M. This loan is overcollateralized like the loans Celsius itself issues. One challenge is that the price of Bitcoin has tumbled more than 60% since the 2021 highs. As a result, Celsius has had to pay down the loan or provide more collateral to bring the LTV back in range, otherwise, the entire $550M collateral would be liquidated. Celsius likely used new customer deposits to secure the collateral consisting of old customer deposits. Celsius came close to losing $550M a couple of times. It has reportedly lost smaller amounts due to insufficient liquidity to shore up the LTV ratio.A sound risk management approach would have considered that crypto prices could fall significantly and perhaps limit Celsius exposure to this high-risk strategy. (b) Over-exposure to stETHCelsius used customer deposits to acquire over $400M of stETH, an irresponsible amount given that no counterparties hold a comparable amount to trade with. stETH is an illiquid receipt stoke for staked ether. stETH is a derivative of ether with each stETH representing one staked ether on the new Ethereum blockchain. However, the price of stETH and the price of ether decoupled in recent months, stETH now has a 3% discount at the time of writing. A sound risk management approach would have considered whether Celsius should have used user’s deposits to acquire stETH, and if decided to, there could have been controls to limit the amount of exposure to this illiquid asset in Celsius portfolio. What next for Celsius customers? ⏭Celsius presented itself like a bank but operated more like a hedge fund. Many customers did not read the fine print in Celsius terms and conditions. Reading through now would yield several realizations. Uninsured depositsDepositors at US banks are protected by the Federal Deposit Insurance Corporation (FDIC). If a US bank goes bankrupt, all depositors’ funds are insured for up to $250k. Unfortunately, Celsius is NOT a bank and did not hold any insurance for depositor’s funds. Section 13 of the Celsius user agreement explicitly states that if the company goes bankrupt, customers may not be able to recover ANY funds. Bankruptcy claimsCelsius customers are filing bankruptcy claims. Some have also written letters petitioning the judge to release funds to them. Interestingly, although Celsius is headquartered in Hoboken NJ, the bankruptcy suit was filed in New York’s Southern District. Judges in this district are thought to be more savvy and experienced with major bankruptcies having previously handled notable cases like Merril Lynch and Bernie Maddoff. Unfortunately, it’s not looking good for customers. What lessons have been learned? 📔Not your keys, not your coinsMy friends who have been in crypto for several years frequently admonish everyone to move their holdings off centralized exchangers like Coinbase and lending platforms like BlockFi and Celsius. This episode has made the reasons painfully obvious. It’s clear to see why they recommend one self custody crypto holdings in a cold wallet. Leadership mattersIt looks like Celsius executives lost their heads in the ecstasy of the bull market. They kept on layering on high risk moves perhaps imagining themselves to be invincible. But truth be told, I think the rot started way before the crypto bull market. The absence of background checks for senior executives, the under-resourcing of compliance are symptoms of a culture that turns its nose at the modern financial services industry. I agree that there are some financial services which are ripe for disruption but there are also risk management practices and standard operating procedures which have successfully safeguarded the interest of customers. These mustn’t be discarded with the bath water. Please do considerable research as you invest your funds. Look at the background and statements of the leaders. Sometimes people who are undisciplined with finances reveal themselves to be undisciplined with their words too.Real human impact1.7 million affected account holders may never fully recover their funds. This would undoubtedly leave a lasting bad impression. Some of the stories are simply heart-breaking. There’s the story of a worker close to retirement who sold off their stocks and bonds and deposited everything into Celsius. There are countless stories of families who put decades of life savings into these accounts. Some people will never recover financially. It must be taking a heavy emotional toll too. I fear, a few people may even take their own lives similar to the suicides following the Great Stock Market Crash of 1929.DiversifyPlease do NOT put all of your eggs in one basket. Diversify to reduce your exposure to any one platform and any one company. Consider moving some or all of your crypto holdings into multiple cold wallets and securely store them in waterproof, fireproof, and tamperproof environments. Risk management is a differentiatorCrypto has been pulling in top talent from a variety of backgrounds. Sometimes I sense a tension between the tech-forward move fast crowd and the deliberate, cautious, and risk averse financial services crowd. But we need both legs to run into the future. The Celsius meltdown has given me a renewed appreciation for risk and compliance. In recent days, crypto lending companies have been at pains to explain their risk management approach and distance themselves from Celsius. I expect there could be a flight to quality, with consumers gravitating to more established and regulated providers. There is an opportunity for banks to make a move here. More curious about DeFiHumans are fallible. People get greedy and risky, then bad things happen. This is not limited to crypto. It happens across every industry. One of the beautiful things about decentralized finance (DeFi) is that it runs on smart contracts aka code. It takes the human out of the equation and executes based on the written code. But no system is infallible. DeFi solves for one risk - human behvaior - while heightening another risk: hackers. DeFi is poised to continue growth and eventually will underpin a chunky slice of the mass market.Brace yourself for more regulationSociety functions around a set of rules of engagement. There are consequences when you break those rules. Every industry needs regulation. Crypto is no different. I hope that the regulation is thoughtful and not a knee-jerk reaction. I hope the regulation would seek to protect the consumer, not prevent the consumer from engaging with crypto. I hope the regulation is crafted in partnership with industry, seeking to support technology advancement and not strangle the baby in the bassinet. I’m optimistic. Many advances we take for granted today went through a storming phase in their infancy. I have seen newspaper clips from the 1800s railing against electricity and cars. Today we can’t imagine our lives without them. I expect the US will eventually strike the right balance with crypto regulations. PS - But wait, there’s moreThere’s more to the Celsius story. For instance, I didn’t get into the alleged token manipulation and potential insider trading.PSS - Former Coinbase PM arrested for insider tradingSpeaking of insider trading, this week, a former Coinbase product manager was arrested along with his brother and a friend for insider trading. Background There are about 2,000 crypto tokens. Binance lists over 300 of them on their exchange. Coinbase has been intentionally listing more tokens to close the gap and give their customers more choice. Coinbase currently lists about 200 tokens. It’s been observed that new tokens experience a significant price jump once they are listed on Coinbase. It could be due to millions of users suddenly gaining access and increasing demand. The Coinbase PM obtained intelligence on which tokens would be listed then relayed it to his accomplices. The trio then got wallets controlled by other people to opportunistically buy and sell these tokens. They earned at least $1.5M through this insider trading scheme. Blockchain to the rescuePublic blockchains permit anyone to view transactions. The challenge is that it’s not always obvious to the observer who owns the wallets but that’s why blockchain analytics firms like Chainalysis, TRM Labs and Elliptic specalize in. An avid observer noticed this pattern of sales from a wallet. He shared his observations on Twitter. Soon financial regulators were hot on the chase and identified the trio and notified Coinbase. The Coinbase PM was invited to a meeting where at Coinbase where he was presumably fired. Regulators sent him a letter. He bought a ticket to fly home to India on the same day. The suspect was apprehended before he could flee the country. Contrary to some widely held beliefs, blockchain technology is not just a haven for would-be-criminals, rather, it can be a valuable tool for law enforcement to catch criminals. It’s been long rumoured that there is significant insider trading at some crypto tokens. Perhaps this case is the first of many to come. The industry needs to police itself and partner with law enforcement. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit afolabio.substack.com

Background: There is increasing interest in the collection of globally comparable disability data. Context may influence not only the rates but also the nature of disability, thus locally collected data may be of greater use in service delivery planning than national surveys. Objectives: The objective of this article was to explore the extent to which two areas, both under-resourced but geographically and socially distinct, differed in terms of the prevalence and patterns of disability.

This week on your Dental Top 5 Podcast your host Amanda Hill talks with Emily Boge. Emily and Amanda talk about the top 5 things Emily wishes someone would have told her when she graduated from dental hygiene school!   Episode Highlights   Emily Boge's Background There is more than one manufacturing company Education is continuing Opportunities Networking Integrity  Quotes   “Im fortunate that I have 18 bright individuals coming back to work”    “It is so important to get out there, and explore the trade shows”   “I'm not just talking about the CE credits to maintain your license…”    “We've got to keep up, because man things are moving fast”    “Just because you read it on Facebook, it doesn't make it true”    “We all only know what we know. There is so much that I didn't know a year ago, or even a month ago”    “Opportunities will knock…but you have to answer”    “When you invest in yourself, it comes back. I PROMISE”    “The butt you kick today, will be the butt you kiss tomorrow”    Links   Emily 's Website: thinkbigdental.com  The Dental Podcast Network Channel One homepage: http://dentalpodcastnetworkchannelone.otcpn.libsynpro.com/ The Dental Podcast Network Channel Two homepage: https://podcasts.apple.com/us/podcast/the-dental-podcast-networks-channel-two/id1478530429 Amanda's email: amandahillrdh@gmail.com

Lucy Watts discusses trends driving the demand for Space-as-a-Service with Caleb Parker on the second episode of the #WorkBold Podcast. Lucy is Senior Director of Strategic Projects for The Instant Group. She shares insights on customer demand: why customers want flexibility and space-as-a-service average requirement sizes what buildings can do to attract fast growing companies Lucy manages Instant's flex and data insight service and explains how Instant has reacted to market demand for more data, insight and overall transparency.  About Lucy Watts Lucy is responsible for key strategic projects across The Instant Group. Starting her Instant Career in 2006, Lucy previously headed up the company's broker division, working with both SMEs and large corporates to help them locate and acquire office space worldwide. She's built long-standing relationships with Instant's key operator partners across the globe to ensure they have the knowledge and market expertise to deliver valuable solutions for clients. Background There are currently 6,000 flexible workspaces in the UK but 4,000 providers. So, whilst the big brands are growing they still only have a small market share. The demand for hybrid space (a mix of coworking and private offices) increased by 25% in 2019.  Did you know that 80% of the UK population live within 30 minutes commute of a flexible workspace? Carsten Foetsch recently revealed that 52% of coworking spaces are profitable but if you have been open more than a year, have over 200 members and have hybrid space the percentage increases to 74%. Subscribe Apple | Spotify | Stitcher | Google   Value Bombs and Tweetables  1) " The average cycle of a business is getting shorter, therefore, you need some flexibility in a typical fixed lease portfolio so that you are not taking on so much risk!"  2) " The demand for data will continue to grow and there will be a continued blurring of the lines between flexspace and the traditional leases as more landlords enter the market with a solution!"  SPONSORS   Bold Helping commercial real estate create & manage flexible spaces to dream, create, share, and succeed in. Now part of NewFlex     NewFlex NewFlex delivers and manages a range of branded solutions for every type of building, in every type of location, for every type of occupier. Including the flexibility to develop your own brand. All enabled by flexible management contracts where we are invested in making money for you.       A Podcast Company   The leading podcast production company for brands, organizations, institutions, individuals, and entrepreneurs. Our team sets you up with the right equipment, training, and guidance to ensure you sound amazing. - https://www.apodcastcompany.com and www.podcastsyndicator.com

BACKGROUND: There are currently seven cigars in the Surrogates lineup. The Surrogates Satin Glove was launched during the summer of 2014. Satin Glove was the first of the line to feature a Mexican San Andres wrapper. It is also the … Continue reading →

On this episode, Matt Perkins interviews Kurtis Parks - Worship Director at National Community Church in Washington D.C. Background:-There were 2 sides:  The “Rock Star wanna be” vs. the Worship Leader.-“I came to a place where I allowed the Holy Spirit to be the loudest voice."-Let the presence of God be the focal point of every service. (click to tweet!)-How can you invest in others?    -NCC is a Dream Factory:    -What is your dream?  We want to be a share holder in that.-Teaching Series - Every series, we write a song to go along with that theme. Trust-"If someone gives you trust, they are lending their ministry to you."-Trust goes hand in hand with affirmation.-Rest in God's affirmation. We can tend to want the benefits of humility without being humble. (click to tweet!) Be your pastor's champion.         Stay connected with us twitter.com/allaboutworshipfacebook.com/allaboutworshipinstagram.com/allaboutworshippodcast[at]allaboutworship.comtwitter.com/wisdommooninstagram.com/wisdommoonmusictwitter.com/mattperkinsfacebook.com/mattperkins  Quick Links NCC Worship - You AloneWorship Ministry Handbook - SAUCEKurtis on TwitterIn A Pit With A Lion On a Snowy Day by Mark Batterson SUBSCRIBE VIA ITUNESSUBSCRIBE VIA STITCHERSUBSCRIBE VIA RSS FEED    

Legend: Time traveler stories have abounded throughout history, but one of the most enduring ones of the past hundred years is the legend of John Titor, a man from the year 2038 who's story of how time travel works proves to be plausible. Background: There are more than few recent stories of folks appearing out of town in old photos or even a Chaplin film and we will visit the most famous of them. Even the guy who found a wormhole while fixing his kitchen sink. If you can't click on these links, visit our website.  The Blue Dress The 25 Best Time Travel Movies Stories of Time Travel - Including John Titor The Solway Firth Spaceman JohnTitor.com The Patent for Titor's Time Machine The Y2038 Problem Schrodinger's Cat Definition of Akimbo Is Everyone a Time Traveler When They're On a Plane? John Titor on Pinterest The C204 Time Displacement Machine Some Background on the 5100 More on the 5100 Current Day Info on IBM's Project Chameleon? More on Chameleon Interesting Facts: There are many UNIX embedded systems that do not keep track of time as it is not relevant to their operation. These machines are not threatened by the Y2038 problem. I was completely wrong about the pronunciation of IMGUR. I apologize to Forrest. Imgur (pronounced /ˈɪmədʒər/like image-er; imager[2] and stylized as imgur) Credits: Episode 012 - 'John Titor and Other Time Travelers' Produced by Scott Philbrook & Forrest Burgess, Ryan McCullough Sound Design   Copyright Scott Philbrook & Forrest Burgess 2015, All Rights Reserved. 

Background: There is an on-going debate about whether to perform surgery on early stage localised prostate cancer and risk the common long term side effects such as urinary incontinence and erectile dysfunction. Alternatively these patients could be closely monitored and treated only in case of disease progression (active surveillance). The aim of this paper is to develop a decision-analytic model comparing the cost-utility of active surveillance (AS) and radical prostatectomy (PE) for a cohort of 65 year old men with newly diagnosed low risk prostate cancer. Methods: A Markov model comparing PE and AS over a lifetime horizon was programmed in TreeAge from a German societal perspective. Comparative disease specific mortality was obtained from the Scandinavian Prostate Cancer Group trial. Direct costs were identified via national treatment guidelines and expert interviews covering in-patient, out-patient, medication, aids and remedies as well as out of pocket payments. Utility values were used as factor weights for age specific quality of life values of the German population. Uncertainty was assessed deterministically and probabilistically. Results: With quality adjustment, AS was the dominant strategy compared with initial treatment. In the base case, it was associated with an additional 0.04 quality adjusted life years (7.60 QALYs vs. 7.56 QALYs) and a cost reduction of (sic)6,883 per patient (2011 prices). Considering only life-years gained, PE was more effective with an incremental cost-effectiveness ratio of (sic)96,420/life year gained. Sensitivity analysis showed that the probability of developing metastases under AS and utility weights under AS are a major sources of uncertainty. A Monte Carlo simulation revealed that AS was more likely to be cost-effective even under very high willingness to pay thresholds. Conclusion: AS is likely to be a cost-saving treatment strategy for some patients with early stage localised prostate cancer. However, cost-effectiveness is dependent on patients' valuation of health states. Better predictability of tumour progression and modified reimbursement practice would support widespread use of AS in the context of the German health care system. More research is necessary in order to reliably quantify the health benefits compared with initial treatment and account for patient preferences.

Background: There appears to be an inconsistency in experimental paradigms used in fMRI research on moral judgments. As stimuli, moral dilemmas or moral statements/ pictures that induce emotional reactions are usually employed; a main difference between these stimuli is the perspective of the participants reflecting first-person (moral dilemmas) or third-person perspective (moral reactions). The present study employed functional magnetic resonance imaging (fMRI) in order to investigate the neural correlates of moral judgments in either first-or third-person perspective. Results: Our results indicate that different neural mechanisms appear to be involved in these perspectives. Although conjunction analysis revealed common activation in the anterior medial prefrontal cortex, third person-perspective elicited unique activations in hippocampus and visual cortex. The common activation can be explained by the role the anterior medial prefrontal cortex may play in integrating different information types and also by its involvement in theory of mind. Our results also indicate that the so-called "actor-observer bias" affects moral evaluation in the third-person perspective, possibly due to the involvement of the hippocampus. We suggest two possible ways in which the hippocampus may support the process of moral judgment: by the engagement of episodic memory and its role in understanding the behaviors and emotions of others. Conclusion: We posit that these findings demonstrate that first or third person perspectives in moral cognition involve distinct neural processes, that are important to different aspects of moral judgments. These results are important to a deepened understanding of neural correlates of moral cognition-the so-called "first tradition" of neuroethics, with the caveat that any results must be interpreted and employed with prudence, so as to heed neuroethics "second tradition" that sustains the pragmatic evaluation of outcomes, capabilities and limitations of neuroscientific techniques and technologies.

Background: There has been a long held belief that patients with drug-susceptible TB are non-infectious after two weeks of therapy. Recent microbiological and epidemiological evidence has challenged this dogma, however, the nature of the Mtb-specific cellular immune response during this period has not been adequately investigated. This knowledge could be exploited in the development of immunological biomarkers of early treatment response. Methods: Cellular response to four Mtb infection phase-dependent antigens, ESAT-6/CFP-10 fusion protein and three DosR encoded proteins (Rv1733c, Rv2029c, Rv2628) were evaluated in a Ghanaian TB cohort (n=20) before and after 2 weeks of anti TB therapy. After 6-days in vitro stimulation, Peripheral blood mononuclear cell (PBMC) culture supernatant was harvested and the concentration of IFN-gamma, Granzyme B, IL-10, IL-17, sIL2R alpha and TNF-alpha were determined in a 6-plex Luminex assay. Frequencies of IFN-gamma + CD4 and CD8 T cells were also determined in an intracellular cytokine assay. Results: All antigens induced higher levels of IFN-gamma, followed by Granzyme B, TNF-alpha and IL-17 and low levels of IL-10 and sIL-2R-alpha in PBMC before treatment and after 2 weeks of treatment. Median cytokine levels of IFN-gamma, Granzyme B, IL-17 and sIL-2R-alpha increased during week two, but it was significant for only Rv1733-specific production of Granzyme B (P = 0.013). The median frequency of antigen specific IFN-gamma + CD4 T cells increased at week two; however, only the increase in the ESAT-6/CFP-10-specific response was significant (P = 0.0008). In contrast, the median frequency of ESAT-6/CFP-10-specific IFN-gamma + CD8 T cell responses declined during week two (P = 0.0024). Additionally, wide inter-individual variation with three distinct patterns were observed; increase in all cytokine levels, decrease in all cytokine levels and fluctuating cytokine levels after 2 weeks of treatment. Conclusion: The second week of effective chemotherapy was characterized by a general increase in cytokine response to Mtb-specific antigens suggestive of an improvement in cellular response with therapy. However, the wide inter-individual variation observed would limit the utility of cytokine biomarkers during this period.

Lipid metabolism alteration and statin intake in myotonic dystrophies A. Schmidt, MS a; L. Kirzinger, MS a, W. Kress, PhD b, and B. Schoser, MD a a Friedrich-Baur Institute, Department of Neurology, Ludwig Maximilians University Munich, Munich, Germany b Institute of Human Genetics, University of Würzburg, Würzburg, Germany. Background: There have been no systematic reports on lipid metabolism alteration in myotonic dystrophies. We assessed the frequency, type, and severity of lipid alteration in both types of DM. Furthermore, the frequency of statin intake and side effects was investigated. Methods: A retrospective multicenter study was conducted. 134 DM2 patients and 29 DM1 patients participated by completing questionnaires. Additionally, their clinical and serological records, including blood lipid parameters for dyslipoproteinemia (cholesterol, HDL, LDL and TG) were screened and reviewed. Results: 71.6% of DM2 and 55.2% of DM1 patients show evidence to suffer from dyslipoproteinemia. In DM2 and DM1 patients the age of onset of dyslipoproteinemia was 47.6y±15.1 and 46.2y±9.7, respectively. Comparing both DM groups, all measured parameters did not differ statistically significant. Nevertheless, comparing all lipid parameters of both types of DM with an average German population data set, we could find a no significant discrepancy for DM1 patients (Cholesterol: p=0.435; HDL: p=0.129), but for DM2 patients (Cholesterol p=0.021; HDL: p=0.001). 23.1% of DM2 and 11.1% of DM1 patients were treated with statins. 50% of all patients discontinued statin therapy because of side effects. Conclusions: According to Robert-Koch-Institute, Germany, one third of German adults show elevated cholesterol levels, which is significantly lower than the rate found here in DM patients. With this high rate of dyslipoproteinemia in DMs, it seems to be obvious, that DM patients show a predisposition for this metabolic disorder. Furthermore, compared with data from Robert-Koch-Institute, DM patients (DM2 23.1%, DM1 11.1%) use significantly more statins than the German average. In addition, the rate of discontinuation is high based on side effects like augmented symptoms (hyperCKemia in 27.8% DM2, muscle pain or weakness in 33.3% DM2) in relation to former studies revealing statin side effects in one of 10000 patients.

Background: There is partially conflicting evidence on the influence of the steroid hormones estrogen (E) and progesterone (P) on the development of ovarian cancer (OC). The aim of this study was to assess the expression of the receptor isoforms ER-alpha/-beta and PR-A/-B in OC tissue and to analyze its impact on clinical and pathological features and patient outcome. Methods: 155 OC patients were included who had been diagnosed and treated between 1990 and 2002. Patient characteristics, histology and follow-up data were available. ER-alpha/-beta and PR-A/-B expression were determined by immunohistochemistry. Results: OC tissue was positive for ER-alpha/-beta in ER-alpha/-beta and 60.1% and PR-A/-B in 36.2% and 33.8%, respectively. We identified significant differences in ER beta expression related to the histological subtype (p=0.041), stage (p=0.002) and grade (p=0.011) as well as PR-A and tumor stage (p=0.03). Interestingly, median receptor expression for ER-alpha and PR-A/-B was significantly higher in G1 vs. G2 OC. Kaplan Meier analysis revealed a good prognosis for ER-alpha positive (p=0.039) and PR-B positive (

Background: There is general consent that empathy is crucial for the physician-patient relationship and thus an important issue in medical education. This comparative study was designed to examine the differences in empathy between first year and final year medical students in Jimma University, Ethiopia. Methods: A comparative cross-sectional study among 131 first year and 106 final year medical students was conducted in Jimma University, Ethiopia on academic year 2010/11. The study subjects were selected using simple random sampling technique from the list of the students. Study participation was voluntary. The Balanced Emotional Empathy Scale (BEES) was used for the detection of "heart-reading"

Background: There have been sporadic reports of hypersensitivity reactions to plants of the Cannabinaceae family (hemp and hops), but it has remained unclear whether these reactions are immunologic or nonimmunologic in nature. Objective: We examined the IgE-binding and histamine-releasing properties of hashish and marijuana extracts by CAP-FEIA and a basophil histamine release test. Methods: Two workers at a forensic laboratory suffered from nasal congestion, rbinitis, sneezing and asthmatic symptoms upon occupational contact with hashish or marijuana, which they had handled frequently for 25 and 16 years, respectively. Neither patient had a history of atopic disease. Serum was analyzed for specific IgE antibodies to hashish or marijuana extract by research prototype ImmunoCAP, and histamine release from basophils upon exposure to hashish or marijuana extracts was assessed. Results were matched to those of 4 nonatopic and 10 atopic control subjects with no known history of recreational or occupational exposure to marijuana or hashish. Results: Patient 1 had specific IgE to both hashish and marijuana (CAP class 2), and patient 2 to marijuana only (CAP class 2). Controls proved negative for specific IgE except for 2 atopic individuals with CAP class 1 to marijuana and 1 other atopic individual with CAP class 1 to hashish. Stimulation of basophils with hashish or marijuana extracts elicited histamine release from basophils of both patients and 4 atopic control subjects. Conclusions: Our results suggest an IgE-related pathomechanism for hypersensitivity reactions to marijuana or hashish. Copyright (C) 2011 S. Karger AG, Basel

Background: There is a high incidence of diarrhea in traveling populations. Norovirus (NV) infection is a common cause of diarrhea and is associated with 7% of all diarrhea related deaths in the US. However, data on the overall prevalence of NV infection in traveling populations is limited. Furthermore, the prevalence of NV amongst travelers returning to Europe has not been reported. This study determined the prevalence of NV among international travelers returning to Germany from over 50 destinations in and outside Europe. Methods: Stool samples of a total of 104 patients with a recent (< 14days) history of international travel (55 male, mean age 37 yrs.) were tested for the presence of NV genogroup (GG) I and II infection using a sensitive and well established quantitative RT PCR method. 57 patients experienced diarrhea at the time of presentation at the Department of Infectious Diseases & Tropical Medicine. The remaining 47 patients had no experience of diarrhea or other gastrointestinal symptoms for at least 14 days prior to their date of presentation at our institute. Results: In our cohort, NV infection was detected in 15.7% of returning travelers with diarrhea. The closer to the date of return symptoms appeared, the higher the incidence of NV, ranging as high as 21.2% within the first four days after return. Conclusions: In our cohort, NV infection was shown to be frequent among returning travelers especially in those with diarrhea, with over 1/5 of diarrhea patients tested positive for NV within the first four days after their return to Germany. Due to this prevalence, routine testing for NV infection and hygienic precautions may be warranted in this group. This is especially applicable to patients at an increased risk of spreading the disease, such as healthcare workers, teachers or food-handlers.

Background There has been ongoing controversy as to whether prosthesis-patient mismatch (PPM, defined as indexed effective orifice area (EOAI)

Background: There is an urgent need to identify subjects with Alzheimer's disease (AD) in the predementia phase, but validated diagnostic approaches are currently lacking. In this paper, we present the background, design and methods of a study, which aims to develop clinical criteria for predementia AD. We also present baseline characteristics of the subjects included. The study was part of the multicentre DESCRIPA project, which is being conducted within the network of the European Alzheimer's Disease Consortium. Methods: Clinical criteria will be based on a prospective cohort study of non-demented subjects older than 55 years and referred to a memory clinic. At baseline, a number of markers and risk factors for AD were collected, including demographic variables, measures of performance in activities of daily living, cognitive, neuroimaging and genetic markers, and serum and cerebrospinal fluid markers. Subjects will be reassessed annually for 2 - 3 years, and we will evaluate which combination of variables best predicts AD-type dementia at follow-up. Results: Between 2003 and 2005, 881 subjects were included from 20 memory clinics. Subjects were on average 70.3 years old, and had 10.4 years of education. The average score on the Mini-Mental State Examination was 27.4. Copyright (C) 2008 S. Karger AG, Basel.

Background: There is insufficient evidence for the long-term efficacy and safety of anti-tumour necrosis factor therapy in patients with ankylosing spondylitis (AS). This is the first report on the treatment with infliximab over 5 years.Methods: As part of a multicentre randomised trial, 69 patients with active AS at baseline (BL) have been continuously treated with infliximab (5 mg/kg i.v. every 6 weeks)---except for a short discontinuation after 3 years (FU1). The primary outcome of this extension was remission according to the ASsessment in Ankylosing Spondylitis (ASAS) criteria at the end of year 5 of the study (FU2).Results: Of the 43 patients who completed year 3, 42 agreed to continue, 38 of which (90.5%) finished year 5 (55% of 69 initially). Partial clinical remission was achieved in 13 of 38 patients (34.2%) at FU1 and FU2. At FU2, the mean Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was 2.5±1.9 (BL:6.4, FU1:2.5). BASDAI values

Background: There is growing epidemiological evidence that short-term and long-term exposure to high levels of air pollution may increase cardiovascular morbidity and mortality. In addition, epidemiological studies have shown an association between air pollution exposure and respiratory health. To what extent the association between cardiovascular mortality and air pollution is driven by the impact of air pollution on respiratory health is unknown. The aim of this study was to investigate whether respiratory health at baseline contributes to the effects of long-term exposure to high levels of air pollution on cardiovascular mortality in a cohort of elderly women. Method: We analyzed data from 4750 women, aged 55 at the baseline investigation in the years 1985 - 1994. 2593 of these women had their lung function tested by spirometry. Respiratory diseases and symptoms were asked by questionnaire. Ambient air pollution exposure was assessed by the concentrations of NO2 and total suspended particles at fixed monitoring sites and by the distance of residency to a major road. A mortality follow-up of these women was conducted between 2001 and 2003. For the statistical analysis, Cox' regression was used. Results: Women with impaired lung function or pre-existing respiratory diseases had a higher risk of dying from cardiovascular causes. The impact of impaired lung function declined over time. The risk ratio (RR) of women with forced expiratory volume in one second (FEV1) of less than 80% predicted to die from cardiovascular causes was RR = 3.79 (95% CI: 1.64 - 8.74) at 5 years survival time and RR = 1.35 ( 95% CI: 0.66 - 2.77) at 12 years. The association between air pollution levels and cardiovascular death rate was strong and statistically significant. However, this association did only change marginally when including indicators of respiratory health into the regression analysis. Furthermore, no interaction between air pollution and respiratory health on cardiovascular mortality indicating a higher risk of those with impaired respiratory health could be detected. Conclusion: Respiratory health is a predictor for cardiovascular mortality. In women followed about 15 years after the baseline investigation at age 55 years long-term air pollution exposure and impaired respiratory health were independently associated with increased cardiovascular mortality.

Background: There is growing evidence that platelets accumulate in the lung and contribute to the pathogenesis of acute lung injury during endotoxemia. The aims of the present study were to localize platelet sequestration in the pulmonary microcirculation and to investigate the role of P-selectin as a molecular mechanism of platelet endothelial cell interaction. Methods: We used in vivo fluorescence microscopy to quantify the kinetics of fluorescently labeled erythrocytes and platelets in alveolar capillary networks in rabbit lungs. Results: Six hours after onset of endotoxin infusion we observed a massive rolling along and firm adherence of platelets to lung capillary endothelial cells whereas under control conditions no platelet sequestration was detected. P-selectin was expressed on the surface of separated platelets which were incubated with endotoxin and in lung tissue. Pretreatment of platelets with fucoidin, a P-selectin antagonist, significantly attenuated the endotoxin-induced platelet rolling and adherence. In contrast, intravenous infusion of fucoidin in endotoxin-treated rabbits did not inhibit platelet sequestration in pulmonary capillaries. Conclusion: We conclude that platelets accumulate in alveolar capillaries following endotoxemia. P-selectin expressed on the surface of platelets seems to play an important role in mediating this platelet-endothelial cell interaction. Copyright (c) 2006 S. Karger AG, Basel.

Background: There is evidence that homocysteine contributes to various neurodegenerative disorders. Objective: To assess the values of homocysteine in patients with Creutzfeldt-Jakob disease (CJD) in both cerebrospinal fluid (CSF) and plasma. Methods: Study design: Case control study. Total homocysteine was quantified in CSF and plasma samples of CJD patients (n = 13) and healthy controls (n = 13). Results: Mean values in healthy controls: 0.15 mumol/l +/- 0.07 (CSF) and 9.10 mumol/l +/- 2.99 (plasma); mean values in CJD patients: 0.13 mumol/l +/- 0.03 (CSF) and 9.22 mumol/l +/- 1.81 (plasma). No significant differences between CJD patients and controls were observed (Mann-Whitney U, p > 0.05). Conclusions: The results indicate that the CSF and plasma of CJD patients showed no higher endogenous levels of homocysteine as compared to normal healthy controls. These findings provide no evidence for an additional role of homocysteine in the pathogenetic mechanisms underlying CJD neurodegeneration. Copyright (C) 2005 S. Karger AG, Basel.

Background: There is a lack of evidence about the effectiveness of cognitive behavior therapies (CBT) in settings of routine clinical care as well as in the treatment of panic and comorbid disorders. Methods: We investigated a group-oriented CBT approach for 80 patients with panic disorder including 35 patients with current comorbid major depression. Assessments took place 6 months before treatment, at the beginning and end of treatment, and 1 year later. Structured interviews and multiple clinical self-rating scales were used. Results: Panic patients with comorbid major depression showed higher anxiety-specific and nonspecific pathology. The most striking benefits were in reducing avoidance behavior, while improvements concerning catastrophic beliefs were smaller, but still significant. For most self-rating scale results, patients with and without comorbid depression improved to a comparable degree. However, the end-state functioning of patients with panic disorder and current comorbid depression at admission is significantly lower than for patients with panic disorder alone, Conclusions: The results point to the necessity to develop and improve treatment approaches for patients with comorbidity of panic disorder and current major depression. Copyright (C) 2000 S.Karger AG, Basel.