Podcasts about cardia

Maracanà con Marco Piccari e Stefano Impallomeni. Ospiti: Ivan Cardia, Andrea Giannattasio

U pacientů s diagnózou diabetes mellitus 1. typu, kteří z nějakého důvodu nemohou podstoupit transplantaci slinivky břišní, je možné zvážit transplantaci Langerhansových ostrůvků. Tyto ostrůvky pak produkují u diabetiků inzulin. Tyto transplantace se provádějí především v IKEM, ale od roku 2023 naši lékaři spolupracují i s lékaři z jiných českých i zahraničních nemocnic. Více o této metodě s Mgr. Ivanem Leontovyčem, Ph.D., z Laboratoře Langerhansových ostrůvků IKEM a Národního institutu Cardia.

A TUTTA C con Lucio Marinucci. Ospiti: Ivan Cardia e Michele Scandariato (Gionale di Sicilia)

Om det som ger puls, färg och liv till allt i en gudstjänst fylld med sång med Cardia-kören. Ludvig Lindelöf predikar i gudstjänsten från Guldhedskyrkan i Göteborg. Lyssna på alla avsnitt i Sveriges Radio Play. Bibeltexter, poem och predikan finns nu att lyssna på eller ladda ner som podd, utan musik, på SRplay!”Livet, eller kanske snarare det levande. Livet pågår hela tiden, men det levande är något annat. Det levande är väsensskilt från det pågående livet. Det är det levande som väcks upp när våren kommer, som ger världen liv. Det är det levande som väcks upp i oss själva, det som ger färg till tillvaron, som får den att skimra i de vackraste färger efter en själens långa vinter. Det är det levande i vår blick som kan se världen darrande av förväntan och förhöjning, som kan se skönheten i flodens silversånger och i gryningssolens sken. Det levande, som ger puls, färg och liv till allt.” (ur predikan)TextPsaltarpsalm 19Johannesevangeliet 4:5-26MusikCathedrals av gruppen (Jay Clifford) Psalm 788 För livets skull (P Harling)Psalm 90 Blott i det öppna (O Widestrand/BG Hallqvist)Fought and Lost (Jamie Alexander Hartman, Thomas Richard Peter Howe, Sam Robert Robinson) Psalm 219 Jag skulle vilja våga tro (T Littmarck)Earth Song (Frank Ticheli)Psalm 153 Livet vann, dess namn är Jesus (trad/O Hartman)Postludium, improvisation över BarnatroMedverkandeLudvig Lindelöf, predikade och ledde gudstjänstenNils Olandersson, läste sin dikt, Du fjäril, samt förbönCamilla James läste Psaltarpsalm 19Körsång av Cardia under ledning av Eva ForngrenKent Andersson, på pianoKristoffer Wallin, bas Producent Neta NorrmoTekniker Thobias Sandin och Thor Anderssonför Sveriges Radio P1liv@sverigesradio.se

Maracanà con Marco Piccari e Stefano Impallomeni. Ospiti: Ivan Cardia

Maracanà con Marco Piccari e Stefano Impallomeni. Ospiti: Ivan Cardia

Maracanà con Marco Piccari e Stefano Impallomeni. Ospiti: Ivan Cardia, Andrea Giannattasio

#202. O título deste episódio foi o tema da mesa-redonda coordenada pela delegação brasileira na última edição da Assembleia do Círculo Ártico (Arctic Circle Assembly), realizado em outubro, na Islândia. Pela primeira vez, o Brasil foi representado por uma comitiva oficial, liderada pelo glaciologista do Centro Polar e Climático, da UFRGS, Jefferson Cardia Simões. Nesta conversa, o cientista fala sobre a importância de ampliar as pesquisas científicas e colaborações para além da Antártica; como foi a primeira expedição do país ao Ártico e o significado do termo "Terceiro Polo". Assista e compartilhe; bons ventos! Confira o episódio com Jefferson Cardia Simões sobre a Expedição Internacional de Circum-navegação Costeira Antártica que foi ao ar no Polarcast, do programa InterAntar: https://open.spotify.com/episode/1RrOHZClXAGl9UxSN7zXx4?si=uKbQMtS7TlalFi3GPqM8yw Se você ainda não viu, estes são os links para dois programas gravados com Jefferson Cardia Simões aqui no Maré Sonora: Episódio 01: O que o Brasil faz na Antártica?: https://youtu.be/cSOKHTic-_g?si=OiQRS0O-Xs22aqK5 Episódio 76: Crise na ciência https://youtu.be/Xvm6UPPSAbA?si=PmtzBPXgnJNb4s1T Apoio: Café do Luiz Café artesanal, especial e cultivado no Sudoeste de MG. Entregas para todo o Brasil através dos contatos abaixo: Em São Paulo (11) 99830-0777 ou 98622-2612 Florianópolis (48) 99621-9288

Maracanà con Marco Piccari e Stefano Impallomeni. Ospiti: Ivan Cardia, Patrick Iannarelli

A TUTTA C con Luca Calamai. Ospiti: Ivan Cardia, Stefano Scarpetti, Massimo Paci

A TUTTA C con Luca Calamai e Daniel Uccellieri Ospiti: Ivan Cardia e Massimo Drago

A TUTTA C con Daniel Uccellieri Ospiti: Ivan Cardia e Matteo Calamai

The Lost Virtues of Ancient Heroes: Rediscovering Courage Unlock the secrets of ancient wisdom in "The Lost Virtues of Ancient Heroes: Rediscovering Courage." In this episode, Josh brings on Alex Petkas, an inspiring academic and entrepreneur. Alex delves into the monumental impact of history on personal development and gender roles. Discover how the lessons from ancient philosophers and heroes can shape a stronger, more courageous version of yourself. Learn why storytelling is crucial for moral formation and how the decline of historical education has left us yearning for authentic wisdom. Hear the inspiring tale of Eumenes of Cardia, a true testament to courage and loyalty. Are you ready to take responsibility for your own education and transform your life? If so, embark on this journey to rediscover the virtues that can build your foundation for personal growth. Don't forget to like, subscribe, and explore more at Command Your Brand to enhance your own story. CHAPTERS: 00:00 - Introduction 00:42 - Alex Petkas Introduction 06:19 - History's Impact on Modern Society 08:14 - Aspirations for Modern Men 09:56 - The Heroic Journey and Personal Growth 14:32 - Lessons from Ancient Heroes 19:48 - Decline of University Credibility 23:17 - Insights from Ancient History 29:35 - Personal Lessons and Insights 33:00 - The Importance of Listening to Heroes 37:55 - Understanding Our Current Historical Context 42:33 - Advice for Young Men Today 46:14 - Connecting with Alex Petkas ________________________________________________________________________ ⇩ LOOKING TO COMMAND YOUR BRAND? ⇩ BOOK A CALL: With Our Team to See How We Can Help https://commandyourbrand.com/book-a-call/ BOOK: Grab Your Copy of Our Book, Command Your Brand: Grow Your Impact, Income and Influence in the New Media Landscape, Rated the # PR Book on Amazon: https://www.amazon.com/Command-Your-Brand-Influence-Landscape/dp/B0CJXGKD15 ________________________________________________________________ DOWNLOAD AUDIO PODCAST & GIVE A 5 STAR RATING!: APPLE: https://podcasts.apple.com/ro/podcast/command-your-brand/id1570323509 SPOTIFY: https://open.spotify.com/show/0wE8jDVdlpsDCmNx8sYZTQ?si=41fd776e1a6b43be (also available Google Podcasts & wherever else podcasts are streamed _________________________________________________________________ ⇩ OTHER VIDEO PLATFORMS ⇩ ➤ RUMBLE: https://www.youtube.com/watch?v=4rInZbdlLiU _________________________________________________________________ ⇩ SOCIAL MEDIA ⇩ ➤ TWITTER: https://twitter.com/CYBmedia ➤ INSTAGRAM https://www.instagram.com/commandyourbrand ➤ FACEBOOK: https://www.facebook.com/commandyourbrand _________________________________________________________________ ➤ CONTACT: INFO@COMMANDYOURBRAND.COM

In this episode of Inside Startup Investing, host Chris Lustrino is joined by Jaeson Bang, CEO of Future Cardia, to explore the groundbreaking developments in heart monitoring technology. Future Cardia is pioneering a minimally invasive, implantable device designed for the continuous monitoring of heart arrhythmia, which represents a significant leap forward in patient care and medical data accuracy.Highlights include…Innovative Heart Monitoring Solution by FutureCardia (0:00)Jason's Background and Industry Experience (2:34)Development and Scientific Aspects of FutureCardia (4:30)Market Disruption and Product Differentiation (6:08)Procedure and Monitoring Details (9:00)Commercialization Strategy and Market Opportunity (13:41)Competition and Market Size (16:34)Insurance Coverage and Pricing Strategy (20:07)Marketing and Future Plans (20:26)Final Pitch and Investment Opportunity (25:09)

Maracanà con Marco Piccari e Francesco Tringali. Ospiti: Ivan Cardia

Janna Cardia returns to the show as we discuss physical fitness and how it helps bring out the best of your abilities as an actor!

Punto di Mercato con Ivan Cardia e Aggiornamenti sulle Olimpiadi con Daniele Petroselli Calciomercato e Ritiri con Marco Piccari e Lorenzo Beccarisi

Punto di Mercato con Ivan Cardia e Punto sulle Olimpiadi con Daniele Petroselli Calciomercato e Ritiri con Marco Piccari e Lorenzo Beccarisi

Punto di Mercato con Ivan Cardia Calciomercato e Ritiri con Cristiano Cesarini e Marco Piccari

"Terzo tempo" con Marco Spadavecchia e Giulia Borletto. Ospiti: Ivan Cardia (Tmw), Camillo De Michelis.

"Terzo tempo" con Marco Spadavecchia e Giulia Borletto. Ospiti: Ivan Cardia (Tmw), Camillo De Michelis.

"Terzo tempo" con Marco Spadavecchia e Giulia Borletto. Ospiti: Ivan Cardia (Tmw), Camillo De Michelis.

Punto di Mercato con Ivan Cardia Intro di Maracanà con Marco Piccari

Punto di Mercato con Ivan Cardia Intro di Maracanà con Marco Piccari

Janna Cardia hops on the show to discuss musical theatre and her hobbies outside of acting!

  In this podcast, Henry devotes most of his attention to 2:28-3:3, with the last several minutes devoted to some linguistic issues found in 1 John 3:4-10. 1 John 2Verse 28        The Greek word “ean” which is typically mis-translated as “when” in verse 28 is more correctly translated, “if ever”. The change to “if ever” enhances the other often mis-translated word (Greek: “parousia”), usually translated “coming”, should, instead be translated “presence”. Thus, the more correct interpretation of this verse would be: If ever He is being present to us [manifesting Himself in us], we should not shrink back at that presence, but live in it. There is a sweetness in His presence of which we need not be ashamed. 1 John 3Verse 2          The above word, “parousia” in this verse has a similar meaning as the word “coming” in verse 28. The Greek word, “phanerothe” (from phanerao) does not really mean “appeared.” Rather, a better translation of the word is “to make apparent/made obvious/manifested”. Thus, when paired with the Greek word, “ean”, the meaning becomes: if ever Christ makes Himself apparent in the follower of Jesus. The implication is not that we are waiting for a second physical coming of Christ, but rather, we are waiting for an inner realization that He is already within one, making Himself apparent. Verse 3Regarding the Greek word, “hagnos” instead of being translated “pure”, it has a more accurate meaning: of “holy” . . . being inwardly holy. Verse 4“Lawlessness”: For a Jew, the Law was everything. To talk about lawlessness was to disregard the Law of Moses. “Cardia”: “heart”. However, in the Greek, the word, “cardia” would today be understood as “conscience” in modern-day English. In the early 17th century, the words “consciousness” and “conscience” began to be separated, developing very different meanings. Verse 7 “Dikaios”: means “righteous”, or “upright”. Verse 9“Sperma”: means “seed” or “semen”. Our English word, “sperm” is derived directly from the Greek.  The quote in our introduction is from the Sixth Chapter of George Fox's Journal.Visit us on our website at ohioyearlymeeting.org. Any who might be interested in joining any of the Ohio Yearly Meeting Zoom online studies should check out the Online Study and Discussion Groups on our website. All are welcome!We welcome feedback on this and any of our other podcast episodes. Contact us through our website, or email us at OYMConservative@gmail.com.

Witam Państwa, nazywam się Jarosław Drożdż, pracuję w Centralnym Szpitalu Klinicznym Uniwersytetu Medycznego w Łodzi, skąd nagrywam podcast Kardio Know-How. W tym odcinku kontynuujemy omawianie doniesień z Kongresu AHA.Szczegółowy TRANSKRYPT do odcinka.Podcast jest przeznaczony wyłącznie dla osób z profesjonalnym wykształceniem medycznym.

Welcome to the MassDevice Fast Five medtech news podcast, the show that keeps you up-to-date on the latest breakthroughs in medical technology. Here's what you need to know for today, January 23, 2024. Check out the show notes for links to the stories we discussed today at MassDevice.com/podcast. The first international procedures were performed with Activ Surgical's visualization technology. Fast Five hosts Sean Whooley and Danielle Kirsh discuss what the visualization system is and how the company envisions it transforming the operating room. Surmodics has positive early results from its Pounce LP thrombectomy system. Learn what the thrombectomy system does and what doctors think of its performance. The FDA has cleared AI-based lung analysis software from Thirona. Whooley explains what the software does and how it will change personalized treatment. Boston Scientific has positive spinal cord stimulation data. The Fast Five hosts discuss some of the data that stuck out the most and what executives are saying. The FDA has granted breakthrough device designation for Pi-Cardia's leaflet modification device for TAVR. Hear more about the device, what it addresses and the optimism executives have.

Deep dive into imaging modalities that can actually show soft plaque. A deep dive into invasive and non invasive techniques. Comparing CT angiograms CCTA, calcium score CAC, coronary angiography cardiac cath, intravascular ultrasound IVUS, optical coherence tomography OCT, 3D vascular ultrasound 3DVUS, versus lipid levels. PESA, PRECAD, CARDIA trials. https://dralo.net/links

Mike Moore sits down with Jae Bang, Founder & CEO of Future Cardia, a company that is redesigning how Heart Failure & Arrhythmia patients will be monitored in the future. Their subcutaneous implant offers simplicity, accuracy, and high compliance for long-term monitoring, with existing reimbursement. Resources & Links Mike Moore https://www.linkedin.com/in/michaeljeffreymoore/ https://www.linkedin.com/company/thebleedingedgeofdigitalhealth/

"A raiva chegará ao mundo com mais força!" - Mensagem de Maria Puríssima para Gisella Cardia

paypal.me/LibroTobias En este audio os comentaré que va a pasar con ELDT, el futuro de este podcast, las decisiones que se han tomado y los motivos que han llevado a tomarlas. Este es un audio grabado con el corazón en la mano y en el que hablo clara y sinceramente del recorrido de este podcast a lo largo de estos diez años y la concatenación de circunstancias que han derivado en la actual situación. Temas: • “Love Loss” de Cardia • “Long Time Ago” de Concrete Blonde Narrador: Asier Menéndez Marín Diseño logo Podcast: albacanodesigns (Alba Cano) Escucha el episodio completo en la app de iVoox, o descubre todo el catálogo de iVoox Originals

Welcome back to Finding Fitness! The show where we discuss fitness & health tools to help you utilize and optimize them in a way that is approachable and adaptable for both the beginner and the advanced individual. We also discuss a variety of lifestyle and current event topics that we find interesting, funny, insightful and valuable. For example studies on fitness/health topics, our lives, weird or bizarre current events, insights on personal growth, mindset, & much more! If you enjoy this podcast please follow or subscribe wherever you get your podcasts so you don't miss any uploads! It helps us grow and spread our message of helping people get more fit & healthy!   Also feel free to leave a rating or review wherever you get your podcasts! It greatly helps and we would love you forever!If you have any questions you would like us to answer live on the show you can DM us @thefindingfitnesspodcast on Instagram or email us @thefindingfitnesspodcast@gmail.com  Check out NED for the highest quality hemp and wellness products here:  https://glnk.io/lq6q/thefindingfitnesspodcast where your 15% off discount will be automatically applied at checkout! Or go to helloned.com and use code FINDINGFITNESS at checkout to save 15% off anything you buy!Thank you NED & thank you listeners for supporting an amazing brand and us!You can follow us on instagram @thefindingfitnesspodcast You can email us @thefindingfitnesspodcast@gmail.com  Check out our website/blog at (new every Monday) https://thefindingfitnesspodcastblog.godaddysites.com/ Check out our free workout playlist on Spotify!https://open.spotify.com/playlist/5aZjtN9NlUQmbpMxFZZ8sp?si=6632efa17dc943afThank you!&Get 1% Better Today!Music:Music by Leonell Cassio from PixabayThanks for listening! Don't forget to follow us on Instagram and subscribe wherever you get your podcasts! Get 1% Better Today!Study Mentioned:Brian T. Steffen, David R. Jacobs, So-Yun Yi, Simon J. Lees, James M. Shikany, James G. Terry, Cora E. Lewis, John J. Carr, Xia Zhou, Lyn M. Steffen. Long-term aspartame and saccharin intakes are related to greater volumes of visceral, intermuscular, and subcutaneous adipose tissue: the CARDIA study. International Journal of Obesity, 2023; DOI: 10.1038/s41366-023-01336-yThanks for listening! Don't forget to follow us on Instagram and subscribe wherever you get your podcasts! Get 1% Better Today!

Commentary by Dr. Candice Silversides

Come hear about the best boy, the most betrayed boy, the most beloved boy! Hear the tales of the Greek who eats adversity for breakfast and treats treachery like it was just a sneeze! He can make scrambled eggs from a rock! He can make a horse run on a treadmill without even using the treadmill! He's loyal to the end! He will call you a moron if you betray him! He's right about everything but no one ever listens! He's Eumenes of Cardia!!! Also, Dustin has some great tips about interacting with horses [MEREDITH EDIT: no, he doesn't].  Sources: https://alexanderstandardpod.weebly.com/sources.html Facebook: The Alexander Standard Podcast Instagram @alexanderstandardpod  Twitter @AlexStandardPod Email: Alexanderstandardpod@gmail.com

Gisella Cardia è la santona che sostiene di parlare con la MadonnaSeguimi su YouTube: https://www.youtube.com/channel/UClkB_8jqDS7SWoltMjIu-3Q/Supporta il progetto qui: https://mercury.streamelements.com/ilverdeeilblue/tipSupport this podcast at — https://redcircle.com/storia/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

La presunta veggente di Trevignano respinge le accuseSeguimi su YouTube: https://www.youtube.com/channel/UClkB_8jqDS7SWoltMjIu-3Q/Supporta il progetto qui: https://mercury.streamelements.com/ilverdeeilblue/tipSupport this podcast at — https://redcircle.com/storia/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Link do cupom de desconto na assinatura de o Antagonista+ e Crusoé: https://assine.oantagonista.com/?cupom=QUERO60OFF Precisa de ajuda? 4858-5813, São Paulo 4003-8846, demais localidades O horário de atendimento é das 9h00 às 18h00, de segunda a sexta-feira, exceto feriados. Você pode entrar em contato conosco pelo e-mail:  assinante@oantagonista.com Inscreva-se e receba a newsletter:  https://bit.ly/2Gl9AdL Confira mais notícias em nosso site:  https://oantagonista.uol.com.br/ https://crusoe.uol.com.br/ Acompanhe nossas redes sociais:  https://www.fb.com/oantagonista​ https://www.twitter.com/o_antagonista ​https://www.instagram.com/o_antagonista https://www.tiktok.com/@oantagonista_oficial No Youtube deixe seu like e se inscreva no canal: https://www.youtube.com/c/OAntagonista

Il fascicolo è a carico di ignoti, ma al centro del caso c'è Gisella Cardia.Seguimi su YouTube: https://www.youtube.com/channel/UClkB_8jqDS7SWoltMjIu-3Q/Supporta il progetto qui: https://mercury.streamelements.com/ilverdeeilblue/tipSupport this podcast at — https://redcircle.com/storia/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

L'Italia continua a parlare della statua della Vergine di TrevignanoSeguimi su YouTube: https://www.youtube.com/channel/UClkB_8jqDS7SWoltMjIu-3Q/Supporta il progetto qui: https://mercury.streamelements.com/ilverdeeilblue/tipSupport this podcast at — https://redcircle.com/storia/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Rubrica di approfondimento sportivo a cura di Vincenzo Marangio Ospiti: Ivan Cardia, Lapo De Carlo, Alain Valnegri

Rubrica di approfondimento sportivo a cura di Vincenzo Marangio Ospiti: Ivan Cardia, Jacopo Galvani, Simone Dinoi, Alain Valnegri

Rubrica di approfondimento sportivo a cura di Vincenzo Marangio Ospiti: Ivan Cardia, Raffaele Garinella, Simone Dinoi, Antonello Gioia, Alain Valnegri

Rubrica di approfondimento sportivo a cura di Vincenzo Marangio Ospiti: Ivan Cardia, Tommaso Loreto, Antonello Gioia, Alain Valnegri

Rubrica di approfondimento sportivo a cura di Vincenzo Marangio Ospiti: Ivan Cardia, Costantino Nicoletti, Simone Dinoi, Alain Valnegri

Rubrica di approfondimento sportivo a cura di Vincenzo Marangio Ospiti: Ivan Cardia, Jacopo Galvani, Dario Marchetti, Alain Valnegri

This week, please join author Ambarish Pandey and Editorialist Linda Peterson as they discuss the article "Frailty Status Modifies the Efficacy of Exercise Training Among Patients with Chronic Heart Failure and Reduced Ejection Fraction: An Analysis from the HF-ACTION Trial" and the editorial "Heart Failure With Reduced Ejection Fraction (HFrEF): ‘The Importance of Being Frail.'" Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast, summary, and backstage pass to the journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, associate editor director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Well, Carolyn, this week's feature article, Heart Failure Reduced Ejection Fraction in Evaluating the Efficacy of Exercise Training. But guess what? It appears it may be more efficacious in those that have high Frailty Index scores, as opposed to those that may not. But before we get to our feature discussion, let's grab a cup of coffee and go through some of the other articles in the issue. Would you like to go first? Dr. Carolyn Lam: I would love to, and this first paper is one that defines epigenetic biomarkers of lifelong cardiovascular health exposure and really contributes to our understanding of their roles in cardiovascular disease development. First though, a little quiz for Greg. So, Greg, what does DNA methylation mean to you? Dr. Greg Hundley: Well, Carolyn, DNA methylation. So, what I understand is these methyl groups get involved with our DNA and actually affect change over time that leads to phenotypic expression of, maybe, new traits. But I don't know. Maybe I'm not quite up to date. Dr. Carolyn Lam: Oh, you're perfect. Indeed, DNA methylation is a widely characterized epigenetic modification, which means exactly as you said. It's a regulatory modification to our DNA induced by environmental exposures and can affect gene expression. And this is the topic of today's paper by Doctors Zheng, Hou, and Lloyd-Jones from Northwestern University Feinberg School of Medicine and their colleagues. So, what they did is they studied blood DNA methylation at over 840,000 methylation markers measured twice over five years in participants of the CARDIA study. Epigenome-wide association analyses on a clinical cumulative cardiovascular health score were then performed in both CARDIA and compared in the Framingham Heart Study. Dr. Carolyn Lam: The authors identified 45 midlife DNA methylation markers associated with clinical cardiovascular health metrics, such as body mass index, blood pressure, blood glucose, and total cholesterol longitudinally measured since young adulthood. The methylation markers were located in genes involved in lipid metabolism, insulin secretion, and cytokine production, which could not be fully attributed to genetic factors. So, they proposed and validated in summary a methylation-based risk score to promote a personalized cardiovascular disease risk evaluation beyond traditional cardiovascular risk factors. Dr. Greg Hundley: Oh, wow, Carolyn. Interesting, a methylation-based risk score to promote personalized cardiovascular disease risk evaluation. Wow! That's really exciting. Dr. Greg Hundley: Well, I'm going to go to the world of preclinical science, and just like last week where we had a really nice article on myocardial regeneration, this week, we've got another. And so, Carolyn, early neonates of both large and small mammals are able to regenerate the myocardium through cardiomyocyte proliferation for only a very short period after birth. This myocardial regenerative capacity declines in parallel with withdrawal of cardiomyocytes from the cell cycle in the first few postnatal days. No mammalian species examined to date has been found capable of a meaningful regenerative response to myocardial injury later than one week after birth. Dr. Carolyn Lam: Interesting. Now, I see that these investigators worked with possums. Could you tell me why they did that, and what did they find, Greg? Dr. Greg Hundley: Right, Carolyn. So, this work was led by Dr. Wataru Kimura from the RIKEN Center for Biosystems Dynamic Research and their colleagues. The reason they studied possums, so the marsupial possum maintains cardiomyocyte proliferation and a capacity for myocardial regeneration for at least two weeks after birth. Remember we stated before, all the other mammalian species, it's only one week after birth. So, this appears to be the longest postnatal duration of such a capacity among mammals examined to date, and AMP kinase signaling was implicated as an evolutionary conserved regulator of mammalian postnatal cardiomyocyte proliferation. Dr. Greg Hundley: And they additionally found that in a separate mouse experiment, the authors noted that the pharmacological inhibition of AMP kinase signaling was sufficient to extend the postnatal window of cardiomyocyte proliferation in neonatal mice, so really exciting work in the area of cardiomyocyte regeneration. Dr. Carolyn Lam: Wow, indeed! And I've learned now about possums. Thank you, Greg. Dr. Carolyn Lam: So, Greg, have you ever asked yourself, what is the frequency, penetrance, and variable expressivity of dilated cardiomyopathy-associated gene variants in the general population? Well, guess what? This next paper addresses just that in more than 18,600 UK Biobank participants who had undergone whole-genome sequencing, ECG, and cardiovascular magnetic resonance imaging. Dr. Greg Hundley: Wow, Carolyn, another really interesting study from the UK Biobank. So, what did they find? Dr. Carolyn Lam: So, this study is from Dr. Chahal from the Center for Inherited Cardiovascular Diseases Wellspan Health in Lancaster, Pennsylvania and colleagues, and they found that approximately one in six of adults with putative pathogenic variants in dilated cardiomyopathy genes exhibited early dilated cardiomyopathy features potentially associated with the genotype. And it's most commonly manifesting with arrhythmias in the absence of substantial ventricular dilation or dysfunction. Dr. Carolyn Lam: Among individuals with putative pathogenic dilated cardiomyopathy gene variants, ECG or CMR-detected early features were nearly four times more common than clinically manifest dilated cardiomyopathy or early features. Over 90% of subjects with these gene variants in dilated cardiomyopathy-associated genes did not have a prior history of dilated cardiomyopathy, and the overall clinical or subclinical penetrance of dilated cardiomyopathy-associated single pathogenic variants was highly variable between genes ranging from zero to 67%. And so, in conclusion, a genotype-first screening approach for dilated cardiomyopathy using a large genetic panel is currently not suitable in the general population due to incomplete understanding of the genetic architecture and reduced penetrance of the associated genes. Dr. Greg Hundley: Very nicely said, Carolyn. Wow! Well, let's take a look and see what's in the mailbag. And first, there's a Research Letter from Professor Huguenard entitled, “Frequency of Screening Detected Intracranial Aneurysms in Patients With Loeys-Dietz Syndrome.” And our own Bridget Kuehn has a really nice piece on Cardiology News. Dr. Carolyn Lam: Nice. There's also an On My Mind paper by Dr. Sattar, McGuire, and Gill entitled, “High-Circulating Triglycerides Are Most Commonly a Marker of Ectopic Fat Accumulation: Connecting the Clues to Advanced Lifestyle Interventions,” and an exchange of letters between Dr. Groothof and myself, Dr. Lam, regarding my article on “Efpeglenatide and Clinical Outcomes With and Without Concomitant SGLT-2 Inhibition in Type 2 Diabetes: An Exploratory Analysis of the AMPLITUDE-O Trial.” Dr. Carolyn Lam: Ah, that was awesome. Well, thanks, Greg. I am so excited to get to the future discussion that you queued us on so well, frailty in heart failure with reduced ejection fraction. Here we go. Dr. Greg Hundley: You bet. Dr. Greg Hundley: Welcome, listeners, to this July 12th, 2022 feature discussion. And we have with us today, Dr. Ambarish Pandey from University of Texas Southwestern Medical Center in Dallas, Texas, and Dr. Linda Peterson, an editorialist for this article from Washington University in St. Louis. Welcome to you both. Well, Ambarish, We're going to start with you. Could you describe for us basically the background information that went into the preparation of your study, and what was the hypothesis that you wanted to address? Dr. Ambarish Pandey: Thanks, Greg, for having me on this, and thanks to Circulation for publishing our article. Yeah, I think the premise for this study stems from the longstanding known benefit of exercise training in patients with heart failure with reduced ejection fraction. Now, that was shown in the HF-ACTION trial, where individuals with chronic stable heart failure with reduced ejection fraction underwent exercise training, and there was demonstrated benefit in quality of life and adjusted analyses. There was a protocol-specified adjusted analysis that did demonstrate improvement in some of the key primary endpoint. Dr. Ambarish Pandey: Based on these results, CMS has approved exercise training and cardiac rehabilitation in patients with chronic stable heart failure with reduced ejection fraction. However, despite this mandate from CMS and generally well-accepted benefits of exercise training in heart failure with reduced ejection fraction, the uptake of exercise training has been pretty low, and there's a lot of heterogeneity in the improvement in outcomes that is associated with exercise training. Dr. Ambarish Pandey: So, we wanted to see whether frailty, which is a well-characterized syndrome of reduced physiologic reserve and impaired homeostatic tolerance to stressors and is common in patients with HFrEF, we wanted to see how frailty modifies the beneficial effects of exercise training in HFrEF. And based on the existing literature and some of the prior works we have done, we hypothesized that individuals who are frail and who have more functional impairments are going to have more targets for improvement in their functional status and thus would be more likely to benefit from exercise training. And we looked at this in the HF-ACTION trial itself and using the Rockwood Frailty Index and the difference in primary outcome and treatment effect of exercise among frail and non-frail individuals. Dr. Greg Hundley: Very interesting, so really sort of a look back in HF-ACTION data. Describe a little bit more for us that study design, and then specifically, what was the study population that you used to test your hypothesis? Dr. Ambarish Pandey: Right. So HF-ACTION was a randomized control trial multi-centered that was sponsored by NHLBI and was conducted in the early 2000s and basically focused on chronic stable patients with heart failure with reduced ejection fraction who have not had a hospitalization in the past six weeks and have ejection fraction less than 35% and class II to IV. And these participants were randomized in one-to-one fashion to getting aerobic exercise training followed by some home-based exercise versus the usual care. Dr. Ambarish Pandey: And in our study, what we looked at was we looked at the effect modification by baseline frailty status on the treatment effect of exercise training. So, we calculated the frailty index, which is a well-established measure of frailty using a Rockwood Index Model, and we stratified patients by frail versus non-frail status based on a Frailty Index cut-off of 0.21, such that higher index identifies more frail participants. And then, we looked at how the treatment benefit of exercise training on different outcomes was differential across the frail and non-frail strata. We looked at qualitative interaction, and we also looked at the Frailty Index, so the continuous variable to assess the benefits of exercise across the spectrum of frailty in the study population. Dr. Greg Hundley: And so, before we get to your study results, how many patients were in your study? Give us an idea of what was the range in age, and then also the composition of sex? How many men? How many women? Dr. Ambarish Pandey: Right, so this is really important because that's addressed to the generalizability of the study. So, the study included around a little over 2,100 participants. The mean age was 59 years. 28% were women, and 32% were self-reported black individuals with chronic stable heart failure. That was the demographic distribution. The age was slightly younger than what you've commonly see in observational studies with heart failure, and that is largely because the study recruited patients who were able to do exercise training and were able to do exercise tests with peak VO2 and peak VO2 peak excess capacity assessment at baseline and follow-up. So, that kind of selected for a slightly younger population. Dr. Greg Hundley: Very nice. And so, what were your study results? Dr. Ambarish Pandey: So our study results are, indeed, pretty interesting. We identified that around 60% of patients with chronic stable heart failure with reduced ejection fraction who were in the trial were actually frail based on the Rockwood Frailty Index Model. And we observed that among the study participants, the exercise training was associated with significant improvement in the primary composite endpoint of all-cause hospitalization or death in frail participants, but not in the non-frail or less fail participants. And there was a significant treatment interaction, such that baseline frailty modified the treatment effect of exercise training for the primary composite endpoint. Dr. Ambarish Pandey: Now, this was largely driven by a significant reduction in all-cause hospitalization among frail individuals who underwent exercise training, and not so much by an effect on mortality. And we did not see a significant difference in the mortality component of the primary composite endpoint across frail versus non-frail status participants. So, in a nutshell, baseline frailty did modify the treatment effect, largely driven by substantial reduction in the risk of all-cause hospitalization among frail participants more than non-frail participants. Dr. Greg Hundley: And before we get to Linda in her interpretation of your study, Ambarish, did you see the same effects in frail men, in frail women? And also, what about in individuals that might be a little older versus those that were perhaps younger? Dr. Ambarish Pandey: That's a really important question, and we were a little bit limited to do further subgroups because we are dealing with around, I think, 2,000 participants and we had frail, non-frail, and we did not do a further subgroup stratification by sex or by age. The age range was rather narrow. It's 58 years plus/minus 13 years, so we didn't really have a lot of older individuals above 75, something like what REHAB-HF Trial has shown in the news, a recent trial. Dr. Ambarish Pandey: We couldn't address the question of whether the effect modification was further modified by sex or age, so I think that's the two-level interaction. But I think that is something that would be interesting to test perhaps in a pool analysis of multiple exercise training studies, which is something we are considering. Dr. Greg Hundley: Thank you. Well, listeners, now we're going to turn to our editorialist, Dr. Linda Peterson, from Washington University in St. Louis, and, Linda, very provocative results here, heart failure reduced ejection fraction. And certainly, we like to go to things like cardiac rehab, but we're hearing this it seemed to make a difference if you were frail versus not frail. Dr. Linda Peterson: Right, I think that's an important distinction here in this article as Ambarish has so eloquently put forth, and it's especially important because other articles have shown in looking at the PARADIGM-HF Study and ATMOSPHERE it appears that one out of two patients with HFrEF are actually frail. And so, the magnitude of these findings and the importance of these findings is highlighted by that study. And this frequency of frailty is roughly double that of community-dwelling adults who are over age 90, so we're thinking of frailty usually as much older adults, but in HF-ACTION, actually, the patients' average age was 60 in the patients with HFrEF. Dr. Linda Peterson: So, there's almost an accelerated aging phenotype we're seeing here in a large proportion of the patients who have HFrEF. I think this has an enormous impact on a lot of the patients that we're seeing with HFrEF, and we should be alerted to looking for frailty and potentially screening for frailty. And I think another highlight of this study is that it points out the importance of frailty because frail patients have a 50% higher risk of hospitalization and death, according to some other studies, particularly one by Faray and their group and also by Yang and their group. Dr. Linda Peterson: And so, it highlights the importance of getting patients who are frail with HFrEF into cardiac rehab or getting them some sort of aerobic exercise training. But paradoxically, frailty is also associated with a lower likelihood of those particular patients on getting into cardiac rehab and also getting on goal-directed medical therapy. And that was shown by Phil Ades and his group. So, I think the importance of these findings by Ambarish and his group are to be commended, and they're very important for a large proportion of our patients with HFrEF. Dr. Greg Hundley: Very nice. Well, let's turn back to Ambarish, and then follow up with Linda. Ambarish, what do you see as the next study that should be performed in follow-up to your study? Dr. Ambarish Pandey: I think that's a great question. And I think we are just beginning to realize the magnitude of impact that frailty has in the care of patients with heart failure. And this goes across the spectrum of ejection fraction, both HFpEF or heart failure with preserved ejection fraction and heart failure with reduced ejection fraction. Indeed, the burden of frailty is higher in patients with heart failure with preserved ejection fraction, and they are more of the accelerated aging phenotype. Dr. Ambarish Pandey: And I think the next study basically should look at a targeted approach to exercise training or category of intervention among patients who are most likely to benefit from it, which would be patients who have a high frailty burden or patients who have HFpEF. I think they go hand in hand when it comes to frailty and HFpEF. So, I think that's the next study to do is to see to what extent we can actually identify and target exercise training in the highest risk individuals who are most likely to benefit from it because that subset of highest modifiable risk is indeed identified by frailty and when you look at other subtypes by HFpEF which has a lot of high frailty burden. Dr. Greg Hundley: And, Linda, from your perspective, what do you see as the next study to be performed in this sphere of research? Dr. Linda Peterson: Yeah, I think this study really provides a springboard for future studies in HFrEF, in particular. One, what hospital interventions can be done in patients to get them moving more, and really assess is there a possibility of different types of exercises to get patients less frail even while they're in the hospital when they're enroute to going home? And then also, how do we have different mechanisms by which we can get more patients into cardiac rehab? Clearly, our national average of getting patients who qualify for cardiac rehab, which is a class I indication is 20% at best, and the aim from the AHA is 70%. Dr. Linda Peterson: There's a big gap there, so interventions looking at implementation and getting patients to cardiac rehab or looking at other types of aerobic exercise training, such as home-based cardiac rehab for patients who don't have a cardiac rehab center next to them, I think the field is wide open for different studies to springboard off of these findings. Dr. Greg Hundley: Very nice. Well, listeners, we want to thank Dr. Ambarish Pandey from University of Texas Southwestern Medical Center in Dallas, Texas, and our editorialist, Dr. Linda Peterson, from Washington University in St. Louis, for bringing us this research study, highlighting that among patients with chronic stable heart failure and reduced ejection fraction, that baseline frailty modified the treatment effect of aerobic exercise training with a greater reduction in the risk of all-cause hospitalization. Dr. Greg Hundley: Well, on behalf of Carolyn and myself, we want to wish you a great week, and we will catch you next week on the run. Speaker 5: This program is copyright of the American Heart Association 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

Alexander the Great's untimely death at Babylon in 323 BC triggered an unprecedented crisis across his continent-spanning empire.Within a couple of days, the very chamber in which he died witnessed a gore-soaked showdown between his previously united commanders and soldiers. Within a fortnight, Babylon saw the first siege of the post-Alexander age.In this special explainer episode to mark the anniversary of Alexander's death, Tristan brings to life the imperial implosion that was the immediate aftermath of the Macedonian king's death - a subject he knows one or two things about, seeing as he's written a book on it!Tristan's book The Perdiccas Years, 323-320 BC (Alexander's Successors at War) is available on Amazon here.This episode was produced by Elena Guthrie and mixed by Aidan Lonergan. It contains translations of contemporary speeches by JC Yardsley & music from Epidemic Sound.If you'd like to learn more, we have hundreds of history documentaries, ad-free podcasts and audiobooks at History Hit - subscribe today! To download the History Hit app please go to the Android or Apple store.Further Reading - Primary Sources Arrian Events After Alexander 1.1–1.9A.Curtius 10.5–10.10.Diodorus Siculus 18.1–18.6.Justin 13.1–13.4.Plutarch Life of Eumenes 3.Secondary Sources Anson, E. (1992), ‘Craterus and the Prostasia', Classical Philology 87 (1), 38–43.Anson, E. (2015), Eumenes of Cardia, Leiden, 58–77.Bosworth, A. B. (2002), The Legacy of Alexander: Politics, Warfare, and Propaganda under the Successors, New York, 29–63.Errington, R. M. (1970), ‘From Babylon to Triparadeisos: 323–320 bc', The Journal of Hellenic Studies 90, 49–59.Meeus, A. (2008), ‘The Power Struggle of the Diadochoi in Babylon, 323bc', Ancient Society 38, 39–82.Meeus, A. (2009), ‘Some Institutional Problems concerning the Succession to Alexander the Great: “Prostasia” and Chiliarchy', Historia 58 (3), 287–310.Mitchell, L. (2007), ‘Born to Rule? Succession in the Argead Royal House', in W. Heckel., L. Tritle and P. Wheatley (eds.), Alexander's Empire: Formulation to Decay, California, 61–74.Worthington, I. (2016), Ptolemy I: King and Pharaoh of Egypt, New York, 71–86 See acast.com/privacy for privacy and opt-out information.

Cardia Summers joined the U.S. Army under an option 40 contract (Ranger), but experienced a setback. He didn't let that setback stop his goals and instead finally passed the Ranger assessment to join 3rd Battalion, 75th Ranger Regiment as a paralegal. After transitioning to a unit in Vicenza Italy, he was partying with buddies a little too hard and received a DUI. After separation from the Army, he took his experiences to create a company that he hopes will help others from obtaining a DUI.

Join Dr. Tara Brandner and Tess Kossow as she shares her three hopeful hints on her journey through infertility and surviving a cardiac arrest. You don't want to miss this inspirational episode. Also, add her book series  I'm Very Ferris to your collection they are amazing!  Connect with Tess Kossow!   Protea Nutrition   Learn from Dr. Tara Brandner: DOWNLOAD your freebies created by Dr. Brandner!  BOOK your FREE discovery call JOIN the Confident Fertility Academy today!  Come say hi over on Tara's Instagram  *Information provided on this podcast provides general health information for educational purposes only. The information provided by me as a fertility coach is not to be used as a substitute for medical advice, cannot diagnose or treat any health condition and does not substitute for care from your healthcare provider.