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2024 was a special year for Carnival and the Japan-New Orleans connection! Lafcadio Hearn's life & works inspired the theme for Rex Parade 2024: "The Two Worlds of Lafcadio Hearn - New Orleans & Japan". But why Hearn? What went into the float design? What other ways has Hearn left a lasting impact on both New Orleans & Japan? Find out today with a super-sized special Mardi Gras bonus episode, featuring insights from Rex historian/archivist Will French & historian/archivist emeritus Dr. Stephen Hales, Royal Artists float designer/artistic director Caroline Thomas, Lafcadio Hearn's great grandson Bon Koizumi, legendary chef John Folse, Captain of the Krewe of Lafcadio John Kelly, JSNO's resident Lafcadio Hearn expert Matthew Smith, and even the Mayor of Matsue Akihito Uesada! Get ready for Mardi Gras 2025 by reflecting on this unique connection between New Orleans & Japan!------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts. Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Music Credits ------Background music provided by: Royalty Free Music by Giorgio Di Campo for Free Sound Music http://freesoundmusic.eu FreeSoundMusic on Youtube Link to Original Sound Clip------ Audio Clip Credits ------Thanks to Dominic Massa & everyone at WYES for allowing us to use some of the audio from the below Rex Clips:Segment about Royal Artist & Float DesignFull 2024 Rex Ball Coverage (Krewe of Lafcadio/Nicholls State segment)Thanks to Matsue City Hall & Mayor Akihito Uesada for their video message below:Message from Matsue Mayor Akihito Uesada------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below & our promo code from the episode!Support your favorite NFL Team AND podcast! Shop NFLShop to gear up for football season!Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! ------ Past KOJ Hearn/Matsue/History Episodes ------Foreign-Born Samurai: William Adams ft. Nathan Ledbetter (Guest Host, Dr. Samantha Perez) (S5E17)Foreign-Born Samurai: Yasuke ft. Nathan Ledbetter (Guest Host, Dr. Samantha Perez) (S5E16)Explore Matsue ft. Nicholas McCullough (S4E19)Jokichi Takamine: The Earliest Bridge Between New Orleans & Japan ft. Stephen Lyman (S4E13)The Life & Legacy of Lafcadio Hearn ft. Bon & Shoko Koizumi (S1E9)Matsue & New Orleans: Sister Cities ft. Dr. Samantha Perez (S1E2)------ Links about Rex ------2024 Rex Parade/Float PDF with Full DesignsCaroline Thomas's Website------ JSNO Upcoming Events ------JSNO Event CalendarJoin JSNO Today!
This season was a long one! The Krewe re-groups to reflect on Season 5 as a whole, and everything that went into it... with a SPECIAL GUEST! Join us for one last audio journey in Season 5 as we discuss all the milestones, top moments, challenges, & fun anecdotes, in addition to a look ahead to Season 6 & listener feedback! Let's GO!------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts. Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below & our promo code from the episode!Support your favorite NFL Team AND podcast! Shop NFLShop to gear up for football season!Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! ------ JSNO Upcoming Events ------JSNO Event CalendarJoin JSNO Today!
Host Dr. Davide Soldato and guests Dr. Suzanne George and Liz Salmi discuss their JCO article "Overcoming Systemic Barriers to Make Patient-Partnered Research a Reality" TRANSCRIPT TO COME Dr. Davide Soldato: Hello and welcome to JCO's After Hours, the podcast where we sit down with authors from some of the latest articles published in the Journal of Clinical Oncology. I am your host, Dr. Davide Soldato, Medical Oncologist at Ospedale San Martino in Genoa, Italy. Today, we are joined by JCO authors Liz Salmi, Researcher and Patient Advocate, and by Dr. Suzanne George, who works as a Medical Oncologist at the Dana-Farber Cancer Institute where she acts as the Chief of the Division of Sarcoma. She is also Associate Professor of Medicine at Harvard Medical School. Today, we are going to discuss with Suzanne and with Liz the article titled, “Overcoming Systemic Barriers to Make Patient-Partnered Research a Reality.” So thank you for speaking with us, Suzanne, Liz. Liz Salmi: Thanks for having us. Dr. Suzanne George: Yes, thanks. Dr. Davide Soldato: I just want to make a brief introduction because I think that the concept of patient partner research is very wide and I'm not sure that all of the readers of JCO really have a deep understanding because I imagine that there are a lot of ways we can involve patient and patient advocates in the research process. And so I was wondering if you could give us a little bit of an introduction about the concept. Dr. Suzanne George: Sure. I think the point that you raise is really important because there are many terms that are used, patient-partnered research, patient advocacy, but I don't think that there's a single definition as to what that actually means. In the context of our work, we've sort of summarized our experience through something called the PE-CGS or the Participant Engagement and Cancer Genome Sequencing network. And in that project, which is a Moonshot funded network, the intention is to have participants in research be true partners working with traditional academic research teams in order to develop networks specifically focused on cancer genomics. So what we've done, every center is a little bit different in the network, but we're really having research participants not just act, but really work on the research team from the beginning of the project inception all the way through the research project. Liz Salmi: What brings me to the PE-CGS network is my 17 years experience as a person living with a low grade glioma, brain tumor or brain cancer and involving patients in the co-design of research is super critical because patients bring unique lived experiences that can shape research questions, study designs and outcome measures in ways researchers might not anticipate. And we're finding this through our network. So through my work, including my patient experience and brain tumor focused study designs, I've seen firsthand that patient insights can drive more practical implementations that ultimately benefit both patients and the researchers. And so the particular project I work on in the network, we've got like five different arms and different groups of cancer types that are being represented, so I'm basically focusing on the OPTIMUM study around how brain tumor patients can help in this study design. So in this project I serve as not just a participant in the research, but also as a patient co-investigator. Dr. Davide Soldato: That is very interesting. And I think that we really captured the essence of patient-partnered research by having both of you here talking with us about the PE-CGS. And the second question that I wanted to ask is: I really think that the network focuses on something that is quite important right now and currently in medical oncology - so cancer genome sequencing, access to novel therapies - and I think that it's really challenging to imagine a way in which we can really get our patient and get patient advocates to help us designing new trials who are looking into this. And I just wanted to know, do you think that there is something that is particularly challenging when we are speaking specifically about cancer genomics and access to this type of drugs that are targeting specific molecular alteration? Because I think that in general it might be a little bit easier, maybe I'm biased on this, so you can also tell me if I'm wrong, but I think that it's a little bit easier when we are trying to design, for example, behavioral intervention or things that are more commonly found in oncology and a little bit more complicated when we are speaking about genomics. Dr. Suzanne George: So I think that's part of what this network is trying to address, which is really what are the barriers and the opportunities around cancer genomics from the patient perspective and how do we make sure that that perspective is included as we're thinking about study design and inclusion? As Liz mentioned, this network has five different networks within the network, five different centers, and each center is slightly different with the population that it engages with. And so there's diversity there in terms of reaching out to different patient communities and partner communities around potential barriers for genomics research. I think one of the things though that we're finding across the network is that people want to be part of this work. People that have a lived experience of cancer want to help move the field forward. And what we ended up writing about was some of the barriers that get in the way of that. It's awesome to have people like Liz that are like all in and then there's people who are on the other end of the spectrum that want to share their information to help move the field forward around genomics, but then there's all these barriers at the systems level that get in the way of that. So I think that that's one of the challenges we're trying to overcome and learn about across the network. Liz Salmi: Yeah, I think I bring this really interesting, I can't say I'm really interesting, but I think I bring this really niche perspective. Not only am I a person living with a brain tumor and I'm a co-investigator but also like a participant in this study. I also, in my day job, I'm an investigator as part of the director of communications and patient initiatives on the OpenNotes lab at Beth Israel Deaconess Medical Center. And our lab really focuses on how open, transparent communication between doctors and patients improves care. And that's been going on for longer than I've been around on our team. But what I bring to that lab is I focus on engaging both patients and clinicians in spreading the awareness about the power of how easy access and transparent communication, access to information across healthcare settings helps patients feel more involved and informed in their care. And I work specifically, it's a really niche area. I work on projects that aim to expand access to notes and test results in diverse care settings, really helping tailoring initiatives so that various patient communities can understand how they can be involved in these types of research projects. Ultimately that's what brought me into this space. I might be one of the first generation of patients that actually starts helping co-design studies on things like this. And I think that across a lot of healthcare settings cancer is really what we're focused on. But patients are now increasingly being involved as research collaborators. And there's many different funding institutions such as the NCI but also PCORI they now mandate that funders reflect a shift towards more patient centered research frameworks. So it's like the PE-CGS network isn't the only group that's being funded to do research in this way. And I think other investigators, even outside of the cancer space, but specifically in cancer, need to learn how to do research in this way. Dr. Suzanne George: Yeah, I agree. And I think the other thing that we need to do is if people want to participate and that participation in many of these networks has to do with record sharing and data sharing, the system needs to accommodate that. If people want to share their information in order to allow research to be performed, then we need to make sure that that can happen, and that it's not that the institution systems don't connect with someone else's systems or that you to pay X, Y and Z dollars for the data to go A, B and C, or that some places are on this EHR and some places are on that EHR and so, sure, you can share it, but you have to go through all of these hurdles in order to make it happen. When a patient signs a consent form that says, “I want my data to be used,” we as an investigator community, we owe it to that patient to make sure that their information is being part of the data set that will be used for learnings. And that's part of what we wrote about, is the lots of behind the scenes things that just get in the way and that we need to work towards improving. Liz Salmi: Both Suzanne and I are really passionate about this stuff. And as a person living with a brain tumor for the last 17 years, I'm a chronic research participant. I always, always, am really curious. I'm like, “Yes, let me contribute my data. Whether that's electronic health record data or maybe I'm being interviewed about certain aspects of the cancer care experience.” And the one thing that bummed me out for like the first 10 years of being this chronic research participant is I would enroll in things, I'd be interviewed for things, I'd fill out these surveys and then I never heard anything about what happened with that information and that time I spent. And people would send me like a $10 gift card to Amazon, like, “Thanks for participating,” but really what I wanted to know is like, did you do anything with that? How did that inform things? So that really annoyed me to the point where I was like, I'm just going to be part of the research process and really figure out how we share that information back to everybody who had spent so much time. And so my participation in this space is like, “Let's change it. Let's give people information back.” And now I know it takes a really long time to have a finding that could be published somewhere that we then get it back. But closing the loop on the communications gap is something I'm really passionate about. Dr. Davide Soldato: Do you think that we are changing a little bit this perspective? I feel like we are getting a little bit better in creating patient communities of patients who are included in specific clinical trials. And then we do the effort of creating a community, of keeping people really involved with the research that they are participating in. I think that we are not quite there yet, but I think that we are making some kind of steps in that direction. For example, trying also to inform patients to participate in the study when the publication that is related to that specific study comes out. What is the benefit? What have we discovered? I think that we are not quite there yet. There is a lot of room for improvement, particularly in the way I think we communicate these to patients who participated in research. But I have the impression that we are making some steps forward. So I don't know. Do you share the same thoughts? Liz Salmi: So Dr. George talked about the PE-CGS network and then there's five different cancer types being studied. So the thing I can reflect on is what we've done in the, this is a really long acronym but, Optimizing Molecular Characterization of Low Grade Glioma. Say that 10 times fast. So our particular group is people who donate tissues about their brain tumors. We're really collecting data from people with multiple brain surgeries over time, which is really complicated and to make that process easier. And then once those tissue samples are stored somewhere, studying that information about what changes in the brain tumors over time and then also giving those results back to people so they can take that research level data and bring it back to their neuro oncology team and say, “Hey. Here's what I found out, “and having a conversation. So, this is a long multi touch point study and in order to do that, to even make that possible is the individual patients need to understand what's in it for them. They're donating precious tissue in order to make the research process work. And so in order to do that, it's not just the investigators saying, “Hey. Give us your brain tissue, peace out.” It is we have a whole research advisory council of people living with these particular tumor types who help us co-design how do we do that outreach, how do we explain why this is important, or how do we message the importance of this work so they understand,“Oh, this is what's in it for me and this is what's in it for other people like me.” And from there then with that process, which again I mentioned, all of these multi-step processes, once we're able to understand how patients want to hear that information, what's in it for them, then we bring it back to like those bench scientists, investigators going, “Okay. And here's how this workflow should work for the patients,” and design everything around the patient experience before we even care about what's happening from the scientist researcher perspective. Dr. Suzanne George: I agree. I think to your point, I think the fact that we're all here today talking about this is just like you said, is that we are making progress, right? Like we're even here having this conversation. Just like you said, I think there's opportunities to improve and further refine the communication and the involvement back in the patient community. When I think- if I put on my clinical investigator hat, I'm very involved in PE-CGS, but my primary research interest historically has been clinical trials and drug development. And I think that our approach in communicating results back has just not been consistent. But I do think that there's opportunities, just like you said, to provide summaries of information to loop back. I don't think that we've completely solved: What do we do? How do we provide information back to loved ones of patients that may no longer be alive that participated? How do we provide information to people who maybe we don't have their contact information? What if we lose track of them? How do we also make sure that we give people the choice to know? Do you want to know about this or would you rather just participate and then give space to that research? Because maybe that's how people's best for them. So I think that you're right, we're making progress, but I think that there's also a lot more that we can do. So I'm glad we're talking about it. Dr. Davide Soldato: How much do you think that directly involving patients in this process, like asking them directly and co-designing the trial from the very beginning and understanding the level of information? This might also be another question inside of the question. So first, how much co-designing this type of research helps, and then do we also need to further refine at that level of communication, different communication depending on the level of information that different people want to have? Because I think that that's another level of complexity that we need to work towards at a certain point. We need to work on that first level of giving back the information. But then I think that there is also the other point of providing the information and information that should also be probably adapted to the cultural belief of different patients, to the ethnicity or to whatever cultural background or social background or whatever they may place their most interest in. Dr. Suzanne George: So I think that you're 100% right on all of those points. I think those are all topics that need to be considered. We may be able to get to a certain degree of granularity around those communication points, but on the other hand, we also want to be able to communicate broadly and accessibly as possible. One of the interesting things about PE-CGS, as Liz was mentioning, is each of the five centers has a slightly different focus. For example, one of the centers is focused on American Indians and Tribal Nations, and the communication practices coming out of that center are really unique and really very special and something that's been really, I think for me, very fascinating to hear about. Because to your point, like, just the strategy and what's considered appropriate is just different. I think if we hope to build a research world where our research participants and research data come from a broad swath of the population that really represents the population, the only way that we're going to be able to do that is find ways that bring meaning across the population as well. And that may be different based on where people are coming from and where people are at in their own journeys and in their own lives. But it's on us to be open to that and like to hear that, so we can do the right thing. Dr. Davide Soldato: And I think that this is one of the objectives of the PE-CGS, really trying to bring this type of research participation to really diverse and underrepresented populations, not only in terms of cultural background, but I also think about different types of tumors. Like Liz was referring about brain cancer or low grade glioma, which is a very niche population. And I also think about sarcomas, for example, the degree of variability that we have in that specific type of disease is such that we really need to probably find different ways to communicate also inside of this diversity in terms of single patient and experiences, but also in terms of single diseases. You were speaking a little bit before about the fact that the manuscript is really on the barriers that we would need to identify and then to change to make this system a reality. We were talking a little bit about consenting information and consenting the sharing of information, and I think that you make a very interesting point about the consent process when we are designing research. Could you give a little bit of your impressions about giving informed consent? What we need to change, how can we improve? Dr. Suzanne George: The bottom line is the consent process needs to be simple, clear, and transparent. And sometimes I feel, because the traditional way that we've always gone about consent is frequently consent is as it should be in many ways. These consent forms are developed from a regulatory framework. What are we required to do to consent and how do we meet those requirements? Sometimes that becomes directly at odds with how do we do this simply, clearly and transparently? And I think as a research community, we have to be able to find a common ground there. That has to include regulatory requirements, that has to include IRBs. When we think about consents and work with our patient communities on this, everybody agrees the consents need to be more simple, except the IRB or maybe the IRB agrees, but it's this tension between how do we make it simple, clear and transparent and not get so bogged down in the regulatory that we lose that intent. Liz Salmi: It's complicated. As a person, I mentioned, I'm a chronic research participant living with a brain tumor for 17 years. I remember enrolling in studies and seeing things that are just so complicated. I'm like, “Well, I'm just going to sign off.” I imagine somewhere somebody who knew more than me said, “I should just fill out this thing.” And then as I switched to the research world, I spent more time digging into, “Wow, this is a really complicated consent,” versus, “This is a really streamlined consent and I love this.” And throughout my work with Dr. George and others on the PE-CGS network, an example of a good consent that's easy for people to understand is what the NIH All Of Us research project did, where they're trying to get a million people, more than that, signed up to be in this longitudinal study. And their consent is to go to their website and they have a whole bunch of short YouTube videos. There's a kind of like a quiz involved and they're animated, they have multiple languages involved. And I signed up for that study and I was like, “This is a beautiful consent.” And it's a very plain language. And more consents like that. If you're looking for a good example, go there. I have not been paid by them in any way. I'm a participant in their study. I'm not sure if you guys and your listeners are aware, but there was I think, October 19th of this year or 2024, there was a special communication published in JAMA on an update on the Helsinki Principles for Medical Research involving human participants. And what they're saying is an ethical update is patient engagement in research, which emphasizes the need for continuous, meaningful engagement with research participants and their communities throughout the research life cycle, before, during and after studies. And so this is what we're talking about here. And it's now been embedded in these updated principles. Dr. Suzanne George: That's really great and I agree with you. I think the All Of Us consent process is very accessible. It feels like you can understand it. But the other thing is that, again, I also am not directly involved with All Of Us, but the other thing about it is that they also have a high-touch way to consent where they have navigators and people that will go into communities in a very resource intensive way. So there's all different ways to go about it. We need to find a way that we can balance the complexity around regulatory and the simplicity and transparency that we need in cancer research. Dr. Davide Soldato: Do you think that in terms of patient engagement we are doing better in academic sponsored research compared to sponsored research? A little bit of a provocative question maybe. Dr. Suzanne George: I think that's a really interesting question. I think this idea of participant engagement and involvement is being infused across the research community. And in part, the FDA has prioritized it as well. I think the industry sees the FDA prioritizing this as well. And I think that there are many companies that are involving participant and advocacy communities in different ways in the study design, in the study process early on. So I think it's happening. Liz Salmi: I'll be spicy. I've been a participant, I've been an investigator, co-investigator on studies and I have been reached out to often by pharma of, “Hey Liz, brain tumor patient advocate, would you be kind of like the poster child of our study or be involved in that way?” And I personally want to have no work in that space. I have no interest. However, I am approached, and other people living with cancer have been approached, by industry about lending their likeness or being commercials. And I don't think there's enough education to patient advocates of what that necessarily means, pros and cons. But I also can't speak on behalf of all of the patient advocates who might want to see that's a way that they could lend their voice and advance research. I personally think that there needs to be more involvement from the academic side of creating spaces where patients can be involved in the co-design of research and they also get compensated for their time fairly at the same level or some version of it in a way so they don't just jump to the pharma side of things. But that's an opinion that I have. Opinions. Dr. Suzanne George: I think it's really interesting the point that you make about providing more awareness or information about what it even means to do these things from a patient side. I certainly don't know that side as well, but I do see, often, the term patient advocate used very frequently in many different contexts that mean many different things. And I think that there's an opportunity there for understanding more about what that really means and what it can mean. Liz Salmi: Yeah. We want to involve patients, we want to do patient engagement. The BMJ or the British Medical Journal, have this new policy in place for patients as reviewers of research. And what I find interesting with the BMJ is they also ask patients to declare their conflicts of interest. So this is kind of a new space. If you're involved in patient research or perhaps working with pharma, patients, if you're involved at that level, should also be declaring their conflicts of interest if they're getting paid by a pharma. Or do I have a conflict now that I'm doing this cool ASCO podcast? Maybe. But do we want to overburden patients with tracking all this information? So it's a new world. The more we have access to information, the more we share information, the more we can read studies and we co-design, there's a new space I think over the next 5 to 10 years where how do we define this in a transparent way. Dr. Suzanne George: Yeah, I think you're right. I know that we're getting long, but I just want to say one other thing about that, which is that you're right. If we're bringing patients in to be partners, then we have to treat each other that way. We have to acknowledge- I think this issue that you raise about compensation and about paying people for their time or acknowledging people for their time, I think that's really important and very under-discussed. Liz and I were at the annual meeting for the PE-CGS and someone was there giving a talk about- this was a guest speaker that was giving a talk about a very large high impact grant and that included a patient advocacy kind of module, let's say. And they put in a specific funding and budget for that component that included compensation for the people- from the people in the advocacy community that were spending their time. And the PI of this project, again, not to get into the details of it, but they were sharing that they got a fair bit of pushback on that. But the PI pushed back and said, “Listen, we're compensating other people for their time. These guys, we want them to be partners, we need to treat them as such.” And I think that also again, kind of we're in a new space, but if we're going to do it right, then we have to acknowledge that we're partners. Dr. Davide Soldato: But I think that maybe an experience like the PE-CGS probably can be also a network for expanding awareness for patient advocates and also for creating sort of a new culture about what does that mean and how can we also improve on that part. Because in the end, if we want to engage, we also need to provide patients with the instruments to engage in a way that we think it's both useful for them, that can make research better, but can also make them at the exact same level as everyone who is participating in that research, which I think it's the bottom line of all the concepts that we are discussing right now. Liz Salmi: Yep. Dr. Suzanne George: Yes, I agree. Dr. Davide Soldato: So I think we have covered a lot of things. Just wanted to make one last reference to a point that Suzanne mentioned earlier, which is the interoperability of systems. And I think that when we come to the cancer genome, that is very important, being able to share information, especially for those diverse and less common cancer types that we were discussing earlier. There is a lot of work in gaining all that information and we need to be able to gather all of that information in the same place to advance research. You were mentioning before that the process is actually very complicated and I was wondering if in the network you are already working on some potential ways to address this type of issue. Dr. Suzanne George: I think our first step is really just calling it out, acknowledging how hard this is and what the barriers are. Oftentimes I think in research, we don't talk enough about what our methodologic barriers are. We talk more about what our results are, but not like how hard it is. But like in our projects, the Count Me In project, my network that I'm involved with, we're doing rare tumors. We can only do the United States and Canada because of privacy issues. And we're doing a completely web based platform. So we have the technology. But the privacy laws are impeding our ability to involve other parts of the world. And even within the United States, it's not as easy as we would like to get records. For example, despite the fact that people are saying, “Yes, use my records.” But then it's like, “Okay. Well, that's not that easy. How are we going to get them?” We had to hire a third party vendor in order to get the records, in order to manage all the different consents and releases that were needed across all these different hospital systems. So I think the first question is just calling it out and then from there working together as a community to try to see what the solutions can be, because we need to come up with those solutions. Liz Salmi: Yeah, we're in the same camp as Dr. George and the fact that of the five partners, we're not associated with one particular institution. So we can reach out around the country and get access to those records. And we need them at multiple points in time, over time and it takes a lot of effort and work. And it's not like you could just, say, call hospital A and they have all the information. It's like all of the calls to all of the other sites. And it's not just from one surgery, it's from two or more surgeries. But also the way that people stay involved, and, by people, I mean patients and family members, there's this promise that at some point you're going to get some sort of information in response. Like, it's the “what's in it for me?” aspect of it. We do interviews with those who've been enrolled in the study, those who could be potential enrollees in the future because they've only had one surgery. And what we're learning overall is there's this altruistic nature that people have of- they want to participate in the research because they're like, “Here's my horrible cancer experience. I know other people are going to go through this as well.” There's this guiding light of “I want to do something, and I'm not going to be the person that creates the cure, discovers the genome or whatever for this particular cancer type. But my little bit of participation in this multiplied by 20, 30, 100, 1000 people, is what is going to lead us to the next phase in development and is going to move the needle for this particular tumor type or other cancer types.” And so what I think the impact in this space and participant engagement isn't just something we figure out, like a little research method and a little finding for one small tumor type, it's like the methods to do that is the big impact. The method around participant engagement can impact even beyond the cancer community. Dr. Davide Soldato: Yeah. As Suzanne was saying, we need to be in a system that really helps us and allows us to do that. So I think that you really have a lot of things to work on inside of the network. Dr. Suzanne George: I think one thing that I would say is I think that this issue of interoperability is acknowledged as a challenge. We refer to several different initiatives across the US where this is supposed to ideally change over time. I think people want it to change over time. I think investigators at the ERTC want it to change over time. I think different countries are working on this. And I think, again, the first step is getting us at the table talking about it, and then figuring out ways to move it forward. And I think it's there. I think that there is the will. We just have to figure out the how and continue to work on that together, because there's just a tremendous opportunity. I live in the rare tumor space, and between the FDA and the EMA and the regulatory, the national and the international research groups, the patient communities, people want this to be solved and I do hope that we will be able to get there. Dr. Davide Soldato: So I would like to thank Liz and Suzanne for joining us today. Dr. Suzanne George: Thanks for having us. Liz Salmi: Thank you. Dr. Davide Soldato: Suzanne, Liz, we appreciate you sharing more on your JCO article titled, “Overcoming Systemic Barriers to Make Patient-Partnered Research a Reality.” If you enjoy our show, please leave us a rating and a review and be sure to come back for another episode. You can find all ASCO shows at asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. DISCLOSURES Liz Salmi Speaking Honoria: Medscape. Research Funding (Inst): Abridge AI, Inc., Yosemite. Dr. Suzanne George Honoraria CStone Pharmaceuticals Consulting or Advisory Role Blueprint Medicines, deciphera, Bayer, Lilly, UpToDate, Research to Practice, MORE Health, Daiichi, Kayothera, Immunicum, BioAtla Research Funding Blueprint Medicines, Deciphera, Daiichi Sankyo RD Novare, Merck, Eisai, SpringWorks Therapeutics, TRACON Pharma, Theseus Pharmaceuticals, BioAtla, IDRx, NewBay Pharma, Acrivon Therapeutics Patents, Royalties, Other Intellectual Property Company name: UptoDate Stock and Other Ownership Interests Abbott Laboratories and Pfizer Recipient: An Immediate Family Member
How many original castles does Japan ACTUALLY have standing? Where is Japan's oldest castle located? When counting castles in Japan, do castle ruins factor in? The Krewe is joined by William de Lange, the author of An Encyclopedia of Japanese Castles & many other Japan-related publications, to get the answer to these questions and so many more!------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts. Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below & our promo code from the episode!Support your favorite NFL Team AND podcast! Shop NFLShop to gear up for football season!Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! ------ Past KOJ Architecture & History Episodes ------Foreign-Born Samurai: William Adams ft. Nathan Ledbetter (Guest Host, Dr. Samantha Perez) (S5E17)Foreign-Born Samurai: Yasuke ft. Nathan Ledbetter (Guest Host, Dr. Samantha Perez) (S5E16)Change in Urban & Rural Japanese Communities ft. Azby Brown (S5E15)KOJ Podcast S5E6 - Inside Japanese Homes & Architecture ft. Azby Brown (S5E6)Kendo: The Way of the Sword ft. Alexander Bennett, 7th Dan in Kendo (S4E16)Jokichi Takamine: The Earliest Bridge Between New Orleans & Japan ft. Stephen Lyman (S4E13)The Chrysanthemum Throne ft. Dr. Hiromu Nagahara [Part 2] (S2E18)The Chrysanthemum Throne ft. Dr. Hiromu Nagahara [Part 1] (S2E17)The Age of Lady Samurai ft. Tomoko Kitagawa (S1E12)------ Links about William de Lange ------An Encyclopedia of Japanese Castles (Amazon)Japan Then & Now (Amazon, Released June 2024)Walking the Edo Sanpu (Amazon, Released August 2024)William's Website------ JSNO Upcoming Events ------JSNO Event CalendarJoin JSNO Today!
In the second episode of "Empowered Intimacy: Getting Your Sexy Back After Breast Cancer," Melissa Berry and Deltra take a deep dive into the difficult challenges they faced in their marriages after their breast cancer diagnoses. They explore how to navigate intimacy, reflecting on their biggest struggles and breakthroughs. Join them as they share personal stories and offer valuable advice for those seeking to rekindle intimacy with their partners after a breast cancer diagnosis. Thank you to our sponsors, Daiichi, AstraZeneca, and Lilly, for making this series possible.
This one goes out to all the ladies out there... well, and the fellas too if you're interested! The Krewe sits down with avid shojo enthusiast Taryn of Manga Lela Instagram/TikTok fame to talk all things shojo. Together they explore the variety of shojo genres, some challenges faced in the shojo industry, & what makes shojo different from those rambunctious shonen titles! Don't miss out!------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts. Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below & our promo code from the episode!Support your favorite NFL Team AND podcast! Shop NFLShop to gear up for football season!Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! ------ Past KOJ Anime/Manga/Pop Culture Episodes ------The Japanese Pop Music Scene ft. Patrick St. Michel (S5E10)Akira Toriyama: Legacy of a Legend ft. Matt Alt (S5E3)The History & Evolution of Godzilla ft. Dr. William (Bill) Tsutsui (S5E1)Thoughts on Godzilla Minus One ft. Dr. William (Bill) Tsutsui (S4Bonus)The History of Nintendo ft. Matt Alt (S4E18)Visiting Themed Cafes in Japan ft. Chris Nilghe of TDR Explorer (S4E15)Japanese Mascot Mania ft. Chris Carlier of Mondo Mascots (S4E8)Tokusatsu Talk with a Super Sentai ft. Sotaro Yasuda aka GekiChopper (S4E6)The Evolution of PokéMania ft Daniel Dockery [Part 2] (S4E3)The Evolution of PokéMania ft Daniel Dockery [Part 1] (S4E2)Japanese Independent Film Industry ft. Award Winning Director Eiji Uchida (S3E18)City Pop & Yu ft. Yu Hayami (S3E14)How Marvel Comics Changed Tokusatsu & Japan Forever ft Gene & Ted Pelc (Guest Host, Matt Alt) (S3E13)Talking Shonen Anime Series ft. Kyle Hebert (S3E10)Japanese Pro Wrestling ft. Baliyan Akki (Part 2) (S3E6)Japanese Pro Wrestling ft. Baliyan Akki (Part 1) (S3E5)Exploring Enka ft. Jerome White Jr aka ジェロ / Jero (S3E1)Japanese Arcades (S2E16)How to Watch Anime: Subbed vs. Dubbed ft. Dan Woren (S2E9)Japanese Theme Parks ft. TDR Explorer (S2E4)Manga: Literature & An Art Form ft. Danica Davidson (S2E3)The Fantastical World of Studio Ghibli ft. Steve Alpert (S2E1)The Greatest Anime of All Time Pt. 3: Modern Day Anime (2010's-Present) (S1E18)The Greatest Anime of All Time Pt. 2: The Golden Age (1990's-2010's) (S1E16)The Greatest Anime of All Time Pt. 1: Nostalgia (60's-80's) (S1E5)We Love Pokemon: Celebrating 25 Years (S1E3)Why Japan ft. Matt Alt (S1E1)------ Links about Taryn/Manga Lela------Taryn's LinksTaryn on TikTokTaryn on InstagramTaryn on Twitter/X------ JSNO Upcoming Events ------JSNO Event CalendarJapan Fest Sign-UpJSNO Annual Meeting RegistrationJoin JSNO Today!
Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma and Biotech world.On September 23, 2024, Lifespan, a healthcare organization, laid off 20% of its executive team as part of a restructuring effort to save $6 million. The FTC sued major pharmacy benefit managers over alleged anticompetitive practices related to insulin prices. Texas Attorney General settled with a generative AI company over accuracy allegations. Steps to minimize the threat of legacy medical devices and the challenges faced by telehealth providers in navigating insurance, compliance, and cash-only models amid state regulations were discussed. The changing landscape of healthcare requires workforce planning strategies to address staffing challenges. Placing AI at the heart of healthcare to improve efficiency and patient care is also highlighted. Additionally, news on cybersecurity risks posed by legacy medical devices, challenges faced by telehealth providers, and industry developments such as new diet plans and games for falls prevention were shared. Healthcare Dive provides in-depth journalism on topics such as health IT, policy & regulation, insurance, digital health, payer-provider partnerships, and value-based care for decision-makers in the healthcare industry.In other news, AstraZeneca and Daiichi's dato-dxd failed to extend lives in breast cancer, adding to previous setbacks in lung cancer. Bristol Myers Squibb is targeting the first new type of schizophrenia drug in three decades. A recent court ruling has revived PhRMA's legal challenge to the Inflation Reduction Act. BMS is laying off employees in New Jersey as part of cost-saving measures. BMS' karxt could soon be the first new schizophrenia drug in decades. Sanofi secured approval for Sarclisa in multiple myeloma and Athira Pharma laid off 70% of its workforce. The BACE credential can help advance a career in biotech. The ongoing battle over drug pricing was also discussed, specifically focusing on insulin and the role of pharmacy benefit managers (PBMs) in inflating costs. The U.S. Federal Trade Commission filed a lawsuit against three major PBMs for allegedly rigging the supply chain to increase insulin prices. Insulin makers like Eli Lilly have set price caps, but the FTC warned all drugmakers about raising list prices for medicines. Big pharma companies are being scrutinized for their efforts in providing access to drugs like insulin in low- and middle-income countries. A report examined the patient reach efforts of 20 major pharma companies in these regions. Overall, the industry is facing pressure to address both pricing and access issues.
Historians Nathan Ledbetter & Dr. Samantha Perez rejoin the Krewe to continue our conversation on foreign-born samurai, this time highlighting the life of William Adams! In this episode, we explore his relationships with both Japanese & non-Japanese while in Japan, the similarities between William Adams's story & House of the Dragon (what?!), how he was a big inspiration for James Clavell's classic novel (and the adaptations) Shogun... AND SO MUCH MORE!------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts. Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below & our promo code from the episode!Support your favorite NFL Team AND podcast! Shop NFLShop to gear up for football season!Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! ------ Past KOJ History Episodes ------Foreign-Born Samurai: Yasuke ft. Nathan Ledbetter (Guest Host, Dr. Samantha Perez) (S5E16)Kendo: The Way of the Sword ft. Alexander Bennett, 7th Dan in Kendo (S4E16)Jokichi Takamine: The Earliest Bridge Between New Orleans & Japan ft. Stephen Lyman (S4E13)How Marvel Comics Changed Tokusatsu & Japan Forever ft Gene & Ted Pelc (Guest Host, Matt Alt) (S3E13)The Chrysanthemum Throne ft. Dr. Hiromu Nagahara [Part 2] (S2E18)The Chrysanthemum Throne ft. Dr. Hiromu Nagahara [Part 1] (S2E17)The Age of Lady Samurai ft. Tomoko Kitagawa (S1E12)The Life & Legacy of Lafcadio Hearn ft. Bon & Shoko Koizumi (S1E9)------ Links about Nate ------Ubisoft's Echoes of History "Japan's First Unifier: Oda Nobunaga"Ubisoft's Echoes of History "Samurai vs Shinobi: The Tensho Iga War"Nate on BlueSky------ JSNO Upcoming Events ------JSNO Event CalendarJoin JSNO Today!
With the exception of military records or a few popular cases, UFO research often gets drawn into an America-centric sphere. Because of this, or other reasons too, the phenomenon is received internationally with heavy reliance on US news and reports. But according to the US Department of Defense in 2023, Japan is a leading hotspot for UFOs as well. In June 2024, the Japanese government launched an 80-person nonpartisan group, including former defense ministers, to study UAP. Japan has three major UFO cases, named after regional areas - Kofu, Kochi, and Hokkaido - but also has mysterious stories like the Utsuro-Bune and the abundance of objects spotted over the Daiichi power plant after the 2011 disaster. Japan also has a Roswell, and a Sedona, in regard to UFO popularity and vortexes. The town is called Iinomachi in Fukushima Prefecture, just outside Fukushima city. Objects and lights have been seen here since at least the 1970s. Just north of the town in the dense forest is the IINO UFO MUSEUM, home to documents, replicas, and books on the subject. Outside is a flying saucer bus stop. Above the museum is Mount Senganmori, which features magnetic anomalies and little alien carvings along its trail. Few know that the Roswell research center and museum, founded in 1991, was not the first of its kind; Kinichi Arai, a Japanese man, formerly in the military, who died in 2002, began the first of its kind museum and research facility in 1979.-FREE ARCHIVE & RSS: https://www.spreaker.com/show/the-secret-teachings Twitter: https://twitter.com/TST___Radio Facebook: https://www.facebook.com/thesecretteachings WEBSITE (BOOKS, RESUBSCRIBE for early show access): http://thesecretteachings.info Paypal: rdgable@yahoo.com CashApp: $rdgable EMAIL: rdgable@yahoo.com / TSTRadio@protonmail.com
Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma e Biotech world.EPRO, or electronic patient-reported outcomes, is increasingly used in clinical trials to improve data accuracy, patient compliance, and reduce administrative burdens. Swing Therapeutics achieved 98% patient compliance in their pilot trial using EPRO, leading to an FDA de novo marketing authorization. EPRO boosts efficiency, saves costs, and improves trial outcomes.The BioSecure Act, which restricts contracts with certain Chinese companies in the US biotech industry, has advanced in the House but still needs Senate support. Bain Capital closed a $3 billion biotech fund and has been acquiring startup companies. Centessa's sleepiness drug showed promising results, lifting the company's shares. New data raise doubts about AstraZeneca and Daiichi's cancer treatment successor. Candid aims to prove the worth of bispecifics in autoimmune diseases.Roivant Sciences has acquired the rights to develop and commercialize Bayer's pulmonary hypertension drug, Mosliciguat, under an in-license agreement worth up to $294 million. Roivant has created a new "vant" called Vant to focus on this project. The Biosecure Act has passed through the U.S. House of Representatives and is set for a Senate vote. AstraZeneca and Daiichi Sankyo's Dato-Dxd failed to significantly improve overall survival in Phase III NSCLC trials, but there is still potential for FDA approval. Terns Pharmaceuticals announced a $125 million raise following positive Phase I data for their oral GLP-1 candidate for obesity.Old Navy is celebrating its 30th anniversary by throwing back to the '90s in a new collection and campaign to enhance its iconic brand. PayPal has launched its largest-ever US ad campaign featuring Will Ferrell, promoting the use of PayPal for both in-store and online transactions. Angela Zepeda, former Hyundai CMO, has been appointed as the global head of marketing for X. Pizza Hut is turning TikTok content into real-world currency for a promotion in the UAE, while Target is targeting pet owners with a collection designed by "fur-fluencers." Marketers are leveraging AI on mobile platforms and genAI is impacting marketing strategies.Merck's Keytruda, a leading immuno-oncology drug, has been highly successful in treating various cancers and has become the world's top-selling drug. However, determining the true value of a drug like Keytruda involves more than just sales numbers. U.S. drug pricing watchdog ICER tracks pricing decisions and their impact, but the industry is exploring new methods to factor in aspects like disability and income disparity. A new formula that considers "standard of living" is being explored to offer a different perspective on pricing in the pharmaceutical industry. As Keytruda celebrates its 10-year anniversary on the market, the impact of this cancer drug and other immunotherapies is being analyzed, along with the future direction of the field.
Joined by guest host Dr. Samantha Perez, the Krewe sits down with Princeton's Nathan Ledbetter to unpack how the term "samurai" evolved over the centuries and dig into foreign-born samurai, specifically Yasuke. Uncover everything they you need to know about the African samurai right here in this episode... AND SO MUCH MORE!------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts. Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below & our promo code from the episode!Support your favorite NFL Team AND podcast! Shop NFLShop to gear up for football season!Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! ------ Past KOJ History Episodes ------Kendo: The Way of the Sword ft. Alexander Bennett, 7th Dan in Kendo (S4E16)Jokichi Takamine: The Earliest Bridge Between New Orleans & Japan ft. Stephen Lyman (S4E13)How Marvel Comics Changed Tokusatsu & Japan Forever ft Gene & Ted Pelc (Guest Host, Matt Alt) (S3E13)The Chrysanthemum Throne ft. Dr. Hiromu Nagahara [Part 2] (S2E18)The Chrysanthemum Throne ft. Dr. Hiromu Nagahara [Part 1] (S2E17)The Age of Lady Samurai ft. Tomoko Kitagawa (S1E12)The Life & Legacy of Lafcadio Hearn ft. Bon & Shoko Koizumi (S1E9)------ Links about Nate ------Ubisoft's Echoes of History "Japan's First Unifier: Oda Nobunaga"Ubisoft's Echoes of History "Samurai vs Shinobi: The Tensho Iga War"Nate on BlueSky------ JSNO Upcoming Events ------JSNO Event CalendarJoin JSNO Today!
With the exception of military records or a few popular cases, UFO research often gets drawn into an America-centric sphere. Because of this, or other reasons too, the phenomenon is received internationally with heavy reliance on US news and reports. But according to the US Department of Defense in 2023, Japan is a leading hotspot for UFOs as well. In June 2024, the Japanese government launched an 80-person nonpartisan group, including former defense ministers, to study UAP. Japan has three major UFO cases, named after regional areas - Kofu, Kochi, and Hokkaido - but also has mysterious stories like the Utsuro-Bune and the abundance of objects spotted over the Daiichi power plant after the 2011 disaster. Japan also has a Roswell, and a Sedona, in regard to UFO popularity and vortexes. The town is called Iinomachi in Fukushima Prefecture, just outside Fukushima city. Objects and lights have been seen here since at least the 1970s. Just north of the town in the dense forest is the IINO UFO MUSEUM, home to documents, replicas, and books on the subject. Outside is a flying saucer bus stop. Above the museum is Mount Senganmori, which features magnetic anomalies and little alien carvings along its trail. Few know that the Roswell research center and museum, founded in 1991, was not the first of its kind; Kinichi Arai, a Japanese man, formerly in the military, who died in 2002, began the first of its kind museum and research facility in 1979.-FREE ARCHIVE & RSS: https://www.spreaker.com/show/the-secret-teachingsTwitter: https://twitter.com/TST___RadioFacebook: https://www.facebook.com/thesecretteachingsWEBSITE (BOOKS, RESUBSCRIBE for early show access): http://thesecretteachings.infoPaypal: rdgable@yahoo.comCashApp: $rdgableBuy Me a Coffee: https://www.buymeacoffee.com/tstradioSUBSCRIBE TO NETWORK: http://aftermath.mediaEMAIL: rdgable@yahoo.com / TSTRadio@protonmail.com
Baseball: Kanto Daiichi, Kyoto International Set for Summer Koshien Final Fri.
High School Baseball: Tokyo's Kanto Daiichi Reaches Koshien Tourney Final
High School Baseball: Kanto Daiichi Makes Koshien Last 4 for 1st Time in 9 Yrs
What's your Japan version of "Ain't Dere No More"? Between changes within the megalopolis of Tokyo to the struggles of keeping countryside communities alive & thriving, Azby Brown returns to the podcast to discuss urban migration, depopulation, revitalization projects, centuries-old feuds raging on today... AND SO MUCH MORE!------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts. Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below & our promo code from the episode (timestamps [hh:mm:ss] where you can find the code)!Support your favorite NFL Team AND podcast! Shop NFLShop to gear up for football season!Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! (00:53:00)------ Links about Azby ------KOJ Podcast S5E6 - Inside Japanese Homes & Architecture ft. Azby BrownAzby's WebsiteTitles by Azby (Amazon)Azby on Twitter/XAzby on IG------ JSNO Upcoming Events ------JSNO Event CalendarJoin JSNO Today!
Join us each week as we do a quick review of three compelling stories from the pharma world — one good, one bad and one ugly. Up this week: The good — Verona wins FDA nod for COPD The bad — FDA issues CRL to Merck-Daiichi lung cancer ADC The ugly — Glenmark recalls 114 batches of potassium chloride capsules
Jason T. Jacobson, MD, FHRS, Westchester Medical Center-New York Medical College, is joined by William H. Sauer, MD, FHRS, Brigham and Women's Hospital, and Christian Thomas Ruff, MD, Brigham and Women's Hospital to discuss a meta-analysis of the 2 recent randomized controlled trials of oral anticoagulation vs aspirin and placebo for atrial high rate episodes detected by cardiac implanted electronic devices. The trials included are NOAH-AFNET6 and ARTESIA, which reported discordant results. When analyzed together, this study shows that anticoagulation does decrease embolic risk in this patient population. https://www.hrsonline.org/education/TheLead https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.067512 Host Disclosure(s): J. Jacobson: Honoraria/Speaking/Consulting: American College of Cardiology, Zoll Medical Corporation, Research: Abbott, Phillips, Stock, Privately Held: Atlas 5D Contributor Disclosure(s): C. Ruff: Honoraria/Speaking/Consulting: Bayer Healthcare Pharmaceuticals, Janssen Pharmaceuticals, Daiichi, Boehringer Ingelheim, Bristol-Myers Squibb, Portola Pharmaceuticals, Research: Daiichi, MedImmune W. Sauer: Honoraria/Speaking/Consulting: Biotronik, Biosense Webster, Inc., Abbott, Boston Scientific, Research: Medtronic
What's the first thing that comes to mind when you think of a Japanese home? Is it the scent of tatami mats? Shoji-style sliding doors? What are other major components and influences that go into making the Japanese home, be it traditional or modern, as well as Japanese Architecture as a whole? With special guest Azby Brown, the Krewe is going to dig into that today!------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts. Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below & our promo code from the episode (timestamps [hh:mm:ss] where you can find the code)!Liquid IV Offer Link to save 20% Off your Entire Order! (00:03:28)Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! (00:53:00)------ Links about Azby ------Azby's WebsiteTitles by Azby (Amazon)Azby on Twitter/XAzby on IG------ JSNO Upcoming Events ------JSNO Event Calendar2024 Matsue-New Orleans Sister City Exchange Program Application
13 years have passed since the catastrophic events of March 11th's Great East Japan earthquake & tsunami, along with the nuclear disaster at the Fukushima Daiichi Plant. Fukushima, as a prefectural community, has demonstrated incredible resiliency in its recovery efforts, but unfortunately there still is a residual stigma attached to the prefecture. One way that Fukushima has been combating that reputation is through some creative initiatives involving education through first-hand experiences. Today, the Krewe sits down with William McMichael, an integral figure in these projects, to discuss how Fukushima University's Fukushima Ambassadors Program & Hope Tourism have helped introduce the world to Fukushima in a different way. ------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts. Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below & our promo code from the episode (timestamps [hh:mm:ss] where you can find the code)!Liquid IV Offer Link to save 20% Off your Entire Order! (00:01:06)Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! (00:57:54)------ Fukushima-Related Links ------Hope Tourism HomepageFukushima Ambassadors ProgramOur Fukushima (Student-run Facebook Page)Our Fukushima (Instagram)Fukushima Hamadori (VR Experience)Krewe of Japan S1E6 "3/11: A Tribute to Tohoku's Recovery & Resilience"Article - Leveraging Fukushima's "Hope Tourism" for a Disaster-Resilient Future (Japan Gov't Website)Article - Changing Hearts & Minds on Reality of Fukushima's Recovery (The Japan Times)Article - Canadian Leads Program on Fukushima for Overseas Students (Kyodo News)William McMichael on LinkedInContribute Today - Japan Disaster: Relief & Recovery via Peace Winds AmericaContribute Today - Emergency Response to Noto Peninsula Earthquake via AAR Japan------ JSNO Upcoming Events ------JSNO Event Calendar2024 Matsue-New Orleans Sister City Exchange Program Application
SEASON 5 is (almost) HERE!! This is your one week warning... as the KREWE is BACK on Friday, March 8th, 12 noon CST. Here's a sneak peek & preview of gusts & episodes to come:- The History & Evolution of Godzilla ft. Dr. William Tsutsui- Witness Fukushima's Recovery through Educational Tourism ft. William McMichael- Japanese Self-Study Strategies ft. Walden Perry- Visit Miyagi Prefecture ft. Ryotaro Sakurai & William Woods- Japanese Homes, Architecture & Aesthetic ft. Azby Brown- A Glimpse into the World of Geisha ft. Peter Macintosh- Japanese Music Scene ft. Patrick St. Michel- Pioneering Louisiana's Only High School Japanese Program ft. Dr. Tara Sanchez- Scoping Out Shojo Anime & Manga ft. Taryn of Manga Lela- as well as some other returning guests like Matt Alt, Rob Dyer, & Kate KitagawaGet Hyped! Subscribe today on your favorite podcast app! See you on March 8th!------ About the Krewe ------The Krewe of Japan Podcast is a weekly episodic podcast sponsored by the Japan Society of New Orleans. Check them out every Friday afternoon around noon CST on Apple, Google, Spotify, Amazon, Stitcher, or wherever you get your podcasts. Want to share your experiences with the Krewe? Or perhaps you have ideas for episodes, feedback, comments, or questions? Let the Krewe know by e-mail at kreweofjapanpodcast@gmail.com or on social media (Twitter: @kreweofjapan, Instagram: @kreweofjapanpodcast, Facebook: Krewe of Japan Podcast Page, TikTok: @kreweofjapanpodcast, LinkedIn: Krewe of Japan LinkedIn Page, Blue Sky Social: @kreweofjapan.bsky.social, & the Krewe of Japan Youtube Channel). Until next time, enjoy!------ Support the Krewe! Offer Links for Affiliates ------Use the referral links below & our promo code from the episode (timestamps [hh:mm:ss] where you can find the code)!Liquid IV Offer Link to save 20% Off your Entire Order! (00:12:38)Zencastr Offer Link - Use my special link to save 30% off your 1st month of any Zencastr paid plan! (00:13:54)------ JSNO Upcoming Events ------JSNO Event Calendar2024 Matsue Exchange Program ApplicationJoin JSNO Today!
Show Notes: https://wetflyswing.com/568 Presented by: Togiak River Lodge, Visit Helena, MT, Smitty's Fly Box Sponsors: https://wetflyswing.com/sponsors Today, Robert Chiasson gives us his biggest tips and tactics on finding and catching Atlantic salmon on a dry fly. He also shares a story on what it felt like to land and see this 48-inch Atlantic salmon caught on the surface with a bomber. Robert is the best person you can find if you want to fish the Margaree River and the waters of Nova Scotia and Cape Breton. You'll find out how to dead drift a fly, how to fish a seam, how to find those fish in that seam with a dry, why the reach cast is a great cast to know, and the best hook for Atlantic salmon. Episode Chapters with Robert Chiasson on Atlantic Salmon 1:20 - Robert grew up learning to salmon fish on the Chéticamp River and eventually became a guide there. He has been guiding regularly since 1992. 2:33 - The Margaree has the largest run of Atlantic Salmon in Cape Breton. He says that it's a very friendly and relaxed river to fish in. He tells more about the Margaree for those who are planning a fly fishing trip there. 7:42 - They fish from June to the end of October. In the first couple of weeks of June, they mostly fish wet flies. By mid to late June, they're heavy into the dry fly season. About 80% of his fly choices throughout the summer are dry flies. 10:30 - In the summer, he suggests using a one-handed rod because dries are better presented with single-handed rods. He also likes switch rods. In the fall, he prefers the larger and longer spey rods. 16:10 - We dig deeper into his recommended setup for catching Atlantic salmon in his area. He also gives an important note on Atlantic salmon fishing. 19:28 - He says that when you get into the river, the first thing to look at is the configuration of the flow, so look for the fastest-moving water. And then on the edge of the fast-moving water is the seam. That's where you'll find fish. 21:30 - Robert doesn't cast his dry flies upstream a lot because he likes to lead with the fly. He tells more about his cast presentation for Atlantic salmon. 24:06 - He describes to us what a good day fishing in the Margaree River looks like. He says that one a day is a good day. 30:58 - He tells us about the biggest Atlantic salmon he has seen which he grabbed the tail with two hands. 36:30 - We dig into reels, particularly the click and pawl versus a drag reel in catching Atlantic salmon. 42:05 - He describes how he builds a leader. Straight eight is what they fished growing up. 43:40 - He tells us how different is fishing in Labrador versus in the Margaree. 49:32 - He uses the Daiichi 2110 down eye for the hooks, which is his go-to hook for dry flies. 51:30 - He gives a valuable tip on not losing an Atlantic salmon. 55:40 - He shouts out to some conservation groups such as the Margaree Salmon Association, the Nova Scotia Salmon Association, the Atlantic Salmon Federation, and the Chéticamp River Salmon Association. They have done a lot of great work on Atlantic salmon conservation. 56:40 - He says that a big factor that affects the Atlantic salmon runs is commercial fishing in Greenland. 58:54 - He recommends some places to stay in for those who are planning to go to their area for a fly fishing trip. 1:00:03 - He tells us some history on the Margaree and Cape Breton. Show Notes: https://wetflyswing.com/568
Good morning from Pharma and Biotech Daily, the podcast that gives you only what's important to hear in the Pharma and Biotech world. Today, we have several news updates from the industry. Let's dive in.Cigna has sold its Medicare businesses to HCSC for $3.7 billion, exiting a sector that has seen its earnings potential shrink. Despite the sale, Cigna still sees Medicare Advantage as an area for future growth. In other news, the No Surprises Act prevented 10 million surprise bills in the first nine months of 2023, according to insurer groups AHIP and BCBSA. However, they also criticized providers for allegedly abusing the billing dispute resolution process set up by the law. Tenet Healthcare plans to sell four California hospitals to UCI Health for $975 million as part of its efforts to reduce debt. An AI-powered solution is being touted as a way to alleviate the critical shortage of medical coders and boost efficiency and revenue in healthcare systems.In the biotech world, Arch is raising $3 billion for startup investing, continuing its track record of creating and investing in biotech startups. Vertex's non-opioid drug showed positive results in a major trial for pain relief, although it fell short compared to a widely prescribed opioid on a secondary goal. Cell therapy for lupus is gaining attention, with several drugmakers conducting trials in this area. Biogen has decided to discontinue its controversial drug Aduhelm and return the rights to the original developer. AstraZeneca and Daiichi are seeking FDA approval for their drug Enhertu as a "tumor agnostic" treatment. Roche has made changes to its early-stage pipeline, focusing on experimental programs for obesity.In recent developments, Philips has stopped selling sleep and respiratory devices in the US due to a consent decree from the FDA. Teleflora used a documentary approach in its marketing campaign to overcome cynicism about love, while Lay's released time-loop ads inspired by the movie "Groundhog Day." Ocean Spray revealed its first major brand overhaul in over 20 years, and Miller Lite turned fans into walking beer ads for the Super Bowl. McDonald's also made headlines with its Hamburglar character hitting the road in a getaway vehicle. Pepsi Wild Cherry created excitement around the Super Bowl with a Vegas sphere takeover.Cigna is still interested in the Medicare Advantage market despite selling its Medicare division. Providence plans to settle allegations of not fulfilling charity care obligations. Walgreens has confirmed additional layoffs as part of its ongoing efforts to achieve cost savings. The Department of Health and Human Services has finalized a rule on telehealth at opioid treatment programs. A new study found that the availability of telehealth for mental healthcare varies by state. Healthcare executives must consider workforce and consumer concerns about generative AI, according to a survey.Alto Neuroscience and Fractyl Health have both gone public in separate IPOs, joining the recent surge of biotech IPOs. The CMS has sent initial price proposals to drugmakers as part of efforts to reform drug pricing. Kyverna Therapeutics is planning an IPO to support the development of its anti-CD19 CAR-T therapies. The Department of Health and Human Services released new data showing that Americans pay significantly more for prescription drugs compared to other developed countries. The ASGCT Annual Meeting will cover topics such as genome editing, muscular dystrophy, and cell and gene therapy.In financial news, AbbVie reported a beat in its Q4 earnings but expects sales decline in oncology and immunology. Bristol Myers Squibb exceeded Q4 estimates and is looking towards new products and M&A following exclusivity loss. Merck posted $60 billion in sales for 2023 driven by Keytruda and HPV vaccine. GlaxoSmithKline saw an increase in sales thanks to vaccines for RSV and shingles. Takeda reported lower profits but closed a $300 million deal with Protagonis
Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in the Pharma and Biotech world. Sarepta Therapeutics has released data on its new drug for Duchenne muscular dystrophy, showing potent boosting of dystrophin protein production. However, some side effects, including electrolyte imbalances, were also highlighted. Astrazeneca and Daiichi are seeking FDA approval for their drug Enhertu as a "tumor agnostic" treatment, and the FDA is currently reviewing their application. Bristol Myers has received positive data from a trial of a subcutaneous formulation of Opdivo in kidney cancer, showing similar efficacy to the intravenous formulation. Biotech IPOs continue to be an important source of funding for the industry, with Alto Neuroscience and Fractyl Health preparing for initial stock offerings. Merck Manuals is focusing on a "one health" approach, integrating human, animal, and environmental health in medical education and practice.Philips has announced that it will stop selling sleep and respiratory devices in the US due to a consent decree from the FDA. This decision comes as Philips faces regulatory scrutiny and potential legal action related to quality issues with its sleep apnea devices. Medical device companies Stryker, Boston Scientific, and BD are set to post their earnings this week. Absolutions has received FDA breakthrough designation for its abdominal wall closure device, aiming to reduce the risk of hernia by distributing suture tension over a large area of tissue. Globus has laid off employees from NuVasive following their merger. Masimo has forced Apple to redesign its smartwatches in a long-running patent dispute.The pharmaceutical industry is in a race to develop groundbreaking drugs for pain relief. Tanezumab, developed by Eli Lilly and Pfizer, was dropped due to safety concerns. Attention has turned to Vertex Pharmaceuticals' candidate vx-548, which has shown positive results in phase 2 trials for chronic nerve pain. South Rampart Pharma has won fast track designation for its novel drug that activates pain signaling pathways without causing liver and kidney toxicities. Tonix Pharmaceuticals is repurposing an existing technology for the treatment of fibromyalgia, with positive late-stage results. These developments offer hope for patients suffering from chronic pain conditions and could generate significant revenue for the companies involved.Overall, these developments highlight ongoing challenges and changes in the medtech industry, including regulatory scrutiny, mergers, and patent disputes. Medtech companies must navigate these complexities while leveraging connected ecosystems, data, and strategic planning to drive innovation in healthcare.Thank you for tuning in to Pharma and Biotech daily. Stay informed, stay ahead.
Daiichi Sankyo has drawn more value from its antibody-drug conjugate pipeline via a $4 billion deal with Merck & Co. On the latest BioCentury This Week podcast, BioCentury's editors analyze the deal in the context of the burgeoning ADC space and size up the assets that Merck is in-licensing as well as how the deal fits with Daiichi's pipeline strategy.The editors break down Monday's $7.1 billion deal by Roche for the Telavant subsidiary of Roivant Sciences, the latest in the evolving TL1A space; and offer highlights from BioCentury's deep dive into how academics and biotechs are expanding the therapeutic potential of base editors.
Audio roundup of selected biopharma industry content from Scrip over the past business week. In this episode: Daiichi's huge ADC deal with Merck; mixed data for Rybrevant at ESMO; Pfizer girds for cost cuts; myeloma helps J&J's Q3; and five key points for cell and gene Meeting on the Mesa. https://scrip.citeline.com/SC149230/Quick-Listen-Scrips-Five-MustKnow-Things
Show Notes: https://wetflyswing.com/516 Presented by: Stonefly Nets, Daiichi, Angler's Coffee Sponsors: https://wetflyswing.com/sponsors Matt Lewis of Redeye Bass Fly Fishing shares his insights on redeye bass and their vital conservation efforts in the Native Fish Coalition to preserve its native population. We will also uncover the unique characteristics of redeye bass, their habitat preferences, and the exciting pursuit of the Redeye Slam. Episode Chapters with Matt Lewis on Redeye Bass 1:40 - Matt tells us how he got into fly fishing. Initially, his focus was to become a medical doctor. He spent decades doing cancer research, but his outlet has always been fishing. 3:15 - One of his friends introduced him to redeye bass fly fishing. He grew up in Alabama where the species is abundant. When his interest grew, he got frustrated that there were limited resources for that species at that time. 6:00 - That led him to write and release a book in January 2018 entitled Fly Fishing for Redeye Bass: An Adventure Across Southern Waters. 9:38 - We dig into the distribution of redeye and other similar species. They exist mostly in Alabama, Georgia, and South Carolina. 13:50 - He tells us what a fall line is. 16:00 - He talks about fishing redeye bass which he says are aggressive top-water eaters very much like brook trout. His favorite bug to use is chartreuse or yellow popper. Any kind of foam attractor like hopper patterns also works well. 18:23 - He mentions East Alabama Fly Fishing which offers guide services in Tallapoosa River for bass fishing. 19:50 - He shares some concerns about the population of redeye bass such as the moving of species to where they don't belong and habitat disturbance. These would have long-term effects on their native population. 28:00 - He briefly talks about their spawning. 29:36 - I ask him about how he got connected with Dorsal Outdoors leading them to make a film called "A Slam That Saves". The film features him and Mary Beth Meeks attempting to catch a "Redeye Slam" in one day. 38:46 - The biggest conservation group that he has worked with was the Native Fish Coalition, a national non-profit organization. He also has worked as an advisory board member for a local riverkeeper organization. 43:35 - He encourages everyone to educate themselves and others on the danger of moving fish around, and to get involved with conservation groups. 45:55 - We give a shout-out to Angler's Coffee. Matt prefers dark roast coffee with bold flavors like the Muddler's Blend from Angler's Coffee. He also gives a shout-out to his go-to fly shop which is the Deep South Outfitters. 48:32 - Aside from redeye bass, the other top species you can fish in Alabama are smallmouth bass, largemouth bass, spotted bass, and panfish among others. He's currently writing a fly fishing guidebook for Alabama. 52:36 - Matt says pursuing redeye bass fishing is growing the sport because it's the easiest entry to fly fishing. 55:06 - He shares a fun fact about the species. 56:53 - I ask about the smallmouth bass distribution. 57:30 - He likes listening to podcasts when driving. Aside from listening to our podcast, he also likes The MeatEater Podcast and The Orvis Fly-Fishing Podcast wherein he was also interviewed last year. 58:48 - He gives a call to action to support the conservation of the redeye bass population. Show Notes: https://wetflyswing.com/516
William H. Sauer, MD, FHRS, CCDS, of Brigham and Women's Hospital is joined by guests Erik Andrews, MD, MPH, and Christian Thomas Ruff, MD, MPH, of Brigham and Women's Hospital to discuss Safety of Switching from a Vitamin K Antagonist to a Non-Vitamin K Antagonist Oral Anticoagulant in Frail Older Patients with Atrial Fibrillation: Results of the FRAIL-AF Randomized Controlled Trial. In the FRAIL-AF clinical trial, there were more bleeding events when elderly patients were switched from warfarin to rivaroxaban, apixaban, edoxaban, or dabigatran. https://www.hrsonline.org/education/TheLead https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.066485 Host Disclosure(s): W. Sauer: Honoraria/Speaking/Consulting Fee: Biotronik, Biosense Webster, Inc., Abbott, Boston Scientific; Research (Contracted Grants for PIs Named Investigators Only): Medtronic Contributor Disclosure(s): E. Andrews: No relevant financial relationships with ineligible companies to disclose. C. Ruff: Honoraria/Speaking/Consulting Fee: Bayer Healthcare Pharmaceuticals, Janssen Pharmaceuticals, Daiichi, Boehringer Ingelheim, Bristol-Myers Squibb, Portola Pharmaceuticals; Research (Contracted Grants for PIs Named Investigators Only): Daiichi, MedImmune
Audio roundup of selected biopharma industry content from Scrip over the past business week. In this episode: Biomarin's next chapter; Amgen's obesity plans; Daiichi's new ADC data; Acelyrin hit by clinical failure; and Skyrizi beats Stelara in Crohn's. https://scrip.citeline.com/SC149072/Quick-Listen-Scrips-Five-MustKnow-Things
Show Notes: https://wetflyswing.com/502 Presented By: Togens Fly Shop, Daiichi, Jackson Hole Fly Company, Angler's Coffee Today we dive into the fascinating world of fishery science and conservation with James Suleski of the Pennsylvania Native Fish Coalition. James is on a mission to bridge the gap between anglers and fisheries scientists. We explore the intricate challenges faced by native brook trout, like climate change and the impact of invasive brown trout. Tune in to learn more about the strategies, misconceptions, and hopes for protecting these precious aquatic inhabitants. Native Fish Coalition Show Notes with James Suleski 2:45 - James is a board member of the Pennsylvania Native Fish Coalition, where he specializes in science communication. He distills complex fishery science research into easily understandable messages for the general audience. 03:55 - Native Fish Coalition is a grassroots, donor-funded 501(c)(3) nonprofit dedicated to protecting, restoring, and advocating for native fish. 04:20 - James says he's just your regular angler who found his way into Pennsylvania's fly fishing scene after college and grad school. There he noticed that anglers and fisheries scientists had completely different takes on what was going on with native fish species, especially brook trout. Native Brook Trout in Pennsylvania 06:00 - James highlights two critical factors affecting native brook trout: climate change and invasive fish species. While climate change is widely acknowledged as a significant issue, the impact of invasive species is often overlooked in discussions about brook trout conservation. 14:40 - James clarifies the misconception about the term "invasive brown trout". He emphasizes that efforts to address this issue are not about removing them from well-known fisheries on a large scale. Instead, it involves carefully selected smaller streams with barriers to protect native brook trout populations. 17:40 - Selective conservation efforts in smaller streams where it's ecologically and socially feasible include stocking reform, catch and release regulations, and controlled harvest of non-native trout species. 41:00 - James remains optimistic because Pennsylvania hasn't yet explored cost-effective management strategies. One such approach is stopping the stocking invasive trout, which has shown promise in small streams. 47:00 - James highlights Dr. Shannon White's research on brook trout, which challenged the previously held belief that brook trout were sedentary. 58:00 - According to the International Union for Conservation of Nature, roughly a third of freshwater fish are at risk of extinction. 1:00:00 - Native Fish Coalition's strategy involves educating the public, encouraging them to reach out to legislators for stocking reforms, and fostering dialogue to promote responsible conservation practices. Show Notes: https://wetflyswing.com/502
After the 2011 Fukushima Daiichi disaster in Japan there was an outcry over nuclear energy, but only for a short period of time. The mainstream media covered the story for ratings, usually downplaying the dangers, while the alternative media painted the meltdown as the end of all life as we know it. Radioisotopes were found a year later in kelp near Southern California; radioactive material was also found in San Francisco as recent as 2018; and even NOAA Fisheries found elevated levels of radiation in some tuna fish. In 2017 the story became widespread again with reports of massive radiation spikes up to 530 sieverts per hour inside Reactor 2. This resulted in robots being destroyed when sent inside. The Japanese government also coerced residents back into the surrounding countryside sooner than later after the disaster under threats of losing financial assistance. Now the Japanese government and TEPCO, Tokyo Electric Power Co., are going ahead with plans to dump 540 Olympic swimming pools worth of tritium-contaminated wastewater into the ocean. Reportedly, the “water was treated with a special filtering system that remove all the radioactive elements except tritium.” What gets forgotten is that it's not so much the current water dumping that is the issue, but the disaster itself which dumped unknown amounts of other radioactive materials into the ocean and atmosphere, including high levels of cesium which was registering at 250 times the acceptable safe limit in 2012, and again in 2019, although at slightly lesser levels.This show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/5328407/advertisement
It seems this country has become numb to the Opioid Crisis. We can not bury our heads, mandate it away, or think it only happens to bad people. Hopefully, it won't take a personal tragedy in someone's life to understand that this crosses all demographics. We have had Hamilton on before to discuss his alcohol use disorder, but today he will tell us how a back surgery led him to a long relationship with opioids. Let's stop stigmatizing this crisis and come together for solutions as this affects everyone.Hamilton Baiden is Youturn Health's CEO. Prior to joining Youturn Health, Hamilton was Executive Vice President of Sales at Avella Specialty Pharmacy where he oversaw the growth of the business from a small regional pharmacy to the largest independent specialty pharmacy in the nation. His knowledge and understanding of the pharmacy industry were developed throughout his professional career, working in various roles for prominent pharmaceutical manufacturing companies, including MedImmune, Serono, Daiichi, and Sanofi. A graduate of The Citadel in Charleston, SC, with strong ties to his community, Hamilton served as Chairman of the Board of Directors for a nonprofit organization dedicated to animal welfare, Altered Tails, and currently serves on the National Board of the American Liver Foundation Southwest Division. Hamilton is also in recovery and committed to helping others.
Seaver Wang's academic training in oceanography makes him a knowledgeable source for discussing Japan's release of tritiated water from Fukushima Daiichi into the Pacific Ocean, a process that began last week. In addition, Wang, the co-director of the climate and energy program at the Breakthrough Institute, discusses future demand for metals and minerals, “radiophobia,” the challenges facing nuclear power, solar supply chains, and China's “cultural erasure” of the Uyghur population in Xinjiang province. (Recorded August 28, 2023)
Spegillinn 23. ágúst 2023 Umsjónarmaður: Ævar Örn Jósepsson Tæknimaður: Mark Eldred Stjórn fréttaútsendingar: Margrét Júlía Ingimarsdóttir. Fjöldi fólks kom saman á fundi sem á þriðja tug hjálpar- og mannréttindasamtaka boðaði til vegna aðstæðna hælisleitenda sem sviptir hafa verið allri þjónustu. Valur Grettisson fór á fundinn og ræddi við Arndísi Önnu Kristínar-Gunnarsdóttur, þingmann Pírata. Yevgeny Prigozhin, stofnandi og leiðtogi hins svokallaða Wagner-málaliðahóps, var á farþegaskrá flugvélar sem fórst skammt frá Moskvu síðdegis. Leikmaður íslenska landsliðsins í knattspyrnu hefur verið kærður fyrir kynferðisbrot. Hann verður ekki valinn næsta landsliðshóp. Rætt er við Vöndu Sigurgeirsdóttur, formann KSÍ. Norskur fiskeldisrisi hefur verið sektaður vegna mikils fiskidauða og fjölda sárra fiska í kvíum þess. Fyrsta indverska loftfarið lenti á tunglinu í dag. Rolling Stones virðast ætla að gefa út sína 31. breiðskífu í september, flestum að óvörum. --- Ítrekaðar stýrivaxtahækkanir Seðlabankans hafa hægt á hagkerfinu, að dómi forseta viðskiptadeildar Háskólans í Reykjavík. Fleira þurfi að koma til ef koma á böndum á verðbólguna og þar skipti ríkisfjármálin kannski mestu. Anna Kristín Jónsdóttir ræðir við Jón Þór Sturluson. Margt er vel gert í almenningssamgöngum á Íslandi en margt má líka bæta. Ævar Örn Jósepsson ræðir við Daða Baldur Ottósson samgönguverkfræðing. Yfirvöld í Hong Kong ætla frá og með morgundeginum að banna innflutning á sjávarafurðum frá tíu héruðum í Japan vegna ákvörðunar japanskra stjórnvalda um að sleppa geislavirku kælivatni frá Daiichi kjarnorkuverinu í Fukushima út í sjó. Ásgeir Tómasson segir frá.
Spegillinn 23. ágúst 2023 Umsjónarmaður: Ævar Örn Jósepsson Tæknimaður: Mark Eldred Stjórn fréttaútsendingar: Margrét Júlía Ingimarsdóttir. Fjöldi fólks kom saman á fundi sem á þriðja tug hjálpar- og mannréttindasamtaka boðaði til vegna aðstæðna hælisleitenda sem sviptir hafa verið allri þjónustu. Valur Grettisson fór á fundinn og ræddi við Arndísi Önnu Kristínar-Gunnarsdóttur, þingmann Pírata. Yevgeny Prigozhin, stofnandi og leiðtogi hins svokallaða Wagner-málaliðahóps, var á farþegaskrá flugvélar sem fórst skammt frá Moskvu síðdegis. Leikmaður íslenska landsliðsins í knattspyrnu hefur verið kærður fyrir kynferðisbrot. Hann verður ekki valinn næsta landsliðshóp. Rætt er við Vöndu Sigurgeirsdóttur, formann KSÍ. Norskur fiskeldisrisi hefur verið sektaður vegna mikils fiskidauða og fjölda sárra fiska í kvíum þess. Fyrsta indverska loftfarið lenti á tunglinu í dag. Rolling Stones virðast ætla að gefa út sína 31. breiðskífu í september, flestum að óvörum. --- Ítrekaðar stýrivaxtahækkanir Seðlabankans hafa hægt á hagkerfinu, að dómi forseta viðskiptadeildar Háskólans í Reykjavík. Fleira þurfi að koma til ef koma á böndum á verðbólguna og þar skipti ríkisfjármálin kannski mestu. Anna Kristín Jónsdóttir ræðir við Jón Þór Sturluson. Margt er vel gert í almenningssamgöngum á Íslandi en margt má líka bæta. Ævar Örn Jósepsson ræðir við Daða Baldur Ottósson samgönguverkfræðing. Yfirvöld í Hong Kong ætla frá og með morgundeginum að banna innflutning á sjávarafurðum frá tíu héruðum í Japan vegna ákvörðunar japanskra stjórnvalda um að sleppa geislavirku kælivatni frá Daiichi kjarnorkuverinu í Fukushima út í sjó. Ásgeir Tómasson segir frá.
Show Notes: https://wetflyswing.com/482 Presented By: Jackson Hole Fly Company, Daiichi, Togens Fly Shop Sponsors: https://wetflyswing.com/sponsors Join us for an awesome episode as we catch up with Riverhorse - an angler, writer, filmmaker, musician, surfer, and Patagonia Fly Fish Ambassador. Having been on our podcast twice before, we'll delve into his recent film projects with Patagonia and his other exciting ventures. We discover how you can contribute to preserving the Boundary Waters through SaveTheBoundaryWaters.org. Beyond his wilderness pursuits, Riverhorse talks about how he leads the Editorial of a magazine called, ToneQuest Report Magazine, featuring contributions from rockstars and musicians. Riverhorse talks about his upcoming fly fishing book filled with essays and adventure stories and also talks about the impact of music on people's lives. Plus, a bonus poetry read at the end! Stay tuned for that! Show Notes with Riverhorse Nakadate 03:00 - Riverhorse had been on the podcast twice at WFS 80 and WFS 266. We talked about saving the Boundary Waters. 03:10 - Riverhorse talks about his most recent film projects with Patagonia and others. 06:50 - He noted a project he did with Patagonia called, It's All Home Water - A Northern Light which resulted in a mining ban for 20 years. 08:45 - We encourage people to explore SaveTheBoundaryWaters.org for the latest updates and discover ways you can contribute to preserving the Boundary Waters. 11:50 - Riverhorse is now running the ToneQuest Report Magazine after his friend who used to run it passed away. A lot of other rockstars and musicians contribute to the magazine. Check out their editorial board here. 13:30 - We noted the song, You'll Never Leave Harlan Alive by Darrell Scott. 18:40 - Riverhorse has been stories for Fly Fish Journal. They just issued a recent one called, HEARTLAND DRIFTING: A MINNESOTA PICARESQUE. 19:15 - Riverhorse is writing a fly fishing book with essays and adventure stories that he's been saving up. 20:45 - We had John Gierach on the podcast twice. His recent one is WFS 434. 25:00 - He noted Erin Block who's a female angler and fly fishing writer. Check out her stuff here. 28:00 - Riverhorse talks about how his mom taught him to communicate his feelings honestly. 30:10 - We talk about how to stay optimistic when it comes to conservation. 37:30 - Riverhorse talks about Jeff Liskay and their adventures together. 39:10 - Jeff Liskay is now part of our podcast with his own series The Great Lakes Dude. 46:00 - We hear the story of when Yvon Chouinard wrote Riverhorse a touching letter of appreciation. 47:00 - We had Craig Matthews on the podcast at WFS 427. 52:30 - Riverhorse talks about his poem, Cloud Burst. Listen to his poetry read starting at 55:10. Show Notes: https://wetflyswing.com/482
Michael S. Lloyd, MD, FHRS of Emory University discusses the Impact of Early Versus Delayed Atrial Fibrillation Catheter Ablation on Atrial Arrhythmia Recurrences. He is joined by guests Jason G. Andrade, MD, FHRS of Vancouver General Hospital and Stefan H. Hohnloser, MD, FHRS of J. W. Goethe University. https://www.hrsonline.org/education/TheLead Host Disclosure(s): M. Lloyd: Honraria/Speaking/Consulting Fee: Medtronic, Baylis Medical Company, Boston Scientific Contributor Disclosure(s): J. Andrade: Honoraria/Speaking/Consulting Fee: Medtronic, Bayer Healthcare Pharmaceuticals, Bristol-Myers Squibb, Servier, Baylis Medical Company, Biosense Webster S. Hohnloser: Honoraria/Speaking/Consulting Fee: Boehringer Ingelheim, Bayer Healthcare Pharmaceuticals, Bristol-Myers Squibb, Daiichi, Pfizer Inc., Zoll Medical Corporation, Sanofi
Show Notes: https://wetflyswing.com/472 Presented by: Daiichi, Chota Outdoor Gear Sponsors: https://wetflyswing.com/sponsors Sara Jo Royalty is here to give some fly tying techniques and take us into her story around sailing and music. We find out whether being a professional golf caddy or a professional fly fishing guide is harder, what's new with her new FFI fly fishing event she got coming up this year, and then she knocks it out of the park with a live guitar solo at the end of the episode. Fly Tying Techniques Show Notes with Sara Jo Royalty 2:49 - Sara talks a bit about the recently conducted NW Fly Fishing Expo in Albany which she attended with Caleb Luzader and tied for Daiichi. We had Caleb in the podcast in episode 431. 5:32 - Sara shares how she got into fly fishing and fly tying. She started on the east coast as a commercial long liner. 8:21 - I ask her about how she got sponsored in fly tying and how that works. She sells flies and also ties ones for Daiichi Fly Fishing. She also tells her goals regarding her widely sold patterns. 12:14 - She talks about her process of tying flies or her fly tying zone. 13:42 - Her most common patterns are perdigons, salmon flies, simulators, and chubbies. Her most popular pattern is the pinfish which costs $45 for a 6-inch fly. You can use it for any and every species. If she can only have one fly in the box, that would be her fly. 16:42 - She pretty much ties all year. She also has a guiding license, but she doesn't guide that much. 18:20 - For her, it's harder to guide than to caddy. 19:40 - We dig into how she got sponsored by Daiichi. 21:55 - We had Steve Potter on recently in episode 444. She mentions her go-to hooks from Daiichi. Her favorite hook from them is the 1730 nymph hook. 27:35 - She talks describes their first fishing camp on the Upper Rogue last year. She invited a number of conservation groups in Oregon. Sara is the vice president of Fly Fishers International in the state of Oregon. 32:21 - For this year, the camp will be open to the public. They'll have passes for one night and two-day camping. They'll also have night passes for the music. Free Creatures will be their main band. 34:12 - We dig into her music. She started as a classical pianist when she was three. Now she writes songs and plays the bass and the guitar. She loves classic rock like The White Stripes. 39:36 - Right now, she has been working full-time at Bandon Dunes Golf Resort as a caddy for 10 years. 42:02 - She explains what she does as a caddy, the difficulty of playing golf, and how it's an excellent place to get to know somebody, especially in business. 47:41 - We talk about Tiger Woods and his son, Charlie Woods, who also plays golf. 50:50 - We get back to fly tying and her process. 55:05 - She shares that time when she encountered a different bug that she hasn't seen before. 56:35 - We talk about how she knew Dick Sagara of Temple Fork Outfitters (TFO). Sara has been with TFO for about eight years. 58:18 - She shares her experience when she was living in a boat just sailing for eight years before moving to Oregon. 1:05:26 - We talk about her music. She already has three albums ready to record. 1:06:08 - She promotes their event from August 18th to 20th called Hook, Wine & Thinker - Conservation Campout by Oregon Council of Fly Fishers International at Rogue River Ranch. 1:07:45 - She asks the listeners for stage name suggestions for her. Send your suggestions to her Instagram @SaraJoFlies. Show Notes: https://wetflyswing.com/472
In this episode of "The Top Line," we talk with ViiV's head of R&D, Dr. Kimberly Smith, about new HIV therapies. We also cover Humira's new biosimilar, foreign pharmaceutical investments, and the rest of the week's headlines. To learn more about the topics in this episode: Explore the categories of the Fierce 50 AstraZeneca stock slides as pivotal lung cancer readout on Daiichi-partnered ADC spooks investors Boehringer Ingelheim launches first interchangeable biosimilar to AbbVie's Humira Moderna strikes deal worth up to $1B to develop, produce mRNA drugs in China: reports GSK's ViiV explores novel pathway to bring long-acting HIV med Cabenuva to tough-to-treat patients "The Top Line" is produced by senior podcast producer Teresa Carey. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.See omnystudio.com/listener for privacy information.
Show Notes: https://wetflyswing.com/462 Presented by: Bearvault, Daiichi, Waters West Sponsors: https://wetflyswing.com/sponsors Jani Himanko is here to talk about fishing Finland and give us amazing options and resources on your next trip there. We find out who the other European lodges that run drift boats are. We also get a feel for this lodge and the restaurant that is literally on the river. We get an insight into the European Hall of Fame as well. Everything Finland today! Let's find out how to plan that next European vacation. Fishing Finland Show Notes with Jani Himanko 3:48 - Jani shares his first memory of fly fishing. When he saw the film A River Runs Through It, he was hooked. That's the main reason he became a fly fisher. 5:26 - He tells the interesting story of how he got to own the Kapeenkoski and how he was hesitant at first to take the opportunity. Currently, they also offer rafting and river boarding besides fishing. 11:12 - They have a place in the lodge for dining and private parties like weddings. This is located by the water which he calls a "trout land" because it's a perfect place for trouts to spawn. 14:51 - We talk about why he chose Willie Boats for their drift boats. Their river has a lot of rocks that's why they prefer aluminum boats. For the oars, I recommend him the ones from Sawyer. 16:39 - He describes Finland as very similar to Norway and Sweden in terms of language and culture. He also talks a bit more about Norway. He loves going there every year to fish with his friends. We also covered fly fishing in Norway in episodes 286 and 419. 19:40 - The closes city to their lodge is Jyvaskyla. He tells us how to visit their lodge if you're flying from New York. According to Jani, you won't be able to find Kapeenkonski on the map. Instead, search for Laukaa or Äänekoivisto. 21:51 - He mentions the species you can find in their river such as brown trout, grayling, and pike-perch or zander. They also have 20-30 lb. northern pikes. 23:28 - We dig into their guided fishing and the fishing seasons at Kapeenkoski. They are already sold out for June this year, but they have availability for July to August. 27:25 - We dig into his fishing techniques. Streamer fishing is his favorite fly fishing method. He also shares a bit about his clients' experiences. 31:45 - The best season for dry flies is late July to August. The Goddard caddis in size 10, 12, or 14 is the best pattern to have in your box. He also recommends the Swedish Super pupa. 33:56 - Aside from the fishing laws in Finland, he also makes the local fishing rules. Clients can euro nymph in their waters, but there are some restrictions which he explains further. 37:37 - We go back to dry fly fishing. 39:04 - He gives tips and information on creating your itinerary for Finland. We also talk a bit about European beers and drinks. He drinks Lonkero which he says is the Finnish national drink of fly fishermen. 43:34 - He tells a funny story about that time when he and his wife visited Munich, Germany. 45:10 - I ask him what food they usually serve their clients in Kapeenkoski. We also talk about the seasons and culture in Finland. The best time to visit is summer. 49:15 - He tells his favorite Guns N' Roses song and album. 50:20 - He shares his perspective on how Finland is different from Germany. We also dig into their country's history involving Russia and other European countries. He already has been to the Kola Peninsula in Russia many times to fish. 55:50 - When Jani was 19, he did military training for 11 months and served as a chef there. 59:16 - We talk about hunting in Finland. The species they usually hunt are ducks and moose. 1:00:41 - We dig into how they do streamer fishing. His friend, Mika Vainio, whom he says is one of the best streamer fishermen in Finland created the Musta Kostaja or "The Black Avenger". 1:04:08 - They have this Finnish fly called Surffilauta or the "surfboard tube fly". It's a dry fly, but it's a streamer. 1:07:09 - I ask him about his recognition as the driving force behind fishing tourism in Central Finland. His name can be found in the Finnish Fishing Hall of Fame in Kotka's Maretarium. 1:07:48 - He also writes articles for some fishing magazines such as Metsastys ja Kalastus which he says is the biggest fishing magazine in Scandinavia. 1:08:46 - I ask him about Scandinavia and fishing in Estonia. He also mentions some rivers in Finland that are great for fishing and the species you can find in each of them. 1:12:11 - We talk a bit about hockey in Finland. Jyp Jyvaskyla is his hometown's team. 1:13:40 - He shares his experience in raising his two daughters. 1:16:20 - He used to be a salesman at Rapala, a lure company. For rods and other fishing gear in Finland, he recommends Vision Fly Fishing. Show Notes: https://wetflyswing.com/462
Show Notes: https://wetflyswing.com/444 Presented By: Waters West, Daiichi Steve Potter is here today to dig into deer hair poppers and walks us through the steps in choosing the right hook for the next fly you're about to tie. We find out the best resources for fly-tying materials including some tips on how to tie bass bugs. Steve tells us why he likes it better to live in Florida than in California and where his go-to fisheries are in that area. We also find out how his signature cigar and hummingbird fly came to be... do they really work on fish? Show Notes with Steve Potter 3:40 - Steve retired from the Navy in 1985. He served for 21 years. 10:30 - We had Pat Cohen on the podcast at WFS 107. 11:10 - Steve is a Daiichi fan. He uses the 2546 hooks. 12:30 - Daiichi's got a new specialty hook - 2477. Steve uses this a lot for his game-changer flies. 16:40 - Steve now uses a regal vise but before that, he used a Thompson vise for a long time. 19:55 - For wet flies, Steve uses a 1550 Daiichi Standard Wet Fly Hook. 22:40 - For Wooly Buggers, he recommends using a 2220 Daiichi 28:40 - Steve's go-to fly is a Clauser Minnow for saltwater fishing. He uses 2546 for this one too. 30:00 - We had Enrico Puglisi on the podcast in episode 210 where we talked about how he developed the EP fibers and brushes. 33:20 - Steve lives near a golf course where there are alligator gars, crappies, and black bass in the pond. 36:00 - Steve tells us why he prefers to live in Florida than in California. 38:30 - We noted the 2720 Stinger Hook. 44:50 - We noted Joe Jackson who we had on the podcast in episode 384. He also ties some hummingbirds and other cartoon-like flies. 46:14 - Steve tells the story of when he gave a Kingfisher fly to Jeff Currier which Jeff then gave to Bryan Gregson from Yellowdog Fly Fishing. Bryan caught a rainbow with it in Kamchatka. Show Notes: https://wetflyswing.com/444
Show Notes: https://wetflyswing.com/442 Presented By: Togens Fly Shop, Daiichi, Stonefly Nets, Angler's Coffee Sponsors: https://wetflyswing.com/sponsors Alen Baker is here to take us to the Fly Fishing Museum of the Southern Appalachians. We discover who some of the most famous people are in this region and why they have a drift boat in the museum. We also learn how they are different and similar to some of the museums around the country. Tune in and get ready to reel in some new knowledge! Fly Fishing Museum Show Notes with Alen Baker 03:00 - Alen shares how he got into fly fishing in 1981, noting that he grew up fishing with worm bait. 04:18 - Alen's idea for the Fly Fishing Museum of the Southern Appalachians came to fruition after a trip to Nova Scotia, where he visited the Salmon Museum and was inspired to create something similar for the South. 08:12 - The museum primarily focuses on the people and methods of fly fishing in the mountains, with a special exhibit on Ray Bergman's rod and book called Trout. 10:03 - Alen noted some individuals that have contributed significantly to the history of fly fishing in the Southern Appalachian region, like Fred and Allaine Hall, who were well-known fly pattern creators. 13:05 - The Hall of Fame has expanded to include the Ozarks and is now known as the Southern Fly Fishing Hall of Fame. It includes people like Bernard "Lefty" Kreh, Davy Wotton, Dave Whitlock, and others who have significantly contributed to the fly fishing industry, including conservationists and craftsmen. 14:08 - Other notable museums include the Catskill Fly Fishing Museum, the Fly Fishers International in Livingston, and the American Museum of Fly Fishing. 16:15 - Alen walks us through the museum's Hall of Fame selection process. The museum holds a meet and greet and induction luncheon for their Hall of Fame, followed by a museum tour. They also host a fundraiser to raise money for groups like Casting Carolinas. 19:08 - Bryson City is well known for whitewater rafting on the Nantahala Outdoor Center and the Smoky Mountain Railroad. 20:54 - The new building for the museum will feature aquariums and a cabin-style museum with a vaulted ceiling to house exhibits such as Gary and Wanda Taylor's McKenzie-style drift boat built and run in the southeast. We had Wanda Taylor on the show before. 26:15 - We had a whole mini-season on drift boats before. In one episode, we also had John Bond talk about moving his drift boat to Norway. We also had Jack Dennis in Episode 217. 28:12 - The museum has also established satellite exhibits in various locations to promote the museum and make it more accessible to people who cannot visit the primary site in Bryson City. They currently have seven satellite exhibit locations. 35:14 - Alen wrote My Fly Fishing Playbook and also a book about the museum. He will also write a follow-up book to Fly Fishermen of Caldwell County: North Carolina Life Stories. 38:46 - Alen recommends the Smoky Mountain Fly Fishing and Tuckaseegee Fly Shop for people who want to fly fish in Bryson City. 42:00 - Jim Casada, Don Kirk, and Jim Dean were some of the individuals that influenced Alen in his fly fishing. Don started his own Hall of Fame called Legends of the Fly. 46:18 - If you build it, they will come. -- Alen Baker Show Notes: https://wetflyswing.com/442
Show Notes: https://wetflyswing.com/437 Presented by: Yellowstone Teton, Daiichi, Mavrk Fly Fishing Sponsors: https://wetflyswing.com/sponsors Jay Peck is here to walk us through New York, and some of the rivers he guides and fishes. We discover his egg setup and how he fishes it, some tips for handling your line and fishing on the water, and an overall primer to fish one of the great states in the union. Get ready to put the feed bags on and find out what it means. Fly Fishing New York Show Notes with Jay Peck 3:45 - Jay tells how he got into fly fishing and guiding. He grew up on a dairy farm in New York. 5:12 - We dig into what rivers to fish in New York in December. He says that the Genesee River in Rochester can be an amazing steelhead river during a dry winter. 7:41 - He talks about fishing in New York specifically near where he lives. 8:37 - He mentions the waters in the state that are great for fishing, including the Beaverkill. 9:53 - He talks about the climate issues he encounters when he fishes in New York. 10:47 - He spends a lot of time fishing in the Salmon River. 12:26 - He loves fishing tributaries and fishing for steelhead, salmon, and brown trout. 13:23 - We dig into lake run browns. 14:42 - He describes the gear he uses for steelhead fishing. He recommends a 10ft 7wt for a one-handed rod. He also uses a 10 1/2ft 6wt with a little switch grip on it and a 10ft switch rod. 16:20 - He walks us through how they present a fly to browns and what fly patterns he uses. 18:18 - He talks about his egg pattern setup when fishing for browns. He uses a lot of nickel roll bugs. He uses a lot of nuclear roe bugs and Oregon cheese is his favorite color for that pattern. 19:37 - We dig into the indicator and the advantages of doing an indicator swing. 22:36 - He mentions the leaders and tips he usually carries with him. 23:41 - He further explains how he does the indicator swinging. 24:51 - I ask him about the best time to swing out there and hit steelheads or browns. 26:41 - He explains where the term feed bag came from. 27:14 - He talks about how they swing for salmon. For Chinook salmon, he uses a lot of woolly buggers. 29:27 - He gives more tips and dos and don'ts on salmon fishing. 34:09 - I ask him how they find a great salmon when there's a bunch of spawners. 36:39 - He talks about the flies he likes to use for swinging. They use a lot of egg-sucking leeches for steelheads. 38:55 - The watershed for the Salmon River is the Tug Hill Plateau. They estimate that the river there produces 20 million young-of-the-year (YOY) wild salmon. 41:43 - Mid to late September is the best time to hit some wild fish. 42:23 - Early to mid-October is the best time to catch some browns. 46:29 - He takes us throughout the year of his guiding. This includes the fish cycles and the species he catches for certain months. 48:43 - We dig into northern pikes. 52:43 - New York has fairly diverse species. 53:48 - He gives us a heads-up on what content they have released and will be releasing on their YouTube channel. 55:25 - He gives a quick summary of their video showing how to fix your waders. 56:37 - We do the two-minute drill. 57:14 - After a long day fishing, he likes listening to Metallica. 57:29 - He tells us his one rod for New York to pick. If it's in the tributaries, he'll go for an 11 ft 7wt switch. He has been using rods from Douglas Outdoors. 59:09 - He prefers the white zonker size six for browns. 59:38 - He gives some tips on spey casting. 1:00:25 - He talks about that one trip that he wants to tick off his bucket list. 1:01:18 - He mentions the people who had the biggest influence on him and his business. 1:03:56 - Listeners can find Jay at JayPeckGuidesFlyFishing.com. Show Notes: https://wetflyswing.com/437
Show Notes: https://wetflyswing.com/431 Presented by: Daiichi, Chota Outdoor Gear Sponsors: https://wetflyswing.com/sponsors Mark Brown and Caleb Luzader are here to break down the Chota Outdoor Gear story and some of the unique products they have in their line. Mark takes us into the history of Chota products. We find out how the waders and hippies came to be and what they are all about. We also get the lowdown on who the mastermind was behind Chota way back in the day. Chota Outdoor Gear Show Notes with Mark Brown and Caleb Luzader 2:46 - Mark tells about how he got into fly fishing and how came into Chota Outdoor Gear. 4:18 - He shares a bit about the history of the company and who the mastermind was behind Chota. 6:35 - Caleb also shares how he got into fly fishing and how he started working in the company. 7:20 - Caleb takes us to that time when he got a scholarship for competitive bass fishing in college. 10:42 - I mention our Euro Nymphing School with Pete Erickson. 11:26 - Mark tells more about Frank Bryant, the man behind Chota, and the development of their boots through the years. 15:38 - He also tells about their hippies and the do's and don'ts in storing and taking care of your Chota wading boots. 19:36 - He shares what they think about when working on a new product. They prioritize durability and comfort. 20:25 - Their bestselling footwear is the HYRB-800. 22:54 - Caleb talks about what he does in the company and his focus for this year. 24:40 - He tells the advantages of wearing their waders and hippies while fly fishing. Their goal is to create an affordable but really good wader. 28:50 - Mark breaks down the features of their waders and how to wear them. 33:00 - He talks about how to take care of your waders and the warranty that comes with buying a pair. 36:30 - He tells the material they use for their waders. 39:21 - Caleb shares what size of waders he gets and how he wears them as someone who is taller than the average. 42:35 - Mark tells a bit about the next big things they'll be doing in Chota. 43:34 - He shares the story of how they came up with their cloak wading shoe cover. 50:00 - Caleb talks about their line of products for women which are being carried by their sister company called Miss Mayfly. 52:50 - Caleb shares his observation on the industry in terms of the consumers most of the similar companies cater to. 55:10 - I ask them about the safety while using their products. 56:37 - Caleb shares an idea on waders for kids. 58:28 - Mark talks about the importance of helping the next generations to get into fly fishing to grow and continue the sport. 1:00:21 - We do the two-minute drill. I ask them about their go-to fly, favorite species to fish, bucket list trips, and recommended conservation groups for people to check out. Show Notes: https://wetflyswing.com/431
On March 11, 2011, fifty minutes after a magnitude 9.0 earthquake hit eastern Japan, a tsunami 45-feet high engulfed the nuclear power plant known as Fukushima Daiichi, knocking out electrical power and all the reactors' safety systems. Three reactor cores experienced meltdowns in the first three days, leading to an unimaginable nuclear disaster. The person the Tokyo Electric Power Company called for help was Dr. Chuck Casto.What an amazing and humble gentleman. A great honour and pleasure speaking with Chuck, I am sure you will love this conversation as much as I did.Dr. Charles Casto is a nuclear safety and regulatory professional with 38 years of experience consisting of positions of increasing responsibility, including executive, regulatory, technical, and operational areas of expertise. He was a member of the U.S. Government's Senior Executive Service, and last held the position of NRC, Regional Administrator, Region III, overseeing 23 reactors in eight states as one of the senior administrators for the United States Nuclear Regulatory Commission.Dr. Casto led the integrated US Government and Nuclear Regulatory Commission (NRC) efforts in Japan during the Fukushima nuclear accident in 2011. Working directly with Ambassador Roos, and coordinating with the NRC's Emergency Operations Center in the U.S., he represented the United States Government to the Japanese Prime Minister's Cabinet. His efforts are widely recognized as being a singular contribution to the emergency response during the Fukushima nuclear crisis, through his efforts in coordinating the U.S. government response, providing technical consultation to the Daiichi plant manager and Japan's nuclear agencies, and serving as a liaison to Japanese Prime Minister Kan Naoto during the Fukushima nuclear disaster. After serving for 11 months in Japan as the U.S. government's lead nuclear representative during the crisis, Dr. Casto received the Presidential Distinguished Award (2012) from President Obama; for his contributions to the U.S. government, he previously received the Meritorious Rank Award (2009) from President Bush.Links.LinkedIn: https://www.linkedin.com/in/dr-charles-chuck-casto-990b948/Website: https://www.castogroup.com/Further context can be gained here: https://www.youtube.com/watch?v=ciRRsCIAy6A Thanks for listening. We have some great guests coming up in future pods so get ready to learn. Until next time, enjoy the rest of your week, and stay safe. https://plus.acast.com/s/health-and-safety-conversations. Hosted on Acast. See acast.com/privacy for more information.
2022's slate of life sciences M&A deals didn't meet expectations. But the year still featured tens of billions of dollars worth of biopharma acquisitions. Querida Anderson and Eric Sagonowsky discuss the top deals of the year. Also on the show, Kevin Dunleavy and Fraiser Kansteiner reflect on last year's largest buyout—Amgen's $28 billion deal for Horizon Therapeutics. They explore what it potentially means for the buyer's market this year. Plus, this week's top headlines and Max Bayer's and Kansteiner's scoop on Johnson & Johnson's R&D overhaul and layoff plans. To learn more about topics in this episode: The top 10 biopharma M&A deals of 2022 Buyout on Horizon: Amgen floats $28B offer for rare disease drug maker as Sanofi exits bidding war J&J's pharma group quietly works through global overhaul, with layoffs expected to reach multiple countries Gilead's Trodelvy snags vital breast cancer nod. But AZ, Daiichi's Enhertu casts long shadow Vertex pricing under fire—again—as activists press 4 governments for Trikafta generics Roche races to regulators after matching AstraZeneca's rare disease blockbuster in phase 3 Call for nominations: The most influential people in biopharma in 2023 The Top Line is produced by senior multimedia producer Teresa Carey and managing editor Querida Anderson with editor-in-chief Ayla Ellison and senior editors Annalee Armstrong, Ben Adams, Conor Hale and Eric Sagonowsky. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.See omnystudio.com/listener for privacy information.
We totaled the salaries, stock options and bonuses awarded to various medtech CEOs to figure out who the highest paid chiefs were. And our top 10 list saw a few ups and downs over the past year. We'll hear from Connor Hale and Andrea Park as they discuss medtech's highest paid CEOs. Also in this episode, we cover the week's biggest headlines including Theranos' COO's jail sentence, highlights from the American Society of Hematology annual meeting, and an update on the Horizon Therapudics bidding war. To learn more about topics in this episode: Fierce JPM Week The top 10 highest-paid medtech CEOs Fierce Biotech's ASH 2022 Coverage Fierce Pharma's ASH 2022 Coverage Theranos' Sunny Balwani lands 13-year fraud sentence after ex-partner Elizabeth Holmes gets 11 years Watch out, Amgen. Mirati kicks off KRAS showdown with FDA approval for Krazati FDA advisers nix Cytokinetics' heart failure med, rejecting argument for subgroup use Buyout on Horizon: Amgen floats $28B offer for rare disease drug maker as Sanofi exits bidding war Sanofi started—and lost—$28B bidding war for Horizon. Is the company's M&A appetite still rumbling? AstraZeneca, Biogen, Daiichi, Lundbeck, UCB all hit with drug marketing breaches, but highest censure reserved for Novo Nordisk "The Top Line" is produced by senior multimedia producer Teresa Carey with managing editor Querida Anderson and senior editors Annalee Armstrong, Ben Adams, Conor Hale and Eric Sagonowsky. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.See omnystudio.com/listener for privacy information.
Before we get into the details of the current case, let's learn some history. In the 1980s, Parvinder Singh inherited Ranbaxy from his father, Bhai Mohan Singh, a wealthy contractor who hailed from Rawalpindi. What had started out as a small pharma business in Amritsar had by then grown into an empire. At a time when most Indian drug-makers were looking inwards, Parvinder decided to take Ranbaxy into international markets. By the time he passed away in 1999, he left behind a global pharma major. And, the way in which Parvinder's sons, Malvinder and Shivinder Singh, squandered away the empire in subsequent years has become the stuff of corporate folklore. According to reports, Malvinder and Shivinder squandered away Rs 22,500 crore over the span of just one decade. So, what are the particulars of the case in which the latest orders have come? Former Ranbaxy promoters Malvinder and Shivinder Singh have been accused of concealing information about wrongdoings at Ranbaxy when they sold a majority stake in it to Daiichi Sankyo, a Japanese firm, in 2008. In 2016, the Singapore tribunal awarded Daiichi Rs 3,500 crore in damages. In 2018, Daiichi Sankyo approached the Indian Supreme Court with the allegation that the Singh brothers were diverting funds using a number of shell companies to avoid the payments. Daiichi had also approached the apex court to stop a deal between Fortis and Malaysia-based IHH Group. As part of the deal, the IHH Group was set to acquire a 30 per cent stake in the Fortis group for 1.1 billion dollars with an open offer of 26 per cent stake. While the deal was signed in August 2018, the SC stayed the IHH open offer in December that same year. But, this too is only the tip of the proverbial iceberg since there are several other cases against the Singh brothers. In October of 2019, Malvinder and Shivinder were arrested by the Economic Offenses Wing of the Delhi Police for allegedly diverting money and causing losses to the tune of Rs 2,397 crore. The allegations were related to Religare Enterprises Limited, or REL, a company that was once led by the brothers. They were accused of diverting money from Religare Finvest Limited, or RFL, an REL subsidiary. According to the allegations, the brothers and other REL officials took loans in RFL's name and then diverted the money to other firms. In 2019, the Serious Fraud Investigation Office, or SFIO, was also probing their role in an alleged fund diversion at Fortis Healthcare. After its initial probe, the SFIO had said that it believed that the fraud could be to the tune of Rs 2,000 crore. The Securities and Exchange Board of India and the SFIO suspected that the Singh brothers had diverted public money from Fortis Healthcare to Gurinder Singh Dhillon, the head of Radha Soami Satsang Beas and other religious bodies. Long before the recent wranglings, there was also the episode with Dinesh Thakur, the whistle-blower who put Ranbaxy in the dock. Thakur joined Ranbaxy in 2003. But, in 2005, Thakur quit and waved a red flag about alleged violations and irregularities at the pharma company. Thakur ended up working with US authorities to expose the fraud and even filed a lawsuit to hold Ranbaxy accountable. Eventually, Ranbaxy pleaded guilty to making fraudulent statements to US regulatory authorities about how it tested drugs at its Indian plants. The firm had to pay $500 million to resolve the civil and criminal violations. It remains to be seen if the recent developments will be the final chapter of their downfall, or whether more skeletons might tumble out of their cupboard. What we know for sure is that Malvinder and Shivinder Singh have all but destroyed the legacy of their grandfather Bhai Mohan Singh and father Parvinder.
Sunday, the U.S. Senate passed the landmark drug pricing bill. While the pharmaceutical industry favors the bill's Medicare out-of-pocket cap for patients, the industry has also put up a major fight against Medicare pricing negotiations, in fact deeming them "price controls." The bill's passage marked a loss for the industry, but analysts aren't sure how much the legislation will actually cut drug prices. Pfizer is riding high on its COVID-19 windfall. And with all that money in the bank, the Big Pharma has been busy scouring the biopharma landscape for new assets and companies to bring into its fold. The latest in its buying spree is a $5.4 billion acquisition of Global Blood Therapeutics and its marketed sickle cell disease drug. To learn more about the topics in this episode: Lilly, AZ, AbbVie and J&J face big potential hit from Medicare pricing bill: analysts 'Litany of false promises': Pharma bemoans drug pricing bill as patient advocates celebrate VC firms, biotechs push back on drug pricing bill that would render small molecule drugs 'uninvestable' Pfizer, riding high on COVID windfall, strikes $5.4B buyout of Global Blood Therapeutics In historic FDA nod, AstraZeneca, Daiichi's Enhertu snags ultrafast approval in broad HER2-low breast cancer use Struggling Novavax halves its sales forecast as COVID shot launch sputters Amid COVID vaccine demand slump, Moderna recorded $800M-plus in charges for unused inventory and more With COVID vaccine demand in free fall, BioNTech's revenue plummets nearly 40% in second quarter GSK bets $1.3B on Mersana's preclinical ADC and chance to expand portfolio beyond Blenrep Merck is back in Alzheimer's saddle with $1B+ Cerevance pact, years after dropping the BACE BMS bites at GentiBio's next-gen regulatory T cells, betting $1.9B on 3 programs In warranty program, Pfizer will refund up to $50K for patients who discontinue use of rare disease drug We're looking for 2022's Fiercest Women in Life Sciences The Top Line is produced by senior multimedia producer Teresa Carey with managing editor Querida Anderson and senior editors Annalee Armstrong, Ben Adams, Conor Hale and Eric Sagonowsky. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.See omnystudio.com/listener for privacy information.
Another ASCO and more CAR-T data. Arcellx presented early results on its multiple myeloma therapy at last weekend's ASCO annual meeting, and we dig into what it would take to stand up to J&J's Carvykti. But that's not all. People were on their feet for the Enhertu breast cancer drug and its unheard-of results. We've got a lot to share about ASCO. Also under discussion is Fierce's special report on the rising stars in the medtech and healthcare fields and what they have in common. Lastly, we finally have boots-on-the-ground at an industry conference. Our reporter headed out to the first in-person ASCO since the pandemic started. She planned to learn about new data releases and discoveries, and also found out something surprising about herself. To learn more about the topics in this episode: Fierce Healthcare and Fierce Medtech's 17 rising stars in health tech ASCO: AstraZeneca, Daiichi's Enhertu could transform breast cancer treatment with landmark HER2-low show ASCO: Gilead's Trodelvy limps forward in new breast cancer lane as below-par showing casts doubt ASCO: ‘Any way you slice' it, Arcellx's CAR-T is matching J&J-Legend's Carvykti, analyst says ASCO: Medidata links CAR-T's cytokine release syndrome risk to common biomarkers in new study ASCO: Black breast cancer patients want to participate in trials, but adequate information is hard to come by Emergent says J&J owes up to $420M for breach of contract. J&J: You want to talk breaches? ADA: Eli Lilly's stellar tirzepatide weight loss data tee up showdown with Novo Nordisk's Wegovy, analysts say ADA: With promising long-term data for its artificial pancreas, Medtronic aims to fully close the diabetes management loop UPDATE: Bristol Myers strikes up Roche rivalry with $4.1B Turning Point buy Eli Lilly wins key dispute over patient warnings in era of DTC advertising ASCO: Return to in-person 'zoo that it always was,' with added COVID challenges—and bad shoes The Top Line is produced by senior multimedia producer Teresa Carey with editor-in-chief Tracy Staton, managing editor Querida Anderson and senior editors Annalee Armstrong, Ben Adams, Conor Hale and Eric Sagonowsky. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. See omnystudio.com/listener for privacy information.
On this week's episode of Inside Outside Innovation, we sit down with Jonathan Brill, author of the new book Rogue Waves: Future-proof Your Business to Survive and Profit from Radical Change. Jonathan and I discussed the coming rogue waves of change and how to prepare your company for resilient growth, innovation, and decision making under uncertainty. Let's get started. Inside Outside Innovation is the podcast to help you rethink, reset, and remix yourself and your organization. Each week, we'll bring the latest innovators, entrepreneurs, and pioneering businesses, as well as the tools, tactics, and trends you'll need to thrive as a new innovator.Interview Transcript with Jonathan Brill, Author of Rogue WavesBrian Ardinger: [00:00:30] Welcome to another episode of Inside Outside Innovation. I'm your host, Brian Ardinger. And as always, we have another amazing guest. Today we have Jonathan Brill. He is the author of the new book, Rogue Waves: Future-proof Your Business to Survive and Profit from Radical Change. Welcome to the show Jonathan.Jonathan Brill: [00:00:58] Thanks. It's a pleasure to be here. Brian Ardinger: [00:01:00] Well, I'm excited to have you on the show to quite frankly learn about what you've seen over your amazing career, when it comes to innovation. To give the audience some context. You are a senior leader and global futurist at Hewlett Packard. Creative director at Frog Design. You've probably helped create over 300 plus products in the innovation firms that you've worked in. And you've been a contributor to Ted and Singularity University and Forbes and Harvard Business Review. And the list goes on and on. Now you've got a new book coming out. So, I really wanted to dive right into it. The title of the book is called Rogue Waves. So, let's start there. What is a rogue wave and why should companies start preparing for them? Jonathan Brill: [00:01:38] So in the deep ocean, literally out of nowhere at the snap of a finger, 120-foot wave and pop up and sink you know, a 600-foot ship. We used to not think these things were real. We thought they were kind of sailors' tales, but it turns out that as we're having better tracking and satellites and whatnot, that these things are happening every day in a major storm, that one of these things might pop up about every eight or 10 hours. So, the issue isn't that rogue waves are rare it's that the world is large. And to use that metaphor and in many ways, the same types of mathematics apply. We're moving faster as a society. We're becoming more connected as a society. The reason, and so more freak occurrences will occur, and when they do, you'll see more contagion, you'll see more movement between those occurrences. And so, when you think about business. When you think about something like COVID right, why did COVID happen? And SARS was a pandemic. It didn't scale in the same way. Mers was a pandemic. It didn't scale in the same way. Lots of reasons. But I would argue that the biggest was we've put a population, the size of Los Angeles into the wilderness and outside of WuHan. So, we increased density, but we did that at the scale of literally the population of the United States and China, over the last 20 years or so. Connected them by 16 high-speed rails.Since 2010, we've increased travel out of China by 10 times, making China the largest spender on tourism in the world. Literally coming from out of nowhere and that didn't just happen in China. It happened in India. It happened across Southeast Asia and it's happening in Africa. And so, what was containable, 10 years ago, or 20 years ago, is suddenly not containable today. Not because of the disease, but because of all of the things that surrounded. All of those overlapping trends that surrounded. And when you think about a rogue wave, that's what it is. It's these independently manageable waves of change that overlap to become massive and unmanageable.Brian Ardinger: [00:03:43] It's not the one particular thing that is necessarily the disruptor. It's the blending of emerging technologies and changing demographics, and the data economy, and all of this colliding at once that creates that seismic events so to speak.Jonathan Brill: [00:03:57] Absolutely. And there are something like 10 major trends. And I picked these because they're the 10 sort of highly trackable trends by analysts and whatnot. And they tend to be highly quantifiable trends, that are overlapping over the next 10 years to virtually guarantee that the next decade will be more volatile than the last decade. And so, what that means is that we'll have more risk. Risk is a measurement of volatility change over time. And most people sort of, a lot of traditional risk management looks at that and says, okay, well, how do we push back the future? How do we protect ourselves from it? But the reality is when a rogue wave comes at you, you cannot protect yourself from it. What you can do is position yourself to try and ride it. Be more resilient. And if you're more resilient, take advantage while your competitors are trying to recover from being capsized. That's a radically different way of looking at the future. Looking at the world, then business schools have been teaching us for the last 30 or 40 years. They kind of assume that even though new competitor might disrupt you, and a new technology might disrupt you, that the rules that the playing field, the game board will stay the same. And that's simply not true anymore.Brian Ardinger: [00:05:13] Do you think companies are getting it so to speak? I mean, obviously COVID was a major factor, I think for most individuals and companies alike. Where I think we've been talking about change and disruption, you can see examples throughout the ages about this. But rarely did it hit everybody at the same time. So, are you seeing companies being able to fundamentally grasp that this type of change is here? And are they getting better or worse when it comes to navigating this type of change? Jonathan Brill: [00:05:40] So within that question, there are so many other questions, right? At the board level, is there an awareness that we need to focus on resilience? Yes. The number or percentage of meeting topics on agendas, that are focused on resilience has gone through the roof. The number of topics that have focused on innovation and other things is also dropped through the roof. And so, I don't know that at the investor level, at the board level, we yet understand that resilience and growth are intertwined issues. You can't focus on one without the other. It's a balance because if you don't have that resilience, if you don't know where to position yourself, it doesn't matter that you're better, you're faster. That you have a life jacket, right? Like you're still out at sea. Brian Ardinger: [00:06:30] So tell me about this book. How did it come about? And what's in it for the readers? Jonathan Brill: [00:06:35] I spent the last several years at HP as the Global Futurist. And a lot of our study was looking at long-term change. What could happen? What risks did we think were static risks? Like hundred-year pandemics that were actually dynamic risk. And so, if you are in that community of people who look at these things, pandemics were becoming more and more and more likely over time.And yet most of us, most of our leaders, 8 of the 10 largest companies in the United States, failed to identify pandemics as a risk in their SEC Risk Filings. So, we were in denial as a, an economy about what was happening. A lot of my job at HP was also to figure out, okay, If the world is changing, what are the new opportunities?Not just what are the risks and how do we become resilient, but how do we turn those into new opportunities? And one of the things our group focused on was how do we deal with disease diagnostics? Because we know that the population is getting older. We know that something like a pandemic can rapidly accelerate this type of work.And I actually just published an HBR article about how to balance that kind of resilience and growth that we experienced at HP over the last year. I've recently left to write this book because it's, and it's really about what I learned as a practitioner. Right. I spent 20 years as a consultant working on contract R and D. All of a sudden was a practitioner and you had to figure out how to actually drive change in the 58,000 person organization. And it turned out that it's a different problem entirely. And so, this book was really about how do you blend that world, that the knowledge of the consultant versus the reality of the practitioner. What are the simple steps that you can take? And there are really three and I call them the ABCs of Resilient Growth.First, you need to increase your awareness as an organization that the world outside is changing. And you need to think about the range of ways it could impact you. It's really easy to look at the world and say, okay, you know, our technologies have to change, or our workforce has to change or whatever. What we discovered over the last year is actually that all has to change at the same time. A lot of times, things overlap to become unmanageable rogue waves of change. So, you need to create awareness, not just of what the changes are, but what would happen if they overlap. Brian Ardinger: [00:08:56] On that front, is it something where you can't manage it incrementally? It is something where you have to transformationaly change these things to actually be able to keep up, or are there opportunities to, to do a more incremental approach to, to this.Jonathan Brill: [00:09:11] I think there are two answers to that. Yes, there are opportunities to do an incremental approach, and that's the only way that works. You can't change your culture overnight and you can't change all of your processes overnight. And by the way, if you do that, there's a better than even chance that you'll, that you'll sink yourself.So, it's this balance. The first piece is building that awareness of there is stuff going on outside. The second is building the skills, the behavior change within the organization. Because even if you know that the wave's coming, if you don't know how to swim, it's not a good idea to pick up big wave surfing. So, you got to build the skills. And then the third is the culture, right? You have to, I don't believe that you can really change corporate DNA. I think that's consultant speak. But I do believe that you can change the RNA. When you think about DNA, this is the deep code that causes life. That allows life to build itself.But RNA is the code that controls the types of proteins that you use to regulate your body. That RNA can actually be changed relatively quickly. If you take a look at an octopus, for instance, or a Cephalopods, like a squid, a cuddle fish, they can change 60% of their RNA in a lifetime. And companies do it all the time.You change your processes, you change your hard incentives, right? Bonuses, bonus structure, and whatnot. And you change your soft incentives right? Who do you encourage? Who gets ahead? Those, those kinds of things. So, you can change that stuff pretty much overnight, but the change is incremental, right? The company has to catch up to the reality that you're serious and that you can sustain the change over time.And that's the real challenge. I see a lot of these sort of change efforts. I read, the other day in Harvard Business Review that 70% of change efforts fail. And so there, I think are two things there, right. One is, do they fail or do people just not keep at them long enough? Do the leaders not convince their population that they're serious?And I think there are kind of like four phases in corporate change of any type, but certainly in becoming what I call a resilient growth organization, right. The first is you come, and you say the future is going to be different. The sky's falling, whatever your story is. And everybody looks at you like you're insane. But you get a few early adopters. The second is that people start saying, well, actually you're not the legitimate person to make that argument. I am. Your arguments dumb, my argument's better. It turns out that's actually a win. And as a, as a manager, if you're asking people to be change agents, you need to recognize when that shift occurs. And that that's actually the big win. What you see though, is that people take whatever the change message is, and they start covering the first page of their PowerPoint deck with it. To justify whatever it was they wanted to do, all right. It's a shift. It's an important shift. It's about being future compliant, as opposed to actually thinking about the future.The third one is when they start actually asking for budget to do new things, and this is where I think a lot of change management breaks down, right? You can get through the first one. Sure. You send in your Avant guard; you send out your Scouts. And you send out your missionaries and they, they preach the future.Couple of people believe it. The better politicians figure out how to do what they already wanted to do. But then a couple of people say, no, I want to find out if you're serious and I'm going to start asking for money. Not like a hundred thousand dollars, like a million dollars, $10 million. A meaningful amount of money and, and talking about large organization terms. Right. And if you say no, think about what happens. Their ideal is almost destined to fail, right? It will be right. It's almost destined to fail. And so, if you're a rational manager, you say, well, I'm not going to invest in something that I know is going to fail. And if you don't support them, when they do fail for trying, you cut off the opportunity. You cut off the change.And I think that's where a lot of change management breaks down, right? That you have the senior manager incentives on an annual basis, versus a senior manager incentives on a long-term basis and they get disconnected. And then the third piece is when your senior managers start looking at this as a process and saying, okay, we're going to embed this in the process. We're going to take whatever the change is. In this case, becoming a resiliently, a growth organization. And we're going to have it be part of our annual decision-making process budget process. And we're going to set a minimum that we spend on this thing. And that's when I think you start to see the long tail of growth from this work. But it's often, you know, it's a three-year or five-year process. It doesn't happen in six months, and it doesn't happen because the board woke up on Tuesday and realized that they'd been cutting resilience for 20 years. Brian Ardinger: [00:13:59] Absolutely. On that you've seen and worked with a lot of different companies and have seen this progression. Where are the biggest struggles or obstacles that companies are facing going through that? Are most of them dying at that stage one stage two stage three? Or is it a combination or, or what are the things that people should be preparing for as they go along this journey?Jonathan Brill: [00:14:19] I think there are two answers to that question. The first is really at the board level, you know. Are you serious about this? If the board has a cocktail party and they say we should be more resilient than, you know, that verbals down, like that happens a lot. That happens a lot. That change isn't going to happen.And the people who participate in that change, especially in performance driven organizations, tend to not keep their job. So you've got to figure out, okay, well, are people serious about this? And that's why phases one and two happened. That I was talking about earlier. That's why they happen. The second question is, if you are serious about this, you know, can you be serious about it from the bottom up?Can you make that change from the bottom up? Or do you have to make it from the top down? I think it's probably generally a bi-directional process where you have to link the communications between the senior leadership and the edge of your organization. And that, that's a huge political challenge, especially like in organizations where you have high longevity of career. You know, where you have 20-year careers and whatnot. It gets really hard to do that. You know, people in the middle, don't like, you know, the people in the center talking to the edge, you got to break through that. And I think that's one of the real places where the issue breaks down. And I think the third, and this is really important to, and I think this is why I wrote the book, or one of the main reasons, is that if you have somebody, if you're headquartered in Indonesia and you have somebody who sees a rogue wave on the horizon in Mozambique, right.That person in Mozambique, probably even if they can talk to the CEO, probably doesn't have the skills to the language, the context. They're just going to sound crazy. And we've all been in that conversation, right? We've all been in that conversation. And so the key thing is you also need to increase the executive judgment, executive communication skills far lower in your organization. If you want to have an innovative organization. You can't trust people to innovate if they don't understand the context. You know, and they don't understand how to take risks, as opposed to just manage. Brian Ardinger: [00:16:32] And maybe that comes back to some of that, like you were talking, one of the first themes is, is awareness. And it's not just awareness at the board level or at the CEO level, it's awareness across the organization that these risks are happening and exist. And what can you do to both understand them, as well then do some behavior or cultural things around it to actually execute or, or take advantage of that. On that awareness front. Are there things that you've seen that can help companies think outside their industry and see what's going on and explore in areas that they don't typically explore. Whether it's technology or human resources or whatever.Jonathan Brill: [00:17:08] Right. So, in a pre COVID world. One of the things that I did was I'd bring teams who'd been in Europe and the US their entire careers. High potential leaders or whatever, and I'd bring them to China. And this is one of these things where if you're an American and you try and explain the Grand Canyon to a European, they just don't get it.If you're an American and you haven't been to Beijing or Shenzhen or Shanghai, you just don't get it. That, you know, every two years, literally they're using the concrete that the U S poured in the United States in the 20th century. The scale is unimaginable. And once you get there, once you see that. Once you see your Grand Canyon, once you see your Beijing, your mind can't go back to the same place.And so that would be my first thing is just kind of, how do you get that cross-cultural awareness of, of what's happening. The scale of change in the world. The second thing that I really suggest is figuring out how to create peer groups outside of your industry, but at your level. And ideally across the world. And that's some of what I do is building those peer groups, so that we can have those conversations. Because otherwise you don't actually understand the challenge. You don't understand the scale of the opportunity. You don't see the rogue wave coming, right. If you were sitting around and you know, you were very specifically, you know, stockpiling face masks for the US government and you see, you know we can get these things cheaper in China. Like let's shut down our supply chains. Let's shut down our local manufacturing. Yeah. That all makes sense. Right? Because it's a price performance issue. Like all the incentives are there to do that. Until you look at the bigger picture, risk is changing. Everyone's going to need all this stuff all at once. And we're going to need it when we need it on a sustained basis. And by the way, it's super cheap. Right. Like there's no, which is the entire problem, right? There's no margin in this. It's so cheap. There's no margin in, this. It totally makes sense, as a middle manager that you'd say let's get rid of that thing. But as a senior manager, as a senior leader, you need to say, okay, that doesn't make any economic sense today, but in the long-term, we're going to have an inevitable need. Brian Ardinger: [00:19:34] So how far out in the future do you think companies should be preparing or looking. To, or is, does it depend on the rogue wave that you're looking at?Jonathan Brill: [00:19:42] How far out should you be preparing and looking are interesting. There, there are two different questions. What I really am interested in is that there's a range of possible futures. There isn't one, the closer you get to that future that, you know, the more the rank shrinks So the farther out you're looking at the broader the range should be obviously. But the goal isn't necessarily to look at 7 years out or 10 years out, or 3 years out, or 1 year out. It's to figure out, am I prepared for the types of threats and opportunities I'm likely to see?And so I think about this as kind of like, what are the financial, operational, external, and strategic aspects of my corporation of my organization. And what types of waves would impact it? What types of challenges or opportunities might you see? And the same thing applies to customers, by the way. Could a static threat, a hundred year disease, suddenly become a dynamic threat, right?We're starting to see these more often. Could a symmetric threat, it's going to impact everybody the same become an asymmetric threat? So you take a look at a Toyota. Their investment in semiconductors, after the Daiichi nuclear explosion in 2011. They looked at, you know, we had an asymmetric thing happened to the us, all those American manufacturers they didn't get hit by this nuclear meltdown. But we did. What would happen when the next thing happened. And how could we move that from a situation where we get hit and no one else does, to we survive and then everyone else gets hit. So how do you shift between symmetric and asymmetric threat? And the result of that is in 2016, when there was an earthquake in Taiwan, China had a six-month supply of chips and they kept operating just fine. Everyone else got hit. This past year, same thing happened. How do you move things from synchronous to asynchronous threats or the other way around? So how do you move them from things that hit everybody at the same time to things that hit people at different times, because you know, often all you really need is enough buffer.All you need is enough time to respond. And then the other is to think about which issues are temporary and which ones are permanent. So, what's amazing to me about the U S response to COVID is this thing that really should have been a 10 year, five-year, ten-year issue historically. Appears at the moment, you know, to have been shifted from a permanent issue in the United States to a temporary issue. Now we're going to need to manage our response permanently. Right. But the economic impact may be temporary. It's one of the greatest innovation moments, you know, I think when we look back 50 years from now, we changed the path of nature. It was one of the great innovation moments of the 21st century.Brian Ardinger: [00:22:36] It's, I mean, truly fantastical times, we're living in, in a number of different ways. Are there particular trends or things that you're seeing or want the audience to pay attention to that they may not be as familiar with? Jonathan Brill: [00:22:47] So we can talk about trends you might be unfamiliar with, but I think the question that you should really be asking is what happens when the trends that you're familiar with collide? I mean, a lot of the things that I talk about were in the news. Can you take a look at the growing risk of a pandemic? I mean, and all of the things they talked about, high speed rail Maglev in China, the explosion of urbanization around the world, massive increases in Chinese Asian travel, the explosion of low-cost airlines around South Asia. Right? These were all front-page news. The issue is that people weren't putting them together. For More InformationBrian Ardinger: [00:23:25] It's a fascinating book and I love folks who are listening to this to take a deeper dive. It really is a really good framework for how to start thinking about these things. And you dig into a lot of the tactics and examples around that as well. So I encouraged people to pick that up. But if people want to find out more about yourself or about the book, what's the best way to do that? Jonathan Brill: [00:23:44] Jonathanbrill.com is my website and there's piles of useful tools, HBR articles, Forbes articles, advisory options, surfaces, and they're all focused on being useful to you.Brian Ardinger: [00:23:58] Well Jonathan, I want to thank you again for being on Inside Outside Innovation and sharing your thoughts on this. I'd love to have you back. You know, as the world changes and we get more used to seeing innovations and digging in and being a part of it, I'm sure things will pop out new best practices and that will emerge. So, I appreciate you sharing what you know now, and hopefully we'll have you back on to talk about the future as the world evolves. Jonathan Brill: [00:24:21] I'd be glad to anytime. Thank you very much for having me.Brian Ardinger: That's it for another episode of Inside Outside Innovation. If you want to learn more about our team, our content, our services, check out InsideOutside.io or follow us on Twitter @theIOpodcast or @Ardinger. Until next time, go out and innovate.FREE INNOVATION NEWSLETTER & TOOLSGet the latest episodes of the Inside Outside Innovation podcast, in addition to thought leadership in the form of blogs, innovation resources, videos, and invitations to exclusive events. SUBSCRIBE HEREYou can also search every Inside Outside Innovation Podcast by Topic and Company. For more innovations resources, check out IO's Innovation Article Database, Innovation Tools Database, Innovation Book Database, and Innovation Video Database.
On this week's episode of Inside Outside Innovation, we sit down with Jonathan Brill, author of the new book Rogue Waves: Future-proof Your Business to Survive and Profit from Radical Change. Jonathan and I discussed the coming rogue waves of change and how to prepare your company for resilient growth, innovation, and decision making under uncertainty. Let's get started. Inside Outside Innovation is the podcast to help you rethink, reset, and remix yourself and your organization. Each week, we'll bring the latest innovators, entrepreneurs, and pioneering businesses, as well as the tools, tactics, and trends you'll need to thrive as a new innovator.Interview Transcript with Jonathan Brill, Author of Rogue WavesBrian Ardinger: [00:00:30] Welcome to another episode of Inside Outside Innovation. I'm your host, Brian Ardinger. And as always, we have another amazing guest. Today we have Jonathan Brill. He is the author of the new book, Rogue Waves: Future-proof Your Business to Survive and Profit from Radical Change. Welcome to the show Jonathan.Jonathan Brill: [00:00:58] Thanks. It's a pleasure to be here. Brian Ardinger: [00:01:00] Well, I'm excited to have you on the show to quite frankly learn about what you've seen over your amazing career, when it comes to innovation. To give the audience some context. You are a senior leader and global futurist at Hewlett Packard. Creative director at Frog Design. You've probably helped create over 300 plus products in the innovation firms that you've worked in. And you've been a contributor to Ted and Singularity University and Forbes and Harvard Business Review. And the list goes on and on. Now you've got a new book coming out. So, I really wanted to dive right into it. The title of the book is called Rogue Waves. So, let's start there. What is a rogue wave and why should companies start preparing for them? Jonathan Brill: [00:01:38] So in the deep ocean, literally out of nowhere at the snap of a finger, 120-foot wave and pop up and sink you know, a 600-foot ship. We used to not think these things were real. We thought they were kind of sailors' tales, but it turns out that as we're having better tracking and satellites and whatnot, that these things are happening every day in a major storm, that one of these things might pop up about every eight or 10 hours. So, the issue isn't that rogue waves are rare it's that the world is large. And to use that metaphor and in many ways, the same types of mathematics apply. We're moving faster as a society. We're becoming more connected as a society. The reason, and so more freak occurrences will occur, and when they do, you'll see more contagion, you'll see more movement between those occurrences. And so, when you think about business. When you think about something like COVID right, why did COVID happen? And SARS was a pandemic. It didn't scale in the same way. Mers was a pandemic. It didn't scale in the same way. Lots of reasons. But I would argue that the biggest was we've put a population, the size of Los Angeles into the wilderness and outside of WuHan. So, we increased density, but we did that at the scale of literally the population of the United States and China, over the last 20 years or so. Connected them by 16 high-speed rails.Since 2010, we've increased travel out of China by 10 times, making China the largest spender on tourism in the world. Literally coming from out of nowhere and that didn't just happen in China. It happened in India. It happened across Southeast Asia and it's happening in Africa. And so, what was containable, 10 years ago, or 20 years ago, is suddenly not containable today. Not because of the disease, but because of all of the things that surrounded. All of those overlapping trends that surrounded. And when you think about a rogue wave, that's what it is. It's these independently manageable waves of change that overlap to become massive and unmanageable.Brian Ardinger: [00:03:43] It's not the one particular thing that is necessarily the disruptor. It's the blending of emerging technologies and changing demographics, and the data economy, and all of this colliding at once that creates that seismic events so to speak.Jonathan Brill: [00:03:57] Absolutely. And there are something like 10 major trends. And I picked these because they're the 10 sort of highly trackable trends by analysts and whatnot. And they tend to be highly quantifiable trends, that are overlapping over the next 10 years to virtually guarantee that the next decade will be more volatile than the last decade. And so, what that means is that we'll have more risk. Risk is a measurement of volatility change over time. And most people sort of, a lot of traditional risk management looks at that and says, okay, well, how do we push back the future? How do we protect ourselves from it? But the reality is when a rogue wave comes at you, you cannot protect yourself from it. What you can do is position yourself to try and ride it. Be more resilient. And if you're more resilient, take advantage while your competitors are trying to recover from being capsized. That's a radically different way of looking at the future. Looking at the world, then business schools have been teaching us for the last 30 or 40 years. They kind of assume that even though new competitor might disrupt you, and a new technology might disrupt you, that the rules that the playing field, the game board will stay the same. And that's simply not true anymore.Brian Ardinger: [00:05:13] Do you think companies are getting it so to speak? I mean, obviously COVID was a major factor, I think for most individuals and companies alike. Where I think we've been talking about change and disruption, you can see examples throughout the ages about this. But rarely did it hit everybody at the same time. So, are you seeing companies being able to fundamentally grasp that this type of change is here? And are they getting better or worse when it comes to navigating this type of change? Jonathan Brill: [00:05:40] So within that question, there are so many other questions, right? At the board level, is there an awareness that we need to focus on resilience? Yes. The number or percentage of meeting topics on agendas, that are focused on resilience has gone through the roof. The number of topics that have focused on innovation and other things is also dropped through the roof. And so, I don't know that at the investor level, at the board level, we yet understand that resilience and growth are intertwined issues. You can't focus on one without the other. It's a balance because if you don't have that resilience, if you don't know where to position yourself, it doesn't matter that you're better, you're faster. That you have a life jacket, right? Like you're still out at sea. Brian Ardinger: [00:06:30] So tell me about this book. How did it come about? And what's in it for the readers? Jonathan Brill: [00:06:35] I spent the last several years at HP as the Global Futurist. And a lot of our study was looking at long-term change. What could happen? What risks did we think were static risks? Like hundred-year pandemics that were actually dynamic risk. And so, if you are in that community of people who look at these things, pandemics were becoming more and more and more likely over time.And yet most of us, most of our leaders, 8 of the 10 largest companies in the United States, failed to identify pandemics as a risk in their SEC Risk Filings. So, we were in denial as a, an economy about what was happening. A lot of my job at HP was also to figure out, okay, If the world is changing, what are the new opportunities?Not just what are the risks and how do we become resilient, but how do we turn those into new opportunities? And one of the things our group focused on was how do we deal with disease diagnostics? Because we know that the population is getting older. We know that something like a pandemic can rapidly accelerate this type of work.And I actually just published an HBR article about how to balance that kind of resilience and growth that we experienced at HP over the last year. I've recently left to write this book because it's, and it's really about what I learned as a practitioner. Right. I spent 20 years as a consultant working on contract R and D. All of a sudden was a practitioner and you had to figure out how to actually drive change in the 58,000 person organization. And it turned out that it's a different problem entirely. And so, this book was really about how do you blend that world, that the knowledge of the consultant versus the reality of the practitioner. What are the simple steps that you can take? And there are really three and I call them the ABCs of Resilient Growth.First, you need to increase your awareness as an organization that the world outside is changing. And you need to think about the range of ways it could impact you. It's really easy to look at the world and say, okay, you know, our technologies have to change, or our workforce has to change or whatever. What we discovered over the last year is actually that all has to change at the same time. A lot of times, things overlap to become unmanageable rogue waves of change. So, you need to create awareness, not just of what the changes are, but what would happen if they overlap. Brian Ardinger: [00:08:56] On that front, is it something where you can't manage it incrementally? It is something where you have to transformationaly change these things to actually be able to keep up, or are there opportunities to, to do a more incremental approach to, to this.Jonathan Brill: [00:09:11] I think there are two answers to that. Yes, there are opportunities to do an incremental approach, and that's the only way that works. You can't change your culture overnight and you can't change all of your processes overnight. And by the way, if you do that, there's a better than even chance that you'll, that you'll sink yourself.So, it's this balance. The first piece is building that awareness of there is stuff going on outside. The second is building the skills, the behavior change within the organization. Because even if you know that the wave's coming, if you don't know how to swim, it's not a good idea to pick up big wave surfing. So, you got to build the skills. And then the third is the culture, right? You have to, I don't believe that you can really change corporate DNA. I think that's consultant speak. But I do believe that you can change the RNA. When you think about DNA, this is the deep code that causes life. That allows life to build itself.But RNA is the code that controls the types of proteins that you use to regulate your body. That RNA can actually be changed relatively quickly. If you take a look at an octopus, for instance, or a Cephalopods, like a squid, a cuddle fish, they can change 60% of their RNA in a lifetime. And companies do it all the time.You change your processes, you change your hard incentives, right? Bonuses, bonus structure, and whatnot. And you change your soft incentives right? Who do you encourage? Who gets ahead? Those, those kinds of things. So, you can change that stuff pretty much overnight, but the change is incremental, right? The company has to catch up to the reality that you're serious and that you can sustain the change over time.And that's the real challenge. I see a lot of these sort of change efforts. I read, the other day in Harvard Business Review that 70% of change efforts fail. And so there, I think are two things there, right. One is, do they fail or do people just not keep at them long enough? Do the leaders not convince their population that they're serious?And I think there are kind of like four phases in corporate change of any type, but certainly in becoming what I call a resilient growth organization, right. The first is you come, and you say the future is going to be different. The sky's falling, whatever your story is. And everybody looks at you like you're insane. But you get a few early adopters. The second is that people start saying, well, actually you're not the legitimate person to make that argument. I am. Your arguments dumb, my argument's better. It turns out that's actually a win. And as a, as a manager, if you're asking people to be change agents, you need to recognize when that shift occurs. And that that's actually the big win. What you see though, is that people take whatever the change message is, and they start covering the first page of their PowerPoint deck with it. To justify whatever it was they wanted to do, all right. It's a shift. It's an important shift. It's about being future compliant, as opposed to actually thinking about the future.The third one is when they start actually asking for budget to do new things, and this is where I think a lot of change management breaks down, right? You can get through the first one. Sure. You send in your Avant guard; you send out your Scouts. And you send out your missionaries and they, they preach the future.Couple of people believe it. The better politicians figure out how to do what they already wanted to do. But then a couple of people say, no, I want to find out if you're serious and I'm going to start asking for money. Not like a hundred thousand dollars, like a million dollars, $10 million. A meaningful amount of money and, and talking about large organization terms. Right. And if you say no, think about what happens. Their ideal is almost destined to fail, right? It will be right. It's almost destined to fail. And so, if you're a rational manager, you say, well, I'm not going to invest in something that I know is going to fail. And if you don't support them, when they do fail for trying, you cut off the opportunity. You cut off the change.And I think that's where a lot of change management breaks down, right? That you have the senior manager incentives on an annual basis, versus a senior manager incentives on a long-term basis and they get disconnected. And then the third piece is when your senior managers start looking at this as a process and saying, okay, we're going to embed this in the process. We're going to take whatever the change is. In this case, becoming a resiliently, a growth organization. And we're going to have it be part of our annual decision-making process budget process. And we're going to set a minimum that we spend on this thing. And that's when I think you start to see the long tail of growth from this work. But it's often, you know, it's a three-year or five-year process. It doesn't happen in six months, and it doesn't happen because the board woke up on Tuesday and realized that they'd been cutting resilience for 20 years. Brian Ardinger: [00:13:59] Absolutely. On that you've seen and worked with a lot of different companies and have seen this progression. Where are the biggest struggles or obstacles that companies are facing going through that? Are most of them dying at that stage one stage two stage three? Or is it a combination or, or what are the things that people should be preparing for as they go along this journey?Jonathan Brill: [00:14:19] I think there are two answers to that question. The first is really at the board level, you know. Are you serious about this? If the board has a cocktail party and they say we should be more resilient than, you know, that verbals down, like that happens a lot. That happens a lot. That change isn't going to happen.And the people who participate in that change, especially in performance driven organizations, tend to not keep their job. So you've got to figure out, okay, well, are people serious about this? And that's why phases one and two happened. That I was talking about earlier. That's why they happen. The second question is, if you are serious about this, you know, can you be serious about it from the bottom up?Can you make that change from the bottom up? Or do you have to make it from the top down? I think it's probably generally a bi-directional process where you have to link the communications between the senior leadership and the edge of your organization. And that, that's a huge political challenge, especially like in organizations where you have high longevity of career. You know, where you have 20-year careers and whatnot. It gets really hard to do that. You know, people in the middle, don't like, you know, the people in the center talking to the edge, you got to break through that. And I think that's one of the real places where the issue breaks down. And I think the third, and this is really important to, and I think this is why I wrote the book, or one of the main reasons, is that if you have somebody, if you're headquartered in Indonesia and you have somebody who sees a rogue wave on the horizon in Mozambique, right.That person in Mozambique, probably even if they can talk to the CEO, probably doesn't have the skills to the language, the context. They're just going to sound crazy. And we've all been in that conversation, right? We've all been in that conversation. And so the key thing is you also need to increase the executive judgment, executive communication skills far lower in your organization. If you want to have an innovative organization. You can't trust people to innovate if they don't understand the context. You know, and they don't understand how to take risks, as opposed to just manage. Brian Ardinger: [00:16:32] And maybe that comes back to some of that, like you were talking, one of the first themes is, is awareness. And it's not just awareness at the board level or at the CEO level, it's awareness across the organization that these risks are happening and exist. And what can you do to both understand them, as well then do some behavior or cultural things around it to actually execute or, or take advantage of that. On that awareness front. Are there things that you've seen that can help companies think outside their industry and see what's going on and explore in areas that they don't typically explore. Whether it's technology or human resources or whatever.Jonathan Brill: [00:17:08] Right. So, in a pre COVID world. One of the things that I did was I'd bring teams who'd been in Europe and the US their entire careers. High potential leaders or whatever, and I'd bring them to China. And this is one of these things where if you're an American and you try and explain the Grand Canyon to a European, they just don't get it.If you're an American and you haven't been to Beijing or Shenzhen or Shanghai, you just don't get it. That, you know, every two years, literally they're using the concrete that the U S poured in the United States in the 20th century. The scale is unimaginable. And once you get there, once you see that. Once you see your Grand Canyon, once you see your Beijing, your mind can't go back to the same place.And so that would be my first thing is just kind of, how do you get that cross-cultural awareness of, of what's happening. The scale of change in the world. The second thing that I really suggest is figuring out how to create peer groups outside of your industry, but at your level. And ideally across the world. And that's some of what I do is building those peer groups, so that we can have those conversations. Because otherwise you don't actually understand the challenge. You don't understand the scale of the opportunity. You don't see the rogue wave coming, right. If you were sitting around and you know, you were very specifically, you know, stockpiling face masks for the US government and you see, you know we can get these things cheaper in China. Like let's shut down our supply chains. Let's shut down our local manufacturing. Yeah. That all makes sense. Right? Because it's a price performance issue. Like all the incentives are there to do that. Until you look at the bigger picture, risk is changing. Everyone's going to need all this stuff all at once. And we're going to need it when we need it on a sustained basis. And by the way, it's super cheap. Right. Like there's no, which is the entire problem, right? There's no margin in this. It's so cheap. There's no margin in, this. It totally makes sense, as a middle manager that you'd say let's get rid of that thing. But as a senior manager, as a senior leader, you need to say, okay, that doesn't make any economic sense today, but in the long-term, we're going to have an inevitable need. Brian Ardinger: [00:19:34] So how far out in the future do you think companies should be preparing or looking. To, or is, does it depend on the rogue wave that you're looking at?Jonathan Brill: [00:19:42] How far out should you be preparing and looking are interesting. There, there are two different questions. What I really am interested in is that there's a range of possible futures. There isn't one, the closer you get to that future that, you know, the more the rank shrinks So the farther out you're looking at the broader the range should be obviously. But the goal isn't necessarily to look at 7 years out or 10 years out, or 3 years out, or 1 year out. It's to figure out, am I prepared for the types of threats and opportunities I'm likely to see?And so I think about this as kind of like, what are the financial, operational, external, and strategic aspects of my corporation of my organization. And what types of waves would impact it? What types of challenges or opportunities might you see? And the same thing applies to customers, by the way. Could a static threat, a hundred year disease, suddenly become a dynamic threat, right?We're starting to see these more often. Could a symmetric threat, it's going to impact everybody the same become an asymmetric threat? So you take a look at a Toyota. Their investment in semiconductors, after the Daiichi nuclear explosion in 2011. They looked at, you know, we had an asymmetric thing happened to the us, all those American manufacturers they didn't get hit by this nuclear meltdown. But we did. What would happen when the next thing happened. And how could we move that from a situation where we get hit and no one else does, to we survive and then everyone else gets hit. So how do you shift between symmetric and asymmetric threat? And the result of that is in 2016, when there was an earthquake in Taiwan, China had a six-month supply of chips and they kept operating just fine. Everyone else got hit. This past year, same thing happened. How do you move things from synchronous to asynchronous threats or the other way around? So how do you move them from things that hit everybody at the same time to things that hit people at different times, because you know, often all you really need is enough buffer.All you need is enough time to respond. And then the other is to think about which issues are temporary and which ones are permanent. So, what's amazing to me about the U S response to COVID is this thing that really should have been a 10 year, five-year, ten-year issue historically. Appears at the moment, you know, to have been shifted from a permanent issue in the United States to a temporary issue. Now we're going to need to manage our response permanently. Right. But the economic impact may be temporary. It's one of the greatest innovation moments, you know, I think when we look back 50 years from now, we changed the path of nature. It was one of the great innovation moments of the 21st century.Brian Ardinger: [00:22:36] It's, I mean, truly fantastical times, we're living in, in a number of different ways. Are there particular trends or things that you're seeing or want the audience to pay attention to that they may not be as familiar with? Jonathan Brill: [00:22:47] So we can talk about trends you might be unfamiliar with, but I think the question that you should really be asking is what happens when the trends that you're familiar with collide? I mean, a lot of the things that I talk about were in the news. Can you take a look at the growing risk of a pandemic? I mean, and all of the things they talked about, high speed rail Maglev in China, the explosion of urbanization around the world, massive increases in Chinese Asian travel, the explosion of low-cost airlines around South Asia. Right? These were all front-page news. The issue is that people weren't putting them together. For More InformationBrian Ardinger: [00:23:25] It's a fascinating book and I love folks who are listening to this to take a deeper dive. It really is a really good framework for how to start thinking about these things. And you dig into a lot of the tactics and examples around that as well. So I encouraged people to pick that up. But if people want to find out more about yourself or about the book, what's the best way to do that? Jonathan Brill: [00:23:44] Jonathanbrill.com is my website and there's piles of useful tools, HBR articles, Forbes articles, advisory options, surfaces, and they're all focused on being useful to you.Brian Ardinger: [00:23:58] Well Jonathan, I want to thank you again for being on Inside Outside Innovation and sharing your thoughts on this. I'd love to have you back. You know, as the world changes and we get more used to seeing innovations and digging in and being a part of it, I'm sure things will pop out new best practices and that will emerge. So, I appreciate you sharing what you know now, and hopefully we'll have you back on to talk about the future as the world evolves. Jonathan Brill: [00:24:21] I'd be glad to anytime. Thank you very much for having me.Brian Ardinger: That's it for another episode of Inside Outside Innovation. If you want to learn more about our team, our content, our services, check out InsideOutside.io or follow us on Twitter @theIOpodcast or @Ardinger. Until next time, go out and innovate.FREE INNOVATION NEWSLETTER & TOOLSGet the latest episodes of the Inside Outside Innovation podcast, in addition to thought leadership in the form of blogs, innovation resources, videos, and invitations to exclusive events. SUBSCRIBE HEREYou can also search every Inside Outside Innovation Podcast by Topic and Company. For more innovations resources, check out IO's Innovation Article Database, Innovation Tools Database, Innovation Book Database, and Innovation Video Database.
Dr. Hope Rugo, professor of medicine and director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco Helen Diller Comprehensive Cancer Center, highlights key studies in breast cancer featured at the 2021 ASCO Annual Meeting. Transcript: ASCO Daily News: Welcome to the ASCO Daily News podcast. I'm Geraldine Carroll, a reporter for the ASCO Daily News. My guest today is Dr. Hope Rugo. She is a professor of medicine and the director of Breast Oncology and Clinical Trials Education at the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco. Dr. Rugo joins me to discuss key advances in the breast cancer field featured at the 2021 ASCO Annual Meeting. Dr. Rugo has received research support for clinical trials through the University of California from Pfizer, Merck, Novartis, Lilly, Roche, and other organizations. Her full disclosures are available on the transcript of this episode at asco.org/podcasts. Dr. Rugo, it's great to have you on the podcast today. Dr. Hope Rugo: Oh, it's great to be here. ASCO Daily News: There were many interesting studies in breast cancer featured at the Annual Meeting. Thank you for being here to highlight some of them. Let's start with the OlympiA trial. This is LBA1. This remarkable study found that adjuvant olaparib extends disease-free survival in BRCA-mutated early stage HER2-negative breast cancer. What can you tell us about this trial? Dr. Hope Rugo: Well, this is really such an amazing study, in terms of the results and its practice-changing impact. The study actually kind of interestingly was published in the New England Journal [of Medicine] 2 days before it was presented. And even though we had all seen the data, it was really such a, I think, moving presentation in terms of really changing the face of treatment for women and men with BRCA1 and BRCA2 associated breast cancer. Of course, olaparib and talazoparib are both PARP inhibitors that are approved to treat metastatic breast cancer associated with BRCA1 and BRCA2 mutations. And in those randomized trials, they showed improvement in response and progression-free survival, but not clear differences in overall survival. So, of course, when we have an impact in the metastatic setting, the next step is to move into early-stage breast cancer. But that's quite a challenge given the fact that you have to test and find the mutation, which is challenging in some parts of the world. And then you have to decide which group of patients need more than standard therapy. So the OlympiA trial randomly assigned patients who had pathogenic BRCA1 or BRCA2 mutations and HER2-negative, either hormone receptor-positive or triple negative breast cancer, to receive a year of olaparib or a placebo. And the patient eligibility was further defined. If you had triple negative breast cancer, you could have had any residual disease after neoadjuvant therapy, or you had to have a tumor greater than two centimeters or a positive node. If you have hormone receptor-positive disease keeping in mind the benefit of adjuvant endocrine therapy. If you didn't have a pathologic complete response to neoadjuvant therapy, you had to have a few other high-risk features using the CPS plus EG score. And if you received adjuvant therapy, you had to have four or more positive nodes, so stage III disease. All patients had to have received at least six cycles of chemotherapy, radiation as indicated, and of course, hormone therapy was given for hormone receptor-positive disease. There were over 1,800 patients randomly assigned, which was pretty, I think, impressive given the fact that everybody had to be tested. And the whole idea behind the trial is that you would enroll a group of patients who still had a high residual risk of recurrence, even though you got standard and reasonable adjuvant or neoadjuvant therapy. It's important to keep in mind when you think about the results of this trial is that having a BRCA mutation, and in particular BRCA1, increases sensitivity to chemotherapy. So the pathologic complete response rates, for example, in the neoadjuvant setting for triple negative breast cancer with the BRCA1 gene mutation, are higher than in patients who don't have a germline mutation. And so you're really looking at a group of patients who have high-risk disease because they didn't have a pathologic complete response if it was the neoadjuvant setting. Now, of the patient population, a little over 70% had BRCA1 mutations. The rest had BRCA2 mutations. And for the triple negative group, that represented a large portion of the population, about 80%. Again, the rest, a little under 20%, had hormone receptor-positive disease. As you would expect, more than 50%, about 60%, were premenopausal. And about 50% received neoadjuvant therapy. There's always a question about whether or not treatment with prior platinum-based therapy, which is also effective when you have DNA repair deficiency, such as in the germline BRCA mutations, whether or not that would affect sensitivity. A little more than a quarter of the patients had received a platinum chemotherapy agents. And the invasive disease-free survival, the primary endpoint of this trial, was really remarkable. There was an 8.8% improvement in a 3-year invasive disease-free survival rate in patients taking olaparib versus placebo, a very big p-value, and a hazard ratio 0.58. This is really dramatic. The curves separated early, and they remained separated. So that it was the IDFS was 77% for patients on placebo and about 86% in patients who were receiving olaparib, just really very impressive. And one of the things you want to find out about is are you changing the rate of distant recurrence. And indeed, not only were there less distant recurrences, but if you look at distant excluding the brain, that's where you really saw the biggest difference. There was a small difference--hard to know if it really is significant--1.5% less brain recurrence is a big issue for patients, particularly with triple negative disease. It was a little less contralateral invasive disease, but it wasn't anything significant. So really, what you were preventing was the kind of recurrence we don't want to see, which is distant recurrence. And then if you looked at the distant disease-free survival, the absolute improvement for metastatic disease was 7.1%. Again, the curve separated early and stayed separated over time. Now, overall survival, of course, is the golden endpoint that you want to look at. There were numerically less deaths in the olaparib arm, 59 versus 86 in the placebo arm. Most of these deaths were due to breast cancer. And the hazard ratio is 0.68. Although the p-value was 0.024, that didn't meet the statistical plan, which was a p less than 0.01 in terms of how the statistics can be balanced in this trial. But the overall difference was 3.7%. And of course, there were subgroup analyses done, which showed that everybody benefited. It was impossible to see a difference. And again, only a small number of patients relatively receive platinum, so it's hard to know whether or not that changed the response. In terms of the side effects--you always want to think about side effects--it was exactly what you would have expected from what we [expect] in the metastatic setting. Not a lot of grade III or greater toxicities. Mainly anemia was the most common at 9%, and 5% neutropenia, a little bit increase of grade III fatigue, but only 2%. The rest of the toxicities were all grade I and II. And of note, olaparib does cause nausea, 57% of patients versus 23% reported nausea with olaparib versus placebo. But normally, you can manage this nausea and the anemia by actually dose reducing and first holding and then dose reducing. One of the big questions, of course, with PARP inhibitors is if you're inhibiting repair of DNA, are you causing leukemia--new primary cancers? And it was very encouraging. Again, it's 3 years, so we need to be followed a little bit longer, maybe 5, but it was 0.2% or 0.3%. There was no increase in myelodysplasia or myeloleukemias with the use of the PARP inhibitor, which is really important. And the global quality of life scores were identical. So even with these side effects, they could be managed and didn't impact global quality of life. And then in terms of the paper, the additional information the paper gave is that most of the people who required a transfusion received only one transfusion of red blood cells. So I think with the caveat that there are some additional side effects, they are generally able to be managed well. Quality of life is maintained. And there's a huge early difference in the most important endpoints that we look for in these trials--invasive disease-free survival and most importantly, distant disease-free survival. So definitely history in the making. ASCO Daily News: Excellent. Thank you for sharing these fantastic results from the OlympiA trial. The ECOG-ACRIN Research Group presented EA1131, a study of platinum-based chemotherapy or capecitabine in patients with residual triple negative basal-like breast cancer following neoadjuvant chemotherapy (Abstract 605). This interim analysis really highlighted the need for better therapies for this patient population. What are your thoughts on this trial? Dr. Hope Rugo: Well, this, I think, is an important trial. Ingrid Mayer from Vanderbilt designed the trial with ECOG and actually presented the data. There will be a lot more data coming from this study because they collected tumor tissue and are doing a lot of different analyses, which might help us understand the benefits of different treatments in different subgroups of patients with triple negative breast cancer. Now, this trial really focused on patients who have the highest risk disease after neoadjuvant therapy, clinical stage II or III triple negative breast cancer diagnosis. They received the standard neoadjuvant chemotherapy. And they had to have tumors that were greater than one centimeter in the breast at the time of surgery or any positive lymph nodes. So this is actually a group of patients who we already know have a high-risk of distant recurrence. They did do an analysis of the tissue using a PAM50 assay to understand which tumors were basal or non-basal like. And patients were randomly assigned to receive capecitabine by the CREATE-X trial, which showed an improvement in overall survival when capecitabine was given to patients with residual triple negative breast cancer after neoadjuvant chemotherapy in Japan and Korea, versus carboplatin or cisplatin by treating physician discretion (DOI: 10.1056/NEJMoa1612645). The patients received four cycles every 3 weeks of carbo or cisplatin. Now, one thing that's important to keep in mind is in Japan where the CREATE-X trial was designed in Korea where it also participated, the capecitabine dose was the original U.S. Food and Drug Administration (FDA)-approved dose, where it was a little bit higher, 1,200 milligrams per meter squared twice a day, 2 weeks on, 1 week off. In the U.S., patients don't tolerate this very well. And there is a different metabolism in Asian patients, where they can tolerate a higher dose of 5FU and capecitabine with not as much toxicity due to pharmacogenomics. The patients in the ECOG-ACRIN trial received capecitabine at 1,000 milligrams per meter squared twice daily with the same schedule, which is really all that's tolerated. So the objective of this trial was to see whether or not you could do better or the same if you received a platinum versus capecitabine with the idea that DNA damaging agents work very well in basal-like triple negative breast cancer. So the patients were enrolled in this trial. 415 patients were randomly assigned. And then the data safety monitoring group who were following the results at the interim analysis ended up closing the trial because they found that based on the statistics so far that it was unlikely that the platinum arm would either be better or worse than the capecitabine arm. And they saw more toxicity in the platinum arm. So the trial was closed. And that's the data that was presented. So there was a total of 160 patients who received capecitabine, [and] 148 [patients] who received platinum. Most of the patients had basal-like disease. The age, it was about 52. It's all what you would have expected to see in this patient population. So I don't think we have any concerns about the patient population. The 3-year invasive disease-free survival in patients with basal-like triple negative breast cancer, the primary endpoint of the trial, was identical between the two arms. But actually, discouragingly, it wasn't great. So IDFS for capecitabine was 49% and platinum 42%. So this was actually very disappointing data. And I think it just highlights how we really need to provide better treatment for our patients who don't achieve pathologic complete responses to the best neoadjuvant therapy. It is true that the ECOG-ACRIN trial didn't require that patients receive anthracyclines, but 85% did. So I think that we feel really comfortable that they got good chemotherapy. They looked in the non-basal-like sub-type. And in the non-basal-like sub-type, which are cancers that are more likely to be responsive to capecitabine in the metastatic setting, actually, the outcome, although small numbers, looked better with capecitabine than with getting the platinum-type therapy. And if you looked at non-basal versus basal, regardless of therapy, the patients who had non-basal-like disease did much better than the patients who had basal-like disease, something that we would have guessed, but hasn't been shown before. So I think it was really important, [and] really helps us to identify the patients who need the most intervention. But even the basal group, the IDFS, the non-basal group, it was 55.5%. So better than basal at 46%, but still you got 45% of patients with invasive disease-free survival event over a 3-year medium follow-up. Overall survival at 3 years, also, was disappointing at about 66% for capecitabine and 58% for platinum. So I think that, really, this trial just identified, I think, in a very confirming way how we need to make progress in the treatment of these patients who have residual disease after neoadjuvant chemotherapy. In terms of toxicity, the platinum-based therapy clearly was more toxic. Most of the toxicity that was seen was grade I and II, as you would expect, but there was more grade III toxicity even with the platinum-type therapy. Again, as you would expect. You get hand-foot syndrome with capecitabine and not with platinum. But there was more of the standard toxicities that you would expect with the platinum or bone marrow suppression, primarily some thrombocytopenia, et cetera. So when they looked overall at the trial population, I mentioned that most had basal sub-type by PAM50. It was 80%. So it is a group of patients where I think even going into neoadjuvant therapy about 80% have basal-like disease. So I think it makes us very interested in the results that we expect to see in the very near future from the KEYNOTE 522 trial, where we've seen an improvement in pathologic complete response, particularly in patients with node positive disease with the addition of pembrolizumab, to standard taxane platinum and anthracycline-based neoadjuvant chemotherapy (DOI: 10.1056/NEJMoa1910549). But a very recent press release noted that they have reached their event-free survival endpoint. And that pembrolizumab improves event-free survival. And the importance of this data, which, of course, has not yet been shared, so we have to see what it looks like and what the differences are, is that they had shown earlier at the FDA's ODAC meeting in February of this year that possibly patients who don't achieve a PCR, who received pembrolizumab before and after surgery, had a better outcome than patients who did not receive pembrolizumab and received placebo. So how we incorporate capecitabine into the post-neoadjuvant treatment or other novel agents will very much be a subject of the next few years as we sort this out. But if the pembrolizumab data is indeed exciting--and we'll talk more about the durvalumab data in just a moment--then I think the question would be, what chemotherapy do you give? And based on this trial, there is absolutely no indication for platinum postoperatively in patients with residual disease after neoadjuvant therapy. Capecitabine should be given. But clearly, we need better options for therapy. And this is also being studied with some of the new antibody drug conjugates, like sacituzumab govitecan to see whether or not we can improve outcome in these patients. ASCO Daily News: Right. Well, let's look at Abstract 506. This is the phase II GeparNuevo study. The data presented by the German Breast Group showed that neoadjuvant durvalumab improves long-term outcomes for patients with triple negative breast cancer. What is your takeaway from this study? Dr. Hope Rugo: You know, this was really interesting, and I think unexpected results based on their original presentation. This was a phase II neoadjuvant trial in patients with triple negative breast cancer. And the data by the GBG and Sibylle Loibl, who runs the GBG, had already presented the data from the primary endpoint of this smaller neoadjuvant trial, which was pathologic complete response. And what they did in this trial was they treated patients with a nab-paclitaxel followed by epirubicin and cyclophosphamide. And the patients were randomly assigned to receive the checkpoint inhibitor durvalumab versus placebo. There were 174 patients stratified by a low, medium, or high TILs. And their main endpoint, as I mentioned, was PCR. So this is a secondary endpoint of invasive disease-free survival. A group of patients received 2 weeks of durvalumab as sort of a lead-in first. And they've looked at that group separately. But it's hard to know because it's such a small trial what that means. And nobody is using a lead-in right at the moment. So their primary endpoint, as I mentioned, has been published already in Annals of Oncology in 2019 (DOI: 10.1093/annonc/mdz158). Although numerically there was a higher PCR rate in the durvalumab treated arm, this was not statistically significant. The p-value is in no way significant. And they looked at, in a forest plot, they showed that the patients who had the window seemed to have a higher PCR, but it was hard to justify exactly why that was the case in this group of patients. Now, it's important to keep in mind that the data that we have from KEYNOTE 522, the neoadjuvant trial with pembrolizumab, and IMpassion 31, the trial with the atezolizumab, showed the benefit, particularly in patients with node-positive disease. In this trial, about a third of the patients had stage zero or I breast cancer. So 61 out of the total of 174 patients did not have positive nodes. So we thought the PCR difference really wasn't seen because they had a low-risk population. But now, they're presenting their secondary endpoint of invasive disease-free survival in this group of patients. And what they saw, actually, at a median follow-up of about 44 months, they saw a 12 IDFS events in the durvalumab arm and 22 in the placebo arm. And actually, there were twice as many distant recurrences in the patients treated with placebo versus durvalumab. So 13 versus six events for distant recurrence. So I think that's actually a really important endpoint. And if you looked at the invasive disease-free survival at 3 years, it was 77% for placebo and almost 86%. So almost a 9% difference in favoring the patients who received durvalumab. Pretty dramatic, you know? A hazard ratio of 0.48. And they did have a p-value of 0.0398. So that was quite interesting. And they looked at distant disease-free survival. Numbers are small here, but I think it's a really important endpoint, and overall survival. Overall survival is early to see, but they could see--this is a long follow-up, but it's a small study rather than early--and they showed that overall survival difference was 83.5% in the placebo arm and 95.2% in the durvalumab arm. Again, secondary endpoints with a hazard ratio is 0.24 and, again, a p-value of 0.1. Distant disease-free survival, such an important endpoint, was a huge difference 78.4% versus 91.7%. Again, hazard ratio of 0.31. So pretty dramatic. And when you looked at subgroups of patients, and they looked at PD-L1 positive versus negative. Almost all of the patients had PD-L1 positive disease, so 138 versus 20 that were PD-L1 negative. So it's kind of hard to interpret any of that. And that trial was stratified by stromal TILs anyway. They did show that patients who had a PCR had a better outcome than patients who did not have a PCR. But among the patients who had a PCR, the patients who had durvalumab did better, again, with almost a 10% difference, favoring durvalumab versus placebo. Now, this is a phase II randomized trial, so it's small. And so this is really hypothesis generating. But given the fact that KEYNOTE 522 and IMpassion 31 (NCT03197935) gave the checkpoint inhibitor for a year, and in this situation patients received durvalumab only in the neoadjuvant setting, it suggests that they saw this impact in patients who had a PCR that was greater in patients receiving durvalumab placebo. So it suggests that even though the PCR improvement was not significant, that just the treatment with a checkpoint inhibitor changes long-term outcome. And we know that there's more toxicity by giving longer course checkpoint inhibitor therapy, so we expect that we might see approval of pembrolizumab based on the KEYNOTE 522 trial. And it will bring up the question of whether or not you need a whole year of treatment to improve outcome. And whether or not simply treatment preoperatively might be sufficient, particularly in the patient group who achieves a PCR. It will be, I think, very, very important to be able to evaluate this in order to reduce the toxicity, both the physical toxicity, as well as financial toxicity from use of checkpoint inhibitors in patients with triple negative breast cancer. Also, we know that a third of these patients had stage I disease. And I think we really need to look at the larger trials quite carefully to understand whether or not all patients need checkpoint inhibitors who have triple negative disease. Or whether or not we could more correctly focus on the patients who have higher risk disease, node-positive disease who've been shown to have less tumor infiltrating lymphocytes than patients who have less burdensome disease at diagnosis. ASCO Daily News: Right. So what about the subset analysis in Abstract 1011 that looked at outcomes in patients who are age 65 and older in the phase III ASCENT study of sacituzumab in metastatic triple negative breast cancer? Can you tell us about ASCENT and the toxicities associated with this antibody drug conjugate in this older patient population? Dr. Hope Rugo: Well, ASCENT, of course, is a practice-changing trial as well. It led to the final formal approval of sacituzumab govitecan for patients with metastatic triple negative breast cancer in the second line or greater earlier this year after accelerated approval was granted earlier in 2020. This antibody drug conjugate is given 2 weeks on, 1 week off. And the primary toxicity is neutropenia, and then to a lesser degree diarrhea. But overall, the drug is quite well-tolerated. In the overall parent ASCENT trial, as the listeners know, showed an improvement in progression-free and overall survival at the first analysis. Very impressive data with sacituzumab in these heavily pretreated triple negative breast cancer population, compared to treatment of physician choice with standard chemotherapy options, where about 50% of the patients received eribulin, which had already been shown to be better in terms of overall survival compared to other chemotherapy in the subset of patients treated in the past with eribulin who had triple negative disease. So at ASCO this year, Kevin Kalinsky presented on behalf of our authorship group a subset analysis looking at patients who were age 65 and older to better understand whether there was more toxicity and as much benefit in this group of patients. So important when we're looking at novel therapies. So overall, there were 44 patients treated with sacituzumab and 46 with treatment of physician choice who were age 65 or older. Most of the patients had received two to three lines of therapy. And about 40% had received greater than three lines of therapy. The median prior anticancer regimen was pretty similar to the overall group. Most of the patients had initially been diagnosed with triple negative disease, but really, interestingly, about a third of the patients had ER-positive or something else disease initially and were triple negative on biopsy in the metastatic setting. So an interesting subgroup of patients that were also looked at separately and appeared to benefit to the same degree as the triple negative patients. So we looked at progression-free survival in this group of patients looking at patients under age 65 and age 65 and older. A hazard ratio was even greater in the age 65 or older for--it's hard. These are subset comparisons, but the hazard ratio is 0.22 going from 2.4 months with standard therapy to 7.1 months with sacituzumab. The hazard ratio in the younger group was 0.46. But still a big difference in progression-free survival. And then in terms of overall survival in the age 65 and older group, it went from 8.2 to 15.3 months with a hazard ratio of 0.37. And so also really quite dramatic. And overall response was also significantly increased with, in fact, the only responses seen in the age 65 or older group seen in the sacituzumab group. There were no complete or partial responses in the treatment of physician choice group. Of course, really important to look at safety in our older patients because we know that generally there is more toxicity in that group of patients. But actually looking at grade III or greater toxicity, keeping in mind it was 49 [patients] in the older group versus 209 patients in the younger group, there was no difference in grade III or greater toxicities. There were more dose reductions. So 35% reduced their dose versus 19% older versus younger. But there was no difference in adverse events that led to discontinuation between the younger and older group. So that was really encouraging. We see this in almost all trials that older patients have more dose reductions and that was seen here as well. And we also looked at this very small subset of patients who are age 75 or older versus age 65 or older. And the rates of adverse events were similar, albeit smaller number of patients. There was, if you looked at specific treatment-related adverse events that led to dose reduction, it was a neutropenia, fatigue, diarrhea, febrile neutropenia in a small number, 6% versus zero in the treatment of physician choice and nausea. So it's helpful to know what those toxicities are when you're thinking about treating these patients in clinical practice. And in a patient who might be a little less strong, a little older, more comorbidities, so slightly more frail, I would consider starting potentially at a 3/4 of the dose and then going up if they tolerate it well, versus starting at the full dose and getting a lot of toxicity. But this was really encouraging data that showed that you can give the drug to patients who are older and even elderly at age 75 or greater. So that was good to see. And then Lisa Carey presented additional data looking at patients who were treated in the second line or greater because the formal approval by the FDA is in second or greater line. But most of the data looked at patients who were treated in the third or greater line. So you were supposed to have at least two chemotherapies for advanced disease, but you could have had one in the early stage setting if your progression occurred within 12 months. So there were 33 and 32 patients in the sacituzumab and treatment of physician arm, respectively, who had a recurrence within 12 months of neo or adjuvant chemotherapy. They got one line of chemotherapy in the metastatic setting. And then they were randomly assigned on the ASCENT trial. And as you would expect, tiny numbers, right? 33 and 32 patients. But you get a lot of events in this patient population. The PFS was much greater in patients getting sacituzumab than treatment of physician choice. Hazard ratio of 0.41. And also, if you looked at overall survival, it was double. The hazard ratio is 0.51, even in the second line setting. I think it's really interesting to look to see what the toxicity is relative to the lines of therapy. But because the numbers are so small, it's really hard to look at this now. We'll see more data on toxicity when we see data in the first line, as well as the post-neoadjuvant setting in ongoing trials. And I think that will help us a lot to understand what I think we see in the current clinical trials and in practice, which is that patients who are treated in this second line setting have less hematologic toxicity as well as GI toxicity and need less growth factor intervention, et cetera. And I expect that we'll see that in the post-neoadjuvant setting as well. These numbers are too small to really look at any differences in toxicity. But all of this data I think was incredibly encouraging for us in terms of the use of sacituzumab in patients with metastatic triple negative disease, as well as the expansion to the first line and to post-neoadjuvant setting. ASCO Daily News: Excellent. Investigators of the phase III MINDACT trial, that's Abstract 500, evaluated the survival of patients with an ultra low risk 70 gene signature. How will MINDACT inform clinical practice? And do you think this study might guide more appropriate choices of chemotherapy in women with node-negative or one to three node-positive disease? Dr. Hope Rugo: Well, how MINDACT will inform clinical practice is a very big question. And it already has informed clinical practice identifying patients who are better candidates for chemotherapy and endocrine therapy versus endocrine therapy alone who have stage I and II hormone receptor-positive early stage breast cancer based on their primary outcome results. This particular analysis was something different. So we think about using this 70 gene score and the recurrence score from the TAILORx trial (DOI: 10.1056/NEJMoa1804710) and RxPONDER to try and identify which patients need more therapy versus less therapy. Now, we also know that these scores have some prognostic impact. Clinically, we mainly have used them to decide who should get chemotherapy in addition to endocrine therapy. This trial looked at a different way to use a gene expression scoring system. It's really to identify which patients need less. Given the fact that your middle of the line therapy is endocrine therapy, which patients do we know who will do very, very well with any endocrine therapy and don't need extended duration endocrine therapy? That's really the question here. So they looked at the patients who were in the MINDACT trial and used data published by my colleague, Laura Esserman who looked at a cohort of patients retrospectively and found that patients who had an ultra low score in MINDACT. And that's a score greater than 0.355 where plus 1 is the lowest end of low risk, and minus 1 is the highest end of high-risk, so greater than 0.355. She identified a group of patients who did well, regardless of whether they received tamoxifen or not apparently in this retrospective long-term outcome where there was 15-year follow-up. So they use that data to go into the MINDACT population and to try and understand which patients benefit. And the MINDACT is a much higher risk group of patients. So if you looked at that original trial that Laura Esserman published, these patients had screen detected cancers. And in fact, the 70 gene signature low and ultra low-risk tumors are, as you would expect, over-represented in screen detected cancers. So you've got this excellent survival regardless of treatment. So how did they apply to MINDACT? So in MINDACT, patients were randomly assigned, of course, who had clinical low, genomic high, or clinical high genomic low to receive chemotherapy or not. In this situation, you're really looking at the patients who have genomic ultra low disease. So most of those patients would not be getting chemotherapy because they would already have ultra low disease. So what they found actually when they looked at the overall population of MINDACT, 6,700 or so patients, they found 15% of patients or 1,000 patients fell into this ultra low category. And if then you looked at the patients who were high-risk, it was 36%. And patients who fell into the big low-risk group, it was about 49%, so about half of the population of patients. So they looked at the different metastasis-free interval rates in patients who had genomic low and ultra low-risk disease, regardless of the treatment the patients receive. They all receive endocrine therapy, remember? So they actually found that in patients who were ultra low versus low-risk, that the hazard ratio is 0.65, showing that patients who had ultra low-risk--remember, this was 1,000 patients at 8 years--there was only 36 events. So they had a 97% 8-year distant metastasis-free interval, compared to 94.5% for low-risk and 89.2 in high-risk disease. They looked at breast cancer-specific survival rates as well. And for ultra low-risk in 1,000 patients, there were exactly eight events. 99.6% 8-year breast cancer-specific survival. So really, quite remarkable. So clinical high-risk tumors tend to have larger size, higher grade, be node-positive. We already know that. For the 1,000 genomic ultra low-risk patients, about almost 70% were greater than 50 years. 80% were node negative. 81% had tumors that were T1, so up to two centimeters. And most of them, except for 4%, were grade I and II. 97% were hormone receptor-positive HER2-negative. Only 14% of patients who had ultra low-risk disease received chemotherapy in MINDACT. And most of the rest received endocrine therapy. Some actually didn't receive endocrine therapy. 16% had no adjuvant systemic treatment at all. So if you looked at the genomic ultra low-risk patients and divided them into clinical low-risk and clinical high-risk, there was really no difference in the events overall, a little bit less 8-year distant metastases-free survival, but not much of a difference. So really, a quite remarkable outcome. Now, what you want to know, of course, then is, does it make a difference if you get endocrine therapy at all? And they looked at the patients who had chemotherapy versus no chemotherapy. And as you would expect, it made no difference. Again, it was a tiny number of patients. But if you looked at endocrine therapy versus no endocrine therapy, it was hard to tell. Because, again, no adjuvant systemic therapy was only 157 patients. There were four events. And for the patients, 685 patients who got endocrine therapy, there were 23 events. So the 8-year metastasis-free interval was identical, but there just aren't enough patients in that no adjuvant systemic therapy group to really understand. So what we know is ultra low-risk defines a group of patients who have excellent outcomes. Does it tell us that they don't need adjuvant systemic therapy? No. Eight years really isn't enough time, unfortunately, in is group because 50% of recurrences occur after five years and out to 20 plus years. We have to keep in mind the Early Breast Cancer Trials Group data showing how many recurrences occurred after five years of endocrine therapy. But in this group of patients who have ultra low-risk disease, they clearly do not benefit from chemotherapy. And I think that's regardless of their clinical risk. And it's likely that 5 years of adjuvant endocrine therapy is absolutely all those patients would ever need. If you have a small cancer that's ultra low-risk, could you get by with less than 5 years of endocrine therapy in a patient with a lot of toxicity? Potentially. And I think that's a really important bit of information to take back into clinical practice when you're talking to patients about the duration of endocrine therapy. But a stage I tumor or stage II with ultra low-risk disease, in general, I would treat for 5 years. I think it's important to keep in mind that premenopausal women, even with ultra low-risk stage II disease, have an ongoing risk of recurrence. And I still think that those patients should be treated with a varying function suppression and aromatase inhibitor if tolerated and tamoxifen otherwise because our very young patients tend to have higher risk of recurrence over time. And it's very hard to separate them out in these studies. Interestingly, there are a few young women who have ultra low-risk disease. So I think this really helps us understand yet another impact of genomic tests, which is who needs less therapy, not just who needs more. ASCO Daily News: Great. That's good to hear. Well, finally, the theme of the Annual Meeting was equity. And in Abstract 1092, you and your colleagues at University of California, San Francisco (UCSF) looked at decreased enrollment of patients with advanced lobular breast cancer compared to ductal breast cancer in interventional clinical trials. Can you tell us about this study? Dr. Hope Rugo: Yes, this was a really interesting evaluation. My colleague surgeon Rita Mukhtar at UCSF actually led this evaluation with a very good student who's working with us on some of our research trials. And the idea was that we had observed anecdotally, as have others, that patients with invasive lobular cancer tend to be less likely to meet criteria for clinical trials. So they don't have measurable disease as much. We tend to see sclerotic bone lesions, diffuse infiltration without measurable disease. And it can be much, much more difficult to meet the criteria for clinical trials. So actually, what my colleagues did in this trial is look at whether or not patients with lobular breast cancer are underrepresented in clinical trials. And so they looked at the proportion of interventional stage IV clinical trials that used RECIST in clinicaltrials.gov. And then actually looked at the patients who have RECIST measurable disease who have lobular cancer. And it's really interesting. I mean, we just have a lot less RECIST measurable disease. And in the UCSF cancer registry, patients who were enrolled in clinical trials, if you looked at invasive lobular cancer were markedly decreased if you compare it to patients with other sub-types of breast cancer. So we think that that's probably due to the requirement for measurable disease. And that what we should do in patients who have metastatic lobular cancer is develop trials that are specifically for lobular cancer that focus on the unique biology. And there's a lot of work going on now looking at that biology. And allow patients to enroll based on their disease control rates rather than response. So that we don't require RECIST measurable disease since that's hard to come by in invasive lobular cancer. So I think it's a really important area. It's about 15% of invasive breast cancers. We see a lot of lobular cancer in the metastatic setting. And I think it's unfortunate not to be able to enroll these patients in clinical trials. There is a lot of interest in the cooperative groups in the United States in Europe and in Asia, of course, in trying to do trials that are focused on addressing the needs of patients with lobular cancer, both in the early and late-stage setting. ASCO Daily News: Excellent. Thank you, Dr. Rugo. It's been great to have you on the podcast today. Thanks so much for sharing your valuable insight with us on the ASCO Daily News podcast. Dr. Hope Rugo: It was really a pleasure to participate and thank you for putting together these podcasts. ASCO Daily News: And thank you to our listeners for your time today. If you enjoyed this episode, please take a moment to rate and review us, wherever you get your podcasts. Disclosures: Dr. Hope Rugo Honoraria: Puma Biotechnology, Mylan and Samsung Research Funding (Institution): Pfizer, Merck, Novartis, Lilly, Roche, Odonate, Daiichi, Seattle Genetics, Macrogenics, Sermonix, Boehringer Ingelheim, Polyphor, Astra Zeneca and Immunomedics. Travel, Accommodations, Expenses: Pfizer, Novartis, Mylan, AstraZeneca, Merck Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
Hamilton Baiden had it all-a wonderful marriage, three healthy children, and a successful career. Or so it appeared from the outside. But this facade of having it all together began to crumble at home. Rich and Hamilton discuss his story and how he would eventually get help. Hopefully, his story will give someone in a similar situation the courage to evaluate where they are and course correct or get the help they need. Hamilton Baiden is President at Heritage Health Solutions. Heritage CARES (Comprehensive Addiction Recovery Education & Support) is a substance misuse program that is entirely digital and proven to help individuals struggling with addiction issues and navigate recovery. The Heritage CARES Program was created under Hamilton's leadership fueled by his desire to help others struggling with substance use disorder.Prior to joining Heritage, Hamilton was Executive Vice President of Sales at Avella Specialty Pharmacy where he oversaw the growth of the business from a small regional pharmacy to the largest independent specialty pharmacy in the nation. His knowledge and understanding of the pharmacy industry were developed throughout his professional career, working in various roles for prominent pharmaceutical manufacturing companies, including MedImmune, Serono, Daiichi, and Sanofi.A graduate of The Citadel in Charleston, SC, with strong ties to his community, Hamilton served as Chairman of the Board of Directors for a nonprofit organization dedicated to animal welfare, Altered Tails, and currently serves on the National Board of the American Liver Foundation Southwest Division. Hamilton is also in recovery and committed to helping others.
El 11 de marzo de 2011 se registró un terremoto de 9 grados en la escala de Richter y un tsunami con olas superiores a los 17 metros de altura en Japón. La central nuclear de Daiichi, en la prefectura de Fukushima, fue impactada, provocando el segundo accidente nuclear más importante de la historia mundial, después del ocurrido en Chernóbil, Ucrania, en 1986. Han pasado 10 años y la ciudad nipona aún sufre las consecuencias de este suceso, pues aún no es habitable y tampoco es apta para actividades agrícolas, pesqueras y ganaderas. De esta situación y los impactos económicos que provocó, ha surgido el debate sobre la política energética mundial, pues tras el suceso se discute sobre la seguridad y pertinencia de mantener y construir plantas nucleares con el fin de proveer de energía a países y grandes aglomeraciones. Para entender la situación de Fukushima y comprender el fondo del debate sobre la energía mundial, consultamos al profesor Carlos Aquino de la Universidad Nacional Mayor de San Marcos, Perú; Erasmo Zarazúa, investigador internacional de la Universidad Iberoamericana, en México; Gustavo Cardozo, analista internacional del Centro Argentino de Estudios Internacionales; y los docentes de la Universidad Nacional de Colombia, Germán Corredor, de la sede Bogotá y Sergio Botero de la sede Medellín. Créditos: Dirección: Profesor Diego Peña Producción sonora: Edgar Guasca, Producción periodística: Claudia Sánchez y Milton Medina; Locución: Paola Medellin
Fukushima in Japan, March 11, 2011. An earthquake, a tsunami and three nuclear meltdowns. Much has happened since then: Cities have been rebuilt, protective walls erected, work continued on the damaged nuclear power plant. Export restrictions for many products have been largely lifted. But only a few people who had to flee their homes ten years ago have actually returned to the region.
On this episode Erica Vella revisits the 2011 Great East Japan Earthquake and the nuclear crisis that followed at the Fukushima Daiichi plant. On Mar. 11, 2011, a magnitude-9.0 earthquake rocked parts of Japan and triggered a massive tsunami that killed almost 20,000 people. Kazuko Moghul, who lives in Ontario, said she had family in parts of Japan that was hit by the earthquake and tsunami. “I watched the program of NHK [Japan Broadcasting Corporation]. … I realized a big earthquake and huge tsunami hit Tohoku region,” she said. “I knew I had to contact my family right away.” Moghul tried to get in touch with her family that day, but had no luck and in the days that followed she would learn that earthquake and deadly waves would take the lives of four family members. The natural disaster caused the Daiichi nuclear power plant in Fukushima to go into meltdown. Ontario resident, Dan Ayotte, an employee for General Electric, was working in the offices of nuclear plant when the earthquake hit. “I really didn't think we were going get out. I thought the building was going to come down,” he said. While Ayotte managed to escape and make it back to his home in Peterborough, Ont., a nuclear crisis was unfolding at the Daiichi plant and concerns had been raised around if people in Canada had been exposed to unsafe levels of radiation. On this episode of Whatever happened to… Erica Vella speaks with Moghul and Ayotte; she also discovers if the nuclear disaster affected people living on Canada’s west coast. For more exclusive content head over to https://globalnews.ca/news/7457185/whatever-happened-to-podcast-great-east-japan-earthquake-daiichi-nuclear-crisis/ Contact: Twitter: @ericavella Email: erica.vella@globalnews.ca See omnystudio.com/listener for privacy information.
PharmaPills - Pillole dal farmaceutico: Novità, Curiosità e Lavoro dal mondo del farmaceutico. A cura di Stefano Lagravinese. In questa puntata parliamo di:Toscana Life Science e Diesse Diagnostica, Astrazeneca e Daiichi Sankyo, Consenso Informato, Ricerca IRCCS, Leucemia linfocitica cronica, Vaccino Anti-Covid.Aziende: AstraZeneca, Daiichi Sankyo, Toscana Life Science, Diesse Diagnostica.Persone: Andrea Paolini (Toscana Life Sciences).Nuove terapie: Ibrutinib+rituximab, Vaccino anti-Covid.Patologie: Leucemia linfocitica cronica, COVID-19.Lavoro: Senior Clinical Project Manager, Clinical Operation Lead, CRA II.Il mercoledì alle h 12.00 su Spreaker.com e iTunes.Seguici su: www.telegram.me/pharmapills www.facebook.com/pharmapills/
PharmaPills - Pillole dal farmaceutico: Novità, Curiosità e Lavoro dal mondo del farmaceutico. A cura di Stefano Lagravinese. In questa puntata parliamo di:Toscana Life Science e Diesse Diagnostica, Astrazeneca e Daiichi Sankyo, Consenso Informato, Ricerca IRCCS, Leucemia linfocitica cronica, Vaccino Anti-Covid.Aziende: AstraZeneca, Daiichi Sankyo, Toscana Life Science, Diesse Diagnostica.Persone: Andrea Paolini (Toscana Life Sciences).Nuove terapie: Ibrutinib+rituximab, Vaccino anti-Covid.Patologie: Leucemia linfocitica cronica, COVID-19.Lavoro: Senior Clinical Project Manager, Clinical Operation Lead, CRA II.Il mercoledì alle h 12.00 su Spreaker.com e iTunes.Seguici su: www.telegram.me/pharmapills www.facebook.com/pharmapills/
In this episode of Occupation Station meet 2008 Albany College of Pharmacy and Health Sciences grad Stephan Esker. Stephan is now Senior Medical Director, Antibody Drug Conjugate (ADC) Franchise at Daiichi Sankyo. From his time as a student and continuing throughout his career, Stephan has been inspired by people who are fighting challenging diseases. His concentrations have mainly centered on HIV and oncology treatments. Stephen says some of the best advice he was ever given was that he should try new things and be willing to accept some failure along the way. He was able to take chances and learn new things while at ACPHS and through summer research opportunities and mentorships.
Hatuey explores focusing on yourself to start then turning to the world. He also touches on the Daiichi plant in Japan that's still radioactive. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/lifetrap/message Support this podcast: https://anchor.fm/lifetrap/support
Tokyo Electric Power Company made headlines around the world when it announced that it would have to discharge radioactive water from the ruined Fukushima Daiichi nuclear plant into the Pacific Ocean. Paul Gunter is director of the Nuclear Oversight Program at Beyond Nuclear. He tells us what would happen if the waste water were released into the ocean and explains why the only viable solution is to build more storage tanks.
Tokyo Electric Power Company made headlines around the world when it announced that it would have to discharge radioactive water from the ruined Fukushima Daiichi nuclear plant into the Pacific Ocean. Paul Gunter is director of the Nuclear Oversight Program at Beyond Nuclear. He tells us what would happen if the waste water were released into the ocean and explains why the only viable solution is to build more storage tanks.
Welcome to the Elevator World News Podcast. This week’s news podcast is sponsored by elevatorbooks.com: www.elevatorbooks.com SCHINDLER OUTFITS LEED-CERTIFIED OFFICE TOWER IN MANILA Jardine Schindler Philippines delivered a vertical-transportation (VT) system including 20 elevators and two escalators to the 42-story office tower The Finance Centre in Manila, Philippines. Developed by Daiichi Properties, the building is in the Bonifacio Global City District and was designed by Gensler with AIDEA to achieve Leadership in Energy and Environmental Design (LEED®) Gold certification. Schindler worked with the team to design a VT system that includes the S7000 high-rise elevator and PORT destination-dispatch system. Delivered in February, the job represents a longstanding professional relationship between Schindler and Daiichi. Image credit: Courtesy of Daiichi Properties To read the full transcript of today's podcast, visit: elevatorworld.com/news Subscribe to the Podcast: iTunes│Google Play|SoundCloud│Stitcher│TuneIn
Particles:と & やUnlike most particlesと and や can be used between particles to mean ‘and’. と: is a very specific and meaning ONLY: A and B. This is also the most common ‘and’ particle. However, this is an exhaustive list. For example, if you say Aと B it is only A and B, nothing else.や: is an inexhaustive and. Meaning, that you can say Xや Y and there could also be Z but you are omitting it. An example of this would be saying you like Sushiや Chicken Katsu, but you also like Takoyaki but neglect mentioning because the list of your favorite foods would be too long.Example Sentences:たけしくん と さやかちゃんは にほんじん です。Takeshi-kun and Sayaka-chan are Japanese.いもうと や おとうとは かぞく です。My little sister and my little brother are family.にほんご と えいごは げんご です。Japanese and English and LanguageagesDialogue: たけし と だいいちは だれ です か? たけし と だいいちは にほんじんです。にほんじん や アメリカじん ひとびと です。Who are Takeshi and Daiichi? Takeshi and Daiichi are Japanese. Japanese and Americans and People.*make sure to check out a more detail description at our website: manga-sensei.com
FUKUSHIMA & 2013/2014 GOP – COLLOSAL MELT-DOWNS! To both of these instances we can pen the following phrase, not actually uttered outright by J. Robert Oppenheimer (“the father of the nuclear bomb”) in 1945 but a thought nonetheless that he later admitted on television that went through his mind on that fateful morning of July 16, 1945 in Trinity, New Mexico while witnessing history's 1st nuclear bomb detonation. It was a line from the Hindu scripture, the Bhagavad-Gita. The words are from Vishnu who is attempting to persuade a prince to do his duty: “Now, I am become Death, the destroyer of worlds.” One can only hope that the spike in thyroid and throat cancers to come to this country in the very near future as a result of the Fukushima Daiichi nuclear power plant melt-down disaster will perhaps not show up in the good and the deserving but rather target only the blowhards and the hate & fear-mongers in the right-wing and just like the radiance of a thousand suns (the mighty Vishnu/the Destroyer of Worlds) blot them and their venom out of existence so that the rest of us normal fools can simply pick up where we left off (way back in 1980 with the election of Ronald Reagan as President) and get on with our lives in some semblance of real normalcy. If, by chance, this comes across to some of you as overly harsh, I'm sorry good & gentle people but that is precisely what this country has come to. And just to give you a heads-up, the upcoming off-year elections in November-2014 will be nuclear in all respects. Drink your barium and tuck yourselves into your basement-equipped bomb shelter until the day after election day.
IPERTENSIONE, PROGETTO ONLINE PER L'ADERENZA Assistenza e informazioni per motivare i pazienti, incoraggiarli a osservare le terapie prescritte; un sistema interattivo per aiutarli a raggiungere uno stile di vita sano; un servizio periodico di sms, e-mail, newsletter, per seguire il paziente passo dopo passo nei suoi progressi. E' il programma di assistenza basato sul web My Hypertension Care (it.myhypertensioncare.eu), dedicato a chi soffre di ipertensione e sviluppato con il contributo di esperti, al fine di migliorare l''impegno e l'aderenza dei pazienti al trattamento, fornendo migliori esiti clinici. -BOOM MEDICINA ESTETICA La cura della bellezza non conosce crisi. Nonostante tutto infatti gli italiani continuano a curare la propria immagine, specie attraverso il ricorso alla medicina estetica che, a differenza della chirurgia plastica, è molto meno invasiva. Infatti in Italia le priorità sono: trattamenti anti-invecchiamento, come rivitalizzazione, filler ( 24%), tossina botulinica ( 15,6) e laser, che nei pazienti ultra cinquantenni arrivano fino al 38% delle richieste, seguiti da quelli per combattere sovrappeso, obesità e cellulite. -ASPIRINA RIDUCE RISCHIO MELANOMA Ricercatori della Stanford University School of Medicine di Palo Alto (Usa) hanno scoperto che chi assume regolarmente aspirina ha un rischio ridotto di sviluppare il melanoma. E che piu' a lungo si prende il farmaco, piu' il pericolo di cancro della pelle si abbassa. Lo studio e' pubblicato on line su 'Cancer'. I ricercatori hanno studiato donne tra 50 e 79 anni per una media di 12 anni, chiedendo quali farmaci prendessero, cosa mangiassero e quali attivita' fisica praticassero. -NUOVO FARMACO PER IL DOLORE AI DENTI Il dolore, acuto e cronico, è un'esperienza che in Europa condiziona la vita di una persona adulta su 5 con un costo stimato in almeno 34 miliardi di euro in termini di giornate lavorative perse. Oggi però arriva una buona notizia per milioni di italiani alle prese con sintomi dolorosi: etoricoxib, molecola MSD dalla comprovata efficacia antalgica e antinfiammatoria, dimostrata nel trattamento a lungo termine delle più comuni patologie osteoarticolari, ha ricevuto l'indicazione anche per il trattamento a breve termine del dolore associato a chirurgica dentale. -TERAPIA INNOVATIVA NELLA RETE EMATOLOGICA LOMBARDA Assicurare a tutti i pazienti lombardi i percorsi di cura e le terapie più aggiornate ed efficaci per il trattamento delle malattie del sangue, come gli anticorpi monoclonali, che hanno rivoluzionato l'approccio terapeutico nei confronti dei linfomi e cambiato le prospettive di sopravvivenza. Intorno a questo obiettivo si è costituta già da qualche anno la Rete Ematologica Lombarda (REL) cui aderiscono tutte le strutture sanitarie della Regione impegnate nella cura delle malattie del sangue quali leucemie, linfomi, mielomi, anemie, patologie emorragiche e trombotiche e che oggi rappresenta un modello di riferimento nazionale, che permette ai pazienti di beneficiare dei migliori percorsi diagnostico-terapeutici e di accedere alle terapie più innovative.
Daïïchi Melts Down, pièce electro acoustique, « Mon idée était avec « Daiichi Melts Down » de donner à entendre le boom de Daiichi, son anéantissement. Pour cela j'ai choisi le « propos électroacoustique » qui justement permet de sortir des sentiers battus et donner force au propos. » Philippe Petit, Réponse à l'enquête de la revue l'Autre Musique. Projet Meanwhile in Fukushima : http://fukushima-open-sounds.net
Daïïchi Melts Down, pièce electro acoustique, « Mon idée était avec « Daiichi Melts Down » de donner à entendre le boom de Daiichi, son anéantissement. Pour cela j'ai choisi le « propos électroacoustique » qui justement permet de sortir des sentiers battus et donner force au propos. » Philippe Petit, Réponse à l'enquête de la revue l'Autre Musique. Projet Meanwhile in Fukushima : http://fukushima-open-sounds.net