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Good and bad unintended consequences.By FinalStand. Listen to the Podcast at Explicit Novels.The highest cost of losing a war is the rage of your children."Maybe the Canadian is not so much an 'ex' girlfriend?" Orsi leered. It was the old 'if he is so good that she still wants him back after a colossal screw up, I wanted a taste' expression."Do you think she will help you?" Katalin inquired."She'll help," Pamela huffed playfully. "My grandson has plenty of ex-girlfriends. Most of them want him back, despite his colorful lifestyle. It is one of his more amusing qualities.""Let's get something to eat," I tried to turn the conversation away from my past sexcapades."You are engaged?" Jolan didn't miss a beat."It is complicated," I sighed. "Let's just say I really like her, but she's seven years older, divorced with one young daughter and has a father who hates that I live and breathe.""Do you have any male friends?" Monika joined the Cáel Quiz Bowl."Yes," I replied with confidence. "My roommate Timothy and I are great friends.""He's gay," Pamela pierced their disbelief. "He and Cáel are true brothers-in-arms, I'll give Cáel that much.""Do you have any straight male friends?" Orsi was enjoying taunting me."Do Chaz or Vincent count?" I looked to Pamela."They are straight males, but they don't really know you yet," Pamela failed to be of much help. "I think Vincent insinuated he'd shoot you if you dated any of his three daughters. It was friendly of him to warn you. I supposed that could be construed as liking you.""Are all your acquaintances violent?" Anya seemed worried."Vincent isn't violent. He's with the US FBI," I retorted. Pause. "Okay, he carries a gun and shoots it, he's a law officer. They can do that.""You seem to be stressed," Orsi put an arm around my waist. "Let us ease your worries." Hallelujah!Note: One of History's LessonsIn the last 75 years of military history, airpower had been a decisive factor in every major conflict, save one. Most Americans would think the one exception was US involvement in Vietnam and they'd be wrong: right country, wrong time. Indochina's War of Independence against France was the exception. There, the French Air Force was simply inadequate to the task.Yes, the United States and its allies eventually lost the struggle in Vietnam. But it was their airpower that kept the conflict running as long as it did. For the most part, the Allied and Communist military hardware on the ground were equivalent. While the Allies had superior quantities of supplies, the Communists countered that with numbers, and therein lies the rub.Airpower allowed the Allies to smash large North Vietnamese formations south of the Demilitarized Zone and thus prevented the numerical advantage from coming into play. The North Vietnamese and Viet Cong made one serious stab at a conventional militarily challenge to the Allies, the Tet Offensive, and after initial successes, they were crushed.With the NVA unable to flex their superior numbers, the Allies were able to innovate helicopter-borne counter-insurgency operations. The North Vietnam's Army (NVA) was forced to operate in smaller units, so the Allies were able to engage them in troop numbers that helicopters could support. The air forces didn't deliver ultimate victory, but air power alone had never been able to do so on land. It was only when the US lost faith in achieving any positive outcome in Viet Nam and pulled out, that the North was finally able to overrun the South 20 months later. But every major power today understands the lesson.End of Note(Big Trouble in Little China)The military importance of airpower was now haunting the leadership of the People's Republic of China (PRC), the People's Liberation Army (PLA) and People's Liberation Army Air Force (PLAAF). Their problem wasn't aircraft. Most of their air fleet consisted of the most advanced models produced during the last two decades. The problem was that 80% of their pilots were dead, or dying. Their ground crews were in the same peril. Even shanghaiing commercial pilots couldn't meet the projected pilot shortfall.Classic PLA defense doctrine was to soak up an enemy (Russian) attack and bog down the aggressor with semi-guerilla warfare (classic small unit tactics backed up with larger, light infantry formations). Then, when the invaders were over-extended and exhausted, the armored / mechanized / motorized forces would counter-attack and destroy their foes. This last bit required air superiority through attrition.The twin enemies of this strategy were the price of technology and the Chinese economic priorities. With the rising cost of the high-tech equipment and a central government focus on developing the overall economy, the Chinese went for an ever smaller counter attack striking force, thus skewing the burden of depth of support far in favor of their relatively static militia/police units.So now, while the PLA / PLAAF's main divisions, brigades and Air Wings were some of the best equipped on the planet, the economic necessities had also meant the militia was financially neglected, remaining little more than early Cold War Era non-mechanized infantry formations. To compensate, the Chinese had placed greater and greater emphasis on the deployment capabilities of their scarcer, technologically advanced formations.When the Anthrax outbreak started, the strike force personnel were the first personnel 'vaccinated'. Now those men and women were coughing out the last days and hours of their lives. Unfortunately, you couldn't simply put a few commercial truck drivers in a T-99 Main Battle Tank and expect them to be anything more than a rolling coffin. The same went for a commercial airline pilot and a Chengdu J-10 multi-role fighter. The best you could hope for was for him/her to make successful takeoffs and landings.A further critical factor was that the Khanate's first strike had also targeted key defense industries. The damage hadn't been irreparable. Most military production would be only a month to six weeks behind schedule. But there would be a gap.It was just becoming clear that roughly 80% of their highly-trained, frontline combatants were going to die anyway. Their Reserves were looking at 30~40% attrition due to the illness as well. In the short term (three months), they would be fighting with whatever they started with. Within the very short term (one week), they were going to have a bunch of high-priced equipment and no one trained to use it. With chilling practicality, the Chinese leaders decided to throw their dying troopers into one immediate, massive counter-offensive against the Khanate.Just as Temujin predicted they would. Things were playing out according to plan.Note: World Events SummaryRound #1 had seen the Khanate unite several countries under one, their, banner. Earth and Sky soldiers had rolled across the Chinese border as their Air Force and Missile Regiments had used precision strikes to hammer Chinese bases, sever their transportation network and crippled their civilian infrastructure.Next, the frontier offensive units had been obliterated, the cities bypassed and the Khanate Tumens had sped forward to the geographic junctures between what the Khanate wanted and from whence the PLA had to come. In the last phase of Round #1, the Khanate prepped for the inevitable PLA / PLAAF counter-strike.Round #2 had now begun:Step One: Declare to the World that the Khanate was a nuclear power. As history would later reveal, this was a lie, but no one had any way of initially knowing that. Hell, the Khanate hadn't even existed 72 hours ago. Satellite imagery did show the Khanate had medium-range strategic missiles capable of hitting any location in the People's Republic. In Beijing, a nuclear response was taken off the table.Step Two: Initiate the largest air-battle in the history of Asia. Not just planes either. Both sides flew fleets of UCAV's at one another. It wasn't really even a battle between China and just the Khanate. Virtually all of the UAV technology the Khanate was using was Japanese, South Korean and Taiwanese in origin, plus some US-Russian-shared technology thrown into the mix.When the South Korean design team saw the footage of their bleeding-edge dogfighting UCAVs shooting down their PRC opponents, they were thrilled (their design rocked!), shocked (what was their 'baby' doing dominating Chinese airspace?) and anxious (members of South Korea's Defense Acquisition Program Administration, DAPA, were rushing over to chat with them).Similar things were happening in Japan, Taiwan, Russia and the United States. The Communist Party leadership in Beijing were beginning to seriously consider the possibility that everyone was out to get them. Of course, all the Ambassadors in Beijing were bobbing their heads with the utmost respect while swearing on the lives of their first born sons that their nations had nothing to do with any of this.These foreign diplomats promised to look into these egregious breaches of their scientific integrity and were saying how sorry they were that the PLA and PLAAF were getting ass-raped for the World's viewing pleasure. No, they couldn't stop the Khanate posting such things to the internet, something to do with freedom. Paranoia had been creeping into the Potentates' thoughts since the Pakistan/Aksai Chan incident.As they watched their very expensive jets and UCAV's being obliterated, distrust of the global community became the 800 pound gorilla in the room. To add habaneros to the open wounds, the United States and the United Kingdom began dropping hints that they had some sort of highly personal communication conduit with the Khanate's secretive and unresponsive leadership. Yes Virginia Wolfe, the Western World was out to get the People's Republic.'Great Mao's Ghost', all that claptrap their grandfathers had babbled on about (1) the Korea War, (2) the Sino-Soviet grudge match, (3) the Sino-Vietnamese conflict and (4) the persistent support for the renegade province of Formosa all being a continuous effort by the liberal democracies and post-colonial imperialist to contain Chinese communism, didn't sound so crazy anymore.Step Three: Plaster all those PLA ground units that had started moving toward them when the air war began and the Chinese envisioned they would control the skies. The T-99 was a great tank. It also blew up rather spectacularly when it was stuck on a rail car (you don't drive your tanks halfway across China, it kills the treads).As Craig Kilborn put into his late night repertoire:"What do you call a Khanate UCAV driver who isn't an ace yet? Late for work.""What's the difference between me coming off a weekend long Las Vegas bender and a Khanate pilot? Not a damn thing. We've both been up for three days straight, yet everyone expects us to work tonight."Some PLA generals decided to make an all-out charge at the Tumens. Genghis's boys and girls were having none of that. They weren't using their Russian-built Khanate tanks to kill Chinese-built PLA tanks. No, their tanks were sneaking around and picking off the Chinese anti-air vehicles.The Chinese tanks and APCs engaged the dismounted Khanate infantry who, as Aksai Chin had shown, possessed some of the latest anti-tank weaponry. In the few cases where the PLA threw caution to the wind, they did some damage to the Khanate by sheer weight of numbers. For the rest, it was death by airpower.With their anti-air shield gone, the battle became little more than a grisly, real-life FPS game. It wasn't 'THE END'. China still had over 2,000,000 troops to call upon versus the roughly 200,000 the Khanate could currently muster. The PLA's new dilemma was how to transport these mostly truck-bound troops anywhere near the front lines without seeing them also exterminated from the air.After the Tumens gobbled up the majority of the PLA's available mobile forces, they resumed their advance toward the provincial boundaries of Xinjiang and Nin Mongol. There was little left to slow them down. The Chinese still held most of the urban centers in Xinjiang and Nei Mongol, yet they were isolated. And Khanate follow-up forces (the national armies they'd 'inherited') were putting the disease-riddled major municipalities under siege.All over the 24/7 World Wide News cycle, talking heads and military gurus were of two minds about the Khanate's offensive. Most harped on the fact that while the Khanate was making great territorial gains, it was barely making a dent in the Chinese population and economy. Uniformly, those people insisted that before the end of November, the Khanate would be crushed and a reordering of Asia was going to be the next great Mandate for the United Nations.A few of the braver unconventional pundits pointed out the same thing, but with the opposite conclusion, arguing:1.There were virtually no military forces in the conquered areas to contend with the Khanate's hold on the regions.2.Their popularity in the rural towns and countryside seriously undercut any hope for a pro-PRC insurgency.3.Driving the Khanate's forces back to their starting points would be a long and difficult endeavor that the World Economy might not be able to endure.When the PLAAF was effectively castrated after thirty-six hours of continuous aerial combat, a lot of experts were left with egg on their faces. One lone commentator asked the most fearful question of all. Where was the Khanate getting the financing, technical know-how and expertise to pull all of this off? There was a reason to be afraid of that answer.And while I was entertaining my six sailor-saviors, there were two other things of a diplomatic nature only just revealing themselves. Publically, Vladimir Putin had graciously offered to mediate the crisis while 'stealthily' increasing the readiness of his Eastern Military District. If there was any confusion, that meant activating a shitload of troops on the Manchurian border, not along the frontiers of the former nations of Mongolia and Kazakhstan.After all, Mongolia was terribly poor. Manchuria/Northeastern China? Manchuria was rich, rich, rich! From the Kremlin, Putin spoke of 'projecting a presence' into the 'lost territory' of Manchuria, citing Russia's long involvement in the region. By his interpretation of history, the Russians (aka the Soviet Union) had rescued Manchukuo (the theoretically INDEPENDENT Imperial Japanese puppet state of Manchuria) from the Japanese in 1945. They'd even given it back to the PRC for safekeeping after World War II was concluded.Putin promised Russia was ready and willing to help out the PRC once again, suggesting that maybe a preemptive intervention would forestall the inevitable Khanate attack, thus saving the wealthy, industrialized province from the ravages of war. Surely Putin's Russians could be relied on to withdraw once the Khanate struggle was resolved? Surprisingly, despite being recent beneficiaries of President Putin's promises, the Ukraine remained remiss in their accolades regarding his rectitude.In the other bit of breaking news; an intermediary convinced the Khanate to extend an invitation to the Red Cross, Red Crescent and the WHO to investigate the recently conquered regions in preparations for a humanitarian mission.That intermediary was Hana Sulkanen; for reasons no one could fathom, she alone had the clout to get the otherwise unresponsive new regime to open up and she was using that influence to bring about a desperately needed relief effort to aid the civilians caught up in that dynastic struggle. A Princess indeed. No one was surprised that the PRC protested, claiming that since the territory wasn't conquered, any intervention was a gross violation of Chinese sovereignty.End of Note(To Live and Die in Hun-Gray)Orsi may have been the troupe leader, but Anya needed me more, so she came first."I need a shower before we catch some dinner," I announced as we meandered the streets of Mindszent. My lady friends were all processing that as I wound an arm around Anya's waist and pulled her close. "Shower?" I smiled down at her, she was about 5 foot 7. It took her a few seconds to click on my invitation."Yeah, sure, that would be nice," she reciprocated my casual waist hold. Several of her friends giggled over her delay. We were heading back to the Seven Fishermen's Guest House."Do you do this, picking up strange girls you've barely met for, you know?" she said in Bulgarian, as she looked at me expectantly."Yes and no," I began, in Russian. "I often find myself encountering very intriguing women, for which I know I am a fortunate man. I embrace sensuality. That means I know what I'm doing, but I'm not the 'bring him home to meet the parents' kind of guy.""What of your fiancée? Do you feel bad about cheating on her?" Anya pursued me."Hana is wonderful. I've met her father and it went badly both times," I confessed."How?" Anya looked concerned for me."Would you two speak a language the rest of us can understand?" Monika teased us."Very well," I nodded to Monika, and turned back to Anya, "The first time, his son raped a girl and I threatened the young man's life," I revealed. "Jormo, Hana's father, wasn't happy when I did so. The second time, he hit me twice, once in the gut and once in the head," I continued."Why did he hit you?" Orsi butted in."I'd rather not say. You may think less of me," I confessed. Pamela gave me a wink for playing my audience so well. I'm glad she's family (kinda/sorta)."The boy, he is dead?" Magdalena guessed. "Hana's brother?""I really shouldn't talk about that," I evaded. "It is a family matter." That's right. The family that my grandmother had brought me into as her intern / slayer-in-training. There is no reason to create a new lie when you can embellish a previous one."Do you ever feel bad about what you do?" Katalin asked Pamela. We love movies."As I see it, if I show up looking for you, you've done something to deserve it," Pamela gave her sage philosophy behind being an assassin."Are you, bi-sexual?" Jolan murmured. Pamela smacked me in the chest as I laughed. "Did I say something wrong?" Jolan worried. Pamela was a killer."No, you are fine," Pamela patted Jolan's shoulder. "I'm straight and happily so. It just so happens that most of my co-workers are women. Day in, day out, nothing but sweaty female bodies working out, sparring and grappling together, and afterwards, the massages."That was my Grandma, poking all the lesbian buttons of the women around me. Best of all, she did it with the detached air of a sexually indifferent matron. She was stirring up the lassies while keeping them focused on me. We walked into the courtyard of our guest house."Don't take too long, you two," Orsi teased us."Ha!" Pamela chuckled. "That's like asking the Sun to hurry up and rise, the Moon to set too soon, or the sea to stay at low tide forever.""Anya," I whispered into her ear. "How many orgasms do you want?" Anya's eyes expanded. Her eyes flickered toward her friends, then back to me. She held up one finger, I grinned speculatively. Anya held up two fingers. I kissed her fingers.
A conversation with the insightful Forensic behavioral scientist Janet Mielke Schwartz, Ph.D., FAPA, FAAFS, CHPP, FACFEI, DABFE, DAAIM, DABFM, DABPS, DABCHS, CDP-1, IAC, DAPA, NCC, NCP, BCCP.
Lisa is a recognized expert in the strengths-based, depathologized treatment of trauma and has been in private practice for 34 years. She presents workshops and keynote addresses nationally and internationally, and is a clinical consultant to practitioners and mental health agencies in the United States, Canada, and UK and Ireland.Lisa has been an Adjunct Faculty member at University of Maryland School of Social Work, University of Baltimore at Maryland, University of Maryland Department of Family Medicine, and is the Founder of The Ferentz Institute -- formerly known as The Institute for Advanced Psychotherapy Training and Education -- now in its 17th year of providing continuing education to mental health professionals and graduating over 1,400 clinicians from her two Certificate Programs in Advanced Trauma Treatment.In 2009, she was voted the “Social Worker of Year” by the Maryland Society for Clinical Social Work.Lisa is the author of:Treating Self-Destructive Behaviors in Trauma Survivors: A Clinician's Guide, now in its second edition,Letting Go of Self-Destructive Behaviors: A Workbook of Hope and Healing, andFinding Your Ruby Slippers: Transformative Life Lessons from the Therapist's Couch.In This EpisodeLisa's website---If you'd like to support The Trauma Therapist Podcast and the work I do you can do that here with a monthly donation of $5, $7, or $10: Donate to The Trauma Therapist Podcast.Click here to join my email list and receive podcast updates and other news.Become a supporter of this podcast: https://www.spreaker.com/podcast/the-trauma-therapist--5739761/support.
Pagar IMPUESTOS en Estados Unidos puede tener consecuencias buenas o malas obviamente dependiendo de lo que pagues y como lo pagues, por eso hemos traido a dos chicas profesionales en el area Diana y Angela representantes de DAPA una empresa de contabilidad, ellas nos dicen y aclaran los mitos y rumores sobre los impuestos en Estados Unidos, apertura de empresas y como la ILEGALIDAD en un negocio puede afectar a toda la comunidad Latina en Estados Unidos. Estamos en todos lados @LEOACTIVAO / leoactivaoigsh=zxdonms4cnm4cthj&utm_source=qr @Brutalmentehonestoo / brutalmente. .
Young actor & director Coleman Peterson talks about Good Night Theatre Collective and Dakota Academy of Performing Arts. He is directing next month's DAPA production of Willy Wonka Jr. Matt Wallace is an incredible sax player from Omaha that often plays locally with the Hegg Brothers. Listen to hear more about his impressive musical resume.
Witam Państwa, nazywam się Jarosław Drożdż, pracuję w Centralnym Szpitalu Klinicznym Uniwersytetu Medycznego w Łodzi, skąd nagrywam podcast Kardio Know-How. W tym odcinku kontynuujemy omawianie doniesień z Kongresu AHA.Szczegółowy TRANSKRYPT do odcinka.Podcast jest przeznaczony wyłącznie dla osób z profesjonalnym wykształceniem medycznym.
Oops...there are a couple of swear words in this episode! Nothing crazy or vulgar...in fact the couple swear words are kind of cute, but wanted to give you a heads up. TW: sexual assault and rape are briefly mentioned in this episode. Nothing specific or detailed is discussed, but if you are not in a place at this time to hear those terms, you may want to come back another time. This conversation is everything! Post traumatic growth and growing through adversity are the cornerstones of what Ginny's speaking, writing, podcast and coaching is all about. Lisa's experience and expertise is coupled with her compassionate and wonderful demeanor for a supportive and meaningful conversation on how people that have faced trauma and adversity can find the light at the end of the tunnel. The passion and connection in the conversation comes through. Normalization and validation are common themes throughout as well as noting that the pain & suffering can co-exist with the growing. This episode is powerful! Lisa is a recognized expert in the strengths-based, de-pathologized treatment of trauma and has been in private practice for over 39 years. She presents workshops and keynote addresses nationally and internationally, and is a clinical consultant to practitioners and mental health agencies in the United States, Canada, the UK and Ireland. She has been an Adjunct Faculty member at several Universities, and is the Founder of “The Ferentz Institute,” now in its sixteenth year of providing continuing education to mental health professionals and graduating several thousand clinicians from her two Certificate Programs in Advanced Trauma Treatment. In 2009 she was voted the “Social Worker of Year” by the Maryland Society for Clinical Social Work. Lisa is the author of “Treating Self-Destructive Behaviors in Traumatized Clients: A Clinician's Guide,” now in its second edition, “Letting Go of Self-Destructive Behaviors: A Workbook of Hope and Healing,” and “Finding Your Ruby Slippers: Transformative Life Lessons From the Therapist's Couch.” Lisa also hosted a weekly radio talk show, writes blogs and articles for websites on trauma, attachment, self-destructive behaviors, and self-care, teaches on many webinars, and is a contributor to Psychologytoday.com. You can follow Lisa's work on her website, www.theferentzinstitute.com, YouTube, LinkedIn and Twitter. Lisa's book on Amazon: https://a.co/d/2PIR9IH Ginny's Instagram: https://www.instagram.com/ginnypriem/ Ginny's website: www.ginnypriem.com --- Send in a voice message: https://podcasters.spotify.com/pod/show/ginny-priem/message
Bojan Stojkovski se nije oduvijek bavio tehnološkim temama. Dapače, za strane medije je počeo pisati o vanjskoj politici, ali je ubrzo shvatio da ga zanimaju startupi koji svojim utjecajem nizu daleko od foreign policy tema. U novoj epizodi Netokracija Podcasta s Bojanom razgovaram o tome kako je pratiti hrvatsku i druge startup scene za regionalne, ali i svjetske medije: Kako founderi dobro predstavljaju svoje startupe; Najveće greške u komunikaciji s novinarima; Kako je drugačije pisati za različite medije; Što hrvatska startup scena može naučiti od susjeda; Najveće lekcije uspjeha hrvatske startup scene. _______________
A propósito del debate que se generó en la opinión pública por el uso o no de helicóptero para que la vicepresidenta Francia Márquez se pueda dirigir hacia su residencia en el sector de Dapa, zona rural de Yumbo, en el Valle del Cauca, en Mañanas Blu, cuando Colombia está al aire, analizamos si la discusión va más allá del uso de los recursos de la nación.See omnystudio.com/listener for privacy information.
En este episodio de 'El Zuletazo' hablaremos de la vicepresidenta de Colombia Francia Márquez, quién a través de una transmisión en redes sociales aclaró porqué está viviendo en una zona rural lujosa de Jumbo, Dapa.See omnystudio.com/listener for privacy information.
El enfrentamiento se dio por cuenta de un video de un helicóptero que estaría llevando a la vicepresidenta Francia Márquez a su casa en Dapa en el departamento del Valle del Cauca.See omnystudio.com/listener for privacy information.
indígenas intentan ingresar a la fuerza al congreso Cuando Petro decía que no se debía negociar la paz con hampones Magistrado Danilo Rueda molesto con los medios de Comunicación Las exigencias del hermano de Gustavo Petro Petro no escuchó reparos sobre reforma a la salud Rudolf Hommes uno de los arrepentidos con Petro Pacto histórico sin candidatos Los viajes de Francia Márquez a Dapa en el Valle Por qué no se fue el Ministro Gaviria del Gbno Petro Simón Gaviria buscando la alcaldía de Bogotá 100 años de la Misión Kemmerer
Të ftuar në emisionin “Pardon My French” kanë qenë aktori i njohur për rolet e tij në “Portokalli” dhe paroditë në rrjetet sociale, Ëngjëll Hoxha dhe muzikanti 17-vjeçar, Orgito Dapa. Të dy ata kanë treguar në Top Albania Radio se si janë njohur me njëri-tjetrin dhe se cilat janë projektet që ata kanë në plan të zhvillojnë të dy së bashku.
O splitskoj udruzi mladih programera DUMP (koja okuplja i mlade dizajnere, marketingaše...) već smo pisali, a osobno sam već duže vrijeme fasciniran kvalitetom njihovog rada.Već godinama organiziraju tehnološku konferenciju DUMP Days koje se ne bi posramile mnoge profesionalne event agencije. Dapače, ova studentska konferencija bolje je organizirana nego mnoge "profesionalne" konferencije u Hrvatskoj.Nakon što su na svom YouTube kanalu počeli redovito objavljivati ne samo podcast intervjue, već i zgodne tehnološke vodiče, morao sam ih posjesti da popričamo kako to sve uspjevaju u udruzi koja broji samo 15 članova.Sjeo sam stoga s potpredsjednikom udruge, Ninom Borovićem, kako bi otkrili sve detalje kako DUMP nikad ne 'dumpa' kvalitetu, ali i kako se uključio u udrugu: Po čemu su drugačiji od drugih studentskih udruga; Kako uključuju alumnije zahvaljujući kojima održavaju kvalitetu; Kako se uključuju predavači, a kako partneri, na DUMP Days; Održavanje kontinuiteta kvalitete kroz detaljnu dokumentaciju; Biranje tema za DUMP YouTube kanal i kvaliteta produkcije; Budućnost DUMP Daysa i drugih DUMP projekata; Kako se već srednjoškolci mogu uključiti u udrugu. _______________
Anda Bukvić Pažin danas je lektorica na Odsjeku za anglistiku Filozofskog fakulteta u Zagrebu i književna prevoditeljica. No, prije svega, ona je čitateljica. Sve je počelo s tetom Sonjom u Gradskoj knjižnici u Metkoviću gdje bi se bijeli kartončići iz džepića na korici knjige stavljali u bijelu iskaznicu. Kad govori o čitanju, voli naglašavati važnost slikovnica; piše i kritičke osvrte namijenjene roditeljima. Naime, Anda tvrdi da ih se prerano ostavimo i da dobre slikovnice nisu samo za djecu. Dapače, kvalitetne slikovnice danas oslanjaju se i na likovnost kao pripovijedanje, a dok djeca primjerice slušajući priču razvijaju maštu, odrasli u slikovnicama iščitavaju priču o ideologiji i moći. A svi imamo 20 minuta da ih pročitamo. -- Pretplatite se i saznajte više o podcastu: www.linktr.ee/bliskisusreti Pratite nas: www.facebook.com/bliskisusreti www.instagram.com/bliskisusreti_podcast www.twitter.com/bliskisusreti Sviđa Vam se što naš rad? Podržite nas kavicom za 2€: www.buymeacoffee.com/bsjv (CC) 2022 Bliski susreti jezične vrste
Printz Ákos nem hivatásos ironman versenyző: „Koppenhágában is bizonyított a vasember családapa”
1976 Au mileu des années septante, le disco émerge comme une réponse à la domination de la scène rock et à la stigmatisation de la musique dance par la contre-culture durant cette période. A son apogée, le genre se popularise largement et donne naissance à beaucoup d'artistes. Donna Summer, qui devient la reine du genre, Gloria Gaynor, les Bee Gees et... le groupe allemand Boney M.
1976 Au mileu des années septante, le disco émerge comme une réponse à la domination de la scène rock et à la stigmatisation de la musique dance par la contre-culture durant cette période. A son apogée, le genre se popularise largement et donne naissance à beaucoup d'artistes. Donna Summer, qui devient la reine du genre, Gloria Gaynor, les Bee Gees et... le groupe allemand Boney M.
Peter is a political activist, most famously as a pioneering member of ACT UP — the grassroots AIDS group that challenged and changed the federal government. He founded both the Treatment Action Group (TAG) and the educational website AIDSmeds.com. An old friend and sparring partner, he also stars in the Oscar-nominated documentary “How to Survive a Plague.” Check out his memoir, Never Silent: ACT UP and My Life in Activism.You can listen to the episode — which gets fiery at times — in the audio player above (or click the dropdown menu to add the Dishcast to your podcast feed). For two short clips of my convo with Peter — on how he and other AIDS survivors turned to meth, and Peter pushing back on my views of critical queer theory in schools — pop over to our YouTube page. There’s also a long segment on just the monkeypox stuff. If that episode isn’t gay enough for you, we just posted a transcript of the episode last year with Katie Herzog and Jamie Kirchick. Both of these Alphabet apostates were on Real Time last month — here’s Jamie:Katie appeared alongside this clapped-out old bear:Come to think of it, two more Dishcast alums were on the same episode of Real Time last month — Michael Shellenberger and Douglas Murray:Oh wait, two more in June — Cornel West and Josh Barro:We now have 20 episodes of the Dishcast transcribed (check out the whole podcast archive here):Bob Woodward & Robert Costa on the ongoing peril of TrumpBuck Angel & Helena Kerschner on living as trans and detransKatie Herzog & Jamie Kirchick on Pride and the alphabet peopleDominic Cummings on Boris, Brexit and immigrationCaitlin Flanagan on cancer, abortion and other Christmas cheerGlenn Greenwald on Bolsonaro, woke journalists and animal tortureJonathan Haidt on social media’s havocYossi Klein Halevi on the origins of ZionismFiona Hill on Russia, Trump and the American DreamJamie Kirchick on the Lavender ScareJohn McWhorter on woke racismJohn Mearsheimer on handling Russia and ChinaRoosevelt Montás on saving the humanities Michael Moynihan on Afghanistan and free speechCharles Murray on human diversityJonathan Rauch on dangers to liberalismChristopher Rufo on critical race theory in schoolsMichael Shellenberger on homeless, addiction and crimeCornel West on God and the great thinkersWesley Yang on the Successor IdeologyA Dishcast listener looks to last week’s episode and strongly dissents:I enjoyed your interview with Matthew Continetti. Unfortunately, an exchange at the end reminded me of why I had to reluctantly tune you out for years: your hero worship of Obama. I respect and admire the way you call out the failures and excesses of both sides, including those of mine (the right), which I acknowledge were glaring even before Trump. During the Obama years, however, it was hard not to cringe when I watched you tear up on Chris Matthews’s show and compare him to a father figure. I also recall you yelling at SE Cupp and aggressively pointing a finger at her on Bill Maher’s show for daring to compare the foreign policies of Obama and W Bush:It’s hard to imagine anyone with that kind of emotional response being objective, and sadly, you never were during his presidency.You argued with Continetti that Obama was a middle-of-the-road pragmatist, when nothing could be further from the truth. He came into office with the economy reeling in a banking and housing crisis, and he took the Rahm Emmanuel approach of never letting a crisis go to waste. Even before his inauguration, he begin planning to rush through major legislation on healthcare, climate, and education. These may be worthy goals, but they are not the actions of a pragmatist who wants to govern by addressing the problems of the moment. He then outsourced the stimulus bill to Pelosi, which was a pork-filled bonanza with almost nothing even remotely stimulative. He refused to incorporate any Republican ideas into the healthcare legislation and arrogantly said to McCain that “the election’s over” when McCain voiced some opposition. Obama then lied in selling the bill to the American people by saying you would be able to keep your plan and your doctor in all cases.When Obama lost his congressional majority, he resorted to gross lawlessness, taking executive actions that exceeded his constitutional authority on everything from carbon emissions to insurance company appropriations to immigration, including on measures that were recently voted down by Congress or (as Continetti noted) he previously acknowledged he lacked the constitutional authority to do. He even flouted his ability to do this — knowing the media would cover for him — by saying he had “a pen and a phone.”Obama was one of the more divisive presidents in history. Every speech followed the same obnoxious shtick of chiding Republicans for playing politics and claiming that he alone was acting in the national interest. We saw this again, even post-presidency, during the funeral of John Lewis. For once, both sides came together, and even Republicans celebrated the achievements of a genuine American hero. But during Obama’s speech, he turned the event into a partisan tirade about voting rights, calling the filibuster a Jim Crow relic (never mind that he used as a Senator).Finally, you argued that Republicans never gave Obama a chance. Not true. When he was inaugurated, his approval ratings were among the highest on record and were even above 40 percent among Republicans. They plummeted among Republican voters because he refused to ever take their concerns seriously or acknowledge that they had any legitimate points. When he finally did something they had even slight agreement with, the Trans Pacific Partnership, most Republicans supported him, while much of his own party opposed him.I respect your objectivity and believe that you are largely back to it. But I’m hoping the next time someone you love comes along, you will remain able to see the forest from the trees. (And sorry about the War and Peace-length email. There isn’t another intellectual I’m aware of who would actually welcome a dissent like that, which is why I wish I became a subscriber sooner.)That’s a lot of political history to litigate, but if you think I was blindly supporting Obama, read “The Fierce Urgency of Whenever,” “Obama’s Marriage Cowardice,” “Obama’s New War: Dumb Dumb Dumb Dumb Dumb,” “Obama’s Two New Illegal Wars,” “Is Obama A Phony On Torture?”, “Obama Is Now Covering Up Alleged Torture,” “Obama’s Gitmo Disgrace,” “Obama To The Next Generation: Screw You, Suckers,” my reaction to his townhall comments on cannabis, “Behind the Obama Implosion,” and my excoriation of his first debate against Romney, if you remember.Obama’s healthcare proposal originally came from the Heritage Foundation; it was the most conservative measure to move us to universal healthcare access available; he passed it; and it remains the law because Republicans realized it was too popular to repeal. If that’s what you call extremism, you have a different definition of the word than I do.His stimulus was — yes — insufficient to the moment. But that’s because it veered toward a fiscal prudence long abandoned by the GOP. And he put it before any other priority. The GOP still refused to give this new president in an economic crisis any support at all, and acted as if the Bush debacle had never happened.Another listener defends the former president’s record — to a point:Obama had one chance to pass health care reform — something presidents had been trying and failing to do for several decades. In reality he had a razor-thin margin, especially in the Senate. He spent months letting moderates like Max Baucus take the lead in Congress. He gave moderate Republicans like Olympia Snowe endless time to pretend to be willing to vote for a centrist bill. Remember: this was largely RomneyCare, an already moderate Republican policy idea and one which had originally come out of a conservative think tank.In the end, no matter how much Big Pharma and other healthcare lobbies had to be bribed and how much Obama compromised — no public option; no federal negotiation via Medicare to lower drug prices — the moderate Republicans had strung him along. He had to give Ben Nelson goodies to get his vote. And, overall, as much as the bill was a corporate sellout, it still — and 12 years on it’s so easy to forget this — still made massively important reforms the public was desperate for: it expanded family access for kids up to 26; it ended the rampant abuse of preexisting conditions to deny coverage; it ended retroactive rescissions in which insurance employees were tasked to comb through patient records and fine print to find pretexts for dumping patients when they needed care the most; it ended lifetime caps on coverage for things like major early childhood diseases and illnesses and catastrophic illnesses in adults; and of course it expanded access to Medicaid (most people don’t realize how stunningly low one’s income has to be to qualify). ObamaCare, flaws and all, was necessary — and a major step forward. There was no Republican compromise to be had in 2010 or ever. Remember what Mitch McConnell said his #1 priority was? Ensuring Obama was a one-term president with no major successes to campaign on. They simply wanted the legislation to crash and burn, similar to how it did in 1994. DACA and DAPA and the rest? Very very different story. And I agree with Continetti: Obama did not have that authority and he knew he didn’t. And after the Gang of Eight fell apart, his second term was all about caving to radical, often openly ethnically chauvinistic, identitarian, open borders advocates. And that’s where the Democratic Party has been stuck ever since. Executive decisions like DACA were a big part of why I soured on the Obama administration. ObamaCare, flawed as it was, was a big reason I volunteered so heavily for Obama in 2012. We’re still not close to the kind of publicly guaranteed, universal health care virtually all peer countries and allies enjoy. But we’re closer due to ObamaCare. And that’s a clear example of what Democrats can accomplish when they’re focused on passing the best bill they can pass (by the barest of margins) for the common good. For the record (see the Daily Dish links above), I also opposed the Libya war, the Iraq surge, and the DACA executive overreach. This next reader is more sympathetic to Obama on DACA:Deporting kids who have never known another country has a 19 percent approval rating. Obama begged Congress for years to do something to correct this. So is the Continetti position that Obama needed to do something that more than 80 percent of Americans don’t want because far-right extremists are holding Boehner hostage? If that is your position, then it’s fundamentally undemocratic.Another clip from last week:Yet another take on the Continetti convo:I’m a moderately liberal person, and I listen to conservative voices to hear good arguments that make me consider more deeply my innate biases. But the conservatism described by Continetti is just uninteresting. Describing the 1964 Civil Rights Act as too large an overreach? Talking about constitutionalism in the same way that Alito does — as frozen, depending upon the section, in either 1789 or 1868? Dissing Obamacare?Obamacare is a big improvement on pre-ACA insurance, and I’m glad Obama persevered after Ted Kennedy's death. Healthcare has a lot of moving parts, but finally we have an individual insurance market with plans as good as those in the employer group market. My kids have used it at various times switching between jobs and school, or even instead of a law school's highly mediocre plan. One of my biggest problems with Biden is that he hasn’t even managed to get the subsidy income limit, which was lifted by the pandemic relief bill, made permanent. My biggest problem with Biden is that I expected that he’d be able to negotiate with someone like Manchin, who’s dim but probably willing to support something. Cranking up the ACA subsidies and funding some solar panel research and LWTR reactor prototypes, with the work being done in part in West Virginia? It can’t be that hard to cut some deal. Instead, we seem to have nothing.So, until the Supreme Court’s decision in Dobbs, I figured the Dems would get wiped out in '22 and '24. I figured the combination of trans-positive teaching in lower schools and race essentialism everywhere would lead to races like the Virginia governor election, where someone with a sane approach to schools would dominate. Dobbs may change all that. From a small sample of Republican suburban voters I know, a lot of people are furious at the Court’s decision. They rightly view it as an ignorant decision that makes even pregnancy for wealthy women in red states far more dangerous than it was, since a partial miscarriage with lots of bleeding — not a rare event by any means — will now require sign-off from a hospital’s legal staff before a lifesaving D&C can be performed, by which time a pregnant woman may well be dead. And while Republicans typically don’t mind making life miserable for poor people (fun fact: a family of four has to have an income below $4,700 per year to get Medicaid in Mississippi), f*****g over the upper middle class will not go over nearly as well.Keeping with the abortion theme, another reader:This caught my eye in your most recent podcast email: “[T]he question of when human life becomes a human person is a highly debatable one.”First, thank you for stating the issue correctly! The issue is NOT when HUMAN LIFE begins. Science has answered that question definitively: at conception. It’s not a “theory,” religious or philosophical doctrine or anyone’s “opinion,” and it’s not debatable. We may not know everything that happens during conception, but no embryologist denies that it’s the beginning of human life. The term “person” is not scientific, and that’s why I avoid using it when debating abortion with non-believers. As I’ve noted before, the term “person” arose out of debates about the relations among the Three Persons of the Trinity in the run-up to the council of Nicea. Before that, the Latin term “persona” just referred to public citizenship. Slaves were not legally persons. The Christian philosophers made it into a much richer and more resonant concept, in order to explain that God could be one God but three “persons” — a way of saying that if God is Love, love is not a monism but a mode of relationality. Anyway, for purposes of modern discussion of abortion, the term “person” now means something close to what the pagan Roman meaning of “person” was: a human being legally granted rights by the state, including the right to life. In other words, some human beings are not “persons.”This distinction is morally troubling and creates issues for defenders of abortion. If it’s really up to the state to say who is or is not a “person,” why stop at the unborn? In the Roman Empire, and in later periods (including our own history, of course), slaves were not legally considered full “persons.”Is “personhood” a sliding scale, or an absolute state of being? Can you have “more” or “less” personhood? Are comatose (but stable) human beings persons, or do they lose their legal rights to life, as many seem to think? What about the conscious but mentally challenged? Do high-IQ people have more “personhood” than low-IQ people? You see where this is going, I’m sure. I’ve had many discussions about this, and there is NO criterion that denies full personhood to the unborn that cannot also be used to deny it to the already-born. I think once you hive off human rights from the status of being human, and attach them to some scientifically indefinable status like “personhood,” you go down a tricky path. Because you’re right, of course. “Personhood” is endlessly debatable, because it’s a philosophical and (ultimately) theological concept. It’s like arguing “Who has a soul, and who doesn’t?”But in our tribally inclined species, the question quickly becomes, who is “human” (i.e, like “us”) and who is “other” (i.e., not really “human”) — with the “other” not possessing the same rights. Most names of tribes for themselves translate to “the Human Beings” or “the People” — with anyone outside the tribe being less than human. (Did you ever see Little Big Man?)Of course, as a Christian I believe ALL human beings are also persons, no matter their mental state, helplessness, poverty or low social status. I also agree that all human beings are images of God. For purposes of argument with non-believers, rather than get side-tracked into personhood, I prefer to say that human rights are anchored in (inherent in) humanness, not “personhood.” This requires abortion advocates (if they have the slightest thoughtfulness or openness to engage in actual discussion) to explain how some human beings aren’t “persons” and who gets to make that determination. But any honest abortion defender who doesn’t want to deny non-contestable science must make that distinction.Here’s the difference between personhood in abortion and every other area. One person is literally inside another person’s body. In a society based on property rights, the body itself — “habeas corpus” — is central to freedom and autonomy. Another reader turns to sexuality:I was struck by one of the dissents you ran last week: “No mention of the 63 million babies who were murdered in the last 49 years, but oh how well you stand up for women and their right to have as many one-night stands as they want without consequences, guilt, or their morality even being questioned.”The second half of that sentence is so interesting. The dissenter is not only offended by potential babies not being born, but also by women having sexual fun without life-altering consequences. To the dissenter, one-night stands are an evil (at least, on the part of the woman), and going through a public pregnancy (look at her! shame!) and having babies (no career for her!) is the least punishment the female participants should deserve. The lost babies are bad, but even worse, look at what all those loose women are getting away with!I’ve always had a sneaking suspicion that some part of the opposition to abortion in this country is actually driven by people who want to bring back 1950s prudery. They see abortion as an evil precisely because it allows more sexual pleasure — and even more galling, more sexual pleasure on the part of women (because this 1950s prudery so often seems to carry 1950s misogyny along with it). Of course we know many abortion opponents are deeply moved by love for potential babies that aren’t born, but this dissenter shows there’s at least one person out there celebrating Dobbs for the renewed opportunities abortion bans will provide to scare women out of sex or, failing that, shame them and derail their careers as punishment.Another reader turns the focus to me:For some context, I am a Christian who has spent most of my life in the evangelical subculture, but I am more moved in worship by liturgical forms. I am politically anti-Trump and I am abhorred by the current state of the Republican Party, though I am a lifelong Republican. Call me David French-like.I am responding to your dissent from the conservative writer and your comment that consent between adults is the sole limiting factor in sexual behavior. You have likely been asked and answered this question many times, so just send me a link if that’s easier for you: Since you are a Christian, what role does the Bible and/or church teaching have in your understanding of human sexuality? One could argue that in addition to consent, the Bible speaks of fidelity, monogamy, love, nurture, self giving, mutual submission, and adoration in sexual relationships. How do you treat the foregoing characteristics (or others) in your sexual ethic? Does your Christian faith have any role to play in your sexual ethics?I enjoy your writing and the Dishcast, keep it up. Guest suggestions: Kevin Williamson. (He had deep dissents on gay marriage, but culturally that train has left the station, and as you know, he has the added benefit of having been fired by The Atlantic three days after hiring — an early example of cancel culture by the insulated Left). Also Jonah Goldberg.I responded to some of these points on the main page. But I’ve written much more widely on this question — and I recommend Out On A Limb for the rest. The essay “Alone Again, Naturally,” comes closest to answering. But I do not share orthodox Christianity’s Augustinian terror of the body and its pleasures. Your guest suggestions are always appreciated: dish@andrewsullivan.com. Here’s one more from a “20-year Dishhead writing for the first time”:I think Iain McGilchrist would be a great guest for the pod — and for TWO episodes, since the ideas in his recent work are so vast, complex, and far-reaching. (I encountered his earlier book on the Daily Dish.) It seems like IMcG is really working to get out his incredibly important, expansive, but very difficult project out and a couple of good conversations with you would be a great way of doing that, not to mention fascinating for us Dishcast listeners.Thanks for everything that you and Chris are doing with The Weekly Dish — trying to help us all think clearly and openly. My wife and I both appreciate having your voice in our lives each week. She especially likes the dissents!Subscribe to read them all — along with everything else on the Dish, including the View From Your Window contest. There are also gift subscriptions if you’d like to spread the Dishness to a loved one or friend — or a frenemy to debate the dissents with. Get full access to The Weekly Dish at andrewsullivan.substack.com/subscribe
Tzv. abandoned carta tj. kupaca koji ne završe svoju kupnju je jedan od najvećih problema ecommerce industrije. Usporedba 41 istraživanja Baymard Instituta pokazuje da kupci napuste oko 69 posto svih svojih kupnji kad govorimo o klasičnim web stranicama. Podaci su još više porazni za kupnju putem mobilnih telefona, s obzirom na to da kupci na mobitelima napuste skoro 85 posto svojih kupnji.Većina vlasnika web shopova u takvim situacijama namjesti podsjetnike koji se korisnicima šalju putem emaila. Na žalost, open rateovi za email podsjetnike su niski kao i za mnogo komunikacije koju tim kanalom šaljemo korisnicima. Alternativa - i potencijalno puno učinkovitija metoda - je poslati SMS podsjetnik. Dok je većina SMS marketinga izrazito spamerska, SMS podsjetnici ne smetaju kupcima. Dapače, kao što će nam u podcastu otkriti Tadej Bogataj, suosnivač CartBossa, SMS podsjetnici vam mogu biti itekako isplativi: ► Zašto su napuštene košarice tako veliki problem; ► Od ecommerce agencije do rješenja za spašavanje košarica; ► Vlasnici web shopova nemaju vremena za namještanje pluginova; ► Za SMS je ključna lokalizacija, posebno na EU tržištima; ► Je li za dovršenje kupnje bolji poticaj popust ili besplatna dostava; ► Kako SMS marketing poboljšava korisničko iskustvo. CartBoss zasad podržava WooCommerce i Shopify, a njihov klijent SWY je postigao 6000 posto povratne vrijednosti na uložen novac ► http://www.cartboss.io _______________
Mabuting Balita | Hunyo 5, 2022 Dakilang Kapistahan ng Linggo ng Pentecostes Ebanghelyo: Juan 20:19-23 Agaw-dilim na noon sa unang araw na iyon ng sanlinggo at nakasara ang mga pinto sa kinaroroonan ng mga alagad dahil sa takot sa mga Judio, dumating si Jesus at pumagitna. At sinabi niya sa kanila: “Kapayapaan sa inyo!” Pagkasabi nito, ipinakita niya sa kanila ang mga kamay at ang tagiliran. Kaya nagalak ang mga alagad pagkakita nila sa Panginoon. At muli niyang sinabi sa kanila: “Kapayapaan sa inyo! Kung paanong isinugo ako ng Ama, ipinadadala ko rin kayo.” At pagkasabi nito, hiningahan niya sila at sinabi: “Tanggapin ang Espiritu Santo! Patatawarin ang mga kasalanan ninuman na inyong patawarin; at pananatiliin naman sa sinuman ang inyong panatiliin.” Pagninilay: Para sa mga Judio sa sinaunang panahon, nagtakda sila ng araw pasasalamat sa Diyos para sa masaganang ani mula sa bukid. Bumilang sila ng limampung araw mula Kapistahan ng Tinapay na Dapa hanggang umabot sa tinatawag nilang Feast of the Weeks, panahon ng pasasalamat kay Yawe para sa mga biyaya ng lupa. Nagtakda ang mga unang Kristiyano ng katulad na pagdiriwang. Limampung araw din ang binilang. Ngunit hindi mga gulay na inani a bukirin ang ipinagpapasalamat natin kundi ang mga kaloob ng Espiritu Santo: karunungan, pagkaunawa, kahatulan, lakas ng loob, kaalaman, kabanalan at takot sa Diyos. Sa Lumang Tipan, matatandaan natin na ibinigay ng Diyos ang kanyang hininga sa mga unang tao na nilalang niya – sina Adan at Eba. Nagpropesiya si Ezekiel kung paanong sa mga huling araw darating ang Diyos at ibibigay niya ang kanyang hininga sa mga kalansay, bibigyan sila ng laman, at makabangon at mabuhay muli. Si propeta Joel ang naglahad ng pagkilos ng Espiritu santo sa mga taong nabubuhay sa lupa: “Ito ang gagawin ko sa mga huling araw, sabi ng Diyos, pagkakalooban ko ng aking Espiritu ang lahat ng tao, at sa ngalan ko'y magpapahayag ang inyong mga anak. Ang inyong mga binata'y makakakita ng mga pangitain. At ang inyong matatandang lalaki'y magkakaroon ng mga panaginip.” Sa Bagong Tipan narinig natin ang Espiritu Santo na ipinangako kay Maria na siyang maglalalang ng isang sanggol sa kanyang sinapupunan. Sa ikatlong araw makalipas ang Muling Pagkabuhay, ibinigay ni Kristo sa mga apostol ang kanyang hininga. Ngunit naghintay sila sa ikalimampung araw bago nila tanggapin ang malakas na hagunot ng hangin at dapuan sila ng Espiritu Santo sa anyo ng mga dilang apoy. Nagsalita sila sa iba't ibang wika ngunit umiral ang pagkakaunawaan. Binaligtad ng Pentekostes ang malagim na sinapit ng mga tao sa Tore ng Babel. Tinangka nilang higitan ang Diyos, nagtayo sila ng isang tore na sing tayog ng kanilang mga ambisyon ngunit nasadlak sila sa gulo at pagkahati-hati at pagkakanya-kanya. Kinikilala ang kapistahan ng pentekostes na birthday ng Simbahan. Nawa bumangon tayo mula sa kalansay ng nakaraan. Nawa makakita ng pangitain an gating mga kabataan at ang mga matatandang lalaki at babae ay huwag bumitiw sa kanilang mga panaginip. - Fr. Paul Marquez, SSP | Society of St. Paul
Külföldi Ironman versenyre készül a családapa! Printz Ákos, ironman versenyző
Nakon što je 17 godina vodio Infinum, odnedavno je CEO njihove 'spin off' tvrtke Productive koja cilja izuzetno konkuretno tržipte na kojem dominiraju Asana i Jira. Tomislav nam otkriva svoje početke, iskustva i buduće ambicije! Na pitanje je li ikad postojala mogućnost da radi za nekog drugog, odgovara da naravno da postoji, posebno jer se dobro sjeća trenutka kad su na žiro računu tvrtke imali samo 400 kuna. Danas je malo drugačija situacija i Infinum je jedna od najvećih tehnoloških tvrtki u Hrvatskoj. Dapače, žele biti holding s cijelim nizom tvrtki u koje su investirali poput Rentlija (o čemu sam s osnivačem Marko Mišulićem pričao upravo na Netokracija Podcastu), onih koje su pokrenuli poput Porsche Digitala Hrvatska, ali i The Productive Company čiji je Car CEO. ► Kako je Infinum krenuo iz Prve (i jedine) karlovačke gimnazije; ► Problem pokretanja dodatnih projekata uz agenciju; ► Što je naučio od mentora poput svog oca, ali i osnivača IN2 Ante Mandića; ► Infinumov eksentričan humor kao employer branding u doba kad su IT tvrtke bile formalne; ► Problemi u product tvrtkama, od strategije proizvoda do određivanja cijena; ► Kako konkurirati na etabliranom tržištu kad vam MVP ne pomaže; ► Zašto trebate izvlačiti informacije iz svojih šefova; ► Jesu li mladi programeri danas razmaženi. _______________
Please join author Mohamed Abdel-Wahab and Associate Editor Stefan James as they discuss the article "Comparison of a Pure Plug-Based Versus a Primary Suture-Based Vascular Closure Device Strategy for Transfemoral Transcatheter Aortic Valve Replacement: The CHOICE-CLOSURE Randomized Clinical Trial." Dr. Carolyn Lam: Welcome to Circulation on the Run. Your weekly podcast summary and backstage pass to the Journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, associate editor, director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Well, Carolyn, this week's feature, a very interesting topic, looking at closure devices at the sites of access for patients that are undergoing TAVR procedures. But before we get to that, how about if we grab a cup of coffee and start with some of the other articles in the issue. Would you like to go first? Dr. Carolyn Lam: I would love to and I would like to describe not just one, but two articles from recent SGLT2 inhibitor trials. So, the first paper is an analysis of the DAPA-HF trial. Now we know that circulating high sensitivity, cardiac troponin T predominantly reflects myocardial injury. And higher levels are associated with a higher risk of worsening heart failure and death in patients with heart failure with reduced ejection fraction or HFrEF. But what about the prognostic significance of changes in high sensitivity troponin T over time and the effects of Dapagliflozin and on clinical outcomes in relation to baseline levels, as well as the effect of dapagliflozin on the high sensitivity troponin T levels? Well, this is what this study answers. It's a biomarker substudy of the DAPA-HF trial from Dr. Berg of the TIMI study group at Brigham women's hospital and colleagues. Dr. Greg Hundley: Wow. Carolyn, very interesting. So remind us about the DAPA heart failure trial. What was it about? Dr. Carolyn Lam: Ah, well, DAPA-HF was a randomized double blind placebo control trial of dapagliflozin in patients with symptomatic HFrEF defined by injection fraction 40% or less wherein dapagliflozin significantly reduced the primary endpoint of cardiovascular death or worsening heart failure events. And in today's biomarker substudy increases in high sensitivity, cardiac troponin T over a one year interval of time were highly predictive of subsequent risk of worsening heart failure and cardiovascular death. The effect of dapagliflozin on the primary endpoint was consistent irrespective of baseline troponin T concentration with no evidence of attenuated treatment benefit in those with very high troponin T concentrations. Dr. Greg Hundley: Very interesting Carolyn. Now you've got another study. Is this one on EMPA? Dr. Carolyn Lam: You are right. Thank you. The next paper is and analysis of the Emperor-Preserved trial. As a reminder, Emperor-preserved study the SGLT2 inhibitor empagliflozin in patients with HFpEF this time, which is a left ventricular ejection fraction above 40, and showed a significant reduction in the risk of cardiovascular death or heart failure hospitalization. The current paper evaluated the efficacy of empagliflozin on health related quality of life in patients with HFpEF and whether the clinical benefit observed with empagliflozin varied according to baseline health status. Dr. Greg Hundley: Very nice, super review Carolyn. So what were the results of this study? Dr. Carolyn Lam: In Emperor-Preserved, baseline health status and quality of life did not influence the magnitude of effect of empagliflozin on the risk of cardiovascular death or hospitalization for heart failure. Empagliflozin improved health status and quality of life as assessed by the Kansas city cardiomyopathy questionnaire across all domains and at all measured time points. Thus an effect that appeared early and was sustained for at least one year. Dr. Greg Hundley: Very nice. So two really informative papers on SGLT2 inhibitors. Well Carolyn, I'm going to turn the conversation to the world of preclinical science and talk about Titin. So Carolyn, titin truncation variants are the most common inheritable risk factor for dilated cardiomyopathy and their pathogenicity has been associated with structural localization. The A-band variants with overlapping myosin heavy chain binding domains appear more pathogenic than the I-band variants and the mechanisms for this are not well understood. So these investigators led by Dr. Hinson at the Jackson Laboratory for genomic medicine, performed a study demonstrating why A-Band variants are highly pathogenic for dilated cardiomyopathy and how they could reveal new insights into dilated cardiomyopathy pathogenesis. Titin functions and therapeutic targets were assessed. Dr. Carolyn Lam: Wow, interesting. So what did they enroll in? How did they do this? what did they find? Dr. Greg Hundley: Great Carolyn, so human Cardiomyocytes and cardiac micro tissue functional assays revealed that highly pathogenic A-Band Titin truncation mutations generate four shortened titin poisoned peptides and diminish full length, titin protein levels. While less pathogenic I-band titin mutations only diminish titin protein levels. And so Carolyn, the authors developed a one and done, genome editing therapeutic approach using CRISPR technology to repair the reading frame of Titin truncation mutations in cardiomyocytes. And therefore these genome editing therapeutics could correct the underlying genetic lesion responsible for dilated cardiomyopathy due to these Titin mutations. Dr. Carolyn Lam: Wow. Interesting. One and done genome editing. You learn something new every day with circulation. You've got another paper? Dr. Greg Hundley: Yes, Carolyn. Thank you. And so this paper comes to us from Dr. Beiyan Zhou From the Yukon health, school of medicine and again, from the world of preclinical science. So Carolyn, while several interventions can effectively lower lipid levels and people at risk for atherosclerotic cardiovascular disease, cardiovascular event risks remain, suggesting an unmet medical need to identify factors contributing to this cardiovascular event risk. Now monocytes and macrophages play central roles in atherosclerosis, but previous work has yet to provide a detailed view of macrophage populations involved in increased atherosclerotic cardiovascular disease risk. Dr. Carolyn Lam: Huh? Okay. Well, I'm super excited to hear what these investigators did Greg. Dr. Greg Hundley: Right, Carolyn. Well these authors developed a novel computational program. They call AtheroSpectrum, which identified a specific gene expression profile associated with inflammatory macrophage foam cells. And additionally, a subset of 30 genes expressed in circulating monocytes jointly contributed to the prediction of symptomatic atherosclerotic vascular disease. So therefore Carolyn, in the future, perhaps incorporating this new pathogenic foaming gene set with known risk factors may significantly strengthen the power to predict atherosclerotic cardiovascular disease risk. Dr. Carolyn Lam: Wow. Super interesting and well summarized. Thank you, Greg. Well also in today's issue, there's a Perspective by Dr. Kirtane on “The Long-Awaited Revascularization Guidelines are Out. What's In Them?” A Research Letter by Dr. Laffin on rise in blood pressure observed among us adults during the COVID 19 pandemic. Dr. Greg Hundley: Very Nice Carolyn. Well in our Cardiovascular News Segment, there's a piece on metabolic risk factors and how they drive the burden of Ischemic heart disease. Well, what a great issue here and now, how about we get onto that feature discussion? Dr. Carolyn Lam: Very Cool. Closure devices after TAVR. Here we go. Dr. Greg Hundley: Well, listeners welcome today to our feature discussion and we have with us Dr. Mohamed Abdel Wahab from Leipzig Germany. And we are going to discuss some issues pertaining to transcatheter aortic valve replacement, in terms of access to the arteries in the lower extremity. Welcome Mohamed. And can you start with, what was some of the background that led you to perform your study and what was the hypothesis that you wanted to address? Dr. Mohamed Abdel-Wahab: Thank you, Greg. And thank you for having me here. So as you mentioned, there are several cardiovascular procedures that currently require large-bore arterial access. The most common of these procedures is transcatheter aortic valve replacement. But there are other procedures as well, like endovascular aortic repair, mechanical circulatory devices. All of these require large-bore arterial access and of course, closure afterwards. And what we were interested in looking at was whether different types of vascular access site closure devices or strategies behave differently in the setting. Particularly in the setting of transcatheter aortic valve replacement. The reason behind this is that for many years, we only had one technique, to percutaneously close arterial access sites after these procedures. And these were mainly based on suture based devices or suture based techniques. Very recently, alternative techniques based on collagen plugs have been introduced. Dr. Mohamed Abdel-Wahab: And we know these types of devices or closure techniques from usual coronary intervention procedures for smaller access sites or for smaller sheath size. But they have been developed a step further for these large-bore procedures. These newer devices, particularly what we call the MANTA device, which is based on the collagen plug has been shown in initial visibility studies and also in registry based analysis to be very safe and effective. It leads to a very rapid hemostasis. And data from observational studies have suggested that it may be even superior to the suture based techniques, largely based on what we call the ProGlide device or the [inaudible 00:10:56]. And this is actually what we were aiming to look at. To compare these two different strategies based on two different devices. The suture based, the classical suture based technique using two ProGlides compared to the newer plug based technique using the MANTA in a population treated with TAVR. Dr. Greg Hundley: Very nice. And describe for us, your study design. And then also maybe explain a little bit more about the study population. Who did you include in this study? Dr. Mohamed Abdel-Wahab: So the design was more or less, very inclusive. So we designed the trial to more or less represent real word population. More or less [inaudible 00:11:40] population receiving transcatheter aortic valve replacement. So we included patients, of course where the procedure is being thought to be indicated and feasible by a multidisciplinary heart team. And also where the heart team thought that the transfemoral access route, which is the main route for the majority of patients, is obtainable and use of a percutaneous closure device is also possible. Dr. Mohamed Abdel-Wahab: Of course we had some exclusions. For example, patients where the use of a surgical access technique was necessary. They couldn't be naturally included in the trial. Patient that already had complications related, for example, to previous coronary angiogram PCI at the access site, they couldn't be included. But we were more or less, very inclusive in this trial. The trial population reflects the patients that are currently being treated with TAVR, so more or less an elderly population. More or less equally split-by males and females, which is very particular, again to the TAVR population. So this is a little bit different than the population that receives PCI, where we usually have a predominantly male population. This is not the case here. So these are the broad lines. Also reflecting current practice, the population that has been included in the trial is more or less overall, an intermediate risk population, when you look at the surgical scores. Dr. Greg Hundley: Very nice. So this was multicenter and then also patients were randomized to each of the two therapies, I believe. And was that a one to one randomization? Dr. Mohamed Abdel-Wahab: Exactly. So it was a multicenter trial. Patients were randomized between these two techniques. We mentioned the ProGlide based and the MANTA based in 1:1 fashion. And steering committee of course was more or less dominated by interventional cardiologists. Of course, in the context of this particular trial setting, the trial was only performed in Germany and it was an investigative initiated trial, not sponsored by the industry. Dr. Greg Hundley: Very nice. And can you describe for us, Mohamed, your results? Dr. Mohamed Abdel-Wahab: Yes. We actually hypothesized based on the observational data we have, that we will have less vascular complications with the MANTA based technique or the collagen based technique. At the end of the day, what we observed is completely the opposite. So the primary endpoint of the trial, which was what we call major and minor vascular complications defined according to the standardized criteria provided by the valve academic research consortium. These events occurred significantly more common in patients that were randomized to the MANTA based technique, as opposed to the ProGlide based technique, which was statistically significant. Dr. Greg Hundley: And did you observe those results across both the men and the women? And also, were there any differences in the results related to participants' age? Dr. Mohamed Abdel-Wahab: Yeah. So there were no interactions with various subgroups, both the predefined ones, including age and sex, as you mentioned. But also we looked at some post hoc subgroups, including for example, whether this is being affected by the size of the access vessels or by the presence and location of calcification, for example. But there were no interactions in all subgroups we looked at, with one exception which was chronic renal insufficiency. But all other subgroups showed actually no significant interaction, favoring the suture based, ProGlide based technique in all subgroups. Dr. Greg Hundley: Very good. And so can you describe in terms of, for individuals performing TAVR procedures and obtaining access, how do we use the results of your study to inform how we might move forward with closure of the artery in the future? Dr. Mohamed Abdel-Wahab: I mean, the first thing I would like to stress is the importance of doing randomized trials in general. Because I think this is not the first time we see opposite results when we are comparing randomized evidence with the evidence from observation studies, with the known limitations of observational comparative analysis. The second thing I think is really reassuring that the suture based technique that we know and that we have been using for many years now is safe and appears to be even more effective than the newly developed plug based technique. So this is one important information I think from this trial. The third piece of information is that the recently developed plug based technique, although being inferior in the study, it still may have some advantages in selected patients. And this is what we probably need to look at in a little bit more details in the future. Dr. Mohamed Abdel-Wahab: For example, what we realized from the study is that it could be a good option as a bailout device. So in some cases where the suture based technique has failed in the study, the crossover to the MANTA device was successful in the majority of cases. And may lead or help avoid complex endovascular interventions and implanting for example, stents or covered stents or even doing surgery. So this is something that is a nice observation from the dataset we have, but of course needs validation in larger studies. Dr. Greg Hundley: Very nice. And so really you've answered, kind of one of our key questions is, your thoughts on the next study that you see needs to be performed really in this area of research? Dr. Mohamed Abdel-Wahab: Yeah, so I think there are several things. One thing is, again, to look at potential patient subgroups that may benefit from the plug based device from the beginning. So probably it's not something that we should be using as a default strategy based on the results of this trial. But there could be certain subgroups we need maybe to dig a little bit more into the details or subgroups, if you wish to say so. Look a little bit more granularly at some patient groups that could benefit. But as mentioned, I think that the bailout indication is a very interesting one and needs to be looked at. Dr. Mohamed Abdel-Wahab: Not only in the TAVR setting, but also in the setting of other procedures. Such as for example, the use of mechanical circulatory assist device or ECMOs, where it may be difficult to apply these sutures post hoc. So the sutures that we apply during a TAVR procedure and what we use in this trial, this is the so-called preclosure technique. So you apply the sutures after gaining access. Then you insert your large-bore sheaths through the procedure. And then the sutures are already there and you can close the access site, usually without problems. Which is difficult, if you obtain access, for example, with an ECMO or an Impella. And then after a couple of days, you need to close it. So the sutures are not yet in place. In this particular scenario, it may be beneficial to use a plug afterwards. Or as a bailout device as previously Mentioned. Dr. Greg Hundley: Very nice well listeners. We want to thank Dr. Mohamed Abdel Wahab from Leipzig Germany for bringing us this study indicating that among patients treated with transfemoral TAVR, this pure plug based vascular closure technique using the MANTA VCD was associated with a higher rate of access site or access related vascular complications. Well, on behalf of Carolyn and myself, we want to wish you a great week and we will catch you next week on the run. Dr. Greg Hundley: This program is copyright of the American heart association, 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American heart association. For more, please visit AHA journals dot org.
How did it take so long to get to Napa?? In this episode Adam and Eric taste through one of the most famous wine regions in the world. Talking history, topography, music inspiration, and how to taste through Napa. Whoopee! Featuring Stephanie Gonzales in the new duet "Perfect Pairing". Educational and entertaining for the amateur wine drinker as well as the seasoned pro. Also delightful for all kinds of music lovers. Entertainment like you've never tasted!!Instagram: https://www.instagram.com/tastingnotestheshow/Contact us: tastingnotestheshow@gmail.comWines Featured:Silverado "Miller Ranch"Sauvignon BlancYountville 2020Groth "Hill View"ChardonnayOakville, 2019PalmazCabernet SauvignonCoombsville, 2017Mt. Veeder "Reserve" Cabernet SauvignonNapa, 2015
Subscribe for more: www.nobu.ai/podcastFollow us on Instagram: https://www.instagram.com/nobuappFollow us on Spotify: https://open.spotify.com/show/3NMIEgjblqmhwT6Uy3l0NmSubscribe to Dear Mind You Matter Podcast: https://podcasts.apple.com/us/podcast/dear-mind-you-matter/id1573642046Leave us a review: https://podcasts.apple.com/us/podcast/dear-mind-you-matter/id1573642046Interested in attending our Educational Events? https://bit.ly/eventsandeducation____For the safety of our listeners, we want to note that the following episode may contain information that some may find triggering and/or may not be suitable for younger audiences. Listening discretion is advised. Lisa is a recognized expert in the strengths-based, de-pathologized treatment of trauma and has been in private practice for over 36 years. She presents workshops and keynote addresses nationally and internationally and is a clinical consultant to practitioners and mental health agencies in the United States, Canada, the UK and Ireland. She has been an Adjunct Faculty member at several Universities, and is the Founder of “The Ferentz Institute,” now in its fourteenth year of providing continuing education to mental health professionals Lisa also hosted a weekly radio talk show, writes blogs and articles for websites on trauma, attachment, self-harm and self-care, teaches on many webinars, and is a contributor to Psychologytoday.com. You can follow Lisa's work on her website, theferentzinstitute.com, Facebook, LinkedIn and Twitter.Lisa is the author of “Treating Self-Destructive Behaviors in Trauma Survivors: A Clinician's Guide,” now in its second edition, “Letting Go of Self-Destructive Behaviors: A Workbook of Hope and Healing,” and “Finding Your Ruby Slippers: Transformative Life Lessons From the Therapist's Couch.” In 2009 voted the “Social Worker of Year” by the Maryland Society for Clinical Social Work. Memorable Moments: 4:12: I realized how inspiring traumatized clients actually are because of their resiliency and their refusal to give up and the creative coping strategies that they actually tap into in order to navigate their challenges and their suffering. They have been the teachers of my heart for all these years.5:08: It [trauma] is unbelievably prevalent. If you look at the research, 1 in 3 women and 1 in 5 men by the time they're 18 have experienced some form of sexual trauma. We know millions of people walk around having lived in families where there perhaps was addiction or mental illness, physical violence, witnessing domestic violence, neglect. Unfortunately, it touches millions of people.6:52: Anything that is subjectively experienced as threatening; anything that subjectively leaves you feeling like your privacy, your boundaries, your body in some way are being violated; anything that feels to you subjectively like a profound a breach of trust, that's in part how we would define what traumatizes a person.8:12: It's very common for people to not connect the dots between past experiences and the current symptoms or struggles that have manifested for them.9:01: Unfortunately, there are many many ways that people can creatively self-medicate.Dear Mind, You Matter is brought to you by NOBU, a new mental health, and wellness app. To download NOBU, visit the app store or Google Play. This podcast is hosted by Allison Walsh and Dr. Angela Phillips. It is produced by Allison Walsh, Ashley Tate, and Nicole LaNeve. For more information or if you're interested in being a guest on this podcast, please visit www.therecoveryvillage.com/dearmindyoumatter.
Raj and Matt join Beyond the Scope to discuss the the Digital Anatomic Pathology Academy, hosted on PathPresenter - a primarily open source cloud based viewing platform for digital slides. DAPA is used as an educational, clinical, and publication tool. DPA members can access DAPA for free to make use of the numerous educational modules (dpa-dapa.com).NOTE: this episode utilizes video for platform tutorials. Please visit https://digitalpathologyassociation.org/dpa-podcast-beyond-the-scope for the video version.2:48 Guest intro7:21 Introduction to the cloud based viewing and educational platform8:47 Tutorial for navigating the platform17:20 DAPA educational module features and demonstration20:45 DAPA use cases; including an interactive way to study for boards26:00 How DPA members and other can access the platform27:50 Open source platform vs. licensed version for private data30:10 MSKCC experience using the platform as an education portal and conference tool33:00 Long term clinical goals of the platform37:55 Utilizing the platform in underserved areas39:23 Utilizing the platform for publications and E-books
(Episode Starts at 02:24) Wan tu tri kelos de kloset tar bau ! Hai gais balik lagi sama kita di sini gatau dimana sih jadi disini aja pokonya,bareng Mata Nadhil,Papih Good,dan si Dapa pake f juga ada bintang tamu spesial telornya dua yaitu Tinto Aji. Disini kita bahas bihis tentang olimpiade di Jepang (buat yang bisa bahasa Jepang tolong ajarin kita bahasa sansekerta dong) dan culture kita pas 17an yaitu lomba lomba unik yang pastinya bikin kangen sama vibe 17an yang lagi dibekukan karena PTSI (Persatuan Tujuhbelasan Seluruh Indonesia) yang lagi dibekukan. Pokonya dengerin ae episode terbaru dari kita dan jangan lupa buat inget ! CIAO !!! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/podcastapaansi/support
Marilyn M. Bui, MD, PhD, FCAP is a senior member in the Department of Pathology at Moffitt Cancer Center where she serves as the scientific director of the Analytic Microscopy Core. She has previously served as president of the DPA and currently chairs many committees for CAP and DPA. Dr. Bui joins Beyond the Scope to discuss her work toward digital pathology adoption and building a connected network of pathologists.1:58 Introduction and what it means to be a pathologist in the digital age6:03 Evolution of pathology toward the digital era10:18 How experience as a molecular biology researcher led to a career focused on DP/AI14:25 Building relationships through the DPA and how to get involved18:24 Highlights throughout the years of DPA leadership22:34 Global digital pathology collaborations24:23 DAPA - a cloud based platform for DP education31:05 Using social media to promote DP adoption and education32:47 Digital health initiatives at Moffitt Cancer Center36:33 Current research projects in DP/AI41:55 The future of pathology - how to improve the workforce,promote a healthy lifestyle, and decrease the workload
Motivated in part by Congress's failure to modernize immigration policy in the United States, Presidents in recent years have turned to administrative law and the regulatory process to make major immigration policy. The Obama Administration's DACA and DAPA immigration policies come immediately to mind. So does the Trump Administration's attempted rescission of DACA, among other regulatory or executive branch actions such as the travel ban, regulation of "sanctuary" cities, and major adjudicative and rulemaking policy changes to asylum and related relief.Now that regulation is the primary means for immigration lawmaking, scholars, judges, and government officials have begun debating the proper regulatory processes for promulgating major immigration policy. In her book Beyond Deportation, for example, Professor Shoba Sivaprasad Wadhia has examined the value of rulemaking over agency guidance for major immigration policy and related relief. In a recent coauthored Duke Law Journal article, Professor Christopher Walker has joined Professor Wadhia to argue that the Biden Administration should shift the immigration policymaking default from administrative adjudication to notice-and-comment rulemaking (and not seek Chevron deference in immigration adjudication).In this episode, an expert panel explores these arguments regarding the appropriate regulatory process for immigration policymaking and how the Biden Administration (and the federal courts) have already started to take up this call to action. Professors Wadhia and Walker are joined by Professors Susan Dudley and Richard Pierce, both of whom have deep expertise in administrative law and regulatory process.Featuring:- Richard Pierce, Lyle T. Alverson Professor of Law, George Washington University Law School- Shoba Sivaprasad Wadhia, Associate Dean for Diversity, Equity, and Inclusion, Samuel Weiss Faculty Scholar and Clinical Professor of Law, and Director, Center for Immigrants' Rights Clinic, The Pennsylvania State University- Christopher Walker, Professor of Law, Moritz College of Law, The Ohio State University- [Moderator] Susan Dudley, Director, GW Regulatory Studies Center & Distinguished Professor of Practice, Trachtenberg School of Public Policy & Public Administration, George Washington UniversityVisit our website – www.RegProject.org – to learn more, view all of our content, and connect with us on social media.
Szórakoztató podcast hírek a legérdekesebb filmekről, televíziós- és streaming csatornák választékából, a színházi életről, könyvekről, és a kulturális életről. A felolvasott hírek itt érhetőek el: https://podcast.hirstart.hu/film-zene-szorakozas/2021/06/21/4532/
Szórakoztató podcast hírek a legérdekesebb filmekről, televíziós- és streaming csatornák választékából, a színházi életről, könyvekről, és a kulturális életről. A felolvasott hírek itt érhetőek el: https://podcast.hirstart.hu/film-zene-szorakozas/2021/06/21/4532/
Hva har noe så retro som et kart på papir å gjøre med å få flere på sykkel, vende blikket vekk fra mobilen, og få folk til å utforske sin egen by? Møt Pavel Sagen og Daniel Andersson, en russisk-svensk duo med et nytt blikk på Oslo. Se også: Dapamaps.com https://www.arkitektnytt.no/nyheter/kartet-pa-veggen https://www.wired.com/story/grayscale-ios-android-smartphone-addiction/
A Hit Rádió további hitéleti hírei: Meghalt a jeruzsálemi régészet és a bibliai leletek királynője, Eilat Mazar / Az amerikaiak többsége ellenzi, hogy transznemű sportolók a választott nemi identitásuk szerinti kategóriában versenyezzenek / Európa legnagyobb lutheránus gyülekezete is kiállt a transz ideológia mellett
Nismo se trudile spojiti St.Patrick's day sa erotskim masažama, ali s obzirom da je danas njihov dan želimo svakom slavljeniku po jedan happy ending :DDok smo prelistavale razne vrste oglasnika u svrhu ove teme, naišle smo na zaista velik raspon usluga i cijena. Iako sve pod krinkom običnih masaža (ali možemo se dogovoriti, ljudi smo, napomenom) kod nas takva vrsta masaža spada pod prostituciju i time je nelegalna. To nikako ne znači da Mia i Bela nešto takvo nisu doživjele. Dapače, u društvu svojih partnera i jedna i druga se slažu u jednom, a to je da te masaže zaista potiču cirkulaciju. Hahahaha ne, nije to poanta već ukoliko niste pretjerali sa uljima i pretvorili tu masažu u lunapark ona zaista može biti prekrasna predigra uz koju partneri postaju još prisniji. Svakako vam preporučujemo da probate ;)Stay tuned!Sva pitanja, zahtjevi za suradnju i oglašavanje te sponzorstvo su dobrodošli. Kontaktirajte Belu i Miju na mail: rozekozepodcast@gmail.com Svoje komentare na ovu temu kao i prijedloge sljedećih tema koje bi voljeli da obradimo šaljite na:rozekozepodcast@gmail.cominstagram@rozekozepodcast
The Defense Acquisition Program Administration (DAPA) announced Wednesday that the military's validation of locally-made defense products will be expanded to beef up Korea's arms exports.The revised policy expands the program to other kinds of equipment and materials starting at the end of March.Listen to the full story in this week's episode. Subscribe to the K-News Bulletin to listen to Korea's biggest headline of the day, written by staff reporters of the Korea JoongAng Daily.Full Article: https://koreajoongangdaily.joins.com/2021/03/10/national/defense/DAPA-military-exports/20210310180700292.html
This week features Two Feature Discussions. In our first discussion, author Thomas Metkus and Guest Editor Allan Jaffe discuss the article "Myocardial Injury in Severe COVID-19 Compared to Non-COVID Acute Respiratory Distress Syndrome." Then in our second discussion, author Naveed Sattar and Guest Editor Ileana Piña discuss the article "Effect of Empagliflozin on Left Ventricular Volumes in Patients with Type 2 Diabetes, or Prediabetes, and Heart Failure with Reduced Ejection Fraction (SUGAR-DM-HF)." TRANSCRIPT BELOW Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast, summary and backstage pass to the journal and its editors. We're your co-hosts, I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: I'm Dr. Greg Hundley, Associate Editor, Director of the Pauly Heart Center at VCU Health in Richmond, Virginia. Dr. Carolyn Lam: Guess what? Double feature again, this episode with the first talking about empagliflozin and its effect on left ventricular volumes in patients with type two diabetes, pre-diabetes, and HFrEF, and this is the sugar DM heart failure study. Dr. Greg Hundley: Carolyn, the second of our double feature Tuesday is a paper that involves myocardial injury in severe COVID-19 compared to non-COVID acute ARDS. Well, let's grab a cup of coffee and Carolyn this week, I'm going to jump into my first paper, which comes to us from Dr. Are Kalstad from the University of Oslo at the Oslo University Hospital. Carolyn, this study tested the hypothesis that the daily addition of 1.8 grams of N-3 PUFA to standard of care, secondary prophylaxis in elderly patients who have survived a acute MI would reduce the risk of subsequent cardiovascular events during two years of follow-up. Dr. Carolyn Lam: Interesting, Greg and a clinically important question. So what did they find? Dr. Greg Hundley: Yes, Carolyn. They enrolled 1,027 subjects who were randomized in this investigator initiated, multi-center randomized clinical trial of adding that 1.8 grams of n-3 PUFA, 930 milligrams of EPA, and 660 milligrams of DHA versus placebo, which was a corn oil supplement, daily to the standard of care in 70 to 82 year old patients with recent, so within two to eight weeks, acute myocardial infarction. The authors found that they could not detect reduction in clinical events in these elderly patients with the recent acute EMI treated with the 1.8 grams of n-3 PUFAs daily for two years. So, a negative study, Carolyn. Dr. Carolyn Lam: Surely, we'll add to that debate that's just so interesting surrounding the PUFAs. But let's go onto another paper I want to tell you about, it provides novel insights into the complex crosstalk between the cardiac endothelial cells and cardiomyocytes during cardiac repair after myocardial infarction. This paper is from Dr. Taleb and colleagues from Park Inserm in France. Their study suggested a deleterious role for endothelial indoleamine 2,30-dioxygenase-1, which I'm now going to abbreviate as IDO, which is an enzyme involved in tryptophan catabolism. They found that the specific deletion of IDO in endothelial cells enhanced cardiomyocytes survival and contractility leading to cardiac function improvement. The IDO dependent effects were mediated by endothelial cell production of kynurenine. The study in essence found that therapeutic strategies targeting cardiac IDO could, in fact, constitute an innovative approach to curb cardiac dysfunction following MI. This was followed by an editorial by Drs. Ma and Wang from Thomas Jefferson University. Dr. Greg Hundley: Very nice, Carolyn. Great studies again from the world of basic science. Well, my next paper comes to us from Professor Gerasimos Filippatos from the University of Athens Hospital. Carolyn, this was a sub-study of the FIDELO-DKD trial that evaluated the effect of the nonsteroidal selective mineralocorticoid receptor antagonists finerenone on kidney and cardiovascular outcomes in patients with chronic kidney disease and type two diabetes with optimized renin angiotensin system blockade. Compared with placebo, finerenone reduced the composite kidney and cardiovascular outcomes. Here the authors report the effect of the finerenone on individual cardiovascular outcomes and in patients with and without a history of atherosclerotic cardiovascular disease. Dr. Carolyn Lam: This is a much anticipated paper. Very excited for you to describe the findings, Greg. Dr. Greg Hundley: Thanks, Carolyn. Among patients with chronic kidney disease and type two diabetes, finerenone reduced the incidents of the composite cardiovascular outcome, that included time to cardiovascular death, myocardial infarction stroke, or hospitalization for heart failure. Additionally, there was no evidence of differences in treatment effect based on pre-existing cardiovascular disease status. Dr. Carolyn Lam: Emerging therapies. Isn't that awesome? Well, some other papers in this issue, there's a White Paper (Frontiers) about the therapy in patients with atrial fibrillation treated with oral anticoagulation undergoing PCI, a North American perspective, 2021 update by Dr. Angiolillo. There's a Research Letter on the gradient of risk and associations with cardiovascular efficacy of ertugliflozin by measures of kidney function, and these are observations from VERTIS-CV trial by Dr. Cherney. There's also a sub-study analysis from Explorer HCM, and that is entitled “Mavacamten Favorably Impacts Cardiac Structure in Obstructive Hypertrophic Cardiomyopathy.” This is by Dr. Saberi. There's another Research Letter on COVID-19 myocardial pathology evaluation in athletes with by CMR and that's by Dr. Clark. Dr. Greg Hundley: Very nice, Carolyn. I have an exchange of letters from Dr. Alkhalil and Kuzemczak, as well as Dr. Navarese regarding the article, “Comparative Efficacy and Safety of Oral P2Y12 Inhibitors in Acute Coronary Syndrome: A Network Meta-Analysis of 52,816 Patients From 12 Randomized Trials.” Next, there's another exchange of letters from Dr. Kastrati and Ferracane regarding the article, “Comparative Efficacy and Safety of the Same Oral P2Y12 Inhibitors in Acute Coronary Syndromes.” Dr. Karabinos has a nice ECG challenge. It's a bizarre down sloping ST segment elevation challenge. Finally, Carolyn, there's a Perspective piece from Dr. Okorodudu entitled, “Exposure to Cardiology as a Strategy to Increase Black Men Involvement in Medicine.” Well, Carolyn, how about we get on to those two feature discussions? Dr. Carolyn Lam: Oh, yes. Exciting. Let's go. Dr. Greg Hundley: Well, listeners, we are here for our first feature discussion today on this February 9th. We have with us Dr. Tom Metkus from Johns Hopkins and Dr. Allan Jaffe from Rochester. Tom, can you tell us what was the background that really framed this study and what hypothesis did you want to address? Dr. Thomas Metkus: This study really arose out of a time and a place in the COVID pandemic. If you can all turn your clocks back to late last spring, we were all enmeshed in the clinical care of many patients with COVID here in the United States, depending on your geography, and also reading an increasing number of reports from other centers that had been enmeshed in the pandemic for some time about myocardial injury, elevated troponin, different aspects of cardiac disease in patients with COVID-19. My background is as a cardiac intensivist, dual boarded in cardiology and critical care, and so this was of particular interest to me, specifically so in that my clinical practice at the time was in a COVID ICU. I spent much of the day every day taking care of these patients, so conceptualizing what myocardial injury meant, what's the pathogenesis, and what does it mean, was an open-ended question at the time. There are certainly many reasons to think that COVID-19 is particularly cardiotoxic. There's obviously the pro-thrombogenic nature of the illness. There's the inflammatory nature of the illness. Dr. Thomas Metkus: Yet, we also found that clinically, there was certainly many patients with COVID-19 who acted like they had myocardial injury from ARDS and pneumonia and we had investigated this in some prior studies prior to the pandemic. Really, the aim of the study was to clarify to the extent that we could and contribute to the growing body of knowledge about what is the prevalence and prognostic significance of myocardial injury in COVID-19. We felt that we had a unique lens on this because we also had a cohort of patients with generic ARDS who had cardiac biomarkers assessed, gave us a nice opportunity to do that. Dr. Thomas Metkus: Our hypothesis, that was really based on our clinical gestalt at the time from being in the ICU every day with COVID-19 patients, was that there are assuredly COVID-19 patients who have unique features of myocardial injury, myocarditis or malignant arrhythmias, or requiring mechanical support. But perhaps more, or at least a majority have myocardial injury that looks and acts an awful lot like it would in a sepsis patient, in an ARDS patient. We hypothesized that myocardial injury in COVID-19 would be more similar than different to the generic ARDS population. As such, we drew a population of patients with COVID-19 from our health system here across several hospitals, and did a bit of a comparison with our historical cohort of ARDS patients. Dr. Greg Hundley: Great description, Tom. Tell us a little more about that study population. You said there was going to be a comparison. What were some of the outcomes that you wanted to evaluate? Dr. Thomas Metkus: Right. This question alludes to an important point as we try to delve and do inference around the COVID literature in general, which is to say the pandemic is heterogeneous across geography and across time. In looking at this study, or indeed any study, and understanding of the study population where these ambulatory patients or intubated patients or patients on the ward, for example, as well as any comparison group are these sepsis patients, pneumonia patients, influenza patients, it's just imperative to do inference and to place the study in context. This study, we sought to look at only intubated patients, and that was partially driven by clinical interest, partially driven by the ability then to provide a comparison to our ARDS cohort. So, intubated patients with COVID-19. Dr. Thomas Metkus: The comparison group is from a study of acute respiratory distress syndrome patients. Primary lung injury patients that were drawn in turn from NHLBI sponsored areas, network clinical trials. That was a study that was a secondary analysis that we did where we checked troponin levels in everybody. A true cross sectional assessment. That's important in that there's a selection bias, isn't there, when you just look at patients who had troponin drawn in the context of clinical care? So, I think for this study in particular, it's important to note that the comparison group of ARDS patients was truly cross-sectional and that it was a population defined who had biomarkers assessed in the entirety; whereas our COVID-19 population was intubated patients who had troponin checked at the point of clinical care. Dr. Thomas Metkus: Now, to address some of the potential biases that are inherent in that assessment of exposure, we purposefully looked at only patients who had troponin assessed within 24 hours of intubation, really to sync up time zero in a sense. It's also important to note the time course of the pandemic. These patients were all in the late spring and very early summer. This was really before steroids, before the recovery trial, before steroids became standard of care. And really, health systems wonder a fair bit of duress at that time and indeed, as many of the listeners will know, the outcomes for hospitalized patients have improved since then for many reasons. But it's only to point out that this study was a place in geography and a place in time, and there are certainly implications about that that I'm sure we'll focus on subsequently. Dr. Greg Hundley: How many subjects did you enroll and what were your study results? Dr. Thomas Metkus: Our COVID-19 patient population here in the Johns Hopkins Hospital included 243 patients. All of them were intubated with COVID-19, so severe disease. Of those, we reported that just over half had clinical troponin levels greater than the upper limit of normal. We assessed the main clinical factors associated with elevated troponin in that patient population, which are largely similar to other reports and they include chronic kidney disease, lactate levels of the marker of malperfusion, ferritin fibrinogen levels as markers of systemic inflammation. We showed as have others that there's a graded increase in mortality with increasing amounts of myocardial injury. Then, probably what I would found the most interesting component of the study is that when we did covariate adjustment for features of critical illness, renal failure, lactate, how severe your hypoxemia was, vasopressor use, age, and sex. Age, sex, and multi-organ dysfunction in a sense. Dr. Thomas Metkus: The association of troponin with mortality attenuated quite significantly. That's similar to what we found in a general ARDS population and consistent with a paradigm of myocardial injury in the non-cardiac critically ill. I think the final finding that we would emphasize is that after you adjust for those mediating factors, the incidence of myocardial injury in COVID-19 was at least comparable to that in the general area's population. It gives an idea to place myocardial injury in context, in my view, as a function of critical illness in most COVID-19 patients. Surely, not all. There are patients with unique syndromes, but in many or most. Dr. Greg Hundley: Well, Alan, let's turn to you. Help us put these results that Tom has described for us really in the context of what we're learning about the heart and in patients with COVID-19. Dr. Allan Jaffe: Well, let me start by saying that as a cardiologist, too, at the Mayo Clinic in Rochester, Minnesota, we've studied previously patients with acute respiratory failure. In point of fact, although most of you are not quite as old and may not remember, when we first started seeing ARDS patients, many of the same issues that are here today for COVID, came up. For example, and people may not remember this, we actually did a randomized trial of anti-platelet therapy in patients with ARDS because we were convinced that thrombosis was ubiquitous and was a frequent contributor to the illness that we saw. So that if one thinks about it in another sense and says, "If you'll correct for modern day technology that gives us some additional insights, how different really is COVID ARDS from standard ARDS." I think what this paper has substantiated is that there are lots and lots of similarities that exist. I think that's important because it keeps us from chasing around and looking for some additional issues for us to try and take care of or treat additionally. Dr. Allan Jaffe: That said, I think the way to conceptualize it is some of the troponin elevations are because patients who have chronic heart disease get COVID and they may have those elevations right at admission. There's an acute component having to do with critical illness that is nicely described in this manuscript. Then, there are those unique clinical features, whether you think it's myocarditis, I'm not sure how common myocarditis, type 2 MI, ischemia, a variety of things, and maybe a new type of myocarditis that we're finding with some very peculiar cells that we see in interstitium with or without increases in troponin. But I think it puts it into the bucket of saying, treat these patients conventionally and look for the other complications. I think that's a terribly important message that I was attracted to when I read this paper. So, thank you, Tom. Dr. Greg Hundley: Very good. Well, Tom, what do you see as the next study really to be performed in this space? I'll ask you first and then come back and gather some of Allan's thoughts. Dr. Thomas Metkus: Absolutely. I love that framing about kind of COVID in the heart, which is to say that there are some things that are direct pathogenic related to COVID and there are some things that are secondary, and then there are some things related to patients with underlying heart disease coming to care. I think the next set of studies that can help us disentangle this are related to that paradigm in that more multimodal phenotyping, biomarker phenotyping, but also echo phenotyping and MRI phenotyping, we're starting to see those come down the pike to say, here's the biomarker evidence of myocardial injury, but what does that mean, functionally? What does that mean from an imaging perspective? The second important facet for the next series of studies will be the long-term follow-up. We know from the general critical care literature, that there is indeed a powerful and important entity of the post critical illness syndrome, and in COVID that's come to be called long COVID or the long hauling. We've known that even patients with general critical illness get that and to the extent that the heart plays a role in that, it implies one needs to follow these patients prospectively. Dr. Thomas Metkus: I think the other implication of this work for the next set of studies is that there are many biases that can be brought to bear when reviewing the pandemic literature and assuredly an editorial team sees the entire spectrum of them, but they would include, as I alluded to, careful selection of patients assuring meaningful classifications of exposure at a uniform time assuring adequate comparison groups. That's really going to be the key to doing good inference. Then, the final thing I'll add is that the next set of studies should and will integrate clinical research and clinical epidemiology with causal inference principles with using what we're learning from the basic science community, to have conceptual models about how has COVID affecting the heart at the cellular level, et cetera, et cetera, et cetera. In a sense, that community of researchers that you see coming together in this pandemic is why doing this work is very rewarding and I think meaningful. I think those are all features of the next set of studies that should include indeed epidemiologic analysis, randomized trials, and basic science analysis. Dr. Greg Hundley: Allan, do you have anything to add? Dr. Allan Jaffe: Well, I want to endorse the idea that one of the problems in this field is that patients present at different times with different clinical syndromes, because some of them have been at home, some of them have been hospitalized, some of them are recognized de novo late. One of the things that's necessary as a consistent repetitive approach so that we get consistent data, not only on each COVID patient sequentially, but also on the control group that is important. The other point I'll emphasize that Tom mentioned is that individuals who have elevated troponins who are critically ill with ARDS and most likely with COVID as well, have some sort of underlying cardiovascular disease. Often once those patients leave the hospital there, the troponin is out of sight and out of mind. COVID is reminding us by showing us the panoply of additional clinical syndromes that exist post-hospitalization. That as with ARDS, I would argue, that's a mistake. These patients need to have follow-up with cardiology to investigate what that underlying cardiovascular component is. Dr. Greg Hundley: Great. Well listeners, we want to thank Dr. Tom Metkus from Johns Hopkins om Johns Hopkins and Dr. Allan Jaffe from the Mayo Clinic in Rochester, Minnesota for bringing us this study regarding intubated patients with COVID-19, indicating that the myocardial injury shares many similarities to that experienced by patients with ARDS. Now listeners, we will turn to our second feature discussion on this February 9th. Dr. Greg Hundley: Well, listeners, welcome to our second feature discussion today. We have with us, Dr. Naveed Sattar from Glasgow, Scotland, and our guest editor, Dr. Ileana Pina from Detroit Medical Center. Welcome to you both. Naveed, we'll start with you. Could you describe some of the background that helped you formulate this study and what hypothesis did you want to address? Dr. Naveed Sattar: Yeah, thanks Greg. When I was watching the empirical outcomes study, I almost fell off my seat when I saw the results in heart failure, hospitalization. I actually, I sent a text to John McMurray who wasn't actually at the meeting and I sit next door to John McMurray who's obviously preeminent heart failure. I worked also with many of the fantastic heart failure colleagues, Mark Pietri, Cardic Joon and colleagues. At that time I felt, well, actually it wouldn't it be lovely, I was aware of MRI studies they've done on other drugs in heart failure and I thought, well, if this drug effects improves heart failure, well potentially, although we didn't have it amply reduced at the time or have heart failure, they've come subsequently. Perhaps it changes, lead to cardiac remodeling. Dr. Naveed Sattar: So we've designed the randomized placebo control trial of empirical fluorescent versus placebo and 105 patients who had heart failure with ejection fraction below 40%. We wanted big 4th ventricles as Professor McBuddy would tell me, we have lots of debates about these things to really give us adequate power follow-up for at least 36 weeks to see if we can see improvements in left ventricular installment volume or global longitudinal strain, which were our primary outcomes. Dr. Greg Hundley: Very nice. Great overview of the study design. Who did you enroll? I know patients with an ejection fraction less than 40%, but equal numbers of men and women, was this ischemic heart disease? Dr. Naveed Sattar: I think the majority of patients were male about two-thirds average age, 68, pretty much like the empirical reduced to that by half population. About 80% here had type two diabetes, about 20% had pre-diabetes. The other characteristics, the majority had class 2, NYHA Class IV heart failure, minority Class III. About a third were already on arnes. Also, the background theoretically was fantastically well. Dr. Naveed Sattar: The other critical thing we really did, we excluded people with atrial fibrillation because that really affects the quality of the MRI. Our group and it's a brilliant journey to be, I'm not a heart failure expert, but working with all these colleagues, they have brilliant experience in this. They know the mistakes to avoid, and one of them is, do not include people with atrial fibrillation because your MRIs will just not be readily interpretable. Also, it needs to be big enough. It needs to have big enough volumes to begin with to be able to see a change. It needs to be long enough to potentially see the remodeling. All that experience of John, Mark and Pandeep were put together in a really tight protocol. When the results came, I almost, again, fell off my seat because well, it worked. I guess, you're going to ask me about the results and what we find. Dr. Greg Hundley: Absolutely. Tell us about those results. We're waiting to hear. Dr. Naveed Sattar: Two primary outcomes were really what we saw was a reduction in the left ventricular and systolic volume index and by six mils per meter squared, and the diastolic volume index by 8.2 mils per meter squared. We didn't see a change in global longitudinal strain. We did not see changes in KCCQ or six minute walk test, but actually the reality is we now know the size of this chart is underpowered to see changes in six minute walk tests or KCCQ, in lieu of another trial that has some changes in that, but we didn't see them and I think our study was done ... I can tell you, Greg, the amount of work that went in this study, the quality control that people should look at the supplement when it comes out, the degree of attention to imaging protocols and quality control was, I think in my experience, unparalleled. Dr. Naveed Sattar: The team really pulled out all the stops to get this, but so the reductions in the volumes, that's probably the key thing. We think that this may reflect the reverse cardiac remodeling and that we think then fits in what you see with other drugs that benefit patients with heart failure. Because the bigger the volumes, the more people tend to die with heart failure or get readmitted. If you shrink the ventricles, that probably their contractility improves. What the actual mechanism is, I don't know, but I'm sure Ileana probably come in there in terms of discussing potential pathways. The final thing I should say is just for the internal validity or external validity, NT-proBNP did come down, suggesting less left ventricle wall stress. Schematic also went up. All the things that we've seen in the big trials was there so I think we've done a really strong, robust trial. Dr. Greg Hundley: Thank you, Naveed. Well, Ileana, as a guest editor, what attracted you to this paper? Then, how do you put the results from this study in the context with some of the other publications related to SGLT 2 inhibition in patients with heart failure? Dr. Ileana Piña: I think all of you know, that we, the heart failure community is pretty excited about these drugs and what they're doing. I also nearly fell off my chair when I saw the first EMPA-REG and I saw those curves splitting. Then, I further did that when the DAPA data came out and you see these curves split up almost immediately. What was attractive about this paper is that we really don't know how this happens. We think we do, but we really don't. We don't think necessarily that it's the glucose excretion, because that maybe happens in diabetics, but not necessarily in the non-diabetics. Yet the drugs seem to work in both. But remodeling is such a fascinating concept. I personally happen to love the concept of reverse remodeling. It's something that we in the heart failure community really believes that if we can reversely remodel the ventricle, then outcomes will get better. Dr. Ileana Piña: We really link them. Your proBNPs were elevated but not huge. This wasn't a very sick debilitated population. This was primarily Class II. Pretty well-medicated in background, you didn't necessarily give the doses clearly, but pretty well with percentages of RAS inhibition and everything else. Now you see that the volumes are coming down and you say, "Wow, is that what's it doing?" If it happens that quickly, because remember, we've got to explain why the curves of heart failure, hospitalizations split up almost immediately. You did show in your time of follow-up that these changes occurred during that follow-up. I am actually not at all surprised that you didn't see anything in the KCCQ because we know that first of all, the patients weren't that sick to start with so it's hard to see improvement when you don't have a lot of sickness and a six- minute walk. This group, for a six-minute walk, is going to have a very wide standard deviation. A six-minute walk doesn't really distinguish the people who are doing well. To me, it's more for the sicker. Dr. Ileana Piña: The fact that neither of these things change doesn't bother me at all. But I think that the next step before Greg asked me, is what's the outcome. In other words, can you tie that reverse remodeling directly to an outcome, be it mortality, which is getting argued out there, whether all the drugs are the same? Or just even the heart failure hospitalization, which I think is a very important outcome in this population. You did it well, you did it carefully, you can tell the data's very clean. You did do a little bit better with the women, so I can't scold you for that as I usually do, because you've had about 30 some percent women, which is very similar to what the big EMPEROR trial has had. I'm always fighting to get more women in the trial. Dr. Ileana Piña: At some point you may want to examine the reverse remodeling by gender, by sex, actually and see, even though you have a small number, you have 105 patients, you may not have enough data. But I think in the future, because we do believe that women remodel differently and reversely remodeled differently. That would be very interesting to see if there's any differences. Dr. Greg Hundley: Thank you, Ileana. Naveed, do you have anything to add? Ileana's really laid out on a nice course to follow forward. Do you have anything to add to her comments? Dr. Naveed Sattar: No, I completely agree with all of them. I think the key thing is nice that this came out straight after EMEPEROR-reduced and a year after that, for heart failure with the team that, John and colleagues were led out. I was involved in the EMPEROR-reduced so that the mechanism helps. I think clinicians buy into this concept. It does what they think drugs do to improve heart failure outcomes. I think that helps and it might help prescribing, get people the confidence that these drugs do work in a mechanism that works. Dr. Naveed Sattar: The only thing that I think we would love to have done is if doing the MRIs even sooner, how quickly do these actual volumes change? We think it's reverse remodeling, but maybe we need another trial doing MRIs at one month, three months just to see how quickly these volumes do actually change. Because I still think that's a bit of doubt. But having said all that, I've loved this journey working with my fantastic Hatfield colleagues, a brilliant team in Glasgow. We're now thinking about the next trial. Let's see where we get to in terms of algorithms and trials, but the diabetes, heart failure, kidney disease fraternity coming together is fantastic. I'd loved being part of that journey. So great. Dr. Ileana Piña: There's another interesting observation in your data was a hematocrit. It's really tiny, but the signal is there, which to me has also been fascinating. We see a lot of anemia in this population. A benefit in the hematocrit, I think, is really important. The fact that you did this with MRI, I don't think this is a good echo study, to do this with echo. I think you need the reliability and the precision of an MRI. Dr. Naveed Sattar: Yeah, I agree. We have other data coming up, Ileana, in terms of renal blood flow, because you've mentioned that as well at the same time, which we haven't yet analyzed. There's a lot more data which needs a good Biobank and pick some of these mechanisms. So, yeah, fantastic. Dr. Greg Hundley: Well listeners, this has been an excellent discussion and we want to thank Dr. Naveed Sattar from Glasgow and our guest editor, Dr. Ileana Pina from Detroit Medical Center, bringing us these results regarding the administration of empagliflozin and favorable changes in left ventricular volumes in patients with heart failure and a reduced ejection fraction. Dr. Greg Hundley: Well, on behalf of Carolyn and myself, we want to wish you a great week and we will catch you next week on the run. This program is copyright of the American Heart Association, 2021.
SGLT2-Hemmer sind nicht mehr ganz die "New kids from the block" - aber dennoch kommen immer mehr Daten zu dieser spannenden Substanzgruppe heraus. In dieser INFOsion widmen wir uns zwei Studien zu Dapagliflozin - DAPA-HF sowie DAPA-CKD.
[Recorded on 31 October 2020] Damo gives his reflection about his most recent periodic evaluation. Can children safely “Halloween” during COVID? The Goats debate the topic. Damon and Damo both reflect on their experiences with submitting officer packages. Damo takes a stand against restaurant that act “stingy” with Veterans Day sales. Is staying in for shore duty really worth it? The guys discuss programs that the military offers that they personally were able to take advantage of. Main topics: The past, present, and future and the mark they believe the next generation will leave the Navy with. Damon talks about his issues with the CMEO and DAPA positions on ships and much more… Links and more information: Matthew Burns (STA-21): https://www.navy.mil/Press-Office/News-Stories/Article/2392653/a-seaman-to-admiral-story/ Seaman to Admiral-21 Program: https://www.netc.navy.mil/Commands/Naval-Service-Training-Command/STA-21/ LDO Program: https://www.public.navy.mil/bupers-npc/officer/communitymanagers/active/ldo_cwo/Pages/applicantinformation.aspx Thrift Savings Plan: https://www.tsp.gov/ USMAP Homepage: https://usmap.netc.navy.mil/ VA Loans: https://www.benefits.va.gov/homeloans/ Tuition Assistance: https://www.military.com/education/money-for-school/tuition-assistance-ta-program-overview.html GI Bill: https://www.benefits.va.gov/gibill/ Damon's Book of the Week: A Country Boy to City Boy (Written by James Cooley) https://www.amazon.com/Country-Boy-City-Journey-that/dp/163393909X#:~:text=COUNTRY%20BOY%2C%20CITY%20BOY%20is,feast%20no%20one%20should%20miss! Damo's Book of the Week: Extreme Ownership (Written by Jocko Willink & Leif Babin) https://www.amazon.com/Extreme-Ownership-U-S-Navy-SEALs/dp/1250067057 Movie Reviewed: Crimson Tide Intro Music Produced by: Lim0 Logo Artwork/Design by: Natashya Vince
Marin Medak je vodeći hrvatski poduzetnik, osnivač Rougemarina i predsjednik Udruge ugostitelja. Za Netokracija Podcast iskreno govori o budućnosti ugostiteljstva u Hrvatskoj, ističući kako rade na integraciji Remarisovog 'kitchen management' softvera s internetskom trgovinom, kao i nezavisnoj polatformi za dostavu sa SPAN-om. Tvrdi kako je na žalost od svih velikih uslužnih industrija ugostiteljstvo najmanje digitalizirano, ali da sad restorani nemaju izbora. Dapače, nakon ove situacije će jako puno radnika odustati od ugostiteljstva i restorani će morati uvesti npr. kioske za naručivanje, jer neće imati koga zaposliti za to! ► Kako je zapravo ugostiteljskoj industriji? ► Ugostiteljstvo je najmanje digitalizirano ► Neće biti radnika u ugostiteljstvu ► Doba ekrana mijenja sve ► Velike tvrtke zamijenit će male restorane? ► Platforme za dostave imaju prevelike provizije ► Nezavisna platforma za dostave ► Koncept "meal kitova" kroz Rougemarin Doma __________ PRIMAJTE NETOKRACIJA NEWSLETTER Besplatno u vašem inboxu ► https://netokracija.com/newsletter DOJAVITE VIJEST Imate prijedlog ili želite dojaviti vijest ► info@netokracija.com PRATITE NETOKRACIJU NA DRUŠTVENIM MREŽAMA Pratite nas na Twitteru ► http://twitter.com/netokracija Pratite nas na Instagramu ► http://instagram.com/netokracija Lajkajte nas na Facebooku ► http://www.fb.com/netokracija PRATITE SVOJE NETOKRATE Ivan Brezak Brkan (IBB) https://www.instagram.com/ivanbrezakbrkan https://linkedin.com/in/ivanbrezakbrkan Mia Biberović http://www.twitter.com/cyberkoza https://www.instagram.com/cyberkoza https://www.linkedin.com/in/miabiberovic/
A Discovery megérkezik a Csillagflotta rejtett főhadiszállásához, a parancsnokságot birtokló Vance admirális azonban még nem áll készen arra, hogy bizalmat adjon Saru legénységének. Egy váratlan döntés értelmében megkezdődik a Discovery csapatának feloszlatása, Burnham azonban egy merész küldetéssel próbálja bebizonyítani, hogy a Csillagflotta úgy veszi a legnagyobb hasznát a legénységnek, ha együtt maradnak. Aktuális adásunk témája a Star Trek: Discovery ’Die Trying’ című epizódja. 0:00:36 | Rövid hírszekció: • 0:00:36 | Az Orville harmadik évadának forgatása december első hetében folytatódhat, a munkálatok még tavasszal álltak le. - https://trekmovie.com/2020/11/09/exclusive-the-orville-season-3-is-returning-to-production-in-december/ • 0:04:02 | Brentwood: Brent Spiner és Levar Burton egy vicces musical rövidfilmben szerepelnek. - https://trekmovie.com/2020/11/11/watch-brent-spiner-battles-levar-burton-in-musical-comedy-short-brentwood/ • 0:08:06 | Vulkáni tisztelgést ábrázoló emlékmű készülhet Bostonban Leonard Nimoy tiszteletére, aki sosem felejtette el helyi gyökereit. - https://trekmovie.com/2020/11/11/proposed-boston-memorial-would-honor-leonard-nimoy-with-vulcan-salute/ 0:12:54 | A kibeszélő tartalmából: • Végre a csillaghajók és az egyenruhák is előkerülnek: így láttuk a 32. századi látványt, valamint az új technológiákat. • Vance admirális és a kezdeti bizalomhiány: a váratlanul előkerült Discovery a megfogyatkozott Föderáció szemszögéből. • David Cronenberg meglepő beugrása és furcsa beszélgetése Georgiouval: vajon hova vezet a rejtélyes történetszál? • Barzan kultúra és Nahn karaktere: epizodikus minirejtély a történetben, hatékony csapatmunka a Discovery fedélzetén. • Kinek mit jelent a Föderáció? 0:45:29 | Összefoglalás, értékelés
John Yoo, the Emanual S. Heller Professor of Law at the University of California Berkeley School of Law, has written what he terms a surprising defense of the actions of Donald Trump as president. In his new book Defender in Chief: Donald Trump's Fight for Presidential Power (All Points Book, 2020), Yoo, who did not support Trump in 2016, argues that Trump has performed in a manner that the Constitution's Framers would applaud. Trump has defended the constitutional functions of the Executive from congressional interference or encroachment, including in his use of the appointment power to the federal judiciary and his role as commander-in-chief of the military. He also defends President Trump's actions regarding the statutory powers used to designate and fund a wall along the U.S. southern border, the administration's efforts to reverse Obama's immigration orders, popularly known as DACA and DAPA, and Trump's exercising of the removal power for Executive branch officials. However, this work is more than a defense of Trump; it is a historical inquiry into the powers of the Executive as intended by the Founders and how that power has been used and threatened by other branches over the course of American history. Ian J. Drake is an Associate Professor of Political Science and Law at Montclair State University. His scholarly interests include American legal and constitutional history and political theory. Learn more about your ad choices. Visit megaphone.fm/adchoices
0:08 – Mondays with Mitch – Mitch Jeserich is the host of Letters and Politics, weekdays at 10AM. Up for discussion this week: the GOP-controlled Senate and Democrat-controlled House are moving on substantially different police reform measures this week. Plus, we talk about disclosures from John Bolton's book and the Trump administration's fumbled attempts to fire Geoffrey Berman, the U.S. Attorney for the Southern District of New York. 0:34 – The Supreme Court ruled 5-4 last week that the Trump administration violated the Administrative Procedure Act when it tried to rescind Deferred Action for Childhood Arrivals, the immigration policy known as DACA. What happens now to current and previous DACA recipients? Could a future president revive the policy DAPA, which would protect parents of U.S. citizen children from deportation? We talk with two guests: Hiroshi Motomura is a professor of law at UCLA, where he teaches immigration and citizenship. His books include “Immigration Outside the Law.” Aidin Castillo is directing attorney of immigrants' rights at Centro Legal de la Raza. Castillo says potential DACA recipients unsure of their status or rights to apply should get in touch with organizations like hers. 1:08 – Assemblymember Rob Bonta, who represents District 18 encompassing Oakland, Alameda and San Leandro, is introducing legislation that would classify discriminatory 911 calls as hate crimes. It's in response to incidents like Amy Cooper calling police on a Black bird-watcher in New York City: a racially-motivated phone call making a false emergency report. 1:18 – What happened the last time white nationalists tried to come to Oakland? Tur Ha Ak joins us to talk about the need for organizing against racists — he is the founder of Community Ready Corps (CRC), a liberation organization that combats white supremacy and actively builds and supports self-determination. White allies can get involved with Community Ready Corps Allies and Accomplices, a companion organization. 1:34 – The Supreme Court is releasing decisions throughout the month. We check in with Marjorie Cohn, professor emerita at Thomas Jefferson School of Law and former president of the National Lawyers Guild. Listeners can read Cohn's articles here. 1:49 – Seattle's police union, SPOG, was successfully booted from the King County Labor Council in a vote last Wednesday, after weeks of organizing by workers in other unions to hold them accountable for racism and brutality against the community. We talk to Jane Hopkins, a registered nurse and executive vice president of SEIU 1199 Healthcare Northwest, and Isaura Jiménez Guerra, public school teacher and union member in the Highline Public School system south of Seattle. Photo by Jonathan McIntosh of 2006 May Day march in Los Angeles, CA. The post Supreme Court protects DACA—for now; Oakland responds to suspected white nationalist killing of a Black worker; and Seattle teachers and healthcare workers successfully boot a police union from their labor council appeared first on KPFA.
Independent investigative journalism, broadcasting, trouble-making and muckraking with Brad Friedman of BradBlog.com
In this episode we hear from Victoria Aguilar and the Denver Immigrant and Refugee Commission as we discussed DAPA and DACA. We also talked about the power of story telling in bringing changes in our communities. We hope you enjoy this episode! --- Support this podcast: https://anchor.fm/voiceofmontbello/support
Independent investigative journalism, broadcasting, trouble-making and muckraking with Brad Friedman of BradBlog.com
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