Podcasts about efs

Det är dags för ett nytt teologiskt forum tillsammans med Johannelundteologerna Tomas Nygren och Stefan Lindholm. Vi fortsätter samtalet om ungdomar, radikalisering och sanningsbegreppet – vad är objektiv och subjektiv sanning när det kommer till den kristna läran och bekännelsen? Vilka livslögner har vår generation köpt och gjort till sanningar och hur avslöjar man dem? Hur skapar vi sammanhang med både rymlighet och tydlighet?   

Since the MacLeod report was first published in 2009, Engage for Success (EFS) has become a flourishing all-volunteer collective for those passionate about colleague engagement. A senior lecturer at Nottingham Business School, Dr. Sarah Pass is a practice-oriented academic who concentrates on employee experience and engagement. As a member of the Engage for Success (EFS) Advisory Board, she co-leads the EFS annual survey, which benchmarks the engagement levels of the UK working population. In this episode, Sarah and Jen discuss the findings of the latest EFS survey, explore the four enablers of engagement and dig into why colleague voice is so important when seeking to build motivation and goodwill at work.   About Dr Sarah Pass Dr Sarah Pass is a practice-oriented academic who concentrates on employee experience and engagement. She is a member of the Engage for Success (EFS) Advisory Board and co-leads the EFS annual survey, which benchmarks the engagement levels of the UK working population. Sarah leads EFS projects focusing on different aspects and influences of engagement in practice and is also Chair of the EFS East Midlands Area Network. Sarah is a Fellow of the RSA, an Academic Associate of the CIPD, and a member of the Involvement and Participation Association (IPA) Working Insights Group. In 2023, Sarah was ranked by HR Magazine as an Influential Thinker in HR. Sarah currently works as a Senior Lecturer at Nottingham Business School (NTU).   Find Sarah on LinkedIn:  https://www.linkedin.com/in/sarahpass/ Sarah at Nottingham Business School: https://www.ntu.ac.uk/staff-profiles/business/sarah-pass Engage for Success: https://engageforsuccess.org/

När EFS 1861 tog ett beslut om att sända missionärer för tjänst bland "hednafolken" så var drivkraften förankrad i missionsbefallningen. Jesu egna sändningsord - gå ut i hela världen.... Lange var en av tre som 1866 landsteg i Massawa i nuvarande Eritrea.

När EFS 1861 tog ett beslut om att sända missionärer för tjänst bland "hednafolken" så var drivkraften förankrad i missionsbefallningen. Jesu egna sändningsord - gå ut i hela världen.... Lange var en av tre som 1866 landsteg i Massawa i nuvarande Eritrea.

Efter en ofrivillig paus är vi tillbaka och tar tag i vårens stora snackis! Helena Cashin, EFS kommunikationschef och Budbärarens chefredaktör är tillbaka och samtalar med Magnus om ungdomar som flockas till kyrkan och kyrkans ibland oförberedda eller ängsliga mottagande. Debatten pågår som bäst och har uppmärksammats långt utanför kyrkans egna forum. Samtalet är viktigt och här finns flera viktiga perspektiv att ta hänsyn till. Kanske framförallt att en föräldralös kyrka förmodligen alltid kommer förbli barnlös. 

At the 2025 American Urological Association (AUA 2025) Meeting in Las Vegas, UROONCO BCa chief editor Dr. Benjamin Pradere (FR) talked to Dr. Neal Shore (US) about the CREST study results: Sasanlimab in combination with bacillus calmette-guérin (BCG) improves event-free survival (EFS) versus bacillus calmette-guérin as standard of care in high-risk non- muscle-invasive bladder cancer (NMIBC). Dr. Shore explains the study rational, the results of the study, and the take home messages he presented during the meeting.

På mandag stilte Daniel spørsmålet: «Hva er roten til fangenskapet vi erfarer i våre liv – og finnes det håp for meg?». Vi så på følgende overskrifter: -       Vårt fangenskap (Joh 8:34): Den dypeste roten til vårt fangenskap på ulike områder av livet, er hva Skriften kaller synd.-       Våre fiender (Matt 4:1-11; Joh 8:44; Efs 4:26f; 1. Joh 2:15f): Gjennom Jesu fristelser og den kristne tradisjon, ser vi at synden primært angriper oss gjennom tre fiender: djevelen, kjødet og verden. Djevelen plager oss med løgner, som spiller på forvrengte lidenskaper i oss, som igjen finner veien inn i verden og kulturen rundt oss – sammen danner dette en ond og selvforsterkende sirkel. -       Vår frelser (Hebr. 9:26; Kol. 2:15): Den kristne fortelling ender ikke i sorg, men i seier! Ved Jesu død og oppstandelse, så blir Han vår stedfortreder og seierherre! Kampen mot våre tre «sjels fiender» er virkelige, men den fantastiske sannheten er at den kristne kjemper fra frihet og ikke for frihet – siden Jesus har vunnet seier! Evangeliets frihet er det dypeste svaret til ethvert fangenskap i våre liv. Denne frihet erfarer vi ved: -       Å ta imot evangeliet (høre)-       Tro evangeliet-       Trå ut i evangeliet Du er skapt til et liv i frihet og Jesus er vår seier!____Hovedtekst: Se prekenoppsummering.____1.     Gå gjennom de ulike overskriftene: Les tekstene og snakk om hvordan de ulike områdene treffer våre liv.  2.     Hvilke områder i ditt liv trenger du at Jesus «bryter lenken» som holder deg fast? 3.     Avslutt med å be for hverandre inn i de områdene!

Send us a textYou've done the ultrasounds, the shots, the bloodwork — and then retrieval day comes, and... nothing. Zero eggs. What just happened?In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols dives into one of the most confusing and emotionally crushing outcomes in IVF: Empty Follicle Syndrome (EFS). But before you panic, know this — most cases aren't what they seem.We'll break down:The difference between true vs. false EFSWhy true EFS is rarer than a unicorn eating tacosHow trigger shot timing and hormone levels can lead to confusionWhat doctors actually mean when they say “empty follicle”Real strategies for preventing and managing this situationWhether you've heard the term before or are just trying to understand your IVF journey better, this episode will give you clarity, peace of mind, and as always — a side of science and salsa.Thanks for tuning in to another episode of 'Taco Bout Fertility Tuesday' with Dr. Mark Amols. If you found this episode insightful, please share it with friends and family who might benefit from our discussion. Remember, your feedback is invaluable to us – leave us a review on Apple Podcasts, Spotify, or your preferred listening platform. Stay connected with us for updates and fertility tips – follow us on Facebook. For more resources and information, visit our website at www.NewDirectionFertility.com. Have a question or a topic you'd like us to cover? We'd love to hear from you! Reach out to us at TBFT@NewDirectionFertility.com. Join us next Tuesday for more discussions on fertility, where we blend medical expertise with a touch of humor to make complex topics accessible and engaging. Until then, keep the conversation going and remember: understanding your fertility is a journey we're on together.

Det är återigen dags för teologisk verkstad och idag samtalar Tomas, Stefan och Magnus om begreppsparet lag och evangelium. Martin Luther behandlade frågan ingående och det är ett av hans viktiga bidrag. Luther menade: »Skillnaden mellan lag och evangelium är den kristna trons främsta kännetecken. Alla som räknar sig som kristna bör känna till och kunna redogöra för denna skillnad. Annars kommer man blanda ihop dem och inte att känna till och bevara någondera, varken det ena eller det andra.« Hur kan vi förstå och kommunicera lag och evangelium i vår tid och vilken tröst kan det skänka eller vilka potentiella problem kan det skapa? 

In this episode of the InfosecTrain podcast, we explore AWS Cloud Storage Services, their key features, and how businesses can leverage them for scalability, security, and cost efficiency.

Pastor Simon Holst från Bet:L i Skövde gästar dagens avsnitt och med utgångspunkt i hans senaste text i Tidningen Dagen samtalar han med Magnus om missiologi för vår tid. En negativ värld behöver inte vara något negativt för kyrkan, utan kan bli tvärtom bli till en guldålder för de kyrkor som vågar stå för och predika ett frimodigt evangelium, lyder Simons spaning. Utifrån tre tids epoker som i texten kallas för positiv värld, neutral värld och negativ värld diskuterar Magnus och Simon hur kyrkan kan finna ett lämpligt och gångbart föredöme i profeten Daniel som verkade i Babylon.  

Magnus gör ett kärt återseende med Aminah Fallgren och lyssnar till hennes fantastiska berättelse! För drygt 20 år sedan dök Aminah upp i kyrkan där Magnus var pastor. Då som en drogmissbrukare sedan 12-års ålder som hade alla sina ägodelar i en väska. Idag har hon varit drogfri i 20 år, blivit beroendeterapeut, är VD och driver egen framgångsrik behandlingsverksamhet som hjälpt åtskilliga. Förutom Aminahs egen inspirerande berättelse om befrielse, tillfrisknande och nya möjligheter, så samtalar Magnus och Aminah om den kamp som alla människor utkämpar med skam, sökande efter bekräftelse, kärlek och frihet. Missa inte ett ärligt och härligt samtal som berör! 

Det är åter dags för ett teologiskt forum med Johannelunds teologerna Tomas Nygren och Stefan Lindholm. I dagens avsnitt samtalas det om nattvarden. Det något högst påtagligt och verkligt som sker i nattvarden och inte bara symboliskt. Därför kallas sakramenten nådemedel – kanaler genom vilka Gud sänker sin nåd och åstadkommer vad han lovar. Kan man därför säga att nattvarden skapar den verklighet den gestaltar? Häng med i dagens samtal! 

Emission Factors (EFs), as we know them, are over. Bold statement? Maybe. True? Absolutely (in our opinion). In this episode, we break down why traditional emission factors are rapidly being replaced by Product Carbon Footprints (PCFs) and what this shift means for businesses.The limitations of traditional emission factorsWhy PCFs provide more accurate, supplier-specific dataWhere businesses need to focus their efforts as PCFs scale upKey considerations when transitioning from EFs to PCFs

EFS kommunikationschef och Budbärarens chefredaktör, Helena Cashin, är tillbaka i podden för en ny runda spaningar tillsammans med Magnus. Dagens avsnitt är fullspäckat och matnyttigt, det spänner över frågorna om kyrkan och gemenskapen såväl som kyrkan och gudsbilder. Har vi skapat en gudsbild som är en projektion av oss själva och våra egna trauman eller önskningar? Vi är hyfsat bra på gudstjänst men vad händer med gemenskapen? Vad innebär det att forma kristna gemenskaper?  

Podden gästas idag av Samuel Björling, musikinspiratör vid EFS Sverigeavdelning. Magnus och Samuel samtalar om kyrkans sång och musik, lovsång och förkunnande sång framförd av solist, nytt såväl som gammalt. Samuel är ansvarig för senaste musiksläppet på Cantio: en EP med namnet ”Hela vägen går han med mig” och konferensen med samma namn. Magnus och Samuel berättar också om de ”helkyrkliga inspirationsdagar” de erbjuder församlingar samt den helkyrkliga mässan som fler och fler visar intresse av. 

Litteraturvetaren och litteraturredaktören på Svenska Dagbladet, Josefin de Gregorio, gästar podden igen för att göra om sin bejublade medverkan förra året. Josefin presenterar en »inne- & utelista« för 2025 utifrån kristenheten. Magnus och Josefin samtalar utifrån listan om många spännande ämnen som kontemplation, framgångsteologi, kristna som bråkar på internet, avgudadyrkan, väckelse och barnens närvaro i kyrkan. Här finns mycket spännande!

Ängelholm Pingstförsamlings pastor Sven Wiborn predikar över Joh 11:21-27 i EFS-kyrkan som avslutning på den ekumeniska böneveckan. Samverkar i gudstjänsten gör även Ängelholms församling, Rönnekyrkan och ELM Ängelholm.

Ängelholm Pingstförsamlings pastor Sven Wiborn predikar över Joh 11:21-27 i EFS-kyrkan som avslutning på den ekumeniska böneveckan. Samverkar i gudstjänsten gör även Ängelholms församling, Rönnekyrkan och ELM Ängelholm.

durée : 00:05:54 - L'invité de la rédaction de "ici Sud Lorraine" - La collecte du plasma est la priorité de l'établissement français du sang (EFS) en 2025. Pour mobiliser les Français, Fréderic Pacoud, le président de l'EFS est en visite ce vendredi à Remiremont (Vosges), où il rencontre donneurs et élus locaux. Il a pris le temps de répondre à nos questions.

Det är dags för en ny omgång teologiprat med Johannelund teologerna Tomas Nygren och Stefan Lindholm. I dagens avsnitt avhandlas dopet som sakrament och vad det förmedlar från Gud och hur det förhåller sig till tron. Räcker dopet eller vilken roll spelar tron? Ska man bygga sitt dop på sin tro eller sin tro på sitt dop - vad Gud har skänkt och gjort i dopet oberoende av med min egen medverkan? Hur kan vi berikas från olika teologiska perspektiv - kan lutheraner lära sig något av baptister och tvärtom? 

Ida-Maria Brengesjö är evangelist och församlings-utvecklare inom Equmeniakyrkan och aktuell med boken »När taket måste brytas upp«. Idag gästar hon podden och samtalar med Magnus om frågor kring kyrkans rymlighet och öppenhet – leder det till flummighet eller går det att kombinera tydlighet med generös rymlighet? 

I söndags var kyrkoårets tema »Jesu dop« och det följer vi upp med att tala om just dopet. Martin Luther skriver att ”det är uppenbart att dopet inge handlar om något som vi människor gör, utan om en skatt som Gud skänker och som vi tar emot genom att tro.« Magnus samtalar med Simon Sjögren från Verbum om deras nya satsningar »Dopkraft« och »Dopglöd« för strategiskt arbete med att stärka dopets innehåll, plats och roll i församlingslivet. 

Torbjörn Freij är sedan länge en profil inom kristenheten i Sverige. Baptistpastor, ledarskribent på Tidningen Dagen, författare till flera böcker och ledargestalt inom såväl ekumenisk förnyelse som Vineyard. Idag är Torbjörn intensivt engagerad i Celebrate Recovery, en kristen variant på 12-stegsprogram men inte bara för traditionella substansmissbrukare utan även för oss alla »normalstörda och vanliga människor«. Här skapas en plats och ett program där man även får bearbeta störningar, söndrighet, sår, ovanor och laster. Vad kan den traditionella kyrkan lära sig av Vineyard och 12-stegsrörelsen? 

Re:formera podden önskar Gott Nytt år!! Helena Cashin är tillbaka i studion ovh gör tillsammans med Magnus spaningar om vad det nya året kan innebära och innehålla utifrån ett kyrkligt perspektiv. Önskningar och förhoppningar blandas med observationer och spaningar. 

Gud som människa, när Ordet blev kött och tog sin boning ibland oss, inkarnationens helt unika mysterium har kristna teologer varit upptagna av genom hela kyrkans historia. Tillsammans med teologerna Tomas Nygren och Stefan Lindholm från Johannelunds teologiska högskola tar Magnus tillfället och dyker ner i julens stora mirakel. 

Re:formera podden önskar God Jul tillsammans med Daniel Röjås som är aktuell boken »Mer än tomtar och glögg«. Magnus och Daniel samtalar om alltifrån varma julminnen, traditioner, julbords favoriter till julevangeliets ljusa hälsning och goda nyheter. Som julgransljus mitt i mörka december och julklappar under granen bär evangeliet bud om en stor glädje till alla människor. Sätt dig ner och julmys tillsammans med oss. 

Executive functions are the skills that allow us to plan for and meet goals, manage time effectively, remember what we've heard and read, and exercise self-control. Peg Dawson, Ed.D., shares strategies you can use to improve your EFs and cement habits. Executive Functioning in Adults: More Resources Self-Test: Do You Have a Working Memory Deficit? Read: 7 Executive Function Deficits Tied to ADHD Read: How Adults with ADHD Think eBook: The Adult's Guide to Stronger Executive Functions Access the video and slides for podcast episode #531 here: https://www.additudemag.com/webinar/executive-functioning-adults-adhd-strategies/ Thank you for listening to ADDitude's ADHD Experts podcast. Please consider subscribing to the magazine (additu.de/subscribe) to support our mission of providing ADHD education and support.

Amber Noel växte upp som pingstpastorns dotter men är idag koordinator för events och partner programmen som The Living Church arrangerar för förnyelse inom den Episkopala kyrkan i USA. Amber och Magnus samtalar om likheterna i deras respektive teologiska och kyrkliga vägar, men även likheterna mellan kyrkorna de idag tjänar. Utmaningar och möjligheter, och vad innebär det att bygga »ekumeniska relationer« och bedriva »ekumeniska samtal« inom sitt eget kyrkosamfund? 

Teologen och författaren Patrik Hagman är aktuell med nya boken »Riket inom räckhåll : Jesus enligt Lukas«. I dagens avsnitt stannar vi upp vid vad Patrik kallar för »Festens evangelium«. Lukas skildring av Jesus innehåller en mängd fester där olika grupperingar, inte sällan de i något slags utanförskap, inbjuds till samvaro kring måltiden. Festen framstår som en tydlig bild på Guds rike. Patrik delar sina tankar om framtidens kyrka som har återtagit festen och som mer och mer lär sig innebörden av vad det innebär att »fira gudstjänst«. 

Själens slagfältEtt personligt och närgånget samtal med Magnus Persson, präst och inspiratör i EFS. Om sjukdom, kamp och ovisshet. Vi delar personliga erfarenheter och jag fångar upp Magnus starka beskrivning om själens slagfält när en plötslig sjukdom gör att styrka blir svaghet. I samarbete med Magnus podcast: Re:formera.

Guest: Anais Nebel: Group Culture and Communications Manager, Lipsy Anaïs is a culture leader and brand strategy expert, passionate about people empowerment. She leads culture and communications for Lipsy, a fashion and beauty group made up of 7 brands including Victoria's Secret UK and Gap UK. Anaïs is known for creating out-of-the box engagement campaigns that create vibrant connections and bring the soul of a company to life. This special episode was recorded following Jo and Anais interview on stage at the 2024 Employee Engagement Summit at the Brewery in London and is hosted by Jo Moffatt, Engage for Success Advisory Board member and regular EFS radio show host. Engage for Success are media partners for Engage Business Media's industry-leading events, including the Future of Work Conference and the Employee Engagement Summit. • The key drivers that led to Lipsy London taking action to add self-empowerment to their wellbeing strategy • Why Lipsy London decided to run a photoshoot initiative • Any challenges in getting employee buy-in • Highlighting the key results that have been seen following the photoshoot • What's next for self-empowerment at Lipsy? • The achievements and impact that create the most pride Join us as we discuss how Lipsy London's recent wellbeing initiative empowered employees through self-confidence. Host: Jo Moffatt

Guest: Anais Nebel: Group Culture and Communications Manager, Lipsy Anaïs is a culture leader and brand strategy expert, passionate about people empowerment. She leads culture and communications for Lipsy, a fashion and beauty group made up of 7 brands including Victoria's Secret UK and Gap UK. Anaïs is known for creating out-of-the box engagement campaigns that create vibrant connections and bring the soul of a company to life. This special episode was recorded following Jo and Anais interview on stage at the 2024 Employee Engagement Summit at the Brewery in London and is hosted by Jo Moffatt, Engage for Success Advisory Board member and regular EFS radio show host. Engage for Success are media partners for Engage Business Media's industry-leading events, including the Future of Work Conference and the Employee Engagement Summit. •    The key drivers that led to Lipsy London taking action to add self-empowerment to their wellbeing strategy •    Why Lipsy London decided to run a photoshoot initiative  •    Any challenges in getting employee buy-in •    Highlighting the key results that have been seen following the photoshoot •    What's next for self-empowerment at Lipsy?  •    The achievements and impact that create the most pride Join us as we discuss how Lipsy London's recent wellbeing initiative empowered employees through self-confidence. Host: Jo Moffatt

Smith Anniversaries, a retirement announcement, EFS updates, customer service news, Brake Safety Week, Clean Inspection Roll Call, Shout Outs with Julie, and Doug's Dad Joke of the Week! #smithtransportdotcom #peterbilt #cld #truckers 

Smith Transport brings you the latest July monthly newscast brings news from Customer Service with scorecards and on-time pick-up and deliveries, Safety has clean inspections and safety tips on rider program and pet policy.  Joe from Operations talks about EFS cards, service, and the increase in freight. Maintenance talks about ways to save your truck batteries.  Recruiting has new openings on our dedicated fleet in Bedford, PA.  Jenn is here with Smith-A-Versaries, and of course we have Dougs 'Dad Joke of the Week'  #safety #service #peterbilt #award #cdl #trucker #trucking #smithtransportdotcom

Guest: Christina Lewis: Gender Equity ERG Lead/Head of Global Rider Experience, Deliveroo Christina leads Deliveroo's Gender Equity Employee Resource Group alongside her role as Head Of Global Rider Experience. In her ERG role, Christina spearheaded the first woman-focused mentoring scheme, as well as introducing accelerate, Deliveroo's programme for high potential women. Christina leads a team of 10 ERG members, focusing on gender equity at Deliveroo. This special episode was recorded live on stage at the 2024 Employee Engagement Summit at the Brewery in London. It takes the form of a ‘Fireside Chat' hosted by Jo Moffatt, Engage for Success Advisory Board member and regular EFS radio show host. Engage for Success are media partners for Engage Business Media's industry-leading events, including the Future of Work Conference and the Employee Engagement Summit. Christina Lewis, Deliveroo's Gender Equity ERG lead and award-winning ‘WiHTL Woman To Watch 2024' explains how ERG groups can boost company culture & employee engagement, drive impact for underrepresented groups, give grassroot insight, as well as the pitfalls to avoid. Join us as we discuss how volunteer led employee resource groups help support company culture and employee proposition. Host: Jo Moffatt

Guest: Christina Lewis: Gender Equity ERG Lead/Head of Global Rider Experience, Deliveroo Christina leads Deliveroo's Gender Equity Employee Resource Group alongside her role as Head Of Global Rider Experience. In her ERG role, Christina spearheaded the first woman-focused mentoring scheme, as well as introducing accelerate, Deliveroo's programme for high potential women. Christina leads a team of 10 ERG members, focusing on gender equity at Deliveroo. This special episode was recorded live on stage at the 2024 Employee Engagement Summit at the Brewery in London. It takes the form of a ‘Fireside Chat' hosted by Jo Moffatt, Engage for Success Advisory Board member and regular EFS radio show host. Engage for Success are media partners for Engage Business Media's industry-leading events, including the Future of Work Conference and the Employee Engagement Summit. Christina Lewis, Deliveroo's Gender Equity ERG lead and award-winning ‘WiHTL Woman To Watch 2024' explains how ERG groups can boost company culture & employee engagement, drive impact for underrepresented groups, give grassroot insight, as well as the pitfalls to avoid. Join us as we discuss how volunteer led employee resource groups help support company culture and employee proposition. Host: Jo Moffatt

Smith Transport, HQ in Roaring Spring, PA is an asset truckload dry van carrier that travels east of I35 with 800 drivers.  If you're looking for a truckload carrier that offers safety and service, call us at 888 GO SMITH. This monthly newscast is the voice-only version of our YouTube, Facebook newscast.  We offer you monthly segments like Shout Outs, news from the shop, custom service, operations, and safety.  This month there are updates on EFS cards, Smith Anniversaries, July CVSA details, Federal Inspections on your truck, Clean Inspection list, and an alternative to the Vector App, and more! 

Dr. Diwakar Davar and Dr. Jason Luke discuss advances in the neoadjuvant immunotherapy space that were presented at the 2024 ASCO Annual Meeting, including promising outcomes in high-risk melanoma from the NADINA trial, as well as other new treatment options for patients with advanced cancers.    TRANSCRIPT Dr. Diwakar Davar: Hello and welcome to the ASCO Daily News Podcast. I'm your guest host, Dr. Diwakar Davar, and I am an associate professor of medicine and the clinical director of the Melanoma Skin Cancer Program at the University of Pittsburgh's Hillman Cancer Center. I am delighted to have my colleague and friend Dr. Jason Luke on the podcast today to discuss key late-breaking abstracts and advances in immunotherapy that were presented at the 2024 ASCO Annual Meeting. Dr. Luke is an associate professor of medicine, the associate director of clinical research, and the director of the Cancer Immunotherapeutic Center at the University of Pittsburgh Hillman Cancer Center.   You will find our full disclosures in the transcript of this episode.  Jason, it's always a pleasure to hear your insights on the key trials in these spaces and to have you back as a guest on this podcast that highlights some of the work, especially advances, that were just presented. Dr. Jason Luke: Well, thanks very much for the invitation. I always love joining the podcast. Dr. Diwakar Davar: We'll start very quickly by talking about some advances and really interesting things that happened both in the context of melanoma but also in immunotherapy in general. And we'll start with what I think was certainly one highlight for me, which was LBA2, the late-breaking abstract on the NADINA trial. It was featured in the Plenary Session, and in this abstract, Dr. Christian Blank and colleagues reported on the results of this phase 3 trial of neoadjuvant ipi-nivo. This is the flipped dose of ipi1/nivo3 versus adjuvant nivolumab in PD-1 naive, macroscopic, resectable, high-risk stage 3 melanoma.  By way of background, neoadjuvant immunotherapy for those listening is an area of increasing interest for drug developers and development for both approved and novel agents. Neoadjuvant immunotherapy has been studied with multiple approved agents, including PD-1 monotherapy, PD-1 LAG-3, PD-1 CTLA-4, T-VEC, as well as investigational agents and multiple randomized and non-randomized studies. The benchmark pathologic response rates with these agents range from 17% PCR with PD-1 monotherapy, 45% to 55% PCR with PD-1 CTLA-4 combination therapy, and slightly higher 57% PCR with PD-1 LAG-3 has recently reported by Dr. Rodabe Amaria from MD Anderson. However, as we embark on phase 3 comparisons for various neoadjuvant compared to adjuvant immunotherapy trials and combinations, we're increasingly moving towards event-free survival as the primary endpoint for neoadjuvant versus adjuvant studies. And this was most recently studied in the context of SWOG S1801, a study that was led by Dr. Sapna Patel.  So, Jason, before we start on NADINA, can you briefly summarize the SWOG S1801 trial and the event-free survival statistic reported by Dr. Patel and her colleagues? Dr. Jason Luke: Well, absolutely. And these data were reported at ESMO about two years ago and then in the New England Journal last year. The S1801 study answered a very simple question: What would happen if you took three of the doses of standard adjuvant therapy with pembrolizumab and moved them prior to surgery? And on a high level, the study is as simple as that. And many of us were somewhat skeptical of this trial design because we thought that just moving the doses earlier may not actually have a major impact.  In the study, you alluded to the event-free survival statistic, and that alludes to what was considered an event. And so, without reading all of it, there were several different aspects that were included in terms of time, based on the date of randomization until the first of a series of events, such as disease progression, toxicity from treatment, if the patient was unable to go to surgery or had surgical complications, or if they had delay in starting the adjuvant therapy due to toxicity, and obviously, recurrence of melanoma or death from any cause. In that context, merely moving the 3 doses of pembrolizumab to the neoadjuvant setting saw an improvement in this two-year event free survival to 72% for the neoadjuvant therapy compared to 49% for the adjuvant therapy. That was quite an outstanding change. And again, noting the power of neoadjuvant treatment, really dictating the impact of anti PD-1, again, just with 3 doses moving from adjuvant into the neoadjuvant setting, and I think all of us were somewhat surprised to see that magnitude of a benefit. But it set up the current study very well, where we now look at combination therapy. Dr. Diwakar Davar: So let's move on to the phase 3 NADINA trial. Do you want to perhaps discuss the study design, particularly focusing on the EFS primary endpoint and maybe also touching on the different schedules? So, SWOG S1801 was a neoadjuvant study of 3 cycles of pembrolizumab and how did that compare and contrast to the neoadjuvant combination that was studied in NADINA? Dr. Jason Luke: Well, as you alluded to, NADINA investigated the regimen of nivolumab plus ipilimumab and compared that against adjuvant therapy with nivolumab alone. So, in the study, as you alluded, the dose and schedule of the two drugs used was nivolumab at 3 milligrams per kilogram, and ipilimumab with 1 milligram per kilogram. That was based on a series of signal finding and safety studies that had been previously done by the same group of authors identifying that as the optimal treatment regimen. And it's worth noting that's slightly different than the labeled indication that's generally used for those same drugs for metastatic melanoma, albeit that the NCCN also endorses this schedule. So, in the trial, 423 patients were randomized, 1:1 to receive either neoadjuvant therapy with those 2 doses of nivolumab plus ipilimumab as compared with standard adjuvant therapy with nivolumab following surgery.   Now, one interesting tweak was that there was an adaptive nature to the study, meaning that patients had a fiducial placed at the index lymph node, and after the neoadjuvant therapy in that arm, that lymph node was removed. And if the patient had a major pathological response, they did not go on to receive the adjuvant portion of the treatment. So it was adaptive because those patients who did very well to the neoadjuvant did not require the adjuvant portion. And in those patients who did not achieve a major pathological response, they could go on to have the adjuvant therapy. And that also included the BRAF therapy for those whose tumors were BRAF mutants.  It's also worth pointing out that the definition of event free survival was slightly different than in the S1801 study that was alluded to just a second ago. And here, EFS was defined from the date of randomization until progression due to melanoma or due to treatment. So that's slightly different than the definition in the S1801 trial. So, a somewhat complicated study, but I really applaud the authors because I think this study does mirror what we would likely be doing in actual clinical practice.  Dr. Diwakar Davar: So, just to briefly summarize the efficacy, and then to get your comments on this, the path response, the PCR rate was 47%. The major pathologic response rate, which is the proportion of patients with between 0% to 1/10% of residual viable tumors, was about 12%. And for a major pathologic response rate of 0% to 10% of 59%. And then the rest of the patients had either pathologic partial response, which was 10% to 50%, or pathologic non response or 50% or greater residual viable tumor, all assessed using central pathology grades. The one year RFS was 95% in the FDR patient population versus 76% in the pathologic partial response patient population, 57% in the pathologic non response patient population. So how do you view these results? Can you context the FDR rates and the EFS rates from NADINA relative to nivo-rela and also potentially SWOG 1801? Dr. Jason Luke: Well, I think these are very exciting results. I think that for those of us that have been following the field closely, they're actually not especially surprising because they mirror several studies that have come before them. When we put them in context with other studies, we see that these rates of major pathological response are consistent with what we've seen in phase 2 studies. They're relatively similar. Or I should say that the results from nivolumab and relatlimab, which was also pursued in a phase 2 study of somewhat similar design, are somewhat similar to this. So, combination immunotherapy does look to deliver a higher major pathological response than pembrolizumab alone, as was known in S1801. Which of course, the caveat being is these are cross control comparisons that we need to be careful about. So I think all of these are active regimens, and I think adding a second agent does appear to enhance the major pathologic response rates. When we look at the event free survival, we see something similar, which is that numerically it looks to be that combination immunotherapy delivers a higher event free survival rate. And that looks to be rather meaningful given the difference in the hazard ratios that were observed between these various studies. And here in the NADINA study, we see that 0.3 hazard ratio for EFS is just extremely impressive.  So the abstract then, from ourselves, out of these specific studies, what does this mean more broadly in the real world, where patients exist and the rest of the landscape for clinical trials? I think we can't take enough time to stop for a second and just think about what a revolution we've come forward in with immune checkpoint blockade and melanoma. When I started my career, now, more than 15 years ago, melanoma was the cancer that made cancer bad. And now here we say, in the highest risk of perioperative patients, we can deliver 2 doses of nivolumab and ipilimumab, and essentially half of the patients then don't need to go on, and more than half the patients don't need to go on to have a full surgery and don't need adjuvant therapy. And from what we could tell of a very, very low risk of every heavy recurrence of melanoma. Of course, there's the other half of patients where we still need to do better, but these are just fantastic results and I think highly meaningful for patients.   In the context of ongoing clinical trials, another abstract that was presented during the meeting was the update to the individualized neoantigen therapy, or V940 with pembrolizumab or against pembrolizumab alone. That's the KEYNOTE-942 study. In that study, they presented updated data at two and a half years for relapse free survival, noting a 75% rate without relapse. So those results are also highly intriguing. And these are in a similar population of very high risk patients. And so I think most of us believe that neoadjuvant therapy with this study in NADINA is now confirmed as the priority approach for patients who present with high-risk stage 3 disease. So that would be bulky disease picked up on a scan or palpable in a clinic. I think essentially all of us now believe patients should get preoperative immunotherapy. We can debate which approach to take, and it may vary by an individual patient's ability to tolerate toxicity, because, of course, multi agent immunotherapy does have increased toxicity relative to anti PD-1 alone. But we'll have to wait now for the full phase 3 results from the V940 individualized neoantigen therapy. And if those come forward, that will be an extremely attractive approach to think about for patients who did not achieve a major pathological response to neoadjuvant therapy, as well as of course to the other populations of patients with melanoma where we otherwise currently give adjuvant therapy stage 2B all the way through stage 4 resected. It's an amazing time to think about perioperative therapy in melanoma. Dr. Diwakar Davar: So this is clearly outstanding data, outstanding news. Congratulations to the investigators for really doing what is an investigative initiated trial conducted across multiple continents with a huge sample size. So this clearly appears to be, at this point in time at least, a de facto standard. But is this going to be FDA-approved, guideline-approved, or is it possible in your mind? Dr. Jason Luke: Well, that's an interesting question. This study was not designed with the intent to necessarily try to register this treatment regimen with the FDA. One would have to take a step back and say, with how powerful these data appear, it sort of seemed like it would be too bad if that doesn't happen. But all the same, I think the community and those of us who participate in guideline recommendations are fully supportive of this. So, I think we will see this move into compendium listings that support insurance approval, I think, very, very quickly. So, whether or not this actually becomes formally FDA approved or is in the guidelines, I think this should become the standard approach that is considered for patients, again presenting with high-risk stage 3 disease.  Dr. Diwakar Davar: Fantastic. So now we're going to go in and talk about a slightly different drug, but also from the melanoma context, and that is the safety and efficacy of RP1 with nivolumab in the context of patients with melanoma who are PD-1 failures. So, this is Abstract 9517. And in this abstract, our academic colleagues essentially talked about these data, and we'll start by describing what RP1 is. RP1 essentially is a HSV-1 based oncolytic immunotherapy. And RP1 expresses GM-CSF as well as a fusogenic protein, GALV-GP-R-. And in this abstract, Dr. Michael Wong from MD Anderson and colleagues are reporting the results of IGNYTE, which is a phase I trial of intratumoral RP1 co-administered with systemic nivolumab in patients with advanced metastatic treatment refractory cutaneous melanoma. And the data presented in this abstract represents data from a registration directed, abbreviated as RD, registration directed cohort of RP1 plus nivolumab in PD-1 refractory melanoma. So, let's start with the description of the cohort.  Dr. Jason Luke: Right. So, in this study, there were a total of 156 patients who were presented, and that included an initial safety and dose finding group of 16, as well as the RD cohort, as you noted, of 140 patients. And it's important to point out that this was a cohort that was selected for a very strict definition of progression on anti PD-1, or a combination immunotherapy as their immediately prior treatment. So, all of the patients in the cohort had exposure to anti PD-1, and 46% of them had anti PD-1 plus anti CTLA4, nivolumab and ipilimumab as their immediately prior therapy. This was also a group of relatively high-risk patients when one considers stage. So, within the stage 4 population, the entry here included 51% who had stage M1B, C, and D melanoma. And that is worth pointing out because this is an injectable therapy. So, trials like this in the past have tended to be biased towards earlier stage, unresectable or metastatic melanoma, meaning stage 3B, 3C, 3D and then stage 4m1a. Again, to emphasize the point here, these were pretreated patients who had a strict definition of anti PD-1 resistance, and over half of them, in fact, had high-risk visceral metastatic disease.  In that context, it's very interesting to observe that the overall response rate was described in the total population, as 31%, and that included 12% who achieved complete response. And so, again, to make sure it's clear, we're talking about a treatment where the oncolytic virus is injected into one or multiple sites of recurrent disease, and then the patients administer nivolumab as per standard. And so, I think these data are quite intriguing. Again, such a high- risk population and their maturity now, with a follow-up of over a year, I think, makes this look to be a very interesting treatment option.  Dr. Diwakar Davar: I guess on that topic of mature follow-up, it probably would be important for us to inform our audience that the top line data for the primary analysis was actually just released, I think, earlier today, and wherein the central confirmed objective response rate was 34% by modified RECIST and 33% by RECIST, clearly indicating that these responses, as you noted, very treatment refractory patient population, these responses were clearly very durable. So, you mentioned that there were responses seen in uninjected visceral lesions, responses seen in both PD-1 and PD-1 CTLA-4 refractory patients. Can you talk a little bit about the response rate in these high-risk subgroups, the uninjected visceral lesions, the patients who had both combination checkpoint and epidural refractory response rate by primary PD-1 resistance.  Dr. Jason Luke: Sure. You know, I think, again, to emphasize this point in the study, we saw that there were responses in the non-injected lesions, and I think it's really important to emphasize that. Some have referred to this as a putative abscopal like effect, similar to what is described in radiation. But it implies that local treatment with the oncolytic virus is triggering a systemic immune response. In the higher risk patient population, we'll note that whereas the overall response rate in PD-1 refractory patients was 34%, in the combination of PD-1 and CTLA-4 refractory patients, the response rate was 26%. So, [this is] still very good. And when we looked at that split by stage, as I alluded to before, in the population of patients that had, what you might call earlier unresectable diseases, so 3B through 4A, the response rate was 38%, and in the stage 4 M1b through M1d, it was 25%. So slightly lower, but still very good. And that would be as expected, because, of course, the patients with visceral metastatic disease have more advanced disease, but those response rates look quite good. Again, looking at the combination refractory population as well as the more high-risk disease. Dr. Diwakar Davar: So, clearly, these are very promising data and exciting times for multiple investigators in the field and the company, Replimune, as well. So, what are the next steps? I believe that a registration trial is planned, essentially, looking at this with the goal of trying to get this combination registered. Can you tell us a little bit about IGNYTE-3, the trial design, the control arm, and what you foresee this trial doing over the next couple of years?  Dr. Jason Luke: So, as this agent has been maturing, it's worth pointing out that the company that makes this molecule, called RP1, but I guess now we'll have to get used to this name vusolimogene oderparepvec as the actual scientific term, they have been having ongoing discussions with the FDA, and there is the potential that this agent could come forward on an accelerated path prior to the results being released from a phase 3 trial. That being said, the phase 3 confirmatory study, which is called the IGNYTE-3 study, is in the process of being launched now. And that's a study investigating this molecule in combination with nivolumab, as was alluded to earlier, and a randomized phase 3 design, where that combination is compared with a physician's choice, essentially a chemotherapy-based option.   In that study, it will be 400 patients with stage 3B through stage 4; patients will have progressed on anti PD-1, either as a combination or in sequence, and then come on the study to be randomized to either vusolimogene oderparepvec plus nivolumab versus that physician's choice. And the physician's choice includes chemotherapy agents, but also nivolumab plus relatlimab as another option, or an anti PD-1 monotherapy, if that's deemed to be a reasonable option by the treating investigator. And the primary endpoint of that study is overall survival. And unfortunately, in this highly refractory patient population, that's something that may not take long to identify with key secondary endpoints of progression free survival, as well as overall response rate. I'm quite enthusiastic about this study, given these data, which have now been centrally confirmed as you alluded to before. I think this is a very exciting area of investigation and really crossing my fingers that this may be perhaps the first locally administered therapy which does appear to have a systemic impact that can hold up in phase 3. Dr. Diwakar Davar: Very, very, very exciting results. And I guess it's worthwhile pointing out that this company also has got, I think, multiple studies planned with both RP1 and cutaneous squamous cell carcinoma in a solid organ transplant patient population where single agent activity has already been reported by Dr. Migden at prior meetings, as well as a novel trial of potentially RP2 metastatic uveal melanoma. So we'll now pivot to Abstract 6014. So, 6014 is a drug by a company known as Merus. Essentially, it's a very novel agent. Merus essentially is a company that is specialized in making bicyclics and tricyclics. And these are not bicycles or tricycles, but rather drugs that essentially are bispecific antibodies. And Merus essentially has come up with petosemtamab. I think we're going to have to figure out better names for all of these drugs at some point. But petosemtamab, or MCLA-158, essentially is a bicyclic, targeting both EGFR as well as LGR-5. So EGR-5, of course, is a known oncogenic driver in multiple tumor types, squamous, including non small cell lung cancer, cutaneous squamous cell carcinoma, but also head and neck squamous cell carcinoma. And LGR-5 essentially is leucine-rich repeat-containing G-protein coupled receptor 5, but it's a receptor in cancer stem cells and certainly highly expressed in head neck squam. And MCLA-158, or petosemtamab is a IgG one bispecific with ADCC-activity because of IgG1 backbone co-targeting EGFR and LGR5. Merus had earlier results that evaluated petosemtamab monotherapy. They defined the RP2D and second- and third-line head and neck blastoma patients with a respectable response rate of 37% investigator-assessed ORR with six months median DoR, and this was published by Ezra Cohen about a year or so ago.  In this abstract, Dr. Fayette and colleagues report on the results of the MCLA-158-CL01 trial, which is a trial of pembrolizumab plus petosemtamab in one front line head and neck squamous cell population. So maybe let's start with the description of the cohort. And it is a small trial, but we'll be able, I think, to dig into a little bit about why this might be exciting. Dr. Jason Luke: Yes. So, as alluded to, it's not the biggest trial as yet, but there were 26 patients with anti PD-1 treatment naive head and neck squamous cell carcinoma. And all the patients in the study did receive, as you alluded to, pembrolizumab plus petosemtamab. Based on the label for pembrolizumab, all the patients in this study were PDL-1 positive. So that's one point that it's worth pointing out to make sure that that's understood. This is the population of patients who would be expected to benefit from pembrolizumab in the first place. Now, in the abstract, they reported out only 10 response evaluable patients, but they updated that in the actual slides of presentation at the meeting. So among 24 patients that were alluded to, 67% were described as having had a response, although some of those were yet to be confirmed responses. And when it was evaluated by PDL-1 status, there didn't seem to be a clear enrichment of response in the PD-1 positive more than 20% group, as compared to the 1-19% group. That isn't especially surprising because that was a trend that one would see, presumably with pembrolizumab alone. But overall, I think these data are pretty exciting in terms of a preliminary study. Dr. Diwakar Davar: You know, you mentioned that the objective response rate was high, almost 60-something%. The prognosis of these patients is generally poor. The OS is typically thought of as between 6-15 months. And based on KEYNOTE-048, which was led by Dr. Burtness and colleagues, the standard of care in the setting is pembrolizumab +/- platinum based chemotherapy regimens. Allowing for the fact that we only have 10 patients here, how do you think these results stack up against KEYNOTE-048? And you made a very important point earlier, which was, by definition, pembro is on label only for the CPS. So PDL-1 score, at least in head and neck squamous cell carcinoma CPS and not TPS. But in the CPS 1% or greater patient population, where pembro is on label, how do these results stack up against the KEYNOTE-048 results. Dr. Jason Luke: Right. KEYNOTE-048 is considered the seminal study that dictates frontline treatment in head and neck cancer. And before we dive into this too far, we do want to acknowledge that here we're comparing 26 patients versus a phase 3 trial. So, we're not trying to get too far ahead of ourselves, but this is just a preliminary comparison. But in KEYNOTE-048, as you alluded to, two regimens were superior to chemotherapy. One was the pembrolizumab monotherapy, as well as pembrolizumab plus chemotherapy. So again, the study overall survival, of course, was much higher, the PDL-1 positive subgroup, which is what dictated the unlabeled use of this. But response to pembro monotherapy in that population of patients is still modest. We're talking about upwards of 20-30%. So, if you compare that to, again, preliminary evidence here from this trial of only 24 patients, that response rate of 60% seems extremely high. And so even if that were to come down somewhat in a larger data series of patients, that still looks to be quite promising as a treatment regimen, that might eventually even be chemotherapy sparing for this population of patients. I think this raises a lot of eyebrows that perhaps this dual targeting approach, EGFR and LDR-5, may bring something really important to the field that evolves it. Dr. Diwakar Davar: So, what are the next steps for petosemtamab? You mentioned that the activity was interesting. Are we going to see a larger trial? Any thoughts on where things are going to go?  Dr. Jason Luke: Well, based on the phase 2 data of petosemtamab alone, even without pembrolizumab, the molecule had already been given fast track designation by FDA, which means allowing for greater communication between the drug sponsor in the FDA and designing a seminal study design. One would assume that this trial will be rapidly expanded quite greatly, perhaps to 100 or 200 patients, to try to flush out what the real response rate is in a more meaningful number of patients. But I think these data will probably also trigger the design and probably near-term evaluation or expedited acceleration of a phase III clinical trial design that would potentially validate this against the current standard of care. So, I'm pretty excited. I think we'll see a lot more about this agent in the relatively near future. Dr. Diwakar Davar: So, finally, we'll pivot to the last abstract that we're going to talk about, which is Abstract 2504. It's a relatively interesting target, CCR8 monoclonal antibody. But this is the efficacy and safety of LM-108, and LM-108 is an anti CCR8 monoclonal antibody that is being developed by LaNova Medicine. And the results that are described, actually a pool set of results of combinations of LM-108 with anti PD-1, two separate anti PD-1, in patients with gastric cancer, mostly done ex-U.S., which is interesting because of this patient population, and it's a pool result of several, 3 phase 1 and 2 studies.  LM-108 is an Fc-optimized anti CCR8 monoclonal antibody that selectively depletes tumor infiltrating Tregs. The abstract reported a pooled analysis of three phase 1, 2 trials with 3 different NCT numbers that all evaluated the efficacy of LM-108 and anti PD-1 in patients with gastric cancer. So, let's start with the description of the cohort. Maybe, Jason, you can tell us a little bit about before you start, as you describe the cohort, sort of what we know, editorially speaking, about the difficulty with which Tregs depletion has been tried and obviously failed up until now in the tumor microenvironment. Dr. Jason Luke: Right. I think that's a really interesting comment. And so, for decades, in fact, targeting regulatory T-cell to alleviate immune exclusion in the tumor microenvironment has been of interest in immuno-oncology. And in preclinical mouse models, it seems quite clear that such an approach can deliver therapeutic efficacy. However, by contrast, in human clinical trials, various different Treg depleting strategies have been attempted, and there's really little to no evidence that depleting Tregs from human tumors actually can deliver therapeutic responses. And by that we're referring to CD-25 antibodies. The drug ipilimumab, the CTLA-4 antibody, was punitively described as a Tregs depleter preclinically, but that doesn't seem to be the case in patients. And so, in that background, this is quite an eye raiser that an anti CCR8 antibody could be driving this effect. Now, before we talk about the results of this trial, I will point out, however, that given the Fc-optimization, it's entirely possible that the Tregs are being depleted by this mechanism, but that more could also be going on. Because Fc gamma RII binding by this antibody that could be nonspecific also has the potential to trigger immune responses in the tumor microenvironment, probably mediated by myeloid cells. So I think more to come on this. If this turns out to be the first meaningful Tregs depletor that leads to therapeutic efficacy, that would be very interesting. But it's also possible this drug could have multiple mechanisms.  So, having said all of that, in the clinical trial, which was a pooled analysis, like you mentioned, of LM-108 in combination with anti PD-1 of a couple different flavors, there were 48 patients treated either with LM-108, with pembrolizumab, or with toripalimab, which is another anti PD-1 antibody. On the drug combination was, generally speaking, pretty well tolerated, noting grade 3 treatment related adverse events in the range of 38%, which is somewhat expected given combination immunotherapy. We talked about nivolumab and ipilimumab before, which, of course, gives even higher rates of immune-related adverse events, with the most common toxicities being anemia, lipase elevations, rash, ALC decrease; albeit, quite manageable. Dr. Diwakar Davar: So, what about the objective response rate? Can you contextualize the efficacy? And as you do that, maybe we'll think about what you'd expect in the context of, say, gastric cancer, especially in patients who've never really had a prior checkpoint inhibitor before. What do you think about the ORR? What do you think about the relative efficacy of this combination? Dr. Jason Luke: Well, so, in the study, they described overall response rate in the 36 patients as 36% and described immediate progression for survival of about 6.5 months. And so that was among patients who were treatment naive. And in second-line patients, they actually described an even higher response rate, although it was only 11 patients, but they're at 64%. And so, I think those data look to be somewhat interesting. When I was actually scrutinizing the actual data presented, it was of some interest to note that the quality of responses seemed to be about as good on the lower dose of LM-108, so 3 milligrams per kilogram as compared to 10 milligrams per kilogram. I think there's definitely more to learn here to try to optimize the dose and to fully understand what the overall efficacy of this treatment combination would be.  I would emphasize that in this disease, I think novel treatment strategies are certainly warranted. While anti PD-1 with chemotherapy has moved the needle in terms of standard of care treatment, it's really only a minor subset of patients who derive durable long-term benefit like we normally associate with immune checkpoint blockade. I think these are preliminary data. They're very intriguing.   You alluded to earlier that this population of patients was an Asian data set, and it is well known that the efficacy of chemotherapy and immunotherapy does appear to be somewhat enhanced in Asian populations, and that goes to distributions of metastasis and tumor microenvironment effects, etc. Very difficult to try to tease any of that out in this abstract, other than to look at these data and suggest that this is pretty interesting, both from a novel therapeutic approach, we talked about the Tregs consideration, but also straight up on the efficacy because I think if these data could hold up in a larger number of patients, and particularly in a western population of patients, I think it would be very intriguing. Dr. Diwakar Davar: Certainly, ASCO 2024 had a lot of interesting data, including data from targeted agents, the LAURA trial, ADCs. But just focusing on the immune therapy subset, we certainly saw a lot of great advances in patients who were treated with neoadjuvant as well as relapse refractory disease in the context of RP1 and then a couple of newer agents such as this petosemtamab as well as LM-108. And of course, we cannot forget to highlight the extended DMFS data from the pembro vaccine study from KEYNOTE-942.  Jason, as always, thank you for taking a little bit of time out of your extremely busy schedule to come and give us insights as to how these agents are impacting the landscape. We really value your input and so thank you very much.  Dr. Jason Luke: Thank you for the opportunity. Dr. Diwakar Davar: And thank you to our listeners for your time today. You will find the links to all the abstracts that we discussed in the transcript of this episode. And finally, if you value the insights that you hear on this podcast, please take a moment to rate, review and subscribe wherever you get your podcasts. So, thank you.   Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   Follow today's speakers:   Dr. Diwakar Davar   @diwakardavar   Dr. Jason Luke   @jasonlukemd      Follow ASCO on social media:    @ASCO on Twitter   ASCO on Facebook   ASCO on LinkedIn      Disclosures:       Dr. Diwakar Davar:     Honoraria: Merck, Tesaro, Array BioPharma, Immunocore, Instil Bio, Vedanta Biosciences    Consulting or Advisory Role: Instil Bio, Vedanta Biosciences    Consulting or Advisory Role (Immediate family member): Shionogi    Research Funding: Merck, Checkmate Pharmaceuticals, CellSight Technologies, GSK, Merck, Arvus Biosciences, Arcus Biosciences    Research Funding (Inst.): Zucero Therapeutics    Patents, Royalties, Other Intellectual Property: Application No.: 63/124,231 Title: COMPOSITIONS AND METHODS FOR TREATING CANCER Applicant: University of Pittsburgh–Of the Commonwealth System of Higher Education Inventors: Diwakar Davar Filing Date: December 11, 2020 Country: United States MCC Reference: 10504-059PV1 Your Reference: 05545; and Application No.: 63/208,719 Enteric Microbiotype Signatures of Immune-related Adverse Events and Response in Relation to Anti-PD-1 Immunotherapy       Dr. Jason Luke:    Stock and Other Ownership Interests: Actym Therapeutics, Mavu Pharmaceutical, Pyxis, Alphamab Oncology, Tempest Therapeutics, Kanaph Therapeutics, Onc.AI, Arch Oncology, Stipe, NeoTX    Consulting or Advisory Role: Bristol-Myers Squibb, Merck, EMD Serono, Novartis, 7 Hills Pharma, Janssen, Reflexion Medical, Tempest Therapeutics, Alphamab Oncology, Spring Bank, Abbvie, Astellas Pharma, Bayer, Incyte, Mersana, Partner Therapeutics, Synlogic, Eisai, Werewolf, Ribon Therapeutics, Checkmate Pharmaceuticals, CStone Pharmaceuticals, Nektar, Regeneron, Rubius, Tesaro, Xilio, Xencor, Alnylam, Crown Bioscience, Flame Biosciences, Genentech, Kadmon, KSQ Therapeutics, Immunocore, Inzen, Pfizer, Silicon Therapeutics, TRex Bio, Bright Peak, Onc.AI, STipe, Codiak Biosciences, Day One Therapeutics, Endeavor, Gilead Sciences, Hotspot Therapeutics, SERVIER, STINGthera, Synthekine    Research Funding (Inst.): Merck , Bristol-Myers Squibb, Incyte, Corvus Pharmaceuticals, Abbvie, Macrogenics, Xencor, Array BioPharma, Agios, Astellas Pharma , EMD Serono, Immatics, Kadmon, Moderna Therapeutics, Nektar, Spring bank, Trishula, KAHR Medical, Fstar, Genmab, Ikena Oncology, Numab, Replimmune, Rubius Therapeutics, Synlogic, Takeda, Tizona Therapeutics, Inc., BioNTech AG, Scholar Rock, Next Cure    Patents, Royalties, Other Intellectual Property: Serial #15/612,657 (Cancer Immunotherapy), and Serial #PCT/US18/36052 (Microbiome Biomarkers for Anti-PD-1/PD-L1 Responsiveness: Diagnostic, Prognostic and Therapeutic Uses Thereof)    Travel, Accommodations, Expenses: Bristol-Myers Squibb, Array BioPharma, EMD Serono, Janssen, Merck, Novartis, Reflexion Medical, Mersana, Pyxis, Xilio

Breaking news from Joe Musselman, our VP of Operations to the Smith Transport drivers... BIG changes are coming for our fuel cards ASAP as we transition from Comdata to EFS!! #efs #fuel #smithtransportdotcom 

Dr. Adele Diamond, PhD, FRSC, is a trailblazer in developmental cognitive neuroscience, pioneering research on 'executive functions' (EFs) crucial for problem-solving and creativity. Her interdisciplinary approach explores the impact of biological and environmental factors on cognitive development, leading to groundbreaking insights that have transformed early education and improved treatment for conditions like ADHD. Through her work, Dr. Diamond emphasizes the vital role of holistic approaches, advocating for the integration of physical activity and the arts to nurture cognitive abilities and overall well-being.Connect with Adele on Her Website.You can explore more of Hernan's work on his website, https://www.hernanchousa.com/.The music enriching our show is the creative work of Sebastian Klauer. You can reach him at klauersebas@gmail.com.

Welcome to part five in the AWS Certification Exam Prep Mini-Series! Whether you're an aspiring cloud enthusiast or a seasoned developer looking to deepen your architectural acumen, you've landed in the perfect spot. In this six-part saga, we're demystifying the pivotal role of a Solutions Architect in the AWS cloud computing cosmos. In this episode, Dave and Caroline chat with Anya Derbakova, a Senior Startup Solutions Architect at AWS, known for weaving social media magic, and Ted Trentler, a Senior AWS Technical Instructor with a knack for simplifying the complex. Unravel the strategies and best practices for designing cost-optimized architectures on AWS. Covering 20% of the exam's scored content, this episode zeroes in on maximizing efficiency and reducing costs across your cloud infrastructure. Discover the art of balancing performance with cost-effectiveness as we delve into AWS cost management services, cost-optimized storage and compute solutions, and the nuances of designing database and network architectures that won't break the bank. In this episode, you'll learn about: • Utilizing AWS cost management service features and tools, including cost allocation tags, multi-account billing, and the AWS Free Tier. • Designing cost-optimized storage solutions with AWS services like Amazon FSx, EFS, S3, and EBS, including data lifecycle policies and backup strategies. • Rightsizing and optimizing compute resources to meet your workload requirements efficiently, from instance selection to utilizing serverless and distributed compute strategies. • Strategies for cost-optimized database solutions, focusing on caching, data retention, capacity planning, and replication to enhance performance while managing costs. • Crafting network architectures that minimize costs associated with data transfer, leveraging AWS services and features to reduce expenses while maintaining robust connectivity. Whether you're fine-tuning existing systems or building from the ground up, we'll provide you with the tools and insights to make cost-aware decisions without sacrificing functionality! Anya on LinkedIn: https://www.linkedin.com/in/annadderbakova/ Ted on Twitter: https://twitter.com/ttrentler Ted on LinkedIn: https://linkedin/in/tedtrentler Caroline on Twitter: https://twitter.com/carolinegluck Caroline on LinkedIn: https://www.linkedin.com/in/cgluck/ Dave on Twitter: https://twitter.com/thedavedev Dave on LinkedIn: https://www.linkedin.com/in/davidisbitski AWS SAA Exam Guide - https://d1.awsstatic.com/training-and-certification/docs-sa-assoc/AWS-Certified-Solutions-Architect-Associate_Exam-Guide.pdf Party Rock for Exam Study - https://partyrock.aws/u/tedtrent/KQtYIhbJb/Solutions-Architect-Study-Buddy All Things AWS Training - Links to Self-paced and Instructor Led https://aws.amazon.com/training/ AWS Skill Builder – Free CPE Course - https://explore.skillbuilder.aws/learn/course/134/aws-cloud-practitioner-essentials AWS Free Workshops - https://workshops.aws/ Running a Minecraft server on Amazon ECS with Spot Pricing: https://github.com/vatertime/minecraft-spot-pricing Subscribe: Spotify: https://open.spotify.com/show/7rQjgnBvuyr18K03tnEHBI Apple Podcasts: https://podcasts.apple.com/us/podcast/aws-developers-podcast/id1574162669 Stitcher: https://www.stitcher.com/show/1065378 Pandora: https://www.pandora.com/podcast/aws-developers-podcast/PC:1001065378 TuneIn: https://tunein.com/podcasts/Technology-Podcasts/AWS-Developers-Podcast-p1461814/ Amazon Music: https://music.amazon.com/podcasts/f8bf7630-2521-4b40-be90-c46a9222c159/aws-developers-podcast Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5zb3VuZGNsb3VkLmNvbS91c2Vycy9zb3VuZGNsb3VkOnVzZXJzOjk5NDM2MzU0OS9zb3VuZHMucnNz RSS Feed: https://feeds.soundcloud.com/users/soundcloud:users:994363549/sounds.rss

In this JCO Article Insights episode, Alexandra Rojek provides a summary on two long term follow studies: "Long-Term Follow-Up of Rituximab Maintenance in Young Patients With Mantle-Cell Lymphoma Included in the LYMA Trial: A LYSA Study" by Sarkozy, et al published on December 18th, 2023 and "Long Term Follow Up of the RESORT Study (E4402): A Randomized Phase III Comparison of Two Different Rituximab Dosing Strategies for Low Tumor Burden Follicular Lymphoma," by Kahl, et al, published January 9, 2024. TRANSCRIPT The guest on this podcast episode has no disclosures to declare. Alexandra Rojek: Hello and welcome to JCO Article Insights. I'm your host, Alexandra Rojek, and today we will be discussing two clinical trial updates published in the March 1st issue of JCO, focusing on the long-term outcomes of rituximab therapy for patients with lymphoma. The first paper discusses the use of maintenance rituximab for mantle cell lymphoma patients in the LYMA trial, and the second paper addresses rituximab dosing strategies for low tumor burden follicular lymphoma in the RESORT study. The first article by Sarkozy et al. for the LYSA group is titled "Long-Term Follow-Up of Rituximab Maintenance in Young Patients with Mantle Cell Lymphoma Included in the LYMA Trial: A LYSA Study." The LYMA trial was designed to answer whether the addition of the CD20-targeting monoclonal antibody rituximab provided additional benefit for patients with mantle cell lymphoma who achieved a response to induction chemoimmunotherapy, followed by consolidative autologous stem cell transplant in randomized patients, maintenance rituximab for three years versus observation alone. The primary analysis of the LYMA trial was published in 2017 and showed that the primary endpoint of four-year event-free survival or EFS was met at 79% in the maintenance rituximab arm compared to 61% in the observation alone arm. Additionally, there was a four-year overall survival or OS benefit of 89% versus 80% in favor of maintenance rituximab. Thus, on the basis of the LYMA trial primary analysis, the use of maintenance rituximab after consolidative autologous stem cell transplantation has become the standard of care in the field for these patients.  The long-term safety and efficacy data presented in this clinical trial update for the LYMA study continue to demonstrate ongoing EFS and OS benefit for patients randomized to maintenance rituximab. Patients were initially enrolled between 2008 and 2012, and 240 patients were randomized to either arm. EFS in this study was defined as absence of disease progression, relapse, or death, severe infection, or allergy to rituximab. The data cutoff for this updated analysis was April 2019, with a median follow-up from randomization of seven years for living patients with a note that this is prior to the COVID-19 pandemic. For those in the maintenance rituximab arm, the seven-year EFS was 76% compared to 46% for those under observation. For those on the rituximab arm, the majority of relapses occurred within three years of randomization and thus while on maintenance rituximab, which the authors suggest does not show an increase in incidence of relapse after the end of maintenance therapy. The seven-year overall survival was 83% for those on the rituximab arm compared to 72% for those on the observation, with a log-rank p-value of 0.08. There was no difference in causes of death between the treatment arms noted.  Notably, the patients who received maintenance rituximab after induction and transplant experienced a shorter second OS after relapse therapy, with a median OS2 of 1.1 years compared to 4.6 years favoring those on the observation arm, without impact of the type of salvage therapy received. Although this study was conducted before BTK inhibitors were approved in France and thus used at a low rate for patients who relapsed after initial therapy. This suggests that those who relapse after maintenance rituximab were those with the most aggressive disease biology. The authors also identified a group of patients who experienced progression of disease within 24 months of initial therapy or POD24 and showed that a Ki-67 score greater than 30% and high MIPI score were prognostic of POD24 events. For those who experienced POD24 within the rituximab arm, they also experienced a shorter OS2 compared to those on observation, again suggesting that those whose disease relapses after maintenance rituximab tend to have more aggressive and difficult-to-treat.  While the interpretation of post-relapse outcomes and therapies needs to be interpreted in the light of a different era of available therapeutic options in more recent years, particularly the newest generation of BTK inhibitors, this updated follow-up of the LYMA study provides additional strength to the standard of care established through the trial's primary analysis of the benefit of maintenance rituximab after induction therapy and consolidative autologous stem cell transplantation for patients with mantle cell lymphoma. Although the extended follow-up was conducted prior to the COVID-19 pandemic, during which increased risk of infection was shown for those undergoing B-cell depletion with agents such as rituximab, this extended follow-up of the LYMA study continues to show that the optimal therapy for mantle cell lymphoma should include maintenance rituximab after transplant. Studies since the design of the LYMA trial have sought to address whether consolidative transplants are necessary when BTK inhibitors are added to induction therapy, and ongoing studies in this era of newer treatment agents will continue to challenge and potentially redefine this now well-established standard of care. The second article by Kahl et al. is titled "Long-Term Follow-Up of the RESORT Study: E4402, a Randomized Phase III Comparison of Two Different Rituximab Dosing Strategies for Low Tumor Burden Follicular Lymphoma." The RESORT study, conducted by the Eastern Cooperative Oncology Group, was designed to address whether rituximab-responsive low tumor burden follicular lymphoma patients benefit from maintenance rituximab until progression versus a rituximab retreatment approach at the time of progression. The primary analysis of the RESORT study, published in 2014, did not show a difference in the primary endpoint, which was defined as time to treatment failure. The five-year risk of treatment failure for those on a maintenance strategy was 53% compared to 50% for those on a retreatment dosing strategy. At the time of the primary analysis, letters were sent to participants and providers, and thus the data was locked for further primary endpoint analysis in late 2011. The data lock for long-term follow-up presented in this paper was continued through 2021.  The authors looked at several endpoints in this long-term follow-up. They found that freedom from first cytotoxic therapy, at a median follow-up of almost nine years, favored the maintenance group over the retreatment group, with 83% versus 63% of patients free from chemotherapy or radiation at year seven. When looking at response duration, the analysis also favored a maintenance over retreatment approach, of 66% versus 30% for 10-year response duration, with a median follow-up of 12 years. However, when looking at overall survival at 10 years, there was no difference between rituximab dosing strategies, with a 10 -year overall survival of 83% for those receiving maintenance versus 84% for those receiving retreatment. While this extended follow-up of the RESORT study was not able to assess the long-term follow-up of the primary endpoint, the secondary endpoints suggest that while a maintenance dosing strategy was superior for prolonging time to first cytotoxic therapy and response duration, this again did not translate to an overall survival benefit. The authors conclude that they continue to recommend a rituximab retreatment strategy for these patients instead of a maintenance strategy, in the absence of a survival benefit, particularly with the high response rates observed with next-line treatment strategies for follicular lymphoma patients.  Similarly to the LYMA study discussed in the first paper, the treatment arms of the RESORT study were completed prior to the COVID-19 pandemic. B-cell depletion, such as with prolonged rituximab therapy, is known to negatively impact the ability to combat viral infections such as SARS-CoV-2. Thus, the authors conclude that, in light of current and future infectious concerns, the extended follow-up of the RESORT study does not support the use of maintenance rituximab for patients with low tumor burden follicular lymphoma. Other studies have also evaluated modified and abbreviated maintenance rituximab dosing strategies for this same population and have also not shown a survival benefit, thus further strengthening this recommendation of favoring a retreatment approach over maintenance therapy. Together, the extended follow-ups of the LYMA and RESORT studies, while addressing different questions regarding the use of maintenance rituximab in mantle cell lymphoma and follicular lymphoma, support the primary endpoints of each respective study. There is a clear role for the use of maintenance rituximab therapy to promote improved event-free and overall survival, as the LYMA study has shown for mantle cell lymphoma patients. However, this does not extend to low tumor burden follicular lymphoma patients in the RESORT study. The updated analyses of these two studies provide additional strength to the nuanced and targeted application of this stalwart of lymphoma therapy that is rituximab, in the modern treatment era. While ongoing studies will aim to address how we optimize therapies with new agents for each subtype of lymphoma patients, the LYMA and RESORT studies continue to guide best practice and standards of care.  This is Alexandra Rojek, thank you for listening to JCO Article Insights. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcasts.  The purpose of this podcast is to educate and inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.  Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

This episode is a discussion with Dr. Adele Diamond about executive functions (EFs), with a focus on children and the developing brain. The conversation covers a wide range of topics, including models of EFs, three core EFs (inhibitory control, working memory, and cognitive flexibility), the differential development of EF components during childhood, the ability of early EFs to predict later life outcomes, relationships between EFs and fluid intelligence, assessment of EFs, task impurity, and interventions to improve EFs in children. Show notes are available at www.NavNeuro.com/138 _________________ If you'd like to support the show, here are a few easy ways: 1) Get APA-approved CE credits for listening to select episodes: www.NavNeuro.com/INS  2) Tell your friends and colleagues about it 3) Subscribe (free) and leave an Apple Podcasts rating/review: www.NavNeuro.com/itunes 4) Check out our book Becoming a Neuropsychologist, and leave it an Amazon rating   Thanks for listening, and join us next time as we continue to navigate the brain and behavior! [Note: This podcast and all linked content is intended for general educational purposes only and does not constitute the practice of psychology or any other professional healthcare advice and services. No professional relationship is formed between hosts and listeners. All content is to be used at listeners' own risk. Users should always seek appropriate medical and psychological care from their licensed healthcare provider.]

Evelyn Osman, Principal Platform Engineer at AutoScout24, joins Corey on Screaming in the Cloud to discuss the dire need for developers to agree on a standardized tool set in order to scale their projects and innovate quickly. Corey and Evelyn pick apart the new products being launched in cloud computing and discover a large disconnect between what the industry needs and what is actually being created. Evelyn shares her thoughts on why viewing platforms as products themselves forces developers to get into the minds of their users and produces a better end result.About EvelynEvelyn is a recovering improviser currently role playing as a Lead Platform Engineer at Autoscout24 in Munich, Germany. While she says she specializes in AWS architecture and integration after spending 11 years with it, in truth she spends her days convincing engineers that a product mindset will make them hate their product managers less.Links Referenced:LinkedIn: https://www.linkedin.com/in/evelyn-osman/TranscriptAnnouncer: Hello, and welcome to Screaming in the Cloud with your host, Chief Cloud Economist at The Duckbill Group, Corey Quinn. This weekly show features conversations with people doing interesting work in the world of cloud, thoughtful commentary on the state of the technical world, and ridiculous titles for which Corey refuses to apologize. This is Screaming in the Cloud.Corey: Welcome to Screaming in the Cloud. I'm Corey Quinn. My guest today is Evelyn Osman, engineering manager at AutoScout24. Evelyn, thank you for joining me.Evelyn: Thank you very much, Corey. It's actually really fun to be on here.Corey: I have to say one of the big reasons that I was enthused to talk to you is that you have been using AWS—to be direct—longer than I have, and that puts you in a somewhat rarefied position where AWS's customer base has absolutely exploded over the past 15 years that it's been around, but at the beginning, it was a very different type of thing. Nowadays, it seems like we've lost some of that magic from the beginning. Where do you land on that whole topic?Evelyn: That's actually a really good point because I always like to say, you know, when I come into a room, you know, I really started doing introductions like, “Oh, you know, hey,” I'm like, you know, “I'm this director, I've done this XYZ,” and I always say, like, “I'm Evelyn, engineering manager, or architect, or however,” and then I say, you know, “I've been working with AWS, you know, 11, 12 years,” or now I can't quite remember.Corey: Time becomes a flat circle. The pandemic didn't help.Evelyn: [laugh] Yeah, I just, like, a look at that the year, and I'm like, “Jesus. It's been that long.” Yeah. And usually, like you know, you get some odd looks like, “Oh, my God, you must be a sage.” And for me, I'm… you see how different services kind of, like, have just been reinventions of another one, or they just take a managed service and make another managed service around it. So, I feel that there's a lot of where it's just, you know, wrapping up a pretty bow, and calling it something different, it feels like.Corey: That's what I've been low-key asking people for a while now over the past year, namely, “What is the most foundational, interesting thing that AWS has done lately, that winds up solving for this problem of whatever it is you do as a company? What is it that has foundationally made things better that AWS has put out in the last service? What was it?” And the answers I get are all depressingly far in the past, I have to say. What's yours?Evelyn: Honestly, I think the biggest game-changer I remember experiencing was at an analyst summit in Stockholm when they announced Lambda.Corey: That was announced before I even got into this space, as an example of how far back things were. And you're right. That was transformative. That was awesome.Evelyn: Yeah, precisely. Because before, you know, we were always, like, trying to figure, okay, how do we, like, launch an instance, run some short code, and then clean it up. AWS is going to charge for an hour, so we need to figure out, you know, how to pack everything into one instance, run for one hour. And then they announced Lambda, and suddenly, like, holy shit, this is actually a game changer. We can actually write small functions that do specific things.And, you know, you go from, like, microservices, like, to like, tiny, serverless functions. So, that was huge. And then DynamoDB along with that, really kind of like, transformed the entire space for us in many ways. So, back when I was at TIBCO, there was a few innovations around that, even, like, one startup inside TIBCO that quite literally, their entire product was just Lambda functions. And one of their problems was, they wanted to sell in the Marketplace, and they couldn't figure out how to sell Lambda on the marketplace.Corey: It's kind of wild when we see just how far it's come, but also how much they've announced that doesn't change that much, to be direct. For me, one of the big changes that I remember that really made things better for customers—thought it took a couple of years—was EFS. And even that's a little bit embarrassing because all that is, “All right, we finally found a way to stuff a NetApp into us-east-1,” so now NFS, just like you used to use it in the 90s and the naughts, can be done responsibly in the cloud. And that, on some level, wasn't a feature launch so much as it was a concession to the ways that companies had built things and weren't likely to change.Evelyn: Honestly, I found the EFS launch to be a bit embarrassing because, like, you know, when you look closer at it, you realize, like, the performance isn't actually that great.Corey: Oh, it was horrible when it launched. It would just slam to a halt because you got the IOPS scaled with how much data you stored on it. The documentation explicitly said to use dd to start loading a bunch of data onto it to increase the performance. It's like, “Look, just sandbag the thing so it does what you'd want.” And all that stuff got fixed, but at the time it looked like it was clown shoes.Evelyn: Yeah, and that reminds me of, like, EBS's, like, gp2 when we're, like you know, we're talking, like, okay, provision IOPS with gp2. We just kept saying, like, just give yourself really big volume for performance. And it feel like they just kind of kept that with EFS. And it took years for them to really iterate off of that. Yeah, so, like, EFS was a huge thing, and I see us, we're still using it now today, and like, we're trying to integrate, especially for, like, data center migrations, but yeah, you always see that a lot of these were first more for, like, you know, data centers to the cloud, you know. So, first I had, like, EC2 classic. That's where I started. And I always like to tell a story that in my team, we're talking about using AWS, I was the only person fiercely against it because we did basically large data processing—sorry, I forget the right words—data analytics. There we go [laugh].Corey: I remember that, too. When it first came out, it was, “This sounds dangerous and scary, and it's going to be a flash in the pan because who would ever trust their core compute infrastructure to some random third-party company, especially a bookstore?” And yeah, I think I got that one very wrong.Evelyn: Yeah, exactly. I was just like, no way. You know, I see all these articles talking about, like, terrible disk performance, and here I am, where it's like, it's my bread and butter. I'm specialized in it, you know? I write code in my sleep and such.[Yeah, the interesting thing is, I was like, first, it was like, I can 00:06:03] launch services, you know, to kind of replicate when you get in a data center to make it feature comparable, and then it was taking all this complex services and wrapping it up in a pretty bow for—as a managed service. Like, EKS, I think, was the biggest one, if we're looking at managed services. Technically Elasticsearch, but I feel like that was the redheaded stepchild for quite some time.Corey: Yeah, there was—Elasticsearch was a weird one, and still is. It's not a pleasant service to run in any meaningful sense. Like, what people actually want as the next enhancement that would excite everyone is, I want a serverless version of this thing where I can just point it at a bunch of data, I hit an API that I don't have to manage, and get Elasticsearch results back from. They finally launched a serverless offering that's anything but. You have to still provision compute units for it, so apparently, the word serverless just means managed service over at AWS-land now. And it just, it ties into the increasing sense of disappointment I've had with almost all of their recent launches versus what I felt they could have been.Evelyn: Yeah, the interesting thing about Elasticsearch is, a couple of years ago, they came out with OpenSearch, a competing Elasticsearch after [unintelligible 00:07:08] kind of gave us the finger and change the licensing. I mean, OpenSearch actually become a really great offering if you run it yourself, but if you use their managed service, it can kind—you lose all the benefits, in a way.Corey: I'm curious, as well, to get your take on what I've been seeing that I think could only be described as an internal shift, where it's almost as if there's been a decree passed down that every service has to run its own P&L or whatnot, and as a result, everything that gets put out seems to be monetized in weird ways, even when I'd argue it shouldn't be. The classic example I like to use for this is AWS Config, where it charges you per evaluation, and that happens whenever a cloud resource changes. What that means is that by using the cloud dynamically—the way that they supposedly want us to do—we wind up paying a fee for that as a result. And it's not like anyone is using that service in isolation; it is definitionally being used as people are using other cloud resources, so why does it cost money? And the answer is because literally everything they put out costs money.Evelyn: Yep, pretty simple. Oftentimes, there's, like, R&D that goes into it, but the charges seem a bit… odd. Like from an S3 lens, was, I mean, that's, like, you know, if you're talking about services, that was actually a really nice one, very nice holistic overview, you know, like, I could drill into a data lake and, like, look into things. But if you actually want to get anything useful, you have to pay for it.Corey: Yeah. Everything seems to, for one reason or another, be stuck in this place where, “Well, if you want to use it, it's going to cost.” And what that means is that it gets harder and harder to do anything that even remotely resembles being able to wind up figuring out where's the spend going, or what's it going to cost me as time goes on? Because it's not just what are the resources I'm spinning up going to cost, what are the second, third, and fourth-order effects of that? And the honest answer is, well, nobody knows. You're going to have to basically run an experiment and find out.Evelyn: Yeah. No, true. So, what I… at AutoScout, we actually ended up doing is—because we're trying to figure out how to tackle these costs—is they—we built an in-house cost allocation solution so we could track all of that. Now, AWS has actually improved Cost Explorer quite a bit, and even, I think, Billing Conductor was one that came out [unintelligible 00:09:21], kind of like, do a custom tiered and account pricing model where you can kind of do the same thing. But even that also, there is a cost with it.I think that was trying to compete with other, you know, vendors doing similar solutions. But it still isn't something where we see that either there's, like, arbitrarily low pricing there, or the costs itself doesn't really quite make sense. Like, AWS [unintelligible 00:09:45], as you mentioned, it's a terrific service. You know, we try to use it for compliance enforcement and other things, catching bad behavior, but then as soon as people see the price tag, we just run away from it. So, a lot of the security services themselves, actually, the costs, kind of like, goes—skyrockets tremendously when you start trying to use it across a large organization. And oftentimes, the organization isn't actually that large.Corey: Yeah, it gets to this point where, especially in small environments, you have to spend more energy and money chasing down what the cost is than you're actually spending on the thing. There were blog posts early on that, “Oh, here's how you analyze your bill with Redshift,” and that was a minimum 750 bucks a month. It's, well, I'm guessing that that's not really for my $50 a month account.Evelyn: Yeah. No, precisely. I remember seeing that, like, entire ETL process is just, you know, analyze your invoice. Cost [unintelligible 00:10:33], you know, is fantastic, but at the end of the day, like, what you're actually looking at [laugh], is infinitesimally small compared to all the data in that report. Like, I think oftentimes, it's simply, you know, like, I just want to look at my resources and allocate them in a multidimensional way. Which actually isn't really that multidimensional, when you think about it [laugh].Corey: Increasingly, Cost Explorer has gotten better. It's not a new service, but every iteration seems to improve it to a point now where I'm talking to folks, and they're having a hard time justifying most of the tools in the cost optimization space, just because, okay, they want a percentage of my spend on AWS to basically be a slightly better version of a thing that's already improving and works for free. That doesn't necessarily make sense. And I feel like that's what you get trapped into when you start going down the VC path in the cost optimization space. You've got to wind up having a revenue model and an offering that scales through software… and I thought, originally, I was going to be doing something like that. At this point, I'm unconvinced that anything like that is really tenable.Evelyn: Yeah. When you're a small organization you're trying to optimize, you might not have the expertise and the knowledge to do so, so when one of these small consultancies comes along, saying, “Hey, we're going to charge you a really small percentage of your invoice,” like, okay, great. That's, like, you know, like, a few $100 a month to make sure I'm fully optimized, and I'm saving, you know, far more than that. But as soon as your invoice turns into, you know, it's like $100,000, or $300,000 or more, that percentage becomes rather significant. And I've had vendors come to me and, like, talk to me and is like, “Hey, we can, you know, for a small percentage, you know, we're going to do this machine learning, you know, AI optimization for you. You know, you don't have to do anything. We guaranteed buybacks your RIs.” And as soon as you look at the price tag with it, we just have to walk away. Or oftentimes we look at it, and there are truly very simple ways to do it on your own, if you just kind of put some thought into it.Corey: While we want to talking a bit before this show, you taught me something new about GameLift, which I think is a different problem that AWS has been dealing with lately. I've never paid much attention to it because it is the—as I assume from what it says on the tin, oh, it's a service for just running a whole bunch of games at scale, and I'm not generally doing that. My favorite computer game remains to be Twitter at this point, but that's okay. What is GameLift, though, because you want to shining a different light on it, which makes me annoyed that Amazon Marketing has not pointed this out.Evelyn: Yeah, so I'll preface this by saying, like, I'm not an expert on GameLift. I haven't even spun it up myself because there's quite a bit of price. I learned this fall while chatting with an SA who works in the gaming space, and it kind of like, I went, like, “Back up a second.” If you think about, like, I'm, you know, like, World of Warcraft, all you have are thousands of game clients all over the world, playing the same game, you know, on the same server, in the same instance, and you need to make sure, you know, that when I'm running, and you're running, that we know that we're going to reach the same point the same time, or if there's one object in that room, that only one of us can get it. So, all these servers are doing is tracking state across thousands of clients.And GameLift, when you think about your dedicated game service, it really is just multi-region distributed state management. Like, at the basic, that's really what it is. Now, there's, you know, quite a bit more happening within GameLift, but that's what I was going to explain is, like, it's just state management. And there are far more use cases for it than just for video games.Corey: That's maddening to me because having a global session state store, for lack of a better term, is something that so many customers have built themselves repeatedly. They can build it on top of primitives like DynamoDB global tables, or alternately, you have a dedicated region where that thing has to live and everything far away takes forever to round-trip. If they've solved some of those things, why on earth would they bury it under a gaming-branded service? Like, offer that primitive to the rest of us because that's useful.Evelyn: No, absolutely. And honestly, I wouldn't be surprised if you peeled back the curtain with GameLift, you'll find a lot of—like, several other you know, AWS services that it's just built on top of. I kind of mentioned earlier is, like, what I see now with innovation, it's like we just see other services packaged together and releases a new product.Corey: Yeah, IoT had the same problem going on for years where there was a lot of really good stuff buried in there, like IOT events. People were talking about using that for things like browser extensions and whatnot, but you need to be explicitly told that that's a thing that exists and is handy, but otherwise you'd never know it was there because, “Well, I'm not building anything that's IoT-related. Why would I bother?” It feels like that was one direction that they tended to go in.And now they take existing services that are, mmm, kind of milquetoast, if I'm being honest, and then saying, “Oh, like, we have Comprehend that does, effectively detection of themes, keywords, and whatnot, from text. We're going to wind up re-releasing that as Comprehend Medical.” Same type of thing, but now focused on a particular vertical. Seems to me that instead of being a specific service for that vertical, just improve the baseline the service and offer HIPAA compliance if it didn't exist already, and you're mostly there. But what do I know? I'm not a product manager trying to get promoted.Evelyn: Yeah, that's true. Well, I was going to mention that maybe it's the HIPAA compliance, but actually, a lot of their services already have HIPAA compliance. And I've stared far too long at that compliance section on AWS's site to know this, but you know, a lot of them actually are HIPAA-compliant, they're PCI-compliant, and ISO-compliant, and you know, and everything. So, I'm actually pretty intrigued to know why they [wouldn't 00:16:04] take that advantage.Corey: I just checked. Amazon Comprehend is itself HIPAA-compliant and is qualified and certified to hold Personal Health Information—PHI—Private Health Information, whatever the acronym stands for. Now, what's the difference, then, between that and Medical? In fact, the HIPAA section says for Comprehend Medical, “For guidance, see the previous section on Amazon Comprehend.” So, there's no difference from a regulatory point of view.Evelyn: That's fascinating. I am intrigued because I do know that, like, within AWS, you know, they have different segments, you know? There's, like, Digital Native Business, there's Enterprise, there's Startup. So, I am curious how things look over the engineering side. I'm going to talk to somebody about this now [laugh].Corey: Yeah, it's the—like, I almost wonder, on some level, it feels like, “Well, we wound to building this thing in the hopes that someone would use it for something. And well, if we just use different words, it checks a box in some analyst's chart somewhere.” I don't know. I mean, I hate to sound that negative about it, but it's… increasingly when I talk to customers who are active in these spaces around the industry vertical targeted stuff aimed at their industry, they're like, “Yeah, we took a look at it. It was adorable, but we're not using it that way. We're going to use either the baseline version or we're going to work with someone who actively gets our industry.” And I've heard that repeated about three or four different releases that they've put out across the board of what they've been doing. It feels like it is a misunderstanding between what the world needs and what they're able to or willing to build for us.Evelyn: Not sure. I wouldn't be surprised, if we go far enough, it could probably be that it's just a product manager saying, like, “We have to advertise directly to the industry.” And if you look at it, you know, in the backend, you know, it's an engineer, you know, kicking off a build and just changing the name from Comprehend to Comprehend Medical.Corey: And, on some level, too, they're moving a lot more slowly than they used to. There was a time where they were, in many cases, if not the first mover, the first one to do it well. Take Code Whisperer, their AI powered coding assistant. That would have been a transformative thing if GitHub Copilot hadn't beaten them every punch, come out with new features, and frankly, in head-to-head experiments that I've run, came out way better as a product than what Code Whisperer is. And while I'd like to say that this is great, but it's too little too late. And when I talk to engineers, they're very excited about what Copilot can do, and the only people I see who are even talking about Code Whisperer work at AWS.Evelyn: No, that's true. And so, I think what's happening—and this is my opinion—is that first you had AWS, like, launching a really innovative new services, you know, that kind of like, it's like, “Ah, it's a whole new way of running your workloads in the cloud.” Instead of you know, basically, hiring a whole team, I just click a button, you have your instance, you use it, sell software, blah, blah, blah, blah. And then they went towards serverless, and then IoT, and then it started targeting large data lakes, and then eventually that kind of run backwards towards security, after the umpteenth S3 data leak.Corey: Oh, yeah. And especially now, like, so they had a hit in some corners with SageMaker, so now there are 40 services all starting with the word SageMaker. That's always pleasant.Evelyn: Yeah, precisely. And what I kind of notice is… now they're actually having to run it even further back because they caught all the corporations that could pivot to the cloud, they caught all the startups who started in the cloud, and now they're going for the larger behemoths who have massive data centers, and they don't want to innovate. They just want to reduce this massive sysadmin team. And I always like to use the example of a Bare Metal. When that came out in 2019, everybody—we've all kind of scratched your head. I'm like, really [laugh]?Corey: Yeah, I could see where it makes some sense just for very specific workloads that involve things like specific capabilities of processors that don't work under emulation in some weird way, but it's also such a weird niche that I'm sure it's there for someone. My default assumption, just given the breadth of AWS's customer base, is that whenever I see something that they just announced, well, okay, it's clearly not for me; that doesn't mean it's not meeting the needs of someone who looks nothing like me. But increasingly as I start exploring the industry in these services have time to percolate in the popular imagination and I still don't see anything interesting coming out with it, it really makes you start to wonder.Evelyn: Yeah. But then, like, I think, like, roughly a year or something, right after Bare Metal came out, they announced Outposts. So, then it was like, another way to just stay within your data center and be in the cloud.Corey: Yeah. There's a bunch of different ways they have that, okay, here's ways you can run AWS services on-prem, but still pay us by the hour for the privilege of running things that you have living in your facility. And that doesn't seem like it's quite fair.Evelyn: That's exactly it. So, I feel like now it's sort of in diminishing returns and sort of doing more cloud-native work compared to, you know, these huge opportunities, which is everybody who still has a data center for various reasons, or they're cloud-native, and they grow so big, that they actually start running their own data centers.Corey: I want to call out as well before we wind up being accused of being oblivious, that we're recording this before re:Invent. So, it's entirely possible—I hope this happens—that they announce something or several some things that make this look ridiculous, and we're embarrassed to have had this conversation. And yeah, they're totally getting it now, and they have completely surprised us with stuff that's going to be transformative for almost every customer. I've been expecting and hoping for that for the last three or four re:Invents now, and I haven't gotten it.Evelyn: Yeah, that's right. And I think there's even a new service launches that actually are missing fairly obvious things in a way. Like, mine is the Managed Workflow for Amazon—it's Managed Airflow, sorry. So, we were using Data Pipeline for, you know, big ETL processing, so it was an in-house tool we kind of built at Autoscout, we do platform engineering.And it was deprecated, so we looked at a new—what to replace it with. And so, we looked at Airflow, and we decided this is the way to go, we want to use managed because we don't want to maintain our own infrastructure. And the problem we ran into is that it doesn't have support for shared VPCs. And we actually talked to our account team, and they were confused. Because they said, like, “Well, every new service should support it natively.” But it just didn't have it. And that's, kind of, what, I kind of found is, like, there's—it feels—sometimes it's—there's a—it's getting rushed out the door, and it'll actually have a new managed service or new service launched out, but they're also sort of cutting some corners just to actually make sure it's packaged up and ready to go.Corey: When I'm looking at this, and seeing how this stuff gets packaged, and how it's built out, I start to understand a pattern that I've been relatively down on across the board. I'm curious to get your take because you work at a fairly sizable company as an engineering manager, running teams of people who do this sort of thing. Where do you land on the idea of companies building internal platforms to wrap around the offerings that the cloud service providers that they use make available to them?Evelyn: So, my opinion is that you need to build out some form of standardized tool set in order to actually be able to innovate quickly. Now, this sounds counterintuitive because everyone is like, “Oh, you know, if I want to innovate, I should be able to do this experiment, and try out everything, and use what works, and just release it.” And that greatness [unintelligible 00:23:14] mentality, you know, it's like five talented engineers working to build something. But when you have, instead of five engineers, you have five teams of five engineers each, and every single team does something totally different. You know, one uses Scala, and other on TypeScript, another one, you know .NET, and then there could have been a [last 00:23:30] one, you know, comes in, you know, saying they're still using Ruby.And then next thing you know, you know, you have, like, incredibly diverse platforms for services. And if you want to do any sort of like hiring or cross-training, it becomes incredibly difficult. And actually, as the organization grows, you want to hire talent, and so you're going to have to hire, you know, a developer for this team, you going to have to hire, you know, Ruby developer for this one, a Scala guy here, a Node.js guy over there.And so, this is where we say, “Okay, let's agree. We're going to be a Scala shop. Great. All right, are we running serverless? Are we running containerized?” And you agree on those things. So, that's already, like, the formation of it. And oftentimes, you start with DevOps. You'll say, like, “I'm a DevOps team,” you know, or doing a DevOps culture, if you do it properly, but you always hit this scaling issue where you start growing, and then how do you maintain that common tool set? And that's where we start looking at, you know, having a platform… approach, but I'm going to say it's Platform-as-a-Product. That's the key.Corey: Yeah, that's a good way of framing it because originally, the entire world needed that. That's what RightScale was when EC2 first came out. It was a reimagining of the EC2 console that was actually usable. And in time, AWS improved that to the point where RightScale didn't really have a place anymore in a way that it had previously, and that became a business challenge for them. But you have, what is it now, 2, 300 services that AWS has put out, and out, and okay, great. Most companies are really only actively working with a handful of those. How do you make those available in a reasonable way to your teams, in ways that aren't distracting, dangerous, et cetera? I don't know the answer on that one.Evelyn: Yeah. No, that's true. So, full disclosure. At AutoScout, we do platform engineering. So, I'm part of, like, the platform engineering group, and we built a platform for our product teams. It's kind of like, you need to decide to [follow 00:25:24] those answers, you know? Like, are we going to be fully containerized? Okay, then, great, we're going to use Fargate. All right, how do we do it so that developers don't actually—don't need to think that they're running Fargate workloads?And that's, like, you know, where it's really important to have those standardized abstractions that developers actually enjoy using. And I'd even say that, before you start saying, “Ah, we're going to do platform,” you say, “We should probably think about developer experience.” Because you can do a developer experience without a platform. You can do that, you know, in a DevOps approach, you know? It's basically build tools that makes it easy for developers to write code. That's the first step for anything. It's just, like, you have people writing the code; make sure that they can do the things easily, and then look at how to operate it.Corey: That sure would be nice. There's a lack of focus on usability, especially when it comes to a number of developer tools that we see out there in the wild, in that, they're clearly built by people who understand the problem space super well, but they're designing these things to be used by people who just want to make the website work. They don't have the insight, the knowledge, the approach, any of it, nor should they necessarily be expected to.Evelyn: No, that's true. And what I see is, a lot of the times, it's a couple really talented engineers who are just getting shit done, and they get shit done however they can. So, it's basically like, if they're just trying to run the website, they're just going to write the code to get things out there and call it a day. And then somebody else comes along, has a heart attack when see what's been done, and they're kind of stuck with it because there is no guardrails or paved path or however you want to call it.Corey: I really hope—truly—that this is going to be something that we look back and laugh when this episode airs, that, “Oh, yeah, we just got it so wrong. Look at all the amazing stuff that came out of re:Invent.” Are you going to be there this year?Evelyn: I am going to be there this year.Corey: My condolences. I keep hoping people get to escape.Evelyn: This is actually my first one in, I think, five years. So, I mean, the last time I was there was when everybody's going crazy over pins. And I still have a bag of them [laugh].Corey: Yeah, that did seem like a hot-second collectable moment, didn't it?Evelyn: Yeah. And then at the—I think, what, the very last day, as everybody's heading to re:Play, you could just go into the registration area, and they just had, like, bags of them lying around to take. So, all the competing, you know, to get the requirements for a pin was kind of moot [laugh].Corey: Don't you hate it at some point where it's like, you feel like I'm going to finally get this crowning achievement, it's like or just show up at the buffet at the end and grab one of everything, and wow, that would have saved me a lot of pain and trouble.Evelyn: Yeah.Corey: Ugh, scavenger hunts are hard, as I'm about to learn to my own detriment.Evelyn: Yeah. No, true. Yeah. But I am really hoping that re:Invent proves me wrong. Embarrassingly wrong, and then all my colleagues can proceed to mock me for this ridiculous podcast that I made with you. But I am a fierce skeptic. Optimistic nihilist, but still a nihilist, so we'll see how re:Invent turns out.Corey: So, I am curious, given your experience at more large companies than I tend to be embedded with for any period of time, how have you found that these large organizations tend to pick up new technologies? What does the adoption process look like? And honestly, if you feel like throwing some shade, how do they tend to get it wrong?Evelyn: In most cases, I've seen it go… terrible. Like, it just blows up in their face. And I say that is because a lot of the time, an organization will say, “Hey, we're going to adopt this new way of organizing teams or developing products,” and they look at all the practices. They say, “Okay, great. Product management is going to bring it in, they're going to structure things, how we do the planning, here's some great charts and diagrams,” but they don't really look at the culture aspect.And that's always where I've seen things fall apart. I've been in a room where, you know, our VP was really excited about team topologies and say, “Hey, we're going to adopt it.” And then an engineering manager proceeded to say, “Okay, you're responsible for this team, you're responsible for that team, you're responsible for this team talking to, like, a team of, like, five engineers,” which doesn't really work at all. Or, like, I think the best example is DevOps, you know, where you say, “Ah, we're going to adopt DevOps, we're going to have a DevOps team, or have a DevOps engineer.”Corey: Step one: we're going to rebadge everyone with existing job titles to have the new fancy job titles that reflect it. It turns out that's not necessarily sufficient in and of itself.Evelyn: Not really. The Spotify model. People say, like, “Oh, we're going to do the Spotify model. We're going to do skills, tribes, you know, and everything. It's going to be awesome, it's going to be great, you know, and nice, cross-functional.”The reason I say it bails on us every single time is because somebody wants to be in control of the process, and if the process is meant to encourage collaboration and innovation, that person actually becomes a chokehold for it. And it could be somebody that says, like, “Ah, I need to be involved in every single team, and listen to know what's happening, just so I'm aware of it.” What ends up happening is that everybody differs to them. So, there is no collaboration, there is no innovation. DevOps, you say, like, “Hey, we're going to have a team to do everything, so your developers don't need to worry about it.” What ends up happening is you're still an ops team, you still have your silos.And that's always a challenge is you actually have to say, “Okay, what are the cultural values around this process?” You know, what is SRE? What is DevOps, you know? Is it seen as processes, is it a series of principles, platform, maybe, you know? We have to say, like—that's why I say, Platform-as-a-Product because you need to have that product mindset, that culture of product thinking, to really build a platform that works because it's all about the user journey.It's not about building a common set of tools. It's the user journey of how a person interacts with their code to get it into a production environment. And so, you need to understand how that person sits down at their desk, starts the laptop up, logs in, opens the IDE, what they're actually trying to get done. And once you understand that, then you know your requirements, and you build something to fill those things so that they are happy to use it, as opposed to saying, “This is our platform, and you're going to use it.” And they're probably going to say, “No.” And the next thing, you know, they're just doing their own thing on the side.Corey: Yeah, the rise of Shadow IT has never gone away. It's just, on some level, it's the natural expression, I think it's an immune reaction that companies tend to have when process gets in the way. Great, we have an outcome that we need to drive towards; we don't have a choice. Cloud empowered a lot of that and also has given tools to help rein it in, and as with everything, the arms race continues.Evelyn: Yeah. And so, what I'm going to continue now, kind of like, toot the platform horn. So, Gregor Hohpe, he's a [solutions architect 00:31:56]—I always f- up his name. I'm so sorry, Gregor. He has a great book, and even a talk, called The Magic of Platforms, that if somebody is actually curious about understanding of why platforms are nice, they should really watch that talk.If you see him at re:Invent, or a summit or somewhere giving a talk, go listen to that, and just pick his brain. Because that's—for me, I really kind of strongly agree with his approach because that's really how, like, you know, as he says, like, boost innovation is, you know, where you're actually building a platform that really works.Corey: Yeah, it's a hard problem, but it's also one of those things where you're trying to focus on—at least ideally—an outcome or a better situation than you currently find yourselves in. It's hard to turn down things that might very well get you there sooner, faster, but it's like trying to effectively cargo-cult the leadership principles from your last employer into your new one. It just doesn't work. I mean, you see more startups from Amazonians who try that, and it just goes horribly because without the cultural understanding and the supporting structures, it doesn't work.Evelyn: Exactly. So, I've worked with, like, organizations, like, 4000-plus people, I've worked for, like, small startups, consulted, and this is why I say, almost every single transformation, it fails the first time because somebody needs to be in control and track things and basically be really, really certain that people are doing it right. And as soon as it blows up in their face, that's when they realize they should actually take a step back. And so, even for building out a platform, you know, doing Platform-as-a-Product, I always reiterate that you have to really be willing to just invest upfront, and not get very much back. Because you have to figure out the whole user journey, and what you're actually building, before you actually build it.Corey: I really want to thank you for taking the time to speak with me today. If people want to learn more, where's the best place for them to find you?Evelyn: So, I used to be on Twitter, but I've actually got off there after it kind of turned a bit toxic and crazy.Corey: Feels like that was years ago, but that's beside the point.Evelyn: Yeah, precisely. So, I would even just say because this feels like a corporate show, but find me on LinkedIn of all places because I will be sharing whatever I find on there, you know? So, just look me up on my name, Evelyn Osman, and give me a follow, and I'll probably be screaming into the cloud like you are.Corey: And we will, of course, put links to that in the show notes. Thank you so much for taking the time to speak with me. I appreciate it.Evelyn: Thank you, Corey.Corey: Evelyn Osman, engineering manager at AutoScout24. I'm Cloud Economist Corey Quinn, and this is Screaming in the Cloud. If you've enjoyed this podcast, please leave a five-star review on your podcast platform of choice, whereas if you've hated this podcast, please leave a five-star review on your podcast platform of choice, and I will read it once I finish building an internal platform to normalize all of those platforms together into one.Corey: If your AWS bill keeps rising and your blood pressure is doing the same, then you need The Duckbill Group. We help companies fix their AWS bill by making it smaller and less horrifying. The Duckbill Group works for you, not AWS. We tailor recommendations to your business, and we get to the point. Visit duckbillgroup.com to get started.

Kate Moyle is a Psychosexual Therapist and EFS & ESSM Certified Psycho-Sexologist, and author of The Science of Sex. In our conversation, we discussed: Most common questions Kate gets asked about relationships or sex from clients The tiny habit that can keep desire and attraction alive in your relationship after the honeymoon phase Prioritizing quality vs frequency when spending time together How to keep sex novel and interesting in longer-term relationships (without making a huge effort) The shocking facts about what happens in your relationship once you have children (and what to do about it) How women and men see sex differently and much more Learn more about Kate: Website: https://www.katemoyle.co.uk/ Instagram: https://www.instagram.com/katemoyletherapy The Science of Sex: https://www.amazon.com/Science-Sex-Every-Question-Answered/dp/0744069602 If you enjoy the podcast, would you please consider leaving a short review on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Apple Podcasts/iTunes⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ and a rating on our ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Spotify show⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠? It takes less than 60 seconds, and it really makes a difference. Past guests on Growth Minds include: ⁠⁠⁠⁠⁠⁠⁠⁠⁠Robert Kiyosaki⁠⁠⁠⁠⁠⁠⁠⁠⁠ (Rich Dad Poor Dad), ⁠⁠⁠⁠⁠⁠⁠⁠⁠Steve Aoki⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠Robert Greene⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠Dr. Jason Fung⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠Dr. Steven Gundry⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠Neil deGrasse Tyson⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠Dennis Rodman⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠Wim Hof⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠Robin Sharma⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠Vanessa Van Edwards⁠⁠⁠⁠⁠⁠⁠⁠⁠, ⁠⁠⁠⁠⁠⁠⁠⁠⁠King Bach⁠⁠⁠⁠⁠⁠⁠⁠⁠, Daniel Pink, Dr. William Davis, Doctor Mike, Lewis Howes (School of Greatness), Tom Bilyeu (Impact Theory), Andrew Yang, Dr. Paul Conti, Charles Hoskinson (Ethereum), Dr. Drew (After Dark), Jo Koy, Jordan Belfort (Wolf of Wall Street), Gad Saad, Adam Carolla, Louis the Child, Vishen Lakhiani (Mindvalley), Bret Weinstein (DarkHorse Podcast), James Nestor, Dave Rubin, Scott Adams (Real Coffee with Scott Adams), and more.

The FDA is certainly staying busy as 2023 comes to a close, approving three treatments for patients with cancer last week alone. Additionally, exciting study findings were released regarding a cancer vaccine for the treatment of melanoma. FDA Approves Iwilfin for High-Risk Neuroblastoma in Adults and Children The FDA approved has Iwilfin (eflornithine) for the treatment of adult and pediatric patients with high-risk neuroblastoma who have shown at least a partial response to a previous multiagent modality therapy, which includes anti-GD2 immunotherapy. Notably, the FDA reported that this drug is the first approval of a therapy used to reduce the risk of relapse in children with high-risk neuroblastoma. Neuroblastoma, as the National Cancer Institute explained on its website, is a cancer of immature nerve cells that most typically occurs in children, and often begins in the adrenal glands. The FDA said the major efficacy outcome measure behind the approval was event-free survival (EFS; time after treatment when cancer does not come back or worsen; disease progression), while other notable findings included overall survival (OS; length of time from diagnosis or start of treatment when a patient is still alive). FDA Approves Welireg for Advanced Kidney Cancer Subtype The FDA approved Welireg ((beluztifan) for patients with advanced renal cell carcinoma (RCC) who have been previously treated with a programmed death receptor-1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitor, and a vascular endothelial growth factor tyrosine kinase inhibitor (VEGF-TKI). The approval was based on findings from the LITESPARK-005 trial. Trial findings presented earlier this year at the European Society of Medical Oncology Annual Congress (ESMO) showed that at a median follow-up of 18.4 months, patients treated with Welireg experienced objective response rates (patients whose disease responded partially or completely to treatment) of 21.9%, compared with 3.5% among patients treated with Afinitor (everolimus), and 12-month progression-free survival (PFS; the time a patient lives without their disease spreading or worsening) rates were 33.7% on Welireg versus 17.6% with Afinitor, and 18-month PFS rates were 22.5% and 9%, respectively. FDA Approves Padcev-Keytruda Combo in Advanced Bladder Cancer The FDA has additionally approved Padcev (enfortumab vedotin-ejfv) plus Ketruda (pembrolizumab) for patients with locally advanced or metastatic bladder cancer. Alongside this, the FDA previously granted an accelerated approval for this patient population who are unable to be treated with cisplatin-containing chemotherapy. In the recent EV-302/KN-A39 trial, both OS and PFS showed significant improvements among the Padcev plus Keytruda group of patients, as the median overall survival for these patients was 31.5 months, while a cohort treated with chemotherapy experienced a median OS of 16.1 months. Regarding progression-free survival, the median was 12.5 months for the Padcev-Keytruda combination group and 6.3 months in the chemotherapy group. Cancer Vaccine Plus Keytruda Reduces Risk of Recurrence or Death in Melanoma Patients with advanced-stage melanoma continue to experience reduced risk of recurrence or death following treatment with a combination of mRNA vaccine mRNA-4157 (V940), an investigational individualized neoantigen therapy (INT), and Keytruda, according to recent study findings. The mRNA-4157 (V940) and Keytruda combination reduced the risk of recurrence or death by 49% and the risk of distant metastasis or death by 52% when compared with treatment with Keytruda alone in patients with stage 3 or 4 melanoma with high risk of recurrence following complete resection, as determined by the phase 2b KEYNOTE-942/mRNA-4157-P201 study, according to a news release from drug manufacturers Moderna and Merck. The latest findings, from a median planned follow-up of approximately three years, build on previously announced primarily analysis data from a median planned follow-up of approximately two years which showed that the combination reduced the risk of recurrence or death by 44% and the risk of distance metastasis or death by 65% when compared with Keytruda alone. Based on the trial's findings, the Food and Drug Administration (FDA) granted Breakthrough Therapy Designation to the combination for the post-surgical treatment of patients with high-risk melanoma earlier this year. Moderna and Merck have also announced the phase 3 INTerpath-001 (V940-001) clinical trial to evaluate the combination as an adjuvant treatment for patients with resected, high-risk stage 3B to 4 melanoma, which is currently enrolling participants, as well as a phase 3 trial for the treatment of patients with non-small cell lung cancer treated with the combination regimen. For more news on cancer updates, research and education, don't forget to subscribe to CURE®'s newsletters here.

Bienvenue à l'épisode #319 de Coram Deo présenté en partenariat avec Publications Chrétiennes qui vous recommande deux livres livres - Stuart Olyott, Les trois sont un de (https://publicationschretiennes.com/products/les-trois-sont-un-ce-que-la-bible-enseigne-sur-la-trinite) - R. C. Sproul, Qu'est-ce que la Trinité(https://publicationschretiennes.com/products/quest-ce-que-la-trinite) ➡️ DESCRIPTION: Alors que nous approchons de Noël et que nous réfléchissons à l'incarnation, nous voulons revenir sur une controverse récente dans les milieux évangéliques: la soumission éternelle et fonctionnelle du Fils de Dieu (EFS). Avec mon invité Michaël St-Amour, nous situerons le contexte de cette controverse avant d'examiner les enjeux qui y sont impliqués. QUESTIONS: 1. Peux-tu nous parler de ton arrière plan comme témoin de Jéhovah avant de devenir chrétien et de l'importance de la doctrine de Dieu dans ton cheminement? 2. Peux-tu situer pour nous la controverse de la soumission éternel du fils (EFS)? Qui? Quand? Quoi? 3. Quels sont les enjeux de cette question d'après les deux points de vue en litige? 4. De quelle façon est-il orthodoxe d'exprimer la soumission du Fils au Père ? 5. De quelle façon peut-il être légitime de comparer les rôles homme/femme à l'ordre trinitaire? Hors-propos: 48:44 (Comment passes-tu le temps des fêtes?) Bêtisier: 51:25

ADHD makes it harder to convert intentions into actions. Ari Tuckman, Psy.D., MBA, outlines a more useful way of thinking about executive functions that involves tweaking your environment, choosing the right tools, and other ways to externalize EFs. Free Resources on Executive Functions and ADHD: Download: Is It Executive Function Disorder? Read: 7 Deficits Tied to ADHD Read: ADHD Minds Are Trapped in Now (& Other Time Management Truths) Access the video and slides for this episode here: https://www.additudemag.com/webinar/executive-function-strategies-time-memory-adhd/ Thank you for listening to ADDitude's ADHD Experts podcast. Please consider subscribing to the magazine (additu.de/subscribe) to support our mission of providing ADHD education and support.

In this enlightening episode of "Aspire to Lead," your host, Joshua Stamper, welcomes Mitch Weathers, an esteemed expert in education and the author of the groundbreaking book, "Executive Functions in Every Classroom." Mitch's extensive experience and insightful research have positioned him as a leading voice in the realm of executive functions and their profound impact on educational success. Join Joshua and Mitch as they explore the critical role of executive functions in every classroom, from kindergarten to higher education. Executive functions are the cognitive skills that allow us to manage our thoughts, actions, and emotions effectively. In this dynamic conversation, you'll gain a deep understanding of how these functions shape students' academic and personal development. Learn how enhanced executive functions can positively influence academic performance and overall well-being, and explore how his new book provides an invaluable resource for educators seeking to unlock the potential of their students. Mitch's expertise is not just theoretical; it's grounded in the tangible improvement of students' lives. Don't miss this compelling episode that promises to reshape your perspective on education and equip you with the tools to make a real difference in the lives of your students. In this episode, we discuss: Executive functioning skills (EFs) modeled in the classroom The power of organization, shared routine, and habits And his new book “Executive Functions For Every Classroom” Pre-Order this wonderful NEW book, Executive Functions For Every Classroom: https://organizedbinder.com/book/ About Mitch Weathers: Mitch became a gifted teacher because he was a mediocre student.  Mitch rarely felt comfortable in the classroom. In fact, it took him 7 years for him to graduate from college.  Choosing to become a teacher, Mitch was fortunate enough to experience school as if it was happening all around him. He was unsure how to jump into his learning with confidence. There is a loneliness to experiencing your education as a passive object as opposed to an active subject.  From the moment he entered the classroom Mitch relied on his personal experiences as a learner. He recognized that what we teach, the content or curriculum, is secondary. We must first lay the foundation for learning before we can get to teaching.  Mitch designed Organized Binder to empower teachers with a simple but research-backed strategy to teach students executive functioning skills while protecting the time needed for content instruction. The secret is found in establishing a predictable learning routine that serves to foster safer learning spaces. When students get practice with executive functions by virtue we set them up for success.   Follow Mitch Weathers: Website: www.organizedbinder.com ...