Podcasts about GLP

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/Podcast/case-conversation-t2dm-part-2 Overview: In the context of a clinical case, faculty will emphasize the importance of developing a guideline-directed diabetes care management plan that places GLP-1 RA therapy before insulin.

Are you an Accredited Investor that's tired of getting crushed by paying so much in income tax? Find out how we're helping others like you keep Uncle Sam out of your pocket. Click the link HERE.  Going Long Podcast Episode 249: Understanding The Fundamental Problem with Qualified Plans (To see the Video Version of today's conversation just CLICK HERE. ) In today's solo show you'll learn the following from Billy himself:   [00:20 - 01:56] Show introduction with comments from Billy. [01:56 - 03:01] Billy shares an honest written review from a GLP listener with the whole Going Long family. [03:01 - 10:31] Billy explains the concept of what a Qualified Plan is, and then also what could be seen as a fundamental flaw in Qualified Plans, and therefore why you might want to choose a different investment route. [10:31 - 11:12] A summary of what we've learned today, and Billy shares a resource to help you on your journey to investing success. [11:12 - 08:17] Billy wraps up the show.   To see the Video Version of today's conversation just CLICK HERE.   How to leave a review for The Going Long Podcast: https://youtu.be/qfRqLVcf8UI    Start taking action TODAY so that you can gain more Education and Control over your financial life.   Are you an Accredited Investor that's tired of getting crushed by paying so much in income tax? Find out how we're helping others like you keep Uncle Sam out of your pocket. Go to https://www.firstgencp.com/goinglong   Be sure to connect with Billy!  He's made it easy for you to do…Just go to any of these sites:   Website: www.billykeels.com Youtube: billykeels Facebook: Billy Keels Fan Page Instagram: @billykeels Twitter: @billykeels LinkedIn: Billy Keels

[CE contact hours--see below.] Often prescribed for obesity, SGLT2is and GLP-1 RAs have a role in heart failure management. Learn about their mechanisms of action, and how their use extends beyond weight loss to cardioprotective and renalprotective properties. Guests: Kim Newlin, MSN, ANP, FPCNA, of Sutter Roseville Medical Center in Northern California, and Colleen McIlvennan, PhD, DNP, ANP, FAHA, FHFSA, from the University of Colorado in Denver. CE Link: https://pcna.net/?p=10718&post_type=online-course&preview_id=10718 2022 AHA/ACC/HFSA 2022 Guideline for the Managment of HF: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063Pocket Guide: Guidelines for Managing CVD Risk in Patients with Diabetes: https://pcna.net/clinical-resources/provider-tools/diabetes-provider-tools/HF Pocket Guide: A Guide to Prevention and Management: https://pcna.net/clinical-resources/provider-tools/heart-failure-provider-tools/ New and Emerging Treatments for Heart Failure: HFrEF and HFpEF (CE course): https://pcna.net/online-course/new-and-emerging-treatments-for-heart-failure-hfref-and-hfpef/ SGLT2is in Heart Failure: ncbi.nlm.nih.gov/pmc/articles/PMC8654149/SGLT2i in HFpEF: multicenter randomized trial: nature.com/articles/s41591-021-01536-xEmpagliflozin in HFpEF: https://www.nejm.org/doi/10.1056/NEJMoa2107038#:~:text=Empagliflozin%20in%20HF%20with%20Preserved%20Ejection%20Fraction&text=Sodium%E2%80%93glucose%20cotransporter%202%20(SGLT2,and%20a%20reduced%20ejection%20fraction. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In adult learning settings, we've seen that “sit and get” rarely works to help adults gain the knowledge they need to succeed. To understand what the latest in brain science tells us about why a traditional approach often fails adults, we talk to LaDonna Pavetti, Vice President for Family Income Support Policy at Center on Budget & Policy Priorities (CBPP). LaDonna shares the critical role that Executive Function skills play in how we learn. She explains how, as designers of learning experiences, we often underestimate what it takes for our learners to absorb and be able to use new information. Listen to this episode for insights on how to apply the latest in brain science to your approach to learning and teaching.   Read the transcripts for the episode on our website.

American Invents Act Has Destroyed Innovation - Cops want to keep mass surveillance app secret; privacy advocates refused - Hackers Hide Malware in Stunning Images Taken by James Webb Space Telescope - TikShock: Don't get caught out by these 5 TikTok scams - Ukrainian Police Bust Crypto Fraud Call Centers Well, the birds are coming home to roost. Well, not the chickens in this case, but this is called the death warrant for American ingenuity. We'll start by talking through this great article from this week's newsletter. [Automated transcript follows.] Well, I hate to say this, but in reality, we are looking at some very, very bad times for inventors, and I've had some of these problems myself before, but last September, there were scores of patent holders who demonstrated in six cities across the US. [00:00:34] They had on these black t-shirts that said homo sapiens, inventor. Endangered species. They were protesting America's decade of stolen dreams. Great article here in the American thinker. It was in my newsletter this year, or excuse me this week, but, uh, but here here's weirdly what happened here. Back in 2011, president Obama pushed through Congress and signed into law. [00:01:04] What they called the America invents act. Now just like the inflation reduction act is going to increase inflation, right? It's all double speak. Isn't it? The American invents act turned over the patent process basically to the biggest Democrat party donors. Big business billionaires, right? Because that's who really is funding them, the Hollywood millionaires, these massive billionaires, Zuckerbergs and, and others. [00:01:35] And what happened here? Is they changed the whole patent law and the basis for it. They flipped the table here, basically. Here's the idea behind the patent law that we've had in place in the United States for well, over a century and patents that are guaranteed in the cons. It used to be that you, if you were first to invent something, if you could show that you were first to invent something, you could file a patent and gain that patent. [00:02:14] Well, what happened is because of all of the donations that went into the Democrats in 2011, from these big, big companies that were lobbying. A, and this is part of the reason I have a huge problem with all this money going to Washington DC, frankly, because it just attracts rodents like these big companies that want to use the law to control you, to gain profit for them. [00:02:39] And really in this case, squash. Potential patent holders. You see there have been piracy for years in the patent field. And this happened to me. I spent a year of my life designing some software, writing some software that emulated an older computer system and allowed you to take. Any of that software and run it on the new system. [00:03:05] And it would run exactly the same way. And a lease on the new hardware was cheaper than just a maintenance contract on the old stuff. Plus it was faster, used less electricity, had more options, et cetera. Right. It was, it was really something, frankly, and I was invited to their headquarters to show them a little bit about. [00:03:27] Did, and, and I was so excited because they wanted to start selling it, right. So they need to understand a little bit better. So I went to the headquarters and met with them, you know, of course paid my own way. Flew down there, stayed in the hotel, rented a car, you know, all the stuff that you have to do. [00:03:43] And then nothing happened afterwards. Wouldn't return phone calls. It just, all of a sudden went silent. And then about a year and a half later Tata, they had an alternative product out on the. . Yeah, and they tried to emulate what I had done, but they did a very, very poor job at it. That's patent theft, that's piracy in this particular case, uh, if you are an inventor, you've probably experienced that sort of thing before, you know, you can put employees all of the non-disclosure agreements you want to have in place, but in reality, good luck enforcing those, especially against a big company. [00:04:25] Well, piracy went on steroids because of president Obama's America and events act. They, as part of that established something, they called the patent trial and appeal board. And it's just gone downhill ever since. So a professor that has more than 40 patents, I'm gonna read a little quote of his, this includes some inventions used in the space shuttles, by the way, which by the way, my invention was used with the space shuttle. [00:04:57] Um, so Dan brown invented something called the bionic wrench. I have one of those. I bought one of those some years back, this is a one size fits all wrench that does not strip bolt corners like it does if you're trying to use vice scripts or some pair of pliers, right. Because you're just too lazy to go and get the right socket size or box wrench or whatever it is. [00:05:22] That's the right size. It very, very. And professor brown says that Sears stole his idea for this bionic wrench right down to the marketing pitch. And then Sears, according to him, went out and hired a Chinese company to make it. And all of a sudden now, what kind of invention does he have? How's he gonna battle somebody like that? [00:05:49] I know a guy who is, uh, completely unethical. You know, I've done many shows from the consumer electronic show and it's really kind of cool, cuz I would get in depth with the inventors and, and explain what they were doing on the air. It was really neat all the way around. It was just a whole lot of fun. [00:06:08] And I met a guy there who was going to the consumer electronic show to find cool new consumer electronics. He thought might be popular. And then he'd go and talk to the people who were exhibiting that wonderful new electronics and say, Hey, I'm interested in, in selling your stuff. I have, you know, retail space and, uh, you know, kiosks in the mall. [00:06:33] What can, uh, what kind of deal can we work out here? Well, you know, first I, can I, let me get a, I, I need a copy of, uh, of your device here. I want a copy of it so I can mess with it and see, see if we really wanna follow through on. Oh, and I, I don't want to carry it around the floor of the consumer electronic show. [00:06:51] So I need you to ship it to me. So they'd ship 'em off. They might be a little speaker. They might be a charger. They might be who knows what? And consumer electronics is pretty broad. And if he liked it, he wouldn't buy it from them. He sent them over to his contacts in China. And had them reverse engineered and make the same thing with his brand label on it. [00:07:16] And he'd sell it in the stores. Now, when it comes to software and a lot of consumer electronics patents, aren't really a big deal because things. Changed so quickly. Right? And if you're a small guy, it's very hard to file a patent. And that's how president Obama sold this American Bens act to us. I remember this very, very clearly where he said, Hey, listen, this is gonna make the patent process way more streamlined, way easier for the small guys to be able to get patents, uh, not only applied for, but actually get them out to market. [00:07:52] And it's just gonna be an absolutely wonderful. It, it isn't because what happens now? Is big companies are not investing in research and development. That is true across the board. Now you might say, Hey Craig, well, how about big companies? How about Tesla? That's R and D. How about SpaceX? That's R and D. [00:08:14] Yes, but they are R and D companies. They're not big companies out there like Facebook, does Facebook try and come up with this or that new invention? Well, yeah, they kind of do from time to time, but most of the time what's been happening is corporate America looks for a winner. And then tries to buy the winner. [00:08:35] Microsoft has been doing that forever. Microsoft in court has lost cases because of what they did to inventors. And now it's been codified in law for over 10 years. So our American ingenuity, which is what we rely on in order to grow our economy, the ingenuity, the, the brain skills, the science, the true science that we have gives us a major competitive advantage because that particular, uh, type of intellectual property has a much higher profit margin than something like manufacturing a widget. [00:09:14] When you get right down to it, that's where the real money is. so a very interesting article and I would suggest you take a little bit of time to read it. If you've ever thought about patenting something, if you had a great idea, it used to be, you know, this is kind of the, the, uh, old wives tale. If you will, if you've got a great idea, you think you might wanna patent it, write it all out, take all of your notes, do it in a, a, a workbook that you can. [00:09:43] Alter right. You can't tear out pages or things. Uh, mail it to yourself in a Manila envelope and make sure you put stamps on it. And then the post office is going to date, stamp it for you or send it to your attorney even better. Right. And your attorney's gonna go ahead and keep that on file. And then when it's time to file the patents, you can say, Hey, look, it here's the proof. [00:10:06] I invented this in April of 2019. It doesn't matter because if some other company sees what you're doing or comes up with a similar or the same idea, and that company has the money to have the lawyers that know patent law inside out and backwards and can go ahead and file that patent claim. You've lost it. [00:10:31] you know, as early as the constitutional convention of 18 or 1787, our founding fathers recognize the need to promote innovation and we have to be promoting it. We've gotta get rid of this Obama era law. Absolutely. We've gotta go from first to file, which is what it has been for a decade. The first person to file you. [00:10:54] And move back to the way it was intended, the way it worked for well over a hundred years where it is a first to invent, it's very, very important for all of us, for economy, et cetera. The, the third law of Congress was a patent act of 1790. It it's just man, have we come a long way, stick around. We'll be right back online. [00:11:19] Craig peterson.com. [00:11:22] You know, we've had firewalls in our cars for a very long time for a very good reason. Right? You wanna keep the engine stuff out of the passenger compartment? The same thing is true. When we're talking about our networks, we're using firewalls to keep things out. [00:11:39] Firewalls are there to keep things out. And we have firewalls in our homes. [00:11:44] If you've got an internet service provider, you've probably got a firewall right there. Something that you don't even think about, right. It's just, there's gonna protect. You, it might, it's providing some services. You might be familiar with them. It's obviously doing a network address translation for you in this day and age. [00:12:06] Pretty much everything is especially with the internet transition that's been going on for years now from, um, IP four to IP six, but, uh, the firewall. is critical for every person and every business out there. But when we get into the configurations of firewalls, frankly, they are really a touchy subject. [00:12:29] You know, every network security professional has their own preferred hardware and software, uh, use Cisco. As a rule, Cisco has some great stuff. What I like the best about the Cisco equipment that we use in software and install at our clients is it is one pane of glass. It's a single vendor that covers everything from endpoint security. [00:12:54] In other words, security on your desktop, through the network itself, the switches, the firewalls, the email filters Absolut. Everything is there and is taken care of by all of the Cisco gear. It it's really quite something to look. I saw, in fact, a survey just last week at businesses who are trying to consolidate, there's just too many vendors in there selling this piece of endpoint, that piece of endpoint. [00:13:25] And, you know, that's part of the problem that I see happen pretty frequently, which is people look at Gartner report. Gartner, of course, a research company. They've got a lot of great research out there that I've used before. I've had Gartner on the radio show before, as well as some of their competitors talking about trends. [00:13:44] Well, There is something known as the upper right quadrant in those Gartner reports where they are rating various vendors for various pieces of software. So there might be for instance, a report on firewalls and the upper right hand cor quadrant is kind of what you want, cuz it's new, it's innovative. It, it innovative. [00:14:06] It's uh, really cool and wonderful. And it's the best. Since life spread. So they go out and they buy that cuz it's upper, right. Gartner quadrant. And then man, they find out, uh, okay, so now we need desk desktop, desktop. Okay. So they find the or buy actually the Gartner report for five to 10 grand. That's like a page long is crazy how expensive these things are. [00:14:32] They then look at that and say, okay, so the best desktop is vendor Y so let me see, we got X for the firewall. We've got Y for the endpoint and then, oh, they need switches. So let's go to the Gartner report. Who's in the upper right quadrant here for switches. Oh, it's uh, vendor Z. Okay. So we got Z. So now all of a sudden. [00:14:51] You end up with all of these different pieces of hardware, different pieces of software that have limited offerability at best interoperability at best. Right? So the, this day and age, when we're talking about cybersecurity, There are so many legitimate attacks every day. I mean, thousands of attacks going on even against a single business. [00:15:18] And there are hundreds potentially of false alarms every day. So how do you deal with that? That that's a good question. So, uh, a lot of businesses turn to companies like mine now, you know, full disclosure, I've been doing internet security work for businesses since, uh, early 1990s. So whew, 30 years now. [00:15:40] And I've been doing internet work for even longer than that, helping to develop it. So they'll go and they'll say, Hey, we need a managed security services provider. Uh, there's a big problem with that. And I, I was watching, uh, Yellowstone that TV show and I, it was a great little example of what we're seeing in the world today. [00:16:05] And Frank, frankly, we've seen forever obviously. And that is if there's a demand for something, all of a sudden, a lot of people will be hanging up shingles. and if they know, if that vendor knows more than you do, or is able to kind of turn, twist your ear and convince you to buy from them, you'll buy from them. [00:16:26] We saw that man around the year, 2000, all of the people who were trying to sell web services that had no idea what they're doing now, we're seeing all kinds of people trying to sell network services, security services that have little idea of what they're doing. We support. These companies that call themselves manage security services providers, where we actually go in, we design the system, we build the system and we implement the system. [00:16:53] We run the system and the third party here builds the client. Right. Cuz it's their client. And you know, that's all fine. It's so well and good, but what should you be looking. Particularly if you are a business, if you want to have a managed firewall, which is, I think important again, it's kind of a long tail thing to have a firewall vendor and, uh, this vendor and a managed vendor, and now it can get to be a headache pretty quickly. [00:17:23] But if you're going to focus on one thing, It's probably the firewall and your end points. Right? So maybe it's two things. So here's what a managed firewall service provider should be able to offer you. First of all, firewall system health and alerting. Software life cycle management, which means your updates, your patches, service, and incident management. [00:17:48] Whenever there's an alarm, they should know about it and they should be handling it. Security policy implementation your reporting, your analysis, your remediation, some of that is required by these various regulations and laws that are out there. You. To do it, uh, you know, without getting in a lot of detail right now, um, network monitoring, uh, the traffic monitoring, you know, the idea here behind any kind of managed service is to bring in a true expert rather than just completely outsourcing. [00:18:24] So you're partnering with someone. One of the things I've, I've bated my head against the wall for, for decades now, is that the it department. Thinks that they're up to snuff to be able to do something, or maybe they just want to do it because it's gonna be wonderful for them on the resume for the next job. [00:18:45] Right. Uh, man, I've seen that a lot of times when, when you are looking at all of this stuff and you've got an it department, maybe you're better off bringing in a very narrow expert to support your it department rather than fight against your it depart. good questions here. Uh, bottom line, they should have better expertise than what you have. [00:19:11] And you've got to read between the lines between your it staff that are currently doing it and the other vendors reducing the burden on your staff. So that maybe what they can do is. Focus more on things that are, uh, revenue generating that are more important to your business. You'll get faster incident response with any luck here. [00:19:33] With service level agreement, proactive security from the managed security services providers, or just regular service providers. Your burden on updates is going to be lower, improved manufacturer support. Because a lot of times, like we do my company mainstream, we have direct connections to the manufacturer. [00:19:56] Our case is usually Cisco because of the volume or services that we have and the equipment that we buy from them, uh, easier to scale there. There's a whole bunch of things, right. Uh, But be careful. One of the things you gotta watch out for too is where are their service people, their support people physically located, and are they us citizens? [00:20:20] A lot of the regulations. In fact, pretty much everyone. I can't think of an exception require us persons to be the ones in control of your network and data. So lots to consider. But keep that all in mind. I think it's an important thing to understand. Stick around. We'll be right back. And in the meantime, visit me online. [00:20:42] Craig peterson.com and sign up for my free newsletter. [00:20:49] The best way to secure a system is something, you know, and something you have, well, many systems have been securing themselves with your phone, right? They send you a text message, but it turns out that that isn't working well. [00:21:05] Having an SMS message sent to you in order to authenticate who you are, has turned out to be well, a problem we've seen over the last few years, people who have things like cryptocurrency who have a cryptocurrency wallet who are keeping their money, if you will, in this wallet and are using. [00:21:30] SMS to verify who they are. So here's how that works. You log into a website using a username or perhaps an email address. Again, it should not be asking for an email address for a login because you probably use the same email address or maybe two or three. And. Have for what? 50, a hundred different sites, maybe a thousand, I've got 3000 records, uh, logins on my one password account. [00:22:02] Okay. So there's a lot of them. They really should be letting you set up your own username so that it can be unique. For every single website that you go to. So, but anyway, that aside, you've got your username, which may be your email address. You've got a password and we've talked about passwords before. [00:22:21] Hopefully you're following the current guidelines, which are, don't worry about random characters, make sure it is long. And that means. A past phrase. So you string three or four words together. You put some digits, some special characters in between the words, maybe, you know, one word is all upper case. You, you play with it a little bit, but it's easy to remember. [00:22:48] So if someone then gets your email address and they get your password, they can potentially log into a website. Correct. And that website might be your bank account. It might be your work account. We've had a lot of problems lately. The FBI is saying that about every 12 hours, they're filing a new report of a company that got their intellectual property stolen. [00:23:22] one of the ways the bad guys steal it is they'll log to your RDP server, your Microsoft remote desktop server, using your credentials that you used at another website. It's that easy. It really is. They might be trying to log in via a VPN again, the same thing. So how do you secure this? How do you secure this? [00:23:47] Well, how to secure this properly? That's where the something you have comes into play. We all have a smartphone of some sort, even if it's not considered a smartphone, it can still receive text messages. So what a lot of these companies did is they asked their underpaid it people to set it up so that when you enter in your username and your password, it then sends you a text message. [00:24:16] Usually with a six digit text message and you then have to type that into the website as well. Seems pretty good. Doesn't it? Well, and, and in 30 it is pretty good. There are however, a few problems. Those people I mentioned who have cryptocurrency accounts and have been using this SMS methodology, which is SMS, of course, text messages have found that sometimes their phones have been hijack. [00:24:48] easy enough to do. And if they know you have a fair amount of cryptocurrency, it's probably worth their effort to spend a few hours to try and get into your account. And they have been getting into your account and people notice, Hey, wait a minute, I'm a kid. They do phone calls or text messages. What's what's with that. [00:25:07] And you found out that they have dismissed you, they have stolen your. Your, uh, SIM card, basically, even though they don't have to physically have hold of it. And there's a number of ways that they do that there's a new scam or newer scam that's out right now that the fishers are using. And that is they're sending out these SSMS, these text messages that are trying to get people to respond. [00:25:34] So how do they get people to respond? Well, In this case, they're primarily going after this company called Octo Octo post. And, uh, there's a number of different types of Octos out there, but anyways, they are trying to get you to. Do something you shouldn't do let me just put it that way. Right. So what they're trying to do is get you to, uh, enter in your username and your password. [00:26:04] Okay. Well, that's been around for a long time. Craig, you're telling me we've had fake bank account, uh, bank website. So they'll send you an email and in it, they'll say, Hey, I need you to go right now. to our bank page and, uh, authorize this $2,000 transaction that wasn't you. And so now you're freaking out, you click on the link, you go to the bank, you try and log in and the login doesn't work well. [00:26:31] That can be because what the fishers did is a made a webpage that looked like the bank's web page. And when you went there and entered in your username and password, you just gave it to the crooks. That's happened a lot. Well, there's a company called Octa O K T a. That is an authentication company. And what the bad guys have done is they have registered domains similar to a company. [00:26:59] So for instance, they went after CloudFlare, which is a huge, um, company they're number one, I think they have like 80% of all of the protection for denial of service and caching a business on the internet. It's just amazing. Cloudflare's huge. And I've used them and continue to use them for some customer. [00:27:19] So, what they did is they found a whole bunch of people that worked for CloudFlare sent them a message. And, and here's what it said. It said alert, your CloudFlare schedule has been updated. Please tap cloudflare-okta.com to view. The changes. So you go there, it looks like a regular Okta login page and they go ahead and ask user name and password, but CloudFlare is smart. [00:27:47] They're using Okta. So they're sending an SMS message to the user to make sure it's really, them turns out what was really happening is yeah, it was sending that guy a text message and it was using telegram. To relay that his response back to the hackers. So now the hackers have your username, they have your password and they have your six digit login key. [00:28:15] That's supposedly unique that supposedly went to you. And in this case, they didn't even have to bother a hijacking your SIM card. In this case, they just sent you that text message. So it's been causing some serious problems. They've been going after all kinds of different companies out there, uh, food service company, DoorDash you've heard of them. [00:28:37] Right? August 25th, they said that there was a sophisticated fishing attack on a third party vendor that allowed a attackers to gain access to some, a door dashes internal company. Tools DoorDash said, intruders stole information on a small percentage of users that have since been notified, big deal, or what a tech crunch, by the way, reported that the incident was linked to the same fishing campaign that targeted Twilio. [00:29:07] That also, as we just mentioned, targeted cloud. So we have to be careful with this. We cannot be using SMS text messages to authenticate ourselves. Some banks now allow you to use one time passwords from things like one password or others. However, some banks don't turn off the SMS, the text messages for authentication, which they really should be doing. [00:29:36] And the other thing I wanna let you know is I like UBI. Y U B ico.com. Yubico check them out. I'm not making a dime off of this, but they have a physical token. That you either have to plug in or the connects via Bluetooth. That is something you have that authenticates you to all major popular websites out there, and many of the tools. [00:30:03] So if you have any questions, just email me, me@craigpeterson.com gimme a few days, but I'll get back to you. [00:30:12] Have you heard about fog reveal? They it's almost invisible when you search for it online, but it's something that police departments have started using. And they're trying to keep all of this secret. So we're gonna tell you what's happening there and got a few others too. [00:30:29] Great little article that was in the newsletter this week. [00:30:32] Hopefully you got my free newsletter, but it is about fog reveal. This is an ours Technica. Often some of these ours Technica stories are carried in multiple places online. It's kind of interesting because we know to some degree what the federal government's doing to collect information on people, they go to open source. [00:30:57] Sources of information. In other words, things that are put out there publicly online, so they might search you your Facebook information or what you've been saying on Twitter, uh, or more, they go to data brokers that anybody can go to. And those data brokers have more information. They probably. Bought records from the states and they know from each individual state what property you own. [00:31:25] If you have a car, if there's liens on it, any mortgages that you might have, right. Putting all of the stuff together. It's kind of an interesting problem, frankly, but that's a, again, they say it's legitimate. Now the federal government is not allowed to collect this information. So they just go to third party data aggregators. [00:31:45] And remember again, If you have apps on your phone, if you have an Android phone, this does not apply to iPhones. Generally it does apply to iPhone apps. However, but, and this is part of the reason I say never, ever, ever use Android. Okay guys, I, I just. Blows my mind. I, I was talking to an old friend of mine. [00:32:09] Uh, he was the, the CTO in fact for the state of New Hampshire. And he was telling me that, uh, you know, we were talking and telling me, yeah, yeah, I got an Android phone. He says, don't you just love Android? And he knows that I do cybersecurity. He knows I've been in it. He hired my company to do a bunch of different tasks for the state, right over the years, we still do business with the state and he's using Android. [00:32:41] He's probably listening right now. BU get a little note from him, but, uh, it, it, it's a problem to use Android any. Those free apps that you're using, that Google maps app that you're using. And of course you can use that on iOS as well is tracking you. They know where you live because they know where your smartphone stays at night. [00:33:04] They know all of this stuff. How do you think the FBI is able to seize a smartphone at a Hardee's drive through. they know where you are. Well, they have some more access to information as it turns out. Uh, one Marilyn based Sergeant, according to the article wrote in a department, email TDY, the benefit of quote, no court paperwork and quote before purchasing the software. [00:33:37] And the Sergeant said the success lies in secre. interesting. So the electronic frontier foundation, FF, who I have supported over the years and the associated press got together. Now, the associated press won a Pulitzer center for crisis reporting, uh, award, I think. But anyways, the Pulitzer center for crisis reporting also got involved here. [00:34:05] So she had these three different organizations trying to figure out. what could, or what would be considered local places best kept secret. So they went online. They started doing some searching, trying to figure this out. And according to ours, Technica, the reporting revealed the potentially extreme extent of data surveillance of ordinary people being tracked and made vulnerable just for moving about. [00:34:38] Small town America. So it isn't just the big cities where you're tracked anymore. Reports showed how police nearly two dozen agencies. One record shows the total figure could possibly be up to 60. Use Google maps, like technology called frog reveal. now this is licensed by fog. I, I keep saying frog it's fog licensed by fog data science, and it gives state and local police a power to surveil. [00:35:10] Hundreds of billions of records from 250 million mobile devices. And if that doesn't scare you, I don't know what does now FF, the electronic frontier foundation found that fog reveal gets its data from veal. That's the same data source the feds use. neither companies disclosing the nature of their business relationship. [00:35:33] Okay. They fog, reveal. Didn't say what Tel is providing and vice versa, right? Yeah. But it really appears that fog reveal is getting data location services to local police at its steep discount. So it's making it more affordable for smaller police departments and private security companies to access major amounts of data and trace devices across months or even years. [00:36:03] isn't that something. So typically FF found that police agencies license the software annually for costs as low as six grand to nine grand. Some agencies spend even more on this tech to track people as they are moving and exactly where they are. Again, think being in a Hardee's drive through having the FBI show up. [00:36:27] Knowing you're there. Uh, ours reviewed one annual contract in Anaheim, California. That was for more than $40,000. So it took months for these three organizations that are used to digging into this sort of stuff, uh, to figure this out, took more than a hundred public records requests to gather thousands of pages of evidence to trying to compile a picture of how local law enforcement. [00:36:55] Is using and mining the location data. Now, to me, this is scary because we look at abuses of power. Through the years and I it's happened again and again and again, we are smelling more and more like Venezuela than we are free us. It's frankly scary, scary to me, but I'm talking about it cuz I think it's important. [00:37:21] That I bring this to light to everybody else out there. Okay. Now fog data science, managing partner, Matthew Brodrick told the associated press that fog reveal has been critical to police to save time and money on investigations, suggesting police who are under-resourced and investigation suffered from reliance on outdated. [00:37:44] Outdated tech now that's true. Isn't it? But isn't it also true that, uh, that's why we have some of these policies and procedures in place. That's why the Supreme court Miranda decision has some policies and procedures. That's why a warrant, a search warrant is supposed to be specific in what they're looking for and where it is located. [00:38:11] We don't allow these broad warrants that the king used to issue, but we are doing that nowadays. It seems against political enemies and that's where it starts really, really scaring me. It isn't that I think that the, the current administration it, or even the next administration in Washington, DC, is going to be rounding up its enemies and putting them up against a. [00:38:38] But when would it happen? Well, it would happen if everything were in place for it to happen. What's one of the most important things for fastest regime. It's to have a citizenry where they know everything about everyone. It, it reminds me of the Soviet era. Show me the man. I'll show you the crime. There's a great book out there right now. [00:39:04] I think it's called, um, three felonies. a day, I think is what the name of it is. But the, it points out how every last one of the people that call ourselves Americans in the United States of America, every one of us commits at least three felonies a day. Now a lot of these things are just absolutely crazy. [00:39:26] You know, there's been a lot of jokes about, oh, did you chair the label off of that pillow? Well, you can cuz you're the consumer, right? It's. The people that are selling it that are in distribution chain that cannot tear that off by law. Okay. But in reality, there is a lot of stuff that could be used against you. [00:39:46] So it it's like when they say, uh, you know, give me this, or why don't you answer that question? It's none of their business. You have a right to be secure in your papers right now, if they have a warrant that's specific, then you need to surrender it. But hopefully the warrant's actually issued by real court. [00:40:08] Some of these agencies now, uh, like the IRS have their own courts that are paid for by the agency. The judges are working for the agency. So you really think they're gonna be fair. I wonder, I wonder. Okay. Couple more things. Next up these pictures taken by the James web space telescope. Have you seen these? [00:40:35] It is amazing. I've seen them side by side with our latest or, you know, our previous high tech pictures. And we're seeing what maybe galaxies that we never could see before. It's just absolutely crazy. Well, guess what bad guys have seen them as. And they are embedding malware inside of some of these amazing images taken by the James web space telescope. [00:41:05] If you can believe this, by the way, they're writing them in go. Uh, so the Phish and emails, they've got a Microsoft office attachment. That's the entry point for the attack chain when you open it, it retrieves and obfuscated, VBA, macro, which in. Auto executed. all of a sudden there is a macro that is de obfuscated and run on your computer. [00:41:34] So be careful careful with that again. And good news. Microsoft is now turning off the execution of macros by default. Double check your machine, making sure that macros are blocked by default. So, yay. Okay. So they are, by the way, changing campaigns to rogue link and ISO files because of the blocked macros. [00:41:56] But, uh, it's good that Microsoft is doing that. Thank goodness. And you Ukraine, the police busted a crypto fraud call center. In fact, more than. And they're also shattering two more Russian bot farms. So we shouldn't be getting as many of those, uh, phone messages from the, uh, the bad guys scammers as we used to get. [00:42:20] Thank you, Ukraine. All right. Online Craig peterson.com. Get that newsletter and stay on top. [00:42:29] Well, we got some election news here from our friends at Google and at Twitter, they are taking opposite directions about exactly how they're gonna handle news postings about the elections. This is an interesting thing. [00:42:46] The federal election commission is the branch of the us government that monitors elections. [00:42:53] It does things like impose fines for misuse of funds. It sets some of the standards for funds and for their use. And. and one of the things it looks at is what are called in kind contributions. This is where someone might, uh, for instance, run a whole bunch of ads on behalf of a candidate. And those ads are coordinated with the campaign and that is illegal. [00:43:24] You're not supposed to do that. And because it's illegal, you know, they try and stop it. But most of the time they end up finding after the fact. And that's part of the reason they want campaigns to be filing their financial reports fairly frequently so they can catch it quite quickly. Well, There have been many complaints from the G O P about what has happened with some of the campaign finance stuff, where you have someone like Facebook or Twitter or Google, who seems to be meddling with the election. [00:44:02] They are running ads for your competition. They are really screening the results from people's searches. And from that those results they're, they're benefiting. There was a study down in orange county here a few years back where they looked at. Google results that were related to the elections going on in orange county and found that the Google results were tainted in such a way that it dramatically favored the Democrats that were running in those districts in orange county, California. [00:44:39] Pretty interesting when you get right down to it. So the GLP says, wait a minute, now that sort of thing is worth millions, tens of millions of dollars, because if they were going to run TV ads, for instance, to get as many eyeballs, to get as much attention to convince people that this is the way they should vote, that would cost them tens of millions of dollars. [00:45:02] So how much is it worth? Where do you go to really straighten things out in order to ultimately make fairness work and well, you know, that's kind of what the federal election commission's supposed to do. Well, here's, what's happening with the next elections. The federal elections commission has decided that Google. [00:45:28] Getting rid of their anti spam measures for. Candidates does not violate a ban on contributions on inkind contributions. So this is an interesting approach because Google's saying, Hey, listen, we want to allow pretty much any political message to come right through to Google Gmail users, inboxes, and not filter those. [00:45:59] Which I frankly think is a smart move on their part. Now some of these campaigns get pretty crazy. They're sending money requests all of the time. It it's been crazy to watch both sides do this and both sides complain about the other side, doing it. But at least by getting rid of these spam rules for the politicians, their messages are gonna get through. [00:46:24] I think that's ultimately a very good thing. So what kind of messages are gonna get through how and why? Well, ultimately they're saying we're gonna let all of them through. and what that means for you. If you already get some of these messages from the politicians, it means your mailbox. At least if it's a Google Gmail box, you are going to be seen even more during elections. [00:46:51] And I think this is gonna go on for very long time. Because Google doesn't want to get caught in the middle. When we're talking about these in kind contributions. If this were to be done for the Republicans or were to be done just for the Democrat, can you imagine the noise that would be made? By both sides and in kind contributions where the Republicans tens of millions of dollars Googled get dull tied up in some of these, uh, you know, lawsuits that would really be inevitable. [00:47:23] Bottom line. Well, Republicans have accused. Google of giving Democrats an advantage in its algorithms. And, and as I said, there have been studies on that that have proved that they have. The big question is why. And there's an article in ours, Technica talking about a meeting that happened in may 20. 22 between Senate Republicans and Google's chief legal officer. [00:47:52] And he said that the most forceful rebuke came from Senator Marco Rubio from Florida who claimed that not a single email from one of his addresses was reaching inboxes. And the Washington post, which of course is a mouthpiece for the Democrat party reported in late July. That the reason it was getting blocked was that a vendor had not enabled an authentication tool that keeps messages from being marked to spam. [00:48:21] Now, if that's true, The Washington post accidentally reported the truth here. And it might be true. I had a company call me up this week. They had their Google ads account banned, and they were trying to figure out the details of why and what happened. And I went in and we solved that problem, and I noticed that they had. [00:48:44] Properly configured their email. There's there's gets technical here. I have a paper we've put together on this, a special report talking about what's called D K I M. These, uh, SPF records DMAR records and how they should all be set up and why I need to use them. So this company was doing marketing. [00:49:04] Obviously they had a Google, Google ad account. They were sending out emails, but because they had not properly and fully configured their email. They were not getting delivered at the rate that they could get delivered. Now that's kind of a very, very big deal when you get right down to it. And the Washington post is saying, well, that's what happened to center to Rubio. [00:49:26] Now there's other things that might happen too. There are. Keywords that are used. There's software called spam assassin. That's very, very common. I have used it since it came out decades ago. I can't even remember how long spam Assassin's been out there, but it looks for certain things in the emails. , it looks for a lot of graphical content, a lot of HTML, even a lot of links and it kind of, it gauges, you know, this is likely spam on this scale. [00:49:56] And typically if the, the score is higher than five or eight, or in some cases, some people said as high as 15, that email is bounced. Well, one of the real big checks as to whether or not this is legitimate email is to check and see. Who is the domain? Does that domain have these special keys that tell us? [00:50:19] Yes, indeed. This did come from us. In other words, in this case did come from Marco Rubio or in the case of my client, it came from their company.com. And is it signed encrypted so that we know that nobody's kind of playing a man in the middle thing, trying to mess things up on us. And they say, okay, well that's a really good score. [00:50:40] So we will, we'll lower that spam score. And, and that's how that game is played. So what by Google doing what it. Talking about doing it's really gonna help out because I have of every company I've checked for email, email deliveries, we've got a, a new customer that is a startup and you know, what do they know? [00:51:02] They they're very narrow. Right? They understand their. Basic technology and their email again, was set up kind of like apparently Senator Rubio's email was set up and, and didn't have these things. And just like this company that I helped this week, they didn't have it set up properly. And, uh, they had experts who supposed experts who had set it up, but both cases, right. [00:51:26] It was outsourced. Yeah. You know how that goes. Now, some Gmail users submitted comments to the federal elections commission and they were criticizing Google's plan cuz they did not want to get more spam. Okay. And there were more than 2,500 comments. You can find them by the way, online, all of the stuff is a matter. [00:51:48] Public record and they call it the docket. And so there's a page out for this particular docket and the commissions through Republicans and Democrat commissioner voted for the order appro Google's plan. I think this is a very, very good deal. And it's really kind of the opposite of what Twitter is planning on doing Twitter has. [00:52:12] essentially announced that it's going to. In the elections. Yeah. So you got Google on the one side saying our hands are clean. We're staying away from this. We don't want anything to do with this. Thank you very much. We love you, but, uh, forget about it. We're just gonna let all the emails. Through, Twitter's saying that it's going to have its wonderful sensors who have been proven right. [00:52:39] Every time he said with his tongue firmly planted in his cheek, and they're gonna have those wonderful sensors that, you know, they're sitting in the basement and, and eating pizza and drinking Coke or red bull. I, I still kinda understand why somebody that's 30, whatever years old needs, energy drinks, you know, come on, come on. [00:53:00] Uh, but anyways, They're they're saying that they, Twitter is going to be the determiner as to whether or not something that is posted on Twitter is correct. Or if it should be censored or if it should be blocked entirely. And they're admitting that they're gonna shadow ban conservative content, they don't like isn't that. [00:53:25] So. Yeah. Uh, that's from the gateway pundit good article. And you'll find it in this week's newsletter. Uh, I think it went out Monday this week and you can follow the link through to these articles on Google and Twitter and the elections or any of the others that we have out there. So stick around, we'll be right back and make sure you sign up. [00:53:46] If you didn't already get that newsletter. Absolutely free. Craig, Peter son.com/subscribe. [00:53:59] I'm not sure a week goes by where I don't hear from a listener saying that somehow Facebook is tracking what they're talking about because all of a sudden ad starts showing up. And they're related to things that they've been talking about. [00:54:16] Meta is the owner of Facebook and Instagram and, and some other things like WhatsApp, which is part of the reason I don't trust WhatsApp, but we've had, I don't know how many complaints from people saying that Facebook is listening in to what they're talking. [00:54:36] And people are kind of wondering, well, wait a minute. Is it listening in on my phone calls? Is it listening when and how? It's a very, very good question. Now Facebook says in a statement that Facebook does not use your phone's microphone to inform ads or to change what in the newsfeed. Some recent articles have suggested that we must be listening to people's conversations in order to show them. [00:55:06] Ads. This is not true. We show ads based on people's interests and other profiled information, not what you're talking out loud about. We only access your microphone if you've given our app permission. And if you are actively using a specific feature that requires audio, this might include recording a video or using in an optional feature. [00:55:30] We introduced two years ago to include music. Or other audio in your status updates. So there it is. There's the official word from our friends over at Facebook. But do you notice there's a little bit of an out in there, right? Facebook does not use your phone microphone to inform ads or change what you see in your news. [00:55:55] Doesn't use your microphone. So there's a study out right now. That is from an X Google engineer. And this article is in the guardian and they are talking about what he found. So, let me explain the background on some of this technology. First, if you are an app developer, if, if you're a developer of any software of any kind you use libraries and these libraries do things like search for a specific set of characters called a string or in search. [00:56:31] Them or move things around or open a connection to another machine. So rather than having implement the whole T C P I P stack and ethernet underneath it and, and all of the operating system work that you'd have to do with all of the interrupts and the buffer fills and reading, toggling. As switches in the hardware, doing all of that sort of stuff. [00:56:52] You just make one library call and say, listen, and you give the port and TA anybody who tries to connect you. It just comes right through. It's all taken care of for you, right? That's what libraries are all about. And they've become much more complex, more recently libraries nowadays can do things like provide you with a full web browser. [00:57:16] Many of the applications that we use on a daily basis, these apps in our phones, particularly, but it's also true with some of the apps on our computers are actually. Just web browsers. They're web browsers that talk to a server out on the internet and yeah, there might be wrapped in various things, but oftentimes if you're trying to pay within an app, it'll go to a third party site. [00:57:44] And part of the beauty of that is. Becomes a, a service to them. They don't have to worry about coding it all up. Right. They don't have to worry about taking your money, keeping everything safe. Am I using really good algorithms here to encrypt it can bad guys hack in? No, no, no. There's, they're just calling this routine that spins up a little web browser. [00:58:07] Inside the application and uses a secure connection to talk to the web server somewhere who cares? Not mine. I'm just the app developer, right? I'm letting you play your farming game or whatever it might be. That makes sense to you guys. So it makes their life much, much easier. Why bother if you've got a website that does everything, why bother coding it all up from scratch in an app? [00:58:34] They don't people don't. Why would. Well, we've seen that again. And again, for instance, look at Microsoft's latest browser out there, edge, not the original edge, but the latest edge, you know how Microsoft is, right. They call it the same thing, even though it's entirely different. Uh, yeah. How many versions of windows where they're like 20 at one point, right? [00:58:56] Different ones or different architectures and just crazy. But now the edge browser is. Built on chromium, which is Google Chrome, which is built on Apple's libraries to manipulate, draw things, et cetera. So you're running your edge browser on your Microsoft windows, computer. You're actually running code libraries. [00:59:21] If you will, from Google and from apple. And that way, if you're developing a browser like edge, you don't have to worry about every little nit bitty thing. That's all taken care of by other programmers who are making a smaller piece of code. Now that's been the whole Unix philosophy forever, by the way. [00:59:42] Instead of having these monolithic applications. That could be just full of bugs and security problems. You just have nice small, easy to maintain, easy to research applications and let other people worry about the little pieces, which is really kind of cool. It's great. Many browsers in fact are based right there on chromium and they modify it around a little bit. [01:00:07] Microsoft added all kinds of spyware to it. Well, it turns out. According to this research from an ex Google engineer that both Facebook and Instagram apps have been taking advantage of this in-app browser technology. And what they're doing is users who click on links inside the Facebook app or inside the Instagram at gram act are actually taken to the webpages. [01:00:39] Using an in-app browser controlled by Facebook or Instagram rather than sending you to your default browser. So if you are using iOS, your default browser might be safari, which is a rather safe. Browser and good for privacy, or you might have decided you wanna use the Chrome browser on iOS or maybe Firefox or brave, or one of dozens of different browsers that are out there. [01:01:10] No, no, it's not gonna use those. It's not gonna use your default browser. It's going to use the in-app browser. And what it's doing with that in-app browser now is here's a quote from him. The Felix Crouse, he's a privacy researcher founded an app development tool that was acquired by Google in 2017. He says, quote, the Instagram app injects their tracking code into. [01:01:37] Website shown, including when clicking on AB ads, enabling them to monitor all user interactions. Like every button that you press, every link you taped, every piece of text that you select or highlight any screenshot you take, any forms, you fill out any user forms, things like passwords addresses, credit card numbers. [01:02:06] Are all seen by the Instagram app? Yes, indeed. So in the statement, of course, uh, medicated that injecting a tracking code, obeyed users preferences on whether or not they allowed apps to follow them. And there was only used to aggregate data before being applied for targeted advertis. Now, this is interesting because according to Crouse, this code injection, uh, was tracked and he was able to look at doing, doing it right for normal browsers. [01:02:42] His test code detected no changes, but for Facebook and Instagram, it finds up to 18 lines of code added by. App into the webpage. So there you go. JavaScript injection and more from our friends at Facebook and Instagram. So they are tracking you, but apparently. They're not listening to your microphone, but they're watching you as you cruise around the web thinking you're using your browser, but no, no. [01:03:18] You're using theirs. Hey, stick around Craig peterson.com. [01:03:24] Cell phone security is something I've talked about for a long time. And you guys know my basics here. If you've been a listener for really any length of time, when it comes to smartphones, we're gonna get into this in more detail, particularly after this raid. [01:03:41] Well, of course everyone's heard, I'm sure about the rate on Trump's property, Mar Lago. [01:03:48] There was something else that happened right. About the same time. And that was representative. Perry Scott Perry was traveling with his in-laws, uh, who are described as elderly. They were on vacation. He's a Republican representative in the house of Congress from Pennsylvania. And he told the Fox news people that three FBI agents approached him, issued him a warrant and demanded he hand over his. [01:04:24] He said they made no attempt to contact my lawyer, who would've made arrangements for them to have my phone, if that was what they wanted. He says I'm outraged. Although not surprised that the FBI. Under the direction of Merrick Garland's DOJ would seize the phone of a sitting member of Congress. My, my phone contains info about my legislative and political activities, personal private discussions with my wife, family constituents, and friends. [01:04:53] None of this is the government's business. Now that's really an interesting point. And, and it brings up the discussion about our smart devices, you know, what should we be doing with our phones and, and what is it frankly, that our phones have in them. Now, just think about that for a minute. Scott Perry rec he, he not recommended. [01:05:21] He mentioned that he had all kinds of records. That were in that phone. You do too. You've got your contacts. Of course. The phone contains information about who you called, where you went, cuz it's got a GPS tracker, but even if GPS is turned off, it's still tracking which cell towers you've connected to. [01:05:43] Uh, we've got all kinds of email in our phones, which are gonna contain business documents, private documents, attorney, client, privilege documents, all kinds of stuff there. And we have the fourth amendment, which protects the right of privacy against unreasonable searches and seizures by the go. Now, in this case, obviously the government got a warrant we could argue about, you know, how legitimate is the warrant and should they have issued it, et cetera. [01:06:16] Right. That that's not what I'm talking about. This is not a political show. In reality. What we're talking about here is the technology. The technology we're using to store this information, this personal information, what should we be using? What shouldn't we be using? How should we use it? Right. All of that sort of stuff. [01:06:38] Well, okay, so we've established that there was not apparently a fourth amendment violation here. There, there might have been, we don't know. We may never know. It doesn't really matter, but if someone gets a hold of your smartphone or your tablet or your computer, what information does it have on there? [01:07:01] And we also have a right under the fifth amendment. against self-incrimination. So if someone's thumbing through our phone, what are they gonna find? People plead the fifth amendment all of the time, because they don't want to get trapped in one of these traps where maybe you don't remember the date. [01:07:24] Right. And all of a sudden you're in a perjury trap because you said something that wasn't true. Well, you know, our, our memories aren't the best, particularly when we're on vacation, we've been drinking a little bit, right. if someone finds your phone, opens it up, someone steals your phone and opens it up. [01:07:44] Someone gets a warrant for your phone and opens it up. What's in there. Now some people have in the past said, okay, what I'll do is I'll just go ahead and I'll wipe my phone remotely and they've done it. Right? The police have had the phone in evidence and in evidence locker and somebody remotely went ahead and wiped their phone. [01:08:04] The police are onto. And what the police have been doing more recently is they put it into a special bag that blocks any sort of signals coming in or out as well as the room. Right. It's kind of a fair date cage anyways, and that way, bad guys, good guys who, if the phones are stolen, they can't remotely wipe them, which is a good thing here, frankly. [01:08:30] But what are we ultimately trying to protect from? That's the question, right? It it's, who's gonna have your phone and what are you trying to protect it from personally? I'm not someone who truly trusts the government. I'm a firm believer in our constitution and our bill of right. Ultimately governments become corrupt. [01:08:52] It happens every time. And even if the whole government isn't corrupt, there's guaranteed to be people within the government, within their bureaucracy, the deep state, if you will, who are out there to get you right. makes sense to you. Makes sense to me. I don't know, but our phones, our smartphones, our computers have a lot of stuff in them. [01:09:14] I've talked on the show before how you should not be taking them to China. If you go to China, because of the evil made. T where they are grabbing your phones. They are duplicating them. Same thing with Russian travelers. Not as much as has been happening in China, but it's happened in Russia, probably a lot now with the whole war thing. [01:09:36] Right. But you shouldn't be taking them because they can be duplicated just like rep Scott. But Scott Perry's phone was duplicated. Now the, the FBI apparently said, well, we're not gonna look through well, why you're duplicating it then. And you know, maybe it's just to preserve evidence. I really don't know, but the bad guys can get at your phone employers if they own your phone can get at your phone and they can get a lot of data out of that. [01:10:06] What do you do? Well, bottom line, if you are traveling internationally, you're gonna wanna make sure to wipe your phone and just bring along maybe a, a basic little flip phone. Uh, cetera. Now there is software that we use. For instance, we use one password and duo in order to keep track of all of our stuff, right. [01:10:31] Our personal information. And. That's the two factor authentication stuff that we use, and we can tell it, Hey, we're traveling out of the country and we will only need these passwords. And it goes ahead and wipes out the password database so that we're not carrying a whole bunch of stuff with us that might be compromised by, uh, a government agency right within what is it? [01:10:54] The USS 50 miles of the border. They can confiscate and examine anything that you have, even if you're not trying to cross the border. and they'll do that at airports. They'll do that at a whole bunch of places. And then you've got the employer side and then you've got the bad guy side. Look at what happened to Khai with the Saudis right here. [01:11:16] He was, uh, you know, a journalist. We could argue that I suppose, but he's a journalist. He is abducted and he is murdered by the Saudis. They get their hands on the phone and they decrypt the. this has happened and it'll happen again. So Apple's done something here that I think is a good step in the right direction. [01:11:40] Apple, of course I've recommended for a long time. Never, ever, ever, ever, ever use Android. Okay. Don't. Use it, Google's using it to track you. You're losing your privacy and the security. Isn't very good. Particularly if your phone's more than three years old, apple has come up with this new lockdown mode on their phones and the lockdown mode is meant for. [01:12:09] People who are really under thumb, you know, people living in Russia or Ukraine, or you name it, Iran, all of these countries that are really out to get their citizens and it it's coming out in iOS. You'll see it there. You probably don't want to use it as a regular person, cuz it does block some of the things you can do, but it also locks it down against these Israeli based companies that have been selling software and hardware to break into cell phones. [01:12:44] So consider iPhones. And if you are one of these people, who's at a high risk consider lockdown mode. [01:12:51] I warned last week about using the ring camera as well as Google's camera. We've got some more news about that today. I was right. A major breakthrough in nuclear fusion and a new toolkit released. Talk about it all now. [01:13:08] Well, quite, quite a time, you know, I, I remember when I first started doing the radio show, uh, 22 years ago, now it started right there year 2000 Y two K and I, I was, uh, wondering, you know, am I gonna have enough stuff to talk about? [01:13:27] and my wife, who was just the most amazing person had been helping me and we subscribed to a bunch of newspapers. Yeah. There used to be newspapers back then. And she went through and was clipping articles that we thought might be good, that people might want to, uh, to hear about. And so she had all. Files. [01:13:49] And we, we subscribe to like four or five different newspapers, including the trashy ones like USA today, just so we knew what was going on out there. We had the financial times and the London times and New York times, and we got just files and files worth of stuff. And didn't take us long to realize, Hey, wait a minute. [01:14:14] There is so much tech news out there and stuff to talk about, uh, that weren't, we don't have to worry about that. So we canceled our subscriptions to all of these different things. I, I have actually a subscription to the New York times still, cuz they gave me a buck a week, which is not a bad deal for the online version because the old gray lady still does have some good text stories. [01:14:39] Some of the other stuff obviously is a problem, but, uh, yeah, tech stories anyways. Now we do a lot of this stuff online, the research, and I put it together and send it out in my newsletter every week. And man, did we have a lot of you guys reading it on Monday was the most, most, uh, red newsletter of mine. [01:15:01] The insider show notes newsletter. Of any of them ever. It was really great. It was like I had a, almost a 50% open rate there within the first day. So that's cool. Thank you guys. And obviously you really value it or you would not have opened that newsletter and click through you. See what I do? Is, uh, you probably know, I appear on radio stations all over the place and I I'm also of course have my own radio show here and elsewhere, and my podcasts, which are on every major podcast platform out there. [01:15:40] And I've been doing this for so long this week. What am I at here? Show? Number, I think it's like 1700. I'm trying to remember weeks. Okay. That's weeks of shows and, uh, we, we have never hit the same stuff twice, which is really rather cool. One of the things I brought up and this was in, uh, a recent show is about. [01:16:09] These ring cameras. And I warned everyone not to use ring and went through the whys. So if you have my newsletter from. A few weeks back, you can just probably search your email box

Medical conferences often are a platform to showcase new clinical trophies. But that wasn't the case for Merck at this year's European Society for Medical Oncology meeting. The Big Pharma presented a series of trial flops for its megablockbuster cancer immunotherapy, Keytruda. We'll discuss if the Merck checkpoint inhibitor has reached a bottleneck or if it was just bad luck.  Also under discussion is the monkeypox test Emergency Use Authorization. Because monkeypox continues to spread in the U.S. and worldwide, the FDA granted its first EUA for a diagnostic test. This regulatory path was also used for COVID-19 tests. But the FDA learned a few lessons from the pandemic and hopes the new guidelines will help avoid the problems seen then.   To learn more about topics in this episode:  ESMO: AstraZeneca, Merck tout Lynparza's 'clinically meaningful' ovarian cancer survival edge but lose one in prostate cancer ESMO: Roche eyes untouched newly diagnosed lung cancer market for solo Tecentriq ESMO: Adding bempeg to Opdivo lowered response rate in Bristol Myers-Nektar failed cancer trial ESMO: GSK keeps the faith in anti-TIGIT plans; it's 'not always about being first' UPDATED ESMO: Amgen's Lumakras confirmatory lung cancer data leave door open for KRAS competitors ESMO: Gilead's Trodelvy makes surprise comeback with above-par breast cancer survival showing Here we go again: FDA opens up emergency authorizations to monkeypox tests Moderna sizes up private COVID vaccine market in US, where shots could cost $100 a pop Sony dives into nascent over-the-counter hearing aid market with WS Audiology partnership OTC birth control could be on the way from Perrigo, as FDA gathers expert panel Altimmune sees phase 1 success in tricky NASH indication with GLP-1 agonist Oramed phase 2 insulin drug data 'paint an exciting picture' in rocky NASH landscape Akero hits endpoints in midphase NASH trial, linking candidate to improvements in fibrosis BMS' preferred drug in its $74B Celgene buy is set to pay dividends, winning its first FDA nod The Top Line is produced by senior multimedia producer Teresa Carey with managing editor Querida Anderson and senior editors Annalee Armstrong, Ben Adams, Conor Hale and Eric Sagonowsky. The sound engineer is Caleb Hodgson. The stories are by all our “Fierce” journalists. Like and subscribe wherever you listen to your podcasts.See omnystudio.com/listener for privacy information.

CME credits: 0.50 Valid until: 15-09-2023 Claim your CME credit at https://reachmd.com/programs/cme/why-weight-loss-should-be-the-primary-goal-of-treatment-in-type-2-diabetes-care/14130/ Dropping 15% or more of body weight has a greater disease-modifying effect than any other glucose-lowering intervention. Join Drs. Donna Ryan and Juan Pablo Frias as they discuss implementing an upstream intervention to weight loss and newer drugs (GIP agonists, GLP-1 receptor agonists, SGLT2 inhibitors) to help your patients experience improved effects earlier and for a longer duration. Tune in to find out how the novel dual GIP and GLP-1 receptor antagonist tirzepatide could fit into your therapeutic strategies.

Are you an Accredited Investor that's tired of getting crushed by paying so much in income tax? Find out how we're helping others like you keep Uncle Sam out of your pocket. Click the link HERE.  ( To see the Video Version of today's conversation just CLICK HERE. ) Going Long Podcast Episode 247: Preparing For Another Great Year  In today's solo show you'll learn the following from Billy himself:   [00:20 - 01:14] Show introduction with comments from Billy. [01:14 - 02:15] Billy shares an honest written review from a GLP listener with the whole Going Long family. [02:15 - 06:53] How you, as a high paid professional, may be getting to the end of another great financial year and feeling happy about what you've achieved, but at the same time may still also be having that bad feeling that comes with losing a high percentage of your earnings through income tax. [06:53 - 07:42] The simple action you can take today to ensure you keep more of your hard earned money, and don't have to give half of it away to Uncle Sam as income tax. [07:42 - 08:17] Billy wraps up the show.   To see the Video Version of today's conversation just CLICK HERE.   How to leave a review for The Going Long Podcast: https://youtu.be/qfRqLVcf8UI    Start taking action TODAY so that you can gain more Education and Control over your financial life.   Are you an Accredited Investor that's tired of getting crushed by paying so much in income tax? Find out how we're helping others like you keep Uncle Sam out of your pocket. Go to https://www.firstgencp.com/goinglong   Be sure to connect with Billy!  He's made it easy for you to do…Just go to any of these sites:   Website: www.billykeels.com Youtube: billykeels Facebook: Billy Keels Fan Page Instagram: @billykeels Twitter: @billykeels LinkedIn: Billy Keels

*Bom dia!* Hoje é *terça-feira, 13 de setembro de 2022*

O #MorningCall da #XPInvestimentos mostra os principais destaques do dia e os impactos para o mercado, antes do pregão. Confira os temas de hoje, 13/09/2022:A atenção do mercado hoje estará voltada à divulgação do CPI nos EUA. O mercado e a XP esperam deflação de -0,1% e -0,3% no mês, respectivamente, fruto principalmente de deflação na gasolina, carros usados e transportes, além de desaceleração nos preços de alimentos. No Brasil, a Petrobras anunciou ontem queda dos preços do GLP nas distribuidoras de 4,7%, que deverá ter efeito pequeno, de até 4 bps, entre os IPCAs de setembro e outubro. E na agenda, o IBGE divulga a Pesquisa Mensal de Serviços (PMS) de julho, projetamos avanço de 0,8% no mês e 5,6% na variação interanual (mediana de mercado em 0,6% e 5,5%).Acompanhe todos os conteúdos da XP em https://t2m.io/8cxPp6xParticipe do canal do Telegram para estar sempre atualizado: https://t.me/xp_investimentosConfira mais conteúdos também através do nosso Instagram: https://www.instagram.com/expertxp/ Assine o Expert Pass e tenha acesso a conteúdos exclusivos: https://bit.ly/ExpertPass.Investir com a XP Investimentos é fácil, basta criar o seu cadastro e em minutos você já pode começar a investir: https://t2m.io/mw7KOHu.

Drs. Karl and Spencer sit down with neurobiologist and obesity researcher Dr. Stephan Guyenet to discuss how the brain is the main organ involved in obesity. Learn: How the brain regulates our body fatness The difference between hunger and cravings Why we eat How the new GLP-1 class of medicines help Visit his blog See if you qualify for the GLP-1 medicines

Los coches que utilizan gas como el GNC o el GLP son una alternativa a los gasolina y diésel que aporta ciertas ventajas económicas y también ahorran emisiones contaminantes. Que sigan ofreciendo estas prestaciones durante mucho tiempo depende, en gran medida, del mantenimiento que les hagamos. Hoy hablaremos de todo esto de la mano de nuestro experto en lubricantes, Antonio Fernández.

A Petrobras anunciou a redução do preço do gás de cozinha vendido em botijão. O recuo será de 4,7%. O preço médio cobrado das distribuidoras pela estatal passa de R$ 4,23 por quilo para R$ 4,03.Confira outros destaques do Giro de Notícias: Rosa Weber toma posse como presidente do STF; CNM calcula impacto de R$ 10,5 bilhões anuais com piso da enfermagem; britânicos começam a se despedir da rainha Elizabeth II; foguete cai após decolagem nos EUA sem deixar feridos; Santos anuncia saída do técnico Lisca.

Heterogeneity across available glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for type 2 diabetes means that agents should be prescribed based on patient characteristics and preferences. So how can we best make that decision? Join Dr Harpreet Bajaj for a discussion of tailoring GLP-1 RA regimens to patient characteristics, including considerations for dosing and treatment intensification. By completing this activity, you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment. References available here Dr Harpreet Bajaj declares the following financial relationships from the past 24 months: Grants/Research Support: Eli Lilly, Novo Nordisk, Sanofi Liberum IME staff, ACHL staff, and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose. The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity. The content for this series was developed independently of the ineligible companies. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantors. This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis. This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers' prescribing information for these products. ACHL requires its speakers to disclose that a product is not labeled for the use under discussion. Target Audience This educational activity is intended for an international audience of non-US and non-UK HCPs. Funding: This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

Por falta de urea, producción de arroz caerá hasta 20% y habrá alza de precios – Según expertos Agenda laboral del gobierno precariza el empleo formal y alienta informalidad - Cenares se lava las manos por contratos irregulares con empresa de hermano del premier - el plan reactivador de Burneo incluye subsidios al GLP, luz y transporte - Servir advierte que viceministros de Boluarte no son idóneos y podría ser sancionada. #PedroCastillo #urea #AnibalTorres

Scott Stevenson talks Bodybuilding Science. TIME STAMPS BELOW- With Scott McNally

Are you an Accredited Investor that's tired of getting crushed by paying so much in income tax? Find out how we're helping others like you keep Uncle Sam out of your pocket. Click the link HERE.  Going Long Podcast Episode 245: How to Escape The Corporate Trap In today's solo show you'll learn the following from Billy himself:   [00:20 - 01:08] Show introduction with comments from Billy. [01:08 - 02:32] Billy shares an honest written review from a GLP listener with the whole Going Long family. [02:32 - 06:26] Billy describes what the ‘Corporate Trap' is, and how to recognise if you are stuck in a Corporate Trap right now. [06:26 - 12:14] Billy's 4 step process to escape the corporate trap.  [12:14 - 13:46] Billy wraps up the show.   To see the Video Version of today's conversation just CLICK HERE.   How to leave a review for The Going Long Podcast: https://youtu.be/qfRqLVcf8UI    Start taking action TODAY so that you can gain more Education and Control over your financial life.   Are you an Accredited Investor that's tired of getting crushed by paying so much in income tax? Find out how we're helping others like you keep Uncle Sam out of your pocket. Go to https://www.firstgencp.com/goinglong   Be sure to connect with Billy!  He's made it easy for you to do…Just go to any of these sites:   Website: www.billykeels.com Youtube: billykeels Facebook: Billy Keels Fan Page Instagram: @billykeels Twitter: @billykeels LinkedIn: Billy Keels

In this episode, we will discuss mechanism, pharmacokinetics, efficacy, safety, and possible place in therapy for tirzepatide (Mounjaro), a new treatment for type 2 diabetes. Key Concepts Tirzepatide is a novel GIP and GLP-1 receptor agonist resulting in glucose-dependent secretion of insulin and a decrease in glucagon secretion. This medication was FDA approved in May 2022 for the treatment of type 2 diabetes as an adjunct to diet and exercise. It is available as a long-acting once weekly pen injection to be administered subcutaneously. Current efficacy data exist from a 40-week trial which showed that tirzepatide was superior to semaglutide in A1c reduction and weight loss. The most common adverse effects of tirzepatide include GI concerns such as nausea, vomiting, and diarrhea as well as hypoglycemia. References Frias JP, Davies MJ, Rosenstock J, et al. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med. 2021;385:503-515. https://www.nejm.org/doi/full/10.1056/NEJMoa2107519 Mounjaro. Package insert. Elli Lilly and Company. 2022. 

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/Podcast/case-conversation-t2dm Overview: In the context of a clinical case, faculty will emphasize the importance of developing a guideline-directed diabetes care management plan that places GLP-1 RA therapy before insulin.

Desde los estudios centrales de ONDACERO Madrid Sur te acercamos las últimas noticias del motor, pruebas de los últimos modelos que llegan al mercado, consejos y recomendaciones y seguridad vial. Nos puedes escuchar en directo en ONDACERO Madrid Sur y ONDACERO Jaén. Analizamos las siguientes noticias: • Geely (dueña de Volvo, Lotus, Lynk&Co...) negocia para quedarse el 40% de la división de coches de combustión de Renault • Los coches eléctricos están siendo más caros si entran averiados en el taller • Los coches eléctricos reducirá la mano de obra para fabricarlos en las fábricas • En nuestra sección de seguridad vial queremos repasar los datos más importantes en cuanto a accidentalidad en este verano de 2022. • Conocemos HyundaFest 2022, el punto de encuentro para todos los propietarios y apasionados de la marca Hyundai. • Skoda renueva su logotipo • Desembarcan los nuevos coches eléctricos de la marca BYD en otoño a Europa. • Skoda Vision 7S, así será el nuevo SUV eléctrico de 7 plazas • Dodge Charger Daytona, ¿el futuro de los superdeportivos americanos será así? • En Alfa Romeo no están muy contentos con el nuevo Dodge Hornet • Hyundai IONIQ 6: más de 37.000 pedidos en 24 horas • California prohibirá los coches nuevos de combustión en 2035, pero recomienda a su población no cargar los coches eléctricos por la tarde. • Es oficial: Audi confirma su entrada en la Fórmula 1 • Hablamos con Guille García Alfonsín de su canal de Youtube PowerArt. El equipo de gala que ha acompañado en este programa especial ha sido: Fernado Rivas y José Lagunar Invitados de la semana: - Guillermo García Alfonsin Intentando dirigir a estos profesionales del motor, Antonio R. Vaquerizo. En el espacio de TotalEnergies conocemos que además de los coches tradicionales de combustión, gasolina o diésel, y los coches electrificados, sean híbridos o gasolina, también existen los vehículos que funcionan con gas, sean, GLP o GNC. Puedes seguirnos en nuestra web: https://autofm.es/ y https://www.podcastmotor.es Twitter: @AutoFmRadio Instagram: https://www.instagram.com/autofmradio/ YouTube: https://www.youtube.com/channel/UC57czZy-ctfV02t_PeNXCAQ Contacto: info@autofm.es #auto #coches #guillealfonsin #guillermoalfonsin #motor #automovil

A ruler within a nation does not have the right or the authority to legislate what is contrary to God's commandments and to enforce it with penalties-that is tyranny. When he does so, he sets himself upon a pedestal to be honored above God -just as Nebuchadnezzar did with his golden image-. Rulers may not command us to bow down and worship an image -as did Nebuchadnezzar-, but when they legislate what is evil, they usurp the supreme authority of God and His law, and they rebel against Christ, the King of kings. This is essentially what Nebuchadnezzar did also.----The tyranny of rebellious rulers is not morally indifferent or neutral. Tyranny is not just a political debate of one political party's position vs. another political party's position. It is still tyranny even if the majority within a nation supports the tyranny. It is tyranny because wicked rulers no longer rule as God's ministers to us for good, but rather assert their own authority to rule by their own wicked laws rather than submitting themselves to the kingship of Jesus Christ and His righteous laws.----Tyranny is satanic, just as Samuel Rutherford writes -Lex Rex, p.34------Tyranny being a work of Satan, is not from God, because sin, either habitual or actual, is not from God- the power -authority-GLP- that is, must be from God . . . .----We can clearly see the religious issue involved in the tyranny of King Nebuchadnezzar here in Daniel 3 in commanding worship to an idol, but let us not be blind to the religious issue involved in all tyranny-man's resistance to God's authority.

The discussion shifts to the challenges behind collaborating in a field that, as Naim puts it, “no one has figured out what to do with.” Mazen calls on the “larger companies” to work with the smaller ones to make these studies more common, noting that the economics and risk profiles of smaller companies require them to focus on getting a single drug to market as quickly as possible. Naim notes that precedent has taken form in Hepatitis C. It was very difficult to treat and different companies' drugs were combined for a while until each company figured out their own combination and that collaboration stopped.A debate next emerges when Naim describes LEGEND, a trial combining the promising PPAR agonist with the SGLT-2 agent, empagliflozin. Naim describes empa as an excellent agent to counteract potential weight gain with lani. Mazen shares his belief that the trial should have combined lani with a drug that provides greater weight loss, possibly a GLP-1 agonist or dual agonist. Roger suggests it depends on the target: liver and metabolic disease targeting might lead to a PPAR/GLP-1 combination, while a more holistic look at metabolic outcomes might prefer SGLT-2s for their proven beneficial effects on kidney and cardiovascular diseases.

This episode explores the future of combination agents in NASH Therapy. First author Naim Alkhouri and last author Mazen Noureddin join the Surfers to discuss their recently published article, Safety and efficacy of combination therapy with semaglutide, cilofexor and firsocostat in patients with non-alcoholic steatohepatitis: A randomised, open-label phase II trial (JHEP, 2022). While the conversation starts by focusing on this article, the discussion itself takes a far broader look at the strategies behind developing combination agents, the likely role these combination therapies will play in treating patients, and, more generally, what Mazen Noureddin describes as the coming “combo-combo” world.At the outset, Naim notes that while this study was published in 2020, it was first presented at AASLD in 2020. The rationale? As he explains, “semaglutide hits every point” in terms of effects on metabolic syndrome, cardiovascular outcomes, obesity and liver fat, but has not yet been proven in monotherapy to regress fibrosis. Novo Nordisk and Gilead Sciences had formed a partnership to develop NASH drugs, and Gilead had two agents with anti-fibrotic effects, the FXR-agonist cilafexor and the ACC agent firsocostat, that might regress fibrosis.This conversation is dense with excellent questions and important observations. Here are some of them:Jörn notes one very important aspect of combination agents: by requiring lower levels of each individual agent, they have the potential to exhibit superior safety and side effect profiles that a higher-dose monotherapy might. In agreeing, NAIM notes with particular enthusiasm how many patients achieved greater than 30% relative fat reduction in such a short study.Mazen raises an intriguing prospect by starting with an interesting acknowledgment: this is an open-label study with neither biopsies nor a placebo arm. However, he suggests, this kind of design will become far more prevalent in a future when one agent in the study has already been approved and is widely used with patients.Louise notes that the ability to show patients “real-world results” quickly will motivate them to maintain therapy and lifestyle modification.Naim proposes a 6-month “futility” standard: if the drug does not provide results in 6 months, discontinue.Roger notes the importance of combination therapy in a disease that has so many theoretical target points and pathways within the liver.Mazen calls on the “larger companies” to work with the smaller ones to make these studies more common, noting that the economics and risk profiles of smaller companies require them to focus on getting a single drug to market as quickly as possible.A debate emerges when Naim describes LEGEND, a trial combining the promising PPAR agonist with the SGLT-2 agent, empagliflozin. Naim describes empa as an excellent agent to counteract potential weight gain with lani. Mazen shares his believe that the trial should have combined lani with a drug that provides greater weight loss, possibly an GLP-1 agonist or dual agonist. Roger suggests it depends on the target: liver and metabolic disease targeting might lead to a PPAR/GLP-1 combination, while a more holistic look at metabolic outcomes might prefer SGLT-2s for their proven beneficial effects on kidney and cardiovascular diseases. The group agrees that 2 or 3 agents are the most they can see in a combination therapy at this time. They all agree that some patients will require combination therapies while others will succeed with monotherapies. This will be linked with disease severity.There are more observations here and a raft of supporting data points and arguments. We lack sufficient space to cover all these in this summary, so read and enjoy yourself!

Are you an Accredited Investor that's tired of getting crushed by paying so much in income tax? Find out how we're helping others like you keep Uncle Sam out of your pocket. Click the link HERE.  Going Long Podcast Episode 243: What Wealthy People Do Differently to Attain & Maintain Their Wealth In today's solo show you'll learn the following from Billy himself:   [00:20 - 01:38] Show introduction with comments from Billy. [01:38 - 02:56] Billy shares an honest written review from a GLP listener with the whole Going Long family. [02:56 - 13:34] Billy shares how he learned about the ways that wealthy people think and do things differently, coming from a lower income blue collar background himself, and then followed on with what he learned to become a successful investor.  [13:34 - 14:25] Details of some quick and effective action you can take RIGHT NOW to help you keep more of the money you earn, and accelerate your path to financial freedom.  [14:25 - 15:19] Billy wraps up the show.   To see the Video Version of today's conversation just CLICK HERE.   How to leave a review for The Going Long Podcast: https://youtu.be/qfRqLVcf8UI    Start taking action TODAY so that you can gain more Education and Control over your financial life.   Are you an Accredited Investor that's tired of getting crushed by paying so much in income tax? Find out how we're helping others like you keep Uncle Sam out of your pocket. Go to https://www.firstgencp.com/goinglong   Be sure to connect with Billy!  He's made it easy for you to do…Just go to any of these sites:   Website: www.billykeels.com Youtube: billykeels Facebook: Billy Keels Fan Page Instagram: @billykeels Twitter: @billykeels LinkedIn: Billy Keels

Episode 59. In this sequel to my previous episode on diabetes, I focus most on diabetes mellitus type 2, speaking about the specific management and monitoring that patients do themselves (like checking fasting and postprandial glucose) and monitoring done by physicians (like monofilament testing). Lifestyle changes is super important in diabetes, as well as reducing impact of other comorbidities such as hypertension, obesity, cardiovascular disease, and renal disease. I cover many of the most common medications used in diabetes, including metformin, GLP-1 agonists, SGLT-2 inhibitors, sulfonylureas, thiazolidinedione, and insulin. I also mention a few misconceptions about diabetes and what aspects of diabetes are stigmatized. 1 in 4 adults over the age of 65 have diabetes. 1 in 10 of all adults have diabetes. Visit First Line's website where you can submit questions and feedback as well as view blog posts: https://poddcaststudios.wixsite.com/firstlinepodcast This episode is sponsored by TrueLearn. TrueLearn special discount codes: For $10 off Shelf/COMAT, use code firstline-shelf For $15 off COMLEX subscriptions, use code firstline-comlex For $35 off USMLE subscriptions, use code firstline-usmle Use this link to easily find First Line on different platforms and social media platforms: linktr.ee/FirstLinePodcast First Line is now available on Spotify & Anchor, Apple Podcasts, Google Podcasts, Overcast, Stitcher, Amazon Music & Audible, iHeartRadio, Vurbl, Breaker, Castbox, PocketCasts, Castro, Player Fm, Pod Bean, Reason, Vurbl, and TuneIn. First Line is on Instagram @firstlinepodcast and on Facebook www.facebook.com/firstlinepodcast Content on First Line is for educational and informational purposes only and should not be taken as medical advice. Please see your primary care physician (DO or MD) for any medical concerns you have. All ideas expressed are individual ideas of the host and do not represent any organizations the host is linked to. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/firstline/message Support this podcast: https://anchor.fm/firstline/support

Podcast Series Title: The 411 on a GLP-1Podcast Series Description: Join series host Dr. Jim Gavin, Clinical Professor of Medicine at Emory University and Chief Medical Officer for Healing our Village in Atlanta, Georgia, and fellow leaders in the field of diabetes as they tackle some of the challenges we face when treating T2D. Topics of discussion include clinical inertia, as well as the mechanism of action, dosing, efficacy, and safety of a GLP-1 RA for adults with T2D.Episode Title: How to Empower Patients with T2D Knowledge and Introduce a GLP-1 RAEpisode Description: What do you need to know about a once-daily GLP-1 RA and what can you do to help your patients taking this T2D therapy? Join this multidisciplinary discussion with Jim Gavin, MD; Curtis Triplitt, PharmD; and Jeffrey Unger, MD, as they review the mechanism of action, dosing, efficacy, and safety of a once-daily GLP-1 RA for adult patients with T2D. This program is intended for clinicians. The information presented is aligned with the views and opinions of the speakers and is sponsored by Novo Nordisk. This podcast is not to be used as medical advice and is intended for educational purposes only.Faculty Presenters:James R. Gavin III, MD, PhDClinical Professor of Medicine, Emory UniversityChief Medical Officer, Healing Our Village, Inc.Atlanta, GeorgiaJeff Unger, MD, FAAFP, FACEDiplomate, American Board of Family PracticeAssistant Clinical Professor of Family Medicine, UC Riverside School of MedicineRiverside, CaliforniaDirector, Unger Concierge Primary Care Medical GroupRancho Cucamonga, CaliforniaCurtis L. Triplitt, PharmD, CDCES, FADCESClinical Associate Professor of Medicine Division of DiabetesUniversity of Texas Health at San AntonioTexas Diabetes Institute, part of the University Health SystemSan Antonio, Texas

Are you an Accredited Investor that's tired of getting crushed by paying so much in income tax? Find out how we're helping others like you keep Uncle Sam out of your pocket. Click the link HERE.  Going Long Podcast Episode 241: Getting Your Feedback and Reacting to it In today's solo show you'll learn the following from Billy himself:   [00:20 - 01:53] Show introduction with comments from Billy. [01:53 - 03:03] Billy shares an honest written review from a GLP listener with the whole Going Long family. [03:03 - 08:19] Billy discusses how to deal with waiting for feedback after having taken a leap of faith by taking action (investing) based on imperfect information, and how to react to that feedback and follow up with further action. [08:19 - 09:30] Billy wraps up the show.   To see the Video Version of today's conversation just CLICK HERE.   How to leave a review for The Going Long Podcast: https://youtu.be/qfRqLVcf8UI    Start taking action TODAY so that you can gain more Education and Control over your financial life.   Are you an Accredited Investor that's tired of getting crushed by paying so much in income tax? Find out how we're helping others like you keep Uncle Sam out of your pocket. Go to https://www.firstgencp.com/goinglong   Be sure to connect with Billy!  He's made it easy for you to do…Just go to any of these sites:   Website: www.billykeels.com Youtube: billykeels Facebook: Billy Keels Fan Page Instagram: @billykeels Twitter: @billykeels LinkedIn: Billy Keels

Delegiertenversammlung der Grünen, GLP und SVP, Transport von ukrainischem Getreide aus dem Schwarzen Meer funktioniert, Trump zementiert seine Macht bei den Republikanern, Auslandschweizer:innen lernen ihre fremde Heimat kennen

Episode 107: Weight Gain Meds. Medications that cause weight gain are also called weight positive medications. Sapna, Danish, and Dr. Arreaza mention some of those medications in this episode. Introduction: Some meds cause weight gainBy Hector Arreaza, MD.You will see patients who keep gaining weight regardless of their sincere efforts to eat better and exercise. Some people experience serious difficulties to lose weight. If you want to know how frustrating it can be, imagine your doctor telling you to add one more inch to your height when you are 35 years old. For some people, losing weight is just as hard. One important step you can take to help your patients lose weight is performing a detailed medication reconciliation. Review the medication list, and you may find some meds that are proven to cause weight gain. Today we will discuss some of those medications, but it takes practice to learn all of them. I hope this episode is helpful for you. This is the Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.___________________________Weight Gain Meds. By Sapna Patel, MS4, and Danish Khalid, MS4. Ross University School of Medicine. Comments by Hector Arreaza, MD. S: Medications associated with weight gain: See Table 1.1 for medications associated with weight gain and alternatives. Antipsychotic agents:A: Ziprasidone is an antipsychotic medicine that causes the least amount of weight gain.Antidepressants:There are many antidepressants which are associated with weight gain, including the tricyclics, monoamine oxidase inhibitors (MAOIs), and some of the selective serotonin reuptake inhibitors (SSRIs). Tricyclic antidepressants, in particular amitriptyline, clomipramine, doxepin, and imipramine, are associated with significant weight gain.Selective serotonin reuptake inhibitors, paroxetine exhibited the greatest weight gain in its class. Whereas fluoxetine exhibited little to no weight gain and remains weight neutral in the class. Amongst the monoamine oxidase inhibitors, phenelzine had the greatest weight gain.  Antiepileptics/Antiseizure: Amongst the antiepileptic drugs used to treat seizures, neuropathic pain, or other psychiatric conditions,  valproate, carbamazepine, and gabapentin are associated with weight gain. Gabapentin is virtually used by all our diabetic patients. Antihypertensive agents: Beta BlockersBeta receptors, specifically beta-2 receptors, stimulate the release of insulin. Thus, patients on beta blockers may experience weight gain as a side effect. There are two beta blockers that cause the least amount of weight gain: Carvedilol (Coreg) and nebivolol (Bystolic). Hypoglycemic medications: Although intended to regulate blood sugar levels, several anti-diabetic medications are associated with weight gain, specifically sulfonylureas, Actos, and insulin. As mentioned earlier, metformin as well as GLP-1 agonists are associated with weight loss. Metformin can be considered weight neutral. Steroids: Steroid hormones such as corticosteroids or progestational steroids are associated with weight gain. Steroids may increase levels of cortisol, one of the end pathways in steroidogenesis. Cortisol, also known as the stress hormone, functions by increasing insulin resistance, and decreasing glucose utilization, thus causing weight gain.  Antihistamine Medications: Diphenhydramine (Benadryl): commonly used for allergies…or how my mom used it, puts you to sleep right before a flight. However, a side effect of using this medication includes weight gain.Cyproheptadine: an antihistamine, used for antidote to serotonin syndrome and migraines, has an appetite stimulant effect causing weight gain. It can be used off-label as an appetite stimulant in children who do not gain weight. Fun Fact: Although it is a common belief that combined oral contraceptives cause weight gain, data suggest that significant weight gain is not a common side effect of combined oral contraceptives. A good practice: Medication reconciliation: Weight positive, weight neutral, or weight negative. Weight positive: Deprescribe or change for another medication if possible. Weight neutral and weight negative: Keep them. Don't be afraid to prescribe anti-obesity meds. We should learn about them, become familiar with side effects, contraindications, dosing, and more, and prescribe them appropriately as part of a weight loss program. Also, don't forget that these medications are used in conjunction with a proper diet.        CategoryDrug ClassWeight GainAlternatives Psychiatric agentsAntipsychoticsClozapine, risperidone, olanzapine, quetiapine, haloperidol, perphenazineZiprasidone, aripiprazoleAntidepressants/mood stabilizers: tricyclic antidepressantsAmitriptyline, doxepin, imipramine, nortriptyline, trimipramine, mirtazapine Bupropion, nefazodone, fluoxetine (short term), sertraline (

I interview the co-founders of the International Lithium Association (ILiA). Anand, known as “The Lithium Raj,” has deep lithium experience. Roland has experience running other major industry associations. We start off discussing Anand's experience as a lithium pioneer marketing spodumene from Australia (Greenbushes) before discussing the International Lithium Association's reason for being. Follow them on Twitter: @ILiA_lithium & Linked In The ILiA website: https://lithium.org/ Topics: The early days & growth of the lithium market in China Building relationships & negotiating in China The early days of Tianqi & Ganfeng. The transition from spodumene use in glass & ceramics to chemical conversion How China competed with low cost brine imports from South America China's rise in battery Moving from Talison to Galaxy & later Pilbara Minerals The thinking behind the creation of the International Lithium Association Attracting the major lithium players as members The Association's areas of focus and challenges Serving members & the general public What does ILiA look like in 2027? Rapid fire with the first "do over" in GLP history

Huberman Lab Podcast Notes Only by clearly defining what you want in your last decade of life can you work backwards and put in place a plan to get thereTwo vectors of longevity: (1) lifespan: literally whether you are alive and breathing; (2) healthspan: how many healthy years you live – biomarkers matter less, physical & performance tests matter more (DEXA scan, VO2, fat oxidation, emotional state, etc.)ApoB is the single most important biomarker to measure – be proactive in obtaining this as early as possible! It's uncommon in the U.S. though used in Europe & other places as part of regular health check You should monitor weight but an annual DEXA scan is more valuable than tracking BMI“There's not one thing I'll tell patients that is more important than exercising.” – Peter Attia“Strength training is an essential part of our existence. It's never to late to start but you should never stop.” – Peter AttiaTry the back casting thought experiment: In detail, what do you want the last 10 years of life to look like? Then you can plan and live accordingly. Until you do, everything is abstract.Peter Attia on the Women's Health Initiative that deterred the medical community from hormone replacement therapy for women: “It's hands down the biggest screw up of the entire medical field in the last 25 years.” – Peter AttiaPhilosophical differences in prevention – Medicine 2.0: we'll treat you if it seems like disease is imminent in the next 5-10 years; Medicine 3.0: treat the causative agent nowRead the full notes @ podcastnotes.orgMy guest this episode is Dr. Peter Attia, M.D., who trained at Stanford University School of Medicine, Johns Hopkins Hospital and the National Institutes of Health (NIH). Dr. Attia is host of The Drive podcast and is a world expert on behavioral approaches, nutritional interventions, supplementation and pharmacological techniques to improve lifespan, healthspan and athletic performance. We discuss how best to evaluate your health status using routine blood work, body scans and regular tests of physical strength and endurance. Dr. Attia explains what he uses with his patients to “back-cast” their health goals as a way to design their exercise and nutritional programs. We also discuss hormone modulation and replacement therapy for both men and women. We explain how cholesterol and related factors contribute to cardiovascular disease risk and how to monitor and mitigate that risk. Dr. Attia details various supplementation, nutrition, exercise and prescription approaches useful to people in every decade of life to improve vitality, reduce their risk of disease and increase the number of years sustaining peak cognitive and physical health.  Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman Thesis: https://takethesis.com/huberman InsideTracker: https://insidetracker.com/huberman Helix Sleep: https://helixsleep.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman For the full show notes, visit hubermanlab.com Timestamps (00:00:00) Assessing Health Status & Improving Vitality  (00:02:51) Momentous Supplements  (00:03:46) Thesis, InsideTracker, Helix Sleep  (00:07:29) Lifespan: Bloodwork & Biomarkers Testing, The “4 Horseman of Disease”  (00:11:51) Healthspan: Functional Testing, Cognitive & Emotional States  (00:13:59) Blood Testing: Best Frequency  (00:16:01) DEXA Scan: Lean Mass & Fat, Bone Mineral Density & Osteoporosis  (00:22:33) Bone Mineral Density & Age-Related Decline, Strength Training, Corticosteroids  (00:29:24) Osteopenia & Osteoporosis Diagnosis, Strength Training (00:31:03) AG1 (Athletic Greens) (00:32:16) Back-casting: Defining Your “Marginal Decade”  (00:38:31) All-Cause Mortality: Smoking, Strength, VO2 max  (00:44:43) Attia's Rule of Supplementation, “Centenarian Decathlete” Physical Goals (00:49:24) Importance of Exercise, Brain Health, MET hours  (00:55:23) Nicotine & Cognitive Focus (01:03:12) Menstruation, PMS & Menopause  (01:10:10) Hormone Replacement Therapy, Menopause & Breast Cancer Risk (01:22:06) Estrogen, Progesterone & Testosterone Therapies in Women (01:26:35) Hormone Replacement Therapy in Men, SHBG & Testosterone, Insulin (01:37:23) Clomid, Pituitary, Testosterone & Cholesterol, Anastrozole, HCG (01:47:46) Fadogia Agrestis, Supplements, Rapamycin  (01:52:06) Testosterone Replacement Therapy & Fertility  (01:59:26) Total Testosterone vs. Free Testosterone (02:02:51) Cholesterol & Dietary Cholesterol, Saturated Fat, LDL & HDL, Apolipoprotein B (02:17:42) Apolipoprotein B, Diet, Statins & Other Cholesterol Prescriptions  (02:25:15) Cardiovascular Disease, Age & Disease Risk  (02:28:53) Peptides, Stem Cells, BPC157, PRP (Platelet-Rich Plasma), Injury Rehabilitation  (02:37:40) Metabolomics & Exercise  (02:40:44) GLP-1 & Weight Loss  (02:47:06) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Instagram, Twitter, Neural Network Newsletter, Huberman Lab Clips Title Card Photo Credit: Mike Blabac Disclaimer

Huberman Lab: Read the notes at at podcastnotes.org. Don't forget to subscribe for free to our newsletter, the top 10 ideas of the week, every Monday --------- My guest this episode is Dr. Peter Attia, M.D., who trained at Stanford University School of Medicine, Johns Hopkins Hospital and the National Institutes of Health (NIH). Dr. Attia is host of The Drive podcast and is a world expert on behavioral approaches, nutritional interventions, supplementation and pharmacological techniques to improve lifespan, healthspan and athletic performance. We discuss how best to evaluate your health status using routine blood work, body scans and regular tests of physical strength and endurance. Dr. Attia explains what he uses with his patients to “back-cast” their health goals as a way to design their exercise and nutritional programs. We also discuss hormone modulation and replacement therapy for both men and women. We explain how cholesterol and related factors contribute to cardiovascular disease risk and how to monitor and mitigate that risk. Dr. Attia details various supplementation, nutrition, exercise and prescription approaches useful to people in every decade of life to improve vitality, reduce their risk of disease and increase the number of years sustaining peak cognitive and physical health.  Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman Thesis: https://takethesis.com/huberman InsideTracker: https://insidetracker.com/huberman Helix Sleep: https://helixsleep.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman For the full show notes, visit hubermanlab.com Timestamps (00:00:00) Assessing Health Status & Improving Vitality  (00:02:51) Momentous Supplements  (00:03:46) Thesis, InsideTracker, Helix Sleep  (00:07:29) Lifespan: Bloodwork & Biomarkers Testing, The “4 Horseman of Disease”  (00:11:51) Healthspan: Functional Testing, Cognitive & Emotional States  (00:13:59) Blood Testing: Best Frequency  (00:16:01) DEXA Scan: Lean Mass & Fat, Bone Mineral Density & Osteoporosis  (00:22:33) Bone Mineral Density & Age-Related Decline, Strength Training, Corticosteroids  (00:29:24) Osteopenia & Osteoporosis Diagnosis, Strength Training (00:31:03) AG1 (Athletic Greens) (00:32:16) Back-casting: Defining Your “Marginal Decade”  (00:38:31) All-Cause Mortality: Smoking, Strength, VO2 max  (00:44:43) Attia's Rule of Supplementation, “Centenarian Decathlete” Physical Goals (00:49:24) Importance of Exercise, Brain Health, MET hours  (00:55:23) Nicotine & Cognitive Focus (01:03:12) Menstruation, PMS & Menopause  (01:10:10) Hormone Replacement Therapy, Menopause & Breast Cancer Risk (01:22:06) Estrogen, Progesterone & Testosterone Therapies in Women (01:26:35) Hormone Replacement Therapy in Men, SHBG & Testosterone, Insulin (01:37:23) Clomid, Pituitary, Testosterone & Cholesterol, Anastrozole, HCG (01:47:46) Fadogia Agrestis, Supplements, Rapamycin  (01:52:06) Testosterone Replacement Therapy & Fertility  (01:59:26) Total Testosterone vs. Free Testosterone (02:02:51) Cholesterol & Dietary Cholesterol, Saturated Fat, LDL & HDL, Apolipoprotein B (02:17:42) Apolipoprotein B, Diet, Statins & Other Cholesterol Prescriptions  (02:25:15) Cardiovascular Disease, Age & Disease Risk  (02:28:53) Peptides, Stem Cells, BPC157, PRP (Platelet-Rich Plasma), Injury Rehabilitation  (02:37:40) Metabolomics & Exercise  (02:40:44) GLP-1 & Weight Loss  (02:47:06) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Instagram, Twitter, Neural Network Newsletter, Huberman Lab Clips Title Card Photo Credit: Mike Blabac Disclaimer

Huberman Lab Podcast Notes Only by clearly defining what you want in your last decade of life can you work backwards and put in place a plan to get thereTwo vectors of longevity: (1) lifespan: literally whether you are alive and breathing; (2) healthspan: how many healthy years you live – biomarkers matter less, physical & performance tests matter more (DEXA scan, VO2, fat oxidation, emotional state, etc.)ApoB is the single most important biomarker to measure – be proactive in obtaining this as early as possible! It's uncommon in the U.S. though used in Europe & other places as part of regular health check You should monitor weight but an annual DEXA scan is more valuable than tracking BMI“There's not one thing I'll tell patients that is more important than exercising.” – Peter Attia“Strength training is an essential part of our existence. It's never to late to start but you should never stop.” – Peter AttiaTry the back casting thought experiment: In detail, what do you want the last 10 years of life to look like? Then you can plan and live accordingly. Until you do, everything is abstract.Peter Attia on the Women's Health Initiative that deterred the medical community from hormone replacement therapy for women: “It's hands down the biggest screw up of the entire medical field in the last 25 years.” – Peter AttiaPhilosophical differences in prevention – Medicine 2.0: we'll treat you if it seems like disease is imminent in the next 5-10 years; Medicine 3.0: treat the causative agent nowRead the full notes @ podcastnotes.orgMy guest this episode is Dr. Peter Attia, M.D., who trained at Stanford University School of Medicine, Johns Hopkins Hospital and the National Institutes of Health (NIH). Dr. Attia is host of The Drive podcast and is a world expert on behavioral approaches, nutritional interventions, supplementation and pharmacological techniques to improve lifespan, healthspan and athletic performance. We discuss how best to evaluate your health status using routine blood work, body scans and regular tests of physical strength and endurance. Dr. Attia explains what he uses with his patients to “back-cast” their health goals as a way to design their exercise and nutritional programs. We also discuss hormone modulation and replacement therapy for both men and women. We explain how cholesterol and related factors contribute to cardiovascular disease risk and how to monitor and mitigate that risk. Dr. Attia details various supplementation, nutrition, exercise and prescription approaches useful to people in every decade of life to improve vitality, reduce their risk of disease and increase the number of years sustaining peak cognitive and physical health.  Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman Thesis: https://takethesis.com/huberman InsideTracker: https://insidetracker.com/huberman Helix Sleep: https://helixsleep.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman For the full show notes, visit hubermanlab.com Timestamps (00:00:00) Assessing Health Status & Improving Vitality  (00:02:51) Momentous Supplements  (00:03:46) Thesis, InsideTracker, Helix Sleep  (00:07:29) Lifespan: Bloodwork & Biomarkers Testing, The “4 Horseman of Disease”  (00:11:51) Healthspan: Functional Testing, Cognitive & Emotional States  (00:13:59) Blood Testing: Best Frequency  (00:16:01) DEXA Scan: Lean Mass & Fat, Bone Mineral Density & Osteoporosis  (00:22:33) Bone Mineral Density & Age-Related Decline, Strength Training, Corticosteroids  (00:29:24) Osteopenia & Osteoporosis Diagnosis, Strength Training (00:31:03) AG1 (Athletic Greens) (00:32:16) Back-casting: Defining Your “Marginal Decade”  (00:38:31) All-Cause Mortality: Smoking, Strength, VO2 max  (00:44:43) Attia's Rule of Supplementation, “Centenarian Decathlete” Physical Goals (00:49:24) Importance of Exercise, Brain Health, MET hours  (00:55:23) Nicotine & Cognitive Focus (01:03:12) Menstruation, PMS & Menopause  (01:10:10) Hormone Replacement Therapy, Menopause & Breast Cancer Risk (01:22:06) Estrogen, Progesterone & Testosterone Therapies in Women (01:26:35) Hormone Replacement Therapy in Men, SHBG & Testosterone, Insulin (01:37:23) Clomid, Pituitary, Testosterone & Cholesterol, Anastrozole, HCG (01:47:46) Fadogia Agrestis, Supplements, Rapamycin  (01:52:06) Testosterone Replacement Therapy & Fertility  (01:59:26) Total Testosterone vs. Free Testosterone (02:02:51) Cholesterol & Dietary Cholesterol, Saturated Fat, LDL & HDL, Apolipoprotein B (02:17:42) Apolipoprotein B, Diet, Statins & Other Cholesterol Prescriptions  (02:25:15) Cardiovascular Disease, Age & Disease Risk  (02:28:53) Peptides, Stem Cells, BPC157, PRP (Platelet-Rich Plasma), Injury Rehabilitation  (02:37:40) Metabolomics & Exercise  (02:40:44) GLP-1 & Weight Loss  (02:47:06) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Instagram, Twitter, Neural Network Newsletter, Huberman Lab Clips Title Card Photo Credit: Mike Blabac Disclaimer

My guest this episode is Dr. Peter Attia, M.D., who trained at Stanford University School of Medicine, Johns Hopkins Hospital and the National Institutes of Health (NIH). Dr. Attia is host of The Drive podcast and is a world expert on behavioral approaches, nutritional interventions, supplementation and pharmacological techniques to improve lifespan, healthspan and athletic performance. We discuss how best to evaluate your health status using routine blood work, body scans and regular tests of physical strength and endurance. Dr. Attia explains what he uses with his patients to “back-cast” their health goals as a way to design their exercise and nutritional programs. We also discuss hormone modulation and replacement therapy for both men and women. We explain how cholesterol and related factors contribute to cardiovascular disease risk and how to monitor and mitigate that risk. Dr. Attia details various supplementation, nutrition, exercise and prescription approaches useful to people in every decade of life to improve vitality, reduce their risk of disease and increase the number of years sustaining peak cognitive and physical health.  Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman Thesis: https://takethesis.com/huberman InsideTracker: https://insidetracker.com/huberman Helix Sleep: https://helixsleep.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman For the full show notes, visit hubermanlab.com Timestamps (00:00:00) Assessing Health Status & Improving Vitality  (00:02:51) Momentous Supplements  (00:03:46) Thesis, InsideTracker, Helix Sleep  (00:07:29) Lifespan: Bloodwork & Biomarkers Testing, The “4 Horseman of Disease”  (00:11:51) Healthspan: Functional Testing, Cognitive & Emotional States  (00:13:59) Blood Testing: Best Frequency  (00:16:01) DEXA Scan: Lean Mass & Fat, Bone Mineral Density & Osteoporosis  (00:22:33) Bone Mineral Density & Age-Related Decline, Strength Training, Corticosteroids  (00:29:24) Osteopenia & Osteoporosis Diagnosis, Strength Training (00:31:03) AG1 (Athletic Greens) (00:32:16) Back-casting: Defining Your “Marginal Decade”  (00:38:31) All-Cause Mortality: Smoking, Strength, VO2 max  (00:44:43) Attia's Rule of Supplementation, “Centenarian Decathlete” Physical Goals (00:49:24) Importance of Exercise, Brain Health, MET hours  (00:55:23) Nicotine & Cognitive Focus (01:03:12) Menstruation, PMS & Menopause  (01:10:10) Hormone Replacement Therapy, Menopause & Breast Cancer Risk (01:22:06) Estrogen, Progesterone & Testosterone Therapies in Women (01:26:35) Hormone Replacement Therapy in Men, SHBG & Testosterone, Insulin (01:37:23) Clomid, Pituitary, Testosterone & Cholesterol, Anastrozole, HCG (01:47:46) Fadogia Agrestis, Supplements, Rapamycin  (01:52:06) Testosterone Replacement Therapy & Fertility  (01:59:26) Total Testosterone vs. Free Testosterone (02:02:51) Cholesterol & Dietary Cholesterol, Saturated Fat, LDL & HDL, Apolipoprotein B (02:17:42) Apolipoprotein B, Diet, Statins & Other Cholesterol Prescriptions  (02:25:15) Cardiovascular Disease, Age & Disease Risk  (02:28:53) Peptides, Stem Cells, BPC157, PRP (Platelet-Rich Plasma), Injury Rehabilitation  (02:37:40) Metabolomics & Exercise  (02:40:44) GLP-1 & Weight Loss  (02:47:06) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Instagram, Twitter, Neural Network Newsletter, Huberman Lab Clips Title Card Photo Credit: Mike Blabac Disclaimer

GLP's, a breakthrough new class of medicines for diabetes and weight loss

Speaker Rosa Berry joins the show to discuss the House's agenda and recent exodus of GLP members, including her predecessor in Speaker Leclair. Then we chat about her press conference yesterday and who's to blame for the LRP sweep in the August State Election.

Episode 106: Weight Loss Meds. Anti-obesity medications are FDA-approved drugs to support your patient's efforts to lose weight. It is important for primary care providers to learn about these medications to continue fighting against obesity in our communities.Introduction: Obesity is a chronic disease.By Hector Arreaza, MD. Obesity has all the characteristics of a chronic disease. Let's use our imagination and think about a patient with hypertension, for example. Let's imagine you are the doctor or Mr. Lee. He is 45 years old and his blood pressure has been persistently high, around 150/100, even after lifestyle modifications. You decide to start chlorthalidone 25 mg and Mr. Lee takes chlorthalidone every day. Four weeks later you see Mr. Lee again and you review his labs with him. He has normal renal function and normal electrolytes. His blood pressure is now 119/75. He is feeling great and reports no side effects to chlorthalidone. Would you stop the medication at this time? Think about it. The most obvious answer is NO, you will not stop chlorthalidone. Today you will listen to a discussion about anti-obesity medications, common indications, contraindications, cautions, and more. We will learn that obesity requires chronic treatment with medications just like any other chronic disease. I hope you enjoy it.This is the Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.___________________________Weight Loss Meds. By Sapna Patel, MS4; and Danish Khalid, MS$. Ross University School of Medicine. Moderated by Hector Arreaza, MD. S: Hello and welcome back to our nutrition series! If you haven't already listened to our previous episodes, pause this and make sure to give them a listen. We have talked about physical activity, meal plans, and intermittent fasting. Today we are going to talk about the clinical management of obesity, specifically the pharmacotherapy that is used. We will divide these drugs into drugs that reduce food intake primarily acting on the CNS, drugs that reduce fat absorption and medications that are associated with weight gain. D: Can anyone who is considered obese take medications to help them lose weight? Pharmacotherapy should be considered if the patient will be taking the medication in conjunction with the overall weight management program, including changes in eating habits, increased physical activity, and realistic expectations of the medication therapy. Adjuvant pharmacologic treatments should be considered for patients with a BMI >30 kg/m2 or with BMI >27 kg/m2 who have concomitant obesity related diseases. A: You are going to find doctors who are pretty much against anti-obesity drugs, but that's not my case.  S: Drugs that reduce food intake primarily acting on the CNS: Let's start with Phentermine and other sympathomimetic drugs A: Phentermine has been in the market over 60 years and it is well tolerated by most patients. It is effective, expect 5-8 lbs weight loss a month when taken with dietary changes and increased physical activity. The weight loss happens mostly the first 3-6 months when you take anti-obesity medications. S: One of the longest clinical trials of the drugs in this group lasted 36 weeks and compared placebo treatment to treatment with continuous phentermine and intermittent phentermine. Both the continuous and intermittent phentermine therapy produced more weight loss than placebo. D: Other options are Phentermine and topiramate ER which is known as  “Qsymia”. These drugs combine a catecholamine releaser and anticonvulsant respectively.  Topiramate is currently approved by the USFDA as an anticonvulsant for treatment of epilepsy and for prophylaxis of migraine headaches. Weight loss was seen as an unintentional side effect during clinical trials for epilepsy.The mechanism responsible for this is thought to be mediated through the modulation of GABA receptors, inhibition of carbonic anhydrase and antagonism of glutamate to reduce food intake The common adverse effects include cognitive impairment, paresthesia, and increased risk for kidney stones. Topiramate is also a teratogenic drug, so patients need to be in a good birth control to take it. It causes cleft palate in the fetus.The 2 phase-III trials called EQUIP and CONQUER, both 1 year randomized  placebo-controlled double-blinded clinical trials, 3 different strengths of a once-a day formulation were tested: full strength dose (15 mg of phentermine and 92 mg of topiramate ER), mid-dose (7.5mg of phentermine and 92 mg topiramate ER) and low dose (3.75mg of phentermine and 23 mg of topiramate ER). Subjects  randomized to the full strength dose in EQUIP and CONQUER trials lost an average of 10.9% and 9.8% body weight in 1 year compared to 1.6% and 1.2% loss for placebo subjects respectively. Significant improvement in fasting glucose, insulin, Hemoglobin A1C and lipid profile were seen.Due to the dose dependent side effects of the medications an initial dose of 3.75/23 mg is prescribed daily for the first 14 days then increased to 7.5/23mg daily. These patients should be re-evaluated after 3 months. If 3% weight loss is not achieved by that time, either discontinue or escalate the dose to 15/92mg for 12 weeks. S: Drugs that reduce fat absorption:Orlistat. What is orlistat? Well it's a selective inhibitor of pancreatic lipase that reduces the intestinal digestion of fat. The mean weight loss when compared to a placebo was 2.51kg at 6 months and 2.75kg at 12 months. A: It is one of the few anti-obesity medications approved to be used in children 12 years and older. D: GLP-1 Receptor Agonist (-glutide): Semaglutide and Liraglutide - Only two that have been approved for treatment of obesity. A 20-week randomized trial, comparing Liraglutide, placebo, and orlistat, showed that patients assigned to liraglutide lost significantly more weight than those assigned to both. When compared to placebo, those on liraglutide lost a mean weight loss of 2.8 kg. Whereas compared to orlistat lost an average of 5.8kg, however this was on the higher doses of liraglutide. A 56-weeks trial, comparing liraglutide with placebo, showed a mean weight loss was significantly greater in the liraglutide group (8.0 kg vs 2.6 kg). Furthermore, those who initially lost weight with diet and exercise, a greater proportion of those taking liraglutide maintained the weight loss.  Similarly, clinical trials favored semaglutide, with a weight loss greater in the semaglutide group versus placebo. For both, weight loss occurred in patients with and without diabetes. Note: Semaglutide: once a week. Helps induce weight loss. Liraglutide: daily.  A: We dedicated a whole episode on Semaglutide and another whole episode on Tirzepatide. Tirzepatide (dual agonist: GLP-1 and GIP) seems promising for weight loss and it is likely to be approved soon for obesity treatment. So, when do we discontinue anti-obesity medications? We can ask the same question for other chronic diseases: When do we stop medication for hypertension or diabetes? When we have a patient is unable to keep their weight off, we can't see him/her as someone who has lost their motivation to keep their weight off. Really what's happened is that their hormones have changed in a way that is promoting weight gain and it's very hard to lose weight. We should be at the patient's side to fight it off. Conclusion: Now we conclude our episode number 106 “Weight Loss Meds.” Phentermine is the most widely used anti-obesity medication. It is a stimulant, and it is a safe and effective medication for most patients who are fighting obesity. Make sure you learn the contraindication, side effects, and precautions when you prescribe it. Also, learn about other meds that are very effective, including GLP-1 receptor agonists, and your patients will thank you. This week we thank Hector Arreaza, Danish Khalid, and Sapna Patel. Audio by Sheila Toro.Thanks for listening to Rio Bravo qWeek Podcast. If you have any feedback, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References: Perreault, L., Apovian, C. (2021). Obesity in adults: Overview of management. Pi-Sunyer,  F.X., Seres, D., & Kunins, L. (Eds.) Uptodate. Available from: https://www-uptodate-com.rossuniversity.idm.oclc.org/contents/obesity-in-adults-overview-of-management?search=weight%20loss%20medications&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2 Perreault, L. (2022). Obesity in adults: Drug therapy. Pi-Sunyer,  F.X., & Kunins, L. (Eds.) Uptodate. Available from: https://www-uptodate-com.rossuniversity.idm.oclc.org/contents/obesity-in-adults-drug-therapy?search=weight%20loss%20medications&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 Dungan, K., DeSantis, A. (2022) Glucagon-like peptide 1-based therapies for the treatment of type 2 diabetes mellitus. Nathan, D.M., & Mulder, J.E. (Eds.) Uptodate. Available from: https://www-uptodate-com.rossuniversity.idm.oclc.org/contents/glucagon-like-peptide-1-based-therapies-for-the-treatment-of-type-2-diabetes-mellitus?search=glp%201%20receptor%20agonists&source=search_result&selectedTitle=2~97&usage_type=default&display_rank=1 Perreault, L., Bessesen, D. (2022). Obesity in adults: Etiologies and risk factors. Pi-Sunyer,  F.X., & Kunins, L. (Eds.) Uptodate. Available from: https://www-uptodate-com.rossuniversity.idm.oclc.org/contents/obesity-in-adults-etiologies-and-risk-factors?search=medication%20associated%20with%20weight%20gain§ionRank=1&usage_type=default&anchor=H1612312650&source=machineLearning&selectedTitle=1~150&display_rank=1#H1612312650. Royalty-free music used for this episode: Salsa Trap by Caslo, downloaded on July, 20, 2022 from https://freemusicarchive.org/music/caslo/caslo-vol-1/salsa-trap/. Space Orbit by Scott Holmes, downloaded on July, 20, 2022 from https://freemusicarchive.org/music/Scott_Holmes/.