Podcasts about High Risk

Five years ago, Jimmy Graham dreamed of walking the El Camino with his two daughters. This year, that dream came true. Join Jimmy and Brian Karch as they reflect on the powerful moments, lessons, and memories from their pilgrimage across Spain.   Who's Jimmy Graham? Jimmy spent over 15 years in the US Navy SEAL Teams earning the rank of Chief Petty Officer (E7). During that time, he earned certifications as a Sniper, Joint Tactical Air Controller, Range Safety Officer for Live Fire, Dynamic Movement and Master Training Specialist. He also served for 7 years as an Operator and Lead Instructor for an Elite Federal Government Protective Detail for High-Risk and Critical environments, to include; Kirkuk, Iraq, Kabul, Afghanistan, Beirut, Lebanon and Benghazi, Libya. During this time he earned his certification for Federal Firearms Instructor, Simunition Scenario Qualified Instructor and Certified Skills Facilitator. Jimmy has trained law enforcement on the Federal, State, and Local levels as well as Fire Department, EMS and Dispatch personnel. His passion is to train communities across the nation in order to enhance their level of readiness in response to active shooter situations.   Make sure you subscribe and stay tuned to everything we are doing. Want to get more training? - https://ableshepherd.com/ Need support? https://able-nation.org/ Follow us on: Facebook - https://www.facebook.com/ableshepherd Instagram - ​​https://www.instagram.com/ableshepherd/ Youtube - https://www.youtube.com/@ableshepherd

In this eye-opening episode, employment attorneys Kristen Prinz and Christina Hynes Mesco explore the complex dynamics of harassment among senior executives—particularly how it impacts women in top leadership roles. Executives often have fewer avenues for reporting sexual harassment than other employees, and women continue to face disproportionate scrutiny and higher standards of behavior in the workplace. At the same time, executives are not immune from being accused of harassment themselves.   Kristen and Christina rely on their own expertise in counseling clients and litigating employment claims to explore the unique position senior women occupy in these conversations and how they can protect themselves and their teams.   Our hosts—experienced employment attorneys—discuss:  ·        Why senior women are often targets   ·        How miscommunications and unclear boundaries can lead to liability  ·        Why retaliation is still one of the most common mistakes companies make  ·        How they advise clients facing these high-stakes issues  ·        What effective organizational responses actually look like  ·        The critical importance of documenting concerns early and clearly  This episode will be instructive for C-suite leaders and aspiring executives, HR professionals and legal counsel, and anyone managing workplace culture and compliance. Whether you're an executive navigating a tricky situation or advising leadership from the wings, this episode offers essential insights on how to lead with integrity, manage risk, and promote healthier workplace culture.       Stay Connected & Learn More:   Kristen Prinz   Christina Hynes Mesco   Christina & Kristen's blog on executive harassment   The Prinz Law Firm

In this JCO Article Insights episode, Michael Hughes summarizes “International Myeloma Society and International Myeloma Working Group Consensus Recommendations on the Definition of High-Risk Multiple Myeloma" by Avet-Loiseau et al. published on June 09, 2025 along with an interview with author Dr Nikhil C. Munshi, MD. TRANSCRIPT Michael Hughes: Welcome to this episode of JCO Article Insights. This is Michael Hughes, JCO's editorial fellow. Today I am interviewing Dr. Nikhil Munshi on the “International Myeloma Society and International Myeloma Working Group Consensus Recommendations on the Definition of High-Risk Multiple Myeloma” by Avet-Loiseau et al. At the time of this recording, our guest has disclosures that will be linked in the transcript. While some patients with multiple myeloma live for decades after treatment, others exhibit refractory or rapidly relapsing disease irrespective of treatment administered. We term this “high-risk myeloma.” Multiple risk stratification systems have been created, starting with the Durie-Salmon system in 1975 and evolving with the advent of novel therapeutics and novel treatment approaches. In 2015, the Revised International Staging System (R-ISS) was introduced, which incorporated novel clinical and cytogenetic markers and remained, until recently, a mainstay of risk stratification in newly diagnosed disease. Myeloma as a field has, just in the past few years, though, undergone explosive changes. In particular, we have seen groundbreaking advances not only in treatments - the introduction of anti-CD38 agents and the advent of cellular and bispecific therapies - but also in diagnostic technology and our understanding of the genetic lesions in myeloma. This has led to the proliferation of numerous trials employing different definitions of high-risk myeloma, a burgeoning problem for patients and providers alike, and has prompted attempts to consolidate definitions and terminology. Regarding cytogenetic lesions, at least, Kaiser et al's federated meta-analysis of 24 therapeutic trials, published here in the JCO in February of 2025 and recently podcasted in an interview with associate editor Dr. Suzanne Lentzsch, posited a new cytogenetic classification system to realize a shared platform upon which we might contextualize those trial results. This article we have here by Dr. Avet-Loiseau, Dr. Munshi, and colleagues, published online in early June of this year and hot off the presses, is the definitive joint statement from the International Myeloma Society (IMS) and the International Myeloma Working Group (IMWG). What is high-risk multiple myeloma for the modern era? The IMS and IMWG Genomics Workshop was held in July 2023 and was attended by international myeloma experts, collaborating to reach consensus based on large volumes of data presented and shared. The datasets included cohorts from the Intergroupe Francophone du Myélome (IFM); the HARMONY project, comprised of multiple European academic trials; the FORTE study, findings from which solidified KRd as a viable induction regimen; the Grupo Español de Mieloma Múltiple (GEM) and the PETHEMA Foundation; the German-Speaking Myeloma Multicenter Group (GMMG); the UK-based Myeloma XI, findings from which confirmed the concept of lenalidomide maintenance; Emory 1000, a large, real-world dataset from Emory University in Atlanta; the Multiple Myeloma Research Foundation Clinical Outcomes in Multiple Myeloma to Personal Assessment of Genetic Profile (CoMMpass) dataset; and some newly diagnosed myeloma cohorts from the Mayo Clinic. Data were not pooled for analyses and were assessed individually - that is to say, with clear a priori understanding of whence the data had been gathered and for what original purposes. Consensus on topics was developed based on the preponderance of data across studies and cohorts. In terms of results, substantial revisions were made to the genomic staging of high-risk multiple myeloma, and these can be sorted into three major categories: A) alterations to the tumor suppressor gene TP53; B) translocations involving chromosome 14: t(14;16) (c-MAF overexpression), t(14;20) (MAFB overexpression), and t(4;14) (NSD2 overexpression); and C) chromosome 1 abnormalities: deletions of 1p or additional copies of 1q. In terms of category A, TP53 alterations: Deletion of 17p is present in up to 10% of patients at diagnosis and is enriched in relapsed or refractory disease. This is well-documented as a high-risk feature, but the proportion of the myeloma cells with deletion 17p actually impacts prognosis. GEM and HARMONY data analyses confirmed the use of 20% clonal cell fraction as the optimal threshold value for high-risk disease. That is to say, there must be the deletion of 17p in at least 20% of the myeloma cells on a FISH-analysis of a CD138-enriched bone marrow sample to qualify as high-risk disease. TP53 mutations can also occur. Inactivating mutations appear to have deleterious effects similar to chromosomal losses, and the biallelic loss of TP53, however it occurs, portends particularly poor prognosis. This effect is seen across Myeloma XI, CoMMpass, and IFM cohorts. Biallelic loss is rare, it appears to occur in only about 5% of patients, but next-generation sequencing is nevertheless recommended in all myeloma patients. Category B, chromosome 14 translocations: Translocation t(14;16) occurs in about 2% to 3% of patients with newly diagnosed disease. In the available data, primarily real-world IFM data, t(14;16) almost always occurs with chromosome 1 abnormalities. Translocation t(4;14) occurs in about 10% to 12% of newly diagnosed disease, but only patients with specific NSD2 alterations are, in fact, at risk of worse prognosis, which clinically appears to be about one in every three of those patients. And so together, the CoMMpass and Myeloma XI data suggest that translocation t(4;14) only in combination with deletion 1p or gain or amplification of 1q correlates with worse prognosis. Translocation t(14;20) occurs in only 2% of newly diagnosed disease. Similar to translocation t(4;14), it doesn't appear to have an effect on prognosis, except if the translocation co-occurs with chromosome 1 lesions, in which case patients do fare worse. Overall, these three translocations - t(14;16), t(4;14), and t(14;20) - should be considered high-risk only if chromosome 1 aberrations are also present. In terms of those chromosome 1 aberrations, category C, first deletions of 1p: Occurring in about 13% to 15% of newly diagnosed disease, deletion 1p eliminates critical cell checkpoints and normal apoptotic signaling. In the IFM and CoMMpass dataset analyses, biallelic deletion of 1p and monoallelic deletion of 1p co-occurring with additional copies of 1q denote high-risk. In terms of the other aberration in chromosome 1 possible in myeloma, gain or amplification of 1q: This occurs in up to 35% to 37% of newly diagnosed disease. It upregulates CKS1B, which is a cyclin-dependent kinase, and ANP32E, a histone acetyltransferase inhibitor. GEM and IFM data suggest that gain or amplification of 1q - there was no clear survival detriment to amplification - is best considered as a high-risk feature only in combination with the other risk factors as above. Now, in terms of any other criteria for high-risk disease, there remains one other item, and that has to do with tumor burden. There has been a consensus shift, really, in both the IMS and IMWG to attempt to develop a definition of high-risk disease which is based on biologic features rather than empirically observed and potentially temporally dynamic features, such as lactate dehydrogenase. Beta-2 microglobulin remains an independent high-risk indicator, but care must be taken when measuring it, as renal dysfunction can artificially inflate peripheral titers. The consensus conclusion was that a beta-2 microglobulin of at least 5.5 without renal failure should be considered high-risk but should not preclude detailed genomic profiling. So, in conclusion, the novel 2025 IMS-IMWG risk stratification system for myeloma is binary. It's either high-risk disease or standard-risk disease. It's got four criteria. Number one, deletion 17p and/or a TP53 mutation. Clonal cell fraction cut-off, remember, is 20%. Or number two, an IGH translocation - t(4;14), t(14;16), t(14;20) - with 1q gain and/or deletion of 1p. Or a monoallelic deletion of 1p with 1q additional copies or a biallelic deletion of 1p. Or a beta-2 microglobulin of at least 5.5 only when the creatinine is normal. This is a field-defining work that draws on analyses from across the world to put forward a dominant definition of high-risk disease and introduces a new era of biologically informed risk assessment in myeloma. Now, how does this change our clinical approach? FISH must be performed on CD138-enriched samples and should be performed for all patients. Next-generation sequencing should also be performed on all patients. Trials will hopefully now begin to include this novel definition of high-risk multiple myeloma. It does remain to be seen how data from novel therapeutic trials, if stratified according to this novel definition, will be interpreted. Will we find that therapies being evaluated at present have differential effects on myelomas with different genetic lesions? Other unanswered questions also exist. How do we go about integrating this into academic and then community clinical practice? How do we devise public health interventions for low-resource settings? To discuss this piece further, we welcome the esteemed Dr. Nikhil Munshi to the podcast. Dr. Munshi is a world-renowned leader in multiple myeloma and the corresponding author on this paper. As Professor of Medicine at Harvard Medical School, Director of the Multiple Myeloma Effector Cell Therapy Unit, and Director of Basic and Correlative Science at the Jerome Lipper Multiple Myeloma Center of the Dana-Farber Cancer Institute, he has presided over critical discoveries in the field.  Thank you for joining us, Dr. Munshi. Dr. Nikhil Munshi: Oh, it's my pleasure being here, Michael, to discuss this interesting and important publication. Michael Hughes: I had a few questions for you. So number one, this is a comprehensive, shall we say, monumental and wide-ranging definition for high-risk myeloma. How do you hope this will influence or impact the ways we discuss myeloma with patients in the exam room? And how do we make some of these components recommended, in particular next-generation sequencing, feasible in lower-resource settings? Dr. Nikhil Munshi: So those are two very important questions. Let's start with the first: How do we utilize this in our day-to-day patient care setting? So, as you know well, we have always tried to identify those patients who do not do so well with the current existing treatment. And for the last 30 years, what constitutes a myeloma of higher risk has continued to change with improvement in our treatment. The current definition basically centers around a quarter of the patients whose PFS is less than 2 to 3 years. And those would require some more involved therapeutic management. So that was a starting point of defining patients and the features. As we developed this consensus amongst ourselves - and it's titled as “International Myeloma Society, International Myeloma Working Group Consensus Recommendation” - this IMS-IMWG type of recommendation we have done for many years, improvising in various areas of myeloma care. Now, here, we looked at the data that was existing all across the globe, utilizing newer treatment and trying to identify that with these four-drug regimens, with transplant and some of the immunotherapy, which group of patients do not do as well. And this is where this current algorithm comes up. So before I answer your question straight, “How do we use it?” I might like to just suggest, “What are those features that we have identified?” There are four features which constitute high-risk disease in the newer definition. Those with deletion 17p with 20% clonality and/or TP53 mutation. Number two, patients with one of the translocations - t(4;14), t(14;16), or t(14;20) - co-occurring with 1q amplification or deletion 1p32. And that's a change. Previously, just the translocation was considered high-risk. Now we need a co-occurrence for it to be called high-risk. The third group is patients having biallelic deletion 1p32 or monoallelic deletion 1p32 along with 1q amplification. And finally, patients with high beta-2 microglobulin, more than or equal to 5.5 mg/dL, with normal creatinine less than 1.2 mg/dL. And the question, “How do we use this?” There are multiple areas where we incorporate high-risk features in our treatment algorithm. One of the first areas is where we would consider the induction regimen. If a patient has a high-risk disease, we would definitely consider a four-drug regimen rather than a three-drug regimen, although we are beginning to incorporate four-drug for all groups. That's one important thing. Number two, those are the patients where we do consider consolidation with transplant or maybe in the new world, considering some of the immunotherapeutic consolidation more early or more aggressively. Number three, these are the patients who get a little bit more maintenance therapy. So normally, lenalidomide might end up being our standard maintenance regimen. In patients who have high-risk disease, we incorporate either addition of daratumumab or the anti-CD38 targeting antibody and/or addition of proteasome inhibitor, either bortezomib or carfilzomib. So you would have multi-drug maintenance therapy in these patients. And in high-risk patients, we follow them with maintenance longer periods of time. One very critically important point to keep in mind is that to get the better outcome in high-risk disease, we must try to get them into MRD negativity because there is clear data that patients who do achieve MRD negativity, despite having high-risk disease, have a much superior outcome. They become near to standard-risk disease. And so, in high-risk patients, I would try to do whatever various options I have to try and get them into MRD-negative status. And when these patients relapse, we do not wait for the classic progression criteria to be met before we intervene. We would propose and suggest that we intervene earlier before the disease really blasts off. And so there are a number of areas in our setting where this high-risk definition will help us intervene appropriately and also with appropriate aggressiveness to achieve better outcome, to make this similar to standard-risk disease. Michael Hughes: Thank you, Dr. Munshi. And thoughts on how to really integrate this not only into academic centers but also lower-resource settings? Dr. Nikhil Munshi: So that's a very important question, Michael. And when we were developing this consensus, we were very cognizant of that fact. So wherever available, I think we are recommending that over a period of next 2, 3, 5 years, we should begin to switch over to sequencing-based methods because two components of this definition, one is TP53 mutation, which we cannot do without sequencing, and also reliably detecting deletion 1p requires sequencing-based method. So in the low-resource countries - and there are many in this world, and also even in our own country, patients may not be able to afford it - the older method with FISH or similar such technology, which is more affordable, is also acceptable for current time. They may miss a very small number of patients, maybe 2% to 3%, where these finer changes are not picked up, but a majority of this would be captured by them. So the current practice might still be applicable with some limitation in those patient populations, and that's what we would recommend. What is happening, fortunately, is that actually sequencing-based method is becoming cheaper. And in many centers, it is cheaper to do the sequencing rather than to do the FISH analysis. And so my hope is that even in low-resource centers, sequencing might be more economical in the end. It's, I think, the access to technology, which is a little bit limited currently, but it's hopefully becoming available soon. Michael Hughes: Thank you, Dr. Munshi. And staying for a minute and looking at the multiple myeloma subsets which might be missed by this really still very broad-ranging high-risk definition, at least by prior risk stratification systems, right, there is this group of patients who have standard-risk cytogenetics by R-ISS or R2-ISS, but they have primary refractory disease or they relapse early. We call these, as you are well aware, functionally high-risk disease. What proportion of previously FHR, functionally high-risk, myeloma patients do you expect to be captured by this novel definition? Dr. Nikhil Munshi: So I think the newer definition - and we can look at it both ways, but the newer definition should capture most of the functionally high-risk definition. To put it differently, Michael, there are patients who we know are, as you mentioned, functionally high-risk. Those are the patients who might have plasma cell leukemia, those who might have extramedullary disease, those who might not respond to our four-drug induction. If you don't respond to the four-drug induction, almost by definition, they are high-risk. However, a majority of them have one of the abnormalities that we are describing here. There would be a very small proportion which may not have. And if they do not have, we know one of the important components of this definition here is also that the genome, we know, keeps on evolving. So there may be a very small clone with the high-risk feature which was not obvious in the beginning. Following treatments or following relapse, that clone predominates, and now the patient's disease becomes high-risk.  So the definition would incorporate or would capture these functional high-risk patients, but as you said, in countries where resources are not available, using this functional high-risk would also be helpful and advantageous. Sometimes LDH ends up being a high-risk. In our studies, LDH has not come out to be high-risk anymore because the features we are describing captures most of those patients, but those alternatives, older, can still be considered if other newer techniques are not available. Michael Hughes: Got you. And in terms of these older definitions, yes, that incorporate tumor burden, these empirical observations about how myeloma presents, do you foresee any additional tumor burden indicators being added to future definitions of high-risk disease? Or do you instead see this particular definition as a major waypoint on the journey towards a fully biologically grounded definition of high-risk disease? Dr. Nikhil Munshi: I think your second part is what is going to happen. I think the tumor burden-related definition is being now replaced by the biological or genomic-based definition. And I think at some point, it will be quite fully replaced. One component not here, and it is because one thing, we don't have enough data; number two, we don't know how it will pan out, is also the influence of the microenvironment on the risk definition. For example, the immune system, the immune function, etc. But not enough data exists to suggest how it would change the current definition. So in future, would a definition be totally genomic or it could be more integrative? And my personal guess is that it would be more integrative and that some immune features might come into the picture, especially now that we are using immune-based therapy as a very important component of treatment - CAR T-cells, bispecific, and antibody-based treatments. What role the immune system plays in either supporting tumor or what role suppression of the anti-tumor immunity plays? They all will be important how patient outcomes end up being, and which in turn could translate into how patient's risk stratification might happen. So I think the older tumor burden-related definitions probably will become things of the past. What we have currently proposed and consensus developed is the new path forward, and over time, some microenvironmental influences, if defined and found to be important, may get some more incorporation if it compares favorably with the genomic features. Michael Hughes: Thank you, Dr. Munshi for that enlightening response.  To conclude the podcast, I'd like to look to the future and to the immediate future, what are the next steps for high-risk disease definition between now and discussing an integrated genomic-microenvironment-based definition? Will we see attempts to refine? Will we see a multi-level system, things like this? Dr. Nikhil Munshi: Yeah, so I think the current definition will be here to stay for the next 10 years or so. I think this has been developed using a large amount of data, so we do believe that this will remain fine. It has been validated now within the last six months by a few of the other studies. So there won't be a quick change. But we will try to, all of us will try to innovate. And as you very rightly bring up, the areas of research would include looking at the expression or transcriptomic component. Does that matter? And we do believe a small number of patients will have transcriptomic changes, not looked at the DNA changes, and may play a role. There are newer components, so long non-coding RNA, for example, is going to be an important component to look at, how it impacts the disease outcome, etc. There are also some of the proteomic-related changes which may become important in our studies. And then as we discussed, microenvironment and immunological changes. So these are the future areas of ongoing research where we all should collect data, and then in the next 5 to 10 years, we'll have another group meeting to see has anything changed or any of the features have become more important.  Most of the time, some of the older features are lost because they are not as critically high-risk, and the newer features come in. And so the historical background for just one second, there was a time when chromosome 13 was considered a high-risk disease. We now don't even mention it because it's not high-risk. The newer treatments have improved the outcome. t(4;14) used to be a high-risk disease. Now by itself today, in this definition by itself is not; it needs to be with something else. And so I think this is a great sign of progress. As we improve the treatment and outcomes, some of the features will become less important, new features will come up, and we'll need to keep on evolving with time and with technology and make it better for patients. Michael Hughes: Thank you so much, Dr. Munshi, for your wisdom, for your sagacity, for your historical perspective as well.  Thank you for listening to JCO Article Insights. Please come back for more interviews and article summaries. And be sure to leave us a rating and review so others can find our show. For more podcasts and episodes from ASCO, please visit asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.  Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

High-risk merchant accounts are one of the most challenging areas in payments. In this week's episode, James Shepherd interviews Jerry Gialanella from Fort Point Payments to break down what it really takes to get high-risk deals approved, the pitfalls to avoid, and how their team gets it done. Afterward, Rich Norton shares actionable sales tips from the field, and Patti Murphy joins James for Today in Payments to discuss major industry shifts—from stablecoin developments and Bitcoin trends to PayPal's latest moves and the GENIUS Act.

From the Best of What On Earth – Wildland firefighters say working conditions threaten the safety of crew and the public in Alberta. People on the front lines say they're losing team members to other employers that offer better pay, benefits and long-term opportunities – leaving what they call a gap in experience on the crews. In the midst of what is shaping up to be Canada's second-worst wildfire season, we revisit our conversation.

What do a brothel in Thailand, ancient Egyptian tombs, and Hollywood's lightsabers have to do with the world's most successful innovators? More than you'd ever imagine.In this jaw-dropping episode of Thrive LouD with Lou Diamond, host Lou sits down with the remarkable Susan Lindner—global keynote speaker, founder of Innovation Storytellers, and a woman whose journey to innovation storytelling began in the most unexpected of places.Episode Highlights:From Brothel to Boardroom: Susan shares her origin story as an HIV educator in 1990s Thailand, working with brothel owners and sex workers to reimagine their roles as heroes of their own stories—a lesson that transformed how life-saving innovations can change behavior and lives.The Real Role of Storytelling in Innovation: Discover why most innovators fail at storytelling, focusing on their inventions instead of the impact they have on actual people. Susan reveals the secret: make the listener the hero, not the creator.Hollywood, Prophets, and Going Viral: What can innovators learn from religious prophets and Star Wars? Susan breaks down how innovations (just like lightsabers) are only as good as the stories told about them—and those stories must be simple, repeatable, and transformative.Overcoming Ego & Building Empathy: Explore the practical exercises Susan uses to help scientists, executives, and even Air Force leaders shift from ego-driven narratives to human-centered stories of struggle, triumph, and transformation.The Power of Distribution: It's not just about telling your innovation's story—it's about getting others to tell it for you. Learn Susan's “prophets' playbook” for building a tribe of storytellers inside and outside your organization.Keep Learning: Subscribe to Susan's newsletter (innovationstorytellers.com) and check out the Innovation Storytellers podcast for weekly inspiration and how-tos from global innovation leaders.Whether you're an entrepreneur, scientist, exec, or just someone trying to make your idea stick, this conversation will forever change how you see—and tell—the story of innovation.Listen now and start transforming how you share your ideas, influence others, and make your innovation go viral.Timestamped Overview00:00 Fighting HIV in Thailand's Brothels03:47 Transforming Brothels: Heroes and Change10:02 Overcoming Ego in Innovation11:45 "Understanding Innovator's Humanity"16:38 "Shifting Perspectives: Gaining Early Adopters"19:58 High Risk, High Innovation23:20 Training Air Force Storytellers24:20 Innovation Storytelling Tips28:26 "Innovation Storytelling Podcast Launch"

In today's episode, crypto OG Scott Melker joins us to break down why this might be the most bullish setup for Bitcoin ever, and whether Ethereum is about to rip past expectations. We dive into ETH/BTC breaking key resistance, new liquidity entering the market, and why crypto-adjacent stocks are becoming the new altcoins.~~~~~

Moderator: James P. Rathmell, M.D. Participants: Nikolay O. Kamenshchikov, M.D. and Lorenzo Berra, M.D. and Kamrouz Ghadimi, M.D. Articles Discussed: Perioperative Nitric Oxide Conditioning Reduces Acute Kidney Injury in Cardiac Surgery Patients with Chronic Kidney Disease (the DEFENDER Trial): A Randomized Controlled Trial Nitric Oxide and Kidney Injury after Cardiac Surgery: A Solution Looking for a Problem

In this episode, Ethereum co-founder Joe Lubin breaks down his boldest move yet: launching SBET, a publicly traded ETH treasury vehicle modeled after Michael Saylor's Bitcoin playbook. From geopolitical shifts and stablecoin dominance to Ethereum's evolving value thesis, Joe lays out why ETH is becoming the backbone of the next financial era, and why now is the moment institutions are loading up.~~~~~

In today's episode, we sit down with Nic Huntley, CEO of Blueprint Finance, who's building the infrastructure that could finally bridge traditional finance and onchain yield. We unpack what's really going on behind the scenes, the ETFs, the treasury strategies, and the hidden middleware that could funnel billions into DeFi without anyone even logging into MetaMask.~~~~~

In this episode, Coinbase Head of Research David Duong breaks down their Q3 2025 outlook, and let's just say, the bulls might not be ready for what's coming. From Bitcoin dominance and ETF-driven supercycles to Ethereum's resurgence and the stablecoin takeover, this one is packed with alpha.~~~~~

Google and Microsoft issue critical updates. CISA warns of active exploitation of a critical flaw in Wing FTP Server. Cloudflare restores their DNS Resolver service following a brief outage. A critical vulnerability in a PHP documentation tool allows attackers to execute code on affected servers. NSA and FBI officials say they've disrupted Chinese cyber campaigns targeting U.S. critical infrastructure. A UK data breach puts Afghan soldiers and their families at risk. Researchers find malware hiding in DNS records. A former U.S. Army soldier pleads guilty to charges of hacking and extortion. Ben Yelin joins us with insights on the Senate Armed Services Committee's response to rising threats to critical infrastructure.The large print giveth and the small print taketh away.  Remember to leave us a 5-star rating and review in your favorite podcast app. Miss an episode? Sign-up for our daily intelligence roundup, Daily Briefing, and you'll never miss a beat. And be sure to follow CyberWire Daily on LinkedIn. CyberWire Guest Today we are joined by Ben Yelin, co host of our Caveat podcast and Program Director for Public Policy & External Affairs at the University of Maryland Center for Cyber Health and Hazard Strategies, discussing the Senate Armed Services Committee's and Trump administration nominees' recent conversation about rising threats to critical infrastructure. You can find the article Ben discusses here. Selected Reading Google fixes actively exploited sandbox escape zero day in Chrome (Bleeping Computer) Windows KB5064489 emergency update fixes Azure VM launch issues (Bleeping Computer) Exploited Wing file transfer bug risks ‘total server compromise,' CISA warns (The Record) Cloudflare 1.1.1.1 incident on July 14, 2025 (Cloudflare) Critical template Injection flaw in LaRecipe Documentation Package enables remote code execution (Beyond Machines) NSA: Volt Typhoon was ‘not successful' at persisting in critical infrastructure (The Record) Defence secretary 'unable to say' if anyone killed after Afghan data breach  (BBC News) Hackers exploit a blind spot by hiding malware inside DNS records (Ars Technica) 21-year-old former US soldier pleads guilty to hacking, extorting telecoms  (The Record) WeTransfer says files not used to train AI after backlash (BBC News) Audience Survey Complete our annual audience survey before August 31. Want to hear your company in the show? You too can reach the most influential leaders and operators in the industry. Here's our media kit. Contact us at cyberwire@n2k.com to request more info. The CyberWire is a production of N2K Networks, your source for strategic workforce intelligence. © N2K Networks, Inc. Learn more about your ad choices. Visit megaphone.fm/adchoices

This podcast highlights three updates: Moderna's Spikevax COVID-19 vaccine is now fully FDA-approved for high-risk children 6 months to 11 years, though rare myocarditis remains a concern. A large study found first-trimester TMP-SMX antibiotics increase congenital malformation risks compared to β-lactams, reinforcing β-lactams as safer. Finally, a trial showed no cardiovascular benefit from taking blood pressure medication at bedtime versus morning dosing.

In this episode, legendary macro analyst Jim Bianco joins us to break down why 2020 was the true start of a new economic cycle, one that central banks are completely unprepared for. From sticky inflation and tariff-fueled CPI shocks to the real risk of Powell getting fired, Bianco pulls zero punches.~~~~~

We have covered Low Dose Aspirin (LDA) for pre-natal preeclampsia prevention MANY times before. But here's a good clinical question: Since preeclampsia can also pop-up in the first 6 weeks postpartum (pp), should we continue it in the immediate pp interval? There is a new publication, an RCT, in the AJOG that looked to answer this- and we will highlight that publication in this episode. PLUS, we will briefly summarize a separate publication from the American J Perinatology back in 2023 that also provided some clinical insights on this topic. Listen in for details.1. The association between postpartum aspirin use and NT-proBNP levels as a marker for maternal cardiac health: a randomized-controlled trial; July 2025 (AJOG): https://www.sciencedirect.com/science/article/pii/S00029378250047522. Christenson E, Stout MJ, Williams D, Verma AK, Davila-Roman VG, Lindley KJ. Prenatal Low-Dose Aspirin Use Associated with Reduced Incidence of Postpartum Hypertension among Women with Preeclampsia. Am J Perinatol. 2023 Mar;40(4):394-399. doi: 10.1055/s-0041-1728826. Epub 2021 May 3. PMID: 33940641.3. Mendoza M, Bonacina E, Garcia-Manau P, et al. Aspirin Discontinuation at 24 to 28 Weeks' Gestation in Pregnancies at High Risk of Preterm Preeclampsia: A Randomized Clinical Trial. JAMA. 2023;329(7):542–550. doi:10.1001/jama.2023.0691

Experts are warning young adults and parents of young children to be aware of early symptoms of meningococcal disease, as Australia enters its peak season. The bacterial infection can strike without warning and progress rapidly, in many cases causing death or leading to life-changing complications.

In this episode of Fill Me In, Jon and Nicole discuss the high-risk areas of injecting, emphasizing the importance of technique, safety, and advanced training. Learn about the crucial zones where complications like vascular occlusion and tissue necrosis can occur, including the glabella, forehead, nose, and other areas. The hosts also share expert advice on safety protocols, the importance of aspiration, and real-life experiences to help injectors navigate these risky zones with confidence. Join us for an in-depth and educational session that's perfect for both new and experienced injectors.Moxie helps medspa entrepreneurs reach multimillion dollar growth—with marketing, compliance, coaching, software, and VIP pricing, all in one place.Fill Me In listeners get $500 off their Moxie launch fee! Just click here: joinmoxie.com/fillmeinThis episode features a Reel from Dr. MJ Rowland-Warmann. Watch the full Reel on her Instagram: https://www.instagram.com/dr_mj_smileworks/On Fill Me In: An Aesthetics Podcast, Jon LeSuer NP-C and Nicole Bauer FNP-BC dive deep in the world of aesthetics. As aesthetic nurse practitioners with their own medical practices, Jon and Nicole fill you in on everything in their field.Follow Fill Me In on Instagram!https://www.instagram.com/thefillmeinpod/Follow Nicole on Instagram:https://www.instagram.com/aestheticnursenicole/Follow Jon on Instagram:https://www.instagram.com/injectorjon/Exhibit Medical Aesthetics website:https://exhibitmedicalaesthetics.com/Tox and Pout Aesthetics website:https://toxandpout.com/Producer of Fill Me In: Joseph Ginexi

In this episode on "Identifying high-risk stone formers: How can we improve early diagnosis and referral?"  Prof. Bhaskar Somani (GB) is joined by Prof. Pietro Manuel Ferraro (IT) and Prof. Esteban Emiliani (ES) to discuss timely and effective strategies for recognising patients with increased risk of kidney stone recurrence and complications.The episode opens with the speakers sharing their clinical backgrounds - Prof. Ferraro as a nephrologist and Prof. Emiliani as an endourologist - laying the foundation for a multidisciplinary exchange. They reflect on challenges currently faced in clinical practice, including the delayed identification of patients who are predisposed to rapid stone formation, complex surgical pathways, or long-term renal complications.Prof. Somani introduces the concept of the SMART Stone MDT and its potential to streamline patient care by enabling earlier recognition and appropriate referral. The discussion highlights the benefits of a structured, team-based model that incorporates both surgical and nephrology perspectives, aiming to reduce complications and improve outcomes.Practical examples and real-world insights are shared throughout the episode, illustrating how MDTs can be integrated into everyday workflows. The conversation underlines the importance of collaboration, early intervention, and tailored patient pathways for high-risk stone formers, including those with primary hyperoxaluria or a solitary kidney.This episode offers valuable takeaways for clinicians seeking to improve kidney stone care through early diagnosis and coordinated referral pathways.AcknowledgmentMedical writing support was provided by Health Unlimited with unrestricted funding from Novo Nordisk, with no involvement in the programme or speaker selection.For more EAU podcasts, please go to your favourite podcast app and subscribe to our podcast channel for regular updates: Apple Podcasts, Spotify, EAU YouTube channel.

Do you really know your breast cancer risk? Many women think they do – trusting family history, regular checkups, and mammograms to keep them safe. But what if these measures leave dangerous blind spots, leading to later, more aggressive diagnoses? Today's episode is a powerful wake-up call. Joining us is globally renowned OBGYN, Dr. Thaïs Aliabadi. Known simply as “Dr. A” to her global following, she's OBGYN to royals and celebrities, and a leading voice on women's health featured on The Kardashians, The Doctors, and Dr. Phil. Dr. Aliabadi shares her own shocking story: how, despite following all the rules, she uncovered a hidden cancer risk that standard screening completely missed. Today you'll learn why your lifetime risk may be higher than you've been told, how diet and lifestyle could change your trajectory, and the essential steps to take today to safeguard your health. This is information every woman needs - don't wait until it's too late. Unwrap the truth about your food

After losing 3 lbs out of his less than 30 pound frame and not eating well in late 2021, Shelby Nadeau took her son Stryder to doctors, neither of whom thought that there was anything wrong with him physically. Just a couple of weeks later however, Stryder was diagnosed with Stage 4 High Risk Neuroblastoma after proper tests were ordered at Sacramento Children's Hospital which showed that there were plenty of tumors to be found. 

Send us a textWelcome back Rounds Table Listeners! We are back today with a solo episode with Dr. John Fralick. This week, he discusses a recently published trial exploring the effects of add-on sotatercept in patients with advanced pulmonary arterial hypertension and a high risk of death. Here we go!Sotatercept in Patients with Pulmonary Arterial Hypertension at High Risk for Death (0:00 – 5:38).The Good Stuff:2025 Scripps National Spelling Bee winning word: éclaircissement (5:39 - 6:34)Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods

In this episode, I was lucky enough to interview Aubrey Amatelli, Founder and CEO of PayRio—the first payment provider focused exclusively on alternative medicine.Aubrey shared how her roots in Silicon Valley and a traditional finance career at JP Morgan eventually led her to launch PayRio, combining her passion for cannabis and her expertise in payments. She walked me through the complicated regulatory landscape that makes payment processing for cannabis so challenging and explained how PayRio uses creative, compliant workarounds like ATM rails and wallet tech to support dispensaries and e-commerce businesses.Aubrey also opened up about the emotional transition from corporate life to cannabis entrepreneurship, including the fear and eventual empowerment that came with “coming out” on LinkedIn. Aubrey discussed how her startup journey began with cold calls and a scrappy three-person team, and how PayRio has grown to serve both mom-and-pop dispensaries and multi-state operators alike.Let's drive all the way to San Francisco and dive into Aubrey Amatelli's bold leap from Wall Street to CBD tech in this episode of The First Customer!Guest Info:PayRiohttps://payrio.co/Aubrey Amatelli's LinkedInhttps://www.linkedin.com/in/aubreyamatelli/Connect with Jay on LinkedInhttps://www.linkedin.com/in/jayaigner/The First Customer Youtube Channelhttps://www.youtube.com/@thefirstcustomerpodcastThe First Customer podcast websitehttps://www.firstcustomerpodcast.comFollow The First Customer on LinkedInhttp://www.linkedin.com/company/the-first-customer-podcast/

07-05-25Support the show: https://www.loveneverfailsus.com/donateSee omnystudio.com/listener for privacy information.

In this episode, UROONCO PCa chief editor Dr. Giancarlo Marra speaks to Prof. Derya Tilki (DE) about the 2025 updates in the EAU Prostate Cancer Guidelines, specifically regarding high risk, locally advanced disease and biochemical recurrence. This discussion includes changes such as the use of PSMA-PET-CT for staging, and updates related to lymphadenectomy. 

All kink carries some level of risk but certain activities are known to be genuinely dangerous. Should kinksters who engage in these scenes – with full consent from both parties – be “allowed” to... The post Ethics and Responsibilities in High-Risk Kink Play appeared first on Loving BDSM.

United Kingdom correspondent Edward O'Driscoll spoke to Lisa Owen about the BCC which has said it will no longer live broadcast "high-risk" performances after the controversy over Bob Vylan's Glastonbury gig, as well as a pair of same-sex penguins at Chester Zoo, who have successfully hatched and raised a chick.

On this episode of the Protector Culture Podcast, Jimmy and BK dive into the new laws being passed in Colorado—and why now is the time to take a stand. Our children's future and our foundational beliefs are under pressure like never before.   Jimmy and BK break down what these changes mean, why it matters, and how we, as protectors, must rise up with conviction and courage.

Guest: Sarah Aoun, Privacy Engineer, Google Topic: You have had a fascinating career since we [Tim] graduated from college together – you mentioned before we met that you've consulted with a literal world leader on his personal digital security footprint. Maybe tell us how you got into this field of helping organizations treat sensitive information securely and how that led to helping keep targeted individuals secure?  You also work as a privacy engineer on Fuschia, Google's new operating system kernel. How did you go from human rights and privacy to that?  What are the key privacy considerations when designing an operating system for “ambient computing”? How do you design privacy into something like that? More importantly, not only “how do you do it”, but how do you convince people that you did do it? When we talk about "higher risk" individuals, the definition can be broad. How can an average person or someone working in a seemingly less sensitive role better assess if they might be a higher-risk target? What are the subtle indicators? Thinking about the advice you give for personal security beyond passwords and multi-factor auth, how much of effective personal digital hygiene comes down to behavioral changes versus purely technical solutions? Given your deep understanding of both individual security needs and large-scale OS design, what's one thing you wish developers building cloud services or applications would fundamentally prioritize about user privacy? Resources: Google privacy controls Advanced protection program

LISTEN and SUBSCRIBE on:Apple Podcasts: https://podcasts.apple.com/us/podcast/watchdog-on-wall-street-with-chris-markowski/id570687608 Spotify: https://open.spotify.com/show/2PtgPvJvqc2gkpGIkNMR5i WATCH and SUBSCRIBE on:https://www.youtube.com/@WatchdogOnWallstreet/featuredTrump isn't trimming the fat. He's slamming the gas pedal.We break down the bold, risky, shoot-the-moon strategy behind Trump's latest economic moves. From yelling at the Fed to push rates down to ramping up growth with no brakes in sight, this isn't fiscal conservatism—it's economic adrenaline.In this episode:What “shooting the moon” means in card games—and economicsHow a $5 trillion debt ceiling hike passed with carve-outs, gimmicks & magic wandsWhy “reconciliation” is D.C.'s dirtiest budget trickHow sex changes for minors and welfare for illegals ended up in the billPLUS: Here's what turbocharging the economy really means in the face of $37 trillion in debt. www.watchdogonwallstreet.com

You are called to assess a pregnant woman who presents to your hospital complaining of shortness of breath. She is 36 weeks pregnant with twins and tells you she had been getting progressively short of breath over the last month but put it down to the physical effects of the twin pregnancy in her abdomen. However last night she couldn't get her breath lying flat, had to sleep sitting up on 3-4 pillows and feels that "it is much worse". On examination she has a respiratory rate of 24/min, SpO2 = 92%, HR 105/min, BP 95/45 and you can hear crepitations in both lung fields. Her initial blood tests come back showing a raised plasma BNP and a bedside ECHO is done by a helpful colleague - who says "subjectively her LV isn't contracting very well". Hi everyone, This week I sit down with Dr Faith Njue the most qualified person here in WA to discuss the rare but important disease - peripartum cardiomyopathy. (See Faith's Bio below). Join us in our wide ranging discussion which touches on the diagnostic challenges, demographics, proposed mechanisms and general principles involved in managing these complex patients. Thanks Faith for a great discussion! Dr Faith Njue - Bio Faith Njue graduated from the University of Western Australia and completed cardiology training in Perth. She undertook further subspeciality training in advanced heart failure/ heart transplantation at Fiona Stanley Hospital and the University of Ottawa Heart Institute in Canada. Thereafter, she undertook further fellowship in cardio-obstetrics at the John Radcliffe hospital in Oxford (UK). She has special interest in women's cardiovascular health, heart disease in pregnancy and heart failure. Faith runs the dedicated Western Cardiology cardio-obstetrics clinic, designed to support women at risk of or with pre-existing heart conditions, through preconception counselling, pregnancy and into the post-partum period. Cardio-obstetrics is an expanding subspecialty that focuses on prevention, early detection, and appropriate management of cardiovascular disease in pregnancy. She holds public consultant positions at Sir Charles Gairdner and Fiona Stanley hospitals. She is part of the Advanced heart Failure and Cardiac Transplant team at FSH. She is the cardiology clinical lead for High Risk pregnancy at FSH. References Anaesthesia and peripartum cardiomyopathy Chapman, K. Njue F, Rucklidge M. BJA Education, Volume 23, Issue 12, 464 - 472 Melanie Ricke-Hoch, Tobias J. Pfeffer, and Denise Hilfiker-Kleiner. Peripartumcardiomyopathy: basic mechanisms and hope for new therapies. Cardiovascular Research (2020) 116, 520–531. doi:10.1093/cvr/cvz252​ Bauersachs J, König T, van der Meer P, et al. Pathophysiology, diagnosis and management of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy. Eur J Heart Fail. 2019 Jul;21(7):827-843. doi: 10.1002/ejhf.1493. Epub 2019 Jun 27. PMID: 31243866​ 2018 ESC Guidelines for the Management of Cardiovascular Disease During Pregnancy. European Heart Journal 2018. Vol 39;3165-3241​ Bromocriptine: Koenig T, Bauersachs J, Hilfiker-Kleiner D. Bromocriptine for the Treatment of Peripartum Cardiomyopathy. Card Fail Rev. 2018 May;4(1):46-49. doi: 10.15420/cfr.2018:2:2. PMID: 29892477; PMCID: PMC5971672 Hilfiker-Kleiner D, Haghikia A, Berliner D, Vogel-Claussen J, Schwab J, Franke A, Schwarzkopf M, Ehlermann P, Pfister R, Michels G, Westenfeld R, Stangl V, Kindermann I, Kühl U, Angermann CE, Schlitt A, Fischer D, Podewski E, Böhm M, Sliwa K, Bauersachs J. Bromocriptine for the treatment of peripartum cardiomyopathy: a multicentre randomized study. Eur Heart J. 2017 Sep 14;38(35):2671-2679. doi: 10.1093/eurheartj/ehx355. PMID: 28934837; PMCID: PMC5837241.

See my $250,000+ Stock Portfolio: https://www.patreon.com/citizenoftheyear/postsCheck out these AMAZING Deals: https://amzn.to/3NGmBPTYieldMax's fund of funds ETF YMAX Universe Fund of Option Income ETFs has now been out for a year and half - how is it fared and will continue to give as juicy monthly dividends and performance going forward? Check out my favorite research tool Seeking Alpha! Premium: https://link.seekingalpha.com/3B2L85W/4G6SHH/Alpha Picks: https://www.sahg6dtr.com/3B2L85W/J8P3N/Disclaimer:This is not financial advice and I am not a licensed financial advisor. Always do your own research before investing and work with a licensed financial advisor. These are my opinions for informational purposes only and not to be taken as investing advice. Some of the links on this page are affiliate links, meaning, at no additional cost to you, I may earn a commission if you click through and make a purchase and/or subscribe. As an Amazon Associate, I earn from qualifying purchases. Affiliate commissions help fund videos like this one

On this episode of Survey Says, a special edition of GT: The Podcast, I. Paul Singh, MD, is joined by guests Erin Sieck, MD, and Arkadiy Yadgarov, MD, to review a real case from his practice involving a patient with elevated IOP on medication and a family history of glaucoma. The guests share their initial thoughts and concerns about the patient, discuss their treatment goals, and weigh their options for next steps. Later, they compare their opinions with the results of a social media poll of GT's audience and find out what Dr. Singh did.

Doug Casey isn't one to mince words, and he unleashes on the insanity of US leadership and their inability to think rationally as Trump threatens to trigger a new world war in service of the leadership of Israel. Doug thinks the West is in big trouble, as propaganda spreads, political corruption ramps up, and debt levels threaten to explode, a potent combination that could also cause civil wars at home, in addition to global wars abroad. Get Your Commodity Culture Merch: https://commodity-culture-shop.fourthwall.comDoug Casey's International Man: https://internationalman.comDoug Casey's Take: https://www.youtube.com/@DougCaseysTakeDoug's Book 'Speculator': https://a.co/d/drQzU59Follow Jesse Day on X: https://x.com/jessebdayCommodity Culture on Youtube: https://youtube.com/c/CommodityCulture

It's finally here! Birthed into the world our new OB Emergency Pocket Guide titled, Confidence in Crisis: A Nurse's Pocketbook Guide to Master OB Emergencies. Join Sarah Lavonne as she has a celebratory and educational conversation with Bre Clinger. The guide was created by Bre Clinger, a Bundle Birth Nurse Mentor, to provide nurses with quick-reference information on 17 major obstetric emergencies. In this episode, you'll get a behind the scenes look at what it took to create the guide, including Bre's personal experiences, motivations and goal of empowering nurses to provide the best care with confidence.The conversation explores the maternal health crisis in the US, the importance of addressing fear and building a love-based approach to emergency situations. Plus, get a mini-class on diabetes in pregnancy and learn a helpful analogy to increase understanding. The OB Emergency Pocket Guide is now available, and we encourage labor & delivery nurses to utilize it as a valuable resource to enhance their knowledge and preparedness for obstetric emergencies. Thanks for listening and subscribing! Helpful Links!OB Emergency Pocket GuideMentorship ProgramTrauma in the Birth Professional On-Demand Class Bereavement On-Demand Class Holly Nichols Graphics IG @hnicholsillustrationMental health conditions leading cause of pregnancy- related deaths

Blood editor Dr. Laurie Sehn discusses the topic of "Aggressive non-Hodgkin lymphoma: defining and managing high-risk subsets" featuring Drs. Mark Roschewski, Grzegorz Nowakowski, and Neha Mehta-Shah, who each contributed to the articles featured in the review series on high-risk aggressive lymphoma.See the full review series on high risk lymphoma in volume 144, issue 25 of Blood.

WR2s are the key to dominating your 2025 fantasy football draft.They're just outside the elite tier — but smart drafters know the real value lives here. Garrett Wilson's talent is undeniable, but the shift from Aaron Rodgers to Justin Fields adds risk. Tyreek Hill's ceiling depends on whether Miami can run the ball well enough to force defenses out of two-high shells. And veterans like Adam Thielen and Cooper Kupp remain sneaky plays. Rich Hribar (Sharp Football Analysis) and Andrew Cooper (Fantasy Alarm) break down which WR2s are worth the investment.

In this eye-opening interview, I sit down with a cosmetic limb lengthening patient who underwent femur lengthening using the LON (Lengthening Over Nail) method on femur and gained 9 centimeters in height. But over 2 years later, he faced a serious setback - osteomyelitis, a deep bone infection that could have changed his life forever...In this raw and honest conversation, he shares his full journey:– Why he chose to undergo cosmetic lengthening– What he thinks about the LON method for limb lengthening surgery– How he discovered he had an infection years later– The signs and symptoms that saved him from permanent damage– What he wants future patients to know before considering this surgery_____________________Timestamps:0:00 - Intro01:56 - Experiencing Pain and Initial Diagnosis04:18 - Discovering Bone Infection Complications06:37 - Treatment Plan for Bone Infection08:49 - Surgery Timeline and Recovery Process11:06 - Challenges with Antibiotic Treatment13:02 - High Risk of Infections in Femur Lengthening15:00 - Lessons Learned from Medical Experience17:07 - Financial and Emotional Impact of Complications19:04 - Final Thoughts and Advice for Patients______________________

In this episode, I discuss the tools available in 2025 and for the next few years that allow business owners and high-earning W2 earners to eliminate the very destructive higher tax brackets without taking risk that you lose all the investment. Saving your hard-earned money from taxes is a powerful emotion and enables the "tax tail to wag the dog" - we get into investments we would not have made with people we don't know because of this emotion. Listen in to hear how reducing taxes is achievable with lower risk strategies in Hierarchy of Wealth Tier 2 - things you directly control.   Highlights Personal connection to taxes pain. Parable of earning money value. Lessons from failed investments. Questioning ethical tax reduction. Real estate depreciation strategy. Hierarchy of wealth explanation. Section 179 and business benefits. Captive insurance as a strategy. Comfort with paying reasonable taxes.   Links and Resources from this Episode Connect with Gary Pinkerton https://www.paradigmlife.net/  gpinkerton@paradigmlife.net https://garypinkerton.com/  https://clientportal.paradigmlife.net/WealthView360    Review, Subscribe and Share If you like what you hear please leave a review by clicking here   Make sure you're subscribed to the podcast so you get the latest episodes. Subscribe with Apple Podcasts Follow on Audible Subscribe with Listen Notes Subscribe with RSS  

Allan Swaringen discusses converting commercial real estate to residential. He says this only happens when these office buildings become “obsolete,” and the Covid-19 pandemic sped up this cycle. “This is kind of a high-risk, high-return venture,” he explains, and goes into detail about what his team looks for before renovating a building. He also talks about types of industrial buildings that are seeing high demand as well.======== Schwab Network ========Empowering every investor and trader, every market day. Subscribe to the Market Minute newsletter - https://schwabnetwork.com/subscribeDownload the iOS app - https://apps.apple.com/us/app/schwab-network/id1460719185Download the Amazon Fire Tv App - https://www.amazon.com/TD-Ameritrade-Network/dp/B07KRD76C7Watch on Sling - https://watch.sling.com/1/asset/191928615bd8d47686f94682aefaa007/watchWatch on Vizio - https://www.vizio.com/en/watchfreeplus-exploreWatch on DistroTV - https://www.distro.tv/live/schwab-network/Follow us on X – https://twitter.com/schwabnetworkFollow us on Facebook – https://www.facebook.com/schwabnetworkFollow us on LinkedIn - https://www.linkedin.com/company/schwab-network/ About Schwab Network - https://schwabnetwork.com/about

In this thought-provoking episode, I sit down with the remarkable Dr K, a high-risk obstetrician and online doula who is walking the delicate line between the medical system and autonomous birth.With rare insight and fierce compassion, Dr K shares what it's like to be an OBGYN working within a system that too often defaults to control, fear, and policy over people. Her mission? To bring balance back into the conversation and ensure that informed consent isn't just a checkbox, it's a sacred part of birth.✨ Inside this episode:What it's really like being an OBGYN in today's high-intervention maternity care modelThe uncomfortable truths around coercion, lack of consent, and birth trauma in hospital systemsWhy Dr K believes every woman deserves balanced, evidence-based, and non-judgmental supportHow she supports clients both clinically and emotionally, as both an online doula and OBGYNThe story behind her social media advocacy and why she started speaking outNavigating both worlds: institutional medicine and sovereign, women-centred careThis is a must-listen for birth workers, pregnant people, and anyone questioning the status quo in maternity care.More from Ashley:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠The VBAC Village⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Insta: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@ashleylwinning⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.ashleywinning.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join our⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ VBAC Homebirth Support ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Group here⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Love the podcast? ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Buy me a⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ coffeeDisclaimer: The VBAC Homebirth Stories Podcast is for educational and inspirational purposes only. The stories and opinions shared are personal experiences and should not be considered medical advice. Every birth journey is unique, and we encourage you to research, trust your intuition, and consult with a qualified healthcare provider before making decisions about your pregnancy, birth, and postpartum care.

In today's episode, we bring on Milk Road Degen creator LG Doucet, a battle-tested expert in navigating the riskiest corners of the market. We unpack how LG spots early winners, flips lunch money into life-changing gains, and avoids getting rekt in a market where thousands of tokens can launch in a day. ~~~~~

Fantasy Football show for June 5, 2025. It's mock draft time! Lots of advice for 2025 fantasy football drafts! Find out which strategies worked best in a 10-team Half PPR mock draft. Plus, the riskiest picks and upside players who could take a step forward in 2025. Manage your redraft, keeper, and dynasty fantasy football teams with the #1 fantasy football podcast.2025 ULTIMATE DRAFT KIT is available now at UltimateDraftKit.com(00:00) Introduction(03:20) NFL News12:00) Mock DraftConnect with the show:Subscribe on YouTubeVisit us on the WebSupport the ShowFollow on XFollow on InstagramJoin our Discord

They say you should never meet your heroes. Daemon Fairless disagrees. First, he has an update on the return of Hunting Warhead. But then he takes us behind-the-scenes on another project he's been working on as a story editor: The Outlaw Ocean.This is a frank, illuminating discussion with Ian Urbina, the Pulitzer Prize winning journalist who quit his New York Times job to do some of the hardest, most difficult and often dangerous reporting in the world. He's since become the de facto beat reporter for the world's oceans — and his investigations reveal the shocking prevalence of forced labour, mind-boggling overfishing, and the hard truth is that it's all connected to the cheap seafood we love.If you have the stomach for the kind of viscerally tough reporting we do on Hunting Warhead, we know you'll appreciate The Outlaw Ocean — another show that sheds light on the darkest corners of the world, and goes where others won't.Find and follow The Outlaw Ocean (S2) here: https://link.mgln.ai/oo-hw

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/AAPA information, and to apply for credit, please visit us at PeerView.com/KDS865. CME/MOC/AAPA credit will be available until June 6, 2026.Facilitating Progress in Early Detection & Intervention in Lung Cancer: Proactive Strategies to Improve Lung Cancer Screening for High-Risk Individuals in VA Healthcare Settings In support of improving patient care, this activity has been planned and implemented by PVI, PeerView Institute for Medical Education, and National Association of Veterans' Research and Education Foundations. PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through an independent educational grant from Merck & Co., Inc., Rahway, NJ, USA.Disclosure information is available at the beginning of the video presentation.

If you just found out that you're testing positive for high-risk HPV on your pap smear result, I'm going to walk you through the five essential steps I recommend for anyone who has received a positive high risk HPV diagnosis. I'm Dr. Doni Wilson, a naturopathic doctor and certified professional midwife who has been in practice for over 25 years helping women understand high risk HPV and what they can do to protect themselves from cancer associated with the high-risk HPV virus. You're in the perfect place to learn exactly what you need to do because I understand how scary it can be when you first get those test results back from your gynecologist showing positive for high-risk HPV. The diagnosis might be type 16 or 18 or one of the other fourteen types of high-risk HPV that are associated with cancer risk. No matter which type is testing positive—or sometimes more than one—it can trigger significant fear, anxiety, and worry about what to do next. What can you do to protect yourself? How can you be proactive? Often, gynecology offices tell patients to "just wait and come back in three to six months or a year, and there's nothing you can do about it." I speak with thousands of women every year, and this is what they consistently tell me their doctor's office says—that there's nothing you can do but wait and see if it causes abnormal cells or cancer. As someone who has been helping women for over 25 years—thousands of women around the world—I'm here to tell you that you don't have to wait and see if it turns into cancer. There are steps you can take starting now, and that's the purpose of this guide: to give you clear direction on what you can do immediately. I know it's challenging to find this We're here to help! LINKS FROM THE EPISODE:   Join Dr. Doni's Kickstart Program: https://hpv.doctordoni.com/hpv/hpv-kickstart-program    Menopause Program with Dr. Doni: https://dv296.infusionsoft.com/app/orderForms/Menopause    Sign up For Dr. Doni's Masterclasses: https://doctordoni.com/masterclasses/    Schedule A Chat With Dr. Doni: https://intakeq.com/new/hhsnib/vuaovx    Read the full episode notes and find more information: https://doctordoni.com/blog/podcasts/ MORE RESOURCES FROM DR. DONI:   Quick links to social media, free guides and programs, and more: https://doctordoni.com/links     Disclosure: Some of the links in this post are product links and affiliate links and if you go through them to make a purchase I will earn a commission at no cost to you. Keep in mind that I link these companies and their products because of their quality and not because of the commission I receive from your purchases. The decision is yours, and whether or not you decide to buy something is completely up to you.

Jamie from Yorkshire dials in to express the collective joy that was Neil Finn at Bush Hall in London on 3 February 2010. This sold out fan-club only show was filled with requests, spontaneous deep cuts, collaborations with audiance members and gentle renditions of soon to be released Intriguer tunes.Performances include Try Whistling This, Anytime, Last To Know, Love You Til The Day I Die, Twice If You're Lucky, Elephants & I Feel Possessed.Listener cover : Anytime by Jonathan & Oli ScottYou can significantly support the continuation of the 240 podcast for a donation of just a couple dollars per month. This goes directly towards covering the monthly cost of buzzsprout hosting fees, riverside video chat platform, editing software & cloud space. Big thank yous if you are in a position to help. Head over here to: http://patreon.com/240neilfinn

Pro Investor David Erfle now sees value in the higher-risk junior miners. David was hesitant to move his investment capital down the food chain into the smaller juniors. But now he sees profit-taking in the major majors which is trickling down into fund flows into the juniors. David shares his commentary on recent precious metals and miner price action. He also discusses how he has managed his portfolio over the past month. David Erfle is a self-taught mining sector investor. He stumbled upon the mining space in 2003 as he was looking to invest into a growing sector of the market. After researching the gains made from the 2001 bottom in the tiny gold and silver complex, he became fascinated with this niche market. So much so that in 2005 he decided to sell his home and invest the entire proceeds from the sale into junior mining companies. When his account had tripled by September, 2007, he decided to quit his job as the Telecommunications Equipment Buyer at UCLA and make investing in this sector his full-time job. David founded the Junior Miner Junky subscription-based newsletter in April, 2017 and writes a weekly column for precious metals news service Kitco.com, whose website attracts nearly a million visits every day. 0:00 Introduction 0:46 Portfolio moves? 7:00 Fund flows into juniors 10:39 Bull market scumbaggery 13:54 Copper 14:59 Value in high-risk juniors now 16:00 Bull market portfolio management 17:01 Pan American Silver buys MAG Silver 18:34 2011 silver bull market wins 20:58 JMJ sentiment indicator David's website: https://juniorminerjunky.com/ Sign up for our free newsletter and receive interview transcripts, stock profiles and investment ideas: http://eepurl.com/cHxJ39 Mining Stock Education (MSE) offers informational content based on available data but it does not constitute investment, tax, or legal advice. It may not be appropriate for all situations or objectives. Readers and listeners should seek professional advice, make independent investigations and assessments before investing. MSE does not guarantee the accuracy or completeness of its content and should not be solely relied upon for investment decisions. MSE and its owner may hold financial interests in the companies discussed and can trade such securities without notice. If you buy stock in a company featured on MSE, for your own protection, you should assume that it is MSE's owner personally selling you that stock. MSE is biased towards its advertising sponsors which make this platform possible. MSE is not liable for representations, warranties, or omissions in its content. By accessing MSE content, users agree that MSE and its affiliates bear no liability related to the information provided or the investment decisions you make. Full disclaimer: https://www.miningstockeducation.com/disclaimer/

In this episode, we explore the challenges and current guidelines for benzodiazepine use in pregnancy, breastfeeding, and adolescence. When is it appropriate to continue benzodiazepines during pregnancy, and what alternatives should clinicians consider? Faculty: Alexis Ritvo, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1 CME: Understanding Benzodiazepine Prescribing: A Clinician's Guide Consequences of Benzodiazepine Use in Pregnancy, Breastfeeding, and Adolescence

There are many nuances in the management of patients with pulmonary embolism in cardiac arrest, peri-arrest or simply in shock: We need to optimize oxygenation and airway management, hemodynamic support, acid/base management, thrombolysis and/or catheter-directed therapies that Anton dives into with guest experts Dr. Lauren Westafer, Dr. Bourke Tillmann and Dr. Justin Morgenstern... EM Cases is proudly FOAMEd - Please consider a donation: https://emergencymedicinecases.com/donation/