Podcasts about igas

O médico Rui Guimarães ganhou 52 mil euros ao fazer cirurgias extra, enquanto liderava o hospital de Gaia. Rejeita "incompatibilidades" e diz que nem a IGAS, nem a ministra apontaram problemas.See omnystudio.com/listener for privacy information.

Adalberto Campos Fernandes e Leal da Costa deixam duras críticas à IGAS por falta de controlo destes casos. Quanto à continuidade do médico: "Se suspeitas forem verificadas, não há condições".See omnystudio.com/listener for privacy information.

Aile Pilberg on naine, kelle elutee on viinud haridusuuendusest ja juhtimiskogemusest kuni Eesti teaduspõhise uneinnovatsiooni – SleepAngel patjade – lansseerimiseni. Selles sügavas ja elulises vestluses räägime unekvaliteedi mõjust tervisele, naha seisundile ja meeleolule, Aile teekonnast ettevõtluses, suhete hoidmise saladustest ning sellest, miks padi, millel sa magad, võib otseselt mõjutada 1/3 sinu elust. Saatesse on põimitud teadmised, inspiratsioon ja praktilised tarkused, mida iga kuulaja endaga kaasa võtta saab. Kood "chriskala" annab kõikidelt SleepAngel patjadelt -5% soodustust. www.sleepangel.ee

Com a Europa num impasse, o PR de França tem sido protagonista, o que deixa a UE em segundo plano. A conclusão é de Sousa Tavares para quem António Costa já "perdeu vários comboios" e terá perguntado ao espelho: "afinal em que é que eu mando"? A atitude de Macron em Washington merece reparos, mas as maiores críticas são para Trump que "aproxima os EUA, em alguns apectos, da Coreia do Norte". Sobre o relatório da IGAS, não restam dúvidas: Governo e MP devem atuar.See omnystudio.com/listener for privacy information.

Os partidos da oposição, da esquerda à direita, já começaram a reagir ao relatório preliminar da Inspecção Geral das Actividades em Saúde (IGAS), conhecido na quarta-feira, sobre as falhas de informação ao INEM durante a paralisação entre Outubro e Novembro do último ano, aumentando a pressão sobre a ministra da Saúde, Ana Paula Martins. O Governo não quer tirar consequências políticas deste caso?See omnystudio.com/listener for privacy information.

A IGAS (que já tem um relatório sobre as greves no INEM), o Sindicato dos Oficiais de Justiça (que promete mais "luta") e o PSD de Lisboa (que não muda) são o Bom, o Mau e o Vilão.See omnystudio.com/listener for privacy information.

Tänases saates "Eesti Pops" jällegi palju uut kodumaist muusikat, aga ka aastate tagust – näiteks aastal 2007 ilmunud lege filmi "Jan Uuspõld läheb Tartusse" soundtrack, aga ka selle uus järg "Jan Uuspõld läheb koju", mille esilinastus on täna! Tavalisest rohkem ka kitarre – fuzziga, overdrivega, distortioniga. Igas saates nüüd ka vähemalt üks välis-Eesti lugu - täna teeme otsa lahti.

A ministra da Saúde (que recorreu à IGAS), Aguiar-Branco (que propõe gravar tudo) e Filipe Araújo (que quer ser o sucessor de Rui Moreira) são o Bom, o Mau e o Vilão.See omnystudio.com/listener for privacy information.

Send us a text"Heida lesima ja vaata, mis toimuma hakkab" – Jaanika ja saatekülaline Tiit räägivad, kuidas hobuserahustina tuntud ketamiin võtab tarvitajal kogu maailma graanuliteks lahti. Teemad, millest seekordses saates veel juttu tuleb:Esimene proovimine ja hilisemad kogemused – kuidas need erinevad?Ketamiini ajalugu ja varasemad kasutusaladŠamanistlik ketamiinitripp rannasKas ja kuidas kasutatakse ketamiini vaimse tervise probleemide ravis?Tarvitamise ohud ja riskidSarja "Ainelised olendid" eesmärk on muuta psühhotroopsete ainete ümber käivaid vestlusi sisulisemaks – mitte hirmutada, vaid rääkida ainete headest ja halbadest külgedest. Igas saates on koos saatejuhiga üks külaline, kellega tulevad jutuks nii teadmised, müüdid kui ka inimeste isiklikud kogemused ja seiklused seoses uimastitega.Võib juhtuda, et mõnes sarja osas tuleb lisaks erinevatele ainetele jutuks poliitika ning elu laiemalt – nii nagu inimesed tegelikult mõtlevad ja arutlevad.

A IGAS (que quer investigar tudo), Pedro Nuno Santos (que não precisa de dados sobre segurança) e a FNAM (que ameaça fazer greve por causa de dois euros) são o Bom, o Mau e o Vilão.See omnystudio.com/listener for privacy information.

Michael and Clay share their Top 5 favorite Christmas songs (in no particular order except #1) .. and their bottom 1. Have a warm beverage, get cozy, and enjoy. Merry Christmas from Michael and Clay! Audio Clippies: Silent Night - The Carpenters Christmastime is Here - Vince Guaraldi Trio Pretty Paper - Willie Nelson I'll Be Home for Christmas - David Galloway, Tiffany Galloway White Christmas - Bing Crosby Christmas in Hollis - Run DMC Carol of the Bells - August Burns Red God Rest Ye Merry Gentlemen - August Burns Red O Holy Night - Daniel Johsnon & First Presbyterian Church of Kilgoe Choir   - - -  O Holy Night begins at   01:28:45 (do it)   https://www.youtube.com/live/huTrMMiNkYg?si=9bI0_n_PLYjfjHE5 O Holy Night - Celine Dion Have Yourself a Merry Little Christmas - The Carpenters Linus and Lucy - Vince Guaraldi Trio Dance of the Sugar Plum Fairy - Pyotr Ilyich Tchaikovsky Hark! The Herald Angels Sing - Amy Grant 

Jack and Peter end the week by answering your questions from X and Instagram!Did the Red Sox give up too much for Crochet? - @jmhall13 on IG Who will be the best prospect moved this offseason? will it end up being teel? (am i forgetting another trade) - @ryan05foster on XWho will be considered the “steal” of the off-season? Maybe someone who is going to get a smaller contract than they deserve or a free agent you guys are very high on. - @GutTakes on XIf the Reds trade from their surplus of starting pitchers, who could they trade and to potentially what team? What could a trade look like? - @TeamKaptain08 on XHow do you think the Orioles and the Mariners could match up in a trade? - KleineSchroeder on X What's best case scenario, from the Cardinal's POV, for an Arenado trade? Hope for a straight salary dump, or could there be an actual interesting piece coming back in return? - @d_rawlings23 on IGAs a Giants fan, I would like to hear your opinion about how the Giants are being ran. Posey says he would like to focus on scouting (assuming he's speaking on drafting) but why do we donate our draft picks for QA free agents? We lost the chapman and snell picks. The west is too strong for a mid Giants team with no farm (we cant even win a top 10 spot in the draft lotto) Does it really make sense to go full force and sign QA free agents instead of signing 1 year flippable players at the deadline? Posey's contract is only for 3 years and he has given away another pick this year. - @moritsugu.ryan on IGThe Tigers, Royals, and Mets were the pleasant surprises of last season. Who is your prediction for surprise team for this upcoming season? - @trebbs44 on IGIf Dombrowski were to push the chips forward to try and bring Kyle Tucker to Philly, what would the package look like that would send him from Houston to Philly? - @gabegarner15 on IGSubscribe to Our New Newsletter!Check out our LinkTree!Get Your Just Baseball MerchUse Code "JUSTBASEBALL" when signing up on BetMGMOur Sponsors:* Check out Uncommon Goods: https://uncommongoods.com/JUSTBASEBALLSupport this podcast at — https://redcircle.com/the-just-baseball-show/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

O Presidente do Sindicato dos Técnicos de Emergência Pré-hospitalar, Rui Lázaro, defende que a IGAS deve estar no responsável máximo da Saúde. Fala numa boa decisão de Ana Paula Martins.See omnystudio.com/listener for privacy information.

Episode description: “Sticks & stones …” but can words actually hurt? Can you convey true pain through song? Can a song be used as “revenge”?  Time Codes for those who like to skip: Ep. 049 - 00:00-46:54 Sleep Like a Cactus - (Original song by Clay) - 46:50-48:18 Ep. 049.5 - 48:15-01:44:08 Clips:   You Oughta Know - Alanis Morissette Silver Springs - Fleetwood Mac Second Hand News - Fleetwood Mac Over My Head - Fleetwood Mac Ep. 049.5 Clips: I Got A Name - Jim Croce Signed, Sealed, Delivered, I'm Yours - Stevie Wonder Ain't No Mountain High Enough - Marvin Gaye / Tammy Terrell  Cruisin' - D'Angelo Girl/Boy Song - Aphex Twin Shame - Stabbing Westward Eyes Without A Face - Billy Idol While My Guitar Gently Weeps - Prince, Tom Petty, Jeff Lynne, Steve Winwood, Dhani Harrison Higher Love - Steve Winwood Cemetery Gates - Pantera Spirit of Radio - Rush

IGas Holdings, Inc. v. EPA

A video snippet of our conversation. Full videos of all Ground Truths podcasts can be seen on YouTube here. The audios are also available on Apple and Spotify.Shane Crotty: A Landmark Study on Upper Airway Mucosal ImmunityTranscriptThis is the first time a Ground Truths podcast is being posted simultaneous with a new publication, this one in Nature, by Professor Shane Crotty and his colleagues at La Jolla Institute for Immunology. Shane is one of the leading immunologists and virologists in the country; he and his group published in 2020 the first detailed analysis for how our immune system responds to SARS-CoV-2. Shane also, among many other notable contributions during COVID, illuminated the role of hybrid immunity vs COVID, the differences between and additivity of vaccination and infection.Today's paper in Nature is indeed a landmark contribution doing something that hasn't been done before—to understand the underpinnings of mucosal immunity of the upper airway. 100 participants had monthly nasal and nasopharyngeal swabs throughout the pandemic. With a median of >100,000 cells per swab recovered, they undertook single-cell sequencing and full characterization of the cells (tissue-resident memory B cells, CD4+ and CD8+ T cells, germinal center follicular helper T cells and B cells, etc.) to determine optimal immune protection of the upper airway, the effect of infections by different variants, breakthrough infections, vaccination, and age.Here is the transcript of our conversation about the new report with links to the audio:Eric Topol (00:06):Hello, it's Eric Topol with Ground Truths, and with me today is Professor Shane Crotty from the La Jolla Institute of Immunology (LJI), not too far away from where I work at Scripps. And Shane has been a go-to immunologist colleague here in the Mesa, and he and his colleagues were the ones that really first published the response to SARS-CoV-2 as far as the immunologic response. And today we're doing something very unique. We're going to go over for the first time in the two year plus history of Ground Truths, going to have a publication with at least simultaneous or near simultaneous podcast. Shane, welcome and congratulations on this really important paper in Nature.Shane Crotty (00:57):Thanks, Eric. Thanks for having me. Yeah, somebody asked if I was going to go over to Scripps for the podcast and I was like, yeah, we could.Eric Topol (01:06):You could. You could. But no, it's good. And it's nice having the logo of this great institute you work at right in the right corner. And you've done so many contributions with your colleagues at La Jolla Institute. It's really a privilege to have a chance to learn from you and particularly about what we're going to talk about today, which is mucosal immunity to upper airway infections, which is especially germane to COVID. And we're actually in the middle of a significant wave of COVID right now. And I guess it would maybe be fair to say, Shane, that we've never truly understood the underpinnings, the real details of upper airway mucosal immunity. Is that a fair statement?Shane Crotty (01:53):Yeah, it is a fair statement.Eric Topol (01:56):Okay. So today we're going to crack the case. This paper from you and your colleagues, of course, you're the senior author and first author, Sydney Ramirez did a remarkable study. I mean, just extraordinary. This is why we're doing a special podcast about it. Maybe you could just kind of give us the overview of the design because you were doing things that haven't been done before.Shane Crotty (02:24):Sure. And, I would say the genesis even of it goes back to what you were introducing. I mean, during the pandemic, we like a lot of scientists spent a lot of time and energy trying to help understanding immune responses to this virus, and immune memory to this virus, and what was involved in protective immunity. And we're certainly proud of the work that we did. And it was hard work. And after a while we were exhausted and we stopped.Shane Crotty (02:59):And then we came back to it after a while and said, well, the virus is still here. And so many people have contributed so much to better understanding the virus and creating vaccines. But there are clearly still things we don't understand. What are those biggest knowledge gaps and where might we be able to contribute? And really to me the biggest one was location, location, location. This is a virus that infects your nose, infects your upper airway—your nose, and throat, and oral cavity. And then obviously if you get severe disease, the severe disease and death are from the lungs. And it's just been a big knowledge gap in terms of understanding what actually occurs in those tissues immunologically and what is associated with protective immunity or what could be associated with protective immunity. And sort of looking forward what might be helpful for mucosal vaccine development from things that we could learn.Shane Crotty (04:12):So we started from what we would call the basics, and what does immune memory look like in the upper airways in normal people? And that hasn't been available really even in, and we started this two years ago, even in the biggest atlases published of the human body. There was no upper airway tissue representation at all. And that's because technically it's just tough to access and difficult to reproducibly get at. And so, we recruited people to a group of 20 to 30 people to come to LJI once a month, and just started testing out, published and unpublished sampling techniques to see were there ways where we could reproducibly sample immune cells in the upper airways from people. And once we got things, so the keys for us were you got to have enough cells that you can collect to learn something from. And luckily with modern techniques of flow cytometry and single cell sequencing, you don't need that many cells. And so, we could get a hundred thousand cells on a swab and that's enough to do a lot with. And second, how reproducible was it? So we showed, we had people come in every month for a year and we could reproducibly find the same things in their swab; same cell types in their swabs. And the third thing was that people would come back.Shane Crotty (06:05):We found that if you have good nurses doing the techniques, we could find ways that this would be a sampling approach that was tolerable and people would come back for repeat measures, which is really valuable to see what's happening in people over time. So that was what we started from in the study and built from.Eric Topol (06:27):And if I am correct, you sampled two places with the swabs, one in the nose and one of the throat. Or, I think one which you have in the paper as the MT for something about the median nasal turbinate and the other adenoid in the back of the throat. Is that right?Shane Crotty (06:50):So all the sampling is a swab into your nose. And when we were doing that, we were really excited to see the diversity of immune cells, particularly T cells and B cells, memory T cells and B cells that we isolated. They're like, wow, there's actually a lot of interesting immune memory up in there. And the lab said, oh, by the way, we're seeing T follicular helper cells (TFH). Now that happens to be my favorite cell type.Eric Topol (07:22):Why is that, Shane? Of all the cells, why do you say that's your favorite? I know you publish a lot on it.Shane Crotty (07:31):Because those are the T cells that are required for basically all neutralizing antibody responses. All high-quality antibody responses depend on—almost all high-quality antibody responses depend on—T cell help. That T cell help comes from T follicular helper cells. Antibody evolution is certainly one of the coolest processes of the immune system. And all of that depends on T follicular helper cells. So the fact that for example, you could get Omicron neutralizing antibodies even after only being vaccinated with ancestral vaccine, that's the immune system making guesses of what variants would look like. And those guesses come about through this antibody evolution that's driven by T follicular helper cells. So, it's really one of the most brilliant things the immune system does, and that's a cell type that's really key, but those processes happen in lymphoid tissue. That's what happens in lymph nodes and spleen. And here we were sampling epithelium, your nasal epithelium, so the cells didn't really belong there.Shane Crotty (08:37):And so, that's what turned the study in another direction. And we said, okay, let's figure out why is it that these cells are present in these swabs? And we had a couple of possibilities. One possibility was that the swab was going all the way back to the posterior wall of your nasopharynx, your top of your throat and sampling adenoid tissue. So adenoid tonsils and adenoids are a true lymphoid tissue and they're a mucosal lymphoid tissue. And so, we came up with multiple ways to validate that that's what we were testing. And in fact, it was the Sydney Ramirez, a clinician, and the ENTs involved who said, well, let's just look. And so, they actually did endoscopies with the swab to actually see where the swab went. We've got videos of the swabs going into the adenoid crypt in the back, and then we've got measurements of here are the cells that you find on those swabs.Shane Crotty (09:58):And what's cool about it is that, yes, so we did studies with two sets. We then shifted to doing studies with two sets of swabs. One where we essentially went “halfway back” where we were detecting that epithelium of your nasal passages and then one where it was all the way back and detecting the adenoid lymphoid tissue. So here we've got two different sites in your upper airways that are about an inch apart, and we're detecting essentially completely different cells of the immune system at those two places. And we tend to think of the cells present in that epithelial tissue as probably the sentinels, the cells that are sitting there that can potentially immediately react and try and protect you against a viral or bacterial infection. Whereas the lymphoid tissue, the adenoids, is really about generating the immune responses in the first place and priming immune responses. And that's where these germinal centers can occur, which are where the TFH are where you can get antibody evolution. And so, we found in the course of the study that with this non-invasive technique that we can.Eric Topol (11:14):By the way, I don't want to be signing up for the one way up there because I mean just a mid-nose enough for me. So wow, I got to give credit to your study participants for coming back every month for a year to have that. Some people call it a brain biopsy.Video of swab of nasopharyngeal tissueShane Crotty (11:33):Right. So I will tell you, it is a different experience than the COVID nasopharyngeal swab might've gotten through your car window. If you're actually sitting down in a comfortable space and there's a nurse doing it with these particular goals. We really found, we had a hundred people in the study and a total of 300 swabs, and the vast majority of people came back if we asked them to.Eric Topol (12:06):That's great.Shane Crotty (12:07):And we're certainly very thankful for the volunteers. Obviously they were volunteering in the first place to participate. So I'm a little hesitant about the video because I've told people to not show it to potential volunteers because it definitely doesn't encourage you to volunteer. You're like, wait, that's what's happening? But actually, I've had it done on me.Video of the swab to the nasopharynx for adenoid (lymphoid tissue) access.Eric Topol (12:37):Not that bad.Shane Crotty (12:39):It's really pretty compelling. And by doing these repeated samples, we actually now have the capacity to look at ongoing immune responses like after an infection or vaccination in people and see how that results in the immune system changing and what might be the source of the protective immunity that comes up. So we've actually got data in the paper looking at this antibody evolution in real time. So we've got affinity maturation of B cells occurring in just normal healthy adults of mucosal B cells against COVID. And so, that's really helping us learn what's possible, basically to figure out, okay, if you're going to try and make a vaccine, what types of immune cells are even possible to generate in this tissue? And where might you try and generate them? Or if you're trying to study some disease state, what are types of cells that might be problematic?Eric Topol (13:45):Yeah, I mean, I think the idea that so many of us have been pushing for a nasal vaccine to induce mucosal immunity because, as you know very well, the current shots are not very good at any durable or substantial protection from upper airway infections of COVID or SARS-CoV-2 and other infections. So I think one of the most important parts of this report is that it lends itself well to helping towards artificially, if you will, make a vaccine to get the protective features that you were able to identify. Maybe you could just [speculate], if you had the ideal nasal airway, what would the cellular profile look like?Shane Crotty (14:44):Ah, I see. Yeah, great question. So, first of all, antibodies are great. So most of my career has been dedicated to most licensed vaccines. The correlate of protection is antibodies. Antibodies clearly can be protective, and if you can get them that's excellent, so certainly I would want, in terms of the non-cellular component, I would want antibodies present, neutralizing antibodies present in it.Eric Topol (15:26):Are these IgA or IgG?Shane Crotty (15:31):Yeah, in an ideal situation, what would I want? I'd want a mix of both, basically. The IgAs look like they have a little more protective efficacy, but the IgGs, just at a molecular level have a longer half-life, stick around a little. So yeah, I'd want both. And then really the premise for most of what we do is saying, in situations where antibody isn't enough or the antibodies don't stay around long enough, or you've got a variant that now obviates the protective efficacy of that particular antibody, are there other types of protective immunity you can have? And the immune system has other stuff besides antibodies for a reason. Of the lymphocytes in your blood, most of them aren't antibody producing cells. Most of them are other things. And so, well sticking with adjacent to antibodies, those antibodies in the mucosa, I'd want them to be made by cells that were literally right there. So plasma cells living in that site so that you've got basically the highest concentration of antibodies you can get because they're not having to diffuse through the whole body. They're just already at their highest concentration right there. Now antibodies come from B cells, that's what encodes the antibodies.Shane Crotty (17:03):And so, the B cells can make neutralizing antibodies if it turns out that you haven't made enough neutralizing antibodies, or if there's a variant that escapes those, maybe there are other B cells that could make, once you get infected, more B cells that could make more antibody rapidly infection, or B cells that recognize this variant that is mismatched to the current antibodies you have. But memory B cells are basically a library of different antibody specificities representing different guesses about what viral variants or structures might look like. And so, I would want memory B cells in that upper airway tissue that could reactivate quickly. There are memory B cells in your blood and we don't know how long it takes. And that's one of the reasons we're hoping we and others build upon this study. But it might take, let's say five days for memory B cells to go from your blood into your upper airway.Eric Topol (18:06):Oh, right.Shane Crotty (18:08):That's right, you were already quite sick by that point. Instead, if memory B cells are right there, as soon as virus showed up, they got activated. Now maybe after (we're not sure yet), but maybe after 48 hours those cells are now activated and doing something useful. That would be optimal. So then we can pivot to the T cell side. So there's a fantastic recognition that T cells being physically present in tissues, tissue resident memory cells, as they're most often called, can really have fantastic protective capacities. From a lot of mouse model systems where you can see T cells are in the skin or the liver, or whatever [tissue] are already there, they're more protective than if the cells are in the blood. So if you could also have T cells essentially permanently parked in the epithelium of your nasal passages and in the adenoid, hopefully those could essentially be sentinels for protective immunity, and as soon as you get infected, those T cells would reactivate and start killing off infected cells. 'That's the mix that I would want to see. And I think there's at least some reasonable evidence in the context of COVID that people who have T cells in their upper airways maybe manage to control the virus so quickly that it's a subclinical infection; they never notice when they get infected. And so, building on those types of observations, that's what I would want.Eric Topol (19:56):That sounds good. I like that. I'd like to have that in my nasal airway. Now, just to make sure I've got this, what you found, of course, the memory B cells, the T cell memory, CD8+, that is the cell-killing T cells that you mentioned, the resident T cells. One clarification on that, they are not really going to do much until there's been some cells that have been infected with the virus, right? Then they come alive and kill those cells. So they're not immediate, but they can work pretty quickly still though, right? If they're resident T cells?Shane Crotty (20:45):Yeah, in theory it might take as little as 12 hours for a virus to infect a cell, and then you get some antigen presentation on that cell that could activate the T cell.Eric Topol (20:58):And that's all happening perhaps within the incubation phase of the virus, right?Shane Crotty (21:07):Correct. That's a tough thing to study, but conceptually that's the way people tend to sketch it out.Eric Topol (21:13):Right. Now the other part of the story is, and you alluded to it earlier, is the lymphoid tissue up there, higher up where there are these germinal centers; is there anything different you want in these germinal centers? Do they contribute to mucosal immunity that you haven't already mentioned?Shane Crotty (21:36):So they really contribute in this forward looking sense or really in the classroom kind of sense. The germinal centers are where you're basically teaching the B cells in advance of seeing the infection either with your vaccine or with your previous infection, evolving better B cells and better antibodies and hopefully instructing them where to go reside to then be ready for the next infection. If you get really great protection that next time, hopefully then you don't need to start.Eric Topol (22:14):Right. So it's like the training grounds for this coordinated response, I guess. Now you also noted this, I mean this is a rich paper, which is we're illuminating something that's never been done before in human beings. I mean it's pretty damn important and impressive. But you also found that you had an age relationship. Can you tell us about that?Shane Crotty (22:39):Sure. This is one of our favorite parts of the study. I'd say in particular for several of the clinicians who were involved, because the general conversations people have about upper airway lymphoid tissue, like your tonsils and including your adenoids, is that adults don't really have functional lymphoid tissue in the upper airway that your tonsils atrophy by the time maybe you're 20 or something. So, immunologically, functionally, what that means is if you have let's say an intranasal vaccine or you get infected with a new [virus] like SARS-CoV-2, if those would normally be the sites that start your immune response, where does it now happen? And instead what we saw was, we had such a diverse group of people in our studies—we realized we had people from age 18 to 68—and so we could directly ask, in normal healthy individuals across a large age span of adulthood is there functional mucosal lymphoid tissue? And the answer was yes, it was there. But it definitely declines over time, and it's declining on a log scale. Our simplest statement was that 75% of everybody we sampled still had functional tissue, but the younger the people were, the more functional it was, and the more germinal centers actually we saw; again these training grounds.Eric Topol (24:35):So this is really important because we know for COVID and obviously for influenza and other respiratory infections that people of advanced age are much more susceptible. And here you are finding something that supports that ,and it's almost like, the thymus, it involutes. After that, what age 20, and our lymphoid tissue [involutes]. We're just set up to fail. Old codgers, like me we're defenseless, I guess, right?Shane Crotty (25:12):So what I've liked about that in a positive sense is that it's not that all of these things go to zero. Like for example, naive T cells are definitely less abundant in people over the age of 60 than under, but they're not zero. And the mucosal lymphoid tissue is definitely less abundant in people over the age of 60, but in most people it still wasn't zero. And I always think about these things from a vaccine immunology perspective, and fundamentally the difference between getting vaccinated and infected frequently is that the whole point of the vaccine is you get to generate the immune response on your own time. And so, even if you're starting with five times fewer T cells or five times fewer germinal centers, if you're getting to do all that training ground in advance, you can end up with just as many bispecific T cells as a 20-year-old or just as many memory B cells as a 20-year-old because these things occur on an exponential scale because of the cell divisions. And so, it might take you three extra days, for example, to get to the same level, which again, if you're racing a virus, can be the difference between life and death. But if it's not a race and if you're doing it in the context of a vaccine, it's a much smaller factor. And that's some of what we've been trying to learn.Eric Topol (26:42):Now we only have started to scratch the surface of your findings. One of the things that drives me nutty in reading papers, especially from great immunologists like you, is that in each figure there's like 20 different panels. We get to one of the figures, figure three is all the way to panel W. I mean that starts with A. That gives you a little impression of the data. It's rich, another one goes to N or R. I mean we're talking about a lot of data. So I've only started to really deconvolute what you've done here, which is just an amazing study. But what are some other things that we should touch on before wrapping up?Shane Crotty (27:35):A lot of the goal in this study was to establish baselines of what is normal in humans in the upper airways. And that's one reason why in this case there actually are a lot of figure panels because we could work out a bunch of individual parts of the immune system that really hadn't been characterized in this way before. And something we really cared about was durability of immune memory. It's often talked about, well, mucosal responses are inherently short-lived. And we're like, well, what does that mean? Does that mean there's just no memory? Is it different kinds of memory? And so, this is the first measurement of memory B cells in this tissue in an antigen specific way. And we were doing it in people who had had recent COVID breakthrough infections. And we saw really the mucosal memory was stable for six months. And so, to me that's quite encouraging that it's not one month and it's gone, at least with an infection, it's at least six months and it looks like it'll project out for substantially longer.Shane Crotty (28:53):Amongst those cells, many of them are IgA. IgA is this antibody isotype that's particularly mucosal associated. And only 5% of the memory B cells circulating in blood were IgA. Whereas many of the memory B cells in the local tissue were IgA, which we think is also telling us that there's a lot of immune memory and the immune system in this tissue that we're probably not sampling in the blood. And so, sampling blood's great, right? It's accessible and we can learn a lot from it, but it does look like there is some tissue compartmentalization.Eric Topol (29:37):Oh, not a question. And the findings you had of the resident T cell is so indicative of that. And what's really striking, of course Shane, is that as we assess the immune system in people at large, we look at a lymphocyte neutrophil ratio [in the blood], we get almost nothing. And then in the course of the pandemic, you and your colleagues there provided such granular data on B and T cells, CD4 and CD8 T cells, and that you illuminated things that are not done ever clinically. These are research, high tier research labs like yours. The only question I have on before I just wrap up with the nasal vaccine story, interferon wasn't really part of this. As we know SARS-CoV-2 can shut down the interferon response, it's considered a frontline part of the defense. Where does that fit into the mucosal immunity of the upper airway?Shane Crotty (30:46):Yeah, it's really important. And that's in this basic divide we do in the immune system, the innate immune system and the adaptive immune system. So everything I was talking about is the B cells, the T cells, and antibodies. That's all the adaptive immune system. That's all virus specific. And then the innate immune system is the generalists, and really sort of the fire alarm, just sensing some danger. And definitely in COVID interferon is very important. I'm quite intrigued to see if using these techniques. I'm curious to see if some of these other aspects of the immune system can compensate somewhat for the fact that this virus. To me, if this virus has one superpower, it's its incredible ability to evade triggering interferon for as long as it does. And that has this massive cascading effect to almost everything about the pandemic essentially. And so, I'm intrigued by whether in people who have immunity are there ways that these other cells of the immune system or even antibodies can do things when a viral infection occurs, that helps trigger the overall immune system to recognize that something's there, even in the absence of type 1 interferons. That's where I think for now it fits in.Eric Topol (32:14):Well. I think you've so aptly described, not surprisingly, the superpower of SARS-CoV-2, which I think a lot of people haven't realized that it's so good at shutting down that defense system. Now on the basis of you having really gotten this understanding of the mucosal immunity in the upper airway, does this make you think that the nasal vaccine that we aspire to have is more of a reality? Do you kind of know what the ideal profile might look like to keep people healthy and resist infections? Do you think this is achievable in any durable sense at high level success with a nasal spray vaccine?Shane Crotty (33:04):I'm optimistic for several reasons. One is we really saw a lot of different immune memory cell types that were present, that was encouraging and seeing the B cell memory durability for at least six months—pretty flat line for that six months—was encouraging. It looks like the immune system knows how to keep these cells around if it wants to for a significant period of time. We'll have to do more in follow up. But again, it was encouraging. Third, we had some people who were vaccinated only and some people who had breakthrough infections. And really in the vaccinated only, we didn't see T cell memory in the upper airways. And I actually consider that encouraging because it suggests local exposure does give you the memory and exposure in your arm really doesn't. So I think there is something to improve upon. It can be improved upon. And lastly, I get asked all the time, I'm sure you get asked all the time: Why aren't there more intranasal vaccines or inhaled vaccines, more mucosal vaccines in some way?Shane Crotty (34:25):And I think there's more than one reason, but I tend to be very practical, and I think one practical reason is there's very little to measure, to guide you in your vaccine development. If you have six ideas or six constructs that you think might work in humans as a nasal vaccine, you basically just have to pick one, try something, and hoping there's not much you can measure it clinical trials for what might be the type of response even. So for example, the FluMist vaccine, it's the only licensed inhaled vaccine, intranasal vaccine. In adults it doesn't have a clear correlate of protection. If you get vaccinated with that, your circulating antibody responses don't increase, but also increases in nasal antibody didn't correlate with protection well. So, what does that mean? That probably means there's other things going on up there that could be indicative of protection but weren't being measured before. So I'm hopeful with these types of approaches. Now, if you're an intranasal vaccine developer, you maybe have 4, 5, 6, 7, 8 ideas or constructs. If you can try those in a few people and make these different measurements and you've got your favorite immune profile that you might, now you have something to, it's more of an engineering problem. It's not a throwing a dart problem. You're like, yeah, this has given me the type of response that I like and I'm going to try and push this into clinical trials. So those are the things that I'm optimistic about moving forward.Eric Topol (36:04):Well, I love it because we really need it. And if anybody's optimistic that means a lot; it's yours. What you've done here has been quite extraordinary because you defined for the first time really the underpinnings of the mucosal immune response, the upper airway, you did it by age, you did it by variant, you did it by vaccine and infection. And most importantly, perhaps for longer term is you established what are the desirable features to have, which didn't exist before. It seemed like whatever I read for nasal vaccines, they were measuring some IgA or IgG, and they didn't get down to the memory B cells and the tissue resident T cells, memory cells, and all these other things that you found. You did all this single cell sequencing and flow cytometry. The work is just really fantastic. So Shane, just in closing, I just want to congratulate you.Eric Topol (37:05):You made seminal findings along the pandemic. You were the one that really illuminated hybrid immunity, the advantage of if you don't want to have an infection of COVID, but if you did have that and a vaccine, you kind of had some extra synergy, if you will. But here you've done something, you and your team. Unique. Congratulations on that. No surprise that it's in Nature this week. I'm sure a lot of people will share your optimism that we will have something beyond just shots in the future because COVID isn't going away. There's other respiratory pathogens. And finally, somebody did the right study, who knows immunology inside and out. So Shane, thanks very much.Shane Crotty (37:52):Thanks Eric. Very much appreciated particularly coming from you.*****************************************Thanks for listening, reading or watching!The Ground Truths newsletters and podcasts are all free, open-access, without ads.Please share this post/podcast with your friends and network if you found it informativeVoluntary paid subscriptions all go to support Scripps Research. Many thanks for that—they greatly helped fund our summer internship programs for 2023 and 2024.Thanks to my producer Jessica Nguyen and Sinjun Balabanoff for audio and video support at Scripps Research.Note: you can select preferences to receive emails about newsletters, podcasts, or all I don't want to bother you with an email for content that you're not interested in. Get full access to Ground Truths at erictopol.substack.com/subscribe

Whether you're in person with a prospective client, on a free discovery call or discussing what working together could look like over email or the DM's, as the Authority of the work, you should always know what to say next because you already know how to lead the hard conversations.  Yes, I said it.  You should already know this.  But - who teaches us that? (Besides shouty American men with funnels on IG)    As the leader of your business, you should know what to say without flinching EVEN when prospective and current clients say:  I would do your thing but I can't afford it right now... I've decided to go with someone else (usually *cheaper*)...  I'll re-book in later...  Can I just do this small thing you have instead of the big offer (which you know is what they actually need to change)  I'm already doing X, Y and Z and don't have the time... I can't right now because this other thing has come up and I have to focus on/pay for that instead...  I'm overwhelmed… (subtext – I want to drop out)  And even when (especially when) they say YES to your offer and then they go radio silent.  All of the above examples are not the time to faun, people please and pander like you keep defaulting to.  All of the above examples of classic responses and objections are the time for you to harness your power and Gravitas.    In this one-of-a-kind episode, I'll deconstruct for you exactly what you need to stop doing in challenging client conversations and the five tactics you need to start to lead the conversation for the highest good of everyone.    Links  Are you a yes to step into the energy of leading higher caliber conversations with higher caliber people that want what you have (but can't feel it right now because you're not in your power or gravitas)?  Then book a pressure-free connection call to experience it for yourself.     On this private call, you'll share with me exactly what you're experiencing energetically, vocally and physically in conversations with your potential clients, current clients and team and I'll share with you the exact methodology I would undertake with you to course correct your unique set of circumstances.      When you open yourself up to lead the qualitative conversations and you'll witness a profound shift in the success of your quantitative measures.  All you need to do is book here: https://laurenwhiteau.as.me/connection-call and you'll instantly feel the relief of being on track to becoming the authority of your White Hot Business.  I'll see you in our powerful conversation soon. See omnystudio.com/listener for privacy information.

No primeiro episódio do podcast O Denunciante, conhecemos a história do médico Jorge Espírito Santo – autor da denúncia que levou a que o Centro Hospitalar Barreiro Montijo fosse condenado, pela Comissão Nacional de Protecção de Dados (CNPD), a pagar uma coima de 400 mil euros. Mas a CNPD não é a única entidade a investigar o caso. Também a Inspecção-Geral das Actividades em Saúde (IGAS) abre um inquérito e inspecciona o hospital do Barreiro. Só que as conclusões das duas entidades são diametralmente opostas. Depois de ouvir todos os envolvidos, a IGAS conclui que a denúncia feita pelo Sindicato dos Médicos da Zona Sul não tem razão de ser e arquiva o inquérito, sem qualquer procedimento disciplinar. Neste episódio, mergulhamos nos arquivos para perceber o que se passava, afinal, no sistema informático do hospital do Barreiro. Que conclusões tiraram as entidades reguladoras que analisaram o caso sobre quem foram os responsáveis? E porque é que chegaram a conclusões opostas? Siga o podcast O Denunciante e receba cada episódio nas próximas quartas-feiras no Spotify, na Apple Podcasts ou noutras aplicações para podcasts. Conheça os podcasts do PÚBLICO em publico.pt/podcasts. Tem uma ideia ou sugestão? Envie um email para podcasts@publico.pt. See omnystudio.com/listener for privacy information.

Marta García Aller reflexiona en 'Más de uno' sobre la polémica ordenanza de Boca de Huérgano, un pequeño pueblo de León, que obliga a los ganaderos a recoger las boñigas de las vacas de las calles, medida con la que los hosteleros están muy satisfechos. 

Marta García Aller reflexiona en 'Más de uno' sobre la polémica ordenanza de Boca de Huérgano, un pequeño pueblo de León, que obliga a los ganaderos a recoger las boñigas de las vacas de las calles, medida con la que los hosteleros están muy satisfechos. 

Saatejuht Jaanika avab karmi, aga olulise teema: mis juhtub siis, kui uimastite tarvitamine vallandab psühhoosi. Külas on Triin, kes räägib avameelselt oma kogemusest ning psühhiaater Ants Kask, kes selgitab keerulise seisundi tagamaid. Sarja "Ainelised olendid" eesmärk on muuta psühhotroopsete ainete ümber käivaid vestlusi sisulisemaks – mitte hirmutada, vaid rääkida ainete headest ja halbadest külgedest. Igas saates on koos saatejuhiga üks külaline, kellega tulevad jutuks nii teadmised, müüdid kui ka inimeste isiklikud kogemused ja seiklused seoses uimastitega.Võib juhtuda, et mõnes sarja osas tuleb lisaks erinevatele ainetele jutuks poliitika ning elu laiemalt – nii nagu inimesed tegelikult mõtlevad ja arutlevad. 

O relatório da IGAS é claro sobre as ilegalidades que foram cometidas no processo. Em causa, o processo burocrático e administrativo que mereceu uma "valente cunha" pedida pelo filho do PR.See omnystudio.com/listener for privacy information.

In moments when you feel pressed, close your eyes, and let the Word(s), 'I can of my own self do nothing' direct you to the Nothing inside. Look at It. Hear It. Feel It. The No Thing that does Everything. Right in that Place that you're attending to now, that you're actually being now, is where you must come back to often during the day. You must retreat here for at least 1-2 minutes every hour. This is how you keep from breaking down. This is how you keep letting go. This is how Love lifts you. I Love you, Nik ******God is afoot! I'm writing, and working on something BIG (and very useful) for your practice! I'll share #ListenerFavorite episodes until I return with new ones in Spring! Look out for announcements soon! Support the show: ▶▶https://www.patreon.com/goodmornings ________________________________ Today's Quotes: "You must not break down so easily." -Maharajji "If you want good things, have belief.  If you want better things, have patience. If you want best things, surrender to Lord Shriram." -Maharajji Even when it seems as if God isn't answering you, He is.  You may be looking for a simple yes or no, but God always faithfully answers: abide." -@Amy_klutinoty IG "As you place yourself in willful dependency on God, he will not disappoint you. In moments when you feel pressed to, and even beyond, your limits, do not panic, nor be afraid" "Do not fear vou will expire as vour resources become depleted, but understand these are the valuable moments in which you will begin to experience me. You will experience me in the times you are in greatest need, and it will shape you and mark you for the rest of your life. You will not forget these times because you will be desperate in your heart, mind, and circumstances. But know, though you are desperate you will not be disappointed, for you will not put your hope, trust, or dependence upon yourself, circumstances, or your resources, but upon me. (1) In this you will learn to move beyond your present limits. You will advance to the edge of your limits, but will encounter me in these limits and will begin to understand how to move beyond them. You will allow yourself to overcome, to understand, and to manifest and possess, what you previously could not. While this experience and process will certainly be uncomfortable, know it will grow you and produce good fruit in your life over the course of time." -Neil Vermillion "Think how it changes the nature of your prayer when you stop looking out or up. Close your eyes and gently, "Look down within," and feel. "Right here, closer to me than breathing, is the very source of everything I shall need in my outer life. There is even the "good pleasure" to give me the entire kingdom." -Joel Goldsmith, Consciousness Transformed "Few souls understand what God would accomplish in them if they were to abandon themselves unreservedly to Him, and if they were to allow His grace to mold them accordingly." -St. Ignatius Loyola

Seekord on Jaanikal külas meelelahutaja Märt, kellega minnakse värvilistele LSD radadele. Juttu tuleb ego surmast, iseendaga psühholoogi kabinetti sattumisest, aga ka sellest, mis juhtuks maailmaga, kui USA presidendid hapet teeksid.  Sarja "Ainelised olendid" eesmärk on muuta psühhotroopsete ainete ümber käivaid vestlusi sisulisemaks – mitte hirmutada, vaid rääkida ainete headest ja halbadest külgedest. Igas saates on koos saatejuhiga üks külaline, kellega tulevad jutuks nii teadmised, müüdid kui ka inimeste isiklikud kogemused ja seiklused seoses uimastitega.

Narkoentusiast Jaanika ületab hirmud ja kutsub külla politseiniku Rait Pikaro. Mida tehakse inimesega, kellelt leitakse gramm kanepit? Või kokaiini? Kas võimud teevad diile kuulsustega, kes on narkoga vahele jäänud?Sarja "Ainelised olendid" eesmärk on muuta psühhotroopsete ainete ümber käivaid vestlusi sisulisemaks – mitte hirmutada, vaid rääkida ainete headest ja halbadest külgedest. Igas saates on koos saatejuhiga üks külaline, kellega tulevad jutuks nii teadmised, müüdid kui ka inimeste isiklikud kogemused ja seiklused seoses uimastitega.

The guys get together and talk about tournament results and world tour finals, billie jean king tournament results,

Welcome back to Making Bank. On today's episode, we have a compilation of previous episodes with Garrett Gunderson, Babak Azad, Henry Kaminski, Marshall Sylver, Mark Podolsky, Cole Hatter and Steven Kotler and in this episode you will hear tips and tricks from top entrepreneurs about the guide to success.   (2:42) Garrett Gunderson Morning rituals are very important. They will be responsible for how your day will be therefore having a healthy morning ritual is the first step to success. You can start with meditation, exercise and a bit of stretching. After this you can also write down in your journal and lastly you can listen to podcasts or shows about personal developments.   (6:01) Babak Azad Before the launch of anything in your business, it's crucial to establish a clear brand identity, defining the promise to customers and positioning the product uniquely, ensuring it stands out among competitors with superior offerings. This not only drives sales and revenue growth but also establishes a foundation of trust and credibility.    (14:50) Henry Kaminski The competition is very high today. You need to be absolutely clear on what you are selling. Ask yourself what your business is offering. Are you offering a better product? A better design? Are you offering better services? What value are you offering to your customers? Find a way to help others get the most value out of your business.   (18:17) Marshall Sylver Avoid WGAs, Minimum Wage Activities. Hire someone else to help you with that. As an entrepreneur, your job is to focus on IGAs, Income Generating Activities. Focus on things that help you make more money. Another important thing you should do is to let people ask you what you're selling and have them believe it was their idea. These are the skills that will get you wealthy.   (21:57) Mark Podolsky Focus on things that will really make you happy. Remember that you are working for freedom and flexibility. Do not ever lose yourself in the pursuit of that. Focus on the quality of your relationship with your family and people around you. Having all the money is great but it will be a very empty life if you do not have anyone around you that you care for.    (26:15) Cole Hatter Being an entrepreneur will give you more security than a day job. Having a job is less secure as compared to knowing how to make money on your own. Learning how to make money is more superior than relying on a skillset where you will be compensated for it. Remember to concentrate on skills that will help you acquire more money.

Welcome back to Making Bank. On today's episode, we have a compilation of previous episodes with Garrett Gunderson, Babak Azad, Henry Kaminski, Marshall Sylver, Mark Podolsky, Cole Hatter and Steven Kotler and in this episode you will hear tips and tricks from top entrepreneurs about the guide to success.   (2:42) Garrett Gunderson Morning rituals are very important. They will be responsible for how your day will be therefore having a healthy morning ritual is the first step to success. You can start with meditation, exercise and a bit of stretching. After this you can also write down in your journal and lastly you can listen to podcasts or shows about personal developments.   (6:01) Babak Azad Before the launch of anything in your business, it's crucial to establish a clear brand identity, defining the promise to customers and positioning the product uniquely, ensuring it stands out among competitors with superior offerings. This not only drives sales and revenue growth but also establishes a foundation of trust and credibility.    (14:50) Henry Kaminski The competition is very high today. You need to be absolutely clear on what you are selling. Ask yourself what your business is offering. Are you offering a better product? A better design? Are you offering better services? What value are you offering to your customers? Find a way to help others get the most value out of your business.   (18:17) Marshall Sylver Avoid WGAs, Minimum Wage Activities. Hire someone else to help you with that. As an entrepreneur, your job is to focus on IGAs, Income Generating Activities. Focus on things that help you make more money. Another important thing you should do is to let people ask you what you're selling and have them believe it was their idea. These are the skills that will get you wealthy.   (21:57) Mark Podolsky Focus on things that will really make you happy. Remember that you are working for freedom and flexibility. Do not ever lose yourself in the pursuit of that. Focus on the quality of your relationship with your family and people around you. Having all the money is great but it will be a very empty life if you do not have anyone around you that you care for.    (26:15) Cole Hatter Being an entrepreneur will give you more security than a day job. Having a job is less secure as compared to knowing how to make money on your own. Learning how to make money is more superior than relying on a skillset where you will be compensated for it. Remember to concentrate on skills that will help you acquire more money.

Welcome back to Making Bank. On today's episode, we have a compilation of previous episodes with Garrett Gunderson, Babak Azad, Henry Kaminski, Marshall Sylver, Mark Podolsky, Cole Hatter and Steven Kotler and in this episode you will hear tips and tricks from top entrepreneurs about the guide to success.   (2:42) Garrett Gunderson Morning rituals are very important. They will be responsible for how your day will be therefore having a healthy morning ritual is the first step to success. You can start with meditation, exercise and a bit of stretching. After this you can also write down in your journal and lastly you can listen to podcasts or shows about personal developments.   (6:01) Babak Azad Before the launch of anything in your business, it's crucial to establish a clear brand identity, defining the promise to customers and positioning the product uniquely, ensuring it stands out among competitors with superior offerings. This not only drives sales and revenue growth but also establishes a foundation of trust and credibility.    (14:50) Henry Kaminski The competition is very high today. You need to be absolutely clear on what you are selling. Ask yourself what your business is offering. Are you offering a better product? A better design? Are you offering better services? What value are you offering to your customers? Find a way to help others get the most value out of your business.   (18:17) Marshall Sylver Avoid WGAs, Minimum Wage Activities. Hire someone else to help you with that. As an entrepreneur, your job is to focus on IGAs, Income Generating Activities. Focus on things that help you make more money. Another important thing you should do is to let people ask you what you're selling and have them believe it was their idea. These are the skills that will get you wealthy.   (21:57) Mark Podolsky Focus on things that will really make you happy. Remember that you are working for freedom and flexibility. Do not ever lose yourself in the pursuit of that. Focus on the quality of your relationship with your family and people around you. Having all the money is great but it will be a very empty life if you do not have anyone around you that you care for.    (26:15) Cole Hatter Being an entrepreneur will give you more security than a day job. Having a job is less secure as compared to knowing how to make money on your own. Learning how to make money is more superior than relying on a skillset where you will be compensated for it. Remember to concentrate on skills that will help you acquire more money.

Welcome back to Making Bank. On today's episode, we have a compilation of previous episodes with Garrett Gunderson, Babak Azad, Henry Kaminski, Marshall Sylver, Mark Podolsky, Cole Hatter and Steven Kotler and in this episode you will hear tips and tricks from top entrepreneurs about the guide to success.   (2:42) Garrett Gunderson Morning rituals are very important. They will be responsible for how your day will be therefore having a healthy morning ritual is the first step to success. You can start with meditation, exercise and a bit of stretching. After this you can also write down in your journal and lastly you can listen to podcasts or shows about personal developments.   (6:01) Babak Azad Before the launch of anything in your business, it's crucial to establish a clear brand identity, defining the promise to customers and positioning the product uniquely, ensuring it stands out among competitors with superior offerings. This not only drives sales and revenue growth but also establishes a foundation of trust and credibility.    (14:50) Henry Kaminski The competition is very high today. You need to be absolutely clear on what you are selling. Ask yourself what your business is offering. Are you offering a better product? A better design? Are you offering better services? What value are you offering to your customers? Find a way to help others get the most value out of your business.   (18:17) Marshall Sylver Avoid WGAs, Minimum Wage Activities. Hire someone else to help you with that. As an entrepreneur, your job is to focus on IGAs, Income Generating Activities. Focus on things that help you make more money. Another important thing you should do is to let people ask you what you're selling and have them believe it was their idea. These are the skills that will get you wealthy.   (21:57) Mark Podolsky Focus on things that will really make you happy. Remember that you are working for freedom and flexibility. Do not ever lose yourself in the pursuit of that. Focus on the quality of your relationship with your family and people around you. Having all the money is great but it will be a very empty life if you do not have anyone around you that you care for.    (26:15) Cole Hatter Being an entrepreneur will give you more security than a day job. Having a job is less secure as compared to knowing how to make money on your own. Learning how to make money is more superior than relying on a skillset where you will be compensated for it. Remember to concentrate on skills that will help you acquire more money.

C dans l'air du 27 octobre 2023 - Emeutes, terrorisme... La France en alerte Quatre mois après la mort de Nahel, tué par un policier à Nanterre et les violences qui ont suivi pendant une semaine dans le pays, un Comité interministériel des villes (CIV) présidé par Elisabeth Borne s'est tenu ce vendredi matin dans les Yvelines. La cheffe du gouvernement était venue parler éducation, sport, emploi, logement dans les quartiers populaires. Un deuxième volet des annonces post-émeutes urbaines après l'aspect sécuritaire présenté hier. Devant 500 maires et élus, la Première ministre avait dévoilé jeudi les réponses "régaliennes" du gouvernement : encadrement des mineurs délinquants par des militaires, stages de responsabilité pour les parents, multiplication par cinq de l'amende du non-respect du couvre-feu, la portant à 7 500 euros, déploiement d'une "force d'action républicaine", possibilité d'un "bannissement numérique" pendant six mois ou encore lancement d'un "nouveau plan national de lutte contre les stupéfiants". Depuis Chanteloup-les-Vignes, il s'agissait donc aujourd'hui pour Elisabeth Borne de présenter cette fois des mesures plus sociales. Il a été question d'accès aux services publics, de transition énergétique dans les quartiers prioritaires, de lutte contre les discrimination à l'embauche ou encore de mixité sociale dans l'habitat. Le gouvernement va ainsi demander aux préfets de ne plus attribuer de logements dans les quartiers prioritaires aux ménages les plus en difficulté, afin de favoriser la mixité sociale, a notamment expliqué la Première ministre. Une semaine d'émeutes urbaines particulièrement violentes avait suivi la mort, le 27 juin, de Nahel, un jeune tué par des policiers lors d'un contrôle routier à Nanterre dans les Hauts-de-Seine. Selon un rapport interministériel, les émeutiers étaient alors en majorité des hommes, très jeunes, peu diplômés, sans revendications idéologiques, nés pour les trois quarts en France. Une étude de l'Inspection générale de l'administration (Igas) conduite cet été à partir des dossiers des 1 800 condamnations prononcées, a montré que 30 % étaient mineurs et 60 % issus de familles monoparentales ou de parents séparés. Les annonces du gouvernement surviennent dans un contexte une nouvelle fois tendu sur le plan sécuritaire. La France est passée en alerte "urgence attentat" après l'assassinat le 13 octobre dernier, du professeur Dominique Bernard dans une attaque terroriste à Arras et sur fond de craintes d'importation du conflit au Proche-Orient. Depuis l'attaque du Hamas, le 7 octobre, contre l'Etat hébreu, son flot d'images tragiques fait la Une des médias. La déflagration est mondiale et la France, qui possède la plus forte communauté musulmane et la plus importante communauté juive d'Europe, n'y échappe pas. Dans une allocution solennelle, le 13 octobre dernier, le président de la République a appelé le pays à « rester uni » malgré les tensions qui pourraient naître de ce conflit. Des tensions et une situation qui s'invitent également dans les discussions sur la sécurité des Jeux de Paris. Dimanche dernier, l'ancien ministre des Sports David Douillet a plaidé pour un "plan B" de la cérémonie d'ouverture pour des raisons de sécurité liées au contexte géopolitique actuel. Une hypothèse qu'a exclue le patron du comité d'organisation Tony Estanguet, assurant mardi que les "conditions de sécurité" seront au "rendez-vous". La ministre des sports a également confirmé jeudi que la cérémonie se fera "bien" sur la Seine. Que contient le plan anti-émeutes du gouvernement ? Comment est-il reçu par les élus locaux et plus largement les Français ? Faut-il craindre une importation du conflit israélo-palestinien en France ? Comment sécuriser les JO de Paris ? LES EXPERTS : - Jérôme FOURQUET- Directeur département Opinion - Institut de sondages IFOP - Nathalie SAINT-CRICQ - Éditorialiste politique - France Télévisions - Vincent BRENGARTH - Avocat pénaliste - Marc HECKER - Directeur de recherche à l'IFRI

Stuudios on tarvitajad. "Aineliste olendite" teise osa kohal lehvib kerge kanepivine ning meie räägime kanepikasutaja Piretiga sellest, mis kanepit kasutades võib hästi või halvasti minna.Sarja "Ainelised olendid" eesmärk on muuta psühhotroopsete ainete ümber käivaid vestlusi sisulisemaks – mitte hirmutada, vaid rääkida ainete headest ja halbadest külgedest. Igas saates on koos saatejuhiga üks külaline, kellega tulevad jutuks nii teadmised, müüdid kui ka inimeste isiklikud kogemused ja seiklused seoses uimastitega.

Esimesel seiklusel räägime uimastiekspert Mart Kalvetiga psühhotroopsete ainete ajaloost ning moraalinormidest, mis ajas pidevalt muutunud on. Sarja "Ainelised olendid" eesmärk on muuta psühhotroopsete ainete ümber käivaid vestlusi sisulisemaks – mitte hirmutada, vaid rääkida ainete headest ja halbadest külgedest.  Igas saates on koos saatejuhiga üks külaline, kellega tulevad jutuks nii teadmised, müüdid kui ka inimeste isiklikud kogemused ja seiklused seoses psühhotroopsete ainetega.

Salon Owners have many tasks & responsibilities that rely on them to ensure their Salon runs smoothly.  Between hiring and managing their team, putting out fires and team dramas, paying bills, managing stock, knowing their clientele, and sales & marketing…the list goes on and on.    They are masters of juggling a million different hats on a good day!  But I believe that the ONE purpose which sits at the root of everything Salon Owners do is spending their time focusing on Income Generating Activities - or what I call IGAs.    Every time a client walks into the Salon, there is an additional income-generating opportunity and all it takes is a small investment of the owner's time.  Keep listening to discover the 3 most important IGAs that will not only drive new clients to the Salon but will ensure the current clients continue to spend more on each visit.  Think of it as your lottery ticket to running a successful, growing Salon. Here are three reasons why you should listen to the full episode: Discover how to futureproof your Salon through easy-to-implement marketing strategies How to upskill your team so they upgrade successfully every time Why a consultation will increase your client's average spend The Salon Profit Bootcamp CLICK HERE to get started Let's chat… I'd like to chat with you a bit more about your business and how I may be able to help you. Just click here to jump over into messenger & chat! Resources: CLICK HERE to join the Profitable & Successful Salon Owners Facebook Group

Filmi juhtiv mõte on: "Kui tahad rahu, võta omaks ning usu! Kui tahad Tõde järgida, pead otsima!" Selle moto olen ma laenanud saksa filosoof Friedrich Nietzsche kirjast oma õele ning see iseloomustab kogu filmi, mis heidab pilgu Euroopa kultuuri ajalukku sügavuti ja küsib: "Kes on need inkvisiitorid, kes fanaatilise järjekindlusega on antiikajast peale püüdnud hävitada klassikalise kultuuri ideaale?" ütleb filosoof ja filmirežissöör Mart Raukas Postimehele antud [intervjuus](https://elu24.postimees.ee/7662176/intervjuu-mart-raukase-uus-film-inkvisiitorid-heidab-pilgu-kustutatud-kultuurile). Ta räägib siin oma mängufilmist "[Inkvisiitorid](https://www.youtube.com/watch?v=jLnzlI7KSlI&t=1s)", mis käsitleb antiikkultuuri süstemaatilise hävitamise näitel meie tänase tühistamiskultuuri lätteid. Ateena ja Jeruusalemm on meie tänase elukorralduse kaks sammast ning nendevaheline pinge võib-olla paljuski praeguste probleemide sügavaim põhjus. "Igas hotellitoas on piibel, sama hästi võiks seal olla aga ka "Odüsseia"," ütleb selle kohta USA jungiaanlik psühholoog James Hillman (vt TT#177 "[Uus hingeteadus](https://www.youtube.com/watch?v=cE0InwTmGO8&t=381s)"). Tänases saates on plaanis rääkida Mart Raukase ja teda filmi heli osas nõustanud [Raun Juurikaga](https://www.youtube.com/watch?v=JAm607tjOpE&t=15s) inkvisiitoritest ja tühistamistkultuurist ning nende kaugematest ajaloolistest lätetest. Peatse kohtumiseni! H.

Käes on aasta 2023 ja kes oleks parem saatekülalisena uut aastat sisse juhatama kui selline vägev mees nagu Mihkel Vetemaa. Mihkel on meile kõigile teada ja tuntud kui Täitsa Pekkis podcasti kaasasutaja ja saatejuht, kuid peale selle on ta ka Bilance äpi kaasasutaja ja tegevjuht. Igas mõttes täiega vägev mees, kes on erinevates podcasti episoodides oma elu lahanud ühest äärmusest teise, kuid selles saates püüdsime Mihklilt kätte saada neid järgmisi kihte ja kilde. Kuula ja saad teada, mida põnevat sellest  saatest välja koorus.Vaata saadet ka Youtube- ist: https://youtu.be/WEvYV9iIGWASAATES RÄÄGIME: Nooruspõlve haavadest- kui olulised on need meie isiksuse kujunemiselEnesesse uskumisest- kust seda võtta ja kuidas oma unistuste suunas edasi liikudaKuidas avada end võimalikkustele, visualiseerides ja võttes maha ootusedKus on see koht, kus me peaksime tegema elus muutuseid ja mitte alla andmaKus kohas on Mihkel oma elus praegusel hetkelSHOW NOTES 00:00 | Sissejuhatus- milline mees on Mihkel Vetemaa?00:50 | Täitsa Pekkis uudised- jaga, subscribe-i ja hakka Patreoni liikmeks01:43 | Mihkli muljed- kuidas on olla teisel pool lauda ja lühidalt enda elust09:48 | Püsivuse, järjepidevuse treenimisest, erinevatest vajadustest ja suhetest vanematega22:42 | Mis innustab Mihklit tegema seda, mida ta teeb, ka siis, kui elu kiusab?34:29 | Uutest võimalikkustest, ootustega toime tulemisest ja visualiseerimisest49:15 | Ärevushäiretest, palgatöö ja suhtega lõpparve tegemisest ning taas tuhast tõusmisest01:04:51 | Mehe kohalolekust, iseendaga rahu tegemisest ja vastutuse võtmisestMIHKEL VETEMAA:Facebook: https://www.facebook.com/vetemaaInstagram: https://www.instagram.com/vetemaa/BILANCE ÄPP:Facebook: https://www.facebook.com/bilancemoneyInstagram: https://www.instagram.com/bilanceapp/LinkedIn: https://www.linkedin.com/company/bilance-technology/Koduleht: https://www.bilanceapp.com/TÄITSA PEKKIS SAADE Koduleht: https://taitsapekkis.ee/Instagram: https://www.instagram.com/taitsapekkissaade/Facebook: https://www.facebook.com/taitsapekkissaadeToeta meid ka Patreonis: https://www.patreon.com/taitsapekkis/Support the show

Happy New Year! This month we've got a New in EM looking at the use of neutrophil-lymphocyte ratios in septic arthritis and a discussion on specificity vs. sensitivity. Becky and Chris look at the new NICE guidance on subarachnoid haemorrhage and Rob talks for too long about it, and then we return to New Online with some new articles for your CPD. If you'd like to email us, please feel free to do so here. here. (02:38) New in EM – Neutrophil:lymphocyte ratio in septic arthritis - Synovial Fluid and Serum Neutrophil-to-Lymphocyte Ratio Novel Biomarkers for the Diagnosis and Prognosis of Native Septic Arthritis in Adults (14:49) Guidelines for EM – NICE Guidance on the diagnosis and management of subarachnoid haemorrhage NICE NG228 - Subarachnoid haemorrhage caused by a ruptured aneurysm: diagnosis and management An Observational Study of 2,248 Patients Presenting With Headache, Suggestive of Subarachnoid Hemorrhage, Who Received Lumbar Punctures Following Normal Computed Tomography of the Head - Sayer et al. (2015) Prospective Implementation of the Ottawa Subarachnoid Hemorrhage Rule and 6-Hour Computed Tomography Rule - Perry et al. (2020) An international study of emergency physicians' practice for acute headache management and the need for a clinical decision rule - Perry et al. (2009) The SHED Study - TERN (56:21) New Online – new articles on RCEMLearning for your CPD GAS, iGAS and Scarlet Fever – Nikki Abela Agents of Change – Public Health in ED – Ines Corcuera and Michelle Ryan

Today's episode is on antibiotics. The balance between increasing resistance and lack of effectiveness and saving lives is increasingly difficult to navigate.Antibiotic resistance: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistanceLonger term effects of antibiotics: https://pubmed.ncbi.nlm.nih.gov/32319703/Vitamin D and sepsis: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377223/Sepsis information: https://www.sepsis.org/sepsis-basics/what-is-sepsis/Invasive group A strep info iGAS - a particular type of group A strep: https://www.england.nhs.uk/publication/group-a-strep/Health Freaks trailer 2013: https://www.youtube.com/watch?v=hEGH4hfxMfUTurmeric and infection: https://www.medicalnewstoday.com/articles/326809THE HEALTH FIX: https://www.amazon.co.uk/Health-Fix-Transform-Your-Weeks/dp/1914239296 Hosted on Acast. See acast.com/privacy for more information.

Vol 217, Issue 8: 17 October 2022. Dr Johanna Birrell is a public health and general medicine advanced trainee at the Northern Territory Centre for Disease Control. Professor Bart Currie is from the Royal Darwin Hospital and the Menzies School of Health Research. They discuss the prevention of invasive group A streptococcal disease, to accompany their research published here. With MJA news and online editor, Cate Swannell.

Background: People with disabilities often participate in income-generating activities (IGAs) in sheltered workshop in South Africa. However, they face many barriers that limit their ability to participate effectively in economic activities hosted by the workshops. Objectives: To illustrate the barriers that limit the participation of people with disabilities in IGAs in a sheltered workshop.

The guys get together for a total CLASSIC episode and discuss the women's side and mens of Wimbledon. How is Fed doing? Igas run ending amd more

CEO Farro Mackenzie from Arro Athletics is joining us today! Tune in for all the details about this innovative athleisure clothing company. Since you're also wondering, HECK YES THEY'RE CANADIAN! Join in on the hilarious girl talk and real life struggles we've had trying to find the perfect leggings. Like many of us Farro felt the same way for so long and decided to take one for the team and DO SOMETHING about it. We learn about her inspiring journey that led her to start Arro Athletics and a taste of how business is going these days.For more about Arro Athletics head over to https://arroathletics.com/@arroathletics on TikTok and IGAs always thank you for listening! To stay connected or work with us:www.girlnowwhatproductions.com@girlnowwhatproductions

QOTD "As we heal, we let go of people who encourage our old patterns and seek ones who complement our growth." Sara Kuburic @millennial.therapist on IG  As life comes together some of us start to feel like everything is falling apart. The stress is overwhelming...we do the yoga, we read the affirmations, take time alone, we feel revamped....until we get around people, then our 'boundaries' are tested.  Why cant they just understand my needs?  How do you respond?  In order to live you must reclaim yourself! I pose the question of what are personal boundaries? (and answer) What does my relationship with my family and others have to do with my boundaries? What do boundaries have to do with peace? An how the only real way to live in peace is to set healthy boundaries. Part 1 of a two part episode.  Book Req  NY Times Bestseller  Set Boundaries, Find Peace : a guide to reclaiming yourself Nedra Glover Tawwab --- Send in a voice message: https://anchor.fm/alexa-lawson/message Support this podcast: https://anchor.fm/alexa-lawson/support