Podcasts about Inflow

CardioNerds (Dr. Jenna Skowronski [Heart Failure Council Chair], Dr. Shazli Khan, and Dr. Josh Longinow) are joined by renowned leaders in the field of AHFTC (Advanced Heart Failure and Transplant Cardiology) and mechanical circulatory support, Dr. Jeff Teuteberg and Dr. Mani Daneshmand to continue the discussion of advanced heart failure therapies by taking a deep dive into the world of durable LVADs (Left Ventricular Assist Devices). In this episode, we will review the history of ventricular assist devices, the basics of LVAD function, selection criteria for LVAD therapy, and surgical nuances of LVAD implantation. Audio Editing by CardioNerds intern, Joshua Khorsandi. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls There have been significant advances in the field of MCS/LVAD therapy since the first implanted LVAD in the 1960s, to the first FDA approved device in the early 2000's, to now the HM3 LVAD, with the most important change being a centrifugal flow/magnetically levitated design that led to minimized hemocompatibility-related adverse events (HRAE's) (MOMENTUM 3 trial comparing HM2 and HM3).  The REMATCH trial in 2001 was a pivotal trial for LVAD therapy, demonstrating that in a population of patients with advanced HF (70% IV inotrope dependent), LVAD therapy significantly improved survival at both 1 and 2 years as compared to medical therapy alone.    MOMENTUM 3 trial was a landmark trial for the HM3 device, showing that in a population of end stage HF patients (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.  There are both patient-specific factors and surgical considerations when it comes to candidacy for LVAD therapy.  RV function prior to LVAD is a key determinant for success post-LVAD  Many patients being considered for LVAD may not have robust RV function, however, predicting RV failure after LVAD is exceedingly difficult.   In general, it doesn’t matter how bad the RV may look on imaging; we care more about the pre-LVAD hemodynamics (look at the PAPi and RA/wedge ratio).   What happens in the OR may be the most important determinant of how the RV will do with the LVAD!  Notes Notes drafted by Dr. Josh Longinow.  1. Historical background of heart pumps and LVADs  LVAD Evolution   FDA approval year  2001  2008  2012  2017  Pump  HeartMate XVE   HeartMate II  Heartware HVAD  HeartMate III  Flow/Design Features  Pulsatile Technology   Continuous flow Axial design  Continuous flow  Centrifugal design  Continuous flow   Full MagLev + Centrifugal design  The 1960's ushered in the first ‘LVADs', when the first air-powered ‘LVAD' was implanted. It kept the patient alive for four days before the patient expired.   The first generation of LVADs were pulsatile pumps   The first nationally recognized, FDA approved LVAD was the HeartMate XVE (late 1990s to early 2000s, REMATCH trial). The XVE pump used compressed air (pneumatically driven) to power the pump.   Prior to the XVE, OHT was the standard of care for patients with advanced, end-stage heart failure.   The second and third generations of LVADs were non-pulsatile, continuous flow devices and included the HVAD, HM2, and HM3 devices.   MOMENTUM 3 was a landmark trial for the HM3 device, showing that in a population of sick patients with end stage HF (86% inotrope dependent, 32% INTERMACS 1-2, and 60% DT strategy), 5-year survival with HM3 was 58% and HM3 had lower HRAE's compared with HM2.   The only pump that is currently FDA approved for implant is the HM3, although other pumps are in clinical trials (BrioVAD system, INNOVATE Trial).  2. What are LVADs, and how do they work?   In simplest terms, the LVAD is a heart pump comprised of several key mechanistic components:   Inflow cannula  Mechanical pump   Outflow cannula  Driveline  Controller/Power source  The HM3 differs from its predecessors (HM2 and HVAD) in several key ways;   HM3 is placed intrapericardial whereas the HM2 was placed pre-peritoneal.   Perhaps most importantly, the HM3 is a fully magnetically levitated, centrifugal flow pump, whereas the HM2 is an axial flow device.  Axial flow pumps are not magnetically levitated, leading to more friction produced between the ruby bearing's contact with the pump rotors, and higher rates of hemocompatibility related adverse events (HRAEs, i.e. pump thrombosis) and the HM2 was ultimately discontinued in favor of the HM3 (MOMENTUM 3 trial).  3. What do the terms ‘Destination Therapy' (DT) or ‘Bridge to Transplant' (BTT) mean when it comes to LVADs?   When LVADs first came on the stage, EVERYONE was a BTT; these early pumps weren't designed for long term use (I.e. REMATCH Trial, Heartmate XVE)  Destination therapy means the LVAD was placed in leu of transplant because there are contraindications to transplant   REMATCH trial brought about the concept of “Destination therapy”, comparing outcomes in patients (with contraindications for transplant) who received an LVAD vs optimal medical therapy  Bridge to transplant means we are placing the LVAD in a patient who may not be a transplant candidate at this moment in time (is too sick, or conversely, not sick enough), but may be down the line   Bridge to recovery is another term used when the LVAD is being placed for a patient we think may have a recoverable cardiomyopathy  4. What are some factors we should consider when assessing a patient’s candidacy for LVAD, in general, and from a surgical perspective?   Patient factors   Older age might push us towards thinking LVAD rather than transplant  In general, age > 70 is the cutoff for transplant, but this is not a hard cut off and varies institution to institution    In general, think about things that help predict recovery after a major surgery; Frailty and Nutritional status are important, we try to optimize these prior to LVAD implant   Right ventricular function remains the Achilles heel of LV support  We know that needing temporary RV support post LVAD puts you on a different survival curve than patients who don’t need RVAD support  Studies have not been able to successfully predict who will develop RV failure after LVAD implantation  What happens in the time between when the patient goes to the OR and when they get back to the ICU is an important determinant who might develop RV failure post LVAD   Surgical techniques such as implanting the HM3 in the intra-thoracic cavity, rather than intra-pericardial may help maintain LV/RV geometry to help optimize the RV post LVAD   Surgical considerations for LVAD candidacy  Small, hypertrophied LV: HM3 inflow cannula is small, but small hypertrophied ventricles tend towards chamber collapse during systole causing suction, needing to run slower with lower flow rates  Chest size/diameter: pumps have gotten so small now, that for adults, these have become less of a consideration  BMI: low BMI used to be more of a concern with the older pumps due to where they were placed, and the relative size of the pump itself, not so much now with the smaller HM 3 pumps  Calcified LV apex: would increase risk of stroke, bleeding   Driveline tunneling becomes a concern in the super obese population, higher risk for driveline infections (might tunnel these driveline's shorter, and to a less fatty region of the abdomen, could even tunnel out the thoracic cavity in the super obese to limit skin motion)    5. Is there a role for MCS (i.e. temporary LVAD such as Impella) in pre-habilitation of patients prior to LVAD surgery?   The theory of being able to improve systemic perfusion, decongest the organs, and make the patient feel better prior to surgery makes sense, but becomes problematic due to the lack of a hard end point/time for prehabilitation which might risk delays in surgery   More likely that it can lead to delay in the surgery, with less-than-optimal benefit; you don't want to prolong the wait for surgery and increase the risk for complications prior to surgery    An Impella 5.5 is currently FDA approved for 2 weeks of support, not 2 months so timing is important to keep in mind  It’s unlikely that you will take a patient and convert them from a malnourished, cachectic person in 2 weeks’ time   6. Is there a role for LVAD therapy in the younger patient population? Should we be thinking of LVAD up front for these patients, with the goal of transplanting down the line?   Recovery may be more likely in certain populations, particularly younger females with smaller LV's; in those populations, perhaps bridge to recovery should be the focus, optimizing them on GDMT etc.   The replacement of transplant, with MCS (LVAD) in young patients has become a topic of discussion, because these pumps have become better and better, with the thinking that an LVAD could bridge a patient for 10 years or so, and they could get a transplant later   It is still a big unknown, but several concerns exist  Patients who get LVADs might end up with complications that become contraindication to transplant down the line (stroke, sensitization etc)   Patients and providers are more hesitant because of the more recent iteration for the UNOS criteria for OHT listing which no longer gives patients with an uncomplicated LVAD higher priority, and therefore they could end up waiting a longer time for a heart after undergoing LVAD  References Rose EA, Gelijns AC, Moskowitz AJ, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345(20):1435-1443. doi:10.1056/NEJMoa012175  Mehra MR, Uriel N, Naka Y, et al. A Fully Magnetically Levitated Left Ventricular Assist Device – Final Report. N Engl J Med. 2019;380(17):1618-1627. doi:10.1056/NEJMoa1900486  Mancini D, Colombo PC. Left Ventricular Assist Devices: A Rapidly Evolving Alternative to Transplant. J Am Coll Cardiol. 2015;65(23):2542-2555. doi:10.1016/j.jacc.2015.04.039  Mehra MR, Goldstein DJ, Cleveland JC, et al. Five-Year Outcomes in Patients With Fully Magnetically Levitated vs Axial-Flow Left Ventricular Assist Devices in the MOMENTUM 3 Randomized Trial. JAMA. 2022;328(12):1233-1242. doi:10.1001/jama.2022.16197  Rose EA, Moskowitz AJ, Packer M, et al. The REMATCH trial: rationale, design, and end points. Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure. Ann Thorac Surg. 1999;67(3):723-730. doi:10.1016/s0003-4975(99)00042-9  Kittleson MM, Shah P, Lala A, et al. INTERMACS profiles and outcomes of ambulatory advanced heart failure patients: A report from the REVIVAL Registry. J Heart Lung Transplant. 2020;39(1):16-26. doi:10.1016/j.healun.2019.08.017  Mehra MR, Netuka I, Uriel N, et al. Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure: The ARIES-HM3 Randomized Clinical Trial. JAMA. 2023;330(22):2171-2181. doi:10.1001/jama.2023.23204  Mehra MR, Nayak A, Morris AA, et al. Prediction of Survival After Implantation of a Fully Magnetically Levitated Left Ventricular Assist Device. JACC Heart Fail. 2022;10(12):948-959. doi:10.1016/j.jchf.2022.08.002  Bhardwaj A, Salas de Armas IA, Bergeron A, et al. Prehabilitation Maximizing Functional Mobility in Patients With Cardiogenic Shock Supported on Axillary Impella. ASAIO J. 2024;70(8):661-666. doi:10.1097/MAT.0000000000002170 

Series 5 – Episode 5 Hosts: Renee Chiuchiarelli & Julie Parks (Hammer & Heels) Length: ~12 minutes Format: Simply Trade Tips Episode Summary In this episode of Simply Trade Tips, Renee and Julie tackle a topic that doesn't always get the spotlight it deserves: learning. With trade rules shifting constantly — tariff changes, executive orders, enforcement priorities, and regulatory updates — relying on static training or tribal knowledge simply isn't enough. Traditional “calendar training” (scheduled webinars, annual sessions, policy rollouts) still has value, but it's disconnected from daily operations. The big idea? Learning must move from a side activity to core infrastructure. Renee and Julie introduce the concept of “inflow learning” — contextual, real-time training embedded directly into workflow systems. Instead of pausing work to learn, professionals access guidance at the exact moment they need it. This shift makes compliance more resilient, scalable, and defensible in today's enforcement environment. Key Topics Covered Why static training creates operational gaps The difference between: Calendar training (scheduled sessions) Inflow training (embedded, contextual learning) How automation can trigger learning during: Origin determinations Classification decisions Filing processes Audit reviews Role-based learning paths for importers, exporters, and compliance teams Micro-learning triggered by real-time errors Using AI to generate contextual training from existing materials Why regulators expect documented training as part of “reasonable care” How embedded learning reduces repeat errors and improves confidence Why knowledge in trade is no longer theoretical — it impacts entries, exports, and balance sheets immediately Key Takeaways Learning must be integrated into daily workflow, not isolated from it Automation supports better decision-making without replacing expertise Real-time learning reduces repeat errors and strengthens defensibility Training documentation can become powerful evidence during audits Trade compliance in today's environment requires resilience, not just proactivity This Episode's FIO (Figure It Out) Take a moment to evaluate your current training model: Is your team relying mostly on scheduled sessions? Do your systems provide contextual, real-time learning prompts? Have you asked your software provider about embedded guidance tools? Have you explored advanced or hybrid learning models that combine live instruction with digital access? Dip your toe in. Explore what's available. Demand better integration between learning and operations. Join the Conversation How is your organization approaching trade training in 2026? Are you relying on memory — or building infrastructure? Join us inside the Trade Geeks Community and share what you're doing to make learning more resilient. Credits Hosts: Renee Chiuchiarelli Julie Parks Producer: Lalo Solorzano

Spot BTC ETFs' $750M inflow pushes bitcoin up. U.S. spot bitcoin ETFs saw their largest daily inflows in three months, with $753.7 million recorded on Tuesday. Is this a sign that investors have rotated back into risk assets following the year-end portfolio rebalancing? CoinDesk's Jennifer Sanasie hosts "CoinDesk Daily." - This episode was hosted by Jennifer Sanasie. “CoinDesk Daily” is produced by Jennifer Sanasie and edited by Victor Chen.

Attention Deficit Hyperactivity Disorder (ADHD), previously known as Attention Deficit Disorder. We look at the ADHD symptoms, diagnosis (including criteria) and the treatment options. PDFs available here:  https://rhesusmedicine.com/pages/psychiatryConsider subscribing (if you found any of the info useful!): https://www.youtube.com/channel/UCRks8wB6vgz0E7buP0L_5RQ?sub_confirmation=1Patreon: https://www.patreon.com/rhesusmedicineBuy Us A Coffee!: https://www.buymeacoffee.com/rhesusmedicineTimestamps:0:00 What is Attention Deficit Hyperactivity Disorder? 0:20 Attention Deficit Hyperactivity Disorder Symptoms 2:29 Attention Deficit Hyperactivity Disorder Complications3:15 Attention Deficit Hyperactivity Disorder Pathophysiology4:01 Attention Deficit Hyperactivity Disorder Causes4:53 Attention Deficit Hyperactivity Disorder Diagnosis (DSM 5 Criteria) 5:48 Attention Deficit Hyperactivity Disorder TreatmentLINK TO SOCIAL MEDIA: https://www.instagram.com/rhesusmedicine/References:BMJ Best Practice, 2025. Attention deficit hyperactivity disorder in adults. [online] Available at: https://bestpractice.bmj.com/topics/en-gb/814.Wikipedia, 2025. Attention deficit hyperactivity disorder. [online] Available at: https://en.wikipedia.org/wiki/Attention_deficit_hyperactivity_disorder.Inflow, 2022. Emotional dysregulation and ADHD: why you feel 'too much'. [online] Available at: https://www.getinflow.io/post/emotional-dysregulation-adhd-signs.National Center for Biotechnology Information (NCBI), 2025. Attention Deficit Hyperactivity Disorder. [online] Available at: https://www.ncbi.nlm.nih.gov/books/NBK441838/.National Center for Biotechnology Information (NCBI), 2025. Presenting ADHD Symptoms, Subtypes, and Comorbid Disorders in Clinically Referred Adults with ADHD. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948439/.Disclaimer: Please remember this podcast and all content from Rhesus Medicine is for educational and entertainment purposes only and is not a guide to diagnose or to treat any form of condition. The content is not to be used to guide clinical practice and is not medical advice. Please consult a healthcare professional for medical advice.

XRP ETFs close in on $1B of inflows. U.S.-based spot XRP exchange-traded funds continued their strong post-launch run, recording their 13th consecutive day of net inflows since opening for trade on Nov. 14. The streak establishes the XRP ETFs among the fastest-growing class of major crypto-asset vehicles, closing in on the $1 billion milestone. CoinDesk's Jennifer Sanasie hosts "CoinDesk Daily." - Break the cycle of exploitation. Break down the barriers to truth. Break into the next generation of privacy. Break Free. Free to scroll without being monetized. Free from censorship. Freedom without fear. We deserve more when it comes to privacy. Experience the next generation of blockchain that is private and inclusive by design. Break free with Midnight, visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠midnight.network/break-free⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ - Need liquidity without selling your crypto? Take out a ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Figure Crypto-Backed Loan⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠, allowing you to borrow against your BTC, ETH, or SOL with 12-month terms and no prepayment penalties. They have the lowest rates in the industry at 8.91%, allowing you to access instant cash or buy more Bitcoin without triggering a tax event. Unlock your crypto's potential today at Figure! ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://figuremarkets.co/coindesk⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ - This episode was hosted by Jennifer Sanasie. “CoinDesk Daily” is produced by Jennifer Sanasie and edited by Victor Chen.

AI agents can already write code, build websites, and manage workflows ... but they still can't pay for anything on their own. That bottleneck is about to disappear.In this episode of TechFirst with John Koetsier, we sit down with Jim Nguyen, former PayPal exec and cofounder/CEO of InFlow, a new AI-native payments platform launching from stealth. InFlow wants to give AI agents the ability to onboard, pay, and get paid inside the flow of work, without redirects, forms, or a human typing in credit card numbers.We talk about: • Why payments — not intelligence — are the missing link for AI agents • How agents become a new kind of customer • What guardrails and policies keep agents from spending all your money • Why enterprises will need HR for agents, budgets for agents, and compliance systems for agents • The future of agent marketplaces, headless ecommerce, and machine-speed commerce • How InFlow plans to become the PayPal of agentic systemsIf AI agents eventually hire, fire, transact, and manage entire workflows, someone has to give them wallets. This episode explores who does it, how it works, and what it means for the economy.

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Coupon Code: HAPPYDIWALI (65% off on Model Portfolio All, Fund-o-meter & Stock-o-meter)Catch up on the biggest market movements and corporate results! This daily news summary covers the massive Q2 earnings from heavyweights like Reliance Industries (RIL), HDFC Bank, and ICICI Bank. RIL posted strong growth driven by Jio and Retail, while HDFC Bank's profit surged 11%. We analyze the return of Foreign Portfolio Investors (FPIs), who injected ₹6,480 crore, reversing the three-month selling trend, boosting Indian market sentiment. Don't miss the details on the landmark cross-border acquisition: the RBL Bank-Emirates NBD deal worth ₹26,853 crore. Globally, US markets soared on positive trade news. Plus, we look at the Nifty outlook, key triggers for the week (including US CPI and trade deals), and the major news of the potential Coca-Cola India IPO and UltraTech Cement's bumper results. Stay informed on the stocks moving the market, including Polycab, Havells, Dixon, and JSW Energy Q2 performance.00:00 Start01:24 US market update02:35 Coca-Cola Eyes $10 Bn India Bottling IPO03:21 India Exports to US Drop on Tariffs04:51 FPIs Pump ₹6,480 Cr into Indian Equities06:02 5 Key Triggers for the Week Ahead07:43 RBL Bank Secures ₹26,853 Cr Emirates NBD Deal09:01 HDFC Bank Q2 Profit Rises 11pc09:57 ICICI Bank Q2 Net Profit Up 5.2pc10:54 IDFC First Sees Sequential PAT Drop12:01 Federal Bank Net Profit Hit By Provisioning12:45 Polycab Q2 EBITDA Jumps 61pc13:24 Havells Q2 Profit Beats Estimates13:41 RIL Q2 Profit Rises 10pc15:42 UltraTech Q2 Profit Jumps 75pc16:07 Dixon Q2 Profit Surges on One-Time Gain17:12 JSW Energy Q2 PAT Drops 17pc17:49 LTTS Revenue Up 15.8pc; Profit Growth Modest18:24 Tata Tech Q2 Growth Remains Modest18:41 Eternal gets GST demand order19:15 Knowledge Section

Are you feeling overwhelmed by clutter and constantly stressed? You don't need endless time or motivation, you need the right strategy! In this of Palm Wine Central Podcast, Ashley Wynn share 10 essential tips to declutter faster, potentially speeding up your process by 20%, 50%, or even 80%!We also dive into the 5 harsh truths about decluttering that nobody talks about, addressing the root causes and challenging common myths that keep you stuck in the clutter cycle.In this video, you will learn:• How to stop the inflow of clutter (the critical 75% of the battle!)• The 80/20 Rule (Pareto Principle) for decluttering high-impact areas like flat surfaces and wardrobes for instant visual relief.• The life-changing secret of "Trash Bag Therapy" and quick trash sweeps.• Why you must be "ruthless" and understand that if it's not a clear yes, it's a no.• The financial and emotional danger of the "Endowment Effect", why your stuff isn't worth what you think.• Why decluttering alone is just a Band-Aid and what four pillars you need to master for a truly clutter-free home (Inflow, Outflow, Systems, Mindset).Find our guest online:Instagram: https://www.instagram.com/outstandingorganizers/Website: https://www.outstandingorganizers.com/blogEmail: info@outstandingorganizers.comPhone Number: 678.887.5757---If you appreciate real talk, LIKE this video and SUBSCRIBE for more episodes that go there: [https://www.youtube.com/@pwcpodcast]FOLLOW THE PODCAST:

In this episode, Sarah Borchersen-Keto and Uma Moriarity, senior investment strategist at CenterSquare Investment Management, discuss the implications of recent Federal Reserve decisions on interest rates and their impact on REITs and the commercial real estate market. They explore historical trends in REIT performance, current investor sentiment, and the valuation differences between public and private real estate markets. Moriarity shares insights on high conviction property types and strategies for building resilient portfolios amidst economic uncertainty.

Sponsored by ⁠⁠⁠⁠⁠⁠⁠⁠Inflow⁠⁠⁠⁠⁠⁠⁠⁠. Try the free ADHD traits quiz. Learn evidence-based techniques to navigate daily challenges associated with ADHD.

Sponsored by ⁠⁠⁠⁠⁠⁠⁠Inflow⁠⁠⁠⁠⁠⁠⁠. Try the free ADHD traits quiz. Learn evidence-based techniques to navigate daily challenges associated with ADHD.

Save $200. Only 1 Early Bird Ticket remains. Wise Squirrels Retreat. Details: ⁠⁠⁠https://wisesquirrels.com/wsretreat⁠⁠⁠ Sponsored by ⁠⁠⁠⁠⁠⁠Inflow⁠⁠⁠⁠⁠⁠. Try the free ADHD traits quiz. Learn evidence-based techniques to navigate daily challenges associated with ADHD.

Het was een rustige week in Bitcoin-land, althans, qua prijs. Bert vertelt waarom we op een kruispunt staan in de markt. Daarnaast hebben we het over de vermogensaanwasbelasting, waar Bart een video over heeft gemaakt. In het nieuws bespreken we de Ethereum Treasury Companies, de Bitcoin-aankopen van Michael Saylor en een update over de cryptowetgeving in de VS. Veel luisterplezier!Probeer Bitcoin Alpha 2 weken gratis!Satoshi Radio wordt mede mogelijk gemaakt door: Amdax, Watson Law, HVK Stevens en onze hoofdsponsor Bitvavo.Timestamps(00:00:00) Welkom en Podcast Introductie(00:02:00) Vermogensaanwas Belasting: hoe zit het?(00:15:00) Hoe kijken we naar rendement op BTC?(00:24:00) Bookmark van Bart: Genius act signed into law(00:29:00) Bookmark van Bart: PNC Bank gaat crypto aanbieden via Coinbase(00:33:00) Bookmark van Peter: ‘14-day streak of positive inflows!'(00:47:00) Bookmark van Peter: Ethena ($ENA) Foundation stort $60M in ‘ENA Treasury Firm'(00:54:00) Bookmark van Bert: ‘JPMorgan overweegt crypto te accepteren als onderpand'(01:20:00) Bookmark van Bart: Microstrategy brengt nieuw financieel product op de markt(01:25:00) Marktupdate(01:57:02) EindeBookmarksBert:‘JPMorgan overweegt crypto te accepteren als onderpand'Goldman Sachs and BNY join forces to transform $7.1 trillion money market industry with digital tokensCrypto firm Bitgo confidentially files for US IPOBart:Genius act signed into lawsquare sellers on bitcoin starting todayPNC Bank gaat crypto aanbieden via CoinbaseRond $550 mrdFBI drops investigation into Kraken founder Jesse PowellStrategy is offering $STRC (“Stretch”), a new Perpetual Preferred Stock via IPO, to select investors.JUST IN: Trump Media buys $2 billion worth of Bitcoin for its treasury.Strategy has acquired 6,220 BTC for ~$739.8 million.Done. We blocked (in collaboration with law enforcement) the 85,977 USDt stolen.Peter:‘14-day streak of positive inflows!'Ethena ($ENA) Foundation stort $60M in ‘ENA Treasury Firm'$1B van Bybit-hack is al witgewassen

Welcome to Episode 59 of This is Not Happening (TINH), an Album of the Month (AOTM) Podcast. We're missing a team-member this month as Davide is on an Anglo-French diplomatic mission. In Part 1 we deep dive into an Album that one of us has chosen and in Part 2 we play 'Spin it or Bin it'.  We pick a theme and each pick a song that represents that theme. We judge the selections by asking the question 'Spin It or Bin It'?In Part 1, Nolan is in the seat. He brings Little Sim'z new album, Lotus. This was a reluctant choice when he made it. He thought it was an interesting album but he was far from loving it. Has that changed in a month?In Part 2, we celebrate New Music. What are our favourite new tracks from the last couple of months?                            ----- Part 1 | Little Simz | 'Lotus' -----This is the 2nd Little Simz album we're reviewed as our little Album of the Month collective. Last time round was here debut album Grey Area which would all pretty much loved. I think our experience of her work since then has varied significantly. This album has been launched in a quite dramatic and controversial environment following the collapse of Simz' relationship with former collaborator Inflo. What does Simz sound like without Inflo? Let's find out.Listen to the album, listen to the pod, tell us what you think. Here are some links that we mention on the pod or think could be useful to explore;Listen to the album ... HERE.We mention the great Louis Theroux podcast interview ... HERE.Watch the video for 'Young' ... HERE.Buy some stuff ... HERE.                            ----- Part 2 | Spin It or Bin It | 'New Music' -----The theme this month is New Music. Simple. What new tunes are we loving? There's LOADS of amazing music out but we also need to pick something that we think the rest of us will vote 'spin it' to.Joey chose 'Feisty' by Smerz.Nolan chose 'Next to You' by Erykah Badu and The Alchemist.David chose 'Tricky' by New Windows.Guy chose 'Lowly' by Young FathersWe all chose 4 tracks as a shortlist which we combine into a belter of a 16 track playlist, listen to that bad boy HERE.We've been writing the blog for years come and have a look - https://thisisnothappening.net/

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What if our inner parts weren't just fragments of the psyche—but vessels designed to receive divine love? My guests today are Chelsea Odhner, Robert Falconer, and Jonathan S. Rose—co-authors of the new book Opening the Inner World: Spiritual Healing, Internal Family Systems, and Emanuel Swedenborg. Together, we explore the playful spirit that brought this project to life and the profound insights that emerged at the intersection of IFS therapy and Swedenborgian spirituality. We discuss Swedenborg's life and legacy, the idea of spiritual awakening as universally accessible, and how our parts—when burdened—can block access to divine inflow. The authors share how Swedenborg's theology aligns with the IFS model, especially around the belief that healing comes from within, through dialogue, compassion, and connection to something greater. This episode is a heartfelt, curious, and spiritually charged invitation to see your inner world not as a problem to fix—but as a sacred system ready to be witnessed, healed, and loved. __________________________ Topics We Explore: ✨ The joy and creativity behind writing Opening the Inner World

Wise Squirrels Retreat, September 19-21. Tickets on Sale Now. https://wisesquirrels.com/wsretreat Sponsored by ⁠⁠⁠Inflow⁠⁠⁠. Try the free ADHD traits quiz. Learn evidence-based techniques to navigate daily challenges associated with ADHD.

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On this TCAF Tuesday, hear an all-new episode of What Are Your Thoughts with ⁠⁠Downtown Josh Brown⁠⁠ and ⁠⁠Michael Batnick⁠⁠! They discuss the latest in market moves, BTFD, Circles IPO, and much more! This episode is sponsored by Betterment Advisor Solutions. Grow your RIA, your way by visiting: https://Betterment.com/advisors   Sign up for ⁠⁠The Compound Newsletter⁠⁠ and never miss out! Instagram: ⁠⁠https://instagram.com/thecompoundnews⁠⁠ Twitter: ⁠⁠https://twitter.com/thecompoundnews⁠⁠ LinkedIn: ⁠⁠https://www.linkedin.com/company/the-compound-media/⁠⁠ TikTok: ⁠⁠https://www.tiktok.com/@thecompoundnews⁠⁠ Investing involves the risk of loss. This podcast is for informational purposes only and should not be or regarded as personalized investment advice or relied upon for investment decisions. Michael Batnick and Josh Brown are employees of Ritholtz Wealth Management and may maintain positions in the securities discussed in this video. All opinions expressed by them are solely their own opinion and do not reflect the opinion of Ritholtz Wealth Management. The Compound Media, Incorporated, an affiliate of ⁠⁠Ritholtz Wealth Management⁠⁠, receives payment from various entities for advertisements in affiliated podcasts, blogs and emails. Inclusion of such advertisements does not constitute or imply endorsement, sponsorship or recommendation thereof, or any affiliation therewith, by the Content Creator or by Ritholtz Wealth Management or any of its employees. For additional advertisement disclaimers see here ⁠⁠https://ritholtzwealth.com/advertising-disclaimers⁠⁠. Investments in securities involve the risk of loss. Any mention of a particular security and related performance data is not a recommendation to buy or sell that security. The information provided on this website (including any information that may be accessed through this website) is not directed at any investor or category of investors and is provided solely as general information. Obviously nothing on this channel should be considered as personalized financial advice or a solicitation to buy or sell any securities. See our disclosures here: ⁠⁠https://ritholtzwealth.com/podcast-youtube-disclosures/ Learn more about your ad choices. Visit megaphone.fm/adchoices

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Crypto Town Hall is a daily Twitter Spaces hosted by Scott Melker, Ran Neuner & Mario Nawfal. Every day we discuss the latest news in the crypto and bring the biggest names in the crypto space to share their opinions.►►OKX Sign up for an OKX Trading Account then deposit & trade to unlock mystery box rewards of up to $60,000! 

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Tam V-Prelude/Overview of Tam Veilleux's Appearance:Get ready for an enlightening journey into the cosmic currents! This Wednesday, April 23rd at 1 p.m. EDT, The BH Sales Kennel Kelp Holistic Healing Hour - Wellness Wisdom welcomes the insightful Tam Veilleux back to the show! Fresh off her Astro Inklings broadcast, Tam will join Grandpa Bill to delve deep into the Energy Almanac 2025. We'll be navigating the energies of April 21st-27th, pinpointing where you can effortlessly tap into your personal "flow"

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Episode OverviewIn this episode of Spiral Deeper, our host, Gaby Azorsky, speaks with Isis Indriya. As a Minister, Culture Creator, Bridgebuilder, and fireplace keeper for the Oracle Clan, an educator of Ritual, Divination, Egyptian Cosmology, and Hermeticism, Isis shares what she has learned along the way all over the world, online, on Ritual Community, and through the school she birthed; Academy of Oracle Arts. She also leads pilgrimages to Egypt and in her Temple hosts community prayers and gatherings. She is on the board for Water Now, Church of the Essence, Living Village Culture, the Oracle Clan and is an advocate for The Fountain.earth, Bioneers, Unify, and the Compass @ Lightning in a Bottle. With over 20 years experience in various forms of gatherings, ranging from one-on-one sessions to facilitation of rituals of over 30k people with Wisdomkeepers from around the world, Isis dedicates her life to learning and creating platforms for teaching of the sacred sciences of the Ancients, Indigenous wisdom, cultural exchange, Nature's intelligence, and inner transformation as pathways for moving forward. Together, they dive into the invisible and unseen, mysteries, pilgrimage, the great unknown, communing with the sacred, temple space and sacred space, ritual, adornment, and touching the wisdom mystery teachings of ancient Egypt / Kemet. Thank you for joining us on this journey of self-discovery, sacredness, and learning!To celebrate the growth and magic of Spiral Deeper (and the launch of Season 3!), I am hosting a giveaway with some of my favorite brands. This is the last week to enter! The winner will receive: 1 planner from In Flow, 1 Anxiety Support bundle with Reishi and Lion's Mane from Rainbo Mushrooms, 3 triangle soaps from Wild Lather, 1 copy of the vintage collectors book Country Women with a little prayer bell from the small shop, The Bell up in Mendocino, 1 beaded healing mat for your altar made by Elle McDaniels, and 1 Ritual Rainforest Serum by Earth Archive. To enter: subscribe to the podcast, leave a written review on Apple Podcasts, and share Spiral Deeper on Instagram by tagging Gaby (@gaby.azorsky) and @spiral.deeper in your IG Stories.Special OfferCODE - SPIRALOFFLOWERS for 20% off your first month in The Flower Portal!Connect and Work with GabyInspiring the connection between Heaven and Earth through Reiki, Tarot, Folk herbalism, Clairvoyance, and Meditation. Together, we co-create harmony, clarity, and alignment with your True Essence. I'd love to support you!Visit my website to learn more: gabyazorsky.comFollow me on Instagram: @gaby.azorskyNewsletter: Sign Up HereBook a 1:1 Session: Book HereJoin My Membership, The Flower Portal: Learn MoreWith Spiral DeeperWebsite - Spiral Deeper PodcastInstagram - @spiral.deeperWith Our Guest, Isis IndriyaWebsite - https://www.academyoforaclearts.com/instructors/isis-indriya/Instagram - @isis_indriyaCreditsSpecial thanks to…Music - Connor HayesSpiral Deeper Icon - Kami MarchandCollaborate with UsInterested in advertising or collaborating with Spiral Deeper? Email gabyazorsky@gmail.com for packages and details.Support the ShowPlease rate, review, and subscribe wherever you listen - it means so much. Be sure to tag @spiral.deeper if you share; thank you for your support!

Mario Treinen, Director Post Courrier and Logistics at Post Luxembourg and CEO of Inflow, talks about Post Luxembourg's big move into B2B parcels. Letter volume trends in Luxembourg Growth in B2C parcel volumes The B2B parcels opportunity Taking the B2C experience to B2B customers Inflow subsidiary coming out of its Michel Greco business Expanding beyond express B2B deliveries into transport and logistics The full range of Inflow services, including temperature-controlled delivery, warehousing, customs services, and more On-premises value added services for some customers How the B2B and B2C businesses interact Leveraging the postie network for selected B2B deliveries Cross-border B2B opportunities, including European next-day Managing mail rooms and other value added services  

Episode OverviewIn this episode of Spiral Deeper, our host, Gaby Azorsky, speaks with Deb Dana. Deb Dana is a clinician, consultant, author, and international lecturer on polyvagal theory-informed work with trauma survivors and is the leading translator of this scientific work to the public and mental health professionals. A founding member of the Polyvagal Institute, Deb developed the signature Rhythm of Regulation® Clinical Training Series: The Science of Feeling Safe Enough To Fall in Love with Life and Take the Risks of Living. By understanding and learning about the nervous system, Deb Dana has created the Rhythm of Regulation® to help humans resolve the impact of trauma in our lives so we may fall in love with life. Deb's work shows how an understanding of Polyvagal Theory is applicable across the board to relationships, mental health, and trauma. Deb believes that we all benefit when we have a basic understanding of the ways the nervous system works and learn how to become active operators of this essential system. Following this passion has led her to offering workshops in partnership with groups and communities outside of the clinical arena - and bringing the Polyvagal perspective to the ordinary, and sometimes extraordinary, experiences of daily living.Together, they dive into rhythms of life, polyvagal theory and her work, our nervous systems, the organizing principles of neuroception, hierarchy, and co-regulation, and more. They also talk about attachment and attunement, safe others to feel nourished, what it means to be regulated as friends/partners/parents, and some ways to start resourcing ourselves to be able to be with what is. Gaby highly recommends this episode if you would like to begin to better understand how our nervous systems function unconsciously, and how we can learn to listen and co-regulate with ourselves and with each other to create lives that are more joyful, grounded, and resilient. Thank you for joining us, and enjoy the episode!To celebrate the growth and magic of Spiral Deeper (and the launch of Season 3!), I am hosting a giveaway with some of my favorite brands. The winner will receive: 1 planner from In Flow, 1 Anxiety Support bundle with Reishi and Lion's Mane from Rainbo Mushrooms, 3 triangle soaps from Wild Lather, 1 copy of the vintage collectors book Country Women with a little prayer bell from the small shop, The Bell up in Mendocino, 1 beaded healing mat for your altar made by Elle McDaniels, and 1 Ritual Rainforest Serum by Earth Archive. To enter: subscribe to the podcast, leave a written review on Apple Podcasts, and share Spiral Deeper on Instagram by tagging Gaby (@gaby.azorsky) and @spiral.deeper in your IG Stories.Special OfferCODE - SPIRALOFFLOWERS for 20% off your first month in The Flower Portal!Connect and Work with GabyInspiring the connection between Heaven and Earth through Reiki, Tarot, Folk herbalism, Clairvoyance, and Meditation. Together, we co-create harmony, clarity, and alignment with your True Essence. I'd love to support you!Visit my website to learn more: gabyazorsky.comFollow me on Instagram: @gaby.azorskyNewsletter - Sign Up HereBook a 1:1 Session: Book HereJoin My Membership, The Flower Portal: Learn MoreWith Spiral DeeperWebsite - Spiral Deeper PodcastInstagram - @spiral.deeperWith Our Guest, Deb DanaWebsite - https://www.rhythmofregulation.com/CreditsSpecial thanks to…Music - Connor HayesSpiral Deeper Icon - Kami MarchandCollaborate with UsInterested in advertising or collaborating with Spiral Deeper? Email gabyazorsky@gmail.com for packages and details.Support the ShowPlease rate, review, and subscribe wherever you listen - it means so much. Be sure to tag @spiral.deeper if you share; thank you for your support!

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Episode OverviewIn this episode of Spiral Deeper, our host, Gaby Azorsky, speaks with Sierra Lash, One of the topics that she is so passionate about and has to offer the world, Nourishment; she will join us each season through this year for a mini episode. How amazing! Sierra's work supports folks all over the world to make sense of life through psychospiritual healing + integration and cultivating self-nourishment practices in harmony with the earth. Her offerings include individuals/couples/family sessions, classes and workshops, and her membership - Closer Friends. Together, they dive into the energies of Spring, recipes, to do lists, cleaning, anger, expression, and more. Thank you for joining us in this fun exploration of living seasonally!To celebrate the growth and magic of Spiral Deeper (and the launch of Season 3!), I am hosting a giveaway with some of my favorite brands. The winner will receive: ****1 planner from In Flow, 1 Anxiety Support bundle with Reishi and Lion's Mane from Rainbo Mushrooms, 3 triangle soaps from Wild Lather, 1 copy of the vintage collectors book Country Women with a little prayer bell from the small shop, The Bell up in Mendocino, 1 beaded healing mat for your altar made by Elle McDaniels, and 1 Ritual Rainforest Serum by Earth Archive. To enter: subscribe to the podcast, leave a written review on Apple Podcasts, and share Spiral Deeper on Instagram by tagging Gaby (@gaby.azorsky) and @spiral.deeper in your IG Stories.Enjoy the episode!Special OfferCODE - SPIRALOFFLOWERS for 20% off your first month in The Flower Portal!Connect and Work with GabyInspiring the connection between Heaven and Earth through Reiki, Tarot, Folk herbalism, Clairvoyance, and Meditation. Together, we co-create harmony, clarity, and alignment with your True Essence. I'd love to support you!Visit my website to learn more: gabyazorsky.comFollow me on Instagram: @gaby.azorskyNewsletter - Sign Up HereBook a 1:1 Session: Book HereJoin My Membership, The Flower Portal: Learn MoreWith Spiral DeeperWebsite - Spiral Deeper PodcastInstagram - @spiral.deeperWith Our Guest, Sierra LashWebsite - https://sierralash.comInstagram - @sierrralashCreditsSpecial thanks to…Music - Connor HayesSpiral Deeper Icon - Kami MarchandCollaborate with UsInterested in advertising or collaborating with Spiral Deeper? Email gabyazorsky@gmail.com for packages and details.Support the ShowPlease rate, review, and subscribe wherever you listen - it means so much. Be sure to tag @spiral.deeper if you share; thank you for your support!

Episode OverviewIn this episode of Spiral Deeper, our host, Gaby Azorsky, speaks with Connor Hayes, her boyfriend. Connor is an artist, fabricator, and maker of many things. He helps people who align with the values of integrity, longevity, and community actualize their visions that give hope to others. Together, they dive into their relationship dynamic and values, how they met, what their dating lives were like before meeting, what they learned from previous relationships, communicating feelings, listening, intention, and why they live in separate homes at this stage in their relationship. It is a vulnerable conversation, with so much appreciation and laughter. Thank you for joining us on this journey of self-discovery and growth!To celebrate the growth and magic of Spiral Deeper (and the launch of Season 3!), I am hosting a giveaway with some of my favorite brands. The winner will receive: 1 planner from In Flow, 1 Anxiety Support bundle with Reishi and Lion's Mane from Rainbo Mushrooms, 3 triangle soaps from Wild Lather, 1 copy of the vintage collectors book Country Women with a little prayer bell from the small shop, The Bell up in Mendocino, 1 beaded healing mat for your altar made by Elle McDaniels, and 1 Ritual Rainforest Serum by Earth Archive. To enter: subscribe to the podcast, leave a written review on Apple Podcasts, and share Spiral Deeper on Instagram by tagging Gaby (@gaby.azorsky) and @spiral.deeper in your IG Stories.Special OfferCODE - SPIRALOFFLOWERS for 20% off your first month in The Flower Portal!Connect and Work with GabyInspiring the connection between Heaven and Earth through Reiki, Tarot, Folk herbalism, Clairvoyance, and Meditation. Together, we co-create harmony, clarity, and alignment with your True Essence. I'd love to support you!Visit my website to learn more: gabyazorsky.comFollow me on Instagram: @gaby.azorskyNewsletter: Sign Up HereBook a 1:1 Session: Book HereJoin My Membership, The Flower Portal: Learn MoreWith Spiral DeeperWebsite - Spiral Deeper PodcastInstagram - @spiral.deeperCreditsSpecial thanks to…Music - Connor HayesSpiral Deeper Icon - Kami MarchandCollaborate with UsInterested in advertising or collaborating with Spiral Deeper? Email gabyazorsky@gmail.com for packages and details.Support the ShowPlease rate, review, and subscribe wherever you listen - it means so much. Be sure to tag @spiral.deeper if you share; thank you for your support!

There is money everywhere.   It's been written about in the book Acres of Diamonds by Russell H. Conwell.  It's a great story based ona a family that sold their land in Pennsylvania during the gold rush and moved to California.    After years of digging, they exhausted their resources dying penniless and broke.     A few years later, the piece of land they sold became the richest piece of land in Pennsylvania hosting the largest oil reserve at that time.  (They would've been billionaires had they just looked where they were.    The same applies in life now.     There is ample opportunity everywhere. Technology and the diversification of A.I. has allowed us to mine different lifestyles and businesses much quicker than ever before in human history.    So, what does this require?    It requires you to increase your outlflow to increase your inflow.    You can't call a lead one time and think they'll call you back to buy what you're offering.    You need to call them 10-15 times.    Develop a relationship.    Gain trust.    Ask prospective problems about their problems and provide solutions.    If you're looking for the biggest chance to change the trajectory of your life starting this week, you're about to get billion-dollar advice.    Be sure to leave a comment on who you are and how I can help you.    A 5-star rating would be appreciated!    About the ReWire Podcast The ReWire Podcast with Ryan Stewman – Dive into powerful insights as Ryan Stewman, the HardCore Closer, breaks down mental barriers and shares actionable steps to rewire your thoughts. Each episode is a fast-paced journey designed to reshape your mindset, align your actions, and guide you toward becoming the best version of yourself. Join in for a daily dose of real talk that empowers you to embrace change and unlock your full potential.    Learn how you can become a member of a powerful community consistently rewiring itself for success at https://www.jointheapex.com/   Rise Above

What if your brand could do more than just look good—what if it could tell a story, attract your ideal clients, and truly reflect your values? That's exactly what Justin set out to do when he left the corporate world to launch Inflow, a branding agency dedicated to helping private practices create meaningful and impactful brand identities. From designing album covers in Detroit's music scene to stepping onto the stage at the APA conference in Seattle, Justin's journey is one of creativity, risk-taking, and transformation. In this episode, he shares why branding isn't just about logos and websites—it's about connection, trust, and the power of a cohesive identity. Tune in as Justin reveals common branding mistakes practice owners make, how to craft a website that actually converts, and why the right name can make all the difference in your visibility. Whether you're just starting your practice or looking to refresh your brand, this conversation will change the way you think about marketing your services. Resources Mentioned In This Episode Read the full show notes here Use the promo code "GORDON" to get 2 months of Therapy Notes free Start Consulting with Gordon The PsychCraft Network The Practice of Therapy Community Mental Health Wear TN Inflow's Resources Website Instagram Facebook Justin on LinkedIn Inflow on LinkedIn About Justin Ahn Inflow was founded by Justin Ahn, a Creative Director inspired by his wife, a clinical psychologist. As he helped her develop client-friendly resources, Justin saw the need for exceptional design in healthcare. Inflow provides top-tier design services, ensuring every healthcare practice has a visual identity that reflects its expertise and communicates compassionate care. About Inflow Inflow Healthcare Designs specializes in crafting brilliant, tailored branding, websites, and graphics exclusively for healthcare practices, becoming your trusted partner in long-term success. More than creating visuals, they shape trust and confidence—transforming your vision into a brand that feels inviting, professional, and authentically you. With client-focused designs that inspire trust, foster meaningful connections, and drive practice growth, every detail tells your story. From compelling logos to seamless websites, they'll help your practice stand out, attract patients, and grow with purpose.

Send us a textThis (part two!) episode centers on the importance of understanding and embracing the cycles of womanhood, from menstruation to motherhood and aging. Bridging personal stories with broader societal themes, Bridget and Kasia discuss the duality of grief and celebration at each life stage and offer practical resources for women to live in harmony with their cycles.Kasia is the founder of In Flow and host of the podcast, The Other Way. Listen to The Other Way and check out In Flow's flagship product, a personalized planner that uses your menstrual cycle (or the moon cycles) to offer tailored guidance in aligning your plans with your cycle.Discount code: 15% off with code BRIDGET15.• Understanding the journey from maiden to mother • Celebrating transitions and recognizing grief • Embracing aging and societal views on wrinkles • Exploring the concept of spirit babies • Practical tips from the In Flow planner for cycle syncing • Encouragement for daily embodiment and self-awarenessCONNECT WITH BRIDGET Email listInstagramBook a free consult callWebsite

Send us a textCyclical living is a transformative approach to understanding how women's menstrual cycles impact productivity, creativity, and overall well-being. Today's episode is part one of Bridget and Kasia's conversation; they discuss the value of living in alignment with one's cycles while exploring practical steps to integrate this awareness into daily life and the workplace. Kasia is the founder of In Flow and host of the podcast, The Other Way. Listen to The Other Way and check out In Flow's flagship product, a personalized planner that uses your menstrual cycle (or the moon cycles) to offer tailored guidance in aligning your plans with your cycle.Discount code: 15% off with code BRIDGET15.• Understanding cyclical living and its implications for women's health • Recognizing the energy levels across different menstrual phases • Challenging societal perceptions of low-energy periods • Cycle syncing strategies for enhancing productivity • Practical tips for aligning personal and professional responsibilities • The potential for corporate environments to embrace cyclical wellness • The importance of self-awareness and listening to one's body • Insights on cultivating a healthier relationship with cyclesCONNECT WITH BRIDGET Email listInstagramBook a free consult callWebsite

Guest: Dr. Christian de Virgilio is the Chair of the Department of Surgery at Harbor-UCLA Medical Center. He is also Co-Chair of the College of Applied Anatomy and a Professor of Surgery at UCLA's David Geffen School of Medicine. He completed his undergraduate degree in Biology at Loyola Marymount University and earned his medical degree from UCLA. He then completed his residency in General Surgery at UCLA-Harbor Medical Center followed by a fellowship in Vascular Surgery at the Mayo Clinic.   Resources:  Rutherford Chapters (10th ed.): 174, 175, 177, 178 Prior Holding Pressure episode on AV access creation: https://www.audiblebleeding.com/vsite-hd-access/ The Society for Vascular Surgery: Clinical practice guidelines for the surgical placement and maintenance of arteriovenous hemodialysis access: https://www.jvascsurg.org/article/S0741-5214%2808%2901399-2/fulltext  KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update: https://pubmed.ncbi.nlm.nih.gov/32778223/    Outline: Steal Syndrome Definition & Etiology Steal syndrome is an important complication of AV access creation, since access creation diverts arterial blood flow from the hand. Steal can be caused by multiple factors—arterial occlusive disease proximal or distal to the AV anastomosis, high flow through the fistula at the expense of distal arterial perfusion, and failure of the distal arterial networks to adapt to this decreased blood flow.  Incidence and Risk Factors The frequency of steal syndrome is 1.6-9%1,2, depending on the vessels and conduit choice Steal syndrome is more common with brachial and axillary artery-based accesses and nonautogenous conduits. Other risk factors for steal syndrome are peripheral vascular disease, coronary artery disease, diabetes, advanced age, female sex, larger outflow conduit, multiple prior permanent access procedures, and prior episodes of steal.3,4  Long-standing insulin-dependent diabetes causes both medial calcinosis and peripheral neuropathy, which limits arteries' ability to vasodilate and adjust to decreased blood flow. Patient Presentation, Symptoms, Grading Steal syndrome is diagnosed clinically.  Symptoms after AVG creation occurs within the first few days, since flow in prosthetic grafts tend to reach a maximum value very early after creation. Native AVFs take time to mature and flow will slowly increase overtime, leading to more insidious onset of symptoms that can take months or years. The patient should have a unilateral complaint in the extremity with the AV access. Symptoms of steal syndrome, in order of increasing severity, include nail changes, occasional tingling, extremity coolness, numbness in fingertips and hands, muscle weakness, rest pain, sensory and motor deficits, fingertip ulcerations, and tissue loss.  There could be a weakened radial pulse or weak Doppler signal on the affected side, and these will become stronger after compression of the AV outflow. Symptoms are graded on a scale specified by Society of Vascular Surgery (SVS) reporting standards:5  Workup Duplex ultrasound can be used to analyze flow volumes. A high flow volume (in autogenous accesses greater than 800 mL/min, in nonautogenous accesses greater than 1200 mL/min) signifies an outflow issue. The vein or graft is acting as a pressure sink and stealing blood from the distal artery. A low flow volume signifies an inflow issue, meaning that there is a proximal arterial lesion preventing blood from reaching the distal artery. Upper extremity angiogram can identify proximal arterial lesions. Prevention Create the AV access as distal as possible, in order to preserve arterial inflow to the hand and reduce the anastomosis size and outflow diameter.  SVS guidelines recommend a 4-6mm arteriotomy diameter to balance the need for sufficient access flow with the risk of steal. If a graft is necessary, tapered prosthetic grafts are sometimes used in patients with steal risk factors, using the smaller end of the graft placed at the arterial anastomosis, although this has not yet been proven to reduce the incidence of steal.  Indications for Treatment Intervention is recommended in lifestyle-limiting cases of Grade II and all Grade III steal cases. If left untreated, the natural history of steal syndrome can result in chronic limb ischemia, causing gangrene with loss of digits or limbs. Treatment Options Conservative management relies on observation and monitoring, as mild cases of steal syndrome may resolve spontaneously. Inflow stenosis can be treated with endovascular intervention (angioplasty with or without stent) Ligation is the simplest surgical treatment, and it results in loss of the AV access. This is preferred in patients with repetitive failed salvage attempts, venous hypertension, and poor prognoses. Flow limiting procedures can address high volumes through the AV access. Banding can be performed with surgical cutdown and placement of polypropylene sutures or a Dacron patch around the vein or graft. The Minimally Invasive Limited Ligation Endoluminal-Assisted Revision (MILLER) technique employs a percutaneous endoluminal balloon inflated at the AVF to ensure consistency in diameter while banding Plication is when a side-biting running stitch is used to narrow lumen of the vein near the anastomosis. A downside of flow-limiting procedures is that it is often difficult to determine how much to narrow the AV access, as these procedures carry a risk of outflow thrombosis. There are also surgical treatments focused on reroute arterial inflow. The distal revascularization and interval ligation (DRIL) procedure involves creation of a new bypass connecting arterial segments proximal and distal to the AV anastomosis, with ligation of the native artery between the AV anastomosis and the distal anastomosis of the bypass. Reversed saphenous vein with a diameter greater than 3mm is the preferred conduit. Arm vein or prosthetic grafts can be used if needed, but prosthetic material carries higher risk of thrombosis. The new arterial bypass creates a low resistance pathway that increases flow to distal arterial beds, and interval arterial ligation eliminates retrograde flow through the distal artery.  The major risk of this procedure is bypass thrombosis, which results in loss of native arterial flow and hand ischemia. Other drawbacks of DRIL include procedural difficulty with smaller arterial anastomoses, sacrifice of saphenous or arm veins, and decreased fistula flow. Another possible revision surgery is revision using distal inflow (RUDI). This procedure involves ligation of the fistula at the anastomosis and use of a conduit to connect the outflow vein to a distal artery. The selected distal artery can be the proximal radial or ulnar artery, depending on the preoperative duplex. The more dominant vessel should be spared, allowing for distal arterial beds to have uninterrupted antegrade perfusion. The nondominant vessel is used as distal inflow for the AV access. RUDI increases access length and decreases access diameter, resulting in increased resistance and lower flow volume through the fistula. Unlike DRIL, RUDI preserves native arterial flow.  Thrombosis of the conduit would put the fistula at risk, rather than the native artery.  The last surgical revision procedure for steal is proximalization of arterial inflow (PAI). In this procedure, the vein is ligated distal to the original anastomosis site and flow is re-established through the fistula with a PTFE interposition graft anastomosed end-to-side with the more proximal axillary artery and end-to-end with the distal vein. Similar to RUDI, PAI increases the length and decreases the diameter of the outflow conduit. Since the axillary artery has a larger diameter than the brachial artery, there is a less significant pressure drop across the arterial anastomosis site and less steal. PAI allows for preservation of native artery's continuity and does not require vein harvest.  Difficulties with PAI arise when deciding the length of the interposition graft to balance AV flow with distal arterial flow. 2. Ischemic Monomelic Neuropathy Definition Ischemic monomelic neuropathy (IMN) is a rare but serious form of steal that involves nerve ischemia. Severe sensorimotor dysfunction is experienced immediately after AV access creation. Etiology IMN affects blood flow to the nerves, but not the skin or muscles because peripheral nerve fibers are more vulnerable to ischemia. Incidence and Risk Factors IMN is very rare; it has an estimated incidence of 0.1-0.5% of AV access creations.6 IMN has only been reported in brachial artery-based accesses, since the brachial artery is the sole arterial inflow for distal arteries feeding all forearm nerves. IMN is associated with diabetes, peripheral vascular disease, and preexisting peripheral neuropathy that is associated with either of the conditions. Patient Presentation Symptoms usually present rapidly, within minutes to hours after AV access creation. The most common presenting symptom is severe, constant, and deep burning pain of the distal forearm and hand. Patients also report impairment of all sensation, weakness, and hand paralysis. Diagnosis of IMN can be delayed due to misattribution of symptoms to anesthetic blockade, postoperative pain, preexisting neuropathy, a heavily bandaged arm precluding neurologic examination. Treatment Treatment is immediate ligation of the AV access. Delay in treatment will quickly result in permanent sensorimotor loss.   3. Perigraft Seroma Definition A perigraft seroma is a sterile fluid collection surrounding a vascular prosthesis and is enclosed within a pseudomembrane. Etiology and Incidence Possible etiologies include: transudative movement of fluid through the graft material, serous fluid collection from traumatized connective tissues (especially the from higher adipose tissue content in the upper arm), inhibition of fibroblast growth with associated failure of the tissue to incorporate the graft, graft “wetting” or kinking during initial operation, increased flow rates, decreased hematocrit causing oncotic pressure difference, or allergy to graft material. Seromas most commonly form at anastomosis sites in the early postoperative period. Overall seroma incidence rates after AV graft placement range from 1.7–4% and are more common in grafts placed in the upper arm (compared to the forearm) and Dacron grafts (compared to PTFE grafts).7-9 Patient Presentation and Workup Physical exam can show a subcutaneous raised palpable fluid mass Seromas can be seen with ultrasound, but it is difficult to differentiate between the types of fluid around the graft (seroma vs. hematoma vs. abscess) Indications for Treatment Seromas can lead to wound dehiscence, pressure necrosis and erosion through skin, and loss of available puncture area for hemodialysis Persistent seromas can also serve as a nidus for infection. The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines10 recommend a tailored approach to seroma management, with more aggressive surgical interventions being necessary for persistent, infected-appearing, or late-developing seromas.   Treatment The majority of early postoperative seromas are self-limited and tend to resolve on their own Persistent seromas have been treated using a variety of  methods-- incision and evacuation of seroma, complete excision and replacement of the entire graft, and primary bypass of the involved graft segment only. Graft replacement with new material and rerouting through a different tissue plane has a higher reported cure rate and lower rate of infection than aspiration alone.9     4. Infection Incidence and Etiology The reported incidence of infection ranges 4-20% in AVG, which is significantly higher than the rate of infection of 0.56-5% in AVF.11  Infection can occur at the time of access creation (earliest presentation), after cannulation for dialysis (later infection), or secondary to another infectious source. Infection can also further complicate a pre-existing access site issue such as infection of a hematoma, thrombosed pseudoaneurysm, or seroma. Skin flora from frequent dialysis cannulations result in common pathogens being Staphylococcus, Pseudomonas, or polymicrobial species. Staphylococcus and Pseudomonas are highly virulent and likely to cause anastomotic disruption. Patient Presentation and Workup Physical exam will reveal warmth, pain, swelling, erythema, induration, drainage, or pus. Occasionally, patients have nonspecific manifestations of fever or leukocytosis. Ultrasound can be used to screen for and determine the extent of graft involvement by the infection.   Treatments In AV fistulas: Localized infection can usually be managed with broad spectrum antibiotics.  If there are bleeding concerns or infection is seen near the anastomosis site, the fistula should be ligated and re-created in a clean field. In AV grafts: If infection is localized, partial graft excision is acceptable. Total graft excision is recommended if the infection is present throughout the entire graft, involves the anastomoses, occludes the access, or contains particularly virulent organisms Total graft excision may also be indicated if a patient develops recurrent bacteremia with no other infectious source identified. For graft excision, the venous end of the graft is removed and the vein is oversewn or ligated. If the arterial anastomosis is intact, a small cuff of the graft can be left behind and oversewn. If the arterial anastomosis is involved, the arterial wall must be debrided and ligation, reconstruction with autogenous patch angioplasty, or arterial bypass can be pursued. References   1. Morsy AH, Kulbaski M, Chen C, Isiklar H, Lumsden AB. Incidence and Characteristics of Patients with Hand Ischemia after a Hemodialysis Access Procedure. J Surg Res. 1998;74(1):8-10. doi:10.1006/jsre.1997.5206 2. Ballard JL, Bunt TJ, Malone JM. Major complications of angioaccess surgery. Am J Surg. 1992;164(3):229-232. doi:10.1016/S0002-9610(05)81076-1 3. Valentine RJ, Bouch CW, Scott DJ, et al. Do preoperative finger pressures predict early arterial steal in hemodialysis access patients? A prospective analysis. J Vasc Surg. 2002;36(2):351-356. doi:10.1067/mva.2002.125848 4. Malik J, Tuka V, Kasalova Z, et al. Understanding the Dialysis access Steal Syndrome. A Review of the Etiologies, Diagnosis, Prevention and Treatment Strategies. J Vasc Access. 2008;9(3):155-166. doi:10.1177/112972980800900301 5. Sidawy AN, Gray R, Besarab A, et al. Recommended standards for reports dealing with arteriovenous hemodialysis accesses. J Vasc Surg. 2002;35(3):603-610. doi:10.1067/mva.2002.122025 6. Thermann F, Kornhuber M. Ischemic Monomelic Neuropathy: A Rare but Important Complication after Hemodialysis Access Placement - a Review. J Vasc Access. 2011;12(2):113-119. doi:10.5301/JVA.2011.6365 7. Dauria DM, Dyk P, Garvin P. Incidence and Management of Seroma after Arteriovenous Graft Placement. J Am Coll Surg. 2006;203(4):506-511. doi:10.1016/j.jamcollsurg.2006.06.002 8. Gargiulo NJ, Veith FJ, Scher LA, Lipsitz EC, Suggs WD, Benros RM. Experience with covered stents for the management of hemodialysis polytetrafluoroethylene graft seromas. J Vasc Surg. 2008;48(1):216-217. doi:10.1016/j.jvs.2008.01.046 9. Blumenberg RM, Gelfand ML, Dale WA. Perigraft seromas complicating arterial grafts. Surgery. 1985;97(2):194-204. 10. Lok CE, Huber TS, Lee T, et al. KDOQI Clinical Practice Guideline for Vascular Access: 2019 Update. Am J Kidney Dis. 2020;75(4):S1-S164. doi:10.1053/j.ajkd.2019.12.001 11. Padberg FT, Calligaro KD, Sidawy AN. Complications of arteriovenous hemodialysis access: Recognition and management. J Vasc Surg. 2008;48(5):S55-S80. doi:10.1016/j.jvs.2008.08.067

In this episode, our host Gaby Azorsky speaks with Kasia Stiggelbout. Kasia is a Soto Zen student, podcast host, and founder of In Flow, a women's wellness brand rooted in feminine cycles. In Flow's first product, a planner, helps women align their schedules, movement routines, and habits with the natural ebb and flow of their cycles to transition from burnout to flow. *In Flow is designed inclusively for all women, whether they bleed or not. Kasia's inspiration for In Flow arose after years of hustle culture led to a severe autoimmune flare, prompting her to rethink her approach to productivity. In 2021, she left a decade-long tech career to study Traditional Chinese Medicine, which sparked a cascade of shifts. Kasia is a graduate of the Institute for Integrative Nutrition, a former Executive Director of TEDxSF, and host of The Other Way, a podcast that explores alternative paths in spirituality, life, health, and business. In her free time, she enjoys spending time in nature, connecting with her husband + pup, and going off-grid (with her LightPhone). In our episode today, we talk about her origin story and how we met, her previous career working in Ad Tech as a Product Manager, being a “recovering type A”, her podcast The Other Way and her company In Flow, the In Flow Planner, tech boundaries, creating a product, we speak about her journey and perspective as her mom has been diagnosed with cancer, balancing where we are in our cycles and the discipline of maintaining a meditation practice, resistance. She also shares so much valuable advice for those of us who are seeking a new job, wanting to create a product, or also feel like a “recovering type A”! Thank you, Kasia! We love you! If you feel inspired by our conversation today, Kasia has offered a code for 15% off your In Flow Planner - Code ‘GABY15'. COME JOIN THE WINTER REIKI CIRCLE CODE SPIRALOFFLOWERS FOR 20% OFF YOUR FIRST MONTH IN THE FLOWER PORTAL ROOT TO CROWN WAITLIST FOR SPRING COHORT SIGN-UP TO RECEIVE GABY'S MONTHLY NEWSLETTER Connect ~ With our guest Kasia Stiggelbout | IG @the_other_way_podcast The Other Way Podcast: **Spotify + Apple** With the In Flow Planner With our host Gaby Azorsky | Website and IG @gaby.azorsky With Spiral Deeper | Website and IG @spiral.deeper Partners ~ Thank you to our partners! Moon Juice - Code ‘GABY.AZORSKY' Activist Manuka Honey - Code ‘GABY15' The Retreat Newspaper - Code ‘GABY100' for your first issue free In Flow Planner - Code ‘GABY15' Music by Gaby's incredible partner, Connor Hayes. Spiral Deeper Icon by Kami Marchand. If you would like to advertise on Spiral Deeper and collaborate, please email gabyazorsky@gmail.com for packages and information. Please rate, review, and subscribe wherever you listen ~ it means so much. Thank you for your support!

As I sit here, reflecting on seven incredible years in business and this milestone 80th episode of Life and Business in Flow, I can feel the gentle stirring of change coming. It's funny how sometimes the biggest shifts come not from pushing harder, but from finally giving ourselves permission to listen to that quiet voice within.   Fresh from beautiful Bali, I've found clarity about my path forward. This year has brought some amazing experiences from a speaking event in Sydney, magazine features, holding space for women at my Spring retreat, being a guest on other podcasts, and connecting with incredible women who, just like me, are seeking a more intentional way of being in this world.   As we step into 2025, I'm embracing an exciting evolution in how I serve and support women, one that honours a life that truly flows and brings women back home to themselves. Before we wrap up this year though, I have a heartfelt announcement to share - something that I've been sitting with for some time now.   This episode is a reminder to be open to change and to the beauty of allowing ourselves to evolve as needed.   ___   Other episodes I think you'll love!

This week on Good Morning Hospitality, we unpack the latest trends and shakeups in the industry. Venture capital inflow is heating up in travel tech, signaling continued investor confidence in innovation within the space. Meanwhile, mergers and acquisitions are on the rise as companies look to scale and dominate niche markets. Plus, Expedia Group and Hopper have called a truce, moving past their contentious history to forge a new partnership—what does this mean for the industry at large? Join us as we break down these stories and their implications for hospitality and travel. — Good Morning Hospitality is part of the Hospitality.FM podcast network and a Hospitality.FM Original. If you like this podcast, then you'll also love Behind The Stays with Zach Busekrus, which comes out every Tuesday & Friday, wherever you get your podcasts! This show is structured to cover industry news in travel and hospitality and is recorded live every Monday morning at 7 a.m. PST/10 a.m. EST. So make sure you tune in during our live show on our social media channels or YouTube and join the conversation live! Thank you to all of the Hospitality.FM Partners that help make this show possible, and if you have any press you want covered during the show, fill out this form! Learn more about your ad choices. Visit megaphone.fm/adchoices

When the life of Christ is flowing into our lives by the Holy Spirit, our lives at home and everywhere else will bear the fruit.

Interview with Nate Geraci, President of the ETF Store. We discuss the Ethereum ETF launch and inflows, potential for a Solana ETF, and Bitcoin ETF inflow outlook.Topics: - Ethereum ETF Launch and inflow performance - Will Staking be added to ETH ETFs in 2025? - Chances of a Solana ETF approval- Hashdex Index ETF Filing - Bitcoin Conference - Donald Trump, RFK JR, and BTC Reserve Asset - Fed, Rate Cuts, and Market Outlook 

Bitcoin is up slightly at $66,729 Eth is up slightly at $3,519 Binance Coin, up slightly at $585 OKX launches Telegram mini-app game. BlackRock's IBIT sees net inflow of $526M Swan Bitcoin shutters Managed Mining HIVE digital Technologies offshores a BTC mine to paraguay NPC labs raises $21M. Learn more about your ad choices. Visit megaphone.fm/adchoices

ETF's aren't supposed to behave like this. They're not supposed to have a nearly $900m inflow day five months in after the hype has purportedly dissipated. Then again, when did Bitcoin ever do things the way others did? Enjoying this content? SUBSCRIBE to the Podcast: https://pod.link/1438693620 Watch on YouTube: https://www.youtube.com/nathanielwhittemorecrypto Subscribe to the newsletter: https://breakdown.beehiiv.com/ Join the discussion: https://discord.gg/VrKRrfKCz8 Follow on Twitter: NLW: https://twitter.com/nlw Breakdown: https://twitter.com/BreakdownNLW